[Congressional Record (Bound Edition), Volume 160 (2014), Part 6]
[Senate]
[Pages 9016-9022]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        CHINESE TRADE PRACTICES

  Mr. CASEY. Madam President, I rise this afternoon to speak about the 
impact of this week's announcement that members of China's People's 
Liberation Army hacked into the computer systems owned by Pennsylvania 
companies to steal trade secrets on our trade policy.
  As we all know, a grand jury in Pittsburgh indicted five individuals 
for hacking into several companies' computers and a labor organization, 
United Steelworkers, in western Pennsylvania. The companies included 
Westinghouse Electric, Alcoa, U.S. Steel and, as I mentioned, the 
United Steelworkers union. According to reports, the individuals in the 
indictment are accused of stealing trade secrets to benefit Chinese 
industry, which is heavily sponsored by the Chinese Government.
  This is just the latest example of the unlevel playing field to which 
our domestic firms are subjected. To give an example, Pennsylvania, as 
are many areas around the United States, is experiencing an energy 
renaissance--Pennsylvania natural gas--which stands to greatly benefit 
the Commonwealth's economy. For the steel industry, it means the 
opportunity to sell a lot of pipe to natural gas drilling sites. Our 
foreign competitors also see this opportunity and have responded by 
aggressively pursuing our market. This competition is expected and 
would be OK if--if--it was fair. Of course, in this instance it is not.
  In fact, our domestic steel industry is facing a new crisis. After 
successfully beating back unfair competition from the Chinese, our 
domestic producers are facing a surge of imports from around the globe. 
According to a recent report by the Economic Policy Institute, domestic 
steel imports increased by almost 13 percent from 2011 to 2013. Without 
action, we stand to lose half a million jobs around the United States 
and some 35,000 in Pennsylvania alone. Just from this action, just from 
them flooding our markets in a way that is illegal and unfair, half a 
million jobs could be lost. We can't afford to send these good-paying 
jobs overseas.
  We should act to level the playing field for our domestic steel 
industry by aggressively enforcing our trade laws and providing 
essential relief to this critical industry. For too long unfair trade 
practices and economic policies have cost jobs in the Commonwealth of 
Pennsylvania and across the country.
  I will return now to the recent indictment I mentioned at the outset 
of my remarks.
  This move is further evidence of China's anticompetitive trade 
practices. What I just said is an understatement. These trade practices 
have taken a dramatic toll on Pennsylvania businesses and pose a threat 
to our national security.
  The Obama administration has taken steps to crack down on China, but 
we must also pursue congressional action. We know that currency 
manipulation continues to take a huge toll on U.S. businesses. Last 
Congress, the Senate passed a tough bill to help level the playing 
field for our companies by holding countries that undervalue their 
currency accountable. The House failed to take up this important bill. 
We must take action.
  I am an original cosponsor of the Currency Exchange Rate Oversight 
Reform Act of 2013. I call on all Senators to turn our attention to 
this bill to send a strong message to the Chinese Government that they 
cannot continue to cheat our companies. When China cheats, we lose 
jobs. It is that simple. The evidence is overwhelming. Our bipartisan 
bill will help American manufacturers and workers by clarifying that 
our trade enforcement laws can and should be used to address currency 
undervaluation. More broadly, the bill would improve oversight by 
establishing objective criteria to identify misaligned currencies. 
Also, it would impose tough consequences for offenders.
  I believe strongly that before proceeding with our busy trade agenda, 
as some might want to do, and passing additional trade agreements or 
fast-track legislation, we should take a close look at our trade 
enforcement policies first, including aggressively addressing currency 
manipulation.
  Pennsylvania companies are some of the best in the world, and I am 
committed to cracking down on unfair trade practices that hurt their 
ability to compete.
  Madam President, I yield the floor and note the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. HATCH. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Markey). Without objection, it is so 
ordered.
  Mr. HATCH. Mr. President, I ask unanimous consent that I be permitted 
to finish this speech.

[[Page 9017]]

  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Religious Liberty

  Mr. HATCH. Mr. President, I rise today to speak about our Nation's 
first freedom--religious liberty.
  Last week a court in Sudan sentenced a woman to death for converting 
from Islam to Christianity and gave her just days to recant. Sadly, 
this sort of tragic oppression is common across the globe.
  The Pew Research Center says that three-quarters of the world's 
people live where restrictions on religion are high or very high and 
that religious hostilities have been increasing for years.
  In the last 10 years the number of countries on the Commission on 
International Religious Freedom's watch list has grown by 150 percent. 
Simply put, religious freedom is increasingly in peril around the 
globe.
  When compared to the rest of the world, some might think that 
religious liberty in America is alive and well. But, in truth, basic 
religious freedom is under attack here at home. Professor Thomas Berg 
writes that ``establishing freedom of religion as both constitutional 
principle and social reality is among America's greatest contributions 
to the world.'' But we have to ask ourselves whether meaningful 
religious liberty is still such a reality in American society and 
whether our Nation is still making that essential contribution to a 
world that needs it now more than ever.
  Hundreds of books, studies, papers, articles, and court decisions 
have explored various aspects, nuances, and implications of religious 
freedom. In the coming days and weeks, I will explore some of these 
issues in greater detail. Today I wish to speak about the definition 
and importance of religious freedom in America as seen both in history 
and in four important documents.
  For 170 years before Thomas Jefferson penned the Declaration of 
Independence, one religious society after another came to America so 
that they could live their faith. Puritans, Congregationalists, Roman 
Catholics, Jews, Quakers, Baptists, Presbyterians, and Methodists had 
all found refuge in the British Colonies by the time the United States 
was born. Roger Williams founded Rhode Island as a haven for religious 
dissenters. William Penn established religious liberty in the colony 
that bears his name.
  From its earliest days, religious freedom in America has been freedom 
not only of belief but also of behavior. In addition to our Nation's 
early heritage, four key documents establish the same understanding of 
religious freedom as encompassing both belief and behavior in both 
private and public spheres.
  The first document is the U.S. Constitution. The First Amendment 
protects the free exercise of religion, a phrase that on its face 
plainly includes conduct as well as belief. It is a phrase that had 
been in use for more than a century when America's Founders placed it 
in the First Amendment. The plain meaning of this phrase, as well as 
its history, is simply incompatible with the view that our 
constitutional freedom of religion is limited to the profession of 
belief and somehow excludes religious conduct.
  As Professor Michael McConnell, director of the Constitutional Law 
Center at Stanford and perhaps America's leading scholar of religious 
liberty has shown, such an artificial and cramped view is 
unsupportable. By its own terms our First Amendment protects both 
religious faith and action.
  The second document is the Universal Declaration of Human Rights, 
which the United States signed in 1984. Article 18 states that every 
person has the fundamental ``right to freedom of thought, conscience 
and religion,'' and that ``this right includes . . . freedom, either 
alone or in community with others and in public or private, to manifest 
his religion or belief in teaching, practice, worship and observance.''
  Plainly stated, religious liberty by its very nature encompasses both 
belief and behavior. In articulating broad principles of basic human 
rights, the authors of the Universal Declaration of Human Rights 
acknowledge that it is meaningless to have one without the other.
  The third document is the Religious Freedom Restoration Act. In 1990, 
the U.S. Supreme Court held that government needs only a rational basis 
for laws that burden but do not target the free exercise of religion. 
That decision changed decades of Supreme Court precedent that had 
required a compelling reason for laws that burden the exercise of 
religion.
  This shift was not just some legalistic or semantic exercise. If 
government needs only a rational justification for burdening the 
exercise of religion, it could do so essentially at will, but if 
government must have a compelling reason, it must respect the 
fundamental liberty and may burden it only when absolutely necessary.
  By shifting from one standard to the other, the Supreme Court made it 
dramatically easier for government to burden the free exercise of 
religion. Congress responded to the Supreme Court's decision with the 
Religious Freedom Restoration Act, or RFRA, which established the 
compelling standard. It passed the House unanimously by voice vote and 
the Senate by a vote of 97 to 3.
  I was the primary Republican cosponsor of the Religious Freedom 
Restoration Act in the Senate. In all of our discussions about RFRA, 
both Democrats and Republicans were united on one fundamental 
principle, the right of all Americans to the free exercise of religion 
should be equally protected.
  I remember when I went to Ted Kennedy, I said: You are going to be on 
this bill with me.
  He said: No, I am not.
  I said: Yes, you are.
  To his credit, he came on the bill. By the time we articulated on the 
floor and afterward when it was signed by President Clinton at the 
White House, on the White House south lawn, one of the biggest boosters 
was my friend Ted Kennedy.
  The fact is I will make that point again. As the primary sponsor of 
the Religious Freedom Restoration Act in the Senate, in all of our 
discussions about RFRA, both Democrats and Republicans were united on 
one fundamental principle: the right of all Americans to the free 
exercise of religion should be equally protected.
  Each religious claim should be judged by the same standard as every 
other, a standard that reflects the true importance of religious 
freedom. We rejected amendments that would have excluded some religious 
claims or favored others.
  In October 1993 I spoke in favor of RFRA on the Senate floor, 
explaining that the bill would restore to all Americans protections of 
the free exercise of their religious conviction. In fact, I stated 
directly that exempting anyone from the basic principle of free 
exercise would set a dangerous precedent.
  The fourth and final document is the International Religious Freedom 
Act enacted in 1998. The House passed it by an overwhelming bipartisan 
majority. The Senate followed suit by a vote of 98 to 0. This law 
established the U.S. Commission on International Religious Freedom, and 
declared that ``the right to freedom of religion undergirds the very 
origin and existence of the United States.''
  It cited the Universal Declaration of Human Rights and reaffirmed yet 
again that religious freedom necessarily includes both belief and 
practice, individually or collectively, in public or in private. As the 
U.S. Commission on International Religious Freedom has explained, by 
its very nature religious liberty is ``a broad, inclusive right, 
sweeping in scope, embracing the full range of thought, belief, and 
behavior.''
  It is central to human identity and dignity. It is essential to 
individual and social well-being. It is beneficial to political, 
economic, and civic life. Religious freedom is a fundamental 
constitutional liberty as well as a universal human right.
  In America religious liberty has always included both the freedom to 
believe and the freedom to act on that belief, the protection to do so 
collectively as well as individually, and the right to do so publicly 
as well as privately. Those basic tenets form the only proper standard 
by which to assess the state of religious freedom in America today.

[[Page 9018]]

  Unfortunately, there is much cause for concern. Let me share a few 
disturbing examples. The equal and universal application of religious 
liberty is now in doubt. Congress was united when enacting the 
Religious Freedom Restoration Act that the right to exercise religion 
freely belongs to everyone and should be protected by the same rigorous 
standard in each case.
  When balanced against important government interests, some religious 
claims would win and others would lose, but a rigorous legal standard 
that creates a high hurdle for government action that burdens religion 
must be applied universally, since the free exercise of religion is a 
fundamental right of all Americans.
  That conviction, however, is unraveling. This year marks the 50th 
anniversary of the Civil Rights Act of 1964. Title VII of that landmark 
law prohibits workplace discrimination based on religion and requires 
that employers reasonably accommodate the religious practices of 
employees. The Supreme Court, however, interpreted the ``reasonably'' 
so broadly that the exception swallowed the rule and workers have been 
without this legal protection ever since.
  Legislation called the Workplace Religious Freedom Act was introduced 
to reestablish legal protection and accommodation for religious 
workers. Originally, it applied this protection to all religious 
claims, just as RFRA required. It would balance the right to religious 
exercise with the legitimate needs of employers, but the most recent 
version of this legislation introduced in the 112th Congress abandoned 
universal applicability and instead would protect some religious claims 
but not others.
  Rather than allowing religious claims of all varieties to stand or 
fall under the same standard, some claims were covered and others were 
excluded from that standard altogether. This is not the only example of 
religious liberty under attack. Among its many other maladies, 
ObamaCare likewise struck a blow to the free religious exercise of 
religion.
  Although President Obama has called religious freedom a universal 
human right, his administration apparently paid that fundamental 
liberty no regard when drafting ObamaCare. Likewise, the Religious 
Freedom Restoration Act plainly states that its basic religious 
protections apply to every future Federal statute. Yet the Obama 
administration gave no consideration whatsoever to such religious 
freedom in formulating the President's signature law, ObamaCare.
  As a result, dozens of lawsuits have challenged ObamaCare's 
requirement that employers provided no-cost health insurance coverage 
for abortifacient drugs and devices as a violation of RFRA's plain 
protections. Two of those cases are before the Supreme Court, one from 
the U.S. Court of Appeals for the Tenth Circuit and one from the Third 
Circuit.
  In the face of its clearly universal requirement, the Obama 
administration nevertheless argued that the Religious Freedom 
Restoration Act does not apply to these plaintiffs. Despite the 
statute's plain text, Obama officials insist that the law does not 
apply to all cases after all. One step at a time, they seek to exclude 
classes of citizens from the basic protections of religious liberty.
  My final two examples involve recent Supreme Court decisions. In 
Hosanna-Tabor v. EEOC, the Supreme Court unanimously held that the 
First Amendment's protection for the free exercise of religion allows a 
church to choose its own ministers. The Obama administration argued 
instead that civil rights statutes trump the Constitution and allow 
judges to dictate to churches who may serve as ministers.
  In fact, as the Supreme Court described it, Obama administration 
lawyers were so dismissive of religious freedom that they argued 
churches were no different in this regard than labor unions or social 
clubs. Can you imagine that? To the Obama administration, the First 
Amendment and its protection for the free exercise of religion 
apparently offers no real protection at all. Thankfully, the Supreme 
Court responded this way: ``We cannot accept the remarkable view that 
the Religion Clauses have nothing to say about a religious 
organization's freedom to select its own ministers.''
  Finally, just 2 weeks ago, the Supreme Court held that allowing 
citizens to offer a prayer of their choice to open a town meeting is 
not an establishment of religion, but four Justices joined a dissenting 
opinion arguing that only certain prayers, using certain language, in a 
certain pattern, would achieve a certain level of diversity and 
therefore be permissible. Four Justices actually believe Federal judges 
may dictate the content and presentation of prayers offered by private 
citizens.
  I can offer many more examples of how our Nation's cherished 
religious freedom is under attack, with forces seeking to limit, 
regulate, manipulate, and undermine the most basic natural and 
constitutional rights we possess.
  I mentioned at the outset that three-quarters of the world's 
population lives under substantial religious restriction. Here at home, 
the same percentage of Americans believes that religion is losing its 
influence in American life. Liberal politicians, secular activists, and 
even some judges are seeking to reduce religion to what Justice Antonin 
Scalia described as ``a purely personal avocation that can be indulged 
entirely in secret, like pornography, in the privacy of one's room.''
  It is no wonder that nearly one-quarter of Americans say religious 
freedom is more threatened than any other First Amendment freedom. 
These recent efforts mark a radical departure from the religious 
freedom that took root in our colonial experience, was nourished by the 
Declaration of Independence, earned a primary place among our 
constitutional liberties, and has been generously applied by 
generations of Americans.
  The notion that religious freedom belongs only to some, even then 
only in private, stands in direct opposition to our traditions, our 
laws, and our beloved Constitution. Some peoples throughout the world 
may be bound by oppressive governments that strictly regulate who may 
express their religious faith, when they may practice the tenets of 
their faith, and where they may act according to their religious 
convictions.
  But that is not America's heritage, and it must not be our future. 
Instead, America must once again be a beacon of religious freedom for 
all--protecting rights of conscience at home and promoting religious 
liberty throughout the world--and I expect it to be that.
  I am hopeful our courts will come to their senses--the ones that 
aren't there--and realize this was listed as the first freedom in the 
Bill of Rights for a very good reason; that is, because our Founding 
Fathers knew how important religion is to a nation that wants to be 
free.
  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. REID. I ask unanimous consent that the order for the quorum call 
be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


             Unanimous Consent Request--Executive Calendar

  Mr. REID. There have been a number of inquiries and statements made 
today, one by the Chamber of Commerce, saying the reason that Stanley 
Fischer, the Vice Chair of the Board of Governors of the Federal 
Reserve System, hasn't been done is because of me. Try that one on for 
size.
  That is what happens around here. Here is a man who has been approved 
with a very strong vote, a strong vote, bipartisan vote, to be a member 
of the Board of Governors of the Federal Reserve System. He is 
eminently qualified, nationally and internationally. You can't become 
vice chair until you become a member of the board.
  Janet Yellen has called, the Chairman of the Federal Reserve, and 
said: It would really be important. He has administrative duties that 
we need his help with.
  So I have made inquiry with my Republican colleagues: Why don't we do

[[Page 9019]]

him? We have already approved him. But we have a situation around here 
where no one gets approved. We will eat up time, this will take hours--
wasted time--and then we will approve him. In the meantime, all we do 
is eat up the taxpayers' time.
  Anyway, without further dialog from me, I would simply say that the 
Chamber of Commerce and others should understand every person on this 
side of the aisle would approve him in a second. I would do it by 
unanimous consent. I would have a vote as soon as we can, which, 
without having filed cloture, wouldn't be until we get back a week from 
Monday.


              Unanimous Consent Request--Calendar No. 767

  Mr. President, I ask unanimous consent that the Senate proceed to 
executive session to consider Calendar No. 767, the nomination of 
Stanley Fischer to be Vice Chairman of the Board of Governors of the 
Federal Reserve System for a term of 4 years; that the nomination be 
confirmed, the motion to reconsider be considered made and laid upon 
the table, with no intervening action or debate; that no further 
motions be in order to the nomination; that any related statements be 
printed in the Record; and that the President be immediately notified 
of the Senate's action and the Senate then resume legislative session.
  The PRESIDING OFFICER. Is there objection?
  Mr. HATCH. Mr. President, on behalf of Senator Paul, I will have to 
object.
  The PRESIDING OFFICER. Objection is heard.
  Mr. REID. May the Record be spread that Harry Reid, who is being 
blamed for this nomination not being put forward, is not at fault. I 
don't mind taking the fall for some things--and I probably have 
deserved a few things--but not this.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. HATCH. I ask unanimous consent that the order for the quorum call 
be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. HATCH. Mr. President, I note for the record that I support Mr. 
Fischer for this position, but there is a legitimate objection by a 
Senator on our side that I had to advance. I hope we can resolve these 
problems, but I appreciate the distinguished majority leader's attempt 
to do this today.
  With that, I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. MURPHY. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Ms. Heitkamp). Without objection, it is so 
ordered.


                        The Affordable Care Act

  Mr. MURPHY. Madam President, I want to tell my colleagues a story 
about Charlene Dill.
  On March 21 Charlene Dill was supposed to bring her three children 
over to the South Orlando home of her best friend Kathleen. The two 
friends had cultivated a really close relationship since 2008. They 
shared every resource they had from debit card pins to transportation 
to babysitting to house keys. They helped one another out. They 
essentially had become each other's safety net.
  As Kathleen described it, they hustled. They picked up short-term 
work. They went to every event they could get free tickets to for their 
kids. They lived the high life on the lowdown. They cleaned houses for 
friends just so they could afford the daily necessities of life. They 
were the quintessential working poor, and they existed in the shadows 
of this economic recovery that is yet to reach a lot of average people 
out there.
  On March 21, when Dill never showed up with her three kids, who often 
came over to play with Kathleen's 9-year-old daughter, Kathleen was 
surprised she didn't even get a phone call from her friend Charlene. 
She shot her a text message--something along the lines of ``thanks for 
ditching me''--without knowing what had really happened.
  Charlene, who was estranged from her husband, had been raising her 3 
children alone--ages, 3, 7, and 9. She had picked up another odd job to 
try to pay the bills. She was selling vacuums on commission for Rainbow 
Vacuums.
  On that day, in order to make enough money to survive and--as you 
will understand--keep herself alive, she made two last-minute 
appointments. At one of those appointments in Kissimmee, she collapsed 
and died on a stranger's floor.
  Charlene had a documented heart condition for which she took 
medication, but she often could not afford the medication, and her 
friend Kathleen often had to turn to crowd-funding Web sites to help 
raise the money that her friend Charlene needed to pay for her heart 
medication. Charlene was the working poor, but she was also among the 
uninsured. After her death, her friend Kathleen used that same crowd-
funding method that she used to occasionally pay for her friend's 
medication to pay for Charlene's funeral.
  Florida has made the decision not to expand Medicaid coverage under 
the Affordable Care Act. They have made a decision--for political 
reasons--to keep hundreds of thousands of people such as Charlene among 
the ranks of the uninsured. The consequences are for many such as 
Charlene absolutely deadly.
  Charlene died because she was on the outside of our health care 
system. Occasionally she would get to see a doctor and occasionally she 
would get the medication she needed for her condition--in part--because 
she had one good friend who went out of her way to try to help 
Charlene.
  The reality is that there are 5.7 million people all across this 
country who have been denied the chance to get health care through 
Medicaid simply because their Governors or their State legislatures 
have decided to score a political point against a President whom they 
don't like by refusing Federal dollars in order to expand Medicaid, and 
that is what this is all about. This is not about good policy, this is 
not about health care, and this certainly is not about finances. This 
is just about a bunch of really angry Republicans that don't want to 
participate in a health care reform law passed by Democrats even though 
they are essentially giving away the money of their constituents.
  The first reason you should do this is because it keeps people such 
as Charlene alive. A 2002 Harvard study of 3 States that expanded 
Medicaid--Arizona, Maine, and New York--showed that the expansion of 
Medicaid in those States was responsible for a 6-percent reduction in 
mortality as compared to other States. It found that for every 500,000 
adults that gained Medicaid coverage, we prevent 3,000 deaths a year.
  I am not really good with quick math, but that is 3,000 deaths 
prevented for 500,000 people covered by Medicaid. We are talking about 
5.7 million adults that are being denied Medicaid because of these 
political decisions; that is a lot of people who are dying needlessly 
every year. That is the first reason you should do it, because it is 
the right and compassionate thing to do.
  The second reason you should do it is because people in States such 
as Virginia or Texas--there are 1.2 million people in Texas alone. 
There are 1.2 million people who could have health care insurance but 
don't have health insurance in one State because the Governor and 
legislature don't like President Obama.
  This is also about those constituents essentially giving their money 
away to other States. The message to people in States such as Florida, 
Virginia, and Texas is that you are funding people getting insurance in 
other States because the Federal Government is contributing almost the 
entire cost of this Medicaid expansion. Texas and Florida's dollars are 
going to Washington and being spent to subsidize the health care of 
somebody else. It does not make any sense from a health care standpoint 
and it certainly doesn't make any sense from a fiscal standpoint. It is 
not just the taxpayers and patients who are getting hurt, but it is all 
the health care providers as well.

[[Page 9020]]

  An Urban Institute study found that hospitals across the country are 
being denied $294 billion because of this refusal to expand Medicaid. 
The Presiding Officer knows this because she has worked in and around 
health care policy her entire life. This idea that denying people 
health care insurance denies them health care is patently false. They 
get health care. They just don't get it until they are so sick they 
show up at the emergency room door and their condition is at a crisis 
point, and then that costs infinitely more. All of this money we are 
spending could be spent in a different place, such as on preventive 
care, instead of on crisis care.
  With a new Secretary of HHS, there is an opportunity for these States 
to think differently. From the beginning, HHS has been incredibly 
willing to be flexible with Governors who are not quite sure of the 
politics of joining in the ACA but know it is the right thing to do. 
States such as Arkansas, Iowa, and Pennsylvania have come up with 
innovative programs in which they take the Medicaid expansion dollars 
and instead of using them to expand State-based Medicaid, they use 
those dollars to help people buy private coverage. It seems to make a 
lot of sense to me.
  At her confirmation hearing, Ms. Burwell said she was willing to 
continue to be as flexible as she possibly could with States that want 
to explore these innovative methods. Hopefully, with a new Secretary 
coming through the doors at HHS, maybe this is a new moment for these 
States to take another look at Medicaid expansion because this is just 
a matter of conscience.
  Madam President, 5.7 million people are going without health care and 
potentially dying, as Charlene Dill did, simply because of politics.
  David from Virginia wrote:

       I am the coverage gap. I am a single 41-year-old male. I 
     save Medicaid thousands of dollars per month by caring for my 
     99-year-old grandmother at home without pay, rather than 
     place her in a nursing home at Medicaid's expense. I do not 
     qualify for Medicaid even though I have a zero income. I have 
     to cross the state line, into Kentucky to receive potentially 
     lifesaving cancer screenings and hopefully receive treatment 
     if I get bad news. Virginia Republicans hate the president 
     and governor so much, they are willing to let thousands of us 
     die. It is high time that these delegates place human lives 
     ahead of party politics and do what is right, for a change!

  Eight million people have signed up through the exchanges. Despite 
these decisions by Governors and Republican State legislatures, 5 to 6 
million more have been added to Medicaid, and 3 million young adults 
have coverage for the first time.
  Prices to the Federal Government are falling. We are spending 
trillions less than we thought we would spend on health care because of 
the Affordable Care Act. Quality is increasing. The number of 
readmissions to hospitals and hospital-acquired infections are 
decreasing because we are starting to pay for outcomes instead of 
paying for performance.
  People are figuring out that the Affordable Care Act works, and that 
is why there are fewer Republicans coming to the floor of the Senate 
and the House complaining about it, and that is why the Koch brothers 
and others have stopped running all of these ads about the Affordable 
Care Act.
  The Affordable Care Act works, but it only works if leaders actually 
try to implement it. It doesn't work if you ignore it for political 
spite, and that is what is happening in State legislatures and 
Governors' mansions all across the country.
  We have a new Secretary of HHS and a new willingness of a lot of 
Republican Governors, including Mike Pence in Indiana, to take a look 
at trying to reverse this reality for 5\1/2\ million people who--if not 
for the political actions of their State leaders--could also figure 
out, as millions and millions of others are doing on a daily basis 
across the country, that the Affordable Care Act works.
  I yield the floor and note the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. BARRASSO. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BARRASSO. Madam President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                              Health Care

  Mr. BARRASSO. Madam President, I come to the floor after having just 
heard my friend and colleague from Connecticut talk about the health 
care law. As a doctor, I am always happy to hear about people who are 
getting better care. My concern is that there are so many people across 
this country who have been hurt as a result of this health care law 
that I feel compelled to speak about so many of the side effects of the 
President's health care law and families who are seeing the government 
waste massive amounts of money that is not going for care. It is not 
helping people actually get better. It is not giving them the care they 
need from a doctor they choose at lower costs, which is what the 
President promised when he said premiums would drop by $2,500.
  I heard the President, as well as my colleague here today, say that 
this law will help keep people out of emergency rooms and they will go 
to primary care doctors instead. So I feel compelled to come to the 
floor to share with my colleagues a study that just came out on 
Wednesday, and perhaps some Members of the Senate who weren't aware of 
it will be made aware that the emergency room visits actually have been 
going up, not down, despite the law. This was the headline in the Wall 
Street Journal this past Wednesday, May 21: ``ER Visits Rise Despite 
Law. Health Act Isn't Cutting Volume.''
  I will point out a couple of things mentioned in this article. It 
starts off:

       Early evidence suggests that emergency rooms have become 
     busier since the Affordable Care Act expanded insurance 
     coverage this year, despite the law's goal of reducing 
     unnecessary care in ERs.

  My colleague said emergency rooms aren't going to be needed as much. 
Well, despite the law's goal of reducing unnecessary care in ERs, what 
we see is an expensive side effect of the President's health care law.
  It goes on to say:

       Democrats who designed the 2010 health law hoped it would 
     do the opposite. They wanted to give the uninsured better 
     access to primary-care doctors who could treat routine 
     ailments and prevent chronic diseases, with the intent of 
     keeping patients out of the ER. The median ER charge was more 
     than $1,200 for the most frequent outpatient diagnoses in a 
     study of over 8,000 ER visits in the years 2006-08, said a 
     2013 report funded in part by the National Institutes of 
     Health.

  This is a report by the NIH.

       Instead, the ER doctor group's research and several other 
     recent studies suggest that people who gain private insurance 
     are more likely to seek emergency care.

  Not more likely to go to a family physician, not more likely to go to 
their own internist or pediatrician; more likely to go to the emergency 
room--the most expensive place for care--despite what the President 
told the American people.

       Among the reasons is that a shortage of primary-care 
     providers in some regions has made it difficult for patients 
     to get appointments.

  So why is there a shortage? Well, if the President's health care law 
actually focused on training physicians, putting money into educating 
and training more providers, instead of putting all of this money into 
hiring IRS agents to examine Americans' tax returns to make sure they 
check the box that says they have insurance and can provide proof of 
that, perhaps we wouldn't have these problems. But now we are seeing a 
very expensive side effect of the President's health care law.
  While we can celebrate people who are helped by the law, there are so 
many people being hurt by the law in every State around this great 
country. We heard about a family from Connecticut who has benefited 
from the law. There are many who have been hurt.

[[Page 9021]]

  There is a couple in Sharon, CT, according to NBC Connecticut. They 
were dropped, according to the headline, from their health care plan. 
It says:

       A Sharon couple says they are running out of options after 
     being dropped from their ObamaCare insurance plan. John and 
     Dawn DiMarco signed up for an Affordable Care Act plan 
     through the state health insurance exchange during open 
     enrollment. They received their insurance card and were 
     covered but their bill was thousands of dollars more than 
     advertised.

  What could happen there?
  It says:

       They spent weeks going back and forth with various State 
     agencies and the insurance company to try to get answers.

  This is dated May 13 of this year.

       Then, this month, their carrier, Anthem BlueCross 
     BlueShield, sent them a cancellation notice. The DiMarcos 
     have been so frustrated with trying to get answers that they 
     posted a sign outside their home that reads--

  This is in Connecticut--

       ``We have no insurance because Access Health has a computer 
     glitch.''

  It's stressful, says Mr. DiMarco. It's overwhelming.
  So why did this happen?
  Well, NBC Connecticut contacted Access Health Connecticut, and they 
told them that it had to do with a computer issue with a vendor, and 
when this gentleman went back to change information during the 
enrollment process, a new form was sent to the insurance company, but 
that form didn't include the couple's subsidy. So the form paperwork 
was wrong.
  How could this happen? Is it just this one DiMarco couple whom this 
has happened to in Connecticut? Not according to a front-page story in 
the Washington Post the other day. The headline is ``Federal health-
care subsidies may be too high or too low for more than 1 Million 
Americans''--paying incorrect subsidies to more than 1 million 
Americans for their health plans, and the government has been unable so 
far to fix the errors.
  The President of the United States goes on TV and says to the 
Democrats: Forcefully defend and be proud.
  Who in America can be proud of the mess the President and his 
administration have made of the Web site and this health care bill? 
Once again, we see, as the Washington Post points out, important 
aspects of the Web site remain defective. They cannot fix this. 
Actually, I am not even sure how hard they are trying. People have been 
sending in paperwork. They are expecting, perhaps, by the end of the 
summer to be able to address the problem that there are 1 million 
Americans whose Federal health care subsidies may be either too high or 
too low.
  ``Forcefully defend and be proud.'' Where are they? Where are these 
defenders? It is sad because the idea is this is to actually help 
people get care. What people have gotten is headaches and heartaches 
and one problem after another.
  It is also interesting, as a doctor who has been very involved with 
preventive care and working on early detection of problems and as 
somebody who has been the medical director of the Wyoming health 
fairs--I think it is important to screen people for problems. It is 
interesting. The New York Times even reported in an article written on 
April 30 on the problem with the health care law that it favors 
screening over diagnosis. So here is one of the issues that come into 
play.
  My wife is a breast cancer survivor. She has been through three 
operations, chemotherapy twice, radiation, the whole thing. She is now 
cancer free. We are delighted. So I think screening tests are 
important. But this is the problem with this law that I believe very 
few Democrats read--very few of the people who voted for it read. I 
believe that about Members of the House and Members of the Senate. I 
read it cover to cover, but I believe many Members who voted for it 
never read it.
  They say: Diagnosis is what we offer to those who have no signs or 
symptoms of disease. Because diagnosis isn't prevention, it is subject 
to deductibles and copays.
  So if somebody actually has a diagnosis of something, there are 
deductibles and copays, but if it is just a screening test, no signs or 
symptoms, then it is covered.
  The New York Times goes on:

       In other words: A woman over 40 can have a free screening 
     mammogram.

  She shows up and says: I want a free screening mammogram. But if she 
notices a breast lump and goes to her doctor to have it evaluated, 
well, then it is not a screening mammogram. Then it is not a free test. 
So she will pay for the diagnostic mammogram that costs $300.
  This goes on:

       So the woman at lower risk for cancer--the one with no 
     signs or symptoms of the disease--has an incentive to be 
     tested, while the woman at higher risk--the one with the 
     lump--faces a disincentive.

  So she goes to the doctor. This goes on and says that the problem is 
they are now pressuring doctors to fraudulently change the paperwork so 
it complies with the screening test and not a diagnostic test. Doctors 
don't want to do that because they want to be honest. Yet the 
incentives set up in this program are to discourage the woman who finds 
a lump from actually going in to have the test, while encouraging 
somebody off the street to go in and have a similar test. It is a great 
concern.
  So when I see a colleague come to the floor to say that the health 
care law, in his opinion, works--I will tell my colleagues, this is an 
Associated Press story that says: ``Consumers frustrated by new health 
plans as they find their doctors are not included.'' They can't go to 
their doctor.
  This is a story out of California. Michelle Pool is one of those 
customers. Before enrolling in a new health plan on California's 
exchange, she checked whether her longtime primary care doctor was 
covered. This woman, Michelle Pool--60 years of age, a diabetic; she 
has had back surgery and a hip replacement--purchased the plan only to 
find that the insurer was mistaken; the doctor wasn't included. So her 
$352-a-month gold plan, she said, was cheaper than what she had paid 
under her husband's insurance and it seemed like a good deal because of 
her numerous preexisting conditions.
  I understand preexisting conditions as the husband of a woman who has 
been through breast cancer treatment. This goes on to say:

       But after her insurance card came in the mail, the Vista, 
     California resident learned her doctor wasn't taking her new 
     insurance.

  It goes on to say, quoting this woman:

       ``It's not fun when you've had a doctor for years and years 
     that you can confide in and he knows you,'' Pool said. ``I'm 
     extremely discouraged. I'm stuck.''

  This is an American who is stuck and hurt by the health care law. It 
goes on to say:

       The dilemma undercuts President Obama's--

  This is an Associated Press article--

       The dilemma undercuts President Obama's 2009 pledge that: 
     ``If you like your doctor, you will be able to keep your 
     doctor, period.''

  The President said: ``period.'' But one of the side effects of the 
President's health care law is that people are continuing to lose their 
doctors.
  It goes on to say:

       Consumer frustration over losing doctors comes as the Obama 
     administration is still celebrating a victory with more than 
     8 million enrollees in its first year.

  There are astronomical concerns that people across the country are 
expressing about this health care law. And yet--and yet--we see one 
Member of the other party coming to the floor and saying: Oh, it is 
working.
  The American people do not believe it is.
  People get insurance through work. The laws are interesting. This is 
a story from Ohio about the cost because that is what really people 
were concerned about when we wanted to do health care reform; it was to 
say let's get the cost down. The President promised families would see 
a $2,500 reduction in the cost of their insurance policies in a year 
once all of this was implemented. But one of the side effects is 
actually higher premiums. This article talks about a man who owns a 
popular brew pub in Cleveland. He has fewer than 50 full-time 
employees. So he is classified under the health care law as a small 
business, which means

[[Page 9022]]

he does not actually have to provide health insurance to his employees. 
But he has been doing so. He has been doing so since he opened this pub 
a number of years ago, and he has done it in spite of some fairly 
significant jumps in the cost of the insurance.
  He said: ``They just seemed to keep going up every year.''
  He opened this pub in 2009. One year he got an increase of 38 
percent; another it was 11 percent.
  The article says: ``This year, under the Affordable Care Act, he saw 
another hike--this one about 20 percent.'' So he is seeing higher 
premiums. He said: ``It just seems odd that we get such a drastic price 
increase when nothing has really changed with us as far as our 
employees and health issues.''

       Most of the workers at [his place] are in their 20s and 
     30s. They are healthy, enthusiastic about their jobs. . . .

  They like the fact that they get insurance, but they are getting 
priced out of the market. That is the concern about this: the health 
care law is making premiums go up.
  From today, Thursday, May 22, The Hill newspaper, right here in 
Washington, DC: ``Premium hike drumbeat before Nov. Election Day.''
  People continue to be shocked by the increases in the cost of their 
insurance, and they are going to go up again across the country. There 
are a number of reasons for that. We have seen it in North Carolina, 
where I expect this is going to be discussed and debated over the next 
months.

       Blue Cross and Blue Shield of North Carolina. . . .

  This comes from the Herald-Sun in North Carolina: ObamaCare enrollees 
older, sicker than insurer forecast--older and sicker than what the 
President told--actually it was not the President; it was Kathleen 
Sebelius, the Secretary of Health and Human Services, when she 
described what she thought success would look like in terms of the 
number of young healthy people who would sign up. It says:

       Blue Cross and Blue Shield of North Carolina officials 
     said--

  This is dated May 8--

       . . . that they found that the people who enrolled in the 
     individual Affordable Care Act plans it sold on the online 
     health exchanges were older and sicker than expected.
       That may mean higher rates--

  Higher premiums--

     for Affordable Care Act plans in the future. . . .

  The insurer's vice president of health policy said: ``[It's] a 
concern when we think about future premiums.''
  They have great concerns about the amount things are going to go up. 
That is not what people want. People wanted affordable care. They 
wanted access to care. They wanted to get the care they need from a 
doctor they choose at lower cost. What they see is waste--money not 
going to help people get care, but money being wasted.
  I found it interesting coming out of Missouri, a story about how an 
ObamaCare contractor pays employees to spend their days doing nothing--
doing nothing--paying their employees to do nothing.

       ``A billion dollar government contract involving hundreds 
     of local workers at an ObamaCare processing center. . . . ''

  So these are people hired by the government or a contractor to work 
at an ObamaCare processing center--hundreds of local workers.

       ``But now employees on the inside are stepping forward, 
     asking, Is this why we're broke? Some of them claim to spend 
     most of their day doing nothing,''. . . .

  This is reported in St. Louis.

       The contractor is called Serco and local reporters 
     discovered that, despite there not being any work to be done, 
     the government contractor is still hiring.

  Why would they be hiring? Because they get a percent of the action. 
That is why they are hiring. They are hiring people to not do anything, 
to take the paycheck. The article continues:

       ``The company is still hiring,'' says a local reporter. ``A 
     current employee wonders why. . . . After providing proof of 
     employment, this . . . employee agreed to speak through the 
     phone with their voice altered. The employee says hundreds of 
     employees spend much of the day staring at computer screens, 
     with little or no work to do.''
       The reporter asks the employee, ``Are there some days where 
     a data entry person may not process a single application?''

  Not a single application? The person who works there said: ``There 
are weeks''--weeks--``when a data entry person would not process an 
application.''

       The anonymous employee says the contract gets paid by the 
     federal government per employee hired.

  That is why they are continuing to hire--because the company gets 
paid by the Federal Government per employee hired, which is why it is 
in their interest to have a bunch of employees sitting around all day 
doing nothing.
  So I have to feel an obligation, when I hear a statement on the floor 
being made that says: Well, a lot fewer people are going to go to the 
emergency room; it is going to save money--that has not happened. 
Studies from emergency room doctors, work from the NIH said it is not 
happening. The exact opposite has happened--a side effect of the health 
care law, when we see that people are not able to keep their doctors, 
in spite of the President promising people that if you like your 
doctor, you can keep your doctor. I feel compelled to come to the floor 
and share that story with those of us who care about care for patients, 
who care about finding a way to make sure patients get the care they 
need from a doctor they choose at lower cost. That is what people want. 
They know what they want. They want access to care. They want 
affordable care. They want care, they want choices, and they want 
quality care.
  I believe this health care law is turning out to be bad for patients, 
bad for providers--the doctors, the nurses, the paramedics, the nurse 
practitioners--who take care of those patients, and terrible for the 
taxpayers when we hear stories like this one out of Missouri, which 
says the employees are being paid to sit around and do nothing, when we 
hear there are a million people who are just waiting to try to get the 
government to correct something that should have been fixed in the 
beginning, when the President, 4 days before the Web site opened up in 
October, said: easier to use than Amazon, cheaper than your cell phone; 
keep your doctor if you like your doctor--there was so much misleading 
of the American public--and then when he says stand and forcefully 
defend and be proud of this health care law.
  I think it is very hard to defend what the President and the 
Democrats have forced down the throats of the American public, and it 
is very hard to be proud of the kind of abuse and waste in a system 
that--whatever the intentions--has proven to the American public to be 
something they do not want, that they want to have replaced with an 
opportunity to have access, affordability, choice, and quality. By 
adopting proposals in a step-by-step fashion that Republicans have been 
promoting--to deal with those sorts of things of access, affordability, 
choice, and quality--we can try to ultimately get the American public 
what they need and what they asked for in the beginning: the care they 
need from a doctor they choose at lower costs.
  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. REID. Madam President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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