Health Savings Account Expansion Act of 2017

Mr. President, the more things change, the more they seem to stay the same. Republicans won the White House. Republicans control the Senate. Republicans control the House. What will the first order of business be for the new Republican majority? To pass a budget that never balances, to pass a budget that will add $9.7 trillion of new debt over 10 years.

Is that really what we campaigned on? Is that really what the Republican Party represents?

Our first order of business will be a budget that never balances, a budget that adds $9.7 trillion to the debt, and they tell us: Oh, but it is not a budget. If you listen, they will say: No, no, it is a vehicle to repeal ObamaCare.

Yet I have the title in front of me, which says a concurrent resolution for the budget of 2017. We have special rules when you pass the budget so that we may be able to repeal ObamaCare, and I am all for that. But why should we vote on a budget that doesn't represent our conservative view? Why would we vote on a budget that adds $9.7 trillion to the debt? Because we are in a hurry, we can't be bothered.

It is just numbers. I was told again and again: Swallow it. Take it. They are just numbers. Don't worry. It is not really a budget.

Yet the legislation says it is a budget. The numbers say we will add $9.7 trillion of new debt.

So I say: If they are only numbers, and if the numbers that are in the budget don't matter, why don't we put numbers in that balance? Why don't we put a vision into the budget that represents what Republicans say they are for?

Republicans say they are the conservative party. Are we? When George W. Bush was President for 8 years, the national debt went from $5 trillion to $10 trillion. The debt doubled under a Republican President and a partially Republican Congress. Yet the words were these: Well, he had Democrats to deal with, and if we could ever take all three branches of government, things would be different.

The Republicans took over the House in 2010. They still didn't control the

Senate, but they said: If we only controlled the Senate, we could be the conservative party again.

We have had an election. The conservative party--the supposedly conservative party--won. Republicans control the House, the Senate, and the Presidency, and the first item of business for the Republicans will be to pass a budget that never balances--a budget that will add $9.7 trillion to the debt over 10 years.

This sign could have been put up for Obama's first budget. Every Republican railed and said: $10 trillion--President Obama will add $10 trillion. And he did. President Obama doubled the debt again.

It went from $5 trillion to $10 trillion. The national debt went from $5 trillion to $10 trillion under George W. Bush, and then it doubled again under President Obama. It went from $10 trillion to nearly $20 trillion.

What are we looking at here? More debt, under a solidly unified Republican Congress and a Republican President.

So you might scratch your head and say: The more things change, the more they stay the same. Is it all smoke and mirrors? Is there really a difference? Are Republicans different than Democrats? It is a pretty important question. We are in such a hurry to repeal ObamaCare. I am all for it. As a physician, nobody thinks that ObamaCare has been worse for the country. Nobody more than me thinks it is a terrible piece of legislation that has not helped the country and that has inflated our costs and not helped. Yet do we have to add nearly $10 trillion of debt in order to get at it?

So as this moves forward, I will offer a replacement. I will offer my own budget. I will offer to strike and remove $10 trillion worth of debt, and I will offer my own budget that balances within 5 years. How do we do it? We give the authority to make the cuts where they should be, where they are most wasteful in government, and we offer this budget by simply freezing expenditures. You don't have to cut any expenditures.

Every department of government could get what they got the last year. If you think some departments of government need more money, cut other departments of government. Frankly, there are some departments of government you could eliminate and you would never know they were gone. If the Department of Commerce were gone, a few corporate executives would not be able to fly around on government jets. They could fly around on their own jets. You would never know the whole entire Department of Commerce was gone.

You can cut spending. You can actually get to the balance by not cutting anything. So here is what happens. If you freeze the on-budget spending, within a little over 5 years, your budget balances.

I remember a time when there were the moderates who were for freezing spending, and the real conservatives were for cutting spending. Now nobody is for cutting spending. When I bring it up that you can absolutely not balance the budget if you are not willing to look at entitlements, do you know what I am told by many well-meaning Republicans? Don't write it down. Don't put it on paper because people will be upset with you if you explain that to save Social Security, to save Medicare, you will have to reform these entitlement programs. They say: Let's just talk about waste. Let's just talk about fraud and abuse. And I do, and we should eliminate all of those. But guess what. If you eliminate all of the budgetary spending that we vote on--this is called the discretionary spending. This would be the military and all the rest of the nonmilitary. It is about $1 trillion, not including the entitlements--Social Security, Medicare, and Medicaid. If you did just the military and the nonmilitary and you reduced it 10 percent a year for 10 years, and you virtually wiped out all discretionary spending, you still don't balance the budget.

So, really, you are not a conservative if you are not willing to look at all government spending. The budget cannot be balanced and the budget will never balance unless we look at entitlements.

What does that mean? It means that because of demographics--we had big families 60 years ago, with three, four, five kids to a family. Now we have less than three kids to a family--probably two kids to a family. So you had all the baby boomers born right after World War II, and they are all retiring--60 million of them. So we have this huge population boom, and you don't have as many workers. So the demographics aren't working. Then you add to that the fact that we are living longer.

When Social Security was started, the average life expectancy was 65. It worked pretty well as a pension plan because you died. But now it is great. We are living on average to 80, and if you make 80, you may well make 90. What a great thing--longevity. But it is not working. Social Security is not working. We spend more on recipients than we bring in with the tax.

Medicare is even worse. The average taxpayer pays about $100,000 over their lifetime in Medicare taxes. The average recipient takes out $350,000. How big a problem is this? Medicare is $35 trillion to $40 trillion in the whole.

It is inexcusable that we are not talking about how we fix Medicare. It is inexcusable that we are not talking about how to fix Social Security. If we don't fix them, there is going to be a cliff. Within about a decade, the cliff is so severe that everyone on Social Security will suffer a 20-percent decline in their monthly check. It will happen all at once if we don't fix it. Can we fix it? Yes, we have to talk about it.

What we are doing today is kicking the can down the road. We have our focus on ObamaCare, but we are taking our focus off the debt. As bad a problem as ObamaCare is, as much as it has disturbed, destroyed, and distorted the health care market, it may be that the debt is a bigger problem.

So it is not a popular stand that I take today. I will be the only Republican to vote against the Republican budget. That won't be popular. But I ran for office. I left my medical practice. I am away from my family. I spend long hours traveling here because I am concerned about the debt.

We borrow $1 million a minute. The debt threatens the very foundation of our country. Yet here we are. The Republican Party controls the House, the Senate, and the White House, and in their haste, they put forward a budget that is going to add this much debt.

This is what the debt has been doing. Here is 1980. We see the growth. It has become exponential--the growth of the debt. This should worry every American. But here is the Republican 10-year budget that we are getting ready to pass. It is virtually a vertical line of accumulation of debt.

People will say: But how could we ever cut any spending? I will give you a couple of examples of where your government spends money and you tell me whether or not we ought to look long and hard at cutting spending.

There was a grant given for autism. I have a great deal of sympathy. I know children with autism. The grant was for $700,000. But do you know what they spent it on? They spent it on studying Neil Armstrong's statement. Remember Neil Armstrong? He landed on the moon and said: ``That's one small step for man, one giant leap for mankind.''

Well, your government, in its infinite wisdom, wanted to know: Did he say ``one small step for man'' or ``one small step for a man''? Your government spent $700,000 studying the preposition ``a.'' Did he say ``a man'' or just ``man''--$700,000. Money that should have been spent on autism was spent on something frivolous.

Is anybody going to fix it? No. Every year, all of the spending bills are globbed together in a 2,000-page bill--and not one iota of reform.

My colleagues may remember that Senator Proxmire from the 1970s used to have something called the ``Golden Fleece Award.'' Every one of those things he complained about in the 1970s happens now but tenfold greater. Nobody fixes it. We don't pass individual spending bills. We do continuing resolutions, which means we continue doing the same thing we have done over and over.

Again, $700,000 was spent studying Neil Armstrong's statement. Do you know what their conclusion was? We are not sure. They spent $700,000, and they are still not sure whether he said ``a man'' or ``one small step for man.''

We spent $500,000 studying whether or not, when you take a selfie, if you are smiling in the selfie, does it ultimately make you feel better? We spent $500,000.

So what do we do? Do we give these people less money? Teach them a lesson. Give them less money, and maybe they will conserve the money. Maybe they will eliminate waste if they have less money next year than they had this year--or what I am proposing: Freeze the spending. Is anybody proposing that? No. We say: They spend a half a million dollars on selfies; give them more next year.

So the Republican budget will increase spending every year. It increases spending at about 5 percent a year. So spending goes up. They say it is the baseline, and they say we are cutting off the baseline. No, no. The baseline goes up 5 percent a year. Spending will increase over the 10-year period. The red line is spending.

Part of that is what the Republicans are proposing. They are going to stay on the spending curve. If we stay on the spending curve, they will continue to spend $700,000 studying Neil Armstrong's statement; they will continue to spend half a million dollars on selfies. They spent another half a million dollars on a climate change game. They spent $45 million to build a natural gas station in Afghanistan--$45 million. The first problem: Nobody in Afghanistan has a car that runs on natural gas. They discovered this after they built the gas station. The gas station was 86 times cost overrun. The original estimate was about half a million for the gas station, but lo and behold, somehow it cost $45 million. If your government had 86 times cost overrun, would you give them more money or give them less money? I, frankly, think we should give them less money. If you give them more money, they will not waste it less; they will waste it the same or worse. They should be given less money.

Mazar-e Sharif is a city in northern Afghanistan. We built an $85 million embassy there and we signed a 10-year lease, and then somebody looked at the place and decided that since there were tall buildings surrounding the entire entity, people would shoot down into the courtyard and kill our diplomats, and they said the building could never been occupied--after they spent 85 billion, after they signed a 10-year lease. How will they get better? Were the people who made this decision fired? No. They are Federal employees, and you never fire Federal employees. Will they make wiser decisions because we give them less money? No. We give them more money.

You would be excused for being upset if you went and voted and said ``I am going to vote for the conservative party'' and if you went and voted and said ``I am going to vote for the party that is going to balance a budget.'' Wouldn't you be upset? Wouldn't you wonder which party that is?

This is the spending curve. We are going to add $9.7 trillion in 10 years, and yet they say: Oh, no, this isn't really a budget.

I have it in front of me, though. It is a budget.

There is no reason why Republicans couldn't have put forward a budget that doesn't add all the red ink. We are at $20 trillion. We are going to nearly $30 trillion under the Republican plan. My goodness, what happened? Where is the conservative party? Where are the conservatives in Congress who would say enough is enough? Now they say: We just have to be done with this. Don't distract the little people. Don't let the people of the country know we are voting on a budget. We are going to call this the vehicle to repeal ObamaCare.

Well, that is not what it is. It is a budget. And we have special rules for dealing with the budget that allow us to repeal ObamaCare, which I am all for, but this is a budget.

They say: Well, how can we get the votes? No Democrats will vote for this budget. This is a Republican blueprint. Not one Democrat will vote for this.

So this is what Republicans are for. This is the blueprint the Republican Party says they are for--$10 trillion worth of new debt. I am not for it. That is not why I ran for office. That is not why I am here. That is not why I spend time away from my family and my medical practice. It is because debt is consuming our country. There is a time and a place to debate ObamaCare, and I am more than willing to debate that. But this is a budget. This is the vote on a budget.

They say: Oh, it is just a gimmick. It is just a game. The numbers don't mean anything.

Well, if the numbers don't mean anything, put honest numbers in there or put conservative numbers in there.

I, for one, will put forward a conservative opposition to the Republican majority's budget. I will put forward a budget that freezes spending and balances the budget over a 5-year period. Would there be some agencies that would get less money? Yes. But it would force us to go through the government and pick and choose what is good spending and what is not good spending.

We have a waste report that we put out. If you look on our Facebook, you can find our waste report. I listed four or five of the most egregious. There are hundreds and hundreds, if not thousands, of things we shouldn't be spending money on. I will give another example.

We have sold $100 billion worth of weapons to Saudi Arabia. They were wanting to spend money giving F-16s to Pakistan. You pay for them and give them to them.

There is riddled throughout the Pentagon--look, the Pentagon has never been audited. You are surprised? The government has never been audited. The Federal Reserve is not audited. The Pentagon is not audited. So what is the Pentagon's response to being audited? The Pentagon says to us: We are too big to be audited. I don't know about you, but that makes me kind of angry, that a part of our government, even a necessary part such as national defense, says they are too big to be audited. Meanwhile, we have $85 million embassies built that will never be occupied and $45 million gas stations that will never be used.

I think it is time that we say enough is enough. Don't give government more money; give them less. The government hasn't been a good steward of your money.

The question is often asked: Are the people who spend your money, are the people involved in government inherently stupid? It is kind of a debatable question. I think they are mostly well-intentioned. I don't think they are inherently stupid, but I do think they don't get the right incentives. Because there is no profit motive in government, because there is no rationale or motive to conserve, money is spent, and because of sheer laziness and ineptitude, we continue to pass the spending bills--glommed together, thousands of pages--without reform. But I won't be party to that. I won't vote for spending bills that are not individualized and don't have reforms in them. I won't vote for budgets that never balance.

So while I may be a lonely voice on this issue, I will continue to bring up to the American people that it is important not to add more debt, that it is important to slow down the accumulation of debt. It is important that we have a $20 trillion debt, and I am not willing to add $10 trillion more in debt. So at the appropriate time, I will introduce an amendment that will strike and replace this budget, and in its place I will put forward a conservative vision for the country--a vision of a balanced budget that balances within 5 years.

Every Republican in the Congress who has been here for a while has voted for a balanced budget amendment. Interestingly, the balanced budget amendment--which would be an amendment to the Constitution--has within it a provision that the budget would balance within 5 years. And even when Republicans get around to saying ``Oh, we will have some gimmicks to balance in 10,'' 10 is not what the amendment says. Why bother voting on an amendment if you are not serious about it?

Republicans are completely in charge. It is a Republican document; it is a document I disagree with; and at the appropriate time, I will be introducing a replacement that will balance within 5 years and provide a conservative view for the country.

Mr. President, first let me comment on what my friend, the distinguished Senator from Texas, said. If my car goes into a ditch, the first thing I don't do is dismantle the car. That doesn't help me get anywhere in terms of transportation.

First of all, let me speak on process before talking about the substance of what we are really talking about and how it affects people. We have a bill in front of us that creates a process for the majority to be able to unravel and repeal essentially our whole health care system. You pull a thread and it goes through not only employer- based care, patient protections, people who have insurance, Medicare, Medicaid. All of it begins to unravel. Interestingly, also in this bill, in the text it adds $1 trillion to the deficit--$1 trillion to the deficit in the bill that our colleagues just voted to proceed to pass.

We need to be very clear on this: If colleagues want to work with us to fix problems and improve health care, we can start this afternoon. It is almost 3:30. By 4 o'clock we could put together a group of people. I am sure our distinguished Democratic leader on the Budget Committee would be happy to sit down and work together on ways to make health care reform better and make health care more affordable and make it more available to people. If that is what we want to do, count us in, but that is not what we are talking about here. We are talking about this crazy idea that no one in their real life would do.

It is like deciding you want a new house, so you tear down the old house. That is the easy part. Then your family is homeless. Then you say: Well, gosh, you know, maybe I better have a plan to get a new house for my family and figure out a way to pay for it, to be able to afford it.

Nobody would do that. Nobody would start by saying: We are going to rip apart the entire health care system and create chaos. We are going to undermine Medicare. We are going to undermine Medicaid. We are going to take away patient protections for everybody who has insurance through their employer, and then we will figure out later what we are going to do to replace it, if anything.

I know there is a division on the Republican side. Certainly Members in the House don't think it should even be replaced at all.

It is interesting. We are talking about one-sixth of the economy that would be destabilized. There is no question that if you do a repeal and insurance companies don't know what is coming--I have talked to hospitals, and they don't know what is coming--behavior will begin to change. Rates will begin to go up. Different decisions will be made because, as businesses, they will not know how to plan. Their investors will not know how to plan.

There is no question about it. When you repeal without creating certainty in the marketplace, you begin a process that results in chaos.

We have an interesting example, one that I have been involved with for a lot of years, where we wanted to change just one piece of the health care system, the reimbursement system for doctors.

I was in the House when they passed Medicare changes. We put in place a new policy. We were going to write a new policy to reimburse physicians for quality instead of quantity. It makes sense. It took 18 years to get agreement. We got agreement last year. It doesn't even take effect for 4 years.

Everybody here knows about this thing called the doc fix. It is an inside term--or SGR, which is even more insider. The truth is, we were trying to change just one thing and could not get agreement to do it for 18 years.

Anyone who thinks that there is going to be a repeal without an ACA extender going on has not looked at past processes.

What is most important, though, is what this means to real people. This

really is about a plan of ripping apart the health care system. There is nothing in its place immediately so we don't even know what will be coming. This is going to make America sick again.

We are talking about a process and a plan that for real people is not a political game. It is not smoke and mirrors. It shouldn't be about politics. It is about the moms and dads who go to bed at night and say: Please, God, don't let the kids get sick. Now, many of them--close to 30 million counting everybody with new coverage--don't have to say that. They can say a different kind of prayer because they can go see the doctor.

We know that when you unravel that system with nothing responsible in its place, we are talking about making America sick again. We want affordable care, not chaos. This plan goes from affordable care to chaos. We talk about some parts of what we passed in health reform, but there are a lot of things we don't emphasize that I think are important to recognize in this debate.

First of all, what we pass in terms of changes in quality care affects every single American with health insurance. A lot of people in my State are fortunate to have employer-based insurance. We have a lot of folks at the collective bargaining table fighting every year to make sure they keep their insurance--150 million people across the country. All of them have benefited from the patient protections we put into health reform. When we take those away, then immediately the insurance companies will be back in charge. If you get sick, you can get dropped. Right now they can't do that. If you are sick or if your child is sick, right now you can't be blocked from buying insurance. We call it a preexisting condition. But before health reform, insurance companies were doing that every single day--a child with juvenile diabetes, someone with cancer or Alzheimer's disease.

I think about a very good friend of mine who just found out her grandson has leukemia. He is 2 years old. He is going through treatment. We pray he is going to be able to get through it successfully. He is going to have a preexisting condition for the rest of his life. With this repeal, there is no guarantee he will ever be able to get insurance. On top of that, if he has to have treatments that go on for some period of time, caps will be reinstituted on the amount of care you can get, the amount of treatment per year, dollar amount, or amount of visits you can get, and there is no guarantee that this little boy will be able to get the treatment he needs so that he can live a healthy, successful life going forward.

In talking with pediatric cancer doctors a couple of weeks ago, it was so amazing and gratifying to me to hear them talk about children whose lives have been extended, whose quality of life has been extended because of the fact that they are able to fully treat these children and insurance companies can't put caps on how much they will pay or how many treatments. Now there is a whole other range of protections for everybody.

One of the fights I was proud to lead in the Finance Committee when we passed the ACA was to make sure that the basic insurance package every company has to provide has to include maternity care. That seems like a no-brainer. People were shocked that it didn't. Before we passed health reform, 70 percent of the insurance companies--the policies you buy in the private market didn't include maternity care. In fact, women were viewed as having a preexisting condition because they might get pregnant, might have a baby. That is not true anymore. Women are not rated differently than men, and maternity care is now available regardless of the kind of insurance you have. That is a pretty good deal. Right now I have a son and a daughter with growing families, and I can tell you that is a very big deal in my family.

There is a whole range of things. We all know about young people who are able to stay on their parents' insurance. They get out of college and they are wrestling with a huge debt, and one thing they don't have to worry about is whether they can stay on their parents' insurance until they can find a job. That goes away with repeal.

Something I care deeply about is mental health. We have all worked together on opioids and substance abuse treatment. Because of what we did in health care reform, insurance companies cannot discriminate if it is mental health or substance abuse treatment rather than physical health treatment. Prior to what we passed, they could charge much higher copays, higher premiums, but not anymore. So the whole body-- above the neck as well as below the neck--is now being treated equally with our insurance reforms.

So there are a multitude of things--preventive health services with no copays, such as cancer screenings for mammograms and contraception. I was talking to someone who said she thought it was so wonderful that her drugstore wasn't charging her for copays anymore on her contraception. I said: Well, you know, that is actually the law. That was changed when we passed the Affordable Care Act.

So there is a whole range of things that relate to reviewing premium increases, if you get removed from your insurance, you have the right to appeal. There is a whole range of things. So that is under the first step. Everybody will feel it when insurance companies are back in charge and, through this vote and the subsequent actions, patient protections are repealed for everybody.

Secondly, this includes cuts in Medicare and Medicaid. Through what we did in health reform, we closed the gap on the high costs of prescription drugs. We called it the doughnut hole. That was in the process of being closed. If you have a lot of medicines and a lot of costs, you suddenly get to a point where there is a gap in coverage and you have to pay the full cost. That goes away and the doughnut hole comes back.

What we did added 12 years of solvency to the Medicare trust fund to keep it strong longer. That goes away. Wellness visits for seniors-- every year they are able to go in and get a physical without a copay-- that goes away. So Medicare is undermined. Then, unfortunately, when you add the incoming nominee as Secretary of Health and Human Services and couple that with the proposals that the Speaker has had and others that I am sure we are going to see to turn Medicare into a voucher--you go into the private market. Here is your voucher. Good luck. That is part of what the new regime is promoting, which only adds to this.

Eighty percent of Medicaid spending is seniors in nursing homes. And we know that the majority of those who--many who have gotten care, in addition to the exchanges, have been folks who have been working hard every single day in minimum wage jobs and who couldn't afford or find insurance before. Now they are covered if their State or their Governor is willing to do that. We have a whole bunch of folks who are working hard every day at minimum wage who at least know they have access to health care and a doctor.

Interestingly, this helps our hospitals, whether they are rural hospitals upstate or up north in Michigan or whether they are our great urban hospitals, safety net hospitals in Detroit and other areas, instead of people walking into the emergency room and not having insurance and having the cost put on everybody who does. Because of the Medicaid expansion, when a working person comes in with Medicaid, they are able to pay for their own care rather than having everybody else with insurance carry the brunt of that, which is the way it was prior to that.

So there are Medicare and Medicaid cuts.

Next, we do know that altogether, counting Medicaid and people using the new exchanges, we have about 30 million people who will be kicked off of their insurance, folks who, like anybody else, want to have health insurance for their families. Can we design that in a better way? I would love to work with you on that. I am not going to kick them off first. I don't want to say: We are going to rip your insurance away. We are going to rip the small businesses I have talked to--rip their insurance away. And then, by the way, don't worry, further down the road we will figure out something else. We don't know what it is, we don't know what it will cost, but trust me.

I wouldn't be trusting that would happen if I were counting on that for my insurance.

The fourth item is that there is no question that costs will go up by destabilizing the marketplace. We know the cost of prescription drugs will go up as a result of taking away the extra help for prescription drugs. There is no question that costs are going to go up for everybody else who has insurance.

When we look at this, I don't know how anybody looking at this outside of a political lens or a rigid ideological lens could say this makes any sense. It doesn't make any sense.

We have a President-elect who is coming in who said that he would not do anything to hurt Medicare or Medicaid or Social Security. Yet the first thing on the floor definitely undermines Medicare and Medicaid. We have a President-elect who said he wants to bring down the cost of prescription drugs. Yet, by undermining Medicare prescription drug coverage, those prices are going to go up. People who have the most medical needs and need the most medicine are going to see their costs go up.

What would be better would be if the new incoming HHS Secretary would be given the ability to negotiate through Medicare for prescription drugs--something we have all fought for, for a long time. Let's allow drug reimportation. Our leader on the budget--and I have as well--put seniors on buses in the past to demonstrate the differences in cost across the bridge between Windsor and Detroit, the cost of the same drug, with the very same safety provisions. That would bring down costs. Taking away Medicare coverage and increasing the gap in coverage is exactly the wrong thing to be doing if, in fact, the incoming President really means it when he says he wants to bring down drug prices.

So there are a number of things we care deeply about on health care. As someone who has worked on this for years--in fact, it was health care and health policy that first got me into politics, leading an effort to save a nursing home in my community. I care deeply about this. I am one of the folks way down deep in the weeds on this. But we don't improve a health system by ripping it out by its roots, by undermining the whole system without figuring out what comes next. That only happens if you really don't care what comes next because if you care, that is not a responsible position.

So, Mr. President, and my colleagues, I feel very strongly that with everything we know that has been made available to strengthen quality, to give people back their own decisionmaking instead of the insurance companies on basics like providing care for themselves and their families, the strengthening of Medicare and Medicaid, the coverage that has been made available, we know there is a way to work together to make things better, and this is not it.

I will be happy to.

Mr. President, I ask unanimous consent that the time be equally divided between the two sides during quorum calls.

I suggest the absence of a quorum.

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

Mr. President, I ask unanimous consent that for the duration of the Senate's consideration of S. Con.

Res. 3, the majority and Democratic managers of the concurrent resolution, while seated or standing at the managers' desks, be permitted to deliver floor remarks, retrieve, review, and edit documents, and send email and other data communications from text displayed on wireless personal digital assistant devices and tablet devices.

I further ask unanimous consent that the use of calculators be permitted on the floor during consideration of the budget resolution.

Mr. President, today we have a new Congress. Soon we will have a new President. For the first time in years, hardworking Americans will have their voices heard as we take the first steps to repair the Nation's broken health care system--steps to remove Washington from the equation and to put control back where it belongs-- with the patients, their families, and their doctors.

The President's health law has pushed insurance markets to the brink of collapse. Premiums for hardworking families are soaring, while patients' choices are dwindling. I urge my friends on the other side of the aisle to face the facts that ObamaCare has failed to deliver on its core promises and is hurting far more than it is helping.

I know our colleagues on the other side of the aisle share our goal of a robust health care system for hardworking families, and I truly hope they will work with us to find common ground that delivers more choices and lowers costs. I welcome the input from all the Nation's lawmakers as we endeavor to listen to the American people in this pursuit. But first, it is important to remember how we got here so that the actions that we will be taking this year are considered in proper context.

After the 2008 election, Democrats controlled the Presidency and had a majority in the House and a supermajority in the Senate. This allowed Senate Democrats in 2009 to pass a health care plan without any Republican support, which is exactly what they did. House Democrats had initially approved a health care reform bill with several important differences. So congressional Democrats needed to address these concerns in a conference committee. But plans to iron out the differences between the House and Senate versions were derailed in early 2010, when Democrats lost their filibuster-proof majority with the Massachusetts special election that resulted in placing Senator Scott Brown in the seat formerly held by the late Senator Ted Kennedy. He had held that seat since 1962.

With the filibuster-proof majority lost, Democrats in the House approved the Senate-passed health care bill without any Republican votes and sent it to the President, while vowing to use the budget reconciliation process to address their colleagues' concerns with the Senate legislation.

Subsequent budget reconciliation legislation was passed by Democrats and signed into law by President Obama. Combined with the initial health care bill, ObamaCare was created.

Now, I share this brief history of ObamaCare only as a reminder that, while my colleagues will surely complain about using the reconciliation process to untangle the country from this unworkable, unpopular, and unaffordable law, they should remember they actually employed the exact same procedure to secure the passage of ObamaCare.

Recent headlines show the ObamaCare problem is only getting worse and discourages people from seeking so-called coverage. Last October, at Bloomberg's The Year Ahead Summit in New York, the CEO of Aetna discussed the issues surrounding their decision not to participate in ObamaCare exchanges, saying:

As the rates rise, the healthier people pull out because

the out-of-pocket costs aren't worth it. . . . Young people

can do the math. Gas for the car, beer on Fridays and

Saturdays, health insurance.

Now, if you are young and healthy, ObamaCare has made it an easy choice to opt out of health coverage. But if you are not so fortunate-- for those who must have coverage--it quickly becomes a frightening reality. I have constituents in Wyoming who have written to me, with worry and concern about their surging health insurance premiums. I recently heard from a young woman who is experiencing the worst of this law. She said:

Dear Senator Enzi,

I am writing with concerns specifically in the way that our

country is heading in respect to healthcare services.

I am a 25 year old with no medical conditions, I rarely

need a doctor visit, however as I looked into the health

insurance for me and my 8 month old son, also without health

problems, I have found insurance to be incredibly expensive.

Based on the cost of our health care last year, which

included a C-section and the birth of our son, our family

would spend less on health care if we paid for medical

expenses out of pocket and did not have health insurance.

However, in order to obey the law this is not an option.

I have researched and calculated the most cost effective

health care option for our family. We are looking at paying

almost $800 a month for our insurance, even with my husband

receiving insurance through work. This is almost 1/3 of our

family's monthly income. . . . Insurance is becoming a huge

burden for our family.

Now, that is the reality for many of our constituents across the country. She is trying to do the right thing for her family's health, but the law is crippling them financially. Our answer must be to not ignore these problems. For many Americans caught up in ObamaCare's tangled and expensive web of regulations, the situation is grim and only getting worse by the day. It is time to act.

One of the most disturbing parts of this law is that Americans are now paying more in taxes to pay for the very health law that is driving up their insurance premiums. The law will saddle American households with $1 trillion--$1 trillion--in new taxes and penalties over the next 10 years, unless Congress acts. ObamaCare's crushing regulations mean smaller paychecks for families, while holding back small businesses from expanding and hiring new workers. For every American, ObamaCare has meant more government, more bureaucracy, and more rules and regulations, along with soaring health care costs--along with soaring health care costs.

It is time to lift the burdens and higher costs this law has placed on all Americans. The Senate is poised to pass a repeal resolution that will set the stage for true legislative relief from ObamaCare that Americans have long demanded, while ensuring a stable transition in which those with insurance will not lose access to health care coverage.

Let me repeat that. The Senate is poised to pass a repeal resolution that will set the stage for true legislative relief from ObamaCare that Americans have long demanded, while ensuring a stable transition in which those with insurance will not lose access to health care coverage. This will allow us to move step-by-step on a new set of reforms, listening carefully to the advice of the millions of Americans affected and to do our best to make sure that we proceed wisely and do no harm.

Fortunately, America now has a President committed to repealing ObamaCare and moving toward a system that offers more choices, lower costs, and more individual control for millions of hardworking Americans.

The American people have endured a lot under ObamaCare and its broken promises. As a Presidential candidate not so long ago, then-Senator Barack Obama, a Democrat from Illinois serving here, promised Americans they could keep their health plan if they liked it. Millions soon learned they couldn't, and others soon wouldn't. This is because ObamaCare has drastically reduced Americans' choice of health care plans through a Federal takeover of the insurance marketplace. In fact, the President's promise that ``if you like your plan, you can keep it'' has proven to be one of many unfulfilled and unattainable promises of ObamaCare.

In Wyoming, we have seen the real impact of ObamaCare on our health insurance market. Wyoming now only has one health insurer in the individual market, both on and off the ObamaCare exchange. Many States are experiencing a similar issue of having insurers leaving the exchanges entirely. So for Wyomingites, the Obama administration's talking points about ``choice'' were in the end just more empty promises.

Americans were also promised lower health care costs, but even the administration admits that ObamaCare is failing to address costs, with average premiums rising by 25 percent for silver-level plans on the Federal exchange. That is in 1 year. This means that families have to decide whether to purchase unaffordable insurance or to pay a fine. In most cases, they are literally paying more money for less control over their health care.

Health care costs in Wyoming continue to be among the highest in the Nation, with other States not far behind. ObamaCare's mandates and taxes on employer-sponsored health plans are not only leading to higher out-of-pocket expenses but also to fewer choices and fewer services for the 150 million Americans with employer-sponsored health benefits. Let me repeat that: The mandates and taxes on employer-sponsored health plans are not only leading to higher out-of-pocket expenses but to fewer choices and services for the 150 million Americans with employer- sponsored health benefits.

According to the nonpartisan Kaiser Family Foundation, individual employees who have job-based insurance have seen their out-of-pocket expenses climb by hundreds of dollars year after year. Employees working for small businesses now have deductibles of over $1,800 on average. Since ObamaCare became law, several large employers have stopped offering benefits to part-time employees altogether.

Over the past 50 years, our Nation has made great strides in improving the quality of life for all Americans, but these transformative changes are always forged in the spirit of bipartisan compromise and cooperation. These qualities are essential to the success and longevity of crucial programs such as Medicare and Medicaid.

This is a crucial time for health care in America. We do not have the luxury of ignoring the growing problems in the health insurance markets and the crushing premiums faced by families across our country. That is why we are doing this first. The failures of ObamaCare have metastasized since its passage.

We must act now to repeal ObamaCare and provide relief to the millions of Americans who have been harmed by this law. Relief will require a stable transition period, which ensures those with coverage today continue to have access to health care tomorrow. Unwinding this tangle of partisan gridlock to make meaningful changes will not be easy. Our goal is to create a health care system where Washington makes fewer decisions and families are empowered to control their own health care with more choices and lower costs.

This is where we find ourselves today. Congress and soon the new President will be in a position to begin the process of repealing ObamaCare. Passing this resolution is just the first step on a path to repair health care for millions of hard-working Americans whose experiences with ObamaCare have meant broken promises, higher costs, and fewer choices.

This is the budget resolution we are debating now. As far as the budget part of it, all this is, is a statement of where we are at the moment. This budget went into effect last October. It has been changed a few times in the meantime, and this is a reflection of the changes that have been made up to this point.

The difference is in title II, which is where the reconciliation can take place. You will notice that it is a very simple title. There is not much to it. It requires that the Committee on Finance of the Senate shall report changes in laws within its jurisdiction to reduce the deficit by not less than $1 billion for the period of fiscal years 2017 through 2026. The Committee on Health, Education, Labor, and Pensions will report changes in laws within its jurisdiction to reduce the deficit by not less than $1 billion for the period of fiscal years 2017 through 2026. There is no specificity in this as to how the reconciliation will take place. That is up to the Finance Committee and the Health, Education, Labor, and Pensions Committee on the Senate side and the Energy and Commerce Committee and the Committee on Ways and Means on the House side to come up with the reconciliation bill, which has to pass a lot of Senate rules in order to be done, but you will notice that there isn't any specificity in here on how to do that.

That comes later. That will be another budget debate we will have, but it sets the stage so that can be done. Hopefully, it will be done quickly and we will be able to find solutions for the hard-working Americans whose experiences with ObamaCare are broken promises, higher costs, fewer choices. I hope our Democratic colleagues will join us in this effort so that we can come up with solutions so that Americans can afford the insurance they want and need.

I remember when we started this debate, I think there were 30 million people uninsured. Today, I think there are 30 million people uninsured. It is a different 30 million, though: The 30 million who couldn't get insurance now have insurance, and 30 million people who had insurance now can't afford their insurance. It is time for us to take care of both 30 millions and not just one. We will have that opportunity if we pass this concurrent resolution to fix ObamaCare.

I yield the floor and reserve the remainder of my time.

Mr. President, I suggest the absence of a quorum, and I ask unanimous consent that the time be divided equally.

Mr. President, I ask unanimous consent that the time in the quorum call be equally divided between both sides.

Mr. President, there has been a flurry of activity this week with the beginning of the new year and the beginning of a new Congress--the 115th Congress--and we have a lot of work to do.

This election that we just went through on November 8 was surprising in many ways, gratifying in many ways. Personally, I think the best thing about it is that it gives us an opportunity to start anew, to deal with the problems that the American people were, frankly, not all that happy with either of the political parties about in terms of the solutions that we were to offer. I would hope that it would also give us an opportunity to hit the reset button when it comes to working together to try to find political consensus to solve some of these big problems.

I mentioned yesterday our friend, the chairman of the Budget Committee, and his 80-20 rule, which I told him I have used time and again to make the point that just because you disagree on some things doesn't mean you can't get

anything done. To the contrary, people of widely divergent ideological, philosophical, and political beliefs can work together by simply trying to find common ground. That is possible. That, in fact, is the way our Constitution created our government to force us to do that, because what we decide here impacts a lot of people--well over 300 million people in the United States alone. But if there was one consistent complaint that I heard from my constituents back in Texas and that we heard in the national media and beyond, it is about the failure of the promise of ObamaCare. We made a solemn commitment to the American people that if they provided us with the majority we needed to do it and if they provided us a President who would sign it, we would repeal ObamaCare and we would replace it with affordable health care that would be of their choosing, as opposed to a top-down mandate, a one- size-fits-all, which is the failure of ObamaCare.

In a previous life, I was attorney general of my State, the State of Texas. We had a huge division of trial lawyers called the consumer protection division. What we did is we sued people who committed consumer fraud--people who promised one thing but delivered another. I can't think of a bigger case of consumer fraud than ObamaCare, which was sold under false pretenses: If you like what you have, you can keep it. If you like your doctor, you can keep your doctor. If you are a family of four, your premiums will go down by an average of $2,500.

None of that has proven to be true.

The reason why ObamaCare is so unpopular is that people have seen their premiums skyrocket. People have seen their deductibles grow to the point where they are effectively self-insured, which is not having insurance at all. Many people have simply seen insurance companies pull out of the insurance market, leaving them with little or no choices in terms of where to buy their health care.

So many remember the PR campaign of the President and Democrats, with which they sold ObamaCare to the American people, and, as I said, promised better coverage, more choices, and lower prices.

That means now that ObamaCare has failed to deliver that. It is incumbent on us to try to repeal it, which we will do, and to replace it with more affordable coverage that people will choose and that fits their needs better. The bad news of ObamaCare picked up throughout last summer into the fall. As I mentioned, insurance companies were losing money and were unable to operate and deliver health care under the tight grip of ObamaCare. But the real losers weren't the insurance companies. It is the tens of thousands of Texans who were forced to find new insurance at higher prices--not insurance they would have chosen on their own, but which they were forced to accept because there was no alternative.

So instead of helping rural Texans--the Senator from Vermont talked about rural residents in his State--I would submit that for people living in rural areas across the country, the implementation of ObamaCare hurt most of our rural country by dwindling the number of choices to one health care option for the year. That sounds like the opposite of more choices and better coverage to me. But we can't forget that behind these numbers and headlines are real personal consequences for families across the country.

So today I want to provide just a snapshot of some of the thousands of letters that I received in my office about ObamaCare and the burdens that it is placing on the backs of the people I represent in Texas. One Texan wrote telling the story that I have heard time and again. She said her insurance plan was discontinued--so much for ``if you like what you have, you can keep it.'' But she did what she had to do, and she switched to a more expensive plan--one with a higher monthly payment and one with an $11,000 deductible. What good is health insurance if you have to spend $11,000 out of your own pocket before the insurance begins to kick in? It is nearly worthless.

Well, nothing about that says affordable health care. Unfortunately, this individual is like many folks across the country, full of questions and with nowhere to turn to find any relief for their families or their small business.

Another one of my constituents had a similar complaint. He wrote to me that he was searching for yet another health insurance plan for the third time in as many years after his was canceled. He went on to highlight this in this letter, which I received from a constituent on November 23, 2015. He said:

I seem to remember the President saying something about

liking your insurance and being able to keep it. For myself

and my family, it has been just the opposite. We loved our

insurance prior to the passage of the Act and since have been

forced to purchase much more expensive insurance with much

higher deductibles.

Well, this Texan is right, but unfortunately, his experience was not isolated. It was shared by millions of people across the country for whom ObamaCare was a false promise. It is not as if he had the freedom to choose. The choice was made for him, and this was the fundamental flaw of ObamaCare. In a country as big and diverse as ours, this notion of ``one-size-fits-all'' and that somehow the people who live and work inside the beltway are smarter than the rest of us and we can figure out what is good for them and a choice they would not themselves make is just simply implausible. It is not true. This constituent ended his letter by asking the Congress:

Do anything. Do anything within your power to reverse this

terrible health care trend. I need relief.

After this historic election, after the promises we made that have given us the opportunity to govern in the majority, with a President in the White House who will work with us, I believe we have a clear mandate to repeal this terrible law and make it a relic of the past. We will do that by adopting the budget resolution submitted by Chairman Enzi of the Budget Committee.

It is not just Republicans who have pointed out the defects of ObamaCare. Many of our Democratic colleagues have pointed out the law's failed promises as well--from an op-ed entitled ``How to fix the Affordable Health Care Act,'' which was written by a Democrat, to statements on the Senate floor, to legislation introduced to ``fix the glitch.'' Even in campaign ads, many of our Democratic colleagues have themselves been outspoken advocates for changing ObamaCare. The senior Senator from Missouri, pointing out the ``huge problem ObamaCare has been in her State'' came up with an entire list of necessary changes. I, for one, would be happy to start with her list and say let's try to use this as a core of issues that we can then try to build consensus around to begin to make that replacement and make it on a bipartisan basis.

We have seen that attempted fixes, unsupported by the Obama administration and vastly insufficient, continually have been met with frustration by Democrats and Republicans. I pointed out yesterday that when the Democrats voted through ObamaCare, they had 60 votes. They had 60 Senators. Today they have 48.

At one point, certainly back in 2009 and 2010 when ObamaCare passed, they had a majority in the House of Representatives. Well, they lost that. Now they have lost the White House itself. I just don't know how much longer, how much more needs to be said or done for them to get the message that this is not working because I believe they are paying a political price for it as people are searching for accountability for what they have to deal with day in and day out.

The senior Senator from Indiana said that he supported the Affordable Care Act to help working and middle-class families have access to health care, but he said that doesn't mean the law is perfect, and it doesn't mean we don't still have work to do.

I was delighted to hear the Senator from Vermont, Mr. Sanders, say he agrees ObamaCare is not perfect. My request of him and others is to work with us to try to replace it with something better.

I recognize that neither side is going to be able to get everything they want. That is just not the way this place works. Indeed, the single failure of the Obama administration is to try to do things on a go-it-alone basis because we are going to see those Executive orders that he issued unilaterally rescinded on the first day President-Elect Trump takes office. All the massive regulations that have been issued, we are going to use the Congressional

Review Act to rein those in or to defund those through the appropriations process. In order for legislation and policy to be sustainable, it is going to have to be bipartisan. I realize our Democratic colleagues are disappointed with the outcome of the election on November 8. That is an understatement. At first they started out in denial: It just can't be true. The next stage was met with anger. Well, they are angry about it, and they are going to obstruct everything the new majority, working with the White House, tries to do, but I would hope they would move past that denial and past that anger and do what the Senate was always designed to do; that is, to work on a bipartisan basis, as our friend and colleague from Wyoming demonstrated to us working on the Health, Education, Labor, and Pensions Committee with the liberal lion of the Senate, Teddy Kennedy. Let's try the 80-20 rule and see how it works. It will work.

The senior Senator from West Virginia, Mr. Manchin--this is another Democrat--has said he would vote to repeal ObamaCare. He said that we should be working together to identify which parts of the law are broken and need to be fixed. We may learn that some parts of the law can't be repaired and we should eliminate those parts entirely. This is our Democratic friend and colleague from West Virginia, Senator Manchin.

I think that is a great place to start because no matter which side of the aisle you sit on, you can see the Affordable Care Act is not working, certainly not as sold to the American people. The choice of the Democrats now is whether to obstruct or whether they will actually work with us, as we should have done in the first place, to come up with something more sustainable that would address costs and preserve individual choice.

It is interesting. It is not just our Democratic colleagues, many of whom voted for ObamaCare. I remember during the Presidential campaign that former President Bill Clinton made some pretty interesting comments. This would have been on October 5, 2016. I am reading from a CNN story here. It said:

Speaking at a Democratic rally in Flint, Michigan, the

former president ripped the Affordable Care Act (ACA) for

flooding the health care insurance market and causing

premiums to rise for middle-class Americans who do not

qualify for subsidies.

Here is what he said:

So you've got this crazy system where all of a sudden 25

million more people have health care and then the people who

are out there busting it, sometimes 60 hours a week, wind up

with their premiums doubled and their coverage cut in half.

It's the craziest thing in the world.

Former President Bill Clinton said that in Flint, MI, on October 5, 2016.

He is right, but that is what you get when you try to do things in a partisan, unilateral fashion. We should learn from our collective mistakes and try to do better, and shame on us if we can't do better than ObamaCare with all of its failed promises.

By repealing ObamaCare, Congress is doing more than just delivering on a promise we made to the people who put us here. We are providing a way forward for millions of people across the country who have been hurt by ObamaCare and are looking for relief.

I look forward to making ObamaCare and the many burdens it has placed on American families a thing of the past in this new year. That is what we will do when next week we pass this budget resolution, and then reconciliation instructions will be sent to the relevant Senate and House committees. They will then report back with the replacement, and, yes, it may take some time to transition into that replacement because it has taken us 6 years to get into the mess, into the ditch we find ourselves in now. When your truck or car is in the ditch, the first thing you need to do is get out of the ditch. Sometimes that takes a lot of hard work.

We are going to have to work as hard as we can. I would hope our colleagues will work with us, not just to resist for resistance's sake, not just to take a partisan position because they feel they are required to do so because of their allegiance to the policies of the Democratic Party. Let's do what this institution has always been best known for; that is, to try to find some way to work together on a step- by-step basis to produce reform which will make health care more affordable and still preserve those choices for individuals and their families, not a one-size-fits-all government mandate which simply has failed in this tragic experiment known as ObamaCare. We can and we will do better.

I yield the floor.

Mike Enzi, the Senator from Wyoming, is a friend of mine. He comes from a beautiful rural State--Wyoming. I come from a beautiful rural State--Vermont. That is probably the end of our commonality. We look at the world very differently, and I hope that in the course of this debate, the American people will see the very profound differences we have not only on health care, not only on tax policy, not only on the deficit, but on many other important issues.

What we are looking at right now is a budget process whose ultimate goal is to remove health insurance from tens of millions of Americans. Let's be clear. Today, the United States of America is the only major country on Earth that--I live 50 miles away from the Canadian border. Many of us have visited Europe. We are the only major country on Earth that does not guarantee health care to all people as a right. It is something I passionately believe in. I believe that health care for all is a human right. I had hoped we would work together to figure out what is a complicated issue as to how we can move forward to guarantee health care to all people in a cost-effective way, but that is not what we are debating today.

Let's be very clear. The Republican plan--their budget plan--lays the groundwork for ending the Affordable Care Act, which will remove tens of millions of Americans from the health insurance they get. There is nothing wrong with change. We can always improve.

I hope that during the course of this debate, my Republican friends who want to repeal the Affordable Care Act will come down and tell us what their plan is, how, in fact, they are going to provide quality, cost-effective health care to all Americans. Well, you know what. They all voted against the Affordable Care Act. Senator Enzi is right--we did not get one Republican to vote for it. They have had 8 years to think about how they are going to come up with a new plan, and I would hope but I do not expect one Republican to come to the floor and say: Oh yeah, we are going to throw 20, 30 million people out of their health insurance. This is our new plan. This is how we are going to provide health care to those people.

They have no ideas. Their theme is to repeal and then delay. Someday they are going to come up with a new plan. You don't destroy a house without having another house in which people can live. You don't throw 30 million people off of health care without having a plan to provide health care to those people.

Under the Republican proposal--something many Republicans have been talking about for years--they want to end Medicare as it presently exists, a program that is life-and-death for millions of seniors. They want to voucherize Medicare, give people a check, and then let them go to the private insurance market and get the best deal they can.

Imagine that you are an 85-year-old senior citizen who has been diagnosed with cancer and you get your check for whatever it may be. We don't know what it will be--$7,000, $8,000, $9,000.

You go to the insurance company and you say: I have $9,000. I am 85. I have been diagnosed with cancer. I want you to take care of me. Give me an insurance program that will take care of my medical needs, my hospital needs.

The insurance agent will laugh in your face because $9,000 or $8,000 will last you, at most, for 1 week.

That is their plan.

I have been all over the country, and right now the American people are outraged at the high cost of prescription drugs in this country-- let's be clear--because of the power of the pharmaceutical industry and their lobbying and their campaign contributions--a power that exists, by the way, not only influencing Republicans but too many Democrats as well. We pay the highest prices in the world for prescription drugs. In fact, one out of six Americans who goes to a doctor to get a prescription for an illness cannot even afford to fill the prescription. Yet, under the Republican proposal, if you eliminate the Affordable Care Act, the doughnut hole fix, which now helps seniors pay for their prescription drugs, will be eliminated and prescription drugs for seniors could rise by as much as 50 percent.

By the way, at a time when we have more income and wealth inequality than any other major country on Earth, when the very rich are getting richer while the middle class shrinks, the Republican proposal not only throws 20 to 30 million people off of health insurance, not only raises the price of prescription drugs for seniors, not only moves forward to privatize Medicare, but, shock of all shocks, our Republican colleagues want to give massive tax breaks to the top 2 percent.

Among many other negative impacts that the repeal of the Affordable Care Act will have will be one that will impact heavily rural States, such as Wyoming, Vermont, and other rural States around this country; that is, as a result of the repeal of the Affordable Care Act, rural hospitals could be forced to close their doors--not getting the funding they need--leaving millions of Americans with nowhere to turn for critical medical care.

I look forward to this debate. Nobody here thinks the Affordable Care Act is perfect. Nobody believes that at all. The goal is how we repair it, how we improve it, how we expand health care to more Americans, how we end what has been the case for decades in this country--that we pay, by far, the highest prices in the world per capita for health care. Maybe we should understand that we are the only major country in the world that allows private insurance companies to profit off of people's illness.

The proposal being brought forth by the Republicans is not only poorly thought out, it really is not popular. It is not what the American people want. Go to your hometowns and ask people--at a time when the top one-tenth of 1 percent owns almost as much wealth as the bottom 90 percent, when the top 1 percent is earning 52 percent of all new income, go out and ask your constituents whether we should give huge tax breaks to the top 2 percent, and they don't think that is a good idea.

According to a poll released this month by POLITICO and Morning Consult, 80 percent of the American people think the Federal Government should be spending more money on Medicare. Only 10 percent think we should be spending less. Seventy-one percent of the American people think we should be spending more on Medicaid.

So 84 percent of the American people think the Federal Government should be spending more on Social Security. In other words, the proposal we are seeing from the Republicans today is way, way out of touch from where the American people are.

There is another issue out there that I find extremely interesting. Senator Enzi mentioned--and, of course, he is right--that within a couple of weeks we are going to have a new President. Donald Trump will be inaugurated as President, and it is interesting that we listened to what Donald Trump said during the campaign. The Democrats heard what he had to say during the campaign, what he campaigned on, and more importantly, Republicans, listened and heard what their leader had to say about these issues. This is what Donald Trump said, and he didn't say it once in the middle of the night. He didn't say it in an interview. This was a central part of his campaign. This is what he asked millions of elderly people and working-class people to vote for him on. These are the principles that Donald Trump ran and won the Presidency on. On May 7, 2015, Donald Trump tweeted: ``I was the first and only potential GOP candidate to state there will be no cuts to social security, Medicare and Medicaid.'' On April 8, 2015, Mr. Trump said: ``Every Republican wants to do a big number on Social Security.'' That is not Bernie Sanders talking; that is Donald Trump talking.

They want to do it on Medicare, they want to do it on

Medicaid and we can't do it. It is not fair to the people

that have been paying in for years.

That is not Bernie Sanders--Donald Trump, our soon-to-be President.

On March 29, 2016, Mr. Trump said:

You know, Paul [Ryan]--

Paul Ryan is the Republican Speaker of the House--

wants to knock out Social Security, knock it down, way down.

He wants to knock Medicare way down and frankly . . . you're

going to lose the election if you're going to do that. I am

not going to cut it, and I am not going to raise ages and I

am not going to do all of the things they want to do, but

they want to really cut it and they want to cut it very

substantially, the Republicans, and I am going to do that.''

What Mr. Trump said was exactly right. Here are the ``they.'' This is the day. They want to cut Social Security. They want to cut Medicare. They want to cut Medicaid. Mr. Trump was right, and millions of people voted for him on the belief that he would keep his word.

Well, it seems to me that Mr. Trump right now has to do one of two things. No. 1, if all that he was talking about was campaign rhetoric, then what he is obliged to do now is to tell the American people: I was lying. Yes, I said that I would not support cuts to Social Security, Medicare, and Medicaid, but I was lying. It was a campaign ruse. I just said what came to my mind to get votes. I have no intention of keeping my word. If that is what he believes, if that is what the case was, let him come forward and say that. But if that is not what the case is, if he was sincere, then I would hope that tomorrow or maybe today he could send out a tweet and tell his Republican colleagues to stop wasting their time and all of our time and for Mr. Trump to tell the American people that he will veto any proposal that cuts Medicare, that cuts Medicaid, and that cuts Social Security. What we are talking about right now--let us be clear: no debate. That is exactly what this goal is. That is what this budget proposal is. It is to move toward the voucherization and privatization of Medicare, to make massive cuts in Medicaid and throw millions of people off health insurance.

So there is a lot of responsibility on Mr. Trump's shoulders, but I would hope that he could save us a whole lot of time by telling the American people that he was sincere in what he said during the campaign, that he was not lying. If that is the case, we can end this discussion, get into the serious business of how we create a quality health care system guaranteeing health care to all people in a cost- effective way.

With that, I yield the floor.

Will my colleague from Michigan yield for a moment?

I want to thank my colleague for her very thoughtful presentation talking about the implications of simply repealing ObamaCare.

The assumption that many of my colleagues seem to start from is that before ObamaCare, the health care system was great in America, that everybody had health care in a cost-effective way and then ObamaCare came along and all of these problems arose.

What the Senator from Michigan just told us--and I want people to remember it--8 years ago, if you were diagnosed with cancer and you walked into an insurance company, they would say: Why would we give you insurance? We will lose money on you. Your cancer may recur.

You are a woman and you want maternity coverage? What do you think is going on? Why should we do that?

You are a family with a kid who is 21 years of age and you want his insurance on your policy? Well, you couldn't have it.

I think what the Senator from Michigan pointed out is not that anyone thinks the Affordable Care Act is perfect--nobody thinks it doesn't need improvement. But to simply throw out all of the benefits, for 30 million people to be thrown off of health insurance--during the budget hearings a couple of years ago that Senator Enzi chaired, I asked a question of my colleagues when this idea came up, and I would ask it again to my good friend from Wyoming. What are the studies you have seen in terms of the number of people who will die when they lose their health insurance? How many thousands of people will die because they no longer have health insurance and they cannot go to the doctor and the hospital? The studies I have seen suggest that many thousands of people will die. That is common sense. If you throw 30 million people off of health insurance, they are going to die. How do you go forward providing a death penalty to thousands of people without having any solution to it?

Further, I would add to the excellent points made by the Senator from Michigan. Senator Enzi and the Senator from Texas before him talked about the impact of health care problems in rural areas. I come from a rural area. Michigan has large parts of the State that are rural. The Senators from rural areas on the Republican side have said they want to make sure their constituents in rural areas can see a doctor. That is certainly a modest proposal. Of course they should be able to see a doctor.

If that is the case, my Republican friends should understand what the Federation of American Hospitals and the American Hospital Association said about repealing the Affordable Care Act. These are major hospital organizations. According to a very recent report, what they said is that a repeal of the Affordable Care Act will mean a reduction in payments to rural hospitals of over $165 billion over a 10-year period. According to the hospital associations, rural hospitals will suffer an additional loss of $289 billion from their inflation updates.

This is a report from the Federation of American Hospitals and the American Hospital Association, major health care institutions in America. They said in their report: ``This reversal of health coverage would represent an unprecedented public health crisis.'' Furthermore, they said: ``The magnitude of reductions would threaten hospitals' ability to serve patients.''

So when we talk about the needs of rural Americans, I would hope my colleagues listen to what the Federation of American Hospitals and the American Hospital Association have to say.

With that, I yield the floor.