Floor Statements

Mr. President, I ask unanimous consent for the following interns in my office to be granted floor privileges until July 22, 2026: Mark Schoeppel and Maggie Ralston.

Mr. President, as regards Calendar No. 44, S. 1041, the Affordable Prescriptions for Patients Act, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 44,

I ask unanimous consent that the committee-reported amendments be considered and agreed to; that the bill, as amended, be considered read a third time and passed; and that the motion to reconsider be considered made and laid upon the table.

Mr. President, I ask unanimous consent that the Senate proceed to the consideration of S. Con Res. 37, which is at the desk.

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

Mr. President, I ask unanimous consent that the Senate proceed to the consideration of S. Res. 809, which is at the desk.

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

Mr. President, I ask unanimous consent that the Senate proceed to the consideration of S. Res. 810, which is at the desk.

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

I ask unanimous consent that when the Senate complete its business today, it stand adjourned until 10 a.m. on Wednesday, July 22; that following the prayer and pledge, the Journal of proceedings be approved to date, the morning hour be deemed expired, the time for the two leaders be reserved for their use later in the day, and the Senate be in a period of morning business, with Senators permitted to speak therein for up to 10 minutes each.

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

Mr. President, I rise, as so many others have, to give tribute to Senator Lindsey Graham.

Lindsey was effective as a Senator, in large part, because he was so well-liked by colleagues and because he liked them in return.

He was affable, always willing to work with others, regardless of how different backgrounds, beliefs, and positions were. He just focused on getting things done and had the courage to take on issues that others would not.

We collaborated on something called Graham-Cassidy, a bill which would have replaced Obamacare with coverage for everyone--literally everyone--but at a lower cost than the Affordable Care Act. I always chuckle when I say the Affordable Care Act.

And we were a good team because we complemented each other. I was a doctor, always thinking about healthcare. He was the politician's politician.

He told me: Bill, you are good at policy, but you are a terrible politician.

And I would say that many people knew exactly what he was talking about. At one point, I was talking to him about healthcare. He said: Oh, Bill, don't talk to me about policy. It gives me headaches. But he said he would fight to get it passed. We came up short but not because he did not and I did not fight.

Once he said: I am going to go on ``FOX Morning.'' If I go on ``FOX Morning,'' I know the President is watching. And if the President is watching the ``FOX Morning'' show and I say we should be fighting to replace Obamacare, it will get the President engaged.

He just knew how to find that audience that was important. He knew how to speak to them. He had a great sense of humor, and, again, he knew how to get things done.

Ultimately, that is why somebody comes to Washington. Some people come to Washington to be a Senator. Others come to Washington to do something as a Senator. Lindsey was someone who came to Washington to do something as a Senator.

I speak for myself, but I echo what colleagues have said. Lindsey Graham shall be missed.

Healthcare

Mr. President, we have got to do something about healthcare. Now, I am a physician. You might think I--of course, Bill cares about it. I can tell you who cares about it is the American people.

I was with an Uber driver last night: What do you think--you know, if you were the President, Uber driver, what would you be talking about right now?

She said: I can't afford things. I can't afford my gas. I can't afford my groceries, my housing. I can't afford my healthcare.

Now, that has been echoed.

And, in fact, what we are seeing is that the inability to afford healthcare is impacting the ability of small businesses to provide health insurance for their employees. The employer-based health insurance system is the most dominant form of providing health insurance for those less than 65, and it is crumbling. The percentage of working-age adults getting health coverage from a job has decreased from 67 percent--oh, about 25 years ago--to about 60 percent now. And the reason why is that premiums are going up so much, particularly for those 62 percent of Americans who get their insurance from a small business.

There is a recent article in STAT which, based upon Federal Government information, if you look at inflation since about 1985, premiums should have

risen about 176 percent. But they have actually risen over 1,000-- almost 1,100--percent higher than they should have. To put it this way, if they should have risen 176 percent, they have actually risen about 1,100 percent. These are premiums.

Now, by the way, these premiums continue to rise after the passage of the Affordable Care Act. Indeed, the rise became higher, faster after the passage of the Affordable Care Act.

And so, if you are a small business, you are trying to make ends meet. Businesses contribute to the health insurance of their employees. Typically, they may employ--it depends upon the business, but they may give, oh, 100 percent. They may give 80 percent. They may give 60 percent. But whatever percent that the small business is contributing to their employees is going up.

The other thing to recognize is that, when it begins to rise too much, then the employer pays less and less for the employees' health insurance. This can be manifested in a couple ways. Instead of paying 80 percent of the cost of the policy, they may pay only 60 percent. Or the small business may decide to get a less expensive policy, in which case they increase the deductible.

Now, the deductible is what we pay out of pocket before the insurance kicks in. That is the problem.

And so, if you look at, since about 2000, the amount of deductible at a big business is about $1,700. At a small business, for a single worker, among workers with a deductible, it is now about $2,600.

So before the insurance begins to work for the employee, they have to come up with, on average, $2,600 to pay before the insurance kicks in.

Now, it may be something like a routine visit, which is covered. They may have preventive care covered, like a mammogram or a screening colonoscopy. But, typically, they have got to put up $2,600, on average, if they go to the emergency room after a car wreck, and only then does the insurance begin to kick in.

Now, why is that important? Because most families have less than $500 of cash in order to pay for their healthcare.

In previous speeches, I have talked about how people are putting their healthcare expenditures on their credit card. And that credit card debt factors into 60 percent of household bankruptcies. So they have a $3,000 deductible, and they don't have the money in their bank account. Their child gets sick, and they bring them to the emergency room. They don't have the $3,000. So they put it on the credit card, and that credit card debt mounts.

Indeed, if you look at the percent of income that Americans are now paying upon credit card interest, which means that they are carrying a balance, it has risen from about 1 percent to 3.2 percent. So 3.2 percent of their income is going to pay for interest on credit cards.

This shows that they are rolling these big credit card balances forward. So with credit card balances not paid, but being the minimal amount being paid, they are up to $10,000.

Much of this relates back to: How do you pay for healthcare? I don't have the money in my account. So I am going to use my credit card in order to pay for these large deductibles.

Well, I have got a way to address that, Mr. President. We call it the MVP Act. Under our plan, we would give an advance, an income tax credit, to the family--on average, for a family of four, about $2,000-- that would go into an account that they use to pay for their benefits.

By the way, this is paid for. This is paid for.

But they would prefund a health savings account.

Now, we don't give it to the insurance company because, if you give the money to the insurance company to subsidize the premiums, the insurance company takes 20 percent of it for overhead and for profit. You give it to the individual or family, and they are going to use 100 percent of it for the healthcare that they need.

Now, we have coupled that. So it is money in your pocket. We couple that by adding value, price transparency, so that the family knows the price they pay before they go in for the service. That could be powerful.

I was up here in DC once. Actually, I remember we were having a crawfish boil. Every year, Louisiana people have a crawfish boil. And there was a woman who saw me on the street. She stopped me.

She said: Hey, Dr. Cassidy.

And I said: Yes.

She said: I am from Texas, but I saw that you gave a speech about price transparency, and that if I paid cash, it would be cheaper than if I went through my insurance. So the doctor ordered an MRI on my son's shoulder, and they told me it was going to cost $2,000. Well, my deductible was whatever it was--say a thousand dollars. So I said: How much, if I pay you cash? They said: Well, if you pay us cash, it is only $600.

In this case, paying cash was cheaper than paying her deductible.

So if you know, if you have price transparency, if you say, ``Wait a second; I am going to have at least a thousand dollars out of pocket because of my deductible, but if I paid cash right now and don't go through my insurance, it only cost me $600,'' you are going to bring value to the patient.

In this transaction, under the MVP plan, there would have been money placed into her health savings account. She could have used--in this case, she did it on her own--price transparency to find out the price. So there is money and value for the patient.

We take the power away from the middleman, the power away from the insurance company to approve or disapprove of the care that the patient knows that she needs; and, instead, we would give the money directly to her, with the tools of price transparency to bring value to the patient.

Now, we are making steps on this. Right now in the HELP Committee-- the Health, Education, Labor, and Pensions Committee--of which I am the chair, we are working on price transparency legislation. We hope to get that passed in the next 2 weeks out of Committee, and we hope this passes on the floor of the Senate. This is how we bring value to the patient, by bringing the power of price transparency, as she chooses what healthcare and where to get her healthcare.

Now, we can get this done. Whenever there is a big idea like this, how do we actually help the American people with affordability? How do we actually put money in their pocket and couple it with tools that would give them the power of price transparency, in order to bring money in their pocket and value for the patient?

People say: Oh, that is too big. We can't get that done--no way.

But, folks, we have actually achieved a lot on healthcare in the last few years. The No Surprises Act blocks about a million surprise medical bills per month for the American people. A PBM reform bill, which was signed into law by President Trump a few months ago but that was negotiated by Congress--and it was tough, but we actually got it so that the value to the patient in terms of lower drug prices, if you will, cutting out or restricting activities of the insurance company in the middle--we got that through. The administration is working on TrumpRx, which allows patients to buy drugs without hidden costs.

So if we are going to make healthcare affordable to the American people, we have to build on that record, and we have to work together.

So my challenge to the Senate, to the House, and to the President: Let us come together. Let us get things done. Let us work for the American people.

Ask any Uber driver, ask our constituents: What is the biggest issue right now?

And they will say: Affording life.

Affording life means to be able to afford healthcare.

And, Mr. President, with the MVP health agenda, we help our constituents afford healthcare.

With that, I yield the floor.

Mr. President, I ask unanimous consent for the following interns in my office to be granted floor privileges until July 15, 2026: Mason Lam and Harper Alspach.

Mr. President, it is really kind of interesting. A couple of years ago, we were talking about student loan debt. Colleges were saddling students with student loan debt, forcing them to live in their parents' basement because they couldn't pay back those loans.

If you look to the people taking these loans, they may not have completed their degree, or the degree they got paid them less in a year than the annual tuition they were forced to pay. And, of course, that tuition--paid for by borrowed Federal money--compounded interest, leaving them mired in debt.

It is a false compassion to say that every person should be able to borrow as much as they want from the Federal Government, to go to the school, whatever the school charges. That is a false compassion.

Republicans are not about false compassion. We are about allowing Americans to live the American dream, but that is not by saddling them with debt like a weight around their neck, pulling them into a pool of debt from which their whole life is affected.

It is pretty clear. The cost of higher education is out of control. And that is, in part, because of Federal lending programs that will allow students to borrow whatever they wanted to--almost. And so universities raise their tuition to maximize income, not to maximize value, but to maximize income.

By the way, a 2023 National Bureau of Economic Research study found that uncapped Federal borrowing for graduate programs did not increase access or degree attainment.

Think about this: Oh, we can give much, much, much more money, but the NBER found that giving as much money as they wanted did not increase access and did not increase degree attainment.

You know what it did increase? Student loan debt. That is what it increased because the universities making profit off of that really, ultimately, were not left holding the bag. It was the student and the U.S. taxpayer who were left holding the bag.

Colleges could increase their prices--the higher the cost, the bigger the loan. The kid drops out. He doesn't graduate. He can't pay back the loan. The taxpayer picks it up. The person is saddled with debt, but the college has the money.

Now, by the way, putting Americans more and more in debt, while colleges raise tuition, only makes the affordability crisis worse.

In August, Republicans put an end to this nonsense, and we passed the Working Families Tax Cut bill. We addressed the root cause of rising costs. We put limits on Federal loans for professional degrees.

As a result, there are universities already lowering their costs. Last fall, Santa Clara University cut law school tuition by $16,000, citing loan limits the Senate Republicans enacted as a catalyst. Think about that: Law schools are 3 years. Mr. President, 3 times 16, we got $48,000 less in borrowing in a response to the legislation that we passed.

UC Irvine recently announced cutting tuition for their MBA program by 38 percent for the upcoming fall semester.

Now, unfortunately, the resolution offered by my friend from Oregon undermines this success. And the claim is that this merely corrects a rule put forward by the Trump administration that limits access to taxpayer-funded loans for certain professions.

That is not true. This resolution would nullify the Department of Education's regulation for implementing all student loan reforms enacted in the reconciliation as part of the Working Families Tax Cut bill. Every part of it is going to be nullified.

A vote for this CRA undermines the $284 billion in savings for the U.S. taxpayer. A vote for this CRA is a vote to undermine changes that are already reducing the cost of higher education.

A vote for this is a vote to allow the student to borrow as much as she wants to in response to a tuition skyrocketing and to land her into a hell of student loan debt that she can never escape.

A vote for this is to go back to the Biden approach to student loans, rather than the historic reforms passed by congressional Republicans and signed into law by President Trump.

Now, by the way, there is a nuance here. If you are thinking about voting for this resolution because you have concerns about how professional degrees have been defined in the rule, we should talk. I am happy to have that because, frankly, I have some concerns about that. And so let's see if we can actually address that in an appropriate way, not in a blunt axe way.

That debate is a separate, targeted conversation, not fit for an overly broad CRA. For example, let's address the criticism that nurses and social workers are excluded from professional degrees.

Now, I am going to be clear. I am a doc. I worked with nurses. They are professionals. They are right up there with me because I have been--at 3 in the morning--taking care of sick patients vomiting blood. I know the professionalism that nurses bring to their care--similarly for social workers. So no one doubts that they are professionals. No one doubts that they are essential to the health system.

But this debate is a debate about certain degrees that are required for entrance into the profession and require longer lengths of study than graduate-level programs. And based on those factors, should you be able to borrow up to $200,000 in taxpayer-backed Federal loan programs to pay for a degree?

More importantly, do you have a realistic ability to pay back that loan? If

someone does not have a realistic ability to pay back the loan, then the university should not be charging that much.

By the way, most nursing students--95 percent of them--borrow less than $100,000 to complete their degree. That is below the borrowing limit Congress established in the Working Families Tax Cut.

The 5 percent of nursing students borrowing more than $100,000 choose to take on that debt. They choose a more expensive option. Clearly, since 95 percent don't need to borrow that much, there are other options, and not all nurses need federally backed loans up to $200,000 in order to get their degree.

So, is my colleague suggesting that taxpayers subsidize the 5 percent of nursing students, regardless of their ability to pay back the loan? I don't think that is fair to them.

If there are limited number--and this is important--if there is a limited number of targeted subspecialties in professions--I think of a CRNA--that are inadvertently and inappropriately excluded by this rule, let's have a conversation. Let's measure their ability to pay back such a large loan and if that loan and the degree it pays for is necessary for their professional subspecialty. And, importantly, can they pay it back?

CRNAs do well. I personally think we should have a higher loan limit for them--that is one example--because they are going to do well financially. And to the point, it could be more expensive for them to have their training.

That is, if you will, a nuanced approach, looking at a group of people for which we know the facts. But that is not what this CRA does. It guts all reforms and sends us back to the Biden administration student loan disaster.

There are bipartisan efforts on my committee to make college more affordable for students, families, and taxpayers. I am leading the College Transparency Act, the CTA, which allows students to compare the differences between a college that they go to, and the major within that college, to see the value of the degree relative to the price of admission.

I ask my Democratic colleagues to work with us to advance these bipartisan solutions, not to push partisan resolutions that raise the cost of college and bury students with debt.

I urge my colleagues to oppose this effort.

Yes, sir.

Correct.

I think it was Santa Clara. I have to go back to my notes. I think it was Santa Clara.

I don't know if the University of Santa Clara is private or public.

I don't know how many have, but the bill has just passed. And I do know that market reforms permeate society.

And as a student realizes, I can go to the community college down the street and get a nursing degree and pay for it entirely with a small amount of money, or I can go someplace far more expensive and have to borrow $100,000--in the case of the previous law, $200,000--that market forces--and, particularly, if we put in the College Transparency Act-- will have that individual go to one where they get the better value for their education. That, I am positive of.

Mr. President, I am so proud of the great State of Louisiana. And sometimes, that is advocating for great policy, but other times, it is delivering a message of sympathy. And right now, I want to deliver a message of sympathy for people in my State.

Today, families are assessing the damage left behind by Tropical Storm Arthur. People are assessing the damage left, and they are cleaning out flooded homes. Businesses are surveying losses. Neighbors are helping each other get back on their feet, giving a warm meal or a place to stay.

If you are in one of these homes, you need a place to stay.

And we are entering hurricane season, which means that people in Louisiana and elsewhere want to be prepared. Being prepared means to plan. But Mike Tyson once said: You have got a plan until a fist hits you in the face.

Well, a hurricane can be a fist hitting you in the face, and the plan you have will go out the window when the tornado hits your home--a tornado spawned by the hurricane.

The damage is always different. Tropical Storm Arthur, fortunately, only caused--although, don't minimize the importance of these--only caused two injuries that we know of, even though there were multiple tornadoes and six parishes under a state of emergency.

Avoyelles Parish was at 29 inches of rain in 1 day--29 inches of rain in 1 day--which, hopefully, is a once-in-a-thousand-year rainfall event.

So you may have a plan, but when you have more than an inch an hour in 24 hours, you cannot be fully prepared.

So I want to remind colleagues that, while news cycles jump from one topic to another overnight, families in my State are dealing with serious damage to their homes and livelihoods.

And to those of you in Louisiana, if you need help, this is what you can do. If you need a low-interest disaster loan to help cover the cost of physical and financial damage, small business owners in Louisiana can call the Small Business Administration at 800-659-2955.

If you need to get connected with a Red Cross caseworker for recovery planning and help with finances, call 1-800-733-2767, and that line is open 24-7.

If you can't reach your homeowners insurance, take a picture of the damage and call the Louisiana Department of Insurance at 1-800-259- 5300.

And if you can't reach those numbers but you know you need to reach those numbers--for example, you need to reach the SBA, but they are not picking up; the Red Cross, somehow, is not connecting; the Louisiana Department of Insurance, ``Hey, I need somebody to pick up the phone,'' then you can call my office at 225-929-7711.

In the meantime, anything I can do to bring Federal resources to bear on our State, I will do it. So as recovery efforts continue, I ask colleagues to keep these families--which we know, at some point in time, may be similar to a family in your State--in your thoughts.

For them, the work of rebuilding remains.

Mr. President, people know that the Federal Government helps Americans purchase health insurance.

We do that by making health insurance tax deductible. When you pay for your premiums, it is on what is called a pretax basis, but something is wrong. The lowest paid Americans in the employer-sponsored insurance market get the least amount of help from the Federal Government.

Now, if you are poor, you get 100 percent of your health insurance paid for by Medicaid. If you are on the exchange, you get below a certain income level, almost 90 percent of your expenses paid, but if you are making, I don't know, $67,000 a year and you get your insurance through your employer, you only get about 15 percent of that coverage. You would get $6,000 toward the typical policy; whereas, if you are on Medicaid, you would get $25,000.

If you are wealthier, you get probably, in some cases, almost half of this coverage, half of your insurance paid for, if you will, by the Federal Government, but if you are the lowest person in the employer- sponsored market, you get the least amount.

Now, why am I talking about healthcare? Affordability is a big issue. If you look at this graph, the annual cost for a family of four--this is all-comers--$37,000 to almost $38,000 per year. Now, a mortgage is $30,000. If you are renting, it is $24,000, private school tuition $20,000, going on down. And we speak about childcare. That is $18,000 a year. That is expensive. But if you are talking about the most expensive item that a family of four has, on average, it is healthcare at $37,000 a year.

Now, if you are making $87,000, how does that figure? Almost half of your salary is going toward healthcare expenses and the price of being insured. That is pharmacy, hospital bills, treatment, medications, and so on.

Now, this is unsustainable for our country, but it is, like, really unsustainable for the family making $80,000 a year. And if you are paying that much, take it to $100,000, it is unsustainable. If you are paying that much, take it to $120,000 to $130,000, it is barely sustainable.

Now, you would think with healthcare costing that much and the Federal Government helping some, that the greatest relief would go to the people who need it most. They actually get the least amount of relief. So if you are speaking about making healthcare more affordable--but if you are on Medicaid or the exchange, it is really affordable. We have set up systems where almost everything, if not everything, is covered.

If you are speaking about people who are doing better financially, they get a far greater benefit. The point being that people that need it most get the least help.

I would argue that we in Congress have a responsibility to do something about that. We are not asking what can Americans sacrifice to make ends meet; we are asking what can we do to make their sacrifice less of a problem.

So I would argue, on a bipartisan basis, that we should sacrifice political pride, any shallow ambition for getting ahead of the other party, and let's plot a path forward.

But it requires both parties, the White House, the President, the Senate, the House, to come together and get engaged and to come up with a plan.

Now, I am going to offer one. It doesn't have to be the final plan, but we have to have a plan, so let's start with this one. I call it the MVP agenda. ``M'' is for money in your pocket. If you take a family of four, and let's imagine that they have $2,000 a year in out-of-pocket expenses, under the MVP agenda, they would get $2,000 in a year into a health savings account to help pay for that out-of-pocket expense.

Now, again, for many families, that would cover the entire out-of- pocket cost they would have per year. That family right now may have a deductible and an insurance policy with a deductible of $3,000. They don't have $3,000. They are putting it on their credit card, and then they can't pay their credit card bill.

Under the MVP plan, we give money in advance to the individual and to the families--not to the insurance company but to the individual--for them to use 100 percent of the money on the care that they know they need.

By the way, if they are going to send it to the insurance company, they take 20 percent of that for overhead and profit. If we send it to the family, they use 100 percent for the care they know they need, and everybody would get an equal amount upfront for their family's health.

So think about that family making $80,000 a year with a $3,000 deductible, and the child has an earache. They can't get that child care or, if they do, they are putting it on a credit card.

In this situation, they would have the money in the account to pay for the care and to have the financial security associated with that.

What about the value? We are working--the Presiding Officer right now is on the HELP Committee. We are working right now on a PRICE Transparency bill. So we give them money in the pocket, but we want to make sure they have the knowledge they need to get the best value for that money.

And in the PRICE Transparency, which means you know the cost before you buy it, if your daughter has an earache, look on your phone: Hey, Siri, where is the least expensive place after-hours to get my daughter's earache evaluated.

And it would say: Hmm, down the street is $50; down that street it is $500. You are going to go to the place which gives you the best value. And this combines the work we are doing on PRICE Transparency with what is being done in the private sector to develop apps that can take that information and deliver it to the family so that they can get the best value for their money.

So it isn't just that we give the money because that money could go in a flash if they don't have the information on how best to spend it. We couple it with the PRICE Transparency and the work being done in the private sector for that money to bring true value. And who does it bring value to? It brings value to the patient. It is the MVP plan.

There is a lot already we are doing on that. Someone said: How is your plan coming? We are working on it right now in the HELP Committee, in the Health, Education, Labor, and Pensions. And we are hoping to get that bill passed for that portion.

In the next portion regarding how do we advance dollars, we just need a commitment from Congress to do it. If we are talking about affordability, if we are talking about housing--which we passed a bill yesterday to address--if we are talking about gasoline, hopefully, that will get better with resolution of things in the Middle East, groceries and healthcare, and of those, healthcare costs the most.

So if we can do something to make things better for the average family, we are truly doing something positive for our fellow Americans.

Now, I think we all have to stand ready to work together. This builds on principles that President Trump said that he wanted to see implemented in any healthcare reform bill; specifically, that the money would go to the patient and not to the insurance company.

It also builds upon a bill that he signed into law in his first term, the No Surprises Act, which I authored, that began to introduce price transparency. His administration has continued to push for price transparency, and I am sure he would welcome the opportunity to sign this bill into law for price transparency.

So we have the pieces of the White House engaged with this, and now we need Democrats and Republicans in the Senate and the House to join the President in bringing relief.

Let's bring relief to the American family. Let's make life more affordable for them, and along the way, let's make life fairer for them.

I yield the floor.

Mr. President, I ask unanimous consent for the following interns in my office to be granted floor privileges until June 24, 2026: Stella Israelite and William Homes.

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

Mr. President, I am a physician. I used to work in a hospital for the working uninsured and the uninsured, the poorly insured, and so, as you might guess, I am very sensitive to the idea, to the understanding, to the fact that healthcare is becoming more expensive and less obtainable to the American people.

And last week, if I can put this up, I pointed out that the average American household has $10,000 in credit card debt, and these aren't people paying it off every month. These are people, like in the State of Tennessee or in the State of Louisiana, who are carrying a balance. And over the last 5 years, to show that this is becoming an increasing problem, the average--if I remember correctly--the average percent of someone's income going to credit card interest has risen from 1.9 to 3.2 percent of their income. They are not paying this off. They are carrying a balance with 22 percent interest sometimes, and they are paying more and more.

And the way this factors into healthcare is that, when someone has a multithousand-dollar deductible, even if they have insurance--they have a multithousand-dollar deductible--in order to pay for the out-of- pocket, they are putting it on their credit card, so much so that over 60 percent of personal bankruptcies relate in part to healthcare expenses, period.

Credit card debt reflecting the overall debt burden--the overall problems of affordability in our society--is huge.

Now, we have an obligation here. We in Congress, whatever our party, working with the President, we all have a mutual obligation to address this issue.

And now I would like to stress that it is not just for the patient, if you will, the family, the individual, the employee--you name how you want to put it--to address this, but it also is important for businesses.

I had a townhall a couple of months ago back home, or a roundtable, and there was a woman named Debbie in DeRidder, LA, who owns a coffee shop. She has 50 employees, and that is 50 employees for which she has to provide insurance. And so she is having a difficult time expanding her business because then she has to provide coverage to more employees, and she cannot afford to expand because of the money that she is putting toward their benefits.

Now, we need businesses to be strong. We need businesses creating more jobs, paying better wages for the people of the United States. By the way, that is not a Republican or Democrat or congressional or Executive office--that is an American priority for our fellow Americans.

So one thing that is kind of lost is the ability to hire new employees--or, I should say, more employees--and the ability to pay them more is getting swallowed up by the increased percent of compensation to an employee that is going to provide health insurance.

To give a little bit more background, whenever a person, whenever a business owner makes a decision to hire an employee, the amount they set aside for that employee is the wage, the Social Security tax they pay upon those wages on behalf of the employee, and then their benefit package. The more that benefit package costs, the less they can pay the employee.

And, right now, we are seeing the cost of health insurance climb to the extent that businesses are not able to pay more wages because they are having to put more into paying for the health insurance.

This is not new. This is getting worse. And we spoke earlier--to kind of feed back into the credit card debt--businesses are compensating by buying the cheapest policy they can. It is still more expensive but cheaper. But that cheaper policy has a deductible that is more and more. That cheaper policy may have a deductible of $5,000.

The average family carrying a $10,000 credit card debt doesn't have $5,000 to pay expenses, and that brings us back to where we started. They don't have it in their money. They don't have it in their pocket. So they are putting it on their credit card. They are carrying the debt, and more and more of their income is going toward paying interest on rolled-over credit card debt.

By the way, it is a big problem in my State of Louisiana. I think we are the No. 3 State in the Nation, in terms of families carrying credit card debt.

And if I remember correctly, 11 percent of families nationwide are going delinquent on their credit card debt, which means they are not even paying the minimal balance required.

This is an issue for Congress, whatever your party, for President Trump to engage with each other to accomplish this mission. And, by the way, we need the President, and I personally will make an appeal to President Trump.

Let's do something for the American people. And you can say it is an election year. No, say it is not an election year. This is the year in which we have got to help the American people afford their household items. It is a huge issue.

And the answer is that President Trump's intuition on this is fantastic. During the debate over extending the enhanced premium tax credits on the exchanges, President Trump said: Don't give the money to the insurance company; give the money to the family--because if you give it to the insurance company, the insurance company takes 20 percent of it for profit and overhead. And, by the way, the family is still left with a multithousand-dollar deductible. So President Trump's intuition on this is the correct intuition.

We need to make it so that, when the Federal Government is taking the money we are already using to subsidize the purchase of health insurance by employers and by the employee, the money is going to the patient, not to the insurance company. Give the patient the power, not the profit to the insurance company.

And so I emphasize: The President's intuition is correct, because that opens the door for the President and for the Congress, no matter your party, to come together to address this issue.

By the way, you could say that it is good politics. I would say: Good policy is good politics. And so it would be important for us to consider to do this.

Now, I have come up with a plan. I call it the MVP plan--MVP, Money and Value for the Patients. How do we do this? So, again, taking the President's intuition, don't give the money to the insurance companies; give it to the patient. We advance the dollars to the patient in a health savings account that they can use to pay for that out-of-pocket expense. Under this plan, a family of four would get about $2,000.

And, by the way, there is a way to pay for this. This would not add to the Nation's debt, because we already are subsidizing the purchase of health insurance by Americans. We just do it a little differently.

And in this you give $2,000 to the health savings account. Why is that important? Sixty percent of American families will not spend more than $2,000 in a calendar year on out-of-pocket expenses for healthcare.

And once you take care of that first 2k, they can take a higher deductible policy, which will lower the cost of the premium. Put together, this could save a family as much as $6,000 on healthcare, on the cost of being insured.

So $6,000 a year, $500 a month--this could help that family carry a $10,000 load right now, the part of that credit card debt coming from the need to put healthcare expenses on the card.

This would help the employer because the employer could, plausibly, get a policy which is less expensive, which keeps more money in the employer's pocket--better able to hire more people or pay more compensation.

And it doesn't increase the Nation's debt. We make it debt neutral.

And it builds upon the President's insight: You don't give the money to the insurance company; you give it to the patient. And you add value. So we bring money in with value to the patient.

In the HELP Committee right now, the committee I am privileged to be the chairman of, we have a bill--bipartisan, with Roger Marshall from Kansas and John Hickenlooper from Colorado. Our committee staff is working hard with them on this, to increase price transparency.

Now, price transparency began with legislation and Executive orders in the first Trump administration. I am familiar with that. Part of it was the No Surprises Act, which I helped author, and that began the process of price transparency.

Price transparency, just to be clear, we know what it means. Price transparency is knowing the price of something before you make the purchase, as opposed to knowing the price afterward.

I use the example--in the No Surprises Act, we made it so that, when you go in for a colonoscopy, they are obligated to tell you if it is going to cost more than anticipated. They have to tell you what that additional cost is going to be.

I chuckle because, in the bad old days, you would find out that you are obligated to pay the extra cost for a colonoscopy when you are waiting to go back for the colonoscopy, and you have been prepped--and, if you have ever had one, you know what that means--and you are sitting there with a thin sheet over you, and they say: By the way, if you want to walk out, you can. Otherwise, we are going forward. Just sign this sheet of paper.

It was not a way to acquaint people with the price beforehand, at a point in which they were prepared to walk away.

Now, under the No Surprises Act, we have to be informed. We are going to increase that--increase the power of price transparency--so that the patient would know, when she is going to go in, how much it is going to cost beforehand, as opposed to afterward.

We teamed this up. There are a lot of applications being developed right now by the private sector, taking the information we are creating to bring value to the patient. For example, I use the example of ``my daughter has an earache, and I need to bring my daughter

to the hospital or to an urgent care center.''

You can take your phone and say: Urgent care center near me. Which one has the lowest price? Is there any difference in quality?

These apps will be able to give the patient--the mom, the dad--the information she or he needs right then as to which urgent care center is near them, is open, their cost for a routine visit or any other type of visit, and the quality of the care.

When you walk out, you can say: Pharmacies near me. Which has the best price for Bactrim DS--I forget the dose; I am a doc, but I haven't prescribed it for so long--say 250 milligrams twice a day?

And they are going to send you to the pharmacy with the best price. Now, you are paying for this from the prefunded money in the health savings account. So you are bringing money in the pocket of the patient, coupled with value proposition, price transparency, and the apps being developed in the private sector for the patient. The effect of this is to take power from the insurance company, power from the middlemen, and give it to the patients--power to the patient, not profit to the insurer.

Now, we can do this. We can do this, but it will take a commitment from Congress and from the President of the United States to do it. But first, you have to care about it. We have to care that the families back home are carrying a balance of $10,000 on their credit cards.

If we care about this, if the President of the United States cares about it--when I say ``we,'' I mean the Senate; I mean the House of Representatives--we can come together and fix it. Let's be constructive. Let's acknowledge that this is something we have to do together, but first, we have to care about it together.

Just to point out that it is doable, earlier this year, the President signed into law a PBM reform bill that Congress had negotiated last Congress but got signed into law this Congress. President Trump is attempting to do this through TrumpRx. The MVP plan would allow--could work with TrumpRx to give the patient access to the better price.

So, ultimately, we have to care. Ultimately, we have to make a decision as a Congress, as a government, to address the issue which is most pressing upon the American people: affordability.

There are some things we can't touch. Housing--whatever solution we put into housing will not affect next year. The price of gasoline and groceries--we cannot affect that as long as the Iranians are holding the Strait of Hormuz. That will be up to the President to come up with an end game that addresses that issue. But one thing we can do collectively is to address the cost of being insured. Some of the things we do immediately, when this happens, will begin to decrease the amount of money a family puts in their personal budget in the cost of healthcare.

Get engaged, all of us. With the President, get engaged. We will be held accountable by those families if we don't, and by golly, we should be.

I yield the floor.

Mr. President, I suggest the absence of a quorum.