Floor Statements

Mr. President, I wish to speak on behalf of Peter John Camino, who is being inducted into the Wyoming Agriculture Hall of Fame. Every year since 1992, Wyoming has recognized individuals who have made substantial contributions to agriculture in our State. As a third-generation rancher dedicating much of his life to Wyoming's agriculture industry, Peter John is well deserving of this honor.

Peter John grew up on his ranch that his grandfather founded near Buffalo, WY. After attending college, he joined

the military and served honorably for several years. Ultimately, the ranch lifestyle called him home and he returned to Wyoming to take over the family operation. Peter John has said the sheep business was thriving upon his return and fondly remembers the community support and good times.

Fortunately for Wyoming, Peter John not only stuck with the agriculture industry during the good times, but took on leadership positions and persevered through the hard times as well. Peter John served as president of the Wyoming Wool Growers Association and played a crucial role in strengthening the organization. He has been described by coworkers and friends as a courageous leader who would always take time to listen to members of the organization. As president, he guided the sheep industry through some tough times and advocated for its cause at the local and Federal levels.

Leadership, courage, and collaboration are only some of the admirable qualities Peter John possesses. He has also shown dedication and selflessness while volunteering in his community and passing on his knowledge of the agriculture industry to younger generations. In addition to volunteering with his church and Knights of Columbus, serving on the board for Johnson County Fire District, and advising the University of Wyoming's Sheep Program, he also serves as sheep superintendent for the Johnson County Fair and often invites schoolkids to his ranch to teach them about ranching, the sheep industry, and the value of wool.

I want to extend my congratulations to Mr. Camino and thank him for his service and years of hard work. Peter John truly lives the ``Code of the West,'' and I am proud to have the opportunity to recognize his achievements as an inductee into the Wyoming Agriculture Hall of Fame. Wyoming is well served by his lasting and continuing contributions to our State.

Mr. President, I call up amendment No. 389.

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

Mr. President, I ask unanimous consent that the time until 5 p.m. be equally divided between the managers or their designees; that at 5 p.m., the Senate vote in relation to the Strange amendment No. 389; further, that following disposition of the Strange amendment, the Senate proceed to the consideration of H.R. 3364, which was received from the House; that there be 20 minutes of debate, equally divided between the leaders or their designees; that following the use or yielding back of that time, the bill be read a third time and the Senate vote on passage of H.R. 3364; finally, that following disposition of H.R. 3364, the Senate resume consideration of H.R. 1628.

Mr. President, I yield myself such time as I need, up to the limit that we have. This week, we have been debating why it is so urgent for Congress to act on rescuing Americans from the collapsing ObamaCare healthcare law.

We have heard from our colleagues across the aisle, questioning our motives and our actions. Congress literally has millions upon millions of reasons to replace and repeal this law. Hard-working American families are begging us to provide them with some relief. These are families who are forced to purchase high-deductible coverage insurance and are facing thousands of dollars of out-of-pocket costs before their coverage even begins. For them, the status quo--doing nothing--is not an option.

For Senate Republicans, rescuing the American people from this law is our only option. But the defenders of this law don't seem to grasp--or are unwilling to admit--that ObamaCare is not affordable insurance and has been a crisis-inducing failure. This is why Republicans are working to fix the damage. Insurance markets are collapsing, premiums are soaring, and healthcare choices are disappearing.

Americans expect the Congress and the President to address the problem. With ObamaCare getting worse by the day, the time to act is now. Just look at my home State of Wyoming, which is down to one insurer in the individual market, both on and off the exchange. This should be treated as the national scandal it is.

Some on the other side of the aisle like to focus on how many people are insured under the law, but let's look at how many are not insured. Almost 28 million Americans remain without insurance under ObamaCare because they cannot afford insurance or no longer have access to it due to ObamaCare's collapsing markets in their State or county. But coverage numbers can be misleading because, even with insurance, many hard-working families still cannot afford the care due to surging deductibles. Insurance with sky-high deductibles is coverage in name only.

When it comes to Medicaid coverage, what most news stories will not tell you is that the newly insured gained coverage only through a flawed Medicaid Program that is providing inferior quality and threatening to bankrupt States across the Nation.

The Democratic leader, Nancy Pelosi, famously said that Congress would have to pass the bill to find out what's in it. Well, Americans soon discovered that President Obama and congressional Democrats focused almost exclusively on coverage numbers boosted by government mandates handed down from Washington, instead of true healthcare reforms that might have actually provided better care, provided affordable care. Obama's alleged coverage numbers are only on paper. Coverage was their sacred cow, worshipped

above all others, because for President Obama, Nancy Pelosi, and Harry Reid, coverage equaled healthcare.

Large coverage numbers touted by the Obama administration and congressional Democrats have proved to have the healthcare utility of a pet rock. Do you remember the pet rock? Millions of people purchased a rock. It was very nicely packaged in a box. They would bring it home and open it up and find a rock. Pet or not, it served no purpose other than its name: a pet rock.

This is essentially how ObamaCare has worked, except people were forced to purchase this marketing gimmick. Americans have purchased insurance through ObamaCare exchanges with the promise of accessible coverage. What they actually received, however, is coverage in name only. It serves no healthcare purpose, and it doesn't work--merely packaging a pet rock, if you will--and millions of Americans soon found out. The high cost of insurance plans they forced people to buy made it nearly impossible for them to pay for the coverage they signed up for, or if they could afford coverage, they realized the care they were paying for came with sky-high deductibles.

Congressional Democrats and President Obama focused almost exclusively on the numbers of people now enrolled in ObamaCare and relentlessly highlighted this information, which showed this law was used mainly for public relations purposes at a large cost, as opposed to an actual policy accomplishment. Instead, the reality is that Americans who were able to get insurance were often plagued with inadequate coverage, joined with enormous out-of-pocket costs. Senators from across the country this week have been sharing stories about families in their States who have had to forgo medical care, not because they don't have insurance but because it was simply too expensive to go to the doctor under the ObamaCare health plan.

For years, Republicans have pledged to repeal this disastrous law, and this week we are working to address the broken promises of ObamaCare to help ensure better care for each and every American. We are doing this by working to stabilize collapsing insurance markets that have left millions of Americans with no options, which will help improve the affordability of health insurance and therefore healthcare. Our goal is to preserve access to care for Americans with preexisting conditions and to safeguard Medicaid for those who need it most by giving States more flexibility, while ensuring that those who rely on this program won't have the rug pulled out from under them. Most importantly, Republicans hope to free the American people from onerous ObamaCare mandates that require them to purchase insurance they don't want or can't afford.

The President and Republicans in Congress last fall promised to rescue the millions of American families suffering under ObamaCare, which is what this bill will do.

Thank you, Mr. President.

I yield the floor.

Mr. President, we have loaned time before to the other side of the aisle. If they would loan us some time so that the person propounding this amendment could have a moment to explain his amendment--they have agreed. So I yield time to the Senator from Alabama.

Mr. President, I call up amendment No. 502, the Heller amendment.

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

Mr. President, I heard somebody say that nobody was listening. Well, I was listening. I have read a little bit from this book before on the floor about healthcare. It is called ``Demystifying ObamaCare'' by David G. Brown, who is a doctor. He does a marvelous job of going through the history of how we got to where we are.

He says, maybe we need to answer the question: ``What does ObamaCare do? What does ObamaCare purport to do? What does ObamaCare not do?''

He says that those answers are relatively simple.

ObamaCare is not a system of healthcare, nor is it a

healthcare reform. It is a system of healthcare control.

ObamaCare was supposed to significantly reduce healthcare

costs, but instead it has dramatically increased costs for

even those who are not directly within the ObamaCare program.

ObamaCare was supposed to increase access to care, but

instead it can actually reduce access (availability) of care.

ObamaCare reduces the effectiveness of the safety net

program, which is so very important to economically poor

Americans.

The quality of healthcare in America was derided when

ObamaCare was passed, but ObamaCare instead reduces the

quality of U.S. healthcare by reducing innovation.

And then he says:

ObamaCare removes a person's ability to make his own

decisions about his healthcare and that of his family. It

does so by removing the freedom to make those decisions.

He continues that what we are trying to do is correct those problems and get back to a system of healthcare where the patient and the doctor get to make some of the decisions, where we encourage more people to be in the system, where we expand the use of HSAs, refundable tax credits, where we also allow people to buy insurance across State lines.

We could put money back into State high-level risk pools. In fact, I really like the invisible risk pools that allow people to continue to pay what they were paying before, but to get the unique care.

We could ``pass Medicaid to the States in terms of `block grants' or `per capita allotments,' '' and we could ``partially privatize Medicare starting in 2024 with the premium support system.''

That is not in the bill; I am reading suggestions that he gives, including ``cap the amount for tax exclusions in higher cost employer- based plans.''

Now, you need to know that in the proposals that we have been putting out, in spite of what I have been hearing on this side, kids under 26 still get to be on their parents' insurance. We are not taking that off. I keep hearing we are eliminating the preexisting conditions. We are not. There hasn't been a proposal to eliminate the preexisting conditions. So quit saying that. That is just fearmongering. As to eliminating the lifetime caps on insurance, I haven't heard a proposal for that. Also, allowing people to continue to be insured even if they change jobs--that is what this guy wrote in the book, and I would like for everybody to read it.

He said there are five factors that drive up healthcare costs. One is taxes, another is mandates. Another is regulations. Another is lack of competition and flexibility within the marketplace. As to the fifth one, I don't know of anybody addressing yet, but it is the medical liability system that encourages defensive medicine and drives the costs up.

Seniors need to be protected. There needs to be an effective and viable safety net system. Nobody is trying to work against that, regardless of what you are hearing here.

I understand my time has expired. I have a lot more of the book I would like to share, but I am not sure it is productive, anyway.

I yield the floor.

Mr. President, for 2\1/2\ days I have been listening to the same rhetoric. It sounds like deja vu. For 2\1/2\ days I have been listening to this. I have been giving extra time to the other side to speak. I have been hoping out of that I would get one constructive suggestion for what could be done with healthcare.

It has all been criticism. It has been criticism against all cuts. Even tonight, after the bill was read here on the floor, I heard that we were changing Social Security. We are not changing Social Security. We can't change Social Security under the budget.

I heard we were changing Medicare. We are not changing Medicare. I am not going to allow other time for that side. I will suggest that side of the aisle go and read the bill. I think it would be a worthwhile exercise.

There isn't even Medicaid in there. You have threatened about what was going to be done about Medicaid. You talked about what was going to be done with Medicaid, but it is not based on fact. So take a look at the bill.

Another way that this is deja vu is I remember being here on Christmas Eve when technical corrections were accepted from the other side, but you went ahead and passed the bill. We mentioned things that needed to be changed in the meantime, and we were told: No, no, that doesn't have to be done. It just needs more time.

Well, we had more time, and there does need to be corrections. You keep talking about how the Republicans have ruined the insurance market. No, last October, the high rates came out for States across this country that pointed out that healthcare was going down the tubes. So something needed to be done. Something needed to be done, but without getting constructive suggestions from the other side--just criticism, saying ObamaCare is perfect, until this debate started, and then I started hearing: It is not perfect. It is not perfect.

Well, where are the suggestions for making it as near perfect as possible? We put up a lot of----

Ms. HEITKAMP addressed the Chair.

I am not asking that as a rhetorical question. Think about it for a little while, come up with constructive suggestions.

No, I will not yield for a question.

When I feel like there is something constructive that is going to be done around here--I remember that one of the Senators on the other side of the aisle said: If you just take Medicaid out, I will be for it. Well, Medicaid is not in this version so that ought to be some kind of a commitment on it.

I keep referring to this book, which goes back to a lot of the history that we have experienced around here. Here is what has happened, and all of this is footnoted. I was reading at first the footnotes. I didn't check out all the footnotes, but I did look to see if they were footnoted.

Under the bill that we are trying to make some changes to, there have been costs from new taxes. There are 21 taxes that have been included in ObamaCare, but the most enormous one is the increased taxes on healthcare companies that are then passed on to the public as higher costs for insurance and pharmaceuticals.

I have heard that word ``pharmaceuticals'' thrown out a lot, and I agree there are things that need to be changed there. I do remember the pharmaceuticals joining in on the process of getting ObamaCare passed because they did this little thing with the pharmaceutical Part D, where there was this doughnut hole, and through the doughnut hole we were hoping that people would switch to generic, but the pharmaceutical companies said: No, no, no. If you will stick with the brand name, we will cover you through the doughnut hole. Do you know why? Because people, as they go through the doughnut hole, go beyond the doughnut hole, and beyond the doughnut hole the Federal Government picks up the cost of the name brands--the name brand pharmaceuticals. My insurance commissioner was by to visit with me, and he mentioned that I have twins in Wyoming, and they have a rare disease. There is a prescription for it, and the prescription is costing $30,000 a year each. Well, that is quite a bit of money, and the insurance company is picking that up. Then the name brand pharmaceutical company bought out the generic one. This was generics they were getting.

So now they have to have name brand because the generic isn't on the market now. The cost? It is $1.6 million for each kid, each year.

That is why the companies, why the insurance companies are dropping out

of the market. I mean, Wyoming is the least populated State in the Nation, and an insurance company that is limited to Wyoming is going to have to bear that $3.2 million worth of cost. So they are going to be saying: We are the only ones covering Wyoming; maybe we shouldn't provide insurance in Wyoming either. We lost the other two companies already, and we are down to just one, but we have one, and they cover all of the counties, unlike--it kind of surprised me that the rules allow companies to just do some counties in some States.

Also, under ObamaCare, the insurance plans have to cover more.

This includes plans for the patient who may not want a

particular coverage but has to have this. [It comes under

the] essential health benefits, which are required through

HHS. This led to 5 million Americans losing their insurance

in the individual market.

Reduction of lower cost plans. High deductible [health

savings accounts] are very important in reducing costs for

individuals, families, and businesses. A RAND study in 2011

found that an HSA/high deductible plan (with a deductible of

at least $1,000) would reduce healthcare spending an average

of 14%. That savings incurred not only for patients but also

for employers and for total healthcare expenditures. These

more effective plans have been reduced under ObamaCare.

Most of the young people on my staff were getting HSAs, and the reason they did is because they did a little bit of a calculation. They did a little bit of financial literacy. They looked to see what the plan was for the full coverage, and then they looked to see what an HSA would cost, and they said: Well, gee, if I take the difference in the cost between the regular insurance and the HSAs and I put that in one of these savings accounts that can grow tax-free, in a maximum of 3 years, I will cover any deductible that I might have.

So they considered that to be good insurance and they got to make a lot of their decisions.

But I don't think we want individuals making their decisions; that appears to be how ObamaCare is constructed.

Then there is an increase in mandates, which is item No. 4.

Mandates existed before ObamaCare but have dramatically

increased with ObamaCare. It added mandates ``guaranteed

issue and community ratings.'' Both have been previously

tried in the states. Such mandates distort the marketplace

and drive up the cost of care. Policies within states that

had more mandates could actually have doubled the cost of

[their] premiums.

5. Increased costs by constricting hospitals and physician

systems. There has been consolidation with increased hospital

mergers by 50% compared with 2009. There has also been

movement of doctor's practices to connect with hospital

systems and both the contractures within the hospital system

and then physician's systems increased costs to the patients.

For example, group practice charges increased costs 18% to

20% and specialty care charges increased costs even more, 34%

after connecting the care with hospital systems. These

changes in care i.e. changing from private practice systems

into hospital-based systems have significantly driven up the

cost of care for the patients.

6. Medical legal liability reform has not been a part of

ObamaCare but is a significant driver of healthcare costs.

That is not considered in it, and it is considered to be about a 10 to 25 percent increase in total costs.

I think this is under my time.

I think the answer that I gave was perhaps your time might be better spent taking a look at the bill because the conversations I have heard here didn't necessarily speak to the bill.

They speak to the process, and I think we have already covered that in 3 days.

Mrs. McCASKILL addressed the Chair.

I want to continue on with why we are trying to change this.

The Galen Institute--Grace-Marie Turner wrote about 70 changes to ObamaCare that occurred after it went into effect. And those changes include the ``employer mandate delay, individual mandate delay, preserved benefits to the military and VA, and reduction of funding to agencies used for implementation of ObamaCare including IPAB, CO-OP's, and IRS.''

Co-ops are an interesting thing. I was suggesting during the time that ObamaCare was being considered that small business health plans might make a real difference in costs for small businesses. Now, the only thing I can see on small businesses in here is that if you are a small business and you have over 50 employees, you have a problem.

I have people in Wyoming who come to me and say: I have this business. It is working really well, and in the next town over--and most of the towns aren't big enough to hold two of the same kind of store--so in the next town over, I would like to put in the same kind of shop.

My question to them is: How many employees do you have?

Most of them have said: Well, I have about 48 employees.

I said: How many will you need in the other store?

They said: Well, I hope to need the same amount of people.

I said: Well, the way this works, you are going to come under much increased healthcare costs, and you better take a look at that before you make your expansion.

So it has cost jobs that way.

Now, with small business insurance, with the small business health plan--

Ms. WARREN addressed the Chair.

I will not yield. I would appreciate the same courtesy from that side that I gave to you when you were doing your expositions about healthcare, which included the things that I have mentioned that aren't even in the bill. Our side has some time, and I would like to use some of that time.

As I have been through this process for a long time now--I have been on the Health, Education, Labor, and Pensions Committee for the whole time that I have been here, which is 20 years. Of course, it wasn't Health, Education, Labor, and Pensions when I first got here, but we thought that that was a clever acronym: We are from the Federal Government, and we are here to help you. There are a lot of people back home who don't think we really help out much.

But, at any rate, the small business health plans, after three of us who were in the Gang of 6 got thrown under the train or under the bus or whatever it was, small business health plans were changed to co-ops, and they were given a significant amount of money to work with, and they haven't fared very well.

I will find the information about the co-ops here. Again, this isn't stuff that I wrote; this is stuff somebody else wrote and footnoted and sent to all of us. Again, the name of the book is ``Demystifying ObamaCare: How to Achieve Healthcare Reform.'' It gives some good suggestions.

He does point out that ``ObamaCare is not a system of healthcare, nor is it

healthcare reform. It is a system of healthcare control.''

People are told what they are going to do.

ObamaCare was supposed to significantly reduce healthcare

costs, but instead it has dramatically increased costs for

even those who are not directly within the ObamaCare program.

ObamaCare was supposed to increase access to care, but

instead it actually reduced access to the availability to

care. ObamaCare reduces the effectiveness of the safety net

program, which is so very important economically for

Americans.

Under an amendment that I would like to see is one that would have covered the people who make a living of under $11,000--because with $11,000, you can't get insurance. They don't get subsidies; they are just left out in the cold. It is one of the corrections that should have been made and wasn't made. ObamaCare does reduce the effectiveness of the safety net program, which is important to economically poor Americans.

There are a lot of people out there in the States, several thousand in my State, who can't get insurance under that.

The quality of healthcare in America was derided when

ObamaCare was passed, but ObamaCare instead reduces the

quality of U.S. healthcare by reducing innovation, and it

removes a person's ability to make his own decisions about

his healthcare and that of his family, and it does so by

removing the freedom to make those decisions by putting so

many qualifications on it.

Again, I repeat that we haven't done anything to take people off of their policy if they are under their parents' policy if they are under the age of 26.

We haven't done anything to deny patients who have preexisting conditions. I have heard that for 3 days.

We haven't eliminated the lifetime caps on insurance. I have heard that for weeks.

So there are things that need to be done. They could be done. We have tried to do it in this bill, again, without constructive suggestions from the other side. For any recognition that there was any problem that ought to be solved, we have gone ahead. It is not my choice for the mechanism that would be used; it is the mechanism that was chosen by leadership and it falls to them. One of the things that makes this difficult is it is a budget reconciliation, so there are things that have to be written in a budget form in order to comply. That limits some of the things that I would have liked to have done that I think would have made quite a difference. And I think there would have been some things the other side might have joined on and been excited about too. But, again, we are limited by the mechanism that we have here, and there is no indication that----

Mr. President, I have heard so many times that the other side would love to be cooperative, but I have yet to see cooperation. I am not going to take questions; I am going to--I really would appreciate it if you would just take some time to look at the bill. I have heard the rhetoric.

Yes, and I have an hour, whether I use it or not. As I said, for the past few days I have been yielding time to the other side. I haven't gotten much satisfaction out of that. I have listened for the last hour, and I didn't get any satisfaction out of that either. I did sit through all of it. I did listen to it. Again, it is complaints about the process, but not constructive suggestions on what could be done.

There are taxes, mandates, regulations, lack of competition in the marketplace, increasing costs. When I travel across Wyoming, I have people who have come up to me and they say: My insurance premium is bigger than my house payment, and it is growing.

And they said: If something happens to us, my deductible is bigger than my year's premium. That shouldn't happen in America, but that is where we are. Those aren't isolated cases; those are a lot of cases. That is the situation we find ourselves in. We are not trying to hurt anybody; we are trying to fix some of these things.

As I said, for 8 years, every time there has been a waiver--that is part of that thing that I mentioned about the 70 changes to ObamaCare so far--a lot of those were in the way of waivers.

Every time there was a waiver, I said: Why are we waiving this? Why don't we just fix it?

I was told: It is not broke; it just needs more time.

Well, it has had more time. Last year--this was before the election, so you can't blame us. We had no idea who was going to be the President. We had no idea who was going to be in the majority. Last October, people started pulling out of insurance markets, and rates increased dramatically. You can't put that blame on us.

No.

Mr. President, I think what we have is a motion to commit and the right for the other side to do other amendments. I would hope that some of them would be constructive, but I am not expecting that. As I said, I have been listening for 3 days and actually listening a lot longer before that time.

I could talk about some of the things we can learn from ObamaCare, because we should. We can learn that decisions have to be made by the patients and not by the bureaucrats for the government. There are some key examples of when the government starts making those decisions. I don't have to pick on ObamaCare for it necessarily; the VA has had a few problems, and I am sure all of you have been working casework on what the VA has been doing. That is where the government and the bureaucrats are making decisions. We have been through some enormous times on that. That is why we did the Choice Act. And the Choice Act had a lot of problems. That is government healthcare.

People say: Well, Choice got to go outside of the government.

That is not quite true. I think the folks with the VA picked the companies you have to go through for healthcare, and when they did, they didn't want it to be efficient. They wanted as much of it as possible to come back to the VA. I am sure all of us, as we travel across our States, are running into people who are having problems with providers not getting paid or not being able to get their appointments. If you check with the providers, you find out what kind of a terrible process they have to go through to get paid. That is government healthcare.

In my State, I provide the VA with a list every week of the new cases I have of people who are not getting care. That shouldn't happen. But they told me when I first inquired: Well, there are only two doctors who haven't been paid.

I said: That is impossible. There are more than two doctors in my own town who haven't been paid, and there are a lot of towns in Wyoming-- when I go to them, I hear that they are not paid.

They said: One was not paid for 30 days, and one wasn't paid for 45 days.

I said: Well, I don't know why either one wasn't paid before those kinds of deadlines.

But I can tell you there are a lot more problems than that.

So if we are thinking about going to a Federal healthcare--and I guess we are not because we had that vote a little bit earlier on whether we would have a single-payer system. I was amazed at the number of people who chose not to vote on that. At any rate, I don't think that is where America wants to go. I have had some people ask me about that. I have given them some suggestions on where to check to see what kind of care they would get under that, and they have come back

to me and said: I don't think that is where we want to go.

I know the other side of the aisle has wanted to go that way for a long time. When I first got here, Phil Gramm was one of my mentors, and I really appreciated all of his advice in so many areas. One of the things he said to me was, you have to watch out for healthcare because where the Democrats want to go is to single-payer healthcare. In other words, they don't care who drives the train as long as it wrecks.

So I look back on ObamaCare and I say: Man, this was 18, 19, 20 years ago that he told me this. Is that where ObamaCare is supposed to go, to wreck the train so we can go to single-payer? I don't think so, but I think we are on the way to a train wreck, and I am not hearing a lot of disagreement about the train wreck. I am hearing some disagreement about the amount of calamity in the train wreck but not on whether there is going to be a train wreck.

There are a number of things we could do to take care of the costs that have gone up under this. That can be confronted within a free market as opposed to the government-run, government-controlled market we are under now. One of them is to reduce the tax burden. I did notice that I have a lot of people in Wyoming--again, we are one of the smallest or least populated in the Nation. We are big in land mass, but we are small in population--In Wyoming, $5.6 million was collected from people for fines for not having the adequate healthcare.

Those were people who said: Wait a minute, I have to spend so much on my healthcare and then a high deductible that I am never going to get anything out of it. So when I calculate the annual cost, the $1,700 that I have to pay as the fine--or $1,500, somewhere in that range--is cheaper than paying for all those premiums and then a deductible if anything ever happens to me.

These are real people I am talking about.

I allowed the other side to have their hour. I expect to have this hour, even if some of it is in silence.

I mentioned reducing the tax burden.

We could also eliminate some regulations. We really need to take a look at some of those regulations within the essential health benefits and see if everybody needs all of them or if there are some they would opt out of, given the opportunity, because they know they will never need them. There are a lot of examples of that.

We could eliminate the mandates from the Federal and State. We have the elimination of the Federal mandates in this bill, both the individual mandate and the employer mandate.

We could also increase competition within the marketplace by increasing flexibility. Some of these things we can't do, particularly to the level we would like to do them, but we could have more competition if we could increase the number of insurance companies. Competition makes a difference.

I have had a number of people, though, who have suggested to me that the biggest thing we could do would be to pass the medical liability reform because doctors are practicing defensive medicine, which drives up the cost, so that if they are ever in a lawsuit, they can prove they did every possible thing that they could ever imagine or that anybody could raise as an issue. There is a cost to doing that. One of the suggestions----

I will not.

It has been suggested that the government could have an appropriate role in healthcare by maybe using advanceable, refundable credits to prevent any lapse in coverage. One of the problems we have right now is that people can wait until they have something terrible happen to them, and they can sign up for insurance on the way to the hospital--you can't pay when you are in the ambulance, and you can't pay when you are getting treatment, and you can't pay when you are getting rehab--and when they are done, they drop out of it. It is hard for an insurance company to figure in the cost of something they are not going to get paid for at all.

There have been a number of suggestions. I don't know whether they are any good. I could throw them out. One of them is that if you don't keep continuous coverage, you should have to pick up your own expenses for the first 6 months. That would encourage people to have continuous coverage. It is just one possible suggestion.

There is a role for government within this setting, and that is requiring some transparency within the system, encouraging the development of new healthcare competition, prevention of collusion between healthcare companies, and having prices posted.

I remember a hearing we had once--

I will not. You got your hour; it is my hour.

When I was chairman or when Senator Kennedy was chairman of the Health, Education, Labor, and Pensions Committee, we switched from doing hearings to doing roundtables. That was an interesting experience too. Instead of having all of the witnesses except one picked by the majority and the other one picked by the minority and then everybody coming up to beat up on the person who was in the opposite field, we went to roundtables.

What you do with a roundtable is you pick 2 or 6 or 8 or 10 people who are actually knowledgeable in that field, who have actually done something, who have had their hands on what we were talking about.

I remember the first one. One of the questions at the end was by Senator Kennedy, and he asked the witnesses that he and I had selected. This wasn't me selecting; this was a joint effort selecting them. He said: What do you think about single-payer insurance? As they went around, there was only one out of 10 people who said: Well, it might be a good idea, but we probably ought to take a look at it. The rest of them said: It won't work in America. We are already used to something different.

When the hearing was over, Senator Kennedy said to me: You know, I think these roundtables are a good idea. I think it is a good thing to kind of hear about what the people are actually experiencing out there before we write the bill.

Well, we did a lot of healthcare roundtables. One of the witnesses was from Safeway. Safeway had been able to hold their costs level and started to bring them down. Of course, we were interested in anybody who could hold healthcare costs level or bring them down. The way they had done that was to find out what the costs of different procedures were in the area where they had stores. After they knew what the cost of the procedure was, they could take the median price for whatever it was, and if the people in their store would take the median price, it didn't cost them anything. If they went above the median price, they had to pay the difference. If they went below the median price, they got the difference. So they were actually paying attention, using some financial literacy in any of the treatments they needed to get, and they appreciated that their company had done this research for them in advance so they could have some kind of an idea of what the market held. He estimated that if they were able to increase the flexibility they had with this, they could bring down their costs by about 5 to 7 percent a year.

I worked on a 10-step plan--in conjunction with Senator Kennedy on a lot of it--and talked about it across the country and particularly across Wyoming. It would have been 10 steps to get healthcare for everyone without mandates but with incentives.

Mr. VAN HOLLEN addressed the Chair.

The Senator will not yield.

Earlier I mentioned the CO-OPS. I would have preferred the small business health plans. I didn't think the CO-OPS would work.

CO-OPS were included in ACA.

These plans were meant to provide competition with existing

health insurance companies.

It was an opportunity to set up insurance companies that actually were funded.

The CO-OPS were given $2.4 billion in ``federal loans.''

The CO-OPS were prohibited from having former healthcare

executives with managerial or accrual experience.

The CO-OPS were conceived to drive down the premiums by

providing competition and underselling the cost for policies.

More than half the 23 CO-OPS went out of business in 2015,

but 8 of the remaining 11 CO-OPS were in financial trouble.

The number of CO-OPS is now down to 7 (4 of the prior CO-

OPS went bankrupt in 2016).

Examples of how the CO-OPS that have failed and have cost

the taxpayers. In 2015 alone, there was a huge amount of

money lost and also cost the enrollees in the CO-OPS their

insurance.

New York Health Republic, 23,000 policies lost, $57 million

dollars lost in the first half of 2015.

Iowan and Nebraska CO-Opportunity Health, 120,000 policies

canceled, $146 million dollars lost. Arizona CO-OP, 59,000

enrollees lost their insurance, $90 million dollars lost.

Colorado CO-OP, 89,000 enrollees insurance canceled, $72

million dollars lost.

Ms. HASSAN addressed the Chair.

No.

Continuing:

The [Health and Human Services] and administration

officials knew that the CO-OPS were at risk even before they

received their first ``loan'' in 2014. Senator Rob Portman,

Chairman of the Senate Permanent Subcommittee on

Investigations, said that the HHS knew of serious problems

concerning the failed CO-OPS enrollment strategies, pricing

and financial management before the department ever approved

their initial loans.

Dr. Mandy Cohen, the director of the CMS, testified before

a House subcommittee that 8 of the 11 remaining CO-OP

companies were in serious financial difficulty and receiving

``enhanced oversight'' and ``corrective action.'' Dr. Cohen

did not explain what that ``corrective action'' or ``enhanced

oversight'' consisted of nor could she indicate the

enrollment figures and the possibility of financial survival

for the CO-OPS that were being monitored.

Also, 4 more CO-OPS have failed over the first half of

2016, leaving only 7 remaining.

I am not sure what today's number is.

The HHS continued to make these federal loans though they

knew the CO-OPS were failing.

Under the small business health plans, there is no requirement to have the Federal Government fund it unless we want to fund more oversight. I am not opposed to that either.

So What are the American People Think of This?

There has been greater than $1 billion dollar loss of

taxpayer money to CO-OPS that have gone bankrupt.

Only 7 of the initial 23 CO-OPS remain in business.

The CO-OPS were constructed as a way of providing

competition against existing companies, however in order to

do that they underpriced their products. No company can

survive if they take in less than what they put out in

services and understandably, the majority of CO-OPS have gone

out of business.

That could be something to do with their being prohibited from having former healthcare executives with managerial and accrual experience.

This was known by the HHS before the first ``federal

loans'' had ever been approved.

Over 800,000 people have lost their insurance because the

CO-OPS have gone out of business and there are more to come.

It speaks to the fact that the HHS and ObamaCare

Administration had very little regard for the American

taxpayer and the American people.

The disturbing question is whether any of the taxpayer's

money will be returned.

I did say those were loans, and there aren't many left that can pay back the loans, which is a little bit of a difficulty.

Of course we did hear that ObamaCare was supposed to bend the cost curve down. I ought to point out some facts on that as well.

From 2009 to 2012 healthcare, spending grew less than 4

percent, as spending started increasing dramatically in the

first quarter of 2014. This was the start of the

implementation of the legislation. Subsequent healthcare

spending from 2015 showed a 6.8% rise. In 2016, it is

estimated to increase to 6.5% spending growth.

We know from last year, which isn't included in this, that it started doubling at that point.

Deductibles both inside and outside ObamaCare exchanges

have increased enormously and will continue to increase.

Healthcare costs are now increasing more than inflation.

Why has spending increased? There has been increased

utilization services. The increased healthcare spending thus

led to higher insurance costs. A particular cause of

increased spending related to ObamaCare is a marked increase

in deductibles and health insurance premiums in the ObamaCare

exchanges. Additionally, because of the increased number of

patients with Medicaid expansion there have been increased

costs. Healthcare costs [will] continue to rise.

The total healthcare spending for 2016 is to increase to

over $3 trillion dollars.

I will get some updated numbers on that.

Total healthcare spending . . . rate of spending increase.

Medicaid increased: 11%

Medicare increased: 5.5%

Private insurance spending increased: 4.4%.

If I would have known that Medicare was going to be mentioned, even though it is not in the bill, I would have shown the little chart that I have, which shows how much revenue we get for different mandatory spending that we have.

All of those mandatory spendings are in a little bit of

trouble because the revenue streams to take care of them are

not sufficient. At one point, they were sufficient in some of

them, and the federal government doesn't have any place to

park cash. The federal government puts bonds in a drawer and

spends the cash. That is kind of double dipping because there

is nothing there for later. There is a Social Security trust

fund.

I have learned from trust funds that you have to find money to put in before you can take money out. I never saw a trust fund that operated that way until I got here. We have some crises that are coming up. We are going to compound healthcare because for Federal pensions, we really don't put any money away for them. We require businesses to put it away, and we have had some other suggestions. I have some small pension plans I would like people to look at, some pooling for that, which I think would encourage more people to have pension plans in small business.

But the cost of administration is extremely high unless

they can share in that. All of them would require that there

be money put away to be able to cover with reasonable growth

in the interest of the fund so that what was promised could

be taken care of.

In 2006, Senator Kennedy and I worked on saving some pension plans, trying to make sure that promises that were made could be met. We did a pension bill that needs to be redone again, particularly for some sectors of the pension.

The private sector is required to put away money. When the

market goes down, it increases dramatically the amount of

money that they need to put in and creates some problems for

business.

The point I am making is that the Federal Government doesn't do that with any excess funds we get. I don't care if it is in healthcare or Social Security or where it is, those excess funds are allowed to be spent with bonds put in a drawer, with the promise that the full faith and credit of the Federal Government will cover them. I don't know how many people at home believe that, but that is what it is.

How has the battle for the quality of healthcare fared? This gets covered in this book too.

Here is a little bit on the quality of healthcare and outcomes.

The infant mortality rate . . . has been used by

politicians and others in political debate to describe the

inferiority of the U.S. healthcare [system]. U.S. ranked only

30th in the world (and the neonatal mortality below that).

When you look at this data, however, you find a very

different picture. The United States followed the World

Health Organization definition that a live birth is any

infant

that shows any sign of life, i.e. a baby that takes a single

breath or has a heartbeat. . . . Other countries however

including both developed and underdeveloped countries use

different standards. The definition of ``live births'' varies

between different countries. For example, in Switzerland a

newborn has to be 30 cm. long to be considered a live birth.

In Belgium and France, infants have to be at least 26 weeks

to be considered as live births. Infants less than 24 weeks

gestational age are excluded from registries of live birth in

multiple other countries including Japan and Hong Kong. In

Canada, Germany, and Austria, the newborns weighing less than

500 grams are not considered viable and are excluded from the

infant mortality rates.

What I am saying is, there are games that can be done with that, with the performance ratings, with the life expectancy data, with the Commonwealth Fund. All of these things are issues that we are embarrassed about and things we ought to be working on, things we ought to improve, things we ought to help with our country.

We need to be looking at all of those outcomes--the cancer outcomes, the cardiac disease outcomes, the stroke outcomes, the chronic illness outcomes, the hypertension outcomes, the diabetes and cholesterol outcomes.

We know that the earlier and more effective there is

treatment of the disease, the better treatment of the disease

for chronic disease, the better the results are. The more

accessible and better technology there is, the more access to

specialty care for early diagnosis and treatment, better

preventive screening, and the inventiveness of the American

people.

I think it was today--my days blend together these days with this healthcare that we are working on. I was visited by a couple of young people from Wyoming who have diabetes. We have put some additional money into research. We, as a Senate, don't say exactly where that money has to go because we shouldn't be kicking the tires on the different diseases and figuring that out. I worry about where we might put the money, if that were the case, because we are affected differently than what our constituents are.

Both of these young people were on a pump, and I have gotten to meet Dean Kamen who invented the pump. It is kind of an interesting story. Of course, that wasn't his first medical invention. His first medical invention was actually when he was a junior in high school and his brother was doing a residency in a hospital that handled transplants for infants. They were mentioning some devices similar to a needle in which medicine can evidently go through. This was needed for transplant of a kidney. He was lamenting they didn't have that capability. He went down to the basement and figured out how to make one of those. That was his first patent. You probably know him more for the patents of the Segway.

After he made some money, he got to experiment with some different things. One of them is that mobile thing that police use and shopping centers use and tourists use where you ride around on a Segway. He built that for a specific medical purpose, which was to figure out a way to have a wheelchair that could climb stairs. Instead of building a ramp and being limited where there wasn't a ramp, he figured out a wheelchair that could climb stairs. It could do a number of other things too. For instance, if the person in a wheelchair went to a cocktail party, they could rotate the wheels up so they were at standing level to everybody else.

He had a lot of problems getting it through FDA. He finally got it through FDA, then was told there are other wheelchairs that are less expensive so we are not going to pay for that. I think another company is coming back in to do that. It is an outstanding experience to sit in a wheelchair and go downstairs with it.

He worked on this diabetic pump. It is interesting how he got into the diabetic pump. He was told pregnant women who are on insulin, if they take the insulin doses, they wind up often with babies that have a bigger head, which makes the delivery a bit more difficult. Everything changes so the head becomes normal after a period of time, but it is a problem at childbirth. He thought, what if we gave them a dose of insulin over a longer period of time; would that have an effect on the infant? So he invented a machine which started out being a fairly good- sized machine, but it worked. If they got their insulin over a slow period of time, but sufficient insulin, the baby didn't have the larger head.

Well, this man is a businessman. He said: That is good. That will provide part of a market, but there ought to be a bigger market for it. He said: I wonder if men would have any benefit from having a diabetic pump? So he was able to have a trial and found out that also worked. He worked it down to be smaller and smaller and is working on other kinds of inventions that will do better things.

We need to keep putting things into innovation. I said a lot of times: If there is a problem in America and we put on a small incentive, there will be somebody who will figure out how to turn that into something very useful.

Mr. President, I think I have been requested by Senator Schumer to have 2 minutes, and to have 5 more minutes by UC perhaps for others, but I would ask that at the end, Senator Cornyn be allowed 2 minutes before the vote.

I was wrong. I need 5 for Senator Cornyn.

I ask for the yeas and nays.

Mr. President, section 3001 of S. Con. Res. 3, the concurrent resolution on the budget for fiscal year 2017, allows the chairman of the Senate Budget Committee to revise the allocations, aggregates, and levels in the budget resolution for legislation related to healthcare reform. The authority to adjust is contingent on the legislation not increasing the deficit over the period of the total of fiscal years 2017 to 2026.

I find that amendment No. 667 fulfills the conditions of deficit neutrality found in section 3001 of S. Con. Res. 3. Accordingly, I am revising the allocations to the Committee on Finance, the Committee on Health, Education, Labor and Pensions, HELP and the budgetary aggregates to account for the budget effects of the amendment. I am also adjusting the unassigned to committee savings levels in the budget resolution to reflect that while there are savings in the amendment attributable to both the HELP and Finance Committees, the Congressional Budget Office and Joint Committee on Taxation are unable to produce unique estimates for each provision due to interactions and other effects that are estimated simultaneously.

This adjustment supersedes the adjustment I previously made for the processing of amendment No. 267. This adjustment applies while this amendment is under consideration. Should the amendment be withdrawn, fail, or lose its pending status, this adjustment will be null and void and the adjustment for amendment No. 267 shall remain active.

I ask unanimous consent that the accompanying tables, which provide details about the adjustment, be printed in the Record. --

Mr. President, I have 12 requests for committees to meet during today's session of the Senate. They do not have the approval of the Democratic leader; therefore, they will not be permitted to meet past 11:30 this morning, but I ask unanimous consent that a list of committees requesting authority to meet be printed in the Record.

Mr. President, I listened with a lot of interest to the Democratic leader's comments this morning and his proposal that there would be cooperation if we went to a system of putting it back through committees and doing that, but I have to say that we would have a lot more confidence in getting a solution if there were a single positive suggestion from the other side for a change. Until that happens, there isn't much confidence on our side that the promise of bipartisanship is going to happen.

They keep saying that it isn't perfect, but they don't put forward ideas for any of the changes. We have been suggesting changes for several years, and we have been told each time that it just needed a little more time, that it was a perfect bill.

Soon we will be trying to do a budget. It would be nice if we had some suggestions on budget items that were positive things. I put out that offer as well.

The reason we are having this is that more than 7 years ago, President Obama and congressional Democrats imposed a risky, partisan healthcare experiment on America that ultimately led to skyrocketing healthcare costs and collapsing insurance markets for millions of Americans across the country. This riverboat gamble has caused a stark and dramatic outcome. Currently, there are projected to be 50 counties across the Nation that will not have a single insurer participating in the ObamaCare exchange.

To add further insult, Americans seeking affordable coverage in these almost 50 counties will still be fined under the ObamaCare mandate for not having health insurance. In other words, many Americans will either be forced to pay for insurance they cannot afford or pay a penalty for not having health insurance under this so-called Affordable Care Act, which they can't even access. Where are these people supposed to go? What can we do to help? Again, we are looking for some positive suggestions.

My colleagues on both sides of the aisle know that this healthcare experiment has failed and that we must work together to free Americans from these mandates and put healthcare decisions back in people's control.

Today, Senate Republicans are taking an important step to rescue the millions of hard-working families trapped by ObamaCare's taxes and

mandates. We are trying to repair the Nation's broken healthcare system because we now have a President in the White House who shares our commitment to improve America's healthcare system and make better care available to all Americans.

One of our top priorities in Congress has been to provide relief for hard-working Americans from ObamaCare, which has pushed insurance markets to the brink of collapse. In Wyoming and across the country, premiums for hard-working families are soaring while choices for patients have dwindled. As I travel across Wyoming, I have a lot of people who tell me that their health insurance costs more than their mortgage and, if they ever need healthcare, they have a deductible that is bigger than that.

Simply put, ObamaCare stumbled out of the starting gate on the very first date the healthcare.gov website launched. You might remember how you couldn't get on the website or how you got kicked off after you had done a lot to put in information. Yes, ObamaCare stumbled out of the starting gate on the very first day that the healthcare.gov website was launched, and it has consistently failed to deliver on its core promises while hurting far more Americans than it is helping.

One thing both parties should agree on is that an accessible and affordable healthcare system should be available to each and every American family, and I truly hope my colleagues on both sides of the aisle will work with us to find common ground on healthcare that truly delivers better care.

Millions of Americans have been suffering under President Obama's healthcare law, and this past fall our Nation voted for a change. These hard-working Americans made it clear that fixing our healthcare must be a top priority for Congress and the President. This week, we are delivering on that promise of relief from ObamaCare.

Making America's healthcare system more efficient and effective has always been an important and challenging endeavor for the public and private sector alike. President Obama and his congressional Democrats pushed Washington into the healthcare market, inflicting far greater uncertainty, cost, and disruption into the healthcare landscape than anyone ever imagined. By taking the important steps necessary to untangle Americans from this unworkable, unpopular, and unaffordable law, hard-working families can expect to see stability in the skyrocketing healthcare costs and egregious penalties imposed on them by the ill-named ObamaCare concept of ``affordable care.''

If you are young and healthy, ObamaCare has made it an easy choice to opt out of health coverage. But for those not so fortunate, for those who must have coverage, soaring healthcare costs are becoming a stunning reality. I have constituents in Wyoming who have written to me with worry and concern about their surging health insurance premiums.

I assume that my 99 other colleagues have received many letters like one I received from a family in Gillette, WY. They recently wrote me that under ObamaCare they are paying more than $2,400 a month-- essentially taking on more than another mortgage.

In their letter to me, they write:

Mike, we are small business owners in Gillette, WY. Between

Obama trying to kill the coal, oil and gas industries and his

insurance fraud, we are stuck between a rock and a hard

place. I just paid a $2400 Blue Cross Blue Shield of Wyoming

Health insurance bill. I can't keep doing that. I am a real

person with real problems created by my own government. HELP

What is the time situation?

Mr. President, I yield such time as the Senator from Kentucky needs.

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

I object.

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

Madam President, I ask unanimous consent that the actions scheduled to take place at 11:30 this morning occur at 3:30 p.m. today and that all other provisions of the previous unanimous consent agreement remain in place.

Mr. President, Senator Blumenthal, the Senator from Connecticut--I ask for 3 minutes from our time, and we will allot that as long as we preserve the full time for the Senator from Wisconsin.

Mr. President, I thank my colleague from Wisconsin, my fellow accountant, for doing a good job of accounting there and providing some charts that very explicitly show what he has been working on, what he has been encouraging people to do, and

some solutions. That is what we keep looking for within the criticism that we are getting from the other side of the aisle--some solutions.

Earlier this year, Congress took an important first step in fulfilling the promise of repealing ObamaCare by passing a budget resolution that paved the way for this debate that we are having right now and paved the way for some real healthcare reforms that we are currently debating. These reforms are focused on rescuing the millions of hardworking families who are trapped by ObamaCare's taxes and mandates.

You heard one example from the Senator from Wisconsin of a family who is paying excruciatingly high prices for their healthcare only to find out that they have $16,000 in deductibles, which makes it very difficult to utilize it at all. Is that insurance, if you have to pay $16,000 before the rest kicks in?

What we are doing here is working to stabilize collapsing insurance markets that have left millions of Americans with no options. We improve the affordability of health insurance. We preserve access to care for Americans who have preexisting conditions while we safeguard Medicaid for those who need it the most by giving States more flexibility. We ensure that those who rely on this program will not have the rug pulled out from under them. Most importantly, we liberate the American people from the onerous ObamaCare mandates of purchasing insurance they do not want and/or cannot afford.

Additionally, these bills can reduce the Federal deficit, the amount the Federal Government overspends each year, by billions of dollars. They can also end up saving taxpayers billions more by improving and reforming the way Medicaid operates. These aspects of the bill are enormously important. This will be the first time in a generation that we will have even attempted to rein in any of these programs and put them on a sustainable path--the ones that are threatening to bankrupt our country--without pulling the rug out from under people, as you saw from the charts by the Senator from Wisconsin.

By reducing spending, lowering the tax burden on hard-working families, and curbing our national debt, which now stands at almost $20 trillion and is on its way rapidly to $29 trillion, we will be ensuring a brighter and stable fiscal future for our children and our grandchildren. Actually, with that kind of debt, we are almost ensuring a brighter and stable future for ourselves. We are in trouble.

While my colleagues complain about using the reconciliation process to untangle the country from this unworkable, unpopular, and unaffordable law, they should remember that they actually employed the exact same procedure to secure the passage of ObamaCare, without having any input or assistance from Republicans, and rushed it through both Houses of Congress in less than a week. Senate Republicans are responsibly utilizing this reconciliation process to address the healthcare crisis that has been thrust upon America by former President Obama and congressional Democrats.

There is also the common misconception that some of my friends across the aisle have promoted--the idea that ObamaCare is a runaway success and that repeal will be tearing down a functioning program. This is, simply, not true. My Democratic colleagues know it is not true. Former President Obama knows that it is not true, and the American people, certainly, know it is not true.

Here is the reality. ObamaCare has put our health insurance markets on the brink of collapse in many parts of the country. As I pointed out in an earlier speech, that began in October of last year, which was before the elections. It has nothing to do with what has transpired since the elections. ObamaCare put our health insurance markets on the brink of collapse in many parts of the country, and what the Republicans are tackling now is what President Obama and congressional Democrats simply could not bring themselves to do when they had control, which was to fix the problems they had created. This may be because ObamaCare has enshrined their idea that bigger government is better and that any changes, unless done by Executive action under the President, were out of the question.

In their zeal to protect this flawed program, they may have missed it when President Obama himself admitted last year that the law had real problems.

He said:

There are going to be people who are hurt by premium

increases or lack of competition and choice.

He went on to say that these problems are simply called ``growing pains.''

Now, these growing pains have forced millions of Americans across the country to grapple with impossibly high health insurance premiums for plans they do not want, out-of-reach deductibles to help with common prescriptions, and disappearing insurance providers to even be allowed to shop for better coverage.

As I noted earlier, for more and more Americans, there is only a single insurer from which they can select health plans, and they may soon not have a single ObamaCare insurer, as 50 counties already do not have one, and others are threatened. Thousands only have one choice. In fact, on the Federal exchanges, one in five consumers will only be able to select plans from a single insurer. Many residents across the country will have only one choice of health insurer. This includes my home State of Wyoming, as well as the entire State of Alaska.

What does this lack of competition mean? Premiums are surging for hard-working families, who now have to choose between unreasonable insurance rates or an unreasonable fine. If my colleagues wanted yet further evidence that competition lowers prices, they need look no further than their constituent mail.

In Wyoming, some families will be forced to pay more than 30 percent of their total income on premiums in order to obtain healthcare coverage, which often includes deductibles of over $1,000. One family faced premiums of more than $1,600 a month. As an alternative, their tax penalty for not carrying coverage was only $1,700 for the year. That is a $1,600-a-month premium charge or a $1,700 penalty for not covering it for the whole year.

So guess what they did? They paid the fine because they could not afford the insurance premium, let alone the deductible. I think $5.3 million in fines were collected in Wyoming from the people who could not afford the insurance. They took the lesser alternative of paying a tax penalty, which gave them nothing.

For those who are lucky enough to be able to afford insurance, particularly in the individual market, under the new health law, premiums are expected to increase faster in 2017 than in previous years. Some States will see insurance premiums rise by as much as 53 percent. That is in 1 year. We are talking about a 4-year doubling of cost. This will be a 50-percent cost increase in 1 year. That is truly a healthcare emergency. Not doing anything and accepting the status quo is simply unacceptable to millions of Americans suffering under this law.

Now that we have discussed why we are doing this, it is important to also ask how we hope to help these suffering Americans. It is vital that we stabilize collapsing insurance markets that have left millions of Americans with no options, while reestablishing the affordability of health insurance.

Our bill will also preserve access to care for Americans with preexisting conditions, and it will safeguard Medicaid for those who need it most by giving States more flexibility, yet ensuring that those who rely on this program will not have the rug pulled out from under them--contrary to the scare tactics being put forth by ObamaCare's defenders.

Most importantly, Congress is working to free the American people from the onerous mandates to purchase insurance they don't want or can't afford.

Congressional Republicans and our President are focused on securing the future of Americans' healthcare system and truly understand the importance of restoring the trust of hard-working taxpayers.

What we are doing here under reconciliation, which is a budget process, will not solve all the problems. There will be an opportunity for bipartisan investigation, support, and changes if the other side is willing to do that. There are some things that need to be

done immediately to protect the American taxpayers and the people who want to have healthcare.

So I ask everyone to focus on securing the future of America's healthcare system and to try to understand the importance of restoring the trust of hard-working taxpayers.

Thank you, Mr. President.

I yield the floor.

I ask for the yeas and nays.

Mr. President, I ask unanimous consent that Senator Enzi or his designee be recognized to offer the Heller amendment No. 288 and that the time until 6:10 p.m. be equally divided in the usual form on the Casey motion to commit and the Heller amendment. I further ask that at 6:10 p.m., the Senate vote in relation to the Casey motion, followed by a vote in relation to the Heller amendment, with 2 minutes of debate equally divided in the usual form between the votes.

Mr. President, I call up the Heller amendment No. 288.

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

I thank the Senator for yielding.

Mr. President, I ask for the yeas and nays.

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

Madam President, section 3001 of S. Con. Res. 3, the concurrent resolution on the budget for fiscal year 2017, allows the chairman of the Senate Budget Committee to revise the allocations, aggregates and levels in the budget resolution for legislation related to healthcare reform. The authority to adjust is contingent on the legislation not increasing the deficit over the period of the total of fiscal years 2017 to 2026.

I find that amendment No. 271 fulfills the conditions of deficit neutrality found in sec. 3001 of S. Con. Res. 3. Accordingly, I am revising the allocations to the Committee on Finance, the Committee on Health, Education, Labor, and Pensions, HELP and the budgetary aggregates to account for the budget effects of the amendment. I am also adjusting the unassigned to committee savings levels in the budget resolution to reflect that while there are savings in the amendment attributable to both the HELP and Finance committees, the Congressional Budget Office and Joint Committee on Taxation are unable to produce unique estimates for each provision due to interactions and other effects that are estimated simultaneously.

This adjustment supersedes the adjustment I previously made for the processing of S. Amdt. 267. This adjustment applies while this amendment is under consideration. Should the amendment be withdrawn, fail, or lose its pending status, this adjustment will be null and void and the adjustment for amendment No. 267 shall remain active.

I ask unanimous consent that the accompanying tables, which provide details about the adjustment, be printed in the Record.

Madam President, I ask unanimous consent that when the Senate completes its business today, it adjourn until 10 a.m. on Thursday, July 27; further, that following the prayer and pledge, the morning hour be deemed expired, the Journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, and morning business be closed; further, that following leader remarks, the Senate resume consideration of H.R. 1628, with the time until 2:15 p.m. equally divided between the two leaders or their designees; and finally, that at 2:15 p.m., the Senate vote in relation to the Daines amendment No. 340, as modified.

Madam President, if there is no further business to come before the Senate, I ask unanimous consent that it stand adjourned under the previous order.

Mr. President, I ask unanimous consent that, for the duration of the Senate's consideration of H.R. 1628, the majority and Democratic managers of the bill, while seated or standing at the managers' desks, be permitted to deliver floor remarks, retrieve, review, and edit documents and send email and other data communications from text displayed on wireless personal digital assistant devices and tablet devices.

Mr. President, I ask unanimous consent that the use of calculators be permitted on the floor during the consideration of H.R. 1628.

Mr. President, what is the regular order with respect to the pending amendment?

Thank you, Mr. President.

I suggest the absence of a quorum and ask unanimous consent that the time be equally divided.

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

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

Mr. President, I ask unanimous consent that there be 1 hour for debate on amendment No. 270, equally divided between the two managers or their designees; that following the use or yielding back of time, Senator Murray or her designee be recognized to make a point of order against the amendment, and that Senator Enzi or his designee then be recognized to make a motion to waive; further, that following the vote on the motion to waive, Senator Enzi or his designee be recognized to offer a second-degree amendment, No. 271, and that Senator Murray or her designee be recognized to offer a motion to commit; finally, that the time from 10 a.m. until 12 noon be equally divided between the managers or their designees; that at 12 noon tomorrow, Senator Murray or her designee be recognized to make points of order, and that Senator Enzi or his designee be recognized to make a motion to waive; that following the motion to waive, the Senate vote in relation to the amendment No. 271; that following disposition of the amendment, the time until 2:15 p.m. be equally divided on the Murray motion to commit, with a vote on the motion at 2:15 p.m. I further ask that following disposition of the Murray motion, Senator Murray or her designee be recognized to offer an additional motion to commit.

Mr. President, I call up the Paul amendment No. 271.

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

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

Mr. President, section 3001 of S. Con. Res. 3, the Concurrent Resolution on the Budget for Fiscal Year 2017, allows the chairman of the Senate Budget Committee to revise the allocations, aggregates, and levels in the budget resolution for legislation related to healthcare reform. The authority to adjust is contingent on the legislation not increasing the deficit over the period of the total of fiscal years 2017-2026.

I find that S. Amdt. 267 fulfills the conditions of deficit neutrality found in section 3001 of S. Con. Res. 3. Accordingly, I am revising the allocations to the Committee on Finance, the Committee on Health, Education, Labor, and Pensions, HELP, and the budgetary aggregates to account for the budget effects of the amendment. I am also adjusting the unassigned to committee savings levels in the budget resolution to reflect that, while there are savings in the amendment attributable to both the HELP and Finance committees, the Congressional Budget Office and Joint Committee on Taxation are unable to produce unique estimates for each provision due to interactions and other effects that are estimated simultaneously.

I ask unanimous consent that the tables, which provide details about the adjustment, be printed in the Record.

Mr. President, I have 7 requests for committees to meet during today's session of the Senate. They have the approval of the Majority and Minority leaders.

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

Committee on Agriculture, Nutrition, and Forestry

The Committee on Agriculture, Nutrition, and Forestry is authorized to meet during the session of the Senate on Tuesday, July 25, 2017 at 8:30 am, in 106 Dirksen Senate Office Building, in order to conduct a hearing entitled ``Commodities, Credit, and Crop Insurance: Perspectives on Risk Management Tools and Trends for the 2018 Farm Bill.''

Committee on the Judiciary

The Committee on the Judiciary is authorized to meet during the session of the Senate on July 25, 2017, at 10 a.m., in room SD-226 of the Dirksen Senate Office Building, to conduct a hearing entitled ``Nominations.''

Committee on Intelligence

The Senate Select Committee on Intelligence is authorized to meet during the session of the 115th Congress of the U.S. Senate on Tuesday, July 25, 2017 from 2:30 pm, in room SH-219 of the Senate Hart Office Building to hold a Closed Business Meeting followed by a Closed Member Briefing.

Subcommittee on Seapower

The Subcommittee on Seapower of the Committee on Armed Services is authorized to meet during the session of the Senate on Tuesday, July 25, 2017, at 2:30 p.m., in open session, to receive testimony on options and considerations for achieving a 355-ship Navy from naval analysts.

Subcommittee on Ocean, Atmosphere, Fisheries, and Coast Guard

The Committee on Commerce, Science, and Transportation is authorized to hold a meeting during the session of the Senate on Tuesday, July 25, 2017, at 10 AM in room 253 of the Russell Senate Office Building. The Committee will hold Subcommittee Hearing on ``Efforts on Marine Debris in the Oceans and Great Lakes.''

Subcommittee on Clean Air and Nuclear Safety

The Subcommittee on Clean air and Nuclear Safety of the Committee on Environment and Public Works be authorized to meet during the session of the Senate on Tuesday, July 25, 2017, at 10 AM, in Room 406 of the Dirksen Senate office building, to conduct a hearing entitled, ``Developing and Deploying Advanced Clean Energy Technologies.''

Subcommittee on East Asia, the Pacific, and International Cyber

Security Policy

The Committee on Foreign Relations Subcommittee on East Asia, the Pacific, and International Cyber Security Policy is authorized to meet during the session of the Senate on Tuesday, July 25, 2017 at 2:30 p.m., to hold a hearing entitled ``Assessing the Maximum Pressure and Engagement Policy toward North Korea.''

Mr. President, I ask unanimous consent that Paul Vinovich and Greg D'Angelo, from my staff, be given all-access floor passes to the Senate floor and that Robert Creager, Tiffany Mortimore, Sean Ross, and Sam Safari, interns for the Budget Committee, be granted floor privileges during the consideration of H.R. 1628.

Mr. President, I ask unanimous consent that when the Senate completes its business today, it adjourn until 9:30 a.m., Wednesday, July 26; that following the prayer and pledge, the morning hour be deemed expired, the Journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, and morning business be closed; further, that following leader remarks, the Senate resume consideration of H.R. 1628, with the time until 11:30 a.m. equally divided between the two leaders or their designees; finally, that the previous order with respect to the vote time in relation to amendment No. 271 be modified to occur at 11:30 a.m. tomorrow, and the vote on the pending motion to commit occur at 3:30 p.m. tomorrow, with all other provisions remaining in effect.