July 30, 2019 - Issue: Vol. 165, No. 129 — Daily Edition116th Congress (2019 - 2020) - 1st Session

[Pages S5163-S5178]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           EXECUTIVE CALENDAR

  The PRESIDING OFFICER. The clerk will report the nomination.
  The legislative clerk read the nomination of Sean D. Jordan, of 
Texas, to be United States District Judge for the Eastern District of 
Texas.
  The PRESIDING OFFICER. The Senator from Maryland.


                            Border Security

  Mr. CARDIN. Madam President, recently, I joined the Senate delegation 
to visit the southern border and view firsthand the migration and 
humanitarian crisis facing the United States.
  We visited the Donna Holding Facility, the Catholic Charities Respite 
Center, the McAllen Border Patrol Station, and the Ursula Centralized 
Processing Center. Earlier this week, I held a roundtable discussion on 
my trip at the Sacred Heart of Jesus Church in Highlandtown. The group 
was organized by the Latino Providers Network in Baltimore, which 
included representatives from the Lutheran Immigration and Refugee 
Service, Catholic Relief Services, Hebrew Immigrant Aid Society, and 
other nonprofits in the community that do work in Baltimore and at our 
border.
  I was impressed by the Catholic Charities Respite Center run by 
Sister Norma Pimentel. The center provides a warm meal, a shower, a 
change into clean clothes, medicine, and other desperately needed 
supplies. These migrants are very lucky to make it there.
  What I saw in McAllen, by contrast, was very disturbing. I saw many 
families huddled together in overcrowded conditions. I saw children 
behind fencing and, basically, in cages. Some children wore clothing 
that was soiled and had not been changed since they arrived in the 
United States. Children and families were supposed to be there in 
temporary holding only for a day or two, but we heard stories that 
families are being held for up to 10 to 14 days and, in some cases, 
even longer.
  Why are migrants leaving their homes in the first place? These 
individuals are desperate. They are desperate because they are fleeing 
violence and persecution in their home countries. These families are 
often given a terrible choice to have their young son or daughter join 
a criminal gang or suffer the consequences as a family. That means 
being attacked, kidnapped, and even murdered. Even though it is a 
dangerous journey, these families feel they have no choice.
  Let me remind my colleagues that these individuals are lawfully 
seeking asylum at our border and should not be treated as criminals. We 
need to respect their human rights, their rights under international 
law, and their rights under U.S. law.
  These migrants are not trying to do harm to the United States. 
Indeed, government officials told us that the vast majority of those 
screened present no safety risk, such as being on a watch list for 
terrorist or criminal behavior, and that most migrants have not tried 
previously to enter the country illegally.
  I am gravely concerned about the new metering system used by Customs 
and Border Protection for those seeking asylum and refuge in our 
country as part of the expansion of the Remain in Mexico program. 
Normally, a migrant would present themselves to a Customs or Border 
Patrol agent at the point of entry and ask to seek asylum. But under 
the Trump administration's new metering policy, Border Patrol agents 
will stop migrants at the border, oftentimes halfway across the bridge 
as they approach a legal border point of entry. Border Patrol will then 
give the migrant a number, and they will have to then wait for their 
number to be called before they can formally present themselves for 
admission at a legal point of entry.
  How long is the wait for your number to be called? In some cases, it 
is weeks or even months. In the meantime, migrants are told to wait in 
a border town and tent city set up on the other side of the border. One 
of most dangerous towns in all of Mexico is Reynosa, just across the 
border from McAllen Border Patrol Station. Migrants staying in these 
tent cities are subjected to violence, extortion, human trafficking, 
and even death at the hands of gangs that operate with impunity in the 
city, which are effectively not controlled by Mexican law enforcement 
authorities. In fact, the town is so dangerous that U.S. law 
enforcement personnel are forbidden by our government from visiting 
there or trying to meet with migrants on the Mexican side of the 
border. This is outrageous, and America can do better to live up to our 
values.
  Migrants who are desperately fleeing violence and prosecution at home 
come to the United States in search of safety for themselves and their 
families. Now they are told they must wait indefinitely on the Mexican 
side of the border in, essentially, a lawless town where they are at 
the mercy of criminals, gangs, and traffickers who prey on the most 
vulnerable.
  What happens next? Many of these migrants decide they have no choice 
but to cross the border illegally so that they can escape the camps in 
Reynosa. When migrants try to cross the border illegally, they face new 
dangers of dehydration, drowning, and even death.
  Under the Trump administration, the United States is undermining our 
asylum policy and America's leadership in the world in welcoming 
refugees and those fleeing violence and persecution in their home 
countries. Indeed, the Trump administration is deliberately trying to 
hurt migration and legitimate asylum seekers and refugees by making it 
more difficult to seek asylum and deter refugees from coming to the 
United States in the first place. Proposed asylum law changes, such as 
expansion of the Remain in Mexico and metering policies, will make it 
more difficult for asylum seekers to apply if they have traveled 
through multiple countries as they make their way to the United States.
  I believe asylum law should be changed to make it easier for migrants 
to apply in their home country, if safe, and expeditiously get an 
asylum determination from the U.S. Embassy so that they do not have to 
make the dangerous journey to the United States and try to cross our 
border with the uncertainty of what awaits them once they reach the 
U.S. border.
  I am concerned, as well, that migrants who do not ultimately make it 
through the process of applying for asylum may not receive proper 
notice of their hearings before an asylum judge to make their case. 
These are people who are released in our country but have to show up 
for a hearing. The notices may be given out in English, which many 
migrants cannot read. The address may be incorrect or outdated in terms 
of where the migrant is heading in the United States to await their

[[Page S5164]]

asylum hearing before the judge. In other words, the information may be 
inaccurate, and they never get the notices to appear. They are 
therefore out of status and never had a chance to make their case.

  NGOs in Texas made a strong case to our delegation to reinstate the 
Family Case Management Program, which the Trump administration has 
canceled. They explained that if ICE reinstated this program, we could 
see 99 percent compliance with immigration court orders without the 
need for expanded detention and overcrowding. This compliance rate is 
backed up by the track record and statistics of the Department of 
Homeland Security itself when the program was in use. This program is a 
promising alternative to detention that should be expanded instead of 
canceled by the Trump administration.
  Let me say a word about the Border Patrol agents themselves. They are 
trying to do their jobs under difficult circumstances. The main problem 
is the Trump administration's asylum policies, not the Border Patrol 
agents. I hope that the recent emergency supplemental appropriations 
measure passed by Congress and signed by the President will help in 
terms of providing better and more humane care to children in Health 
and Human Services Department custody, under the auspices of the Office 
of Refugee Resettlement. The measure seeks to improve conditions for 
migrants in the Department of Homeland Security's custody by addressing 
the dangerous overcrowding found by the Department of Homeland 
Security's inspector general. The bill improves due process for 
migrants and seeks to ease the immigration court backlog by hiring new 
immigration judges to hear cases and giving migrants greater access to 
the legal orientation program.
  What should Congress do to address the immediate needs of migrants, 
particularly the children, as well as addressing the root cause of this 
humanitarian crisis? I am a cosponsor of the Stop Cruelty to Migrant 
Children Act. This bill would provide guardrails and minimum standards 
for the treatment of children and families, ensuring that government 
funds are not used to traumatize or harm asylum seekers. It would do so 
by dramatically reducing family separations, setting health and safety 
standards, ending the operation of refugee shelters by for-profit 
contractors, making it easier to place children with sponsors, and 
ensuring that unaccompanied children have access to legal counsel.
  In terms of root causes, I have joined with my colleagues in 
introducing the Central America Reform and Enforcement Act designed to 
address the endemic violence and humanitarian crises that are driving 
immigration from Central America and also to smooth the path of those 
seeking asylum in this country. This bill would condition assistance to 
the Northern Triangle governments in order to address the root causes 
of the violence and instability that are driving migration and crack 
down on smugglers, cartels, and traffickers exploiting children and 
families.
  This legislation also enhances monitoring of unaccompanied children 
after they are processed at the border, provides a fair legal process 
for asylum seekers, and improves immigration court efficiencies. Those 
are some of the things we can do.
  In particular, this legislation would reverse the ill-advised foreign 
aid cuts made by the Trump administration that are worsening the 
migration crisis in the Northern Triangle, which includes Honduras, El 
Salvador, and Guatemala.
  I am concerned, however, that the President sees immigration and 
immigrants as a good political issue for the 2020 election. Congress 
needs a partner to take up and pass comprehensive immigration reform, 
which I believe could pass comfortably in both Houses if the President 
of the United States would join us in a constructive manner for 
comprehensive immigration reform.
  This administration has shown just the reverse. The administration 
has proposed a Muslim ban, canceled temporary protected status, 
canceled the DACA--Deferred Action for Childhood Arrival--Program for 
Dreamers, tried to institute an asylum ban, lowered and now seeks to 
eliminate refugee admissions, increased domestic immigration 
enforcement for nonviolent offenders, and sought to expand the program 
of expedited removal of residents in the United States without due 
process or a court hearing.
  In many of these cases, the Trump administration's decisions have 
been subjected to successful legal challenges in court, and, 
thankfully, our independent judiciary has largely continued to uphold 
the rule of law and serves as an important check and balance against 
the worst excesses of the Trump administration as it disregards our 
laws and the Constitution.
  I therefore urge the President to reverse course and work with 
Congress on comprehensive immigration reform, which must include 
sensible border security. Yes, we do need border security. In these 
times, when we have international terrorism and international drug 
trafficking, we need to know who is coming into our country. We have to 
have an orderly way to process those who want to work or live or go to 
school in the United States. But it must include an asylum policy for 
families who are at risk in their native country.
  Let us build on the proud history of America and welcome those who 
seek refuge from persecution and want to help build a better America.
  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. TESTER. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                              Debt Ceiling

  Mr. TESTER. Madam President, as I travel across Montana, I hear from 
folks who work tirelessly every day to make ends meet.
  Many work long hours for too low wages, and they face ever-rising 
costs in housing and healthcare and other basic necessities, but folks 
in Montana are resilient, they are resourceful, they know how to live 
within their means, and they know how important it is to make the 
numbers add up at the end of the month.
  I rise because, as usual, Washington, DC, could learn a lot from 
Montana. This week, we will vote on a bill that swipes Washington's 
credit card to the tune of about $250 billion over the next 2 years--
dollars that will come out of the pockets of our kids and our 
grandkids. Now, this $250 billion comes on top of the $1 trillion the 
United States will add to the national deficit this year because our 
budget is that far out of whack. The previous year to this year was 
$800 billion that we added to the national debt.
  So to put that in perspective, that is about $2.2 trillion in just 2 
years. If you are sitting at home wondering, $2.2 trillion; how much is 
that, it is far more than $250 billion.
  With $250 billion, half the students going to college for 4 years 
would not have to pay anything to go to school in the United States. We 
are adding $2.2 trillion, and it is going to continue on until we get 
our budget in line.
  Unfortunately, this sort of reckless spending by both parties has 
shown a disregard for its impact on the national debt, and it is now 
the norm in Washington, DC.
  Folks on both sides of the aisle are calling for this agreement, and 
they are calling it a compromise, but in reality, the only thing it 
will compromise is our children and our grandchildren's future.
  Montanans expect me to hold Washington, DC, accountable and fight 
back against irresponsible spending and poor tax policy. This falls on 
the irresponsible spending side.
  The bipartisan Committee for a Responsible Federal Budget projects 
that this administration's policies will add $4 trillion to the debt 
over the next 10 years. I am here to tell you that is too conservative 
a figure.
  At this point in time, we are going to be adding about $1.2 trillion 
to the debt every year if things don't change. Our debt is 
skyrocketing, and guess what. We are not fixing the healthcare problems 
that need to be fixed; we are not fixing the high cost of education; we 
are not investing in our infrastructure, but our debt continues to 
skyrocket because of irresponsible spending and, quite frankly, a 
Republican tax giveaway for the wealthy at the expense of our kids and 
our grandkids.
  I have listened to colleagues on both sides of the aisle during my 
tenure here

[[Page S5165]]

who warned of debt and how our national debt could damage our economy 
and our national security.
  Two years ago, my Republican colleagues passed a partisan tax 
giveaway, drafted behind closed doors, with no--with no--public input 
from Montanans or anyone else in this country. They promised that this 
tax giveaway would pay for itself, but it did not. Let me say that one 
more time. They promised the tax giveaway would pay for itself, but 
guess what. Just like the previous ones, it didn't.
  Instead, it tacked about $2 trillion onto our national debt, and it 
is another example of why we can't get our books in order--because we 
have a shortsighted fiscal approach that makes us the first generation 
to inherit from our parents and borrow from our kids.
  My colleagues made campaign promises to tackle this debt. As a 
Congressman--as a Congressman--Mick Mulvaney, who happens to be the 
President's Chief of Staff, pledged to eliminate it, but this White 
House has done just the opposite.
  As we stand here today, the debt has exploded to more than $22 
trillion, and it continues to climb higher every day, despite the 
country being in the middle of the longest period of economic expansion 
in our history.
  Now, I am going to tell you it is one thing to run a deficit when you 
are in a recession--it is necessary to bring the economy back--but when 
you are in the longest period of economic expansion in this country's 
history, we should be paying down that debt, and we are not. We are 
adding to it as if we were in a recession.
  Running trillion-dollar deficits during times of growth like this 
one, and everybody in this body knows it, puts the economy on a sugar 
high. It feels good now, but we all know it is not sustainable, and a 
crash is inevitable.
  The same folks who voted to pile $2 trillion onto the deficit now 
argue--some of them--that we cannot find the money to provide our 
veterans with the healthcare they have earned. They say we need deep 
cuts--deep cuts--into Medicaid and Social Security and other programs 
that many folks have paid into for their entire life, but yet we are 
going to cut them.
  I have known, and we all know, that budgets and spending are about 
priorities, and it is clear that Congress's priorities are out of 
whack.
  You wouldn't know it from watching C-SPAN, but it is possible to be 
fiscally conservative without cutting working folks off at the knees. I 
know this because, as president of the Montana Senate, I negotiated and 
passed a balanced budget because the State constitution requires it. 
Since coming to the U.S. Senate, I have led a push to add a 
constitutional amendment requiring that Congress pass a balanced 
budget.
  Now, look, we all know it can't be done overnight, but in a measured 
approach, with bipartisan cooperation, we can at least get headed in 
the right direction. There is no reason why we cannot make smart 
investments in working families, our kids' education, 21st century 
infrastructure, and the other needs across this country without 
bankrupting future generations. Folks in the Treasure State know that, 
and Washington, DC, needs to know that too. It is time for Congress to 
follow Montana's lead.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Tennessee.
  Mr. ALEXANDER. Madam President, I ask unanimous consent to speak for 
as much time as I may require.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                               Healthcare

  Mr. ALEXANDER. Madam President, I often recommend to Tennesseans that 
they look at the U.S. Congress as if it were a split-screen television 
set.
  Here is what I mean by that. During the last month, on one side of 
the screen you saw the usual Washington, DC, turmoil--Trump versus the 
squad, Mueller testifying, impeachment votes, battle over the border, 
Presidential candidates posturing, and of course the daily tweets.
  On the other side of the screen was the President and congressional 
leaders agreeing to a 2-year budget that will strengthen our military, 
help our veterans, fund research for medical miracles, fund research 
for our National Laboratories, support our national parks, and save 
taxpayers a boatload of money by providing stability in funding.
  I might add that this part of the budget--31 percent of the budget--
is not the part of the budget that is creating the budget deficit. This 
part of the budget that we will be voting on tomorrow has gone up at 
about the rate of inflation for the last 10 years and is projected by 
the Congressional Budget Office to go up at about the rate of inflation 
for the next 10 years.
  It is the entitlement part of the budget that is the problem, which 
is why I am voting for what the President and the congressional leaders 
have recommended, but then also on that side of the screen, away from 
the Washington, DC, turmoil, there was another story, which is the 
story I want to talk about today.
  During that last same month, three Senate committees, by my count, 
made more than 80 bipartisan proposals, sponsored by at least 75 U.S. 
Senators of both political parties, to reduce the cost of healthcare 
that Americans pay for out of their own pockets.
  On June 26, after 17 hearings, 6 months of work, recommendations from 
400 experts, our Health Committee, which I chair and of which Senator 
Patty Murray, the Democrat from Washington State, is the ranking 
member, voted 20 to 3 to recommend to the full Senate 55 proposals from 
65 Senators that would end surprise medical billing, increase 
transparency so you can know the cost of your medical care--you can't 
lower your healthcare costs if you don't know your healthcare actually 
costs--and increase competition to reduce the cost of prescription 
drugs.
  The next day after our Health Committee reported that legislation, 
the Judiciary Committee, headed by Senator Graham and Senator 
Feinstein, reported out 4 proposals from 19 Senators that would reduce 
prescription drug costs by banning anticompetitive behaviors by drug 
manufacturers and helping the Federal Trade Commission to block those 
who game the citizen petition process to delay generic drugs and 
biosimiliars.
  Then, last Thursday, the Finance Committee--this one headed by 
Senator Grassley and Senator Wyden--by a vote of 19 to 9, reported more 
than two dozen additional bipartisan proposals also aimed at reducing 
the cost of prescription drugs.
  That is not all. The House Energy and Commerce Committee has passed 
its own solution to surprise billing.
  Last Thursday, Senator Murray's staff and I met with Representatives 
Frank Pallone and   Greg Walden, the leaders of the House Energy and 
Commerce Committee. The four of us agreed to work together to lower 
healthcare costs.
  All of this work is consistent with what Secretary Azar and the 
President have been saying and doing to lower prescription drug costs 
and increase transparency.
  For example, last week, after the Finance Committee released its 
legislation, the White House said it ``is encouraged by the bipartisan 
work of Chairman Grassley and Senator Wyden to craft a comprehensive 
package to lower outrageously high drug prices, and today we are 
engaging with coalitions to help build support.'' That is from the 
White House.
  Here is why this amount of activity is, in so many ways, such a good 
sign for the American people. In our committee, what we have seen 
before with fixing No Child Left Behind, 21st Century Cures Act, last 
year's response to the opioid crisis--the last of which occurred, by 
the way, while on the other side of the split-screen television was the 
acrimonious Kavanaugh confirmation hearing--what we have seen with 
these recent new laws I just mentioned is that when that many Senators 
and that many Congressmen of both political parties go to work together 
on a big issue that affects millions of American people, there is 
likely to be a result that affects the American people.
  In other words, I believe legislation to end surprise medical 
billing, increase transparency, and lower prescription drug costs is 
looking like a train that will get to the station when Congress 
reconvenes in September, and well it should.
  The cost of healthcare is Americans' No. 1 financial concern, 
according to

[[Page S5166]]

Gallup, and at one hearing before our Health Committee, experts from 
the National Academy of Medicine testified that up to half of what our 
country spends on healthcare is unnecessary.
  That is such a startling fact that I sat down then with Senator 
Murray and with Senators Grassley and Wyden and with Senators Graham 
and Feinstein, and I said to the leaders of those committees: Surely, 
if the experts say that half of what we are spending is unnecessary, 
Democrats and Republicans can find some things we can agree on that 
reduce the cost of what we pay for healthcare out of our own pocket, 
and we have.
  The work of these three committees, more than 80 proposals from 75 
Senators, is the result of that work over the last 6 months.
  Let me say a word about perhaps the most visible proposal in the 
Health Committee's bill. Surprise medical billing is one of the most 
urgent problems that the House, the Senate, and the President are 
trying to fix.
  After about 20 percent of all emergency room visits, patients are 
surprised a few months later to receive an unexpected bill. It could 
range from $300 to $3,000 to $30,000. This happens because patients see 
a doctor they didn't choose, either because of emergency care at an 
out-of-network hospital or because an out-of-network doctor, not chosen 
by the patient, treats them at an in-network hospital.
  In his State of the Union Address and again at a White House event in 
May, President Trump called for an end to surprise billing. At the 
event, he gave me a copy of this medical bill, which we have enlarged 
on this chart. It was a bill sent to Liz Moreno, a Texas college 
student who had back surgery, and during a postsurgery followup visit, 
her doctor ordered a urine test. A year later, this bill showed up: 
$17,850 for a urine test. That is about the price of a new Nissan 
Sentra. The bill was sky high because the lab that ran the test--a lab 
Liz did not choose--was considered out of network by her insurer.
  Take Drew Calver, a Texan who told the President his story about 
getting $110,000 in bills--the emergency room he was rushed to during 
his heart attack was out of network and so were the doctors who treated 
him.
  That day, the President said: ``For too long, surprise billings . . . 
have left some patients with thousands of dollars of unexpected and 
unjustified charges. . . . So this must end.''
  The Lower Health Care Costs Act the Senate Health Committee passed 
last month by a vote of 20 to 3 would have protected Liz and Drew from 
receiving those surprise bills. Here is how it works: Insurance 
companies would pay out-of-network doctors a local, market-driven 
benchmark rate, which would be the same local, market-based rate that 
insurers negotiated with doctors who agreed to be in network. 
Obviously, this would have saved Liz and Drew because they wouldn't 
have gotten a surprise medical bill.
  The Congressional Budget Office says that by ending surprise medical 
billing, this approach would generally lower health insurance premiums. 
CBO also estimates that the approach would save taxpayers $25 billion 
over the next 10 years.
  Based on data from Kaiser, only about 5 percent of doctors at 10 
percent of hospitals send most of these surprise medical bills. So our 
solution primarily affects those doctors whom patients have little 
control over choosing--anesthesiologists, radiologists, pathologists, 
emergency room doctors, and neonatologists. It does not affect doctors 
whom a patient can choose, such as cardiologists or primary care 
doctors or pediatricians. In fact, the American Academy of Family 
Physicians, representing primary care doctors, supports our Lower 
Health Care Costs Act that ends surprise medical billing.
  Over the 17 hearings our Health Committee conducted in developing our 
legislation, we heard many stories about surprise billing. Here are a 
few.
  Todd, a Knoxville father who wrote me, took his son to the emergency 
room after a bicycle accident. Todd was surprised when a few months 
later he received a bill for $1,800--because, even though the emergency 
room was in network, the doctor who treated his son was not.
  Ahead of the birth of their first child, Danny and his wife Linda, 
from Georgia, chose an in-network doctor and hospital. Of course, they 
thought their insurance would cover their bills. When Luke was born 3 
weeks premature, he had to spend 11 days at the in-network hospital's 
neonatal care center. In the weeks after Luke went home, $4,279 in 
bills were sent to Danny and Linda because the neonatal care center, 
located in their in-network hospital, was out of network.
  Carrie Wallinger, from Phoenix, AZ, received a $9,000 surprise 
medical bill after going to an in-network emergency room after her dog 
bit her finger. The doctor who came to stitch up her finger was from an 
out-of-network facility, and so she got an unexpected $9,000 surprise 
bill.
  A South Carolina woman who had to have an emergency C-section 
received a $15,000 bill from an out-of-network anesthesiologist.
  Usually when you are being wheeled into an emergency room for an 
emergency operation, you are not thinking about choosing a doctor, and 
you are not interviewing them about whether they are in network or out 
of network.
  In Texas, after an ATV crushed his arm, Dr. Naveed Khan, a 
radiologist, needed advanced medical care. The cost of a 108-mile trip 
in an out-of-network helicopter cost $44,631.
  Nicole Briggs, from Colorado, had emergency surgery to remove her 
appendix at an in-network hospital. She owed $4,727 because the surgeon 
was out of network.

  In Mississippi, Stacy White took her husband to the emergency room at 
an in-network hospital. The emergency physician who saw her husband was 
out of network, and to her surprise, they received a bill for $2,700.
  West Coz, a 3-year-old with a 107-degree fever, was airlifted from a 
small community in West Virginia to a more advanced hospital 75 miles 
away. His parents were left with a $45,000 bill for the helicopter.
  In Maine, the State representative who sponsored a bill to protect 
patients against surprise bills received a several-hundred-dollar bill 
himself because the radiologist who read his daughter's x-ray was out 
of network even though he took his daughter to an in-network hospital.
  There are many more stories I could tell, but the bottom line is, in 
each case, this happened because the patient almost always had little 
choice. If you don't have choice, then you really don't have a 
functioning market. It is a market failure.
  One reason for the uptick in surprise bills is that this market 
failure is now being exploited by private equity firms. Oftentimes, 
hospitals will contract with a company to staff their emergency rooms 
and hospitals. These companies will handle billing, manage schedules, 
and hire doctors to staff the hospital emergency room.
  Here is some research done by Yale economist Zack Cooper. He found 
that two of the leading staffing companies--both backed by private 
equity firms--significantly increase the rate of out-of-network billing 
in a hospital once the firms are hired.
  In the case of one of the physician staffing companies that Cooper 
studied, a large insurer's data showed that the cases of surprise 
billing increased by 100 percent at six different hospitals once this 
physician staffing firm took over those hospitals' emergency rooms.
  In a New York Times article, Cooper described the 100-percent jump in 
surprise bills once these private equity-backed staffing companies 
entered by saying it was ``almost . . . like a light switch was being 
flipped on.''
  In Axios, Cooper said: ``If you're willing to engage in some fairly 
unsavory billing practices, (these services) could be quite lucrative. 
. . . That's just discouraging, and it makes people want to go to 
single payer.'' These surprise bill abuses make Americans want to go to 
single payer.
  Our goal is to protect patients, not private equity firms and 
companies that are taking advantage of patients. Surprise medical bills 
are one of the most visible problems for the 180 million Americans who 
get their health insurance on the job.
  When growing numbers of patients are receiving surprise medical bills 
that could bankrupt their families, it is time for Congress to act. If 
Congress can't fix such an obvious market failure in healthcare, 
pressure will only grow for a radical Federal takeover of healthcare 
that will take away private insurance from the 180 million Americans 
who get insurance on the job and

[[Page S5167]]

leave patients with less choice, fewer doctors, and worse healthcare.
  Avik Roy wrote in Forbes that ``if we do nothing [to address surprise 
medical bills], the problem will get far worse. If we do something that 
is too incremental, we'll pat ourselves on the back and then be forced 
to revisit the problem in a few years. Americans deserve market-based 
alternatives to single-payer health care. Without reform of exploitive 
hospital prices, we'll never get there.''
  Americans want to be mindful consumers of healthcare. When Todd, the 
Knoxville father, wrote me, he said: ``If I'm expected to be a 
conscientious consumer of my own health care needs, I need a little 
more help.'' In other words, he needs for Congress to end surprise 
medical bills.
  It is unacceptable to say to patients that, even by paying their 
premiums every month, even by researching and choosing in-network 
hospitals and doctors, they may be on the hook for thousands of 
unexpected dollars because of a surprise bill over which they had no 
control.
  At least 75 Senators and the President of the United States have made 
it clear that our intent is to end surprise billing and to reduce what 
Americans pay out of pocket for their healthcare. When Congress 
reconvenes in September, I would encourage all of my colleagues to 
support these efforts to reduce healthcare costs.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Maryland.


                          Trump Administration

  Mr. VAN HOLLEN. Mr. President, I am here on the Senate floor today 
with my friend and colleague, the senior Senator from the State of 
Maryland, Mr. Cardin, and I think we both agree that we would rather 
not be here today to talk about this subject. But I feel compelled to 
come to the Senate floor today because, in my view, we have a duty to 
speak out when the President of the United States of America engages in 
conduct that brings dishonor and disgrace to the Office of the 
Presidency. That is what we witnessed, once again, over the weekend 
when President Trump unleashed a torrent of personal, nasty, and racist 
attacks on Congressman Elijah Cummings and the city of Baltimore, and 
President Trump has continued his poisonous barrage for days.
  Congressman Cummings can defend himself. He grew up having to 
confront racist bullies. In the face of these attacks, he has shown 
great strength and great integrity--the same strength and integrity he 
has brought to his efforts to fight for his dear city of Baltimore, his 
entire congressional district, and his constituents over many years.
  Baltimore is a great American city with great people, great spirit, 
and great heart. Yes, of course, Baltimore faces many challenges. It is 
facing those challenges with determination, with unity, and with grit. 
The President's attacks on this great American city have only served to 
rally the people of Baltimore, the people of Maryland, and, in fact, 
the people of the United States of America to support the city and the 
people of Baltimore.
  Mr. President, I ask unanimous consent to have printed in the Record 
an op-ed that appeared in the Baltimore Sun today entitled ``Baltimore 
leaders: `Proud not only to be in Baltimore, but of Baltimore.' ''
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                [From the Baltimore Sun, July 30, 2019]

     Baltimore Leaders: `Proud Not Only To Be in Baltimore, but of 
                               Baltimore'

                 (By Ronald J. Daniels and Kevin Plank)

       We are proud and privileged to call Baltimore home. 
     Baltimore is a city of creativity, optimism, and 
     determination. Home to leading public and private research 
     universities, world-class medical institutions, and a diverse 
     business community, Baltimore is a city where both artists 
     and start-ups thrive. From creating one of the nation's first 
     racially integrated library systems to producing today's 
     modern medical and technological breakthroughs, our city has 
     a proud legacy of leadership in improving lives and setting a 
     national example for a stronger tomorrow. It's no wonder we 
     are often named as a place where millennials are moving and 
     staying. This is a city where people not only want to live, 
     but love to live.
       That is why we, as leaders of 10 of Baltimore's anchor 
     institutions, reject the recent unfair and ungenerous 
     characterizations of our great city and its region. Like so 
     many cities across America, Baltimore is a place of paradox, 
     at once vibrant and full of promise and yet also burdened by 
     the weight of generations of racial and economic inequities, 
     deindustrialization, and disinvestment. Like other cities of 
     our size and history, we face urgent challenges with crime, 
     housing equity and our education system. But like all 
     Americans, Baltimoreans deserve respect, support and 
     steadfast partnership from elected officials at every level.
       Baltimore is not and will not be defined by our challenges. 
     What defines us is that we continually meet those challenges 
     with resilience and persistence, that we invest in innovation 
     for Baltimore and for the nation, and that we harness the 
     talent of so many exceptional individuals to create 
     opportunity not for the few, but for the many.
       Baltimore's remarkable people include icons past and 
     present like Supreme Court justice Thurgood Marshall; the 
     longest serving woman in Congress, Sen. Barbara Mikulski; and 
     Rep. Elijah Cummings, outspoken advocate for all his 
     constituents, from west Baltimore to Catonsville and beyond. 
     These leaders are known not only for their deep commitment to 
     our city and communities, but for their stature and public 
     service on the national stage.
       We see the promise of Baltimore because we are fortunate to 
     work, serve and live here, alongside our colleagues, 
     employees, students and neighbors. Such promise is proven 
     daily in our shared commitment to our city's growth and the 
     success of its residents. Baltimore fosters talent in its 
     strong academic institutions and has seen rising venture 
     capital investment in its businesses--a testament to the 
     dynamism and innovative spirit of our businesses large and 
     small. Our leading businesses and non-profits, called upon 
     and supported by our vibrant faith community, launched 
     BLocal, a targeted economic investment and community 
     development plan that over three years has invested more than 
     $280 million and hired more than 1,700 Baltimore residents in 
     underserved neighborhoods. BLocal expresses to the fullest 
     the deep and long-term investment of the city's anchor 
     institutions.
       We never move forward as a community--or indeed, a nation--
     by denigrating each other. Nor does it serve any of us to 
     demean a vibrant city and its citizens who exemplify those 
     most American of qualities: can-do optimism, grit and 
     creativity.
       Justice Thurgood Marshall wisely counseled that ``In 
     recognizing the humanity of our fellow beings, we pay 
     ourselves the highest tribute.'' And as this city has shown, 
     time and again, when we work together, we rise together. For 
     this and so many reasons we are proud not only to be in 
     Baltimore, but of Baltimore.

  Mr. VAN HOLLEN. This is signed by many of the leaders in our 
community, including the President of Johns Hopkins University; the 
head of Under Armour, a great American company; the head of a number of 
major companies in the city of Baltimore; the Casey Foundation; Morgan 
State University, a great HBCU; Eddie Brown, one of our great civic 
leaders; and many other leaders of Baltimore--diverse leaders who have 
come together to stand up with pride for the city of Baltimore.
  I would like to read to the Senate what they say in the first 
paragraph:

       We are proud and privileged to call Baltimore home. 
     Baltimore is a city of creativity, optimism, and 
     determination. Home to leading public and private research 
     universities, world-class medical institutions, and a diverse 
     business community, Baltimore is a city where both artists 
     and start-ups thrive. From creating one of the nation's first 
     racially integrated library systems to producing today's 
     modern medical and technological breakthroughs, our city has 
     a proud legacy of leadership in improving lives and setting a 
     national example for a stronger tomorrow.

  I want to pay particular attention to these next sentences:

       It's no wonder we are often named as a place where 
     millennials are moving and staying. This is a city where 
     people not only want to live, but love to live.

  If you come to Baltimore today, you will, in fact, find lots of young 
people from other parts of the country coming to settle, work, and 
raise their families in this great American city. The President may say 
that nobody wants to live in Baltimore, but the facts show a very 
different story about young people--young people who understand that 
they have a great future in Baltimore and are moving to that great 
city.
  Of course, it is true that Baltimore faces a series of problems. In 
Baltimore we have had a legacy of racial discrimination and 
segregation.
  I would like to read from yesterday's editorial in the Baltimore Sun.
  Mr. President, I ask unanimous consent to have printed in the Record 
the editorial from the Baltimore Sun, dated July 29, 2019.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

[[Page S5168]]

  


                [From the Baltimore Sun, July 29, 2019]

Cummings Didn't Cause Baltimore's Woes; It Was People Who Profited From 
                   Racism. Sound Familiar, Mr. Trump?

                   (By Baltimore Sun Editorial Board)

       It's not our job to defend Rep. Elijah Cummings from 
     President Donald Trump's Twitter rants. For one thing, he's 
     quite capable of doing it on his own, and for another, our 
     role isn't to offer blind loyalty to political leaders of any 
     party but to hold them to account. Likewise, we're not in the 
     business of defending Baltimore from any and all criticism. 
     Our city has problems, big ones, and we don't shy away from 
     them, nor do we give any politicians a pass for failing to do 
     as much as humanly possible to fix them. But we are sticklers 
     for facts and perspective, and in case anybody is still 
     interested in those things, we have a few that are worth 
     mentioning.
       Mr. Cummings has not single-handedly solved Baltimore's 
     racial and class inequities, its injustices, its blight, its 
     epidemics of lead poisoning and asthma, its violence or, 
     indeed, its problems with rats. And he has been in office for 
     a long time, more than 30 years between Congress and the 
     Maryland House of Delegates. But Baltimore's problems go back 
     a lot farther than that.
       President Trump, whose early career was marred by a federal 
     housing discrimination suit, may be interested to know that 
     Baltimore was something of a pioneer in that regard. It 
     enacted the first housing segregation ordinances, which were 
     soon invalidated by the Supreme Court, leading to subtler and 
     more nefarious tactics. Racially restrictive covenants, 
     privately enforced, prevented the sale of homes in certain 
     neighborhoods to minorities. Redlining prevented minorities 
     from getting financing to buy homes in white neighborhoods. 
     And blockbusting made rich the unscrupulous men who 
     capitalized on racism and fear to drive white flight. They 
     profiteered on blacks who sought security and better 
     opportunities but instead found themselves exploited and 
     impoverished.
       Those days aren't nearly so far in the past as we might 
     like to think. Just seven years ago, Baltimore settled a 
     landmark lending discrimination suit against Wells Fargo, 
     which steered minority borrowers into subprime mortgages--the 
     sort of abuse the Consumer Financial Protection Bureau, which 
     Mr. Trump has eviscerated, might have prevented. Landlords in 
     Baltimore continue to take advantage of rules stacked in 
     their favor to evict low-income (and frequently minority) 
     tenants; in a particularly egregious example, the Kushner 
     Cos. (as in Trump son-in-law Jared Kushner) has aggressively 
     sought to jail tenants who fall behind on their rent.
       As whites moved to the suburbs, sped along the way by 
     massive investments in new highways, water and sewer systems, 
     schools and other public amenities, Baltimore City's 
     infrastructure began to crumble. Neighborhoods like those in 
     the East and West Baltimore portions of Mr. Cummings' 
     district became increasingly isolated from economic and 
     educational opportunities. (Mr. Cummings was among the 
     Baltimore leaders who sought to address that problem through 
     the development of a new light rail line connecting those 
     neighborhoods to employment centers including the Social 
     Security Administration and Johns Hopkins Bayview Medical 
     Center, but Gov. Larry Hogan, who over the weekend responded 
     to Mr. Trump's tweets by calling Baltimore ``the very heart 
     of the state'' and on Monday by asking why politicians aren't 
     ``focused on solving the problems and getting to work,'' 
     killed the project.)
       Meanwhile, back in the '90s, Democrats and Republicans both 
     discovered that espousing zero-tolerance policing was great 
     politics, so long as it was enforced disproportionately 
     against blacks and Hispanics in the nation's cities and not 
     against whites in suburban and rural communities. Plenty of 
     people share blame for that, including former Vice President 
     Joe Biden and former Maryland Gov. (and former Baltimore 
     mayor) Martin O'Malley. But not a lot of them continue to 
     espouse the notion that locking more people up for minor 
     offenses or stopping and frisking people on the streets are 
     good ideas, as the Trump administration has done.
       The Obama administration tried to do something about the 
     pockets of concentrated poverty in American cities (and 
     Baltimore specifically) by using federal housing policy to 
     affirmatively foster desegregation, something the Fair 
     Housing Act had called for 50 years before, but Mr. Trump's 
     HUD secretary, Baltimore's own Ben Carson, has been working 
     to dismantle those efforts.
       We will agree with President Trump on one thing, though. We 
     wish Mr. Cummings weren't so focused on investigating the 
     Trump administration. We wish, for example, that immigrant 
     children weren't being held in inhumane conditions at the 
     border, that the White House complied with congressional 
     subpoenas, that administration officials weren't conducting 
     public business on private email accounts or that the 
     president of the United States didn't look on the office as a 
     giant profit center for himself and his family. If not for 
     things like that, Mr. Cummings' role as chairman of the House 
     Committee on Oversight and Reform would probably take up much 
     less of his time.

  Mr. VAN HOLLEN. Here is what yesterday's Baltimore Sun editorial 
states:

       President Trump, whose early career was marred by a federal 
     housing discrimination suit, may be interested to know that 
     Baltimore was something of a pioneer in that regard. It 
     enacted the first housing segregation ordinances, which were 
     soon invalidated by the Supreme Court, leading to subtler and 
     more nefarious tactics. Racially restrictive covenants, 
     privately enforced, prevented the sale of homes in certain 
     neighborhoods to minorities. Redlining prevented minorities 
     from getting financing to buy homes in white neighborhoods. 
     And blockbusting made rich the unscrupulous men who 
     capitalized on racism and fear to drive white flight. They 
     profiteered on blacks who sought security and better 
     opportunities but instead found themselves exploited and 
     impoverished.

  They go on to make the point:

       Those days aren't nearly so far in the past as we might 
     like to think. Just seven years ago, Baltimore settled a 
     landmark lending discrimination suit against Wells Fargo, 
     which steered minority borrowers into subprime mortgages--the 
     sort of abuse the Consumer Financial Protection Bureau, which 
     Mr. Trump has eviscerated, might have prevented. Landlords in 
     Baltimore continue to take advantage of rules stacked in 
     their favor to evict low-income (and frequently minority) 
     tenants; in a particularly egregious example, the Kushner 
     Cos. (as in Trump son-in-law Jared Kushner) has aggressively 
     sought to jail tenants who fall behind on their rent.

  We do have a legacy of discrimination in Baltimore City to overcome. 
The President, instead of challenging that legacy, has decided to pile 
on in the manner he did with his comments.
  I know that Baltimore will rise above this. I know the city is 
resilient, and I know this great city's greatest days are still ahead 
as we tackle that legacy and move on to the future. But I think we as a 
body--both Republicans and Democrats alike--have an obligation to also 
stand up for our country. We cannot allow these kind of remarks out of 
the Oval Office to go unanswered. We cannot allow silence when the 
President of the United States challenges the very idea of what it 
means to be American, which is a place where people of all different 
backgrounds, all different races, and all different religions can come 
together: ``E pluribus unum.'' The President wants to drive a stake in 
that idea. He wants to divide the country, and we cannot be silent 
while he soils the Oval Office.
  I ask all of us to speak out, wherever we are, when we see this kind 
of attack by the President of the United States. It is wrong for our 
country. It is bad for our country. It is a disgrace to the Oval 
Office.
  The one thing I can say is that, in the face of that disgrace, 
Baltimore has shown great dignity, incredible dignity, the dignity of a 
city of people who see a wonderful future ahead, and we should all work 
together to make that future as bright as possible.
  Mr. President, I ask unanimous consent to have printed in the Record 
an article from today's Baltimore Sun editorial board.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                            [July 30, 2019]

                Better To Have a Few Rats Than To Be One

                   (By Baltimore Sun Editorial Board)

       In case anyone missed it, the president of the United 
     States had some choice words to describe Maryland's 7th 
     congressional district on Saturday morning. Here are the key 
     phrases: ``no human being would want to live there,'' it is a 
     ``very dangerous & filthy place,'' ``Worst in the USA'' and, 
     our personal favorite: It is a ``rat and rodent infested 
     mess.'' He wasn't really speaking of the 7th as a whole. He 
     failed to mention Ellicott City, for example, or Baldwin or 
     Monkton or Prettyboy, all of which are contained in the 
     sprawling yet oddly-shaped district that runs from western 
     Howard County to southern Harford County. No, Donald Trump's 
     wrath was directed at Baltimore and specifically at Rep. 
     Elijah Cummings, the 68-year-old son of a former South 
     Carolina sharecropper who has represented the district in the 
     U.S. House of Representatives since 1996.
       It's not hard to see what's going on here. The congressman 
     has been a thorn in this president's side, and Mr. Trump sees 
     attacking African American members of Congress as good 
     politics, as it both warms the cockles of the white 
     supremacists who love him and causes so many of the 
     thoughtful people who don't to scream. President Trump bad-
     mouthed Baltimore in order to make a point that the border 
     camps are ``clean, efficient & well run,'' which, of course, 
     they are not--unless you are fine with all the overcrowding, 
     squalor, cages and deprivation to be found in what the 
     Department of Homeland Security's own inspector-general 
     recently called ``a ticking time bomb.''

[[Page S5169]]

       In pointing to the 7th, the president wasn't hoping his 
     supporters would recognize landmarks like Johns Hopkins 
     Hospital, perhaps the nation's leading medical center. He 
     wasn't conjuring images of the U.S. Social Security 
     Administration, where they write the checks that so many 
     retired and disabled Americans depend upon. It wasn't about 
     the beauty of the Inner Harbor or the proud history of Fort 
     McHenry. And it surely wasn't about the economic standing of 
     a district where the median income is actually above the 
     national average. No, he was returning to an old standby of 
     attacking an African American lawmaker from a majority black 
     district on the most emotional and bigoted of arguments. It 
     was only surprising that there wasn't room for a few classic 
     phrases like ``you people'' or ``welfare queens'' or ``crime-
     ridden ghettos'' or a suggestion that the congressman ``go 
     back'' to where he came from.
       This is a president who will happily debase himself at the 
     slightest provocation. And given Mr. Cummings' criticisms of 
     U.S. border policy, the various investigations he has 
     launched as chairman of the House Oversight Committee, his 
     willingness to call Mr. Trump a racist for his recent attacks 
     on the freshmen congresswomen, and the fact that ``Fox & 
     Friends'' had recently aired a segment critical of the city, 
     slamming Baltimore must have been irresistible in a Pavlovian 
     way. Fox News rang the bell, the president salivated and his 
     thumbs moved across his cell phone into action.
       As heartening as it has been to witness public figures rise 
     to Charm City's defense on Saturday, from native daughter 
     House Speaker Nancy Pelosi to Mayor Bernard C. ``Jack'' 
     Young, we would above all remind Mr. Trump that the 7th 
     District, Baltimore included, is part of the United States 
     that he is supposedly governing. The White House has far more 
     power to effect change in this city, for good or ill, than 
     any single member of Congress including Mr. Cummings. If 
     there are problems here, rodents included, they are as much 
     his responsibility as anyone's, perhaps more because he holds 
     the most powerful office in the land.
       Finally, while we would not sink to name-calling in the 
     Trumpian manner--or ruefully point out that he failed to 
     spell the congressman's name correctly (it's Cummings, not 
     Cumming)--we would tell the most dishonest man to ever occupy 
     the Oval Office, the mocker of war heroes, the gleeful 
     grabber of women's private parts, the serial bankrupter of 
     businesses, the useful idiot of Vladimir Putin and the guy 
     who insisted there are ``good people'' among murderous neo-
     Nazis that he's still not fooling most Americans into 
     believing he's even slightly competent in his current post. 
     Or that he possesses a scintilla of integrity. Better to have 
     some vermin living in your neighborhood than to be one.

  Mr. VAN HOLLEN. With that, I yield to the senior Senator from 
Maryland, my friend, Ben Cardin.
  The PRESIDING OFFICER. The Senator from Maryland.
  Mr. CARDIN. Mr. President, first, I thank Senator Van Hollen, my 
seatmate and friend representing the State of Maryland in the U.S. 
Senate. His comments reflect the views, I hope, of the overwhelmingly 
majority of Americans. It is critically important that we speak out as 
to what the President has said.
  I have lived my entire life in Baltimore. I love Baltimore. It is a 
great city. As Senator Van Hollen has said, it has an incredible 
history. It is a vibrant city. There are so many good things happening 
there. It has a great future, and it needs our help from the point of 
view of any major urban center in America.
  On weekends, my wife and I will frequently walk areas of Baltimore 
City in order to get some exercise, to clear our heads from the 
workweek, and to see what is happening in Baltimore. I must tell you 
that it is so energizing to see the building cranes in downtown 
Baltimore building new housing for our young people coming into our 
city because they know the economic future of Baltimore. They are there 
because they want to live in an exciting place in Baltimore City.
  We see the optimism on their faces as they are doing their exercise 
in the morning and walking the streets of Baltimore. We see a great 
city that is continuing to rebuild in a modern economy. So when the 
President of the United States insults the city of Baltimore and 
Congressman Cummings, it is incumbent on all of us to speak out and 
tell the President: This is unacceptable.
  We know the Office of the President is frequently referred to as a 
bully pulpit that he can use, but the President of the United States 
cannot be a bully. Yet that is exactly what he is doing, trying to 
bully minorities and others in this country. It will not work.
  The bully is not Elijah Cummings, as President Trump called him. The 
bully is President Trump. The person who is dividing our country is 
President Trump, and he should be the one bringing us together.
  Why does he do this? I don't think any of us believe that he isn't 
doing it for political reasons. He wants to distract from what is 
happening in this country. In the Congress of the United States, 
Congressman Cummings is leading a committee that has the responsibility 
of checks and balances of our system to act as a check on the President 
of the United States.
  Does anybody in this Chamber believe there shouldn't be a check and 
balance in our system on this President? Look at how he has used his 
Executive powers and abused his Executive powers and the emergency 
declarations that he has used.
  The Mueller report spells out how the President tried to interfere in 
the investigation. The way he talks about our judiciary, saying that he 
is not going to follow the orders of our court, and the way he trashes 
our free press--all of that cries out for an aggressive check and 
balance on the independent first branch of government, and that is what 
Elijah Cummings is doing.
  So why is the President using these personal attacks against Elijah 
Cummings and the city he represents, Baltimore? To try to distract from 
the legitimate role Congress plays as a check and balance on the powers 
of President Trump.
  It won't work. I can assure you that Congressman Cummings is going to 
continue to do his work. His committee is going to continue to do its 
work. I am going to continue to do my work as a U.S. Senator, and 
Senator Van Hollen is going to continue to do what is right to make 
sure we carry out our constitutional responsibilities.
  He also does this, quite frankly, for a political appeal against 
minority communities. That is inexcusable for any American, but for the 
President of the United States, it is totally outrageous.
  As Senator Van Hollen said, we don't have to defend Elijah Cummings. 
He can defend himself.
  I have known Elijah Cummings now for about 40 years. When I was 
speaker of the house of delegates in Annapolis, there was a young, new 
legislator who came upon the scene--Elijah Cummings. I recognized from 
the beginning that he was going to be a great leader, and he showed 
that in his very early years. He rose to become speaker pro tempore of 
our house of delegates, and he was a leading voice as a member of the 
house of delegates.
  You see, we had something in common. Both Elijah Cummings and I 
graduated from the same public high school in Baltimore City, Baltimore 
City College. By the way, so did Dutch Ruppersberger and three members 
of Congress--from the same public high school in Baltimore City. We 
both attended the same law school, the University of Maryland School of 
Law.
  So I recognized from the beginning that there was a lot in common, 
and I wanted to help this young legislator. He then, of course, ran for 
Congress. He was elected to Congress, and he has done an incredible 
job. He is a gifted orator. He motivates people by his speech. He is a 
mentor for young people, and he has helped so many young people with 
their lives.
  He lives in Baltimore City in a neighborhood where he is an 
inspiration to people who otherwise would not have much hope. He has 
used his own life experiences to lift the lives of others, and, yes, I 
can tell you the record of so many accomplishments that he has.
  Just this past week, along with Senator Van Hollen, we announced a 
$125 million grant for the Howard Street tunnel for which Congressman 
Cummings played a critical role in getting those funds. That is going 
to mean thousands of jobs for Baltimore and economic opportunity for 
our region. That is just one example.
  In the revitalization of Penn Station, Amtrak is going to invest $90 
million in revitalizing that part of Baltimore. Elijah Cummings was 
instrumental in getting that done.
  In the Ellicott City flood--two floods within a 20-month period--it 
was part of his congressional district. President Trump doesn't quite 
understand how Congressman Cummings' district is redistricted, but he 
represents Ellicott City. He was on the scene immediately and helped 
bring in all of the Federal partners so that Ellicott City could beat 
the odds.

[[Page S5170]]

  When you have a major flood like that, most businesses don't return. 
In Ellicott City, they returned. Why? Because of the Federal 
partnership in which Elijah Cummings played a critical role, as well as 
other members of our congressional delegation.
  Affordable housing--Congressman Cummings has brought affordable 
housing to Baltimore.
  Public safety--after Freddie Gray, I will never forget the scene I 
was watching on the television screen. We saw the riots and the 
disruption that started in Baltimore. There was Elijah Cummings on the 
streets, calming things down and saving lives. That is what he was 
doing to represent his community. That is the type of legislator he is.
  He has provided support for public safety in Baltimore, for public 
education in Baltimore, and for STEM education in Baltimore City public 
schools.
  So, President Trump, when you say this guy hasn't done his work to 
represent the people in the Seventh Congressional District, you are 
absolutely wrong. Come to Baltimore. Let us show you exactly what we 
have been able to accomplish and how you can help us, but don't defame 
our city. You are the President of the United States. Act as President. 
Bring us together. Recognize that you are responsible for this entire 
country, and help us with the reputation of Baltimore.
  Again, I don't have to defend my city. My city is well known. It is 
one of the great cities in America, but I am going to do it anyway 
because I want my colleagues to understand how proud we are of our 
city, those of us who represent the State of Maryland and represent 
Baltimore City.
  There is the Nation's first Washington Monument, the National 
Aquarium, Oriole Park, M&T Bank, Fort McHenry. Talk about Enoch Pratt 
library, one of the great libraries in America that gave free libraries 
to the people of our city. There is Eubie Blake National Jazz Institute 
and Cultural Center.
  I could go through all the museums we have in Baltimore: the American 
Visionary Art Museum; the Baltimore Museum of Art; the Baltimore Museum 
of Industry; Walters Art Gallery; the Jewish Museum of Maryland; Babe 
Ruth's birthplace--born in Baltimore; the Reginald F. Lewis Museum; and 
the B&O Railroad Museum. How many of us have been there? The great 
history of the railroads in Baltimore started there. There is the 
Maryland Science Center.
  There are great sports icons that have come out of Baltimore--from 
Johnny Unitas to Frank Robinson, to Brooks Robinson, Cal Ripken, and 
Ray Lewis.
  We have great healthcare institutions--Johns Hopkins. I just got an 
email as I was sitting on the floor. I know the rules of the Senate 
prohibit me from looking at my electronic device, but U.S. News & World 
Report today ranked the Johns Hopkins department of neurology No. 1 in 
the Nation. It is located in Baltimore City, MD.
  We can go over the other great institutions we have, such as the 
University of Maryland Medical Center, the Kennedy Krieger Institute, 
and the Lieber Institute for Brain Development.
  We have great colleges, from Morgan State University to the 
University of Maryland School of Law, to Loyola University, Johns 
Hopkins University, Baltimore Coppin State, Notre Dame of Maryland 
University.
  The list goes on and on: farmers markets and public markets; trend-
setting writers from John Waters to David Simon, Tom Clancy, and Barry 
Levinson; the unique neighborhoods from ``Lil' Itlee'' to Pigtown.
  Baltimore is well known. The Taste of Baltimore--how many of you know 
that the only place you can get a really legitimate crab cake is in 
Baltimore City? We all know that. And there are Old Bay Seasoning, 
Berger Cookies, and Goetze's Candies.
  There is the Port of Baltimore, the economic heart of our State; 
Domino Sugar; and Under Armour, which is investing hundreds of millions 
of dollars into Baltimore City because they know the future.
  There are the NGOs that are centered in Baltimore--the Annie E. Casey 
Foundation, Abell Foundation, Center for Urban Families, Catholic 
Relief Services, and Lutheran Immigration and Refugee Services.
  I do this in hopes that the President might be listening so that he 
can learn a little bit about why we are so proud of Baltimore City. 
What we do ask is very simple. To the President: Come and learn about 
our urban centers and how you can help us in meeting the problems that 
we have in Baltimore and many urban cities around the Nation. We need a 
Federal partner who will help us with our economic growth and help us 
meet the challenges of the future.
  It is exciting to live in Baltimore, and it is exciting to see our 
city grow. I am proud to be a Baltimorean, and I am proud to represent 
Baltimore in the U.S. Senate.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Maryland.
  Mr. VAN HOLLEN. Mr. President, I thank my colleague, Senator Cardin, 
for talking about some of the highlights of Baltimore City and the 
storied history of Baltimore City. It is a history of much good but 
also a lot of challenges that I recounted earlier. It doesn't do 
Baltimore City or any city in this country any good when the person in 
the highest office in this country launches these nasty, personal, 
racial diatribes.
  I know the President had a history of these kinds of comments before 
he came to the Oval Office. But now that he is in the Oval Office, all 
of us have an obligation and responsibility to speak out when he fouls 
the office in that way.
  If the President really wants to help cities like Baltimore, he can 
do some of the things Senator Cardin talked about. On a bipartisan 
basis in the Appropriations Committee, we are working to make 
investments that will help that city and many other cities with things 
like the CDBG--community development block grants--things like economic 
development administration proposals, things like financing through 
CDFIs, and things like minority business enterprises. Those are four 
investments. They don't solve the problems, but they certainly help.
  Here is the thing. In President Trump's budget, zero--he zeroed out 
every single one of those programs.
  I propose a major additional investment in our schools throughout 
this country, including title I schools, which are schools in lower 
income areas. That would be a huge boost to education throughout the 
country and to the city of Baltimore.
  As Senator Cardin said, we need to make investments in our national 
infrastructure. We have a great, thriving port in Baltimore with good-
paying jobs, so we need to expand it.
  There are so many things we can and should be doing, but the 
President, apparently, according to many, has this political strategy 
where he doesn't want to talk about those things. It is a political 
strategy that seeks to divide this country, not to unite this country. 
If you think about that, that is a pretty sick political strategy. It 
is sick for the country, sick for Maryland, and sick for Baltimore.
  So I hope all of us will work to focus on the things we can do to 
make Baltimore and Maryland and this country stronger and end this kind 
of divisive rhetoric. Part of ending it means speaking out against it 
when we see it. We need everybody in this body to join us in doing it.
  Again, I think when it comes to the city of Baltimore, it is going to 
rise way above the President's comments. It understands it has 
challenges, but it also understands it has a great future. Let us--all 
together--be part of a great future for Baltimore and this country, and 
that means coming together to serve the interests of all of our 
constituents.
  I thank the Senate for the time Senator Cardin and I have had here.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wyoming.


                            Budget Proposal

  Mr. ENZI. Mr. President, I rise to talk about the need to fix our 
broken budget and spending process.
  Picking up efforts we began in the 114th Congress, the Senate Budget 
Committee has spent the last several months holding hearings and 
meetings with Members of Congress, State officials, the administration, 
and stakeholder groups to listen to their budget

[[Page S5171]]

reform priorities. Along the way, we have collected a lot of good 
ideas.
  Today, I come to the floor to outline the fiscal reform plan that 
incorporates a lot of the feedback we received. It reflects suggestions 
from Members on both sides of the aisle and from groups that span the 
political spectrum. These reforms are not driven by politics but, 
instead, are rooted in fixing our broken budget and spending process in 
favor of a system that works for everyone.
  In developing this plan, my focus was on creating a durable system to 
substantially manage our country's finances, to improve transparency, 
to improve oversight, to improve accountability in the budget process, 
and to end the brinksmanship in our fiscal debates.
  I have broken the plan down into four separate discussion drafts, 
which I am sharing this week with Senate Budget Committee members. Each 
of the drafts tackles a different aspect of the broken budget and 
spending process.
  The first proposal is the most ambitious. It would reorient the 
budget process around long-term planning and shift the Federal 
Government to a biennial budgeting and spending system. There are 20 
States, including my home State of Wyoming, that have some form of 
biennial budgeting and appropriations. I have long believed that one of 
the most important reforms we could do at the Federal level would be to 
move to a biennial process to have the problem only every other year.
  The plan proposes to maintain the budget resolution as a concurrent 
resolution but with a few important changes.
  First, it would change how we write the budget. Topline discretionary 
figures would be clearly stated in the resolution, while mandatory 
spending would continue to be displayed on a portfolio basis. This new 
approach will allow each individual Member to have more of a say in the 
budget through the amendment process.

  Second, it would require the budget resolution to include debt-to-GDP 
targets to focus Congress on creating a path to stabilize our debt 
levels and sustainably manage our finances. It could even provide an 
estimate of anticipated revenues.
  Third, the plan would allow for, upon adoption of a concurrent 
resolution on the budget, the automatic enrollment of a bill that would 
set discretionary spending caps--something that has taken until right 
now to get done this year--enforced by both Congress and OMB and 
increase the debt limit in line with the levels assumed in the 
resolution. It saves a lot of time.
  The proposal seeks to encourage Congress and the President to reach 
agreement on a fiscal framework early in the budget process while 
maintaining the budget resolution as a congressional document. The 
budget resolution would be enforced whether or not the President signs 
the joint resolution.
  To encourage Congress to adhere to its budget blueprint, the proposal 
would create a special reconciliation process that would be triggered 
if the Congressional Budget Office finds that Congress is not on a path 
toward meeting the budget resolution's fiscal target that everybody 
voted on. This process would allow Congress to make surgical changes to 
achieve the debt target and could only be used for deficit reduction. 
The Byrd rule, which prohibits changes to Social Security in 
reconciliation, would apply.
  The plan also seeks to get legislative committees more involved in 
the budget process. It would require them, at the beginning of the 
process, to share their plans to address spending on unauthorized 
programs in their jurisdiction, as well as programs that Agency-based 
inspectors general and the Government Accountability Office have 
identified as ``in need of improvement.'' For that budget cycle, the 
committee would have to suggest a dollar amount for those programs 
listed as ``such sums.''
  It would change our committee's name to the Fiscal Control Committee 
to better reflect the committee's focus on setting spending and revenue 
guardrails. It would also require the chairs and ranking members of the 
Appropriations and Finance Committees, if not already members of the 
Fiscal Control Committee, to serve as nonvoting members of the 
committee. This change is intended to increase the input in the primary 
spending and taxing committees in developing fiscal plans.
  The second discussion draft I am releasing deals with congressional 
budget enforcement. Justice Louis Brandeis once wrote that ``sunlight 
is said to be the best disinfectant.'' In keeping with this principle, 
the proposal would require reports tracking Congress's adherence to its 
budget plan to be regularly printed in the Congressional Record and 
posted on a publicly accessible website. This would help ensure that 
Members of Congress and the leadership of each committee are 
accountable for their fiscal decisions.
  The other two components of this draft deal with Senate budget points 
of order, which are the means through which the body enforces 
congressional budgets and rules. These points of order are supposed to 
create a meaningful obstacle to breaching the budget, but in recent 
years they have been routinely ignored or waived.
  The discussion draft proposes to make it harder to rewrite 
``inconvenient'' budget rules. There have been a number of attempts in 
recent years to rewrite budget rules outside of the normal budget 
process to allow for more spending. There is already a point of order 
against this practice under the Congressional Budget Act, but that 
point of order lies against the whole measure, making it a very blunt 
instrument. The discussion draft would make the current point of order 
surgical so it would target only the offending provision without 
threatening to shut down the whole bill.
  In a similar vein, the discussion draft would disallow global waivers 
for surgical points of order. Right now, any Senator can make a single 
motion to waive all budget points of order that lie against a measure. 
These global waivers allow numerous budget rules to be broken with one 
vote, regardless of whether the points of order that lie are surgical 
or apply to the whole measure. These waivers have even been used to 
preemptively prevent surgical points of order that could alter the bill 
text from being raised. The discussion draft aims to end that practice 
and ensure the ability of Senators to raise points of order that could 
remedy a budget violation without killing the bill.
  The third discussion draft I am releasing deals with Congressional 
Budget Office operations and transparency. The CBO serves a vital role 
in the budget and legislative processes. While the Agency's 
longstanding mission has been to produce timely, objective, and 
accurate information for Congress, there have been growing calls for 
increased transparency in the estimating process. The discussion draft 
aims to build on bipartisan transparency reforms already underway at 
the CBO in a number of ways.
  No. 1, it would require CBO to report on its transparency 
initiatives, review past estimates to see where the Agency got it right 
or got it wrong, and produce underlying data for its estimates of major 
legislation.
  No. 2, it would require interest costs to be included as supplemental 
information in cost estimates, ensuring that lawmakers and the public 
have better information about the true costs of legislation.
  No. 3, it would require public cost estimates of appropriations 
legislation. Unlike legislation reported from authorizing committees, 
there is not currently a requirement for CBO to provide public 
estimates of legislation reported by the Appropriations Committee.
  No. 4, it would require CBO and the Government Accountability Office 
to conduct ongoing portfolio reviews of Federal programs to help 
lawmakers identify spending on duplicative, overlapping, and fragmented 
programs, as well as long-term funding trends and liabilities.
  That was my third discussion draft.
  My fourth discussion draft relates to how budget resolutions are 
considered on the Senate floor. The Congressional Budget Act provides 
special expedited procedures for consideration of a budget resolution 
on the Senate floor. These procedures were meant to ensure that the 
budget is considered and adopted in a deliberate but efficient manner. 
However, arcane floor procedures and a quirk of the act have undermined 
this intent by allowing a

[[Page S5172]]

marathon of votes known as a vote-arama. Once debate on the budget has 
ended, we have a vote-arama. Without time for debate or analysis of 
what is being proposed, this process is not conducive to substantive 
consideration of fiscal policy and serves as a major deterrent to 
considering a budget on the floor. The discussion draft aims to 
establish a more orderly process for Senate consideration of the budget 
resolution that ensures the ability of Senators from both sides of 
the aisle to offer and have votes on amendments.

  It would change the current 50-hour rule on debate of a budget 
resolution to a limit on consideration and force the Senate to consider 
amendments after all allotted general debate time expires. Amendments 
would alternate between those offered by the minority and those offered 
by the majority, and the maximum debate time on the first-degree 
amendments would be reduced from 2 hours to 1 hour, to allow for the 
consideration of more amendments.
  Under this proposal, even if the maximum debate time was burned on 
each amendment, 24 amendments could be considered. Coincidentally, 24 
is both the average and the median number of rollcall votes on budget 
resolutions since 1976. Of course, it isn't 1 minute of debate. It 
would be an hour of debate.
  This proposal would apply only to the Senate consideration of budget 
resolutions. It would not preclude adoption of a managers' package, 
apply to reconciliation bills, or change House procedures.
  We can all agree that the current budget and spending system has 
broken down. Reforming this dysfunctional system has been a goal of 
mine since entering the Senate and is one of my top priorities before I 
leave this body at the end of this Congress.
  I encourage my colleagues to consider the reform ideas I have laid 
out today and invite their feedback. I am hopeful that through this 
process, we will be able to reach bipartisan agreement to end the 
current dysfunction and put our country back toward a sustainable 
fiscal future--and on time so we will not have government shutdowns.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from West Virginia.


              America's Transportation Infrastructure Act

  Mrs. CAPITO. Mr. President, yesterday I joined the fellow leaders of 
the Environment and Public Works Committee to introduce America's 
Transportation Infrastructure Act, a 5-year reauthorization bill that 
would deliver resources to repair and maintain critical surface 
transportation infrastructure.
  Today the committee approved our comprehensive legislation with a 
strong bipartisan vote of 21 to 0 this morning.
  As the chair of the EPW's Transportation and Infrastructure 
Subcommittee, I am incredibly proud of this legislation, which is the 
result of months of serious negotiations with the full committee 
chairman, Senator Barrasso, and Ranking Member Carper, my subcommittee, 
and my ranking member, Senator Cardin of Maryland.
  It was not always easy, but I think we have produced a bill that 
achieves our priorities and secures needed investments in our Nation's 
infrastructure. First and foremost, the bill provides additional 
funding for highway investment. How many times do we hear: We don't 
have enough money to complete this. We can't get it done.
  This also maintains the States' shares through formula dollars. That 
means a rising tide lifts all boats, whether a State is urban or rural, 
like my home State of West Virginia.
  The majority of these funds--90 percent--are distributed by the 
formula to the States, providing maximum flexibility to our State 
programs, and with a full 5-year reauthorization, State DOTs will have 
the certainty they need to plan their investments without fear of 
lapses in their contracting authority. After all, it is the States, not 
the bureaucrats in Washington, that know their communities' needs the 
best.
  Our legislation would get rid of some of the obstacles the States 
face as they work to start and finalize infrastructure plans. They take 
forever, and they cost so much. The bill incorporates the Trump 
administration's focus on One Federal Decision. Under that policy, the 
U.S. Department of Transportation is in charge of leading the 
regulatory review process--One Federal Decision--and it would 
consolidate the review of other Federal agencies like the EPA, the 
Corps of Engineers, and others who weigh in on these projects. That 
means the States will not end up in a regulatory purgatory, going back 
and forth from agency to agency seeking endless approvals.
  DOT would also maintain a Federal dashboard system so the States can 
see where they stand in the process.
  America's Transportation Infrastructure Act directs the Department of 
Transportation to work to complete its review process within 2 years 
and to push other agencies to expedite their regulatory reviews. 
Everything drags on so much, and it makes it so long and expensive. 
This would push our agencies to expedite their regulatory reviews under 
its own categorical exclusions. That is a fancy term for when the 
Department doesn't think a full, costly, and time-consuming permitting 
process is necessary for a straightforward infrastructure project such 
as replacing a bridge from right where it is and putting a new bridge 
right where it is. It takes forever. So we would eliminate that.
  We also worked in a bipartisan way to promote natural infrastructure 
that will help reduce costs and timelines, diminish environmental 
impacts, and improve the resiliency of our infrastructure to natural 
disasters such as floods that are so common in my part of the country.
  West Virginia has the unfortunate title of being in the top five 
States of structurally deficient bridges. That is why I am very proud 
that America's Transportation and Infrastructure Act includes language 
I cosponsored with Senator Brown implementing the new Bridge Investment 
Program.
  This program will infuse $6 billion over 5 years in additional 
funding to fix bridges in poor condition--dedicated funding that is 
essential to addressing this problem.
  When faced with the decision on using scarce taxpayer dollars on a 
new highway expansion or improving bridge safety, too often--it is too 
tempting--States opt for the appeal of a ribbon-cutting on a new 
stretch of highway. Now, hopefully, they won't have to make that choice 
and we can reduce both congestion and the odds of a bridge failure--
something that not only threatens our lives but also cuts off a 
community while they wait for a costly replacement.
  The climate and resilience portion of America's Transportation 
Infrastructure Act will reduce emissions from the transportation sector 
and ensure that the taxpayers are not repeatedly replacing 
infrastructure affected by natural disasters.
  This portion of the bill also includes important bipartisan 
legislation that I cosponsored. The first is called the USE IT Act. 
This would facilitate the deployment of carbon capture, utilization, 
and storage technologies by reducing regulatory obligations that the 
project stakeholders would face. It also includes the Diesel Emissions 
Reduction Act, which will provide funding to States and communities to 
replace older, smog-producing vehicles--like obsolete schoolbuses--with 
modern vehicles that use diesel, propane, natural gas, and electricity.
  Most importantly for West Virginia and for broader Appalachia, this 
legislation includes several provisions, which I wrote, to accelerate 
the completion of the Appalachian Development Highway System and 
reauthorize the economic development activities of the Appalachian 
Regional Commission. The commission was first authorized in 1965. The 
Appalachian Development Highway System was designed to better integrate 
our region with the Midwest, Northeast, Mid-Atlantic, and South. For an 
economically-distressed area with communities that are relatively 
isolated, this infrastructure network is vital. It is vital for 
attracting investment, creating new economic opportunities, and 
improving quality of life.
  The Appalachian Regional Commission has found that the highway system 
has already created and supported more than 168,000 jobs and generated 
$7.8 billion in wage income that otherwise would not have existed. 
Those wages, in turn, drive local and Federal

[[Page S5173]]

tax bases. Completing this system would generate an additional $8.7 
billion in annual economic activity. It would support another 46,000 
jobs and lead to an additional $2.7 billion in worker income. These are 
very significant numbers. I can't really overstate the impact this 
additional economic activity would have in our region.
  Unfortunately, the Appalachian Development Highway System is only 90 
percent complete. The remaining 10 percent generally represents the 
most challenging mountain terrain, and that means these are the 
costliest and most environmentally complicated miles to complete. We 
have to get this done.
  The highway system was started almost 55 years ago. America is better 
than letting an infrastructure priority just sit around for more than 
half a century with no end in sight due to lack of funding or 
regulatory uncertainty. This was also a promise made to the people of 
Appalachia.
  The Appalachian Development Highway System completion was identified 
as being in our national interest in the last two highway bills. But it 
is America's Transportation Infrastructure Act that will actually 
provide a mechanism to move us toward the finish line.
  Beyond the regulatory reforms I just spoke about, my language allows 
States that for whatever reason have accrued significant Appalachian 
Development Highway System balances to exchange those dollars with 
States like West Virginia that are still working to complete projects, 
like our Corridor H. But we lack the resources to engineer and 
construct these challenging remaining miles. In return, those States 
that turn their dollars back in to the Appalachian Development Highway 
System will receive dollars that they could use for any project in 
their State that would otherwise be eligible as a Federal highway 
project. That means that States can respond to the changing 
transportation needs in their particular area. They use excess dollars 
from an undersubscribed Federal loan program, which has historically 
not contributed to infrastructure investment in rural America.
  This would be a win for all States involved. Those needing additional 
funding will be able to continue to advance the Appalachian Development 
Highway System, and States that have needed to shift their focus--say 
on growing urban transportation needs--will have the added flexibility 
to be able to do that.
  I appreciate my fellow Appalachian Development Highway System State 
committee colleagues for working with me to include this provision, as 
well as Leader McConnell's support on this section of the bill and our 
counterpart legislation, the Advancing Infrastructure Development in 
Appalachia Act.
  The committee also included language that I wrote and worked with 
those individuals on to reauthorize the Appalachian Regional 
Commission--a key economic development agency--at $180 million a year. 
My provision also doubles to $20 million the funding available for 
something that I care deeply about, and that is broadband deployment in 
Appalachia, which is a critical tool for connecting our communities and 
making and keeping our region more competitive.
  I thank Leader McConnell and Ranking Member Cardin and Senator Wicker 
for their support of this language and the stand-alone ARC 
authorization bill.
  Leader McConnell also joined me in authorizing the ARC to provide up 
to $5 million in grants to support the development of a central 
Appalachian natural gas liquids storage hub, along with the associated 
downstream manufacturing sector for it. This infrastructure project 
would be huge for the economies of West Virginia, Kentucky, 
Pennsylvania, and Ohio. In fact, the American Chemistry Council 
estimates that this regional market and downstream manufacturing would 
generate $36 billion in capital investment and more than 100,000 jobs. 
It would also help keep a much larger share of the economic value and 
employment opportunity in our States where the resources are, compared 
to just producing and then exporting the gas and associated natural gas 
liquids to other parts of the country or abroad.
  Secretary Perry and the Department of Energy have also endorsed the 
concept of this project, as well as the significant economic and energy 
security dividends that it would pay for Appalachia and the entire 
United States.
  This is somewhat of a modest investment given the significant private 
sector capital needed to build this out, but it is essential that the 
Federal Government send clear messages to potential investors that it 
supports this driver of economic growth in an area that would greatly 
benefit.

  This legislation gives the ARC the power to lead the way.
  Investment in our country's infrastructure is vital to the many 
aspects of our American life, from keeping us competitive in the global 
economy and keeping our drivers safe--there are a lot of safety aspects 
in this bill--to reducing irritating congestion and minimizing impacts 
to the economy.
  America's Transportation Infrastructure Act delivers on all these 
fronts and ensures that rural America will benefit equally from these 
investments. Not only will our legislation help rebuild and repair our 
infrastructure system, but it will also help us create new 
infrastructure opportunities for generations to come.
  I appreciate my colleagues' collaboration. My colleague from Rhode 
Island is on the floor. He was on the committee this morning when we 
both voted in favor of this legislation. It is a bipartisan bill 
working to make sure that this country sees a 5-year highway 
reauthorization and all the benefits it would provide.
  I think all my Senate colleagues will find a lot to like in this 
legislation. I am hoping we get it on the floor in the fall. I 
encourage their support when it comes time for a vote.
  I yield the floor.
  The PRESIDING OFFICER (Ms. McSally). The Senator from Rhode Island.
  Mr. WHITEHOUSE. Madam President, I thank the distinguished Senator 
from West Virginia for her work on the highway bill that we voted out 
of the Environment and Public Works Committee today and on our 
industrial emissions bill and on carbon capture. It has been a terrific 
working relationship.


            Tribute to Dr. Kim Binsted and Dr. Ryan Edwards

  Madam President, as I begin my 251st ``Time to Wake Up'' remarks, I 
would like to thank two AAAS fellows who will be shortly leaving my 
office.
  Dr. Kim Binsted came to us from the University of Hawaii, where she 
was principal investigator on the NASA-sponsored Hi-Seas project, 
studying conditions like those that astronauts would encounter on Mars. 
Next month, she returns to Hawaii to continue her research.
  Dr. Ryan Edwards joined us after completing his Ph.D. at Princeton 
University, where he studied carbon capture and storage. He hails from 
Australia and is thus by far the best cricket player on my staff--low 
bar. Next up for him will be Houston and more carbon capture research.
  I thank both of them for their service and their expertise, and I 
wish them the best.


                             Climate Change

  Madam President, tomorrow, about 2\1/2\ miles from here, executives 
from some of the biggest fossil fuel companies in the world will be 
meeting at the U.S. Chamber of Commerce. It is a power-packed event. 
The chamber is the most powerful lobbying force here in Washington and 
a fierce political operator. The fossil fuel industry runs remorseless 
and often covert political operations. They are defending a $650 
billion annual subsidy, as the International Monetary Fund estimates, 
so hundreds of millions spent on lobbying and election mischief is 
money well spent: The Chamber and Big Oil together have stopped climate 
progress here.
  For the member companies of the chamber, including companies that say 
they support climate action, it is time to confront the relationship 
between the chamber and the fossil fuel industry. The Earth is spinning 
toward climate catastrophe. Action in Congress to limit carbon 
pollution is essential to averting this catastrophe. Yet the chamber, 
according to the watchdog InfluenceMap, is in a virtual tie as the most 
obstructive group on climate change, blocking legislation, opposing 
Executive action, and even seeking to undermine climate science. The 
chamber is so obstructive, it would be better called the Chamber of 
Carbon.
  The chamber has opposed one comprehensive climate bill after 
another--

[[Page S5174]]

first, the bipartisan cap-and-trade bill in 2005, the Energy Policy 
Act. The chamber helped defeat it with a Key Vote Alert--a signal that 
whoever voted in favor of the bill could face an onslaught of Chamber 
political attacks in the next election.
  In 2007, the chamber ran political TV ads against climate 
legislation, claiming that it would prevent people from heating their 
homes or that they wouldn't be able to drive to work any longer. Here 
is somebody cooking an egg over candles.
  In 2009, the chamber led the charge against the Waxman-Markey bill. 
For that legislation, the chamber pulled out all the stops--haranguing 
Members, more ``vote alerts'' and ``how they voted'' scorecards, 
sending more messages of election doom if they dared to support Waxman-
Markey. Since the U.S. Chamber tanked Waxman-Markey, Republicans in 
Congress have refused to hold hearings on, mark up, debate, or vote on 
any legislation proposing a policy framework for economy-wide 
reductions in carbon pollution.
  It is not just in Congress that the chamber wields its baleful 
influence; the chamber also fought climate action in the courts and at 
the executive branch. In fact, in 2010, the chamber sued the EPA to 
overturn the finding that greenhouse gas emissions endanger public 
health and welfare. You would think it would be obvious that they do. 
Look around, and you will see that they do. Disabling the endangerment 
finding would cripple the Agency's ability to regulate carbon pollution 
under the Clean Air Act, so off went the chamber.
  When the courts rejected this lawsuit on the endangerment finding, 
then the chamber became central command for corporate lawyers, coal 
lobbyists, and Republican political strategists to devise legal schemes 
to fight climate regulations. This produced another chamber lawsuit to 
block the Clean Power Plan reducing carbon pollution from powerplants.
  Of course, once President Trump took office, the chamber went from 
defense to offense and attacked many Obama administration rules 
limiting carbon pollution. The chamber even funded the phony report the 
Trump administration used to justify leaving the Paris accord.
  Perhaps, worst of all, the Chamber has fought against science itself. 
It has proposed putting the evidence--the scientific evidence--of 
climate change on trial in what its own officials have branded the 
``Scopes monkey trial of the 21st century.'' That is what this crowd 
was for. Indeed, the Chamber has said the trial ``would be evolution 
versus creationism.'' Guess what side it would be on.
  This is not your hometown Chamber, folks.
  The Chamber has even tried to limit the scientific studies that 
regulators could consider. The Chamber's evident target was public 
health studies that demonstrate just how dangerous burning fossil fuels 
is to public health. The Chamber is an electioneering force, not just a 
lobbying force, and it spends massive sums in politics to shore up its 
control in Congress. Since the 2010 Citizens United decision has 
allowed outside groups to spend unlimited sums on electioneering 
activities, the Chamber has funneled, roughly, $150 million into 
congressional races, which has made the Chamber the largest distributor 
of undisclosed donations--dark money, we call it--in congressional 
races.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. WHITEHOUSE. I ask unanimous consent to speak for an additional 5 
minutes.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. WHITEHOUSE. I thank the Presiding Officer. I appreciate that 
courtesy.
  Blocking action on climate has been the central focus of the 
Chamber's campaign spending. It ran this ad in Pennsylvania in 2016. 
Two moms watch their children on a playground. One comments on how much 
energy the children have. The other says: Oh, don't say that. The 
candidate wants to tax that energy. The ad gets even weirder when a 
faceless woman arrives in a car and steps out toward the children. 
Alarmed, one of the mothers yells the ad's punch line: ``Run, Jimmy. 
Run.'' Classy stuff. I wonder who the Chamber was fronting for.
  So how does the Chamber's anti-climate crusade square with its big 
corporate members?
  It has members like Coke and Pepsi, which have good internal climate 
policies and websites that are full of commitments to reduce corporate 
carbon footprints, and they have signed letters on climate action.
  Pepsi signed the Ceres BICEP Climate Declaration. Coke plans to 
reduce CO2 emissions by 25 percent. It says it ``will work 
to reduce the greenhouse gas emissions across its value chain, making 
comprehensive carbon footprint reductions across its manufacturing 
processes, packaging formats, delivery fleet, refrigeration equipment 
and ingredient sourcing.''
  Yet both Coke and Pepsi fund the Chamber of Commerce, and they fund 
the American Beverage Association, which, in turn, runs more money to 
the U.S. Chamber of Commerce. The end result? Two companies that are 
actively reducing their carbon emissions and that enthusiastically 
support good climate policy have the position in Congress, via their 
funding of the Chamber, of opposing climate action here in Washington--
the place where it really counts.
  Verizon has reduced its carbon intensity by 28 percent since 2016, 
and its CEO has publicly stated Verizon's commitment to combat climate 
change. Yet Verizon, too, funds the Chamber's obstruction.
  Then there is Google with its motto: ``Don't be evil.'' Google is 
warning its investors that climate change threatens its systems. It 
says that it is vulnerable to damage or interruption from natural 
disasters and to the effects of climate change, such as sea level rise, 
drought, flooding, wildfires, and increased storm severity. Google has 
signed pledges to fight climate change; yet Google, too, funds the 
Chamber's anti-climate crusade.
  Coke, Pepsi, Verizon, and Google are just four examples among many. 
These companies say they support climate action but fund one of climate 
action's worst opponents.
  Why does the Chamber put these members in this position? The best 
explanation I have is that the fossil fuel industry is secretly calling 
the shots at the Chamber; that is, it is secretly funding the Chamber. 
That would explain the Chamber's refusal to disclose its funders.
  I think this is a governance issue now for these companies, 
particularly for those members who serve on the Chamber's board. Board 
members of nonprofit organizations have a common law duty of care. Not 
knowing who is funding your organization looks like a breach of that 
duty of care.
  The Chamber's member companies need to ask themselves: Do we know who 
is funding the Chamber? Do we know how much each donor is giving? Do 
those donations explain the Chamber's years of obstruction?
  The Chamber holds itself out as a business association. Another 
question: Why is it accepting money from nonbusinesses?
  In 2012 and 2014, the Chamber took at least $5.5 million from front 
groups that have been backed by the Koch brothers. In 2014, it took 
$5.25 million from a front group that was affiliated with Karl Rove.
  Did the Chamber's board members know this? Did they exercise the 
proper duty of care? Do they know what nonbusiness money is funding the 
Chamber these days? Do they know what percentage of the Chamber's 
funding comes secretly from fossil fuel interests?
  I don't think the Chamber's board members know the answers to any of 
these questions.
  Here is a question for the general counsel of these board member 
corporations: Should they know or are you going to go with willful 
ignorance? Good luck with that.
  The bottom line is simple. Chamber board members with good climate 
policies are supporting one of the worst climate obstructors in 
America. Indeed, they are writing big checks to do so. This, I believe, 
is not just a moral problem but a governance problem. If these 
companies aren't asking these tough questions and if they are not 
pushing the Chamber to be transparent about its funding sources, they 
are answerable. Until this mess gets sorted out, in spite of all of 
corporate America's efforts to reduce emissions, its

[[Page S5175]]

funding of the ``U.S. Chamber of Carbon'' means that corporate America 
is doing more harm than good for our climate.
  Again, I thank the distinguished Senator from Oklahoma for his 
courtesy in allowing me the extra time.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oklahoma
  Mr. INHOFE. Madam President, first of all, despite what some people 
might think, I have the highest regard for the Senator from Rhode 
Island.
  It is very interesting in that the climate is changing, and the 
climate has always changed. All evidence out there--all historical 
evidence, all scriptural evidence--tells us over and over again that 
the climate is changing. It always has been changing, and it always 
will change.
  The good news is that the world is not coming to an end because of 
climate change. That is because the climate is always changing. So, for 
those people who believe the world is coming to an end because of 
greenhouse gas emissions, the good news is it is not. I am happy to 
share that good news with you.


                     Bipartisan Budget Act of 2019

  Madam President, I am here to speak about some other good news, which 
is that we have an opportunity with a vote that is coming up. Some 
people call it the budget vote or the budget agreement. I don't refer 
to it as such. I call it a defense agreement. I think everybody knows 
where I stand on this. This is a vote that is going to have to come up 
before too long, and there is a unique group of people in the U.S. 
Senate who know the reason that we have to pass the defense budget. 
They are the members of the Senate's Committee on Armed Services. It 
happens that I chair that committee and that we have done really great 
work.
  I ask unanimous consent to speak as in morning business for such time 
as I may consume.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. INHOFE. Madam President, we had a situation in which we went 
through an 8-year period of time when our military was somewhat 
devastated, and I want to share some of the specifics of that because 
it is a serious thing. We are going to be voting on the defense budget 
agreement, and I have already stated where I stand on it. I am here to 
outline why the budget agreement is necessary for our national defense.
  This defense budget agreement will be able to focus on the Senate's 
Armed Services' top priorities, one of which is to fix the on-base 
privatization of military housing.
  Remember that this happened about 6 months ago. We discovered, all of 
a sudden, that we were not doing a good job on our privatized housing. 
Hey, I have to admit that I am partly responsible for that because I 
was around here when we decided to privatize the housing. It did work 
for a while. I think, after a period of time, people got a little 
careless, and there was a little slack. Some of the contractors who 
made that commitment got a little bit greedy. This information as to 
how bad the conditions were came from a person at Tinker Air Force Base 
who was the spouse of a military person. When I first heard this, I 
thought there were bad conditions just in my State of Oklahoma, but 
there were not; they were all over the Nation.
  So we fixed that thing. We fixed it with our defense authorization 
bill, and we had a lot of provisions in there. We are now modernizing 
our military housing in a way that is going to be good for all of our 
spouses and others who are forced to live there. For some reason, if 
our defense budget agreement were to go down in flames and not be 
passed, there wouldn't be the modernizing of our military or the giving 
to our troops a well-deserved pay raise, and they have not had a pay 
raise in a long time. This is going to be the largest pay raise for our 
military people in the last 10 years. It is a good thing.
  By the way, people are always talking about how we can be so 
concerned about building our military when we have China and Russia 
that have passed us up in many areas and spend just a fraction of the 
amount. The reason is very simple, which is that China and Russia are 
countries that don't have to do anything for their soldiers. We take 
care of ours. We try to provide good housing. We provide the types of 
things that our all-volunteer force can be very proud of and are very 
proud of. That is something we have to incur. The largest single 
expenditure that we have in the military is end strength--the people 
out there. Communist countries--China, Russia--don't have to worry 
about that. ``Here is a gun. Go out and kill somebody.'' We don't have 
that luxury, and we wouldn't do that if we wanted to.
  If we don't pass this budget bill, the effects on the military will 
be devastating. Let me just share a couple of things that would happen.
  We would force the Department of Defense to operate under a 
continuing resolution, which would shortchange our troops and waste 
taxpayer dollars. We all know that. We would face destructive, 
haphazard cuts in sequestration. What is it we hear on our committee? 
The Presiding Officer is fully familiar, for she is one of the most 
loyal members of the Senate's Committee on Armed Services. We have 
posture hearings for about 6 months at the beginning of every year with 
the leaders of the various branches of the military--General Votel, 
Gen. Thomas Waldhauser, ADM Craig Faller, ADM Phil Davidson, all of 
these people.
  What do they tell us?
  They tell us, if we don't actually start funding our military again, 
we are going to have sequestration. Look, if we vote for this thing and 
pass it, we will end the sequestration problems and threats forever. It 
will not happen again.
  What else do they tell us?
  They tell us that a CR, which is a continuing resolution, would be an 
absolute disaster. A lot of people in this body don't know this, but 
every member of the Senate's Committee on Armed Services does know this 
because they were there.
  All of these people--16 leaders--come in for posture hearings each 
year, and we know the problems we are having and the problems we are 
confronted with. We would be faced with cuts in sequestration.
  This document right here is the ``Assessment and Recommendations of 
the National Defense Strategy Commission.'' Here it is right here. This 
is our blueprint of what we are doing to save America and to put us 
back on top in all of these areas in which we are deficient. If, for 
some reason, we don't pass this defense budget agreement, then we will 
not be able to continue the implementation of the national defense 
strategy, and we all know that. Certainly, we don't all know that, but 
the members of the Senate's Committee on Armed Services do know that.
  So that is what would happen. But what would this mean? The members 
of the Armed Services Committee know what it means, but for everybody 
else, the deficit budget deal would end the threat of sequestration 
forever. You don't need me to tell you that sequestration would be 
devastating.
  General Milley, just confirmed to be the Chairman of the Joints Chief 
of Staff, said that the levels of funding caused by sequestration would 
place America ``at great risk.''
  Remember, unfortunately, Heather Wilson, the former Air Force 
Secretary who had to leave her position. She said the cuts would be 
``absolutely devastating in scope and scale.''
  If we were hit by sequestration, there would be an across-the-board 
cut of $71 billion to the defense programs. That would halt our 
progress on the Space Command and developing crucial capabilities like 
hypersonic weapons and artificial intelligence. Those are two areas 
where we have actually been passed up by both Russia and China.
  Just yesterday, the DARPA announced that they have completed a 
successful design review of a hypersonic weapons program. Now, that is 
a good first step. I am really glad because we were way ahead of them 
back before the last administration came into office, and then, all of 
a sudden, over that period of time, we got behind. So, meanwhile, China 
and Russia are already testing their hypersonic weapons, and they are 
ahead of us. We are just trying to catch up, and that is what this 
budget vote is all about.
  The 2020 NDAA invests in hypersonic weapons, but we can't move 
forward if we are hit by sequestration. It would mean it would set us 
even further behind.

[[Page S5176]]

  By the way, the hypersonics that we are talking about are the state 
of the art. That is a new thing. That is a weaponry that moves at five 
times the speed of sound, and here we are, allowing our--I don't want 
to characterize China and Russia as enemies. They are not enemies, but 
they are certainly on the other side, and people are in shock when they 
find out that they have something that we don't have. We have to be 
competitive with them, and we are going to be if we pass this defense 
budget vote that we are going to have before us.
  So another example, in our NDAA that we passed overwhelmingly just 
last month, it authorized a 3.1-percent pay raise, or increase, for our 
troops. They deserve that pay raise, and under sequestration that pay 
raise is at risk.
  The ability for basing facilities to receive the next generation of 
aircraft is also at risk. If your State is like my State, your State is 
slated to house the F-35 or the T-X trainer or the KC-46. The KC-46 is 
a system that is going to replace the KC-135, which has been in place 
now for over 50 years and so is 50 years old. That is a system, and if 
you were going to have one of these systems in your State, you may not 
get it because of this deal. Without the budget vote that is going to 
take place, we wouldn't be able to move forward with our plan, and we 
would be hit by sequestration. It could all be over.
  I am talking about systems like the F-35, which we talk about every 
day, and the T-X trainer. We have had the trainers in existence now for 
some 50 years, and the KC-46, the same thing.
  So, anyway, that is what would happen if for some reason we vote 
against and don't pass the defense bill that we are going to be asked 
to vote on probably tomorrow.
  We have also made plans to continue increasing our end strength by 
17,000 troops from the Obama era to our current goal, and without this 
defense budget deal, that wouldn't be possible. I think we all know it.
  Now, maybe we don't all know it in this Chamber, but as for every 
member of the defense authorization committee, the Senate Armed 
Services Committee, they all know because they have been told over and 
over, and that is why it is so important that they be very responsible 
in their vote.
  It would be kind of hard to say that you are working for the defense 
of our Nation and then turn around and vote to gut their funding.
  Now, we have made remarkable gains in readiness over the past couple 
of years, thanks to President Trump's leadership and greater budgetary 
stability. For just one example, at the end of the Obama 
administration, only 5 percent of our brigade combat teams were ready 
to what they call ``fight tonight''--only 5 percent.
  Now, we have made a huge improvement. That is up to 50 percent now 
after just 2 years of this administration, but we have a lot more to 
do. All the improvements we have made in fiscal years 2018 and 2019 
would be at risk if we were not able to go forward and pass our defense 
budget act that we are going to be asked to support.
  Sequestration would undo what we have done and take us back where we 
were before. It would be abandoning our troops right when we said we 
would be there for them. A continuing resolution means funding will go 
to the wrong places--places that were important last year but don't 
need to be funded this year. That is just wasteful. We all understand 
that, but a continuing resolution would be especially devastating for 
the military.
  Every one of these military people whom I was just reading about came 
in for their annual meeting. They all said the same thing: It would be 
devastating if we had to go into a continuing resolution. We would be 
forced to do programs that otherwise we would not be doing.
  So General Dunford said it himself. He said: ``The fact that we have 
routinely not had a budget at the beginning of the year has delayed new 
starts, and it's been incredibly inefficient in how we prioritize and 
allocate resources throughout the year.'' That was General Dunford.
  A continuing resolution means that our military will lose key 
planning ability. David Norquist, nominated to be the Deputy Secretary 
of Defense, gave a great example to the Senate Armed Services Committee 
last week. He said: Let's say a unit is planning right now for some 
training in October, but we are operating under a continuing 
resolution. At that time, they will cancel training because they don't 
know how much money they would be getting in order to accomplish that. 
We may eventually get more money, but in the meantime we will have lost 
a month in the process.

  With sequestration off the table and with a stable 2-year budget deal 
in place, the Department of Defense can move forward with what is 
really important: implementing the National Defense Strategy. This is 
what my committee has been focusing on all year. We are facing a 
different, more dangerous world than we were 10 years ago.
  I look back wistfully. I have said this many times. I look back 
wistfully at the days of the Cold War. We had two super powers. We knew 
what they had, and they knew what we had--mutually assured destruction. 
It doesn't mean anything anymore. You have countries that are run by 
people that are mentally deficient having the capability of blowing up 
one of our American cities. It is a scary world out there. That is what 
we are doing. That is why it is so important that we pass this budget, 
because our defense is depending on it.
  Not everybody knows this, but the members of the Armed Services 
Committee do know it. We are falling behind China and Russia as they 
continue to build their militaries. We are seeing persistent threats 
from North Korea, from Iran, from the terrorist groups, and we no 
longer have the best of everything, and most people don't understand 
that. Of course the members of our committee do understand that.
  We have set clear priorities, and now we need to fund it. The future 
of our Nation is at stake. This is what it will take to regain the 
qualitative and quantitative advantages that we have lost.
  I would have liked to have seen even more funding provided to this. 
The National Defense Strategy Commission--by the way, they set up a 
system that they can use, and that system is that we should be putting 
together between a 3- and a 5-percent increase over inflation, but we 
have not done it. We have not done it even with the budget that we are 
working on now.
  The National Defense Strategy Commission, which is nonpartisan, has 
said that 3 to 5 percent growth is what is needed, and that is what we 
did not do.
  But at the end of the day, I am willing to take this smaller than 
ideal increase and give our military what it needs--predictability. It 
is also more than what the House passed in their Defense authorization 
bill, which was dangerously low.
  Every member of Armed Services Committee should vote for this defense 
budget because they know everything we have been talking about. They 
know that we are outranged and outgunned in artillery. They know that 
we are at a disadvantage in air defense, having only two Active-Duty 
battalions. Nuclear Triad modernization has not been taking place. We 
aren't there. China and Russia are.
  So, anyway, what I am trying to impress upon you is that those 
individuals who are members of the committee are fully aware of the 
problems we have had. They remember that under the Obama 
administration, at the end of the Obama administration, our Air Force 
was short 2,000 pilots, and 1,500 of them were fighter pilots. Only 
one-third of our brigade combat teams, one-fourth of our aviation 
brigades, and half of our divisions were ready. Also, 60 percent of our 
F-18s weren't flyable. This is what we are in the process of 
correcting, and it is all dependent upon the passage of this budget.
  So I would say to those individuals who are on the committee, I can't 
imagine that any of them would not be supporting this defense budget 
when it comes up, and I would hope that we don't have members of our 
committee who are anticipating doing things such as hearings back in 
their State or amendments to go as we put our Defense authorization 
bill through the next steps, because now is when our defense system 
needs to have this budget passed.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Iowa.

[[Page S5177]]

  

  Mr. GRASSLEY. Madam President, I ask unanimous consent to speak as in 
morning business for 15 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                        Prescription Drug Costs

  Mr. GRASSLEY. Madam President, I want to inform my colleagues and the 
American people about some progress that has been made on a very 
important bipartisan piece of legislation, plus what a couple other 
committees are doing along the same line of keeping healthcare costs 
down--that we are making progress to reduce the price of prescription 
medicine for the American people.
  I have been tilling the fields of legislative policy long enough to 
know that we have our work cut out for us. The ranking member and I of 
the Finance Committee started out 6 months ago to cultivate a 
bipartisan consensus for much needed reforms. We knew that we had a 
long row ahead. Our efforts to reduce drug prices face big-time 
opposition from Big Pharma.
  As we worked side by side in a Republican and Democratic way, we 
planted the seeds to grow a strong bipartisan coalition--one strong 
enough, I believe, to withstand the influence of moneyed special 
interests.
  Now, it should be no surprise to anybody that Big Pharma and other 
stakeholders in the drug supply chain are working six ways from Sunday 
to throw sand in our gears. We know they will continue to fight us 
during the August work period.
  As a lifelong farmer from Iowa, I learned a long time ago that the 
fruits of one's labor will not be worth a hill of beans without proper 
groundwork. For months, we have been tilling the soil and fertilizing 
the legislative fields to bear fruit at harvest time. We have teamed up 
with leadership of other key committees of jurisdiction.
  Together with the chairman and ranking member of the Senate Health 
Committee, Senators Lamar Alexander and Patty Murray, and the chairman 
and ranking member of the Senate Judiciary Committee, Senators Lindsey 
Graham and Dianne Feinstein, the Senate has a real opportunity this 
Congress to deliver meaningful reforms that would yield real savings 
for what Americans spend on healthcare.
  Both the Health and the Judiciary Committees have advanced 
legislative packages that help address drug prices, including bills I 
have sponsored, such as the CREATES Act, the Stop STALLING Act, and the 
Prescription Pricing for the People Act.
  Since January, the Finance Committee, which I chair, and Senator 
Wyden is the ranking member, has held a series of hearings to examine 
the vulnerabilities in the drug supply chain that are ripe for abuse. 
We don't have the answers to all the problems, but it is really crystal 
clear that a strong dose of transparency is desperately needed to shed 
light on a convoluted pricing system when dealing with prescription 
drugs.
  From the drug manufacturer to the patient's medicine cabinet, the 
drug supply chain is shrouded in secrecy and is exceedingly complex. 
This opaque pricing system has allowed exorbitant price hikes to climb 
higher and higher and higher, with no end in sight.
  Don't forget, the taxpayers of the United States foot the bill for 
the lion's share of prescription drugs through Medicare and Medicaid.
  The woolly drug supply chain allows taxpayers to be fleeced year 
after year. We need to let the sunshine in to help root out their 
abusive practices. Secrecy in the supply chain has grown into a noxious 
weed, damaging our free market ecosystem.
  Transparency is needed to help rein in unsustainable costs 
threatening the fiscal viability of Medicaid and Medicare. Seniors, 
individuals with disability, and low-income Americans depend on these 
programs for lifesaving medicine and innovative cures.
  Last week, the Senate Finance Committee approved the bipartisan 
Prescription Drug Price Reduction Act. The carefully sown Grassley-
Wyden bill limits seniors' out-of-pocket costs without limiting access 
to lifesaving cures Americans expect. It injects reasonable incentives 
in government prescription drug programs for drug manufacturers and 
insurers to keep prices low. Pharmaceutical companies and insurers need 
to have more skin in the game to keep prices down. It also fixes flawed 
policies that distort free market principles to lower the lid on 
spending.
  We all know in the town meetings and other places we go that 
Americans have spoken very loudly on this subject. They want high 
prescription drug prices addressed. Furthermore, Americans want 
Congress to act and to act now.
  The Senate Finance, HELP, and Judiciary Committees have acted. Now it 
is time to get the job done.
  As my fellow lawmakers go home over the August recess, I encourage 
each of you to share the good news with your constituents. Americans 
are fed up with sticker shock at the pharmacy counter. We have the 
opportunity to deliver a badly needed legislative remedy.
  First, we have to drain the swampy special interests blocking the 
path to victory. The moneyed players in the drug supply chain will use 
the August recess to unleash a public relations blitz against our 
bipartisan efforts. You can bet the farm that Big Pharma, hospitals, 
and pharmacy benefit managers will whip themselves into a real frenzy 
to kill these bipartisan reforms.
  Let's remember why we started down this path in the first place. It 
is simply democracy working, representative government working.
  Americans are demanding relief at the prescription counter. We hear 
it from our constituents in our town meetings, in our letters, in our 
emails, and in the phone calls we get. Unchecked drug prices are 
putting Medicare and Medicaid in financial peril. The payment structure 
is unmoored from fiscal reality, and the American taxpayer is on the 
hook. Congress has a real opportunity to do something about the 
spiraling of drug prices.
  For my colleagues who are on the fence about our bipartisan 
proposal--and there is nothing wrong with being on the fence because 
you have plenty of time to become acquainted with an issue you hear 
from your constituents all the time and to become acquainted with our 
solution--here are a series of questions I want you to ask yourself: Do 
Americans want us to act to reduce runaway drug prices? Do Americans 
want to keep access to breakthrough drug therapies and innovation? Do 
older Americans want protection from coverage gaps and out-of-pocket 
costs? Do people with disabilities and poor and elderly Americans who 
depend on Medicaid deserve access to innovative cures and next-
generation therapies?
  The answer to all of these questions, I think, is a resounding yes.
  Farmers are smart enough to make hay while the Sun shines. Let's 
apply that time-tested farm lesson in the Congress. Don't bail out on 
the opportunity to make a meaningful difference for the people whom we 
are elected to serve. Too many Americans are rationing or skipping 
doses because they can't afford their prescription medicines.
  I will finish as I started out by saying, on behalf of Senator Wyden, 
Senator Alexander, Senator Murray, Senator Graham, Senator Feinstein, 
and others, I suggest to our colleagues that this is our Goldilocks 
moment. Let's not let it be a gridlock moment. Our legislative reforms 
are not too far right and not too far left. That is what makes our 
bipartisan remedy to lower prescription drug prices just exactly right 
for the American people.
  I yield the floor.
  The PRESIDING OFFICER. The majority leader.


            Unanimous Consent Agreement--Executive Calendar

  Mr. McCONNELL. Madam President, I ask unanimous consent that 
notwithstanding rule XXII, following disposition of the Jordan 
nomination, the Senate vote on the motions to invoke cloture on the 
following nominations in the order listed: Executive Calendar Nos. 205, 
231, 232, 233, 326, 327, 345, 350, 352, and 364, and then up to 10 
minutes of debate under the control of Senator Menendez prior to the 
vote on cloture on Calendar No. 402. I further ask consent that if 
cloture is invoked, the confirmation votes on the nominations be at a 
time to be determined by the majority leader in consultation with the 
Democratic leader. Finally, I ask consent that the cloture motions on 
the following nominations be withdrawn: Executive Calendar Nos. 48, 55, 
344, 346, 351, and 394, and the Senate vote on the

[[Page S5178]]

nominations at a time to be determined by the majority leader in 
consultation with the Democratic leader.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.


                 Unanimous Consent Agreement--H.R. 3877

  Mr. McCONNELL. Madam President, as in legislative session, I ask 
unanimous consent that the cloture motion on the motion to proceed to 
H.R. 3877 be withdrawn and that at a time to be determined by the 
majority leader in consultation with the Democratic leader, the Senate 
proceed to the consideration of H.R. 3877. I further ask consent that 
notwithstanding rule XXII, if cloture is filed on H.R. 3877, there be 
up to 2 hours of debate, equally divided between the leaders or their 
designees. I ask consent that the only amendment in order be Paul 
amendment No. 932 and that following the use or yielding back of that 
time, the Senate vote on the amendment with a 60-affirmative-vote 
threshold needed for adoption. Finally, I ask consent that following 
the disposition of the Paul amendment, the Senate vote on the motion to 
invoke cloture and that if cloture is invoked, all postcloture time be 
considered expired.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.


                   Vote on Sean D. Jordan Nomination

  The PRESIDING OFFICER. All time has expired on the Jordan nomination.
  The question is, Will the Senate advise and consent to the Jordan 
nomination?
  Mr. McCONNELL. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The bill clerk called the roll.
  Mr. THUNE. The following Senators are necessarily absent: the Senator 
from Louisiana (Mr. Cassidy) and the Senator from Georgia (Mr. 
Isakson).
  Mr. DURBIN. I announce that the Senator from Colorado (Mr. Bennet), 
the Senator from New Jersey (Mr. Booker), the Senator from New York 
(Mrs. Gillibrand), the Senator from California (Ms. Harris), the 
Senator from Virginia (Mr. Kaine), the Senator from Minnesota (Ms. 
Klobuchar), the Senator from Massachusetts (Mr. Markey), the Senator 
from Vermont (Mr. Sanders), the Senator from Virginia (Mr. Warner), and 
the Senator from Massachusetts (Ms. Warren) are necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 54, nays 34, as follows:

                      [Rollcall Vote No. 241 Ex.]

                                YEAS--54

     Alexander
     Barrasso
     Blackburn
     Blunt
     Boozman
     Braun
     Burr
     Capito
     Collins
     Cornyn
     Cotton
     Cramer
     Crapo
     Cruz
     Daines
     Enzi
     Ernst
     Fischer
     Gardner
     Graham
     Grassley
     Hawley
     Hoeven
     Hyde-Smith
     Inhofe
     Johnson
     Jones
     Kennedy
     Lankford
     Lee
     Manchin
     McConnell
     McSally
     Moran
     Murkowski
     Paul
     Perdue
     Portman
     Risch
     Roberts
     Romney
     Rounds
     Rubio
     Sasse
     Scott (FL)
     Scott (SC)
     Shelby
     Sinema
     Sullivan
     Thune
     Tillis
     Toomey
     Wicker
     Young

                                NAYS--34

     Baldwin
     Blumenthal
     Brown
     Cantwell
     Cardin
     Carper
     Casey
     Coons
     Cortez Masto
     Duckworth
     Durbin
     Feinstein
     Hassan
     Heinrich
     Hirono
     King
     Leahy
     Menendez
     Merkley
     Murphy
     Murray
     Peters
     Reed
     Rosen
     Schatz
     Schumer
     Shaheen
     Smith
     Stabenow
     Tester
     Udall
     Van Hollen
     Whitehouse
     Wyden

                             NOT VOTING--12

     Bennet
     Booker
     Cassidy
     Gillibrand
     Harris
     Isakson
     Kaine
     Klobuchar
     Markey
     Sanders
     Warner
     Warren
  The nomination was confirmed.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. CORNYN. Madam President, I ask unanimous consent that the 
remaining votes in the series be 10 minutes in length.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________