Floor Statements

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

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

I announce that the Senator from New Jersey (Mr. Menendez) is necessarily absent.

Mr. President, what is the business of the Senate this morning?

I ask unanimous consent to speak as in morning business.

Mr. President, I wish to say that the comments made by the Democratic leader, the Senator from New York, really touched me because they go to the heart of this institution.

It was only a few weeks ago, in a dramatic moment, when Senator John McCain returned from Arizona to come to the floor of the Senate and cast a historic vote to move forward on the debate on healthcare. He asked for 15 minutes after that vote to say a few words about his experience as a person and his observations as a Senator, and I stayed in my chair because I wanted to hear him.

John McCain came to the House of Representatives the same year I was elected. Our careers have at least been close or parallel in some respects, though I couldn't hold a candle to him in terms of his personal life experience and his experience in the military, as well as being a candidate for even higher office.

I listened carefully as he reminded us of what it takes for the Senate to work. What it takes, of course, is the determination of both political parties to solve a problem. He reminded us that means sitting down in committee, with experts, working through some of these issues, particularly the more complex issues--the give-and-take of the legislative process.

He pointed specifically to the effort to repeal ObamaCare as a failure by those standards. He used as an example the fact that ObamaCare, during the period of Republicans' efforts to repeal, was actually gaining popularity in this country--exactly the opposite of what the other party might have expected. It was an indication to him that we needed to do things better in Senate. Just a few days later, he cast a critical vote to stop what was a flawed process on the Republican side--to repeal ObamaCare without a good alternative, without a good substitute.

I remember that vote early in the morning, right here in the well of the Chamber, and I remember what followed when I saw Senator Lamar Alexander and Senator Murray behind me in front of the cloakroom in a bit of a huddle after that historic vote. I later learned that they had decided it was their turn to step up on a bipartisan basis and find a way to strengthen our healthcare system, not what we had just seen but a different way--a way that kind of relied on experts at State levels to give us advice and experts in Washington to really cull through the ideas to find the very best. They invited other Members of the Senate to join them, even those of us not on the committee.

Senator Alexander and Senator Murray have had several meetings, which I have attended and which were very productive meetings--bipartisan gatherings over coffee and donuts with insurance commissioners from States all across the Nation, commissioners from both political parties, bipartisan meetings of Governors from States all across the United States. They were basically sitting down and saying: What can we do now? What can we all agree to do, regardless of party, that will reduce the increasing costs of health insurance premiums, provide coverage for more people, and provide better healthcare--quality care? It was a good-faith effort, and it was encouraging, after 7 wasted months of political debate on the floor of the Senate.

I went to those meetings and came away feeling very positive. It was clear that some very basic ideas were emerging from all over the United States. One of the ideas was cost-sharing reduction so that health insurance companies that took on sicker, older patients and had worse loss experiences would be able to be compensated so they could reduce premium costs, bring the cost of health insurance down, and make sure more people had it available.

Another proposal was reinsurance. That is the same basic idea. Let's find a way to make the increase in health insurance premiums slow down. I remember the commissioner from the State of South Carolina, a Republican, who said that his experience was that in the next year, health insurance premiums in the individual marketplace were going up 30 percent.

He said that, if you bring in the cost-sharing reductions, which the Federal Government can do, it would only be 10 percent. Ten percent is bad enough. Thirty percent is painful.

Here is something we can do on a bipartisan basis to reduce the cost of health insurance premiums. It struck me as obvious that this is what we should be doing as the Senate.

I applauded Senator Alexander personally and publicly, and Senator Murray, as well, for doing what the Senate was supposed to do. Little did I know that at the same time they were making this bipartisan effort, there was another Republican effort under way to derail them, to stop them, to end the bipartisan conversation that was under way in the HELP Committee.

The Cassidy-Graham proposal, which may come to the floor as early as next week, is an effort to repeal ObamaCare, but it is a flawed effort.

Earlier this morning, the Republican leader came to the floor and spoke of the debate that we have had over and over about what we are going to do in the future, and he talked about the failed ideas of the past. I can tell you that the Cassidy-Graham proposal is a return to failed ideas--ideas rejected once by the Senate but certainly by the American people.

In this morning's Chicago Tribune, one of the business writers, Michael Hiltzik, wrote an article entitled ``The GOP's last-ditch ObamaCare repeal bill may be the worst one yet.''

Mr. President, I ask unanimous consent to have printed in the Record this article in its entirety.

Let me quote a few sentences from this article because I think they make the case dramatically about how bad the Cassidy-Graham substitute would be. Here is what he said:

Compared with its predecessors, the bill would increase the

ranks of America's medically uninsured more--by millions of

people--cost state governments billions more and pave the way

for the elimination of all protection for those with

preexisting medical conditions.

He goes on to say:

Among the biggest losers of federal funding would be the

states that had the foresight to expand Medicaid under the

Affordable Care Act and the resolve to reach out to lower-

income residents [and provide health insurance] coverage.

He goes on to say that, under this Cassidy-Graham bill, ``they'd be punished with draconian cuts in healthcare funding.''

He goes on to write:

Among the big winners would be the states that have done

nothing of the kind for their residents--refusing the

Medicaid expansion and interfering with outreach efforts [to

bring more people into health insurance coverage].

They would be rewarded, perversely, for doing the wrong thing.

He writes:

Over the last week or so, reviews of the measure have been

pouring in from healthcare experts, and they're almost

unanimously negative. Major health provider and consumer

organizations have turned thumbs down, as have analysts

looking at its economic effects.

He talks about the impact of this bill beyond increasing Federal funding for States that did not help their residents and cutting Federal funding for States that did. The bill provides no replacements for the tax credits available for small businesses and the subsidies for health insurance premiums currently in the law beyond a capped block grant to States.

He writes:

In effect, it's a repeal-and-no-replace bill. The

Congressional Budget Office, as it happens, analyzed that

approach in July in connection with a different bill. It

found that by 2026 the number of uninsured Americans would

increase by 32 million, compared with under current law.

That's about 50% more people uninsured than it estimated for

other Republican repeal-and-replace measures, which the

budget office said could cut enrollments by 20 million to 22

million.

Honestly, can my colleagues on the other side of the aisle in good conscience go home to their States and say: I voted to repeal ObamaCare and you are going to lose your health insurance as a result of it.

I can tell you what it means in my State. A million people would lose their health insurance because of this Republican repeal effort. I don't know how Members of Congress--House or Senate--from Illinois could in good conscience vote to take health insurance away from massive numbers of Americans.

We are blessed here. Those of us who serve in Congress have access to good health insurance. It is not cheap. It shouldn't be. But it is there. It is always there, and we don't have to worry about it. Some Members are wealthy enough that they take care of it in other ways. For most Members of Congress, we use the insurance marketplace and pay our share of the premiums. The government pays a share of it, just as it does for Federal employees.

We have access to health insurance. How then could we turn and say to the people we represent: I just voted for a bill to take away your access to health insurance.

That is what this Cassidy-Graham bill does. That to me is hard to imagine--that a Member can believe they were elected to the Senate for that purpose.

What does it do to the States with this capped block grant in terms of their loss of Federal funds? It is amazing. Some States would lose as much as 60 percent of what they currently receive under the current law.

According to the numbers crunched by the Center on Budget

Policy Priorities, among the states that went all-in on

Obamacare, including expanding Medicaid and mounting

aggressive enrollment support for the marketplaces,

California would get $27.8 billion less in federal funding in

2026, New York $18.9 billion less, and Massachusetts $5.1

billion less.

I looked at the list for my State of Illinois. It would lose $1.4 billion in Federal funding by 2026. Just to show the contrast, as for the State of Texas, which did not expand Medicaid and which did not cover low-income individuals with health insurance, what would the Cassidy-Graham bill do for the State of Texas? They wouldn't lose a penny. They would add in Federal funding $8,234 million.

They would be big winners because they turned their back on low- income individuals and didn't expand Medicaid or increase the number of enrollees. What a perverse incentive for Governors and governments on a State basis to turn down coverage knowing that at some point they will be rewarded for that approach.

Another provision of Cassidy-Graham that is significantly

worse than its predecessors is the latitude it gives states

to eviscerate consumer-protection rules in the Affordable

Care Act.

One of the most important parts of the Affordable Care Act was a reform that said: If you are going to buy health insurance, it is going to be there when you need it. First, you will be able to buy it, even if you have someone in your family with a preexisting condition. That is one of the first casualties of Cassidy-Graham--going back to a failed idea in the past, which said if you have a sick baby or if you have a spouse who survived cancer, you either can't buy health insurance or you can't afford it. We got rid of that once and for all. At least we thought we did. Cassidy-Graham brings it back to life. It says: Let the insurers decide if they want to cover you or not.

Another thing we said is that the disparity in premium costs between the most expensive policy and the least will be 3 to 1. Cassidy-Graham tosses it out and says it is 5 to 1. What it means--and AARP knows this better than any other organization--is that senior citizens are going to end up paying more for their health insurance under Cassidy-Graham than they currently do under the Affordable Care Act.

When you look at the other protections that we built in to provide that your policy, when you bought it, would cover mental illness and substance abuse treatment, that is considered revolutionary but important. Finally, after all of these years in America, we are looking at mental illness as an illness rather than a curse. We are looking at it as something that can be successfully treated. Yet here comes Cassidy-Graham tossing out that requirement as well.

Let the insurers decide what they want to offer. I was talking to one of the Republican Senators the other day, and he said: Well, you know, some people just may not want to buy certain coverage.

I can understand that, but I can also understand the reality of life. Who can predict that next year or next month you would learn that perhaps your high school daughter has been taking opioids and now is addicted to heroin? You didn't know it before, not when you bought your health insurance policy. Now that you know it, who is going to cover the substance abuse treatment?

Under the Affordable Care Act, it is built into your health insurance policy. Under the Cassidy-Graham approach, it is an option. Try it if you like it. It doesn't work in a lot of circumstances. We buy insurance for things we pray will never happen, but we want to be covered in case they do. Cassidy-Graham walks away from that. They are for what they call ``flexibility.'' It is flexibility to buy insurance that isn't there when you really need it.

When you look at the litany of all of the States that are winners and losers under Cassidy-Graham, you have to shake your head. Why would we be richly rewarding States that have not done their part to expand Medicaid coverage? Why would we devastate the Medicaid Program, which is so important for so many people?

Medicaid is a program that many people didn't understand until we got into this debate, but it is a program that is essential if you have a disabled child.

A woman in Champaign, IL, with a young son in his twenties suffering from autism told me that without Medicaid coverage he would have to be institutionalized, and there is no way her family could afford it.

We know that Medicaid is there for that family and for many low- income families when it comes to pregnancies, to make sure that mom has a successful pregnancy and that the baby is born healthy and ready to thrive.

Is that an important asset? Of course it is, and it is an important element of Medicaid. The one thing that costs the most in Medicaid is something the Republicans don't want to acknowledge, and that is the fact that two out of three people in nursing homes--seniors who are under medical care--rely on Medicaid. Without that Medicaid assistance, who is going to pay that bill? The family reaching into their savings? Some can, but most will not be able to afford it.

How will the Republicans explain that away as just one of the benefits of flexibility--that Medicaid is not there when your parent or grandparent desperately needs it?

So now we have this debate before us, which will come up by the end of next week, and it is one that really will affect a lot of people across America. I, for one, will do everything I can to stop this. Any program that is going to take health insurance away from a million people in Illinois and up to 30 million nationwide is a bad start, a bad idea, a failed idea.

I yield the floor.

I suggest the absence of a quorum.

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

I announce that the Senator from New Jersey (Mr. Menendez) is necessarily absent.

Mr. President, I rise in opposition to the nomination of Noel Francisco to be the Solicitor General of the United States.

The Solicitor General--often called the ``tenth Justice''--argues on behalf of the United States in the Supreme Court. It is a critical position in our government, and it is critical that we have a Solicitor General with the independence to tell the President when the position he wants the United States to take before the Court is indefensible.

Mr. Francisco already had a troubling tenure as Acting Solicitor General earlier this year. He led the effort to defend the original version of the President's controversial travel ban. That Executive order was blocked repeatedly in Federal courts and was then withdrawn. In defending this unconscionable order, Mr. Francisco argued that there should be no judicial review when a President makes decisions on immigration policy on the basis of his national security assessment. The Ninth Circuit stated that ``there is no precedent to support this claimed unreviewability, which runs contrary to the fundamental structure of our constitutional democracy.'' If he is confirmed, Mr. Francisco would likely be called upon again to defend President Trump's latest iteration of the travel ban when it is considered by the Supreme Court in October.

When he was under consideration by the Judiciary Committee, I asked Mr. Francisco many questions to give him the opportunity to show his independence from President Trump. For example, I asked him if he agreed with President Trump's absurd claim that 3 to 5 million people voted illegally in the 2016 election. He refused to answer the question.

I asked him if he believed it was appropriate for a President to ask an FBI Director to pledge loyalty to him. He declined to comment.

I also asked him about the Constitution's Emoluments Clause, which prohibits government officials from accepting gifts or benefits from foreign states without Congress's consent and which many legal scholars believe President Trump has violated. Mr. Francisco actually had written an opinion on the Emoluments Clause when he was in the Justice Department's Office of Legal Counsel. I asked him what he believed the Founding Fathers intended this clause to mean. His response? ``I do not have any well-formed views on the scope of the Emoluments Clause.'' It is puzzling that an originalist like Mr. Francisco would not comment on the original meaning of a constitutional provision, but he clammed up when it came to this particular clause which is directly relevant to President Trump's behavior.

While Mr. Francisco has been reluctant to demonstrate independence from President Trump, he has been willing at many points in his career to demonstrate loyalty to special interests. For example, Mr. Francisco gave a speech at the 2015 annual conference of the Community Financial Services Association, better known as the trade association for the payday lending industry. Here is what he said: ``The payday lending industry is facing the challenge of a lifetime. It is essential that, as an industry, you be prepared to respond on all fronts, and it has been my privilege to assist you in doing this over the last few years. This includes the legislative front, the regulatory front, and--my favorite--the legal front.''

Let's be clear. We don't need a Solicitor General who thinks it is a privilege to assist payday lenders.

Mr. Francisco also was a prominent lawyer for the tobacco industry. His advocacy on their behalf prompted a number of national antismoking and health organizations to call for Mr. Francisco to recuse himself from tobacco-related litigation matters if he were confirmed. I asked Mr. Francisco if he would commit to recuse himself from tobacco litigation, but he would not make that commitment.

Mr. Francisco has been eager to position himself alongside rightwing groups like the Federalist Society and the Heritage Foundation. He made this particularly clear at a speech he gave to the Heritage Foundation on May 19, 2016, when he said: ``We live in an era where our views, traditional views, are under constant attack. Our adversaries have not even really tried to beat us through the democratic processes, but instead go straight to the courts, where they often win not by asserting that our views are legally wrong, but that they are so fundamentally illegitimate that the Constitution prohibits them. And they now have an increasingly compliant Judiciary that agrees with their policy views and that is unconstrained by legal principle.''

This is a troubling characterization, to claim that people who do not share the views of the Heritage Foundation are ``our adversaries.'' It is just as troubling to claim that the Judiciary is acting ``unconstrained by legal principle'' whenever it disagrees with the views of the Heritage Foundation. Comments like this raise serious questions about the ideology Mr. Francisco would bring to the Solicitor General's office.

Make no mistake--President Trump is likely to keep the Supreme Court

busy. It has never been more important to choose a Solicitor General who displays independent judgment and who is willing to say no if the views the President wants to execute are improper or unlawful. In my questions to him, I repeatedly gave Mr. Francisco the opportunity to display that independent judgment, but he did not do so, and what I have seen in his speeches and his advocacy concerns me.

In short, I do not believe Mr. Francisco has demonstrated that he can be the Solicitor General that our Nation needs. I will oppose his nomination.

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

I announce that the Senator from New Jersey (Mr. Menendez) is necessarily absent.

I announce that the Senator from Hawaii (Ms. Hirono), the Senator from New Jersey (Mr. Menendez), the Senator from Florida (Mr.

Nelson), and the Senator from Hawaii (Mr. Schatz) are necessarily absent.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

I announce that the Senator from New Jersey (Mr. Menendez) is necessarily absent.

I announce that the Senator from New Jersey (Mr. Menendez) is necessarily absent.

Mr. President, the Senate has spent a great deal of time over the last 6 or 7 months on healthcare in America. For years after the passage of the Affordable Care Act, the Republican Party--the House and Senate--has called for repeal of the bill. Yet, when the time came, with the majority of Republicans in the House and the Senate and, of course, a Republican President, and the task was immediately before them, they faltered because they didn't have a replacement. They didn't have something to propose that was better. As a consequence, their efforts stopped short--one vote short--on the floor of the Senate several weeks ago.

We still face some significant challenges. Some of those are very immediate.

Before the end of September, we will face the prospect of needing to reauthorize the Children's Health Insurance Program, known as CHIP. This program provides health insurance coverage for more than 9 million children and pregnant women across the country--350,000 in my State. This vital program, the CHIP program, has had two decades of broad bipartisan support, and it is going to expire in 12 days.

The good news is that the Finance Committee chairman, Orrin Hatch of Utah, and his ranking member, Ron Wyden of Oregon, have reached a bipartisan agreement on a 5-year reauthorization of the CHIP program.

The bad news is that instead of preserving healthcare for low-income children and pregnant women, the Senate Republican leadership seems more interested in the next 12 days in calling a different issue--a different bill--altogether, the Graham-Cassidy bill, relating to health insurance across America. That bill would take health insurance coverage away from millions of Americans, including 1 million in the State of Illinois.

From where I am sitting, reauthorizing the CHIP program is a priority to not only serve the 9 million children and pregnant women across our country but 350,000 in my State.

There is another bill we need to reauthorize before the end of September: the funding of our Nation's community health centers. Like CHIP, funding for community health centers expires at the end of this month--in just a few days. Also like CHIP, community health centers have enjoyed decades of broad bipartisan support. We have 10,000 community health centers across our country. They serve 26 million Americans. Community health centers serve 1 out of every 10 children, 1 in 6 Americans living in rural areas, and more than 330,000 of our Nation's veterans.

Illinois' 52 health center organizations receive $150 million in Federal funding in order to provide care to the 1.3 million people in 360 locations in the State of Illinois. I have been to many of these locations, and I have said in real candor and honesty that if I had a medical issue or if there were one in my family, I would enter the community health centers in my State with confidence that I and my family would receive the very best of care. They are outstanding organizations.

If Congress doesn't act within 12 days, community health centers in my State and across the Nation will see their funding cut by 70 percent. That dramatic funding cut would result in 2,800 community health centers closing across America, 50,000 jobs lost, and 9 million people losing access to healthcare.

Well, there is good news here as well. Because of Senators Blunt and Stabenow taking the lead, they are pushing for swift reauthorization of community health center funding. But the problem is that there is another bill--the Graham-Cassidy bill--which has captured the attention and apparently the calendar time for the Senate--at least that is the possibility we hear. So why shouldn't Congress be spending the next 12 crucial days reauthorizing the Children's Health Insurance Program across America and making certain our community health centers don't lose the critical Federal funding they need to serve so many people?

Right now, we know we face some challenges when it comes to the health insurance market in America. Approximately 6 percent of Americans--3 percent of people in my State--purchase their health insurance in the individual marketplace, with more than 50 percent of these people receiving some subsidies to help pay for costs. However, many of these people are seeing dramatic increases in premiums. We know that, and we know it is a challenge and one we need to address.

Here is the good news--and it is time for some good news when it comes to healthcare. Almost from the minute that the critical vote was cast ending the repeal of ObamaCare, meetings started taking place. I can recall, as the Senate was adjourning, I looked back by the cloakroom, and there was Senator Lamar Alexander and Senator Patty Murray talking in the middle of the night--about 3 o'clock in the morning. I later learned that they had reached an agreement between them--a Republican, a Democrat--on the HELP Committee to start a series of hearings about what we could do as a Senate to actually strengthen the healthcare system in America. That was before our August recess.

When we got back from recess, they had kept their word. I attended three or four of the Member hearings, which they held before the official public hearings a little later in the morning. These were good meetings. At the first one, I recall Senator Alexander saying 53 Senators--Democrats and Republicans--showed up for coffee and doughnuts to meet with insurance commissioners from five different States. Just a few days after that, there was another coffee-and-doughnut session, another good bipartisan turnout of Senators as we sat down with five Governors, Democrats and Republicans, who talked about health insurance. A few days later, another meeting took place where experts came in and talked about the subject.

I felt there was more accomplished in those 3 hours with those outstanding witnesses from across the country than all of the time we had spent giving speeches to one another on the floor of the Senate in the previous 7 months. It was interesting. We brought in these people from different States, different political parties, and they virtually had the same thing to tell us. There were a handful of things which we could do that could make an immediate, positive impact to make the cost of health insurance a lot more predictable--not to say we are going to bring it down--I don't want to be overpromising--but to slow the rate of growth in health insurance costs as well as provide stability in the insurance market.

Here are the things that came out loud and clear from these bipartisan Senate meetings.

First, they told us to stop playing games with cost-sharing reduction subsidies. These are subsidies to insurance companies that take on individuals with expensive health histories. These insurance companies are given support by subsidies so that they can keep the premium costs for these individuals under control.

These cost-sharing reduction subsidies help 7 million Americans afford their copayments and deductibles on their health insurance policies. The current Trump administration has repeatedly threatened to stop the payments. As a result, individual market premiums keep going up because of the uncertainty of whether the government is going to keep its promise to make these cost-reduction subsidies.

I remember the commissioner from the State of South Carolina told us, I say to the Senator from Oregon, who is our ranking Democrat on the Finance Committee--he said: I am going to announce a 30-percent increase in health insurance premiums. If I knew that these cost- sharing reduction subsidies were coming, it would be 10 percent. I can eliminate 20 percent of the anticipated increase in premium costs if these subsidies come through.

It is pretty clear to me, this is sound policy, on a bipartisan basis, which would have a dramatic impact in reducing the cost of premiums to many individuals. That came through loud and clear in every meeting we had with Senators Murray and Alexander.

The second thing they talked about was State reinsurance. I don't understand that as well as some, but it has worked in States where the State picks up a share of the liability for health insurance between certain dollar amounts so the private insurance companies don't end up with that burden. Because of this reinsurance, they are able to keep premium costs down.

The third thing is to provide States with more flexibility without undermining some really fundamental issues--without undermining, for example, the preexisting condition protection we currently have.

I left those meetings feeling encouraged. After 7 months of bitter political rhetoric, which led to nothing on the floor of the Senate, we were finally sitting down, on a bipartisan basis, with Democrats and Republicans all across our country with specific suggestions which could help our healthcare system. That, to me, is the way to move forward. That, to me, is the lesson learned from much wasted time so far this year. Unfortunately, this whole effort may be derailed.

Senators Cassidy and Graham have come up with a legislative alternative they want to move forward. Unfortunately, the measure they have proposed has not been scored by the Congressional Budget Office nor carefully measured to find out what impact it would have on the American healthcare system, which accounts for one-sixth of the American national economy.

Here is what we know about the Cassidy and Graham proposal. What they are suggesting is basically eliminating the subsidies which help individuals pay for private health insurance and bringing to a halt the Medicaid expansion which has covered millions of Americans and given them health insurance.

What they say instead is something which has been said many times on the

floor: We will just give all the money to the Governors, and they will figure it out. They will figure out how to save money in their States. It turns out, Governors of both political parties warn us: If you are going to give us a set amount of money as the cost of healthcare continues to go up, don't expect us to cover as many people or provide as good a coverage if we do it on a State-by-State basis.

So who supports this new Cassidy-Graham approach and who opposes it? Every single medical advocacy group--the hospitals, the doctors, the nurses--all across America oppose this Cassidy-Graham approach, as well as the medical advocacy groups, because they understand their approach would allow discrimination against individuals insured based on a history of preexisting conditions--going back to the bad old days before we passed the Affordable Care Act.

The Cassidy-Graham approach, which they brought to us, doesn't add up. If you take $300 billion or $400 billion out of this healthcare system, dump it into the laps of Governors across this country and say, ``Good luck. Do it on a local basis. I am sure it will all work out,'' they will quickly tell you, as they have had in the bipartisan meetings we have had, it will not work. It does not compute. It may be able to check the box from some things to repeal the Affordable Care Act, but they certainly didn't replace it with anything of equal or better value. The opposite is true. That is why I think we ought to think twice.

There is a mad dash now in the last 12 days to do many things. From a political viewpoint, there is a limited opportunity for this repeal effort. That 12-day period is a limited window under the Senate rules of reconciliation. It is a mistake, as far as I am concerned, for us to move toward Cassidy-Graham--concepts which have been roundly opposed in my State and across the Nation, concepts which have failed on the floor of the Senate.

Let us roll up our sleeves and do three things that do make sense: Let's reauthorize the Children's Health Insurance Program. Let's make sure those kids and their pregnant moms are going to have the basic coverage they have enjoyed for almost 20 years.

Let's also reauthorize the community health centers. We know they work. We know when people have a medical home, they are less likely to let medical conditions get worse and more expensive. That, to me, is a good investment to make sure they continue.

Finally, let's turn toward a real bipartisan effort, a measure which can emerge soon--I hope within days--from Senators Murray and Alexander on a bipartisan basis. I know they are still working on it. They haven't reached a final agreement on what they are doing, but I hope all of us, in both political parties, will encourage them to do the right thing.

Remember when John McCain came to the floor after he had been diagnosed with the cancer he is battling now. He came here and cast a crucial vote to proceed to debate this whole issue of healthcare. Then he asked to speak for 15 minutes, and I stayed in my chair. I wanted to hear it. He reminded us of the importance of doing things on a bipartisan basis and doing them thoughtfully when it comes to something as important as healthcare. Let us keep that speech by John McCain and that lesson in mind. Let us resist this Cassidy-Graham approach, which has no support when it comes to the medical community, and instead work on the bipartisan approach from Alexander and Murray, together with the Finance Committee--which I know Senator Wyden is going to address next--so we can have a bipartisan solution.

The American people sent us here to solve problems, not to create them. Cassidy-Graham creates problems. Let's find solutions which solve problems.

Mr. President, I yield the floor.

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

Mr. President, each year the Department of Defense funds billions of dollars in military-relevant medical research--research that offers our servicemembers concrete treatments for the particular diseases and afflictions that impact them the most, research that offers families hope, research that improves lives, and research that saves lives.

Last summer, during consideration of the fiscal year 2017 Defense Authorization Act, there was a question as to whether Congress would permit this lifesaving research to continue or whether instead we would wrap it up in so much redtape that it would basically go away.

I was proud that this Senate Chamber, on a bipartisan basis, voted resoundingly to continue medical research in the Department of Defense by a vote 66 to 32. It was an important, bipartisan vote, especially in a Senate where we have a difficult time finding common ground. When it came to medical research in the Department of Defense for members of the military and their families, we said unequivocally that we are committed to it on a bipartisan basis. I was proud to lead that fight, along with Senator Roy Blunt of Missouri, a Republican, to protect defense medical research. Altogether, 40 of my Republican and Democratic colleagues co sponsored our effort.

That vote was not just a vote for medical research, it was a vote for the men and women in the military and their families. The vote recognized that right now, we are closer than ever to finding cures for dreaded diseases like cancer; closer than ever to understanding how to delay the onset of neurological diseases like Alzheimer's and Parkinson's; closer than ever to developing a universal flu vaccine. That vote recognized that now is the time to be ramping up our investment in medical research, not scaling it back. The Senate spoke, but unfortunately it didn't end the debate.

This year, the fiscal year 2018 National Defense Authorization Act now pending on the floor of the Senate repeats last year's research- killing provisions and, for inexplicable reasons, adds two more. Just like last year, these provisions in the bill pending on the floor of the Senate would effectively end the Department of Defense medical research program. Like last year, these provisions wrapped this research in more redtape than you could possibly explain. And we face the prospect for the second year in a row of the end of this critical, lifesaving medical research.

These provisions are dangerous, and by cutting medical research, they will cost lives--the lives of our military and their families. So I filed a bipartisan amendment, along with 53 additional cosponsors and my lead cosponsor, Senator Roy Blunt, Republican of Missouri, to remove these provisions from this Defense authorization bill so that lifesaving research can continue.

The underlying Defense authorization bill has four provisions that, if enacted, will end the DOD's research.

The first provision, section 733, would require the Secretary of Defense to certify that each medical research grant awarded is ``designed to directly protect, enhance or restore the health and safety of members of the Armed Forces''--not veterans, not retirees, not the spouses of military members, not the children of military members.

To make matters worse, after the Secretary makes this certification in writing to the Armed Services Committee, the Defense Department is then required to wait 90 days before awarding the grant. It is not only redtape, it is built-in delay.

In my view, veterans, retirees, and spouses and children of servicemembers are all vital members of the Department of Defense's military community. They use the Department of Defense healthcare system. They deserve to be counted. When a member of the military deploys, the family deploys, and we ought to stand by all of them.

The second provision, section 891, requires that medical research grant applicants meet the same accounting and pricing standards that DOD requires of procurement contracts. That sounds simple enough, doesn't it? But these are regulations that private companies have to meet to sell the Department of Defense goods and services, like weapon systems and equipment.

The third provision, section 892, changes the ground rules for how to handle the technical data generated by this research--information related to clinical trials and manufacturing processes. How does this bill change it? This should sound familiar: by wiping away the existing regulations and imposing overly burdensome and unappealing regulations that would scare off research partners.

I am sympathetic to what this section may be attempting to do. In the face of ever-increasing prescription drug costs, it does make sense for the Federal Government to have more rights when it comes to products and treatments developed with Federal taxpayer dollars. However, we must be more strategic about how to approach this. I look forward to working across the aisle on ways to beef up the government's role in helping to keep drug costs down, especially for products that would not have been possible without Federal investments.

The fourth provision, section 893, requires the Defense Contract Audit Agency to conduct audits on each grant recipient.

For those who aren't familiar with this audit agency, it is currently backlogged with tens of billions of dollars' worth of procurement contracts that it has to audit. This provision in the bill would add to this pile, requiring it to conduct an additional 800 audits per month on medical research grants--more redtape; no real reason.

Taxpayers deserve to know how their money is being spent, and the existing system does that. The grant application must show that the research is relevant to the military. No grant makes it through the first round without showing clear military relevance. If an applicant fails this test, that is the end of the story. If they clear the hurdle, then they are subjected to a long list of critical defense researchers

and issue experts in the disease in question to ensure that their research proposal is worth the investment. But that is not it. Representatives from the National Institutes of Health and the Department of Veterans Affairs also have input at that point to make sure it doesn't duplicate any existing research. These rules are in place to protect taxpayer dollars, and they work.

This year's Defense authorization attempts to add redtape to the program in the name of protecting it but in reality ends it. Simply put, these provisions would strangle the Department of Defense medical research program in suffocating redtape. Don't take my word for it. The Coalition for National Security Research, representing a broad-based coalition of research universities and institutes, said:

[These sections] could jeopardize funding for research

activities that have broader relevance to U.S. military,

including the health and wellbeing of military families and

veterans, and the efficiency of the military healthcare

system.

We asked the Department of Defense how the new system proposed in this bill would work. Here is their analysis:

This language would, in essence, eliminate military family

and military retiree relevant medical research, inhibit

military medical training programs, and impact future health

care cost avoidance. Impacts will take place across all

areas. . . . [Researchers] would most likely not want to do

business with the DOD. . . . [The provisions] may create a

chilling effect on potential awardees of DOD assistance

agreements.

A ``chilling effect'' on medical research--is that what we want to go on the record to vote for with this bill? Is that what the Senate wants? Is that what we want to say to members of the military, their families, and retirees? I don't think so.

These provisions are simply put in the bill to erect roadblocks to critical, important medical research.

Let's talk for a minute about the medical research funded by DOD, the real-world impact.

Since fiscal year 1992, the Congressionally Directed Medical Research Programs has invested almost $12 billion in innovative medical research. This medical research command determines the appropriate research strategy, filling research gaps, and creates a public-private partnership between the Federal Government, private universities, and those who desperately need this research.

In 2004, the Institute of Medicine, an independent organization, looked at the medical research program that I have discussed, and what did they find? ``The CDMRP has shown that it has been an efficiently managed and scientifically productive effort.'' That is a pretty solid endorsement of $12 billion worth of medical research. They found that this program ``concentrates its resources on research mechanisms that complement rather than duplicate the research approaches of major funders of medical research in the United States, such as the National Institutes of Health.'' They also found that ``the program appears to be well-run, supports high-quality research, and contributes to research progress.''

The Institute of Medicine also reviewed the program in 2016. This was their conclusion just last summer about the same program:

CDMRP is a well-established medical research funding

organization, covering many health conditions of concern to

members of the military and veterans, their families, and the

general public. . . . In general--

And this is highlighted--

the committee found CDMRP processes for reviewing and

selecting applications for funding to be effective in

allocating funds for each research program.

This program has been closely vetted, as it should be. It is a matter of medical research critical to members of the military and their families. It is a matter of life and death. It is a matter of the integrity of spending taxpayers' dollars. It is a good program, a solid program. It has not been wrought with scandal. There is no reason for us to turn it upside down or to turn the lights out in the offices of these researchers.

The Institute of Medicine had this right. We have real results to back up the way we feel about this. What areas have they embarked on with critical successful research? One of the greatest success stories of this program is advances we have made in breast cancer treatment. In 1993, the Department of Defense awarded Dr. Dennis Slamon two grants totaling $1.7 million for a tumor tissue bank to study breast cancer. He began his work several years earlier with funding from the National Cancer Institute. The DOD kicked in to help.

Dr. Slamon's DOD-funded work helped to develop Herceptin, which is now FDA approved, one of the most widely used drugs to fight breast cancer. This research has not only saved the lives of countless women in the military, but it has had application far beyond the military. The same thing is true when it comes to prostate cancer and Parkinson's disease. What we found over and over is that money invested in this program for medical research is money well spent. Why, then, would we bury this program in redtape?

I am happy that some 54 or 55 Senators from both sides of the aisle are going to stand with me, and I see I have other colleagues preparing to speak. I will return to speak more specifically about the programs of this agency.

Is there a person in this country who believes that America is spending too much money on medical research? Well, perhaps there is, but I haven't met them. What I have found over and over is that Members of both political parties are committed to medical research. The Department of Defense does a great job with the resources given to them.

Let's continue this program as a salute to our men and women in the military, their families, and our veterans.

I yield the floor.

Will the Senator yield for a question?

Mr. President, I ask unanimous consent for 2 minutes.

I announce that the Senator from New Jersey (Mr. Menendez) and the Senator from Florida (Mr. Nelson) are necessarily absent.

I announce that the Senator from Vermont (Mr. Leahy), the Senator from New Jersey (Mr. Menendez), and the Senator from Florida (Mr. Nelson) are necessarily absent.