[Congressional Record (Bound Edition), Volume 163 (2017), Part 6]
[Senate]
[Pages 8425-8429]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           EXECUTIVE CALENDAR

  The PRESIDING OFFICER. The clerk will report the nomination.
  The bill clerk read the nomination of Amul R. Thapar, of Kentucky, to 
be United States Circuit Judge for the Sixth Circuit.
  The PRESIDING OFFICER (Mr. Gardner). The Senator from New Hampshire.


                         Healthcare Legislation

  Mrs. SHAHEEN. Mr. President, I am deeply concerned by warnings from 
leading health insurance companies and State insurance commissioners 
that the Trump administration is now deliberately undermining the 
Affordable Care Act, leaving insurance plans no choice but to sharply 
raise premiums or exit the marketplaces.
  I understand--I think we all do--that the Affordable Care Act 
continues to experience stresses and that it needs to be strengthened. 
There is no doubt about that. I have been saying from the beginning 
that we need to correct what is not working, that we need to keep what 
is working, and that we need to work together to change it. Yet, in 
2016, there were abundant signs that the law was working and that 
insurance markets were stabilizing.
  For instance, in my State of New Hampshire, health insurance premium 
increases last year averaged just 2 percent. That is the lowest annual 
increase in history. Today, it is a very different picture. Because of 
the efforts of the Trump administration to undermine the Affordable 
Care Act, insurance companies in New Hampshire and across the country 
face widespread uncertainty. Many of them are deciding that they have 
no choice but to protect themselves by drastically increasing premiums.
  This week, there was a report in the New Hampshire Union Leader, 
which is our State's largest newspaper, that premiums in New Hampshire 
could increase by as much as 44 percent. Now, President Trump says that 
the Affordable Care Act is ``exploding,'' but let's be clear. If 
ObamaCare is exploding, as President Trump says, it is because this 
administration lit the fuse and has been working aggressively to 
undermine the law.
  We can see on this poster what is being reported in other parts of 
the country. In the LA Times, we see that health insurers and State 
officials say that Trump is undermining ObamaCare and pushing up rates 
and that health insurers plan big ObamaCare rate hikes, and they blame 
Trump.
  Perhaps the greatest damage has been done by the administration's 
refusal to commit to funding cost-sharing subsidies, which are the 
Federal subsidies that help millions of people pay for coverage. To 
protect themselves, many insurance companies are preparing two sets of 
premiums for next year--one premium level if the administration agrees 
to fund the cost-sharing subsidies and a second, dramatically higher 
premium level if the administration says no to cost-sharing subsidies.
  More broadly, the administration's mixed signals and erratic 
management of the Affordable Care Act are causing uncertainty in the 
marketplace. Paul Markovich, the CEO of Blue Shield of California, has 
said that health plans are being forced to raise premiums to compensate 
for all of the turmoil.
  It gets worse.
  Last week, the Los Angeles Times reported that Seema Verma, the 
Administrator of the Centers for Medicare and Medicaid Services, 
shocked a meeting of insurance industry executives by threatening to 
cut off funding for cost-sharing reductions unless insurers agreed to 
support the House Republicans' bill to repeal the Affordable Care Act--
the bill that was passed several weeks ago.
  Washington State Insurance Commissioner Mike Kreidler criticized the 
administration's actions as playing Russian roulette with Americans' 
health insurance coverage. He said: ``This has real impact on people's 
lives.''
  One insurance company executive said this about the administration's 
actions: ``There's a sense that there are no hands on the wheel, and 
they are just letting the bus careen down the road.''
  Physicians and other healthcare professionals live by a time-honored 
pledge to do no harm, but the Trump administration is pursuing a course 
that will do tremendous harm to millions of Americans who have gained 
health coverage for the first time because of the Affordable Care Act. 
Unless and until Congress repeals the Affordable Care Act, it is the 
law of the land, and this administration has a responsibility to 
administer this law with fairness, with rigor, and with competence. The 
administration certainly does not have the right to take active steps 
to undermine or even sabotage the law or to threaten insurance 
companies with such steps if they do not support the repeal of 
ObamaCare.
  It is time for the administration to reconsider its approach to 
healthcare reform. To date, regrettably, the administration's approach 
has been highly partisan, with no outreach to Democrats. Instead of a 
``do no harm'' approach, instead of taking steps to fill President 
Trump's pledge that we are going to have insurance for everybody--and 
he came through New Hampshire on multiple occasions during his primary 
campaign and during the general election campaign. What he said about 
health insurance was that we were going to make sure that everybody has 
it; we are going to make sure that they pay less and that they get 
quality coverage. The administration now seems determined to take 
health coverage away from tens of millions of Americans.
  The Congressional Budget Office estimated that the House Republicans' 
bill--the first one--to repeal the Affordable Care Act would take 
coverage away from 24 million Americans. Yesterday, the administration 
proposed a budget that would cut Medicaid by as much as $1.3 trillion 
over the next decade. That would end coverage for millions of low-
income Americans, people with disabilities, and so many of our elderly 
in nursing homes. In New Hampshire, where we are really on the 
frontlines of the heroin and opioid epidemic, it would end treatment 
for many people who are getting treatment for their substance use 
disorders because of the expansion of Medicaid.
  When we think about the people who would be hurt by this, it is 
unconscionable to hear Office of Management and

[[Page 8426]]

Budget Director Mick Mulvaney say: ``There is a certain philosophy 
wrapped up in the budget, and that is that we are no longer going to 
measure compassion by the number of programs or the number of people on 
those programs.'' I disagree with that view. By deliberately taking 
healthcare coverage from 24 million Americans, it shows the lack of 
compassion of this administration.
  This is not about numbers. He is right about that. This should not be 
about numbers. This should be about people, about their families, and 
about what these proposals will do to everyday Americans who will no 
longer have access to affordable health coverage. Whether they have 
preexisting conditions or whether they need to get treatment for 
cancer, for substance use disorders, or for whatever their healthcare 
needs are, under this proposal, they are not going to be able to afford 
it. Millions of Americans will not be able to afford it.
  I think there is a better way forward. Instead of tearing down the 
Affordable Care Act and taking health coverage away from people, we 
should be building on the gains and on the achievements of healthcare 
reform.
  On that score, I want to share an extraordinary letter to the editor 
that was written by Carol Gulla, of Newmarket, NH.
  I am reading her letter:

       I was in good health; why bother with a physical?
       That was my mentality for years before the Affordable Care 
     Act (aka Obamacare). I work for a small nonprofit business, 
     so we don't qualify for group health insurance plans. An 
     annual physical wasn't included in the high premium, high 
     deductible plans that were available to me on the individual 
     health insurance market so they were often a luxury. But it 
     was OK; I felt great! Why bother with doctors?
       Because of the Affordable Care Act, last June I went for a 
     routine physical. During [the exam] a lump was discovered in 
     my breast. Ten days later, breast cancer was diagnosed. . . . 
     Fast forward to today. I've just completed my final 
     chemotherapy treatment and my prognosis is very positive. 
     That physical saved my life.
       Let me restate that--Obamacare saved my life.
       That crucial physical in June would not have happened had 
     it not been an essential preventive service included in all 
     health plans under the ACA. While not perfect, my insurance 
     through the ACA is far better than anything available to me 
     as an individual in the past.

  Ms. Gulla's letter continues:

       Up until this point I have been pretty quiet about my 
     diagnosis simply because I didn't want cancer to be the main 
     topic of every conversation I had. But, with the Republican 
     majority in Washington, including Secretary of Health & Human 
     Services Tom Price, promising to repeal the ACA, being quiet 
     is no longer an option. I am being asked to entrust my health 
     and well-being to hollow promises of it will ``be replaced by 
     something better; it will be great.'' Forgive me if I'm 
     skeptical!
       This is my life we're talking about! Do not tell me to be 
     patient. Do not tell me to ``wait and see.'' Either outline a 
     . . . plan for improving the Affordable Care Act, or leave my 
     health insurance alone!

  She signs it with her name, Carol Gulla, of Newmarket, NH.
  I think we need to listen to Carol and to so many other people like 
her all across America.
  Instead of allowing this administration to undermine and even 
sabotage the Affordable Care Act, we in the Senate need to work 
together, Democrats and Republicans, to strengthen the parts of the 
Affordable Care Act that are working in the real world, including 
Medicaid expansion, and to fix what is not working. According to 
multiple recent polls that I have seen on this issue, this is what the 
great majority of Americans want us to do. It is time for us to listen 
to the American people.
  The Affordable Care Act has had a profoundly positive impact all 
across America, but it needs commonsense repairs and it needs 
strengthening. Mend it, don't end it, and certainly don't sabotage it. 
This should be a bipartisan focus in the Senate. I intend to do 
everything I can to encourage such a bipartisan effort. I know my 
colleagues on both sides of the aisle would be willing to do this 
important work if they understood how much the American people want to 
see us do this.
  We know that the Affordable Care Act has had positive impacts in each 
of our States, including giving people peace of mind, knowing they 
can't be denied coverage based on preexisting conditions. So let's work 
together. Let's ensure that the Affordable Care Act works even better 
in the future for all Americans.
  Thank you, Mr. President.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Illinois.
  Mr. DURBIN. Mr. President, I want to thank my colleague from New 
Hampshire before she leaves the floor for her statement on the 
Affordable Care Act. I know she made reference to the recent report 
from the Congressional Budget Office that we just received, and it 
tells the whole story. It tells us all we need to know about TrumpCare 
2--the second attempt by the Republicans to replace the Affordable Care 
Act. What it tells us in the starkest terms is exactly the reason why 
the Republicans didn't want to wait around for this analysis.
  For the record, the Congressional Budget Office is a nonpartisan 
agency of the Federal Government that analyzes our great ideas and 
tells us what is going to happen if they become law. I know this agency 
pretty well because when we wrote the Affordable Care Act, we waited 
and waited and waited, sometimes weeks at a time, until some bright 
idea that we thought we had was analyzed in the cold reality of 
healthcare in America. Sometimes they came back and said good idea, and 
many times they came back and said bad idea.
  The Republicans passed TrumpCare 2 in the House about 3 weeks ago and 
wouldn't wait for the Congressional Budget Office analysis. We thought 
to ourselves, that is unusual. That is the standard everybody uses in 
Congress. They wouldn't wait because they knew what was coming, and 
today it was announced.
  This afternoon, here is what the Congressional Budget Office said 
about the Republican attempt to repeal the Affordable Care Act. Next 
year, under the Republican plan, 14 million Americans would lose their 
health insurance. How about that for a starter. That is the starting 
point of their analysis. Over the next 10 years, 23 million Americans 
would lose their health insurance. Next year, premiums--the cost of 
health insurance--would increase 20 percent in the individual market. 
The CBO affirms that under current law--the Affordable Care Act--the 
marketplaces are stable. However, under the Republican repeal bill, 
one-sixth of the population resides in parts of America where the 
individual market would become unstable beginning in the year 2020.
  There will be $834 billion in cuts in Federal Medicaid Programs over 
the next decade. Do we know what those cuts mean? In my State, half the 
children born are covered by Medicaid. The mothers get prenatal care so 
the babies are healthy--paid for by Medicaid. The delivery is paid for 
by Medicaid. The postnatal care of that little infant is paid for by 
Medicaid.
  That is not the most expensive part of Medicaid in my State and in 
most States. The most expensive part is for your mom and your 
grandmother in the nursing home. That is where most of Medicaid money 
goes. Two-thirds of it goes to those folks in nursing homes who have no 
other source of income, not to mention the disabled who count on 
Medicaid.
  What the Congressional Budget Office tells us is that the Republican 
plan is going to devastate Medicaid across the United States. Which of 
the groups I just mentioned do we think we can toss overboard--babies 
born to low-income mothers, or the elderly who have no place to turn 
and have exhausted their savings and are living in nursing homes, or 
the disabled who need the help of Medicaid on a regular basis? Those 
are the casualties of this Republican repeal plan, not to mention the 
fact that the real driving force behind these terrible healthcare 
decisions is a tax cut for the wealthiest people in America.
  This is from the Congressional Budget Office again: $88 billion in 
tax cuts for the superwealthy and big businesses, including drug 
companies.

[[Page 8427]]


  Mrs. SHAHEEN. Mr. President, will my colleague yield for a question?
  Mr. DURBIN. I am happy to yield.
  Mrs. SHAHEEN. Those numbers came out while I was speaking on the 
floor, because I was talking about the first House-passed bill to 
repeal the Affordable Care Act. What the Senator from Illinois is 
telling me is that the numbers for the bill they passed to fix the 
first bill they couldn't pass are just as bad and in some ways even 
worse than the original bill.
  Mr. DURBIN. Mr. President, through the Chair, in response to the 
Senator from New Hampshire, they are equally disastrous.
  Listen to these quotes from the Congressional Budget Office this 
afternoon about the Republican repeal plan: ``People who are less 
healthy, including those with preexisting conditions, would ultimately 
be unable to purchase comprehensive individual market insurance at 
premiums comparable to those under current law if they could purchase 
it at all.''
  Listen to this. It goes on to say: ``In particular, out-of-pocket 
spending on maternity care and mental health and substance abuse 
services could increase by thousands of dollars in a given year for the 
individual market enrollees who use those services.''
  Let me bring this home to your State. Your State has been 
devastated--our State has been hurt badly--your State has been 
devastated by the opioid crisis. I would like the Senator from New 
Hampshire, if she would, to respond to that by giving us some detail. 
What they are saying is that the Republican repeal of the Affordable 
Care Act is going to deny coverage in health insurance for substance 
abuse treatment for families whose kids are discovered to be on 
opioids.
  I yield through the Chair without yielding the floor to the Senator 
from New Hampshire to describe her challenge in New Hampshire.
  Mrs. SHAHEEN. Well, that was going to be my followup question. In New 
Hampshire, we have the second highest percentage of overdose deaths in 
the country. We lose more people in New Hampshire to deaths from 
overdoses of opioids and fentanyl and heroin than we do to car 
accidents. And an overwhelming percentage of people--over 90 percent--
are getting treatment for their substance abuse disorders through the 
expansion of Medicaid, which has been a bipartisan program in New 
Hampshire that has covered about 60,000 people, many of whom are 
getting treatment for substance abuse disorders.
  So what the Senator from Illinois is telling me, from the CBO, is 
that based on the plan that passed the House that Republicans have 
supported, those people who are getting their treatment--lifesaving 
treatment for mental health issues and substance abuse disorders--they 
are going to be kicked off of their plan, and they are not going to 
have any other option for getting that care.
  Mr. DURBIN. That is what the Congressional Budget Office reports.
  So we have these discussions on the floor--and the Senator from New 
Hampshire has been in the middle of them because of her State's 
experience with opioids--and both parties come together and wring their 
hands and say: What are we going to do about the opioid-heroin crisis 
in America? And we have come up with some good ideas. But here we have 
the Republican effort repealing the Affordable Care Act, which cuts the 
legs out from under all of our efforts because it takes away from 
families' Medicaid coverage that they are using for drug treatment, as 
well as coverage in their health insurance plans.
  Mrs. SHAHEEN. Mr. President, if my colleague will yield once more, 
last year we passed the 21st Century Cures Act, which appropriated $1 
billion--$500 million this year and $500 million next year--to address 
the heroin and opioid epidemic we are having, and in the recent passage 
of the omnibus bill, we got $700-plus million to help us fight this 
epidemic. So on the one hand, we are putting money in to address it, 
and on the other hand, we are taking away the treatment people need by 
passing a healthcare bill that is going to throw people off their 
treatment and give them no other option to address their substance use 
disorders.
  Mr. DURBIN. That is exactly what the Congressional Budget Office 
reports to us.
  This afternoon we had a press conference and we invited four or five 
families to come in with their kids. The theme of the press conference 
was, what is going to happen if your child has a preexisting condition?
  Well, there were some amazing little kids there and some heroic moms 
and dads telling the story about what happens when you discover that 
your little infant has a cantaloupe-sized tumor from neuroblastoma and 
what happens for that family, what happens to that infant. Thank 
goodness those kids were all standing there smiling. They fought the 
good fight, and they have to continue to fight it, and each and every 
one of them is branded as having a preexisting condition. Back in the 
old days, before the Affordable Care Act, that meant those families 
were unable to buy health insurance, or if they could buy it, they 
couldn't afford it because the premiums were too high. So we passed the 
Affordable Care Act and said: Enough. We are not going to allow you to 
discriminate against anyone for a preexisting condition.
  If you have a spouse with diabetes, if you have somebody in your 
family who is a cancer survivor, they can't use it against you. They 
can't discriminate. Now the Congressional Budget Office tells us what 
is going to happen to those people. We are going back to the bad old 
days when those families will not only have to stay awake at night 
worrying about whether that baby of theirs is going to survive, they 
are going to stay awake at night also worrying about how in the world 
they are going to pay for their health insurance.
  Is that the Republican answer? Is that Trumpism at work when it comes 
to healthcare in America? I can't believe the American people voted for 
that. I can't believe they are saying to our Republican colleagues: We 
really don't care if our health insurance covers preexisting 
conditions. Of course they care.
  They come back with something called high-risk pools. I am sure the 
Senator from New Hampshire can remember those. Let me tell you about 
some of those warnings around swimming pools that say: No diving, the 
pool is too shallow. Well, the high-risk pools for preexisting 
conditions are way too shallow. No family with preexisting conditions 
should dive into those pools because the amount of money provided for 
by the Republicans in their affordable care repeal would only cover 
about one out of four families with preexisting conditions. Three out 
of four families: You are on your own.
  Think about that. If you have ever been in a position in life where 
you are a parent with a sick child and have no health insurance, you 
will never forget it as long as you live. I know because I have been 
there. When I was a law student with a little baby who was sick, I had 
no health insurance. I will never forget it as long as I live.
  Why don't the Republicans hear the same message we hear? Why aren't 
they listening to these families and the struggles they are going 
through to keep their kids alive? And they come up with a repeal plan 
that is going to make it exceedingly difficult--in some cases 
impossible--to provide quality care to these kids and to people with 
preexisting conditions. That, to me, is not our responsibility.
  I go to the conclusion of the Senator from New Hampshire, which I 
think is the right one. Is the Affordable Care Act perfect? No. It is 
one of the most important and I think the most giving bills I have ever 
voted for, but it is far from perfect. We should be sitting down with 
the other side of the aisle--Republicans and Democrats--not to repeal 
the Affordable Care Act but to make sure we make the repairs that make 
a difference.
  Each one of us has a list of things we would like to see addressed. 
The cost of premiums are too high in the individual market. Let's 
address that directly, and we should. The fact that pharmaceutical 
drugs don't have any regulation or control in terms of pricing is just 
plain wrong. And third--I

[[Page 8428]]

will just put on my agenda--I think every American should have the 
option of a public option plan like Medicare. You can decide if that is 
right for you or your family, but a not-for-profit plan based on 
Medicare should be available to every American no matter where you 
live. Those are the three things I would put on the table right away. 
To walk away from coverage for 23 million Americans and to endanger the 
coverage for those who remain with premiums they can't afford is hardly 
humane and hardly consistent with American values.
  So I thank the Senator from New Hampshire for her contribution in 
this. We have to get the message out.
  Mrs. SHAHEEN. If I could just add one more group of folks who are 
going to be affected by this bill that passed the House several weeks 
ago. That is our veterans. We have millions of veterans in this country 
who get their healthcare through Medicaid. We have asked these folks to 
put their lives on the line for this country, and now we are talking 
about taking away the healthcare they depend on.
  I was at one of our community mental health centers in New Hampshire 
last week and met with a number of veterans who get their care through 
the expansion of Medicaid. They talked about what it means to be able 
to get care, to be able to go into that community mental health center 
and work with the veterans outreach coordinator who works with 
veterans, trying to make sure they get the help they need. If this bill 
goes forward, PTSD, which affects so many veterans, would be considered 
a preexisting condition and they wouldn't be able to get health 
insurance going forward.
  This is bill is nothing but mean-spirited. As the Senator said, all 
of the efforts to save money in the bill are so money can be used to 
give huge tax breaks to the wealthiest among us. I don't think that is 
what Americans want. As the Senator says, we need to work with our 
colleagues. We need to get a good bill that improves the Affordable 
Care Act, fixes what is not working, and makes it better.
  Mr. DURBIN. If I may also say, I agree completely that discriminating 
against veterans should hardly be the starting point for the reform of 
our healthcare system.
  I want to make this point because I know exactly what the first 
speech will be from the Republican side of the aisle. This point in the 
Congressional Budget Office affirms that under current law insurance 
marketplaces are stable. They are stable. That isn't what you will hear 
from the other side of the aisle. The other side of the aisle loves to 
use the phrase ``death spiral,'' that the current healthcare system in 
America is in a death spiral.
  The only death spiral in the current healthcare system is brought on 
because the Republicans have their hands around the throat of that 
system and they are choking it. Their sabotage of our current 
healthcare system is the reason there is uncertainty in the insurance 
markets. The insurance companies told us that this week: We don't know 
where you are going in Washington. We don't know what the future will 
hold. We have an obligation to our shareholders and people who work for 
us to make sure we protect ourselves. So we are going to hold back in 
terms of commitment.
  So to the Republicans I would say: This is no death spiral. This is a 
self-fulfilling prophecy to bring down our healthcare system, and shame 
on those who would do it at the expense of vulnerable populations 
across America.
  I will mention one other group while the Senator from New Hampshire 
is on the floor. The Illinois Hospital Association roundly opposes this 
Republican TrumpCare bill. The reason they do is they say it endangers 
smalltown hospitals--and we have a lot of them in our State--and inner-
city hospitals as well. I am sure that is the case in New Hampshire.
  Mrs. SHAHEEN. Actually, the New Hampshire Hospital Association also 
opposes the bill for the very same reason. We have hospitals at risk if 
this bill is passed.
  Mr. DURBIN. I am sure, in the Senator's State, like in our State of 
Illinois, there are larger cities with big hospitals that treat all 
kinds of cases, but were it not for that safety net of hospitals in 
small towns, these people living there would drive an extra 50 or 100 
miles to get to a hospital and would see the loss of critical services 
for trauma and emergencies that currently exist with these smalltown 
hospitals.
  According to the Illinois Hospital Association and others, the first 
casualties of the Republican repeal bill--the first casualties of 
TrumpCare--it is estimated in Illinois that we will lose 60,000 
healthcare jobs at our hospitals because of the Republican approach. 
How important are these jobs? I will go out on a limb: In most 
communities, they are the best paying jobs in the community. The men 
and women who are the doctors and the nurses and the specialists who 
provide that basic care in these towns, sure, they get compensated 
better than most, but we want to compensate them and keep them there 
because without them, people don't have the basic health services they 
count on.
  So from every perspective, whether it is the doctors, the nurses, the 
pediatricians, substance abuse treatment, hospitals and clinics, the 
Republican approach to repealing ObamaCare--repealing the Affordable 
Care Act--is devastating, and the Congressional Budget Office put it in 
writing today.
  I might say, we should close by saying what is happening in the 
Senate after the House passed this terrible bill, which the 
Congressional Budget Office told us about. Well, we don't know. It is a 
mystery. We would have expected that someone in the Senate would have 
decided: Let's put a bill on the table, let's have an open public 
hearing, let's have a debate about where we go, and let's make a good, 
sound decision that is in the best interests of the American families. 
That is not the case at all.
  Instead, the Republican leader in the Senate has chosen 12 or 13 men 
to sit in a room outside of the view of the public and to craft an 
alternative to the terrible bill that passed the House. Nobody has seen 
it, nobody wants to talk about it. It has not been scored. It has not 
been debated. That is their idea of reforming healthcare in America. 
That is not going to work--at least not going to work for the best 
interests of the families I represent.
  If we are going to come together on a bipartisan basis to repair and 
strengthen the Affordable Care Act, let's do it, but let's do it in the 
light of day, instead of hiding behind the doors of some room with 13 
Senators who have been given this blessing, anointed, to try to come up 
with a new healthcare system for America. That, to me, is inconsistent 
with our responsibility--our public responsibility--when it comes to 
this critical issue.
  So I thank the Senator from New Hampshire for her input on this. 
There will be more to be said.
  Mrs. SHAHEEN. There will be. If I could ask one final question 
because not only is this effort in the Senate happening behind closed 
doors, but initially it excluded women.
  Women are more than 50 percent of this country. We have particular 
needs when it comes to healthcare. Fortunately, the essential health 
benefits part of the Affordable Care Act provide requirements for 
preventive health for women, for mammograms. They cover maternity 
benefits when you have a baby. They are talking about writing this 
legislation without taking into consideration the women in the Senate, 
the women in the country, and what we need to do to make sure we have 
access to healthcare. That is just unconscionable, added to the fact 
that it is all being done behind closed doors.
  Mr. DURBIN. I agree with that. Also, as the Senator from New 
Hampshire knows better than anybody, originally being a woman was a 
preexisting condition.
  Mrs. SHAHEEN. Absolutely. They want to take us back to that.
  Mr. DURBIN. It would disqualify you or raise your premiums because 
you are a woman. We got rid of that gross discrimination against women 
when we did the Affordable Care Act. We shouldn't have a similar level 
of discrimination when it comes to writing any improvement in this 
Affordable Care Act.

[[Page 8429]]

  This is a big enough Senate and a big enough place for us to all 
gather around the table and make sure we do this in the best interests 
of all Americans, regardless of gender, regardless of background, 
regardless of where you live. That is the way we should approach 
something as serious as an item that accounts for $1 of every $6 in the 
American economy--an item that is literally life and death for families 
all across Illinois, New Hampshire, and all across the United States.
  The Congressional Budget Office said it all today. It is time for us 
to put Trump 2.0 to rest and try to come up with something which really 
is befitting this great Nation.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Lee). The clerk will call the roll.
  The 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. Without objection, it is so ordered.
  Ms. WARREN. Mr. President, I rise to oppose the nomination of Judge 
Amul Thapar to serve as a judge on the Sixth Circuit Court of Appeals.
  It should surprise absolutely no one that Judge Thapar is the second 
nominee to a Federal court to come up for a vote in this Congress. His 
nomination comes on the heels of the nomination of now-Justice Neil 
Gorsuch, an ultraconservative who could not earn enough support to be 
confirmed under Senate's normal rules, a judge so radical, so 
controversial that Senate Republicans had to change the Senate rules 
and lower the vote threshold to force his nomination through the 
Senate.
  Now the Senate is poised to vote on a judge cut from the same cloth. 
Like Justice Gorsuch, Judge Thapar made the list of 21 acceptable 
judges that far-right groups drew up and handed to President Trump--
judges who would tilt the scales of justice in favor of the rich and 
the powerful. As in Justice Gorsuch's case, those radical groups are 
committed to doing whatever it takes to make sure Judge Thapar sits on 
the Nation's highest courts.
  For those groups, the goal is not just to get a few ultraconservative 
judges on our Federal courts; it is to capture the entire judicial 
branch. For years, billionaire-funded, rightwing groups have worked 
hand in hand with Republicans to ensure that our courts advance the 
interests of the wealthy and powerful over the rights of everyone else. 
They abused the filibuster to stop fair, mainstream judges from filling 
vacancies on Federal courts, they slowed the judicial nominations 
process to a crawl, and they threw the Constitution and Senate 
precedent out the window by refusing to consider President Obama's 
Supreme Court nominee. Under their watch, judicial vacancies stacked up 
and courts became overloaded with cases. Now Republicans and their 
extremist friends have a President who shares their concern about the 
interests of the 1 percent, and they are ready to stack our Federal 
courts with judges who will advance their radical agenda. Judge Thapar 
is much more than up to the task.
  There are many reasons to oppose Judge Thapar's nomination to the 
Sixth Circuit, from his decisions making it harder for working 
Americans to get access to the judicial system to his support for 
sentencing policies that don't make us safer but that exacerbate the 
problem of mass incarceration. There is a lot to object to, but I want 
to highlight one area that should concern every person who thinks 
government should work for all of us; that is, Judge Thapar's stance on 
money in politics.
  For decades, our laws restricted the amount of money that individuals 
and corporations could pour into the political process. In recent 
years, Federal courts chipped away at those laws, and then Supreme 
Court decisions in cases like McCutcheon and Citizens United took a 
sledgehammer to campaign finance laws, unleashing a flood of dark money 
into the political system.
  There are now dozens of perfectly legal ways for the 1 percent to buy 
influence and favor: corporate campaign contributions and super pacs, 
the revolving door between government and the private sector, bought-
and-paid-for experts to push alternative facts, armies of lobbyists 
swarming the Halls of Congress. Their investments have paid off in the 
form of special breaks, exemptions, deals, riders, subsidies, 
loopholes, and every other handout industry can imagine. That money--
that unaccountable, dark, unlimited money--has fundamentally distorted 
our democracy.
  Judge Thapar would make the problem worse. Judge Thapar believes that 
actual speech and monetary contributions are basically the same thing. 
When he had to decide on the constitutionality of a Kentucky rule 
preventing State judges and judicial candidates from donating to 
political groups or campaigns, he concluded that the rule was 
unconstitutional. In his decision, Judge Thapar said: ``There is simply 
no difference between `saying' that one supports an organization by 
using words and `saying' that one supports an organization by donating 
money.'' No difference between talking about a candidate and dumping a 
bucket of money into the candidate's campaign. Wow.
  In Judge Thapar's view, the Constitution should protect a 
billionaire's right to dump unlimited sums of money into the political 
process to influence the outcome of elections. That is even further 
than the Supreme Court has gone. As the Sixth Circuit reminded Judge 
Thapar when it reversed his decision on donations, even the Supreme 
Court has refused to treat monetary donations as equivalent to direct 
speech.
  The issue of concentrated money in our political system is one that 
doesn't split down party lines. Americans of all political views cringe 
at the massive amounts of secret money that slither through our 
political process. They have seen politicians beholden to the handful 
of deep-pocketed individuals and giant corporations, and they have seen 
those politicians turn their backs on the constituents they were 
elected to represent. That is at the heart of what is wrong in our 
Nation. Our government should work for everyone, not just for the 
millionaires and billionaires.
  Fighting for a government that is accountable to the people means 
fighting to reduce the influence of concentrated money and concentrated 
power in our political system. It is time to take down the sign that 
says ``government for sale'' that hangs above Washington, DC, and we 
can start today by rejecting Judge Thapar's nomination to serve on the 
Sixth Circuit Court of Appeals.
  Mr. President, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. McCONNELL. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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