Floor Statements

Madam President, will my friend from Oregon yield for a question?

Madam President, our friend from Oregon is pointing out that this legislation would impact virtually every American because, in one way or another, we all interface with the healthcare system.

I would ask my friend to confirm: This legislation would impact what percentage of the U.S. economy?

One-sixth of the American economy is over $3 trillion every single year.

Now, when we are dealing with legislation that impacts virtually every American, over $3 trillion every year, would my friend from Oregon please tell me this--and I know that he is the ranking member of the Finance Committee, and I am on the Health, Education, Labor, and Pensions Committee: How many hearings have been held in the Finance Committee to discuss the economic implications of this legislation? Were there five, ten? How many hearings on this enormously

complicated and important issue have there been?

No hearings?

There have been no hearings on a bill that impacts one- sixth of the American economy and every single American.

Now, let me ask my friend from Oregon this. Obviously, before my Republican colleagues would go forward on radical legislation like this that would throw some 32 million Americans off of the health insurance they have, they have obviously consulted with doctors and hospitals to get their views as to the impact this legislation would have on patients and hospitals all over America.

What kind of testimony did the doctors make on this bill or the hospital administrators make?

Right, so if my understanding is correct--and I am quite sure it is--the American Medical Association, which is not one of the great progressive groups in America but the group that represents the physicians in this country, A, they have not been able to make testimony. But, B, what is their view on this legislation? What do the doctors of America feel about this important legislation?

But we have not heard yet from one doctor making public testimony at a hearing.

In other words, this bill is not saying to doctors: What will this mean to your patients? What happens if 32 million people are thrown off of medication? How many of them will get sick? How many of them will die?

No testimony.

How about hospitals? What kind of testimony have we heard from hospital administrators, those in rural America, about the impact of this legislation on rural hospitals in Vermont and rural hospitals in Oregon?

Let me ask my friend from Oregon: What kind of testimony have we heard as to the impact of this legislation on older working people, in terms of what it might mean in increased premiums? Have we heard much discussion? Has the AARP, which is strongly opposed to this legislation, been able to come forward at a public hearing and express their point of view?

Madam President, would my colleague please repeat that. I think it is important for older Americans to hear this.

We had a candidate running for President of the United States by the name of Donald Trump, and he ran all over this country and said he was going to stand up for working families and he was going to stand up for the working class of this country.

Please repeat what this legislation would mean if somebody were a 62- year-old worker in Vermont or in Oregon. What kind of premium increases might he or she see?

Now, while the AARP and other senior groups have not been able to testify, would my friend from Oregon tell me what their views are on this particular legislation because of its impact on older workers and seniors in general?

But it is not only older workers because we have as an aging population more and more people in nursing homes. Would my friend from Oregon describe what happens under this legislation if somebody has a mom or a dad in a nursing home, struggling with Alzheimer's or some other terrible illness?

I think it is important to repeat that because this is not something that I think most Americans are aware of. Medicaid now pays, as I understand it, for two out of three nursing home beds in this country; is that correct?

And a massive cut in Medicaid would be devastating to those families who have loved ones in nursing homes?

I have asked my colleague from Oregon a little bit about some of the cruel and devastating impacts this legislation would have, but we have to be honest and acknowledge that there are some beneficiaries in this legislation as well.

Would my friend describe the beneficiaries in the House bill, in particular? While millions were thrown off of Medicaid, while 23 million people lost their health insurance, some people actually did gain from this bill, and we have to acknowledge that; is that true?

Correct me if I am wrong, but my recollection is that in the House bill there were $300 billion in tax breaks going to the top 1 percent at exactly the same time that 23 million Americans were thrown off of their health insurance; is that correct?

If I could, let me ask my colleagues from Oregon or Michigan maybe to speculate here.

If the House bill were to be successful--and we are going to do everything in our ability to make sure it is not successful--and Medicaid were severely cut back, what do my colleagues think will eventually happen in the near future--not eventually, but in the short term, to programs like Medicare and Social Security? Would it be a reasonable assumption that this is the beginning of the effort on the part of the Koch brothers and Republicans in the Congress to begin dismantling virtually every Federal program that helps working people? Is it not true that the House Budget Committee has already passed legislation that would move toward voucherizing Medicare and privatizing it?

I have a meeting that I have to get to. I want to summarize this. My friends from Oregon and Michigan can correct me if I am wrong.

We are looking at a bill that came from the House and various proposals being introduced in the Senate, which essentially says that we are going to throw over 20 million Americans off of the health insurance they currently have. What I haven't heard much discussion about is what happens to someone who today has health insurance and is struggling with cancer, maybe getting chemotherapy or radiation therapy right now. What happens to someone who is in treatment for diabetes? What happens to someone with a serious heart condition, who had a stroke and is on Medicaid? What happens to those people when their health insurance is simply cut?

Mr. President, I raise a point of order that the pending amendment violates section 313(b)1(A) of the Congressional Budget Act of 1974.

I am glad that the Senator from Nevada is concerned about Medicaid, but I would remind the Senate that yesterday the vast majority of Republicans voted to throw 15 million people off of Medicaid on their way to end health insurance for 22 million Americans.

Our job as a nation is to guarantee healthcare to every man, woman, and child and join the rest of the industrialized world, not throw disabled children off of the healthcare they currently have.

I urge a ``no'' vote.

Mr. President, I raise a point of order that the pending amendment violates section 313(b)1(A) of the Congressional Budget Act of 1974.

Mr. President, I do not know--and I don't know if anyone knows--whether the Republican so-called healthcare legislation will pass tomorrow, whether the beginning of the debate will take place or whether it will not. I don't know that, but this I do know. The legislation being proposed--and by the way, we still don't know what that legislation is. In general, what we do know is that the legislation being proposed is the cruelest, most destructive, and irresponsible piece of legislation ever brought to the U.S. Senate in the modern history of our country.

I know the media focuses on, do the Republicans have the votes, how is this Senator going to vote, how is that Senator going to vote? All of that is interesting to those of us inside the beltway. The far more important issue--which we don't discuss enough; the media doesn't cover enough--is what this legislation actually would do if it were implemented.

Right now, unique among major countries on Earth, we do not guarantee healthcare to all people as a right. The result of that is that we now have today--before this disastrous legislation--28 million Americans who have no health insurance and even more who have high deductibles and high copayments, preventing them from getting to a doctor when they should.

We have a bad situation now. It is better today than before the Affordable Care Act was passed, when we had over

50 million people without insurance, but no one suggested what we have today is where we should be. Yet we have 28 million people uninsured. The Republican solution to this problem is to throw another 22 million people off of the health insurance that they currently have.

I want the American people to, for one moment, put themselves in the place of someone tonight who may be watching what we are talking about here, who has cancer, who has heart disease, who has diabetes or some other life-threatening illness. Millions of people are in that position. They are struggling for their lives right now. They are under treatment. They are thinking, what happens if this Republican bill is passed? Will I live and continue to get the treatment that I need or will I die?

I think there are very few Members of the Senate who have met with their constituents on this issue, who have not seen people break into tears, asking: What is going to happen to me or my children or my parents?

We did a teleconference townhall a few weeks ago in Vermont. We had some 16,000 people on the line, and a woman whose kid has a very, very serious illness called. The cost of the prescription drugs are off the chart. She asked: What is going to happen to my child if this bill goes through?

Do you know what? I didn't have the guts to tell her what might happen to her child. I don't want to be on the phone telling any person in Vermont or in America that their child might die because of the legislation that might proceed tomorrow.

This legislation would cut Medicaid by almost $800 billion over a 10- year period, taking healthcare away from lower income and working-class families, including many children with special needs, kids with Down syndrome, kids who have serious emotional problems, kids whose lives now depend on Medicaid. When you cut Medicaid by $800 billion, many of those children will lose coverage entirely or receive significantly fewer benefits.

This legislation, when we cut Medicaid by $800 billion, will have a severe and dramatic impact on nursing homes all over America. A lot of people don't know this, but if your mom has Alzheimer's and is in a nursing home or your dad has a terminal illness and is in a nursing home, guess what: Medicaid pays almost two-thirds of the costs associated with nursing home care in America. What happens to the people in nursing homes when you slash Medicaid? How many of them will get thrown out of the nursing homes? Where do they go? Are families in America, working-class families, going to be forced to make the choice of whether they take care of their parents or whether they send their kids to college? Those are the choices that working-class families may have to make if this horrific legislation gets passed.

This legislation would dramatically decrease funding for the opioid and heroin epidemic that is sweeping this country, including my State of Vermont, including Kentucky, West Virginia, New Hampshire, Ohio, and States all over the country that are struggling with the opioid addiction problem.

The program that provides the most funding to help deal with addiction treatment and addiction prevention happens to be Medicaid. What happens to our efforts to try to get a handle on this terrible, terrible epidemic sweeping our country when you make massive cuts to Medicaid?

I found it amusing that when Donald Trump ran for President--oh, he was a great friend of the working class. He was going to stand up for the working class. Let me mention to workers all over this country who are in their sixties that if this legislation passes, your premiums are going to go up dramatically. That is one of the reasons the AARP strongly opposes this legislation.

If you live in Baltimore, for example, where I was this morning, speaking to the NAACP--in Baltimore, if you are 60 years of age and you make $40,000 a year, your average health insurance premiums will go up from about $4,000 a year now to $8,800 per year, more than double. If you are a 62-year-old worker, making $40,000 a year--not a lot of money--how are you going to pay that?

Remember, all that Donald Trump said about what a great friend of the working class he was. This legislation would defund Planned Parenthood.

I get a kick out of hearing my Republican friends talk about choice, freedom. Oh, my goodness, they love choice and freedom. They want the American people to go to any place they want to go. It is all about what America is about. Two and a half million women have made a choice, and the choice they have made is that they want to get their healthcare from Planned Parenthood. That choice, that freedom would be taken away from them, starting tomorrow, if this legislation is passed.

When you think about insurance, you think that insurance is about covering you in your time of need. Before the Affordable Care Act was passed, many millions of the American people could not get the health insurance they needed to address their particular healthcare crisis. If you had a heart disease, if you had breast cancer, if you had diabetes, the insurance companies would say: We are in the business of making money. Why on God's Earth would we want to insure you if you had breast cancer 5 years ago and it is possible it might recur? That is a losing proposition for us.

That is what insurance companies want to do. They are not in the business of providing healthcare. They are in the business of making money. They denied, unbelievably--think about how crazy this is; they actually would deny coverage to people who had preexisting conditions.

I have problems with the Affordable Care Act. It is far, far from perfect. It did end that obscenity of allowing insurance companies not to cover people who had preexisting conditions--something that is quite unbelievable.

Guess what. If this legislation is passed, in all likelihood, many people in this country with preexisting conditions will not be able to get healthcare that they need at a price they can afford. We don't quite know how many of them will die. Nobody can make that prediction.

I want to read for you a very interesting article that appeared from an institution called PolitiFact. PolitiFact is an entity that tries to keep a check on what politicians say. They look at you and you make a statement, and they say: Is this true or is this guy not telling the truth? I was on a TV program called ``Meet the Press'' a number of weeks ago. I said: Well, you know, if this Republican legislation is passed, thousands of Americans will die.

And my Republican colleagues and the rightwing media said: Bernie Sanders is engaging in hyperbole. He is exaggerating. Who wants to see anybody die?

I know nobody here wants to see anybody die. Of course not. No Republican does. No Democrat does. No Independent does. But we have to look at the consequences of what we do.

So what PolitiFact did was take a look at the studies to see whether I was telling the truth.

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

One of the studies my office cited was published on June 22, 2017, by the Center for American Progress. It was coauthored by a Harvard professor of social epidemiology, two medical students who graduated from Harvard's T.H. Chan School of Public Health, and two policy specialists at the Center for American Progress. I won't go through all of the details, but I will say this, quoting from PolitiFact:

The Harvard-Center for American Progress study projected

that there would be one excess death for every 830 people who

lose coverage as a result of the AHCA.

The Republican bill.

Using Congressional Budget Office projections of the impact

of the House version of the bill, the authors estimated an

additional 217,000 deaths over the next decade, or 21,700 per

year.

That is not Bernie Sanders; that is a study done at Harvard.

The second piece of evidence Sanders' office cited was an

op-ed by yet more health policy specialists who are

affiliated with Harvard--David Himmelstein and Steffie

Woolhandler, who are professors of public health at Hunter

College-City University of New York as well as lecturers at

Harvard Medical School.

Adapting the findings of the 2012 study to a scenario in

which 20 million Americans lost coverage--which turned out to

be lower than what the CBO found for the House bill--

They estimated 23 million would lose coverage--

Himmelstein and Woolhandler estimated that there would be

43,956 deaths annually due to the GOP's health policy

changes.

Quoting again from PolitiFact:

So can Sanders' assertion be supported by the peer-reviewed

literature alone?

Then they cite some studies.

In 2002, a panel of more than a dozen medical specialists

convened by the federally chartered Institute of Medicine

estimated that 18,000 Americans had died in the year 2000

because they were uninsured. In January 2008, Stan Dorn, a

senior research associate at the Urban Institute, published a

paper that sought to update the IOM study with newer data.

Replicating the study's methodology, Dorn concluded that the

figure should be increased to 22,000.

A 2009 American Journal of Public Health study concluded

that a lack of health insurance ``is associated with as many

as 44,789 deaths in the United States, more than those caused

by kidney disease.''

And on and on it goes. This is not Bernie Sanders talking; this is scientific and medical study after medical study saying what is obvious--that if you have a life-threatening disease and cannot get healthcare, you will die.

So I would hope that my Republican colleagues, as they vote tomorrow, understand the consequences of their vote. I know no Republican--nobody here--wants to see anybody die, but when you take 23 million people off of the health insurance they have, many thousands of those people will die.

I think most Americans would think that when you are dealing with an

issue like healthcare, which impacts, by definition, every single person in our country, and when you are dealing with an issue that impacts about one-sixth of the American economy--over $3 trillion a year--that you just might want to have some serious discussions on that issue. You might want to ask--here is a radical idea--doctors what they think about this legislation. What is it going to mean to their patients? Wow, that is a pretty radical idea when dealing with healthcare for all the American people. You might want to have one hearing, maybe, and say to doctors: Doctors, what do you think about this bill?

What about hospitals? How will this bill impact hospitals, especially rural hospitals in Vermont, Virginia, and all across this country? You might want to talk to a hospital administrator. You might want to talk to a patient advocate, maybe somebody from the American Cancer Society or somebody who is active in the diabetes effort. You just might want to talk to the experts on healthcare as to how this legislation might impact the work they do. But, amazingly, in an unprecedented way, this legislation was written behind closed doors. I think it was 12, 13 Republican Senators who wrote this bill. Most Republican Senators don't even know what is in this bill, let alone Democrats and let alone the American people.

How do you write legislation that impacts every American, one-sixth of the economy, and not have one public hearing to hear from those most knowledgeable about healthcare in America? But that is exactly what the Republican leadership has done. I know why they did that. It is not a secret. If you had a horrific piece of legislation, trust me, you would want as little public discussion as possible. You would try to hide what this bill does. I understand that. Yet, despite all of that, it turns out that virtually every major healthcare organization in America opposes this bill.

I don't know how you can go forward with legislation that has had zero public hearings, that is opposed overwhelmingly by the American people--last poll that I saw from USA TODAY had 12 percent support for this legislation--and go forward with legislation opposed by every major healthcare organization in America. This bill is opposed by the AARP, the largest senior group in America. It is opposed by the American Hospital Association, the American Medical Association, the American Cancer Society, the American Heart Association, the American Academy of Family Physicians, the American Academy of Pediatrics, the American Psychiatric Association, the Federation of American Hospitals, the Catholic Health Association, the American Lung Association, the Cystic Fibrosis Foundation, the March of Dimes, the National MS society; and the American Nurses Association. In other words, virtually every major healthcare organization does not want to see this bill passed.

The American people overwhelmingly do not want to see this bill passed. So how come it might pass? People don't want it. Healthcare organizations don't want it. Who wants it? I will tell how wants it-- people who are going to get tax breaks. They think it is a great idea. Billionaires who got $200 billion in tax breaks from the House bill think it is an extraordinary idea. So what if 23 million people lose their health insurance from the House bill. The top one percent will get $200 billion in tax breaks. Large healthcare corporations like it. The insurance companies and the drug companies are going to get a combined hundreds of billions of dollars.

I will tell you who else likes it: those people associated with the Koch brothers who are spending hundreds of millions of dollars on elections. They like it because their ideology, their philosophy is that government should play no role in the concerns of the American people. Mark my words--if this bill, which would cut Medicaid by $800 billion, passes, Medicare will be next. And in the House, they have already passed legislation that would voucherize Medicare. Social Security will not be far behind. That is the ideology of the Koch brothers and the people who fund the Republican Party. Their concern is with large campaign contributors, not the American people.

I hope very much that tomorrow when we assemble here--I gather in the afternoon--for a vote, the Republicans will think more about people in their own State, about their children, the elderly, the sick, and not just about their campaign contributors.

Thank you very much, Mr. President.

I yield the floor.

Madam President, I wanted to say a few words about the new Republican healthcare plan that was just announced a few hours ago. While there are some modest changes in it, the truth of the matter is that this plan remains a disaster. It remains an embarrassment. I think the indication that it is an embarrassment is that with legislation that would impact about one-sixth of the American economy of over $3 trillion a year--legislation that, because it is healthcare, impacts virtually everybody--there has not been one public hearing on this legislation. It has all been done behind closed doors. Honestly, no matter what one's view may be on where we as a Nation should go with healthcare, whether you like this bill or you don't like this bill, I just don't know how someone can seriously say that we don't have to hear from physicians about the impact of this legislation on their ability to treat their patients. I just don't know how you do that--or that we don't have to hear from hospitals.

I come from a rural State. What will the impact of this legislation and the massive $800 billion cuts on Medicaid do to rural hospitals all over the United States? There is some belief that many rural hospitals in areas where they are desperately needed will be forced to shut down. Is that the truth? That is what I hear, but I can't tell you definitively because there hasn't been a hearing on that issue. So I don't know how we go forward with legislation without having administrators from rural hospitals coming before the committee--I am on the Health, Education, Labor, and Pensions Committee--or the Finance Committee to answer that question.

The Presiding Officer comes from a State and I come from a State where we have a major opioid crisis. It is devastating the entire country. What will this bill do to our ability to prevent and treat the opioid crisis, which is decimating this country from one end of America to the other? What happens if you cut $800 billion in Medicaid? How will people get the treatment they need today--which is inadequate? In my State, it is inadequate. I don't think there is a State in the country that today is providing the necessary treatment or prevention capabilities to deal with this opioid and heroin crisis, which is ravaging America. What impact will an $800 billion cut have on that? I understand there is some additional money going into opioid treatment, but how do you do that without the framework of allowing people the access to get healthcare? If you get thrown off of healthcare, what will the additional opioid money mean? I think not a whole lot.

In this bill, there are still hundreds of billions of dollars-- several hundred billion dollars--in tax breaks to large health insurance companies, to drug companies, to medical device companies, and to tanning salons. As a nation, are we really interested in giving significant tax breaks to large insurance companies and then throwing children who have disabilities off of the Medicaid they currently receive? Is that what the American people want? I don't think they do.

I have to tell my colleagues that this Republican legislation, as the Presiding Officer knows, has been opposed by almost every major national healthcare organization in the country, including the American Medical Association, the American Hospital Association, the AARP, which is the largest senior group in America, the American Psychiatric Association, the American pediatrics association. Virtually all of the major healthcare groups are saying that this legislation would be a disaster for the people they serve.

Just last night we had a teleconference townhall in Vermont and we had some 15,000, 16,000 people on the phone. The calls that were coming in were very painful calls. I almost didn't want to be honest in answering the calls. A woman calls up and she says: My son has a very serious medical illness, and we spend a fortune on prescription drugs. What is going to happen if this bill passes? What was I going to tell her, that perhaps her son would die? It is just not something I feel comfortable even talking about.

The truth is--and this is not Bernie Sanders talking, this is study after study after study that says that if you do as they did in the House, which is throw 23 million people off of health insurance, including people who are struggling with cancer, people who are struggling with heart disease, people who are struggling with diabetes, what does common sense tell us? If you are struggling with cancer and you lose your health insurance, what do you think is going to happen to you?

What study after study has shown is that thousands of people will die. It is not that any Republican here wants to see anyone die, but that is the consequence of what happens when you throw, as the House bill did, 23 million people off of health insurance. We should not be giving tax breaks to insurance companies and then throwing disabled children, or people with terrible illnesses who are fighting for their lives, off of health insurance.

The AARP is very strongly opposed to this legislation. The reason is pretty clear. What every person in America should understand, and I am not sure that many do, is that Medicaid now pays for over two-thirds of all nursing home care--two-thirds. What happens to the seniors and persons with disabilities who have their nursing home coverage paid for by Medicaid today? What is going to happen to those people?

What happens if your mom is in a nursing home? You don't have a lot of money, and your mom is in a nursing home paid for by Medicaid. What happens if Medicaid is slashed? What is going to happen to your mom? Is she going to be thrown out on the street or end up in the basement of your house? Are you going to have to make the choice about whether you take care of her or put away a few bucks to send your kid to college? If suddenly a daughter or a son is going to have to care for a mom or a dad thrown out of a nursing home, how do they go to work to earn the money their families need?

These are legitimate questions, and it would have been nice to have a hearing or two in order to answer those questions.

The bottom line is that we have legislation before us that is widely rejected by the American people. The last poll that I saw, which was done by USA Today, suggested that 12 percent of the American people supported this legislation--12 percent. Virtually every major healthcare organization in America opposes this legislation. There is nothing I have seen today--none of the tweaks that have been put into this make this legislation in any way, shape, or form acceptable.

It is no great secret that the Affordable Care Act is far from perfect. I don't think you hear anybody here say: Hey, the ACA is great; it doesn't need any changes. It does need changes. Deductibles are far too high in Vermont. Premiums are too high. Copayments are too high. And the cost of prescription drugs in Vermont and all over this country is off the charts.

I was in West Virginia, and I talked to a woman for a moment after I spoke, and she said that she is taking care of her older brother. Her brother has seizures. The medicine her brother was using went up by 900 percent over the last few years. Why? Because that is what the drug companies can get away with. Tomorrow it may be 1,000 percent. Does anybody in America think that makes sense? Is anybody happy in America? Are people in Missouri happy, are people in West Virginia and people in Vermont happy that we are paying by far the highest prices in the world for prescription drugs? I don't think so. There are ideas out there about how we can significantly lower the costs of prescription drugs in this country, how we can lower deductibles, how we can lower copayments.

Now, as I have said many, many times, I happen to believe that while it is important that we improve the Affordable Care Act, at the end of the day, this country must do what every other major country on Earth does, and that is to understand that healthcare is a right, not a privilege.

Right now, we have 28 million people who have zero health insurance. If this bill in the House were to go through, there would be another 23 million on top of the 28--over 50 million people--without any health insurance. Does that make any sense to anybody?

Our job is to join the rest of the industrialized world and make sure that every man, woman, and child has healthcare as a right, no matter what your income is. When you get sick, you go to the doctor. When you have to go to the hospital, you don't go bankrupt. That is what a civilized democracy is about. That is what they do in Canada. That is what they do in the UK, France, Germany, Scandinavia, and Holland. Every major country on Earth guarantees healthcare to all people. That is where I want to see our country go, and I will be introducing legislation to make sure that happens.

More and more people all over this country want to move us in that direction. But right now, our job is to make sure that millions of people do not lose their health insurance in order to give tax breaks to insurance companies. Our job is to make sure that disabled children continue to get the care they need and older folks aren't thrown out of nursing homes. That is what we have to do.

So I urge in the strongest possible way the defeat of this legislation. Then, let's go forward to improve the Affordable Care Act, not destroy it.

I yield the floor.

Mr. President, my staff recently had the pleasure of visiting with Jen Kimmich of The Alchemist Brewery in Stowe, VT.

The Alchemist owners Jen and John Kimmich are model employers who have shown considerable dedication toward creating positive working conditions for their employees. Their workers receive excellent benefits and working conditions, including livable wages, paid sick days, vacation time, health insurance, wellness opportunities, paid family leave, and generous retirement benefits. The Alchemist not only produces an internationally award-winning product, but it has also fostered a workplace culture where people are put before profits.

Further, I would like to thank Jen for her statewide leadership championing workers' rights. She serves on the State Workforce Development Board helping to create opportunities for good jobs in Vermont. Through her volunteer work with Main Street Alliance, Jen has advocated for paid sick leave and paid family leave legislation.

I also commend the company for developing The Alchemist Foundation.

The Foundation provides college scholarships and career pathway opportunities for area youth.

I am grateful for all that they do for their employees, their community, and the entire State of Vermont. Companies across the Nation should follow in The Alchemist's footsteps by supporting workers' rights and creating a positive workplace.

Mr. President, let me be as clear as I can be. The so- called healthcare bill that passed in the House of Representatives several months ago, strongly supported by President Trump, is the most anti-working-class legislation that I have ever seen. The Senate bill, also supported by Mr. Trump, in some respects is even worse.

At a time when working families in Vermont and all across this country are working longer hours for low wages--many people in my own State are working two or three jobs just to bring in enough income to maintain a family--this legislation will cause devastating harm to millions of our families from one end of America to the other.

The American people are united. This weekend I was in West Virginia and Kentucky--so-called conservative States--but I tell you that what is true there, what is true in Vermont, and what is true all over this country is that the American people are standing up and saying loudly and clearly that we will not allow 22 million Americans to be thrown off of the health insurance they currently have in order to give over $500 billion in tax breaks to the wealthiest 2 percent, to the drug companies, to the insurance companies, and to other profitable corporations. We will not support a bill that takes from the most vulnerable people in our country--the children, the elderly, the disabled, the sick, and the poor--in order to make the very, very rich even richer. This is unconscionable, un-American, and the American people will not accept it.

Plainly stated, this so-called healthcare bill is really nothing more than a massive transfer of wealth from the working families of this country to the very rich. While this bill contains massive cuts to Medicaid; while seniors will pay far, far more in premiums; while Planned Parenthood will be defunded, the 400 highest income taxpayers, most of whom are billionaires, will get about $33 billion in tax cuts.

There is no State in this country--none, not the most conservative-- that thinks that you throw 22 million people off of health insurance, including disabled children, in order to give $33 billion in tax breaks to the wealthiest 400 Americans. At a time when so many people in America are struggling, the very wealthy are already doing phenomenally well. They do not need more tax breaks.

Not only is this bill a disaster, but the secretive, backroom process by which it has been written is unprecedented and literally beyond belief. That is not just me speaking; I think a number of my Republican colleagues who disagree with me on everything make that point as well. This bill impacts one-sixth of our economy--over $3 trillion--and by definition, dealing with healthcare, it impacts virtually every American. Yet the discussions and negotiations on this legislation have never been made public. In fact, I suspect they are going on right now--not here on the floor but behind closed doors.

Unbelievably, with legislation that would completely revamp our healthcare system, there have been no doctors, no nurses, no hospital administrators, no representatives of senior citizens, no experts on the opioid crisis--which is sweeping our country--who have testified in public about the impact this legislation will have in our country. How can one possibly dream of drafting a bill of such enormous magnitude without hearing one public comment from the most knowledgeable people in America with regard to healthcare?

How can you possibly go forward without one public hearing where Senators have the opportunity--Democrats, progressives, Independents-- to ask questions? But that is precisely the process this legislation has gone through.

I fully understand there are a lot of people who will say: Well, big surprise, Bernie Sanders, a strong progressive, opposes this Republican bill. What else is new?

But I want you all to understand that it is not just Bernie Sanders or Democrats here who oppose this legislation; this legislation is opposed by virtually every major healthcare organization in the United States.

I am not quite sure how we can go forward with major legislation impacting one-sixth of the economy, opposed by every major healthcare organization in the country, and not have one hearing. I am not quite sure how that can be done, but that is precisely what the Republican leadership here is doing.

It is not just Bernie Sanders who opposes this legislation. It is the AARP, which is the largest senior group in America. It is the American Medical Association. Hey, those are our doctors. When you get sick, you go

to a doctor. Many of them are members of the American Medical Association. They say this bill is a disaster. It is not just doctors. It is nurses. It is hospital administrators. It is the American Cancer Society, the American Heart Association, the American Academy of Family Physicians, the American Academy of Pediatrics, the American Psychiatric Association, the Federation of American Hospitals, the Catholic Health Association, the American Lung Association, the Cystic Fibrosis Foundation, the March of Dimes, the National MS Society, and the American Nurses Association, among many other organizations that oppose this bill being written behind closed doors.

Several months ago, as I think everybody knows, with the strong support of President Trump, the House passed their disastrous healthcare bill. Now, we know what is in the House bill. The Senate bill probably is being worked on as we speak, so we don't know what is in that exactly, but let me tell my colleagues what the House bill does. At a time when 28 million Americans today--before the Republican bill--have no health insurance and millions more are underinsured, with high deductibles and copayments, this bill from the House will throw another 23 million Americans off of the health insurance they currently have.

Think about it. Gee, if we have 28 million Americans off of health insurance, what most Americans would say is: OK, how do we lower that number? In fact, the Affordable Care Act added another 20 million people to the ranks of the insured. This bill throws 23 million on top of the 28 million we currently have uninsured, almost doubling the uninsured in America to over 50 million people. Think about it. People have a hard time even beginning to believe that legislation that is being seriously debated would almost double the number of uninsured in America.

Everybody understands--there is no debate about this--that the Affordable Care Act is far, far from perfect. This is a point I have been making from the day the Affordable Care Act was passed. Premiums in my State of Vermont and around this country are too high, deductibles are too high, copayments are too high, and too many Americans remain uninsured or underinsured. But in each and every one of these legitimate concerns, the Republican legislation that has been brought forward and passed in the House would only make a bad situation much worse.

The Republicans say: Oh, the Affordable Care Act is a bad piece of legislation. It has problems. The Affordable Care Act does have problems. Their legislation exacerbates every single one of the problems that it has.

So our job today, and I think what the average American understands-- OK, we have problems. What are the problems? We have listened. Deductibles are too high. Copayments are too high. Premiums are too high. Prescription drug prices are way too high. OK. Let's discuss it. What is your idea? How do we deal with these problems? That is what the American people want. The American people want us to address the problems that are in the Affordable Care Act, not destroy it.

It seems to me clearly that our job right now--and the American people are rising up. They are not going to accept this Republican legislation. Together we are going to defeat it.

I wish to speak for a moment about what it means if this legislation were to pass. What are the implications of throwing 22 million people-- that is the Senate bill--off of health insurance, and 23 million people in the House bill? Let me tell my colleagues. I want every American to think about this. Just think about it. Think about somebody today who has cancer and is maybe in chemotherapy or maybe in radiation, somebody who has heart disease, somebody who has diabetes or some other life- threatening disease. There are God knows how many people in this country right now who are sick. What happens if they lose their health insurance? A simple question. You have cancer, you are getting treatment today, and the Republican bill takes away your health insurance. What happens to you when you cannot afford to go to the doctor when you feel a lump in your breast or when you have problems with your heart? What happens to you if you have a heart attack or a stroke and need significant care, but you have no health insurance and you don't have the money to pay for the outrageously high cost of care?

Here is the horrible and unspeakable truth that has to be brought out into the open; that is, if this legislation were to pass, many thousands of our fellow Americans would die, and many more would suffer and become much sicker than they should. Now, I am not suggesting that there is anybody in this body who wants to see anybody die unnecessarily. Nobody does. But people have to take responsibility for their actions, and if you throw 23 million people off of health insurance, many of whom might have life-threatening illnesses, thousands of people will die.

Several weeks ago I was on a television program, and I said just that, and then right after that, I was criticized by Republicans and rightwing critics: Why did you say that? What a terrible thing. Why are you frightening the American people? ``Some people will die''--that is not true.

Well, PolitiFact is a nonpartisan organization that checks out what public officials say, and they took a look at well over 10 different studies on the issue of mortality rates and lack of insurance coverage. That is what they studied. They looked at more than 10 different studies looking at mortality rates and lack of healthcare coverage. What PolitiFact concluded is that the point that I made--that many thousands will die--is well supported. It is not Bernie Sanders. I am not coming up with some idea off the top of my head. This is what many, many medical and scientific studies have told us.

Obviously nobody can predict exactly how many people will die if 23 million people lose their health coverage, but what experts at the Harvard School of Public Health estimate is that if 23 million people are thrown off of health insurance, as the House bill does, up to 28,000 people could die each and every year--28,000 people. That is nine times more than the tragic loss of life we suffered on 9/11, and that would take place each and every year. In the wealthiest country in the history of the world, we must not allow that to happen.

This bill would impact the children, many of whom are covered by the CHIP program, covered by Medicaid. You tell me what happens to a kid who has a disability right now and whose family receives Medicaid. Some of those children may have Down syndrome. Some of those children may have cerebral palsy, muscular dystrophy, maybe autism. They may have mental health needs, such as depression or anxiety, or complications from premature birth. Today, Medicaid and CHIP cover 5 million--or 44 percent--of those kids, providing them with coverage so that they can live with dignity and security.

But it is not just the children who will be impacted, it is also the elderly. What every person in America should understand--and many do not--is that Medicaid now pays for over two-thirds of all nursing home care. So I ask my Republican friends: What happens when you slash Medicaid? Who will pay for somebody's mom or dad in a nursing home dealing with Alzheimer's disease? How many seniors in this nursing home will get thrown out on the street or be forced to live in their children's basement? Well, we don't know the answer to that. We haven't had any hearings. We haven't heard any people testify to that. But I think we will see a whole lot of families disrupted, having to make the choice about whether to take care of their parents or provide for their kid to go to college.

It is not just nursing home care. What happens if you are just an older worker. Maybe you are 60 years of age. Well, the likelihood is that if you are a 60-, 62-year-old worker, the cost of your premiums is going to soar. Again, this is not Bernie Sanders' view; it is what the AARP says.

This is a quote from the AARP from June 22:

This new Senate bill was crafted in secrecy behind closed

doors without a single hearing or open debate--and it shows.

The Senate bill would hit millions of Americans with higher

costs and result in less coverage for them.

AARP is adamantly opposed to the Age Tax, which will allow

insurance companies to charge older Americans five times more

for coverage than everyone else while reducing tax credits

that help make insurance more affordable.

That is the AARP.

What about the opioid epidemic, which is hitting my State of Vermont hard and hitting States all over this

country? Each and every day, more than 90 people in America die from an opioid overdose. Can you believe that? Ninety people die every single day. Nearly 4,000 people begin abusing prescription painkillers, and about 600 start using heroin. We have a major, major crisis in opioid addiction and heroin overdoses.

It turns out that if you cut Medicaid by $800 billion, which is what the Republicans are talking about, our ability to address the opioid crisis will be severely curtailed. At a time when we should be expanding prevention efforts, expanding treatment efforts, the Republican bill will make it much harder for us to deal with the opioid crisis.

This legislation is not what the American people want. I understand that the Republican leader today suggested that Members of the Senate may have to stay here for a few more weeks in August, and I can understand that. If I were the Republican leader, I would not want my Senators to go home to hear what the American people have to say about this legislation.

The truth is, poll after poll shows overwhelming opposition to this disastrous legislation. According to the latest USA TODAY/Suffolk University Poll, just 12 percent of the American people support the Republican bill.

As a matter of fact, according to a recent report, this is the most unpopular piece of legislation in the last three decades. It is more unpopular than the $700 billion bailout of Wall Street. That is pretty unpopular. The American people are catching on as to what is in this bill, and they do not want to see it.

Let me conclude by saying what is as obvious as can be. It is what the American people want. Are there problems with the Affordable Care Act? Absolutely. Premiums are too high, deductibles too high, copayments too high, prescription drug prices are off the charts.

Let's deal with it. What is the problem? Let's deal with it. Put it on the table, and let us address those problems. The American people want to improve the Affordable Care Act, not destroy it.

Let me now, speaking for myself only, say this. I hope very much there can be bipartisan efforts to improve the Affordable Care Act, but I happen to believe we have to go further than that. I intend to help lead that effort.

In my view, there is something profoundly wrong when the United States of America is the only major country on Earth--the only one-- that doesn't guarantee healthcare to all people as a right, while at the same time we spend far more per capita on healthcare. We spend far more per capita on prescription drugs, and our healthcare outcomes are not particularly good compared to many other countries.

I think the time is long overdue as to why we do not ask ourselves: How is it Canada can guarantee healthcare to all people, the UK can do it, Germany can do it, France can do, Scandinavia can do it? Every major country on Earth recognizes that healthcare must be a right, not a privilege.

I happen to agree with that. That is why I will--as soon as this debate is over and as soon as, hopefully, we defeat this disastrous Republican legislation--introduce a Medicare-for-all, single-payer bill, which will in fact guarantee healthcare to all of our people in a cost-effective way.

Let me conclude by saying that the current Republican bill in front of us is a moral outrage. There are very few people in America who think you should throw 22 million of our people off of health insurance in order to give huge tax breaks to billionaires. This is a moral outrage, and it must be defeated. I will do everything in my power to see that it is defeated.

I yield the floor.

Mr. President, today's Congressional Budget Office analysis of the Trump-McConnell healthcare bill gives us 22 million reasons why this legislation should not see the light of day. What CBO tells us in truth is that this bill really has nothing to do with healthcare; rather, it is an enormous transfer of wealth from the sick, the elderly, the children, the disabled, and the poor into the pockets of the wealthiest people in this country.

According to CBO--and that report came out just a few hours ago--this bill would throw 22 million Americans off of health insurance, cut Medicaid by over $770 billion, defund Planned Parenthood, and substantially increase premiums for older Americans. Under this bill, a 64-year-old with an income of $56,000 could see his or her premiums increase from $4,400 under current law to $16,000--an increase of nearly 850 percent. How are older workers in this country going to deal with an 850-percent increase in their premiums? Meanwhile, the Trump- McConnell bill would provide a $231 billion tax break to the top 2 percent and hundreds of billions more in tax breaks to the big drug companies and insurance companies that are ripping off the American people every day.

At a time when the middle class of this country continues to shrink and when families all across America are struggling to make ends meet, to put food on the table, to pay their rent, to save a few bucks for retirement, we cannot take from working-class families and we cannot take from the sick and the elderly and the children in order to give even more to the very wealthiest people in this country--people who are at this moment doing phenomenally well.

Mr. President, this, in fact, is a barbaric and immoral piece of legislation. But let's be very clear. It is not just Bernie Sanders who opposes this bill. It is not just every Member in the Democratic caucus who opposes this bill. It is not just that the overwhelming majority of the American people oppose this legislation. According to a recent NBC/ Wall Street Journal poll, only 16 percent of the American people thought this bill was a good idea. This bill is opposed by virtually every major healthcare organization in this country--the people on the frontlines, the people who today, yesterday, and tomorrow are dealing with healthcare issues, dealing with the sick, working in hospitals, working in community health centers. Almost without exception, every major healthcare organization in this country opposes this bill.

Maybe my Republican friends might want to get beyond the politics, get beyond Republicans and Democrats, and ask the people who really know about healthcare in America and ask yourself, how does it happen that virtually every major healthcare organization in this country opposes this legislation?

The AARP opposes this legislation--the largest senior group in America, which knows what high premiums for healthcare will do to their membership. The American Hospital Association knows a little bit about hospitals and what will happen to rural hospitals if this legislation is passed. The American Medical Association is a conservative organization. This is the doctors organization all over this country. This is not any progressive radical group; these are our doctors, the doctors we go to. They oppose this legislation because they know what will happen if there are massive cuts to Medicaid, if 22 million people are thrown off of health insurance. The American Academy of Family Physicians knows what this legislation will mean to the children of our country. The American Psychiatric Association, the Federation of American Hospitals, the Catholic Health Association, the American Lung Association, the Cystic Fibrosis Foundation, the March of Dimes, the National MS Society, the American Nurses Association--every one of these

organizations opposes the Republican legislation; not Bernie Sanders but every major healthcare organization says do not go forward with this disastrous bill.

This is what the AARP, the largest senior group in America, said recently:

This new Senate bill was crafted in secrecy behind closed

doors without a single hearing or open debate--and it shows.

The Senate bill would hit millions of Americans with higher

costs and result in less coverage for them.

AARP is adamantly opposed to the Age Tax, which would allow

insurance companies to charge older Americans five times more

for coverage than every one else while reducing tax credits

that help make insurance more affordable.

I ask all of my Republican friends to think for a moment about the implications of this bill and what it will mean to your constituents when they lose the healthcare they currently have. Put yourself in their place. Today you have health insurance, but tomorrow, next year, you might not. What does that mean? Think about it.

What does it mean if you are an individual today--and, sadly, there are too many of them. If you are a person today suffering with cancer and you are fighting for your life--maybe you are on radiation treatment. Maybe you are on chemotherapy. You are scared to death. You don't have a lot of money. You have cancer. You are struggling. And now you are reading in the papers that this Republican bill may take your health insurance away from you? How do you think they feel? I suspect scared to death. It is the same with people who have heart disease, who have asthma, who have diabetes or any other life-threatening illness. What happens to those millions of people when they cannot afford to go to the doctor when they are sick, cannot afford to buy the medicine they desperately need?

Mr. President, I know this is a sensitive issue, but I am going to raise it, and that is that the horrible and unspeakable truth is that if this legislation were to pass, and I am going to do everything I can to see that it doesn't, but if it were to pass, many thousands of our fellow Americans every single year will die, and many more will suffer and become much sicker than they should. That is not, again, Bernie Sanders talking; that is exactly what a number of studies have shown. Study after study, including one from the American Journal of Public Health to the New England Journal of Medicine, to the Harvard School of Public Health have told us. Again, this is not Bernie Sanders engaging in a rhetorical debate; this is what scientists and doctors who have studied the issue are telling us.

In fact, just this afternoon, a few hours ago, the Annals of Internal Medicine, a prestigious medical journal, published an article from researchers at the City University of New York School of Urban Public Health at Hunter College and Harvard Medical School entitled: ``The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly?'' That is the title of the article appearing today.

According to a summary of this article, ``Insurance decreases the odds of dying among adults by at least 3 percent and as much as 29 percent and `being uninsured substantially raises the risk of dying.' ''

The coauthor of this article, Dr. David Himmelstein, commented:

According to the CBO, the Senate Republicans' plan would

strip coverage from 22 million Americans. The best estimate

based on scientific studies is that about 29,000 Americans

would die each year as a result.

I know no Republican wants to see anybody die--none of us do--but that is the reality we are dealing with, and you cannot ignore it. If somebody has cancer, if somebody has heart disease and you take away their health insurance, I don't need studies from Harvard University to tell me and to tell you what you know to be the case. This is the United States of America, and we can do better than that.

Mr. President, I ask unanimous consent that the article that appeared today in the ``Annals of Internal Medicine'' be printed in the Record.

Mr. President, this issue is really not just about healthcare. This is a profound moral debate defining who we are as a people today and whom we want to be as a people in the future.

A great nation is not simply one judged by how many millionaires and billionaires we have and by how many tax breaks we can give to billionaires. A great nation is judged by how we treat the weakest and the most vulnerable amongst us--those people who don't have fundraising dinners, those people who don't contribute hundreds of thousands of dollars into the political process. A great nation is judged by how we treat the children, the elderly, the sick, the poor, the people who have disabilities. This is what a great nation is. This legislation is not worthy of a great nation. This legislation must be defeated.

I yield the floor.

Mr. President, this month we celebrate the Montpelier Senior Activity Center's 50th anniversary. For half a century, the center has provided opportunities for healthy aging and lifelong learning that enhance the quality of life for seniors. The Montpelier Senior Activity Center, established in 1967 and nestled in our State's capital, has the mission of enhancing the quality of life for the older adults in the Montpelier area by developing physical, mental, cultural, social, and economic well-being in a welcoming and flexible environment.

A Nation is judged by how it cares for its most vulnerable. It is undeniable that we are living in a time when many Vermonters and Americans are having to do more with less and the most vulnerable among us are making the unacceptable decisions like choosing between paying for healthcare, food on the table, or a roof over their head. In Vermont, more than 11,000 seniors are living in poverty.

At a time of massive political discontent, we need to focus on building up, not dismantling, our communities. In Montpelier, VT, just that is happening, as seniors are able to access services that help them live out their lives in dignity.

The center serves more than 1,000 seniors every year, including more than one of every five seniors in Montpelier. In 2016, the Montpelier Senior Activity Center provided more than 17,000 nutritious home- delivered and community meals for seniors. More than 80 percent of senior activity center participants report that their participation makes them feel healthier.

The Montpelier Senior Activity Center celebrated its 50-year anniversary on Saturday, June 10, 2017. To know that seniors have been able to access supportive care and resources for so long and have truly become a well-established part of the community is commendable. As Montpelier Senior Activity Center Day is commemorated, please understand that the center's work saves and empowers countless lives. I join the Montpelier community to celebrate this milestone anniversary.

Mr. President, let me thank the Senator from Massachusetts for his very cogent and important remarks.

Let me just start off by asking the Chair, asking the leader of the Republican party, what are you afraid of? What are you afraid of? Health care constitutes one-sixth of the American economy. It impacts every man, woman, and child in our Nation. Yet we have 13 Republicans, all men, working behind closed doors to produce legislation that will be brought to the Senate at the last moment so the American people don't know the disaster that it is.

You know, what politics is about or should be about is, if you are proud of what you do, you tell the world about it. You explain to the American people and to your constituents why this is what you are proposing, this is how you voted, and this is why it is good for the people in your State and your country.

It should tell every American--whether you are a Democrat, a Republican, or an Independent, whether you are conservative or progressive, it should tell you something that major legislation is being written at this moment and that most Republicans don't have a clue as to what is in that legislation, let alone the Democrats, let alone average Americans.

So I say to the Republican leadership, what are you afraid of? Bring out that bill.

I am a member of the Health, Education, Labor, and Pensions Committee, the HELP Committee. The HELP Committee is supposed to be the committee that deals with health issues.

I see Senator Murray is here, the ranking member of that committee. She will concur with me that the HELP Committee has held zero hearings.

It is the HELP Committee. We have had not one hearing to ask members of the administration, people throughout this country, what the impact of this legislation will be on the children, on the elderly, on working families, on those who have chronic diseases, on ordinary Americans. What impact will this legislation have on the lives of 300-plus million people? We have not had one hearing, not one open discussion. I would think that every Republican would be embarrassed by this. I know many of them are embarrassed by it.

So before there is any vote on any health care legislation, we need to have a series of hearings to discuss the implications of what the legislation is about.

Mr. President, as I think you heard during the debate on the Affordable Care Act--and I am a member of that committee, and we had 47 bipartisan hearings, not only in the Health, Education, Labor, and Pensions Committee but also in the Finance Committee and other committees. There were roundtables and there were walkthroughs of the Affordable Care Act. There was consideration of more than 300 amendments. Some 150 amendments offered by Republicans were accepted.

In 2009 and 2010, the Finance Committee held 53 hearings, meetings, negotiations, and walkthroughs on the Affordable Care Act. That committee marked up the Affordable Care Act for 8 days. A markup means you accept amendments and you have debates on amendments. That was the longest markup in 22 years, and adopted during that process were over 10 Republican amendments.

When the bill was considered on the Senate floor, the Senate spent 25 consecutive days in session on health reform--the second longest session in history. Oddly enough and interestingly enough, many of my Republican colleagues, during that process--after 25 consecutive days on the Senate floor and after numerous hearings in the HELP Committee and in the Finance Committee, there were Senators who said that wasn't enough time. They said: This is such an important piece of legislation, and it is going to impact so many people. We need even more time.

Senator Enzi said that ``cutting off Senate debate and deliberation with a budget reconciliation process would shortchange legislation with enormous impact.''

Senator Lamar Alexander said:

I don't think people are going to feel as good about a bill

that restructures one-sixth of our economy, that affects

every single American's health, and the healthcare bill is

being written behind closed doors in the Democratic leader's

office.

In other words, you had Republican leaders thinking that the hundreds and hundreds of hours of discussion and debate on the Affordable Care Act was not enough. I find it amazing that those same Republicans seem to think it is OK for legislation to be written behind closed doors and not have one single committee hearing.

Now the truth is, I can understand why Republicans do not want open discussion and open debate on this issue--because the bill they are working on, which is based on the disastrous bill passed in the House last month, is a bill that would do incalculable harm to people all over our country and really should not be considered as a healthcare bill.

How do you talk about a so-called healthcare bill when you are throwing 23 million people off of health insurance? When we talk about a healthcare bill, the assumption is that we are improving healthcare in America, not doing what the Republican House bill does--wants to throw 23 million Americans off of health insurance. Surely that is not improving healthcare for the American people.

Cutting Medicaid by over $800 billion--and God only knows what the implication of that will be for the children, for the elderly, for people who are in nursing homes.

You are not improving healthcare when you defund Planned Parenthood. After all the rhetoric about choice, choice, choice--we want the American people to be able to go to their provider of choice--oh, 2.5 million women who today get their healthcare through Planned Parenthood, I guess their choice doesn't matter.

We hear about the needs of working-class people. We had the candidate Donald Trump who talked about the needs of working-class people. The House Republican bill--and we think the Senate bill will be very close to it--substantially raises premiums for older workers. That is why, among other groups opposing the House bill, the AARP made the point that this would be a disaster for older workers.

The truth is, this is not a healthcare bill; this is a tax break for the rich and multinational corporations bill. This is a bill that would provide over $200 billion in tax breaks to the top 2 percent. This is a bill that would provide hundreds of billions of dollars in tax breaks to the drug companies and the insurance companies. Last information I received, the pharmaceutical corporations, the major drug companies, made over $50 billion in profit, but this legislation would throw Americans off of health insurance to give drug companies even more profit.

This legislation, the House bill--and, I think, similarly, the bill being worked on behind closed doors--is not only opposed by the AARP, which is the largest seniors group in America, but it is opposed by the American Cancer Society, the American Heart Association, the American Lung Association, the Cystic Fibrosis Foundation, the March of Dimes, the National Multiple Sclerosis Society, and the American Medical Association because the doctors know what a disaster this will be for healthcare for millions of Americans--also, by the American Nurses Association and the American Hospital Association. You have all of these groups that are the pillars of healthcare in America saying: No, no, this is a disastrous bill. Yet we have the Republican leadership and a dozen or so Members who are working behind closed doors.

Nobody here has suggested that the Affordable Care Act should not be improved. In my view, it should be improved. In my view, deductibles are too high, copayments are too high, and premiums are too high. Certainly, the fact that we are paying twice as much as any other country for prescription drugs has to be dealt with also.

The task right now, among sensible people, is to put it on the table and to be honest about it. What are the problems of the Affordable Care Act? How do we lower deductibles? How do we lower copayments? How do we control the escalating cost of healthcare?

Those are reasonable questions that honest people should debate, but the answer is not to throw 23 million Americans off of health insurance. That is not a solution to the problem. That is an insult to the American people.

Let me just conclude by stating this. Our job right now is to make sure that this disastrous Republican proposal never sees the light of day. I would urge my Democratic colleagues, on behalf of the American people--the vast majority of whom know how bad this legislation is--to stand up and fight in an unprecedented way to make sure that that legislation never sees the light of day.

After we win that struggle, I would hope that we would come forward as a nation and join every other major country on Earth, whether it is Canada--and I live 50 miles away from the

Canadian border--the United Kingdom, France, or Germany--and say that healthcare is a right of all people, not a privilege. If you are an American, you are entitled to healthcare. You should not be one of the 23 million people thrown off of healthcare, bringing the total of uninsured in America to over 50 million people. That is outrageous.

I think you are going to hear the American people stand up loudly and clearly and demand transparency and demand serious debate on an issue of this consequence. I think, at the end of the day, this legislation will be defeated.

I yield the floor.

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

Madam President, I have just been informed that the alleged shooter at the Republican baseball practice this morning is someone who apparently volunteered on my Presidential campaign. I am sickened by this despicable act.

Let me be as clear as I can be. Violence of any kind is unacceptable in our society, and I condemn this action in the strongest possible terms. Real change can only come about through nonviolent action, and anything else runs counter to our most deeply held American values.

I know I speak for the entire country in saying that my hopes and prayers are that Representative Scalise, congressional staff, and the Capitol police officers who were wounded make a quick and full recovery. I also want to thank the Capitol Police for their heroic actions to prevent further harm.

Thank you, Madam President.

Mr. President, I rise to speak in support of the Murphy- Paul-Franken resolution of disapproval and to outline my concerns about the unfettered sale of arms to Saudi Arabia. The Saudi-led war in Yemen has created a humanitarian disaster in one of the region's poorest countries. Many thousands of civilians have been killed, many more made homeless, and millions are at risk of starvation, according to the United Nations refugee agency. The chaos in Yemen has also been strategically disastrous for the United States, providing fertile ground for extremist groups like al-Qaida and ISIS and creating new opportunities for Iranian intervention.

In addition to being morally indefensible and strategically shortsighted, the Trump administration's unconditional support for the Saudi coalition, including billions of dollars in arms sales, risks dragging the United States into yet another war in the Middle East.

These are the reasons I strongly support the resolution of disapproval offered by my colleagues and their effort to block some of these arms sales to Saudi Arabia.

I also think it is long past time that we begin to take a very hard look at our relationship with Saudi Arabia. This is a country that is run by a hereditary monarchy in which women are treated as third-class citizens.

I would like to mention for a moment the case of Loujain Alhathloul, a Saudi Arabian human rights activist who was arrested at King Fahd International Airport on June 4. She has been an advocate for women's rights in Saudi Arabia.

In 2014, she was arrested for defying the country's ban--are you ready for this--on women drivers and imprisoned for 73 days.

In 2015, she ran as a candidate in a local council election--the third in the nation's modern history and the first in which women were allowed to both

vote and run--even though her name was never added to the ballot.

More recently, Alhathloul criticized a Saudi Government-sponsored women's empowerment summit, which was attended by Ivanka Trump, for its lack of inclusiveness.

While she has now been released from jail--and I am very glad to hear that--this is no way to treat a peaceful dissident. The human rights organization Amnesty International reported that during her detention, Alhathloul was not allowed access to an attorney, nor was allowed to speak to her family.

Finally and perhaps more significantly, it is important that here on the floor of the Senate, we begin to discuss the decades-long effort by Saudi Arabia to export an ultra-reactionary form of Islam throughout the world.

A recent piece in the Boston Globe by Stephen Kinzer, a journalist who has covered the Middle East for many years--Mr. President, I ask unanimous consent to have his article printed in the Record.

Mr. President, this article by Mr. Kinzer used the example--this is just one example--of Indonesia to demonstrate the incredibly negative impact Saudi financing has had in many places around the world.

I will quote from his article:

Saudi Arabia has been working for decades to pull Indonesia

away from moderate Islam and toward the austere Wahhabi form

that is state religion in Saudi Arabia. The Saudis' campaign

has been patient, multi-faceted, and lavishly financed. It

mirrors others they have waged in Muslim countries across

Asia and Africa.

Successive American presidents have assured us that Saudi

Arabia is our friend and wishes us well. Yet we know that

Osama bin Laden and most of his 9/11 hijackers were Saudis,

and that, as Secretary of State Hillary Clinton wrote in a

diplomatic cable eight years ago, ``Donors in Saudi Arabia

constitute the most significant source of funding to Sunni

terrorist groups worldwide.''

Recent events in Indonesia shine a light on a Saudi project

that is even more pernicious than financing terrorists. Saudi

Arabia has used its wealth, much of which comes from the

United States, to turn entire nations into hotbeds of radical

Islam. By refusing to protest or even officially acknowledge

this far-reaching project, we finance our own assassins--and

global terror.

That is the end of a quote from that excellent article from the Boston Globe.

We all understand that there are times when we must work with problematic governments in order to advance our security goals, but for far too long, we have been giving a pass to a government in Saudi Arabia that supports ideas and policies that are fundamentally at odds with American values and that have led to extremely negative consequences for American security.

I think the time has come for the Congress to take a very hard look at this relationship and assess whether it is actually serving the interests and values of the American people.

Mr. President, I yield the floor.

I suggest the absence of a quorum.

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

Mr. President, I am strongly supportive of adding sanctions against Russia to the bill that is scheduled to come up this afternoon. As I think we all know, Russia actively worked to influence our 2016 Presidential election and continues to try to destabilize democracies around the world, including our own, and that is unacceptable.

At the same time, I have serious concerns about the sanctions on Iran contained in this bill. As we have heard from former Obama administration officials, including Secretary Kerry and Ambassador Sherman, these measures could undermine the Joint Comprehensive Plan of Action, the very important nuclear agreement signed in 2015 between the United States, our P5+1 partners, and Iran. But above and beyond that, let us be aware and cognizant that earlier today, the people of Iran suffered a horrific terror attack in their capital, Tehran, in which 12 people were killed and many more were injured. The Islamic State has claimed credit for this attack.

At a time when tensions are extremely high in that part of the world, our goal must be to find ways to bring people together to reduce tensions rather than to exacerbate this very painful and dangerous situation. Let us also remember that the leaders of Iran immediately expressed condolences for the September 11 attacks against the United States and that hundreds of Iranians held a candlelight vigil.

It seems to me to be the right thing to do--on a day when Iran has been attacked by ISIS, by terrorism, now is not the time to go forward with legislation calling for sanctions against Iran. I would respectfully request that we delay our vote on this bill until next week. Let us tell the people of Iran that while we have serious disagreements with them on a number of issues, that today, when they are mourning, when they are dealing with the shock of a terrorist attack, today is not the day to go forward with this piece of legislation.

With that, I yield the floor.

I suggest the absence of a quorum.

Mr. President, in the U.S. Senate, it is the Parliamentarian's office that determines whether a reconciliation bill is in compliance with the rules of the Senate. That is not the function of the chairman of the Budget Committee. If it were, we could save taxpayers' money and get rid of the Parliamentarian's office, but that is not what we should be doing.

I am extremely concerned, therefore, that the chairman of the Budget Committee, in an apparently unprecedented manner, appears to have made that determination himself with regard to the Trump-Ryan healthcare bill that was passed several weeks ago in the House. As I understand it, the Parliamentarian has made a narrow ruling with respect to the jurisdiction of a provision in this bill that would eliminate healthcare subsidies for low-income Native Americans.

I look forward to hearing from the Parliamentarian as soon as possible on the broader ruling on whether the Trump-Ryan healthcare bill is in compliance with the instructions contained in the budget resolution requiring this bill to save at least $1 billion in the HELP Committee and at least $1 billion within the Finance Committee.

I yield the floor.

Mr. President, I want to recognize George Albert Perreault, Jr., a Korean war veteran whose remains are being brought home to Vermont, 66 years after he was declared missing in action. CPL Perreault enlisted in the U.S. Army after graduating from Burlington High School, and he served bravely in the Korean war. CPL Perreault was assigned to Headquarters Battery, 15th Field Artillery Battalion, 2nd Infantry Division, which was supporting a regiment of the Republic of Korea Army in the area known as the Central Corridor in South Korea. Tragically, CPL Perreault went missing in 1951, after the Chinese People's Volunteer Forces launched a massive attack against the regiment at Changbong-ni. He was declared killed in action in 1954.

CPL Perreault's family, including his sisters and their husbands, Pauline and Jim O'Brien and Lorraine and Edward Winkowski, devotedly preserved his memory over the years. Pauline and Jim also joined families of other missing servicemembers at Department of Defense meetings to discuss efforts to recover the remains of their loved ones.

Last December, the POW/MIA Accounting Agency at the Defense Department identified CPL Perreault's remains using family DNA and anthropological analysis.

While sisters Pauline and Lorraine and their spouses are now deceased, Pauline and Jim's children will be present to welcome their uncle home, including Karen O'Brien, James O'Brien, Jr., Patricia O'Brien, Mary Kay Wyand and her husband Daniel, John O'Brien and his wife Kathy, Anne Booska and her husband Joseph, Daniel O'Brien and his wife Angela, and Sheila O'Brien, as well as CPL Perreault's 18 great- nieces and great-nephews, and 23 great-great-nieces and great-great- nephews.

I have long believed that we have a responsibility to families like CPL Perreault's to account for those missing in action from all conflicts. I commend the POW/MIA Accounting Agency for their tireless efforts to locate and identify the remains of CPL Perreault, more than six decades after he first went missing.

I also want to thank the U.S. Army, the Vermont Army National Guard, and the Veterans of Foreign Wars for their assistance in returning CPL Perrault's remains to his family. Lastly, I also want to thank the staff at Delta Airlines and Burlington International Airport who made it possible for CPL Perreault's remains to be flown home to Vermont, where they will be received with full military honors, surrounded by his family.

At long last, George Albert Perreault, Jr., will be laid to rest in Vermont on Saturday, May 13, next to his parents, George and Yvonne Perreault.

Mr. President, today I wish to recognize Cindy Turcot and congratulate her on her term as the chair of the ESOP Association. Cindy has been committed to advancing the employee ownership model in Vermont and around the country. For the last 2 years, Cindy served as chair of the association, working to promote the interests of employee stock ownership plan, ESOP, companies across the country.

In my State of Vermont, we have seen firsthand the many benefits that employee ownership can bring to businesses and employees. Study after study has shown that employee ownership has been proven to spur employment, increase productivity, grow sales, and raise wages. Importantly, data from the General Social Surveys from 2002 to 2014 shows that employee-owned companies have layoff rates that are four to eight times less than conventionally owned companies.

Cindy has been a vital ally in the efforts to expand broad-based employee ownership and bolster middle-class jobs in our communities. As chair, Cindy advocated for the ESOP business model and the benefits of employee ownership all across the country. I know many in the employee ownership community are so appreciative of Cindy's energy, motivation, and empowerment. Over the last 2 years, Cindy dedicated much of her time and energy to expanding broad based employee ownership to help create a sustainable economy that benefits all of us.

In addition to her work as chair of the ESOP Association, Cindy serves as board treasurer of the Vermont Employee Ownership Center. VEOC has provided numerous Vermont companies with assistance in transitioning to employee ownership, and Cindy has been a crucial resource in those efforts. As we continue to work together to help the employee ownership model realize its true potential, I know Cindy will continue to be an invaluable partner.

Mr. President, it is no great secret that the American people do not have a great deal of confidence in their government. It is no secret that the American people think the Congress is way out of touch with their needs and aspirations. In fact, just confirming that point, a recent poll appeared in the Washington Post and ABC News, and it found that 58 percent of the American people believe that President Trump is out of touch with the concerns of most people in the United States today; 62 percent of the American people believe that the Republican Party is out of touch with the concerns of most people in the United States; and 67 percent of the American people believe that the Democratic Party is out of touch with the concerns of most people in the United States today. Those are numbers that should cause a great deal of concern to Members of the Senate and the House, to Democrats and Republicans, to everybody.

I think one of the reasons is that there is a world outside of Capitol Hill where people are in pain; where people are working longer hours for lower wages; where people are scared to death about facing retirement because they have, in many cases, no money in the bank; where people today are paying 40 percent, 50 percent of limited incomes for affordable housing; where single moms can't afford childcare for their kids; where young people can't afford to go to college; where other people are leaving college deeply in debt. And all of that is taking place within the context of almost all new wealth and income going to the top 1 percent.

We have the absurd situation today where the top one-tenth of 1 percent owns almost as much wealth as the bottom 90 percent, and 52 percent of all new income is going to the top 1 percent. The middle class is shrinking. There are 43 million Americans living in poverty, and the very wealthy are getting wealthier.

In the midst of all that, my Republican colleagues and President Trump are desperately trying to provide hundreds of billions of dollars in tax breaks for the top 1 percent and cut back on programs that working families desperately need, whether it is Pell grants to make it easier for kids to go to college, whether it is afterschool programs, whether it is the Meals on Wheels program, whether it is affordable housing, or whatnot--tax breaks for billionaires, cutbacks on programs that people desperately need.

The American people will not regain confidence in the U.S. Congress unless we keep promises that were made to them. Today I want to talk about promises that were made to coal miners. For decades, coal miners contributed to their pension funds with the promise that when they retired, they would receive a pension and retiree health benefits that would last for a lifetime. Those were the promises to the people who went underneath the ground, who worked incredibly difficult jobs, who died of black lung disease or a myriad of other diseases or injuries. Promises were made to those workers, and those promises were broken.

If Congress does not act by tomorrow, the retiree health benefits of more than 22,000 coal miners will be eliminated. We cannot allow that to happen. It is not only unfair to the retired coal miners and their families, it once again will tell the American people that they cannot trust their government. Promises were made, but they were not carried out.

My understanding is that an agreement to protect these retiree health benefits may be included in the continuing resolution to keep the government from shutting down. As I have walked the hallways here in the Senate, I have met with members, retirees of the United Mine Workers, who have been back here week after week after week, and I applaud them for their persistence.

Let us hope that, in fact, the continuing resolution does contain an agreement to protect those retiree health benefits. It is absolutely imperative that the agreement contain those benefits and that those promises be kept.

Even if we do put that provision in the CR, it still does not address another problem faced by retirees in the coal industry and retirees all over the country, and that is the fact that we are doing nothing to protect the pension benefits of coal miners and tens and thousands of other workers. This is an issue that is of major crisis proportions all across this country, and it is an issue that must be addressed. That is why I am a proud cosponsor of the Miners Protection Act. That is also why I will be introducing legislation on May 9 to protect the pensions of not only 90,000 coal miners throughout this country, but the retirement benefits of 10 million workers in multiemployer pension plans--10 million workers.

Over 40 years ago, the Federal Government made a solemn commitment to the workers of this country. If a retiree is promised a certain pension benefit after a lifetime of hard work, a company could not renege on that promise. Making that commitment 40 years ago was exactly the right thing to do. When someone works for their entire life, when they give up pay raises, when they work overtime, when they work weekends in order to make sure that he or she has a secure retirement, it is absolutely unacceptable to pull the plug from that worker's benefit.

Guarantees were made, and those guarantees must be kept. This is not the negotiating of wage increases. This is not the negotiating of overtime. This is a promise made to workers and paid for by workers, which simply cannot be nullified if people are to have any faith in our political system.

But more than 2 years ago behind closed doors, a provision was slipped into a must-pass spending bill that now makes it legal to cut the pension benefits of about 10 million workers and retirees in multiemployer pension plans. As a result, retirees all over this country are waking up to the unacceptable reality that the promises made to them could be broken and that the pension benefits they are receiving today may soon be cut by 30, 40 or even 65 percent. What this means is that retirees who are currently receiving a pension benefit of $18,000 a year are in danger of seeing their benefits cut by $3,843, a 21-percent cut. Retirees who are currently receiving a pension benefit of $36,000 a year could see their pension benefits cut by up to $21,000, a 60-percent cut.

In other words, tens of thousands of retirees all over this country who today are in the middle class, who worked hard their entire lives, who gave up on wage increases, who worked overtime in order to protect those pensions may be seeing significant reductions in what they anticipated. We are talking about retirees who will no longer be able to pay their mortgages. We are talking about retirees who will not be able to pay their utility bills. We are talking about families who may have to go on food stamps to feed their families after working their entire lives. That is unconscionable. We cannot allow that to happen.

In my view, we have to send a very loud and very clear message to the Republican leadership in Congress and to the President of the United States, and that is when a promise is made to the working people of this country with respect to their pensions and retiree health benefits, that promise must be kept.

Today, about 150 multiemployer pension plans are in trouble financially, but let's be clear. The retirees are not

the reason these pension plans are struggling financially. The reason many of these pension plans are in trouble is because of the greed, recklessness, and illegal behavior on Wall Street that drove this country into the worst recession since the Great Depression of the 1930s. Let us never forget, when the largest financial institutions were on the verge of collapse 7 years ago, it was the taxpayers of this country who bailed them out. I didn't vote for it, but a majority of the Members of Congress did.

Congress gave Wall Street some $700 billion in financial assistance. The Federal Reserve provided $16 trillion in virtually zero-interest loans to every major financial institution in this country and to foreign banks throughout the world because they were, as we will all recall, too big to fail. If Congress can bail out Wall Street, if Congress can bail out foreign banks, we have to protect the pension benefits of American workers.

The legislation that I will be reintroducing on May 9 would prevent the retirement benefits of about 10 million workers and retirees from being cut by repealing the anti-pension rider that was included in an appropriations bill 2 years ago. It establishes an emergency fund within the Pension Benefit Guaranty Corporation to make sure that multiemployer pension plans can continue to provide every pension benefit owed to every eligible American for decades to come.

It is fully paid for by closing two tax loopholes that allow the wealthiest Americans in this country to avoid paying their fair share of taxes. Closing these loopholes will allow us to protect the earned pension benefits of every worker and retiree in multiemployer pension plans in this country.

At a time of massive wealth and income inequality, when half of all older workers have no retirement savings at all, when 20 percent of seniors are living on less than $13,000 a year, we have to do everything we can to protect and expand the fine pension benefit plans in America.

I look forward to the support of my colleagues for this important legislation.

Mr. President, I yield the floor.

I suggest the absence of a quorum.