Maria Cantwell

Ms. CANTWELL

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Ms. CANTWELL

Ms. CANTWELL. Mr. President, I come to the floor this afternoon with my colleague, the Senator from Hawaii, who has been leading our efforts on coordinating a very loud and resounding voice on trying to stop the FCC from running over an open internet, and I thank him for his organization for today. I know we will be joined by our colleague, Senator Wyden from Oregon--and perhaps the other Senator from Oregon and several others--to talk about this important issue. We are here today to try to draw attention to one of those important economic issues before us: the need to preserve an open internet with strong net neutrality laws. We are facing a pivotal moment in the fight to preserve an open and fair internet. A strong and open internet is, without question, one of the great innovations of our time and one of the great job creators of our time. Yet the Trump administration stands poised to undo the bedrock principle of net neutrality in the face of evidence it would undermine our economy and undermine future job growth. The FCC has announced its intention to go against the demands of 5 million American consumers and reverse what is an existing rule so that big cable companies and telecom providers can erect toll lanes; that is, if you want fast internet speed, you have to pay more. This would threaten the fundamental nature of our internet and the innovation economy. Last week, FCC Commissioner Clyburn and I held a townhall meeting on net neutrality in Seattle. More than 300 people attended, and not one was in favor of paying higher prices to their cable company for worse or inhibited internet services. Many people shared their personal stories about how an internet with toll lanes would affect them negatively. We heard from many small businesses and startups that they were afraid of losing business because they might have to charge higher prices to their customers if these important protections were reversed. I heard from people with health problems and their concerns about health emergencies while away from home. The absence of net neutrality rules would mean that a doctor in their small hometown could not get critical information to the medical practitioners who are dealing with a patient in an emergency so that they could get important lifesaving treatments. Whether you are a doctor examining a patient via telemedicine or in an emergency room in Seattle or a student in a rural community trying to access the internet to get information, take a test or do research, a fast connection is necessary. Your ability to have a fast connection is something you are more than just a little concerned about. Being artificially slowed down in favor of big companies that buy faster lanes would turn our economy in the wrong direction. Our economy is in the midst of a massive technological transformation. As technology advances, incredible opportunities and new jobs are created. Every business plan of every startup relies on the ability to get content to consumers. Largely as a result of innovation and the proliferation of hundreds of startups in the United States, the internet economy today is now worth $966 billion and accounts for almost 6 percent of our U.S. GDP. This is a higher percentage of the U.S. economy than many other industry sectors, including construction, mining, utilities, agriculture, and education. Net neutrality--meaning you have an open internet that is not artificially slowed down unless you pay a ransom--is important for small businesses and startups and entrepreneurs who rely so much now on an integrated business model where internet access, marketing, and advertising their products and services to reach customers is critical. We need an open internet. We need it to foster job creation, competition, and innovation for the almost 3 million Americans workers who already rely on the internet economy today. When net neutrality was implemented a year-plus ago, we were protecting and making sure there was no uneven playing field. Basically, because of the regulations, we were able to help small businesses and entrepreneurs thrive. But our internet providers are internet gatekeepers, and without net neutrality, they would seize upon the opportunity to change that. One slice of the internet economy--the app economy, which is growing every single day--consists of everyone who makes money and has a job, thanks to mobile apps powered by an open internet. Today, 1.7 million Americans have jobs because of this economy. Nearly 92,000 of those jobs are in my State of Washington. Over the past 5 years, the app economy jobs have grown at an annual rate of 30 percent. I don't know of another sector that is growing that fast. The average growth rate for all other jobs is about 1.6 percent. By 2020, the app economy could grow to over $100 billion. Why is this so important? Because we all know that these various applications and apps make our lives better. They make it easier. In a busy world, they are helping us do the things that are so important to us with more ease and more certainty. The internet economy is dynamic and supercharged in creating job growth. This phenomenon of economic growth trajectory would not be possible without the internet as a platform for economic activity. This is why it is so important that the FCC not, in the dark of night, put down a rule without public comment to try to stop and change this direction that has already been protected by past FCC Commissioners. This is why my colleagues and I are here today on a date when everybody is trying to raise awareness--because the FCC could act as early as August 18 to try to change these rules. It is important that we oppose any new FCC actions trying to dismantle an open internet. We need to make sure we are talking about the harm to consumers, the harm to innovation, and the fact that internet speeds for American consumers are important and consumers shouldn't be burdened by a cable company holding you at ransom to pay more just to get faster speeds. Consumers are already struggling with high prices. Cable bills rose 39 percent from 2011 to 2015, eight times the rate of inflation. In 2015, the average consumer cable TV bill was $99 a month; just a year later, the average consumer cable bill had risen by 4 percent to over $103. My guess is a lot of people listening to this now are probably thinking, boy, where are we today? One of the most popular arguments by the enemies of an open internet is that it suppresses investment and leaves consumers with poor broadband infrastructure. That is a false claim. Data shows that investment by publicly traded cable companies and big telephone companies was 5 percent higher during the 2-year period following our protection of an open internet. Clearly, people are continuing to make investment. I want to make sure people understand that we do not want to see a change in this policy. We do not want to see American consumers run over by large cable companies that are demanding higher rates. We want to make sure that we don't end up with a two-tiered internet system-- one for big companies who will pay and pay and pay for faster rates, and consumers who are left with a very slowed-down, challenging to use internet, which makes it hard for us to continue to innovate. I encourage the American consumer to go out and contact the FCC. Yes, your voice can be heard. The FCC has already received 5 million comments, and they have until August 17 to hear more. Today, we are asking everybody in America to say: Please don't slow down my internet connection. Don't hurt our economy; don't hurt American business. Invest in innovation, and keep an open internet for the future. I yield the floor.

Ms. CANTWELL

Ms. CANTWELL. Mr. President, I have joined my colleague in coming to the floor to talk about how we need to make progress on healthcare and make sure that we don't pull healthcare out from millions of Americans. I thank the Senator from Illinois for talking about his constituents. Like the Senator from Illinois, I was at home this past July recess talking to my constituents, and I heard many of them talk about their individual healthcare needs and their concerns about what is happening in Washington. I met a young woman who told me about her daughter who was born prematurely and weighed less than 2 pounds. Her daughter required specialized, expensive treatment as a newborn. She was concerned that if we keep moving ahead with the repeal of the Affordable Care Act, she and her husband would be overwhelmed with crushing hospital debt if, in fact, we hadn't covered preexisting conditions. She is one of millions of Americans who are scared that they are going to lose their health insurance under the proposal that is being talked about, that has been talked about for the last several weeks, and from what we can tell-- because, obviously, there is a lot of secrecy--may still include details about reducing coverage for those who have access to care through Medicaid. I have come to the floor tonight to talk about the latest idea because I think one of the things that is clear--and probably why the Senate majority leader said that he wanted, basically, to cancel the first 2 weeks of the August recess--is that my colleagues don't want to go home and talk about the proposal that was brought before them. In fact, they are now trying to bring up a new proposal, thinking that, again, with a very limited time period, without floor discussion, without committee debate, without an amendment process, somehow our colleagues on the other side of the aisle will fall prey to the notion that there is a silver bullet, a magic solution. I have come to the floor knowing that an amendment or a discussion piece or the new behind-closed-doors discussion proposal being advanced by my colleagues from Texas and Utah is basically to allow junk insurance into the marketplace. What do I mean by junk insurance? I mean a proposal that basically offers less than the essential benefits, such as hospitalization, prescription drug benefits, lab costs, and all of those things; that, basically, by offering a market where you can get junk insurance, you can say: Oh, well, you have to have one offering of insurance that does cover all the basics and essentials, but then you can have junk insurance. I say ``junk insurance'' because this is the wrong idea for the marketplace. It is basically mixing good and bad and not having adequate risk spread across--so basically it means that you don't have to have compliant plans for the market. I know this firsthand because we had this in Washington. We had this same experiment in Washington in the 1990s, and people tried to do the exact same thing--basically, have a compliant plan, and then say that you have a bunch of less-than- adequate proposals for insurance in the market that really aren't giving individuals coverage. What happened? It drove up the cost of the compliant plans that covered most of healthcare and basically drove the insurers out of the market. That was the experience in Washington State. This same idea was tried, and it failed because basically it ran up the price, and insurers didn't stay around to offer options. They couldn't make the mandate of the required plan work because it basically took the risk out of the system. The notion that somehow this new idea by my colleagues is going to be the silver bullet is, in my opinion, not an answer at all. People who would be the ones who could get that kind of coverage for a short period of time would then end up leaving the rest of the people without adequate coverage. As I said, what happens is, the costs then just go up, and then the market has to adjust. I would say that in our State-- because a lot of people are talking about leaving the individual markets over the proposals that we are talking about today because they are concerned about the costs and who is going to be covered--you would see a very rapid collapse of the individual market exacerbated by what my colleagues from Texas and Utah are proposing. There are numerous nonpartisan health experts who seem to be saying the same thing. There is the American Academy of Actuaries, where one individual said: People who are healthy now would tend to choose noncompliant plans with really basic benefits. People who want or need more comprehensive coverage could find it out of their reach, because it could become unaffordable. Another individual from the American Enterprise Institute wrote that ``the main effect of the Cruz-Lee amendment would be to shift costs from healthy consumers to less healthy consumers and households with lower incomes.'' Douglas Holtz-Eakin, a Republican and former Director of the Congressional Budget Office called the amendment by my colleagues from Texas and Utah ``a recipe for a meltdown.'' Larry Levitt, senior vice president at the Kaiser Family Foundation, summed it up best when he called the amendment ``a recipe for instability and discrimination.'' So you can see that many people already understand the idea of junk insurance is not a market solution at all. It is not really even healthcare coverage. In its May 24 score of the House proposal, the CBO provided a definition of health insurance, saying that they would ``broadly define health insurance coverage as consisting of a comprehensive major medical policy that, at a minimum, covers high-cost medical events and various services, including those provided by physicians and hospitals.'' To me it seems pretty clear that the types of plans that could be sold under this proposal don't meet that definition. What are essential benefits that we expect to be covered in a plan? Obviously, hospitalization, emergency services, ambulatory services, mental health, prescription drugs, rehabilitation, if needed, laboratory services, like lab tests, and we have moved toward some preventive, health, and wellness measures. Those are the essential benefits that are supposed to be in a plan, and I want my colleagues to know that this experiment was tried. It failed. It drove insurers out of the marketplace because it just made the plans that were covering essential benefits so costly by distorting--really tearing the market apart. The second point about the proposal we are hearing about is that it is still a war on Medicaid. In my opinion there are cost-effective ways for us to continue access to healthcare. I have brought them up on the Senate floor. One would be looking at rebalancing from nursing home care to community-based care or, as I have mentioned, a basic health plan that bundles up a population and serves them up to get a discount so that individuals would have as much clout as a large employer would have in the marketplace. I hope that my colleagues will stop the focus on capping, cutting Medicare--because it would throw so many people off of the system--and focus on rebalancing people to the type of healthcare that will help us save costs, keep people in their homes, and give consumers the ability to compete cost effectively in the individual market. These are the problems I still see with this proposal. To think, basically, that junk insurance will be the way for us to get a proposal and to see that Medicaid is still the target in a war on Medicaid, to me, is not the proposal to move forward on. I hope our colleagues will realize that both of these have severe faults and will sit down and talk about the proposals that will help us in establishing a more robust individual market. I thank the Presiding Officer. I yield the floor.

Ms. CANTWELL

Ms. CANTWELL. Mr. President, together Senator Murray and I will continue to advocate for this critical infrastructure, working to ensure our colleagues and the administration understand the importance of the waterways and navigation systems in the Pacific Northwest. Investing in our water infrastructure supports jobs, economic security, and healthy communities. Senator Murray and I are proud to fight for the investments the Army Corps needs to operate, maintain, and restore the Ballard Locks.

Ms. CANTWELL. Mr. President, I join my colleague Senator Murray in commemorating the Ballard Locks' 100th anniversary. As our constituents in Washington State know, these locks are an integral part of our regional economy. The safe and efficient operation of the Ballard Locks supports $1.2 billion in total lock-related economic activity, more than 3,000 full-time jobs, and more than 1 million tons of freight. With over 1.3 million visitors a year to see the locks and the fish ladder and visit the Carl S. English Jr. Botanical Gardens, the Ballard Locks are one of the region's top tourist attractions generating another $40 million in economic activity per year. The Ballard Locks provide critical public safety and environmental functions, maintaining the water level of Lake Washington and Lake Union and preventing salt water intrusion from Puget Sound into these freshwater lakes. The locks support two floating highway bridges-- Interstate-90 and State Route-520--the water and sewer systems that serve Mercer Island residents, and approximately 75 miles of developed commercial, municipal, and residential shoreline. It also allows for emergency response by the Seattle Fire Department, Seattle Harbor Patrol, King County Sheriff, and U.S. Coast Guard. The facilities spillway and fish ladder serve as a link for salmon and steelhead migrating from the ocean upstream to freshwater spawning grounds, which is important to fulfilling Federal Tribal treaty responsibilities.

Ms. CANTWELL

Ms. CANTWELL. Mr. President, I join my colleagues here from the Finance Committee. Although I don't want to admit it, it was 10 years ago that we had this discussion in the Finance Committee--my colleagues from Maryland, from Delaware, and from Oregon. What people don't realize--even the Presiding Officer knows we spent a lot of time talking about healthcare. This was not ``let's have a few meetings and roll out a bill.'' There was a very long period. In fact, the Chair knows that, in fact, our side got a lot of heat for a lot of dialogue that happened with him and our colleague from Maine at the time--a lot of heat for dialogue with her. I think there was a period of time, about 6 or 7 months, where every single day I went to at least one thing in the discussion of the healthcare policy--at least one thing every day for like 6 months. That wasn't even the markup. Those weren't even the meetings. That was just the time period where the committee had designated various subgroups so we would talk about policy. I don't know if the two of you remember that period, but my recollection is every single day I was going to something regarding the healthcare policy and listening to experts and recommendations, and then, of course, we had these--I call them more roundtables than hearings. We had a lot of roundtable discussions, and we obviously went through a very formal bill process. There is a little bit of irony that we are the ones out here today still talking about this healthcare bill. I think it is because we knew what the challenges were, and we tried to address them and were not afraid to keep addressing them. We are not afraid to be out here today talking about solutions we want to see as well. I thank my colleague from Delaware and my colleague from Oregon for both being part of that effort because it really was an unbelievable amount of time and energy and discussion and formulation. The notion that somehow now we would take something that is one-sixth of the economy and draft something up in a dark process, then throw it out here--I am not surprised today that there aren't the votes. The thing to do now is not try to just rack up some votes in the next few days and come back in July. The thing to do is to sit down and have a serious discussion. I notice a couple of my colleagues are down at the White House. They are positioned right there next to the President. Maybe they are trying to put them on the hot seat. He is sitting there talking about the individual market. He is talking about the individual market in Alaska. All I am thinking is that the individual market in Alaska--we are sitting here, and the other side is proposing to cut 15 million people off of Medicaid. What does that have to do with the individual market? Nothing. I don't know if people are ready to focus on this the way we focused on it in that time period for more than a year--more than a year, day after day, meeting after meeting, hearing after hearing. I hope what they will do is stop this proposal and sit down and have an open process and have a discussion on these policies because they are so important. We have been having all this discussion, and a lot of the frustration people have talked about is the individual market, where 7 percent of Americans get health insurance. There are ways to fix and improve the individual market. I feel like I was fortunate enough to put forward one of the better ideas that worked successfully, at least it is working successfully in the State of New York, the Basic Health Program. So 650,000 people are on the Basic Health Program as a proposal. I think they call it, in that State, the Essential Plan. Two adults in a family of four can buy a policy for about $500 in premiums, on an annual basis, instead of about $1,500 on the exchange for that population that is above the Medicaid rate that needed to have a solution in the marketplace. There are 13 different companies offering insurance to those 650,000 people, so that is obviously working. Now, it got implemented late. New York did it in 2016 because they were off to the races, but other States should now consider this. What is so great about this and helping to address the individual market is because, where we are on this side, we are willing to allow individuals who don't work for a large company to get the same clout as if they worked for a large company. When you buy in bulk, you get a discount. Americans know that. That is why they shop at Costco. If you go there and buy in bulk, you get a discount. That is what they are doing in New York. So 650,000 people have been bundled up like they are a big company and saying to the marketplace: Who wants to bid on selling us insurance? The end result has been more affordable insurance in the individual market. That is what they should be discussing down at the White House today. That is what they should be discussing, not cutting 15 million people off Medicaid. That is not a smart idea. I am sure my colleagues here have already gone over this notion that once you cut people off of care, they end up in the emergency rooms or have exacerbated healthcare needs. So there are longer periods of time to get access to healthcare, more complicated healthcare costs, rising premiums. We have gone around our State and heard loud and clear from the provider community and the hospitals that they have seen downward pressure on the price of private insurance because we expanded Medicaid, and the economic numbers are out there now to show the same thing. Cutting people off of Medicaid is not the solution to the individual market. I hope somebody down there at the White House brings that up. In 2020, when the Medicaid cap--if it did go into effect--the analysis is it would cost shift $324 million per year to my State. They would be cutting people off of Medicaid, and then basically the cost would be $324 million a year to our State. You can imagine that our State doesn't have that money and isn't interested in picking up that tab. By 2028, when the Medicaid cuts start to kick in, we would be cost-shifting $4.2 billion per year to the state of Washington. That is not smart economics for us. Over the weekend, I visited Virginia Mason Hospital in the northwest--again, a great success in delivery system reform. They implemented the Toyota model of production. There is, literally, faster turnaround time on lab reports and better expedience of nursing care. I think there was something like a 72-percent reduction in insurance liability costs. I mean, there are huge successes by changing and improving the delivery system that helps put pressure down on price. This is what we need to be talking about. There is much innovation that was in the Affordable Care Act. We need to now ask the question: What further things do we need to do to make sure we drive down costs in the individual market as well? But with this Senate bill, you are not going to drive down price. There are reports now out by the Center on Budget and Policy Priorities last Friday that show the price will actually go up in the individual market if you cut people off of Medicaid. Basically, it will just increase by several thousand dollars the actual amount of money the people in the individual market will have to pay for insurance, so that clearly is not the solution. I urge my colleagues on the other side of the aisle--I hope they come back and say that it is time to work in a discussion about these ideas in a broad way, not just another Hail Mary pass. Just get rid of this notion that cutting poor people off of Medicaid is somehow going to magically fix the individual market. It is not. I thank my colleagues from the Finance Committee who went through all of that. Believe me; I am telling you, these discussions went on for weeks and weeks and weeks. Some people here are trying to come up with a score and get an answer in a week on this entire package. I think we debated, I would say, probably 2 or 3 weeks just on the notion of reforming-- getting off of fee-for-service and focusing on a value index and getting the priorities of the delivery system focused on better outcomes at lower costs. This is something that really should be a big priority in healthcare. I remember we had private meetings. We had the head of CBO come down and talk to us. We had hearings. We probably spent 3 weeks just on one concept of how effective that would be in the healthcare delivery system. I see we are still here. We are still talking. We are still willing to improve this delivery system and make sure people have better access to care, and I thank my colleagues for including me in this discussion today. I want to again thank the Senator from Oregon, the ranking Democrat on the Finance Committee. I know he knows exactly what I am talking about when we talk about innovation. There is so much innovation he put into the Affordable Care Act, giving states discretion. They already have all the discretion they need; they have all the discretion they need to keep innovating. Hopefully we will get our colleagues to follow suit because this is where we are going to deliver better care at lower costs and help improve the access for everybody in America. I thank the Senator from Oregon.

Ms. CANTWELL

Ms. CANTWELL. Mr. President, I come to the floor to join my colleagues. We can see there are numerous colleagues on this side of the aisle who are speaking, just as my colleague from Vermont just did with great passion or my colleague from Massachusetts did with great passion and as I am sure my colleague from Minnesota will. We have all been home for the weekend talking to our constituents. We are all back here now with the CBO news, and we are here because we are very concerned about the next steps the Senate might take in this healthcare debate. When I was at home, I heard some unbelievably positive stories about healthcare. I was at a hospital in our State, Virginia Mason, which has been one of the leaders in reducing healthcare costs by utilizing new efficiencies. They have improved the return time of getting lab results to patients by 85 percent; they have increased productivity in some areas by 90 percent; they have reduced liability insurance premiums by 76 percent. They have innovated. They have innovated. They have innovated. They talked about the direction healthcare should go, and not once did they mention cutting or capping Medicaid as a solution. I also talked to a community health center which, under the Affordable Care Act, was actually able to expand in a community. They literally cut in half the uninsured, and they are delivering great adult dental access to thousands of people in a county that didn't have good access to dental care. They are making great progress. I talked to a veteran who served our country, who literally got out and is now going to school but without the help of Medicaid would not have been able to cover her healthcare expenses. I met a woman on the street who told me her husband had lost his job. She never thought they would be on Medicaid, but when he lost his job, they went on Medicaid, and they depended on that to provide healthcare for themselves and their children. I met a gentleman who also said he, too, lost his job, and after that came down with a serious, life-threatening illness, and it was only Medicaid that saved him. So what do we know today that is different than last Friday? We now have some CBO numbers. We know the numbers. We know the numbers: that 22 more million Americans, as a result of this bill, if it is passed, would be uninsured; 15 million of them on Medicaid; and $772 billion in Medicaid cuts. We know we thought it was heartless. Now we see the numbers that say cutting that many people off of Medicaid is, in my opinion, as my colleagues have also said, not something we should be pursuing as a nation. It leaves us to ask about not just the impact of this on individuals, as I just mentioned--because I believe there is a much better way to go with innovation--but what it also does for the individual market. A lot of this debate started because people thought the individual market hadn't seen some of the benefits of the employer- sponsored system. Well, why not talk about the individual market? If 7 percent of the way people access health insurance, the individual market, was having a problem, why not talk about ideas to improve the individual market? Instead, we have a bill from the House and the Senate that beats up on the Medicaid population as if they are the culprit. If you want to improve Medicaid and delivery services and help decrease costs, let's do that. There are so many innovative ideas, but just cutting people off Medicaid to solve the individual market problem doesn't even make sense to me. We now have, as of last Friday, too, the Center on Budget Policy and Priorities' assessment, talking about how this would raise individual premiums in the individual market. They gave some examples. For example, in West Virginia and Nevada, a 60-year-old with an income of $36,000 would pay respectively, $5,000 and $4,000 more than what they are paying now. In Alaska, a 60-year-old making $45,000 would pay $5,777 more than what they are paying now for premiums. So the notion that this bill is driving down costs is just a fallacy. We have heard from Republican and Democratic Governors talking about this. They sent us a letter saying the first thing we should do is focus on improving our Nation's private health insurance system. Where did the Governors ask that you come and beat up on Medicaid? They didn't say that. They didn't say: Please beat up on Medicaid, have a big party covering people on Medicaid as a partner with us for 65 years and then leave us stuck with the bill. They didn't say that. They say: Medicaid provisions included in this bill are problematic. Instead, we recommend Congress address factors we can all agree need fixing. That is a pretty clear message, I believe, from Republican Governors who are saying this is not the way to fix healthcare. Also, last week, a nonpartisan study by the George Washington University found that the House-passed bill would have a huge economic impact on our country. States' economies would shrink by $93 billion, compared to what they would be without the bill. Business output would be cut $148 billion. The study notes that the bill, combined with normal economic cycles ``could contribute to a period of economic and medical hardship in the U.S.'' That report also talks about job loss throughout the country, saying that individual states would see more than $1 billion in lost gross State product, just because of the number of people who wouldn't be covered, the number of healthcare providers who would no longer be there, the loss of healthcare infrastructure and then the impact on the healthcare system overall for uncompensated care. These are costs we can't afford. As my colleague Senator Sanders mentioned, there are all these healthcare organizations that have now come out saying they don't support this Senate-drafted bill. The Academy of Family Physicians knows about caring for the Medicaid population. They are seeing so many patients, and they know what this challenge is. The American Psychological Association doesn't support this bill. Other healthcare associations, such as the Catholic Health Association, do not support this bill. I have a long list. Mr. President, I ask unanimous consent to have printed in the Record the list of healthcare-related organizations and others that don't support this legislation.

Ms. CANTWELL. Mr. President, I hope my colleagues understand that there are those here who are very willing to talk about how we can improve our healthcare system, but we are not going to make poor Americans the scapegoat of our healthcare challenges. A gentleman named Joe Baker, president of the Medicare Rights Center, I think, said it best. He said: You or someone you love is going to need Medicaid. You may not need the nursing home care . . . but you may rely on community-based services, like home care, that will allow you to stay in your home and out of a nursing facility. Medicaid is the lifeline that covers many of the benefits that Medicare does not provide. Now why did I read that? Why did I pick a guy who is the head of a Medicare organization? Because he knows what his individual organization participants need in a healthcare delivery system. Everybody knows--everybody knows the people of America are living longer and as they age they need more healthcare. To our colleagues who want to reduce those costs, we are ready to come and talk about how we are going to reduce those costs. I have talked about how I authored a community-based ``rebalancing'' program--the kind of rebalancing that helped our State save more than $2 billion. If we did that in every State, we would be saving billions of dollars, but the notion that we are going to proceed in the next 24 hours or so on a motion, after we have a CBO report that says this would have a devastating impact on millions of people with Medicaid, is not the right way to go. Taking this out on the poor people of America who need Medicaid will make it worse for us as well. It will raise our rates, return the costs to where they were, and not help us solve this problem for the future. I hope our colleagues will understand that so many people are raising so many concerns about this. Yes, it is about economics, but there are also personal stories of people, such as our colleague from Hawaii who said: You never know. You never know when an individual situation is going to affect you, and you want to make sure there is healthcare to help you get through that crisis. Thank you. I yield the floor.

Ms. CANTWELL

Ms. CANTWELL. Madam President, I thank my colleague from Maryland for articulating the issues in this discussion draft that has been released this morning. As I hear him talk about these complex kids, how the cap is going to work, and when people are going to be affected, it reminds me of the book, ``The Smartest Guys in the Room.'' Right? Basically, people cook up schemes they think other people can't understand or the broader public will not catch on to in the hopes they can pass something. That is exactly what is going on here, a hoax and a scheme that is not cost- effective for the American taxpayer and will literally cut people off of access to healthcare, and literally, if the House bill was mean, this is doubling down on mean. So I thank my colleague from Maryland for articulating the complex kids issue because these are concepts. If this is a discussion draft, I would hope my colleagues would come to the floor and discuss it-- discuss the concepts that are in this bill and debate them, but that is not what is happening. In fact, we know very little detail at this point in time because people are assessing the information and trying to read and assess in between the lines. I can state what I know and have gleaned so far by the accounts, and that this is a continuation on the war on Medicaid. I say that because with regard to this war on Medicaid, we didn't know where the Senate would go in their proposal. We know what the House decided to do. The premise and structure of the House bill is to cut Medicaid by capping it and continually driving down the amount of Federal obligation to this program. I will tell you, it is not even a smart idea. If you want to reform and deliver better healthcare at a lower cost, there are many ways to do that and save dollars and give better patient care, but that is not what the House proposal is. It was a budget mechanism. I am not just saying that. I am talking to my healthcare providers at home, I am talking to university professors, people who know and understand healthcare and have studied it for a long time. What the House did and now the Senate is doubling down on is nothing but a budget mechanism to cut people off of healthcare--as my colleague said, the most vulnerable of our population. It is a wrong-headed idea. It is not going to help us control costs. Medicaid reduces bankruptcy rates, helps people stay employed, and boosts our GDP. Why would we want a draconian idea like cutting Medicaid as the centerpiece of a budget proposal by our colleagues on the other side of the aisle? As people have said, because they want to take that revenue and give it away in tax breaks for the wealthy. I guarantee you that is not what we should be doing. The access to Medicaid is so important. Our veterans access the healthcare system through Medicaid. Many of them receive care through the VA, but also they receive services through Medicaid. Veterans would be impacted and would lose care. Our children who are seen at hospitals, such as the Children's Hospital in Seattle, are Medicaid populations, and they would not have the resources to get access to care. Our institutions that are covering individuals at Medicaid rates would take a hit. All the Senate proposal does is basically move that cap, but it is a steeper cap at a point in time that makes and exacerbates this problem of cutting people off of access to care. So if the House bill is mean, this is just doubling down on mean. There is nothing about destructing this safety net that is so important to Americans that goes hand-in-hand with the philosophy about how to drive down costs to healthcare. If you think about it, if we came out here and had a discussion with 100 U.S. Senators and said a great way to drive down the cost of healthcare would be to cut people off of healthcare, most people would say that is not a smart idea because when people are cut off of healthcare, we know that uncompensated care exacerbates healthcare needs, challenges other parts of our system, and delivering care to them makes it more expensive. When we have had discussions and roundtables about the proposal that the House had put out, providers in my State told me point-blank, covering the Medicaid population has helped drive down and control the rate of insurance in the private markets. By saying we are going to cut Medicaid at a more drastic rate, we are going to just send a signal to the market that rates for the private insurers should go up. I don't think that is what my constituents want. They want us to innovate. They want us to drive quality care and managed care into parts of the United States where it doesn't exist. They want us to take care of our most vulnerable population, and they want to make sure we are not delivering that off people who are going into the emergency room 50 times in a year because they don't have insurance. We know the Medicaid rate is critically important. Medicaid costs up to one-quarter less than private insurance. It is a way to deliver care. We know measures we put into the Affordable Care Act, such as moving people off of nursing home care to community-based care, has saved Medicaid dollars. More States should do it. We know plans such as bundling up the individual market into larger programs so they can have clout like others who work for a larger employer has also driven down costs. So those are the things we should be accelerating, not this notion that we move forward as a country by cutting the most vulnerable off of healthcare. I ask my colleagues to come out and discuss this concept, discuss this idea, how it will affect the healthcare providers in their States. I plan to do that with my State. I hope they will come out here and tell us why it is a smart strategy to cut people off from Medicaid. I know no State that has the money to make up for the Federal share of Medicaid that is going to be doubled down in this bill. I do not want to see a war on Medicaid. What I want to see is innovation. What I want to see is that covering people with some level of insurance basically helps save everybody on their insurance bills as well. I hope my colleagues will take this discussion draft and be proud to come out here and discuss it, but we have heard very little of that thus far. Let's look at the real numbers, and I guarantee that we will hear from Governors, we will hear from States, we will hear from providers, we will hear from businesses, and we will hear from people who do not think this is a good idea. Already there are comments from the National Association of Area Agencies on Aging: ``This strategy will also put . . . Medicaid [and] states [and consumers] on a fiscally precarious path.'' We have heard from other people that the Medicaid cap is up to twice as bad for States, will cause problems, and also from children's healthcare groups: ``Converting Medicaid into a per capita cap . . . would dismantle critical protections . . . to care for all enrollees.'' These aren't just partisan comments. These are the facts. What my colleagues don't realize is that by taking a huge chunk out of Medicaid, you are taking a huge chunk out of the safety net so many Americans depend on. It will not help us lower costs. It will exacerbate an escalation of rates for everyone in the market. I thank the Presiding Officer, and I yield the floor.

Ms. CANTWELL

Ms. CANTWELL. Mr. President, I come to the floor tonight to join my colleagues to raise concern about a proposed Senate healthcare bill that might move through the U.S. Senate, as my colleagues are pointing out, without a hearing, without attention to details, actually almost in secret. I guess it would be secret--if we didn't know exactly what was in the House bill, it would be even more secret. People have said it is probably going to be 80 percent of what is in the House bill. I can tell you, I agree with President Trump. That was a mean bill. So if it is just 80 percent mean, I guarantee it is still going to be mean. I say that because I have been at home listening to my constituents, and they do not appreciate it one bit. If you are Harborview Medical Center and you are a public hospital and you are going to cut $627 million out of their budget because of your cap on Medicaid and you are going to leave a regional hospital without resources, they are mad. If you are talking about children's hospitals and they see children who are on Medicaid and they are not going to be able to see those children or get coverage, they are mad. Just Saturday I was with veterans in Vancouver, WA. People don't understand, but veterans of the United States of America do not get all of their healthcare coverage through the VA. They get it with Medicaid at individual clinics for services. I have met several of these people in my State, and they have told me point-blank, without access to Medicaid, they would not get the benefits they need as veterans of our country. I think it is mean to break our promise to veterans and not give them access to Medicaid. I think this whole discussion is basically the fact that we are trying to box with these guys on a proposal. If their proposal is so great, they should come to the Senate floor and just-- don't even talk about the bill, talk about the principles. I want to know, in the Republican proposal, what ideas do you have to lower costs, increase the quality of care, or improve access. Those are the milestones by which you should be debating healthcare. Now, if your goal is to just cut Medicaid and cut people off Medicaid and cut their benefits so you can give tax breaks to the rich, OK, you might convince me that, yes, you have a proposal--because I think that is exactly what their proposal is--but if your proposal is about reducing costs, then come out here and debate it. Don't even tell me what is in the bill; just show up on the Senate floor and debate us and say: Here is our idea for reducing costs. I will tell you what my idea of reducing costs is because I wrote it into the Affordable Care Act and some States are doing it and it was a good idea. It was called give the individual who doesn't work for a big employer the ability to negotiate with clout and be bundled up with other people. That is what they did for the working poor in New York. So 650,000 people in New York are now on something called the Basic Health Program. Why? Because they didn't work for an employer that could negotiate a big discount for them. We asked, on our side of the aisle: Why would we let poor people just get thrown around in the market and not be able to drive a decent price? I call it the Costco model. So we said to them: We are going to let you be bundled up like the big employer is and you are going to be able to drive a decent price in the marketplace. That plan is giving a family, with $40,000 a year of income and four individuals in the family, a yearly annual premium of about $500 instead of $1,500 on the exchange. So that is an idea. So come out here and discuss that or, if you want to tell me you have figured out a way to give better quality of care, I would love to hear that idea. I would love for you to come out and tell me how you are going to deliver better quality of care because I can tell you there are things in this bill that are about quality of care. They are about improving the way that organizations deliver care so they are rewarded for achieving better outcomes for patients. The whole idea of accountable care organizations are that you put the patient at the center of the delivery system, and you reward them for doing a good job of delivering better outcomes. We have innovated. We have innovated in the Affordable Care Act. If you are talking about access, come out and tell us what proposal you have that is about increasing the access to healthcare. I would love to hear it because in the Affordable Care Act, we already did that too. We said: You know what. It is kind of crazy and expensive to think that everybody who ages, particularly in Medicaid, should spend time in a nursing home. Why? It is more expensive, and I don't think I have met one Washingtonian who told me they really wanted to go to a nursing home. They want to stay at home. So we wrote into the Affordable Care Act incentives for States to change the delivery system, as we have done in the State of Washington, and deliver affordable care to people at home in their communities. By gosh, actually some States--Texas, Arizona, Indiana, other States--took us up on it. They said: What a great idea. We want to reduce costs. So if that is such a great working aspect of the Affordable Care Act and you think it works and it increases access to care by giving people community-based care and reduces Medicaid costs, come out here and talk about it. Talk about what you want to do to put that program on steroids so more people in America can benefit from better access to care and not think they are going to spend their last days in a nursing home. That is what we should be debating. But we can't even see or hear or have a hearing about what this proposal is. Yet my colleagues can't even come out here and throw a concept on the table. But the fact that you want to affect over 1 million veterans who have fought for our country and you are going to cut many of them off of the Medicaid care they deserve to have access to--that is a broken promise. It is just as broken a promise as what President Trump said. President Trump tweeted: I was the first and only GOP candidate to state that there will be no cuts to Social Security, Medicare, and Medicaid. So I am not surprised that he calls it a mean bill. But he should also own up that it cuts Medicaid. We all have an office budget. I see my colleague from Virginia here. If we took our office budget and said: We are going to cut it and cap it, and next year it is going to be lower, and next year it is going to be lower, and next year--in perpetuity--that is what their idea is, it is to put a cap on Medicaid and cut it in perpetuity and basically cut it out of existence. I don't know why they are beating up on Medicaid, because Medicaid has provided great stability to so many people in our country. It has lifted people out of poverty, provided healthcare, stabilized communities, and raised the economic standard of living in many communities in our country. I received a letter from a superintendent from the Vancouver School District. He wrote to me about the devastating impacts that capping Medicaid would have on his students. He wrote: Our school-based Medicaid programs serve as a lifeline to children who can't access critical healthcare and services outside of their school. He goes on to say: Restructuring Medicaid to a per capita cap system would undermine Vancouver Public Schools' ability to provide America's neediest children access to vital healthcare [insurance]. So why would we do this? I met a veteran, Kristina, who is 46 years old and a full-time student. She suffers from chronic and disabling injuries and needs a high level of care. The care she gets from Medicaid helps her access the medication that manages her chronic care and keeps her going, and she is working toward that degree. Why would we cut somebody like that--a veteran--off of Medicaid just because someone's idea over here is to cap and reduce Medicaid? These stories are from all over the country, and people are wondering: Why would you take this level of investment in Medicaid out of our entire economic system? Why would you impact our school districts, our regional hospitals, our veterans, our Medicaid population? Why would you affect a community that has a large Medicaid base? And that is the way they serve them. Our hospitals have told us: We have stabilized private insurance premiums because more of the population is covered and has access to Medicaid. You rip that back, and we will be back to skyrocketing costs, with people in the emergency room, no access to care other than that facility, with impacts on everybody on private insurance and on Medicaid. It is just not a good idea. So I ask my colleagues, come out here. Don't say you want a patient- centered healthcare delivery system, because we are all for that, and we actually put things in the Affordable Care Act that did that and are working. If you want to make that claim, come out here and say what it is that you don't like about the patient-centered delivery system that we are working on promoting, and how you want to change it. If you say your proposal increases access to Americans, let's hear it, if it is about better quality. But I don't hear any of that. I just hear a drumbeat by some people who want to be heartless and cut people who have access to healthcare, people who are less fortunate in our society, because they want to cut Medicaid. The President promised he wasn't going to do that. I ask my colleagues to live up to that, and let's start talking about the substance that truly will increase access, lower costs, and give better care to our constituents and the people of the United States of America. Mr. President, I yield the floor.

Ms. CANTWELL

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

Ms. CANTWELL. Mr. President, this side of the Capitol is obviously sending our thoughts and prayers to colleagues in the House of Representatives--particularly, to Congressman Scalise--and to the other wounded law enforcement individuals and staff. Certainly, our hearts and prayers go out to those individuals too. These men and women who protect us every day here in the Capitol do an outstanding job. We really want to make sure they understand how important it is and how much we appreciate their protection of us and the security they provide to everyone here in the Capitol. (The remarks of Ms. Cantwell and Ms. Collins pertaining to the introduction of S. 1352 are printed in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'')

Ms. CANTWELL

Ms. CANTWELL. Mr. President, I come to the floor this afternoon with my colleague from Maine to talk about an important issue, as well, something we had long planned to introduce today and did so this morning--the reintroduction of a Senate bill focusing on apprentice programs. My colleague Senator Collins and I, in the past Congress, wanted to make sure people understood how important we thought the apprentice program was, and we introduced legislation then to create a Federal incentive for apprentice programs. We are coming back now in this Congress and reintroducing this legislation. I know there has been a lot of talk about apprentices this week. We just had a roundtable discussion this morning with some of our business and labor leaders talking about the skills gap and the need for more apprentice investing as it relates to manufacturing. I know the President is doing some discussion of the apprentice program too. Obviously, it is no surprise to anybody in America that the President knows--or at least has used--the word ``apprentice'' in a pretty aggressive way throughout his career. So I hope he will tune in and listen to what my colleague from Maine and I have to say about this. We are saying that it is time in America to have a Federal priority on apprentices; that is, the first-ever tax incentive for hiring an apprentice. Why do we want a Federal priority? Because we know that in America we need to skill and train a workforce for tomorrow, and so many people in America aren't training and aren't skilling for those jobs. In the downturn of our economy, a lot of people lost faith. What should they invest their time and money in? There was so much transition in the economy that people weren't sure where they should skill themselves. As we see a transitioning economy now in various sectors, as they continue to modernize, and as technology continues to change, people also say to themselves: What should I skill myself in? What should I get trained in? Because they are not sure that, at the end of that period, they will be right there with what the job market wants. That is why apprenticeship is so important today. By giving a Federal incentive for the apprentice program, we are saying: Hire and train. We are actually saying: The apprentice program is earning while you learn, and it will help so many Americans take that issue off the table where they weren't sure whether or how they should skill themselves. They actually are hired and trained on the job. This is something we have known as a country for a long time. We know the apprentice program has worked. We have seen it across many sectors, in building trades and construction. We have seen it in other areas. In aviation, for example, in the Pacific Northwest, the Boeing Company has taken great advantage of the apprentice program. There are so many other sectors. The maritime sector has taken advantage of the apprentice programs. What we are saying today is that we need to make this a national priority in a more aggressive way. The Department of Labor and registered apprentice programs are part of what we make an investment in here in the Federal budget. But what we are not doing is putting it on steroids, and that is what we need to do now. Our legislation would create enough incentives for 500,000 new apprentice program individuals over the next 10 years. We think this is critically important because we know how much the U.S. economy needs these skilled workers. According to the National Skills Coalition, 53 percent of U.S. jobs are middle-skilled, meaning that they require some postsecondary education. Yet only 43 percent of U.S. workers are trained at that level. According to the National Association of Manufacturers, 67 percent of their members report a shortage of available, qualified workers. We are going to need 3.5 million manufacturing jobs over the next decade, and this leaves us with a shortage of about 2 million. So we need to give our businesses the skill levels they are looking for so they can be competitive, so they can meet their market needs, and so they can make profits and help grow our economy. We can't let them be deterred by the fact that they have the opening and they have the jobs, but they just don't have the skill level. By doing an incentive program, we can help get a national message out: The apprentice program is a key part of our economic strategy, and skilling a workforce for the jobs of today and tomorrow is the best recipe for growing our economy. There has been an overall decline in employer-provided training over the last two decades. By making this investment now, we are going to help U.S. businesses with the investment that should be made and, further, as I said, expedite getting people into the programs we need to get them into. If we are going to be competitive and our businesses are going to compete in this global economy and they are going to continue to innovate, they need the workforce to do it. I think about the chip fabrication industry. Before Intel came along, probably no one knew how to do chip fabrication. But there was a sector of our economy that taught and educated people on chip manufacturing. That will not be the last innovation our economy sees. In aerospace, we have been able to, with composite manufacturing, make lighter weight planes. That composite was a huge shift from the aluminum that dominated aerospace. But composite manufacturing is a whole new skill level in which we are still training and educating the workforce. We need to compete in that sector, which is so important to manufacturing jobs. I would say that every aspect of our economy needs apprentices. But what does the apprentice get out of it? Not only do they get a job and they get to be skilled on the job, but they also earn more. Over the course of their career, a registered apprentice earns about $300,000 more than a non-apprentice working in the same field. A study done by our State Workforce Training and Education Coordinating Board found that completing apprentices earned $13,000 more per year just as they started. So apprentices are a win-win for us and our economy. They give the employer the skills they are seeking to make their companies successful, and the individual worker gets trained and hired in a field that takes away this uncertainty about our economy, which has so plagued us over the last decade or two, and the community gets a more successful employment base and successful companies that add to the economy of a region and to our country. I am so glad to be here with my colleague Senator Collins, who has known that this apprentice program has been a success, and that is why she and I have partnered for years on this program. We hope now that by reintroducing it and getting more of our colleagues to join in, they, too, will talk about why apprentices are so important today. We hope there is a guy down the street in the White House, who had a program called ``Apprentice,'' who takes seriously the bipartisan effort of two Senators who have been at this for a few years, and says: This is where we should be spending our money and making an investment to skill, educate, and employ Americans right now, for today. I yield to my colleague from Maine.

Ms. CANTWELL

Ms. CANTWELL. Mr. President, I come to the floor this afternoon with my colleague from Maine to talk about an important issue, as well, something we had long planned to introduce today and did so this morning--the reintroduction of a Senate bill focusing on apprentice programs. My colleague Senator Collins and I, in the past Congress, wanted to make sure people understood how important we thought the apprentice program was, and we introduced legislation then to create a Federal incentive for apprentice programs. We are coming back now in this Congress and reintroducing this legislation. I know there has been a lot of talk about apprentices this week. We just had a roundtable discussion this morning with some of our business and labor leaders talking about the skills gap and the need for more apprentice investing as it relates to manufacturing. I know the President is doing some discussion of the apprentice program too. Obviously, it is no surprise to anybody in America that the President knows--or at least has used--the word ``apprentice'' in a pretty aggressive way throughout his career. So I hope he will tune in and listen to what my colleague from Maine and I have to say about this. We are saying that it is time in America to have a Federal priority on apprentices; that is, the first-ever tax incentive for hiring an apprentice. Why do we want a Federal priority? Because we know that in America we need to skill and train a workforce for tomorrow, and so many people in America aren't training and aren't skilling for those jobs. In the downturn of our economy, a lot of people lost faith. What should they invest their time and money in? There was so much transition in the economy that people weren't sure where they should skill themselves. As we see a transitioning economy now in various sectors, as they continue to modernize, and as technology continues to change, people also say to themselves: What should I skill myself in? What should I get trained in? Because they are not sure that, at the end of that period, they will be right there with what the job market wants. That is why apprenticeship is so important today. By giving a Federal incentive for the apprentice program, we are saying: Hire and train. We are actually saying: The apprentice program is earning while you learn, and it will help so many Americans take that issue off the table where they weren't sure whether or how they should skill themselves. They actually are hired and trained on the job. This is something we have known as a country for a long time. We know the apprentice program has worked. We have seen it across many sectors, in building trades and construction. We have seen it in other areas. In aviation, for example, in the Pacific Northwest, the Boeing Company has taken great advantage of the apprentice program. There are so many other sectors. The maritime sector has taken advantage of the apprentice programs. What we are saying today is that we need to make this a national priority in a more aggressive way. The Department of Labor and registered apprentice programs are part of what we make an investment in here in the Federal budget. But what we are not doing is putting it on steroids, and that is what we need to do now. Our legislation would create enough incentives for 500,000 new apprentice program individuals over the next 10 years. We think this is critically important because we know how much the U.S. economy needs these skilled workers. According to the National Skills Coalition, 53 percent of U.S. jobs are middle-skilled, meaning that they require some postsecondary education. Yet only 43 percent of U.S. workers are trained at that level. According to the National Association of Manufacturers, 67 percent of their members report a shortage of available, qualified workers. We are going to need 3.5 million manufacturing jobs over the next decade, and this leaves us with a shortage of about 2 million. So we need to give our businesses the skill levels they are looking for so they can be competitive, so they can meet their market needs, and so they can make profits and help grow our economy. We can't let them be deterred by the fact that they have the opening and they have the jobs, but they just don't have the skill level. By doing an incentive program, we can help get a national message out: The apprentice program is a key part of our economic strategy, and skilling a workforce for the jobs of today and tomorrow is the best recipe for growing our economy. There has been an overall decline in employer-provided training over the last two decades. By making this investment now, we are going to help U.S. businesses with the investment that should be made and, further, as I said, expedite getting people into the programs we need to get them into. If we are going to be competitive and our businesses are going to compete in this global economy and they are going to continue to innovate, they need the workforce to do it. I think about the chip fabrication industry. Before Intel came along, probably no one knew how to do chip fabrication. But there was a sector of our economy that taught and educated people on chip manufacturing. That will not be the last innovation our economy sees. In aerospace, we have been able to, with composite manufacturing, make lighter weight planes. That composite was a huge shift from the aluminum that dominated aerospace. But composite manufacturing is a whole new skill level in which we are still training and educating the workforce. We need to compete in that sector, which is so important to manufacturing jobs. I would say that every aspect of our economy needs apprentices. But what does the apprentice get out of it? Not only do they get a job and they get to be skilled on the job, but they also earn more. Over the course of their career, a registered apprentice earns about $300,000 more than a non-apprentice working in the same field. A study done by our State Workforce Training and Education Coordinating Board found that completing apprentices earned $13,000 more per year just as they started. So apprentices are a win-win for us and our economy. They give the employer the skills they are seeking to make their companies successful, and the individual worker gets trained and hired in a field that takes away this uncertainty about our economy, which has so plagued us over the last decade or two, and the community gets a more successful employment base and successful companies that add to the economy of a region and to our country. I am so glad to be here with my colleague Senator Collins, who has known that this apprentice program has been a success, and that is why she and I have partnered for years on this program. We hope now that by reintroducing it and getting more of our colleagues to join in, they, too, will talk about why apprentices are so important today. We hope there is a guy down the street in the White House, who had a program called ``Apprentice,'' who takes seriously the bipartisan effort of two Senators who have been at this for a few years, and says: This is where we should be spending our money and making an investment to skill, educate, and employ Americans right now, for today. I yield to my colleague from Maine.

Ms. CANTWELL

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

Ms. CANTWELL

Ms. CANTWELL. Mr. President, I come to the floor to talk about the President's proposed budget as it relates to Medicaid and the fact that it is just a war on Medicaid; that is, it continues the wrongheaded ideas that have been proposed in the House bill on healthcare reform and takes that and continues to make cuts to Medicaid that are unsustainable for our healthcare system. The President's budget would impose a block grant or per capita cap on States in 2020 in exchange for so-called flexibility. I haven't met one State administrator of healthcare in our State who says they need more flexibility. They have a lot of flexibility on Medicaid currently, but they know this is just a budget cap and a budget cut. The budget would result in $610 billion in cuts to States, in addition to what would happen if they were successful in passing the House bill in the Senate. As the Center on Budget and Policy Priorities put it, the Trump budget cuts Medicaid ``considerably more deeply than the House bill's per capita cap proposal would do.'' No doubt what the budget is proposing from the President today and what our House colleagues have proposed on healthcare means more damage for healthcare and more damage for Medicaid. Let's be more specific. Medicaid for healthcare is about children. It is about seniors. It is about the disabled. It is about working families. It is about young people. Medicaid covers half of the births and the majority of long-term care stays. What people may not realize is that the President's budget cut to Medicaid also cuts children's healthcare, as a new study reveals, by at least $43 billion, according to Avalere Health. That is taking healthcare away from children, poor children, who need access to healthcare. Additionally, the budget impacts 1.75 million veterans who also get healthcare through Medicaid. How can we possibly be standing here with a budget proposal by the President of the United States--after he promised not to cut Medicaid-- that not only proposes to cut Medicaid but cuts childrens' and veterans' healthcare when they need it most? Medicaid is a lifeline for people who can't get covered or can't get a fair deal. It is a highly cost-effective, dynamic, and innovative program that has worked well, and Medicaid is a winning economic strategy for how to help families get out of poverty. It is one of the most successful anti-poverty programs in the United States and the second largest program to combat extreme poverty. Its expansion in Washington has helped create jobs indirectly and directly and has saved our State about $353 million in our State budget. It injects billions into the economy and supports our high- wage, high-skill jobs throughout the healthcare economy. As we know, our colleagues, in the House draconian healthcare act, would for the first time cut Medicaid's successful program by introducing a cap that would result in reductions every year to the Medicaid Program. Regardless of who needs access, regardless of those children, regardless of those veterans, it would continue to push down Medicaid funds by more each year. I have said to my colleagues in the House that there are far more innovative ways to help our healthcare delivery system that are cost- effective, but simply cutting veterans or families or children off of Medicaid is not the way to do it. The President's budget released today would reinforce this permanent cap. Currently, Medicaid is a needs-based partnership between the States and the Federal Government. During economic recessions, natural disasters, or public health emergencies, States know they can count on the Federal Government. Under what has been proposed in the House, the per capita cap would give States only a fixed amount and start reducing the amount of money each year. It would leave a tsunami of seniors and others without new technologies, prescription drugs, or tools to address new healthcare threats. There is nothing about it that is reform. It is not innovation. It is simply a budget mechanism to cut Medicaid. I don't know how the President, given that he promised before not to cut Medicaid could do this. He said: ``I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid.'' If that is what the President tweeted, if that is what he said he was going to do, why is he now proposing a budget that actually cuts Medicaid? We do not want to throw 600,000 Medicaid beneficiaries off of coverage in my State--and 14 million across the country--and take $1.4 billion out of Washington State's economy every year. These are numbers according to the Congressional Budget Office's most recent estimates and estimates by the State of Washington. I think it is time to say no to the President's budget proposal. It is time to remind the President of his promise not to cut Medicaid, and it is time to stop talking about the silly idea of capping Medicaid and reducing funding to the States. I mentioned the impact on children and veterans. I also want to mention the impact on those suffering from the opioid epidemic and what we have been trying to do to treat those individuals. Also, those facilities would be in great danger in continuing to treat that population if they don't have Medicaid. So the notion that this is a smart healthcare strategy or a smart healthcare budget--it is not. It is a draconian measure that is going to leave many more Americans without healthcare. As I said, Medicaid is a successful program. The promise should be kept, and we should continue to improve the delivery system as a way to make it more cost- effective. I know we can't afford to leave sick children without access to healthcare, and now is not the time to leave veterans without the healthcare they deserve. I thank the Presiding Officer. I yield the floor. I suggest the absence of a quorum.

Ms. CANTWELL

Ms. CANTWELL. Mr. President, I come to speak against the Congressional Review Act resolution to overrun an important rule that has been put in place to protect the American taxpayer and to protect the health of American citizens. For almost 100 years, the Federal Government has regulated undue waste in oil and gas fields. The story of oil and gas waste is as old as the story of oil and gas. Early oil gushers, like Spindletop in Texas, revealed two things about oil as an emerging source of energy: First, there was a huge amount of it. Second, without rules in place, it could be easily wasted. That is why, way back in 1915, Attorney General Thomas Gregory issued a report to the public about this issue. Gregory wrote that the law at the time allowed oil companies to ``occupy and operate any number of tracts of public oil land without restraint upon the quantities of oil produced or the methods of production and without rendering to the . . . government anything in return.'' One can imagine that concern. Gregory went on to point out that ``the incentives to speculative occupation, negligent and wasteful operation, and excess production become obvious.'' Some of my colleagues who are not on the Energy and Natural Resources Committee may not be familiar with the law Congress passed after Attorney General Gregory put his finger on the waste problem. The Mineral Leasing Act of 1920 established our modern leasing program for oil and natural gas. More than anything else, the leasing act enshrined the principle that the public should benefit from mineral production on public lands. This seems like a no-brainer today, but it took over a decade of debate to pass the leasing act. One of the main parts of the leasing act was a requirement to avoid wasting oil and gas. There are many environmental reasons to avoid wasting this resource, but let's be clear: It was dollar signs that led to the waste provision. Overproduction would glut the market and damage the oil reserves, and wasted oil provided no return to the owners--the taxpayers. The leasing act is still the law, and the law says that oil and gas operators must ``use all reasonable precautions to prevent waste of oil or gas developed in the land.'' The law says that Federal leases must include ``a provision that such rules . . . for the prevention of undue waste as may be prescribed by [the] Secretary shall be observed.'' The BLM's methane rule is entirely in keeping with that history. The rule says that the outdated 1979 version of this rule needed to be updated. The rule was put in place before the fracking took place that revolutionized the industry, before the shale plays opened, and before infrared imaging became commonplace. What has not changed since 1920 is that oil and gas companies cannot waste public resources on public lands. When equipment is leaky or old, oil and gas producers vent natural gas directly to the sky. If they do capture the gas but have nowhere to send it, the gas just gets burned on site. This venting and flaring causes a big problem. This photograph shows that actual problem happening. I am sure there are many citizens across the United States who have witnessed this and have been concerned about what pollutants might be entering the atmosphere. The hazardous health impacts of this are tremendous--benzene, which causes cancer--and I will talk more about that in a minute. The amount of venting that is happening is enough gas to supply 6.2 million American households for a year. According to more recent research, even higher estimates are coming in. That is enough gas to supply every home in the interior West--Idaho, Montana, Wyoming, Colorado, Utah, Nevada, Arizona, New Mexico--with gas left over for the Dakotas. Every home. The amount of gas we waste every single year on Federal lands would be enough to supply Tennessee forever, and there could be some left over for West Virginia. On Federal lands, operators have more than doubled how much gas they have flared and wasted between 2009 and today, and that is the practice we are trying to stop. Under the old 1979 rule, operators had to apply to BLM every time they wanted to vent or flare. In practice, BLM, because they did not have a new rule in place, basically just had a ``yes'' or ``no'' answer. In 2014, the Bureau of Land Management received 25 times more applications to vent or flare than in 2005. What was happening was that we as a Federal Government were failing in our responding and updating the act to make sure producers were living up to the intent of that earlier law, so government watchdogs got on the issue and started calling for a solution. The Government Accountability Office and the Interior Department's inspector general concluded that the Bureau of Land Management needed to change these rules. The Government Accountability Office concluded in 2010 that about 40 percent of wasted natural gas on Federal leases could be economically captured with existing technology. Some States had already taken action into their own hands. In Colorado, the State passed a strong venting and leak detection regulation, which really became the model for the national Bureau of Land Management, and oil and gas production has since increased. There was a notion that in making sure that waste was not promulgated--that it somehow was going to slow down the industry, but it has been just the opposite. In fact, some of my colleagues and some ranchers and others in these areas have talked about how the United States should lead the way on new technology to stop the leakage and to prevent these flarings as a way for the industry to show technology leadership. Also, in North Dakota, a Republican administration passed flaring restrictions after years of there being uncontrolled flaring in the Bakken. States took action, and various watchdog groups and investigators here in Washington said the Bureau of Land Management needed to act. The BLM finally acted, and its final rule is similar to the North Dakota approach. So States have already been leaders on this methane issue. But this patchwork of State rules is not what we need; we need a Federal baseline. It is bad enough that wasted natural gas will never have an economic use. Making the issue worse is that every cubic foot that is vented or flared is another cubic foot we have to produce somewhere else. What does that mean for our wallets? Research by ICF International shows that $330 million of natural gas is wasted intentionally on Federal lands every year. Over time, the public is losing billions of dollars. Over a decade, the lost royalties that have been calculated by the Government Accountability Office on wasted gas will add up to $230 million. While the final amount, of course, depends on the price of natural gas, we cannot afford to give up this revenue. A vote for disapproving the resolution will let the oil and gas industry roll back the clock to 1979. This resolution lets people continue avoiding giving the taxpayers their fair share. It is another example of special interests trumping the public interest. Even worse than the taxpayer issue, though, is that wasted natural gas harms public health. That is why those States took action. One of the most prevailing problems on this issue is in the Four Corners States, and my colleague from New Mexico will be talking about this shortly. When one looks at the entire United States on a map that shows the amount of waste of flaring, one can see all of this yellow coloring in the Midwest--in Ohio--and in other States, but one can see the hotspot in the Four Corners area. The Four Corners States have tried to take action--places like Colorado and New Mexico, with, obviously, Arizona and Utah being affected--because wasted natural gas basically releases a volatile organic compound. It creates ozone and smog. It also can make people sick. This pollution worsens asthma, emphysema, and increases the risk of premature death. It releases toxins, like benzene, that cause cancer. And the methane, the main constituent of the natural gas, is 25 times more powerful at trapping heat than carbon dioxide. That is why a recent analysis by the Clean Air Task Force found that over 9 million people are exposed to these dangerous levels of air pollution from oil and gas production. That is why my colleague Senator Bennet of Colorado has been such an outspoken advocate of keeping this rule in place. It is because that corner of Colorado has faced so many impacts that they want to make sure their citizens are protected. With the rolling back of this Federal rule, basically what one would be saying is that it is OK to continue this level of pollution--an anathema to what the people of Colorado have been asking for. Oil and gas pollution can make rural areas seem like the middle of a city. A few years ago, NASA scientists discovered a massive cloud of methane over the Four Corners region. This is the highest concentration of methane in the Nation. After aerial surveys, NASA found that over half of the methane is from natural gas equipment, including tanks, wells, pipelines, and processing plants. The ozone pollution in the Four Corners is almost as bad on some days as in the city of Los Angeles--a city with 300 times as many people. As bad as methane waste is on Federal land, this rule only targets 10 percent of that wasted by the oil and gas industry because we are targeting Federal land. It only affects a small minority of the oil and gas production. Ninety-five percent of that production is in other areas. But this rule is important to put in place because we cannot ignore the impacts on pollution, and we cannot ignore the costs to our Federal lands. The Bureau of Land Management compared the costs and benefits of this rule without factoring in the reductions in ozone, particulate matter, or smog, and the BLM ignored the value of reducing carcinogens. We know that this particular conservative analysis shows a net benefit of between $46 million and $204 million each year. This makes economic sense to implement. Under the very obsolete 1979 regulation that the methane rule replaces, oil and gas operators had to apply to the BLM whenever they wanted to vent or flare natural gas. The old rules also had no specific equipment requirements in place. As I said earlier, the world has changed dramatically since 1979 when it comes to oil and gas production. The new rule takes commonsense approaches to stepping up our attempts to reduce this waste and prohibit the venting, except in emergencies and in some circumstances. They estimate that it will cut the venting by 35 percent. It also sets capture targets for flaring, allowing operators flexibility on how to meet those targets. The BLM estimates they will reduce flaring by 49 percent. The rule requires operators to inspect their wells and their equipment. People may have heard unbelievable stories from California about a huge methane leakage that caused unbelievable amounts of damage. We know that we want the best equipment, that we want the best detection, and that we want a strong rule in place to stop wasting this natural gas, give the taxpayers a fair deal, and protect the American people from harmful levels of pollution. That is why we want this rule to stay in place. With America's increased natural gas production, now is not the time to take a very solid rule off the books--a rule that protects the American people. The technology to conduct these inspections already exists. Infrared imaging and other technology has been sold commercially for decades. What we are really saying is that people just do not want to spend the money to implement them. Fourth, the rule requires operators to replace leaky equipment, like the pneumatic controllers and pumps, and it is trying to make sure that we eliminate the methane waste. So the final rule is in step with what the Government Accountability Office told us 7 years ago--that about 40 percent of the waste can be captured economically. BLM took those best practices and State examples, as I mentioned, including North Dakota and Colorado, and implemented a new rule. It includes Colorado's venting and inspection and retrofitting requirements, and regulation 7. It includes North Dakota's capture targets for flared gas in it, and it includes Wyoming's venting and inspection requirements in the Upper Green River Basin. Not only did the Bureau of Land Management adopt the best practices of States, but it also included a variance provision in the final rule. Any State or Tribe with equally effective regulation in place can minimize their methane waste and can apply for a variance from the Department of the Interior. There is a lot of flexibility there, I would say, for States that are trying to lead the way. But based on this careful approach, the final rule and its benefits are estimated, as I said earlier, to be $204 million a year. So the public in these States that are most affected certainly want this rule. As more Americans understand the level of natural gas production and the wasteful venting that continues to take place, they want this rule in place as well. Passing the resolution just after a few hours of debate and trying to undermine this rule would go against the 330,000 public comments that were collected during the process of establishing this rule. So we certainly don't want to overturn what was a very long and elaborate process to put this very important rule in place. Proposing more waste is not going to solve our economic challenges. Proposing more pollution is not a solution. We know that in the most recent annual poll by Colorado College, western voters said that 81 percent of them supported making sure that the Bureau of Land Management had strong methane rules. My colleagues appear not to understand how much the public wants to get this implemented. I hope my colleagues will continue to support the effort to turn down the Congressional Review Act resolution and instead keep this very, very important public health and economic taxpayer solution on the books. As Mark Boling, an executive with Southwestern Energy, a major natural gas producer, said, this resolution and trying to turn back the rule is ``a huge mistake.'' He pointed out that it could have ``unintended consequences for oil and gas technology.'' So I want to make sure this rule stays in place. Let's keep a strong rule on the books, as I said, for the health of the American people and to make sure that taxpayers get a fair deal with these companies that are producing on Federal lands. I thank the Chair. I yield to my colleague from New Mexico, who has been outspoken on this issue in making sure that Congress addresses the flaring and leakage of natural gas.

Ms. CANTWELL

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

Ms. CANTWELL. Mr. President, I come this morning to talk about the impending passage of a very failed healthcare bill in the House of Representatives and to remind my colleagues that this legislation moving through the House of Representatives is the first time in the 50-plus years of the Medicaid Program that they are going to pass legislation to cap and cost-shift Medicaid costs to States. This is an $839 billion cost shift from the Federal government to States and a one-quarter cut to the Federal Medicaid investment over a period of ten years. Some 14 million Americans will lose Medicaid coverage. These draconian and arbitrary budget caps will leave States with impossible choices to cut people from care, cut provider reimbursements, or reduce benefits. Overall, 24 million Americans will lose their health insurance. That is according to a recent Congressional Budget Office analysis. Why do I say this is a broken promise? Because it was very clear that, when President Trump was a candidate, he said he was not going to cut Social Security, Medicare, or Medicaid. Why is that important? Because these are trusted programs that have worked cost effectively for so many Americans in giving them access to care. Now is not the time, as we have seen a Medicaid expansion, to now cost-shift Medicaid to the States by breaking this promise and putting in it, for the first time in 50 years, a substantial change to the way Medicaid works. It does represent, in my opinion, a war on Medicaid-- one that we cannot afford to wage. Communities that have benefited from Medicaid expansion have seen the value of coverage and a healthy population. All you have to do is to talk to healthcare providers, hospitals, chambers of commerce, and others to get them to say that, yes, having more people with healthcare coverage in our community has helped us in raising the standard of living. Why is that? First of all, uncompensated care is no longer put at the hospital's doorstep. Secondly, the population with healthcare coverage is healthier, getting treatment in advance as opposed to waiting for a crisis. It represents an investment in the community that allows a community to stabilize. These are important issues for us to discuss. I hope my colleagues in the Senate will not fall for this ploy or that they will not go back on promises made by this administration not to cut Medicaid. There are other aspects of the bill coming over from the House of Representatives, obviously, dealing with preexisting conditions, and we know from our own experience in the State of Washington that high-risk pools have covered only a tiny portion of people with preexisting conditions and are inadequate unless properly funded. As an article from the Seattle Times, from 2009, entitled ``Dozens of patients cut from state's high-risk insurance pool'' stated: ``with premiums that can top $20,000 a year, patients don't exactly clamor to join the state's high-risk health-insurance pool--a public insurer of last resort for patients with cancer, AIDS and other serious diseases . . . ,'' and ``the premiums cover only about 30 percent of the patients' medical and prescription expenses.'' There are many things that are working in the Affordable Care Act. We have done great things on rebalancing; that is, to rebalance people from nursing home care to community-based care. This chart shows how many States in the United States of America are doing this. This is in the Affordable Care Act. We wrote a provision encouraging States to try to rebalance their population, not encouraging so much nursing home care because it is so expensive, and instead, trying to deliver the long-term care people need in their individual communities. The great success of this is that many States in the Affordable Care Act took us up on it--States like Nevada, Iowa, Missouri, Texas, Arkansas, Mississippi, Georgia, Kentucky, Ohio, Pennsylvania, New York, and Maine. I saw in our own State, over a 15-year period of time, that we saved roughly $2.7 billion. That is $2.7 billion of cost. Instead of paying for a Medicaid population in expensive nursing home settings, we instead innovated and put them into what was a cost-effective delivery system in which people love to stay in their home as they age as opposed to the notion of expensive nursing home care. I mention that because that $2.7 billion could be the kind of savings we would see in these States. So I tell my colleagues from the House: Innovate; don't capitate. Don't try to say that you have an ingenious idea on how to take care of healthcare costs by simply capitating, for the first time in 50-plus years, the Medicaid Program and then leaving the States to pick up the bill. It won't work. Follow the ideas and strategies that are much better in helping us cut costs for an aging population that is living longer, and look for fixes that are already there in the Affordable Care Act to do so. I yield the floor. I suggest the absence of a quorum.

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

Ms. CANTWELL. Mr. President, I note, too, that we are going to be moving today, before we leave here, to what is the Omnibus resolution to keep the government open. I wanted to mention an important aspect of the legislation we are going to be voting on. Pursuant to provisions in the Customs bill, we are now going to put funding into trade enforcement--a very important aspect of our trade agenda. We know that more than 96 percent of the world's customers live outside the United States. By some estimates, at least 70 percent of the world's purchasing power is outside the United States. That means that we need to keep working hard to reach these new markets and these customers. The growing middle class has great purchasing power. In 2015, the global middle class spent $33 trillion. By some estimates, the middle class could surpass 4 billion people by the year 2021, making it a majority of the world's population. Approximately one in three jobs in the State of Washington are tied to international trade. Washington State exported approximately $80 billion in goods in 2016--from airplanes and coffee to apples and software. I know this about our State: we understand that we are in a global economy and that we have great products to sell in international markets. Agriculture exports are very important to our State. Agriculture adds about $51 billion a year to our State's GDP, and the agricultural sector makes up more than 13 percent of our State's economy. In 2016, Washington exported $15 billion worth of food and agriculture products with $7 billion being of Washington origin. We are No. 1 in the nation in production of apples, hops, spearmint oil, wrinkled seed peas, concord grapes, sweet cherries, pears, green peas, raspberries for processing, blueberries and aquaculture. We are No. 2 in production of potatoes, certain kinds of grapes, nectarines, apricots, prunes, plums, sweet corn for processing, and a variety of other things. This is to say that in the State of Washington, we grow a lot for overseas markets. Why am I talking about this important aspect of this bill that is passing to keep our government open today? Because in our State and across our country, we need to encourage more small businesses to export. And we need to make sure we have enforcement of a level playing field so that U.S. companies of all sizes and U.S. workers are protected as they compete in that global economy. That is why, in the previously passed Customs bill, I created a Trade Enforcement Trust Fund at the Office of U.S. Trade Representative. Now, with this legislation passing today, we are putting $15 million toward that trust fund to be spent exclusively on enforcing trade agreements. We need to enforce the agreements and make sure Washington and businesses around the country get a fair deal as we work on trade. And $15 million in the fund would help us fight trade issues we have seen all over the globe. For example, sometimes people try to sell their products by taking the great labels we have on Washington apples and putting them on foreign apples making them seem like Washington apples, when in reality they are not. This bill gives us money for trade enforcement to address these challenges. Sometimes we have intellectual property that is hijacked or stolen from companies in our State. This bill puts more enforcement in place to fight those crimes and to make sure we are enforcing our trade agreements. The trust fund gives the framework and workforce to enforce trade laws governing exports to that burgeoning, as I said, growing middle class outside the United States. We must make sure our products are sold and sold correctly and any disputes that are happening are resolved and resolved quickly so our trade with those countries can be cost-effective to our growers, to our manufacturers, and to the workforce within our State. I am sure every Member here who has companies that have done trade in this global economy can tell you stories of how the lack of trade enforcement has cost them business. This fund is a very positive shot in the arm to our U.S. trade office, so they have the resources to do more enforcement and make sure our products are winning in the overseas markets. I yield the floor.

Ms. CANTWELL. I suggest the absence of a quorum and ask unanimous consent that the time be equally divided.

Ms. CANTWELL

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

Ms. CANTWELL

Ms. CANTWELL. Mr. President, President Trump, in his attempt to deflect focus from the 100-day performance in his administration is, today, throwing a Hail Mary pass to try to allow offshore oil and natural gas drilling to take place in very protected areas of our Outer Continental Shelf. The President's approach is unlawful and should be withdrawn before taxpayers pay any amount of money to go forward with it. He is attempting to open up coastal areas to oil and gas production, and he is touting job creation as a factor in his decision. I believe that the economic numbers revealed today show that we need to be doing more, but I doubt that this approach will be a successful approach for more American jobs. The truth is that instead of creating new jobs, President Trump is poised to favor sectors that will compete with the already growing and thriving industries of fishing, tourism, and recreation, and in some potential areas will also threaten defense issues where we could have a potential conflict. The bottom line is that the BP Deepwater Horizon explosion and subsequent oil spill was a catastrophic human, economic and ecological disaster. Eleven members of the crew were killed in the explosion, and 17 others were injured. Oil spewed in the ocean for nearly 3 months, resulting in the largest oil spill disaster in the history of the United States. In the end, the BP Horizon disaster resulted in 134 million gallons of oil spilled into the Gulf of Mexico; that is 12 times more than the Exxon Valdez tanker spill in 1989 in Alaska. I should say that many attempts have been made by Democrats in Congress to make sure we continue to update our laws. But Republicans have repeatedly blocked legislation that would hold polluters liable for oil spills and improve offshore safety and environmental responses. So today it is very frustrating that the President of the United States is proposing to roll back the important safety regulations that were put in place during the Obama administration. In fact, this book right here shows the Deepwater Horizon impact that was discussed by Members of Congress, the problems we had at the Department of Interior, and asked that these new regulations be put in place. These regulations by the Obama administration helped put a new regime into place after Deepwater Horizon. But now President Trump is bringing those regulations into question, suggesting that we should roll them back. He is even questioning the new regulations on blowout preventer systems and well control, which, if my colleagues will remember, was the centerpiece of the problem with Deepwater Horizon. The blowout preventers used had not been tested; the information was not overseen and regulated properly. So after all of that damage was outlined in this report and we made sure to implement changes, now President Trump, in his first 100 days as the President of the United States, instead of coming up with a better economic strategy is simply saying: Roll back regulations on polluters as a strategy for moving forward. President Obama had also put large portions of the Arctic and dozens of underwater canyons off the east coast permanently off limits to drilling during his time in office, using his authority under the Outer Continental Shelf Lands Act. In the finalized Offshore Oil and Gas Leasing Program for 2017-2022, the Obama administration removed the west coast, east coast, and Arctic waters from oil and gas exploration. Why did he do that? He did that primarily because of the maritime economy. In Washington State alone, the maritime economy supports 148,000 jobs and $30 billion in economic activity. Many of these parts of the United States could not afford to be devastated again by oil spills or exploration into ecologically sensitive areas like the Arctic. I believe the Atlantic region was rightly removed due to strong local opposition, conflicts with other ocean uses, and market dynamics. The Department of the Interior recognized the potential environmental and economic impacts and competing ocean uses. For example, the economic value of commercial fishing in just the Mid-Atlantic region is worth more than $1.5 billion, and ocean-dependent tourism is more than $10 billion in the Atlantic region. So I would say that the fishing economy, the tourism economy, and DOD's need for sea lanes in the Atlantic are all important, and we should not be trying to roll back Obama administration regulations in these areas. It is not surprising that there was significant opposition to the oil and gas leasing from citizens, local officials, and people who reside in these communities. I can tell you, if this rule includes the west coast, there will be strong opposition from the State of Washington, the State of California, and the State of Oregon, where we are so dependent on healthy oceans and sustainable fisheries. We hope to clarify whether or not the west coast will be included in President Trump's executive order, but if it is, the west coast will speak loudly. From our shellfish growers to our vibrant commercial and recreational fisheries, and generations of families who have to have sustainably harvested Dungeness crab, salmon, and halibut. We do not want to put them at risk with offshore drilling. Not only would a spill impact our fisheries and habitat, but it could impact our Olympic National Marine Sanctuary. It would also have an impact on one of the busiest shipping lanes in the Strait of Juan de Fuca, in and out of Washington's busy, busy ports. Washington's coast is a trade superhighway. Our shipping and trade economy is growing faster than ever. In the first quarter of this year, the total domestic and international container volume increased by 10 percent. In our State, this maritime economy is worth $30 billion in economic activity. It supports over 148,000 jobs, in fishing, in seafood processing, in shipbuilding, and other maritime sectors. Because of this importance, we believe in protecting the west coast. President George H.W. Bush signed the first Executive order banning offshore drilling in the Pacific in 1990. We would recommend that this President follow suit. It is so unfortunate that this new effort to repeal protections is going forward, but I believe it is going to fail. Many know that this action is just an attempt to reverse the past President's withdrawal of sensitive areas, like in the Arctic and the Atlantic, and is not authorized. It is not authorized under the Outer Continental Shelf Lands Act, and, therefore, the President should not spend money. He should go back to the people who know the law and understand that this is a waste of taxpayer dollars. I hope the President will dialogue with Congress about any of our ideas to stimulate our economy. I am happy to talk at any point in time about ideas that we have that will move our country forward, produce jobs, and help stimulate economic growth. But expanding offshore drilling and exploration to areas that already have been limited and set aside by past Presidents is not the way to proceed. We need to make sure that an industry that has made mistakes is held accountable and recommendations that were in this report not be reversed back to the days before Deepwater Horizon. This is what we need to do to protect our vital maritime economy and make sure there are laws on the books that the oil and gas industry need to comply with. I yield the floor.

Ms. CANTWELL

Ms. CANTWELL. Mr. President, yesterday President Trump issued an Executive order that undermined the protection of dozens of our national monuments that were established over the past two decades by three different Presidents. In continuing his administration's war on our public lands, President Trump and Secretary of the Interior Zinke have attacked one of our Nation's most prized conservation laws--the Antiquities Act, which gives the President the authority to protect our nationally important lands and waters on Federal land by designating them as national monuments. In the 111 years since the Antiquities Act was signed into law by President Teddy Roosevelt, 16 Presidents--8 Republicans and 8 Democrats--have used the law's authority to designate over 150 national monuments. President Trump is trying to undo over 100 years of conservation in just a few days. Many of our Nation's iconic national parks were first protected by using the authority of the Antiquities Act, including the Grand Canyon, Acadia, Glacier Bay, Joshua Tree, Zion, and in my home State of Washington, Mount Olympus National Monument, which later became Olympic National Park. No doubt Presidents of both parties have used the Antiquities Act to preserve the most beautiful places in our country. However, President Trump appears to be very uninformed on the history or the importance of the Antiquities Act. In his remarks signing the Executive order yesterday, he described the designation of national monuments as an ``egregious use of federal power'' and vowed he would ``give that power back to the States.'' He truly does not understand the Antiquities Act, nor does he appreciate the bold leadership of all of those Presidents, both Democrats and Republicans, over a period of time--eight Republicans and eight Democrats--who have used this authority in an appropriate way to preserve for all Americans in the future and those in the past who have enjoyed these beautiful places--and to preserve our access to public lands. I can't tell you how important access to public lands is for schoolchildren, our returning veterans, our families, hunters, fishermen, and hikers. Putting the Antiquities Act and the millions of acres of national monuments that have been protected back into the hands of a few who are more aligned with special interests to try to open these areas up to oil and gas exploration is the antithesis of what the Antiquities Act is all about. We plan to continue to emphasize how wrong the President's Executive order is. First and foremost, in the Executive order, the President directed the Secretary of the Interior to review the designation or expansion of national monuments under the Antiquities Act where the Secretary deems that the designation or expansion was made without adequate public comment or coordination with relevant stakeholders. That literally gives the Secretary of the Interior broad authority to look at all the land that has previously been designated since 1996 and potentially open it up to saying they are going to try to reverse that. There have been many discussions about the last 20 years of the designation of some unbelievable, beautiful places in America that are so special--the Grand Staircase-Escalante National Monument in Utah, which is 1.7 million acres; the Grand Canyon-Parashant National Monument in Arizona; the Giant Sequoia National Monument in California; the Canyon of Ancients National Monument in Colorado--I know my colleague Senator Bennet from Colorado was speaking about it earlier; Hanford Reach National Monument in Washington, which covers 195,000 acres; the Ironwood Forest National Monument in Arizona; the Vermilion Cliffs National Monument in Arizona; the Carrizo Plain National Monument in California; the Sonoran Desert National Monument in Arizona; the Upper Missouri River Breaks National Monument in Montana; the Rio Grande del Norte National Monument in New Mexico, on which my colleague Senator Heinrich worked so hard; the Organ Mountains-Desert Peaks National Monument, also in New Mexico; the San Gabriel Mountains National Monument in California; the Berryessa Snow Mountain National Monument in California; the Basin and Range National Monument in Nevada; the Mojave Trails National Monument in California; the Sand to Snow National Monument in California; Bears Ears, as I have mentioned, in Utah; and the Gold Butte National Monument in Nevada. That sounds like a lot of designations that we have made over the last 20 years. Presidents were very judicious about those designations. It took a lot of public comment, many community meetings, and a lot of scientific analysis about the preservation of these areas. The end result is that for these generations and future generations, national monuments have been designated on public lands that are in our national interests. This has been so important to us as a nation. As I said, places like the Grand Canyon, Olympic National Park in my State--many places have created what has become an outdoor recreation economy. That outdoor recreation economy is now over $800 billion of annual revenue and dwarfs what the oil and gas industry represents as an economy of the future. In fact, this industry sector is on par to compete with other large sectors of our economy--the financial service sector and the healthcare sector. So why are we taking away the very tool that has launched so much outdoor activity and a burgeoning job economy, with 7 million outdoor industry workers? Why are we taking away national monument designations that have been the priority of past Presidents and trying to return them because someone doesn't understand what the Antiquities Act is all about? In addition to those large monuments that I just mentioned, also under review will be a group of other monuments that are marine national monuments. Yes, according to the definition I mentioned earlier, Secretary Zinke could review all of these monuments. In fact, I noticed that there were several people at the President's signing who represented some of these monuments. I don't know if they are urging the President to remove their areas, but it raises great concern about how important these marine monuments have been. There is the Papahanaumokuakea marine national monument in the Hawaiian islands that was established in 2006; the World War II Valor in the Pacific National Monument, also in Hawaii; the Rose Atoll National Monument in American Samoa; the Pacific Remote Islands National Monument in Hawaii; the Marianas Trench National Monument in the Mariana Islands; and the Northeast Canyons and Seamounts Marine National Monument in the Atlantic. In addition to all of those maritime national monuments of grand scale, these also under consideration are an additional two dozen or so--I think it looks like 25--smaller national monuments that could also be reviewed by the Secretary of the Interior. Even though they were designated with this Presidential authority, in previous administrations after great review, they could, by this President and this Interior Secretary, be wiped away very quickly. We definitely do not believe the President has this legal authority, and we will pursue a vigorous fight. Why should we be wasting taxpayers' money when taxpayers' money was already spent to make these designations, and the taxpayer is getting the huge economic benefit of having these outdoor areas? What else could be on the President's list according to this Executive order? The California Coastal National Monument; Cascade- Siskiyou National Monument; President Lincoln and Soldier's Home National Monument in Washington, DC; Kasha-Katuwe Tent Rocks National Monument in New Mexico; Minidoka National Historic Site in Idaho; Pompeys Pillar National Monument in Montana; Virgin Islands Coral Reef National Monument; Governors Island National Monument in New York; the African Burial Ground National Monument in New York; Fort Monroe National Monument in Virginia; Fort Ord National Monument in California; Chimney Rock National Monument in Colorado; the Cesar Chavez National Monument in California; San Juan Islands National Monument in the State of Washington; the Harriet Tubman Underground Railroad National Monument; the First State National Historic Park in Delaware; the Charles Young Buffalo Soldiers Monument; the Honouliuli National Monument in Hawaii; the Pullman National Monument in Illinois; Browns Canyon National Monument in Colorado; Waco Mammoth National Monument in Texas; Castle Mountains National Monument in California; the Belmont-Paul Women's Equality National Monument; Stonewall National Monument in New York; the Birmingham Civil Rights Monument in Alabama; the Freedom Riders National Monument in Alabama; and the Reconstruction Era National Monument in South Carolina. The Executive order says the Secretary of the Interior can review any national monument designation since 1996 ``Where the Secretary determines that the designation or expansion was made without adequate public outreach and coordination with relevant stakeholders.'' The Executive order says that for any national monument on the list I just mentioned, the Secretary of the Interior could decide there was not appropriate public outreach. Even though the process used by Presidents under the Antiquities Act makes sure you have that, this Secretary could decide there wasn't enough and recommend to undo any of these monuments and eliminate access to the public for the purposes of recreation and enjoyment. So this administration has it dead wrong. He is no Teddy Roosevelt. In fact, I saw he had a press conference with a statue of Teddy Roosevelt behind him. Teddy Roosevelt would be appalled because his concept of preserving Federal land was so important. Teddy Roosevelt was an outdoorsman who spent many a time in these great places of our Nation and understood their great significance. That is why we have the Antiquities Act. He knew that these resources strengthened our country. They made us strong as a nation. They show the crown jewels of the United States of America in all their glory and beauty. He knew it was important to protect them for future generations to enjoy, not just for the special interests to take advantage of in the near term. We have a lot of Federal land and offshore land that is used for resource exploration and development. As people know, natural gas is at an all-time high in the United States and driving an all-time low price. It is not as if you need access to Bears Ears National Monument to drive down the price of natural gas or other fossil fuel. What you are going to do by pursuing this wrongheaded approach on Bears Ears is take away one of the historic and beautiful archaeological histories of Native Americans and early Americans in the United States--and an area that has excellent outdoor recreation opportunities--and throw it, along with the concept of the Antiquities Act, over the side just because someone wants to try to reverse what our previous Presidents, starting with Teddy Roosevelt, have done to protect these monuments in our national interest. Representing a State where we have several counties that have lots of Federal land, whether forest lands or BLM lands, I know that it can be challenging for local communities to maintain the infrastructure, the education, the hospitals, the law enforcement. I am a big believer in making sure that what are called PILT payments and the Secure Rural School Program are well funded and financed to make sure that these communities can be there to help us support these public lands. But the notion that with one act we would throw in Teddy Roosevelt's face all of these national monuments and now say that we are going to try to use it in reverse to review the work in the near term, of 3 different Presidents who used this authority is simply wrongheaded. What we need to do is embrace the outdoor economy. As I said, it is 7 million jobs with over $800 billion of economic activity. In fact, since the last time they did their report, there has been a $200 billion annual increase in the economic impact in the United States of America. What great news. An industry and sector, particularly in retail, is growing by leaps and bounds. It is an industry that is providing people with more tools and opportunity to enjoy our beautiful places. The only thing we can do to screw that up is start taking away the beautiful places where people go to recreate. I would say we should be examining how well these areas we have protected are being used and figure out how we can continue to communicate to the general public about these wonderful experiences. Do not think for one minute that the American people in their souls are not connected to the spiritual nature of these beautiful lands. They are. And that is what Teddy Roosevelt knew. He knew this is where we go to rejuvenate. Let's not take it away for some oil and gas exploration. I yield the floor.