[Congressional Record Volume 165, Number 172 (Wednesday, October 30, 2019)]
[Senate]
[Pages S6263-S6271]
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''--Resumed

  The PRESIDING OFFICER. Under the previous order, the Senate will 
resume consideration of S.J. Res. 52, which the clerk will report.
  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''.

  There being no objection, the Senate proceeded to consider the 
resolution.
  Mr. McCONNELL. 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.
  Mr. SCHUMER. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                   Recognition of the Minority Leader

  The PRESIDING OFFICER. The Democratic leader is recognized.


                             Appropriations

  Mr. SCHUMER. Mr. President, even as we consider the package of 
appropriations on the floor this week, we must also think about how 
both parties can reach an agreement on all 12 bills we need to pass 
before Thanksgiving. It is way past time for Democratic and Republican 
appropriators to sit down and hammer out bipartisan agreement on 
allocations to the various agencies, known as 302(b)s. That is how we 
got this done in the past. Democrats and Republicans in Congress have 
successfully negotiated two budget deals. The key to those agreements 
was that the President allowed Congress to do its work and stayed off 
to the side. I believe that, again, if left to our own devices, 
Congress could work out an agreement to fund the government.
  As everyone remembers, the President's meddling and erratic behavior 
caused the last government shutdown--the longest in our Nation's 
history. The best way to avoid another shutdown would be for the 
President to keep out of the appropriations process and for Republicans 
to stop the games and get serious about negotiating in a bipartisan way 
forward.
  I believe there was a meeting yesterday, and there may be some 
progress. I think some progress was made. Let's continue moving in that 
direction, the four corners of the Appropriations Committee--House and 
Senate, Democrats and Republicans--and put together an agreement we can 
all support.


                          Trump Administration

  Mr. President, on the whistleblower, as the House of Representatives 
continues its impeachment inquiry as to whether the President 
jeopardized national security by pressuring Ukraine to interfere with 
our 2020 locations, the White House, their allies in Congress, and the 
media have resorted to despicable tactics to falsely discredit 
individuals who have provided the House testimony.
  Yesterday, LTC Alexander Vindman, an Active-Duty Army officer serving 
on a detail in the White House, testified before Congress. Since 
Lieutenant Colonel Vindman's testimony was announced and especially in 
the past 24

[[Page S6264]]

hours, he has been vilified by individuals in the media and elsewhere. 
Although he has served our country for more than 20 years, although he 
is a recipient of the Purple Heart after being wounded while serving in 
Iraq, he has been called derogatory terms, and some have even gone so 
far as to call him a spy and question his loyalty to the United States.
  These attacks are outrageous. They are unacceptable, and they are not 
unlike the attacks the President and his allies have levied against the 
whistleblower whose account first alerted Congress to the President's 
misconduct with Ukraine. The President has publicly suggested the 
whistleblower is treasonous and a spy.
  Separately, recent public reports suggest that a Republican member of 
the House Intelligence Committee is actively trying to expose and leak 
the whistleblower's identity. This is so, so wrong. Disclosing or 
causing to be disclosed the identity of a whistleblower is such a 
breach of faith of our whistleblower laws, which are designed to see 
that the truth gets out. Anyone seeking the release of the 
whistleblower's identity is frustrating the truth and is potentially in 
violation of Federal law. Not only that, the disclosure of the 
whistleblower's identity may result in reprisals and threats to their 
personal safety and the safety of their families.
  Today, I am sending a letter to the Secretary and Chief of Staff of 
the Army asking them to provide us with what actions the Army is taking 
to ensure that Lieutenant Colonel Vindman is afforded appropriate 
protections. Lieutenant Colonel Vindman and whistleblowers like him are 
standing up for the Constitution they swore an oath to defend. Their 
lives and families must not be put in jeopardy by an outrageous attack 
or disclosure.


                               Healthcare

  Mr. President, now on healthcare, today the Senate will hold a vote 
on a resolution to repeal a Trump administration rule promoting junk 
health insurance plans, which offer a way around protections for 
Americans with preexisting conditions. The administration has worked to 
make it easier for States to use taxpayer dollars to subsidize these 
junk insurance plans, many of which don't cover essential benefits, 
like maternity care, preventive screening, and mental healthcare. These 
junk plans leave families vulnerable and are nothing but a boon to 
health insurance companies.
  For nearly 3 years, Republicans in Congress and the Trump 
administration have sabotaged Americans' healthcare. Funding to sign up 
Americans for health insurance has been eliminated. Programs to help 
low-income Americans afford insurance has been canceled. President 
Trump's budgets have threatened deep cuts to Medicare and Medicaid. 
Now, the Trump administration is suing to repeal the entirety of the 
healthcare law.
  Yesterday--just yesterday--new data showed that 400,000 fewer kids 
have health insurance now, most of whom are under 6--innocents. When 
they have bad health, they need help. That breaks your heart. The 
effect of all this sabotage is very, very real.
  Now, think about this issue, about protections for Americans with 
preexisting conditions. Think of a mom or dad who has a son or daughter 
and they discover that he or she has cancer. They go to the doctor, and 
the doctor says: Look, I have this very expensive medication or this 
expensive treatment that will help cure your child, but the insurance 
policy doesn't cover it.
  The family doesn't have enough money to pay for it, and they watch 
their child suffer. That should not happen in America. We want to 
prevent it from happening.
  That is why we hope our colleagues will join us in this CRA to 
overturn what the administration has done that would allow that 
terrible example to go forward.
  Let me continue on healthcare for a minute. Despite making explicit 
promises to defend protections for Americans with preexisting 
conditions in campaign ads--I even heard some speak about it as 
recently as yesterday--Republicans have voted to undermine these 
protections in Congress on several occasions. There is no getting 
around the fact that junk insurance plans offer a way around these 
important protections and drive costs up for everyone else.
  Do Republicans want to use taxpayer dollars to fund these junk plans 
and add to insurance company profits?
  I hope not, but we will see today. Today, my Republican colleagues 
face a test. They can vote to defend healthcare protections for 
Americans who need it most or they can stand with President Trump and 
vote to allow these junk health insurance plans with so many 
devastating effects on so many families flood the market.


                                 Syria

  Mr. President, finally, on Syria, we were informed yesterday that 
after multiple requests, the Senate will finally receive an all-Member 
briefing by the administration on the situation in northern Syria this 
afternoon. I am glad the briefing is taking place, but it is 
regrettable that it has even taken this long.
  Secretary Pompeo also will not participate, which is profoundly 
disappointing, given that we must hear from the Secretary of State at 
times and on issues such as this.
  Nevertheless, those members of the administration who will be there 
today must answer several important questions. What is our strategy 
moving forward on northern Syria? How are we going to protect troops 
and our national interest? And, most importantly, exactly what is our 
plan to ensure the enduring defeat of ISIS and to make sure that those 
who are still imprisoned don't escape and those who have already 
escaped don't hurt us?
  These urgent questions go to the heart of America's national 
security, and we need them answered today.
  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.
  Mr. THUNE. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The majority whip is recognized.


                     Death of Abu Bakr al-Baghdadi

  Mr. THUNE. Mr. President, ISIS took a big hit over the weekend when 
U.S. forces raided ISIS leader Abu Bakr al-Baghdadi's compound in 
Syria. Al-Baghdadi died in the raid after he detonated a suicide vest 
in a final act of cowardice, killing three children with him. The 
second in command was confirmed killed in a second military strike 
hours later, leaving the organization temporarily leaderless.
  Over the past few years, ISIS has spilled a river of blood across the 
Middle East. Its brutality has set it apart even among other terrorist 
organizations. Torture, rape, enslavement, crucifixions, beheadings, 
and the deliberate targeting of whole populations based on their 
religious beliefs--the list of crimes is long and often nearly 
unspeakable.
  The world is a safer place today because of al-Baghdadi's death. This 
impact will only be temporary unless we dedicate ourselves to ensuring 
that ISIS is permanently defeated.
  The successful raid on al-Baghdadi's compound is a reminder of the 
fact that our military may be called on at a moment's notice to head 
halfway around the world to fight evil. The men and women of the U.S. 
military stand on guard 24 hours a day, 365 days a year, ready to put 
themselves between us and danger.
  This past weekend, I had the honor of helping to welcome home 112 
South Dakota Army National Guard soldiers of the 147th Forward Support 
Company and Bravo Battery of the 147th Field Artillery Battalion. These 
citizen soldiers were in Europe for nearly a year working with our NATO 
allies and increasing unit readiness.
  As Members of Congress, we have no more fundamental responsibility 
than ensuring that our men and women in uniform are prepared to meet 
any threat. We do that by providing timely and adequate funding for the 
current and future needs of our Armed Forces. That means funding the 
military through regular order appropriation bills--not through 
temporary funding measures that leave the military in doubt about 
funding levels and unable to start essential new projects.
  Unfortunately, our efforts to fund the military in a timely fashion 
have been stymied by Democrats who blocked the Senate from passing the 
Defense appropriations bill in September before the end of the fiscal

[[Page S6265]]

year. We are now a month into the new fiscal year, and Democrats are 
still indicating that they intend to block this year's Defense 
appropriations bill.
  Let me briefly review what Democrats are blocking. They are blocking 
funding to support a pay increase for our military men and women. They 
are blocking funding for weapons and equipment that our troops need 
right now. They are blocking investment in the equipment and technology 
that our military will need to defeat the threats of the future. They 
are blocking funding for missile defense, for research and development, 
for ships, planes, and combat vehicles to update our aging fleets, and 
they are blocking funding for our allies, including $250 million in 
military assistance for Ukraine.
  Let me just repeat that last point. Democrats, who are currently 
trying to impeach the President for allegedly delaying Ukraine funding, 
are currently blocking $250 million in assistance for Ukraine. Now, I 
am pretty sure that is the definition, if you look it up, of both irony 
and hypocrisy.
  Toward the end of the summer, it looked like Democrats might actually 
be willing to work with Republicans to pass this year's appropriations 
bills. Both Democrats and Republicans agreed to a bipartisan deal 
laying out funding levels for both defense and nondefense spending, 
but, apparently, that was as far as Senate Democrats were prepared to 
go. Now that it has come time to honor the spirit of that agreement and 
get this year's Defense appropriations bill done, Senate Democrats are 
balking.

  Democrats would like us to believe they are serious about 
legislating; that their yearslong obsession with impeaching the 
President isn't distracting them from doing their job. Well, they are 
going to have a chance to prove that in the very near future.
  If Democrats are actually serious about legislating, if they are 
serious about meeting their responsibilities, then they will work with 
Republicans to move forward on the Defense appropriations bill and to 
get this legislation to the President as soon as possible. I hope that 
is what they will choose to do.
  As Chairman Shelby noted on the floor last week, Congress's failure 
to do its job and fund our military is making the military's job more 
difficult, and that, as Chairman Shelby noted, is unacceptable. It 
should be unacceptable to all of us. It is time to get our men and 
women in uniform the funding they need and the pay increase they 
deserve. It is time to get this year's Defense appropriations bill 
done. It is time for the Democrats to stop stalling and foot-dragging 
and blocking, and for them to work with us to make sure our men and 
women in uniform have what they need to protect Americans and keep us 
safe.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. ALEXANDER. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ALEXANDER. Mr. President, at 12:15 p.m., the Senate will vote on 
a Democratic proposal to overturn a Trump administration guidance from 
the Department of Health and Human Services that would lower insurance 
rates all across America. Seems like a strange thing to do, but to 
justify that, the Democrats have come up with a scary fairytale that 
has no basis in truth, that suggests that somehow this effort to lower 
insurance rates would jeopardize the protection for preexisting 
conditions that all Americans have according to the law. Of course, 
that can't happen because the law doesn't permit it. So I want to talk 
about that a little bit today.
  What the Senate Democrats want to overturn is a Trump administration 
guidance regarding what is called a section 1332 waiver. Now, a 1332 
waiver was part of the Affordable Care Act of 2010 that Democrats 
passed. No Republican voted for it. So you had the Affordable Care Act, 
which says, among other things, that every American who has a 
preexisting health condition is protected. That means that if I have a 
preexisting health condition, and I want to buy insurance, I have a 
right to buy it. I can't be charged any more for it because of my 
preexisting health condition, and I am covered if I get sick. That is 
what we mean by protection for preexisting conditions. That is in the 
Federal law. No American can be denied that protection.
  In the very same law, the Affordable Care Act, Democrats wrote 
another provision to give States more flexibility in how they spend 
ObamaCare money with the hope that they might be able to lower rates 
for Americans who have health insurance. That would be a good thing 
because in Tennessee, and across the country, really, since ObamaCare 
passed, rates have gone up 163 percent. Those rate increases especially 
hurt people who make a little bit more than $50,000--say a songwriter 
in Nashville or a farmer like Marty, whom I ran into in the Chick-fil-A 
outside Nashville, who said: I can't afford health insurance. I have to 
pay $15,000 or $20,000 because I don't get any ObamaCare subsidy.
  States are trying to take advantage of this provision of the 
Affordable Care Act--ObamaCare--that says States may have some 
flexibility in how they spend Obamacare money. The law also says states 
cannot jeopardize preexisting conditions protections for anybody.
  Now, the best evidence that what we are talking about is a scary 
fairytale is that 12 States already have used a 1332 waiver. Remember, 
this is the provision in the Federal law that was designed to give 
States more flexibility in how they spend Federal dollars. Twelve 
States have already used that provision in law to lower rates. There 
are 12 waivers from States that have been approved by the Trump 
administration, and premiums have gone down in all 12 States as a 
result of this action. This is what the Democrats want to stop. They 
want to stop States from using this provision which the Democrats 
invented in 2010 to lower insurance rates. That is why it is a scary 
fairytale that only on Halloween anybody could imagine could come up 
with.
  Now, 7 of the 12 waivers that were approved by the Trump 
administration were under an Obama definition of Section 1332, and 5 
have been approved since the new guidance that is the subject of the 
vote today. For any State to get a 1332 waiver, the Centers for 
Medicare and Medicaid Services has to approve it. Seema Verma is the 
Administrator of that agency. She has made it very clear, No. 1, that 
none of the 12 waivers that have been approved jeopardize preexisting 
health condition protections for anybody. In other words, the waivers 
did lower rates for some people, but they didn't hurt anyone's ability 
to buy insurance who had a preexisting condition. Just because it 
helped some people didn't mean it hurt other people.
  Seema Verma went on to say very clearly:

       To be very clear, the 2018 guidance--

  The one we are talking about today--

       does nothing to erode ObamaCare's preexisting condition 
     provisions, which cannot be waived under Section 1332.

  In other words, the law the Democrats wrote in 2010 does not allow 
States to waive the preexisting condition. Seema Verma goes on to say:

       ``Section 1332 does not permit States to waive Public 
     Health Services Act requirements such as guaranteed 
     availability and renewability of health insurance, the 
     prohibition on using health status to vary premiums, and the 
     prohibition on preexisting conditions exclusions. 
     Furthermore, a section 1332 waiver cannot be approved that 
     might otherwise undermine these requirements. This 
     administration stands committed to protecting people with 
     preexisting conditions.''

  The bottom line is, 12 States have already used section 1332 waivers 
to reduce premiums. More States want to come up with other ideas to do 
the same. In none of the 12 States were preexisting condition 
protections jeopardized for one single person. Seema Verma says it 
cannot be, under the law, and if any of the other States have some sort 
of new proposal--she wouldn't approve it.
  There is no doubt there is a good reason why so many Governors may 
want 1332 waivers. In fact, many of the States that have already been 
granted waivers have Democratic Senators as well as Democratic 
Governors. Many States are trying to reduce health insurance rates 
because ObamaCare has driven those rates so high. In the four

[[Page S6266]]

bipartisan Health Committee hearings I chaired in September of 2017, 
virtually, every witness told our committee that the process of 
applying for a 1332 waiver was too cumbersome, too inflexible, and 
expensive for States to use.
  In the fall of 2017, provisions to improve that waiver application 
process were included in bipartisan legislation that was proposed by 12 
Republican Senators and 12 Democratic Senators. At one point, the 
distinguished Senator from New York, the minority leader, Senator 
Schumer, said it was such good policy that every Democrat ought to vote 
for it.
  In 2018, Senate Democrats blocked that bipartisan legislation, which 
would have, by the way, lowered insurance premiums by 40 percent over 3 
years, and it became clear Democrats were refusing to change even a 
word of ObamaCare.
  I encouraged Secretary Azar and the administration to take a look at 
the section 1332 waiver and, within the current law, do whatever they 
could to give States more flexibility. Fourteen Governors wrote the 
Secretary seeking help to make 1332 waivers work so they could start 
lowering premiums in their State.
  In October of 2018, the Trump administration issued new guidance with 
much needed flexibility so States can use 1332 waivers. Democrats who 
vote at 12:15 to overturn this guidance are taking a tool away from 
their States, a tool that many States want, to lower health insurance 
rates and, in every single case, without jeopardizing protection for 
preexisting conditions.

  That was the whole purpose of the 1332 waiver. That is why Democrats 
put it in the Affordable Care Act. That is why 13 States have approved 
those waivers and 12 have been approved just for one type of solution 
called reinsurance. That is when States take some money and put it in a 
reinsurance pool. A State can take the sickest people in that State and 
put them there. When the sickest people are out of the other pool, it 
lowers rates for the people who are left. States can do reinsurance 
with Obamacare money. States lower health insurance rates for these 
people in the pool. You make sure the people who are sickest have 
insurance, and you don't take away anyone's right to buy insurance who 
has a preexisting condition.
  In each of the States, health insurance premiums have gone down as 
much as 43 percent in some cases. North Dakota has seen the average 
ObamaCare premium decrease 20 percent; Colorado, 16 percent; Delaware, 
13 percent; Montana, 8 percent; Rhode Island, 6 percent. You want to 
overturn a guidance that attempts to give States more of that same kind 
of flexibility to lower insurance premiums without affecting the 
ability of any American to buy insurance with preexisting condition 
protections? There is no reason States shouldn't be able to have that 
flexibility.
  Let me give you an example of what this guidance that we are talking 
about today would mean. In 2017, Iowa submitted a waiver application 
that would have restructured the premium subsidies. That is the money 
Iowa gets from Washington under ObamaCare. According to Iowa Governor 
Kim Reynolds, Iowa's waiver would have given 18,000 to 22,000 Iowans 
access to more affordable insurance. These were Iowans who made too 
much to qualify for Federal subsidies and were left behind by 
ObamaCare's skyrocketing profits. This might be a farmer in Iowa making 
$55,000 a year and, with no subsidy, paying $15,000 or $20,000 for an 
insurance policy. The rates would be lower under Iowa's proposal.
  Under the old guidance, Iowa's innovative waiver couldn't be 
approved. Now, with the new guidance--the one you seek to overturn 
today--Iowa can work with Administrator Verma to get the kind of 
creative waiver so 18,000-22,000 more Iowans can afford health 
insurance. To be clear--to emphasize--just as with the other 12 
examples that have been approved, no new waiver can be approved that 
would take away the right of any Iowan who has a preexisting health 
condition to buy insurance at the same price as if that person didn't 
have a preexisting health condition and to keep insurance coverage when 
that Iowan gets sick.
  It is simply a scary Halloween fairytale drummed up by the other 
side--for reasons I can't imagine since so many of their States are 
benefiting from 1332 waivers--to take away from States the ability to 
reduce health insurance costs. As I said earlier, any waiver that is 
approved--as 12 already have been--to help some people get lower cost 
health insurance cannot hurt another person in that State by taking 
away their right to buy insurance at the same price that covers their 
preexisting condition. States with 1332 waivers include these States 
with Democratic Senators who will be voting today: Hawaii, Maryland, 
Minnesota, New Jersey, Oregon, Wisconsin. Do they really want to take 
away from their State the ability to lower health insurance premiums in 
a way that doesn't jeopardize preexisting conditions? That is pretty 
strange. Then there is Colorado, Montana, Delaware, Rhode Island, 
Alaska, North Dakota--the same.
  I think this just gets back to the point that Democrats have elevated 
ObamaCare to the 67th book of the Bible, and they can't change a word 
of it, even though they wrote the 1332 waiver in the Affordable Care 
Act to give States the flexibility to reduce healthcare premiums, which 
12 States now have done. Democrats also wrote, in the Affordable Care 
Act, that you cannot take away from any American the right to buy 
insurance at the same price if you have a preexisting health condition. 
That has been reaffirmed by the Trump administration. It is in the law. 
To suggest otherwise, as I said earlier, is a scary fairytale dreamed 
up for Halloween.
  I hope that all Senators--especially from those States who have seen 
the 1332 waiver work so well--will vote not to overturn the guidance 
that gives more Americans a chance to pay lower healthcare premiums.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Sasse). The Senator from Wisconsin.


                   Unanimous Consent Request--S. 1556

  Ms. BALDWIN. Mr. President, I rise to join my colleague Senator Mark 
Warner and the entire Senate Democratic caucus to force a vote on his 
resolution to protect Americans with preexisting health conditions and 
stop the Trump administration from using American taxpayer dollars to 
promote junk insurance plans that don't even have to cover people who 
have preexisting health conditions.
  The difference between the two sides of the aisle here is really 
clear. The Senate Republicans have worked with President Trump to pass 
repeal plans that would take people's healthcare away and allow 
insurance companies to charge more for people with preexisting health 
conditions.
  When their effort failed legislatively, instead of working in a 
bipartisan way to lower healthcare costs for working families, 
President Trump and his administration spent 2 years working to 
sabotage our healthcare system. The Trump administration's sabotage has 
made it harder for people to sign up for quality, affordable coverage, 
and there are more Americans who are uninsured today than when 
President Trump took office.
  The Trump administration is even in court to support a lawsuit to 
overturn the Affordable Care Act completely, which will take away 
guaranteed health protections and raise costs for Americans with 
preexisting health conditions. If they succeed, insurance companies 
will again be able to deny coverage or charge higher premiums for 
nearly 130 million Americans who have preexisting health conditions.
  Meanwhile, this administration has expanded what we call junk 
insurance plans. These are plans that can deny coverage to people with 
preexisting health conditions and don't have to cover essential 
services like prescription drugs, emergency room visits, and maternity 
care.
  I ask my friends on the other side of the aisle to think about this 
for a moment. President Trump supports overturning the law that 
provides protections for people with preexisting health conditions 
while he expands these junk plans that don't provide those protections. 
This is what the Senate Republicans support. This is their plan.
  Last year, we forced a vote on my legislation to block President 
Trump's expansion of junk insurance plans that don't have to cover 
people with preexisting health conditions. The final vote tally was 50 
to 50, with the entire Senate Democratic Caucus and one

[[Page S6267]]

Senate Republican voting in support of my legislation. Those who say 
they support healthcare coverage for people with preexisting health 
conditions should support the No Junk Plans Act. Today, I want to take 
another vote.
  Mr. President, I ask unanimous consent that the Committee on Health, 
Education, Labor, and Pensions be discharged from further consideration 
of S. 1556 and that the Senate proceed to its 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 Tennessee.
  Mr. ALEXANDER. Mr. President, in reserving the right to object, the 
Senator from Wisconsin is exactly correct. Every Senate Democrat has 
voted to take away a low-cost insurance option from what the Urban 
Institute says is 1.7 million Americans. These people can't afford 
other kinds of insurance. That is what they want to take away, and she 
is attempting to do that once again. I have plenty of constituents who 
have a right to get their insurance but who can't afford it. This is 
the only kind of insurance they can buy.
  This kind of insurance was good enough for the George W. Bush 
administration. It was good enough for the Clinton administration. It 
was good enough for the Obama administration right up until the last 
few days, and it should be good enough under the Trump administration.
  According to the Urban Institute, all the Trump short term plan rule 
does is give 1.7 million Americans an opportunity to buy short-term 
insurance while they move from one job to another or while they look 
for a different situation. According to the Urban Institute, those 1.7 
million Americans would otherwise go uninsured, and that is what the 
Democrats are for.
  I object.
  The PRESIDING OFFICER. Objection is heard.
  The Senator from Wisconsin.
  Ms. BALDWIN. Mr. President, obviously, I am disappointed with the 
objection.
  I would point out that these junk plans are often called short-term 
plans, but the change that was made by this administration was to go 
from a 3-month sort of transition plan that, as my colleague indicates, 
could be used when one changes employment or other short-term use, and 
now they are available and renewable for up to 3 years. These plans do 
not preserve the protections under the Affordable Care Act to cover 
people with preexisting health conditions and essential health 
benefits.
  You don't have to take my word for it. We can read directly from the 
fine print on the actual plans that are being debated.
  One of these junk plans from Companion Life, which is currently 
available in my home State of Wisconsin, reads: ``This plan has a pre-
existing limitation provision that may prevent coverage from applying 
to medical conditions that existed prior to this plan effective date.''
  Another junk plan from Golden Rule says that the plan doesn't comply 
with the guaranteed essential benefits provided by the Affordable Care 
Act.

  To quote directly from the plan, the description reads: ``Even if you 
have had prior Golden Rule coverage and your preexisting conditions 
were covered under that plan, they will not be covered under this 
plan.''
  It is abundantly clear that these plans don't cover protections for 
people with preexisting conditions.
  The people of Wisconsin did not send me to Washington to take away 
people's healthcare. I want to protect the guaranteed healthcare 
coverage that millions of Americans depend on. I want to help more 
families get the quality, affordable healthcare they need.


                   Unanimous Consent Request--S. 1905

  Despite the sabotage that I have described from this administration 
against the Affordable Care Act, in Wisconsin this year, things are 
getting better with the new Governor. Thanks to strong leadership from 
Governor Evers and the investments his administration is making, 
Wisconsinites will have more choices and more affordable rates for 
quality health insurance plans this year. Wisconsinites in every corner 
of the State will be able to find healthcare plans this year that 
include essential benefits like prescription drug coverage, maternity 
care, emergency room visits, and mental healthcare at more affordable 
prices.
  Governor Evers is providing funding for more health insurance 
navigators and is conducting awareness campaigns in the State so that 
families in Wisconsin will have the information they need to sign up 
for quality and comprehensive healthcare plans. That is why enrollment 
navigators are so important. We need to keep up the funding for 
navigator programs so that more people can find affordable healthcare 
plans that meet their needs. Navigators help millions of Americans, 
including those in rural communities, sign up for quality healthcare 
coverage.
  The Governor of Wisconsin understands the importance of navigators, 
but Washington has failed to step up. Unfortunately, since President 
Trump took office, his administration has slashed Federal funding for 
the navigator program by 84 percent. Trusted navigator programs, like 
those in Wisconsin, have had their funding cut by nearly 75 percent 
since 2017, meaning fewer people in Wisconsin have received the support 
they need to obtain affordable coverage.
  That is why I introduced the ENROLL Act this year with my good friend 
from Pennsylvania, Senator Casey. This bill restores funding for the 
navigator program and helps to ensure that Americans have better access 
to the affordable healthcare coverage that they need and want. The 
ENROLL Act passed the House of Representatives earlier this year. We 
should also pass it in the Senate so that Americans can more easily 
enroll in quality healthcare coverage.
  Mr. President, I ask unanimous consent that the Committee on Health, 
Education, Labor, and Pensions be discharged from further consideration 
of S. 1905 and that the Senate proceed to its 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 Tennessee.
  Mr. ALEXANDER. Mr. President, in reserving the right to object, in 
2017, the Centers for Medicare and Medicaid Services found that 
navigators were not cost-effective in enrolling people in health 
insurance.
  During the 2017 open enrollment period, navigators received over 
$62.5 million in Federal grants while enrolling 81,426 individuals. 
That is less than 1 percent of those enrolled in the Federal exchanges, 
which comes out to a cost of $767 per enrollee. In other words, the 
taxpayer is paying $767 per enrollee for each person enrolled. The CMS 
also found that nearly 80 percent of the navigators failed to reach 
their enrollment goals.
  I object.
  The PRESIDING OFFICER. Objection is heard.
  The Senator from Wisconsin.
  Ms. BALDWIN. Mr. President, I am disappointed to see my Republican 
colleague again object to the legislation that will help more Americans 
access quality, private health insurance, Medicaid, or the Children's 
Health Insurance Program. This is especially harmful to families in 
rural communities who already lack access to in-person assistance for 
shopping and enrolling in quality, affordable health insurance 
coverage.
  So let me lay plain for everyone what we are seeing here from the 
Republicans and this administration.
  Today, the Republicans objected to passing my ENROLL Act, which would 
provide funding for healthcare enrollment assistance to help people 
find high-quality, affordable plans that would actually meet their 
healthcare needs.
  Today, the Republicans objected to passing my legislation to stop the 
expansion of junk insurance plans that don't even have to cover people 
with preexisting health conditions.
  The Republicans are working to make it harder for one to sign up for 
high-quality, affordable healthcare.
  This administration is encouraging Americans to buy junk insurance 
plans that don't provide the health coverage

[[Page S6268]]

that they need and that can deny coverage to people who have 
preexisting health conditions.
  Finally, the Republicans and the Trump administration are supporting 
a lawsuit that would overturn the entire Affordable Care Act and take 
healthcare away from literally millions of American families.
  The choice for the American people could not be clearer. I am working 
with my Democratic colleagues to help make things better for the 
American people. Sadly, the Senate Republicans are helping the Trump 
administration make things worse. I will not give up this fight.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. BRAUN. 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

  Mr. BRAUN. Mr. President, we are going to vote on a CRA later this 
afternoon, and this has been the issue dominating D.C. and did in my 
campaign: the cost of healthcare.
  I am going to vote against the CRA, and I am not going to go into the 
particularities of it. I just want to tell you how it works on Main 
Street USA and kind of my perspective of how we really solve healthcare 
in a way that is going to be affordable and last for a long time.
  I just finished visiting all 92 counties in Indiana talking to 
Hoosiers, young and old, small businesses to farms. Everyone is 
concerned about where is healthcare cost going in the future.
  We don't seem to, here, have a real good plan for it. As a Main 
Street entrepreneur that took it on myself a few years ago to create a 
sustainable, affordable plan, most people think it absolutely can't 
happen using free market principles. I will go into a few details of 
how that works in my own business.
  ObamaCare was addressing an issue that has been boiling up for a long 
time. I took on the insurance companies to fix it in my own company 
back in 2008--covered preexisting conditions, no caps on coverage.
  But ObamaCare was a solution that was never going to work. It was Big 
Healthcare in cahoots with Big Government. Never have I seen that 
result in something less expensive and more effective.
  I believe in free markets driving the solutions, and the healthcare 
industry is who I blame for being in this pickle. That sounds unusual 
coming from a free market guy that doesn't believe in government.
  But not all markets are free. One of the most disappointing things is 
when my own Republican colleagues mistake the healthcare industry for 
being one that is free and transparent. It has evolved over the years 
to where it has become as bloated and dysfunctional as the Federal 
Government that runs trillion-dollar deficits.
  ObamaCare decisions are made by healthcare industry executives and 
Federal Government bureaucrats, instead of by patients, employees, and 
mostly employers who are the only ones that really have skin in the 
game when it comes to our healthcare system.
  I believe the underlying principles of ObamaCare were right on. No 
one should go broke because they get sick or have a bad accident.
  I believe that you cover preexisting conditions with no caps on 
coverage. Kids staying on the plan until they are 26? Fine. But it 
didn't work from the beginning, and it won't be an affordable--it was 
the Affordable Care Act. It turned into the un-Affordable Care Act, and 
it is not a solution in the long run.
  The solution will be to get the industry out of the doldrums and to 
realize that when 80 Senators weigh in with an idea of how to fix your 
business, the cat is out of the bag. You have a problem. Sadly, in a 
place like this, which you can see can get sidetracked in so many 
different ways and then never really craft solutions that last in the 
long run, that is kind of what we are up against now.
  The bills that have come through from three different committees--
primarily Finance and the one I am on, Health, Education, Labor, and 
Pensions--do some good things. Senator Grassley and I did an op-ed this 
week about negotiating drug prices in a way that is going to bring them 
down. These bills have real things that will work. I am disappointed 
that they are not aggressive enough, but we need to start somewhere.
  The drug companies have been notoriously involved in--after they do 
such a good job coming up with a solution, a remedy, then hand it over 
to a broken distribution system that ends up--and I will tell a little 
story.
  When I was uninsured, after I had to get off my great company's 
insurance that was based upon wellness, not remediation, and my 
employees and patients were encouraged on dollar one to shop around and 
find solutions--that worked. Here, the industry does everything it can 
to not make it work. This should have been a simple thing to do.
  Luckily, I don't have many prescriptions. I knew it was a generic 
that should cost 15 to 20 bucks. I had six or seven places to choose 
from in my hometown. I went to the first one that would have been the 
most convenient and fumbled around for 2, 3, 4 minutes. They kept 
asking me what my insurance plan number was. I said: I have none. I am 
uninsured. I want your best deal.
  It came back $34.50.
  I made another call to a place that I know has been on the leading 
edge. It took them 10 seconds, $10, and they said: By the way, we can 
have it ready in 10 minutes.
  That is the way things worked in the real world.
  Any of us that run businesses where you have transparency, 
competition--take LASIK surgery for instance. It is the only part of 
healthcare that actually works. Do you know why? Insurance companies 
aren't involved. Providers deal with patients, consumers. Ten, 12 years 
ago, $2,000 to $2,500 an eye, done with a scalpel. Now the technology 
is better, and you can get it done for $250 to $500 an eye. That is the 
way things should work.
  The solution is not more of what we tried that has failed. It 
certainly isn't Medicaid for All. How can that work when, if you are 
honest about how much it is going to cost, it would nearly double the 
size of our Federal Government. Plus, why would you turn something like 
that over when we can't even get it right in the Veterans' 
Administration, where about 10 million patients are covered, not 330 
million? That would be jumping from the frying pan into the fire. It 
would be a disaster. We can't afford it. Of course, no one around here 
ever asks the question about how you pay for anything.
  We are going to completely exhaust the Medicare trust fund in 6 to 7 
years. Employers and employees have been paying into that since the 
1960s. That will probably be the first reality check this place has--
maybe along with the fact that foreign countries and everyone else are 
not going to keep lending us money to finance trillion-dollar 
deficits--which, by the way, will hit $1.5 trillion in 6 to 7 years, 
when the interest on the debt is going to be more than we are paying 
for defense.
  In conclusion, our healthcare system needs radical change, but it 
needs to be changed in a way that takes the power from the industry and 
government and gives it back to the patient/consumer, like it works in 
the real world.
  I will use this example: I know that in my hometown, if you are 
buying a big-screen TV--which, by the way, costs about one-fourth to 
one-third of what it did 10 years ago, kind of like LASIK surgery--I 
know people in my hometown would probably drive 50, 60 miles to save 50 
bucks on a thousand-dollar purchase. We don't do that. The healthcare 
consumer has atrophied. They talk about they love employer-provided 
insurance. Well, that is because the consumer pays for very little of 
it.
  I will give a few details of what can happen when you are innovative, 
when you incorporate the concepts of skin-in-the-game, doing more than 
asking others to pay for it. In our own plan, people enter their 
deductible less than they did 11 years ago because the incentives were 
put in place. But I found a way to do it uniquely, where most CEOs 
didn't want to take the risk.
  I believe in insurance for everyone. I believe in access. You heard 
me earlier. In this day and age, preexisting conditions--that ship has 
sailed. I backed

[[Page S6269]]

that up with actions in my own business. But I don't believe that you 
can take more of what is proven never to work and try to get it to be 
where it is twice the size of our current government.
  Republicans can lead on healthcare but only if we stop acting as 
apologists for a healthcare industry that is dysfunctional and broken 
to the core, and then you set yourself up, for politicians here--and a 
public that generally falls for it--that that is going to be the 
solution.
  On our first foray into surrendering that right to the government 
through ObamaCare, it yielded what it was predicted to--higher costs 
and fewer options.
  The only prescription for our ailing healthcare system is consumer-
driven, transparent competition. I look forward to unveiling more of 
those ideas, and that is why I will vote against the CRA this 
afternoon.
  I put the challenge and the onus on the back of the healthcare 
industry to get with it before you have a business partner that you are 
not going to like--the Federal Government.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Mr. President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                         Remembering Kay Hagan

  Mrs. MURRAY. Mr. President, while I am so sad to be here, I am always 
glad to have the opportunity to recognize Senator Kay Hagan.
  There are certain people who carry with them a warmth and kindness 
that lift up others, even in places that are not always warm or kind 
and even when the going gets tough. Kay was exactly that kind of person 
and one of the best examples I can think of. She wasn't only that--not 
at all. As another mom in the Senate, I saw how deeply she was 
dedicated to her family--her husband, Chip, and her children, 
Jeannette, Tilden, and Carrie. Kay was smart, witty, and fierce, and 
she was an unwavering champion for North Carolina families and 
communities.
  Nine years ago almost to this week, Kay came to the floor to advocate 
for health reform, and she did it as she always did--by putting North 
Carolinians first.
  Kay came here and she shared the story of Tim and Marilyn, a family 
from Mooresville, NC. They had racked up tens of thousands of dollars 
in debt because Marilyn's preexisting condition meant her only option 
was a high-cost, high-deductible plan. Kay called powerfully for 
protections for preexisting conditions.
  Nearly a decade has now passed since the Affordable Care Act became 
law, so not everyone remembers how, in that fight, every single Senate 
vote mattered, and there were certainly some Senators who listened to 
the pundits and the naysayers at the time who wanted the bill to fail. 
Kay tuned out all of that and listened to people from her home State, 
like Tim and Marilyn, instead, and because she did, more than 4 million 
North Carolinians with preexisting conditions have protections in law 
today. They have the peace of mind Kay wanted so badly for Tim and 
Marilyn and every one of her constituents.
  Democrats are going to be talking a lot about healthcare this week, 
and in particular, we are taking a very important vote on upholding 
those protections that Kay fought so hard for. So especially throughout 
this week, I will be thinking about Kay. I will be thinking about the 
difference her love for her State has made in the lives of people 
across North Carolina and our country. I will be grateful, as so many 
others are, for her amazing friendship, her wisdom, and her willingness 
to stand up for what is right.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. WARNER. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Daines). Without objection, it is so 
ordered.


                              S.J. Res. 52

  Mr. WARNER. Mr. President, it has been just over 2 years since the 
Senate voted down legislation that would have repealed the Affordable 
Care Act. If we had voted down the Affordable Care Act, that would have 
also erased the protections for Americans with preexisting medical 
conditions.
  In the time since then, two things have happened. One, my colleagues 
from across the aisle have read the writing on the wall. They 
recognized that the American people support the protections for 
preexisting conditions on an overwhelmingly bipartisan basis; and, two, 
the Trump administration released the rule that we are discussing 
today--a rule that would allow taxpayer dollars to subsidize these 
short-term junk plans that actively undermine the insurance market and 
jeopardize the one very popular part of the ACA, protecting folks with 
preexisting conditions.
  I know that my colleague, Senator Baldwin, was here earlier, and 
Senator Brown, Senator Wyden, and Senator Murray. They have outlined in 
some detail the challenges around these junk plans, or some refer to 
them as short-term plans. The truth is, these plans don't have to cover 
things such as emergency room visits, maternity care, or other 
essential benefits, and they once again allow insurance companies to 
discriminate against Americans based on their medical history.
  With all due respect to my Republican colleagues, you can't have it 
both ways. If you support protections for preexisting conditions, you 
can't sit by and let this administration dismantle them. You have to 
stand up and defend these protections because, as you know, folks in 
Virginia are depending on them and constituents in your States are as 
well.
  Very shortly, each Member of this body will have a chance to go on 
the record with this resolution of disapproval.
  I fear some Members of this body have forgotten what it was like 
before the ACA, when an unexpected surgery or a diagnosis of a chronic 
illness could mean a one-way ticket out of the middle class.
  Unfortunately, this is not a hypothetical. Earlier today, a group of 
us had a press conference where a young woman from my State came 
forward, and not only did her child have an enormous medical condition, 
but her husband was then diagnosed with lymphoma, and she was diagnosed 
with brain cancer.
  Without the protections of the ACA, she testified she would not be 
able to afford healthcare coverage.
  The PRESIDING OFFICER. The Senator's time is expired.
  Mr. WARNER. Mr. President, I ask unanimous consent for an additional 
3 minutes.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. WARNER. I will speed this up.
  Let me also point out that, recently, one of my constituents, a man 
named Jesse, received a $230,000 medical bill for his back surgery. 
Unbeknownst to him, he purchased one of these so-called short-term junk 
plans only to discover that he now fell into the category of having a 
preexisting condition, and this plan didn't cover his challenge.
  Jesse is 1 of the more than 3 million Virginians with a preexisting 
medical condition. Nationwide, more than 130 million Americans have 
preexisting medical conditions like diabetes, asthma, or cancer.
  Before the Affordable Care Act, an insurance company had every right 
to deny these individuals coverage, charge them unaffordable premiums, 
or terminate their plans. We cannot go back to those days.
  Unfortunately, this administration has used every tool at its 
disposal to destabilize the market in the hopes that it will come 
crashing down so they can finally repeal the ACA.
  The rule we are talking about here today is a perfect example, among 
many others, of what this administration has done. They have defunded 
cost-sharing payments that reduce premiums in the marketplace. They 
have shortened the enrollment period and cut the budget for outreach 
navigators--all folks who have helped Americans find a plan that works 
best for them.
  Look at the recent case. The Texas v. United States lawsuit that 
could be decided this very week would, overall,

[[Page S6270]]

strike down the health insurance system as we know it, with no 
replacement plan in place.
  The truth is, if these protections for people with preexisting 
conditions are going to survive, we have to have a stable insurance 
market.
  We can and should have legitimate debates about 1332 waivers. Certain 
States have used those in a very productive way, but that is not what 
we are talking about today.
  The Trump administration's rule is not a good-faith effort to bring 
down costs or drive innovation. It is a direct effort to undermine the 
stability of the insurance market and is an attack on the viability of 
protections for Americans with preexisting conditions.
  Again, I know we are going to vote on this CRA action very shortly. I 
urge my Republican colleagues to support it so folks with preexisting 
conditions can go about their daily lives knowing they will be 
protected.
  Thank you. I appreciate the courtesy of my colleagues giving me those 
extra couple of minutes.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Tennessee.
  Mr. ALEXANDER. Mr. President, I ask unanimous consent for 2 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ALEXANDER. Mr. President, I know it is Halloween, and it is time 
for trick or treat, but I urge my colleagues not to be tricked by this 
scary fairytale dreamed up by the Democrats that would suggest that the 
section 1332 waiver that give States more flexibility, which they 
wrote, somehow jeopardizes protections for people with preexisting 
health conditions, which they also wrote. Both are in the 2010 
ObamaCare law.
  Preexisting health conditions are protected. The law says so. The law 
does not allow any 1332 waiver, which is the subject of what we are 
voting on in a few minutes, to change that.
  Twelve States have had their 1332 waivers approved by the Trump 
administration, and in no case did it affect preexisting conditions.
  Seema Verma, who has to approve all of these waiver applications from 
the Department of Health and Human Services, says the law doesn't 
permit any change in preexisting condition protections, and if somehow 
a waiver asked for it, she would not approve it.
  What my Democratic friends are voting for today is to take away a 
tool from States that has been used to reduce rates by 43 percent in 
Maryland, 20 percent in Minnesota, and 15 percent in New Jersey. It has 
been used in Hawaii, Wisconsin, Colorado, Minnesota, Delaware, Rhode 
Island, Alaska, and North Dakota.
  Why would you take away a flexibility option that you wrote to give 
your own voters lower health insurance rates?
  I know it is Halloween, but don't be tricked. Don't believe this 
scary fairytale. Protection for preexisting conditions when you buy 
health insurance is the law. Nothing in the 1332 waiver guidance 
changes that.
  I urge my colleagues to vote no.
   Mr. LEAHY. Mr. President, today we will vote to reject yet another 
attempt by the Trump administration to sabotage the Affordable Care 
Act, ACA. The President has tried to do everything within his power to 
dismantle the law. He has tried to repeal it through Congress twice and 
failed both times. When that did not work, his administration joined 
Republican State attorneys general in a lawsuit that would strike down 
the ACA with no plan to replace it, one of the reasons Congress 
rejected his initial repeal efforts. Now, this President has decided to 
unravel the ACA through other means.
   We have seen efforts to destabilize the health insurance market by 
not making cost-sharing payments, reducing funding to help enroll 
individuals in plans, or by allowing insurers to sell less 
comprehensive plans through short-term coverage or association health 
plans. This administration has also welcomed waivers from States that 
want to restrict Medicaid coverage by conditioning benefits on whether 
or not someone has a job.
   Throughout its ongoing efforts to sabotage the ACA, the Trump 
administration issued its rule to allow States to discriminate against 
Americans with preexisting conditions. This rule gives States new 
options for pursuing a section 1332 ``state innovation waiver'' under 
the ACA. Section 1332 of the law gives states additional flexibility to 
implement State-specific improvements that expand coverage, reduce 
costs, and provide more comprehensive benefits. I am proud that Vermont 
was the first State to apply for a waiver when the application process 
first started in 2016.
   Now this administration wants to significantly change the 
enforcement of the four important guardrails enacted by Congress that 
waiver proposals must meet in order to be approved. These guardrails 
ensure that the waivers must offer comprehensive plans at an affordable 
rate that protect patients with preexisting conditions and do not 
increase the Federal deficit. Under this rule, States can increase 
costs for vulnerable populations and reduce their quality of coverage. 
That is unacceptable, especially for this President who promised on the 
campaign trail that ``everybody is going to be taken care of.'' The 
intent of the 1332 provision was to let States innovate, so long as 
they continue to cover the same number of people and maintain the 
consumer protections set forth in the law. Vermont's waiver is 
consistent with the ACA and seeks to expand coverage to improve 
healthcare outcomes for all Vermonters.
   By allowing States to permit the sale of health insurance plans that 
do not cover essential health benefits such as maternity care, 
emergency room visits, or mental healthcare, those that need 
comprehensive health insurance coverage will be forced into a high cost 
plan, or stuck with an insurance plan that can deny benefits for 
whatever reason. These consumer protections were at the heart of the 
ACA and are why Vermont and a number of other States have enacted State 
laws to maintain these critical protections for those with preexisting 
conditions.
   Throughout their numerous attempts to sabotage the ACA, this 
administration has made dubious claims that they support protections 
for Americans with preexisting conditions. Certainly, their well-
established record clearly and unequivocally refutes this claim. Today, 
Senate Republicans can show the American people that they do genuinely 
want to protect Americans with cancer, diabetes, arthritis, substance 
use disorders, behavioral health disorders, or any of the other 
preexisting conditions that States would not have to cover under this 
rule.
   This vote is about the more than 130 million Americans with a 
preexisting condition who need strong protections. It is about who we 
are as a nation and how we care for our people. Congress must ensure 
that all Americans have access to comprehensive, high-quality health 
insurance plans that meet their needs at an affordable rate. The 
passage of Senator Warner's the Protect Pre-Existing Conditions 
Congressional Review Act resolution would be a step in the right 
direction. We must not send our country back to the days when insurance 
companies could discriminate against people with preexisting 
conditions. We must not go backward.
  The PRESIDING OFFICER. All time is expired.
  The clerk will read the joint resolution for the third time.
  The joint resolution was ordered to be engrossed for a third reading 
and was read the third time.
  The PRESIDING OFFICER. The joint resolution having been read the 
third time, the question is, Shall the joint resolution pass?
  Mr. ALEXANDER. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The senior assistant legislative clerk called the roll.
   Mr. DURBIN. I announce that the Senator from Colorado (Mr. Bennet), 
the Senator from New Jersey (Mr. Booker), the Senator from California 
(Ms. Harris), the Senator from Vermont (Mr. Sanders), and the Senator 
from Massachusetts (Ms. Warren) are necessarily absent.
   The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
   The result was announced--yeas 43, nays 52, as follows:

[[Page S6271]]

  


                      [Rollcall Vote No. 337 Leg.]

                                YEAS--43

     Baldwin
     Blumenthal
     Brown
     Cantwell
     Cardin
     Carper
     Casey
     Collins
     Coons
     Cortez Masto
     Duckworth
     Durbin
     Feinstein
     Gillibrand
     Hassan
     Heinrich
     Hirono
     Jones
     Kaine
     King
     Klobuchar
     Leahy
     Manchin
     Markey
     Menendez
     Merkley
     Murphy
     Murray
     Peters
     Reed
     Rosen
     Schatz
     Schumer
     Shaheen
     Sinema
     Smith
     Stabenow
     Tester
     Udall
     Van Hollen
     Warner
     Whitehouse
     Wyden

                                NAYS--52

     Alexander
     Barrasso
     Blackburn
     Blunt
     Boozman
     Braun
     Burr
     Capito
     Cassidy
     Cornyn
     Cotton
     Cramer
     Crapo
     Cruz
     Daines
     Enzi
     Ernst
     Fischer
     Gardner
     Graham
     Grassley
     Hawley
     Hoeven
     Hyde-Smith
     Inhofe
     Isakson
     Johnson
     Kennedy
     Lankford
     Lee
     McConnell
     McSally
     Moran
     Murkowski
     Paul
     Perdue
     Portman
     Risch
     Roberts
     Romney
     Rounds
     Rubio
     Sasse
     Scott (FL)
     Scott (SC)
     Shelby
     Sullivan
     Thune
     Tillis
     Toomey
     Wicker
     Young

                             NOT VOTING--5

     Bennet
     Booker
     Harris
     Sanders
     Warren
   The joint resolution (S.J. Res. 52) was rejected.

                          ____________________