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 text of the bill be printed in the Record.

Mr. President, several weeks ago the House of Representatives passed a bill to repeal the Affordable Care Act and to replace it. It was passed without hearings. It was passed without an amendment process, and it was passed before the Congressional Budget Office provided the traditional analysis that we count on before we take up a measure of such magnitude.

The measure passed with a party-line vote--all Republicans. Had two Republicans voted the other way, it would not have moved forward.

After it passed, the President of the United States decided to have a celebration at the White House. We saw him on television, gathering the Republican Members of the House of Representatives and celebrating the fact that this measure had passed and that, finally, they were going to repeal the Affordable Care Act.

But then the American people took a close look and the Congressional Budget Office issued its analysis, and it turns out that 23 million Americans would lose their health insurance because of this Republican measure that passed the House of Representatives.

It turns out as well that there would be a dramatic increase in health insurance premiums for people between the ages of 50 and 64.

It turns out that in my State and many other States hospitals were in danger. The Illinois Health and Hospital Association says they would lose 60,000 jobs in Illinois with the dramatic cutbacks in Medicaid, endangering hospitals in rural areas and inner-city areas.

The facts started coming out about this repeal bill passed by the House of Representatives, and the President of the United States had a change of heart and announced to the American people that it was a mean bill--a mean bill. The President was right. It was mean legislation-- mean to the millions who lost their healthcare, mean to seniors who would find their premiums going up dramatically, and mean to the people living in rural areas and small towns who count on those hospitals.

The President was right. It was mean.

Then, the responsibility shifts to the Senate. The majority leader, Senator McConnell, and his Republican followers had a chance to do a bill that was not mean. They had a chance to sit down on a bipartisan basis and to have the same process we used to create the Affordable Care Act.

That would have involved public hearings. We had 50 public hearings on the Affordable Care Act. It would have involved a real amendment process. The Affordable Care Act had 300 amendments. How many were offered by the Republicans? There were over 150 offered and adopted in a bipartisan process when we passed the Affordable Care Act. The American people got a good look at the bill. The Congressional Budget Office issued their analysis before we voted on it. We passed it, and I am glad we did, and I am proud of that vote.

But what happened in the Senate when it came to the Republicans? They went into secrecy. Thirteen chosen Republican Senators all sat in a room and wrote the alternative, or so we are told. They met in secret and never once had a public hearing, never once disclosed to the American people what was being debated, never once gave an opportunity for real bipartisan cooperation to strengthen our existing healthcare system--not at all.

So all we have at this moment is truly press accounts of what has been announced to the Republican Senate caucus, what they are going to get a chance to read and see. But it is enough to see that when it comes down to the basics, there is not much of a change between the House of Representatives' effort and the Senate effort.

You can put a lace collar on a pit bull, and it is still a mean dog.

What we have here with the Republicans in the Senate is an attempt to dust off the edges of the House bill and say: This is not as mean. I will tell you, at the end of the day, from the reports we have, this is still a mean dog, and one the people of the United States don't want to see happen.

There isn't a single medical advocacy group--not one in my State, and I don't know of any nationwide--that endorses what the Republicans in the House have accomplished with the passage of their bill, and this bill mirrors it, as well, and we can expect the same result.

So the only thing we can offer the American people is a chance to be part of the conversation on a bill that will literally change healthcare for millions of Americans. If they are going to be part of the conversation, there has to be a chance for amendment and debate, at least, and a chance for the American people to see what is in the Senate Republican measure.

So I ask unanimous consent that any substitute or perfecting amendment offered to Calendar No. 120, H.R. 1628, be subject to a point of order if the text of the amendment has not been filed at the desk and made available on a public website for at least 72 hours, along with an analysis by the Congressional Budget Office of the bill's budgetary, coverage, and cost implications; and that a motion to waive the point of order be in order, and if a motion to waive is made, an affirmative three-fifths vote of those duly chosen and sworn is required to waive the point of order.

Madam President, it was about a month ago that the House of Representatives, by a narrow vote, voted to repeal the Affordable Care Act and to replace it with their own creation. That effort by the House of Representatives passed by, I believe, 2, 3, or 4 votes. It was very close, and it was a partisan rollcall--all Republicans voting for it and no Democrats voting for it. So it came to the floor of the House without any bipartisan preparation. It was only after the vote that the Congressional Budget Office took a look at the measure and reported to the American people its impact.

Now, that is unusual because, when you take a big issue like the reform of America's healthcare system, historically, traditionally, Members of the Congress--the House and Senate--will send their versions of the bill to the Congressional Budget Office and ask for an analysis: Tell us how much this will cost. Tell us the impact on the deficit. Tell us what it will do in terms of healthcare coverage. But the House Republicans chose to vote before the analysis.

Well, the analysis still came out, and when it came out, the report was unsettling because it had a dramatic negative impact on healthcare in America. The House Republican repeal, according to the Congressional Budget Office, would mean that 23 million Americans would lose their health insurance.

Remember, we started this debate 6 or 7 years ago because we were concerned that too few Americans had health insurance and we wanted to expand the reach of health insurance and make sure that it was good health insurance, and that is why we passed the Affordable Care Act. We fell short in some respects, but we certainly achieved our goal of increasing the number of insured Americans with the Affordable Care Act. In my home State of Illinois, the percentage of those uninsured with health insurance was cut in half. In fact, it was even better than that. So more and more people ended up with coverage through Medicaid, as well as through private health insurance.

Now comes the repeal of the Affordable Care Act, and the Republicans in the House decide to not only erase all of that progress in providing more health insurance for more families but to make it worse--to make the number of the uninsured even higher than it was. So if that is the starting point of healthcare reform, you ask yourself: Is that really a worthy goal? Why would you do that?

Well, they were forced to do it. They really were. The House Republicans really, in fairness to them, had no choice, because they made the initial decision that their highest priority was to give a tax break of about $700 billion to the wealthiest people in America. So by creating this tax break--giving this money back to wealthy people--they took that same amount of money out of America's healthcare system. When you take $700 billion out of America's healthcare system, here is what happens. People who are currently receiving their health insurance through Medicaid, a government program, will have fewer and fewer opportunities to take advantage of Medicaid. In fact, they acknowledged that. The Republicans said in the House: We are just cutting back on Medicaid.

Secondly, you reduce or eliminate the helping hand we give to working families who can't afford to pay their hospitalization premiums. If you are in certain categories, we give you a subsidy to pay for your premiums. So follow the logic: If you cut the taxes by $700 billion and take $700 billion out of the healthcare system, you have less money to provide Medicaid health insurance for those in low-income categories, and you have less money to help working families pay for their health insurance premiums.

The Congressional Budget Office looked at that and said that the net result at the end of the day is that 23 million Americans will lose their health insurance because of this decision by the Republican House. In the State of Illinois, a State of about 12.5 million people, 1 million people would lose their health insurance because of this action taken by the Republican House of Representatives.

Well, from basic civics we know that here we are in the Senate and we get our chance once the House has acted. So we have been waiting-- waiting for almost a month for the process to begin. The sad reality is it never even started--not the ordinary, open, public, transparent process of debating a change in America's public health system.

Instead, Senator McConnell, the Republican leader, said: What I am going to do is to take 13 of my male Republican Senators, put them in a room, and let them write an alternative to the House bill. Why he didn't initially include the women in his caucus, he can explain, but it was 13 of the male Republicans who would sit in a room to write, in secret, their alternative.

We think: Well, most legislative ideas start with that kind of a meeting--a closed-door meeting in the quiet of a room, basic negotiation. But it is the nature of a democracy and our form of government that at some point this becomes public. Shouldn't it? If we are going to change the laws about health insurance--basic fundamental coverage for American families--shouldn't we know it? Shouldn't we know what the changes will be before we vote on them?

Well, there is a pretty rampant rumor that tomorrow, for the first time, there will be a limited disclosure of this Republican effort over the last several weeks. We are told--and it is only a rumor--that the Senate Republican leadership will sit down with the Senate Republican caucus and show them for the first time what they want to propose that we vote on.

One might say: Well, that sounds like the beginning of a good, long process.

It is not. It is the beginning of a short process, because the Republican leader has said that this time next week we will be into debating that issue and voting on it to its conclusion--in 10 days. That is 10 days, start to finish, to rewrite the healthcare system of America, 10 days on a measure that has not been disclosed to the Republican Senators--not all of them--let alone the Democratic Senators and let alone the American people. That is what we are faced with.

When we wrote the Affordable Care Act, which was widely criticized by the Republicans, let me tell you the process we followed with the Affordable Care Act. In 2009, the Senate HELP Committee--or the Health, Education, Labor, and Pensions Committee--held 13 public, bipartisan hearings, 20 walk-throughs of various proposals, and a markup in the committee that went on for 1 calendar month, and 160 amendments offered by the Republicans were adopted. That was in 2009 with the Affordable Care Act.

The Senate Finance Committee, which writes the tax laws, held 17 roundtables, summits, and hearings on the legislation, 13 Member meetings and walk-throughs, and 38 meetings and negotiations.

Keep in mind that we still haven't seen the Republican proposal we are supposed to vote on next week--this secret proposal.

The Senate Finance Committee on the Affordable Care Act held a 7-day markup and adopted 11 Republican amendments. At the end of the day, not a single Republican Senator voted for the measure, but they offered amendments, and those amendments were debated and many of them were adopted by the Democratic majority.

When the Affordable Care Act came to the floor of the Senate, we spent--and I remember this well--25 consecutive days in session considering that bill--25 days. As to what Senator

McConnell and the Republicans will offer to us in what we call reconciliation, we will be lucky to get 25 hours. We spent 25 days on the Affordable Care Act. In total, the Senate spent more than 160 hours on the Affordable Care Act and more than 150 Republican amendments were adopted, though not a single Republican Senator ended up voting for the bill. We opened it to their amendments and adopted their amendments. It was a bipartisan effort.

What has been the process this time around? No hearings, no markups, no public input, no support from the medical advocacy community at all. I don't have a single medical advocacy group in Illinois that supports what the Republicans did in the House of Representatives--not one. Hospitals, doctors, nurses, pediatricians, and disease advocacy groups, like cancer and heart, are all opposed to what was done in the House of Representatives, and we are being told, when it comes to the Senate's turn: Get ready, it is going to be fast. Don't blink, you might miss it.

Let me tell my colleagues what else we have. We have a record of quotations from leaders on the Republican side who, even though the Affordable Care Act went through all of these hearings and all this deliberation, were very explicit in their criticism. Here is Majority Leader Mitch McConnell, a Republican of Kentucky, in December of 2009, on the Affordable Care Act. He said: ``This massive piece of legislation that seeks to restructure one-sixth of our economy is being written behind closed doors, without input from anyone, in an effort to jam it past not only the Senate but the American people.''

I might say to Senator McConnell: How would you explain what you are doing now when it comes to rewriting the healthcare system behind closed doors without input from anyone? Is it an effort to ``jam it past not only the Senate but the American people''?

Senator Marco Rubio last week was quoted as saying: ``The Senate is not a place where you can just cook up something behind closed doors and rush it for a vote on the floor.''

I agree with Senator Rubio, but that is what they are trying to do.

Senator Lisa Murkowski, a Republican of Alaska, said: ``If we had utilized the process that goes through a committee, I would be able to answer not only your questions but my constituents' questions.''

Senator Murkowski, a Republican of Alaska, expressed what most of us feel. How could we even answer an honest, legitimate question from someone we represent when we can't even see the measure that is being produced by the Republicans.

Senator Jerry Moran, a Republican from Kansas, said last month:

I want the committees of jurisdiction to hold hearings,

bring the experts who know about healthcare from across the

country, bring the constituents to tell us their stories.

Then I want every Senator, all 100 of us, to have the chance

to offer amendments.

Thank you, Senator Moran. I agree with you. That is how the Senate is supposed to work, but that is not how it is working now.

Let me tell my colleagues what some of the groups have said about this Republican effort to repeal the Affordable Care Act. You expect: Oh, it is a partisan comment from a partisan Senator. These are nonpartisan groups.

The American Heart Association, what do they say? They say: ``The House bill would seriously erode preexisting condition protections, including for patients suffering from cardiovascular disease.''

About a third of us on Earth--or at least a third of us in America-- have some preexisting condition. For the longest time, insurance companies said: If you are a woman, it is a preexisting condition.

Go figure. But now, at least a third of us have some condition which, in the old days, would disqualify us from insurance coverage or make it too expensive.

So now we put in the Affordable Care Act a prohibition against discriminating against any American because they have a preexisting medical condition. I think that is pretty important. My family has certainly had the same experience as other families when it comes to preexisting conditions.

Now the Republicans have said: We are going to take that out. We want to give you more choice. We want the insurance companies to give you more choice. Choice means another reason to say no. Choice means coverage that isn't there when you need it. Choice means restrictions on your health insurance policy. That may not bother you at all today, but tomorrow, when you go to that doctor for that diagnosis you will never forget as long as you live or get involved in an accident and finally take a close look at that health insurance policy, you want to make sure it is there if you need it, don't you?

The Republicans say we need more choice. The American Heart Association says that, when it comes to preexisting conditions, the House Republican repeal bill would seriously erode protection of Americans.

The American Medical Association, the largest group of physicians in America, said: ``We cannot support [the bill] that passed the House as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations.''

The American Diabetes Association said: ``It would give insurers the ability to charge people with pre-existing conditions--such as diabetes--higher prices [for health insurance] . . . and would allow insurers to deny people with diabetes the care and services they need to treat their disease.''

The American Association of Retired Persons has weighed in. Here is what they say: ``This bill would weaken Medicare's fiscal sustainability, dramatically increase health care costs for Americans aged 50-64, and put at risk the health care of millions of children and adults with disabilities, and poor seniors who depend on the Medicaid program for long-term services and supports.''

AARP is working overtime to notify Americans over the age of 50 and their kids that the repeal of the Affordable Care Act that passed the House of Representatives is a bad deal for seniors and their families.

There is something else going on, too. For more than 6 years, Republicans in Congress have been shouting ``repeal and replace'' from the rooftops, and they voted more than 60 times to repeal the Affordable Care Act. They never liked it from the start. They put language into bills to make it more difficult for the Affordable Care Act to work, such as funding needed to make individual insurance markets work as intended. Then, on his first day in office, President Trump signed an Executive order directing Federal agencies not to enforce the Affordable Care Act.

The Trump administration cut the open enrollment timeframe in half, making it harder for people to sign up for insurance--meaning fewer people covered, fewer people in the insurance pools, and premiums going up as a result. The President, to this day, continues to make uncertainty in the insurance market. He refuses to say whether he will continue providing cost-sharing reduction payments to help 7 million Americans afford health insurance. Without the payments, insurers tell us premiums will skyrockets 20 percent next year.

Let me mention one other thing that has happened as part of this health insurance debate. We decided to make a historic change in healthcare in America. I have told the story repeatedly, and I will not tell it in detail, but it was Paul Wellstone, a progressive from Minnesota, who sat right there, and Pete Domenici, a conservative from New Mexico, who sat right there, who came together--these two unlikely partners--because they each had members of their families who suffered from mental illness. They said: Why is it that we don't treat mental illness like an illness? Why is it that health insurance just covers physical illness?

They were right. They fought the insurance companies for years, and they won. We put it in the Affordable Care Act. We said: If you offer health insurance, you have to cover mental illness. My friends, it is time for us to step out of the shadows, where mental illness was considered a curse and not an illness, and deal with it as something that can be successfully treated. We put it in the bill, and most Americans would agree that it was the right thing to do.

There was another part of it, though, that slipped my attention and now I know it is critically important. It wasn't just mental illness. It was coverage for mental illness and substance abuse treatment.

How important is substance abuse treatment in America today? Go to Maine, go to Iowa, go to Illinois, and ask the question: Are there any problems with opioids? Heroin? Overdosing? Death? Of course.

When you go to the rehab and addiction treatment centers and you ask people: How is your family paying for this care to try to rescue this young child in your family or someone dealing with addiction, they say they are either under Medicaid, the government insurance program, or their health insurance policy covers substance abuse treatment. Why? Because Wellstone and Domenici effectively included that in the bill. Now, under the bill that passed in the House of Representatives, an estimated 1.3 million Americans with mental disorders and 2.8 million seeking help with substance abuse will lose their coverage for treatment. It is no longer a priority under the Republican idea of giving you choice with your health insurance.

Choice--when you are a father buying health insurance for your family and you are picking out a health insurance policy and you have a choice, could you anticipate the teenaged daughter you love with all your heart will one day face an addiction and desperately need substance abuse treatment to save her life? Did you think about that when you signed up for the right choice in a lower cost health insurance plan?

I feel, and many feel, that this is essential when it comes to services and health insurance. Republicans say: No, it is an option; take it or leave it. People who leave it and then need it find themselves in a terrible predicament. They can't provide the lifesaving treatment their kids and other members of the family they love desperately need.

I see my colleague on the floor, and I will not go any further other than to say this: Why are we in this position when, 10 days before the final vote on changing healthcare for 360 million Americans, it is in a proposal that no one has seen and no one has read and no one has analyzed? It is an embarrassment to this great institution, the Senate, that we are not deliberating on this measure--this lifesaving, life- and-death measure--with the kind of respect that it deserves, with the kind of expertise that it deserves.

My Republican Senate colleagues have said it well--Senator Murkowski, Senator Moran, and others: The Senate ought to do what the Senate was elected to do. Take up an important measure like this, read it carefully, debate it, amend it, bring in the experts, and don't move so quickly on it that you could jeopardize the healthcare of millions of Americans. I am sorry it has reached that point.

If 3 Republican Senators out of 52--if three of them--will step up and say: This is wrong; we need to do this the right way, a transparent way, a fair way, a bipartisan way. If three will step up and do that, then we can roll up our sleeves and do the right thing for America.

I yield the floor.

I announce that the Senator from Vermont (Mr. Leahy) is necessarily absent.

Mr. President, let me thank my colleague from New Jersey for his excellent remarks on the Affordable Care Act and its future and really spotlight the point he made. He and I have been around legislatures for a long time, both at the local level, State level, and here in Washington. If you have something you are really proud of--a bill--you can't wait to roll it out. We have a place for a press conference about every 15 feet in the corridors around here. We have a press corps that fills the Gallery when they all show up, and they are anxious to hear our story. If you have something you are proud of--and each of has had that legislation--you put it in a press release and do the social media and the whole number.

If you are unfortunate to be in the position to bring a bill to the floor you are not very proud of--you don't know how you can explain it back home--you keep it secret. You do it behind closed doors.

What the Senator has said is exactly the truth--and we know it, as our colleagues on the other side know it. They have, for the past several weeks, since the House passed their bill, been meeting behind closed doors. So 13 male Senators--why they couldn't invite the women Republicans in the Senate--it is their decision--I can't understand. They have not produced one thing for public consumption--nothing. Yet, Senator McConnell, the Republican leader, tells us: Well, you have 10 days. We are going to pass the new healthcare system for the United States of America in 10 days, and pretty soon we are going to show you what we are going to propose.

It tells you the whole story. There is something in there that is painful, that hurts them politically, and that they can't really explain. After all these years--``Repeal ObamaCare, repeal ObamaCare,'' they can't come up with an alternative they can sell to the American people.

I thank the Senator for pointing out his experience, and the experience he is finding in New Jersey. I am finding the same thing back in Illinois.

I thank my colleague from New Jersey for his statement.

This last Saturday, I was invited to debate a Republican House Member from my hometown of Springfield, IL, on his vote in favor of TrumpCare--if you want to call it that--the Republican healthcare plan in the House. We were invited by the Ministerial Alliance of Springfield, the African-American ministers. I accepted the invitation on a Saturday afternoon, and he did as well.

He put conditions on it. No. 1, no media coverage. This is not open to the public. Really? We are going to debate a healthcare system change for America that is going to affect millions of people, and we will not talk about it in public? But that was his ground rule. And then in the midst of it, he thought someone was taping him while it was going on and stopped full sentence and said: I don't want this taped. Well, here is a bill he voted for to change the healthcare system for the people he represents, including the folks in that room, and he didn't want to be on the record or public about that discussion. That tells me a lot as well.

It isn't just a secret bill we haven't seen, it is a lot of Republican House Members who voted for it--and they were all Republicans--passed by, I believe, two or three votes, and now they don't want to talk about it. Well, there is a message there.

Here is what I have concluded after looking at this in a lot of different ways. Where you stand on healthcare in America depends on where you start on the question: Do you believe every American has a right to affordable, quality healthcare? If the answer is, no, that is for people who are lucky or rich or have the right job, then you can reach the same conclusion they did in the House when they passed the Republican measure because, you see, their bill removed health insurance coverage from 23 million Americans, instead of expanding the percentage of Americans with health insurance coverage, which we set out to do with the Affordable Care Act. The Republicans have reversed field. They are taking away health insurance from more people than the Affordable Care Act gave.

Is that a press release from the Democratic National Committee I just quoted? No. It was the Congressional Budget Office--a bipartisan group here, an agency in Washington that analyzes our legislation and gives us their analysis. They looked at the Republican bill and said it will cost 23 million people in America their health insurance.

If you started with the position that healthcare is a right, you would stop at that point and say: Well, this bill clearly doesn't work because it takes away healthcare coverage instead of creating healthcare coverage.

Where you start is where you stand.

The second question is this: If you believe the highest priority of this effort is to cut taxes on wealthy people, then, of course, you would vote for what they passed in the House--$700 billion in tax cuts. Now, that tax cut came right out of the healthcare system of America. That is the tax revenue that is used to expand Medicaid insurance coverage to those who are lower income workers. That is the money that is used to help subsidize the premium payments of middle-income workers who can't afford the monthly premium.

But they believed--the Republicans who voted in the House--that there is a higher priority than helping those people to have health insurance, and that is cutting the tax burden of the wealthiest people in America. So if you start with that premise--that you have to cut taxes by $700 billion regardless of what happens--this is what you end up with, the measure that came over from the House of Representatives. I don't know what the Senate Republicans will come up with in response to that, but clearly it must be parallel or close to what the House of Representatives did.

Let's take a close look at this measure and take a look at the history that brought us to this moment. As I mentioned, we still don't have the text of the Republican secret bill to repeal the Affordable Care Act. Six years and counting, they can't produce a replacement. It looks like we are going to vote on this in a few days. By congressional standards, this is a high crime and misdemeanor. To think that we are going to consider a bill within 10 days affecting every American, affecting one-sixth of the American economy--a bill that will say to some people: You are going to lose your health insurance, and to others: We are going to offer you a health insurance policy that really isn't worth the paper it is written on, and we haven't seen the bill.

Well, what is the history of this? Is this the way the Republicans always operate? Not really. In December 2009, Republican Senator McConnell, their leader, said, when we were debating the Affordable Care Act: ``This massive piece of legislation that seeks to restructure one-sixth of our economy is being written behind closed doors without input from anyone in an effort to jam it past, not only the Senate, but the American people.'' That was Senator McConnell about the Affordable Care Act when it was being proposed by President Obama.

Well, what is the fact? During the passage of the Affordable Care Act, the Senate held over 50 bipartisan hearings on the bill. How many bipartisan hearings have we held on the new Republican healthcare proposal? None, not one.

At that time, 6 years ago, we had a week-long markup in the Finance Committee and a month-long markup in the HELP Committee. The Senate spent--and I remember this well--25 consecutive days in session on the floor of the Senate debating this bill. It is the second longest consecutive period of time ever spent on a bill in the Senate.

We considered on the floor of the Senate hundreds of amendments. You know, we ended up adopting 150 Republican amendments to the Affordable Care Act. Not a single one of them would vote for it, but we took their proposals to make it better seriously and adopted 150 changes.

How much of a chance will we have to amend the Senate Republican bill that may come before us as soon as this week? It remains to be seen. It could be what we call a vote-arama around here, which is a corruption of what this grand institution really established as a standard of operation for generations and centuries. The vote-arama lets you vote on an amendment offered to the bill, with 2 minutes of debate.

You are changing the healthcare system and you have 1 minute on each side to debate your amendment? Is that a serious undertaking with something that is that consequential for so many Americans? No one has seen this secret bill--not Democrats, not many Republican Senators.

I asked Secretary of Health and Human Services Tom Price last week in a hearing: Have you seen the bill? You are the one that is going to have to implement it.

He said: No, I haven't seen it either .

This weekend the Presiding Officer, Senator Rubio, a Republican from Florida, said:

The Senate is not a place where you can just cook up

something behind closed doors and rush it for a vote on the

floor.

Mr. President, I couldn't agree more.

Senator Ron Johnson, a Republican from Wisconsin, said:

I want to make sure the American people, I want to make

sure the members of Congress have enough time to evaluate it.

I want to have enough time to really take a look at what

we're voting on.

That was Republican Senator Ron Johnson of Wisconsin.

Senator Bob Corker, a Republican Senator from Tennessee, said:

I've said from Day 1 and I'll say it again: The process is

better if you do it in public. Obviously, that's not the

route that is being taken.

I didn't pull these quotes from months and years ago. They are from the weekend. The comments were made over the weekend by Republican Members about their very own leadership and the process they are following in preparing to change America's healthcare system.

Let's talk about some numbers. Let's start with zero. How many hearings have we had on the Senate bill to repeal the Affordable Care Act? Zero. How many markups have we had? Zero. How much time has the Secretary of Health and Human Services, the man responsible for implementing this bill, spent on it to review it? Zero. How much Democratic input has been allowed for this secret negotiation? Zero. How many women Senators have been involved in crafting the bill? Zero. How many medical organizations or patient groups support the secret Senate bill? Zero. And most concerning of all, how much time has the public had to even read this bill? Zero.

Let's take a look at another number: 23 million. The Congressional Budget Office estimates that 23 million Americans will lose their health insurance under the House-passed repeal bill--1 million in Illinois.

I have said it before, but I will say it again--and this is a driving factor in terms of my views on the subject: If you have ever in your life been the parent of a seriously ill child and didn't have health insurance, you will never forget it as long as you live. I know. I have been there.

I was a law student, newly married, with a brand new baby girl with a really serious health issue, and I had no health insurance. My wife and I sat in the charity section at Children's Hospital waiting for them to call our name so we could take our little girl in to the latest resident, with a hundred questions and who wanted to go through them all over again. I thought to myself: Durbin, how did you ever reach this point where you don't have health insurance?

I fixated on health insurance from that point forward. From the time I got out of law school, for years afterwards while my daughter was growing up, I not only had health insurance, but I sometimes had two health insurance policies. I was so worried about having coverage if I ever really needed it.

So we want to take health insurance away from 23 million Americans? Do you want it to be your family, your son, your daughter? I sure wouldn't.

Here is another number: 750. Lower income older Americans would see their premiums increase 750 percent under the House-passed repeal bill, from $1,700 under ACA to $14,000 under the Republican plan. Now, how can that happen? How can you see the premiums go up that fast? We built into the affordable care bill a guaranteed protection for disparity in premium payments of no more than three to one. The most expensive health insurance policy cannot be more than three times the lowest cost policy. The Republicans changed that to five to one. Well, who does that affect?

If you are between 50 and 64 years of age, you are in a category of people not yet eligible for Medicare. If you are now facing chronic illnesses that could make health insurance more expensive, you will pay the higher premiums. The higher premiums, when calculated, are dramatically higher for this group. That is why the American Association of Retired Persons has come out foursquare against the Republican TrumpCare, the Republican repeal bill. It is just unfair to those between the ages of 50 and 64.

Some 130 million, that is how many people nationwide have preexisting conditions. Almost half of the people in Illinois have a preexisting condition. Several weeks ago, I had a procedure for an atrial flutter. It worked out just fine. Now I have a preexisting condition. I am in that category. What does that mean? If you went out to buy health insurance with a preexisting condition, you are charged more, if you could buy insurance at all.

So when the Republican bill that passed the House does not guarantee, as the Affordable Care Act, that you cannot be discriminated against because of a preexisting condition, it makes millions of Americans--130 million--more vulnerable.

Is that what they wanted to achieve?

Where you stand depends on where you start. If you think everyone is entitled to health insurance, then you can't be standing for something that allows preexisting conditions to be used against you. A lot of the people whom I am talking about have employer insurance, but what about those who shop on the individual market or purchase individual insurance in the future? Under the House repeal bill, insurers would, once again, be allowed to charge people with preexisting conditions more money for insurance.

The next number is 33,000. Senator Menendez referred to it. That is how many people are dying every year because of the opioid or heroin overdose--33,000, and 1,800 a year in Illinois.

Now, listen to this. The Republican bill dramatically cuts the Medicaid Program, the Nation's largest provider of substance abuse treatment services, and it allows insurers, once again, to refuse coverage for those needed services.

I have been here a few years, and I can remember that desk because that is where Paul Wellstone of Minnesota sat, and I remember that desk because that is where Pete Domenici of New Mexico sat. You couldn't ask for two more polar opposites politically. Paul Wellstone was a garrulous, proud liberal. Pete Domenici was a proud conservative. One was from Minnesota, and one was from New Mexico, and they came together on an issue.

Do you know what the issue was? Each of them had someone they loved in their family who suffered from a mental illness, and they said: Why in the world will health insurance companies refuse to write coverage for people with mental illness? They fought for years against the insurance companies, and they finally won.

We included, in the Affordable Care Act, the requirement that your health insurance policy cover not only physical illness but mental illness. It was a breakthrough. For the first time, we stopped treating mental illness like a curse and treated it like an illness that could be treated.

They added a section at the end that most of us didn't even notice: mental illness and substance abuse treatment. I didn't know it was there until the opioid crisis, and I started going to these rehab facilities and saying to these people there: How are you paying for this care? Some of them were under Medicaid, but those under private health insurance said: My policy covers it. It covers it because Wellstone and Domenici insisted on putting it in.

After that historic victory, you would think the Republicans would include mental illness and substance

abuse treatment as one of the basic essential services for health insurance, but they don't.

When they say we are going to write a bill that gives Americans more choice in their health insurance--oh, that sounds appealing--the choice is whether you want mental illness and substance abuse treatment or you don't.

Well, from where I am sitting, that is the kind of insurance coverage that should be basic to everyone. You never know whether that little girl that you are raising--that beautiful little girl--6 years from now is going to be struggling with an addiction. At that point, you better hope that your health insurance policy has some coverage so that you can save her life and bring her back from that addiction.

Now, 280,000 is the next number. That is how many children in Illinois depend on Medicaid for school-based health and medical services, from feeding tubes and handicapped buses to special education teachers. I made a point this last week when I was home to visit the schools in Chicago and Bloomington and hear firsthand what cuts in Medicaid meant to local school districts.

Many Senators don't realize this, but the kids with whom you are dealing who have learning disabilities and other disabilities, many of them are supported at your local schools by Medicaid dollars. The Medicaid dollars pay for the counselors, pay for the special buses, and pay for the feeding tubes for these kids to survive. So when you make a dramatic cut in Medicaid, as the Republican bill that came out of the House does, you endanger the very services and the very benefits that these special ed kids need. The school districts are mandated by law to help these kids, but if the money is cut off from Medicaid, what are they going to do?

The Republican repeal bill that every Republican Congressman in my State voted for slashes $40 billion in Medicaid funding to Illinois, including money to school districts.

Three--this is the most important single number in the next 10 days in the Senate--3. That is the number of Republican Senators needed to stop this. Surely, there are three Republican Senators who are concerned enough about this secret, behind-closed-doors process that we are witnessing when it comes to rewriting healthcare in America--at least three Republican Senators who want to take time to properly review this legislation that affects one-sixth of our economy.

Just the Senators who have publicly stated their personal concerns about this process--if the three of them would come together, we could stop this and do it the right way.

I said privately to a Republican Senator last week, after the tragedy where a Republican Congressman was shot at a baseball practice: Isn't this the moment when we ought to get together quietly--Democrats and Republicans--when we ought to sit down and write a bill we can both be proud of? I am hoping he was listening.

I am hoping that three Republican Senators, if they stand up for it, will help us achieve that goal. Surely there are three Republican Senators who are worried about the kids in their States like I am worried about the kids in mine, who do not want to make the opioid epidemic any worse, who want to make certain--underline the word ``certain''--that they are protecting the people they represent from discrimination because of preexisting conditions. Surely there are at least three Republican Senators who do not want to throw millions of Americans off of health insurance coverage. Maybe some of the Senators who represent States that have been ravaged by the opioid epidemic will step forward. There are a lot of them. It only takes three to change this.

To Republican Senators, I say: Do not do this. Do not do this secret process. Democrats are willing to work with you to improve our healthcare system. I have said before that the only perfect law that I know of was carried down a mountain on clay tablets by Senator Moses. All of the other efforts can use some work, and in this case, we are willing to work with you. Take repeal off the table, and we will put a chair up to the table.

Over the past week, I have received thousands of emails and letters from Illinoisans who are worried about what is happening in the Senate today.

Helen, from River Forest, IL, is 47 years old. She is a primary caregiver for her parents. Her mom has Alzheimer's and is in a nursing home.

Here is what Helen writes:

Just before Thanksgiving, my dad's health deteriorated. He

is now in hospice in the same nursing home. I have spent all

of their savings--my mom and dad's savings--on healthcare. My

mom is finally eligible for Medicaid. Without Medicaid, I

would need to bring my parents to my home and quit my job to

personally nurse them myself because I don't have the money

myself to keep them in the nursing home and pay for private

care. Please protect ObamaCare and Medicaid.

Here is Madeline from Chicago, who writes:

My younger sister is disabled. Before the Affordable Care

Act went into effect, she was just about to hit the maximum

lifetime limit on her private insurance policy.

That used to be the case. You would sign up for insurance, and you would say: Oh, great coverage--no copays, no extra charges. Then you would find in the fine print that there is a limit to the coverage of $100,000. My friends, I can tell you that we are--each and every one of us--one diagnosis or one accident away from having more than $100,000 in medical bills. It happens pretty quickly. That used to be built into insurance policies. We outlawed it under the Affordable Care Act. Now, in the name of ``choice,'' the Republicans want to bring that back.

Madeline writes:

Before the ACA went into effect and my daughter was about

to hit the maximum lifetime limit on her private insurance

policy, she was going to have to apply to be part of a high-

risk pool, but that was going to involve a long wait, without

any insurance, plus high premiums if and when she was

accepted into the pool. The Affordable Care Act came just in

time for my sister and for our family.

When the Republicans in the House say not to worry about people with preexisting conditions, that they have set aside $8 billion to take care of them in private risk pools, it is sad and, in a way, tragic that they would say that. That is not nearly enough money, and there is no guarantee that private risk pools that never worked before the Affordable Care Act would work in the future. It is a way to give an answer to the obvious question of why they are dropping so many people with preexisting conditions from guaranteed coverage.

The last note is from Erin of Chicago, who writes:

I implore you to force a public hearing on the ACA repeal

that the Republicans are trying to sneak through. If this

bill passes, many of my friends and family will lose coverage

either due to preexisting conditions or because the

deductibles are too high. Additionally, my parents are self-

employed and getting older. Under the proposed act, their

health insurance premiums will likely increase to $14,000 a

year. They cannot afford it. They just can't. They will not

have coverage, will get sick, and be unable to afford care.

If the Republicans have a better idea than the Affordable Care Act, for goodness' sake, stop hiding it from the American people. Stop talking about it behind closed doors. If it is such a good idea, bring it out for the world to take a look at. There will be critics. There were certainly critics with regard to the Affordable Care Act. I remember that very well. Yet that is what this body is all about.

The Senate is supposed to be a place where we deliberate on the important issues of our time. Is there anything more important than your health, the health of the people whom you love, and your opportunity to get basic healthcare so that you can protect them?

I implore the Republicans and those who know that this is the wrong way to go to stand up and say so. It only takes three Republican Senators to do this a much different way so as to bring credit to this institution and create a bill--create a change--that makes healthcare more affordable, more accessible, and more fair to more Americans.

I yield the floor.

Mr. President, I want to take a few moments to acknowledge my friend, Joan Claybrook. Joan is a legend. She is one of the most effective champions this Nation has ever seen--and she is still leading the charge. Last week, Joan celebrated her 80th birthday, and one thing is clear, Joan Claybrook isn't slowing down.

Like so many bright young people in Washington, Joan began her career right here in the U.S. Congress, working for Senator Walter Mondale and Representative James Mackay as a congressional fellow. In the summer of 1966, the Senate unanimously passed the National Traffic and Motor Vehicle Safety Act, the first major legislation to improve auto safety in this country. This effort was led by consumer advocate, Ralph Nader, and working right by his side was Joan Claybrook. It led to important safety standards we take for granted today: seatbelts, windshield wipers, outside mirrors, and dashboards. This landmark legislation also launched Joan's impressive career as a consumer advocate.

During the Carter administration, Joan served as the head of the National Highway Traffic Safety Administration, where she led efforts to improve vehicle safety and increased consumer access to safety information. Prior to her time with the National Highway Traffic Safety Administration, she ran Congress Watch, worked for the Public Interest Research Group, National Traffic Safety Bureau, Social Security Administration, and the U.S. Department of Health, Education, and Welfare.

In 2009, Joan retired as president of Public Citizen, after nearly three decades of service championing consumer interests and campaigning on issues from campaign finance reform, to truck safety, and business regulation. Among her many accolades at Public Citizen, Joan was able to limit the number of triple- and longer double-trailer trucks on the road, and she helped to ensure that health, safety, and environmental agencies were able to continue its important work protecting the American people, but her proudest, and perhaps most impactful, achievement was winning a 20-year battle with the auto industry to install airbags in cars. Because of Joan's work, countless lives have been saved. I want to thank her for these contributions that improved the health and safety for so many across the country.

Joan Claybrook has been honored by numerous organizations, including the Philip Hart Distinguished Consumer Service Award from the Consumer Federation of America, an Excellence in Public Service Award from the Georgetown University Law Center, and an award for Superior Achievement from the National Traffic Safety Bureau--just to name a few. In her precious spare time, Joan serves on the board of Citizens for Tax Justice and Public Justice. She also cochairs the Advocates for Highway and Auto Safety and Citizens for Reliable and Safe Highways.

It is not simply Joan Claybrook's extraordinary resume that earned her such great respect; it was her approach to the job. Joan brought humility, integrity, and fairness to every challenge she faced. Her energy, passion, and optimism are infectious, and her continued drive to ensure all Americans have the chance to lead safe and equitable lives make her an inspiration. Joan may have retired, but her commitment to those values has never wavered. She is a force of nature.

I will close with this. I strongly believe in the role of public service to create change and make a difference. Joan Claybrook's years of service reflect these values and prove that, with the right approach, change is possible. I am lucky to count Joan as a friend. It is with great pride that I ask my colleagues to join me in celebrating Joan Claybrook's 80th birthday and congratulate her on an outstanding career. I hope Joan enjoys this special day, and I wish her many more wonderful years.

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

Mr. President, have you announced the business for the day?

I ask unanimous consent to speak as in morning business.

Mr. President, today is the fifth anniversary of the Deferred Action for Childhood Arrivals Program, known as DACA. DACA provides temporary legal status to immigrant students who arrived in the United States as children and infants, if they register with the government, pay a fee, and pass a criminal background check.

The program is based on the DREAM Act, a piece of legislation I introduced 16 years ago in 2001. That legislation gave undocumented students who grew up in this country a chance to earn a path to legal status and citizenship. These young people have come to be known as DREAMers. What used to be a word reserved for rock-and-roll groups is now a word that has become part of our common language to describe an immigration challenge and opportunity.

These DREAMers came to the United States as children. They are American in every way except for their legal immigration status. We have already invested a lot of money in these kids. We educated them. We made them part of this country, and it makes no sense to squander their talents by deporting them at this moment in their lives.

In April 2010, I sent a letter to President Obama. Dick Lugar, the Republican Senator from Indiana, joined me. On a bipartisan basis, we said to President Obama: Stop deporting these young kids. They did nothing wrong. Their parents made the decision to come here. Give them a chance. The President responded. It is now clear the DACA Program he created by Executive order has been a great success. More than 780,000 DREAMers have come forward and received DACA protection and status that has allowed them to contribute more fully to this country as students, as teachers, as nurses, as engineers, as entrepreneurs.

A recent study by the Center for American Progress found that ending DACA--saying to these 780,000 young people they are no longer part of America--would cost us. It would cost our economy over $400 billion in gross domestic product over the next 10 years. These are productive citizens doing good things for America. I should take that back. They are not citizens yet. They are productive people doing good things for America whom I want to make citizens if the DREAM Act becomes law.

I have many differences with President Trump on immigration. For example, the President's January 25 Executive order makes up to 8 million immigrants priorities for deportation, and seeks to create a deportation force by tripling the number of immigration agents. This ignores the reality that the vast majority of undocumented immigrants are law-abiding individuals who make important economic contributions to this country, and have deep roots in the United States.

I am grateful, and I say that publicly. I have said it before. I am grateful President Trump has decided to keep the DACA Program in place. Homeland Security Secretary John Kelly and the U.S. Citizenship and Immigration Service Director nominee, Francis Cissna, have promised me personally and publicly that they will maintain the existing guidelines for the DACA Program. I appreciate this commitment. I intend to hold them to it.

Congress also has an obligation to do its job. We ought to do something we rarely do in the U.S. Senate--pass legislation, fix our broken immigration system. Think about this: On June 27, 2013--4 years ago--the Senate, on a bipartisan basis, passed comprehensive immigration reform by a vote of 68 to 32, better than 2 to 1. I was glad to be part of the Gang of 8 Democratic and Republican Senators who worked for months on the bill that passed by this margin. It strengthened border security, protected American workers, and it established a tough but fair path to citizenship for 11 million undocumented people in this country.

Unfortunately, the Republican majority of the House of Representatives would not debate it, would not consider it, would not bring it for a vote, and it died in the U.S. House of Representatives. If they had done their job, their work, it would have passed with a bipartisan majority. President Obama would have signed it into law. I might not be standing here today talking about this issue.

Over the years, I have come to the floor of the Senate to tell story after story about DREAMers, the young immigrant students who grew up in this country. These stories put a human face on the DACA Program and the DREAM legislation. They show that immigration makes our country stronger.

Today, I want to say a word about Gissel Escobedo. This is Gissel. She came to the United States at the age of 3. Her family emigrated from Mexico. She grew up in my home State of Illinois, in the town of Cicero. She was an honors student in high school. She attended their gifted program. She had a big responsibility personally. From a young age, she was one of the primary caregivers for her brother who suffers from severe autism. During the little spare time she had, Gissel was a volunteer in her community, helping organizations provide care for children with autism.

As an undocumented student though, Gissel was not eligible for any Federal assistance to go to college, but as a result of her academic achievements in high school, she received a private scholarship to attend the University of Illinois at Chicago. As a college student, Gissel was a writing tutor and a leader in student organizations for future teachers. In 2010, she graduated from the University of Illinois Chicago and the College of Education with a degree in elementary education. After the graduation ceremony, Gissel received a Dean's Merit Award. She delivered the graduation speech for her class.

She wanted to start using her degree as an elementary school teacher, but because she was undocumented, that wasn't possible. Instead, she continued her education and earned a master's degree at the University of Illinois. She was accepted into a disability leadership program as a family advocate.

Then, in 2012, the world changed for the better for Gissel. President Obama established the DACA Program. She immediately applied for DACA. Then, in 2013, she completed her master's degree and became an elementary school teacher. For the last 4 years, Gissel has been a teacher in the Berwyn South School District. Last year, she was awarded a certificate of achievement for her leadership as one of two teachers to implement the first-ever dual-language program in the district.

Gissel sent me a letter. I would like to read part of it as part of the Record. Here is what she said:

DACA has enabled me to become a meaningful member of

society by opening doors that would have otherwise not been

accessible. DACA recipients, like myself, are more than just

a policy. My hope is that when people listen to our stories,

they will notice the kind of individuals that we are and the

kind of contributions we make--not only to the economy, but

to our society.

I reflect on that paragraph to think about this young woman, the challenges she has faced within her family, and challenges imposed by the fact that she was undocumented. She has never lost sight of her commitment to her family, to her disabled sibling, and to many others in her community.

Now she wants to be a teacher. Wouldn't you be proud and honored to have your child in a classroom with someone with Gissel's master's degree and values? I certainly would. Gissel and other DREAMers have so much to give to the United States, but without DACA and without the DREAM Act, Gissel would be deported back to Mexico--a country she hasn't lived in since she was 3 years old.

Will America be a stronger country if we send away people like Gissel, if we deport them and say we don't need them in our future? Of course not. The answer is clear. Gissel will make America a better place. Today we celebrate the DACA Program, which has given Gissel and hundreds of thousands of other DREAMers the chance to finally come out of the shadows, but we also recognize DACA as a temporary solution.

Ultimately, Congress--and especially the Senate--must step up and show leadership here; make certain that we address the failings and weaknesses of our broken immigration system; say to the 780,000 protected by DACA that you stepped forward, paid your fee, submitted yourself to a background check, and have been given a temporary opportunity to be part of America. Now it is our job to translate that into a permanent opportunity for these young people to make America a better place.

Mr. President, I yield the floor.

Recognition of the Minority Leader

I announce that the Senator from Maryland (Mr. Van Hollen) is necessarily absent.

Mr. President, it has been more than 6 months since a major foreign adversary undertook a cyber act of war against our election.

The Russian attack sought to undermine faith in our democratic system and favor one candidate over another--

in this case, one seen as more favorable to the Kremlin's interests.

This was truly a historic event--one that requires a response of equal magnitude--not only to deter any such attacks on our future elections and those of our Western allies, but to make sure our election infrastructure is secure from any future cyber threats.

Unfortunately, President Trump has refused to even acknowledge the Russian act of cyber war and the Republican-controlled Congress has similarly refused to act to retaliate against Russia or strengthen our cyber defenses.

All the while, Russia has predictably continued its belligerent military and cyber actions against our NATO allies and Ukraine, as well as ongoing cyber attacks on the election of our democratic allies, most recently in France.

This should come as no surprise. We were warned by our own experts and our allies about the danger of American inaction.

For example, last month, former Director of National Intelligence James Clapper warned, ``An American citizen should be very concerned about a foreign government, particularly our primary adversary, interfering with the most important foundational process that we have in this country, which is free and fair elections.'' And former FBI Director James Comey also recently warned about the Russians ``They're coming after America . . . They will be back.''

I heard the same warnings in Eastern Europe, where our allies starkly warned that Russia would feel emboldened to continue its attacks if the United States did not even respond to the attack on its own election. So I am understandably pleased that, at least this week, we are taking action to maintain and toughen sanctions against Russia.

This bill takes a number of long overdue steps, including codifying existing sanctions against Russia put in place by the Obama administration, adding new sanctions on Russia, and making it harder for President Trump to lift any sanctions on Russia without congressional review.

I think these are important steps we must take to respond to Russia and to protect our democracy, but they are not nearly enough.

We must also pass legislation to help protect against any such future attacks on our election and to safeguard our electoral infrastructure.

We must get to the bottom of questions regarding possible collusion between the Trump campaign and the Russians.

We must be prepared for President Trump to use the waivers and designation authority granted to him in this bill to ultimately do little to nothing to toughen sanctions against Russia.

You see, the way we usually write sanctions language is to instruct that the ``President shall'' take such action as described and then provide a national security waiver.

Well, this President has spent more time trying to endear himself to the Russians than warning them to never attack our Nation again. In fact, this President continues to deny that there was a Russian attack on our election. What can we expect this President to do with the discretion given in this bill dealing with these exact issues?

I hope he does the right thing to protect our national security and democratic system from foreign attack, but I and others will be watching to make sure he does and ready with additional measures if he does not.

Mr. President, let me say at the outset that I support the position from the Senator from Kentucky. I believe that what he has said about the situation between the United States and Saudi Arabia is timely and needs to be heard. People across the United States and around the world should be aware of the fact that we are witnessing four famines across this world. One of them is in Yemen, and three others are on the continent of Africa. This is a famine that is created not by drought, not by national defense, but by human disaster--by a war that has been created and is one that has been pushed largely by the Saudis at the expense of the people--the innocent people--who live in the country of Yemen.

What the Senator from Kentucky is basically calling on all of us to do is to ask: What role is the United States playing in Saudi Arabia's aggressive activities? Should we be more vigilant in our knowing that what we are selling them is being used in ways that are inconsistent with the values of the United States of America? We know the record of the Saudi monarchy when it comes to human rights, and the Senator from Kentucky has spoken to that quite eloquently. We know what they have done to their own people, to the people who live in their country, and to those who seek to have the basic freedoms that we take for granted in America.

We also know that, when it comes to the Saudi activity of promoting their version--the most extreme version--of Islam, they have been guilty of promulgating Wahhabism, which has led to extreme forms of the Muslim faith in some places in the world. Those are realities.

We know the reality of 9/11. When we traced the origins of those who came and killed 3,000 innocent Americans, too many roads led back to Riyadh; too many roads led back to Saudi Arabia. So why can't we be more open and honest in our relationship with this country?

The Senator from Kentucky has told us this morning that the amendment that will be offered shortly by him and by Senator Murphy is one that calls on the Senate to take an honest look at Saudi Arabia today and its relationship with the United States.

May I add one other element on a personal basis?

It is so rare on the floor of the Senate to see what we have just seen this morning--a proposal for an amendment to be debated and an amendment to be voted on on the floor of the Senate. I can count on one hand how many times that has happened this year in the Senate. What used to be the most deliberative body in America--the great debating society and so forth--has turned into a place of rubberstamps and unanimous consents. I am glad--win or lose in our effort here on this amendment--that the Senator is bringing this important issue to the floor. I thank him for making it a bipartisan effort in the process.

Healthcare Legislation

Mr. President, what I have come to the floor to speak to is another issue that really calls on the Senate and asks the basic question: Why are we here?

I think we know that we were elected to make America a better nation and to help families across this Nation realize the great opportunity and goodness of this Nation.

One of the issues that most people worry about the most in their daily lives is healthcare. They should. Many times, I have said on the floor that, if you have ever been in a position in your life as a father of a seriously sick child and have had no health insurance when that has happened, you will never forget that as long as you live. I know. I have been there. I went through a period of time with my wife, in raising our daughter, when she needed the best medical care in America, and we did not have any health insurance. It was frightening to think what would happen to our little girl because we did not have the protection of health insurance and the quality care that everybody wants for themselves and for the people they love.

At this moment in time, we are in a debate about the future of healthcare in America--the future of health insurance in America. I cannot think of a more serious topic. People say: Well, it is one-sixth of the American economy--our healthcare system. That is critically important. Even more so, this is such a personal matter for every individual.

The Affordable Care Act, which was passed 6 or 7 years ago, I was proud to vote for. We couldn't get any support from the other side of the aisle--not one single vote, not one Republican vote in support of it. Our goal, of course, with the Affordable Care Act was to reduce the number of Americans who were uninsured when it came to health insurance. We achieved a major part of our goal. The rate of uninsured in health insurance in America was cut in half by the Affordable Care Act. We expanded opportunities for health insurance through the Medicaid Program, as well as through private insurance exchanges, which were moved in the right direction.

We also said something else in that we wanted to build into the health insurance system of America protections for families. We wanted to make sure that you could not be discriminated against in buying health insurance simply because someone in your family had been sick. Think of how many of us--one out of three, I might add--have preexisting conditions or of someone in our family who has a preexisting condition. It happens--a child surviving cancer, a child with diabetes, somebody in the family who has a heart condition. Those are the realities of life for families across America.

Before the passage of the Affordable Care Act, the health insurance companies could say not only no to you but, really, no when it came to coverage, or they could charge you premiums that were way beyond what people could afford to pay. We eliminated that in the Affordable Care Act--eliminated it. You cannot discriminate against an American on the basis of his having a preexisting medical condition.

The insurance companies went wild in defining what a preexisting condition was that might raise your premiums or to deny you coverage. Having had acne in your adolescence was a preexisting condition. The fact that you were a woman who might give birth to a child was a preexisting condition. The list went on and on. We eliminated that and said that you cannot discriminate against Americans because of those things.

We have people on the other side who have said that we have to get rid of that protection. If we do, what will happen to all of these people?

On Saturday, I went to a march in Chicago, in Lincoln Park. It was the Children's Heart Foundation and the congenital heart defect alliance. Of course, it speaks for itself. The No. 1 birth defect among children in America is a heart defect, and 1 out of 100 babies born has a heart problem. These are kids with preexisting conditions. You should have seen the families show up in big, big numbers, supporting little kids--some of them just babies. They were proudly wearing T-shirts, standing up, and saying that we are going to fight for this little boy or little girl. They were trying to promote medical research to save their lives.

It is something that really touched me as I looked at 600 people on that hot Saturday afternoon, marching in Lincoln Park in Chicago. I said to them: When it gets down to the basics in life, the most important thing in your life is your baby. The next most important thing is your family, whom you have standing behind that baby. Then there is the doctor--that doctor whom you are counting on to do everything in his power or her power to make sure your baby survives. But you need to bring into this conversation another group-- politicians, Senators, and Congressmen--because we are making decisions right here in Washington that will decide whether the families who marched in Lincoln Park in Chicago on Saturday and families like them all across America will have access to affordable health insurance, real health insurance that will cover them. That is what the debate is about.

It was just a few weeks ago that the House of Representatives passed a measure to repeal the Affordable Care Act and to replace it. At the end of the day, not a single Democrat voted for the measure. It passed by two votes--two votes--in the House of Representatives.

When they came back and analyzed what the Republicans had voted for in the House of Representatives when it came to healthcare, here is what they found: Their proposal to eliminate the Affordable Care Act-- the one that passed the House of Representatives several weeks ago-- according to the Congressional Budget Office--a nonpartisan, expert group--according to the CBO, 23 million Americans will lose their health insurance under the plan that passed the House of Representatives. In my State of Illinois, with 12.5 million people in our population, 1 million people would lose their health insurance.

I will just tell my colleagues, I don't see how any Member of Congress can stand before us and say: I have a great solution for healthcare in America. We are going to take health insurance away from 23 million people. But that is what the vote did. And their vote, sadly, eliminated the protection against discrimination because of preexisting conditions.

So what has been the reaction to the House repeal bill that was passed? I can tell my colleagues that in my State there is not a single group, not one medical advocacy group, who supports what the House of Representatives did.

I am from downstate Illinois, outside the city of Chicago. I have a congressional district down there in smalltown America, great people. If you went into that part of Illinois and said to them ``I am going to vote for a measure that is going to put in jeopardy the future of your local hospital,'' the people would literally rise up to resist it.

The Illinois Hospital Association tells us that the Affordable Care Act repeal passed by the House of Representatives endangers hospital services all across our State but especially in small towns and in rural America. They estimate that we are going to lose 60,000 jobs at these hospitals in our State. I can tell you what those hospital jobs are in smalltown America, in rural America. They are the best jobs in the community. These are medical experts, doctors and nurses and supervisors and administrators who keep these hospitals operating, and they are paid well to do it, and they should be. Those are the jobs at risk of being eliminated by the vote in the House of Representatives.

One million people in our State could lose health insurance, and our hospitals are threatened with closure.

That is why the Illinois Hospital Association opposes what the Republicans did in the House of Representatives, and that is why the Illinois State Medical Society--our doctors--and the Chicago Medical Society have come out against what happened in the House of Representatives. That is why the nurses have opposed what was passed in the House of Representatives as well. Not a single medical advocacy group supports what happened in the House of Representatives. Not one in my State. Can't find one of them.

So now we remember from basic civics that after it passes the House, it is our turn in the Senate. What are we going to do with healthcare reform? Well, I wish I could tell you. We are told we are going to vote on it. Maybe as soon as 2 weeks from now, we will come to the floor and vote on changing the healthcare system of the United States of America.

What is the proposal of the Republicans in the Senate when it comes to the future of our healthcare system in America? I don't know, and the reason I don't know is it is being done in secret. There have been no committee hearings, no opportunity to offer amendments. In fact, we haven't even seen the measure we are going to be asked to vote on in 2 weeks.

The Congressional Budget Office, which is supposed to analyze it, hasn't published any analysis of the Republican plan. Yet they are moving forward at a breakneck pace to have us vote on it, up or down, before we leave for the Fourth of July recess. It is a frightening prospect.

They will do it under what is known as reconciliation. I won't bore people with Senate procedure, but what it basically means is they can move it through with a simple majority vote in the U.S. Senate. Amendments will be considered on what they call a vote-arama basis. And if it sounds like some kind of a game, it is almost a game. You offer an amendment and you get perhaps 1 minute to explain your amendment on changing healthcare in America, and the other side gets 1 minute to explain their opposition, and off you go to a vote and then another one and another one. Your head is spinning, trying to figure out what in the world each of these amendments and each of these votes is going to mean. Those are the measures to be taken by the Senate when it comes to healthcare.

This is exactly the opposite of what happened when the Affordable Care Act was passed. We adopted 160 Republican amendments to the Affordable Care Act. None of them voted for final passage, but 160 amendments were offered by Republicans to change it, and they were adopted. It was a bipartisan process on the amendments.

How many amendments will we be able to offer to the Republican Senate proposal that is going to come before us in 2 weeks? The answer is that we don't know because we have never seen the Republican proposal. It has been done in secret. Thirteen Republican Senators were chosen by the majority leader to sit in private and come up with this bill. There was no open committee hearing, no open discussion. Some Republicans were invited in, and some were not. We don't know what the ultimate product will look like, but I can tell you this: Whatever the Republican Senators come up with, it is going to have a dramatic impact on each and every single American, every one of us in our communities back home.

I know this idea of repealing the Affordable Care Act in 2 weeks is a solemn political promise that many Republicans made, but they also made a promise to the people they represent to do what they can to help these families through their difficult times. That is why we need to make sure the product that is passed by the Republicans in the Senate is one that serves the needs of people across the United States of America.

If this product coming from the Republicans is like the House measure that takes away health insurance for 23 million Americans, then I can understand why the Republicans want to do this in secret. I can understand why they don't want us to see it until the very last minute and then vote on it and get out of town as fast as they can, because it is an embarrassment to think that the U.S. Senate and the House, for that matter, would vote to take away health insurance from 23 million Americans. That is a dereliction of duty, and from where I am sitting, it is just flat immoral to take away health insurance from that many people.

What if we end up with a product like the House of Representatives' that jeopardizes rural hospitals and hospitals in the inner cities, that closes down these community healthcare clinics, reduces access. Well, I will tell you what will happen. People without health insurance will still show up at the hospital sick, in the emergency room, and they will still be treated, but they won't be able to pay for it. Who will pay for their care? We will pay for their care. Everyone else with health insurance will pay more because people who are uninsured will receive free medical care. That is the reality. And, of course, if you don't have a regular doctor or a regular medical home, as they call it these days, what started off as a minor problem could turn into a major problem, even life-threatening. That is why the Affordable Care Act builds into it community healthcare clinics and opportunities to create a medical home.

When I met with the Chicago Medical Society at a convention they had in Chicago this last week, I was surprised by a few things. First, I was surprised to learn that out of the 5,000 physicians in the Chicago Medical Society, they received responses back from over 1,000 who said they thought the measure that passed the House of Representatives--the Republican repeal bill--was the worst news they had heard when it came to the future of healthcare. They preferred the Affordable Care Act. But they went on to say something that may surprise people. These doctors--over 1,000 of them responding to the survey--said they thought it was time for us to talk about very significant changes to our healthcare system in America. They are tired of fighting the private insurance companies. What they suggested is that we look at a plan like Medicare for all.

Right now, Medicare serves 50 million or 60 million Americans. People can't wait to turn 65 and finally qualify for Medicare, with no exclusions for preexisting conditions, and they know that Medicare is going to give them quality care, and it is not going to bankrupt them as individuals.

These doctors in the Chicago area have said it is now time for America to seriously look at Medicare for all, and I agree with them. I think it is time to look at it because the private health insurance system, even as we have tried to save it, salvage it, remake it through the Affordable Care Act, has real shortcomings.

I hope those on the other side who are considering changes in our healthcare system will actually listen to doctors, listen to hospital administrators, and listen to the families they represent. Why they are doing this in secrecy, why they are refusing to give us a chance for committee hearings and amendments I can't tell you, other than the obvious: Clearly, what they have come up with is something they don't believe the American people will accept, so they need to push it through without disclosure at the last minute and get out of town in the hopes that people won't blame them.

Well, when it comes to healthcare, people don't forget. I won't forget, and the people of Illinois won't forget the votes that were cast in the House of Representatives which threaten to take away health insurance from 1 million people in my State.

Mr. President, I yield the floor.

I announce that the Senator from Michigan (Ms. Stabenow) is 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.

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

Mr. President, I voted no today on the motion to invoke cloture on the motion to proceed to consideration of S. 722, the Iran sanctions bill.

I did so not because I oppose the underlying bill and the need to further sanction Iran's belligerent missile and terrorist activity; in fact, I support that legislation. I voted no to give a moment's pause after the terrible ISIS attack in Tehran that just occurred.

Earlier today, a pair of deadly attacks occurred over several hours in Tehran, including in the nation's parliament building, indiscriminately killing at least 12 people and wounding dozens more. The heavily armed assailants targeted guards, cleaners, and administrative employees of the parliament. ISIS later claimed responsibility for this barbaric attack.

I certainly have my differences with the Iranian regime, its continued sponsorship of Hezbollah and Hamas, its threats to Israel, its proxy wars in Yemen and Syria, and its human rights abuses, but we must remember that the Iranian regime isn't the same as the Iranian people, many of whom expressed sympathy with the American people after we suffered the horrific attack on September 11.

In fact, the Iranian Government issued a surprisingly strong statement of condemnation of the terrorists responsible after the September 11 attack.

There was even some hope after those statements that our two nations might work together on other shared interests, although unfortunately, other than the historic nuclear agreement, that has not come to pass.

Nevertheless, I think it is important that we pause and reaffirm the statement made today by our State Department that condemns the attack in Iran

and expresses condolences for the families and victims.

I also think it is critical that we finally take some action here in the Congress to address Russia's attack on our election, which occurred more than 7 months ago.

We have overwhelming evidence of this historic attack--an attack that I liken to a cyber act of war.

The majority party here in Congress has done nothing to respond to Russia's aggression or to help protect America against any future such attack on our democracy.

President Trump still refuses to acknowledge the Russian attack-- seemingly more interested in befriending the Russians and complaining about former Federal Bureau of Investigation Director Comey than convincingly telling Russia to never interfere in our election again or face the consequences.

This lack of resolve is truly an abdication of our national security responsibilities in Congress.

As one Polish security expert recently warned me, if the United States does not respond to the Russia attack on its own democracy, then Putin will feel emboldened and free to conduct further such attacks against other Western democracies.

Sadly, that has already proven true--just look at Russia's meddling in the recent French, German, and Dutch elections.

As we act to address Iran's troubling missile and destabilizing activity in the Middle East, including its continued threat against Israel, we must also act against Russia, which conducted a cyber act of war against our Nation.

We must ensure that existing sanctions placed on Russia for its destabilizing actions in Ukraine and Europe and its attack on our election are not lifted until such Russian actions are reversed or addressed.

I voted no on cloture today--out of respect for the Iranian people who suffered the horrific attack today and because I think it is long overdue for the Congress to finally respond to Russia's attack on our Nation--and stand prepared to support the final Iran sanctions bill after addressing these matters.