[Pages S4706-S4715]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           EXECUTIVE SESSION

                                 ______
                                 

                           EXECUTIVE CALENDAR

  The PRESIDING OFFICER. Under the previous order, the Senate will 
proceed to executive session and resume consideration of the following 
nomination, which the clerk will report.
  The senior assistant legislative clerk read the nomination of Daniel 
Aaron Bress, of California, to be United States Circuit Judge for the 
Ninth Circuit.
  The PRESIDING OFFICER. The Senator from Illinois.


                   Major League Baseball Park Safety

  Mr. DURBIN. Madam President, if you are a baseball fan, and many of 
us are, this is a big day--the day of the All-Star game.
  I would like to spend just a few moments reflecting on an important 
issue for the fans of baseball across America.
  Thirty-five million people every year enjoy one of America's great 
summer experiences--seeing a game at a Major League Baseball park. Fans 
join their friends and family to eat hot dogs, nachos, peanuts, and so 
much more. We sing the national anthem together at the start of the 
game and ``Take Me Out to the Ball Game'' at the seventh inning 
stretch, a tradition started by a man named Harry Caray in a place 
called Wrigley Field.
  Some--the more dedicated fans--keep scorecards of home runs, RBIs, 
and earned run averages. Sadly, there is another statistic that has 
been seeing more and more attention lately--injuries to fans.
  A Bloomberg report from 2014 estimated 1,750 fans suffer injuries in 
Major League Baseball parks every season. Some are hit by balls; others 
are injured trying to escape being hit by a ball. This is far too many.
  On May 29, a 2-year-old girl was hit by a foul ball at Houston's 
Minute Maid Park. She suffered bleeding, bruises, and brain contusions 
from the ball's impact. Her skull was fractured. She continues to 
suffer seizures.
  What makes her injuries even more disturbing is that they likely 
could have been prevented had the safety netting behind homeplate been 
extended.
  Cubs outfielder Albert Almora, who hit the ball, was so devastated by 
the little girl's injuries that he could barely speak. One will never 
forget the image of his head bowed, crying, when he saw the damage that 
was done to this innocent little 2-year-old girl by a foul ball that he 
hit.
  What did he say afterward? ``I want to put a net around the whole 
stadium.''
  In the weeks following, we have seen more injuries in the stands. On 
June 10, a woman was struck by a line drive at Guaranteed Rate Field in 
Chicago. Two weeks later, a young woman was hit by a foul ball at 
Dodger Stadium in Los Angeles.
  A survey by the polling organization FiveThirtyEight found that 
14,000 more foul balls were hit in 2018 than 1998, and there is just no 
way--no way--for fans to entirely protect themselves. Here come these 
baseballs at 105 miles an hour off the bat. Even if you are watching it 
intently, you just can't protect yourself or the people you love who 
are watching the game with you. Bryant Gumbel made that point on his 
cable TV show on this very subject.
  If fans can't do more, baseball teams can. In 2017, after a child was 
hit by a line drive at Yankee Stadium in New York, I wrote a letter to 
Major League Baseball commissioner Rob Manfred. I urged the league to 
extend safety netting at all Major League Baseball stadiums past the 
home plate to the far edge of each dugout. To their credit, the league 
did exactly that.
  It is now clear, however, that is not enough. The little girl at 
Minute Maid Park was 10 feet beyond current netting.
  In June, the Chicago White Sox became the first Major League Baseball 
team to announce it is going to extend netting to the foul poles. Let 
me tip my hat to Jerry Reinsdorf, the owner of the Chicago White Sox, 
for leading the way with this safety measure. The Washington Nationals, 
the Texas Rangers, and the Pittsburgh Pirates are all planning to do 
the same, and the Los Angeles Dodgers are conducting a study before 
making a protective strategy permanent.
  I commend all these clubs for their leadership and commitment to fan 
safety, but I think we need more. We need a leaguewide standard.
  Last month, my colleague from Illinois, Senator Tammy Duckworth, and 
I wrote to Commissioner Manfred calling on all 30 Major League Baseball 
teams to extend the protective netting to the right- and left-field 
corners.
  Folks who complain that extending the safety netting to the foul 
poles will create an obstructed view ignore the obvious--right now, the 
most expensive seats in baseball are behind the nets, and people don't 
complain. It is something you get used to, and you can get used to the 
safety of it as well. We should be reminded that the most expensive and 
popular seats have been behind netting for decades.
  In 2002, a 13-year-old girl named Brittanie Cecil died after being 
struck in the head by a hockey puck at a National Hockey League game in 
Columbus, OH. The National Hockey League responded quickly, ordering 
protective netting behind the goal. Major League Baseball should show 
equal concern for its fans.
  Ensuring the safety of fans at baseball stadiums is a tradition that 
stretches back to 1879, when the Providence Grays put up a screen 
behind homeplate to shield fans from the area that was called ``the 
slaughter pen'' at that time.
  The increasing number of fans hit by balls makes it clear that new 
safety standards are needed at ballparks.
  Today, we will see Major League Baseball's finest players at the All-
Star game. Baseball fans deserve the best too. I urge Commissioner 
Manfred and all baseball teams to extend safety netting at Major League 
Baseball parks to the foul poles. Let's not wait until next season. 
Increasing fan safety is a win for everyone.


                        Prescription Drug Costs

  Madam President, if you ask the American people about issues they 
truly care about, let them volunteer what they think about, what they 
worry about, the No. 1 item on the list is the cost of prescription 
drugs.
  We all know the problem. You reach a point where you need a drug or 
someone in your family needs a drug, and then you face the reality of 
what it is going to cost. If you are lucky, and you have a good health 
insurance plan, it covers the cost--no worries--but for many people, 
that is not the case. They have copays and deductibles or sometimes no 
real coverage when it comes to the cost of prescription drugs.
  Of course, the prices of these drugs are way beyond our control. You 
go to a drugstore, and you are shocked to learn that what sounded like 
a great idea in the doctor's office turns out to be a very expensive 
idea at the cash register. For some people, it is an inconvenience, an 
annoyance, but for other people, it is a burden they just can't bear. 
They can't pay the cost. It is just too much.
  Some of these drugs are just not minor additions to your life; they 
may be matters of life and death. In those circumstances, what are you 
to do?
  I am reminded of people I have met across my State of Illinois as I 
have talked about this issue. One group

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stands out because there are many of them--people who are suffering 
from diabetes.
  Of course, they know that using insulin and taking care of themselves 
is the way to have a good, normal life, but it turns out that the cost 
of insulin has gone up dramatically.
  Did you know that insulin was discovered in Canada almost 100 years 
ago? The researchers who discovered this drug--this life-saving drug 
for diabetes--said at the time that they were going to surrender their 
legal patent rights to sell the drug for $1, give it away for $1. Do 
you know why? They said it was because no one should make a profit on a 
life-or-death drug. That was almost 100 years ago. But what are we 
faced with today? We are faced with a dramatic increase in the cost of 
insulin, a life-or-death drug.
  I have sat down with parents and their children and talked about what 
they go through to have enough insulin so that their diabetic daughter 
can survive. It is incredible. Mothers in retirement go back to work to 
take a job to pay for the daughter's insulin.
  The cost of insulin has gone up dramatically. In 1999, Humalog--a 
very common form of insulin made by Eli Lilly--ran about $39 a vial. 
What has happened to the cost of that drug in 20 years? It has gone up 
to $329, a dramatic increase on a drug that was discovered 100 years 
ago.
  At the same time, Eli Lilly is selling that drug in Canada for $39--
$329 in the United States. Why? Because the Canadian Government has 
said to Eli Lilly: That is the most you can charge in our country. We 
are going to fight for the people who live in Canada to have affordable 
drugs.
  Let me ask an obvious question. Who is going to fight in the United 
States for affordable drugs for our people, for those sons and 
daughters with diabetes--and not just for diabetes but so many other 
conditions for which life-and-death drugs are now being priced way 
beyond the reach of ordinary Americans? Do you know who is supposed to 
fight? We are supposed to fight for it. That is why we were sent here--
Members of the U.S. Senate and the House of Representatives--to pass 
legislation to bring these under control.
  Now we have legislation coming forward from the Senate HELP Committee 
on the issue of healthcare, and many of us had hoped that committee 
would use this opportunity to put in provisions to bring the cost of 
prescription drugs under control. Unfortunately, with only one 
exception, the bill is silent on the major issues.
  The measures coming out of the Senate Judiciary Committee, where I 
serve, don't go to the heart of the matter. They really will not make a 
big difference on the insulin scandal that we are now facing or on the 
cost of drugs in general.
  I had a simple measure that I introduced with Republican Senator 
Chuck Grassley last year. Think about this. Have you ever seen an ad 
for drugs on television? If your answer is no, it is because you 
obviously don't own a television. You can't turn it on without seeing a 
drug ad, right? And if you watch during the day, when many seniors are 
watching, it is one after the other after the other.
  I have said with amusement here we have even reached the point at 
which we can not only pronounce but spell the word XARELTO. We see 
those ads so often for XARELTO and HUMIRA and so many other things that 
they just bombard us. Why? They bombard us with these ads in the hope 
that consumers watching those TV ads will go to the doctor and say: 
Doctor, I need XARELTO.
  Well, XARELTO is a blood thinner. There are other alternatives that 
are much cheaper. But if you ask for that high-priced prescription drug 
and the doctor doesn't want to get in a debate with you and puts it on 
the prescription pad, guess what you have just done. You may have the 
right drug for you at the moment--maybe--but you may have just added to 
the cost of healthcare by putting the most expensive drug out as an 
option when another form would work just as well.
  In all of the things they tell you about these ads, some of the 
things I think are the most amazing and amusing are claims like this: 
If you are allergic to XARELTO, don't take XARELTO. Excuse me. How will 
I know I am allergic to it? After I take it, maybe.
  Those sorts of things and warnings about suicide and death and 
everything else come at us, but there is one thing that isn't included 
in those drug ads--one very basic thing. Excuse me, Eli Lilly; excuse 
me, Sanofi. How much does this cost? They don't tell you because it is 
shocking sometimes for them to tell you that some of these drugs cost 
thousands of dollars, and perhaps getting rid of that little red patch 
on your elbow of psoriasis will not be worth $5,000 a month if you know 
the price.
  So Senator Grassley and I put this in the bill last year and passed 
it in the Senate. How about that? It happens so rarely around here. We 
passed in the Senate a bill that required the drug companies to 
disclose the actual list price that they list for the cost of the drug. 
It passed the Senate, and it got killed in a conference with the House 
when the pharmaceutical companies came in and said: We don't want to 
tell anybody what these drugs cost.
  Then I got an interesting call from the Trump administration. Notice, 
I am on the Democratic side of the aisle, so I was surprised. Dr. Azar 
from Health and Human Services called me and said: We like your bill. 
The President wants to make your bill the law, so we are going to pass 
a rule that requires drug companies to disclose the cost of 
pharmaceutical drugs on their ads. Direct-to-consumer advertising has 
to tell the cost of the drug. Well, that is progress--a rule in that 
direction.
  Do you know what happened yesterday? In a Federal court hearing in 
Washington, the judge struck down that rule. The judge said: Congress, 
you haven't given this administration or any administration the 
authority to do that on its own. You have to change the law, giving it 
the authority, or you have to change the law itself to require the 
disclosure of drug pricing. Does it sound like a radical idea to people 
that we would disclose to them how much these drugs cost in the drug 
advertising itself? It isn't unusual for people to list the cost of 
items we buy every day. When it comes to lifesaving drugs, shouldn't we 
have that disclosure as well? Well, I hope we will. I hope this bill 
that is coming to the floor will consider that as well as several other 
aspects when it comes to prescription drug pricing.
  For example, did you know that the Veterans Administration, on behalf 
of the men and women who have served our country, actually negotiated 
with the pharmaceutical companies to have lower prices for the drugs 
that are used in VA hospitals and clinics? They sit down with these 
same drug companies and negotiate lower prices for our veterans. Good. 
Our veterans deserve it. But why won't our Federal Government negotiate 
for those who are under Medicare? Why can't we use the same drug 
formulary and pricing for the VA when it comes to Medicare? If we want 
to give our veterans a break--and we should--why wouldn't we give our 
seniors a break?
  I think we ought to have negotiated pricing in Medicare. I think the 
drug companies will get along just fine. Incidentally, they are pretty 
profitable today. If we had that commitment for renegotiating for 
Medicare, it could make a difference.
  I also think we ought to take on this insulin issue head-on--head-on. 
A story on ``60 Minutes'' recently was about a heartbroken mother from 
Minnesota whose son was on her health insurance plan under ObamaCare 
until he reached the age of 26. Then he was on his own. He was managing 
a restaurant. He didn't have drug coverage, and he was diabetic. He 
couldn't afford to pay the thousand dollars that was being charged for 
his insulin, so he decided to ration the dosage himself. It cost him 
his life. He, unfortunately, died because he couldn't afford enough 
insulin at the high prices that are currently being charged.
  We can change that. We can come to the side of consumers across 
America, to families who are trying to keep their kids alive, and many 
others. We can do that because we work in a place called the U.S. 
Senate, but in order to do that, we have to act like Senators. We have 
to say to the pharmaceutical companies: I am sorry, but there comes a 
point where you have pushed it way too far. There comes a point where 
we

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have to step in on behalf of families and consumers in America and 
speak up on their behalf. Watch closely to see if that happens.
  The gentleman who was on the floor, my colleague from Kentucky, will 
be the person who will decide that. Senator McConnell will decide 
whether we are going to challenge the pharmaceutical companies this 
year.
  Do you remember how I started? It is the No. 1 issue that American 
families volunteer to us. So is it important? Yes. Secondly, will it 
make a difference? You bet--not just in Illinois but I bet in Kentucky 
as well. Many a family can step forward and talk about how tough it is 
to pay for these prescription drugs.
  Do we have a chance to do it? You bet we do. There is a series of 
bills coming out of committee in the next couple of weeks. We could 
bring this to the floor of the Senate. Wouldn't that be amazing if the 
U.S. Senate, instead of doing a handful of nominations of people you 
have never heard of, ended up actually passing a bill, making a law 
that addresses the issue of prescription drug pricing in America? That, 
to me, is a reason we were sent here.
  What I would like to see and hope to see is a bipartisan effort. We 
Democrats are ready to stand up, but there are certain things we 
believe in. First, we believe in keeping the Affordable Care Act on the 
books. People with preexisting conditions shouldn't be discriminated 
against. Families ought to be able to keep their kids on their health 
insurance plans until kids reach the age of 26. We are willing to fight 
for that even though this week there is a lawsuit by the Trump 
administration to do away with it.
  Secondly, we believe we should negotiate prices under Medicare so 
that seniors get the price breaks that our veterans get today and many 
others do too.
  Third, we need to do something about the overpricing by these drug 
companies, not just price disclosure on the ads but changing the patent 
laws to give American consumers a fighting chance. Canada is fighting 
for Canadians. When is America going to fight for Americans?
  When it comes to pharmaceutical prices, this is our chance to do it, 
and we can get it done in the next 2 weeks. Who will decide that? The 
majority leader from Kentucky, Mitch McConnell. He will decide whether 
this comes to the floor, whether it is important enough to the people 
living in Kentucky, Illinois, New York, Mississippi, or wherever. It is 
his choice. It is in his power to make that decision. I hope the 
American people will reach out to him to encourage him to do that.
  I yield the floor.


                   Recognition of the Minority Leader

  The PRESIDING OFFICER. The Democratic leader is recognized.


                     U.S. Women's World Cup Victory

  Mr. SCHUMER. Madam President, yesterday, I sent a letter to U.S. 
soccer that officially invited the U.S. women's soccer team to come to 
the Senate to celebrate their outstanding World Cup victory. Happily, I 
heard last night that Megan Rapinoe, one of the team's cocaptains and 
stars of the tournament, has accepted our invitation. I greatly look 
forward to scheduling a time when these inspiring women can come to the 
Nation's Capital.
  What they have accomplished on and off the pitch is a credit to our 
Nation. Millions of young girls and young boys look up to these 
players. Millions of women, sports fans or not, admire the light they 
have shown on the disparities between the men's and women's game--part 
of a broader fight for equal treatment and fair pay in the workplace 
for all women.
  I believe it would be a fitting tribute to this great women's soccer 
team to bring legislation to the Senate floor that would make it easier 
for women to get equal pay in the workplace. The House has already 
passed a bill to do just that. I call on Leader McConnell, again, to 
bring that bill to the floor of the Senate, particularly in light of 
the great victory of the women's team and the knowledge that they get 
paid much less than the men, even though they work just as hard and 
bring, at least in recent years, even greater glory to the United 
States.
  Wouldn't it be great if we could pass that bill while the women's 
national team is visiting the Chamber? Wouldn't that send a powerful 
message of our commitment to rooting out discrimination everywhere?
  I urge Leader McConnell to consider it. Right now that bill lies in 
Leader McConnell's all-too-full legislative graveyard. Perhaps this 
great victory might spring it free so that we could do something for 
women's equality.


                            Jeffrey Epstein

  Madam President, on a much less happy note, this week, billionaire 
Jeffrey Epstein was indicted in New York on Federal sex trafficking 
charges. The newly released evidence of Epstein's behavior involving 
dozens of children is sickening, is appalling, is despicable.
  Epstein should have been behind bars years ago, but, unfortunately, 
the Secretary of Labor, Alex Acosta, cut Epstein a sweetheart deal 
while Acosta was a U.S. attorney in Florida in 2008. While a Federal 
prosecutor, Acosta signed a nonprosecution agreement that allowed 
Epstein and his coconspirators to remain free and evade justice, 
despite overwhelming evidence.
  Mr. Acosta hid this agreement from Epstein's victims. No one can 
figure out why Mr. Epstein was able to persuade U.S. Attorney Acosta 
not to prosecute, other than that Epstein could afford high-powered, 
high-priced attorneys. As the Miami Herald editorial board wrote this 
morning, it was not just that Acosta failed to get it right in 2008; 
the evidence suggests ``he didn't care to.''
  Accordingly, I am asking three things. First, I am calling on 
Secretary Acosta to resign. It is now impossible for anyone to have 
confidence in Secretary Acosta's ability to lead the Department of 
Labor. If he refuses to resign, President Trump should fire him. 
Instead of prosecuting a predator and serial sex trafficker of 
children, Acosta chose to let him off easy.
  This is not acceptable. We cannot have as one of the leading 
appointed officials in America someone who has done this--plain and 
simple.
  Second, I am calling on the Department of Justice's Office of 
Professional Responsibility to make public the results of its review of 
Acosta's handling of the Epstein case. Senators Murray and Kaine have 
called for these findings, but the Justice Department so far has 
stonewalled, has refused to make them public. This rebuke cannot be 
kept in the dark, and there should be hearings.
  Third, the President needs to answer for the statements he has made 
about his relationship with Mr. Epstein. In 2002, he said he had known 
Epstein for 15 years and that he was a ``terrific guy'' who enjoyed 
women ``on the younger side.'' Epstein was also reportedly a regular at 
the Mar-a-Lago Club for years. The President needs to answer for this, 
and ``I don't recall'' is not an acceptable answer in this case, 
particularly since President Trump appointed Mr. Acosta to such a 
powerful position.


                               Healthcare

  Madam President, on healthcare, today oral arguments begin in Texas 
v. United States, and the fate of our entire healthcare system hangs in 
the balance due to this nasty, cruel lawsuit led by President Trump's 
Department of Justice. If the courts ultimately strike down the law, 
the healthcare of tens of millions of Americans would be gone--gone. 
Prescription drug costs, high enough as they are, would go up even 
further. Protections for preexisting conditions that affect more than 
100 million Americans would be eliminated. A mother or father whose 
child had cancer would have to watch them suffer because the insurance 
company could cut them off and say: We are not paying for this anymore.
  We cannot tolerate that. Yet President Trump and his administration 
and 19 Republican attorneys general filed a suit that would do just 
that.
  The case reveals the depth of the hypocrisy and cruelty of the 
Republican position on healthcare. Senate Republicans, come campaign 
season, express unequivocal support for protections for preexisting 
conditions, but they have repeatedly blocked our attempts to have the 
Senate intervene in this lawsuit and fight back against the Trump 
administration's position, which threatens to eliminate these very same 
protections.
  I say to my Republican friends: You can't have it both ways. You 
can't say ``Oh, I want to protect people with preexisting conditions,'' 
and then prevent

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us from doing something to actually protect them. Instead, they are 
going along, knees shaking, with President Trump's cruel lawsuit, and 
that is what every Republican in this Chamber--just about every 
Republican--has done.
  President Trump has himself issued--also totally hypocritical--a 
laundry list of quotes in support of protections for preexisting 
conditions. He talks all the time about bringing down prescription drug 
costs while his administration actively pursues this lawsuit, which 
would raise the cost of drugs and eliminate protections for preexisting 
conditions.
  How much hypocrisy can America tolerate? It is mind-bending. The 
hypocrisy is patently obvious. I don't care if you love President 
Trump. You should be calling him out for this hypocrisy, which will 
affect the vitality--God's most precious gift to us--the ability to 
live long and healthy and well. President Trump is trying to take it 
away, despite what he says to you, Trump supporters.
  Senate Democrats will head to the steps of the Capitol to highlight 
what this lawsuit could mean to average Americans. My Republican 
friends should take note. The American people are keenly aware of which 
party is trying to take away their healthcare. Even if it happens 
through the courts in this Trump-supported lawsuit, they will know that 
congressional Republicans, by their silence--their meek, supine 
acquiescence--are complicit in the unraveling of our healthcare system. 
I believe the American people will hold them accountable at the ballot 
box if they don't change.


                           Election Security

  Madam President, on election security, tomorrow the Senate will 
gather for a briefing by senior officials of the defense, law 
enforcement, and intelligence community on the threats facing our 
elections in 2020.
  Russia has interfered in our elections. Everyone agrees with that. 
Our administration is doing nothing to stop it from occurring again in 
2020, so we need a briefing by law enforcement on how serious the 
threat is--they have said ``serious'' in public statements--and what we 
are doing to stop it.
  I am glad that Leader McConnell agreed to my request and has worked 
with us to schedule a briefing. It should dispel all doubt in this 
Chamber about the need to take action ahead of next year's Presidential 
elections.
  I would say this: A briefing is important; a briefing is necessary, 
but it is by no means sufficient. We must then debate and adopt 
measures to protect our democracy and preserve the sanctity of our 
elections. Even though Leader McConnell has finally agreed to have this 
hearing, he has so far been content--once again, a legislative 
graveyard--to have the Senate do nothing--do nothing--when it comes to 
one of the greatest threats to our democracy, that a foreign power will 
reach in and interfere for its own purposes, not to help Americans.
  Bipartisan bills exist. We could put them on the floor right now. 
This is not a partisan issue. Senators Rubio and Van Hollen have the 
DETER Act. Senators Menendez and Graham have the Russia sanctions bill. 
But all of these bills have languished, victims of Leader McConnell's 
legislative graveyard. We have many more options when it comes to 
election security--legislation from Senators Klobuchar and Warner, 
Feinstein and Wyden, Blumenthal and many others. It is time we move on 
these bills. As we continue to negotiate appropriations bills, we 
should include significant resources for election security. Nothing 
less than the vitality of and faith in our democracy is at stake.
  There are not two sides to this issue. A foreign adversary attacked 
our democracy. I expect that Special Counsel Mueller's testimony next 
week will highlight once again that Russia's efforts to interfere in 
our democracy were sweeping and systematic.
  What are we waiting for? What are we waiting for--for them to 
interfere again and for more Americans, whether they be Republican or 
Democrat or Independent, left, right, or center, to no longer believe 
this democracy is legit? For 243 years, since the Declaration of 
Independence and certainly since the signing of the Constitution a few 
years later, we have had faith in this democracy, even when the outcome 
isn't what we want. But that faith is already eroding in good part 
because foreign powers can interfere in our elections. We cannot--we 
cannot--let that happen, no matter who you are, what your politics are. 
But Leader McConnell is standing in the way of what could eat at the 
roots of our democracy and eventually make this mighty oak, the 
American experiment, fall. We don't want that to happen.
  The briefing tomorrow is a good step, but it is only one step. We 
need to take more. We need to act, to prepare our democracy for the 
challenges ahead.


                                FOX News

  Madam President, I felt it was important to point this one out: 
President Trump amazingly attacked FOX News in the last few days in a 
series of tweets for coverage he viewed as unfavorable to his 
administration. This is FOX News, a news outlet that, frankly, is 90 
percent or more on the President's side. Their most popular shows seem 
to just be cheerleaders for President Trump. To me, it is the most 
biased newscast there is of the major news stations, not that any of 
them are free of any bias. Yet when President Trump hears a small, 
dissident tweet, dissident note, from FOX News, and now he attacks it--
what kind of thin skin does this man have? What kind of thin skin? But 
it is worse than his thin skin--when a President can attack a news 
organization that is overwhelmingly friendly to him, with some of his 
leading advocates getting prime time space, some of them going to his 
rallies, it shows he really doesn't believe in freedom of the press. 
Dictators--dictators--shut down the press and try to shame the press 
when they speak truth to power, which is what our President has done in 
all the years of this Republic.

  When President Trump can even attack FOX News because once in a blue 
Moon it says something he doesn't like, that shows he doesn't really 
deserve to be President because a President must protect our liberties 
whether or not he is under fire.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. COTTON. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                        Remembering River Nimmo

  Mr. COTTON. Madam President, I want to call your attention to a story 
that is tragic but also heartwarming and uplifting.
  Honorary Colonel River ``Oakley'' Nimmo of Camden, AR, passed away 
last month at the age of 5 after a protracted struggle with his enemy, 
a rare form of cancer called neuroblastoma. Oakley's family remembers 
him as a ``sweet, brave boy'' who liked to play with power wheels and 
toy guns, but all those who knew him or who have learned about him will 
remember Oakley for an act of service that perhaps only a child could 
perform.
  Oakley wanted to be an Army man when he grew up. Even in the advanced 
stages of his fight with cancer, you would find him at the hospital 
wearing camouflage fatigues and a helmet, with his trusty rifle by his 
side and a smile on his face.
  Oakley fought his cancer valiantly, going above and beyond the call 
of duty. He was strengthened along the way by his Arkansas neighbors, 
who held yard sales and sold bracelets to help the Nimmo family pay for 
his care. He was also supported by 20,000 prayer warriors on a Facebook 
page entitled ``Prayers for Oakley Nimmo.'' But ultimately it was God's 
will that Oakley should return home to him. He passed away on the 20th 
of June.
  In light of Oakley's heroic struggle, as well as his dream of 
becoming an Army man, Oakley was named an honorary colonel in the 
Arkansas National Guard. In the days leading up to his funeral, his 
family made a simple request: that veterans and servicemembers show up 
at the funeral in their uniform to give Oakley the proper sendoff. Word 
got around, and dozens came. Some traveled from nearby towns. Most had 
never even met this little boy, but it didn't matter--he was a soldier 
like one of them. Soldiers from the Arkansas National Guard provided 
funeral honors for Oakley. They presented Oakley's mother, Shelby, with 
the flag and a special ID tag with

[[Page S4710]]

his name on it. Like a true soldier, Oakley was sent off from this 
world to the moving tune of ``Taps'' played by a military bugler.
  Colonel Nimmo's tour of duty on this Earth was brief, but he did 
teach an important lesson to all of us. At times, some voices may 
express doubts about our military, but Oakley reminded us--as perhaps 
only a child could--that being an Army man, a brave protector of our 
Nation, is one of the highest honors to which an American can be 
called.
  The veterans and the servicemembers who attended Oakley's funeral 
were there to honor him, but, in fact, it was a double honor because 
through his life and dreams, little Oakley honored them in return.
  Oakley looked up to our troops in life. Now he looks down on them 
from above, where he will remain in God's presence and our memory as a 
brave fighter against cancer, an inspiration, and indeed, for all time, 
an Army man.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Scott of Florida). The clerk will call the 
roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. CORNYN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                               Healthcare

  Mr. CORNYN. Mr. President, yesterday our friend from New York, the 
minority leader, spoke on the Senate floor about the latest challenge 
to ObamaCare--the Affordable Care Act--which is being considered by the 
Fifth Circuit Court of Appeals this week. Also, if you can believe the 
press, he is also going to have a press conference with the Speaker and 
other notable Democrats to talk about the danger of a court decision on 
the constitutionality of the Affordable Care Act. As one might imagine, 
he painted a pretty grim picture of what would happen if the court were 
to strike down the Affordable Care Act, affirming the judgment of the 
trial court. Of course, he tried to place the blame squarely on those 
of us on this side of the aisle. It is strange to me because blaming 
Republicans in Congress for a yet-to-be-decided court case doesn't make 
a lot of sense, but it is pretty consistent with the message we have 
heard from our Democratic friends.
  If the minority leader is going to pick a bone with anyone, then I 
guess his complaint is really about the Constitution itself. Court 
cases are decided on a case-by-case basis based on what the law is, 
and, of course, the Constitution is the fundamental law of the United 
States. So if a court ultimately holds an act of Congress to be 
unconstitutional, it is because the Constitution prohibits it. And a 
consensus among all Americans is that the Constitution shall be 
inviolable, dating back to the early 19th century. The Supreme Court 
has made clear that is ultimately their job--not to decide what the 
policy should be but whether the policy enacted by Congress is 
consistent with the requirements of the Constitution.
  So I find it pretty bizarre that in about an hour, the Democratic 
leader will join Speaker Pelosi for a news conference to talk about 
coverage for preexisting conditions, and I have no doubt that once 
again they will try to blame Republicans as the bad guys and somehow 
perpetuate this myth that Republicans are opposed to covering people 
for preexisting conditions in their health insurance policies. They 
know that is false. They know that is a bald-faced misrepresentation of 
what our policy choices are in this body and in Congress as a whole. 
There is one thing that I think there is a consensus on in Congress 
with respect to healthcare, and that is that preexisting conditions 
should be covered. In fact, there are pieces of legislation that I have 
cosponsored in the Senate that do that expressly. The illogical fallacy 
of their argument is that the only way one can do that is through the 
Affordable Care Act.
  As we know, the Affordable Care Act has been a Trojan horse for a 
whole lot of other policies that, frankly, are not particularly popular 
because they have resulted in high deductibles and high premiums and 
have made it harder and harder for people to afford coverage. It has 
also precluded individuals from picking the kind of coverage that best 
suits their family's needs at a price they can afford.
  I think it is important for the American people to understand what we 
all understand--including the Democratic leader and the Speaker--which 
is that what they are saying about preexisting conditions is false. 
They know it, we know it, and it can be demonstrated. Yet they persist 
in saying it because they believe that people are either uninformed, 
naive, or so partisan that they will not be guided by the facts but, 
rather, by the partisan rhetoric.
  Here is the other strange thing in all of this. Most progressive 
Democrats--we used to call them liberals; now they call themselves 
progressives--have embraced Medicare for All as a solution to our 
Nation's healthcare challenges. As the Presiding Officer knows, 
Medicare for All would be a recipe to bankrupt Medicare, which has 
traditionally, legally, and historically been a benefit earned and 
contributed to by seniors in order to cover their healthcare when they 
are 65 or older. So dumping 180 million or so additional people into 
Medicare who have private health insurance is really a recipe for 
bankrupting it, thus undermining the benefit that seniors thought they 
were buying into during their entire lives.
  Here is the other irony I find. When he was trying to sell the 
Affordable Care Act, we heard that President Obama said, if you like 
your existing healthcare policy, you can keep it. That is what he said. 
It didn't end up being the case, but that is what he said. Yet now our 
Democratic colleagues have become so radicalized on healthcare that 
they are essentially saying, if you have private health insurance you 
like, you can't keep it. You can't keep it.
  This is a very strange place to work sometimes because people say 
things they know are not true, but they hope they can capitalize on 
people's ignorance or on their partisanship. Yet, as many have said 
before, facts are stubborn things, and those are the facts; that there 
are other ways to cover preexisting conditions other than with the 
Affordable Care Act. For a party that has embraced this idea of 
Medicare for All and that wants to destroy privately held health 
insurance, it seems pretty rich for them to then blame this side of the 
aisle for wanting to destroy private health insurance that covers 
preexisting conditions.
  A January Gallup poll found that 7 in 10 Americans have a negative 
view of our healthcare system and have described it as being in a state 
of crisis or as having major problems, which is to say that ObamaCare 
is not working as well as the advocates thought. As we know and as I 
have said, it is not the only way to protect patients who have 
preexisting conditions.
  Earlier this year, I cosponsored a bill that was introduced by our 
friend from North Carolina, Senator Tillis, called the PROTECT Act, 
which would ensure that no American would ever be denied health 
coverage because of one's having a preexisting condition. Now, the 
Democratic leader and the Speaker know that. Yet, presumably, today, at 
12:30, when they hold their press conferences, they will say all 
Republicans are opposed to covering preexisting conditions because of 
this court case in the Fifth Circuit that has yet to be decided. They 
are just gleeful that this will provide, they think, some way for them 
to argue what they know is not true--that the Republicans are opposed 
to covering people's preexisting conditions.
  I believe health coverage for these patients shouldn't hang in the 
balance of a court decision because, ultimately, it is our decision. If 
we pass the PROTECT Act, it would finally codify what I hope every 
Member of this body would agree on--that Americans deserve access to 
healthcare coverage. The PROTECT Act is just one example of the 
countless healthcare bills that are working their way through the 
Senate right now.
  In addition, in the Senate Finance Committee, we are considering a 
package of bills to reduce prescription drug prices, just as we have in 
the Health, Education, Labor, and Pensions Committee and in the 
Judiciary Committee. The HELP Committee overwhelmingly passed a 
bipartisan bill to reduce healthcare costs, to increase transparency, 
and to eliminate surprise

[[Page S4711]]

medical bills. Last week, the Judiciary Committee unanimously reported 
out legislation that would keep pharmaceutical companies from gaming 
the patent system. Our colleagues--or political candidates--can go on 
TV and try to spin the ObamaCare system all they want, but we are going 
to continue to work hard to make real meaningful changes to make our 
healthcare system better.


                            Border Security

  Mr. President, on another matter, we know that a record number of 
migrants is continuing to cross our southern border, and the impact on 
Texas communities--the State I represent--has been overwhelming.
  Detention centers are over their capacities. Customs and Border 
Protection officers and agents are pulling double duty in their being 
law enforcement officers and caregivers to children, not because that 
is what they have been trained to do but because that is what they must 
do in order to take care of this flood of humanity. Nongovernmental and 
community organizations are unable to keep up with this pace of the 
thousands of people who have been coming across the border each and 
every day.
  Before the Senate recessed for the Fourth of July week, which was 
about 10 weeks after the President requested emergency funds, we 
finally passed a bipartisan bill to send much needed humanitarian 
relief. It includes additional funding for the departments and agencies 
that have depleted their resources in trying to manage this crisis, and 
it makes $30 million available in reimbursement for which impacted 
communities may apply--charges that should be the Federal Government's 
responsibility and not the local governments'. As I said, after some 
hand-wringing and delay, the House passed this bill, and the President 
signed it. I hope my constituents back in Texas who have been working 
tirelessly to manage this crisis will soon find some relief.
  It is important to remember, though, that depleted funding isn't the 
reason for the crisis; it is only a symptom of a larger problem. In 
other words, we are dealing with the effects and not the cause of the 
basic problem. Without getting to the root cause, we are only setting 
ourselves up for failure, which means we will be back here in another 
couple of months and will have to pass another emergency appropriations 
bill for an additional $4.5 billion to try to deal with the problem we 
can fix but have refused to.
  Sadly, this issue has become so politicized that few are willing to 
reach across the aisle and find solutions, and most of the proposals we 
have seen are ultrapartisan. The Democrats who are running for 
President support things like decriminalizing illegal border crossings 
or providing free healthcare to undocumented immigrants, both of which 
are unpopular, unsafe, and completely unaffordable. The vast majority 
of Americans oppose open borders and already struggle to manage their 
own bills. They certainly don't want to be burdened with the costs of 
people who enter our country illegally and don't pay taxes.
  We don't need these radical proposals to solve the crisis at our 
southern border. Both in the short term and the long term, we need 
bipartisan solutions that can provide some real relief. If we want to 
get to the root of the crisis and avoid making emergency funding bills 
the norm, we need to get down to brass tacks and talk about real 
reforms that, No. 1, will fix the problem and, No. 2, will stand a 
chance of actually becoming law.
  Right now, there is only one bill, to my knowledge, that has 
bipartisan and bicameral support, and that is a bill called the HUMANE 
Act. I introduced this bill with my Democratic friend in the House, 
Henry Cuellar, to address the humanitarian crisis at the border.
  First and foremost, the HUMANE Act includes important provisions to 
ensure that migrants in our custody receive proper care. It requires 
the Department of Homeland Security to keep families together 
throughout their court proceedings, and it includes additional 
standards of care. Beyond suitable living accommodations, the HUMANE 
Act requires each facility to provide timely access to medical 
assistance, recreational activities, educational services, and legal 
counsel.
  It would require all children to undergo biometric and DNA screening 
so family relationships could be confirmed so as to ensure these 
children would be, in fact, traveling with their relatives rather than 
with human smugglers or sex traffickers.
  In order to better protect children who would be released to Health 
and Human Services, this bill would place prohibitions on certain 
individuals who could serve as guardians. For example, no child should 
be released into the custody of a sex offender or a human trafficker. I 
would hope we could all agree on that.
  In addition to improving the quality of care for those in custody, 
the HUMANE Act would improve the ways migrants would be processed. It 
would require the Department of Homeland Security to establish regional 
processing centers in high-traffic areas, which would serve as a one-
stop shop by which the process would take place. This was a 
recommendation from the bipartisan Homeland Security Advisory Council. 
It would also alleviate the long wait times that are experienced by 
many asylum seekers. These centers would have personnel on hand from 
across the government to assist, including medical personnel and asylum 
officers.
  In addition to these changes, the legislation would also include 
provisions to make some commonsense improvements, such as additional 
Customs and Border Protection personnel and training for CBP and ICE 
employees who work with children.
  The HUMANE Act would make much needed reforms to improve the 
processing and quality of care for migrants. Importantly, it would also 
take steps to address the flow of those who enter our country by the 
tens of thousands each month.
  I spend a lot of time talking to folks who live and work on the 
border about the status quo and what we need to do to prevent this 
crisis from becoming even bigger. The most common feedback I get is 
that we need to close the loopholes that are being exploited by the 
people who are getting rich off of trafficking in human beings from 
Central America, across Mexico, and into the United States.
  One of the most commonly exploited loopholes is something called the 
Flores settlement agreement, which was created to ensure that 
unaccompanied children don't spend long periods of time in the custody 
of the Border Patrol. It was and remains an important protection for 
the most vulnerable people who are found along our border. It also 
ensures they can be processed and released to either relatives or to 
the Department of Health and Human Services pending the presentations 
of their cases before immigration judges when they claim asylum. Yet a 
misguided 2016 decision by the Ninth Circuit effectively expanded those 
protections from children to families.
  One thing I can say with some certainty is that human smugglers and 
traffickers are not fools; they are entrepreneurs. They are twisted and 
criminal, to be sure, but they are entrepreneurs. They know how to 
exploit the gaps in our system, and they know how to make money while 
doing it. They know, if adults are traveling alone, they could be 
detained for long periods of time before they are eventually returned 
home after presenting their cases before immigration judges. So now, 
rather than there being single adults who arrive at the border alone, 
adults are bringing children with them so they can be processed as 
family units, thus taking advantage of that expansion of the Flores 
settlement agreement and drawing out the process to the point at which 
it overloads the system. They realize they can bring a child--any 
child--and pose as a family so they will be released after 20 days, 
never to be heard from again.
  We have seen a massive increase in the number of families who have 
been apprehended. In May of 2018, roughly 9,500 families were 
apprehended. In May of this year, the number skyrocketed to more than 
84,000. So, in just 1 year, it went from 9,500 to 84,000. Now, are 
legitimate families crossing the border? Absolutely. Yet we know many 
of these people who claim to be related are fraudulent families who use 
innocent children as pawns to gain entry into the United States. 
Something that nobody wants to talk about is, often, these children are 
abused and assaulted along the way, and many arrive at the border in 
critical health.

[[Page S4712]]

  If we care about the welfare and the lives of these children, we 
cannot let these practices continue. It is unfair not only to these 
children but to the American people and to the immigrants who have 
waited patiently to enter the United States legally for people to be 
able to game the system, move to the head of the line, and break all 
the rules while doing it.
  The HUMANE Act would clarify that the Flores agreement applies only 
to unaccompanied children. It would also provide greater time for 
processing and immigration proceedings to take place before a family is 
released from custody.
  Eliminating this pull factor is an important way to stop the flow of 
those illegally entering our country because they know how to game the 
immigration system.
  While the HUMANE Act will certainly not fix every problem that exists 
in our broken immigration system, it is an important start. It is a 
necessary start. It is the only bill pending before the Congress that 
is bipartisan and bicameral, and I would encourage all of our 
colleagues who are serious about our responsibilities to get to the 
root of this humanitarian crisis to join us and get this passed and 
sent to the President for his signature.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Virginia.


                          Affordable Care Act

  Mr. KAINE. Mr. President, I rise today in support of the Affordable 
Care Act and to discuss the devastating impact its potential 
elimination would have on rural families and rural communities.
  My State, Virginia, has so many rural communities, and in that, I am 
with every other Member of this body, and I want to talk specifically 
about them.
  The Trump administration has sought for years to end the Affordable 
Care Act using every tool available. They have worked on that task here 
in Congress to repeal it and sabotage it and even dismantle it in the 
court system. Today marks another milestone in that deeply troubling 
effort.
  The U.S. Fifth Circuit Court of Appeals will hear oral arguments in a 
case that could strike down the Affordable Care Act in its entirety. If 
the ACA were struck down, families and communities around the country 
would bear life-altering consequences, and the healthcare system would 
be thrown into chaos. Tens of millions of Americans would lose 
healthcare coverage and protections for preexisting conditions, among 
the countless other consumer protections that have been put in place by 
the ACA.
  A number of my colleagues are going to be on the floor this afternoon 
speaking about particular aspects of this that trouble them. I want to 
focus on one in particular: how important the Affordable Care Act's 
Medicaid expansion is to rural America and how much is at stake for 
those communities should the Affordable Care Act be eliminated.
  Medicaid expansion enables low-income, rural residents to get 
affordable, quality health insurance so they can get the care they 
need. It is often the case that insurance companies do not compete with 
the same intensity in rural communities because there are just not 
enough patients. So it is common in rural America for somebody wanting 
to buy an insurance policy on the exchange, for example, to maybe have 
only one option. Medicaid expansion has turned out to be a huge benefit 
for many low-income people living in rural America. Many of those who 
are receiving insurance pursuant to Medicaid expansion were previously 
uninsured, and so for some, it is the first insurance they have had in 
their lives.
  A particular impact of Medicaid expansion has not been on just 
individuals receiving that Medicaid but on the hospitals that are sort 
of the healthcare and even economic pillars in rural communities. Rural 
hospitals often have a difficult time making the finances work. Again, 
lower patient volumes make it difficult. Medicaid expansion has meant 
that the care they have been providing that in the past might not have 
been reimbursed at all--they are now able to at least get a Medicaid 
reimbursement, and that has been a significant financial benefit to 
these hospitals.
  Mr. President, you understand this because your State is like mine, 
and there are a lot of rural communities. Rural hospitals are often the 
lifeblood of rural communities. They can be the largest employers in a 
town or a county. They often do a tremendous amount of outreach on 
healthcare and other philanthropic efforts not just within the hospital 
walls but outside the hospital walls--sponsoring the Little League 
teams and doing the things that make a community a community.
  Residents of rural communities need access to healthcare, but they 
also need access to jobs and good healthcare information. Rural 
hospitals provide that.
  I have seen the impact of rural hospital closures in Virginia 
firsthand. Two rural hospitals in Virginia closed in recent years 
because Virginia did not expand Medicaid initially. In the last year, 
Virginia has done Medicaid expansion, but before Medicaid expansion was 
done, we saw hospitals close in two communities in Virginia: Patrick 
County, which is a south side Virginia county that is on the border 
with North Carolina, and Lee County, which is a far southwestern 
Virginia county that is on the border with Kentucky and Tennessee. Two 
hospitals have closed in those communities.
  I got a letter from a mother in Christiansburg, VA, which is actually 
up near Virginia Tech. Her name is Robin, and she wrote about the 
closure of the Pioneer Hospital in Patrick County in 2017.
  She wrote this:

       My mother who recently turned 70 still lives in the county, 
     and we are approaching a point of either moving back to 
     Patrick County or moving my mother to Christiansburg where we 
     currently live. My son has severe food allergies that could 
     lead to anaphylactic shock (which would require immediate 
     medical attention) so this variable also weighs very heavily 
     on my mind when considering the options of how to manage my 
     family's land and take care of my mom. I don't want to live 
     somewhere without access to emergency health care. It seems 
     inconceivable that this is the case in the era in which we 
     live now. . . . Please help get my home county back on the 
     medical map to give its economy and its people a fighting 
     chance.

  Blacksburg is probably an hour and a half to 2 hours away. The mother 
is living in a county that now has no hospital--she has turned 70--so 
she doesn't have access to the care that she needs. The daughter is 
trying to decide: Do I move back? But I have a son who needs care 
because of allergies. Do I have to move my mother out of the home where 
she would rather stay?
  Rural hospitals across the country are struggling to keep their doors 
open for a number of reasons, but here is an amazing set of statistics. 
Whether a State expands Medicaid pursuant to the ACA is a massively 
significant factor in rural hospitals' financial outlook and 
decisionmaking. Without Medicaid expansion, rural hospitals may be 
forced to cut vital services or even close. Here is the data point that 
really says it all: Since January 2010, 107 rural hospitals have closed 
in the United States, and 93 of those 107 hospitals were in States that 
had not expanded Medicaid at the time of the closure.
  Hundreds more rural hospitals are at risk of closure. Rural hospital 
closures disproportionately occur in States that have not expanded 
Medicaid. The success of the Texas case would wipe out the ACA, 
including Medicaid expansion, and deeply penalize these rural 
hospitals.
  A comprehensive 2018 study published in Health Affairs found that 
Medicaid expansion is directly associated with hospital financial 
performance and that expansion substantially reduces the risk of 
hospital closure, particularly in rural areas. The study also found 
that going back to pre-ACA eligibility for Medicaid would drive even 
more rural hospitals to closure.
  So we think about Robin's dilemma of a mother living in a rural area 
where the hospital has closed. If the ACA is struck down and there is 
no Medicaid expansion, this is going to be faced by more and more rural 
communities across the country, and that means this is a dilemma 
individuals and their families will ultimately face.
  Research from Georgetown University's Health Policy Institute 
indicates that the uninsured rate for low-income adults in rural 
communities fell three times as fast in States that expanded Medicaid 
as compared to States that did not expand. Turn that around.

[[Page S4713]]

States that expand Medicaid find that rural families have a 
dramatically higher likelihood of having insurance than those in rural 
areas where the States haven't expanded Medicaid.
  As of now, 36 States, including Virginia, have expanded Medicaid and 
14 have not. I am thrilled that earlier this year Virginia, after a 
multiyear battle, finally announced that Medicaid expansion was 
happening. In less than a year after expansion, nearly 293,000 adults 
are newly enrolled in Medicaid in Virginia, many of whom never had 
health insurance before in their lives--293,000 adults in a State where 
the population is about 8.5 million. That is a significant number of 
people who have received insurance through Medicaid expansion. They 
risk losing their eligibility if the administration is successful in 
its efforts to gut the ACA.
  If we care about rural residents and rural communities, there are a 
number of things we can do.
  First, we need to stand up against the administration's attempt to 
end the ACA, including its Medicaid expansion.
  I have now been in public life for 25 years since I was elected to 
the Richmond City Council in May 1994. I will say that in all of the 
elections I have been in, up or down, and all the various legislative 
and other battles, the single most dramatic moment in my life as an 
elected official was standing on the floor of this body at 2 o'clock in 
the morning when Senator John McCain, fresh out of a hospital after 
being diagnosed with a glioblastoma brain tumor, cast the deciding 
vote, and by one vote--one vote--we saved the Affordable Care Act. I 
have never in my life in the public realm experienced something that 
was so dramatic and so consequential.
  We have to continue to stand up. I would have thought that vote might 
have moved us to a new chapter where we would be talking about fixing 
and improving rather than repealing, but that is not the case, as 
evidenced by the lawsuit today. But my hope is that we will resist 
efforts to sabotage and destroy and instead join together in efforts to 
improve. I have joined with my colleagues to cosponsor a resolution 
allowing Senate legal counsel to intervene in the lawsuit, to defend 
the Affordable Care Act.
  The second thing we can do to help rural communities is focus on the 
14 States that haven't yet expanded Medicaid and provide them a clearer 
path and encouragement to do so.
  I am proud to be an original cosponsor of something called the SAME 
Act, which would extend the same level of Federal assistance to every 
State that chooses to expand Medicaid regardless of when the expansion 
occurs. I think that is important.
  Let's use the original Medicaid Program as an example. It was passed 
in 1965. It was not a mandate; it was an option. The last State--
Arizona; State 50--that joined didn't join until 1982. There was a 17-
year period between when the first State joined the then-voluntary 
Medicaid Program and when the last State joined.
  Let's make sure that whenever States join, they are treated the same. 
If this bill passes, States that choose to expand now--these 14 
States--we would make sure that they get the full Federal level of 
assistance as was available to those States that initially joined, and 
that should help remaining States get off the sidelines.
  Finally, we need to stand up against administrative sabotage to the 
Affordable Care Act. We shouldn't promote skimpy insurance plans. We 
shouldn't slash funding for enrollment, outreach, or marketing. We 
should build on and improve and, yes, fix--because it is not perfect--
the ACA to extend its promise of affordable coverage to even more 
Americans.
  That is why I have introduced Medicare-X legislation to establish a 
public insurance plan that could be offered on the ACA exchanges, 
beginning in rural areas. My bill would also make the ACA's tax credits 
more generous, expand tax credit eligibility to additional families, 
and allow for an enhanced reimbursement rate in rural communities where 
low patient volumes often pose financial challenges to healthcare 
providers.
  In closing, the ACA has meant the difference between life and death 
for many families across the country, and I run into them every day.
  I am going to be standing with some Senate colleagues on the steps of 
the Senate in a few minutes talking about a youngster from Winchester, 
VA, who has a series of significant healthcare challenges that would 
essentially in the past have made him uninsurable because of 
preexisting conditions but who now--because of that protection within 
the ACA, he and his family at least have the peace of mind of knowing 
that he can't be kicked off insurance or turned down for insurance 
because he happened to be born with a condition over which he had no 
control.
  If the ACA were to be struck down, families and communities would 
suffer, and I think that in Virginia, that would particularly be the 
case in our rural communities.
  Again, I am just going to hold up this issue of our rural hospitals. 
We need to protect rural hospitals not only because of the healthcare 
they provide but because they are employment centers and centers of 
community outreach. When we see the closure of rural hospitals 
overwhelmingly being in States that have not expanded Medicaid, that 
tells us how valuable that portion of the ACA has been to stabilize the 
provision of rural healthcare.
  I will continue to fight to protect the ACA and the health of my 
rural communities in Virginia and elsewhere. I encourage my colleagues 
to do the same.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. THUNE. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Cruz). Without objection, it is so 
ordered.


                              The Economy

  Mr. THUNE. Mr. President, we received more good economic news on 
Friday with the announcement that the economy created 224,000 jobs in 
June.
  Meanwhile, unemployment remained near its lowest level in half a 
century. June marked the 16th straight month that unemployment has been 
at or below 4 percent. That is a tremendous record.
  June also marked the 11th straight month that wage growth has been at 
or above 3 percent. Before 2018, wage growth had not hit 3 percent in 
nearly a decade.
  Friday's announcement was just the latest piece of good news about 
the economy. Thanks to Republican economic policies, the economy has 
taken off during the Trump administration. Economic growth is up, wage 
growth is up, personal income is up, and the list goes on.
  Importantly, the benefits of this economic growth are being spread 
far and wide. One of the distinguishing features of the economic 
expansion that we have been experiencing is the way it has been 
reaching those who have trailed behind economically.
  Over the past 3 years, pay hikes for the lowest income workers have 
exceeded pay hikes for the richest workers. Huge numbers of new blue-
collar jobs have been created, and the employment situation for 
minorities has improved substantially.
  The unemployment rates for Asian Americans, African Americans, and 
Hispanic Americans are all at or near record lows. The Wall Street 
Journal notes that ``Nearly one million more blacks and two million 
more Hispanics are employed than when Barack Obama left office, and 
minorities account for more than half of all new jobs created during 
the Trump Presidency.''
  So where has all this economic progress come from? At the end of the 
Obama administration, 2\1/2\ years ago, the economic outlook wasn't too 
rosy. The economy was sputtering, and American families were 
struggling. Some were predicting that a weak economy would be the new 
normal.
  Republicans, however, didn't agree with that. We knew that American 
workers and American businesses were as dynamic and creative as ever. 
But we also knew that burdensome regulations and an outdated tax code 
were holding our economy back and reducing the opportunities available 
to workers. So when we took office in 2017, we got right to work on 
improving

[[Page S4714]]

our economy in order to improve life for the American people.
  We eliminated burdensome regulations that were acting as a drag on 
economic growth, and we passed a historic reform of our Tax Code to put 
money in Americans' pockets and make it easier for businesses to grow 
and to create jobs. Now we are seeing the results: a thriving economy 
that is extending more opportunities to more Americans.
  For all of Democrats' talk about inequality, it is actually 
Republicans and President Trump who have done something about it. We 
have helped create an economy that is lifting up people across the 
entire economic spectrum.
  There is still more work to be done, of course. For one thing, we 
need to make sure that the agriculture economy is able to catch up to 
the economy at large. But thanks to tax reform and other Republican 
economic policies, American workers are doing better than they have in 
a very long time.
  It is unfortunate that the gains we have made would be reversed if 
Democrats have their way. Democrats' plans--from budget-busting 
government-run healthcare to free college--all have one thing in 
common: They would cost a lot of money.
  Where would the government get most of that money? From tax 
increases--tax increases on businesses and tax increases on ordinary 
Americans.
  Thanks to the tax relief that Republicans passed, the economy has 
expanded, paychecks have increased, and more jobs and opportunities 
have been created.
  Raising taxes would result in the opposite: fewer jobs and 
opportunities, a smaller economy, and more families struggling to get 
by on smaller paychecks.
  Republicans are determined to make sure that doesn't happen. We are 
committed to building on the progress we have made and further 
expanding economic opportunity for all Americans.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Pennsylvania.


                               Hong Kong

  Mr. TOOMEY. Mr. President, I rise today to speak about the very high-
stakes political and social crisis that has been unfolding in Hong Kong 
over the past several weeks.
  Hong Kong is a very exceptional city. It boasts of a very robust free 
market economy that has thrived for centuries. It has a very vibrant 
free press. It has an independent judiciary and a partially democratic 
election system. Those freedoms, combined with Hongkongers' natural 
entrepreneurial spirit and appreciation for individual liberty, have 
made Hong Kong a jewel of the financial and business world, one of the 
freest places in Asia, and a great place to live--for a time, anyway, 
as I did back in 1991.
  Economic and political achievements are particularly impressive when 
you consider that Hong Kong is, after all, a part of China, which has 
neither a free economy nor a politically free society.
  Back in 1997, Great Britain transferred Hong Kong to China on a 
condition--an explicit written agreement--that Hong Kong's social and 
economic systems would remain unchanged under a ``one country, two 
systems'' arrangement that would last for at least 50 years, until 
2047.
  The Chinese Government also made a pledge at the time--a pledge that 
Hong Kong's legislative and executive leaders would be elected through 
``universal suffrage.'' Yet, here we are, 22 years later. Hongkongers 
still do not enjoy complete universal suffrage, and Hong Kong has faced 
deep and persistent efforts by the mainland to erode the independence 
and the authority of Hongkongers.
  On the surface, this ongoing crisis in Hong Kong was clearly caused 
by the Hong Kong Government, probably at the behest of the Chinese 
leadership in Beijing to pass a deeply unpopular extradition bill. This 
bill would diminish Hong Kong's independent legal system very 
dramatically, and it would do so by allowing and exposing individuals 
in Hong Kong--including Hong Kong citizens, foreigners, and even 
tourists--to being extradited to China.
  The accused would then face prosecution by an authoritarian 
government in mainland China that does not uphold the rule of law, nor 
does it practice the fair and impartial administration of justice. 
Let's face it. The judicial system in China is politicized and 
controlled by the Chinese Communist Party.
  Some people are concerned that if this bill were to become law, it 
would even pave the way for Chinese state-sponsored kidnapping of 
dissidents. It certainly would have a chilling effect on freedom in 
Hong Kong, a chilling effect on the ability of Hong Kong people to live 
their lives and express their views without the fear of political 
repercussions. It is simply a fact that mainland China is a legal black 
hole, and Hong Kong's extradition bill would be a step to exposing Hong 
Kong residents directly to mainland China's opaque and often blatantly 
unfair legal system.
  In response to this threat, the people of Hong Kong have for weeks 
poured into the streets, calling for a withdrawal of this bill and 
deeper democratic reforms. Remarkably, last month, one of these 
protests--one of these demonstrations brought together an estimated 2 
million Hongkongers into the streets. It is stunning anywhere in the 
world that 2 million people would come out to protest anything. But in 
Hong Kong, it is truly staggering because the total population of Hong 
Kong is only 7.4 million. That is about one in four Hongkongers who 
were on the streets protesting.
  Just today, the Hong Kong Chief Executive said that bill was dead. 
But it has not been formally withdrawn, as I understand it, and I think 
the threat remains.
  It is also important to note that on a deeper level these ongoing 
protests are really a response to efforts by the Chinese Government to 
``mainlandize'' Hong Kong. It is an effort in which political, 
cultural, and even physical distinctions between Hong Kong and mainland 
China are meant to be diminished, the differences blurred, and the 
distinction eroded.
  The extradition bill is just the latest example of the Hong Kong 
people's struggle for the freedom, democracy, and respect for human 
rights that they cherish, that they want to hold on to, and that were 
promised to them when the handover occurred in 1997.
  Hongkongers really have a rich history of protest, and I think that 
history reveals their enduring grassroots desire for the freedoms they 
have grown to love and cherish and for a democratic form of government 
that they deserve.
  Back in 1989, the Tiananmen Square massacre that we all remember--the 
30th anniversary was just last month. On the eve of the massacre, once 
it was clear the Chinese Communist Government would respond to peaceful 
protesters with bullets and tanks--once that became clear, about 1.5 
million Hongkongers marched in the streets of Hong Kong in solidarity 
with the students in Tiananmen.
  In 2003, the Hong Kong leadership proposed an anti-subversion bill. 
Hongkongers rightly saw this bill as an attack on their freedom of 
speech and freedom of association. The Hong Kong leadership proposed 
it--again, doing it at the behest of the mainland Chinese Government--
and 500,000 citizens protested and eventually forced the government to 
withdraw the bill.
  In 2014, the Hong Kong Government announced a reform to change how 
Hong Kong's Chief Executive was selected. The proposal was meant to 
continue what already existed, and that was mainland Chinese Communist 
control over the election process in Hong Kong. One of the mechanisms 
they used to achieve this was that only candidates vetted by a 
committee of mostly pro-Beijing supporters would be allowed to seek the 
office of Chief Executive.
  In response to this undemocratic measure, Hong Kong students staged a 
campaign of civil disobedience and peaceful protest to oppose this 
effort. Up to a half a million people participated in the movement. 
Students famously used umbrellas to shield themselves from tear gas and 
pepper spray that was being launched at them by the police, so much so 
that the pro-democracy protesters were quickly termed the ``Umbrella 
Movement.''
  All of these protests and acts of civil disobedience make it clear 
that Hongkongers want more freedom, not less freedom.
  I think this matters. This matters obviously in Hong Kong, but it 
matters

[[Page S4715]]

beyond Hong Kong. It matters to us. It should matter to us. What is 
happening in Hong Kong is not just important for those residents but 
for the rest of the world. Today the people of Hong Kong are fighting 
against an unpopular and unfair extradition bill. They are really 
fighting for a future in which they can enjoy basic human rights, 
natural rights that everyone should have, including the right to free 
speech, the right to a fair trial, the right to be confident that your 
government will follow the laws of the society in which it exists, and 
participation in a just and fair representative system of government.
  If the Chinese officials in Beijing and the Communist Chinese who 
rule mainland China have their way, they will extinguish these rights 
for the people of Hong Kong. If the extradition bill were to become 
law, it would threaten all of those rights because of the chilling 
effect of the threat of being extradited to the lawlessness of the 
Chinese judicial system.
  In some important ways, I think Hong Kong can be seen as a canary in 
a coal mine for Asia. What happens in Hong Kong will at least set 
expectations, create a climate that will maybe affect what happens in 
Taiwan over time, other Asian nations that are struggling for freedom 
in the shadow of China. The fact is, China itself is controlled by an 
authoritarian government, interested primarily in its own survival. 
That is the top priority of Beijing's leadership. They have created a 
modern-day police state. They use mass surveillance, censorship, 
internet applications in order to control their own citizens. They have 
imprisoned over a million of their own citizens, the Muslim Uighur 
minorities, in concentration camps.
  China's authoritarianism threatens free and open societies all around 
the world. A democratic Hong Kong is a direct threat to the Communist 
regime in Beijing because people across China, naturally, ask the 
question: Why do Hongkongers get to have more rights and a better life 
and more freedom than we have? That is the threat the government in 
Beijing is trying to extinguish.
  We, of course, recently had the blessing of being able to celebrate 
our own Independence Day, when Americans reflect on our own struggle 
against tyranny, against an unjust government, and our successful 
effort to throw that off and establish this, the world's greatest, most 
vibrant, and freest democratic society.
  In many ways, the Hongkongers are fighting for some of the very same 
values as our Founding Fathers did during the American Revolution. I 
think it is important that we in the United States not turn a blind eye 
to the struggle for freedom that is happening outside our borders. I 
think it is important that Americans continue to stand in support of 
the voices in Hong Kong calling for freedom, for democracy, and respect 
for basic human rights. I will do what I can in the Senate to support 
the people of Hong Kong in their peaceful protests for their own 
freedom, and I call on my colleagues in this administration to join me.
  I yield the floor.

                          ____________________