EXECUTIVE CALENDAR--Continued; Congressional Record Vol. 165, No. 93
(Senate - June 04, 2019)

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[Pages S3179-S3181]
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                     EXECUTIVE CALENDAR--Continued


  Mr. CORNYN. Mr. President, this week, the Senate will consider 
another batch of well-qualified nominees. These are men and women who 
have chosen to serve the American people in a variety of ways 
throughout the Federal Government, and we owe it to them to get them 
off the Senate calendar and on the job.
  Among the nominees we are considering this week is Susan Combs, who, 
as the Presiding Officer knows, is a fellow Texan who has been 
nominated to serve as the Assistant Secretary for Policy, Management 
and Budget at the Department of the Interior. Susan has led an 
impressive career in both the public and private sectors and has served 
our State as a member of the Texas House of Representatives, then as 
the first female agriculture commissioner, and, later, as the Texas 
comptroller of public accounts.
  In each job, she gained the respect of virtually everyone she worked 
with. So, for those who know Susan, her nomination has come as no 
surprise. What is surprising, though, is how long it has taken her to 
reach this point and be confirmed. She was nominated in July of 2017. 
Within 1 month, she testified before the Committee on Energy and 
Natural Resources, and she received unanimous support. Suffice it to 
say, her nomination was not controversial. So why has it taken 2 years 
for her to get a vote on the Senate floor?

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  Unfortunately, our colleagues across the aisle have pulled every 
trick in the book to slow down the nominations process, not because 
they have objected to a particular nominee or because a nominee has 
been unqualified, but because it has been part of a broader effort to 
stymie the President and this administration and bring the work of this 
body to a crawl.
  With each day that has passed since the President has been 
inaugurated, the growing backlog of nominations has allowed hundreds of 
important positions throughout the Federal Government to have remained 
vacant. That is not fair to the people who have been nominated; that is 
not fair to the administration; and it is particularly not fair to the 
American people, whom these individuals are to serve.
  A couple of months ago, we passed a modest rules change that broke 
the logjam, at least to some extent, and allowed us to finally begin to 
make some much needed progress. In the, roughly, 3 months prior to the 
rules change, we were able to confirm only 23 nominees. In the, 
roughly, 2 months since, we have more than doubled that number. We have 
begun to fill dozens of positions, including those of Federal judges, 
ambassadorships, and sub-Cabinet officials at various Departments and 
Agencies. Two weeks ago, we confirmed the 41st circuit court judge 
since President Trump took office, and we are making progress on 
filling more judicial vacancies.
  As we approach the 2-year anniversary of Susan Combs' nomination 
having been sent to the Senate, I am glad we can finally vote on her 
confirmation and continue our work to confirm well-qualified nominees.


  Mr. President, on another matter, we continue to hear cries from the 
left about Medicare for All--the one-size-fits-all healthcare plan they 
continue to embrace.
  It is ironic, in having been in this Chamber during the battle over 
the Affordable Care Act and when President Obama famously said ``If you 
like your policy, you can keep it,'' that now, apparently, the 
Democrats have abandoned that promise. Instead, their promise is, if 
you like your employer-provided health insurance policy, you can't keep 
  The fact is that this plan would drain the vital program that our 
seniors have relied on for more than a half a century and would force 
all Americans to participate in a watered-down version, which, clearly, 
would not be financially sustainable. More than 180 million Americans 
would be kicked off of their private insurance plans and be forced onto 
a government-run plan. This strikes me as a solution in search of a 
  Don't get me wrong. Our healthcare system isn't perfect, and there 
are things we need to do to make it better, but they don't want to pay 
higher taxes and be put on the same healthcare plan as every other 
American. They want to be able to choose their coverage at prices that 
work best for them and their families, and, yes, we need to improve our 
healthcare system so it focuses on patients and allows all individuals 
and families to choose what works best for them. Fortunately, Senate 
Republicans have been working hard to create legislation that would do 
exactly that.
  Earlier this year, I cosponsored the Protect Act, which is being led 
by our colleague from North Carolina, Senator Tillis. This bill would 
make sure that no one would be denied coverage or would be forced to 
pay a higher premium because of one's having a preexisting condition. 
With the future of ObamaCare hanging in the balance, we need to provide 
peace of mind for the millions of Americans who have preexisting 
conditions and who worry about the uncertainty of their healthcare.
  This legislation would also prohibit discrimination against patients 
based on their health status. That includes denying coverage, limiting 
what treatments are covered, or increasing premiums because of one's 
having a preexisting condition. This is an important step we can and 
should take to affirm that all Americans deserve access to affordable 
care at affordable prices. In addition, by codifying the association 
health plans, we can help self-employed individuals and small business 
employees who don't receive employer-provided coverage.
  Association health plans were initially established by the Department 
of Labor. They allow businesses in the same region or industry to come 
together and purchase insurance. These plans have proven to be a great 
solution for small businesses across the country that represent a host 
of small businesses and sole proprietors because they are afforded the 
opportunity of getting, essentially, the same quality of coverage 
provided by large employers but at the same lower prices that people 
pay who are in these large employer-provided plans.
  Historically, the problem has been in the individual market, which is 
where most of these individuals would find themselves, in that the pool 
of risks is not sufficiently broad. Because of perverse incentives, 
they would actually end up paying much higher premiums than other 
people who would be similarly situated who would have employer-provided 
  Association health plans address that directly by providing a larger 
pool of insured individuals, which would help to bring down the 
premiums and help to bring down the deductibles over what they are 
currently under the Affordable Care Act. Several chambers in Texas are 
using these association health plans for their members, and I would 
like to be able to provide more flexibility for AHPs so that more 
Americans may take advantage of this employer-provided insurance.
  In codifying this Labor Department rule and making insurance more 
affordable and accessible, we must also look at healthcare costs beyond 
the premiums people pay for their health insurance. That is why we need 
to take a look at out-of-pocket costs for prescription drugs. When it 
comes to drugs that have just come on the market after lengthy research 
and development, you would expect the prices to be higher. That is the 
price we pay for the innovation and lifesaving new drugs. Companies 
patent their drugs to ensure that the money spent during the research 
and development phases can be recovered once the drugs hit pharmacy 
  These patents--a form of individual property protection--are 
important in order to encourage innovation. Unfortunately, on occasion, 
we see companies that abuse this system and try to get new patents on 
existing drugs in order to prolong their exclusivity and, of course, to 
maintain the high profits they get on a patented drug. This type of 
behavior is not what Congress intended. We cannot allow bad actors to 
game the system in order to turn higher profits and prevent more 
Americans from getting access to these drugs at lower prices, which is 
what the system is designed to do once they go off patent.
  Recently, I introduced the Affordable Prescriptions for Patients Act, 
which encourages competition within the pharmaceutical industry by 
stopping these sorts of corrupt practices. The bill would define 
product hopping and patent thickets--two practices used by some 
manufacturers--as anticompetitive behavior. Certainly, this doesn't 
prevent manufacturers from making improvements in their products. It 
doesn't limit patent rights, and it doesn't hamper innovation. Yet it 
does stop those who knowingly abuse the patent system by allowing the 
Federal Trade Commission to bring antitrust suits against the bad 
  In addition to these bills, I recently introduced a bill to protect 
the integrity of the Medicare part D system. This is the prescription 
drug system that Congress created years ago, which actually provides 
seniors with access to prescription drugs at a modest cost. Currently, 
part D's sponsors may voluntarily report fraud data to the CMS, but 
they are not required to report the specific number of instances of 
fraud, waste, and abuse they identify or the actions they take to 
correct these problems. This bill would implement recommendations made 
by the Health and Human Services Office of Inspector General to require 
plan sponsors to report fraud and improve oversight of this important 
  These are the types of reforms we need. We don't need Medicare for 
All, which will force 180 million people off of their private health 
insurance and bankrupt the Medicare system that we pledged to be there 
to provide access to healthcare for our seniors once they

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qualify. These are the types of reforms we need instead. Overhauling 
our entire healthcare system to put everyone on the same subpar plan 
would not help anyone.
  The way I see it is we have two options. One option is Medicare for 
All, which forces everyone onto the same plan. The government tells you 
what clinic to go to, what doctor to see, what brand of prescription 
you can get access to. You lose the power to make decisions about your 
own healthcare, and you simply have to take what you get on somebody 
else's timeframe. That is Medicare for All. It would simultaneously 
ruin Medicare by forcing all 330 million Americans onto the same plan, 
which will bring down the quality of care for our seniors, who have 
paid over the years into the plan, and which will bankrupt our country 
in the process.
  I think there is a better choice, a better option. Rather than the 
government's telling you what you have to do, let's make smart, 
targeted reforms that allow patients to determine the coverage and care 
they want at more affordable prices. I believe we can implement these 
reforms in a way that will bring down costs without reducing choice.
  We can continue to protect Americans with preexisting conditions, 
which is something we all agree should be done. We can lower the costs 
of prescriptions and out-of-pocket costs and stop the bad actors who 
game the system. We can provide the States with more flexibility to 
allow for more coverage options so that families can pick the plans 
that are right for them. Yes, we can also encourage innovation so our 
country will remain at the forefront of medical solutions and 
  Those are two words you don't ordinarily see--``government-run'' plan 
and ``innovation''--in the same sentence. As a matter of fact, they are 
polar opposites.
  Finally, we need to preserve Medicare for our seniors who have paid 
into this over their lifetime.
  I appreciate my colleagues who are hard at work to make these kinds 
of reforms a reality. And I have heard from my constituents loud and 
clear. When it comes to healthcare, they want more choices, more 
affordability, not the one-size-fits-all that Medicare for All would 
  I yield the floor.