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tv   U.S. Senate Democrats Debate Graham- Cassidy Health Care Bill  CSPAN  September 18, 2017 2:59pm-5:00pm EDT

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factors we've seen the party away from that reagan, george we bush model and illegal immigration to more of a stevege king, donald trump party that doesn't mean that george bush or ronald reagan has disappeared but it's attention. it's a battle and war right now in the gop has been for a decade and there's no resolution in sight. >> host: robert, for the. washington post, you can follow him on twitter. you can also watch him on washington week on pbs. moderator there. thank you. >> u.s. senate is gambling in now to finish up work on the 692 billion-dollar defense programs and policy bills for 2018. it authorizes funding for department of defense and energy department defense-related programs. also it sets troop levels and military pay and base closures and realignments and a final passage vote is expected at about xpm and if that is true it will go into conference at the
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house. while the nomination of solicitor general and after wednesday the senate will take a break for the rest of the week on the state work. live coverage of the u.s. senate on c-span2 the presiding officer : the senate will come to order. the chaplain, dr. barry black, the chaplain, dr. barry black, the chaplain: let us pray. holy and gracious god, let your light shine out of darkness into our hearts.
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today, fill our lawmakers with a knowledge of your purposes, providing them with the insights to accomplish your will. inspire them to humble themselves under your mighty hand, so that you may exalt them in due time. lord, keep them mindful of the great responsibility you have placed upon them, and may they trust your power to do through them more than they can ask or imagine. watch over and guard them and their loved ones in their going
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out and coming in. lord, thank you for your loving care and tender mercies that you provide us each day. we pray in your loving name. amen. the presiding officer: please join me in reciting the pledge of allegiance to the flag. i pledge allegiance to the flag of the united states of america, and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the presiding officer: the clerk will read a communication to the senate.
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the clerk: washington, d.c., september 18, 2017. to the senate: under the provisions of rule 1, paragraph 3, of the standing rules of the senate, i here by appoint the honorable todd young, a senator from the state of indiana, who will perform the duties of the chair. signed: orrin g. hatch, president pro tempore. mr. mcconnell: i want to thank the committee on the committee who supported this year's ndaa and send it to the senate floor. it showed another testament to the leadership of senator mccain and senator reed. so thank you, chairman mccain, thank you, ranking member reed, and everyone else who worked so hard on this legislation.
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now let's pass it. on an entirely different matter, last week the senate confirmed a talented and experienced nominee with an impressive career in law enforcement to be the u.s. attorney for the western district of kentucky. russell coleman is the right person for the job. after graduating from my alma mater, the university of kentucky college of law, russell entered public service. his wide ranging experiences at the department of justice, the federal bureau of investigation, the senate, and in private practice make him particularly qualified for this new roam. as the chief federal law enforcement officer for the western district of kentucky, russell will use his skills to serve the people of kentucky and the united states very well. having served as a special agent with the f.b.i., he understands the particular challenges facing law enforcement in that role. he collaborated with local law
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enforcement officials on a vast array of issues and he is well respected in the law enforcement community. for instance, kentucky continues to struggle with the opioid addiction epidemic that is tearing communities and families apart. russell stands ready to collaborate with community leaders to combat it. he earned the support of the kentucky narcotics association which looks forward to his leadership on drug enforcement issues. russell also worked in my office as legal counsel, helping me serve the people of kentucky with good humor an unmatched determination. he advocated for the issues important to my constituents. the president of the kentucky fraternal order of police wrote to me in support of russell's nomination. they said, russell was forever thoughtful and courteous and true friend to our membership. i would like to congratulate him
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and look forward to his service to the commonwealth and to the country. now on one final matter. i'd like to take a brief moment to recognize a talented member of the senate community who will be retiring this month after 20 years of service to this body and to the nation. nancy kurvin is a reference librarian in the senate library and for years whenever my office needed assistance with a seemingly impossible research question, she was always ready to lend a helping hand. he couldn't let her depart without giving her the recognition she so richly deserves. nancy came to the senate following a wide-ranging career in publishing and research and through her work here, nancy has made a lasting mark. to members of my staff and others, nancy is the first person they call when facing a difficult research question.
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nancy signature combination of unyielding perseverance has enabled her to complete countless research projects on numerous subjects throughout her time in the senate. she is widely known for her kindness and good humor. my office worked closely with nancy on a number of different projects over the years, but there's one project that was of tirk importance to -- particular importance to me i would like to mention. a number of years i began a series of speeches focusing on the lives and legacies of prominent u.s. senators from the commonwealth. my staff has regularly looked to nancy for help. she's been an indispensable research for each speech in kentucky i have delivered. her work, gathering sources and putting the information in its proper context has helped me pay tribute to many distinguished kentuckians. therefore it's fitting she holds
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the highest honor my state can bestow upon a civilian, that of a kentucky colonel. after her years of dedicated service, nancy deserves a relaxing retirement along with her husband seven, another stalwart member of the senate who will retire from the senate historical office. nancy plans to spend time working in her garden. she will be sorely missed here. i would like to thank nancy and her husband on that careers of this chamber. i wish them both a happy retirement. i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:
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quorum call:
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the presiding officer: the senator from utah. mr. lee: mr. president, i ask unanimous consent to suspend the quorum call and to grant floor privileges to a member of my judiciary staff. the presiding officer: without objection, the quorum call is suspended. mr. lee: mr. president, i ask unanimous consent to grant floor privileges to a member of my
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staff. the presiding officer: without objection. under the previous order, the leadership time is reserved morning business is closed. under the previous order, the senate will resume consideration of h.r. 2810, which the clerk will report. the clerk: calendar number 175, h.r. 2810, an act to authorize appropriations for fiscal year 2018 for military activities of the department of defense, and so forth and for other purposes. the presiding officer: the senator from utah. mr. lee: mr. president, i rise to speak in support of the nomination of makin delrahim as the assistant attorney general of the department of justice. mr. delrahim is someone i have known for over 20 years. he is eminently qualified and i have no doubt he will make an outstanding assistant attorney general. mr. delrahim has a long and
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distinguished career within the antitrust world. his service in this area includes service as senior staffer for the senate judiciary committee of the antitrust modernization commission, and previously at the u.s. department of justice. i could go on and on regarding mr. delrahim's accomplishments, regarding his character and his aptitude as a lawyer generally and as an antitrust lawyer in particular, but instead of taking my word for it, allow me to read just a little bit of the wide-ranging support mr. delrahim's nomination has from both sides of the aisle, people within the senate and outside the senate, on both sides of the aisle have been supportive of this nomination. a bipartisan group of former assistant attorneys general over the antitrust division at the department of justice, including a.a.g.'s for antitrust under
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president obama, president clinton, and president carter submitted a letter expressing strong support for making csh makan delrahim's nomination. they said he has the experience, intelligence, judgment, and leadership skills necessary to serve as an intelligent excellent assistant attorney general. similarly, a bipartisan group of former commissioners of the antitrust modernization commission -- this is a group of well-respected, seasoned antitrust officials -- submitted a letter supporting mr. delrahim's nomination. the letter said that delrahim will, quote, serve with high distinction and be an outstanding assistant attorney general for antitrust, and the authors of this letter also strongly urge the committee to look favorably upon his nomination with the hope that the senate can confirm him as soon as possible. because mr. delrahim is so well
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respected, his nomination is one that that has enjoyed broad bipartisan support including broad bipartisan support within the senate judiciary committee on which i serve. he was voted out of the committee by a vote of 19-1. that's not all that common these days. ranking member feinstein went out of her way to explain that mr. delrahim will fully and fairly enforce our antitrust laws. despite this strong bipartisan support, mr. delrahim's nomination has languished on the floor. in fact, the wait to confirm makan delrahim is the longest for someone appointed to this position in 40 years. not since the carter administration has a new administration been forced to wait this long to fill a vacancy at the antitrust division, and president carter's wait was largely due to the fact that he
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took more than twice as long to nominate an assistant attorney general for antitrust than did president trump. some democrats are apparently so eager to resist that they are unwilling to allow us to confirm a nominee that many of them support. this is unacceptable. democrats understand that antitrust is essential to ensuring that consumers receive the benefits of a competitive economy. lower prices, more innovation, and more choice. you see, when you have competition, good things happen. when you have competition, it inevitably brings down prices and it inevitably results in higher quality. in fact, last month some democrats reiterated the importance of a strong antitrust enforcement to our economy, and they did so by releasing their better deal plan. the democrats' plan describes
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the effects that anticompetitive mergers can have, such as harming consumers, customers, and suppliers. senator klobuchar along with several democratic colleagues followed up on this plan by proposing legislation to enact some of these policies into law. although i don't agree with all their proposed solutions, i do agree with my colleagues from across the aisle that antitrust enforcement should be a priority. the best way to ensure that antitrust laws are being properly prioritized is to make sure that our antitrust agencies are fully staffed and that they have leaders in place, leaders who have the requisite expertise and ability, leaders who have broad bipartisan support from sitting senators, practitioners and former agency leaders who know the position and the exacting demands required by the position, leaders who fit the description of making delrahim
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-- of makan delrahim. given his broad support, these impeccable qualifications and the importance of this position, there is not a good reason to delay this confirmation. quite to the contrary, mr. president, this is an issue that is neither republican nor democratic. it is a position that is neither liberal nor conservative. this position is there to advance bipartisan issues that affect every american and makan delrahim is positioned at a critical time in our nation's history, at a critical time for antitrust law. it's especially important that we have him in place. antitrust law is an area in which the united states has excelled above and beyond what its peer nations have been able to achieve. we developed this area of the law and we did so with an eye towards protecting consumers and competition itself rather than protecting individual
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compettors. we have to lead and the best way we can start to do that is confirm makan delrahim. i call on the senate to confirm makan delrahim for the assistant attorney general for the antitrust division at the u.s. department of justice. mr. president, i ask unanimous consent that george elmer shambecause, a national security fellow be granted floor privileges for the remainder of the 150th congress. the presiding officer: without objection. a senator: mr. president? the presiding officer: the senator there florida -- the senator from florida. mr. nelson: mr. president, i want to speak about the defense bill, but before i do, i want to give the senate a report. senator rubio and i have been
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together quite a bit this past week as florida has not only encountered a hurricane that was quite unusual in that it basically affected almost all of the state of florida. florida is a big state. if you went all the way from key west to pensacola, that's as far as going from pensacola all the way to chicago. that's how big our state is. almost 21 million people, the third largest state, 75% of that a population is along the coast and of course you know what coasts do when hurricanes start threatening those coasts. this was an unusual one because it was first going to hit the east coast of florida. that was the track.
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the national hurricane center has gotten quite good in their ability to project the path and the actual velocity of the winds. but indeed it took -- once it took a turn unexpected as a category 5 hitting the north coast of cuba, it reduced its velocity and its forward motion and then took a more westerly coast first hitting landfall in florida at the middle lower keys where the winds were category 3 approaching category 4. and of course the residents were not even let back in to that part of the county to see their homes until sunday morning. and as of this moment, although
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fema is present in both the lower keys, key west, in the upper keys, key largo, individual assistance help disaster teams were still trying to get into the places that had the biggest impact of the winds. the area around big pine key and around marathon. it is a slow process. it is painfully slow. no doubt fema is stretched to the limit because fema is having to deal with the problem in texas and now this enormity of this storm affecting almost all of florida, fema is stretched. but that's what fema is supposed to do is to bring emergency
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assistance to people, to organizations, to local governments in the aftermath of a natural disaster. that will be a work in progress as we go on. there are some places that both senator rubio and i have gotten personally involved in asking fema to come in. the areas in lee county, collier county, areas where fema had not visited, they now have come in in lee county. that's east of fort myers, le lehigh acres. the farmer community of amokly was torn up. there is a story that students at a nearby university opened up the university -- the university
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president opened up the field house so that a lot of the poor people in amokley had a place to go if they didn't have another shelter. indeed they took in some 400 people, elderly people in an apartment complex, that their caregivers had left were picked up by the sheriff and taken to the university and the students took them in and took care of them for four nights. this is a great example of floridians helping floridians and we have seen that throughout. this senator having been all over the state, much of it with my colleague demonstrating that the two senators in a bipartisan way actually get along and were there to try to help the people. a first right after the storm
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into the florida keys. and we saw the damage in key west and bocachichi but that was the back side of the storm. the eye of the storm had gone further to the east so the damage of the northeastern qawt drant being the most severe -- quadrant being the most severe winds were on up into the big pine key and the marathon area. and yet already the military, the coast guard, and fema and the engineers were coming in immediately after the storm. floridians helping floridians. americans helping americans. then senator rubio and i were up in the jacksonville area. quite unusual. all the extra rainfall had
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flowed into the st. john's river basin. that river had swollen. and all of that water trying to get its normal outlet into the atlantic ocean at jacksonville. but lo and behold the winds covering up the entire peninsula moving northward, now the eye over land between tampa and orlando and that northeastern quadrant of those winds coming from east going west, what did it do at jacksonville? it pushed all of that water that needed to get out into the atlantic, pushed it back. that combined with the incoming high tide and what you had was a phenomenal flooding, an overflowing of the banks of the st. john's river in many places in the upper st. john's at
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considerable loss of property and considerable distress to the citizens. a good part of jacksonville, downtown itself was flooded. senator rubio and i then went the next day and we ended up in a citrus grove, lake wales, florida. this citrus grove, 50% of its fruit on the ground. you go further south, 75% of the citrus crop on the ground. they can't salvage that. that's a huge percentage of the loss. and so it made senator rubio and me all the more determined that we are going to try to pass an amendment to the tax code that would give the citrus growers of florida not only because of this loss but because of every grove
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now infected by a bacteria that will kill the tree in five years called citrus greening, to give the citrus industry a chance to start over by plowing under the grove of those diseased citrus trees, replanting in new stock that has new promise to outlast the bacteria at least for a number of years more than the five years that will kill the tree until we can find the cure. and we're working on that. but to do that in the i.r.s. code by allowing them to expense in the first year, that plowing under and replanting in order to save the citrus industry. senator rubio and i in that grove, seeing all of that crop lost, this was going to be a promising crop for the first
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time in ten years of decline of the citrus crop because of the bacteria. this was going to be a good year. and yet we saw in that grove, half of that on the ground, lost, gone. citrus crop insurance, that's not going to really help them. only that insurance if it's a much greater loss is what happens. from there the two of us went on to a poor part of florida, east of lake oa okeechobee. a lot of residences had been torn up. this was a hurricane whose winds affected virtually all of the peninsula of florida and even reached ever over into the panhe
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as far as tallahassee and even parts west. and there in bel bell glade, we served a meal that charities had come together to bring food to hungry people because they had no power, they had no refrigeration, and it had been several days since the hurricane, and, therefore, they had no food. from there to another very poor part of florida, immokalee, florida, which i had described earlier had been torn up considerably. mr. president, whether it was what i just described or whether it was also feeding poor people in apopka, florida, that at this point had been without power for five days and they had no food because of no refrigeration or
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whether it was going down to lehi acres where the florida national guard had organized the distribution of m.r.e.'s, meals ready to eat, and gallons and gallons of fresh water because so many of those homes out in lehi acres east of fort myers were on water wells and without electricity, there were no pumps to give them water. all of these things that so often we take for granted, you take away power, not only are you suffering because of the 90 degrees plus of heat and the humidity, but you can't even get any water because you're on a water well. and so, too, what a privilege to be there with the florida national guard handing out that food, handing out that water and
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talking to those local residents that are living paycheck to paycheck, and now they have no paycheck, and where is the fema assistant to help them because there's no power. they can't go online to apply for individual assistance. they can't, in fact, pick up the phone because of intermittent cell service. and even if they could get a cell signal, they couldn't get through to the fema number. and that's why we wanted the fema representatives to come in and, fortunately, just yesterday they finally did come in. mr. president, it's been quite a couple of weeks, first anticipating the storm coming in and getting all of the emergency
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operation centers ready. and fortunately people obeyed the evacuation orders. it was estimated only 10,000 people out of a population of almost 100,000 in the keys, only 10,000 left. that was a huge evacuation. but those folks never got in to find out what was left of their homes until yesterday. you can imagine, after a week, it being that the storm hit the weekend before the keyston keyse weekend, the heat and the humidity, the mold and the mildew, you can imagine the mess to clean up. and fema all the while having to worry about texas, now florida, and maybe another hurricane that's going to come up that looks like it's going to turn
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out to sea but is still going to have some of the wind effects along the northeast atlantic coast. mr. president, floridians helping floridians. and then there was a great, great tragedy. this occurred four days after the hurricane. why there is not a requirement that every nursing home or assisted living facility, an a.l.f., have a generator, not only for power, for things like lights, but have a generator capacity that will run air conditioning units, why there is not a requirement for that in florida i think is going to be the subject of great debate and i hoping changing that
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requirement in the state of -- and i hope changing that requirement in the state of florida because eight people died. eight people died in a nursing home right across the street from a major hospital in hollywood, florida. eight frail elderly from ages 70 to 99, eight needless deaths as --eight needless deaths. as a result -- we will know -- a criminal investigation is under way. all the phone calls that were not answered, both to the government as well as to the power company, as reported by the press -- specifically a miami television station. we don't know all the facts. it'll come out in the criminal
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investigation. but it is inexcusable that eight frail elderly people would die over heat exhaustion by being left to their condition to deteriorate over the course of three or four days. what is wrong with the regulatory scheme that does not have a backup generator that would kick in? i mean, in fact, the hospital right across the street had it. so what was the disconnect there? why did it take days and days until 911 was called? this we will find out in this
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great tragedy, but i can tell you that "the miami herald" had done a series over the last couple of years, three investigative pieces, that in fact point out that these a.l.f.'s in these nursing homes and have not properly managed or regulated by the state of florida. to be determined. and so hurricane irma is just another reminder that we are going to confront huge natural occurrences and maybe, just maybe, people will realize that there is something to the fact that the earth is getting hott hotter. and because of that, two-thirds of the earth covered by oceans, the oceans absorbing 90% of that
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heat, and what happens to water when it is heated? it expands. and, thus, the sea levels are rising. and so, as we turn to this defense bill, this is an issue for national security. as secretary of defense mattis has said, and i quote, climate change is impacting stability in areas of the world where our troops are operating today. maybe we should pay attention to things like i've just described in florida. or maybe out in texas, or what about tornadoes causing damages to military depots in georgia, or what about the severe heat canceling military training and
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hailstorms damaging aircraft in texas? what about the coastal erosion not only in florida threatening early-warning radar in alaska? what about the wildfires causing ranges to be closed and the flooding not only that we saw in texas but flooding military logistics rail in louisiana and warehouses in virginia containing hazardous materials? and so that's why in this version of the defense bill that we will pass today, there's a provision in there that this senator had something to do with which calls for the defense department to conduct a comprehensive assessment of threats to the training and readiness of our armed forces and the military infrastructure
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caused by climate-related events. it's critical that we recognize the threat so we will ensure our forces and installations are resilient enough to withstand and quickly recover from all of these natural disasters that we've been talking about. not only must we ensure that our military infrastructure is resilient, we must also ensure that it provides our war fighters with the space that they need to train and the technology they need to stay ahead of our adversaries. and so, mr. president, i have opined on this subject over and over in speeches to the senate. i've opined over and over about gulf test and training range that the air force needs to make rouge investments in for the
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precise measurements for all of our sophisticated weapons and our systems. i want to thank chairman mccain and ranking member reed for their good work on the bill, a understand it begins to address -- and it begins to address some of the training and readiness shortfalls in our military. and i look forward to continuing to discuss this. mr. president, i yield the floor. mr. schumer: mr. president? the presiding officer: the democratic leader. mr. schumer: thank you, mr. president. let me once again thank my friend and colleague from florida. there is no one -- no one -- who has defended his state more diligently, more assiduously, more effectively than the senior senator from the state of florida. and i know he -- millions -- close to 20 million people in florida are grateful, as are all of us. thank you. now, mr. president, we'll vote today on the final passage of ndaa. i'm pleased with the bipartisan
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manner in which the senate worked on this important legislation. senators mccain and reed managed the bill with great skill. i commend them for their bipartisan work on this important legislation. now i'm going to use the rest of my address to address something that is not so bipartisan, terribly partisan. that is the issue of health care. and i hope the american people l closely. -- and i hope the american people listen closely. after a few months of lying dormant, trumpcare is back. it is meanor. it now lives u $under the name of cassidy-graham. guess what? it is another bill that would drastically cut back on health care funding for americans who need it most. so my colleagues, my fellow americans, this is a red alert
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moment for the entire country. our health care system again is threatened by a hastily constructed piece of legislation put together in a back room by only one party, no c.b.o. score, not a single hearing, totally -- everyone is totally in the dark about the effects of this bill. and yet there is an effort to rush it forward. this frankenstein monster of a bill that would so harm so many americans just keeps coming back and back and back. and somehow each time it has managed to get worse. here's what we know the new trumpcare bill would do. it would roll back protections for americans with preexisting conditions. it would allow states to impose burdensome requirements as a
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condition on medicaid coverage. it would defund planned parenthood, stripping millions of women of their right to access to affordable health ca care, and most crucially, the new trumpcare would plunge a dagger deep into the heart of medicaid, immediately ending medicaid expansion and establishing a per capita cap on medicaid spending. that jeopardizes coverage for 11 million americans and puts at great risk the coverage and affordable care act of insurance for the 12 million who buy insurance on the marketplaces. it would take the money used for medicaid expansion and block grant it to the states. but in proposing a massive cut on funding that helps so many americans well into the middle class, the term block grants may
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sound harmless, but in practice they're anything but. right now our health care system reimburses states for the costs of what their citizens actually need and use. block grants are a fixed amount of money given to each state. forcing people who need health care to fight among each other as to whoest goes those dollars -- as to who gets those dollars. people are parents in nursing homes will fight with those on opioid treatment who will fight with those who have kids with preexisting conditions, who will fight with those who simply need to go see a doctor. they'll all be pitted against one another in a heartless scheme, a heartless scheme that will hurt so many. block grants are a not-so-clever way of disguising a massive, massive cut to health care. cutting back care, raising
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premiums, hurting millions and millions of average americans. that's the case with this new trumpcare. the center on budget policy priorities took a look at the new trumpcare and found that the block grants in the bill would deprive states of hundreds of millions, sometimes billions, of dollars. i'm going to mention a few states here. my colleagues should know the effect of the bill. they don't. c.b.o. has told us -- i'll talk more about this later -- that they cannot give us a full score but simply note whether it meets the budget reconciliation. they say it will cut $1 billion. that's all it will say. we won't know how many citizens are hurt, but center for budget priorities, whose numbers are very, very reliable, has done a calculation. i would ask my colleagues to pay attention. i just picked out some states.
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there are more. arizona would lose $1.6 billion in federal funding. alaska would lose $255 million in federal funding. maine would lose $115 million in federal funding. west virginia would lose $554 million in federal funding. colorado would lose $823 million
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in federal funding. ohio, the state most racked by the opioid epidemic, would lose over $2.5 billion in health care funding. and iowa would lose $525 million in federal funding. these are devastating numbers. and, my colleagues, if you don't believe the accuracy of these numbers, then have the courage and decency to wait for a c.b.o. score, wait for a c.b.o. score. to go pass this legislation before c.b.o. measures out the
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effect on your state would be legislative malpractice of the highest. these numbers, we believe, are accurate. they come from a group that has had years of expertise and accurately predicted health care effects. devastating cuts to so many in so many states. if you don't believe these numbers, then show us what yours are. wait for c.b.o., an impartial arbiter, and see what they have to say. the numbers are devastating. they represent millions of americans, especially middle-income and low-income, who will receive poorer health care, face higher costs or both. who do they represent? they're an american family, a nice middle-class family,
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making a good income. you have a parent in a nursing home? it's likely to be paid for by medicaid. that parent is at risk if this graham-cassidy bill passes. you have a young son or daughter afflicted by opioids, the treatment they receive would often be at risk if this bill passes. you give birth to a child with a preexisting condition who desperately needs help. we've met so many of these families, every one of us. that child's life in many cases would be at risk if this bill passes. this is the poorest way of legislating i have seen in all
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my years here. to try to rush this bill through, no hearings, no c.b.o. score, no knowledge of how it actually affects your constituents, how can we do that? already some republican governors have spoken out against this legislation, governor kasich, governor baker, 16 patient and provider groups have come out against this trumpcare. the american cancer society, the american heart association, rating agencies fitch says cassidy-graham would be, quote, even more disruptive than all the other a.c.a. bills. all the others. the american people have rejected trumpcare repeatedly. its numbers in the polls are below 20%. hard-core supporters of donald
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trump do not want us to pass this bill. virtually one -- only one in five americans wants us to pass this bill. nobody. hardly anybody. we're going to go do it for political scalp? so i know there are some on the other side of the aisle who say they can work it out so each state wouldn't be hurt as badly as under the current draft of the bill, these bad, bad numbers, that they can tweak a formula for one state or another that would make the cuts less devastating. first, you're never going to come up with that kind of money. i heard one governor was told by a senator, don't worry about the big cuts to your state. we'll make it up with disproportionate share payments, uncompensated care.
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it's impossible. it's impossible. the amount of money in the dsh program is so much less than the amount of these cuts, we couldn't even come close. that's what's being thrown around here. lots of different surmises. maybe we'll do this, maybe we'll do that. playing with people's lives. that is so wrong. states will end up facing a harsh cut. most of the states of the union, many states represented like my colleagues on the other side of the aisle who voted for the previous bills. we shouldn't do it on substance. but we also shouldn't do it on the basis of regular order. to have such a major bill that affects so many people, be rushed at the last minute in the dark of night, no discussion,
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no analysis, no real knowledge of how it affects each of our states, legislative malpractice of the highest order, the founding fathers were looking at this chamber now and watching, they'd be turning over in their graves. an america founded on debate and discussion and sunlight is veering off all of that in a really nasty way. there is no regular order here. there are no bipartisan public hearings on the graham-cassidy bill. the health and finance committees are not debating the legislation. it's the same backroom one-party sham of the legislative process that ultimately brought the previous hour down. contrive an 11 hour hearing in the homeland security committee, a committee that has
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very little jurisdiction over health care matters does not even come close to suggesting regular order. and, madam president, in conclusion, i think many of us on both sides of the aisle thought there was a ray of light the last few weeks. the partisanship that had governed this place over the last eight months seemed to be breaking. i had good meetings in the white house, hope of working together. senators alexander and murray began talking about how we move forward. i was joyful that maybe the partisanship could end and we could work together, and the majority leader and i are getting along very well. this bill, if done this way and passed, would dash those hopes. there's a way out. senator alexander, senator
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murray have had hearings. they have had discussion. they're negotiating at this moment. what they'll come up with, they'll have some things i don't like and some things people on the other side of the aisle don't like. that's the legislative process. it's not to rush a bill through in the dark of night without even among of how it affects people because now c.b.o. has said they cannot measure how many people would lose coverage and how it would be affected until a few weeks because this is a block grant, it takes a long time to weigh it. well, so after two weeks of thinking bipartisanship, that flickering candle might gain some new light, this is the last thing we need. it's not go back to the divisive, destructive health care process that paralyzed the senate for much of this year. let the leader and i talk to one another and come up with
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bipartisan solutions not just on this bill but on bills to come. let's pursue the bipartisan path courageously used by senators alexander and murray. so in conclusion, i'd ask every american who hears these words, who longs for us to work together, call yours senators and congressmen and let them know. tell them that this bill is even worse than the previous bill. tell them it hurts average families dramatically. tell them there's a better way. the same level of activism that we saw on the previous bills must be garnered now or they will just slide through in the dark of night. its effect, devastating and unknown. madam president, democrats in the senate, we have no choice.
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our constituencies, our consciences compel us. we will oppose cassidy-graham in every way we can using every tool at our disposal. we ask the american people to speak out once again to make their voices heard. the hour is late. the need is desperate. i yield the floor. a senator: madam president. the presiding officer: the senator from maryland. mr. van hollen: thank you, madam president. i first want to thank the democratic leader for his efforts to work and reach out to the republican leader, senator mcconnell, as we move forward to try to take some sensible steps to improve our health care system, not try to blow up the entire health care system. and, madam president, just last month the overwhelming majority of the american people
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side a great sigh of relief when this senate voted down the earlier trumpcare proposal that would have destroyed the affordable care act and which would have had a devastating impact on the entire american health care system. madam president, we'll all recall at that point in time that senator mccain gave a powerful and impassioned speech on this floor about the importance of the senate going through the regular order, about working in a transparent way, in a bipartisan way to improve and strengthen our health care system, not another cynical partisan effort to ram through a piece of legislation that impacts hundreds of millions of our fellow americans. and it seemed for a time that we were making headway on that front. senator lamar alexander and senator patty murray in the help
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committee working together, holding hearings, bringing people from all points of view in front of that committee to testify about how we can improve and strengthen our current system. but now instead of heading down that bipartisan path, we're seeing another and last-ditch effort to destroy the affordable care act, and in the process reap incredible damage to our entire health care system. the latest incarnation of trumpcare is the graham-cassidy legislation. and make no mistake, in many ways this is far worse than the earlier proposals that we've seen. it would end the medicaid expansion program which in my state of maryland actually has provided more affordable care to more marylanders than the
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changes that were established under the affordable care act. it will dramatically cut the funds under the medicaid program through a block grant proposal that gives very little given the huge responsibilities that the state has. it will give a green light to states throughout the country to eliminate the really important patient protections, protections based on preexisting conditions like diabetes or asthma or whatever it may be. it will give a blank check to those who want to eliminate the important essential benefit appropriations that provide important coverage gairch tees for -- guarantees for women's health and for substance abuse. madam president, doctors in this country take a very simple oath,
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the hippocratic oath, which says, first do no harm. this piece of legislation -- this latest incarnation of truck, will do -- trumpcare will do devastating harm to our health care system. you don't have to take my word for it. as more and more groups are looking at this legislation and looking at the details, they are phoning our offices, sending us e-mails and texts and other members will see the outpouring of opposition to this bill they saw to the earlier ones. already we have seen strong statements of option from the american cancer society, from the american diabetes association, from the american heart association, the american lung association, and the list goes on and on and it just started. it's important for us to remember that these are not
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republican groups, they are not democratic groups. they have no partisan affiliation at all. their only interest is to protect patients in this country and we should have the same interest in protecting the health of our constituents. it's not just the patient advocacy groups opposed to this. those who provide health care in our system to our loved ones, to our parents, to our children are coming out strongly opposed to this already. here's what the children's hospital association has to say about the graham-cassidy provision -- quote, their provision would slash funding for medicaid, the largest funding program for children by one-third, reducing access in coverage for more than 30 million children in the
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program. furthermore, the legislation weakens important consumer safeguards, and as a result, millions of children in working families would no longer be assured that their private insurance covers the most basic of services without annual and lifetime limits. they go on. that is the children's hospital association. those are the hospitals caring every day for kids throughout this country. they are not alone in already opposing this legislation. the american academy of family physicians, the american academy of pediatrics, the american college of physicians, the nurses association. in short, all of those organization representing all those people out there who are providing health care to our fellow americans, to our
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constituents, they are opposed to this bill. aarp, which, of course, represents millions -- in fact tens of millions of older americans -- is strongly opposed to this bill because once again it opens the door towards aim discrimination and -- age discrimination and the amount that is charged. older americans, elderly americans will see their premiums go through the roof with this legislation and that's why aarp is strongly opposed. madam president, just when we thought we were at a point where we thought we were going to focus on improving the health care system, which has a whole lot of room for improvement, just when we began to see bipartisan hearings and legislation possibly emerge from the help committee, we now see this last-ditch effort on the
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floor of the senate to do what other bills had tried to do but in an even worse fashion. and we're hearing already from americans, not with political hats on or independent hats or or republican hats on, just people who care about the health care of the people of this country, and they are resoundingly opposed to this. let's not try and ram something through here in the next two weeks to try to meet an artificial clock that has been set by the rules of the senate. there's been ample time to debate this and we've debated the earlier versions. let's not allow a final sneak attack on the health care system to get through this body. it would be a very sad day for the united states senate. i thank the senator.
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the presiding officer: the senator from indiana. mr. young: madam president, i rise today to discuss a national defense authorization. i want to begin by thanking senators mccain and reed, chairman and ranking member of the committee. i thank them for their collaboration on behalf of our service members. as someone who served in the united states marine corps and served on the house armed services committee. i understand the importance of congress fulfilling our constitutional duties to men and
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women in uniform. this legislation is important for our country. it's also important to my neighbors, that includes hoosiers serving on active duty in the reserves and in the indiana national guard, as well as for their families. it includes those working at the u.s. naval base and the defense finance service which is essential to our service members. for the last 55 years, congress has passed the national defense authorization act. given the threats our country confronts it is important that we pass this legislation and provide our troops with the training, weapons, and support they need to accomplish their missions and return home safely. but that is not enough. congress must pass defense authorization and appropriation
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bills before the end of the fiscal year. stop the habitual use of resolutions for the department of defense and end defense sequestration once and for all. i stand ready to work with senators of both parties to achieve these objectives. i'm committed to doing my part, and that's why i voted to end debate on this legislation last week and why i'll support further advancing the bill today despite the fact that we weren't able to debate and vote on amendments here on the floor. today will -- i will only note that i've introduced a couple of bipartisan amendments relate to saudi arabia's actions in yemen, it these are amendments 585 and 1081. i believe these amendments deserve full consideration by the full senate. i again look forwarded to speaking on this issue in the coming days.
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i share the frustration of chairman mccain and ranging member -- ranking member reed with the lack of floor votes. i think each senator, those we represent, and the troops who protect us, are right to expect better. with that said, i applaud chairman mccain and ranking member read for working to include over 100 noncontroversial amendments in this bill. i'm proud of the fact that the defense bill we're going to vote on, and hopefully pass this evening, includes three amendments important to hoosiers that i introduced than had i worked with the committee to improve. i'd like to quickly mention two of them and then spend a little more time on the third. the first provision is amendment number 793. this provision would press the department of defense to implement government
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accountability office office recommendations or explain why they aren't doing so. let me explain why this is so important. our nation confronts challenges and threats of extraordinary scope, yet the resources we have are limited. that means we need to ensure the department of defense is operating as efficiently and effectively as possible with the money the taxpayers provide. that's what our national security demands and what u.s. taxpayers are right to expect. so when a respected organization, such as g.a.o., our federal government's auditor, conducts independent and rigorous analysis and identifies key areas for improvement within d.o.d., congress and the pentagon should take it seriously. here's the problem. as of this morning there were 1,008 open g.a.o. recommendations, including 75
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priority recommendations that d.o.d. alone has failed to fully address. now, some of these priority recommendations relate to missile defense, ship maintenance, military readiness, service member health care, and financial management. and some of these open recommendations go back to 2009 and even earlier. there may be a few of these recommendations in which d.o.d. has a persuasive justification for not implementing g.a.o.'s recommendation, but i believe the burden of proof should be on d.o.d. to either implement g.a.o.'s recommendations without delay or justify to congress why they believe the recommendations should not be adopted. s that essentially what my -- that's essentially what my provision would do. i look forward to working with the leaders and staff of the armed services committees to sen
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sure that this provision is included in the final legislation. i'd also like to highlight a second amendment, amendment number 882 that i worked to introduce in the bill we will soon adopt. this provision will require the navy to adopt and have the congress provide a comprehensive review of u.s. maritime surveillance and targeting imraibts, also known as isrt. in light of growing chinese and russian marinetime capabilities, this report would require the navy to identify stesk capability -- specific capability gaps when it comes to isrt and offer solutions and resources needed to address those capability gaps in areas of risk. the review will help ensure the united states retains the -- the
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ability to deter aggression and defend our national security interest. now, lastly, i'd like to highlight amendment 821. i introduced and worked with the committee to include this in the bill and i want to thank senator donnelly for cosponsoring my amendment. on january 27, the president issued a memorandum that emphasized the need for a, quote, modern, robust, flexible, resilient, readyings, and -- ready, and appropriately tailored nuclear deterrent. this memorandum reiterated the longstanding and bipartisan consensus that deterring a nuclear attack on our country and our allies depends on our ability to maintain a strong nuclear deterrent. our nuclear deterrent includes three legs, also referred to the
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nuclear triadd, consisting of land-based intercontinental ballistic missiles and long-ranger bomber aircraft. this includes complementary capability making clear to any aggressor that a nuclear attack on the united states would be suicidal and thereby deterring such an attack in the first place. perhaps that's why secretary of defense mattis, referring to the deterrence of potential aggressors said just last week, quote, if i want to send the most compelling message, i've been persuaded that the triad is the right way to go. now, the challenge is that in just the next two decades, essentially all of our nation's nuclear delivery systems and all of our nuclear weapons will need to be refurbished or replaced. according to a february 2017
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study by the nonpartisan congressional budget office, that could cost a total of $400 billion over the next decade. now,s that an enormous that's an enormous cost when the department of defense has many other modernization bills coming due. consequently, we must identify opportunities to minimize costs while not sacrificing capability. so consistent with that fact, on january 31, secretary mattis issued a memorandum calling for a, quote, ambitious reform agenda which will include a horizontal integration across department of defense components to improve efficiency and take advantage of economies of scale. consistent with that memorandum and the memorandum of the president, my amendment would require the office of the secretary of defense, working with our navy and our air force,
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to submit a report to congress on the potential to achieve more value. that is, enhanced nuclear deterrence at a lower cost by integrating elements of acquisition programs related to the modernization and sustainment of the nuclear triad. if we can improve efficiency and program management costs and schedule by increasing integration, colocation and commonality between the strategic and deterrent programs of the navy and air force and their associated systems, engineering, technology processes, then we should do so. back home in indiana, skilled workers at naval service worker has supported the navy's strategic systems program for more than 60 years. crane is the largest d.o.d. supplier to the strategic systems program.
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crane provides the navy's only organic high-reliability radiation-hardening capability. crane also serves as a leader in trusted microelectronics. but what's less well known is that crane provides important support to the air force's icbm ground-based strategic deterrent program. more importantly, there is good reason to believe that crane can dramatically increase its level of support to the air force's strategic programs. that's the kind of joint collaboration between the air force and the navy that my amendment envisions. by breaking down stovepipe barriers between our military services, by eliminating unnecessary duplication, and by looking for commonsense opportunities for joint cooperation, we can keep our country safe and save money in the process. it's not only a win for crane. it's a win for the navy.
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it's a win for the air force. it's a win for taxpayers. and it's a win for the safety and security of every american. that's why i looked forward to working with the leadership and the staff of the armed services committees to include this provision in the final bill. so in conclusion, i want to thank chairman mccain and ranking member reed again for their hard work, for their tireless leadership on the senate armed services committee, and for your work to bring the national defense authorization act to this point. madam president, i yield the floor.
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a senator: madam president. the presiding officer: the senator from arkansas. mr. cotton: i want to clarify something about what's going to happen this afternoon. whenever a democratic senator says they are worried about the state of our military, they are horrified about the kind of cuts we're making, they can't sleep at night because of what we're doing to our troops in the field, don't believe them. they don't mean it. they're not serious. it's all for show, because they had the perfect opportunity to stop all these terrible cuts. and not just for the troops but for their own states, for their constituents, even for their little parochial projects. and what do they do? they turned it down. they said no. actually, i take that back.
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they didn't say no. they couldn't even bring themselves to say no. they didn't have the courage to say no. they did something much worse. they said nothing. because we're not even going to vote on the amendment i wanted to offer, which would have repealed the sequester spending cuts for defense and nondefense. defense and nondefense spending. now, the members of this body know i'm no fan of frivolous pork-barrel spending. i think a lot of the projects that my democratic colleagues sponsor could easily fall in that category and that we should rein that sort of thing in at a time when we're $20 trillion in debt. but i understand the only way we are going to get something done about the radical spending cuts to our military was to forge a bipartisan compromise. after all, it's not like the sequester spending cuts really did that much to control spending. did spending go down in 2011 and
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2012 and 2013? yes. from $3.6 trillion down to $3.4 trillion. the sequester wasn't even in effect those first two years. spending went down because republicans won control of the house in 2010. at the end of 2013, however, congress raised the budget caps and pushed off the sequester for those two years ahead, so by 2015, federal spending was back to $3.6 trillion, and it's been growing ever since. time and time again, congress has proven itself utterly incapable of sticking to the caps under the budget control act of 2011. so instead of actually saving money, all the sequester does is create an endless series of crises for congress to escape just in the nick of time. take this year. we all know what's going to happen. we just passed a three-month
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continuing resolution earlier this month. we're going to reach a two-year budget agreement in october or november that doesn't control spending. we're going to have an omnibus in december written in secret in our leaders' offices, and then we're going to have another omnibus spending bill written in secret in our leaders' offices next december. and then we'll repeat that entire cycle over again in 2019 and "20/20". how do i know -- and 2020. how do i know that? because it's exactly what happened in 2013 and 2015. if we never make the cuts the budget control act called for, we'll just pass giant budgets nobody has read at the last minute in an attempt to avoid these crises of our own making. my amendment was the last best chance in years to stop this bust and boom cycle of budgeting, but what did the democrats do? they threw it away. they took a perfectly good bipartisan opportunity to repeal these automatic spending cuts and they threw it away.
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you have to ask yourself what goes through senators' heads when they make such a cynical political calculus? do they not understand the implications of what they're doing? do they not see the appalling lack of readiness that's so apparent to everyone else? did they not see what happened to the u.s.s. john mccain? did they not see what happened to the u.s.s. fitzgerald? did they not see all those caskets carrying dead bodies of america's young coming home, families in grief? did they not see them? or did they see them and just not care? what do they think when they rather respected men like secretary jim mattis say, quote, no enemy in the field has done more to harm the readiness of our military than sequestration? what do they think when secretary mattis says after four short years of retirement when he's returned to the department of defense, quote, i have been
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shocked by what i have seen about our readiness to fight? is that just background noise? does it not register with the democratic senators? in fact, what they must think, what they have been saying for the exact same thing for years. the junior senator from connecticut, the so-called sequester is another sad example of governing at its worst. the junior senator from new jersey -- it is brunt -- blunt, brutal and blind. he gets bonus points for i will lit ration. the senior -- i will iteration. the senior senator from virginia. the sequestration is stupidity on steroids. i can make a lot of claims. we need to replace sequestration as quickly as possible but apparently not if it requires a vote on the cotton amendment. the junior senator from minnesota, there are a lot of people suffering needlessly
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because of the sequester and that's not a voc, even coming from -- a joke, even coming from him. i guess these cries for anguish are falling on deaf ears. the senior senator from new hampshire, the blind cuts of sequestration are not the right approach but by all means let's keep them in place, rather than vote on the cotton amendment. the senior senator from connecticut, the safety and strength of our nation also require that congress eliminate the rightly malign sequestration straitjacket for all federal programs. maligned yet not repealed. and my favorite, the senior senator from rhode island, the senior democrat on the armed services committee. instead of dodging fiscal responsibilities, republicans need to help end sequestration and get back to a normal budget process. republicans gave you a perfect example to do that, sir, and you turned it down.
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that's what this amendment would have done. but now we won't have a single dime more for the military. we won't give a dime more to fema or the national weather service or the noaa or nassau or what have you. we won't give one penny more to the domestic programs they claim to care about. as it turns out, they must not care that much about them or maybe i'm being too much. maybe they do like them a lot. they like uses them to gin up political support. when the time came to put their money where their mouth is, they walked away. now, the democrats will tell you they oppose this amendment because it wouldn't repeal the automatic sequester of mandatory spending. don't give me that. that is nonsense. that is a pure pretext. the automatic sequester consists of a small, almost trivial amount of cuts. and it wouldn't have affected
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one penny, not one penny from social security or medicare or veterans benefits. and here's what's most important. every single democratic senator has voted to extend that mandatory sequester into the foreseeable future. so far from thinking it's a problem, they voted to extend its life. but, hey, how about i strike a new deal. here's my offer. i'll support hiding behind procedural niceties, hiding in your cloakroom and not voting on my amendment. if you agree to do one thing. go home in person to your military bases, in your home states, and explain to the men and women of our armed forces face to face why you couldn't bring yourselves not just to repeal these spending cuts but not even being tough enough to take a vote one way or the
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other. so the democratic leader can go to new york and tell the men and women of the tenth mountain division of fort drum, the democratic whip can go to the naval station great lakes, the senior senator from rhode island, the senior democrat on the armed services committee, he can go to the naval war college. the senior senator from missouri can go to the 131st bob wing. the junior senator from new york can go to the soldiers at fort drum as well. the senior senator from new hampshire can go to the portsmouth naval shipyard. the junior senator from hawaii can go to a dozen different military bases in hawaii while the senior senator from florida can go to 20 different military installations in his state. the senior senator from connecticut can go to the groton submarine base. the senior senator from indiana can go to am general in south bend whose manufacturing he always touts for political
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purposes. the junior senator from virginia can go to norfolk or the pentagon or fort myer or any one of the numerous bases in virginia. the junior senator from maine can go to bath iron works. the junior senator from new mexico can go to kirtland and canyon air force base. the junior senator from michigan can go to general dynamics outside detroit and the senior senator from massachusetts could shake hands with all 115, 563 of the people in her state whose jobs are directly tied to defending our nation. every one of those democrats who sit on the armed services committee and have claimed to want to stop these automatic spending cuts can go home and tell the men and women in uniform in their states that they had a chance to vote on it and they were too cowardly even to put their name on the rolls.
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they can look all these americans in the eye and say sorry, just politics. hope you understand. that's all this is, politics of the lowest kind. maneuvering, posturing, posing, they are caving to the demands of the democratic leader simply because he wants more leverage for more pork barrel spending when we have a budget deal negotiated in secret in december. he twisted their arms and they screamed like little kids. they're putting politics ahead of our troops. they're holding our troops hostage to politics solely because their leader wants them to. because if they weren't, they'd allow a vote on this amendment. they had a he vote aye and -- they'd vote aye and vote eagerly and enthuse asically but they can't even do that. they can't put their names down as a yes or no on something at
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the a all said they support -- they all said they support for years. so they just hide behind procedure. they behind in their cloakroom. they hide from the voters. they hide in the back corridors and hallways of this building. they hide to save their own skin. they hide because they're ashamed and they sure as hell should be ashamed. madam president, i yield the floor. i note the absence of a quorum. the presiding officer: the clerk will call the roll. the senator from hawaii. ms. hirono: i ask unanimous consent to vitiate the quorum call. the presiding officer: without objection. ms. hirono: madam president, two months ago millions of americans rose up and defeated trumpcare. in doing so we reaffirmed that in the wealthiest nation on earth, health care is a right and not a privilege reserved only for those who can afford
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it. the president and the republican party believe the opposite. to them health care is just another commodity to be bought and sold but we all know this is not like buying a new car or a big screen tv. the republican position shows no heart, no care, and no compassion. it's the exact opposite of what so many of you showed me when i was diagnosed with kidney cancer. although we successfully defeated trumpcare in july, we face fresh assaults to deny every american's right to health care. it doesn't have to be this way. in july so many of us were moved by senator john mccain's impassioned plea for the senate to return to regular order, to debate how to strengthen our health care system on a bipartisan basis. since then senators lamar alexander and patty murray worked to build consensus for a bill that was -- that will
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strengthen insurance markets and reduce out-of-pocket costs for consumers. they've done this the right way through committee hearings, bipartisan meetings, and careful deliberation. instead of embracing and endorsing this effort, the president and the majority leader have chosen to double down on their obsession with depriving health care to millions of people across the country now through the graham-cassidy bill. let me be clear. this bill is not a compromise. it is not a new and better idea for delivering health care in this country. it's just a new version of trumpcare. and i might say an even worse proposal than the one we defeated in july. the details matter. this version of trumpcare eliminates the affordable care act's medicaid expansion, and that threatens coverage for more than 110,000 hawaii residents now receiving such coverage.
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and there are millions all across the country who now get health care coverage thanks to medicaid -- medicare expansion -- medicaid expansion in their states. this bill establishes a health care block grant, establishing a per capita cap on medicaid spending that would severely limit federal funding for health care. funds that states rely upon. republicans, including the cosponsors of this bill, argue that this approach would provide more local control over health care. this, however, is what we in hawaii call shabai or b.s. local control through a block grant is just an excuse conservatives and republicans use as a pretext to make deep cuts to programs that americans depend upon and you see the resort to block granting everywhere from education to health care. a new study from the center for budget and policy priorities
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reveals the cost of this latest version of tru -- of trumpcare firsthand. under the proposal hawaii would lose $659 million in federal funding for medicaid over ten years. part of some $80 billion in cuts across the country. this is a lot of money for hawaii to lose, money that is being put to great use across our state. last month i visited the clinic on the big island where the medicaid expansion under the a.c.a. has improved health outcomes to poor, rural communities across that island. the clinic is a primary health care provider to six of the ten poorest zip codes in the entire state of high where many residents went years without health coverage. thanks to the affordable care act, bay clinic has successfully enrolled thousands more people in medicaid and decreased the
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number of uninsured patients coming through their doors. they decreased this number -- astounding what the numbers show. patients coming through their doors cut from 29% in 2010 to only 10% in 2015. that is how many more people on the island of hawaii is able to get health care coverage. and over that same time period, bay clinic saw a nearly 20% increase in the number of patients it serves every year. in the years following the passage of the a.c.a., bay clinic and community health centers all across hawaii have hired more doctors, nurses, and expanded the types of services that they provide. bay clinic, for example, has expanded their mobile health unit where doctors go to rural communities where residents would not otherwise have access to primary care providers. this program and others like it
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in hawaii and across the country face an imminent threat from this newest version of trumpca trumpcare. unfortunately, this bill's devastating cost to medicaid is only part of what makes it so mean and so dangerous. it eliminates all premium subsidies that allow lower income americans to afford coverage and eliminates cost-sharing subsidies that reduce out-of-pocket expenses for consumers. these are the very issues relating to the affordable care act that chair lamar alexander and ranking member patty murray are addressing in their regular order addressing of how to provide health care for more people in our country. so this bill, the cassidy bill creates a process through which states can receive waivers to roll back essential health benefits and eliminate important consumer protections, like
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guaranteed coverage for millions of americans living with preexisting conditions, people like me. i've said many times on the floor of the senate that we are all only one diagnosis away from a major illness. every day 6, 540 people are diagnosed with cancer in our country. 4,109 are diagnosed with diabetes. 1,309 are diagnosed with alzheimer's every day in this country. we are all one diagnosis away from a major illness. these are people like me, many of them going about their business and wham, suddenly you get a devastating diagnosis. and not all of these people will have health insurance. and under trumpcare even more of them, this version of trumpcare, will have access to health care. when i was diagnosed with kidney cancer, i had insurance. instead of worrying about how to pay for my treatme,

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