[Congressional Record (Bound Edition), Volume 163 (2017), Part 9]
[Senate]
[Pages 12415-12416]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           EXECUTIVE SESSION

                                 ______
                                 

                           EXECUTIVE CALENDAR

  The PRESIDING OFFICER. Under the previous order, the Senate will 
proceed to executive session to resume consideration of the Newsom 
nomination, which the clerk will report.
  The senior assistant legislative clerk read the nomination of Kevin 
Christopher Newsom, of Alabama, to be United States Circuit Judge for 
the Eleventh Circuit.
  The PRESIDING OFFICER. The assistant Democratic leader.


                               Healthcare

  Mr. DURBIN. Mr. President, last week, on a bipartisan basis, the 
Senate rejected a bill that would have repealed the Affordable Care 
Act. This should be a turning point, not just in our healthcare debate 
but in the way that we move forward in the Senate.
  The speech given by Senator McCain when he returned to the Senate 
Chamber last week lasted about 15 minutes, and, in that short period of 
time, the senior Senator from Arizona reminded us of our historic 
responsibility here in the Senate and the role that we play under our 
Constitution as an independent branch of government, and he then 
exhorted us to put away the partisanship and the gamesmanship and move 
to what we would call regular order in the Senate: Send a bill to a 
committee, have the committee consider the bill, bring in experts, go 
through an amendment process, report it to the floor, and have another 
amendment process hoping that the collective wisdom of the committee 
and the body will result in a work product that actually achieves the 
goal that we set out to achieve. That is the regular order. That is 
what John McCain asked us to get back to, and now we have that chance.
  On a bipartisan basis, I believe the Senate must come together and 
work on solutions to improve our healthcare system. First, we have to 
stabilize it. In just a few weeks, the major insurance companies are 
going to announce their premiums for the next year, and I am afraid 
they are going to show dramatic increases, because what the industry 
has told us over and over is that the one thing they can't calculate is 
the uncertainty of policy decisions. So as long as we have not done our 
job in stabilizing the healthcare system, they will either step away 
from risk or charge higher premiums to cover the possibilities of 
greater risk. That is what we face in just a few weeks and particularly 
if this administration--the Trump administration--follows what the 
President has said over and over in his tweets. We have listened to the 
President basically say what I consider to be an irresponsible thing: 
Let the healthcare system fail; then the Democrats will come on their 
knees and beg us to change it.
  Well, if the healthcare system fails, it will not have much impact on 
the President and his immediate family. They will still have health 
insurance. But if it fails, many people will not be able to afford 
basic health insurance. They may lose it, and others may lose their 
coverage altogether. It could be a personal disaster--a family disaster 
across the board. I can't believe that anyone--let alone the 
President--would suggest that is the best path to a constructive 
outcome. Responsibility suggests that there is a better way.
  Thanks to the Affordable Care Act, 20 million previously uninsured 
Americans have gained healthcare coverage, including more than 1 
million people in my State of Illinois. Thanks to the Affordable Care 
Act, our Nation's uninsured rate is at the lowest level in history. We 
cut it in half in Illinois. Thanks to the Affordable Care Act, 
insurance companies can no longer engage in the type of abusive conduct 
that was well known and well established before the passage of the 
Affordable Care Act.
  Before the passage of that law, insurance companies decided that 
women, because of their gender, had a preexisting condition and, 
therefore, had to pay more for health insurance than men. They used to 
charge older people exorbitantly more than younger people for 
insurance. They would deny maternity care, mental health or substance 
abuse care, deny insurance to people with preexisting conditions or 
charge them sky-high premiums. They would impose annual or lifetime 
caps on benefits and kick people off insurance when they got sick and 
needed care.
  The Affordable Care Act changed each and every one of those things. 
Young adults, in addition, can now stay on their parents' health 
insurance plans up to the age of 26, and seniors with Medicare are 
getting free preventive care and substantial discounts on their 
pharmaceuticals.
  The law is far from perfect. Improvements can and should be made. We 
have done that over the years to Social Security and Medicare. We 
should do it again here. Six percent of Americans and 3 percent of 
Illinoisans purchase their insurance in the individual market, and more 
than 50 percent of those people receive premium subsidies to help them 
pay for their monthly premiums. For these people, especially those who 
don't qualify for subsidies, insurance options can be limited or 
expensive. So while there are clear challenges, we also need to be 
honest about the scope of the problem and where we need to make fixes. 
There are ways to help.
  First, the 19 States that have refused to expand their Medicaid 
Program should do so. If they did, 4.5 million more Americans would 
instantly gain access to healthcare coverage. Many of these people who 
would gain coverage go to work every single day--sometimes to more than 
one job a week--

[[Page 12416]]

and they don't have any healthcare benefits where they work. They have 
no place to turn. Medicaid can help. If Republicans are serious about 
wanting to provide people with access to affordable health insurance, 
Medicaid expansion is the most commonsense measure we can take.
  Second, the administration should stop stoking uncertainty in the 
individual market and commit to paying cost-sharing reduction subsidies 
known as the CSRs. These Federal subsidies now help 7 million Americans 
with out-of-pocket health insurance costs. If the Trump administration 
sabotages the healthcare system and refuses to make these payments, 
premiums on these individuals would increase by 20 percent next year 
alone. Now, many of my Senate Republican colleagues, including HELP 
Committee Chairman Lamar Alexander of Tennessee, support the CSR 
payments. I think that is a responsible course of action. In fact, they 
are even included in some of the Republican healthcare repeal bills. It 
is time to end this ``will they or won't they'' game--this 
uncertainty--and reassure Americans and insurers that payments are 
going to be made. The uncertainty is going to raise the cost of health 
insurance for everybody. For goodness sake, let's move in the opposite 
direction, bring stability and bring assurances of where we are headed 
so that healthcare premiums can stabilize and perhaps not go up as far 
as they would otherwise.
  Third, we should give people in the individual market more affordable 
options. I support offering a Medicare-like plan. If insurers choose 
not to participate in the individual market, why wouldn't the 
government step in and offer an option that individuals can decide 
whether they want to take it.
  Finally, we have to do something about the high cost of prescription 
drugs. They are contributing directly to massive premium increases. The 
health insurance companies tell us--in Blue Cross Blue Shield's case in 
Illinois, they are paying more for prescription drugs in Illinois than 
they are paying for inpatient hospital care--that is driving premiums 
higher.
  What have we done to deal with prescription drug costs exactly? 
Nothing. There is nothing in the Affordable Care Act that even monitors 
these costs when it comes to the public at large and very little, if 
anything, has been proposed or passed in Congress to deal with these 
out-of-control increases in prescription drug prices. I think drug 
companies should have to publicly justify their prices and provide 
ample lead time when they are going to raise these prices.
  Drugs that are developed with significant Federal taxpayer dollars--
and that is many of them--whether from the National Institutes of 
Health or the Department of Defense, should commit to reasonable 
pricing in their products. If these drug companies are using taxpayer 
subsidized research to develop a drug, I think they have a special 
public responsibility when it comes to the marketing of that drug to 
make sure the pricing is reasonable. The taxpayers helped them to a 
profitable position. They shouldn't go overboard and overcharge.
  Last week when Senator McCain made his appeal on the Senate floor, he 
really called on us to work together to get something done. I have 
noticed that there is a bipartisan effort underway in the House. I 
believe we will hear one this week in the Senate. I am glad that we are 
heeding his advice. I agree with the Senator from Arizona that it is 
time for the Senate to turn to regular order, hold hearings, bring in 
experts, and really work together on proposals that would expand access 
to affordable health insurance coverage and care. Democrats stand ready 
to work with Republicans to do this. It is time to put ObamaCare repeal 
behind us. It is time to move forward on behalf of those who are 
counting on us.
  I yield the floor.


                   Recognition of the Majority Leader

  The PRESIDING OFFICER. The majority leader is recognized.


                         Work Before the Senate

  Mr. McCONNELL. Mr. President, as I said yesterday, the Senate has a 
number of nominations to consider in the coming days.
  Yesterday we voted to advance a well-qualified judicial nominee to 
serve on the Eleventh Circuit Court of Appeals.
  Soon we will consider one of the President's nominations for the 
National Labor Relations Board, and we obviously need to confirm an FBI 
Director. I would hope, with all the threats facing us at home and 
abroad, our Democratic colleagues would not launch the first filibuster 
of a nominee to be FBI Director, especially one who was reported out of 
the Judiciary Committee by a vote to 20 to 0. These are just a few of 
the many nominees who need to be acted upon and quickly.
  Up until now, our friends across the aisle have thrown up one 
unnecessary procedural hurdle after the next on even the most 
uncontroversial of nominees. As a result, I noted last month that at 
the pace we were going, it would take more than 11 years to confirm the 
remaining Presidential appointments. Well, that pace has slowed even 
further. Now it would take 12 years.
  It is time to end this.
  I look forward to our Democratic colleagues cooperating with us to do 
that so the Senate can spend its time considering other things that are 
important to our constituents. We have legislation to address over the 
remainder of this work period as well. Our veterans deserve the best 
care the country can provide. Under the last administration's VA 
scandal, the veterans were let down in a big way. Congress came 
together in the wake of that scandal to pass the Veterans Choice 
Program, which allows many veterans to skip the long wait and travel 
times at some VA facilities and access private care.
  The House recently acted to shore up this program on an 
overwhelmingly bipartisan basis, 414 to nothing. Now the Senate needs 
to act as well.
  We also need to renew the FDA User Fee Program. This program is 
critical to speeding up the drug approval process, and that is 
important to everyone frustrated by the time and costs of bringing 
lifesaving drugs to market. Without it, the important work of ensuring 
that drugs and devices are safe and effective would literally come to a 
screeching halt. Every 5 years, these agreements need to be reviewed 
and reauthorized. The Senate legislation to do so was reported by the 
HELP Committee on a 21-to-2 bipartisan vote, and given the lifesaving 
developments in immunotherapy and personalized medicine on the horizon, 
it is more important than ever.
  We have important work to do over the remainder of this work period. 
I hope colleagues will cooperate across the aisle in our efforts to do 
so.

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