tv U.S. Senate Approves Iran Russia Sanctions Bill CSPAN June 15, 2017 1:29pm-3:30pm EDT
responder requires a big navy. admiral john richardson, the chief of naval operations, put it best in his future navy white paper released last month. he said, quote, numbers matter. the number of ships in the navy's fleet determines where we can, and being there is a key to naval power. unquote. again, the current fleet about 277 ships is way too small. it is important to remember that not all ships are deployed or deployable. in fact, only about 100 ships are currently deployed out of the 277. the other two-thirds are undergoing heavy maintenance, routine sustainment or training to deploy. the navy recently validated its requirement for 355 ships. a 47-ship increase over the previous requirement. the lack of ships has created coverage gaps all over the world, and i'll give you two
examples, mr. president. first, the commander of pacific command, admiral harry harris, recently told congress he has only half the submarines he needs. admiral harris is responsible for deterring china and north korea, but he's missing half of the submarines he needs. closer to home, the commander of southern command, admiral kirk tidd, has zero, zero navy ships permanently assigned to his area of operations. these are just two of the many alarming instances where the lack of ships is having major consequences. while we watch our edge erode, america's real and potential adversaries are building the size and capability of their fleets. they are on the field competeing while in america many of our players are still in the locker room. china is building a modern navy capable of projecting global
power. china is modernizing every type of ship and submarine in its fleet. china commissioned 18 ships last year. in april, china launched its first domestically built carrier and plans to build at least six more carriers. by 2030, china will have more than twice as many attack submarines and four times as many small surface ships as the united states. beijing is developing its first overseas naval base in the horn of africa. china's naval buildup may attempt to push the united states further out of the western pacific, away from critical trade chokepoints and our allies in south korea and japan. and i would call the attention of members to the poster that i have -- and i hope it's printed large enough for you to see, mr. president. in terms of -- of five types of
ships, it compares where we were in 2000, where we are today, and where we're projected to be if current trends continue. so, for example, on the farthest column, attack submarines. the black portion of each circle represents china's capability and the blue represents our capability of the united states of america. in 2000, it was 64-655 in -- 64-55 in favor of the chinese. in 2016, as you can see 56-47. but under current projections, by the year 2030, when it comes to attack submarines, the chinese will have 87 and the united states will only have 42, mr. president.
a disturbing trend which the navy would like to reverse if we have the ability and the wisdom to give them the requirement that they said they need. with regard to ballistic missile submarines, in 2000, quite a mismatch. only one for china as compared to 18 for the united states. then only last year, four for china and 14 for the united states navy. and then projected in 2030, and really that's only 13 short years. hard to believe. there will be more chinese ballistic missile submarines than american ballistic missile submarines unless we take the navy's requirement to heart and take action beginning this year to rectify that situation. with regard to small surface ships, as you can see, a 79-62
advantage in sheer numbers in 2000. a 103-23 advantage of the chinese in 2016 and in 2030. still, a mismatch in terms of numbers of 123 small surface ships compared to only 40 for the united states of america. with large surface ships, it was 20-79. then 19-84. by the year 2030, as you can see, the chinese are projected to have 34 large surface ships. and with regard to aircraft carriers, as i have pointed out, they were not in that game at all, mr. president, in 2000. they delivered their first last year, and they are projected to go to four by the year 2030. it all adds up to 260-ship fleer
china and only 199 for the united states unless we act and act responsibly in response to what the navy and the marine corps and what the best military minds in the pentagon are telling us, and i hope we'll do that. an increasingly aggressive russia is also modernizing. the kremlin is pouring money into new attack and nuclear ballistic missile submarines. russian submarine patrols have doubled and those patrols are stretching closer to the united states homeland. the russian navy operating areas have expanded to include regular operations in the baltic, black, mediterranean and caspian seas. russia is also exploiting new opportunities in the arctic,
building naval bases in the high north. so both china and russia are investing heavily in their fleets and in new bilingualistic and cruise missiles that can target u.s. naval forces. and of course we need to turn to the subject matter of north korea. kim jong-un will stop at nothing to develop a nuclear weapon that can strike oural ice, that can strike explode u.s. forces and eventually our homeland. a nuclear bilingualistic submarine would essentially make north korea i am pervious to threats of preemption. north korea is building fortified submarine bunkers and has begun testing submarine-launched ballistic missiles within the past year. iran is another rogue state developing a massive fleet of fast attack boats, and many submarines to deny the free passage of ships through the violate straits of hormuz.
naval -- through the vital straits of hormuz. naval competition is intact. china, north korea and iran have been clearly up the size and sophistication of their fleets. the chief of naval operations has a word to describe the pace of competition, and that word is exponential. the c.n.o. puts it this way -- time is an unforgiving characteristic of the maritime environment. things are moving faster, including our competitors. so let's start competing again, mr. president,. building a larger fleet is a national project. it will require sustained commitment by the president, by the congress and the department of defense. as chairman of the sea powers dismeet, i intend to begin laying a firmer foundation -- subcommittee, i intend to begin laying a firmer foundation this year for a significant buildup in the future, and i hope my colleagues will join me. thank you, mr. president. i yield the floor.
mr. toomey: mr. president. the presiding officer: the senator from pennsylvania. mr. casey: thank you, mr. president. i ask consent to speak as if in morning business. thank you, mr. president. i want to start this afternoon with a reflection on what happened yesterday. we're thinking today of the individuals who were hurt in the attack when there was a baseball practice in virginia, and of course we're praying for those who were injured. i will list some -- many of the names we already know but i think it's important to list them. of course, representative steve scalise from the state of louisiana. his family, we're thinking of them and praying for them and hope for his speedy recovery.
matt mika, who works for tyson foods, was also a shooting victim, like representative scalise. zachary barth who works for congressman roger williams was a shooting victim. and special agent crystal griner , of course, with the capitol police who exhibited such courage in the line of duty, and we're thinking of crystal at this time as well. we know that also there were individuals injured at the scene. special agent david bailey of the capitol police, who was not shot, apparently, but suffered an injury and was released from the hospital. we're happy to hear that he has been released. and representative roger williams who was hurt at the scene as well. not a shooting victim but hurt. and of course two of our colleagues were there at the
time, senator paul, senator rand paul and senator jeff flake. we're thankful that they were not injured in any way. so on these -- on these days, we come together as a family to remember those who have been the victims, and we're thinking of them and their families and praying for them. mr. president, i rise today to talk about the health care debate and in particular the -- not just the issue of health care but the effort under way by senate republicans in their attempts to repeal the patient protection and affordable care act. i have grave concerns about the substance of the legislation or what we know about it. it's been kind of a secretive process. we don't know a lot. we have some general sense of where they're headed. i also have a grave concern
about the lack of transparency employed by the republican majority around the development of this health care plan. like millions of americans, i oppose this secretive process and i have to say it's a partisan process as well that could hult in major legislation that would harm children who will lose their health care, especially by -- by way of the cuts to medicaid. it could harm individuals with disabilities. by one recent estimate in pennsylvania, that means over 722,000 pennsylvanians with a disability to rely upon medicaid. and of course seniors, a lot of seniors across the country cannot get into a nursing home absent the full support of the medicaid program. we're concerned about them as well.
finally, of course, middle-class families who may not be able to afford health care if the house bill were to become law or a substantially similar bill passed by the senate. in 2009, the legislation passed the senate after a year-long open process and included a total of 44 bipartisan hearings, roundtables and summits. that was both in the committee on healt, education, labor, and pensions, of which i was a member at the time and remember well those hours and hours and days and days of hearings. the committee on finance at that time also had many hearings ove. this whole process by two committees led to the consideration of some 435 amendments offered by both parties, the majority and
minority, and a full debate on the senate floor that lasted over 25 consecutive days. in fact, a number of republican senators were able to offer and get a vote on their amendments, some of which passed and became part of the patient protection and affordable care act. yet, in the last five months, there have been no senate hearings on this proposed legislation, no hearings on the house proposal, and certainly no hearings on what's being developed here in the senate. if that's the case, if that remains the case over the next couple of days and weeks, then i believe we should institute a very basic rule. if you have no hearings, you have no vote. in other words, you can't have a vote on the senate floor on a bill that would affect so many tens and tens of millions of americans and will change dramatically, and i would argue
adversely, to the detriment of a lot of people our health care system. so i would hope that the majority would agree with that, that if you don't have a hearing, you shouldn't have a vote on the senate floor. there have been no relevant bills considered in executive session by any of the committees of jurisdiction. every indication is that the republican majority will jam this legislation through with minimal opportunity for debate. this is unacceptable to me, but i also believe it's unacceptable to people across the country in both parties. we know, for example, the reasoy reasons, i should say, that folks would want to vote -- would want a hearing before a vote, and that's because we're getting a sense of what the substance is. just to give you one example, i won't enter this whole report
into the record, but i'm holding a full copy of the congressional budget office cost estimate. this estimate is dated may 24, 2017, and this is an estimate analyzing h.r. 1628, the american health care act of 2017. this is the bill that passed the house. page 17 of that c.b.o. report says, quote, medicaid enrollment would be lower throughout the coming decade, culminating in 14 million fewer medicaid enrollees in 2026, a reduction of 17% relative to the number under current law. that's quoted directly from page 17 of the c.b.o. report, that over the decade 14 million people will lose their medicaid coverage. now, i know some here, and some
across this city who are commenting on this legislation -- either members of this administration or members of congress or otherwise -- are refuting this. i would add i think when you have an congressional budget office report that both parties have relied upon, and it is not only the c.b.o. joint -- this is a report authored by the -- not just the congressional budget office but also the joint committee on taxation. so 14 million fewer people on medicaid. what is that relevant to the senate debate if they were looking at the house bill? well, here is one think tank that has analyzed this for years, the center for budget and priorities. they put forward this report on
monday, june 12. in that report of just a couple of pages, they had a chart i'm holding, and i don't expect people to see it. it says -- it has four columns. the first column has the major provisions of the house bill and what's likely, based upon reporting and information we can -- we can ascertain so far -- major provisions of the house bill. what happens if the house bill passes and the major provisions of the senate bill. there's a section entitled medicaid expansion. according to the center on budget priorities, when they compare the house bill to what we know so far about the senate bill that's being proposed -- or least the development of it -- basically the center on budget says there's no -- no long-term impact on any reported changes from one bill to the other.
medicaid per capita cap, another very disturbing development that that's being considered. when they compare the senate bill to the house bill, they say, no major changes. so we're very concerned about what happens to medicaid. i'm very concerned because of the 1.1 million children in pennsylvania, the disability number that i mentioned before -- over 722,000 people with disabilities who get medicaid -- and, of course, the seniors who are on medicaid. we are talking about over time about medicaid and also the medicaid program itself. so in addition to those numbers, i want to highlight a few individual stories so people get a sense of what's at stake when it comes to this bill and when it comes to medicaid. this past friday i met with
herman paroddi from philadelphia. here's his story. in 2001 he was the victim of a carjacking and shot in the neck leaving him paralyzed. he was nursed back to health by his grandmother and worked for the past 16 years to be a full citizen, going to school, working, owning his home, now caring for his grandmother who once cared for him. herman, who now uses a wheelchair to get around, has worked to achieve what everyone wants, to be a successful student, own a home, and care for his parents. he can do this because of his knowledge, skills, and perseverance. he has been able to achieve these goals balls he gets direct care services from medicaid.
he gets help to get showered and get breakfast. medicaid makes it possible for him to use his skills to be successful. he told me that qowt medicaid, -- told me without medicaid, quote, i was told i would have to live in an institution. this would dramatically affect my life and my grandmother's life. while talking to me, he said, quote, please do everything in your power to protect my life and everyone whoa's life is like mine. latoia maddux, who is from german town. she was born with a multiplrch ex disability that limits the use of her limbs. she uses a wheelchair to get around. she's smart, energetic, and the
other of a son-to-be 6-year-old. she is a junior at westchester university working on her bachelor's degree and working at one of pennsylvania's independent living centers. latoia is a successful young professional because she works hard and takes advantage of the opportunities presented to her. she has support from medicaid in the form of direct support of professionals who help her with his daily tasks. without medicaid, the wheelchair and the other equipment she needs, she would not be able to attend work and care for her son. while talking to her, she said, quote, medicaid makes it possible for me to live a regular, full, productive life, to be a parent, go to school, and to be a reliable employee. unquote. while talking with her, it was
clear that latoya was proud of her son. she was clear that the support she received from medicaid makes it possible for her to be that proud parent. she closed her remarks by saying, quote, medicaid makes it possible for me to be me. unquote. my last example. karen stoffer. she is from bucks county, pennsylvania. she a small business owner. she operates the river of life natural food store. she purchased her health care policy from the pennsylvania affordable care act exchange. before the exchange, she said she saw her premiums increase from $300 to $1,300. she said because of preexisting
conditions such as high blood pressure and lyme disease, she was worried she would lose her health care. she has passage of the a.c.a. was a relief for her. her premiums were reduced to $500, after being as high as $1,300, and knew she had the protection of the law because preexisting conditions. she shared her fears about what she has been hearing about the house bill and what might come out of the senate. that at 61 years of age, her premiums could be five times -- five times that of younger policyholders, and that the meager subsidies proposed by the republican majority would make health care unaffordable for her. she said to me, quote, i'm, frankly, terrified about what could happen to me in the next four years. my income has gone down.
i have preexisting conditions, and instead of making adjustments in improvements to the affordable care act, legislators are causing insurers to become concerned about the future. unquote. so says karen. karen was distraught when talking about the future and reminded me, quote, we all could be one accident or illness away from disaster. that's what karen said. so umond, karen, and latoya give us a lot to think about. i would hope that the majority when they are making the final edits to their bill will make sure that any american with medicaid, for example, who has it now, a child who comes from a low-income family, an adult or a child with a disability, or a senior trying to get into a nursing home -- if they have medicaid today and need it in
the future, that there would be a guarantee that they don't lose their medicaid, that they don't lose it this year or five years from now or ten years from now or longer, stretching it out over many years and eliminating that coverage year after year or a little bit each year is going to be just as bad in the long run. so i hope that the majority would think of those families and the families in their own states when they are considering health care legislation in the senate. and we should have a vote only if there's a hearing on this legislation or, frankly, more than one hearing to consider something this complicated. mr. president, i would yield the floor.
mr. merkley: mr. president. the presiding officer: the senator from oregon. mr. merkley: mr. president, yesterday we had a horrific tragedy here in the capitol area, and i know i speak for all of my colleagues who are holding the victims of the attack in their hearts and in their prayers. congressman steve scalise is still in critical condition. zack barth, legislative correspondent who works for congressman williams of texas, who was injured, and matt mika of tysons food who represents them here on the hill, and two of our police officers, david bailey and krystal griner of
the -- crystal griner of the capitol police. we have to reinforce the understanding that we are blessed to have the opportunity to raise our voices in our democratic republic. we're able to raise them by speaking to our members who are elected in local, state, and federal government by writing to them and meeting them in town halls. in my state you can call them up and they will sit down with you in a cafe. we have an opportunity to weigh in by writing letters to the editors, by protesting in the streets, by overflowing the e-mail and phone lines. we have all kinds of ways to weigh in in america, but violence is absolutely
unacceptable -- absolutely unacceptable and we have to try to diminish and eliminate the hate speech that so often becomes a foundation for hate and violence. we've had a very divisive 18 months here in america where various folks have sought to increase the divisions between groups of american, to attack women and to attack african americans and to attack hispanics, and to attack muslims, and to attack lgbt citizens. we need to eliminate that strategy of division. here in america we're a tappestry of talents from all over the world, of different cultural backgrounds that come together to make this nation incredibly strong. unless you're 100% native american, you're either an immigrant yourself or the son or
daughter of immigrants. we bring that diversity to bear and we make this nation powerful in ways few other nations could even come close to having. so let's take this as a moment in which we seek to encourage public participation in all of the legitimate forms of free speech, but to put hate speech out of bounds and hate violence out of bounds. it's ironic that this conversation takes place at a moment where we really have a unique process underway that is designed to limit political discourse. because everything i'm saying
about participation assumes that you will have a chance to weigh in, whether you are elected or whether you're a citizen. yet, we have a process right now in the senate that is designed to prevent the citizens of america from weighing in and to prevent debate -- debate by the members of the senate. and that's not acceptable. it's not acceptable that we the people, constitutional republic, a democratic republic, designed to facilitate conversation and dialogue, to produce decisions that reflect the will of the people that work for all americans. instead we have a secretive process. more the type of process you'd expect in a kingdom where the king and the counselors hide themselves away with no public input and make decisions for the masses. that's not the design of our
government. our government is designed for public input. so here is a phrase that should resonate. no public input, no vote. no hearing? no vote. and i'm speaking specifically about the dialogue over trumpcare. trumpcare which was passed by just a few votes in the house and came over here to the senate doesn't reflect a process of the people, by the people, for the people. in fact, it's by the privileged, for the privileged, by the privileged. the house deliberately excluded the public. they had their own consolidated, confined process to make sure that it was difficult to have a full debate, amendment process for folks to weigh in and consider alternatives and
improvements. and here we are in the senate and it's even worse because we have the secret 13 crafting a plan, planning and plotting to bring it to the floor of this senate probably two weeks from today in order to hold a vote with only a few hours of debate, no committee process of any kind, not a single committee hearing, not a single committee opportunity to consider amendments. no chance for the public to get a copy and read through it and weigh in with their members of the senate. no chance for health care stakeholders and experts to examine it and point out the difficulties and the flaws. what i think is most egregious of all, the complete exclusion of the citizens of the united states of america. it's unacceptable. now, i was fascinated by the
fact that the majority decided to have this secret 13 committee. 13 is considered to be an unlucky number by much of america. friday the 13th or buildings that don't have a 13th floor. well, i hope that in this case having 13 members meet in secret is unlucky. that is unlucky in terms of trying to fulfill their mission of passing a bill with no input by the public. last week the majority leaders start -- majority leader started the process to make this happen without a committee. it's called the rule 14 process. it means a process designed to bring up a health care that would rip health care coverage from millions of america and, by the way, give away billions of dollars to the richest americans all in the same bill, straight to the senate floor without a committee being involved.
not the finance committee which certainly has many elements related to the financing of health care in america, and not in the health committee that has members of both parties who have worked for years to develop expertise and consult with stakeholders to understand what works and what doesn't work. they benefit from each other's input. i was part of the health committee in 2009 and for five weeks we sat in a room with a television camera operating so the whole public could see what we're doing and we proposed amendments and debated them around this big square set of tables, full public scrutiny, five weeks of bipartisan dialogue about what should go into health care. that was 2009. and the finance committee had a very similar process. but now we have a different objective by the majority leader wanting to bring this bill with
no finance committee involvement, no health committee involvement, and no citizen involvement. in fact, no chance for senators who aren't in the secret circle to be able to participate and see the bill and go to town halls and ask people what they think of this. i do a lot of town halls. i'm doing a couple more this weekend. i've had over 20 town halls this year. i have a town hall an nch every -- an average every ten days since i was deleected in 2 -- elected and came to the senate in 2009. i'm going to keep holding these town halls. i know my citizens would like to see this bill and go through the elements and give me feedback on what makes sense and what doesn't. that's a we the people democratic republic. but this secrecy strategy, that is not. that is not. that's a strategy for nonconstitutional governments.
that's a strategy for dictators. that's a strategy for kings and queens. it's a strategy for people who hate democracy. so let's not have that process here in the united states. let's have colleagues from both sides of the aisle go to the leadership and say this is unacceptable. i want my citizens to have a chance to see this bill. i want to benefit from talking to the hospitals in my community and my state and get their feedback. i want to talk to the health care clinics and get their feedback. i want to talk to the doctors and find out what they think. i want to hear from the nurses because they are so respected in their understanding of the direct delivery of health care. that's what every member of this senate should be saying to our majority leader. this process of secrecy, no debate, public excluded is totally unacceptable. so why does this process, why is
it going on? in fact, just earlier today the secret 13 went into a room off a hallway where the press is not allowed so they couldn't be seen coming and going from the rooms, they couldn't be talked to by the press coming and going from the room. why all this secrecy? it boils down to this. they know the american people don't like what's in this bill. so they are terrified of getting that feedback. they get that feedback, they might lose a majority in passing this bill. how much public support is there for the trumpcare bill? just 21%, according to a recent yin pi kislyak -- recent quinnipiac poll. well, that's not very much support for it. even president trump said that trumpcare is terrible. he said it this way. he said that bill from the
house, it's mean. that was his exact quote. it's mean. and then he used another phrase which i won't repeat here on the floor of the senate to say just how absolutely awful that bill is. so i asked the secretary of health tom price today in committee, i said do you share as secretary of health the president's opinion that his own bill, his own trumpcare bill passed out of the house is an absolutely terrible bill, a mean bill? and he didn't want to answer the question. well, certainly i found that curious that the secretary of health won't tell us whether he shares the president's opinion or not. and then i asked him why did the president call it a mean bill? is it because it throws 20 million people out of health care? the secretary didn't want to answer. did the president say it was a mean bill because it eliminates the guarantee of essential health benefits so that an
insurance policy is in fact insuring you when you get sick whether than perhaps not even being worth the paper it's printed on. there's a lot of health insurance policies before we had essential care package, essential benefits package, that you paid the insurance company but when you got sick, they didn't cover anything. those policies weren't worth the paper they were printed on. i asked the secretary of health. is that the reason the president said this is a mean process or a mean bill? is that the reason he described this bill in terms that i won't repeat here on the floor? and the secretary of health wasn't interested in relating -- relaying any insights into why the president said it was a mean bill. i asked, is it because the bill destroys the guarantee that if you have preexisting conditions you can still get a policy at the same price as everyone else? again, no answer.
and i said, or is it a mean bill because if you're an older american, you have to pay perhaps up to eight times more for the same policy as you pay under current law? you know, an individual who is 64 years old, a man who's earning $26,500 a year, currently they pay -- that individual would pay about $140 a month for a policy under current law. but the same policy under trumpcare would cost $1,200 a month. now, i ask you, is there anyone in this senate chamber that thinks an individual earning $26,500 a year can afford a health care policy that costs $1200 a month? let me translate this. if you are earning $26,000 a year, you're earning a little over $2,000 a month.
is there anyone who believes in this chamber, please come to the floor and tell us if you do, that individual can buy a health care policy costing $1,200 a month? is there anyone who thinks that it's an egregious mistake to use high pricing to force older americans out of our health care system? now, i believe in treating our citizens graciously of all ages, not of forcing them out of health care in an eight-fold increase in their premiums. is that the reason the president said that this health care bill, trumpcare bill from the house is a mean bill and spoke of it in derogatory terms? now, the trumpcare bill isn't even popular in the president's own party. just 48% of republicans surveyed in the same poll supported president trump and speaker
ryan's health care plan. but when asked if they like the current health care plan, 55% said they do. well, right now regular order, the regular legislative, deliberative process that makes sure that there's a full debate before a significant bill comes to vote, that makes sure there's significant and substantial time for the citizens of america to weigh in, that regular order or regular process is being run over by a steam roller. it's being crushed. it's being demolished. why would my colleagues support destroying the fundamental principles of legislative deba debate? well, i'd love to hear the answer. perhaps it's because like president trump said, the bill
is mean. perhaps it's because it's extremely unpopular with the american people who believe that there should be affordable, quality health care available to every single american. now, we've heard that the secret 13 have a plan to sweeten the bill to kind of -- a little spoonful of sugar to make the medicine go down. what's that plan? well, we're hearing maybe they will put in extra funds to help take on the opioid addiction epidemic. well, that's a good thing. why have they fought us so hard against supporting such programs to help americans on this crucial question? we've heard they want to slow down -- show down the process of throwing people off health care so it won't hurt them in the 2018 elections, maybe not hurt
them so much in the 2020 elections, but if you're destroying something piece by piece, you're still destroying it. you know, if you're cooking a lobster and you turn it -- up the heat fast or whether you turn up the heat slowly, you still kill the lobster. and this bill is still going to kill health care for millions of americans. doing it more slowly doesn't make it a good thing. putting in a spoonful of sugar doesn't make a diabolical act better. franklin roosevelt once said, let us never forget that government is ourselves. and he continued, the ultimate rulers of our democracy are not a president and senators and congressmen and government officials but the voters of this
country. and isn't that what we the people means? governor of, by, and for the people? but nowhere in the republican secret 13 process can the voices of the people of the united states be heard. how about if one of the 13 comes to the floor now and distributes the bill? i mean, we should have weeks to consider this. but we should have maybe a month to consider it. we had a whole year in the process in 2009. wouldn't that be the right thing to do, to clue in folks about what's in this bill so we can get the stakeholders engaged and the citizens engaged and hold those town halls and get that feedback? wouldn't that be the right thing to do? well, unfortunately, we're still waiting.
we're still paused, saying, please, bring the bill to the floor, distribute t maybe it's not your final draft, but that's okay. we had draft after draft after draft of the health care bill in 2009. we had 53 hearings on health reform. they spent eight days marking up their version of the a.c.a. during those eight days, 135 amendments were considered, amendments from both republicans and democrats. and then there was the health committee, which i served on. and it held 47 bipartisan hearings, round tables, and walk-throughs. 300 amendments during a month-long markup, one of the longest in the history of congress. more than 100 republican amendments, minority amendments, were accepted into the committee's version of health care reform. and right here in this chamber we spent 25 days considering the bill before we voted.
25 days. considering a lot of floor amendments, a lot of floor time. is there a single member of the majority party who will commit to having at least 25 days of debate here on the floor of the senate so that we can get a full vetting of the issues, so we can get full input by the citizens of the united states of america? well, i am concerned that we're not on the path that values the construction of our government, our constitutional we the people government. i'm afraid we're on a path where powerful special interests, meeting secretly with 13 members of the senate, are crafting the bill that's great for the powerful and the privileged but, in fact, it's terrible for americans. and that that's why they're so afraid to show us the bill. so this is unacceptable. we need the citizens of america
to pay attention because why is this happening right now? well, because the fact that the secret process is going on, it can be camouflaged by all of the conversation about russiagate. how much did the russians interfere in our elections and what about all those secret meetings by members of the campaign team? were they coordinating or collaborating? we don't know the answer, but that question is central to whether there was treasonous conduct undermining the integrity of our elections. so this kind of, let's do this now, this secret health care plan with no debate while america is trying to fight for fairness and integrity of our elections, let's do it now when schools are out of session and we're in summer and people are on vacation, let's sneak it through now, this act that strips health care for millions of americans. but here's the principle we should come back to: no hearing, no vote. no hearing, no vote.
no vote on a piece of legislation that affects the lives of millions of american families, if we haven't had due deliberation by the key committees. no vote on a bill that destroys health care for millions of families, if we haven't had the chance to consult with the experts in health care -- the nurses and doctors and hospitals and clinics. no hearing, no vote. no vote if we haven't had a full chance for the citizens of america to weigh in, to see the full details and say what they like and don't like and share that with their respective senators. on an issue of this magnitude, one that will affect the peace of mind and the health of millions of americans, we need a full, thorough legislative
process. mr. president, the choices that are made here in this chamber over the next few weeks will have a big impact on quality of life of millions of american citizens. a provision that eliminates medicaid expansion, the organ -- the oregon health care expansion in my state, in my state, whether it is implemented or implemented fast, it is going to rip health care from 400,000 oregonians. that's enough oregonians that if they were holding hands, they would stretch from the pacific ocean to idaho. 400 miles across the state. that's a profound impact. and, in addition, those folks who are going to the clinics and hospitals and don't have health care, they won't be able to pay for it, and so the finances of the clinics and the hospitals will be dramatically hurt. i asked secretary price today,
is that the reason that the president said that trumpcare bill out of the house is a mean bill? is that the reason he used the derogatory phrase to attack the trumpcare bill out of the house? is it because of the fact that it'll undermine the finances of the clinics and hospitals? and he said, you know, i don't accept the premise that that will happen. well, covering your eyes and covering your ears and pretending on such an important issue is not a responsible act by a secretary of health. the clinics have been coming to us and saying, this is how our finances improved when our citizens were able to pay for the services, because our rate of uncompensated care dropped dramatically. and with that income, we hired a lot more people. i have a clinic in the northeast corner of our state where the
number of people employed, they told me, doubled, from 20-something to 50-something. they're able to provide more health care in that local, rural community. and that's true in clinic after clinic after clinic. and if one would take their hands off their ears or off from in front of their eyes, and listen to the presidents or scif directors -- or executive directors of rural hospitals, they would hear them say, this will really hurt us. this will hurt not just our ability to provide care to those who won't have insurance, it'll diminish our care for everyone in this rural community. everyone will be hurt. -- everyone will be hurt by trumpcare. is that what the president meant when he said, this bill is mean? well, if that's what he meant, if what he meant, it's mean because it rips health care from 20 million americans, then he agree with the president.
if when the president criticized the trumpcare bill as being mean, if he meant that because it was going to destroy the guarantee of access by folks with preexisting conditions, then i agree with him. if he said it because it will destroy essential benefits and allow there be insurance policies that aren't worth the paper they're written on, then i agree with the president. if it's because it's going to greatly increase the cost of insurance for older americans, up to eightfold times, if that's why the president said it's mean, i agree with the president. and the president should weigh in and say, no secret process on a bill so important to the health care of millions of americans. president trump should weigh in and say, i don't want a bill that looks anything like that house bill because it's defective in this area and this area and this area, hurting everybody in the communities, undermining the clinics,
undermining the hospitals, destroying insurance, destroying the opportunity of access for preexisting conditions, and ripping away the guarantee that essential benefits will be covered. that's what the president should do. he thinks the bill is terrible because he finally looked at it. well, he's going to think the bill crafted by the secret 13 is terrible, too. he has a chance to stand up and fight for the american people and say, i will never sign a bill that goes through a secret process that excluded the insights from our rural hospitals and our insights from our rural clinics, and our insights from our nurses and doctors. i will never sign a bill in the oval office that excluded the american people from being able to weigh in on the conversation. i will never sign a major bill that hurts so many people in my oval office, if it never had a committee hearing, never had amendments, never had a chance to go through the legislative
process. the way envisioned in our we the people constitution. that would be the right thing for president trump to do. he's recognized the bill is profoundly flawed. he has a chance to stop not only a flawed bill but a profoundly unacceptable process in our constitutional democratic republic. former chief justice hughes sa said, we are here not as masters but as servants, not to glory in power, but to attest our loyalty to the commands and restrictions laid down by the people of the united states, in whose name and by whose will we exercise our brief authority. each one of us is here for a short period of time, but we take our constitutional role as senators from the foundation of the power of the american
people, the we the people constitution. to exclude them from the process is to violate the very premise on were i our nation -- on which our nation was founded. so we have to stop this process. we have to stop it in its tracks. whether you are a democrat or a republican, whether you come from a rural state or a highly populated state, it's a responsibility to stop this process, return to regular legislative deliberation, so that we can in fact have a we the people conversation fully honoring the experts and the feedback from ordinary citizens across our nation. no hearing, no legislative deliberation, no vote -- no hearing, no vote. thank you, mr. president.
mr. thune: mr. president? the presiding officer: the senator from south dakota. mr. thune: mr. president, once again we have more bad news about obamacare. last week anathema nnounced that it will pull out of ohio's health insurance exchange for 2018. that means that a minimum of 18 ohio counties will be without an exchange insurer next year. 25 missouri counties are in the same boat, and more americans are likely to find themselves in the same situation. on june 2, the omaha world herald announced that 100,000 nebraskans could end up with zero options for individual coverage in 2018. insurers have been pulling out of the exchanges right and left. in february, humana announced its decision to completely pull
out of the exchanges for 2018. three months later, aetna, which had already sharply reduced its exchange participation in 2017, also confirmed that it would pull out completely in 2018. in 2016, 7% of u.s. counties had just one choice of insurer on their health care exchange. in 2017, this year, roughly one-third of u.s. counties have just one choice of insurer. and based upon the information available so far, "the new york times" is currently estimating that about 45% -- 45%, mr. president -- of u.s. counties will have one or no insurer next year. one thing is for sure, mr. president. americans are facing fewer and fewer health insurance choices.
and the prices of those choices are going up. proposed rates -- proposed rate increases for 2018 are emerging and once again they're not looking good. 17.2%, 33.8%, 30%, 45%, 38%, 58.8% -- those are just some of the average rate hikes facing americans around the country. mr. president, three weeksing a the department of health and human services released a report comparing the average individual market insurance premium in 2013, which is the year that most of obamacare's mandates were implemented. with the average market premium in 2017 in the 39 states that use healthcare.gov. they're's what they found. between 2013 and 2017, the average individual market monthly premium in the
healthcare.gov states increased by 105%. 105%. in other words, on average, individual market premiums more than doubled in just five years. that's from h. h.s. in their report an just came out in the last couple of weeks. three states saw their premiums triple over the same period. triple in just five years. well, mr. president, i don't know too many families who can afford to have their premiums triple over five years. and what we know about that is, mr. president, that obamacare status quo is unacceptable and it's unsustainable. more than one insurance c.e.o. suggested that obamacare is in a death spiral, and it's pretty hard to disagree. if you combine soaring premiums with a steady insurer exodus and sooner or later you get a partial or complete insurance c exchange collapse which is what we're facing today, not to mention all of the other
obamacare problems like deductibles that are sometimes so high that people can't afford to actually use their health care plans. or narrow planet works with few provider choices. higher premiums, higher deductibles, higher costs, fewer options, fewer choices. well, mr. president, republicans are currents working on legislation to help americans struggling under obamacare. my colleagues in the house made a good start working to build on a bill that they passed here in the senate. we're committed to helping americans trapped on the obamacare exchanges. we're committed to addressing obamacare's skyrocketing premium increases. we're committed to preserving access to care for americans with preexisting conditions, and we're committed to making medicaid more sustainable by giving states greater flexibility while ensuring those who rely on this program don't have the rug pulled out from under them. we need to make health care more
affordable, more personal, more flexible, and less bureaucratic, mr. president. and my colleague from oregon was just talking about, you know, the complaints that they have about the health care process, the discussions that are going on and how much pain, if this passes, is going to cause the american people. i can tell you one thing, mr. president, it's pretty darned painful for families today that i talk to in my state of south dakota -- hardworking farm and ranch families -- who are having to pay $2,000 a month, $24,000 a year for insurance coverage in some cases with $5,000 deductibles, assuming that they can even afford to use that expensive policy by being able to cover the deductible. there are people across this country who are hurting because of this failed health care insurance program. and it's high time for us to fix it. and i believe that the american people want to see congress act
in a way that will make health care insurance more affordable to them, more personal, that they'll have more choices, greater options and more competition. that will help bring those premiums down to a more reasonable level. and that they have more than one choice. i mean, my gosh, 45% of the counties in america have one or fewer -- one i should say or zero options on the exchanges. that is an unacceptable situation and one that we've got to fix. so, mr. president, i also want to just take a few minutes today to discuss the important national security bill that the senate just passed, the cowan it terg iran's -- the countering iran's destabilizeation security act. i hardly need to cite what makes iran a clear and present danger to peace. iran engages in systematic human rights abuses from torture to the targeting of religious minorities. and of course iran has long
provided critical support to syrian president bashar al-assad who is perhaps most notable for the repeated use of chemical weapons on his own people. the fact that assad still remains in power after the long list of atrocities his regime has committed is due in no small part to the support that iran has provided. in addition to propping up assad's reign of terror, iran also provides support to the houthi rebels in yemen. secretary of defense james mattis recently noted, and i quote, we see iranian-supplied missiles being fired by the houthis into saudi arabia. end quote. well, providing these missiles puts iran in violation of at least two u.n. security council resolutions. not that iran appears to care. but in fact, mr. president, violating u.n. security council resolutions and international law is common practice for the iranian government whether it involves supplying missiles to the houthis or increasing iran's own stockpiles.
and when it's not violating the letter of the law, iran is also happy to violate the spirit of international agreements. after the misguided iran deal went into effect, iran resumed ballistic missile testing even though the u.n. security council resolution endorsing the nuclear deal called upon iran not to engage in these activities. most recently iran unsuccessfully tested a submarine launch missile in the strait of hormuz in may following ground-based missile tests in january and march. and of course, mr. president, many of those missiles have the range to reach targets not only throughout the middle east, but outside of it. mr. president, under the last administration, iranian belligerence was too often ignored or even rewarded. that needs to end now. we cannot afford to let iran continue to destabilize the middle east. we need to make it clear that the united states and its new leadership will not tolerate
iranian aggression and the terrible human suffering that has resulted. and we need to reassure our allies, especially israel, our closest and most reliable ally in the middle east, that we are committed to standing with them against iranian threats. the countering iran's destabilizing activities act will send a clear signal to iran that the united states and its new leadership is serious about cracking down on iranian misconduct. this bill will sanction individuals involved with iran's ballistic missile program or any other program designed to deliver weapons of mass destruction. it will sanction individuals who contribute to iranian violations of arms embargoes. it will allow the president to impose sanctions on individuals who perpetrate a rights violations against human rights crusaders in iran. and perhaps most importantly, mr. president, this legislation identifies and will hold accountable the entire iranian
islamic revolutionary guard corps, not just the quds force, for its role in implementing iran's destabilizing agenda. there is no easy solution to the unrest and violence in the middle east. but this bill offers one commonsense step forward. yesterday the senate passed an amendment to this bill proposing, or i should say imposing additional sanctions against another country stirring up unrest in the middle east, and that's russia. russia's increasing boldness honest international stage is a natural consequence of the obama administration's passive foreign policy. from annexing crimea to supporting the murders of the assad regime in syria to meddling in our elections, we can't allow this level of the russian aggression to go unchallenged. the russianing sanctions amendment to the iran bill codifies and strengthens additional russia sanctions and imposes new ones. human rights abusers,
individuals supplying weapons to assad's regime, actors acting on behalf of the russian government and russians involved in corruptions are all sanctioned in this amendment. i'm grateful, mr. president, to senators corker, crapo, the chairman of the foreign relations committee and chairman of the banking committee for the work they have done on the sanctions russia amendments. it was a bipartisan bill. our colleagues on the other side, the senator from maryland, others were involved until crafting this legislation, mr. president, and it is demonstration that this body can come together and do consequential things. these are two big national security and foreign policy measures that we have moved today. mr. president, there have got to be consequences for iranian and russian aggression. and this legislation makes sure that there will be. and i'm pleased that it moved today with large bipartisan support here in the united states senate senate, because it will send a clear message to
those we hope to make sure hear it. thank you, mr. president. i yield the floor. mr. cardin: mr. president. the presiding officer: the senator from maryland. mr. cardin: mr. president, in april was national minority health month. i point that out because i work with many of my colleagues in order to advance minority health. and we've done, i think, some very important things in recent years which i'm very proud of. many of them were included in the affordable care act. i know that senator carper and senator blumenthal will be on the floor. senator carper is here now. he has been instrumental in advancing quality health care for all americans, but we do recognize that we have a special role in regards to historic discrimination on minority health. so i was pleased that the affordable care act included the national institute for minority
health and health disparities so that we could have a foe cal point at n.i.h. to deal with these historic problems and to have a game plan to advance that. i was also pleased that the affordable care act provided coverage for minorities in greater number because when we looked at the number of one insured, the number of minorities were much higher percentage than the general percent of uninsured. when we look at inadequate coverage, we saw the same numbers. so we have made advancements. so in april, historically i have filed a resolution in order to acknowledge the progress that we made and to continue our commitment to make sure all americans have access to affordable quality health care and we do not discriminate. that resolution has always cleared without any difficulty until 2017. and for reasons i cannot
explain, there was republican objections and we were not able to pass the resolution commemorating minority health month. i'm going to consent that a copy of that resolution be included in the record. mr. president, i ask consent that a copy of that resolution be included in the record. the presiding officer: without objection. mr. cardin: i want to thank senators menendez, blumenthal, brown, klobuchar, peters, duckworth and collins for their help in regards to minority help and the resolution. so we couldn't do that, which is a pretty easy thing to do, but now the republicans are looking to bring out the next two weeks a rewrite of our entire health care law, one-sixth of our economy. and they're talking about bringing this out for perhaps passage in the united states
senate toward the next two weeks. i don't know of anyone who has seen a copy of this bill. i certainly have not seen it, and i'm a member of the senate finance committee. senator carper is a member of the senate finance committee. we have not seen a copy of the bill even though we're the committee of jurisdiction, along with the help committee. i would certainly want to be able to look at this bill, make sure that there are public hearings and opportunity for input from all members of the united states senate. first those who serve on the relevant committees through the committee markup and then on the floor of the united states senate. but what i understand from the majority leader, that that may not be the case. that would be an affront to our democratic institution. that would be insulting the members of the senate and the committees that i serve on, the senate finance committee. but i need to mention that because we do know what the
house of representatives sent over to us. now we don't know if that's going to be the bill that's going to be brought out, but there hasn't been any hearing on the bill that the house of representatives sent over to us. now, compare that to the passage of the affordable care act. we had numerous, dozens of hearings on the affordable care act. we had months of negotiations on the affordable care act, back and forth, bipartisan negotiations. we had committee markups in two of our committees. and hundreds of amendments were considered. many republican-sponsored amendments adopted on the affordable care act. we went through a regular legislative process. and yet, the republican leadership is telling us that we are going to re -- totally change the affordable care act, totally change the health care
system and not offer the american people an opportunity to see what we're doing, and their elected representatives to be able to offer comment or amendments to that? that is, is outrageous. that's not a democratic institution. we need to speak out about it. now we're all vulnerable to that. all americans. i talked about in my state the 400,000 that have coverage under the affordable care act that did have coverage prior to the affordable care act -- that did not have coverage prior to the affordable care act. they are very much at risk because according to the congressional budget office if we have on the floor of the senate anything similar to what the house passed, most of those 400,000 are going to lose their insurance coverage. what are they going to do? then we're talking about putting a cap on medicaid. well, have you talked to the governor of your state? have you talked to your state
legislature as to how they're dealing with their budgets? do you really believe the states can pick up what we cut? the answer is obviously no. we offered an expansion of medicaid so more working families, more veterans, more people who are vulnerable could get coverage. that's gone under caps that republicans are talking about, putting our most vulnerable at risk. i started by talking about minority health and let me underscore that with medicaid. when you look in my state and every state, the percentage of people who are covered under medicaid is much higher than what the minority can do. they historically have been discripple made it. they don't have the -- disdplaimentd. they don't have the coverage. a higher percentage of veterans are under the medicaid system. that will affect our veterans. our seniors depend on medicaid
for long-term care. they will be adversely affected by these caps on the medicaid program. and then we had the impact on all of us who have insurance and may be able to keep our insurance after thiep of legislation -- this type of legislation. we are going to be adversely affected. why? who do you think pays for those who don't have health insurance? you get cost shifting, and it is done in a more costly and expensive way. so our health costs go up, those of us who have insurance pay more, and those who don't have insurance don't get the early interventions that they need in order to stay healthy. the vulnerablities continue because one of the things that was affected by the house-passed bill was what we call the essential health benefits. and what we did is require that those benefits be provided under all health plans including
medicaid. so, yes, i could talk about obstetrics for women could be covered under all plans and women who need obstetrics would have to pay a higher premium because of the way the insurance is done only the women who needed that plan would get into it but it costs more. that discriminates against women. minority communities that have coverage for mental health and addiction, it is under the affordable care act, when they get into tight situations, they lose that coverage. we are all talking about the opioid explosion addictions in our country. in maryland i think the rate is 60% higher this year than last year of o.d. deaths. do we really want to cut one of the major tools we have in trying to get this epidemic under control? that's what we're talking about
in regards to what the house bill does. so, mr. president, at a minimum we need to have public hearings to know what we're doing. this is a democratic institution. under the affordable care act we had dozens of hearings. the committees of jurisdiction need to work on this bill, need to be able to mark it up, need to be able to offer amendments. that was afforded to every member of this body under the affordable care act and many of our colleagues who voted against the affordable care act have amendments that were included in the aaffordable care act. that's how a democracy works. everyone's affected by this process, but particularly the vulnerable, particularly those who are uninsured and those who will become uninsured, those who have insurance and have very low options are going to have their
options reduced. older americans, women will be discriminated against. at a time when we want to focus on the progress that we made to narrow the gap on minority health and health disparities, it would be a tragedy moving in the wrong way to reverse the progress that we made and to do that without an appropriate process of transparency, which has been the hallmark of american democracy. so i urge my colleagues that there's still time. if you have proposals, work with us. all members -- all 100 members. i certainly have worked with my republican colleagues on many health care issues that are now the law of this land working together. we offered to work with you. all we say is, don't tell us you are going to do this by repealing a bill and then come
to us to try to fix it. work with us to improve our health care system and we'll work with you. there's still time. let's work together. let's have public hearings. let's get public input. let's offer amendments. let's debate those amendments. the end result will not only be better legislation for the american people, but legislation we know will stand the test of time and give predictability to the health care stakeholders in our country. with that, mr. president, i would yield the floor. the presiding officer: the senator from delaware. mr. carper: thank you, mr. president. i want to thank my friend and neighbor from maryland for inviting us to come to the floor to talk about the affordable care act. i am honored to stand next to him here. we sit next to each other on the
finance committee and the environment and public works committee. he's a great leader on both those committees. he and i were on the floor earlier today, along with the presiding officer. we voted on legislation that attempts to send the message to iran that -- who, by the way, just had elections not just a month ago where the president was reelected by a big margin -- there are a lot of young people in that country who want a better relationship with this country. they elected a number of women to serve in positions of real responsibility, not just in their parliament, but as members of day -- tehran's city council. the iranians are keeping their word with respect to the -- with the agreement between five
nations, including the u.s., china, russia, britain, france, germany, they are keeping their word with the nuclear agreement that was entered into two years ago. what they are not doing, they are testing ballistic missiles and there's -- the u.n. basically sent a strong message to iran. they said if you do, we will sanction you. they continue to test ballistic missiles. they say it is for defense purposes, but we can't be sure. so we strengthened those sanctions. we also included with those sanctions sanctions that basically say to russia who has intervened all 17 intelligence agencies in this country -- the russians intervened in our last election, no question. they intervened on one candidate, president trump. they wanted to make sure he was
elected and hillary clinton wasn't elected. they succeeded. every one of our 17 intelligence agencies have come to the same conclusion testified publicly to that effect. as a result, this legislation was initially focused just on iran, focused and we focused maybe even more on -- on russia to sanction them for their misdeeds, which i think are, in many ways, more significant than what the iranians have done and have been sanctioned for again. why do i go back to this legislation we just debated and adopted here this morning? consistent with what senator cardin has talked about -- and he's very much an architect around right involved in the middle of the effort to bring that legislation to the floor. it came out of his committee. bob corker of ten sten the
chair -- of tennessee is the chair. a member -- many of them worked to bring bipartisan legislation to the floor. i didn't see what the final vote count was. 98-2 -- 98-2. that's what we can accomplish when we work together. and i think it's a great message as we pivot and talk about the affordable care act. when our friend from south dakota, senator thune, who is a great friend for, i think all of us, admired by both sides. when he was talking about -- how deplorable obamacare was and how it's in a death spiral and so forth, one of the things i wanted him to ask to yield to me so i could say when barack obama and joe biden stepped down as president and vice president of the united states, every county
in every state had access to health care to health care exchanges. where did the idea of the health care exchanges come from? republicans. the right-wing republican think tank, they came up with an idea that says, let's create exchanges in every state where people who don't have health care coverage can get their coverage through a large purchasing pool. the legislation said, let's have a sliding scale tax credit to make sure that low-income families who don't have coverage can afford that coverage in the exchanges. as their income goes up, the tax credit will provide the coverage. the republican legislation, 93 -- fashioned by heritage, that it will be thraw an individual mandate. you can't make people get coverage, but there would be a fine. and not lastly, but the idea of
employers with a certain size would have to get coverage. you could not deny people because of preexisting conditions. those were in the concepts in the previous legislation, cosponsored by senator hatch from utah and senator grassley, they are the two most senior members on the finance committee. i sat as recently as last week when the secretary of h.h.s. was before our committee. i applauded senator hatch, i applauded senator grassley for cosponsoring that 1993 legislation which became the foundation for health care coverage in massachusetts where they cover everybody. it's called romney care.
it was adopted when he was governor. and when we are debating and senator cardin and i are on the finance committee -- debating the affordable care act, we literally took those republican ideas from heritage, from senator chafee, 23 republican cosponsors, from romney care, we took those ideas and made them the foundation of obamacare. it was ironic to hear my friend senator thune talk about the tale of horribles from the affordable care act. the things that he and my republican friends are criticizing the most were their ideas -- their ideas from 24 years ago. personally i think they are pretty good ideas. if they were given a fair chance, they could be very effective -- very effective. one of my republican friends said the other day that when the affordable care act was debated
and voted on and so forth, the republicans were pretty much shut out of the process. it's too bad the democrats are shut out of the process now as we revisit health care coverage with the terrible legislation that's come out of the house of representatives. i think without -- if i'm not mistaken, without a hearing, correct me if i'm wrong, senator cardin, they adopted without a hearing -- i think they adopted on a straight party line vote and i think they did it without any kind of score from the congressional budget office and just sent it over here. while they were doing that, i will go back in time, if i can, to the year 2009 when we debated the affordable care act here. we had two committees of jurisdiction, one is the health, education, labor and pension. that committee held no less than 14 bipartisan roundtables. a roundtable is very much like a hearing. it's not quite as formal, but 14 bipartisan roundtables that were designed to try to develop consensus around the affordable
care act to get health care coverage in this country. this is, again, in 2009. in 2009 the same committee, health, education, labor and pensions committee, held 13 bipartisan hearings, so 14 roundtables, 13 bipartisan hearings. in all during the -- the actual time they were debating on and voting on the legislation itself, the help committee in their debate in actually marking up the bill, some 300 amendments -- 300 amendments were considered, offered by democrats and republicans. more than half of those were accepted and of those more than half of those 300 accepted, it turned out 160 of them happened to be offered by republicans. think about that. 14 bipartisan roundtables, 13 bipartisan hearings, 300 amendments offered, over half of them republican amendments that were -- over half of those 300
were actually adopted, 160 in all, were republican amendments. that doesn't sound like they were shut out on the health, education, labor and pensions committee. and on the finance committee where senator cardin and i serve, we had 17 roundtables and hearings, we had 38 negotiationing meetings, 17 days of voting on amendments and i think roughly a dozen republican amendments were offered and accepted. i ask him how he's doing, he always says compared to what? i would say the process right now that we're looking at, with the republican response, if you will, belated response to the affordable care act coming out of the house and now being negotiated -- not debated but negotiated -- in private, some would say in secret -- hard to
keep a secret around here. but certainly in private. and to my knowledge, no bipartisan round tables, no bipartisan hearings. to my knowledge, there will not be an opportunity for markups or business meetings where hundreds of amendments can be offered, debated and voted on. none of that. and they will use a process called reconciliation where whatever they come up with in these closed meetings, and we get a chance to vote on it up or down. the house never had a score, if you will -- the congressional budget office never had a chance to say this is how many people will lose coverage, have degraded coverage. this is what it's going to cost for people who don't get help through medicaid. this is what it's going to happen to folks losing their coverage altogether. they never did that in the house. i don't know if we'll see that in the senate either. there's a right way and a wrong
way to do this stuff. our republican friends will probably never agree that -- with this. we tried to do it the right way in 2009. what we came up with was the affordable care act. i'd be the first to say it's not perfect. i'm sure senator cardin feels that way. i'm sure the presiding officer who is with us today, he knows a lot about health care, he probably would be able to change a number of things. i've said for months, i've said for years actually, why don't we just figure out as one, a bipartisan group like we were today on the sanctions for russia and iran, why don't we try working together on this stuff? and we're sort of waiting to see if we might have a taker. the presiding officer has been great about reaching out, and i applaud him for that. i think he and i will be in a forum together maybe next week and talk about this stuff in public. but i applaud his efforts to
reach out and see if we can't foster a better dialogue. let me close with this. some of you know, i spent some years of my life in uniform. i was a -- for while i was a civil air patrol cadet growing up in virginia. i wanted to go to the air force academy. didn't know how to apply. i applied too late, missed it. i found out about the navy rotc, went to ohio state and became a shipman and four years later a naval flight officer off to pensacola. spent five years in active duty in southeast asia, after that in the cold war as a commander. loved the navy. loved the navy and feel privileged. the navy helped me go to undergraduate school and active duty to go to -- move to delaware and get an m.b.a. thanks to the g.i. bill. i was privileged to be elected governor, served as commander in chief of the delaware national guard for eight years. over half my life has been involved in the military.
a lot of times when i was younger, i'd think about who has helped in health care under medicaid. i used to think folks helped the most under medicaid are women -- poor women and their children. as it turns out today, especially as the baby boomers get older -- the baby boomers get older that more and more of them are being could have had by medicaid. they receive their coverage because they spend down their assets. a lot of them have dementia, have other disabilities, and they end up in nursing homes. more than half of money spent on medicaid these days is on those folks. a lot of them are in my generation and older, our parents, uncles, aunts. as it turns out, unbeknownst to me, about two million -- roughly 23 million veterans we have in this country, 22 million veterans we have in this country are served by medicaid.
they're served by medicaid. the day that i showed up at ohio state to be a navy rotc midshipman, we had only white males in our rotc. only white males. turned out i think that's what they had in the army rotc and the air force rotc. when i got to my squadron on active duty, i think in the many years i was in my active duty squadron i think we had two or three african americans, an asian american officer. we had no women who were officers. that has all changed now. that has all changed now. and the face of our military, officer corps and enlisted corps looks a whole lot more like america today than it used to. and as it turns out, the folks that are veterans in this country, those 22 million people, they look a whole lot more like america today than maybe was the case a number of years ago.
they are caucasian, they are african american, they are latino, they are asian american, all of the above. and some of those people are veterans depending on medicaid, a number of them are minorities. a number of them are minorities. and ner going to be add -- and they are going to be adversely affected if we're not careful with what we do in the house or if we replicate something like that, similar to that, ultimately in a conference that tries to represent a compromise or two. i'll just close with this, mr. chairman. thisthis can end in a better wa. we just got a good example for how to do it right with the legislation we just passed earlier today. sanctions on priewsh and -- sanctions on russia and in iran. my hope is we'll use that as a
template and come back and do this, make changes to the affordable care act. we'll do it in a way that fixes what needs to be fixed and preserves what needs to be preserved. and i thank my friend for his leadership on this and god knows how many others to thank. a senator: mr. president. mr. carper: mr. chairman. i think i still have the floor. just a quick -- if i could. senator mccain and i have -- senator kaine and i have offered legislation that i think has been shared with your office, mr. president, that seeks to help stabilize the exchanges and the ability of the health insurance companies to have additional predictability and certainty through reinsurance,
and my hope is we'll have a chance to share what we've offered and maybe see if that's something you would be interested in joining us in and supporting. i yield the floor at this time. thanks so much. a senator: mr. president. the presiding officer: the senator from georgia. mr. perdue: mr. president, i rise today to talk about a train wreck that is coming to our country right before our very eyes. yesterday the federal reserve for the fourth time in the last year and a half increased the federal discount rate by one-quarter point. one-quarter point. that's a rounding era in most people's imaginations and yet i think it's a very impactful number. that's the fourth increase in the last year and a half that amounts to 100 basis points or one percentage point, one full percentage point increase and a
discount rate. with a $20 trillion debt that equates to about $200 billion of new interest that we will be required to pay out of the revenue that we get off the backs of working men and women in america. the $20 trillion debt, i've risen on this floor to talk about a lot. but as we see what's happening now, we see the reality of what's being -- has been predicted over the last few years, and that is as we start talking about growth and the economy, you see demand for capital and interest rates rising. we also see the federal reserve talking about adjusting their balance sheets. some $4.5 trillion on their balance sheet, the largest balance sheet they have had in history. so these are dramatic impacts on what we're talking about right now, and that's how do we fund what we're going to be doing. not only in health care. our military as well as the domestic programs that we're here to talk about. what's even more disturbing about the debt that we're talking about and the increases
in interest is the structure of that debt, mr. president. over the last eight years the prior administration decided strategically to keep our bond portfolio that supports this debt, the bonds that we issue, that is that pays for this debt, the average duration, the length of those bonds is under three years. some 60% almost of all the government debt that we have in the united states today matures in three years or less. that means that these increases we're talking about are going to roll on us and the backs of the american taxpayer almost immediately. this is not something that's going to happen in 10 or 15 years, mr. president. it's right here on us. let me put that in perspective. most every other country in the world that has significant debt -- and there are a lot of them -- not to the percentage that we do, have already dealt with this duration problem. the u.k., for example, over the last eight years, instead of going short when interest rates were virtually zero, they
went long. 48% of the united kingdom's debt is 20 years or longer in maturity. again, 60% of our debt, because of the last administration's strategic decision to stay short. borrow short and spend long. that's a prescription for failure, mr. president, in business and in government. but 60% of our debt matures in less than three years. that is a formula for absolute disaster, and that's what i'm talking about. but even more important than the debt and the duration and the way this, these interest rate increases are going to impact us almost readily is the fact that we have about 43 days -- i rose last week and called out that we had 50 days in. today we have 43 days left in this fiscal year, working days in the senate in in fiscal year, before september 30. that means that we have to fund the federal government for
fiscal year 2018 by the end of september. now, in the last 43 years this body, congress, has only done that four times, mr. president, in regular order. according to the 1974 budget act, only four times. what's worse than that is in the 43 days that we have, from an effective standpoint, we really only have 25 working days left in this senate. i would argue that with the debt ceiling, with health care, with a tax package, with the appropriation process and the funding of the government, i just don't see any way that's possible, mr. president. i think that when we're talking with the american public we need to come clean. i believe like most years in the past we're going to be pressured in this body again, like we have 178 times we've been forced into a continuing resolution in this body in order to get past some archaic financing limitation that we've had. that means we've got by the end of september, to fund the federal government,
historically only four times we've done that, according to regular order. the other times, the other of the 43 years, either a c.r. or omnibus was done, about 14 fiscal resolutions got -- about 148 fiscal resolutions got us past the year, moved on to an omnibus and the release valve was more debt, more spending. it's very difficult because the budget process itself is broken. and because of that, between now and the end of september, i personally -- and i'm just a business guy, mr. president, but i have no imagination of how we're going to fund this government by passing 12 appropriations bill. as a matter of fact, since 1974, this body has only averaged passing two and a half appropriations bill a year, out of the 12. you tell me in the next 43 days we're going to pass 12 bills to fund this federal government? there's no way mplets and so my
call to our colleagues here on both sides of the aisle is let's get busy right now. i don't care what the structure is as long as it's not a continuing resolution, because that ties the hands of our military. they cannot deal with that. it limits their ability to move money from one department to another. if they wanted to move money from armor to infantry, in just in the army alone, they cannot do that, mr. president. with the risks we face around the world that is an impossibility. we're working feverishly to change the budget process. it will not affect us this year. this is something that we've got to get serious on right now. i just believe that we're sitting -- we're poised to have a turnaround in this economy. consumer confidence is up, mr. president. it hasn't been higher at this level in 13 years. c.e.o. confidence is higher than it's been in 15 years. and manufacturing confidence hasn't been this high in over 20 years. why? because they see some regulations being rolled back right now by this administration and this senate. we passed 13 bills out of 14
that we tried, that pulled back owners regulations. we had the secretary of treasury just this week tell us that some 70% of the limitations on our banks -- not the controls that protect us against another 2008 and 2009 disaster, but the controls that are unnecessary in keeping capital tied up in small and regional banks unnecessarily.we have some $6 trillion not at work because of bad fiscal policy. we are trying to unwind that and get it back in the economy. if the fed reserve releases their $4.5 trillion and we don't find a way to release this $6 trillion, tell me where the capital will come from. i'm here to tell you we're on the brink, i believe, of an economic turnaround if we it affect a reasonable improvement in health care. get on and fund the government
in a responsible way before september 30, get a tax package done, mr. president. people are working on their budget for fiscal year 2018. their capital budgets that go out many years are being done now. they are handicapping whether we will get that tax package done. my argument is let's get these things done in a tim lie basis, the debt ceiling, funding the government so we can get that done so the business entities in our free enterprise system can budget accordingly so we can get some of these benefits into the economy as early as late next year. if we don't get it done before christmas, i don't believe we will have fiscal impact in 2018. with the events this week, i would hope that our body would find a way to lower the hysteria
when we have a difference of opinion, to find a way to look at what we might agree on when we have an issue, as well as what we might disagree on. as i listen, just today, i'm shocked because the business is the same. the misinformation is at an extremely high level. remember when then-president obama said, if you like your insurance, you can keep your insurance, if you like your doctors, you can keep your doctors, premiums will go down, deductibles will go down. everyone will have insurance. the c.b.o. overestimated the number of people who will sign up for obamacare and also have a 30-hour workweek to -- to 2009 full-time work.
well, we now know -- both sides are even agreeing -- that it's failing. they are saying, they are relying on the argument, let's move to regular order. let's get this done together. where was that conversation in 2008 and 2009 when behind closed doors a supermajority crammed down the minority this thing called obamacare. remember when speaker pelosi said, when you want to find out what's in the bill, you have to vote for the bill. i think there was a matter of hours to look at that bill. obamacare is collapsing. we know that rates are up over 105% nationally. in my state alone they more than doubled in the last three years. 45% of the counties in the united states are down to one carrier, mr. president, in my state alone, georgia. we have 159 counties in our
state, 96 are down to one carrier, states like virginia, iowa, tennessee, and others are told they are down to their last carrier. before the affordable care act, 48 million people in the united states did not have insurance. that was a catastrophe. we all agree with that. today, however, what nobody talks about -- on the other side talks about is that 28 million people in america still do not have health care coverage. ip can't see,000 -- i can't see how that's a success by any measure. of the 20 million that got insurance over the last six years, 16 of them did not get it through obamacare. of the remaining four trillion, two trillion, like me and my wife, were canceled and had to come back into the affordable care act unwillingly, but that was our only choice. by the way, we had to have a
program with so many other features that our rates doubled over that period of time. it seems to me, mr. president, that what we have before us today is an opportunity to clean up this mess and provide for the things that were broken in 2008. we know that we've tbt to cover -- that we are have to cover preexisting conditions. we don't want people to have their insurance canceled because they are sick that. is the not the american way. people have to have access and right now with the cost, many people are coming off of health care in the individual market because they simply make the financial equation work. the premiums are too much an -- in one of my -- my son can't understand the deductibles. the financial equation for the people who need it doesn't make sense. we can do things to get premiums down by allowing an insurance product that people want and don't ask them to pay for products they don't need.
we have to make sure that medicaid can be sustained long term. lastly, i think we have to make sure that as we deal with the preexisting conditions, that we make sure that everybody in america has health care -- has access to health care. nobody's talking about taking access away from the american people in terms of health care. mr. president, whether it's health care, the military, the v.a., or any of our domestic programs, we have a serious funding problem. our mechanism to fund the federal program is broken. it has never worked since 1974 except for four times prior to 1980. we have to fix it. between now and september 30, we have to fund the government or all of this other rhetoric will be idle chatter. mr. president, i yield the floor. the presiding officer: the senator from oklahoma. mr. inhofe: mr. president, i ask to be recognized with as much time as i may consume and be in
a period of morning business. the presiding officer: without objection. mr. inhofe: let me say something about the junior senator from georgia. i'm glad he is taking this on. this is something that some of us who have been in this body longer have gone through before. i think everybody realizes that what was attempted to do by president obama was a single-payer system. that's what liberals wanted. i can remember back in the 1990's, what was referred to as hillary health care, back during the clinton administration, and i can remember the efforts that were taking place. sometimes i just go back to my state of oklahoma just to be around logical people and they'll ask the question, you know, if this is a system that's not working in canada, it's not working in sweden, it's not working in great britain, why do think -- why do they think it
would work here? real liberals think, it would work if i were running the show. we are going through the same thing again, and i'm so happy that we have leaders -- the occupier of the chair, we have more doctors now in the united states senate. this is the time to make these changes and really accomplish things. but that's not why i'm here. i wanted -- i noticed in the news this morning that one more of these incidents happened where they had groups of people going to the antarctic or the arctic to try to reaffirm their positions that somehow the world is coming to an end because of global warming and it is because of manmade gases which is not the case. the interesting thing about yesterday is that a group of them went up there -- these are some scientists, some individuals, some environmental extremists, activists were going to the arctic to show that things were melting and bad and
they got stuck in the ice. this is the fourth time this has happened in the last four years because they didn't anticipate the fact that we have some areas where it's increasing. and i thought, well, it's time to make one last compliment to the president when he came and had the courage to pull out of the paris climate agreement. a lot of people don't know what these climate agreements are. that was the 21st year that we had a climate agreement. it was all started by the united nations some 21 years ago and the idea was to go to exotic places around the world, invite all 192 countries to come in and convince them to reduce their greenhouse gases, their co2 emissions. toward the end of the obama administration, after eight such meetings like this, they decided it wouldn't work. they finally decided that they would go ahead and try to make
one look like an agreement, and hence, was the paris agreement -- not a treaty, but an agreement, not anything that would come for ratification, obviously. i'll tell you what's interesting about this and i've been over there for some of it these meetings. most of the countries of the 192 countries that are involved in these meetings, they think that if the president says something, it's going to happen. they forget about the fact that we have another branch of government that's called congress and we have to ratify some of these decisions. anyway i wanted to make a couple of comments about what the president had to accomplish by getting out of this agreement. i want to first of all say since there is a deliberate effort to make people who are reluctant believe one narrow view in terms of the world coming to an end as a reality is that they try to make it change into the argument that climate change -- anyone
that's against the idea that we're having these problems out there as opposed to the idea of climate change. no, look, you guys, we've said so many times on the floor that climate has always changed. all the evidence -- historic evidence, scripture evidence shows that climate is always changing. the arrogance is that somehow climate change can be managed by man and, you know, did the man ever cause the ice age or any of the other extreme weather patterns that the earth has seen over the past few,000 years? -- few thousand years? the answer is know. they have found, quote, little agreement is found with climate model simulations and consistently and underestimate the temperature changes. it is not a surprise that they
forecasts to be inaccurate. every summer is going to be the hottest. i haven't seen a summer where it's not the hottest. one of the charts from the study that i have here -- let's put this up. all you have to do is go back and look historically as what has happened in this country. we -- we go through warming periods, we go through ice ages, and there we come right up -- i'll tell you what's interesting about this chart, the largest increase that we had in global warming happened right after world war ii in 1945, that was the year that we had the largest number of co2 emissions that took place and historically no one disagrees with that. that precipitated not a warming period, but a 20-year cooling period and so we have been going
through this for a long period of time now. essentially the finding of the study shows that climate patterns we see now are not significant in the grand scheme of things as we see on this chart. people like to vilify us and question the statements and so-called findings of fearmongerring scientists telling everyone that the world is ending because of manmade gases. just because we question how much man affects climate change, corruption must be involved and so forth. when you look at the real scientists -- i have not yet met him personally, but i know about a guy named dr. richard lindson. he is an m.i.t. professor. he arguably could be considered the most knowledgeable person in this field. he made the statement, he said
regulating co2 is a bureaucrat's dream. if you regulate co2, you regulate life. we have watched this play out now for about 20 years. to question the idea that man has single-handedly responsible for the changes in climate and that doomsday is here due to the fact that we burn fossil fuels is entirely inappropriate. one of the well-known climate fanatics named michaelman -- i remember -- michael mann -- paris was the 21st meeting that the united nations had. in 2009 that meeting was held in copenhagen. at that time i chaired the environment and public works committee. at that time we had a lady who was the -- was the director of the e.p.a. and i -- i --