president's nominees fair and respectful and timely consideration. unfortunately, the unprecedented partisan obstruction we've seen over judge merrick garland's nomination to the supreme court has been a fact of life longer than that at the banking committee. the under secretary for terrorism and financial crimes is one of the most important national security posts in our government. mr. szubin disiewp serves in an acting capacity. besides bipartisan, his evidence by the vote out of committee and as evidenced by his initial appointment to the executive branch by president bush, his nomination has languished for a year, a full year because of one thing, republican obstruction. allow thg proven leader -- allowing this proven leader to remain unconfirmed weakens his position and undermines american influence in our efforts to track terrorists and stop them from raising money on the black market or elsewhere. the mission of treasury's office
of terrorism and financial intelligence is too important right now for us to have anything less than our best person in that role with the full backing of this senate. mr. szubin served republican and democratic administrations in senior positions related to economic sanctions in countering terrorism financing. his job is to disrupt terrorist financing by isis, al qaeda and other groups. there's absolutely no question that he's qualified. over the last decade and a half mr. szubin's distinguished himself as a tough and aggressive enforcer against north korea, money lawndz i.r.s.es, terrorists. given all the concerns surrounding terrorists financing, you would think a nomination for this position would be a priority. in the senate banking committee and in the u.s. senate in 2015 and 2016, that has not been the
case. i repeat, one year ago he was nominated. one year ago the senate banking committee got his nomination. mr. szubin's mentor bush administration under secretary stewart levy was confirmed by the senate three weeks after his nomination came to the banking committee when the democrats were in control of this senate. mr. szubin's immediate predecessor took the senate just two and a half months to consider. this is a critical national security post. it must be filled permanently. szubin heads what's in effect treasury's economic war room, managing u.s. efforts to combat terrorist financing and fight financial crimes. he leads the charge to choke off isil's funding sources and prevent it from developing additional capacity to strike targets around the world. cutting off the money supply, including profits from illicit oil sales, money laundering, extortion and other crimes by isis actor ss a critical part of our strategy to defeat this terrorist organization. he works to hold iran to its
commitment under the nuclear deal, to lead a campaign against the full range of iran's other terrorizing and destructive and destabilizing activities, including its support for hezbollah and other terror proxies. he has broad support across the political spectrum. even groups opposed to the iran nuclear deal support him. he is described as imminently qualified. the recent panama paper scandal shows how some of the world's rich's and most powerful people may have used shell companies and off shore accounts to evade taxes and launder money and dodge sanctions. the leak of these documents underscores the role that mr. szubin and the office of terrorism and financial intelligence play in cbating money laundering and terrorist finance networks. yet another reminder of why szubin's confirmation is so urgent. mr. szubin's regarded around the world for his intellect, his courage, his experience, his expertise, his integrity.
he deserves the strong backing of the senate. confirming him would demonstrate the commitment of the united states to disrupt and destroy the global financial networks of terrorist organizations. without it his position to operate here and abroad is undermined. treasury must have in place an experienced watchdog with the know-how, with the authority to lead u.s. efforts to track and choke off the financial life blood of terrorist organizations. mr. president, the bottom line is n. republicans in congress need to stop holding our national security apparatus hostage to political demands. we need to allow adam szubin and other national security nominees to be approved. the senate needs to do its job. so, mr. president, i ask unanimous consent that the senate proceed to executive session to consider calendar 478, the nomination of adam j. szubin to be under secretary for terrorism and financial crimes. if the senate proceed to vote on the nomination without
intervening action or debate and that following disposition of the nomination, the senate resume legislative session. the presiding officer: is there an objection? a senator: mr. president? the presiding officer: the senator from arkansas. a senator: reserving the right to object. i will object. mr. cotton: until just a few weeks ago i did not object to mr. szubin's nomination. i did oppose the nomination in the banking committee because he supports a clearly inconsistent interpretation of the iran threat reduction act because it would hinder the implementation of the iran nuclear deal. to be fair to mr. szubin, he is well respected on both sides of the aisle having worked in the former bush administration. i suspect this is not his interpretation. this is the interpretation of the community organizer and the nailed novelist and the political operative who are in charge of implementing these parts of the iran nuclear deal. however, i couldn't in good conshens support the nomination given that clearly flawed interpretation. to or three weeks ago secretary jack lew gave a speech in which he all but announced that the united states government was going to allow iran access to
the u.s. dollar. this would truly unravel every last sanction that we have against iran, not just for their nuclear program, but for their campaign of aggression and terror throughout the middle east. this is in direct contradiction to what secretary lew said and in direct contradiction to what mr. szubin said. in fact, i would note his testimony before the banking committee last summer. quote orks iranian banks will not be able to clear u.s. dollars through new york, hold correspondent account relationships with u.s. financial institutions or enter into financing arrangements with u.s. banks. in short, iran will continue to be denied access to the world's principle, financial and commercial market. further in another quote, nor will iran be able to access the u.s. banking sector. even for that momentary transaction to what we call dollarized a foreign payment. yet secretary lew has all but announced that the united states government will allow iran to
dollarize their foreign transactions. in fact, secretary of state john kerry just this week is meeting with his iranian counterpart to try to figure out more ways we can heap economic benefits on the world state sponsor of terrorism. so until president obama and secretary kerry and secretary lew publicly and conclusively renounce any intent to allow iran to dollarize a foreign transaction, i will object to this nomination. at the -- that the senator from ohio and 41 other democrats don't like that, they should have considered that before they voted for a deal that gave over a hundred billion dollars to the world's worst state sponsor of terrorism. i object. the presiding officer: the objection is heard. mr. brown: mr. president? the presiding officer: the senator from ohio. mr. brown: i find it ironic. this is the first time we've actually heard specific reasons all seeming fairly recent, mostly seeming fairly recent about objections to mr. szubin. i also find it interesting that they talk about sanctions are
not being fully enforced. well, don't you need someone in place that has the full appointment to the position, not just nomination and serving as interim, full appointment with confirmation. i just stand puzzled by that. but i also understand the partisan nature of this. i understand -- i remembered my colleague's letter to the 46 republican senators signed to the country of iran with -- saying for all intents and purposes don't negotiate with president obama. i mean, this is a lot about president obama. but i don't care about that. what i care about is he's the acting -- he's acting in that position and not confirming him makes no sense for our country. i -- a full year has gone by. i intend to continue to press for approval of adam szubin and others before our committee in the weeks ahead. i yield the floor.
over the supreme court vacancy created by the untimely death of justice antonin scalia. this conflict has two dimensions. one focusing on the nominee and the second focusing on the confirmation process. america's founders established a system of government that preserves liberty by limiting government and defining -- or including a defined rule for judges. three of america's founders provide principles helping to define that judicial role. james wilson signed the declaration of independence, helped draft the constitution, and was one of the six original supreme court justices appointed by president george washington. he explained our system of government by saying that -- quote -- "here the people are the masters of the government" -- unquote. the second principle is from president washington himself, who said in a farewell address on behalf of our system of government that the basis of our system of government is that
authority to control the constitution belongs to the people. alexander hamilton served in the continental congress, helped draft the constitution, and became the first secretary of the treasury. he wrote 51 of the 85 installments of the federalist papers. the single most important reference for understanding the constitution. in federalist number 78 wrote that the judiciary is the weakest and least dangerous branch because judges exercise judgment but not will. these three principles outline the proper role for judges in our system of government. the people are the masters of government. they alone have the authority to control the constitution and judges may exercise judgment but not will. our system of government and the liberty it makes possible requires judges who leave control of the law in the hands of the people.
the conflict over the appointment of judges is really a conflict over the power of judges. a conflict over whether this should still be the proper judicial job prescription -- description. those whose political agenda fares poorly with the american people and their elected representatives want a very different kind of judge. they want willful judges who will impose their political agenda by manipulating statutes or the constitution. this is the first dimension of the conflict over filling the scalia vacancy. i have spoken and written extensively about how the senate owes the president some deference regarding nominees who are qualified by both legal experience and judicial philosophy. those considerations are relevant when the confirmation takes -- process takes place. the second dimension in the conflict over filling the scalia
vacancy, however, focuses on the process rather than the nominee -- when and how the confirmation process should occur is rarely a question at all, but it is a serious one under the circumstances we face today. ignoring the integrity of the process, actioning as if -- acting as if the ends always justify the means, would be a serious dereliction of the senate's duty. the president has the constitutional power to nominate judges, but he cannot appoint them. -- without the advice and consent of the senate. the constitution, however, does not tell either the president or the senate how to exercise their powers. deciding when and how to conduct the confirmation process is as valid an exercise of the senate's advice and consent power as is taking a final confirmation vote at the end of that process. our late colleague daniel
patrick moynihan of new york once said that everyone is entitled to his own opinion but not his own facts. the minority leader recently offered a similar axiom when he said that quote -- quote -- "nor how many times you tell a falsehood, it is still false." democrats and their liberal allies are telling them real whoppers. the minority leader, he can, has said that the senate's obligation to hold a hearing and a floor vote for president obama's nominee is -- quote -- "in the constitution" -- unquote. he has made that claim in different forms here on the senate floor more than 40 times. i understand that democrats want the senate to confirm the president's nominee to the scalia vacancy, but i cannot understand why they would put all their eggs in this completely fictional basket. as falsehoods go, this one is especially easy toexpose because the constitution obviously says in a such thing.
this is why the "washington post" fact-checker called the democrats' claim that the constitution requires senate consideration a politically convenient fairy tale. one of the reasons that the constitution says nothing about judiciary committee hearings is that the committee was not created until 29 years after the constitution was written. in fact, the committee's practice of nominees regularly appearing in public hearings did not begin until the 1960's, during the 110th congress, chairman patrick leahy deny add hearing to dozens -- denied a hearing to dozens of president george w. bush's judicial nominees. if the minority leader is right that the constitution requires such a hearing, then chairman leahy was guilty of serially violating the constitution. between 2003 and 2007, senators patrick leahy, charles schumer, and richard durbin voted dozens of times to deny floor votes to
republican judicial nominees. so did senators hillary clinton, joseph biden, and john kerry. if the minority leader is right that the constitution requires a floor vote on every nominee, then these senators were guilty of deliberately attempting to violate the constitution over and over again. so was the minority leader himself because he voted 25 times to deny the very floor votes that today he claims the constitution requires. the constitution does not require committee hearings and it does not require floor votes. the constitution leaves to the senate the judgment about when and how to conduct the confirmation process and each situation. republicans have made that judgment by deciding that the kreurgs process for filling the scalia vacancy should be deferred until after the
presidential election season is over. we're following the recommendation of vice president joe biden in 19 1992 when he chaired the judiciary committee. the circumstances compelling his recommendation to defer the confirmation process exists in equal or greater measure today. neither democrats nor their left-wing allies have ever attempted to argue that the 1992 biden speech and his recommendation do not apply today. instead they have had three different reactions. first, some have simply dismissed it as not worth taking seriously. president obama, for example, responded by saying, -- quote -- "we know senators say stuff all the time." others have complained that republicans are misconstruing that speech or somehow taking it out of context. just as anyone contesthes t minority leader's claim about the constitution by reading the
constitution, however they contest our discussion to chairman biden's 1992 speech by reading that speech. "the washington post" read it and reported this on february 23. let me just refer to this chart right here. biden's remarks -- quote -- "biden's remarks were spoeurbl spoeurbl -- especially pointed voluminous and relevant to the current situation. embedded in his roughly 20,000 words he delivered on the senate floor where rebuttals to virtually every point democrats have brought forth to argue for the consideration of obama's nominee." in his 1992 speech, chairman biden addressed how the confirmation process should be conducted in two different scenarios. first, he spoke about a supreme court vacancy and a presidential election year. this was his recommendation right here. let me just make the quote to
you. "it would be our pragmatic conclusion that once the political season is underway -- and it is -- action on a supreme court nomination must be put off until after the election campaign is over." that was then-senator biden, chairman of the committee. second, chairman biden separately discussed how the confirmation process -- quote -- "might be changed in the next administration, whether it is a democrat or a republican." he used the phrase "the next administration" no less than four times. this was his recommendation -- quote -- "if the president consults and cooperates with the senate or moderates his selections absent consultation, then his nominees may enjoy my support. but if he does not, as is the president's right, then i will oppose his future nominees as is my right." unquote. two separate scenarios, two
separate recommendations. the first scenario involved a supreme court vacancy in a presidential year, like 1992. and the recommendation involved the entire appointment process. those circumstances and that recommendation apply fully today. the second scenario chairman biden addressed involved the next administration outside a presidential election year. and his recommendation involved his personal support or opposition. those circumstances and that recommendation do not apply today. i understand that chairman biden's recommendation for deferring the confirmation process in a presidential election year is a very inconvenient truth for his party today. the only ones misconstruing that speech today, however, are those trying to create confusion where none exists by conflating these two separate scenarios and
recommendations. the third reaction to chairman biden's 1992 speech is to pretend that he said something he simply did not say. i've heard the claim, for example, that chairman biden would have gone forward with the confirmation process in 1992 if the president consulted the senate before choosing a nominee. let me once again quote the minority leader. it's pretty clear. "no matter how many times you tell a falsehood, it is still false." unquote. read his speech. chairman biden said no such thing. i also want to comment on the president's recent remarks about the scalia vacancy at the university of chicago. he said, for example, that -- quote -- "there has not been a circumstance in which a republican president's appointee did not get a hearing." unquote. the senate's power of advice and consent of course applies across the board. if the constitution requires
hearings and floor votes for some nominees, it requires them for all nominees. last month the congressional research service confirmed in a new memo that during the 102nd congress, when democrats control the senate, 52 -- 52 -- republican judicial nominees never even got a hearing. vice president biden chaired the committee and denied those hearings. in september 1992, "the new york times" reported on page 1 that this was part of a deliberate strategy to keep judicial vacancies open in the hope that bill clinton would be elected. the president also said that there has not been a circumstance when a republican president's nominee did not get a floor vote. obviously none of the dozens of nominees denied a hearing ever got a floor vote. the 52 republican judicial
nominees i just mentioned were not only deep tphaoeud -- denied a hearing, they were never confirmed at all. when the president served in this body, he voted to deny floor votes to multiple republican judicial nominees. in fact, he has the distinction of being the only president ever to have voted to filibuster a supreme court nominee. the president was a senator during the 110th congress when chairman leahy denied a hearing to dozens of republican nominees. i could find no record that then-senator obama objected in any way that these nominees were being denied full consideration. the president also said that the increasing use of the filibuster to defeat nominees is unacceptable. democrats first used the filibuster to defeat a majority support of judicial nominee in 2003. they were the ones who started this. they led nearly two dozen
filibusters during the 108th congress alone preventing one appeals court nominee after another from being confirmed. president obama should know this because, as i mentioned, he participated in and supported this filibuster campaign. the president should also know that filibusters of judicial nominees declined by 65% after he took office in january 2009. that did not matter to democrats who in november 2013 abolished the very filibusters they had used so aggressively. the president also expressed concern that an increasing partisan confirmation process would erode the judiciary's institutional integrity and that the american people will lose confidence that courts can fairly decide cases. i submit that the kind of judge
a president advocates has a much bigger impact on the american people's view of the courts. when he was a senator, the president said that judges decide cases based on their personal views, concerns and what is in their hearts. when he ran for president, he told planned parenthood he would appoint judges who have empathy for certain groups. as president, he has nominated men and women who share this politicized activist approach. believing that judges may make the constitution conform to current social practices and evolving cultural norms. our fellow citizens, i think, can easily see that relying on personal empathy and personal concerns is the opposite of impartiality. since president obama took office, the percentage of americans disproving of the way the supreme court is handling its job has risen by more than
20 points, and the percentage saying the court is too liberal has risen steadily. three-quarters of americans now believe that supreme court justices decide cases based on their personal or political views even though most americans think they should not do so. is the kind of judge that president obama and other liberals favor has much more to do with such trends than how we handle some procedural matters within the united states senate. finally, i want to respond to the minority leader's recent attack on the judiciary committee and its distinguished chairman, senator grassley. the minority leader recently made the bizarre claim that chairman grassley -- quote -- "forced his committee members to sign --" i first thought i must have heard wrong. that statement is completely
detached from reality. and i thought no senator would utter something so strange on the senate floor, but there it is in the "congressional record." the minority leader may be referring to the letter dated february 23 signed by the republican members of the judiciary committee affirming that there will be no hearing for any nominee from president obama for the scalia vacancy. the chairman did not force anyone to sign anything. it may come as a surprise to the minority leader, but we sincerely and freely came to the conclusion that the confirmation process should be deferred. but if the minority leader really wants to characterize senators acting together as evidence of a -- quote -- "loyalty oath" then i have another example for everyone to consider. when democrats led 20 filibusters of president george w. bush's judicial nominees during the 108th congress, not a single democrat voted even once to end debate.
not one. every one of the 868 total votes for those filibusters was cast by a democrat. 20 of them by the minority leader himself. now that's loyalty. mr. president, i have yet to hear an argument from the other side regarding the scalia vacancy that is not contradicted by present facts, by their own past actions or both. the constitution assigns to this body the responsibility of advice and consent as an important check on the president's power to appoint. advice and consent begins with the judgment about the best way to exercise that power in each situation. we have done so in different ways at different times, under different circumstances. democrats and their left-wing allies are peddling the false claim that the constitution requires the senate to conduct the confirmation process now for
this president's nominee to the scalia vacancy. they are of course free to claim that the constitution requires today the very hearings and floor votes that they denied to republican nominees in the past. they may say those falsehoods as often as they wish, but they are still false. mr. president, i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:
that today is the one-year anniversary of adam szubin's nomination to a key federal post that works to stop financing for terrorism. ms. heitkamp: yet he still waits a confirmation vote in the full united states senate. mr. szubin, if you've met him, i think almost anyone would agree he is one of the most qualified people for this job to enforce u.s. sanctions and terrorism finance laws against countries like seer yarks iran, north korea -- syria, iran, north korea as well as against terrorist organizations, narco traffickers and money launde launderers. the senate needs to do its job by holding a vote on mr. szubin's nomination as well as the nominations of so many other federal nominees. we have to stop putting politics above national security. exactly one year ago today adam szubin was nominated to serve on
u.s. treasury's department under secretary for terrorism and financial crimes. and for one year adam szubin and his family have been waiting if a vote in the united states senate. and his family. i think way too often when we delay votes, when we string out these nomination processes we forget that it's not just the nominee. it's also the families of the nominees that are waiting a final decision. mr. szubin received a vote in the senate banking committee in march. now the senate needs to do its job and vote on his confirmation up or down. i have a particular soft spot for adam because i am convinced that he is one of the most intelligent people i have ever had in my office. and especially in this critical and important job. he has 15 years of experience
countering the financing of terrorism in both republican and democratic administrations. during mr. szubin's confirmation in the senate banking committee last september, chairman shelby had called mr. szubin eminently qualified. if we're serious about enforcing sanctions against iran and defeating terrorist organizations like isil and al qaeda, we have to stop the financing of terrorisms. -- of terrorism. that means we need adam szubin to be able to do his job at the united states department of treasury. in january i visited the mideast on an official senate trip with seven other senators. we visited saudi arabia, turkey, israel, and austria. the goal was to learn more about the ongoing threats posed by terrorist groups like isil and the progress that we've made to roll back iran's nuclear program. we met with allies in the region to learn more about how to best
prepare the united states to face these issues. this trip was about protecting the safety and well-being of our country. during our meetings, the issue that came up over and over and over again is how do we stop the financing of terrorism. we know that financing is the linchpin of a terrorist organization to be able to do everything that they do threatening our country and threaten the world. for the united states to ably and effectively do that work, adam szubin needs to be confirmed to the job that he has been recommended. so some would say it doesn't really matter that adam szubin is still at the department of treasury and we really don't need to do this. i think we need to look at, number one, what it means for the individual and their
families when we delay these confirmation votes. and i'm not saying and members on both sides of the aisle will have to make up their mind on how they're going to vote on that confirmation. but why is it that we can't even get a vote? why is it that we can't even get our job done? and here is a position for which most people in this body would say is absolutely critical to the security of our country. if adam szubin isn't the right guy for the job, the right person for the job, then let's find that out according to the advice and consent of this body and nominate somebody else. but why are we holding back on this critical job against a nominee that i would tell you is eminently qualified and we should be so lucky as to have someone with his qualifications, his capability helping protect our country. yet we ask him to wait.
we ask other nominees to wait. we ask that they sit by the sideline ws their professional -- sidelines with their professional life in limbo while we have political discussions in the united states senate. is this a political decision? might be. but you know what? let's take the vote. how is this so hard? how is it so hard to actually put up a number of nominees, take the vote, make the decision, and move on. i think that as i and many of my colleagues spend a lot of time talking to young people, encouraging them to be involved in public service, encouraging them to be part of a system that really does benefit all the people of this country, we ask people to go into public service and then when they aspire and work to achieve some of the highest positions in our country, we say not only are we not going to consider your familiar nation, we're not going
to vote on it even after it comes out of committee. that is not a formula that speaks well to our recruitment of the best and brightest in serving the american people. and so a year later adam szubin remains in limbo. his family remains in limbo. his confirmation remains in limbo. please let's just vote. there's plenty of votes probably on the other side to say we're not going to confirm you. but it is not right. it is not right. it's not fair to his family. it's not fair to him. and it's not fair to the people of this country to not have a confirmed person in the position that adam szubin has been nominated for. with that, mr. chairman, i hope that we can take a look at all of these nominees, break this logjam and eventually get folks put in positions that are
essential for american security. i yield the floor. a senator: mr. president? the presiding officer: the senator from tennessee. a senator: mr. president, on behalf of the senator from california and myself, i ask unanimous consent that the committee reported substitute for h.r. 2028 be withdrawn and that amendment number 3801 remain pending and be considered the committee reported substitute amendment. the presiding officer: the presiding officer: is there an objection? without objection so ordered lex mr. president, i notice the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:
mr. toomey: mr. president? the presiding officer: the senator from pennsylvania. mr. toomey: mr. president, i ask unanimous consent that the quorum call be dispensed with. the presiding officer: without objection. mr. toomey: thank you, mr. president. i rise this afternoon to talk about a huge problem that's affecting, i'm pretty sure, every one of our states. i no know it's a certainly affecting my state in a very, very serious way. this is the abuse of opioid painkillers, which often leads to the abuse of heroin and leads
to overdose and is leading to deaths. mr. president, this is just wreaking havoc all across pennsylvania. it is affecting every geographic part of the state. it's in urban areas, suburban, rural areas. it's every demographic group, every age group, and the scale of the problem is shocking. the increase in the number of people that are overdosing, that are becoming addicted is really, really disturbing. i began hearing about this immediately when i became senator in 2011, and this problem frankly is getting worse. recently i became the chairman of the senate finance subcommittee on health, and that's given me an opportunity to delve into this ever more deeply. we've had a series of hearings across pennsylvania to get as
much expertise as possible, so that we can learn about what's causing this, how do we deal with it, and there's three areas that have come to my attention, three directions that i think the federal government can pursue to help deal with this very complex, very widespread problem of opioid addiction. one is certainly to improve the access to and the quality of treatment for people who are addicted. there's no question that this is a very, very difficult disease to treat. there's so much of it we don't understand. we don't understand what predisposes someone to be more likely to develop an addiction. we don't develop the genetic implications. we know there's some -- there's behavioral issues -- we just don't understand as much as we need to understand about it. we know that often there are underlying mental health issues
that contribute to this problem. but whatever these causes are, we need to learn more so that we can treat them better and prevent them better, and we need to treat the people who are currently finding themselves in the very, very difficult situation of facing addiction. so i would say that's category number one, mr. president. but there's another thing that we can do here in the federal government, and that is take steps to reduce the diversion of these powerful prescription narcotics to the black markets. in fact, prescription opioids are available on the street for a price. there is a market for them, and they contribute to the addiction problem that we have. they don't get there because a burglar broke in and stole them from a pharmacy. that's not the typical way that these narcotics get to the street. they get there because someone prescribed it and a prescription was filled. and so we need to look at ways
to reduce that phenomenon. i introduced legislation with senator casey, my pennsylvania colleague -- also with senators portman, senator brown, and senator king -- and that legislation was designed to do just that; to reduce the frequency, the occurrence of prescription opioids finding their way into the black market of th-- and the way our bill wos it provides to medicare a tool that medicaid and private insurers have long had. and that's a tool called lock-in. and when it refers to is when an insurer -- in the case of our legislation, it would be medicare -- when the insurer discovers that a patient is doctor shopping, systematically going to multiple doctors, getting multiple prescriptions for opioids, then filling them at multiple pharmacies and ending up with a commercial-scale quantity, what our legislation would do is
allow our -- any person with a legitimate need can get that need met but we could put an end to some of these very large quantities reaching the black markets. the good news is our legislation was offered as an amendment -- senator casey and i offered it as an amendment to the cara legislation a few weeks ago. it was adopted by the senate and of course the underlying cara legislation bassed by the senate -- was passed by the senate. so i'm hoping that the house will take this up, will pass this and we'll get it to the president who i'm confident will sign t that would be a good step in the right direction. the third category of action that i think we need to consider is steps that would reduce overprescribing, recovery prescribing in the first -- overprescribing in the first place. one of the things that i've learned from the many a had across par is doctors who are
told me and described for me a culture within medicine which has put so much emphasis on eliminating all pain that doctors are tending to prescribe these opioids in far greater quantities than would have been imagined certainly a couple of decades ago. so that -- that's an important piece. you've raised questions about -- i've raised questions about whether it is appropriate to use opioids to treat long-term chronic pain as opposed to short-term acute pain. that's another area that we ought to be raising questions for health care professionals to help us understand and answer. but there's yet another way, mr. president, that i think we can address here in the senate, and that is an unintended consequence of obamacare, a provision in obamacare that i think is encouraging doctors to overprescribe opioids in the hospital setting, and that's
what i want to talk about toda. so a little background on this. obamacare created a system that provides financial rewards to hospitals that perform well on certain outcomes, like reducing readmissions and hospital-acquired infections, for instance. and if you do badly in those areas, then you are penalizinged, you get lower reimbursements. so it is a financial set of incentives to get better outcomes. and those two examples that i just mentioned, those are objective. those are measurable. those are quantifiable. and there's little doubt that we want to see less of those things. you can tharg it makes sense to -- you can argue that it makes sense to have financial incentives to deal with that. but obamacare also links reimbursement for hospitals to a much more subjective outcome separate aapart from the ones i just mentioned.
specifically, the federal government mandates that hospital survey their patients will their stay at a hospital, using a form known as the hospital consumer assessment of health care providers and systems, or h-caps. it is known as h-caps. that's the survey that hospitals are required by obamacare to administer to their patients. and hospitals that have a higher score on this survey get more money, and hospitals that have lower scores on the survey get less money. there's roughly $500 million swing -- i'd say nationally, across the country -- based on the -- these personal patient satisfaction scores alone. so it's not just that the government is saying that these scores are important, the government is making it financially important to these
hospitals. well, this raises a question, and the question is: is the hospital score on some bureaucrat's test always in the patient's best interest? it's not clear to me that it always s now, there's no doubt that hospitals, physicians, nurses, health care providers generally -- of course they wnts to have satisfied patients. we all dovment we want to be a satisfied patient when we go to see a doctor or go to the hospital. it is obviously a good thing if a patient has as good an experience as possible. but specifically the survey questions on pain management per se raise a lost red flags, not just with me, with health care professionals, with people who have been studying this. a recent "time" magazine article -- and we've got a little excerpt here -- and the title was "how obamacare is fueling america's opioid epidemic." and this article is a lengthy
investigation into the unintended but, as i said, predictable consequences of this obamacare-created h-cap survey, and specifically the questions in the survey that relate to pain management and the prescriptions of opioids. here s from the survey. one of the questions is: during this hospital stay, did you need medicine for pain? the second question, during this hospital stay, how often was your pain well controlled? and finally, during this hospital stay, how often did the hospital staff do everything they could to help you with your pain? these are the questions that patients respond to and they contribute to the overall score on the test and the score on the test determines in part the level at which the hospital is reimbursed by medicare. there's a very powerful
financial incentive for hospitals to make sure that patients are answering these questions in a way that will get the desired response from c.m.s., from medicare. they're graded on these questions. so it's a big incentive. and when you tie the measurement of these kinds of questions to reimbursement, you're very likely to get changes in behavior. and in fact, that seems to be what's happening. you know, i think we need to ask ourselves whether we're striking the appropriate balance here when 27,000 people are dying from heroin and prescription painkiller overdoses. and many of the people who are dying from heroin overdoses began with prescription opioids, and they moved on to heroin when they discovered that it was cheaper and more available than the prescription opioid that they god addicted -- they got addicted to in the first place
so there is increasing evidence now that physicians and hospitals are in fact responding to these incentives, these financial incentives, and they're responding by prescribing more opioids. dr. nick sawyer, a health policy fellow at the u.c. davis department of emergency medicine told "time" magazine -- and i quote -- "the government is telling us we need to make sure a patient's pain is under control. it's hard to make them happy without a narcotic. this policy is leading to ongoing opioid abuse." end quote. the survey by south carolina medical association found almost half of over 150 doctors responding, these doctors reported themselves that they were prescribing inappropriate narcotic pain medication because of the patient's satisfaction questions. one doctor wrote that drug seekers -- quote -- "are well aware of the patient's
satisfaction scores and how they can use these threats and complaints to obtain narcotics." here's two examples from a story titled patient satisfaction is overrated published by the family academy of physicians from a survey that often includes these h-cap questions. one doctor reported he had to give dilaudid for minor pain because his score on this test was too low the previous month. an emergency room doctor with poor survey scores started offering hydro codone goody bags to dispatients to improve his ratings -- to discharge patients to improve his ratings. i have had multiple hearings across pennsylvania to hear firsthand from recovering
addicts law enforcement people who were dealing with these issues in a variety of ways. one of the our witnesses last october was dr. jack kobany. he testified -- and i quote -- "physicians who have compensation or employment tied to patient satisfaction scores may feel pressured to prescribe opioids in response to patient pain complaints. another e.r. doctor told my doctor how his hospital administrator told him that the e.r. patient satisfaction scores were in the 50th percentile or average and that he should find a way to get them higher or -- quote -- "i'll find someone who can." end quote. this is a big concern. this is a range of evidence that doctors and hospitals have been changing their prescribing habits in response to these pain
questions. now let me be clear about one thing. none of us wants to see anyone needlessly suffer. none of us wants to themselves go through pain that's unnecessary. none of us want to see a loved one or anybody experiencing pain if it could be appropriately managed. and for the terminally ill, then of course it makes sense to do everything possible to make those folks as comfortable as they can in their final days. but what i'm asking is are we appropriately weighing the risks and the benefits here? sure, there is a benefit to complete and immediate elimination of all pain that a powerful narcotic can temporarily provide. but we know that there is also a risk of addiction to that narcotic. that risk is very significant. it's increased exponentially and that addiction is incredibly dangerous because it can spiral
out of control and lead to even heroin abuse, addiction and death. have we gone too far in creating an expectation that the result for every patient must be zero pain? or are there some circumstances in which it's better to treat pain as best we can with nonnarcotics, other ways or other medicines, or other treatments. there's physical therapy. there are other ways to diminish pain. it may not be 100% effective all the time, but if it's temporary and it has zero risk of opioid addiction, maybe we ought to be considering that a little more frequently. so, mr. president, let me say this is definitely a complicated issue. there are many factors contributing to the heroin epidemic, the opioid epidemic, but it's increasingly looking like one of the contributing
factors at some level is the financial incentives created by this aspect of obamacare, this particular questionnaire that focuses significantly on complete elimination of pain. and i think we need to ask ourselves whether this is appropriate. last week the group physicians for responsible opioid prescribing sent a petition signed by more than 60 nonprofit groups and medical experts including pennsylvania's department of health secretary karen murphy, they sent a letter to c.m.s. calling for the removal of the pain questions from the h-cap survey. that's one approach. senator johnson from wisconsin, he's introduced a bipartisan bill that has a lot of merit. his bill is called the promoting responsible opioid prescribing act. what his bill does is it removes the results of the pain questions from medicare's calculations of reimbursement. so the questions would still be asked. we would still learn about how
patients feel about the extent to which their pain was managed. but it wouldn't affect the hospital's reimbursement. i think there's a lot of merit to that proposal. and again, mr. president, it's because we are in the midst of a deadly crisis. it is killing people every day. the impact of opioid addiction and heroin addiction and overdose on a family is so, so devastating, i can only imagine the grief, but i know people who have been through the grief of losing a child, losing a loved one to this terrible scourge. and that's why i'm down here on the senate floor today. that's why i want to continue to focus on this. i think there are many things that we need to consider, but one of them is decoupling the results of these pain questions from the level of reimbursement, because the evidence is starting to mount that the financial tie is creating incentives to change
a senator: i ask that the quorum call be lifted. the presiding officer: without objection. mr. blumenthal: thank you, mr. president. mr. president, the faces and voices of the opioid and heroin epidemic are all around us. the victims and survivors are everywhere in connecticut and across the country. just this past weekend one of them perished, a young woman, erica lynn hughes, found unconscious in her boyfriend's apartment, later dying from a heroin overdose. erica was only 21 years old, her whole life ahead of her and a future destroyed as a result of
this epidemic. and her family bravely and strongly has chosen to speak out and stand up in the midst of their shock and grief to say that they hope that erica's story will inspire action to combat this epidemic of overdose and addiction. rampant opioid overdose and abuse and misuse in our country has reached epidemic proportions, and it shows no signs of slowing. in connecticut, i've seen these stories firsthand, how this public health hurricane has swept our state and our nation, crashing down on the lives of families and innocent people much as a natural disaster would
destroy homes or landscape, leaving a path of pain, heartbreak and addiction in its wake. the numbers in connecticut are as shocking as they are tragic. last year in my state, a record number of people, nearly 700, died from opioid overdoses. sadly, this number is abstract but it reflects a disheartening trend that has led to a 75% increase in prescription drug overdoses in connecticut since 2012. and i've seen these stories and faces and voices firsthand in round tables that i conducted around the state of connecticut, nine in all, involving public health experts, doctors,
specialists, public officials, law enforcement, and maybe most movingly and profoundly, recovering addicts and their families. i heard from parents who have buried children far too young. i heard from first responders whose quick actions save lives using narcan. i heard from doctors who understand the changes needed to prevent this disease from spreading further and from families and professionals in torington and rocky hill, willimantic, bridgeport, london, new haven, across our state, people who came forth to break the silence and defeat the denial that is one of our greatest enemies in this fight
against opioid addiction and dispute. this problem knows no boundaries, no distinctions in income, race, religion, zip code. it afflicts and affects everyone everywhere. and that is the beginning truth to solve the problem. i heard heartbreaking stories from a woman who lost both of her sons to addiction. the sobering conversations i had with her family and others while not always easy were absolutely crucial to my understanding how widespread and pervasive this problem is. what i heard from them and what i believe is necessary is a call
to action. it is more than an effort to honor their legacy. the legacy of connecticut citizens we lost last year, mothers and fathers, daughters and sons, sisters and brothers. but to teach every one of us how we can reach and assist those who are still fighting their own private battles against this disease and make no mistake, it is a disease. it is every bit a disease as much as any that we discuss on this floor as requiring research and action and urgent and drastic steps that we can and must provide because it is demeaning and reducing our
nation's fabric. it goes to the core of america. these conversations led me to do a report, and i was inspired by the loved ones and families who have lost the most. they've lost members of their family to do a call to action. and it's called opioid addiction, a call to action which has specific and definite recommendations, 23 of them, some requiring funding but others without fiscal impacts. and in a series of speeches on the floor, i hope to discuss them at length, not leave this issue at one talk, one speech, one remark but talk about it continuously as we all should be
doing in our communities because again denial and silence are the enemies here. this report outlines 23 policy proposal focusing on curing our nation's addiction to opioids. the proposals are all grass roots, community-based solutions suggested by people who have a first-hand knowledge. they are experts, maybe not in academic training, maybe without ph.d.'s and qualifications based on formal study, but they know this pervasive problem. they've seen it firsthand. they have observed the wreckage and destruction that opioid addiction causes, and they cannot bring back the lives of their loved ones but they are determined that others will be spared this hurricane's effects.
each of these proposals which touch on prescribing practices, adequate treatment, emergency medical response, law enforcement, and help for our veterans has the common goal of ending this crisis. they are a response to the most pressing issues i heard throughout our conversations. while none is a panacea, none is a single bullet, all of them together are the beginning of a long process that must be undertaken toward curbing this epidemic. a place to start is with our prescribing practices which is where misuse and abuse so often begin. our nation makes up 5 mrs of the -- 5% of the world's population. we use 80% of its opioid painkillers.
in 2012 doctors wrote 259 million prescriptions for painkillers, enough for every american adult to have a bottle of these controlled substances for themselves, everyone a bottle of painkillers in the united states. now, many of us have children. my wife, cynthia, and i have four. every one of them has played sports. every one of them has suffered sports injuries, and most of them could have availed themselves of these painkillers. we drew the line and said no. other parents should be doing the same, but more important the providers should be exercising greater discipline and self-restraint. because every one of those bottles, even if prescribed for
legitimate injury, broken bones, repaired lcl, other kinds of injuries are potentially a risk. just last week a couple in connecticut were arrested for selling pain killers out of their home. for two years they collected 1400 powerful painkillers from their local pharmacy. abusing their own prescriptions in the process. in the pharmacy visit that got them arrested, the couple picked up 300 oxycodone and 140 oxy morphine tablets. this flagrant misuse of the system cannot and should not be possible in our state or any other. there are legitimate reasons for
pain killers to be prescribed, especially in the case of chronic pain or end of life situation. there's no need to deprive people of those pain killers when they need them for those inevitable reasons. but my call to action outlines steps to confront this issue where it can be addressed so as to minimize the risk of abuse or misuse or overuse, especially when young people are involved, such as our children. it would mandate training for medical professionals to reduce opioid overprescribing. it would call for drug enforcement agency guidelines for partial fill of opioids, meaning fewer of these deadly drugs would make it on to our streets. of course reducing prescriptions can't be the only answer,
particularly when so many who need care go without it. my report also seeks to improve treatment options, calling for meaningful mental health parity and implementation of the law requiring it much more vigorous and effective enforcement to ensure that people who need help actually receive it. this step includes access to medication and assisted therapy that can prove essential to the recovery process. we can do more to guarantee that that lax yoan -- that lax yoan -- nalaxone remains both affordable and accessible. this means holding manufacturers accountable when they begin raising prices to astronomical
levels. the prices have been skyrocketing. local police and firefighters are often unable to afford it in their current budgets, and it means also pushing for elimination of co-pays when it's prescribed at pharmacies. insurance ought to cover it. it also means that the federal government must do our part and increase funding for narcan so that cash-strapped first responders can actually afford it to save lives. law enforcement officials require both the training and resources needed to keep our streets safe and our communities healthy and drug free. and that means funding to establish prescription drug monitoring programs. really fecialghtive programs to take -- effective programs to
facilitate training so that police officers can recognize when suspected criminals are actually people struggling with addiction and to assist drug takeback programs throughout our state and nation that allow the return of unused prescription drugs. finally in my role as ranking member on the senate veterans affairs committee, i encourage the establishment of more consistent and safe v.a. prescribing practices and the creation of an integrated service model for mental health and pain management. i am pleased that the senate raised this issue and addressed it and passed the addiction recovery act earlier this year. but that measure is a downpayment. it's only a beginning. i hope that policy levels have all -- of all ranges of government will draw on the strategies delineated in this
legislation and in my report and elsewhere to combat the devastating epidemic of addiction and abuse. passing new laws is not the only answer. enforcement and implementation of existing ones is necessary, too. and the prime example is on mental health care where still years after president bush signed that measure in 2008, its implementation is inconsistent and inadequate and enforcement of mental health parity remains an aspiration, not an action. part of what we need to do is make sure that existing laws are implemented effectively and fairly and that the investment is made in common sense practical measures like the 23
recommendations i've outlined in this report, by no means a sole or exclusive way to deal with this problem. i have no pride of authorship in these 23 recommendations. i would yield to wiser and better suggestion, but the point is action is necessary. it's necessary now because every day we lose lives. despite the best efforts of our first responders and our medical community, we continue to lose lives and futures and our families continue the grief and heartbreak that i saw in my round table and that families in connecticut feel today. i thank you, mr. president. i yield the floor. a senator: mr. president? the presiding officer: the senator from florida. a senator: mr. president, i want to speak today about the fiscal
crisis that faces puerto rico. in addition to offering some thoughts on what the island's own leaders need to do, i would like to commend the house leadership for their efforts to solve the problem with the recent bill they proposed. we need to take a close look at their proposed solutions because their right to tackle this problem head-on and i look forward to offering more ideas as the debate i hope reaches the senate. mr. rubio: whenever i speak about puerto rico, i would like to start by reminding people of a very basic fact. the people of puerto rico are american citizens and right now they are living in dire economic conditions. more than three and a half million of our fellow americans on the island of facing tremendous economic hardship in large part because of irresponsible leadership from the government in san juan. as we all know puerto rico has a debt crisis of enormous proportions and it has thrown off the stability of its economy from top to bottom. while some have suggested washington can deliver a silver bullet solution to help puerto rico out of its debt, the reality is nothing washington does will be effective unless
puerto rico's leaders turn away from decades of failed policies. the debt crisis goes hand in hand with a deeper problem. puerto rico's economy is not growing and if the economy in puerto rico does not start growing, they will never generate the revenue necessary to pay their debt or their billions of dollars in unfunded liabilities that they currently have on their books. in other words, the promised payments they have made to future generations, they're completely unreal list sticks. why is their economy not growing? decades of left-leaning economic policies that have made it too expensive to do business. the tax rate in puerto rico is too high. government regulations are stifling. the island is unattractive to investors, their leadership has simply been irresponsible. this year alone, even with all the fiscal problems they're having, they barely row duced their budget from last year. in that serntion the problem in puerto rico is not unlike the problem we have here in washington, d.c. puerto rico, it's government is spending more money than it
takes in, and anytime you spend more than you take in, you're going to have debt. no restructuring is going to solve that unless you restructure the way you spend money. and the bankruptcy protection alone is not going to solve it either. without reforms, if we grant bankruptcy protection by itself, puerto rico will simply be bankrupt again not far down the road. as a result of all these problems, there is a massive exodus of professionals and others from puerto rico. they're leaving and heading to florida and other places in the mainland united states. if we don't solve the problem on the island, you're going to continue seeing thousands of puerto ricans leave, which is going to further cripple the island's economy and reduce its revenue. so the leadership in san juan has to show its willingness to get their fiscal house in order. they need to accept that their decades of liberal policies have not sick seeded and must knorr now be traded in for pro-growth policies. if they keep refusing to do this, our options in washington
will be more limited and we won't have support. to help puerto rico, first and foremost we need to do the same things necessary to help the rest of the united states. we need pro-growth and pro-family tax reform at the federal level. we also need to repeal the and replace obamacare so we can end the disproportionate damage the obama administration has inflicted on the island by raiding its medicare advantage funding and reducing reimbursement payments for medicare, which have left patients with fewer health options and higher costs. puerto rican consumers need to be treated the same as other american consumers on the mainland. it may be that the best path forward for puerto rico would be at some point to include a limited opportunity to restructure it's debts. but that would require a serious discussion first to ensure the solution is responsible and fair to creditors as well. any mechanism for debt restructuring must be a last resort. it must come after brain leaders have shown -- brain leader leade
-- puerto rican leaders have shown courage in tackling the problem. it cannot be seen as the silver bullet. otherwise, protection will only amount to a cosmetic solution that does not nothing to deal with the underlying disease. in close, the problem must be addressed for the sake of the people of puerto rico. and while there is a significant amount of responsibility on the shoulders of the government on the island, we cannot ignore that crisis here either. we, too, have a responsibility to our fellow americans who live on the island of puerto rico to tackle this issue with the same urgency and the same attention that we would if this fiscal crisis was confronting one of our 50 states. and so i hope that we will take up this calling and act. i congratulate again the leadership in the house for trying to do something and we hope they'll continue that work to arrive at something that can pass there. but i think it's important for us to take up the cause here as well. for over a century, puerto ricans have contributed to our economy. they've enriched our culture and
noblably sacrificed in our wars. puerto ricans are americans. they deserve better than indifferent leadership in washington and atrocious big-government management in san wafnlt puerto rico's leaders must answer the challenge but by taking some of the steps outlined herbs leaders in washington can and must do their part as well. with that, mada mr. president, i yield the floor. the presiding officer: the senator from arizona. mr. mccain: i ask unanimous consent to address the senate as if in morning business. the presiding officer: without objection. mr. mccain: last week a story appeared in fox news that captured a glimpse of the real damage being done to our military by years of senseless budget cuts known to many of us here as sequestration. mr. president, i don't think there's one -- 100 americans who know what the word "sequestration" means. but what it means is senseless budget cuts that have
emasculated our military and harmed our ability dramatically to defend this nation. this poses a risk to the lives of the men and women who are serving our nation in uniform. in a story entitled "budget cuts leaving marine corps aircraft grounded" marine officers warn fox news that the marine corps aviation service is being stretched to the breaking point -- unquote. today the vast majority -- i quote from the story. "today the vast majority of american corps aisht can't fly. out of 276-18 hornet strike fighters in the marine corps inventory, only about 30% are ready to fly. similarly, only 42 of 147 heavy-lift ch-53 super-stallion helicopters are air-worthy. in short, marine corps aviation is in a crisis and being left grounded. what is the cause of this
crisis? according to dozens of marines interviewed by fox news -- quote -- "the reason behind the grounding of these aircraft include the toll of the long wars in afghanistan and iraq, the fight against isis, and budget cuts -- i.e., sequestration -- precluding the purchase of the parts needed to fix an aging fleet." the report continued to say, "u.s. military spending declined from $691 billion to $560 billion in 2015." so as the world has become more dangerous, as conflict has spread throughout the world, the cuts have taken place in an unscheduled, unplanned, and unorchestrated operation. the cuts come just as the planes were returning from 15 years of war, suffering from overuse and extreme wear and tear.
lack of funds has forced the marines to go outside the normal supply chain to procure desperately needed parts. cannibalization or taking parts from one multimillion-dollar aircraft to get other multimillion-dollar aircraft airborne, has become the norm. one marine likened the difficult job of maintaining these aircraft to -- quote -- "taking a 1995 cadillac and trying to make it a ferrari." this job is only more difficult because 30,000 marines have been cut from the force as a result of sequestration and its misguided budget cuts. as major michael mall loan put it, "we don't have enough marines to do the added work efficiently. we're making it a lot harder on the young marines who are fixing our aircraft." lieutenant matthew brown add, "this burden is coming on the
backs of our young marines. they're the ones who are working 20 to 21 hours a day to get them ready to go on deployment." the commandant of the marine corps, robert necessarilier, has said, "we don't have enough aarons that we would call ready-basic aircraft and that aviation readiness is its number-one concern. it is no wonder because this readiness crisis is literally putting the lives of our marines at risk." lieutenant colonel harry thomas commands a squadron of fa-18's. he told fox news that last year he deployed to the pacific with 10 jets. only 7 made t his own jet caught on fire in guam. lieutenant colonel thomas was able to land the aircraft safely, but the incident nearly cost taxpayers $29 million and lieutenant colonel thomas' life. now his squadron is getting
ready to deploy in three months but only two of his 14 hornets can fly. the aircraft shortage also means training is suffering and our pilots could be losing their edge. as the fox news report details, "ten years ago marine pilots averaged between 25 and 30 hours in the air each month. today in lieutenant colonel thomas' squadron, the average flight time per pilot over the last month was just over four hoirs. i assure my colleagues, you cannot mean readiness and capability in a modern-day aircraft flying four hours a month. it can't be done. super-stallion helicopters have flown thousands of marines into combat over the past three decade. but these age aircraft filled with a tangled web of hundreds of wires and fuel lines, present a daunting challenge for young marines assigned to inspect each and every one.
as the fox news report explained, "one failure can be catastrophic, as happened in 2014 when a navy version of the aircraft crashed off the coast of virginia after a fire engulfed the aircraft due to faulty fuel lines." the bottom line is this: years of budget cuts have left us with a marine corps that is too small and has too few aircraft. the aircraft it does have are too old and can barely flievment and only by cannibalizing parts from other aircraft. and young marines -- young marines are being asked to muddle through this with shrinking resources knowing that if they fail, their comrades flying and riding in those aircraft could pay a fatal price. the crisis in marine corps aviation would be shocking if it were not such a tragically common story throughout each of our military services.
arbitrary budget cuts, sequestration have shrunk the army by nearly 100,000 soldiers since 2012, bringing the army to a size that army chief of staff general mark milli-testified has put the army at "high military risk." these budget-driven reductions were decided before russia's invasion of ukraine and the rise of isil. as the force has shrunk, readiness has suffered. just one-third -- one-third of army brigade combat teams are ready to deploy and operate decisively. indeed, just two -- just two of the army's 60-brigade combat teams are at the highest level of combat readiness. to buy readiness today, as lackluster as it is, the army is being forced to mortgage its future readiness and capability by reducing end strength and
delaying modernization needed to meet future threats. and the result of budget cuts, forced reductions, and declining readiness is clear: in an unforeseen contingency, general milley testified this month before the armed services committee that the army -- and i quote -- "risks not having ready forces available to provide flexible options to our national leadership and, most importantly, risks incurring significantly increased u.s. casualties." i relate, "significantly increased u.s. casualties." likewise, by any measure, the navy's fleet of 272 ships is too small to address critical security challenges. even with recent shipbuilding increases, the navy will not achieve its requirement of 308 ships until 2021. and there's no plan to meet the bipartisan national defense
panel's unanimous recommendation for a fleet of 325 to 346 ships a shrinking fleet operating at high tempo has forced difficult trade-offs. for example, the last five carrier groups -- the last five carrier strike group deployments were exceeded eight months. keeping sailors at sea for eight months is damaging to morale and will sooner or later affect retention. it takes a toll on sailors, ships, and aircraft, unable to continue years of deferred maintenance, the nay is no d. shall the navy is no longer able to provide constant carrier presence in the middle east or the western pacific. the air force is the oldest and the smallest in its history, and the combination of decades of relentless operational tempo and misguided reductions in defense spending in recent years has depromoted readiness. -- depleted readiness.
today, less than 50% of the air force's combat squadrons are ready for full-spectrum operations well below the air force's stated requirement of 80%. the air force does not anticipate a return to full-spectrum readiness for another decade. in other words, after flying in uncontested skies over the middle east for more than a quarter of a century, our air force is not ready for a hay-end fight -- a high-end fight against a near peer adversary. the truth is this: the on-going war in afghanistan, the rise of of isil, russia's aggression in europe, and china's assertiveness in the pacific have all increased the demands imposed upon our service members and their families. but, at the same time, the requirements of our military have continued to grow. for five years -- five years now -- the budget control act of
2011 has imposed caps on defense spending. and despite periodic relief from those caps, including the bipartisan budget act passed last year, every one of our military services -- the a.m., the navy -- the army, the navy, the air force, and, yes, the manner kor -- remains undersized, unready, and underfunded to meet current and fiewmp threats. unfortunately, the president's defense budget request for the coming year does little to nothing to address this problem. instead it continues down the dangerous path of budgeting based not on what our military needs, but on what arbitrary defense spending constraints allow. in order to strictly adhere to the defense spending floor in last year's bipartisan budget act, the department of defense