Lamar Alexander

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I would like to take a moment to explain my reason for the objection. First, I would like to say to the Senator from Wisconsin that I am grateful for her work on the Health, Education, Labor, and Pensions Committee, where she is a valuable, diligent, and constructive member. We work on a great many things together and have agreed to very many things. However, we disagree on this one, and here is why. Let me summarize it at the beginning of my remarks and then explain it with a little more detail. No one who has a Perkins loan today loses that loan, period. So if you are a student anywhere in the country and you have a Perkins loan for this year, you don't lose that loan, period. Second, no one who has a Perkins loan for next year loses that loan because no one has one. They were ended 2 years ago. Every student was told in his or her financial aid information that the Perkins Loan Program ends this year, so no one could expect to have one next year. No one has been granted one for next year, so no one who has a loan is losing a loan. Why did we, in December of 2015--2 years ago--reach a bipartisan agreement to sunset, or end, the Perkins Loan Program in 2 years, which is the end of this week? In that agreement, we allowed graduate students to receive Perkins loans for 1 additional year and undergraduates to receive Perkins loans for 2 additional years. It was made clear at that time--2 years ago--that this was the last time the program would be extended, but we wanted to have a smooth transition, and we did not want students and colleges and universities to be surprised. That agreement, therefore, included many requirements for institutions of higher education to inform students over the last 2 years that the Perkins Loan Program would end on September 30 of this year, which is the end of this week. That agreement also set policies to make the sunsetting of Perkins loans as smooth as possible for students. The expiration of this loan program was not and should not have been a surprise. It has not received any appropriation since the year 2004, and the U.S. Department of Education reminded institutions that it was ending the program this year. Now, why? Why are we ending the program? Why did we agree to do that 2 years ago, and why have the last three Presidents recommended that we end it--President Obama, President Trump, and President Bush? The Department of Education estimated that in the 2016 to 2017 school year--that is the school year that just ended--the Perkins Loan Program provided less than $800 million in new Perkins loans to about 300,000 recipients. That may seem like a lot, but by comparison, the Department estimated that the Federal Government disbursed over $22 billion to almost 7 million undergraduate students in the Stafford Subsidized Loan Program, or the regular Direct Loan Program. The Perkins loan--a separate loan--provides an average loan of roughly $2,000, and it illustrates the complicated mess in which students find themselves because of our Federal student aid system today. The Perkins loans have a higher interest rate than other loans that are available to students today. The interest rate is 5 percent, compared with 4.45 percent for undergraduate loans. And students who have a Perkins loan aren't eligible for certain programs that exist for students with other loans, such as the income-based repayment programs and the public service loan forgiveness programs, which help students manage repayment of their loans. Those aren't available to students with a Perkins loan. The default rate for Perkins loans is higher than for the Stafford loan. The bill which the Senator from Wisconsin has offered would cost taxpayers, according to the Congressional Budget Office, $900 million for a 2-year extension. If we were to extend the program over 10 years, it would cost $6.5 billion, according to the Congressional Budget Office. The bill does not have an offset, so these billions of dollars would only serve to add to the $20 trillion Federal debt we already have. I object because I think it is time for our country, through legislation by this Congress, to move on to a simplified Federal student aid program that has only one Federal loan for students, one Federal grant for students, and one work-study program for students. As I have spoken often about on this floor, along with Senator Bennet from Colorado, we would like to reduce the application form for those Federal grants and loans called FAFSA--the dreaded FAFSA which 20 million students and their families fill out every year. We would like to reduce that from 108 questions to 2 or 5 or 10 questions. We need a much simpler program for Federal student loans, and the end of the Perkins Loan Program is a small step toward that end. As I mentioned, President Bush recommended that the program end, President Obama recommended that the program be changed and folded, in effect, into the regular Direct Student Loan Program, and President Trump has the same position. I look forward to working with my colleagues, including the Senator from Wisconsin, on the reauthorization of the Higher Education Act later this year, when we can work together to improve our Federal student loan programs and our grant programs, find ways to simplify them, make it easier and cheaper for students to attend college, and to help students pay those loans off, after they get them, in a fair and simpler way. I thank the Presiding Officer. I yield the floor.

Mr. ALEXANDER. Mr. President, I will conclude my remarks because I see the Senator from Mississippi is here. Of course I will be glad to work with the Senator from Wisconsin. The fact is, 2 years ago we agreed to end the program. The graduate loans ended last year, and the undergraduate loans end this year. Everybody was told about it. Every student who wants a loan can get a direct student loan from the government at a lower rate, with better repayment programs and better payment provisions than the Perkins loan. So no one is losing a loan, and everyone can get a better loan if they apply for a direct loan. We do need a simpler program, and we need to simplify the application process for applying for the loans and grants and for paying them off. I thank the Presiding Officer. I yield the floor.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, today the Senate will vote on the confirmation of William Emanuel to be a Member of the National Labor Relations Board, NLRB. I am glad that we are moving this nomination because, once Mr. Emanuel is confirmed, we will have a full five-member National Labor Relations Board, which has not been the case in nearly 2 years. The NLRB was created in 1935 by the National Labor Relations Act, NLRA, which was significantly amended in 1947 by the Taft-Hartley Act. It has the statutory mission to promote ``free flow of commerce'' by allowing employees to organize and bargain collectively. The statute provides that ``employees shall have the right to self- organization, to form, join, or assist labor organizations, to bargain collectively through representatives of their own choosing, and to engage in other concerted activities for the purpose of collective bargaining or other mutual aid or protection, and shall also have the right to refrain from any or all of such activities.'' The statute further provides that it is an unfair labor practice for unions to ``restrain or coerce employees in the exercise of their rights.'' After years of playing the role of advocate for organized labor, the new Board should return to the role of neutral umpire. Board partisanship did not start under President Obama, but it became worse under him. When the Board is too partisan, it creates instability in our Nation's workplaces and does not serve the intent of the law, which is stable labor relations and free flow of commerce. The Obama Board overturned numerous longstanding precedents that had been upheld for decades by both Republican and Democrat boards. Under President Obama, the Board took three particularly harmful actions. First, the joint-employer decision, which was the biggest attack on the opportunity for small businessmen and women in this country to make their way into the middle class that anyone has seen in a long time--threatening to destroy the American Dream for owners of the nation's 780,000 franchise locations. Second, the ambush elections rule, which can force a union election before an employer and many employees even have a chance to figure out what is going on. This rule also forces employers to provide union organizers with a list of employees' telephone numbers, email addresses, employee work locations, shifts, and job classifications--highly personal information that many employees may not wish to share. Third was the microunion decision, which gave factions of employees within single businesses a path to forming their own unions. This decision risks fracturing workplaces and creating the potential for conflict and uncertainty among employees. The Senate has the opportunity today to help reverse this harmful trend and bring stability to our Nation's workplaces by voting for William Emanuel and filling out the Board--again, for the first time in nearly 2 years. Mr. Emanuel is eminently qualified to serve on the NLRB. He is currently a shareholder at Littler Mendelson in Los Angeles where he works on labor and employment matters. Mr. Emanuel has spent the entirety of his impressive career in the private sector, representing trade associations, hospitals and healthcare organizations, schools, as well as transportation, logistics, and manufacturing companies. Mr. Emanuel has previously represented his clients before the NLRB and has filed amicus briefs on behalf of trade associations. Mr. Emanuel was nominated to be a member of the NLRB on June 29, 2017. The committee received Mr. Emanuel's HELP application on June 30. On July 6, the committee received Mr. Emanuel's Office of Government Ethics paperwork, including his public financial disclosure and ethics agreement. Based on these documents, OGE determined that Mr. Emanuel ``is in compliance with applicable laws and regulations governing conflicts of interest.'' We held Mr. Emanuel's hearing on July 13, and he completed all paperwork in accordance with the HELP Committee's rules, practices, and procedures. Mr. Emanuel offered to meet with all HELP Committee members. Mr. Emanuel met with nine of them, including five Democratic members. Following the hearing, Mr. Emanuel responded to 62 questions for the record, QFRs, or 101 if you include subquestions, and those responses were provided to Senators prior to the markup. The HELP Committee favorably reported out Mr. Emanuel's nomination on July 19. I look forward to voting for William Emanuel, who will serve on the National Labor Relations Board with distinction.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I ask unanimous consent that after the disposition of the Brouillette nomination, the Senate resume consideration of the motion to proceed to H.R. 2430, that all postcloture time be expired, and the motion to proceed be agreed to; further, that there be no amendments in order to H.R. 2430, that there be 10 minutes of debate equally divided in the usual form, and that following the use or yielding back of that time, the bill be read a third time and the Senate vote on passage of the bill with no intervening action or debate.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I ask unanimous consent that the Committee on Health, Education, Labor, and Pensions be discharged from further consideration of S. 1052 and the Senate proceed to its immediate consideration.

Mr. ALEXANDER. Mr. President, I ask unanimous consent that the bill be considered read a third time and passed and the motion to reconsider be considered made and laid upon the table.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I ask unanimous consent that the Committee on Health, Education, Labor, and Pensions be discharged from further consideration of S. 581 and the Senate proceed to its immediate consideration.

Mr. ALEXANDER. Mr. President, I ask unanimous consent that the Manchin-Capito substitute amendment be agreed to, the bill, as amended, be considered read a third time and passed, and the motion to reconsider be considered made and laid upon the table.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I see Senators Isakson and Tester are here. I think they want to make remarks before the vote. Let me say a few words following up on Senator Murray, and then I will place the rest of my comments in the Record. This is very important legislation. Last year, we passed the 21st Century Cures Act to move these modern medical miracles into medicine cabinets and doctors' offices more rapidly. This is funding that pays for one-quarter of the Food and Drug Administration, which has a critical role in approving the safety and effectiveness of drugs, treatments, and devices. As with most things in the Senate that actually are important and work well and get a result, a lot of hard work has gone into this. It started 2 years ago with Republicans and Democrats; Senator Murray and I and our staffs working together with the House of Representatives at the same time, working with manufacturers, the FDA, many others, working out many differences of opinion. So now we are going to get to a result within a few minutes. We are probably going to adopt this by voice vote almost unanimously. Everyone will say that must have been easy. It wasn't that easy, but it is how work gets done in the U.S. Senate when we do it well. I want to comment on our colleagues and the staff and the House of Representatives on what they have done. We will continue to focus our attention on the 21st Century Cures Act. A piece of legislation is not worth the paper it is printed on unless it is implemented properly, but this funding today, done in a timely way, says to the men and women who work at the Food and Drug Administration and to their leader, Dr. Gottlieb: We value what you do. In the 21st Century Cures Act, we gave the Commissioner more authority to hire and pay talented people to work at FDA and approve these medical miracles that are coming. We are reauthorizing the user fees in a timely way so the FDA's work will not be interrupted. I thank Senator Murray for the way she worked on this. This is typical of our committee when we work well, which we most always do. I will make remarks in the Record concerning the staff. They are almost too numerous to mention. Senator Murray's staff, my staff, Chairman Walden's staff, Ranking Member Pallone's staff, Food and Drug Administration staff, Congressional Budget Office legislative counsel, and Senator McConnell's staff--they have all been critical to the success we are about to have today. I would like to thank the staff who have been devoted to reauthorizing these important programs. Some of them have been working on this bill for over 2 years. I am deeply grateful to them. I have deep appreciation for their hard work, their ingenuity, and their skill in helping us come to this result. Without their hard work and tireless effort, we wouldn't have been able to pass this before the deadline, ensuring the FDA can continue its important mission. On Senator Murray's exceptional staff, I would like to thank Evan Schatz, John Righter, Nick Bath, Andi Fristedt, and Remy Brim. On my hard-working and dedicated staff, I would like to thank David Cleary, Lindsey Seidman, Allison Martin, Mary-Sumpter Lapinski, Grace Stuntz, Margaret Coulter, Curtis Vann, Lowell Schiller, Bobby McMillin, Liz Wolgemuth, Margaret Atkinson, Taylor Haulsee, Elizabeth Gibson, and Anthony Birch. On Chairman Walden's staff, I would like to thank Ray Baum, Paul Edattel, and John Stone. On Ranking Member Pallone's staff, I would like to thank Jeff Carroll, Tiffany Guarascio, and Kimberlee Trzeciak. I would also like to thank much of the hard-working staff from the Food and Drug Administration who provided great help in getting this bill completed and working out the user fee agreements in a timely manner. From legislative counsel from the House and Senate, I would like to thank Warren Burke, Michelle Vanek, Kim Tamber, and Katie Bonander. From the Congressional Budget Office, I would like to thank Darren Young, Andrea Noda, Chad Chirico, Holly Harvey, Ellen Werble, and Rebecca Yip. On Senator McConnell's staff, I would like to thank Scott Raab. On Speaker Ryan's staff, I would like to thank Matt Hoffman. Finally, I would like to thank all the patients, doctors, researchers, innovators, thought leaders, and experts who dedicated time and expertise to helping improve the legislation and supporting its approval. To reiterate, today the Senate will take up and I expect it will pass the Food and Drug Administration Reauthorization Act of 2017 to speed cures and treatments into patients' medicine cabinets. Last year, 94 Senators voted to pass 21st Century Cures and send $4.8-billion to spur medical research at the National Institutes of Health. Leader McConnell called it the ``most important piece of legislation'' that year. Today's passage of the FDA user fees will help ensure advancements in research supported by 21st Century Cures actually make it to patients who are waiting. The Food and Drug Administration is the agency responsible for making sure promising research supported by 21st Century Cures can turn into lifesaving treatments and cures. This legislation we will vote on today includes four FDA user fee agreements--which are set to expire on September 30--and will speed the agency's ability to review new prescription drugs, generic drugs, biosimilar drugs, and medical devices and bring those treatments and cures to patients more quickly. This legislation will reauthorize the authority for the FDA to accept user fees--paid by manufacturers of drugs and medical devices--that account for $8 to $9 billion over 5 years and is over a quarter of all FDA funding. The reauthorizations are based on recommendations from industry and FDA after a thorough public process. FDA posted meeting minutes after every negotiation and held public meetings before discussion began and to hear feedback on the draft recommendations last fall. We began almost 2 years ago working in a bipartisan way to reauthorize and update the user fee agreements. We held 15 bipartisan Senate health committee briefings, including several with the House Energy and Commerce Committee. In the Senate HELP Committee, we held two bipartisan hearings on these agreements--one in March and one in April of this year. We heard from the FDA, witnesses representing the manufacturers of drugs and medical devices, and witnesses representing the patients who rely on the products they make. Throughout this process, we have worked closely with the House. In April, the leaders of the Senate and House health committees released a discussion draft of bipartisan legislation to reauthorize and update the user-fee agreements and which reflected the recommendations sent to Congress by the FDA in January. In May, the Senate HELP Committee overwhelmingly approved this legislation reauthorizing the user fees by a vote of 21 to 2. This also included over 20 provisions that were adopted in committee and were priorities for HELP members. The bill includes provisions from Senators Isakson and Bennet to improve the medical device inspection process; Senators Hassan and Young to improve communication about abuse-deterrent opioid products; Senators Enzi and Franken to encourage medical device development for children and make sure FDA has appropriate expertise to review devices for children; Senators Roberts, Donnelly, and Burr to allow more appropriate classification of accessories used with medical devices; Senators Collins, Franken, McCaskill, and Cotton to improve generic drug development and help lower prescription drug costs; Senators Hatch, Bennet, Burr, and Casey to improve access to clinical trials for all patients; and Senators Bennet, Rubio, Van Hollen, and Gardner to increase the development of new drugs to treat pediatric cancers and other diseases. The House passed this user fee legislation on July 12 by voice vote. Now it is our turn to pass this bipartisan legislation that is integral to helping patients and families who rely on the lifesaving medical innovation that FDA is responsible for reviewing. The goal of getting this to the President's desk is an important one. If we do not pass this legislation before the end of September, FDA will begin sending layoff notices to more than 5,000 employees to notify them that they may lose their job in 60 days. If we do not pass this bill, a FDA reviewer who gets started reviewing a cancer drug submitted to the agency in April could be laid off before the reviewer is able to finish his or her work. A delay in reauthorizing the user fees would not only harm patients and families who rely on medical innovation, but it would threaten biomedical industry jobs and jeopardize America's global leadership in biomedical innovation. I am glad the Senate is taking the step of voting on this legislation today. I look forward to supporting this important bipartisan bill and sending it to the President's desk. I urge my colleagues to support it as well.

Mr. ALEXANDER

Mr. ALEXANDER. Madam President, I thank Senator Murray and the committee for 2 years of work to produce a bipartisan result. This bill funds the Food and Drug Administration and advances the 21st Century Cures legislation that Senator McConnell called the most important bill of the last Congress. Senator Murray and I have already spoken to the bill and have thanked everybody involved. Senators have other appointments they would like to keep. I yield back all time.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, today the Senate will vote on the confirmation of Marvin Kaplan to be a member of the National Labor Relations Board, NLRB. I am glad that we are moving this nomination because the National Labor Relations Board needs to function as intended. The board hasn't been full in nearly 2 years. I am certainly not the only one of us who thinks a full Board is important. One Democratic senator said at a hearing on May 16, 2013: ``I strongly support a fully functioning NLRB with five members. I think confirming the entire slate will ensure that the NLRB is working for American workers and American employers.'' Another said at the same hearing: ``What we don't need now--the last thing we need here in Washington or across the country--is more rancor, more division, more ideology, at a time we need this Board fully functioning. We need five people to get confirmed here. Any Senator who is standing in the way of getting five people confirmed and having a functioning Board has a lot of explaining to do . . .'' Then-Chairman Harkin said in September 2014: ``Keeping the NLRB fully staffed and able to do its work will send a strong message to the American people that yes, Washington can work, and our government can function.'' The National Labor Relations Board has five members with 5-year, staggered terms, and a general counsel with a 4-year term. There is no statutory requirement regarding party affiliation, but the tradition has been for the President to appoint members on a 3-2 ratio favoring the administration, with nominations for the two minority seats recommended by the Senate minority leader. While we may often disagree with the opinions of the nominees for the other party's seats--many of us have ensured they had an up or down vote. For example, since 2013, I have voted for cloture for two board members and the current general counsel who I then voted against confirming. Marvin Kaplan has been nominated for a position that has sat vacant for 23 months since President Obama declined to nominate a Republican for the then-minority seat. My hope is that this nominee will help restore some balance to the labor board. After years of playing the role of advocate, the Board should be restored to the role of neutral umpire. Board partisanship didn't start under President Obama, but it became worse under him. When the Board is too partisan, it creates instability in our Nation's workplaces and does not serve the intent of the law--which is stable labor relations and free flow of commerce. For example, under President Obama, the Board took three harmful actions, including the joint employer decision--which threatened to destroy the American dream for owners of the Nation's 780,000 franchise locations; the ambush elections rule, which can force a union election before an employer and many employees have a chance to figure out what is going on; and the micro-union decision, which gave factions of employees within single stores a path to forming their own unions. Nominee Marvin Kaplan is currently chief counsel for the Occupational Safety and Health Review Commission, where he has served since August 2015. From 2009 to 2015, Kaplan worked as counsel for the House Education and Workforce Committee and the House Oversight and Government Reform Committee. Today some Senators have argued about Mr. Kaplan's experience practicing law. I want to note that Mr. Kaplan is in fact well- qualified under the National Labor Relations Act statute. He is an experienced lawyer. He earned his law degree at Washington University in St. Louis and is a member of the New York and New Jersey State bars. The years he has spent considering cases and writing opinions at the Occupational Safety and Health Review Commission, OSHRC, are an excellent preparation for the work of the National Labor Relations Board, NLRB. I will also point out that there have been a number of NLRB members confirmed with limited experience representing clients in labor law matters. Mr. Kaplan has an admirable record of public service spanning a decade. He could have taken a number of different career paths, but he chose public service, and that should be praised. There is bipartisan respect for Mr. Kaplan. At a July 2015 business meeting of the House Education and the Workforce Committee, Ranking Member Bobby Scott said this of Mr. Kaplan: ``A lot is said about the working relationships around here and how bad they are from time to time. Staff can contribute to that. I just would like to say that Mr. Kaplan has not been part of that; he's been very cooperative even when you disagree. We have been able to work with my staff, have had good working relationships; a cooperative relationships. I want to add my two cents worth to your congratulations and God speed.'' Mr. Kaplan was nominated to be a member of the NLRB on June 20, 2017. We held his hearing on July 13, and he completed all paperwork in accordance with the HELP Committee's rules, practices, and procedures. Our rules require that their HELP paperwork be submitted 5 days before their hearing. We received Mr. Kaplan's HELP paperwork and his Office of Government Ethics, OGE, paperwork on June 26, 17 days before his hearing. Mr. Kaplan also offered to meet with all HELP members. Mr. Kaplan met with 10 of them, including 5 Democrats. Following the hearing, Mr. Kaplan responded to 53 questions for the record, QFRs, or 81 if you include subquestions, and those responses were provided to Senators prior to the markup. The HELP Committee favorably reported out his nomination on July 19. Recent comparisons show that this process was far from rushed. In comparison, under Chairman Harkin, the HELP Committee held hearings and markups on NLRB nominees with far less time for consideration. For former Board member Kent Hirozawa's seat, which Mr. William Emanuel has been nominated to fill, Mr. Hirozawa's hearing was held 7 days after his nomination, and his markup was held the next day. Former Board member Nancy Schiffer's hearing was held 7 days after her nomination. The HELP Committee also held a markup on her nomination the next day. Committee members were not able to get responses to any QFRs from Kent Hirowzawa or Nancy Schiffer before being forced to vote on them. I look forward to voting for this nominee. I hope the Senate will take up the nomination of William Emanuel, also for the NLRB, very soon, so we have a full board.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I ask unanimous consent to have printed in the Record a copy of the commitment letter for the Generic Drug User Fee Act, GDUFA, reauthorization for fiscal years 2018 to 2022, known as GDUFA II.

Mr. ALEXANDER. Mr. President, I ask unanimous consent to have printed in the Record a copy of the commitment letter for the Medical Device User Fee Amendments of 2017.

Mr. ALEXANDER. Mr. President, I ask unanimous consent to have printed in the Record a copy of the commitment letters from the Secretary of Health and Human Services to the chairman of the Committee on Health, Education, Labor, and Pensions of the Senate and the chairman of the Committee on Energy and Commerce of the House of Representatives regarding reauthorization of the Biosimilar User Fee Act, Generic Drug User Fee Act, Prescription Drug User Fee Act, and Medical Device User Fee Amendments.

Mr. ALEXANDER. Mr. President, I ask unanimous consent to have printed in the Record a copy of the commitment letter for the Prescription Drug User Fee Act, PDUFA, reauthorization for fiscal years 2018 to 2022, known as PDUFA VI.

Mr. ALEXANDER. Mr. President, I ask unanimous consent to have printed in the Record a copy of the commitment letter for the Biosimilar User Fee Act, BsUFA, reauthorization for fiscal years 2018 to 2022, known as BsUFA II.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I thank the Senator from Rhode Island for his courtesy in allowing me to go next.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, this afternoon, Senator Murray, the Senator from Washington State who is the ranking member of the Senate Committee on Health, Education, Labor, and Pensions, and I, the chairman of the committee, made a joint bipartisan announcement that the Senate's HELP Committee will hold hearings beginning the week of September 4 on the actions Congress should take to stabilize and strengthen the individual health insurance market so Americans will be able to buy insurance at affordable prices in the year 2018. We will hear from State insurance commissioners, from patients, from Governors, from healthcare experts, and insurance companies. Committee staff will begin work this week, working with all committee members to prepare for these hearings and discussions. That was the announcement Senator Murray and I made today. Now, in my own words, the reason for these hearings is that unless Congress acts by September 27, when insurance companies must sign contracts with the Federal Government to sell insurance on the Federal exchange next year, millions of Americans with government subsidies in up to half of our States may find themselves with zero options for buying health insurance on the exchanges next year, 2018. Many others without government subsidies will find themselves unable to afford health insurance because of rising premiums, copays, and deductibles. There are a number of issues with the American healthcare system, but if your house is on fire, you want to put out the fire. The fire, in this case, is the individual health insurance market. Both Republicans and Democrats agree on this. Our committee, the HELP Committee, had one hearing on the subject on February 1 and will work intensively between now and the end of September in order to finish our work in time to have an effect on health insurance policies next year, sold in 2018. I am consulting with Senator Murray to try to make these hearings as bipartisan as possible and to involve as many committee members as possible. I will be consulting with Senator Hatch and Senator Wyden so the Finance Committee is aware of any matters we discuss that might be within its jurisdiction. A number of Senators, both Democratic and Republican, have approached Senator Murray and me and said they would like to be involved. We are going to find a way for them to be involved and update them on our progress. In these discussions--the ones I am describing--we are dealing with a small segment of the total health insurance market. Only about 6 percent of insured Americans buy their insurance in the individual market. Only about 4 percent of insured Americans buy their insurance on the Affordable Care Act exchanges. While these percentages are small, they represent large numbers of Americans, including many of our most vulnerable Americans. We are talking about roughly 18 million Americans in the individual market. About 11 million of them buy their insurance on the Affordable Care Act exchanges. About 9 million of these 11 million have Affordable Care Act subsidies, and unless we act, many of them may not have policies available to buy in 2018 because insurance companies will pull out of the collapsing markets. It would be like having a bus ticket and no bus coming through town. Just as important, unless we act, costs could rise, once again, even making healthcare unaffordable for the additional 9 million Americans in the individual market who receive no government support to help buy insurance, roughly 2 million of them who buy their health insurance on the exchanges but who don't qualify for a subsidy, and roughly 7 million who buy their insurance outside of the exchanges. This means they have no government help paying for their premiums, their copays, and their deductibles. As we prepare for these discussions, I have urged again that President Trump temporarily continue the cost-reduction payments through September so Congress can work on a short-term solution for stabilizing the individual markets in 2018. These cost-sharing reduction subsidies reduce copays, reduce deductibles, and reduce other out-of-pocket costs to help low-income Americans buy their health insurance on the exchanges. We are talking about those who make under 250 percent of the poverty level or roughly $30,000 for an individual or $60,000 for a family of four. Without payment of these cost-sharing reductions, Americans will be hurt. Up to half the States will likely have bare counties, with zero insurance providers offering insurance on the exchanges, and insurance premiums will increase by roughly 20 percent, according to the American Health Insurance Plans. In my opinion, any solution that Congress passes for a 2018 stabilization package would need to be small, bipartisan, and balanced. It should include funding for the cost-sharing reductions, but it also should include greater flexibility for States in approving health insurance policies which should reduce costs. Now, it is reasonable to expect that if the President were to approve continuation of cost-sharing subsidies for August and September and if Congress, in September, should pass a bipartisan stabilization bill that includes cost-sharing for 1 year--that is 2018--it is reasonable to expect that the insurance companies in 2018 would lower their rates. They have told us--in fact, Oliver Wyman, an independent observer of healthcare, has told us that lack of funding for cost-sharing reductions would add 11 to 20 percent to premiums in 2018. So if the President, over the next 2 months, and the Congress, over the next year, take steps to provide certainty that there will be cost- sharing subsidies, that should allow insurance companies to lower the premiums they have projected they will charge in 2018. In fact, many insurance companies have priced their rates for 2018 at two different levels--one with cost-sharing and one without cost-sharing. So it is important not only that the President improve temporary cost-sharing for August and September but that we, the Congress, in a bipartisan way, find a way to approve it for at least 1 year so we can keep the premiums down. Now, this is only one step in what we want to do about health insurance and about the larger question of healthcare costs so we will proceed step by step. A subsequent step will be to try to find a way to create a long-term, more robust individual insurance market, but for the short-term, our proposal is that by mid-September, we will see if we can agree on a way to stabilize the individual insurance market to keep premiums down and make affordable insurance available to all Americans. I thank the Presiding Officer. I yield the floor.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, last Wednesday at the White House, President Trump invited Republican Senators there, and he recommended to us that we repeal and replace ObamaCare at the same time, simultaneously. He said that before in his interview on ``60 Minutes'' in January--we should repeal and replace ObamaCare simultaneously, which means, to me, at the same time. That is one reason I voted yes on Tuesday for us to proceed to the House of Representatives' bill, because it would replace and repeal ObamaCare at the same time. That is one reason I voted on Tuesday for the Senate healthcare bill, which would have replaced and repealed ObamaCare at the same time. I agree with the President--we should replace and repeal ObamaCare at the same time. The House voted to do that, the President recommended we do it, and I agree we should repeal and replace at the same time. Why would I say it needs to be done at the same time? There was a time in the past where we might have just repealed it and said: In 2 years, we may come up with an answer. But we can't do that now. Conditions have changed in Tennessee. Our State insurance commissioner, Julie McPeak, says our individual insurance market is ``very near collapse.'' That means that up to 350,000 individuals in our State-- songwriters, workers, farmers--who buy their insurance on the individual market are sitting there worrying in July and in August whether they will have any option to buy insurance in 2018. So I don't think we can wait 2 years to repeal and replace ObamaCare, which is why I voted twice on Tuesday to do it now and why I voted against an amendment yesterday that said: Repeal it now and replace it in 2 years, if you can. I don't think Tennesseans would be very comfortable canceling insurance for 22 million Americans now and saying: Trust Congress to find a replacement in 2 years. Pilots like to know where they are going to land when they take off, and so should we. We are proceeding ahead with our debate on the healthcare bill. It may be a little convoluted for people watching from the outside, but it is fairly straightforward. The House of Representatives has gone through a series of processes in committees and votes, and it passed a bill to repeal and replace ObamaCare now, to do both now. The Senate has been working for 6 months not just to repeal ObamaCare but to repeal and replace it now. There is some urgency about this. We have millions of Americans who are worrying they may not be able to buy insurance in 2018. That is a very personal worry for millions of Americans. They want us to address it now, not 2 years from now. How do we do that? Well, later today we will have an opportunity to vote for a bill which will take us to the place called a conference committee with the House of Representatives, where we can get a solution to our goal of repealing and replacing ObamaCare now. It is being called a skinny bill because it won't have much in it. It is not a solution to the Affordable Care Act problems, but it is a solution to how we get to a place where we can write the solution to the Affordable Care Act problems. And it is wide open. For those who want to watch late into the night or early into the morning, we are here. We will be offering amendments. People can see that. When we move to the conference committee with the House of Representatives, historically those deliberations have been open. People can watch that. They can see that. That will take place over the next several weeks. After the conference committee agrees--if it does--on a bill to repeal and replace major parts of the Affordable Care Act now, not in 2 years, then it goes back to the House and back to the Senate for debate and approval on an up-or-down vote. That is the process. I want to make it clear to the American people that insofar as I am concerned, I am not interested in telling you we are going to repeal something now, and trust us--trust the Congress--to come up with some answer in 2 years. I don't want to say that to the American people. What I do want to say is, we have major problems with the Affordable Care Act. We can't repeal all of it in the budget process, but the House of Representatives showed we can make major changes and major improvements, and the Senate bill, which I voted for on Tuesday, to repeal and replace ObamaCare, shows that we can make major changes and major improvements. I am convinced that if we can move this process to a conference committee today, between the House of Representatives and the United States Senate--which is part of our regular procedure--we will be able to agree on a way to improve the Affordable Care Act. What that means is that we will repeal major parts of it, and we will replace those parts with parts that work better, parts that give Americans more choices of insurance, that give 350,000 Tennesseans in the individual market some peace of mind to know they will actually be able to buy insurance next year, whereas if we don't act, many of them won't be able to, just like millions of Americans may not be able to. If we do not act, there will be counties in the United States where some of the most vulnerable Americans will have zero insurance options in 2018, no support to buy insurance, and if they don't get a subsidy from the Federal Government, a hard-working American who might be earning $50,000 or $60,000 a year--no Federal subsidy--that person will have insurance so expensive, with such high deductibles, they won't be able to buy insurance either. So I think we are on a path toward a solution, and the solution means, No. 1, that we move the debate out of the Senate this afternoon on to the conference committee and that our goal when we get there is to repeal major parts of ObamaCare, the Affordable Care Act, and replace those parts with provisions that transfer responsibilities to the States to make decisions that give consumers more choices of health insurance at lower costs. That is a noble goal, one we are pursuing, and one in which I hope we succeed. Mr. President, I yield the floor.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. ALEXANDER. Mr. President, I ask for the yeas and nays.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I have 9 requests for committees to meet during today's session of the Senate. They have the approval of the Majority and Minority leaders. Purusant to rule XXVI. paragraph 5(a) of the Standing Rules of the Senate, the following committees are authorized to meet during today's session of the Senate:

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I am here with Senator Corker today to address the Senate and encourage this body to vote in support of Bill Hagerty as our Ambassador to Japan. In 2013, when Bill Hagerty was the commissioner of economic and community development for Tennessee, he gave a speech entirely in Japanese at the American Embassy in Tokyo. I have looked it up. There have been 16 U.S. Ambassadors to Tokyo, a very distinguished group since World War II: a five-star general, two former Senate majority leaders, a former Vice President of the United States, a former Speaker of the U.S. House of Representatives, the daughter of a former President of the United States. So far as I know, none of them were able to do what Bill Hagerty did in 2013 when he made a speech entirely in Japanese at the American Embassy in Tokyo. That is just one reason I think Bill Hagerty is one of President Trump's best appointees. He was born in Tennessee, graduated from Vanderbilt University, was associate editor of the law review, worked as a consultant for the Boston Consulting Group. During his final 3 years, he lived in Tokyo, and he served as senior managing executive for their clients around Asia. He was selected by President George H.W. Bush to be on his staff, and there he worked on trade, commerce, defense and telecommunications issues. He was a White House fellow. He was founder and chairman of a company in private life that became the third largest medical research company in the United States. He founded his own private equity and investment firm. From 2011 to 2015, he was the commissioner of economic and community development for Tennessee. In that role, working with Governor Haslam, he was enormously successful. They secured $15 billion in investments and 90,000 jobs for our State. For 2 of those years, Tennessee was the No. 1 State for economic development and the No. 1 State in job creation through foreign direct investment. Bill Hagerty is a distinguished Eagle Scout. He was head of a capital campaign for the Scouts. He served on the board for the Far East Council of the Scouts, encouraging the growth of Boy Scouts throughout Asia. One way he intends to continue that mission is that his two sons will join their respective troops in Japan following his confirmation. His wife, Chrissy, would want me to quickly add that there are two aspiring Girl Scouts in their family who will have time to do the same. This is not only one of the best appointments but one of the most important of this President. There is a reason we have had such a distinguished list of Ambassadors since World War II, including our former majority leader, Senator Howard Baker from Tennessee. Mike Mansfield, another former majority leader of this body, was also Ambassador. He used to say in every speech he made that the Japanese- American alliance is the most important two-country relationship in the world, bar none. Ambassador Mansfield said that so often that Americans in Tokyo used to call our Embassy there the ``Bar None Ranch.'' If you will permit a little parochialism, Mr. Hagerty comes from a state, Tennessee, which has the most important relationship with Japan of any State, bar none. That began about 40 years ago. I remember President Carter saying to me as a new Governor and to other Governors: ``Go to Japan. Persuade them to make in the United States what they sell in the United States.'' Off we all went. During my first 24 months as Governor, I spent 3 weeks in Japan and 8 weeks on Japanese-American relations. I explained to Tennesseans that I thought I could do more good for our State in Japan than I could in Washington, DC. It turned out to be true. Nissan, Bridgestone, Komatsu, and other companies came, and so did the jobs. By the mid-eighties, Tennessee had 10 percent of all the Japanese capital investment in the United States, and this has continued. Nissan and Bridgestone have North America's largest auto plants and tire plants in Tennessee. With Mr. Hagerty's help, Bridgestone, as well as Nissan, have decided to locate their North American headquarters in our State. Bill Hagerty, if approved by the Senate, would go to Japan not only able to speak the language but, having lived and worked there, understanding how close ties between Japan and the United States can create bigger paychecks for Americans, as well as for the Japanese. I join my colleague, the chairman of the Foreign Relations Committee, Senator Corker, in enthusiastically saying it is my hope that the Senate will approve today his nomination and that he will soon be on the job, and his children will be in their respective Scout troops in Japan. I yield the floor.

Mr. ALEXANDER. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. ALEXANDER. I ask for the yeas and nays.