[Congressional Record (Bound Edition), Volume 161 (2015), Part 14]
[Senate]
[Pages 19311-19361]
[From the U.S. Government Publishing Office, www.gpo.gov]




   RESTORING AMERICANS' HEALTHCARE FREEDOM RECONCILIATION ACT OF 2015

  The PRESIDING OFFICER. Under the previous order, the Senate will 
resume consideration of H.R. 3762, which the clerk will report.
  The legislative clerk read as follows:

       A bill (H.R. 3762) to provide for reconciliation pursuant 
     to section 2002 of the concurrent resolution on the budget 
     for fiscal year 2016.

  Pending:

       McConnell amendment No. 2874, in the nature of a 
     substitute.

  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Mr. President, I ask unanimous consent that the time spent 
in quorum calls requested during Senate consideration of H.R. 3762 be 
equally divided and come off of the reconciliation bill.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. ENZI. Mr. President, I ask unanimous consent that for the 
duration of the Senate's consideration of H.R. 3762, the majority and 
Democratic managers of the reconciliation bill, while seated or 
standing at the managers' desks, be permitted to deliver floor remarks, 
retrieve, review, and edit documents, and send email and other data 
communications from text displayed on wireless personal digital 
assistant devices and tablet devices. I further ask unanimous consent 
that the use of calculators be permitted on the floor during 
consideration of the budget resolution.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. ENZI. For the information of Senators, this UC does not alter the 
existing traditions that prohibit the use of such devices in the 
Chamber by Senators in general, officers, and staff. It also does not 
allow the use of videos or pictures, the transmitting of sound, even 
through earpieces, for any purposes, the use of telephones or other 
devices for voice communications, any laptop computers, any detachable 
keyboards, the use of desktop computers or any other larger devices.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. ENZI. Mr. President, earlier this year, Congress approved its 
first balanced 10-year budget since 2001. In addition to helping make 
our government more efficient, effective, and accountable, this 
balanced budget resolution contained reconciliation instructions to 
provide for the repeal of Obamacare and pave the way for real health 
care reforms to strengthen the doctor-patient relationship; expand 
choices; lower health care costs; and improve access to quality, 
affordable, innovative health care.
  These instructions focused on the key congressional committees with 
jurisdiction over Obamacare--the Senate Finance Committee; Senate 
Health, Education, Labor and Pensions Committee; House Energy and 
Commerce Committee; House Education and the Workforce Committee; and 
the House Ways and Means Committee.
  Our friends in the House passed their repeal bill in October and 
November, which repealed key parts of Obamacare, including the 
individual and employer mandates, the Cadillac tax, and the medical 
device tax, which is pending here today.
  As most everyone knows, while the House and Senate are known 
collectively as Congress, they both have very different rules. This is 
why it is important to ensure that the House-passed repeal bill is in 
line with Senate rules and procedures.
  The reconciliation process is governed by a combination of statutory 
rules, budget resolution provisions, precedents--and the 
interpretations of all these applicable standards ensure that any 
legislation which says it qualifies for reconciliation does actually do 
so.
  The repeal bill passed by the House, H.R. 3762, contained material 
that qualified the bill in the House as meeting the conditions for 
reconciliation. The provisions were marked up and reported out of the 
three House reconciled committees, combined together by the House 
Budget Committee, improved upon by the House Rules Committee, and acted 
on by the full House of Representatives.
  The Obamacare repeal bill approved by the House contains provisions 
which fall in the jurisdiction of the Senate Finance and HELP 
Committees and satisfies the Senate reconciliation instruction by 
reducing the deficit well over $1 billion.
  However, while the House bill does qualify as meeting the essential 
standards necessary for reconciliation in the Senate, it is not immune 
from the Senate-specific requirements under the Byrd rule, which is the 
reason for the McConnell amendment offered earlier.

[[Page 19312]]

  The Byrd rule was crafted in an effort to ensure that matter inside a 
reconciliation bill has at its core a budgetary effect. The Byrd rule 
and the reconciliation instruction work together to evaluate the 
material inside H.R. 3762 for its consideration in the Senate.
  Working with the committees reconciled in the Senate, Leader 
McConnell and his leadership team, the House Budget Committee, the 
Senate Parliamentarian and her staff, the staff of the minority and the 
Congressional Budget Office and the Joint Committee on Taxation, H.R. 
3762 has been exhaustively examined, debated, and had decisions 
rendered as to how to evaluate it from a reconciliation and Byrd rule 
perspective.
  I think it is important for all Senators to understand what has been 
done to address those challenges to ensure that the House bill's 
provisions are not vulnerable to a variety of Byrd rule challenges.
  In H.R. 3762, section 1 contains both a short title and a table of 
contents that have no score and therefore do not qualify as 
reconciliation material. The McConnell substitute amendment does not 
contain section 1.
  Obamacare mandated that businesses with more than 50 employees 
automatically enroll their employees in Obamacare, the so-called auto-
enrollment provision. H.R. 3762 eliminated that mandate. Subsequent to 
House passage, the administration struck a spending deal with Congress, 
which used the repeal of the auto-enrollment provision as an offset. 
Since that provision is now law, it does not score for purposes of 
reconciliation and was Byrdable. The House removed that language when 
it engrossed the bill and sent it to the Senate last month. It is no 
longer in the House bill and is not addressed in the McConnell 
amendment.
  Obamacare created a fund, the so-called Prevention and Public Health 
Fund, which has been used for a variety of purposes since 2010. The 
House bill in section 101 repealed that fund and rescinded its 
unobligated balances. The McConnell amendment does the same.
  In section 102 of H.R. 3762, a deficit reduction provision for 
Medicaid was included, creating a new class of prohibited entities for 
which Medicaid reimbursement is barred. While the House language 
qualifies for reconciliation consideration in the Senate, the McConnell 
amendment makes even clearer how the language is to apply to Medicaid, 
not any Federal spending. As well, it clarifies the tests applied to 
entities to determine whether or not they fall into the prohibited 
class.
  Section 103 of the House bill created new resources for community 
health center programs, and the McConnell amendment contains the same 
language.
  Obamacare imposed mandates to purchase health care insurance on both 
individuals and employers. Sections 201 and 202 of the House bill 
repealed those mandates.
  Unfortunately, this language does not qualify under the Byrd rule in 
the Senate. In the judgement of the Parliamentarian, the policy impact 
of these repeals outweighs their fiscal impact. As well, there is 
technical and conforming language in both sections 201 and 202 of the 
House bill that do not score and therefore are inappropriate for 
reconciliation in the Senate.
  As a result, the McConnell amendment addresses the mandates but in a 
different way. Rather than containing language that repeals them, the 
McConnell amendment repeals the penalties, which Obamacare instituted 
to punish those who wanted the freedom to choose in the health care 
insurance market.
  Obamacare imposed a tax on medical devices, which section 203 of H.R. 
3762 repealed. The McConnell amendment does the same without the 
conforming and clerical amendments in this section that the House bill 
contains. Clerical and conforming amendments do not score and so do not 
qualify for consideration under the Byrd rule.
  Obamacare imposed a tax on high-quality health insurance, the so-
called Cadillac tax. H.R. 3762 repealed that tax, but the repeal 
contained technical and conforming language that violates the Byrd 
rule. As well, according to CBO, the House language created a possible 
deficit sometime well after the reconciliation window, which is another 
violation of the Byrd rule.
  To address these problems, the McConnell amendment removes the 
technical and conforming language that violates the Byrd rule and 
sunsets the Cadillac tax repeal at the end of 2024.
  The McConnell amendment also contains an additional policy.
  Working in concert with the Senate Finance Committee, the McConnell 
amendment contains reconciliation-compliant language to recapture 
excess exchange subsidies that have been paid but which were not 
supposed to go out the door. Over 10 years, this will have a 
significant deficit reduction impact.
  The pending McConnell amendment, then, addresses the Byrd rule 
challenges contained within the House bill. It has a deficit reduction 
impact equal to the House-passed bill. It is reconciliation compliant. 
It will be the pending language to which amendments should be drafted 
and offered during consideration of the repeal bill.
  The Budget Act calls for a submission for the Record of Byrdable 
material contained in the reconciliation bill, and I will ask that the 
list of Byrdable material in H.R. 3762 be printed in the Record.
  Mr. President, pursuant to section 313(c) of the Congressional Budget 
Act of 1974, I submit for the Record a list of material considered to 
be extraneous to H.R. 3762, the Restoring Americans' Healthcare Freedom 
Reconciliation Act of 2015. The inclusion or exclusion of a provision 
on this list does not constitute a determination of extraneousness by 
the Presiding Officer of the Senate. I ask unanimous consent the list 
be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
               Section                           Subject                Violation                                  Rationale
--------------------------------------------------------------------------------------------------------------------------------------------------------
1...................................  Short Title, Table of              313(b)(1)(A)  No budgetary effect
                                       Contents.
 
                                                        Title I--Committee on Energy and Commerce
 
102(a) lines 15-16..................  Federal Payments to States..       313(b)(1)(A)  No budgetary effect\1\
 
                                                         Title III--Committee on Ways and Means
 
201.................................  Repeal of individual mandate       313(b)(1)(D)  Budgetary effects are merely incidental
202.................................  Repeal of Employer Mandate..       313(b)(1)(D)  Budgetary effects are merely incidental
204(b)..............................  Tax on Employee Health             313(b)(1)(A)  No budgetary effect
                                       Insurance Premiums--
                                       Reporting Requirement.
204(c)..............................  Tax on Employee Health             313(b)(1)(A)  No budgetary effect
                                       Insurance Premiums--
                                       Clerical Amendment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\This matter contains citations in error. Permissible if corrected.

  Mr. ENZI. I also ask unanimous consent that two scores from CBO be 
printed in the Record: a score of H.R. 3762 as received in the Senate 
and a score of the McConnell amendment.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

[[Page 19313]]



ESTIMATE OF DIRECT SPENDING AND REVENUE EFFECTS OF H.R. 3762, THE RESTORING AMERICANS' HEALTHCARE FREEDOM RECONCILIATION ACT, AS PASSED BY THE HOUSE AND
                                                FOLLOWING ENACTMENT OF THE BIPARTISAN BUDGET ACT OF 2015a
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                             By fiscal year, in billions of dollars--
                                         ---------------------------------------------------------------------------------------------------------------
                                            2016     2017     2018     2019     2020     2021     2022     2023     2024     2025   2016-2020  2016-2025
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                    ESTIMATED CHANGES WITHOUT MACROECONOMIC FEEDBACK
 
Changes in Direct Spending
Title I--Committee on Education and the
 Workforce
Auto-Enrollment for Certain Large
 Employers:b:
    Estimated Budget Authority..........        0        0        0        0        0        0        0        0        0        0          0          0
    Estimated Outlays...................        0        0        0        0        0        0        0        0        0        0          0          0
Title II--Committee on Energy and
 Commerce
Prevention and Public Health Fund:
    Estimated Budget Authority..........     -1.0     -1.0     -1.3     -1.3     -1.5     -1.5     -2.0     -2.0     -2.0     -2.0       -6.0      -15.5
    Estimated Outlays...................     -0.2     -0.5     -0.9     -1.1     -1.3     -1.4     -1.6     -1.8     -1.9     -2.0       -4.1      -12.7
Medicaid:
    Estimated Budget Authority..........     -0.2        *        *        *        *        *        *        *        *        0       -0.2       -0.2
    Estimated Outlays...................     -0.2        *        *        *        *        *        *        *        *        0       -0.2       -0.2
Community Health Center Program:
    Estimated Budget Authority..........      0.2      0.2        0        0        0        0        0        0        0        0        0.5        0.5
    Estimated Outlays...................      0.1      0.2      0.1        *        0        0        0        0        0        0        0.5        0.5
Title III--Committee on Ways and Means
Repeal Individual and Employer
 Mandatesc:
    Estimated Budget Authority..........     -8.7    -17.2    -21.1    -24.5    -26.7    -28.6    -30.6    -32.2    -33.9    -35.4      -98.3     -258.9
    Estimated Outlays...................     -8.7    -17.2    -21.1    -24.5    -26.7    -28.6    -30.6    -32.2    -33.9    -35.4      -98.3     -258.9
Repeal Excise Tax on Certain High-
 Premium Insurance Plans:
    Estimated Budget Authority..........        0        0     -0.7     -0.9     -1.4     -1.6     -2.4     -3.1     -3.9     -4.1       -3.0      -18.2
    Estimated Outlays...................        0        0     -0.7     -0.9     -1.4     -1.6     -2.4     -3.1     -3.9     -4.1       -3.0      -18.2
    Total Changes in Direct Spending:
        Estimated Budget Authority......     -9.7    -18.0    -23.1    -26.7    -29.6    -31.7    -35.0    -37.3    -39.8    -41.5     -107.1     -292.4
    Estimated Outlays...................     -9.1    -17.5    -22.6    -26.5    -29.3    -31.6    -34.6    -37.1    -39.7    -41.5     -105.1     -289.6
Changes in Revenues
Title I--Committee on Education and the
 Workforce
    Auto-Enrollment for Certain Large           0        0        0        0        0        0        0        0        0        0          0          0
     Employersb.........................
Title III--Committee on Ways and Means
    Repeal Individual and Employer          -10.1     -7.7     -7.0     -8.1     -8.2     -8.4     -9.4    -10.1    -10.4    -10.7      -41.2      -90.4
     Mandatesc..........................
    Repeal Medical Device Tax...........     -1.4     -2.0     -2.1     -2.2     -2.3     -2.5     -2.6     -2.8     -2.9     -3.1      -10.0      -23.9
    Repeal Excise Tax on Certain High-          0        0     -2.9     -8.1     -9.7    -11.5    -14.0    -17.1    -20.8    -25.0      -20.8     -109.3
     Premium Insurance Plans............
    Interaction within Title III........        0        0        *      2.1      2.0      1.7      1.7      1.6      1.6      1.4        4.1       12.1
    Total Changes in Revenues:              -11.5     -9.7    -12.0    -16.3    -18.2    -20.7    -24.3    -28.4    -32.5    -37.4      -67.9     -211.5
        On-Budget.......................    -13.0    -13.8    -16.2    -20.5    -22.4    -24.6    -27.7    -31.3    -34.9    -38.9      -86.2     -243.7
        Off-Budgetd.....................      1.5      4.1      4.2      4.2      4.2      3.9      3.5      2.9      2.4      1.5       18.3       32.2
 
                                       NET INCREASE OR DECREASE (-) IN THE DEFICIT WITHOUT MACROECONOMIC FEEDBACK
 
    Impact on Deficit...................      2.4     -7.9    -10.6    -10.2    -11.1    -10.8    -10.3     -8.6     -7.2     -4.0      -37.2      -78.1
        On-Budget.......................      3.9     -3.7     -6.4     -6.0     -6.9     -7.0     -6.8     -5.8     -4.8     -2.6      -19.0      -45.9
        Off-Budgetd.....................     -1.5     -4.1     -4.2     -4.2     -4.2     -3.9     -3.5     -2.9     -2.4     -1.5      -18.3      -32.2
 
                                                  ESTIMATED BUDGETARY IMPACT OF MACROECONOMIC FEEDBACKe
 
    Effects on Outlays..................        *     -0.2     -0.3     -0.2        *      0.4      0.6      0.8      1.0      1.1       -0.7        3.1
    Effects on Revenues.................      0.5      1.1      2.5      4.3      5.4      6.4      7.2      8.1      8.9      9.6       13.8       54.0
    Effects on the Deficit..............     -0.6     -1.3     -2.8     -4.5     -5.3     -6.0     -6.6     -7.3     -8.0     -8.6      -14.5      -50.9
        On-Budget.......................     -0.3     -0.8     -1.9     -3.1     -3.7     -4.2     -4.6     -5.1     -5.6     -6.0       -9.9      -35.4
        Off-Budgetd.....................     -0.2     -0.4     -0.9     -1.4     -1.6     -1.8     -2.0     -2.2     -2.4     -2.6       -4.6      -15.5
 
                                               TOTAL ESTIMATED CHANGES, INCLUDING MACROECONOMIC FEEDBACKf
 
    Effects on Outlays..................     -9.1    -17.7    -22.9    -26.8    -29.3    -31.2    -34.0    -36.3    -38.7    -40.4     -105.8     -286.5
    Effects on Revenues.................    -11.0     -8.6     -9.5    -12.1    -12.9    -14.4    -17.1    -20.3    -23.6    -27.8      -54.1     -157.5
    Effects on the Deficitd.............      1.9     -9.1    -13.4    -14.7    -16.4    -16.8    -16.9    -16.0    -15.1    -12.6      -51.7     -129.0
        On-Budget.......................      3.6     -4.6     -8.3     -9.2    -10.6    -11.1    -11.5    -10.9    -10.4     -8.6      -28.9      -81.3
        Off-Budgetd.....................     -1.7     -4.6     -5.1     -5.5     -5.8     -5.7     -5.4     -5.0     -4.8     -4.1      -22.8     -47.7
--------------------------------------------------------------------------------------------------------------------------------------------------------
Sources: Congressional Budget Office; staff of the Joint Committee on Taxation.
Notes: Numbers may not add up to totals because of rounding;* = an increase or decrease between zero and $50 million.
On October 23, 2015, the House passed H.R. 3762 (see https://www.congress.gov/114/bills/hr3762/BILLS-114hr3762eh.pdf). That bill removed subtitle B of
  H.R. 3762 as reported by the House Committee on the Budget on October 16, 2015, which would have repealed the Independent Payment Advisory Board.
  Additionally, the Bipartisan Budget Act of 2015 (Public Law 114-74) was enacted on November 2, 2015, and included a provision identical to title I of
  this legislation. This estimate differs from CBO and JCT's prior estimate of H.R. 3762 as reported by the House Committee on the Budget (see https://
www.cbo.gov/publication/50918) as a result of these two legislative actions.
aFor outlays, a positive number indicates an increase (adding to the deficit) and a negative number indicates a decrease (reducing the deficit); for
  revenues, a positive number indicates an increase (reducing the deficit) and a negative number indicates a decrease (adding to the deficit); for the
  deficit, a positive number indicates an increase and a negative number indicates a reduction.
bThe Bipartisan Budget Act of 2015 (P.L. 114-74) was enacted on November 2, 2015. Title VI of that law includes a provision identical to title I of this
  legislation. Therefore, CBO estimates that title I would have no effect relative to current law.
cCBO previously estimated additional effects of combining the repeal of the auto-enrollment requirement for large employers with the repeal of the
  individual and employer mandates. Because the former is now current law (see P.L. 114-74), that interaction effect is included in our estimate of the
  repeal of the individual and employer mandates.
dExcluding macroeconomic feedback, all off-budget effects would come from changes in revenues. (The payroll taxes for Social Security are classified as
  off-budget.) Off-budget effects from macroeconomic feedback include changes in Social Security spending and revenues.
eAn explanation of these estimates of macroeconomic feedback can be found in the cost estimate for H.R. 3762 as reported by the House Committee on the
  Budget on October 16, 2015. The effects of the changes proposed in the legislation analyzed here are quite similar to the effects estimated
  previously. As a result, CBO and JCT's estimated economic effects and macroeconomic feedback to the budget are not appreciably changed from that
  previous analysis.
fIncluding macroeconomic effects, CBO and JCT estimate that enacting the legislation would not increase net direct spending by more than $5 billion in
  any of the first three consecutive 10-year periods beginning in 2026; however, the agencies are not able to determine whether enacting the legislation
  would increase net direct spending by more than $5 billion in the fourth 10-year period. The agencies estimate that enacting the legislation would
  increase on- budget deficits by more than $5 billion in one or more of the four consecutive 10-year periods beginning in 2026. Excluding macroeconomic
  feedback, the agencies estimate that enacting the legislation would not increase net direct spending by more than $5 billion in any of the four
  consecutive 10-year periods beginning in 2026, and would increase on-budget deficits by more than $5 billion in one or more of the four consecutive 10-
  year periods beginning in 2026.


    PRELIMINARY ESTIMATE OF DIRECT SPENDING AND REVENUE EFFECTS OF H.R. 3762, THE RESTORING AMERICANS' HEALTHCARE FREEDOM RECONCILIATION ACT, WITH AN
                                                  AMENDMENT IN THE NATURE OF A SUBSTITUTE (S.A. 2874.)a
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                             By fiscal year, in billions of dollars--
                                         ---------------------------------------------------------------------------------------------------------------
                                            2016     2017     2018     2019     2020     2021     2022     2023     2024     2025   2016-2020  2016-2025
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                    ESTIMATED CHANGES WITHOUT MACROECONOMIC FEEDBACK
 
Changes in Direct Spending
Title I--Finance
Medicaid:
    Estimated Budget Authority..........     -0.2        *        *        *        *        *        *        *        *        0       -0.2       -0.2
    Estimated Outlays...................     -0.2        *        *        *        *        *        *        *        *        0       -0.2       -0.2
Eliminate Individual and Employer
 Mandate Penalties:
    Estimated Budget Authority..........     -7.5    -14.3    -17.7    -21.0    -23.2    -25.2    -27.3    -29.0    -30.9    -32.6      -83.9     -228.8
    Estimated Outlays...................     -7.5    -14.3    -17.7    -21.0    -23.2    -25.2    -27.3    -29.0    -30.9    -32.6      -83.9     -228.8
Repeal Excise Tax on Certain High-
 Premium Insurance Plans:
    Estimated Budget Authority..........        0        0     -0.7     -0.9     -1.4     -1.6     -2.4     -3.1     -3.9     -1.2       -3.0      -15.3
    Estimated Outlays...................        0        0     -0.7     -0.9     -1.4     -1.6     -2.4     -3.1     -3.9     -1.2       -3.0      -15.3
Elimination of Limitation on Subsidy
 Recapture:
    Estimated Budget Authority..........     -1.8     -3.3     -3.8     -3.9     -3.9     -4.0     -4.2     -4.4     -4.6     -4.8      -16.6      -38.5
    Estimated Outlays...................     -1.8     -3.3     -3.8     -3.9     -3.9     -4.0     -4.2     -4.4     -4.6     -4.8      -16.6      -38.5
Title II--Health, Education, Labor and
 Pensions
Prevention and Public Health Fund:
    Estimated Budget Authority..........     -1.0     -1.0     -1.3     -1.3     -1.5     -1.5     -2.0     -2.0     -2.0     -2.0       -6.0      -15.5

[[Page 19314]]

 
    Estimated Outlays...................     -0.2     -0.5     -0.9     -1.1     -1.3     -1.4     -1.6     -1.8     -1.9     -2.0       -4.1      -12.7
Comnumity Health Center Program:
    Estimated Budget Authority..........      0.2      0.2        0        0        0        0        0        0        0        0        0.5        0.5
    Estimated Outlays...................      0.1      0.2      0.1        *        0        0        0        0        0        0        0.5        0.5
    Total Changes in Direct Spending:
        Estimated Budget Authority......    -10.3    -18.4    -23.5    -27.1    -30.0    -32.3    -35.9    -38.5    -41.4    -40.6     -109.3     -297.9
        Estimated Outlays...............     -9.7    -17.9    -23.0    -26.9    -29.7    -32.2    -35.5    -38.3    -41.3    -40.6     -107.3     -295.1
Changes in Revenues
Title I--Finance:
Eliminate Individual and Employer           -10.3     -8.9     -8.0     -9.0     -9.1     -9.3    -10.3    -10.9    -11.2    -11.5      -45.4      -98.6
 Mandate Penalties......................
Repeal Medical Device Tax...............     -1.4     -2.0     -2.1     -2.2     -2.3     -2.5     -2.6     -2.8      2.9     -3.1      -10.0      -23.9
Repeal Excise Tax on Certain High-              0        0     -2.9     -8.1     -9.7    -11.5    -14.0    -17.1    -20.8     -8.9      -20.8      -93.2
 Premium Insurance Plans................
Elimination of Limitation on Subsidy          0.3      1.2      1.5      1.6      1.5      1.5      1.5      1.6      1.6      1.7        5.9       14.0
 Recapture..............................
Interaction within Title I..............        0        0        *      2.1      2.0      1.7      1.7      1.6      1.6      1.4        4.1       12.1
    Total Changes in Revenues:..........    -11.4     -9.7    -11.5    -15.6    -17.6    -20.1    -23.7    -27.6    -31.7    -20.4      -66.2     -189.6
        On-Budget.......................    -12.8    -13.5    -15.5    -19.6    -21.5    -23.7    -26.8    -30.3    -33.9    -25.4      -83.3     -223.2
        Off-Budgetb.....................      1.4      3.8      4.0      4.0      3.9      3.6      3.2      2.7      2.2      5.0       17.1       33.6
                                       Net Increase or Decrease (-) in the Deficit Without Macroeconomic Feedbackc
Impact on Deficit:                            1.7     -8.3    -11.5    -11.3    -12.1    -12.0    -11.8    -10.6     -9.6    -20.1      -41.1     -105.5
        On-Budget.......................      3.1     -4.4     -7.5     -7.3     -8.2     -8.5     -8.6     -8.0     -7.4    -15.2      -24.1      -71.9
        Off-Budgetb.....................     -1.4     -3.8     -4.0     -4.0     -3.9     -3.6     -3.2     -2.7     -2.2     -5.0      -17.1     -33.6
--------------------------------------------------------------------------------------------------------------------------------------------------------
Sources: Congressional Budget Office; staff of the Joint Committee on Taxation.
Notes: Numbers may not add up to totals because of rounding; * = an increase or decrease between zero and $50 million.
This amendment triggers the requirement for a macroeconomic analysis. However, because of the very short time available to prepare this estimate, CBO
  and JCT have determined that it is not practicable to provide that analysis at this time.
aFor outlays, a positive number indicates an increase (adding to the deficit) and a negative number indicates a decrease (reducing the deficit); for
  revenues, A positive number indicates an increase (reducing the deficit) and a negative number indicates a decrease (adding to the deficit); for the
  deficit, a positive number indicates an increase and a negative number indicates a reduction.
bExcluding macroeconomic feedback, all Off-Budget effects would come from changes in revenues. (The payroll taxes for Social Security are classified as
  off-budget.)
cExcluding macroeconomic feedback, the agencies estimate that enacting title I or title II would not increase net direct spending or on-budget deficits
  in any year after 2025 or in any of the four consecutive 10-year periods beginning in 2026.

  Mr. ENZI. I think Members are looking forward to an open and spirited 
debate about the future of America's health care system and the 
importance of restoring the trust of hard-working taxpayers.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington.


                Amendment No. 2876 to Amendment No. 2874

   (Purpose: To ensure that this Act does not increase the number of 
  uninsured women or increase the number of unintended pregnancies by 
establishing a women's health care and clinic security and safety fund)

  Mrs. MURRAY. Mr. President, I call up my amendment No. 2876.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Washington [Mrs. Murray] proposes an 
     amendment numbered 2876 to amendment No. 2874.

  Mrs. MURRAY. Mr. President, I ask unanimous consent that the reading 
of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The amendment is printed in today's Record under ``Text of 
Amendments.'')
  The PRESIDING OFFICER (Mr. Cotton).
  The Senator from Washington.
  Mrs. MURRAY. Mr. President, I think we can all agree there is a lot 
of work that needs to be done in this Congress--priorities such as 
continuing to improve health care for our families, creating jobs, 
boosting wages, expanding economic security for workers, and making 
higher education more affordable and accessible, just to name a few. 
Unfortunately, instead of working with Democrats to focus on those 
challenges--the ones that families face every day--far too many 
Republicans have doubled down on a favorite pastime--attacking women's 
health and rights in order to pander to their extreme base.
  I am very proud to be on the floor today with many of my Democratic 
colleagues to say enough is enough and to make clear that even as 
Republicans try to take women's health backwards, we are going to push 
harder in the other direction for continued progress on women's access 
to health care and constitutionally protected reproductive rights.
  This year alone, according to NARAL Pro-Choice America, more than 40 
bills have been introduced in this Congress that would undermine a 
woman's constitutionally protected right to make her own choices about 
her own body. The House and Senate have voted a total of 17 times--17 
times--on legislation to undermine women's health care and rights. That 
is right. In the year 2015--in the year 2015 alone--Republicans in 
Congress have introduced over 40 bills and held 17 votes on whether 
Congress should roll back women's rights. That is completely 
unacceptable. The bill we are debating here on the floor today would 
defund Planned Parenthood, and that is just more of the same. It is 
another effort to force through extreme policies under a fast-track 
process.
  A vote on the bill before us today is a vote on whether a young woman 
should be able to go to the provider she trusts to get birth control, 
whether cancer screenings should be more or less available to women 
across the country, and whether the 2.7 million men and women who visit 
Planned Parenthood each year should continue to get health care 
services they rely on.
  Over the last few months of Republican political attacks on Planned 
Parenthood and women's health, I have been proud to stand with women 
nationwide who are making their voices heard and fighting for their 
right to make their own health care decisions--women such as Shannon, 
who lives in Tumwater, WA, and says the care she received at Planned 
Parenthood as a young woman protected her ability to have children and 
that today she has Planned Parenthood to thank for her little girl; 
women such as Breanne from Seattle, who went to Planned Parenthood as 
an uninsured student, where providers caught abnormal cell growth on 
her cervix wall before--before--it could turn into cancer; and the 
women and advocates at the Planned Parenthood Center in Pullman, WA, 
who, after their building was damaged in an arson attack, came together 
as a community and established a pop-up clinic to make sure that women 
and families could continue to get the care they needed.
  I know many of us here today are thinking of those who are suffering 
and who lost loved ones as a result of the tragic violence in Colorado 
Springs last week. People across the country--men and women--have had 
enough of extremism and violence, including at Planned Parenthood 
health care centers. When a woman seeks health care--constitutionally 
protected health care--she should not have to feel threatened in any 
way. A doctor in a women's health clinic should not have to worry about 
wearing a bulletproof vest under her lab coat. Women's health care 
should not be controversial, much less a cause for violence in the 21st 
century. Women and their families have had enough.
  I have heard from so many women and men who are tired of women's

[[Page 19315]]

health being undermined, being threatened, and being used as a 
political football here in Washington, DC. Who can believe that in the 
21st century a Presidential candidate would claim that expanding access 
to birth control is as easy as setting up a few more vending machines 
in men's bathrooms? These women and men across the country are speaking 
up and saying ``not on our watch'' to those who want to turn back the 
clock on women's health and women's rights. I am going to continue, 
along with my colleagues, to bring their voices and their stories and 
their fight to the Senate floor.
  As we all know, this is a tired political effort to dismantle the 
Affordable Care Act and take Planned Parenthood down with it. It is at 
a dead end. But if Republicans are going to try to cut off women's 
access to health care, I am going to make sure they hear about it and 
that people across this country know exactly where Democrats stand--
with women. That is why I am very proud to be introducing this 
amendment today that would strike the harmful language defunding 
Planned Parenthood from this legislation and replace it--replace it--
with a new fund to support women's health care and clinic safety.
  There is so much more we need to do to improve women's health care in 
this country today, from strengthening the women's health care 
workforce to expanding access to constitutionally protected 
reproductive health care to raising awareness about violence against 
women--so much more. This fund that is part of this amendment would 
offer an opportunity to make progress on goals such as these and more 
to support women's health providers and clinics at a time when they 
need it most. Critically, it would show women and families that their 
constitutional rights, that their safety and their health care should 
come before tea party political pandering, not the other way around. By 
the way, this amendment is fully paid for by the Buffett rule.
  Democrats are going to keep standing up for women and encouraging 
Republicans to focus on the real challenges that families face, rather 
than their political attacks that their tea party base is so focused 
on. I urge my colleagues to join me in standing against this harmful 
effort to defund Planned Parenthood and delivering a clear message, 
again, to Republicans in Congress who want to play politics with 
women's health--not on our watch.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wisconsin.


                Amendment No. 2875 to Amendment No. 2874

  Mr. JOHNSON. Mr. President, I ask unanimous consent to set aside the 
pending amendment in order to call up my amendment No. 2875.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  The clerk will report.
  The legislative clerk read as follows:

       The Senator from Wisconsin [Mr. Johnson] proposes an 
     amendment numbered 2875 to amendment No. 2874.

  Mr. JOHNSON. Mr. President, I ask unanimous consent that the reading 
of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

 (Purpose: To amend the Patient Protection and Affordable Care Act to 
   ensure that individuals can keep their health insurance coverage)

       At the appropriate place, insert the following:

     SEC. __. AMENDMENT TO THE PATIENT PROTECTION AND AFFORDABLE 
                   CARE ACT.

       (a) In General.--Part 2 of subtitle C of title I of the 
     Patient Protection and Affordable Care Act (42 U.S.C. 18011 
     et seq.) is amended by striking section 1251 and inserting 
     the following:

     ``SEC. 1251. FREEDOM TO MAINTAIN EXISTING COVERAGE.

       ``(a) No Changes to Existing Coverage.--
       ``(1) In general.--Nothing in this Act (or an amendment 
     made by this Act) shall be construed to require that an 
     individual terminate coverage under a group health plan or 
     health insurance coverage in which such individual was 
     enrolled during any part of the period beginning on the date 
     of enactment of this Act and ending on December 31, 2013.
       ``(2) Continuation of coverage.--With respect to a group 
     health plan or health insurance coverage in which an 
     individual was enrolled during any part of the period 
     beginning on the date of enactment of this Act and ending on 
     December 31, 2013, this subtitle and subtitle A (and the 
     amendments made by such subtitles) shall not apply to such 
     plan or coverage, regardless of whether the individual renews 
     such coverage.
       ``(b) Allowance for Family Members To Join Current 
     Coverage.--With respect to a group health plan or health 
     insurance coverage in which an individual was enrolled during 
     any part of the period beginning on the date of enactment of 
     this Act and ending on December 31, 2013, and which is 
     renewed, family members of such individual shall be permitted 
     to enroll in such plan or coverage if such enrollment is 
     permitted under the terms of the plan in effect as of such 
     date of enrollment.
       ``(c) Allowance for New Employees To Join Current Plan.--A 
     group health plan that provides coverage during any part of 
     the period beginning on the date of enactment of this Act and 
     ending on December 31, 2013, may provide for the enrolling of 
     new employees (and their families) in such plan, and this 
     subtitle and subtitle A (and the amendments made by such 
     subtitles) shall not apply with respect to such plan and such 
     new employees (and their families).
       ``(d) Effect on Collective Bargaining Agreements.--In the 
     case of health insurance coverage maintained pursuant to one 
     or more collective bargaining agreements between employee 
     representatives and one or more employers that was ratified 
     before December 31, 2013, the provisions of this subtitle and 
     subtitle A (and the amendments made by such subtitles) shall 
     not apply until the date on which the last of the collective 
     bargaining agreements relating to the coverage terminates. 
     Any coverage amendment made pursuant to a collective 
     bargaining agreement relating to the coverage which amends 
     the coverage solely to conform to any requirement added by 
     this subtitle or subtitle A (or amendments) shall not be 
     treated as a termination of such collective bargaining 
     agreement.
       ``(e) Definition.--In this title, the term `grandfathered 
     health plan' means any group health plan or health insurance 
     coverage to which this section applies.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect as if included in the Patient Protection 
     and Affordable Care Act (Public Law 111-148).

  Mr. JOHNSON. Mr. President, at a townhall meeting in Green Bay, WI, 
on June 11, 2009, President Obama was trying to sell his health care 
law, and this is the claim he made. This is the quote, and this is the 
promise he made to the American public. He said:

       No matter how we reform health care, I intend to keep this 
     promise: If you like your doctor, you'll be able to keep your 
     doctor; if you like your health care plan, you'll be able to 
     keep your health care plan.

  Less than a week later, in remarks to the American Medical 
Association, the Nation's largest association of medical doctors, the 
President said:

       I know that there are millions of Americans who are content 
     with their health care coverage--they like their plan and, 
     most importantly, they value the relationship with their 
     doctor. They trust you. And that means that no matter how we 
     reform health care, we will keep this promise to the American 
     people: If you like your doctor, you will be able to keep 
     your doctor, period. If you like your health care plan, 
     you'll be able to keep your health care plan, period. No one 
     will take that away, no matter what.

  Now, a number of years have passed since President Obama made that 
promise. It wasn't just those two times that President Obama made that 
promise either. I think it has been documented that he made that 
promise to the American people over 30 times. Other supporters of the 
bill repeated that promise. It was a promise. It was a promise to the 
American public. It was a promise he knew would not be kept. It was a 
promise about which the supporters of the bill knew there was no way 
under ObamaCare that people would be able to keep their health care 
plan, that they would become able to keep and maintain the relationship 
with the doctor they trusted, knew, and had faith in.
  President Obama called it a promise. PolitiFact had another name for 
it. PolitiFact, in 2013, termed that promise its ``Lie of the Year.'' 
Think of that. The President of the United States was trying to sell a 
massive restructuring of a health care system--and that is what he was 
trying to do. He was trying to sell it. He was marketing a bill, a law, 
a concept, and in order to market that concept, President Obama and 
other supporters of the bill repeatedly made a promise

[[Page 19316]]

that PolitiFact termed the ``Lie of the Year'' of 2013.
  I come from the private sector. It is incumbent on people in the 
private sector, when they are selling products to consumers, to tell 
the truth about the product. If you don't, you will be accused of 
consumer fraud. You can be sued. You can probably be sued out of 
existence. Imagine how the trial bar would treat a businessperson who 
tried to sell a product by making a promise that turned out to be 
2013's ``Lie of the Year.'' I don't believe that business would be in 
business today.
  ObamaCare, at its heart, is a massive consumer fraud--a massive 
consumer fraud. So the purpose of my amendment has the purpose of a 
piece of legislation I introduced in 2013--the same thing. It is 
designed to honor the promise that President Obama made and that he did 
not keep--the promise that was made under ObamaCare that was not kept.
  The bill I introduced in 2013 was simply titled ``If You Like Your 
Health Care Plan, You Can Keep it Act.'' What is rather unique about my 
piece of legislation is that it used the exact same wording of 
ObamaCare. ObamaCare actually did have a section in it called a 
grandfather clause that purported to allow people to keep their health 
care and allowed them to maintain their relationship with their doctor 
if they liked their health care plan and their doctor. The problem is 
it was a grandfather clause that allowed you to keep your plan as long 
as you completely changed it. So what my bill in 2013 did was it just 
said: Listen, you can actually keep your health care plan and you don't 
have to change it.
  That is what my amendment does today. It restores that promise--the 
promise of President Obama and the supporters of ObamaCare. Let me use 
the real name: The Patient Protection and Affordable Care Act. Of the 
Orwellian-named laws that have been passed through this Chamber, this 
is probably the most Orwellian because the Patient Protection and 
Affordable Care Act did neither, because that promise was not kept. It 
was a lie. Patients weren't protected. They lost their health care 
plan. We have all received letters from constituents, often 
heartbreaking letters. There was a couple in Wisconsin, they both had 
cancer. He is recovering from prostate cancer. She had stage IV lung 
cancer. They had health care in the State high-risk pool. They could 
afford it. It worked for them. They lost it because of ObamaCare. They 
called our office panicked--panicked--because they couldn't log on to 
healthcare.gov. They tried almost 40 times. They lost their health care 
plan. That promise was broken. I don't hear supporters of the law 
pointing to those individuals.
  So my amendment would restore the promise that if you had health care 
that you liked in 2013, insurance companies can offer those same plans 
again. They were far more affordable--far more affordable. As I just 
stated with that one little example, patient protection in the 
Affordable Care Act didn't protect patients, and it certainly hasn't 
been more affordable. We have also received hundreds of letters from 
people whose premiums have doubled, their out-of-pocket maximum has 
doubled and tripled. They can't even afford to use the health care they 
were able to secure because it has become so expensive. The reality of 
ObamaCare is it has been a miserable failure, and the promises made 
under it literally were abject lies. That is the reality. That is the 
very sad fact.
  I encourage all my colleagues to unanimously support the promise 
President Obama and the law's supporters made and vote for my 
amendment, which would allow Americans, if they like their health care 
plan, if they like their doctor, they actually will be able to keep it.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from California.
  Mrs. BOXER. Mr. President, I thoroughly support the right of my 
colleague to his opinion, but we have never had more people insured in 
modern history because of ObamaCare. It doesn't mean it is perfect, but 
let me tell you--I don't know what my colleague's constituents tell 
him, but I will tell you what mine do. They say thank you. Thank you 
for the fact that I can get insurance. Thank you for the fact that I 
can get it even if I have a heart condition. Thank you for the fact 
that my child can stay on my policy until he is 26 years old. Thank 
you. Thank you. Thank you. Thank you for the lifesaving preventive care 
I get. Thank you. Thank you for the cheaper prescription drugs.
  So people live in a different universe, I guess, but I prefer to 
stick with the facts, and the facts are millions and millions and 
millions of Americans now have the peace of mind of being insured. They 
don't become a burden on their families, they don't become a burden on 
the emergency room, and they don't become a burden on their 
communities. I thank President Obama for his courage. We can fix what 
is wrong with ObamaCare, but time and time again--more than 50 times--
they tried to repeal it, the GOP, and they are going to try again, and 
they are going to fail again. Secretly, I think they hope they fail 
because they have nothing--nothing--to replace it with. It is kind of a 
joke. Nothing. Oh, let's just open up the free market. Well, folks, we 
tried that forever. ObamaCare isn't government care. It is insurance 
exchanges, and it is Medicaid expansion in those States that wish to 
have it. I have to tell you, in those States who have it, the people 
are very happy.


                           Amendment No. 2876

  I rise not only to respond to that attack on health care that we have 
heard again for the 90th time from the other side, I really rise to 
thank Senator Murray. I thank her again for her unbelievable leadership 
in protecting women's health. Beyond that, she is a leader in 
protecting children's health, men's health, families' health, and our 
seniors' health. Today what she is doing is very important. She is 
saying to the Republicans: We don't like the fact that you are 
defunding a health care organization that serves 3 million Americans 
every year with lifesaving health care, preventive health care, STD 
testing, breast cancer exams, and these 3 million Americans want us to 
stand and fight for them. That is what Senator Murray is doing today, 
and I am proud to be by her side.
  What she is simply saying is, no, we are not going to defund Planned 
Parenthood. She is going to strike that out of this bill they have put 
forward, but also we are going to pay for an expansion of women's 
health care because we know all you have is your health. Just ask 
people who may have everything else in the world, but somebody gets 
cancer, somebody gets a heart attack, somebody gets a stroke, someone 
in the family is diagnosed with Alzheimer's, Parkinson's, their whole 
world is turned upside down.
  So what do my friends on the other side do? They strike funding from 
an organization that has more respect in this country than their party 
or my political party or this Congress has. Well, it would be easy to 
beat the reputation of this Congress, but the vast majority of the 
American people understand the role of Planned Parenthood.
  So I strongly support this amendment, and I want to reiterate 
something Senator Murray said. Republicans have introduced more than 40 
bills to take away women's health care in this Congress--40 bills--40 
bills. And then they say: Oh, no, we are not conducting a war on women. 
Yes, you are. Yes, you are. When you want to turn the clock back to the 
days when women died from back-alley abortions, you are conducting a 
war on women. By the way, if you don't believe a woman should have the 
right to choose, I respect you. Take that ideology to your own family, 
of course, but don't tell everyone in America they have to think the 
way you think. I don't tell them they have to think the way I think. If 
I have a constituent who says: Senator, I have a certain belief and it 
means no abortion, I say: God bless you, of course. But if you don't 
have that belief and you do believe in Roe v. Wade--which most of the 
people in this country do, where a woman should have the right to 
choose early in her pregnancy without government interference--if you 
do believe in that, and that is the law of the land, then you should 
have that right.

[[Page 19317]]

  May I ask that there be quiet? Thank you. This is a very serious 
point--a very serious point.
  I have to say, you have now, over on the other side, in the House, a 
new special committee which is going to continue the witch hunt on 
Planned Parenthood. Why do they need a new committee? They have several 
committees. I served proudly in the House for 10 years. There are so 
many committees that have jurisdiction over health, health care, 
science, and the rest. If you want to repeal Roe v. Wade, if you want 
to take away a woman's right to choose, then have the courage to 
introduce an amendment and do it--just do it. The last time it was 
done, it failed, here, but if that is what you want to do, I respect 
you. Come on down and say you think abortion should be a crime, subject 
to jail time for women, for doctors. Go ahead. Do it. Do it. I will 
debate you.
  I was thinking the other day, the GOP has changed--the Grand Old 
Party that I knew. The first President George Bush was on the board of 
Planned Parenthood--was on the board of Planned Parenthood. I was on 
the board of Planned Parenthood in the 1970s. I was one of the few 
Democrats. This was a bipartisan issue, women's health, reproductive 
freedom. It was not a partisan issue. So the Grand Old Party has 
changed from the GOP. I call them the POP, the ``party of the past.'' 
They are the party of the past. Not only do they want to reverse Roe v. 
Wade, but they don't have the courage to come down and do it directly. 
Oh, no, they defund Planned Parenthood. Come on. I wasn't born 
yesterday. It is obvious, and I know what this is all about: take away 
the clinics, take away the health care, take away women's right to 
choose. It is happening all over the country. If you don't like Roe v. 
Wade, come down and try to overturn it here.
  OK. Now, fetal tissue research. There are organizations all over this 
country that do make fetal tissue available to save lives--to save 
lives. How long has this been in place? It was under Ronald Reagan, 
when he was President, that he set up this special committee that was 
headed by a pro-life judge, an anti-choice judge. They studied this and 
said it is very important to do it--very important to do it.
  In 1993, Congress voted to federally fund fetal tissue research. If 
you don't like fetal tissue research, if you think we ought to stop it, 
come down with a bill, introduce it, and we will argue it. If you don't 
want to do fetal tissue research, if you don't think it is good to find 
cures for Parkinson's, Alzheimer's, you come down and put the bill in 
the hopper. Oh, no, they don't want to do that. They just want to 
conduct a witch hunt on one of the organizations that help make fetal 
tissue research possible, and this after--this after they had the head 
of Planned Parenthood before the Congress for 4 or 5 hours straight, 
only topped by what they did to former Secretary of State Hillary 
Clinton. I think she was there 11 hours. So after all those hours that 
Cecile Richards--and they asked her what she was paid to do her work. I 
never heard them ask anybody else what they get paid. As it turned out, 
she was on the low scale of what equivalent jobs are. That is not the 
point. They harassed her for hours--hours--and their rhetoric was not 
good.
  What we say matters. What we say matters. When I say I respect people 
who feel they would never allow their child or their wife to have an 
abortion, I respect that, but if somebody else says we agree with Roe 
v. Wade that in the early stages it ought to be an option for women and 
their family, I respect them. I don't demonize one side, but the other 
side does over and over again. I have stood on this floor for many 
years now, frankly, with my colleague Patty Murray and my colleague 
Dianne Feinstein, and we have heard mostly men come down and lecture us 
about how it is terrible. Roe v. Wade should never be the law of the 
land. There should be no abortion, and the rest of it. That is their 
right. I do not believe it is their right to take away funding from an 
organization that serves 3 million Americans a year and saves lives.
  So while Republicans--the party of the past--have put in 40 bills to 
take away a woman's right to choose, essentially, we say today, through 
the Murray amendment, we are looking at the future, we are looking with 
clear eyes, we are looking at our people, and we support people who go 
to Planned Parenthood for their health care, and we are going to vote--
and I pray we win this vote--to strip out this attack on Planned 
Parenthood. We are here to say: Stop this assault on women's health 
care. It is wrong. It is absolutely wrong.
  I want to put it into context. I said that Planned Parenthood serves 
3 million people. I want to give even more specifics. Four hundred 
thousand women receive their Pap tests to protect themselves against 
cervical cancer. They want to stop that funding. They want to take away 
services from 400,000 women. They say: Oh, no, we really don't. They 
will go other places. They will go to little health care centers.
  Excuse me. I have those health care system centers--more than 
anybody. They are overworked, overloaded, and they support Planned 
Parenthood. They are attacking 500,000 women who get breast exams, and 
if a doctor finds a lump, they refer them for a mammogram. They go 
after women and men who have nowhere else to turn for their most basic 
health care. We have been down this road before.
  A few months ago in this very Senate, we defeated the Republicans' 
attempt to defund Planned Parenthood, but they are back again with the 
same old, same old party of the past attitude. They are attacking 
Planned Parenthood because Planned Parenthood has a host of services, 
97 percent of which have nothing to do with abortion. If you don't want 
to have abortion legal, you want to make it a crime, you want to put 
doctors in jail, you want to put women in jail, then come down here and 
put something in a bill form, repeal Roe v. Wade, and criminalize 
abortion.
  I am old enough to remember when it was a crime. Let me tell you 
something. There are graves all over this country with women who died 
from back-alley abortions and botched abortions. They never said it was 
from that because then they would have died as a criminal. We are not 
going to go back to those days. The party of the past is not winning on 
this. They are not going to win, because President Obama is going to 
veto this bill. Maybe this next Senate will have a pro-choice Senate 
for a change.
  In 2011, Republicans threatened to shut down the entire Government of 
the United States of America if Planned Parenthood wasn't defunded. 
Remember, 97 percent of what Planned Parenthood does has nothing to do 
with abortion, but Planned Parenthood is in their line of attack and 
they haven't stopped. The rhetoric matters. What they say matters.
  In fact, these attacks go back to 1916 when Planned Parenthood's 
founder was arrested because she was providing birth control 
information to poor people. Imagine, a woman was arrested for 
explaining to some people how they could prevent unwanted pregnancies--
arrested. I admit that we have come a long way, but these people want 
to take us back. Yes, a woman was arrested for advocating birth 
control. Now you have Republicans right in this Senate and in this 
Congress who say that women shouldn't have access to free birth 
control.
  If they don't want to take birth control, fine. Don't; it is fine 
with me. I respect it. If you don't think your family should ever have 
an abortion, I am with you all the way on your right. That is your 
right. But this is America. We don't have Big Government think. We 
don't have Big Government telling you what to think about your own body 
or what your religion should be.
  This is a major issue. I always thought the old GOP was the party of 
independence. We have our views, but people have a right to think the 
way they want to think. No, that is the old GOP. This is the new POP, 
the party of the past.
  Let me say this. This is sad. This is the 21st century. We should be 
working together to ensure that every family has access to legal health 
care. If you want to make something illegal, have

[[Page 19318]]

the courage to come down here and say it is illegal. Don't start 
defunding organizations that give women health care. Also, stop the 
demonizing rhetoric. One candidate for President on the Republican side 
called people who were pro-choice barbarians, and he happens to be a 
Senator. He called us barbarians.
  What we say matters. Political witch hunts are wrong. What we say 
matters. Special committees set up to demonize an organization like 
Planned Parenthood--that is wrong. I wrote to Speaker Ryan. I asked him 
to disband the latest House committee that was set up. It is costing 
taxpayers hundreds of thousands of dollars for a special committee when 
they have a slew of committees that have jurisdiction over health care 
and over science and fetal tissue research. It is a political witch 
hunt being paid for by taxpayers after they hauled the President of 
Planned Parenthood before them and had her sit there for hour after 
hour.
  The American people have to wake up to this. That is why I am taking 
all of this time. This isn't a small matter of supporting Patty 
Murray's amendment, which is so important. It is a very simple 
amendment. We are going to stop them from defunding Planned Parenthood, 
and we are actually going to increase spending on women's health. I can 
assure you that when you catch breast cancer early, it pays dividends, 
first and foremost to the woman and her family--she is going to live--
and second of all, to the taxpayers. They don't have to treat cancer 
with expensive drugs and surgeries. The same is true when you catch 
cervical cancer.
  When my friend suggests that we spend more on health care to prevent 
these problems, she is doing something right for the taxpayers. Let's 
be clear. There is a dangerous climate out there for Planned 
Parenthood, and it is going to be exacerbated today. Since 1977, there 
have been 11 murders, 17 attempted murders, 42 bombings, and 186 arsons 
against abortion clinics and providers for doing something that is 
legal. Anything we say that promotes this kind of terrorism and 
violence--anything we say that results in this--we should never say. We 
need to protect medical personnel and staff who put their lives on the 
line every day working in these clinics, and we should protect the 
patients who rely on them.
  As my colleague said, imagine a doctor, a nurse having to wear 
protective gear under their uniform. The Women's Health Care and Clinic 
Security and Safety Fund that my friend is proposing is very important. 
It is a very important vote. It will provide compensation for health 
providers who provide the full spectrum of comprehensive women's health 
care services, and it will enhance safety at clinics.
  The great Ted Kennedy and I worked on the FACE Act. That was his 
bill. The FACE Act was meant to protect patients and doctors at 
clinics. All those years ago--I was a young, new Senator then, and he 
asked if I would be his lieutenant and help him get the bill through.
  We got the bill through, but I think what Senator Murray is doing 
today is responding to the violence, the increased violence, the 
atmosphere of fear that we see at these clinics. Her amendment also 
requires the Secretary of Health and Human Services to work in 
coordination with the Attorney General's National Task Force on 
Violence Against Health Care Providers to submit an annual report to 
Congress identifying the best practices to ensure the security and 
safety of clinics, providers, facilities, and staff. We cannot waste 
another minute on yet another vicious, wrongheaded assault on women's 
health.
  As I said, if you don't want women to have the right to choose, then 
have the courage to come down here and take it away. But don't do it 
through the back door by attacking an organization that provides health 
care to 3 million people every year. If you don't want fetal tissue 
research that has been legal for a very long time--since 1993 we have 
had government funding. If you don't like it, if you don't think it is 
helping find cures for diseases, come down here and stop it. Don't 
attack an organization that is involved in that activity legally. If 
you want to take us back to pre-1973 when women died in back alleys, 
have the courage to come down here and make your case. Believe me, we 
will take you on, but do it because that is what you want. Don't hide 
behind attacking these organizations. That is a phony way to approach 
something. Approach it straight ahead.
  We have fought this fight before. We have won this fight before. They 
wanted to shut down the government. We said: Go ahead; try it. And we 
beat them.
  They are doing it again. I have to say, this isn't about me. This 
isn't about Senator Murray. This isn't about any individual Senator on 
the other side.
  We are here for a little time in history. In America, we don't go 
back. I say to the party of the past: We don't go back in America. We 
go forward. We don't take away rights. We expand rights. We don't have 
Big Government telling people what to do in the privacy of their own 
homes, their own bedrooms, their own lives. We let them make the 
decision, as long as it is legal. We are going to fight to make sure 
men and women across this country continue to get the services they 
need. We are going to make sure that Planned Parenthood is still there 
for the millions of women and families who depend on it.
  I strongly support the Murray amendment. I compliment her for putting 
it together. I hope we get a good vote--maybe even a majority vote--and 
make a strong statement for this Senate that we stand with the 3 
million people who rely on Planned Parenthood, and we stand for health 
care.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oklahoma.
  Mr. LANKFORD. Mr. President, I have been able to sit in and listen to 
the debate today about bringing forward a bill that will do two simple 
things: remove funding from the single largest provider of abortions in 
the country, an organization that has recently sold the body parts of 
children to the highest bidder. Also, we would deal with one of the 
main issues that I face every single day in my State, as people 
struggle under the harmful effects every day of the Affordable Care 
Act, which has proven to be neither affordable nor caring to many 
people in my State.
  Let me say some of the things that I have heard recently--that this 
is all about going after women's health. As a very proud husband of a 
very beautiful lady and a proud dad of two beautiful daughters and as a 
son of a breast cancer survivor, this has nothing to do with going 
after women's health, nor demonizing women, nor the war on women, nor 
all the other accusations that I have recently heard. This is not about 
protecting what I have heard called a lifesaving health care 
organization where 325,000 children died in it last year. This is about 
a simple thing: children.
  In the past, back in the old days, they used to identify tissue as 
just tissue. The wart on your skin and other tissues in your body were 
expendable, and it was just tissue, so why does it matter? In the past 
people used to think that way, but now science is able to look inside 
the womb and is able to count 10 fingers and 10 toes on a child and 
watch a child suck its thumb. Scientists can look inside and take a 
sample and see that that child has different DNA than the mom and dad. 
We are now able to look inside the womb and see a unique fingerprint 
that is different from the mom and dad's fingerprint. We understand 
something different now because in the past there was a belief that it 
was just tissue, but now we understand it is not tissue. It is a child. 
As Americans we believe in a simple thing: life, liberty, and the 
pursuit of happiness. It has been what we have been all about from the 
beginning. This is not some attack on women's health. These are 
millions of voices rising up around the Nation and saying: We are 
better than this as a nation.
  Why would we continue to supplement the death of children? Why would 
we do that? Can we be better than

[[Page 19319]]

that? In the days ahead, I firmly believe we are on the right side of 
history, those of us who stand up for children and for those who cannot 
speak for themselves. The most innocent and vulnerable in our society 
need our protection. Just because they are small and just because you 
can't see them doesn't mean they are not valuable and can be thrown 
away. These are children we are talking about--little girls, little 
boys--and we think it is important that someone in this country speaks 
out for them.
  I have heard of late that those of us who speak for life should be 
quieter because there are irrational people in the country who would 
attack a Planned Parenthood clinic. I just have to reinforce this 
point: No one who speaks for life goes and takes a life. No one who 
speaks for the lives of children runs out and takes the life of an 
adult and says that is justifiable. It is not justifiable. It is 
horrific. But just like those individuals who speak tenaciously against 
religion shouldn't be silenced because there was a shooting in a 
church, saying people who are anti-faith should suddenly have no voice 
in America because some irrational person shoots someone in a church, 
the same is true that individuals who speak out for the lives of 
children shouldn't suddenly be silenced by being screamed down because 
an insane person does a shooting in a clinic. Both of them are wrong.
  It is reasonable for us to ask a simple question: Can we, as a 
nation, start a conversation again about children with 10 fingers and 
10 toes and unique DNA with life and promise? Can someone speak out for 
them? I think we can.
  This conversation today is also about the Affordable Care Act, its 
promises, and what has actually occurred. There is no question we have 
major health care delivery issues in America. There is no question we 
have major insurance issues in America. It has been that way for a 
while, and it needs desperate resolution.
  My State, like many other States, started stepping into this. A 
Democratic Governor from my State led the way with our legislature in 
2004 to pass something called Insure Oklahoma and start the process in 
our State, asking: What can we do to try to help the most vulnerable in 
our State? How can we help provide some supplement to another plan?
  We received waivers around Medicaid and started working through a 
process both for those who are employed and not employed to help 
provide that safety net for those individuals. It was a very successful 
plan until the Affordable Care Act was passed, and then the waivers 
were removed from our State and those individuals under that plan lost 
their plan and had to change to another one. In fact, I had some of 
those individuals approach me and say: I know this is a plan that is 
provided by our State so it will be grandfathered into the Affordable 
Care Act, won't it? I had to tell them: No, it will not. We have been 
denied on that.
  It is remarkable to me, as we deal with these two topics side by 
side, how some of the opponents of life can say: We want freedom of 
choice and Big Government out of our lives, but when we get to health 
care delivery, the bigger the government, the better. We want less 
choice. We don't want States to have the option to do that. We don't 
want businesses to be able to choose how they are going to do that. We 
don't want individuals to be able to have that choice. We want Big 
Government to step into people's lives and their health care delivery 
and tell them how it is going to be done. It is fascinating to me to be 
able to see those two issues juxtaposed all of a sudden--get government 
out of our lives but get more government into our health care.
  Now what do we do?
  In 2010, President Obama made this statement in his State of the 
Union Address:

       By the time I'm finished speaking tonight, more Americans 
     will have lost their health insurance. Millions will lose it 
     this year. Our deficit will grow. Premiums will go up. Co-
     pays will go up. Patients will be denied the care they need. 
     Small business owners will continue to drop coverage 
     altogether. I will not walk away from these Americans and 
     neither should the people in this Chamber.

  It is an interesting statement based on what actually occurred then 
after the Patient Protection and Affordable Care Act was actually 
passed, which is another issue to me. It is interesting to me how now 
this is really called ObamaCare or the Affordable Care Act. Almost no 
one calls it the Patient Protection and Affordable Care Act, when that 
was originally its name, and now for some reason patient protection has 
been dropped from our vernacular when this bill is discussed.
  So he made the statement that more Americans will have lost their 
health insurance. I have already referenced how we had thousands of 
Oklahomans lose their health care coverage as soon as the Affordable 
Care Act went into place because they were on Insure Oklahoma. That 
coverage was lost for them. We now have fewer options in Oklahoma for 
health care.
  Blue Cross Blue Shield began notifying 40,000 Oklahomans it will no 
longer offer the Blue Choice provider network to individuals. 
CommunityCare of Oklahoma, a Tulsa-based company offering health 
maintenance organization plans, has notified the Federal Government it 
plans to drop out of the Affordable Care Act market. GlobalHealth, 
another Tulsa-based HMO insurer, said it has already notified 
Oklahomans it is leaving the Affordable Care Act market. Assurant 
Health, a Wisconsin company that has also covered Oklahomans, has now 
notified the government it is leaving the health care coverage area. 
UnitedHealthcare, the new participant in Oklahoma's Affordable Care Act 
market, has not announced the details of the plans it will offer, but 
State officials said its rates will be competitive. That will be 
interesting because next year the rates in Oklahoma will go up, on 
average, 35 percent. That is not some projected number. That is the 
actual number that rates will increase in my State--35 percent.
  It is interesting to me that yesterday on this same floor I heard 
arguments back and forth about the cost-of-living increase and the need 
for individuals who are in a vulnerable position and are receiving 
Social Security--need that help for a cost-of-living increase. I 
completely understand the dynamic of that, but at the same time 
individuals who would support a cost-of-living increase for Social 
Security recipients don't seem to bat an eye when people in my State 
have health insurance increases of 35 percent next year. Do you know 
how difficult it is to cover a 35-percent health care premium increase?
  While the President was speaking in 2010, he said that the premiums 
will go up. Under the plan he put into place, the premiums will 
dramatically go up in my State in 2016. The President said while 
speaking in 2010: ``The copays will go up unless we don't do 
something.''
  The editorial board of the great Oklahoma newspaper, The Oklahoman, 
on November 30, said:

       Numerous reports have noted that policies sold through 
     ObamaCare exchanges increasingly rely on very high 
     deductibles with limited provider networks. For someone with 
     a major illness such as cancer, these policies are still 
     beneficial. But for relatively healthy people, the 
     deductibles are so high that there's little functional 
     difference between being uninsured and insured when it comes 
     to an impact on one's personal finances.

  I cannot tell you the number of Oklahomans I have talked to who have 
said this one thing to me: I have insurance because the law requires me 
to do it, but it is so expensive I cannot use it. So I literally pay 
for something because I am forced to, but I can't actually use it on a 
day-to-day basis because the copays are so high.
  I hear the same thing from doctors and hospitals. Hospitals were told 
that their charity care would go down because everyone will be forced 
to have insurance. Here is what I actually hear from the hospitals in 
Oklahoma: Their charity care has gone up, all of them. Their charity 
care and their writeoff have gone up because now those individuals walk 
into those hospitals and say: I have insurance. But when they get the 
bill and realize how high their payment will be, they say: I cannot pay 
it. So the charity care at hospitals has actually gone up.
  This is from a statement President Obama made in 2010: ``Patients 
will be

[[Page 19320]]

denied the care that they need.'' Well, let me give you an example. On 
June 4 of this year, there was a highlight of Kaylen Richter, a 4-year-
old who was denied coverage under the marketplace for a prescription 
she needed for her asthma. We have a loss of choice and a loss of 
competition in my State. Instead of more options, we have fewer 
options.
  Doctors' offices are selling out because physicians can't seem to 
make ends meet. There are so many requirements on them, they are 
selling their private practice and going into larger hospital 
practices. Hospitals are actually having to take in diagnostic 
facilities. Hospitals are taking care of individual physician 
practices. Hospitals are combining with other hospitals.
  Instead of greater competition, we see a smaller number of hospitals 
and a smaller number of entities. Instead, hospitals and entities are 
becoming larger and larger to be able to sustain that. We have even 
seen that nationally in the insurance market. Because of what is 
happening in the Affordable Care Act, it is pushing out insurance 
around the country. Remember the great statement: It is not government-
controlled health care, it is insurance. Right now, Anthem, Cigna, 
Aetna, and Humana are all going through a combining process, where 
those four insurance companies that are national, large-scale companies 
realize they cannot make it under the Affordable Care Act and are 
merging into one giant company to see if they can make it as a giant 
company, resulting in fewer options, fewer choices, and centrally 
controlled health care.
  How do we turn this back? I will tell you in some ways, you can't. 
The Democrats and President, who have passed this, have succeeded in 
permanently changing health care in America.
  Those individual physicians who used to practice individual medicine 
all over the country and have now merged into larger hospitals, you 
don't undo that. Those individuals who were going to go into medical 
school but chose not to now, you don't undo that for a generation. 
These insurance companies that combined into large groups, you don't 
undo that. The diagnostic facilities that are going out of business and 
merging with large hospitals, you don't just quickly undo that. They 
have succeeded at permanently changing health care delivery in America.
  The challenge now is, How do we help in the days ahead? What do we 
do? I will say that some things can be done. We can continue to provide 
greater options, but the first thing we can do is stop the 
hemorrhaging. First, do no harm. First, engage and try to help the 
people who are affected by this.
  I have offered an amendment in this bill that deals with something 
called the health care compact. It allows individual States that want 
to be able to manage their health care to be able to manage the health 
care in their State. This may seem like a crazy idea except it is 
already done in every single State right now. Every single State 
already has a Medicaid process, has a health care authority, and has 
already made decisions which are severely limited by Federal 
regulations, but that structure is already in place to take care of the 
most vulnerable in our Nation.
  The health care compact would allow States to be able to broaden 
their authorities and to be able to do what needs to be done in order 
to take care of the individuals in their State, as my State has tried 
so hard to do with Insure Oklahoma and other options to be made 
available to people in my State that are being forbidden by the Federal 
Government. This would open that back up and would allow that 
competition.
  I can assure you that every time I speak to smaller rural hospitals 
in my State, they cannot get the attention of CMS and the Federal 
Government because they are small and rural and people in DC don't know 
where they are located and they don't have a big enough lobbying voice. 
They are just another one of those community hospitals out there. That 
doesn't happen if they are interacting with people in my State. Because 
those health care parameters are being set by people in Oklahoma City 
and our State capitol, they know every small rural hospital and the 
dynamics and difficulties there. They are not last in line. They are a 
part of the family.
  Allowing individual States to be able to make health care decisions 
through a health care compact that actually allows that State to be 
able to manage health care in their State is a tremendous asset. My 
State, along with eight other States, has asked for that. It is not an 
unfair request. It is something we should make available to States that 
choose to do that.
  Will every State choose to do that? No. Some States will probably 
want the Federal Government to be able to manage their health care. 
Those States are free to do that, but for States that want to be able 
to have that choice, allow them to have the freedom to do that. If they 
have the structure in place to fulfill the needs within their State, 
why would we forbid it? Why in the world would we say that those of us 
in Washington, DC, know and care more for Oklahomans than Oklahomans? 
When the folks in Washington, DC, say: No, we care more about that 
State and those people in that State rather than the people of that 
State, I think they are misguided. This can be done differently.
  What are we up against? We are up against real people who face real 
issues. It has been incredibly difficult for them to be able to walk 
through the ObamaCare transition. This is not about patient protection, 
and it has been far from affordable as prices continue to go up.
  Let me read one story from my State. It is from a lady who lives in a 
rural area in my State, which has been one of the toughest areas. The 
Affordable Care Act assumes everyone lives in New York City or some 
metropolitan area. Welcome to the rest of America. Not everyone lives 
in big, urban settings. This is one of those folks. She lives in a 
rural area, not too far, but a good distance, from Oklahoma City.
  She said she sold some land recently--and by the way, she is on a 
health care exchange. She sold some land recently, which we do in rural 
America. That made her income go up significantly for that 1 year--one 
land sale. She said the marketplace doesn't see it as a 1-year thing, 
so they take all the information about her subsidies on that before 
taxes. So it raised her premium from $43 to $400. She said she is going 
to try to figure out a way to be able to manage that.
  Then she says this: Why does she have to pay so much for a plan that 
is not even usable in her area? No one will take her insurance, and 
providers are dropping it because they are not getting paid. She has to 
travel now all the way to Oklahoma City so she can find care at all. 
All she is looking for is an affordable option and providers in her 
area that will actually take it. It is one thing to say it provides an 
option. It is another thing to say people can actually access that 
option.
  We can do better as Americans. This is a conversation we should have. 
Let's have it. Let's talk about a better way to be able to do this. 
This is not about fixing something. This is about a transition that is 
happening in health care in America that needs to be corrected. We can 
never go back to where we were. There has been too much permanent 
damage in the system. Now it is a matter of what can be done that is 
best for people--not what is best for the Federal Government but what 
is best for the people of our States. Let's do it.
  I encourage the adoption of my amendment, and I encourage the 
adoption of this reconciliation package that is before our Nation and 
this body in the days ahead.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from California.
  Mrs. BOXER. Mr. President, I have a few remarks to respond to my 
colleague's remarks, and then I ask--I am not going to be long--to be 
immediately followed by Senator Blumenthal.
  Mr. LANKFORD. Mr. President, I would have objection to that request 
if I am not able to respond to the comments she makes.
  Mrs. BOXER. OK, I will just yield to the Senator from Connecticut for 
a

[[Page 19321]]

question, and I will give him his time that way.
  My colleague from Oklahoma came down, and, first of all, he talks 
about ObamaCare and forgets the fact that there are millions and 
millions and millions of Americans who now have insurance, the same 
kind of insurance he has as a Senator and I have as a Senator. He 
forgets the fact, No. 1, that we have seen more people insured than in 
modern history. He conveniently forgets that fact. He forgets the fact 
that there are no limits on coverage. Insurance companies can't cancel 
a person's health insurance.
  He talks about children with great eloquence--and I am sure he is a 
fantastic parent--but he forgets that 17 million children with pre-
existing conditions are insured, which is a pretty important point.
  I really have to take offense to some of the remarks of my colleague. 
He makes an eloquent point about States' rights. He finishes his 
argument about ObamaCare saying: Don't have the Federal Government tell 
my State what to do. Well, in essence, ObamaCare doesn't do that. We 
have an exchange. But, yes, we do require people to get insurance. That 
is true, and that comes from the plan of a Republican Governor named 
Mitt Romney. Then he says: Leave my State alone. Then he wants to take 
away a woman's right to choose an abortion. He wants to do that. He 
thinks the Federal Government should do that. So he makes an eloquent 
point about States' rights, but he, as a Senator who doesn't believe in 
abortion--and that is his total right, and I respect it and I defend 
it--basically says he wants to decide for everybody in the country that 
they shouldn't be able to have an abortion because he doesn't approve 
of that. What makes his opinion more important than mine? There are 
dozens--it isn't. This is America. We all have different views about 
when life begins, about Roe v. Wade. Yet he stands here and uses 
rhetoric that I say is irresponsible. That is my opinion. It is my 
opinion, not his.
  Now, the Senator started off his discussion by saying the truth, that 
he has a beautiful wife and a beautiful family. Well, I want the 
Senator to know I have a handsome husband and a beautiful family. So he 
has a beautiful wife and a beautiful family, and I have a handsome 
husband and a beautiful family. What the heck does that have to do with 
anything else? We are both parents. I am a grandparent. I gave birth. 
What does that have to do with this conversation? The fact of the 
matter is it is not about your beautiful family or my beautiful family. 
It is about the beautiful families out there who, A, need insurance, 
and B, will make their own decision in America about when life begins, 
and who will make their own decision in America as to whether they 
support Roe v. Wade.
  Then my friend says that someone in his family survived cancer--and 
thank God. I have had friends who have survived it, and I have friends 
who have died from it and family members as well.
  This conversation has nothing to do with our lives personally. It has 
to do with the other lives that we impact when we say we are going to 
take away health care from 3 million Americans who get it from Planned 
Parenthood.
  Now, my friend lectures us. He has done this before. He and I have 
gone at this before. It is fine. He talks about his deep feelings about 
how he is against abortion at any stage. Then why doesn't he come to 
the floor, after all his rhetoric--I listened to it and I am offended 
by it, frankly--why doesn't he come down here and right a wrong that 
says it is a crime to have an abortion and you should go to jail. That 
is what he is basically saying, if we listen to his rhetoric, the words 
he used. No, he doesn't do that. I checked his legislative record. He 
just wants to defund organizations that are operating under complete 
legality--under Roe v. Wade, the law of the land.
  Abortion has been legal since 1973. The Senator doesn't agree with 
it. I have total respect for that. But if you think it is a crime, then 
go ahead, instead of coming here and giving these speeches about those 
of us who happen to believe it is up to a woman to decide these issues. 
He is really basically saying we are advocating a crime, and that is 
offensive. I would never say that to my friend, never. And then, of 
course, the whole party over there is attacking an organization that is 
operating legally under the law. Ninety-seven percent of what they do 
is breast cancer screenings, STD screenings, cervical cancer 
screenings--saving peoples' lives. I have met them. I have looked them 
in the eye. I know what I am talking about.
  So if you don't think that 3 percent of the work Planned Parenthood 
does--which is absolutely connected to reproductive health, the 3 
percent--then come down and say it is a crime. But I bet none of my 
friends would do that, because if I went to my people and I said 
Republicans think you should go to jail if you have an abortion or go 
to jail if you take a contraception--some of them feel that way, not 
all of them--they would really be in trouble at the polls.
  When you make these verbal attacks on people who don't agree with 
you, sir, your words matter. Your words matter. They have an impact. 
You are here because you are eloquent. Your words have an impact, and 
if what you want to have happen is to put people in jail for performing 
a legal procedure, come down here and do that, but don't come down here 
and say what you think is a crime and then say, therefore, we are going 
to defund an organization that is operating illegally.
  Now, my friend from the other side of the aisle may not like it, but 
3 million people count on Planned Parenthood, and his approach is an 
attack on those 3 million people. More than--I don't know how many 
people live in Oklahoma, but I would assume it is fewer than that, 
perhaps.
  This obsession in repealing ObamaCare, despite the fact that it is 
helping so many people, is of epic proportions. We have seen a repeal 
in the House of Representatives 52 times.
  I wonder if my friend from Connecticut wanted me to yield for a 
question or if he is going to wait.
  Mr. BLUMENTHAL. I will wait.
  Mrs. BOXER. Mr. President, just to sum it all up, it is offensive to 
hear someone describe what is the law of the land as a criminal act. It 
is offensive, to describe it as a crime. But more than that, if that is 
what you believe--and I respect your right to believe it--then come up 
here and do what you are doing. Overturn Roe v. Wade. Tell the women of 
America they have no right to choose anymore. If that is what you want 
to do, go ahead and do it. If you want to make it a crime, make it a 
crime. That is honest. What is dishonest is to attack an organization 
that is acting within the law, which is helping 3 million people, and I 
would say that is what this debate is about.
  I just hope the Murray amendment passes today. It will send a strong 
signal. And if it doesn't pass, we know this bill is going to be 
vetoed, because this President understands that this government is not 
the be all and end all. We are not the moral voice of the universe. We 
are not. People don't even like us as an institution. Let them make up 
their own minds in their own homes, with their own God, with their own 
family. I support them, whatever their decision is. Whether they are 
pro-choice, whether they are anti-choice, I will fight for their right 
to decide for themselves, but I will not force my view on somebody 
else. That is what being pro-choice means, that you are willing to 
understand that there are different positions. I don't have every 
answer, and the Senator from Oklahoma doesn't have every answer. It is 
called humility. I don't have the answer. I will trust my constituents 
to make that decision.
  I hope that we will stop this attack on Planned Parenthood. If this 
is really about a woman's right to choose, let's have that debate. If 
you want to call it a crime, which I have heard on this floor, then put 
your bill out there. Tell people they are committing a crime. Put them 
in jail. Do that. We will have the debate, and we will win that debate, 
but don't go after organizations that are acting completely within the 
law.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Wyoming.

[[Page 19322]]


  Mr. ENZI. Mr. President, I yield such time as the Senator from 
Oklahoma needs to respond.
  The PRESIDING OFFICER (Mr. Sullivan). Senators are reminded that they 
will refer to each other in the third person.
  The Senator from Oklahoma.
  Mr. LANKFORD. Thank you, Mr. President.
  That was actually the first thing I was going to say, that we refer 
back to Senate rules that we are to address the Presiding Officer 
rather than each other, and I appreciate the Presiding Officer 
acknowledging that, according to Senate rules.
  My simple statement today was not intended to be offensive. In fact, 
I think if I went back through the transcript of what I said--I am 
looking for what was offensive rhetoric that was stated multiple times 
by the Senator from California. As I try to think back through what was 
offensive rhetoric, my saying that children have ten fingers and ten 
toes, unique DNA, and a unique fingerprint doesn't seem to be 
offensive. I think also if I went through the legislative record, I 
never talked about criminalizing anything. I heard multiple times 
through a conversation on the floor that I was criminalizing, 
criminalizing, criminalizing. I was actually speaking out for millions 
of children each year that die and saying: Would we not want to 
reconsider the new science that has been available in America for 
decades now, to look inside the womb and see ten fingers and ten toes 
and unique DNA and a fingerprint that is different from the mom or the 
dad, and to understand that we have a basic principle as Americans to 
life, liberty, and the pursuit of happiness? That is a unique value.
  Even the Supreme Court, when they ruled on Roe v. Wade, talked about 
viability. Current science continues to press on what is viable. A 
friend of mine delivered last year a little girl that was 14 ounces. 
That little girl is a healthy little girl now over 1 year old, 
continuing and doing fine. In 1973 that child would not have been 
viable. She is very much a child. She is beautiful.
  As for this whole conversation about millions of people losing 
insurance if ObamaCare goes away and don't I care about millions of 
people and insurance, the issue is not millions of people being 
covered. There are other ways to be able to help millions of Americans. 
As I acknowledged when I spoke, there are real issues in health care 
delivery in America and there are significant issues that continue to 
this day. My simple statement was that those issues get larger and 
larger, and my concern is that while individuals would stand up and say 
we have millions of people covered, they ignore a 35-percent increase 
of premiums in my State. They ignore the reality of a growing copay in 
my State and that people are forced by law to buy a product they cannot 
actually afford to use. My simple statement is this: Can we not 
acknowledge--not that there are not millions of people not newly 
covered--that we have millions of people now that have a coverage that 
they cannot use and cannot afford to keep yet they are compelled by law 
to do it. In fact, they become criminals if they don't buy the health 
care coverage required by law. These are real issues and they really do 
need dialogue. Good civil dialogue will help us work these things out--
and centering in on the facts.
  With that, I yield back.
  The PRESIDING OFFICER. The Senator from Connecticut.


                           Amendment No. 2876

  Mr. BLUMENTHAL. Mr. President, I want to thank my colleagues from 
Oklahoma and California for this exchange of views, and most 
particularly I want to thank my colleague from the State of Washington 
for the amendment that she has offered that would, in effect, remove or 
eliminate a harmful provision in the budget reconciliation bill, a 
provision that would eliminate funding for Planned Parenthood and other 
providers of reproductive health services for women. Very importantly, 
it would also establish a fund to assist the Department of Justice in 
monitoring and combating violent opposition to women seeking access to 
lawful reproductive health services.
  We can have a broad and comprehensive debate on a great many of the 
subjects that are related to the amendment offered by Senator Murray, 
but the simple fact is that funding for Planned Parenthood helps with 
women's health care. It provides services such as cancer screening, 
birth control, and STI testing and treatment that simply are 
inaccessible and unavailable to those women anywhere else. For all the 
talk about alternatives to Planned Parenthood, the women who receive 
services through Planned Parenthood have nowhere else to go in so many 
instances. In the majority of the care provided by Planned Parenthood, 
cancer screenings, birth control, and STI testing and treatment result 
in pregnancies that are wanted and intended and produce healthy 
children, as opposed to pregnancies that are unintended and unwanted, 
which certainly in this body and in America generally, no one wants to 
see.
  So I hope that we have common ground here, that an organization such 
as Planned Parenthood, which does so much good, and the men and women 
of Planned Parenthood, who have so much courage and fortitude in the 
face of threats and intimidation that confront them every day, should 
be supported, not demeaned or dismissed. Their funding should be 
enhanced, not diminished. So far as enforcement is concerned, the 
Department of Justice should be doing more and doing better. It should 
be provided with those funds that will assist in combatting and 
monitoring the violent opposition to women who are seeking services. We 
have seen in just the past few days the impact of that violence, 
tragically, in death and injury in Colorado. But that tragedy is simply 
the tip of ongoing and apparently unceasing threats and intimidation at 
many of those clinics and health care services around the country. So I 
say with sadness--not anger but grief--in seeing the horrific impact of 
this violence, that the services are necessary, health care should be 
supported, and violent opposition should be monitored and prosecuted 
wherever it occurs.
  Today I pay tribute to clinicians, professionals, volunteers, 
escorts, and all those who support Planned Parenthood and who continue 
their work in the face of the dangers that confront them day in and day 
out. I hope my colleagues will support me in endorsing Senator Murray's 
amendment so we can ensure women continue to have access to these 
necessary basic health care services.
  Thank you, Mr. President.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. At the end of the year, Mr. President, when there is so 
much to do, I think it is particularly important for this body to try 
to find common ground on difficult issues, to try to be bipartisan. I 
mentioned it yesterday, but literally 24 hours ago, I joined with the 
senior Senator from Iowa, Mr. Grassley, on a bipartisan effort to deal 
with this enormous challenge of making sure that when we have 
breakthrough cures for serious illnesses here in our country, Americans 
are going to be able to afford them. Senator Grassley and I teamed up 
for 18 months, reviewed 20,000 documents, did an exhaustive inquiry 
into the new drugs that have come out to deal with hepatitis C, and 
they are extraordinary drugs. The question is, Will Americans be able 
to pay for them? Senator Grassley and I thought it was very important 
to do it because this is what the future is going to be about.
  I know the distinguished Senator's son is very interested in these 
health issues. As we try to get cures for Alzheimer's, diabetes, heart 
disease, and the question of hepatitis C, it is wonderful to have the 
cure. The question is, Is it going to be beyond the reach of the 
people? Senator Grassley and I, for over 18 months, worked 
painstakingly in a bipartisan kind of way, and it has been very well 
received. So 24 hours ago we were talking about that, and what I am so 
troubled about this morning is that when we need bipartisanship more 
than ever, we are looking at a partisan reconciliation bill that, in my 
view, will undermine women's health care in this country by denying 
funding to Planned Parenthood.

[[Page 19323]]

  My view is that to take away health care choices from American women 
that have nothing to do with abortion--particularly after the horrific 
act last week in Colorado--is just an act of legislative malpractice 
that is beneath the Senate.
  I note that it is going to get a veto if it hits the President's 
desk. My hope is that this body will not let it get that far.
  It is long past time, in my view, to end the ongoing campaign to 
undermine the fundamental right of all women to make their own 
reproductive choices and access affordable high quality health care. 
Millions of American women, including tens of thousands in my home 
State of Oregon, turn to Planned Parenthood for the routine health care 
services that this bill puts at risk. I have read this list on the 
floor before, but it appears not to be sinking in. So let me repeat it. 
This bill, for millions of women, could eliminate access to pregnancy 
testing, possibly gone; and birth control, possibly gone; prenatal 
services, possibly gone; HIV tests, possibly gone; cancer screenings, 
possibly gone; vaccinations, possibly gone; testing and treatment for 
sexually transmitted infections, possibly gone; basic physical exams, 
possibly gone; treatment for chronic conditions, possibly gone; 
pediatric care, possibly gone; hospital and specialist referrals, 
possibly gone; adoption referrals, possibly gone; and nutrition 
programs, possibly gone. When you wipe out Planned Parenthood's 
funding, you dramatically curb access for women in this country to 
health care services that have absolutely nothing to do with abortion. 
I know that there is a smear campaign out there that says that is not 
the case, but it is.
  Senator Murray and I have a proposal that has taken a different tack. 
Our amendment says that instead of putting women's health care at risk, 
let's do more to guarantee that women in Oregon and Washington and 
Alaska and across the country get the high quality care they need. 
Let's help our health care clinics treat more women, and let's help 
them keep their patients safe when they walk through that door. The 
proposal that Senator Murray and I have put forward, in my view, is 
worthy of support from Democrats and Republicans. That has always been 
the case.
  I have enjoyed talking to my new colleague from Alaska, and we talked 
about what has happened to this question of the Senate's historically 
bipartisan approach, which is why I spent some time talking about how 
proud I was to team up yesterday with the distinguished senior Senator 
from Iowa, Mr. Grassley, on this question of making sure that when 
there are breakthrough blockbuster cures, people can actually afford 
them and can actually get them. Those kinds of issues, along with 
women's health, ought to be a bipartisan cause. It has historically 
been a bipartisan cause. My hope is that my new colleague from Alaska, 
the distinguished Presiding Officer of the Senate, is going to continue 
that as we talk about that kind of historical approach where we try to 
find common ground on issues such as women's health care.
  I also wish to note, colleagues, the reconciliation bill involves the 
Senate Finance Committee. Chairman Hatch, of course, chairs the 
committee; I am the ranking member. We have a significant role with 
respect to these public health programs, and we have tried to work in a 
bipartisan way. But this reconciliation bill is a rejection of 
bipartisanship. It is going to pump more noise into the echo chamber, 
but my view is it is going to drive the parties further apart in this 
effort that I look forward to talking to our new colleague about, which 
is how we are going to get people together to work in a bipartisan way 
for improving women's health care.
  When you create such a vitriolic fever pitch, there are obviously 
real consequences. To me, the politics of hostility and extremism help 
spark a culture of violence. And amid that dangerous and toxic culture, 
a man walked into a Planned Parenthood clinic determined to do enormous 
harm. In my view, it attacks women's health. It is an attack on the 
American public, and it cannot be tolerated. It must be fought and 
resisted at every opportunity.
  At a moment when the Senate has a long list of issues to wrap up 
before the year's end and many serious challenges to face, my view is 
that we ought to be in the business of trying to solve problems, not 
create more of them. It is not as if there is a shortage of things that 
have to be addressed; we have plenty of stuff. So why in the world 
would we want to reject the Senate's long tradition of bipartisanship 
and take a very partisan turn with this reconciliation bill?
  I hope my colleagues will support the Murray-Wyden amendment when we 
vote on it, end the campaign against women's health, and do everything 
we can to restore the historic tradition of this body working in a 
bipartisan way on women's health.
  Without going into too much of the history when I was thinking about 
coming over and thinking about the tradition of the Senate, one of the 
first things that happened when I came to the Senate is I had the 
opportunity to work with our former colleague Senator Snowe of Maine, 
who was a champion of exactly these kinds of issues: choices for women 
and improvements in women's health care.
  We can have all of that again--men and women working together in the 
Senate on behalf of the States that sent us to support improvements in 
women's health. To do that this week you have to support the Murray-
Wyden amendment.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Alabama.
  Mr. SESSIONS. Mr. President, I support the reconciliation bill that 
is before us. It will do the job. It will end the Affordable Care Act 
that the American people rightly have opposed, and it will put us in a 
position to repeal this monstrosity of a 1,700-page bill that was 
jammed through Congress in the last hours before Christmas Eve in 2009.
  I remember that day very well. It was a strict party-line vote and 
was passed despite the objections of the American people. It resulted 
in quite a number of people who voted for it not being in the Senate or 
the House again, and it remains a decisive issue for our country.
  Six years ago, the American people did not favor this legislation, 
they resisted it. But the Democratic leadership and President Obama 
determined they were going to pass it, no matter what the people said. 
They were going to get this done, and they rammed it through on 
Christmas Eve of 2009, even though Scott Brown was elected a month 
later in Massachusetts on a campaign to kill the bill. Had he been here 
at that time, there would have been only 59 votes, insufficient votes 
to shut off debate, and the bill would not have passed. He won in 
Massachusetts--one of our most liberal States--on a campaign that said: 
I will be the vote that kills this legislation. So I want to say first 
and foremost that the American people knew this wouldn't work. They 
opposed it from the beginning, they opposed the philosophy of it, and 
they knew we were going to have a mess on our hands.
  Now we have a majority of Republicans in both Houses. There are 54 
Republican Senators in the Senate. We are going to move this 
reconciliation bill, and it will end the effectiveness of ObamaCare. 
But we know the President will veto it.
  I will just say this, colleagues. This is a historic moment. This is 
a moment of great importance nearly 6 years after this bill passed. You 
can be sure the people who pushed it to passage were absolutely 
confident that although the people opposed it then, they would get used 
to it, they would go along with it, and it could never be repealed. But 
that has not happened. The voters have elected Members of Congress to 
oppose this legislation. The polling data shows continued strong 
opposition to this legislation. What we are going to do is establish 
that the elected Congress, a majority in both Houses, opposes this 
terrible law and we will vote to end this incredible piece of 
legislation.

[[Page 19324]]

  We knew it was bad, but there was no way we could have understood 
what was in all of those pages. Health care is utterly complex. It is 
so different in every state from Wyoming, Alabama, New York, 
Massachusetts, and California, and even cities within the States--it is 
all different. So, a one-sized-fits-all approach dictated by the 
federal government simply will not work.
  The Federal Government cannot run anything very well, frankly. We 
absolutely do not need to be involving ourselves in and dominating 
health care in America. That is not the way to get better health care 
for our people.
  It was obvious from the beginning that we were going to have high 
costs and difficulties, but it actually rolled out with more difficulty 
than people could have imagined, starting with the failed computer 
systems. We had Democrats and Republicans concerned over how it was 
being carried out. It was bad from the beginning, and things are not 
getting any better.
  One of the most dramatic promises the President of the United States 
made to the American people was in September of 2009. In pushing for 
this legislation, he said:

       The plan I'm announcing tonight would meet three basic 
     goals. . . . it will slow the growth of health care costs for 
     our families, our businesses, and our government.

  Well, that has not happened. In fact, health care costs for the 
insured in America are surging. In Alabama we are seeing 28 percent 
increases in premiums. I am going to read some letters from people who 
say what has happened to their insurance premiums and how incredibly 
high the deductibles are. No one has written my office to tell me that 
their healthcare costs have decreased.
  President Obama went so far at one point to promise that his health 
care plan would ``bring down premiums by $2,500 for the typical 
family.''
  The American people didn't buy that. They have heard these kinds of 
big government schemes before. They want to go to their doctors. They 
were pretty confident in their plans, and they were worried about 
costs, so this promise meant a lot to them. The President of the United 
States had said that costs were going to come down. That meant a lot, 
but they were skeptical. Their instinct, though, was correct because it 
hasn't happened, and health care costs have continued to go up.
  The administration has acknowledged that many consumers will see 
noticeable premium increases--and indeed we have--when buying health 
care on the ObamaCare exchanges in 2016. According to Health and Human 
Services' own data--government's agency--premiums would increase by an 
average of 7.5 percent for the benchmark silver plans in 2016 in 37 
States using the exchanges, which includes Alabama. But, the rates for 
the benchmark plan in Alabama will increase by even more than that in 
2016--by 12.6 percent.
  For 2016, Blue Cross Blue Shield of Alabama, the largest insurer in 
the State, reported an increase of 28 percent for individual plans and 
13.8 percent for small group plans. These are huge costs. Currently, 
Blue Cross Blue Shield plans on the Obamacare exchange cover about 
174,000 Alabamans. This is real money for a lot of people.
  BCBS initially proposed to increase the premiums for the platinum 
plans, the highest coverage, by 71 percent but later reported a final 
increase of 28 percent. We saw the same trend with the gold plans--BCBS 
initially requested a 53 percent increase, but it was finally reduced 
to 28 percent.
  UnitedHealthcare, the second largest insurer in the State and one of 
the largest in the country, reported an average increase of 24.5 
percent. This amounts to real money out of the pockets of real 
Americans.
  So, it is clear that the healthcare law is fundamentally raising 
costs, reducing choice, and is opposed by the American people.
  In June of 2009, President Obama stated:

       If you like your health care plan, you will be able to keep 
     your health care plan. Period.

  That meant a lot to people. A lot of people said: Well, if they do 
all that--but if I can keep my plan, I am not too worried about it, as 
long as I can keep my plan.
  Did that turn out to be true? No, it did not. By the end of 2013, the 
Associated Press reported that 4.7 million Americans received 
cancellation notices for their insurance plans due to the Affordable 
Care Act.
  In 2013, PolitiFact defined the ``Lie of the Year'' as President 
Obama's promise that ``If you like your health care plan, you can keep 
it.''
  They just said it. Costs are going down, and you can keep your health 
care plan if you want to. They continued to say that, and they were 
able to get the law through Congress. But even then, the polling data 
showed the American people did not support this plan. Scott Brown of 
Massachusetts ran on it in the liberal State of Massachusetts. He said: 
Elect me, and I will be the vote that kills it. But, they got it done 
before he could take office.
  Under this so-called ``affordable act,'' we have higher premiums and 
higher deductibles. Great Scott, I am amazed at how high the 
deductibles have become. This is a communication from an individual in 
the Birmingham area. He wrote to me in June of this year:

       I am an owner of a small 10 person CPA firm in Vestavia. In 
     our group plan offered by BCBS, for our family of 5 our BCBS 
     health insurance went up by $6k a year last year and we are 
     facing more increases this year from BCBS. In our case, this 
     puts our family spending right at $24,000 a year on health 
     insurance. We are blessed enough that we don't qualify for a 
     subsidy and our new policy has less coverage much higher 
     deductibles and more out of pocket costs than ever before. 
     But that said, we are currently spending 18% of our family's 
     AGI on health insurance premiums.

  He is not happy.
  Another individual from Mobile, AL, writes me:

       First year premiums 300 per month, last year 405 dollars 
     per month and now for 2016 premium to be 1562 per month. I am 
     being penalized for having worked all my life and having a 
     retirement and income that puts me in an area with no 
     subsidy. The premium is more than what I get from Social 
     Security. This is going to put me into a area where we 
     decide, my wife and I, on whether or not to get insurance.

  This is from a Ph.D., who wrote:

       For the first time, in 2011, my medical insurance premiums 
     exceeded my mortgage, and they have continued to climb ever 
     since. I now pay over $1,400 a month for mediocre coverage, 
     and it's breaking us. . . . We need a new approach that is 
     market driven and consumer oriented, an approach that doesn't 
     penalize people for failure to participate in the market 
     through a cleverly disguised fine designed to coerce 
     participation from the free citizens of these United States.

  Another individual in the Montgomery area wrote:

       We just received notification at my place of employment 
     that our health insurance premiums are going [up] at least 25 
     percent this year and possibly 40 percent next year. As the 
     controller here, with 100 employees, we cannot afford these 
     increases. We have already seen our benefits reduced to try 
     to keep the costs lower but if we keep on at this rate we 
     will be paying even more for less coverage.

  That is the real world. And I feel strongly that this is happening 
out there all over our country.
  What I want to say to those who are frustrated, who think nothing can 
be done, that is not so. What will be demonstrated today is that the 
majority of both Houses of Congress has the ability to pass legislation 
that will essentially eliminate this plan and require a complete 
overhaul of our health care system. We have the votes to do it. Yes, it 
will be vetoed by the President of the United States. He has rejected 
any and all improvements ever since the bill was passed. He has fought 
virtually everything that would make the bill better. No changes can be 
made in this legislation. But he won't be President forever. We are 
going to have another President soon. That is a fact. And this new 
President can sign a reconciliation bill. We will then be able to 
improve health care in America, to use common sense and not create a 
government bureaucracy of monumental proportions, and to actually serve 
the people we represent. We can enable them to have the type of health 
care policies that they need, at prices they can afford, and help 
people in need, in the same

[[Page 19325]]

way we do today. But, we will eliminate this entire government takeover 
of healthcare.
  Several years ago, when asked if he believed in a single-payer plan 
for health care in America, Senator Reid, the Democratic leader, said: 
Yes, yes, absolutely yes. I raised that in the Committee on the Budget, 
and we had two Democratic members say: I, too, believe in a single 
payer for health care in America. One said: I will acknowledge the 
health care law is not workable today, and the only way to really make 
it work is to go to a single payer--in other words, a government-
dominated health care system in America. I don't think that is the 
right way to go. The American people don't think that is the right way 
to go. They oppose that now, they opposed it steadfastly throughout, 
and they are being proven correct. It is not working. The promises made 
for it were wrong then and are being proven wrong every month that goes 
by.
  Mr. President, this is an important vote. Don't let anyone suggest it 
is not. It is a definitional vote: Do you want to fix the broken health 
care system or do you want to just continue it with no real reform? 
That is the choice.
  I hope we will have bipartisan support for making this kind of 
change. I hope and believe that if this legislation is vetoed by this 
President, we will have a new President in not too many months who will 
sign such legislation and allow us then to create the kind of positive 
health care system the people of this country deserve.
  I thank the Chair, and I yield the floor.
  The PRESIDING OFFICER. The Senator from California.
  Mrs. BOXER. Mr. President, I want to say that it has been interesting 
to hear the debate. It has touched on a lot of things that are close to 
my heart and that I know are close to a lot of other people's hearts, 
which is getting health care to more people--health care that is 
affordable, health care that wasn't available before--and also, 
frankly, making sure we don't have attacks continue on an organization 
called Planned Parenthood that delivers lifesaving health care to 3 
million Americans each and every year.
  There are a couple of points I would like to make. In a very strong 
debate I had with the Senator from Oklahoma, Mr. Lankford, I stated 
that I was offended because I believed that--Mr. President, I will go 
through you. The Senator basically said that those of us who are pro-
choice are essentially supporting a crime against children, and he took 
issue with that and said he didn't. Well, I want to place in the Record 
his exact words, if I might.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mrs. BOXER. This is from the transcript. After talking about 
abortion, he says:

       Why would we continue to supplement the death of children?

  ``Why would we continue to supplement the death of children?'' As I 
read the English language, that would be an accessory to a crime. So I 
stand by my words. And I would say again, if the issue is whether 
abortion should be legal, that is a fair issue. And I think if people 
feel it is a crime, then they ought to come down here with their 
legislation to put women in jail. I think that debate would be 
important. But they shouldn't attack an organization that is legal--
Planned Parenthood--that is living within the law, and 97 percent of 
what they do has nothing to do with choice, and the other 3 percent is 
totally legal.
  The GOP has tried to repeal ObamaCare dozens of times. This is 
another time. I do agree we have to fix certain aspects of the 
Affordable Care Act, ObamaCare. Absolutely. In my State, it is a raging 
success. In California, I want you to know we have 40 million people, 
so this is a very big test case. We are like the fifth or sixth largest 
country when it comes to the economy. We have seen the uninsured rates 
in California drop from 17.2 percent in 2013 to 12.4 percent today--in 
2014. We have seen more than 4 million previously uninsured 
Californians get some sort of health care coverage. And I can say that, 
yes, we have to make sure the competition works. What we have in place 
is not a single-payer law. We have in place an exchange where private 
companies come in. The competition is important, and if it isn't 
robust, there are going to be these increases. So I think it is very 
important. For the people who can't afford to get insurance off Covered 
California, which is our exchange, we have seen 3.5 million more 
Californians enroll in Medi-Cal thanks to the Medicaid expansion.
  Also, in this country, 30 million women with health insurance are 
able to access contraception without any cost-sharing. That is very, 
very important because I would hope we would agree that unintended 
pregnancies are not what we want regardless of whether we are pro-
choice or anti-choice. That is important for planning pregnancies. In 
2013 women across this country saved more than $483 million in out-of-
pocket costs for birth control.
  I know there is concern about ObamaCare that continues and rages on. 
I think the question is, Do we want to make it work better--of course 
there are things we can do to make it work better--or do we want to go 
back to the days when if you had high blood pressure or diabetes, you 
couldn't get a policy?
  I remember so clearly constituents grabbing me by the arm and saying: 
My son was born with a disability. I can't get coverage. What am I 
going to do?
  People went broke. People lost their homes and they lost their 
savings before the Affordable Care Act.
  As I say, nothing is perfect, nobody is perfect--not each of us, that 
is for sure--and the Affordable Care Act is not perfect. We need to fix 
it, but what we have heard over and over again from the other side is 
not a legitimate point; it is just an attack, a screaming attack 
against ObamaCare--the Affordable Care Act--and there is nothing in its 
stead. We have said to the other side: Let us know. Well, the reason 
there is nothing in its stead is the underlying form of ObamaCare--the 
Affordable Care Act--is a Republican idea, and it is that everybody 
needs to get health care, and it was based on Mitt Romney's plan that 
he put into effect in Massachusetts.
  So I could go on and on about the amazing results of the Affordable 
Care Act. I mean, I have had people come up and say: Oh my God, my 
child can stay on my policy until age 26. That is amazing. I have 
cancer, and I used to have a limit on what my insurance would pay. Now 
those limits are off because of ObamaCare.
  So whether it is preexisting conditions, or kicking a child off, or 
getting sick and then finding out, guess what, that is it for you, I 
don't want to go back to those bad old days. I am willing to sit down 
with anyone of good will and fix the parts of ObamaCare that aren't 
working. That is fine. But, again, what we see constantly is this 
trying to completely torpedo--and in this case by taking away the 
funds. In the case of Planned Parenthood, it is just: We do not like 
the underlying women's health reproductive laws, so we are going after 
the face of women's health--Planned Parenthood. That is an attack on 
women.
  What we are seeing from the other side is an attack on women, an 
attack on reproductive health care, an attack on the Affordable Care 
Act--ObamaCare--which, although not perfect, is saving families, saving 
lives. This is important.
  I hope we will support the Murray amendment today. If that passes, 
then Planned Parenthood will still be funded. If it fails, the 
President is going to veto this bill, and we will have enough votes to 
sustain that. But this is an exercise that is unfortunate because it is 
an attack on an organization that is doing everything under the law, 
everything that is legal. They had the president of Planned Parenthood 
sit for hour after hour after hour after hour after hour, haranguing 
her--haranguing her--a woman who really, in many ways, is working to 
save lives because when you discover breast cancer early--I think the 
Chair would agree with me--it is so treatable and so curable. If you 
find STDs, you can treat them. If you find cervical cancer in an early 
stage, you can save a life. That is what they are doing.

[[Page 19326]]

  As my friend Senator Wyden said--he is the ranking member of the 
Committee on Finance and a champion for women's health and health in 
general--the fact is, 97 percent of what Planned Parenthood does are 
these screenings, these important screenings. This is basic health 
care--making sure someone's blood pressure is OK. There are so many 
people who go there for their first line of health care. The fact that 
they are in women's reproductive health care--3 percent of their work 
entails that. It is legal. It is legal. It has been legal since 1973.
  I say to my friends on both sides who don't like it, if you don't 
like it, come down here and try to change the law. Make it a crime. Do 
what you want. We will fight you. We will beat you. But that would be 
honest. What isn't honest is attacking an organization that has been in 
place for almost 100 years and the rhetoric associated with it.
  We have seen across this country--I am not talking about Colorado 
because the facts aren't in--an increase in threats to doctors, nurses, 
patients, and clinics. We have seen real problems. So what we say 
matters. What we do matters. I want to thank my friend, who has worked 
so hard on this. I am so strongly supporting the Murray-Wyden 
amendment. I think it is absolutely critical. What I love about it is 
you expand access to health care, but you pay for it. That is really 
important.
  So let's come together over party lines. Let's support that 
amendment, and let's defeat this attack on the Affordable Care Act, 
which, yes, we can make better. But to toss it out or to make it 
unworkable with cuts that we see in these reconciliation bills would be 
a blow to tens of millions of Americans.
  I yield the floor.
  The PRESIDING OFFICER (Mrs. Ernst). The Senator from Wisconsin.


                           Amendment No. 2875

  Mr. JOHNSON. Madam President, I was listening to the good Senator 
from California use a couple words, obviously, calling the health care 
law the ``Affordable Care Act.'' To use the full name, the Patient 
Protection and Affordable Care Act is a real Orwellian name. She used 
the word ``amazing'' about the act.
  She also accused Republicans of attacking women. Let me read an email 
I received from a 60-year-old woman in Spooner, WI, who describes an 
attack on her by the Patient Protection and Affordable Care Act. The 
email reads:

       I am a 60-year-old married female and have maintained an 
     individual health insurance policy since retiring from 
     teaching in June of 2012. Prior to the implementation of the 
     Affordable Care Act, my monthly premium was $276.16 a month. 
     On December 1, 2014, the premium increased by 23 percent to 
     $339.68 to comply with the coverages of the Public Health 
     Service act. That is a 23 percent increase. In August 2015, I 
     received notification that my insurance plan was no longer 
     available, and in order to comply with the Affordable Care 
     Act I would have to have new coverage effective December 1, 
     2015, with an annual premium of $661.94, a 95 percent 
     increase.

  Let me just review that. Prior to the Affordable Care Act, this 60-
year-old woman in Spooner, WI, a retired teacher, was paying $276 per 
month for her health care, and she lost her health care plan. She could 
no longer buy that plan. Another plan was going to cost $661.94--a 95-
percent increase in 1 year.

       Today, October 31, 2015, I received notification that the 
     ACA requires all coverage to renew on January 1st of every 
     year, and that effective January 1, 2016, the premium would 
     be $786.68, an increase over the December premium which would 
     be in effect for only 1 month of 19 percent.

  So she summarizes:

       The increase in my premium between November 2014 and 
     January 2016 is $510, a 185 percent increase.

  She asked the very legitimate question of the Patient Protection and 
Affordable Care Act. She asked: ``How is this affordable?'' Of course, 
the answer is, it is not, and she was not protected. She goes on:

       I have worked since I was age 16, and I have maintained my 
     own health insurance either through my employer or 
     individually. Now at age 60 I find that I can no longer 
     afford the $9,440 annual premium for my health insurance. My 
     husband and I are not wealthy. We have always lived modestly 
     and saved as much as possible so we could live comfortably in 
     our retirement. Now we are penalized for that savings, 
     because our combined incomes, my husband is on Social 
     Security and has income from a 401(k), we do not qualify for 
     any financial assistance.

  She ends with a pretty simple sentence, a pretty simple request--a 
request that I am going to try to honor today. She says: ``Please work 
to repeal this unfair act.''
  Let me review this one more time--again, the results, the attacks, 
the assault on our freedom caused by ObamaCare, the Patient Protection 
and Affordable Care Act. This 60-year-old woman from Spooner, WI, prior 
to ObamaCare was paying $276 per month for her insurance. She could 
afford it. She liked her health care plan. She probably liked her 
doctors. Next year, she will be paying $786 per month, a 185-percent 
increase--actually 2.3 times higher than what she was paying prior to 
the Affordable Care Act. Again, she lost coverage she liked. That has 
been the result of ObamaCare for far too many Americans.
  So having listened to the Senator from California talk about how 
Republicans are attacking women, I think this email from a real person 
who has been damaged, harmed by ObamaCare in Spooner, WI--I would say 
the attack on women has come from the Patient Protection and Affordable 
Care Act.
  Earlier this morning I offered my amendment, and I would like to 
thank Senator Cory Gardner from Colorado for helping me offer it. It is 
a pretty simple amendment. It was modeled under the bill I introduced 
in 2013, the If You Like Your Health Plan, You Can Keep it Act. We have 
a similar type of amendment. It is designed to protect women who are 
under attack by ObamaCare, such as this 60-year-old woman from Spooner, 
WI, to restore their freedom--their choice--to be able to buy the 
health care they could afford, that suited their needs, that paid for 
medicine and health care with the doctor they trusted.
  That is what ObamaCare has taken away from the American public, from 
this 60-year-old woman from Spooner, WI. It has taken away that 
freedom. It has taken away that choice. It has cost her dearly. It has 
been an attack on that woman from Spooner, WI. That is the reality. I 
don't care how much lipstick you try to put on the pig we call 
ObamaCare, the reality of the situation is it has done great harm to 
real people, and it is past time--well past time--that we repeal it. I 
will be pleased to vote yes in honor of her request to please work to 
repair or to repeal this unfair act.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. CORNYN. Madam President, I congratulate the Senator from 
Wisconsin for his amendment. I look forward to voting on it, this 
afternoon, I understand.
  This is actually the promise that President Obama made: If you like 
the coverage you have, if you like your health insurance, you can keep 
it. But, in fact, we know that has not proven to be true.
  I know when the Senator from Wisconsin ran for the Senate, one of the 
primary motivating factors was his own experience with his own 
daughter. I have heard him tell that story time and again. I know he 
feels strongly about it, as well as he feels strongly about his 
constituents who have been harmed as a result of this law, which has 
not performed as advertised.
  Mr. JOHNSON. Will the Senator yield?
  Mr. CORNYN. I will.
  Mr. JOHNSON. The Senator mentioned my daughter, who, by the way, just 
blessed us with a granddaughter just 3 weeks ago. It is a very short 
story, if the Senator doesn't mind me telling it. It did motivate me to 
run. I think it illustrates how damaging ObamaCare has been and could 
be in the future.
  Our daughter Carey was born 32 years ago with a very serious 
congenital heart defect. Her aorta and pulmonary artery were reversed. 
The first day of life, there was an incredibly dedicated, incredibly 
skilled medical professional--a doctor who President Obama just weeks 
before had accused of looking to fee schedules--not that individual 
doctor but doctors in general--

[[Page 19327]]

to see what they would be willing to charge to take out a set of 
tonsils or amputate a foot to make a few more bucks. That charge is so 
offensive on so many levels because those doctors came in on her first 
day of life at 1:30 in the morning and saved Carey's life.
  Then, 8 months later, when her heart was the size of a small plum, 
and with 7 hours of open-heart surgery, a team of incredibly dedicated 
medical professionals in 7 hours of open-heart surgery rebaffled the 
upper chamber of her heart. Her heart operates backwards today, but she 
is 32 years old. She is actually a nurse practitioner, practicing in 
the same hospital where her life was saved. Now she is a new mom, and 
she made me a new granddad.
  Our health care system wasn't perfect prior to ObamaCare, but it was 
still a marvel. I am so concerned about the loss of freedom. My wife 
and I just went to renew our health insurance policy. We are buying it 
in Wisconsin. We can't buy a policy that will pay for care outside of 
the network. Our freedoms are being restricted. If I had that health 
care today, would I be able to go to the specialist outside of our 
network and get that first-class care that saved my daughter's life? I 
am not so sure. That is why it is vital that we repeal ObamaCare and, 
at a minimum, vote for this amendment so that if you actually do like 
your health care plan, this amendment allows you to keep it.
  I appreciate the Senator for yielding and allowing me to tell that 
story.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. CORNYN. Madam President, I appreciate getting to hear that story 
again. I have heard that story a number of times from the Senator from 
Wisconsin. I think it shows how special this effort is to try to get 
people the health care they want at a price they can afford and how 
ObamaCare has done just the opposite. Rather than being part of this 
false narrative about a war on women, there are a lot of women and 
young girls who have been harmed by ObamaCare, which has been a 
disaster.
  Of course, I remember being here on Christmas Eve, 7 a.m., 2009, when 
our Democratic colleagues, then in the majority, had 60 votes and they 
passed ObamaCare without a single Republican vote. I think that was a 
terrible mistake. It was a terrible mistake to take something as 
important to most Americans or virtually to every American--their 
health care--and totally reform the health care system in a partisan 
way and one that could not be sustained. Indeed, we have seen in the 5 
years since that time that our country's health care system is in 
complete disarray.
  We have all read the headlines that describe the double-digit premium 
increases and the skyrocketing deductibles that make people wonder why 
they should buy health insurance in the first place. I guess the answer 
to that is this: If you don't, under ObamaCare you are going to get 
penalized. That is the individual mandate that President Obama at one 
point said he was opposed to when he ran for President in 2008, 
although I guess he came to love it.
  But that is the way the government operates when it mandates what you 
do. It takes away from your freedom, as the Senator from Wisconsin 
said, but it also uses coercion and financial penalties to force you to 
do something you wouldn't naturally do because it is not good for you 
or your family. You are being forced to buy coverage you don't need at 
a price you can't afford. So the only way the government makes this 
function--to the extent it has functioned--is out of coercion, out of 
penalizing the American people and forcing them to buy something they 
don't want. So it is no surprise that such a massive program of Federal 
overreach comes with a major pricetag. This is something that we 
haven't talked about enough.
  In order to pay for ObamaCare, the Congressional Budget Office 
estimates it will cost taxpayers more than $116 billion a year--$116 
billion. Over the next 10 years, that pricetag totals more than $1 
trillion in new taxes. Now, I know for most of us we can't even 
conceive of what that number must be, but that is big. That is huge. It 
is a huge burden on American taxpayers and hard-working families. One 
reason people are struggling to pay the premiums for their ObamaCare 
coverage is because over the last 7 years wages have been basically 
stagnant. Our economy has been bouncing along the bottom, just barely 
out of range of a recession. So people are finding their cost of living 
going up--their price for food, their price for health care. Perhaps 
the only good news in the last few years has been that the price of 
gasoline has come down because of unrelated reasons. But people are 
struggling to make ends meet, hard-working middle-class families who 
previously had been thriving in this economy.
  The bottom line is that ObamaCare has left the American people paying 
more for their medical needs while reducing access and weakening 
coverage. The people I work for back home are adamant they want this to 
stop. So that is the vote we will have tomorrow--to stop this huge 
government overreach that does not serve the interests of the people 
whom presumably it was designed to protect and to provide access for.
  The phone calls and letters and social media posts and face-to-face 
meetings that I have had in Texas over the last 5 years tell me how 
ObamaCare has hurt, not helped, hard-working Texans. Last month I 
received even more letters from my constituents who are exasperated 
about their health care plans. I heard from Texans who have lost their 
doctors and their insurance plans for the same reason that the Senator 
from Wisconsin mentioned. They no longer covered certain specialties 
that are outside the network, and that is because they have had to try 
to find a way to economize. What they have done is they have restricted 
access to doctors and hospitals.
  Then there are the rising premiums. Because of the mandates, you are 
being forced to buy coverage that you don't need. For example, healthy 
men are being forced to purchase maternity care. It makes no sense. 
Young, healthy individuals are being forced to buy coverage to 
subsidize older Americans.
  Then there is the matter of the deductibles. If there is one story 
that I have heard after another, it is from hospitals in Texas, saying 
that people are admitted to our hospital but they have such a high 
deductible, it is as if they are self-insured. Many of them can't 
afford to the pay the deductibles, so we have to eat it. We have to 
find a way to provide them health care because we know they won't able 
to pay their bill, particularly if it is not within the deductible.
  One constituent wrote:

       We were happy with our insurance, but we didn't get to keep 
     it. We were happy with our doctors, but we didn't keep them.

  The same constituent said, ``Our plans to retire early have been 
sidetracked by the unaffordable cost of healthcare.''
  I have also heard from folks who have lost their employer-provided 
health insurance and are now forced to pay double their previous rate.
  One of my constituents wrote:

       Like many other companies [mine] dumped its retired 
     employee medical benefits and said go get your own health 
     care insurance. . . . [Before, it] was only $150 a month. 
     Now, under ObamaCare our [insurance] will cost us $366 a 
     month!

  That may not seem like a lot of money to a lot of people, but if you 
are a retired person and you are on fixed income and if you made plans 
for your future--including your health care--to see your health care 
premiums more than double is a big deal.
  The same person continued: ``I know where you stand on this issue, 
but wanted you to see another example of how terrible the problem is.''
  That is a good word for it: ``terrible.''
  I have also heard from other folks back home who are forced to spend 
countless hours of time and energy researching new plans because their 
previous insurance was canceled. The President and his allies in this 
takeover of America's health care system have said to some people who 
liked their health coverage that it wasn't good enough, so they 
basically made it illegal to continue to sell it.

[[Page 19328]]

  One of my constituents wrote and said:

       I have to spend my valuable time researching yet again, a 
     plan that meets my healthcare needs and possibly stays within 
     my budget. . . . where is the affordable in the Affordable 
     Care Act?

  That is another good question. I think it is useful to understand 
that ObamaCare is not a topic that Texans or most Americans are simply 
indifferent about. People care strongly about making this law a thing 
of the past. My constituents overwhelmingly want this law repealed and 
replaced with more choices where people can buy the health care they 
need at a price they can afford. That does not seem like a lot to ask.
  With the increasing reports from across the country about how 
ObamaCare is hurting American families, there should be no doubt about 
this vote. Although, I predict this will be a party-line vote where all 
of our Democratic friends who supported ObamaCare are sticking with it 
to the very end. But it is unsustainable. It will not work. What we 
would be more productive in doing is trying to work together to come up 
with what the alternative would be that would provide people more 
affordable care and the coverage they need.
  The American people have made crystal clear--last November, in 
particular, when they put Republican majorities in both Chambers of 
Congress--that they want us to do something about this ill-advised, 
misguided law. I look forward to delivering on our promise to vote to 
repeal ObamaCare tomorrow evening before we adjourn for the week.
  This legislation we are currently considering would eliminate more 
than $1 trillion in tax increases and will likely save the American 
people hundreds of billions of dollars in future spending. This is a 
time when our national debt is $18 trillion plus. All we are doing is 
adding more and more debt to future generations who someday are going 
to have to pay it back. Maybe my generation will not be around long 
enough to have to pay that bill, but the next generation and beyond 
will.
  By repealing ObamaCare, we can craft a better way to provide health 
care options that actually work for every American at an affordable 
price. I look forward to getting this bill passed and hopefully 
providing relief to millions of Americans who are burdened by 
ObamaCare.
  I wish to close by saying a good word about the chairman of the 
Budget Committee who has been a counselor, adviser, and navigator of 
sorts to many of us in this challenging procedural exercise known as 
budget reconciliation. I am incredibly grateful, not only for the good 
work he did in assisting us in passing the first budget that we have 
passed since 2009--that is pretty important--but now shepherding us 
through this very difficult process and helping us as the new majority 
to keep our promise to the American people to repeal ObamaCare. When we 
do that and we vote to pass this repeal of ObamaCare tomorrow evening, 
it will be in large part because of the invaluable contributions made 
by the chairman of the Budget Committee, the Senator from Wyoming, and 
his able staff. This has been a team effort. There is no doubt about 
it, but he has been a leader of that team effort.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Maryland.
  Mr. CARDIN. Madam President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                      Paris Climate Change Summit

  Mr. CARDIN. Madam President, as the ranking Democrat on the Senate 
Foreign Relations Committee, my highest priority is America's security. 
Let me share with my colleagues how the climate change summit that is 
taking place in Paris affects global and U.S. security. Climate change 
is a global problem. Global problems require global solutions. As 
negotiators from over 180 nations gather in Paris, I think it is 
important that the Senate take note of this historic moment--when all 
countries, developed and developing, are finally coming together to 
tackle the global threat of climate change. The achievement of a new 
international agreement under the United Nations Framework Convention 
on Climate Change in Paris is our chance to ensure that future 
generations have the opportunity to enjoy a safer, healthier, and more 
prosperous world. Time is running out for us to act.
  As world leaders gather to find cooperative solutions to combating 
climate change, I am reminded of the message of Pope Francis's Climate 
Change Encyclical and the environmental crisis facing our planet. Let 
me quote from Pope Francis.

       The urgent challenge to protect our common home includes a 
     concern to bring the whole human family together to seek a 
     sustainable and integral development, for we know that things 
     can change. . . . I urgently appeal, for a new dialogue about 
     how we are shaping the future of our planet. We need a 
     conversation which includes everyone, since the environmental 
     challenge we are undergoing, and its human roots, concern and 
     affect us all. . . . Climate change is a global problem with 
     grave implications: environmental, social, economic, 
     political, and for the distribution of goods. It represents 
     one of the principal challenges facing humanity in our day.

  Pope Francis is correct. World leaders are heeding the Holy See's 
call for collective action, and for the first time in history, we are 
on the cusp of reaching an agreement where all countries will commit to 
doing their fair share to lower greenhouse gases. Now, 187 nations 
representing 97 percent of the global carbon emitters have already 
submitted plans to lower or limit their carbon pollution.
  U.S. diplomatic leadership helped spur countries like China, Brazil, 
Mexico, South Africa, and others, some of which were previously 
reluctant to pledge any action on reducing emissions or to make serious 
commitments to curb greenhouse pollution. To underscore these 
commitments, some developing countries are also contributing to the 
international climate finance mechanisms that will help the world's 
most vulnerable populations adapt to the world's worst impacts of 
climate change. China alone has pledged more than $3 billion to this 
effort.
  Now that the United States has finally persuaded the broadest 
possible group of countries to take actions against climate change, it 
is no longer true to argue that the United States shouldn't reduce its 
emissions because developing countries refuse to follow suit. We have 
gotten them all to act. Paris is the best chance we have of forging an 
agreement where all countries pledge to lower their carbon emissions.
  U.S. leadership brought us to where we are today, and now the United 
States must seize the opportunity for a truly global agreement to 
address climate change. The United States voluntarily submitted its 
carbon reduction goals very early in the process. Our deliberative 
early action, which included an explanation of the national policies 
that will result in the achievements of our mission reduction goals, 
spurred more than 180 countries to do the same.
  China, for example, committed to lower its carbon emissions per unit 
of GDP by 60 percent to 65 percent below 2005 levels and increase 
renewable energy to account for 20 percent of its electricity 
generation by 2030. This will require China to build an additional 800 
to 1,000 gigawatts of nonfossil electric generation, which is close to 
the entire installed capacity of all powerplants in the United States.
  The global outpouring of support for cooperation is a true testament 
to the strength of U.S. global leadership on climate change. Optimism 
and global cooperation in these efforts are at an all-time high, and 
that is largely due to constructive U.S. engagement. If we want to lock 
in this progress, we must support a strong and ambitious agreement in 
Paris.
  These initial pledges will not put an end to global warming, but they 
are a strong first step that sets the international community on a path 
to limit the rise of temperature by 2 degrees Celsius by 2100. 
Continuing on our current trajectory would result in a projected 
warming of 3.6 degrees Celsius

[[Page 19329]]

by the end of this century. But with the pledges currently on the table 
in Paris, we can lower this to 2.7 degrees--more than halfway to the 2 
degree goal.
  More importantly, however, these Paris pledges are only the first 
wave of action. Actions coming out of Paris will give us a lasting 
framework whereby countries can update their pledges over time to 
ensure that they meet their global goal of 2 degrees Celsius.
  By implementing their initial commitments and making further 
investments in clean energy, cheaper renewable fuels will allow for 
even more ambitious carbon reductions in the future. The Paris 
agreement alone will not end the threat of climate change, but it is a 
solid first step--one that includes countries at every stage of 
economic development.
  The private sector has also come out to voice its support for this 
ambitious agreement in Paris. Already 154 U.S. companies, representing 
$4.2 trillion in annual revenue, operating in all 50 States, and 
employing 11 million Americans, have signed the American Business Act 
on Climate Pledge and are voicing their support for a positive outcome 
in Paris. It is not just governments. It is also the private sector, 
which we desperately need for Paris to be successful.
  The Paris agreement will help send a strong market signal for clean, 
renewable energy worldwide, and that long-term certainty is exactly 
what investors need. If we don't embrace the clean energy revolution 
that the world is poised to leap forward into, then our competitors 
will. It will be the doubters and the deniers who will be blamed for 
the United States' descent from a global leader in clean energy 
technology innovation.
  U.S. deployment of clean energy and technologies has grown 
exponentially in recent years. Renewable energy generation has 
experienced the fastest growth of all generation sectors. Since 2008, 
the cost of clean energy technologies has dropped dramatically, 
fostering this growth. For example, with wind energy, as of 2014, there 
were more than 65,000 megawatts of utility-scale wind power deployed 
across 39 States--enough to generate electricity for more than 16 
million households. In solar energy, by 2014 the total capacity of the 
utility-scale solar PV reached 9.7 gigawatts with 99 percent of these 
installations occurring after 2008. This trend has continued with 15 
percent of all electric generation capacity brought online from January 
to September 2015 arising from the utility-scale PV.
  There is almost limitless growth potential in clean energy. The 
United States has traditionally led the world in energy technology 
development for more than a century. U.S. energy innovations brought 
power and light to the world, and that continued spirit of leadership 
is powering the global clean energy revolution. Strong outcomes in the 
international agreement that is coming together at COP21 Paris will be 
a catalyst in the clean energy revolution. The world is looking to the 
United States for continued leadership.
  This week's announcement of the new Mission Innovation Initiative led 
by the U.S. Department of Energy and Secretary Moniz, which includes 19 
other nations, is a gleaming example of U.S. clean energy diplomacy, 
sending another strong signal of U.S. cooperation and commitments to 
growing job and investment opportunities in the United States while 
providing global clean energy solutions that will allow developing 
global communities to bypass cheap and dirty power and thrive through 
deployment of affordable clean energy solutions. It will be U.S. 
technology helping the global community produce energy in a more cost-
effective and cleaner way, thereby creating more jobs in the United 
States.
  Climate change affects us all. The people of Maryland understand 
that. Those who live on Smith Island in the Chesapeake Bay are seeing 
their island disappear due to the more frequent storms we are 
experiencing and the health of the Chesapeake Bay.
  Climate change is also a world stability issue. Climate refugees are 
a real concern for regional and U.S. security, so this is a national 
security imperative. The solution is COP21 Paris. Two percent Celsius 
goals will dramatically improve the environmental health of the planet, 
thereby helping us with our national security. It will give us energy 
security because we have renewables that are a lot easier to get to and 
are more plentiful than the fossil fuels. Health energy security will 
enable us to no longer be dependent on circumstances that occur in 
other parts of the world. And, yes, we will also create more jobs, 
particularly by the use of U.S. innovations.
  The Paris agreement will serve as an important role in transitioning 
the world toward more renewable energy which will serve as a source of 
American job growth and innovation and put America back in control of 
our own energy future.
  Paris is our best opportunity to avoid the most devastating impact of 
climate change. We need an agreement to ensure that all countries do 
their fair share to address this problem. In order to lock in years of 
U.S. leadership, we need an agreement to maintain the clean energy 
revolution that is so critical to job creation here at home and 
protecting our Nation's energy security, but most importantly, we need 
an agreement to make sure we avoid the most catastrophic impacts of 
climate change that threaten the rights of our children and our 
grandchildren to pursue a healthy, safe, and prosperous life.
  I thank my colleagues for their indulgence, and I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.


                           Amendment No. 2875

  Mr. WYDEN. Madam President, the distinguished Senator from Wisconsin 
has offered an amendment dealing with the Affordable Care Act. I have 
been talking to the staff of both the Finance Committee and the Budget 
Committee, and frankly it is a real head-scratcher because it appears 
that our colleague from Wisconsin is seeking to bring back the so-
called grandfathered health plans that existed between 2010 and the end 
of 2013. We are still trying to sort through this, but at this point it 
looks to me like something of a health care Frankenstein. It seeks to 
bring the dead back to life by having all those plans that were 
grandfathered on December 31, 2013, and died on that date magically 
brought back to life by the Senator from Wisconsin. Many of the plans 
that were in existence on December 31, 2013, don't exist anymore. Plans 
continually change. Plans also changed in 2014, and they changed again 
in the beginning of 2015.
  I am a U.S. Senator who believes very strongly in the role of the 
marketplace in American health care, but it seems to me that the 
amendment by the Senator from Wisconsin, as it is written, distorts 
marketplace forces. Knowing the Senator from Wisconsin as I do, I can't 
believe that would be his intent. We have been reviewing this 
amendment, and our understanding is that this amendment reflects an 
approach to private insurance that is not the way private insurance in 
America works.
  I again come back to my desire to work with colleagues on both sides 
of the aisle and to work in a bipartisan fashion on health care. That 
is what the distinguished chairman of the Judiciary Committee did over 
an 18-month period when he was working with me on pharmaceutical 
issues. Yesterday, we issued an exhaustive report together that was 
bipartisan. What we were seeking to do was to make sure that the 
wonderful cures that are going to be coming to America to address 
horrendous illnesses will also be ones that will be affordable and 
accessible.
  The important point is that this is bipartisan, and that is the way 
the big health care issues have historically been dealt with. But I 
don't see how you can turn back the clock on the health insurance 
market and somehow bring a dead period back to life. Plans change. That 
is the nature of the private insurance market. That is the way private 
insurance in America works.
  I am sure we are going to have some more conversations about that, 
but I do want colleagues to know that at this point, I will have to 
oppose the amendment offered by the Senator from Wisconsin because I 
just don't see

[[Page 19330]]

how we are going to take, as I said, health plans that died and bring 
them back to life.
  With that, 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. ROBERTS. 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. ROBERTS. Madam President, for the first time in 5 years, Congress 
has enacted a full budget that balances. Under our previous leadership, 
we only passed one budget. We have to look all the way back to 2001 to 
find the last time Congress passed a balanced 10-year budget.
  It is vitally important that we go through the regular budgeting 
process to ensure we are being efficient and effective when spending 
hard-working taxpayers' dollars.
  Now that we have a final budget framework, we can have the 
opportunity to adjust spending and make policy changes to rein in the 
excesses of this administration. The first step in this is the 
consideration of the budget reconciliation bill.
  We have before us a budget bill that not only reduces the Federal 
deficit, but it does so by dismantling many of the key provisions of 
the President's health care law known as ObamaCare. We are more than 5 
years into its implementation; however, many of the same problems that 
those of us who were here during the original debate warned of are 
still causing harm to consumers, and new issues continue to arise. We 
continue, unfortunately, to see higher costs, less choice for 
individuals, and higher taxes.
  Prior to open enrollment starting, CMS released the ``2016 
Marketplace Affordability Snapshot.'' This shows that across the 37 
States that use the Federal marketplace, Kansas included, the cost of 
the second lowest silver plan, or the benchmark plan, will increase on 
average 7.5 percent as of next year. That number is more than double 
for Kansas. On average, they are facing a 16-percent increase in the 
benchmark plan. I would assume the same thing will happen in Iowa, the 
State of the distinguished Presiding Officer. This is not the promised 
reduction in premiums the President promised. This is simply not 
affordable.
  Madison from Overland Park, KS, recently wrote to me about her 
family's struggles. She said:

       Yet again our rates are going up to the point where we 
     cannot afford our health insurance that I have had since 
     before 2008. Out of network hospital and doctors limit my 
     ability to provide for my children the health care they need.

  Madison, you certainly hit the nail on the head.
  Even if you can afford the increased premiums to maintain coverage, 
the high deductibles may make it nearly impossible for you to utilize 
the health services under your plan or your doctors are no longer in 
your network, thereby limiting your ability to keep the doctor you 
liked--another broken promise from the President.
  Another local problem of concern for me was the announcement that one 
of the insurance companies that provided coverage on the exchange in 
Kansans will no longer be offering plans as of next year. This impacts 
nearly half of all Kansans enrolled through the marketplace who now 
will again have to find a new plan and possibly new providers.
  We need to repeal this law--a law that includes more than $1 trillion 
in new taxes over the next 10 years. For Kansas households, the 
economic impact is an average tax increase of $876 a year.
  We need to eliminate the individual and employer mandates. The 
employer mandate is stifling job creation, it is reducing workers' 
hours, and it is a disincentive for businesses to grow and expand.
  Jeff from Kansas City contacted me about this one and the effect the 
law is having on his manufacturing business. He said:

       Without an exemption [from the employer mandate] I will be 
     forced to cut my staff below 50 or let ObamaCare simply put 
     me out of business in the year 2016. Taking the penalty by 
     not offering health care to my staff is the least expensive 
     option in 2016 and will still put me in the red.

  These are not the options our job creators should be stuck 
contemplating--reducing staff or facing closure.
  The individual mandate tax is set to increase on January 1. 
Individuals opting not to purchase or those not able to afford to 
purchase insurance next year will now face a penalty of $695 or 2.5 
percent of household income, whichever is higher. Again, let me point 
out, whichever is higher not lower.
  Removing this penalty will not only provide financial relief for 
these individuals, but it will restore the individual freedom of all 
Americans to choose whether to purchase the government-approved 
insurance. We need to repeal the so-called Cadillac tax, which if left 
in effect will lead to reduced benefits and increased costs for 
employers. We also need to remove the medicine cabinet tax--that is the 
medicine cabinet tax--a new requirement that people must obtain a 
prescription to purchase over-the-counter medication--the things we 
should not need a prescription for--with funds from people's flexible 
spending accounts.
  This reconciliation bill eliminates many of the core provisions--the 
foundations, so to speak--of ObamaCare, and without a strong foundation 
of mandates and taxes to finance this massive overhaul, we can then 
turn to beginning to fix health care. I emphasize fix health care, not 
ObamaCare.
  We need to give peace of mind to the families hurt by ObamaCare. The 
relief provided by this package does just that. I urge my colleagues to 
support this bill so we can then provide freedom to all Americans from 
the mandates of this law and give us an opportunity to pursue more 
patient-centered reforms that will improve access as well as lower 
costs for patients.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Hawaii.


    Expressing Condolences to the Families of Those Affected by the 
                      Shooting in Colorado Springs

  Ms. HIRONO. Madam President, before I begin my remarks, I wish to 
take a moment to express my condolences to the families of those 
affected by last week's shooting in Colorado Springs, including the 
family of Jennifer Markovsky. Jennifer grew up in Waianae, HI. She was 
killed this past Friday at a Planned Parenthood clinic in Colorado in a 
senseless act of violence. I spoke recently to Jennifer's husband Paul 
to express my condolences to him, their two young children, her 
parents, and her ohana.
  Madam President, I wish to speak on an issue of grave importance to 
all women of the United States; that is, the Republican efforts to 
defund Planned Parenthood. One of my first forays into politics 
happened when as a young woman I wrote to my elected officials and 
asked them about their views on a woman's right to choose. At that 
time--1970--Hawaii was considering a bill that would legalize abortion. 
In fact, Hawaii became the first State to do so for our residents.
  Choice to me is not something that should be restricted, whether it 
is the right to choose to end a pregnancy or the right to access birth 
control. Having control over one's health care decisions is a 
fundamental right. When a woman has access to a full range of health 
care services, she has control over her life and her future. Access to 
birth control and other reproductive options means that women have real 
control over their economic and personal security.
  This latest attack on women's reproductive rights by defunding 
Planned Parenthood is a misguided attempt to demonize Planned 
Parenthood. There is currently no Federal funding for abortion 
services--a policy that already hinders the ability of lower income 
women to access a full range of reproductive options. Some States such 
as Hawaii recognize how fundamentally unfair this is and provide State 
funding for abortion services.
  Limiting the ability of women to access health care services at 
Planned Parenthood clinics across the country is just one part of the 
Republican anti-

[[Page 19331]]

women agenda. They refuse to fund day care, family leave or early 
childhood education. In fact, one Republican health care proposal would 
allow insurance companies to eliminate maternity care. What is going on 
here? On the one hand Republicans want to deny women access to 
reproductive care, on the other they also want to punish women for 
having children by not funding programs that support families.
  I repeat, Federal law already prohibits family planning funding from 
being used for abortion services by anyone, including by Planned 
Parenthood. So the measure before us today does nothing more than deny 
millions of women across the country access to birth control and other 
health care services that are not only not prohibited but which are 
perfectly legal.
  The real work of Planned Parenthood is preventive health care 
services. Birth control, STD screenings, and well women exams are the 
bulk of services provided by Planned Parenthood and its affiliates. 
Defunding Planned Parenthood will unjustly punish women who have access 
to no other health care providers for their basic health care needs.
  The harm caused by defunding Planned Parenthood is brushed aside by 
my colleagues. They will argue that they have provided additional 
funding to community health centers to make up for the loss of funding 
for Planned Parenthood. This is a red herring. This very limited 
additional funding will not and cannot replace Planned Parenthood 
clinics and their important role as a safety net provided for millions 
of women across the country.
  Defunding Planned Parenthood is nothing more than an attempt by some 
in Congress to pander to a fringe base. The fact is, the majority of 
Americans support Planned Parenthood and support health care services 
for women. The continuing efforts to defund Planned Parenthood are 
false proxies for banning abortion--that is calling a spade a spade--
and all that will happen is that women's health care will be put at 
risk.
  These attacks on Planned Parenthood must end. So let's stop wasting 
time undermining women's health care and get back to the real business 
at hand. Let's fund the government. Let's give middle-class families 
and small businesses tax relief. Let's pass bills to invest in our 
infrastructure and our children's education. These are all things we 
need to do in the next week that will actually make a difference--a 
positive difference--in the lives of millions of Americans.
  I ask my colleagues to join me in rejecting this extremely partisan 
measure before us and move on to the real business of the Senate.
  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. COATS. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Tillis). Without objection, it is so 
ordered.
  Mr. COATS. Mr. President, for those of us who were seeking office for 
the Senate in 2010, one of the primary issues we were engaged with and 
heard from tens of thousands, if not hundreds of thousands, of our 
citizens about was the concern over the passage of the
Affordable Care Act, now called ObamaCare and now also called the 
Unaffordable Care Act. That was the bill that was jammed through the 
Senate on Christmas Eve without one Republican vote. Republicans were 
denied that vote because the Democratic Party controlled both the 
executive branch and the legislative branch, with numbers that put them 
in a position where they could jam anything through that they wanted 
without any offsets, without any amendments, without any changes, 
without any improvements, without any input from the other party.
  I think we have learned through history that when one party has total 
control and passes legislation, it doesn't represent what the American 
people want. They want debate. They want adjustments. They want the 
other side of the story to be told. Then they want their 
representatives to be able to come to a kind of consensus in terms of 
how we would deal with, yes, an important issue called health care for 
the American people.
  Were there needed improvements in our health care system that had to 
be addressed? Yes, there were. There was consensus--almost--on both 
sides of the aisle, Republicans and Democrats, that changes could be 
made, but the way the American people wanted that done was for us to 
represent their views, to look at all the options, to have some 
balance, which is generally how major programs that need to be 
addressed successfully can be addressed successfully.
  Welfare reform is an example. Under President Clinton, it was a 
bipartisan effort, with both parties recognizing that changes needed to 
be made to a system that wasn't working as well as it could. By working 
together in a bipartisan way, we ended up with a very effective and 
efficient new system compared to the old system. That was not the case 
with ObamaCare.
  So throughout the 2010 period of time, when I was campaigning for 
office, I heard the stories from Hoosiers all across the State--big 
cities, small cities, rural coffee shops, factories, including 
employers and employees, and I heard their concerns about how this 
would play out.
  We were promised by the President that we didn't have to worry about 
losing our health insurance and that if we liked our current plan, we 
could hang onto it. That turned out to be totally false. We were also 
promised by the President that this would not cost one penny to the 
American taxpayer. Now we have the contrast to what this program has 
cost and will cost over a 10-year period of time, and it comes close to 
$1 trillion. So one penny compared to $1 trillion--there is a pretty 
good gap between those numbers. Those were the taxes that were inserted 
into the Affordable Care Act, or ObamaCare, on the American people that 
were supposed to cover the cost of up to $1 trillion over a 10-year 
period of time.
  We were told by the President that if we liked our current plan, the 
premiums would not go up, the premiums would not increase at all, 
period. Trust me. Take it to the bank. Obviously, that has not been 
true. We have now seen the rolling out of this done in a way that only 
the Federal Government could screw it up. Only the Federal Government 
could fail after spending an extraordinary amount of money--well over a 
billion to roll out this thing in a totally dysfunctional way.
  Today, we continue to hear from our constituents about failed 
promises, about higher premiums, extraordinarily higher copayments, 
about how people have not been able to keep the doctor they had, and 
they are paying taxes to cover something that simply has not worked.
  It has been a tortuous process to get to the point where we have the 
opportunity of not being blocked by the other side. We have an 
opportunity now that will occur tomorrow to finally get an up-or-down 
vote on a reconciliation bill that essentially is designed to repeal 
ObamaCare. There have been many alternatives out there that have been 
tried, tested, and true in terms of how we can deal with our health 
care system. We are not just simply walking away, leaving people in a 
lurch. We are simply saying this whole thing needs to be repealed so we 
can build a much better way of providing health care for our citizens, 
and this is the opportunity.
  There will be all kinds of amendments. There will be gotcha 
amendments. I dare you to vote for that. They will be irrelevant to the 
final issue of what we are doing and what we are voting on. It will be 
clear to the American people that this is a vote strictly on the repeal 
of ObamaCare. You are either for it or against it. Come down here and 
defend it if you like it, if it has worked in your State. I haven't 
really heard any people coming down and singing its praises. But come 
down to the floor and say this is why we need it, this is why it is 
good, and refute what we say here. But I think it is pretty hard. I 
don't think I heard anybody come down and defend

[[Page 19332]]

the statement that if you like your health care plan, you can keep it; 
that it won't cost you a penny, and that your premiums won't rise. We 
simply know that is not the case. So this is the moment.
  We will be able to make our yea be yea and our nay be nay, and the 
American people will know exactly where we stand, and I believe we will 
have the votes to pass this in the Senate, as we will have a vote to 
pass it in the House of Representatives. It will then go to the 
President, and the President then will know where the Congress stands 
and where the American people stand, if he doesn't know already.
  I would like to mention one aspect of it that has a pretty astounding 
negative impact on my State, and that is the imposition of a gross 
sales tax on the sale of medical devices. My State is one of the 
leading States in the Nation of medical device manufacturers. This tax 
is levied on their gross sales, not on their profits. In that sense, 
those small companies that are trying to develop something that will 
improve people's lives or save people's lives through medical device 
research and development and then ultimately market it have struggled 
because through the development process they have to pay a 2.3 percent 
tax on everything they sell, even if they are not yet making a profit. 
It has been devastating in terms of employment, in terms of research 
and development in this cutting edge business and manufacturing that is 
saving lives and improving the lives of people. So critical to this 
vote is the medical device tax, which is denying people the opportunity 
to produce medical devices that save people's lives and enhance their 
lives.
  We have more than 300 FDA-registered medical device manufacturers in 
Indiana. It is boosting our State's economy and producing technologies 
that are changing and saving lives, but since the implementation, these 
companies have had to lay off workers and shelf plans to expand and 
build new facilities. One major manufacturer had lined up five new 
plants in Indiana for a significant increase in employment, a 
significant increase in research and development and production of 
medical devices, simply to cover the costs they now had to pay on the 
tax for previous sales of their other products. It is an egregious tax 
that has affected many companies in the State of Indiana.
  In conclusion, how ironic it is that ObamaCare, which President Obama 
said would increase health care coverage, is actually a barrier to 
improving lives. So it is long past time for Washington to stop 
punishing the medical device industry and innovators in Indiana and 
across this country.
  I want to conclude by saying ObamaCare, a poorly written and poorly 
executed health care plan, is not working for the overwhelming majority 
of Hoosiers in my State and the majority of Americans. Remember when 
the then Speaker of the House said: Well, we really don't know what is 
in this plan; we will have to pass it before we know what is in it. We 
now know what is in it. We now know what the impact has been. I have 
been on this floor for hours over the past 5 years talking about real-
life examples of impacts of this Unaffordable Health Care Act on 
Hoosiers. I have given personal testimonies that have been given to me 
by people. I have heard the horror stories of people losing their 
insurance, of their premiums skyrocketing, of their deductible putting 
them in a position where they are not able to afford health care and 
praying every day that someone in the family won't get sick because 
they can't even afford the deductible before they get the coverage. 
This poorly written and poorly executed health care law is not working, 
and the law's continued unpopularity is a testament to what it has 
meant for most American families: rising premiums, higher costs, 
decreased choices, and a poor health care process. All the innovation 
and things that we could have done had we worked through a normal 
process on this are sitting on the shelf.
  The time is now. It is an opportunity we have been waiting for now 
going on 6 years. So when we have that vote tomorrow--and despite all 
the chatter and despite all the attempts to define it as something 
other than what it is--the real vote comes down to whether you want to 
continue government-run health care or you want to look for a better 
model.
  With that, 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.
  Mrs. FISCHER. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mrs. FISCHER. Mr. President, we are on the verge of fulfilling a 
promise that we made to the American people. They selected a new 
majority here in the Senate to repeal ObamaCare. In Nebraska, words and 
promises still mean something. They are not taken lightly. Trust me; 
Nebraskans will let you know when you aren't keeping your word.
  Since the first day I took office, I have heard from Nebraskans about 
how this law is making it harder, not easier, for them to get health 
care. Nearly 20,000 people have contacted my office, and they have 
expressed their concerns about this law to me. They face a new reality 
and struggle to afford premiums for plans requiring thousands in out-
of-pocket expenses. I have come to the floor many times to share these 
stories from Nebraskans, and unfortunately, these stories continue to 
come in.
  Vivian from Saunders County in the State wrote regarding the 
deductible on her ObamaCare plan, which is so high that her husband, 
who is a cancer survivor, is forgoing regular checkups. They simply 
cannot afford the costs.
  Kevin from Chappell, NE, shared his experience with struggling to 
afford the expensive premium while still facing a $10,000 deductible. 
He wants answers for why his family is being forced to buy a plan that 
includes services they just don't need.
  Ann from Lincoln shared with me her struggle to get coverage for 
herself and her two children. After jumping through bureaucratic hoops 
to get health care coverage, she is now forced to buy an insurance plan 
that will take 25 percent of her income. That is a quarter of her 
income.
  Some could argue that these are only anecdotes--a small snapshot of 
what is happening in the State--but let's look at how premiums have 
changed in Nebraska since this law was passed. Next year, many 
Nebraskans will see double-digit increases in their health care costs. 
In 2014, some Nebraskans saw their premiums go up over 100 percent. Why 
are we still debating whether this law has been a success?
  The President has said: ``If you like your plan, you can keep it.'' 
We have all heard that. Nebraskans were promised they could keep the 
plans they liked. Well, tell that to the thousands of people in 
Nebraska who have lost coverage when Nebraska's co-op failed last year. 
They were blindsided on Christmas Eve with news that they had to choose 
a new coverage. Now many more Americans are facing this same challenge 
as over half of the country's co-ops have failed.
  Democrats have said this law would help the American people. 
Americans were promised more. They were promised lower costs for health 
care. We were promised a $2,500 decrease in insurance costs. Well, 
clearly that is not the case. This is a mess, and it didn't have to 
happen.
  It is now our duty to fix it. I am proud that Republicans are taking 
the lead. We are showing the American people our commitment in 
repealing this law. We can do better. We can provide patient-centered 
health care. We can let people decide what kind of coverage they need. 
We can let people take their insurance with them when they move across 
State lines. We do that with car insurance. But the first step is to 
end this--a law that costs families more money and doesn't meet their 
needs.
  So I ask, for the sake of all Americans, it is time to take that next 
step. We need to step up. We need to fix it.
  Thank you, Mr. President.
  I yield the floor.

[[Page 19333]]

  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. TOOMEY. 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. TOOMEY. Mr. President, I want to address an amendment that I have 
for the ObamaCare repeal bill we will be voting on, possibly soon. It 
is a simple amendment. I think it is an important one, and it addresses 
part of the $1.2 trillion in tax increases that are embedded throughout 
ObamaCare. This, in particular, is a tax increase on middle-class 
Americans who are battling with catastrophic health care challenges and 
costs. So I think it was a particularly ill-conceived tax increase and 
I want us to repeal it.
  This is what the tax increase was about. Prior to ObamaCare, if a 
family had out-of-pocket medical expenses that exceeded 7.5 percent of 
their income, they could deduct from their taxable income any cost 
above 7.5 percent of their income. ObamaCare raised that threshold to 
10 percent, and that has very real consequences. There was an exception 
for senior citizens, but that exception expires in 2016, and this tax 
increase on middle-class Americans makes it harder for families who are 
trying to deal with, to battle some kind of very problematic health 
situation they are in. It could be a chronic disease. It could be a 
catastrophic event.
  Let me be specific with an example. Prior to ObamaCare, if a family 
who earned $50,000, for instance, had extraordinary medical costs, for 
whatever reason, that were, say, $4,500--so 9 percent of their income--
that is a huge medical bill for a family who earns $50,000, obviously. 
Well, at least prior to ObamaCare, they could deduct $750 of it. That 
portion which exceeded the 7.5 percent of their income was deductible. 
Under ObamaCare, they can't deduct any of it. They get no deduction.
  So think about what we are doing. We are saying that a middle-class, 
working-class family with unusually, extraordinarily high medical bills 
should lose the opportunity they have historically had to at least get 
a modest deduction to help soften the blow of the catastrophic health 
crisis they are dealing with. I think this is a terrible idea--to hit 
these folks with this tax increase--especially at a time when they are 
dealing with these very difficult circumstances or they wouldn't get 
the deduction anyway.
  So I think it was a bad idea and one of many bad ideas in ObamaCare. 
What my amendment would do is simply restore that deduction to where it 
was before ObamaCare. It would restore the ability to deduct that 
extraordinary health care cost when it exceeds 7.5 percent of income 
rather than having to hit the 10-percent hurdle ObamaCare created.
  By the way, I should point out that this is totally a tax increase on 
middle-class families. The IRS quantified this. They determined that 86 
percent of the taxpayers who claim this deduction--86 percent--earn 
less than $100,000. This isn't a tax deduction for rich people. This is 
a tax deduction for ordinary Americans who are going through very 
difficult times.
  Having the ability to take this deduction is more important now than 
it has ever been because ObamaCare has done so much to drive up 
people's costs. That is not just I saying this. A November 15 New York 
Times headline read: ``Many Say High Deductibles Make Their Health Law 
Insurance All but Useless.'' That is the New York Times.
  High deductibles are one of the main contributing factors to people 
having high out-of-pocket costs. So ObamaCare has driven these plans 
into these high deductibles, thereby forcing people to lay out more 
cash and at the same time they are saying: Oh, but you can't deduct it 
like you used to be able to.
  On November 2 CNBC reported that ``ObamaCare's cheapest plans just 
got more expensive.'' There are deductibles that are soaring to over 
$12,000, out-of-pocket maximums that are near $14,000. People are 
incurring out-of-pocket expenses like never before, and they are 
getting hit with the fact they can no longer take the kind of deduction 
they used to.
  This was a bad idea in the first place. It is a tax increase on those 
who can least afford it--people who are sick, people who are undergoing 
maybe a terrible accident, some other disaster that caused them to 
incur these expenses. It could apply to someone who has long-term care 
expenses for a relative in a nursing home. It could be the special 
education expenses for a handicapped child. It could be a mom 
undergoing reconstructive surgery after a mastectomy. It could be a 
couple seeking to conceive a child needing fertility treatment. There 
are any number of circumstances for which I don't think we should be 
punishing people in this fashion.
  My amendment would simply, as I said, restore the tax deduction to 
the threshold we had before ObamaCare and I would urge its adoption.
  As I mentioned, I think this medical expense deduction issue is just 
one flaw of ObamaCare. It is important, but it is a narrow aspect of an 
unbelievably flawed bill. It is hard to know where to begin with the 
flaws of ObamaCare, but I would suggest several big categories of 
problems: The first is higher costs; the second, I would suggest, is 
the loss of employment; and the third, which is indisputable, is the 
loss of freedom.
  I think higher costs are undeniable. The President promised us that 
average premiums would fall, they would fall by $2,500 in fact. He was 
confident enough to give us a figure, and of course the exact opposite 
is what has actually occurred. ObamaCare premiums have gone up 
dramatically. In my State of Pennsylvania, premiums are up, for next 
year alone, 11 percent. That is after several years of increases prior 
to an 11-percent increase. Whom do you know who has gotten an 11-
percent pay raise? I don't know anybody. That is not what is happening. 
Yet their expenses are going up because of ObamaCare. Deductibles are 
rising at the same time. So not only does it cost more to buy the 
insurance, but the insurance covers less.
  I have gotten letters from literally thousands of Pennsylvanians 
explaining their personal circumstances. One letter came from the 
DiBello family of Montgomery County and says that before ObamaCare they 
paid $662 a month for a health insurance plan for their family and they 
had a $6,000 deductible. They were happy with their plan. They were 
promised if they were happy with their plan they could keep their plan. 
We all heard that promise. How many times was that promise made? That 
promise was made to the DiBello family. The only slightly unfortunate 
problem here is everybody knew it was untrue, including the people 
making the promise because the legislation explicitly forbids whole 
categories of plans. How could you keep your plan if it is being banned 
by the Federal law?
  Unfortunately, the DiBello family experienced that. So the plan they 
are buying that goes into effect in 2016, instead of a $662 monthly 
premium, they are going to have to pay $1,141, and instead of a $6,000 
deductible, they are going to have a $12,800 deductible.
  You almost have to wonder what is your insurance paying for if the 
deductible is that high, but that is what ObamaCare has done to the 
DiBello family of Montgomery County, PA, and let me assure you they are 
but one of thousands and thousands of families I have heard from across 
Pennsylvania who are experiencing similar real difficulties.
  I mentioned jobs as another category of problem that ObamaCare has 
created. Again, I think it is completely irrefutable. We know if you as 
an employer hire a 50th employee, you are suddenly subject to all the 
mandates of ObamaCare. That means the costs of health insurance for 
your workforce go through the roof. It creates a huge incentive not to 
hire the 50th employee. That is a terrible incentive to have, 
especially at a time when we have too few people working and we have 
inadequate wages. Yet this provision guarantees that it will be more 
difficult to get a job with a company that has 40-some employees.

[[Page 19334]]

  In addition, ObamaCare puts pressure on employers to cut back on 
hours for workers because you are deemed to be a full-time worker if 
you work 30 hours or more. One way to deal with that is to have people 
work less than 30 hours. The problem is, employees want 40 hours. They 
want a normal workweek. But they can't get it because of the costs 
ObamaCare triggers if they were to have it.
  Third is the loss of freedom. Again, that is completely irrefutable. 
If you had a plan you were happy with, if you had a plan that worked 
for you and your family, if it was the right mix of benefits, premiums, 
and deductibles for you and you wanted to keep that plan, well, good 
luck--you can only keep it if the government approves of it. So now we 
don't have the freedom to have the health insurance plan we want. We 
are forced to buy the health insurance plan the government dictates we 
should have whether we like it or not. What an egregious affront to the 
personal freedom of Americans to decide what is right for them and 
their families.
  The last thing I want to point out is a very fundamental structural 
flaw in the model of ObamaCare--yet another reason why this needs to be 
repealed--and that is, this bill was designed with the idea that young 
and healthy people would buy health insurance through ObamaCare at an 
inflated price. Of course, in addition to dictating what is in a health 
care plan, ObamaCare dictates pricing as well. The theory was, what we 
will do is we will have all these expensive mandates, but we will force 
this category of people who tend to be younger and healthier--we will 
force them to pay more than it costs to actually insure them, and that 
is how we will subsidize coverage for people who are older and need 
more health care. There is only one small problem with that; that is, 
the younger and healthier people figured out pretty quickly that they 
are being forced to buy a product that doesn't suit their needs very 
well and they are forced to pay more than it is worth. So guess what. 
They are not doing it. And ObamaCare is falling short by millions on 
the number of these younger, healthier people their model depended on.
  What is the result of that? Insurance companies are left insuring a 
population that therefore tends to be older and sicker. That costs 
more. When insurance companies lose many millions of dollars, which is 
what they have been doing, they go back to ``We have to raise premiums 
even further.'' That creates an even more powerful incentive for 
younger and healthier people not to buy the product. What started off 
as overpriced is now even more overpriced for them. This is known in 
insurance terms as a death spiral, this downward spiral whereby it 
becomes impossible to have a viable continuation of these insurance 
policies, because, increasingly, the only people who will buy them are 
the people who are very sick, and people who are relatively healthy are 
priced out of the market.
  This explains why half of all insurance co-ops in America have 
already folded. Many seem to be heading in the same direction. A year 
from now, I doubt there will be many co-ops remaining. This also 
explains why, increasingly, insurance companies are simply saying: We 
are going to have to consider getting out of this market altogether. We 
are going to have to consider simply not participating in ObamaCare.
  What does that mean for Pennsylvania families? It means they are 
going to be out of choices. If there are no insurance plans being 
offered through this exchange because the whole dynamic doesn't work, 
then how are my constituents going to get health insurance? This is the 
problem when the government steps in and tries to take control over an 
industry--in this case, something so important and so personal as our 
health care.
  This is a fatally flawed piece of legislation. Americans have been 
living through its disastrous consequences in the form of losing the 
health care plans that they want, that they valued, that they chose; 
experiencing much higher premiums, higher out-of-pocket costs, and 
higher taxes on the costs they do incur; and fewer jobs and less hours 
for those who are employed. Now, in addition to all this, we see what I 
think is the relatively early stages of this death spiral that is going 
to result in probably a pretty massive exodus from this market.
  It is long overdue that we repeal this legislation. I am very glad we 
will be able to consider this over the next day or so. I urge support 
for my amendment, which would restore the ability of people facing 
catastrophic costs to have the deduction they were able to have before 
ObamaCare, and I urge adoption of this repeal legislation.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Georgia.
  Mr. PERDUE. Mr. President, I rise today to speak about a massive 
expansion of government that was fundamentally flawed from the start: 
the Affordable Care Act, better known as ObamaCare.
  In the past 100 years, we have had three supermajorities, all 
Democratic. The first gave us the New Deal; the second, the Great 
Society; and the third gave us ObamaCare and Dodd-Frank. In many ways, 
these progressive, sweeping government spending programs have failed 
the very people they claim to champion: the working men and women of 
America. Together, they come at a massive expense to taxpayers and 
still continue to add to the Nation's debt crisis.
  Right now, this law is saddling Americans with more than $1.2 
trillion of new taxes over the next 10 years. In my State alone, 
ObamaCare is costing taxpayers over $2.7 billion over the next decade. 
The Senate's actions this week will help reverse the harmful effects of 
ObamaCare and remove the law's burdensome taxes on American families.
  When I am back home in Georgia, one of the most frequent and sobering 
concerns I hear about is the insidious, negative impact of ObamaCare--
whether it is reduced hours, increased premiums, increased deductibles, 
or just the mere fact that they can't get the doctor they want. I hear 
this more than any other complaint about what is going on in Washington 
today.
  By enacting this law, President Obama and Washington put our health 
care system--almost one-sixth of our total economy--under government 
control, and the consequences are disastrous. ObamaCare has driven up 
the cost of health care. In addition, premium costs and deductible 
costs are also up, precluding many Americans from even applying for 
coverage. The law has eliminated health care choices, forced rural 
hospitals out of business, created a doctor shortage, and failed to 
live up to the expectations promised to the American people by the 
Obama administration.
  First, Georgians are seeing their health care costs double. Just this 
week a headline on the front page of the Atlanta-Journal Constitution 
read ``Health care costs on the rise in 2016'' and ``Some Affordable 
Care Act plans seeing double-digit hikes.'' The article went on to 
describe the peril of a Georgia family who plans to cancel their 
insurance plan because it is no longer affordable for them. And this 
family is not alone. As we just heard in the prior speech, deductibles 
have risen to a point now where people can't afford the health care 
plan that was picked for them.
  In Georgia, premium increases are expected to range from 27 to 29 
percent for Alliant Health individual policyholders, and the problem 
could only get worse as more insurance companies exit the ObamaCare 
exchange program. And deductibles are increasing seven times as fast as 
wages are increasing.
  Last week, UnitedHealth Group--the largest health insurance company 
in the country--announced it is considering dropping out of ObamaCare 
because it is losing so much money and the marketplace doesn't appear 
to be sustaining itself. As a matter of fact, yesterday, UnitedHealth 
CEO Stephen Hemsley even admitted that joining the ObamaCare exchange 
was ``for us a bad decision.'' He went on to say, ``We did not believe 
it would form this slowly, be this porous, or become this severe.''
  Washington cannot overlook this warning. Like my wife Bonnie and me,

[[Page 19335]]

many people have already had their plans canceled--no matter what the 
administration said. They said: If you like your policy, you can keep 
your policy; if you like your doctor, you can keep your doctor. I can 
personally tell you that did not happen. A lot of people have lost 
access to their preferred doctors or were forced into insurance plans 
that cost more, not less--dramatically more. If UnitedHealth Group--the 
largest player in this space--exits, Americans will only have less 
choice, not more.
  Aside from driving up health care costs and limiting insurance 
options, ObamaCare is forcing rural hospitals out of business as well. 
Since 2010 alone, five rural hospitals in Georgia have closed, and 
there is a possibility for more in the immediate future. Across the 
country, more than 50 rural hospitals--this is incredible--have closed 
just since 2010, and more than 280 are in danger of shutting down. Each 
closure eliminates local jobs and Americans' access to health care.
  Additionally, given the growing aging population, ObamaCare is 
contributing to a dangerous doctor shortage. The Association of 
American Medical Colleges is predicting a shortage of as many as 90,000 
doctors by 2025.
  Another survey by the Physicians Foundation found that 81 percent of 
doctors describe themselves as either overextended or at full capacity, 
and 44 percent have said they plan to cut back on the number of 
patients they see. They may even retire and/or work part time. This 
further reduces access for people who need medical care.
  Finally, the Obama administration's promise of greater access to 
health insurance has proven to be totally misleading. In fact, now 
almost half of health insurance co-ops created under ObamaCare have 
collapsed due to their failing financial performance. This has resulted 
in hundreds of thousands of Americans scrambling to find sustainable 
health insurance for their families, and the ones who do find it can't 
afford the deductibles that, as we said, have risen dramatically.
  President Obama promised that his massive restructuring of the health 
care industry would give more people insurance. In reality, the law 
continues to disrupt Americans' health care at every turn, while 
failing to cover anywhere near as many people as its supporters 
predicted.
  I am counted as one who signed up for ObamaCare. I didn't have a 
choice. My plan was canceled. My access to my doctor was eliminated. I 
had no choice. But I am counted, as a statistic, as one who signed up 
for it.
  Make no mistake--our health care system needs to change. But one 
thing is clear: ObamaCare is ill-conceived law and is hurting people 
and our economy. It must be fully repealed and replaced. Georgians and 
Americans want access to affordable health care options and 
transportability across State lines. People want to keep their health 
care decisions between themselves and their doctors and not have to go 
through a bureaucrat.
  These are commonsense health care policies we can debate now that 
would lower costs, increase accessibility and transportability, and 
restore the sacred doctor-patient relationship. It won't be easy, but 
it is achievable. We need to start debating replacement plans now. 
There are alternatives to Washington taking over our health care 
system, almost 17 percent of our economy.
  Today, for the sake of our kids and our grandkids, we are taking a 
very important step to repeal ObamaCare and stop government-mandated 
insurance. We are also removing Washington's tax on the very medical 
devices patients and doctors rely on to deliver quality care.
  It is quite clear that this law was flawed from the very beginning. 
The Web site failed, access went down, deductibles went up, and 
premiums are still skyrocketing. The Obama administration is in total 
denial, and they misled the American people and failed to live up to 
the promises made during campaigns and afterward. What further evidence 
do we need to realize this law--this sweeping expansion of the Federal 
Government that pushes more tax dollars to Washington--is not working?
  In order to solve our debt crisis, we absolutely must fix this health 
care crisis, which is why the Senate is eliminating ObamaCare's fines 
on individuals and businesses and finally sending this broken law back 
to the President's desk.
  Today is a momentous day. This week we will actually have this vote. 
I urge my colleagues to put partisanship aside and do what is right for 
the people of America.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Scott). The Senator from Delaware.
  Mr. COONS. Mr. President, I ask unanimous consent that following my 
remarks, the Senators from Connecticut and Ohio be recognized.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.


                         Tribute to Fred Sears

  Mr. COONS. Mr. President, I rise to recognize a close friend from 
Delaware, Fred Sears, a community leader and a passionate advocate for 
all in our community, a man whose name is synonymous with business 
leadership and public service in my home State of Delaware and a man I 
am proud to call my friend. Fred is known statewide for his generosity, 
his enthusiasm, and his business acumen. For decades, his impact has 
been felt by elected officials, nonprofit, community leaders, and 
countless Delawareans of all backgrounds and careers. He is a true 
leader, an authentic champion of the community, and the embodiment of 
what service means in Delaware.
  Fred Sears is a Delawarean through and through. He was born blocks 
away from his boyhood home at what was then called Wilmington Hospital, 
and he grew up across the river from Brandywine Zoo. This Delaware 
native attended Mt. Pleasant Elementary, Aldred I. DuPont Junior High, 
and Wilmington Friends for high school. Fred went on to earn a business 
degree from the University of Delaware. He had a great deal of fun, 
including a truly memorable spring break trip to the Bahamas with Joe 
Biden, his classmate and friend.
  After graduating from UD in 1964, Fred began a nearly 40-year career 
in banking. Fresh out of college, Fred was scheduled to interview for a 
job with the Bank of Delaware but accidentally walked into Delaware 
Trust instead. Fortunately, Delaware Trust was also hiring. After 
starting as a management trainee, he rose to become the institution's 
first vice president of business development. From there, Fred went on 
to later work at Wilmington Trust, then Beneficial National Bank, and 
ultimately Commerce Bank, where he was Delaware market president.
  While Fred was widely known as a leader in our financial services 
industry, he found many other ways to serve our community as well. 
Early in his career, Mayor Tom Maloney asked his friend Fred to take a 
leave of absence from Delaware Trust to serve as the city's director of 
finance and then later as director of economic development. Fred not 
only fulfilled those two roles terrifically, but decided afterward to 
run for an at-large city council seat in 1976. Fred won and went on to 
serve two full terms.
  Many of us in younger generations in politics after Fred's elected 
service have called on his wisdom, his insight, and his ability to 
bring people together as we had important decisions to make. Fred 
served on the transition teams of Wilmington Mayor James Sills, 
Delaware Gov. Ruth Ann Minner, and co-chaired my transition team after 
I was elected New Castle county executive in 2004.
  For many of us, decades of success in finance, business, and politics 
might be the hallmark of a complete and successful career, but for Fred 
these experiences were just a few of the ways he fulfilled a lifelong 
passion for service in our State of Neighbors.
  Just over 13 years ago, while Fred was at Commerce Bank, our mutual 
friend Jim Gilliam, Jr., called Fred one day and said to him: I have a 
job for you. After some convincing, Fred accepted the job. Since then, 
he has served admirably at the helm of one of the most important 
organizations in Delaware--the Delaware Community

[[Page 19336]]

Foundation. The DCF plays an integral role in my home State, helping 
local nonprofits direct philanthropy to Delaware's most worthy causes 
and encouraging long-term charitable giving to improve our State. Since 
Fred began as CEO in 2002, the DCF has tripled its long-term charitable 
funds. It built its assets to $285 million. Dozens of nonprofits and 
community funds have flourished under Fred's leadership. He and his 
team and their astute financial guidance continues to generate the 
funding that enables them to serve. Fred didn't join the DCF, though, 
just to raise money and to be important and recognized; rather, he 
sought to improve the entire philanthropic community and the quality of 
community life in Delaware. His success in doing so reflects his values 
and his vision.
  Fred is a true leader: honest, insightful, thoughtful, creative, 
positive, and confident. Fred possesses that rare quality, the ability 
to inspire others. He has used his passion for service to motivate the 
next generation of great leaders in our State. Take one of Fred's many 
initiatives called the Next Generation. It is one he is most proud of 
and justifiably so. Next Gen takes groups of civic-minded young 
professionals, with limited or no experience in philanthropy, and with 
just the right amount of guidance and encouragement, helps mold them 
into nonprofit board leaders. Since 2004, Next Gen's chapters up and 
down the State have helped direct over $300,000 in grants to community 
needs all over my home State of Delaware.
  My good friend Tony Allen, who also calls Fred a mentor and a friend 
and a brother, tells a story of how Fred helped establish the African 
American Empowerment Fund. The fund today is known as the Council on 
Urban Empowerment, and it promotes philanthropy that supports 
educational, social, and economic empowerment of African-American 
Delawareans. As Tony notes, Fred didn't just help establish the fund, 
he wasn't just one of its first donors, he attended every meeting of 
the group.
  In 2010, Tony introduced Fred when Fred Sears was set to receive an 
award for nonprofit leadership. As Tony put it then, while patience is 
a virtue, impatience is a weapon--and Fred can be appropriately 
impatient. Fred doesn't demur to what others would call insurmountable 
tasks or taboo topics of conversation. He takes every opportunity to 
constructively push the status quo. Tony is absolutely right. Given 
that legacy of leadership, it is no surprise Fred has been honored by 
countless organizations for his business and community efforts. He has 
received the Lifetime Achievement in Philanthropy Award from the 
Association of Fundraising Professionals. He has been given a 
Distinguished Service Award by the Wilmington Rotary Club. He has been 
deemed a Superstar in Business by the Delaware State Chamber of 
Commerce and was named Citizen of the Year by the Delmarva Council of 
the Boy Scouts of America.
  Those awards and merits are certainly a reflection of Fred's values 
and his many successes, but those of us who have had the privilege to 
work closely with Fred and to know him know that his commitment to 
service shines most brightly in the hundreds of interactions he has 
with Delawareans every day, whether he is offering ideas or advice or 
saying a quick hello.
  We know that even though Fred is leaving the Delaware Community 
Foundation, he will undoubtedly continue to serve the community he 
loves. In fact, Fred just accepted an appointment from Governor Markell 
to chair Delaware's Expenditure Review Commission, suggesting Fred has 
no intention of taking retirement literally.
  In a testament to Fred's thoughtfulness, leadership, and sense of 
compassion, just a day after the passing of our beloved friend Beau 
Biden earlier this year, Fred spoke to the Bidens and offered to help 
the family establish an organization in Beau's name. That idea became 
the Beau Biden Foundation for the Protection of Children. Two days 
after it was launched, they had already raised over $125,000.
  If this is all there was to Fred's story, it would be a remarkable 
one, but there is even more to Fred as a businessman, philanthropist, 
and a person. If you speak to those who have been around him the 
longest, they will tell you his true passion is his family: his wife 
JoAnn, his son Graham, his daughter-in-law Kathryn, his son Jason, his 
daughter-in-law Jen, and his treasured grandchildren, Kylie, Paxton, 
and Charlie. I have no doubt Fred's retirement means he will be 
spending a lot more time as Pop Pop to his three treasures, becoming 
even more of a fixture at their frequent school functions and baseball 
and soccer games.
  Fred's friends and family will also tell you how much he adored his 
mother Marjorie, visiting her daily at Stonegates until her passing, 
and how much he cares for his father-in-law today. They will tell you 
that Fred loves dancing, snappy suspenders, and vinyl records.
  Fred's friend Tom Shopa will tell you about Fred's passion for golf 
and how for decades he has kept track of all of his golf scores, the 
number of putts he made, the weather that day--recording every single 
detail just as his father did.
  Friends and colleagues will tell you that they hear Fred say thank 
you dozens of times every day. Today I pause for a moment on the floor 
of this great institution to say thank you to Fred. Thank you for 
giving your time and talents, over decades, to more than 40 community 
nonprofit organizations, for serving on countless boards from 
Christiana Care to Rodel Foundation, from the Wilmington Housing 
Partnership to the United Way. Thank you for your decades of service to 
Wilmington and Delaware, for your lifelong commitment to family, 
friends, and community.
  Fred, as our friend Tony Allen puts it, everyone in Delaware is 
better off because of your efforts. Thank you, Fred Sears, and 
congratulations on many jobs well done. I eagerly look forward to 
seeing where your so-called retirement will take you next.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Mr. President, 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. MURPHY. 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. MURPHY. Mr. President, I am on the floor to speak to the debate 
that is happening now on reconciliation, specifically, the fact that we 
are here for the 16th time in the Senate debating the repeal of all or 
significant parts of the Affordable Care Act, and stack that on top of 
the 50 to 60 times this has been debated--the repeal of all or major 
parts of the Affordable Care Act--in the House of Representatives. As 
many of us have said over and over, we think the debate over repeal is 
over and that we should, A, accept the success of the Affordable Care 
Act and, B, to the extent that there need to be changes made, do it on 
a bipartisan basis--find the ways we can work together to try to 
perfect a law that is by and large working.
  The data only tells one story. I want to review it for a moment 
because if you hear many of my Republican colleagues talk, they act in 
the absence and in the denial of the overwhelming evidence that tells 
you the Affordable Care Act is working. There are 17 million Americans 
who have insurance today who didn't have it before the Affordable Care 
Act. They have gotten it either through these exchanges, these private 
health care exchanges with a tax credit from the Federal Government or 
they have gotten it through Medicaid expansion.
  We have reduced the number of people without health care insurance in 
this country by 30 percent in the few first few years of 
implementation. That is with many States doing everything they can to 
undermine the act. That is with many States refusing to accept the 
expansion of Medicaid coverage that could make that number even greater 
than 17 million or 30 percent.
  In my State of Connecticut, where we have been aggressively trying to 
implement the Affordable Care Act, we have

[[Page 19337]]

actually reduced the number of people without insurance by 50 percent. 
The total numbers in Connecticut are pretty extraordinary, given the 
short amount of time we have had and given the fact that in Connecticut 
we had a pretty robust Medicaid Program to begin with.
  Overall costs to the Federal Government are under control for the 
first time in many of our lifetimes. The average medical rate of 
inflation to the Federal Government is about 2 or 3 percent. The 
overall rate of medical inflation is the lowest since 1960. That is 
because the Affordable Care Act is transitioning payments away from 
volume-based payments, rewarding you for the more medicine you 
practice, to outcomes-based payments, rewarding you for keeping your 
patients healthy.
  Quality is getting better. You look at a broad array of metrics. 
Things such as hospital readmission rates or hospital acquired 
infections are all going down. Let's be clear, the Affordable Care Act 
was not designed to fix every single problem in the health care system. 
There are still going to be problems, there are still going to be 
anecdotal failures, but if you are working to undermine the act in your 
State, you are going to have more problems with your health care 
system.
  When I hear my colleagues come down to the floor of the Senate and 
complain about hospitals closing in their State, when their State is 
actively rejecting Federal money that would help expand Medicaid and 
provide more people walking into hospitals with reimbursement attached 
to them, there is more than a hint of irony to that complaint. If you 
want your health care system to work, then implement the Affordable 
Care Act.


                           Amendment No. 2875

  Senator Johnson is offering an amendment which could be of particular 
harm to the people in my State and in neighboring States. His amendment 
would allow for plans that don't comport with minimum coverage 
requirements of the Affordable Care Act to continue to be offered.
  Before I relinquish the floor, I wish to speak for a moment about 
this particular amendment. There is a little boy named Kyle from 
Simsbury, CT, whom I have talked about before on the floor. Kyle 
requires injections that cost about $3,000 per dose, and he has to take 
them three to four times a week for the treatment of a blood disorder. 
Because his previous insurance plan had an annual lifetime limit, his 
treatment threatened to bankrupt his family. That fear is no longer a 
reality for his family because the Affordable Care Act says if you want 
to offer an insurance plan in this country, it has to be a fair plan. 
It can't have annual or lifetime limits, and it can't charge you more 
because you are a woman. It has to cover basic medical necessities, 
such as maternity coverage.
  The requirement of having insurance plans provide actual insurance 
that doesn't discriminate against a person based on their medical 
history or gender not only allows people to have access to health care 
they didn't have before, but it has given millions of families like 
Kyle's family peace of mind.
  The Johnson amendment would take that peace of mind away from 
millions of families by allowing for plans to go back on the market 
throughout the country--plans that would cap coverage on an annual or 
lifetime basis and that could once again discriminate against you based 
on your gender or medical history.
  There may be a lot of parts of the Affordable Care Act that people 
support or don't support. But the one thing that the people of all 
parties have generally supported is the idea that we should put 
patients and consumers back in charge of their health care, instead of 
the old days when the insurance companies were in charge and would tell 
you that you have insurance, but then halfway through the year, just 
because you used a lot of it, yank it away from you.
  There are a number of reasons why we should reject this specific 
amendment, but on behalf of the millions of families like Kyle's out 
there that don't want to go back to a world in which their insurance 
companies could take away their coverage just because they needed it 
more than other families, their stories alone are example enough to 
reject this amendment.
  I hope that we can move on from this debate and try to work 
together--Republicans and Democrats--to perfect the Affordable Care Act 
and that we can get beyond this perpetual, ongoing, never-ending debate 
about repeal. Specifically, with respect to the Johnson amendment, 
let's think about all of those families that have been jerked around by 
insurance companies for far too long and need relief that the 
Affordable Care Act has given them.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. BROWN. Mr. President, I wish to add to the comments of Senator 
Murphy in opposition to that amendment. I wish to also to point out 
that one of the previous speakers bemoaned the number of hospitals that 
have closed in his State over the last 10 years. I bemoan them too. I 
also know that more of those hospitals would have closed if the 
Affordable Care Act hadn't passed. More of those hospitals would have 
closed if, in States like mine, the Governor didn't expand Medicaid.
  We know that in States where rural hospitals have closed--
particularly if there was a Republican Governor--the hospital 
association and many, many, many health care providers of all kinds, 
including nurses, physical therapists, and others, asked the Governor 
of that State to expand Medicaid so these hospitals could stay in 
business and keep serving rural people. This issue is not just about 
the rural poor people in South Carolina, but rural middle-class people 
who had insurance and were paying, but those hospitals couldn't stay 
open because they didn't have the revenues coming in. If Governors from 
those States had actually expanded Medicaid--as was the intent of the 
Affordable Care Act--instead of scoring political points, many of those 
hospitals would not have had to close.
  I thank Senator Murphy for his efforts.
  Mr. President, I come to the floor to talk about an amendment that I 
will not offer at this time but will probably offer later today about 
Medicaid--again, to help perfect the Affordable Care Act.
  Since the passage of the health law, Medicaid expansion has helped 
600,000 Ohioans--many for the first time in their lives--in my State 
have health coverage just because of Medicaid's expansion. That is why 
the amendment I will offer will permanently extend the Medicaid 
expansion Federal matching rate at 100 percent. Some Governors--I think 
a bit disingenuously, but at least they are saying it--didn't expand 
Medicaid because the States will eventually have to pay up to 10 
percent, even though the State gets all kinds of economic benefits, not 
to mention the humanitarian concerns that it addresses. Nonetheless, my 
amendment will make it 100 percent--no more excuses, first of all, to 
refuse to expand Medicaid.
  At a time when some are looking to halt support for Medicaid, we 
should be increasing that support. Since its enactment in 1965, 
Medicaid served as a lifeline for millions of Americans ranging from 
children and pregnant women to seniors who almost certainly would 
otherwise not afford nursing home care without it.
  Thanks to the Affordable Care Act--while my colleagues on the other 
side of the aisle are attempting to dismantle it--States now have the 
option to expand Medicaid the way Governor Kasich, the Republican 
Governor of my State did, including nonelderly adults without children. 
Thirty States, including the District of Columbia and, as I said, my 
State of Ohio, have taken up Medicaid expansion, and it has obviously 
mattered to a whole lot of people.
  Federal Medical Assistance Percentages, which determine how much the 
Federal Government will pay for covered services in the State Medicaid 
programs, were increased for States that chose to expand their Medicaid 
under the Affordable Care Act. Under the health law, States that expand 
their Medicaid programs receive an enhanced Federal reimbursement for 
the costs incurred by newly eligible enrollees. That matching rate will 
phase

[[Page 19338]]

down from 100 percent to 90 percent in 2020.
  My amendment would make the enhanced FMAP, the Medicaid expansion 
reimbursement, permanent. It is paid for by closing corporate tax 
loopholes. States that have expanded Medicaid have experienced 
significant drops in the number of uninsured. They have realized budget 
savings and cut the cost of uncompensated care for hospitals.
  The number of hospitals I have visited recently, including the 
hospital in which I was born, Medcentral in Mansfield, are bringing in 
more patients who are paying because of Medicaid and the Affordable 
Care Act and fewer patients for which they are uncompensated, thereby 
having to cut costs a little bit less and making that hospital easier 
to manage. Too often hospitals have to cut patient services when they 
have to cut their costs.
  We should continue to support States that have done right and 
expanded access. We can do this by maintaining their current FMAP 
rates. This policy will provide States with financial security. It will 
free up State Medicaid budgets to address other Medicaid needs, such as 
increased access to mental health services or the higher costs of 
prescription drugs. With millions of Americans falling into the 
coverage gap in nonexpansion States--those couple of dozen States that 
have refused to expand Medicaid even though the Federal Government pays 
for almost all of it--this policy is likely to help encourage expansion 
of Medicaid in those States.
  As I said, Ohio is one of the first States to accept Federal funds. I 
thank Governor Kasich, the Republican Governor of Ohio, for doing that. 
Without expansion, Ohioans would have fallen through the cracks by 
making too much for traditional Medicaid but too little to qualify for 
subsidies in the insurance marketplace. Now these individuals, 
including 600,000 in Ohio, have affordable coverage.
  I don't understand how people who represent my State in the House or 
Senate can vote to repeal the Affordable Care Act when they have 
600,000 people in Ohio who have insurance--and that is just the 
Medicaid part--let alone the hundreds of thousands of others. How can 
they vote to take away their insurance? Do they know those people? Do 
they ever look those people in the eye and say: Sorry; I am scoring a 
political point. I will vote against the Affordable Care Act. Sorry; 
you are going to lose your insurance, but maybe we will do something 
down the road to help you.
  Under these new provisions, 24,000 Medicaid enrollees in Ohio are 
being treated for cancer. These include Ohioans like Pamela Harris, the 
mother of four children. She had no health insurance before the State 
expanded Medicaid--again giving credit to Republican Governor Kasich--
and she found herself having to choose between paying for utility bills 
or medication. After her first stroke, Ms. Harris was unable to afford 
followup care and physical therapy, but when she survived her second 
stroke, her recovery was much better. Why? Because she was eligible for 
health insurance through Ohio's Medicaid expansion.
  There are so many reasons to do this. Mr. President, 2015 marks the 
50th anniversary of Medicaid. We should be strengthening the program 
that provides good quality health insurance to millions of Americans, 
including hundreds of thousands of people in Wyoming, Tennessee, South 
Carolina, and my State of Ohio. We should do that and not vote to take 
it away.
  I will offer the amendment later.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Ms. STABENOW. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Ms. STABENOW. Mr. President, I come to the floor today to speak on 
behalf of millions of Americans who are very grateful they have health 
care now under the Affordable Care Act that they didn't have a few 
years ago.
  Looking back over the years, I am reminded of the steps forward that 
we, as Americans, have taken, starting with Medicare and Medicaid, and 
how we have helped to lift a generation of seniors out of poverty and 
ill health because of lack of insurance and not having access to 
prescription drugs. The majority of Medicaid coverage, about 80 
percent, is for seniors in nursing homes.
  We are moving forward again and putting in place the ability of 
people to see a doctor and get the medical care that they need. With 
the Affordable Care Act, we took the next important step for over 17 
million Americans. Moms and dads don't have to go to bed at night 
anymore and say: Please, God. Don't let the kids get sick. They know 
they will be able to take their child to a doctor. They know they are 
going to be able to get coverage and won't get dropped if they get 
sick, which was happening in too many cases before the Affordable Care 
Act. Women now know that just simply being a woman is not a preexisting 
condition, where we were paying twice as much for basic insurance or 
blocked from certain kinds of care.
  I will never forget the debate in the Finance Committee when we 
included an amendment of mine for comprehensive preventive care, 
including maternity care for women, and a colleague asked: Why should 
we cover maternity care? He didn't need maternity care. I reminded him 
that his mom did, and I reminded him of the importance of maternity 
care for women and children and those of us who are now adults. So that 
is now a part of the Affordable Care Act.
  Young people are now able to stay on their parents' insurance while 
looking for a full-time job after they graduate from college. Slowing 
the growth of insurance premiums is what we still need to do. That is 
what we should be focusing on today together--to continue to be laser 
focused in that area as well.
  Now, 17.6 million Americans have health insurance coverage. Under the 
reconciliation bill--the budget bill in front of us--the rug is going 
to be pulled out from all of them, from millions of Americans. Passing 
this reconciliation bill will dismantle the framework, the structure 
for health care for millions of Americans--men and women and children.
  It also will do something else. Instead of celebrating health care 
services that we have had for years--nearly 100 years of preventive 
health care services--through Planned Parenthood providing essential 
health services to men and women, particularly in areas that don't have 
services, such as in rural parts of my State as well as around the 
country--instead of strengthening those services, what we see is an 
effort to actually eliminate preventive health care services for women. 
It seems one more time women's health care is attacked. It takes on all 
kinds of different forms, but it always ends up with the same thing--
challenges to women's health care.
  So I am urging my colleagues to vote no on this Republican budget 
proposal that guts health care for families, that would strip funding 
for preventive health care, for family planning, and for other 
preventive health care. Millions will lose their coverage if this 
passes.
  Instead of focusing on this bill, which is essentially something that 
we know is going to be vetoed by the President of the United States--he 
is not going to allow that health care coverage to be taken away; he is 
not going to allow preventive health care services to be taken away. We 
know what the outcome is really going to be. So this is really a 
political exercise. I understand that people want to say that they 
voted to eliminate the Affordable Care Act, to take away health 
insurance for people, and to stop funding for Planned Parenthood and 
other preventive health care services. But we all know where it is 
going to end. First of all, I can't believe that people think it is a 
good idea to do that, but maybe other States are different than 
Michigan, where people want to have health care for themselves and 
their families.
  We have in front of us a whole other range of things that are very 
important to do right now. There is a major

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effort on a transportation bill that is, in fact--rather than being 
partisan and divisive as this budget reconciliation is--bipartisan, and 
we need to move that as soon as possible.
  We are working on budget issues and tax policy and other areas where 
we can work together. The list is long of things the American people 
want us to get done.
  We need to be tackling the affordability of college so that more 
people have the ability to work hard, get good grades, get accepted to 
school, and go to college. Instead, here we are debating whether people 
should have health care in the United States of America.
  The bottom line is that according to the nonpartisan budget office, 
this bill on the whole would increase premiums by roughly 20 percent 
above what would be expected under current law. So on top of 
everything, including over 16 million people losing their health 
insurance, everybody is going to see their rates go up. Merry 
Christmas, happy Hanukkah, happy New Year--20-percent, on average, 
increase in premiums.
  This reconciliation bill makes no sense. It is bad for the American 
people. It is bad for women. We ought to be focused on things that 
actually improve quality of life and continue to improve health care 
and bring down costs for all Americans.
  I hope we will reject this bill and move on to things that make a lot 
more sense, certainly for families in Michigan and across the country.
  I yield the floor.
  Mr. ENZI. Mr. President, 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. BLUNT. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Toomey). Without objection, it is so 
ordered.
  Mr. BLUNT. Mr. President, I have listened carefully to the Presiding 
Officer's comments earlier and the comments of others who have talked 
about the importance of passing this bill and drawing focus again to 
the health care plan that is just not working. It is not working. The 
State exchanges are failing. They are sort of fleeing to a bigger 
Federal exchange, and the insurance companies are fleeing the Federal 
exchange as well as the State exchanges. They are moving out of the 
family market. They are moving out of the individual market.
  The biggest health insurance company announced recently that they 
were likely to abandon this particular process next year. The plan 
where the insurance companies that had a profit would use some of that 
profit to offset the loss of other companies isn't working because, as 
others have well explained, the incentive for young, healthy people to 
be part of this plan is just not there. The premiums are too high, and 
the deductibles are too high.
  There is no reason to be part of this, and there should be nothing 
new here. The failures of this plan were almost guaranteed when the 
House and Senate, under the control of our friends on the other side, 
decided they were going to pass the bill the Senate passed when there 
were 60 Democrats here to vote for a bill. It doesn't matter how flawed 
that bill was. It doesn't matter how many problems were in that bill. 
It is the only thing we can do, and we are going to do it, and in doing 
it, we are going to interject a government between not only a whole lot 
of the economy but between people and their health care.
  I have said on this floor before and many other places that somebody 
told me one time that when everybody in your family is well, you have 
lots of problems; when somebody in your family is sick, you have one 
problem.
  When the Federal Government decides they are going to help families 
in ways that families don't want that help, when the Federal Government 
decides they are going to interject themselves between families and 
their doctors, families and their health care, families and their 
insurance company choices, you can't really expect good things to 
happen.
  The anticipation not too long ago was that on the individual 
exchange, where you go get your own insurance for yourself, there would 
be 20 million people signed up by the end of last year. When that 
projection was made, I think there were 14 million Americans on the 
exchange. Not too many weeks ago, they were back down to 9 million, and 
the Secretary of Health and Human Services said a better and more 
realistic goal for the end of 2016 would be 10 million people--exactly 
half of the number the administration thought would be there 6 months 
ago. What would be wrong that would cause that to happen? How could you 
be that far off in how you thought Americans and American families were 
going to respond to this? You could be that far off by just not 
listening.
  For the first year of implementation of this plan, I came to the 
floor week after week after week, and week after week after week, I had 
letters, calls, and emails from Missourians talking about how this was 
impacting the lives of their families. I have told those stories on 
this floor before, so I won't tell them again today, but there are 
hundreds of them multiplied by thousands if you talk to anybody who has 
talked to anybody about this system.
  Interestingly, those calls, letters, emails, and contacts appear to 
be coming back because people have now decided that this is not as bad 
as they thought it was; it is worse than they thought it was. The 
problems aren't as great as they had feared; they are worse than they 
had feared.
  In 2013, Lance called our office. He was very concerned. He liked his 
coverage. The President said you could keep your coverage, but his 
coverage didn't conform to the new standards the Federal Government has 
suddenly decided you needed to have no matter what you thought and the 
Federal Government has decided you needed to pay for no matter whether 
or not you could pay for it. So he was told: You can't keep that 
policy. Well, like so many other things in this law, he was pretty 
quickly then told: Well, no, we figured out a way that for a year or 
so, you can keep your policy. So Lance was going to keep the policy, 
but he found out that for any number of reasons related to this big 
change in health care, the policy he wanted to keep was $150 more a 
month than he had been paying for it and the deductible increased by 
$7,500. So, like a lot of other people, he would have loved to have 
kept the policy he had before, but none of it made any sense for him 
anymore.
  I received a letter just a few days ago from a friend of mine who 
runs a business in Kimberling City. In that letter, she mentioned they 
were 3 or 4 employees short of 50 employees. As employers, they didn't 
have to do this, but they had always provided group health and life. 
They wanted to do that again, but in her letter, she said that the 
prices have skyrocketed and the way companies now feel as though they 
have to aggregate their employees is much different than it used to be, 
particularly for older employees, if you are over 47.
  Here are some numbers she gave me in that letter. If you are over 52, 
the increase this year over last year was $2,128. That is the annual 
increase. That is not the annual premium; that is the annual increase, 
$2,128.76. If you are 58, the annual increase was $4,599.60. Again, 
that is not the cost of the policy; that is the increase this year over 
last year. And if you were 61, the increase was $5,680.20.
  This is a company that for years has done everything it could to 
provide this as a benefit. One, it is clearly a benefit they have a 
hard time affording, and suddenly it is a benefit that creates a huge 
obstacle for older workers. Where everybody used to be rated the same, 
they would rate your group, now they want to rate the individuals in 
your group.
  In our State, in Missouri, the average premium has increased by more 
than 10 percent. In Kansas City, the increase is 20 percent. The silver 
plan--not the best plan and not the worst plan--is 13 percent higher. 
The bronze plan, which sort of meets the minimum standards the 
administration says you have to have or pay the penalty, is 16 percent 
higher. That is just 1 year, and this is

[[Page 19340]]

just your insurance. It is not your higher utility bill that is higher 
because of another government regulation; it is not your higher this or 
your higher that; this is just your higher cost of not having to pay 
the penalty.
  Just the other day, Health and Human Services said for the first time 
ever, the average deductible is over $2,000. There is a little merit to 
having some of your own money invested in your own health care as you 
make these decisions, but the average is over $2,000. Many families are 
now seeing a $5,000 individual deductible with a maximum of two family 
members, if you happen to have two people sick in the same year. Those 
same families may be paying $500, $600, $800 a month or more for 
insurance, so you have your insurance costs approaching $1,000 a month 
and your deductible of $10,000. For most families, that is just like 
not having insurance at all. You are writing this check every month 
hoping nobody gets sick. If you get sick, you might have to write 
another $10,000 check or more. As a matter of fact, I just mentioned 
that Lance had the policy where his deductible went up $7,500 as his 
premium was going up $150.
  I spent a lot of time with the hospital community in our State. Over 
and over again, I said: OK, what is your fastest growing column of bad 
debt? Over and over again, the answer is people with health insurance. 
People with health insurance are the fastest growing column of bad debt 
because the health insurance has a deductible that family can't pay. If 
the deductible had been $500, you had that discussion: Well, we can do 
$200 of that, and maybe your mom and dad could help us with half of the 
other $300, and somebody else would help with the other $150, and we 
will pay it. But if it is a $5,000 deductible, many families just say: 
We are never going to pay--we can't pay $5,000. And so the health care 
provider writes that off.
  They are also taxing health savings accounts and flexible savings 
accounts, which are other tools people were using and using pretty 
effectively to have that money for a deductible, to have that money to 
offset things they didn't want to insure against.
  This is a system that is simply designed to fail, and there is no 
news here. There is no news here. Every time I came to this floor to 
talk about this--and that was many, many times--I explained why the 
system would fail. Some of the press in my State--at least I remember 
one column that said: Senator Blunt is spending way too much time 
talking about the weaknesses of ObamaCare. This is everybody's health 
and 60 percent of the economy. It is pretty hard to spend too much time 
talking about those things.
  The other thing we constantly hear is that there were no 
alternatives. Let me quickly list those, and I am going to then yield 
the floor to others.
  The things that could have been done and still could be done, things 
that were proposed even though we constantly hear ``Well, there were no 
other ideas out there''--there were lots of ideas out there. Expand 
health savings accounts. Let those accounts be used for long-term care 
or long-term care insurance. Let small businesses join as a group. Let 
young adults stay on the policy longer. Liability reform, fair tax 
treatment, and buying across State lines are the kinds of things that 
could happen. Prohibit policy cancellation. Use what were very strong 
high-risk pools--expand those so that people with preexisting 
conditions could never be shut out of the insurance market. All of that 
fell on deaf ears, and now all we hear is that there were no other 
ideas, this is the only idea. This is a plan that is not working.
  I urge my colleagues to vote yes on this bill that puts the 
responsibility right back where it belongs--on the President's desk.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from South Dakota.
  Mr. THUNE. Mr. President, you just heard my colleague from Missouri 
talk about many of the things that could be used to replace ObamaCare. 
There were a lot of ideas that make sense when it comes to health care 
in this country, that put patients and consumers more in charge of 
their health care decisions, and that create more competition and allow 
market forces out there to work to drive health care prices down, which 
is the exact opposite of what we have with ObamaCare.
  For those who suggest there aren't other ideas out there, you just 
heard the Senator from Missouri go through a quite lengthy list of 
ideas that could be incorporated into a replacement for what has been a 
disastrous piece of legislation for the American people. The reason for 
that is because after 5 years now, one thing has become abundantly 
clear; that is, ObamaCare just isn't working. It flat isn't working. It 
is not lowering premiums, it is not reducing health care costs, and it 
is not protecting access to doctors or hospitals.
  Instead, Americans are paying more for their premiums. The average 
cost of a family health care plan has risen to $17,545 a year up from 
$13,770 in 2010. That is nearly $4,000 a year in additional costs that 
the typical family in this country is having to contend with.
  In addition to paying higher premiums, Americans with job-based 
insurance are also facing increased deductibles. The situation is also 
bad on the ObamaCare exchanges. Premiums on the exchanges will rise 
once again this year, with many Americans facing rate increases in the 
double digits.
  Then there are the tax increases Americans are facing as a result of 
the law. While the Obama administration did its best to hide the true 
costs of the law, the truth is ObamaCare implements almost a dozen new 
taxes to the tune of $1 trillion. American families are going to face 
an average of $20,000 more in taxes over the next 10 years thanks to 
ObamaCare.
  Now, I could go on. I could talk about the failing co-ops, the failed 
exchanges, the taxpayer dollars the law has wasted and much, much more. 
But today I would like to take just a few minutes to talk about the 
people behind those statistics--the individual Americans who are 
struggling under the tremendous burden ObamaCare has imposed. Over the 
past 5 years I have received numerous letters from constituents sharing 
the pain ObamaCare has caused them. I want to highlight just a few of 
the most recent.
  I had a constituent of mine from Hill City, SD, write to tell me:

       My premium is going from $624.16 a month to $1,054.42 per 
     month, an increase of 68.93 percent. My wife's premium is 
     going from $655.70 to $1,083.41 per month, an increase of 
     65.23 percent. I was under the assumption that the new 
     Affordable Health Care Act was to be just that, affordable. 
     How can a yearly bill of $25,653.96 be affordable to a 
     retired couple?

  That is from a constituent in Hill City, SD. Another constituent in 
Aberdeen, SD, wrote to share a similar story:

       We just received our rate increase for our family health 
     insurance. We have been paying $1,283.81 a month and the 
     $557.45 increase will bring it up to $1,841.26. This amount 
     has gone from 26 percent to 37 percent of our income. . . . 
     After having insurance coverage for the past 38 years, we are 
     faced with dropping coverage, which is ironic since that is 
     not the purpose of the Affordable Care Act. We are 
     considering dropping insurance and facing the penalty just so 
     we can continue to live in our house, pay the bills, and buy 
     groceries.

  Another constituent from Redfield, SD, wrote to tell me:

       My current monthly premium is $863.12. The monthly change 
     in my premium is $470.67, making my monthly premium a hefty 
     sum of $1,333.79. I think this is outrageous.

  Again, this is from a constituent in Redfield, SD. She continues to 
say:

       I know I am not the only one facing such enormous premium 
     increases. My son, who is married and has two small children, 
     received notice that his monthly premium will increase $495, 
     making his monthly premium $1,571.

  Well, unfortunately, she and her son are far from the only ones to 
face such enormous premium increases. A constituent in Sioux Falls, SD, 
is facing a 50-percent premium increase. The premium of a Deadwood 
constituent is increasing by 47 percent. A constituent in Milbank is 
facing a 62-percent premium increase. As I mentioned above, a 
constituent in Hill City is facing an increase of almost 69 percent.
  More than one constituent has written to tell me that his health 
insurance

[[Page 19341]]

costs more than his mortgage payment--more than a mortgage payment. One 
constituent told me she and her husband would have to pay 60 percent of 
their income to insure themselves and their four children--60 percent 
of their income. Think about that. If any more evidence was needed to 
demonstrate ObamaCare has failed, that should be sufficient.
  The Affordable Care Act may have been a well-intentioned law, but it 
has failed to achieve its objective. Not only has it failed to make 
health care more affordable, but it has actually driven up health care 
prices to unthinkable levels for far too many Americans. South Dakota 
families cannot afford 50-percent premium increases or health insurance 
payments that are double their mortgage payments. No family can afford 
that--no family anyplace in the country.
  It is time for Democrats to stop defending this broken law and to 
work with Republicans to repeal it and to begin building a bridge to 
real health care reform for hard-working families across the country. 
The legislation before us today would do just that. It would give us 
that opportunity to move away from a health care plan that has failed, 
that has led to higher premiums and higher deductibles and higher 
copays and higher out-of-pocket costs and constructed networks where 
you can't get access to the same providers you perhaps could in the 
past. So the whole idea that if you like your health care, you can keep 
it is just not reflected in reality for most Americans.
  The promises that were made have been broken. This health care law is 
a failed law. We can do much better by the American people, if we have 
that opportunity, but it starts with repealing this bad law and 
starting over and putting in place a health care system for this 
country that creates more affordable, more accessible health care for 
more Americans. I hope our colleagues here in the Senate will join 
together on both sides of the aisle and repeal this bad law.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Idaho.
  Mr. CRAPO. Mr. President, I rise in opposition to the ObamaCare 
legislation we are dealing with today and in an effort to repeal. I 
join my colleagues in calling on the President to work with us to 
reform this very badly written law.
  By any objective measure, the President's health care law is a 
disaster. Six years ago, at Christmastime, I was here on this floor as 
we held the final debate and held the final vote, after nearly a year 
of trying to stop this legislation from being forced into law. 
Unfortunately, it was passed in the most partisan and misguided way on 
a straight party-line vote after virtually every serious effort to 
amend it and repair it had been rejected outright.
  Since that time, the American people have felt the impact of the law. 
Thirty of the Senators who forced it through this Chamber no longer 
serve in the Senate any more. I don't believe this legislation could 
pass again were it brought before us. Those of us who fought over it at 
that time raised a number of concerns and warned the American people 
that this proposal would result in widespread dislocation of the 
American health care economy, that it would increase taxes on nearly 
everyone, force people from health insurance plans and doctors whom 
they have and whom they like, push up premiums and out-of-pocket 
expenses, cut Medicare services, and, finally, undermine the employer-
based health insurance program and market that so many people and 
families rely upon.
  Unfortunately, time and again, we have been proven right. In truth, 
today we see that the situation is much worse than even we said it 
would be. The President not only managed to mangle the 2013 rollout of 
the ObamaCare exchanges, but he repeatedly has delayed key parts of the 
law because of the entirely predictable problems that have arisen and 
made selective interpretations of the law necessary to advance the 
administration's political interests.
  The President, or a top administrative official, stated 37 times: 
``If you like your health care plan, you can keep it.'' These included 
numerous national townhalls and weekly Presidential addresses. This 
statement proved to be PolitiFact's 2013 ``Lie of the Year.''
  Since those statements, millions of cancellation notices have been 
sent out to Americans across this country, including over 100,000 in 
Idaho alone in 2013, rendering meaningless the President's oft-repeated 
pledge.
  In January, CBO updated its estimate of the effects of the health 
care law, indicating that over 10 million individuals will lose their 
employer-based health care coverage by 2021. Further, CBO estimates the 
law will leave 31 million people uninsured, up from its original 2011 
forecast of 23 million people.
  We are also learning that the health care Consumer Operated and 
Oriented Plan Program--the CO-OP program--is failing nationally, 
despite receiving over $2 billion in taxpayer bailouts. Today, over 
half--12 of the original 23 public co-ops--have failed. Between October 
9 and October 16, 4 co-ops announced they would not offer health 
insurance in 2016, leaving 176,000 patients scrambling to find a new 
plan.
  The President is also annually faced with the reality of rising 
premiums and out-of-pocket expenses for health insurance plans. What is 
his line of argument? He again tries to lower expectations, saying that 
these costs are not as bad as they initially were projected to be, even 
though they are still going up.
  Throughout the 2008 Presidential campaign, then-Senator Barack Obama 
repeatedly promised that his health care plan would bring down premiums 
by as much as $2,500 for the typical family. As President, he continued 
to make this claim, even after studies demonstrated that the opposite 
would occur. The truth was that the opposite did occur. Health care 
premiums have skyrocketed.
  For the most recent open enrollment period, the average premium 
increase for the midlevel silver plans on the Federal exchange is 7.5 
percent, more than triple last year's increase. In Idaho, which 
operates a State exchange, the average premium increase for a Blue 
Cross of Idaho plan is 23 percent. The average premium for a Regence 
BlueShield of Idaho plan is 10 percent. And the average premium 
increase for a SelectHealth plan is 14 percent. This is after year 
after year of increasing health care premiums.
  What is the justification from the insurers? This is the first year 
prices are based on post-ObamaCare patients, enrollments costs, and 
mandates. Premiums are skyrocketing.
  There are better solutions. To address the increasing costs and 
decreasing choices, the bill we have before us today eliminates the 
individual and employer mandates so Americans can once again choose the 
plan that fits their health care and budget needs.
  It also repeals the taxes on employer contributions to flexible 
spending accounts and expands the availability of health savings 
accounts, FSAs, and health reimbursement accounts. These accounts are 
central to a consumer-driven health care system.
  But it is not just premiums that are increasing. People are facing 
higher deductibles and copays as well, sometimes thousands of dollars 
higher than before. For the lowest cost ObamaCare plans in 2016, 
deductibles have increased by 10.6 percent for individuals and 10 
percent for families.
  Let me give just a couple of examples from constituents in Idaho. 
Daniel from Meridian, ID, recently contacted my office to explain why 
he and his family are uninsured for the first time in their lives. 
Daniel is employed and the sole provider for his family. His employer 
offers health coverage, but the estimated cost of premiums for his 
family would be over $900 per month. He chose to purchase insurance 
from the exchange but decided the coverage was not worth a $500-per-
month premium and an $8,000 deductible. That is right, an $8,000 
deductible.
  Daniel is not the only constituent who has contacted my office about 
the so-called family glitch--an unfortunate but not uncommon flaw in 
ObamaCare

[[Page 19342]]

that has left millions of Americans families uninsured.
  Bill from Boise, ID, is a small business owner. He purchases his own 
health insurance and provides coverage to his 45 employees. He saw his 
premiums increase by 7 percent in 2014, by 12 percent in 2015, and was 
recently notified by his insurance company that premiums will increase 
by 25.6 percent in 2016. Bill says these increases, in addition to 
other regulations and mandates coming from the government, will likely 
cause small businesses to close their doors.
  Lane from Melba, ID, experienced his premiums increase to over $900 
per month for his family. Even without preexisting conditions, his plan 
includes a $3,500 deductible. These cost increases come as individuals 
are paying more in taxes also as a result of ObamaCare.
  People may recall that at the time of the debate, the President 
stated again and again:

       I can make a firm pledge . . . no family making less than 
     $250,000 will see their taxes increase . . . not your income 
     taxes, not your payroll taxes, not your capital gains taxes, 
     not any of your taxes. . . . You will not see any of your 
     taxes increase one single dime.

  Well, when we debated the bill we pointed out that there was over $1 
trillion--maybe close to $1.5 trillion--of new taxes, most of which 
were going to fall squarely on the middle class. Yet, during 
consideration of ObamaCare, the nonpartisan Joint Committee on Taxation 
sent me a letter confirming that there were at least seven specific tax 
increases in the bill which would raise taxes on middle-income American 
families.
  According to CBO, ObamaCare will cost taxpayers more than $116 
billion a year in taxes. The average American household can expect to 
pay more than $20,000 in new taxes over the next 10 years. In Idaho, my 
constituents will pay $360 million more in taxes over the next decade, 
or $6,055 per household.
  The legislation we are considering today will solve this problem as 
well. It will eliminate more than $1 trillion in tax increases and save 
more than $500 billion in spending. And for all of the additional 
burdens, mandates, and costs, consumers are finding narrower insurance 
networks and limited plan offerings. In its recent Notice of Benefit 
and Payment Parameters for 2017, CMS actually stated that an excessive 
number of health plan options makes consumers less likely to make any 
plan selection and that standardized options are needed to provide 
consumers the opportunity to make simpler comparisons. This means these 
standardizations will once again mandate that insurers offer consumers 
fewer options.
  To sum up, millions of Americans are being forced from plans they 
like and the doctors and hospitals they know. They face higher premiums 
and higher deductibles and out-of-pocket expenses, they navigate one of 
the least customer-friendly Web sites ever designed, they are obligated 
to share personal and sensitive financial information through a network 
that hackers have called a gold mine for thieves--and, which is managed 
by the IRS--and, in return, they are paying higher taxes and seeing 
Medicare benefits cut.
  It is time that we in Congress place on the President's desk a 
solution, a repeal of these onerous and misguided health care policies 
and a reform of our health care system that will help move us to 
achieve the true objectives that Americans are asking for--helping to 
get a proper health care delivery system with a market-based delivery 
foundation that will help to reduce costs, increase the quality of 
care, and expand access to care across this country. We know we can do 
it. But we know now very clearly that ObamaCare is not the solution.
  The PRESIDING OFFICER. The Senator from Utah.
  Mr. HATCH. Mr. President, I ask unanimous consent that I be allowed 
to finish my remarks.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. HATCH. Mr. President, this week marks another milestone in the 
long, sordid history of the so-called Affordable Care Act.
  It has been roughly 5\1/2\ years since this law, cobbled together 
with spit and baling wire, went into effect. In a few weeks, we will 
reach the 6-year anniversary of the initial Senate passage of the 
legislation that would eventually become ObamaCare. Many of us remember 
those days well because we were here when it happened. Others who were 
here back then are no longer serving in Congress, and, in many cases, 
as a direct result of how they voted at the time. Still, for those of 
us who remain, I expect that this week--as we debate and hope to pass 
legislation to repeal the most harmful elements of ObamaCare--will 
bring back a flood of memories. It already has for me.
  We all remember the absurd promises that were made by the President 
and his allies to try to win over the American public: If you like your 
health insurance, you can keep it; the bill will bring health care 
costs down; only rich people and evil corporations will see their taxes 
go up--and so on and so forth.
  We all remember the deals cut behind closed doors to bring reluctant 
Democratic Senators on board. A number of those deals ended being so 
notorious that they even got nicknames: the ``Cornhusker kickback,'' 
the ``Louisiana purchase,'' the ``Bay State boondoggle,'' and 
``Gatorade.'' We all remember a sitting Speaker of the House arguing 
with a straight face that Congress would have to pass the health care 
law before the American people could know what was in it.
  More than anything, we all remember a Senate majority--a super 
majority, as some called it at the time--that was so committed to 
giving their President a political win that they forced a massive, 
poorly drafted bill through the Senate without a single Republican 
vote. They didn't need any Republican votes to pass it, and they sure 
weren't looking for any. Instead, they threw together a massive 
overhaul of a huge portion of the U.S. economy and forced it on the 
American people on a strictly partisan basis--not only here but also in 
the House.
  I will tell you something else that I personally remember from that 
time. I remember sitting here on the floor shortly before the final 
cloture vote during the Senate's consideration of the bill and 
listening to our distinguished majority leader, who was at the time the 
minority leader. It was December 21, 2009. It was late, nearly 1 
o'clock in the morning, and the good Senator stood up and offered some 
dire warnings for those who supported the bill. After detailing many of 
the problems the bill would cause--predictions that have all come true, 
by the way--Senator McConnell said:

       I understand the pressure our friends on the other side are 
     feeling, and I don't doubt for a moment their sincerity. But 
     my message tonight is this: The impact of this vote will long 
     outlive this one frantic snowy weekend in Washington. Mark my 
     words: This legislation will reshape our Nation. . . .

  And he was right. That legislation--now a law--has in many ways 
reshaped our Nation, including some ways that I am not even sure 
Senator McConnell could have predicted that night.
  Yes, it has had a disastrous impact on our health care system. I will 
have more to say about that in a moment. But, in my view, it has also 
eroded the public's confidence in our institutions and undermined the 
ability of our government to function well. By passing this law--
forcing it through Congress on a purely partisan basis--its proponents 
sent a clear message that partisanship trumped good judgment and the 
will of the voters.
  After running a masterful election campaign, President Obama came 
into office in 2009 riding a wave of goodwill and promises to usher in 
an era of ``post-partisanship''--whatever that was supposed to mean--
and allow us to transcend ideology to focus on good government and 
pragmatic solutions. Yet his biggest campaign promise, the top priority 
of his first term and his signature domestic achievement, ObamaCare, 
was the result of the largest exercise in naked partisanship in our 
Nation's history.
  By any estimation, the debate and passage of ObamaCare deepened our 
Nation's partisan divide and drove

[[Page 19343]]

more voters--on both ends of the spectrum--into deeper and more 
entrenched partisan and ideological positions. It made people more 
cynical and less trusting of our government and its leaders. It gave 
additional credence to the perception that politics and governing in 
America are more about tribalism and conflict than about providing real 
solutions to the problems plaguing our citizens.
  Can anyone seriously argue that our Nation is less partisan or less 
divided now than it was prior to the passage of ObamaCare? I would like 
to see anyone try to make that claim with a straight face.
  Sadly, that is not all. The damage wrought by ObamaCare extends well 
beyond our Nation's political discourse and into our governing 
institutions themselves. Most notably, we have had an administration so 
committed to ObamaCare that it has, on numerous occasions, exceeded its 
constitutional authority in order to preserve it.
  The examples of overreach and abuse of power have been well 
documented. The Obama administration has unilaterally moved deadlines 
set by the statute that they found to be inconvenient. They have 
rewritten provisions in the law to give favors and carve-outs to 
political supporters. They have selectively enforced other provisions 
in order to give more teeth to their regulations. And that is just the 
tip of the iceberg.
  Make no mistake. President Obama's penchant for Executive overreach 
extends well beyond the implementation of the Affordable Care Act. But 
clearly, many of the most egregious examples of abuse on the part of 
this administration were undertaken to preserve a poorly constructed 
health system that simply could not work the way the law was drafted. 
Simply put, ObamaCare has led directly to a weakening of our 
constitutional order and an erosion of the separation of powers. Given 
all of these negative consequences, the question ultimately becomes 
this: Has it been worth it?
  Don't get me wrong. In my opinion, all these terrible aftereffects 
would, by themselves, be enough justification to undo what was done in 
this Chamber nearly 6 years ago. Still, if the law was working--if it 
was having a positive overall impact on our health care system--
proponents might have something to hang their hat on when it comes to 
this law. Indeed, if the American people now had better, more 
affordable health care, supporters of ObamaCare could at least try to 
argue that all of these other problems have been in service of some 
noble cause. Of course, we know the law is not working. The American 
people do not have better, more affordable health care under ObamaCare. 
Instead, the parade of horribles that began the day the law was enacted 
has extended beyond our politics, beyond our institutions, and into the 
lives and livelihoods of everyday Americans.
  The system created by the Affordable Care Act--so-called Affordable 
Care Act--was based largely on the premise that the government could 
impose drastic new regulations on the individual health insurance 
market without dramatically increasing the cost of insurance because 
younger, healthier consumers would be drawn into the market, bringing 
down costs for everyone else. This claim was obviously fiction. 
Republicans argued at the time that without serious effort to reduce 
costs overall, this prized demographic group would stay out of the 
market, and premiums would skyrocket due to the various mandates and 
regulations. We now know that we were right. Younger and healthier 
patients are, by the millions, choosing to forego health insurance and 
pay fines rather than enter into the individual insurance market. 
According to most surveys, many of these individuals are choosing to go 
uninsured because, even with the benefit of ObamaCare premium 
subsidies, they cannot afford the cost of insurance.
  As a result, premiums are going up all over the country. Premium 
spikes in the double digits have been increasingly common in the 
current enrollment period. My own home State of Utah has seen premiums 
go up in this enrollment period by an average 22 percent, which will 
undoubtedly wreak havoc on family budgets and local businesses. Other 
States have it even worse, with premiums spiking as much as 25 percent, 
30 percent or, in the case of a State such as South Dakota, 63 percent.
  Even with increased premiums, insurers are having a harder time doing 
business in a number of markets, leading providers to exit the various 
exchanges where patients buy insurance with the aid of ObamaCare 
subsidies. Just a few weeks ago, in fact, we saw reports that the 
largest health insurance company in the Nation--UnitedHealth Group--was 
considering withdrawing from the exchanges entirely. The result will 
inevitably mean fewer insurers, which means fewer choices and even 
higher premiums for consumers. It is no wonder, therefore, that next 
year's enrollment estimates for the exchanges are down dramatically. 
And, as enrollment drops, all of this--the costs, the reduced options, 
and the overall state of care--will get even worse in the individual 
health insurance market.
  This downward spiral is all the more maddening when we consider that 
the President promised the American people that his law would actually 
reduce the cost of health insurance in the United States.
  I am not done yet. There are other problems worth discussing here 
today. There is, for example, ObamaCare's massive Medicaid expansion. 
In virtually every case, when the proponents of ObamaCare cite numbers 
of newly insured individuals under the law, most of the increase can be 
attributed to the Medicaid expansion. Let's be clear. Medicaid is one 
of the most poorly constructed programs in all of government. It is 
extremely costly at the Federal level and even more so at the State 
level, where it is not uncommon for the program to take up as much as 
one-fourth to one-third of a State's financial resources. Even with all 
that cost, it is, in terms of available providers and services, one of 
the worst, if not the worst health insurance options in the country.
  Some of us in Congress have been working for years to reform the 
structure of the Medicaid Program in order to reduce costs, improve the 
program, and preserve it for those who are in need. The Affordable Care 
Act did not fix these problems; it made them worse. Under ObamaCare, 
Medicaid is more expensive to taxpayers and an even larger burden on 
the States. With dramatically increased enrollment, Medicaid reform is 
likely to be even more difficult in the future.
  Why anyone would brag about adding enrollees to an insolvent 
government health program that provides the lowest standard of service 
in the country with the fewest provider options is beyond me. I suppose 
those tasked with claiming ObamaCare is a success have to cite positive 
figures wherever they can dig them up.
  The Affordable Care Act also increased taxes dramatically. It raised 
taxes on drug companies and medical device manufacturers, which have 
been passed directly to middle-income and lower income consumers 
because that is what happens when you increase taxes on businesses that 
produce goods and services. It includes a tax on the so-called Cadillac 
insurance plans, which proponents claim would only impact rich 
employees of very large corporations. Of course, the tax was structured 
in a way that guarantees that in the not too distant future, millions 
of middle-class Americans will be hit by the tax and see their 
insurance costs go up even further.
  All told, there have been about $1 trillion in new taxes under 
ObamaCare. While the President and his allies may claim these taxes 
hold the middle class harmless, the facts tell a different story. That 
story, of course, isn't just now coming to light. Many of us on the 
Republican side have been talking about these issues from the very 
beginning.
  I can go on and on. For example, the Affordable Care Act, with its 
various mandates, also increased costs to employers around the country, 
resulting in fewer new hires and reduced opportunities for many 
existing employees.

[[Page 19344]]

Many small businesses now choose not to expand in order to avoid 
reaching the number of employees that will trigger new requirements. At 
the same time, because the law perversely defines a full-time employee 
as one working a minimum of 30 hours, other companies are avoiding the 
triggers by cutting back on workers' hours.
  All of these developments--every single one of them--were predicted 
way back in 2009 when the law was being debated. The President told us 
we were wrong. His supporters in Congress did the same. They ignored 
the obvious warnings, and now the American people, as well as small 
businesses and job creators, are paying the price.
  These issues and many others are why Republicans have spent more than 
5 years fighting against ObamaCare. We have introduced bills to repeal 
the whole law, others to repeal just the most harmful elements. I 
personally have introduced bills to repeal the individual mandate, the 
employer mandate, and the medical device tax. On the Senate Finance 
Committee, we have conducted rigorous oversight on numerous aspects of 
the law and the implementation of various programs. Other committees 
have done the same within their jurisdictions. Virtually all of us have 
supported efforts to challenge elements of the law in court.
  While we have differed on tactics from time to time, Republicans have 
been united in our desire to repeal and replace this misguided attempt 
at health care reform. Some of us have even come up with specific ideas 
on how to replace ObamaCare. For example, earlier this year, Senator 
Burr, Chairman Fred Upton from the House, and I released the latest 
draft of the Patient CARE Act, a legislative proposal that would fix 
many of the things the authors of ObamaCare got horribly wrong.
  Most notably, as a number of health care experts have concluded, our 
proposal would actually reduce health care costs. As we all know, 
rising costs are the single biggest problem plaguing our health care 
system. Yet the President's health law did virtually nothing to address 
this issue. Unlike the poorly named Affordable Care Act, the Patient 
CARE Act would actually make health care more affordable throughout the 
United States.
  At the beginning of this year, Republicans assumed the majority in 
the Senate, having committed--even promised in some cases--to work to 
repeal this so-called Affordable Care Act. This week, with the bill now 
before us, we will take a major step toward delivering on those 
promises. The legislation we are now debating would send the broadest 
possible ObamaCare repeal to the President's desk.
  As the chairman of the Senate Finance Committee, I am pleased to have 
joined with my colleagues--the distinguished chairman of the Budget and 
HELP Committees, as well as the Senate Republican leadership--to lead 
this latest fight against ObamaCare. This bill would repeal many of the 
worst parts of ObamaCare. Among other things, it would repeal the 
individual mandate, the employer mandate, the medical device tax, and 
the Cadillac tax. All of these different parts of ObamaCare have 
contributed in one way or another to the long, slow death march we have 
witnessed over the past 5 years. All of them would be dealt with under 
this legislation.
  The legislation would address another contentious debate: the one 
dealing with Planned Parenthood. The debate over Planned Parenthood has 
perplexed Congress and divided our country for years as many people 
have expressed ever more opposition to providing such a controversial 
organization--and I am being generous with that label--with taxpayer 
funds. As we all know, this debate reached a boiling point earlier this 
year.
  The reconciliation package before us would prohibit Federal payments 
to Planned Parenthood and direct more funds to the Federal community 
health center program, putting an end to the Federal Government's 
entanglements with Planned Parenthood while alleviating legitimate 
concerns about funding for women's health. This is yet another reason 
to support this legislation.
  As I said, the debate we are having this week is an important 
milestone in the history of ObamaCare, maybe even the most important 
milestone yet. But we need to be realistic. While this bill is an 
important step, it stands no real chance of becoming law. For that to 
happen, we are going to have to see even more changes. But that doesn't 
mean our efforts here are for nothing. This bill may not result in new 
law, but it will give the American people a fresh accounting of where 
each of us stands when it comes to ObamaCare.
  It is funny, Republicans have taken some flack--not a lot but some--
for referring to the Affordable Care Act as ``ObamaCare'' or ``the 
President's health care law.'' The President, for his part, hasn't 
shied away from these labels, but I have read a few pundits who think 
these terms are specifically intended to undermine the legitimacy of a 
statute duly passed by Congress. In some respects, I suppose that might 
be true. After all, even though we constantly refer to the law as 
``ObamaCare,'' it is not as though President Obama passed it himself. 
He was aided and abetted by his allies in Congress.
  While it may be useful shorthand to attach the President's name to 
it, I don't think the American people have forgotten the others who 
helped bring this terrible law to pass. President Obama will forever 
own the Affordable Care Act, that is for sure. People will likely 
always refer to it as ``ObamaCare.'' But those in Congress who drafted 
and voted for the law will own it too.
  When President Obama vetoes this legislation, as we all expect he 
will, he will take ownership of the Affordable Care Act--not that he 
hasn't in the past--along with its many failures and gross inadequacies 
all over again. I think the same can be said for any of our colleagues 
who vote against repealing the worst elements of the law this week.
  I hope my colleagues on the other side of the aisle will think about 
that as this debate moves forward and that they will consider voting 
with us to send this repeal to the President's desk. I think it would 
be a very wise move on their part.
  This isn't going away even if the President does veto this bill. I 
hope he doesn't, but if he intends to do it, it would be a breath of 
fresh air for our colleagues on the other side of the aisle to help us 
to have a veto-proof majority to tell the President once and for all 
that this bill is not what we want in America.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Colorado.
  Mr. GARDNER. Mr. President, I come to the Senate floor today to talk 
about the broken promises of ObamaCare and the negative impacts this 
poorly written law have had on my State of Colorado. While there have 
been many broken promises of ObamaCare, there have been three major 
broken promises that are the center of focus for hundreds of thousands 
of Coloradans.
  I want to start with broken promise No. 1. If you like your plan, you 
can keep it. The President said over 35 times that Americans shouldn't 
worry about ObamaCare because if you like your plan, then you can keep 
it. And it wasn't just the President; time after time, supporters of 
ObamaCare came to the floor of the House or the Senate or before 
townhalls in their States or districts and repeated those words: If you 
like your plan, you can keep it. In fact, these words were used to 
justify the reason they supported ObamaCare in the first place.
  Coloradans quickly learned this promise was far from the truth. In 
late 2013, roughly 335,000 insurance policies in Colorado were canceled 
because of ObamaCare. These cancellations also affected my family 
health care plan. Unfortunately, the cancellations in 2013 were the 
very beginning. In January of 2014, the Colorado Division of Insurance 
canceled an additional 249,000 plans because those plans didn't meet 
the requirements of ObamaCare.
  The President said: If you like your plan, you can keep it. 
Supporters in Congress said: If you like your plan,

[[Page 19345]]

you can keep it. But what he meant was, as long as the government 
approves of your plan, you can keep it.
  In 2015, an additional 190,000 plans were canceled. In total, 
according to the Congressional Research Service, over 750,000 health 
insurance perhaps plans in Colorado were canceled between 2013 and 
2015.
  The fact-checking organization PolitiFact said this promise was 
``impossible to keep'' and went on to deem President Obama's promise 
that if you like your health care plan, you can keep it the ``Lie of 
the Year'' for 2013.
  Supporters of ObamaCare will tell you that it is OK that this 
happened because these 750,000 individuals must have had inferior 
health insurance and that the government knows best. You see, that is 
the exact problem with government. That is the arrogance of government 
and the arrogance of ObamaCare--that people in the government, 
bureaucrats and others, believe they know better than the American 
consumers what is best for them. They believe it is OK to cancel 
750,000 policies because they must have been bad, so go ahead and 
cancel them. They will also say that it is all right because there are 
additional plans they can choose from. But that wasn't the promise of 
ObamaCare.
  Broken promise No. 1: If you like your health care plan, you can keep 
it.
  Broken promise No. 2: ObamaCare will reduce the costs for families, 
businesses, and our government.
  Remember, when ObamaCare was passed, they said the family would save 
$2,500 a year relatively soon after its passage. Unfortunately, 
Coloradans have felt that broken promise as well. It is a broken 
promise that hit their pocketbooks and has broken the bank as well. For 
example, take the Western Slope of Colorado. I have a chart here. 
According to the Colorado Division of Insurance, individual insurance 
premiums for 2016 on the Western Slope of Colorado will rise by an 
additional average of 25.8 percent.
  There are people across America who are familiar with Colorado's 
Western Slope. These are the incredible mountain vistas, our forests, 
our national parks, our ski resorts.
  They received a 25.8-percent increase in their health care costs this 
year. That is far from the promise of lowering the health care costs 
that ObamaCare was passed with. No one can afford these high prices. In 
fact, in 2013 one of my Democratic colleagues in the Colorado 
delegation even tried to exempt one of the wealthiest counties in 
Colorado from ObamaCare, citing that health insurance premiums would be 
too expensive. Let me say that again. A Member of the U.S. House of 
Representatives, a Democrat, tried to exempt portions of his district 
from ObamaCare because it was making his constituents pay too much for 
their insurance. Here is a quote:

       We will be encouraging a waiver. It will be difficult for 
     Summit County residents to become insured. For the vast 
     majority, it's too high a price to pay.

  It doesn't matter whether you live in the Eastern Plains, Fort 
Collins, or the Western Slope, ObamaCare has simply made it more 
costly. Plans are getting more expensive, and promises are being 
broken.
  Broken promise No. 3: President Obama promised greater competition in 
the marketplace through consumer-run co-ops. Yet over 80,000 Coloradans 
are feeling the impacts of this broken promise. To date, 12 out of 23 
co-ops created by ObamaCare have been shut down across the United 
States, including the co-op in Colorado, which failed in October of 
this year.
  Nationwide, the failed co-ops were loaned over $1 billion, which came 
from the hard-working taxpayers of this country. That taxpayer money 
was supposed to help get these co-ops off the ground, but now with 
these failures, that taxpayer money is at risk of never being paid back 
to the people of this country, and the health care of nearly 700,000 
individuals across the United States is in jeopardy.
  ObamaCare allowed policies to be offered that were never actuarially 
sound because they assumed there would be a bailout by the government 
to help make them actuarially sound. By banking on a bailout, they sold 
the American people a bill of goods.
  Today we have a path forward that is turning away from the failed 
health care law that has been built on broken promises. The first step 
of this path forward is to repeal ObamaCare, and I urge my colleagues 
to support the repeal of ObamaCare that we will be voting on this week. 
Repealing ObamaCare will clear the way for a replacement plan and will 
put our country's health care on the right track.
  First, we have to restore the ability of individuals to choose what 
is best for themselves instead of having Big Government choose for 
them. Coloradans don't want Dr. Congress. They want to keep the doctor 
they were promised they could keep in the first place. The best way to 
do this is to ensure that people get to keep the health plans that they 
want, and that is why I am working with Senator Ron Johnson from 
Wisconsin on his amendment that simply says that if you like your 
health care plan, you can keep it.
  I heard from countless individuals in Colorado who lost the plans 
they liked and wanted to keep. They were certainly promised they could 
keep them, and just because ObamaCare can't fulfill the promise that it 
was sold under doesn't mean we shouldn't do our jobs to make that 
promise a reality. The amendment Senator Johnson and I have offered 
would allow individuals to continue receiving health coverage on plans 
that would otherwise be canceled because of ObamaCare.
  Second, we must ensure that taxpayer dollars are used responsibly. I 
filed an amendment that will help recover taxpayer money that was 
loaned to the failed co-ops. More than $1 billion in Federal loans were 
awarded to these failed co-ops. Congress has a duty to spend taxpayer 
dollars responsibly, and this amendment will ensure just that.
  Lastly, we must make sure individuals have certainty in the health 
coverage they choose. My final amendment will make certain that co-ops 
can't rely on bailouts when they are calculating insurance premiums, 
setting false expectations for consumers. Several co-ops counted on 
these bailout provisions to keep premiums artificially low. Because 
these premiums were artificially low and since many co-ops were 
planning on receiving the bailout, many could no longer cover their 
expenses. Allowing co-ops to rely on a bailout was irresponsible and 
has resulted in nearly 700,000 individuals nationwide whose health 
coverage is now uncertain.
  It is time to act. It is time to take the path forward. It is time to 
repeal ObamaCare, which is simply one big broken promise after another. 
This path to repeal ObamaCare will allow us to replace ObamaCare and 
will have fewer health care regulations for businesses and individuals. 
It will put us on a path forward for individual freedoms and a more 
prosperous America.
  I yield back my time.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. NELSON. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Gardner). Without objection, it is so 
ordered.


             Omnibus Appropriations Bill and Policy Riders

  Mr. NELSON. Mr. President, we are about to consider a big 
appropriations bill all wrapped up into one called an Omnibus 
appropriations bill. I think it will be a good bill. But here we go 
again, trying to attach all kinds of goodies to it.
  Now, with just a few days left of funding before the U.S. Government 
spending authority and appropriations expire--to the best of my 
recollection that is about 9\1/2\ days away--we have to get something 
done. But what is happening is that the special interests are coming 
out of the woodwork, and they are hard at work to sneak sweetheart 
deals into what is a must-pass piece of legislation--the funding to 
keep the Government of the United States functioning. So these special 
interests that are suddenly popping up and sneaking around the corner 
don't have to get the votes to get it passed

[[Page 19346]]

through their regular order for whatever their particular interest is. 
They want it so their interests are riders on the appropriations bill, 
and everybody has to vote for it with their special interests because 
if we don't, the government shuts down, which is obviously an 
unacceptable alternative.
  These handouts to special interests are known as appropriations 
riders. Most ordinary Americans don't know that this stuff is going on.
  Well, based on the appropriations bill that we saw earlier this year, 
we know that many of these riders could work their way in. For example, 
some people, particularly in the banking community, don't like some of 
the restrictions. In September of 2008, when we nearly had a financial 
meltdown as a result of Lehman Brothers going down, there was a big 
financial death spiral going on. A lot of excesses happened during that 
time in the bailout so that Wall Street would not go under, and there 
was legislation to correct some of those excesses. It is known by the 
name of the two authors, Senator Dodd and Congressman Frank. There are 
going to be people trying to put in a rollback of some of those 
provisions, but I hope some of our colleagues will remember what those 
were put in for, so that we don't have the likelihood of having another 
financial death spiral like that which almost occurred.
  I hope we remember the picture in our minds of the Republican 
Secretary of the Treasury at the end of the George Bush administration, 
begging the leadership of Congress to pass the troubled assets relief 
bill to keep the financial integrity of the U.S. Government. There were 
a lot of excesses, including excessive executive salaries that came 
from that.
  We know all about what happened to that supersized insurance company 
called AIG. I don't think Americans would want these kinds of things 
put on a necessary funding bill for the United States Government.
  I will give another example. Another policy rider is to prohibit the 
United States from working with other countries to address climate 
change. This Senator has been in the middle of it because Miami Beach 
is ground zero on climate change. The measurements over the last 40 
years are an additional 5 to 8 inches that the sea level has risen at 
the seasonal high tide. The streets of Miami Beach are flooded. It is a 
real problem.
  There are some, such as Senator Inhofe, who don't believe it. So we 
can have that debate. I am respectful of Senator Inhofe and of his 
position, although I think we can easily refute it with scientific 
evidence, but we ought to have that debate. Don't sneak it in on a 
rider on a must-pass, gargantuan appropriations bill in order to keep 
the government functioning.
  There are other riders that are being discussed that are bad for the 
safety of families and making our highways more dangerous. For example, 
we picked up that some of the appropriators have suggested to continue 
the delay of the important implementation of safety laws, such as how 
long does it take for a trucker to become tired if they have to work 
longer and longer hours, and is that a safety concern. As the ranking 
member of the Commerce Committee, which has jurisdiction, we work on 
these issues. We debate them. Don't go trying to sneak something in 
under the rug in an appropriations bill regarding safety for surface 
transportation. We just hammered that out in a conference committee on 
the highway bill. The highway bill is a lot more than just highways and 
bridges; it is surface transportation. It includes safety measures as 
well for all modes of surface transportation.
  Let me give an example of another rider that is out there lurking. 
There are some who want to take all of the additional fees--when 
someone buys a ticket to fly on an airline, a person ought to have the 
opportunity of knowing what all those fees are, and on a person's 
airline ticket that one buys from the airline, one usually does. But 
there are others who want to sell those airline tickets--not the 
airlines--and not disclose all of those fees. Yet the consumers are the 
ones who are paying for it. They are trying to sneak in under the rug 
another provision that would become law on an unrelated appropriations 
bill.
  So I just wanted to add my voice to the others who are speaking this 
afternoon. Let's put the American people first, and let's use what we 
hear about all the time: Regular order. Let the committee system work 
to hammer out what ought to be in the bills instead of, at the eleventh 
hour of the 59th minute as we have to fund the government, trying to 
sneak something in, in the dead of night, in order to scratch the itch 
of someone's special interest.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Tennessee.
  Mr. ALEXANDER. Mr. President, I ask unanimous consent to lead a 
colloquy with Senators Burr, Isakson, Cassidy, and Scott for up to 20 
minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ALEXANDER. Mr. President, today we are talking about repealing 
Obamacare and moving in a completely different direction toward more 
choices and lower costs for Americans as they search for their health 
care plans.
  I came to the floor yesterday and brought back a memory from 5\1/2\ 
years ago of the President's health care summit, nationally televised 
all day long at the Blair House, with 36 Members of Congress and the 
President of the United States. I had a chance, leading off for the 
Republican speakers that day, to say respectfully to President Obama: 
Mr. President, this health care plan of yours is going to impose a huge 
Medicaid unfunded mandate on State budgets, which will raise tuitions 
and take money from other State programs. It will take money out of 
Medicare and spend it on something else. It will increase taxes, it 
will raise premiums, and it will cost jobs. Unfortunately, that all 
turned out to be true.
  The Senator from Georgia, Mr. Isakson, was there, as I was, on that 
Christmas Eve. It was a cold night when the Democrats had, for a few 
months, 60 votes, and they rammed through Obamacare in the middle of 
the night with all Democratic votes, no Republican votes, with us 
warning what would happen.
  Now, I say to Senator Isakson, the premiums in Georgia, I believe 
will go up 29 percent for some plans.
  Mr. ISAKSON. That is correct.
  Mr. ALEXANDER. And I wonder if the Senator has been hearing from some 
of his constituents about their premium increases.
  Mr. ISAKSON. Mr. President, let me confirm what the Senator from 
Tennessee just said about that cold night on Christmas Eve 6 years ago 
when the administration was promising lower premiums, better benefits, 
and that ObamaCare was going to be the solution for the problems of 
American families.
  As the Senator from Tennessee said, I have gotten letters, as has he. 
Every Member has gotten letters from people who are having higher 
premiums, bigger deductibles, and fewer benefits. Let me give an 
example. A family in Roswell, GA, wrote me, a family of five. They had 
just been notified that their premium was going from $849 a month to 
$1,075 a month, a $300 increase, with a deductible of $11,900, an 
increase of $6,900 in their deductible. The mother, who had a family 
history of breast cancer, was denied mammograms because of her age, and 
a young daughter who had a precancerous mole removed was refused 
reimbursement.
  So here is an increase in premiums, a reduction in benefits, and an 
increase in their deductible. It doesn't make any sense, but it is all 
because of the mandates of the ObamaCare law.
  Secondly, a young couple in Smyrna, GA, wanted to plan for their 
retirement and start saving early in their early years of productivity. 
They recently received a notice from their insurance company that their 
premium was going from $607 a month to $1,379 a month--over a 100-
percent increase. Where is that money coming from? They are having to 
reduce their savings for retirement just to pay the ObamaCare premium 
and get less of a benefit because their deductible is going from $2,000 
to $4,000.
  The promise of lower cost health care and better benefits was exactly 
wrong

[[Page 19347]]

and what the American people were promised was wrong. I am proud that 
Mr. Enzi, the Senator from Tennessee, and others who have led this 
reconciliation vote to repeal ObamaCare have done so. It is time the 
American people got the truth--better coverage, lower costs, but do it 
the old-fashioned way with a private competitive system.
  Mr. ALEXANDER. I thank the Senator from Georgia for his leadership on 
the HELP Committee on which all of us serve.
  One of the newer members of the HELP Committee brings a lot of 
expertise: Senator Cassidy from Louisiana. He wasn't there, at least 
not in the Senate, on the night Obamacare passed, but he has written 
forcefully about the fact that while premiums have been going up, 
something else was going down, and that is family incomes because of 
the 30-hour work week. Senator Cassidy had an article in Forbes 
magazine in 2014 that pointed out the impact of the 30-hour work week 
in Obamacare and how that was hurting working families.
  Mr. CASSIDY. I say to Senator Alexander, one of the ironies of this 
is that it was promoted as a way to help lower income families make 
ends meet better. But if you require employers to provide insurance to 
low-wage workers, the predictable response of an employer who has thin 
margins is to actually convert those full-time workers to part-time 
workers. This doesn't happen for the CEO or for the CEO's lieutenants, 
and it doesn't happen for middle management. The folks it happens most 
to are those lower paid workers.
  I once went grocery shopping in Baton Rouge, and a woman rung me up. 
The next day my wife sent me to another store to get something else at 
another store. The same woman was ringing me up. I said: I just saw you 
at that store, but now I see you at this store. She said--I am 
paraphrasing--my first employer reduced my hours, so now I have had to 
take a second job to make ends meet.
  Now, that is the personal story. But what the labor statistics show 
is that since the recession has technically ended, the hours worked per 
week have recovered for higher income workers, but as for the lower 
income workers, they have continued to suffer. The most vulnerable have 
been the most affected in terms of hours worked, but it is not just the 
most vulnerable, it is also the middle class.
  The New York Times wrote an article 2 weeks ago. The headline says it 
all: ``Many Say High Deductibles Make Their Health Law Insurance All 
But Useless.'' They quote a gentleman, David Reines from New Jersey. He 
is 60 years old. He said:

       The deductible, $3,000 a year, makes it impossible to 
     actually go to the doctor. . . . We have insurance, but can't 
     afford to use it.

  So it is the middle-income worker who also has a policy which 
previously would have allowed him or her to go to the doctor. Now they 
can't because the way ObamaCare is so structured is that it is too 
expensive for that out-of-pocket first exposure.
  Mr. ALEXANDER. What the Senator is saying, if I hear him right, is 
that in the worst of circumstances, the effect of Obamacare on some of 
the people he is talking with means they are working less hours, so 
they have less money. Their insurance premium is higher, and so is 
their deductible. That is the effect.
  Mr. CASSIDY. When it comes to insurance premiums, you can't make this 
up.
  This is a fellow from Homewood, LA. His first name is Mark; we 
scratched out his last name. This is his letter from Blue Cross and 
Blue Shield of Louisiana informing him that his policy, which had 
previously been $207 per month, was going up in 2016 to $961 per month. 
His policy, which had been roughly $2,400 a year, is going up to 
$11,500 a year. And this is because of the Affordable Care Act--the 
Unaffordable Care Act.
  Mr. ALEXANDER. The essential problem with Obamacare for people who 
buy individual insurance, it seems to me, I say to Senator Isakson, is 
that Washington tells you what insurance to buy.
  I think of a woman named Emilie in Middle Tennessee who has lupus and 
who had a policy she could afford. It had modest benefits and it didn't 
cost very much, but it fit her needs, but Obamacare canceled that 
policy. When she went online to find another policy under Obamacare, 
her costs went up from $100 to $400 a month. I guess the Senator has 
heard stories like that as well in Georgia.
  Mr. ISAKSON. All the time, because what happened with ObamaCare is 
the following: People who had insurance they could afford and who had 
bought coverage they needed were forced to buy coverage they didn't 
need because of the mandates in ObamaCare in terms of what had to be 
included. So it forced more coverage that you didn't need, which raised 
the premiums you paid. So you end up paying more and getting less, and 
it was the mandates of ObamaCare that did it.
  Mr. ALEXANDER. Senator Cassidy, of course, has a unique perspective 
on this as a practicing physician. I think he still practices some--as 
much as he can within the Senate rules--but he sees patients regularly. 
I ask Senator Cassidy, what was the effect of this new health care law 
5\1/2\ years ago on the ability of patients to choose their own 
physicians?
  Mr. CASSIDY. The way the market has responded, in order to make 
insurance affordable despite the mandates, is there are so-called 
narrow networks. So someone signs up for the most affordable policy 
they can get. It turns out that the doctor they previously saw is not 
on this plan. So the narrow network is going to be just a small set of 
doctors. The specialists may be in another town; one hospital, not all 
hospitals. And patients are unfamiliar with this. They did not expect 
it. But that was their only affordable option. The mandates have driven 
up the costs so much.
  By the way, going back to the letter you got about the mandated 
benefits, in my recent campaign, I had a woman walk up to me, and she 
said: My name is Tina, and I am angry. I had a hysterectomy. I am 56 
years old and I have no children. My husband and I are paying $500 more 
per month for insurance, which we cannot afford, and I am paying for 
pediatric dentistry, and I am paying for obstetrical services.
  She had had a hysterectomy, was 56 years old, and had no children.
  Another woman--she was 58 and her husband was 57--told me: The only 
reason I would need obstetrical services, which I am forced to buy, is 
if my name is Sarah and my husband is Abraham, but that is not the 
case.
  Mr. ALEXANDER. Senator Isakson, before he came to the Senate, was a 
small businessman in Georgia.
  Probably the largest employer in our country is the hospitality 
industry--restaurants, hotels, that sort of thing, employing many young 
people, many minority people. I met with a number of restaurant owners, 
who told me after Obamacare passed that because of the costs of that 
insurance to the company, their goal would be to reduce the number of 
employees from 90 to 70. So Obamacare costs jobs. Did the Senator have 
that kind of experience in Georgia as well?
  Mr. ISAKSON. Not only did it cost jobs, but it forced many people who 
had full-time jobs into part-time jobs because of the mandates. Small 
business got hurt and their employees got hurt.
  The mandates of ObamaCare for coverage, the mandates for taxation, 
and the mandates for deductibles all contributed to the increasing 
costs of ObamaCare and made health care more out of reach than more 
accessible.
  Mr. ALEXANDER. Memphis is proud of the fact that it is a center for 
medical device innovation. Some of the leading medical device companies 
in the world are located in Memphis, TN. The Obamacare bill--part of 
its trillion dollars in new taxes included a medical device tax which 
put an especially onerous tax on the gross income of medical devices 
companies, causing the President in Costa Rica to put up signs saying 
``Welcome to Costa Rica'' to medical device companies.
  I wonder if in Louisiana or Georgia you had any experience with the 
impact of the medical device tax on your constituents?
  Mr. CASSIDY. There is a fellow who started a medical device startup 
in

[[Page 19348]]

New Orleans, and he was saying that he had an offer to move his 
business to Panama because a major portion of his market is overseas.
  So the medical device tax is, of course, a tax upon the gross of a 
business. If he moves overseas to Panama, taking those jobs with him, 
and continues to sell internationally and not pay tax on that but is 
taxed only on that which he brings back to the United States, then he 
is obviously reducing his tax burden. Those are high-paying, white-
collar jobs in New Orleans, a city recovering from Katrina. If the 
power to tax is the power to destroy, this tax has the power to destroy 
the ability of this gentleman to continue to expand in New Orleans.
  Mr. ALEXANDER. I say to Senator Isakson, I recall one of the most 
vigorous debates we had 5\1/2\ years ago was first the President 
saying: We won't touch Medicare. Next thing you know, they took $700 
billion out of Medicare to spend on new programs, at a time when the 
Medicare trustees, whose job it is to tell us things like this, said: 
The program is going to go broke unless we do something about it. We 
were saying: If you are going to take money away from grandma's 
Medicare, you better spend it on grandma. But they didn't. It impacted 
Medicare recipients in Georgia, Tennessee, and Louisiana.
  Mr. ISAKSON. Well, the President basically robbed Peter to pay Paul. 
He robbed the beneficiaries of Medicare benefits and then took the 
money and spent it on somebody else. So the person who had the benefits 
didn't have the benefits any longer.
  The problem with this entire deal is it was a charade. Promises were 
made that if you like your policy, you can keep it. That turned out to 
be wrong. Premiums were going to go down. That turned out to be wrong. 
If you couldn't get insurance, you would be able to get insurance. 
Well, that ended up being true in part, but it became something known 
as a bronze policy. Do you know what a bronze policy is? It was a 
policy that gave you coverage, but the deductible was so big, you 
couldn't get to the coverage. So every time there was a promise, it was 
a broken promise, an increased cost, and less accessibility to 
coverage.
  Mr. ALEXANDER. Mr. President, how much time remains in our colloquy?
  The PRESIDING OFFICER. There is 6 minutes remaining.
  Mr. ALEXANDER. Six minutes remaining.
  We have heard a lot in the news about co-ops. Co-ops were an 
invention of Obamacare that were designed to provide health care to 
many Americans. I know that in South Carolina, for example--closure of 
these co-ops for 67,000 South Carolinians and 27,000 Tennesseans--means 
that suddenly they have to find new coverage. I wonder if either in 
Louisiana or Georgia, you have had any experience with the new co-ops 
in Obamacare?
  Mr. CASSIDY. Louisiana's co-op failed. It attempted to lower costs 
with a skinny network, but ultimately it still could not compete.
  If I may point out, we have talked about how the low-wage worker has 
had her opportunity diminished by the law. We discussed how the middle-
class family, who oftentimes had insurance they were told they could 
keep, lost it, and now they have a deductible of $3,000, which they say 
makes the insurance something they cannot afford. We are speaking about 
the U.S. taxpayer. The U.S. taxpayer has put billions of dollars toward 
these co-ops. There is some evidence that the administration continued 
to put money into them even when they knew they were going to fail, and 
yet now they are failing--over half and supposedly more slated to do 
so. It isn't just the low-wage worker and the middle-class family; it 
is all the taxpayers who have taken a hit for promises made but 
promises broken.
  Mr. ALEXANDER. During the debate 5\1/2\ years ago at the health care 
summit at the Blair House, our Democratic friends said: Well, when are 
you Republicans going to come up with a big, comprehensive plan? My 
answer to them was: If you are waiting for Senator McConnell to roll a 
wheelbarrow onto the Senate floor with a 2,700 page McConnell-care 
bill, you are going to be waiting until the sky turns purple because we 
don't believe in that. We don't think we are wise enough in Washington, 
DC, to write a comprehensive plan for everything about the American 
health care for all the people in this country.
  Instead, what we proposed to do--and we proposed it over and over 
again--was to move step by step in a different direction toward more 
choices, more freedom, and lower costs. In fact, I counted it up, and 
173 times in the Congressional Record in the year 2009, we Republicans 
laid out our plans step by step toward those causes, steps like the 
step Senator Scott from South Carolina took in a bipartisan way just 
this year to give States the ability to set the rates for the kind of 
insurance small businesses could buy and avoid an 18-percent increase 
in premiums. Those are the kinds of steps we would take in a different 
direction to give the American people those options.
  Our time for the colloquy has expired. I thank the Senator from 
Georgia, Mr. Isakson, and the Senator from Louisiana, Mr. Cassidy. We 
Republicans said 5\1/2\ years ago that premiums would go up, taxes 
would go up, jobs would be lost, and that State budgets would be 
burdened by Medicaid, and all that turned out to be true, 
unfortunately.
  The President said: If you like your plan, you can keep it. That 
turned out to be untrue, unfortunately.
  We are prepared to go in a different direction--more choices, more 
freedom, lower costs--but first, this week we are going to repeal 
Obamacare, which has caused such problems for the American people, and 
then we will head in a different direction.
  I thank the Presiding Officer.
  I yield the floor.
  Mr. ISAKSON. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. Will the Senator withhold that request?
  Mr. ISAKSON. I will withdraw the request.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. MERKLEY. Thank you, Mr. President.
  I ask unanimous consent to conduct a colloquy with my colleagues from 
Massachusetts and Florida for roughly the next 30 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                 Appropriations Bills and Policy Riders

  Mr. MERKLEY. Mr. President, 7 years ago Wall Street imploded, sending 
us into a recession that we hadn't seen since the Great Depression. 
While our economy has slowly bounced back, the memory of that crisis is 
still fresh in the minds of many Americans, millions of whom lost their 
jobs, millions of whom lost their homes, and millions of whom lost 
their retirement savings.
  Nobody wants to repeat the financial collapse, the bailouts, the 
recession. Indeed, we have spent the last 6 years digging out of a 
hole. Despite this, Republican colleagues at this very moment are 
holding meetings and preparing policy riders to gut the reforms that 
shut down the Wall Street casino. They are working to open up that 
casino again, to the great detriment of families across this country. 
Their goal is to add poison pill policy riders to the fiscal year 2016 
appropriation bills that may well be consolidated into an omnibus.
  That is why I am here on the floor with my colleagues from Rhode 
Island and Massachusetts. Our colleague, Senator Bill Nelson from 
Florida, spoke earlier about these issues. We are here to say no to 
these policy riders that are seeking to reopen the Wall Street casino 
and put American families at peril.
  To start things off, I turn to my colleague from Rhode Island, who 
has brought great expertise and diligence to this conversation over the 
responsible regulations, the ones that serve like the traffic signals 
that enable traffic to move slowly so they don't end up in auto wrecks, 
but they don't shut it down--the responsible regulations that will keep 
us from having another crash doing great damage to American families.
  Mr. REED. Mr. President, I thank my colleague from Oregon for his 
leadership on this issue, and I thank my colleagues who are going to 
join us later.

[[Page 19349]]

  I am joining them in urging all of our colleagues in the Senate not 
to roll back the protections that are in place due to the Dodd-Frank 
Wall Street Reform and Consumer Protection Act of 2010.
  Let me remind everyone where we have come from. When we passed the 
Wall Street reform act, the Dodd-Frank act, we were in the most painful 
financial crisis since the Great Depression. The Dow Jones dropped from 
roughly 13,700 points in July of 2007 to 7,235 points by March of 2009, 
about a 47 percent drop in wealth as indicated by the stock market. It 
was a huge, huge hit. The line at that time was: What is happening to 
your 401(k) plan?
  Well, we have come back, and one of the reasons we have come back is 
because Dodd-Frank has now provided safer rules of the road for 
financial institutions.
  Back then and going forward, we lost 8.6 million jobs from January of 
2008 until January of 2010. There were 8 million jobs lost primarily 
because Wall Street lost its way, frankly. The unemployment rate 
doubled from 5 percent in January of 2008 to 10 percent in October of 
2009. In that period of time, roughly from July 2007 to November of 
2014, nearly 7.5 million families lost their homes.
  These are sobering numbers. Behind each of these numbers is an 
individual or family--our constituents, who suffered real and serious 
damages. Again, this was traceable almost directly back to excesses on 
Wall Street, which we consciously tried to correct in the Dodd-Frank 
act, and it has provided a solid foundation for economic recovery. Slow 
as it has been, we are coming back.
  What happened was that these families lost their retirements--wiped 
out. It was not only the financial loss but the sheer psychological 
trauma of being either retired or on the edge of retirement and 
suddenly it was all gone. It has left a lasting impression.
  People have lost jobs, as I have indicated. It was a huge loss of 
jobs. Some have never gotten back into the market or gotten a job at 
the level they had before.
  Then, of course, there were the foreclosures, thousands and thousands 
of Americans losing their homes. Without their homes, some of our 
constituents lost their whole sense of belonging to the community and 
their ability to find a new job because they were just battling a day 
at a time for shelter and for subsistence. These were real issues, and 
we seem to have forgotten all of that. We seem to have forgotten that 
Wall Street--without sound regulations, strong regulation--will find 
its way off the path and into this type of difficulty.
  We all know people who suffered these losses, and we all are 
committed that they won't suffer them again. But that commitment 
requires us to follow through on the Dodd-Frank act, the Wall Street 
reform act.
  In that legislation, I worked very closely with Senator Warren to 
create the Consumer Financial Protection Bureau. It is just one of the 
examples of the efforts in that bill that actually protected our 
constituents, not theoretically but practically. They have been 
protected from tricky people who were giving them mortgages they 
couldn't afford, engaging in illegal servicing and foreclosure 
practices in the mortgage industry, steering consumers into excessive 
loans they couldn't afford--and the person doing the steering knew they 
couldn't afford them--but those tricky people took the money and 
literally ran, and we have tried to stop them.
  Because of the efforts of the Consumer Financial Protection Bureau, 
$11.2 billion in relief has been given to families throughout this 
country; $11 billion has been given to individuals and families all 
across this country. This is an example not of theoretical legalistic 
procedures but of practical help for people. That is the direct result 
of Dodd-Frank, and some of the proposals that we are hearing about 
would undo that.
  In the process of creating the Consumer Financial Protection Bureau, 
I am particularly proud of working with colleagues to create the Office 
of Servicemember Affairs within the Consumer Financial Protection 
Bureau to serve as a watchdog for our military personnel. Under the 
leadership of Holly Petraeus, it has done a remarkable job. More than 
$90 million has been returned to servicemembers and their families from 
unscrupulous companies that preyed upon our military families 
deliberately--understanding the vulnerability of families that are in 
transit because of deployments and other things. Another example, the 
Military Lending Act, which has capped annual interest rates for 
military personnel, has been enforced through the efforts of the 
Consumer Financial Protection Bureau.
  This has not only helped these families, but it has helped this 
Nation. It has helped our military readiness. I can tell you that 
basically a long time ago, I had the privilege of commanding soldiers, 
paratroopers in the 82nd, and it is hard to be a good soldier when you 
worry about whether your family is going to be able to make it through 
the week or the month to get your next paycheck. This is real help, and 
it is the result of Dodd-Frank. No, many things are the result of Dodd-
Frank.
  So why do we want to roll back these reforms? You ask people, and 
they will say: Well, it is burdensome, and they are hurting these 
financial institutions; you know, it is just so hard to operate a 
financial institution today.
  Then you take a look at the stock performance of these institutions, 
the American global systemically important banks and even our regional 
banks. These institutions have seen their stock prices increase from 
July 2010 at least by 31 percent and in some cases as high as 114 
percent. That is the market saying to these institutions and to all of 
us that they are in good shape. They are in great shape. They are not 
being burdened by financial regulations. They are not being 
overwhelmed. They are profit centers. They are doing great. Name other 
companies that have increased their value so much. One reason is 
because everyone is confident there is a stable, sound, rigorous 
regulatory structure that is ensuring that banks will not go off the 
cliff as they did in 2007 and 2008 when their stock prices collapsed.
  So if you look at that, if you look at the markets, they are not 
complaining about Dodd-Frank. The markets are looking to say: That is 
where the money should go. That is what you should invest in.
  So if you look at that growth and then draw a contrast between what 
has happened to average American families--they haven't seen that kind 
of wage growth. I don't know many working families who have seen a 31 
percent increase in their income or a 114 percent increase in their 
income, but we have to do better with respect to our working families.
  One thing we have to do is make sure that we keep in place 
protections that were built into the Dodd-Frank act.
  There are always ways you can improve legislation, and there are a 
myriad of technical corrections that could be done, but to disguise 
some of these proposals as technical corrections is not appropriate.
  I think also, frankly, if we are going to be sensible, sound, and 
thoughtful about technical corrections, let's go ahead and do it the 
way it should be done, the way Dodd-Frank was done. I was on the 
banking committee. We had hearings. We had a markup. We had, in fact, 
several markups until we got it right. Then we brought it to the floor, 
we had a vigorous debate, and we amended the bill. Then we took that 
bill to conference, then we had it changed in conference, and then we 
sent it to the President for his signature.
  So if we are going to do corrections to improve the Dodd-Frank bill, 
let's do it the way we did it originally, not finding a convenient 
vehicle--a highway bill, an appropriations bill, any other bill--and 
sticking them in as sort of ``take it or leave it''--you have to do 
this or you lose highway funding or you lose funding for our schools, 
for education, for national defense.
  I would hope that we can move forward in regular order and make 
corrections where necessary, but certainly let's not use these waning 
days of this session to undermine the Dodd-Frank

[[Page 19350]]

Act with some of the proposals I have heard.
  With that, I yield back to my colleague, the Senator from Oregon.
  Mr. MERKLEY. I thank my colleague from Rhode Island for his comments 
and insights.
  Now we are going to turn to the Senator from Massachusetts. We will 
be delighted to hear her thoughts on this challenge of taking serious 
issues related to the Wall Street casino, a system that brought down 
the prospects for so many American families, and how there is the 
consideration of restoring the Wall Street casino in the dark of night 
by policy riders being attached to other bills.
  Ms. WARREN. Mr. President, I am pleased to join Senator Merkley, 
Senator Nelson, and Senator Reed on the floor today. I thank Senator 
Merkley for pulling us together.
  We are here to say no--no to the industry lobbyists, no to their 
friends in Congress who are threatening a government shutdown if we 
won't roll back rules that protect consumers and protect the safety of 
our financial system.
  It is a pretty neat trick. The lobbyists probably know they can't get 
a rollback of financial regulations passed out in the open where the 
American people can actually see what is happening and see which 
Senators and which Representatives voted to gut the rules that protect 
working families. So instead they tack rollbacks onto must-pass 
legislation, such as the upcoming government funding bill, to give 
their friends in Congress a lot of cover for voting yes.
  It is cynical. It is cynical and it is corrupt, but it usually works. 
Just last year, Citigroup lobbyists wrote a provision to blast a hole 
in Dodd-Frank. The part of the law that was blown up was called--and I 
am quoting the title--``Prohibition Against Federal Government Bailouts 
of Swaps Entities.'' The idea behind the rule was pretty simple. If a 
big bank wanted to engage in certain kinds of risky deals, such as the 
credit default swaps that had been at the heart of the 2008 crisis, 
they had to bear all of that risk themselves instead of passing it 
along to taxpayers.
  Now the big banks wanted that rule repealed, and the only way to do 
it was to put it on a bill that had to pass or the government would 
shut down, and that is exactly what they did.
  For 1 year, Congressman Elijah Cummings and I worked to document the 
impact of that Citigroup amendment, and we finally got what we needed. 
The FDIC estimates that the provision written by Citigroup lobbyists 
last year that allows a few big banks to put taxpayers on the hook for 
risky swaps has an estimated value of almost $10 trillion. And who is 
gobbling up that $10 trillion of risk? It is three huge banks: 
Citigroup, JPMorgan Chase, and Bank of America. It is three banks, 
nearly $10 billion, and $10 trillion is a lot of risky business. These 
banks will happily suck down the profits when their high-stakes bets 
work out, and they will just as happily turn to the taxpayers to bail 
them out if there is a problem. All of this is because the lobbyists 
persuaded Congress to do just one little favor in a must-pass bill.
  Now, a year after the Citigroup amendment, there are rumors of new 
giveaways in the upcoming funding bill: rollbacks that would make it 
harder for the government to stop the next AIG from taking down the 
entire economy, rollbacks that would exempt many of the 40 largest 
banks in the country from tougher oversight, rollbacks that would 
undermine the consumer agency's rules to clean up mortgage- and auto-
lending markets, rollbacks that would stop the agency from protecting 
consumers rights if they are cheated on credit cards or checking 
accounts, rollbacks that would allow financial advisers to continue 
lining their own pockets while robbing retirees of billions of dollars.
  Why are these rollbacks at the top of Congress's agenda? Are 
constituents flooding the phone lines begging their Senators to weaken 
the rules for financial institutions? Are they writing in by the 
thousands insisting that their Senators make it easier for people to 
get cheated?
  Of course not--survey after survey has shown that hardworking 
Americans want stronger regulation of Wall Street and more 
accountability for CEOs who break the law.
  But like so many things around here, this process isn't about doing 
what hard-working Americans want. It is about pleasing the rich and 
powerful who are lined up for special favors.
  I know some of my Democratic colleagues are frustrated by all of the 
gridlock in Washington. They say: Wall Street accountability is 
important, but I just want to get something done around here for a 
change; so let's go along with the Republicans and the special 
interests. Well, yes, I want to get something done too. Who doesn't? 
But I didn't come here to carry water for Wall Street and a bunch of 
special interests.
  If Republicans think it is time to talk about financial reform, then 
let's put it on the table. If the industry wants to push rollbacks, 
then I want to make it easier to send bankers to jail when they launder 
money or cheat consumers. If the industry wants to chip away at 
financial oversight, then I want to have a serious conversation on the 
record about breaking up the biggest banks. If they are too scared to 
have that conversation out in the open, then Senators shouldn't be 
handing out special favors behind closed doors.
  The upcoming debate about a government funding bill is going to boil 
down to one question: Whose side are you on? Are you on the side of 
working families who got punched in the gut and want stronger rules for 
Wall Street or are you on the side of the giant financial institutions 
that broke the economy, got bailed out, and are once again trying to 
call the shots on Capitol Hill? Well, me, I am with the families, and I 
am ready to say no to the bank CEOs, no to the industry lobbyists, and 
no to all of their buddies here in Congress.
  Mr. President, I yield the remainder of my time to Senator Merkley.
  Mr. MERKLEY. Mr. President, I appreciate the remarks of the senior 
Senator from Massachusetts, who has brought so much personal research 
in the course of her career and passion and insight to this battle and 
who put forward the idea of the Consumer Financial Protection Bureau to 
provide oversight of these predatory practices and who has been such a 
watchdog about these practices.
  I would just ask her before she leaves the floor, why is it that this 
discussion is happening right now, in terms of policy riders on must-
pass spending bills, rather than happening in the light of day with a 
committee hearing--a banking committee hearing--where this can be fully 
discussed and debated?
  Ms. WARREN. Well, the Senator raises the right question, but I think 
it is pretty obvious. If these proposals were debated out in public, 
where everyone in America could see and hear them, they wouldn't pass. 
People don't want to line up to vote for fewer restrictions on Wall 
Street. They do not want to line up to vote for more opportunities to 
cheat American families. So, instead, the idea is just tack it on 
something else that is going to move through. Then the question is, 
Will people vote to keep the government open? And that gives a lot of 
people in Congress who want to help the big financial institutions a 
lot of cover, and that is fundamentally wrong.
  Mr. MERKLEY. One of the things we have a lot of concern about is 
making sure that predatory mortgages don't return. They were a key 
product in helping drive the collapse in 2007-2008. We are concerned 
those could return if the ability of the CFPB to regulate them is 
diminished by changing the government structure of the CFPB or shutting 
down the funds that enable it to operate. Would that be a good idea or 
a bad idea?
  Ms. WARREN. You know, the CFPB works. It works to help protect 
America's families. It works to help level the playing field. Already 
that agency has been up and operational for just a little over 4 years, 
and it has forced the biggest financial institutions in this country to 
return more than $11 billion directly to families they cheated. It has 
handled more than 750,000 complaints against big financial 
institutions, against payday lenders, and against college loan services 
that are

[[Page 19351]]

cheating people and that are tricking people.
  So what is the response? Well, it is helping the American people, but 
it is costing a handful of the biggest financial institutions in this 
country real money, and they are trying to find a way to make sure the 
consumer agency doesn't do its job. They want to find a way to weaken 
that agency, to tie that agency down, and to keep that agency from 
leveling the playing field for American families.
  Mr. MERKLEY. I know my colleague and I have talked about this--the 
number increases. I will say something like the CFPB has returned $3 
billion, and my colleague will say: Oh, Senator, it is now $5 billion. 
And when I say it is $5 billion, my colleague will remind me it is now 
$8 billion. And here we are at $12 billion?
  Ms. WARREN. I think it is $11 billion.
  Mr. MERKLEY. So $11 billion in returns. I believe that number 
includes real cash returned to individuals but does not include the 
vast savings that have come from families who were never cheated in the 
first place.
  Ms. WARREN. I think one of the most important parts of this is the 
consumer agency said--when credit card companies, for example, got 
caught cheating people, it said to those credit card companies: Look, 
you have people's addresses to be able to cheat them. Now you have 
people's addresses to send them checks to pay them back.
  It is as the Senator said. It was like a warning shot to everyone 
else out there cheating consumers. It said that this agency is on the 
level. This agency is tough. So I think there are millions of Americans 
who don't get cheated, who don't get tricked in one scam or another 
because we have a real watchdog out there--someone who is on the side 
of the American family.
  Mr. MERKLEY. I thank my colleague so much for presenting this idea 
before she came to the U.S. Senate and for helping--well, stepping in 
to be the initial Director, getting it up and running, and now being 
here to make sure we defend its ability to provide fairer financial 
products for America's families--products that enable families to build 
their wealth rather than having wealth-stripping scams hurt and destroy 
the finances of American families.
  Ms. WARREN. I only want to add that I am grateful for all the work my 
colleague has done on behalf of American consumers and all the work he 
did to get the consumer agency through Congress and now to protect it 
when the big banks were coming after it.
  So I thank my colleague Senator Merkley for all he did.
  Mr. MERKLEY. I thank the Senator very much.
  Mr. President, as we have heard from this colloquy--and I appreciate 
that Bill Nelson was here earlier, the Senator from Florida, to discuss 
his insights on these dark-of-night policy riders designed to restore 
the Wall Street casino and cheat American families. I appreciate the 
comments he brought to this and that Jack Reed, the senior Senator from 
Rhode Island, has brought forward and Elizabeth Warren, the senior 
Senator from Massachusetts, each of whom made important points. So I 
will be brief because they have laid out most of the issues I will try 
to echo.
  The key point is the debate over changing the rules for these 
powerful financial institutions should be debated in the open, in front 
of the TV cameras, in front of the American people, not in secret 
negotiation rooms and not in the dark of night, which is happening at 
this very moment, because a lot is at stake.
  We found from before that when regulations were stripped away and the 
Wall Street casino went wild, we ended up with a crash that destroyed 
the finances of millions of families, many of whom will never recover. 
They lost their homes, their dreams of homeownership. That has been 
shattered, and they are not going to get it back. They lost their job 
and have been derailed and will never get back on track. They lost 
their retirement savings, and they will never be able to rebuild them. 
In fact, that golden vision of retirement may be something they feel 
they will never be able to be a part of--that chapter of their life 
will never come.
  So a tremendous amount is at stake, and these dark-of-night 
negotiations to repeal, to undermine, to delay the shutdown of the Wall 
Street casinos are just wrong. Let us have the debate in the committee 
where it belongs. This is critical for working families everywhere in 
the country and certainly in my home State.
  Let me mention one of the riders, which is to take and allow the 
Volcker rule to be voided for some of the financial institutions. What 
is the Volcker rule? The Volcker rule shut down the Wall Street casino. 
It said banks cannot bet with taxpayer-insured deposits. If a group 
wants to make big bets on the future of interest rates or monetary 
exchanges or the quality of mortgages and so forth, they must do so 
with private wealth funds, where the only persons at stake are those 
who have invested in the fund. Don't do it with taxpayer-insured banks. 
That is one example.
  A second example is that we need to keep the quality mortgages we 
have now so they do not return to being a predatory instrument. We had 
a legalized kickback scheme, and that structure meant mortgage 
originators were paid for steering families from a prime mortgage that 
would build their wealth into a subprime mortgage with an exploding 
interest rate which would destroy their wealth. We ended those 
kickbacks. Let us not let that happen again.
  Let us not undermine the role of the Financial Stability Oversight 
Council. When we had this dramatic massive increase in subprime loans, 
starting in 2003 and going through 2007, nobody was watching. We need 
to have someone say: Look at that surge in subprimes. And because of 
that surge, what is going on? Is this creating a bubble? Is this a big 
bet that is going to go bust? Is this going to destroy families?
  We actually had an agency that was responsible for controlling these 
predatory practices. It was the Federal Reserve, but the Federal 
Reserve, full of sophisticated economists, said: Well, we want to talk 
monetary policy. That is what we do up in the penthouse of the Federal 
Reserve building. So they put consumer protection down in the basement 
and they locked the door and threw away the key and said: You know, we 
have that responsibility, but we just aren't going to do anything about 
it, and they let predatory schemes run wild and destroy millions of 
American families.
  Now we have an organization--the Consumer Financial Protection 
Bureau--that is the watchdog making sure the disclosures and the 
structures are fair and square for American families so we can build 
the success of those families. You cannot be for the success of 
American families and be for these secret, dark-of-night measures 
designed to destroy the effort to rein in this Wall Street casino.
  I hope we will see a return to regular order, the type of regular 
order my colleague from Rhode Island talked about, the type of light-
of-day committee discussions my colleague from Massachusetts talked 
about because this is so important to our future and the success of 
American families. Let's make sure we work together to build the wealth 
and success through fair financial practices, not special favors done 
for very powerful institutions that are designed to exploit and operate 
as predatory measures to strip the wealth of American families.
  I thank the Chair.
  The PRESIDING OFFICER (Mr. Lee). The Senator from North Dakota.
  Mr. HOEVEN. Mr. President, I rise to speak in support of repealing 
ObamaCare and replacing it with a step-by-step approach that restores 
choice and competition to consumers. The problems with ObamaCare are 
legion and have often been reported in the media and identified on the 
floor of the Senate.
  I know we have all heard from our constituents. Hundreds of thousands 
have written and called all of our offices and, as a matter of fact, I 
will read one of the letters that came into my office--or at least part 
of it. It is addressed to me and starts out saying:


[[Page 19352]]

       I'm sure I'm not the first one to contact you about rising 
     health insurance deductibles. I have had this job for 3 
     years. The first 2 years my company plan had a $3,000 yearly 
     deductible with no copay.

  So he had a $3,000 yearly deductible with no copay. He continues:

       Last year, it went to $4,000 with a 20 percent copay.

  Again, it goes from $3,000 to $4,000 in annual deductible and it goes 
from no copay to a 20-percent copay.

       This coming year, 2016, it will go to $6,700 with a 20-
     percent copay.

  So in just 3 years it goes from a $3,000 yearly deductible with no 
copay to $6,700--more than double--with a 20-percent copay.
  He goes on:

       Even before my current job, I had a Blue Cross North Dakota 
     policy that had a $2,000 deductible and a very fair monthly 
     premium. I have always had good health insurance. Now I have 
     an essentially worthless policy.
       I had bone cancer in my pelvis 1\1/2\ years ago. Had to go 
     to Mayo and have my left pelvis removed. I have spent the 
     last 18 months learning to walk again. Doctors weren't able 
     to reconstruct it.
       I will have twice yearly follow up cancer screenings for 
     the next several years. These follow ups cost about $3500.00 
     each. So I spend $7000.00 a year, which is all of my 
     deductible.

  He goes on:

       What are you doing to make changes to this health care act?

  He clearly identified what consumers across the country are 
experiencing. This is just one example. I have many more, as do all of 
the Members of this body.
  As bad as ObamaCare is for them, it is going to get worse. In 2016, 
consumers will see significantly higher premiums yet again. Premiums 
for the lowest cost silver plan will increase by 13 percent, and the 
lowest cost bronze plan will rise by 16 percent on average.
  That is not all. The inaptly named Affordable Care Act has led to 
higher out-of-pocket costs for older, middle, and lower income 
Americans as well. Today, the average deductible is more than $2,000 
and for some it exceeds $6,000, discouraging people from seeking 
necessary care.
  The law is also resulting in fewer choices. Employers are already 
reducing benefits for many family members. By 2018, more than half of 
employers plan to significantly reduce benefits for employees' children 
and spouses.
  While many are seeing higher premiums and deductibles with fewer 
choices, ObamaCare has created dozens of new taxes that ultimately are 
passed down to small businesses and consumers. The Congressional Budget 
Office has estimated that ObamaCare will increase taxes by $1.2 
trillion over the next decade.
  The result is fewer jobs. Simply put, employers are already cutting 
jobs or reducing hours to part time to avoid the higher costs of 
ObamaCare.
  I do believe there is a consensus across the Nation that we need 
health care reform, but ObamaCare is not the answer. Americans want 
commonsense reforms--reforms that truly are affordable and that truly 
do empower patients to make their own choices. In the short run, we 
need to pass budget reconciliation legislation that repeals ObamaCare, 
and, in particular, the individual and employer mandates. In the long 
run, we need to take a step-by-step approach to put individuals, 
families, and businesses on a path to better reforms. The right 
approach to health care reform empowers people to make their own 
choices in selecting health care providers and insurers that is patient 
centered and respects the relationship between doctor and patient. The 
way to accomplish that is with a market-based plan that creates more 
competition and reduces health care costs.
  Here is what we could do: To foster competition and reduce health 
care costs, we can do things like expand tax-free health savings 
accounts, flexible savings accounts, and Archer medical savings 
accounts to encourage individuals to save for future health care needs. 
Combined with high-deductible, low-premium policies, people will be 
able to meet their immediate health care needs and still be protected 
in the event of costly, serious illness.
  We should provide portable health care plans so that individuals and 
families don't experience gaps in coverage when they change jobs. These 
plans could be given favorable tax treatment. For example, they could 
be treated as tax-preferred accounts so that dollars towards premiums 
could receive tax-exempt treatment. We should allow health care 
policies to be sold across State lines. This would result in more 
choices, more competition, and reduced costs for customers. We should 
give States more flexibility to manage Medicaid for low-income 
individuals and families. We should ensure affordable health care 
options are available to those in need and certainly those patients 
with preexisting conditions. That means bolstering State high-risk 
pools to make sure everyone has an opportunity to be covered.
  ObamaCare is far from being the panacea it was promoted to be. The 
sticker shock hasn't faded. On the budget reconciliation we now have a 
real opportunity to turn the page on a failed experiment so that we can 
take steps toward replacing it with something the American people want.
  I urge my colleagues to get behind the effort so we can start that 
process.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Montana.


                              GMO Labeling

  Mr. TESTER. Mr. President, I want to talk a little bit today about 
food, transparency, and consumers' rights to know what is in their 
food.
  As many folks in this body know, in my real life I am a farmer. I get 
to see exactly where my food comes from. Last month, I spent some time 
butchering and processing beef, knowing exactly where that came from. I 
like that. But not all Americans have the ability to know where their 
food comes from.
  A few months ago, in July, the House passed a bill called the Safe 
and Accurate Food Labeling Act. It couldn't be anything more different 
from that, by the way. It basically denies Americans the right to know 
what is in their food by prohibiting the Federal Government, States, 
and municipalities from imposing any labeling standards that deal with 
genetically modified food.
  I come from a State where transparency is very important. It makes 
our government work better. For the Federal Government in this case to 
undermine States and municipalities and not allow the consumer to know 
what is in their food--it is exactly the wrong step to take.
  So why am I bringing this subject up today? I am bringing it up today 
because, quite frankly, there is some talk about air dropping an 
amendment that would allow the DARK Act to go into effect. It is not a 
bill we have debated on the floor to my knowledge. I don't know that it 
has even been heard in committee. But the bottom line is that this is 
bad policy.
  The arguments would be that it is confusing; it is going to be 
expensive. That is bunk. Consumers are smart. They pay attention to 
what they eat. If you give them the ability to choose and the ability 
to know what is in their food, they will make the decision--which is 
their decision to make--on what they are going to feed their family and 
what mothers are going to feed their children.
  It goes against everything this country stands for about letting 
people know we do have a great food system in this country. So let's be 
proud of it. Let's label it. Let's talk about what is in it. Let's let 
consumers have the choice. Consumers are smart, and they will 
absolutely make a choice that is best for their family.
  Food is very important. Food, in my opinion, is medicine. If you know 
what you are eating, you will have a healthier family. If you pay 
attention to these kinds of things, your health care costs will go 
down.
  The truth is that other countries require GMO labeling--countries 
like Russia, China, Saudi Arabia--not exactly countries that we would 
think would be very helpful to their consumers or transparent. But they 
think it is important to label it. We ought to here in this country 
too.
  Big Money is coming in here saying: We don't want the consumers to 
know if they have GMO products in food; we want consumers to be 
ignorant. That is

[[Page 19353]]

not something this body should do. Let's give consumers the information 
they deserve. Let's allow this labeling to move forward, as Vermont has 
already done. Other States like Maine and Connecticut also are taking 
steps in that direction.
  The bottom line is, to put in an amendment that stops States or 
municipalities from requiring labeling is a step in the wrong 
direction. It is not fair to consumers, and, quite frankly, it is not 
fair to the folks who produce food in this country.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. PORTMAN. Mr. President, I want to talk a little about the 
legislation before us to repeal and replace ObamaCare, otherwise known 
as the Affordable Care Act.
  When I travel around my home State of Ohio, I hear about a couple 
things a lot. One is the tough job market and flat wages, which makes 
it difficult to get ahead. The other is--and it is related--escalated 
health care costs. People are seeing in their lives that it is tough to 
find that job, and if they do have a job, they are finding their wages 
aren't going up as they would normally expect. Unfortunately, when we 
look nationally this is true. Wages on average are not just flat; they 
are slightly down. In other words, they have declined, which is not 
typical. On the other hand, expenses are up, and the biggest expense: 
health care.
  So the middle-class squeeze is very real. It is affecting the people 
I represent as they see, again, unusually low wages, not the growth 
that we normally expect on the one hand, and on the other hand higher 
expenses, with health care taking the lead in those expenses.
  Today in the Senate and tomorrow, as we debate this and vote on it, 
we have a chance to move the ball forward and show people that at least 
a majority in the Congress agree we ought to address this issue--the 
health care issue, of course--and try to stop the incredibly fast 
increase in premiums, deductibles, copays. Families, small businesses 
are getting hit hard. Also, we can help give the economy a shot in the 
arm by coming up with smarter ways to deal with health care.
  This vote will show there are some in Congress who are listening and 
have some answers. Our job is to do what is right, and that is to pass 
this legislation to repeal and replace ObamaCare, to give us a chance 
to get rid of some of the most detrimental aspects of it that are 
eliminating jobs, that are pushing health care costs higher and higher.
  The legislation--the Affordable Care Act--was sold as actually 
reducing costs. It was sold under false pretenses.
  Specifically, the President said it would bring down premiums. He 
talked about it going down $2,500 on average per family. No; in fact, 
premiums are going up.
  We were told Americans would be able to keep their insurance. Of 
course, millions have lost their health care insurance.
  We were told that if you have a doctor whom you like, you can keep 
your doctor. Of course, a lot of people are now being told that under 
their new plan, they can't keep the doctor they have had.
  We were told the Affordable Care Act could keep our economy strong, 
that it would grow jobs, create jobs. Instead, again, it has made 
things worse. If we look at the economy and what has happened, a lot of 
the issue is that people have given up looking for work. The so-called 
labor force participation rate is the lowest it has been since the 
1970s--over 30 years. Some of that, again, is because we have this weak 
economy. Some of that is because a lot of the jobs that are available 
are part-time jobs, and the Affordable Care Act encourages part-time 
work, as we will talk about in a second.
  So the results are in. We have seen it. We have seen that ObamaCare, 
with its mandates and centralized control, its top-down approach, has 
made it more difficult to get a job and has increased health care costs 
for families and small businesses--not the right way to provide quality 
health care for the people I represent in Ohio.
  I hear stories every day. Sometimes they come in through our Web 
site, sometimes people call, sometimes I just run into people, and they 
tell me their stories. I got one this morning. We have our weekly 
Buckeye coffee, where we bring in people who are here in Washington 
from around Ohio to talk to us about their issues. I ran into a small 
business owner, very typical--a manufacturer in this case. He said: 
Rob, my margins are between 2 and 3 percent. In other words, that is 
what my profit is, and yet I am seeing my health care costs go up by 
double digits every year. It just doesn't work. I can't make ends meet. 
I am having to pass this along, either to my employees with higher 
premiums, higher deductibles, higher copays, or to try to pass them on 
to my customers. But I am in a very competitive market and I can't 
really do that. That could mean having to lay some people off, downsize 
the business.
  Take another small business owner who wrote to me recently who said 
this is going to hurt his business. He said he is going to have to tell 
his 35 employees their insurance will be canceled and that the cheapest 
replacement policies would include a 35-percent increase in premiums as 
well as a 33-percent increase in deductibles. This is another small 
business in Ohio.
  Take the father of five who saw the cost of his family's insurance 
double under the Affordable Care Act or the man who saw his $100 
deductible go to $4,000. Does that sound familiar? There are probably 
some people listening tonight who had that same experience where their 
deductible goes up so high, it is almost like you don't have insurance. 
This guy said he saw his deductible soar to $4,000 while his premiums 
went up to $1,000 a month.
  Batavia is in Clermont County, OH, right near my home. Recently, a 
woman from Batavia wrote to me and said:

       I am a single mother. I pay for my own health insurance. I 
     am active and fit. I have cycled over 4000 miles this year. I 
     am seldom sick. In the three years that I've paid for my own 
     insurance, I went to the doctor once for illness. My rate was 
     $146 [a] month. In September, I received a letter from Anthem 
     saying my plan does not meet the requirements of the 
     Affordable Care Act and will be discontinued. I was offered 
     the same coverage for $350 per month.

  This is a real problem for this single mom, but it is for families 
all over Ohio. I am concerned about the impact on those families, 
concerned about the impact on our small businesses. I am also concerned 
about the indirect impact on employees who work for those small 
businesses.
  We talked earlier about the fact that there is more and more part-
time work and that jobs are hard to come by in Ohio. More and more 
small businesses in Ohio are becoming what they call 49ers or 29ers. 
Forty-niner refers to the fact that employers sometimes feel they have 
no choice but to freeze their growth, and they are hiring at 49 
employees rather than 50 employees because when you hit 50, you come up 
with new requirements and mandates under ObamaCare.
  Others have tried to reduce the hours their employees work. If you 
work less than 30 hours a week, you are not covered by the mandates 
under ObamaCare. So some employers have reduced hours from 40 hours to 
29 hours. Those are the 29ers. That is one reason full-time work is 
harder to come by.
  It is no surprise to me that the underemployment figure--those 
working part time but wanting to return to work full time--has been on 
the rise. When you see the jobs numbers coming out every month, look at 
the number of people who are part time rather than full time. It is 
concerning. Some of this has to be driven by what is happening with the 
Affordable Care Act. I am certainly hearing about it. I am certainly 
hearing about it from people on the ground, real-world situations. It 
is sad.
  This morning I talked to Todd, the president of a small manufacturing 
company, and he talked about a double-digit increase in his health care 
expenses. Mike from Westlake wrote to me and said:

       I own a small business. Our health insurance rates for 
     single employees under 30

[[Page 19354]]

     went from $198 per month last year to $560 per month this 
     year. That's a 260% increase thanks to ObamaCare! This bill 
     is going to put small businesses out of business.

  This one is from Tim in Canton. He said:

       The ACA fees being charged to us are $3,250 per year for 11 
     covered employees, which will be passed on to them. We are 
     paying for the insurance premium increase of $15,186 by 
     reducing our year-end bonus program. We also are offering an 
     even higher deductible plan than we have now. (I will take 
     the higher plan to lower the overall cost to soften the blow 
     for my staff).

  This is an interesting one because it is what I hear around Ohio. 
They are discontinuing their bonus program because of this. Other 
companies say we are discontinuing a research project. Others say we 
are discontinuing our match on our 401(k). Others say we are just plain 
cutting back; in other words, not hiring as many people as they would 
have.
  It is happening out there. I know some economists have debates on 
this issue, but I hope they are talking to people in the real world who 
are being affected by this Affordable Care Act, the top-down approach, 
the mandates, and the inflexibility.
  Not only are these small businesses affected by these new mandates, 
but a lot of them are now subject to one of the new taxes included in 
the Affordable Care Act. I think there are 21 new taxes in the 
Affordable Care Act. One of them is a tax on medical devices. This is 
an industry that is very important to Ohio and to our country. We have 
had a competitive edge in medical devices. We have a lot of great 
innovators in this country, including my home State of Ohio. We have 
been able to not only create some great opportunities in this country 
but we are exporting medical devices around the world. It is hard to 
overstate the impact the industry has on our State of Ohio and the 
ripple effect through our communities.
  Over the past decade, we have added about 370 new bioscience and 
medical device companies in Ohio alone. It has been a growth area. 
These companies have brought high-paying jobs. I am told that for every 
one job, they create another 2.3 additional jobs. I visited a lot of 
these companies around the State of Ohio. I have been to companies in 
Cleveland, Cincinnati, and Columbus. Recently, I visited Zimmer 
Surgical, which is a company that employs about 300 workers in Dover, 
OH. They expressed the same concern I have heard at all these other 
companies I talk about, which is that this new tax under the Affordable 
Care Act makes it hard for them to be able to compete.
  It is a very interesting tax. Normally you would have a tax on 
profits. If a company makes money, it pays taxes on those earnings and 
those profits. This is a tax on revenue, whether there is profit or 
not. It is an excise tax. Since this tax has taken effect, the 
companies I am talking about have seen a decrease in their operating 
margins. They are resulting in fewer jobs, they tell me, and less 
investment in the United States. Again, a lot of them say they are 
cutting back on research because they cannot afford to do the research 
they used to do because of the excise tax on their revenue--again, not 
on their profits, the money they are making, but just their revenue. 
That means their seed corn, as they call it, is being cut back.
  I talked about the great innovation and the fact that this has been a 
cutting-edge industry for us in Ohio and around the country. The seed 
corn is research. That is what makes America a cutting-edge country in 
terms of these great medical device companies. A bunch of them are 
cutting back on research and that concerns me. Some have gone overseas. 
Some have moved their research overseas, even though they stayed 
headquartered in the United States.
  If this tax continues, some have told me that they will be forced to 
close down manufacturing facilities. At a time when we need, more than 
ever, more made-in-America products in innovation, the medical 
technology industry is one where we are a leader on the world stage, 
and we should not be coming up with this kind of burdensome tax. That 
is why I am so glad that on this legislation that we will vote on 
tomorrow or the next day, that we will have the opportunity to repeal 
the medical device tax. By the way, there is a bipartisan consensus 
around that, I think. I know a lot of my colleagues on the other side 
of the aisle have talked about the need for us to do that as well.
  If we do not do that, we are going to find out we have lost ground. 
Again, this goes to our economy. One thing that concerned me was that 
the founder of Zimmer Surgical in Dover, OH, told me that had this tax 
been in place when he started his company, he doesn't think he ever 
would have made it off the ground. I talked earlier about the number of 
new startups. This is going to keep some of those startups from taking 
root in the first place and creating those jobs and opportunities.
  Repealing a job-killing medical device tax, therefore, is a great 
step forward to promote policies to get Americans back to work. Even 
though we need to repeal these top-down mandates we talked about and 
get rid of some of these taxes that are so onerous on workers and hurt 
our economy, I don't think we should go back to the pre-Affordable Care 
Act status quo. I don't think it is enough to say we should repeal this 
bad law. I think we also should say: Let's come up with a better way to 
deal with health care costs. Health care costs are going to be a big 
problem unless we deal with them in a much more sensible way than the 
Affordable Care Act does. I think real reform is needed. It must be 
patient-centered. In other words, it must be about the patient giving 
them the incentive to be able to save costs by focusing on prevention 
and wellness, focused on their families, focused on what they need for 
themselves and family rather than these mandates that say you can't 
have this insurance policy you had for years, as this young woman in 
Clermont County told me who has seen her premiums go up so 
dramatically. She had a policy she was very happy with. Let people have 
the policies they want for themselves and their families.
  Let's have less government and bureaucracy and more focus on 
patients. Let's be sure it is responsible in terms of keeping the tax 
burden down and does not kill jobs as the medical device tax does. 
ObamaCare should be repealed. It should be repealed and replaced with a 
system that actually works. The failures to ObamaCare actually point 
the way as to how we can do that. As I said, patient-centered, costs 
should be the focus. There are steps we can take--and take them today--
to remove some of the shackles of government regulations from the 
market and help make health insurance and health care less expensive. 
We should start by allowing health care to be sold across State lines. 
Let's be sure we can compete, and the people who live in Cincinnati, 
OH, can get health care across the river in Kentucky or across the 
border in Indiana. It makes no sense. Some people live in Indiana and 
work in Ohio and vice versa or work in Kentucky and live in Ohio and 
they only get health care in the place where they live.
  We should be able to look for our health care in New York or 
California. Whatever works best for our family. Make these companies 
compete for our business. We should take commonsense steps to rein in 
the staggering costs of frivolous lawsuits. This could save billions 
and billions of dollars in our health care system. There is a CBO 
estimate of the cost to the Federal Government that could be saved 
alone. It is tens of billions of dollars, but the medical profession 
will tell you it is more like hundreds of billions of dollars as it 
applies to all of us. That will help to make health care more 
affordable.
  We should cover more Americans by creating a healthy, vibrant 
individual health care market, giving people a tax incentive to 
purchase health care insurance comparable by the incentives they 
receive at their employer-provided plan. Why shouldn't they have that 
same opportunity in the individual market that is part of the way you 
cover more people?
  The sad truth about ObamaCare is that the coverage numbers are very

[[Page 19355]]

disappointing, even to those who strongly supported the bill. Why? 
Because what has happened is that some people have gotten coverage, but 
others have lost coverage. The estimates by the Congressional Budget 
Office are that still 10 years after this legislation is in place there 
will be something like 30 million Americans without coverage.
  We can do it and do it in a more cost-effective way and be sure 
people do have the opportunity to have access to quality health care. 
The bill we have before us this week will take that first step at 
removing the shackles of government regulation and put the country on 
the path forward to real health care reform. Not only does the 
legislation remove the mandates ObamaCare placed on individuals and 
businesses to purchase insurance, but it also rolls back some of the 
new programs, while giving the new President, the next President, and 
the new Congress, the next Congress, the time to be able to enact 
alternative reforms that will ensure all families have access to 
quality, affordable health care. It has to be a top priority to 
actually come up with not just repealing what is there but replacing it 
with something that makes more sense for families in Ohio and around 
the country.
  I look forward to this vote and this debate because it gives us an 
opportunity to send to the President sensible legislation that gets rid 
of so many of the detrimental impacts of ObamaCare and sets us down the 
path of debating about what that future ought to be.
  Some Democrats have said: Why are you doing this--because the 
President said he will veto it. I would ask them to look at what the 
majority of the American people are saying, which is that they do not 
believe the Affordable Care Act is the right way to go. I guess I would 
look at the fact that the majority in the Senate may feel that way as 
well. We should represent those folks back home. Because the President 
doesn't support it doesn't mean we shouldn't act and do what is right. 
Every President who served in this great country has had the 
opportunity to veto legislation coming from Congress. It doesn't mean 
Congress shouldn't send them legislation. I hope the President will not 
veto it. He probably will. It doesn't mean the Senate shouldn't act. I 
am glad we are acting.
  I stand ready to work with my colleagues going forward on both sides 
of the aisle to enact real reforms that do provide the people I 
represent and people all around this great country the access to the 
quality care they deserve.
  Mr. President, I yield my time.
  The PRESIDING OFFICER. The Senator from Illinois.
  Mr. DURBIN. Mr. President, for those who are keeping score, this is 
the 17th time that the Senate will be asked by the Republicans to vote 
to end ObamaCare, and they have added to this to defund Planned 
Parenthood. As one individual said the other day, here is a 
breakthrough press release: President Barack Obama is not going to end 
ObamaCare. That seems pretty obvious. So this is a political exercise. 
It doesn't solve the problems of America. It doesn't even address the 
problems of America.
  The Affordable Care Act finds health insurance for 17 million 
Americans. We have reduced the number of uninsured Americans by 45 
percent with this bill. The Republicans have opposed it from the start, 
never providing a single vote in support, never willing to sit down 
after it was passed to talk about changes that would make it even 
stronger or better. They want to end it. It is ObamaCare. It has the 
President's name on it--enough said for many of them. They want it to 
go away.
  The reality is if it goes away, so does health insurance protection 
for millions of Americans. So you would expect that the Grand Old 
Party, the Republican Party, would have an alternative for us, right? 
Wrong. They have never come forward with any alternative that would 
provide coverage for these millions of Americans and the others who 
should have health insurance coverage as well. It just tells you that 
they are prepared to go back to the bad old days before ObamaCare and 
the Affordable Care Act.
  Remember those days? Remember when a health insurance company could 
say to you: Sorry, you happen to have a sick child in your family, and 
we are not going to give you health insurance. Preexisting conditions 
were enough to say no, and if they said yes, it was at a premium that 
an average family couldn't even consider. We ended that discrimination 
against families and sick children. We ended it.
  The Republicans today want to go back to those good old days when 
health insurance companies could turn you down in a New York minute and 
say: There will be no health insurance for you or your kids. They want 
to go back to those good old days. They are wrong.
  They want to go back to the days when a family's health insurance 
plan wouldn't cover the graduate from college until he reached the age 
of 26. That is what the Affordable Care Act does. It says that a family 
can keep that youngster--young man or woman--on their health insurance 
plan for their family while they are looking for a job, serving an 
internship or have a part-time opportunity.
  I will tell you, as a father who has raised three children, I can 
remember those days after college when those kids didn't have coverage, 
and I used to ask them about that. I asked my daughter, Jennifer: Do 
you have health insurance now? She said: Dad, I don't need it; I feel 
just fine. That is not what a father wants to hear. The Republicans 
want to return to those good old days when those young men and women, 
after just having graduated from college, had to buy their own health 
insurance and couldn't stay on the family plan.
  What about senior citizens with prescription drugs? The Affordable 
Care Act, which they want to repeal, helped seniors pay for their 
prescription drugs. They want to go back to the bad old days when 
seniors had a gap in coverage and had to go to their life savings to 
buy lifesaving prescription drugs. Those are the good old days that the 
Republicans want to return to. Well, those days weren't so good, and 
they certainly shouldn't return.
  We have seen for the last 5 years the slowest rate of increase in 
health care costs in the last several decades. We have slowed down that 
rate of growth. We can do better. We should work together to do better 
on a bipartisan basis.
  But instead, we are faced with a 17th vote by Republicans in the 
Senate to eliminate ObamaCare, to return to the old days of 
discrimination because of preexisting conditions and to take your kids 
who have graduated from college off your family health insurance plan. 
That is what they want to go back to.
  America is not going to let that happen. Thank goodness this 
President won't let that happen. But we are going to waste several days 
on the floor of the Senate while they go through speeches that have 
been carefully rehearsed and delivered 17 different times with the same 
ultimate result, and nothing is going to happen. Instead, they should 
join us in a bipartisan effort to make the Affordable Care Act even 
stronger, fairer, and to help people have affordability and access to 
health insurance.


                       Shooting in San Bernardino

  Mr. President, earlier today there was a mass shooting in San 
Bernardino, CA. News reports are saying that up to three heavily armed 
gunmen attacked a social services center that helps developmentally 
disabled people and their families in the community.
  Preliminary reports say that there have been 14 people killed and 14 
wounded, although we don't know the exact number yet. There are videos 
of wounded people actually lying in the streets. The suspects 
apparently fled the scene in a black SUV, and a manhunt is underway.
  This story is horrific, but it is also horribly familiar. There have 
been over 350 mass shootings in America this year. On average, 297 
Americans are shot every single day, 89 fatally. Listen to this grim 
and sad statistic: There have been over 50 school shootings this year 
in America.
  Our thoughts and prayers are with the victims and first responders in 
San Bernardino. But they and all the victims across our country deserve 
more

[[Page 19356]]

than our thoughts and prayers. They deserve action. It is time for 
Congress--in a level-headed, commonsense moment--to vote on and pass 
legislation to protect innocent people across America from this 
horrific gun violence.


                            Syrian Refugees

  Mr. President, I don't know if it was George Washington who said--
although I think he is given the credit--when describing this 
institution of the Senate: It is the saucer that cools the tea.
  I served in the House for 14 years and was proud to do it. We were 
elected every 2 years. It was a more volatile atmosphere because we 
were constantly running for reelection. The Senate is a different 
institution, with 6-year terms and a little more reflection, I hope, in 
what we do. I hope that we take the time that is necessary to exercise 
our constitutional opportunity here and think things over clearly and 
not react emotionally.
  Well, it was about 2 weeks ago when the House of Representatives took 
action on the Syrian refugees and passed a measure that would give what 
they called a pause to receiving Syrian refugees in the United States. 
It was a heated moment. It was after the terrible tragedies that 
occurred in Paris and Beirut, and there were concerns about ISIL and 
the spread of their terrorist ways around the world. It was an 
emotional moment that really needs some reflection.
  The simple fact of the matter is this. Over the last 4 years, during 
the course of the Syrian war, the United States has received about 
2,000 refugees from Syria into our country. It is an elaborate, lengthy 
process.
  Mr. President, I ask unanimous consent to have an article from last 
weekend's New York Times, which outlines all of the steps that need to 
be taken in order for a Syrian refugee to enter the United States, 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                [From the New York Times, Nov. 20, 2015]

      Why It Takes Two Years for Syrian Refugees To Enter the U.S.

                  (By Haeyoun Park and Larry Buchanan)

       Syrians must pass many layers of security checks before 
     being admitted to the United States, a process that can take 
     two years or longer. In most cases, the refugees do not enter 
     the United States until the very end. They are also subject 
     to an additional layer of checks beyond those for refugees of 
     other nationalities; after the Paris attacks, the House voted 
     to further tighten screening procedures. Since 2011, the 
     United States has admitted fewer than 2,000 Syrian refugees.
       1. Registration with the United Nations.
       2. Interview with the United Nations.
       3. Refugee status granted by the United Nations.
       4. Referral for resettlement in the United States. The 
     United Nations decides if the person fits the definition of a 
     refugee and whether to refer the person to a country for 
     resettlement. Only the most vulnerable are referred, 
     accounting for fewer than 1 percent of refugees worldwide. 
     Some people spend years waiting in refugee camps.
       5. Interview with State Department contractors.
       6. First background check.
       7. Higher-level background check for some.
       8. Another background check. The refugee's name is run 
     through law enforcement and intelligence databases for 
     terrorist or criminal history. Some go through a higher-level 
     clearance before they can continue. A third background check 
     was introduced in 2008 for Iraqis but has since been expanded 
     to all refugees ages 14 to 65.
       9. First fingerprint screening; photo taken.
       10. Second fingerprint screening.
       11. Third fingerprint screening. The refugee's fingerprints 
     are screened against F.B.I. and Homeland Security databases, 
     which contain watch list information and past immigration 
     encounters, including if the refugee previously applied for a 
     visa at a United States embassy. Fingerprints are also 
     checked against those collected by the Defense Department 
     during operations in Iraq.
       12. Case reviewed at United States immigration 
     headquarters.
       13. Some cases referred for additional review. Syrian 
     applicants must undergo these two additional steps. Each is 
     reviewed by a United States Citizenship and Immigration 
     Services refugee specialist. Cases with ``national security 
     indicators'' are given to the Homeland Security Department's 
     fraud detection unit.
       14. Extensive, in-person interview with Homeland Security 
     officer. Most of the interviews with Syrian refugees have 
     been done in Amman, Jordan and in Istanbul.
       15. Homeland Security approval is required. If the House 
     bill becomes law, the director of the F.B.I., the Homeland 
     Security secretary and the director of national intelligence 
     would be required to confirm that the applicant poses no 
     threat.
       16. Screening for contagious diseases.
       17. Cultural orientation class.
       18. Matched with an American resettlement agency.
       19. Multi-agency security check before leaving for the 
     United States. Because of the long amount of time between the 
     initial screening and departure, officials conduct a final 
     check before the refugee leaves for the United States.
       20. Final security check at an American airport.
       Sources: State Department; Department of Homeland Security; 
     Center for American Progress; U.S. Committee for Refugees and 
     Immigrants.

  Mr. DURBIN. It starts with registration with the United Nations, 
interview with the United Nations, refugee status granted by the United 
Nations, referral for resettlement in the United States, interview with 
State Department contractors, the first background check, higher level 
background checks, another background check, fingerprint screening with 
a photo taken, the second fingerprint screening, the third fingerprint 
screening, the case reviewed by U.S. immigration headquarters and then 
in some cases referred for additional review, extensive in-person 
interviews with Homeland Security officers, and then--and only then--
could Homeland Security approval be required. At that point the 
potential refugee is screened for contagious diseases, goes through a 
cultural orientation class, matched with an American resettlement 
agency, goes through a multiagency security check before leaving to 
enter the United States, and then faces a final security check when 
they arrive at an American airport.
  I am entering this into the Record because those who are suggesting 
that we are taking Syrian refugees without appropriate screening are 
not aware of the reality. It is a process that takes 18 to 24 months, 
and in the 4 years we have accepted about 2,000 Syrian refugees, not a 
single one has been found to be involved in a terrorist activity.
  We accept about 70,000 refugees in the United States each year, and I 
am glad that we do because for some people in some parts of the world, 
it is the only place they can turn to.
  The public reaction against the House action that bars Syrian 
refugees is interesting. There was a Congressman, and I don't know him 
personally, but his name is Congressman Steve Russell of Oklahoma.
  This is according to the POLITICO article:

       He voted for the bill with serious reservations but in the 
     hopes of affecting the debate as it moved ahead. If the 
     existing bill were to come before the House again, ``I would 
     vote against it,'' Russell said. ``I think it creates 
     impossible barriers to refugees.''

  Just 2 weeks ago, he voted for it, but he has thought it over. Why? 
This article says:

       For Russell, the issue is personal. One of his close 
     friends is an American citizen who was trying to get his 
     mother out of Syria. The mother died this past summer before 
     she could leave that war-torn country. Out of respect for his 
     friend's privacy, [Congressman] Russell [of Oklahoma], a 
     retired Army lieutenant colonel, declined to offer specifics, 
     including exactly what happened to the woman. But he said: 
     ``I'm certain had he been able to get her to the United 
     States, she would still be alive.''
       [Congressman] Russell urged [his fellow] Republicans in the 
     Senate to think carefully before supporting the House bill, 
     saying they should not get refugees confused with the broader 
     issue of immigration. He pointed out that in the past the 
     U.S. has denied entry to people in need of help, including 
     Jews [who were] fleeing the Nazis [in Europe during World War 
     II].
       ``We have had dark periods when we have done this in the 
     past,'' he said. ``History never judges it kindly--never.''

  That was a quote by Congressman Russell, a Republican from the State 
of Oklahoma.
  I think it is important to note, too, that ``in a letter to lawmakers 
released [yesterday], a group of national security experts, including 
figures prominent in Republican circles such as former Secretary of 
State [Henry] Kissinger, retired Gen. David Petraeus and former 
Homeland Security Secretary Michael Chertoff, urged [us] to stop the 
House bill.''

       ``Refugees are victims, not perpetrators of terrorism,'' 
     the signatories wrote. ``Categorically refusing to take them 
     only feeds the

[[Page 19357]]

     narrative of [the Islamic State] that there is a war between 
     Islam and the West, that Muslims are not welcome in the 
     United States and Europe, and that the [Islamic State] 
     caliphate is their true home.''

  Perhaps the saucer is cooling the tea, and perhaps the Senate will 
have the good sense not to follow the action of the House of 
Representatives in passing this provision.
  I have two other items to add to the Record before I yield the floor 
to my colleagues who have gathered here today.
  The first is an article that comes out of the city of Chicago, which 
I am honored to represent. I ask unanimous consent that the article be 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                [From the Chicagoist.com, Dec. 1, 2015]

Meet the Nuns Who Are Preparing Their West Ridge Home To Take in Syrian 
                                Refugees

                            (By Tony Boylan)

       Three nuns living in West Ridge plan to take in a Syrian 
     refugee family not just with the blessing of their local 
     community, but at its urging.
       Despite Illinois Gov. Bruce Rauner's decision last month to 
     join a number of other state governors in vowing to make it 
     tougher for Syrian refugees to resettle in the U.S. in the 
     wake of a recent terrorist attack on Paris, these women are 
     preparing their home to make life a little easier for a 
     refugee family.
       The sisters, part of the Society of Helpers, live in a 
     historic home once owned by the Dr. Scholl's Family with a 
     finished basement they in the process of turning into a 
     family apartment. The Society is an international order with 
     progressive values based on the teachings of St. Ignatius. In 
     other words, they get their hands dirty working with lots of 
     issues other people of faith aren't always quick to embrace; 
     the homeless, addicts, teenage mothers, domestic violence and 
     those most in need of support and assistance.
       From their mission statement: ``As contemplatives in 
     action, we don't just pray for social justice and for peace--
     we make it our life's work.''
       Putting their faith in action, the sisters moved swiftly to 
     ready themselves to provide shelter to a refugee family they 
     think could be with them as soon as January. Political 
     leaders can debate and demagogue on the issue all they'd 
     like, but the sisters don't care about that. Their faith 
     declares what it declares, they say, and offering help is 
     their faith.
       ``We would rather not make our decision on fear, we would 
     rather make our decision on compassion,'' said Sister Mary 
     Ellen Moore, a registered psychologist and one of three nuns 
     who lives in the house. ``We were certainly disappointed in 
     Gov. Rauner's statement on this issue. That kind of mentality 
     if frightening and we know what it's led to in Europe and in 
     other places in the past. It's really very sad.''
       The plan predates the attacks in Paris, which have somehow 
     been blamed on refugees--the same people trying to flee the 
     horrific powers behind the carnage. The nuns and the members 
     of St. Gertrude's parish in Edgewater took to heart the 
     Pope's call for every congregation in America to help ease 
     the international crisis and find a way to accommodate 
     refugees.
       The sisters do find it important to note that this isn't an 
     entirely free ride. Refugee families from Syria, or anywhere 
     else, are required as part of their status to obtain work 
     almost immediately after getting settled. Catholic Charities 
     will assist them with that. The family will also be asked to 
     contribute something for electricity and other utilities in 
     due time, and after a store of donated food is exhausted, the 
     family will rely on its own income and some help from charity 
     for food.
       In this case, though, a family couldn't ask for hosts more 
     qualified and prepared to help them assimilate. And the 
     sisters think the multicultural nature of their 
     neighborhood--near Devon Avenue and Loyola University--will 
     be helpful.
       Members of the parish, where the sisters attend church, but 
     have no official attachment, almost immediately began 
     collecting donations of money, furniture, bedding, kitchen 
     supplies, and all the mundane things a family starting over 
     with nothing might need to get by. (There still is a need for 
     everything except clothing, which will wait until they know 
     who is coming and can collect items appropriate to ages and 
     size. Any help is appreciated and can be donated through 
     either the Society of Helpers Facebook Page or website.
       It's not as if the parishioners or sisters are entering 
     into this without thinking through any potential risks. It's 
     just that they know the risks are being wildly overstated and 
     their mission is clear.
       A letter written by parishioner John Neafsey was circulated 
     among church members recently read, in part:
       ``Security concerns are understandable in the aftermath of 
     the Paris attacks. But our understanding is that there is 
     already a thorough and lengthy screening process in place for 
     checking the backgrounds of refugees (agreed upon between the 
     UNHCR and host countries, including the U.S.) prior to 
     approving them for resettlement to the United States. We 
     believe that an arbitrary refusal to allow Syrian refugees to 
     come to our state is unnecessary, unfair, and un-Christian. 
     This would needlessly scapegoat and penalize innocent men, 
     women, and children who are fleeing violence and persecution. 
     It deprives them of the chance to get a new start in a safe 
     place where they are welcome. The motto of our parish is `All 
     Are Welcome.' For us, ``all'' includes Syrian refugees, 
     whether they are Christian or Muslim.''
       While neither the church members nor the sisters want this 
     matter to be political, they understand the climate that has 
     been created.
       ``It's very sad people just jump to judgement because 
     people are different,'' said Sr. Jean Kielty, Director of the 
     House of Good Shepherd and a social worker who has aided the 
     homeless for a quarter century. She shares the house with 
     Sister Mary Ellen, Sister Anna Maria Baldauf, and their dogs, 
     Mocha and Snowball.
       ``This is just a different kind of homelessness--a more 
     tragic one.''
       There is a one ramification Sister Jean is concerned about, 
     though: ``I'm not sure if my family will come visit me 
     anymore.''
       Here's a little more information about the nuns behind this 
     initiative and the residence where they are providing a 
     basement apartment to a refugee family next year:


                            Jean Kielty, SH

       As a social worker, Jean's ministry has focused on 
     addressing homelessness in the Chicagoland area for more than 
     25 years. She has served as Director of Interim Housing with 
     Catholic Charities of the Archdiocese of Chicago and is 
     currently the Executive Program Director of the House of Good 
     Shepherd. Jean is the founder and current chairperson of the 
     board for Casa Esperanza, a transitional housing program for 
     women and their children located in South Chicago. Jean is 
     one of three leaders of the U.S. Province of the Society of 
     Helpers and resides in her West Ridge home with two other 
     Helpers and their dogs.


                      Mary Ellen Moore, SH, Ph.D.

       Mary Ellen is a registered psychologist and co-founder of 
     Claret Center in Hyde Park that offers psychotherapy, 
     workshops, and professional development that support 
     wholeness in mind, body, and spirit. In addition to her 
     advisory role at Claret Center, Mary Ellen provides 
     psychotherapy and supervision to clients and students and is 
     the director of training for the practicum at ``The Circle,'' 
     a Helpers-sponsored resource center for Latina immigrant 
     women in Brighton Park. Mary Ellen served served two previous 
     terms as the Helpers' U.S. Provincial from 1985-1995 and 
     another term from 2008-2014.


                            The Miller House

       This West Ridge modified Georgian Colonial Revival was 
     built by the Hutchins Brothers in 1911. In 1923, the Hutchins 
     family sold the home to Frank Scholl, brother of Dr. William 
     M. Scholl who founded the company Dr. Scholl's. Frank joined 
     the business in 1910 and oversaw European operations. 
     Featured on the 1996 Annual Fall House Tour and the 2013 
     Annual House Tour, this historical home boasts 5000 square 
     feet with 5 bedrooms, 5.5 bathrooms and related living 
     quarters.
       Although this ``large home'' has undergone changes with 
     each of the five previous owners, it maintains many qualities 
     of its original historic charm. The Society of Helpers 
     purchased the home in 2014, planning to utilize its space to 
     welcome other Helpers visiting from around the world. They 
     were thrilled to be able to offer the related living quarters 
     to a Syrian refugee family when their parish, St. Gertrude, 
     and Catholic Charities provided an opportunity to present a 
     family in need of a safe home.

  Mr. DURBIN. The article talks about a house in West Ridge, Chicago. 
It is a place where an order of Catholic nuns called the Society of 
Helpers has a house that they have turned into a refuge for homeless 
people. They have announced that they are going to accept Syrian 
refugees into their home so that the refugees know they will have a 
safe place to stay in the United States.
  Sister Mary Ellen Moore, a registered psychologist and one of the 
nuns who lives in the house, said:

       We would rather not make our decision on fear, we would 
     rather make it on compassion . . . We were certainly 
     disappointed in Gov. Rauner's statement on this issue. That 
     kind of mentality is frightening and we know what it's led to 
     in Europe and other places in the past. It's really very sad.

  The people of France, after these horrific terrorist incidents, 
announced that they are going to accept 30,000 Syrian refugees. The 
people of Canada, after the terrible incident in Paris, announced 
virtually the same thing. And

[[Page 19358]]

what has been the response of the United States and the House of 
Representatives? It has been an irrational response of fear.
  Mr. President, I ask unanimous consent that this letter, which comes 
from a group called HIAS, and has the headline ``1000 Rabbis in Support 
of Welcoming Refugees'' be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                     [From hias.org, Dec. 1, 2015]

             1,000 Rabbis in Support of Welcoming Refugees

       We, Rabbis from across the country, call on our elected 
     officials to exercise moral leadership for the protection of 
     the U.S. Refugee Admissions Program.
       Since its founding, the United States has offered refuge 
     and protection to the world's most vulnerable. Time and time 
     again, those refugees were Jews. Whether they were fleeing 
     pogroms in Tzarist Russia, the horrors of the Holocaust or 
     persecution in Soviet Russia or Iran, our relatives and 
     friends found safety on these shores.
       We are therefore alarmed to see so many politicians 
     declaring their opposition to welcoming refugees.
       Last month's heartbreaking attacks in Paris and Beirut are 
     being cited as reasons to deny entry to people who are 
     themselves victims of terror. And in those comments, we, as 
     Jewish leaders, see one of the darker moments of our history 
     repeating itself.
       In 1939, the United States refused to let the S.S. St. 
     Louis dock in our country, sending over 900 Jewish refugees 
     back to Europe, where many died in concentration camps. That 
     moment was a stain on the history of our country--a tragic 
     decision made in a political climate of deep fear, suspicion 
     and antisemitism. The Washington Post released public opinion 
     polling from the early 1940's, showing that the majority of 
     U.S. citizens did not want to welcome Jewish refugees to this 
     country in those years.
       In 1939, our country could not tell the difference between 
     an actual enemy and the victims of an enemy. In 2015, let us 
     not make the same mistake.
       We therefore urge our elected officials to support refugee 
     resettlement and to oppose any measures that would actually 
     or effectively halt resettlement or prohibit or restrict 
     funding for any groups of refugees.
       As Rabbis, we take seriously the biblical mandate to 
     ``welcome the stranger.'' We call on our elected officials to 
     uphold the great legacy of a country that welcomes refugees.

  Mr. DURBIN. I will close by reading just a portion of this letter 
that was handed to me this morning by this group that represents these 
Jewish rabbis all across the United States, from virtually every State 
in the Union.
  It says:

       We, Rabbis from across the country, call on our elected 
     officials to exercise moral leadership for the protection of 
     the U.S. Refugee Admissions Program.
       Since its founding, the United States has offered refuge 
     and protection to the world's most vulnerable. Time and time 
     again, those refugees were Jews. Whether fleeing the pogroms 
     in Tzarist Russia, the horrors of the Holocaust or 
     persecution in Soviet Russia or Iran, our relatives and 
     friends found safety on these shores.
       We are therefore alarmed to see so many politicians 
     declaring their opposition to welcoming refugees.
       Last month's heartbreaking attacks in Paris and Beirut are 
     being cited as reasons to deny entry to people who are 
     themselves victims of terror. And in those comments, we, as 
     Jewish leaders, see one of the darker moments of our history 
     repeating itself.

  They go on to talk about the United States turning away the SS St. 
Louis in 1939, and 900 Jews were sent back to Europe. The Holocaust 
Museum tells us that 200 of them perished in the Holocaust because the 
United States refused to accept them as refugees.
  They end by saying:

       As Rabbis, we take seriously the biblical mandate to 
     ``welcome the stranger.'' We call on our elected officials to 
     uphold the great legacy of a country that welcomes refugees.

  I yield the floor.
  The PRESIDING OFFICER (Mrs. Ernst). The Senator from Oklahoma.
  Mr. INHOFE. Madam President, before we get too wrapped up with our 
concern for the Syrian refugees, let's keep in mind that this 
administration doesn't have a policy in the Middle East today and 
hasn't had one since it came into office. It doesn't have a policy in 
Syria. They don't know where we are. He has drawn a line in the sand 
and just ignored his commitments. We wouldn't have all of these Syrian 
refugees if we had a policy in the first place.
  Secondly, it was this administration's own Director of National 
Intelligence, James Clapper, who said that it is a fact that the 
refugees who come in from Syria could very well be bringing terrorists 
into the United States, and I think we need to consider that and 
consider our citizens before we consider some of the others. There are 
other options. We could have no-fly zones and have refugees settled in 
their own country, and that would be a lot safer for America and a lot 
cheaper.
  Anyway, that is not why I am here.
  President Obama made a lot of points to the American people in 2010 
about how ObamaCare would improve health care for everyone. He said it 
would lower costs, it would expand access, and it would make health 
care more affordable for everyone. Yet, 5 years after this law's 
passage, ObamaCare has only increased premiums and increased 
deductibles, cut down employee work hours, and threatened the religious 
liberty of many employers who are providing needed jobs in a slow 
economy.
  Since Obama's disastrous rollout, I have listened to heartbreaking 
accounts of how ObamaCare has negatively impacted middle-class Oklahoma 
families. I go back every weekend and I talk to these people. Their 
budgets are taking the hardest hits. The longer this law has been on 
the books, the worse the stories have become.
  Oklahoman Fred Imel's premium is going from $1,100 a month to $1,700 
a month. In fact, it was just announced that next year Oklahomans will 
see an average increase of 35.7 percent in premium prices, which is the 
highest in the Nation. That is why I am concerned about this. We have 
an opportunity, actually, tomorrow to act on something that can change 
all of this.
  In addition, BlueCross BlueShield notified 40,000 Oklahomans earlier 
this year that they will no longer offer their current plans and that 
policyholders would be forced to move to other plans in the two other 
networks in the State. Both plan options have fewer participating 
doctors, hospitals, and other providers. In other words, access to care 
is going down for these people, all the while costs are going up.
  At the same time, many other insurance companies are dropping out of 
the Affordable Care Act market altogether, leaving Oklahomans with even 
fewer choices, not more, as President Obama promised back in 2010. In 
fact, nationwide, ObamaCare offers, on average, 34 percent fewer 
providers than health care networks outside the exchanges.
  But ObamaCare isn't delivering bad news just to Oklahoma. Across the 
Nation, federally backed co-ops are going under due to ObamaCare. On 
October 16, the Wall Street Journal had an article that said that these 
cooperatives are ``collapsing at such a rapid clip that some co-ops and 
small insurers are forming a coalition to consider legal action to try 
to change health-law provisions they blame for their financial 
distress.''
  Twelve out of the 23 ObamaCare established co-ops have gone under. 
More than half of them have gone under, leaving more than 500,000 
currently insured Americans to find new insurance once again or face a 
steep penalty from the Federal Government. These co-ops also received 
over $1 billion in taxpayer loans from the Federal Government, most of 
which will never get repaid. So it is really worse economically for 
this country.
  Since the beginning of this Congress, I have sponsored 12 bills to 
dismantle and fully repeal ObamaCare, and my colleagues and I are 
committed to maintaining our promise to repeal and replace ObamaCare. 
This reconciliation bill is a step in that direction. The House passed 
reconciliation on October 23 with a vote of 240 to 189.
  This bill repeals the major components of ObamaCare, including the 
individual and employer mandate. It also repeals the medical device tax 
and the Cadillac tax, which is a tax placed on certain high-value, 
employer-sponsored insurance plans.
  The Senate reconciliation bill also takes repeal of ObamaCare a lot 
further by repealing $1 trillion in ObamaCare taxes and fully repealing 
the Medicare expansion and all ObamaCare subsidies by 2018.
  Importantly, the reconciliation bill also prohibits Federal funding 
for

[[Page 19359]]

Planned Parenthood and instead uses that money that is saved by that 
repeal to increase funding for community health care centers. We hear 
people talk about health care for woman who are going to be hurt if we 
get rid of Planned Parenthood, yet we have more than 9,000--9,000--
community health centers. These facilities are better equipped to 
provide women with the health care they need when compared to only 700 
Planned Parenthood facilities. So keep in mind that there are 700 
Planned Parenthood facilities and 9,000 community health centers, so 
they actually have the opportunity to get better care.
  This issue is of particular importance given the sting videos that 
were released over the last few months showing the lengths Planned 
Parenthood affiliates have gone to profit from the sale of fetal tissue 
following abortions.
  Planned Parenthood is a private institution that largely serves urban 
areas. While abortion may not be the only service they provide, it is 
what they are primarily known for. Everybody knows that. Whether they 
have broken the law or not, the taxpayer money they currently receive 
would be better directed toward the community health centers, which, on 
a ratio of 12 to 1, would be able to help with women's services.
  Life is one of the single most important issues we consider here in 
the Senate, and I am proud of what we have already done this year. A 
few months ago, a majority of Senators voted to defund Planned 
Parenthood. That vote has already taken place. A majority of us here--
although the tally did not pass the 60-vote threshold that was 
necessary to break a filibuster, it did show that more than a majority 
of Senators support ending subsidies to the largest abortion provider 
in America.
  More important than the Senate's views of this, a majority of the 
American people support protecting life of the unborn. Every survey 
demonstrates that very clearly. When I go back home, people say: Why is 
it that if this is something the American people want, this taking of 
life continues?
  The American people support it, and it is very important to me and my 
constituents that we do everything possible to protect the sanctity of 
life. That is among the top reasons why it is necessary to vote for 
this reconciliation bill. We have the chance to end the Federal 
financing of the institution that has chopped up babies and negotiated 
the most profitable price for their organs. There is no moral gray area 
here.
  Let me tell my colleagues something about Oklahoma. I am going to 
tell my colleagues about how immoral and abrasive ObamaCare has been. 
In my State of Oklahoma--I was in the State senate back in 1970. I had 
a good friend then whose name is David Green. He developed a business 
in his garage--this was in 1970--where he made picture frames. He had 
only one employee, and then he started growing. Over a period of time, 
he has grown to where he now has Hobby Lobby. Hobby Lobby has 600 
stores, 23,000 employees, and it started in a garage in 1970.
  David Green is a real Jesus guy. He loves the Lord. He has his own 
principles, his own morality, and his employees do too. So ObamaCare 
came along and required a contraceptive type of pill taken after 
fertilization that is very similar--it is a type of abortion, in the 
eyes of this man. Well, he refused to force his employees to do that.
  ObamaCare--the Federal Government--came along and they sued him and 
they--no, they were fining him $1 million a day--$1 million a day for 
refusing to take human life. He filed a suit. Now, keep in mind, $1 
million a day. He went to district court, and he won the case by a 
close decision over ObamaCare. Then they appealed the case to the 
circuit court. He won there, and he won ultimately in the U.S. Supreme 
Court by a split vote of 5 to 4. Here is a guy who is willing to risk 
$1 million a day because he knew what was morally right. This is 
something that actually happened.
  I will tell my colleagues, we have to get rid of ObamaCare and get 
out of the abortion business. We will have that chance tomorrow.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Utah.
  Mr. LEE. Madam President, nearly 6 years ago this body was on the 
verge of passing the Patient Protection and Affordable Care Act. Today 
the Senate is poised to repeal that insultingly misnamed law.
  Back in the winter of 2009, of course, we still had yet to pass the 
bill to see what was in it, although one didn't need a Ph.D. in 
economics to foresee that the Affordable Care Act would be a mess. It 
wasn't just conservatives and Republicans raising concerns; every 
sensible observer saw the obvious flaws and the inevitable disasters 
embedded in the rickety, ideological scheme congressional Democrats 
were foisting on the American people in an exercise of unprecedented 
partisanship.
  Six years later, the Democratic Party's dream of ObamaCare has become 
the American people's nightmare. For the past 5 years, the American 
people have lived with and have suffered through the chaos and 
dysfunction wrought by ObamaCare's assault on American health care. At 
every step along the way, opposition to the law has grown stronger and 
calls for its repeal by the American people have grown louder, which 
brings us here today.
  Last year Republicans running for Congress promised to repeal 
ObamaCare as a first step toward replacing it with real health care and 
real insurance reform. It was largely on the basis of this pledge that 
the American people elected to put the GOP in charge of both the House 
of Representatives and the U.S. Senate. The bill we are scheduled to 
vote on later this week brings us as close to fulfilling that promise 
as is possible under the Senate rules, pursuant to the instructions 
from the budget resolution that Congress passed just a few months ago.
  I applaud the majority leader for his steadfast leadership over the 
past several days and weeks, and I commend the Senate Budget Committee 
for its tireless efforts, as Republicans have worked together to craft 
a reconciliation package that doesn't just tinker around the edges of 
ObamaCare but lays the groundwork for ObamaCare to be erased from the 
books altogether. This is the only responsible step for Congress to 
take because by the law's own standards, according to the promises of 
the ideologues who imposed it on an unwilling country, ObamaCare has 
been a failure.
  As its name suggests, the overriding objective and promise of the 
Affordable Care Act was to make health care more affordable for 
Americans. Yet, nearly 5 years after its passage, no one seriously 
claims the law has made it easier or more affordable for the American 
people to access the health care services they need. Facts are not 
optional, and the facts prove that quality, affordable health care is 
harder to find in America today than it was 6 years ago, especially for 
low- and middle-income Americans.
  With so much political and ideological capital invested in propping 
up and defending ObamaCare, President Obama and his allies here in 
Congress are forced to simply try to skirt the facts. Take, for 
instance, the left's favorite half-truth--the notion that ObamaCare has 
succeeded because there are fewer uninsured Americans today than before 
the Affordable Care Act was signed in the law. But the other salient 
fact routinely omitted by the President and congressional Democrats is 
that the vast majority of the newly insured receive their coverage 
through Medicaid. The reason ObamaCare supporters have made a habit of 
ignoring this fact is obvious: For 50 years, Medicaid has served as the 
preeminent case study of how not to run a health insurance program. 
Medicaid's abysmal track record of failing our most vulnerable 
populations will only get worse as millions of new, able-bodied adults 
join the program.
  Then there is the fact that in 2016, insurance premiums are set to 
continue their steep ascent toward unaffordability. That goes for 
insurance plans on the ObamaCare exchanges as well as commercial plans 
purchased in the private market.

[[Page 19360]]

  ObamaCare supporters have long promised that rising premiums would be 
at worst a brief detour on the centrally planned road to affordable 
health care, but as it turns out the iron laws of economics have once 
again triumphed over ideological wishful thinking. According to a 
survey of commercial insurance brokers conducted by Morgan Stanley, the 
average rate hike in 2016 for individual insurance plans will be 12.6 
percent--slightly higher than the 11.2-percent increase last year--and 
the increase in small group rates will be 13.5 percent, up from a hike 
of 11.7 percent last year. So this creep continues. It keeps getting 
worse for the American people.
  The outlook for insurance plans on the ObamaCare exchanges is just as 
bleak. Last month the Department of Health and Human Services announced 
that insurance premiums will rise an additional 7.5 percent next year 
in the 37 States using the notoriously defective and flawed 
healthcare.gov, and that is just the average, which obscures the more 
dramatic premium increases for residents in several States in 
particular, such as Oklahoma and Alaska, both of which are projected to 
see their ObamaCare premiums spike more than 30 percent next year.
  Compounding the continued acceleration of premium hikes is the 
simultaneous increase in deductibles and the narrowing of choices that 
patients face in the health care market. In my home State of Utah, for 
instance, the residents of 20 out of my State's 29 counties are limited 
to only one health insurance plan option.
  This toxic combination of rising health care costs and limited health 
care choices has already had serious consequences, especially for low- 
and middle-income Americans who are most severely affected by the law 
and who are the least capable of dealing with adverse consequences. 
According to a recent Gallup poll, nearly one in three Americans report 
that they or a family member have postponed or delayed medical 
treatment within the past year because of the cost, and they are more 
likely to have done so for a serious medical condition than for a 
medical condition deemed nonserious. What is even more remarkable is 
that the proportion of Americans who delay medical treatment because of 
the cost has remained basically unchanged for the last decade, even as 
the number of Americans with insurance coverage has increased. It is 
not just patients who have found ObamaCare to be too expensive. 
Insurance providers are coming to the same conclusion. To date, half of 
the 23 cooperatives created by ObamaCare collapsed despite receiving 
billions of dollars of taxpayer subsidies. The shuttering of the once-
celebrated ObamaCare co-ops is not just a sign of the law's 
unsustainability, it is also a major source of the stress and anxiety 
that millions of Americans are experiencing as a result of this 
unfortunate law.
  Just ask the hundreds of thousands of Utahans who recently found out 
that Arches Health Plan, a co-op that served roughly one-quarter of the 
State's exchange enrollees could not afford to stay in business next 
year. The announcement came only 5 days before open enrollment began 
this fall, leaving families across Utah scrambling to find a new plan 
and hoping they can afford it--like so many before them, the collateral 
damage of the President's repeated broken promise that if you like your 
health care plan, you can keep it.
  Then there was the recent warning from United Healthcare. United is 
the Nation's largest health insurance provider. It was supposed to be 
big enough and with enough efficiencies built into its operations to 
absorb the new costs associated with doing business within the 
ObamaCare regulatory framework. Yet just a few weeks ago, United 
announced that the financial realities of its ObamaCare plans may soon 
force the insurance giant to stop offering insurance plans through the 
public exchanges.
  The Affordable Care Act has been described by some of its supporters 
as a train wreck. It certainly looks that way as we watch hard truths 
and economic realities unravel the coalition of insurers that were once 
great champions of ObamaCare, but when you think about it, the term 
``train wreck'' isn't quite the right metaphor to describe the calamity 
that is the Affordable Care Act. It misses the crucial point. Train 
wrecks are accidents, aberrations, anomalies. The failures of ObamaCare 
were no such thing. They were entirely predictable. We knew they were 
coming, despite the President's repeated assurances to the contrary.
  There was nothing unexpected about the collapse of a national health 
care pseudo market, governed by a perverse set of incentives and 
exemptions that encouraged young and healthy individuals to stay out of 
the health insurance market. Now, nearly 5 years after its passage, 
there is no denying the manifest failures of ObamaCare. The only 
question left is, What are we going to do about it?
  For the Democratic Party, the answer is--as we have come to expect--
more of the same. Shield the ramshackle architecture and bloated 
bureaucracy of ObamaCare from any meaningful reform, and whenever 
possible double down--more ill-conceived and costly regulations, more 
Federal micromanagement of the health decisions of individuals, 
families, doctors, hospitals, and insurance companies, more price 
controls, all peddled using the same hackneyed promises and 
proclamations of compassion and fairness that have nearly drowned out 
any honest discourse during the past 6 years regarding health care.
  ObamaCare has given the American people a preview of this approach to 
health care policy, and they have emphatically rejected it, which is 
why the Senate will soon vote to repeal the Affordable Care Act, but 
just saying no is not by itself enough.
  Conservatives and Republicans must also offer the country a health 
care reform agenda to be for, something they can support affirmatively, 
proactively. Already there are a number of conservative leaders in 
Congress who have developed reform plans that would replace ObamaCare's 
cumbersome, bureaucratic, and expensive health care system with one 
that is flexible, decentralized, and affordable. We must build on these 
plans and advance legislation that empowers patients and families--not 
distant, coercive, powerful bureaucracies--to decide how they want to 
spend their health care dollars, and that encourages innovation and 
investment across all health care sectors. Repealing the Affordable 
Care Act is the first step in that process--the beginning, not the end 
of our road to building a market-based, patient-centered health care 
system in America.
  I look forward to joining my colleagues in voting to repeal ObamaCare 
and entering this new phase of health care reform. I thank my 
colleagues who cooperated and worked together in developing this bill 
that I wholeheartedly support.
  Thank you, Madam President.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. DAINES. Madam President, last year when I decided to run for 
Montana's open Senate seat, I promised the people of Montana I would 
work tirelessly to repeal ObamaCare. I am upholding that promise. 
Tomorrow the Senate will vote to repeal President Obama's broken health 
care law because for many Montana families the President's health care 
law hasn't been what it was promised to be.
  Too many Montanans have seen their work hours cut, have been forced 
off the plans they liked, and were told they couldn't see the doctors 
they trusted. Health care premiums are not as affordable for Americans 
as President Obama claimed they would be. We are seeing premiums rising 
once again. In Montana, folks who are purchasing plans from the 
ObamaCare exchanges are getting hit with double-digit rate increases. 
More than 40,000 Montanans are expected to receive notices that their 
insurance rates have increased by double digits--an average of 34 
percent for some plans. To put that into perspective, that is another 
$1,000 a year for a 40-year-old on one of Montana's silver plans.
  Some Montanans have been hit with even higher rate increases. Take 
Cindy

[[Page 19361]]

from Missoula, MT, who received a letter from her health insurance 
company that her premiums were increasing by 40 percent. Unfortunately, 
these rate hikes are the predictable result of forcing a partisan piece 
of legislation through Congress without transparent consideration or 
bipartisan input. Sadly, those impacted the hardest by these steep rate 
increases are often those who can least afford it.
  Americans need access to affordable care, but ObamaCare not only 
takes uninsured Americans in the wrong direction, it is failing to 
reliably provide the basic coverage Americans deserve. Look no further 
than the health co-op system established under ObamaCare. All but one 
lost money in the last year--all but one. More than half have 
collapsed, forcing more than 700,000 Americans to find new health 
insurance options.
  In 2007, President Obama said himself that by the end of his first 
term ObamaCare would ``cover every American and cut the cost of a 
typical family's premium by up to $2,500 a year.''
  Montanans haven't seen their premiums decreased by $2,500 a year. It 
is not even close. Montanans are forced once again off the health care 
plans they liked and away from the doctors they trusted because when 
Washington, DC, bureaucrats take over a health care system, inevitably 
prices go up and the quality of care goes down. That is exactly what we 
have seen happen with ObamaCare. After more than 5 years of this Obama 
experiment, it is clear ObamaCare isn't working.
  I grew up in Montana. Spending time outdoors is an important way of 
life for us back home. I was fly fishing before Brad Pitt made it cool 
in the movie ``A River Runs Through It.'' When you are in one of 
Montana's blue-ribbon streams and your fishing line gets tangled up, 
you have a couple different options. Sometimes you can take some time 
to untangle it and make another cast, but other times, your line gets 
so tangled up and knotted up that the best option is to cut the line 
and start over. It is time to cut the line on President Obama's failed 
health care law and tie on a new fly. That is what the Senate is going 
to do this week.
  This bill dismantles President Obama's bungled health care law. It 
also puts our States on a glide path away from ObamaCare. It will build 
a bridge to replace this broken law with State-led solutions that put 
patients back in the center of the health care equation and return the 
health care decisions to Americans, to families, to their doctors and 
away from a bunch of DC bureaucrats. When we pass this historic 
legislation tomorrow, it will be the first time an ObamaCare repeal 
bill will be on President Obama's desk for his signature. He is going 
to have to decide whether to put the American people first or if he 
will continue imposing fines and substandard care on the hard-working 
people of this country.
  Even if the President rejects the will of the American people and 
vetoes this bill, I will continue working to protect Montanans from 
rising health care costs, and I will keep working to ensure that all 
Americans receive the quality health care they deserve.
  I yield the floor.
  The PRESIDING OFFICER. The majority leader.

                          ____________________