Floor Statements

The following communications were laid before the Senate, together with accompanying papers, reports, and documents, and were referred as indicated:

EC-653. A communication from the Director, Office of

Management and Budget, Executive Office of the President,

transmitting, pursuant to law, a report relative to spending

limits; to the Committee on the Budget.

EC-654. A communication from the Federal Register Liaison

Officer, Alcohol and Tobacco Tax and Trade Bureau, Department

of the Treasury, transmitting, pursuant to law, the report of

a rule entitled ``Changes to Certain Alcohol-Related

Regulations Governing Bond Requirements and Tax Return Filing

Periods'' (RIN1513-AC30) received during adjournment of the

Senate in the Office of the President of the Senate on

January 18, 2017; to the Committee on Finance.

EC-655. A communication from the Acting Assistant

Secretary, Legislative Affairs, Department of State,

transmitting, pursuant to law, a report relative to

construction of the Keystone XL Pipeline; to the Committee on

Foreign Relations.

EC-656. A communication from the President of the United

States, transmitting, pursuant to law, a report relative to

the Mental Health and Substance Use Disorder Parity Task

Force, received during adjournment of the Senate in the

Office of the President of the Senate on January 19, 2017; to

the Committee on Health, Education, Labor, and Pensions.

EC-657. A communication from the General Counsel, United

States Access Board, transmitting, pursuant to law, the

report of a rule entitled ``Information and Communication

Technology (ICT) Standards and Guidelines'' (RIN3014-AA37)

received in the Office of the President of the Senate on

January 17, 2017; to the Committee on Health, Education,

Labor, and Pensions.

EC-658. A communication from the General Counsel, United

States Access Board, transmitting, pursuant to law, the

report of a rule entitled ``Americans With Disabilities Act

(ADA) Accessibility Guidelines for Transportation Vehicles''

(RIN3014-AA38) received in the Office of the President of the

Senate on January 17, 2017; to the Committee on Health,

Education, Labor, and Pensions.

EC-659. A communication from the General Counsel, United

States Access Board, transmitting, pursuant to law, the

report of a rule entitled ``Standards for Accessible Medical

Diagnostic Equipment'' (RIN3014-AA40) received in the Office

of the President of the Senate on January 17, 2017; to the

Committee on Health, Education, Labor, and Pensions.

EC-660. A communication from the Secretary of the Board of

Governors, U.S. Postal Service, transmitting, pursuant to

law, a report relative to the Postal Accountability and

Enhancement Act of 2006; to the Committee on Homeland

Security and Governmental Affairs.

EC-661. A communication from the Assistant Attorney

General, Office of Legislative Affairs, Department of

Justice, transmitting, pursuant to law, a report entitled

``Uniformed Services Employment and Reemployment Rights Act

of 1994 (USERRA) Quarterly Report to Congress; First Quarter

of Fiscal Year 2017''; to the Committee on Veterans' Affairs.

EC-662. A communication from the Acting Director, Office of

Sustainable Fisheries, Department of Commerce, transmitting,

pursuant to law, the report of a rule entitled ``Fisheries of

the Exclusive Economic Zone Off Alaska; Exchange of Flatfish

in the Bering Sea and Aleutian Islands Management Area''

(RIN0648-XF010) received in the Office of the President of

the Senate on January 12, 2017; to the Committee on Commerce,

Science, and Transportation.

The following executive reports of nominations were submitted:

Mr. President, I ask to have printed in the Record some of the finalist essays written by Vermont high school students as part of the seventh annual State of the Union essay contest conducted by my office.

The material follows:

Mr. President, I ask to have printed in the Record some of the finalist essays written by Vermont high school students as part of the seventh annual State of the Union essay contest conducted by my office.

The material follows:

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

Mr. President, I rise today to oppose the nomination of Mike Pompeo to be the Director of the Central Intelligence Agency. At a time when we are facing massive attacks against privacy rights thanks to the explosion of technology, we should be greatly troubled by giving power to a person who has stated flat-out that he wants to expand the surveillance state, not rein it in.

Here is the kind of world we are now living in, a world that should be of concern to every freedom-loving American, whether you are Democrat or Republican or Independent, conservative or progressive. We are living in a world where government and the private sector often know where you are at any time. They know where you are. They know where you are traveling. They know what books you are reading, what Web sites you are visiting, and maybe the emails you are sending out or reading.

I hear a whole lot of discussion on the floor of the Senate about freedom, about our desire to live and defend a free society. I would ask my colleagues and the American people--when we talk about freedom, one of the attributes of a free society is the right to live our lives the way we want to live our lives, without Big brother knowing everything there is to know about us. You want to do what you want to, it is your business; I want to do what I want to do, it is my business--if we are not harming other people. I believe that is a basic American right and a basic constitutional right, and I want to see people at the CIA, at the NSA, at other intelligence agencies who, yes, will be vigorous about defending us from terrorism but will do it in a way that is constitutional, that protects the civil liberties and the civil rights of the American people.

According to the Pew Internet Project, today 95 percent of American adults own a cell phone. More than three-quarters of American adults own a smartphone. Eighty-eight percent of American adults use the Internet. These advancements obviously have enormous advantages. Everybody knows all of the extraordinary things we can do on the Internet and all the information we can gain. It is almost unthinkable that we were living not so many years ago without the advantages of the Internet. All of these advantages, all of these conveniences come with a price.

If you have a Google account and the GPS enabled on your phone, Google creates a map for you of every single place you go in a given day. Facebook amasses a massive amount of data on you to better target commercials and advertisements to you. Credit card companies track your spending habits. Even innocuous things like a loyalty program in which you gain benefits by buying at a certain store give the private sector and the government eventually access to a massive amount of information about you.

When you go to the grocery store and scan your card, it is very convenient, moves things faster, and you can get a discount, but the store gets to track everything you purchase. Is that really what want? Do you want the whole world to have knowledge of everything you purchase? For just one rather famous example, Target--a huge chain in America--could tell if a woman was pregnant based on what she was purchasing at the store. Do we really feel comfortable about that kind of information getting out into the private sector or the government sector?

If you are wearing a tracking device today to count your steps, to count your heart rate and your sleep patterns, you may see it as a way to become healthier. Your employer or health insurance company, however, may see it as a way to charge you more if you don't meet certain employee wellness targets. Are we really comfortable about corporations knowing all about our health? If you are dealing with a serious illness, maybe it is something you and your family want to keep within the bosom of your family and not spread to the whole world.

That companies are collecting this much information on their own is very troubling to me, but Mr. Pompeo apparently wants to go even further. Last January, he published an op-ed in the Wall Street Journal in which he wrote:

Congress should pass a law reestablishing collection of all

metadata, and combining it with publicly available financial

and lifestyle information into a comprehensive, searchable

database. Legal and bureaucratic impediments to surveillance

should be removed.

Wow. What we are talking about is the U.S. Government having, in many ways, more information about us than we may even understand about our own lives. In many ways, it sounds to me that we are moving toward an Orwellian society where, between the government and the private sector, there is very little about ourselves that is not known by somebody else. I am very, very uncomfortable about that.

I want at the head of the CIA somebody who understands thoroughly the Constitution of the United States and privacy rights and understands that we can fight terrorism effectively within the Constitution and the privacy rights guaranteed to the people of our country.

Since June of 2013, here is what we have already learned that the NSA collects: phone call metadata, including the numbers of both parties-- my number and the number of the person I call--the location, time, and duration of that telephone call. NSA has access to text messages, email chat, and Internet browsing history, smartphone app data, including map data, which can pinpoint a person's location to within a few yards. They have maps of people's social networks and bank and credit card transactions. That is a lot of information held by the government and/ or the private sector on the personal lives of the American people.

As I have mentioned, there is nobody in this Congress who does not understand the threat of terrorism and does not want to see our government be as strong and vigorous as possible in fighting terrorism and getting all the information we need to effectively combat terrorism, to make sure that if somebody is a suspect in terrorist activities, that we go after that person as strongly and as effectively as we can. I believe from the bottom of my heart that we can do that without invading the privacy rights of the American people.

It is not acceptable for Senator after Senator to come here and say we are defending freedom, we live in a free society, and then vote to allow the government or the private sector to have an unbelievable amount of knowledge about each and every one of our personal lives.

Now more than ever, it is vital to have a head of the CIA who will stand up for our Constitution, stand up for privacy rights. Unfortunately, in my view, Mr. Pompeo is not that individual.

With that, I yield the floor.

Mr. President, I ask to have printed in the Record some of the finalist essays written by Vermont high school students as part of the seventh annual State of the Union essay contest conducted by my office.

The material follows:

Mr. President, since 2010, I have sponsored a State of the Union essay contest for Vermont students. The contest, now in its 7th year, is an opportunity for Vermont's high school students to articulate what issues they would prioritize if they were President of the United States. A panel of Vermont teachers reviewed all of the essays submitted and selected the top 20.

I would like to congratulate each and every finalist and to specifically acknowledge Quinn Nelson Mayo as this year's winner of the contest. I would also like to recognize Musa Mayange for placing second and A.J. DeFelice for placing third. I ask to have printed in the Record the winning essays.

The material follows:

quinn nelson mayo, st. johnsbury academy junior (winner)

The United States was founded on several core values; the

most important, as most of us agree, is freedom. This shared

belief has been the foundation of our country for over 200

years. And for centuries, media has been a major outlet for

people to exercise this freedom because it allows them to

share their opinions with the masses. The idea of free speech

took on a different meaning with the development of the

internet in the late 80s. Since then, this liberty has grown

exponentially. Now people have the ability to share their

thoughts with a much larger audience. It is possible to do

this anonymously and without fear of consequence. The

internet is an incredible asset which has helped with

globalization and the spread of information. However, this

form of media does have its drawbacks. The leading issue is

that it enables the spread of false information. So, while

the internet embodies our nation's core value of freedom, it

can also be detrimental to another vital aspect of our

society: educated and well informed citizens.

Regardless of one's political views, we can all agree that

2016 has been a tumultuous year for politics, here in the

United States and across the globe. The 2016 presidential

campaign was a dramatic affair, and just the opening act to

one of the most high-stakes elections in our country's

history. The actions and rhetoric of the president-elect have

inspired a great political shift, as well as a burgeoning

sense of xenophobia and hatred throughout the country. During

times such as these, it is important to focus on what we can

do to create a better future. Much of the hate directed

towards certain groups of people is due to ignorance and can

be traced back to stereotypes perpetrated by unreliable media

sources. Forcing media sites to drastically increase their

censorship would rightfully anger their users, on the grounds

that it restricts their constitutional right to free speech.

Therefore, the most plausible and effective solution to the

problem of misinformation is to educate people.

As of this year, 78% of the United States population has a

social media profile (Statista). Facebook and Twitter have

billions of users across the world. It is imperative that we

use such sites with care. The recent controversies over fake

news have made the influence of the media on politics

increasingly apparent. The rumor now known as ``Pizzagate''

is a prime example of a fake news story with tremendous

influence. Millions of people believed that Hillary Clinton

was involved in a child-prostitution ring run out of a pizza

parlor. This is because, for a vast number of people, social

media and biased news sources are their only ways of

acquiring information. In fact, it is estimated that 62% of

American adults use social media at least occasionally as a

news source (Pew Research Center). However, many blindly make

the assumption that it is accurate. When hundreds of

thousands of people are susceptible to hate-driven fake news,

it can have a huge impact on our democracy.

This is why I propose the incorporation of media literacy

as a core subject in all public schools. Public schools

educate the majority of our nation's children. Which is why,

by teaching America's youth how to approach sources

impartially and critically, we can fix this problem of

misinformation. Integrating media literacy as a required

course at elementary and high-school levels is an investment

in our future generations.

musa mayange, winooski high school senior (second place)

Twelve years and still no change. After fleeing from a

civil war in Somalia in 1992, my parents took refuge at a

refugee camp in Kakuma, Kenya. After 12 years of struggle, in

2004 we flew from the National Airport of Kenya to J.F.K.

International Airport in New York thinking our lives were

saved. Finally here, the land of the free and the home of the

brave. One of the only places on earth where you can taste

opportunity and smell a second chance. At the age of 17, I

can see it now. America's resistance to change.

Racism exists in America. Surveys reveal that whites apply

stereotypical thinking about blacks, considering them lazy

and unintelligent. What are we going to do about these

attitudes towards persons of color?

The American National Election Studies asked voters to rank

blacks and whites from hardworking to lazy, from intelligent

to unintelligent. In 2012, 62 percent of whites gave blacks a

lower score in at least one area. In 2008, 45 percent of

whites expressed negative feelings about black stereotypes.

(Milbank, Washington Post)

For a while, we thought that the issue of racism was over

and that our nation was going to move forward and ``leave the

past in the past.'' It almost had me fooled because we live

in Vermont and we sometimes can be isolated from world

issues. But racism is still here. When everyone thought that

it was no longer ``relevant,'' it's still alive.

As a young African-American immigrant, how can I wrap my

head around this? As Vermonters how can we annihilate racism

and get our community to be accepting of all races, cultures,

and ethnic backgrounds?

Ta-Nehisi Coates addresses the disadvantages of living with

black skin in Between the World And Me. Coates says ``. . .

today, when 8% of the world's prisoners are black men, our

race has been refinanced to the Dream of being white. Black

life is cheap, but in America, black bodies are a natural

resource of incomparable value.'' Black people are born with

a disadvantage. We are more likely to go jail than white

people. The Center for American Progress says, ``In the

United States, black people account for 60 percent of those

imprisoned. The prison population grew by 700 percent from

1970 to 2005, a rate that is outpacing crime and population

rates.

Black people make up 17% of the United States population

yet more of us are in jail. A black man is twice as likely to

go to jail than a white man, even if they did the same crime.

Racism was born when humans identified skin color as a

positive or negative factor. If each of us could accept that

we are all humans, we come from different places, and have

different interests, we could accept racial differences, but

not let them divide us. We will never move forward if we

don't work together side by side and knock down obstacles.

aj defelice, hartford high school freshman (third place)

The United States is one of the greatest countries on

Earth, prized for its natural beauty, economic opportunities,

and democratic principles. However, many challenges face our

nation. Among the most pressing issues are climate change,

immigration, and income inequality.

Perhaps the most daunting problem we face is climate

change, and the crucial role our country plays in it.

Although President Obama recently signed the Paris Agreement

to limit greenhouse gas emissions, much must still be done to

combat this issue. We can begin by putting unemployed or low-

income Americans to work--manufacturing, transporting, and

installing renewable energy products--such as solar panels,

wind turbines, and more. This would produce a similar effect

as the New Deal put into place by President Franklin D.

Roosevelt to combat the negative effects of the Great

Depression. Additionally, a carbon tax should be established

nationally, to lower emissions, and encourage the usage of

renewable energy. A carbon tax would also allow for tax

reductions in other areas, and combined with employing

Americans to transition to widespread renewable energy, would

create economic growth, while simultaneously reducing our

carbon footprint.

Another controversial issue which troubles our nation is

immigration. The United States is a country built on the

backs of immigrants, and to deny a path to citizenship to

millions who long only for a higher quality of life is

unpatriotic. We must stop dehumanizing these people and see

them only for who they are--people. Immigrants strengthen our

economy, whether it be as producers, consumers, or

developers. To deny them access to citizenship in our nation

would be depriving ourselves of economic growth and cultural

diversity. Economic and cultural change that would only

strengthen American society.

Income inequality is another issue which plagues our nation

today. According to countless years of research, income

inequality has a direct correlation on social and health

issues. A study conducted by the University of Wisconsin

found that people who reside in more financially unequal

communities are more likely to die before the age of 75. As

national income inequality decreases, so do social and health

problems. This decline can be seen in Scandinavian countries,

where having a more equal gross domestic product per capita

results in a higher quality of life. To make this possible

for the United States, corporations must be regulated and

held accountable by lawmakers to be sure that the American

people are receiving the representation they deserve. As

citizens, we must be responsible in electing officials who

will place the needs of the greater population

above the interests of wealthy corporate executives.

Our nation is at a turning point in its history, and the

choices we make today will have lasting effects on future

generations.

The United States of America will remain a strong,

respected, and prosperous nation if we are able to look past

our disagreements and focus on making progress through

compromise. We must act wisely, and keep our eyes on what is

most important--the liberty we treasure as our nation's

crowning promise.

Mr. President, I thank my friend from Delaware for yielding. When we talk about the health care crisis in this country, it is not just health care, it is also the outrageously high cost of prescription drugs. I know in my State of Vermont, and in fact throughout this country, millions of people today are unable to afford the medicine they need.

In fact, almost one out of five Americans who go to the doctor and get a prescription are unable to afford to buy the medicine their doctors prescribe. Frankly, that is insane because what happens if you don't take the medicine your doctor prescribed, often you are going to get sicker. Sometimes you may die. Sometimes you may end up in the emergency room. Sometimes you may end up in the hospital. It is literally beyond comprehension that almost one out of five Americans today are unable to afford the medicine they need.

Meanwhile, while so many of our people cannot afford the medicine they need, the top five drug companies last year made $50 billion in profit--$50 billion in profit. The top 10 CEOs in the pharmaceutical industry earned over $300 million.

So what we have is a scenario in which the American people pay the highest prices in the world for prescription drugs. Millions cannot afford the medicine they desperately need, but at the same time the drug companies make out like bandits, and their CEOs earn exorbitant compensation packages.

I happen to live 50 miles away from the Canadian border. A number of years ago, I took a busload of Vermonters across the Canadian border, not just to do some sightseeing in Montreal, which is a beautiful city, but to go there to purchase the same exact medicine that Vermonters, many of whom were dealing with breast cancer, were buying but yet buying it in Montreal, Canada, for a fraction of the price they were paying in the United States.

In fact, on that particular trip, many of the women who were dealing with breast cancer purchased the medicine they needed for one-tenth of the price they were paying in Vermont--one-tenth of the price. Let me take a moment today to review the costs of some of the exact same drugs sold in the United States compared to their costs in Canada.

Here in the United States, EpiPen, as we all know, costs more than $600 a set. That price has skyrocketed in recent years. In Canada, the same exact set costs $290, less than half of what we pay in the United States.

Crestor, a popular drug to treat high cholesterol levels, is $730 here but $160 across the border. We are not talking about generics. We are not talking about another drug. We are talking about the same exact same drug manufactured by the exact same company.

I may be mispronouncing it, but I think it is Abilify, a drug for depression, is more than $2,600 for a 90-day supply here in the United States but only $436 in Canada.

I can go on and on and on. By the way, let's be clear--

Mr. President, I ask unanimous consent to have printed in the Record a chart of drug prices around the world which will show that prices in the United States are not only almost always higher than in Canada but higher than in the UK, Spain, and the Netherlands as well.

Mr. President, perhaps people then will ask a simple question: How does it happen? How does the same exact same medicine sold in the United States sell in countries around the world for a fraction of

the price that we have to pay? The answer is severalfold. No. 1, we are the only major country on Earth, of course, that does not have a national health care system guaranteeing health care to all people. We are the only major country on Earth not to have that.

As part of that problem, we are the only major country not to negotiate drug prices with the pharmaceutical industry. You can walk into a drug store today, and the price could be double or three times what you paid a year ago. There is no law to stop them. They can and they will raise prices as high as the market will allow. If people die as a result of that, not a problem for them. If people get sick, not a problem for them.

Perhaps next to Wall Street, the pharmaceutical industry is the most powerful political force in this country. They have spent more than $3 billion on lobbying since 1998, and they have 1,400 lobbyists on Capitol Hill. We have 100 Senators. There are 435 Members of the House. Yet the drug companies have 1,400 lobbyists on Capitol Hill. They have lobbyists all over the country in every State capital.

These are no small-time lobbyists. These are former leaders of the Democratic Party, leaders of the Republican Party, people who have enormous contacts. So the drug companies are able to raise prices to any level they want because we as a nation, uniquely among major nations, do not negotiate prices with them. The reason we do not negotiate prices with them is they got lobbyists and they make very hefty campaign contributions to make sure Congress, in fact, does not pass legislation which will lower drug prices in this country.

The pharmaceutical industry is an industry that is not only incredibly greedy, but they have a business model which is largely based on fraud. Like Wall Street, their business model is largely based on fraud. Almost every major drug company, not widely known--but almost every major drug company in this country--multi, multibillion-dollar corporations--have been fined for illegal activities and for cheating consumers in our country and all over the world.

Since 1991, with lax enforcement--it is not like we have a vigorous Attorney General's office that really goes after these guys. With relatively lax enforcement policies, drug companies over the years since 1991 have paid over $35 billion in fines or reached settlements for fraud and misconduct. Imagine that. This is just when they are caught, and I suspect that most of the times they cheat, they don't get caught--but $35 billion in fines or settlements since 1991 from the major drug companies in this country.

Let me give you just a few examples of some of the settlements and fines the major drug companies have made in recent years.

In 2013, the Justice Department ordered Johnson & Johnson to pay $2.2 billion in fines because they ``recklessly promote drugs for uses that have not been proven to be safe and effective.''

According to the U.S. attorney handling the case, Johnson & Johnson's ``promotion of Risperdal for unapproved uses threatened the most vulnerable populations of our society--children, the elderly, and those with developmental disabilities.''

In 2010, AstraZeneca Pharmaceuticals paid $520 million to resolve allegations that it illegally marketed the antipsychotic drug Seroquel for uses not approved as safe and effective by the Food and Drug Administration.

In 2009, Eli Lilly was fined over $1.4 billion for its off-label promotion of another antipsychotic product known as Zyprexa. According to Federal investigators, Eli Lilly's ``illegal activity increases patients' costs, threatens their safety and negatively affects the delivery of healthcare services to the more than nine million military members, retirees and their families who rely on'' TRICARE.

Very interestingly--and I am sure many of the Members saw it-- President-Elect Trump had a press conference this morning, and in his press conference, he said that pharma is ``getting away with murder.''

Mr. Trump: Pharma is ``getting away with murder.''

Do you know what? Mr. Trump is exactly right. Pharma is getting away with murder. Pharma has gotten away with murder for many decades.

The interesting issue is, with a Republican President-elect telling the truth, that pharma is getting away with murder, will the Republicans, will all the Democrats have the guts finally to stand up to the pharmaceutical industry and their lobbyists and their campaign contributions and fight for the American consumer and end the disgrace of having our country pay, by far, the highest prices in the world for prescription drugs?

The good news is--I say to my fellow Republicans and to Democrats-- the good news is that tonight you are going to have that opportunity because as part of the so-called vote-arama, I will be offering a very simple amendment which I hope wins strong bipartisan support. In fact, there have been a number of Republicans over the years--in the House and in the Senate--who have supported the concept of reimportation for many years.

What this amendment will do is allow pharmaceutical distributors and pharmacists and those involved in the pharmaceutical industries--those people who sell drugs--to import low-cost medicine from Canada and other countries which will be FDA-approved. In other words, all over this country people ask a very simple question: We can eat fish and vegetables that are grown all over the world, but somehow we cannot get into this country brand-name prescription drugs manufactured by some of the largest drug companies in the world from an advanced country like Canada? The reason we can't do that is for one reason and one reason alone, and that is the power of the pharmaceutical industry.

I would hope that tonight, both Democrats and Republicans will stand together and demand that this country be able to import safe, low-cost medicine from Canada and from other countries.

I should also mention that I will be introducing legislation with Representative Elijah Cummings from Maryland in the coming days on this very issue, on the issue of reimportation and also another issue that Mr. Trump touched on, I believe, today; and that is, the need for Medicare and the government, in general, to negotiate prices with the pharmaceutical industry. The VA does it. Clearly, Medicare should be doing it as well. I believe we are going to have an amendment on the floor tonight. I would hope people support that amendment. I will be introducing legislation on that issue as well as reimportation.

When we talk about the health care crisis in America, one of the issues of concern to most Americans is the outrageously high cost of prescription drugs. The question is whether the Congress has the guts to take on an enormously powerful industry, the pharmaceutical industry, with all of their lobbying and all of their campaign contributions. I certainly hope we will do the right thing, and tonight we can begin that process.

With that, I yield the floor.

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

Mr. President, tonight is an important night because it allows what is very rare here in the Senate--for Members of the body to bring forth amendments and ideas that are very important to them, and that, unfortunately, don't often get debated or voted upon here on the floor.

I know I speak for virtually all Democrats in saying that we have deep concern about the Republican proposal that would repeal the Affordable Care Act without having any alternative plan in place. We think the idea of throwing some 30 million Americans off of the health insurance they have and significantly reducing funding for Medicaid will not only be very, very problematic for lower income people but also impact middle-class people who depend upon Medicaid to help pay for the nursing home care their parents get. We are deeply concerned about the possible privatization of Medicare, making Medicare into a voucher program. We are concerned about the increase in prescription drug costs for seniors that would occur. If the Affordable Care Act were repealed, seniors would have to pay far more than they are paying right now, at a time when many seniors cannot today afford the high cost of prescription drugs. What we find is outrageous is that, in the midst of all these attacks on the middle class and working families of this country, the Republican repeal of the Affordable Care Act would end up providing hundreds and hundreds of billions of dollars in tax breaks for the top 2 percent. I believe there are very few people in America who think we should devastate the health care programs that millions of Americans depend upon and at the same time give huge tax breaks to the very, very wealthy.

Tonight we are going to hear a number of Senators on the Democratic side come down to the floor and offer very, very important amendments which I hope can receive bipartisan support.

We are going to hear Senator Manchin talk about the need to protect rural health. As a Senator from a rural State, I understand very clearly that if the Affordable Care Act is repealed, it will be devastating to rural hospitals all across this country.

Senator Nelson is going to talk about the high cost of prescription drugs and what the repeal of the Affordable Care Act would mean in raising prescription drug prices. Senator Baldwin will be talking about the need to make sure that, as is currently the case, young people 26 years of age or younger can continue to stay on their parents' health insurance. Senator Tester is going to be offering an amendment which will oppose limiting veterans' ability to choose.

I will be offering an amendment making certain the people in our country do not have to pay more for medicine than the people in Canada and in other countries. Senator Casey is concerned about protecting individuals with disabilities and chronic conditions. Senator King is concerned about protecting health insurance for people, many of whom are working in very dangerous occupations.

Senator Menendez is concerned about protecting Medicaid expansion. Millions of Americans have received health care, in some cases for the first time in their lives because we were able to expand Medicaid.

Senator Gillibrand is concerned about protecting women's health. The Affordable Care Act has gone a long way in terms of equity for women, in terms of the health care they receive, and I hope nobody wants to see that disappear.

Senator Manchin will address a very important issue about the opiate epidemic that exists in West Virginia and all across this country.

Senator Stabenow will be speaking about the need to protect mental health services. We have a major crisis in mental health care in this country. We need to do a lot more than we are currently doing, and we certainly do not need to do less.

Senators Cantwell and Carper will be talking about the need to protect delivery system reform. Senator Brown will be talking about the need to protect the Children's Health Insurance Program. Senator Coons will be talking about the need to make sure there are no limits on the health insurance people with serious illnesses receive.

So there are a lot of very, very important amendments that will be offered, and I look forward to an interesting evening of discussion.

I would just conclude my remarks to say that I find it beyond comprehension that at a time when we are the only major country on Earth not to guarantee health care to all of our people--we are the only one--that at a time when we pay significantly more per capita for health care than do the people of any other nation, that at a time when we pay by far the highest prices in the world for prescription drugs-- what we need is to have a health care system that protects the needs of the middle class and working families of our country, not just the insurance companies and not just the drug companies. In fact, the votes tonight are really about whether we are prepared to stand up for ordinary Americans or whether we are going to continue to kowtow to the insurance industry and the pharmaceutical industry.

I yield the floor.

Reserving the right to object--and I will not object--I have one mild correction.

Amendment No. 172 is Klobuchar-Sanders.

Yes. Klobuchar-Sanders. I know that because I am Sanders.

Mr. President, I ask that the amendments be called up as under the previous order.

Mr. President, pursuant to section 904 of the Congressional Budget Act of 1974, I move to waive section 305(b) of that act for purposes of the pending amendment, and I ask for the yeas and nays.

Mr. President, I urge a strong ``no'' vote on the Barrasso amendment. The language calls for strengthening Social Security, but we all know what strengthening Social Security means. It means cutting Social Security. It means cutting Medicare. It means cutting Medicaid. We are into Orwellian language. ``Strengthening'' is not cutting programs, it is not throwing 20 million Americans off health insurance, it is not privatizing Medicare, it is not raising prescription drug costs for senior citizens. I urge a ``no'' vote on the Barrasso amendment.

Mr. President, I ask unanimous consent that the following amendments be called up en bloc and reported by number, and that they be considered following disposition of the Stabenow amendment No. 94: Cantwell amendment No. 143; Brown amendment No. 86; and Coons amendment No. 126.

Mr. President, this amendment should be aptly called the Orwellian amendment because it says one thing and does something very much the opposite. It talks about strengthening Social Security, affordable coverage for all Americans. What is really going on is a desire to cut Social Security benefits and throw 20 million Americans off of health insurance.

I urge the defeat of this amendment.

Mr. President, I raise a point of order that the pending amendment is not germane to the underlying resolution and therefore violates section 305(b)(2)of the Congressional Budget Act of 1974.

Mr. President, I raise a point of order that the pending amendment is not germane to the underlying resolution and, therefore, violates section 305(b)(2) of the Congressional Budget Act of 1974.

Mr. President, reserving the right to object, and I won't, I would appreciate it if we could add to the end of that tranche the Klobuchar-Sanders amendment. Would that be all right?

OK. If we could add Klobuchar-Sanders as the fourth amendment of that tranche--it is all right. OK. Thank you.

Amendment No. 61

Mr. President, the repeal of the Affordable Care Act will throw perhaps up to 30 million people off of health insurance.

I would yield to my friends if they will tell me now what the replacement is. How many of those 30 million people are going to die? What is your plan to cover them, plus the other 28 million people who have no health insurance? How are you going to end the international embarrassment of the United States being the only major country on Earth not to guarantee health care to all people?

They don't have a plan. I understand Senator Corker wants more time. Maybe they will develop a plan. Right now what they are talking about is repealing legislation which has brought millions of people health care, and they have no substitute.

I would urge the defeat of the Barrasso amendment.

Madam President, I raise a point of order on Barrasso amendment No. 181, that the pending amendment is not germane to the underlying resolution and therefore violates section 305(b)(2) of the Congressional Budget Act of 1974.

Madam President, pursuant to section 904 of the Congressional Budget Act of 1974, I move to waive all applicable sections of that act for purposes of the pending amendment, and I ask for the yeas and nays.

Madam President, people in the United States pay by far the highest prices in the world for prescription drugs.

I live 50 miles away from Canada, and in many cases they pay 50 percent less for the same exact medicine that we buy in Vermont or in America, and we all know the reason why. The power and wealth of the pharmaceutical industry and their 1300 lobbyists and unlimited sums of money have bought the U.S. Congress. Let's be clear about it.

Today Mr. Trump--a guy I don't quote very often--said that pharma gets away with murder. That is what Trump said. He is right. Year after year, the same old, same old takes place. We get amendments like Senator Alexander's, and the pharmaceutical industry makes more and more money, and the American people pay higher and higher prices.

The time has come for us to stand up to the drug companies. Let's do it tonight. Let's defeat the Alexander amendment. Let's support the Klobuchar-Sanders amendment.

Madam President, I raise a point of order that the pending amendment is not germane to the underlying resolution and therefore violates section 305(b)(2) of the Congressional Budget Act of 1974.

Mr. President, last year the five major drug companies made $50 billion in profit, while one out of five Americans cannot afford the medicine they need. Please don't tell me that we can import fish from all over the world, but we can't bring medicine in from Canada.

I ask for the yeas and nays.

Mr. President, the adoption of this budget resolution will allow Republicans to come back to the floor of the Senate with a budget reconciliation package which will repeal the ACA with a simple majority. If they do that, up to 30 million Americans will lose their health care, with many thousands dying as a result. Because if you have no health insurance and you can't go to a doctor or a hospital, you die.

Medicare will be converted into a voucher program. Medicaid will be decimated. Rural hospitals will be closed, and they have no alternative proposition. They want to kill ACA, but they have no idea about how they are going to bring forth a substitute proposal. This is not what the American people want. This is irresponsible. This is dangerous. This should be defeated.

How am I recorded?

On behalf of elderly people who cannot afford higher prescription drugs, I vote no.

Mr. President, as the ranking member of the Budget Committee, I want to take this opportunity to make several points in opposition to the Republican side-by-side amendment and in support of the amendment that I have offered.

Like many Republican proposals, if you read the Republican amendment, it sounds good on the surface, but if you probe half an inch into it, you recognize what an incredible disaster it will be for working families of this country--nice words, but devastating impacts. So I want to talk about that.

No. 2, I want to talk about what it will mean if, in fact, the Republicans

are successful in doing what they want to do, which is repealing the Affordable Care Act--something which I, and I think virtually every Democrat, will do our best to oppose--and what it will mean to the American people if the Affordable Care Act is repealed without any alternative to replace it.

What that, in fact, will mean is throwing 30 million people off of their health insurance. Thirty million people will lose their health insurance. I have not seen any Republican studies as to how many of those people will die, but certainly many thousands of them will die because if you are sick and you don't have any money and you don't have any health insurance, you cannot get to a doctor or you cannot get to a hospital. In fact, there have been some studies suggesting that thousands of people will die, and certainly many others will become much sicker than they should be. That is what happens when you simply throw 30 million people off of health insurance and you have no alternative plan.

Nobody in the Senate thinks the Affordable Care Act is perfect, least of all me. I think it needs significant changes. Let's work together to change it. But you cannot just repeal it without any alternative.

Not only will a repeal throw 30 million people off of health insurance, it will devastate millions and millions of low- and moderate-income families by making major cuts to Medicaid, and that includes many middle-class families who use Medicaid to support payments for their parents who are in nursing homes.

If you repeal the Affordable Care Act without a replacement, you are going to significantly increase the cost of prescription drugs for senior citizens, many of whom have a hard time right now paying for their medicine. And while you have thrown millions off of health insurance, while you make devastating cuts to Medicaid, while the repeal of the Affordable Care Act will raise the cost of prescription drugs for seniors, a repeal would do something else, which is not terribly surprising coming from Republicans. It would provide $346 billion in tax breaks to the top 2 percent. Millions lose their health care, the costs of prescription drugs go up, middle-class families will not be able to afford nursing home care for their parents, but, importantly, from the Republican perspective, $346 billion in tax breaks will go to the top 2 percent.

Now, this is a set of priorities which I, frankly, believe the American people do not support.

Also this afternoon I want to touch on another issue that is actually even more important than the previous two, and that is, to my mind, in a Democratic society, a candidate for President--in this case Mr. Trump--cannot simply say one thing over and over again, cannot go out to the American people and make campaign promises, but the day after the election, forget about what those promises were about.

Now, here is the purpose of the Republican amendment. This is what is in front of all of us right now.

Purpose: To strengthen Social Security and Medicare without

raiding it to pay for new Government programs, like

ObamaCare, that have failed Americans by increasing premiums

and reducing affordable health care options, to reform

Medicaid without prioritizing able-bodied adults over the

disabled, and to return regulation of insurance to State

governments.

That is the exact quote of the purpose of the Republican amendment that we will be voting on in a few moments. It sounds pretty good. But let us translate it into English, and let us be very clear about what these words actually mean and why this amendment should be opposed by every Member of the U.S. Senate.

The Republicans say in their purpose that they want to ``strengthen Social Security and Medicare.'' Well, count me in. That is exactly what I want to do. But how do they propose to go about doing that? They are going to strengthen Social Security and Medicare by making devastating cuts to Social Security and Medicare. That is a strange way to strengthen a program.

As we speak right now, the Republican chairman of the House Ways and Means Subcommittee on Social Security--the committee that has jurisdiction over Social Security--has introduced legislation which will make devastating cuts to Social Security. That is a very unusual way to strengthen that program.

My Republican friends will tell us that the only way we can ``strengthen Social Security'' is, in fact, to cut Social Security. Now, talk about fake news; talk about Orwellian language. We are strengthening Social Security by cutting Social Security. To all those seniors and disabled veterans who are out there and who are trying to get by on $13,000, $14,000, $15,000 a year in Social Security benefits, my Republican colleagues are going to ``strengthen'' Social Security and they are going to do it by cutting your benefits. That is a very strange way to strengthen Social Security.

It seems to me that if we are serious about really strengthening Social Security, what that means in plain English--not Orwellian language--is, No. 1, if you want to strengthen it, we have to extend the life of Social Security. Social Security now can pay out every benefit owed to every eligible American for 17 years. That is OK. It means we are not in a crisis, but it is not good enough. I want to see Social Security be solvent for another 50 or 60 years. That is strengthening Social Security.

When we talk about strengthening Social Security, that means increasing benefits, not cutting benefits. The truth is that seniors in this country cannot make it on $13,000 or $14,000 a year in Social Security benefits; we need to increase and expand their benefits.

Thirdly, if we are serious about strengthening Social Security, we need to end the absurdity of seniors who this year got a COLA of three- tenths of 1 percent, and in recent years have gotten COLAs of zero percent because the formula that determines COLAs for people on Social Security is totally inadequate and an incorrect formula, not really measuring the cost-of-living expenditures of senior citizens.

That is what we have to do to strengthen Social Security.

How do we do that? I have legislation that will do just that. But do my colleagues know what? Despite all of the talk of my Republican colleagues wanting to strengthen Social Security, we have zero Republican cosponsors on that idea.

The way we do it--a concept supported by many of the major senior organizations in this country--would eliminate the earnings cap on all taxable income above $250,000. Right now, if you make $1 million a year, $10 million a year, you contribute the same amount into the Social Security trust fund as somebody who makes about $118,000. That is wrong. That is unfair. Lifting that cap, starting at $250,000 and above, would impact only the top 1.5 percent. If we do that, we can extend the life of Social Security for well over 50 years and we could expand benefits for people living on less than $16,000 a year by more than $1,300 a year. That is how we strengthen Social Security. But I have not heard one Republican in this body speak in support of that proposal.

Now, Republicans say they want to strengthen Medicare without raiding it to pay for new government programs like ObamaCare. That is what they state in their purpose. So let me be absolutely clear. That is a totally false statement. It is not true. The so-called raid was an effort to save some $700 billion over a 10-year period by making Medicare more efficient and more cost effective.

My Republican friends talk every day about the need to bring increased efficiencies into government programs. They are right. We need to do that. And that is precisely what the Obama administration did. My Republican friends will not get up here and tell us that there was one nickel of Medicare benefits cut as a result of the creation of the Affordable Care Act. There was not one nickel of benefits cut. They know it. I know it. They will not say otherwise.

So the $700 billion was in savings, doing the right thing--not cutting a nickel of benefits from Medicare. I hope my Republican colleagues will not continue to try to spread this mistruth.

The Republican amendment that we are going to be voting on talks about reforming Medicaid without prioritizing able-bodied adults over the disabled. It sounds good. What are they talking about in real English? What they want to do is ``reform'' Medicaid without prioritizing able-bodied adults over the disabled. What does that

mean? It means not only do they not want to see Medicaid expanded, as over 30 States have done, what they want to do, and what this language is really about, is to throw millions of people off of Medicaid. We are the only major country on Earth that does not guarantee health care to all people. Some 28 million Americans today have no health insurance. They want to throw millions more off health insurance.

So if you are an ``able-bodied'' adult making the Federal minimum wage of $7.25 an hour--which, by the way, they don't want to raise. Vermont has raised its minimum wage to $10 an hour. I don't know what it is in Wyoming--$7.25. But if you are in a State where minimum wage is still $7.25 and you are able-bodied, do the arithmetic. If you have a couple of kids, health insurance will cost you $10,000, $15,000 a year. How do you afford that when you are making $8, $9, $10 an hour? You don't afford it. That is able-bodied.

The last I heard, it is not criminal activity to be working and making $8, $9, $10 an hour. Unfortunately, that is what millions of people do. They cannot afford health insurance. What many of us have tried to do is expand Medicaid so that they will get health insurance, but what the Republican proposal and their language is about is the denying health insurance for the so-called able-bodied. Let's get rid of the word ``able-bodied.'' Let's talk about working people at starvation wages who cannot afford health insurance. That is what that language means in English.

The Republican's proposal we will be voting on also talks about ``returning regulation of insurance to State governments.'' OK. It sounds good. What does that mean in the real world? That means you could be denied coverage for a preexisting condition.

I just met a woman last night dying of breast cancer. That is her reality, but she was able to get health insurance, despite having a very severe situation, because we abolished the insurance companies' ability to say no to her and to millions of other people who have preexisting conditions.

When you want to return regulation of insurance to State governments, that is precisely what they can do--the law is gone. The insurance companies can say: You have cancer; we are not going to cover you because you are going to cost us too much money, and we can't make any money from you. Insurance companies could refuse to cover needed things like maternity care, prescription drugs, or high-cost diseases like HIV and many others. That is what they mean when they talk about returning regulation of insurance to State governments, doing away with all of the patient protection we have passed here in Washington that is widely supported by the American people. Go out to Wyoming, go to Vermont, go to Oregon, go to any State and ask the people if we should repeal preexisting conditions so insurance companies can discriminate against people with illness, and they will tell you overwhelmingly no.

So the Republican proposal, which sounds nice, is in fact a devastating amendment that would very negatively impact many millions of people. I hope every Member of the Senate will reject that Republican amendment and in fact vote for an amendment I will be offering which addresses two very important issues:

No. 1, at a time of massive income and wealth inequality, at a time when a tiny sliver of our population--the people on top--are getting phenomenally wealthy, phenomenally richer, we have an explosion of billionaires in recent years while the middle class continues to shrink. At a time when we are the only major country on Earth not to guarantee health care as a right to all of our people, it would be absolutely unacceptable to take away health insurance from 30 million Americans, unacceptable to privatize Medicare, unacceptable to slash Medicaid, unacceptable to increase the costs of prescription drugs for seniors, unacceptable to defund Planned Parenthood--a high-quality health care organization providing health care to over 2 million Americans, many of whom are low income women. So a vote for the Sanders amendment rejects all of those very bad ideas.

If we throw 30 million people off health insurance and if we do not have a plan to replace it, I would hope my Republican colleagues would have the decency to tell us how many of those 30 million people will die. If we are going to be considering this legislation and throwing 30 million people off who can no longer get to a doctor, can no longer get to the hospital because they don't have the money, how many of them will die? Tell us. Tell us so we can hold that in consideration as we look at this proposal.

For years, it is no secret Republican leaders like Paul Ryan and Congressman Tom Price have wanted to end Medicare as we know it. That is what they have told us. It is not what I am saying. It is not a great secret.

What does that mean? What does it mean if we end Medicare as we know it and if we turn it into a voucher program, handing a 65-year-old senior who has been diagnosed with cancer an $8,000 check and telling them to go out to a private insurance company and buy insurance on their own. That is what privatizing Medicare is about. It is a voucher program. Here is a check. You go out to the private insurance companies. You do your best.

If you are an 80-year-old suffering with cancer and you have a check for whatever it may be--$8,000, $9,000 a year--and you go to an insurance company and you say: What do I get for my $8,000 check, they will laugh at you. They will laugh at you because they understand the cost of your care--your hospital care, your prescription drugs--will go well beyond 8,000 in the first week, let alone year. You will get nothing. That is what the Republican idea is in terms of privatizing Medicare.

Let me get to the last point I want to make, and that gets well beyond the Affordable Care Act and well beyond Medicaid, Medicare, and Social Security. It gets to the essence of what our political system is supposed to be about, and that is, if we run for office--and every person in the Senate has run for office. If you run for President, you cannot say over and over again that you are going to do this, and the day after the election decide you are not going to do it. That is why so many people in this country are disgusted with the political process. They see people saying: Hey, vote for me. I am going to do A, B, and C, and the day after the election you do the very opposite, D, E, and F.

When he ran for President, Donald Trump ran a very unconventional campaign. That is for sure. He said: I am not a typical Republican. That is what he said. He said: If I am elected President, I, Donald Trump, am not going to cut Social Security, I am not going to cut Medicare, and I am not going to cut Medicaid. He didn't say that once. He wasn't caught in an ambush interview. That was the heart and soul of his campaign. That is what he said to the elderly and to working-class Americans, and many voted for him precisely because he said he would not cut Social Security, Medicare, and Medicaid.

On May 7, 2015, Mr. Trump tweeted: ``I was the first and only potential GOP candidate to state there will be no cuts to Social Security, Medicare, and Medicaid.''

April 18, 2015, Trump said:

Every Republican wants to do a big number on Social

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

on Medicaid, and we can't do it. And it's not fair to the

people that have been paying in for years. Now, all of a

sudden they want to cut it.

August 10, 2015, Trump said:

I will save Medicare, Medicaid, and Social Security without

cuts.

Without cuts.

We have to do it. People have been paying in for years and

now many of these candidates want to cut it.

March 29, 2016, Trump said:

You know, Paul [Ryan]--

Paul Ryan is, as we all know, the Speaker of the House--

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

. He wants to knock Medicare way down.

Two things. You will lose the election if you are going to do that. I am not going to cut it, and I am not going to raise ages, and I am not going to do all the things that they want to do. Welcome to ``they.'' That is what the Republicans are trying to do.

Back to the quote:

But they want to really cut it, and they want to cut it

very substantially--the Republicans--and I am not going to do

that.

That is where we are today. Republicans have a proposal which will make

devastating cuts to Social Security over in the House, and here by repealing the Affordable Care Act, they are going to cut Medicare and Medicaid.

In December of 2011, Trump wrote:

Now, I know there are some Republicans who would be just

fine with allowing Social Security and Medicare to wither and

die on the vine. The way they see it, Social Security and

Medicaid are wasteful entitlement programs. But people who

think this way need to rethink their position. It's not

unreasonable for people who paid in to a system for decades

to expect to get their money's worth. That's not an

entitlement. That's honoring a deal. We as a society must

also make an ironclad commitment to providing a safety net

for those who can't make one for themselves.

On May 21, 2015, Trump tweeted:

I am going to save Social Security without any cuts. I know

where to get the money from. Nobody else does.

On and on and on. These are just some of the quotes. This is not like a statement in the middle of the night. This is what he campaigned on.

What this amendment is about and says to my Democratic colleagues and says to my Republican colleagues is, do we hold and support the process in which a candidate runs for office and over and over and over again tells working families and the elderly he will not cut Social Security, Medicare, or Medicaid--do we hold him to his word or do we just say: Hey, that is just campaign rhetoric. He lied. That is OK. That is politics in America. It doesn't matter what he said. This is the reality. We are going to cut Social Security, Medicare, and Medicaid.

So this amendment tells us that if we go forward with what the Republicans want to do, it will be devastating to the American people, but perhaps, more importantly, what this amendment says is that in a democratic society, we must have faith with the American people. You cannot run a campaign, make promises, and the day after forget about everything you said.

I would hope very much that my Republican colleagues will join all of us on this side in supporting what democracy is supposed to be about. We have differences of opinions. Mr. Enzi and I disagree on a lot of things, but I have never suggested that Mr. Enzi--when he campaigns, I believe he says what he believes. People vote for him or they vote against him. It is called democracy. Now you have a situation where a candidate for President goes to the working class and says: I will not cut Social Security, Medicare, and Medicaid. Let us tell Mr. Trump: Let us keep faith with the American people. We heard what you said, and we are going to hold you to your word. Let us support the Sanders amendment.

Mr. President, I yield the floor.

Mr. President, when my friend Senator Flake talks about reforming Social Security, what he is talking about is cutting Social Security. He is suggesting that is the only way we can save Social Security. Of course, that is nonsense. I would urge my good friend from Arizona to get on board legislation that I will be offering. Do you know what it does? It extends the life of Social Security for 55

years and expands benefits, and it does that by lifting the cap so that billionaires contribute more into the Social Security trust fund.

To suggest that nobody on this side wants to do anything is inaccurate. We do want to do something. We want to raise benefits and extend the life of Social Security. And, yes, some campaign donors-- billionaires--may have to pay more in taxes.

I urge my colleagues to reject the Flake amendment and support the Sanders amendment.

Mr. President, I raise a point of order that the pending amendment, No. 52, is not germane to the underlying resolution and therefore violates section 305(b)2 of the Congressional Budget Act of 1974.

Mr. President, this amendment does two basic things. No. 1, it says that the Senate should not go on record in throwing 30 million people off of health insurance, raising the cost of prescriptions drugs for seniors, and privatizing Medicare.

But it also does something else maybe even more important. It says that we should support President-Elect Trump when he campaigned throughout this country saying that I, Donald Trump, will not cut Social Security, will not cut Medicare, will not cut Medicaid. Let's tell the American people that we think that when a candidate for President says something over and over and over, when he promises the working people and the elderly that he will not cut Social Security, Medicare, and Medicaid, we stand with him and we are going to support him and make sure that there are no cuts to Social Security, Medicare, and Medicaid.

Thank you.

Mr. President, pursuant to section 904 of the Congressional Budget Act of 1974, I move to waive all applicable sections of that act for purposes of the pending amendment, and I ask for the yeas and nays.

Mr. President, I begin by thanking Senator Paul. He has shown a lot of courage for standing and exposing the hypocrisy of the Republican budget resolution.

Year after year, we have heard from our Republican colleagues that the United States is going broke, that we have huge deficits, that we have a $19 trillion national debt, that we have to cut Social Security, we have to cut Medicare, we have to cut Medicaid, we have to cut funding for education, we have to deal with the deficit.

As Senator Paul has indicated, if the Republican budget resolution passes, the Federal deficit would more than double over the next decade, going from $571 billion this year to over $1.3 trillion 10 years from now.

I hope all of the deficit hawks on the Republican side hear what Senator Paul has to say and support him.

I will not support him because I understand that the cuts that he is proposing are devastating to working families, to the elderly, to the children, to the sick, and to the poor. They would mean massive cuts in Medicare, Medicaid, Federal aid to education, and a variety of programs people desperately need, so I will oppose the amendment.

All of my Republican friends who talk about the deficit year after year, here is a vote you should cast.

Thank you.

Mr. President, I call up amendment No. 19, which is at the desk.

Mr. President, I ask unanimous consent that the reading of the amendment be dispensed with.

Mr. President, I ask unanimous consent to set aside the pending amendment and call up amendment No. 20.

I ask unanimous consent that the reading of the amendment be dispensed with.

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

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

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

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

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

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

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

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

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

That is their plan.

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

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

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

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

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

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

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

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

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

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

that have been paying in for years.

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

On March 29, 2016, Mr. Trump said:

You know, Paul [Ryan]--

Paul Ryan is the Republican Speaker of the House--

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

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

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

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

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

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

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

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

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

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

With that, I yield the floor.

Will my colleague from Michigan yield for a moment?

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

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

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

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

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

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

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

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

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

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

With that, I yield the floor.

Mr. President, I ask unanimous consent that Jenna Sablan and Natalie Rico, detailees to the Budget Committee, be granted floor privileges during the consideration of S. Con. Res. 3.

Mr. President, I ask unanimous consent that Mike Jones and Josh Smith from my staff be given all-access floor passes for the Senate floor during consideration of the budget resolution, S. Con. Res. 3.

Mr. President, I ask unanimous consent to speak for up to 20 minutes.