[Congressional Record (Bound Edition), Volume 163 (2017), Part 2]
[Senate]
[Pages 2312-2364]
[From the U.S. Government Publishing Office, www.gpo.gov]




                     EXECUTIVE CALENDAR--Continued

  Mr. McCONNELL. Mr. President, for the information of all of our 
colleagues, including our newest colleague from Alabama, who is going 
to have a very long first day here, if all time is used postcloture on 
the Price nomination, the Senate will have two votes at 2 a.m. Senators 
should be prepared to stay in session and take those votes tonight. If 
an agreement is reached to yield back time and to cast those votes 
earlier, we will notify Members the moment such an agreement might be 
reached.
  I thank my friend from Maryland.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Maryland.
  Mr. CARDIN. Mr. President, the point I was starting with is that in 
Maryland, yes, there are 400,000 people who now have coverage who 
didn't have coverage before, and they are benefiting by being able to 
get preventive health care and get affordable care, but it is all 
Marylanders who are benefiting because there is less use of emergency 
rooms and fewer people who use our health care system who don't pay for 
it, the uncompensated care.
  Many of my colleagues have read letters that they have received from 
constituents, or phone calls, and I am going to do that during the 
course of my discussion. I am going to tell you a story that I heard 
from a 52-year-old who lives in Harford County who frequently used the 
emergency department prior to the adoption of the Affordable Care Act. 
This is what this Harford County resident told me: After the passage of 
the Affordable Care Act, I began working with Healthy Harford Watch 
Program and shortly after was insured. I have been successfully linked 
to community health services and no longer depend upon the emergency 
room as my only source of health care.
  I can give many more accounts of people who had to use the emergency 
rooms and are now getting preventive health care and are getting their 
health care needs met.
  We also now have been able to eliminate the abusive practices of 
insurance companies. As I said, over 2 million people have private 
health insurance in Maryland. They are all benefiting from the 
Affordable Care Act.
  If Mr. Price has his way and we repeal the Affordable Care Act, every 
Marylander will be at risk. They will be at risk because of the 
protections that we put in the Affordable Care Act against abusive 
practices of insurance companies.
  To me, probably the most difficult thing to understand by my 
constituents was the cruel preexisting condition restrictions that were 
placed in the law prior to the Affordable Care Act. Simply put, if you 
had a preexisting condition, the insurance company would restrict 
coverage for that preexisting condition. So exactly what you needed the 
health care system to pay for, your insurance company didn't pay for 
it. They said: Look, you had this heart condition before you were 
insured; we are not going to pay for your heart needs. You had cancer; 
we are not going to pay for your cancer treatment in the future. You 
have diabetes, and that leads to a lot of different health care needs. 
We are going to restrict your insurance coverage and not pay for 
diabetes care. That is a thing of the past with the Affordable Care 
Act.
  Once again, we are now talking about repealing the Affordable Care 
Act. We don't know what it will be replaced with, if at all. Mr. Price, 
in the House, has not given us a satisfactory explanation during the 
confirmation process of how we are going to be able to guarantee that 
everyone who has insurance and everyone who has a need for coverage 
with preexisting conditions will be able to get insurance that won't 
discriminate against that person because of preexisting conditions.
  Another aspect that was an abusive practice before the Affordable 
Care Act is that our insurance policies had caps on how many claims you 
could make in a year over the lifetime of your policy, and that would 
kick in exactly when people who have chronic needs need insurance the 
most.
  Let me give an example. Juanita, who lives in Hyattsville, MD, told 
me about her son. She said her son seemingly was in perfect health, had 
graduated from Harvard with a master's degree and was working at a 
nonprofit. Then he was diagnosed with a rare cardiovascular disorder. 
He didn't know he was going to have that. Well, that required him to 
have multiple operations, and it would have fully exceeded his lifetime 
cap in hospital stays, and he would not have been able to afford the 
care. Thanks to the Affordable Care Act, Juanita's son has full 
coverage. That is another example of a person who is at risk if Mr. 
Price is able to carry out what he said--repeal the Affordable Care 
Act--and we don't have a way to guarantee that insurance companies must 
take all comers and must eliminate the caps that we have seen in the 
policies before.
  Another area which I think has been a pretty popular part of the 
Affordable Care Act and which I heard many of my colleagues on both 
sides of the aisle say they want to keep is allowing 26-year-olds to 
stay on their parents' policies--under 26 years of age. That is a very 
popular provision. I heard many of my colleagues speak in favor of it. 
Remember, when you repeal the Affordable Care Act, that will be 
repealed. Unless we have adequate replacements, unless we have an 
improvement, that is at risk as well.
  I want to talk about another provision that was in the Affordable 
Care Act. I authored the provision. It is called a prudent layperson 
standard for emergency care. Let me take you back before the Affordable 
Care Act. This is why it is important for Congress to be careful as to 
how we pass laws. And if we repeal laws, we can go back to these types 
of practices. Before the Affordable Care Act, if you had chest pains 
and shortness of breath, you would do what I would think any reasonable 
person would do: You would be taken to the emergency room as soon as 
possible to see whether you are having a heart attack. Those are 
classic signs of a heart attack. Yet there were insurance policies that 
said that if you went to a hospital that was out of network, they 
weren't going to pay the full amount even though you went to the 
closest hospital because you had an emergency situation. That makes no 
sense at all, but that was the case.
  You went to the hospital. You did the right thing, and you found out 
you didn't have a heart attack. You went home. You were happy until you 
got the bill, and your insurance company said you didn't need to go to 
the emergency room because you didn't have a heart attack. Then you do 
have a heart attack because you can't pay the bill.
  That was the circumstance that existed before the Affordable Care 
Act, and we put into the Affordable Care Act, for all insurance 
companies, the prudent layperson standard. If it was prudent for you to 
go to the nearest emergency room, your insurance plan must cover that 
cost. That is the standard today, and I wonder whether, if we repeal 
the Affordable Care Act, we will be going back to those types of 
abusive practices.
  Before the Affordable Care Act, women in some circumstances were in

[[Page 2313]]

and of themselves a preexisting condition. Are we going to go back to 
those days?
  Let me go on to another point that worries me about Mr. Price's 
position if we were to repeal the Affordable Care Act, and that is 
affordability. It is one thing to say people can buy insurance--you 
know, there is insurance out there; just buy it. It's another thing 
whether you can afford the insurance coverage.
  One of the benefits of the Affordable Care Act that I don't think has 
been fully explained to the American people is that since the passage 
of the Affordable Care Act, we have been able to keep the growth rate 
of health care costs below what we had seen before the passage of the 
Affordable Care Act. We have reduced costs for all individuals and 
companies that have health policies. The rate of growth has been at a 
slower rate because of the Affordable Care Act. And I have already 
alluded to one of the reasons--we reduced uncompensated care because 
more people are paying their bills. We kept the growth rate down.
  But there are other aspects to the Affordable Care Act that have 
helped bring down the costs, and that is, we have premium tax credits. 
In 2015, 70 percent of those who were enrolled in the Maryland Health 
Connection--that is our exchange in the State of Maryland--received 
some form of a credit. That was provided in the Affordable Care Act. We 
recognize that not everyone can afford the premiums, so we provided 
credits. If you repeal the Affordable Care Act, we may very well not 
have affordable policies for those individuals who have been able to 
get credits under the Affordable Care Act.
  I want to talk about a situation that was brought to my attention at 
several of the roundtable discussions I have held in Maryland with 
interest groups on health care, and that has to do with small 
businesses.
  Before the Affordable Care Act was passed, if I had a forum on small 
businesses--and I did. I have been a member of small businesses and 
entrepreneurship committees since I first came to the Senate. I believe 
in the importance of small businesses. That is where job growth and 
innovation takes place. It is critically important that we help small 
businesses.
  Before the passage of the Affordable Care Act, the No. 1 issue that 
would come up at roundtable discussions I had with small business 
leaders of Maryland was the affordability of health coverage for their 
employees. It is no longer an issue that they talk about because the 
Affordable Care Act has allowed small companies to have competitive 
premium costs with larger companies.
  Before the passage of the Affordable Care Act, if you were a small 
business owner and you had maybe 10 people in your employ on your 
health policy and one of those individuals unfortunately had a major 
health episode during that year, you knew that the next year you were 
going to get a major premium increase because you were rated on your 
own experiences as a small group. That is a thing of the past under the 
Affordable Care Act. Now, under the Affordable Care Act, you are in 
this big pool, and you are not discriminated against because you happen 
to have someone in your employ who needs health care.
  It also enables small business owners to hire people who have 
particular health needs. They are not going to be discriminated against 
because they hire somebody who happens to have the need for health 
insurance. Before that, small companies were very reluctant to hire 
individuals who had health needs because they knew it would affect 
their health policy.
  I want to mention one other factor that is pretty telling. Let me 
read from a letter I received from Nancy of Silver Spring. This is 
something that really gets to me, something I think we have to be very 
careful about, because the repeal of the Affordable Care Act is going 
to hurt our economy.
  Nancy of Silver Spring is a 60-year-old freelance writer/editor and 
depends upon the Maryland Health Connection exchange for her health 
insurance and the tax credit that helps reduce her premium. She is a 
healthy 60-year-old, but no insurance company will write her an 
individual policy, she knows--she tried. One of the big factors that 
helped Nancy get the courage to leave her salaried, full-benefits job 
and go out on her own was the fact that the ACA was right on the 
horizon when she made the leap in 2012.
  Nancy writes:

       You want a world-class work force? How about giving 
     everyone access to affordable health care so we can keep 
     ourselves functioning? You want job creation? How about 
     keeping the ACA so freelancers, gig workers, and startup 
     entrepreneurs don't have to split their energy between the 
     jobs they are creating and some soul-sucking ``day job'' just 
     for the sake of keeping our health insurance?

  This is a real problem. You repeal the Affordable Care Act, people 
become what is known as job-locked. They don't like where they work, 
they know they can do better, but they can't afford to leave and lose 
their health coverage. It may be their spouse, it may be their child, 
may be their self, but they are job-locked because they don't have the 
protection of knowing they can get affordable coverage if they give up 
the insurance they currently have. That hurts our economy. That hurts 
the entrepreneur spirit. That hurts innovation. And it is something 
that is critically important that we solved in the Affordable Care Act.
  Mr. Price talks about the repeal and we will have something to 
replace it with. That is not an easy one to fix. That is not one that 
you can just say we will take care of because you have to have pools 
for individuals in small companies that are competitive. If we don't 
have the type of comprehensive coverage we have under the Affordable 
Care Act, it is very difficult to understand how that can, in fact, be 
done. So that gives me great heartburn with someone who espouses the 
repeal of the Affordable Care Act.
  We have many stories, many letters here from people who literally 
would have had to go through bankruptcy.
  In Laurel, MD, Mark tells me about his son Timmy, who developed a 
rare genetics syndrome called Opitz G/BBB. Timmy's medical expenses 
would have reached his family's lifetime maximum of $1 million when he 
turned 3 months old. When Timmy finally made it home, the ACA covered 
and continues to cover his cost of medical equipment. The law covers 
all of Timmy's specialist appointments, surgeries, and hospital stays.
  Recently, Timmy was sick and coughing up blood. Mark and his wife 
took him to the emergency room without fear that he would incur debt he 
would never be able to pay. Without the Affordable Care Act, Mark's 
family would likely be in bankruptcy.
  Go back before the Affordable Care Act. Look under bankruptcies. Look 
up what the major reason was for bankruptcy. It was people's inability 
to pay their medical bills in the United States of America. That is 
something we don't want to go back to.
  I started my comments by talking about pediatric dental. The 
Affordable Care Act provides essential health benefits so that every 
person who is insured, every person who is in our system, is guaranteed 
certain benefits. That affects nearly 3 million Marylanders who are 
protected by the essential health benefits in the current law. They 
include such things as maternal benefits and newborn health care, 
mental health and addiction.
  Mr. President, you have been the leader of this body on dealing with 
mental health services and addiction services, and I applaud you for 
your efforts, but quite frankly, if we lose the essential health 
benefits, private insurance companies aren't going to cover these 
costs.
  We have an epidemic nationwide on drug addiction. We have seen opioid 
misuse lead to heroin, lead to fentanyl. The death rate in Maryland is 
up about 20 percent every year. We have doubled and quadrupled the 
number of ODs the last 5 or 6 years, and the numbers are still going 
up. We need coverage so that we can, first and foremost, stop people 
from using it in the beginning--an education program, a prevention 
program; we have to do more of that. We also have to keep people alive 
and get them into treatment and save their lives, and the Affordable 
Care Act helps us get that done.

[[Page 2314]]

  You repeal these essential health benefits, I really worry as to 
whether--mental health and drug addiction have never been a priority 
for private insurance companies or, for that matter, the Medicaid 
system. So we have to make sure that we maintain that type of coverage, 
and the repeal of the Affordable Care Act puts all of that at risk.
  One of the areas I worked on very carefully when I was in the House, 
and now in the Senate, was preventive health care services. 
Immunization, cancer screenings, contraception--those types of services 
are critically important. We had a meeting at lunch today. I found out 
that unwanted pregnancies are at a historically low level. Are we going 
to go back to the day where women cannot afford contraceptive services? 
That makes no sense at all. It is counterproductive to what we all 
agree we need to do.
  I want to talk about one or two other issues which I think are 
important which are also in jeopardy with the repeal the Affordable 
Care Act or policies that have been espoused by Mr. Price. One is the 
Medicaid expansion.
  The Medicaid expansion covers our most vulnerable. These are people 
who don't really have a strong voice in our political system. They are 
people who really depend upon us, every one of us in the Senate, to 
protect their health care needs. These are people who are desperate, 
who can't afford health care other than through our medical assistance 
program, the Medicaid Program. Yet there has been talk about block-
granting that program to the States. Have you looked at State budgets 
recently? Do you really believe our States have the financial capacity 
to deal with the Medicaid population without a partnership with the 
Federal government?
  Maryland has been a pretty strong State with Medicaid expansion. My 
Governor is doing the right thing. I am proud of what Maryland has 
done, but if you withdraw the Federal partnership, the Governor doesn't 
have that type of flexibility in the budget to make up the difference. 
It is going to hurt. It is going to hurt our health care system, hurt 
our most vulnerable.
  It has been estimated that a block grant--that by 2019, Maryland will 
lose close to $2 billion. We can't make that up. Would we still cover 
substance abuse under Medicaid? We didn't before. If we don't cover 
that, are we going to now be denying those centers that are located for 
substance abuse? All this is put at great risk.
  We know that Mr. Price, in his fiscal year 2017 budget proposal, 
looked at this proposal, and I believe it was at $1 trillion at that 
time.
  There is a provision in the Affordable Care Act that I authored that 
sets up Offices of Minority Health and Health Disparities within all 
our health departments and sets up the National Institute for Minority 
Health and Health Disparities. We elevated it in the Affordable Care 
Act. I would certainly hope that we would not be repealing that, 
although it is in the Affordable Care Act. But I can tell you that the 
mission of Minority Health and Health Disparities will be severely 
restricted if we repeal the Affordable Care Act or we block-grant the 
Medicaid Program because it is the minority population who had been 
discriminated against historically in our health care system who are 
most at risk.
  I can give you one example of that: our qualified health centers. We 
significantly increase the resources in the qualified health centers as 
part of the Affordable Care Act. I have been to our qualified health 
centers in Maryland, and I have seen that they now have dental services 
that they didn't have before the Affordable Care Act. They now have 
mental health facilities. It is one thing to have third-party coverage 
but another thing to have access to a facility. We know that in rural 
areas, it is very challenging. In poor neighborhoods, it is also 
challenging. Qualified health centers help fill that void.
  I was talking to our qualified health centers in Maryland. I said: 
What happens now if we repeal the Affordable Care Act? They literally 
told me that they can't stay in business because they would lose so 
much of their reimbursement because it is now being reimbursed under 
the Medicaid system because these people enrolled; that it would 
jeopardize their ability to provide the types of services they are 
providing today. So you are not only denying people third-party 
reimbursement, you are denying them access to care by the repeal of the 
Affordable Care Act.
  Lastly, let me talk about our Medicare population. Medicare was part 
of the Affordable Care Act. We don't hear too much talk about that 
today. We extended the solvency of Medicare as a result of the 
Affordable Care Act. We brought down the cost of Part B premiums as a 
result of the Affordable Care Act. And we are closing the doughnut hole 
coverage gap for prescription medicines within the Medicare system. 
Before the Affordable Care Act, how many times would we go to a senior 
center and someone would tell us they didn't pick up their 
prescriptions from the counter because they didn't have the money to 
pay for the cost because they were in the doughnut hole? Well, that is 
coming to an end. It has already closed enough so people are not in 
that vulnerable situation. But it is now coming to an end as a result 
of the passage of the Affordable Care Act.
  So I take this time today because of Mr. Price's nomination. I care 
deeply about the principle Senator Van Hollen talked about and others 
have talked about; that is, health care in America should be a right 
not a privilege. The Affordable Care Act has helped us in achieving 
that.
  Somehow I believe that if we ask the American people, some would say: 
Well, we don't like this ObamaCare, but we like this Affordable Care 
Act. Let us be honest with the American people. Let us recognize that 
this bill has changed the landscape of health care in America for the 
better: reduced costs, extended coverage, more quality coverage, 
insurance companies now have to spend at least 80 percent of their 
premiums on benefits.
  So much of that has been done as a result of the Affordable Care Act. 
Can we do it better? Absolutely. Let's work together, Democrats and 
Republicans, to improve the health care system in this country without 
scaring Americans that they are going to lose the benefits they already 
have.
  For those reasons, I believe Mr. Price does not represent what we 
need, and I will, unfortunately, be voting against his confirmation.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Georgia.
  Mr. PERDUE. Mr. President, I rise tonight actually to support the 
confirmation of my friend and fellow Georgian and our next Health and 
Human Services Secretary, Dr. Tom Price. I have known Dr. Price 
personally and worked with him for quite some time. He is a remarkable 
individual, and we should take comfort in his nomination to this 
important position because he has years of service and years of 
experience working with our Nation's health care system.
  He has been a practicing physician, a state legislator, and a Member 
of the House of Representatives. Dr. Price knows that government 
intrusion has already negatively impacted patient care in the last few 
years. He has years of professional experience as a physician and he is 
seen as a leading voice in health care policy. My colleagues across the 
aisle oppose him, they say primarily because of his opposition to the 
Affordable Care Act. Well, the truth is, ObamaCare is collapsing under 
its own weight today. In my State of Georgia, this year alone, after 
double-digit increases last year, premiums are up 33 percent this year. 
Nationwide, premiums are up 26 percent. So the other side talks about 
it being affordable. People back home--I am getting letters every week 
about the fact that people are withdrawing from ObamaCare because of 
the increase in premiums, and most insidious are the increases in 
deductibles. Some two-thirds increase--67 percent--increase in 
deductibles.
  You know, we don't have to worry about repealing ObamaCare because it 
is collapsing under its own weight. We just have to sit back and watch 
it die of its own volition. Here is how it is going to happen. It is 
very simple. In

[[Page 2315]]

my State, out of 159 counties, we have 99 counties that only have one 
health care provider because of the Affordable Care Act. Even in that 
carrier, there are limited insurance programs available to their 
customers.
  What happens if that carrier decides they cannot profitably afford to 
be in Georgia? Then 99 counties will lose any health care carrier. 
Where do they go? They will be fined under the Affordable Care Act for 
not having insurance. Where do they go? Well, the Federal Government 
has an answer, obviously. The U.S. Government can always step in and be 
the insurer of last resort. Is that not the single-payer strategy that 
was behind this all along? It is not what American mainstream voters 
want.
  The fearmongering that is going on right now about any potential 
repeal is just hypocrisy. I believe there is no question that there is 
a plan. We know there is, but to fix ObamaCare is very difficult 
relatively to the way it was built to begin with. It was based on the 
wrong premise; that is, that the Federal Government is going to step in 
and take care of everybody's health care.
  If you like the Veterans' Administration, you are going to love 
health care done by the Federal Government in the Affordable Care Act. 
By the way, if you like the way the post office is run, you are going 
to love the way the Federal Government runs our health care.
  With all of that in mind, the No. 1 objective of Dr. Price that I 
have heard today and throughout this week has been nothing more than 
the vitriolic argument that he opposes ObamaCare. That is sad. I think 
we are taking a great American who is willing to volunteer and become a 
member of this President's Cabinet and try to make health care better 
for every American.
  I can't think of another person in this country who is more qualified 
for this timely responsibility. Dr. Price will work to end Washington's 
takeover of our health care system, and I know he will work tirelessly 
for a health care system that compassionately improves the lives of 
every American. Truly, there is no one more qualified to serve as our 
next Health and Human Services Secretary than my good friend, Dr. Tom 
Price.
  I am proud to support him. I am glad we are finally grinding our way 
to his confirmation later tonight, but while we talk about his 
confirmation, we also need to talk about this frog walk that the 
opposition is making us go through to get these nominees confirmed in 
this Cabinet. This is taking the longest time to confirm a Cabinet 
since George Washington.
  We see extreme delays, longer delays than we have seen at any time 
since the first President was in office. Imagine if Hillary Clinton was 
President right now. Imagine. Imagine if Republicans in the Senate were 
doing what the people across the aisle are doing today. Imagine if we 
were delaying her Cabinet nominees to the point where we are now 
confirming them at a pace slower than any time since George Washington 
was in office in 1789.
  Imagine. Imagine how the mainstream media would be screaming about 
that story and how it would be a very different story than what is 
being told today. This last week, the Senate demonstrated exactly the 
type of behavior that folks in my home State of Georgia, and I must say 
around the country, are absolutely fed up with and sick and tired 
after.
  They know this is exactly why Washington is gridlocked and why we are 
not getting results for the American people. We are wasting time. 
People are out of work. The other side says this is very real. Of 
course it is very real. It is time to move on. We have a new President. 
Put his team in place. The American people are being hurt by and paying 
attention to this failure of responsibility.
  Real results can only be achieved if Washington politicians 
prioritize the well-being of Americans, rather than their own 
individual political careers and their next election cycle. The 
minority party is well within their rights, of course, to dissent and 
oppose the President's nominees on solid ground. Republicans have done 
that in the past, but at no time in history have we seen this sort of 
frog-walk delay being perpetrated on the people of America.
  They are using the rules of the Senate inappropriately, in my mind, 
to slow down and bring to a halt the confirmation process of a 
President they don't support. No President since George Washington has 
had to endure this sort of historic delay, obstruction, and slow-
walking we have seen here since President Trump was inaugurated.
  If the minority party had its way, all Cabinet-level nominees would 
not be confirmed until June or July of this year. By the way, that is 
one-eighth of the first term of this President--12 percent is being 
wasted right now--if, in fact, the Republican leadership in this Senate 
were not doing what it is doing. The minority party knows it can't stop 
any of these nominees on their own merits individually. So they are 
grinding the entire process to a halt using procedural delays. This is 
a clear abuse, in my mind, of the intent of the rules to protect the 
minority, authored by James Madison. To combat that, the Republican 
leadership has kept the doors of the Senate open 24/7. The people of 
America should know that we are here doing their business and doing 
their bidding to make sure we proceed as fast as we can to the 
confirmation of this President's nominees.
  We have to move past these delays perpetrated by the minority party 
intended to do nothing but to delay the potential impact of this new 
President. It is time to get results. The American people have spoken. 
President Trump has named his team. He is ready to get to work. He is 
already showing that he is willing to move at a business pace, not a 
government pace.
  The people in Washington, looking at this President through the lens 
of the political establishment, are having a hard time dealing with 
him, but I have to say, the quality of nominees is something we have 
not seen for decades, if ever. It is time to put these people in their 
responsible positions and let them go to work. He is already moving at 
a pace that we have not seen in many Presidencies.
  Like me, President Trump came here to focus on getting results and 
changing the direction of the country. He has a plan to do just that. 
We need to get on with that business, debate those issues, come to some 
conclusion, compromise where necessary, but get government moving, as 
the Senate has done for every previous President.
  We should confirm this President's nominees now and spend our time 
debating those critical issues that will get our country moving again, 
to change the direction of our country, to put people back to work. 
Things like growing our economy, updating our antiquated tax system, 
unleashing our full energy potential, updating our antiquated and 
unnecessary regulatory regime, fixing the broken budget process, 
changing our outdated immigration system, saving Social Security and 
Medicare, and, yes, addressing the spiraling health care costs that, 
no, the Affordable Care Act did not even attempt to address.
  The American people elected a new President. That President has named 
his slate of potential nominees to be Cabinet members. It is time to 
cut the foolishness and get down to business.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. WHITEHOUSE. Mr. President, my distinguished friend, Senator 
Perdue, is actually right. There is something unprecedented going on 
around here with these nominations, but it is not the Democratic effort 
to try to make sure that those nominees get a fair hearing and some 
light on them before they get into office.
  What is unprecedented around here with these nominees is, first of 
all, what a hash the Trump administration made of getting them ready. 
They were not ready to go. They were not prepared for the ethics 
reviews. They were dead in the water, and they have a lot of 
responsibility just in terms of the simple incompetence of getting a 
Cabinet ready to go.
  That is not the Senate's fault. The Senate should not roll over in 
its advice and consent role because an executive branch can't prepare 
nominees.

[[Page 2316]]

Then you get behind the incompetence of the executive branch in 
preparing nominees and you start looking at the nominees.
  What else is unprecedented about them is the huge array of conflicts 
of interest they bring. We have never seen anything like this. We call 
it the ``swamp cabinet'' because it is, in fact, swampy with conflicts 
of interest. Many of these candidates have such massive financial 
complexities--because it is billionaire after billionaire after 
billionaire--that they have had to do all sorts of business contortions 
to try to get ready for their appointment.
  That also is not our fault. That actually makes our responsibility 
greater so we can do our constitutional job in the Senate, as providing 
advice and consent, to look at potential conflicts of interest. It is 
part of why we have advice and consent, so we can screen for that. When 
we are not getting disclosure, we can't even do that.
  There are still disclosure gaps for a lot of these nominees. The 
controversy and special interest connections of some of them are, 
frankly, appalling. So there are, indeed, nominees whom we would love 
to stop. If we could stop them, we would do it because we think they 
are going to do damage to the American people; damage to Medicare, 
which seniors rely on; damage to Medicaid, which so many sick kids rely 
on; damage to clean air, which I think everybody tends to rely on if 
they breathe; damage to clean water, which fishermen and sailors and 
people count on across the country. It is not a question here of doing 
the people's business, it is a question of trying to prevent these 
people from giving the people business because this looks like the 
special interest Cabinet of all time. If you go down one by one through 
the civilian Cabinet, you can more or less pick who the most influenced 
special interest is, the one who is most harmful to the American people 
in that particular area, and bingo, there is your nominee. So we should 
not slow down the advice and consent process just for the sake of 
slowing down the advice and consent process, but we should slow down 
the advice and consent process when we are not getting the basic 
information necessary to do our jobs, and we should slow down the 
advice and consent process when we are handing over agencies of 
government to big special interests. Those are two very good reasons to 
have the Senate's noble tradition of advice and consent followed 
scrupulously.
  As to the nominee for HHS, Dr. Price, he is right in that list. He 
has conflicts of interest. He has real harm that he proposes to the 
American public.
  I think Medicare is one of the great things the United States has 
done. It is one of our signal achievements. It has lifted seniors out 
of poverty in a way that very few other countries can match and that 
the United States had never seen before we did Medicare. It is probably 
the most efficient health care delivery system in the United States of 
America, and our seniors count on it and love it.
  That is not good enough for the good Dr. Price, though. He wants to 
voucherize Medicare. What do you do if you are a Medicare patient who 
is elderly and infirm? How do you go shopping for health insurance? I 
can remember when I was quite capable as a fit lawyer, and I was given 
the H.R. forms by the U.S. attorney's office to make my choice. It is a 
complicated mess. And you expect some woman who may be in a hospital 
bed to sort through that? Great job giving her a voucher. It is just so 
unfair and so wrong.
  Medicaid. Children across Rhode Island depend on Medicaid. If you are 
a family and you have a child with a significant illness, you are very 
likely to have that support for that child come through the Medicaid 
Program. This is a man who wants to block-grant Medicare and projects 
trillion-dollar cuts--trillion-dollar cuts? Who is going to make up the 
trillion dollars if we are not taking care of these kids? Is it going 
to go back to the families or the care just isn't going to be there for 
the Medicaid children? That is just wrong.
  These are ideological candidates who want ideological victories that 
will hurt real people like Henry, from Warwick. A woman named Lisa 
wrote to me. She is a teacher and lifelong resident of Warwick, RI. She 
has a son, Henry. Henry was just born last year, and before he was even 
1 month old, Henry was diagnosed with cystic fibrosis.
  Cystic fibrosis, as I am sure we all know, is a genetic disorder. It 
affects more than 30,000 people in the United States, and it is one of 
the crueler diseases on the face of the planet. As cystic fibrosis 
progresses, it can cause infections, it causes difficulty breathing, 
and eventually it renders the child unable to breathe and respiratory 
failure results. There have been important advances and treatment for 
this disease, but there is no cure.
  So Henry needs regular tests and treatment. He will need them for the 
rest of his life as doctors fight to extend his life as long as they 
can in hopes that a cure will arise. His parents are extremely grateful 
for the wonderful work of our doctors at Hasbro Children's Hospital who 
take care of Henry. But Lisa and her husband are also worried about 
their health insurance, and Henry's, because Henry has a preexisting 
condition. If Secretary Price were to have his way, the Affordable Care 
Act would be repealed, and without it there would be no protection for 
people like Henry--a child like Henry with a preexisting condition. 
Either he would face outrageous health care premiums or be denied 
coverage altogether. Since then, having to face the scrutiny of 
confirmation, he has said: Oh, no, that part we are going to try to 
save. But when you go through the parts that my Republican friends are 
going to try to save, you end up with pretty much the whole bill. If 
you are going to try to save every part of the bill, why bother 
repealing it? Why not make it better and move on?
  How irresponsible it was to say, ``Repeal,'' when all these points 
were in it. When repeal was the great mantra, nobody said: ``Repeal. 
Oh, but not that.'' ``Repeal. Oh, but let's protect the seniors from 
the doughnut hole.'' No, it was just ``Repeal ObamaCare. Repeal 
ObamaCare.'' Frankly, chanting ``Repeal ObamaCare'' I think is about as 
disqualifying to lead Medicare and Medicaid as chanting ``Lock her up'' 
would be to be Attorney General of the United States.
  Catherine is a constituent of mine who lives in Cranston. She is a 
breast cancer survivor. She owns a small family business. Her family 
had health insurance before the Affordable Care Act, but their 
insurance company decided that their little company had too few 
employees to qualify as a small business, and it dropped them from 
their coverage. So it was thanks to the Affordable Care Act that 
Catherine and her husband could get affordable and quality health 
insurance through our exchange that we call HealthSourceRI. With this 
coverage, they go on about their business. They don't have to worry 
about whether their insurance company is going to change the rules and 
pitch them out again. Catherine and her husband tell me they don't 
understand how anyone could say they support small business and want to 
repeal the Affordable Care Act.
  Timothy wrote to me. He is a freelance writer in Rumford, RI. He has 
affordable health care for the first time in his life. There is no big 
company to help you if you are a freelance writer; you are on your own. 
But the Affordable Care Act has been there for Timothy. He has multiple 
chronic health conditions that require medication. Before he had 
coverage under the Affordable Care Act, Timothy was hospitalized for a 
heart problem. He couldn't afford the resulting hospital bills. Without 
health insurance, he couldn't pay for his prescriptions. Having health 
insurance, Timothy told me, has changed his life. He feels dignity, he 
feels peace, he feels assurance, and a lot of that is simply the 
reassurance that you can afford the medications you need to stay 
healthy. His chances of having to be hospitalized in the future are 
down. If the ACA is repealed, Timothy may be forced to forgo care that 
he needs, endangering his health, and potentially, by the way, costing 
the system a lot more.

[[Page 2317]]

  Martha, who lives in Cranston, RI, knows well the dangers of being 
uninsured. Before the Affordable Care Act, Martha went several years 
without health insurance, gambling that she could get away with it 
because she couldn't afford it. A gall bladder infection required 
emergency surgery. She was taken to the hospital, the surgery was 
performed. It went well, but she was left with a $60,000 hospital bill. 
Unable to pay the bill, she declared bankruptcy.
  Now she can have coverage, and by the way, when the hospital has to 
do the surgery, it gets paid with her insurance. That is why the 
American Hospital Association and the Hospital Association of Rhode 
Island are saying: Don't repeal ObamaCare. That would be reckless.
  Martha and her husband and her 24-year-old son have all been able to 
purchase insurance through the Rhode Island exchange. By the way, our 
exchange is doing great. People may complain about exchanges in other 
States. We are seeing costs steady; we are seeing costs going down. One 
of our major insurers, Neighborhood Health Plan of Rhode Island, is 
advertising on TV. Whoa. Our rates are going down, and their coverage 
is fine, and Rhode Island is a success story under the Affordable Care 
Act. The $283 per month that Martha and her family now pay in total for 
insurance certainly beats the $500 a month that she and her husband 
each faced for individual coverage before the ACA.
  Paula wrote to me from Cranston about how the Affordable Care Act has 
helped her and her husband bridge the gap until they get to the safe 
haven, finally, of Medicare. Paula is 63 years old. She works part 
time. Her husband who is 64 years old and retired has health insurance 
through our exchange, HealthSourceRI. Paula has beaten breast cancer 
once, but she is at high risk of recurrence.
  If the Affordable Care Act is repealed, Paula would be at risk to 
lose her health insurance and the ability to have tests that would help 
her catch a recurrence of cancer in time. Paula and her husband worked 
hard and saved well, but as Martha's story shows, one illness can wipe 
you out if you don't have health insurance, and they are so content and 
comforted knowing they have a good health insurance plan through our 
exchange.
  Travis is a social worker in Providence. He provides psychotherapy 
and counseling to recovering addicts who are receiving medication and 
assisted treatment. This is a particularly touching point in Rhode 
Island because we lost 239 Rhode Islanders to opioid-related overdoses 
last year. That is 239 fatalities in Rhode Island last year.
  The Affordable Care Act, Travis believes, is the reason that many of 
his patients are actually able to get care and stay away from the risk 
of overdose. He wrote of his patients, many of them never accessed 
methadone treatment prior to the passage of the Affordable Care Act, 
let alone sought treatment for their psychiatric conditions which may 
underlie the substance abuse disorders. By the way, a recent report 
came out that said if you repeal the Affordable Care Act and its 
coverage requirements for mental health and substance abuse, you pull 
about $5.5 billion worth of coverage out from American families. Is 
that really what this Congress wants to be responsible for doing? I 
certainly hope not, not after all the fine statements we heard about 
the Comprehensive Addiction and Recovery Act and the funding for it.
  Let me make one last point because I see the Senator from Michigan 
here and I know she wants to add her thoughts. You can talk about the 
personal stories, and it shows how poignant and important having the 
Affordable Care Act around is in the lives of real actual people, but 
we also have to deal with budget issues in Washington, and I just want 
to show this chart.
  This chart shows the spending projections for Federal health care 
spending. The red line on the top was the projection in 2010 done by 
the CBO, the Congressional Budget Office. In 2010, they said: Here is 
how we think our spending is going to be in Federal health care. They 
predicted that. Then they came back and they did another prediction in 
2017.
  One thing that happened is that after the passage of the Affordable 
Care Act back here, we came in well below predicted expense for Federal 
health care. We saved a lot of money in that period. Then when they 
rebooted the prediction in 2017, they started off actual and they did a 
new prediction right here. The difference in this 10-year period in 
Federal health care costs between what they expected to have happen in 
that 10-year period before the Affordable Care Act came along and what 
experience and the new projections show the savings are since the 
Affordable Care Act are $3.3 trillion--$3.3 trillion--and we have this 
person who wants to be the Secretary who wants to cut the program? We 
are saving money in the program under this. It doesn't make any sense 
fiscally, and it is cruel to the individuals and families who have 
found comfort and peace and security from the Affordable Care Act.
  So I will leave us with that, but if we are going to be responsible 
about doing something about our outyear health care costs, find me 
something else that shows $3.3 trillion in savings during the period of 
2017 to 2027, over 10 years. For these costs, we sometimes look out 30 
years, and that number would grow even greater. We have saved trillions 
of dollars as a result of the Affordable Care Act, and CBO shows it.
  Thank you very much. I yield the floor.
  The PRESIDING OFFICER (Mr. Young). The Senator from Michigan.
  Ms. STABENOW. Thank you very much, Mr. President.
  The decisions made by the next Secretary of Health and Human Services 
will affect all of us, and that is why we are here. That is why we have 
spent so much time and will continue to talk about the issues. This is 
not personal with the individual, this is about everyone in our country 
and how they are impacted by the ideas and the policies of this 
individual as well as the person who has nominated him.
  This particular individual has a very clear record as to what he 
believes should happen as it relates to Medicare and Medicaid, and our 
entire health care system. More than 100 million people rely on 
programs like Medicare--seniors, people with disabilities on Medicare. 
With Medicaid, the majority of money spent through the Medicaid health 
care system goes to seniors in nursing homes. That is where the 
majority of dollars go, long-term care for seniors. So Congressman 
Price's ideas, his proposals, the things he has pushed in the House 
matter because they show us what he believes should happen to Medicaid 
and to Medicare.
  We need to make sure the next Health and Human Services Secretary 
will fight for the health care of families in Michigan--at least I need 
to be sure. That is where my vote goes, based on what is best for 
families in Michigan. That is what is best for our communities, rural 
communities, where the hospital, like where I grew up in Clare, was the 
largest employer in the community, greatly affected and impacted by 
what happens to Medicare and Medicaid funding. If the hospital is not 
there, chances are the doctors aren't there either or the nurses. Our 
larger communities are where, obviously, our hospitals are critically 
important as well.
  So when we look at communities and hospitals and doctors, families, 
children, seniors, and the broad economy--and, by the way, one-sixth of 
the whole economy in our country is connected to health care. So who is 
in charge as Secretary of Health and Human Services is a big deal. That 
is why we have focused so much on this individual, his policies, his 
ideas, and his own background as well.
  As we have gone through the confirmation process, it is clear to me 
that Congressman Price's policies do not--do not--have the best 
interests of the people I represent in Michigan at heart, which is why 
I will be voting no on his confirmation.
  I have heard from thousands of people around Michigan. I have heard 
from people who like our hospitals and live in the community, and 
businesspeople and nurses and doctors with great concerns. I have also 
heard from people

[[Page 2318]]

around the country and have helped to lead a forum for people to come 
and speak, people who were not invited into the actual hearing for the 
confirmation hearing. I thought it was important, as did my Democratic 
colleagues, to have a forum where people could speak about the ideas, 
the bills, the policies that Congressman Price has passed in the House 
of Representatives.
  So we heard a lot of stories and, overwhelmingly, people were opposed 
to this nominee.
  One of the people who shared her story was from Michigan. I was very 
appreciative that she came in from Michigan. Ann was diagnosed with 
multiple sclerosis when she was 4 years old. It resulted in functional 
quadriplegia. She has limited use of her right arm and no use of her 
left arm. She was fortunate to have strong employee benefits and to be 
covered until she went on Medicare at 65. By the way, this nominee 
thinks the age should go up--66 or 67, I am not sure how far. But Ann 
made it to 65 and, like so many people I know, was holding her breath 
to get there so she could have comprehensive quality health care that 
she paid into her whole life called Medicare.
  Over the course of the last few decades, the price of her 
prescription drugs have skyrocketed and would cost her tens of 
thousands of dollars a year without Medicare and Medicaid. For her, the 
decision about our Health and Human Services Secretary makes an 
enormous impact on her life.
  She told us: Without Medicare and Medicaid, things would have been 
very different for my family. I don't know how I could have cared for 
my mom on top of managing my own care. My family would have lost our 
home, all of our savings, trying to keep up with the bills. So many 
families are squeezed like ours, having to afford care for their aging 
parents and their own care, or childcare at the same time. But with 
support, we don't have to suffer to just be alive.
  If these programs are cut, if we see the kinds of proposals on 
Medicare and Medicaid that Congressman Price has put forward in the 
House, in the Budget Committee, people will face more catastrophes than 
ever before.
  Our new President campaigned on a promise not to cut Medicare and 
Medicaid. He said himself: ``I am not going to cut Social Security like 
every other Republican, and I am not going to cut Medicare and 
Medicaid.'' But it doesn't square with the person he has nominated for 
this critical position, who will be making administrative decisions as 
well as leading his efforts on health care. So actions speak louder 
than words, at least that is what we say in Michigan.
  Just this fall, Congressman Price said he expects Medicare to be 
overhauled--overhauled within the first 6 to 8 months of Trump's 
administration. He also believes the age of eligibility needs to 
increase--his words--and that ``the better solution is premium 
support.'' What does that mean? That is another word for voucher. Some 
people say privatization. But basically instead of having an insurance 
card and a health care system where you can go to the doctor and know 
that you are covered with insurance, you get some kind of a voucher or 
an amount of money, and then you would be able to go find your own 
insurance, I guess, or figure out a way to pay for your insurance.
  Before Medicare, seniors were trying to figure that out and couldn't 
find affordable insurance in the private market, which is why, in 1965, 
Medicare was created. There is no way in the world I will support going 
backward to that kind of approach.
  As chair of the Budget Committee, Congressman Price proposed a budget 
that would have cut Medicare by nearly $500 million, not counting what 
he wants to do with Medicaid, the majority of which goes to fund senior 
citizens in nursing homes.
  We need to have a Secretary who supports making it easier and more 
affordable for people to get care, not less.
  Let's talk about health care for a moment in the broader sense. We 
know more and more people--some 30 million people--would be affected, 
their health insurance ripped away, if the repeal is passed that has 
begun--the process has begun by Republicans in the House and in the 
Senate. The Affordable Care Act has provided health care and the 
opportunity for people to get care for children to be able to see a 
doctor. There are parts of the country where we need more competition, 
where prices are too high. I want very much to work on that. I am 
committed to working to make that system better, and we can do that 
without ripping the entire system apart.
  There is also another part of the Affordable Care Act that affects 
every single person with insurance--things that I know have made a 
tremendous difference to anybody with employer-based insurance; first 
of all, being allowed to have your child on your insurance until age 
26; secondly, knowing that if you get sick, you can't get dropped by 
your insurance company, and if you have a chronic disease, something 
has happened to your health, you can't be blocked from getting 
insurance; and we also know things like making sure you can get all the 
cancer treatments your doctor says you need, not just those up to the 
cap that the insurance company will pay for. I had pediatric cancer 
physicians tell me they have been able to save children's lives who 
have cancer because there was no longer a cap on the amount of care.
  Mental health and substance abuse services, where if they were 
covered at all before the Affordable Care Act, it always cost more 
money: higher copays, higher premiums. Now you can't do that. You have 
to have the same kinds of copays and the same kinds of premiums.
  So many patient protections have basically said to insurance 
companies: You don't get, just based on profits, to decide what is 
going to happen; that when you buy insurance, you actually get health 
care. And that is something true for everyone today.
  So we have a Secretary nominee who supports doing away with all that, 
changing all that, who is not someone who is interested in having a 
basic set of services identified in health care, like maternity care. I 
talked with him, questioned him in the Finance Committee. This is an 
area I had championed when we passed the Affordable Care Act to make 
sure that basic services for women were viewed as basic services in 
health care, and it starts with prenatal care and maternity care. Prior 
to the Affordable Care Act, it was very hard to find private insurance 
that covered maternity care, unless you wanted to pay for--some 70 
percent of the plans out in the private market require women to pay 
more. So I asked Congressman Price, did he believe maternity care was a 
basic service and should be covered under basic insurance. He said: 
Well, women can purchase that if they need it, which is exactly what 
happened before--which is, no, it is not basic care, but you can 
purchase it on top of your regular premium, if you need maternity care.
  So right now the law says you can't discriminate and charge women 
more than men, and in fact being a woman is no longer a preexisting 
condition.
  But the person whom the President has nominated for Health and Human 
Services would take us back there, and he would take us back there on a 
whole range of areas that create access for people to be able to have 
the care they need.
  Here is an example from a doctor in west Michigan who wrote me 
regarding just basic medical care for someone in need. He said:

       In December, a young man arrived in our emergency room with 
     a badly mangled hand from a machining accident. He knew the 
     hand was seriously injured and was willing to allow his 
     coworker to bring him into the hospital so that it could be 
     stitched up. When our physician studied the wound, they knew 
     he needed surgery to repair the bone and blood vessel damage. 
     The patient refused, thinking the only thing he could 
     possibly afford was stitches.

  They then connected this man with a financial services specialist who 
took a few minutes to find out that he was eligible for Medicaid, 
working; now, because of the expansion, able to receive health care 
under Medicaid. He was then able to get the surgery he needed.
  Beaumont physicians said that if the surgery hadn't happened, the man 
could have had an open wound for an

[[Page 2319]]

indefinite amount of time, been prone to infection, and possibly lost 
his hand entirely, making him unable to ever work at his job or maybe 
any job again.
  Expanding Medicaid health care to working people is a good idea, and 
millions of people have been impacted and have been able to get the 
care they need for themselves and for their children.
  Access to health care saved this man's arm and possibly his life, and 
that is really what is at stake here, both with this nominee and the 
larger debate on where we are going to go in our great country on the 
whole issue of health care.
  We all know that the advice of the Secretary of Health and Human 
Services will be a strong influence on the President's decision to 
promote, to sign, to veto legislation. We know he has the ability 
administratively to do a number of things--to cut off care, to cut off 
access to women's health care, to change the system that we have now, 
to destabilize it so that the Affordable Care Act will not work. I am 
extremely concerned that because of Congressman Price's record and his 
actual proposals and decisions and votes, he will be willing to 
actually do that. Whether it is cutting Medicare or Medicaid or 
removing some of the critical policies that keep people healthy and 
care affordable, I am deeply concerned about the decisions this nominee 
will make and the recommendations he will make to the President of the 
United States.
  Again, we don't have to speculate about this. He has put these plans 
on paper. He has supported them. He has passed them. It is very clear. 
We don't have to guess where he wants to go: to dismantle Medicare as 
we know it, to gut Medicaid, most of which goes for seniors in nursing 
homes, and to unravel the entire health care system and the patient 
protections that every American who has insurance has right now that 
allow them to get the health care they are actually paying for.
  I need to raise one other thing because this is very serious and goes 
to serious issues surrounding conflicts of interest and likely ethics 
violations that relate to this nominee.
  There are a lot of unanswered questions and serious concerns related 
to Congressman Price's investments in health care and pharmaceutical 
companies. Frankly, he misled the Finance and the HELP Committees with 
answers to questions, and just the night before he was to have a 
confirmation hearing and vote, we learned from company officials that 
he got a privileged offer to buy stock at a discount. In other words, 
he got a special deal on health care stock. He told us he had not; they 
had paid fair market value, even though it was already an issue that he 
had purchased stock and then put legislation in related to similar 
companies or the same companies involved. But then we found out it was 
even worse because he got a special deal.
  As Democrats, we asked for answers. We did not want to move forward 
without asking the Congressman to come back before us so we could ask 
questions about what he had said to the committee versus what the 
business that sold him the stock said afterwards. Unfortunately, that 
did not happen, requiring the Finance Committee to be in a situation 
where the rules ended up being broken and the nomination was forced 
through the committee without having bipartisan participation.
  I have a number of concerns related to the ethics and possible legal 
violations of this nominee. On multiple occasions, he did purchase 
stock within days of introducing legislation that would have affected 
that company's bottom line and his investment. Despite multiple 
requests over several weeks, we still don't have the answers and, more 
importantly, the American people don't have the answers from the person 
who will oversee health insurance, oversee Medicare, Medicaid--the 
entire system. Someone who has invested and then helped the same 
companies indicated he didn't get a special deal, and now we have 
information that says otherwise. I think that is very concerning and 
should have been addressed before we were asked to vote on this 
particular nominee.
  There are a number of reasons--policy, track record, questions that 
have been raised that I find extraordinary that they haven't been 
answered and shocking that folks haven't felt they should be answered 
at this point. But for many reasons, it is my intention to vote no on 
behalf of the people in Michigan who care deeply about a strong, 
effective Medicare system, about making sure Medicaid is there for our 
children as well as our seniors and nursing homes, and for everyone who 
believes that in this great country, all should have the ability to see 
a doctor and get the medical care you need for your child or yourself.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Mr. FRANKEN. Mr. President, my understanding was that the Democratic 
leader wanted to come and speak for 5 minutes between Senator Stabenow 
and myself. But he is not here, so I am going to speak.
  Before I start my remarks that I have prepared, I want to say 
something specifically to the Presiding Officer because he is a new 
Senator from Indiana.
  I read a front-page article in the New York Times just a few weeks 
ago. It featured Indiana University Hospital and the health physicians 
there. It was an article about the savings and the delivery reform that 
have been driven by the Affordable Care Act, things that will be 
staying with us even if this is repealed, which I hope it isn't. But 
this is a quote I would like to read for the Presiding Officer from Dr. 
Gregory Kira, cochief of primary care, Indiana University Health 
Physicians.
  I would ask the Presiding Officer for his attention for a second. 
This is what it says: ```I've been a registered Republican my whole 
life, but I support the Affordable Care Act,' said Dr. Gregory C. 
Kiray, co-chief of primary care for IU Health Physicians, `because it 
allows patients to be taken care of.'''
  I admit, I didn't have 49 others for every State, but I had 
remembered reading this.
  On February 3, 2009, Tom Daschle, President Obama's nominee for 
Secretary of Health and Human Services, withdrew his nomination because 
he hadn't paid his taxes on his car service. On January 9, 2001, Linda 
Chavez, President George W. Bush's nominee for the Department of Labor, 
withdrew her nomination after questions were raised about her decision 
to shelter an undocumented immigrant. Most recently, Vincent Viola, 
President Trump's nominee to be--
  Would the leader like me to yield to him for a few minutes?
  Mr. SCHUMER. That would be great.
  Mr. FRANKEN. Really?
  Mr. SCHUMER. I would appreciate it.
  Mr. FRANKEN. Would that be good for me and my career?
  Mr. SCHUMER. Your career is so great, you don't need me.
  Mr. FRANKEN. Well, I am going to yield to our leader in just a 
moment, when he manages to get there, and it will be the esteemed 
Senator from New York, Charles Schumer. I will narrate as he is 
stepping over there, walking now to the podium--the leader, whom I will 
yield to.
  Mr. SCHUMER. First, let me thank my colleague from Minnesota.
  The PRESIDING OFFICER. The Democratic leader.
  Mr. SCHUMER. And I meant what I said: He doesn't need any help. He 
does it so well on his own. So I will regard this not as a quid pro 
quo--although he can get what he wants--but as an act of kindness and 
generosity.
  Mr. President, I rise this evening to oppose the confirmation of 
Representative Tom Price to be Secretary of HHS and urge my colleagues 
to vote no on his nomination.
  Representative Price might be the quintessence of President Trump's 
Cabinet: a creature of Washington, deeply conflicted, and far out of 
the mainstream when it comes to his views on health care.
  Like other nominees, philosophically he seems completely opposed to 
the very purpose of his Department: the good governance of the health 
programs that cover tens of millions of Americans.

[[Page 2320]]

  Candidate Trump promised he would not cut Medicare or Medicaid, but 
Congressman Price has spent his entire career trying to cut Medicare 
and Medicaid and dismantle the Affordable Care Act. Just listen to 
these quotes:
  The nominee for Secretary of Health and Human Services has said, 
``Nothing has had a greater negative effect on the delivery of health 
care than the federal government's intrusion into medicine through 
Medicare.'' That one might have come out of the 1890s, if we had had 
Medicare then.
  He said he expects lawmakers to push forward with an overhaul of 
Medicare, ``within the first six to eight months'' of this new 
administration. Does that sound like someone who doesn't want to cut 
Medicare and Medicaid? It doesn't to me. It doesn't to the American 
people. In fact, if you could pick someone who in either House of 
Congress was most likely to cut Medicare and Medicaid, you would pick 
Congressman Price. It could not be more of a contradiction to what 
Candidate Trump promised in the campaign.
  So here is what worries me: From what I know of the President, he 
will cede great authority to Cabinet officials, content to jump from 
one topic to the next, one tweet to the next. I would put much greater 
stock in Representative Price's record than anything the President 
promised during the campaign, and that is very bad news for seniors and 
the American people generally.
  For that reason, every American who receives benefits from those 
programs--the millions of American seniors, women, families, and people 
with disabilities--should be gravely concerned about what the tenure of 
a Secretary Tom Price will mean for their health.
  Make no mistake, in the dark hours of the early morning, with the 
confirmation of Secretary Price, the Republicans launch the first 
assault in their war on seniors. The war on seniors begins when we 
select Representative Price over our votes as Secretary of Health and 
Human Services.
  When it comes to the health care of older Americans, confirming 
Representative Price to be Secretary of HHS is akin to asking the fox 
to guard the henhouse. It has been revealed that in his time in the 
House, Representative Price engaged in a number of questionable 
practices related to the trading of stocks in issues that his 
legislation impacted. There are many instances.
  There were reports late last year that Congressman Price had traded 
stocks in dozens of health care companies valued at hundreds of 
thousands of dollars during a time when he introduced, sponsored, or 
cosponsored several pieces of legislation that potentially impacted 
those companies. In one instance, Congressman Price bought shares in a 
medical device manufacturing company just days before introducing 
legislation in the House that would directly benefit that company.
  These were far from isolated incidents. Just yesterday, USA Today 
reported that Congressman Price ``bought and sold health care company 
stocks often enough as a member of Congress to warrant probes by both 
federal securities regulators and the House ethics committee.''
  These allegations alone might be enough to sink a nominee in another 
administration, but it seems this Cabinet is so rife with ethics 
challenges and conflicts of interest that Representative Price's 
conduct in the House doesn't place him too far outside this unethical 
norm. But that should be no excuse. When you are a Congressman or a 
Senator, you must endeavor to avoid even the hint of a conflict of 
interest, let alone a situation where you are actively trading stocks 
that may be impacted.
  So this is a sad evening. The war on seniors by the Trump 
administration begins when we confirm Representative Price. People will 
look back and say that the public war on seniors began at 2 a.m. Friday 
morning when the Senate, unfortunately, confirmed Representative Price.
  I urge my colleagues to vote no.
  I yield the floor and once again thank my colleague.
  Mr. FRANKEN. Thank you, Mr. Leader.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Mr. FRANKEN. Mr. President, I have to start this over fresh. I don't 
know if the Congressional Record needs to have this first half 
paragraph twice, but so be it.
  On February 3, 2009, Tom Daschle, President Obama's nominee for 
Secretary of Health and Human Services, withdrew his nomination because 
he hadn't paid his taxes on his car service. On January 9, 2001, Linda 
Chavez, President George W. Bush's nominee for the Department of Labor, 
withdrew her nomination after questions were raised about her decision 
to shelter an undocumented immigrant. Most recently, Vincent Viola, 
President Trump's nominee to be the Secretary of the Army, withdrew his 
nomination after it proved too difficult for him to distance himself 
from his business ties.
  Congressman Price's conflicted financial investments and his 
affiliation with conspiracy-theory-peddling extremists should be enough 
to disqualify his nomination. On top of that, Congressman Price's 
policy agenda squarely contradicts what the majority of the American 
people want and the key promises President Trump made during his 
campaign. It is, frankly, hard to believe that we are seriously 
considering someone who has advanced policies that would privatize 
Medicare, gut Medicaid, and rip coverage away from millions of 
Americans.
  For all of these reasons, I strongly oppose Congressman Price's 
nomination for Secretary of Health and Human Services.
  Let's take these issues one by one.
  First, Congressman Price's stock trades. Public documents show that 
between 1993 and 2012, Congressman Price owned shares in tobacco 
companies worth tens of thousands of dollars. At the same time, 
Congressman Price voted against landmark legislation in 2009 that gave 
the Food and Drug Administration the authority to regulate tobacco and 
bring down the death toll inflicted by tobacco products. That means 
Congressman Price, a physician who swore to uphold the Hippocratic oath 
of ``do no harm,'' voted against public health and for Big Tobacco. 
This is the person who is slated to become the next Secretary of Health 
and Human Services, someone who personally profited from increased 
sales of deadly, addictive products.
  When asked about this during his hearing in the Health, Education, 
Labor, and Pensions Committee, Congressman Price's best defense was 
that his broker made the stock trades on behalf without his knowledge.
  Here is the problem with that defense:
  First, Congressman Price annually reported his financial holdings, 
signing off on documents acknowledging his investments in tobacco 
companies, meaning that he would have knowledge of the fact that his 
vote to block tobacco regulation could have a direct financial benefit 
to him.
  Second, these were not investments in diversified funds; these were 
individual stocks that he owned for nearly 20 years and that he 
reported paid him dividends. Let me repeat that. Congressman Price, 
medical doctor, owned individual tobacco company stocks that paid him 
dividends.
  Owning tens of thousands of dollars of tobacco stocks while voting to 
help tobacco companies was not Congressman Price's only questionable 
investment. In late December, the Wall Street Journal reported that 
over the past 4 years, Congressman Price has traded stocks worth more 
than $300,000 in about 40 health-related companies while at the same 
time serving on the House Ways and Means Committee, where he drafted 
and cosponsored legislation that could affect his investments.
  Let's talk about one example that is particularly troubling. 
Congressman Price made his largest ever stock purchase in a company 
called Innate Immunotherapeutics, a small biotech company based in 
Australia. This is a company that has only one experimental therapy in 
the early stages of testing, has never generated revenues

[[Page 2321]]

from drug sales. It is not exactly a household name. How did 
Congressman Price get in on this sweetheart deal? He was told about 
Innate by Congressman Chris Collins, who, in addition to being a Member 
of the House of Representatives, serves on the board of directors for 
Innate Immunotherapeutics and is the company's largest shareholder.
  The Wall Street Journal reported that Congressman Price was part of a 
small group of fewer than 20 U.S. investors who participated in the 
private stock sale. The New York Times and the Buffalo News reported 
that many of those people had close ties to Congressman Collins, 
including Collins' chief of staff, a prominent DC lobbyist, and several 
of Congressman Collins' campaign contributors.
  On August 31, Congressman Price reported that as part of this special 
private stock sale, he bought about 400,000 shares of Innate stock for 
as little as 18 cents a share. That same day, the stock was trading on 
the Australian Stock Exchange for the equivalent of 31 cents per share. 
That is a 42-percent difference--42 percent below the market price--and 
Congressman Price now stands to make a profit of more than $200,000. 
That is quite a stock tip.
  Richard Painter, George W. Bush's chief ethics lawyer, describes 
Price's stock trades as ``crazy. . . . We wouldn't have put up with 
anybody in the Bush administration buying and selling health care 
stocks.'' Painter went on to explain that ``if you, as a member of 
Congress, buy and sell health care stocks at the same time you are 
possessing non-public information about that legislation, you are 
taking the risk of being charged with criminal insider trading.''
  Let me repeat that. Mr. Painter, who was George W. Bush's chief 
ethics official, suggested that Mr. Price's actions risk a criminal 
insider trading charge.
  Congressman Price could have directed his broker to stay away from 
tobacco stocks. He could have directed his broker to stay away from 
health care stocks or individual stocks altogether given that health 
care was one of his legislative priorities. But he did not. Why would 
Congressman Price take this risk?
  My colleagues and I have sent Congressman Price a number of letters 
asking for more information about his stock trades and investments. If 
this is all aboveboard, then Congressman Price should have nothing to 
hide. I also submitted questions for the record as a member of the HELP 
Committee. In response to all of these questions, I have received 
nothing. It makes no sense that his nomination has been brought to the 
floor despite his refusal to respond to committee questions.
  Congressman Price has demonstrated a lack of judgment with his stock 
trades and now is stonewalling the committee, refusing to answer our 
inquiries, but Congressman Price's questionable stock trades aren't the 
only area raising red flags.
  My second set of concerns stems from Congressman Price's longstanding 
association with conspiracy-peddling, anti-science extremists. For more 
than 25 years, Congressman Price has been a dues-paying member of the 
Association of American Physicians and Surgeons. He has spoken at the 
organization's conferences and even described the organization's 
executive director as one of his personal heroes. This organization is 
way out of the mainstream. It promotes anti-vaccine pseudoscience and 
denies the scientific fact that HIV causes AIDS. It is an organization 
that blames ``swarms'' of immigrant children for disease and has 
published scientifically discredited theories linking abortion to 
breast cancer. At one point, it even accused President Barack Obama of 
hypnotizing voters with ``neuro-linguistic programming.''
  Let me repeat that. It accused President Barack Obama of hypnotizing 
voters with ``neuro-linguistic programming.''
  That is not all. The statement of principles for the Association of 
American Physicians and Surgeons has an entire section devoted to 
urging doctors to refuse to participate in Medicare, in which it says 
the effect of such government-run programs is ``evil, and participation 
in carrying out his provisions is, in our opinion, immoral.'' 
Congressman Price--the person poised to become the next Secretary of 
Health and Human Services, the person responsible for leading 
Medicare--has been an active, engaged member of this organization for 
25 years.
  Just in case you don't think he has bought into these ideas, let me 
read you what Congressman Price wrote in 2009 in an op-ed: ``I can 
attest that nothing has had a greater negative effect on the delivery 
of health care than the federal government's intrusion into medicine 
through Medicare.''
  Since Congressman Price will not answer my questions, I will pose 
this to one of my Republican colleagues: How are the American people 
supposed to trust Congressman Price as Secretary of Health and Human 
Services given that he has belonged to an organization for over 25 
years that has such blatant disregard for science and a propensity for 
putting partisanship and ideology above evidence?
  Lastly and most importantly, the policy reforms that Congressman 
Price has put forward are so extreme that they should be disqualifying 
in and of themselves. As an editorial recently published in the New 
England Journal of Medicine stated, ``As compared with his 
predecessors' actions, Price's record demonstrates less concern for the 
sick, the poor, and the health of the public and much greater concern 
for the economic well-being of their physician caregivers.'' That is 
from the New England Journal of Medicine.
  Mr. President, I ask unanimous consent to have the article printed in 
the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

       [From the New England Journal of Medicine; Jan. 12, 2017]

Care for the Vulnerable vs. Cash for the Powerful--Trump's Pick for HHS

        (By Sherry A. Glied, Ph.D. and Richard G. Frank, Ph.D.)

       Representative Tom Price of Georgia, an orthopedic surgeon, 
     will be President-elect Donald Trump's nominee for secretary 
     of health and human services (HHS). In the 63-year history of 
     the HHS Department and its predecessor, the Department of 
     Health, Education, and Welfare, only two previous secretaries 
     have been physicians. Otis Bowen, President Ronald Reagan's 
     second HHS secretary, engineered the first major expansion of 
     Medicare, championed comparative effectiveness research and, 
     with Surgeon General C. Everett Koop, led the fight against 
     HIV-AIDS. Louis Sullivan, HHS secretary under President 
     George H.W. Bush, focused his attention on care for 
     vulnerable populations, campaigned against tobacco use, led 
     the development of federally sponsored clinical guidelines, 
     and introduced President Bush's health insurance plan, which 
     incorporated income-related tax credits and a system of risk 
     adjustment. In their work at HMS, both men, serving in 
     Republican administrations, drew on a long tradition of 
     physicians as advocates for the most vulnerable, defenders of 
     public health, and enthusiastic proponents of scientific 
     approaches to clinical care.
       Tom Price represents a different tradition. Ostensibly, he 
     emphasizes the importance of making our health care system 
     ``more responsive and affordable to meet the needs of 
     America's patients and those who care for them. But as 
     compared with his predecessors' actions, Price's record 
     demonstrates less concern for the sick, the poor, and the 
     health of the public and much greater concern for the 
     economic well-being of their physician caregivers.
       Price has sponsored legislation that supports making armor-
     piercing bullets more accessible and opposing regulations on 
     cigars, and he has voted against regulating tobacco as a 
     drug. His voting record shows long-standing opposition to 
     policies aimed at improving access to care for the most 
     vulnerable Americans. In 2007-2008, during the presidency of 
     George W. Bush, he was one of only 47 representatives to vote 
     against the Domenici Wellstone Mental Health Parity and 
     Addiction Equity Act, which improved coverage for mental 
     health care in private insurance plans. He also voted against 
     funding for combating AIDS, malaria, and tuberculosis; 
     against expansion of the State Children's Health Insurance 
     Program; and in favor of allowing hospitals to turn away 
     Medicaid and Medicare patients seeking nonemergency care if 
     they could not afford copayments.
       Price favors converting Medicare to a premium-support 
     system and changing the structure of Medicaid to a block 
     grant--policy options that shift financial risk from the 
     federal government to vulnerable populations. He also opposed 
     reauthorization of the Violence Against Women Act and has 
     voted against legislation prohibiting job discrimination 
     against lesbian, gay, bisexual,

[[Page 2322]]

     and transgender (LGBT) people and against enforcement of laws 
     against anti-LGBT hate crimes. He favors amending the 
     Constitution to outlaw same-sex marriage.
       In addition, he has been inconsistent in supporting 
     investments in biomedical science. He opposes stem-cell 
     research and voted against expanding the National Institutes 
     of Health budget and against the recently enacted 21st 
     Century Cures Act, showing particular animus toward the 
     Cancer Moonshot.
       Price has also been a vociferous opponent of the Affordable 
     Care Act (ACA) and a leader of the repeal-and-replace 
     movement. His proposal for replacing the ACA is H.R. 2300, 
     the Empowering Patients First Act, which would eliminate the 
     ACA's Medicaid expansion and replace its subsidies with flat 
     tax credits based on age, not income ($1,200 per year for 
     someone 18 to 35 years of age; $3,000 for someone 50 or 
     older, with an additional one-time credit of $1,000 toward a 
     health savings account). Price's plan is regressive: it 
     offers much greater subsidies relative to income for 
     purchasers with high incomes and much more meager subsidies 
     for those with low incomes. In today's market, these credits 
     would pay only about one third of the premium of a low-cost 
     plan, leaving a 30-year-old with a premium bill for $2,532, 
     and a 60-year-old with a bill for $5,916--along with a 
     potential out-of-pocket liability of as much as $7,000. By 
     contrast, subsidies under the ACA are based on income and the 
     price of health insurance. Today, a low-income person (with 
     an income of 200% of the federal poverty level) pays, on 
     average, a premium of $1,528 per year (regardless of age) for 
     a plan with an out-of-pocket maximum of $2,350, and that 
     payment does not change even if health insurance premiums 
     rise.
       To put the plan's subsidies into perspective, consider that 
     in 1992, when per capita health expenditures were just one 
     third of what they are today, President Bush and HHS 
     Secretary Sullivan proposed a slightly larger individual tax 
     credit ($1,250) for the purchase of insurance than Price 
     proposes today. Even in 1992, analysts reported that the 
     credit would be insufficient to induce most people to buy 
     coverage.
       The Price plan would eliminate the guaranteed-issue and 
     community-rating requirements in the ACA and create anemic 
     substitutes for these commitments to access to comprehensive 
     coverage for Americans with preexisting conditions. These 
     replacements include an extension to the nongroup market of 
     the continuous-coverage rules that have long existed in the 
     group market with little benefit; penalties on reentering the 
     market for anyone who has had a break in coverage; and a very 
     limited offer of funding for states to establish high-risk 
     pools. In combination with relatively small tax credits, 
     these provisions are likely to lead low-income and even 
     middle-class healthy people to forgo seeking coverage until a 
     serious health problem develops. Without the income- and 
     premium-based subsidies in the ACA acting as market 
     stabilizers, Price's provisions would erode the non-group 
     health insurance market.
       Price's plan would withdraw almost all the ACA's federal 
     consumer-protection regulations, including limits on insurer 
     profits and requirements that plans cover essential health 
     benefits. By allowing the sale of health insurance across 
     state lines, the plan would also effectively eliminate all 
     state regulation of health insurance plans, encouraging a 
     race to the bottom among insurance carriers. Finally, Price 
     would fund his plan by capping the tax exclusion for 
     employer-sponsored health insurance at $8,000 per individual 
     or $20,000 per family. These caps are well below those 
     legislated through the Cadillac tax in the ACA, a provision 
     that Price himself has voted to repeal.
       In sum, Price's replacement proposal would make it much 
     more difficult for low-income Americans to afford health 
     insurance. It would divert federal tax dollars to people who 
     can already buy individual coverage without subsidies and 
     substantially reduce protections for those with preexisting 
     conditions. The end result would be a shaky market dominated 
     by health plans that offer limited coverage and high cost 
     sharing.
       Whereas Price's actions to date have not reflected the 
     tradition of the physician as advocate for the poor and 
     vulnerable, they do harken back to an earlier tradition in 
     American medicine: the physician advocate as protector of the 
     guild. His Empowering Patients First Act would directly 
     advance physicians' economic interests by permitting them to 
     bill Medicare patients for amounts above those covered by the 
     Medicare fee schedule and allowing them to join together and 
     negotiate with insurance carriers without violating antitrust 
     statutes. Both these provisions would increase physicians' 
     incomes at the expense of patients. Price has consistently 
     fought strategies for value-based purchasing and guideline 
     development, opposing the use of bundled payments for lower-
     extremity joint replacements and proposing that physician 
     specialty societies hold veto power over the release of 
     comparative effectiveness findings. These positions reduce 
     regulatory burdens on physicians at the cost of increased 
     inefficiency and reduced quality of care--and reflect a 
     striking departure from the ethos of his physician 
     predecessors, Secretaries Bowen and Sullivan.
       The HHS Department oversees a broad set of health programs 
     that touch about half of all Americans. Over five decades and 
     the administrations of nine presidents, both Democratic and 
     Republican secretaries have used these programs to protect 
     the most vulnerable Americans. The proposed nomination of Tom 
     Price to HHS highlights a sharp contrast between this 
     tradition of compassionate leadership and the priorities of 
     the incoming administration.

  Mr. FRANKEN. This article cites his votes against mental health 
parity--think about what that means in terms of treatment during this 
opioid crisis--against funding for AIDS, malaria and tuberculosis, 
against the expansion of the State Children's Health Insurance Program, 
against tobacco regulation, against the reauthorization of the Violence 
Against Women Act, and more.
  Price has also been a champion of efforts to repeal the Affordable 
Care Act. The Congressional Budget Office recently estimated that if 
the ACA is repealed, nearly 20 million Americans will lose their health 
care coverage immediately, with the number growing to 32 million over 
the next 10 years, and 300,000 of those individuals live in my State of 
Minnesota. Let me tell you about at least two of them.
  Leanna has a 3-year-old son named Henry. Henry has been diagnosed 
with acute lymphoblastic leukemia, and his treatment will last at least 
until April of 2018. Henry often needs around-the-clock care to manage 
his nausea, vomiting, pain, and sleepless nights. This is a 3-year-old 
boy. Henry's immune system is so compromised that he is not supposed to 
go to daycare. So Leanna left her job to take care of him. Leanna's 
family is supported by her spouse, but they couldn't pay for Henry's 
treatment on one salary. Leanna says:

       It is because of the ACA that Henry gets proper health 
     care. Henry can get therapy and the things he needs to 
     maintain his health and work toward beating cancer. Henry is 
     still with us because of the ACA.

  Let me say that again: ``Henry is still with us because of the ACA.''
  I have asked Republicans repeatedly to show me the plan they have to 
make sure Leanna and her son Henry and the hundreds of thousands of 
Minnesotans who have gained coverage don't lose the care they need. I 
have yet to see their plan. What I have seen Congressman Price advocate 
for so far is pretty awful. His proposals would strip away coverage for 
people with preexisting conditions, strip away preventive health 
benefits, strip away protections from annual and lifetime limits, strip 
away coverage for young adults. Moreover, Congressman Price views 
Medicaid and Medicare as government expenditures to be cut, rather than 
lifelines to millions of seniors, disabled populations, children and 
families. As chairman of the House Budget Committee, Congressman Price 
introduced proposals to cut funding for Medicaid by more than $2 
trillion.
  In my State, Medicaid provides health insurance to 14 percent of the 
residents. That includes two out of five low-income individuals, one in 
four children, one in two people with disabilities, and one in two 
nursing home residents. Think about that. One in two people in nursing 
homes are covered by Medicaid in my State.
  What is going to happen to these people--our parents, our children, 
our spouses, our families--if Congressman Price and his colleagues 
succeed in slashing Medicaid's budget? I can guarantee you, it will not 
be kind and it will not be just and Americans are going to lose out.
  Congressman Price's assault on our health care system doesn't end 
there. He wants to slash Medicare's budget by hundreds of billions of 
dollars, undermining our basic guarantee of coverage to our Nation's 
seniors, and no wonder. Let me remind you, this is the same person who 
wrote: ``I can attest that nothing has had a greater negative effect on 
the delivery of health care than the Federal government's intrusion 
into medicine through Medicare.''
  Do we really want the person who wrote this to be running Medicare? 
Price's determination to gut Medicaid and Medicare is directly opposed 
by the vast majority of Americans and in direct opposition to President 
Trump's

[[Page 2323]]

campaign promise never to cut Medicaid or Medicare.
  When Tom Daschle withdrew from consideration for HHS Secretary, he 
talked about the challenges of health care reform and said:

       This work will require a leader who can operate with the 
     full faith of Congress and the American people, and without 
     distraction. Right now, I am not that leader, and will not be 
     a distraction.

  So I say to Congressman Price, you do not have the full faith of the 
Congress, and you do not have the full faith of the American people. 
You are not the leader this country needs, and you should not be a 
distraction. Since you have not withdrawn your nomination, I urge my 
colleagues to do the right thing and oppose this controversial 
nomination.
  I yield the floor to my colleague from Hawaii.
  The PRESIDING OFFICER. The Senator from Hawaii.
  Ms. HIRONO. Mr. President, I rise to address the deep anxiety in 
Hawaii and across the country about President Trump's choice to lead 
the Department of Health and Human Services, HHS, Congressman Tom 
Price.
  I am particularly concerned about this nominee because of the mixed 
messages President Trump has been sending about health care. During the 
campaign, President Trump promised to protect Medicare and Medicaid. 
Yet he has nominated Congressman Price to head HHS. Congressman Price 
has led the effort to privatize Medicare and dismantle Medicaid in the 
U.S. House. This is hardly someone who would protect Medicare and 
Medicaid.
  Shortly before taking the oath of office, President Trump said he 
supported the concept of universal coverage. He said:

       We are going to have insurance for everybody. They can 
     expect to have great health care.
  Yet he nominated Congressman Price, who has spent the past 6 years 
trying to end universal health care coverage by repealing the 
Affordable Care Act.
  President Trump says a lot of things. He tweets his thoughts daily, 
but at this point, instead of listening to what President Trump says, 
we should pay attention to what he does. By nominating Congressman 
Price, the President demonstrated he does not intend to protect access 
to quality, affordable health care for all Americans--not by protecting 
Medicare and Medicaid, not by protecting health insurance fraud. 
President Trump's health care agenda would have far-reaching, negative, 
painful consequences for tens of thousands of people in Hawaii and 
millions all across the country. Maybe President Trump should tweet 
less and listen more.
  Over the past few months, I have heard from thousands of Hawaii 
residents concerned that they will no longer be able to afford health 
care if President Trump succeeds in repealing the Affordable Care Act 
and privatizing Medicare. I would like to read a few of the messages I 
have received.
  Catherine from Honolulu wrote:

       I am writing to you to express serious concern over the 
     repealing of ACA and other health insurance changes. As a 
     working (teacher) and single parent of two young children I 
     am very afraid for our future. I am afraid my insurance will 
     not cover my psoriatic arthritis if I change jobs, they 
     change companies, or for some reason I should lose my job or 
     coverage. My medicine without insurance would cost more than 
     my mortgage payment, and would thus be cost prohibitive.
       If I don't have my medication I would be in so much pain. I 
     would be unable to work and would therefore lose my insurance 
     which would mean I would never be able to get coverage 
     because of a preexisting condition. I am certain there are 
     many other people out there with similar stories.
       Please do everything you can to make sure this scenario 
     doesn't happen to us. If there is anything I can do, please 
     don't hesitate to let me know. I just don't know who else to 
     turn to.

  Next, I would like to share a note I received from Julie from 
Papaaloa on the Big Island.

       My husband and I are on Medicare, together with a 
     supplemental plan. We are totally dependent on Social 
     Security for our income and Medicare for our health plan. 
     Many millions of seniors are in the same situation as we are. 
     Please continue to fight for us as this abominable horror of 
     an administration goes forward. I shudder to think what would 
     happen if these programs are repealed or privatized.

  Finally, I would like to share a heartbreaking story from Desi from 
Mililani on Oahu. Desi is an extremely hard-working, self-employed 
teacher and the single mother of two daughters. Her youngest daughter 
has Down syndrome, autism, and is hearing impaired. Desi is self-
employed because she needs the flexibility to work and care for her 
daughter. This year, as a sole proprietor over the age of 55, Desi's 
premiums for her HMO plan rose to over $680 per month for 2016.
  In a letter she wrote to me, Desi said:

       Paying this high monthly premium was no longer possible and 
     was jeopardizing our family's ability to pay our mortgage, 
     food, and other essentials alone.

  Desi successfully found a cheaper plan in the ACA marketplace for 
2017. In her letter she went on to say:

       If the ACA is successfully repealed, we will no longer be 
     able to afford medical coverage! Families like ours are the 
     reasons why it is so important to defend the Affordable Care 
     Act.

  These letters and stories demonstrate what is at stake for our 
200,000 seniors on Medicare in Hawaii and millions more across the 
country. That is why I will continue to fight tooth and nail to prevent 
any cuts that would jeopardize our crucial social safety net progress.
  The fight has already begun. Last month, Republicans in Congress 
pushed through a partisan budget resolution that would give them the 
tools they need to repeal the Affordable Care Act. This assault on the 
Affordable Care Act is also an assault on Medicare and Medicaid because 
the ACA strengthened Medicare and Medicaid through, for example, 
closing the prescription doughnut hole and providing free preventive 
checkups for seniors. This is why I joined with my colleague from 
Indiana, Senator Donnelly, to introduce an amendment that would block 
congressional Republicans from privatizing Medicare or increasing 
eligibility standards for Medicare. It would also prevent changes that 
reduce funding for Medicaid.
  During the debate on our amendment, one of our Republican colleagues, 
in his opposition to the amendment, basically made our point for us. He 
said something to the effect of, a vote in favor of our amendment to 
protect Medicare and Medicaid is a vote against repealing the 
Affordable Care Act. Exactly. In the end, it was a close vote on our 
amendment. While the amendment lost, I was encouraged that two of our 
Republican colleagues, Senator Heller of Nevada and Senator Collins of 
Maine, voted in favor of the amendment.
  In the coming weeks and months, there will be other battles to 
protect Medicare and Medicaid. It is going to be a daunting fight, but 
I am not going to shy away from it. I am going to do whatever I can, 
whenever I can to protect the Affordable Care Act, Medicare, and 
Medicaid. In this fight, I strongly urge my colleagues to vote no on 
Tom Price's nomination to serve as Secretary of Health and Human 
Services. Tom Price is not the champion that millions of people in our 
country are counting on to protect their health and welfare.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. MENENDEZ. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                          Travel Ban Decision

  Mr. MENENDEZ. Mr. President, I have come to the floor to speak on the 
nomination of Congressman Price to be the Secretary of Health and Human 
Services. But before I do, I must speak to the decision that the U.S. 
Court of Appeals for the Ninth Circuit just decided in the case of the 
State of Washington and the State of Minnesota v. the President and the 
Department of Homeland Security.
  I am pleased to see that the courts of the United States are still 
part of the separate coequal branch of government that the Founders 
dictated when they

[[Page 2324]]

ultimately created an ingenious document, the Constitution of the 
United States, which served the Nation well for so long, even though it 
seems the President may need a review of history and an understanding 
of the Constitution as it relates to the separate coequal branches of 
government, because he seems to be willing to try to disparage the 
judiciary in an effort to try to either effect their decisionmaking or 
to call into question the legality of their decisions or the 
righteousness of their decisions.
  I am glad to see that that has not affected our judicial system. I 
just want to read some elements of the court's decision, which I think 
are pretty extraordinary. Of course, this is far from a final decision 
on the merits, but it was on a motion for a stay of the order of the 
district court that said, basically, that the Muslim ban could not be 
continued to be enforced.
  The court said--and I am quoting--in a unanimous opinion which speaks 
very powerfully to their decision:

       We therefore conclude that the States--

  Meaning the State that brought forth--Washington, as well as the 
State of Minnesota--

     that the States have alleged harms to their proprietary 
     interests traceable to the Executive Order. The necessary 
     connection can be drawn in at most two very logical steps: 
     (1) the Executive Order prevents nationals of seven countries 
     from entering Washington and Minnesota; (2) as a result, some 
     of these people will not enter state universities, some of 
     them will not join those universities as faculty, some will 
     be prevented from performing research, and some will not be 
     permitted to return if they leave.
       We therefore hold that the States have standing.

  That was one of the critical legal bars.
  Secondly, they opined on the reviewability of the Executive order. 
This is, I think, extraordinarily important. The Court went on to say--
I am paraphrasing at this point: Yes, the courts owe substantial 
deference to the immigration and national security policy 
determinations of the political branches--legislative and executive. 
But it went further to say:

       Instead, the Government has taken the position--

  This is on behalf of the executive branch--

     that the President's decisions about immigration policy, 
     particularly when motivated by national security concerns, 
     are unreviewable--

  Unreviewable--

     even if those actions potentially contravene constitutional 
     rights and protections. The Government indeed asserts that it 
     violates separation of powers for the judiciary to entertain 
     a constitutional challenge to executive actions such as this 
     one.

  I did not really capture that the government had made that argument. 
But that is an extraordinary argument. The court went on to say:

       There is no precedent to support this claimed 
     unreviewability, which runs contrary to the fundamental 
     structure of our constitutional democracy. Within our system, 
     it is the role of the judiciary to interpret the law, a duty 
     that will sometimes require the ``[r]esolution of litigation 
     challenging the constitutional authority of one of the three 
     branches.'' We are called upon to perform that duty in this 
     case.

  Further they say: ``Although our jurisprudence has long counseled 
deference to the political branches on matters of immigration and 
national security, neither the Supreme Court nor our court has ever 
held that courts lack the authority to review executive action in those 
arenas for compliance with the Constitution.''
  That is an extraordinary set of statements that the government made, 
saying that the President's actions are unreviewable in this regard.
  They further go on to say: ``Nonetheless, `courts are not powerless 
to review the political branches' actions' with respect to matters of 
national security.''
  It would indeed be ironic if, in the name of national defense, we 
would sanction the subversion of one of those liberties which make the 
defense of the Nation worthwhile.
  Well, I fully agreed with the circuit court's determination in that 
regard.
  It goes on to say: ``In short, although courts owe considerable 
deference to the President's policy determinations with respect to 
immigration and national security, it is beyond question that the 
Federal judiciary retains the authority to adjudicate constitutional 
challenges to executive action.''
  Well, all I can say is, thank God. Thank God that the courts of the 
United States feel that they are not controlled by the executive branch 
in pursuing the decisions that are made. This is a great day for 
democracy in our country and for the preservation of the separation of 
powers. This is a great day, I think, from my own perspective, that a 
ban that does not help the United States but harms us and is against 
every fiber of our being and the nature of the history of our Nation, 
which was founded by those fleeing religious persecution--ultimately, 
today, we restore that sense of our history, and we restore who we are 
as a nation both at home and across the world.
  But today's decisions in this regard are also important as we 
consider the nomination of Congressman Price, so I want to rise today, 
along with so many of my colleagues, to voice my strong opposition to 
the confirmation of Congressman Price to be the Secretary of Health and 
Human Services.
  I am deeply concerned about his views on what is the core mission of 
Health and Human Services, not only his career-long opposition to the 
very existence of Medicaid and Medicare but his wavering fidelity in 
science and his regressive views of women's health care and the social 
safety net.
  The Secretary of Health and Human Services is one of the few Cabinet 
positions that affect virtually every single man, woman, and child in 
America. It affects the health care of 56 million seniors on Medicare, 
of 74 million low-income individuals and children on Medicaid, and of 
12 million Americans who have enrolled in the Affordable Care Act 
coverage. But more than that, the Department of Health and Human 
Services is home to the world's leading institutions of research at the 
National Institutes of Health, of advancing public health and 
epidemiology at the Centers for Disease Control and Prevention, known 
worldwide, of working to ensure that we have access to the most 
advanced, most effective, and safest medications at the Food and Drug 
Administration, and many other critical departments and agencies that 
we as Americans rely on.
  Many of our Republican colleagues have pointed out that Congressman 
Price's history as an orthopedic surgeon is enough evidence that he is 
someone who should be in charge of the Department of Health and Human 
Services. I can't speak to his credentials and qualifications in the 
operating room, but I do have a constitutional obligation to speak 
about his credentials and qualifications to be the Secretary of Health 
and Human Services. So I can say without hesitation that his career in 
Congress and his positions on key issues of policy have proven to me 
that he is not the right person for the job.
  Throughout his time as a congressman--most recently as the chairman 
of the House Budget Committee and during his confirmation process 
through the Senate Finance Committee, on which I am privileged to 
serve--it has become abundantly clear that Congressman Price views 
patients, including seniors on Medicare and even those with private 
employer coverage, as nothing more than a source of revenue or a budget 
line item. The characteristics that had defined Congressman Price's 
career run contrary--contrary--to the fundamental mission of the 
Department of Health and Human Services, and it should be a cause for 
concern across the aisle and across the country.
  Despite the alternative reality portrayed during his confirmation 
hearings in both the Finance Committee and the Health, Education, 
Labor, and Pensions Committee, Congressman Price's vision for our 
Nation's health care system has been laid bare for the public to see 
for years. All one has to do is look at the legislation he has 
introduced and the radical budget proposals he, along with Speaker 
Ryan, has been pushing through the House of Representatives. Let's look 
at some of them.

[[Page 2325]]

  Let's start by taking a look at his plan for Medicare, which is, by 
all intents and purposes, a plan to fundamentally end Medicare as we 
know it, end Medicare as we know it. Despite Congressman Price's 
seeming denial of this fact, when I asked him about it directly during 
his confirmation hearing, there is absolutely no other way to 
characterize his plan: It ends Medicare as we know it.
  Currently and for more than 50 years, Medicare has provided a 
guarantee--a guarantee; that word is critical--to seniors that they 
will have coverage, access to care, and the ability to rest assured 
that their health care needs will be taken care of. It is a system into 
which they paid their entire working lives and a compact that has been 
made with the Federal Government that we will uphold our end of the 
deal and ensure that they have quality coverage to stay healthy.
  The Affordable Care Act, despite the years-long gnashing of teeth and 
fake tears shed by some of my Republican colleagues, has improved upon 
this deal and made Medicare stronger. It has extended the life of the 
Medicare trust fund by more than a decade. It has saved seniors $27 
billion on prescription drugs and last year alone provided more than 40 
million seniors access to no-cost preventive services--no-cost 
preventive services. In my home State of New Jersey last year, seniors 
on Medicare saved more than $263 million on prescription drugs, and 
nearly 1 million seniors were able to receive free preventive services.
  Additionally, thanks to the law's health care delivery system 
reforms, we are seeing far fewer hospital-acquired conditions and 
greater coordination of care that has resulted in a healthier 
population and a more efficient health care delivery system. That 
reality stands in stark contrast to Tom Price's vision of what he 
thinks Medicare should be and in stark contrast with the vast majority 
of seniors who want to protect the program for their loved ones and for 
themselves.
  Unfortunately, President Trump, who himself spent an entire campaign 
promising that he is ``not going to cut Medicare or Medicaid,'' 
nominated a leading member of this radical anti-Medicare movement to 
impose devastating cuts to the program, force seniors to pay higher 
costs, and lower the quality of care throughout the health care system.
  Congressman Price's destructive legislative history on Medicare does 
not lie. It is there. It is in the record. It is there for anybody who 
wants to see it. It tells a stark truth about his desire to increase 
the eligibility age, about ending the guarantee--the guarantee of 
coverage.
  You know, that is why we call it an entitlement. If you meet the 
criteria under the law, you are entitled to those health care services; 
you are guaranteed those health care services. But his whole 
legislative history is about ending the guarantee of coverage we 
currently have and replacing it with the possibility of coverage. The 
difference between a guarantee and a possibility is a far, far too 
significant gulf to be able to overcome--but only if you can afford the 
difference between Congressman Price's coupon and the actual cost of 
care under his vision. The Congressional Budget Office has shown that 
this will unquestionably increase costs for seniors.
  His dark view of Medicare, that--to quote Congressman Price--
``nothing has a greater negative impact on . . . health care than the 
Federal Government's intrusion . . . through Medicare''--that is an 
extraordinary statement. I am going to quote it again. ``Nothing has a 
greater negative impact on . . . health care than the Federal 
Government's intrusion''--intrusion, mind you--``through Medicare.'' 
That is understandably causing a lot of concern back home in New 
Jersey. Many people have been calling and writing me to express their 
thoughts.
  Dr. William Thar of Summit, NJ, himself a retired physician of more 
than 50 years, wrote in that Price's ``willingness to privatize 
Medicare indicates a lack of concern for Americans who need health care 
coverage.''
  I also heard from Cara Davis of Glen Ridge, NJ, who wrote in on 
behalf of her uncle, who has end-stage renal disease and requires 
dialysis, saying, ``If [Price] and the Trump administration 
successfully move Medicare to a voucher program''--again, that is 
different from a guarantee--``I fear that my uncle will not be able to 
afford the necessary coverage for his dialysis treatments.''
  For me, the battle to protect Medicare is more than a political 
battle; it is more than a theoretical battle; it is a deeply personal 
battle to protect a program that allows seniors to live with dignity 
during the twilight of their lives.
  My personal connection to the value of the Medicare Program stems not 
from my experience but that of my late mother, Evangelina. For 18 long, 
difficult years, my mother suffered from Alzheimer's disease. During 
those years, we watched as this strong, courageous woman drifted 
further and further away from us. After her diagnosis, I, like so many 
families across our Nation, hoped for the best, but we expected the 
worst. And while there were times early on when she seemed just fine, 
those times turned into lost moments, and those lost moments eventually 
lasted forever.
  At this point, I had to wonder if all the moments of her life--her 
struggle to flee her homeland and seek freedom in the United States, of 
my youth and all of the time spent together--were still in there, still 
with her somehow, or whether those memories were lost forever.
  As her illness progressed, she lost her cognitive abilities, and 
eventually we had to admit to ourselves that our mother was no longer 
with us, until, mercifully, the Good Lord took her, and the long 
goodbye came to an end.
  Throughout this experience, throughout her struggle of fighting back 
against the progress of Alzheimer's, our family knew that Medicare 
would be there to provide her with access to the health care she 
needed. I learned that Medicare wasn't just there for her; it was there 
for the rest of us, too, providing her with access to care, while 
granting us the ability to focus on making the most of the limited time 
we had together.
  Medicare was there to meet the challenges of her illness as well as 
the intergenerational challenges that arise when caring for a parent in 
the twilight of their lives while simultaneously working to put your 
own children through college. I lived it, I saw it, and I understand 
it. My mother would not have lived with the dignity that she deserved 
in the twilight of her life after working a lifetime and paying for 
Medicare, but for Medicare as a guarantee.
  I know all too well that an underfunded voucher would undermine 
Medicare's ability to live up to the responsibility that we have to 
care for one another and to provide that same dignity to seniors as 
they and their families prepare to say good-bye for the last time.
  That is why I couldn't agree with Dr. Thar or Ms. Davis more, and I 
share their concerns about what Congressman Price has in mind, despite 
the repeated pledges from President Trump to the contrary for the 
future of Medicare.
  My concerns about Congressman Price don't stop with his desires to 
end Medicare, because those desires also extend to end Medicaid, as we 
know it, as well. His desires to end Medicaid are really a two-front 
war. The first is to repeal the highly successful expansion of Medicaid 
provided for under the Affordable Care Act, which has extended 
lifesaving care and coverage to over 200,000 New Jerseyans, many of 
whom are covered for the first time.
  Nationwide, the Affordable Care Act's Medicaid expansion is one of 
the most successful aspects of health reform. Currently, 32 States and 
the District of Columbia have taken advantage of Medicaid expansion, 
making coverage available to 11 million people, because they recognize 
the value in providing people with coverage, with access to preventive 
care, with the ability to manage chronic conditions--all of which lead 
to a healthier, more productive population.

[[Page 2326]]

  The second is to eviscerate funding from Medicaid by taking away the 
current funding structure and replacing it with a block grant or some 
other form of arbitrary underfunding that they mask as allowing for 
``state flexibility.''
  We have seen this picture before. Take away an obligation, an 
entitlement, move it to a block grant, underfund it, and ultimately 
slay that opportunity for people to have a guarantee.
  We all know what is meant when Congressman Price talks about State 
flexibility. He means the flexibility to slash enrollment and deny 
people access to coverage. He means forcing States to choose between 
cutting payments to doctors for treating low-income Medicaid patients 
or cutting other vital State services like education and 
infrastructure. He means unraveling Medicaid benefits so that for those 
few still able to enroll, they won't have adequate coverage for most of 
the health care issues they need treated. It means simply putting his 
radical ideological opposition of the Federal Government being involved 
in health care ahead of the lives of millions of men, women, children, 
and seniors and the disabled across the Nation. That is truly 
remarkable for a man who took the oath to ``first do no harm.''
  As with his views on Medicare, his desire to end Medicaid expansion 
has caused a lot of people from New Jersey to write me about their 
concerns. I would ask Congressman Price and other like-minded 
Republicans to consider carefully the stress and potentially 
devastating impacts these policies have on real people--real people 
like Jolie Bonnette from Brick, NJ, who wrote to me about how she was 
able to finally gain access to health coverage, thanks to Medicaid 
expansion. She wrote: ``Without this care and my Medicaid medication 
coverage, I would have died, because I would have no access to doctors 
or medications.''
  Jill Stasium from Jersey City wrote in saying that thanks to 
Medicaid, ``[I] have been receiving top quality health care for the 
first time in my life.''
  I ask my colleagues how the mantra of State flexibility, which is 
just another way of ensuring funding for Medicaid is slashed and access 
to life-enhancing treatment is denied, is going to impact Ms. Bonnette 
and Ms. Stasium. I ask how they can justify taking away their 
coverage--coverage that has provided, for the first time in their 
lives, not only the peace of mind of having health insurance, but also 
it is the first time they have had regular access to the doctors and 
medication necessary to live.
  How do we justify that? We can't do it on the basis of State 
flexibility and surely not on the basis of a 6-year-long political 
vendetta against the Affordable Care Act. Yet somehow, with this 
nominee and this Republican Congress, this is something that we are all 
going to have to justify to every single one of our constituents.
  Unfortunately, the list of destructive policies supported by Tom 
Price doesn't end with his desires to end Medicare as we know it and to 
dismantle Medicaid. This is also not surprising given the Republican 
agenda for the last 7 years to repeal the Affordable Care Act, throw 
millions of Americans off their health insurance, and return us to the 
dark ages where insurance companies have free rein to deny coverage for 
preexisting conditions, cancel coverage after a devastating diagnosis, 
limit what benefits are covered, and discriminate against women. That 
is what the marketplace was before the Affordable Care Act.
  Now, this is not new. The Republicans have been trying to repeal 
health care reform and deny millions of Americans health care coverage 
since before the law was even passed. It has sadly become dogma for 
Republicans--dogma to repeal ObamaCare, which they voted to do 60-some 
odd times. But now, after 7 long years, the chickens have come home to 
roost.
  They now have the ability to live up to their dream of repealing the 
law, but are starting to realize what the implications are--starting to 
realize that real people will face real life-and-death situations that 
result from Republicans putting partisan ideology ahead of the well-
being of their constituents, starting to realize that on-the-ground 
implications of the Affordable Care Act mean real people receiving real 
treatment for real health conditions.
  One of these people is David Konopacki from South River, NJ. David is 
a diabetic who, thanks to the Affordable Care Act, no longer has to 
choose between paying for college and paying for the medication he 
needs. David put it so succinctly: ``The Affordable Care Act is 
literally the difference between life and death for so many.''
  The same holds true for Mrs. Lori Wilson from Morristown, NJ. Her 
son, like David, has diabetes and has had diabetes since birth. As she 
writes, her son ``is just one citizen among millions whose life, 
literally, depends on access'' to care, and under the Price Republican 
plan, that access is denied.
  I mentioned that repealing the Affordable Care Act means reinstating 
the ability of insurance companies to deny coverage for preexisting 
conditions. As diabetics, these folks would find it impossible--
certainly, financially impossible--to find coverage that would allow 
them to get their medications and see their physicians. That is what is 
shocking about Tom Price. Despite knowing full well that the ban on 
preexisting conditions is one of the most widely supported and 
critically important aspects of the Affordable Care Act, he considers 
it to be a ``terrible idea.''
  Let me say that again. Tom Price's views on health care are so 
radical that he thinks insuring people with preexisting health 
conditions--like diabetes from birth--and guaranteed access to coverage 
is a ``terrible idea.'' That is an extremely callous way to put 
ideology above people's lives.
  Let me close on this. I have spoken about the many reasons I am 
opposed to Congressman Price's nomination to run the Department of 
Health and Human Services, including his long-held opposition to 
Medicare. But above all else, one of the reasons I am opposing 
Congressman Price is because of the seeming lack of fidelity to the one 
thing that runs at the heart of health care and the heart of the Health 
and Human Services Department, which is science.
  For years Congressman Price has been a member of a group called the 
Association of American Physicians and Surgeons. This is a group of so-
called doctors who push dangerous conspiracy theories and widely 
debunked claims that have serious implications for the public health. 
The prime example of this is their assertion, despite all evidence to 
the contrary, that vaccines aren't safe and that they cause autism. 
Nothing could be further from the truth. In fact, this week I received 
a letter signed by 350 organizations, including several from New Jersey 
and several representing the autism community, restating the fact that 
``vaccines are the safest and most cost-effective way of preventing 
disease, disability, and death'' but unfortunately, because of 
widespread misinformation, the United States ``still witnesses 
outbreaks of vaccine-preventable diseases,'' including the biggest 
outbreak of whooping cough since 1955, and the fact that we have 
upwards of 50,000 deaths a year from complications of vaccine-
preventable influenza.
  While Tom Price, personally and as a physician, might understand 
these basic facts, what worries me most is that the President of the 
United States does not, posting on Twitter for years that vaccines are 
dangerous and appointing anti-vaccine conspiracy theorists to critical 
posts in the White House and possibly to key positions within the 
Department of Health and Human Services.
  When I asked Congressman Price directly about his fidelity to science 
and his willingness to stand up to the President about adhering to 
science as the guiding principle at the Department of Health and Human 
Services, his answers were far less than satisfactory, and he left me 
with the impression that he is unwilling to counter the President when 
he touts untrue claims about health care and ensure that personnel 
within HHS are stewards of sound science and not ideology.

[[Page 2327]]

  For the Department that oversees the Centers for Disease Control, 
which is the global beacon of health care that must be focused on 
science, that is simply incredible.
  I rise today to give my voice in opposition to Nominee Tom Price as 
the next Secretary of Health and Human Services, and I rise to be the 
voice of Dr. William Thar, Cara Davis, Jolie Bonnette, Jill Stasium, 
David Konopacki, Lori Wilson and the over 6,000 New Jerseyans who have 
called and emailed me to vote in opposition to Tom Price's nomination. 
I will do that when it comes time for a vote.
  With that, I yield the floor.
  Mr. LEAHY. Mr. President, the Cabinet nomination we are considering 
today is one of great consequence. The reach of the Department of 
Health and Human Services is extensive, with direct and indirect 
consequences for the health and well-being of all Americans. Like many 
other nominations that this body is rushing to confirm, Representative 
Price has not satisfied the many questions that have been raised about 
his ability to defend programs that are vital to so many Americans. In 
fact, his record in Congress runs counter to these goals.
  I have always believed that all Americans deserve access to quality, 
affordable health care. We made a tremendous step in this direction 
through the Affordable Care Act, ACA, which has extended health 
insurance coverage to more than 20 million Americans and their families 
through cancer screenings, immunizations, and preventative health care 
at little or no cost-share. The law has ensured that vulnerable 
populations have access to quality care through State expansions of 
Medicaid. The ACA stopped insurance companies from discriminating 
against women, seniors, and individuals with preexisting conditions. 
And it has already saved taxpayers billions in Federal health care 
costs, while bolstering reserves for our Nation's Medicare and Social 
Security Trust funds.
  Unfortunately, Representative Price does not see it this way. As one 
of the first lawmakers to draft legislation calling for the full repeal 
of the ACA, Representative Price believes that health care should once 
again be under the largely unfettered control of big businesses and 
insurance companies. He may say that he wants more Americans to have 
``access to affordable coverage,'' but his record in the House shows 
otherwise.
  It is not only the Affordable Care Act that Representative Price has 
put in the crosshairs, but virtually every Federal, health program. 
Representative Price's track record in opposing programs like Medicaid, 
Medicare, and Social Security is extensive. As Congressman, he has 
proposed dissolving or block granting Medicaid and replacing Medicare 
with vouchers, unadjusted for income, for consumers to purchase private 
plans on the market. In November, he released an agenda proposing 
across-the-board cuts to Medicare, Medicaid, and Social Security. He 
has also long fought against women's healthcare and access to family 
planning services. And he has advocated banning abortions and 
abolishing funding for Planned Parenthood, which would make it far more 
difficult for women to have access to health care.
  Medicare, Social Security, and Medicaid are crucially important to 
patients and their families. Medicaid provides vulnerable populations, 
including children, with essential and comprehensive health benefits, 
like mental health care and substance abuse treatment, which are 
required to be covered by Medicaid under the ACA. And for decades, 
Medicare and Social Security have offered health care protections to 
low-income Americans and seniors, offering guaranteed resources in 
retirement. These are earned benefits that hard-working Americans have 
paid into throughout their lives. It is only fair that these people 
should expect to have these resources when they enter retirement.
  We cannot deny the vital health protections of Medicaid, Medicare, 
and Social Security to our Nation's families. And I cannot in good 
conscience support someone who does not share this game goal. Lives, 
literally, are at stake.
  I am also deeply concerned about allegations of Representative 
Price's violation of the STOCK Act, which prohibits Members of Congress 
from making investment decisions based on information they receive as a 
result of their roles in Congress. Serious questions of his all-too-
coincidental trading with medical companies, after introducing 
legislation that supports these very companies, are troubling, and 
signal that this nominee is unfit to lead the very agency responsible 
for protecting the health of Americans.
  I am glad the minority members of the Senate Finance Committee 
refused to join the business meeting scheduled to move Representative 
Price's nomination last month. There remain serious questions relating 
to potential conflicts he would have as Secretary. Despite these 
concerns, Republicans on the Finance Committee made the unprecedented 
decision to change the rules and confirm Congressman Price without even 
one Democratic member present. This move runs counter to the majority's 
own rules. But more importantly, it contradicts what we stand for in 
promoting the interests of Americans as their elected officials.
  If confirmed, there are valid reasons for the American people to be 
concerned that Representative Price's agenda will make its way into the 
Department of Health and Human Services, and Americans will suffer for 
that. It is the responsibility of this agency to uphold and protect the 
well-being of the people of this great and good country, and it would 
be counter to this goal to allow someone like Representative Price to 
oversee such efforts. That is why I will strongly oppose his 
nomination, and I encourage all in the Senate to do the same.
  Mr. UDALL. Mr. President, I rise today to oppose the nomination of 
Congressman Tom Price to be Secretary of the Department of Health and 
Human Services.
  I oppose the nomination because Mr. Price wants to dismantle 
America's health care system--with no guarantee that Americans will 
continue to receive the health care coverage they now enjoy. He is part 
of the Trump ``repeal with no plan'' contingent.
  In my view, any repeal of the Affordable Care Act must be coupled 
with a program that has rock solid guarantees to the American public, 
guarantees that Americans will not lose the health care benefits they 
now have.
  Further, I oppose any vote on Mr. Price's nomination until there has 
been a full investigation and disclosure to the American public of his 
conflicts of interest. Mr. Price has invested in companies just prior 
to introducing legislation that would benefit those very companies. 
Before we vote on Mr. Price, the American public needs a full 
accounting whether his investments comply with Federal insider trading 
laws and ethical provisions.
  The President's first order of business was an attack on Americans' 
health care. His Executive order gives Federal agencies broad authority 
to grant waivers, exemptions, and delays of provisions in the ACA. As 
Secretary of Health and Human Services, Mr. Price will be given rein 
not only to grant waivers but to not enforce key ACA provisions and to 
pass regulations that undercut ACA protections. For example, 
undermining the individual mandate--a key target of Mr. Price's--could 
lead to collapse of the individual health insurance market and drive up 
premiums for everyone.
  The ACA has resulted in the broadest health care coverage Americans 
have ever known. Now over 91 percent of Americans have health 
insurance.
  In my own State of New Mexico, the number of uninsured has dropped by 
over 50 percent. New Mexico is not a wealthy State. We had one of the 
highest rates of uninsured in the country before the ACA--19.6 percent. 
That's almost one in five people. Now, only 8.9 percent of New Mexicans 
do not have insurance. This is still too high, but it is a big 
improvement.
  Americans strongly support ACA protections. Almost 70 percent of 
Americans think insurance companies should not be able to deny 
insurance because of a preexisting condition. Eighty-five percent of 
Americans want their young

[[Page 2328]]

adult children to be able to get coverage on their insurance policies. 
Eighty-three percent think preventative services should be free.
  The Republicans and Mr. Price have no plan to make sure Americans do 
not lose these rights and benefit.
  Now, the ACA is not perfect. We all know this. It needs improvement. 
It needs work. But the solution is not to throw the health care system 
into chaos with no plan. The solution is to work together on a 
bipartisan basis and fix the ACA's problems.
  Hundreds of my constituents have called and written asking me to 
protect the ACA. New Mexicans are scared--really scared--that their 
health care will be taken away. People are scared their health is in 
jeopardy. For some, they are scared their lives will be put at risk.
  I am angry that the President, Mr. Price, and the Republicans have 
created so much fear and worry among my constituents and around the 
Nation. None of them has to worry whether their children will get the 
health care they need. My constituents now do.
  Kevin, from Albuquerque, now has to worry whether his 33-year-old 
daughter Amber will get the health care she needs. Amber has multiple 
sclerosis. That is a tough disease. I talked about Amber once before 
here, and her story bears retelling.
  Amber's annual medical costs are high. Her medications alone are 
$60,000 a year. Her doctor visits and MRIs run into the thousands of 
dollars.
  But Amber now has health insurance through the open market thanks to 
the ACA. And, thanks to the ACA, she is healthy. She works. She leads a 
productive life.
  Without the ACA, Kevin worries his daughter will be kicked off her 
health insurance plan because her medical expenses are so high and that 
she will not be able to get new health insurance--because of her 
preexisting MS. For Amber and Kevin, the ACA's protections mean 
everything.
  There are literally hundreds of thousands of New Mexicans and 
millions of Americans like Amber. This one ACA provision--prohibiting 
discrimination based on preexisting illness--protects an estimated 
861,000 New Mexicans and 134 million Americans. If we ourselves don't 
have a serious illness like Amber, we have a family member or friend 
who does.
  Same with people who have high medical costs. These are the people 
who need medical care the most. The ACA provision--prohibiting lifetime 
benefit limits--protects an estimated 555,000 New Mexicans and 105 
million Americans.
  Why is there even any discussion about jeopardizing millions of 
Americans' health care?
  The ACA saves lives. It saved Mike's life. Mike and his wife, Pam, 
are from Placitas, NM. Before the ACA, they didn't have insurance. They 
couldn't afford it and probably couldn't get it for Pam because she had 
a preexisting illness.
  As soon as they could, they signed up for an insurance plan under the 
ACA. Using their new preventive care services, they found out Mike had 
an aggressive form of cancer. Thankfully, they caught it early. Mike 
was treated at the University of New Mexico Cancer Center and is cured.
  Pam says there is ``no question'' that the ACA saved her husband's 
life.
  Hundreds of thousands of New Mexicans and millions of Americans 
benefit because the ACA requires health insurance companies to provide 
free preventatives services. It is well documented that such services 
prevent illness, save lives, and save money in the long run.
  I am also concerned about the impact ACA repeal would have in Indian 
Country. During his confirmation hearings, Congressman Price was asked 
specifically about the devastating consequences Medicaid expansion 
repeal would have on Indian health providers. These providers depend 
heavily on this Federal funding to provide lifesaving services to our 
Native communities. Any reduction in Federal funding to these 
facilities would be unconscionable.
  But Congressman Price has a clear record of voting to support the 
elimination of the Medicaid expansion and, when asked directly, could 
offer no solution for making Indian Country whole if this funding were 
to be cut. Nothing in his hearing or written answers has assured me 
that Congressman Price intends to protect Native communities from the 
negative impact of ACA repeal.
  And, finally, ACA repeal would be devastating to my State's economy. 
That is what a Ph.D. economist from New Mexico State University told 
the New Mexico Legislature last week. Dr. Jim Peach said ACA repeal 
would be ``devastating'' to our State.
  As I said, New Mexico is not a wealthy State. We have one of the 
highest unemployment rates in the country, at 6.6 percent.
  But the ACA has been an economic boon for us. Seven of the 10 
fastest-growing job categories in New Mexico are in health care. In 
fact, boosts from health care and tourism actually led to positive job 
growth for the last 2 months. So health care jobs are of critical 
importance in New Mexico.
  But, if the ACA is repealed, it is estimated New Mexico could lose 
between 19,000 and 32,000 jobs. I can tell you right now New Mexico 
cannot take that kind of hit in its employment numbers.
  And, the loss in spending in New Mexico would be astronomical.
  ACA repeal would mean a loss of $93 million in Federal marketplace 
spending in 2019 in New Mexico and $1 billion between 2019 and 2028.
  It would mean a loss of $2.2 billion in Federal Medicaid funding in 
2019 and almost $27 billion between 2019 and 2028.
  This hit to our economy would be immediate and would be sustained. 
Tax revenues would decrease. And the New Mexico legislature is 
struggling mightily now how to balance the State budget.
  The fact is no State budget is ready to take on the extra load if the 
ACA is repealed and health care gets pushed back to the States. We will 
go back to the days of no care, uncompensated care, and use of 
taxpayer-subsidized ER services as a last resort.
  But Mr. Price and the Republicans are not talking about any of the 
damage in human or fiscal terms if the ACA is repealed.
  In fact, they are already moving to undermine the Affordable Care 
Act, roll back its protections, reduce assistance to families, create 
chaos in the insurance markets--by executive action alone.
  President Trump's Executive order directed his government not to 
implement the Affordable Care Act wherever possible under existing law. 
And we cannot be confident they will not bend the law in pursuit of 
this Presidential decree.
  I cannot support a nominee to head our health care system who is not 
firmly committed to maintaining the health care coverage Americans now 
have. And who will not push--and push hard--for the right of every 
American to have health care.
  Finally, I cannot support holding a vote on Mr. Price until all 
financial conflicts of interest of his have been fully vetted and the 
American public knows there has been no violation of law or ethical 
responsibilities.
  Mr. Price is a wealthy man, like so many of Mr. Trump's cabinet 
nominees. And he has tried to increase his wealth by investing in 
health-related companies. It is widely reported--in the Wall Street 
Journal and elsewhere--that Mr. Price has made over $300,000 worth of 
investments in health-related companies--companies that could benefit 
from his legislation.
  We are all familiar with the STOCK Act. It applies directly to us and 
prohibits us from using inside information that we obtain through our 
positions as Members of Congress for personal gain.
  There are serious questions whether Mr. Price's investments ran afoul 
of the STOCK Act.
  I would like to refer to a February 7, 2017, column from the New York 
Times discussing Mr. Price's widely reported investments. So, a first 
example, in March of last year, Congressman Price announced opposition 
to a Medicare measure that would limit the money doctors could make 
from drugs they

[[Page 2329]]

prescribe their patients. The proposal was meant to reduce doctors' 
financial incentives to prescribe expensive drugs.
  Makes sense--we don't want doctors to prescribe more costly drugs 
because they would personally benefit.
  But, just 1 week later, Mr. Price bought stock in six pharmaceutical 
companies that would benefit if this consumer protection measure were 
defeated.
  And then, at the very same time, those very same companies were 
lobbying Congress to block the measure. And Big Pharma succeeded.
  A second example--last year, he purchased shares in Zimmer Biomet, a 
company that makes hip and knee implants.
  Six days later, he introduced a bill that would have directly helped 
Zimmer. His legislation sought to delay a Federal regulation that would 
have changed payment procedures for Zimmer. In fact, Zimmer was one of 
two companies that would have been hit the hardest by the regulation.
  Mr. Price has said his broker bought the Zimmer stock. But these 
circumstances warrant investigation. And, bottom line, Mr. Price is 
responsible for his investments.
  A third example--last summer, Mr. Price was offered a special deal--
to purchase shares at deeply discounted price from Innate 
Immunotherapeutics, an Australian drug company. He got in at 18 cents a 
share--at a time the stock value was increasing rapidly, rising to more 
than 90 cents a share. The value of his shares rose more than 400 
percent.
  At the same time, Innate Immuno needs Federal Drug Administration 
approval for one of its drugs.
  This deal raises questions whether Mr. Price gained from an 
investment opportunity--unavailable to the public--from a company whose 
profits could be influenced by his political decisions.
  A Cabinet nominee should not come into office under a cloud of 
conflicts. A vote on his nomination before there is full inquiry into 
his investments and ethical behavior is premature.
  For these reasons, I will vote no on the nomination of Mr. Price as 
Secretary of Health and Human Services.
  I ask unanimous consent that the New York Times column I referred to 
be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                [From the New York Times, Feb. 7, 2017]

                   Tom Price, Dr. Personal Enrichment

                          (By David Leonhardt)

       Each year, a publication called Medscape creates a portrait 
     of the medical profession. It surveys thousands of doctors 
     about their job satisfaction, salaries and the like and 
     breaks down the results by specialty, allowing for 
     comparisons between, say, dermatologists and oncologists.
       As I read the most recent survey, I was struck by the 
     answers from orthopedic surgeons. They are the highest-paid 
     doctors, with an average salary of $443,000 in 2015--which, 
     coincidentally, was almost the exact cutoff for the famed top 
     1 percent of the income distribution.
       Yet many orthopedists are not happy with their pay. Only 44 
     percent feel ``fairly compensated,'' a smaller share than in 
     almost every other specialty. A lot of orthopedists aren't 
     even happy being doctors. Just 49 percent say they would go 
     into medicine if they had to make the decision again, 
     compared with 64 percent of all doctors.
       I know that many orthopedists have a very different view: 
     They take pride in helping patients and feel fortunate to 
     enjoy comfortable lives. But despite those doctors, it's 
     clear that orthopedics suffers from a professional culture 
     that does not live up to medicine's highest ideals. Too many 
     orthopedists are rich and think it's an injustice that 
     they're not richer.
       This culture helped shape Dr. Tom Price, the orthopedic 
     surgeon and Georgia congressman who is Donald Trump's nominee 
     for secretary of health and human services.
       Price had a thriving practice near Atlanta before being 
     elected to Congress in 2004. His estimated net worth of more 
     than $10 million (and possibly a lot more) makes him one of 
     the House's wealthier members.
       Yet he hasn't been content to make money in the standard 
     ways. He has also pushed, and crossed, ethical boundaries. 
     Again and again, Price has mingled his power as a congressman 
     with his desire to make money.
       So far, the nominee receiving the most attention is Betsy 
     DeVos, Trump's choice for education secretary, and she 
     definitely deserves scrutiny. Still, I think Democrats have 
     made a mistake focusing so much on her rather than on Price. 
     He could do more damage--and his transgressions are worse 
     than those that have defeated prior nominees.
       Last March, Price announced his opposition to a sensible 
     Medicare proposal to limit the money doctors could make from 
     drugs they prescribe their patients. The proposal was meant 
     to reduce doctors' financial incentives to prescribe 
     expensive drugs. (And, yes, if you're bothered that your 
     doctor has any stake in choosing one drug over another, you 
     should be.)
       One week after Price came out against the proposal, he 
     bought stocks in six pharmaceutical companies that would 
     benefit from its defeat, as Time magazine reported. At the 
     time, those same companies were lobbying Congress to block 
     the change. They succeeded.
       It's a pattern, too. Price has put the interests of drug 
     companies above those of taxpayers and patients--and invested 
     in those drug companies on the side.
       Last year, he also bought shares in Zimmer Biomet, a maker 
     of hip and knee implants. Six days later, according to CNN, 
     he introduced a bill that would that have directly helped 
     Zimmer.
       In his defense, a spokesman for Price has said that his 
     broker bought the Zimmer stock and Price didn't find out 
     until later. That's certainly possible, but still not 
     acceptable. Members of Congress bear responsibility for their 
     personal stock transactions, period.
       A third episode may be the worst. Price accepted a special 
     offer from an Australian drug company to buy discounted 
     shares, as The Wall Street Journal and Kaiser Health News 
     reported.
       He told the Senate that the offer was open to all 
     investors, although fewer than 20 Americans actually received 
     an invitation to buy at the discounted price. The stock has 
     since jumped in value, and Price underreported the worth of 
     his investment in his nomination filings. It was a ``clerical 
     error,'' he says.
       Even without any larger context, his actions are 
     disqualifying. He's repeatedly placed personal enrichment 
     above the credibility of Congress. The behavior is 
     substantially worse than giving money to an illegal immigrant 
     (which defeated a George W. Bush nominee) or failing to pay 
     nanny taxes (which scuffled a Bill Clinton nominee).
       But of course there is a larger context. Price has devoted 
     much of his political career opposing expansion of health 
     insurance. His preferred replacement of Obamacare would 
     reduce health care benefits for sicker, poorer and older 
     Americans.
       His views have a long history within the medical 
     profession. For decades, doctors used their political clout 
     to help block universal health insurance. They offered many 
     rationales, but money was the main reason. Many doctors 
     feared that a less laissez-faire health care system would 
     reduce their pay.
       It's to the great credit of today's doctors that they have 
     moved their lobbying groups away from that position and 
     helped extend insurance to some 20 million people. They 
     understand that some principles matter more than a paycheck.
       Or at least many of them do.

  The PRESIDING OFFICER. The Senator from Washington.
  Ms. CANTWELL. Mr. President, I come to the floor this evening to 
continue my remarks from earlier today in opposition to the nomination 
of Congressman Price to be Secretary of Health and Human Services and 
to continue talking about the Medicaid program.
  My colleague from New Jersey was talking about the affordability of 
health care in general and some of the critique about where we are 
going with health care in the future. That is really what I think the 
next few years here in the Senate are going to be about--the future of 
health care.
  Unfortunately, the nominee before us is more about the past of health 
care, focusing on issues like fee-for-service instead of the patient-
centric health care that we need.
  Earlier today, I was talking about the innovation that is happening 
in Medicaid through the Affordable Care Act and, specifically, what is 
happening in Midwestern States, Eastern States, Southern States, and 
Western States--how the expansion of Medicaid is not just giving more 
people access to health care but how innovative programs that are 
reaching that population are allowing people, instead of going into 
nursing home care and costing States more and having more expense, 
going into community-based care and home-based care that will help us 
keep costs down and give patients what they want: the ability to stay 
at home and have care.
  I also talked about how, on top of the Medicaid expansion, we put a 
program

[[Page 2330]]

like the Basic Health Plan into place, which drove down the costs of 
premiums for people in that program.
  Through Medicaid, not only have we expanded health insurance by 
helping states cover their citizens, but the uninsured rate has also 
dropped. I mentioned that in our State of Washington, it dropped to 
just 6 percent. Through delivery system reforms, we are also driving a 
better way for us to improve the Medicaid Program.
  Now I want to contrast that to the position of this administration 
and to Congressman Price, because it is a very different view. As I 
said, I think it is a very backwards-looking view about what we need to 
improve our health care system. I want to make sure that our colleagues 
on both sides of the aisle understand this.
  Now, my biggest concern is that the current administration and 
members of that administration are talking about what they want to do 
with Medicaid. I know that Speaker Ryan has said that he would like to 
block-grant Medicaid back to the States. This may sound like some great 
idea until you realize that, right now, Medicaid is already a state 
option. Medicaid is a voluntary program for States to participate in. 
The money goes back to the State based on the need. It is not block-
granted.
  I talked earlier today about when you block-grant it and cap it at a 
certain level, you are asking people to do more with less. Instead of 
addressing their needs and improving the system, like I mentioned on 
rebalancing to community-based care versus nursing home care, or making 
it more affordable like in the Basic Health Plan, all you are doing is 
capping it and continuing to give an amount of money that doesn't meet 
the needs of individual citizens. So I did not like the fact that 
Speaker Ryan seems to be on this parade of saying: Let's block-grant 
Medicaid.
  The reason we came to this is that my dear colleague from Vermont 
came to the Senate floor one night and showed a tweet from--I think it 
was actually then-Candidate Trump, but it might have been President 
Trump--that said: No, I am not touching Medicare or Social Security or 
Medicaid. My colleague from Vermont wanted to know whether the 
President was going to stick to that promise. What has happened since 
then is we have seen that there has been a promise, so to speak, on 
some of these programs, but not on others.
  I know Vice President Pence said that he and Donald Trump will give 
States new freedom and flexibility through block-granting Medicaid. So 
they are for this idea of block-granting Medicaid.
  In fact, White House Counselor Kellyanne Conway said: block-grant 
Medicaid to the States.
  So many on the other side are saying you are going to keep your 
health care; don't worry, it is going to be there for you; no one is 
going to lose it. I guarantee that if we block-grant Medicaid, which is 
the premise that Mr. Price has been rallying on, not just once but many 
times, it is not going to work out for many Washingtonians in my State, 
and it certainly is not going to work out for many people all across 
this country.
  Mr. Price wrote a budget that would block-grant Medicaid. And he 
wrote a bill that would repeal the Medicaid expansion in its entirety 
and repeal all of the Affordable Care Act. So I know for some people, 
as I said, that might sound like giving the States flexibility, but 
right now, that dollar goes up and down based on need. When Medicaid is 
block-granted, you are going to give States a set amount of money and, 
as I said, that set amount of money may not keep pace with the cost of 
care.
  Through Medicaid waivers authorized by Congress and approved by the 
Centers for Medicare and Medicaid Services, States can work with the 
Federal Government to deliver flexibility. I just mentioned two 
programs that are already in the Affordable Care Act.
  Earlier today I mentioned all of the States that were utilizing 
rebalancing programs and the shift they are seeing in keeping people 
out of nursing home care and putting them in community-based services. 
So that is a huge win.
  A number of States have pursued these Medicaid waivers through a 
section of the Social Security Act called 1115. It is really not 
necessary for anybody to know the number, but basically those 
innovations are allowing States to continue to improve the delivery of 
health care. In the State of Washington, that means we are delivering 
better care, better outcomes, at lower cost. That should be our 
target--not taking a hatchet to Medicaid and chopping it and saying we 
are going to give you less and less money.
  We know that our health care delivery system is going to be 
challenged in the future, and we know Mr. Price's budget would cut one-
third of Medicaid funding within 10 years. That is a huge cost to the 
Medicaid program. So what would it mean? It would mean millions of 
Americans would lose their health insurance because States will not 
have the investments to cover them. Uncompensated care will skyrocket, 
and that would really hurt the safety net that hospitals provide. 
People don't go without health care just because Medicaid doesn't cover 
them. They show up in the emergency rooms, they get uncompensated care, 
it is more expensive, or they ignore their health care needs until they 
can absolutely afford it. We are seeing this across America even now. 
We have had physicians tell us stories of people who are just waiting 
until they can afford coverage.
  So that is why it is so important to get affordable coverage like the 
Affordable Care Act has been able to provide and to unleash innovative 
programs within these systems, like the Basic Health Plan that I 
mentioned earlier today, which allows us to buy in bulk, like a Costco 
model. Costco delivers Americans a lot of cheaper products because they 
buy in bulk; it drives down the price. The consumer wins and the 
insurer wins because they know they are going to get big purchases, and 
that provides flexibility. I mentioned how New York has more than 
600,000 people on the Basic Health Plan, and instead of paying a yearly 
premium of about $1,500, they were basically saving about $1,000 or 
more on their annual insurance premiums. Why? Because the State was 
able to offer up a bundle to New York residents and drive down costs. 
That is the kind of flexibility we need in the health care system. We 
don't need to just say we are going to cut one-third over a 10-year 
period of time.
  Let me again contrast this progress with Mr. Price's ideas. 
Congressman Price's budget would cut $1 trillion from States over 10 
years through Medicaid block grants--$1 trillion, leaving States with a 
hole in their budget that I know, if they are like our State and are 
challenged with other issues, they would not be able to cover. The 
notion that block-granting Medicaid and repealing the Medicaid 
expansion is the way forward is absolutely not what the people of 
Washington State think. I am here to represent the viewpoint that 
innovations in the Affordable Care Act are working, and we shouldn't 
just simply block-grant and cut Medicaid.
  So instead of improving the delivery system of health care and 
instead of expanding coverage and giving peace of mind, here is what 
Mr. Price's Medicaid cuts would do, according to some of the 
independent experts who study Medicaid.
  The National Council on Disability says about block grants: ``Older 
Americans and people with disabilities would be at special risk. . . . 
States would face strong financial pressure to reduce services to low-
income seniors and people with disabilities if the Federal Medicaid 
funds were capped.''
  The Center on Budget and Priorities says: ``To compensate for the 
federal Medicaid funding cuts a block grant would institute, states 
would either have to contribute much more of their own funding or, as 
is far more likely, use the greater flexibility the block grant would 
give them to make draconian cuts to eligibility, benefits, and provider 
payments.''
  The Commonwealth Fund says that ``the federal contribution under a 
block grant program would remain the same, or grow only according to a 
present formula, no matter how large the population in need becomes or 
how much a

[[Page 2331]]

State actually must spend on health care for Medicaid recipients.''
  So we can see that people understand that block-granting Medicaid is 
nothing more than a war on Medicaid--nothing more than a war on 
Medicaid.
  That is why I cannot support Mr. Price's nomination. We gave him 
chances in the hearing to talk about why this kind of approach is not 
acceptable and why the programs within the Affordable Care Act that are 
driving down costs, giving people access, making improvements, working 
all across the United States in various parts of our Nation are 
actually the right ways to improve the delivery system, but we couldn't 
get commitments.
  So if my colleagues are being honest with themselves or if they 
actually understand this, they should be very afraid of the notion that 
Mr. Price is putting forward in wanting to block-grant Medicaid. I 
think some of them do understand. It is why the Governor of Nevada, 
Brian Sandoval, and the Governor of Michigan, Rick Snyder, and others, 
are asking Congress to let them keep the Medicaid gains already in the 
Affordable Care Act and not shift those costs to the States.
  So while shifting costs to the States might be exactly what some 
people want to do, this is exactly why we need to fight to make sure 
that the Medicaid expansion remains supported, and that we have the 
right focus moving forward--a delivery system, that is, that works for 
the patients and improves outcome and lowers costs. That is why I 
mentioned two aspects of the Affordable Care Act. We did the Medicaid 
expansion, and then, for a working family just above the Medicaid 
eligibility level, which is 138 percent of the federal poverty level, 
they were able to buy in bulk and get the kind of cost savings in 
health care that, as I said, let more than 600,000 New Yorkers sign up 
for truly affordable health care in impressive numbers.
  So that kind of progress being made in Medicaid and in the income 
levels just above it is exactly the kind of progress we must keep 
pursuing. Our colleagues seem to want to turn back the clock on this 
plan.
  We did not get a single commitment from Mr. Price on keeping Medicaid 
healthy for more than the 70 million Americans that depend on it. 
Therefore, all I can do is go back to his record, his votes, and his 
comments to understand his desire to block-grant Medicaid, which is a 
war on Medicaid. It will not make that population healthier. It 
certainly will not really control health care costs for the future, and 
it is certainly the reason I will be voting no on Mr. Price.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Massachusetts.
  Ms. WARREN. Mr. President, I rise today to urge my colleagues to vote 
against the nomination of Tom Price to be the Secretary of the 
Department of Health and Human Services.
  The decisions made at HHS touch the lives of every family in America. 
The Secretary who runs this agency makes decisions about everything 
from safety of the food we eat to the drugs we take, to the health 
insurance we buy and the quality of nursing homes we live in. This is 
an extremely important job, and we should not hand over the keys to 
this agency unless we are certain that the person will put the American 
people first every minute of every day.
  President Trump has nominated Congressman Tom Price to serve in this 
job. Unlike many of the President's other nominees who are stunningly 
inexperienced in areas where they will be setting policy, Congressman 
Price has a lot of experience in health care policy. Yes, he has 
experience, but it is the kind of experience that should horrify us if 
we care about Medicare, if we care about Medicaid, or if we care about 
our own insurance coverage.
  Congressman Price's record is perfectly clear. He wants to destroy 
fundamental protections that millions of Americans depend on for their 
health and economic security, and, frankly, he isn't very subtle about 
it. He has described ACA's ban on discriminating against individuals 
with preexisting conditions as ``a terrible idea.'' He has voted 10 
times to defund Planned Parenthood--voted 10 times against a group that 
provides lifesaving cancer and sexually transmitted infection 
screenings to millions of patients a year. He has tried to privatize 
Medicare and raise the age of eligibility. Privatize Medicare; think 
about that. And he has been one of the chief boosters in Congress for 
gutting the Medicaid program--the Medicaid program, which provides 
health care for millions of kids, for people with disabilities, for 
families with parents in nursing homes--cut money to keep people in 
nursing homes.
  Nonpartisan analyses of these plans are not pretty. Millions of 
people in this country, young and old, children and grandparents, poor 
and middle-class workers would be denied access to lifesaving care.
  Congressman Price touts his own magic numbers that say differently, 
but make no mistake, this is the record of someone who wants to use his 
position at HHS to advance a radical, reckless agenda that puts 
rightwing, anti-government ideology ahead of the health and safety of 
the American people.
  During his hearing before the HELP Committee, I asked Congressman 
Price some pretty simple questions. I asked him about more than $1 
trillion in cuts that he has proposed to Medicare and Medicaid. I asked 
him if he would keep or undermine President Trump's campaign claim that 
he would protect these programs. I asked him to guarantee that not one 
dollar in cuts to Medicare would take place on his watch. I asked him 
to guarantee that not one dollar in cuts for Medicaid to help people 
living in nursing homes would happen on his watch. I asked him to 
guarantee that not one dollar in cuts for people with disabilities 
would happen on his watch.
  I asked him three separate times to make this commitment, and three 
separate times he refused to do so. Think about that--cut Medicare for 
millions of seniors, cut help for people with disabilities, cut 
Medicaid for people living in nursing homes. This is the person Donald 
Trump wants to put in charge of those programs.
  We have a lot of work we need to do on health care. We need to reduce 
the cost of insurance. We need to make sure insurance is available to 
small business owners, gig workers, and part-time workers. We need to 
make sure insurance continues to cover health care for women and people 
with preexisting conditions who otherwise are not going to be able to 
get insurance. What we don't need is to put someone in charge who is 
hell-bent on destroying health care in America.
  For me, this is easy. When someone says he wants to cut Medicare, I 
am done with him. When someone says let's take away the money that 
people rely on to pay for nursing homes, this guy is finished. When 
someone says that protecting people with preexisting conditions is a 
bad idea, they don't get the job. This should be easy for everyone in 
Congress. This is a moment for Senator Republicans to step up and say 
no.
  There is another reason to reject Congressman Price's nomination, a 
reason that has nothing to do with his terrible ideas, a reason that 
would disqualify him even if we agreed on every single issue. The 
reason is basic ethics.
  During his time in Congress, Mr. Price has made money by trading 
hundreds of thousands of dollars' worth of stock in healthcare-related 
companies at exactly the same time that he pushed legislation that 
could affect the value of these stocks. His formula has been pretty 
simple. First he buys the stock, then he pushes bills to help the 
company, which helps the stock price go up.
  For example, Congressman Price bought stock in a company that makes 
hip and knee replacements, and then he introduced a bill to suspend a 
Federal rule affecting Medicare reimbursements for hip and knee 
replacements. Congressman Price bought stock in a bunch of 
pharmaceutical companies, then cosponsored a bill to suspend a Federal 
rule that would hold down drug prices for the drugs that these 
companies manufacture. Congressman Price bought stock in an Australian 
biotech company with an experimental drug to

[[Page 2332]]

treat multiple sclerosis, and then he voted for a bill that would make 
it easier for the FDA to approve these drugs.
  So what does Congressman Price have to say for himself? How does he 
explain this connection between buying stock, then supporting changes 
in the law that would boost the value of the stock he just bought? 
Well, he has his excuses lined up, and I have to say they are doozies.
  He says he didn't know about the trades; his broker made them without 
asking him first. Oh, wait. He did know about the trades. He just 
happened to know about an obscure Australian biotech firm, and he just 
happened to decide to invest as much as $100,000 in it because it was a 
good investment. Then he hit his last excuse: It is all OK because he 
paid the same price as anyone else who bought the stock.
  Wow, that is really a heaping, steaming pile of excuses, and the 
excuses stink. These are Congressman Price's stock trades, not anyone 
else's. He made those decisions to buy those stocks, and then he 
repeatedly pressed for rules that would increase the value of those 
stocks. In fact, with one of the deals, it isn't just a question of 
stinkiness; it is a question about whether he broke the law.
  By his own account, Congressman Price found out about an Australian 
biotech company called Innate Immunotherapeutics from a fellow House 
Member who, it just so happens, sits on the company's board and holds 
the largest stake in the company. So when he decided to buy his latest 
batch of stock, Congressman Price got access to a private sweetheart 
deal, meaning he got a discount on the price of the shares the general 
public couldn't get.
  This sequence of events might break the law. That is not good at all. 
And getting special access to a sweetheart deal doesn't help your claim 
that you are just an ordinary guy with a boring stock portfolio. So 
when Congressman Price appeared before the Finance and HELP Committees, 
he said he had not paid a lower price than had been available to other 
investors. That is just not true. The company itself pointed it out. In 
fact, Congressman Price got a special discount that went to only 20 
people in the country--20 special friends, including the Congressman 
who could help write the laws that would make the company even more 
valuable.
  An outside watchdog has called for an SEC investigation into whether 
Congressman Price committed insider trading. Price lied to Congress 
about his trades, and that should be the end of it. No more nomination 
for Secretary of HHS. The Congressman should have the decency to 
withdraw his nomination. It should have happened weeks ago. And if he 
didn't go voluntarily, the President and his friends in Congress should 
have quietly but forcefully pushed him out, but that is not what 
happened either. Instead, Republicans barreled straight ahead, and they 
changed the rules to do it.
  Since Congressman Price lied to the committee, Democrats wanted him 
back for another hearing to ask him about it. Republicans refused, and 
Democrats boycotted the Finance Committee to try to force Price to 
explain why he lied. So the Republican response was to just suspend the 
Senate rules so they can run around the Democrats and move forward 
Price's nomination anyway.
  Do we do not care about basic ethics anymore? Is that just gone? A 
Congressman should not be buying stocks then pushing laws to help the 
company, and that Congressman sure shouldn't be lying to the United 
States Senate about it.
  Because Congressman Price has no shame, it will take three Senate 
Republicans to reject his nomination. Where are the three Republicans 
who will say no to a man who bought stock and then tried to get the 
rules changed in Washington so the companies would be more profitable? 
Where are three Republicans who will say no to a man who got a special 
stock deal that went to only 20 people in the whole country? Where are 
three Republicans who will say no to a man who lied to a Senate 
committee? This has nothing to do with politics. It is about basic 
ethics. It is about potentially illegal behavior. Where are three 
Republicans who will say no to this man?
  When Donald Trump selected Congressman Price for this job, he said 
Price was part of a ``dream team that will transform our healthcare 
system for the benefit of all Americans.'' Over the past few weeks, I 
have been trying to understand exactly what that dream looks like.
  For families all over this country, the dream is pretty simple. They 
want to know that when they get sick, they can go to the doctor and not 
be hit with a surprise bill they can't pay. When they buy insurance, 
they want to be sure it covers birth control or cancer screenings and 
preexisting conditions. They want to be able to fight cancer and not 
lose their house or declare bankruptcy because their insurance company 
imposes a lifetime limit on benefits.
  President Trump does not share this dream for health care in America, 
and neither does Congressman Price. From his first day in office, 
President Trump has acted to undermine access to health care. Now he 
has nominated an HHS Secretary who will help him sabotage our Nation's 
health care system from inside the Department of Health and Human 
Services.
  Yes, we have our differences over health care, and, yes, there are 
fixes we need to make, but where are three Republicans who will say no 
to a man who wants to cut Medicare? Where are three Republicans who 
will say no to a man who wants to cut nursing home care? Where are 
three Republicans who will say no to a man who wants to cut insurance 
coverage? Democrats can't do this alone. Three Republicans need to put 
aside partisanship and stand up for the American people. We need you. 
The American people need you.
  With my remaining time, I want to share some of the letters I have 
been getting from families in Massachusetts who have seen the reckless, 
radical plans that President Trump, Congressman Price, and Republicans 
in Congress have put forth for the Nation's health care system. These 
families know exactly what is at stake in this debate. Congressman 
Price didn't have an answer when I asked him to protect Medicare and 
Medicaid, but these letters are from constituents and they show just 
how important these programs are.
  Lee from Holliston wrote to me, concerned about cuts to Medicare and 
Medicaid. I am just going to read an excerpt from his letter:

       I am a 65 year old disabled woman who depends on the 
     generosity of MassHealth and Medicare to survive. I am 
     terrified that Medicare and Medicaid will be so drastically 
     cut that I will no longer be able to maintain my life. I live 
     in HUD housing, receive Medicare and MassHealth which covers 
     all of my healthcare and allows me to continue to live on my 
     own through senior services and the Personal Care Attendant 
     program.
       I guess I am just feeling scared and hopeless as I realize 
     the potential for destroying the lives of seniors who live on 
     Social Security and nothing else. I wear an insulin pump, 
     have type 1 diabetes going on 53 years, and I have multiple 
     complications--including an amputation 11 years ago.
       My healthcare costs are just unaffordable without all the 
     assistance. Medicare and MassHealth covers everything for me 
     so that the $1,050 per month I receive is doable for living 
     expenses.
       I just need to know it is going to be OK.

  Lee, we need three Republicans to help out here. Congressman Price 
has made it clear that he wants more than $1 trillion in cuts to 
Medicare and Medicaid, and that affects you. We have to find three 
Republicans to help out and to help stand up for you and the rest of 
America.
  I also heard from Alan from South Shore, who is worried about his 
daughter Meg. Here is what he wrote:

       My daughter Meg is 29. She was born with a condition called 
     neurofibromatosis. As a result of this, she has benign but 
     inoperable tumors on her spine. They cause her chronic pain 
     and problems walking. On some days, she cannot walk even one 
     step. On other days, she might begin walking with a walker, 
     then suddenly collapse on the floor.
       Meg cannot hold down a job: She spent the last quarter of 
     2016 in and out of hospitals. She receives about $700/month 
     from Social Security Disability. She has no savings. She pays 
     for her Medicare prescription drug Part D supplement out of 
     her Social Security. MassHealth is free for her, and it pays 
     for

[[Page 2333]]

     Meg's Medicare Part B. I am retired, so I can only help her a 
     bit.
       If Trump's first idea about TrumpCare goes into law--where 
     he assumes you will buy your health insurance out of 
     savings--I fear Meg will live in her bed, watching repeats of 
     quiz shows on her television. And her network of care--
     including emergency services, rehab physical therapy, chronic 
     disease management prescription drugs--will be reduced.

  I understand why you are worried, Alan. I am worried, too, because I 
think that is exactly the path we are on with Congressman Price's 
nomination to head up HHS. That is why we are fighting back.
  Boston Center for Independent Living also shared with me a story from 
a constituent named Jill who receives health care from the State's 
Medicaid Program. Let me tell you a little bit about Jill.
  Jill is 62 years old. She has a heart defect, a seizure disorder, and 
serious osteoporosis. She had a varied career as a manager of a women's 
clothing company a decade ago, and in the 1980s, she installed some of 
the first computer networks in public schools. In the past several 
years, Jill has had significant health problems: surgery for her heart 
condition and multiple broken bones due to her worsening osteoporosis.
  MassHealth, the State's Medicaid Program, has covered hospital bills, 
appointments with specialists, rehab stays, and an affordable 
medication plan.
  Jill is now hoping to use a personal care assistant to give her 
support with shopping, making meals, and basic housekeeping.
  Jill said: ``For me, Medicaid is a lifeline--any cuts from Washington 
would be a disaster.''
  I hear you on that, Jill. I just hope that Congressman Price, 
President Trump, and the Republicans hear you as well.
  Medicaid helps a lot of people in Massachusetts, including the very 
youngest. I got a very powerful letter from Marika from Duxbury, who 
wrote to me about giving birth to her son Jack after just 28 weeks of 
pregnancy. I want to read parts of her letter:

       I'm writing to you today because I am horrified about the 
     changes that may be happening to healthcare in the United 
     States.
       My husband and I welcomed our son, Jack, at 28 weeks in 
     July of 2015. I had a very normal, healthy pregnancy--until 
     suddenly it wasn't. I ended up with rapid onset of HELLP, a 
     rare and life-threatening syndrome, and an emergency C-
     section saved both my life and Jack's.
       Jack was 1 pound, 14 ounces when he was born. We were both 
     in the ICU for some time, my son Jack for 110 days. He had 
     all the issues you'd imagine at 28 weeks--cardiac, pulmonary, 
     feeding.
       Today, at 18 months old, Jack is a fighter--my hero 
     really--and despite still needing oxygen and a continuous 
     feeding tube that is surgically inserted into his intestines, 
     he is cruising, talking, and ALIVE.
       He is alive, and quite frankly, I'm alive because of our 
     amazing healthcare. I have the benefit of an exceptional 
     employer plan from Harvard University. But Jack also 
     qualified (because of his birth weight) for MassHealth. And 
     our public health insurance has been an incredible resource:
       Jack's hospital bills were in the millions after his 110 
     day stay in the NICU. This doesn't even include my own 
     hospital costs for my stay. Despite having excellent jobs and 
     resources, my husband and I would have been bankrupt, and 
     immediately so, without our private health insurance and 
     MassHealth benefits.
       Since coming home from the NICU, Jack is still on a feeding 
     tube and oxygen, and he cannot be accepted into regular 
     daycare. He would go to a medical day care, but he has no 
     cognitive delays, and so placing him in such a facility would 
     not ensure that he gets the regular developmentally 
     appropriate engagement that he needs. And so MassHealth pays 
     for skilled nursing care in our home with no out of pocket 
     costs. This means that Jack gets the care that he needs, and 
     my husband and I can still work at the jobs that we love.
       Jack participates in early intervention programs and 
     receives feeding therapy, physical therapy and occupational 
     therapy free of charge.
       Jack's Synagis shots cost zero dollars. Synagis is a 
     prescription medication that is used to prevent a serious 
     lung disease caused by respiratory syncytial virus, RSV, in 
     children at high risk for severe lung disease from RSV. The 
     average wholesale price is $780.15 for the 50 milligram 
     Synagis vial, and $1,416.48 for the 100 milligram vial. Jack 
     gets a 150 milliliter shot every month.
       I cannot imagine this life without my son's public health 
     insurance. I recently enjoyed the NICU Family Advisory Board 
     at Beth Israel Deaconess Medical Hospital in Boston (where 
     Jack and I were cared for) as a way to give back. Today, I 
     mentor other families who have unexpectedly found themselves 
     the parent to a tiny premature baby fighting for life. In 
     nearly every case, navigating the insurance system and fears 
     about money are top of mind.

  I am glad to hear that Jack is doing well, but I understand why it is 
that you want to hang on to MassHealth and why it is that we cannot 
take the cuts Congressman Price has proposed.
  Families in Massachusetts are also deeply worried about the future of 
the Affordable Care Act. Jackie from Norwood wrote to me about how the 
ACA helped her get coverage for therapy after her mother was killed. 
She wrote:

       My mother was murdered when I was 24. I was on her 
     healthcare, which kicked me off the day after she died. I had 
     recently accepted a new job and I was set to start that 
     Monday (she was killed on Saturday). I had already left my 
     previous full-time job the Friday before.
       Due to having to move states after her death, I couldn't 
     start my new job. I didn't know when I'd have work again that 
     could provide insurance, nor did I have another parent whose 
     plan I could join. I also had no way of affording COBRA 
     payments.
       So in the matter of one night, I was left helpless in so 
     many ways. Not having health insurance was one of many side 
     effect issues that no homicide victim's family should have to 
     worry about. Especially the next day and when planning a 
     funeral.
       Thanks to the Affordable Care Act, I was able to get 
     covered almost immediately, which meant I could still afford 
     my current medications and I was able to get into needed 
     therapy right away. If it weren't for the ACA, I would have 
     been left struggling and sick as a result of something FAR 
     out of my control.

  Very true, Jackie.
  Jackie goes on to say:

       I ended up finding work within a couple of months, and I am 
     still in treatment for PTSD. I was lucky enough to find 
     employment at Harvard University and no longer needed 
     coverage through the ACA. I have generous health benefits 
     provided to me. However, I never want a fellow citizen or 
     victim of homicide to be without medical care due to cost, 
     preexisting conditions, or other setbacks. I am happy my tax 
     dollars go to help programs like MassHealth and the ACA. We 
     all work hard, but that doesn't mean we are all as fortunate.
       I am not the typical poster child for a homicide victim/
     survivor. I am white and college educated. I work for an Ivy 
     League school. I still needed help when disaster struck, and 
     so many others less privileged than me need help finding 
     affordable health care.
       Please continue fighting for me and other victims and 
     survivors of homicide.

  That is what we are here for, Jackie. That is what we are supposed to 
do. We just need three Republicans to help us out on this.
  I also heard from Jennifer from Northampton, who is terrified for her 
family if the ACA is repealed. She says:

       I suppose I can't say when our story starts. Maybe the day 
     I met my then-life partner (now wife) of 16 years. Maybe it 
     begins when she had to have emergency surgery in Maryland 
     when she wasn't covered under my insurance, because our union 
     wasn't legally recognized. Maybe it begins with the tens of 
     thousands of dollars of debt we incurred in uncovered medical 
     expenses when we tried to get pregnant with our son.
       Or maybe it started two days ago when the unthinkable 
     happened. My wife got laid off. After seven years of 
     exemplary services to a large human services agency whose 
     mission is supporting individuals and families affected by 
     homelessness, my wife was given no warning, no severance and 
     no compassion in her sudden dismissal from the agency. For 
     any family this would be devastating. Now we come to the dire 
     part.
       About a year ago, my younger sister, Stephanie, was 
     diagnosed with an aggressive form of Triple Negative Breast 
     Cancer at 35 years of age. But this story isn't about that.
       Six months later, my mother got diagnosed with Stage 4 
     Metastatic Breast Cancer.
       I didn't have to be an over-educated lesbian to know that 
     there was something genetic going on in my family. I got 
     tested for the BRCA gene and was found positive for the 
     mutation that causes breast cancer, specifically Triple 
     Negative (like my sister had) and am currently looking at an 
     80% chance of developing Breast Cancer in my lifetime.
       I need a double mastectomy and I need it soon. It's 
     scheduled, in fact, for March 6th, 2017. And now, my wife 
     doesn't have a job. I am a Behavior Analyst who specializes 
     in the treatment of children with Autism Spectrum Disorder. I 
     have a small private practice and don't make enough money to 
     support our household. I also don't have access to health 
     insurance through any of my contracts.
       That is why it's dire.
       One laid-off spouse, one four year old son, one self-
     employed wife with an 80% chance of

[[Page 2334]]

     developing breast cancer and fear of the ACA being repealed. 
     This is dire.
       We are terrified, I am terrified.
       This isn't a ``wait and see'' situation for my family. This 
     is us. This is now. And this is real.

  Yes, Jennifer, and that is why we are here tonight, in the U.S. 
Senate, to debate whether or not Congressman Price--a man who wants to 
cut Medicare, cut Medicaid, repeal the Affordable Care Act--is going to 
be the next head of Health and Human Services. That is why we are 
fighting. That is why we are looking for three Republicans to step up 
with the Democrats and turn him down. We must protect the Affordable 
Care Act.
  I also got a letter from Olivia, a college student from North 
Reading. Olivia wrote me about what the ACA means to her as someone 
living with multiple chronic illnesses. She wrote:

       I am a twenty-two year old white woman from a middle-class 
     suburb of Boston. I attend the University of Massachusetts 
     Amherst and will be applying to graduate school next year. I 
     eat an anti-inflammatory diet, I exercise regularly, do not 
     smoke, and drink lots of water. I am on my parents' 
     insurance, which they receive through their employer. I am a 
     patient at some of the best hospitals in the world.
       I am so fortunate to live in a state that protects my right 
     to affordable health care. I was also hopeful when I heard 
     that President Trump was considering modifying ObamaCare 
     rather than repealing it. However, I am still worried about 
     the actions that will be taken in 2017 by his administration 
     and by Congress.
       If you met me you would see a ``young, vibrant, and 
     ambitious woman''--other people's words, not mine. Many 
     people and politicians in this country would meet me and not 
     assume that I rely on the ACA. I am not from a low-income 
     family, I don't live in an area that doesn't have adequate 
     medical facilities, and I appear well. I am, however, living 
     with multiple chronic illnesses. I suffer from asthma, 
     fibromyalgia, chronic urticaria, chronic migraines, irritable 
     bowel system, gastro-esophageal reflux disease, and a rare-
     genetic kidney disorder.
       I take multiple medications daily that keep me alive, 
     prevent further health complications, and that allow me to 
     take care of myself. I also seek other therapies to manage my 
     conditions, such as chiropractic care and physical therapy. I 
     currently have great health insurance, yet I still pay 
     hundreds of dollars a month just to give myself any quality 
     of life.
       I read the Trump/Pence administration's health care plan 
     and I am aware of the efforts by the GOP to repeal Obamacare 
     and their readiness to do so now that President Trump has 
     taken office. I don't believe I have to explain to you why 
     this worries me.

  No, you don't.

       I won't go on a rant about why health care reform should be 
     about the people not the money (though I could). I will also 
     not talk about why we should have universal health care 
     (though I could). I am hoping that my story offers a slightly 
     different perspective on why certain aspects of the ACA 
     cannot be modified.
       Please remind your fellow senators that millions of 
     Americans suffer from multiple chronic illnesses, many of 
     which are invisible, and that we are a minority that is often 
     forgotten. Many people are just like me. We are college 
     students and new graduates who have to learn to manage our 
     medical conditions before going out into the real world.
       To do this, we may have to stay on our parents' insurance 
     until we are twenty-six years old. We are people who can only 
     work part-time jobs and will need insurance to help keep our 
     medical costs down. We may require expensive prescriptions 
     and numerous doctor visits a year; we cannot have a cap on 
     our care because our conditions are chronic and 
     unpredictable. We are people who will have to apply for 
     insurance with pre-existing conditions which should not be 
     held against us. We are thankful for preventative care 
     because it prevents illnesses that would exacerbate our other 
     conditions.
       Health care is a business that we need but that we didn't 
     ask to be a part of. It is a business we all take part in, 
     whether we plan to or not. We are NOT burned-down houses--we 
     are citizens who provide meaningful contributions to our 
     country.
       I hope that Congress can work together to continue to give 
     people like me a fighting chance.

  I am with you on that. I hope Congress can work together to give 
people like you a fighting chance.
  I also got a letter from Christine in Canton, who wrote to me about 
her son. She writes:

       My oldest child is a 21-year-old college student (soon to 
     turn 22 in February), who is also transgender. He suffers 
     from anxiety and depression. He's been working very hard to 
     complete college while also seeking treatment for his mental 
     health issues. He sees a therapist weekly and has also been 
     hospitalized twice for mental health issues since he's been 
     in college.
       Luckily, due to the Affordable Care Act, he is able to 
     remain on our insurance, where the co-payments for both 
     therapy and hospitalization are at least manageable. If he 
     were not to have coverage through our insurance, I'm not sure 
     that we could afford to pay for his treatment--and as a 
     college student, he certainly could not afford to pay for it. 
     It frightens me to think of what will happen to him if he is 
     not able to receive treatment to keep him healthy.
       Like so many others covered by the Affordable Care Act, it 
     is a life or death situation. I need to know that you will 
     fight by any means possible to keep the Affordable Care Act 
     from getting repealed.
       I also have a 19-year old college freshman and a 17-year 
     old high school senior. While they do not have the same 
     health issues as their brother, we all know how that can 
     change in an instant. The repeal of the Affordable Care Act 
     will also have consequences for them down the line.

  I guarantee, Christine, I will be here to fight for you, to fight for 
keeping the Affordable Care Act for you and for families like yours.
  Denise from southeastern Massachusetts wrote to me about how her 
family is fighting cancer. Here is what she said:

       We are family of four, with three cancer survivors. My 
     husband is a childhood cancer survivor who is now fighting a 
     blood disorder and is a patient at Dana Farber. I am a three-
     time cancer survivor. Having been diagnosed with breast 
     cancer at age 42 (with no family history), I have since had 
     two recurrences.
       I have had radiation, five years of tamoxifen therapy, a 
     bilateral mastectomy, and reconstruction. My reconstruction 
     has been difficult, with five surgeries within 18 months. I 
     have been postponing another surgery due to cost, since my 
     insurance has changed for the worse. At age 23, my daughter 
     was diagnosed with Hodgkin's lymphoma and underwent surgery 
     and seven months of chemotherapy.
       We are a family that has always been proactive and 
     responsible in receiving regular health care. Now, my husband 
     and I have been rejected for long-term care. My daughter, who 
     has two children, pays a higher premium for life insurance 
     and has been denied cancer insurance. We are in a position 
     where we cannot even succeed in our attempts to take 
     responsibility for ourselves.
       This outreach to you is a further attempt to do just that; 
     to maybe give you one more example of reality in your fight 
     for us. We are not whining; we are fortunate to be a close, 
     loving family that has had the strength to rally every time 
     adversity has struck.
       But we are tired from the fight and very afraid for the 
     future. It is shocking to us that, in the richest country in 
     the world, after years of working, planning and saving, that 
     we are at the point of fearing a possible bankruptcy in our 
     later years. We also fear financial destruction for our hard-
     working children due to uncovered medical expenses or the 
     possible exorbitant premiums of a high-risk insurance pool.
       Please, please never tire in the fight for access to 
     comprehensive affordable healthcare. Good medical care should 
     not be a privilege for the rich, but a fundamental right for 
     all.

  Boy, I am with you on that one, Denise. It is a fundamental right for 
all, and that is what we will continue to fight for.
  I also received a letter from Jenny in Worthington. And I want to 
read you Jenny's entire letter because she really underlines what is at 
stake in this fight.

       My husband and I have spent our entire careers in the arts. 
     I write music for the theater; my husband is a novelist, 
     playwright, and freelance medical writer. We have two 
     children. We own a home. We paid back every dime on our 
     student loans and we contribute regularly to our self-funded 
     retirement accounts. We have no consumer debt. In short, we 
     are hardworking, fiscally responsible people.
       We recognize the trade-offs that come with being our own 
     bosses. We enjoy the freedoms of self-employment, and take 
     seriously the extra burden that society imposes on us, 
     including making our own Social Security payments, 
     contributing to Medicare, and buying health care on the 
     individual market, something we have done our entire adult 
     lives.
       When the Affordable Care Act was passed, we were thrilled. 
     For the first time, we had adequate coverage for our family. 
     Our deductibles shrank. We lost the dreaded co-insurance 
     provision and began to think that we could prepare 
     financially should we face the worst.
       Or so we believed.
       Our difficulties began in late 2014, when I was diagnosed 
     with breast cancer. Over the weeks that followed, I endured 5 
     surgeries, including a unilateral mastectomy and 
     reconstruction. Almost immediately after, I began to 
     experience complications. Since then, I've come to learn that 
     I was having a reaction to the silicone implant used in my

[[Page 2335]]

     reconstruction and that was just the early stage of a complex 
     autoimmune condition that still lacks a name.
       Back then, all I knew was that I was wracked with constant, 
     severe pain. I lost the ability to walk. I could no longer 
     think straight and I lost sight in my right eye. Luckily, we 
     stumbled upon an article by a Dutch team that had examined a 
     cohort of women suffering from the same condition. After 
     consulting with the lead author of the paper, we decided that 
     my implant was to blame, and we determined to have it 
     removed.
       Although I experienced some relief immediately after ex-
     plantation, I have never fully recovered. The joint pain and 
     exhaustion persist. I have shed more than a third of my body 
     weight. The battery of medications I take do little more than 
     keep my pain at bay, permitting me to drive my son to school 
     or shop for groceries, but not much more.
       As for my artistic life, it has been put on hold. I have 
     unfinished commissions from two theaters--Chicago Shakespeare 
     Theater and Playwrights Horizons, in New York City--and both 
     institutions have been incredibly patient. Yet the truth is 
     that I have been unable to work for more than two years.
       Severe cognitive impairment is a hallmark of my condition, 
     and I have serious problems with my short-term memory. 
     Holding the thread of conversation is incredibly difficult, 
     and I experience blinding headaches if I write music for more 
     than a couple of hours. Frequently, it feels as though 
     someone has reorganized my brain but forgotten to leave me 
     the instructions. It is frustrating; it's terrifying.
       Only one thing has made it possible for me to survive this 
     at all: the coverage I receive through the ACA.
       The day I got my cancer diagnosis, I was in the process of 
     re-certifying through the Massachusetts Health Connector. I 
     was thrilled when my local Navigator told me that thanks to 
     my new diagnosis, I qualify for Massachusetts' Breast and 
     Cervical Cancer Treatment Program, a Medicaid-backed 
     initiative designed to cover middle and low-income women 
     through their treatments. Not only would I be covered, but 
     our two children would also be insured by MassHealth, our 
     state's Medicaid program. Though my husband continued to 
     purchase care through a separate plan, this single event 
     saved our family from financial ruin.
       Now, all of that stands to change. With the repeal of the 
     life-saving provisions guaranteed by the ACA, we are faced 
     with the complete erosion of our savings. The Republican 
     Congress has already voted to eliminate the ban on denying 
     individuals coverage on the basis of previously existing 
     conditions, meaning that I will most likely be uninsurable. 
     What will happen then? Will we go bankrupt? Will we lose our 
     home? How will I cope without my medications when we can no 
     longer afford to pay for them?
       The passage of the ACA did more to shore up our little 
     family than any other piece of legislation in my lifetime. It 
     has enabled me to face my grave illness without worrying 
     whether cost would be a factor in my treatment or whether I 
     could try the next medication my doctors prescribed to 
     relieve my pain.
       In sharing our story on social media, I have been 
     overwhelmed by the outpouring of concern from our tiny 
     community of theater professionals. The President of the 
     Dramatists' Guild, a professional association for theatre 
     artists, called me to offer the assistance of their Emergency 
     Fund should we need it. And while it is heartwarming to 
     receive the support of my professional community, the hard 
     truth is that even the most doggedly determined not-for-
     profits can't possibly replace the broad social safety net of 
     the Federal government--a safety net Republicans are 
     determined to shred.
       In every industrialized country but ours, health care is 
     considered an inalienable human right. It is abhorrent to 
     claim that care is something Americans should have to ``shop 
     for.'' Price-comparison shopping may seem like a wonderful 
     market-driven design, but in reality it forces us to confront 
     the terrifying arithmetic of balancing how much care we need 
     against what we can afford. The sicker one grows, the harder 
     it becomes to solve that equation.
       We have no idea what the Republicans intend by way of a 
     replacement to the ACA. They refuse to specify, despite their 
     years of claiming that the ACA is a failure. They talk of 
     expanding Health Savings Accounts (HSAs), though such 
     accounts represent nothing but a disingenuous transfer of the 
     cost to the consumer. Even if such an approach made sense, 
     how far would $6,750 (the current HSA limit) go in meeting 
     actual health care costs? That amount would be wiped out 
     after a single visit to the emergency room.
       What's more, where do they expect sick Americans--those 
     fighting for their lives and unable to work precisely because 
     of their illnesses--to suddenly uncover $6,750 to sink into a 
     tax-sheltered HSA?
       Clearly, this idea has been put forward by people who do 
     not depend on their health insurance for their very lives. 
     They pretend that this sort of thing will save ``our 
     system,'' but their proposal is like offering a patient an 
     Advil for an amputation--laughably inadequate at best; an 
     utter horror at worst.
       What's more, efforts like the expansion of Medicaid under 
     the ACA have already saved us. Or many of us. Certainly me, 
     in any case. A Republican friend wrote me recently, venting 
     about the ``third-world'' coverage Medicaid provides. What he 
     had to say was ignorant and false. Medicaid isn't failing. To 
     the contrary, it has saved my life and the lives of many 
     others who have simply had the misfortune of falling ill. And 
     isn't that, after all, one of the primary functions of 
     government? To care for its citizens and return them to the 
     ranks of the healthy and productive?
       We have no idea what the year ahead holds for us. It is 
     likely we will face health premiums of $24,000 or more for a 
     low-level plan. Our premiums will consume 30% of our income, 
     more than our mortgage. Despite MassHealth, we shelled out 
     nearly $15,000 for uncovered medical expenses in 2016, and we 
     are already on track to surpass that number this year. On top 
     of everything else, this is the year our daughter starts 
     college. I'm not the typical Medicaid patient that people 
     seem so fond of demonizing, nor am I some poster child of the 
     ACA. I am simply one of the countless individuals whose story 
     does not fit the narrative the Republicans are attempting to 
     feed us about the ACA and about what it means to be sick in 
     America. Medicaid is on the chopping block not because it is 
     failing, but because the people who benefit from it too often 
     fail to speak up on their own behalf. Their silence has 
     nothing do with a lack of will or words. They are simply too 
     busy struggling to survive.
       Medicaid benefits our poorest, yet it also assists those 
     slightly higher on the income ladder--people like me who 
     would vastly prefer to be thriving without it. Many more 
     people than you suspect have turned to it in a time of need. 
     They aren't merely characters in some musical or play. Trust 
     me, I know. They are your friends and neighbors. They are 
     families whose lives have been unended by illness. This is 
     what happened to my family. And, with a single diagnosis, it 
     could be your family too.

  Thank you. Thank you for writing. This is why we are here to fight.
  I also heard from Kaitlyn, from Cambridge, who said the ACA has 
allowed her to continue pursuing her postdoctoral research. She says:

       I am postdoctoral fellow at MIT, and I have a pre-existing 
     condition. In 2012, during my second year of grad school, I 
     started having debilitating pain in my abdomen. The pain was 
     so bad I couldn't eat or sleep, and I lost 30 pounds over two 
     months. The pain was so bad I couldn't wait the full 3 months 
     to see a specialist, and I went to the ER and finally got a 
     diagnosis for an autoimmune disease and began treatment.
       However, my condition was so advanced that a little over a 
     year later I needed an emergency surgery while I was visiting 
     family out of state. I spent six nights in the hospital and 
     rang up a bill in excess of $50,000. Luckily, I was 25 and 
     still on my parent's insurance. Additionally, I was doubly 
     insured by the student health insurance from the University 
     of California, for which I was automatically enrolled through 
     my graduate program. Other than a $200 deductible, my 
     hospital bill was paid in full.
       Now that I have a chronic illness, having quality 
     healthcare and regular checkups is vital to staying healthy 
     and productive. My medication, Humira, costs $5,000 a month 
     out-of-pocket, which was more than double my grad school 
     stipend. With insurance, I only pay $25 a month. Though 
     surgery helped me tame the inflation in my intestines, my 
     disease began to express itself as arthritis in my joints. 
     The pain was so bad that one Christmas I canceled my trip 
     home to see my family and spent the whole time alone on my 
     couch. I had a bad reaction to some of the medications and 
     became so severely anemic that I needed a blood transfusion. 
     Additionally, one of the medications I take causes severe 
     birth defects. So I needed an IUD to prevent pregnancy.
       Easily, all these conditions could become overwhelmingly 
     expensive. But with my student health insurance through the 
     University of California, I could afford it. The premium was 
     $300 per month, part of which was covered by the university. 
     My medications cost $110 a month, and I had a yearly out-of-
     pocket maximum of $2,000. While I didn't get my insurance 
     through the exchanges, the other conditions of the ACA which 
     determine the minimum quality of care made it possible for my 
     care to be affordable.
       By having proper treatment and care, I can be a productive 
     member of society. I have received my PhD in Applied 
     Mathematics and my research contributes to the design of 
     medical devices that can be used for cancer screening. I am 
     able to mentor young girls and encourage them to study math 
     and science. And who knows--one of them may cure cancer one 
     day! Since I am no longer in pain and I am not in debt, I was 
     able to find a prestigious job after graduation. When a state 
     provides for the health of its people, they can thrive at 
     home and at work. It is not only the moral choice, but also a 
     good choice for the economy.

  Kaitlyn, thanks for writing and thanks for being one of the big 
success

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stories under the Affordable Care Act. This is what we are fighting for 
tonight.
  I also heard from a young woman in Somerville named Samantha. Here is 
what she wrote:

       I've been dealing with severe mental health issues since I 
     was a kid. I am now 27. In that time, I have been through 
     numerous hospitalizations, residential treatment, day 
     treatment, intensive outpatient treatment, and outpatient 
     treatment.
       When I was 18, I had to drop out of college and spent 3 
     months in residential treatment for my eating disorder. The 
     year prior, I spent 2 months in residential treatment and 6 
     months between day and intensive outpatient treatment, and I 
     had been in therapy for 4 years.
       Due to Massachusetts law, I was still covered by my 
     parent's insurance, but the Massachusetts health care reform 
     didn't stop insurance companies from imposing lifetime 
     limits. At 18 years old, fighting for my life, I overheard my 
     parents discussing lifetime limits in regard to my health 
     care. I don't know how much all that treatment cost, or how 
     much of my lifetime limit I had consumed. For the next 7 
     years, I was in and out of treatment at various levels.

  Mr. President, I ask unanimous consent to extend my time by 10 
minutes, if I might, to finish my stories.
  The PRESIDING OFFICER (Mr. Johnson). Without objection, it is so 
ordered.
  Ms. WARREN. Thank you.

       In 2014, when I had my own health care, I had a bad 
     relapse. For the first time I was paying for my own 
     treatment. I had health insurance through my employer that 
     was really good, but even with that, for 1 month of 
     residential treatment, 1 month of day treatment, and 3 months 
     of intensive outpatient, plus therapy, a nutritionist, a 
     psychiatrist and medication--all crucial to my recovery--my 
     out-of-pocket health care costs reached almost $10,000.
       These days, I am much more stable and have remained in 
     relatively good health, but all because of the continued 
     support I get from my therapist, psychiatrist, and doctor. I 
     can only imagine how much money has been spent and how close 
     I'd be to my lifetime limit if those were still in place. And 
     of course, all that adds up to being a ``pre-existing'' 
     condition.
       The simple fact is that I would most likely be dead today 
     were it were not for the protections provided by the ACA, and 
     if I lose those protections, if I have another relapse, I 
     will either end up dead or unemployed and mired in debt.

  Samantha, thank you for writing. Thank you for fighting. That is why 
we are on the floor of the Senate tonight, to continue to fight for the 
Affordable Care Act and to continue to fight against cuts to Medicare 
and Medicaid. This is what is at stake for families in Massachusetts.
  As Jennifer said in her letter: This is us. This is now, and this is 
real. Congressman Price wants to cut more than $1 trillion from 
Medicare and Medicaid. But I am not giving up, because I am here to 
fight for Lee and Meg and Jill and Marika's baby Jack.
  Congressman Price wants to rip up the behavioral health protections 
in the Affordable Care Act. But I am not giving up, because I am here 
to fight for Christine's son and Jackie and Samantha.
  Congressman Price wants to get rid of the ACA's ban on discriminating 
against individuals with preexisting conditions. But I am not giving 
up, because I am here to fight for Jenny and Kaitlyn and Olivia and 
Denise and Jennifer.
  I will fight for every one of them and for the tens of millions of 
people who are counting on Medicare and who are in need of Medicaid to 
pay nursing home bills and to help with home health care for people 
with disabilities and who need that Medicaid money for children with 
serious problems. I will fight for every one of them. Where are three 
Republicans who will do the right thing and fight alongside me? That is 
what tonight is all about.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. SANDERS. Mr. President, I rise in strong opposition to the 
nomination of Congressman Tom Price to be the next Secretary of Health 
and Human Services. My opposition to Mr. Price has less to do with his 
well-known, extreme, rightwing economic views than it has to do with 
the hypocrisy and dishonesty of President Trump.
  The simple truth is, Congressman Price's record is the exact opposite 
of what President Trump promised to working families and for senior 
citizens all over this country. If President Trump had run his campaign 
for President by saying: OK, Americans, I am going to cut Social 
Security, and I am going to cut Medicare, and I am going to cut 
Medicaid, and I am going to put together a Cabinet that will do just 
that, I think Congressman Price would have been the perfect candidate 
for Secretary of HHS, but that is not the kind of campaign Donald Trump 
ran.
  He ran a campaign in which he said over and over again: I am a 
different type of Republican. I am not going to cut Social Security, I 
am not going to cut Medicare, and I am not going to cut Medicaid. Yet 
he has nominated individuals like Congressman Price, who have spent 
their entire career doing the exact opposite of what Donald Trump 
promised the American people he would do.
  If Mr. Trump had said: I want to prevent the American people from 
getting low-cost prescription drugs from Canada, and I want to continue 
to prohibit Medicare from negotiating for lower drug prices, 
Congressman Price would have been a great choice, but that is not what 
Donald Trump said during his campaign.
  This is what President Trump said. During the campaign on May 7, 
2015, Mr. Trump tweeted:

       I was the first and only GOP candidate to state there will 
     be no cuts to Social Security, Medicare, and Medicaid.

  On August 10, 2015, Mr. Trump said:

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

  Without cuts.

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

  On November 3, 2015, Mr. Trump said:

       I'll save Social Security. I'll save Medicare. . . . People 
     love Medicare. . . . I am not going to cut it.

  On May 21, 2015, Mr. Trump tweeted:

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

  On January 24, 2015, Mr. Trump said:

       I'm not a cutter. I'll probably be the only Republican that 
     doesn't want to cut Social Security.

  Mr. Trump did not make these statements in the middle of the night. 
It wasn't an ambush interview with some reporter who caught him off-
guard. This was one of the centerpieces of his campaign for President. 
And I think whether you are a Republican or a Democrat or Independent 
or whatever you are, you will acknowledge that Mr. Trump said: I am not 
a conventional Republican. I am going to do it differently. Everybody 
else, all the Republicans, they want to cut Social Security, Medicare, 
and Medicaid. And he is absolutely right. They do. But he made a 
promise to the American people that he would be different, that he 
would not cut Social Security, Medicare, and Medicaid.
  President Trump sends out tweets every single day, but the American 
people are waiting, are still waiting for that one tweet which says: I 
will keep my promise. I will not cut Social Security, Medicare, and 
Medicaid, and if Republicans give me legislation to do that, I will 
veto that legislation.
  In fact, the President could save us all a whole lot of time if he 
would get on the phone now with the Republicans in the House and some 
here in the Senate and say: Hey, save your efforts. Don't waste your 
time because if you bring me legislation that will cut Social Security, 
cut Medicare, cut Medicaid, I am going to veto it.
  If President Trump sent that tweet, it would save us all a whole lot 
of time but, more importantly, it would tell millions of seniors who 
today cannot make it on $13, $14, $15,000 a year in Social Security 
that he will not make their lives more difficult. He will tell seniors 
who are struggling with difficult, painful, costly illnesses that he is 
not going to devastate Medicare.
  He will tell low-income people who are trying to survive on minimum 
incomes that he will not take away the health insurance they have 
through Medicaid, and he will tell middle-class families and working-
class families that, no, they do not have to worry that their parents 
can remain in nursing homes and have those bills paid by Medicaid.

[[Page 2337]]

  What I think the American people are worried about is not just that 
Mr. Trump has not yet sent out that tweet. We did get a tweet about 
Arnold Schwarzenegger and how well he is doing on his TV show--we got 
several tweets about that--but we did not get the tweet that tells 
seniors and working people they do not have to worry about their 
future; that this President was not lying but was telling the truth 
when he said he will not cut Social Security, Medicare, and Medicaid.
  The problem is, President Trump has nominated people like Congressman 
Price whose views are absolutely contradictory to what he campaigned 
on. So why would you appoint somebody whose views run exactly opposite 
to what you told the American people during your campaign?
  The truth is, in the House of Representatives, Congressman Price has 
led the effort to end Medicare as we know it by giving seniors 
inadequate vouchers to purchase private health insurance.
  In 2009, Congressman Price said, and I quote--and I hope people 
listen to this quote and try to ask yourselves: How could somebody who 
ran on a campaign of not cutting Medicare appoint this gentleman to be 
Secretary of Health and Human Services? This is what Congressman Price 
said:

       Nothing has had a greater negative effect on the delivery 
     of health care than the Federal Government's intrusion into 
     medicine through Medicare. . . . We will not rest until we 
     make certain that government-run health care is ended.

  Now, how does that tally with Candidate Donald Trump saying: I will 
not cut Medicare and Medicaid.
  We don't need an HHS Secretary who will end Medicare as we know it. 
We need an HHS Secretary who will protect and expand Medicare. The idea 
of this voucher program, of ending Medicare as we know it, as a defined 
benefit plan and converting it into a voucher plan, not only 
contradicts what Candidate Donald Trump said, but it will be a disaster 
for millions of seniors.
  Right now, if you are a senior and you are diagnosed with a serious 
and costly illness, you have the comfort of knowing that Medicare will 
be there throughout your illness. It will pay your bills.
  The Republican plan, led by Congressman Paul Ryan, has a very 
different approach, and what that plan is about is a voucher plan which 
says that we will end Medicare as we know it. We will give seniors a 
voucher of an undetermined amount--the last number I heard was $8,000; 
it may go up, it may be lower--and give that check to a senior who then 
goes out into the private insurance market looking for the best policy 
that he or she can get.
  I would like the American people to think for a moment what kind of 
policy an 80-year-old person who is struggling with cancer and who has 
a check for $8,000 can get. The answer is, when you go into a private 
insurance company.
  Also, if the Republicans are successful in doing away with the 
Affordable Care Act and the patient protections within the Affordable 
Care Act, including a ban on the insurance companies' ability not to 
insure you if you have a preexisting condition--now let's assume they 
got rid of that.
  Now you are 80 years old. You walk into an insurance company, and you 
say: I have been diagnosed with cancer, and here is my check for 
$8,000.
  The insurance agent looks at you and says: Are you kidding? Don't be 
absurd. Why would we cover you? What do you think we are going to give 
you for $8,000 when you are about to run up some enormous health care 
costs related to cancer? You are going to be in the hospital. You are 
going to undergo all kinds of treatment. You are going to need 
expensive drugs, and you expect us to take you with an $8,000 check. 
How are we going to make any money out of you? Because that is what our 
job is. We are an insurance company. We don't care about health care. 
We care about making money. That is our function. We don't make money 
on $8,000 for taking care of somebody who is 80 years of age who has 
cancer. Furthermore, because the Republicans got rid of the law 
protecting people with preexisting conditions, we don't even have to 
take you. Or maybe we will take you, but you are going to have to add 
another $10,000 on top of that $8,000 because that is the only way we 
make money.
  Oh, by the way, also, so there is no confusion, they want to raise 
the retirement age to make sure you keep working until 67 years of age.
  So not only is that a disaster, but maybe in a deeper sense, if we 
take democracy seriously, if we think candidates should run for office 
based on what they really believe, all of that stuff is a direct 
contradiction to what Candidate Donald Trump talked about.
  I have heard many Republicans say: Look, what he was talking about 
was really absurd. It was ridiculous. Of course we are not going to do 
that.
  Well, then, that takes us to a whole other discussion: What does it 
mean if you have a candidate who runs for office who simply lies to the 
American people and really doesn't mean anything he says?
  I have no problems getting up and debating or disagreeing with my 
colleagues who have a very conservative point of view. That is their 
point of view. This is a democracy, and we have different perspectives. 
And many of those candidates ran on positions. They were honest enough 
to say: Hey, if you elect me, I think we have to cut Social Security, 
and they gave their reasons. I think we have to cut Medicare; they gave 
their reasons. I think we have to cut Medicaid; they gave their 
reasons. I think we have to give huge tax breaks to billionaire; they 
gave their reasons.
  Well, for some reason or another, the people in their State elected 
them. That is fine. It is called democracy.
  But that is not what Donald Trump did as a candidate. So I rise in 
opposition to Congressman Price becoming Secretary of HHS because his 
appointment would go in diametrical opposition to what Candidate Donald 
Trump told the American people. I think that is a bad thing for 
democracy. If you run for office, keep your word, you know? Do what you 
told the American people you would do. The profound disgust so many 
millions of people feel for the American political process is not just 
of what we believe, it is that we don't keep our word, the promises we 
make to them, and this is exactly where Donald Trump is today.
  Let me touch on another area where I think President Trump has not 
been clear with the American people, and that is, we pay today by far 
the highest prices in the world for prescription drugs. One out of five 
Americans between 18 and 65 cannot afford to fill the prescriptions 
that their doctors write for them. The numbers go down after 65 because 
of Medicare Part D. But can you imagine living in a nation where one 
out of five people cannot afford to fill the prescriptions their 
doctors write?
  Mr. Trump campaigned on taking on the pharmaceutical industry. Well, 
the record of Congressman Price is very different from the rhetoric 
that Candidate Donald Trump used during his campaign.
  So I eagerly await Mr. Trump's statement--he can do it through a 
tweet; that would be fine with me--that says he will support concrete 
legislation that some of us are going to be offering very shortly which 
does two fundamental things that will substantially lower prescription 
drug costs in America today.
  No. 1, at a time when you can buy many medicines for far less cost in 
Canada or in many other countries around the world, at a time when we 
have free trade agreements so that the lettuce and tomatoes you are 
having dinner can come from Mexico or Latin America or anyplace all 
over the world, the fish you eat can come from anyplace all over the 
world, we will introduce legislation that says that individuals, 
pharmacists, and prescription drug distributors will be able to 
purchase lower cost medicine in Canada and eventually in other 
countries around the world.
  Mr. Trump--President Trump had talked during his campaign about 
taking on the pharmaceutical industry. I hope very much that he will at 
least keep his word on that issue and that he

[[Page 2338]]

will join us in supporting legislation to allow for the reimportation 
of brand-name prescription drugs from Canada and many other countries 
around the world. If he is prepared to do that, we will pass it. We 
will pass it because there are a number of Republicans who support it, 
and the vast majority of Democrats support it. We have the votes to 
pass it, and if President Trump signs that bill, we will go a long way 
in ending the burden that so many elderly people and working people and 
people with chronic illnesses are facing today, and that is the 
outrageously high cost of prescription drugs.
  By the way, this huge increase in prescription drug costs takes place 
at a time when, in 2015, the five largest pharmaceutical companies in 
this country made $50 billion in profit--$50 billion in profit in 
2015--yet one out of five Americans under 65 cannot afford the medicine 
they need. The top 10 CEOs or executives in the pharmaceutical industry 
that year made over $300 million in salary.
  Passing reimportation is one mechanism to lower the cost of 
prescription drugs, but it is not the only one. We have a totally 
insane prescription drug pricing system in America right now. If you 
are Kaiser Permanente, you will pay a certain amount for a drug. And by 
the way, of course, we don't know what that amount is that you are 
paying; that is secret. If you are Medicare, you will pay a different 
amount. If you are the Veterans' Administration, you will pay a 
different amount than Medicare. And if you are Medicaid, you will pay a 
different amount than Medicare or the Veterans' Administration. We have 
a situation today where by law the Veterans' Administration is able to 
negotiate drug prices with the pharmaceutical industry. Today we have a 
situation where Medicaid, by law, is guaranteed a significant rebate 
over list price. But in terms of Medicare, which spends over $4 billion 
a year for prescription drugs, a number of years ago Republicans 
insisted that Medicare would not be able to negotiate drug prices with 
the pharmaceutical industry.
  President Trump has indicated in vague language that perhaps he would 
support the ability of Medicare to negotiate prices with the 
pharmaceutical industry. Given all of the tweets he has sent out on so 
many subjects, I would hope that he has the time to send out a very 
simple tweet which says: If Congress passes legislation allowing 
Medicare to negotiate drug prices with the pharmaceutical industry, I 
will sign that bill. That tweet will have a profound impact on 
taxpayers because we can save very substantial sums of money, and it 
will also result in lowering the cost of prescription drugs.
  Unfortunately, once again Congressman Price is coming from a 
different place than Candidate Trump came from--again, that 
contradiction of a President appointing somebody whose views are 
diametrically opposed to the views he raised during the campaign.
  I think the American people are growing increasingly concerned about 
the contradictions in general, not just on health care, of what 
Candidate Trump said and what President Trump is doing. During the 
course of his campaign, not only did Candidate Trump say he would not 
cut Social Security or Medicare or Medicaid, he also said that he 
thought Wall Street was causing all kinds of problems and that you 
can't clean up the swamp by bringing people in who are a part of the 
swamp, in so many words. You can't bring people in to clean up the 
problem who have caused the problem in the first place. And you know 
what, he is exactly right. He is exactly right. You can't bring in 
people whose greed and recklessness and illegal behavior on Wall Street 
caused us the worst economic downturn in modern history of this 
country. You can't bring those people in and then say: We are going to 
solve the problem that Wall Street caused.
  But in an exactly similar way to what he has done with the Secretary 
of Health and Human Services, he is bringing in top Wall Street 
executives. His main financial adviser comes from Goldman Sachs, one of 
the largest financial institutions in this country, a financial 
institution that required a multibillion-dollar bailout from the 
taxpayers, an institution whose illegal behavior caused them to have to 
pay a $5 billion fine to the Federal Government. Those are the people 
he is bringing in to regulate, to take on Wall Street. He is bringing 
Wall Street executives who caused the worst financial crisis in modern 
history of this country to take on Wall Street. Well, I don't think 
most Americans believe that.
  So, Mr. President, let me close by saying that I hope that tonight 
the Senate stands up for the American people, demands that President 
Trump keep the campaign promises he made, and that we reject the 
nomination of Congressman Price to be the next Secretary of Health and 
Human Services.
  With that, Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. BLUMENTHAL. Mr. President, I am very honored to follow my 
distinguished colleague from Vermont on issues that he has worked so 
long and so hard and so well, and that is health care for our Nation 
and focusing on the fight for women's health, for access to affordable 
care for all Americans, and for a Cabinet truly free of conflict and 
corruption--a cause that we share in opposing Tom Price as the 
Secretary of the Department of Health and Human Services.
  What is so painfully apparent to him and me and many of our 
colleagues is that Representative Price's nomination is a doubling down 
of the ongoing blatant attack on women's health by his administration. 
His radical anti-choice policies, antiquated views on reproductive 
health, and demands to repeal the women's health provisions of the 
Affordable Care Act disqualify him from serving as the next Secretary 
of Health and Human Services.
  Before the ACA was signed into law, being a woman meant higher health 
care costs for simply being a woman. It is estimated that this 
discrimination cost them about $1 billion more every year. They had to 
pay higher costs simply because they were women.
  Representative Price has been clarion clear about where he stands on 
this issue, with his policy effectively eliminating important 
protections against discrimination that were guaranteed under the 
Affordable Care Act. Under Representative Price's reckless proposal, 
all women, including healthy women, could see their insurance costs 
rise--and rise astronomically. His plan also means guaranteed coverage 
of maternity care services could be lost. It means well-woman visits, 
birth control, domestic violence screening, and breastfeeding support--
all provided now without any out-of-pocket costs--would be lost. The 
simple truth is, with Representative Price's policies, many women will 
go without necessary care.
  More than a quarter of all women and 44 percent of low-income women 
already rely on publicly funded health clinics like Planned Parenthood 
for contraception. Without guaranteed access to birth control, without 
cost-sharing, this number will certainly climb.
  It isn't hard to see why, despite the lonely opposition of 
Representative Price and the Republican Party, 70 percent of Americans 
support a birth control benefit. Representative Price callously asked 
to see one woman who couldn't afford birth control, one woman who was 
left behind. If he is confirmed and if the policies he vigorously 
supports are enacted, he will see millions without necessary health 
care and particularly birth control.
  As many know, Representative Price's attempt to defund Planned 
Parenthood means more than just losing access to birth control; it 
means cutting off preventive care, cancer screenings, and STD testing 
for millions of low-income women. The women who get their care from 
Planned Parenthood seek what all of us want, what all of us should have 
a right to receive--trusted, compassionate, and medically sound health 
care. Representative Price's politically motivated tax on Planned 
Parenthood put this care, and their lives, at risk.
  Clearly, Representative Price is one of the most extreme Members of 
his party on issues of women's health, and that includes his views on 
women's reproductive rights--a woman's right to

[[Page 2339]]

choose. He has supported radical legislation that would ban virtually 
all safe abortions and even some forms of birth control, which, in 
essence, would send our country back to a time when women died because 
the care they needed was outlawed. It was made unlawful; it was banned. 
That time has gone. We do not want it to come again.
  Simply put, Representative Price's anti-choice views are not only 
ill-informed and unconstitutional, but they are downright dangerous.
  Representative Price has also shown remarkable indifference to the 
concerns of the millions who will see their health insurance 
disappear--vanish--following repeal of the Affordable Care Act, if that 
disgrace should occur. For millions, the Affordable Care Act has been 
the difference between seeing a doctor at the first signs of disease 
and waiting until treatment is no longer an option. It has been the 
difference between financial security and bankruptcy. Much of the 
bankruptcy in the United States of America has to do with medical 
costs.
  For many, it has been the difference--no exaggeration--between life 
and death.
  The numbers support this point, whether or not Representative Price 
wants to believe them. Since the passage of the Affordable Care Act in 
2010, the percentage of uninsured Americans is the lowest it has been 
in 50 years or more. The positive impact of this law is felt every 
single day in the State of Connecticut. It has reduced our uninsured 
rate by a massive 34 percent, resulting in 110,000 Connecticut 
residents gaining coverage. Many of my constituents have felt emphatic 
about--and have told me so--exactly how the Affordable Care Act has 
changed their lives and their family's lives for the better.
  Representative Price refuses to guarantee that these families will be 
covered following repeal. So I hope he hears their stories and 
understands what the Affordable Care Act means to them and the millions 
of other Americans whom he chooses not to see, not to hear, not to know 
exist.
  Representative Price refuses to guarantee that these families will be 
covered. For example, I point to a woman in Connecticut named Colleen 
who told me that before the ACA was passed, her medications alone cost 
$250,000 each year. That is a quarter of a million dollars. Thanks to 
this law, she has affordable care, no lifetime limits, and knows she 
will not be a victim of discrimination or denied coverage of her 
preexisting condition. Colleen said the Affordable Care Act has been 
the difference for her between life and death.
  I have also heard from a father whose daughter has a chronic illness. 
He asked that I emphasize to all of you, my colleagues, that health 
insurance is ``not a luxury, but a necessity'' for his family. His 
daughter represents one of the 1.5 million people in Connecticut who 
are now protected from discrimination based on preexisting conditions, 
thanks to the Affordable Care Act.
  I have heard from a retired pastor who counts on the Affordable Care 
Act for coverage, a farmer who fears for his family's health after 
repeal, a young woman who was able to start her own business because of 
the assurances promised by health reform, and a veteran who is scared 
for his wife.
  Representative Price cannot promise that these people will keep their 
coverage, and he has said that outlawing discrimination because of 
preexisting conditions is ``a terrible idea.'' He thinks it is a 
terrible idea to outlaw preexisting conditions. I saw the effects of 
preexisting conditions year after year when I was attorney general, and 
I went to bat and fought for people who were denied health care because 
their insurance companies told them that health care isn't to take care 
of a preexisting condition not covered by their policy. His proposals 
do not expand access to affordable care, and they do not protect 
patients.
  Representative Price's nomination is wrong for the people of 
Connecticut and for the people of this Nation.
  Representative Price's plans would also do away with the expansion of 
Medicaid under the Affordable Care Act, disrupting the lives and health 
of nearly 15 million Americans. This would leave so many people without 
access to preventive care, lifesaving medications, and necessary 
medical interventions. This is simply unacceptable and cannot be the 
policies of the Secretary of Health and Human Services.
  In fact, instead of expansion, Representative Price wants to block-
grant Medicaid and cap the program, resulting in higher costs, less 
coverage, and devastation for millions of Americans, half of them 
children who rely on this program.
  In Connecticut, we have been hit hard by the opioid addiction 
epidemic. It is a national scourge, a public health crisis, and we have 
relied heavily on Medicaid to fill the gaps. At a time when this 
epidemic needs more resources, not less, Representative Price would 
work to strip that away, leaving people who rely on Medicaid without 
treatment.
  His plan for our Nation's seniors is just as dismal. He champions 
privatizing Medicare by turning it into a voucher system and ending the 
promise of guaranteed health benefits.
  Giving seniors a fixed amount of funds to buy health insurance would 
result in high premiums, increased out-of-pocket costs for seniors, 
many of them already on a fixed income. And for many Americans, 
Representative Price may mean the difference between being able to 
purchase lifesaving medications and putting food on the table or 
heating their homes.
  Finally, like many of my colleagues--and Senator Sanders made this 
point so well--I have serious concerns over Representative Price's 
potential conflicts of interest. Having repeatedly purchased stock in 
health care and pharmaceutical companies that would directly benefit 
from his legislative efforts and advocacy on the company's behalf, he 
nonetheless made those investments and kept them.
  In the face of these allegations, Representative Price has simply 
refused to provide information that could disprove violations, which 
has led many Americans to question whether Representative Price will 
truly put their best interests before crony capitalism.
  The American people know better. These potential conflicts of 
interest and views on the Affordable Care Act, Medicaid, and Medicare 
are out of touch and out of line with what Americans want and our 
Nation needs. We should be building on the success of these programs, 
not tearing them down, and we should be working with one another to 
improve the health of all Americans, not fostering divisions. Sadly, 
Representative Price's views and policies make this very attainable 
goal really impossible. Simply put, his proposals are dangerous, they 
are disgraceful, and they are disqualifying.
  I cannot vote for Representative Price to lead the Department of 
Health and Human Services. I will oppose his nomination and I urge my 
colleagues to do the same.
  Thank you, Mr. President.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Jersey.
  Mr. BOOKER. Mr. President, we have had a lot of long nights here, and 
I just want to take a moment again to really give my gratitude to the 
staff. A lot of folks go into making the Senate work. We can see a lot 
of them down here. I can't imagine the days that they have been 
pulling, as we have been pulling long nights. Many of them get here 
early in the morning and they go a long way. So I want to thank them, 
from the stenographers to many of the Senate staff who make it work.
  I also want to thank the pages again. These are young folks who have 
to carry a full load of classes and course work--hard stuff. I don't 
understand why they haven't come to me to help them with their calculus 
homework. But the reality is they are working a full class load of 
courses as well as being here with us around the clock. They probably 
aren't caught by cameras. They aren't even getting C-SPAN glory. But 
your presence here really means a lot, and I am grateful for that as 
well.
  I rise specifically to speak about the President's nomination of 
Congressman Price to be his Secretary of Health and Human Services.

[[Page 2340]]

  I want to take a step back and talk about the profound history that 
the United States of America has in terms of our bringing together the 
resources of this country to combat public health crises. We have a 
country where every generation has been able to step up and take on 
things that threaten the common health.
  There was a time in this Nation when we had actual child death rates 
that were tragically high, and that for an industrializing nation, our 
water, the quality of our milk, women dying in child birth, and 
children dying was a common thing. But we had this bold understanding 
that in America, a Nation that believes in life, liberty, and the 
pursuit of happiness, the common health is important. And we took steps 
that, frankly, in a booming industrial economy, the private sector 
couldn't do. We took steps to protect the public health, and we made 
great strides.
  It was a Republican President, actually, in 1953, Dwight D. 
Eisenhower, who actually created what was then a version of what is now 
the Department of Health and Human Services. Specifically, it was 
called the Department of Health, Education, and Welfare.
  Now, the very first Secretary was a woman, and her name was Colonel 
Oveta Hobby. She had served as the director of the Women's Army 
Auxiliary Corps during the Second World War. She was, in my just great 
reverence, someone who served and fought for health and safety and 
security during World War II.
  As Secretary, Secretary Hobby had an expansive and expanding role. It 
was a demanding role. She was coordinating the distribution of polio 
vaccine, overseeing countrywide hospital expansions, overseeing Social 
Security and the Federal education policy. She had a huge role, one 
that was so full that one newspaper joked that ``when she [actually] 
learns her job, Oveta Hobby may trim her week to just 70 hours.'' This 
was someone who went out there as an agent of the government to lift up 
the welfare of all of our citizenry, the health and well-being of 
everyone, again pushing toward those ideals.
  In the United States, we really do believe in this idea of life, 
liberty, and the pursuit of happiness, freedom from deprivation, 
freedom from illness, the belief that we can have life and have it more 
abundantly. To Secretary Hobby, this was her duty to her country--
someone, again, who served valiantly in World War II.
  In the collection of papers from Secretary Hobby's lifetime, Rice 
University includes that she was a great humanitarian and that she 
believed there was a role--a ``common thread,'' to use her words--to 
service to her country toward the empowerment of health for all. She 
set a standard, a powerful standard, as the first Secretary of Health 
for the greater good that we, acting collectively, could do to ensure 
the health and well-being of our Nation.
  In fact, it was an understanding from President Dwight D. Eisenhower 
all the way down to Secretary Hobby that if we ensure people's health 
and access to health care, it is not just an individual concern, but 
actually, societally, we become better and we become stronger. The 
healthier all children are, the more likely they are to go out there 
and compete. If you are battling sickness, it undermines your economic 
well-being. In the world of infectious diseases, the words of Martin 
Luther King are true: Injustice anywhere is a threat to justice 
everywhere; in fact, an illness somewhere is the threat of an illness 
to people everywhere. This was the brilliance of Republican President 
Dwight D. Eisenhower, and it is how this great Department began, 
setting the standard, understanding that in many ways we are all in 
this together when it comes to our health.
  So for me, this is another point in history. It is a challenge to us 
as to who we will be as a Nation. Will we continue to be a country that 
believes, as a fundamental birthright in the richest Nation on the 
Planet Earth, that everyone can access the highest quality health care, 
the best access to quality doctors with wide avenues to pursue the rich 
abundance of life because we have the best health care system on the 
Planet Earth?
  I actually was happy to hear President Trump on the campaign trail 
talk specifically about this issue, tell us we were going to have a 
health care system better than the one we have now, specifically 
calling it ObamaCare; that we were going to have one that is amazing, 
one that is going to be covering more people. I think the word that was 
used was ``terrific''; it was going to be terrific. He specifically 
spoke about some of the bedrock elements of our current health care 
system that Republicans and Democrats both agree are things we want to 
preserve, protect, and in fact make better. He specifically talked 
about Medicare and Medicaid, defending them: They wouldn't be taken 
away; they wouldn't be undermined; people wouldn't be kicked off.
  So with this excitement, hearing that we have a President committed 
to these ideals, creating a terrific health care system, we stand on 
this history in our country where we know our greatness, and it is an 
affront if we don't have a system that takes care of our most valuable 
natural resources: the people of this country and a global, knowledge-
based economy. What helps us compete is the quality of our workforce.
  I am telling you right now, I have learned in my professional life 
that when children are sick, they don't learn; when a mother is sick, 
it throws the whole family into crisis; if someone can't afford their 
medication, it is not just a sin to this country's values, it is a sin 
morally.
  So when President Trump nominated his person to be Health and Human 
Services Secretary, we might imagine they would reflect the values that 
he espoused during his campaign and reflect the values he has talked 
about as President. But instead, he has chosen someone who is 
diametrically opposed to the things he says he is for--preservation of 
Medicare. More than this, he has advocated a view on health care that 
unequivocally would take millions of Americans off of health coverage, 
thrust millions of Americans into economic crisis, and put the health 
of many millions of Americans in jeopardy. Usually people say these 
things hyperbolically, but this is quite clearly a matter of life or 
death.
  For years, Congressman Price has told us who he is. He has led the 
charge in the House of Representatives to repeal the Affordable Care 
Act and take coverage away from millions of Americans while advocating 
specifically for the privatization of Medicare and the gutting of 
Medicaid. For years, Congressman Price has advocated for anti-choice, 
anti-contraception access, anti-commonsense measures, and supported 
efforts to defund and eliminate proven programs like title X family 
planning, programs like Planned Parenthood which, through their 
Medicare reimbursements, often in many communities is the only access 
women have in their communities for cancer screenings or to get 
contraception.
  Congressman Price has been one of the loudest voices on tearing down 
many of the things that now Americans overwhelmingly say ``Hey, now 
that we've got this, we don't want to lose it,'' whether that is not 
having insurance companies dictating to you whether you get health 
insurance or not having pharmaceutical companies ratchet up prices so 
much that your lifesaving drugs are out of reach.
  Then finally, at a time when we cannot afford to have people who have 
conflicts, we have a Congressman right now for whom other House Members 
are calling for ethics investigations because his personal financial 
interests clearly have been in conflict. In fact, he seems to be 
building a career as a Congressman working on health policy on one hand 
while building a fortune trading health stocks directly related to that 
work. This is a man who is so conflicted, a man who is so contrary to 
what our President says he believes, a man who has been leading the 
charge to take our health care back in an affront to the ideals that 
literally stem from the founding history of our Department of Health. I 
cannot support this individual.
  But let me quickly go through some of these things. We now have to 
have

[[Page 2341]]

an honest conversation in our country about this idea of repealing the 
Affordable Care Act without replacing it because objective 
organizations like the Congressional Budget Office, conservative 
organizations like the American Enterprise Institute, and fellow 
Republican Senators of mine have acknowledged that to repeal the 
Affordable Care Act would throw into crisis millions of hard-working 
Americans who have been able to get coverage because of the health 
insurance marketplace and the Medicaid expansion. Millions of Americans 
can now go to a doctor when they feel sick instead of going to an 
emergency room. By the way, as a local mayor--when people use emergency 
rooms as their primary care facility, it is extraordinarily more 
expensive; it is fiscally irresponsible.
  Because of the ACA, millions more Americans can now access basic 
health and preventive services that can lead to lifesaving 
opportunities that did not exist before. Millions more Americans have 
the peace of mind of knowing that they are no longer one illness away 
from financial ruin.
  Let me put up a chart for a second about the history of people having 
insurance.
  This is the percentage of uninsured in the United States--going 
along, about 18 million uninsured. And then what happens? The uninsured 
rate has been driven down. Enrollment in the individual market 
continues to rise but has now decreased since 2014.
  In late December 2016, Standard & Poor's--hardly a Democratic 
organization, but a market-based organization--released an incredibly 
optimistic report for the future of the individual market in the 
Affordable Care Act. But Congressman Price, on the other hand, has 
repeatedly introduced legislation and resolutions to repeal critical 
elements or the entirety of the law responsible for these successes 
without any regard for consequences. He has done this again and again 
and again and again, eight times. He authored a bill last year that 
would repeal critical parts, like the Medicaid expansion provision that 
has expanded access to care for millions, tax credits that would help 
millions buy insurance. And Congressman Price has introduced 
legislation that would fully repeal the Affordable Care Act.
  I want to let you all understand that, to me, this is a point in our 
American history where this isn't arguing over opinion; these are facts 
about what Congressman Price has done. If he were successful in any of 
those eight attempts to rip down the Affordable Care Act, we now know 
objectively from organizations like the independent Congressional 
Budget Office that it would mean 18 million people losing their health 
insurance in the first year alone, 32 million of our fellow Americans 
by 2026. Objectively, there would be increases in premiums in the 
market by 20 to 25 percent; 4.4 million of those Americans who would 
lose coverage would be children; and 11 million of the most vulnerable 
would lose their Medicaid coverage.
  There is a man named Andy Slavitt who is a former Acting 
Administrator of the Centers for Medicare and Medicaid--again, what our 
President says he wants to preserve. He put together a list because so 
many people were calling him, writing him: What are going to be the 
consequences if they repeal the Affordable Care Act without replacing 
it? What are the consequences? And he just went through a list: Small 
businesses, farms, self-employed Americans represent 20 percent of the 
coverage of the exchange. These are individual entrepreneurs, many of 
whom, by the way, experience something called job lock, where they are 
afraid to become entrepreneurs because if they lose their jobs, they 
lose health insurance. Twenty percent are covered by the exchange, and 
127 million Americans--127 million Americans--have preexisting 
conditions. They would be put at jeopardy, and insurance companies 
would be able to deny them coverage.
  Seniors, Medicare beneficiaries, have saved $2,000 on prescription 
drugs because of the ACA--$2,000; 30 million Americans are on 
individual policies and Medicaid; 2.8 million Americans with drug 
disorders would lose coverage; 1.25 million Americans with mental 
health disorders would lose coverage--1.25 million Americans with 
mental health disorders. In other words, the ACA put mental health care 
on parity with physical health care. A 42-percent reduction in 
uninsured rates for veterans has resulted. He said that bad debt--bad 
debt, bankruptcy--would go up by $1.1 trillion because health care 
bills would again be the lead cause in this country of bankruptcy. In 
other words, before the ACA, the No. 1 reason people were declaring 
bankruptcy was because of medical bills. After the ACA, that can't 
happen. There are steps to prevent that from happening, at least to the 
extent of $1.1 trillion.
  The Medicare trust fund, which has been extended, will have several 
years reduced off its life expectancy. Taxpayers will lose $350 billion 
added to the deficit and $9 trillion would be added to the debt if it 
is repealed--2.6 million jobs lost, especially in communities like 
rural hospitals, where they depend upon the ACA to keep doors open and 
hospitals running. Anyone who likes free preventive services like 
mammograms and better cancer treatment, preventive services that 
literally save lives by early detection, gone.
  Young adults, 3.1 million right now on their parent's plan because of 
extending the years. Women who want to buy health insurance will pay 
more than men in premiums because, amazingly, at times insurance 
companies would be charging you more simply because of your gender and 
105 million people had lifetime limits on what insurance companies pay.
  This is a list from one of the great experts who knows factually what 
would happen if we were to turn back the clock. Let me drill down a 
little bit more. As head of Health and Human Services, Congressman 
Price would be responsible for insuring the continuance of Medicaid.
  Americans like Kelley from New Jersey are able to access care right 
now because of the Medicaid expansions under the ACA. I want to read 
what she said. She said:

       Thank you for supporting the ACA. I hope that you will 
     continue to fight hard for it. It's the ACA and Medicaid that 
     allow me to be able to seek medical treatments for my 
     scoliosis (which causes me to suffer from chronic pain) and 
     ensure that my newborn receives appropriate medical care when 
     need be.
       I work full time and go to college but I still struggle to 
     pay the bills, as I'm only 18 and fast food doesn't pay much 
     even at 35 to 40 hours a week.

  Here is someone going to college, raising a child, working full time, 
and relying on the ACA so she can inch toward her American dream, being 
a college graduate, getting a better paying job.
  She concludes by saying:

       I want my baby to have the health care she deserves so she 
     can be happy and healthy.

  The Medicaid expansion under the ACA has extended access for millions 
in our country, millions of hard-working people like Kelly and their 
children, like her baby, across the country.
  In New Jersey alone, hundreds of thousands of people gained coverage. 
Uncompensated costs were driven down, and my State saved a billion 
dollars, all because of Medicaid expansion.
  Republican Governor of New Jersey: Medicaid expansion was the right 
fiscal decision for our State and for our communities' families who 
live in our State.
  In Price's efforts to undo ACA Medicaid expansion, he has indicated 
people like Kelly and her newborn baby are not a priority.
  I know for a fact that hard-working people across the country and in 
my community will suffer if Price is able to do what he intends to do 
and has tried to do.
  Let me go to another issue; that is, Medicaid. How about Medicare? As 
Secretary Price, he will be responsible for overseeing Medicare, the 
health care program that services 57 million American seniors and those 
with disabilities.
  Under the Affordable Care Act, we know that the quality of Medicare 
coverage has improved. The life of the Medicare trust fund has been 
extended, and we have begun to close the gap in prescription drug 
coverage that too many seniors and people with disabilities--they know 
about this. It is

[[Page 2342]]

known as a doughnut hole. There is more work to do to strengthen 
Medicare and to make prescription drugs more affordable for everyone, 
including our seniors.
  The changes we have done already have had real positive impacts on 
the daily lives of Americans. Let me read another letter from Myra in 
Willingboro, NJ. She wrote to tell me about the difference that 
Medicare is having for her family as they live with chronic illness. 
She said:

       As your constituent and an advocate of affordable, 
     accessible health insurance, I would like to share how 
     adjustments to the health care system could impact me. As you 
     consider policy changes, I urge you to think about how your 
     constituents living with chronic conditions will be affected.
       It is so important to my husband who lives with Parkinson's 
     disease and myself who is being treated for Chronic Lymphatic 
     Leukemia that our Medicare benefits continue without any cuts 
     in benefits. It is most important that we continue to be able 
     to visit doctors able to care for our specific needs and have 
     the expensive medications covered that are needed as we live 
     with these diseases.
       As a support group leader for people living with 
     Parkinson's disease--

  I pause here to say, my father suffered for years with Parkinson's, 
died from Parkinson's. The support groups are essential, and the 
medical challenges that this chronic disease brings are great.
  I continue with her letter.

       As a support group leader for people living with 
     Parkinson's disease and their caregivers, I know all the 
     members would echo my requests. Many people actually need 
     further assistance to purchase the needed drugs as their 
     policies do not cover them adequately presently. Often the 
     medication prices are prohibitive for folks. They have to 
     constantly check to see which drug plan will allow their 
     medication at an affordable price.
       In addition, specific supports for caregivers is another 
     very important need for the Parkinson disease population. 
     Please consider assistance for these people who require 
     assistance throughout the day.

  Let me tell you, this is a person writing to say keep what we have 
and make it better because it is still not enough to meet the 
challenges. Instead, we are considering making someone the Secretary of 
Health and Human Services who doesn't want to improve, build upon, get 
better but wants to throw out.
  Take Tom, who believes that for his family, their lifeline to health 
care access is an intrusion. This is Tom Price--excuse me, who believes 
that this is an intrusion. He writes: ``I can attest that nothing has 
had a greater negative effect on the delivery of health care than the 
federal government's intrusion into medicine through Medicare.''
  I want to put these words up. This is what the nominee to Health and 
Human Services is saying about one of the most valued parts of our 
health care in America. He is saying: ``I can attest that nothing has 
had a greater negative effect on the delivery of health care than the 
federal government's intrusion into medicine through Medicare.''
  I would like to tell you that is an insult to Myra and her husband, 
millions of American seniors, those on disabilities who rely on what he 
calls an intrusion. Someone who is calling for an end to a program that 
millions of Americans rely on, that the President himself swore that he 
would do nothing to disturb, we are now putting the chief architect of 
the destruction of Medicare from the House into a position where they 
can wreak havoc on the health care of millions.
  I want to go into that area of preexisting conditions. Imagine 
yourself as someone who has a child with diabetes or that you are a 
survivor of cancer and an insurance company can now look at you and 
say: I am sorry. I am not going to cover you. The people driven by the 
market, driven by profits, driven by the bottom line are going to look 
at you and your humanity and simply say: Sorry, I am not going to cover 
you. And you live in that place in America, that dark, painful place 
where you know you are one illness away from destitution.
  This is what Maureen wrote to me recently. She said:

       Please do not repeal the Affordable Care Act. My 18-year-
     old son has been fighting cancer for over a year. I am scared 
     to death of what his future will hold without the protections 
     of the ACA. He may be subject to a lifetime cap on insurance 
     payments or be rejected for health insurance entirely on the 
     basis of a preexisting condition. He is only 18. He could be 
     financially ruined before he even gets his adult life 
     started. After fighting cancer as a teen, it scares and 
     upsets me to think that his battles will continue throughout 
     his life in the form of financial hardships from the loss of 
     protections he currently has through the ACA.

  She ends saying:

       Please consider my family when voting on the ACA.

  Please consider my family. There are millions of Americans who now 
are living in this state of fear, looking at the rising and the 
ascendancy of Congressman Price to a position--someone who has tried 
again and again to end insurance for people with preexisting 
conditions.
  I don't understand what we are trying to achieve with putting someone 
who believes that somehow the free market will take care of these 
folks. I began with our history as a country: booming industrial 
economy. The free market didn't take care of ensuring that our waters 
and rivers were cleaned up. The free market didn't take care of 
eradicating polio. We are a nation that has learned from our history 
that we have a responsibility to each other, and in our common civic 
space and in the governments that are established amongst men and 
women, we have to do better for folks who are victims or vulnerable to 
the vicissitudes of the free market.
  That is why we are stepping up to say that we can create a system 
that serves all. We are the richest country on the planet Earth. What 
even makes this worse than Medicaid under assault, Medicare under 
assault, people with preexisting conditions, which are issues that are 
simply around contraception.
  Congressman Price would be expected to uphold protections currently 
in place that prohibit insurance companies from charging women more 
because of their gender and ensuring that insurance companies abide by 
the Affordable Care Act's contraceptive care.
  All that talk about preexisting conditions, many insurance companies 
saw gender as a preexisting condition. As something as critical as 
having access to contraception, Tom Price has voted time and time again 
to restrict access to essential health care services and limit 
reproductive rights.
  Before the Affordable Care Act was passed, cost was a major barrier 
for women seeking access to birth control. Congressman Price has 
repeatedly opposed the provision requiring insurance plans to cover 
contraception. This is what he said in an interview in 2012:

       Obviously one of the main sticking points is whether 
     contraception coverage is going to be covered under health 
     insurance plans and at hospitals, and whether or not they're 
     going to be able to pay for it, especially low-income women, 
     where do we leave these women if this rule is rescinded?''

  That is the question. Price's response was simple:

       Bring me one woman who's been left behind. Bring me one. 
     There's not one.

  I am sorry, in this case, Price is not right; Price is wrong. There 
is not just one you could bring. There are millions of women who were 
left behind and struggled with access to coverage before the Affordable 
Care Act. For this man to stand there and cast a shadow over the basic 
commonsense understanding that when you allow women to make their 
reproductive health decisions and have access to contraception, you 
give them power over their lives and their destinies. You actually 
reduce unwanted pregnancies dramatically. This is an economic issue. 
This is an empowerment issue. This goes to the core freedoms as a 
country.
  The Center for American Progress reported in 2012 that before the ACA 
contraceptive provision went into effect, that ``a recent study shows 
that women with private insurance paid about 50 percent of the total 
costs for oral contraceptives, even though the typical out-of-pocket 
cost of non-contraceptive drugs is only 33 percent. Surveys show that 
nearly one in four women with household incomes of less than $75,000 
have put off a doctor's visit for birth

[[Page 2343]]

control to save money in the past year.'' Because of the ACA's 
contraceptive provision, America has changed. According to the National 
Women's Law Center, 55 million women have saved $1.4 billion on birth 
control pills alone since 2013.
  Listen to Rachel from West Orange, NJ, a couple towns over from where 
I live. She benefited from the contraception provision of the ACA as 
well as access to Planned Parenthood. This is what she wrote:

       The Affordable Care Act is something that has made a huge 
     impact on my life. I come from a poor background, and there 
     is no additional money to spare on things like birth control, 
     which I take for my independence and legitimate medical 
     issues. Without birth control, I'm unable to get out of bed 
     for days at a time because of painful periods. This means 
     losing out time off work and opportunities because of a 
     serious medical malady.
       I never thought I would be able to normalize my life 
     because I can't afford a $40 copay every month, in addition 
     to my expensive transportation passes, student loan payments, 
     and helping my parents pay their bills. However, with the 
     Affordable Care Act, I have access to free birth control that 
     allows me to live my life and succeed. It enables my 
     independence, and makes me a healthier individual. I am 
     terrified that any repeal of the Affordable Care Act will 
     harm my health, my career and my ability to lead a normal 
     life.

  We want people to lead the life of their dreams--their health, their 
careers. What she is asking for is not a luxury. It actually benefits 
us all because we are empowering her to succeed. That makes this 
country greater. Yet Tom Price, this nominee, has voted 38 times on 
measures that would restrict women's access, including 10 times voting 
to defund Planned Parenthood. At a time when there are fewer unwanted 
pregnancies, when women have more power, more control over their lives, 
Tom Price wants to roll things back.
  Struggling women are fighting to raise families and go to college and 
pay the bills and run businesses or be entrepreneurs, that they are 
having constrictions placed on their lives--you empower women, you 
empower this Nation.
  In New Jersey, Planned Parenthood's 26 health centers provide access 
to lifesaving care for women across the socioeconomic spectrum. I will 
fight tooth and nail with all that I have for not rolling things back. 
We are not going back. And a Congressman who has pledged to do just 
that should not be the Secretary of Health and Human Services.
  Tom Price has spoken out against sex education. I am a believer. I 
said this when I was mayor, all the time. In God we trust--I am a man 
of faith--but everybody else, bring me data. Sex education is actually 
something that has a powerful economic benefit. When it comes to 
advocating for better health options and outcomes, we know this is not 
an idea or theory, but there is a connection between poor, incomplete, 
or absent sexual education and increasing rates of teen pregnancy, 
sexually transmitted diseases, sexual assault. Young people are also 
disproportionately infected, without sex education, with HIV, and HIV 
rates among young adults are truly problematic in this country. Kids 
who are granted full information live healthier lives. But Congressman 
Price advocates against that. He thinks sex education doesn't reduce 
rates of teen pregnancies--it does; doesn't reduce rates of sexually 
transmitted diseases--it does; doesn't reduce rates of sexual assault--
it does; doesn't reduce rates of HIV--it does. But he thinks that it 
promotes promiscuity among young people.
  I want to end with my last point. All of this is enough, but this is 
the more astonishing part of my opposition because in this, I would at 
least think we could get my Republican colleagues to join with me 
because if you look at past Presidents, something less than this has 
sunk nominations before. This doesn't have to do with health policy; 
this has to do with conflicts of interest.
  There was a great Senator who pulled himself out of consideration for 
what, compared to this, is a mild issue that he moved to correct on 
paying taxes on a benefit that he received. He pulled himself out of 
consideration. He had that kind of dignity to say: You know what, I 
have this small issue. I am pulling myself out of consideration.
  But Tom Price is charging right ahead, while people in the House are 
calling for his investigation. Some of my colleagues have already 
addressed this, so I won't go into it much, but the SEC investigation 
should be there. An independent watchdog from the Office of 
Congressional Ethics should be there. We don't know because these 
organizations, the SEC and the Office of Congressional Ethics, don't 
announce when they are investigating somebody. But there are a whole 
bunch of people saying that Congressman Price has potentially violated 
something called the Stock Act, which was basically put in place so 
that Congresspeople, who know things about regulations or issues 
affecting companies, can't benefit off of that insider information to 
profit themselves. I don't understand why, at a time that this is all 
hanging over his head, that there should be an investigation, that we 
should get to the bottom of it before we put him in the President's 
Cabinet, Democrats and Republicans here, given past history and past 
nominees who had to withdraw, why aren't we joining in a bipartisan way 
and saying: Hey, there is a lot of smoke here, and the facts are kind 
of screaming for attention.
  Let me just be clear. As an example, last March Congressman Price 
bought between $1,000 and $15,000 worth of shares in a company called 
Zimmer Biomet. They are a medical manufacturer that specializes in hip 
and knee devices. House ethics disclosures show that he invested in the 
company just 6 days before introducing a bill that would have directly 
benefited hip and knee replacement companies like Zimmer Biomet, H.R. 
4848. Let's do this again. He invests in a company 6 days before he 
introduces legislation that would have benefited such a company. That 
is astounding, to me, and it should raise alarms in terms of the codes 
of conduct of a potential Cabinet nominee. He invested in a medical 
manufacturer of hip and knee devices and shortly thereafter introduces 
a bill, the HIP Act.
  What is more, though, is while Congressman Price has said that he was 
unaware of the stock purchase because it was bought by a broker, his 
financial disclosure forms show that he initialed the purchase to note 
an error. He initialed the purchase. So to say he had no knowledge of 
it is a stretch.
  Congressman Price then added nearly two dozen cosponsors to the bill 
over the next 3\1/2\ months. I am sorry, if a Senator here did that--
knowingly buying stock, then introducing a bill--I know this body would 
look askance on that. More than that, I don't think you need to explain 
much of this because it is so obvious that American folks at home are 
knowing that you should not introduce legislation to self-deal to 
yourself.
  Let me give another example. Price also bought stock in an obscure 
Australian biopharmaceutical firm called Innate Immunotherapeutics 
through a private offering that was not made available to the public. 
The private stock offering gave Congressman Price access to hundreds of 
thousands of discounted stock.
  At his Senate confirmation hearing, he asserted the stocks were 
``available to every single individual that was an investor at the 
time,'' but this is how the Wall Street Journal reported it--not quite 
a liberal periodical. It said:

       In fact, the cabinet nominee was one of fewer than 20 U.S. 
     investors who were invited last year to buy discounted shares 
     of the company--an opportunity that, for Mr. Price, arose 
     from an invitation from a company director and a fellow 
     Congressman.
       The shares were discounted at 12 percent off the traded 
     price in mid-June only for investors who participated in a 
     private placement arranged to raise money to complete a 
     clinical trial. The company's shares have since tripled 
     during the offering.

  I am sure that Americans at home who are saving for their retirement 
would love to have an insider deal like this, would love to be clued in 
by company heads to an opportunity to triple their money, but clearly 
something is wrong when a Congressman is doing that. That should cause 
us to pause as a nation before we put him in as a Cabinet Secretary 
over all of our health care.

[[Page 2344]]

  It is a disturbing pattern when Congresspeople use their position of 
power for personal gain with no regard for public interest. This type 
of behavior would be unacceptable in most industries. It should be 
unacceptable to Congress, to Senators on both sides of the aisle who 
have to advise and consent.
  Look, we are at a point in our country where we have taken steps 
forward on health care. It has been controversial, I understand, but 
there is no arguing with the fact that we are now at a point in America 
where someone with a preexisting condition is not stopped from having 
health insurance, where young people all over our country have the 
security of knowing they can stay on their parents' health insurance 
until they hit 27. We are at a point now where being a woman is not a 
preexisting condition, where we have expanded access to contraception. 
We are at a point in our country where the uninsured population has 
gone down dramatically.
  We cannot have someone whose attitude is not what I would hope it 
would be, one of ``Hey, we accomplished a lot. Let's figure out a way 
to make it better. Let's build on it.'' Instead, they not only want to 
take back the gains I just mentioned, but they want to go further and 
take back Medicaid and Medicare, privatize them, gut them, block-grant 
them.
  So this is not a close call. This is a Congressperson who for years 
has told America what his intentions are. He just didn't have the power 
to do it then because he was 1 out of 435. Frankly, if you include the 
Senate, he was 1 out of 535 and had a Democratic President also to get 
through. He couldn't get done what he wanted to get done. Now he is 
going to go from being one voice on the fringe, yelling for getting rid 
of Medicaid and Medicare, yelling against women's access to 
contraception, yelling to put insurance companies back in charge of 
your life, your destiny, and your health care--he is going to go from a 
fringe voice, 1 out of 435, to now being the head of the Department of 
Health, advising the President on things, frankly, that he has said, at 
least, that he doesn't want to do: gutting Medicare, gutting health 
care for seniors.
  So I go back to where we came from--a Republican President, Dwight D. 
Eisenhower, and the first head of the Health Department, an incredible 
woman, World War II--served soldiers in World War II. And they had a 
vision for this country, that, hey, what we have is not good enough. 
Let's figure out a way to do better because a healthy society is an 
economically strong society. A healthy society is a prosperous society. 
A healthy society lives up to our common values.
  We are the United States of America. We should set the national 
standard for health care. When it comes to the most vulnerable amongst 
us, whether it is a poor kid on a farm, whether it is someone in an 
inner city, whether it is an immigrant, we are a country that 
believes--like the old African proverb: If you want to go fast, go 
alone, but if you want to go far, go together.
  One of the great singers and artists and inspirations in my State is 
a guy named Bruce Springsteen. He has a song where he says: We take 
care of our own. Well, we have done well on that idea. We have gotten 
better. We have made strides toward that standard.
  We have work to do. We should be working together, both sides of the 
aisle, to make our health care better, more inclusive, more accessible, 
and more affordable. We have a lot more work to do. But I don't want to 
go back. So help me, I will fight every day to prevent us from going 
backward where there will be fewer people covered, more people, because 
they can't afford things, suffering untold health crises.
  I don't want to go backward to where women are denied coverage or 
access to empowering things, basic things, fundamental things like 
contraception.
  I don't want to go backward with senior citizens who are in the 
sunsetting years of their lives, when they should be free of stress and 
worry and strain but suddenly are worried again and struggling and 
suffering. I don't want to go back to those days; therefore I will vote 
a resounding, full-throated no on Congressman Price because, as the 
poet Maya Angelou said, if someone tells you who they are, believe 
them. He is someone who has told us what he wants to do. We should stop 
him from doing it.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Perdue). The Senator from Florida.


                          Venezuelan Passports

  Mr. RUBIO. Mr. President, I wanted to take a few moments today. I 
know we are in the middle of this debate about the health care law, 
about the nomination. On a topic I have been working on for a while, I 
was compelled to come to the floor at this late hour because it has now 
broken in the press. It is important to kind of give some clarity.
  As my colleagues know, I have spent a significant amount of time over 
the last few years discussing the issues in the nation of Venezuela, 
which has a direct impact on my home State of Florida but ultimately on 
the country. It is a nation that faces some very significant 
challenges, primarily because its political leadership is a disaster. 
It is no longer truly a democracy. It is now a government run by a 
tyrant who has basically ignored the Constitution. They have taken over 
the courts. The members of the judiciary in Venezuela are now basically 
under the complete control of their so-called President, Nicolas 
Maduro, and before that, Chavez. They control the press. They have a 
national assembly that actually is controlled by the minority party or 
the opposition party to the government. But it is pretty shocking. My 
colleagues would be shocked by this. We all travel abroad often. 
Imagine if you lived in a country where the President denied you the 
ability to travel abroad. Well, that is what has happened.
  One of the members of the National Assembly in the opposition, Luis 
Florido was trying to go to Peru to travel and was denied the ability 
to leave the country. Imagine that. Imagine that one of our Democratic 
colleagues here in the Senate decided they wanted to take a trip next 
week overseas in the conduct of their office and were told that the 
President was not allowing them to travel abroad. That happened in 
Venezuela. Another one, Williams Davila, had his passport taken away by 
the President of Venezuela. So the country is a disaster because of 
their leadership. It is actually headed into a cataclysm.
  In April of this year, Venezuela has to make a $6 billion payment on 
their debt. They will not be able to make that payment. The Government 
of Venezuela knows that. It is a terrible situation.
  But in the midst of all of that, I have argued that the national 
security interests of the United States is at stake in what is 
happening in Venezuela. This is not just about the issue of democracy; 
it is also about the threat it potentially poses to the United States. 
That is what I come to the floor to speak about tonight.
  My office has been engaged with a number of people over the last few 
months and year who have been coming to us with information. We have 
been working on some of this. Some of that has now broken into the 
press tonight in a CNN report that I am about to describe in a moment, 
but first, let me lay out the scene.
  There have been about 8.5 million names added to Venezuela's 
immigration system since it was last independently audited in the year 
2003. OK. So 8.5 million people were added to their immigration system, 
the new names that have come about. Of the 8.5 million names that were 
added, 221,000 of those--over 221,000 of those are foreign nationals, 
and at least 173 of those 221,000 foreign nationals are from the 
following countries: Iran, Syria, Iraq, Lebanon, and Jordan. So 173 
people from these countries were provided government passports and 
national IDs between the year 2008 and 2012, which leads me to this: In 
November of 2015, a Venezuelan attache by the name of Misael Lopez 
Soto, who was assigned to the country's Embassy in Baghdad, became a 
whistleblower, and he began to reveal the identities of several of 
these 173 names.

[[Page 2345]]

  Understand that this is important because there has been a 168-
percent jump in U.S. asylum applications from Venezuela since October 
of 2015, now the third highest nation of origin for asylum applicants 
to the United States. The overwhelming majority of them are legitimate 
people fleeing all this craziness that is happening. But I lay the 
groundwork to understand the connection between Venezuela and the 
United States.
  I now want to go into the story of Mr. Soto, who, as I said, used to 
work at the Embassy.
  Mr. Soto was assigned to work at the Embassy of Venezuela in Iraq. As 
he began to work there, he noticed some irregularities, so he began to 
report what he says was a scheme to sell passports and visas for 
thousands of dollars out of that Embassy. He was offered all kinds of 
money to do this, to get a cut of those thousands of dollars. He says 
he declined it.
  CNN and CNN en Espanol have over the last year teamed up on a joint 
investigation, relying on much of the same information that I have had 
access to, looking into all of these allegations and what they 
uncovered. In the story that posted tonight was evidence of serious 
irregularities in the issuing of Venezuela passports and visas, 
including passports that were given to people with ties to terrorism.
  According to CNN, one confidential intelligence document obtained by 
CNN--intelligence documents from nations in the Western Hemisphere, not 
from the United States--actually directly links Venezuela's now new 
Vice President, who is in line to potentially become the President when 
the current dictator is going to have to give up power here soon 
because of this cataclysm that they are facing--the name of that Vice 
President is Tareck El Aissami. There are now links, according to CNN, 
to the current Vice President, Tareck El Aissami, and the 173 
Venezuelan passports and IDs that were issued to individuals from the 
Middle East, including people connected to the terrorist group 
Hezbollah.
  It is important to understand--and the CNN article appropriately 
outlines this--if you have a passport from Venezuela, you are allowed 
to enter over 130 countries on this planet without a visa. That 
includes the 26 countries in the European Union. So a Venezuelan 
passport is a valuable commodity for someone who is trying to travel 
around the world under an assumed name with a valid government 
document. That is why it is important.
  Mr. Lopez, the whistleblower who once worked at the Embassy, is a 
lawyer. He used to be a police officer in Venezuela. He said, according 
to the article, that he thought that becoming a diplomat was a great 
career opportunity that would allow him to serve his country, so he 
moved to Baghdad and started his new life at the Embassy.
  He remembers what he calls an unwelcome surprise on his first day in 
July of 2013. His new boss was Venezuelan Ambassador Jonathan Velasco. 
The Ambassador handed him a special envelope, he said.

       ``He gave me an envelope full of visas and passports,'' 
     Lopez recalled. ``He told me, `Get this, this is one million 
     U.S. dollars.' I thought it was like a joke. Then he told me 
     here people pay a lot of money to get a visa or a passport to 
     leave this country.''

  Meaning Iraq.
  About a month later, Lopez said he realized it was no joke.
  An Iraqi employee of the Embassy who was hired to be an interpreter 
told him that she, the interpreter, had made thousands of dollars 
selling Venezuelan passports and visas and that he could make a lot of 
money too. He says he told her it was wrong and he refused. The 
employee pressed the issue, telling him that there were thousands of 
dollars to be made, even discussing an offer to sell visas to 13 
Syrians for $10,000 each.
  Lopez said that he was stunned when he found the document inside the 
Embassy. It was a list of 21 Arabic names with corresponding Venezuelan 
passport numbers and Venezuelan identification numbers. A Venezuelan 
immigration official told CNN that a crosscheck of the passport numbers 
indicated that the passports are valid and that those passports, given 
to these people with the 21 Arabic names--when he ran the crosscheck, 
they actually matched the names on the list Lopez found, meaning the 
people on the list could be able to travel using those Venezuelan 
passports.
  But here is what is incredible: A publicly available database in 
Venezuela examined by CNN shows that 20 of the 21 identification 
numbers of the people with the Arabic names that match the passports 
are actually registered to people with Hispanic names, not the Arabic 
names listed on the passports.
  So basically CNN has uncovered evidence that at least on 21 
occasions, the Venezuelan Government--the Venezuelan Embassy has sold 
passports to someone from the Middle East but assigned them a Hispanic 
surname or a Hispanic name. People are traveling under assumed 
identities from the Middle East. We have a couple of those names we are 
going to share with you in a moment.
  In April 2014, only 9 months after he started the job, he emailed a 
report about all this to the Ambassador. He said the Ambassador did 
nothing, and, in fact, the Ambassador, Velasco, threatened to fire him.
  By 2015, he was so frustrated that no one would investigate it that 
he took what he found to Delcy Rodriguez, who was Venezuela's Foreign 
Minister. He emailed the report and said that there was fraudulent 
issuing of visas, birth certificates, and Venezuelan documents. He said 
nothing happened. With nowhere else to turn, Mr. Lopez said he 
contacted an FBI official at the U.S. Embassy in Madrid.
  By the end of 2015, the Venezuelan Government accused him of 
abandoning his post and removed him. A police official showed up at his 
home in Venezuela with a document that said he was under investigation 
for revealing confidential documents or secrets.
  Now, this is not the first time this Congress hears about this. U.S. 
lawmakers heard reports about Venezuela's passport fraud during 
congressional hearings as far back as 2006. In fact, a congressional 
report warned that ``Venezuela is providing support, including identity 
documents that could prove useful to radical Islamic groups.''
  A State Department report at that time concluded that ``Venezuelan 
travel and identification documents are extremely easy to obtain by 
persons not entitled to them.''
  Roger Noriega, the former U.S. Ambassador to the OAS, a former 
Assistant Secretary of State for the Western Hemisphere, said in 
prepared remarks before Congress in 2012 that ``Venezuela has provided 
thousands of phony IDs, passports and visas to persons of Middle 
Eastern origin.''
  In 2013, confidential intelligence reports from a group of Latin 
American countries obtained by CNN said that from 2008 to 2012--I 
already outlined this earlier--173 individuals from the Middle East 
were issued Venezuelan passports and IDs. Among them were people 
connected to the terrorist group Hezbollah. The official who ordered 
the issuing of those passports, the report said, is Tareck El Aissami, 
who just a few months ago was appointed and is now the Vice President 
of Venezuela. Back then, he was the Minister in charge of immigration, 
as well as a Governor. He personally took charge of issuing granting 
visas and nationalizing citizens from different countries, especially 
Syrians, Lebanese, Jordanians, Iranians, and Iraqis, the report said.
  So what we have now is an unbelievable situation in which a country 
in this hemisphere, according to both the whistleblower, independent 
reports, and now CNN's own investigation--Venezuela--has been providing 
passports to people from the Middle East under false pretenses, 
basically fraudulent documents that allow them to travel all over the 
world.
  Among them, Hakim Mohamed Ali Diab Fattah, a Palestinian and 
suspected Hezbollah member, was given national ID No. 16.105.824, 
issued on July 12, 2012. He was deported from the United States in 2002 
for his possible connection to the 9/11 hijackers via

[[Page 2346]]

aviation school in the United States. He was detained and arrested by 
Jordanian authorities on May 3, 2015, for suspicion of financing 
terror. This individual has that national ID number from Venezuela and 
a passport that was allowing him to travel.
  Here is another one: Ahmad Adnan Ali, an Iraqi, another suspected 
Hezbollah member. He is a convicted trafficker facing charges in France 
and Denmark, and he has documents under two aliases: Ahmed El Timmy 
Villalobos, with the number 29.645.898. That is the number on the ID 
that was issued on January 16, 2014. He has another alias and another 
document: Ahmad El Timmy Gomez. His name is neither Villalobos nor 
Gomez, but he has these documents.
  By the way, all of this, according to CNN, is no surprise to General 
Marco Ferreira, who was in charge of the immigration office in 
Venezuela in 2002. He now lives in Miami. He was granted political 
asylum. ``He told CNN that he personally witnessed corrupt senior 
officials ordering passports for people who were not citizens when he 
was running the department.'' He said it was ``very easy'' to assume 
someone else's identity. It was ``very, very easy to go and be a 
Venezuelan or pretend being born in Venezuela.''
  I bring this up in the midst of all these other things because we now 
understand that what we are facing in Venezuela is not just a corrupt 
government and a tyranny but a nation that is under the corrupt 
leadership of its now Vice President and, of course, its President, a 
nation that is trafficking in selling passports and travel documents to 
individuals with links to terrorism. That poses a direct threat to the 
national security of the United States. I hope in the days to come, 
with this new information and with this report, that we can work with 
the Justice Department and the State Department to take appropriate 
measures to protect our Nation and the world from what is occurring at 
the hands of the Venezuelan Government under the tyrant Maduro and 
under its Vice President, who personally ran the department that was 
undertaking these corrupt activities.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Massachusetts.
  Mr. MARKEY. Mr. President, tonight I am here to speak in opposition 
to the nomination of Tom Price to be the Secretary of Health and Human 
Services, and I am standing here this evening in solidarity with 
millions of Americans across this country who, thanks to the Affordable 
Care Act, have health insurance, some for the very first time in their 
lives--not just access to coverage but actual health insurance for 
themselves and for their families, coverage that provides preventive 
care without copays, coverage despite preexisting conditions, coverage 
supported by subsidies for those who need it to help make health 
insurance affordable for their families.
  Tom Price's position on health care is contrary to everything those 
millions of Americans rely upon, and it is against everything that my 
State of Massachusetts stands for.
  So let's take a look at Tom Price's formula for health care for 
America. First, Congressman Price wants to repeal the Affordable Care 
Act. He wants to bring back discrimination against those with 
preexisting conditions. He wants to kick 32 million Americans off their 
health coverage. He wants to deprive women of reproductive health 
choices, and all of this, ultimately, is going to raise prices of 
insurance, of health care coverage for everyone who has insurance right 
now, which is 80 percent of America who gets their private coverage.
  Second, Tom Price wants to end Medicare as we know it. He would 
increase the Medicare eligibility age and create a voucher system that 
pushes the cost of the program directly onto seniors. Finally, he wants 
to slash Medicaid, which provides health care to disabled and poor 
families across this country.
  So that is his plan. This is the Tom Price health care plan for 
America in the 21st century: No. 1, repeal the Affordable Care Act; No. 
2, end Medicare as we know it; and, No. 3, gut Medicaid and raise 
premiums for everyone else in our country. No one with any sense 
believes this is a winning formula.
  Voting for the Affordable Care Act was the best vote of my entire 
political career, and that is because I agreed with Senator Ted Kennedy 
that health care is a right and not a privilege and that everyone in 
our country is entitled to health care coverage and that that health 
care is the solid foundation for our entire country to build their 
lives on.
  Ralph Waldo Emerson said: ``The first wealth is health.'' Without 
health, you have nothing. That is what the Affordable Care Act is all 
about--to give every American the first wealth, the most important one, 
the access to the health care which they need. That is the promise that 
all Americans were made with the Affordable Care Act, and it is a 
promise that we still must keep.
  Before Tom Price and his Republican allies came up with their 
blueprint to dismantle the ACA and put their big health insurance 
companies back in charge of your health, there was a Massachusetts 
blueprint that helped to create that historic health care law. Many of 
those core fundamentals were from Massachusetts and were then just 
built right into the Affordable Care Act: creating a marketplace so 
that insurance companies compete for customers, expanding Medicare to 
cover more low-income residents in our State, helping lower and middle-
income people buy insurance with tax subsidies, encouraging people and 
businesses to buy in so we are all splitting the cost and sharing the 
benefits, and a employer-responsibility requirement for all large 
employers to offer coverage to their workers.
  In Massachusetts, we call this RomneyCare, a good Republican program 
from my Republican Governor--RomneyCare. Then on a national level, they 
called it ObamaCare. In Massachusetts, we just called it successful. It 
worked. It is a good plan.
  Right now in Massachusetts, 98 percent of all adults have health care 
insurance; 99 percent of all children have health insurance. The 
Massachusetts unemployment rate is 2.8 percent. We are No. 1 in math, 
verbal, and science at the fourth, eighth, and tenth grades out of all 
50 States. We have the cleanest environment in the United States. We 
have health care for all children and all adults, and our unemployment 
rate, again, is 2.8 percent.
  It is not a choice. In fact, it is a business plan for the State. It 
works--the healthiest families, the most educated children in the 
Nation, the lowest unemployment rate. It all comes together. It is a 
plan.
  Now, to listen to the critics of this idea--that everyone is entitled 
to health care--you would think that it would destroy our economy, and 
they are still waiting for it to happen, as our unemployment rate 
continues to go down and down and down.
  What is up? I will tell you what is up. Cancer screenings are up. 
Preventive care visits are up. Diabetes treatments have gone up. Health 
disparities among women and minorities are down. That is who we are. We 
can do this. It is a plan. It is a plan. It actually ensures that every 
child in America, every family in America really doesn't have to worry 
about something happening, some bankruptcy taking place because they 
can't afford the health care that one of their family members needs. 
That is what was happening before the Affordable Care Act passed.
  So what makes Massachusetts one of the healthiest places in the world 
to live is in jeopardy with the nomination of Tom Price. He is coming 
for this plan. He doesn't think it works. He doesn't understand what 
has happened in Massachusetts or across our country.
  In fact, in the State of Kentucky, the Democratic Governor, Governor 
Beshear, has instituted this plan in his red State, and he took the 
total number of people up to 95 percent of total coverage for 
Kentucky--hundreds and hundreds of thousands of people.
  If we did that across the whole country, then we would essentially 
have the Affordable Care Act of Massachusetts in the whole country, but 
there has been strong resistance from States

[[Page 2347]]

that are ideologically opposed to having this kind of a plan be put in 
place. So they are coming for it. That is what Tom Price is doing.
  Let me give you an idea as to what Tom Price's plan does for 
Massachusetts and ultimately for the rest of the country that has 
adopted the plan. In Massachusetts alone, there will be an average per 
person loss of $2,280 in tax credits, and 83,000 seniors and people 
with disabilities may lose $1,000 per year in saved prescription drug 
costs. We could lose an estimated 57,000 jobs just in Massachusetts 
with all these services just being eliminated. We would have the loss 
of $1.85 billion in Medicaid expansion funding and the loss of more 
than $700 million in Federal premium tax credits and cost sharing 
reduction payments for middle-income families.
  We also have to consider the Affordable Care Act's prevention and 
public health fund. Here is what went wrong with our health care system 
in the 20th century: We were running a sick care system, not a health 
care system. So what the Affordable Care Act did was it began to shift 
the emphasis towards prevention. How do you stop people from getting 
sick in the first place? That is the way we should be viewing disease 
in our country. The Affordable Care Act is our government's single 
largest investment in prevention.
  Since enactment of the ACA, the prevention fund has provided more 
than $5 billion to States and communities across the country to support 
community-based prevention programs. Nationally, the prevention fund 
also funneled hundreds of millions into the preventive health services 
block grant. These grants have been critical in Massachusetts, for 
example, helping our communities respond to the heroin, prescription 
drug, and fentanyl crises.
  Unfortunately for all of us, Tom Price's assault on health care 
wouldn't stop there. Congressman Price's march on the Affordable Care 
Act would slash Medicaid--and listen to this number--which pays for $1 
out of every $5 in America for substance use disorder treatment.
  The repeal of Medicaid expansion would rip coverage from 1.6 million 
Americans, newly insured Americans who have substance use disorders. We 
have an opioid crisis in America, a fentanyl crisis, a prescription 
drug crisis. People are dying in record numbers. What Tom Price is 
proposing is going to take 1.6 million of these Americans who are 
receiving treatment right now and just strip them of this health care 
benefit.
  What happens to them? We know what happens if you don't have 
treatment. We know what happens if you don't have prevention when you 
have a drug problem. It leads, inextricably, inevitably, toward a 
conclusion that is now affecting tens of thousands of people in America 
every single year, and that is death. You tell these 1.6 million people 
they no longer have coverage, and you are sentencing them to 
consequences that, I don't think, our country wants to see.
  I have served in Congress for nearly 40 years, and I have never seen 
anything like this opioid epidemic, never.
  In Massachusetts, 2,000 people died last year. We are only 2 percent 
of America's population. If the whole country was dying at our rate, 
that would be 100,000 people a year dying from drug overdoses. That is 
two Vietnam wars every single year.
  What Tom Price is saying is that he is going to rip away the 
Affordable Care Act funding for those who have substance abuse. 
Nationally, opioids have now killed more people than gun violence, auto 
accidents. Many people who have substance use disorders benefit from 
protections under the ACA. It is guaranteed. The funding is there for 
it. So this is for me just one perfect example of many, many examples 
which I can use in order to kind of just give people insight as to the 
horrors that are going to be done to vulnerable families all around the 
country.
  Donald Trump is bragging today that he is going to provide a big 
league tax cut for businesses in America, big league tax breaks for the 
wealthiest people in our country. That is a commitment. The wealthiest 
can get a big tax break, businesses can get a big tax break.
  Where will that money come from? Well, in order to pay for the 
Affordable Care Act, hospitals across the country kicked in about $500 
billion over 10 years in order to help with the costs, but the 
hospitals received something in return. Because of the Medicaid 
subsidies for patients, they would now have insurance, and when they 
showed up at the hospitals, they would actually have insurance 
coverage. So that would help the hospitals have the revenue they need 
in order to take care of business. Since many fewer people were now 
going to arrive at the emergency room, the uncompensated care--that is 
the funding which the hospitals just had to provide for patients who 
just walked into an emergency room--would now be dramatically reduced 
because the patients would have insurance through the Affordable Care 
Act. The $500 billion they had promised to the Federal Government that 
would not be an expenditure, that would be the tradeoff.
  Then you say to yourself, what is the Republican plan now? What they 
are saying is, they are going to kill these subsidies that have reduced 
the number of people who do not have insurance going into emergency 
rooms, and they are going to strip that away. They don't have a plan. 
This is the Tom Price plan--nothing. But they are also saying they are 
not going to give back the money to the hospitals which had been used 
in order to deal with the uncompensated care. So it is a con job. The 
President says you have a big tax break to the wealthiest in our 
country, big tax break to the businesses in our country. Where is the 
money coming from? Where is the piggy bank? Here is the piggy bank. The 
piggy bank is the money that was being used to give insurance for 
people to go to hospitals with their families. That is being taken 
away, and they will use it to give tax breaks to the businesses. You 
are taking it from the people who need it the most, for health care, 
preventive services, and families and you give it to the people who 
need it the least, the wealthiest and the businesses in the country. It 
is a con job--take the money and hand it over to the largest 
constituency in the Republican Party. And who is the architect? Tom 
Price.
  Is that why he would destroy this health care system? Is that why you 
would cut back Medicare? Is that why you would gut Medicaid? You do it 
so you can give huge tax breaks to the wealthiest in our society? That 
is an unacceptable plan, and it makes him an unacceptable candidate to 
be the Secretary of Health and Human Services in our country.
  We have a raging epidemic of opioids. We have all kinds of problems 
that can be dealt with if people had the insurance coverage and they 
knew they could go in order to get the help they need.
  Now let's focus on the Medicare Program because they want to save 
money there too. How are they going to accomplish that? Well, there 
were doom-and-gloom prospects about the Medicare programs that came 
from the Republicans, Tom Price himself, but just the opposite 
happened. The Medicare Program since the Affordable Care Act went into 
place has resulted in the lowest per member rate of spending growth in 
its 50-year history for Medicare. Premiums paid by enrollees in 
Medicare Part B and Part D have gone down against all the predictions 
of its opponents, and perhaps more importantly, the savings have helped 
America's seniors by ensuring that Medicare will continue to be there 
for them.
  Here is a big number for you. Medicare had previously faced a 
projected insolvency that could have occurred this year--this year. 
Medicare insolvent. However, because of the Affordable Care Act, it 
extended the insolvency date of the Medicare trust by 12 years. Good 
news for seniors. Repealing the law jeopardizes Medicare for a 
generation of Americans.
  But Tom Price doesn't just want to repeal the Affordable Care Act, 
the second part of the health care assault is to transform Medicare 
into a voucher program and increase the Medicare eligibility age. After 
a lifetime of hard work, Congressman Price would make

[[Page 2348]]

seniors wait longer for the benefits they earned.
  My father was a milkman for the Hood Milk Company. His arms were the 
size of my legs. Milk men work hard. Blue-collar people work hard 
across our country. Working-class people work hard. Should they have to 
wait until they are 66, 67, 68, 69 to receive a Medicare benefit? They 
work hard. That makes no sense whatsoever. That is Tom Price. How do 
you increase the age when people can receive Medicare coverage for 
their health when they are old in order to save money--for what 
purpose? To then have a tax break for the wealthiest who already have 
the money they need in order to take care of the health care of their 
families. That is one thing you never have to worry about. The wealthy 
in America have all the money they need for their families.
  Do you want to know another thing? The higher your income, the more 
likely you are going to live longer than people who don't have money. 
You don't have to worry about wealthy people. They are fine. Their 
health is fine. Their children are fine. Any problems in their family 
are fine.
  Well, how about other families in our country? That is what this plan 
does. They want to lose that plan in order to give more money to the 
people who already have enough for the rest of their lives. So that 
would wind up increasing premiums for grandma and grandpa by hundreds 
of dollars, making them pay more out-of-pocket for less care. What Tom 
Price essentially wants to do is get us into the Wayback Machine and 
return us to a time when corporate insurance companies were calling the 
shots in our country, back to a time when a person could go bankrupt 
because of medical bills, back in time to when Americans had to choose 
between paying for the rent or paying for a lifesaving medical 
treatment.
  The Affordable Care Act moved our country from being a sick care 
system to a health care system, but Congressman Price wants to undo all 
of that progress and get rid of all of those protections.
  Here is Tom Price's bottom line: repeal the Affordable Care Act, 
which results in fewer insured patients, and that means more patients 
in the emergency room and higher premiums for everyone else. That 
formula is as bogus as a degree from Trump University. It doesn't add 
up.
  The people who have to pay for it are everyone else's insurance 
policies that are going to go up. Because you better believe the 
hospitals and insurance companies, when that money is not there in the 
Affordable Care Act, insurance policies for those people, and you don't 
get back the $300 to $500 billion that the hospitals have now committed 
back to the Federal Government, somebody is going to have to pay. 
Somebody is going to pay, and you don't have to be Dick Tracy to figure 
this out. The people who are going to pay will be every other American 
who has an insurance policy. It will just go up 5, 10, 15 percent, 
everybody else's insurance policies. The hospitals are getting their 
dough; the insurance companies are getting their dough.
  When people go to an emergency room, they are not going to be turned 
away. Somebody is going to have to pay. Where is the payment going to 
come from? Everybody else's insurance policies, which are going up, and 
the money that had been saved is going to the Federal Government for 
tax breaks to the Trump administration. He said today big league tax 
breaks for the wealthy, big league tax breaks for businesses. Great. 
This is the plan that if you kicked it in the heart you would break 
your toe. What about ordinary people? What about the people who need 
help?
  Martin Luther King, Jr., said: Of all forms of inequality, injustice 
in health care is the most shocking. You cannot work if you are ill, 
you cannot learn if you are sick, you cannot be secure if you are 
constantly worried that medical bills can wipe out your entire savings. 
These clearly are not concerns for Tom Price, who has a legislative 
history that has repeatedly favored wealthy individuals and 
corporations over the health of the majority of Americans.
  Congressman Tom Price championed legislation that would eliminate 
young adults' ability to stay on their parents plan until age 26. 
Congressman Price trumpeted a plan that would let insurance reinstate 
lifetime and annual limits on coverage and charge women more because of 
their gender.
  Tom Price would rip away the Affordable Care Act income-based 
subsidies and instead offer inadequate tax credits that can be given to 
a billionaire, not the middle-class, working-class, blue-collar 
American.
  If Tom Price had his way, he would implement a plan that would cause 
health care premiums in individual markets to skyrocket, increasing 
premiums for average Americans by 25 percent immediately and doubling 
over the next 10 years. He wants to strip Planned Parenthood of all its 
resources, and 2.5 million people would lose access to care in those 
community clinics. If that happens, fewer mammograms, fewer prenatal 
exams, fewer cancer screenings, and loss of all those vital services 
would hit women of color and low-income women hardest. It would 
increase health inequity and health disparity in our communities of 
color.
  Tom Price's assault on women's health doesn't end there. He has 
proposed legislation that would allow health insurance companies to 
charge women more than men. He has repeatedly cut and limited access to 
family planning services. He does not believe that women should get 
birth control with no out-of-pocket costs. He is an outspoken and 
virulent opponent of reproductive health and would push women's 
reproductive rights back to the 18th century. Good physical health and 
reproductive freedom are critical to supporting women as productive 
members of their households and our economy. We cannot allow Tom Price 
to turn back the clock.
  So this is the challenge. We have an administration committed to 
increasing defense spending big time, increasing tax breaks to the 
wealthiest and to corporations big time, and then promising to cut the 
Federal budget by $10 trillion over the next 10 years. Well, where is 
the money going to come from?
  We know what they are targeting. They are targeting all these 
programs that help those who need the help the most in our society. So 
I urge my colleagues to vote no on this nomination of Congressman 
Price. He is the wrong man at the wrong time for the wrong job. It just 
doesn't match up, not with a 21st century strategy that we need to have 
the healthiest population in the world to compete against our economic 
rivals across the planet, and if for no other reason, just the moral 
obligation we have to make sure families are not desperate when their 
loved ones are hurting.
  I thank you for giving me the opportunity to come out here at this 
time, and I urge my colleagues to vote no on Congressman Price's 
nomination.
  I yield back the remainder of my time.
  The PRESIDING OFFICER. The Senator from Maine.
  Mr. KING. Mr. President, I am a former Governor, and as such, I have 
an inclination to support the Executive's nominees for their Cabinet--
for their Secretaries or Commissioners in my case, in Maine. I think 
that is an important principle, and it is how I start when I approach 
the analysis of any nominee to any position put forward by the 
Executive, whether the Executive is Donald Trump or Barack Obama or 
anybody else. That is a kind of starting point, and that is how I 
started this January. And, indeed, thus far, as we have voted here on 
the floor, I have supported five of the seven nominees who have come 
before us, plus I supported two additional nominees in committee which 
have not yet come to the floor, but whom I will support on the floor.
  So I am not in total opposition: Don't vote for any nominees. I don't 
think that is the way our system works, and it is certainly not the way 
I intend to approach these issues. I have approached them one at a 
time, looking at the position of the nominees, their policies, their 
views, their

[[Page 2349]]

hearings. I have tried to follow the hearings as closely as possible, 
including their answers to questions. Again, I start with a bias toward 
approval, perhaps because of my experience as a chief executive myself.
  But I can't support nominees who are fundamentally opposed to the 
mission of the agency they have been asked to lead. To me, that just 
doesn't make sense. That is why I voted against Betsy DeVos 2 days ago 
because I didn't believe that she had the best interests of American 
education--particularly public education--at heart. Her whole career 
has been about attacking and undermining public education by trying to, 
in effect, voucherize it, provide vouchers to people to use in other 
schools which, by the way, in a rural State like Maine, simply wouldn't 
work as a practical matter. So I could not support her because I felt 
she was hostile to the very premise of the agency that she was being 
asked to lead.
  Today, I come to the floor to talk about Dr. Price. I think he falls 
into the same category. I understand policy differences, and I 
understand the election took place, and I understand elections have 
results and that there are going to be different policies, but his 
policies on the fundamental mission of the Department of Health and 
Human Services are just inimical to what that Department was 
established to do for the American people. The title is Health and 
Human Services, and that is the role that Department has played and 
should play and will play in the future of America.
  Now, my problems with Dr. Price and his positions--and there is no 
doubt about his positions on various issues. He has a long record in 
the House of Representatives writing and legislating and advocating, so 
there is not much argument about where he stands, and there are really 
three areas that I want to touch on tonight. One is Medicare, one is 
Medicaid, and one is the Affordable Care Act. I want to try to put 
these all in the context of my home State of Maine.
  Health care in Maine is an enormous part of our economy. It is 
somewhat higher, actually, as a percentage of our GDP than it is 
nationally. We are at about 20 percent of GDP. One-fifth of our economy 
is health care. In part, that is because we have a great number of 
seniors who, of course, require more health care expenditures, but it 
is a very important part of our economy, which I will touch on a little 
bit later. But let's talk about Medicare.
  First, Medicare in Maine: 306,000 people in Maine are Medicare 
beneficiaries. The expenditure in Maine by Medicare is $2 billion. Now, 
when we are talking about cutting or changing Medicare, of course we 
focus, as we should, on those 306,000 people--and I will talk about 
them--but we also need to talk about that $2 billion. If we are talking 
about savings--savings don't just evaporate, they occur in real life, 
and those are funds that don't go to support medical care for seniors 
in Maine and don't go to our hospitals and don't go to our 
practitioners. So $2 billion is a very significant part of our GDP, and 
that is just what Medicare spends in Maine, 306,000 people.
  Now, I want to touch on an aspect of this that I don't think has been 
discussed much in these debates; that is, the burden of anxiety about 
health care and the cost of health care that was lifted from 
generations of seniors in this country by the passage of Medicare, now 
some 50-plus years ago. As you get older, there is anxiety about 
retirement, there is anxiety about income, there is anxiety about your 
health, but there is also anxiety about the cost of health care. The 
miracle of that Medicare was that it lifted that burden of anxiety from 
our seniors. It was one thing they didn't have to worry about. ``I have 
Medicare'' have been the words that have comforted thousands and 
millions of people in this country since 1965.
  To change the fundamental premise of Medicare, which is what Dr. 
Price has advocated for vigorously and continuously, from the current 
system, which is, if you get sick, if you have hospitalization, if you 
need medical care and you qualify for Medicare, it is paid for. To 
change that to a system which is essentially a voucher, which is capped 
at some level of inflation but not the health care level of inflation, 
is a cruel trick on our seniors. What it will do is, through 
compounding of interest, if inflation is 2 percent a year, and medical 
inflation--the cost of medical treatment--increases at 4 or 5 or 6 
percent a year, which is typical of what has happened in the last 15 or 
20 years; there have been ups and downs, but 4, 5, 6 percent is about 
where medical inflation has been. So if inflation is at 2 percent, and 
that is what your voucher is going to increase to, and medical costs 
increase at 6 percent, that gap is going to grow to the point where we 
are back where we were in 1964, before the passage of Medicare. Then, 
seniors suddenly have to worry about how they are going to pay for 
their health care. They are going to have an added burden of anxiety, 
and they are going to have an added burden of money, of finance, of 
cost.
  You can call it all kinds of highfalutin things. You can call it a 
voucher program, whether or not it is privatization. There are all 
kinds of ways to paper it over, but what it really is, is shift and 
shaft. It is shifting the cost from Medicare to seniors, and over time 
that shift and shaft is only going to increase. I think that is 
unconscionable, and there is no reason for it.
  Yes, the cost of Medicare is going up as a percentage of our budget. 
That is because we are getting older. That is because we have a 
demographic bulge going through our society for people who were born in 
the 1940s and 1950s--the baby boom generation--but that is anticipated, 
that is understood. There are things we can do to deal with that issue 
without the radical solution of essentially shifting the cost over to 
the seniors. It makes the Federal books look good, but it is not going 
to make the household books in Maine look good.
  That is what really bothers me about this policy. We are trying to 
improve our miserable budget situation by shifting a great deal of 
these costs off to individuals. That is just wrong. Medicare is too 
important financially, emotionally, psychologically. It is too 
important as an essential part of the promise that we have made to each 
generation of Americans for the past 50 years. And to fundamentally 
change that and realize, I believe cynically, that as the gap increases 
over time, the percentage of the premiums that is being shifted onto 
seniors is going to grow over time, until at some point--and you can do 
the arithmetic--it is going to eat the whole thing. And the Federal 
share, yes, will be capped--or capped at some lower level, and the 
share that is paid by the individual, by the family, by your mom, by 
your dad is only going to be greater. That is wrong. That is a breaking 
of the promise that we made to our seniors.
  The second piece where Dr. Price, I believe, is fundamentally at odds 
with the premise, with the mission of the agency, is in Medicaid. He 
has talked about various programs. First, let's get rid of the 
expansion of Medicaid and the Affordable Care Act and then let's block-
grant Medicaid and send it to the States. It is the same principle: It 
is shift and shaft, only this time you are shafting the States. You are 
taking a program which now says, if you have medical expenses and you 
are qualified, they are paid for, and you are saying, OK, in the 
future, we will give you a fixed amount of money, but if the medical 
expenses go up, it is on you, Mr. State; it is on you, State of Maine 
or Michigan or California or Georgia or Florida, or anywhere in this 
country.
  It is simply, again, repairing the miserable books of the Federal 
Government because we are not facing up to our responsibility to pass 
reasonable budgets. It is fixing those books at the expense of somebody 
else. Those moneys they are talking about: a $2 trillion cut in 
Medicaid. Great, Medicaid is going to look a lot better, but that $2 
trillion doesn't evaporate and doesn't go anywhere. It is not like 
everybody is going to say: Well, they are cutting Medicaid so we are 
going to charge less for our hip or for our surgery or for our 
treatment of drug abuse. It is going to have consequences. It is going 
to come out of treatment. It is going to come out of health.

[[Page 2350]]

  There is something about Medicaid that often isn't observed. I 
learned this as Governor. People think of Medicaid as a kind of welfare 
program, and there are these people who are taking advantage of it, and 
perhaps there are. There are always people who take advantage of 
programs.
  The truth is, the majority of the funds for Medicaid go to people in 
nursing homes--your parents, your uncle, your aunt. Nursing home 
expenditures for the elderly are a significant cost for Medicaid. 
Medicare doesn't pay nursing home expenses except for a limited period 
of time, but a great deal of Medicaid expenses go to nursing homes. You 
are going to cut Medicaid? You are going to have people who aren't 
going to be able to afford to stay in nursing homes. That is going to 
shift that cost back on to the family.
  The other majority of people on Medicaid are children. They are 
children who are covered who wouldn't have coverage otherwise.
  One of the best things in this country is the combination of Medicaid 
and CHIP, which has resulted in an enormous increase in the covered 
health coverage of children. And it is so important because health 
problems in children that can be dealt with when they are young, when 
they are children, when it is covered by insurance, can save us 
enormous costs later on.
  So, again, what does Dr. Price want to do? Cap, eliminate ACA 
expansion of Medicaid, and block-grant it.
  Let's not kid ourselves. Block-granting is shifting and shafting to 
those elderly people who would lose coverage for nursing homes, to the 
children who need the coverage, but most especially, to the States. As 
a former Governor, I can see the impact of this on my State of Maine. 
It is a difficult issue, and if we limit it, the only option will be to 
limit coverage or to cut back.
  Of course, Medicaid is one of the places we are covering the 
treatment of opioid addiction. The greatest public health crisis in 
this country in my lifetime is the opioid crisis. We are losing 1 
person a day in the State of Maine to overdose deaths--1 person every 
day. I met a young man at Christmastime at a treatment center. I went 
to the Christmas party and met his family and he was hopeful and he was 
under treatment. I learned this week that he is gone. He is gone, taken 
by the scourge of drugs.
  These are real people. These are real people. These aren't just 
numbers and statistics. In the next hour, as we are here debating this 
nomination, four people in America are going to die of overdoses--four 
people an hour. And when you think of how we mobilized this country and 
the money we spent to deal with Ebola where one person died--one person 
in the whole country--and yet we have this horrible disease and scourge 
that is just decimating our societies and we are talking about cutting 
back one of the basic props for providing treatment. We have cases 
where we--there is a huge backlog of treatment beds.
  I have been working on this problem in Maine for a long time. One of 
the things I have learned is that once a person who is addicted reaches 
a stage where they are willing to ask for help, we have to be there--
then. To say to that person there will be an opening in 3 weeks or 3 
months is akin to a death sentence because they might not be able to 
make it 3 weeks or 3 months; yet that is the situation in much of the 
country today. That is the situation, and we are talking about knocking 
one of the props out from under our ability to deal with this horrible 
public health crisis that is devastating this country in every State, 
but particularly in rural States. It is taking people out of the 
workforce that we need, it is tearing families apart, and it is 
affecting everybody. It is not just certain people in certain places. 
It is everybody. It is middle-class families. It is people of all ages.
  To blithely talk about we are going to block-grant Medicaid and fix 
the amount--it is the same as what I said about Medicare; the iron law 
of the percentage changes. If you fix it today and inflation continues, 
then ultimately it withers away, and it is not going to meet the needs 
of our people. Yet that is what the nominee for the Department of 
Health and Human Services wants to do. I don't get it.
  Finally, there is the Affordable Care Act. I have talked on this 
floor before about the Affordable Care Act and why I feel so 
passionately about it, how having insurance when I was a young man 
saved my life, how not having insurance costs lives.
  The mathematics is pretty clear. There have been a number of studies: 
For every million people who don't have insurance, there are a thousand 
people who die prematurely. The Affordable Care Act now covers 
something in the neighborhood of 22 million people, so here is the 
arithmetic: 22,000 premature deaths a year. This isn't ideology. These 
are people. To ignore that and say we want free markets and free 
choice--free choice means death for a lot of people. It meant death for 
a young man who had what I had 40 years ago and didn't have insurance, 
didn't get a checkup, didn't have surgery, and he is gone and I am 
here, and that is not fair. That is not fair.
  I have said since I got here that the Affordable Care Act isn't 
perfect. It can be changed; it can be fixed. I hear every now and then 
that my colleagues are saying: Let's repair it. I am all for it. Let's 
repair it. Let's get over this talk about repeal. But Dr. Price has 
been one of the leading voices, if not the leading voice, in the 
Congress to repeal the Affordable Care Act. I don't know his exact 
voting record, but I suspect he voted for every one of those repeals in 
the House 60, 70 times over the last couple of years: Repeal, repeal. 
Well, you are repealing people's health care.
  He doesn't want to have the patient protections in the Affordable 
Care Act, the ones that keep it so that you can't discriminate against 
women in health insurance because they are women. And there have to be 
preventive services. Preexisting conditions--he says: They have to 
insure; they have to keep you on for the preexisting condition. But if 
you lose your health insurance for a few months, sorry. The clock 
stops, and you can't get it again because of a preexisting condition. 
That is one of the most important and fundamental promises of the 
Affordable Care Act, yet he wants to get rid of it.
  Here is the reality in Maine. We are a rural State. We have a lot of 
rural hospitals. I urge every Member of this body to talk to their 
hospitals. I have done it. I have gone to the hospitals and sat down 
with them. I did it as recently as 2 weeks ago with a small rural 
hospital, the Penobscot Valley Hospital in Lincoln, ME. They told me 
the repeal of the Affordable Care Act would cost them $1 million a 
year, and they can't afford it. I have been to the Bridgton Hospital. I 
have talked to people from--not all, but many of our small hospitals, 
and 50 to 60 percent of our rural hospitals are running in the red 
right now. The Affordable Care Act has provided insurance coverage to 
people who are the customers of those hospitals, and the estimates are 
that repeal of the Affordable Care Act without a reasonable replacement 
would reduce their revenues anywhere from 5 to 8 to 10 percent. These 
hospitals can't stand that kind of cut, and they have told me there are 
only two choices: One is to shrink their services to their communities, 
and the other is to close their doors.
  In Maine, in our rural State, we have only 16 counties. In 8 of our 
16 counties, the hospital is the largest employer in that county. I am 
sure that is true in all of the States in our country that have these 
small rural hospitals; the hospital is the major employer. So again, 
when we are talking about cutting the Affordable Care Act and all these 
policy things and ideological things, what we are doing is cutting jobs 
in small towns that can't afford to lose them, and they are good jobs. 
If that is what you want to do, fine. But fess up and understand that 
is the consequence of policies that are espoused enthusiastically by 
this nominee for the Department of Health and Human Services. It 
doesn't make sense to be putting someone in charge of an agency that is 
supposed to be looking out for the welfare and the health of our 
citizens who is diametrically opposed to maintaining the health and 
welfare of our citizens.

[[Page 2351]]

  In Maine, we have 75,000 people on the Affordable Care Act. I know 
people who have it who couldn't have coverage otherwise without those 
subsidies. But he is not going to allow those subsidies anymore. It is 
every man for himself. Every man for himself means a lot of people fall 
by the wayside, and that is wrong. That is wrong in Maine, and I can't 
vote for somebody who is going to put a dagger in the heart of these 
citizens of Maine. I cannot do it. My conscience will not let me.
  So on Medicare, shift and shaft to the seniors. On Medicaid, shift 
and shaft to the States. On the Affordable Care Act, shift and shaft to 
those people who need health insurance and the hospitals in our 
communities, the hospitals in those communities. If you take paying 
customers away, it is a double whammy: You lose the revenues from the 
customers, and then you have to treat them as charity care. It makes 
the bottom line in these hospitals even worse. As I said, they have 
told me in my State--and I suspect this is true practically 
everywhere--50 to 60 percent of our hospitals are skating on the edge. 
They are in negative territory. They are in the red, and we are going 
to cut their revenues by 8, 10 percent? It is unconscionable. It is 
truly unconscionable. That is a word used around here sometimes, but 
this is it.
  All in the name of some kind of ideology, we want to go back to the 
health care--I can't believe we are debating Medicare, a program that 
has been so successful and so important to seniors throughout the last 
three to four generations. We are now debating it? It doesn't make any 
sense. To put somebody in charge of the Department of Health and Human 
Services that is inimical to Medicare, Medicaid, and the Affordable 
Care Act--this guy is a wrecking ball. He is not a Secretary. He is 
going into this agency to destroy it. He wants to undercut and diminish 
and, in some cases, literally destroy some of the major underpinnings 
of providing health care to people in this country.
  If we were sitting in this body and somebody walked by me and was 
stricken by a heart attack and fell on the floor, I would help him. 
Every one of us would help him. I suspect Dr. Price would help him. He 
would be the first one there. But by these changes, what we are doing 
is having people fall by our side and ignoring them in large scale 
across the country. It is just as real as if it is happening right 
before our eyes. Twenty-two thousand people will die if health 
insurance is lost prematurely. Seniors will take on a burden of anxiety 
and fiscal drain that they can't afford that they have avoided for 50 
years.
  The final point is that this man's policies are at odds with those of 
his boss. Through the campaign, President Trump issued pretty much 
ironclad guarantees to seniors that he was going to maintain Medicare, 
maintain Social Security, but then he appoints a guy whose whole 
professional career has been aimed at undermining Medicare. I think 
they had better get on the same page. I don't always agree with 
President Trump, but in this case I think he is right. I wish he would 
whisper into the ear of his nominee: You can't have it both ways. You 
are either for it or you want to gut it. That is what we are facing in 
this vote.
  This is a vote of conscience for me. It is also a vote about my 
State. I love those people. I know them. I started out as a legal 
services attorney in a small town in Maine. My first boy was born in 
that town, in a little, rural hospital that is struggling. I can't 
stand by and see someone take over this Department who is going to do 
harm. That is the medical creed, isn't it? Do no harm; that is the 
oath. But we are talking about harm to seniors, to children, to people 
with insurance who will not have it. We are talking about real harm.
  That is why I come to the floor tonight to urge my colleagues to 
reject this nominee. If the President wants to put somebody forward who 
is conservative and has ways of fixing some of these things and thinks 
some improvements should be made--and we don't have to do everything 
the way we have always done it. I'm not arguing that. But goodness, 
gracious, don't give us a nominee whose whole career has been spent 
aimed at undermining and diminishing and gutting the very programs that 
have meant so much to the people of America.
  I am voting no on this nominee. I believe my colleagues should do so 
as well.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. Mr. President, before Senator King leaves the floor, let 
me just say, as one who ran the legal services for the elderly program 
in Oregon, that the Senator makes all of us in legal services proud 
tonight. Senator King has really put a face on what is at stake here in 
the way he has focused on the opioid scourge that is hammering areas 
from coast to coast. Rural health care--without rural health care, we 
can't have rural life. It is just that simple. Certainly when we get to 
the closing here in perhaps an hour and a half or so, we are going to 
get to the bottom line, as the Senator did. I think these changes take 
America back to the day where health care was for the healthy and 
wealthy.
  So I thank the Senator for his passion and his commitment to his 
citizens, but also to the people of this country. Anybody in legal 
services tonight will be very proud, as I am, because what it is all 
about is standing up for people, and the Senator has said it very well.
  Mr. President, we will be having our closing remarks here in perhaps 
an hour and a half or thereabouts. We have several Members of the 
Senate who are on their way for their remarks, and several Members of 
the Senate have discussed various elements of the serious and 
unanswered ethics questions surrounding Congressman Price's nomination. 
It is my view that these are issues that have set off loud ethical 
alarm bells.
  I want to take a little bit more time to lay out the full story here.
  The stock trades Congressman Price made while working on health care 
policy do, in fact, raise serious ethical and legal questions. None of 
Congressman Price's stock trades raise more questions than the hundreds 
of thousands of shares he bought in the obscure Australian biotech 
company known as Innate. His stock in this company is by far his 
largest of holdings, both in terms of the hundreds of thousands of 
shares he owns and the value of those shares, and that exceeds a 
quarter of a million dollars.
  Congressman Price told the Finance Committee that he did not get a 
special deal. He told the Health, Education, Labor Committee that he 
did not get a special deal. But the fact is, Congressman Price paid 
bargain-basement prices for Innate stock in a private sale last August. 
The private stock sale was limited to a small group of well-connected 
American investors.
  Congressman Price's participation has been described as a 
``sweetheart deal'' by Kaiser Health News and a ``privileged, 
discounted offer'' by the Wall Street Journal.
  As I said during his nomination hearing, Congressman Price's 
participation in the private stock sale showed bad judgment at best. At 
worst, it raised serious questions about whether he violated the STOCK 
Act or other security laws. I will take a minute to read section 3 of 
the STOCK Act. It says: ``Members of Congress . . . may not use 
nonpublic information derived from such person's position . . . or 
gained from the performance of such person's official responsibilities 
as a means for making a private profit.''
  It is well known that Congressman Price learned about Innate from a 
House colleague, Congressman Chris Collins of New York. Collins is not 
just a casual reader of the Australian business pages; he is actually a 
member of the company's board and its largest shareholder.
  This raises additional questions: Did Congressman Price have access 
to nonpublic information about Innate or its private stock because of 
his position as a Member of Congress? Did he get special access to the 
discounted private sale because of his position? Does he stand to 
profit because of the information or access he may have received?

[[Page 2352]]

Finally, did Congressman Price tell the Finance Committee the truth 
about how he learned about the private stock sales and the ability of 
typical investors to participate?
  Congressman Price would have us believe that he decided to make these 
investments based on his own research into the company. That is what he 
told the Finance Committee.
  Let me quote from the Wall Street Journal's article published January 
30:

       Mr. Price wasn't in line to buy shares in the last private 
     placement because he hadn't previously participated in 
     private fundraising rounds. . . . Mr. Price first invested in 
     the company a year ago, buying shares through the open market 
     on the Australian exchange. He learned about the company from 
     Mr. Collins, who holds a 17 percent stake in it. Mr. Collins 
     said Mr. Price is ``one of my friends'' and that he sits 
     ``next to him'' on the House floor. . . . Mr. Price got it on 
     the discounted sale after Mr. Collins filled him in on the 
     company's drug trial, according to Mr. Collins.

  The fact is, you don't just get in on a private stock offering by 
accident. As the Wall Street Journal explained, Congressman Price 
didn't originally even meet the criteria for participating in the 2016 
private offering because he hadn't participated in any previous 
offerings. Yet he was able to buy over 400,000 shares of stock with 
Congressman Collins' help.
  My view and the view of my Democratic colleagues is that Congressman 
Price failed to come clean with the Senate Finance Committee on the 
details of the special discounted deal. He has assured the committee he 
followed the law, but straightforward questions have been met with 
dodging, weaving, and obfuscation. Details of his purchase continue to 
emerge, and the public's understanding of his involvement continues to 
evolve.
  Meanwhile, as scrutiny of the deal continues to mount, Innate's top 
executives are defending Congressman Price at the behest of his 
colleague Congressman Collins, who sits on the company's board of 
directors.
  After the Wall Street Journal story was published, the company and 
Congressman Price went into spin control. The public knows this only 
because Congressman Collins made a mistake that everybody who uses 
email for work has seen made at least once: He mistakenly hit ``reply 
all'' when responding to an email from the company's CEO, Simon 
Wilkinson. Instead of a private note to Mr. Wilkinson, the note wound 
up going to a CNN reporter covering the story.
  In the email, Congressman Collins, the company's top shareholder, 
said the Wall Street Journal was ``yellow journalism,'' and he thanked 
Innate's chief executive, Mr. Wilkinson, for defending Congressman 
Price and the company. According to CNN, Congressman Collins 
acknowledged the email to be authentic.
  The Finance Committee's own experience with Innate only adds to the 
sense that there is a coverup as Republicans seek to race Congressman 
Price across the confirmation finish line.
  The day after the Wall Street Journal story ran, I wrote my own 
letter to Innate's CEO, Mr. Wilkinson. I asked the company to respond 
to the article and the inconsistencies in Mr. Price's explanations and 
for documentation of details of the private stock sales. The company 
refused to answer my letter.
  This looks to me like a coverup, and it ought to shake this body's 
confidence in Congressman Price's nomination. This situation, in my 
view, demands that further questions be asked and answered. Instead of 
taking time to explore these issues, Republicans took the unprecedented 
step of suspending the Finance Committee's rules to rush this 
nomination to the floor before any more questions could be asked, let 
alone answered.
  In years past, as with the nominations of Senator Daschle, Secretary 
Geithner, and Ambassador Kirk, the Finance Committee left no stone 
unturned in the vetting process. Not this time. The majority party, in 
my view, is on its way to an ethical double standard to cut off the 
vetting process. That leaves me with a question for Congressman Price 
and my Republican colleagues in the Senate: What is there to hide?
  Mr. President, before I continue, I ask unanimous consent to have 
printed in the Record the letter that I sent to Simon Wilkinson, chief 
executive of Innate, on January 31, 2017.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                             United States Senate,


                                         Committee on Finance,

                                 Washington, DC, January 31, 2017.
     Mr. Simon Wilkinson,
     Chief Executive Officer,
     Innate Immunotherapeutics Limited,
     Sydney, Australia.
       Dear Mr. Wilkinson: As part of the U.S. Senate's 
     constitutional duty to confirm presidential appointments, I 
     have been reviewing the record of U.S. Representative Thomas 
     Edmunds Price, who has been nominated to be the Secretary of 
     the U.S. Department of Health and Human Services.
       To that end, I am writing to you seeking prompt assistance 
     in providing information and documents related to Congressman 
     Price's investment in Innate. Please provide the requested 
     information and documents:
       1. The New York Times reported that ``Mr. Wilkinson and 
     Michael Quinn, Innate's chairman, said they had never heard 
     of many of the company's more prominent investors, and said 
     they first learned that Mr. Price had invested in the company 
     from an article in The Wall Street Journal [published online 
     December 22, 2016], which first reported his investment.''
       In written response to questions from the Committee, 
     Congressman Price said ``I communicated with Representative 
     Collins, who is a director of Innate. As noted above, I 
     learned about Innate through a general conversation with him 
     in the fall of 2014. I also communicated with Simon Wilkinson 
     of Innate regarding my interest in participating in the 2016 
     private placement of company stock.'' In addition, the Wall 
     Street Journal reported that ``Mr. Collins said he told Mr. 
     Price of the additional private placement. He said Mr. Price 
     asked if he could participate in it. `Could you have someone 
     send me the documents?' Mr. Collins recalled Mr. Price asking 
     him.''
       a. Please identify any meeting or communication between 
     you, the company, its officers, employees, directors, 
     consultants or affiliated personnel, and Congressman Price. 
     In so doing, please include the person or persons involved in 
     such communication or meeting, the date, method, location of 
     the communication, and the subject of the communication.
       b. Please provide any e-mail or other written 
     communications between you, the company, its officers, 
     employees, directors, consultants or other affiliated 
     personnel, and Congressman Price. In addition, please provide 
     any documents transmitted by Innate to Congressman Price, and 
     any document Congressman Price transmitted to the company.
       2. Regarding the August 2016 private stock placements 
     reference in the company's Notice of Annual General Meeting 
     and Explanatory (``Notice'') on July 25, 2016:
       a. Please describe how Innate found and solicited potential 
     buyers for the private stock sale in August 2016. In so 
     doing, please provide all dates that solicitations or other 
     communications regarding the stock sale was sent to 
     investors. Please also note any differences between how U.S. 
     and non-U.S. investors were solicited. Please provide the 
     number of U.S. investors at the time of the solicitation, the 
     number of U.S. investors who were solicited, the number who 
     agreed to participate, and the number who were considered 
     accredited, ``friends and family,'' or met some other 
     classification or category. Please provide any and all 
     solicitation materials, offering documents, or other 
     information related to the sale that were sent to 
     participants in the placement.
       b. Please describe the criteria by which the company 
     determined who could participate in the sale both within the 
     U.S. and outside the U.S. Please provide supporting 
     documentation regarding the company's criteria for 
     participants in the sale, if the not contained in the 
     offering documents described in Question 2(a).
       c. It has been reported that these private offerings were 
     made available--in the U.S.--only to shareholders who had 
     previously participated in private stock placements. Is it 
     correct that shareholders had to have previously participated 
     in Innate's private stock placements?
       i. Please provide any documents that describe eligibility 
     for the August 2016 private placements, if not already 
     provided in response to Questions 2(a) or 2(b).
       ii. Did Congressman Price participate in any private stock 
     placements prior to the August 2016 private placement?
       d. Based on interviews with you and Congressman Collins, 
     the Wall Street Journal reported that Congressman Price 
     qualified for the August 2016 private placements in the U.S. 
     as one of six ``friends and family'' solicited for the sale.
       i. Was Congressman Price one the ``friends and family'' 
     participants described by the Wall Street Journal?
       ii. What were the requirements for ``friends and family'' 
     participation?
       iii. Please provide any and all offering documents that 
     were provided to this class of

[[Page 2353]]

     participants for the August 2016 sale. Please provide any and 
     all documents that show the company's eligibility criteria 
     for determining this class of participant in the August 2016 
     sale. Please provide any and all documents that describe 
     eligibility for this class of participant in the August 2016 
     private placements.
       e. Did the names of individual participants or criteria for 
     participation in the August 2016 sale come before Innate's 
     officers or its board of directors for consideration, 
     including Congressman Price? If so, please describe what 
     actions or consideration officers or directors took. Please 
     provide any supporting documentation of the selection 
     decisions.
       f. Did the company use an investment banker or other agent 
     for the August 2016 private placements? If so, please provide 
     the name of the bank or agent and its employees who were 
     involved in the sale.
       g. What role did Congressman Collins--a director and 
     Innate's largest stockholder--play in the U.S. 2016 private 
     placements?
       Please provide the requested information and documents via 
     email on a rolling basis as they become available. Please 
     contact my staff at +1 (202) 224-4515. Thank you to your 
     prompt attention to this matter and your timely response.
           Sincerely,
                                                        Ron Wyden,
                                                   Ranking Member.

  Mr. WYDEN. I would also refer my colleagues to the following news 
articles: ``Trump's HHS Nominee Got A Sweetheart Deal from A Foreign 
Biotech Firm,'' a story published by Kaiser Health News on January 13, 
2017; ``Representative Tom Price Got Privileged, Discounted Offer on 
Biomedical Stock, Company Says,'' a story published by the Wall Street 
Journal on January 30, 2017; and ``In accidental `reply all' to 
reporter, Collins thanks CEO for defending HHS nominee,'' a story 
published by CNN on January 31, 2017.
  Mr. President, I wish to now discuss what is known about the facts 
and timing of Congressman Price's investment in Innate. This is a 
timeline that is based on public documents, press reports, and 
information the nominee provided the Finance Committee.
  If you have never heard of Innate until the last few weeks, you would 
be forgiven. The New York Times described it as a ``tiny pharmaceutical 
company from Australia that has no approved drugs and no backing from 
flashy venture capital firms.'' Innate has fewer than a dozen full-time 
employees. The company's stock was first listed on the Australian Stock 
Exchange in 2013, and until recently its market capitalization was well 
below $100 million. Innate has never generated revenue from drug sales. 
It has repeatedly teetered on the brink of running out of cash. It has 
just 2,500 shareholders. By way of comparison, a major American 
pharmaceutical company could have hundreds of thousands of 
shareholders.
  Innate is planning to submit an investigational drug application to 
the Food and Drug Administration, and its ultimate goal is to one day 
sell itself to a large pharmaceutical manufacturer, which would take 
its early-stage experimental therapy to market.
  What I am describing is, this company is the poster child for obscure 
companies. It is so small and so obscure, it doesn't even have a 
Wikipedia page. So the question is, How did Congressman Price come to 
learn about this company, and how did he decide to make it the single 
largest investment in his sprawling portfolio of health care stocks? 
The answer is, the Congressman learned about Innate in 2014 during a 
conversation with his colleague, Congressman Collins of New York. As I 
indicated, Congressman Collins sits on Innate's board of directors. 
Congressman Collins is also the company's largest shareholder, holding 
38 million shares. Congressman Collins' adult children, his chief of 
staff, and many of his political backers are also heavily invested in 
the company. I am going to touch on those issues in a few minutes.
  According to disclosures with the House Ethics Committee, Congressman 
Price bought some 61,000 shares of Innate stock in 3 separate purchases 
during January of 2015. At the time, the stock was trading at roughly 
10 cents a share. Congressman Price testified to the Health, Education, 
Labor, and Pensions Committee that he directed his broker to make the 
January 2015 purchases.
  Fast-forward to August 2016. Congressman Price bought another 400,000 
shares of Innate as part of a private stock sale for U.S. investors. 
When the private sale took place, Innate's shares were trading on the 
Australian Stock Exchange for the equivalent of 31 American cents. 
Participants in the private sale got the shares at a deep discount.
  In written testimony to the Finance Committee, Congressman Price said 
he paid 84,000 American dollars to buy the 400,000 shares. He bought 
250,000 of those shares for 18 American cents per share in one private 
stock placement. He bought another 150,000 shares for 26 American cents 
each in a second private stock placement. Congressman Price's House 
Ethics Committee disclosures showed that he acquired the stock on 
August 31. On that day, Innate's stock was trading for the U.S. 
equivalent of 31 cents a share on the Australian Stock Exchange. In my 
book, that is a special deal.
  The bottom line is that Congressman Price bought these shares for 
$40,000 less than an average investor would have paid to buy the same 
amount of stock off the open market. That is nearly 33 percent off the 
price on the Australian Stock Exchange at the time. Since that time, 
Innate's stock has more than doubled. These facts are not in dispute.
  Mr. President, I ask unanimous consent to have printed in the Record 
Congressman Price's written testimony in response to my questions for 
the record as part of his nomination hearings.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                        Questions for the Record


``the honorable thomas e. price nomination hearing for hhs secretary'' 
                     hearing date: january 24, 2017

         questions for the record from ranking member ron wyden

                  Innate Immunotherapeutics purchases

       5. The nominee owns 461,238 shares of Innate 
     Immunotherapeutics Ltd. (``Innate''), a small Australian 
     biopharmaceutical firm developing a multiple sclerosis 
     therapy. The nominee acquired the stock in four separate 
     purchases on January 8, 9 and 23 of 2015 (``2015 tranche''), 
     and in a pair of private stock placements on August 31, 2016 
     (``2016 tranche''). Regarding Innate:
       a. Question: Please describe how and when the nominee first 
     learned about Innate.
       Answer: I previously answered this question for the SFC. I 
     learned about Innate during the course of a conversation in 
     the fall of 2014 with Representative Chris Collins regarding 
     their respective personal backgrounds. I cannot recall the 
     specific date of that conversation. During that exchange, 
     Representative Collins told me that he sat on a number of 
     public company boards including Innate, which was developing 
     a treatment for multiple sclerosis (MS),
       b. Question: Did the nominee or his staff ever meet or 
     otherwise communicate with current or former employees, 
     directors, consultants or other officials affiliated with 
     Innate. If so, please describe the communication, including 
     who it involved, the date, subject, place and form (e.g. in 
     person, by phone of communication.
       Answer: I previously answered this question for the SFC.
       I communicated with Representative Collins, who is a 
     director of Innate. As noted above, I learned about Innate 
     through a general conversation with him in the fall of 2014. 
     I also communicated with Simon Wilkinson of Innate regarding 
     my interest in participating in the 2016 private placement of 
     company stock. According to Innate's website, Mr. Wilkinson 
     is currently the Managing Director and CEO of Innate.
       My Congressional staff has not met or otherwise 
     communicated with current or former employees, directors, 
     consultants or other officials affiliated with Innate.
       c. Question: Please describe any communication between the 
     nominee and Congressman Collins regarding Innate 
     Immunotherapy, including the date, subject, place and form.
       Answer: I previously answered this question for the SFC.
       I had a conversation with Representative Collins in the 
     fall of 2014 that brought Innate, as a company, to my 
     attention. The nature of that conversation did not, however, 
     influence my decision to invest in the company in either 2015 
     or 2016.
       I believe I had subsequent general communications with 
     Representative Collins regarding Innate. I do not have a 
     specific recollection of when those conversations occurred or 
     their substance. Any such communications did not impact my 
     investment decisions, however, because my purchases of Innate 
     stock were based solely on my own research.

[[Page 2354]]

       d. Question: The nominee bought 400,316 shares in the 2016 
     tranche in a private stock sale that included two placements 
     at two prices. Please provide the number of shares bought in 
     each placement, and the price at which the shares were 
     bought.
       Answer: I previously answered this question for the SFC. I 
     purchased 250,000 shares of Innate in Private Placement 1 at 
     US$0.18/share--the same price offered all participants in 
     this private placement. I purchased 150,613 shares of Innate 
     in Private Placement 2 at US$0.26/share--the same price 
     offered all participants in this private placement.

  Mr. WYDEN. I also refer my colleagues to the following news articles 
and documents: ``Australian Drug Maker has Low Profile but Powerful 
Backers in Washington,'' printed in the New York Times on January 13 of 
this year; ``Aussie shareholding puts heat on President's Ally,'' 
published in the Australian on February 6 of this year; the 2016 Annual 
Report to Shareholders of Innate; a periodic transaction report that 
Congressman Price filed with the House Ethics Committee on September 
12, 2016; a list of the 20 largest investors in Innate dated January 
17, 2017; and a stock price history of Innate.
  I wish to turn to the issue of misleading testimony. What remains 
unresolved are major inconsistencies between Congressman Price's 
testimony to the Finance Committee, statements by Congressman Collins, 
and statements by Innate's CEO Simon Wilkinson published last week in 
the Wall Street Journal.
  Simply put, Innate's chief executive and Congressman Collins, the 
company's top shareholder, provided one version of events to one of the 
world's most respected newspapers. Congressman Price provided a 
different version of events to the Finance Committee and the Health 
committee. These inconsistencies are among the reasons that Democrats 
boycotted last week's Finance Committee markup. The Senate has an 
obligation to know the truth about these transactions in order to 
protect the integrity of this body and its constitutional duty to 
consider executive branch nominees.
  Now, with respect to exclusivity of the sale, Congressman Price told 
the Finance Committee that the August sale was available to all Innate 
shareholders, which contradicts what Innate's management told the Wall 
Street Journal. Congressman Price was definitive in his response to my 
question during the hearing.
  Reading back the transcript, I said: ``Well, you purchased stock in 
an Australian company through private offerings at discounts not 
available to the public.''
  Here is Congressman Price's response: ``Well, if I may, those--they 
were available to every single individual that was an investor at the 
time.''
  That is not what Innate executives told the Wall Street Journal. Here 
is an extended passage from the Wall Street Journal:

       Rep. Tom Price got a privileged offer to buy a biomedical 
     stock at a discount, the company's officials said, contrary 
     to his congressional testimony this month. . . .
       The cabinet nominee is one of fewer than 20 U.S. investors 
     who were invited last year to buy discounted shares of the 
     company--an opportunity that, for Mr. Price, arose from an 
     invitation from a company director and fellow Congressman. . 
     . .
       At Mr. Collins' invitation, Mr. Price in June ordered 
     shares discounted in the private placement at 18 cents 
     apiece, and then more in July at 26 cents a share, Mr. 
     Collins said in an interview. Those orders went through in 
     August, after board approval. Mr. Price invested between 
     $50,000 and $100,000 according to his disclosure form. . . .
       Mr. Wilkinson said investors who had bought in a previous 
     private placement were called to ``make friends and family 
     aware of the opportunity. . . . We are always looking to 
     increase our shareholder base. But those new parties have to 
     meet the definition of sophisticated financial investor.'' 
     Only six U.S. investors, including Mr. Price, fell into the 
     friends-and-family category, Mr. Collins said. About 10 more 
     U.S. investors were offered discounted shares by the company 
     because they previously had been invited to partake in 
     private placement offerings.

  In other words, Congressman Price not only got a deal that wasn't 
publicly available, he was in a special group of six investors in a 
special category called ``friends-and-family,'' whereas other American 
investors got in on the private deal because they previously 
participated in the company's private placements. Congressman Price 
bypassed that requirement. He got in as what could only be called a 
special guest--a ``friends-and-family'' guest of his House colleague, 
Congressman Collins.
  As I mentioned earlier, when I asked the company how Congressman 
Price was able to get this special status, the company refused to 
provide an explanation. The Wall Street Journal also reported a key 
distinction between U.S. investors and the company's shareholders in 
Australia and New Zealand. The paper reported:

       The discounted stock offered in Innate Immuno, as the 
     company is known, was made to all shareholders in Australia 
     and New Zealand--but not in the United States, according to 
     Mr. Collins and confirmed in a separate interview with Innate 
     Immuno CEO Simon Wilkinson.

  The Wall Street Journal's account is supported by company documents, 
specifically a ``Rights Issue Booklet'' that Innate published on June 
10, 2016. The booklet noted that the shareholders would buy one new 
share for every nine shares they already own. The booklet noted that 
the shareholders would have ``the option to pay for their new shares in 
either Australian dollars or New Zealand dollars.'' The booklet goes on 
to describe the private stock sale in which Congressman Price 
participated. I will read briefly from the book:

       In conjunction with this rights issue, Innate announced 
     that it also completed a private placement at an issue price 
     of U.S. 18 cents, raising U.S. $1.8 million.

  The booklet states clearly that the private placement was announced 
on the June 10, 2016, the same day Innate announced the rights issue 
for investors in Australia and in New Zealand.
  Our staff has reviewed all of the company's publicly available 
documents and found no similar advertisements for the private placement 
to American investors. So this paper trail pokes more holes in 
Congressman Price's argument that the private stock sale was open to 
all the company investors.
  First off, the company didn't announce the existence of the private 
sale until after it already had been completed. So unless an investor 
was on the company's short list of go-to people, they were just 
excluded.
  Second, the company's documents clearly show that Congressman Price 
and other participants in the private stock sale were able to buy far 
more discounted shares than the company's typical investors. Innate 
documents showed that the company restricted the number of shares the 
typical investor could buy in the rights issue to just one new share 
for every nine they already owned. No such limit appears to have been 
imposed on Congressman Price and the other American participants in the 
private stock sale. In fact, Congressman Price owned just over 60,000 
shares at the time of the sale. His participation in the private stock 
sales allowed Congressman Price to buy 400,000 more shares. If 
Congressman Price had been held to the same rules as everyday 
investors, he would have been restricted to buying less than 7,000 
shares.
  The bottom line to me is what Congressman Price said was untrue. The 
deal Congressman Price got was not open to every other shareholder. And 
again, when I sent a letter last week to the Innate CEO, asking him to 
explain all of this, he declined. He told my staff that as an 
Australian firm, the company had no obligation to cooperate.
  So to recap, Congressman Price told the Finance Committee and the 
Health Committee that the stock sales he participated in were open to 
all shareholders. That is not true. The private sale does not appear to 
have been widely marketed to American investors and was certainly not 
advertised in the company's public documents. The private sale 
reportedly included less than 20 American investors. Congressman Price 
was part of an even smaller subgroup known as friends and family, 
invited by other investors--in this case, by his House colleague, 
Congressman Collins. How many people were eligible to be in the friends 
and family group? Just six.
  That brings me to the next issue, which is, How did Congressman Price 
learn about the special sale in the first place? Congressman Price told 
the Finance Committee his conversations

[[Page 2355]]

with Congressman Collins had no influence on his investment decisions.
  I am going to again quote from his written response to questions for 
the record asking Congressman Price to describe the communications with 
Congressman Collins regarding Innate. Congressman Price said:

       I had a conversation with Representative Collins in the 
     fall of 2014 that brought Innate as a company to my 
     attention. The nature of the conversation did not, however, 
     influence my decision to invest in the company in either 2015 
     or 2016. I believe I had subsequent general communications 
     with Representative Collins regarding Innate. I do not have a 
     specific recollection of when those conversations occurred or 
     their substance. Any such communications did not impact my 
     investment decisions, however, because my purchases of Innate 
     were based solely on my own research.

  I am going to quote again from the Wall Street Journal:

       Mr. Price got in on the discounted sale after Mr. Collins 
     filled him in on the company's drug trial, according to Mr. 
     Collins. Mr. Collins said he told Mr. Price of the additional 
     private placement. He said Mr. Price asked if he could 
     participate in it. ``Could you have someone send me the 
     documents,'' Mr. Collins recalled Mr. Price asking him. 
     Congressman Price wants us to believe that Congressman 
     Collins had no influence on the decision to buy Innate stock. 
     But Congressman Price would not have known about the company 
     in the first place if he hadn't talked to Congressman 
     Collins, and he wouldn't have known about the private 
     placements without hearing about them from Congressman 
     Collins.

  Congressman Price characterizes his conversation with Congressman 
Collins in 2015 and 2016 as being general in nature. But again, 
according to the Wall Street Journal, Congressman Collins, one, told 
Congressman Price about the upcoming drug trial; two, alerted him to 
the private stock sale; and three, arranged to ensure that he could 
participate. To me, this seems like more than ``subsequent general 
communications with Congressman Collins regarding Innate'' as 
Congressman Price put it in his written response to the committee.
  With respect to reporting to the committee and the Office of 
Government Ethics, I would just say that I think I described issues--
ethical issues--that are serious enough on their own. However, it took 
no small amount of effort to unravel Congressman Price's holdings in 
the company because he failed to fully disclose them to Federal ethics 
officials, the American people, and the Finance Committee. I don't 
believe this issue would have ever come to light if it were not for the 
work of the committee's minority investigations team.
  On February 7, 2 days ago, Congressman Price sent a letter to the 
independent Federal ethics officials at the Office of Government Ethics 
that amended his original public ethics disclosure. This letter 
confirmed the suspicions of Finance Committee Democrats that 
Congressman Price's original ethics disclosure to the public 
understated the value of his Innate stock holding by roughly a quarter 
of a million dollars. Put another way, his stake in Innate was more 
than five times the figure initially reported to the American people.
  Congressman Price's original disclosure reported that he owned less 
than $50,000 in Innate stock. At the time the disclosure was filed, by 
my calculation, his shares had a value of more than $250,000. Today his 
stake is valued at more than $300,000. Quite simply, it appears the 
shares he bought in the private stock sale in 2016 were excluded 
entirely from the Congressman's financial disclosure to the Office of 
Government Ethics. And because it is the Office of Government Ethics 
disclosure that is posted on a public Web site so the public can see 
the investment ties and investments the President's nominees hold, the 
American people, too, were kept in the dark about how much stock 
Congressman Price held in this company.
  In addition, the Congressman was also less than forthcoming in his 
disclosure of the value of Innate holdings to the Finance Committee. In 
his response to the committee questionnaire, Congressman Price valued 
Innate stock he bought in the private sale between $50,000 to $100,000. 
However, that amount was based on the $84,000 discounted price the 
Congressman paid to buy his stocks in the August private stock sale. It 
was not based on the actual value of the stock on the Australian stock 
exchange--the true value of his holdings.
  By December, when he made his disclosure to the Finance Committee, 
the stock price had nearly tripled and the shares he bought in those 
private sales were worth nearly $230,000. In other words, he told the 
committee that his private purchases were less than half the value they 
really were.
  Mr. President, I ask unanimous consent that the following items be 
printed in the Record: a memo from Finance Committee Staff to the 
Finance Committee, dated January 23 of this year, and a letter from 
Congressman Price to the Office of Government Ethics dated February 7, 
2017, amending his public ethics disclosure.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                Memorandum for Finance Committee Members

     From: Senate Finance Committee Staff
     Date: January 23, 2017
     Re: Nomination of Dr. Thomas E. Price

       This memo describes the Senate Finance Committee staff 
     review of the 2013, 2014, and 2015 tax returns, and other 
     documentation of Dr. Thomas E. Price in connection with his 
     nomination to be the Secretary of the Department of Health 
     and Human Services (HHS).


                               Background

       Finance Committee staff conducted a review of Dr. Price's 
     Senate Finance Committee (Committee) Questionnaire, tax 
     returns for 2013, 2014, and 2015, and financial disclosure 
     statements. As part of this review, a due diligence meeting 
     was held with the nominee and his legal representation on 
     January 16, 2017. His accountant participated via telephone. 
     In addition to the due diligence meeting, staff submitted 
     multiple rounds of written questions to the nominee.
       At the conclusion of this process, three issues have been 
     identified that have been deemed appropriate to bring to the 
     attention of Committee Members.


 Senate Finance Committee Questionnaire--Ethics Investigation and Late 
                     Property Tax Payments Omitted

       All nominees referred to the Committee are required to 
     submit the Senate Finance Committee Statement of Information 
     Requested of Nominee (``Questionnaire'').
       Part D. Legal and Other Matters, Question 1, asks nominees: 
     ``Have you ever been the subject of a complaint or been 
     investigated, disciplined, or otherwise cited for a breach of 
     ethics for unprofessional conduct before any court, 
     administrative agency, professional association, disciplinary 
     committee, or other professional group?''
       In his response, submitted December 21, 2017, Dr. Price 
     responded, ``No.'' However, in 2010, the Office of 
     Congressional Ethics (OCE), an independent office of the 
     House of Representatives, conducted an investigation into Dr. 
     Price's 2009 fundraising activities. OCE voted 4-0-1 to refer 
     the case to the House Ethics Committee, which, after 
     conducting a second investigation, ultimately found no 
     wrongdoing in 2011.
       In written questions submitted to Dr. Price on January 6, 
     2017, Committee staff requested an explanation for the 
     omission of the ethics investigation. Dr. Price stated it was 
     an inadvertent omission and that the majority of activities 
     investigated related to his authorized campaign committee, 
     rather than him personally. The information pertaining to 
     this investigation has been and continues to be available on 
     the webpage of the House Ethics Committee.
       Part F. Financial Data, Question 10, asks nominees: ``Have 
     you paid all Federal, State, local, and other taxes when due 
     for each of the past 10 years?'' Dr. Price responded, 
     ``Yes.'' However, upon examining Washington, D.C. and 
     Nashville, Tennessee real estate tax records, Committee staff 
     determined late tax payments had been made in relation to 
     rental properties owned by Dr. Price, totaling $1,583.45 for 
     late payments made over the past seven years.
       In written questions submitted to Dr. Price on January 6, 
     2017, Committee staff requested an explanation for the 
     omission of the late tax payments. Dr. Price stated that, 
     regarding the DC property, he believed that ``late fees and 
     penalties derived from not receiving timely property tax 
     notices.'' Regarding the Tennessee property, the nominee 
     noted that ``notices regarding property taxes for this rental 
     property . . . were either not being received or being 
     wrongly mailed to the tenant at the property and not reaching 
     the nominee and his spouse.''


   Depreciation of Land Value and Miscellaneous Employment Deductions

       Committee staff received 2013, 2014, and 2015 tax returns 
     from Dr. Price on December 21, 2016. In addition to the 
     written questions submitted on December 28, 2016 and January 
     6, 2017, Committee staff spoke with Dr.

[[Page 2356]]

     Price's accountant on January 9, 2017. Following the due 
     diligence meeting with Dr. Price, Committee staff then 
     submitted an additional round of written questions to the 
     nominee on January 16, 2017.
     Improper Inclusion of Land Value in Depreciation Calculations
       Taxpayers who own rental property are generally allowed to 
     deduct depreciation expenses associated with the wear and 
     tear of those buildings. Taxpayers are not, however, allowed 
     to include the value of land in the depreciable amount.
       Dr. Price owns rental condominiums in Washington, D.C. and 
     Nashville, Tennessee, and claimed depreciation expenses 
     associated with those properties for years 2013, 2014, and 
     2015. It appears these values included depreciation for the 
     value of the land. According to property tax records, the 
     land value of Washington, D.C. condominium was listed as 
     $95,640, and the land value of his Nashville condominium was 
     listed as $30,000.
       Under current tax rules, these values are not allowable for 
     depreciation expenses. Committee staff asked for 
     clarification on this issue in the due diligence meeting with 
     Dr. Price and sent written follow-up questions on January 16, 
     2017.
       In his response to the Committee, received on January 23, 
     2017, Dr. Price's accountant stated he had taken the position 
     that the land had a fair market value of zero. However, given 
     the lack of another valuation besides the property tax 
     assessments, Dr. Price has committed to address the 
     discrepancy by filing a Form 3115 to adjust the depreciation 
     and account for the improper deductions on his 2016 tax 
     returns, though adjustments may be spread out over four 
     years.
     Absence of Documentation of Employment Deductions
       In 2013, 2014, and 2015, Dr. Price claimed miscellaneous 
     employment deductions, totaling $19,034. Dr. Price, and his 
     wife, also a medical doctor, both list their occupations as 
     ``PHYSICIAN'' on the second page of their Form 1040s. Neither 
     Dr. Price nor his wife actively works as a physician, though 
     Dr. Price has noted he has maintained his medical license. 
     Committee staff requested substantiation and further 
     explanation of the deductions in written questions submitted 
     December 28, 2016.
       Committee staff spoke with Dr. Price's accountant on this 
     matter on January 9, 2017, and again during the due diligence 
     meeting on January 16, 2017. In those discussions, Dr. 
     Price's accountant noted that Dr. Price and his wife, 
     Elizabeth, would compile a variety of expenses, including 
     vehicle expenses, and discuss with the accountant what 
     portion of those expenses would be appropriate to deduct as 
     employment expenses, frequently settling on an amount equal 
     to roughly 60 percent. Though the Prices no longer actively 
     work as physicians, their accountant believed that the 
     deductions were appropriate, and were reflective of expenses 
     incurred by Mrs. Price. After the January 16, 2017, due 
     diligence meeting, staff suggested that in the absence of 
     full documentation of the deductions, that the returns be 
     amended.
       In a response, received January 23, 2017, Dr. Price's 
     accountant noted that proper documentation could not be 
     located. Dr. Price's 2013, 2014, and 2015 tax returns will be 
     amended to remove the $19,034 of deductions. Since Dr. Price 
     was subject to the Alternative Minimum Tax (AMT) in each of 
     those years, the changes will not result in any change to tax 
     liability.


                              Asset Values

       In separate financial disclosure filings to the House of 
     Representatives, to the Committee, and to the public through 
     the Office of Government Ethics (OGE) Form 278, the nominee 
     reported ownership of stock in an Australian pharmaceutical 
     company--Innate Immunotherapeutics Ltd. The nominee purchased 
     these shares in two tranches: one in 2015 valued at $10,000 
     at the time of purchase, but was valued at between $15,000 
     and $50,000 on December 20, 2016, the date of filing. A 
     second tranche was purchased in August 2016 of 400,613 
     shares, through a private placement offering, and was listed 
     on the Committee questionnaire as being valued between 
     $50,000 to $100,000, which was based upon the purchase price. 
     An analysis done by multiplying the number of shares by the 
     market price on December 20, 2016 demonstrates a value higher 
     than that reported by the nominee. The nominee noted that the 
     amounts reported to the Committee were a good faith 
     valuation. The nominee agreed to recalculate the value of the 
     shares based on the market value at the time the Committee 
     Questionnaire was completed. The revised value of the second 
     tranche was between $100,000 and $250,000 when filed.
       The nominee and Committee staff also agreed that the 
     tranche of shares acquired in August 2016 was not accounted 
     for on the OGE Form 278, and the nominee told staff that 
     income attributable to his holding in the company reported on 
     OGE Form 278 was incorrect. The nominee noted that it is 
     unclear how information related to his holding in this stock 
     was misstated on the published form. The nominee agreed to 
     contact OGE to correct the form.
                                  ____

                                                 February 7, 2017.
     Ms. Elizabeth J. Fischmann,
     Associate General Counsel for Ethics, Designated Agency 
         Ethics Official,
     Washington, DC.
       Dear Ms. Fischmann: The purposes of this letter are to 
     amend the financial disclosure report that I signed on 
     December 15, 2016, and to supplement the ethics agreement 
     that I signed on January 11, 2017.


                     a--financial disclosure report

       To correct inadvertent errors in my December 15, 2016, 
     financial disclosure report, the items identified below are 
     amended, as follows:

                                                                         Part I
--------------------------------------------------------------------------------------------------------------------------------------------------------
         #            Organization Name        City/State         Organization Type       Position Held               From                    To
--------------------------------------------------------------------------------------------------------------------------------------------------------
2                   Chattahoochee         Atlanta, Georgia....  General Partnership.  Managing and General                  11/1993  Present
                     Associates.                                                       Partner.
--------------------------------------------------------------------------------------------------------------------------------------------------------


                                                     Part 2
----------------------------------------------------------------------------------------------------------------
        #              Description         EIF              Value              Income Type       Income Amount
----------------------------------------------------------------------------------------------------------------
1                  Chattahoochee        no               $100,001-$250,000  ................  None (or less than
                    Associates.                                                                $201)
----------------------------------------------------------------------------------------------------------------


                                                     Part 6
----------------------------------------------------------------------------------------------------------------
        #              Description         EIF              Value              Income Type       Income Amount
----------------------------------------------------------------------------------------------------------------
14.55              Amazon Com Inc.....  n/a             None (or less than  Capital Gains     $2,501-$5,000
                                                                   $1,001)
15.1               Innate               n/a                $15,001-$50,000  ................  None (or less than
                    Immunotherapeutics                                                         $201)
                    Ltd. (INNMF).
----------------------------------------------------------------------------------------------------------------

       To correct an inadvertent error in my December 15, 2016, 
     financial disclosure report, the following item is added to 
     that financial disclosure report:

                                                     Part 6
----------------------------------------------------------------------------------------------------------------
        #              Description         EIF              Value              Income Type       Income Amount
----------------------------------------------------------------------------------------------------------------
28                 Innate               n/a              $100,001-$250,000  ................  None (or less than
                    Immunotherapeutics                                                         $201)
                    Ltd. (INNMF).
----------------------------------------------------------------------------------------------------------------

       With regard to the assets disclosed in my December 15, 
     2016, financial disclosure report other than those listed 
     above, the U.S. Office of Government Ethics has asked me to 
     confirm that I disclosed the current value at the time of 
     reporting. By this letter, I am confirming that I used 
     current value with regard to those assets. This letter makes 
     no changes to the value categories disclosed in that 
     financial disclosure report other than those indicated above.


          b--Supplement to January 11, 2017, Ethics Agreement

       The new item listed above (Innate Immunotherapeutics Ltd./
     $100,001-$250,000) is covered by the commitment I made in my 
     January 11, 2017, ethics agreement to divest all interests in 
     Innate Immunotherapeutics Ltd. within 90 days of 
     confirmation. In addition, the following commitments 
     supplement my ethics agreement dated January 11, 2017.
       In February 2017, I resigned from my position as Managing 
     and General Partner of

[[Page 2357]]

     Chattahoochee Associates and transferred my ownership 
     interest to my spouse. I will not participate personally and 
     substantially in any particular matter that to my knowledge 
     has a direct and predictable effect on the financial 
     interests of Chattahoochee Associates, unless I first obtain 
     a written waiver, pursuant to 18 U.S.C. Sec. 208(b)(1).
       If I have a managed account or otherwise use the services 
     of an investment professional during my appointment, I will 
     ensure that the account manager or investment professional 
     obtains my prior approval on a case-by-case basis for the 
     purchase of any assets other than cash, cash equivalents, 
     investment funds that qualify for the exemption at 5 C.F.R. 
     Sec. 2640.201(a), obligations of the United States, or 
     municipal bonds.
       I understand that as an appointee I will be required to 
     sign the Ethics Pledge (Exec. Order no. 13770) and that I 
     will be bound by the requirements and restrictions therein in 
     addition to the commitments I made in the ethics agreement I 
     signed on January 11, 2017.
       I have been advised that this supplement to my ethics 
     agreement will be posted publicly, consistent with 5 U.S.C. 
     Sec. 552, on the website of the U.S. Office of Government 
     Ethics with ethics agreements of other Presidential nominees 
     who file public financial disclosure reports. I understand 
     that this letter will also be released as an attachment to my 
     public financial disclosure report.
           Sincerely,
                                             Thomas E. Price, M.D.

  Mr. WYDEN. I also refer my colleagues to the following documents: an 
announcement by Innate on June 10, 2016, entitled ``Private Placements 
and Rights Issue to Raise Additional Working Capital,'' and the Public 
Financial Disclosure Report signed by Congressman Price on December 15, 
2016, that was filed with the Office of Government Ethics.
  I want to take a minute to return to the Innate company itself. I 
noted earlier that the company has put on a full court press to defend 
Congressman Price in recent weeks, as details of his special deal have 
come to light.
  I am going to describe why that might be. Innate's executives have 
sought to portray the company as being a small firm from Down Under 
that has been inadvertently caught in political crossfire on the other 
side of the world. But the fact is that Innate has longstanding 
connections to Congressman Collins and his inner circle, a circle that 
includes Congressman Price. As the Australian City Newspaper wrote this 
week, ``Mr. Collins, his children and his `intimate political allies' 
and donors controlled at least 27.25 percent'' of Innate's voting 
shares.
  Then there is the baffling assertion mailed by Mr. Wilkinson, the 
CEO, that he only recently learned of Congressman Price's existence 
through news articles. This is a stretch to believe and flies in the 
face of Congressman Price's own testimony.
  On January 13, the New York Times reported:

       Mr. Wilkinson and Michael Quinn, Innate's chairman, said 
     they had never heard of many of the company's more prominent 
     investors, and said they first learned that Mr. Price had 
     invested in the company from an article in the Wall Street 
     Journal, which first reported his investment.

  On February 5, Mr. Wilkinson, the CEO of Innate, told the Buffalo 
News, ``I think the first time I heard that a gentleman named Tom Price 
had invested was after the U.S. media started reporting it.''
  But Congressman Price was quite clear that he had communicated with 
Wilkinson. In written testimony, responding to questions for the 
record, he said: I also communicated with Simon Wilkinson of Innate 
regarding my interest in participating in the 2016 private placement of 
company stock. According to Innate's Web site, Mr. Wilkinson is 
currently the managing director and CEO of the company.
  Congressman Price's name was also listed twice in the documents of 
the company, which reported the private stock sale participants to the 
Australian stock exchange last summer. Congressman Price also appeared 
to have bought nearly 5 percent of the discounted shares made available 
in the private stock sale. Given all that, it seems difficult to 
believe Mr. Wilkinson's story that he had no idea who Congressman Price 
was.
  Finally, The Australian, the Sydney paper I just mentioned, reported 
on Monday that Innate and Congressman Collins are facing questions 
about possible violations of Australia corporation law with regard to 
his holdings in the company. So why does this matter? It matters 
because a nominee to be a Cabinet Secretary, Congressman Price, was 
brought into this web of questionable stock transactions and 
obfuscations about just how special the special deal he really got was 
by a company insider, his friend, Congressman Collins.
  As I get ready to close, I refer my colleagues to the following 
articles and documents: ``Congressman Collins under fire for 
`suspicious' stock trades,'' published in the Buffalo News on January 
17 of this year; ``Collins shared biotech stock news with big Buffalo 
names,'' again from the Buffalo News on January 19; ``Collins' 
controversial stock venture could be boom or bust,'' from the Buffalo 
News on February 5 of this year; the Notice of Innate's 2016 Annual 
Meeting and Explanatory Statement filed on July 29 of 2016; documents 
filed by Innate on September 12, 2016, and September 26, 2016, 
reporting results of the 2016 private stock placement.
  As we close, I want to return to section 3 of the STOCK Act. It says:

       Members of Congress . . . may not use nonpublic information 
     derived from such person's position . . . or gained from the 
     performance of such person's official responsibilities as a 
     means for making a private profit.

  So did Congressman Price have access to nonpublic information about 
Innate or its private stock sale because of his position as a Member of 
Congress? I believe the answer is yes.
  Did he get special access to the discounted private sale because of 
his position? I believe the answer is yes.
  Does he stand to profit because of the information or access he may 
have received? I believe the answer is yes.
  Finally, did Congressman Price tell the Finance Committee and the 
HELP Committee the truth about how he learned about the private stock 
sale and the ability of average investors to participate? Congressman 
Price told the Finance Committee and the HELP Committee that the 
special stock deal he got in on was open to everyone.
  According to the Wall Street Journal and company documents, that is 
not true. The deal he got was clearly different than what was offered 
to everyday investors. According to the Journal, his previous purchase 
of Innate stock did not qualify him to participate in the private 
placement without being a specially invited friends and family guest. 
This arrangement allowed Congressman Price to buy more shares than 
other investors were allowed to buy.
  Congressman Price told the Finance Committee that his conversations 
with Congressman Collins, again, a director of the company, its largest 
shareholder, had no influence on his investment decisions. According to 
the Journal, this is not true. The Journal report made clear that 
Congressman Collins told him about the upcoming drug trial, alerted him 
to the private stock sale, and arranged to ensure he could participate.
  Now the majority party has shut down the vetting process, allowing 
Congressman Price's nomination to reach the floor before all the facts 
have come into view. I believe the Senate can do better. It needs to do 
better. The American people are owed better.
  I thank my colleagues, particularly Senator Reed, for his patience 
and his courtesy.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Daines). The Senator from Rhode Island.
  Mr. REED. Mr. President, I rise today in opposition to President 
Trump's nomination of Congressman Tom Price for the Department of 
Health and Human Services. The Department he has been picked to lead is 
charged with protecting the health of all Americans, from safeguarding 
Medicare and nursing home care for seniors to investing in medical 
research and supporting public health programs, such as lead poisoning 
prevention and youth suicide prevention.
  Unfortunately, Congressman Price has demonstrated over the last 
decade in Congress that he is unwilling or unfit or both to protect 
these critical health programs. In his role as chairman of the House 
Budget Committee,

[[Page 2358]]

Congressman Price has offered plans to repeal the Affordable Care Act 
and turn Medicare into a privatized voucher program. This is the 
opposite of protecting the safety net programs for our most vulnerable 
citizens.
  Time and again, Congressman Price has proved that he favors corporate 
interests over patients, which has raised ethics concerns. For these 
reasons, I will oppose his nomination.
  First, I would like to talk about the Affordable Care Act. About a 
month ago, I was here talking to my colleagues on the floor about the 
impact of the ACA in my home State of Rhode Island and the consequences 
of repeal. In short, repeal of the ACA would be catastrophic in Rhode 
Island and across the country. Yet Congressman Price has led the 
efforts in the House of Representatives to repeal the ACA without any 
replacement. In fact, he is the architect of legislation to do just 
that.
  The uninsured rate today is at its lowest point in recent history. 
That holds true in my State of Rhode Island. The uninsured rate there 
has fallen from nearly 12 percent to under 4.5 percent. That translates 
to over 100,000 Rhode Islanders who have gained coverage because of the 
ACA.
  While it is not the case in every State, in Rhode Island insurance 
rates have dropped. In fact, consumers in Rhode Island have saved $220 
million since 2012.
  We cannot go back to a system that allows private insurers to deny 
coverage for preexisting conditions or charge more to those who need 
insurance the most. By contrast, Congressman Price opposes the 
preexisting conditions ban, one of the most popular provisions of the 
ACA.
  His plan would allow insurance companies to deny coverage or to 
charge more to those with preexisting conditions, older Americans, and 
women. He has also proposed getting rid of the essential benefits 
package in the ACA. These protections require insurance companies to 
cover things like prescriptions drugs, maternity care, pediatric 
services, and mental health care. These are really things that any 
basic health coverage should include, yet Congressman Price has 
advocated taking away these consumer protections.
  Stop and think about that. Congressman Price does not think that 
health insurance should cover pregnancy, for example. I mean, we are 
not really talking about extravagant services. These are the services 
that a reasonable person would expect their health insurance to cover. 
In fact, Congressman Price's plan, the Republican plan to repeal the 
ACA, would mean that nearly half a million Rhode Islanders with 
preexisting conditions--that is nearly half the population of my 
State--could be denied coverage or charged more. Those who might still 
be able to get coverage would quickly find that it does not cover that 
much.
  These consumer protections that are embedded in the ACA affect 
everyone, not just those who have coverage because of the ACA. Before 
the ACA, the Affordable Care Act, insurance plans, including coverage 
through your employer, could impose annual or lifetime limits on 
coverage, meaning coverage could end just when you need it most. With 
Congressman Price in charge, if he has his way, we will see a return of 
these limits, even for employer-sponsored health plans.
  The nominee's stance on the Affordable Care Act is not my only worry 
because when it comes to Medicare and Medicaid, benefits that Americans 
have worked hard to earn and to fund, Congressman Price's views are far 
outside the mainstream.
  Medicare is one of the great success stories in expanding access to 
care and keeping seniors out of poverty. Since the passage of Medicare 
in 1965, we have seen significant decreases in the numbers of seniors 
living in poverty, and this is largely because of Medicare and, of 
course, Social Security, another critical safety net program for 
seniors. I believe that Medicare is essential for the quality of life 
of Rhode Island's seniors and for seniors across the country.
  In fact, I supported the ACA because it made key improvements to 
Medicare that strengthened its long-time solvency and increased 
benefits, such as closing the prescription doughnut hole and 
eliminating cost sharing for preventive services, such as cancer 
screenings.
  Over 15,000 Rhode Islanders saved $14 million on prescriptions drugs 
in 2015, an average of $912 per beneficiary. In the same year, over 
92,000 Rhode Islanders took advantage of free preventive services, 
representing over 76 percent of beneficiaries. We see these benefits 
because of the Affordable Care Act.
  Repealing the Affordable Care Act, as advocated by the Congressman, 
means repealing these benefits for seniors and shortening the life of 
the Medicare trust fund by over a decade. What is worse is that 
Congressman Price not only wants to repeal the ACA and the Medicare 
benefits that come with it, but he has also advocated for privatizing 
Medicare, turning it into a voucher-based program, as well as raising 
the eligibility age.
  Simply put, this would end Medicare as we know it. Millions of 
Americans, including over 200,000 Rhode Islanders, have paid into the 
system, counting on the benefits that they have earned and worked their 
entire life for. Under Congressman Price's plan, Republicans would 
shift more costs to seniors who have played by the rules and planned 
for retirement with quality Medicare coverage.
  Congressman Price and Congressional Republicans will tell you that 
they are trying to cut costs under the banner of trying to save 
Medicare. If that is the Republican standard, then why do they oppose 
the ACA which actually improved Medicare services, cut costs, and 
extended Medicare solvency? That seems to be a pattern with many on the 
other side: Act very serious and concerned about Medicare's finances, 
but then make every effort to demonize and roll back these 
improvements.
  In fact, Medicare spent $453 billion less from 2009 to 2014 than it 
expected under growth trends prior to the ACA, all while increasing 
benefits like free preventive care and better prescription drug 
coverage and adding over a decade of solvency to the Medicare trust 
fund. The projected cost--the best projections were actually lowered by 
the ACA while benefits were increased. This talk of supposedly saving 
Medicare is really, in my view, a ruse to make draconian cuts to free 
up more Federal funding for things like tax breaks for the wealthy. We 
cannot allow Republicans under Congressman Price's leadership to go 
back on the Medicare guarantee we have made to seniors that we 
represent all across this country.
  Congressman Price has also made a number of troubling statements 
about Medicaid and the Children's Health Insurance Program, CHIP. 
First, repeal of the ACA would have a disastrous effect on State 
Medicaid programs, kicking 11 million Americans off their health 
insurance, including 70,000 Rhode Islanders.
  However, this is not enough for Congressman Price. He has offered 
legislation to cut Medicaid even further, to the tune of $1 trillion, 
by turning Medicaid into a Block Grant Program.
  I think my colleagues should really consider how this would impact 
their States. Including those newly insured by the ACA, Medicaid covers 
74 million Americans. Who makes up this population? Well, half of the 
Medicaid enrollees are children.
  Medicaid also pays for half the births in this country.
  These are staggering numbers. In Rhode Island, one in four children 
is covered by Medicaid or CHIP, and one in two people with disabilities 
is covered by Medicaid.
  While Medicaid was initially designed to help low-income families, 
seniors now account for approximately half of Medicaid's spending 
nationwide. Nearly 60 percent of nursing home residents are covered by 
Medicaid across the country, and that holds true in my State of Rhode 
Island.
  Many of these people are our neighbors, our friends. They have been 
working all their lives, and they have qualified for this coverage 
because they have been able to move some of their assets out of their 
ownership because

[[Page 2359]]

our rules don't recognize retirement accounts. So these are our 
neighbors.
  When Congressman Price talks about turning Medicaid into a block 
grant program, every Member of this Chamber has to stop to realize that 
there is no way to cut Medicaid by trillions of dollars without harming 
children and seniors and placing each of our States in a very difficult 
position because they, too, contribute to Medicaid; because they have a 
responsibility to children and seniors for health care; because they do 
also help support nursing home, nursing facilities for seniors and the 
disabled. And they would be in a disastrous situation.
  Now, all of these are, I believe, reason enough to oppose Congressman 
Price's nomination. However--and I alluded to this earlier, and Senator 
Wyden went into great detail--Congressman Price has a history of 
conflicts of interest, such as investments in the very issues and 
companies he worked on, as a Member of Congress.
  Congressman Price traded hundreds of thousands of dollars in health 
care pharmaceutical stocks, all the while advocating for regulation 
legislation that would financially benefit these very companies. Again, 
Senator Wyden has made a very detailed and very persuasive case in this 
regard.
  In fact, as Senator Wyden has pointed out, after receiving 
information from a fellow Congressman and now a member of President 
Trump's transition team, Congressman Price was one of a small group who 
was offered the chance to purchase stock in a biomedical group at a 
discounted price.
  Now, Democrats are not going to have the opportunity to fully examine 
these issues. I find the examples we do have to be deeply concerning. 
The very articulate, eloquent, and detailed--exhaustively detailed--
statement by Senator Wyden adds further credence to this presumption.
  This is a very disconcerting pattern of behavior. Indeed, I believe 
this pattern of behavior warrants further investigation, but those 
requests have been denied by the Republican majority. These allegations 
are now even more concerning because of the need for further 
investigation, but those requests have been denied by the Republican 
majority. These allegations are even now more concerning because 
Congressman Price is being considered for the top role in this 
administration in charge of protecting the health of all Americans and, 
indeed, affecting the corporate situation of thousands of companies 
throughout this land that he may or may not have a financial interest 
in.
  Now I have heard from hundreds of Rhode Islanders who have expressed 
these concerns to me, from his support for the efforts to repeal the 
ACA and cut Medicaid and Medicare to his questionable investments. I 
agree with them.
  As such, I am unable to support Congressman Price's nomination for 
Secretary of the Department of Health and Human Services, and I would 
urge others to look very carefully at the record, carefully at the 
advocacy for the elimination, basically, of Medicare as we know it, of 
block-granting Medicaid, which would harm children and seniors and put 
excruciating financial pressure on every State in this country, and his 
own behavior with respect to personal investments.
  With that, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Ms. HASSAN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Ms. HASSAN. Mr. President, I rise today to join my colleagues in 
opposing Congressman Tom Price's nomination to be the Secretary of the 
Department of Health and Human Services.
  Every American deserves the opportunity to have quality, affordable 
health insurance coverage to help them live healthy and productive 
lives. Having health care is not just critical to the freedom, dignity, 
and well-being of our citizens but also to the strength of our economy.
  As Governor, I worked with Democrats and Republicans in New Hampshire 
to expand health insurance coverage--including coverage for substance 
use disorder and behavioral health services--to tens of thousands of 
Granite Staters.
  We need to bring this same bipartisan approach to the Senate. We know 
that there are serious challenges in our health care system that must 
be fixed, and we need to work across party lines to support commonsense 
improvements to move our Nation's health care system forward, not rip 
health insurance coverage away from millions of Americans.
  This is why I cannot support Congressman Price's nomination. 
Throughout his time in office, Congressman Price has promoted policies 
that would undermine the health care that so many in my State and 
across our Nation depend on. Congressman Price wants to repeal the 
Affordable Care Act, which would strip coverage away from millions of 
Americans. Those who seek to repeal the ACA, including Congressman 
Price, have not come up with a plan to replace it.
  Repealing the ACA without a replacement would send insurance markets 
reeling. It would be devastating for millions of people who have 
coverage because of the law.
  Repealing the ACA would eliminate New Hampshire's bipartisan Medicaid 
expansion plan, harming our State's efforts to combat the heroin, 
fentanyl, and opioid crisis. This crisis is the most pressing public 
health and public safety challenge facing our State, and thousands of 
Granite Staters have accessed substance misuse treatment because of 
Medicaid expansion.
  Just a couple of weeks ago, I met a young man named Noah at Harbor 
Homes in Nashua. Noah is an active participant in the Nashua drug court 
and a former enrollee in our Medicaid expansion program.
  Last month, after 14 years of struggling with addiction, Noah was 
celebrating 1 year sober. Because of legislation that expanded 
Medicaid, passed under bipartisan leadership, Noah received health 
insurance through Medicaid expansion, and he was able to quickly begin 
treatment.
  Noah's recovery process required medication-assisted treatment which 
he would not have been able to afford had it not been covered under 
Medicaid. He is now 5 months off that treatment and hasn't had an 
instance of relapse.
  Noah said the ACA and Medicaid expansion are ``working miracles every 
single day in this recovery community.'' For Noah and so many others, 
we cannot afford to set back our efforts, but that is what the repeal 
of the ACA would do.
  I also oppose Congressman Price because he is determined to turn back 
the clock on women's access to reproductive health care. He has fought 
against the woman's constitutionally protected right to make her own 
health care decisions and control her own destiny. He has voted 10 
times to defund Planned Parenthood, and he has voted against a 
resolution to protect employees from being punished or fired by their 
employers for their reproductive health decisions.
  And I oppose Congressman Price because he has pushed to turn Medicare 
into a voucher program, which will increase costs for seniors. 
Congressman Price's views and priorities are simply at odds and out of 
touch with the views and priorities of many, many Granite Staters.
  Additionally, Mr. President, serious issues have been raised 
throughout this nomination process regarding Congressman Price's 
conflicts of interest and his potential violation of the STOCK Act, 
including recent reports suggesting that he received a private discount 
to purchase a health company stock while engaged in legislative efforts 
that would directly affect the company's financial interests. 
Congressman Price's insufficient responses concerning his stock 
purchases raise the question of whether, if confirmed, he will put 
corporate interests ahead of the American people. That is unacceptable. 
I believe we need a health care system that works for every American, 
and that is why I will vote against Congressman Price's confirmation.

[[Page 2360]]

  I want to talk a little bit more about what Congressman Price's 
confirmation would do with respect to Medicaid expansion and 
particularly how it would affect the opioid crisis in New Hampshire. In 
New Hampshire, we proved that Democrats and Republicans can come 
together to move our health care system forward when we passed our 
Bipartisan Medicaid Expansion Program. Passing and reauthorizing this 
program included healthy debate, and at times some argument, but what 
matters of course is what we do after our argument, after those 
debates. We were able in New Hampshire to put our differences aside and 
take a critical step forward to continue strengthening our families, 
our businesses, and our economy. This is the approach we need to be 
taking in the United States Senate.
  The benefits of Medicaid expansion are clear, over 50,000 Granite 
Staters are now covered in a population of 1.3 million people. We 
included in Medicaid expansion coverage of substance use disorder and 
behavioral health services. I have heard story after story of Granite 
Staters who are in recovery, thanks to Medicaid expansion. I told 
Noah's story just a few minutes ago.
  At another round table I met a young woman named Ashley at the Farnum 
Center in Manchester, CT. Ashley told of suffering from addiction for 
over 10 years. One day she woke up to discover that her husband had 
died of an overdose. She lost custody of her young daughter, but 
because of Medicaid expansion, Ashley was able to get treatment. She 
has been in recovery now for a little bit over a year--recovery through 
medical treatment made possible by Medicaid expansion. Because she is 
in recovery, she was able to get a job. Because she began working 
again, she actually has now moved off Medicaid expansion onto private 
health insurance. So Medicaid expansion was there when she needed it to 
get healthy. Now she doesn't need it anymore, and she is participating 
in the private health insurance market. By the way, she is beginning to 
reestablish her relationship with her young son. That is the power of 
the Affordable Care Act. That is the power of Medicaid expansion.
  Representative Price, on the other hand, has advocated for repeal of 
these very programs. Such a repeal would have such harmful impacts, 
pulling the rug out from those who have coverage right now for critical 
medical conditions. At his confirmation hearing, Representative Price 
declined to guarantee that Americans with substance use disorders who 
got on insurance through Medicaid expansion would still be covered for 
these services if the Affordable Care Act is repealed under 
Representative Price's leadership.
  He also would not commit to continuing the requirement under the 
Affordable Care Act that health insurance companies must cover 
essential health benefits, including treatment for substance abuse.
  Representative Price's support for the repeal of the Affordable Care 
Act also requires more discussion. The Affordable Care Act has helped 
families across our Nation access quality, affordable health insurance 
coverage. We need to come together now and find bipartisan areas in 
which we can agree to improve the law, but we should not be repealing 
it. We should not be taking coverage away from millions of people. I 
have joined a number of my colleagues in expressing our willingness to 
work across the aisle with our colleagues to improve the law, but 
unfortunately it seems our colleagues in the Senate are headed down a 
path to repeal the law without a plan to replace it. Repealing the ACA 
without any replacement is a recipe for upheaval and instability, a 
recipe for hurting our families, small businesses, and our economic 
progress. Representative Price and those who seek to repeal this law 
have not agreed on any path forward other than repealing and stripping 
coverage away from millions of Americans. Repealing would have major 
consequences for many Granite State families and small businesses.
  My office has heard from constituents about the impact the Affordable 
Care Act has had on their lives. One resident from Keene, NH, wrote to 
say this law has helped fulfill his goal of starting a small business. 
He wrote:

       I have had health insurance through the exchange under the 
     ACA since late 2015, when I quit my job to start up a 
     business. Before the ACA, I wouldn't have taken the risk to 
     start a business, because I have a preexisting condition and 
     I wouldn't have been able to get an individual health 
     insurance policy.

  He continued:

       Under the ACA, I am able to get good health insurance at an 
     affordable premium. Since I left my job I built up a 
     profitable business and expect to be in a position to hire 
     employees within a year or two. None of this would have been 
     possible without the ACA.

  And he added:

       If the ACA is repealed, I am concerned that I will need to 
     put my business on hold in order to go back to a corporate 
     job that I don't need, only to get the health care benefits. 
     The ACA has flaws, but overall it has allowed me to take an 
     entrepreneurial risk and start a small successful business.

  It is clear that this law has truly made a difference not just for 
the health of our citizens but also for our economy, and we cannot 
undermine the progress we have made.
  I am also deeply concerned about Representative Price's record and 
his statements concerning women's health care. Representative Price has 
consistently opposed women's reproductive freedom. I have always fought 
to protect a woman's right to make her own health care decisions and to 
chart her own course, and I always will. This is not just a matter of 
individual freedom, which of course is a good enough reason in its own 
right to support women's reproductive choice, but it is also a matter 
of economics. When women have to pay more for their health care than 
men do, it puts them at a financial disadvantage.
  As Governor, I restored family planning funds and pushed to restore 
State funding to Planned Parenthood because I know how critical these 
services are for the women and families of my State. It is unacceptable 
that Washington Republicans continue to play games with women's health, 
and Representative Price has been at the forefront of that effort. 
Representative Price does not support a woman's constitutionally 
protected right to a safe and legal abortion. He has cosponsored and 
repeatedly voted for measures that would ban all medically appropriate 
abortions, without exceptions for rape, incest, or to protect a woman's 
health. He has voted to penalize small businesses that choose private 
health plans that include abortion coverage. Additionally, he has voted 
to allow employers to discriminate against employees based on their 
reproductive health decisions. He voted to eliminate the Title X Family 
Planning Program. He voted 10 times to defund Planned Parenthood.
  Defunding Planned Parenthood, a critical health provider, would have 
devastating effects. A recent article in the Washington Post 
highlighted the impact of what can happen when legislatures attempt to 
defund Planned Parenthood.
  This report in the post found:

       In 2011, the Texas legislature cut the two-year budget for 
     funding family planning from $111 million to $38 million in 
     an effort to defund Planned Parenthood. After these cuts, 82 
     Texas family planning clinics, one out of every four in the 
     state--closed or stopped providing family planning services. 
     An unintended consequence of the law was that two-thirds of 
     the clinics that closed were not even Planned Parenthood 
     clinics. Organizations that remained open, many with reduced 
     hours, were often unable to offer the most effective methods 
     of contraception, such as IUDs and contraceptive implants, to 
     women who wanted them. The closings and reduced hours also 
     limited or cut back access to primary care providers for a 
     significant number of women.

  Women and their families deserve better than an HHS Secretary who 
would disregard their constitutional right and roll back their access 
to reproductive health care. They deserve better than an HHS Secretary 
who appears to believe that women are neither capable nor trusted to 
make their own health care decisions. I believe women should be full 
and free citizens in the United States of America and can be trusted to 
make their own health care decisions.
  Representative Price's nomination and his confirmation would be 
harmful

[[Page 2361]]

to our seniors as well. Seniors deserve a high quality of life, high-
quality care, and access to the benefits that they have earned 
throughout their life. I believe we must continue to strengthen and 
protect Medicare for years to come, not undermine it. Unfortunately, 
Representative Price has long sought to undermine Medicare and the 
important benefits it provides to seniors. His budget proposals have 
included extreme cuts to the program. He supports turning Medicare into 
a voucher program. In fact, he even said he wants to voucherize 
Medicare within the first 6 to 8 months of the Trump administration. 
This would increase costs for seniors.
  He has also repeatedly opposed allowing Medicare to negotiate drug 
prices for seniors. He has argued that seniors have no drug cost 
problem. Imagine that, a Health and Human Services Secretary who 
believes that drug costs are not an issue for our seniors. He even said 
allowing Medicare to negotiate prices for prescription drugs would be 
``a solution in search of a problem.''
  I can tell Representative Price that there are certainly seniors in 
New Hampshire who have found that the cost of their prescription drugs 
are truly a problem, and as we talk about the need to shore up and 
strengthen the Medicare Program, one of the best ways to stabilize its 
finances would be to allow Medicare to negotiate for prescription drug 
prices to lower those prices, lower the cost of the program, while 
making the program even more affordable for our seniors.
  That is not something that Representative Price has even expressed a 
willingness to consider because he doesn't even acknowledge there is a 
problem. Representative Price has also supported raising the Medicare 
age from 65 to 67. This amounts to a devastating benefit cut for 
seniors, shifting costs onto them, which is unacceptable.
  Whenever I hear people suggesting raising the retirement age for 
Social Security or the age for Medicare eligibility, I am reminded of 
my father-in-law. My father-in-law was one of the hardest working 
people I ever knew. He worked as a wholesale meat cutter, and for 
anybody who has never seen what that means, it means standing on your 
feet for hours at a time in a cold meat locker as large carcasses come 
through, and with time pressures, the way any production facility has, 
cutting those carcasses into salable product.
  My father-in-law left the house before dark. He often came home, 
having been assigned overtime, after dark, having been standing on his 
feet in the cold, doing incredibly hard, physical labor.
  When it came time for him to retire, when he became eligible for 
Medicare, he really couldn't have worked at that job much longer. And 
the fact that he had a dignified retirement after those years of hard 
work was in large part due to Medicare. Before the physical impacts of 
that job slowed him down, it was our great pleasure to watch a man who 
had provided for his family with such hard work know the dignity of 
playing with his grandchildren, sleeping in until 7:30 or 8 in the 
morning, and watching his family grow and strengthen and thrive.
  That is the dignity of Medicare. It is the dignity of Social 
Security. And to have a Health and Human Services Secretary who 
believes we should just be raising that age, as Representative Price 
does, contradicts the very notion of what it means to earn a benefit 
and to know a dignified retirement.
  I am proud of the progress we have made to help ensure that more 
Granite Staters and Americans have the quality health care they need at 
an affordable cost. There is much more work to do to move our health 
care system forward and to combat the heroin opioid and fentanyl crisis 
that has devastated far too many families in New Hampshire and across 
our Nation. I am ready and willing to work with anyone who is serious 
about making improvements to our health care system to improve 
affordability and access to care, but that does not start with pulling 
the rug out for millions of Americans. It does not start with rolling 
back women's access to critical health care services.
  Congressman Price's record demonstrates that he puts a partisan 
agenda and corporate interests before the health and economic well-
being of our families. The American people deserve a Secretary of 
Health and Human Services who will help more Americans receive quality, 
affordable health insurance coverage, not one who supports stripping it 
away by repealing the Affordable Care Act without a replacement.
  For these reasons, I will be voting no on Congressman Price's 
nomination, and I urge my colleagues to do the same.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Tillis). The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. WYDEN. 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. WYDEN. Mr. President, the debate on Congressman Price's 
nomination, in my view, is a referendum on the future of health care in 
America.
  On this side of the aisle, we think it is worth spending 30 hours 
talking about a subject this important to our people. My view is that 
this is about whether the United States is going to go back to the dark 
days when health care worked only for the healthy and the wealthy.
  Based on the public record, Medicare is a program Congressman Price 
does not believe in, and it offers a guarantee of services he doesn't 
believe seniors should have.
  On the Affordable Care Act, he is the architect of repeal and run. He 
wrote the bill himself. He proposed weakening protections for Americans 
with preexisting conditions. He would shred the health care safety 
net--Medicaid--for the least fortunate among us. He would take away 
health care choices for women, particularly the opportunity to go to 
the physician that they trust.
  As we wrap up and get ready to vote, think about the common thread 
among these proposals: They take away coverage from our people, make 
health care coverage more expensive for millions of people, or both. 
That is what Congressman Price stands for when it comes to health care. 
Every Senator who casts a vote for Congressman Price has to stand by 
that agenda.
  Beyond what this means for the future of American health care policy, 
there is the lingering spectre, as I have discussed tonight in detail, 
of serious legal and ethical issues. Congressman Price got special 
access to a special deal on stock in an Australian biomedical company. 
He claimed multiple times before Senate committees that the deal he got 
on discounted company stock was open to all shareholders. All the 
evidence--all the evidence--says that this is untrue.
  First, he had to go through the back door to get access to the 
discounted price. He got a special friends-and-family invite from his 
colleague in the House, Congressman Chris Collins, the company's top 
shareholder and a member of its board.
  Second, rules that apply to other investors didn't apply to 
Congressman Price. Other shareholders were bound by a limit. They were 
able to buy one discounted share for every nine they already owned. 
That would have allowed Congressman Price to buy just 7,000 discounted 
shares. He bought 400,000 discounted shares. In my view, he can't get 
around that. That is the definition of a special stock deal.
  The Congressman introduced legislation that would have lowered the 
tax bills of three major pharmaceutical companies in which he owns 
stock. He invested $15,000 in a medical equipment company and then 
introduced legislation to increase the amount Medicare pays for that 
type of equipment. Parts of his bill went on to become law. He bought 
thousands of dollars' worth of stock in a company called Zimmer Biomet 
less than a week before introducing legislation that had the potential 
to drive up the value of those shares. Now he has argued that he

[[Page 2362]]

didn't purchase the stocks; his broker did. But at the very least, he 
would have known about those deals within days of the purchase when he 
filed the periodic transaction reports in the House. Under his 
brokerage agreement, he could have quickly resold the stock, but he did 
not. Furthermore, he didn't consult with the Ethics Committee regarding 
any of the trades I have spoken about as directed by the House Ethics 
Manual.
  As I wrap up, I want to put a human face on why so many Senators on 
this side of the aisle have come to the Senate floor to speak so 
passionately about their grave concerns with this nomination. Nothing 
sums up our concerns more clearly than a line from an op-ed Congressman 
Price wrote in 2009 that discusses Medicare. His quote speaks volumes 
about his perspective on this program.
  It is a lifeline. I first became acquainted with it back in the days 
when I was codirector of the Oregon Gray Panthers, ran the legal aid 
program for older people. I saw then that seniors were walking on an 
economic tightrope, balancing their food bill against their fuel bill, 
their fuel bill against the rent bill. They saw Medicare as one of the 
great achievements in American policymaking.
  Here is what the Congressman wrote--his words, not mine: ``Nothing 
has had a greater negative effect on the delivery of health care than 
the federal government's intrusion into medicine through Medicare.'' 
When I read that, I was reflecting on my Gray Panther days, and I think 
a lot of other Senators go back working with community organizations. 
We just heard a wonderful presentation from Senator King, who was also 
a legal services advocate.
  Before Medicare, before this program that Congressman Price thinks is 
such a negative intrusion into medicine, a lot of older people were 
warehoused in poor farms. I am absolutely certain that Congressman 
Price doesn't want to go back to those days, but when he speaks about 
the involvement of Medicare in American health care as though a plague 
has descended on the land, we just have to question his commitment to a 
program that has become a lifeline to millions of older people.
  The fact is, Medicare has always been a promise. That is what we said 
back in the early days with the senior citizens. Medicare was a 
promise. It was a promise of guaranteed benefits. Again, based on the 
public record, Medicare is a program Congressman Price doesn't believe 
in, and it offers a guarantee of services he doesn't think seniors 
ought to have.
  He has said he wants to voucherize the program within the first 6 to 
8 months of the administration. What we are talking about when you want 
to do that is you are breaking the promise of Medicare. You are 
breaking the promise of guaranteed benefits, and you are going to sort 
of hand people a piece of paper and say here is your voucher, I hope it 
works for you. If your medical expenses are greater than your vouchers, 
that is the way it goes, tough luck.
  The price budget cut Medicare by nearly $1 million. By the way, that 
is exactly the opposite of the Trump pledge, not to cut Medicare that 
the American people heard on the campaign trail. There is a big gap 
between what President Trump said about Medicare and the bills and 
legislative efforts of Congressman Price in the other body--big gap. 
That is why it sure looks to me like the promise of Medicare is one 
that Congressman Price would break.
  By the way, we all ought to understand that if confirmed, Congressman 
Price would be the captain of the Trump health care team. What he says 
matters, and what he offered--legislatively, his positions and his 
votes. He voted again and again to repeal the Affordable Care Act.
  It really matters what his past record is. If past is prologue, it is 
certainly relevant. It really matters. He was the architect of what 
amounted to repeal and run. He wrote legislation creating loopholes in 
the protection for those with preexisting conditions, and the big 
beneficiary there was clearly the major insurance companies.
  Women would find it much harder to make the health care choices they 
want and see the doctors they trust if the price proposals were lost. 
Medicaid pays 65 percent of the nursing home bill in America. And on 
this side of the aisle, we are going to fight Congressman Price's block 
grant proposals that are going to put seniors at risk.
  I am going to close with this. I always hope I am wrong when I raise 
the prospects of real threats to the welfare of the American people 
because the reason public service was important to me was because of 
those first days with the Gray Panthers. I never thought I would have 
that kind of wonderful opportunity; that I would have had this 
opportunity for public service. For me and so many on this side of the 
aisle--I see my colleagues who have been active in their communities--
this has always been about the welfare of the American people. That is 
what it is about--all those faces we see when we are home, having 
community meetings and getting out with our people.
  The public record in this case indicates that as Secretary of Health 
and Human Services, Congressman Price would, in fact, be an 
extraordinary threat to seniors on Medicare, vulnerable older people 
who need Medicaid for access to nursing homes, millions of kids for 
whom Medicaid is the key to a healthy future, and women across the 
country who have a right to see the doctors they trust.
  I am going to oppose this nomination. I urge my colleagues to join me 
in opposition.
  Mr. President, I wish to take a few minutes to address Congressman 
Price's stock purchases. At best, this is behavior that cuts ethical 
corners. At worst it is dangerously close to outright insider trading. 
Congressman Price has a lot of questionable trading activity. He 
introduced legislation that would lower the tax bills of three major 
pharmaceutical companies he owned significant amounts of stock in. He 
invested $15,000 dollars in a medical equipment company then introduced 
legislation to increase the amount Medicare pays for that type of 
equipment. Parts of his bill went on to become law.
  But let's look at one investment in particular, Congressman Price's 
investment in Zimmer Biomet. Zimmer is a medical device company that 
specializes in joint replacements, including knee, hip, shoulder, and 
foot and ankle replacements.
  Hip and knee replacements are high cost procedures, and they are two 
of the most common procedures performed on Medicare patients. According 
to CMS, more than 400,000 hip and knee replacement procedures were 
performed in 2014, costing more than $7 billion for the 
hospitalizations alone. Despite the high frequency of these surgeries, 
costs vary widely across geographic areas, and complications like 
infections or implant failures after surgery can be three times higher 
at some facilities.
  In November 2015, in an attempt to incentivize higher quality 
procedures for Medicare recipients and control the cost of these 
replacements, CMS finalized a new pricing model slated to be 
implemented in April 2016. This new pricing model was a cost-bundling 
payment model; instead of Medicare paying for each individual service, 
Medicare reimburses hospitals with a single lump-sum payment, allowing 
hospitals to coordinate overall care for the patient.
  These changes were designed to incentivize improved care for 
patients, lowering costs and improving quality. However, according to 
independent analysts, medical device companies, especially those who 
specialize in orthopedic implants, could face ``material headwinds'' 
from the new pricing model since hospitals facing reimbursement 
pressures are likely to pass some of that burden onto those device 
companies.
  In September 2015, Congressman Price led an effort to send a letter 
from members of the House of Representatives to CMS challenging many of 
the features of the CMS proposal. A copy of the letter, dated September 
21, 2015, is available on the Congressman's website.

[[Page 2363]]

  This is where Zimmer Biomet comes in. Zimmer is a medical device 
manufacturer with significant exposure to the new pricing model. 
According to analysts, over 60 percent of Zimmer's revenues come from 
hip and knee devices, and the CMS guidelines had the potential to 
significantly affect the company's profits.
  On March 17, 2016, a few weeks before the CMS model was set to go 
into effect, Congressman Price bought thousands of dollars worth of 
Zimmer Biomet stock through his brokerage account. On March 23, 2016, 
less than a week later, Congressman Price introduced H.R. 4848, the 
``HIP Act,'' which would have delayed the implementation of CMS 
regulations for Medicare coverage of joint replacements.
  Let's pause right here. In 2016, Congressman Price had a financial 
stake in one of the companies that stood to benefit most from the 
legislation he was promoting. Those basic facts are not in dispute. 
Congressman Price introduced legislation that had the potential to add 
to his personal fortune.
  Now, various arguments have been made, by Congressman Price and 
others, to defend this activity. First is the argument that there 
wasn't much money at stake, just a few thousand dollars. But the truth 
is a few thousand dollars is a lot of money to a lot of Americans. An 
unexpected medical bill that size could have a serious effect on many 
Americans and the person in charge of our health care system should 
take that amount of money just as seriously.
  Second, there is the argument that he didn't purchase the stock; his 
stockbroker purchased it. I am going to return to that issue in more 
detail in a moment, but one thing is clear. That is the fact that 
Congressman Price knew this stock had been purchased in his name, in 
his account, within a matter of days.
  On April 15, 2016, Congressman Price filed what is called a Periodic 
Transaction Report which Members of Congress are required to do within 
30 days of reportable stock purchase. Not only did Congressman Price 
file a report that he had purchased Zimmer Biomet along with dozens of 
other stocks, he initialed the entry for Zimmer Biomet in order to 
correct a mistake on the document; a correction making it clear that 
the Zimmer Biomet transaction was a stock purchase.
  There is also the question of whether this activity violated House 
Ethics rules. Congressman Price also said, in answer to written 
questions, that ``no conflict existed and no consultation was 
necessary.'' He also said, ``Throughout my time as a Member of the 
[House], I have abided by and adhered to all ethics and conflict of 
interest rules applicable to me.''
  He gave the same answer regarding three other bills that appear to 
conflict with investments he held: H.R. 4185, the Protecting Access 
through Competitive-pricing Transition Act of 2015, the PACT Act; H.R. 
5400, a bill pertaining to tax rates in Puerto Rico, which would have 
likely impacted drug manufacturers he owned Eli Lilly, Bristol Myers 
Squibb, and Amgen; H.R. 5210, the Patient Access to Durable Medical 
Equipment (PADME) Act of 2016.
  Let's go through that in some detail.
  It is true that the House Ethics rules, like the Senate Ethics rules, 
allow a member to cast a vote on a matter relating to a company in 
which he or she owns stock. However, that standard only applies to 
casting votes. If you do more, and become an active advocate of a bill 
that could benefit a company that you own stock in, a different 
standard applies.
  On page 237 of the House Ethics Manual, it says that before 
undertaking active advocacy of legislation that will benefit a company 
in which a member owns stock, such as before introducing a bill, ``the 
Member should first contact the [Ethics] Committee for guidance.''
  The Ethics Manual is crystal clear. If you go beyond voting, and you 
are actively pushing a bill that would benefit a company in which you 
own stock, you should consult with the Ethics Committee.
  Congressman Price did not consult with the Ethics Committee regarding 
any of these trades.
  In a written question, I asked Congressman Price about this. I asked 
whether, in light of the House Ethics Manual's recommendation, he had 
consulted with the Ethics Committee regarding his purchase of Zimmer 
Biomet and other stocks. He did not answer the question. Instead, he 
resorted to the same talking point--that the Zimmer Biomet stock was 
purchased by his broker and that there was not need to consult because 
there was no conflict.
  By my reading, this interpretation is flat wrong. Under the House 
Manual, he should have consulted with the Ethics Committee.
  To be clear, the Ethics Committee might have concluded that it was a 
relatively small purchase, and that Congressman Price's advocacy was 
consistent with his longstanding position, and therefore that it was 
fine for him to go ahead and purchase the stock and then introduce the 
bill. On the other hand, the Ethics Committee might have reached a very 
different conclusion. It might have advised him to refrain from 
purchasing the stock.
  The public will never know, because he didn't ask. Despite the clear 
guidance in the House Ethics Manual, he didn't even ask. And now the 
majority party is carrying his nomination toward the finish line.
  Apart from conforming with House Ethics rules, there is also the 
question of whether Congressman Price's activity violated insider 
trading laws. Lawmakers in both the House and the Senate have a duty of 
public trust. The STOCK Act, which Congressman Price and I both voted 
for in 2012, and longstanding SEC rules denote that Members of Congress 
have a fiduciary duty to the American people. What that means is that 
we will use the public power we've been granted to benefit the 
interests of all Americans. The SEC's Rule 10b5, in particular, 
prohibits the purchase or sale of stock on the basis of material 
nonpublic information.
  As a threshold matter, Congressman Price claims that insider trading 
laws don't apply to him because the Zimmer Biomet stock was purchased 
by his broker without his knowledge. But as I've discussed at length, 
this argument is a red herring because Congressman Price did have 
knowledge of these trades. He submitted signed records of the trades 
shortly after they were made. Furthermore, the laws related to insider 
trading give clear guidance on how to trade through a broker without 
violating insider trading laws. And just as with the House Ethics 
rules, when faced with clear guidance on how to manage conflicts of 
interest, Congressman Price chose not to follow it.
  Whether those stocks were purchased directly or through a broker is 
not, by itself, a defense to insider trading. According to SEC rules, 
Congressman Price and his broker needed to agree to a ``written plan 
for trading securities'' that does not ``permit the person to exercise 
subsequent influence over when, how, or whether to effect purchases or 
sales of securities.'' So, if Congressman Price had, in writing, given 
his broker complete control over his portfolio we wouldn't be 
discussing this issue today. But he did not do so.
  Congressman Price returned to the ``my broker did it'' defense for 
weeks before finally providing the Finance Committee with an excerpt of 
his brokerage agreement.
  Here's what it says:

       In the Portfolio Management (``PM'') program, a Financial 
     Advisor(s) who meets the program certification requirements 
     manages your assets on a discretionary basis. In other words, 
     your Financial Advisor, and not you, has the discretion to 
     decide what securities to buy and sell in your account. This 
     discretion is subject to the parameters described below and 
     your ability to direct a sale of any security for tax or 
     other reasons.

  In the course of our investigation, committee staff spoke with 
experts, and they confirmed what seems obvious from the plain language 
of the text. This agreement does not hand over complete control of 
Congressman Price's portfolio to his broker. His agreement with his 
broker simply does not shield him from insider trading laws, no matter 
how many times he tries to say it does.
  This isn't a question of whether Congressman Price followed the 
technical

[[Page 2364]]

letter of the law, he didn't follow it in spirit either. Congressman 
Price could direct his broker to make trades when he wanted to, and he 
did. Case in point, when Congressman Price wanted to act on a stock tip 
from Congressman Collins, he called up his broker and had her buy 
shares of an Australian biomedical firm called Innate 
Immunotherapeutics.
  Another question raised by Congressman Price's conflicts of interest 
is whether they go beyond a violation of the public's trust and 
constitute an outright violation of insider trading laws. That question 
cannot be answered today. We have seen that time and time again that 
Congressman Price purchased stocks then turned around and promoted 
legislation that would help those companies, and his investments in 
them. What is not clear is whether the introduction of this legislation 
meets the legal standards of being ``material'' and ``nonpublic.'' 
Neither case history, nor the legislative history of the STOCK Act 
provide clear guidance on when pending legislation is material and 
nonpublic.
  The bottom line is that Congressman Price's activities are in 
uncharted waters. That is why the public and members of this body ought 
to be outraged that the majority party has cut off the vetting process 
and rushed this nomination toward completion.
  In my view, because of how this nomination was handled, the Senate 
Finance Committee has set a double standard. If you look to the recent 
past at the nominations of Senator Tom Daschle, Secretary Tim Geithner 
and Ambassador Ron Kirk at the outset of the Obama administration, the 
vetting process was extremely thorough and bipartisan. The committee 
turned over every stone, peered around every corner and followed every 
lead to its conclusion. Now, when a glaring issue comes up that 
undeniably deserves investigation, the party in power has shut down the 
vetting process. The Finance Committee and the Senate ought to do 
better.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. COTTON. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The PRESIDING OFFICER. The question is, Will the Senate advise and 
consent to the Price nomination?
  Mr. COTTON. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The senior assistant legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from Missouri (Mrs. 
McCaskill) is necessarily absent.
  The PRESIDING OFFICER (Mr. Cassidy). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 52, nays 47, as follows:

                       [Rollcall Vote No. 61 Ex.]

                                YEAS--52

     Alexander
     Barrasso
     Blunt
     Boozman
     Burr
     Capito
     Cassidy
     Cochran
     Collins
     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
     Strange
     Sullivan
     Thune
     Tillis
     Toomey
     Wicker
     Young

                                NAYS--47

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

                             NOT VOTING--1

       
     McCaskill
       
  The nomination was confirmed.
  Mr. McCONNELL. Mr. President, I move to reconsider the vote on the 
nomination.
  The PRESIDING OFFICER. The question is on the motion to reconsider.
  Mr. McCONNELL. I move to table the motion to reconsider.
  The PRESIDING OFFICER. The question is on agreeing to the motion to 
table.
  The motion was agreed to.

                          ____________________