Floor Statements

Mr. President, before addressing the topic that I want to take up--and I know it is one that is near and dear to the Presiding Officer's heart--which is rural healthcare, I want to express my admiration and thanks to Senator Reed, the Senator from Rhode Island, and Senator McCain for their incredible leadership of the Armed Services Committee. They show us what it is like to lead. They show us what it is like to take on difficult issues and to work out difficult problems, and I would like to express my appreciation to them for that.

I see the Senator----

Absolutely.

I thank the Senator.

I say to Senator Reed, I appreciate your leadership.

Mr. President, I did a mathematic calculation a couple of years ago, and it resulted in an interesting conclusion. The Senate is a rural body. Eighteen Members of the U.S. Senate represent a majority of Americans. That means 82 percent--or 82 out of 100 Senators-- represent smaller States, more rural communities.

Today, I want to talk about a disastrous development that is headed for our rural communities that we have the capability to fix, and it is one we should fix sooner rather than later. I am talking about Federal funding for federally qualified health centers, which expired on October 1. Seventy percent of the funding for the FQHCs expired on October 1. One hundred percent of the National Health Service Corps funding expired on October 1.

These are vital programs that serve rural America and provide incredibly important healthcare services. They are an overlooked part of our national healthcare system, in part because they are traditionally in rural and outback locations.

In Maine, we have 20 centers and 70 facilities scattered all over our State, and they are providing services every day to over 200,000 people. This is a vital part of our healthcare system. Yet the funding expired at the end of September, and so far nothing has been done.

How important is it? In Maine, there are 1,700 employees at these facilities; a total economic impact of over $300 million a year; $8 million in State and local tax revenue and $32 million in Federal tax revenue. They provide $16 million worth of uncompensated care that goes to Maine people who need the help. They are efficient. In Maine, they have saved Medicaid over $100 million, and $257 million is the estimate for what they have saved the overall healthcare system. Again, FQHCs provide 1,700 jobs and support another 1,000 jobs in their communities.

But this isn't only about economics and economic development and jobs; it is about healthcare. One in six people in Maine gets their healthcare from FQHCs--210,000 people. They accept everybody who comes to their door. I have been to them all over the State. They use a sliding-fee scale for people who are low income, who don't have insurance, and they provide all manner of services. It depends on the center; different centers have different services. They have medical, behavioral health, dental, substance abuse treatment and support, case management, optometry, podiatry, OB/GYN, prescription assistance, outreach and enrollment, pharmacy, radiology, and school-based healthcare services. These are the healthcare providers for rural America. And it is not only Maine; it is across the country. There are 10,000 sites across the United States. Some 26 million patients are at risk.

Well, what is the big deal? The big deal is that people are going to lose their healthcare services. We estimate that in Maine, we are going to lose about 400 clinicians and administrative and support staff who will have to be laid off at the beginning of the year unless we solve this problem in the immediate future. At least 25 of these sites will be forced to close, and we believe there will be almost 30,000 Maine residents who will lose access to their healthcare system.

Most of the FQHCs--federally qualified health centers--are getting by on their funding from last year, so the expiration of the funding hasn't hit them yet, but it will begin to hit them on January 1. That is what we have to respond to.

It is also already having an effect just by creating uncertainty. I got an

impassioned letter from the leader of one of our centers in Maine about the fact that they have been very diligently recruiting a dentist to come to their community. Dentists are very hard to come by in rural America. They had one who was ready to come, and then suddenly they heard about the uncertainty surrounding the funding--that it may or may not come through--and that dentist is now reconsidering their decision to go to this Maine community. That is a tragedy. That is a tragedy for the people of that town, where these services are literally not available.

So what does it matter? It matters because we are talking about people losing their healthcare services.

This has never been a partisan issue. I don't think there is a heck of a lot of debate around here about the importance of FQHCs and that we need to get them refunded. In fact, the Presiding Officer and Senator Stabenow have sponsored a bill, the CHIME Act, that would resolve this issue. We just need to get it on the floor and get it done.

We have proved today by the passage of the National Defense Authorization Act that we can take major issues, bring them to the floor, and move them forward, especially those that aren't particularly controversial. But my concern is that even though there doesn't seem to be controversy, it is just not happening, and now our centers are having to make plans for layoffs, for closures, and for closing their doors to the people who need the care.

This is something we can do. This is something we can resolve. It is within our power. The legislation is ready to go, and we should get this done.

We are leaving today for the Thanksgiving holiday, but if we leave at the end of the year and haven't done this, it will be a tragedy for rural America. It will be a betrayal of rural America. It will be a betrayal of our constituents.

All of us have been to these centers and seen the care that they provide, the caring that they provide, the passion that the people bring to the services in their communities, and how much they mean to their communities. This is one of the best Federal programs ever created, and it has always been supported on a bipartisan basis.

I urge my colleagues today to prepare ourselves to get this done as soon as we possibly can when we get back after Thanksgiving. We have so much to be thankful for, and I want my people in Maine to realize that they can be thankful for those health centers that are literally lifelines in their communities and mean so much to them. I believe this is something we can and should and will do.

Thank you, Mr. President, and thank you for being a leader on this issue.

I yield the floor.

I suggest the absence of a quorum.

Mr. President, I would like to recognize the efforts of the many organizations that have agreed to come together to establish a single continuum of care for the State of Maine. Continuums of Care are supported by the U.S. Department of Housing and Urban Development to promote a communitywide commitment to the goal of ending homelessness. They are a vital partner in the works to quickly rehouse homeless individuals and families to minimize trauma and dislocation; promote access to and effective use of mainstream programs; and optimize self- sufficiency among individuals and families experiencing homelessness. Continuums of Care make important decisions about priorities for Federal funding of programs that provide significant services.

Prior to establishing this single continuum of care for Maine, there were three separate entities that existed: the City of Portland, Greater Penobscot, which was centered on Bangor, and everything else fell under the ``Balance of State'' Continuum. While receiving funding to operate a continuum of care funding requires a competitive application process, these three groups have consistently worked closely together and coordinated their means. In 2012, the Greater Penobscot Continuum and ``Balance of State'' merged together to create the Maine Continuum of Care. Then, in 2017, the Portland Continuum consolidated with the Maine Continuum--achieving a single continuum of care--an effort that greatly advanced the level of collaboration among the member agencies and has proven to be an important step in streamlining efforts and assuring available resources are meeting the needs of those who become homeless. The merger of the two continuums has resulted in more accurate collection and management of data about the extent and characteristics of homelessness in Maine.

A single continuum of care has achieved efficiencies in administrating the responsibilities delegated by the Federal Government to meet the challenge of ending homelessness in Maine. As a unit, they identify the homeless service priorities and distribute resources accordingly. The organizations and agencies that participate in continuum of care include: Maine's network of 37 emergency shelters serving the entire State; MaineHousing and the Department of Health and Human Services; homeless youth providers; veterans groups; mental health and substance abuse service providers; supportive housing developers; local governments and public housing authorities; and homeless advocacy organizations. In addition to providing housing and services, the members of the Maine Continuum of Care play a major role in several other statewide initiatives, including participating in the data collection and entry for the annual homeless assessment report AHAR, and new system performance measure reports.

This significant merger was a collaborative endeavor involving Maine's homeless provider organizations, social service providers, and State and Federal agencies. I especially want to thank the leadership and guidance provided by MaineHousing, the State's housing authority, and the chairs of Maine's continuums throughout the merger process. I am honored to recognize all who were involved and to thank them for placing the individuals and families who are struggling to meet this basic human need for a warm, safe, and stable home at the center of our collective efforts to end homelessness in the State of Maine.

Mr. President, I don't wish to take much of the Senate's time, but I want to emphasize and echo the comments made by the Senator from Tennessee. He and his ranking member, Patty Murray of Washington, have done a magnificent job. What I want to emphasize is not necessarily the content of the bill, which he has outlined expertly, but the process by which this bill has come to the U.S. Senate. To me, it is an example of how this place can and should work.

There were a series of essentially four all-day hearings. There were workshops to which all Senators were invited, and I think at least half of the Senate attended several of those workshops. We had a bipartisan witness list. We had Governors. We had insurance commissioners. We had experts on the health services industry from around the country. The result was a piece of negotiated, compromised but thoroughly worked through, and important legislation that can do exactly what the Senator from Tennessee outlined: Lower premiums, end the chaos in the individual market, save the Federal Government money over the period of the next 10 or 20 years, and really make a difference for the people of Maine.

I particularly want to compliment and express my appreciation to Senator Alexander and Senator Rounds for the work they have done to bring the issue to this point. I deeply hope, as the Senator from Tennessee, Mr. Alexander, just said, that when the President returns from his trip, he will see this bipartisan agreement--or in my case, a nonpartisan agreement--that has come forward to solve some serious problems. It doesn't solve all the problems, but it is a step forward. It also is exactly what the American people want us to do--to talk to each other, listen to each other, gather the data and the information, and come up with legislative proposals that make common sense and will make a better place, a better healthcare system, and serve our citizens and our people across the country in a better way than the current arrangement.

Again, I want to compliment my colleague from Tennessee and also my colleague from South Dakota, Senator Rounds, for the work they have done on this. We are at a place where we can really do something good, not only substantively but also by showing the Nation how this body can and should work.

I yield the floor.

Mr. President, today we remember the life of Bernard ``Bernie'' Shaw, who passed away earlier this year at the age of 88. As a lifelong resident of Maine, a wonderful husband and father to three, and a champion for agriculture, future generations will continue to remember Bernie by the lasting impact he has left on the State.

Originally from Limestone, Bernie attend the Limestone schools and later the University of Maine. It was after this that he met his beloved wife, Norma. In over 65 years of marriage, Bernie and Norma raised three children--Steve, Susan, and Sara--all while running a successful family farm and giving back to their community in numerous ways.

Bernie first began farming with Norma's father, Herman Ward, and eventually took over the family business, before moving to Augusta in 1987. From 1988 to 1994, Bernie served the State of Maine as the commissioner of agriculture. Over the years, he served on local, State, and national level agriculture committees, drawing from his own experience as a former Aroostook County potato farmer. Only a few out of the many groups he championed for, Bernie devoted his time to the Maine Potato Council, the Maine Potato Board, the Agricultural Bargaining Council, and the Land For Maine's Future Board.

After retiring, Bernie devoted much of his time to volunteering at the Augusta Food Bank, and the Windsor Fair. He was honored for this commitment back in 2012, when he received the Agriculture Commissioner's Distinguished Service Award, along with his wife, Norma. Both were lauded for their weekly efforts with the food bank and their success in expanding the number of families able to be helped.

Bernie Shaw represented in so many ways the values we hold dear in Maine: family, faith, community, service, and tradition. We have much to be thankful for in Maine because of Bernie's dedication and service to the State, and he will be deeply missed by many.

Mr. President, today I wish to recognize the significance of Maine Veterans Cemetery-Caribou and the individual and community spirit of generosity that sustains it as an honored and hallowed resting place for our Nation's veterans.

Conceived in 1998, the Maine Veterans Cemetery in Caribou was created because of a small but determined grassroots effort in Aroostook County, ME, that I was proud to support when I was Governor of Maine and am proud today to acknowledge as Senator for Maine. A diverse team of dedicated people came together to create the Northern Maine Veterans Cemetery Corporation, NMVCC, comprised of members from various veteran service organizations, community members, and veterans themselves who knew the significance of this undertaking. Since the first concept many hands have helped develop and beautify these 46 acres which provide inground burial for 12,000 and columbarium wall niches for over 1,000 more of our honorably discharged veterans. But this cemetery represents so much more than a final resting place.

It is fitting to include in this statement the name of John T. Noble, the distinguished veteran who epitomizes the efforts behind this cemetery. John would not want all the credit to go to him, and indeed there were many who worked tirelessly to make their dream come to fruition; however, it was the late John T. Noble, along with his wife Joyce, who made the first significant and lasting donation of 33 acres of his family's land to honor veterans and their families for their service and sacrifice. They went on to donate even more land and provide countless donations to ensure this cemetery was one to be proud of. John lived by example as a person of great ethics, compassion, and generosity. He possessed these traits throughout his life as a member of the U.S. Armed Forces, a businessman, a husband, and a quiet philanthropist who didn't seek recognition for his good works. His motivations were never about himself but about how he could give back to others.

Our veterans risk their lives in the service to our great Nation. They make countless personal sacrifices to protect freedom, and many go on to continue to find ways to serve others--like the honorable efforts of a small community in northern Maine to turn what once was farmland into a reverent final resting place for those who gave so much. It is my honor to recognize the Maine Veterans Memorial Cemetery-Caribou and to pay tribute to John and Joyce Noble. Due to the generosity they demonstrated, the northern region of Maine is able to provide a proper final resting place for our brave veterans.

Mr. President, today I wish to honor the 40th anniversary of the Maine Coalition to End Domestic Violence, MCEDV, and its nine member organizations and resource centers: Hope and Justice Project, Partners for Peace, Next Step, New Hope for Women, Family Violence Project, Safe Voices, Family Crisis Services, Caring Unlimited, and Immigrant Resource Center of Maine. I am humbled and thankful for their tireless service to end the cycle of abuse existing in too many homes across Maine, our Nation, and the world.

Originally formed in 1977 as the Maine Coalition for Family Crisis Services, and renamed the Maine Coalition to End Domestic Violence in 2001, the MCEDV has spent four decades being advocates for victims of domestic violence and have never lost their focus. Their efforts have helped countless people find their own voices and regain their strength to live a violence-free life. The MCEDV has helped ensure there are direct service programs, shelters, transitional housing, and court advocacy available to everyone throughout our State. Not only do they partner with the nine member-projects mentioned above, but they also coordinate efforts and give voice to the education of the public, lawmakers, law enforcement, friends, and neighbors to make domestic violence a community-State-national and global issue that each of us has a responsibility to confront.

It is not possible to put words to the significant impact the MCEDV has had, the lives that have been saved, and terrifying existences turned into futures of peace. However, it would not be fair to their work to not acknowledge the lives that have been lost to domestic violence. All genders, all ages, all

races, all socio-economics categories, domestic violence knows no boundaries, and fear continues to be a strong silencer. However, with the support and services provided by the MCEDV and its membership, many victims have found exceptional strength to tell their story, found their courage to name the abuse and the abuser and support others to shine a light on this pandemic of violence.

I cannot overstate how awe-inspiring the exceptional staying power and determination of this coalition of advocates is and how impactful their efforts are. They have not only mobilized a state-wide interest in the topic of domestic violence but have also inspired people to work with them to even further strengthen the message that there is no excuse for domestic abuse. It has been said that peace in the world starts with peace in the home. Thank you to the MCEDV for living those words and helping to change the world for the better.

Madam President, today we remember Richard Dudman, who passed away this August in Blue Hill, ME, at the age of 99. Throughout his long and illustrious career as a journalist, Richard was never one to turn away from a good story, even if chasing it meant putting himself in danger.

After college, Richard served his country in the Merchant Marine and the Navy before becoming a reporter for the Denver Post. In 1954, he moved to Washington, DC, to work for the St. Louis Port-Dispatch's Washington bureau. In this position, he would cover the assassination of John F. Kennedy and the Watergate Scandal, as well as war and revolution all over the world.

Richard will perhaps be most remembered for the time he spent in Cambodia as a prisoner of the Viet Cong. He and his colleagues were mistaken for CIA operatives and were kept captive for 40 long days. Towards the end of their captivity, once it had become clear that the journalists were not, in fact, working for the CIA, their captors began to refer to them not as prisoners of war, but as ``travelers who lost their

way.'' It was this experience that inspired Richard to write the well- received ``Forty Days with the Enemy.''

Even after retiring, Richard did not stop reporting. In fact, on his last day at the Post-Dispatch in 1981 Richard raced out of his own retirement party to cover the attempted assassination of Ronald Reagan. From his home in Ellsworth, ME, Richard continued to contribute to the Post-Dispatch and wrote editorials for the Bangor Daily News until 2012.

In retirement, Richard and Helen, his wife of 69 years, were active and constructive members of the Maine community. Ellsworth City councilor Gary Fortier, a friend of the couple, described them as ``true givers,'' saying that ``Ellsworth is a much better place because they have been part of it.'' Richard and Helen received the Golden Eagle Award from the Boy Scouts of America in 2014 in recognition of their outstanding community service.

Richard's dedication to covering the news, regardless of how far from home it occurred, won him the prestigious George Polk Award in Journalism in 1993. In 2014, in recognition of that same dedication, Richard was inducted into the Maine Press Association Hall of Fame. I am pleased to be just one of many to remember and praise the many achievements of Richard's career. The State of Maine was incredibly lucky to have him for the time that we did. He will be deeply missed.

Mr. President, I rise not in opposition to the amendment but to compliment the Senator for bringing this issue forward. I intend to support the amendment, but I just want to make the point that this is a broader issue in that we are going to have to address the child and dependent tax credit.

One of issues is making it refundable so the tax credit is available and useful to lower income families, who are the hardest hit by high child care costs, and also making it available to those families who use these funds to care for perhaps an aged relative or an injured relative.

I agree with the amendment, and I support it, but I think we need to make the point that there is more work to be done. I have introduced a bill with Senator Heller, Senator Burr, and Senator Collins on this subject, and I look forward to bringing that forward for consideration at an appropriate moment.

I urge support for Senator Rubio's amendment.

Mr. President, I listened with interest to the comments of the Senator from Pennsylvania, and as always he was articulate and thoughtful and made a strong case.

I would like to speak to the issue we are going to be addressing over the next few days, the next few weeks, and probably the next few months, not necessarily to be unalterably opposed but to talk about how we can get where we all want to be, which is lower taxes, higher growth, and a stronger U.S. economy.

I think it is important to emphasize at the beginning, just so we all know, what we are talking about the next couple days isn't the budget. As the Senator from Pennsylvania noted, it is really a vehicle for a massive tax cut.

My problem with the tax cut is not necessarily that we are going to have

one, but the question is, How is it structured? Who gets the benefits? How to pay for it?

As the Senator pointed out, we still don't know what the plan is. We have an outline; we have principles; we have bullet points; we have lists, but we don't have a plan. Therefore, it is difficult to analyze.

We do have some particulars that have been released. You don't need to be an economist to understand that if the rate for the lowest taxpayers is being increased and the rate for the highest taxpayers is being decreased, that the overall effect will be loaded toward those at the upper income level.

The only analysis we have from the tax policy foundation, an outside nonpartisan group, is that under the plan, as it has been described by the White House and by Members of Congress, about 80 percent of the benefits of this proposal go to the top 1 percent of wage earners in this country. Eighty percent of the benefits go to the top 1 percent.

It may be that as the details of the plan are more well known and more thoroughly described, we will find it is slightly different than that. One of the things that really bothers me about this budget resolution we are going to be voting on is, it explicitly waives a longtime budget rule that before you can vote on issues such as this, there must be a Congressional Budget Office score 28 hours prior to the vote. It waives that provision. That is not a good sign. That doesn't reassure me that we are going to have a clear idea of what we are voting on.

When you combine the cuts proposed to Medicare and Medicaid, which go into paying for these massive tax cuts, it looks to me like the biggest losers in this whole process will be seniors.

When you look at what we know about the structure of the tax cuts and the fact that there is a one-half trillion-dollar cut in Medicare projected over 10 years and a $1.5 trillion cut in Medicaid, seniors are going to take the most serious hit. Why do I say that? Well, we all know Medicare specifically applies to seniors, so that is pretty easy. If you are cutting Medicare, you are hitting seniors.

Secondly, though, what a lot of people don't realize about Medicaid is that 70 percent of the nursing home beds in America are paid for by Medicaid. By definition, who is in those beds? Seniors. When you cut Medicare and Medicaid, you are going to be impacting seniors.

The provisions of the tax plan, as we know it--and I keep emphasizing ``as we know it'' because we are voting on something today to clear the path for a major tax cut, and we don't know what it is, but it appears it will impact seniors disproportionately.

I want to touch on a couple of other points. One is the argument that the cuts to Medicaid and Medicare aren't really cuts; they are just reductions in growth. Well, that argument applies if you are talking about the NASA budget, for example. If the NASA budget is projected to grow 5 percent a year, and we cut it to 4 percent a year, that is a reduction in growth; that we are going to do one less trip into space or whatever the policy outcome of that cut is.

Medicare and Medicaid are different, however. They have to pay costs in the real world as they come up when necessary. The increased growth that is projected in those two programs is based upon two unalterable facts. One is demographics.

We are getting older, and that means more work, more demands on the medical system. It also is based on medical inflation, which everyone knows in recent years has proven to be higher than the ordinary rate of inflation. This is the best projection we have, but if you project that the current level of medical costs today, 8 years from now or 10 years from now are going to cost what they cost today, plus medical inflation, plus the impact of demographics, people getting older, that is a real cost. If you cut that, fewer people are going to get services. Rural hospitals will close. There will be undeniable impacts on both the economy of our rural regions of the country and real people.

This argument that cuts to Medicare and Medicaid are just a cut in growth--it is not really a cut--is just not true. That may be true in some areas, but it is not true here because these are real costs that are going to be incurred. If the costs go up and fewer dollars are there to meet them, somebody is going to get hurt. These are real cuts to real people.

The other thing I want to touch on is the deficit and debt. I have to say, I am sort of puzzled by this whole process because as I have been here over the past 5 years and as I have lived my life over the past 25 years, the majority party in the Senate has been focused on the debt and on the deficit and the dangers of the debt to our country, to our economy, and how bad it was that we were mortgaging our children's future, and all of a sudden it is no big deal. All of a sudden it is OK to knowingly, consciously, deliberately talk about a $1.5 trillion increase in the debt over the next 10 years. That assumes, by the way, that the cuts to Medicare and Medicaid take place and that other cuts that are in the budget, exemptions and deductions, take place. It could be that the effect on the debt and the deficit will be much greater.

I remember 2 or 3 years ago, when we were in a recession and people were trying to get jobs and we had millions of people unemployed, there was a motion to extend unemployment benefits for 6 months. I can't remember the cost. I think it was $5 or $6 billion. Oh, no, point of order. We can't do that. It will increase the deficit. We are talking about $1.5 trillion that we know of, but that is OK. That is OK.

I think we need to understand this. What this really is, if we pass unfunded tax cuts, they aren't really tax cuts. They are simply a deferral of the tax from us to our kids. We don't have to pay the tax, but the money to be spent is still going to be spent, so the hole gets deeper. We borrow that money, and our kids and our grandchildren are going to have to pay it back with interest. That is called shift and shaft. That is not a tax cut. We are just shifting the tax and shafting our kids. It is as if on your deathbed you call your children over and say: I have some final words for you. The kid leans over, and you say: Here is my credit card bill. I had a wonderful trip to Acapulco. I hope you don't mind paying for it. That is what we are doing. We are indulging ourselves and stealing from the next generation because we are not willing to pay the costs of the programs we all support and think are important.

I think there is another fact that needs to be realized. As we build up this deficit and debt, eventually the bill is going to come due, and because we have used up all of our resources, the only place to go to cut them is going to be Social Security and Medicare because the discretionary budget is essentially going to be all gone.

It is really simple to make the interest rate calculation. We now owe $20 trillion. Seventy-seven percent of our annual GDP we owe. The interest rate calculation is simple: 1 percent, $200 billion a year.

I think it is more a question of when than if. When interest rates return to a more normal level of 5 percent, that is $1 trillion a year in interest, just interest. That happens to be very close to the entire discretionary budget of the U.S. Government--$1.1 trillion--this year, defense and nondefense. We will be paying almost as much in interest as the entire discretionary budget. How are we going to manage that situation? The only way it can be managed is to start talking about Social Security and Medicare.

So this is a long-distance, slow-motion diminution of the value of those programs that are so important to so many Americans, particularly senior Americans.

The final point I wish to touch on relates to the Senator from Pennsylvania basically predicting: Don't worry, these tax cuts will pay for themselves. I have been hearing that all my adult life; I have never seen it work. It didn't work in the middle of the last decade during the Bush tax cuts. All those tax cuts were going to pay for themselves: Don't worry, the stimulus of economic growth will be such that there will be more income, more revenues, and we will, in fact, as the Senator said, reduce the deficit.

The problem is there is no evidence that it has ever worked in the history of mankind. The best economic research I have seen says that maybe the economic growth will offset about 20 percent of the cost of the tax cuts, but 80 percent is going to go straight to the debt. So to make the assumption that

somehow this is all going to pay for itself, I believe, is irresponsible.

I have a modest suggestion for those who are making that argument. Will my colleagues accept a friendly amendment which says that if the growth does not occur, then the taxes--or certain taxes--are automatically retriggered in order to fill the gap? If my colleagues are right, that will never need to happen, but if you are not right, that will protect our kids. I think that is a reasonable solution. I don't think it is going to happen. Why? Because it hasn't happened. It hasn't happened in Kansas. It hasn't happened here. I have never seen it happen.

I have looked at the economic research and, as near as I can tell, there is no data that indicates an automatic correlation between tax cuts and economic growth. I suspect there are tax cuts that can stimulate economic growth; it depends on where they are and what they are. But there is no evidence that is the case regarding tax cuts in general.

So those of our membership who believe this rosy scenario--the temptress, rosy scenario--is going to occur, fine. But if it doesn't, let's put language in the whole tax program which says that insofar as the growth does not occur as projected, the deficit will be maintained at no worse than current levels by automatically triggering tax increases to fill the gap. Then we are being honest. Then we are being honest to the next generation.

I believe there are important areas where tax cuts are necessary in order to make us more competitive, in order to help to grow our economy. However, I don't think what I have heard so far is the answer, and there are many problems with what has been described. I am willing to hold my fire and see what the Finance Committee comes up with and see whether, as the Senator from Pennsylvania said, it will be an open and bipartisan process, with amendments. If that is the case, we, I think, could come up with, on a bipartisan basis, a reasonable tax change--tax cuts, tax reform--that will strengthen our economy without adding to the deficit and without requiring massive cuts to programs such as Medicaid and Medicare that are so important to millions of Americans. It can be done right.

In 1986, it was done right. That was true tax reform. That was the last time we did tax reform. And I think it is very interesting that over the last several months, the language that describes what we are about to do has migrated from ``tax reform'' to ``tax cuts.'' Tax reform means you change the Tax Code, get rid of the inefficiencies, simplify it, take away some exemptions and deductions, lower rates, but we end up revenue neutral and we have a stronger economic base from which to proceed. Tax cuts simply add to the deficit or are based upon unrealistic and, indeed, cruel cuts to people in the future.

I think we have an opportunity to do this right. I think there is more consensus here than perhaps people realize on the question of doing tax reform in a way that will benefit the entire country. I don't think the Members on this side of the aisle are categorically opposed to tax cuts under any circumstances.

When I was the Governor of Maine, we cut taxes--I can't remember, 10 or 15 times--overall by about 15 percent. We cut the income tax. We cut the sales tax. We cut the property tax. So it can be done. That was done on a bipartisan basis with a legislature that went back and forth between Republican and Democratic control. They had this sort of strange Independent Governor, but we made it work. It can be done, and it can be done on a bipartisan basis.

It certainly looks as though this is about to be railroaded. It is about to be shoved down our throats without adequate analysis and without fully understanding it. I deeply hope that is not the case. I hope we learned something from healthcare, that we can do good things when we work together. When we don't, it rarely ends well.

So I understand that the votes are probably there to pass this budget, but the real question will come: What happens next? What does the plan look like? How responsible is it? What kind of assumptions is it based on? What kind of analysis do the Joint Taxation Committee and the Congressional Budget Office provide us on a nonpartisan basis as to what it will really do? Then we can have a real debate. Then we can talk about what is best for America. I think, between the group of us who work here and down the hall, we can find a good solution. But if the solution is thrust upon us, if it is ill-conceived, if it is skewed toward the wealthy, if it balances the budget on the backs of seniors, on Medicare, and Medicaid recipients, if it is based upon unrealistic assumptions about growth, then we are going to harm our country, not help it.

Eventually, if we keep going down the road we are traveling in terms of the national debt, the piper will have to be paid. It may not have to be paid by our generation, but it is going to have to be paid by these young people and by their peers all across America. I don't think that is right. That is not the legacy I came here to leave to my children and grandchildren.

Thank you, Mr. President. I look forward to working with my colleagues to find a path forward that is responsible and responsive to the needs of the American people.

I yield the floor.

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

Mr. President, I rise today to talk about a subject that has been on our minds in recent weeks and months and, in fact, years; that is, healthcare--one of the most complex and confusing but important topics that we have to consider.

Before I get into the bulk of what I want to address, I want to make the point once again that as we are debating healthcare and debating who pays, how much they pay, whether it is the ACA or Medicare or Medicaid or private insurance or private pay, we also

have to begin a serious discussion about the underlying cost of healthcare.

Regardless of who is paying, it is going to break us. If healthcare continues to grow in cost as it has over the last 20 years, it is going to eat the Federal budget, family budgets, individual budgets, and it is going to be something we absolutely have to address. Usually around here we don't address something until it is a crisis.

I would argue, as we are approaching 20 percent of GDP, with $1 out of every $5 in the country being committed to healthcare costs--more than twice as much as most other countries in the world, far more than any other country in the world--we have to address this issue.

Arguing about who pays is not going to solve the problem. That is important because in the interim, that is what is going to protect our citizens' coverage and what is going to protect our citizens from a healthcare disaster, a healthcare crisis.

I want to preface my remarks with--I think this is something we all need to be thinking about--how do we move beyond the discussion we are having now, not that it is unimportant, but we also need to move beyond the discussion and start talking about the underlying cost and why is it that Americans are paying virtually twice as much as anyone in the world for healthcare per capita--or as a percent of GDP or however you want to calculate it--without noticeably better results? In fact, most worldwide studies indicate the results of our healthcare system are not as good as those in many other countries.

It would be one thing if we were paying a lot of money and getting absolutely superior care across the board in our country, but that is not the case. In measurements such as infant mortality, longevity-- standard basic healthcare indicators--we are not doing very well. Yet we are paying twice as much. There is something wrong with that, and we have to address it.

I want to talk about the Affordable Care Act. I want to start with the point that it is the law of the land. It is the law of the land.

I am rising today in sadness but also in anger because there is a lot of talk about the Affordable Care Act collapsing, imploding. It is not collapsing. It is being mugged. It is being stabbed in the back. It is being sabotaged deliberately and consciously by the actions of the administration.

I want to emphasize that this isn't about ideology. It is not about politics. It is not about who wins and who loses or which party is up or who voted or who didn't. This is about people. It is about people in Maine. It is about people, many of whom got care for the first time under the Affordable Care Act; lobstermen, small farmers, small businesspeople, individuals finally had a shot at reasonably priced healthcare.

It is not perfect by any means. I would never argue that. In fact, I have been working on proposals since the day I got here on how to improve it, how to fix some of the problems, how to make it better, how to have the effects be less intense on some parts of our economy. It is the law of the land. The impacts of what we do here or don't do here fall on real people--real people, in my case, in my home State of Maine.

The Affordable Care Act is not collapsing; it is being sabotaged. Here is a partial list.

In January, during the period of the last open enrollment, one of the first acts of the new administration was to cut the advertising on television, advising people that they had this healthcare option. Cut the ads, that is No. 1. That was in January.

Then they announced they were going to minimize the enforcement of the personal mandate. If you tell somebody you are not going to enforce something, that is an invitation to not abide by it, to not pay any attention to it. People can argue about whether that is desirable, but that is the law. To announce that administratively you are not going to enforce it, again, what does that do? It reduces the number of people who are going to get healthcare. That, in turn, undermines the individual market, and that, in turn, makes it less financially viable. That is a deliberate act that will undermine the viability of this law.

In April, there began a series of what turned into seven different threats from various people in the administration to not make the legally mandated CSR payments--the cost-sharing reduction payments-- which are not bailouts to insurance companies but which were designed as part of the law to hold the rates down and to hold the deductibles down for those people buying coverage under the Affordable Care Act. Continuously threatening the reduction or the elimination of these payments has created an uncertainty in the marketplace that is now coming home to roost.

Just last week, Anthem announced they are leaving the Maine marketplace. They cited a number of reasons, but one of the chief reasons was the uncertainty created by whether these payments are going to be made.

Recently, the HELP committee had a series of hearings on this subject. They had a bipartisan group of Governors. They had a bipartisan group of insurance commissioners, health experts from across the country. I was at all but one of those hearings. I believe I am right in saying it was unanimous that we must ensure the continuation of the CSR payments in order to stabilize the market and reduce premiums projected to increase this coming year.

The number nationally is estimated to be about 20 percent--a 20- percent increase attributable to the failure to ensure that the CSR payments will be made because an insurance company, if they are setting rates, has to factor into their rates the risk of these payments not being made. The testimony is--it depends somewhat on the State, but roughly a 20-percent increase is attributable to just this fact.

If we could pass legislation here--unfortunately, we missed the deadline, but we may be able to work on that because the deadline was just last week. But if we could simply ensure those payments are made, that in itself would lower rates by 20 percent next year on a silver plan.

By the way, if those CSRs aren't made and the rates go up, ironically, that means the mandatory payments of subsidies to individuals under the Affordable Care Act will also go up. So it will cost the Treasury money--additional money not accounted for, roughly $200 billion over the next 10 years.

What else has gone on? In May, there was another one from the head of the Office of Management and Budget. The administration has not decided whether to pay the CSRs. That is a big red signal to the insurance companies: You can't count on this, so you better raise rates. In May, the budget was released. In the budget, there were drastic cuts in the call centers for the Affordable Care Act, in the in-person assistance, and in marketing. And just for good measure, they announced they were cutting the enrollment period in half, from 3 months to 6 weeks. What possible reason can there be to do that, except that you want fewer people to sign up? That is called sabotage--reducing from 3 months to 6 weeks.

Then, all along, the Health and Human Services Department has been monkeying around with the website, taking down explanatory material about the Affordable Care Act, taking down material indicating why this would be a good deal for people and, instead, putting up critical material.

On August 31, the administration announced reductions in outreach of 90 percent and cuts in assistance to people trying to navigate this system by 40 percent. This is complicated material. Any of us who have signed up for insurance--we all have the Affordable Care Act. Most people don't know that. But we had to go on the website and choose a policy for ourselves. It is hard, it is complicated, and to take away the people who are in the communities helping people work through these various decisions and weigh the different policies, the deductibles, and how to compare them is the same as taking away the coverage. It is an act of sabotage.

The most recent one I just learned about this morning. This is amazing. The Affordable Care Act is based on a website, healthcare.gov. We all know it had terrible problems when it started. There is no excuse for that. I was critical of it at the time. Those were problems that were not intentional.

Now intentional problems are being created. This is the one that really gets me. I just learned this morning that every Sunday during the bobtail enrollment period, the 6-week enrollment period, the website is going to be closed

for 12 hours for maintenance. Isn't that amazing? For 12 hours on the one day of the week when many working people are going to have an opportunity to try to understand this system and enroll, they are going to be down from midnight Saturday night until noon on Sunday, the middle of the day on Sunday.

I want to go back to the beginning. This isn't about ideology. This is about seeing that the laws are faithfully executed. That is why they call it the administration. The administration is supposed to administer the laws, not unadminister them.

We are talking about people. Why does anyone want to have fewer people with insurance? I am at a loss to understand the motivation. I can understand if you don't like the ACA. If you don't like the ACA, let's work together and find ways to improve it and change it, but figure out how to keep people with health insurance.

The uninsured rate in America has fallen 50 percent because of the Affordable Care Act. That is an enormous achievement. It is one that should be celebrated, not sabotaged. That is what is so puzzling to me about this: fewer people with coverage and higher costs to the Treasury.

We can do better than this. These are all things the administration in good faith can say: OK, we don't like the ACA, but we are going to move beyond the politics of this and try to help people get the coverage they desperately need.

This is about real people's lives. This is about lifting the threat, the cloud of a healthcare disaster, both physically and financially, from families across America. We are talking about millions of families--not tens of thousands but millions of families. I don't get why we are deliberately trying to undermine and sabotage something that is so meaningful to so many people. As one can tell, it makes me angry. Mostly, it makes me sad because I know people in Maine who have benefited, who have gotten coverage, who did not have it before and who will not have it if this is taken away--people who need those navigators to help them, people who need to be able to use the website on a Sunday morning, people who need to have rates that are lower because the CSRs have been funded, and we are not continuously raising the uncertainty of that piece of this law.

We can do better. This is about the health of our people. I cannot think of anything more important. We can have different ways of getting there, but right now we have a law that is in place, and until we change it--and we should change it; we should fix it--we should administer it straight up, straightforwardly, as it was written and as it was intended. This is too important for politics, and it is too important for ideology. This is all about people and their health.

Thank you.

I yield the floor.

Mr. President, today I wish to honor the service of an extraordinary individual in northern Maine. Mr. Stephen M. Farnham, of Mapleton, has been a driving force behind the Aroostook Area Agency on Aging. Steve began with the Aroostook agency in its infancy in the mid-1970s and is stepping down after having led the agency for the last 40 years.

Steve attended the University of Maine in Presque Isle, where he earned his bachelor of arts and went on to earn his master of public administration degree from the University of Maine in Orono. He also received a number of certificates and attended specialized courses that helped him continuously improve services and collaboration at the agency. While serving as an adjunct professor, he taught courses at public and private institutions in Maine, as well as health and safety courses with the American Red Cross. He also held many different positions with the Katahdin Area Council of the Boy Scouts of America, for which he has been recognized with multiple awards.

As chief executive officer of the not-for-profit corporation Aroostook Area

Agency on Aging, Steve oversaw its expansion to 140 employees, an annual budget of $3.4 million, and the responsibility for a congregate housing project which the agency developed, owned, and managed. His professional appointments and boards on which he served insured that the State of Maine, as well as the Nation, were able to capitalize on his expertise on aging related policies. These ranged from being a delegate to the White House Conference on Aging three times, serving with the Federal Council on Aging, and helping incorporate, lead, and direct the Aroostook Regional Transportation System.

In addition to the entities already mentioned, Steve also served his hometown on the budget committee and has received a number of meritorious awards, including the Presque Isle Area Chamber of Commerce Citizen of the Year Award, the Maine State Bar Association John Ballou Distinguished Service Award, and was named a Rotary International Paul Harris Fellow. Despite all the very public recognition for a job well done at work and beyond, the most telling recognition is the strength of the programs and the high praise by clients and collaborators. Steve is universally respected, well-loved, and will be greatly missed, but the solid structure that he put in place and strengthened over the years will stand. I thank Steve both for his work at the helm of the Area Agency on Aging and his work serving communities across Aroostook County.

Mr. President, first I want to join the Democratic leader in his comments about the devastation of these hurricanes. This has been truly a malign visitation on our country over the last several weeks. Florida, Texas, the Virgin Islands, and Puerto Rico have really suffered and are suffering. I know that the administration is working hard on this, and I commend them for the efforts that they have made.

I think that now much of our attention is turning to Puerto Rico and the Virgin Islands in order to mitigate what is really a humanitarian disaster. One difference between those islands and Florida and Texas is the fact that they are islands. It is harder to get there. It is harder to get aid there. I understand that just this morning the San Juan airport was open for the first time, and it has opened in a limited way.

So this is clearly a responsibility that we have as Senators, as Members of Congress, and as Americans to reach out to our neighbors in a situation such as this. When a crisis hits, it often calls forth the best of America, and I believe that is happening right now.

Opioid Epidemic

Mr. President, I want to talk about a different kind of hurricane, a slow-motion hurricane. It is a slow-motion hurricane that is sweeping our entire country, not just the Southeast. It is sweeping through our small towns, our cities, our families, and our schools. It is taking lives on a scale that is unprecedented and almost unthinkable.

I am talking about the hurricane epidemic of opioid abuse and overdose deaths. Many of us this week are watching with rapt attention Ken Burns' magnificent study of the Vietnam war. We are losing more people per year to overdose deaths than were lost in the entire Vietnam war. That is one way to think about the magnitude of this catastrophe that is striking our country. The problem is that it strikes

here and there. It strikes a family here and a family there, a community here and a community there, but it doesn't strike all in one place. So it is not so apparent.

If we were losing a small city in America of 63,000 people once a year, we would be turning ourselves inside out to solve the problem that was causing those deaths, and 63,000 people were killed last year through overdose deaths. It was almost 400 in my State of Maine. That is more than one a day. All indications are that it is increasing--one a day. Now, 63,000 is about 7 people an hour--24 hours a day, 365 days a year--who are succumbing to this plague. That is the right term for it. It is a medieval plague that is afflicting people all over our country.

Lives are lost, families torn apart, and our communities compromised. It is a huge cost. I hesitate to talk about things like dollars when you are also talking about lives, but it is a cost in both ways. Not only are lives being lost and families being torn apart, but the estimates are that it costs our society something over $400 billion a year in everything from medical costs and criminal justice costs to lost economic and lost productivity in our society and our economy.

But I am here today because all hope is not lost. Contrary to what some people hear--and you hear sometimes that this is hopeless and that there isn't anything we can do about it--there is ample evidence that treatment can work. This is not a death sentence. Opioid abuse is terrible, and from talking to people who have suffered from it, it literally changes your brain, and it becomes almost impossible to escape. But it can be escaped. The reason we know that is that there is data from across the country, but the reason I know that is because of my friends in Maine--Andrew, Matt, and Chris.

These are people whom I know, with whom I have interacted, and with whom I have sat down. Andrew is a guy who is at the University of Southern Maine. He was trapped in the throes of addiction. He went through treatment, and now he is in recovery. Indeed, there are 25 million people in this country who are in recovery, and they will tell you that they will always be in recovery because they can never shake this disease, whether it is alcohol or the really destructive one that we are focusing on right now, which is opioids.

Andrew has made a new life. He is at school. He is at the University of Southern Maine. He has helped form a student-centered community to help people who are in recovery or who are working on getting there.

Matthew is a young man who, in 2009, again was trapped by this horrible scourge. Now he is hoping to go to medical school.

Chris is a guy who sat in my office. He worked in the White House. He was in it up to his neck and above. He had criminal justice problems. He was in jail. He was convicted. But now he is a member of the Maine State Bar Association. He got himself through school, and he got himself through law school.

There was an important moment that I think all of us should think about when we think about people who are in this situation. When he went to apply to law school, the people at the law school said: Well, we don't know if we can take you because you have this record.

His question, which was brilliant and indicates to me that he is going to be a pretty good lawyer, was this: What was my sentence when I was convicted? The response was 3 years. He said: You are putting me in for life. If you don't let me move forward with my life, you are making that a life sentence, not a 3-year sentence. He was accepted to law school. He graduated, and this year he passed and was accepted in the Maine State Bar Association. He is making a contribution to his community.

Treatment can work. It doesn't always work the first time. Anybody that has been through this, whether it is alcohol or even quitting smoking or anything else, will tell you that it doesn't work the first time necessarily. Sometimes it does, and sometimes it doesn't. Sometimes it will take multiple trips through the recovery and treatment process, but it can work. We know it can work. I have 25 million reasons to tell you that it can work and 3 that I know.

I am going to be introducing a resolution later today--I hope the Senate can take it up and pass it--designating next month as National Recovery Month, honoring and recognizing the people who are in recovery. So if it works, what is the problem? Why is this hurricane still sweeping our country? Why does 2017 look like it is going to be worse than 2016?

Well, the sad truth is that, out of all of those millions of people who are addicted, who are stuck, who are trapped, only 1 in 10 has access to treatment--only 1 in 10. Now, what do we have to do to deal with this problem? Of course, it is like most other problems. There is no single answer. It involves law enforcement. It involves interdiction, and let me pause for a moment on interdiction. The Presiding Officer and I are both on the Armed Services Committee, and we have heard testimony in our committee that we only have the Coast Guard and Navy resources to interdict one-fourth of the drug shipments that we know of coming up from South and Central America by sea. In other words, we have intelligence where we know of 100 boats, and we can only stop 25. There is no excuse for that. So, yes, law enforcement, at the source or along the way in our States, is an absolutely essential part of this process, but it is not the whole answer. We also have to work on prevention.

Frankly, I have been talking to groups around Maine and around the country on this. We are all still trying to figure out how to make prevention work. What will work? I haven't yet heard a really strong answer to that question. I guess it varies from person to person, but prevention has to be part of it. Treatment can work, but if only 1 in 10 people have treatment available to them or have access to treatment, that means 9 are sentenced to life and maybe to death.

Last year, a year and a half ago, we passed CARA, the Comprehensive Addiction Recovery Act. It is a great bill, with lots of good things in it, but no money. That is like sending the fire department to the fire and saying: Fight that fire, but we are not going to give you any water. We know this costs money, and it is something we have to commit to. It has to be part of it.

Whatever we do around here about healthcare and about budgets, we have to realize we are losing our people, and these aren't bad people. These aren't people over there. I sat at a roundtable in a small town in South Paris, ME. Next to me was a deputy sheriff. He lost his daughter. These aren't strangers. These are often middle-class people. These are people whose kids or sometimes parents--this is not age specific--are caught up in this scourge.

I guess I want to leave us today with two points. One is, treatment works. The second is, we need more of it. If we know something works, but only 1 in 10 people have access to it, shame on us for not remedying that situation. To me, the most tragic case--and I have talked to people in Maine about this--the saddest moment, the most tragic case is when someone who is in the throes of opioid abuse is ready to ask for help and they have to be put on a waiting list. That is tragic and inexcusable. It is hard to get to that point. It is hard to admit that you are trapped and that you are no longer in control of your life. Once you are willing to do that and say, ``I need help,'' then it is up to us to be sure the help is there. That is what we are talking about today.

So this is a different kind of hurricane, but it is a hurricane, nonetheless, that is destroying our families, destroying our communities, and wrecking the lives of our friends, but it is no act of God. We can't stop the winds of Maria or Irma, but we can mitigate the effects, ameliorate the effects, soften the effects. That is exactly what we need to do for those who are victims of the hurricane of opioids that is sweeping our country.

I hope and believe we will respond to this challenge as we have at other times in our history, and, indeed, as we are this week to the hurricanes of the Caribbean. I want to respond also to the hurricane that is sweeping America that we can, indeed, ameliorate, mitigate, and soften.

Thank you, Mr. President.

I yield the floor.

I suggest the absence of a quorum.

Mr. President, today we remember the life of Alan Hutchinson, who passed away earlier this year at the age of 70. As a beloved family man, veteran, author, and tireless environmental advocate, Alan dedicated his life to preserving Maine's most precious land, water, and wildlife. Future generations of Americans will enjoy all that the Maine outdoors has to offer thanks in part to Alan's dedication to conservation.

Originally from Rhode Island, Alan first came to Maine as a student at the University of Maine at Orono, where he earned his bachelor and master's degrees in wildlife management. During the Vietnam war, he served his country as a biological research aid at Walter Reed Medical Hospital in Washington, DC. Upon returning to Maine, he began an illustrious career in environmental conservation, as a civil servant and leader of one of the largest land trusts of the United States, the Forest Society of Maine.

In his career as a civil servant, he led the acquisition and conservation of 250 coastal islands and headed Maine's newly formed Endangered Species Group. With leadership, patience, and perseverance, he worked with diverse partners to protect our coast and wildlife. In 1997, Alan became the first executive director of the Forest Society of Maine, FSM. During his tenure, the FSM grew from a one-person operation into a national leader in forestland conservation, helping to conserve over 1 million acres of forestland. Just as he did leading the Endangered Species Group, Alan achieved this success by bringing together diverse groups under a common purpose of protecting our forests. His notable conservation achievements include the 20,000-acre Nicatous Lake easement, protecting 6 miles of the beautiful Moosehead Lake shore, the 329,000-acre West Branch Project, and the unprecedented 360,000-acre Moosehead Region conservation easement.

In addition to his conservation work, Alan also authored two books, ``Just Loons: A Wildlife Watcher's Guide,'' 1998, and ``Just Eagles: A Wildlife Watchers Guide,'' 2000. These books reflect his passion for Maine's outdoors that embodied his life's work. Alan will be remembered for his thoughtful leadership, dedication, and passion. Above all that, nothing exceeded his deep love for his family and his devotion to his friends. Alan will be sorely missed by all, and we owe him an enormous debt of gratitude.