[Congressional Record Volume 165, Number 171 (Tuesday, October 29, 2019)]
[Senate]
[Pages S6220-S6235]
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 AND THE SECRETARY OF HEALTH AND HUMAN SERVICES RELATING TO
``STATE RELIEF AND EMPOWERMENT WAIVERS''
Mr. WARNER. Madam President, I will turn to a different matter.
I move to proceed to Calendar No. 278, S.J. Res. 52.
The PRESIDING OFFICER. The clerk will report the motion.
The senior assistant legislative clerk read as follows:
Motion to proceed to Calendar No. 278, S.J. Res. 52, a
joint resolution providing for congressional disapproval
under chapter 8 of title 5, United States Code, of the rule
submitted by the Secretary of the Treasury and the Secretary
of Health and Human Services relating to ``State Relief and
Empowerment Waivers''.
Mr. WARNER. Madam President, I know of no further debate.
The PRESIDING OFFICER. Is there further debate on the motion?
The motion was agreed to.
The PRESIDING OFFICER. The clerk will report the joint resolution.
[[Page S6221]]
The senior assistant legislative clerk read as follows:
A joint resolution (S.J. Res. 52) providing for
congressional disapproval under chapter 8 of title 5, United
States Code, of the rule submitted by the Secretary of the
Treasury and the Secretary of Health and Human Services
relating to ``State Relief and Empowerment Waivers''.
The PRESIDING OFFICER. There will now be up to 10 hours of debate
equally divided between the proponents and opponents.
Mr. WARNER. I yield the floor.
The PRESIDING OFFICER. The Senator from Oklahoma.
(The remarks of Mr. Inhofe pertaining to the introduction of [S.
2731] are printed in today's Record under ``Statements on Introduced
Bills and Joint Resolutions.'')
Mr. INHOFE. With that, I yield the floor.
The PRESIDING OFFICER. The Senator from West Virginia.
American Miners Act
Mr. MANCHIN. Madam President, I want to first say thank you to my
colleagues Senator Warner and Senator Casey for joining me on the floor
today and also to Senator Jones, Senator Brown, Senator Kaine, and the
Presiding Officer for standing with all of us to protect the coal
miners.
When coal companies go bankrupt, coal miners' benefits are the bottom
of the priority list, which is why we are here today to introduce the
American Miners Act amendment to the appropriations minibus to protect
coal miners' pensions and healthcare.
At this time, I yield my time to my good friend from Virginia,
Senator Warner, and I will come back later.
Senator Warner.
The PRESIDING OFFICER. The Senator from Virginia.
Mr. WARNER. Madam President, first of all, I have done this a number
of times. I know you care. I know my colleague from Pennsylvania cares,
but nobody has kept this issue alive more often and more consistently
than Joe Manchin from West Virginia.
I am only going to take a minute or two, then I have to step off. I
appreciate our leader on this issue giving me a little time.
In a few minutes, he will point out that last night, we had another
coal company go bankrupt, Murray Energy. That potentially leaves 70,000
folks without a pension.
In Virginia, we have about 7,000 miners who are dependent upon UMWA
funds for their healthcare retirements. Another company, Westmoreland
Coal, has already gone bankrupt as well, where literally folks are
weeks away from losing their benefits.
The truth is, this issue may not affect everybody across the country,
but the people it does affect, it affects in a way that oftentimes
undermines widows and pensioners--their very ability to maintain their
livelihoods.
Our country made a commitment back in 1947 to honor miners, and we
would stand by that work. We are now going to be put to the test. My
hope would be that this Miners' Act amendment would be included in the
appropriations bill. I will do everything I can in my power to urge my
colleagues to consider it.
Again, I thank the Senator from West Virginia. I will turn it back to
the Senator from West Virginia, but I also want to again acknowledge
the Senator from Pennsylvania, who has also been a leader on this.
Let's make sure we commit to get this done.
Thank you.
The PRESIDING OFFICER. The Senator from West Virginia.
Mr. MANCHIN. Madam President, I thank Senator Warner. I appreciate
very much the hard fight to get in the middle of this with me and
everybody else that is in this room right now that is in this fight
because we have a lot of people's lives at stake.
I came to the floor and warned that, without passing this bill, the
American Miners Act, the UMWA pension fund would be insolvent by 2022,
and that timeline could be accelerated to within a year if one of the
major coal companies declared bankruptcy. Last night, that happened.
Murray Energy, the largest coal company in the United States, filed
for bankruptcy, making it the eighth coal company in the past 12 months
to do so. Murray Energy has contributed 97 percent of the money going
into the UMWA pension fund annually. With Murray's bankruptcy filing,
the UMWA pension fund will become insolvent even faster. They are
telling me, by this time next year, there will have to be drastic cuts
into people's pension checks and, if not, eliminated.
Most of those checks, I would remind everybody watching and
listening, are $600 or less, and most of them are for widows from their
husbands that have passed away. They still depend on them for their
basic necessities of life.
Once the United Mine Workers Pension fund becomes insolvent, this is
going to start the snowballing effect. The crisis will truly go into a
snowball effect and impact every other multiemployer and pension fund
for America.
To say that this does not affect all of America is wrong because
anybody that goes to work and pays into a benefit package, with their
employer matching it, is in this same condition and in this same
vulnerability. That is going to be another day that I am going to be
speaking about this and what we can do to prohibit that from happening
also.
That is why it is essential that we protect the coal miners' pensions
now--not next year, not the year after, but now--and the reason for
that is it is going to be too late if we do it any later than now.
The only problem is that we have a little bit of a stumbling block
with the majority leader, Senator McConnell. I know he is concerned
about other pensions. We are all concerned about other pensions, but
this is on the front burner now. When this happens, everything else
will tumble and snowball with it.
The American Miners Act would amend the current Surface Mining
Control and Reclamation Act of 1977 to transfer the funds. These are
funds that are in excess of the amounts needed to meet the existing
obligations under the Abandoned Mine Land fund.
So you know what AML is--the Abandoned Mine Land fund--for every ton
of coal that is mined, there is a certain percentage of that put aside
to take care of the reclamation that is going to be done if it is
abandoned so we don't leave the environment in a horrible shape, and
that is what we work towards.
This fund has some excess funds. We are still meeting those
obligations. We are using those excess funds to try to prevent this
insolvency. It also raises the cap on these fund transfers from $490
million a year to $750 million to make sure that the pension plan has
sufficient future funding also. The funding for coal miners' pensions
is already there. It is already there. This is the product that they
have worked and developed and basically extracted. So we are working in
the same realm of what their livelihood has been--and it is exactly
what our amendment will do--it will reallocate those funds that they
worked for.
Everybody that receives a paycheck, which is over 10.6 million hard-
working men and women, they take home less wages and instead invest
their pensions. As I was telling you, they invest into these
multiemployer pension funds, and they take money out, and they expect
it to be there.
When it is not and the bankruptcy courts allow them to walk away, the
miners and the workers are put on the back burner, and that has got to
change. When workers expect the wages that they have contributed to be
there when they retire as they were promised and it evaporates, there
is no answer. It is all in bankruptcy. Because of the bankruptcy, they
are told that they are sorry they lost all the money they have
invested. It is not their fault. They gave the company everything they
had.
Under the current law, workers' pensions are not protected, and
executive and investment firms exploit the code to benefit from filing
for bankruptcy. If you have never read anything about bankruptcy, read
one case, Sears & Roebuck. If you want to find out the unraveling of
America and what happens to 250,000 workers that gave their life to
this company and how basically investors came in and raiders came in
and took advantage of every person's pension plan, that is the one case
you want to read, Sears & Roebuck.
That is why I am here today to introduce the American Miners Act as
an amendment to the appropriations minibus the Senate is voting on this
week because it is imperative that we do it now. We cannot wait.
[[Page S6222]]
Since the majority leader won't allow the American Miners Act to come
to the floor for a vote, which is his prerogative, my colleagues and I
are here today to introduce the American Miners Act as an amendment to
the appropriations minibus that the Senate is planning to pass this
week.
If we include the American Miners Act in the minibus, we would
protect coal miners' pensions now before it is too late, and we will
protect other pensions from starting to unravel and the snowball
effect. We will also protect the PBGC, which is a guarantee from the
Federal Government. If not, all of this is going to come into fruition,
which will be horrible for the workers of America, the most important
of the economy in this country, and a lot of people will be hurt by
that.
These coal miners and their families deserve peace of mind knowing
that the pension they paid into paycheck after paycheck is secure.
There are so many. Less than $600 is the average check of a miner's
retirement. Most of that is retired miners' widows. They have passed on
from the hard work they did. The widows are still there trying to
manage what they have, which is very small at times. This is just a
stifling of what they need, and to take this away will be very
detrimental to their lives, the quality of their lives, and the family.
We can give them that peace of mind today if we can agree, in a
bipartisan way, to do the right thing for the people that made America,
the working men and women, and especially the coal miners. They get up
every day, they go to work, and they produce the energy.
And I will say this: When you think about a coal miner and what they
have given and the families that committed and dedicated to live their
lives in these coal communities, they basically never complained. They
have done the heavy lifting. They mined the coal. They made these
buildings and built the guns and ships. They built the factories that
built the middle class. They have been there every step of the way from
this great country of the United States of America to become the super
power of the world, and we owe them at least to give them the money
back they paid into it.
It is not your taxpayer money but the money they paid into it. Don't
let somebody steal it. Wall Street doesn't have a right to that money,
but they have taken it as if it was their own little treasure chest. It
is just wrong.
We are introducing this amendment, and we hope that we have
bipartisan support. I would appreciate it very much. I appreciate my
dear friend from Pennsylvania, who has the same hard-working people.
It doesn't matter where your State is. If you have good, hard-working
coal miners and they and their families have sacrificed for this
country, they need a Senator such as Senator Casey.
With that, I yield the floor.
The PRESIDING OFFICER (Mrs. Blackburn). The Senator from
Pennsylvania.
Mr. CASEY. Madam President, I commend and salute the work of Senator
Manchin, the senior Senator from West Virginia, for his work on behalf
of American workers generally, but, in particular, his passionate
advocacy and his hard work to make sure that we, in this body, the
United States Senate, that we do everything we can to keep our promise.
I pick up from where he left off. As he has so often said when he
came to this floor, as he did today, to talk about the people whose
retirement security is on the line, this debate applies to a whole
range of workers, but when you consider just coal miners and their
families, who have given the country so much, I am reminded of a story
from my home area, northeastern Pennsylvania.
We produce, in a few counties in northeastern Pennsylvania, the hard
coal, anthracite coal. The great novel of Stephen Crane came to that
region in the 1890s. He would go on to become famous for writing the
novel, ``The Red Badge of Courage.'' But Stephen Crane, when he was a
young man--and he never made it to his 30th birthday, so he was an
accomplished writer even as a young man--he wrote an essay about a coal
mine in Scranton, my hometown in Lackawanna County.
In that essay, he described going into a coal mine and what he saw.
At one point in the essay, he said that the mine was a place of
inscrutable darkness, a soundless place of tangible loneliness. Then he
went on to describe what the coal miners did--what really the children
were doing, little boys in the mine and men in the mine. Then, at the
end of the essay, he listed all the ways a miner could die in those
mines in the 1890s.
Now, I know we made progress over the generations and over the
decades, but even in modern times, coal mining has been very dangerous
and very difficult work, work that I can't even begin to imagine. I
never had to do it, but my ancestors did. These miners not only worked
in those dangerous conditions and not only put their lives on the line
to do that work, but they also did it with a sense of keeping their
promise.
They made a promise to their employer that they would work hard every
day, and they kept that promise. They made a promise to their families
that they would work hard to provide a living for their families--in
some cases, provide a living for several generations of their
families--and they kept that promise. Some of them even made a promise
to their country to serve in war all the way from World War I and all
the way to our most recent conflicts. A lot of them died in Vietnam. A
lot of them died in battlefields all over the world, in World War II
and other conflicts.
They kept their promise to their country. They kept their promise to
their family and to their employer. All they have asked of us is to
keep our promise. It is not hard to do it either. All you have got to
do is put your hand up and say, ``I support that bill,'' or ``I support
that amendment.'' It is not hard to do. It doesn't take a lot of floor
time either to have these matters considered.
Now, what are we facing today? The bankruptcy filing of Murray
Energy, which stems largely from competition from cheaper alternatives
like natural gas and decline in exports. This could bring the pension
and healthcare coverage for our coal miners to the very brink and to
result in us not keeping our promise. Failure to act could result in
devastating consequences for these coal miners in communities across
Pennsylvania and West Virginia. We heard from the senior Senator from
Virginia, Senator Warner, and indeed all across the country.
Now, there is another bill that deals with pensions more generally,
the Butch Lewis Act. Now, the House passed the Butch Lewis Pension
Act--I am adding the word ``Pension'' into it. It is called the Butch
Lewis Act. The House passed that 3 months ago, and the majority leader,
Senator McConnell, has chosen not to have a vote on that bill. I don't
understand that. I am not sure that there are many people that do, but
I would hope--I would hope--that he would reconsider and have a vote on
the Butch Lewis Act.
We should also have a vote on the American Miners Act, the
legislation that Senator Manchin has worked so hard on. We know that in
the House, as well, a bipartisan effort led by Chairman Grijalva and
Chairman Scott, we know that the Health Benefits for Miners Act of 2019
and the Miners Pension Protection Act were voted out of the Natural
Resources Committee last week by a voice vote.
So, in the House, they are doing voice votes to advance legislation
to help these workers, to help miners, and here, there is not even a
vote--voice vote, rollcall vote, any kind of vote. We are not asking
for days of floor time. All we are asking for is a short time for
debate, but mostly, we are just asking for a vote. That vote is real
simple: Keep your promise. Keep our promise and the promise our country
made to these miners and the promise that our employers make to workers
every day of the week. There is still a lot of work to do on pensions
generally, as outlined by some of these bills, but they have kept their
promise over and over again. It is about time we kept our promise.
I yield the floor.
The PRESIDING OFFICER. The Senator from West Virginia.
Mr. MANCHIN. Madam President, first of all, I thank Senator Casey
because he comes from the same coal mining regions that I come from and
the hard-working families and communities they have there. It is
unbelievable the commitment and dedication these people have had their
entire life
[[Page S6223]]
and the patriotism they have. Most of them have served. Most of them
have been there. Most of them will always be there.
In 1946, this promise was consummated by Congress and the President
of the United States, and all they have said, up until that time
there--my grandfather and all my family members working the mines--they
had nothing. So if you ever heard that song, ``I owe my soul to the
company store,'' they really did. There was never any money that
transferred. They had scrip, and by the time they buy everything from
the company store, their pay basically was eaten up. There was nothing
left.
In 1946, they said there has got to be more, and that is when it came
in. Truman was determined not to let this country fall into a recession
or a depression after the war by keeping the mines working because we
needed the energy for that. They have produced this energy in a
patriotic way every time. If we can't even keep our promise to them
through an act of Congress, then God help us all. That is what we are
here to ask for.
We implore all of our friends--the Senator from Wyoming is here now,
and he comes from a coal mining region. We are asking everyone just to
help us do the right thing for the working people who built this
country. That is what our request is, and it has to be done this week;
if not, I guarantee you this problem is going to grow much larger much
quicker and more than anybody wants to bite off and chew. I ask all my
colleagues to please help us get this miners act to the floor. We can
take care of this pension and keep other pensions from tumbling behind.
I yield the floor.
The PRESIDING OFFICER. The Senator from Wyoming.
S.J. Res. 52
Mr. BARRASSO. Madam President, I come to the floor today to once
again discuss healthcare in America and, specifically, to oppose S.J.
Res. 52, which is the latest congressional disapproval resolution.
What is happening here is that the Democrats are trying to block the
efforts Republicans are making to actually lower the cost of health
insurance. We are working on ways to lower the cost of health insurance
for American families, and the Democrats are trying to block it.
Let me explain. People certainly understand that after the Obama
healthcare law was passed, healthcare insurance premiums all across the
country went way up. I strongly oppose the passage of this resolution,
and I strongly opposed the passage of this law, which many of the
Democrats running for President are now willing to admit has failed.
It is interesting that the Democrats now just say: Scrap the whole
thing, and go with a one-size-fits-all, government-run healthcare
program in which people will pay more to wait longer for worse care.
Ironically, it is the Republicans who, today, are delivering on so
many of the Democrats' empty promises about ObamaCare because
Republicans are actually doing things to lower the cost of care and the
cost of health insurance for American families.
I like to think of Republicans as EMTs arriving on the scene of the
ObamaCare train wreck. We didn't cause the accident. We are trying to
help the victims, and the victims live in States all across this
country. For nearly 3 years, Republicans have tried to treat the
victims of ObamaCare and tried to help people who have been hit by
skyrocketing health insurance premiums.
Last week we saw a major breakthrough. For the second year in a row,
on average, we saw insurance premiums on the ObamaCare exchanges
actually come down. They have actually come down. Well, it is very
welcome news for people who have to pay these premiums. Yet, what we
see is that the 2020 Democratic candidates, when you listen to them,
don't seem to be concerned about lowering the costs. They are too busy
pushing this astronomically expensive $34 trillion Medicare for All
health insurance healthcare scheme--one that by Republicans and
Democrats alike has been called a pipe dream.
To put the cost into perspective, this total dollar figure has been
estimated by people on the Republican side of the aisle, the Democratic
side of the aisle, folks who looked at what promises are being made,
and all have come to the conclusion that the cost will be greater than
what we spend right now in this country on Medicare, Medicaid, and
Social Security combined. Add it all up, and it does not even reach the
point of what the Bernie Sanders-Elizabeth Warren Medicare for All plan
would cost.
Interestingly, when taking a look at the proposal, they actually want
to take away from the American people--the 180 million people who have
earned health insurance through work--they want to take that away from
180 million Americans and put them all on a one-size-fits-all,
government-run program. Even union workers, who, as part of their
contract negotiations, negotiated the health insurance they want, would
lose their hard-fought healthcare benefits if it were ever to become
law.
We see Democrats backing what I believe is a very foolish resolution
of disapproval. They are attacking part of President Obama's healthcare
law. We are talking about ObamaCare section 1332. This section of the
law helps give States more flexibility. The Presiding Officer's State
and mine like to have flexibility to provide better coverage and to
bring premium costs down.
We need to set the record straight on one key point. Section 1332
never can be used to waive protections for the American people, such as
for people with preexisting conditions. They can never waive those. It
is not happening.
My wife is a breast cancer survivor. She has had three operations,
chemotherapy twice, and dozens of radiation treatments. I know, as a
doctor and as a husband, how important it is for patients to have
protections of their preexisting conditions. Republicans remain 100
percent committed to protecting people with preexisting conditions. We
will protect them today, tomorrow, and always.
The House Energy and Commerce Committee Chairman, Greg Walden,
asked the Centers for Medicare and Medicaid Services for clarification
regarding this section 1332. Administrator Seema Verma responded: ``To
be very clear, the 2018 guidance does nothing to erode the [healthcare
law's] pre-existing condition provisions, which cannot be waived under
section 1332.''
Madam President, I ask unanimous consent that the full text of the
CMS Administrator's letter be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Department of Health & Human Services, Centers for
Medicare & Medicaid Services
Hon. Greg Walden,
Ranking Member, Committee on Energy and Commerce, House of
Representatives, Washington, DC.
Dear Representative Walden: Thank you for your continued
interest in new state flexibility available under guidance
recently issued interpreting section 1332 of the Patient
Protection and Affordable Care Act (PPACA) (the 2018
guidance). Working within the limitations of the PPACA, this
2018 guidance is an important element of the Administration's
actions to expand options and lower costs for patients around
the country. I wanted to take this opportunity to set the
record straight and reaffirm this Administration's commitment
to lowering healthcare costs, increasing consumer choices,
and protecting our most vulnerable citizens. including those
who have pre-existing conditions.
To be very clear, the 2018 guidance does nothing to erode
the PPACA 's pre-existing condition provisions, which cannot
be waived under section 1332. Section 1332 does not permit
states to waive Public Health Service Act requirements such
as guaranteed availability and renewability of health
insurance, the prohibition on using health status to vary
premiums, and the prohibition on pre-existing conditions
exclusions. Furthermore. a section 1332 waiver cannot be
approved that might otherwise undermine these requirements.
This Administration stands committed to protecting people
with pre-existing conditions.
Under the PPACA, we have seen dramatically higher premiums
and decreased options for millions of consumers, in large
part due to the law's overly prescriptive mandates and
excessive Federal government takeover of areas traditionally
under state oversight. In 2019, the average monthly premium
for a benchmark plan for a family of four on HealthCare.gov
is now over $1,500, which can easily exceed a family's
mortgage. There are many areas of the country with far higher
monthly premiums. For example, a 60-year-old couple living in
Grand Island, Nebraska, making $70.000 a year, will need to
pay over $3,000 per month for the lowest cost silver plan
available. That's almost $38.000 per year for a plan with an
11,100 deductible. That's over half their income.
[[Page S6224]]
For millions of Americans, coverage this expensive is not a
realistic option, and many choose to go without coverage at
all. In fact, after average premiums rose by 21 percent, 1.3
million unsubsidized people walked away from the market in
2017 last year the prior administration oversaw open
enrollment. While these higher premiums force some people to
go uninsured, coverage is generally not optional for people
with a pre-existing condition and so, without a subsidy,
someone with a pre-existing condition must face the full
burden of the PPACA's skyhigh premiums. This Administration
has not forgotten the people facing this hardship.
Section 1332 of the PPACA provides the discretion to
approve a section 1332 state waiver plan if the following
four statutory guardrails are met: affordability,
comprehensiveness, coverage, and federal deficit neutrality.
Section 1332 allows states to develop new healthcare programs
and solutions that would be not permissible without a section
1332 waiver.
Unfortunately, guidance issued under the prior
Administration in December 2015 (the 2015 guidance) regarding
section 1332 waivers had the effect of significantly
restricting the innovation states could pursue. The prior
Administration imposed a one-size-fits-all approach to these
waivers, making it difficult for states to address the
specific needs of their residents.
In October, the Administration issued guidance under
section 1332 of the PPACA to provide states with significant
opportunities to chart a different course for their markets
through expanded flexibility. Section 1332 and the 2018
guidance ensure that consumers who wish to retain coverage
similar to that provided under the PPACA can do so, but they
empower states to take steps to stabilize their markets and
allow more affordable coverage options that may be more
attractive to individuals and families priced out of the
current market, including people with pre-existing
conditions.
Over the past two years, this Administration has approved
seven section 1332 waivers authorizing reinsurance programs
to help fund claims for people with high healthcare costs.
These reinsurance programs provide much needed premium relief
for people in the market and, in particular, for people with
pre-existing conditions without other coverage options. These
section 1332 waivers were all approved under the prior, more
restrictive 2015 guidance. I believe, given the expanded
flexibility discussed in the 2018 guidance, states will be
able to develop additional healthcare programs and solutions
that work for their residents.
As you know, some have criticized the state flexibility
offered under the 2018 guidance, claiming that states will
pursue section 1332 waivers that undermine their own
individual market risk pools and make coverage more expensive
for their own residents with pre-existing conditions. Again,
I want to make clear that a section 1332 waiver cannot
undermine coverage for people with pre-existing conditions.
Moreover, any section 1332 waiver will need to carefully
account for any impact on the individual market risk pool and
guarantee that access to coverage is at least as
comprehensive and affordable as would exist without the
waiver.
So, if a state seeks to pursue the use of more affordable
options, such as catastrophic plans or short-term limited
duration plans, under a section 1332 state waiver plan, the
state must ensure access to coverage that is overall as
affordable and comprehensive for people who remain in the
individual market risk pool.
Thank you again for your shared interest in bringing down
healthcare costs and protecting our fellow Americans with
pre-existing conditions. We remain focused on improving our
nation's health care system by empowering states to innovate
and develop new solutions to expand access to affordable and
high value coverage options, and we look forward to working
with you to achieve these goals. Should you have questions,
please contact the CMS Office of Legislation.
Sincerely,
Seema Verma.
Mr. BARRASSO. Madam President, the letter proves that all patients
will be protected. Section 1332 simply gives States some leeway--a
little wiggle room for following the law and how to use and apply the
law best in their own States.
All State waivers must meet the following conditions: They must
provide coverage at least as broad as is currently offered under the
healthcare law; they must provide coverage and cost-sharing at least as
affordable as under the healthcare law; they must provide coverage to
at least as many people as under the healthcare law; and they must not
increase the Federal deficit.
The section 1332 waivers leave protections for preexisting conditions
unharmed. They are not just popular with Republican Governors. It is
interesting that the people applying for these 1332 waivers are
Democratic Governors from around the country. They are at odds with
what the Democrats in the Senate are trying to do. They are pursuing
waivers. They are asking the Trump administration for waivers for their
States as well. Why would these Democratic Governors come to the Trump
administration and ask for waivers? It is because they work. The reason
the Democratic Governors are coming to the Trump administration asking
for waivers is that they work. In fact, a number of States are using
these waivers today to help lower the cost of health insurance.
Let's look at the States whose section 1332 waivers have been
approved since the Trump administration guidance was issued. Let's look
at just the States that have applied for waivers since the new Trump
administration guidance was issued. Again, these waivers were approved
using the very same guidance that the Democrats in the Senate now want
to have repealed.
It is astonishing. The States with 1332 waivers since the Trump
administration came out with its guidance are Colorado, Delaware,
Montana, North Dakota, and Rhode Island. Nearly all have Democratic
Governors--four out of the five do--and have Democratic Senators in
many cases or they have both.
Take a look at what has happened for the proposed premiums for 2020--
what they are expected to be in States under the leadership of
Democratic Governors who have asked for and have been granted waivers
from the Trump administration and what the impact is on insurance
premiums in these States. In Colorado, with a Democratic Governor and
one Democratic Senator, the rates are going to fall this next year by
about 16 percent. In Delaware, with a Democratic Governor and two
Democratic Senators, the rates will fall about 13 percent. In Montana,
with one Democratic Governor and one Democratic Senator, one Republican
Senator, rates will fall by 8 percent. In Rhode Island, with a
Democratic Governor and two Democratic Senators, rates will fall by
about 6 percent.
So in State after State where Democratic Governors applied for and
were granted a waiver, they have seen rates go down. Yet Democratic
Senators on the other side of the aisle are offering a resolution to
remove these waivers, to remove the guidance from the Trump
administration that is resulting in rates of insurance and the costs
going down.
Of course we need to fix healthcare in this country, but we need to
take a scalpel to our healthcare problems, not a meat cleaver, which is
what we see the Democrats doing.
The Obama healthcare law was a train wreck. Republicans opposed it
all the way. We are still treating the victims of this wreck, and we
want to help them for years into the future by changing and coming out
with guidance that will make it easier and give flexibility to the
States, whether their legislature is Republican or Democratic, to help
lower the high cost of ObamaCare insurance.
I find it outrageous that Senate Democrats are wasting precious
healthcare debate time. They should be working with us to find
solutions to lower the cost of care, to lower the cost of prescription
drugs, to provide more accountability and more transparency so that
patients can make more informed decisions.
Even as we address this issue and vote on this joint resolution
tomorrow, it is time to really take a look at what the Democrats are
saying in the Senate as opposed to what the Democrats who are in the
statehouses are doing across the country.
I say, let's make sure the States can keep the relief they are asking
for and are getting by rejecting what the Democrats in the Senate are
proposing. Let's keep working to give patients what they need, which is
the care they need from a doctor they choose at lower costs.
I yield the floor.
The PRESIDING OFFICER. The Senator from Arizona is recognized.
Ms. SINEMA. Madam President, I rise today to address one of the
biggest concerns facing everyday families in Arizona: making healthcare
more affordable and maintaining critical healthcare protections.
Sometimes the issues discussed on the Senate floor appear far removed
from the concerns of everyday Americans, but not today. Today's debate
focuses the Senate's attention on the most important issue for many
Arizonans and offers elected officials the opportunity to reject
partisan political games in favor of commonsense solutions.
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Not long ago, insurance companies were allowed to deny care or
overcharge Americans based on the fact that those Americans had been
sick before or had been born with a chronic condition.
Arizonans who had been previously treated for skin cancer or diabetes
were told that no insurance company would cover them or that the
insurance plans they purchased would not cover their preexisting
conditions, despite promises of comprehensive coverage. Beyond major
illnesses, Arizonans with even common conditions, such as high blood
pressure, high cholesterol, asthma, and even acne, were denied the
coverage they needed. Until recently, insurance companies had also been
allowed to charge consumers high prices for insurance plans only to
leave out coverage for essential health benefits that virtually all
Americans eventually need, such as prescription drug costs, ambulance
costs, and hospital stays--critical needs that consumers rightly expect
will be covered.
Insurance is supposed to be there when people need it. Hard-working
Americans who play by the rules and pay their monthly premiums
shouldn't have the rug pulled out from under them at the very moment
they need healthcare. That is why such discrimination against people
with preexisting health conditions is now banned and why health
insurance plans are now required to cover essential health benefits.
That is why it is so disturbing that the administration and some
Members of Congress have begun moving backward, allowing insurance
companies to again sell plans to Americans that lack the very health
protections consumers need.
Congress has a lot of work to do to make healthcare affordable and
protect access for American families and businesses, from lowering
premiums to stopping surprise medical billing, but partisan approaches
will not solve these challenges. We can and must work across the aisle
to pass bipartisan solutions, such as increasing the number of doctors
to address provider shortages, lowering costs for home health services,
expanding mental healthcare, and eliminating the health insurance tax.
I have partnered with colleagues on both sides of the aisle to
sponsor legislation that achieves these goals, but allowing insurance
companies to return to their old practices will only hurt everyday
Arizona families. These health plans lack key protections. They are
often called junk plans and for good reason. Junk plans mislead
Arizonans--selling something billed as health insurance when, in fact,
it is better described as a bill of goods. When Arizonans who are sold
these plans need to actually use the coverage they paid for, the rug
gets pulled out from under them yet again.
I hear from hard-working Arizonans on a daily basis who deserve
access to critical health protections; Arizonans like Chantal, who has
a preexisting autoimmune disease that without treatment would cause her
to become blind; Arizonans like Corrine from Phoenix, whose daughter
was born with a congenital heart condition--before the law protected
people with preexisting conditions, Corrine's family was unable to find
an insurer who would cover their family--and Arizonans like John from
Casa Grande, who signed up for a plan that he was told covered
preexisting conditions only to find out after he paid his first month's
premium, that his particular preexisting condition wouldn't qualify for
coverage.
There are 2.8 million Arizonans under the age of 65 just like
Chantal, Corrine, and John who live with preexisting health conditions.
That is half of all nonelderly Arizonans whose healthcare is at risk.
These Arizonans remind us exactly what is at stake and exactly what is
wrong with partisan politics in Washington today. For too long, too
many elected officials here have focused on how they can score
political points to help them win the next election, all at the expense
of the health and security of everyday families.
Arizonans are rightly worried that the dysfunction and chaos they see
coming from Washington could threaten their family's coverage, and that
is unacceptable.
It is time to get partisan politics out of Arizonans' healthcare. I
call on both parties to quit the partisan games, come together, and
stop the sale of junk plans that fail to protect people with
preexisting conditions. We must protect access to healthcare for these
millions of Arizonans and tens of millions of Americans, and we must
make healthcare more affordable for everyday families.
I urge my colleagues to vote yes on S.J. Res. 52.
I yield the floor.
The PRESIDING OFFICER. The Senator from Delaware.
Impeachment
Mr. COONS. Madam President, I come to the floor as a proud Member of
this Chamber of the Senate and as someone who believes earnestly in our
role in our country's constitutional order. I am on the floor because a
real and significant challenge to this body and each of our Members is
potentially in the very near future.
Right now, the House of Representatives is holding an impeachment
inquiry, focused on grave and significant charges against our President
related to the very threats to our democracy of foreign interference
that our Founders feared the most. I am not here to argue over whether
President Trump's actions deserve impeachment or perhaps even removal
from office. It is, I think, inappropriate to reach that point.
Instead, I am here today, as the inquiry proceeds in the House, to urge
my colleagues in the Senate--Republicans, Independents, and Democrats--
to take seriously the moment we are in and the tests we may have soon
ahead as a Senate when we will need to uphold and defend the role of
this institution.
I am on the floor to issue a challenge to all of my colleagues. If an
impeachment trial does take place in the Senate, all of us must decide
to approach it as Americans--less as people representing any parochial
or partisan or particular interest, less as Democrats or Republicans or
Independents, and instead as Senators. If we are called to serve as
jurors in an impeachment trial, all of us must show our Nation and the
world that this body--that this institution--has not been completely
overtaken by the divisive political era in which we live. Nothing less
than the Senate's very legitimacy will be at stake.
Our Founders warned about the challenge of this moment. They warned
specifically that foreign powers improperly influencing our American
Government were, in the words of Alexander Hamilton, ``the most deadly
adversaries of republican government.'' This is why our Constitution
entrusts Congress with the enormous power of potential removal through
impeachment.
James Madison called impeachment ``indispensable . . . for defending
the Community [against] the incapacity, negligence or perfidy of the
chief Magistrate''--a reference to the President. Alexander Hamilton
argued that the Senate was the proper body to hold an impeachment
trial. The Founders entrusted us to protect our country from ``the
misconduct of public men'' and ``the abuse or violation of some public
trust.''
George Mason put forward the precise language that appears in our
Constitution, the language of ``high crimes and misdemeanors'' and
urged that impeachment must be a remedy to remove even a President,
asking: ``Shall any man be above Justice?'' Our Founders insisted that
no one--no one--in our Nation, in our constitutional order, not even
our President, is above the law. This fundamental principle remains the
very linchpin of our government.
Based on what we know today from press reports about the President's
actions and from notes of a conversation, I believe it is critical that
the House conduct a thorough impeachment inquiry. If the House does
vote impeachment articles, Members of the Senate will have to live up
to the responsibilities which the Framers of our Nation entrusted to
us. The eyes of history will be upon us.
Let me be clear. I am not saying that if the House should vote
articles of impeachment, it will be the Senate's duty to vote to remove
him. It will be, instead, the responsibility of every single Senator to
carry out their duty to serve as impartial jurors with their principle
focus--their oath--to uphold and defend the Constitution and nothing
else informing our decisions.
[[Page S6226]]
This is a challenge to all of my colleagues. Both Republicans and
Democrats must appreciate the gravity of this process as we call on our
colleagues to do the same. Democrats, equally with Republicans, must
not allow our vigorous disagreements with this President and our
colleagues to influence our judgment and cloud it. We have to
understand that this process--this likely future moment--is far more
important than our own individual political fortunes. An impeachment
trial of a President would be a true test of the integrity and
capabilities of the Senate--our commitment to follow the facts, to
consider the evidence, and to apply the rule of law. It will be a test
that we, as a body, cannot afford to fail.
It is important to begin the process of establishing what that
process might look like as soon as there are impeachment articles, if
that is the direction the House takes. The basic rules are clear as
stated in the Constitution: The House is given the ``sole power of
impeachment,'' and the Senate ``the sole power to try,'' as jury, ``all
impeachments.'' If the House votes to impeach, the Senate must conduct
a trial and either convict by two-thirds or acquit on whatever counts
are presented.
At that trial, the Chief Justice of the U.S. Supreme Court will
preside; the House managers will present the case; the President's
counsel presents his defense; and the Senators serve as the jury. The
manner in which our leaders, Leader McConnell and Leader Schumer,
direct the Senate in the event of a trial will be the most important
test in a generation of whether our Senate remains capable of enforcing
the law, living up to the Constitution, and upholding the
responsibilities our Founders bestowed upon us.
I will remind you of the opening vote in the Senate of the
impeachment trial for President Clinton. The vote that set the rules
under which that trial would proceed was unanimous. It was 100 to 0. An
impeachment trial, should it come in the near future here, must not be
gamed or politicized or subjected to brinksmanship, and any trial
should be governed by rules that are passed on a broad and bipartisan
basis, animated by justice over partisanship.
In many ways, an impeachment trial would mean that our institution of
the Senate would itself also be on trial. We as a body need to show the
American people and the world that we are more than just 100 elected
politicians who have been brought here by partisan whim or by a bare
majority of our States but, instead, by a body whose sum is much more
than its individual parts. We must act as stewards together for our
democracy. History is watching us, all of us--Democrats, Independents,
Republicans. How we respond will shape and impact our Senate and our
Nation for years to come.
In the days, weeks, or months to come, I hope my colleagues will rise
to the challenges we face, deliberate with an eye toward history, an
ear toward our constituents, and a heart focused on our Constitution,
and prove that, in this body, we answer to the Constitution, not to any
particular or partisan loyalty to our President or to any other elected
official. The health of our very institutions and of democracy itself
is at stake.
Remembering Sonia Schorr Sloan
Madam President, in my home State of Delaware, we have just lost a
dear friend and a remarkable leader.
Sonia Schorr Sloan was a force of nature. ``Sonny,'' as we
affectionately called her, dedicated her life to confronting social
injustices, and her activism, her philanthropy, her mentorship, and her
public service made my home State of Delaware a better place for
everyone. So I rise to celebrate and honor her work, her spirit, and
her impact on so many of us.
Her story began on April 1, 1928. She was born in Wilmington, DE, to
parents Sigmund and Rosalia Schorr. Sigmund Schorr was a well-known
Wilmingtonian haberdasher, who was elected to the Delaware General
Assembly and later served for many years as president of the New Castle
County Board of Elections. Rosalia, her mother, worked as a public
schoolteacher and was very active with community and civic groups, like
the Young Women's Hebrew Association and the Gardeners Guild of the
Arden Club. Sonny credited her parents for raising her in an atmosphere
of active community involvement.
Throughout her life, she was exceptionally bright and gifted. As an
honors graduate of Wilmington High School, she pursued a bachelor's
degree in bacteriology and graduated magna cum laude from Syracuse
University in 1949. She was accepted to Jefferson Medical College in
Philadelphia, where she earned her master's degree in microbiology. She
was the very first woman to graduate from Jefferson in its 125-year
history and was the first student to complete graduate work there.
After teaching several years at Temple University School of Medicine,
she became the very first woman hired by DuPont to work in the
prestigious central research department in Wilmington, which is where
many great inventions were made.
While at DuPont, she got involved with the Young Democrats and met
fellow scientist Gilbert Jacob Sloan of nearby Fairfax. Sonny and Gil,
who were, frankly, inseparable for the rest of their lives, fell in
love. A few years later, they were married at Temple Beth Emeth on
Memorial Day of 1957. Together, they raised two wonderful sons, Victor
and Jonathan.
During this period, Sonny became more and more involved with local
community groups and political organizations. Sonny's commitment to
public service was a hallmark of her life. She was a skilled and
forceful advocate, a tireless campaign organizer, and a relentless
fundraiser for community groups and campaigns alike. Whether it seemed
doable or not, when she saw a need, she would fill it.
When people felt like Delaware needed a more active advocacy
organization or they were concerned about civil liberties and civil
justice and civil rights, Sonny and others founded and launched the
Delaware Chapter of the ACLU. When she became increasingly concerned
about the restrictions on access to reproductive rights, she launched
and ran a capital campaign to build a brandnew facility for Planned
Parenthood of Delaware. She was involved in the creation and launch of
an AmeriCorps program, Public Allies of Delaware, and the Cancer
Support Community of Delaware. She was involved in so many different
civic and community organizations and in so many campaigns that they
are more than I could relate in my time on the floor.
Her legacy of service to our State, which began more than 60 years
ago, steadily grew over the next 50, 60 years. She eventually formed
her own fundraising firm, and according to Sonny, it raised over $100
million for various nonprofits and agencies. She was able to pick and
choose the causes she championed and didn't do anything for which she
lacked passion. Her work touched our whole community, from the Food
Bank of Delaware and the West End Neighborhood House to the YWCA of
Delaware and the Delaware College of Art and Design.
Besides supporting these many causes, Sonny invested in the people in
whom she believed. She was a mentor from the very first days of when a
young, then-29-year-old Joe Biden launched his campaign first for
county council and then for the U.S. Senate, and she played a central
role in Joe Biden's first election in 1972 to this body. Sonia Sloan
mentored countless other people and dozens of other elected officials,
not just my predecessor and the Vice President. She was a mentor to
this young candidate as well when I first ran for office.
Equally, if not more importantly, she was a tireless and engaged
mentor for folks no one has heard of--folks not elected but folks in
need. She was a mentor for a young man who had just been released from
our local juvenile detention center. Sonny helped him get a State
identification card, helped him get a new job, and helped him get a new
bicycle--a reliable means of transportation. She helped him, mentored
him, and supported him until he was able to get back on his feet.
She recorded books for the blind. At one point, she even agreed to
put up the deed of her own home to bail out a Vietnam war protester
from jail. These were the sorts of things Sonny did that many have
never heard of.
She won too many awards in our State to name, but she was inducted
into the Hall of Fame of Delaware Women. Yet she wasn't the sort of
person to hold up these accomplishments.
[[Page S6227]]
Aside from her civic engagements, she loved to run and was often seen
jogging around Rockford Park, which is near my home. She adored cooking
for her family; she collected stamps; she could play the flute and
piano; and she loved to read.
Upon learning that Sonny had passed away at age 91, one friend
remarked that Sonny still had so many stories to share and so much
energy and passion to give.
Another friend called her a beacon of light and a pillar of courage
whose light will shine for many years to come.
She never stopped taking a chance on young candidates and on first-
time candidates.
A friend of mine, recently elected State Senator Laura Sturgeon,
said: Sonny Sloan took a chance on me, even though I had no political
experience, name recognition, or resources. Once people heard she was
in my corner, endorsements and support poured in. I am who I am because
of my parents, but I am where I am, representing the Fourth District in
the State Senate, because of Sonia Sloan.
It is clear that she accomplished many firsts, broke many barriers,
and paved endless paths for many people. She had strong and passionate
feelings about countless issues, but the empowerment of women, the
election of women to office, and the advancement of women in our
society was absolutely at the forefront.
As she so often said, ``Women's issues are not just women's issues;
they are everybody's issues.''
One of the last times I got to see Sonny was at a dinner in her honor
in March of this year. It was there that I joined hundreds of friends
and neighbors to recognize her legacy of service, from her efforts to
end the Vietnam war to her advocacy for women's rights. She lived her
life committed to a deep belief she shared with many of us--to focus on
what you can do to change just one life for the better because, as the
Talmud teaches, when you change one life, you can change the world.
Sonny did that thousands of times.
She was tough and determined, funny and smart. She never hesitated to
offer very direct input to those of us she knew needed correction or
direction, but she could equally offer compelling and comforting
advice. She has been and will continue to be that voice of conscience
inside my head, challenging me not to settle for the easy but to push
for what seems difficult or even impossible.
Her dedication for fighting for justice was rivaled only by her
tireless love for Gil, Victor, Jonathan, her five granddaughters, and
five great-grandchildren. She was the best of what we are as
Delawareans. Her sharp intelligence, her fierce resolve, and her
unwavering dedication to people and causes will be impossible to
replace.
So, to Sonny, I wish to say: We will all miss you--family, friends,
neighbors, and the thousands whose lives you have touched. You have
affected the lives of countless Delawareans. I am truly grateful to
have known you and to have been a part of your work to make our State
and our world a better place. You will forever have my deepest thanks.
Back in October of 1969, in concluding an anti-war rally, Sonia read
a Jewish prayer with some touching and, I think, fitting final words:
Bless our country, that it may always be a stronghold of
peace, and its advocate among the nations. May contentment
reign within its border, health and happiness within its
homes. Strengthen the bonds of friendship among the
inhabitants of all lands, and may the love of Your name
hallow every home and every heart.
These are touching and fitting words.
Sonny, bless you and thank you.
I yield the floor.
The PRESIDING OFFICER. The Senator from Colorado.
H.R. 3055
Mr. GARDNER. Madam President, I come to the floor to talk about
several amendments I am working on in relation to the Commerce,
Justice, Science, and Related Agencies; the Agriculture; the Interior
and Environment, and Related Agencies; and the Transportation, Housing
and Urban Development, and Related Agencies appropriations bills that
this body will be working on shortly.
The first amendment I am offering to the legislation addresses a very
serious issue; that being the rising scourge of methamphetamine around
the country.
Methamphetamine--meth--use is something we talked a lot about a
decade ago. Conversations turned to opioid abuse in this country--and
rightfully so--and focused on opioids, but unfortunately meth use is
now increasing dramatically in States like Colorado as we continue to
address the opioid epidemic.
When I traveled across Colorado over the summer and last week and
through the August work period, I heard from rural sheriffs across the
State who were especially concerned about the severe impact that meth
was having on our small communities. Headlines this summer and as
recently as this week talked about the increase in meth use across
Colorado and the country.
From 2011 to 2018, treatment admissions for meth across Colorado
increased by nearly 40 percent. In 2018, 318 people died in Colorado
from meth overdoses. That is a 750-percent increase over 10 years. From
1999 to 2018, there has been a 1,450-percent increase in meth deaths in
Denver alone. In 2018, which was just last year, the Denver Police made
nearly 1,500 meth-related arrests. Indeed, there were more meth arrests
in Denver than there were arrests for heroin and cocaine combined.
Meth causes property damage. It damages our families. It can cause,
certainly, permanent damage to the individual who is using meth, and it
causes tremendous harm to families. In Utah, just in August, nearly
$2.2 million worth of methamphetamine was confiscated--seized--in the
State of Utah that was heading to Colorado. That $2.2 million was
enough meth to provide 1.1 million individual doses in Colorado. It was
on its way, and it would have done great harm.
I have introduced an amendment that would add $1 million to the COPS
Anti-Methamphetamine Program. This $1 million increase would allow one
more fully funded grant to go to an area, to a State, to a drug program
to help reduce and to break up this cycle of meth.
We have heard from the people in Colorado. We have heard from the
sheriffs. We have heard from our communities to do more. I believe this
amendment does more to help to address the epidemic of meth and the
lives it is shattering in Colorado, and I hope my colleagues will be
able to support this issue.
In particular, I thank Senator Daines, Senator Tester, Senator
Gillibrand, Senator Baldwin, and Senator Jones, who have all joined me
in adding $1 million, fully paid for and offset within the bill, in
order to help combat this epidemic of meth in our country and certainly
in our States like Colorado.
Another amendment I have been working on is the bulletproof vest
amendment. We have seen far too many attacks on our law enforcement
over the past several years. This legislation would provide a $1.1
billion fund for our Nation's law enforcement officers with type 3
bulletproof vests. These vests are capable of stopping more powerful
rifle ballistics and, therefore, would allow more officers to come home
at the end of the day from their service. That is what we need to be
focusing on--how to protect the men and women in blue in our
communities.
I am proud to have joined legislation earlier this year that has been
signed into law that permanently reauthorizes the Bulletproof Vest
Partnership Grant Program, and I hope we continue to build and offer
our support to those who defend that thin blue line.
The crown jewel of our conservation programs, the Land and Water
Conservation Fund, has benefited Colorado and this country so
significantly over the past several decades. It is something that has
affected every State in the country in our being able to preserve and
protect some of our most pristine environments across this great land.
Last spring, we were able to work together in a bipartisan effort to
permanently authorize the Land and Water Conservation Fund.
This legislation, which is the amendment I will be offering to the
bill, would fully fund the Land and Water Conservation Fund. So, while
we have done a great thing in permanently authorizing the Land and
Water Conservation Fund, we need to fully fund the Land and Water
Conservation
[[Page S6228]]
Fund. This amendment would do just that and fully fund the Land and
Water Conservation Fund.
Why is this important?
The outdoor economy, that of protecting our public lands, is so
critical to the State of Colorado. The outdoor economy alone in
Colorado generates $28 billion in consumer spending and $2 billion in
State and local tax revenue. It employs close to 230,000 people just in
Colorado alone, which makes Colorado the year-round destination for
visitors. If you are interested in skiing, there are already 40 inches
of snow in Summit County, and several ski resorts have opened up
already. It is snowing right now in Colorado, so this amendment is all
the more important as people look to our State for the continued
enjoyment of the great outdoors.
I have a bipartisan amendment with seven of my colleagues--Senators
Bennet, Daines, Tester, Burr, Heinrich, Collins, and Shaheen--that will
fully fund the Land and Water Conservation Fund for fiscal year 2020,
and I hope this Chamber will support the legislation.
I am also working on an amendment that will address the ski area fees
that our ski resorts pay to the Federal Government in order to operate
on public lands and have their ski runs on public lands. Many times,
the ski resorts, the ski areas, are the largest employers in our
mountain communities and contribute significantly to the economy and to
the health and stability of our local communities.
There are 122 of our ski areas that operate on National Forest System
lands. They generate, roughly, $37 million in rental fees for the
Treasury. Yet staffing levels for those very recreation programs are
40-percent lower than they were in the year 2000. Just as more and more
people are enjoying our public lands, we see fewer and fewer people who
are employed by the Federal Government to deal with those public lands,
to process the permitting needs, and to address the needs of our public
lands.
Fire borrowing has been an issue that has gobbled up some of the
funding that has helped manage our forests. We have put a bipartisan
fix in place that will no longer allow that money to be gobbled up, but
we need to find a solution as to the ski area fee retention as well so
we can allow that money to stay within the forest in which it is
generated.
Now that we have the fire borrowing fix, we can put the ski area fee
bill in place and have even more dollars returned to the forest from
which those fees are generated so we can address the staffing issues
and other complex issues we face in our national forests. This bill
alone would allow a portion of that $37 million to be returned to the
forests from which they were generated. That means more timely permit
application processing at the Forest Service and better customer
service from those in the ski areas that are trying to accommodate even
more and more people who visit our great ski areas.
I am also working on an amendment to the legislation that deals with
RTD, which is our public transit system in Denver, and the Front Range.
Years ago, the Department of Transportation was working on an effort
that refunded some programs in Colorado. The RTD, more than 20 years
early, had basically paid off the loan on one of these projects. The
RTD was told it would be reimbursed by the Department of Transportation
if it paid this off. Unfortunately, even though it has paid it off
early, it has not been reimbursed.
If you look at the effort and the project it accomplished with this
loan, the Denver Union Station project is one of the highlights of
urban renewal in the country. The RTD got the loan successfully paid
off early--a great success. Now it needs that money back in order to
continue investing in Colorado. I am working with Senator Bennet to
make sure this money gets back to Colorado, which is one of the
amendments we have filed.
Mr. GARDNER. The National Institute of Standards and Technology is
one of the Nation's premier research agencies in the Federal
Government. Colorado is lucky to house the second-largest contingent of
NIST staff in Boulder, where they work on issues like
telecommunications, biosciences, forensics, and quantum information
science and technology.
NIST's Boulder campus, and their affiliated NIST/JILA partnership,
has won three Nobel Prizes and three National Medals of Science. These
preeminent experts were charged with continuing to build on the
successes in the National Quantum Initiative Act, which passed into law
just this last Congress.
But in order to remain competitive globally, competing against
countries like China, the United States has to continue its robust
investments in science and research and development, and that is going
to require investing in our science facilities as well.
When I was able to travel to the NIST facilities in Boulder, I
witnessed a trash can and giant trash bag used to collect rainwater
from a leaky roof. Nobel scientists--prize-winning scientists working
there. It is harmful to think that it is okay for this great country to
have Nobel Prize-winning scientists working in a facility that can't
even keep them dry because the roof leaks.
While I am grateful to the Appropriation Committee's attention to
increasing the construction and facilities budget for NIST in recent
years, we have a lot more work to do. That is why, in light of the
National Quantum Initiative, I introduced an amendment to the
Appropriations bill to provide an additional $161 million for
construction and renovation costs for NIST projects.
In partnering with universities, like the University of Colorado at
Boulder, NIST can continue to expand their work on issues like quantum
in renovated and new state-of-the-art research facilities. That
benefits the United States and will retain and grow our competitive
advantage around the globe.
Another issue that I continue to hear about in Colorado, that we were
able to address through the appropriations package before us, is
affordable housing. It is an urban issue; it is something that you face
in Boulder or Denver or Colorado Springs. But it is an issue that I
hear in some of the smallest communities, as well as the biggest
communities.
So Senator Young and I have been working on an amendment that deals
with affordable housing. We know we have a relationship between the
lack of affordable housing and issues relating to health, education,
nutrition, and job outcomes. And those issues, combined with
homelessness and lack of affordable housing, combine with other issues
to create strains on government and other social services.
The amendment we have offered will help us better understand those
challenges and the root causes of and lack of affordable housing, and
help us understand the effects of the affordable housing crisis on
health and education and employment as well.
It will help us to understand what work we need to do to solve the
problem or whether there are smaller programs that are already working
to expand, to help, do even more good.
These are a number of bills related to the great State of Colorado,
and in this country and I think will do a lot of good, and as we
process these appropriations bills in a bipartisan fashion, we will be
able to improve and help in addressing some major issues.
With that, Madam President, I yield the floor.
Health Insurance Plans
Mr. CARDIN. Madam President, today I wish to discuss this
administration's perpetual actions to weaken protections for people
with preexisting conditions.
Last fall, the administration issued guidance for the Patient
Protection and Affordable Care Act--ACA--that would loosen the
statutory guardrails for 1332 State waivers. The guidance encourages
states to increase access to ACA non-compliant coverage.
The actions of the administration cannot make this message any
clearer: President Trump does not support protections for people with
pre-existing conditions.
Because of the ACA, health insurance companies cannot refuse to cover
someone or charge someone more just because they have a prexisting
condition. Among the most common pre-existing conditions are high blood
pressure, behavioral health disorders, high cholesterol, asthma/chronic
lung disease, heart conditions, diabetes, and cancer.
[[Page S6229]]
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
nonelderly Marylanders with a preexisting condition, 320,000 of which
are children.
Unfortunately, the Trump administration is taking actions that
directly threaten these 133 million Americans, actions, which can lead
to them being denied access to healthcare.
The Trump administration's updated guidance on section 1332 waivers
skirts the intention of the law. Originally section 1332 of the ACA
provided States with the flexibility to test new health coverage
programs, as long as innovation waivers met certain criteria. States
applying for 1332 waivers had to show that their proposal provided
residents with health coverage with at least the same level of
protections guaranteed by the ACA, that was at least as affordable, and
covered at least a comparable number of State residents as currently
covered under the ACA.
For example, Maryland was able to use a 1332 waiver to establish a
State reinsurance program, which lowered insurance premiums by as much
as 22 percent from 2018 premiums.
However, the Trump administration has issued guidance that redefines
the guardrails of section 1332 and will now allow States to include
plans that do not comply with the ACA's consumer protections. The
guidance also encourages states to allow premium tax credits for non-
ACA compliant plans, plans that don't offer essential health benefits
or protect those with preexisting conditions.
The updated 1332 guidance allows State waiver applications to ignore
statutory guardrails to ensure that coverage is not less affordable
under a waiver, especially for those with high healthcare spending.
This new guidance also sets a dangerous precedent, where a State waiver
could skew numbers to disproportionately count junk plans in a State's
total number of lives covered.
The updated 1332 guidance again makes it very clear that President
Trump and this administration do not support affordable insurance for
those with preexisting conditions. I was proud to join Senator Warner
in introducing a Congressional Review Act resolution to overturn the
administration's 1332 waiver guidance to ensure protections for
individuals with preexisting conditions.
The harm done by this administration towards individuals with
preexisting conditions will lead to higher costs of care for the
millions of Americans. This resolution is a clear opportunity to show
our opposition to the actions of the Trump administration to deny
coverage for individuals with preexisting conditions.
My Democratic colleagues and I are calling attention to ACA, which
has worked and is working, and how the Trump administration's actions
seek to overturn the progress we have made to strip consumer
protections like protections for preexisting conditions away from
patients. We can't afford as a country to go back to the days before
the ACA. Nearly 130 million non-elderly Americans relay on the
protections provided by the ACA to guarantee that no insurer could deny
them coverage.
The PRESIDING OFFICER. The Senator from Rhode Island.
Mr. REED. Madam President, today I would like to address my
colleagues to discuss one of the latest attempts from the Trump
administration to undermine and sabotage the Affordable Care Act. This
week, the Senate will vote on a Congressional Resolution of
Disapproval--CRA--on a Trump administration final rule that gives
States broad latitude to ignore the consumer protections of the
Affordable Care Act.
The rule essentially gives patients in those States the choice
between health insurance that doesn't provide coverage when it is
needed the most--so-called junk plans--or being priced out of the
health insurance market entirely.
As we have already seen, Republican lawmakers in some States are more
than eager to dismantle the protections of the Affordable Care Act and
bring back the days of insurance companies being in charge, putting
profits above the health of consumers in those States.
In fact, about 20 such States have gone a step further by moving
forward a lawsuit seeking to invalidate the ACA in its entirety. This
is not a theoretical threat to our healthcare system. Over the next
year, we will see a final ruling on this lawsuit, and a ruling in favor
of these States will be nothing short of catastrophic.
Not only will this upend the healthcare system as we know it in those
States, this ruling would apply to every State, even those like my home
State of Rhode Island, which has done an outstanding job of
implementing the ACA, expanding coverage, and making healthcare more
affordable for all.
The Affordable Care Act has given individuals and families more
choice, more affordable options, and more control over their
healthcare. With these new options for health coverage, the uninsured
rate in Rhode Island has reached historic lows, hovering around 4
percent.
Today, because the ACA is the law of the land, insurance companies
can no longer deny you coverage for preexisting conditions or put an
annual lifetime cap on how much they will pay for your care. Because of
the ACA, young adults can stay on their parents' plans until they turn
26 years of age, and women cannot be charged more based on their
gender. Also, under the ACA, basic healthcare services like maternity
care and behavioral and mental healthcare must be covered. The ACA has
helped keep costs down by requiring insurance companies to provide
preventive care at no charge so that the small things do not turn into
bigger, expensive medical problems, like surgery.
Yet President Trump continues to put all of this progress at risk.
The rule that we are voting to invalidate this week is just one such
example. In his first year in office, President Trump failed to pass
his bill to repeal the ACA when he had Republican majorities in both
the House and the Senate.
Despite widespread opposition to these efforts, the administration
has since moved forward with its sabotage strategy in the absence of a
legislative win. President Trump ended Federal funding for a key ACA
program which helps keep plans more affordable for those in the private
market by covering some costs for patients with the most expensive
medical conditions.
Next, the administration put forth new rules which allowed more junk
plans, plans which can charge more for preexisting conditions and that
can refuse to cover needed health services.
Now, the rule subject to this week's vote goes one step further in
allowing States to expand these partisan attempts to weaken the ACA,
increase costs on consumers, and increase the uninsured rate. If this
was not enough, a single court case, championed by partisans looking
for a political win, could overturn ACA as soon as next year.
If President Trump's strategy succeeds, many Americans will suffer.
Preexisting condition protections will go away, and over 50 million
Americans with preexisting medical conditions will go back to being
priced out of coverage.
The Medicaid expansion that helps States cover more than 12 million
Americans will also go away. Young adults will be kicked off their
parents' insurance. Women could be charged more, as would older
Americans. People will lose access to mental healthcare, and
prescription drug costs for seniors will go up.
In Rhode Island, it is estimated that approximately 100,000 people
could lose coverage if President Trump's lawyers convince the courts to
cut down the ACA. The State will lose hundreds of millions of dollars
in Federal funding for healthcare, all to satisfy President Trump's and
congressional Republicans' desire for a political win at the expense of
the American people.
We cannot afford to go back to the days when insurance companies were
in control. We cannot wait until the Trump administration and
Congressional Republicans come up with a plan.
The ACA was signed into law almost 10 years ago and still its
opponents have no alternatives.
Americans with preexisting conditions, those who are fighting
illnesses, parents with children with complex medical needs, young
people who need
[[Page S6230]]
coverage while they explore new career opportunities, these people--our
constituents, our neighbors, our families--do not have the time to wait
for Republicans to come up with a solution for a problem they,
themselves, are creating.
We should instead be spending our time working on solutions to
today's problems. There are pressing issues that Congress should be
spending time addressing to improve health in this country.
Prescription drug costs continue to skyrocket. In fact, addressing
prescription drug costs alone would go a long way towards bringing down
healthcare costs overall; yet, if the ACA goes away, this will be for
naught. It won't matter if the drug companies are required to negotiate
fair prices for drugs and are prevented from gouging customers. Without
affordable health insurance, consumers will continue to be priced out
of lifesaving drugs and treatment.
Further, without the ACA, requirements that plans must cover
prescription drugs would go away. Indeed, before the ACA, many plans
did not cover needed prescription drugs, leaving patients to pay
entirely out of pocket for lifesaving treatments and interventions that
prevent more expensive conditions down the road.
Congress has made significant bipartisan progress over the last
couple of years on the opioid epidemic, providing considerable funding
to States to help people access treatment to get on the path to
recovery.
However, one of most effective interventions in the epidemic has been
the ACA's Medicaid expansion, helping those with substance abuse
disorders get treatment and get back on their feet.
Without the ACA, the bipartisan laws Congress has passed in response
to the opioid epidemic will be nowhere near enough in both effort and
funding to successfully combat this crisis.
We have also seen new data from the Centers for Disease Control and
Prevention showing growing rates of suicide in this country, especially
among young people--nothing short of an epidemic. I have been working
with my colleagues across the aisle, such as Senator Kennedy from
Louisiana, to increase funding for the National Suicide Prevention
Lifeline, and with Senator Gardner to make the Lifeline more
accessible. This is important work. We need to ensure that, when
someone courageously reaches out to get help in a time of crisis, that
we are able to connect them with affordable mental healthcare for the
long term. Without the ACA, that care may be out of reach.
There is certainly more we can be doing to increase access to
healthcare, and I have been working with my colleagues to do just that.
However, allowing the administration to continue its efforts to destroy
the ACA not only undermines healthcare for the most vulnerable
Americans, but also all of our bipartisan work on critical healthcare
issues such as lowering drug costs. The American people--my
constituents and yours--expect better.
I implore my colleagues on the other side of the aisle to stand up to
this administration's reckless plans to upend our healthcare system and
work with us to improve our healthcare system instead.
Madam President, before I conclude my remarks, I would like to make
some comments on the death of my dear colleague Senator Kay Hagan, and
I would ask unanimous consent that these remarks be placed in the
appropriate section of the Congressional Record in which other tributes
of Senator Hagan are placed.
The PRESIDING OFFICER. Without objection, it is so ordered.
Remembering Kay Hagan
Mr. REED. Madam President, Kay Hagan was an extraordinary individual,
a great Senator from the State of North Carolina, and a great person.
I had the opportunity to express my thoughts to her husband Chip,
whom I talked with yesterday. We will all miss her advocacy, her
spirit, her support of military families, small businesses, students,
and Americans everywhere, particularly in her home State of North
Carolina.
I had the pleasure of serving with her in this body and the Armed
Services and Banking, Housing, and Urban Affairs Committees, and we
traveled together to Iraq, Afghanistan, and Pakistan in 2010.
All of us here in the Senate are saddened by this loss, and we send
all of our thoughts to Chip and her family.
I must share a vivid memory. Senator Hagan and I were in Afghanistan,
and, again, this dauntless, courageous Senator--we were together on a
moonrise infantry patrol, moving from a forward operating base far away
from Kabul, far away from the center of our activities in a remote
corner of Afghanistan. We were moving from the base to a meeting with
local Afghan fighters.
As we rolled down this dusty road, I looked over and pointed and
said, ``Kay, see all those beautiful red flowers?'' She said, ``Yes,
they are very attractive. What are they?'' I said, ``Well, they are
opium poppies.''
You see, we were in the middle of a battle in which we had to support
our Afghan allies but at the same time not alienate the Afghan
population. It was one of the complex issues involved in that struggle.
She understood that. But she understood also the sacrifice and service
of the men and women who were there that day with us in the middle of a
combat zone, and she fought for them relentlessly.
Many of them were constituents from Fort Bragg, NC, from Camp
Lejeune, from other places around that State. She had a deep and
abiding influence in that, and she was not afraid to go forth to
dangerous places to see what they were sharing in terms of danger and
deprivation.
She was an extraordinary woman--such decency, such care, such
compassion, such humanity. I deeply, deeply mourn her passing.
To Chip and all of her family, my sincerest condolences on the
passing of an extraordinary woman who graced this Chamber with decency
and dignity, and I know--I know--her example of courage, strength, and
love will continue to sustain and inspire her family and those of us
who were privileged enough to serve with her.
May she rest in peace.
I yield the floor.
The PRESIDING OFFICER. The Senator from Oklahoma.
United States-Mexico-Canada Trade Agreement
Mr. LANKFORD. Madam President, a couple of weeks ago, I had the
privilege to stand at Iron Horse Industrial Park. It is a brand-new
industrial park just outside of Shawnee, OK. It is run by the Citizen
Potawatomi Nation, and for almost 10 years, they have had the dream of
opening up a location in Oklahoma, where there could be foreign trade;
different countries could come in to do manufacturing there, and they
would be able to work through raw materials and products and sales. It
has been a remarkable dream for them.
I stood on a platform with the leadership of the Citizen Potawatomi
Nation, members of the Shawnee community, sitting right next to folks
from the Canadian Consulate and a Canadian business owner who is
opening up a manufacturing plant in just a couple of months, right
there on that spot, to be the first company in that location to start
doing international trade in that part of Oklahoma.
That location of Pro-Pipe will start manufacturing pipe that they
will send all over the place. It is a Canadian company, but it will
have about 40 or 45 jobs that are Oklahoma jobs that are there.
Now, why do I mention that? I mention that because it was a
reminder--again, as I sat on that platform next to Canadians, the
Japanese delegation that was there, the Taiwanese delegation that was
there, and others from multiple other countries--about how integrated
we really are.
If I took you to Shawnee, OK, there are some great people--and it is
a fantastic community--the first thing you would think of probably
wouldn't be international trade, but it should be now.
In Oklahoma, our top two trading partners are Canada and Mexico. We
have an overwhelming amount of trade just with those two countries. In
fact, we exported $2.4 billion worth of goods just to Canada and Mexico
last year.
We are a very connected economy, and working through the trade issues
is incredibly important to us. That is why this new trade agreement
that replaces NAFTA, which is now decades old and needs a revision, is
so important, because our Oklahoma economy depends a lot on how we
trade. A lot of
[[Page S6231]]
our jobs are connected through agriculture, manufacturing, digital
sales, other financial services that are connected through trade to
Canada and Mexico. They cooperate with us; we cooperate with them.
So a new trade agreement started in the negotiation process. It
started in August of 2017. The Trump administration, the administration
in Mexico and in Canada all sat down and decided to reopen NAFTA after
the Trump administration put tremendous pressure on Canada and Mexico
to update this agreement.
Initially, everyone said they didn't want to change a thing, and from
August 2017 until September of 2018, our three countries negotiated a
new trade agreement that all three countries now have come back in
their leadership and said: That is a better deal than what NAFTA was.
That works better for everyone. It provides new elements on things like
digital trade that wasn't an issue in the 1990s. E-commerce wasn't a
thing at the time; now, it is. So there are digital trade updates.
There are also areas about innovation and intellectual property that
help protect inventors in all three countries to protect what they have
invented and to make sure the benefits come back to those inventors and
back to those countries.
There are also new protections for labor. There have been
longstanding issues in labor practices in Mexico. This addresses some
of those things and some basic human rights elements for Mexico.
It also adds new environmental requirements so that we would take on
as a whole of North America in the way we do manufacturing, the way we
do fishing, the way that we handle marine litter, the way that we
handle sustainable forest management, all of those things would be
addressed in this trade agreement.
It is a very comprehensive agreement--the USMCA agreement--and it is
very important that we actually get it passed. I hope you didn't miss
the timeline that I laid out. The negotiation started in August of
2017. The negotiation finished in September of 2018. Since October of
2018, that agreement has been waiting on a vote in the House of
Representatives.
Mexico has already long since passed it. They have not only passed
the agreement, they have passed the laws doing the implementing
language. They have long since passed it. Everyone is waiting for the
United States to pass this trade agreement that will help us in labor
issues, help us in manufacturing, help us in ag exports, help us in our
digital trade, help us in environmental policy. We are all waiting on
the House of Representatives to take it up.
We are now past a year that the House has had this. It has to start,
constitutionally, in the House, and I cannot say strongly enough how
important this is to be able to maintain our momentum in trade with
Canada and Mexico that we should not have to wait.
Now, some in the House say this is about not giving President Trump a
win, so they don't want to vote on it because it will give President
Trump a win. This is not about the President of a country. In fact,
Mexico has already changed Presidents since the time of this agreement.
This is about giving the American people a win. This is, quite frankly,
to be selfish, about the people of Oklahoma getting a win. It is
additional jobs, it is additional protections, it is additional
opportunities to do investment that we would like to be able to see for
my State and for the people of my State, so I can't encourage enough
the House to take this up.
I do want to also compliment the administration for taking this
agreement on. Three years ago, no one thought this agreement could be
done nor should be done, and now, when it is in the process of being
finalized, everyone seems to be nodding their head, saying: That is
better. Let's keep going.
The administration has also recently struck a deal with Japan. Japan
is a trade partner already, just like Canada and Mexico, but we have
had some problems with Japan. The United States exported $14 billion in
food and agricultural products to Japan just in 2018--$14 billion. But
out of that $14 billion, right at half, $7.2 billion of those had a
need to address some of the issues about tariffs and about some
additional protections. So this new trade agreement that the
administration just struck with Japan is exceptionally helpful to us.
It takes out half of the tariffs--either reduces them or eliminates
them entirely--of our ag trade back and forth with Japan.
Why is that a big deal for Oklahoma? You may say Oklahoma is a long
way from Japan. It is, except we ship a lot of beef that way, and we
could ship a lot more.
This agreement specifically deals with things like beef, pork,
poultry, sorghum, wheat. Those are products that are all coming right
out of my State, and it is exceptionally important that this agreement
has been done.
Now, this agreement doesn't have to come through Congress. It is an
executive agreement. It is not like the USMCA. It is done. So we have
already seen a gain in Oklahoma based on that trade agreement in Japan.
The encouragement I can make to the administration is: Keep doing this.
We have further negotiations we need to have completed in the
Pacific. While they have done step one with Japan, there is more to be
done with Japan on lowering other tariffs, but we would also like to
see a trade agreement with New Zealand. We would also like to see a
trade agreement with other partners in the Pacific where we still need
trade deals done. Keep going, and keep expanding markets.
The big issue right now is with China. Our trade issues with China
have been significant. They have been significant for decades. The last
five Presidents have all tried to deal with some of the problems with
China and trade, their theft of intellectual property, their violations
of basic dignity for their workers. The environmental policies they
have in China has been deplorable.
We should address the issues of trade with China, and we should
address how we can further not only cooperate but deal with some of the
inequities of workers and deal with some of the inequities of
environmental policy and certainly deal with the theft of intellectual
property.
As China is one of the worst human rights violators in the world, in
our trade negotiations, we should talk about things like free press,
freedom of religion, and opportunities for the Uighurs, who are
literally bound up in concentration camps being reeducated to be more
Chinese rather than being able to live out their faith as Muslims there
in China.
There are many issues we need to deal with that go beyond just
dollars. It is how we actually interact with each other. So for the
administration, as they are finalizing the final moments of how they
are going to deal with a trade deal with China, I continue to encourage
them to keep doing the work. The last five Presidents have all tried to
resolve issues with China.
Keep going. We have to be able to get this done, but hold China to
account on human rights issues, while we are also dealing with economic
issues. This is our moment to address those critical needs.
With that, I yield the floor.
The PRESIDING OFFICER (Mr. Cassidy). The Senator from Washington.
Healthcare
Mrs. MURRAY. Mr. President, this afternoon, I join with a number of
my colleagues to put Republicans on notice that their healthcare
charade is coming to an end.
Tomorrow, the Senate will go on the record and make clear, once and
for all, whether they stand with patients and families who are counting
on them or with President Trump and big insurance companies.
Tomorrow, Democrats will force the Senate to vote on our bill to
reverse President Trump's rule that undermines protections for people
with preexisting conditions and promotes junk health plans and higher
costs for families.
For too long, Republicans have been making empty promises on
healthcare, while taking harmful steps that make things worse for
patients and families.
Time after time, Democrats have asked Republicans to work with us to
actually make healthcare work better for patients and families, but,
time after time, Senate Republicans have said no. In fact, there has
been no greater cheerleader for President Trump's relentless attacks on
families' healthcare and no greater obstacle to
[[Page S6232]]
passing solutions to repair the damage than Senate Republicans.
This isn't just a hypothetical conversation. Any day now--any day
now--we could get a ruling on the partisan lawsuit brought by President
Trump that would undermine healthcare for over 100 million people by
ending protections for people with preexisting conditions, stripping
away coverage families got through the exchanges and Medicaid expansion
and letting young adults get kicked off of their parents' insurance
before they turn 26.
A Republican win on this could absolutely drive up costs by scrapping
the caps on patients' out-of-pocket costs, while bringing back lifetime
and annual caps on their benefits--even for those insured through their
employer--and ending essential health benefits that require insurers to
cover prescription drugs, maternity care, mental healthcare, emergency
care, and more.
When Senate Democrats took a stand against this dangerous lawsuit and
introduced this legislation to fight for patients and protect their
care, Senate Republicans ducked for cover and did not bring it to a
vote, just like they have done with Senate Democrats' efforts to bring
down drug prices through impactful steps like Medicare negotiation, or
to restore funding to help people find the care that is right for them
when open enrollment starts this week, or make coverage more affordable
for working families.
Democrats in the House have already made progress on some of these
steps, from successfully joining the lawsuit to fight for patients to
passing legislation that would restore navigator funding, reverse
President Trump's harmful junk insurance rule, and more.
Republicans in the Senate have blatantly failed to live up to their
promise to fight for families' healthcare instead of working with us on
these steps to help our families and protect patients with preexisting
conditions--to do what families sent us here for. They have buried each
of these solutions in their legislative graveyard so that they don't
even have to admit on the record that they aren't doing anything to
help protect families' care--well, not tomorrow. Tomorrow, Democrats
are going to bring forward a bill to ensure protections for preexisting
conditions that Leader McConnell cannot bury and Republicans can't hide
from.
Tomorrow, every single one of us is going to have to go on the record
about where we really stand on families' healthcare and protections for
preexisting conditions. Tomorrow, we will be voting on Democrats'
legislation to reverse a step President Trump took to work a tool that
was meant to encourage innovation into one that encourages States to
eliminate protections for patients with preexisting conditions,
increases costs, undermines essential health benefits, and promotes
harmful junk insurance plans that can charge vulnerable patients more
and cover less.
Letting President Trump's rule stand could leave millions of patients
with higher premiums, higher out-of-pocket costs, and no affordable
options to get the healthcare they need.
Our vote tomorrow to reverse this rule that takes protections away
from patients and gives power back to insurance companies offers a very
clear test about who Senators are actually fighting for. People across
the country are going to be watching tomorrow and taking note of who is
pushing for solutions to protect their care and who is blocking them,
who is trying to repair the damage President Trump has caused and who
is trying to cause even more harm, who is fighting for their healthcare
and who is fighting against it.
I hope each and every one of my Republican colleagues think long and
hard about the promises they have made to their constituents and how
they are going to look them in the eye after the vote tomorrow. I hope
each of them finally decides to do the right thing and stand up for
families' healthcare, even if it means being a Republican who stands up
against President Trump.
I believe issues as important as families' healthcare should come
before party, and I hope we will see tomorrow that Republicans agree.
Thank you.
I yield the floor.
The PRESIDING OFFICER. The Senator from New Hampshire.
Ms. HASSAN. Mr. President, first, I thank my colleague, the
distinguished Senator from Washington, for her leadership on the issue
of providing healthcare to all Americans. In a democracy where everyone
counts, everyone should have access to high quality, affordable care.
I rise today to discuss the Trump administration's efforts to
undermine our health insurance system and scam healthcare consumers by
allowing harmful health plans to be sold to unsuspecting, vulnerable
Americans.
Since the President's first day in office, his administration has
taken measure after measure that makes it harder for patients to access
necessary care, weakens our healthcare system, and increases costs.
This latest effort to expand access to what are appropriately
referred to as ``junk'' health insurance plans would allow insurance
companies to discriminate against Americans who experience preexisting
conditions and would also leave patients with higher healthcare costs
and worse insurance coverage.
Junk plans don't cover even basic benefits, such as prescription
drugs, substance use disorder treatment, or maternity care. People
often don't realize how inadequate these plans are until they are in
the middle of a medical crisis.
Unless you can guarantee that you will never get sick, never break a
limb, or never get into an accident, these plans are a bad deal for
you. We all know that life doesn't come with those guarantees, and when
the worse does happen, when illness or injury strikes, these plans are,
more often than not, barely worth the paper they are written on.
This can lead to two very bad outcomes. The first is that the patient
chooses to receive the critical care they need, but, because the short-
term junk plan doesn't cover the care, the patient ends up being stuck
with an incredibly high out-of-pocket medical bill, or the patient,
upon learning that the junk plan doesn't cover critical care, chooses
not to get the care they need, which leads to adverse outcomes or an
unplanned trip to the emergency room, the cost of which may be footed
by the taxpayer.
If you are someone with a preexisting condition, such as asthma,
diabetes, or cancer, you could be charged more, sometimes truly
astronomical amounts, for insurance that will not even cover many of
your most basic benefits or you can be denied certain benefits
altogether.
If that sounds familiar, it is because it is the same situation
people with preexisting conditions were in before the passage of the
Affordable Care Act. That is why I am calling on all of my colleagues
on both sides of the aisle to vote to repeal the Trump administration's
rule that authorizes these junk plans, threatening protections for
millions of Americans with preexisting conditions and increasing
healthcare costs all across the board.
If there is one thing that Republicans and Democrats should all agree
on, it is that we must ensure that people with preexisting conditions
are protected and that they can be covered--people like Bernadette
Clark of Manchester, whose youngest son is living with cerebral palsy,
a complex medical condition, and would not have access to the type of
health insurance that she and her family need if not for the
protections that the Affordable Care Act afforded to people with
preexisting conditions.
Doctors, nurses, hospitals, and patients universally oppose these
junk plans because they know how dangerous these plans are for the
health and well-being of our people.
I urge every Senator to stand with Granite Staters and all Americans
in opposing the Trump administration's latest attack on our healthcare
system.
Thank you.
I yield the floor.
The PRESIDING OFFICER. The Senator from Vermont is recognized.
Mr. LEAHY. Mr. President, as the Senator knows, Senator Shelby and I
have been working very hard on the appropriations bills. I commend his
staff and my staff for all the work they have done. It is not just the
bill's first page and the number at the end that counts. There is a
whole lot that goes in in between.
There are a number of policy considerations that are in there. There
are
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things that Senators from both parties want that make a great deal of
sense and both parties are for it, and we are putting those together. I
would hope, having done all that, it means that within the next day or
so we can get at least four of these appropriations bills passed.
I remind everybody that the last time Senator Shelby and I went
through this exercise, we passed most of the bills, if not unanimously,
virtually unanimously. I think it helps the Senate. It shows that we
are doing our work and that we can set aside partisan differences and
do what is best for the country.
The other body has been working very hard in the House of
Representatives on their appropriations bills. Their Appropriations
Committee is led by two of the finest members I have served with: Nita
Lowey, the chair from New York, and Kay Granger, the ranking member
from Texas--one a Democrat and one a Republican--both of whom believe
in the Congress and have our support, and they worked hard. I say that
just because I have had so many Members ask me how it is going. I think
it is going better than anybody thought it might at this point earlier.
We will get it done.
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.
Mrs. SHAHEEN. 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. 52
Mrs. SHAHEEN. Mr. President, since President Trump was sworn in, he
has made it his mission to dismantle the Affordable Care Act. Last
Congress, time and again, we saw the House and Senate majorities try--
and fail--to repeal the law of the land, the Affordable Care Act.
After their attempt to repeal the Affordable Care Act failed in the
Senate, the Trump administration made it abundantly clear that they
would do everything possible to sabotage the act through regulations
and administrative action. Through this sabotage, the administration
has undermined the critical protections healthcare provides for people
with preexisting conditions.
I just want to reiterate my support for the Congressional Review Act
disapproval resolution that I worked on with Senator Warner, and I
congratulate him for his leadership. What that resolution points out is
that preexisting conditions and short-term insurance plans, also known
as junk plans, are inconsistent. I am proud to support the disapproval
resolution that we will vote on this week that would reverse this
administration's so-called 1332 waiver rules.
Those rules allow for the use of taxpayer dollars to subsidize junk
insurance plans. These waiver rules are part of the Trump
administration's ongoing attempt to make an end run around Congress and
dismantle the Affordable Care Act through the regulatory process.
I think it is important to understand the shortcomings of these junk
plans that the administration is promoting. These plans are allowed to
deny coverage to someone who has a preexisting condition. They also
allow insurance companies to charge higher premiums if somebody has a
preexisting condition. They are not required to cover the Affordable
Care Act's essential benefits, such as maternity care, substance use
disorder treatment, or prescription drugs. In New Hampshire, where we
have a real challenge with the opioid epidemic, without coverage for
substance use disorders, we have thousands of people who would not be
able to get treatment for their substance use disorders.
These plans are allowed to place arbitrary limits on the dollar value
of services that will be covered annually, and they also don't have to
comply with the Affordable Care Act's caps on how much insurers can
require that patients pay out of pocket. In short, these junk plan
policies are often not worth the paper they are written on, but for
some reason, these are plans that are favored by this administration.
The administration's 1332 waiver rules effectively rewrite the law to
allow the Affordable Care Act premium tax credits to be used to
purchase junk plan coverage. So rather than help subsidize
comprehensive healthcare coverage as was intended in the act--coverage
that will actually allow people to get the healthcare services they
need--what the Trump administration waiver does is have those taxpayer
subsidies cover junk plans that generally do not provide the care that
people need.
Allowing taxpayer dollars to subsidize junk plan coverage is not only
dangerous for consumers, who can be duped into purchasing junk plans,
but it also poses a threat to the stability of the insurance market. By
aggressively pushing enrollment in junk plans, this administration is
seeking to split the insurance market into two: one market for younger
and healthier individuals and a second, much more expensive market for
older individuals and people with chronic health conditions. This is
not the outcome that people in New Hampshire and patients across this
country want or deserve.
That is why I intend to vote in favor of the Congressional Review Act
resolution, which will overturn these rules that are sabotaging the
Affordable Care Act.
Unfortunately, the waiver rules are not the only grave threat that
this administration is posing to access to healthcare coverage and
protections for people with preexisting conditions. In addition to the
sabotage of the ACA that is going on, the Department of Justice--our
Nation's highest law enforcement authority--continues to refuse to
defend the law of the land, the Affordable Care Act, in Federal court.
Instead, the Justice Department has argued that the Affordable Care Act
should be struck down, resulting in the loss of coverage for millions
of Americans. The estimate is that if the Affordable Care Act is struck
down, 20 million Americans will lose their healthcare.
In New Hampshire, approximately 90,000 Granite Staters have obtained
health insurance coverage through either the Affordable Care Act or
Medicaid expansion. Across the country, more than 17 million Medicaid
expansion enrollees and 11 million people in the marketplace health
plan depend on the ACA for their coverage. So these families can see
their coverage ripped away if the Department of Justice gets its way in
the courtroom.
If the Department is victorious in its litigation, they will also
take away the best tool we have for combating the opioid epidemic--the
Medicaid expansion. In New Hampshire, more than 11,000 people have
substance use treatment thanks to Medicaid expansion. Access to those
services will be gone without the Affordable Care Act. At a time when
so many families are struggling with sky-high prescription drug prices,
a victory by the Department of Justice in this case would increase
prescription drug costs for Granite State seniors, who currently save
an average of $1,100 a year thanks to the ACA's Medicare Part D drug
discount program.
That is not all. If the courts strike down the Affordable Care Act,
insurers would once again be able to exclude coverage for prescription
drugs, and the FDA's approval pathway for less expensive biosimilar
medication would be invalidated.
I have been watching these ads on behalf of President Trump and the
administration that talk about his commitment to lowering prescription
drug prices and the importance of the pathway for biosimilar
medications that are basically generic drugs for biologics. Yet this
pathway to approve those less costly biosimilar medications would be
invalidated if the Affordable Care Act gets struck down.
The stakes are really just too high for us to continue the partisan
bickering around the Affordable Care Act. We should be coming together
to tell the Justice Department to defend the law of the land. That is
why I filed an amendment to the Commerce, Justice, Science
appropriations bill that would prohibit the Justice Department from
using Federal funds to argue against the Affordable Care Act in court.
That is why we need to support the Congressional Review Act vote that
we will have this week, which would ensure that people with preexisting
conditions are not going to be cut off of their health insurance when
they are tricked into buying junk plans through this administration's
deceptive advertising.
[[Page S6234]]
This Friday is the start of the 2020 open enrollment season for the
Health Insurance Marketplace coverage under the Affordable Care Act. At
this important juncture, we should be sending a very clear message that
the Department of Justice should defend the law of the land and that
the administration's promotion of junk plans should not continue. If we
fail to do so, we are going to be endangering vital access to care for
millions--tens of millions--of Americans.
I yield the floor.
The PRESIDING OFFICER. The Senator from Illinois.
Unanimous Consent Request--S. 916
Mr. DURBIN. Mr. President, it is my honor to come to the floor to
speak on an issue that is important for so many Americans.
Let me start at the outset--before I move to unanimous consent on a
specific piece of legislation--by saying that I believe that the change
in the Affordable Care Act, which prohibited discrimination against
people because of preexisting conditions, is one of the most
fundamental changes in health insurance in America. Who among us
doesn't have a member of their family or a friend with a preexisting
condition?
There was a time, of course, when because of that, people were denied
any coverage or charged exorbitant amounts of money. Overwhelmingly, we
understand that if we are going to have a health insurance system that
really serves the entire Nation, we cannot allow health insurance
companies to pick and choose.
Prior to the Affordable Care Act's passage in 2010, health insurers
used to charge people with preexisting conditions higher monthly
premiums or simply deny them coverage all together. Health insurance
companies used to impose annual lifetime caps on what they could pay
for. These arbitrary limits disproportionately hurt people with
preexisting conditions who often needed ongoing intensive medical care,
and insurance companies before the Affordable Care Act used to refuse
coverage for certain healthcare services that people with preexisting
conditions needed--prescription drugs, hospital visits, mental health
and substance abuse treatment, maternity and newborn care.
The Affordable Care Act changed all of that. There are no more
denials or higher premiums for preexisting conditions, which is an
amazing breakthrough. There are no more annual or lifetime caps on
benefits and no more refusals to cover maternity benefits or doctors'
visits.
Ten years ago, every single Democrat--I was one of them--voted in
favor of the Affordable Care Act, and I would do it again today. It was
a law that ensured these protections for people with preexisting
conditions really meant something and were enforceable.
Ten years ago, every single Senate Republican voted against the
Affordable Care Act. Since it has been signed into law, House and
Senate Republicans have voted more than 100 times to repeal the
Affordable Care Act. Their efforts have failed. There was one most
dramatic effort, which many of us can recall happened just a couple of
years ago, right here in the well of the Senate when the late Senator
John McCain, Republican of Arizona, came to the floor in the middle of
the night and cast a ``no'' vote. He believed, and I think he was
right--I am sure he was right when he said: You can't be just against
something; you have to be for something. The Republican side of the
aisle has no alternative to the Affordable Care Act. They are just
against it. They don't like it. They don't like the name of it. They
don't like ObamaCare. They don't like Obama's administration. They just
vote no over and over again.
Right now, there is a pending lawsuit that even would try to
eliminate the entire Affordable Care Act, including the protection for
people with preexisting conditions. Eighteen Republican-led States,
including the State of Texas, brought the suit after congressional
Republicans eliminated the CRA's individual mandate. President Trump's
Department of Justice supports this bill to eliminate the Affordable
Care Act. If this lawsuit is successful, nearly 20 million Americans--
600,000 of them living in Illinois--could lose their health insurance,
and nearly 133 million Americans with preexisting conditions--3 million
in Illinois--could once again be at risk of discrimination by health
insurance companies. As if that weren't bad enough, President Trump has
also proposed new rules that would allow States to discriminate against
Americans with preexisting conditions.
This week, the Senate will be voting on a Congressional Review Act
resolution to overturn the Trump administration's latest assault on
Americans with preexisting conditions. Senator Warner of Virginia has
offered a resolution of disapproval, cosponsored by every single Senate
Democrat. If any Senator on the Republican side really wants to help
people with preexisting conditions, join us. Make this a bipartisan
effort to tell President Trump and his administration it is wrong. We
should not discriminate against people with preexisting conditions.
I hope that Senate Republicans will consider supporting a piece of
legislation known as the MOMMA's Act. I am cosponsoring it; in fact, I
am the lead sponsor in the Senate. The House sponsor is Congresswoman
Robin Kelly of Illinois. It would ensure that all pregnant women get
the care they need. Why is this important to raise in a modern country
like America, with our great natural and medical resources? Because the
United States is 1 of only 13 countries in the world where maternal
mortality rates are worse now than they were 25 years ago. I want to
repeat that because it is an incredible statement, though true. The
United States is 1 of only 13 countries in the world where maternal
death rates are worse now than they were 25 years ago.
Fortuitously, the Presiding Officer is a medical doctor. I know he
has devoted a good part of his professional career to serving people of
low income, limited means.
You think when you hear that number about maternal mortality in the
United States, it cleverly must be associated with economic levels,
income levels, wealth levels, education levels. It turns out it is not.
Nationwide, more than 700 women die every year as a result of
pregnancy, and more than 70,000 suffer near-fatal complications. More
than 60 percent of maternal deaths are preventable.
Sadly, the tragedy of maternal mortality is even more pronounced when
it comes to mothers of color. In the United States, women of color are
three to four times more likely than White women to die as a result of
pregnancy. In Illinois, they are six times more likely than White women
to die.
When I researched this, I went to the University of Chicago and asked
the OB/GYNs there to look into the stats, look into the studies, and
tell me what is behind this. They said: Senator, there is no
correlation among income, education attainment, and this death rate
among women. It is only a question of color. We are losing new moms,
and, sadly, we are losing babies as well. Every year, more than 23,000
infants die in the United States, largely due to factors that could be
prevented. Black infants are twice as likely to die as White infants--a
disparity that is greater than it was in the year 1850 in this country.
That is why Representative Kelly, my colleague Senator Duckworth, and
I introduced the MOMMA's Act. First and foremost, our bill would expand
the length of time that a new mom can keep her Medicaid healthcare
coverage. Currently, Medicaid has to cover women only for 2 months
postpartum--after the baby is born. Our bill would expand that to a
full year.
Next, the MOMMA's Act would improve access to doulas, as well as
improve implicit bias and cultural competency training among healthcare
providers. Too often, Black women are just not listened to or taken
seriously by healthcare providers. Doulas can provide education,
advocacy, and support for women whose voices are being ignored.
Lastly, our bill would improve hospital coordination reporting on
maternal healthcare outcomes.
Leader McConnell has made it clear that he has no intention of
allowing the Senate to debate and pass legislation, instead, rendering
the Senate to what has been characterized as a ``legislative
graveyard.'' Senator McConnell says with pride that he will be the Grim
Reaper--his words--the Grim Reaper. Nothing will pass in the Senate.
[[Page S6235]]
But I hope he will make an exception for the MOMMA's Act, which is
currently moving through the House of Representatives. Whether you are
pro-choice or whether you are right to life, shouldn't we all stand
together--Democrats, Republicans, and Independents--and say: Let's do
something to eliminate this unacceptable level of maternal mortality in
the United States. Let's do something to save these babies. Let's agree
on that part if we can't agree on anything else.
Mr. President, I ask unanimous consent that the Finance Committee be
discharged from further consideration of S. 960 and the Senate proceed
to the immediate consideration; that the bill be considered read a
third time and passed; and that the motion 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 Iowa.
Mr. GRASSLEY. Reserving the right to object, this bill is in the
jurisdiction of a committee that I am chairman of, the Senate Finance
Committee. I think the Senate Finance Committee has a reputation for
doing things in a very bipartisan way and moving a lot of important
legislation. For example, we moved a bill out of committee to,
hopefully, get consideration on the floor. It is a very bipartisan bill
that reduces the cost of prescription drugs. We did that on a 19-to-9
vote.
There are a lot of other things we are working on, including some
trade legislation. We want to consider, hopefully, in a bipartisan way
the U.S.-Mexico agreement. We also have an agreement out on encouraged
savings and things of that nature.
I want to respond to my friend by reminding him how our committee
works. Last night was the first time that I heard there was an interest
in moving Senator Durbin's bill. The bill has not been through the
committee process, and, therefore, there has been no opportunity to
weigh in with what we know and to determine what we need.
There are a number of programs focused on reducing maternal
mortality, and it is unclear how this bill coordinates with those
efforts. This bill makes a number of long-term changes to Medicaid, and
the policy and budgetary impacts are unknown.
I am offering a counterproposal in the Medicaid Program to address
maternal health and identify underserved areas. Additional funding is
provided for existing Maternal and Child Health Services Block Grants.
This focus is fully offset by a policy that saves money by focusing our
limited resources on moms and babies, rather than spending on prisoners
at a higher percentage in our most vulnerable populations.
I am going to offer Senator Durbin this proposal that I just
described. I ask the Senator to modify his request to include my
amendment, which is at the desk.
I ask unanimous consent that the amendment be considered and agreed
to; that the bill, as amended, be considered read a third time and
passed; and that the motion to reconsider be considered made and laid
upon the table.
The PRESIDING OFFICER. Will the Senator so modify his request?
Mr. DURBIN. Reserving the right to object, the Senator from Iowa is
my friend. We throw that word around here on the Senate floor, and it
usually doesn't mean much, but it is true. We are friends. I respect
him very much. I think he is a good father, good grandfather, and I
think the time will come--and I hope soon--when we can sit down and
take his proposal and my proposal and put them together and make a bill
we will both be proud of. We have done that before, even to the point
of getting the President to sign the bill into law.
For the time being and because his proposal cuts some Medicaid
benefits that are a great concern to me, I am going to object in the
hope that we can use this opportunity and this moment as a basis for
sitting down and finding a bill we can agree on.
I object.
The PRESIDING OFFICER. Objection is heard on the modification.
Is there objection to the original request?
Mr. GRASSLEY. I object.
The PRESIDING OFFICER. Objection is heard.
The PRESIDING OFFICER (Ms. McSally). The Senator from Kentucky.
Tribute to Jim Milliman
Mr. PAUL. Mr. President, I rise to honor and pay tribute to one of
the most tenacious and dedicated Kentuckians I have had the pleasure of
knowing, Mr. Jim Milliman.
Jim began his career in 1964 after graduating from the University of
Notre Dame. He subsequently graduated magna cum laude from the
University of Louisville School of Law in 1970. He married Nan
Milliman, and they made their home in Louisville, KY. They have been
married for 48 years.
When I first met Jim, I knew him as one of Kentucky's finest
attorneys, who represented Brown & Williamson during the tobacco
litigation and the State Republicans in election law matters. I knew
him as an accomplished managing partner of the Louisville-based law
firm, Middleton Reutlinger. I also knew him as the fiery conservative
cohost who often sat opposite Congressman John Yarmuth on WAVE 3 TV's
political show ``Hot Button.'' He was known for his spirited debate and
for not backing down.
After having over 40 successful years in commercial litigation and
receiving numerous awards from his peers, such as being named one of
the top 50 attorneys in Kentucky, Jim decided to retire--from the law,
at least. In 2010, right after I was elected to the Senate, I convinced
Jim to come out of retirement and be my State director for Kentucky. I
am truly grateful that he said yes because, for nearly a decade, Jim
has served in that role and has been one of my most trusted advisers.
Anyone who knows Jim knows that he is a force to be reckoned with. He
is fiercely loyal, a real problem solver, and a highly accomplished
legal mind. Moreover, he is an incredibly kind person who cares deeply
about his friends and colleagues. When I ran for President, Jim
spearheaded the approval of a caucus for Kentucky so I would not be
kept from the ballot for President and the U.S. Senate.
Recently, Jim has decided to transition from the daily State director
duties into more of an advisory role. Considering he tried to retire
over 10 years ago, I think it is well-deserved. No matter in what
capacity, I will always be thankful to have Jim as a part of my team as
an ally and an adviser.
He has dedicated so much of his time to the pursuit of liberty and
freedom, to defending the principles that made this Nation great, and
to supporting a pro-Kentucky policy agenda.
Thank you, Jim, for your service to Kentucky and to this country.
I yield the floor.
The PRESIDING OFFICER. The majority leader.
Order of Business
Mr. McCONNELL. Madam President, I ask unanimous consent that debate
time for S.J. Res. 52 expire at 12:15 p.m. on Wednesday, October 30,
and that notwithstanding rule XXII, the cloture motions filed during
yesterday's session of the Senate ripen following the disposition of
S.J. Res. 52.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
____________________