>> i couldn't think of a better way to wrap up an amazing morning. thank you for being so frank and honest spirit i guess they will be hearing over there they are rearranging where the country is. the focus on family, the focus on stopping denial. i'm very grateful and on behalf of the washington post, thank you all for listening. we are going to be putting up clips from today@"washington post" live.com and more comments about this whole amazing morning. thank you. [applause] >> date news on capitol hill this morning, the release said the gop replacement bill. republican senators will look at

the bill and it's now posted on the senate budget committees website and on our website, c-span.org. majority leader mitch mcconnell will be talking about the bill shortly as the senate gavel thing. the presiding officer : the senate will come to order. the chaplain, dr. barry black, will lead the senate in prayer. the chaplain: let us pray. almighty god, lord of the universe, inspire our lawmakers today with the magnetism of your presence. give them a longing to know and

do your will, receiving your guidance and following your admonition. provide them with the liberating assurance that all things are possible to those who believe. go before our senators to guide, beside them to inspire, above them to bless, behind them to protect, and within them to transform. fill their minds with your spirit and their hearts with your joy becoming their providential guide in all they think, say, and do.

we pray in your holy 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. the clerk: washington, d.c., june 22, 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 dan sullivan, a senator from the state of alaska, who will perform the duties of the chair. signed: orrin g. hatch, president pro tempore.

the presiding officer: the majority leader. mr. mcconnell: seven years ago democrats imposed obamacare on our country. they said it would lower costs. it didn't. in 20 -- from 2013 to 2017 premiums have on average doubled in a vast majority of states on the federal exchange. next year obamacare premiums will go up across the country once again, potentially by as much as 43% in iowa, 59% in maryland, and even a staggering 80% in new mexico. does it sound like obamacare is working? they said it wouldn't increase choice -- they said it would increase choice. they said it would increase choice, but, of kowrgs, it didn't. this year 70% of american counties have had little or no choice of insurers under obamacare. next year at least 44 counties

are projected to have no choice at all, meaning, yet again, americans could be thrown off their plans in states like missouri and ohio and wisconsin. does it sound like obamacare is working? democrats tell us it would be wrong for the senate to actually address these problems in a serious way while the law they've defended for seven years teeters -- literally teeters -- on the edge of total collapse. they were wrong before, they are wrong again now because obamacare isn't working by nearly any measure it has failed and no amount of lefnth hour denying or buck passing by democrats is going to change the fact that more americans are going to get hurt unless we do something. i regret that our democratic friends made clear early on that they did not want to work with

us in a serious way to address the obamacare status quo. but republicans believe we have a responsibility to act and we are for our constituents, for our states and for our country. we've long called for a better way forward and we've been engaged in intensive talks on how to get there. through dozens of meetings open to each and every member of the conference, we've had the opportunity to offer and consider many ideas for confronting the obamacare status quo. we debated many policy proposals, we considered many different viewpoints. in the end we found that we share many ideas about what needs to be achieved and how we can achieve it. these shared policy objectives and the solutions to help achieve them are what made up the health care discussion draft that we -- we finished talking through. we agreed on the need to free

those under the obamacare mandate. the individual mandate will be repealed so individuals will no longer have to buy insurance they don't need or can't afford, we will repeal the employer mandate so americans no longer see their hours and take-home pay cut by employers because of it. we agreed on the need to improve the affordabilityf contained in the discussion draft will do that. it will eliminate costly obamacare taxes that are passed on to consumers so we can put downward pressure on premiums, expand tax-free savings accounts and help defray out-of-pocket costs and shift power from washington to the states so they have more flexibility to provide more americans with the kind of affordable insurance options they actually want. we agree on the need to stabilize the insurance markets

that are collapsing under obamacare as well as policies contained in the discussion draft will implement stabilization policies so we can bring financial certainty to insurance markets and hope to americans who face the possibility of limited or zero options next year under obamacare. and ultimately transition away from obamacare's collapsing system entirely so more americans will not be hurt. we also agree on the need to strengthen medicaid, preserve access to care with preexisting conditions, and allow children to stay on their parents' health insurance through the age of 26. i'm pleased that we were able to arrive at a draft that incorporates input from so many different members who represent so many different constituents who are facing so many different challenges. the draft containing the solutions i mentioned, along with so many others, are posted

online and i encourage everyone to carefully review testimony. there will be ample time to analyze, discuss, and provide thoughts before legislation comes to the floor, and i hope every senator takes that opportunity. next week we expect the congressional budget office to release a score, after that we will proceed with a robust debate and open amendment process here on the senate floor -- a process that i would encourage each of our 100 senators to participate in when legislation does come to the floor it will present senate democrats with an opportunity to do what is right for the american people. they can choose to keep standing by as fair failing law continues to collapse and hurt more americans. but i hope they will join us instead to bring us to help the families who have been struggling with obamacare for far too long. either way -- either way it's time to act because obamacare is a direct attack on the middle class and american families

deserve better than its failing status quo. they deserve better care. that's just what we're going to continue to work to bring them. the presiding officer: under the previous order, the leadership time is reserved. morning business is closed. under the previous order the senate will proceed to executive session to resume consideration of the marshall billingslea nomination. the clerk: department of treasury, marshall billingslea to be assistant secretary of terrorist financing. mr. schumer: mr. president. the presiding officer: the democratic leader.

mr. schumer: well, we're beginning to receive the first bits of information about the senate republican health care bill, which until now, has been shrouded in absolute secrecy. i can see why. even as we continue to get more details, the broad outlines are clear. this is a bill designed to strip away health care benefits and protections from americans who need it most in order to give a tax break to the folks who need it least. this is a bill that would end medicaid as we know it, rolling back medicaid expansion, cutting federal support for the program even more than the house bill which cut medicaid by $800 billion. let me remind everyone in this chamber medicaid is not just a health insurance program for americans struggling in poverty, though that is an important and necessary part of it. medicaid is increasingly a

middle-class program. medicaid is how many americans is -- are able to access opioid abuse treatment. medicaid foots the bill for two-thirds of all americans living in nursing homes, and medicaid provide the cushion, particularly in rural areas, so hospitals can survive and give top-notch health care to all of us. from what is reported, in just three short years under the senate bill, millions will be cut off medicaid coverage. and then starting in 2025, the plan will institute even more medicaid cuts and each year those cuts get deeper than the year before. within 10 years of this new funding system, the cuts to medicaid could total hundreds of billions of dollars above the more than 800 billion the house

bill already cuts from the program. every senior in america should read the fine print of this bill. it looks like american seniors could be paying way more. why do this? looking at the bill, the answer is because the republicans want to give a tax break to the wealthiest americans, those making over $200,000 a year and set themselves up to give these folks another even larger tax cut in their tax bill. even though much of the early reporting says the bill will keep certain protections for americans with preexisting conditions, the truth is it may well not guarantee them the coverage they need. by allowing states to waive essential health benefits, what the bill is saying to those americans is insurance still has to cover you, but it doesn't

have to cover what you may actually need, it doesn't have to cover all or most of your costs. if you need treatment for opioid addiction, your plan may no longer cover it. if you are pregnant and need maternity care, your plan may decide that is too much to cover. what people actually need to cover their health needs may become nonexistent under this bill. simply put, this bill will result -- not right now, at the end of my remarks. simply put, this bill will result in higher costs, less care, and millions of americans will lose their health insurance, particularly through medicaid. it's every bit as bad as the house bill. in some ways it's even worse. the president said the senate bill needed heart. the way this bill cuts health

care is heartless. the president said the house bill was mean. the senate bill may be meaner. the senate republican health care bill is a wolf in sheep's clothing, only this wolf has even sharper teeth than the house bill. it's clear that republicans know that cutting medicaid will hurt so many people in the middle class, so many in my home state of new york. republicans know that people want to sengs -- want essential health benefits. so they created a disguise by saying these changes won't occur for a year. but in reality, the senate republican bill is a wolf in sheep's clothing, only this wolf has even sharper teeth than the house bill. and we're potentially voting on it in a week -- no committee hearings, no amendments in

committee, no debate on the floor save for ten measly hours on one of the most important bills we're dealing with in decades. that brings shame on this body. we won't even know the full cost or consequence of the bill until c.b.o. scores it. and that could take a few days more. how can my friend, the majority leader, expect this body to fairly consider this legislation, prepare amendments, and debate it in one week with only ten hours of debate? how can he expect his own members to do the same? many of them on the republican side are learning the details of the bill the same way we democrats are. they're reading it today. now, listen to what the majority leader had to say in 2009 when we were debating health care. his words. this is a very important issue.

we shouldn't try to do it in the dark. and whatever final bill is produced should be available to the american public and to members of the senate, certainly for enough time to come to grips with it. and we're going to insist, the american people are going to insist that it be done in a transparent, fair, and open way. is five or six days enough time for the american people and members of the senate to come to grips with a bill that affects one-sixth of the economy and the lives of every american in this country? i don't think so. neither do the american people, and neither do a whole bunch of republican senators. senator cassidy. would i have preferred a more open process? the answer is yes. senator collins. i don't think it gives enough time to thoroughly analyze the

bill, but we'll see when it comes out. there is member after member, rand paul, lindsey graham, jerry moran, marco rubio, bob corker, who repeatedly have said this process, in their words and now in mine, is unfair, is truncated, is rushed. for my dear friend, the majority leader, to say we're going to have an open amendment process is turning truth upside down. i would ask our leader rhetorically, because i know the answer, can we allow at least one hour on each amendment, not two minutes? will we have more time than ten hours to debate the bill? i hope so. but if not, please don't call this an open and fair process.

if you want to rush it through, admit the consequences. now, mr. president, the debate over health care has been fierce. we know that the republicans and democrats had differences when we debated the affordable care act. at least we had a debate. at least we had committee hearings and a process, and more broadly than that, at least we democrats were trying to pass a health care bill that helped more americans afford insurance and tried to bring costs down and end some of the most egregious practices of the health care industry. what is this bill, trumpcare, trying to achieve? it seems designed to slash support for health care programs in order to give tax breaks to the very wealthy, and when the c.b.o. score comes out, i believe it will verify that millions of americans in this

great country will be unable to afford insurance or the insurance they can afford won't cover the services they need. somewhere in america, mr. president, there's a family who takes a trip each friday to visit grandma or grandpa at a nursing home, who sacrificed all of their savings to pay for their health care until they had no more savings, and now relies on medicaid to help pay the costs of long-term care in a nursing home. somewhere in america, there's a father who is eaten up inside, watching his son struggle with opioid addiction, who knows in his heart that his son would be able to go on and live a healthy and fulfilling life if he could

only afford treatment to get him out from under his devastating addiction. somewhere in america, there's a parent whose child has cancer, a mother and father who stay up late at night, worried that their insurance will either not be available or run out when the family needs it most. in the america that my republican friends envision with this health care bill, those americans and many more beside might not get the coverage and care they need. we live in the wealthiest country on earth. surely, surely we can do better than what the republican health care bill promises. now i have a unanimous consent request. i'm going to have to delay my friend from asking questions until we finish our unanimous consent requests. i ask unanimous consent that any

substitute or perfecting amendment offered to calendar numbered 120, h.r. 1628, not be in order if the text of the amendment has not been filled at the desk and made available on a public website for at least 72 hours, along with an analysis by the congressional budget office of the bill's budgetary coverage and cost implications. the presiding officer: is there objection? mr. mcconnell: mr. president, reserving the right to object, my colleague, senator cornyn, was going to ask the question, which i will answer, which was the majority leader's referring to a bill that he hadn't seen a copy of because it hadn't yet been released, so the speech you just heard was about a bill that he hasn't seen. with regard to his consent, i object. mr. schumer: mr. president. the presiding officer: objection is heard. mr. schumer: mr. president, parliament privilege -- not

parliament privilege. leader time. the presiding officer: the senator has the floor. mr. schumer: thank you. 142 pages thus far of this supposed bill have been printed online, and that's what i have used. mr. durbin: mr. president. the presiding officer: the minority whip. mr. durbin: mr. president, several weeks ago, the house of representatives passed a bill to repeal the affordable care act and to replace it. it was passed without hearings. it was passed without an amendment process, and it was passed before the congressional budget office, provided that traditional analysis, which we count on before we take up a measure of such magnitude, that measure passed with a party-line vote. all republicans. had two republican senators voted the other way, it would not have moved forward. after it passed, the president of the united states decided to have a celebration at the white house. we saw him on television gathering the republican members of the house of representatives and celebrating the fact that

this measure had passed and finally they were going to repeal the affordable care act. but then the american people took a close look and the congressional budget office issued its analysis, and it turns out that 23 million americans would lose their health insurance because of this republican measure that passed the house of representatives. it turns out as well there would be a dramatic increase in health insurance premiums for people between the ages of 50 and 64. it turned out that in my state and many other states, hospitals were in danger. the only hospital -- the illinois hospital association says they would lose 60,000 jobs in illinois with the dramatic cutbacks in medicaid, endangering hospitals in rural areas and inner city areas. the facts started coming out about this repeal bill passed by the house of representatives and the president of the united states had a change of heart and announced to the american people it was a mean bill, a mean bill.

the president was right. it was mean legislation. mean to the millions who lost their health care. mean to seniors who would find their premiums going up dramatically. mean to the people living in rural areas and small towns who count on those hospitals. well, the president was right. it was mean. and then the responsibility shifts to the united states senate. the majority leader, senator mcconnell and his republican followers had a chance to do a bill that was not mean. they had a chance to sit down on a bipartisan basis and to have the same process we used to create the affordable care act. that would have involved public hearings. we had 50 public hearings on the affordable care act. it would have involved a real amendment process. the affordable care act had 300 amendments. how many were offered by the republicans? over 150 offered and adopted, in a bipartisan process when we

passed the affordable care act. the american people got a good look at the bill. the congressional budget office issued their analysis before we voted on it, and we passed it and i'm glad we did and i'm proud of that vote, but what happened in the senate when it came to the republicans? they went into secrecy. 13 chosen republican senators all sat in a room and wrote the throrn, or so we're told. they met in secret and never once had a public hearing, never once disclosed to the american people what was being debated, never once gave an opportunity for real bipartisan cooperation to strengthen our existing health care system. not at all. so all we have at this moment is truly press accounts of what's been announced to the republican senate caucus, what they're going to get a chance to read and see, but it's enough to see that when it comes down to the basics, there's not much of a change between the house of

representatives effort and the senate effort. you know, mr. president, you can put a lace collar on a pit bull and it's still a mean dog. what we have with the republicans in the senate here is an attempt to dust up the edges of the house bill and say this is not as mean. i'll tell you at the end of the day from the reports we have, this is still a mean dog and one that the people of the united states don't want to see happen. there isn't a single medical advocacy group, not one in my state and i don't know any nationwide that endorse what the republicans in the house have accomplished with the passage of their bill, and this bill mirrors it as well, and we can expect the same result. so the only thing we can offer the american people is a chance to be part of the conversation on a bill that will literally change health care for millions of americans, and if they are going to be part of the conversation, there's got to be a chance for amendment and debate at least and a chance for the american people to see what's in the senate republican

measure. so, mr. president, i ask unanimous consent that any substitute or perfecting amendment offered to calendar numbered 120, h.r. 1628, be subjected to a inpoint of order -- to a point of order if the texas of the amendment has not been filed at the desk and made available on public website for at least 72 hours, along with an analysis by the congressional budget office of the bill's budgetary coverage and cost implications, and that a motion to waive the point of order be in order, and if a motion to waive is made, an affirmative three-fifths vote of those duly chosen and sworn is required to waive the point of order. the presiding officer: is there objection? mr. mcconnell: reserving the right to object, i want to thank my friend and assistant democratic leader for confirming that the majority leader's remarks obviously were made on the basis of news accounts. the bill has only been posted online for the last 20 minutes.

mr. schumer: would the majority leader? mr. mcconnell: i will field for a question -- yield for a question. mr. schumer: does the majority leader know that only a half-hour before we came to the floor were 142 pages of the bill listed online, and that's what we used in our report. and i would ask the majority leader a further question, if there is anything i said, anything i said that is not going to be in the bill, could he clarify? mr. mcconnell: i object. the presiding officer: objection is heard. mrs. murray: mr. president. the presiding officer: the senator from washington. mrs. murray: mr. president, what we are seeing today is just the latest broken promise from president trump and his republican party after weeks of secret negotiations, back room deals, shutting outpatients and families and democrats and even many republicans from this process, senate republican leaders are now just days away from putting a bill on the floor

that could not be more impactful or more devastating to families' bank accounts and their health. as even republicans are pointing out, there has not been a single hearing, no robust debate, no opportunity for the people who will really suffer under this bill to see exactly how bad it would be. mr. president, this disastrous trumpcare bill deserves full scrutiny under an open process, like the process that democrats conducted when we passed the affordable care act. we held hearings. we took amendments from both sides, and we certainly didn't leave the fate of women's health care up to a few republican men. senate republicans are right to be ashamed of this mean and heartless legislation. just like the house trumpcare bill, it will increase premiums, it will undermine protections

for people with preexisting conditions, it will defund planned parenthood and allow insurance companies, insurance companies to charge women more. it's going to gut medicaid. it will take away care for our seniors, for pregnant women, people with disabilities, and it will take health insurance coverage away from millions of people across the country. and for what? to give another massive tax cut for the wealthy and well connected. mr. president, oid' be ashamed, too, if i had to defend a bill this cruel. i can certainly understand why republican leaders do not want to give time to see what's in this bill and why they don't even want to give their own members time to see how much their constituents hate it. but that's the bed senate republicans have now made. if they're going to try and pass this disastrous version of trumpcare, at the very least they shouldn't get to jam it through without the public knowing good and well what

they're up to. so, mr. president, i ask a parliamentary inquiry. is the chair able to confirm that the committee on health, education, labor and pensions considered s. 1679, the affordable health choices act which was ultimately incorporated into the patient protection and affordable care act in executive session on 13 calendar days prior to reporting the bill favorably? the presiding officer: the secretary of the senate's office through the senate library can confirm that. mrs. murray: that is confirmed. so i ask unanimous consent today that any substitute or perfecting amendment offered to calendar number 120, h.r. 1628 not be in order if the text of the amendment has not been subject of a hearing, subject of an executive session during which amendments from both the majority and minority were considered and reported favorably by the committee on finance and the committee on

health, education, labor, and pensions. the presiding officer: is there objection? mr. cornyn: mr. president? the presiding officer: the majority whip. mr. cornyn: reserving the right to object. mr. president, none of these senators have read the bill. it's -- i have the floor, mr. president. the bill is 142 pages long compared to 2,700-page long obamacare bill. they can read the bill. if they have objections to the provisions, we can debate them but what they're talking about is a bill that does not exist which they have not read. i object. the presiding officer: the objection is heard. mr. schumer: mr. president? the presiding officer: minority leader. mr. schumer: would my dear colleague from texas yield for a question? the presiding officer: the senator from texas does not have the floor. you have the floor. mr. schumer: i would like to just then tell the -- my friend from texas, this is the bill. it was posted online a half-hour before we came online. and i'd ask a page to come over and bring it to my dear friend and ask him if this is the bill,

which we have read. mr. cornyn: mr. president, all senators have a copy of this discussion draft bill. it is a discussion draft which will be open to an amendment process with unlimited amendments that could be offered by both sides following -- after which -- or before which we'll have a fullsome debate. our colleagues are complaining about secrecy that doesn't exist. this bill is online. the american people can read it. you can read it. i would suggest that they do read it before they start criticizing it. mr. schumer: i would ask my friend from texas to yield for another question. mr. cornyn: i will. mr. schumer: will we get more than two minutes to debate each amendment we ask for or will we be under reconciliation process where we have simply ten hours of debate and then every amendment only gets two minutes? and does he consider that two minutes, if that's a case, a full and fair debate on each amendment? mr. cornyn: mr. president, i

would say in response to my friend from new york, the fact that we're having to conduct this under the reconciliation rules is a result of their refusal to participate in the process, thus necessitating republicans doing this under reconciliation rules. if they would do this in a true bipartisan way where we could get 60 votes to get on the bill and open it to amendment process, we could have a better bill. but given the refusal of our democratic colleagues to participate in the process, this is the only way we can come to the rescue of the people who are being hurt by the meltdown of obamacare today. mr. schumer: mr. president? the presiding officer: just to clarify did the senator from texas object to the senator from washington. mr. cornyn: i do object. the presiding officer: objection is heard. mrs. murray: mr. president? the presiding officer: the senator from washington. mrs. murray: mr. president, i heard the objection. i just have to say the exchange we just heard is exactly what we've been objecting to. we were told that the bill would be online at 9:30 this morning.

it was online at 11:00. i have a copy of it. but we're hearing from the other side now that this isn't the bill. this is a discussion draft. we aren't going to see the bill. we won't see the real bill apparently until next week, even though we were told we'd see it this morning. this has been the problem we've had since the -- this discussion started. we started in january with the process that cut us out of this under reconciliation. 13 men in a private room wrote this, quote, discussion draft that's not a bill that we're supposed to now look at and decide whether or not we like it and the american public. a discussion draft? a bill? even the other side doesn't know what we have. that's what we're objecting to. we're asking that the american people who have a right to know what is going to impact every one of their lives, every one of their families, every one of their communities, every one of their businesses have more than a discussion draft, more than ten hours of debate, time to look at it and know how we're even going to do an amendment

process next week. this is deplorable. mr. cornyn: would the senator yield for a question? the presiding officer: the majority leader. mrs. murray: happy to. mr. cornyn: mr. president, i would ask the senator from washington if she's aware of the fact that under the budget reconciliation process, there will be an unlimited number of amendments could be offered by either side to the bill that's ultimately filed. mrs. murray: mr. president, i am well aware of that. i will remind our colleagues and everybody in this country what will happen is that there will be ten hours of debate where we hopefully have more than a discussion draft, that we will be allowed to offer amendments on, and there will be no debate on those amendments. no one will know what it is. it will be a chaotic process on this floor. the american public won't know. we'll be able to tell them days later after this gets undone. that's not an amendment process. that is not what we went through when we passed the affordable care act. the american public deserves better. the presiding officer:

minority leader. mr. schumer: i'd ask my colleague a question. what would be wrong with one hour of debate on every amendment to this bill? what is the objection to that since the majority is proposing no debate on amendments and then saying it's an open process? what is wrong with one hour of debate on every amendment offered to this bill? mr. cornyn: mr. president? the presiding officer: the majority whip. mr. cornyn: mr. president, i'd say in response to my friend, the minority leader, that it is as a result of their refusal to participate in the usual process of passing legislation through the regular order. the presiding officer: the senate will be in order. mr. cornyn: that we have to resort to the budget reconciliation process. it has a set of statutory provisions and rules. there will be a fulsome debate. there's already been a debate on a bill that you haven't read. i subject you take the time to read it and then we can talk about the details. but this bill, 142 pages compared to 2,700 pages of

obamacare, it doesn't take that long to read. this is a start. this is not the finish. and this is called the normal legislative process. and i suggest colleagues rather than criticize the bill that they haven't read, they read it and then let's have a credible debate. mr. schumer: mr. president? the presiding officer: democratic leader. mr. schumer: i would ask my friend, the minority -- the majority whip from texas, a series of questions. what was -- what was the date that reconciliation was added to the budget resolution which said we didn't need any democratic votes? was it may? was it april? was it march? or was it the very beginning of this session? i'd ask him another question. where were the meetings held to discuss this bill and were any democrats invited? i'd ask him another question. why did the majority leader not accept our offer to go into the old senate chamber, a hundred

senators, no press, no anything else, and debate the bill? and how can my good friend, and he is a good friend. we're on the bikes in the morning, my good friend from texas, say there was a bipartisan process when at the outset, on the outset our republican colleagues said the only thing we'll rebate is repeal and then replace. there was no discussion of whether repeal was the right thing to do or the wrong thing to do, and now overwhelmingly the american people prefer fixing obamacare which we offered to do than repeal and replace and it's no wonder, i would say to my colleague as he anxiouses these questions, that this bill is being brought in the dark of night. it is because my colleagues on the other side of the aisle are ashamed of the bill because believe you me, mr. president, if they like this bill, they'd have brass bands down every main street in america talking about

it, but they're trying to sneak it through because mainly their goal is a tax cut for the rich. so i'd ask my colleague to answer those three questions and then he can respond to my rhetoric. the presiding officer: majority whip. mr. cornyn: mr. president, i'm really taken aback by the characterization of the minority leader here. the minority has made it clear that you don't want to participate in the process of rescuing the american people from the failures of obamacare. the presiding officer: the senate will be in order. mr. cornyn: it's been made clear to us that you don't want to participate in the process, and you are turning a blind eye to the people -- to millions of people who are being hurt today by outrageous premiums, deductibles they can't afford, and a loss of choices because insurance companies have pulled out of the individual market. you're -- your response to them is we don't care. we care. and we're doing our best to deal with this. this is like going by a car

accident or somebody seriously injured and rather than stopping and rendering aid, just driving on by. that's what our colleagues on the other side are doing. they're turning a blind eye driving right on by a seriously injured person in a car accident. we are coming to the rescue of the people, the millions of people who are being hurt by obamacare today. we would love to have our democratic friends join us and do something truly sustainable. but you have to remember, my friends, how this started. democrats jammed obamacare through on a partyline vote and republicans weren't able to participate in that process. so what we are trying to do is we're trying to save the people who are currently being hurt and whose health care has become unaffordable. if you'd like to join us in this process, we'd love to have you. but failing that, we're going to get it done and you can just drive right by the car wreck. mr. schumer: mr. president? the presiding officer: a senator: leader. mr. schumer: here's the correct analogy. yes, there's been an accident.

yes, someone needs help. someone who's not a doctor, not a physician doesn't know how to help the patient. our republican friends go by the side of the road. but they don't know what to do. so the democrats come by. we're doctors. we say we know how to fix this system. we know how to fix this patient. and the republicans say no, don't help us. we'll drive right by. and now the patient is ailing. but i'd ask my colleague let's forget the past for a moment because we've got a much better argument than you. we had hundreds of amendments offered by republicans that became part of our bill. i doubt there will be a single democratic amendment that will be. we had hours of hearings, hours of debates. you didn't. you may have thought the process wasn't perfect. it's a lot more open than yours. i have a proposal to my friend. let us forget this draft bill. let us right now, democrats and republicans, sit down and try to come up with a bipartisan bill. we're willing to do it today,

now, this minute. will you accept that offer? mr. cornyn: mr. president? the presiding officer: the senate will be in order. mr. cornyn: mr. president, if i thought that was a sincere offer, i would take it in a minute, in a new york minute. but it's not. the presiding officer: the senate will be in order. mr. cornyn: the fact of the matter is that insurance companies are having to go to the state regulators as we speak to get insurance rates approved for 2018. that's the urgency that we are experiencing here, and unless we act and act in an expedited fashion here very soon, we're going to see millions of people have their insurance rates raised by another double digit. it's been 105% since 2013, 105%. obamacare was sold under the premise that families of four would see a reduction of $2,500. if you liked your policy, you can keep your policy. if you like your doctor, you can

keep your doctor. all of that's false, false. this is a failed experiment. they may not be willing to help but we will. and we will get it done and help the american people who are being hurt by the failure of obamacare today. a senator: mr. president? the presiding officer: the senator from oregon. mr. wyden: mr. president, i'm struck by this conversation as the ranking democrat on the senate finance committee, my colleague, the distinguished senator from texas, is on the finance committee, he knows that i know something about writing bipartisan health reform bills. i've written them. they become law. i can tell my colleagues i have not once, not once been asked to be part of any bipartisan effort with respect to this legislation. and i think, colleagues, it's real clear what is going on

here. senate republicans are going to keep telling americans they're fixing their health care right up until the second it gets taken away. now, as itself ranking member of the finance committee, i find it bizarre that a health bill of this importance was hidden for so long behind closed doors, denying the american people the opportunity to see it together in an open debate. there have been no hearings on this dangerous, destructive proposal. not one hearing on whether medicaid should be slashed to pay for tax cuts for the fortunate few, not one hearing on whether the bedrock protections for those with preexisting conditions ought to be shattered. not one hearing on whether americans should have to face

higher costs. this secretive process of concealing and rushing this bill, which until today has been seen by nobody -- nobody outside of the republican leadership and their lobbyists allies who dwell on k street, the secretive process stands in sharp contrast to the process that led to the affordable care act. is the committee on finance to consider america's health future act which was ultimately incorporated into the patient protection and affordable care act on eight separate calendar days prior to reporting the bill favorably. the presiding officer: the secretary of the senate's office through the senate library confirms that. mr. wyden: i have information that indicates that 135

amendments were considered in committee, and of those 14 amendments offered by republican members of the committee or offered in a bipartisan manner were adopted during the consideration of s. 1796. is the chair able to confirm that? the presiding officer: the secretary of the senate's office through the senate library confirms that. mr. wyden: therefore, mr. president, i ask unanimous consent that no motion to proceed to calendar number 120, h.r. 1628 be in order until the bill has been the subject of executive committees in the committee on finance and health, education, labor and pensions committee during which the majority and minority receive votes and the bill has been favorably reported from those committees. the presiding officer: is there objection? mr. cornyn: mr. president. the presiding officer: the majority whip. mr. cornyn: reserving the right to object. our colleagues are coming here today to say they want to fix what is broken in affordable

care act. i have in my hand a newsletter that the democratic leader and his colleagues sent saying that they refuse to participate in the process unless we drop all of our plans to repeal and replace obamacare. they refuse to participate in the process. i would just point out, mr. president, the failures of obamacare didn't just start today. it's been failing over seven years and they did nothing -- nothing -- nothing to help the millions of people who are being hurt, who had to move from full-time work to part-time work because their employer didn't want to pay the employer penalty for not providing obamacare coverage. we know that many people have been hurt by it and not -- not the least of which are the people who are finding their premiums skyrocketing. they will do so again next year unless we come to their rescue. they've seen their deductibles so high they've effectively been

denied the value of their insurance. i had a conversation just a couple of days ago -- i won't name what the democratic senator because it was done in confidence -- who confided to me that his own son had effectively seen his premiums go up so high that it cost roughly $12,500 out-of-pocket to deal with his deductible and to pay his premiums -- $12,000 500. that's not -- $12,500. that is not afford, certainly not to the middle class. so i would object. the presiding officer: objection is heard. the presiding officer: the senator -- the senator from michigan. ms. stabenow: before the distinguished majority whip leaves, what is being talked about here is like having a hole in the roof of your house, and

instead of patching it, they want to burn down the house. what we are not willing to participate in is burning down the house. we are more than happy and in fact have proposals and anxious to work with the majority to improve health care, not rip it athe part and take tens of millions of people's health care away, but improve it. before asking a question of the majority whip, i want to indicate for all those listening, we have the bill and we can read pretty quickly. it has been out. and even though it is considered a rough draft, we have it, we are analyzing it. what our leader -- the democratic leader -- indicated is that we have read in the discussion draft, which is not only the same, but it is worse for seniors, for those in nursing homes, for children in emission, and a -- for children,

for those in -- for children in michigan. i ask the majority whip, instead of burning down the house and ripping apart the health care system, would you join with us in putting forward a bill that would allow medicare negotiate prescription drug prices for seniors which my hospitals and insurance companies tell me are one of the driving forces raising the cost of health care. would you be willing to work with us on a bill to lower prescription drug prices and allow medicare to lower drug prices on behalf of american seniors. mr. cornyn: mr. president. the presiding officer: the majority whip. mr. cornyn: mr. president, i would say to the senator from michigan, we would be happy to work with you on high drug prices. that is a prime problem and one of the primary drivers of health care costs today, but this bill

doesn't touch medicare at all and so we leave in tact the health care for seniors and it's not touched by this at all. but when the time comes for us to deal with medicare, i think that's a debate we should have and we would welcome. the presiding officer: the senator from michigan. ms. stabenow: to the distinguished majority whip, with this legislation, which is essentially burning down the house, that you join with us where you admitted that one of the top drivers of health care costs in this country, which is what we want to tackle, mr. president. we want to bring down the costs -- bring down the costs of prescription drugs, and out-of-pocket costs for those whose premiums are too high. taking away the ability for a parent to take a child to the

doctor or someone with cancer or a small business owner being blocked from getting health care because of a preexisting condition, we consider that burning down the house. we are opposed to that. frankly, we would like to have a ceremony and light this on fire and then come back together and then work together on the number one driver which is the cost of prescription drugs. the presiding officer: the majority whip. mr. cornyn: mr. president, maybe i misunderstood the question initially. i would suggest to the senator from michigan that it is the democrats under obamacare who burned down the house because the individual market for health care has been decimated -- decimated -- and we are coming to the rescue of those millions of people who don't have employer-provided insurance, they don't get their coverage under medicare or any other government program. they get it from the individual market. you are talking about individuals and small businesses. right now people have almost no choices in many parts of the country and those who have

choices simply don't have it -- it is simmably unaffordable -- simply unaffordable. it is an important conversation to have on drug prices and medicare. i'm happy to do that. that would do nothing, zip, zero, nada to help the people who are hurting now as far as obamacare and that's who we are determined to help by passing this legislation after an open-amendment process and fulsome debate. the presiding officer: the senator from michigan. ms. stabenow: i would like to make one other comment, than is for the people in michigan who are purchasing on the private exchange, over half of which are able to get a policy today for their families for less than $100, i would say they would have a different perspective. we need to fix those things that are not working. but for the 95% of children in michigan who can now see a doctor because of what has been done, for the hospitals who are seeing 50% fewer people walking

into the emergency room without insurance that are raising the costs for all policies, for the savings that the state of michigan is going to have in its budget next year of $432 million of savings to taxpayers because they did the right thing by allowing children to go to a doctor instead of getting sick and going to the emergency room, i would suggest this is the wrong direction. thank you. mr. schumer: mr. president, i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

the presiding officer: the senator from massachusetts. mr. markey: mr. president, i ask unanimous consent that the order for the quorum call be rescinded. the presiding officer: without objection. mr. markey: mr. president, last week president trump reportedly told several of our republican colleagues that the house-passed version of trumpcare's health care repeal of the affordable care act was mean. this week white house press secretary sean spicer said that the president would like to see a health care bill from the senate that, quote, has heart in it. but what did we get? we got a bill from my senate

republican colleagues that is identical to, and in some cases, even worse than the house-passed american health care act that would rip coverage away from 23 million americans and tbut medicaid -- gut medicaid by more than $800 billion. nothing changes the fact that this undemocratic secretive process has resulted in legislation that is so mean spirit it would make the wicked witch of the west cringe. the senate republican bill will rip away economic security for young family, make grandma and grandpa pay more for health insurance simply because they are old, and tear away coverage for opioid addiction patients desperate for treatment, and

punish americans with preexisting conditions like cancer and diabetes and alzheimer's. so for once, i agree with president trump -- this bill is mean. so let's take a closer look about what is really inside of the senate g.o.p.'s proposal on health care. let's start by looking at the lower quality coverage. first, this bill will roll back the clock to the days before the affordable care act when an insurance card did not guarantee comprehensive coverage. because of the affordable care act, there are certain things an insurance plan just has to cover, things like emergency services, maternity care,

prescription drugs, mental health services. there is security in knowing that if you pay your premiums, this sort of basic minimum coverage is in place when you need it. republicans want to rip that away. they want to give states and insurance companies the option to not cover these things. this would make it so that a consumer could easily be faced with an unexpected medical bill for services they assume were covered with their health care plan. independent signals from the congressional budget office estimates that out-of-pocket costs for maternity care or mental health and substance abuse disorder services could increase by thousands of dollars in a given year under trumpcare. that's not increasing quality, as president trump promised.

that is lower quality. that just increases inequality between the healthy wealthy who can pay out-of-pocket for their care and everyone else, providing lower quality coverage, that is mean. and second, an age tax. an age tax. since the affordable care act became law, the uninsured rate for americans age 50-64 decreased by one half. those are the baby boomers, and it is estimated that more than 28 million of these baby boomers will develop alzheimer's disease between now and the age of -- the year of 2050. this reduction in the uninsured rates came about because the affordable care act expanded medicaid and put protections in

place to prevent insurers from charging exorbitant prices just because of age. but instead of caring for our family and friends as they age and ensuring that they can afford quality coverage on what may be a dwindling income, trumpcare punishes you for achieving your milestone 50th birthday. under the republican health care proposal, insurance companies can charge older americans five times more than younger americans for the same coverage. that is unconscionable. it doesn't matter fur a 50-year-old marathoner in the best shape of your life, you will still be paying at least five times more for your insurance than your 40-year-old neighbor who smokes. as a result, americans over the age of 60 could see their

premiums increase by an average of $3,200 or 22%. that might not sound like a lot to some people, but for those with decreasing incomes and fewer job opportunities, it's the difference between being able to eat or being kicked out on the street. to add insult to injury, the subsidies in trumpcare to help individuals purchase insurance are far less generous than what is currently available under the affordable care act. because that will result in premiums which are higher. the tax credits won't keep pace to help pay for more expensive insurance, and as a result, this age tax is going to be mean to those who are older in our country. number three, medicaid cuts.

medicaid is a lifetime helper for families across our country. more than 70 million americans, nearly half of which are children, depend upon it. but it's clear that trumpcare's cuts to the program that republicans want medicaid to flatline. for a program that covers more than one-fifth of the nation's population, including the sickest, the oldest and the poorest amongst us, medicaid is especially irreplaceable. but republicans harbor an ancient animosity towards medicaid. republicans say that we need to restructure medicaid's financing to help control the program's spending and make it more efficient. that's just another way of saying to america's most vulnerable that you're not just -- as important as those

who donate to our campaigns. raiding the medicaid coffers achieves two goals for the republicans and president trump. first, it tears holes in a critical social safety net for more than 70 million low-income and working class americans. and second, it provides the g.o.p. with an open checkbook to pay back their donors with huge tax breaks. republicans might want to report these changes as capping the medicaid program, but won't be fooled. what capping really means is decapitated access to primary care, decapitating the ability of grandma and grandpa to secure a nursing home bed. decapitating access to treatment to substance abuse and mental health condition. gutting the medicaid program.

that is mean. next, they're going to reduce access to care. this one is simple. less insurance coverage equals less access to care. while it's possible to get a doctor's appointment and treatment without health insurance, it's usually at prices that are impossible to afford for a typical uninsured person. most working americans can't see paying more than $150 every time they want to visit a primary care doctor or footing the bill for a couple of thousand dollars in the event that they need more specialized care. the best medicines and the most effective treatments are only as good as the insurance coverage people have to help them to access to it. so how will these 23 million

americans who lose insurance under trumpcare get the care which they need? they won't get the care. and unfortunately, when patients do try to access care, it will be because their illness has progressed to the point where it can no longer be ignored. and instead of seeking care with a primary care doctor in a less expensive health care setting, most uninsured patients will end up going straight to the emergency room, the most expensive site for care, and the cost of that uninsured patient, that's going to get absorbed by everyone else in our country, and our rates for treatment and insurance coverage increase to make up for this uncompensated care. so reduce access to care -- reduced access to care, that is

mean. and then we move on to higher premiums. higher premiums are going to be the new rule in our country, because that is going to be what happens if the republicans are successful in repealing the affordable care act. according to the nonpartisan congressional budget office, trumpcare would increase premiums by an average of 20% in 2018. in massachusetts alone, premiums for next year could increase by $600, threatening coverage for more than 180,000 of my constituents with private insurance. and because of everything else in trumpcare, even though you are paying more, you will be getting less. it's like paying for a cadillac but only getting a tricycle. this will only prevent americans from securing access to the care

and the treatment that they need and they deserve. less costs, less care for more costs? that is going to be meaner. premiums are going to go up for everyone. and finally, threaten all of those in america who have preexisting conditions, because for so many americans, allowing insurance companies to refuse coverage or charge more because of a preexisting condition is inhumane, and it is immoral. anyone who tries to buy individual health insurance before the affordable care act remembers this problem. before the health care act passed in most states, if you had a preexisting condition, you could either be denied coverage, charged a much higher premium, or forced to wait potentially

for years before treatment for the condition to be covered. for many, this meant that either had to go without needed care or spend their entire savings, and for those with the most serious conditions, it was the difference between life and death. the anxiety of suffering from an illness was only exacerbated by financial insecurity. it was a cruel and unusual form of punishment. so sadly, the republicans want to take us back to this era. so threatening preexisting conditions, that might be the meanest of them all. because protections for families that have preexisting conditions is something that goes right to the heart of what the affordable care act provided as a protection. and why would millions of americans have to suffer these cruelties?

these indig indignities, these punishments? well, that's the most outrage part of all of this. president trump and the republicans are proposing this health care. also they can give tax breaks to the wealthiest in our country. we heard it from president trump himself last night when he talked about the people he hired for his cabinet. i just don't want a poor person, he said. but who does he want running the government and our economy? he wants the wealthiest people in america. he wants people who are billionaires to be making the decisions of how we run our economy. president trump has in place a goal of turning over to the richest people in our country their responsibility for putting together the plan to cut the

programs for the poor and the working families in our country. the republicans and their wealthy planners have put together a very simple one-step program. the rich get richer and the rest get sicker in the united states. and make no mistake, this health care plan is of the rich, by the rich and for the rich. it's giving billions in tax breaks to people who don't need or deserve them, paid for by people who can't handle or afford it. that is cruel, that is inhumane, that is immoral, that is just plain wrong. and i and my democratic colleagues will not stand for it. we are standing up to say no to ripping away coverage for millions of americans. we are raising our voices to say no to increasing costs for middle-class families. we are saying here today that we are going to say no to this

legislative malpractice. the health of the american public is too important for us to be so mean, so callous to the people we were elected to serve. this republican proposal has never been about policy. it has always been about politics, and it's time to stop playing political games with people's lives, with people's health care. health care is a right and not a privilege. that is the promise we made to the american people with the affordable care act, and it's a promise that we must keep. the president is keeping his promise to the rich in our country. they have now written a health care plan for one-sixth of our economy that slashes $800 billion that would be used for the poor, for the sick, for the working class, for senior

citizens in nursing homes by $800 billion in order to give an $800 billion tax break over to the wealthiest people in our country. that is wrong. this is a critical moment in our country's history, and we as democrats are going to battle every single day here on the senate floor and across this country to make sure that every person understands what the consequences of this incredibly callous, mean bill will mean, for lower quality coverage, an age tax on the elderly, medicaid cuts that hurt families across our country, reduced access to care, threatening the protections for preexisting conditions, and resulting in higher premiums for everyone. it will be a disgrace. madam president, i yield back the balance of my time.

a senator: madam president? the presiding officer: the senator from maryland. mr. cardin: madam president, first i want to thank senator markey for his comments. i share his concerns. i agree with what he has said, the risk factors of the bill that was announced this morning by the republican leader, what it could do to millions of people around this country, what it will do for coverage for hundreds of thousands of people in my state of maryland who will lose coverage, and just about every marylander whose health care will be impacted if this bill were to become law. but i want to start, madam president, by saying i think this is a shameful moment for the united states senate. the senate which traditions have made it be known as the most deliberative body in the world, the senate which has been known

as a body that allows for robust debate and benefits from the views of all 100 members, that each of us have opportunities to get our voices heard, that tradition has been badly damaged by what the majority leader has done in bringing a bill that affects one-sixth of the economy of our country to the floor of the united states senate without deliberation by our committees and without transparency to the american people. madam president, when i got to the united states senate, i worked hard to get on to the senate finance committee. i did that because the jurisdiction of the senate finance committee contains areas that i've devoted a good part of my public career to, including issues of taxation and issues concerning social programs in our state, but it also included

health care, an area that i worked on when i was first in the maryland state legislature. i wanted to be on the committee that had a role in developing the health policy of this nation. i thought i would add to that debate with my experience, and i wanted to make sure the people of maryland had a voice as we developed health policy in america. madam president, that role was being denied by what the republican leader is doing in bringing this bill to the floor without the benefit of hearings. let me just repeat that. there has not been one hearing held on the legislation being brought forward by the majority leader. there hasn't been one committee markup of the bill. now, let me explain to the general public what a markup is. it's when the bill -- the committee that has expertise on

it -- in this case it would be the health, education, labor, and pensions, the finance committee, have a chance to bring the public in and get their views on the legislation, to have the committee staff go through it and explain all of the aspects to the members of the committee, an opportunity for us to offer amendments to improve the bill, and then ultimately taking a vote on the recommendations to the full senate. that is regular order on legislation. but it's particularly the regular order on complex pieces of legislation. i don't think there's a member of this body who would say this is not a complex field when we're dealing with health care, one-sixth of our economy. but the process that was used denied the people of maryland, the people of this nation the opportunity to have their voices heard through their elected

representatives. it's a shameful moment. now, madam president, i know this has been done before on the floor. i'm going to repeat it one more time. compare this to how the affordable care act was passed by the united states senate. we had transparency, opportunities for the public to have input. we had hearings, many, many hearings that took place. my staff tells me there were 50 hearings or roundtable discussions or walk-throughs. we had 26 consecutive days of senate debate. there were hundreds of amendments offered by both democrats and republicans that were adopted on the bill before the bill reached the floor of the united states senate. that all took place before we started the debate on the bill. you cannot justify this process. this is an abuse by the majority, and it will affect the functioning of the united states

senate. more of concern is what this bill will do. the process terrible. the impact on the senate terrible. but the real tragedy here is the impact if this bill were to become law, the impact it would have on health care in america. so let me talk a little bit about my state of maryland. it has been projected under this bill that the -- those who will not have insurance coverage will go back basically to what it was prior to the passage of the affordable care act. that's a little over 400,000 marylanders are at risk of losing basic health coverage. now, madam president, it's going to affect everyone's insurance in maryland. i'll get to that in a moment, but as many as 400,000 are in jeopardy of losing their insurance because of what is done in regards to the alliances

and the medicaid program itself. many more will lose quality coverage. senator markey talked about preexisting conditions. you claim that there's protection for preexisting conditions, but it does not guarantee that the services will be provided. because the states are given tremendous discretion as to what would be a required benefit, essential benefits within the health care plans. so someone has a mental illness or someone has a drug addiction, is there a guaranteed coverage that that person would be able to get services? if that person has a preexisting condition, it may very well not be covered because of the absence of essential health

benefits. let me just give you another example of what could happen under this bill. and this is a real example on gender discrimination. obstetrics coverage is critical for a child-bearing woman. now, if that becomes an optional coverage because of the state plans and discretion that it's given, obviously only those women who are planning to have children will take that covera coverage. why would someone who doesn't need that coverage take the coverage? what is the consequences of allowing that type of choice? it's very clear. younger women are going to pay a lot more for their health insurance than they otherwise would. is that fair? i think not. i think not. and that's the consequences of the type of changes that are being made in the affordable

care act. i was very instrumental in making sure that we had full coverage for pediatric dental. why? well, unfortunately in my state in 2007, the year i first started in the united states senate, we had a youngster, demonty driver who lived not far from here who died because of untreated tooth decay. became abscessed. went into his brain. he had to go through a couple of surgeries and he lost his life. what was needed was $80 dental care. he couldn't get access to it because there was no coverage for it. he had no access to that care. he lost his life and of course the health care system was -- had to pay a lot of money when it only needed to spend $80 to keep him healthy. well, we took care of that and fixed that with the essential health benefits now including pediatric dental.

is that protected under the republican bill? the answer is unclear. probably not. up to the states. may be different in one state versus another. we don't have the protection. and then we get to the affordability issue for marylanders to be able to afford to have health insurance. under this bill there will be discrimination on those that are older. they're going to have to pay more for their health insurance. is that right? no, it's not right. i heard the majority leader this morning give examples of how the affordable care act is in dang danger, and he cited high premium increases. one of the states he quoted was the state of maryland, which was very misleading the way h he did that. he was talking about the individual marketplace, and he was talking about one segment of

that and what he didn't tell you is care first, the insurance company proposing that rate increase, indicated that at least half of that increase is a result of action taken by the trump administration. the trump administration has not made it clear whether they will fund the cost-sharing provisions which keeps the costs down and affordability in the individual marketplace. that's a self-inflicted increase by the trump administration. and there's a second issue that care first mentions. that is the president's insistence on not enforcing the individual mandate. by the way, that's in the republican bill. means that younger, healthier people will choose not to have health insurance. now, if they happen to ride a motorcycle, wrap themselves around the tree and get flown to

shock trauma in baltimore, we're going to treat them, guess who is going to pay the bill? all of us is going to pay the bill through uncompensated care. it's going to raise my insurance policies and everybody's insurance policy. that person should have had insurance. but that person thought he or she didn't need that insurance. so they didn't take out the policy. and you find that those who will take out the insurance policies are the higher risk because they know they need the insurance. so those with high-risk issues will be in the pool raising the cost. and that's why care first has a higher -- because they know it's less likely that healthier people will be in the pool than projected under the original affordable care act. why? because of president trump. when the leader says that the affordable care act is falling

apart, the affordable care act is strong but it's been made vulnerable by actions of the trump administration and provisions in this bill will even make it weaker. 1.2 million marylanders are in our state medical assistance, medicaid program. now, madam president, many of these people are working families. many of these people are our seniors who need long-term care and are in the medicaid program because it pays for their long-term care expenses. many of these people are veterans, are returning warriors who are under the medicaid program. under the republican-released bill, they may make it a gentler slope before we get to the full impact of the medicaid reductions, but the medicaid reductions, if i understand

correctly, are even more severe than under the house-passed bill. now, i could speak for maryland. i know our legislature. our legislature is going to try to do what's right. but they have limited resources in order to try to meet the needs that are out there. it's just not right to say that we're passing these problems on to the states when the states don't have the fiscal capacity to deal with it. who gets hurt? the 1.2 million marylanders who rely upon the medicaid program, and all marylanders who don't want to see what we call cost shifting, when someone doesn't have health insurance ends up in our emergency room, doesn't pay the bill and everyone else pays those bills. so why are we doing this? what is the reason why we've gone through this pain? i've heard my colleagues talk about it. it's absolutely true. the republicans need to make room for the tax cut.

they're pretty clear about it. close to a trillion dollars in tax cuts. that's would they need to do. who benefits from tax cuts? the wealthy, those who have access to health care and. and who pays for the tax cuts? those who are the most vulnerable in our community. that is just wrong. i want -- my staff has put together a lot of individual letters that have been sent to us. i don't need to go through them. i can tell you just experiences that i've had walking on the streets of baltimore or, quite frankly, walking anywhere, including here in washington. when people come up to me and said, senator cardin, keep up the fight, you know what's going to happen if that health care bill becomes law -- we've done some tests, and we have certain genes. we're in a high-risk pool of cancer. we're not going to be able to

get coverage, if you let the insurance companies to go back to the practices they had before the passage of the health care act. or people say if they didn't have the insurance that they think now they're going to lose, they would have to go through personal bankruptcy. that's not hypothetical. bankruptcy -- the leading cause before the passage of the affordable care act was unpaid medical bills. we're going to go back to those days. i talked to a parent who has a child with a disability, and they go over the costs of that child in the health care system. and they don't possibly have the means to be able to afford that, if they didn't have access to health coverage without discrimination. you leave these discretions to how the insurance companies respond, they're businesses, they're going to figure out a way that that family that has that disabled child will not have adequate coverage.

that's what's at risk. senator markey is right. health care should be a right, not a privilege. and we're moving in the wrong direction. in maryland we have hospitals that are located throughout our state to meet the needs of the people of maryland, so we have hospitals that are located in areas where they have a lot of elderly, a lot of poor people. but because of the way that we deal with our hospital reimbursements, we don't have cost-shifting. we can have what's -- we can have what's known as a taxpayer rate. a hospital can locate in an inner city or in a poor neighborhood. if you increase the cost-shifting, if people don't have insurance, health care facilities will not locate in those communities,ed aing to the cost -- adding to cost of everyone's health care. one of the great benefits, one of the great achievements of the

affordable care act, is that we now have facilities that are more conveniently located to the people of this country, whether they live if a rural area or an urban setting. some are qualified health centers, some are just health clinics, but they're located because more people have third-party coverage, have insurance in order to pay those bills. so i read with interest that certain segments of the advocacy community are going to be given certain concessions in this bill, and they think they're going to be okay. one, as i understand -- i'm not sure what this term means, so maybe someone can explain it to me: medicalically complex children. if i understand the bill correctly, there's going to be a carve-out in the medicaid system so that these complex cases will be, at least for a period of time, reimbursed. where are they going to get care? right now they're getting care

in many cases in a school-based health clinic that's going to be closed under the republican bill that's out here. it's not qualified to receive reimbursement. or the expansion of our qualified health centers under the affordable care act is going to be in deep jeopardy. i've met with the c.e.o.'s of our qualified health centers, where we've expanded the deal with pediatric care, dental care, mental health. that is in jeopardy of being contracted, if you don't have the reimbursements from the people that live in that community that we have under the medicaid expansion. that's in jeopardy. so don't believe that you're protecting any vulnerable populations, when you don't provide the structure in which you can have reasonable reimbursements so that doctors and hospitals and clinics can locate in communities and be treated fairly under our reimbursement structure.

so, madam president, i am deeply disappointed. i am deeply disappointed what we've done to this great institution on this -- such an important subject. i'm deeply concerned as the impact this is going to have on the people of maryland and our nation. and i will join my colleagues in doing everything i possibly can during the limited opportunities we have, only on the floor of the senate, no the in our committees, to do everything -- not in our committees, to do everything i can to protect the people of maryland and our nation so that health care can be a right and not a privilege. with that, madam president, i yield the floor. the presiding officer: the senator from washington. ms. cantwell: madam president, i thank my colleague from maryland for so articulating the issues in this discussion draft that's been released this morning, as i hear him talk about these complex kids and how the cap is going to work and when people are going to be

affected, it reminds me of that book "the smartest guys in the room," right? i mean, basically people cook up schemes they think other people can't understand or the broader public won't catch on to in the hopes that they can pass something. that's exactly what's going on here is a hoax and a scheme that is not cost-effective for the american people, literally will cut people off of access to health care, and literally, if the house bill was mean, this is doubling down on mean. so i thank my colleague from maryland for articulating this about the complex kid issue because these are concepts -- if this is a discussion draft, i would hope my colleagues would come to the floor and discuss it, discuss the concepts that are in this bill and debate them. but that's not what's happening. in fact, we know very little detail at this point in time because people are assessing the information and then trying to read and assess in between the lines.

well, i can tell you what i know and have gleaned so far by the accounts, and that is this is a continuation on the war on medicaid. i say that because this war on medicaid, we didn't know where the senate would go in their proposal. we know what the house decided to do. the premise and structure of the house bill is to cut medicaid by capping it an continually driving down the amount -- and continually driving down the amount of federal obligation to this program. now, i will tell you, it is not even a smart idea. if you want to reform and deliver better health care at lower cost, there are many ways to do that and save dollars and give better patient care. but that's not what the house proposal is. it was a budget mechanism, and i'm not saying that, i'm talking to my health care providers at home. i'm talking to university professors, people who know and understand health care and have studied it for a long time.

what the house did and now the senate is doubling down on is nothing but a budget mechanism to cut people off of health care. and as my colleague said, the most vulnerable of our population. so it's a wrongheaded idea. it is not going to help us control cost. actually, medicaid reduces bankruptcy rates, helps people stay employed, and boosts our g.d.p. so why would we want a draconian idea like cutting medicaid as the centerpiece of a budget proposal by our colleagues on the other side of the aisle? as people have said, because they want to take that revenue and give it away in tax breaks for the wealthy. i guarantee you that's not what we should be doing. the access to medicaid is so important. our veterans access the health care system through medicaid. many of them through the v.a. but many services also through medicaid. they would be impacted and

veterans would lose care. our children who are seen at hospitals, like children's hospital in seattle, the medicaid populations, they would not have the resources to get access to care. our institutions that are covering individuals at medicaid rates would take a hit. so all the senate proposal does is basically move that cap, but a steeper cap, at a point in time that makes and exacerbates this problem of cutting people off to access to care. so if the house bill was mean, this is just doubling down on mean. there is nothing about destructing the safety net that is so important to americans that goes hand in hand with the philosophy about how to drive down costs to health care. think about it. if we came out here and had a discussion of 100 united states senators and we said, the great

way to drive down the cost of health care is to cut people off of health care, most of my colleagues would say, that's not a smart idea. because when people are cut off of health care, we know that uncompensated care exacerbated health needs, challenges with other parts of our system, delivering care to them makes it more expensive. and when we've had discussions and round tables about the proposal that the house had put out, providers in my state told me point-blank, covering the medicaid population has helped drive down and control the rate of insurance in the private market. so now all we're doing by saying we're going to cut medicaid at a more drastic rate is you are going to just send a signal to the market that rates for the private insurers should go up. i don't think that's what my constituents want. they want us to innovate.

they want us to drive quality care and managed care into parts of the united states where it doesn't exist. they want us to take care of our most vulnerable population, and they want to make sure that we're not delivering that off people who are going into the emergency room 50 times in a year because they don't have insurance. we know that the medicaid rate is critically important, that medicaid costs up to one-quarter cost than what the private insurance. so it's a way to deliver care. we know that things that we've put into the affordable care act, like moving people off of nursing home care to community-based care, has saved medicaid dollars. more states should do it. we know that plans like bundling up the individual market into larger programs so they can have clout, like others who work for a larger employer, has also

driven down cost. so those are the things that we should be accelerating, not this notion that we move forward as a country by cutting the most vulnerable off of health care. so i ask my colleagues to come out and discuss this concept, discuss this idea, how it will affect the health care providers in their states. i plan to do that with my state. i hope they'll come out harder and tell us -- i hope they'll come out here an tell us why it is a smart trait -- and tell us why it is a smart strategy to cut people off. i know no state that has a strategy to make up for the people cut off of medicaid that has been doubled down in this bill. so i do not want to see a war on medicaid. what i want to see is innovation. what i want to see is that covering people with some level of insurance basically helps save everybody on their insurance bills as well. so i hope my colleagues will take this discussion draft and be proud to come out here and discuss it, but we haven't heard

very little of that thus far. let's look at the real numbers, and i guarantee you that we will hear from governors, we will hear from states, we will hear from providers, we will hear from businesses, we will hear from people who do not think this is a good idea. i know that already the national association of area agency on age is, quote, this strategy will put consumers on a fiscally precarious path. we've heard from other people that the medicaid cap is up to twice as worse for states. it will cause problems and also from children's health care groups, quote, converting medicaid into a per capita cap would dismantle critical protections to care for all enrollees, end quote. so these are just part -- so these aren't just partisan comments.

these are the facts. what my colleagues don't realize is that by taking a huge chunk out of medicaid, you are taking a huge chunk out of the safety net that so many americans depend on. it will not help us lower costs. it will exacerbate an ex-can alation of rate -- an ex-can alation of rates for everyone in the market -- an escalation of rates for everyone in the market. i thank the president and i yield the floor. a senator: madam president? the presiding officer: the senator from iowa. mr. grassley: in march, mr.

mr. comey briefed ranking member feinstein and me, as chairman and ranking member of the judiciary committee, on the russian investigation. this included telling us who was and who was not under investigation. after that meeting, i publicly called for mr. comey to tell the public what he had told us about whether president trump was under investigation. let me ask the leader, mr. leader, i didn't realize you were going to be here to speak, so i'll yield the floor and start over again. mr. mcconnell: i would thank my friend from iowa. i'll just be a minute. madam president, i ask unanimous consent that not withstanding roulette 22, all -- rule 22 all postcloture

time on the billingslea nomination expire at 2 p.m. today and pore on the kristine l. svinicki nomination expire on monday, june 26. the presiding officer: is there objection? without objection. mr. mcconnell: i thank my friend from iowa. mr. grassley: madam president. the presiding officer: the senator from iowa. mr. grassley: in march, mr. comey briefed ranking member feinstein and this senator on the russia investigation. this included telling us who was and who was not under investigation. after that meeting i spunically called -- i publicly called for mr. comey to tell the public what he had told us about whether president trump was under investigation. i did this because the public

had a right to know. mr. comey told me and other congressional leaders that president trump was not under investigation. he even told the president himself -- and i understand that it was repeatedly told to the president. but mr. comey didn't listen to my request for transparency. and i think transparency in government is very important because transparency brings accountability, and government needs to be accountable. mr. comey didn't listen to the president's request. only months later has the truth finally come out. well, it ought to raise a question with anybody what happened in the meantime. what happened because mr. comey refused to tell the american people that the president wasn't

under investigation. the short answer is something you see almost hourly, particularly in this city. media hysteria. countless media articles falsely claimed the president was under investigation for colluding with russia. and unfortunately, a number of our democratic colleagues in the house and senate played right along. over and over again the media published selective leaks. they published classified half-truths. all this was used to make false allegations of sinister conduct by the president. and of course, there was a lot of people who believed it. the intelligence community conducted an assessment of russia's efforts to interfere in the election. that assessment said one of

russia's goals was to undermine public confidence in our democratic system. because mr. comey refused to tell the public that the f.b.i. was not investigating the president, conspiracy theories and, of course, wild speculation have run rampant about the election, about the president, and about russia. these conspiracy theories and wild speculation have played right into russia's aim of undermining faith in our democratic system. now that doesn't come out very often in these stories, but you have to understand, russia makes a career out of not only in the united states undermining

democrat systems, look at what they've done in the ukraine militarily. look at what they've done in france with the elections, netherlands with the elections, and they're talking about upcoming elections in germany where they'll try to do the same thing. because, you see, autocrats don't like democratic systems that work, and what they can do to undermine those democratic systems is going to obviously make them look better. those national security concerns should have taken precedent. mr. comey said that he was worried about the duty to correct the record if evidence of collusion involving the president came to light later on. but that concern was merely hypothetical. in other words, pure speculation.

in the unlikely event that it came to pass, the public should know if the f.b.i. is pursuing a criminal investigation against the president. just like the public should know if the f.b.i. is pursuing a criminal investigation against a major party's nominee for president. but mr. comey agreed with attorney general lynch to shade the truth in favor of the clinton campaign rhetoric and call what was an investigation a matter -- ,quote-unquote, -- a matter, instead of using the word "investigation" at the ordering by the -- it came about because of the ordering by attorney general lynch. after a year of the entire might of the united states

intelligence community and the f.b.i. looking for evidence of collusion with the russians, where is that evidence? but after all of this chaos and mountains of innuendo about the president and collusion with russia, the truth finally came out. the f.b.i. was not investigating president trump in the russia probe. so the media was wrong. so the democrats were wrong. so the wild speculation and conspiracy theories ended up harming our country. they played right into russia's hands. and how did we all learn about this truth? in president trump's letter

removing mr. comey from office, at first most didn't believe it. the media scoffed when they wrote what the president said in that letter. they insisted that mr. comey would never tell the president he was not under investigation. well, we learned earlier this month from mr. comey himself that he had done exactly that. it wasn't a surprise to me because mr. comey had told me the same thing. i have to note something else here. mr. comey didn't just tell the president, senator feinstein and me that the president was not under investigation. he had also told the gang of eight. of course the gang of eight includes senate minority leader, senator schumer. but even after mr. comey told the gang of eight that the president was not under

investigation, the minority leader told the media that the president was under investigation. and of course that further helped feed media hysteria. the majority leader even tried to -- or the minority leader even tried to say that the senate should vote on the supreme court nomination because a president was under investigation. and the whole time he knew it wasn't true. so media hysteria and baseless political attacks filled the vacuum left by mr. comey's failure to inform the public to be transparent, to be accountable. the odd thing about it is none of this fiasco had to happen if mr. comey had just been

transparent with the public, as i understood it to be, it could have been avoided. unfortunately, now it looks like mr. comey and the media might be doing the same thing to attorney general sessions. to weeks ago mr. comey said that he didn't tell the attorney general about the conversation he supposedly had with the president about general flynn. mr. comey said, this was because he believed the attorney was going to recuse himself from the russia investigation. mr. comey said the f.b.i. was aware of the facts that he couldn't discuss in an open setting that could have made the attorney general continue engagement problematic. well, that vague statement sounds very miss -- mysterious to people who don't know the

whole truth. they will wonder what were these secret facts? and what did the f.b.i. conclude about those secret facts? was the attorney general under investigation? did the attorney general collude with russia? once again, mr. comey is not being as transparent about senior government officials and the russia investigation as he could or should be. now the speculation is running rampant again, this time about the attorney general. instead of the president. cnn reported that mr. comey told the intelligence committee behind closed doors that the issue was a possible additional meeting between sessions and the russian ambassador. the media has begun to speculate all sorts of nefarious things.

so here we go again. the rumor mill is back in business. it's insinuating improper ties with russians and undermining people's faith in another senior government officials with also the follow-up that it also undermines people's confidence in our institutions in government and maybe even in our constitution. this is the same destructive pattern, and it plays right into russia's hands again. well, this time around we shouldn't put up with it. we ought to say enough is enough. there's no reason mr. comey couldn't have told the public the whole truth. wednesday -- once again threel months ago mr. comey

specifically told members who was and who was not under investigation in the russian probe. he should also tell the public whether the f.b.i. ever had an open investigation on attorney general sessions. he should tell the public whether the f.b.i. checked out the times sessions met the russian ambassador. he should tell the public whether the f.b.i. looked into the mayflower meeting, the may flower hotel meeting and the event that went on there. he should tell the public if the f.b.i. found nothing improper about these meetings. if there was nothing to it, he should say so publicly. he should not be telling senators one thing behind closed doors and then making public insinuations that are different. he is the person that can nip

this ridiculous speculation in the bud. mr. comey should have told the public earlier what he told members about the president. and now he should tell the public what he told members about the attorney general. enough of this nonsense. the investigations of russian interference and of circumstances surrounding mr. comey's firing will continue. i'm confident that we will eventually get all the facts one way or another. and we will go -- we're going to go where the facts take us. in the meantime, it's time to stop the rumor mongering. it's time to stop the innuendos and half-truths. it'sim