Floor Statements

Mr. President, I ask unanimous consent that the Senate proceed to the consideration of S. Res. 78, submitted earlier today.

Mr. President, I ask unanimous consent that the resolution be agreed to and the motion to reconsider be considered made and laid upon the table with no intervening action or debate.

Mr. President, as if in executive session, I ask unanimous consent that the Senate consider the following nominations: all nominations on the Secretary's desk in the Air Force, Army, Marine Corps, Navy; that the nominations be considered en bloc; that the motions to reconsider be considered made and laid upon the table with no intervening action or debate; that no further motions be in order to any of the nominations; and that the President be immediately notified of the Senate's actions.

Mr. President, I ask unanimous consent that when the Senate completes its business today, it stand adjourned to convene for pro forma sessions with no business being conducted on the following dates and times: Friday, February 17, at 10 a.m.; Tuesday, February 21, at 11 a.m.; Thursday, February 23, at 9:30 a.m.; further, that when the Senate adjourns on Thursday, February 23, it next convene at 3 p.m. on Monday, February 27; that following the prayer and pledge, the morning hour be deemed expired, the Journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, and Senator Lankford be recognized to deliver Washington's Farewell Address, as provided under the previous order; that following his remarks, morning business be closed and the Senate proceed to executive session to resume consideration of the Walker nomination; and that the cloture motion filed during today's session ripen at 5:30 p.m.

Mr. President, if there is no further business to come before the Senate, I ask unanimous consent that it stand adjourned under the previous order, following the remarks of Senator Murphy.

I ask for the yeas and nays.

Mr. President, I rise today to honor the lives lost during the tragic earthquake that shook southern Turkey and northwestern Syria and to reaffirm the American commitment to provide assistance to recover from this disaster. In the early morning hours of February 6, a magnitude 7.8 earthquake, one of the strongest quakes in the region's history, struck near the city of Gaziantep, causing the deaths of thousands of innocent individuals and wreaking disaster and destruction on many communities that were already struggling from the effects of war.

I am devastated by the growing loss of life and injuries in Turkey and Syria. As of today, the earthquake has left more than 20,000 dead in Turkey and Syria and over 50,000 injured. Rescue missions continue to search for scores more that remain missing. In this great time of sadness for their countries, the United States will stand in humanitarian solidarity to provide relief, recovery, and efforts to build back even stronger.

Within hours, the U.S. Agency for International Development activated a Disaster Assistance Response Team--DART--to lead the U.S. Government's humanitarian response to the disaster. The DART is working closely with Turkish authorities on the frontlines and will continue provide search and rescue support and identify priority humanitarian needs in the days to come.

Globally, the outpouring of support in resources and rescue workers has been encouraging. The White Helmets, a volunteer organization that has assisted in the rescue of the many civilians suffering from attacks by the Syrian regime, has sprung into action. The internationally renowned group is currently working around the clock and has sent out over 300 search and rescue teams--several times their normal operating capacity.

Over 20 NATO allies and partners have provided more than 1,400 emergency response personnel, including firefighters, engineers, search-and-rescue and medical teams. I am heartened by the generosity of individuals, countries, and organizations, which include the Catholic Relief Services--CRS--a humanitarian agency based in Baltimore, MD. CRS is supporting emergency relief efforts by local partners in Turkey and Syria, including partner organizations Caritas Turkey, Caritas Syria, and Caritas Anatolia.

Today, we honor those lost and injured in this week's disaster. We will continue to provide rescue support, and send our thoughts and prayers to the people of Turkey and Syria.

Mr. President, I ask unanimous consent that the following be printed in the Record.

Mr. President, I ask unanimous consent that the Senate be in a period of morning business, with Senators permitted to speak therein for up to 10 minutes each.

Mr. President, I take this time to celebrate the success of the Affordable Care Act. We just completed the open enrollment period for 2023. Over 16 million Americans signed up for health coverage under the Affordable Care Act. That is about a 100-percent increase from the first year's enrollment in 2014. In less than 10 years, we have doubled the number of enrollees under the Affordable Care Act.

It has contributed to a substantial reduction in the number of uninsured, which, in and of itself, is an important goal in healthcare. Uninsured individuals have less ability to access quality

care in this country. That is something we all need to be concerned about and do our best to make sure everyone has access to healthcare.

But they also contribute to what is known as cost-shifting, and it causes a dislocation of healthcare facilities in the proper locations in our community. It also makes our healthcare system less efficient. If an individual does not have coverage for preventive healthcare and diseases are discovered later, it makes it more expensive and less likely a successful result.

We all can celebrate the numbers but recognize we also are taking a big bite out of the uninsured medical population in this country. My numbers in Maryland are very impressive: 180,000 Marylanders enrolled in our State insurance exchange under the Affordable Care Act. That is, by the way, for minorities, a 9-percent increase in the Hispanic population and a 3-percent increase in the Black population. We are committed to eliminating health disparities in America.

There are many provisions in the Affordable Care Act. I want to mention one I am particularly proud of because I had something to do with its creation, and that is elevating the National Institutes of Health with the National Institute on Minority Health and Health Disparities. We made it a full Institute under NIH. We set up an office for minority health within the Health and Human Services Agencies. We did this so there would be a focus on dealing with the systemic challenges we have to medical care in this country. And the research that is being done by the National Institute on Minority Health and Health Disparities is cutting edge on reasons why we have disparities in this country, and it is leading to corrective action being taken.

I will just give you one example: NIH UNITE Program, which deals with incentives to create a more diversified workforce in healthcare, which is critically important to access, as well as to make sure that clinical trials include all of our population so that the results are meaningful for all communities in America.

The results that we have been able to move forward in bridging the disparities for access to healthcare in America, all this has been done under the Affordable Care Act.

But we didn't stop there. We recognized we had to improve the Affordable Care Act. I am very proud of the leadership of President Biden and the Democrats in our initiatives under the American Rescue Plan and the Inflation Reduction Act. We enhance the subsidies to make it affordable for all Americans to be able to purchase their insurance through the health exchanges. We made that a commitment so every American could have access to affordable, quality healthcare.

We need to make those enhancements permanent so we still have work to do. I want to thank our colleague Senator Shaheen for her leadership in legislation, which I strongly support, that would make the enhancements in the subsidies under the Affordable Care Act permanent so that we can keep having these impressive numbers of Americans enrolling in health insurance.

Americans are benefiting from the Affordable Care Act, not just in having comprehensive, affordable insurance coverage but also the quality of that coverage. No longer do they have to worry about exclusions for preexisting conditions. It wasn't too long ago that just about everyone in this country was concerned as to whether their insurance coverage would cover their entire healthcare needs because they had a prior episode sometime in their life. Women were concerned whether childbirth was a preexisting condition. Well, we eliminated that fear with the Affordable Care Act in that insurance companies cannot exclude coverage or limit coverage based upon preexisting conditions.

And as you recall, the leading cause of bankruptcy in America was unpaid medical bills. But under the Affordable Care Act, we eliminated lifetime and yearly caps on the coverage that you have--again, helping American families deal with their healthcare needs.

There is still more to be done. I want to acknowledge that. We need to do some things.

I want to say, first, that I was pleased that under the Inflation Reduction Act, we were able to reduce the cost of prescription drugs. Insulin, starting last month--January--was limited to $35 a month. That was a game changer for millions of Americans to know they have an affordable supply of insulin to deal with their needs. That has already taken effect. And included in the Inflation Reduction Act will be a cap on Part D out-of-pocket expenses of no more than $2,000 a year. So we are also capping today the unlimited exposures seniors had on prescription medicines.

I must tell you, we passed legislation--as I think everybody here is aware of--under the Inflation Reduction Act, to start, by 2026, doing something that most Americans would be shocked that we are not doing today: negotiate prices with the pharmaceutical industry, using our market share to bring down the cost of medicines so American consumers are not gouged compared to the international marketplace. Starting in 2026, we will have negotiated the price, starting with the 10 most expensive drugs in this country.

I want to mention an area where I think we need to do more. I have been very much engaged in oral healthcare. Most people know that when I came to the Senate in 2006, a year later, Deamonte Driver, a youngster in Prince George's County, lost his life because he couldn't get access to oral healthcare. I made that a crusade with my former colleague, the late Elijah Cummings, in trying to do something about that. I am pleased that both the Affordable Care Act and the Children's Health Insurance Program require coverage for pediatric dental care. That is a step in the right direction, but we haven't completed the needs that are out there.

If you neglect your oral healthcare, you are likely to be neglecting your general healthcare. It is an area where we can prevent a lot of illness and problems. Most dental problems are preventable if you have access to dental care.

I have introduced legislation that would remove any annual or lifetime limit on oral healthcare under the Children's Health Insurance Program, the CHIP program. I want to thank Senator Stabenow for joining me in this effort. To me, this is something that is very consistent with the Affordable Care Act, and I hope that we will be able to get that passed.

But we also have to expand coverage. Medicaid coverage for dental care is primarily determined by the States, and many States limit coverage to emergency dental care, which means people, many families, can't afford their normal checkups for the adults who are in the family. We must do better as a nation. We need to expand Medicaid to cover oral healthcare. And for the 37 million seniors who are on Medicare, many cannot afford their dental annual visits. We need to expand Medicare to cover dental care as well. I want to thank my friend Senator Sanders for his leadership, also, on that particular issue. The bottom line: Let us all work together so that we can achieve the goal of the Affordable Care Act. We have achieved a great deal to date by the passage of that bill, but we still need to do more to make sure healthcare is a right and not a privilege and that every American has access to affordable, quality care. Working together, we can achieve that goal.

I suggest the absence of a quorum.

Madam President, I rise today, on the eve of the second anniversary of the military coup in Burma, to introduce a resolution marking the occasion--and the terrible 2 years that the people of Burma have had to suffer since then. I am proud to introduce this resolution today alongside my colleagues Senators Young, Merkley, and Collins.

The resolution condemns the illegitimate Burmese military coup and calls for an immediate return to democratic governance grounded in respect for civil liberties. Demonstrating our support for the Burmese people is more important than ever, as the human rights situation in Burma threatens to deteriorate even further.

Tomorrow marks 2 years since the Burmese military overthrew the democratically elected Government in Burma, on the eve of what was to have been the convening of the Parliament that was elected on November 8, 2020, and installed a repressive, authoritarian regime.

Since February 1, 2021, the Burmese military has reversed years of uneven but generally positive democratic reform. The military has engaged in mass atrocities, including by detaining over 13,000 people for exercising basic freedoms and killing over 2,800 civilians, including children. Today, over 17 million people in Burma are in need of humanitarian aid, and 1.5 million people remain internally displaced due to the ongoing violence and instability fostered by the military.

I would note that it is the same military officers now running the country who were implicated in the genocide waged against the Rohingya people, an assault that was recognized by the Secretary of State on March 21, 2022, only the eighth such determination since the Holocaust. The Burmese military continues to systemically target its most vulnerable people, including women, children, and ethnic and religious minorities. The junta also continues to silence activists and opposition parties, most recently illustrated by the 33-year prison sentence handed down to State Counsellor Aung San Suu Kyi after a series of sham trials.

Today, we honor those lives we have lost due to the junta's violent repression and calls upon the Burmese military to end its senseless killing of its own people.

The U.S. Senate fully stands behind those peacefully protesting for their

rights to freedom of speech, assembly, and the press. We also remain committed to free and fair elections in Burma and the peaceful and expedient transition to a civilian-led government. The United States and the international community must hold accountable human rights violators for their actions. This resolution calls on the President to impose targeted sanctions and restrictions on those responsible for the February 2021 coup and human rights abuses in Burma, including through the bipartisan BURMA Act of 2022, which I was proud to have led, and which was enacted as part of the NDAA in December.

While the February 2021 coup represents a major step backwards, the United States remains steadfast in support of a free and prosperous future for Burma. This resolution, which I am proud to introduce today, will reaffirm the United States' solidarity with the Burmese people in their quest for sustainable peace and democracy.

I would invite my colleagues to cosponsor the resolution, and I look forward to early action in the Foreign Relations Committee and by the full Senate.

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

Mr. President, tomorrow, January 27, is the 77th anniversary of the liberation of Auschwitz, which is located in German- occupied Poland. January 27 has been designated by the United Nations as Holocaust Remembrance Day.

At Auschwitz-Birkenau were the most notorious of the atrocities committed during World War II in concentration, labor, and death camps run by the Nazis in Germany during World War II. Six million Jews were murdered during World War II and 5 million others--Romas, Afros, Germans, gay men and women, people with disabilities, and others--who were just disliked by the Nazi regime. Eleven million people perished as a result of these atrocities.

Our responsibility? To remember, to never forget what happened during World War II--what was committed--and to do everything in our power to make sure that these types of atrocities never happen again. We owe that to support the survivors so that their heroism is not forgotten, and we need to support Holocaust education.

I want to thank my colleagues in the appropriations process. We have made funds available to help the survivors of the Holocaust and to provide for Holocaust education.

``Never again'' is what we need to achieve. We have not achieved it to date. We can look back at the atrocities committed in Rwanda or we could take a look at what is happening today with the Uighurs or with the Rohingyas or with the Yazidis--we see atrocities being committed around the world--or we could take a look at what is happening in Ukraine, perpetrated by Russia--the atrocities and war crimes that are being committed by the Russians.

So, on this day of remembrance, it is important for us to understand where we are and to take steps to protect us against atrocities.

I serve on the U.S. Holocaust Memorial Museum Board as the Senate representative. That is an institution that is dedicated to compiling information about the Holocaust, making it available through education and other opportunities for people to understand what happened, and to have a mission to prevent atrocities in the future.

I also serve as the Senate Chair of the U.S. Helsinki Commission. The U.S. Helsinki Commission is best known for its commitment to advance human rights globally. I am proud of the work that we have done in Holocaust education and in fighting the rise of anti-Semitism.

I also serve as the Special Representative of the Organization for Security and Cooperation in Europe's Parliamentary Assembly on Anti- Semitism, Racism and Intolerance.

I mention all of that because I want to share with you the concerns, the warning bells, that have gone off as to the rise of hate in our own community and around the world that should be of concern to all of us.

In 2021, there was the highest number of instances of anti-Semitism in the United States in its history. We broke the record in 2021. According to the ADL, there was a 60-percent increase in 2021 over 2020 in anti-Semitic activities. The U.S. Department of Homeland Security has issued a warning about the heightened potential for violent domestic attacks. These anti-Semitic activities are deadly. I need not remind us all of the Tree of Life synagogue in Pittsburgh, in 2018, where 11 people were murdered by anti-Semitic activity. There are 25 percent of Jews who live in America who fear violence caused by anti- Semitism.

I have had a chance to visit a lot of countries as a Member of the U.S. Senate and as a former Member of the House. I try to visit synagogues when I travel abroad, and it is understood that there will be security in front of the synagogue buildings when I attend the services, but I always felt comfortable in the United States that that would not be necessary. It is now necessary for synagogues to have security here in the United States and for mosques and other areas that are vulnerable to violence caused by hate.

We are also at risk today in our own democratic institutions. Anti- Semitism and hate is fueled by conspiracy

theories, the replacement theory, which is based upon the old-age, anti-Semitic trope. That leads directly to violence. It is also a threat to our democratic institutions. Conspiracy theories about election deniers led up to the January 6 attack on this sacred building. We fight for the peaceful--we believe in the peaceful transfer of power, and we saw violence trying to prevent the peaceful transfer of power, which is critically important to our democratic institutions.

Mr. Putin's campaign, in part, is based upon anti-Semitism. He says he wants to denazify Ukraine. Ukraine has a Jewish President, I would like to remind my colleagues. We all have a responsibility to fight anti-Semitism and any form of hate in our community.

In 2004, I participated in the Berlin Conference, which was the first major international conference in recent times to coordinate strategies to fight anti-Semitism. What came out of that conference was that leaders have a responsibility to lead. Our words mean something. When there is violence in our community, we need to speak out against it. If any minority group is unsafe, we are all unsafe. We need to form coalitions to fight all forms of intolerance in our community.

On November 29 of last year, I convened a roundtable discussion.

I want to thank Senator Rosen and Senator Blumenthal for joining me and Congressman Veasey from the House of Representatives.

We brought together representatives from the Department of Homeland Security, from the Department of Justice, from the White House, and from the Department of State. We had representatives from the Anti- Defamation League and from the American Jewish Committee.

I want to compliment the Second Gentleman, Doug Emhoff, for holding a similar discussion in the White House.

What came out of those discussions is that we need a whole-of- government approach in order to stop the tide--the rise--of hate and violence in our community. So I was so pleased that President Biden, on December 12, established an interagency group, led by the Domestic Policy Council, to increase and better coordinate U.S. Government efforts to counter anti-Semitism, Islamophobia, and related forms of fear and discrimination.

We need a coordinated strategy. We all need to be part of that coordinated strategy. This is not 1 day a year; it is every day--365 days a year. We all need to be engaged. We all have a responsibility to join together in a coordinated strategy so that ``never again'' means never again.

So, on this day of remembrance, as we acknowledge the liberation of the Auschwitz death camps, let us also rededicate ourselves to doing everything in our power so we really can say ``never again.''

I suggest the absence of a quorum.

Madam President, today I am proud to reintroduce the Preventive Health Savings Act. This bipartisan legislation would reform the Congressional Budget Office's CBO, scoring to better reflect the savings from preventive health initiatives by expanding the budgetary window the CBO evaluates.

Currently, the CBO scores the budgetary implications of legislation over a 10-year period. Oftentimes, however, the cost-savings of preventive care are not clear within the current 10-year ``scoring'' window. This legislation would direct the CBO to extend its analysis beyond the existing 10-year budget window to two additional 10-year periods, which will give a truer picture of the benefits of health initiatives and better enable Congress to pass effective policies.

Chronic and mental health conditions account for 90 percent of our Nation's $4.1 trillion in annual medical expenditures. In 2018, more than half of U.S. adults had 1 of 10 chronic conditions, and 27.2 percent had multiple chronic conditions, and this number is only expected to grow. Chronic diseases disproportionally affect racial and ethnic minorities. For example, when compared to non-Hispanic White adults, Black adults are 1.6 times, Asian American adults are 1.4 times, Hispanic adults are 1.7 times, American Indian and Alaska Native adults are 2.9 times, and Native Hawaiian and Pacific Islander adults are 2.5 times more likely to be diagnosed with diabetes. Additionally, Black adults are 1.4 times, American Indian and Alaska Native adults are 1.2 times, and Native Hawaiian and Pacific Islander adults are 1.3 times more likely to have asthma than non-Hispanic Whites.

As more Americans experience chronic conditions, the healthcare costs in the United States will continue to rise. Not only are these costs a heavy burden on millions of Americans and their families, but they are also primary drivers of our annual Federal budget deficits and accumulated debt. As medical expenditures continue to rise, it is crucial that we capture the long-term savings that can be achieved by focusing our efforts on averting, halting, or slowing preventable diseases. This is why I have long been a champion for expanded access to affordable, high-quality preventive health care and am proud to have championed initiatives from coverage for colon screenings to increased access to oral health care. But we still have progress to make.

I am encouraged by the cutting-edge research that world-class institutions in my home State of Maryland, such as the National Institutes of Health, NIH, are doing to address chronic diseases. Interventions, including screenings, vaccinations, and behavioral changes, can prevent or delay the onset of new cases and mitigate the progression of a preventable illness, which can result in large reductions in the financial, physical, and emotional toll of developing one or more chronic diseases. By having the data to enable us as lawmakers to look at cost-benefit analyses, we can most effectively use our Nation's resources to improve the health of Americans while reducing medical costs. The first step to altering the trajectory of chronic diseases and curbing healthcare costs is to have more accurate information on the cost savings of preventive care.

I thank Senators Crapo, King, and Cramer for joining me in introducing this legislation and urge my other Senate colleagues to consider cosponsoring the measure.

Madam President, today I am proud to reintroduce the Preventive Health Savings Act. This bipartisan legislation would reform the Congressional Budget Office's CBO, scoring to better reflect the savings from preventive health initiatives by expanding the budgetary window the CBO evaluates.

Currently, the CBO scores the budgetary implications of legislation over a 10-year period. Oftentimes, however, the cost-savings of preventive care are not clear within the current 10-year ``scoring'' window. This legislation would direct the CBO to extend its analysis beyond the existing 10-year budget window to two additional 10-year periods, which will give a truer picture of the benefits of health initiatives and better enable Congress to pass effective policies.

Chronic and mental health conditions account for 90 percent of our Nation's $4.1 trillion in annual medical expenditures. In 2018, more than half of U.S. adults had 1 of 10 chronic conditions, and 27.2 percent had multiple chronic conditions, and this number is only expected to grow. Chronic diseases disproportionally affect racial and ethnic minorities. For example, when compared to non-Hispanic White adults, Black adults are 1.6 times, Asian American adults are 1.4 times, Hispanic adults are 1.7 times, American Indian and Alaska Native adults are 2.9 times, and Native Hawaiian and Pacific Islander adults are 2.5 times more likely to be diagnosed with diabetes. Additionally, Black adults are 1.4 times, American Indian and Alaska Native adults are 1.2 times, and Native Hawaiian and Pacific Islander adults are 1.3 times more likely to have asthma than non-Hispanic Whites.

As more Americans experience chronic conditions, the healthcare costs in the United States will continue to rise. Not only are these costs a heavy burden on millions of Americans and their families, but they are also primary drivers of our annual Federal budget deficits and accumulated debt. As medical expenditures continue to rise, it is crucial that we capture the long-term savings that can be achieved by focusing our efforts on averting, halting, or slowing preventable diseases. This is why I have long been a champion for expanded access to affordable, high-quality preventive health care and am proud to have championed initiatives from coverage for colon screenings to increased access to oral health care. But we still have progress to make.

I am encouraged by the cutting-edge research that world-class institutions in my home State of Maryland, such as the National Institutes of Health, NIH, are doing to address chronic diseases. Interventions, including screenings, vaccinations, and behavioral changes, can prevent or delay the onset of new cases and mitigate the progression of a preventable illness, which can result in large reductions in the financial, physical, and emotional toll of developing one or more chronic diseases. By having the data to enable us as lawmakers to look at cost-benefit analyses, we can most effectively use our Nation's resources to improve the health of Americans while reducing medical costs. The first step to altering the trajectory of chronic diseases and curbing healthcare costs is to have more accurate information on the cost savings of preventive care.

I thank Senators Crapo, King, and Cramer for joining me in introducing this legislation and urge my other Senate colleagues to consider cosponsoring the measure.

Madam President, I have two requests for committees to meet during today's session of the Senate. They have the approval of the Majority and Minority Leaders.

Pursuant to rule XXVI, paragraph 5(a), of the Standing Rules of the Senate, the following committees are authorized to meet during today's session of the Senate:

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

I suggest the absence of a quorum.