[Congressional Record (Bound Edition), Volume 163 (2017), Part 4]
[Senate]
[Pages 5130-5147]
[From the U.S. Government Publishing Office, www.gpo.gov]




    PROVIDING FOR CONGRESSIONAL DISAPPROVAL OF A RULE SUBMITTED BY 
                 SECRETARY OF HEALTH AND HUMAN SERVICES

  The VICE PRESIDENT. The Senator from Alaska.
  Mr. SULLIVAN. Mr. President, I yield back all Republican time in 
relation to H.J. Res. 43.
  The VICE PRESIDENT. The time is yielded back.
  The Senator from Washington.
  Mrs. MURRAY. Mr. President, this vote had to be held open in order to 
allow time for Vice President Pence to come down and break a tie.
  My colleagues and I came to the floor weeks ago to make clear that 
this harmful legislation should not come to the floor. Republicans 
didn't listen to us, and they didn't listen to women across the country 
who made it clear that restricting women's access to the full range of 
reproductive care is unacceptable. We are not going to give up. We are 
going to keep holding them accountable, and we are going to keep making 
sure that women's voices are heard.
  I want to thank all of my colleagues who have already come and will 
continue to come to the floor today to stand against this shameful, 
dangerous resolution.
  The march that was held after President Trump was inaugurated was one 
of the most inspiring events I have ever had the opportunity to be a 
part of. Millions of people--men and women--marched in Seattle in my 
home State, here in Washington, DC, and in cities and towns in between 
and all across the world. They carried signs, they chanted, and they 
made it absolutely clear that when it comes to women's rights and 
healthcare, people across the country do not want to go backward. Since 
then, millions of people have continued to speak up and stand up. And 
last Friday, by the way, was no different.
  Republicans have been threatening for years now to dismantle the 
Affordable Care Act, but it took just a few weeks for families 
nationwide to stand up and fight back and shut down a deeply harmful 
plan that would have taken healthcare away from tens of millions of 
people, spiked our premiums, targeted seniors for higher costs, and cut 
off access to critical services at Planned Parenthood.
  I was so inspired by the countless people who bravely shared their 
personal stories about their health and their loved ones in order to 
make clear just how damaging--and even deadly--TrumpCare would have 
been. I am proud to say that women led the way and made it known, in no 
uncertain terms, that Republicans would be held fully accountable for 
the disastrous TrumpCare legislation.
  And try as they might, last week, Republicans couldn't ignore them. 
This was an absolute, undeniable victory for women and families in this 
country.
  But while TrumpCare was dealt a significant blow last week, it is 
clear the terrible ideas that underpin it live on now, today, in this 
Republican Congress. It is unprecedented that we are here, with the 
Vice President breaking a tie vote on an attack on women's health 
across this country.
  We are here today, once again, because President Trump and 
Republicans in Congress are not getting the message. Today, continuing 
on their extreme, anti-women agenda, Senate Republicans are rushing now 
to roll back a rule that protects family planning providers from being 
discriminated against and denied Federal funding.
  Let me explain a little bit about what family planning providers mean 
to our communities. Those providers that are part of the title X 
program--which has, by the way, bipartisan history--deliver critical 
healthcare services nationwide, and they are especially needed in our 
rural and our frontier areas.
  In 2015 alone, title X provided basic primary and preventive 
healthcare services--services like Pap tests and breast exams and birth 
control and HIV testing--to more than 4 million low-income women and 
men at nearly 4,000 health centers. In my home State of Washington, 
tens of thousands of patients are able to receive care at these centers 
each year, and they often have nowhere else to turn for their 
healthcare. In fact, 40 percent of women who receive care at health 
centers funded by title X consider it to be their only source of 
healthcare.
  So taking resources away from these providers, which this resolution 
would do, would be cruel, and it would have the greatest impact on 
women and families who need it the most. It would undo a valuable 
effort by the Obama administration to ensure that healthcare providers 
are evaluated for Federal funding based on their ability to provide the 
services in question, not on ideology. In doing so, this resolution 
would make it even easier for States led by extreme politicians to deny 
family planning providers Federal dollars, not because of the quality 
of care that they get or provide or their value to the communities they 
serve, but based on whether the politicians in

[[Page 5131]]

charge--the politicians in charge--agree that women should be able to 
exercise their constitutionally protected right to reproductive 
healthcare.
  This is wrong. It is dangerous, and we cannot let this stand.
  If Republicans think that millions of people who stood up last week 
have suddenly stopped paying attention, they are sorely mistaken. And 
if they think that Senate Democrats are not going to fight back, they 
have another thing coming. They can expect every single Democrat in the 
Senate--and I hope some Republicans who are concerned about losing 
healthcare providers in their States--to fight back against this 
resolution with everything they have.
  This vote won by a tie vote, and the Vice President was the tie vote. 
It will take one Republican this afternoon on the final vote to say yes 
for the women in their State and States' rights to say no. That is all 
we are asking for the women of this country.
  While I have the floor, I want to say we should all be aware there is 
more headed our way. In a matter of weeks, we all know that government 
funding is going to run out. Everybody understands this. I know that 
since they didn't get their way last week and they are pushing this 
resolution so hard today to the point where they bring the Vice 
President to break a tie, it is a safe bet that extreme Republicans are 
going to try to attach riders that try to take away Planned Parenthood 
funding in the spending bill for the rest of this year.
  So I want to be very clear from the outset: That is a complete 
nonstarter. We have been here before. We have shown that we can win, 
and we are going to fight these efforts every step of the way.
  So I urge people across the country to let their Senators know that 
this is not acceptable. Stand up for women and families and for their 
rights to take care of their own reproductive healthcare at the 
facility that provides for them in their own communities.
  I urge my colleagues: Don't make the same mistake again. End the 
damaging political attacks on women, and stand with millions of women 
and men and families. They need us.
  Thank you.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Sullivan). The clerk will report the joint 
resolution.
  The senior assistant legislative clerk read as follows:

       A joint resolution (H.J. Res. 43) providing for 
     congressional disapproval under chapter 8 of title 5, United 
     States Code, of the final rule submitted by Secretary of 
     Health and Human Services relating to compliance with title X 
     requirements by project recipients in selecting 
     subrecipients.

  Mrs. MURRAY. 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. BLUMENTHAL. 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. BLUMENTHAL. Mr. President, I rise today in a near empty Chamber. 
Indeed, there is no Republican colleague here today. Our Republican 
colleagues have yielded back all their time on this resolution, and the 
reason they have yielded back all their time is that they apparently 
have no interest in appearing here and talking about a resolution of 
disapproval of a rule that is vital to ensuring that women have access 
to the family planning provider of their choice. It is really that 
simple.
  Defending Planned Parenthood is what we have done on this side. 
Defunding Planned Parenthood has been the interest on the other side of 
the aisle.
  They have also taken an inordinate interest in reinstating gender 
ratings in health insurance and are now damaging title X networks 
through this resolution. They have demonstrated an unmitigated desire 
to cut women's access to healthcare in order, apparently, to win 
political points. But their actions today show that the politics of 
this issue and, most importantly, the people of America are not on 
their side.
  Title X is a critical program delivering important family planning 
and preventive health services in underserved areas of our great 
Nation. In 2015 alone, title X programs provided basic primary and 
preventive healthcare services. We are talking about Pap tests, breast 
exams, birth control, and HIV testing for more than 4 million low-
income women and men at nearly 4,000 health centers across the country. 
For 40 percent of women, their visit to a family planning health center 
is the only healthcare they receive annually. Think of that number for 
a moment. Forty percent of those women have no access elsewhere except 
at these healthcare centers.
  By overriding this regulation, Republicans will allow States and 
title X grantees to pick and choose who provides these services based 
on arbitrary criteria that have nothing to do with the quality of 
services patients will receive. It is no wonder that none of them is 
here to talk about it. Now, if they were here--and they have said so in 
public--they might argue that they support this resolution because they 
oppose abortion. So let me be clear. This regulation is about access to 
family planning services, not about access to abortion.
  I know many of my colleagues disagree with me that abortion should be 
safe and legal. They have shown that disagreement by their repeated 
attempts to undermine Roe v. Wade and make it harder for women to 
access constitutionally protected healthcare.
  While they may disagree, it is still the law of the land. In any 
event, this regulation is not about access to abortion. This regulation 
is about ensuring that States cannot discriminate against qualified 
providers that are an essential part of a safety net that serves women 
who have no place else to go. Those providers are willing to provide 
necessary, culturally sensitive care to individuals who otherwise would 
simply be without access to that care.
  Title X funding does not go to abortion services. It goes to provide 
much needed family planning services. There is so much that the title X 
program does that I believe my colleagues would agree is absolutely 
vital to the health of women. I know we agree on wanting to reduce teen 
and unintended pregnancies. Without the contraceptive care provided by 
title X sites, the teen pregnancy rate would be 30 percent higher and 
the unintended pregnancy rate would have been 33 percent higher. We 
should agree on that point.
  We should also agree on wanting to find ways to save money in the 
healthcare system. In 2010, health services provided at title X centers 
resulted in net savings of $7 billion in Federal and State funds. Those 
savings are indicative of the fact that every dollar invested in 
publicly funded family planning saves taxpayers $7. That is a great 
deal for the taxpayers of our Nation. That is a humane and profoundly 
significant deal for the women whose lives are bettered. We should all 
agree that preventing disease and saving health and lives is not only 
about dollars and cents. It is about the future of our Nation.
  Title X began as a bipartisan program to support family planning 
services over 40 years ago, an era that was less divisive and when this 
Chamber was less divided. I urge my colleagues to recognize the 
importance of ensuring these services. States cannot restrict an 
already overburdened network of safety net providers.
  Family planning services are provided through State, county, and 
local health departments, as well as hospitals, family planning 
councils, Planned Parenthood, and federally qualified health centers. 
Providers that focus on reproductive health comprise 72 percent of all 
title X-supported sites, and they are critical to delivering high-
quality family planning services. They are particularly able to offer 
the full range of contraceptive methods and to help women start and 
effectively use the methods that will work best for them individually.
  There is simply no excess capacity in that safety net system now. For 
Republicans to allow States to remove providers from the networks based 
on arbitrary criteria is simply unwise and,

[[Page 5132]]

in fact, unconscionable. The foundation of the program's success is the 
longstanding intent that its provider network be designed by the 
communities it serves to help patients have access to trusted, highly 
qualified, family planning providers.
  Just a few weeks ago, I met with some providers and volunteers from 
Planned Parenthood of North Hartford. I was deeply impressed with their 
dedication, their skill, and their humanity. In a high-need, low-income 
community like North Hartford, access to primary care is limited. Young 
men and women who come to this clinic have chronic health conditions, 
such as diabetes, depression, high blood pressure, and headaches. Left 
untreated, they have to be addressed at emergency rooms at much higher 
costs.
  The clinicians recognized that there was an additional need for 
health services and for other providers in the community to meet them, 
but they were currently unable to do so. So they decided to initiate 
full-scope primary care services in Hartford, in addition to the 
comprehensive women's health services, so as to fully serve the men and 
women who choose to come to Planned Parenthood of North Hartford for 
their reproductive health and family planning care needs.
  Patients there are seen for acute conditions and chronic problems, 
physicals, preventive vaccinations, as well as services to quit 
smoking. If there were ever a cost-effective program anywhere in the 
United States, then the North Hartford project is a sterling example.
  Just to give one example, recently, a young woman came to this 
Planned Parenthood for birth control. She was found to have high blood 
pressure. So her provider started her on blood pressure medication and 
counseled her on dietary and lifestyle changes. She started exercising 
regularly and improved her diet, lost 30 pounds, and no longer needed 
the medication to control her blood pressure. Is that kind of treatment 
cost effective? The facts speak for themselves--the real facts--giving 
patients a choice, giving them a chance, giving them the counseling and 
care they need to save dollars and save lives.
  Community healthcare centers like that in North Hartford simply 
cannot accommodate all the family planning patients who would lose 
coverage or funding if title X funds to Planned Parenthood affiliates, 
like Planned Parenthood of Southern New England, are eliminated. That 
is a lesson of this Planned Parenthood that is undeniable.
  That may well be why our Republican colleagues have yielded back all 
of their time.
  The real facts are undeniable. The real need is irrefutable. My 
colleagues and I are here today not because we are asking for more 
money or a change in how the funding program is used. We are standing 
up and speaking out against shortsighted efforts that would restrict 
access to family planning services for some of the most vulnerable 
patients--many of them voiceless in these halls; faceless, otherwise--
in areas that are least able to absorb this cruel and inhumane change 
in the rules.
  I ask my colleagues to oppose this resolution and to stand strong for 
women's and men's healthcare across the country.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Hawaii.
  Ms. HIRONO. Mr. President, the Congressional Review Act, or CRA, 
resolution we are debating today is the latest attack in the 
unrelenting Republican crusade against funding--or defunding--Planned 
Parenthood. They have tried everything: passing stand-alone bills, 
attaching poison pills to must-pass bills, threatening a government 
shutdown, struggling and failing to pass TrumpCare.
  Today, we are debating whether to repeal an administrative action 
that protects abortion providers, like Planned Parenthood, that receive 
title X funding. Just a little while ago, Vice President Pence was here 
to break a tie because Republicans in Congress couldn't get enough men 
to tell women what to do with their bodies.
  For nearly 50 years, title X funding has helped low-income Americans 
access vital health services like birth control and cervical and breast 
cancer screenings. Title X funding has been a healthcare lifeline for 
millions of women in all parts of the country. But if this 
Congressional Review Act resolution is passed, Planned Parenthood 
clinics across our country can be prohibited from receiving title X 
funding, even though it is currently illegal to use Federal dollars to 
fund abortion services. Let me repeat: No Federal dollars can be used 
to fund abortion services, period.
  I understand the strong anti-abortion belief held by some of my 
colleagues, but I don't understand why this translates into relentless 
attacks on an organization that uses no Federal funds for abortion. 
Planned Parenthood uses Federal funds to provide vital healthcare 
services to millions of people, mainly women. Yes, I acknowledge there 
are men who go to Planned Parenthood also.
  In 2014, Planned Parenthood provided over 600,000 cancer screenings 
and over 4 million tests and treatments for sexually transmitted 
infections. But this is a factual argument, and we have learned over 
the years that many of my Republican colleagues simply will not listen 
to facts when it comes to Planned Parenthood.
  Let me share a few stories from my constituents about the 
transformational impact Planned Parenthood has had in their lives. 
Perhaps after hearing these stories, we will think twice about 
attacking the vital services Planned Parenthood provides all across our 
country.
  Hawaii is home to a large military community. Taylor from Honolulu is 
a military spouse who wrote to me that she and other military 
dependents turn to Planned Parenthood because of long wait times and 
confidentiality concerns within the military healthcare system. Taylor 
wrote:

       My friend was experiencing severe cramping and pelvic pain 
     to the point where she had to utilize a sick day. When she 
     visited the medical services provider through the military, 
     they scheduled her for an appointment for four days out. She 
     was sent home with no pelvic exam or ultrasound. The pain was 
     so severe that she went to Planned Parenthood because she 
     could not wait to see her primary care physician. They 
     immediately performed a pelvic exam, an ultrasound, and an 
     STD screening. She was diagnosed with pelvic inflammatory 
     disease. Annually, 100,000 women become infertile as a result 
     of PID, so receiving quick treatment for this condition is 
     critical.

  Taylor continued:

       Defunding Planned Parenthood means that individuals who 
     experience common reproductive healthcare issues like this 
     would have lessened chances of receiving quick, necessary and 
     comprehensive medical care. Had it not been for Planned 
     Parenthood, she could have lost her ability to have children 
     in the future.

  Do my Republican colleagues want to deprive military spouses of vital 
healthcare services?
  I also heard from Tiffany, a student at the University of Hawaii, who 
went to a Planned Parenthood clinic after a pregnancy scare. She wrote:

       I was afraid because I knew that having a child was beyond 
     my means. I was just starting out my university years at 21; 
     and I have extremely conservative parents who would have 
     surely not approved of my actions. I knew how difficult 
     having a child was for someone in my situation, especially 
     while going to school, and risking sacrificing my future, my 
     key to stepping out of poverty, was not an option. I was 
     unemployed and had Medicaid at the time as well, and Planned 
     Parenthood accommodated my financial situation.
       Thankfully, I discovered I was not pregnant, and Planned 
     Parenthood took the extra time to sit me through my options 
     without any judgment whatsoever. I was also prescribed birth 
     control, offered an STD test, and was given Plan B in the 
     event I ever missed my birth control. The sense of relief, 
     reassurance, and care I felt walking out of the clinic left 
     me with a very strong impression, especially after so many 
     days of anxiety.

  Do my Republican colleagues want to take away resources that help 
thousands of young women like Tiffany fulfill their full potential?
  These stories aren't rhetoric. They aren't hyperbole. They aren't 
spin. They are powerful reminders that each day, women turn to Planned 
Parenthood in a time of need.

[[Page 5133]]

  Some of my colleagues have argued that all these thousands of women 
who go to Planned Parenthood clinics can go to community health centers 
if Planned Parenthood clinics have to close because of defunding.
  This morning, I met with over a dozen leaders from Hawaii's community 
health centers. So I asked them, could you take in all of Planned 
Parenthood's patients? Their answer was an unequivocal no. Our 
communities cannot afford to lose Planned Parenthood clinics.
  A vote for this CRA is a vote to deprive women like Taylor and 
Tiffany and millions more throughout our country of these important 
healthcare services. Let's stop these attacks on women's healthcare. I 
urge my colleagues to vote no.
  I yield the floor.
  The PRESIDING OFFICER (Mrs. Fischer). The Senator from New Hampshire.
  Mrs. SHAHEEN. Madam President, I come to the floor to join my 
colleagues in opposing this misguided measure, which would leave 
millions of women and families with fewer healthcare options, and it 
would drastically decrease women's access to basic primary and 
preventive health services, including lifesaving cancer screenings and 
HIV testing.
  Make no mistake about it, as my colleagues have said, the primary 
target of this legislation is Planned Parenthood. For years now, we 
have seen Republican leaders in Congress attempt to defund this 
essential healthcare provider, which serves millions of women 
nationwide, including nearly 12,000 women in New Hampshire, most of 
them with incomes below or near the poverty line. The sad irony of 
these attacks is that study after study has shown that restricting 
access to birth control and other family planning methods actually 
increases the number of abortions.
  The authoritative Guttmacher Institute estimates that in 2014 alone, 
contraceptive care provided under title X helped women avert more than 
900,000 unintended pregnancies and 326,000 abortions. Without 
contraceptive care provided by title X funded centers, the U.S. rates 
of unintended pregnancy and preventable abortions would be an estimated 
33 percent higher, and the teen pregnancy rate would be 30 percent 
higher.
  At the end of the Obama administration, teen pregnancy in the United 
States was at its lowest point since we have been keeping track. As 
Senator Hirono said, these services don't provide abortions. Federal 
law expressly forbids the use of Federal funds to pay for abortion, 
except to save the life of the mother.
  So the real issue here is not about abortion. This is about ensuring 
that American women have access to the basic healthcare they need, 
where they want to receive it. This is just a mean-spirited effort to 
keep women from seeing the provider they want to see and getting care 
at rates they can afford. For 40 percent of women, their visit to a 
family planning center is the only care they receive annually.
  In 2015 alone, title X provided basic primary and preventive 
healthcare services such as Pap tests, breast exams, birth control, and 
HIV testing to more than 4 million women and men at nearly 4,000 health 
centers. Planned Parenthood plays an essentially important role in 
delivering health services to low-income, uninsured, and vulnerable 
individuals, including in rural areas.
  I am sure that every person in this Chamber has received letters and 
emails and phone calls from constituents on this issue. They are 
pleading with us: Don't take away our access to healthcare from Planned 
Parenthood.
  I received a letter from Sandra Sonnichsen of Goshen, NH. She writes:

       Planned Parenthood was my only affordable source of 
     gynecological healthcare for most of my life. I received 
     good, wise, and thoughtful care. I think it is not extreme to 
     say they saved my life. Abortions were not involved. They--

  Meaning Planned Parenthood--

     remain very important, especially for poor or uninsured 
     women. There are not enough alternate low cost women's 
     clinics available. Not providing birth control services to 
     women who want it is not a good economic or social solution. 
     Don't let it be defunded.

  In a follow-up call, Sandra said that without Planned Parenthood, she 
would not have had any healthcare at all. Because her mother died of 
breast cancer, Sandra is deeply grateful that she has been able to 
receive mammograms, thanks to Planned Parenthood.
  I also heard from Meredith Murray of Exeter, NH. She says:

       Nine years ago I graduated from college and immediately 
     began my journey to become a medical provider. . . . During 
     this time in my life, I was surviving almost entirely on 
     student loans. And I knew that during this time, especially, 
     I needed to ensure that I was doing all I could to prevent 
     pregnancy. . . . With my insurance--an IUD would have cost 
     $900. That was not possible for me to afford. Then I 
     remembered--Planned Parenthood. . . . I was informed, due to 
     title X funding, my IUD would be completely covered. I 
     continued to use Planned Parenthood services for the next 5 
     years for my routine screenings while in medical school. The 
     care I received was phenomenal. As I proceeded through my 
     medical training, I strived to be as kind, compassionate, and 
     knowledgeable as those who work Planned Parenthood health 
     centers. I am now a practicing medical provider, married, and 
     still using an IUD because Planned Parenthood offered me that 
     opportunity.

  I received this letter from Samantha Fox of Bow, NH. She writes:

       In 2007, I was a 19-year-old just barely starting out when 
     I was denied health insurance due to a preexisting condition. 
     Had I been able to access affordable coverage, my preexisting 
     condition, a reproductive system disorder, would have been 
     easily manageable. . . . At that time, I was able to access 
     care through Planned Parenthood, which likely preserved my 
     ability to conceive in the future.

  And finally, let me share this message from Robina Parise of Rye, NH. 
She says:

       I started utilizing the services at Planned Parenthood for 
     birth control when I was about 17 years old. . . . Planned 
     Parenthood made sure I was protected and healthy. They gave 
     me access to vital protection and healthcare when I could not 
     get it anywhere else. They regularly called me with reminders 
     to have exams and to pick up my prescription. Planned 
     Parenthood is the reason my husband and I were able to 
     graduate from high school and college. . . . I'm not sure 
     what our lives would be like now without their support.

  I don't know. Do the people who are voting for this CRA believe it 
would be better to have allowed the people whom I just talked about--to 
prohibit their access to these healthcare services so that their lives 
would have been disrupted, so they might not have finished college, so 
we wouldn't have another doctor in the world, so they wouldn't be able 
to afford healthcare? I hope we will listen to our constituents who 
have been speaking out in passionate support of Planned Parenthood and 
other family planning clinics.
  This is about respecting women's access to healthcare services, 
including millions of vulnerable women who have nowhere else to turn 
for essential care. This is also about respecting women's 
constitutionally protected right to make our own reproductive choices. 
We must not allow Congress to strip away investments in family planning 
clinics by allowing States to discriminate.
  Finally, I want to point out that we haven't heard from any of our 
colleagues on the other side of the aisle who are voting for this 
measure about why they think it is so critical. I don't know. Maybe 
they are not willing to come to the floor and tell my constituents why 
they should be denied access to healthcare from the provider they want. 
Well, I am disappointed that we haven't heard from anyone who is 
willing to stand up and defend this vote. I hope they are going to have 
to defend it to the American people.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Madam President, I want to thank my colleagues who are 
here speaking out against this shameful resolution that is before us 
today that goes after women's rights and their opportunity to make 
their own healthcare decisions with their own provider.
  I, too, want to echo the comments that were just made. I find it 
amazing that the Republicans have yielded back all of their time. They 
are not going to come out here and defend their vote; they are just 
going to take the vote.

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  In fact, it seems clear to me that President Trump is clearly focused 
on attacking women's healthcare--so much so that he sent his women's 
health adviser, Vice President Pence, here just moments ago to break a 
tie on this latest disgusting attack on women's healthcare. It is truly 
appalling.
  Women and men across the country are watching what is happening here 
today, watching what Republicans are trying to do, and they are paying 
attention.


                       Nomination of Neil Gorsuch

  Madam President, I wish today's resolution was the only shameful 
attack on women's health to talk about, but sadly that is not the case. 
So I do want to take a few minutes at this time to talk about another 
one that is very critical to women and families--not just today, but 
actually for years and years to come it will be happening, and that is 
the Supreme Court.
  Last week I announced I would be voting against Judge Neil Gorsuch's 
nomination to the Supreme Court, and I will oppose a cloture motion 
ending debate. I did not reach that conclusion lightly. I consider my 
decisions about whether to support a lifetime appointment to the 
Supreme Court to be among the most important and consequential choices 
I make as a Senator. But I made it in part because this is not a normal 
nomination.
  This process really began about 12 months ago when Senate Republicans 
refused to even consider President Obama's nominee to the Supreme 
Court, Judge Merrick Garland. And because since President Trump entered 
office, he has shown complete disregard for the law, for our 
Constitution, for the well-being of families across the country, 
leaving me unable to trust that he is acting in our Nation's best 
interest, I am unable to support his choice for the Supreme Court.
  In addition to my deep concerns about this process and this 
administration, I also have strong concerns about this nominee 
specifically. Today, as Republicans appear to be rushing Judge 
Gorsuch's nomination through the Judiciary Committee as fast as they 
can, I want to lay out why putting Judge Gorsuch on the Supreme Court 
would be an attack on women's health, rights, and opportunity, one that 
has the potential to undo decades of progress we have made toward 
making sure women are equally able to participate in and contribute to 
our country.
  The Trump administration has broken almost every one of its promises, 
but one it has certainly kept is its promise to do everything in its 
power to turn back the clock on women's health and women's rights. 
Extreme Republicans in Congress are doing the same and have more, 
apparently, in store. Right now, we are debating whether to undo a rule 
that prevents discrimination against family planning providers based on 
the kinds of services they provide to women. Congressional Republicans 
are already gearing up to attach riders to the coming budget bills in 
order to cut off access to critical services at Planned Parenthood for 
millions of patients in this country. There are similar attempts to 
undermine women's access to healthcare in cities and States nationwide.
  More often than we would like, the Supreme Court is going to be the 
place of last resort for protecting women's hard-fought gains. The buck 
has to stop with the Supreme Court on women's health and rights.
  I do not want Judge Neil Gorsuch anywhere near the bench. Time and 
again, Judge Gorsuch has sided with the extreme rightwing and against 
the tens of millions of women and men who believe that in this 21st 
century, women should be able to make their own choices about their own 
bodies.
  Let me give a few examples. When the Tenth Circuit ruled in the case 
of Hobby Lobby v. Burwell that a women's boss--a woman's boss--could 
decide whether her insurance would include birth control, Judge Gorsuch 
didn't just agree, he thought the ruling should have gone further. That 
alone would be enough for me to oppose this nomination, but 
unfortunately there is more.
  Judge Gorsuch has argued that birth control coverage included in the 
ACA as an essential part of a woman's healthcare--one that has now 
benefited 55 million women--is what he calls a ``clear burden'' on 
employers that would not long survive.
  When it comes to Planned Parenthood, he has already weighed in on the 
side of defunding our Nation's largest provider of women's healthcare. 
What was his reasoning? Well, Judge Gorsuch thought that in light of 
completely discredited sting videos taken by extreme conservatives, 
women in the State of Utah should have a harder time accessing the care 
they need. Just this week, the makers of those false videos, by the 
way, got 15 felony charges. Women deserve independence and objectivity 
in a Supreme Court Justice, and that is clearly not it.
  Attempts to control women's bodies aren't always about reproductive 
rights. Sure enough, Judge Gorsuch is on the wrong side here as well. 
He concurred in a ruling against a transgender woman who was denied 
regular access to hormone therapy while she was in prison. This ruling 
rejected the idea that under our Constitution, denying healthcare 
services is cruel and unusual punishment. Think about that. That is not 
the kind of judgment I want to see on the bench, and I think most 
families would agree.
  I also want to be clear as well about what Judge Gorsuch's nomination 
could mean for a woman's constitutionally protected right to safe, 
legal abortion services under the historic ruling in Roe v. Wade, which 
was, by the way, reaffirmed just last summer by the Court. In his 
nomination hearings, Judge Gorsuch wouldn't give a clear answer on 
whether he would uphold this ruling which has meant so much to so many 
women and families over the last four decades.
  Judge Gorsuch has donated repeatedly to politicians who are dead-set 
on interfering with women's constitutionally protected healthcare 
decisions, and he has even made deeply inaccurate comparisons between 
abortion and assisted suicide.
  I remember the days before Roe v. Wade very clearly. I heard and saw 
firsthand the stories of women faced with truly impossible choices 
during those times. Women from all across the country have shared 
deeply personal experiences because they know what it would mean to go 
backward. I know that millions of women who have already done so much 
to lead the resistance against this administration and its damaging, 
divisive agenda are going to fight this nomination as hard as they can. 
They know the Trump Presidency will be damaging enough for 4 years, but 
Judge Gorsuch's nomination could roll back progress for women over a 
lifetime. I am proud to stand with them and do everything I can to make 
sure they are heard loud and clear here in the Senate, and I oppose 
Judge Gorsuch's nomination in light of everything it would mean for 
women now and for generations to come. Next week is when we will vote 
on that.
  Today here in the Senate, we just saw a historic moment. The Senate 
Republicans put forth a resolution that would allow States to deny 
funding to providers in their States who provide healthcare services 
for women--funding that is desperately needed. They got only 50 votes, 
and those in opposition got 50 votes, so they brought over the Vice 
President of the United States, and he broke that tie in order for us 
to be here to debate this resolution now. This vote will now occur, 
under the order, later this afternoon, and he will be brought back once 
again to deny women the healthcare choices they deserve to have. It is 
a sad day for the Senate.
  I want my friends, colleagues, and the women who have stood up and 
have spoken out since the day after the election, marched here in 
Washington, DC, and across the country, to know that I stand with them. 
My voice will not be silenced. I will continue to fight back.
  I will say one more time that it will take one more Republican on the 
other side this afternoon--one--to stand up and let their voice be 
heard and say that women should get access equally in their States for 
the healthcare they deserve.
  Madam President, I yield the floor.

[[Page 5135]]

  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. CARDIN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CARDIN. Madam President, I rise to express my strong opposition 
to H.J. Res. 43, a resolution of disapproval with respect to the title 
X regulation--a resolution which effectively endorses discriminatory 
practices toward family planning and safety net providers.
  Title X is the Nation's only Federal grant program that is dedicated 
solely to providing individuals with comprehensive family planning and 
related preventive health services. Last year, title X funding made it 
possible for nearly 4,000 health centers to provide basic primary and 
preventive healthcare services to over 4 million low-income women and 
their families. I am talking about critical services, such as Pap 
tests, cervical cancer screenings, contraception, breast exams, and HIV 
testing.
  In Maryland, there are 55 title X funded health centers that span the 
State. These include federally qualified health centers, local health 
departments, Planned Parenthood clinics, and school-based health 
centers. In fiscal year 2015, Maryland received over $3.8 million in 
title X funding and provided health services to over 64,000 patients. 
These are low-income, underinsured, and uninsured individuals who would 
otherwise lack access to such basic healthcare.
  As many of my colleagues know, Planned Parenthood, a high-quality 
health provider, has been under constant attack by the Republicans, who 
want to eliminate the organization's Federal funding. Just last week, 
the Republicans' Affordable Care Act repeal-and-replace bill threatened 
to defund Planned Parenthood, which is a trusted healthcare provider, 
by eliminating clinics' Medicaid reimbursements. This week, Republicans 
want to roll back protections that were put in place for family 
planning clinics and allow for discrimination against our Nation's 
family planning providers.
  What I find even more disappointing is that this is a major policy 
shift for our Nation, and we are using a procedure known as the 
Congressional Review Act to make that decision. Yet those who support 
this are not even taking to the floor to defend it. This is outrageous 
that one would use a procedure to repeal this type of funding and not 
even be on the floor to defend those actions.
  In December of 2016, the Obama administration finalized the 
regulation before us today to protect family planning providers from 
such discrimination. The regulation was intended to protect access to 
care in States that have issued their own regulations and legislation 
that block family planning providers from receiving title X funds. By 
overriding this regulation, Republicans will empower States to pick and 
choose who provides these services, but it will be based on arbitrary 
criteria that will have nothing to do with the quality of services the 
patients will receive. Republicans are actively condoning 
discrimination against providers, which will, ultimately, deny women 
and their families access to family planning and preventive health 
services.
  It is not just Democrats who are concerned. Multiple healthcare 
providers have come out against this resolution because discrimination 
against any healthcare provider is wrong. Let me name just a few of the 
groups that oppose this action: the American Academy of Pediatrics, the 
American Academy of Family Physicians, and the American Congress of 
Obstetricians and Gynecologists. They are all alarmed because they know 
low-income, underinsured, and uninsured patients will be unable to 
access needed health services if it passes.
  In Maryland, for example, 84 percent of the 64,000-plus patients 
served with title X funds have incomes at or below 100 percent of the 
Federal poverty line. That means that they earn $11,770 a year or 
less--under $12,000 a year. How do you expect these families to be able 
to get their healthcare needs met if this resolution of disapproval is 
passed? Ninety-four percent of title X patients in Maryland earn less 
than $29,425 a year. Overturning this regulation will hurt our most 
vulnerable communities.
  Let's be clear about this. This is not about abortion. There is no 
Federal funding for abortion. This is about low-income men and women 
not having access to pregnancy testing, contraceptive services, pelvic 
exams, high blood pressure and diabetes screenings, STD and HIV/AIDS 
screenings, infertility services, and health education. It is a war on 
the poor, and it is a war on access to preventive healthcare.
  The American people deserve better from their elected officials. I am 
committed to fighting these reckless attempts to repeal a reasonable 
regulation that has been promulgated to prevent discriminatory 
practices that will harm thousands of low-income women and their 
families in Maryland and across our Nation.
  I urge my colleagues to reject this procedural resolution, which will 
allow discrimination and deny adequate care to low-income families.
  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.
  Ms. WARREN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Sasse). Without objection, it is so 
ordered.
  Ms. WARREN. Mr. President, since coming to Washington, I have 
observed something interesting about Republican politicians. 
Republicans talk a big game about respecting women, but when it comes 
time to vote on laws to help real, live, American women, a lot of 
Republicans turn their backs.
  Take Paul Ryan, Speaker of the House of Representatives. Just a few 
months ago, Speaker Ryan was adamant that American women deserve 
respect. ``Women,'' he said, ``are to be championed and revered.''
  ``Championed and revered''--so what exactly does championing and 
revering women mean to Speaker Ryan? Does it mean he will promote 
policies that make us healthier, that he will help us access basic 
medical services, that he thinks we can make our own decisions about 
our bodies without government interference? No.
  Over the past few months, Speaker Ryan has worked overtime on the 
American Health Care Act--a bill that would make it harder for millions 
of women to access healthcare. That miserable bill even included a 
special provision singling out certain health clinics and stripping 
them of the funding they use to provide women's health services.
  Last week, Paul Ryan failed to get that bill out of the House, but 
Republicans are back to take another shot at cutting women's access to 
healthcare. This time the plan is to undermine the title X family 
planning program. This plan, just like their healthcare bill, is 
incredibly unpopular, even with Republicans who had to rush Vice 
President Pence over from the White House this morning to cast a 
deciding vote to start this debate on attacking women's healthcare.
  Title X is a bipartisan program started back in 1970. It is the only 
Federal grant program dedicated to providing Americans with high-
quality, low-cost family planning services. Title X funded clinics 
provide birth control, cancer screening, STI testing, and counseling. 
Just so there is no confusion about this, title X dollars cannot be 
used to fund abortion services--none.
  In 2015 alone, title X clinics helped 2.9 million women access birth 
control. They provided over 700,000 Pap smears, performed 1.1 million 
HIV tests, and gave over 1 million breast exams. And Paul Ryan's way of 
making sure that women are ``championed and revered'' is to try to 
reduce their access to these lifesaving services.
  Last December, the Department of Health and Human Services passed a 
very simple rule to keep States from pulling political shenanigans to 
shut

[[Page 5136]]

down women's health centers. The rule prevents States from blocking a 
healthcare provider from the program ``for reasons other than its 
ability to provide Title X services.'' In other words, follow the law. 
If a provider is doing a bad job at delivering family planning 
services, by all means, kick them out of the program. But you don't get 
to kick someone out because you don't like the name of their 
organization or you don't like their politics or because of your 
politics or because of any other dumb reason that has nothing to do 
with their ability to deliver women's health services.
  In February, House Republicans voted to overturn this rule. So Paul 
Ryan's version of championing and revering women is to let States close 
down women's health centers. Now Senate Republicans plan to do the same 
thing. Sure, Republicans give a bunch of reasons, but American women 
are not stupid. We know pretext when we see it. So let's just call it 
like it is. Republicans want to weaken the title X program because they 
want to make it harder for women to access reproductive health clinics, 
like Planned Parenthood, that also provide safe, legal abortion 
services.
  Just so we are clear, there are over 3,900 title X funded health 
centers. Only 10 percent of those health centers are affiliated with 
Planned Parenthood. The vast majority of centers getting title X money 
have nothing to do with Planned Parenthood, and the vast majority of 
Planned Parenthood's activities have nothing to do with abortion. But 
women should be able to choose a reproductive health provider without 
the interference of Republican politicians, and millions of women 
choose Planned Parenthood every year. The Congress representing those 
women should stop demonizing Planned Parenthood and stand with Planned 
Parenthood.
  Yes, as it stands, title X makes sure that if women's healthcare 
centers, including Planned Parenthood, offer first-rate care, then 
their work will be reimbursed. The Senate should reject any efforts to 
change that.
  Women in this country work their tails off. They should be able to 
choose their own healthcare providers. They don't need a ``champion'' 
to choose for them. They don't need to be ``revered'' into passive 
silence. Women want the respect that they deserve and to be able to 
access medical care without Republican politicians getting in the way.
  Mr. President, 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. BROWN. 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. BROWN. Mr. President, I rise in opposition to the title X CRA. It 
is just a continued abuse of power, something we have never seen in 
this body--one after another, after another, along party-line votes--to 
overturn rules and overturn decisions that this government has made. It 
is disgraceful that this body is debating yet another effort that will 
threaten a woman's right to healthcare.
  Title X ensures that women across the country have access to 
affordable healthcare, including family planning at clinics that are 
convenient and affordable. These are a vital resource for preventive 
care and for primary care.
  Overturning this rule will allow States to discriminate against 
providers, allow States to pick and choose and potentially put 
thousands of healthcare centers out of business. We know that because 
we have seen this kind of activity in some State legislatures. These 
clinics are often the only places women and men have to turn to for 
basic health services.
  Why do this in the same week that the House, fortunately, failed to 
throw 20 million people off of health insurance and throw off 200,000 
Ohioans who are getting opioid addiction treatment and who have 
insurance because of the Affordable Care Act? The House did not do 
that, but now the Senate wants to do this? Again, it compromises 
people's healthcare, as it takes away, in some cases, their insurance 
and, in other cases, their clinics and health services they cannot get 
elsewhere.
  Some 6 in 10 women who turn to title X for visits to family planning 
health centers say it is their regular source of healthcare. Many of 
them have nowhere else to turn. They either cannot afford healthcare 
elsewhere or they live too far away from another health center for 
there to be meaningful access to basic healthcare.
  Let's be clear. This is not about defunding abortion, clearly. The 
Federal Government does not provide funding for abortions. I will say 
that again. The Federal Government does not provide funding for 
abortions, period. I support a woman's right to make a personal, 
private healthcare decision for herself and with her doctor. No matter 
your personal feelings about abortion, whether you call yourself pro-
choice or pro-life or something else, surely, we can agree that cancer 
screenings and programs that have helped bring down Ohio's teen 
pregnancy and STD rates are a good thing. Cutting these services will 
have a real and serious impact on women and families across Ohio.
  If these actions by men--and it is, overwhelmingly, by men in 
Washington--whose healthcare is paid for by taxpayers continue to chip 
away at women's healthcare access, we will see more undiagnosed 
cancers, more untreated illnesses, and more unintended pregnancies.
  I emphasize again that these are mostly men in this body, or men down 
the hall in the other body, who are voting--men with insurance that is 
paid for by taxpayers. Their insurance is subsidized by tax dollars. 
Last week, down the hall, they voted to take away healthcare--in this 
case, mostly for women but also for men--for people who are getting 
opioid treatment.
  In case after case, privileged Members of this body, who get 
insurance paid for by taxpayers, take healthcare services away from, 
literally, millions of Americans. It is shameful. It is morally 
questionable. It is something we, simply, should not do.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. LEAHY. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Perdue). Without objection, it is so 
ordered.
  Mr. LEAHY. Mr. President, what is the legislative situation?
  The PRESIDING OFFICER. The Senate is considering H.J. Res. 43.
  Mr. LEAHY. Mr. President, I wish to speak for just a few minutes 
about H.J. Res. 43. I see this as a misguided and unfortunate attack on 
healthcare for women. Certainly that is what I am hearing from women 
from the State of Vermont.
  Three months into the 115th Congress, the Senate has yet to consider 
real legislation aimed at addressing the many challenges we Americans 
face today. Instead, the Senate, with simple-majority votes--
permissible through the rarely used Congressional Review Act--is 
rolling back key protections for the American people that were put in 
place by the last administration. Never mind that the current 
administration has the power to address certain aspects of regulations 
that they wish to rewrite. No. They could address these. They could 
seek a rewriting of them. They could seek legislation. But, instead, 
Republicans in Congress are intent on using this blunt procedure to 
unravel years of very careful and deliberative work. These raw power 
plays are part of the Trump-Republican ``know-nothing, anti-science'' 
agenda, in which the winners are not the American people. They are not 
the women of my State. They are not the average person you might meet. 
Instead, they are typically the wealthy and powerful special interests 
and big polluters. They win, and the losers are real Americans.
  Today, we are considering the 12th such resolution, one that rolls 
back protections under the Title X program. Title X of the Public 
Health Service Act is the only Federal grant program dedicated to 
providing those eligible

[[Page 5137]]

with comprehensive family planning and preventive health services. In 
rural areas--and every single State has a rural area, but my State is 
especially rural--we know that Title X is crucial in making sure women 
have access to the basic healthcare they need. Unfortunately, in recent 
years, some States have made exceptions about which providers may 
deliver services under Title X, excluding family planning clinics.
  Seeing the burden these rules would place on women seeking 
healthcare, the Obama administration finalized a regulation in December 
2016 that protects these providers from this type of discrimination, 
and women from these hardships. The resolution we are considering today 
would undo this regulation, once again allowing States to discriminate 
against providers, thereby limiting access to healthcare services for 
millions--that is not hyperbole; it really is millions--of women and 
their families. Worse still, the resolution would prevent a similar 
rule or regulation from being implemented in the future.
  In Vermont, our sole Title X provider is Planned Parenthood. Even in 
a State as rural as Vermont, no one has to drive longer than 45 minutes 
to reach a clinic. That is important to us. We consider 4 to 5 inches 
of snow a heavy dusting, but we often have 10 to 15 inches of snow. 
Nobody should have to drive farther than that to reach healthcare.
  This type of access is critical for those who need these services. It 
is especially important because for 40 percent of women, their visit to 
a family planning health center is the only healthcare they receive 
during the year. Vermonters are lucky because our State recognizes that 
this issue isn't about abortion, it is about ensuring the best network 
of providers for the people of our State. But other States have already 
worked to undermine family planning clinics like Planned Parenthood.
  The passage of this resolution will allow these discriminatory 
efforts to advance, especially discriminatory efforts against women. 
There is no question about it: A vote for this resolution is a vote 
against women. This resolution would not only affect the lives of 
millions of American women, but it would also affect the lives of men 
and young people who trust and depend on family planning clinics for 
their basic healthcare needs, including for annual health exams, 
cervical and breast cancer screenings, and HIV screenings.
  Last year in Vermont--keep in mind that Vermont has a population of 
just over 600,000 people--Planned Parenthood centers provided vital 
primary and preventive services to more than 16,000 patients. In a 
small State like Vermont, this harmful impact cannot be overstated.
  Those who support this resolution argue that the States should be 
able to determine who receives Title X grants, and that women under 
this program can simply find another clinic to go to. Well, that is 
simply not the case. In fact, that argument is false. It is a lie. 
Family planning clinics overwhelmingly serve populations in rural and 
medically underserved parts of the country where access to healthcare, 
especially for low-income individuals, is difficult.
  It is easy--easy--for Senators to vote to cut off this healthcare for 
women and children and people in rural areas because each one of us, if 
we need healthcare, can walk 2 minutes down this hall and walk to the 
Capitol physician and say ``I am a U.S. Senator. I need healthcare,'' 
and we are going to get it. While that may be the reality for 100 
people in this body, it is not the reality for millions and millions of 
people in every single State we represent.
  What this partisan resolution would do is force women and families in 
States who depend on family planning clinics for their healthcare to 
find another doctor--and often very few are available--or what is more 
likely, go without care at all. So they don't get preventive care, they 
don't get checkups, and they don't find the first indication that they 
may be facing melanoma or some other serious health problem. That 
undermines all of our efforts, which we should be joining, to 
strengthen our Nation's healthcare system, to try to make our 
healthcare system at least as good as many other countries', and to 
ensure access to care for everyone.
  This Republican resolution marks just the latest overreach and 
intrusion into women's healthcare.
  We even voted for a resolution to allow people to spy on what you do 
on the internet, and then sell that information for their own profit, 
destroying your privacy, but making money doing it.
  Until the House failed to even take it up, the Senate was scheduled 
to consider a reconciliation bill this week that would have defunded 
Planned Parenthood and would have allowed health insurers to deny 
coverage for maternity care, thus requiring women to pay more for 
health insurance.
  In the last Congress, it was more of the same--deny coverage for 
maternity care, and then go out and say: We believe in the right to 
life. Clearly not so much for the mother when she needs maternity care.
  Should we really walk back from the remarkable progress we have made 
as a nation in women's health? Of course not. But I am concerned that 
we will still see the same irresponsible attack surfacing again and 
again.
  Look, it is 2016; it is not 1917. It is time for the mean-spirited 
and ideological assaults on women's healthcare to end. Women are not 
second-class citizens. My wife is not, my daughter is not, and my three 
granddaughters are not. They deserve the same access to care as men.
  I urge my colleagues to vote against this resolution that will 
degrade the healthcare and access to healthcare, of so many Americans.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mrs. GILLIBRAND. Mr. President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mrs. GILLIBRAND. Mr. President, I rise to oppose the title X 
Congressional Review Act resolution of disapproval.
  This resolution would permit discrimination against family planning 
healthcare providers that provide primary preventive and reproductive 
healthcare services to millions of women around the country. It will 
allow States to take away Federal funding from family planning clinics 
and make it much harder for millions of American women to meet with 
their healthcare providers and access basic care.
  I am struggling to understand, amidst all these problems we are 
having to solve in this country and around the world, why this Congress 
seems to have such a singular fixation on controlling women's access to 
basic healthcare. This legislation is so far out of touch with the 
actual needs of our constituents. If we cut funding for women's health 
clinics, is that going to create more good-paying jobs? Is it going to 
open more factories in our upstate rural towns? I don't believe it 
will. It is certainly not going to make anyone healthier.
  There are millions of American women, including thousands of women in 
my State of New York, who rely on title X health clinics for 
treatments, preventive care, and for family planning services. They 
need these health clinics because they provide contraception 
counseling, cancer screening, and medical expertise right there in 
their communities. Many of the women who use these services have 
nowhere else to go for access because title X clinics are often the 
only affordable option for them and may even be the only place within 
driving distance of their communities. Yet, once again, my colleagues 
are pushing legislation to limit women's options for accessing 
healthcare and making it harder for thousands of New York women to get 
the care and treatments they need. I continue to be amazed by how 
little empathy there seems to be for millions of women in our country 
who don't have the resources to travel to a major hospital outside of 
their communities and desperately need these local clinics to stay 
healthy.

[[Page 5138]]

  Let's be very clear about who this legislation would hurt the most. 
This bill will hurt women in small towns and rural communities more 
than anyone else. It will cause lower income women to struggle even 
more. Every single one of my colleagues has many women in their States 
who rely on title X clinics and would suffer if these clinics had their 
Federal funding taken away.
  So I urge my colleagues in this Chamber: When it is time to vote on 
this legislation, think about the women who live in your States. Think 
about the women who live in small towns and rural communities who are 
just trying to access basic women's healthcare services that they can 
afford. Think about the women who don't have big hospitals or big 
cities nearby. Think about the women who don't have enough money to 
travel. The bill is going to hurt them. It will make their lives 
harder, not easier.
  We all have the responsibility to stand up for the women in our 
States, and that includes defending their access to healthcare and 
basic family planning services. I urge my colleagues to vote against 
this very discriminatory resolution.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Ms. HASSAN. Mr. President, I rise today in opposition to the 
Congressional Review Act measure, which would allow discrimination 
against title X family planning providers, which in turn could roll 
back access to family planning and preventive health services for women 
and their families in New Hampshire and across our country.
  Throughout my time in public service, I have always fought to ensure 
that women have meaningful access to the healthcare they need. I have 
fought to ensure that they can make their own healthcare decisions, 
and, in doing so, control their own destinies.
  To compete economically on a level playing field, women must be able 
to make their own decisions about if--or when--to start a family. They 
should not have to pay more than men do for healthcare. They should be 
able to visit providers of their own choice who understand their 
healthcare needs. To fully participate not only in our economy but also 
in our democracy, women must be recognized for their capacity to make 
their own healthcare decisions, just as men are. They also must have 
full independence to make their own health decisions, just as men do.
  During my time as Governor of New Hampshire, I restored family 
planning funds and pushed to restore State funding for Planned 
Parenthood, and I am going to continue fighting to ensure that women 
have the care they need, while standing firm against efforts here in 
Congress to roll back the progress that has been made.
  Unfortunately, the vote we are taking today is a continuation of a 
partisan agenda that has been focused on restricting the care that 
women and their families can receive. The fact that Vice President Mike 
Pence was called in to cast the deciding vote to advance this measure 
shows just how far Republican leadership will go in order to undermine 
women's access to critical healthcare.
  For more than 40 years, title X has provided women and their families 
with comprehensive family planning and preventive health services. When 
the legislation was originally passed in 1970, it was part of a 
bipartisan effort, with the support of prominent Republicans. In the 
years that have followed, title X has been essential in delivering 
important services to some of our Nation's most underserved 
communities. That is why, in New Hampshire, title X and Planned 
Parenthood still have broad support in our communities, even if they 
have been the subject of political gamesmanship here in Washington.
  Title X has support from Granite Staters because they have seen the 
real difference it has made in their lives and in the lives of their 
neighbors. They know that in some parts of the State there are no other 
options or, if other options do exist, they don't provide women with 
the same expertise and commitment to reproductive health that title X 
providers do.
  For those in rural communities, for low-income women and men, and for 
members of the LGBTQ community, title X supported health centers have 
been a major source of preventive care and reproductive health 
services, including cancer screenings, birth control, HIV and STI 
tests, and counseling services. And title X's important public health 
services translate into savings for taxpayers. In 2010, title X 
investments resulted in net savings for Federal and State governments 
of $7 billion.
  The measure we are voting on today would undermine this progress and 
the safety net for countless citizens. This measure would allow States 
to discriminate against providers and take away investments in family 
planning clinics, ultimately taking away these key services for those 
who need them most.
  Last year, more than 4 million women and men at over 4,000 health 
centers across our Nation received care through title X. This includes 
around 20,000 patients in New Hampshire, including roughly 11,000 
patients receiving care through title X supported Planned Parenthood 
centers. Those services can't just be replaced by other providers, even 
community health centers that do great work. But two counties in New 
Hampshire don't have a community health center at all. Others don't 
have the capacity to replace this work or this specialized experience 
that can make a critical difference to a woman's health.
  In New Hampshire and other States, Planned Parenthood and the 
community health centers are often partners, working in tandem to get 
patients the reproductive healthcare they need. But when I hear from 
community health centers around New Hampshire, they tell me they would 
not be able to pick up the slack if Planned Parenthood is defunded.
  Make no mistake about it, this CRA, which would let States 
discriminate against providers in the title X program, combined with 
the consistent attempts to defund Planned Parenthood by some in 
Congress, would be a disaster for women in New Hampshire and all across 
the Nation. That is why a number of leading advocates have come out 
against these efforts to overturn title X regulations, including the 
American Congress of Obstetricians and Gynecologists, the American 
Academy of Pediatrics, the National Family Planning & Reproductive 
Health Association, the Human Rights Campaign, and dozens more. I share 
their concerns and oppose the measure we will consider today, and I am 
going to continue to fight against these attempts to roll back access 
to reproductive health and preventive services.
  It is critical that we have a healthcare system that ensures that all 
women and their families can get the care they need. What we cannot do 
is eliminate services and discriminate against providers who have been 
providing critical, cost-effective healthcare to millions of Americans 
for decades. I strongly oppose this effort to undermine the title X 
program, and I will vote against this measure today.
  We need just one more vote, and I urge my colleagues to listen to the 
voices of their constituents and vote no today.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. MERKLEY. Mr. President, last week the Senate watched the House 
and the American people watched the House because the House was on the 
verge of taking away access to healthcare for 24 million Americans. 
Then last Thursday, a week ago from today, the House said: We are going 
to postpone that vote. We are not sure we have the votes to take 
healthcare away from 24 million Americans, but maybe we will vote 
tomorrow, Friday.
  That was 6 days ago. Friday came, and the House said: No, we are not 
going to do that vote today because we don't have the votes.
  Why didn't they have the votes? Because across the country, millions 
of Americans said that taking away healthcare is the wrong thing to 
do--to take away healthcare from Medicaid expansion, the Oregon Health 
Plan; to

[[Page 5139]]

take away healthcare by restricting standard Medicaid as it existed 
before ACA; to take away the healthcare bill of rights that people so 
much appreciated; to undermine the ability of low-income working 
families to buy policies with significant subsidies on the exchange--
all of that.
  The House set it aside. I thought that was tremendous because this 
week, we are not going to have a diabolical bill destroying healthcare 
here on the floor of the Senate. But the majority party decided: No, we 
can't go a week without destroying healthcare, so we are going to put 
up this Congressional Review Act that would take healthcare away from 5 
million mostly low-income women who gain access to healthcare through 
Planned Parenthood. We won't bring up on the floor the bill that failed 
in the House for 24 million Americans; no, we will just focus on 5 
million mostly low-income women and take away their healthcare.
  That is what this vote is about right now, later today. Clearly this 
attack on healthcare for women across America is wrong, just as it was 
wrong to try to destroy healthcare for 24 million Americans. It is an 
attack on women's right to choose what to do with their own bodies. It 
is an attack on the basic decency and compassion of the American 
people.
  Since 1970, the title X family planning provider network has been 
dedicated to providing individuals with comprehensive family planning 
and critical health services, such as screenings for breast and 
prostate cancer and sexually transmitted diseases.
  Just in 2015 alone, title X provided basic primary and preventive 
healthcare services, including Pap tests and breast exams and birth 
control and HIV testing, to more than 4 million low-income women and 
men at nearly 4,000 health centers across the country. That is a huge 
impact on the health of the individuals served through title X.
  In 2010, title X services prevented 87,000 preterm or low birth 
weight births. I can tell you, when my wife Mary was carrying each of 
our two children, I so much hoped that we would not have a complication 
that would result in a low birth weight birth or a preterm birth in 
which the child might not even survive. So failing to provide that care 
is really setting back not just the health of thousands of babies but 
maybe affecting whether they live or die.
  Title X services prevented 2,000 cases of cervical cancer. That is a 
big deal, cervical cancer, and it is a good deed to have title X 
services preventing it.
  For 40 percent of women in America, their visit to a title X family 
planning health center is the only healthcare they receive annually.
  So let's be honest about what repealing this rule means. It means 
family planning providers can be discriminated against by States that 
want to withhold Federal funding from family planning providers for 
reasons other than their ability to offer family planning services. It 
means less access to quality care and less access to affordable care.
  By overriding this regulation, Republicans empower States to pick and 
choose who provides services on a criteria that has nothing to do with 
the quality of care patients receive. States have done this in the 
past, and it resulted in dramatically fewer women accessing critical 
family planning and healthcare services.
  We know what this is about. It is about any Federal funding for 
Planned Parenthood, an organization that provides care and resources to 
5 million women every year. They have been doing it for 100 years. And 
they are the target. But what has been their mission? Their mission has 
been to provide easy and affordable access to address reproductive 
health and enable women to make their own decisions about their 
healthcare. But now, thanks to this Congressional Review Act proposal 
before us, that principle is under attack, that principle of easy and 
affordable access to women's healthcare and women's control over 
healthcare choices, to keep the politicians out of their choices. This 
resolution is about putting the politician in charge of the individual 
healthcare decisions of women in America, and that is just wrong.
  I encourage my colleagues to take a close look at this. You were 
spared having to vote on eliminating healthcare for 24 million 
Americans, but now you are required today to vote on eliminating 
healthcare for 5 million women--mostly low-income women--in America. 
Are you going to attack the healthcare of those women? Are you going to 
injure the babies they are carrying? There will be more low birth 
weight and preterm babies. That is the wrong thing to do.
  Vote no.
  The PRESIDING OFFICER. The Senator from Michigan.
  Ms. STABENOW. Mr. President, just yesterday, the White House held a 
forum on empowering women. Sean Spicer said the President made women's 
empowerment a priority throughout the campaign, but earlier today, Vice 
President Pence traveled to the Capitol to cast a tie-breaking vote to 
move ahead on a resolution to undermine women's access to preventive 
healthcare. That doesn't sound like women's empowerment to me.
  Title X was enacted in 1970. It passed the Senate unanimously at that 
time and was signed into law by a Republican President. Title X is the 
only Federal healthcare program dedicated solely to providing 
comprehensive family planning and other related preventive healthcare 
services so important to women, as well as preventive services for men.
  Last year alone, 4 million women and men at 4,000 health centers all 
across our country got basic care because of title X funding--critical 
Pap tests to head off cases of cervical cancer, counseling to help 
women plan for a healthy pregnancy, contraception, breast exams, HIV 
testing, vaccinations. These services prevented 87,000 preterm or low 
birth weight babies and 2,000 cases of cervical cancer. These health 
services also save money. The taxpayer saves $7 for every $1 invested 
in preventive healthcare.
  For more than 2 million people, the title X funded clinic is their 
only source of healthcare. This matters to small towns and rural 
communities all across Michigan, as well as all across the country. 
Title X funds clinics in three-fourths of all the counties in the 
United States. In Michigan, you can benefit from the services in the 
beautiful Upper Peninsula of Michigan, where I will be this weekend, 
where funds support the health department in Iron County, or the 
Planned Parenthood clinic in Marquette--at the opposite end of the 
State, down in the southeastern corner--where funds support the health 
department in Monroe County.
  So what are we voting on today? Plain and simple, this is an effort 
to take away women's family planning and other healthcare services. 
Right now, title X funds are awarded solely based on the provider's 
ability to serve the patient, as it should be. Republicans want to 
discriminate against certain family planning services, certain 
providers, and reduce access to this care, frankly, based on politics 
or their own personal beliefs.
  The vote this afternoon is very simple: It is about basic healthcare 
for women. A ``yes'' vote is a vote against women in Michigan and all 
across our country. A ``yes'' vote will take away healthcare. A ``yes'' 
vote will take away healthcare for millions of Americans.
  I strongly urge my colleagues to vote no.
  Mr. VAN HOLLEN. Mr. President, the majority is continuing its assault 
on women's reproductive healthcare rights, this time using the 
Congressional Review Act to reverse a rule and tear a hole in our 
safety net for access to family planning and preventative healthcare. 
The resolution before us would overturn the Department of Health and 
Human Services' rule, which reinforces regulations that prevent States 
from denying title X funds to health clinics like Planned Parenthood, 
even though none of these funds are used for abortions. Repealing this 
rule would limit access to healthcare, which would harm public health 
in communities that rely on this funding.

[[Page 5140]]

  Congress created the Title X Family Planning Program with bipartisan 
support in 1970 to help provide comprehensive basic primary, family 
planning, and preventative services to uninsured and low-income people. 
It continues to be the only Federal grant dedicated to providing family 
planning and preventive service. Recipients of the grants use the 
program's funding to provide basic healthcare, such as cancer 
screenings, HIV testing, and family planning counseling to 4 million 
women and men. Both public and private entities run title X service 
sites. These sites broaden access to healthcare services in rural parts 
of our country. Often, they are the only option for the populations 
they serve. About 40 percent of women who use title X service sites say 
that they are their primary healthcare service provider.
  Despite the benefits of the funding, States have taken actions that 
discriminate against family planning clinics. Texas, for example, 
slashed its family planning budget by 65 percent. As a result, Texas 
forced a quarter of its family planning providers to close their doors 
to patients in need.
  To ensure that States do not discriminate against family planning 
providers, the Obama administration issued a rule that forbids States 
from withholding title X funding for family planning providers for any 
reason other than being unable to deliver effective services. This rule 
prevents States like Texas from attempting to defund needed providers 
like Planned Parenthood. This rule protects access to vital preventive 
services that provide a safety net for our country's most vulnerable 
patients.
  All people should have a right to affordable, high-quality 
healthcare. Reversing this rule will deny critical healthcare services 
to women, men, and their families. I urge a ``no'' vote.
  Ms. STABENOW. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mrs. MURRAY. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mrs. MURRAY. Mr. President, I have to say that this is a sad day for 
the Senate. I know many of us here today--certainly my Democratic 
colleagues--are truly appalled. Once again, instead of working on the 
many pressing issues at hand, Republicans are continuing their tired, 
dangerous obsession with attacking women's health.
  Once again, women's health is being used as a political football, 
with Republicans attempting to cut off access to vital healthcare 
services. Once again, millions of families across the country are 
watching Congress, wondering why there isn't just one more Republican 
who will stand up for them.
  The Republicans just held a vote open for nearly an hour to force a 
vote that would allow politicians to discriminate against family 
planning providers. Of course, whenever they can't make a vote, when 
women's health is being attacked, whom do Senate Republicans call to 
break that tie in the Senate? Vice President Mike Pence.
  We have actually seen this before. We all remember what happened in 
the nomination of Secretary DeVos, and we all know that enough is 
enough. This is shameful. This is wrong. It cannot stand.
  Families have spoken time and again, and they have made it absolutely 
career that when it comes to women's rights and healthcare, they do not 
want to go backward. But today, thanks to my colleagues on the other 
side of the aisle, thanks to Vice President Pence, the Senate will hold 
a vote on whether critical healthcare services should be taken away 
from millions of women across the country.
  Let's not forget, it hasn't even been a week since people nationwide 
completely rejected TrumpCare, that disastrous bill that would have 
undermined women's rights and healthcare in so many ways.
  Now, here in the Senate today, we are about to vote on whether a 
young woman should be able to go to the provider that she trusts to get 
birth control; whether it is Pap tests, breast exams, birth control, or 
HIV testing, which should be more or less available to women across the 
country; whether healthcare providers are evaluated for Federal funding 
based on their ability to provide services or ideology; whether women 
are able to exercise their constitutionally protected rights to 
reproductive healthcare; and whether the Senate is going to turn back 
the clock today on women's health.
  For me and for Democrats, and I know even for some Republicans, it is 
disappointing, deeply disappointing, that we are even having this vote 
today--a vote that was jammed through, with 48 Democrats and 2 
Republicans voting no and Vice President Pence coming down to break the 
tie.
  Put simply, rolling back this rule today will put at risk women's 
lives, like a constituent of mine from Tacoma, WA. She wrote me a 
letter recently to tell me the many reasons this is so important to 
her.
  When she was 20, she was uninsured. She had no other options. A 
family planning center was there for her. During a routine Pap test, 
her doctor discovered a precancerous condition in her cervix. That led 
to surgery, which saved her life and saved her fertility.
  Without access to that provider, she would not have been able to get 
a regular Pap smear and checkup and most likely would have developed 
cervical cancer. She would not have been able to get pregnant, go on to 
have a daughter, become a community college counselor, and today, at 
the age of 65, be cancer-free.
  I hope that some of my Republican colleagues are listening and that 
they think of women just like this, whose lives are healthier and have 
been saved because of the services of so many family planning centers. 
That is who I will be thinking about. That is what has always kept me 
going.
  I urge people across the country right now to let Senators know that 
this vote today, this rule is not OK. It is not acceptable. Make phone 
calls. Go on Facebook. Tweet about it. Everything helps. Tell your 
Senator today that in about an hour, with their vote, to stand up for 
you, for your family, and for women across the country.
  We need only one more Republican--one more--to join us. This vote 
that we are about to have in about an hour is dead even, on the razor's 
edge. Fifty Senators--48 Democrats and 2 Republicans--will vote to 
reject this harmful, disgusting resolution. We just need one more 
Republican to join us, to stand on the side of women and men and 
families, and put an end to this damaging political attack on women.
  I am sure people will hear about this. I am going to be here on the 
floor. Many of my colleagues are going to be out here talking about it. 
People nationwide will have the opportunity to know exactly where every 
Republican stands on this.
  I urge our Republican colleagues: Stop to think about what you are 
doing, taking away the ability of women in communities across our 
country to go to the provider they trust for the care that is most 
important to them, their families, and our country's future. I urge 
them to make the right choice.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Illinois.
  Mr. DURBIN. Mr. President, most Americans agree--and I think last 
week's vote in the House indicated--that there is something special 
about healthcare. This just isn't the right of every American to own an 
SUV; it is the right of every American to have access to healthcare. 
That is really at the heart of our healthcare debate.
  There are some who believe that health insurance ought to be another 
product on the shelf, and if you have enough money, you can buy it. But 
there are others, like me, who believe it is more fundamental.
  Healthcare in America, as far as I am concerned, should be a right--
not a privilege, a right--so that it doesn't go just to wealthy people. 
Everyone should have that peace of mind.
  I have told the story many times on the floor of the Senate--and many 
of us

[[Page 5141]]

are products of our own life experience. My wife and I got married when 
I was a student in law school here at Georgetown, in Washington. God 
sent us a beautiful little girl right away, but she had some medical 
problems--serious ones--and I didn't have any health insurance. I was a 
law student, had no real income, a wife, and a baby with a medical 
problem.
  I ended up sitting in the charity ward of the local children's 
hospital with a number in my hand, waiting to see who would come 
through the door to provide me with healthcare for my little girl. I 
had never felt worse in my life as a father, as a husband, to think 
that I had reached this point where I didn't have health insurance, and 
I wasn't sure that I was bringing the very best medical care to my 
little girl.
  Well, I never forgot that experience in the many years since, and I 
never will. I don't believe anybody should be sitting in that chair, 
worried because they don't have health insurance--whether they have the 
kind of healthcare that their family needs.
  I think that is at the heart of this debate on our healthcare system 
in America and its future. What we are talking about today is part of 
it, as well, because we had decided 40 years ago--maybe more--that we 
were going to make sure, if you were poor in America, as a woman, you 
would still have access to basic healthcare. Poverty would not exclude 
you from healthcare. So we created this title X program to provide 
healthcare primarily for low-income families but for women and 
children. The services that are provided are basic life-and-death 
services--everything from breast and cervical care screening, high 
blood pressure screening, anemia, diabetes testing, and so on.
  There is not much debate as to whether we should provide those 
services, but you know what this is all about. It is not about what I 
just read. It is about family planning, and it is about abortion. That 
is what this is really all about.
  The Republicans who are voting to deny women access to healthcare are 
saying: We are doing this to reduce the incidence of abortion.
  There is something they should admit: You cannot spend one penny of 
Federal money for abortion services, except in cases of rape, incest, 
or where the life of the mother is in danger. Not here in the United 
States, not overseas.
  What they say instead is: Well, we don't want to provide any money to 
any place that might use their own funds for abortion services, like 
Planned Parenthood. So we have this amendment before us.
  For thousands of women and families in my State of Illinois, as 
Senator Murray has explained, it means the Republicans--who were all 
for choice in healthcare--don't want women of limited means to have 
their ultimate choice of Planned Parenthood for their services. So the 
Republicans have brought in the Vice President of the United States to 
vote in the Senate Chamber.
  For those who are following the Senate, that doesn't happen very 
often. It has to be a big deal. And it must be a big deal to the Vice 
President and to the Republican Party to bring back one of our 
colleagues, who has been on the mend from medical care, and to bring in 
the Vice President to make that difference.
  Their argument is: Well, we are just trying to reduce the number of 
abortions.
  Well, if you have taken anything beyond Birds and Bees 101, there are 
some things that you might know. We had a study in St. Louis that was 
reported in 2012 that tells many people who are at least aware of the 
basics of how children are born something that we knew already and knew 
intuitively. Here is what it found:

       The abortion rate in the St. Louis area declined by more 
     than 20 percent from 2008 to 2010, coinciding with a research 
     study that gave free birth control to thousands of area 
     women.
       Although the drop in abortions in St. Louis cannot be 
     attributed solely to the project, the abortion rate for the 
     rest of Missouri--

  Not in the study--

     remained constant.
       Contraception is key to reducing unintended pregnancies and 
     abortions, said Dr. Jeff Peipert. ``We need to remove cost 
     barriers,'' Peipert said. ``I think all women should have 
     equal access.''
       Teenage participants--

  In this study--

     experienced a birth rate of 6.3 babies per 1,000 girls, 
     compared with the national rate of 34.3, according to the 
     study published . . . in the journal Obstetrics and 
     Gynecology.
       There were an average of six abortions a year for every 
     1,000 women in the project, compared with the national rate 
     of 20.

  Coincidence? I don't think so.
  When you make family planning accessible to potential mothers and to 
the families, people are educated and make informed choices. There are 
fewer unplanned pregnancies. There are fewer teenage pregnancies. There 
are fewer abortions.
  So the Republicans, by reducing the access of women to clinics and 
agencies that are providing family planning, reduce the likelihood they 
will get the information they need and the likelihood that abortions 
will increase--exactly the opposite of what they say they are trying to 
do.
  Common sense dictates that--whatever your position is on abortion and 
choice--if you believe that an uninformed and uneducated young mother 
is the right person to make this decision as to whether they are going 
to have a family, I think you understand what all of us do: 
Information, assistance, and quality healthcare is critically important 
for women to make the right choice for themselves and their families 
and to avoid unplanned pregnancies.
  We are now experiencing the lowest rates of unplanned pregnancies in 
the United States in the last 30 years and the lowest incidence of 
teenage pregnancies in the last 30 years, and the abortion rate is 
going down. It works. It is connecting.
  This vote that the Republicans are forcing us to take--which the 
President, I am afraid, would sign, if it were sent to his desk--really 
gets at the heart of the issue. If you want to reduce the number of 
abortions in America, if you want to make them safe, legal, and rare, 
as they say, for goodness' sake, provide basic family planning 
information and services to women who otherwise might not have it.
  This is a war against Planned Parenthood and a few other facilities 
that is mindless. It really is stopping information from people who 
desperately need it. Without that information, there will be bad 
results--bad results that often lead to abortions.
  So I would just say flat out that we don't talk a lot about the A-
word, ``abortion,'' on the floor, but that is really what is driving 
this debate. That is what is really behind it.
  I hope that one more Republican colleague will decide that if you are 
truly against abortion, you should be in favor of family planning and 
giving basic information and counseling to young women who need it. 
That was proven in St. Louis. It is proven by our human experience. I 
hope my colleagues will join me in opposing this effort.
  I thank the Senator from Washington for leading this debate on the 
floor.
  Mr. President, I yield the floor.
  Mrs. MURRAY. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. SCHUMER. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SCHUMER. Mr. President, I rise this afternoon on the pending 
business of the CRA that would allow States to discriminate against 
women's healthcare providers.
  Before I begin, I want to recognize the members of the HELP 
Committee. Senator Murray, who understands this issue as well as anyone 
in our caucus and speaks powerfully about it, has been such a great 
leader on these issues, even in these difficult times when we are in 
the minority. I think our entire caucus is grateful to her and all of 
the members of the HELP Committee. It is an outstanding group of 
people.

[[Page 5142]]

  As my colleagues have explained, this CRA would empower States to 
discriminate against healthcare providers, specifically title X family 
planning providers. The practical result of this measure is that State 
legislatures would pass laws to deny certain providers the funding they 
need to operate, which would prevent access to family planning and 
preventive care for millions of American women.
  This CRA is just another example of the Republican war on women. It 
would let States treat women as second-class citizens who do not 
deserve the same access to healthcare as men. Some States say this is 
about abortion, but let me be clear. This is not about abortions. In 
fact, title X funding cannot be used to pay for abortion services. Some 
of our Republicans who are sort of tied in a knot on abortion say they 
are for other kinds of health services, contraception and things like 
that, but this would take that away. Our Republican friends could not 
get TrumpCare through, which sought to shut down Planned Parenthood for 
a year. Now they have moved on to this measure. It is just bad policy.
  Title X clinics are a critical resource for women, especially in 
rural areas. This bill would hurt those areas most. Many of my 
Republican friends represent rural areas. I would like to remind them 
that in many of these places--and I have several in Upstate New York--
these clinics are the only family planning and preventive care services 
that are available. Sometimes they are the only healthcare services 
available at all. I am sure that is why two of my Republican 
colleagues, with a great deal of courage--the Senators from Maine and 
Alaska--voted against moving to debate on this measure. They know that 
it would hurt women and hurt families in their States, particularly in 
the rural areas, and, of course, Maine and Alaska are both rural 
States.
  For the second time this year, the Republicans had to beckon Vice 
President Pence down from the White House to break a tie here in the 
Senate on a measure that has bipartisan opposition.
  President Trump, who once said, ``No one has more respect for women 
than I do,'' sent Vice President Pence down here to the Senate to break 
a tie on a bill that would allow States to discriminate against women's 
health providers. The next time the President says, ``No one has more 
respect for women than I do,'' I would ask the women of America to not 
look at his words but his actions because this is just another example 
in which the President has said one thing, but his policies have done 
exactly another.
  I urge my Republican friends, particularly those in rural States, 
where this could really hurt, to please think about it and vote against 
this CRA. We only need one more vote to stop this resolution that would 
allow States to dramatically reduce the access for women to essential 
healthcare services. I urge each of my Republican friends to consult 
their conscience before they vote in the next hour.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Michigan.
  Mr. PETERS. Mr. President, I rise to express my opposition to the 
resolution of disapproval that is currently before the Senate, which 
would decimate Federal title X funding for healthcare providers across 
our Nation who provide vital preventive care and family planning 
services.
  Let me put it in simpler terms. Republicans in Congress are once 
again rushing to advance legislation that will make it harder for 
Michiganians to get the healthcare they need. Just last week, we saw 
Speaker Ryan and President Trump in their efforts to take away 
healthcare from 24 million Americans and to defund Planned Parenthood, 
but this is a new week, and we are seeing a new assault on healthcare.
  Today's resolution is just the latest in a long series of attacks 
against Planned Parenthood. A vote for this legislation is a vote to 
make it harder for millions of Americans to access birth control, 
cancer screenings, and testing for sexually transmitted infections.
  ``Title X funding'' sounds arcane, but it is actually pretty 
straightforward. It is a bipartisan program which was established more 
than 40 years ago and which provides individuals with family planning 
and preventive health services. Not one penny covers abortion. Let me 
say that again. Not one penny covers abortion--not one. This is 
established Federal law, and anyone who says otherwise is simply lying 
to you or has no idea of what he is talking about.
  We should take a step back and ask, what can we agree on here? I 
think every Senator would agree that we want to reduce unintended 
pregnancies and teen pregnancies and save money and prevent cancer. 
Today, unfortunately, we are voting to do the opposite.
  Right now, we have the lowest rate of teen pregnancies in our 
Nation's history, and we are getting ready to heavily restrict a 
successful program that saves $7 for every public dollar invested. 
Preventive screenings are quick, affordable, and save lives. Cancer 
devastates families, ends lives, and is expensive to treat. 
Historically, low teen pregnancy rates have not happened in a vacuum; 
they have happened because of concerted efforts to promote education 
and prevention and give women a say in their own health.
  The pain inflicted today will not be felt uniformly; it will 
disproportionately hurt people in rural and underserved areas in which 
these clinics are more often than not the primary sources of 
healthcare. Michigan has 19 Planned Parenthood clinics, and half are 
located in areas that are federally designated as ``rural and medically 
underserved.'' As a direct result of title X funds, Michigan family 
planning clinics prevent over 18,000 unintended pregnancies and over 
1,000 cases of sexually transmitted diseases and cervical cancer each 
and every year.
  Every woman has a fundamental right to make her decisions about her 
reproductive health. The government has absolutely no right to stand in 
her way. I strongly oppose this resolution and implore just one more of 
my Republican colleagues to join me in stopping this misguided effort.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Ms. KLOBUCHAR. Mr. President, I rise to join my colleagues in 
speaking about the harmful effects of this resolution of disapproval.
  I thank the Senator from Michigan for his words and for the very 
important point that we are seeing the lowest number of teen 
pregnancies that we have seen for a long, long time. Why would you want 
to mess with something that is finally reducing the number of teen 
pregnancies?
  I thank Senator Murray, who has been here diligently leading in this 
effort, because rolling this rule back will result in something very 
simple: It will result in less access to care for women and families.
  Title X funding supports vital family planning and related preventive 
care for low-income, uninsured, and young people across this country. 
Every year, more than 4 million people, including many who are living 
in rural and medically underserved areas, go to the over 4,000 health 
centers that rely on this funding. This includes 41 service sites in 
Minnesota that provide access to cancer screenings, birth control, and 
testing for sexually transmitted infections. In fact, 40 percent of 
women who receive care at title X clinics consider it to be their only 
source of healthcare--40 percent--which is incredibly important in 
rural areas.
  One thinks of, just recently, in the last few years, the Zika scare. 
People wanted to go and get birth control. They wanted to know what 
they could do to prevent themselves from getting Zika in order to save 
the lives of their babies. This is true, and this is what will be 
happening if they make these cuts.
  The regulation we are voting on today should be common sense. It 
simply makes clear that funds will be awarded solely based on a 
provider's ability to serve a patient, and it guarantees that women 
have access to the care they are entitled to under Federal law.

[[Page 5143]]

  We should be strengthening our efforts to provide better and more 
affordable care that best serves patients. Instead, repealing this rule 
will take essential services away from women when they need them most. 
By overriding this regulation, States will now pick and choose who 
provides these services, which will be based on arbitrary criteria that 
has nothing to do with the quality of services patients will receive. 
That should be our benchmark--the quality of services.
  When States have done this in the past, it has blocked access to 
critical family planning and healthcare services for many women, 
including those in rural areas who rely on the health centers that need 
these funds.
  As Senator Murray said this morning, women across the country have 
made it clear that restricting women's access to the full range of 
reproductive care is unacceptable.
  We have a situation in which this existing rule has yielded the 
lowest number of teen pregnancies in years. We have a situation in 
which two of our Republican colleagues have joined us in opposition to 
this repeal. We have a situation in which the Vice President of the 
United States had to come in and break a tie.
  Do you know what I would say? I would say that this resolution should 
be disapproved of, that rolling this rule back will result in less 
access to care for women and families, and that this rule should stay 
in place.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Cassidy). The Senator from New Jersey.
  Mr. MENENDEZ. Mr. President, I come to the floor today, just as I 
have many times before, to stop another rightwing attack on title X 
funding and to defend access to healthcare for millions of women.
  Not even a week has passed since the American people successfully 
beat back Republican efforts to repeal the Affordable Care Act and give 
insurance companies permission to charge women higher premiums simply 
because of their gender. Yet apparently less than a week is not too 
soon for Republicans to launch yet another attack on women's access to 
healthcare. This morning, my Republican colleagues needed the Vice 
President of the United States to come to Capitol Hill and cast a vote 
to overturn protections for 4 million patients served by title X funded 
health centers every year.
  For many low-income women, title X funding is the lifeline that 
ensures their access to birth control, testing for sexually transmitted 
infections, cancer screenings, and other basic health services. In 
fact, 85 percent of the people served by family planning centers like 
Planned Parenthood have incomes below 200 percent of the Federal 
poverty level. Approximately 20 percent of these patients identify as 
Latina, and approximately 14 percent identify as Black.
  In 2015 alone, title X funded nearly 800,000 Pap tests, breast exams 
to 1 million women, nearly 5 million tests for STIs, and 1 million HIV 
tests. Title X did not pay for a single abortion. Indeed, no Federal 
funding goes to abortion-related care. And indeed, for every dollar 
that title X funding spent, we saved about $4 and prevented nearly 2 
million unintended pregnancies per year.
  Family planning services at New Jersey's title X funded health 
centers helped prevent 20,500 unintended pregnancies in 2014, which 
would have likely resulted in 10,000 unintended births and 7,400 
abortions. Without publicly funded family planning, the number of 
unintended pregnancies in New Jersey would be 21 percent higher. Title 
X funded services produce significant cost savings to the Federal and 
State governments. Services provided at title X supported sites in New 
Jersey accounted for nearly $232.9 million in such savings in 2010 
alone.
  I hope President Trump knows that when my Republican colleagues vote 
to defund Planned Parenthood, they aren't voting to stop a single 
abortion; they are voting to defund the family planning care that helps 
avoid unwanted pregnancies and reduce the need for abortion.
  A vote to defund title X is a vote to defund breast cancer exams. A 
vote to defund title X is a vote to defund cervical cancer screenings. 
A vote to defund title X is a vote to defund testing for sexually 
transmitted diseases.
  The American people--those who voted for President Trump--voted for 
more affordable healthcare, certainly not less. Not one of my 
Republican colleagues has come to the floor to make the case in favor 
of repealing title X--not one. But if my Republican colleagues prevail 
in this cynical vote, they will jeopardize access to affordable family 
planning services; they will force many health centers to stop 
providing care to patients; and they will leave doctors, nurses, and 
other healthcare providers working on the frontlines to abandon those 
who need them the most.
  I, for one, refuse to allow the GOP to pander to the extreme elements 
of their party and in doing so limit a woman's access to affordable, 
accessible healthcare. This vote is about every one of our sisters, our 
daughters, our grandchildren. This vote is about women across this 
country, and I don't understand how we can take away their access to 
the healthcare they so critically need.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Mr. President, I see my colleague from Illinois is here. 
While she is setting up, I just want everybody to realize what is 
happening here. We are debating a rule that, should the Republicans--
with the Vice President voting to break the tie this afternoon--put it 
in place, will allow the discrimination of healthcare providers for 
women across the country.
  I have many Democratic colleagues here making the case for those 
women, mostly low income, who have no other access, particularly in our 
rural and urban regions. I just want to note that there are no 
Republicans out here saying why this rule needs to be passed. They just 
want it done, over with; the Vice President to break the tie, and it is 
out of here. We are noticing. Women are noticing. People are noticing.
  I thank all of my Democratic colleagues and a few brave Republicans 
who are with us for their support to get this done. We need one more 
Republican to be able to defeat this.
  I yield to my colleague.
  The PRESIDING OFFICER. The Senator from Illinois.
  Ms. DUCKWORTH. Mr. President, this vote to allow States to defund 
Planned Parenthood and other title X funded health programs is simply 
shameful and dangerous, and millions of Americans across this country, 
including tens of thousands of women and men in Illinois, are going to 
suffer as a result.
  This vote is particularly devastating to the 2.7 million Americans 
who depend on Planned Parenthood for their basic preventive healthcare 
each year. I personally understand what is at stake with this vote 
because I have been there. When I was working my way through college as 
a waitress, with the help of Pell grants and student loans and student 
work-study, I relied on Planned Parenthood for my basic healthcare, for 
services that are just as simple as a simple physical that I needed to 
get that waitressing job. I went to Planned Parenthood because that is 
all I could afford on a student's budget, and I needed to get that 
second job.
  While I can relate to the obvious good that Planned Parenthood does, 
many of our colleagues on the other side of the aisle, unfortunately, 
simply cannot. They don't understand what is at stake.
  Let's take a look at my home State of Illinois. In Illinois alone, 
Planned Parenthood serves 64,000 patients annually. Of those, 34,000 
seek testing for sexually transmitted diseases, and nearly 7,000 are 
seeking out cancer screenings. So by defunding this organization, what 
they are really doing is stripping thousands of Illinoisans and 
Americans all across this country from access to essential healthcare. 
That is simply unacceptable.
  We can't play politics with women's healthcare. Planned Parenthood 
should be able to do its job and continue providing quality care and 
services without fear of partisan or discriminatory attacks.

[[Page 5144]]

  The bottom line is that Planned Parenthood is one of the Nation's 
largest women's healthcare providers, and it is essential to the health 
of our families and our country.
  This vote makes taking away not just Planned Parenthood's funding but 
funding from any organization that receives title X easier, turning 
women around the country into second-class citizens and harming 
millions of Americans in the process. Why would we make it easier to 
take away a health center that helps our women's public health system 
and serves as a lifeline for affordable, preventive services like 
physicals, disease testing, and cancer screenings? Women and men all 
over the country need these services. Our States and our local 
communities need these services because they meet a need that would 
otherwise not be met.
  I want the men and women across this country to know that I am not 
going to give up. Democrats are not going to give up. I will continue 
to fight to protect title X funding and the patients who depend on it. 
It is just too important.
  I yield the floor.
  Mrs. MURRAY. Mr. President I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Ms. CANTWELL. 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. CANTWELL. Mr. President, I rise to join my colleagues here on the 
Senate floor, and I thank the Senator from Washington for her 
leadership on this issue. I rise to join my colleagues in voicing 
strong opposition and deep concern on H.J. Res. 43, a resolution of 
disapproval we are considering today in the U.S. Senate.
  This resolution will threaten access to healthcare for thousands of 
women and families in the State of Washington and millions of people 
across the Nation.
  H.J. Res. 43 would make it easier for States to discriminate against 
healthcare providers who serve low-income and vulnerable patients under 
title X of the Public Health Services Act.
  Title X is the only Federal funding program dedicated to supporting 
the family planning safety net, and it was widely supported by the 
public when it was enacted with strong bipartisan support. So despite 
what my colleagues say on the other side of the aisle, this issue is 
something where all my colleagues should make sure we are not taking 
away access to healthcare.
  My colleagues on the other side of the aisle in the House--and I know 
my colleague, the senior Senator from Washington, can testify to this, 
have on many occasions tried to de-fund Planned Parenthood. They have 
used Planned Parenthood as a bargaining chip in a litany of high-stakes 
legislative negotiations. They even tried to shut down the Federal 
Government because they didn't want to fund Planned Parenthood. 
Moreover, during the 114th Congress, Republicans voted 22 times to 
undermine women's health. Today, they are continuing the same thing.
  These health centers are an essential part of communities' delivery 
systems. They provide preventive services. They help prevent deadly 
disease. They save taxpayers money. They help families with their 
healthcare. Time and again, constituents in our States tell us how 
access to these high quality care centers translates into economic 
empowerment, independence, and the ability to thrive in their lives and 
careers. In short, these health centers don't just provide good 
healthcare for America. They provide a good economic strategy for 
America.
  In our State, 34 Planned Parenthood centers provide contraceptive 
care, breast cancer screening, and STD and HIV screening and treatment, 
and they have prevented thousands of unintended pregnancies thanks to 
their efforts and outreach. In the very isolated communities of 
Pullman, Moses Lake, and Shelton, and many more, they are oftentimes 
the only family provider that will furnish care to low-income 
individuals. Major medical organizations--representing obstetricians, 
gynecologists, family physicians, and pediatricians--have also made it 
clear that this resolution is divorced from medical science and will 
hurt patients.
  I urge my colleagues to resist continuing their senseless political 
crusade. I hope they will be smart enough to understand that a 
healthcare strategy is an economic strategy. I hope they will defeat 
this resolution.


                            Gonzaga Bulldogs

  Mr. President, what a great moment--my colleague from Washington is 
here, and my colleague from Nevada is here as well. I just want to 
clarify something. We definitely want to cheer on the Gonzaga Bulldogs 
in Saturday's game. But so many people say: Where is Gonzaga? It is in 
Spokane, WA, and we are very proud of Spokane. It is a city that hosts 
Hoopfest, a three-on-three basketball game that many people attend, and 
an enormous Bloomsday race that so many people come to from across the 
country right on the first of May. I think somewhere around 60,000 
people are in that race. But we are also so proud that we also have a 
Gonzaga School of Law graduate here on the Senate floor--the Senator 
from Nevada. Gonzaga also produces great academic minds.
  So for everybody from Spokane, congratulations and good luck on 
Saturday's big game.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Nevada.
  Ms. CORTEZ MASTO. Mr. President, I say to my colleague from the great 
State of Washington, I do know where Gonzaga is, and I am with you. As 
a graduate from the Gonzaga School of Law, we are going to the final 
four, and this time we are going to win. I am very excited.
  Congratulations to the players, the coach, and to everyone at the 
school.
  Mr. President, I take the floor today to urge my colleagues across 
the aisle to stand up for their constituents and vote against the 
measure on the floor, which will restrict access to safe, affordable, 
basic healthcare to millions of Americans across this country. This 
measure will allow States to discriminate against title X family 
planning clinics for no other reason than petty partisan politics that 
degrade women's access to healthcare and turn it into a Republican 
talking point.
  These clinics provide essential family planning and health services 
to millions of American women, men, and families--many of whom are poor 
and low-income and in rural areas. This measure will cause these 
families to suffer by limiting their access to healthcare.
  In my home State of Nevada, there are 23 clinics that risk losing 
funds as a result of this measure. These clinics are in Nevada's major 
cities and in our rural areas, like Hawthorne, Lovelock, Pahrump, 
Tonopah, Ely, Winnemucca, and Fallon. For many families in our rural 
areas, these clinics are the only healthcare facilities where they can 
access family planning services, as well as basic primary and 
preventive healthcare services.
  The votes today empower States to discriminate against providers and, 
in turn, threaten the health and safety of the men, women, and families 
who rely on these clinics for basic and, at times, lifesaving services. 
We should be promoting access to healthcare, especially for our 
vulnerable communities. We should be expanding access to care, 
especially for Americans living in rural areas.
  Republicans' actions today are an affront to American women and 
families. Their political agenda and shortsighted approach will do 
nothing but cause harm to Americans. It is time for Republicans to stop 
playing politics with women's health and actually put Americans' health 
and safety first.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wisconsin.
  Ms. BALDWIN. Mr. President, instead of focusing on bipartisan reforms 
to improve access to healthcare for the American people, Republicans 
are again pursuing divisive policies that jeopardize women's health and 
put politics, politicians, and the government between a woman and her 
doctor. This

[[Page 5145]]

measure that we are debating this afternoon attacks a critical 
healthcare program known as the Title X Family Planning Program.
  The Title X Family Planning Program provides basic healthcare, like 
cancer screenings, contraception, and HIV testing to more than 4 
million women and men. This politically motivated provision that we 
have before us today would allow States to discriminate against trusted 
health providers like Planned Parenthood. In eight counties in 
Wisconsin, Planned Parenthood is the only health clinic that provides 
the full range of publicly funded contraceptive services.
  I met with Laurie from Bristol, WI, who told me that as a young 
teacher, she went to Planned Parenthood and they discovered that she 
had cysts and tumors in her ovaries. The providers immediately helped 
her get the care she needed. She had quick surgery and was able to 
recover, which allowed her to eventually have a family.
  Republicans are playing doctor and telling women they can't access 
basic primary and preventive healthcare services at the health center 
of their choice. This would cut off access to care for millions of men 
and women, prohibiting access to high-quality, preventive services just 
because of the sign on the door. They would prevent women like Laurie 
from accessing lifesaving services when they need it the most.
  We have already seen too many States enact record numbers of laws and 
regulations that restrict a woman's access to reproductive health 
services and the freedom to make her own healthcare decisions. In my 
home State of Wisconsin, our Republican Governor has signed a number of 
laws that target healthcare providers and simply have left far too many 
Wisconsin women out in the cold. He signed a law that forces women to 
undergo unnecessary and invasive medical procedures, and he has imposed 
unreasonable requirements on the doctors that deliver care to women. He 
has worked to close health clinics, including several Planned 
Parenthood clinics. But he hasn't stopped there. He also signed two 
laws that would effectively defund Wisconsin Planned Parenthood, which 
could leave thousands of Wisconsinites without access to critical 
health services.
  The threat in Wisconsin and in States across the country--and right 
here in Congress--is clear: Politicians across the country are playing 
doctor, and this is a dangerous game for women and their families. The 
millions of Americans who rely on title X for primary care and their 
trusted providers are being held hostage. They are being used as a 
political punching bag by congressional Republicans. Their agenda is to 
attack women's health.
  Women's access to comprehensive healthcare--the healthcare they need 
and deserve--should never depend upon their ZIP Code. So I urge my 
colleagues to oppose this dangerous measure and to protect title X 
programs for all of our families.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Massachusetts.
  Mr. MARKEY. Mr. President, we are here today because Republicans' 
discrimination against women knows no boundaries. They think a woman's 
right to choose is still up for discussion. It is not.
  Let me be clear. A woman's right to choose is a discussion for a 
woman and her doctor. That is it. A healthcare provider receiving 
Federal funds should be judged on their ability to serve a patient. 
That is it.
  Today, Republicans are voting on a measure that would allow States to 
discriminate against family planning providers simply because they do 
not like the populations they treat or the services they provide. It 
would embolden a State to restrict Federal funding for only health 
centers that serve primarily minority populations or patients who 
identify as LGBTQ, and it would allow a State to strip away Federal 
investments in family planning clinics that serve women's reproductive 
health needs.
  These are not hypothetical concerns. Women's reproductive care is 
under attack by extreme rightwing Republicans across this country. 
State politicians introduced more than 500 bills restricting access to 
reproductive healthcare in 2016, enacting more than 60 new abortion 
restrictions last year.
  Let's be clear. The result of today's vote means that there will be 
less access to care for women and families across this country. Health 
centers receiving title X funding provide basic primary and preventive 
healthcare services, such as HIV testing and contraception, to more 
than 4 million women and men at nearly 4,000 healthcare centers 
nationwide. It is because of the work done at these centers that we are 
now at a 30-year low in unintended pregnancies, a historic low in teen 
pregnancies, and we have the lowest rate of abortions since the Supreme 
Court ruled that abortion was legal in 1973. We are a healthier Nation 
because of family planning clinics that receive title X funding.
  Now, more than ever, we need to stand and raise our voice against the 
Republican Party's agenda of discrimination. It is about fighting for 
the freedom to make decisions in our personal lives without the fear of 
interference from our own government. It is about the access to 
opportunity that comes from quality, affordable healthcare and making 
sure that access is never restricted, no matter what gender you are. 
But with Donald Trump as President and both Chambers of Congress now 
controlled by the GOP, national Republicans are in the best position in 
decades to enact a radical agenda that rolls back women's rights. Today 
is just one step in their massive plan to take women's rights right 
back to the 19th century.
  I know they will not back down from enacting their radical agenda, 
but I also know that we who want to protect women's rights will not 
back down from this fight. It is a historic battle. This vote is a 
historic vote.
  I urge all Members to vote no.
  I yield back the remainder of my time.
  The PRESIDING OFFICER. The Senator from Colorado.
  Mr. BENNET. Mr. President, I am pleased to be here with the Senator 
from the Commonwealth of Massachusetts and the ranking member of the 
HELP Committee to address this important issue.
  You would think that after the healthcare debacle last week, the 
other side would have gotten the message, which is that the American 
people didn't send us to Washington to take away their healthcare.
  When I think about healthcare in Colorado, I think about sort of a 
circle that contains healthcare that people in my State are either 
getting or not getting, and some part of that is ObamaCare, that is for 
sure, but a lot of it has nothing to do with that. They are unhappy 
with the way our healthcare system works. They want more access than 
they have. The House bill went at this in exactly the wrong direction 
from where they are interested in going.
  I would like to work with Republicans and Democrats to solve that, 
but this afternoon we are here once again because the resolution before 
us would risk funding for vital primary care, preventive and family 
planning services for more than 4 million Americans across our country, 
especially women and those who live in rural communities of my State 
and other States.
  Since 1970, this body has supported title X funding to expand access 
to affordable healthcare for low-income men and women. We did that 
because we understood that it wasn't just the right thing to do, we 
recognized that it was a good investment. Each dollar invested in 
publicly funded family planning programs saves the government over $7 
in Medicaid-related costs.
  The other side rails against Medicaid spending. In fact, last week, 
they had a bill that cut it by about $850 billion. But if they succeed 
on this vote today, Medicaid spending will almost certainly rise as a 
result of what they are trying to do.
  We supported title X funding with both Republican majorities and 
Democratic majorities in the Senate. Now a narrow majority is trying to 
ram this measure through.
  This isn't supported by a consensus of Americans, and you know it is 
not

[[Page 5146]]

when Vice President Pence has to drive over here from the White House 
to cast a tie-breaking vote. Just yesterday, the Vice President was at 
a White House forum on women's empowerment. It begs the question: Did 
he learn anything at the forum?
  It is easy for Senators, apparently, to vote against healthcare for 
struggling Americans. I wonder sometimes whether the reason for that is 
that we are not affected by this vote. That is doubly true when 50 
Senators--overwhelmingly men--vote to cut healthcare for millions of 
low-income women.
  The vote today has real consequences for Colorado. If this measure 
passes, it will threaten to cut funding for title X health centers 
serving over 52,000 men, women, and teens each year. It will also risk 
funding for the over 20 Planned Parenthood clinics throughout Colorado 
that provide healthcare services to more than 86,000 men, women, and 
teens. Planned Parenthood is a critical part of Colorado's healthcare 
system, providing essential services in a quarter of the State's 
counties. This support is especially vital for our rural areas. Two 
weeks ago, I visited Alamosa and Durango, CO, where these health 
centers are some of the only places women can turn to for preventive 
care and family planning services.
  We should not do this. Pediatricians are against it. Family 
physicians are against it. Nurses are against it. But on the other 
side, we have a narrow majority voting to strip funding for vital 
primary and preventive care, including breast cancer screenings and HIV 
testing.
  I would invite anyone voting against this measure, including the Vice 
President, to come to Alamosa and Durango and see what these health 
centers are doing in our communities. I invite them to come and meet 
the people they help, the lives they change.
  I urge my colleagues to vote against this measure. It will hurt many 
of our fellow Americans. It will hurt women in my State and 
particularly working people, and it should not pass.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. Mr. President, I hear colleagues from the other side of 
the aisle talk again and again about how they want patient-centered 
healthcare. That is the refrain--patient-centered healthcare. Make no 
mistake about what this resolution is all about. It turns that phrase 
on its head because what it says to certainly women who are patients: 
You are not free to go get the healthcare you want.
  It seems like this never ends--another day, another effort to deny 
women the opportunity to have the kinds of healthcare choices and the 
healthcare services that they feel strongly about.
  I am not going to take long; I know colleagues are in a hurry. I just 
want to say that the next time you hear this lofty rhetoric--
particularly from the majority--about how everything they are going to 
do in American healthcare is going to put the patients at the center of 
healthcare, give people more choices, and protect the freedom that they 
talk about in healthcare--understand, if you vote for this resolution, 
you are repudiating all of those speeches. I have heard Senator Murray 
talk about it. She says it very eloquently.
  The bottom line is that this resolution not only doesn't support that 
lofty rhetoric about patients being at the center of healthcare, this 
resolution deprives women of choices and access to healthcare services 
they want.
  I hope my colleagues will join Senator Murray and understand the 
dangerous consequences of what is at stake. Oppose this resolution and 
save the Vice President the trip to the Hill.
  I yield back.
  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Mr. President, I want Senate Republicans who are about 
to take this vote--and Vice President Pence--to be very clear on what 
they are about to do. As a direct result of their choices today, 
extreme politicians in States across the country will have greater 
power to take away women's choices.
  I think it speaks volumes that the vote to uphold this rule--which 
simply says family planning centers, where women can exercise their 
constitutionally protected rights, should not be discriminated 
against--is bipartisan. But do you know what I think is most striking 
about this vote? The deafening silence from the group of almost 
entirely male Republican Senators who are voting today to make it 
harder for women to get the healthcare they need. Not one spoke today 
to justify this vote. Where are those Republican Senators? Why did they 
feel so entitled not just to interfere with women's healthcare 
decisions but to do so without explaining themselves? If they are 
ashamed of their votes, which they should be, they had ample 
opportunity to reconsider.
  I came to the floor with my Democratic colleagues weeks ago to urge 
Republicans not to bring this damaging legislation to the floor. We 
asked for just one Republican vote today to prevent this attack on 
women's health. And women across the country, in Republican and 
Democratic States, called, emailed, tweeted, and organized to say that 
these restrictions on women's access to healthcare have no place in our 
country or in the 21st century. But what have these 50 Senate 
Republicans done? They refused to listen, and they refused to answer 
for their actions.
  Frankly, women deserve better. The thing is, women know it. So today, 
as a woman, I am angry. As a mother and a grandmother, I am furious 
about what attacks like this mean for our daughters and our 
granddaughters, especially those who are struggling and 
disproportionately rely on family planning centers. But as a Senator, I 
am more confident than ever that Republicans who fail to listen to the 
women of this country do so at their own peril. I have had the chance 
to see how much impact women have when they call and march and organize 
and make their voices heard.
  The fact that Vice President Pence had to come and break this tie 
today, that Senate Republican leaders could not twist enough arms to 
pass this bill on their own, is clear evidence. So is the failure of 
House Republicans' abysmal TrumpCare bill, which would have cut off 
access to critical services at Planned Parenthood.
  I know without a doubt that Republican Senators who vote against 
women and with their extreme base today and who rely on this anti-women 
administration to jam this resolution through will be held accountable 
both by women across the country and women right here in the Senate. We 
will keep making our voices heard. We will fight back against these 
attacks on our rights and our own self-determination, and ultimately, 
you can be sure, we will win.
  I yield the floor.
  I yield back the time on this side.
  The joint resolution was ordered to a third reading and was read the 
third time.
  The PRESIDING OFFICER. The joint resolution having been read the 
third time, the question is, Shall the joint resolution pass?
  Mr. INHOFE. 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 bill clerk called the roll.
  The yeas and nays resulted--yeas 50, nays 50, as follows:

                      [Rollcall Vote No. 101 Leg.]

                                YEAS--50

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

                                NAYS--50

     Baldwin
     Bennet
     Blumenthal
     Booker
     Brown
     Cantwell
     Cardin
     Carper
     Casey
     Collins
     Coons
     Cortez Masto

[[Page 5147]]


     Donnelly
     Duckworth
     Durbin
     Feinstein
     Franken
     Gillibrand
     Harris
     Hassan
     Heinrich
     Heitkamp
     Hirono
     Kaine
     King
     Klobuchar
     Leahy
     Manchin
     Markey
     McCaskill
     Menendez
     Merkley
     Murkowski
     Murphy
     Murray
     Nelson
     Peters
     Reed
     Sanders
     Schatz
     Schumer
     Shaheen
     Stabenow
     Tester
     Udall
     Van Hollen
     Warner
     Warren
     Whitehouse
     Wyden
  The VICE PRESIDENT. On this vote, the yeas are 50, the nays are 50. 
The Senate being equally divided, the Vice President votes in the 
affirmative, and the joint resolution, H.J. Res. 43, is passed.
  The majority leader.

                          ____________________