[Congressional Record (Bound Edition), Volume 163 (2017), Part 1]
[Senate]
[Pages 469-481]
[From the U.S. Government Publishing Office, www.gpo.gov]




    CONCURRENT RESOLUTION ON THE BUDGET, FISCAL YEAR 2017--Continued

  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. SANDERS. Mr. President, as the ranking member of the Budget 
Committee, I want to take this opportunity to make several points in 
opposition to the Republican side-by-side amendment and in support of 
the amendment that I have offered.
  Like many Republican proposals, if you read the Republican amendment, 
it sounds good on the surface, but if you probe half an inch into it, 
you recognize what an incredible disaster it will

[[Page 470]]

be for working families of this country--nice words, but devastating 
impacts. So I want to talk about that.
  No. 2, I want to talk about what it will mean if, in fact, the 
Republicans are successful in doing what they want to do, which is 
repealing the Affordable Care Act--something which I, and I think 
virtually every Democrat, will do our best to oppose--and what it will 
mean to the American people if the Affordable Care Act is repealed 
without any alternative to replace it.
  What that, in fact, will mean is throwing 30 million people off of 
their health insurance. Thirty million people will lose their health 
insurance. I have not seen any Republican studies as to how many of 
those people will die, but certainly many thousands of them will die 
because if you are sick and you don't have any money and you don't have 
any health insurance, you cannot get to a doctor or you cannot get to a 
hospital. In fact, there have been some studies suggesting that 
thousands of people will die, and certainly many others will become 
much sicker than they should be. That is what happens when you simply 
throw 30 million people off of health insurance and you have no 
alternative plan.
  Nobody in the Senate thinks the Affordable Care Act is perfect, least 
of all me. I think it needs significant changes. Let's work together to 
change it. But you cannot just repeal it without any alternative.
  Not only will a repeal throw 30 million people off of health 
insurance, it will devastate millions and millions of low- and 
moderate-income families by making major cuts to Medicaid, and that 
includes many middle-class families who use Medicaid to support 
payments for their parents who are in nursing homes.
  If you repeal the Affordable Care Act without a replacement, you are 
going to significantly increase the cost of prescription drugs for 
senior citizens, many of whom have a hard time right now paying for 
their medicine. And while you have thrown millions off of health 
insurance, while you make devastating cuts to Medicaid, while the 
repeal of the Affordable Care Act will raise the cost of prescription 
drugs for seniors, a repeal would do something else, which is not 
terribly surprising coming from Republicans. It would provide $346 
billion in tax breaks to the top 2 percent. Millions lose their health 
care, the costs of prescription drugs go up, middle-class families will 
not be able to afford nursing home care for their parents, but, 
importantly, from the Republican perspective, $346 billion in tax 
breaks will go to the top 2 percent.
  Now, this is a set of priorities which I, frankly, believe the 
American people do not support.
  Also this afternoon I want to touch on another issue that is actually 
even more important than the previous two, and that is, to my mind, in 
a Democratic society, a candidate for President--in this case Mr. 
Trump--cannot simply say one thing over and over again, cannot go out 
to the American people and make campaign promises, but the day after 
the election, forget about what those promises were about.
  Now, here is the purpose of the Republican amendment. This is what is 
in front of all of us right now.

       Purpose: To strengthen Social Security and Medicare without 
     raiding it to pay for new Government programs, like 
     ObamaCare, that have failed Americans by increasing premiums 
     and reducing affordable health care options, to reform 
     Medicaid without prioritizing able-bodied adults over the 
     disabled, and to return regulation of insurance to State 
     governments.

  That is the exact quote of the purpose of the Republican amendment 
that we will be voting on in a few moments. It sounds pretty good. But 
let us translate it into English, and let us be very clear about what 
these words actually mean and why this amendment should be opposed by 
every Member of the U.S. Senate.
  The Republicans say in their purpose that they want to ``strengthen 
Social Security and Medicare.'' Well, count me in. That is exactly what 
I want to do. But how do they propose to go about doing that? They are 
going to strengthen Social Security and Medicare by making devastating 
cuts to Social Security and Medicare. That is a strange way to 
strengthen a program.
  As we speak right now, the Republican chairman of the House Ways and 
Means Subcommittee on Social Security--the committee that has 
jurisdiction over Social Security--has introduced legislation which 
will make devastating cuts to Social Security. That is a very unusual 
way to strengthen that program.
  My Republican friends will tell us that the only way we can 
``strengthen Social Security'' is, in fact, to cut Social Security. 
Now, talk about fake news; talk about Orwellian language. We are 
strengthening Social Security by cutting Social Security. To all those 
seniors and disabled veterans who are out there and who are trying to 
get by on $13,000, $14,000, $15,000 a year in Social Security benefits, 
my Republican colleagues are going to ``strengthen'' Social Security 
and they are going to do it by cutting your benefits. That is a very 
strange way to strengthen Social Security.
  It seems to me that if we are serious about really strengthening 
Social Security, what that means in plain English--not Orwellian 
language--is, No. 1, if you want to strengthen it, we have to extend 
the life of Social Security. Social Security now can pay out every 
benefit owed to every eligible American for 17 years. That is OK. It 
means we are not in a crisis, but it is not good enough. I want to see 
Social Security be solvent for another 50 or 60 years. That is 
strengthening Social Security.
  When we talk about strengthening Social Security, that means 
increasing benefits, not cutting benefits. The truth is that seniors in 
this country cannot make it on $13,000 or $14,000 a year in Social 
Security benefits; we need to increase and expand their benefits.
  Thirdly, if we are serious about strengthening Social Security, we 
need to end the absurdity of seniors who this year got a COLA of three-
tenths of 1 percent, and in recent years have gotten COLAs of zero 
percent because the formula that determines COLAs for people on Social 
Security is totally inadequate and an incorrect formula, not really 
measuring the cost-of-living expenditures of senior citizens.
  That is what we have to do to strengthen Social Security.
  How do we do that? I have legislation that will do just that. But do 
my colleagues know what? Despite all of the talk of my Republican 
colleagues wanting to strengthen Social Security, we have zero 
Republican cosponsors on that idea.
  The way we do it--a concept supported by many of the major senior 
organizations in this country--would eliminate the earnings cap on all 
taxable income above $250,000. Right now, if you make $1 million a 
year, $10 million a year, you contribute the same amount into the 
Social Security trust fund as somebody who makes about $118,000. That 
is wrong. That is unfair. Lifting that cap, starting at $250,000 and 
above, would impact only the top 1.5 percent. If we do that, we can 
extend the life of Social Security for well over 50 years and we could 
expand benefits for people living on less than $16,000 a year by more 
than $1,300 a year. That is how we strengthen Social Security. But I 
have not heard one Republican in this body speak in support of that 
proposal.
  Now, Republicans say they want to strengthen Medicare without raiding 
it to pay for new government programs like ObamaCare. That is what they 
state in their purpose. So let me be absolutely clear. That is a 
totally false statement. It is not true. The so-called raid was an 
effort to save some $700 billion over a 10-year period by making 
Medicare more efficient and more cost effective.
  My Republican friends talk every day about the need to bring 
increased efficiencies into government programs. They are right. We 
need to do that. And that is precisely what the Obama administration 
did. My Republican friends will not get up here and tell us that there 
was one nickel of Medicare benefits cut as a result of the creation of 
the Affordable Care Act. There was not one nickel of benefits cut. They 
know it. I know it. They will not say otherwise.

[[Page 471]]

  So the $700 billion was in savings, doing the right thing--not 
cutting a nickel of benefits from Medicare. I hope my Republican 
colleagues will not continue to try to spread this mistruth.
  The Republican amendment that we are going to be voting on talks 
about reforming Medicaid without prioritizing able-bodied adults over 
the disabled. It sounds good. What are they talking about in real 
English? What they want to do is ``reform'' Medicaid without 
prioritizing able-bodied adults over the disabled. What does that mean? 
It means not only do they not want to see Medicaid expanded, as over 30 
States have done, what they want to do, and what this language is 
really about, is to throw millions of people off of Medicaid. We are 
the only major country on Earth that does not guarantee health care to 
all people. Some 28 million Americans today have no health insurance. 
They want to throw millions more off health insurance.
  So if you are an ``able-bodied'' adult making the Federal minimum 
wage of $7.25 an hour--which, by the way, they don't want to raise. 
Vermont has raised its minimum wage to $10 an hour. I don't know what 
it is in Wyoming--$7.25. But if you are in a State where minimum wage 
is still $7.25 and you are able-bodied, do the arithmetic. If you have 
a couple of kids, health insurance will cost you $10,000, $15,000 a 
year. How do you afford that when you are making $8, $9, $10 an hour? 
You don't afford it. That is able-bodied.
  The last I heard, it is not criminal activity to be working and 
making $8, $9, $10 an hour. Unfortunately, that is what millions of 
people do. They cannot afford health insurance. What many of us have 
tried to do is expand Medicaid so that they will get health insurance, 
but what the Republican proposal and their language is about is the 
denying health insurance for the so-called able-bodied. Let's get rid 
of the word ``able-bodied.'' Let's talk about working people at 
starvation wages who cannot afford health insurance. That is what that 
language means in English.
  The Republican's proposal we will be voting on also talks about 
``returning regulation of insurance to State governments.'' OK. It 
sounds good. What does that mean in the real world? That means you 
could be denied coverage for a preexisting condition.
  I just met a woman last night dying of breast cancer. That is her 
reality, but she was able to get health insurance, despite having a 
very severe situation, because we abolished the insurance companies' 
ability to say no to her and to millions of other people who have 
preexisting conditions.
  When you want to return regulation of insurance to State governments, 
that is precisely what they can do--the law is gone. The insurance 
companies can say: You have cancer; we are not going to cover you 
because you are going to cost us too much money, and we can't make any 
money from you. Insurance companies could refuse to cover needed things 
like maternity care, prescription drugs, or high-cost diseases like HIV 
and many others. That is what they mean when they talk about returning 
regulation of insurance to State governments, doing away with all of 
the patient protection we have passed here in Washington that is widely 
supported by the American people. Go out to Wyoming, go to Vermont, go 
to Oregon, go to any State and ask the people if we should repeal 
preexisting conditions so insurance companies can discriminate against 
people with illness, and they will tell you overwhelmingly no.
  So the Republican proposal, which sounds nice, is in fact a 
devastating amendment that would very negatively impact many millions 
of people. I hope every Member of the Senate will reject that 
Republican amendment and in fact vote for an amendment I will be 
offering which addresses two very important issues:
  No. 1, at a time of massive income and wealth inequality, at a time 
when a tiny sliver of our population--the people on top--are getting 
phenomenally wealthy, phenomenally richer, we have an explosion of 
billionaires in recent years while the middle class continues to 
shrink. At a time when we are the only major country on Earth not to 
guarantee health care as a right to all of our people, it would be 
absolutely unacceptable to take away health insurance from 30 million 
Americans, unacceptable to privatize Medicare, unacceptable to slash 
Medicaid, unacceptable to increase the costs of prescription drugs for 
seniors, unacceptable to defund Planned Parenthood--a high-quality 
health care organization providing health care to over 2 million 
Americans, many of whom are low income women. So a vote for the Sanders 
amendment rejects all of those very bad ideas.
  If we throw 30 million people off health insurance and if we do not 
have a plan to replace it, I would hope my Republican colleagues would 
have the decency to tell us how many of those 30 million people will 
die. If we are going to be considering this legislation and throwing 30 
million people off who can no longer get to a doctor, can no longer get 
to the hospital because they don't have the money, how many of them 
will die? Tell us. Tell us so we can hold that in consideration as we 
look at this proposal.
  For years, it is no secret Republican leaders like Paul Ryan and 
Congressman Tom Price have wanted to end Medicare as we know it. That 
is what they have told us. It is not what I am saying. It is not a 
great secret.
  What does that mean? What does it mean if we end Medicare as we know 
it and if we turn it into a voucher program, handing a 65-year-old 
senior who has been diagnosed with cancer an $8,000 check and telling 
them to go out to a private insurance company and buy insurance on 
their own. That is what privatizing Medicare is about. It is a voucher 
program. Here is a check. You go out to the private insurance 
companies. You do your best.
  If you are an 80-year-old suffering with cancer and you have a check 
for whatever it may be--$8,000, $9,000 a year--and you go to an 
insurance company and you say: What do I get for my $8,000 check, they 
will laugh at you. They will laugh at you because they understand the 
cost of your care--your hospital care, your prescription drugs--will go 
well beyond 8,000 in the first week, let alone year. You will get 
nothing. That is what the Republican idea is in terms of privatizing 
Medicare.
  Let me get to the last point I want to make, and that gets well 
beyond the Affordable Care Act and well beyond Medicaid, Medicare, and 
Social Security. It gets to the essence of what our political system is 
supposed to be about, and that is, if we run for office--and every 
person in the Senate has run for office. If you run for President, you 
cannot say over and over again that you are going to do this, and the 
day after the election decide you are not going to do it. That is why 
so many people in this country are disgusted with the political 
process. They see people saying: Hey, vote for me. I am going to do A, 
B, and C, and the day after the election you do the very opposite, D, 
E, and F.
  When he ran for President, Donald Trump ran a very unconventional 
campaign. That is for sure. He said: I am not a typical Republican. 
That is what he said. He said: If I am elected President, I, Donald 
Trump, am not going to cut Social Security, I am not going to cut 
Medicare, and I am not going to cut Medicaid. He didn't say that once. 
He wasn't caught in an ambush interview. That was the heart and soul of 
his campaign. That is what he said to the elderly and to working-class 
Americans, and many voted for him precisely because he said he would 
not cut Social Security, Medicare, and Medicaid.
  On May 7, 2015, Mr. Trump tweeted: ``I was the first and only 
potential GOP candidate to state there will be no cuts to Social 
Security, Medicare, and Medicaid.''
  April 18, 2015, Trump said:

       Every Republican wants to do a big number on Social 
     Security. They want to do it on Medicare, they want to do it 
     on Medicaid, and we can't do it. And it's not fair to the 
     people that have been paying in for years. Now, all of a 
     sudden they want to cut it.

  August 10, 2015, Trump said:

       I will save Medicare, Medicaid, and Social Security without 
     cuts.

  Without cuts.


[[Page 472]]

       We have to do it. People have been paying in for years and 
     now many of these candidates want to cut it.

  March 29, 2016, Trump said:

       You know, Paul [Ryan]--

  Paul Ryan is, as we all know, the Speaker of the House--

     wants to knock out Social Security, knock it way down. . . . 
     . He wants to knock Medicare way down.

  Two things. You will lose the election if you are going to do that. I 
am not going to cut it, and I am not going to raise ages, and I am not 
going to do all the things that they want to do. Welcome to ``they.'' 
That is what the Republicans are trying to do.
  Back to the quote:

       But they want to really cut it, and they want to cut it 
     very substantially--the Republicans--and I am not going to do 
     that.

  That is where we are today. Republicans have a proposal which will 
make devastating cuts to Social Security over in the House, and here by 
repealing the Affordable Care Act, they are going to cut Medicare and 
Medicaid.
  In December of 2011, Trump wrote:

       Now, I know there are some Republicans who would be just 
     fine with allowing Social Security and Medicare to wither and 
     die on the vine. The way they see it, Social Security and 
     Medicaid are wasteful entitlement programs. But people who 
     think this way need to rethink their position. It's not 
     unreasonable for people who paid in to a system for decades 
     to expect to get their money's worth. That's not an 
     entitlement. That's honoring a deal. We as a society must 
     also make an ironclad commitment to providing a safety net 
     for those who can't make one for themselves.

  On May 21, 2015, Trump tweeted:

       I am going to save Social Security without any cuts. I know 
     where to get the money from. Nobody else does.

  On and on and on. These are just some of the quotes. This is not like 
a statement in the middle of the night. This is what he campaigned on.
  What this amendment is about and says to my Democratic colleagues and 
says to my Republican colleagues is, do we hold and support the process 
in which a candidate runs for office and over and over and over again 
tells working families and the elderly he will not cut Social Security, 
Medicare, or Medicaid--do we hold him to his word or do we just say: 
Hey, that is just campaign rhetoric. He lied. That is OK. That is 
politics in America. It doesn't matter what he said. This is the 
reality. We are going to cut Social Security, Medicare, and Medicaid.
  So this amendment tells us that if we go forward with what the 
Republicans want to do, it will be devastating to the American people, 
but perhaps, more importantly, what this amendment says is that in a 
democratic society, we must have faith with the American people. You 
cannot run a campaign, make promises, and the day after forget about 
everything you said.
  I would hope very much that my Republican colleagues will join all of 
us on this side in supporting what democracy is supposed to be about. 
We have differences of opinions. Mr. Enzi and I disagree on a lot of 
things, but I have never suggested that Mr. Enzi--when he campaigns, I 
believe he says what he believes. People vote for him or they vote 
against him. It is called democracy. Now you have a situation where a 
candidate for President goes to the working class and says: I will not 
cut Social Security, Medicare, and Medicaid. Let us tell Mr. Trump: Let 
us keep faith with the American people. We heard what you said, and we 
are going to hold you to your word. Let us support the Sanders 
amendment.
  Mr. President, I yield the floor.
  Mr. DURBIN. Mr. President, today, Senate Democrats will be voting to 
protect three programs--Medicare, Medicaid, and Social Security. These 
programs represent core commitments our Nation has made to seniors, 
low-income Americans, children, and those living with disabilities.
  Social Security, Medicare, and Medicaid reflect who we are as 
Americans. At one time or another throughout our lives, most of us have 
or will count on these programs for health care or for financial 
stability.
  During last year's Presidential debate, President-Elect Trump sought 
to distinguish himself from the field of Republican candidates by 
stating he was the first and only Republican candidate who would 
promise not cut Social Security, Medicare, or Medicaid. Yet, in their 
first major action of the new Congress, Republicans have taken the 
first step to dramatically alter and decimate core programs that 
comprise our safety net. Congressional Republicans want to gut funding, 
limit benefits, constrict eligibility, and turn guaranteed earned 
benefits into a voucher and a ``good luck'' wish. Their approach would 
violate the pledge we have made to millions of Americans and truly 
disrupt lives. This is unacceptable. That is why I am cosponsoring 
Senator Sanders' amendment to prohibit the Senate from considering any 
legislation that would violate Donald Trump's promise of not cutting 
Medicare, Medicaid, or Social Security.
  I am committed to ensuring that we meet the promise we made to 
Americans. Sixty million Americans, including 2 million Illinoisans, 
depend on Social Security for their well-being, and we must make sure 
that this vital program is there for both current and future 
generations.
  By 2034, without any reform, Social Security will be unable to 
fulfill its promise to its beneficiaries. If Congress does not act, 
beneficiaries would immediately see their benefits reduced by one-
fifth.
  It remains Congress's responsibility to look to the future and 
protect the long-term solvency of Social Security while ensuring 
benefits meet the needs of beneficiaries, especially the most 
vulnerable among us.
  Waiting until tomorrow to do what we could do today--an approach that 
I have seen fail in Illinois--only makes the task more difficult and 
likely to cause disruption.
  I was a member of the Simpson-Bowles Commission, where we tried to 
address our budget challenges and the long-term solvency of Social 
Security. I voted for the Commission's report because I believe we must 
face the difficult reality that doing nothing may harm the very people 
we are trying to protect--beneficiaries that rely on the promises we 
have made. I firmly believe that we, as Members of Congress, have a 
duty to have these debates and make difficult decisions, not just wait 
for the inevitable.
  While I did not support everything in the final Commission's report, 
I believe the report included some commonsense options to improve the 
longterm solvency of Social Security: accelerating the alignment of 
payroll taxes to their intended level of 90 percent of wages and 
realigning benefits to reflect current poverty levels among seniors.
  I believe there can and should be evenhanded, bipartisan agreement on 
a path forward. To do so, we need a collaborative and good-faith 
partnership to examine the universe of policy options.
  Make no mistake--I oppose privatization of Social Security. And 
recent solvency changes have weighed heavily on beneficiaries. That is 
why conversations should be balanced and targeted. There must be a dual 
goal of ensuring the adequacy of benefits, especially for those who 
rely on Social Security the most, and the long-term solvency of this 
program.
  I look forward to working across the aisle in the future to maintain 
and build upon our promise to Americans.


                            Amendment No. 52

  The PRESIDING OFFICER. Under the previous order, there will be 2 
minutes of debate, equally divided, prior to a vote in relation to 
amendment No. 52, offered by the Senator from Wyoming, Mr. Enzi, for 
Mr. Flake.
  The Senator from Arizona.
  Mr. FLAKE. Mr. President, I rise today to speak in favor of the Flake 
amendment, No. 52, to protect the elderly and vulnerable.
  I think the Senator speaking on the other side of the aisle talking 
about Republicans wanting to cut Medicare and Social Security has it a 
little backward. According to the nonpartisan Congressional Budget 
Office, under current law Social Security's disability insurance trust 
fund will be exhausted by 2022 and its retirement fund will be 
exhausted by 2030. Once exhausted, Social Security beneficiaries could 
be subject to a cut in their benefits as high as 31 percent if we do 
nothing, unless we fix these programs.

[[Page 473]]

  The problem with the other side of the aisle right now is they don't 
want to fix these programs. If we adopt the Sanders amendment, it will 
make it difficult to actually go in and reform these programs in a 
manner that will make sure they survive for future generations.
  We all know we have to have entitlement reform. We want to do it in a 
way that protects future generations. Unless we reform these programs--
and they go in 2022 and 2030--if these benefits are exhausted, people 
might be subjected to a 31-percent cut. That is not what we want. That 
is why we have to go in and reform them, and that is why we need to 
adopt my amendment.
  With that, I yield back.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. SANDERS. Mr. President, when my friend Senator Flake talks about 
reforming Social Security, what he is talking about is cutting Social 
Security. He is suggesting that is the only way we can save Social 
Security. Of course, that is nonsense. I would urge my good friend from 
Arizona to get on board legislation that I will be offering. Do you 
know what it does? It extends the life of Social Security for 55 years 
and expands benefits, and it does that by lifting the cap so that 
billionaires contribute more into the Social Security trust fund.
  To suggest that nobody on this side wants to do anything is 
inaccurate. We do want to do something. We want to raise benefits and 
extend the life of Social Security. And, yes, some campaign donors--
billionaires--may have to pay more in taxes.
  I urge my colleagues to reject the Flake amendment and support the 
Sanders amendment.
  Mr. President, I raise a point of order that the pending amendment, 
No. 52, is not germane to the underlying resolution and therefore 
violates section 305(b)2 of the Congressional Budget Act of 1974.
  The PRESIDING OFFICER. The Senator from Arizona.
  Mr. FLAKE. Mr. President, pursuant to section 904 of the 
Congressional Budget Act of 1974 and the waiver provisions of 
applicable budget resolutions, I move to waive all applicable sections 
of the act and applicable budget resolutions for the purpose of the 
Flake amendment, No. 52, and I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on agreeing to the motion.
  The clerk will call the roll.
  The senior assistant legislative clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Alabama (Mr. Sessions) and the Senator from North Carolina 
(Mr. Tillis).
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The yeas and nays resulted--yeas 31, nays 67, as follows:

                       [Rollcall Vote No. 5 Leg.]

                                YEAS--31

     Burr
     Cassidy
     Collins
     Corker
     Cotton
     Crapo
     Cruz
     Daines
     Ernst
     Fischer
     Flake
     Gardner
     Graham
     Heller
     Hoeven
     Inhofe
     Johnson
     Lankford
     Lee
     McCain
     Moran
     Murkowski
     Portman
     Risch
     Rubio
     Sasse
     Scott
     Sullivan
     Thune
     Toomey
     Young

                                NAYS--67

     Alexander
     Baldwin
     Barrasso
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Brown
     Cantwell
     Capito
     Cardin
     Carper
     Casey
     Cochran
     Coons
     Cornyn
     Cortez Masto
     Donnelly
     Duckworth
     Durbin
     Enzi
     Feinstein
     Franken
     Gillibrand
     Grassley
     Harris
     Hassan
     Hatch
     Heinrich
     Heitkamp
     Hirono
     Isakson
     Kaine
     Kennedy
     King
     Klobuchar
     Leahy
     Manchin
     Markey
     McCaskill
     McConnell
     Menendez
     Merkley
     Murphy
     Murray
     Nelson
     Paul
     Perdue
     Peters
     Reed
     Roberts
     Rounds
     Sanders
     Schatz
     Schumer
     Shaheen
     Shelby
     Stabenow
     Tester
     Udall
     Van Hollen
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                             NOT VOTING--2

     Sessions
     Tillis
  The PRESIDING OFFICER. On this vote, the yeas are 31, the nays are 
67.
  Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected.
  The point of order is sustained and the amendment falls.


                            Amendment No. 19

  Under the previous order, there will be 2 minutes of debate, equally 
divided, prior to a vote in relation to amendment No. 19, offered by 
the Senator from Vermont, Mr. Sanders.
  The Senator from Vermont.
  Mr. SANDERS. Mr. President, this amendment does two basic things. No. 
1, it says that the Senate should not go on record in throwing 30 
million people off of health insurance, raising the cost of 
prescriptions drugs for seniors, and privatizing Medicare.
  But it also does something else maybe even more important. It says 
that we should support President-Elect Trump when he campaigned 
throughout this country saying that I, Donald Trump, will not cut 
Social Security, will not cut Medicare, will not cut Medicaid. Let's 
tell the American people that we think that when a candidate for 
President says something over and over and over, when he promises the 
working people and the elderly that he will not cut Social Security, 
Medicare, and Medicaid, we stand with him and we are going to support 
him and make sure that there are no cuts to Social Security, Medicare, 
and Medicaid.
  Thank you.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Mr. President, I don't think that is exactly what this is 
about. This amendment is corrosive to the privilege of the budget 
resolution, meaning it is outside of the scope of what is appropriate 
for a budget resolution. Any inappropriate amendment could be fatal to 
the privilege of this resolution, which would destroy our efforts to 
repeal ObamaCare.
  In other words, a vote in favor of this amendment is a vote against 
repealing ObamaCare. In addition, this amendment is not germane to this 
budget resolution. This budget resolution is much more focused than a 
typical budget resolution. The Congressional Budget Act requires that 
amendments to a budget resolution be germane. Since this amendment does 
not meet the standard required by budget law, a point of order would 
lie; as such, I raise a point of order under section 305(b)(2) of the 
Congressional Budget Act of 1974.
  The PRESIDING OFFICER (Mr. Hoeven). The Senator from Vermont.
  Mr. SANDERS. Mr. President, pursuant to section 904 of the 
Congressional Budget Act of 1974, I move to waive all applicable 
sections of that act for purposes of the pending amendment, and I ask 
for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The question is on agreeing to the motion.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Alabama (Mr. Sessions) and the Senator from North Carolina 
(Mr. Tillis).
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The yeas and nays resulted--yeas 49, nays 49, as follows:

                       [Rollcall Vote No. 6 Leg.]

                                YEAS--49

     Baldwin
     Bennet
     Blumenthal
     Booker
     Brown
     Cantwell
     Cardin
     Carper
     Casey
     Collins
     Coons
     Cortez Masto
     Donnelly
     Duckworth
     Durbin
     Feinstein
     Franken
     Gillibrand
     Harris
     Hassan
     Heinrich
     Heitkamp
     Hirono
     Kaine
     King
     Klobuchar
     Leahy
     Manchin
     Markey
     McCaskill
     Menendez
     Merkley
     Murphy
     Murray
     Nelson
     Peters
     Reed
     Sanders
     Schatz
     Schumer
     Shaheen
     Stabenow
     Tester
     Udall
     Van Hollen
     Warner
     Warren
     Whitehouse
     Wyden

[[Page 474]]



                                NAYS--49

     Alexander
     Barrasso
     Blunt
     Boozman
     Burr
     Capito
     Cassidy
     Cochran
     Corker
     Cornyn
     Cotton
     Crapo
     Cruz
     Daines
     Enzi
     Ernst
     Fischer
     Flake
     Gardner
     Graham
     Grassley
     Hatch
     Heller
     Hoeven
     Inhofe
     Isakson
     Johnson
     Kennedy
     Lankford
     Lee
     McCain
     McConnell
     Moran
     Murkowski
     Paul
     Perdue
     Portman
     Risch
     Roberts
     Rounds
     Rubio
     Sasse
     Scott
     Shelby
     Sullivan
     Thune
     Toomey
     Wicker
     Young

                             NOT VOTING--2

     Sessions
     Tillis
  The PRESIDING OFFICER. On this vote, the yeas are 49, the nays are 
49.
  Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected.
  The point of order is sustained and the amendment falls.
  The Senator from Vermont.
  Mr. LEAHY. Mr. President, the 115th Congress convened just last week. 
I had hoped that with all the turmoil in the country that we would 
begin the year with a renewed sense of cooperation. But I am sorry to 
say, my friends in the Republican Party have chosen a different path.
  The very first thing on the agenda is to press forward with a sham 
budget. If you ask why we have a sham budget, a fake budget, an 
unrealistic budget--we find out that its only purpose is to set up a 
process to repeal the Affordable Care Act with a simple majority vote. 
Why? Because they know the American people would never allow a repeal 
to pass otherwise.
  So instead of working to finalize appropriations bills for this 
year--already more than 3 months in--or to invest in our Nation's 
critical infrastructure, or to truly bolster our Nation's cyber 
security, when we see countries such as Russia and other places 
attacking our cyber systems, or even to improve the Affordable Care Act 
so we can ensure that more people can receive affordable coverage, I am 
afraid the Republicans are recklessly rushing forward solely to fulfill 
an ill-considered campaign promise.
  They are pushing American families over the cliff with the vague 
promise: Yeah, we will repeal it, but don't worry because eventually we 
will come up with a plan to replace it.
  Jump first, plan later is anything but a responsible formula for 
someone's health, for sound decisions; and all the more so when the 
health insurance of tens of millions of Americans and American families 
all over the country--Republicans, Democrats, and Independents alike--
is at stake.
  The majority leader and others have said the repeal of the Affordable 
Care Act is only the first step. They say that a full repeal is 
necessary to pave the way for a replacement. They say: Let's leave 
ObamaCare in the past. Well, when you strip away the rhetoric and get 
rid of it, the only alternative they offer the American people is don't 
get sick--because if you get sick, you are in trouble.
  The American people have a right to know what a vote to repeal the 
Affordable Care Act really means. A repeal of this law would not just 
take away the rights and care of millions of patients and their 
families; it would eliminate insurance coverage for millions more--
especially the aging, the elderly, men and women with preexisting 
conditions, and the most vulnerable children.
  A repeal of the Affordable Care Act would turn back the clock to a 
bad time in this country where once again women would have to pay more 
for health insurance than men, where insurance companies could rescind 
a health insurance policy simply because someone gets sick, and 
coverage could forever be denied to someone born with a disease or 
ailment, and that includes children. So you could buy a health 
insurance policy so you were covered in case you got sick, but the 
insurance companies could then say: Oh, you are sick. Sorry, no more 
insurance.
  Now, in my State of Vermont, the Affordable Care Act has reduced the 
number of Vermonters without insurance by 53 percent. Tens of thousands 
have gained coverage under the expansion of Medicaid. And because the 
Affordable Care Act closed the prescription drug ``donut hole,'' more 
than 10,000 Vermont seniors saved $12 million in prescription drugs in 
2015 alone. And this is just in the second smallest State in the Union. 
Can you imagine what it is like in larger States?
  I have heard stories from many Vermonters about how vital this law is 
to them and their families. I have heard from family doctors, like one 
in the southwest corner of our State in Bennington, who remembers when 
his patients couldn't afford treatment because of lifetime and annual 
limits on health care coverage, something that was very common. Or a 
woman from Westminster, VT, whose family hit hard times--she moved from 
job to job. She couldn't afford continuous health coverage until the 
Affordable Care Act offered her a quality plan she could keep. Now, we 
are talking about throwing her off.
  Other young Vermonters are able to pursue careers in public service 
or the arts because they can stay on their parents' health insurance 
until age 26. Countless others have underscored that because of 
previous health issues, such as diabetes or cancer, health coverage 
would otherwise be unaffordable.
  It would be a vicious cycle. They had a disease, but they couldn't 
afford to do anything about it, and they would go into greater debt. 
Now, even though they have a preexisting condition, they have 
guarantees and subsidies provided by the Affordable Care Act so they 
can have health coverage, instead of health coverage being 
unaffordable.
  Opponents of the Affordable Care Act have gone to new lengths to 
repeat and prolong this political battle. And that is all this is. They 
have had 6 years to propose a better alternative. Instead, 
congressional Republicans and the President-elect have decided to put 
the cart before the horse. They want to dismantle our health care 
system, and they don't want to figure out how to fix it. They just want 
to figure out how to get rid of it. And, by the way, they say somebody 
is going to come up with a bright idea for something better.
  The American people rightly expect us to work together and make 
progress on the many challenges that we face today. Instead, we are 
engaging in dangerous political gamesmanship that will not affect 
Members of the Congress, but the millions of families we represent 
throughout this country because they will not have health insurance, 
and their children will not have health insurance. Just think what this 
is eventually going to cost Americans--a lot more than we pay now.
  I will not support a return to less protection, less coverage, less 
fairness, and higher costs because that is what a repeal means. The 
Affordable Care Act extended health insurance to millions of families, 
not only in Vermont, but across the country. Those who represent the 
American people in Congress should stand ready to get to work for their 
constituents. Not to make their constituents sick, but to give them a 
program that works.
  I will not support an effort to reverse the many reforms and 
achievements we have made through the Affordable Care Act and instead 
cobble back together a broken system that for too long burdened most 
American households with health coverage uncertainty and crippling 
costs.
  I am not going to go and tell Vermonters: Too bad that you have 
cancer. Tough. We just fixed it so you can't have insurance. Too bad 
that you have diabetes. We just fixed it so you can't get insurance. 
Too bad that your child was born with a physical defect. Too bad. We 
just fixed it so you can't get insurance. Or to the person who just 
lost a job who doesn't have insurance: Too bad that you are without 
health insurance. Better pray you don't get sick because, if you do, 
you will lose a lot more than your job.
  No, I can't look Vermonters in the eye and say that is what I 
support.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. FLAKE. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.

[[Page 475]]

  The PRESIDING OFFICER (Mrs. Fischer). Without objection, it is so 
ordered.


                           Wasteful Spending

  Mr. FLAKE. Madam President, I rise to speak on a subject that often 
goes overlooked in this body.
  The subject of wasteful spending on parochial pet projects is often 
treated as a trivial matter--simply the cost of doing business around 
here. Imagine if every Member of Congress were as obsessed with 
searching for government waste as the players of the mobile game 
Pokemon Go are obsessed with finding the elusive Pokemon, as the chart 
shows here.
  Just like the monsters in the popular game, government pork projects 
come in all shapes and sizes. They pop up just about everywhere. As 
individual expenses, these pet projects can seem rather harmless--cute, 
even. But taken together, their cost adds up to one very menacing 
boondoggle debt monster that continues to grow and threaten every 
taxpayer. In fact, within days, the U.S. national debt will top $20 
trillion.
  As we debate the budget resolution, we need to get serious about 
controlling the debt like the true national security challenge it is. 
We start by eliminating unnecessary spending and catching government 
waste.
  My friend and former colleague Senator Tom Coburn of Oklahoma created 
an annual report cataloging some of the most egregious ways Washington 
wastes our tax dollars. It is called the Wastebook. Today, I am 
releasing the latest installment, which profiles 50 new examples of 
questionable expenditures. This year's edition is entitled ``Wastebook: 
PORKemon Go.''
  Like the Pokedex, which lists the various Pokemon for players to 
catch, Wastebook provides an index of questionable expenditures lurking 
throughout the Federal budget. These collectively cost taxpayers more 
than $5 billion, but instead of Pikachu, we are looking out for 
PORKachu.
  The top entry in this year's Wastebook is a spaceport--which is just 
a fancy word to say a rocket launch site--all the way over in Alaska. 
It has been derided as space pork, not because it is launching an elite 
unit of porcine astronauts into the big trough in the sky, it is 
because Congress used earmarks to force the Department of Defense to 
build the facility, over the objections of the military, as part of an 
illegal kickback scheme.
  A midlevel DOD employee, who was sentenced to prison for 
masterminding the plot, eventually confessed that building the launch 
facility ``doesn't make sense.'' He said the Pentagon ``just paid for 
meaningless work.'' Keep in mind, this was a contractor on that 
project. After sitting unused for several years, the Pentagon is now 
sinking another $80 million into the spaceport. This is despite the 
fact that it is not even equipped with the type of missiles that DOD 
plans to launch for the site.
  Another entry, the National Comedy Center in New York must be 
laughing all the way to the bank with $1.7 million from the Economic 
Development Administration, or EDA. This will be spent to bring Lucille 
Ball back to the stage as a hologram. The three-dimensional illusion of 
Lucy is formed with light beams from a laser, which will replicate 
standup routines using existing audio recordings.
  Holograms of other comedians who are no longer with us will also take 
the stage in the center's comedy club. Other features will include a 
boot camp on how to deliver jokes--maybe I need that one--as well as a 
heckle booth, which we can do without. This is likely to once again 
make Washington the punch line of jokes, but it is no laughing matter 
for taxpayers.
  Next up, the U.S. Department of Agriculture, USDA, has a program that 
allows taxpayer-funded farm loans to literally be paid back with 
peanuts. This program shelled out $74 million in the past year. In 
typical Washington fashion, the government pays more for the peanuts 
than the market price, which has turned the program into a cash cow, or 
pig--however you want to view it--and the pile of surplus peanuts the 
government has amassed is so large that government can't even give it 
away.
  Here we have a farm program where we are giving loans to farmers to 
grow peanuts. If they check at the end of the year and the market price 
for peanuts isn't very good, they can unload those peanuts on the 
government and keep the cost of the loan. Then, government has to store 
these peanuts, which we do in warehouses all over the country.
  Based on USDA's own numbers, the Congressional Research Service is 
warning that the storage costs alone could pile up to $1 billion a 
year. That is not just peanuts; that is enough to make anyone salty 
about our debt and deficit.
  Instead of filling potholes, $35,000 from the Department of 
Transportation literally went to pot. The money was paid for a giant 
glow-in-the-dark doobie displayed in Denver that was intended to remind 
motorists who smoke marijuana not to drive while they are stoned; 
$35,000 for a big poster or banner on a building of a giant joint.
  Even the Nation's most prestigious science agencies are spending 
taxpayer funds investigating subjects that most of us would consider 
obvious or rather offbeat. Studies on the habits of college students 
funded with $5 million of NIH grants counted more than 500 different 
drinking games that are popular on college campuses.
  According to researchers, ``All of these games have the same goal--
causing participants to become intoxicated.'' I think that is rather 
obvious. They observed that fraternity brothers drink, smoke, and 
generally party more than other students, and they also sleep in later. 
This led the researchers to speculate that ``one explanation for this 
finding is that Greek students recognize their sleep needs.'' A more 
likely reason is that they are sleeping off their partying lifestyle, 
but you are paying for it.
  NIH is also drilling down to determine why some people are afraid of 
the dentist as part of another $3.5 million research project. The 
researchers found that--surprise here--``fear of pain has been shown to 
be a critical component.''
  The monkey business doesn't end there. NIH spent nearly $1 million to 
study the evolution of monkey drool and another $230,000 to determine 
if the color red makes female monkeys feel more romantic. In case you 
are wondering, it does.
  As part of an effort supported by both the National Science 
Foundation and DOD to teach computers how to understand computer 
behavior, the machines were programmed to watch television shows. After 
viewing over 600 hours of ``Desperate Housewives,'' ``The Office,'' and 
other shows, the computers were still unable to predict how humans 
would behave in most situations. Anybody who has watched those shows 
realizes that is rather obvious.
  A $1 million NASA project is preparing the world's religions for the 
possible discovery of extraterrestrial life forms--$1 million to 
prepare the world's religions for the possible discovery of 
extraterrestrial life forms. Do we need to spend that, really?
  A major sticking point for the participants was defining what life 
is: ``Much of the discussion centered on the question, `What is life?' 
It turns out that life is notoriously difficult to define,'' they 
concluded.
  The fishiest study of all tested how long a fish can run on a 
treadmill. This was part of a study paid for by a $565,000 grant from 
the National Science Foundation. Everyone remembers the infamous shrimp 
on a treadmill funded by NSF. It turns out that last year's competitor 
had a leg, or several, up on the competition. With five pairs of 
walking legs and five pairs of swimming legs, the shrimp could run for 
hours. The latest NSF-funded treadmill study participant was literally 
a fish out of water. The experiment forced mudskippers to ``run'' for 
as long as 15 minutes at a time on a treadmill. These fish possess the 
unique ability to survive out of water for extended periods of time, 
using their fins like legs, although they didn't appear to enjoy 
running on the treadmill, as you can imagine.
  Certainly, we have bigger fish to fry with our Federal research 
dollars and, I might add, better puns to find as well.

[[Page 476]]

I could go on and on with examples of completely unnecessary spending 
identified by this year's Wastebook. There is waste in every 
department, every agency. All you have to do is look. Ferreting out 
every bit of wasteful spending, no matter how small, is the only way to 
reduce our debt and to rein in the cost of our Federal Government. It 
can be a daunting task because, much like Pokemon, these programs are 
good at hiding. Our mission is simple: You have to catch them all.
  Madam President, I yield back.
  The PRESIDING OFFICER. The Senator from Maine.
  Mr. KING. Madam President, I rise this afternoon to supplement some 
remarks I made on the floor last evening about the Affordable Care Act. 
Last night, I talked about my own experience as a young staff member in 
the U.S. Senate 43 years ago when, because I had an insurance policy 
provided by my employer--that policy had preventive care as part of the 
policy, just as Affordable Care Act policies do today--I had a routine 
physical checkup. It was the first I had in a number of years, which 
caught malignant melanoma, a particularly virulent form of cancer. 
Because it was caught early and because I was treated, here I am today.
  As I mentioned last night, it has always haunted me that someone who 
didn't have insurance, a young man or a young woman somewhere in the 
country who was in exactly my situation, because they didn't have 
insurance, they didn't have preventive care, didn't get the checkup, 
the disease wasn't caught, and they are gone.
  I find it very hard to justify that, to understand that. It doesn't 
seem fair. It doesn't seem ethical. It doesn't seem moral. Today I 
wanted to also bring to the attention of the Senate some stories from 
today about the effect of the Affordable Care Act in Maine, where we 
have over 80,000 people enrolled, many of whom had never been able to 
have insurance before.
  A young woman, Whitney, who graduated from college in 2013, said:

       I graduated . . . with a degree in wildlife ecology, [but 
     it was very difficult to find a job.]
       Thanks to the ACA, I was able to stay on my family health 
     insurance plan through this period of unemployment. I did 
     finally get employed in my field, but permanent, year-round 
     jobs with benefits are the equivalent of winning the lottery.

  Many young people are in that situation. It even has a name. It is 
called the gig economy, people who work gigs, who work short periods of 
time, several months here, several months there, but there are no 
benefits attached to those jobs. She said:

       Many of us work seasonal jobs, building trails on the 
     Appalachian Trail, rescuing lost hikers, managing volunteers, 
     and running programs for veterans to reconnect with Maine's 
     woods. We do good work in this state. Before the ACA we 
     worked dangerous outdoor jobs that only provided minimum 
     worker's comp. . . . But with the ACA and the tax credit, I 
     could afford a silver plan, I could get dental for my teeth, 
     could go to the doctor again, get flu shots and get my joints 
     looked at.

  It is important to realize that without the ACA, this young woman 
would have literally no options. A health savings account is 
unrealistic for somebody who is making $15,000 to $20,000 a year. 
Buying insurance across State lines isn't going to help this young 
woman.
  She said getting the ACA coverage ``was life changing. I know it is 
not perfect but I am terrified of going back to [where we were] before, 
where health and financial ruin was one wrong step away.''
  Another letter from an older adult:

       My wife is sixty-three years old she is no longer able to 
     work full time. She has had major back surgery and has 
     arthritis in her neck. Because of these health issues she had 
     to reduce her work hours.

  Here is the catch-22. She had to reduce her work hours. Therefore, 
her employer dropped her from her health care coverage.

       We were fortunate [enough] to obtain coverage for her 
     through the Affordable Care Act. It is expensive and is not 
     the best coverage--

  Nobody in this body says it is best possible result and that the law 
is perfect. We all agree it needs to be repaired and fixed and 
modified. The writer goes on to say--

     but it is good enough for us to know that a major health 
     issue will not bankrupt us.
       We are appealing to you as our representative to insure 
     that a reasonable replacement will be put in place when the 
     Affordable Care Act is ended. Better yet, improve it, don't 
     destroy it.

  I couldn't have said it better myself. Donald, in his letter to me, 
says: ``Better yet, improve it, don't destroy it.'' That is what we 
ought to be talking about.
  This letter is from a fellow named Ryan in North Central Maine. He 
also makes an important point about the Affordable Care Act. The term 
that I refer to is ``job lock.'' There are hundreds of thousands, if 
not millions, of people in this country who are locked into the jobs 
they have that they don't really like, that isn't giving them the 
satisfaction they want because they can't afford to leave their health 
care.
  One of the hidden benefits of the Affordable Care Act is it has 
allowed those people to follow their dreams, to start a business and 
not have to worry about having health insurance. This is an 
entrepreneur in Maine, a small business person. He said:

       Affordable healthcare is a major roadblock to those 
     calculating whether they can take the leap to become self-
     employed. As we prepare for next year's ice cream season, I 
     am about to leave my benefit-providing job in order to commit 
     to making the volume of ice cream we need. This is a scary 
     and questionable decision given our financial situation and 
     the fact that we are raising our two small children of four 
     and seven years old. The first comment I hear from everyone 
     who finds out I am leaving my job is, ``Are you sure? What 
     are you going to do about health insurance??''

  The answer is, the Affordable Care Act. It enables this young man, 
this gentleman, to follow his dream, to start his business, to commit 
to his business, and this is good for the country. This is a hidden 
benefit that is rarely discussed about the Affordable Care Act to allow 
people to give vent to their dreams and their innovation and their 
contribution to the economy.
  Here is how he ends his letter. He says:

       Please don't let me down. Please don't let my family down. 
     Please don't let down the millions of families who really are 
     on the bottom of this country and are the very ones that all 
     of you from every party claim to support. I don't care about 
     the details of how it gets done, whether the ACA is thrown 
     out, or just revised, or what compromises have to be made by 
     either party, but please make sure there is a health care 
     option available and that it is at an affordable price for 
     those of us with the guts to take a stab at our own small 
     business. The key is ``Affordable Care.'' It matters.

  As in my own case, health insurance also saves lives. There was a 
study done by the Journal of Public Health in 2009, which basically 
concluded that for every million people without health insurance, there 
are a thousand premature deaths. It is pretty easy math. Before the 
Affordable Care Act, we had 45 million people without health insurance 
in this country. The calculation in this extensive study was that 
46,000 deaths were attributable to not having health insurance. I am 
living proof of that. If I hadn't had health insurance, I would be 
gone. With the disease that I had, either you catch it in time or you 
are a goner. That is why I am so passionate about this.
  We would not let people die in our front yards. If we saw somebody 
who was in danger of losing their life, we wouldn't stand by. Nobody in 
this body would stand by and say: Sorry, we can't help you. But not 
providing health insurance to people is a death sentence to 10, 20, 30, 
40,000 people.
  The Affordable Care Act is now covering something like 25 million 
people. That is 25,000 lives saved. If we take it away, it will be 
25,000 lives lost.
  Here's the letter:

       I am a Maine woman in my late 30s, who works 2 part-time 
     jobs and also run my own business.
       Because we were on [ACA] health insurance that had an 
     affordable deductible, after not feeling well for a while, my 
     husband went to a doctor and had a CT scan of his lungs. . . 
     . It turned out he had a very rare form of an illness, even 
     though he was only 38 at the time. Had we not had this 
     insurance and such an affordable premium and deductible, he 
     would never have gotten that CT scan done. This insurance 
     saved his life and covered every expense we've had over the

[[Page 477]]

     last 2 years with multiple stays at MidCoast Hospital and 
     Maine Med, 2 surgeries, pick-lines, medications, therapies, 
     the list goes on. There is no cure for what he has but he's 
     doing better now, thanks to the ACA.

  Another person from Maine:

       My sisters and I watched my mom die. We were physically in 
     the room when it happened. We cried for probably half an hour 
     straight.
       Before the Affordable Care Act, most of her illnesses were 
     considered pre-existing conditions. She survived cancer three 
     times . . . but had to pay exorbitant monthly premiums just 
     to have to pay most of her treatment out of pocket.

  He said:

       I don't care about the ACA because of some theory or 
     ideology. I watched my mom die, sooner than she needed to, 
     because she couldn't afford to get preventative care early 
     enough. I watched my mom die because market solutions refused 
     to solve her problems. An open insurance market actively 
     refused to compete to cover my mom. The insurance market 
     before the ACA is one of a number of factors that led to my 
     mom's death.
       This is a real, physical, immediate memory for me whenever 
     someone talks about healthcare, and it always comes to mind 
     when people talk about it in vague terms and market forces. I 
     am crying even as I write this, and it has been years.

  He writes to me:

       I am begging you, as a son who watched his mom who was 
     younger than you--

  Than me--

     die in a hospital because she couldn't afford the care she 
     needed, please protect the Affordable Care Act. Protect it as 
     a legislator, protect it by recognizing how appointments you 
     choose to confirm or deny will affect my family's ability to 
     stay healthy and alive. Through grants and research, you've 
     worked to improve access to health care. Please, protect the 
     ACA.

  Another one--one more. This is a letter I received just back in the 
fall, a little before Christmas:

       I have an incurable, generally non-lethal form of bone 
     cancer and have been under treatment for over 12 years. The 
     multiple surgeries [and costs] . . . I cannot afford to pay 
     for ongoing treatment without insurance. I am very pleased 
     the current ACA does not allow for ``preexisting 
     disqualification'' and I would hate to see that removed. 
     Having this condition is naturally stressful, debilitating 
     and undesired. I do not want or need the added stress of 
     having to worry about the details of coverage.
       Additionally I have two boys, aged 23 and 26, both of whom 
     have benefited from remaining on our family insurance policy. 
     That is a great policy and my boys are healthier as a result.
       Finally, access to quality health care is and must be a 
     right as it benefits both the individual and society. Health 
     is key to happiness and success and happy successful people 
     pay taxes, support the government, [and] give back to the 
     community.

  I understand the debate that surrounded this. I understand the 
emotion. I understand the pressure that people feel in order to 
maintain a campaign promise or to meet promises made over the last 
several years. But we are not talking about maybe what will happen; we 
are talking about real cases, real people. I am talking about real 
people in Maine, in small towns and cities. I am talking about rural 
hospitals that are on the verge of being rendered financially 
incapacitated because if this law is repealed, it will take away a 
significant part of their support. I am talking about seniors having to 
pay more for drugs. But mostly, I am talking about people's lives.
  These cases are people who can give specific examples. There are 
thousands, tens of thousands, and millions that we can't articulate--
people who are saved who don't even know it because they went in to get 
that checkup, who are saved the stress of wondering how they are going 
to pay for some kind of treatment.
  As a parent, I remember having to stress about whether to take my 
child to a doctor because I didn't know whether I could afford to pay 
that bill. Yet we all know that is the proper course. We shouldn't have 
to make those kinds of choices. We have a vehicle, imperfect as it is. 
Imperfect as it is, we have a vehicle for providing that care.
  Let's slow down. Let's take a breath and say: OK. We talked about 
repeal, but it isn't really practical. We can't harm that many people. 
Let's talk about what we are going to replace it with. The idea that we 
are going to repeal it today and replace it 3 years from now is just 
cruel. That is what I am hearing from people: Don't put us through 
that. People who finally got insurance after preexisting conditions, 
who have insurance and have a condition now--they depend upon that 
insurance. Let's not make them go through that pressure, the financial 
anxiety added to the health anxiety. We have an opportunity to rise 
above politics. This really shouldn't be political or a policy or 
something that divides us.
  There is nobody in this body who wants to see people suffer, who 
wants to unnecessarily put people through the pressure of both health 
problems and financial problems. We ought to be able to find a 
solution. Every other industrialized country in the world has found a 
solution. It is not like this is some impenetrable box.
  I realize that part of the solution has to involve controlling costs 
and facing the fact that we pay twice as much for health care per 
capita as anyone else in the world. That is an issue the Affordable 
Care Act does not sufficiently address, in my view, and we have to talk 
about that.
  In the meantime, let us remember those people who are counting on us 
for their very lives. That is a commitment I believe we can respect and 
should meet.
  Thank you, Mr. President.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Tennessee.
  Mr. ALEXANDER. Mr. President, we are engaged in the first step to 
debate what is important to virtually every American. What we want to 
do is to find good ways to reform and replace ObamaCare and then repeal 
the provisions of it that have damaged so many Americans.
  Before we start talking about a big subject, sometimes it helps to 
ask the question: Exactly what are we talking about? So, very quickly, 
where do Americans get our health care insurance? It might be 
interesting to note that 91 percent of us have some sort of health 
insurance--290 million. We get it from four places, basically. One is 
Medicare--18 percent of us with insurance. This is not a bill to change 
Medicare. That is a discussion for another day. So we are talking about 
these three areas.
  One is employers, on the job. Sixty-one percent of us with insurance 
get it on the job--178 million people.
  Medicaid, managed by States, paid for by the Federal and State 
governments--22 percent of covered Americans there get their insurance 
through Medicaid.
  Then there is the individual market, people who buy it on their own. 
That includes the exchanges we hear so much about. Here is where all 
the news is; here is where the turmoil is. That is just 6 percent of 
everyone who is insured, although that is 18 million Americans. This is 
information from the U.S. Census.
  Who is not insured? That is interesting too. According to the Kaiser 
Family Foundation, there are 27 million people who aren't insured, but 
17 million of those are eligible for some help to get insurance and 
just haven't taken it. Of the 11 million who are not eligible for any 
help, nearly half of them--5 million--are illegally here. Of the rest, 
some make too much money to be eligible for assistance, and some 
dropped through the Medicaid coverage gap. So it is fair to say that 91 
percent of us are insured one way or the other. Then, of the 27 
million--the 9 percent who are not insured--17 million of those are 
eligible for some sort of assistance.
  How should we approach this? Following the Presidential election, 
President-Elect Donald Trump said on ``60 Minutes'' that replacement 
and repeal of ObamaCare would be done ``simultaneously.'' To me, that 
means at the same time.
  Just today, Speaker of the House Paul Ryan said that repeal and 
replacement of ObamaCare would be done concurrently. To me, 
simultaneously and concurrently mean ObamaCare should finally be 
repealed only when there are concrete practical reforms in place--that 
give Americans access to truly affordable health care. Let me say that 
again: ObamaCare should be repealed, finally, only when there are

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concrete, practical reforms in place that give Americans access to 
truly affordable health care.
  The American people deserve health care reform that is done in the 
right way for the right reasons and in the right amount of time. It is 
not about developing a quick fix. It is about working toward a long-
term recovery that works for everyone.
  Here is one way to think about what simultaneously or concurrently 
might mean. I would ask you to think about ObamaCare as if it were a 
local bridge in, say, South Dakota that is collapsing--because that is 
just what is happening with ObamaCare. According to the Tennessee 
Insurance Commission, the ObamaCare insurance market in our State is 
``very near collapse.'' Across the country, premiums and copays are up. 
Employers have cut jobs to afford ObamaCare costs. Medicaid mandates 
are consuming State budgets. In one-third of America's counties, 
citizens with Federal subsidies have only a single choice of a company 
to buy insurance from on an ObamaCare exchange. Without quick action 
this year, next year, these Americans may have zero choices. Their 
subsidies may be worth about as much as a bus ticket in a town where no 
buses run.
  If your local bridge in South Dakota or Wyoming or Tennessee were 
very near collapse, what would you do? I think the first thing you do 
is to send in a rescue crew to repair it temporarily so no one else is 
hurt. Then you start building a better bridge--or more accurately, many 
bridges--as States develop their own plans for providing truly 
affordable health care to replace the old bridge.
  Finally, when the new bridges are finished, you close the old bridge. 
That is how we propose to proceed: to rescue those trapped in a failing 
system that is ObamaCare, to replace that system with a functional 
market or markets, and then repeal ObamaCare for good.
  First, we will offer a rescue plan so that the 11 million Americans 
who buy insurance now on the exchanges can continue to do so while we 
build a better set of concrete, practical alternatives.
  Second, we will build the better systems. Note that I say systems, 
not one system. If anyone is expecting Senator McConnell to roll a 
wheelbarrow onto the Senate floor with a great big comprehensive 
Republican health care plan, they are going to be waiting a long time 
because we don't believe in that. We don't want to replace a failed 
ObamaCare Federal system with another failed Federal system.
  We want to create many systems across this country, step-by-step, to 
give Americans more choices of insurance that cost less. We will do 
this by moving more health care decisions out of Washington and into 
the hands of State and patients and by reducing harmful taxes. We will 
do it carefully, step-by-step, so that it is effective.
  Finally, we will repeal what remains of the law that did all of this 
damage and created all of this risk. That is what we will do.
  Here is what we will not do. This is not a bill for Medicare reform. 
That will be handled separately.
  Second, you won't be disqualified from getting insurance if you have 
a preexisting health condition. If you are under the age of 26, you 
will still be able to be covered under your parents' plan.
  That is what, in my opinion, we mean by repeal and replace 
``simultaneously,'' as the President-elect said, or ``concurrently,'' 
as Speaker Ryan said.
  Here are three steps we will take beginning immediately. No. 1 is the 
rescue plan. Six percent of Americans with insurance buy their 
insurance in this individual market, about two-thirds of those on the 
ObamaCare exchanges. This is where today's turmoil is. This is where 
the copays are up, the premiums are up, where insurance companies are 
pulling out of the markets.
  While we build replacements, we want the 11 million Americans who now 
buy insurance on the exchanges to be able to continue to buy private 
insurance. This will require Congress and the President to take action 
before March 1, which is when the insurance companies begin to decide 
whether they will offer insurance in these markets during 2018.
  In general, the goal is to get as close as possible to allowing any 
State-approved plan to count as health insurance under ObamaCare rules 
while we are transitioning to new systems. Among the actions that will 
help are to allow individuals to use their ObamaCare subsidies to 
purchase State-approved insurance outside the ObamaCare exchanges; to 
adjust ObamaCare's special enrollment periods; to approve the temporary 
continuation of cost-sharing subsidies for deductibles and copays; to 
allow States more flexibility to determine so-called essential health 
benefits, age rating rules, and small group restrictions; to expand 
health savings accounts; eventually, to provide tax credits to help 
lower-income Americans buy insurance; and to repeal the individual 
mandate when new insurance market rules are in place.
  When the new administration rewrites the guidance on ObamaCare 
section 1332 State innovation waivers to allow for more State 
flexibility, States will have the authority to further innovate to 
build more modern health systems.
  Now, second is employer insurance. Remember, that is where 61 percent 
of us get our insurance--on the job. We will repair the damage 
ObamaCare has done so that employers can offer employees more 
personalized patient-centered care. We will do that by repealing 
ObamaCare's employer mandate penalty. We will allow States to determine 
the so-called essential health benefits and thereby lower costs for 
small businesses. We will repeal ObamaCare's restrictions on 
grandfathered health plans, on wellness benefits, on small group plans, 
and provide more flexibility for small businesses so they can work 
together to buy insurance--a proposal for which the Senator from 
Wyoming has championed for years.
  This will mean more State authority, more choices, and lower costs 
for the 178 million Americans who obtain insurance on the job.
  Third is Medicaid. Twenty-two percent of all insured Americans are 
covered by Medicaid. We will give States more flexibility to offer 
those 62 million citizens more options by making Federal Medicaid 
waivers more flexible.
  So in summary, we will first send in a rescue crew to repair 
temporarily a collapsing health care market so no one else is hurt. 
Second, step-by-step, we will build better systems--that give Americans 
access to truly affordable health care. We will do this by moving 
health care decisions out of Washington, DC, and back to States and 
patients.
  Finally, when our reforms become concrete practical alternatives, we 
will repeal the remaining parts of ObamaCare in order to repair the 
damage it has caused Americans. This is what I believe we mean when we 
say ObamaCare should be repealed and replaced simultaneously and 
concurrently.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Rounds). The Senator from Wyoming.
  Mr. ENZI. Mr. President, I want to thank the Senator from Tennessee, 
Mr. Alexander, who is also the chairman of the Health Committee--that 
is, the Health, Education, Labor, and Pensions Committee--for the 
succinct speech that he gave. I will be encouraging everybody on both 
sides of the aisle to read that speech. I know that many were not here 
to listen. But it is a fault that we have in this Chamber. We often 
speak to an empty Chamber.
  But it is all recorded thanks to the people who do that for a job. 
You placed that so well that there should not be much doubt about what 
we are going to try to do. You heard it from the chairman of the Health 
Committee. He is the one that will be in charge of the health aspects 
of this.
  The Finance Committee is a part of the bill too. But they are in 
charge of the monetary part of this. But without the health care part, 
that does not work. I love the way you expressed that in the way of 
taking care of a collapsed bridge, because I think people

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across America do realize that the bridge on health care has collapsed 
and they want to know what we are going to do about it.
  You stated that very well. That should relax a lot of people. It 
probably won't because of the process that we are in, but I certainly 
hope that it does. So I thank you for your words and your effort and 
know that it is in good hands as we lead it through this process.
  All that this resolution we are doing right now does is set it up so 
that this can be done. This really does not change any health care at 
this point. It sets it up so that we can do reconciliation, so that we 
can repeal what we can, so we can replace what we can, and then we can 
set up that system of bridges that will get us to the point where all 
Americans who want insurance can have insurance, but more importantly, 
so that all Americans can get the health care they need and deserve.
  I thank the Senator for his comments.
  The PRESIDING OFFICER. The Senator from Tennessee.
  Mr. ALEXANDER. Mr. President, I thank the distinguished chairman of 
the Budget Committee, who has spent a great deal of time on this. I 
like the way he put that because I think what we want to assure people 
of--at least, I think that is what almost all of us feel--is that this 
is step 1. It involves reforms, replacing, and repealing--as the 
President-elect has said, ``simultaneously,'' and as the Speaker has 
said, ``concurrently.'' It involves not just one big system replaced by 
another big system. In our view, the one big system needs to be 
replaced step-by-step by many different systems as we move more 
decisions to the States.
  For example, on employer insurance, or people who get their insurance 
on the job, we know right now steps that we can take to repeal 
ObamaCare, which damaged the employer system and which increased costs 
for employers. I remember sitting around with a group of restaurant 
company chief executive officers 6 years ago when ObamaCare passed. 
They pointed out that they were going have to hire fewer people to 
afford the cost of ObamaCare.
  We don't want that to happen. We would like for them to be able to 
hire more people and to offer more people insurance. How would we do 
that? Well, if we repeal the Washington rules in an orderly way and 
transfer back to the States responsibility for regulating most 
insurance, the insurance commissioners have told us they believe they 
can do that very well--do it one way in South Dakota, another way in 
Tennessee, another way in Wyoming, and fit the needs of that community, 
reduce costs, increase choices, and have truly affordable health care.
  So we can repeal those provisions that interfere with employer 
insurance and make sure that that repeal does not go into effect until 
South Dakota, Wyoming, Tennessee, and other parts of the market have in 
place concrete practical alternatives so they go together. But we have 
to get started. This is step 1.
  Now, we can do the same with Medicaid. We have a former Governor of 
South Dakota in the Chair. Governors spend most of their time trying to 
figure out how to afford Medicaid. They almost feel that, if Washington 
would just allow the States to have more flexibility in terms of how 
the available money is spent, we could cover more people better, offer 
more options.
  Well, we can do that. But we are not going to do that tomorrow. We 
will have to sit down with the Governors and say: How do you suggest we 
do this? Then, as we do that, we can repeal the extensive Federal 
regulation that creates a jungle of redtape for Medicaid. But it only 
would take effect as the States tell us that there are concrete 
practical alternatives in effect. So this is the step-by-step way to go 
about making those kind of changes.
  Finally, as the Senator said, we have to have a rescue team here. I 
mean, the ObamaCare market is in turmoil. It is only 6 percent of all 
of those who have insurance, but that is millions of people. If we 
don't act before March 1 to make sure insurance companies are selling 
into those markets, we will have many millions of people who will not 
be able to buy insurance. This will be, as I said, like having a bus 
ticket in a hometown with no buses running.
  So that is really one of the first things we have to do--get that 
rescue team going. I like the analogy of the collapsing bridge. 
ObamaCare is collapsing in Tennessee, and I would say it is around the 
country, if you have one-third of the counties where you can only 
choose insurance from one company.
  So, if a bridge is collapsing, you send in a crew to deal with that 
emergency so no one else is hurt. Then you start building these new 
bridges. After a while, in a prudent way, as you build each of those 
systems, as States build their systems, then you close that old broken-
down bridge that was damaging so many people.
  So that is an orderly way to go about things. I hope that, over time, 
we will have bipartisan support for these. We need a consensus. We 
don't, in the end, want to have just a partisan bill. But we have been 
acting like the Hatfields and McCoys in West Virginia for 6 years, 
arguing with each other about ObamaCare--Republicans and Democrats.
  So it may take a little while to get there. But we can start, and we 
are starting under the leadership of Senator Enzi. Then, we will move 
concurrently and simultaneously to reform, replace, and repeal 
ObamaCare so that Americans have access to truly affordable insurance. 
By the time we get to that, I am hopeful that we will begin to have a 
consensus within this body that involves Democrats and Republicans 
both.
  Mr. ENZI. Mr. President, I only need to add one footnote to that 
fantastic summary; that is, that the Senator from Tennessee is the 
chairman of the Health, Education, Labor, and Pensions Committee. For 
years we heard about the difficulties with No Child Left Behind. There 
were a lot of efforts to build a different bridge, and they never got 
completed within the timeframe that was necessary, even though both 
sides recognized there was a problem.
  The Senator from Tennessee undertook that, got bipartisan solutions 
on it, and put forward a bill that did kind of what we are talking 
about with ObamaCare. It sent it back to the States. It got rid of the 
national school boards, and that passed, I think, with 88 votes in the 
Senate. That is very bipartisan. That is the kind of an effort he puts 
forth. You can tell from the comments he has made about what we need to 
do that he has that well in mind, and I am certain some from the other 
side will join us to make sure we can get that done as well.
  I thank the Senator, and I yield the floor.
  I suggest the absence of a quorum, and I ask unanimous consent that 
the time be equally divided.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. PETERS. 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. PETERS. Mr. President, today I rise to express my strong 
opposition to partisan attempts to engage in a fast-track process to 
take health insurance away from hundreds of thousands of individuals in 
my State and millions across our country. In Michigan alone, 887,000 
people are in jeopardy of losing their health coverage if Republicans 
have their way and repeal the Affordable Care Act without a 
replacement. Important protections for people with preexisting 
conditions will disappear. Not only will they lose them but so will 
their spouses and children.
  We will be repealing reforms that have benefitted seniors and saved 
more than 5 million beneficiaries an average of over $1,000 in drug 
costs in 2015. Repealing the Affordable Care Act will significantly 
increase drug costs for those seniors and threaten long-term solvency 
for Medicare. Republicans are rushing a process that increases Medicare 
costs for seniors and weakens the program for future generations. Our

[[Page 480]]

Nation's seniors have worked hard their entire lives, and they deserve 
our best efforts to ensure they can depend on Medicare to help them 
enjoy a dignified and secure retirement.
  Over 1 million seniors are enrolled in Medicare in Michigan, and they 
deserve a health care program that will cover the costs of prescription 
drugs and other health care services they need. Since 1965, Medicare 
has done a tremendous job of giving seniors the care they need, and we 
should be working to strengthen this successful program, not putting it 
at risk.
  Let's be clear. Reforms in the ACA extend the solvency of Medicare by 
over a decade. Let me say that again. It extends the solvency of 
Medicare for over a decade.
  Given these challenges, we have to ask: Why are we rushing to 
dismantle these reforms?
  We are rushing a process that will ultimately hurt the Medicare 
Program, our Nation's seniors, and so many others.
  Many of my colleagues on the other side of the aisle suggest that we 
can simply keep or quickly reinstate the popular parts of this law, 
such as preventing discrimination based on preexisting conditions, 
allowing children to stay on their parents' coverage until they are 26, 
and helping seniors afford their prescriptions. I would pose this 
simple question to any of my colleagues advocating for repeal: What 
comes next? Show us your plan. Just show us your plan.
  Former Governor Cuomo of New York famously said: ``You can campaign 
in poetry, but govern in prose.'' We are now facing a majority that 
campaigned on a bumper sticker and is trying to govern with an IOU. 
Enacting a repeal of the ACA that takes effect at some undetermined 
point in the future will create chaos in our insurance markets. Health 
care reform is not a stand-alone program that can be removed overnight 
without creating widespread ramifications for our economy.
  Yesterday, I attended the North American International Auto Show in 
Detroit. As a Michigander, I am always thinking about cars. Let me 
suggest an analogy. Many Republicans in Congress talk about the ACA 
like it is some sort of after-market addition on a car--a flashy rear 
spoiler, perhaps, or new rims that can just be unbolted and removed. 
Well, the ACA is actually like the antilock brakes that keep a driver 
from getting into an accident in the first place and the airbags that 
deploy to protect everyone inside when the worst happens.
  I agree that our health care system needs a tuneup, but we cannot 
start ripping out safety features without a plan to help keep us safe 
on the road. We need to fix the Affordable Care Act. We need to do more 
for small business owners who want to do right by their employees and 
provide them with quality, affordable health care coverage.
  I have offered and supported several proposals to fix the Affordable 
Care Act, including measures to help our Nation's small businesses. I 
am ready to work with my colleagues across the aisle to improve this 
law. However, repealing the ACA without showing the American people 
their plan for replacement is quite simply irresponsible.
  I understand Americans want to see positive changes to the Affordable 
Care Act, and I agree with them. We should be working together to enact 
bipartisan improvements through regular order, not fast-tracking 
repeal. The fact is that most Americans do not want to have this law 
repealed entirely. In the New York Times, a woman named Patricia 
Meadows from Macomb County, MI, who voted for President-Elect Trump, 
stated that she hoped that President-Elect Trump would not repeal the 
Affordable Care Act. Ms. Meadows revealed that, because of the 
Affordable Care Act, her daughter was able to obtain insurance coverage 
for just $50 a month.
  Another constituent from my State, Ben Irwin, revealed to CNN that 
the Affordable Care Act allowed him to take his dream job at a small 
firm that didn't provide health insurance. Because of the ACA, Ben was 
able to get private insurance at an affordable cost. Without the ACA, 
he would have been forced to work at a larger company just to have 
access to affordable health care.
  Ben's story is not unique. I heard from countless entrepreneurs that 
the Affordable Care Act ended job lock and has enabled them to start 
their own businesses and pursue careers and dreams they otherwise would 
not be able to pursue.
  I heard from a constituent in Saline, MI, who contacted my office to 
say that the ACA provided her with the coverage she needed to fight her 
son's aggressive cancer. This same woman later discovered during her 
first appointment, after gaining her own ACA coverage, that she, too, 
had cancer. The ACA gave her and her son the coverage they needed to 
fight their cancer without fear of being kicked off of their insurance 
plan.
  I have also heard from a father in Traverse City, MI. He contacted my 
office to say that the expanded health coverage under the ACA literally 
saved his son's life. Before the ACA, his son only had access to 
emergency room care. His father often wondered: Why is it that I had to 
wait until my son tried to kill himself before I could get help? Now, 
due to the ACA, this father and his son have the health coverage they 
need to appropriately treat his son's mental illness.
  These stories are just a fraction of the thousands upon thousands of 
stories my staff and I have heard about how the ACA has positively 
impacted people's lives.
  I am asking my colleagues to just take a moment and think about the 
individuals they will be hurting. We are talking about mothers and 
fathers, children, seniors, and even our Nation's veterans.
  As a former lieutenant commander in the U.S. Navy Reserve, I 
understand the tremendous sacrifice our men and women in uniform 
undertake to defend our freedom. I believe we have a duty to honor 
their service to the best of our ability, both during and after 
service.
  Since the passage of the Affordable Care Act, hundreds of thousands 
of uninsured veterans have gained insurance coverage. Between 2013 and 
2015, when key provisions of the Affordable Care Act were implemented, 
such as the Medicaid expansion and the private exchange, the number of 
uninsured veterans decreased by 42 percent. Uninsured rates for spouses 
of veterans and their dependents have decreased as well. These veterans 
represent a small fraction of the individuals this fast-track process 
will hurt.
  I have proposed an amendment that will simply require Republicans to 
show us their plan for providing these veterans the health care 
benefits they deserve before they vote to repeal the ACA and take it 
away. Every American deserves to know what will happen to their health 
benefits before Republicans vote to take them away. Please, just show 
us your plan.
  But our Nation's veterans, who have risked their lives and health to 
keep us safe, should have the right of knowing how Republicans will 
ensure that veterans who gained health care coverage following 
enactment of the ACA do not lose their coverage.
  The damage of repealing the ACA stretches beyond affected individuals 
and families. It will disrupt hospitals and businesses and create 
tremendous economic uncertainty.
  Hospitals in my State, especially rural facilities, are absolutely 
terrified about what the ACA repeal means for them and their ability to 
stay open and to serve patients in their community. Executives from two 
hospitals in the rural Upper Peninsula of Michigan have told my office 
about how coverage expansions under ACA have allowed many critical 
access hospitals in Michigan's rural communities to afford their 
operations for the first time ever. If the ACA is repealed, they tell 
me that these critical access hospitals will be forced to close--
forcing residents in rural communities to drive over 2 hours to seek 
hospital care.
  A recent report by the Urban Institute predicts that if the ACA is 
repealed without replacement, uncompensated care costs sought from 
hospitals and doctors will reach $1.7 trillion over the next 10 years. 
This will

[[Page 481]]

bankrupt many of our Nation's hospitals, killing jobs, and severely 
limiting access for their patients. We can and must do better.
  We owe the American people a better health care system and not a 
bigger deficit. Unfortunately, that is exactly what we are going to be 
getting under repeal. This budget resolution before us would increase 
annual deficits by upwards of $1 trillion. It will add more than $9 
trillion to the Federal debt over 10 years, leaving our entire economy 
on shaky ground, while ripping health care from millions of Americans.
  In their rush to repeal the ACA and fulfill years of campaign 
promises, I am concerned my colleagues on the other side of the aisle 
have not fully considered the far-reaching ramifications their actions 
might have. They have refused to slow this process down and fully think 
through the actions they are about to take.
  A University of Michigan study published in the New England Journal 
of Medicine just last week found that Medicaid expansion in my State 
alone generates at least 30,000 jobs every year. In addition, a recent 
study by the nonpartisan and independent Commonwealth Fund found that 
the ACA repeal could lead to significant economic disruption and 
substantial job losses in every State, including over 100,000 private 
sector jobs in Michigan and 2.6 million jobs around our Nation.
  By any and all means, the level of uncertainty repealing the ACA will 
create is bad business practice, and I assure my colleagues that it is 
very bad for business. We owe it to our constituents to do our 
homework, to govern with facts, and to be informed.
  Republicans have refused to listen to health care experts who tell 
them that enacting a repeal of the ACA will cause insurance premiums to 
skyrocket. Republicans have refused to listen to economists when they 
tell them this will spike our national debt and lead to substantial job 
losses. Republicans have refused to listen when the nonpartisan 
Congressional Budget Office has told them that repealing the Affordable 
Care Act will cause millions of Americans to lose their health 
coverage. And Republicans have refused to listen when actuaries state 
that the ACA repeal will weaken Medicare and increase drug costs for 
seniors.
  Republicans have refused to listen when Democrats have simply asked 
them to slow down, come to the table, and work in a bipartisan way to 
find solutions to make the health care system work even better. 
Instead, Republicans have opted to move full steam ahead with this 
process that will certainly make America sick again.
  Why move forward with this fast-track process to repeal the 
Affordable Care Act? Why repeal all of the great things that Americans 
appreciate about the Affordable Care Act instead of just making it 
better?
  Republicans are trying to take us backwards. They are moving ahead 
with a dangerous process that will hurt working-class Americans, hurt 
seniors, and hurt our Nation's most vulnerable, while providing a huge 
payout for wealthy Americans and special interests.
  Republicans are voting to give billions in tax breaks to corporations 
and the wealthy and raising taxes on the rest of us.
  The nonpartisan Tax Policy Center estimates that the top 1 percent of 
earners would get an average tax cut of about $33,000 and individuals 
in the top one-tenth of 1 percent would get an average tax cut of about 
$197,000. If you are not in this group of American earners, then tough 
luck. This legislation will not help you.
  We need to get serious, put politics aside, and do what is best for 
the American people. This fast track repeal of the Affordable Care Act 
is not the answer.
  I stand ready and willing to work with my colleagues on both sides of 
the aisle to make our Nation's health care system better. We cannot 
simply repeal this law and leave the American people with another empty 
IOU.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Rubio). The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. ENZI. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________