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tv   Senate Narrowly Rejects Health Care Law Repeal in 49-51 Vote  CSPAN  July 27, 2017 3:59pm-6:00pm EDT

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echoing a point that so many colleagues on this side have said. this is not about saying look, we're just against what you want to do. quite the opposite. for all my time in professional -- in public service, i said what i want to do is try to find common ground with people of common sense. let us defeat this skinny sham, shell game kind of process that looks like what we're going to be voting on tonight and then get serious about doing what legislators do, which is not take each other's crummy ideas but take good ideas and work on them in a bipartisan way. mr. president, i yield the floor.
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a senator: mr. president. the presiding officer: the senator from pennsylvania. mr. toomey: mr. president, i ask unanimous consent to speak on the health care topic for 15 minutes. the presiding officer: without objection. mr. toomey: thank you, mr. president. i'm going to speak mostly about some medicaid reforms that were proposed in the bcra. but in the course of the discussion, i'm going to touch on some of the issues that our colleague who just finished raised. as we know, the bcra bill is not going to be the vehicle that we will take to a conference committee with the house, but i hope we will get to a conference committee with the house. and i hope that the result of that, among other things, is that we'll address the need to make important reforms to medicaid because they're long overdue. let me start by introducing --
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i'll start with a chart here that illustrates our federal deficit and what exactly is driving our federal deficits. the fact is, i think we all know here we have two big categories of federal spending. one is the discretionary spending that congress approves at congress' discretion every year. and the other category are the programs that are on auto pilot. program spending is driven by a person's eligibility for the program without congress acting in any way. that latter category we call mandatory spending. and in 1980 that was only 50% of the federal budget. by 1995 it was 64%. last year that was 70% of our entire budget, and we are on a path to have these mandatory spending -- that's the blue line. you can see the growth in mandatory spending. you can see the relative lack of growth in the other categories
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of spending, be it defense or nondefense discretionary spending. the budgetary problem we have is mandatory spending. this is not breaking news. this is nothing that's controversial. anybody who has taken an honest look at the numbers can come to no other conclusion. the discretionary portion of the budget which used to be the lion's share of the budget has been relatively flat. actually has even declined in recent years. the mandatory spending has been going through the roof. of course there are multiple problems with this, not the least of which is had this kind of growth in mandatory spending, the first thing it does is squeezes out all other categories of spending. we're already living through that as the discretionary spending, including on our nation's defense, have been declining because you can't do so much of both. but in time you could zero out all the discretionary spending, and there still won't be enough for all the mandatory spending
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that is coming our way if we stay on the path that we're on. so where is all this mandatory spending coming from? well, the next chart shows that pretty clearly. the bulk of mandatory spending, especially in recent years, is from medicaid. and the reason i say that is social security is a big program, but social security has a dedicated revenue stream. it's a payroll tax. the historically it used to cover all of it. for awhile there it covered more than the ongoing payments for social security. while that fluctuated when we suspended the payroll tax, by and large the payroll tax pays most of the social security costs that we have day to day. medicare also has a revenue stream that is dedicated from payroll taxes, but it doesn't cover nearly as large a percentage of the medicare costs as social security. so you see the green line generally is higher than the blue line. but the line that's higher than
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all by far is the medicaid line because there is no dedicated revenue stream to medicaid, and the net expense, therefore, is by far the biggest of all our entitlement programs. medicaid has been growing at a really shocking rate for years. in 1980 medicaid spending was only 2.4% of our budget. a half a percent of our economy. by 1995 it was almost 6% of our budget. today it's 10% of our whole budget. 17% of all health care spending. so this is happening because medicaid is growing much faster than our economy is growing. and the fact is no federal program can grow faster than the economy definitely because the economy has to fund the entire government. the main purpose of our economy is to provide a livelihood for
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the people who create it. but medicaid, as you can see, is growing at a staggering rate compared to our economy as measured by g.d.p. this picture right here summarizes really for me the very definition of an unsustainable federal program because as it continues to grow the a a rate that's much greater than our economy, it necessarily is consuming an ever greater percentage. an ever greater portion of our economy and our federal budget. nothing can grow faster than the economy indefinitely. i mean it's just arithmetic. eventually it would become bigger than the economy which is obviously an impossibility and long before that happened it would cause a fiscal crisis. this is the very essence of what is unsustainable. but you don't have to take my word for it, and i'm certainly not the first person to observe this. we could take the words of
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democratic president bill clinton who told us this very thing. he said back in 1995, and i will quote president william jefferson clinton said, we all know looking ahead now that our number-one entitlement problem is medicare and medicaid. they're growing much more rapidly than the rate of inflation plus population. now, president bill clinton wasn't making this point because he's some kind of ideologue that wants to get rid of medicaid. i don't think he's ever been accused of that. it's not because he's got some passionate ideological commitment to reducing the size of government. i don't think he's ever been accused of that. i think bill clinton was making this point because he knew that this program was unsustainable and he wanted to reform it so that it would be sustainable, so that our federal budget would be sustainable, so that medicaid would be there for the next generation. i think that was bill clinton's
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motivation at the time. so what was his solution? what was it that bill clinton thought we ought to do about this program that was unsustainable? president bill clinton suggested that the federal government put caps on the amount of money it would contribute to the states based on the number of individuals enrolled. so, in other words, it was a per beneficiary limit on the federal contribution. that's what bill clinton proposed in 1995. he wanted to maintain the eligibility of individuals to participate in the program, but he wanted to put limits on what the federal government's share would be. and he wanted to have it grow at about the rate that the economy would grow. so thank -- that you wouldn't continue to have this accelerating line but that the two lines would converge. because then, as bill clinton knew, the program would be
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sustainable over time. we'd be able to afford it. so you might wonder what did congress think of this idea at the time. this is 1995. bill clinton comes along and says let's establish per beneficiary caps on medicaid expenditures by the federal government, and let's limit the growth of those caps to about the growth of the economy. that was bill clinton's idea. well, helpfully the democrats who controlled the senate decided to weigh in on the matter. and on december 13 in 1959, senator patty murray, who serves with us today, she submitted a letter to the "congressional record," and i'm going to read a very brief comment that she made when she submitted this for the record. she said -- mrs. murray, the senior senator from washington, said mr. president, i hold in my hand today a letter to president clinton that is signed by all 46 members of the democratic caucus. this letter urges him to hold
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firm to our commitment to the basic health care for children, pregnant women, the elderly and the disabled in this country. this letter supports a per capita approach to finding savings in the medicaid program. it was signed by every single democratic senator. they expressed their strong support for the medicaid per capita cap structure. now they -- i want to be very specific about this. as they developed the particulars, they decided that the caps should not grow at an index that was tied to health care spending. they wanted it to be tied to an index that would grow at the rate of the economy overall. and they proposed that it would go into effect the very next year. they didn't want to wait. they didn't want to have a transition. they didn't want it to be gradual. they wanted it to go into effect the next year.
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they proposed implementing the changes for the very next fiscal year. so, mr. president, you can imagine that some of us are a little bit surprised by the shrill over the top attack that we've been hearing from the other side. we republicans have been accused of launching a war on medicaid. we've been accused of draconian cuts. we've been accused of wanting to decimate health care for the most vulnerable. we could go on, as you and i both know, all across the country, on this floor, in every form imaginable, our democratic colleagues have attacked republicans for the proposal in the bcra bill that we've been considering. what's so really outrageous about this is we proposed a democrat solution. what we've proposed was bill clinton's idea as ratified by every single democrat serving in the senate at the time,
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including several who are still with us today. we proposed that we take medicaid and we restructure it the way the federal government reimburses states for their expenses, so that we would put caps on the amount that the federal government would contribute per beneficiary. and we'd allow the caps to grow. but just as president clinton and all the democrats in the senate suggested, we'd make sure that that growth eventually converges to the growth of our economy so that we would have a sustainable program. two big differences, mr. president, between what the democrats proposed in the mid-1990 and what many of us have proposed these last few weeks. one is we proposed that the change occur more gradually. we suggested that we would implement these changes but we do it over time, not suddenly the bay they -- way they had proposed it. the other big difference i would suggest is that they proposed this structural change to medicaid before obamacare came
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along and made an unsustainable program worse. we're proposing it in the aftermath of that huge problem. so i get that our democratic colleagues have done a 180 reversal. i get that they no longer acknowledge that this is no longer sustainable. i get they don't want to do anything about entitlements. i understand all that. you're entitled to change your opinion, decide you want to ignore this issue. but it's a little bit over the top to attack our motives, our integrity when we're proposing exactly what they themselves proposed just a few years ago under president clinton. so i wish we could have a substantive discussion about the policy without the character attacks. let me get into a little bit more about these changes to medicaid. as you know very well, mr. president, traditionally medicaid was available from the time the program was launched to four categories of americans,
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four categories of people who were of very low income and were deemed to be unable to purchase health care for themselves. those were the elderly poor, disabled, blind and disabled, children, and adults with dependents. so the program set up a partnership with the states, a generous partnership. the federal government has always paid a majority of the costs ranging anywhere in some states as high as 75% of the costs and other states -- in no state less than 50%. on average 57%. obamacare came along and created a new category of eligibility. under president obama, for the first time under obamacare, a new category was created, and that is adult working age, able-bodied people with no dependents would now be eligible for medicaid if their income was below 138% of the poverty line. and the federal government would pay all of the costs initially and then after a short period of time it would go to 90%. and then the federal government would pay 90% in perpetuity.
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there was a few problems with this design. the most fundamental and obvious is the federal government couldn't afford this. we were not on a sustainable path before, and now we've created this whole new liability. that can only make it worse and bring a fiscal crisis closer to the present. and the second thing is when states have no skin in the game, we find out that they behave as though they have no skin in the game. when states have to contribute only 10% of the cost, think about it. every dollar a state spends in this category gets matched with nine federal dollars. nine free dollars. that's a huge incentive to spend a lot. and guess what? that's exactly what they've done. medicaid spending in this category has ended up being over 50% more than what was expected. so what did the senate propose in our legislation? we proposed not that we would disallow this coverage, not that we would eliminate this category of eligibility, not that we would throw a single
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person off medicaid. we said in fact we'll codify the expansion. we'll make it permanent. no one loses eligibility. no one gets thrown off. but what we will do is gradually , over seven years we'll ask states to pay their fair share for this new category, this expansion category, the able-bodied adults with no dependents. we'll ask the states to pay the same amount for these folks that they pay for the traditional four categories of eligibility. that's the first category. the second reform that we proposed is what i eluded to earlier, about per beneficiary caps, and that was in our legislation -- on those caps, though, what the underlying senate bill did was allow the spending to grow very rapidly on those caps. only in the eighth year did we ask that the growth rate slow
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down slightly so that we would have a reasonable chance that the growth in the program would be about the same as the economy. so that's what we proposed. that was what was in the bill. that's what we have been hearing about all of these draconian cuts. let's get into the discussion about these cuts. we have another chart that illustrates some of this because this has been a favorite theme for some of my colleagues on the other side to talk about all of these cuts. well, if you look at c.b.o. score -- now, again, is this the senate bcra, the legislation that we didn't get enough votes this week to pass this, but i hope we will revisit this. the largest of the so-called cuts in medicaid spending comes from c.b.o.'s assumption that if you repeal the individual -- the stamp ute that says -- the statute that says you must have insurance, if we repeal that,
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millions of people on medicaid, millions of people who get free insurance will decide, i won't have free health insurance anymore. if i'm being forced -- i don't want free health care. that is counterintuitive to me. to my friend from oregon who was attacking the so-called skinny bill, 100% of the so-called medicaid cuts in that bill come from exactly this source. the assumption that if people are not forced by the government to have insurance, they won't want medicaid. you can decide how much creditability you want to put in that assumption. it strikes me as ridiculous. that's the truth. that's the reality. in the bcra, that was only the lion's share of the so-called cuts. the other category of so-called
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cuts in the analysis of the bcra are their assumptions about expansion. they decide that under current law if nothing else happens, a whole lot of states will choose to become medicaid expansion states. they haven't made that choice yet. they can't point to which ones. it's a political decision in various states. they don't know who will be leading those states. they have no idea how that will happen. yet, they predict states that have chosen not to be medicaid expansion states would adopt the expansion under current law, but if we passed the law that was proposed earlier, those states will not make that decision. and furthermore, some states that have expanded will rescind the decision to expand. any honest person, including the folks at the c.b.o., have to acknowledge that is entirely speculative. they can't name a single state that will expand under the
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current law but hasn't yet. they can't name a single state that would rescind its expansion having already done so. they are just speculating that could happen. that, my friends is the lion's share of the c.b.o.'s headline numbers about all of these cuts in medicaid. and despite that -- let's go to chart five. despite, -- despite that, even if you go with c.b.o.'s numbers that people will participate, even if you accepted all of them, these are the draconian cuts. each and every year under the bcra, federal spending on medicaid grows. it grows every year. every single year. so it's only in washington can spending increase every year and it's a draconian cut.
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no, the truth of the matter is what we do under that legislation is we slow down the rate of growth. we slow the rate at which the program grows to a rate that is sustainable so that this program is viable, so that we are diminishing the -- the certainty of a fiscal crisis. that's what we do. now, if somebody's got a better idea for how we put medicaid on a sustainable path, i'm all ears. i'd love to hear it. we did in the 1990's, our democratic colleagues proposed exactly what we are proposing now. that was a constructive idea. unfortunately there wasn't a consensus to do it. but that was a shame. i ask that my democratic colleagues go back to their notes and arguments they were making and back to the floor,
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that's the arguments we are making now. mr. president, the fact is medicaid is a very, very important program. the most vulnerable americans depend on medicaid to a very significant degree. the fact is in its current form it is unsustainable. our democratic colleagues in the past have -- used to recognize this. they used to acknowledge this and they used to want to do something about it. i urge them to return to that attitude so that we can work together and get something done. the sooner we act on this, the sooner we can have gradual -- gradual, sensible, thoughtful reforms that make the program sustainable and allow our states to plan for these changes and allow for transition. if we wait too long, the fiscal crisis that will hit us will force sudden and draconian changes. mr. president, we're not going to vote on this provision today. this was embedded in the bcra. that is behind us this week, but
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it is my hope that we will pass a version of obamacare repeal that will enable us to go to conference, that we'll be able to begin to repair the enormous damage to the individual markets that obamacare has done, that we'll be able to stabilize them, that they will -- we will be able to move in the direction of consumers having control of their own health care once again, and that we will put medicaid on a sustainable path because the time is overdue. i yield the floor. the presiding officer: the senator from oregon. wide wye how much -- mr. wyden: how much time remains on our side? the presiding officer: the senator has three minutes remaining. mr. wyden: i will be brief. just to respond to my friend from pennsylvania. number one, none of what he has discussed has come up in the senate finance committee. what i can tell you about past debates is our side was always interested in reform-minded ideas, for example, bringing the private sector into the delivery
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system of medicaid. s that number one. -- that's number one. number two, we still have not seen the skinny bill. i said earlier, who knows what happened at the republican senate lunch between one course and another. we would like to see the skinny bill. and i think once again we have heard from the other side that they disagree with the umpire. they disagree with the nonpartial c.b.o., and i think that's unfortunate. with that, mr. president, i yield. the presiding officer: the senator from wyoming. mr. grassley: mr. president. the presiding officer: the senator from iowa. mr. grassley: i ask for consent to speak for 17 minutes. the presiding officer: without objection. mr. grassley: and it's my understanding if the managers need time to break into my speech, i'll be glad to accommodate that. i rise today to inject a dose of badly needed reality into this
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very important debate. health care is a profoundly personal issue that matters to every single american. in fact, every single senator in this body ought to agree on this point -- health care hits home for each and every constituent we represent from our home states, from standard wellness checks to lifesaving cancer treatments, each of us want the best, most effective, and affordable medical care for the people we love and for ourselves. as policymakers, it's our job to solve problems, and it goes without saying that we're facing a big problem right now. access to affordable health care is simply out of touch for millions of americans, and that's despite the promises made over and over again. remember that obamacare was rammed through on a last-ditch
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christmas eve party-line vote. look at what that got us. health insurance markets are collapsing around the country. since 2013, the average premium increase on the individual market has jumped 105%. remember when president obama promised affordable health care for all, he promised we could keep our doctor. he promised that americans, they could keep their health care plan, and he promised all americans that their premiums would go down by $2,500. now we all know obamacare did not uphold these promises. instead, we got higher taxes, costly penalties, double-digit premium increases, and unaffordable copays, job and
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wage-crushing employer mandates, and thickets of federal regulations. and now obamacare is collapsing. no one on the other side of the aisle has made an attempt to legislate remedies to the law despite its grave condition. at this very moment 72,000 iowans in my home state are gripped with uncertainty. two insurance carriers have dropped out of the exchanges, leaving only one to have individual plans starting in january. the policies offered by that insurance company will go up over 40% next year on huge increases -- on top of huge increases this year, making it still unaffordable. obamacare is unsustainable, unaffordable, and unacceptable. this brings me then to the
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reality check that i mentioned when i started. as i listen to some of my colleagues on the other side of the aisle, i'm, frankly, astounded that they can deliver their talking points with a straight face. they would like the american people to believe that republicans are dead set on ripping health care away interest children, the elderly, and the disabled. despite their red hot rhetoric, we have neither horns nor tails, but we are dead set on working the -- working out the delvish -- devilish details. democrats hyperbole is standing in the way. legislating in good faith is hard work.
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obamacare defenders would rather disparage than engage. they would rather obstruct a path forward than to construct a path forward. they are standing in the way of solving problems, and in the process, they are scaring the living daylights out of hardworking americans who aren't able to stretch their paychecks to afford health insurance for their families. if there is one job the defenders of the big government have mastered, it's the roll of chicken little. they squawk, cluck, and crow at every opportunity to grow the size, scope, and reach of government into our daily lives. to their way of thinking obamacare was a step toward single payer. they will say and do whatever it takes to secure sweeping universal government control of the health care system no matter how much it costs the taxpaying
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public, the toll it takes on the u.s. economy or the loss of personal freedom. their message is dead wrong. our reform efforts are making -- are not making the sky fall. the democrat rhetoric reminds me of a similar situation. the debate 20 some years ago was to reform welfare by raining in -- reining in runaway federal spending. just like now that debate was full of dire predictions. .so my colleagues -- some of my colleagues will recall the late patrick daniel moynihan of new york. he strongly opposed efforts to reform the welfare system. he predicted that bipartisan
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proposals would result in an apocalypse and said, quote, if in ten years time we find children sleeping on greats picked -- grates picked up in the morning frozen and asked why are they here savaging awful toll themselves, awful to you one another, well, will anyone remember how it began? it will have begun on the house floor this spring and the senate chamber this autumn. that's the end of the quote 20 years ago from senator moynihan. the facts will show that welfare reform was in fact not, quote, legislative child abuse, unquote. quite to the contrary. two decades since historic bipartisan welfare reform was
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enacted, realty shatters this doomsday prophecy of 20 years ago. the realty is that an african american children living in poverty has fallen to its lowest level in history. the problem still exists and deserves our attention, of course, but 1.5 million fewer children are in poverty today. -- 3.4 million families are independent from assistance. at the time of welfare reform, the chicken littles forecasted homelessness, poverty and despair. senator moynihan also said that requiring welfare recipients to work and limiting the length of time that they could collect benefits added up to, quote, the most brutal act of social policy since reconstruction. those involved will take this disgrace to their graves.
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end of quote. with all due respect to the memories of my former colleagues, their rhetoric simply does not square with realty. the 1996 welfare foreman law lifted millions -- welfare foreman law lifted millions out of generational policy, replacing lifestyles of dependency with livelihoods restored with hope and opportunity. these facts separate democrat rhetoric from realty. in the absence of a credible reason to continue with obamacare's failure, the only defense tactic left to the democrats is fear. in a similar vein to her predecessor from new york, former senator and democratic presidential nominee hillary clinton said, quote, if republicans pass this bill, they are the death party.
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end of quote. in another similar vein to her predecessor, another senator from massachusetts said, quote, i've read the republican health care bill. this is blood money. they're paying for tax cuts with american lives. they are not alone in their obstructionism. the minority leader has said that republican-led efforts to reform obamacare are, quote, heartless. it is a wolf in sheep's clothing. it brings shame on the body of the senate. end of quote. another democrat chimed in that the senate bill is -- ,quote-unquote, -- down right diabolical and would be, additional quote, one of the blackest marks on our national history. still another democrat said his constituents are, quote, scared for their children. they're scared for their powses.
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they're scared for their aging parents and their own health and well-being. another one chimed in, quote, our emergency rooms would be overwhelmed, unable to deal with the scope of that kind of humanitarian need. not surprisingly -- that was the end of the quote. not surprisingly the law's champion in chief, president obama, has fueled the fear factor saying that americans' efforts to reform the hk health care law would put pregnant mothers, addicts, children with disabilities and poor adults in harm's way. such overheated rhetoric shows democrats have abandoned rhyme, reason and realty. too often the arguments from the other side are based on what medicare was supposed to do, not what it actually did, which fell far short of projections from the experts. defenders of obamacare are relying on a phantom rather than
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the realty of the law. democrats are refusing to work with us towards a better solution that truly works. after years of neglecting consequential problems with a partisan past law now on the books, they say they have a better deal. let me tell you, thousands of iowa families and small business owners have contacted me with their personal stories of hardships. to them, obamacare has been nothing but a raw deal rather than a better deal. what good is having insurance, they say, if it's too expensive to use? after more than seven years of obamacare, the chickens have come home to roost. and in less than ten years, look what happened when government gets in the way of the free market and consumer choice. well, it's obvious. higher premiums, bigger
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co-pays, fewer choices, less freedom. health insurance that costs too much to use is just not working for hardworking american families. i'll end my speech today with an appeal for an iowan from avoke, iowa. she has contacted me many times about the hardships her family has experienced since obamacare was enacted. she pays more than $25,000 a year to insure her family on the individual market. if that sounds like chicken feed to some of the obamacare defenders, i urge you with all sincerity to get your heads out of the clouds and join us to fix this flawed law. republicans and democrats can work together for the greater good of the country. it's -- it is said when there is a will, there's a way. many of us recognize that obamacare isn't working as promised. half of us voted this week to
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move ahead to fix this problem. the other half is blocking any effort put forward to reform the broken law. they're digging in their heels and pulling out all stops of any solution and doing it -- and stopping it dead in its tracks. again it reminds me of those who fought tooth and nail to stop welfare reform 20 years ago. i've quoted those people from 20 years ago. at the time they predicted those dire consequences would befall our most vulnerable citizens. thank goodness the pessimists back then did not prevail in their obstruction against welfare reform. while welfare reform has not been perfect, it has restored hope and opportunity to millions of americans. we can't afford to let the pessimists and obstructionists prevail today against health
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care reform. and they seem to be acting like the very same people that opposed welfare reform 20 years ago. the american people deserve high-quality, affordable health care. obamacare has not lived up to its promises. so it's time elected leaders lived up to our promise that we made to the american people. let's worry less about who wins and worry more about who will lose when congress fails to restore the collapsing federal law. i yield the floor. mr. enzi: mr. president. the presiding officer: the senator from wyoming. mr. enzi: mr. president, i ask unanimous consent that the time until 5:00 p.m. be equally divided between the managers or their designees and that at 5:00 p.m. the senate vote in relation to the strange amendment number 389. further, that following disposition of the strange amendment, the senate proceed to the consideration of h.r.
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3364, which was received from the house, that there be 20 minutes of debate equally divided between the leaders or their designees, that following the use or yielding back of that time the bill be read a third time and the senate vote on passage of h.r. 3364. finally, that following disposition of h.r. 3364, the senate resume consideration of h.r. 1628. the presiding officer: is there objection? without objection.
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who yields time? if no one yields time, time shall be charged equally to both sides. mr. enzi: mr. president. the presiding officer: the senator from wyoming. mr. enzi: i yield myself such time as i need up to the limit that we have. this week we've been debating why it's so urgent for congress to act on rescuing americans from the collapsing obamacare health care law. we've heard from our colleagues across the aisle question our motives and our actions. congress literally has millions upon millions of reasons to replace and repeal this law. hardworking american families who are begging us to provide them with some relief, these are families that are forced to
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purchase high-deductible coverage insurance and are facing thousands of dollars of out-of-pocket costs before their coverage even begins. for them, the status quo, doing nothing, is not an option. for senate republicans, rescuing the american people from this law is our only option. but the defenders of this law don't seem to grasp or are unwilling to admit that obamacare is not affordable insurance and has been a crisis-inducing failure. this is why republicans are working to fix the damage. insurance markets are collapsing. premiums are soaring. and health care choices are disappearing. americans expect the congress and the president to address the problem. with obamacare getting worse by the day, the time to act is now.
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just look at my home state of wyoming, which is down to one insurer in the individual market. both on and off the exchange. this should be treated as the national scandal it is. some on the other side of the aisle like to focus on how many people are insured under the law. but let's look at how many are not insured. almost 28 million americans remain without insurance under obamacare because they cannot afford insurance or no longer have access to it due to obamacare's collapsing markets in their state or county. but coverage numbers can be misleading, because even with insurance many hardworking families still cannot afford the care due to surging deductibles. insurance with sky-high deductibles is coverage in name only. when it comes to medicaid coverage, what most news stories won't tell you is that
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the newly insured only gained coverage through a flawed medicaid program that's providing inferior quality and threatening to bankrupt states across the nation. democrat leader nancy pelosi famously said, quote, congress would have to pass the bill to find out what's in it. end quote. well, americans soon discovered that president obama and congressional democrats focused almost exclusively on coverage numbers, boosted by government mandates handed down from washington. instead of true health care reforms that might have actually provided better care, provided affordable care, obama's alleged coverage numbers are only on paper. coverage was their sacred cow, worshipped above all others. because for president obama, for nancy pelosi and for harry reid, coverage equaled health
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care. large coverage numbers touted by the obamacare administration and congressional democrats has proven to have the health care utility of a pet rock. you remember the pet rock? millions of people purchased a rock. it was very nicely packaged in a box. they'd bring it home and open it up and find a rock. pet or not, it served no purpose other than its name. a pet rock. this is essentially how obamacare has worked, except people were forced to purchase this marketing gimmick. americans have purchased insurance through obamacare exchanges with the promise of accessible coverage. what they actually received, however, is coverage in name only. it serves no health care purpose and it doesn't work. merely packaging a pet rock, if you will, and millions of americans soon found out. the high cost of insurance
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plans, they forced people to buy made it nearly impossible for them to pay for the coverage they signed up for. or if they could afford coverage, they realized the care they were paying for came with sky-high deductibles. congressional democrats and president obama focused almost exclusively on the numbers of people now enrolled in obamacare and relentlessly highlighted this information, which showed that this law was used mainly for public relations purposes at a large cost as opposed to an actual policy accomplishment. instead, the reality is that americans who are able to get insurance were often plagued with inadequate coverage, joined with enormous out-of-pocket costs. senators from across the country this week have been sharing stories about families in their states that have had to forgo
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medical care, not because they don't have insurance but because it was simply too expensive to go to the doctor under the obamacare health plan. for years, republicans have pledged to repeal this disastrous law, and this week we're working to address the broken promises of obamacare to help ensure better care for each and every american. we are doing this by working to stabilize collapsing insurance markets that have let millions of americans with no options, which will help improve the affordability of health insurance and therefore health care. our goals are to preserve access to care for americans with preexisting conditions and to safeguard medicaid for those who need it most by giving states more flexibility while ensuring those who rely on this program won't have the rug pulled out from under them. most importantly, republicans hope to free the american people
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from onerous obamacare mandates that require them to purchase insurance they don't want or can't afford. the president and republicans in congress last fall promised to rescue the millions of american families suffering under obamacare, which is what this bill will do. thank you, mr. president. i yield the floor. mr. blunt: mr. president. the presiding officer: the senator from missouri. mr. blunt: could i inquire of the remaining republican time. the presiding officer: three minutes. mr. blunt: the majority time is three minutes? the presiding officer: yes. mr. blunt: senator strange is coming. i will take my time later.
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the presiding officer: the senator from wyoming. mr. enzi: we would loan time to the other side of the aisle if they would loan us time so that the person pro pounding this amendment could have a moment to explain his amendment, and they have agreed, so i will yield
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time to the senator from alabama. mr. strange: mr. president. the presiding officer: the senator from alabama. mr. strange: i would like for permission to speak up to two minutes. the presiding officer: without objection. mr. strange: thank you. mr. president, i rise today in support of an amendment that will relieve millions of americans of a moral conflict. for too many, access to health care coverage comes only with the restriction of deeply held personal convictions about the sanctity of human life. the amendment before us offers the opportunity to end the flow of taxpayer dollars to abortion procedures once and for all. it allows high protections to be extended to all funds appropriated through the legislative -- through health care legislation we are considering today. let me provide some context. premium tax credits implemented under the obamacare -- under obamacare currently provide over
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$8.7 billion in annual subsidies for nearly 1,000 different insurance plans that cover elective abortion on the state exchanges. this provision stands in violation of the fundamental principles of the hyde amendment and the long-held understanding that the united states government has no role in funding abortions. in recent weeks, the senate has debated countless nuances of health care policy, and we have taken several crucial votes on efforts to rescue the american people from a failed social experiment, bringing us to this moment. under our current procedural circumstances, in order to ensure that both the spirit and the letter of the hyde amendment's provision against taxpayer-funded abortion is upheld, we need a new solution. my amendment would establish a matching arrangement between stability funds and premium tax credits, delivering an arrangement that complies with
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the byrd rule. starting in 2019, the value of premium tax credits that continue to subsidize elective abortions would drop to 10%, with the remaining 90% being made available as hyde-protected monthly payments to insurers to benefit the same people who relied on those tax credits. let me be clear, mr. president. this amendment does not reduce the amount of tax credit dollars available to low-income americans. it does not result in their losing coverage. it certainly does not create or expand an entitlement program. mr. president, when hardworking americans pay their taxes, they do so with the understanding that the rights granted to them by the constitution are not checked at the door. for the people of my state, the
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right to life is foremost among these. codified by the hyde amendment and ingrained in the conscious of the majority of americans. the amendment before us allows for a clear conscience. it allows for a concise conservative solution to a problem that has dogged this chamber for the 44 years since roe v. wade changed the landscape of american society. on behalf of the unborn and the conscious rights of millions of americans, i am proud to offer this amendment and i urge my colleagues to join me in this effort. mr. president, i yield the floor.
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mr. schatz: mr. president? mr. president? the presiding officer: the senator from hawaii, mr. schatz. mr. schatz: thank you, mr. president. make a point of order that the pending amendment violates section 302-f of the congressional budget act of 1974.
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a senator: mr. president? mr. strange: mr. president? the presiding officer: the senator from alabama. mr. strange: pursuant to section 904 of the congressional bulk art of 1974 and the waiver provision provisions, i move to waive all applicable sections of that act and applicable budget resolution the for purposes of amendment number 389 and if adopted for the provisions of the adopted amendment included in any subsequent amendment to h.r. 1628 and any amendment between houses or conference report thereon and i ask for the yeas and nays. the presiding officer: is there a sufficient second? there appears to be. the clerk will call the roll.
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vote:
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vote:
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vote:
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the presiding officer: are there any senators in the chamber wishing to vote or change their vote? if not, on this vote, the yeas are 50, the nays are 50. three-fifths of the senate duly chosen and sworn not having voted in the affirmative, the motion is not agreed to. the point of order is sustained and the -- sustained and the amendment fails. under the previous order, the senate will proceed to the
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consideration of h.r. 3364, which the clerk will report. the clerk: h.r. 3364, an act to provide congressional review and to counter aggression by the governments of iran, the russian federation, and north korea, and for other purposes. the presiding officer: there are now 20 minutes of debate to be equally divided. the senate will come to order. members will come to order. the senator from maryland. mr. cardin: mr. president, i yield myself three minutes. mr. president, first i want to thank senator cork,i thank to thank senator crapo and senator brown, senator schumer and mcconnell l for their help in getting us to this moment. this is an important moment for our country. and i'm very proud of what we were able to accomplish.
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a senator: order, mr. president. the presiding officer: members will come to order. mr. cardin: the legislation we are about to vote on will give the united states the strongest possible hand to stand up against the aggression of russia. russia attacked us and our democratic institutions. russia invaded the sovereignty of other countries, including ukraine and georgia. russia has participated in war crimes in syria. and this legislation will give the united states the strongest possible hand in taking action against russia, mandatory sanctions are included in this legislation in regards to the energy sector, the financial sector, intelligence and defense sector. not only with primary sanctions but with secondary sanctions. this legislation provides for a democracy fund working with europe to protect ourselves against russia's attacks. this legislation provides a review process so the president
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on his own cannot eliminate sanctions. he must come to congress, as president obama had to in regards to the iran sanctions. the president would have to come to congress in regards to sanction relief against russia. this is a tough bill to stand up to what russia has done and requires mandatory action. i want to -- there's so many people to thank in regard to this. we also, of course, have the iran sanctions. i must tell you, i want to thank senator menendez on our side in particularly on the iran sanctions. we are taking action against iran for their nonnuclear violations, their ballistic missile violations, their support of the arms embargo, human rights violations. what we do here is totally consistent with the jcpoa. those two sections, mr. president, the bills are very consistent to what passed this chamber 98-2. we maintained the integrity of the iran and russia provisions
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consistent with what was done in our committees. and in regards to north korea, i know we all want to take action against north korea. the provisions that are added by the louse those that are those that we think are appropriate for north korea. mr. president, this is an important moment for our country. i really do want it thank all involved. but i know senator corker and senator brown and senator crapo would agree with me, i really want to thank our dedicated staff. we could not have done this without our staff. they worked 24/fo-- 24/7 for the last several weeks to get this done. the united states is going to be in a better position dealing with russia when this legislation is enact enacted and i'm proud to be part of that. i reserve my triumphant. mr. corker: mr. president, i thank the ranking member for his outstanding efforts along with many others. what i would like to do now is yield to senator mccain and i will speak last, if that is appropriate. the presiding officer: the senator from arizona.
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why don't you let senator mccain go ahead and speak. the presiding officer: the senator from arizona. mr. mccain: mr. president? the presiding officer: the senator from arizona. mr. mccain: i thank the democratic leader for his courtesy, as always. in just the last three years under vladimir putin, russia has invaded ukraine, annexed crimea, threatened neigh a lice and ingate conveniented militarily in syria, leaving a trail of death, destruction and broken promises in its wake. and of course last year russia attacked the foundations of american democracy with a cyber and information campaign to interfere in america's 2016 election. i am proud -- i am proud of the two individuals who just spoke, the senator from maryland and the senator from tennessee. both of them have worked in a bipartisan fashion and gotten legislation to this floor, although it's long overdue due. it is here and i believe we will see and overwhelming vote.
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thank them for their bipartisanship. in the last eight months, what price has russia paid for atta attacking american democracy? very little. this legislation would begin to change it. the legislation would impose mandatory sanctions on transactions with the russian defense or intelligence steek terse including the f.s.b. or the g.r.u., the military intelligence agency that was primarily responsible for russia's attack on our election. i believe my colleagues know what's in this. it would codify existing sanctions on russia by placing into law six executive orders signinged by president obama in response to both russian interference in the 2016 election and its illegal actions in ukraine, and it would take new steps to tighten those sanctions. the legislation would target the russian energy sector, which is controlled by vladimir putin's cronies, with sanctions on investment in russian petroleum and natural gas development as
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well as russian energy pipelines. my friends, the united states of america needs to send a strong message to vladimir putin and any other aggressor that we will not tolerate attacks on our democracy. that's what this bill is all about. we must take our own side in this fight, not as republicans, not as democrats, but as americans. it's time to respond to russia's attack on american democracy with strength, with resolve, with common purpose, and with action. i'm proud to have played a small role, but i'm most proud of the partisanship that you are seeing manifested today by both sides of the aisle. we need a little more of it. mr. president, i yield the floor. mr. corker: mr. president, i want to thank the distinguished senator from arizona for his dedication to our national
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security, for his tremendous involvement in this legislation, and that all he does on behalf of all of us to make sure that our nation is secure. thank you so much for those comments and your deep involvement in this legislation. do you want to take leader time before we turn this over? mr. brown: i thank the chairman of the foreign relations committee and the ranking member, senator cardin. senator crapo and i began working on this months and months ago. i appreciate that partnership. senator mccain, i read an op-ed he wrote in "usa today" about three weeks ago about what putin tried to do with some level of success in montenegro, and nobody's watched putin and his intervention in our elections and european elections and their governments and his desire to destabilize democracy around the world. nobody's recognized it quite as early with the kind of acute
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sense that senator mccain has, and we thank him for that. i rise to urge my colleagues to join me and vote for this critical sanctions legislation. it's a product of months of bipartisan effort in this body. at a time when it's difficult to get things done in this far too partisan senate, this effort proves it's still possible for congress to come together and accomplish big things. the bill provides for a range of tough new sanctions against iran and russia and north korea. the ukrainian community in my state knows firsthand the dangers of decades of unchecked russian aggression. congress must act to punish russia for its continued actions in ukraine and east ukraine, in crimea, its interferences in our presidential election and to deter future such aggression. this bill will prevent president trump from relaxing sanctions on russia without congressional review. we're all concerned about that. iran's one of the world's
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leading state sponsors of terrorism and a continuing source of instability throughout the region. this bill was carefully written to avoid violating u.s. commitments under the iran nuclear agreement. it applies new sanctions in response to iran's support for terrorism, its human rights abuses, its ballistic missile program. it also incorporates sanctions on north korea, including measures to toughen enforcement of current u.n. security council rules. north korea's efforts to develop nuclear capabilities must be countered. we must take a stand against its horrendous human rights record, including the savage treatment of ohio's otto warmbier that led to his death. these are important first steps. more can be done to address the situation in north korea. i thank my staff, colin mcginnis and mark pouten and grant steele in this. i appreciate the work of the staff in all four of these offices, on banking and foreign relations, and i ask my
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colleagues to concur. thank you, mr. president. mr. corker: mr. president. mr. schumer: leader time. the presiding officer: the democratic leader. without objection. mr. schumer: thank you, mr. president. and last year, we know the united states was the victim of an attack by a foreign power in the very foundation of this dear democracy, the right of the people to a free and fair election. the consensus view of 17 agencies is that mr. putin interfered in the 2016 election. for that alone, the united states has more than just cause to sanction president putin and intelligence -- putin, an intelligence apparatus he directs. but to date, mr. putin and his allies have not suffered serious repercussions for this stunning breach of our right as a sovereign nation not to have our elections disturbed by a foreign capital. that all changes today. congress has drafted this sanctions bill to hold mr. putin
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accountable for his actions and to send a message to him and the rest of the world, any further attempts to degrade our democracy will meet further sanctions and action. we will not stand by idly as this has done. there is no process more sacred in a democracy than the guarantee of free and fair elections. that fundamental right was attacked by mr. putin, and with this vote, let us finally, finally, finally officially condemn and forcefully respond to that attack on our country, and let us send this bill to the president's desk for his signature. we still don't know if president trump will sign this legislation, but i say to my colleagues if the congress speaks loudly enough and strongly enough and we send this bill with a veto-proof majority, it won't matter what president
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trump decides. now, before i yield the floor, i'd like to thank my colleagues, the top of the list, senators mccain and graham who early on had the idea to do this, and their strength against transgressions against this country are wonderful. i want to thank the chairman of the foreign relations committee. he had to pursue this legislation through ups and downs, and he didn't relent, and here we are today because of his efforts. i want to thank his ranking member, senator cardin. they were a great bipartisan team. similarly, chairman crapo and ranking member brown. again, in a bipartisan way, not letting partisan politics get in the way, they passed this legislation. and i'd like to thank leader mcconnell because when he and i talked about bringing this legislation to the floor, he didn't blink, he didn't hesitate, he was forthright and said let's do it. now, this piece of legislation,
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mr. president, proves that when this body works the way it should, when both parties talk to each other, work with each other, the committee chairman, ranking members negotiate legislation through proper procedure, we can produce good, strong bipartisan legislation. i would be remiss if i didn't mention in this moment of bipartisanship the same thing could happen with health care. with that, i urge all of my colleagues to vote yes, and i yield the floor. mr. corker: i thank the minority leader for his comments and would yield a moment to senator crapo who played such an outstanding role as the leader of our banking committee. mr. crapo: thank you, senator corker. i, too, thank all of those who have been mentioned. the foreign relation leadership, senator corker and senator cardin. senator brown, my colleague in the banking committee, and all of the others who have been so involved in this issue. this is one of the examples of how we can work together in a bipartisan fashion to craft
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critical legislation for protecting and strengthening america. it frankly is past time for us to stand strong as a nation in response to the increasing aggression that we see in russia around the world, whether it be in the ukraine, in the crimea, in syria, in facilitating corruption globally or in the cybersecurity attacks that we have seen that have been directed not only at us but at our allies across the world. it's very important that we implement this legislation, and i'm glad to see the solid bipartisanship that we have been able to build on it. i hope also we can build this bipartisanship on many, many other issues. we're going to be looking at north korea, as has already been said, and i'm hopeful and confident that we will stand again on this floor soon as we deal with the threats that we face from north korea. again, i thank all of those who have worked so closely with us on this legislation and appreciate the opportunity for us to move forward united
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tonight on this critical issue. thank you very much. i yield back. mr. corker: thank you, senator crapo. i yield the floor to senator menendez. mr. cardin: first, i want to join in thanking senator mccain and senator graham for their work. mr. cardin: we started in january on this legislation. their legislation, how we drafted it is intact here, and i want to thank senator mccain and senator graham. the leader on the iran sanctions, going back many, many congresses, has been senator menendez. i just really in introducing him want to thank him for his leadership on iran and also these other bills and look forward to his comments. mr. menendez: mr. president, let me thank the ranking member for his kind comments. i thank the chairman for his continuous engagement in this regard and leadership. i remind my colleagues that what gave us the vehicle to consider
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russia and north korea was the countering iran act that i was pleased to author with the chairman and with the ranking member and other colleagues in a bipartisan approach, and when we started on iran, there were those who only wanted to look at its intercontinental ballistic missile violations, and i and others persisted and said wait a minute, iran is far more in its nefarious activities beyond intercontinental ballistic missiles, and it was a collective leadership that brought us to a much broader bill that we are about to vote on today. where iran is being purr sued for the violation of its international order. we just had the prime minister of lebanon here, and he was talking to us about if you're concerned about hezbollah, then find where the source of money is, and the source of money for
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hezbollah is iran. and if you are concerned about intercontinental ballistic missiles, i would add it's iran. if you are concerned about the greatest exporter of terrorism, it is iran. if you are concerned about human rights violations within iran, it's the leadership of iran. so this is about sending a message to iran that, in fact, when you violate the international order, there are consequences to it. it's about sending a message to russia that when you violate the international order, you annex crimea, you invade ukraine, you indiscriminately bomb civilians in syria, and then when you try to affect the elections of the united states of america, you have a cyber attack by my view on the election process that whether or not we can -- we can debate whether or not it affected the election or not, that is not the issue. the mere fact that russia tried to affect our elections should
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be upsetting from the average citizen to the president of the united states. and we have an opportunity to make it very clear to russia and to any other nation that that won't be tolerated. and then finally, to north korea. north korea's danger provocations in its path to nuclear weapons and a delivery system to be able to deliver that nuclear weapon is one of the greatest challenges we have. so we have an opportunity to come today and say you've got to observe the international order. we have got to go back to the rules basis that ultimately came about after our leadership in world war ii to preserve the international order that has broad us peace and prosperity, and there are only a handful of peaceful diplomacy tools that you can pursue. one of them is the use of sanctions in order to try to prod countries to move in a certain direction and to observe the international order. that's our opportunity today with iran, with russia, with north korea. and i hope we'll seize it
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unanimously, because when we do that, we send the most powerful message in the world that the united states, democrats, republicans, independents stand together in terms of defending the national interests and security of the united states. i yield the floor. mr. corker: mr. president, i thank the senator from new jersey for his outstanding leadership on iran and his leadership both on the russia bill but also north korea. you have led us for years and years in sanctioning iran and brought them to the table, and i thank you for that. for those who are here and want to vote, i'm going to yield one minute to senator gardner, i'm going to speak for about a minute and a half, and to my knowledge, we'll be ready to vote, and i thank all of you for your patience. senator gardner. mr. gardner: thank you, mr. chairman. i appreciate the opportunity to talk about what this senate did last congress. last congress, we passed unanimously the north korea sanctions enhancement act. this legislation that we're about to vote on builds on the success that we built -- that we started out with last year, but we have more work to do to stop
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the crazed kim regime. i thank the chairman and the leader for committing to further conversations on north korea, further action that needs to be taken, because we know that in china, there are over 5,000 businesses still doing business with north korea. china's responsible for 90% of the north korean economy. ten of those 5,000 businesses are responsible for 30% of the economic activity, the imports from north korea into china. more work has to be done to stop this madman in pyongyang. i thank the senate for moving forward on legislation today to build on the success we had last year. i urge its passage. and we have got more work to do to do -- to put an end to this regime. mr. corker: thank you for your leadership on north korea and many other things. thank you for speaking. mr. mr. president, i will be very brief, as i normally am. this bill has taken passion,

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