Zero-Baseline Budget Act of 2018

Mr. President, before Senator King leaves the floor, let me just say, as one who ran the legal services for the elderly program in Oregon, that the Senator makes all of us in legal services proud tonight. Senator King has really put a face on what is at stake here in the way he has focused on the opioid scourge that is hammering areas from coast to coast. Rural health care--without rural health care, we can't have rural life. It is just that simple. Certainly when we get to the closing here in perhaps an hour and a half or so, we are going to get to the bottom line, as the Senator did. I think these changes take America back to the day where health care was for the healthy and wealthy.

So I thank the Senator for his passion and his commitment to his citizens, but also to the people of this country. Anybody in legal services tonight will be very proud, as I am, because what it is all about is standing up for people, and the Senator has said it very well.

Mr. President, we will be having our closing remarks here in perhaps an hour and a half or thereabouts. We have several Members of the Senate who are on their way for their remarks, and several Members of the Senate have discussed various elements of the serious and unanswered ethics questions surrounding Congressman Price's nomination. It is my view that these are issues that have set off loud ethical alarm bells.

I want to take a little bit more time to lay out the full story here.

The stock trades Congressman Price made while working on health care policy do, in fact, raise serious ethical and legal questions. None of Congressman Price's stock trades raise more questions than the hundreds of thousands of shares he bought in the obscure Australian biotech company known as Innate. His stock in this company is by far his largest of holdings, both in terms of the hundreds of thousands of shares he owns and the value of those shares, and that exceeds a quarter of a million dollars.

Congressman Price told the Finance Committee that he did not get a special deal. He told the Health, Education, Labor Committee that he did not get a special deal. But the fact is, Congressman Price paid bargain-basement prices for Innate stock in a private sale last August. The private stock sale was limited to a small group of well-connected American investors.

Congressman Price's participation has been described as a ``sweetheart deal'' by Kaiser Health News and a ``privileged, discounted offer'' by the Wall Street Journal.

As I said during his nomination hearing, Congressman Price's participation in the private stock sale showed bad judgment at best. At worst, it raised serious questions about whether he violated the STOCK Act or other security laws. I will take a minute to read section 3 of the STOCK Act. It says: ``Members of Congress . . . may not use nonpublic information derived from such person's position . . . or gained from the performance of such person's official responsibilities as a means for making a private profit.''

It is well known that Congressman Price learned about Innate from a House colleague, Congressman Chris Collins of New York. Collins is not just a casual reader of the Australian business pages; he is actually a member of the company's board and its largest shareholder.

This raises additional questions: Did Congressman Price have access to nonpublic information about Innate or its private stock because of his position as a Member of Congress? Did he get special access to the discounted private sale because of his position? Does he stand to profit because of the information or access he may have received?

Finally, did Congressman Price tell the Finance Committee the truth about how he learned about the private stock sales and the ability of typical investors to participate?

Congressman Price would have us believe that he decided to make these investments based on his own research into the company. That is what he told the Finance Committee.

Let me quote from the Wall Street Journal's article published January 30:

Mr. Price wasn't in line to buy shares in the last private

placement because he hadn't previously participated in

private fundraising rounds. . . . Mr. Price first invested in

the company a year ago, buying shares through the open market

on the Australian exchange. He learned about the company from

Mr. Collins, who holds a 17 percent stake in it. Mr. Collins

said Mr. Price is ``one of my friends'' and that he sits

``next to him'' on the House floor. . . . Mr. Price got it on

the discounted sale after Mr. Collins filled him in on the

company's drug trial, according to Mr. Collins.

The fact is, you don't just get in on a private stock offering by accident. As the Wall Street Journal explained, Congressman Price didn't originally even meet the criteria for participating in the 2016 private offering because he hadn't participated in any previous offerings. Yet he was able to buy over 400,000 shares of stock with Congressman Collins' help.

My view and the view of my Democratic colleagues is that Congressman Price failed to come clean with the Senate Finance Committee on the details of the special discounted deal. He has assured the committee he followed the law, but straightforward questions have been met with dodging, weaving, and obfuscation. Details of his purchase continue to emerge, and the public's understanding of his involvement continues to evolve.

Meanwhile, as scrutiny of the deal continues to mount, Innate's top executives are defending Congressman Price at the behest of his colleague Congressman Collins, who sits on the company's board of directors.

After the Wall Street Journal story was published, the company and Congressman Price went into spin control. The public knows this only because Congressman Collins made a mistake that everybody who uses email for work has seen made at least once: He mistakenly hit ``reply all'' when responding to an email from the company's CEO, Simon Wilkinson. Instead of a private note to Mr. Wilkinson, the note wound up going to a CNN reporter covering the story.

In the email, Congressman Collins, the company's top shareholder, said the Wall Street Journal was ``yellow journalism,'' and he thanked Innate's chief executive, Mr. Wilkinson, for defending Congressman Price and the company. According to CNN, Congressman Collins acknowledged the email to be authentic.

The Finance Committee's own experience with Innate only adds to the sense that there is a coverup as Republicans seek to race Congressman Price across the confirmation finish line.

The day after the Wall Street Journal story ran, I wrote my own letter to Innate's CEO, Mr. Wilkinson. I asked the company to respond to the article and the inconsistencies in Mr. Price's explanations and for documentation of details of the private stock sales. The company refused to answer my letter.

This looks to me like a coverup, and it ought to shake this body's confidence in Congressman Price's nomination. This situation, in my view, demands that further questions be asked and answered. Instead of taking time to explore these issues, Republicans took the unprecedented step of suspending the Finance Committee's rules to rush this nomination to the floor before any more questions could be asked, let alone answered.

In years past, as with the nominations of Senator Daschle, Secretary Geithner, and Ambassador Kirk, the Finance Committee left no stone unturned in the vetting process. Not this time. The majority party, in my view, is on its way to an ethical double standard to cut off the vetting process. That leaves me with a question for Congressman Price and my Republican colleagues in the Senate: What is there to hide?

Mr. President, before I continue, I ask unanimous consent to have printed in the Record the letter that I sent to Simon Wilkinson, chief executive of Innate, on January 31, 2017.

I would also refer my colleagues to the following news articles: ``Trump's HHS Nominee Got A Sweetheart Deal from A Foreign Biotech Firm,'' a story published by Kaiser Health News on January 13, 2017; ``Representative Tom Price Got Privileged, Discounted Offer on Biomedical Stock, Company Says,'' a story published by the Wall Street Journal on January 30, 2017; and ``In accidental `reply all' to reporter, Collins thanks CEO for defending HHS nominee,'' a story published by CNN on January 31, 2017.

Mr. President, I wish to now discuss what is known about the facts and timing of Congressman Price's investment in Innate. This is a timeline that is based on public documents, press reports, and information the nominee provided the Finance Committee.

If you have never heard of Innate until the last few weeks, you would be forgiven. The New York Times described it as a ``tiny pharmaceutical company from Australia that has no approved drugs and no backing from flashy venture capital firms.'' Innate has fewer than a dozen full-time employees. The company's stock was first listed on the Australian Stock Exchange in 2013, and until recently its market capitalization was well below $100 million. Innate has never generated revenue from drug sales. It has repeatedly teetered on the brink of running out of cash. It has just 2,500 shareholders. By way of comparison, a major American pharmaceutical company could have hundreds of thousands of shareholders.

Innate is planning to submit an investigational drug application to the Food and Drug Administration, and its ultimate goal is to one day sell itself to a large pharmaceutical manufacturer, which would take its early-stage experimental therapy to market.

What I am describing is, this company is the poster child for obscure companies. It is so small and so obscure, it doesn't even have a Wikipedia page. So the question is, How did Congressman Price come to learn about this company, and how did he decide to make it the single largest investment in his sprawling portfolio of health care stocks? The answer is, the Congressman learned about Innate in 2014 during a conversation with his colleague, Congressman Collins of New York. As I indicated, Congressman Collins sits on Innate's board of directors. Congressman Collins is also the company's largest shareholder, holding 38 million shares. Congressman Collins' adult children, his chief of staff, and many of his political backers are also heavily invested in the company. I am going to touch on those issues in a few minutes.

According to disclosures with the House Ethics Committee, Congressman Price bought some 61,000 shares of Innate stock in 3 separate purchases during January of 2015. At the time, the stock was trading at roughly 10 cents a share. Congressman Price testified to the Health, Education, Labor, and Pensions Committee that he directed his broker to make the January 2015 purchases.

Fast-forward to August 2016. Congressman Price bought another 400,000 shares of Innate as part of a private stock sale for U.S. investors. When the private sale took place, Innate's shares were trading on the Australian Stock Exchange for the equivalent of 31 American cents. Participants in the private sale got the shares at a deep discount.

In written testimony to the Finance Committee, Congressman Price said he paid 84,000 American dollars to buy the 400,000 shares. He bought 250,000 of those shares for 18 American cents per share in one private stock placement. He bought another 150,000 shares for 26 American cents each in a second private stock placement. Congressman Price's House Ethics Committee disclosures showed that he acquired the stock on August 31. On that day, Innate's stock was trading for the U.S. equivalent of 31 cents a share on the Australian Stock Exchange. In my book, that is a special deal.

The bottom line is that Congressman Price bought these shares for $40,000 less than an average investor would have paid to buy the same amount of stock off the open market. That is nearly 33 percent off the price on the Australian Stock Exchange at the time. Since that time, Innate's stock has more than doubled. These facts are not in dispute.

Mr. President, I ask unanimous consent to have printed in the Record Congressman Price's written testimony in response to my questions for the record as part of his nomination hearings.

I also refer my colleagues to the following news articles and documents: ``Australian Drug Maker has Low Profile but Powerful Backers in Washington,'' printed in the New York Times on January 13 of this year; ``Aussie shareholding puts heat on President's Ally,'' published in the Australian on February 6 of this year; the 2016 Annual Report to Shareholders of Innate; a periodic transaction report that Congressman Price filed with the House Ethics Committee on September 12, 2016; a list of the 20 largest investors in Innate dated January 17, 2017; and a stock price history of Innate.

I wish to turn to the issue of misleading testimony. What remains unresolved are major inconsistencies between Congressman Price's testimony to the Finance Committee, statements by Congressman Collins, and statements by Innate's CEO Simon Wilkinson published last week in the Wall Street Journal.

Simply put, Innate's chief executive and Congressman Collins, the company's top shareholder, provided one version of events to one of the world's most respected newspapers. Congressman Price provided a different version of events to the Finance Committee and the Health committee. These inconsistencies are among the reasons that Democrats boycotted last week's Finance Committee markup. The Senate has an obligation to know the truth about these transactions in order to protect the integrity of this body and its constitutional duty to consider executive branch nominees.

Now, with respect to exclusivity of the sale, Congressman Price told the Finance Committee that the August sale was available to all Innate shareholders, which contradicts what Innate's management told the Wall Street Journal. Congressman Price was definitive in his response to my question during the hearing.

Reading back the transcript, I said: ``Well, you purchased stock in an Australian company through private offerings at discounts not available to the public.''

Here is Congressman Price's response: ``Well, if I may, those--they were available to every single individual that was an investor at the time.''

That is not what Innate executives told the Wall Street Journal. Here is an extended passage from the Wall Street Journal:

Rep. Tom Price got a privileged offer to buy a biomedical

stock at a discount, the company's officials said, contrary

to his congressional testimony this month. . . .

The cabinet nominee is one of fewer than 20 U.S. investors

who were invited last year to buy discounted shares of the

company--an opportunity that, for Mr. Price, arose from an

invitation from a company director and fellow Congressman. .

. .

At Mr. Collins' invitation, Mr. Price in June ordered

shares discounted in the private placement at 18 cents

apiece, and then more in July at 26 cents a share, Mr.

Collins said in an interview. Those orders went through in

August, after board approval. Mr. Price invested between

$50,000 and $100,000 according to his disclosure form. . . .

Mr. Wilkinson said investors who had bought in a previous

private placement were called to ``make friends and family

aware of the opportunity. . . . We are always looking to

increase our shareholder base. But those new parties have to

meet the definition of sophisticated financial investor.''

Only six U.S. investors, including Mr. Price, fell into the

friends-and-family category, Mr. Collins said. About 10 more

U.S. investors were offered discounted shares by the company

because they previously had been invited to partake in

private placement offerings.

In other words, Congressman Price not only got a deal that wasn't publicly available, he was in a special group of six investors in a special category called ``friends-and-family,'' whereas other American investors got in on the private deal because they previously participated in the company's private placements. Congressman Price bypassed that requirement. He got in as what could only be called a special guest--a ``friends-and-family'' guest of his House colleague, Congressman Collins.

As I mentioned earlier, when I asked the company how Congressman Price was able to get this special status, the company refused to provide an explanation. The Wall Street Journal also reported a key distinction between U.S. investors and the company's shareholders in Australia and New Zealand. The paper reported:

The discounted stock offered in Innate Immuno, as the

company is known, was made to all shareholders in Australia

and New Zealand--but not in the United States, according to

Mr. Collins and confirmed in a separate interview with Innate

Immuno CEO Simon Wilkinson.

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

In conjunction with this rights issue, Innate announced

that it also completed a private placement at an issue price

of U.S. 18 cents, raising U.S. $1.8 million.

The booklet states clearly that the private placement was announced on the June 10, 2016, the same day Innate announced the rights issue for investors in Australia and in New Zealand.

Our staff has reviewed all of the company's publicly available documents and found no similar advertisements for the private placement to American investors. So this paper trail pokes more holes in Congressman Price's argument that the private stock sale was open to all the company investors.

First off, the company didn't announce the existence of the private sale until after it already had been completed. So unless an investor was on the company's short list of go-to people, they were just excluded.

Second, the company's documents clearly show that Congressman Price and other participants in the private stock sale were able to buy far more discounted shares than the company's typical investors. Innate documents showed that the company restricted the number of shares the typical investor could buy in the rights issue to just one new share for every nine they already owned. No such limit appears to have been imposed on Congressman Price and the other American participants in the private stock sale. In fact, Congressman Price owned just over 60,000 shares at the time of the sale. His participation in the private stock sales allowed Congressman Price to buy 400,000 more shares. If Congressman Price had been held to the same rules as everyday investors, he would have been restricted to buying less than 7,000 shares.

The bottom line to me is what Congressman Price said was untrue. The deal Congressman Price got was not open to every other shareholder. And again, when I sent a letter last week to the Innate CEO, asking him to explain all of this, he declined. He told my staff that as an Australian firm, the company had no obligation to cooperate.

So to recap, Congressman Price told the Finance Committee and the Health Committee that the stock sales he participated in were open to all shareholders. That is not true. The private sale does not appear to have been widely marketed to American investors and was certainly not advertised in the company's public documents. The private sale reportedly included less than 20 American investors. Congressman Price was part of an even smaller subgroup known as friends and family, invited by other investors--in this case, by his House colleague, Congressman Collins. How many people were eligible to be in the friends and family group? Just six.

That brings me to the next issue, which is, How did Congressman Price learn about the special sale in the first place? Congressman Price told the Finance Committee his conversations with Congressman Collins had no influence on his investment decisions.

I am going to again quote from his written response to questions for the record asking Congressman Price to describe the communications with Congressman Collins regarding Innate. Congressman Price said:

I had a conversation with Representative Collins in the

fall of 2014 that brought Innate as a company to my

attention. The nature of the conversation did not, however,

influence my decision to invest in the company in either 2015

or 2016. I believe I had subsequent general communications

with Representative Collins regarding Innate. I do not have a

specific recollection of when those conversations occurred or

their substance. Any such communications did not impact my

investment decisions, however, because my

purchases of Innate were based solely on my own research.

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

Mr. Price got in on the discounted sale after Mr. Collins

filled him in on the company's drug trial, according to Mr.

Collins. Mr. Collins said he told Mr. Price of the additional

private placement. He said Mr. Price asked if he could

participate in it. ``Could you have someone send me the

documents,'' Mr. Collins recalled Mr. Price asking him.

Congressman Price wants us to believe that Congressman

Collins had no influence on the decision to buy Innate stock.

But Congressman Price would not have known about the company

in the first place if he hadn't talked to Congressman

Collins, and he wouldn't have known about the private

placements without hearing about them from Congressman

Collins.

Congressman Price characterizes his conversation with Congressman Collins in 2015 and 2016 as being general in nature. But again, according to the Wall Street Journal, Congressman Collins, one, told Congressman Price about the upcoming drug trial; two, alerted him to the private stock sale; and three, arranged to ensure that he could participate. To me, this seems like more than ``subsequent general communications with Congressman Collins regarding Innate'' as Congressman Price put it in his written response to the committee.

With respect to reporting to the committee and the Office of Government Ethics, I would just say that I think I described issues-- ethical issues--that are serious enough on their own. However, it took no small amount of effort to unravel Congressman Price's holdings in the company because he failed to fully disclose them to Federal ethics officials, the American people, and the Finance Committee. I don't believe this issue would have ever come to light if it were not for the work of the committee's minority investigations team.

On February 7, 2 days ago, Congressman Price sent a letter to the independent Federal ethics officials at the Office of Government Ethics that amended his original public ethics disclosure. This letter confirmed the suspicions of Finance Committee Democrats that Congressman Price's original ethics disclosure to the public understated the value of his Innate stock holding by roughly a quarter of a million dollars. Put another way, his stake in Innate was more than five times the figure initially reported to the American people.

Congressman Price's original disclosure reported that he owned less than $50,000 in Innate stock. At the time the disclosure was filed, by my calculation, his shares had a value of more than $250,000. Today his stake is valued at more than $300,000. Quite simply, it appears the shares he bought in the private stock sale in 2016 were excluded entirely from the Congressman's financial disclosure to the Office of Government Ethics. And because it is the Office of Government Ethics disclosure that is posted on a public Web site so the public can see the investment ties and investments the President's nominees hold, the American people, too, were kept in the dark about how much stock Congressman Price held in this company.

In addition, the Congressman was also less than forthcoming in his disclosure of the value of Innate holdings to the Finance Committee. In his response to the committee questionnaire, Congressman Price valued Innate stock he bought in the private sale between $50,000 to $100,000. However, that amount was based on the $84,000 discounted price the Congressman paid to buy his stocks in the August private stock sale. It was not based on the actual value of the stock on the Australian stock exchange--the true value of his holdings.

By December, when he made his disclosure to the Finance Committee, the stock price had nearly tripled and the shares he bought in those private sales were worth nearly $230,000. In other words, he told the committee that his private purchases were less than half the value they really were.

Mr. President, I ask unanimous consent that the following items be printed in the Record: a memo from Finance Committee Staff to the Finance Committee, dated January 23 of this year, and a letter from Congressman Price to the Office of Government Ethics dated February 7, 2017, amending his public ethics disclosure.

I also refer my colleagues to the following documents: an announcement by Innate on June 10, 2016, entitled ``Private Placements and

Rights Issue to Raise Additional Working Capital,'' and the Public Financial Disclosure Report signed by Congressman Price on December 15, 2016, that was filed with the Office of Government Ethics.

I want to take a minute to return to the Innate company itself. I noted earlier that the company has put on a full court press to defend Congressman Price in recent weeks, as details of his special deal have come to light.

I am going to describe why that might be. Innate's executives have sought to portray the company as being a small firm from Down Under that has been inadvertently caught in political crossfire on the other side of the world. But the fact is that Innate has longstanding connections to Congressman Collins and his inner circle, a circle that includes Congressman Price. As the Australian City Newspaper wrote this week, ``Mr. Collins, his children and his `intimate political allies' and donors controlled at least 27.25 percent'' of Innate's voting shares.

Then there is the baffling assertion mailed by Mr. Wilkinson, the CEO, that he only recently learned of Congressman Price's existence through news articles. This is a stretch to believe and flies in the face of Congressman Price's own testimony.

On January 13, the New York Times reported:

Mr. Wilkinson and Michael Quinn, Innate's chairman, said

they had never heard of many of the company's more prominent

investors, and said they first learned that Mr. Price had

invested in the company from an article in the Wall Street

Journal, which first reported his investment.

On February 5, Mr. Wilkinson, the CEO of Innate, told the Buffalo News, ``I think the first time I heard that a gentleman named Tom Price had invested was after the U.S. media started reporting it.''

But Congressman Price was quite clear that he had communicated with Wilkinson. In written testimony, responding to questions for the record, he said: I also communicated with Simon Wilkinson of Innate regarding my interest in participating in the 2016 private placement of company stock. According to Innate's Web site, Mr. Wilkinson is currently the managing director and CEO of the company.

Congressman Price's name was also listed twice in the documents of the company, which reported the private stock sale participants to the Australian stock exchange last summer. Congressman Price also appeared to have bought nearly 5 percent of the discounted shares made available in the private stock sale. Given all that, it seems difficult to believe Mr. Wilkinson's story that he had no idea who Congressman Price was.

Finally, The Australian, the Sydney paper I just mentioned, reported on Monday that Innate and Congressman Collins are facing questions about possible violations of Australia corporation law with regard to his holdings in the company. So why does this matter? It matters because a nominee to be a Cabinet Secretary, Congressman Price, was brought into this web of questionable stock transactions and obfuscations about just how special the special deal he really got was by a company insider, his friend, Congressman Collins.

As I get ready to close, I refer my colleagues to the following articles and documents: ``Congressman Collins under fire for `suspicious' stock trades,'' published in the Buffalo News on January 17 of this year; ``Collins shared biotech stock news with big Buffalo names,'' again from the Buffalo News on January 19; ``Collins' controversial stock venture could be boom or bust,'' from the Buffalo News on February 5 of this year; the Notice of Innate's 2016 Annual Meeting and Explanatory Statement filed on July 29 of 2016; documents filed by Innate on September 12, 2016, and September 26, 2016, reporting results of the 2016 private stock placement.

As we close, I want to return to section 3 of the STOCK Act. It says:

Members of Congress . . . may not use nonpublic information

derived from such person's position . . . or gained from the

performance of such person's official responsibilities as a

means for making a private profit.

So did Congressman Price have access to nonpublic information about Innate or its private stock sale because of his position as a Member of Congress? I believe the answer is yes.

Did he get special access to the discounted private sale because of his position? I believe the answer is yes.

Does he stand to profit because of the information or access he may have received? I believe the answer is yes.

Finally, did Congressman Price tell the Finance Committee and the HELP Committee the truth about how he learned about the private stock sale and the ability of average investors to participate? Congressman Price told the Finance Committee and the HELP Committee that the special stock deal he got in on was open to everyone.

According to the Wall Street Journal and company documents, that is not true. The deal he got was clearly different than what was offered to everyday investors. According to the Journal, his previous purchase of Innate stock did not qualify him to participate in the private placement without being a specially invited friends and family guest. This arrangement allowed Congressman Price to buy more shares than other investors were allowed to buy.

Congressman Price told the Finance Committee that his conversations with Congressman Collins, again, a director of the company, its largest shareholder, had no influence on his investment decisions. According to the Journal, this is not true. The Journal report made clear that Congressman Collins told him about the upcoming drug trial, alerted him to the private stock sale, and arranged to ensure he could participate.

Now the majority party has shut down the vetting process, allowing Congressman Price's nomination to reach the floor before all the facts have come into view. I believe the Senate can do better. It needs to do better. The American people are owed better.

I thank my colleagues, particularly Senator Reed, for his patience and his courtesy.

I yield the floor.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, the debate on Congressman Price's nomination, in my view, is a referendum on the future of health care in America.

On this side of the aisle, we think it is worth spending 30 hours talking about a subject this important to our people. My view is that this is about whether the United States is going to go back to the dark days when health care worked only for the healthy and the wealthy.

Based on the public record, Medicare is a program Congressman Price does not believe in, and it offers a guarantee of services he doesn't believe seniors should have.

On the Affordable Care Act, he is the architect of repeal and run. He wrote the bill himself. He proposed weakening protections for Americans with preexisting conditions. He would shred the health care safety net--Medicaid--for the least fortunate among us. He would take away health care choices for women, particularly the opportunity to go to the physician that they trust.

As we wrap up and get ready to vote, think about the common thread among these proposals: They take away coverage from our people, make health care coverage more expensive for millions of people, or both. That is what Congressman Price stands for when it comes to health care. Every Senator who casts a vote for Congressman Price has to stand by that agenda.

Beyond what this means for the future of American health care policy, there is the lingering spectre, as I have discussed tonight in detail, of serious legal and ethical issues. Congressman Price got special access to a special deal on stock in an Australian biomedical company. He claimed multiple times before Senate committees that the deal he got on discounted company stock was open to all shareholders. All the evidence--all the evidence--says that this is untrue.

First, he had to go through the back door to get access to the discounted price. He got a special friends-and-family invite from his colleague in the House, Congressman Chris Collins, the company's top shareholder and a member of its board.

Second, rules that apply to other investors didn't apply to Congressman Price. Other shareholders were bound by a limit. They were able to buy one discounted share for every nine they already owned. That would have allowed Congressman Price to buy just 7,000 discounted shares. He bought 400,000 discounted shares. In my view, he can't get around that. That is the definition of a special stock deal.

The Congressman introduced legislation that would have lowered the tax bills of three major pharmaceutical companies in which he owns stock. He invested $15,000 in a medical equipment company and then introduced legislation to increase the amount Medicare pays for that type of equipment. Parts of his bill went on to become law. He bought thousands of dollars' worth of stock in a company called Zimmer Biomet less than a week before introducing legislation that had the potential to drive up the value of those shares. Now he has argued that he didn't purchase the stocks; his broker did. But at the very least, he would have known about those deals within days of the purchase when he filed the periodic transaction reports in the House. Under his brokerage agreement, he could have quickly resold the stock, but he did not. Furthermore, he didn't consult with the Ethics Committee regarding any of the trades I have spoken about as directed by the House Ethics Manual.

As I wrap up, I want to put a human face on why so many Senators on this side of the aisle have come to the Senate floor to speak so passionately about their grave concerns with this nomination. Nothing sums up our concerns more clearly than a line from an op-ed Congressman Price wrote in 2009 that discusses Medicare. His quote speaks volumes about his perspective on this program.

It is a lifeline. I first became acquainted with it back in the days when I was codirector of the Oregon Gray Panthers, ran the legal aid program for older people. I saw then that seniors were walking on an economic tightrope, balancing their food bill against their fuel bill, their fuel bill against the rent bill. They saw Medicare as one of the great achievements in American policymaking.

Here is what the Congressman wrote--his words, not mine: ``Nothing has had a greater negative effect on the delivery of health care than the federal government's intrusion into medicine through Medicare.'' When I read that, I was reflecting on my Gray Panther days, and I think a lot of other Senators go back working with community organizations. We just heard a wonderful presentation from Senator King, who was also a legal services advocate.

Before Medicare, before this program that Congressman Price thinks is such a negative intrusion into medicine, a lot of older people were warehoused in poor farms. I am absolutely certain that Congressman Price doesn't want to go back to those days, but when he speaks about the involvement of Medicare in American health care as though a plague has descended on the land, we just have to question his commitment to a program that has become a lifeline to millions of older people.

The fact is, Medicare has always been a promise. That is what we said back in the early days with the senior citizens. Medicare was a promise. It was a promise of guaranteed benefits. Again, based on the public record, Medicare is a program Congressman Price doesn't believe in, and it offers a guarantee of services he doesn't think seniors ought to have.

He has said he wants to voucherize the program within the first 6 to 8 months of the administration. What we are talking about when you want to do that is you are breaking the promise of Medicare. You are breaking the promise of guaranteed benefits, and you are going to sort of hand people a piece of paper and say here is your voucher, I

hope it works for you. If your medical expenses are greater than your vouchers, that is the way it goes, tough luck.

The price budget cut Medicare by nearly $1 million. By the way, that is exactly the opposite of the Trump pledge, not to cut Medicare that the American people heard on the campaign trail. There is a big gap between what President Trump said about Medicare and the bills and legislative efforts of Congressman Price in the other body--big gap. That is why it sure looks to me like the promise of Medicare is one that Congressman Price would break.

By the way, we all ought to understand that if confirmed, Congressman Price would be the captain of the Trump health care team. What he says matters, and what he offered--legislatively, his positions and his votes. He voted again and again to repeal the Affordable Care Act.

It really matters what his past record is. If past is prologue, it is certainly relevant. It really matters. He was the architect of what amounted to repeal and run. He wrote legislation creating loopholes in the protection for those with preexisting conditions, and the big beneficiary there was clearly the major insurance companies.

Women would find it much harder to make the health care choices they want and see the doctors they trust if the price proposals were lost. Medicaid pays 65 percent of the nursing home bill in America. And on this side of the aisle, we are going to fight Congressman Price's block grant proposals that are going to put seniors at risk.

I am going to close with this. I always hope I am wrong when I raise the prospects of real threats to the welfare of the American people because the reason public service was important to me was because of those first days with the Gray Panthers. I never thought I would have that kind of wonderful opportunity; that I would have had this opportunity for public service. For me and so many on this side of the aisle--I see my colleagues who have been active in their communities-- this has always been about the welfare of the American people. That is what it is about--all those faces we see when we are home, having community meetings and getting out with our people.

The public record in this case indicates that as Secretary of Health and Human Services, Congressman Price would, in fact, be an extraordinary threat to seniors on Medicare, vulnerable older people who need Medicaid for access to nursing homes, millions of kids for whom Medicaid is the key to a healthy future, and women across the country who have a right to see the doctors they trust.

I am going to oppose this nomination. I urge my colleagues to join me in opposition.

Mr. President, I wish to take a few minutes to address Congressman Price's stock purchases. At best, this is behavior that cuts ethical corners. At worst it is dangerously close to outright insider trading. Congressman Price has a lot of questionable trading activity. He introduced legislation that would lower the tax bills of three major pharmaceutical companies he owned significant amounts of stock in. He invested $15,000 dollars in a medical equipment company then introduced legislation to increase the amount Medicare pays for that type of equipment. Parts of his bill went on to become law.

But let's look at one investment in particular, Congressman Price's investment in Zimmer Biomet. Zimmer is a medical device company that specializes in joint replacements, including knee, hip, shoulder, and foot and ankle replacements.

Hip and knee replacements are high cost procedures, and they are two of the most common procedures performed on Medicare patients. According to CMS, more than 400,000 hip and knee replacement procedures were performed in 2014, costing more than $7 billion for the hospitalizations alone. Despite the high frequency of these surgeries, costs vary widely across geographic areas, and complications like infections or implant failures after surgery can be three times higher at some facilities.

In November 2015, in an attempt to incentivize higher quality procedures for Medicare recipients and control the cost of these replacements, CMS finalized a new pricing model slated to be implemented in April 2016. This new pricing model was a cost-bundling payment model; instead of Medicare paying for each individual service, Medicare reimburses hospitals with a single lump-sum payment, allowing hospitals to coordinate overall care for the patient.

These changes were designed to incentivize improved care for patients, lowering costs and improving quality. However, according to independent analysts, medical device companies, especially those who specialize in orthopedic implants, could face ``material headwinds'' from the new pricing model since hospitals facing reimbursement pressures are likely to pass some of that burden onto those device companies.

In September 2015, Congressman Price led an effort to send a letter from members of the House of Representatives to CMS challenging many of the features of the CMS proposal. A copy of the letter, dated September 21, 2015, is available on the Congressman's website.

This is where Zimmer Biomet comes in. Zimmer is a medical device manufactrurer with significant exposure to the new pricing model. According to analysts, over 60 percent of Zimmer's revenues come from hip and knee devices, and the CMS guidelines had the potential to significantly affect the company's profits.

On March 17, 2016, a few weeks before the CMS model was set to go into effect, Congressman Price bought thousands of dollars worth of Zimmer Biomet stock through his brokerage account. On March 23, 2016, less than a week later, Congressman Price introduced H.R. 4848, the ``HIP Act,'' which would have delayed the implementation of CMS regulations for Medicare coverage of joint replacements.

Let's pause right here. In 2016, Congressman Price had a financial stake in one of the companies that stood to benefit most from the legislation he was promoting. Those basic facts are not in dispute. Congressman Price introduced legislation that had the potential to add to his personal fortune.

Now, various arguments have been made, by Congressman Price and others, to defend this activity. First is the argument that there wasn't much money at stake, just a few thousand dollars. But the truth is a few thousand dollars is a lot of money to a lot of Americans. An unexpected medical bill that size could have a serious effect on many Americans and the person in charge of our health care system should take that amount of money just as seriously.

Second, there is the argument that he didn't purchase the stock; his stockbroker purchased it. I am going to return to that issue in more detail in a moment, but one thing is clear. That is the fact that Congressman Price knew this stock had been purchased in his name, in his account, within a matter of days.

On April 15, 2016, Congressman Price filed what is called a Periodic Transaction Report which Members of Congress are required to do within 30 days of reportable stock purchase. Not only did Congressman Price file a report that he had purchased Zimmer Biomet along with dozens of other stocks, he initialed the entry for Zimmer Biomet in order to correct a mistake on the document; a correction making it clear that the Zimmer Biomet transaction was a stock purchase.

There is also the question of whether this activity violated House Ethics rules. Congressman Price also said, in answer to written questions, that ``no conflict existed and no consultation was necessary.'' He also said, ``Throughout my time as a Member of the [House], I have abided by and adhered to all ethics and conflict of interest rules applicable to me.''

He gave the same answer regarding three other bills that appear to conflict with investments he held: H.R. 4185, the Protecting Access through Competitive-pricing Transition Act of 2015, the PACT Act; H.R. 5400, a bill pertaining to tax rates in Puerto Rico, which would have likely impacted drug manufacturers he owned Eli Lilly, Bristol Myers Squibb, and Amgen; H.R. 5210, the Patient Access to Durable Medical Equipment (PADME) Act of 2016.

Let's go through that in some detail.

It is true that the House Ethics rules, like the Senate Ethics rules, allow a

member to cast a vote on a matter relating to a company in which he or she owns stock. However, that standard only applies to casting votes. If you do more, and become an active advocate of a bill that could benefit a company that you own stock in, a different standard applies.

On page 237 of the House Ethics Manual, it says that before undertaking active advocacy of legislation that will benefit a company in which a member owns stock, such as before introducing a bill, ``the Member should first contact the [Ethics] Committee for guidance.''

The Ethics Manual is crystal clear. If you go beyond voting, and you are actively pushing a bill that would benefit a company in which you own stock, you should consult with the Ethics Committee.

Congressman Price did not consult with the Ethics Committee regarding any of these trades.

In a written question, I asked Congressman Price about this. I asked whether, in light of the House Ethics Manual's recommendation, he had consulted with the Ethics Committee regarding his purchase of Zimmer Biomet and other stocks. He did not answer the question. Instead, he resorted to the same talking point--that the Zimmer Biomet stock was purchased by his broker and that there was not need to consult because there was no conflict.

By my reading, this interpretation is flat wrong. Under the House Manual, he should have consulted with the Ethics Committee.

To be clear, the Ethics Committee might have concluded that it was a relatively small purchase, and that Congressman Price's advocacy was consistent with his longstanding position, and therefore that it was fine for him to go ahead and purchase the stock and then introduce the bill. On the other hand, the Ethics Committee might have reached a very different conclusion. It might have advised him to refrain from purchasing the stock.

The public will never know, because he didn't ask. Despite the clear guidance in the House Ethics Manual, he didn't even ask. And now the majority party is carrying his nomination toward the finish line.

Apart from conforming with House Ethics rules, there is also the question of whether Congressman Price's activity violated insider trading laws. Lawmakers in both the House and the Senate have a duty of public trust. The STOCK Act, which Congressman Price and I both voted for in 2012, and longstanding SEC rules denote that Members of Congress have a fiduciary duty to the American people. What that means is that we will use the public power we've been granted to benefit the interests of all Americans. The SEC's Rule 10b5, in particular, prohibits the purchase or sale of stock on the basis of material nonpublic information.

As a threshold matter, Congressman Price claims that insider trading laws don't apply to him because the Zimmer Biomet stock was purchased by his broker without his knowledge. But as I've discussed at length, this argument is a red herring because Congressman Price did have knowledge of these trades. He submitted signed records of the trades shortly after they were made. Furthermore, the laws related to insider trading give clear guidance on how to trade through a broker without violating insider trading laws. And just as with the House Ethics rules, when faced with clear guidance on how to manage conflicts of interest, Congressman Price chose not to follow it.

Whether those stocks were purchased directly or through a broker is not, by itself, a defense to insider trading. According to SEC rules, Congressman Price and his broker needed to agree to a ``written plan for trading securities'' that does not ``permit the person to exercise subsequent influence over when, how, or whether to effect purchases or sales of securities.'' So, if Congressman Price had, in writing, given his broker complete control over his portfolio we wouldn't be discussing this issue today. But he did not do so.

Congressman Price returned to the ``my broker did it'' defense for weeks before finally providing the Finance Committee with an excerpt of his brokerage agreement.

Here's what it says:

In the Portfolio Management (``PM'') program, a Financial

Advisor(s) who meets the program certification requirements

manages your assets on a discretionary basis. In other words,

your Financial Advisor, and not you, has the discretion to

decide what securities to buy and sell in your account. This

discretion is subject to the parameters described below and

your ability to direct a sale of any security for tax or

other reasons.

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

This isn't a question of whether Congressman Price followed the technical letter of the law, he didn't follow it in spirit either. Congressman Price could direct his broker to make trades when he wanted to, and he did. Case in point, when Congressman Price wanted to act on a stock tip from Congressman Collins, he called up his broker and had her buy shares of an Australian biomedical firm called Innate Immunotherapeutics.

Another question raised by Congressman Price's conflicts of interest is whether they go beyond a violation of the public's trust and constitute an outright violation of insider trading laws. That question cannot be answered today. We have seen that time and time again that Congressman Price purchased stocks then turned around and promoted legislation that would help those companies, and his investments in them. What is not clear is whether the introduction of this legislation meets the legal standards of being ``material'' and ``nonpublic.'' Neither case history, nor the legislative history of the STOCK Act provide clear guidance on when pending legislation is material and nonpublic.

The bottom line is that Congressman Price's activities are in uncharted waters. That is why the public and members of this body ought to be outraged that the majority party has cut off the vetting process and rushed this nomination toward completion.

In my view, because of how this nomination was handled, the Senate Finance Committee has set a double standard. If you look to the recent past at the nominations of Senator Tom Daschle, Secretary Tim Geithner and Ambassador Ron Kirk at the outset of the Obama administration, the vetting process was extremely thorough and bipartisan. The committee turned over every stone, peered around every corner and followed every lead to its conclusion. Now, when a glaring issue comes up that undeniably deserves investigation, the party in power has shut down the vetting process. The Finance Committee and the Senate ought to do better.

I yield the floor.

I suggest the absence of a quorum.

Mr. President, I rise today to urge my colleagues to vote against the nomination of Tom Price to be the Secretary of the Department of Health and Human Services.

The decisions made at HHS touch the lives of every family in America. The Secretary who runs this agency makes decisions about everything from safety of the food we eat to the drugs we take, to the health insurance we buy and the quality of nursing homes we live in. This is an extremely important job, and we should not hand over the keys to this agency unless we are certain that the person will put the American people first every minute of every day.

President Trump has nominated Congressman Tom Price to serve in this job. Unlike many of the President's other nominees who are stunningly inexperienced in areas where they will be setting policy, Congressman Price has a lot of experience in health care policy. Yes, he has experience, but it is the kind of experience that should horrify us if we care about Medicare, if we care about Medicaid, or if we care about our own insurance coverage.

Congressman Price's record is perfectly clear. He wants to destroy fundamental protections that millions of Americans depend on for their health and economic security, and, frankly, he isn't very subtle about it. He has described ACA's ban on discriminating against individuals with preexisting conditions as ``a terrible idea.'' He has voted 10 times to defund Planned Parenthood--voted 10 times against a group that provides lifesaving cancer and sexually transmitted infection screenings to millions of patients a year. He has tried to privatize Medicare and raise the age of eligibility. Privatize Medicare; think about that. And he has been one of the chief boosters in Congress for gutting the Medicaid program--the Medicaid program, which provides health care for millions of kids, for people with disabilities, for families with parents in nursing homes--cut money to keep people in nursing homes.

Nonpartisan analyses of these plans are not pretty. Millions of people in this country, young and old, children and grandparents, poor and middle-class workers would be denied access to lifesaving care.

Congressman Price touts his own magic numbers that say differently, but make no mistake, this is the record of someone who wants to use his position at HHS to advance a radical, reckless agenda that puts rightwing, anti-government ideology ahead of the health and safety of the American people.

During his hearing before the HELP Committee, I asked Congressman Price some pretty simple questions. I asked him about more than $1 trillion in cuts that he has proposed to Medicare and Medicaid. I asked him if he would keep or undermine President Trump's campaign claim that he would protect these programs. I asked him to guarantee that not one dollar in cuts to Medicare would take place on his watch. I asked him to guarantee that not one dollar in cuts for Medicaid to help people living in nursing homes would happen on his watch. I asked him to guarantee that not one dollar in cuts for people with disabilities would happen on his watch.

I asked him three separate times to make this commitment, and three separate times he refused to do so. Think about that--cut Medicare for millions of seniors, cut help for people with disabilities, cut Medicaid for people living in nursing homes. This is the person Donald Trump wants to put in charge of those programs.

We have a lot of work we need to do on health care. We need to reduce the cost of insurance. We need to make sure insurance is available to small business owners, gig workers, and part-time workers. We need to make sure insurance continues to cover health care for women and people with preexisting conditions who otherwise are not going to be able to get insurance. What we don't need is to put someone in charge who is hell-bent on destroying health care in America.

For me, this is easy. When someone says he wants to cut Medicare, I am done with him. When someone says let's take away the money that people rely on to pay for nursing homes, this guy is finished. When someone says that protecting people with preexisting conditions is a bad idea, they don't get the job. This should be easy for everyone in Congress. This is a moment for Senator Republicans to step up and say no.

There is another reason to reject Congressman Price's nomination, a reason that has nothing to do with his terrible ideas, a reason that would disqualify him even if we agreed on every single issue. The reason is basic ethics.

During his time in Congress, Mr. Price has made money by trading hundreds of thousands of dollars' worth of stock in healthcare-related companies at exactly the same time that he pushed legislation that could affect the value of these stocks. His formula has been pretty simple. First he buys the stock, then he pushes bills to help the company, which helps the stock price go up.

For example, Congressman Price bought stock in a company that makes hip and knee replacements, and then he introduced a bill to suspend a Federal rule affecting Medicare reimbursements for hip and knee replacements. Congressman Price bought stock in a bunch of pharmaceutical companies, then cosponsored a bill to suspend a Federal rule that would hold down drug prices for the drugs that these companies manufacture. Congressman Price bought stock in an Australian biotech company with an experimental drug to treat multiple sclerosis, and then he voted for a bill that would make it easier for the FDA to approve these drugs.

So what does Congressman Price have to say for himself? How does he explain this connection between buying stock, then supporting changes in the law that would boost the value of the stock he just bought? Well, he has his excuses lined up, and I have to say they are doozies.

He says he didn't know about the trades; his broker made them without asking him first. Oh, wait. He did know about the trades. He just happened to know about an obscure Australian biotech firm, and he just happened to decide to invest as much as $100,000 in it because it was a good investment. Then he hit his last excuse: It is all OK because he paid the same price as anyone else who bought the stock.

Wow, that is really a heaping, steaming pile of excuses, and the excuses stink. These are Congressman Price's stock trades, not anyone else's. He made those decisions to buy those stocks, and then he repeatedly pressed for rules that would increase the value of those stocks. In fact, with one of the deals, it isn't just a question of stinkiness; it is a question about whether he broke the law.

By his own account, Congressman Price found out about an Australian biotech company called Innate Immunotherapeutics from a fellow House Member who, it just so happens, sits on the company's board and holds the largest stake in the company. So when he decided to buy his latest batch of stock, Congressman Price got access to a private sweetheart deal, meaning he got a discount on the price of the shares the general public couldn't get.

This sequence of events might break the law. That is not good at all. And getting special access to a sweetheart deal doesn't help your claim that you are just an ordinary guy with a boring stock portfolio. So when Congressman Price appeared before the Finance and HELP Committees, he said he had not paid a lower price than had been available to other investors. That is just not true. The company itself pointed it out. In fact, Congressman Price got a

special discount that went to only 20 people in the country--20 special friends, including the Congressman who could help write the laws that would make the company even more valuable.

An outside watchdog has called for an SEC investigation into whether Congressman Price committed insider trading. Price lied to Congress about his trades, and that should be the end of it. No more nomination for Secretary of HHS. The Congressman should have the decency to withdraw his nomination. It should have happened weeks ago. And if he didn't go voluntarily, the President and his friends in Congress should have quietly but forcefully pushed him out, but that is not what happened either. Instead, Republicans barreled straight ahead, and they changed the rules to do it.

Since Congressman Price lied to the committee, Democrats wanted him back for another hearing to ask him about it. Republicans refused, and Democrats boycotted the Finance Committee to try to force Price to explain why he lied. So the Republican response was to just suspend the Senate rules so they can run around the Democrats and move forward Price's nomination anyway.

Do we do not care about basic ethics anymore? Is that just gone? A Congressman should not be buying stocks then pushing laws to help the company, and that Congressman sure shouldn't be lying to the United States Senate about it.

Because Congressman Price has no shame, it will take three Senate Republicans to reject his nomination. Where are the three Republicans who will say no to a man who bought stock and then tried to get the rules changed in Washington so the companies would be more profitable? Where are three Republicans who will say no to a man who got a special stock deal that went to only 20 people in the whole country? Where are three Republicans who will say no to a man who lied to a Senate committee? This has nothing to do with politics. It is about basic ethics. It is about potentially illegal behavior. Where are three Republicans who will say no to this man?

When Donald Trump selected Congressman Price for this job, he said Price was part of a ``dream team that will transform our healthcare system for the benefit of all Americans.'' Over the past few weeks, I have been trying to understand exactly what that dream looks like.

For families all over this country, the dream is pretty simple. They want to know that when they get sick, they can go to the doctor and not be hit with a surprise bill they can't pay. When they buy insurance, they want to be sure it covers birth control or cancer screenings and preexisting conditions. They want to be able to fight cancer and not lose their house or declare bankruptcy because their insurance company imposes a lifetime limit on benefits.

President Trump does not share this dream for health care in America, and neither does Congressman Price. From his first day in office, President Trump has acted to undermine access to health care. Now he has nominated an HHS Secretary who will help him sabotage our Nation's health care system from inside the Department of Health and Human Services.

Yes, we have our differences over health care, and, yes, there are fixes we need to make, but where are three Republicans who will say no to a man who wants to cut Medicare? Where are three Republicans who will say no to a man who wants to cut nursing home care? Where are three Republicans who will say no to a man who wants to cut insurance coverage? Democrats can't do this alone. Three Republicans need to put aside partisanship and stand up for the American people. We need you. The American people need you.

With my remaining time, I want to share some of the letters I have been getting from families in Massachusetts who have seen the reckless, radical plans that President Trump, Congressman Price, and Republicans in Congress have put forth for the Nation's health care system. These families know exactly what is at stake in this debate. Congressman Price didn't have an answer when I asked him to protect Medicare and Medicaid, but these letters are from constituents and they show just how important these programs are.

Lee from Holliston wrote to me, concerned about cuts to Medicare and Medicaid. I am just going to read an excerpt from his letter:

I am a 65 year old disabled woman who depends on the

generosity of MassHealth and Medicare to survive. I am

terrified that Medicare and Medicaid will be so drastically

cut that I will no longer be able to maintain my life. I live

in HUD housing, receive Medicare and MassHealth which covers

all of my healthcare and allows me to continue to live on my

own through senior services and the Personal Care Attendant

program.

I guess I am just feeling scared and hopeless as I realize

the potential for destroying the lives of seniors who live on

Social Security and nothing else. I wear an insulin pump,

have type 1 diabetes going on 53 years, and I have multiple

complications--including an amputation 11 years ago.

My healthcare costs are just unaffordable without all the

assistance. Medicare and MassHealth covers everything for me

so that the $1,050 per month I receive is doable for living

expenses.

I just need to know it is going to be OK.

Lee, we need three Republicans to help out here. Congressman Price has made it clear that he wants more than $1 trillion in cuts to Medicare and Medicaid, and that affects you. We have to find three Republicans to help out and to help stand up for you and the rest of America.

I also heard from Alan from South Shore, who is worried about his daughter Meg. Here is what he wrote:

My daughter Meg is 29. She was born with a condition called

neurofibromatosis. As a result of this, she has benign but

inoperable tumors on her spine. They cause her chronic pain

and problems walking. On some days, she cannot walk even one

step. On other days, she might begin walking with a walker,

then suddenly collapse on the floor.

Meg cannot hold down a job: She spent the last quarter of

2016 in and out of hospitals. She receives about $700/month

from Social Security Disability. She has no savings. She pays

for her Medicare prescription drug Part D supplement out of

her Social Security. MassHealth is free for her, and it pays

for Meg's Medicare Part B. I am retired, so I can only help

her a bit.

If Trump's first idea about TrumpCare goes into law--where

he assumes you will buy your health insurance out of

savings--I fear Meg will live in her bed, watching repeats of

quiz shows on her television. And her network of care--

including emergency services, rehab physical therapy, chronic

disease management prescription drugs--will be reduced.

I understand why you are worried, Alan. I am worried, too, because I think that is exactly the path we are on with Congressman Price's nomination to head up HHS. That is why we are fighting back.

Boston Center for Independent Living also shared with me a story from a constituent named Jill who receives health care from the State's Medicaid Program. Let me tell you a little bit about Jill.

Jill is 62 years old. She has a heart defect, a seizure disorder, and serious osteoporosis. She had a varied career as a manager of a women's clothing company a decade ago, and in the 1980s, she installed some of the first computer networks in public schools. In the past several years, Jill has had significant health problems: surgery for her heart condition and multiple broken bones due to her worsening osteoporosis.

MassHealth, the State's Medicaid Program, has covered hospital bills, appointments with specialists, rehab stays, and an affordable medication plan.

Jill is now hoping to use a personal care assistant to give her support with shopping, making meals, and basic housekeeping.

Jill said: ``For me, Medicaid is a lifeline--any cuts from Washington would be a disaster.''

I hear you on that, Jill. I just hope that Congressman Price, President Trump, and the Republicans hear you as well.

Medicaid helps a lot of people in Massachusetts, including the very youngest. I got a very powerful letter from Marika from Duxbury, who wrote to me about giving birth to her son Jack after just 28 weeks of pregnancy. I want to read parts of her letter:

I'm writing to you today because I am horrified about the

changes that may be happening to healthcare in the United

States.

My husband and I welcomed our son, Jack, at 28 weeks in

July of 2015. I had a very normal, healthy pregnancy--until

suddenly it wasn't. I ended up with rapid onset of HELLP, a

rare and life-threatening syndrome, and an emergency C-

section saved both my life and Jack's.

Jack was 1 pound, 14 ounces when he was born. We were both

in the ICU for some time,

my son Jack for 110 days. He had all the issues you'd imagine

at 28 weeks--cardiac, pulmonary, feeding.

Today, at 18 months old, Jack is a fighter--my hero

really--and despite still needing oxygen and a continuous

feeding tube that is surgically inserted into his intestines,

he is cruising, talking, and ALIVE.

He is alive, and quite frankly, I'm alive because of our

amazing healthcare. I have the benefit of an exceptional

employer plan from Harvard University. But Jack also

qualified (because of his birth weight) for MassHealth. And

our public health insurance has been an incredible resource:

Jack's hospital bills were in the millions after his 110

day stay in the NICU. This doesn't even include my own

hospital costs for my stay. Despite having excellent jobs and

resources, my husband and I would have been bankrupt, and

immediately so, without our private health insurance and

MassHealth benefits.

Since coming home from the NICU, Jack is still on a feeding

tube and oxygen, and he cannot be accepted into regular

daycare. He would go to a medical day care, but he has no

cognitive delays, and so placing him in such a facility would

not ensure that he gets the regular developmentally

appropriate engagement that he needs. And so MassHealth pays

for skilled nursing care in our home with no out of pocket

costs. This means that Jack gets the care that he needs, and

my husband and I can still work at the jobs that we love.

Jack participates in early intervention programs and

receives feeding therapy, physical therapy and occupational

therapy free of charge.

Jack's Synagis shots cost zero dollars. Synagis is a

prescription medication that is used to prevent a serious

lung disease caused by respiratory syncytial virus, RSV, in

children at high risk for severe lung disease from RSV. The

average wholesale price is $780.15 for the 50 milligram

Synagis vial, and $1,416.48 for the 100 milligram vial. Jack

gets a 150 milliliter shot every month.

I cannot imagine this life without my son's public health

insurance. I recently enjoyed the NICU Family Advisory Board

at Beth Israel Deaconess Medical Hospital in Boston (where

Jack and I were cared for) as a way to give back. Today, I

mentor other families who have unexpectedly found themselves

the parent to a tiny premature baby fighting for life. In

nearly every case, navigating the insurance system and fears

about money are top of mind.

I am glad to hear that Jack is doing well, but I understand why it is that you want to hang on to MassHealth and why it is that we cannot take the cuts Congressman Price has proposed.

Families in Massachusetts are also deeply worried about the future of the Affordable Care Act. Jackie from Norwood wrote to me about how the ACA helped her get coverage for therapy after her mother was killed. She wrote:

My mother was murdered when I was 24. I was on her

healthcare, which kicked me off the day after she died. I had

recently accepted a new job and I was set to start that

Monday (she was killed on Saturday). I had already left my

previous full-time job the Friday before.

Due to having to move states after her death, I couldn't

start my new job. I didn't know when I'd have work again that

could provide insurance, nor did I have another parent whose

plan I could join. I also had no way of affording COBRA

payments.

So in the matter of one night, I was left helpless in so

many ways. Not having health insurance was one of many side

effect issues that no homicide victim's family should have to

worry about. Especially the next day and when planning a

funeral.

Thanks to the Affordable Care Act, I was able to get

covered almost immediately, which meant I could still afford

my current medications and I was able to get into needed

therapy right away. If it weren't for the ACA, I would have

been left struggling and sick as a result of something FAR

out of my control.

Very true, Jackie.

Jackie goes on to say:

I ended up finding work within a couple of months, and I am

still in treatment for PTSD. I was lucky enough to find

employment at Harvard University and no longer needed

coverage through the ACA. I have generous health benefits

provided to me. However, I never want a fellow citizen or

victim of homicide to be without medical care due to cost,

preexisting conditions, or other setbacks. I am happy my tax

dollars go to help programs like MassHealth and the ACA. We

all work hard, but that doesn't mean we are all as fortunate.

I am not the typical poster child for a homicide victim/

survivor. I am white and college educated. I work for an Ivy

League school. I still needed help when disaster struck, and

so many others less privileged than me need help finding

affordable health care.

Please continue fighting for me and other victims and

survivors of homicide.

That is what we are here for, Jackie. That is what we are supposed to do. We just need three Republicans to help us out on this.

I also heard from Jennifer from Northampton, who is terrified for her family if the ACA is repealed. She says:

I suppose I can't say when our story starts. Maybe the day

I met my then-life partner (now wife) of 16 years. Maybe it

begins when she had to have emergency surgery in Maryland

when she wasn't covered under my insurance, because our union

wasn't legally recognized. Maybe it begins with the tens of

thousands of dollars of debt we incurred in uncovered medical

expenses when we tried to get pregnant with our son.

Or maybe it started two days ago when the unthinkable

happened. My wife got laid off. After seven years of

exemplary services to a large human services agency whose

mission is supporting individuals and families affected by

homelessness, my wife was given no warning, no severance and

no compassion in her sudden dismissal from the agency. For

any family this would be devastating. Now we come to the dire

part.

About a year ago, my younger sister, Stephanie, was

diagnosed with an aggressive form of Triple Negative Breast

Cancer at 35 years of age. But this story isn't about that.

Six months later, my mother got diagnosed with Stage 4

Metastatic Breast Cancer.

I didn't have to be an over-educated lesbian to know that

there was something genetic going on in my family. I got

tested for the BRCA gene and was found positive for the

mutation that causes breast cancer, specifically Triple

Negative (like my sister had) and am currently looking at an

80% chance of developing Breast Cancer in my lifetime.

I need a double mastectomy and I need it soon. It's

scheduled, in fact, for March 6th, 2017. And now, my wife

doesn't have a job. I am a Behavior Analyst who specializes

in the treatment of children with Autism Spectrum Disorder. I

have a small private practice and don't make enough money to

support our household. I also don't have access to health

insurance through any of my contracts.

That is why it's dire.

One laid-off spouse, one four year old son, one self-

employed wife with an 80% chance of developing breast cancer

and fear of the ACA being repealed. This is dire.

We are terrified, I am terrified.

This isn't a ``wait and see'' situation for my family. This

is us. This is now. And this is real.

Yes, Jennifer, and that is why we are here tonight, in the U.S. Senate, to debate whether or not Congressman Price--a man who wants to cut Medicare, cut Medicaid, repeal the Affordable Care Act--is going to be the next head of Health and Human Services. That is why we are fighting. That is why we are looking for three Republicans to step up with the Democrats and turn him down. We must protect the Affordable Care Act.

I also got a letter from Olivia, a college student from North Reading. Olivia wrote me about what the ACA means to her as someone living with multiple chronic illnesses. She wrote:

I am a twenty-two year old white woman from a middle-class

suburb of Boston. I attend the University of Massachusetts

Amherst and will be applying to graduate school next year. I

eat an anti-inflammatory diet, I exercise regularly, do not

smoke, and drink lots of water. I am on my parents'

insurance, which they receive through their employer. I am a

patient at some of the best hospitals in the world.

I am so fortunate to live in a state that protects my right

to affordable health care. I was also hopeful when I heard

that President Trump was considering modifying ObamaCare

rather than repealing it. However, I am still worried about

the actions that will be taken in 2017 by his administration

and by Congress.

If you met me you would see a ``young, vibrant, and

ambitious woman''--other people's words, not mine. Many

people and politicians in this country would meet me and not

assume that I rely on the ACA. I am not from a low-income

family, I don't live in an area that doesn't have adequate

medical facilities, and I appear well. I am, however, living

with multiple chronic illnesses. I suffer from asthma,

fibromyalgia, chronic urticaria, chronic migraines,

irritable bowel system, gastro-esophageal reflux disease,

and a rare-genetic kidney disorder.

I take multiple medications daily that keep me alive,

prevent further health complications, and that allow me to

take care of myself. I also seek other therapies to manage my

conditions, such as chiropractic care and physical therapy. I

currently have great health insurance, yet I still pay

hundreds of dollars a month just to give myself any quality

of life.

I read the Trump/Pence administration's health care plan

and I am aware of the efforts by the GOP to repeal Obamacare

and their readiness to do so now that President Trump has

taken office. I don't believe I have to explain to you why

this worries me.

No, you don't.

I won't go on a rant about why health care reform should be

about the people not the money (though I could). I will also

not talk about why we should have universal health care

(though I could). I am hoping that my story offers a slightly

different perspective on why certain aspects of the ACA

cannot be modified.

Please remind your fellow senators that millions of

Americans suffer from multiple chronic illnesses, many of

which are invisible, and that we are a minority that is often

forgotten. Many people are just like me. We are college

students and new graduates who have to learn to manage our

medical conditions before going out into the real world.

To do this, we may have to stay on our parents' insurance

until we are twenty-six years old. We are people who can only

work part-time jobs and will need insurance to help keep our

medical costs down. We may require expensive prescriptions

and numerous doctor visits a year; we cannot have a cap on

our care because our conditions are chronic and

unpredictable. We are people who will have to apply for

insurance with pre-existing conditions which should not be

held against us. We are thankful for preventative care

because it prevents illnesses that would exacerbate our other

conditions.

Health care is a business that we need but that we didn't

ask to be a part of. It is a business we all take part in,

whether we plan to or not. We are NOT burned-down houses--we

are citizens who provide meaningful contributions to our

country.

I hope that Congress can work together to continue to give

people like me a fighting chance.

I am with you on that. I hope Congress can work together to give people like you a fighting chance.

I also got a letter from Christine in Canton, who wrote to me about her son. She writes:

My oldest child is a 21-year-old college student (soon to

turn 22 in February), who is also transgender. He suffers

from anxiety and depression. He's been working very hard to

complete college while also seeking treatment for his mental

health issues. He sees a therapist weekly and has also been

hospitalized twice for mental health issues since he's been

in college.

Luckily, due to the Affordable Care Act, he is able to

remain on our insurance, where the co-payments for both

therapy and hospitalization are at least manageable. If he

were not to have coverage through our insurance, I'm not sure

that we could afford to pay for his treatment--and as a

college student, he certainly could not afford to pay for it.

It frightens me to think of what will happen to him if he is

not able to receive treatment to keep him healthy.

Like so many others covered by the Affordable Care Act, it

is a life or death situation. I need to know that you will

fight by any means possible to keep the Affordable Care Act

from getting repealed.

I also have a 19-year old college freshman and a 17-year

old high school senior. While they do not have the same

health issues as their brother, we all know how that can

change in an instant. The repeal of the Affordable Care Act

will also have consequences for them down the line.

I guarantee, Christine, I will be here to fight for you, to fight for keeping the Affordable Care Act for you and for families like yours.

Denise from southeastern Massachusetts wrote to me about how her family is fighting cancer. Here is what she said:

We are family of four, with three cancer survivors. My

husband is a childhood cancer survivor who is now fighting a

blood disorder and is a patient at Dana Farber. I am a three-

time cancer survivor. Having been diagnosed with breast

cancer at age 42 (with no family history), I have since had

two recurrences.

I have had radiation, five years of tamoxifen therapy, a

bilateral mastectomy, and reconstruction. My reconstruction

has been difficult, with five surgeries within 18 months. I

have been postponing another surgery due to cost, since my

insurance has changed for the worse. At age 23, my daughter

was diagnosed with Hodgkin's lymphoma and underwent surgery

and seven months of chemotherapy.

We are a family that has always been proactive and

responsible in receiving regular health care. Now, my husband

and I have been rejected for long-term care. My daughter, who

has two children, pays a higher premium for life insurance

and has been denied cancer insurance. We are in a position

where we cannot even succeed in our attempts to take

responsibility for ourselves.

This outreach to you is a further attempt to do just that;

to maybe give you one more example of reality in your fight

for us. We are not whining; we are fortunate to be a close,

loving family that has had the strength to rally every time

adversity has struck.

But we are tired from the fight and very afraid for the

future. It is shocking to us that, in the richest country in

the world, after years of working, planning and saving, that

we are at the point of fearing a possible bankruptcy in our

later years. We also fear financial destruction for our hard-

working children due to uncovered medical expenses or the

possible exorbitant premiums of a high-risk insurance pool.

Please, please never tire in the fight for access to

comprehensive affordable healthcare. Good medical care should

not be a privilege for the rich, but a fundamental right for

all.

Boy, I am with you on that one, Denise. It is a fundamental right for all, and that is what we will continue to fight for.

I also received a letter from Jenny in Worthington. And I want to read you Jenny's entire letter because she really underlines what is at stake in this fight.

My husband and I have spent our entire careers in the arts.

I write music for the theater; my husband is a novelist,

playwright, and freelance medical writer. We have two

children. We own a home. We paid back every dime on our

student loans and we contribute regularly to our self-funded

retirement accounts. We have no consumer debt. In short, we

are hardworking, fiscally responsible people.

We recognize the trade-offs that come with being our own

bosses. We enjoy the freedoms of self-employment, and take

seriously the extra burden that society imposes on us,

including making our own Social Security payments,

contributing to Medicare, and buying health care on the

individual market, something we have done our entire adult

lives.

When the Affordable Care Act was passed, we were thrilled.

For the first time, we had adequate coverage for our family.

Our deductibles shrank. We lost the dreaded co-insurance

provision and began to think that we could prepare

financially should we face the worst.

Or so we believed.

Our difficulties began in late 2014, when I was diagnosed

with breast cancer. Over the weeks that followed, I endured 5

surgeries, including a unilateral mastectomy and

reconstruction. Almost immediately after, I began to

experience complications. Since then, I've come to learn that

I was having a reaction to the silicone implant used in my

reconstruction and that was just the early stage of a complex

autoimmune condition that still lacks a name.

Back then, all I knew was that I was wracked with constant,

severe pain. I lost the ability to walk. I could no longer

think straight and I lost sight in my right eye. Luckily, we

stumbled upon an article by a Dutch team that had examined a

cohort of women suffering from the same condition. After

consulting with the lead author of the paper, we decided that

my implant was to blame, and we determined to have it

removed.

Although I experienced some relief immediately after ex-

plantation, I have never fully recovered. The joint pain and

exhaustion persist. I have shed more than a third of my body

weight. The battery of medications I take do little more than

keep my pain at bay, permitting me to drive my son to school

or shop for groceries, but not much more.

As for my artistic life, it has been put on hold. I have

unfinished commissions from two theaters--Chicago Shakespeare

Theater and Playwrights Horizons, in New York City--and both

institutions have been incredibly patient. Yet the truth is

that I have been unable to work for more than two years.

Severe cognitive impairment is a hallmark of my condition,

and I have serious problems with my short-term memory.

Holding the thread of conversation is incredibly difficult,

and I experience blinding headaches if I write music for more

than a couple of hours. Frequently, it feels as though

someone has reorganized my brain but forgotten to leave me

the instructions. It is frustrating; it's terrifying.

Only one thing has made it possible for me to survive this

at all: the coverage I receive through the ACA.

The day I got my cancer diagnosis, I was in the process of

re-certifying through the Massachusetts Health Connector. I

was thrilled when my local Navigator told me that thanks to

my new diagnosis, I qualify for Massachusetts' Breast and

Cervical Cancer Treatment Program, a Medicaid-backed

initiative designed to cover middle and low-income women

through their treatments. Not only would I be covered, but

our two children would also be insured by MassHealth, our

state's Medicaid program. Though my husband continued to

purchase care through a separate plan, this single event

saved our family from financial ruin.

Now, all of that stands to change. With the repeal of the

life-saving provisions guaranteed by the ACA, we are faced

with the complete erosion of our savings. The Republican

Congress has already voted to eliminate the ban on denying

individuals coverage on the basis of previously existing

conditions, meaning that I will most likely be uninsurable.

What will happen then? Will we go bankrupt? Will we lose our

home? How will I cope without my medications when we can no

longer afford to pay for them?

The passage of the ACA did more to shore up our little

family than any other piece of legislation in my lifetime. It

has enabled me to face my grave illness without worrying

whether cost would be a factor in my treatment or whether I

could try the next medication my doctors prescribed to

relieve my pain.

In sharing our story on social media, I have been

overwhelmed by the outpouring of concern from our tiny

community of theater professionals. The President of the

Dramatists' Guild, a professional association for theatre

artists, called me to offer the assistance of their Emergency

Fund should we need it. And while it is heartwarming to

receive the support of my professional community, the hard

truth is that even the most doggedly determined not-for-

profits can't possibly replace the broad social safety net of

the Federal government--a safety net Republicans are

determined to shred.

In every industrialized country but ours, health care is

considered an inalienable human right. It is abhorrent to

claim that

care is something Americans should have to ``shop for.''

Price-comparison shopping may seem like a wonderful market-

driven design, but in reality it forces us to confront the

terrifying arithmetic of balancing how much care we need

against what we can afford. The sicker one grows, the harder

it becomes to solve that equation.

We have no idea what the Republicans intend by way of a

replacement to the ACA. They refuse to specify, despite their

years of claiming that the ACA is a failure. They talk of

expanding Health Savings Accounts (HSAs), though such

accounts represent nothing but a disingenuous transfer of the

cost to the consumer. Even if such an approach made sense,

how far would $6,750 (the current HSA limit) go in meeting

actual health care costs? That amount would be wiped out

after a single visit to the emergency room.

What's more, where do they expect sick Americans--those

fighting for their lives and unable to work precisely because

of their illnesses--to suddenly uncover $6,750 to sink into a

tax-sheltered HSA?

Clearly, this idea has been put forward by people who do

not depend on their health insurance for their very lives.

They pretend that this sort of thing will save ``our

system,'' but their proposal is like offering a patient an

Advil for an amputation--laughably inadequate at best; an

utter horror at worst.

What's more, efforts like the expansion of Medicaid under

the ACA have already saved us. Or many of us. Certainly me,

in any case. A Republican friend wrote me recently, venting

about the ``third-world'' coverage Medicaid provides. What he

had to say was ignorant and false. Medicaid isn't failing. To

the contrary, it has saved my life and the lives of many

others who have simply had the misfortune of falling ill. And

isn't that, after all, one of the primary functions of

government? To care for its citizens and return them to the

ranks of the healthy and productive?

We have no idea what the year ahead holds for us. It is

likely we will face health premiums of $24,000 or more for a

low-level plan. Our premiums will consume 30% of our income,

more than our mortgage. Despite MassHealth, we shelled out

nearly $15,000 for uncovered medical expenses in 2016, and we

are already on track to surpass that number this year. On top

of everything else, this is the year our daughter starts

college. I'm not the typical Medicaid patient that people

seem so fond of demonizing, nor am I some poster child of the

ACA. I am simply one of the countless individuals whose story

does not fit the narrative the Republicans are attempting to

feed us about the ACA and about what it means to be sick in

America. Medicaid is on the chopping block not because it is

failing, but because the people who benefit from it too often

fail to speak up on their own behalf. Their silence has

nothing do with a lack of will or words. They are simply too

busy struggling to survive.

Medicaid benefits our poorest, yet it also assists those

slightly higher on the income ladder--people like me who

would vastly prefer to be thriving without it. Many more

people than you suspect have turned to it in a time of need.

They aren't merely characters in some musical or play. Trust

me, I know. They are your friends and neighbors. They are

families whose lives have been unended by illness. This is

what happened to my family. And, with a single diagnosis, it

could be your family too.

Thank you. Thank you for writing. This is why we are here to fight.

I also heard from Kaitlyn, from Cambridge, who said the ACA has allowed her to continue pursuing her postdoctoral research. She says:

I am postdoctoral fellow at MIT, and I have a pre-existing

condition. In 2012, during my second year of grad school, I

started having debilitating pain in my abdomen. The pain was

so bad I couldn't eat or sleep, and I lost 30 pounds over two

months. The pain was so bad I couldn't wait the full 3 months

to see a specialist, and I went to the ER and finally got a

diagnosis for an autoimmune disease and began treatment.

However, my condition was so advanced that a little over a

year later I needed an emergency surgery while I was visiting

family out of state. I spent six nights in the hospital and

rang up a bill in excess of $50,000. Luckily, I was 25 and

still on my parent's insurance. Additionally, I was doubly

insured by the student health insurance from the University

of California, for which I was automatically enrolled through

my graduate program. Other than a $200 deductible, my

hospital bill was paid in full.

Now that I have a chronic illness, having quality

healthcare and regular checkups is vital to staying healthy

and productive. My medication, Humira, costs $5,000 a month

out-of-pocket, which was more than double my grad school

stipend. With insurance, I only pay $25 a month. Though

surgery helped me tame the inflation in my intestines, my

disease began to express itself as arthritis in my joints.

The pain was so bad that one Christmas I canceled my trip

home to see my family and spent the whole time alone on my

couch. I had a bad reaction to some of the medications and

became so severely anemic that I needed a blood transfusion.

Additionally, one of the medications I take causes severe

birth defects. So I needed an IUD to prevent pregnancy.

Easily, all these conditions could become overwhelmingly

expensive. But with my student health insurance through the

University of California, I could afford it. The premium was

$300 per month, part of which was covered by the university.

My medications cost $110 a month, and I had a yearly out-of-

pocket maximum of $2,000. While I didn't get my insurance

through the exchanges, the other conditions of the ACA which

determine the minimum quality of care made it possible for my

care to be affordable.

By having proper treatment and care, I can be a productive

member of society. I have received my PhD in Applied

Mathematics and my research contributes to the design of

medical devices that can be used for cancer screening. I am

able to mentor young girls and encourage them to study math

and science. And who knows--one of them may cure cancer one

day! Since I am no longer in pain and I am not in debt, I was

able to find a prestigious job after graduation. When a state

provides for the health of its people, they can thrive at

home and at work. It is not only the moral choice, but also a

good choice for the economy.

Kaitlyn, thanks for writing and thanks for being one of the big success stories under the Affordable Care Act. This is what we are fighting for tonight.

I also heard from a young woman in Somerville named Samantha. Here is what she wrote:

I've been dealing with severe mental health issues since I

was a kid. I am now 27. In that time, I have been through

numerous hospitalizations, residential treatment, day

treatment, intensive outpatient treatment, and outpatient

treatment.

When I was 18, I had to drop out of college and spent 3

months in residential treatment for my eating disorder. The

year prior, I spent 2 months in residential treatment and 6

months between day and intensive outpatient treatment, and I

had been in therapy for 4 years.

Due to Massachusetts law, I was still covered by my

parent's insurance, but the Massachusetts health care reform

didn't stop insurance companies from imposing lifetime

limits. At 18 years old, fighting for my life, I overheard my

parents discussing lifetime limits in regard to my health

care. I don't know how much all that treatment cost, or how

much of my lifetime limit I had consumed. For the next 7

years, I was in and out of treatment at various levels.

Mr. President, I ask unanimous consent to extend my time by 10 minutes, if I might, to finish my stories.

Thank you.

In 2014, when I had my own health care, I had a bad

relapse. For the first time I was paying for my own

treatment. I had health insurance through my employer that

was really good, but even with that, for 1 month of

residential treatment, 1 month of day treatment, and 3 months

of intensive outpatient, plus therapy, a nutritionist, a

psychiatrist and medication--all crucial to my recovery--my

out-of-pocket health care costs reached almost $10,000.

These days, I am much more stable and have remained in

relatively good health, but all because of the continued

support I get from my therapist, psychiatrist, and doctor. I

can only imagine how much money has been spent and how close

I'd be to my lifetime limit if those were still in place. And

of course, all that adds up to being a ``pre-existing''

condition.

The simple fact is that I would most likely be dead today

were it were not for the protections provided by the ACA, and

if I lose those protections, if I have another relapse, I

will either end up dead or unemployed and mired in debt.

Samantha, thank you for writing. Thank you for fighting. That is why we are on the floor of the Senate tonight, to continue to fight for the Affordable Care Act and to continue to fight against cuts to Medicare and Medicaid. This is what is at stake for families in Massachusetts.

As Jennifer said in her letter: This is us. This is now, and this is real. Congressman Price wants to cut more than $1 trillion from Medicare and Medicaid. But I am not giving up, because I am here to fight for Lee and Meg and Jill and Marika's baby Jack.

Congressman Price wants to rip up the behavioral health protections in the Affordable Care Act. But I am not giving up, because I am here to fight for Christine's son and Jackie and Samantha.

Congressman Price wants to get rid of the ACA's ban on discriminating against individuals with preexisting conditions. But I am not giving up, because I am here to fight for Jenny and Kaitlyn and Olivia and Denise and Jennifer.

I will fight for every one of them and for the tens of millions of people who are counting on Medicare and who are in need of Medicaid to pay nursing home bills and to help with home health care for people with disabilities and who need that Medicaid money for children with serious problems. I will

fight for every one of them. Where are three Republicans who will do the right thing and fight alongside me? That is what tonight is all about.

I yield the floor.

Mr. President, as the Senate begins to consider the Price nomination, I wanted to see if I could put a little perspective on the upcoming debate.

Focusing on bipartisanship has always been important to me. I know many of my colleagues on the Senate Finance Committee, on the Democratic side, share that view, and in 2009, the nominations of Democrats Tom Daschle, Tim Geithner, and Ron Kirk were all handled in a bipartisan way.

Issues came up in the vetting process in each of these cases, and both sides of the committee took the investigation seriously. Unfortunately, that has not been the case in 2017.

While Congressman Price served on the powerful Ways and Means Committee, he traded in health care stocks, pushed policies that helped his portfolio, and got special access to a promising stock deal.

I asked the congressman directly in his Finance Committee hearing whether he got a special deal. He said that he did not.

I don't think you could be much clearer than the following passage from a recent report by a Pulitzer prize-winning reporter at the Wall Street Journal. He wrote: ``Rep. Tom Price got a privileged offer to buy a biomedical stock at a discount, the company's officials said, contrary to his congressional testimony this month.''

I want to repeat that because I think it goes right to the heart of why Finance Committee Democrats feel that the effort to do the vetting necessary with respect to Congressman Price is not completed.

A Pulitzer Prize-winning reporter at the Wall Street Journal--I will just read it again--wrote: ``Rep. Tom Price got a privileged offer to buy a biomedical stock at a discount, the company's officials said, contrary to his congressional testimony this month.''

So, as I indicated, my Democratic colleagues and I on the committee said it was important to take more time to look into this issue. But the majority, when we said we needed to take more time to look at it, decided to look the other way. That is the first reason for concern on my side.

The second is how Congressman Price would manage Health and Human Services, a Department that is really all about people: services for seniors, services for the poor, for the disabled, for children, and for families. These are the powerful threads of our safety net. If the safety net is not there for those who have nowhere else to turn, those poor will suffer greatly.

Now, the debate on Congressman Price's nomination, in my view, is a referendum on the future of health care in America. In short, it is a debate about whether it makes sense for our country to go back to the dark days when health care worked only for the healthy and the wealthy.

Based on the public record, Medicare is a program Congressman Price doesn't believe in, and it guarantees services he doesn't believe seniors should have.

On the Affordable Care Act, he is the architect of repeal and run. He wrote the bill himself. He proposed weakening protections for Americans with preexisting conditions. He would slash Medicaid, shredding the health care safety net for the least fortunate in our country. He would take away health care choices for women across the country.

Look for the common thread, Mr. President and colleagues, among the Price proposals. They take away coverage for our people and make health care more expensive for individuals or both. That is where Congressman Price stands when it comes to American health care.

Every Senator who casts a vote for Congressman Price has to stand by that agenda. Beyond what this means for the future of American health care, there is the lingering specter of serious legal and ethical issues.

Tonight and in the hours ahead, this debate is going to tackle each of those issues and more. As it gets underway, I am going to begin with Medicare.

In my view, Medicare has been a historic achievement in the way policy is made in our country. In any debate like this one, I recall my days when I was the codirector of the Oregon Gray Panthers, when I worked with seniors who couldn't imagine life without Medicare. But I will tell you, they told me stories about what it was like for their grandparents when there wasn't Medicare. There were poor farms-- literally, poor farms--where older people who had served our country in the Armed Forces very often spent their last days in what amounted to squalor at these poor farms. Then Medicare came along. For millions of older people, it was a godsend.

So I want to start my discussion with respect to Medicare with a comment that Congressman Price made about Medicare in 2009. It is a quote that speaks volumes about the Price perspective on the Medicare program that is so treasured by millions of older people.

Congressman Price wrote in 2009: ``Nothing has had a greater negative effect on the delivery of health care than the federal government's intrusion into medicine through Medicare.''

I would just say to my friend, the Presiding Officer of the Senate knows how seniors in Oregon see this. Seniors in Oregon consider Medicare to be a Godsend, not an intrusion into medicine, as you see from the Price perspective.

Here is the bottom line, colleagues, as we begin here today: Medicare is a promise. Medicare is built on a promise of guaranteed benefits-- guaranteed benefits that will be there for you. It is not a voucher. It is not a slip of paper. It is guaranteed benefits that you can count on, and it is a promise that Congressman Price has indicated--and it is a matter of public record--it is a promise that Congressman Price is more than willing to break.

It is a promise that when you turn 65, you will be guaranteed health care benefits regardless of your economic station in life or the status of your health. And the reason Medicare was built with this special guarantee is straightforward: No American knows how healthy they will be when they reach age 65. Perhaps you are a marathoner at age 50 and you develop arthritis or Alzheimer's or cancer a decade and a half later. Furthermore, no one knows what the economy is going to look like years ahead or decades ahead into the future. For the less fortunate, high inflation or a stock market crash could all but wipe out what they set aside over a lifetime of work. Seniors could find their benefits exposed to new danger every time there is a financial downturn.

During the recent campaign, the American people heard a standard Trump pledge: No cuts to Medicare. But when you look at the Price record and the promise of President Trump, there is a big gap between the two. When you look at Congressman Price's plan, it is clear that the Trump pledge was on the ropes the minute he was nominated. In fact, Congressman Price said that he wants to voucherize Medicare within the first 6 to 8 months of the administration. Let me repeat that again.

Mr. President, some of these statements that the Congressman has made are so far-fetched that once in a while I am going to have to repeat them so that people really get a sense of why we are so concerned.

Congressman Price said he wants to voucherize Medicare within the first 6 to 8 months of the administration. So what that would mean is that right out of the chute, the Medicare promise, the promise of guaranteed benefits--Congressman Price wants to break the promise. In his budget, the Congressman called for privatizing Medicare and cutting it by nearly $500 billion.

He also championed legislation to allow a practice called balanced billing in Medicare. That means seniors could be forced to cover extra charges above what the program pays for the services they receive in the doctor's office. Older Americans on fixed incomes would be forced to pay more for their care.

Colleagues, I believe the Congress has no greater duty than to uphold the promise of Medicare. In my view, there is no need to mince words: Privatizing Medicare as Congressman Price has thought to do means an end--an end to the program-guaranteed health benefit. It would break the Medicare promise, the promise of guaranteed benefits and services, and end Medicare as our country knows it.

Now let me turn to the Affordable Care Act. When it comes to the Affordable Care Act, for years now, there has been a steady drumbeat coming from my colleagues on the other side: Repeal and replace. Repeal and replace. I think it has gotten to the point where children sing it almost as a jingle. Repeal and replace. It has been said so many times. A government shutdown all built around that slogan--repeal and replace.

At one point, the President-elect said repeal and replace would happen, in his words, ``simultaneously.'' Shortly before inauguration, he said they would come within the same hour, and he said Congressman Price was writing the replacement plan and it was nearly ready to be unveiled.

But the public heard a different story during Congressman Price's Finance Committee hearing. At that hearing, our colleague Senator Brown of Ohio asked: The President said he is working with you on a replacement plan for the Affordable Care Act, which is nearly finished, and it will be revealed after your confirmation; is that true?

That was the question posed by Senator Brown to Congressman Price.

The Congressman said: It is true that he said that, yeah--that he said that, yeah. A moment later he added, ``I have had conversations with the President about health care, yes.''

So if anybody is waiting for the curtain to rise on the Price replacement plan, it sounds like you are going to have to wait a while longer. In fact, the President said this weekend, just this weekend, Americans might have to wait until next year to see the replacement, but the uncertainty about what comes next sure hasn't slowed down the charge of many toward repeal. In fact, the President issued a day one Executive order instructing the executive branch to roll back the Affordable Care Act in any way possible.

So I thought given these developments, the fact that Congressman Price is the architect of a repeal-and-run bill; that the President immediately on day one tried to set in motion a strategy to gut some of the key protections in the Affordable Care Act, I thought I ought to follow this up with Congressman Price during his nomination hearing in the Finance Committee. So I asked Congressman Price during his finance nomination hearing whether the Congressman would state that nobody would be worse off under the President's Executive order--not real complicated.

There had been all this talk through the campaign about how now President Trump could do a better job, less money. That was the constant refrain. I decided, given these ominous developments that I just described since the beginning of this year, I thought I would just ask Congressman Price whether anybody would be worse off under the Executive order. He ducked the question.

I remember asking him about whether people would be worse off with respect to coverage, and I remembered he said something about how people would have access to health care. Well, I will tell you, hearing the word ``access'' rather than ``coverage'' means that

somebody is walking back a commitment to people really getting care. Everybody pretty much can have access. Sure, if I had the money, I could get it. It is about coverage. So we asked Congressman Price whether people would be worse off and he ducked the question.

So then I asked if he would commit that no one would lose coverage, and he ducked once more.

Then I asked if he would commit to holding off on implementing the Executive order until a replacement plan was enacted. He ducked.

So the Congressman was given an opportunity to, in effect, say that he would honor what the American people were told by President Trump in the campaign; that the two would be hand in hand, the replacement and repeal would go hand in hand, but he had the chance to say that at the nomination hearing and he ducked and ducked and he ducked some more.

Americans are still being told that the Affordable Care Act is the problem and it has to be repealed. It looks to me that what Republicans have on offer now isn't repeal and replace at all. It is what I have been calling it since last year, repeal and run, and the architect of repeal and run is Congressman Price. In fact, he wrote the bill. He wrote the bill that would have gutted the ACA the last time around.

Under the Price plan, 18 million Americans would lose their health insurance in less than 2 years. By 2026, it would be 32 million who would lose coverage. Today 26 million Americans are uninsured. In a decade it would be 59 million. Working Americans would make up four out of every five people who lose their coverage. These are folks struggling to climb the economic ladder. No-cost contraceptive coverage for millions of women would be gone. We would have hundreds of thousands of women losing access to care almost immediately just by the defunding of Planned Parenthood. Hundreds of thousands more would lose their choice to see the doctors they trust. Just think about that. Legislation that is going to take away from American women the chance to see the doctor of their choosing, the doctor they trust. I don't know anybody in the last election who thought they were voting to see women lose the choice of the doctor they trust.

Under the Price plan, premiums jumped by hundreds of dollars a year as the individual market for health insurance collapses. Health care costs skyrocket. It is a gut punt to all, even those who get their health insurance at work because what it would do is, in effect, it would shrink--it would shrink the health care market in a way that there would be many more people who are seriously ill and had great expenses, and when you try to pass those on, that would mean people in the marketplace and those who had health insurance from their employer would see increases.

Another issue in the Price plan that ought to set off any alarm bells, in my view, is what Congressman Price has proposed for those with preexisting health care conditions. This is especially important in my view. When I proposed my own health plan, eight Democrats, eight Republicans, I was especially pleased that Senators on both sides of the aisle understood that making sure that insurance companies could not knock the stuffing out of people with a preexisting condition any longer was central to reform. Because when you allow discrimination against those with a preexisting condition, what you are essentially saying is health care in America is going to be for the healthy and wealthy. If you are healthy, no problem with a preexisting condition. If you are wealthy, again, no problem.

So right at the heart of the Affordable Care Act is a guarantee that insurance companies cannot discriminate against Americans with preexisting conditions. Frankly, I was very pleased to see that because as I indicated, 16 Senators--8 Democrats and 8 Republicans--on our bill said that was right at the heart of what they wanted in health care reform. So the ACA--the Affordable Care Act--said, No denying coverage to pregnant women, no denying coverage to cancer patients, no denying coverage to kids with autism. Under the Affordable Care Act, that is the law of the land. It protects every single American. No American under the Affordable Care Act should have to feel, when they go to bed at night, that they are going to get hammered as in the old days because they have a preexisting condition.

Now, Congressman Price, once again turning to the public record--it is all in the public record here. Congressman Price doesn't believe the American people should have the protection of that kind of real ban against discrimination for a preexisting condition. In fact, he was quoted in 2012 saying that it was, in his words, ``a terrible idea.'' So he, like the law, changed, and his way to change a law that guarantees universal protection is to get rid of the guarantee that you aren't going to get discriminated against if you have a preexisting condition.

Our colleague, Senator Nelson of Florida, asked Congressman Price about the issue of making sure those with preexisting conditions don't get discriminated against when the Finance Committee held their nomination hearing. Once again, Congressman Price ducked, bobbed, and weaved. Senator Nelson asked if the Congressman thought that the proposal to continue the ban on discriminating against people with a preexisting condition is a terrible idea. Here is what Congressman Price said: ``What I have always said about preexisting conditions is that nobody, in a system that pays attention to patients, nobody ought to be priced out of the market for having a bad diagnosis. Nobody.''

Now, that probably is a pretty good sound bite. It is a good sound bite if you are trying to duck a question, but it is not a real answer to what Congressman Price was asked by Senator Nelson. And if you examine Congressman Price's own proposal, when it comes to actually protecting people with a preexisting condition from discrimination, you can see why Congressman Price isn't very interested in giving a straight answer.

I am going to turn now to one of the Congressman's bills. It is ironically called ``Empowering Patients First.'' Instead of a ban on discrimination against those with preexisting conditions, the Price bill opened up loopholes to benefit insurance companies. The Price plan hinged on something called continuous coverage, and Americans are going to probably hear a fair amount about that in the months ahead.

The Price plan said that insurance companies had the right to inspect your recent past when you applied for coverage to the private market. If they found gaps when you went without insurance, they could deny coverage for your preexisting condition for up to a year and a half, or they could hike your premiums by 50 percent. In short, under the Price plan, insurance companies could take your money and skip out on covering the health care that you actually need.

Short summary of the Price health provision there: Worse health care, higher costs.

Now let's think about what this would mean for a cancer patient who suffers a job loss: Up to 18 months without coverage for cancer treatment they need that could be the difference between life and death. Congressman Price's bill didn't allow any special exceptions for certain gaps in coverage. No matter why you lost your insurance--maybe a layoff, maybe your spouse passed, quitting your job to start a business or go back to school--insurance companies with the Price plan again would be allowed to discriminate. And Congressman Price's bill didn't create any safeguards for particular patients with life- threatening illnesses. No matter what kind of preexisting condition you have, you would be at risk of losing access to care. And going by the practices those companies followed before the Affordable Care Act, more than 130 million Americans under age 65 may have a preexisting condition.

Now, it is correct that Republicans may not decide to go ahead with Congressman Price's bill as the final measure on replacement. But make no mistake about it: If confirmed, Congressman Price will be the captain of the Trump administration's health team. His proposals matter. And his approach is one that is followed by just about every other Republican who has put forward a plan of their own.

Colleagues, I think it would be an enormous mistake for this Senate-- for

our country--to turn back the clock and go back to the days when health care was for the healthy and wealthy. I don't think there ought to be a debate about the need for real, truly strong protection for our people against discrimination for those with a preexisting condition.

The Affordable Care Act locked it in to black letter law. It set a new standard: Nobody in America is going to be denied insurance due to a preexisting condition. In my view, it would be unconscionable to look to yesteryear, turn back the clock, and undermine those strong protections for the millions and millions of Americans who suffer from those preexisting health conditions. That, as a matter of public record, is what Congressman Price's proposal would do.

I want to turn now to his ideas with respect to Medicaid. This, in my view, is an especially important program, and a part of it that is usually missed is the nursing home benefit for seniors. Back when I was the director of the Oregon Gray Panthers and I ran the legal aid office for the elderly, I saw in particular what Medicaid meant for seniors who needed nursing home care.

Medicaid now covers costs for two-thirds of the seniors in nursing homes. And I think we ought to think about who these people are because these are people in Colorado, in Oregon, and across the country, who worked hard. They always played by the rules. They put their kids through school. They were part of their communities. They saved, they scrimped, they didn't go on an extra vacation; maybe they were thinking about buying a boat, but they didn't do any of that. They didn't do any of that because they wanted to save and make sure their spouse could have a dignified retirement, that they could put their kids through school, and they did everything right. So they saved and they saved and they saved.

But the fact is, it costs a lot to be a senior in America today. So perhaps they spent down all those savings, and their kids--the kids they love so much--aren't doing that well economically, so it is hard for the kids to help out with long-term care.

Without Medicaid--and particularly the nursing home benefit--seniors, 65 percent of whom depend on the program for nursing homes, wouldn't be able to have a dignified retirement.

So that nursing home benefit that is paid for by Medicaid is also one that Congressman Price has proposed slashing. He does that by cutting $2 trillion out of Medicaid over the course of two stages. First, Congressman Price repeals the expansion of Medicaid created under the Affordable Care Act. This means that more than 11 million Americans lose their coverage. And it is a plan that even Republican Governors are speaking out against. John Kasich of Ohio--I think he would probably tell you he is not anybody's idea of a bleeding heart liberal--said recently: ``So if all of a sudden that goes away, what do we tell those 700,000 people? We are closed? Can't do that.''

But that is exactly what Congressman Price's plan is going to end up doing. It is going to end up telling those 700,000 Ohioans, along with millions of people across the country in Oregon, and across the land-- and that is because he is pushing to take away their coverage and hasn't offered any real alternative that would preserve their access to care.

So for all of those seniors--the ones who worked hard and saved and did everything right--we all know them; perhaps they are the widower down at the end of the block--there is not going to be a way to pay for their health care, and they are not going to be able to have a dignified retirement, in spite of the fact they did everything all their life to plan and save.

Congressman Price's second Medicaid cut turns the program into a block grant and introduces a cap approach. That slashes another 30 percent of its funding and sets it up to be squeezed even more down the road.

Now, Medicaid goes a lot further in terms of taking on some of the biggest health care challenges in America. I cited the nursing home benefit because that is one that I dealt with again and again when I was director of the Gray Panthers. But the fact is that the program is helping communities across the country take on a whole host of health care challenges. The opioid epidemic is one example.

Now, we know that opioid addiction has hit American communities like a wrecking ball. More than a million people struggle with substance abuse, and they would lose access to care if the Price plan to repeal Medicaid expansion goes through. And further cuts to Medicaid would make the problem even worse, and it wouldn't just be for adults.

Tens of thousands of babies are born with a dependency to drugs each year. It is largely a product of the opioid crisis. My view is that number can only rise under Congressman Price's plan to cut Medicaid, a key source of primary care, prenatal care, and substance abuse treatment for pregnant women.

Medicaid is also the biggest source of funding for community and home-based care for those vulnerable Americans with serious disabilities. It is a huge source of AIDS treatment in America, particularly with the Affordable Care Act expansion.

All in all, 74 million Americans rely on Medicaid, and they are certainly not among the most fortunate. Half of them are kids, including millions with special needs. The program covers nearly half of all births and millions of Americans with disabilities.

I want to come back again to the faces of these people because I am not sure, when people hear the word ``Medicaid,'' what they see. I mention that it is so many seniors who, after planning, saving, and scrimping, need the program for nursing home care. It covers people who toil through hard work, even multiple jobs, bringing home just enough to keep them out of poverty. For many, signing up for the Medicaid Program brought an end to the years when they had to choose between visiting the doctor and putting food on the table. Medicaid is their health care safety net. Make no mistake about it; Congressman Price's proposals leave that safety net in tatters. There isn't any other backstop for those vulnerable Americans. From small, tiny children to seniors who depend on it for nursing home care, there is no other backstop if their access to health care through Medicaid goes away.

One of the arguments made by advocates of block grants and caps is that States would have flexibility, and they point to a section of the Affordable Care Act I wrote to support their case. I believe they are talking about what is called section 1332. There is a big difference between what I wrote in the Affordable Care Act and what block grants would do. We had a number of Senators on both sides of the aisle who were interested in this issue. What I wrote is this: With that flexibility, the Affordable Care Act lets States do better by their people. The Price plan to block grant and cap Medicaid costs lets States do worse.

Slashing Medicaid also hits State budgets extraordinarily hard. That is a big reason why Governors across the country have been skeptical-- even Republican Governors, like John Kasich and Rick Snyder of Michigan. Today, Medicaid comes with an open-ended kind of feature. Federal funding for the program doesn't tick down to zero. Nobody gets cut off. If you are working in America and are eligible for Medicaid, you don't have to worry about being locked out of the doctor's office if the program goes into the red. Block granting and capping the program changes that. States get a chunk of money each year. There is a big risk that money runs out, especially during times of economic downturn. That is when Medicaid is needed most, at times when working Americans have the most trouble walking the economic tightrope.

This is in addition to the undeniable, routine demands on the program: an aging baby-boomer population that will be in increasing need of nursing home and home-based care, public health emergencies like the Zika virus that can come without warning, natural disasters like Hurricane Katrina or the Flint water crisis that devastate communities, new high-priced drugs that can be cures but come with a steep price.

The reality is if a State's block grant runs out, that raises questions that ought to be alarming to all who care about vulnerable Americans having access to the care they need.

What happens if seniors lose their nursing home benefits in the middle of the year? Where would they go? Would patients in substance abuse treatment

lose access to care? If a State's Medicaid funding dries up midway through the fiscal year, who would pay for a birth? Would the parents of a newborn child have to bear the entire cost when they are on a modest income, working hard, and a hospital bill could reach tens of thousands of dollars?

When it comes time to pitch this very extreme health care agenda to the American people, Congressman Price is very articulate and sticks closely to well-rehearsed language. That is because the Price agenda would strip tens of millions of Americans of their insurance coverage and force people to pay much higher costs for much lesser care. It isn't going to go over very well when people really understand what is at stake.

One of the priorities Congressman Price talks about most frequently is access--always saying that his vision is Americans are going to have access to care. That is one very hollow theory. Access to health care doesn't mean a lot if you can't afford the cost. So when Americans hear the Price plan that people will have access, rather than coverage, pay attention. Pay attention, because if you have coverage today, and he is going to promise you access in the future, chances are you are going into the hole and you had better figure out how you are going to pay for it.

The Congressman talks about flexibility for patients. But under Congressman Price's plans that wipe out consumer protections and minimum standards for coverage, it is insurance companies that get the most flexibility.

The Congressman likes to talk about using metrics to measure health care. It is very hard to follow what this metrics approach is all about. When his proposals are challenged using facts and figures, including those that come from our nonpartisan scorekeepers at the Congressional Budget Office, he disagrees or he dodges. During his hearing, he just disagreed with the Congressional Budget Office when I asked him about some of his funding cuts that would deprive women of access to preventive care. He objects to even the simplest of measures--how much funding his proposals cut from our health care programs--as calculated by the nonpartisan experts. In my view, you can't run from the metrics when they don't tell you what you want to hear.

Finally, the Congressman and many others say patients should be at the center of care. Now, I want it understood, I don't see how anybody could dispute that idea. Of course patients should be at the center of care. But when I look at the Price proposals, I don't see the patient at the center of health care. I see money and I see special interests at the center of health care.

The Price plan tells vulnerable Americans that their health care will only go as far as their bank accounts are going to take them. The well- to-do may be able to manage just fine under the Price proposals and the costs they push onto patients, but I am absolutely certain that millions of working Americans won't be able to do it.

I am going to wrap up talking about several glaring ethical issues with respect to Congressman Price. I will begin with the Congressman's significant investments in an Australian biomedical company. A lot of information about those investments has come into view over the course of months of investigation and reporting. What the facts show is that in 2016, the Congressman was part of an exclusive deal to buy stock at a discounted price--a deal called a ``private placement.'' On multiple occasions he was given opportunities to come clean and explain his participation in the special stock sale. He never has. Now, the majority on the Finance Committee has cut off the vetting process before getting all the facts or having the Congressman correct the record. So I am going to take a moment tonight to lay out the facts.

It is well known that Congressman Price learned about the company from a House colleague, Congressman Chris Collins. But Chris Collins isn't exactly a casual observer of the Australian business pages. He is Innate's--the company's--largest shareholder and a member of its board. Many of the company's other major shareholders are people in Congressman Collins' orbit, family members and chief of staff and others that he is close to. After learning about the company from his colleague, Congressman Price made his first purchase of the company's stock in 2015. He bought 61,000 shares.

Now let's fast forward to August 2016. The Congressman bought another 400,000 shares of Innate as part of a private stock sale for U.S. investors. When the private sale took place, Innate's shares were trading on the Australian stock exchange for the equivalent of 31 American cents, but participants in this private sale got the shares at a steep discount. That discount meant that Congressman Price paid tens of thousands of dollars less than a typical investor would have paid on the open market.

With respect to that purchase, the record remains unclear. It does come down to two issues: how he came to participate in the private placement, and whether he got special access that other investors didn't have. On those issues, Congressman Price tells one story; company officials, Congressman Collins, and public documents tell another.

First I am going to examine how Congressman Price came to participate in this private deal. As he tells it, he decided to make that purchase based on his own research into the company. But the Wall Street Journal and a little common sense say otherwise. I will read from a January 30 report.

Mr. Price got in on the discounted sale after Mr. Collins

filled him in on the company's drug trial, according to Mr.

Collins. . . . Mr. Collins said he told Mr. Price of the

additional private placement. He said Mr. Price asked if he

could participate in it. ``Could you have someone send me the

documents?''

Mr. Collins recalled Mr. Price asking him.

It paints a pretty clear picture. Congressman Price got information from his colleague, the company's top shareholder, and he got an invitation to a special deal. The claim that his conversations with Congressman Collins had no effect on Congressman Price's decision to invest just does not pass muster.

So I will turn to the second point--whether or not the deal was available to all company shareholders. Congressman Price insists it was. Here is the exchange he and I had during his nomination hearing in the Finance Committee.

I said: ``You purchased stock in an Australian company through private offerings at discounts not available to the public.''

Congressman Price responded: ``Well, if I may, those--they were available to every single individual that was an investor at the time.''

But that is not what Innate management--including the CEO--told the Wall Street Journal. According to the Wall Street Journal's report, Congressman Price was one of six special American investors in a category called ``friends and family.'' I will read a passage from the story.

The cabinet nominee [Mr. Price] was one of fewer than 20

U.S. investors who were invited last year to buy discounted

shares of the company--an opportunity that, for Mr. Price,

arose from an invitation from a company director and a fellow

congressman.

At Mr. Collins's invitation, Mr. Price in June ordered

shares discounted in the private placement at 18 cents

apiece, and then more in July at 26 cents a share, Mr.

Collins said in an interview. Those orders went through in

August, after board approval. Mr. Price invested between

$50,000 and $100,000, according to his disclosure form . . .

Mr. Wilkinson [the company's CEO] said investors who had

bought in a previous private placement were called to make

friends and family aware of the opportunity. . . . We are

always looking to increase our shareholder base. But those

new parties have to meet the definition of sophisticated

financial investor.

Only six U.S. investors, including Mr. Price, fell into the

friends-and-family category, Mr. Collins [his friend in

Congress] said. About 10 more U.S. investors were offered

discounted shares by the company because they had previously

been invited to partake in private placement offerings.

Furthermore, Congressman Collins and Mr. Wilkinson added more detail.

The discounted stock offer in Innate Immuno, as the company

is known, was made to all shareholders in Australia and New

Zealand--but not in the U.S., according to Mr. Collins and

confirmed in a separate interview with Innate Immuno CEO

Simon Wilkinson.

Bottom line, Congressman Price got in as a special guest, a friends and family guest of Congressman Collins. What he told the committee-- that the

deal was open to shareholders--was dead wrong. I am going to repeat this quote from the Wall Street Journal. This was part of a report that was authored by a Pulitzer Prize-winning journalist. This is what he wrote in the Wall Street Journal: ``Rep. Tom Price got a privileged offer to buy a biomedical stock at a discount, the company's officials said, contrary to his congressional testimony this month.''

The stock deals I outlined are of very great significance. They aren't the only ethical issue at hand. Congressman Price introduced legislation that would lower the tax bills of three major pharmaceutical companies in which he owns significant amounts of stock. He invested $15,000 in a medical equipment company and then introduced legislation to increase the amount Medicare pays for that type of equipment. Parts of his bill went on to become law.

Then there is his investment in a company called Zimmer Biomet. In 2015, Medicare was preparing a new pricing model that would change the way the program paid for hip and knee replacements. Instead of paying for each individual service, Medicare said it would try to make its payments more efficient by bundling the costs together in one lump sum. The new system, however, had the potential to affect the revenues of Zimmer Biomet.

On March 17, 2016, a few weeks before the government's model--that is, the CMS model was set to go into effect--Congressman Price bought thousands of dollars' worth of Zimmer Biomet stock through his brokerage account. On March 23, 2016, less than a week later, he introduced H.R. 4848, the HIP Act, which would have delayed the implementation of CMS regulations for Medicare coverage of joint replacements. He was the lead Republican sponsor of the bill.

Bottom line, Congressman Price introduced legislation that certainly had the potential to add to his personal fortune. Congressman Price has argued that he didn't purchase this stock and others; his broker was making the deal. But at the very least, he would have known about the deals within days when he filed his periodic transaction reports with the House.

On August 15, 2016, not only did Congressman Price file a report that he had purchased Zimmer Biomet along with dozens of other stocks, he initialed the entry for Zimmer Biomet in order to correct a mistake on the document.

Wrapping up, I want to go back to the fact that when Congressman Price came before the Finance Committee, he didn't give us the whole story. In effect, I think the Finance Committee regrettably has an ethical double standard now. Look at the nominations of Tom Daschle, Tim Geithner, and Ron Kirk at the outset of the Obama administration. That vetting was vigorous. It was bipartisan. We looked over every stone and peered around every corner. Now, when a glaring issue comes up that undeniably deserves investigation, the party in power is shutting down the vetting process and moving toward confirmation. I think this is sending a dangerous message to nominees in the future.

I will close by way of saying this is a nominee with an extreme agenda. His proposals strip tens of millions of Americans of their health care coverage. His proposals would put Americans with preexisting conditions in danger of losing coverage through the care they need. It would unravel the Medicare promise, the guarantee of secured benefits of vital importance to millions of American seniors.

When it comes to ethics, as I have described, Congressman Price falls well short of the standard the American people expect nominees to meet. I will not support his nomination. I urge my colleagues to join me in opposition.

I yield the floor.

Mr. President, we have had a lot of long nights here, and I just want to take a moment again to really give my gratitude to the staff. A lot of folks go into making the Senate work. We can see a lot of them down here. I can't imagine the days that they have been pulling, as we have been pulling long nights. Many of them get here early in the morning and they go a long way. So I want to thank them, from the stenographers to many of the Senate staff who make it work.

I also want to thank the pages again. These are young folks who have to carry a full load of classes and course work--hard stuff. I don't understand why they haven't come to me to help them with their calculus homework. But the reality is they are working a full class load of courses as well as being here with us around the clock. They probably aren't caught by cameras. They aren't even getting C-SPAN glory. But your presence here really means a lot, and I am grateful for that as well.

I rise specifically to speak about the President's nomination of Congressman Price to be his Secretary of Health and Human Services.

I want to take a step back and talk about the profound history that the United States of America has in terms of our bringing together the resources of this country to combat public health crises. We have a country where every generation has been able to step up and take on things that threaten the common health.

There was a time in this Nation when we had actual child death rates that were tragically high, and that for an industrializing nation, our water, the quality of our milk, women dying in child birth, and children dying was a common thing. But we had this bold understanding that in America, a Nation that believes in life, liberty, and the pursuit of happiness, the common health is important. And we took steps that, frankly, in a booming industrial economy, the private sector couldn't do. We took steps to protect the public health, and we made great strides.

It was a Republican President, actually, in 1953, Dwight D. Eisenhower, who actually created what was then a version of what is now the Department of Health and Human Services. Specifically, it was called the Department of Health, Education, and Welfare.

Now, the very first Secretary was a woman, and her name was Colonel Oveta Hobby. She had served as the director of the Women's Army Auxiliary Corps during the Second World War. She was, in my just great reverence, someone who served and fought for health and safety and security during World War II.

As Secretary, Secretary Hobby had an expansive and expanding role. It was a demanding role. She was coordinating the distribution of polio vaccine, overseeing countrywide hospital expansions, overseeing Social Security and the Federal education policy. She had a huge role, one that was so full that one newspaper joked that ``when she [actually] learns her job, Oveta Hobby may trim her week to just 70 hours.'' This was someone who went out there as an agent of the government to lift up the welfare of all of our citizenry, the health and well-being of everyone, again pushing toward those ideals.

In the United States, we really do believe in this idea of life, liberty, and the pursuit of happiness, freedom from deprivation, freedom from illness, the belief that we can have life and have it more abundantly. To Secretary Hobby, this was her duty to her country-- someone, again, who served valiantly in World War II.

In the collection of papers from Secretary Hobby's lifetime, Rice University includes that she was a great humanitarian and that she believed there was a role--a ``common thread,'' to use her words--to service to her country toward the empowerment of health for all. She set a standard, a powerful standard, as the first Secretary of Health for the greater good that we, acting collectively, could do to ensure the health and well-being of our Nation.

In fact, it was an understanding from President Dwight D. Eisenhower all the way down to Secretary Hobby that if we ensure people's health and access to health care, it is not just an individual concern, but actually, societally, we become better and we become stronger. The healthier all children are, the more likely they are to go out there and compete. If you are battling sickness, it undermines your economic well-being. In the world of infectious diseases, the words of Martin Luther King are true: Injustice anywhere is a threat to justice everywhere; in fact, an illness somewhere is the threat of an illness to people everywhere. This was the brilliance of Republican President Dwight D. Eisenhower, and it is how this great Department began, setting the standard, understanding that in many ways we are all in this together when it comes to our health.

So for me, this is another point in history. It is a challenge to us as to who we will be as a Nation. Will we continue to be a country that believes, as a fundamental birthright in the richest Nation on the Planet Earth, that everyone can access the highest quality health care, the best access to quality doctors with wide avenues to pursue the rich abundance of life because we have the best health care system on the Planet Earth?

I actually was happy to hear President Trump on the campaign trail talk specifically about this issue, tell us we were going to have a health care system better than the one we have now, specifically calling it ObamaCare; that we were going to have one that is amazing, one that is going to be covering more people. I think the word that was used was ``terrific''; it was going to be terrific. He specifically spoke about some of the bedrock elements of our current health care system that Republicans and Democrats

both agree are things we want to preserve, protect, and in fact make better. He specifically talked about Medicare and Medicaid, defending them: They wouldn't be taken away; they wouldn't be undermined; people wouldn't be kicked off.

So with this excitement, hearing that we have a President committed to these ideals, creating a terrific health care system, we stand on this history in our country where we know our greatness, and it is an affront if we don't have a system that takes care of our most valuable natural resources: the people of this country and a global, knowledge- based economy. What helps us compete is the quality of our workforce.

I am telling you right now, I have learned in my professional life that when children are sick, they don't learn; when a mother is sick, it throws the whole family into crisis; if someone can't afford their medication, it is not just a sin to this country's values, it is a sin morally.

So when President Trump nominated his person to be Health and Human Services Secretary, we might imagine they would reflect the values that he espoused during his campaign and reflect the values he has talked about as President. But instead, he has chosen someone who is diametrically opposed to the things he says he is for--preservation of Medicare. More than this, he has advocated a view on health care that unequivocally would take millions of Americans off of health coverage, thrust millions of Americans into economic crisis, and put the health of many millions of Americans in jeopardy. Usually people say these things hyperbolically, but this is quite clearly a matter of life or death.

For years, Congressman Price has told us who he is. He has led the charge in the House of Representatives to repeal the Affordable Care Act and take coverage away from millions of Americans while advocating specifically for the privatization of Medicare and the gutting of Medicaid. For years, Congressman Price has advocated for anti-choice, anti-contraception access, anti-commonsense measures, and supported efforts to defund and eliminate proven programs like title X family planning, programs like Planned Parenthood which, through their Medicare reimbursements, often in many communities is the only access women have in their communities for cancer screenings or to get contraception.

Congressman Price has been one of the loudest voices on tearing down many of the things that now Americans overwhelmingly say ``Hey, now that we've got this, we don't want to lose it,'' whether that is not having insurance companies dictating to you whether you get health insurance or not having pharmaceutical companies ratchet up prices so much that your lifesaving drugs are out of reach.

Then finally, at a time when we cannot afford to have people who have conflicts, we have a Congressman right now for whom other House Members are calling for ethics investigations because his personal financial interests clearly have been in conflict. In fact, he seems to be building a career as a Congressman working on health policy on one hand while building a fortune trading health stocks directly related to that work. This is a man who is so conflicted, a man who is so contrary to what our President says he believes, a man who has been leading the charge to take our health care back in an affront to the ideals that literally stem from the founding history of our Department of Health. I cannot support this individual.

But let me quickly go through some of these things. We now have to have an honest conversation in our country about this idea of repealing the Affordable Care Act without replacing it because objective organizations like the Congressional Budget Office, conservative organizations like the American Enterprise Institute, and fellow Republican Senators of mine have acknowledged that to repeal the Affordable Care Act would throw into crisis millions of hard-working Americans who have been able to get coverage because of the health insurance marketplace and the Medicaid expansion. Millions of Americans can now go to a doctor when they feel sick instead of going to an emergency room. By the way, as a local mayor--when people use emergency rooms as their primary care facility, it is extraordinarily more expensive; it is fiscally irresponsible.

Because of the ACA, millions more Americans can now access basic health and preventive services that can lead to lifesaving opportunities that did not exist before. Millions more Americans have the peace of mind of knowing that they are no longer one illness away from financial ruin.

Let me put up a chart for a second about the history of people having insurance.

This is the percentage of uninsured in the United States--going along, about 18 million uninsured. And then what happens? The uninsured rate has been driven down. Enrollment in the individual market continues to rise but has now decreased since 2014.

In late December 2016, Standard & Poor's--hardly a Democratic organization, but a market-based organization--released an incredibly optimistic report for the future of the individual market in the Affordable Care Act. But Congressman Price, on the other hand, has repeatedly introduced legislation and resolutions to repeal critical elements or the entirety of the law responsible for these successes without any regard for consequences. He has done this again and again and again and again, eight times. He authored a bill last year that would repeal critical parts, like the Medicaid expansion provision that has expanded access to care for millions, tax credits that would help millions buy insurance. And Congressman Price has introduced legislation that would fully repeal the Affordable Care Act.

I want to let you all understand that, to me, this is a point in our American history where this isn't arguing over opinion; these are facts about what Congressman Price has done. If he were successful in any of those eight attempts to rip down the Affordable Care Act, we now know objectively from organizations like the independent Congressional Budget Office that it would mean 18 million people losing their health insurance in the first year alone, 32 million of our fellow Americans by 2026. Objectively, there would be increases in premiums in the market by 20 to 25 percent; 4.4 million of those Americans who would lose coverage would be children; and 11 million of the most vulnerable would lose their Medicaid coverage.

There is a man named Andy Slavitt who is a former Acting Administrator of the Centers for Medicare and Medicaid--again, what our President says he wants to preserve. He put together a list because so many people were calling him, writing him: What are going to be the consequences if they repeal the Affordable Care Act without replacing it? What are the consequences? And he just went through a list: Small businesses, farms, self-employed Americans represent 20 percent of the coverage of the exchange. These are individual entrepreneurs, many of whom, by the way, experience something called job lock, where they are afraid to become entrepreneurs because if they lose their jobs, they lose health insurance. Twenty percent are covered by the exchange, and 127 million Americans--127 million Americans--have preexisting conditions. They would be put at jeopardy, and insurance companies would be able to deny them coverage.

Seniors, Medicare beneficiaries, have saved $2,000 on prescription drugs because of the ACA--$2,000; 30 million Americans are on individual policies and Medicaid; 2.8 million Americans with drug disorders would lose coverage; 1.25 million Americans with mental health disorders would lose coverage--1.25 million Americans with mental health disorders. In other words, the ACA put mental health care on parity with physical health care. A 42-percent reduction in uninsured rates for veterans has resulted. He said that bad debt--bad debt, bankruptcy--would go up by $1.1 trillion because health care bills would again be the lead cause in this country of bankruptcy. In other words, before the ACA, the No. 1 reason people were declaring bankruptcy was because of medical bills. After the ACA, that can't happen. There are steps to prevent that from happening, at least to the extent of $1.1 trillion.

The Medicare trust fund, which has been extended, will have several years reduced off its life expectancy. Taxpayers will lose $350 billion added to the deficit and $9 trillion would be added to the debt if it is repealed--2.6 million jobs lost, especially in communities like rural hospitals, where they

depend upon the ACA to keep doors open and hospitals running. Anyone who likes free preventive services like mammograms and better cancer treatment, preventive services that literally save lives by early detection, gone.

Young adults, 3.1 million right now on their parent's plan because of extending the years. Women who want to buy health insurance will pay more than men in premiums because, amazingly, at times insurance companies would be charging you more simply because of your gender and 105 million people had lifetime limits on what insurance companies pay.

This is a list from one of the great experts who knows factually what would happen if we were to turn back the clock. Let me drill down a little bit more. As head of Health and Human Services, Congressman Price would be responsible for insuring the continuance of Medicaid.

Americans like Kelley from New Jersey are able to access care right now because of the Medicaid expansions under the ACA. I want to read what she said. She said:

Thank you for supporting the ACA. I hope that you will

continue to fight hard for it. It's the ACA and Medicaid that

allow me to be able to seek medical treatments for my

scoliosis (which causes me to suffer from chronic pain) and

ensure that my newborn receives appropriate medical care when

need be.

I work full time and go to college but I still struggle to

pay the bills, as I'm only 18 and fast food doesn't pay much

even at 35 to 40 hours a week.

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

She concludes by saying:

I want my baby to have the health care she deserves so she

can be happy and healthy.

The Medicaid expansion under the ACA has extended access for millions in our country, millions of hard-working people like Kelly and their children, like her baby, across the country.

In New Jersey alone, hundreds of thousands of people gained coverage. Uncompensated costs were driven down, and my State saved a billion dollars, all because of Medicaid expansion.

Republican Governor of New Jersey: Medicaid expansion was the right fiscal decision for our State and for our communities' families who live in our State.

In Price's efforts to undo ACA Medicaid expansion, he has indicated people like Kelly and her newborn baby are not a priority.

I know for a fact that hard-working people across the country and in my community will suffer if Price is able to do what he intends to do and has tried to do.

Let me go to another issue; that is, Medicaid. How about Medicare? As Secretary Price, he will be responsible for overseeing Medicare, the health care program that services 57 million American seniors and those with disabilities.

Under the Affordable Care Act, we know that the quality of Medicare coverage has improved. The life of the Medicare trust fund has been extended, and we have begun to close the gap in prescription drug coverage that too many seniors and people with disabilities--they know about this. It is known as a doughnut hole. There is more work to do to strengthen Medicare and to make prescription drugs more affordable for everyone, including our seniors.

The changes we have done already have had real positive impacts on the daily lives of Americans. Let me read another letter from Myra in Willingboro, NJ. She wrote to tell me about the difference that Medicare is having for her family as they live with chronic illness. She said:

As your constituent and an advocate of affordable,

accessible health insurance, I would like to share how

adjustments to the health care system could impact me. As you

consider policy changes, I urge you to think about how your

constituents living with chronic conditions will be affected.

It is so important to my husband who lives with Parkinson's

disease and myself who is being treated for Chronic Lymphatic

Leukemia that our Medicare benefits continue without any cuts

in benefits. It is most important that we continue to be able

to visit doctors able to care for our specific needs and have

the expensive medications covered that are needed as we live

with these diseases.

As a support group leader for people living with

Parkinson's disease--

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

I continue with her letter.

As a support group leader for people living with

Parkinson's disease and their caregivers, I know all the

members would echo my requests. Many people actually need

further assistance to purchase the needed drugs as their

policies do not cover them adequately presently. Often the

medication prices are prohibitive for folks. They have to

constantly check to see which drug plan will allow their

medication at an affordable price.

In addition, specific supports for caregivers is another

very important need for the Parkinson disease population.

Please consider assistance for these people who require

assistance throughout the day.

Let me tell you, this is a person writing to say keep what we have and make it better because it is still not enough to meet the challenges. Instead, we are considering making someone the Secretary of Health and Human Services who doesn't want to improve, build upon, get better but wants to throw out.

Take Tom, who believes that for his family, their lifeline to health care access is an intrusion. This is Tom Price--excuse me, who believes that this is an intrusion. He writes: ``I can attest that nothing has had a greater negative effect on the delivery of health care than the federal government's intrusion into medicine through Medicare.''

I want to put these words up. This is what the nominee to Health and Human Services is saying about one of the most valued parts of our health care in America. He is saying: ``I can attest that nothing has had a greater negative effect on the delivery of health care than the federal government's intrusion into medicine through Medicare.''

I would like to tell you that is an insult to Myra and her husband, millions of American seniors, those on disabilities who rely on what he calls an intrusion. Someone who is calling for an end to a program that millions of Americans rely on, that the President himself swore that he would do nothing to disturb, we are now putting the chief architect of the destruction of Medicare from the House into a position where they can wreak havoc on the health care of millions.

I want to go into that area of preexisting conditions. Imagine yourself as someone who has a child with diabetes or that you are a survivor of cancer and an insurance company can now look at you and say: I am sorry. I am not going to cover you. The people driven by the market, driven by profits, driven by the bottom line are going to look at you and your humanity and simply say: Sorry, I am not going to cover you. And you live in that place in America, that dark, painful place where you know you are one illness away from destitution.

This is what Maureen wrote to me recently. She said:

Please do not repeal the Affordable Care Act. My 18-year-

old son has been fighting cancer for over a year. I am scared

to death of what his future will hold without the protections

of the ACA. He may be subject to a lifetime cap on insurance

payments or be rejected for health insurance entirely on the

basis of a preexisting condition. He is only 18. He could be

financially ruined before he even gets his adult life

started. After fighting cancer as a teen, it scares and

upsets me to think that his battles will continue throughout

his life in the form of financial hardships from the loss of

protections he currently has through the ACA.

She ends saying:

Please consider my family when voting on the ACA.

Please consider my family. There are millions of Americans who now are living in this state of fear, looking at the rising and the ascendancy of Congressman Price to a position--someone who has tried again and again to end insurance for people with preexisting conditions.

I don't understand what we are trying to achieve with putting someone who believes that somehow the free market will take care of these folks. I began with our history as a country: booming industrial economy. The free market didn't take care of ensuring that our waters and rivers were cleaned up. The free market didn't take care of eradicating polio. We are a nation that has learned from our history that we have a responsibility to each other, and in our common civic space and in the

governments that are established amongst men and women, we have to do better for folks who are victims or vulnerable to the vicissitudes of the free market.

That is why we are stepping up to say that we can create a system that serves all. We are the richest country on the planet Earth. What even makes this worse than Medicaid under assault, Medicare under assault, people with preexisting conditions, which are issues that are simply around contraception.

Congressman Price would be expected to uphold protections currently in place that prohibit insurance companies from charging women more because of their gender and ensuring that insurance companies abide by the Affordable Care Act's contraceptive care.

All that talk about preexisting conditions, many insurance companies saw gender as a preexisting condition. As something as critical as having access to contraception, Tom Price has voted time and time again to restrict access to essential health care services and limit reproductive rights.

Before the Affordable Care Act was passed, cost was a major barrier for women seeking access to birth control. Congressman Price has repeatedly opposed the provision requiring insurance plans to cover contraception. This is what he said in an interview in 2012:

Obviously one of the main sticking points is whether

contraception coverage is going to be covered under health

insurance plans and at hospitals, and whether or not they're

going to be able to pay for it, especially low-income women,

where do we leave these women if this rule is rescinded?''

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

Bring me one woman who's been left behind. Bring me one.

There's not one.

I am sorry, in this case, Price is not right; Price is wrong. There is not just one you could bring. There are millions of women who were left behind and struggled with access to coverage before the Affordable Care Act. For this man to stand there and cast a shadow over the basic commonsense understanding that when you allow women to make their reproductive health decisions and have access to contraception, you give them power over their lives and their destinies. You actually reduce unwanted pregnancies dramatically. This is an economic issue. This is an empowerment issue. This goes to the core freedoms as a country.

The Center for American Progress reported in 2012 that before the ACA contraceptive provision went into effect, that ``a recent study shows that women with private insurance paid about 50 percent of the total costs for oral contraceptives, even though the typical out-of-pocket cost of non-contraceptive drugs is only 33 percent. Surveys show that nearly one in four women with household incomes of less than $75,000 have put off a doctor's visit for birth control to save money in the past year.'' Because of the ACA's contraceptive provision, America has changed. According to the National Women's Law Center, 55 million women have saved $1.4 billion on birth control pills alone since 2013.

Listen to Rachel from West Orange, NJ, a couple towns over from where I live. She benefited from the contraception provision of the ACA as well as access to Planned Parenthood. This is what she wrote:

The Affordable Care Act is something that has made a huge

impact on my life. I come from a poor background, and there

is no additional money to spare on things like birth control,

which I take for my independence and legitimate medical

issues. Without birth control, I'm unable to get out of bed

for days at a time because of painful periods. This means

losing out time off work and opportunities because of a

serious medical malady.

I never thought I would be able to normalize my life

because I can't afford a $40 copay every month, in addition

to my expensive transportation passes, student loan payments,

and helping my parents pay their bills. However, with the

Affordable Care Act, I have access to free birth control that

allows me to live my life and succeed. It enables my

independence, and makes me a healthier individual. I am

terrified that any repeal of the Affordable Care Act will

harm my health, my career and my ability to lead a normal

life.

We want people to lead the life of their dreams--their health, their careers. What she is asking for is not a luxury. It actually benefits us all because we are empowering her to succeed. That makes this country greater. Yet Tom Price, this nominee, has voted 38 times on measures that would restrict women's access, including 10 times voting to defund Planned Parenthood. At a time when there are fewer unwanted pregnancies, when women have more power, more control over their lives, Tom Price wants to roll things back.

Struggling women are fighting to raise families and go to college and pay the bills and run businesses or be entrepreneurs, that they are having constrictions placed on their lives--you empower women, you empower this Nation.

In New Jersey, Planned Parenthood's 26 health centers provide access to lifesaving care for women across the socioeconomic spectrum. I will fight tooth and nail with all that I have for not rolling things back. We are not going back. And a Congressman who has pledged to do just that should not be the Secretary of Health and Human Services.

Tom Price has spoken out against sex education. I am a believer. I said this when I was mayor, all the time. In God we trust--I am a man of faith--but everybody else, bring me data. Sex education is actually something that has a powerful economic benefit. When it comes to advocating for better health options and outcomes, we know this is not an idea or theory, but there is a connection between poor, incomplete, or absent sexual education and increasing rates of teen pregnancy, sexually transmitted diseases, sexual assault. Young people are also disproportionately infected, without sex education, with HIV, and HIV rates among young adults are truly problematic in this country. Kids who are granted full information live healthier lives. But Congressman Price advocates against that. He thinks sex education doesn't reduce rates of teen pregnancies--it does; doesn't reduce rates of sexually transmitted diseases--it does; doesn't reduce rates of sexual assault-- it does; doesn't reduce rates of HIV--it does. But he thinks that it promotes promiscuity among young people.

I want to end with my last point. All of this is enough, but this is the more astonishing part of my opposition because in this, I would at least think we could get my Republican colleagues to join with me because if you look at past Presidents, something less than this has sunk nominations before. This doesn't have to do with health policy; this has to do with conflicts of interest.

There was a great Senator who pulled himself out of consideration for what, compared to this, is a mild issue that he moved to correct on paying taxes on a benefit that he received. He pulled himself out of consideration. He had that kind of dignity to say: You know what, I have this small issue. I am pulling myself out of consideration.

But Tom Price is charging right ahead, while people in the House are calling for his investigation. Some of my colleagues have already addressed this, so I won't go into it much, but the SEC investigation should be there. An independent watchdog from the Office of Congressional Ethics should be there. We don't know because these organizations, the SEC and the Office of Congressional Ethics, don't announce when they are investigating somebody. But there are a whole bunch of people saying that Congressman Price has potentially violated something called the Stock Act, which was basically put in place so that Congresspeople, who know things about regulations or issues affecting companies, can't benefit off of that insider information to profit themselves. I don't understand why, at a time that this is all hanging over his head, that there should be an investigation, that we should get to the bottom of it before we put him in the President's Cabinet, Democrats and Republicans here, given past history and past nominees who had to withdraw, why aren't we joining in a bipartisan way and saying: Hey, there is a lot of smoke here, and the facts are kind of screaming for attention.

Let me just be clear. As an example, last March Congressman Price bought between $1,000 and $15,000 worth of shares in a company called Zimmer Biomet. They are a medical manufacturer that specializes in hip and knee devices. House ethics disclosures show that he invested in the company just 6 days before introducing a bill that would have directly benefited hip and knee replacement companies like Zimmer Biomet, H.R. 4848. Let's do this

again. He invests in a company 6 days before he introduces legislation that would have benefited such a company. That is astounding, to me, and it should raise alarms in terms of the codes of conduct of a potential Cabinet nominee. He invested in a medical manufacturer of hip and knee devices and shortly thereafter introduces a bill, the HIP Act.

What is more, though, is while Congressman Price has said that he was unaware of the stock purchase because it was bought by a broker, his financial disclosure forms show that he initialed the purchase to note an error. He initialed the purchase. So to say he had no knowledge of it is a stretch.

Congressman Price then added nearly two dozen cosponsors to the bill over the next 3\1/2\ months. I am sorry, if a Senator here did that-- knowingly buying stock, then introducing a bill--I know this body would look askance on that. More than that, I don't think you need to explain much of this because it is so obvious that American folks at home are knowing that you should not introduce legislation to self-deal to yourself.

Let me give another example. Price also bought stock in an obscure Australian biopharmaceutical firm called Innate Immunotherapeutics through a private offering that was not made available to the public. The private stock offering gave Congressman Price access to hundreds of thousands of discounted stock.

At his Senate confirmation hearing, he asserted the stocks were ``available to every single individual that was an investor at the time,'' but this is how the Wall Street Journal reported it--not quite a liberal periodical. It said:

In fact, the cabinet nominee was one of fewer than 20 U.S.

investors who were invited last year to buy discounted shares

of the company--an opportunity that, for Mr. Price, arose

from an invitation from a company director and a fellow

Congressman.

The shares were discounted at 12 percent off the traded

price in mid-June only for investors who participated in a

private placement arranged to raise money to complete a

clinical trial. The company's shares have since tripled

during the offering.

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

It is a disturbing pattern when Congresspeople use their position of power for personal gain with no regard for public interest. This type of behavior would be unacceptable in most industries. It should be unacceptable to Congress, to Senators on both sides of the aisle who have to advise and consent.

Look, we are at a point in our country where we have taken steps forward on health care. It has been controversial, I understand, but there is no arguing with the fact that we are now at a point in America where someone with a preexisting condition is not stopped from having health insurance, where young people all over our country have the security of knowing they can stay on their parents' health insurance until they hit 27. We are at a point now where being a woman is not a preexisting condition, where we have expanded access to contraception. We are at a point in our country where the uninsured population has gone down dramatically.

We cannot have someone whose attitude is not what I would hope it would be, one of ``Hey, we accomplished a lot. Let's figure out a way to make it better. Let's build on it.'' Instead, they not only want to take back the gains I just mentioned, but they want to go further and take back Medicaid and Medicare, privatize them, gut them, block-grant them.

So this is not a close call. This is a Congressperson who for years has told America what his intentions are. He just didn't have the power to do it then because he was 1 out of 435. Frankly, if you include the Senate, he was 1 out of 535 and had a Democratic President also to get through. He couldn't get done what he wanted to get done. Now he is going to go from being one voice on the fringe, yelling for getting rid of Medicaid and Medicare, yelling against women's access to contraception, yelling to put insurance companies back in charge of your life, your destiny, and your health care--he is going to go from a fringe voice, 1 out of 435, to now being the head of the Department of Health, advising the President on things, frankly, that he has said, at least, that he doesn't want to do: gutting Medicare, gutting health care for seniors.

So I go back to where we came from--a Republican President, Dwight D. Eisenhower, and the first head of the Health Department, an incredible woman, World War II--served soldiers in World War II. And they had a vision for this country, that, hey, what we have is not good enough. Let's figure out a way to do better because a healthy society is an economically strong society. A healthy society is a prosperous society. A healthy society lives up to our common values.

We are the United States of America. We should set the national standard for health care. When it comes to the most vulnerable amongst us, whether it is a poor kid on a farm, whether it is someone in an inner city, whether it is an immigrant, we are a country that believes--like the old African proverb: If you want to go fast, go alone, but if you want to go far, go together.

One of the great singers and artists and inspirations in my State is a guy named Bruce Springsteen. He has a song where he says: We take care of our own. Well, we have done well on that idea. We have gotten better. We have made strides toward that standard.

We have work to do. We should be working together, both sides of the aisle, to make our health care better, more inclusive, more accessible, and more affordable. We have a lot more work to do. But I don't want to go back. So help me, I will fight every day to prevent us from going backward where there will be fewer people covered, more people, because they can't afford things, suffering untold health crises.

I don't want to go backward to where women are denied coverage or access to empowering things, basic things, fundamental things like contraception.

I don't want to go backward with senior citizens who are in the sunsetting years of their lives, when they should be free of stress and worry and strain but suddenly are worried again and struggling and suffering. I don't want to go back to those days; therefore I will vote a resounding, full-throated no on Congressman Price because, as the poet Maya Angelou said, if someone tells you who they are, believe them. He is someone who has told us what he wants to do. We should stop him from doing it.

I yield the floor.

Mr. President, I have come to the floor to speak on the nomination of Congressman Price to be the Secretary of Health and Human Services. But before I do, I must speak to the decision that the U.S. Court of Appeals for the Ninth Circuit just decided in the case of the State of Washington and the State of Minnesota v. the President and the Department of Homeland Security.

I am pleased to see that the courts of the United States are still part of the separate coequal branch of government that the Founders dictated when they ultimately created an ingenious document, the Constitution of the United States, which served the Nation well for so long, even though it seems the President may need a review of history and an understanding of the Constitution as it relates to the separate coequal branches of government, because he seems to be willing to try to disparage the judiciary in an effort to try to either effect their decisionmaking or to call into question the legality of their decisions or the righteousness of their decisions.

I am glad to see that that has not affected our judicial system. I just want to read some elements of the court's decision, which I think are pretty extraordinary. Of course, this is far from a final decision on the merits, but it was on a motion for a stay of the order of the district court that said, basically, that the Muslim ban could not be continued to be enforced.

The court said--and I am quoting--in a unanimous opinion which speaks very powerfully to their decision:

We therefore conclude that the States--

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

that the States have alleged harms to their proprietary

interests traceable to the Executive Order. The necessary

connection can be drawn in at most two very logical steps:

(1) the Executive Order prevents nationals of seven countries

from entering Washington and Minnesota; (2) as a result, some

of these people will not enter state universities, some of

them will not join those universities as faculty, some will

be prevented from performing research, and some will not be

permitted to return if they leave.

We therefore hold that the States have standing.

That was one of the critical legal bars.

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

Instead, the Government has taken the position--

This is on behalf of the executive branch--

that the President's decisions about immigration policy,

particularly when motivated by national security concerns,

are unreviewable--

Unreviewable--

even if those actions potentially contravene constitutional

rights and protections. The Government indeed asserts that it

violates separation of powers for the judiciary to entertain

a constitutional challenge to executive actions such as this

one.

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

There is no precedent to support this claimed

unreviewability, which runs contrary to the fundamental

structure of our constitutional democracy. Within our system,

it is the role of the judiciary to interpret the law, a duty

that will sometimes require the ``[r]esolution of litigation

challenging the constitutional authority of one of the three

branches.'' We are called upon to perform that duty in this

case.

Further they say: ``Although our jurisprudence has long counseled deference to the political branches on matters of immigration and national security, neither the Supreme Court nor our court has ever held that courts lack the authority to review executive action in those arenas for compliance with the Constitution.''

That is an extraordinary set of statements that the government made, saying that the President's actions are unreviewable in this regard.

They further go on to say: ``Nonetheless, `courts are not powerless to review the political branches' actions' with respect to matters of national security.''

It would indeed be ironic if, in the name of national defense, we would sanction the subversion of one of those liberties which make the defense of the Nation worthwhile.

Well, I fully agreed with the circuit court's determination in that regard.

It goes on to say: ``In short, although courts owe considerable deference to the President's policy determinations with respect to immigration and national security, it is beyond question that the Federal judiciary retains the authority to adjudicate constitutional challenges to executive action.''

Well, all I can say is, thank God. Thank God that the courts of the United States feel that they are not controlled by the executive branch in pursuing the decisions that are made. This is a great day for democracy in our country and for the preservation of the separation of powers. This is a great day, I think, from my own perspective, that a ban that does not help the United States but harms us and is against every fiber of our being and the nature of the history of our Nation, which was founded by those fleeing religious persecution--ultimately, today, we restore that sense of our history, and we restore who we are as a nation both at home and across the world.

But today's decisions in this regard are also important as we consider the nomination of Congressman Price, so I want to rise today, along with so many of my colleagues, to voice my strong opposition to the confirmation of Congressman Price to be the Secretary of Health and Human Services.

I am deeply concerned about his views on what is the core mission of Health and Human Services, not only his career-long opposition to the very existence of Medicaid and Medicare but his wavering fidelity in science and his regressive views of women's health care and the social safety net.

The Secretary of Health and Human Services is one of the few Cabinet positions that affect virtually every single man, woman, and child in America. It affects the health care of 56 million seniors on Medicare, of 74 million low-income individuals and children on Medicaid, and of 12 million Americans who have enrolled in the Affordable Care Act coverage. But more than that, the Department of Health and Human Services is home to the world's leading institutions of research at the National Institutes of Health, of advancing public health and epidemiology at the Centers for Disease Control and Prevention, known worldwide, of working to ensure that we have access to the most advanced, most effective, and safest medications at the Food and Drug Administration, and many other critical departments and agencies that we as Americans rely on.

Many of our Republican colleagues have pointed out that Congressman Price's history as an orthopedic surgeon is enough evidence that he is someone who should be in charge of the Department of Health and Human Services. I can't speak to his credentials and qualifications in the operating room, but I do have a constitutional obligation to speak about his credentials and qualifications to be the Secretary of Health and Human Services. So I can say without hesitation that his career in Congress and his positions on key issues of policy have proven to me that he is not the right person for the job.

Throughout his time as a congressman--most recently as the chairman of the House Budget Committee and during his confirmation process through the Senate Finance Committee, on which I am privileged to serve--it has become abundantly clear that Congressman Price views patients, including seniors on Medicare and even those with private employer coverage, as nothing more than a source of revenue or a budget line item. The characteristics that had defined Congressman Price's career run contrary--contrary--to the fundamental mission of the Department of Health and Human Services, and it should be a cause for concern across the aisle and across the country.

Despite the alternative reality portrayed during his confirmation hearings in both the Finance Committee and the Health, Education, Labor, and Pensions Committee, Congressman Price's vision for our Nation's health

care system has been laid bare for the public to see for years. All one has to do is look at the legislation he has introduced and the radical budget proposals he, along with Speaker Ryan, has been pushing through the House of Representatives. Let's look at some of them.

Let's start by taking a look at his plan for Medicare, which is, by all intents and purposes, a plan to fundamentally end Medicare as we know it, end Medicare as we know it. Despite Congressman Price's seeming denial of this fact, when I asked him about it directly during his confirmation hearing, there is absolutely no other way to characterize his plan: It ends Medicare as we know it.

Currently and for more than 50 years, Medicare has provided a guarantee--a guarantee; that word is critical--to seniors that they will have coverage, access to care, and the ability to rest assured that their health care needs will be taken care of. It is a system into which they paid their entire working lives and a compact that has been made with the Federal Government that we will uphold our end of the deal and ensure that they have quality coverage to stay healthy.

The Affordable Care Act, despite the years-long gnashing of teeth and fake tears shed by some of my Republican colleagues, has improved upon this deal and made Medicare stronger. It has extended the life of the Medicare trust fund by more than a decade. It has saved seniors $27 billion on prescription drugs and last year alone provided more than 40 million seniors access to no-cost preventive services--no-cost preventive services. In my home State of New Jersey last year, seniors on Medicare saved more than $263 million on prescription drugs, and nearly 1 million seniors were able to receive free preventive services.

Additionally, thanks to the law's health care delivery system reforms, we are seeing far fewer hospital-acquired conditions and greater coordination of care that has resulted in a healthier population and a more efficient health care delivery system. That reality stands in stark contrast to Tom Price's vision of what he thinks Medicare should be and in stark contrast with the vast majority of seniors who want to protect the program for their loved ones and for themselves.

Unfortunately, President Trump, who himself spent an entire campaign promising that he is ``not going to cut Medicare or Medicaid,'' nominated a leading member of this radical anti-Medicare movement to impose devastating cuts to the program, force seniors to pay higher costs, and lower the quality of care throughout the health care system.

Congressman Price's destructive legislative history on Medicare does not lie. It is there. It is in the record. It is there for anybody who wants to see it. It tells a stark truth about his desire to increase the eligibility age, about ending the guarantee--the guarantee of coverage.

You know, that is why we call it an entitlement. If you meet the criteria under the law, you are entitled to those health care services; you are guaranteed those health care services. But his whole legislative history is about ending the guarantee of coverage we currently have and replacing it with the possibility of coverage. The difference between a guarantee and a possibility is a far, far too significant gulf to be able to overcome--but only if you can afford the difference between Congressman Price's coupon and the actual cost of care under his vision. The Congressional Budget Office has shown that this will unquestionably increase costs for seniors.

His dark view of Medicare, that--to quote Congressman Price-- ``nothing has a greater negative impact on . . . health care than the Federal Government's intrusion . . . through Medicare''--that is an extraordinary statement. I am going to quote it again. ``Nothing has a greater negative impact on . . . health care than the Federal Government's intrusion''--intrusion, mind you--``through Medicare.'' That is understandably causing a lot of concern back home in New Jersey. Many people have been calling and writing me to express their thoughts.

Dr. William Thar of Summit, NJ, himself a retired physician of more than 50 years, wrote in that Price's ``willingness to privatize Medicare indicates a lack of concern for Americans who need health care coverage.''

I also heard from Cara Davis of Glen Ridge, NJ, who wrote in on behalf of her uncle, who has end-stage renal disease and requires dialysis, saying, ``If [Price] and the Trump administration successfully move Medicare to a voucher program''--again, that is different from a guarantee--``I fear that my uncle will not be able to afford the necessary coverage for his dialysis treatments.''

For me, the battle to protect Medicare is more than a political battle; it is more than a theoretical battle; it is a deeply personal battle to protect a program that allows seniors to live with dignity during the twilight of their lives.

My personal connection to the value of the Medicare Program stems not from my experience but that of my late mother, Evangelina. For 18 long, difficult years, my mother suffered from Alzheimer's disease. During those years, we watched as this strong, courageous woman drifted further and further away from us. After her diagnosis, I, like so many families across our Nation, hoped for the best, but we expected the worst. And while there were times early on when she seemed just fine, those times turned into lost moments, and those lost moments eventually lasted forever.

At this point, I had to wonder if all the moments of her life--her struggle to flee her homeland and seek freedom in the United States, of my youth and all of the time spent together--were still in there, still with her somehow, or whether those memories were lost forever.

As her illness progressed, she lost her cognitive abilities, and eventually we had to admit to ourselves that our mother was no longer with us, until, mercifully, the Good Lord took her, and the long goodbye came to an end.

Throughout this experience, throughout her struggle of fighting back against the progress of Alzheimer's, our family knew that Medicare would be there to provide her with access to the health care she needed. I learned that Medicare wasn't just there for her; it was there for the rest of us, too, providing her with access to care, while granting us the ability to focus on making the most of the limited time we had together.

Medicare was there to meet the challenges of her illness as well as the intergenerational challenges that arise when caring for a parent in the twilight of their lives while simultaneously working to put your own children through college. I lived it, I saw it, and I understand it. My mother would not have lived with the dignity that she deserved in the twilight of her life after working a lifetime and paying for Medicare, but for Medicare as a guarantee.

I know all too well that an underfunded voucher would undermine Medicare's ability to live up to the responsibility that we have to care for one another and to provide that same dignity to seniors as they and their families prepare to say good-bye for the last time.

That is why I couldn't agree with Dr. Thar or Ms. Davis more, and I share their concerns about what Congressman Price has in mind, despite the repeated pledges from President Trump to the contrary for the future of Medicare.

My concerns about Congressman Price don't stop with his desires to end Medicare, because those desires also extend to end Medicaid, as we know it, as well. His desires to end Medicaid are really a two-front war. The first is to repeal the highly successful expansion of Medicaid provided for under the Affordable Care Act, which has extended lifesaving care and coverage to over 200,000 New Jerseyans, many of whom are covered for the first time.

Nationwide, the Affordable Care Act's Medicaid expansion is one of the most successful aspects of health reform. Currently, 32 States and the District of Columbia have taken advantage of Medicaid expansion, making coverage available to 11 million people, because they recognize the value in providing people with coverage, with access to preventive care, with the ability to manage chronic conditions--all of which lead to a healthier, more productive population.

The second is to eviscerate funding from Medicaid by taking away the current funding structure and replacing it

with a block grant or some other form of arbitrary underfunding that they mask as allowing for ``state flexibility.''

We have seen this picture before. Take away an obligation, an entitlement, move it to a block grant, underfund it, and ultimately slay that opportunity for people to have a guarantee.

We all know what is meant when Congressman Price talks about State flexibility. He means the flexibility to slash enrollment and deny people access to coverage. He means forcing States to choose between cutting payments to doctors for treating low-income Medicaid patients or cutting other vital State services like education and infrastructure. He means unraveling Medicaid benefits so that for those few still able to enroll, they won't have adequate coverage for most of the health care issues they need treated. It means simply putting his radical ideological opposition of the Federal Government being involved in health care ahead of the lives of millions of men, women, children, and seniors and the disabled across the Nation. That is truly remarkable for a man who took the oath to ``first do no harm.''

As with his views on Medicare, his desire to end Medicaid expansion has caused a lot of people from New Jersey to write me about their concerns. I would ask Congressman Price and other like-minded Republicans to consider carefully the stress and potentially devastating impacts these policies have on real people--real people like Jolie Bonnette from Brick, NJ, who wrote to me about how she was able to finally gain access to health coverage, thanks to Medicaid expansion. She wrote: ``Without this care and my Medicaid medication coverage, I would have died, because I would have no access to doctors or medications.''

Jill Stasium from Jersey City wrote in saying that thanks to Medicaid, ``[I] have been receiving top quality health care for the first time in my life.''

I ask my colleagues how the mantra of State flexibility, which is just another way of ensuring funding for Medicaid is slashed and access to life-enhancing treatment is denied, is going to impact Ms. Bonnette and Ms. Stasium. I ask how they can justify taking away their coverage--coverage that has provided, for the first time in their lives, not only the peace of mind of having health insurance, but also it is the first time they have had regular access to the doctors and medication necessary to live.

How do we justify that? We can't do it on the basis of State flexibility and surely not on the basis of a 6-year-long political vendetta against the Affordable Care Act. Yet somehow, with this nominee and this Republican Congress, this is something that we are all going to have to justify to every single one of our constituents.

Unfortunately, the list of destructive policies supported by Tom Price doesn't end with his desires to end Medicare as we know it and to dismantle Medicaid. This is also not surprising given the Republican agenda for the last 7 years to repeal the Affordable Care Act, throw millions of Americans off their health insurance, and return us to the dark ages where insurance companies have free rein to deny coverage for preexisting conditions, cancel coverage after a devastating diagnosis, limit what benefits are covered, and discriminate against women. That is what the marketplace was before the Affordable Care Act.

Now, this is not new. The Republicans have been trying to repeal health care reform and deny millions of Americans health care coverage since before the law was even passed. It has sadly become dogma for Republicans--dogma to repeal ObamaCare, which they voted to do 60-some odd times. But now, after 7 long years, the chickens have come home to roost.

They now have the ability to live up to their dream of repealing the law, but are starting to realize what the implications are--starting to realize that real people will face real life-and-death situations that result from Republicans putting partisan ideology ahead of the well- being of their constituents, starting to realize that on-the-ground implications of the Affordable Care Act mean real people receiving real treatment for real health conditions.

One of these people is David Konopacki from South River, NJ. David is a diabetic who, thanks to the Affordable Care Act, no longer has to choose between paying for college and paying for the medication he needs. David put it so succinctly: ``The Affordable Care Act is literally the difference between life and death for so many.''

The same holds true for Mrs. Lori Wilson from Morristown, NJ. Her son, like David, has diabetes and has had diabetes since birth. As she writes, her son ``is just one citizen among millions whose life, literally, depends on access'' to care, and under the Price Republican plan, that access is denied.

I mentioned that repealing the Affordable Care Act means reinstating the ability of insurance companies to deny coverage for preexisting conditions. As diabetics, these folks would find it impossible-- certainly, financially impossible--to find coverage that would allow them to get their medications and see their physicians. That is what is shocking about Tom Price. Despite knowing full well that the ban on preexisting conditions is one of the most widely supported and critically important aspects of the Affordable Care Act, he considers it to be a ``terrible idea.''

Let me say that again. Tom Price's views on health care are so radical that he thinks insuring people with preexisting health conditions--like diabetes from birth--and guaranteed access to coverage is a ``terrible idea.'' That is an extremely callous way to put ideology above people's lives.

Let me close on this. I have spoken about the many reasons I am opposed to Congressman Price's nomination to run the Department of Health and Human Services, including his long-held opposition to Medicare. But above all else, one of the reasons I am opposing Congressman Price is because of the seeming lack of fidelity to the one thing that runs at the heart of health care and the heart of the Health and Human Services Department, which is science.

For years Congressman Price has been a member of a group called the Association of American Physicians and Surgeons. This is a group of so- called doctors who push dangerous conspiracy theories and widely debunked claims that have serious implications for the public health. The prime example of this is their assertion, despite all evidence to the contrary, that vaccines aren't safe and that they cause autism. Nothing could be further from the truth. In fact, this week I received a letter signed by 350 organizations, including several from New Jersey and several representing the autism community, restating the fact that ``vaccines are the safest and most cost-effective way of preventing disease, disability, and death'' but unfortunately, because of widespread misinformation, the United States ``still witnesses outbreaks of vaccine-preventable diseases,'' including the biggest outbreak of whooping cough since 1955, and the fact that we have upwards of 50,000 deaths a year from complications of vaccine- preventable influenza.

While Tom Price, personally and as a physician, might understand these basic facts, what worries me most is that the President of the United States does not, posting on Twitter for years that vaccines are dangerous and appointing anti-vaccine conspiracy theorists to critical posts in the White House and possibly to key positions within the Department of Health and Human Services.

When I asked Congressman Price directly about his fidelity to science and his willingness to stand up to the President about adhering to science as the guiding principle at the Department of Health and Human Services, his answers were far less than satisfactory, and he left me with the impression that he is unwilling to counter the President when he touts untrue claims about health care and ensure that personnel within HHS are stewards of sound science and not ideology.

For the Department that oversees the Centers for Disease Control, which is the global beacon of health care that must be focused on science, that is simply incredible.

I rise today to give my voice in opposition to Nominee Tom Price as the next Secretary of Health and Human Services, and I rise to be the voice of Dr. William Thar, Cara Davis, Jolie Bonnette, Jill Stasium, David Konopacki, Lori Wilson and the over 6,000 New Jerseyans who have called

and emailed me to vote in opposition to Tom Price's nomination. I will do that when it comes time for a vote.

With that, I yield the floor.