Effective Prosecution of Possession of Biological Toxins and Agents Act of 2018

Mr. President, I have a motion to commit at the desk.

Mr. President, first, I thank my friend from Indiana, Senator Donnelly, for his remarks this afternoon and also for his efforts to help to protect and preserve Medicaid so that hundreds of thousands of people in our States and across the country can continue to live in the community.

I want to point out that today is the 27th anniversary of the signing of the Americans with Disabilities Act. This legislation, known as the Americans with Disabilities Act, is 27 years old. It is a piece of legislation that both recognizes and guarantees the rights of people with disabilities. It is, at its heart, a civil rights bill, one that promotes and promises liberty and freedom for people with disabilities--the liberty and freedom that all Americans are promised, that our founding documents guarantee, and that we in the Senate are charged with protecting for all citizens.

We should be celebrating the liberty and freedom of people with disabilities, but instead of having a celebration of the Americans with Disabilities Act on this anniversary day, the Senate Republican bill-- which, I guess, is basically the House bill that we are on right now-- threatens that freedom and threatens that liberty that was accorded in the Americans with Disabilities Act with regard to those with disabilities.

Now, I have heard a lot of speeches on this floor by my Republican colleagues about freedom and liberty in the context of healthcare--lots of speeches about both of those words. I would argue that, if you consider this legislation and the Senate versions of it that came after the House bill, all of these Republican healthcare bills were really, simply, about decimating Medicaid, limiting community-based care, and cutting long-term services and support, which will rob people with disabilities of their rights that the Americans with Disabilities Act advanced.

I think everyone here knows the disabilities story. I will just do a quick summary.

For centuries, people with disabilities have been placed against their will in institutions like this one. This is a building in Pennsylvania. When it was open and operating, it was known as Pennhurst. There were lots of places like this across the country, not just in one or two States. These institutions were, in fact, over time, warehouses, in which people had few, if any, rights. They were told what time to wake up, what time to go to bed, and when to eat. They were told they could never leave. That was the basic set of rules they lived by when they lived in institutions like that. These were places where choice was unknown and where freedom, liberty, and self- determination were also unknown.

Over the past 50 years, we have made some improvements--slow improvements--with the voices of people with disabilities leading the way. Throughout those 50 years, individuals and families have fought for their freedom and have worked to create laws that protect their freedom.

For example, the 1973 Rehabilitation Act Amendments and the Americans with Disabilities Act affirmed and protected the rights of people with disabilities to have access to all of society. The 1999 Olmstead Supreme Court decision reaffirmed the right of people with disabilities to live where they want to live and to be free of the confines of an institution.

Let's take it from the institution down to the individual--to individuals like Jensen, who is pictured right here. People like Jensen, who were once forced to live in nursing homes, now live where they want to live and pursue their dreams. Yet we know that rights alone do not equal freedom and liberty for people with disabilities.

Medicaid provides the supports that are necessary to live in the community and to have that full measure of freedom and that full measure of choice. Medicaid protects the hard-won rights of people with disabilities to have real choices. Medicaid home-based and community- based supports mean that people with disabilities can live in their own apartments, hold jobs, and contribute to their communities. Medicaid makes it possible to use the talents, skills, and knowledge of people with disabilities. Medicaid makes their rights a reality.

Do not take my word for it. Just ask the people who were here today in the Gallery, the people who are outside this Chamber and are walking the halls of the Senate, walking throughout the buildings, marching, demonstrating, and greeting people on the streets, with some of them staying overnight at one place to make their voices heard. Ask the members of ADAPT. Ask the members of the National Council on Independent Living. Ask The Arc's 700 affiliates around the country. Ask the folks from Easterseals, the Association of University Centers on Disabilities, the Autistic Self Advocacy Network, and on and on and on--groups across the country that are telling us with one voice: Do not move forward with cuts to Medicaid as have been proposed in each of these bills.

These Americans will tell you that their rights are not real without community supports. This bill will drive people back into those institutions that I just showed you a picture of.

In the midst of voting on my amendment--which would basically say: Let's go back to the committee of jurisdiction--in this case, the Finance Committee--and spend some time to have some hearings, have some regular order, which some have called for here, and really consider this issue seriously--I know there will be talk that some will reject my amendment and will introduce and maybe have a vote on a sense of the Senate.

There is a time and a place for that kind of measure when the Senate speaks with one voice on a matter. This is not one of those times. This is a time when we have to do more than just have a sense of the Senate. We have to be serious about a particular matter of public policy--in this case, of making sure that we protect people with disabilities so that they have all of the rights and all of the promises fulfilled in the Americans with Disabilities Act and other legislation.

So we are hearing that there might be a sense of the Senate offered as a side-by-side to the amendment that I will offer. This is totally inadequate in terms of the serious issue that we are here to talk about--in this case, protecting people with disabilities. It is a totally inadequate response to that. The people with disabilities who are in the Gallery, who are in the reception area, or who are back at home in congressional districts and States--those folks in each and every community around the country--want to ensure that the promise that we made to them in the ADA and in other measures will be kept-- that we will keep our promise. If Medicaid community-based services are slashed, statements by the Senate will not help very much.

What will we likely have in front of us in the next couple of hours or between today and tomorrow?

I know it has been described in a lot of ways, if the Republicans want to get there. Here is the way I describe it. It is a congressional Republican scheme that they are working on to get to repeal--not repeal and replace. In this case, it would be repeal and decimate--decimating Medicaid, repealing the entire Patient Protection and Affordable Care Act.

Some here will argue that they can support this because this next version--this scheme--will not include Medicaid and will likely not even include tax cuts for the very wealthy. Cuts to Medicaid have been the core part of every House version of healthcare and every Senate bill that we have seen so far. They will get to those cuts one way or another, and they will also get to the tax cuts for the superrich.

The bill that we are debating, H.R. 1628, as you know, creates block grants in the context of Medicaid. Block-granting, in a sense, may be sending to the States a limited amount of money and saying: Good luck when you have to balance your budget and pay for Medicaid services. It will have per capita caps, which would, again, limit what States can do in terms of the dollars they have, or it would just continue to have cuts to Medicaid, as every bill has had, the likes of which we have never seen--sometimes over $800 billion, sometimes over $700 billion, but it is in that neighborhood of hundreds and hundreds of billions of dollars of cuts to Medicaid. This next version of the Senate bill will do the same.

When you consider the cuts to Medicaid juxtaposed with the tax breaks given to the superrich--really giveaways--there is no other word that I can come up with other than ``obscene.'' There are probably other words, but that is, I think, a good description of what that is. That is one of the reasons that these measures have been so unpopular across the board with every income group. Those folks who would get those big giveaways--I think most of them would not want them if they knew the price of that tax giveaway to someone with a lot of money would be to decimate Medicaid.

So passing this version of the bill--passing a scaled-down scheme-- means that Republicans have not abandoned their Medicaid cuts. They are going to get to that as soon as they can. This is simply what we are going to see over the next couple of hours--a back door to cutting and capping Medicaid--and anyone who believes otherwise is probably deceiving themselves.

What we need are serious policies crafted to ensure long-term supports and services that provide and guarantee community-based services that promote choice and freedom for people with disabilities. This bill doesn't promise freedom or liberty. It doesn't promise the choice to live in a community and to be part of a family, like this family, where one member of that family has a disability and gets to live in a house with other members of the family. That is not possible for many Americans without Medicaid.

For people with disabilities, this bill is anything but a bill that would enhance freedom or enhance choice. This bill would, in fact, be an anti-freedom bill when it comes to people with disabilities. It is not a key to liberty. It is really just a pathway to institutional care, where we were years ago and where we have come from, from whence we have made progress. It is a return to limited choices, a lack of rights, and a place where freedom is not possible.

In conclusion, let me thank the Members of the Senate who have supported

this motion: Senators Stabenow, Duckworth, Hassan, Van Hollen, Murray, Brown, Blumenthal, Carper, Durbin, Kaine, Baldwin, Wyden, Markey, Murphy, Harris, Cardin, Warren, Hirono, Reed, Nelson, Klobuchar, Warner, Shaheen, Coons, Bennet, King, Menendez, Whitehouse, Leahy, and Booker. I want to thank them for joining me in this effort.

Mr. President, I yield the floor.

I suggest the absence of a quorum.

Mr. President, I know the Chair said I may speak for a few minutes before the vote. I spoke earlier so I will not reiterate every argument.

Really, what we are doing with this particular amendment is sending this legislation to the Finance Committee so as to focus it as the motion itself says: When this bill would be recommitted to the Finance Committee, the Finance Committee could examine it from the perspective, in this case, of people with disabilities and to focus on changes that could be made in order to prevent harm to individuals with disabilities as defined in the Americans with Disabilities Act of 1990.

The reason we mention that particularly is that is the seminal piece of legislation to protect people with disabilities who would be harmed by this legislation because you cannot just have rights that are guaranteed without the support for those rights. Medicaid provides that support so folks, if they want to live at home or if they want to live in a community-based setting, can do that, but they can only do that with the help of Medicaid. It is a pretty simple amendment to make sure there is some adequate review of the impact on Americans with disabilities.

We have, in Pennsylvania, for example, over 720,000 people who have a disability and depend upon Medicaid. I want to make sure every one of those Pennsylvanians has all of the protections we say we are guaranteeing with disability legislation--with laws like the Americans with Disabilities Act and with the protections Medicaid provides.

This is critically important. At a time when we are talking about freedom and liberty in the context of healthcare, I would hope we would take steps to guarantee that freedom and liberty apply to those with disabilities so that as the Americans with Disabilities Act has enshrined in our law, they may be able to choose the kind of places they want to live and choose the settings within which they want to live their lives, to be able to have the freedom to choose that by way of the support they can get from Medicaid. I hope that is something that is reasonable enough so as to get support from both sides of the aisle.

I know my friend from Nevada is offering a sense of the Senate in the next vote. I just do not think that a sense of the Senate, in any way, is commensurate with the gravity of this problem. There is a time and a place for a sense of the Senate--when we are expressing a sentiment that is bipartisan--but we need more than sentimentality here. We need more than good wishes. We need to make sure we get this policy right as it relates to people with disabilities.

Mr. President, I yield the floor.

Madam President, I intend to offer the following motion to H.R. 1628, and I ask unanimous consent that it be printed in the Record. The motion is supported by Senators Stabenow, Duckworth, Hassan, Van Hollen, Murray, Brown, Blumenthal, Carper, Durbin, Kaine, Baldwin, Wyden, Markey, Murphy, Harris, Cardin, Warren, Hirono, Reed, and Nelson.

Mr. President, I am advised we are not in a quorum call. Is that correct?

Mr. President, yesterday we took a giant step toward delivering on our promise to the American people to provide relief from the failures of the Affordable Care Act, otherwise known as ObamaCare.

Over the last 7 years, we have discussed what our solution would look like, and everybody who has been willing to participate in that conversation--sadly, not our Democratic colleagues, who simply refuse to do so, but every Member of our conference--has engaged in discussions and has had input on how best to accomplish the goal of providing people affordable coverage, increased access, market stability, and better care.

We can talk about all of the details, but basically what this boils down to is how to provide people with access to quality, affordable health care. I know some of our friends across the aisle thought the Affordable Care Act was it, but it failed. It started with the promises that were made by President Obama when he sold this to the American people, saying: If you like your policy, you can keep your policy; if you like your doctor, you can keep your doctor. He said that premiums would go down $2,500 for a family of four, none of which have proved to be true--none of which have proved to be true.

Now we find that in many parts of the country, insurance companies are pulling out, limiting if not denying altogether people's access to coverage within the exchanges. We know what has happened to premiums. Since 2013, they have gone up 105 percent nationally--a 105-percent increase in premiums.

People find that their deductibles are so high that they effectively are self-insured. They have been denied the benefit of their own insurance. Nominally, they may have insurance, but the fact is, if you go to the hospital, you are going to be responsible personally for what is not covered by that deductible.

Even our colleagues across the aisle admit that ObamaCare has failed to provide stable access to insurance markets, but their solution has been to pay more money to insurance companies. I would call that an insurance company bailout without any reform, without any changes in the basic structure of ObamaCare, which has caused this failure.

What we have tried to do on this side of the aisle--and we have repeatedly invited our Democratic colleagues to join us because optimally this would be a bipartisan effort, but so far they have refused to participate whatsoever and really are focused solely on trying to blow up the current process.

What we have said we want to accomplish are four things. We want to stabilize the insurance markets. We want to bring premiums down so they are more affordable. We want to protect people with preexisting conditions. We want to put Medicaid--the safety net for low-income Americans--on a sustainable path.

Of course, as you might imagine with something as complex as healthcare, we have had a number of opinions on how best to achieve these goals. Even as approaches and ideas have differed, one thing has remained constant: the belief that the status quo is simply unacceptable. It is unacceptable.

Take, for example, one of my constituents in Texas, who wrote me recently to say that his monthly insurance premium under the Affordable Care Act had nearly tripled, to $690, and his deductible, to my earlier point, went from $1,500 to $6,000.

I don't know many people--unless they happen to be well-to-do--who can afford to absorb those sorts of increases in premiums and deductibles. Because his coverage went from a PPO, a preferred provider organization, to an HMO, a health maintenance organization, some of his doctors are no longer in the network, forcing him to switch healthcare providers entirely.

This story is certainly not unique. It is typical. This is the norm under the Affordable Care Act. I often hear from Texans who would rather drop their coverage and pay the costly fine rather than have to pay for insurance that will cost them more and more each month, which they can't afford.

Here is a telling statistic. More than 400,000 Texans who earn less than $25,000 a year have decided to pay the penalty rather than to be forced to buy the insurance they can't afford, so many of them pay the penalty because of the individual mandate in the Affordable Care Act. They are left with nothing, other than having to pay the penalty as required by the law. That is not a solution. That is why I hope that someday we can get out of this rut and off of the talking points on each side and say: What can we do to try to provide people access to affordable health care? That is the key.

People are going to make their own decisions based on their own economic self-interest. If you are a young person, you might decide: What I would like to do is to buy a policy that will cover me in emergency circumstances if I have to go to the hospital, but I don't want to have to pay for all the bells and whistles that raise the price. You can't do that under the Affordable Care Act and take advantage of the tax subsidies that everybody else can. It is basically a false promise.

I also heard from another small business owner in Donna, TX, who was forced to fire four employees just to comply with the employer mandate or otherwise owe the government more than $100,000 in fines that he said could bankrupt his business. Those are the kinds of decisions that ObamaCare is forcing. Rather than hire enough people--or if you have more than 50--you decide you need to fire people in order to avoid these penalties that come from the employer mandate. That is not good for the economy. That is not good for the job prospects of hard-working Texans.

I shared the story of a constituent in Needville, TX, who, after a 50-percent increase in his monthly premiums, still lost his doctor because the doctor wouldn't accept his ObamaCare plan.

Then there is the emergency room employee in North Texas, who wrote me to say that she has seen a significant increase in the Medicare and Medicaid patients in the emergency room because fewer and fewer doctors would accept these patients.

In my State, only about one-third of doctors will accept a new Medicaid patient because it pays at such a low rate. We have a better idea that will make people up to 350 percent of the Federal poverty level eligible for a tax credit they can use to buy private insurance, which will increase their access to care and make it more affordable. We have coupled that with something called the innovation and stability fund, in which we have taken the authority out of Washington and sent it back to the States to let Governors and State legislators and regulators at the local level design policies that meet the needs of the people in the States.

The basic structural failure of ObamaCare was to assume that you could write a one-size-fits-all plan for 320 million-plus people that would work. It hasn't. We know that. That is not speculation; this is based on experience.

I know my colleagues across the aisle have heard similar stories from their constituents, as well, but apparently they don't seem to care very much about that. Otherwise, they would join with us in trying to improve the status quo, which they have refused so far to do.

One thing about the procedure that we are undertaking here is that any Senator who wants to offer an amendment to improve the bill or even offer a complete substitute to the bill is entitled to do so, and they will get a vote on that. Our colleagues on the Democratic side, despite hearing from their own constituents that they are hurting as a result of the status quo, appear not willing to lift a finger to help them.

Indeed, the only proposal I have heard from the other side--I have heard two. One is an insurance company bailout, which does nothing to effect reforms that would ultimately address the structural problems with ObamaCare or else they say: We want to have a single-payer system, which will bankrupt the country. Those are their solutions.

On Monday, I noted that in an effort to try to unite their deeply divided party after last year's elections, our Democratic colleagues unveiled an economic agenda aimed at, they say, lifting up lower and middle-class Americans. That is an admirable goal.

If Democrats are really serious about helping lower and middle-income Americans, one glaring and immediate action they could take is to join us in alleviating the burdens placed on these very same folks by ObamaCare--the types of people I have been talking about back in Texas, whom I know exist in their States as well.

If the Democratic leader refuses to help get rid of one of the biggest economic burdens on lower and middle-income Americans, then his plan is not worth the paper it is printed on. What they are offering is false hope. Unless you are willing to deal concretely with the problem here and now, that is just another campaign promise--one they will not be able to keep until they address what the failures of the Affordable Care Act have imposed on low- and middle-income Americans.

Simply stated, ObamaCare is a failed experiment. It has failed because Washington has tried to do too much at the expense of individual choices, individual liberties, and family control over what are deeply personal decisions.

With each day that passes, ObamaCare keeps getting worse. The premiums for 2018 will soon be announced by the insurance companies, and we are going to see double-digit increases again, over and above what ObamaCare has seen so far--105-percent increases since 2013 alone--on top of that.

After yesterday's vote, we now have the opportunity to provide relief from this failed law. I know Members have a lot of ideas about how to fix the mess that ObamaCare has left us, but that was precisely why it was so important for us to get on the bill yesterday, so Members on both sides of the aisle can offer amendments and share their ideas.

Do you know how many Democrats voted to get on the bill and begin the debate and offer amendments? Zero, zip, nada. Their protestations that they somehow want to do things on a bipartisan basis really have fallen flat, as demonstrated by their own failure to act.

If they were really interested in working with us to do something on a bipartisan basis, why wouldn't they take advantage of this opportunity to do so?

Last night we began the process of considering amendments, including one from my colleague in Texas, Senator Cruz, who has a plan to provide people who choose a lower cost premium insurance product the opportunity to do so, as long as the State also requires a comprehensive plan as well. This is something that is ideal for many people who want an insurance safety net but don't necessarily want their health insurance to pay for their regular medical expenses or doctor visits. They can handle those through a health savings account or some other way.

Later today we will continue to work toward bringing relief to millions of Americans suffering from the failure of ObamaCare. Yesterday was a big step toward ending ObamaCare and the first step toward ending the mandates, the

penalties on low- and middle-class Texans who are having to choose between buying unaffordable insurance or paying a penalty that their government is forcing them to pay. We are going to end that.

We are going to end the job-killing employer mandate, which is forcing employers either to lay people off or not hire additional people because they don't want to run into the additional costs required by the employer mandate.

Then there is the single mom, whom I met in Tyler, TX, a few years back. She said: I want to work full time. I want to work at least 40 hours a week, but the restaurant where I work figured out that if they put me on part time, 29 hours a week, then they wouldn't be required to meet the mandates of the Affordable Care Act.

What this single mother, who wanted to work full time, was forced to do because of ObamaCare was to work part time. Do you know what? She can't make it on 29 hours a week, so she has to get two jobs. Effectively, she had to go from 40 hours a week doing a job she enjoyed, which helped her pay the bills, to working two jobs in order to make ends meet.

We can and we should do better, and we invite our colleagues across the aisle to join us, if they will.

People keep talking about a secret process. Well, this is about as open and transparent as it gets. Everybody will have an opportunity to offer an amendment, to discuss what is in the amendment, and to vote on it. To the extent that the Senate's work product differs from what the House of Representatives provides us, we can go to a conference and work out those differences. That is how the legislative process is supposed to work. Sitting on your hands and complaining about something while offering no effort to try to help solve the problem simply boils down to hollow words. Unfortunately, that is all we have been hearing so far.

We hope our colleagues will change their minds and join us. Insurance bailouts with reform are not the answer, a single-payer system is not the answer because it will bankrupt the country, but we are more than happy to entertain any reasonable proposal from our colleagues across the aisle. We will guarantee they get a chance to debate it and to have a vote on their amendment. I don't think they could ask for anything more.

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

Mr. President, I ask for the yeas and nays.

The following Senator is necessarily absent: the Senator from Wisconsin (Mr. Johnson).

Mr. President, I ask unanimous consent that my speaking time be taken from leader time, not the debate time.

Mr. President, as the Senate continues the debate on the Republican healthcare bill, it seems the Republican majority is no clearer on what the endgame is because there is no good way out of this.

Last night, the Senate Republican TrumpCare bill--after months of backroom negotiating and provisions aimed at all kinds of individual States and Members--died, with nine Republicans voting against the measure and many others who voted for it gritting their teeth unhappily.

Later today, we will vote on a bill to repeal the Affordable Care Act without replacing it. I know that you, Mr. President, have championed that bill. Based on public comments and public criticism from the other side of the aisle, repeal without replace will fail as well. It is becoming clearer that in the end, the majority leader might push a much scaled-back version of repeal in the hopes of passing something--a so- called skinny repeal--just to get to conference. My colleagues, make no mistake about it, skinny repeal is equal to full repeal. It is a Trojan horse, designed to get the House and Senate into conference where a hard-right flank of the House Republicans, the Freedom Caucus, will demand full repeal or something very close to it. They will demand all the things--deep cuts to Medicaid, generous tax breaks for the wealthy, elimination of preexisting conditions, slashing the kinds of things people need for nursing homes and opioid treatment and disabled kids-- that many of my Republican colleagues in the Senate have very sincerely tried to undo.

There is no such thing as skinny repeal. It is a ruse to get to full repeal, with all the concomitant cuts to Medicaid and tax breaks which are so unpopular and which so many of my Republican colleagues here on the other side have opposed. It is clear House and Senate Republicans are miles apart. They are divided on major issues--on Medicaid, tax breaks, and preexisting conditions. The differences between House Republicans and Senate Republicans are virtually irreconcilable. So what is the point of a conference?

You can imagine a conference that turns into an endless game of hot potato; the Republican leader and the Senate passing the potato to the House; the Republican leader of the House passing the potato back to the Senate because neither wants to be responsible for what is inevitable: the demise of TrumpCare. Of course, it is likely a conference could probably produce no agreement at all, keeping the incredibly toxic and unpopular TrumpCare bill the topic of conversation for another 3 months, stalling the legislative agenda for another 3 months, and in the end getting nothing done.

My Republican colleagues should consider that. Many of them want to work with us on so many issues. Above all, NDAA, which my dear friend John McCain, who we pray for every day, wants to get to right away, and the Energy bill, which my colleague from Washington and her chair, the senior Member from Alaska, could bring to the floor and get moving in a bipartisan way. Leader McConnell has made it clear he wants to move nominations.

If we stop playing this game with TrumpCare and send it back to committee and do regular order, as John McCain preached so well yesterday, we could move on to all these other things in a good, strong bipartisan way and start to get things done. My Republican colleagues should consider that carefully.

We Democrats want to start working with our Republican colleagues on the issues I mentioned. We also want to work on improving ACA. No one has ever said ObamaCare was perfect. I have called five or six of my Republican colleagues on the other side and said if we stop this effort with TrumpCare--with repeal or repeal and replace with something far worse than the present--we can go back to committee and improve the present healthcare system and get premiums lower, make healthcare better, and stabilize the system so there is more competition. We will do that.

My good friend the Senator from Wyoming, not the Senator sitting here but his colleague--I heard he was saying to some Members: Oh, the Democrats will never negotiate. Schumer will never negotiate. I saw him last night on the floor, and I assured him we will. That is our goal. He accepted that in good faith, which I very much respect.

So the bottom line is simple. I say to my Republican colleagues, when you find yourself in a hole, the first rule is stop digging. By continuing this process--trying to send something, anything, to conference with the House--Republicans are just digging a deeper and deeper hole for themselves and for this body. I implore my Republican colleagues to stop digging and come work with Democrats. We can work to improve our Nation's healthcare system, but Republicans have to turn back soon, and they are running out of chances.

One more thing I would add. I heard my friend the Republican leader say we are going to have a full amendment process. He is trying to convince the folks on the other side that, oh, we will do a bunch of amendments, and then we will have no choice, we will have to send something to conference because we couldn't get anything major done. That is a lot of bunk. We have had no hearings, we had no amendments, we had no bipartisan discussions, and we will not even be able to have debate on many amendments on one of the most major bills affecting us, that affects tens of millions of people's health, and affects one-sixth of the economy. Don't fall for this, oh, we are having a full process. I like my friend the Republican leader. We get along well, but sometimes he says things that when I hear them, I get a little twinge in the stomach. We have a full and open amendment process, he said three or four times. Everyone in this Chamber knows that is not the case. Don't be deluded into thinking, well, we tried. We haven't tried until we go back to regular order.

Comments of the President on Attorney General Sessions

Mr. President, on another matter, President Trump continues to find new ways to humiliate his own Attorney General, Jeff Sessions, a man who stuck his neck out for the President before any other Senator would. I heard President Trump say: I was already popular. As I remember it, when Jeff Sessions supported him, he was an underdog, and everyone said: Wow, Jeff Sessions is doing that out of loyalty and friendship with Donald Trump, not because he was jumping on a train that was headed down the track. Maybe he saw that, but no one else did, and now the President humiliates him.

I would say to my fellow Americans--Democratic, Republican, liberal, conservative--every American should be troubled by the character of this person who humiliates and turns his back on a close friend after only 6 months. We are already far beyond the dangers of a chilling effect at the Department of Justice. The President is taking almost every opportunity in public to demonstrate an open hostility toward the Attorney General. It seems clear the President's intention is to make life unbearable for the Attorney General, hoping to prompt his resignation. All Americans should be wondering why the President is publicly demeaning and humiliating such a close friend and supporter--a member of his own Cabinet. They should wonder if the President is trying to pry open the office of Attorney General to appoint someone during the August recess who will fire Special Counsel Mueller and shut down the Republican investigation. Let me say, if such a situation arises, Democrats will use every tool in our toolbox to stymie such a recess appointment.

Second, I can't imagine my friends on the Republican side, particularly my friends in the Republican leadership, the majority leader and Speaker Ryan--I can't imagine they would be complicit in creating a constitutional crisis. They must work with us and not

open the door to a constitutional crisis during the August recess.

Sanctions Bill

Mr. President, one final point because I know my colleagues are waiting: sanctions--finally, a word on them. Yesterday, the House of Representatives passed nearly unanimously, 419 to 3, a sanctions bill that was a product of bicameral, bipartisan negotiations and includes strong sanctions against Russia, Iran, and North Korea. The Senate must act quickly on the legislation from the House.

I understand that earlier today the chairman of the Foreign Relations Committee indicated he plans to strip out a section of this package that relates to North Korea. This is yet another delay generated by Republicans to prevent this bill from landing on the President's desk before we leave for the recess. Even as we debate other items here on the floor, we shouldn't delay this legislation any longer.

I will work with the majority leader to schedule another vote on the sanctions bill so that we can send the legislation to the President's desk before the recess, and I expect the vote will constitute a veto- proof majority, just like the vote in the House.

Mr. President, I yield the floor.

Madam President, I rise this evening to announce the Democrats will offer no further amendments to the pending legislation until the Republican leader shows us what the final legislation will be.

Clearly, the Senate bill--repeal and replace--has failed. Senator Paul's bill--repeal without replace--has also failed. We know the Republicans are not going to take a final vote on the underlying House bill, which is still the pending legislation.

Now the Republican leadership team has been telling the press about a yet-to-be-disclosed final bill. If the reports are true, the Republicans will offer a skinny repeal plan.

We just heard from the nonpartisan Congressional Budget Office that under such a plan as reported in the press, 16 million Americans would lose their health insurance and millions more would pay a 20-percent-- 20-percent--increase in their premiums--at least 20 percent.

I thank Senator Murray and Senator Wyden for working with CBO so that we could figure out what exactly is going on, if this skinny bill is the bill that is brought to the floor.

My Republican friends come to the floor every day to assail the problem of high premiums. If the reporting is accurate and skinny repeal is their plan, it makes premiums far higher than they are today. We don't know if skinny repeal is going to be their final bill, but if it is, the CBO says that it would cause costs to go up and millions to lose insurance.

In the meantime, Democrats are not going to continue to try and amend the House plan that is already dead. Certainly, we are not going to do that while there is some secret legislation--skinny repeal it is reported--waiting to emerge from the leader's office.

The Republican leader has said that this is a robust amendment process. No, it isn't--far from it. We don't even know what bill to direct our amendments to. Certainly, a process that bypassed the committees and public hearings was never an open and transparent process. There was never a robust amendment process to this bill, but now it has gotten even worse. Since the beginning of this debate, we have just been taking votes on amendments to a piece of dead legislation.

What kind of process is this? Anyone who listened, as we all did, so intently to Senator McCain's wonderful speech yesterday and applauded the sentiment that he mentioned--getting back to regular order and proper procedure--anyone who listened to that speech would blush at this sham of an amendment process thus far. We don't even have a final bill to amend. The idea that this is a robust amendment process, I would say to my dear friend the leader, defies credulity. No one believes it. I bet not a single person on either side of the aisle believes it. So Democrats are not going to participate in this one- sided and broken process.

Once the majority leader shows his hand, reveals what his bill will actually be, Democrats will use the opportunity to try to amend the bill. But we have to see it first, and we ought to see it soon in broad daylight, not at the eleventh hour.

Until we see the real bill, Democrats will offer no further amendments.

Thank you, and I yield the floor.

Mr. President, I have listened very carefully to the majority leader and his requests that we come forward and bring amendments to the floor--all of our ideas about how we can improve our healthcare system so that this would be an opportunity through budget reconciliation for us to deal with those issues.

I asked my staff to prepare amendments in order to protect the Medicaid system from cuts. I asked my staff to prepare amendments to protect the essential health benefits that are in the Affordable Care Act because it is important that we preserve those benefits, whether it is mental health and addiction services or one that is particularly important to Maryland; that is, pediatric dental. In Maryland, we all recall the loss of a 12-year-old not too many years ago because he couldn't get dental care--Deamonte Driver.

I asked my staff to take a look at preparing amendments to protect minority health and health disparities because the Affordable Care Act made tremendous advancements in trying to close that gap on the disparities in minority health and health disparities. I asked my staff to take a look at the tax provisions because we want to make sure that we are not giving tax cuts to wealthy people at the expense of cutting the Medicaid system. I asked them to look at this in a lot of different ways.

Listening to the majority leader, I also have introduced legislation that I will talk about that could build on the Affordable Care Act, and I was wondering what bill I should amend? What is the bill that we are considering? It is not the bill that Senator McConnell brought forward because that bill was defeated. It is not the repeal--and we are starting with a blank slate--because that was defeated. I don't believe it is the House bill because that has been discredited, called a mean bill by the President, as well as by Members of this body, who said it has no chance of passing. So my dilemma is that I don't know what I should be amending.

I expect we will get to see another bill somewhere along the process with virtually no notice and no opportunity to read and no opportunity to amend, but the majority leader says I am going to have that opportunity. Yet we don't know what the bill is that I am supposed to be addressing my amendments to.

We know that all the bills we have seen today--every single one from the Republicans--have been scored by the Congressional Budget Office as to tens of millions of Americans losing their insurance coverage--tens of millions. I understand it is about 33 million if we just repeal the Affordable Care Act, 22 million if we use the type of replacement that the majority leader was suggesting. All of those move in the wrong direction.

We also know that in every one of these proposals to date, insurance premiums are going to go up, not down.

That is one thing I have heard from my constituents. They would like to see us bring down the growth rate of health insurance costs and healthcare, not increase it. So, yes, I would like to be able to offer amendments, but I don't know what to offer amendments to.

I also am concerned when I see that every one of the bills that have been suggested by the Republicans would reverse the protections that we put in law against the wrong practices--the discriminatory practices-- of insurance companies. I have talked to many of my constituents who tell me that if we reimpose caps, either yearly or lifetime--they have the circumstance where their child was born with a disability and that cap would have been expended within a matter of months--they would be left without insurance coverage. They tell me about how preexisting conditions could be jeopardized. All of us have some form of preexisting condition, and, on a lot of these plans that are being suggested where you could choose the type of coverage you want, insurance companies are not going to offer the benefits you need. People who have challenges are going to be most discriminated against. So I don't quite understand how I can offer amendments and we could have a vote on the floor when we don't know what we are trying to amend.

I must state that there is a common theme here, and we know it. We know that there is now talk that the majority leader might bring up, sometime during this process, what has been called in the press a ``skinny'' bill. I call it a slow death of the Affordable Care Act, and, in fact, I am afraid it might be a fast death of the Affordable Care Act because, if the reports are accurate, one of the provisions that the majority leader is looking to bring in as the final bill that we would vote on would eliminate the requirement that companies have to provide insurance coverage to their employees and individuals must have coverage.

Now that seems innocent enough, except for the tens of millions who are going to lose their insurance coverage--people who are working for companies that decide to terminate their policies, healthy people who decide not to buy insurance policies. I believe you are going to find that there still will be tens of millions of people losing their insurance coverage, and that is unacceptable. But it goes beyond that. That proposal will also increase premium costs by a very large percent. Why?

Think about this for a moment. If you don't have to buy insurance and you are young and healthy, are you going to buy insurance or not? Many will say no until they need the insurance, and then they will buy the insurance. Actuaries tell us that without the requirement to have insurance, the insurance pools will contain a very high percentage of adverse risks--people at higher risk--and when that happens, the purpose of insurance to spread the risk is no longer done. It means premiums will go up dramatically. That doesn't help the people who are going to need it.

What you also find when you eliminate this requirement is that people get what we call job locked. They may have a company that provides health benefits, but now they may have to leave that company. But if they want to leave that company and start a job or go to another job that doesn't have insurance, they are locked into where they work. All of that adds to anxiety, adds to lack of coverage, adds to people who don't have health insurance, adds to people not getting adequate healthcare, adds to bankruptcies, adds to the problems that we addressed with the Affordable Care Act.

But there is another explanation here. Maybe this is just a shell bill that is going to go back--hopefully, as the Republicans believe, but I hope it does not happen--to the House, and then we will put in the Medicaid cuts and the tax relief and all the other things that are not in the bill. This is just a shell to get us back to one of the bills that couldn't get the votes here on the floor, where tens of millions of people will lose their insurance coverage, premiums will go up, and insurance company arbitrary and discriminatory practices will return.

Every one of these proposals--every single one--moves us in the wrong direction in healthcare. We recognize that we can improve our healthcare system. I am for improving our healthcare system. I think we can work together--Democrats and Republicans--to improve our healthcare system.

So here is my request: Vote for the Casey motion. Why? For two reasons. One, I would hope that on this anniversary of the ADA, or the Americans with Disabilities Act, we would want to do no harm to those with disabilities in our healthcare system and they would have adequate coverage. I was in a celebration over the weekend in Baltimore City with the disabilities community. We celebrated one of the great victories in America, the Americans with Disabilities Act--a bipartisan bill, with Democrats and Republicans coming together in a proud moment, in the best traditions of the Senate, to say that people with disabilities will be treated fairly in America. On this day we should adopt the Casey motion on the issue of protecting people with disabilities.

But there is a second issue here.

Mr. President, I ask unanimous consent to speak for 2 additional minutes.

I will try to conclude my remarks. On this day that we are celebrating the anniversary of the Americans with Disabilities Act, let's do right by that. There is a second part to the Casey motion that sends it back to committee so we can use the regular process, as Senator McCain talked about yesterday. Let's have the committee hearings, as Senator Alexander talked about. Let's have the committee markups and work together. I introduced legislation that would bring down the cost of healthcare and lower the rate of increase of individual premiums. I do that by suggesting more competition in the individual marketplace, by having a public option, by providing stronger subsidies to lower income families, by making sure that cost- sharing is in fact paid for so we don't have that uncertainty, with the reinsurance that Senator Carper was talking about to deal with the overall cost of healthcare, by dealing with prescription drug costs, and by dealing with coordinated care so that we can deal with the whole patient rather than their individual disease.

All of those issues would improve the Affordable Care Act, but before we get there, we have to get off of this train. We have to stop this disastrous course. I am going to do everything in my power to make sure that, as to the bill we have, whenever it comes forward, we stop it right here, and then work together, Democrats and Republicans, to improve our healthcare system, not to take away insurance coverage and increase costs for so many Americans.

With that, I yield the floor.

Madam President, I intend to offer a motion to commit the reconciliation bill to the Finance Committee with instructions to report the bill back to the Senate within 3 days, not counting any day on which the Senate is not in session, with changes eliminating provisions that would weaken access to essential health benefits, reduce access to affordable preventive services, and undermine the prohibition of annual and lifetime limits and caps on out-of-pocket expenditures for health insurance plans.

I am offering this motion because the reconciliation bill affects tens of millions of Americans who gained health coverage under the Patient Protection and Affordable Care Act, ACA. The reconciliation bill allows insurers to eliminate coverage of essential health benefits. Insurance companies could exclude essential benefits like maternity care, substance use disorder treatment, mental healthcare, prescription drugs, and hospitalization--the very services people buy insurance to obtain. Before the ACA, one-third of individual market health plans did not cover substance use disorder services, nearly one- fifth of those plans did not cover mental health, and only nine States required all insurers on the individual market to cover maternity care.

Allowing States to waive essential health benefits would also allow insurance companies to reinstate annual and lifetime caps. This means that a premature baby could exceed its lifetime limit within its first few months of life or that a cancer patient could hit an annual cap just a couple of months into treatment.

Before the ACA, too many people and families were hurt physically and financially because they could not afford access to healthcare. They didn't get the tests they needed. Perhaps they did not catch a preventable disease early enough--so the treatment costs skyrocketed. We saw too many families go through bankruptcy because they could not afford the healthcare that they needed. We saw too many people literally cutting their prescription pills in half, hoping to stretch out their medicine because they could not afford more, even though they knew they were compromising their health. We cannot go back to this cruel, dreadful situation.

The following Senators support my motion to commit: Senators Carper, Brown, Blumenthal, Warren, Nelson, Van Hollen, Duckworth, and Stabenow. I ask unanimous consent that the full text of my motion to commit be printed in the Record.

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

Mr. President, let me just tell my colleagues where I am coming from.

Under the current system--ObamaCare as we know it--the money to help people buy insurance and the money for Medicaid expansion, those two pools of money--here is what happens under ObamaCare: California is 21.39 percent of all the money, and they are 12.15 percent of the population. Maryland gets 2.35 percent of the money, and they are 1.86 percent of the population. Massachusetts gets 6.67 percent of all the money, and they are 2.11 percent. New York gets 8.62 percent, and they are 6.11 percent. That is a lot of math for a guy who didn't do well in math. So 39 percent of all the money goes to four States that represent 22 percent of the population. I like these people. They are all good Americans. I just don't like them that much. The bottom line is, the rest of us--46 States--get 60 percent to divide up among ourselves. How can that be?

Senator Cassidy explained that the current system is weighted to the benefit of four States at the expense of the rest of us. I would like to fix that, and if you don't live in one of those States, you will want to fix it too.

What I want to do is take the money that we are spending under ObamaCare and block grant it back to the States so that we can level out the disparity in funding but go even further and allow people in each State to develop healthcare systems that meet the needs of that State.

If you are for single-payer healthcare, you will hate this idea because that will be the end of single-payer healthcare because the money and the power will leave Washington and it will go back to people where they live. It will be healthcare closest to the patient. So if you believe that

government is better--closer to the voter, closer to the people--if the idea of government close to the people is a good idea, I would argue that healthcare closer to the patient is a good idea.

I regret we didn't think of this sooner.

What Senator Cassidy said is that our goal is to make sure that no matter in what State you live, you are going to get X amount of dollars, and it is going to be fairly equal no matter where you live. If you live in a State with a unique disease problem or an aged State, you will get a little bit more because you will need a little bit more.

The model we have today is really disproportionate. It doesn't work. It is driving up healthcare costs all over the country. People are dropping coverage because the ObamaCare mandates are too expensive.

So what we are doing is we are leaving the taxes on the wealthy in place. To my conservative friends, I am sorry, but that is what we are going to have to do to make this work. We eliminate the medical device tax because that hurts innovation. We eliminate the individual employer mandate because that stifles the whole idea of having creativity at the State level. We leave the taxes on the wealthier Americans in place. We are able to take that money, plus money we would give to insurance companies to stabilize the national market, and block grant it back to the States with a formula that is fairer.

Let me tell my colleagues what that would look like. Let me drill down to what two States do, by the way. California and Massachusetts by themselves are 28 percent of all ObamaCare money and 14 percent of the population.

Let's look at Alabama. Beginning in 2020, you are going to get 200 percent more. How can that be? It is where you start from. The people in Alabama are going to get a lot more money because when you look at the money coming through the ObamaCare system to the good people of Alabama and how we spend per patient, you are way behind. You are going to get a lot of money to catch up with what should be the national average.

Our friends in California are going to get a 38-percent reduction, but we are going to give you time to adjust for that. There is going to be a wind-down period. It is not going to happen overnight. There will be a fund that can help you if you can prove you have a unique population of people who are sicker and older.

To my good friend from Colorado, you get 42 percent more. How can that be? Under ObamaCare, the money that was going to these four States gets a little higher percentage if you block grant. Not only will you get 42 percent more money than ObamaCare would give the good people of Colorado, you actually get a chance to spend the money unique to the needs of Colorado.

Let's go to Oklahoma, since we have a guy from Oklahoma here whom we like a lot. You get 200 percent. Congratulations. Why do you get 200 percent? You are starting way behind everybody else. The bottom line is, we want to catch you up beginning in 2020. We are going to have to take away from some other people because they are hoggish.

New York, California, we want to help you transition, but the rest of us are not going to sit on the sidelines anymore and watch you take most of the money. We are going to begin to level this out.

Where is South Carolina? I have a unique interest in that State. How did we do? We get 123 percent. That shows you where we start from.

In about 6 years, we are all going to meet. It is going to take 6 or 7 years to level this all out, and we are going to get more. Other States are going to get a little bit less. The ones that are about where they need to be will get about the same.

The big benefit for all of us is, the people in your backyard get to make decisions about healthcare rather than a Washington bureaucrat whom you will never meet. The big thing about this to me is, you have a voice now as a consumer.

Right now, if you don't like your healthcare under ObamaCare, whom do you complain to? Do you complain to your Congressman? I guess your Senator. At the end of the day, most of ObamaCare is administered by the Federal Government through a bureaucracy. We don't manage healthcare in the Senate.

Under this construct, the same amount of money is going to go back to your backyard, and you will get a better deal if you are starting on the tail end of this now. If you don't like what is going on in your State, you can actually complain to somebody whom you vote for in the statehouse. You can go to your State capital and complain to your Governor.

The likelihood that the person you are complaining to goes to the same hospital as you and your family goes up. Wouldn't it be nice to be able to complain to somebody who is in the same boat you are who goes to the same healthcare network because they live in your neighborhood?

To me, the most innovative thing we could do in healthcare in America is allow people in their own backyard to design healthcare systems that meet the unique needs of that State and give consumers a voice that really can be heard because, under this model, your statehouse and your Governor are going to have a lot of flexibility. They can't spend it on roads and bridges. They have to spend it on healthcare.

If they get really efficient, the savings they will accrue stays in that State to even do more for healthcare so you will have a race for efficiency rather than just a race to write bigger and bigger checks.

The big benefit to me is, if you are a healthcare consumer, you will finally have somebody you know you can talk to about what works and what doesn't.

We are about to talk about how we end this debate. I hope this idea will be looked at by not just Republicans but Democrats. If you are from West Virginia--our good friend Joe Manchin--West Virginia gets 43 percent more dollars under the block grant than they would ObamaCare. West Virginia gets to determine how to spend that money more under the block grant than they would under ObamaCare. You can't spend it on roads and bridges, but you have to spend it on healthcare.

There are three things we are trying to achieve. We are not going to let four States take most of the money, a disproportionate share of the money. Over time, we are going to create a system--no matter where you live--you are going to get roughly the same amount of money from the Federal Government, but the money comes in a bock grant so the people in that State can use it without being dictated to by a Washington bureaucrat as long as it is on healthcare. The biggest thing we give you is a chance to have a voice about your healthcare because the people in charge of your healthcare will be in your own backyard, not in Washington, somebody who doesn't know you, you will never get to meet, and quite frankly doesn't understand your world.

I hope we can rally around this. These are not 100 percent done numbers. Generally speaking, this is pretty accurate. It came from the Labor-HHS people. It may change a little bit, but when you start the debate with four States getting 40 percent of the money, clearly most of us are going to get more. When you see these big numbers like our friends in Oklahoma and Montana, the reason you are getting so much more now is that the current system leaves you behind in an unfair way.

My goal is, if you live in Oklahoma, New York, and California, the Federal Government is going to provide healthcare resources as equal as possible, but those resources will be managed by people in the State, not bureaucrats in Washington.

I hope over the coming day and a half that maybe we can rally around an idea that we should have started with to begin with. I don't mind being generous when it comes to putting money on the table to make sure people can afford healthcare. The tradeoff is as follows. We leave most of the ObamaCare taxes in place because we need a funding stream to level out the inequities. We are going to have a tax cut bill later. I want a flatter tax, a smaller corporate tax, and lower individual taxes, but this revenue stream coming from wealthy Americans is going to be used in a different fashion. It is going to provide resources to States that they can manage, unlike ObamaCare where one-size-fits-all.

To me, this is a tradeoff. To the people in West Virginia, I am not asking you to take less and have a tax cut for rich people. We are going to keep the wealthy taxes in place. I am asking the people of West Virginia to take 43 percent more money. It is not a trick. Use it wisely.

Thank you all. I hope over the next day we can inform you about how your State benefits. To those States who are going to have to ramp down, the only reason you are ramping down is you are taking so much more from the rest of us. Quite frankly, that is not fair. We want to be fair to you and give you a chance to adjust, but the rest of us should stand up and say it is not fair that an American in California or New York or Massachusetts--all fine States--gets 40 percent of the money. That is not right.

It is not right to have a one-size-fits-all healthcare system because you will not get the best product. The best product will come from innovation. Your strongest voice will come from having a say to people who live in your same community, talking to a politician who sends their kids to the same hospital you do. That is what this is all about.

With that, I yield the floor.

Madam President, I appreciate the remarks of my friend.

I would simply note that nothing he has said explains why you would want to strip hundreds of millions of dollars out of Medicaid or why you want to deny coverage to elderly folks who get Medicaid support for their nursing homes, people who are in the throes of addiction getting medical support for opioid treatment, children are often born on Medicaid--why you want to do all that. Nor does it explain why you would want to give big tax breaks to the most well-off people in the country.

Fine, let's fix the markets, if that is the problem, but this isn't really about that. This is stripping money out of Medicaid to give it to very wealthy people who are doing quite well already, in my view.

I yield the floor.

Madam President, something else happened this afternoon in Washington that I wish to relate today on the floor, which is that the American Enterprise Institute hosted the launch of Senator Schatz's and my American Opportunity Carbon Fee Act. I am delighted the American Enterprise Institute did that. Their conservative credentials are rock solid, but they do not fear debate, and they were extraordinarily helpful and open-minded in allowing us to make the announcement and in hosting a discussion on the bill that followed.

Virtually every person on the Republican side who has thought the climate change problem through to a solution has come to the same place--a revenue-neutral, border-adjustable price on carbon. That means that all of the revenues are returned to the American people.

Former Treasury Secretaries Baker, Shultz, and Paulson--all Republicans--former EPA Administrators Ruckelshaus, Thomas, Reilly, and Whitman--all Republicans--and leading economists and former Presidential economic advisers Arthur Laffer, Gregory Mankiw, and Douglas Holtz-Eakin--all Republicans--along with many others, support a revenue-neutral, border-adjustable carbon fee. Well, that is what we do.

You all know the phrase ``offering an olive branch.'' Former Republican Congressman Bob Inglis described our proposal as an olive limb, not a branch, when pairing a carbon tax with corporate tax reduction. He said it provides what he called ``an opportunity for conservatives to show how free enterprise can solve climate change.''

When I first came to the Senate in 2007, this place was humming with bipartisan action on climate change for years--but, in 2010, a dead stop. The Republican Party disappeared from the field after the fossil fuel industry secured from five Justices on the Supreme Court the infamous Citizens United decision. The fossil fuel industry, as if it saw the decision coming, immediately launched a veritable Soviet May Day parade of political artillery and rocketry. No special interest had that kind of political muscle before Citizens United. The combination of this industry political weaponry, plus the proliferation of dark money, plus the shady science simulacrum of climate denial has been formidable.

Despite this, there is room for optimism. There are Republicans who are willing to work with us. They just need some prospect of safe passage through the political kill zone that the fossil fuel industry has created.

Over 1,000 American companies have voiced their support for the Paris climate agreement, including corporate powerhouses like Walmart, Goldman Sachs, PepsiCo, and Google. If American companies were to mobilize in

Congress just like they did for the Paris Agreement, that would be a game-changer.

But notwithstanding all of that corporate support, the big business trade associations and lobbying groups have lined up against action on climate change. The so-called U.S. Chamber of Commerce--probably more accurately described as the U.S. chamber of carbon--is one of climate action's most implacable enemies, despite the good climate policies of so many of its member companies. How is it representing its members? It is incredible.

The American Petroleum Institute represents Shell, BP, Total, and Exxon--companies that claim to support the Paris Agreement and the Climate Leadership Council's carbon fee proposal--but API opposes anything getting done.

We all know here that corporate America commands extraordinary attention in our political system. If American corporations aligned their political engagement on climate change with their actual position on climate change, which should not be asking too much of them, we could get going.

So, in a spirit of hopefulness, Senator Schatz and I reintroduced at the American Enterprise Institute our American Opportunity Carbon Fee Act, a framework that I hope both Republicans and Democrats can embrace. The bill would establish an economy-wide carbon fee on carbon dioxide and other greenhouse gas emissions. The fee would be assessed where it is easiest to administer, minimizing the compliance burden. Other greenhouse gases would be tied to their carbon dioxide equivalency with a bumper for fluorocarbons to account for their high greenhouse gas potency. Sequestering, utilizing, or encapsulating carbon dioxide emissions would earn you a credit. The market would begin to work in this space.

Our bill sets the 2018 fee per ton of carbon emitted at $49--the central range of the social cost of carbon last estimated by the Office of Management and Budget. That fee would increase each year at a real 2 percent until emissions fall 80 percent below 2005 levels, and then it would follow inflation.

Border adjustments for energy-intensive goods traded with countries that have weaker or no carbon pricing will make sure that we protect our industries at home. We took care to design the border adjustments in harmony with World Trade Organization rules.

This carbon fee would produce meaningful reductions in carbon emissions. The nonpartisan Resources for the Future projects a 36- percent drop by 2025, compared to the benchmark year of 2005, exceeding the U.S.-Paris Agreement commitment significantly.

In addition to the environmental value, of course, a carbon fee also generates revenue--in this case, nearly $2.1 trillion in revenue over 10 years. Our plan would return every dime of that to the American people. Here is how.

First, the bill lowers the top corporate income tax rate from 35 percent to 29 percent--a longstanding goal of Republicans. This would cut American corporate taxes by almost $600 billion over the first decade.

Second, it provides workers with a $550 refundable tax credit--$1,100 for a couple--against payroll taxes. The tax credits, which would grow with inflation, would return almost $900 billion to the pocketbooks of American households over the first 10 years.

Third, it would provide a matching benefit to Social Security beneficiaries, veterans program beneficiaries, and certain other retirees. These benefits would total nearly $500 billion over 10 years.

Finally, the bill would establish a block grant program, delivering the remaining funds to our States--over $100 billion to help workers in coal country, for instance, or provide coastal protection for seaside States facing terrible threats of sea level rise, at the discretion of the State, to meet local needs and concerns.

I understand the suffering in coal country. Coal country will continue to decline as natural gas drives coal out of the energy market. There is now no mechanism to remedy that inevitability.

Remember Huey Long's old slogan, ``Every Man a King''? With a carbon fee, we could make every miner a king--a solid pension, retirement at any time, full health benefits for life, a cash bonus based on years worked, a voucher for a new vehicle, a college plan for their kids. These things become doable with carbon fee revenues.

It is not the miners' fault that the coal industry has collapsed. They worked hard. They did dangerous work. It is a rigorous occupation to be a coal miner, and they are entitled to respect. Give them their dignity. Make them kings. With a small fraction of the revenue from a carbon fee, we could assure every single coal miner a lifetime of comfort, security, and financial stability.

Senator Schatz and I extend an open hand, an olive branch. Give Senator Schatz and me a Republican to negotiate with. That shouldn't be too much to ask. Then let's talk about the economics. Let's talk about where the revenue should go. And because I know it is a part of the Baker-Schultz-Paulson proposal, let's talk about where we can get fact- based, scientifically rigorous analytics of which regulations might become unnecessary or duplicative of a carbon fee's emission reductions.

Let's restart the bipartisan conversation we had going until 2010.

Let me close with an appeal to our patriotic sense. America holds herself out as an exemplary nation, a ``City on a Hill.'' The tactics of climate denial and political menace the fossil fuel industry has deployed around here have degraded our city.

There is a remorseless functioning of the laws of physics, of chemistry, and of biology. Deny them all you want, but time will tell. And even now, everyone, from our Secretary of Defense to every single Senator's home State, State university, understands that climate change is real and urgent, is teaching the science of climate change in those universities, and is warning of the dire consequences.

When the Presiding Officer left the Environment and Public Works Committee the other day, I was talking about the Leopold Center at Iowa State University and the powerful language in which they describe the present effects on agriculture of climate change and the danger of disruption to the fundamental systems of the planet. That is the home State universities telling us what the facts are.

So one day there will be a reckoning, and the longer our American democracy lies incapacitated at the hands of the fossil fuel industry, the worse the outcome will be, and the worse the outcome, the greater the harm to the country we love that holds its example up to the world.

We are all extremely fond of John McCain. John McCain returned to the Senate yesterday and called our country ``the strong, inspiring, inspirational beacon of liberty and defender of dignity of all human beings.'' Some beacon, if we continue to get this wrong because of what one industry did to our politics, using political menace, dark money, and fake science.

America deserves better than what we are doing in this Chamber on this issue.

I thank the Presiding Officer.

I yield the floor.

Madam President, I intend to file the following motion to H.R. 1628 and I ask unanimous consent that it be printed in the Record. The motion is supported by Senators Brown, Franken, Van Hollen, Cardin, and Feinstein.

I thank the Presiding Officer, and I want to start by thanking my friend and our colleague, Senator Joe Donnelly, for standing up for Hoosiers and, in standing up for Hoosiers, standing up for all Americans whose healthcare is threatened if we continue to proceed down this very dangerous road in the Senate.

He talked about the opioid epidemic. Just last week I met with a dad by the name of Rick Warner and the brother and sister of a young man by the name of Jamie Warner who had recently graduated from the University of Maryland. He was a Terp.

Jamie died of an opioid overdose. He was part of the opioid epidemic that is sweeping the country. Rick Warner and his family were here in the Senate asking Senators--in fact, pleading with Senators, Republicans and Democrats alike--not to pass this healthcare bill.

He had lost his son Jamie, and he is determined that other moms and dads not lose their children to opioid overdose. This bill--make no mistake--will make those tragedies much more likely by taking away access to care in the way Senator Donnelly just mentioned.

Yesterday, with the tie-breaking vote of Vice President Pence, the Senate began down a very dangerous path, but we can get off that path. We can make sure we do not reach the end of that very dangerous journey. It was as if yesterday we lit the fuse and the fire is traveling down that fuse and at the end of the fuse is the plan to totally blow up the Affordable Care Act, which will wreak havoc on our healthcare system. That is why we have to put out the fire on that fuse right here in the Senate. We have the power to do that. We have the power to prevent the chaos and harm that will be created in our healthcare system if we continue down this path.

The reality, we know, is that all the healthcare plans that we have seen emerge to date--whether it was House plan 1 or House plan 2, or Senate plan 1 or Senate plan 2, or the proposal to repeal entirely the Affordable Care Act, which would cause great harm--have the same rotten core. All of them have the same nasty DNA, and that is this: They would deny access to affordable care for tens of millions of our fellow Americans in order to give tax breaks to the very powerful and very rich and to big corporations. In fact, the proposal we are voting on very soon, which is entirely repealing the Affordable Care Act with no replacement, will result, according to the nonpartisan Congressional Budget Office--these are the nonpartisan referees who look at these proposals and tell the American people what the impact will be--in 32 million fewer of our fellow Americans having access to affordable care than today. They also tell us that we will double the health insurance premiums compared to today. And for what? They give a gigantic tax break to the wealthiest Americans.

Warren Buffett, a name most Americans know, said about a month ago: For goodness' sake, I don't need a $670,000 a year tax cut in order to throw tens of millions of Americans off of affordable care. Don't do that. I don't need it.

Make no mistake. This has never been about healthcare. It has been about wealth care. I want people to think about this. If this were really about healthcare, why is it that all of the folks involved in providing healthcare to the American people are against it--the nurses, doctors, and hospitals?

People hear a lot of facts and figures from Senators and from the House. Some people may dismiss those numbers, but why don't we ask the people whose daily business it is to take care of the American people? What the doctors say is that all of these Republican plans violate their Hypocratic oath. What is the Hypocratic oath? It is the oath that every doctor in the country takes and the first principle is to first, do no harm.

Doctors, nurses, and hospitals all want to make people better. They all want to cure us. They all want to improve our health situation, but their No. 1 rule is not to make things worse, and all of these bills make things worse. That is what the numbers show us, and that is what the doctors, hospitals, and nurses show us. I think it is worse to have 32 million fewer Americans have access to affordable care.

What about our colleagues? Don't they think that is worse? I think it is worse when you double health insurance premiums and raise the cost of healthcare to Americans. That sounds like it is worse to me, not better.

It is not just all the folks who provide healthcare. Why don't we ask all of the patient advocacy groups across America about this so-called healthcare bill? What do they say?

The American Cancer Society: Bad bill--don't pass it. It will create harm. It will be a setback in our fight against cancer.

The American Diabetes Association says the same thing: Bad news for patients with diabetes.

The American Heart Association tells us that this will be bad and harmful to people with heart disease.

There is the Alzheimer's association, and we can go down the list. Every single patient advocacy group in America that has taken a position on this bill says it is a bad bill, it is dangerous to our health, and it will do harm.

So I don't know how our Republican colleagues can bring Senate bill 1, Senate bill 2, or Senate bill 3 before this

House and call it a healthcare bill when all the people who provide healthcare to our constituents say it is harmful to their health and when every patient advocacy group that has weighed in says that it is bad for their health. How is that a healthcare bill?

It is good for one group of Americans--those who will get a windfall tax break, but many of them, like Warren Buffett, are saying: Hey, I don't want this.

Now there are some very big corporations that are wanting their tax breaks, and, yes, as corporations, they are going to get this windfall benefit at the expense of everybody else in America and at the expense of our healthcare system.

So let's not go down this path. The way to avoid going down this path is to vote down all of these amendments and make sure that we don't put this bill into the House of Representatives, where they have already passed a bill that is harmful to Americans' health.

In fact, I think people will remember that President Trump had this big celebration in the Rose Garden of the White House after the House passed that bill. They were slapping each other on their backs before the cameras.

Yet, behind closed doors, what did President Trump have to say about the House bill? Behind closed doors, he called it a mean bill, and it is a mean bill. These Senate bills, when it comes to cuts in Medicaid that our colleague Senator Donnelly was talking about, are even meaner than the House bill, with deeper long-term cuts. This is not according to me. It is according to the nonpartisan Congressional Budget Office.

Those cuts get translated into stories of people like Rick Warner, the dad I talked about at the beginning of my comments who lost his son Jamie. Those numbers get translated into harm to people throughout this country who have been crying out. We heard some of them in the Gallery just yesterday. What did they say? ``Kill the bill. Don't kill us.''

The reality is, when you deny access to affordable care to millions of Americans, you are putting their lives at risk, and when you raise premiums and costs, you are putting people's livelihoods at risk. So let's not go down this path.

The motion by Senator Donnelly and others will do what Senator John McCain asked us to do yesterday--to go back to regular order, to go back to the committee process, to go back to the way this democratic institution is supposed to work, which is when we hear from our constituents, we hear from the doctors, we hear from the nurses. We do not cover our eyes and ears to the facts and the truth.

That open process is designed to protect the American people. It is designed to protect the American people from bills just like this one for which this Senate took that dangerous first step down the road on proposals that only 11 percent of the American people think is a good idea--11 percent. I cannot even find that 11 percent myself. I have gone all over the State of Maryland, to those parts of our State that voted for Donald Trump for President and to those that did not. I cannot find 11 percent in Maryland who are for this bill. That is why what we call the regular order around here is supposed to protect the public interest--because when you have a committee hearing on a bill like this and the doctors and the nurses and the hospitals all come out and testify against it, they let people know how bad it is. Instead, we have had this process in secret, behind closed doors. In many cases, we do not even know what the next amendments after this one that is coming up are going to be. We do not know what the Republican leader is cooking up behind closed doors.

Let's do what Senator McCain urged us all to do. Let's get back to regular order. Let's get back to a process that is designed to provide transparency because with transparency comes accountability. It lets the American public know exactly what we are doing and how we are going to impact their lives.

Here is what I do know. Everybody across this country who knows about this bill--everyone I have spoken to and from the phone calls we are getting and the emails we are getting and at the rallies and the townhalls--is catching on. Why would we just steamroll over all of that important public sentiment coming from all political views? The American Cancer Society is not a Republican or a Democratic organization. The American Diabetes Association is not partisan. These groups are crying out and saying: Stop.

So let's get off this path, this very dangerous path. Let's get back to regular order. We all know our healthcare system is not perfect. We all know the Affordable Care Act is not perfect. Senator Donnelly and I and others and many of our Republican colleagues have put forward much more narrow plans that focus on improving our healthcare system, not on blowing it up entirely. That is the path we should take.

I hope all of our Senators will agree not to continue to let that fire burn on the fuse until it gets to the end and blows up our healthcare system. Let's stop now. Let's get together, and let's have a committee process. Let's do something that really improves our healthcare system and not something that destroys it.

Thank you, Mr. President.

Mr. President, first of all, I thank my friend, the Senator from Massachusetts, for her comments today and for her relentless willingness to take on this fight and so many other fights that are so important to our country.

I come to join her call to point out some of the challenges in this legislation but also to make an appeal to my friends on the other side that this does not have to be the way we go. I have been one who has acknowledged for many years that there are challenges in the Affordable Care Act and that there are areas in which there could be common interests in finding solutions, but what we have before us now is a series of ``bad, badder, and baddest'' choices. In effect, we have a series of options that ask: Do we want to pass legislation that would take 16 million Americans off healthcare? Do we want to pass legislation that would take 22 million people off healthcare? Do we want to pass legislation that would take 32 million Americans off health insurance?

What parts of these choices do my Republican colleagues really embrace?

I think that in the 8 years I have been here, I have never seen a series of pieces of legislation that have been so unpopular, even before they are passed, than this litany of options from full repeal to skinny repeal and all of the variations in between.

As has been said by the Senator from Massachusetts and I know by the Senator from Washington State as well, the American people know this. That is why our phones are ringing in our offices and I know in our Senate Republican colleagues' offices. People are saying do not pass this kind of legislation.

I think about the fact that in the last couple of weeks, the parents of a number of children and young adults who have enormous disabilities have come to my office. In Virginia, we run a very skinny Medicaid Program. Frankly, it has not been very generous. Some of the individuals who have come to my office have waited 5, 6 years--one person has waited 10 years--to get a Medicaid waiver. These families, these children, in any of the proposals that have been put forward, would be the first to lose their coverage.

Family after family talked about the fact that, right now, both parents can work because they have a little bit of relief to take care of their disabled young adults in certain cases. In many cases, it is because the young adults can at least find someplace to do some productive work themselves. Yet, if they were to lose the Medicaid waiver, one of the parents would have to stop working, and the child would have to stop his form of employment. Net-net, it would be a loss not only to that family, but it would be a loss to our economy.

I mentioned that I used to be the Governor of Virginia. In 2016, Virginia received about $4 billion in Federal Medicaid funds--51 percent of the State's funding for people covered by Medicaid. As I mentioned, we are ranked one of the skinniest programs in the country. Unfortunately, we rank about 47th, I believe, in terms of our payments. Yet, under any of these proposals that decimate Medicaid, Virginia would be penalized for running an efficient program.

Again, one of the ironies of this is that the States that are the least penalized in the Republican proposals, in terms of the $700 billion-plus of Medicaid cuts, are actually the States that have more generous programs. They are often States that are represented by Democratic Governors. In what way do these proposals help our Republican colleagues or, for that matter, their constituents?

We have heard, as well, that the American Cancer Society, the American Medical Association, the American Academy of Pediatrics, the American Hospital Association, and AARP--a who's who of groups affiliated with healthcare--have come in and pleaded: Please, do not do this, this way--any one of these litany of proposals that we will be dealing with over the next few days.

From what I have heard on an individual basis--and I take enormous pride in the fact that in my time here--and sometimes it has even gotten me crosswise with the ranking member of the HELP Committee--I have tried to reach out on virtually every piece of legislation I have worked on to find a Republican partner. I actually got put in a timeout by a previous leader for doing too much of that.

What I hear from my Republican colleagues is, they do not want to own this. They know, in many ways, that this is walking the plank on what is both bad policy, bad politics, bad for their constituents, but the notion that somehow they have to provide a win for a President who has provided zero leadership before they can take some kind of August recess is literally the worst reasoning I have heard in my 8 years in the Senate as to why to pass a piece of legislation, particularly a piece of legislation that affects one-sixth of our economy. In many ways, it is almost one-third of the people who will be affected by some of these changes.

I think many of us were touched yesterday when we saw Senator McCain, who is an American hero and who himself is having to grapple with enormous healthcare challenges, come back to the floor and, frankly, admonish us appropriately but also say that while he was going to vote to start debate on this bill, the real way we ought to go about doing this is to roll up our sleeves, in a bipartisan fashion, and take this legislation back to where it should start, which is in the HELP Committee, where the Senator from Washington serves, in the Budget Committee, whose chairman is on the floor, and in the Finance Committee. Two of those three committees I have the honor of serving on.

I commit to my Republican colleagues that I will work with them. I have laid out a series of ideas, some of which they have endorsed in terms of there potentially being cheaper options, in terms of selections; the idea, as long as we protect consumers, of allowing insurance policies to be sold across State lines and other ideas in terms of reinsurance that other colleagues have worked on. There are a host of ideas we all agree on. Let's start with that premise, in terms of coming to a solution, not coming up with legislation that is cooked up behind closed doors that even my strongest Republican colleagues have acknowledged they cannot vote on when they only get an hour to look at it.

Think about all of the same criticisms--some of them valid--that were made against the Democrats when we passed the ACA; although I would continue to remind my friends that we had, literally, hundreds of amendments which were Republican amendments that were accepted into that legislation. It was not a perfect process, but let's learn from that and take this advantage right now. Listen to the American public, and let's work together to get this right.

The other item that will come about from any of this Republican legislation put forward, even from the skinniest of their proposals, would dramatically affect those individuals with preexisting conditions. I have three daughters. One of my daughters has juvenile diabetes. She has had it for 18 years. Another daughter has asthma and a very strange set of allergic reactions that have actually caused her to have been hospitalized 38 times in the last 40 months.

I am an extraordinarily lucky individual. I know that both through health insurance and because I had the resources, every time my two children got sick, I could make sure they got the medical attention they deserved. I cannot imagine talking to any Virginia family or Washington family or Wyoming family or Arkansas family who has a child with those same afflictions and trying to explain to them that my kids who have juvenile diabetes, asthma, and allergic reactions--through no fault of their own and that have caused this number of hospitalizations--have a right to healthcare and that their kids who have preexisting conditions do not have that right.

Our country is much better than this. We can figure out a way to get this right, but we are not going to get it right if we continue to have this ploy of one closed-door, cooked-up deal after another that is put forward, with no review and no real attempt to find a common solution.

I do not come to the floor that often, and I do not often talk about the medical needs of my family. This is for the sake of not only my kids who get the coverage they need and deserve but for

all the kids who now get the coverage they did not have prior to the ACA and who have it now. It is the idea that insurance companies cannot discriminate against you because you have preexisting conditions.

Let's see if we can make sure we maintain that commitment. In the greatest country in the world, as Senator McCain so eloquently put it yesterday, let's see if we can work through to a way that makes this body, once again, the greatest deliberative body in the world. Let's see if we can find that common ground that would allow us to put forward legislation that at the end of the day, we would all be proud of. That is a goal worth working on.

My hope is, over the coming days, we will find that common group of Senators who will say we are going to take that path rather than the path we are on right now.

I yield the floor.

Madam President, I intend to offer the following motion to H.R. 1628 and I ask unanimous consent that it be printed in the Record. The motion is supported by Senators Stabenow, Baldwin, Kaine, Coons, King, Carper, Nelson, and Peters.

Madam President, I intend to offer the following motions to H.R. 1628 and I ask unanimous consent that they be printed in the Record.