Benjamin Cardin

Mr. CARDIN

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. CARDIN

Mr. CARDIN. Mr. President, there are reports that we may be having a vote next week, under reconciliation, dealing with the healthcare system of this country. We know that colleagues have filed a new bill, but it is basically the same bill we have seen in the past but this time even more consequential to our healthcare system and the people of this country. I mention first the process because this bill has not gone through any regular order. It has not been referred to a committee for consideration. It has not been marked up or debated in our committees. It is going to supposedly be brought up as an amendment but with us returning to reconciliation. Let me first explain what that means. That means there will be no chance for us to offer amendments to the legislation. That means there will be no opportunity in our committees to mark up legislation or to get the cost of the legislation or the technical help to do any bill, let alone a bill that affects a large part of our economy. The Presiding Officer and I both serve on the Finance Committee, which has jurisdiction over healthcare. We are not going to get the opportunity to get the expertise and help from our staff to look at the consequences of the Cassidy bill and have a chance to work on it to make it work. Instead, what is going to happen if the game plan goes forward is that this bill is likely to be on the floor next week during budget reconciliation, where a simple majority will be able to pass it. There will be no chance for debate on the floor because it is what is known as a vote-arama, and it will affect one-sixth of our economy. That is not the way we should be operating. I am also told that it will be done without a Congressional Budget Office score. That is unconscionable. We know from previous Congressional Budget Office scores on the other proposals that have been brought out that tens of millions of Americans would lose their health insurance coverage. Premiums would increase by, in some cases, 20 to 25 percent. It was certainly information from our objective staff that caused many of us to say: What are we doing? But at least we had that information before we voted. We are now being told that we may get a one-liner from the Congressional Budget Office giving us the bottom-line impact on the deficit but not the specific information as to how many millions of Americans are going to lose their coverage and what is going to happen, for those of us who currently have insurance, with our premium increases. This is not the way we should be proceeding. It retreats from the progress we have made against the abusive practices of the insurance industry. Under the Cassidy bill, as I understand it, each State could basically set up its own rules for how they wish to have coverage. The entire Medicaid system of this country would be block-granted and would be capped. So the Federal Government could be getting out of the Medicaid business. The States would be given greater flexibility on how to operate the exchanges in their State and would no longer be subject to the same national requirements. We all pride ourselves that we eliminated preexisting conditions. But, in reality, if the State determines what benefits are going to be covered and under what conditions, preexisting conditions come back. That is something we should not ever allow to happen. Yet, under the Cassidy bill, we are going to be telling people that we may not be covering their mental health needs. We may not be covering the opioid addiction problems. We may not be covering maternity benefits. We may not be covering pediatric dental coverage. We don't know what plans will be offered. Today we know that under the Affordable Care Act we have the national protections so that everyone is on a level playing field. So a State could design a plan that would be totally unaffordable for people who need the coverage because they isolate the group into such a small number. That is not what we should be doing. That strategy would provide inadequate coverage. Let me explain what I mean. I have a young family that came to me and told me about the circumstance of their child being born prematurely with significant challenges. They said that, if that child had been born before the Affordable Care Act, the parents' policy would have reached their lifetime cap within the first year. Then, the family would have had to make some horrendous decisions on how to take care of their child. That is why we passed the protection against annual lifetime caps. That could return again under the bill that could be brought to the floor next week. I know circumstances where families have been able to get preventive healthcare and discover cancer at an early stage. That coverage wasn't there before the Affordable Care Act. There is no guarantee that coverage will be there afterwards. We could return again to bankruptcies. Healthcare costs were the leading cause of bankruptcy before we passed the Affordable Care Act. Now we are going to say that because of inadequate coverage and lack of coverage, American families are going to be faced with taking care of their family, running up bills, and ultimately facing bankruptcy. We are going to be affecting people's lives. Make no mistake about it. But the real tragedy of this proposal, and why it is so different from some others, is that it is an abandonment by the Federal Government of the Medicaid system. It would institute draconian cuts to the Medicaid system, to the extent that it would cripple it and make it ineffective. The States would be unable to respond. It is interesting that we just got a letter from 10 Governors in our country--five Democrats and five Republicans. All of these Governors said: No, don't do this. We can't do what you are asking us to do. We would have to make horrible decisions on whether we are going to continue to provide long-term care to our seniors, whether we are going to expand coverage, whether we are going to narrow benefits, whether we are going to cover prescription drugs, or whether we are going to cut providers who may not be able to treat Medicaid patients. These are decisions the States are going to have to make if this bill ever becomes law. It affects so many. Some of the things that maybe are misunderstood about the Medicaid system is that 1.75 million veterans are in the Medicaid system. Quite frankly, their coverage has never been enough, and the Medicaid system has helped fill the gap. That is going to cause a problem for our veterans. I will just give one example. We pride ourselves on federalism, and federalism, to me, is very important. I served for several years in the State legislature. I am the former speaker of the Maryland General Assembly. I take pride in the fact that Maryland has been an innovator in healthcare. They have been able to do that because of the partnership between the Federal Government and the States. That is federalism. It has worked. If this bill were to become law--the Cassidy bill--it would prevent the States from innovating. It is not giving them more flexibility if you don't give them the resources and tools to deal with this because you can't. For example, in Maryland we have what is known as an all-payer rate structure for hospital costs, regardless of who covers your insurance. Whether you are Medicare, Medicaid, or private insurance, or you pay on your own, you pay the same rate in my State for hospital care at the same hospital. It is an all-payer structure. We don't have cost- shifting, and we don't have charity hospitals. Therefore, we have hospitals that are located in all of our communities. It saves the Federal Government money, it saves the State government money, and it has proven to be more cost-effective. The State experimented and it worked, and the Federal Government has partnered with us. Can we continue that program if we get these draconian cuts in Medicaid? The answer is no. Can we continue this program if we see the uninsured rates go up in Maryland because of people losing their health coverage under this bill? The answer is no. You can't do this if the uninsured rates go from 6 percent to 12 percent to 15 percent of uncompensated care in our hospitals. That is what is at risk with the Cassidy bill. To me, it really is also an affront to federalism in that you are creating States versus States. I am in a State that did Medicaid expansion. As the Cassidy bill has been scored, it will cost my State $2.1 billion. I know that our legislature doesn't have that money. I know the Governor doesn't have it. He just recently went to the Maryland Board of Public Works and reduced the State budget because they were running a deficit and they are not allowed to run a deficit. They can't possibly cover the $2.1 billion. Here is another tragedy of this bill. The tragedy is that some States do much worse than other States. Why? Because Maryland expanded Medicaid, as did many other States and, therefore, we got more Federal funds because we had more people in the program. That seems fair. We are covering more people. But the Cassidy bill takes away from those States that expanded coverage, and we lose more. I thought this was the United States. I thought we were all in this together. The people of Maryland are proud to help the people of Texas or Florida because of the hurricane, and now you are coming back and saying you are going to hurt the people in Maryland because we did the right thing on Medicaid. Is that what this country is all about? Is that the United States? Is this body going to condone that type of discrimination against States? I hope that is not the case. So I hope, for many reasons, on substance and on process, that this bill is not brought up. Let's return to regular order. I heard Senator McCain say that so eloquently on the floor of the Senate. For the last two weeks I have been working with my Republican and Democratic colleagues to come up with bipartisan ways to improve our healthcare system. We have made progress. We have some good ideas that stabilize the individual marketplace and bring down the cost of healthcare, working together. Guess what. If we succeed in regular order and bipartisanship, we will not only do the right thing so people have stronger protections, but we will also have policy that will stand the test of time and give predictability to the healthcare system of this country. That is what we should be doing, in the best tradition of the Senate. So I urge my colleagues: Let's work together, and let's reject this proposal. Let's not bring it up. Let's continue our work on a bipartisan basis. Certainly, don't use reconciliation. Let's work together for the people of this country. With that, I suggest the absence of a quorum.

Mr. CARDIN

Mr. CARDIN. Mr. President, today I wish to address one of the most pressing and most challenging national security issues facing our Nation: North Korea's growing nuclear and ballistic missile programs and its continued belligerent behavior. North Korea has developed an active nuclear weapons program and is making considerable progress in developing nuclear-capable ballistic missiles that can reach our allies and partners in the region, including South Korea and Japan, U.S. territories like Guam, and, likely, the continental United States as well. The time for illusions about North Korea's programs, or wishful thinking about our policy options, is past. With each passing day, North Korea's continued defiance of the international community makes it clear that the Trump administration's policy of maximum pressure is yielding minimal results. If the United States continues on the path laid out by President Trump, there are only two realistic outcomes, both bad: North Korea becomes a nuclear power or a large-scale conventional war breaks out on the Korean Peninsula that would result in the loss of hundreds of thousands and possibly millions of lives. If our policy options leave us with only capitulation or war as possible outcomes, those policies are deeply flawed. There should be a lot of space between war and capitulation on the Korean Peninsula. I strongly believe that we must therefore adjust our strategy to fill that space with an all-out ``diplomatic surge,'' one that results in serious, hard constraints on North Korea's nuclear ambitions and a more peaceful, stable, and prosperous Northeast Asia for all. The initial objective of this surge would be to begin a diplomatic process, with Pyongyang first verifiably halting their nuclear and ballistic missile testing and the United States and our allies taking steps to deescalate the current tensions on the Korean Peninsula. We have not arrived at the current situation with North Korea overnight. Where we are today is an outgrowth of two decades of steady progress by North Korea's nuclear and ballistic programs. The tense situation on the Korean Peninsula highlights the failure of the international community and multiple administrations, Republican and Democratic alike, to end North Korea's nuclear and missile programs and to promote greater security and stability in the region. This year alone, North Korea has conducted at least a dozen ballistic missile tests, including ICBM tests, and now a nuclear test of what is likely a thermonuclear weapon. We may not like this reality, but we must face the fact that North Korea already has a small but nonetheless operational nuclear arsenal. At this critical moment, the President, instead of providing responsible leadership, has engaged in bluster and provocative statements about nuclear war with North Korea. He continues to show he lacks the temperament and judgment to deal with this serious crisis. He continues to increase tensions rather than reduce them and to issue threats when it is far from clear he is willing to back them up. President Trump's dangerous rhetoric has painted the United States into a corner. The President has zig-zagged from one extreme to the other, as the Washington Post recently put it, veering between bellicose tweets aimed at North Korea, threats to our allies and partners, efforts to flatter Beijing, offers of diplomacy, and then strident rejections of it at the same time. He has created an environment of uncertainty amongst our allies and partners, emboldened our adversaries, and confused and deeply concerned the American people about their safety. I therefore feel a solemn responsibility as the ranking member of the Senate Foreign Relations Committee to put forward an approach to North Korea that I believe represents the type of responsible bipartisan leadership the world has come to expect from the United States. When the United States leads with our values and interests at the fore, others follow, but when we abdicate or purposefully cause doubt, well, that kind of uncertainty makes the world less safe. Therefore, the United States should put its full weight into creating and executing a comprehensive policy that includes the immediate imposition of additional sanctions, active engagement with our allies, vigorous support for human rights and the pursuit of principled multilateral measures to shape the regional environment. Most urgently, we should begin immediate and direct diplomatic engagement with Pyongyang, guided by strategic clarity, to curtail North Korea's nuclear ambitions, protect our allies, and bring stability to the Korean Peninsula. Underlying our current North Korea policy--or lack thereof--are a series of assumptions, which I believe must be reconsidered in light of our decades-long failure to achieve our strategic objectives. First, will China, ever really ``carry our water'' on economic sanctions? My assessment is China prioritizes its own interests in maintaining North Korea stability over denuclearization and will never place enough pressure on North Korea to force them to give up their nuclear program. That said, and as I will discuss further, China has a crucial role to play as a partner in this process, both imposing costs on North Korea up front and providing security and economic guarantees on the back end, but we should not expect that China will solve this issue for us. Second, do we still think that North Korea wants and needs to rejoin the international community? In other words, do they need us more than we need them? Based on its current actions, one would have to conclude no--and that holding out that possibility is not in fact an incentive for Pyongyang because it does not interest them. We should also be clear about North Korean intentions. Indeed, for all the talk about how irrational and unpredictable North Korea is, they have pursued these weapons--and developed tactics to evade international sanctions and pressure--with clarity and determination. They have not hid their intentions, the reasons why they believe they are seeking these weapons, or their vision for the peninsula. Even so, I believe Pyongyang will respond to incentives and to pressure, but we must get both the pressure and the disincentives right to be effective. Third, is time still on our side? The regime continues to move forward with its nuclear and missile programs, defying consistent predictions since the end of the Cold War that North Korea was on the verge of immediate collapse. All signs indicating that Kim Jung-Un is firmly in control and faces no serious challenges. He has even had members of his own family murdered to keep his iron grip on the country firm and in place. So while time has not run out, it is not on our side, either. Finally, are negotiations with North Korea pointless because they will always renege on their commitments? I recognize the history of numerous efforts to engage with North Korea that have ended in failure and acrimony, but it is also important to remember that while the 1994 framework agreement had many problems, it did limit and constrain North Korea's stockpile of plutonium for an 8-year period. Yes, North Korea continued with a part of its nuclear programs in secret, but there is no question that, during this period, the United States and our allies were safer and more secure than they would have been given the alternatives, which were war or acquiesce to North Korea's nuclear program. While it is certainly possible that the agreed framework would have fallen apart regardless, it is also possible, if the agreement had been maintained, it would have provided options for bringing the North's nuclear ambitions to a more permanent end. So while the Agreed Framework was far from perfect, it does suggest there are pathways by which a diplomatic surge can succeed in constraining and binding North Korea and in creating a more stable security environment in the region. I want to be very clear--I have no illusions about North Korea or about the low chances of success for even the best strategy for dealing with this regime. Nevertheless, it is incumbent on those of us in Congress, as well as our colleagues in the executive branch, to think through a policy that gives us the best chance of success and to take the necessary steps to see if this approach might lead to a better outcome. So, what would a policy geared for success with North Korea look like? First, we must immediately begin a sustained diplomatic effort with the goal of first constraining and then ultimately eliminating Pyongyang's nuclear and missile programs. Working with China is critical to these efforts. We can't expect China to solve North Korea for us. However, that does not mean that there is no space to make common cause with Beijing to contain North Korean's nuclear and missile programs and thereby reduce tensions in East Asia, which would benefit our mutual national security interests. At the end of the day, China understands that it, too, benefits from a denuclearized peninsula and that increased military tensions in the region, let alone war, do not serve China's interests well. So we can work with China to assure that sanctions are fully implemented-- especially those which China has already signed up for at the United Nations but has been slow to bring into force, an immediate test being the unanimously passed Security Council sanctions just this week. We can encourage China to take necessary measures that can force Pyongyang back to the negotiating table. To make this strategy work, we must indicate to China and Russia that we are ready and willing to engage in negotiations with North Korea. As we turn the screws on North Korea and strengthen our alliances, we need to be open to wide-ranging talks. We should be willing to discuss measures to deescalate the conflict on the Korean Peninsula, ways to improve the lot of the downtrodden people of North Korea, and ultimately a pathway forward for a denuclearized Korean Peninsula. To begin this process, Pyongyang will first have to verifiably halt their nuclear and ballistic missile testing, and the United States and our allies must indicate a willingness to take steps to deescalate the current tensions on the Korean Peninsula. China's assistance will be necessary not only in getting talks started but also in helping them reach a successful conclusion. Only China can provide North Korea with certain kinds of security guarantees which likely will be necessary to enhance Pyongyang's confidence that any agreement will be enduring. Second, it is worth emphasizing that an ``America Alone'' approach is not a formula for success in dealing with North Korea--or anything else for that matter. A complex threat like North Korea can't be successfully confronted without assistance from our allies and partners in the region--and any successful approach must start by strengthening our alliances and partnerships with Japan and Korea. The scope and range of partnership with our allies--starting with Japan and Korea--is both dynamic and comprehensive and has been critical for maintaining peace, stability, and economic prosperity throughout the Asia-Pacific region. This stability and prosperity has also made the United States more secure and more prosperous. It is why the United States, after the devastation of the Second World War and the Korean war, built partnerships with Japan, South Korea, and other Asian nations. These actions turned the region into one of the greatest foreign policy success stories of the past 70 years. Any successful policy toward North Korea must be built on this foundation and recognize that our strategic alliances combine not just military but also diplomatic and economic elements. The election of Moon Jae-in as President of South Korea and our partnership with Prime Minister Abe in Japan have created new opportunities to reconsider and recalibrate our approach and encourage us to align and coordinate our approach with that of our regional allies. Nations such as Australia, Singapore, and our other ASEAN partners also have important roles to play. The United States has worked diligently for the past several years, starting under the Obama administration, to strengthen our alliances and partnerships in the region by enhancing our defense and deterrence capabilities in light of emerging North Korean threats. This has included missile defense, extended deterrence, counterprovocation planning, and a suite of other capabilities relevant to the new security environment. We must continue and deepen these defense efforts to assure that we can stay ahead of North Korean threats, to provide leverage for diplomacy, and to maintain an insurance policy for the sort of ``containment'' that will be necessary should diplomacy fail. Third, the United States has an important opportunity to set the broader regional context for peace and stability on the Korean Peninsula by engaging in forward-leaning, principled, multilateral diplomatic engagement. Over the years, there have been numerous proposals for multilateral architecture in Northeast Asia proposed by the nations of the region, as well as by the United States. While there is ample room for discussion and debate over which model might be best, it is clear we need a forum to draw the nations of Northeast Asia together to engage in confidence-building measures and to address outstanding diplomatic, security, and political issues so that the right context exists for a stable Korean Peninsula. When President Trump travels to Asia this November, he has an important opportunity to move the multilateral architecture debate forward as a necessary supporting element of a broader North Korea strategy. Fourth and finally, the administration must seek to fully exercise our economic leverage, not incrementally but robustly and to the maximum extent feasible, and should immediately impose additional economic sanctions on Pyongyang. Secondary sanctions imposed upon firms that trade with North Korea, along with other targeted sectoral and financial measures through the UN Security Council, are essential to make it more difficult for the Kim Jong Un regime to support its prohibited nuclear and missile programs, including the financing that fuels its illegal activities. The administration must also rigorously implement and enforce the North Korea Sanctions and Policy Enforcement Act of 2016, the relevant sections of the recently passed Countering America's Adversaries Through Sanctions Act and UNSC resolutions 2270 and 2321 on North Korea. I know several of our colleagues, including Senators Gardner, Markey, Toomey and Van Hollen, also have legislation to impose new and additional sanctions. Critically, while many past efforts have been targeted at imposing costs on North Korea by curtailing trade leaving North Korea, to be truly effective a sanctions regime must have as its primary purpose halting the flow of goods, finances, and material into North Korea. We know that when oil shipments have been curtailed in the past or when we threaten the ability of North Korea to use the international financial system to bring its ill-gotten funds home, we have gotten Pyongyang's attention. We will get their attention again if we cut off North Korean elites' ability to continue to enjoy luxury goods. By cutting off access to these goods, through existing sanctions that are often not seriously enforced, we will provide an opportunity to focus minds in Pyongyang. China plays a key role in bringing this sort of pressure to bear on North Korea, but so do others. Russia, for example, houses some 30,000 North Korean slave laborers, a key source of regime income, and has also supplied North Korea with oil and aviation fuel in the past, sometimes illicitly. Other partners, including Singapore, have been key hubs for North Korean activity. Robust implementation of current sanctions to address these activities is crucial across all members of the international community. What I have laid out today are lofty goals to be sure, but we should stand up and try to reach them. Let's try to stop North Korea through diplomacy while watching to make sure North Korea will not cheat during negotiations or on any final agreement, as they have in the past. While imperfect in the short term, a freeze on North Korea's nuclear and missile program serves our national security interests. If nothing is done to slow North Korea down, its nuclear program and delivery systems will continue to grow, imperiling our allies and the American people. Diplomatic engagement that allows us to constrain and eventually reverse North Korea's nuclear ambitions may not be ``perfect'' security, but it is enhanced security and by far the better option available. Time is no longer on our side, but the clock hasn't run out yet. The United States and the international community have an opportunity to test the proposition of what a robust diplomatic surge to North Korea's aggression might look like. It is critical that we take the opportunity now.

Mr. CARDIN

Mr. CARDIN. Mr. President, I rise today with my colleagues Senators Collins, Brown, Blumenthal, Markey, Portman, King, Warren, Menendez, and Klobuchar to recognize the week beginning September 10th, 2017-- this week--as National Direct Support Professionals Recognition Week. The Senate has passed a similar resolution for the past nine years. Direct Support Professionals are an invaluable part of our Nation's health care system, caring for the most vulnerable Americans, including the chronically ill, seniors, and those living with a disability. With the help of Direct Support Professionals, these individuals can perform daily activities that many people take for granted, such as eating, bathing, dressing, and leaving the house. The work of Direct Support Professionals ensures that these individuals can be active participants in their communities. In our Country, we are incredibly fortunate to have millions of service-oriented Americans who are willing to rise to the task of becoming a Direct Support Professional. According to the Bureau of Labor Statistics, the employment of DSPs is projected to grow by an average of 26 percent from 2014 to 2024, compared to a 7 percent average growth rate for all occupations during that period. Unfortunately, direct support professionals are often forced to leave the jobs they love due to low wages and excessive, difficult, work hours. Many Direct Support Professionals rely on public benefits, and some must work multiple jobs in order to provide for themselves and their families. Now, more than ever, it is imperative that we work to ensure that these hard-working individuals have the income and emotional support they need and deserve. I urge my colleagues to join me in expressing appreciation for the critically important work of our Country's Direct Support Professionals, in thanking them for their commitment and dedication, and in supporting the resolution designating the week beginning September 10, 2017, as National Direct Support Professionals Recognition Week.

Mr. CARDIN

Mr. CARDIN. Mr. President, earlier this week, we commemorated the 16th anniversary of the attack on our country on September 11. It was a day that I think none of us will ever forget. We were attacked, and we wanted to take all necessary action to protect our country and go after those who perpetrated this attack against America. I was part of the Congress at that time and was part of the Congress that passed the 2001 authorization for the use of military force that was targeted toward Afghanistan, and I was part of the Congress that when we took up the 2002 authorization for use of military force against Iraq, I voted against that authorization. It has now been 14 years after the U.S. invasion of Iraq and the end of the Saddam Hussein regime. Yet we still have the authority for the use of military force against Iraq, and it is still being used. It is time for that authorization to end. I take this time to support Senator Paul's efforts to put a termination date on the 2002 authorization and to put a termination date on the 2001 authorization. The 2001 authorization was the first we passed. It was done virtually unanimously. There was some objection, but very few, because we wanted our country to hold those responsible in Afghanistan for the attack against America. That authorization is now 16 years old. Let me read for my colleagues exactly what that authorization said, what we passed 16 years ago: That the President is authorized to use all necessary and appropriate force against those Nations, organizations, or persons he determines planned, authorized, committed, or aided the terrorist attacks that occurred on September 11, 2001, or harbored such organizations or persons, in order to prevent any future acts of international terrorism against the United States by such nations, organizations or persons. That is the authorization. It is pretty specific. It is pretty specific to go after those who were responsible for the attack against the United States that was centered in Afghanistan, and it was used for that purpose. Our military took action against Afghanistan as a result of the attack against our country, and that was authorized by Congress. It is hard to understand how you can get from the reading of this authorization of the use of military force today as congressionally authorized against ISIS in the Middle East, in Africa, or anywhere in the world, but that is the interpretation that has been given to the action of Congress in 2001. I think that interpretation cannot be defended. Congress has a responsibility to act. We have a responsibility to specifically authorize the new threats that we have against our country and what military force is appropriate. That is our responsibility. This is a different threat than we saw 16 years ago. It is our responsibility to give congressional authorization for the use of military force. Some say it cannot be done. Well, if it can't be done, then we don't agree on the authorization of force. Let me just remind my colleagues that the Senate Foreign Relations Committee, over 3 years ago, passed an authorization for the use of military force. We came together in our committee, and I know Senator Kaine and Senator Flake have worked on a proposal that is certainly much more focused toward the current circumstances. Some of us may have amendments to that, some of us may disagree with it, but that is the debate we should be having. There should be no debate that the 2001 authorization does not apply to our current circumstances. We should pass an authorization that is tailored to allow the President to effectively go after the direct threats to the United States. That is our responsibility. We owe it to the American people and we owe it to the men and women who serve in our military to give them clear authority from Congress in their military operations. There clearly needs to be direction given by Congress. We have seen an abuse of the 2001 authorization, so we need to be pretty clear. I must tell you that I have heard over and over again from our generals that there is no military-only victory against ISIS. We can't win this by a military victory alone. We need to make sure that there are leaders in countries that protect their citizens, not only their physical security but good governance in their human rights. We have new challenges we need to deal with--cyber threats against the United States. We are concerned about a physical caliphate; now we are concerned about a virtual caliphate as we take more and more of the territory away from the ISIS forces. So that is what we need to do. Senator Paul's amendment gives us that opportunity by saying quite clearly that the 2001 and 2002 authorizations need to end--need to end--that we don't today have clear authorization from Congress to pursue the military campaign against ISIS, and we need to have that. There are some who say: Well, what happens if we don't meet that deadline? Well, let me tell you something. The President has plenty of authority. Read article 2 of the Constitution. He has the inherent power to protect our country and our national security, and he can take action in order to do that. I was particularly struck as to why we need the Paul amendment when I received a letter in my capacity on the Senate Foreign Relations Committee from Secretary Mattis and Secretary Tillerson. You see, the Senate Foreign Relations Committee was having meetings, trying to figure out how to proceed on the authorization for the use of military force. During one of those meetings, we had the opportunity to have Secretary Mattis and Secretary Tillerson before us, and we had a candid discussion about what type of authorization would make sense. It was done in a closed setting so we could have a candid discussion, and I am not going to reveal the specifics because I thought that is what we should be doing. But I can tell you, I left with the impression that there was room for Congress to work with the administration on the authorization of force, and I was hopeful that we were going to have an open hearing in the Senate Foreign Relations Committee, the committee of jurisdiction, on the AUMF. We had similar discussions under the Obama administration. As a result of those discussions, President Obama submitted to Congress what he believed would be an appropriate authorization for the use of military force. That authorization was never taken up, but he asked for it. Well, just recently, we received notice from Secretary Tillerson and Secretary Mattis that the President does not want Congress to adjust the authorizations because he has adequate authority to do what he wants to do. I understand that. If you take their interpretation--it is not just this administration; it is prior administrations' interpretation of the AUMF--they have a blank check. But that is not our responsibility being carried out. We are the ones who are responsible for the authorization of force, not the President of the United States, and according to this President, he has blank-check authorization from Congress. So it is our responsibility to make sure that when our men and women are sent into harm's way, they have direct authorization from the Congress of the United States unless, by the way, there is an urgent situation that requires the President to act, which he can do under article 2. So I urge my colleagues that we have a chance to start this debate right here and now by supporting the Paul amendment, and I intend to do that. With that, I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, I would like to take this opportunity to thank Dr. Donald F. Boesch, who is stepping down as president of the University of Maryland Center for Environmental Science, UMCES, a position he has held for the past 27 years. Since 1990, Dr. Boesch has led an institution with an excellent reputation for Chesapeake Bay science to global prominence in coastal watershed science and its application, building highly capable research facilities at each of the UMCES's four laboratories. Since 2008, he has also served as vice chancellor for environmental sustainability for the University System of Maryland. During Dr. Boesch's tenure, UMCES went through remarkable transformations. Research grants more than tripled and significantly diversified with multiple agency and private and philanthropic sponsors. This allowed UMCES scientists to expand their research into new and emerging topics critical to understanding Maryland's environment. He also initiated the Integration and Application Network, which is responsible for the annual ``report card'' on the Chesapeake Bay, to inspire and produce timely syntheses on critical environmental issues and identify practical and effective solutions to the bay's problems. Thanks to Don's unstinting passion and dedication to environmental issues, UMCES has had a profoundly positive impact on improving the health of Maryland's environment, playing a major role in the university's mission to enhance the quality of life in Maryland and our region. UMCES has become recognized as the State's foremost research authority on environmental matters that are critical to Maryland and the Nation, from enhancing the health of the Chesapeake Bay to restoring our State's oyster population. Don Boesch has been an extremely effective leader of people. He worked with the University of Maryland Baltimore County and the University of Maryland, Baltimore to form a novel research partnership, the Institute of Marine and Environmental Technology, located on Baltimore's Inner Harbor. He spearheaded the effort to design and construct the state-of-the-art research vessel Rachel Carson to help understand and monitor the Chesapeake Bay and coastal Atlantic Ocean. He led UMCES, a longtime partner in graduate education and classroom instruction with the University of Maryland, to receive accreditation to award joint graduate degrees in environmental science. Don has been involved in research on the Chesapeake Bay for more than 35 years, becoming one of the Nation's most widely recognized and respected experts in applying science to public policies for the protection, sustainable use, and restoration of coastal ecosystems. He has been an official adviser to Federal agencies, the Chesapeake Bay Program, and five Maryland Governors. He is a member of the Governor's Chesapeake Bay Cabinet. He has also served as chair of the Ocean Studies Board of the National Academy of Sciences and member of the National Academies Committee on America's Climate Choices. In 2007, he won the ``Award for Lifetime Leadership in Ecosystem Restoration, National Conference on Ecosystem Restoration.'' In 2010, President Barack Obama appointed Don to the National Commission on the BP Deepwater Horizon Oil Spill and Offshore Drilling. In 2015, he earned the ``Admiral of the Chesapeake Award,'' which was presented to him by the Governor. Don's interest in coastal watershed science probably came naturally; he was born and raised in New Orleans, and he received his B.S. in biology from Tulane University in 1967. He went on to earn a Ph.D. in oceanography from the College of William & Mary in 1971. He was awarded a Fulbright postdoctoral fellowship to study in Australia and then spent 8 years on the faculty at the Virginia Institute of Marine Science. From 1980 to 1990, he served as the first executive director of the Louisiana Universities Marine Consortium and worked as a professor of Marine Science at Louisiana State University. He returns to the gulf coast frequently to lead task forces and scientific panels on gulf ecosystem protection and restoration. Dr. Donald F. Boesch has had an exemplary career at the intersection of science and public policy. He has been incredibly helpful to me and the rest of the Maryland congressional delegation; we have all valued his wise counsel. I am comforted by the fact that, while Don is stepping down as president of UMCES on September 17, he will join the faculty and focus his energies on completing several research publications. I ask my Senate colleagues to join me in congratulating Don on this milestone event and thanking him for his extraordinary contributions to understanding and protecting our environment.

Mr. CARDIN

Mr. CARDIN. Mr. President, I take this time to share with my colleagues a meeting that I had last Thursday in Montgomery County, MD, with CASA de Maryland. We put together a roundtable discussion to talk about immigration and the need for immigration reform and the concerns we had about the current status of people who are concerned about what is happening with immigration enforcement. That was before the President had made his announcement on terminating the DACA Program, which is the program that provides relief for the Dreamers--those who have been in this country for a long period of time and know only America as their home. I must tell you that, at that discussion I had last Thursday in Montgomery County, MD, the fear of uncertainty was clear to me. I talked to many families who were concerned about how the Trump administration was enforcing our current laws, what would be the resolution of the temporary protective status, TPS, under which people are here legally, and I had a chance to see firsthand some of the Dreamers who are here under the protection of the DACA Program. It was very clear to me that what the people in that meeting were looking for was leadership in Washington that recognized that it is in our national interest for us to provide the type of legal protection to these individuals who have made America their home--who took the risk to come here for a better life for their families. These individuals came to this country--the Dreamers, who are the children, particularly--when they came with their parents. It was the parents' decision to try to find a better life for their children. They know only America as their country. They do not know the countries from which they have come. America is their own home. They have helped to build this great Nation. They have attended our schools. They have joined our military. They have joined our workforce. They are, truly, the future of America. The DACA Program, which recently celebrated its fifth anniversary, provided protection for these Dreamers against their arbitrary removal. It applied only to those who had come to this country when they were younger than 16 years of age. They had to have been here before January 2007. They had to have gone through a background check to make sure that they had not violated any of our criminal statutes, and they had to have been enrolled in schools or our military. It was really dealing with young people who were innocent with regard to any of the violations of our immigration laws. It really dealt with individuals who had come to this country and had been part of America. The DACA Program provided not only protection against their removal but gave them protection in the workforce. They were given documentation so that they could legally work here in the United States and get the protection of our labor laws and not be subjected to an underground economy or the abuses in the workforce that we sometimes see among immigrant families. So 800,000 children have taken advantage of the DACA Program. In my State of Maryland, 10,000 are registered under the DACA Program. Then came President Trump's decision this past week to terminate the program in 6 months--terminate it now, as far as new DACA registrations--but to terminate this program. That immediately created uncertainty and fear for 800,000 individuals in this country and their families. President Trump's decision is tragic in three ways. First, it has the potential of ripping families apart--800,000 people here in the United States. It creates uncertainty for those who are currently in the DACA Program. It creates fear as to what tomorrow will bring, and it will drive many of these individuals into the shadows, into the underground, into protecting themselves against the enforcement of removal. This decision by President Trump is tragic for a second reason. It will hurt our economy. The numbers in Maryland I think are somewhere around one-half of $1 billion to our State GDP from the Dreamers alone. The Dreamers are part of our economy. They are adding to our economy. I got a phone call from one of our major employers in Maryland expressing grave concern about President Trump's decision and the impact it will have on that company and on our economy. These are individuals who have been trained in our schools, who have gone to our colleges, who have served in our military, and who are now adding to the economic strength of America through their employment and their innovation. It makes no sense from the point of view of our economy. The third reason the President's decision is tragic is one that speaks to the strength of America--what makes America the great Nation it is. Yes, we are proud of those who serve in our military. We know that we have the strongest military in the world, and we are very proud of the way our military protects this country and provides global leadership. Yes, we are very proud of our economy and what it produces and the economic growth it provides for the people in this country and its engagement in the global economy. But what really makes America the unique, strong Nation that it is are our values, including what we stand for, our democratic institutions, the fact that we are the beacon of hope for people all over the world for providing opportunity. People can come to this country with dreams, and those dreams can become reality. That is what America's values are about. President Trump's decision to end the DACA Program runs afoul of the principles that have made America the great Nation it is--a safe haven for those who are seeking refuge from persecution, a nation that embraces diversity and recognizes diversity as our strength. President Trump's decision to end the DACA Program runs afoul of America's core values. It weakens us as a nation and certainly weakens our ability to lead globally with our values as we present them to the global community. So, as a result of that decision, what do we need to do? Each one of us needs to stand up and be counted, to speak out about America and what makes this Nation the great Nation it is. Then, collectively, we need to take action to show the American people that we will stand up not just for the Dreamers--and we need to stand up for the Dreamers-- but we will also stand up for the values that have made America the great Nation it is. I support S. 1615, a bipartisan bill that has been introduced by Senator Durbin and Senator Graham. I thank both of our colleagues for their leadership in bringing that bill forward. That bill will provide protection for the Dreamers and for the DACA Program so that Congress can say: No, Mr. President, we do not want to terminate this program. This program is in our national security interests. This program is why America is the strong Nation that it is. It is not only right for 800,000 people; it is right for all people in this country. This body showed great leadership a few years ago when we passed comprehensive immigration reform. I am for passing comprehensive immigration reform. Let's take care of and protect the Dreamers, and then let's work together to pass comprehensive immigration reform that we did just a few years ago that was never taken up in the House of Representatives. Let me close by telling a few stories about Dreamers in Maryland. One story appeared in the Baltimore Sun. It begins: Jesus Perez doesn't remember much about his journey to the United States two decades ago, beyond his parents using a simple phrase that would change the course of his life: ``We're leaving.'' Perez was 5 when he left Mexico. He's never been back. Perez [is] now a 25-year-old research assistant at the Johns Hopkins University in Baltimore. For Perez, the DACA program was a ``relief'' that allowed him to come out of the shadows. It also allowed him to take the job at Hopkins, and to get a standard driver's license. ``To now have it in limbo means that you either lose it all, and restart all over again--'' Perez said, trailing off. ``I'm not going to let that happen. We will win in the end.'' I want Mr. Perez to know that we are going to fight here in the U.S. Senate, not just for his ability to remain here in the United States but for what that means for the strength of our country. Our university community in Maryland has strongly supported the DACA Program. Dr. Loh, president of the University of Maryland, College Park, called the decision ``antithetical to the core values'' of higher education. He vowed in a letter to students and staff to ``continue to identify all avenues available for offering support.'' Johns Hopkins University President Ron Daniels and Provost Sunil Kumar reaffirmed the university's support for DACA, saying that Johns Hopkins University students directly impacted by the decision will be given the aid they need to complete their degrees. President Daniels and Provost Kumar said: ``The decision on DACA will not deter us from working to ensure that all members of our community can participate fully in our mission--the pursuit of excellence in education, discovery and service to the world.'' As President Loh and President Daniels fight on behalf of the DACA children, we need to also let the American people know that we are going to fight for what makes this Nation the great Nation that it is. The Baltimore Sun also told the story of Monica Perez, who is one of dozens of Dreamers from Maryland who rallied near the White House on Tuesday to protest the decision. The 23-year-old Baltimore woman came to the United States from Mexico when she was 7 years old. Ms. Perez said DACA ``gave us the opportunity to feel safe. We've already been in the shadows for so long.'' Ms. Perez works for CASA de Maryland. ``I'm just scared for my parents, for myself, and for my whole community.'' Mr. President, let us do the right thing and immediately extend the DACA Program. These are not 800,000 faceless individuals. I urge all of my colleagues to get to know the Dreamers and to understand their life story. It is heart-wrenching--the courage that they have shown, the obstacles they have overcome. Let's not put obstacles in their way. Let's allow their dreams to be able to come true. Let's stand up and be counted and fight for the Dreamers. Let's work together to protect their status, and then let's work together to fix our broken immigration system. That is our responsibility. This is our opportunity. Let's work together to get this done With that, I suggest the absence of a quorum.

Mr. CARDIN

Mr. CARDIN. Mr. President, today I would like to congratulate a dear friend of mine, Mr. Ernest ``Ernie'' Grecco, for 55 years of dedicated service to the labor movement and to working men and women and their families in the Baltimore-Washington metropolitan area and across the Nation. Ernie recently retired after serving for 20 years as president of the Metropolitan Baltimore AFL-CIO Council, which covers Baltimore City and Anne Arundel, Baltimore, Carroll, Cecil, Harford, and Howard Counties. For the last 15 years, he also served as secretary on the board of directors of the United Way of Central Maryland. Ernie's vocation and his avocation have been to make life better for other people. There is an old saying, ``You make a living by what you get; you make a life by what you give.'' Ernie has given so much to so many for so long. It is why I feel privileged and proud to call him my friend. Ernie became involved in the labor movement in 1962 while he was working at Calvert Distilleries. He was a member of Distillery Workers Union Local 34 and was elected shop steward. He served as shop steward until 1970, when he was elected secretary-treasurer of Local 34-D. He also served as trustee of the Distillery Workers International Union. In 1973, then-President Nick Fornaro of the Baltimore Central Labor Council hired Ernie as a job placement officer for the Institutional Training Project. In this capacity, Ernie was responsible for helping find jobs for hundreds of men and women housed at the Jessup and Hagerstown Penal Institutions who were qualified for work-release status. In 1976, he became the director of the Metropolitan Baltimore AFL-CIO Council's Committee on Political Education, COPE. He served in this position until 1983 when he became the COP director for the Maryland State and District of Columbia AFL-CIO. He was elected to serve as president of the Metropolitan Baltimore AFL-CIO Council in 1987, and he also served as first vice president of the Maryland State and DC AFL-CIO. Ernie has held many other leadership positions over the course of his illustrious career. For instance, he chaired the Young Trade Unionists, which was created to bring younger people into the labor movement, and he served as president of the Union Label & Service Trades Council, which promoted the purchase of union services and products. Ernie has also served on the Baltimore Workforce Investment Board, the Maryland Transportation Commission, the Maryland Workers Compensation Commission, and the Maryland Racing Commission. As president of the Metropolitan Baltimore Council, Ernie established monthly meetings with the mayor of Baltimore City to encourage better communications and collaboration between the city and the unions. The committee consists of all city unions and a representative from the building trades. Ernie also championed the council's community services division. The community services division provides assistance to working people through information and referral advocacy to help them solve personal and family crises. The services include education and training for union peer counselors; Baltimore Works, a job placement program for dislocated workers; and Project LEAP, an adult education literacy program. It should come as no surprise that Ernie has received numerous awards for his indefatigable service to people. He has the distinction of receiving not one, but two, national awards for community service, the Samuel Gompers Award from the American Red Cross in 1991 and the Joseph A. Beirne Award from United Way of America in 1999. Last year, United Way of Central Maryland gave Ernie its Philip H. Van Gelder Award for Community Services. In 1995, the Baltimore City Fire Fighters Local 734 and Baltimore City Fire Officers Local 964 created the Grecco Labor Award to be given to a firefighter who ``best exemplifies the continuing and complex efforts of the local union membership to build the relationship between labor and management.'' During Ernie's career, he has been much loved and respected not just in Baltimore, but in Annapolis and across the State of Maryland for his steadfast commitment to the labor movement and working people. He is, understandably, an avid Orioles, Ravens, and horse-racing fan. His retirement is bittersweet because his beloved wife Dorothy--``Dot''-- recently passed away, but I know Ernie will spend much of his time with his daughter, Nina Grecco Dukes, and his son, Gary, and Gary's wife, Kelly, and his grandchildren, Ashley, Adam, Katy, and Ben. I have relied on Ernie's sage counsel on labor matters and other issues over the years, and I treasure our friendship. I have been a better and more effective legislator because of Ernie's friendship and advice for which I am truly grateful. On behalf of the entire U.S. Senate, I congratulate Ernie on his accomplishments and his well-deserved retirement, but knowing Ernie as I do, he will find new ways to be of service to others; it is simply at the core of who he is.

Mr. CARDIN

Mr. CARDIN. Mr. President, I intend to offer a motion to commit the reconciliation bill to the Finance Committee with instructions to report the bill back to the Senate within 3 days, not counting any day on which the Senate is not in session, with changes that would strike any provision that would eliminate, limit access to, or reduce the affordability of pediatric dental services by repeal all or part of the Patient Protection and Affordable Care Act, ACA, or otherwise negatively impact children's access to coverage or such services. I am offering this motion because the Finance Committee should review the implications of depriving millions of children of access to dental care. An estimated one of five children aged 5 to 11 years and one of seven adolescents aged 12 to 19 years in the U.S. have at least one untreated decayed tooth. Consequently, tooth decay has led to 51 million school hours lost annually, and related dental disease can cost billions to our healthcare infrastructure. Early childhood cavities and related oral health complications also disproportionately affect low- income families and minority communities. The ACA has expanded access to dental services nationwide by designating pediatric dental services as one of the essential health benefits. Expanding access to affordable dental benefits is essential to securing the health and well-being of our children. Many have heard me speak before about the tragic loss of Deamonte Driver, a 12-year-old Prince George's County resident, in 2007. Deamonte's death was particularly heartbreaking because it was entirely preventable. What started out as a toothache turned into a severe brain infection that could have been prevented by an $80 extraction. We cannot let what happen to Deamonte happen again. I ask unanimous consent that the full text of my motion to commit be printed in the Record.

Mr. CARDIN. Mr. President, I intend to offer a motion to commit the reconciliation bill to the Finance Committee with instructions to report the bill back to the Senate within 3 days, not counting any day on which the Senate is not in session, with changes that would eliminate or reduce access to affordable preventive services that are currently offered without copayment or cost-sharing under the Patient Protection and Affordable Care Act, ACA, including blood pressure screening, colorectal screening, breast cancer screening, cervical cancer screening and domestic and interpersonal violence screening and counseling. I am offering this motion because the Finance Committee should review the implications of reducing access to affordable preventative services to millions of Americans. A key provision of the ACA is the requirement that private insurance plans cover recommended preventive services without any patient cost-sharing. Chronic diseases, such as heart disease, cancer, and diabetes, are responsible for 7 of every 10 deaths among Americans each year and account for 75 percent of the Nation's health spending. Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they develop into more complicated, debilitating conditions. I ask unanimous consent that the full text of my motion to commit be printed in the Record.

Mr. CARDIN. Mr. President, I intend to offer a motion to commit the reconciliation bill to the Finance Committee with instructions to report the bill back to the Senate within 3 days, not counting any day on which the Senate is not in session, with changes that would strike any provision that would eliminate, limit access to, or reduce the affordability of health services for homeless individuals. I am offering this motion because the Finance Committee should review the implications of depriving millions of children of access to dental care. On any single night, over 500,000 people experience homelessness. On any single night over 50,000 of these individuals are homeless veterans. Many individuals experiencing homelessness have significant healthcare needs and may suffer from mental health conditions, substance use disorders, and chronic diseases like diabetes, asthma, and hypertension. Without access to health services, individuals tend to use hospitals and emergency departments at high rates, driving up overall healthcare costs. The Patient Protection and Affordable Care Act, ACA, has greatly decreased the uninsured rate among homeless individuals, leading to better health outcomes, and creating stability in the individual's life. Health centers that treat the poor and homeless in States that expanded Medicaid report that 80 or 90 percent of their patients are now covered by insurance. I ask unanimous consent that the full text of my motion to commit be printed in the Record.

Mr. CARDIN. Mr. President, I intend to offer a motion to commit the reconciliation bill to the Finance Committee with instructions to report the bill back to the Senate within 3 days, not counting any day on which the Senate is not in session, with changes that would strike any provisions that would eliminate or reduce access to mental health services and substance abuse treatments. I am offering this motion because the Finance Committee should review the implications of reducing access to mental health services and substance use treatment to millions of Americans. An estimated 43.6 million Americans ages 18 and up experience some form of mental health condition, and over 20 million adults have a substance use disorder. Of these, over 8 million have both a mental health condition and a substance use disorder. That Patient Protection and Affordable Care Act, ACA, has been vital to giving these individuals access to affordable treatment options where they had none before. I ask unanimous consent that the full text of my motion to commit be printed in the Record.

Mr. CARDIN

Mr. CARDIN. Mr. President, I yield myself 3 minutes. I first thank Senator Corker, Senator Crapo, Senator Brown, Senator Schumer, and Senator McConnell for their help in getting us to this moment. This is an important moment for our country, and I am very proud of what we were able to accomplish. The legislation we are about to vote on will give the United States the strongest possible hand to stand up against the aggression of Russia. Russia attacked us and our democratic institutions; Russia invaded the sovereignty of other countries, including Ukraine and Georgia; Russia is participating in war crimes in Syria, and this legislation will give the United States the strongest possible hand in taking action against Russia. Mandatory sanctions are included in this legislation with regard to the energy sector, the financial sector, the intelligence and defense sectors--not only with primary sanctions but with secondary sanctions. This legislation provides for a democracy fund, working with Europe, to protect ourselves against Russia's attacks. This legislation provides a review process so the President, on his own, cannot eliminate sanctions. He must come to Congress. As President Obama had to in regard to the Iran sanctions, the President would have to come to Congress in regard to sanction relief against Russia. This is a tough bill to stand up to what Russia has done and requires mandatory action. There are so many people to thank in regard to this. Of course, we also have the Iran sanctions. I thank Senator Menendez, on our side, particularly on the Iran sanctions issues. We are taking actions against Iran for their nonnuclear violations, their support of terrorists, their ballistic missile violations, their support of the arms embargo, human rights violations. What we do here is totally consistent with the JCPOA. The bills are very consistent with what passed this Chamber 98 to 2. We maintained the integrity of the Iran and Russia provisions consistent with what was done in our committees. In regard to North Korea, I know we all want to take actions against North Korea. The provisions added by the House are consistent with what we think are appropriate for North Korea. This is an important moment for our country. I really do want to thank all involved. I know Senator Corker, Senator Brown, and Senator Crapo would agree with me: I really thank our dedicated staff. We could not have done this without our staff. They worked 24/7 for the last 7 weeks to get this done. As a result of their action, the United States is going to be in a better position dealing with Russia when this legislation is enacted, and I am proud to be part of that. I reserve the remainder of my time.

Mr. CARDIN. May I have a moment? First, I want to join in thanking Senator McCain and Senator Graham for their work. We started in January on this legislation--their legislation. How we drafted it is intact here, and I thank Senator McCain and Senator Graham. The leader on the Iran sanctions, going back many, many Congresses, has been Senator Menendez. In introducing him, I want to thank him for his leadership on Iran and, also, these other bills. I look forward to his comments.

Mr. CARDIN

Mr. CARDIN. Mr. President, I wish to commend Dr. Joseph T. ``Tim'' Arcano, technical director for Naval Surface Warfare Center, NSWC, Carderock Division, who is retiring after a lifetime of service to the U.S. Navy, our Federal Government, and the scientific community. Tim Arcano has dedicated his professional life to serving our country, first in the military and later as a civil servant. His knowledge of ships and the oceans they sail and nuclear safety and capabilities has been developed through his education and in his myriad positions throughout the Navy and our Federal Government. Two of Dr. Arcano's academic degrees were earned in my us, home State, where he attended the U.S. Naval Academy, and later earned his Ph.D. at the University of Maryland. In addition, he holds an Ocean Engineer degree and a masters in mechanical engineering from the Massachusetts Institute of Technology, MIT. Dr. Arcano's first career was in our military, where he served for 30 years in both Active and Reserve service. As technical director and ship design manager for the Virginia-Class Submarine Program, as technical authority for advanced submarines at Naval Sea System Command, NAVSEA, and as a program manager at the Defense Nuclear Facilities Safety Board, Dr. Arcano developed an understanding and expertise that few can match. Those skills were further utilized in five Reserve commands. Dr. Arcano's dedication to our country continued after his transition from Active service to the Reserves in 1992 and his later retirement from the Navy as captain in June of 2008. He served as deputy chief of Nuclear Safety at the United States Department of Energy and as the director of the Office of Ocean Exploration and Research at the National Oceanic and Atmospheric Administration. During that time, he returned to the Naval Academy to hold the Corbin A. McNeill Endowed Chair in Naval Engineering, where he created a course on engineering of submersible systems. Dr. Arcano came to NSWC Carderock in May of 2013, bringing his wealth of experience as he took the helm of a campus of over 3,000 employees. His impact has been magnified by his commitment to STEM education and developing the next generation of scientific leaders. Under Dr. Arcano's leadership, employees at NSWC Carderock have mentored countless high school and college interns, even reaching to our youngest developing scientists by leading elementary students in FIRST Robotics clubs. Dr. Arcano ``walks the walk'' himself, giving greatly of his own time by taking interns under his wing to offer advice and helping them chart their path, wherever that might lead. As part of his encouragement of STEM education, Dr. Arcano and NSWC Carderock have continued to host the International Human Powered Submarine Races. Teams from not just corporations and research centers, but from universities and even high schools come from around the world to race their independently built one- or two-person submarines through a course at the historic David Taylor Model Basin at Carderock. For 2 years, these competitors learn about hydrodynamic design, propulsion, underwater life support, materials science, and other scientific principles in creating their own designs for these vehicles. The lessons learned, both in science and engineering and in collaborating on a team project, help to fuel their enthusiasm for careers in science and technology. Dr. Arcano's career reflects his selflessness, his unparalleled leadership capabilities, and his devotion to our country. He commands the respect and admiration of all who have had the privilege to know and work with him. His leadership will be greatly missed, but he has left a legacy of scientific leadership that will continue to develop through the principles and practice that he exercised every day. We are deeply grateful for his devotion to our national security, to naval science, and to America's future generations. I offer the thanks of a grateful nation to Dr. Arcano and, by extension, to his family--his wife, Brenda, their daughter, Heather, and sons, Greg, Joseph, and Tyler--for as we all know, the support of family is critical. I am honored and pleased to recognize Dr. Tim Arcano for his outstanding career in public service and wish him all the best in his future pursuits.

Mr. CARDIN

Mr. CARDIN. Mr. President, I have listened very carefully to the majority leader and his requests that we come forward and bring amendments to the floor--all of our ideas about how we can improve our healthcare system so that this would be an opportunity through budget reconciliation for us to deal with those issues. I asked my staff to prepare amendments in order to protect the Medicaid system from cuts. I asked my staff to prepare amendments to protect the essential health benefits that are in the Affordable Care Act because it is important that we preserve those benefits, whether it is mental health and addiction services or one that is particularly important to Maryland; that is, pediatric dental. In Maryland, we all recall the loss of a 12-year-old not too many years ago because he couldn't get dental care--Deamonte Driver. I asked my staff to take a look at preparing amendments to protect minority health and health disparities because the Affordable Care Act made tremendous advancements in trying to close that gap on the disparities in minority health and health disparities. I asked my staff to take a look at the tax provisions because we want to make sure that we are not giving tax cuts to wealthy people at the expense of cutting the Medicaid system. I asked them to look at this in a lot of different ways. Listening to the majority leader, I also have introduced legislation that I will talk about that could build on the Affordable Care Act, and I was wondering what bill I should amend? What is the bill that we are considering? It is not the bill that Senator McConnell brought forward because that bill was defeated. It is not the repeal--and we are starting with a blank slate--because that was defeated. I don't believe it is the House bill because that has been discredited, called a mean bill by the President, as well as by Members of this body, who said it has no chance of passing. So my dilemma is that I don't know what I should be amending. I expect we will get to see another bill somewhere along the process with virtually no notice and no opportunity to read and no opportunity to amend, but the majority leader says I am going to have that opportunity. Yet we don't know what the bill is that I am supposed to be addressing my amendments to. We know that all the bills we have seen today--every single one from the Republicans--have been scored by the Congressional Budget Office as to tens of millions of Americans losing their insurance coverage--tens of millions. I understand it is about 33 million if we just repeal the Affordable Care Act, 22 million if we use the type of replacement that the majority leader was suggesting. All of those move in the wrong direction. We also know that in every one of these proposals to date, insurance premiums are going to go up, not down. That is one thing I have heard from my constituents. They would like to see us bring down the growth rate of health insurance costs and healthcare, not increase it. So, yes, I would like to be able to offer amendments, but I don't know what to offer amendments to. I also am concerned when I see that every one of the bills that have been suggested by the Republicans would reverse the protections that we put in law against the wrong practices--the discriminatory practices-- of insurance companies. I have talked to many of my constituents who tell me that if we reimpose caps, either yearly or lifetime--they have the circumstance where their child was born with a disability and that cap would have been expended within a matter of months--they would be left without insurance coverage. They tell me about how preexisting conditions could be jeopardized. All of us have some form of preexisting condition, and, on a lot of these plans that are being suggested where you could choose the type of coverage you want, insurance companies are not going to offer the benefits you need. People who have challenges are going to be most discriminated against. So I don't quite understand how I can offer amendments and we could have a vote on the floor when we don't know what we are trying to amend. I must state that there is a common theme here, and we know it. We know that there is now talk that the majority leader might bring up, sometime during this process, what has been called in the press a ``skinny'' bill. I call it a slow death of the Affordable Care Act, and, in fact, I am afraid it might be a fast death of the Affordable Care Act because, if the reports are accurate, one of the provisions that the majority leader is looking to bring in as the final bill that we would vote on would eliminate the requirement that companies have to provide insurance coverage to their employees and individuals must have coverage. Now that seems innocent enough, except for the tens of millions who are going to lose their insurance coverage--people who are working for companies that decide to terminate their policies, healthy people who decide not to buy insurance policies. I believe you are going to find that there still will be tens of millions of people losing their insurance coverage, and that is unacceptable. But it goes beyond that. That proposal will also increase premium costs by a very large percent. Why? Think about this for a moment. If you don't have to buy insurance and you are young and healthy, are you going to buy insurance or not? Many will say no until they need the insurance, and then they will buy the insurance. Actuaries tell us that without the requirement to have insurance, the insurance pools will contain a very high percentage of adverse risks--people at higher risk--and when that happens, the purpose of insurance to spread the risk is no longer done. It means premiums will go up dramatically. That doesn't help the people who are going to need it. What you also find when you eliminate this requirement is that people get what we call job locked. They may have a company that provides health benefits, but now they may have to leave that company. But if they want to leave that company and start a job or go to another job that doesn't have insurance, they are locked into where they work. All of that adds to anxiety, adds to lack of coverage, adds to people who don't have health insurance, adds to people not getting adequate healthcare, adds to bankruptcies, adds to the problems that we addressed with the Affordable Care Act. But there is another explanation here. Maybe this is just a shell bill that is going to go back--hopefully, as the Republicans believe, but I hope it does not happen--to the House, and then we will put in the Medicaid cuts and the tax relief and all the other things that are not in the bill. This is just a shell to get us back to one of the bills that couldn't get the votes here on the floor, where tens of millions of people will lose their insurance coverage, premiums will go up, and insurance company arbitrary and discriminatory practices will return. Every one of these proposals--every single one--moves us in the wrong direction in healthcare. We recognize that we can improve our healthcare system. I am for improving our healthcare system. I think we can work together--Democrats and Republicans--to improve our healthcare system. So here is my request: Vote for the Casey motion. Why? For two reasons. One, I would hope that on this anniversary of the ADA, or the Americans with Disabilities Act, we would want to do no harm to those with disabilities in our healthcare system and they would have adequate coverage. I was in a celebration over the weekend in Baltimore City with the disabilities community. We celebrated one of the great victories in America, the Americans with Disabilities Act--a bipartisan bill, with Democrats and Republicans coming together in a proud moment, in the best traditions of the Senate, to say that people with disabilities will be treated fairly in America. On this day we should adopt the Casey motion on the issue of protecting people with disabilities. But there is a second issue here.

Mr. CARDIN. Mr. President, I ask unanimous consent to speak for 2 additional minutes.

Mr. CARDIN. I will try to conclude my remarks. On this day that we are celebrating the anniversary of the Americans with Disabilities Act, let's do right by that. There is a second part to the Casey motion that sends it back to committee so we can use the regular process, as Senator McCain talked about yesterday. Let's have the committee hearings, as Senator Alexander talked about. Let's have the committee markups and work together. I introduced legislation that would bring down the cost of healthcare and lower the rate of increase of individual premiums. I do that by suggesting more competition in the individual marketplace, by having a public option, by providing stronger subsidies to lower income families, by making sure that cost- sharing is in fact paid for so we don't have that uncertainty, with the reinsurance that Senator Carper was talking about to deal with the overall cost of healthcare, by dealing with prescription drug costs, and by dealing with coordinated care so that we can deal with the whole patient rather than their individual disease. All of those issues would improve the Affordable Care Act, but before we get there, we have to get off of this train. We have to stop this disastrous course. I am going to do everything in my power to make sure that, as to the bill we have, whenever it comes forward, we stop it right here, and then work together, Democrats and Republicans, to improve our healthcare system, not to take away insurance coverage and increase costs for so many Americans. With that, I yield the floor.

Mr. CARDIN. Madam President, I intend to offer a motion to commit the reconciliation bill to the Finance Committee with instructions to report the bill back to the Senate within 3 days, not counting any day on which the Senate is not in session, with changes eliminating provisions that would weaken access to essential health benefits, reduce access to affordable preventive services, and undermine the prohibition of annual and lifetime limits and caps on out-of-pocket expenditures for health insurance plans. I am offering this motion because the reconciliation bill affects tens of millions of Americans who gained health coverage under the Patient Protection and Affordable Care Act, ACA. The reconciliation bill allows insurers to eliminate coverage of essential health benefits. Insurance companies could exclude essential benefits like maternity care, substance use disorder treatment, mental healthcare, prescription drugs, and hospitalization--the very services people buy insurance to obtain. Before the ACA, one-third of individual market health plans did not cover substance use disorder services, nearly one- fifth of those plans did not cover mental health, and only nine States required all insurers on the individual market to cover maternity care. Allowing States to waive essential health benefits would also allow insurance companies to reinstate annual and lifetime caps. This means that a premature baby could exceed its lifetime limit within its first few months of life or that a cancer patient could hit an annual cap just a couple of months into treatment. Before the ACA, too many people and families were hurt physically and financially because they could not afford access to healthcare. They didn't get the tests they needed. Perhaps they did not catch a preventable disease early enough--so the treatment costs skyrocketed. We saw too many families go through bankruptcy because they could not afford the healthcare that they needed. We saw too many people literally cutting their prescription pills in half, hoping to stretch out their medicine because they could not afford more, even though they knew they were compromising their health. We cannot go back to this cruel, dreadful situation. The following Senators support my motion to commit: Senators Carper, Brown, Blumenthal, Warren, Nelson, Van Hollen, Duckworth, and Stabenow. I ask unanimous consent that the full text of my motion to commit be printed in the Record.

Mr. CARDIN. Madam President, I intend to offer a motion to commit the reconciliation bill to the Senate Health, Education, Labor & Pensions, HELP, Committee with instructions to report the bill back to the Senate within 3 days, not counting any day on which the Senate is not in session, with changes that would eliminate provisions in the bill that would increase health disparities among certain populations, including disparities on the basis of race and ethnicity, socioeconomic status, gender, religion, disability status, geographic location, and sexual identity and orientation. I am offering this motion because communities of color and disenfranchised communities have faced significant barriers to accessing affordable health coverage, and these barriers have contributed to health disparities, which are evident in higher rates of diabetes, heart disease, hepatitis B, HIV/AIDS and infant mortality, among other conditions. The Patient Protection and Affordable Care Act's vital coverage reforms, which include Medicaid expansion, cost sharing reductions, eliminating annual and lifetime limits, and creating coverage options for individuals with preexisting conditions, has led to sharp declines in the uninsured rates for minorities and low-income populations. With the implementation of the major ACA coverage provisions in 2014, the uninsured rate dropped dramatically and continued to fall in 2015. In 2015, the nonelderly uninsured rate was 10.5 percent, the lowest rate in decades, with the most dramatic changes seen among low-income Latino Americans, African Americans, and Asian Americans. Minorities now make up more than 35 percent of the American population, and that number is expected to rise in the future. Every community across this great Nation deserves optimal health. A person's ethnic or racial background should never determine the length or quality of his or her life. We must work to bridge health equity across communities, ensure that all Americans have access to affordable, high- quality healthcare, and continue our efforts to eliminate health disparities. The following Senators support my motion to commit: Senators Booker, Hirono, Brown, Carper, Stabenow, Markey, Blumenthal, Van Hollen, and Nelson. I ask unanimous consent that the full text of my motion to commit be printed in the Record.

Mr. CARDIN. Madam President, I intend to offer a motion to commit the reconciliation bill to the Finance Committee with instructions to report the bill back to the Senate within 3 days, not counting any day on which the Senate is not in session, with changes that would eliminate provisions that hand out tax breaks to large corporations and the most affluent Americans while the bill makes cuts to Medicaid, which serves millions of our most needy Americans, including the elderly poor and poor children. I am offering this motion because the Finance Committee should review the implications of depriving millions of Americans, including children, veterans, individuals with disabilities, and older people, of their health insurance while at the same time providing large tax breaks to the richest Americans and biggest corporations. H.R. 1628 offsets those tax breaks by voraciously cutting the Medicaid Program. Republicans are using the Medicaid Program as a pay-for for these large tax breaks. As a result, the Republican bill harms far more people than it will help. Former President John F. Kennedy said, ``To govern is to choose.'' The Republicans have made a cruel choice, and I object to it. The following Senators support my motion to commit: Senators Harris, Van Hollen, Casey, Udall, Coons, Markey, Booker, and Leahy. I ask unanimous consent that the full text of my motion to commit be printed in the Record.

Mr. CARDIN

Mr. CARDIN. Madam President, first, let me thank the Democratic leader for his statement on a better deal for all Americans. I had a chance over the weekend to travel throughout my State, and I heard over and over again the people of Maryland talking about what we need to do on a better deal. I had an interesting forum on healthcare, and Marylanders want a better deal on healthcare. They want to make sure healthcare is affordable, that they can get access to quality care, and they can make sure we maintain the highest quality healthcare. What they don't want to see is us moving in the wrong direction. I heard over and over again their concerns about what is happening with the consideration of the bill the Republican leadership is anticipating having a vote on later this week. That bill would proceed on legislation that would eliminate healthcare coverage for, at least, 22 million Americans, maybe as high as 33 million Americans. I must tell you that is not a better deal for Americans on their healthcare needs. We could do much better moving in the opposite direction and making healthcare more affordable, not cutting people out of healthcare insurance. In my State of Maryland, in 2018 alone, 221,000 people in my State would lose coverage under the proposals the Republican leadership is suggesting, including 4,200 veterans, 164,000 people in the Medicaid system, and 62,000 people in the individual marketplace. That is going to hurt. These are people today who have healthcare coverage who would lose their healthcare coverage. It would hurt our seniors in the coverage they get under the Medicaid system for long-term care. It would hurt those who are working to try to end this opioid drug addiction issue. Under the current law, mental health, behavioral health, and drug addiction is covered under the essential health benefits. It is covered under private insurance. It is covered under the Medicaid system. That is in danger of being lost under the legislation being considered. I heard from public health and law enforcement over the weekend how that would move our community in the wrong direction if those bills were considered. I also heard from the majority leader that all he wants to do is get on this bill, and then we can offer amendments. Well, that is not accurate. You can't offer any amendments you want on a bill that is under reconciliation instructions, and we certainly aren't going to get a fair shot at trying to make this bill a better bill under the restrictions we are operating under: We had no committee hearings. We had no committee markups. That is not the way legislation should be considered. The other issue I heard about from people in Maryland--I think you will hear this from people around the country--is they want to bring down the cost of their healthcare coverage. They want to bring down the cost of their healthcare. They want to reduce the high growth rate in healthcare costs in this country. Yet the Senate Republican bill increases the average premium by as much as $1,700 in Maryland by 2020 and preserves what we call the age tax--a 5-to-1 difference. So if you happen to be 55 years of age, you are going to pay a lot more than that in increases in your health insurance premiums. That is not what people in Maryland want to see. That is not what people in this country want to see. They are concerned that we should be building on the Affordable Care Act to bring down the cost of their premium increases, not to increase it by that dramatic amount of money. The increase in deductibles in Maryland could be as high as $3,300 for a person making $42,000 per year and $5,600 for a person making about $18,000 a year. Those are increases in deductibles. They can't afford that. The concerns we have--people like the Affordable Care Act, and they want us to improve it. They want us to improve it. They don't want us to add to their costs, and the bill the majority leader is asking us to consider would have people in Maryland and around the country paying more--not less, which they want. The people in Maryland and around this country like the consumer protections we have under the Affordable Care Act. They like the idea that there is no annual cap or lifetime cap. I had several people who came up to me to tell me about their own personal circumstances. One father explained to me that his child was born with serious issues and that they reached their cap within a matter of months. Without the protection in the Affordable Care Act, they would have had no other insurance coverage. Yet, under the bill being considered by the Republican leadership, that family could lose that protection because you could see the imposition of caps. All of us know of people who are very concerned about preexisting conditions. The bill that is being considered under the Republican leadership weakens those protections against discrimination of preexisting conditions. Let me just remind my colleagues of what we saw before the Affordable Care Act in discriminatory practices by private insurance companies. We had reined much of that in under the Affordable Care Act. All of that could be lost if we proceed on legislation--and move it forward--that doesn't provide the consumer protections, allows the elimination of caps, allows discriminatory practices in regard to preexisting conditions, restricts the amount of money going into the Medicaid system so our States are forced basically to cut back on the Medicaid system. We lose the expanded coverage--the Congressional Budget Office has already told us that--and we go back to the days of job lock. I want to talk about that for one moment because I think this is one of the untold stories. We haven't had a lot of discussion on the floor. If you go in the wrong direction and you do what the Republican leadership is talking about doing and repeal the Affordable Care Act and either repeal and later replace or replace it now with a program that will eliminate a lot of coverage and once again eliminate these consumer protections we have in health insurance, what you do is people get locked into employment. They are afraid to leave their job because they have insurance that covers their family--they have a spouse with cancer or they have a child with a major disability. Yes, they would like to do what this country is best known for, and that is set out with an entrepreneurial spirit, start a company or go and take risks, but they can't do it because they know they are jeopardizing their family's healthcare because they can't get the type of insurance they need to cover their risks. That is called job lock and that works against the growth of our economy. There are so many reasons to be concerned about what the majority leader is asking us to do--to proceed on this bill that all the options we have seen will cost tens of millions of people their coverage, take away a lot of the consumer protections we have seen in the law, and discriminate against our elderly, discriminate against minorities and women. That would be returning to our old healthcare system. No, that is not the right way to do it. I am frequently asked: Well, what should we do? The Affordable Care Act, doesn't it have problems? Doesn't it need to be fixed? The Affordable Care Act has done a lot of good. It has given people coverage who never had coverage before. It has reined in the discriminatory practices of health insurance companies. It has made a dramatic improvement on dealing with minority health and health disparities. It has provided essential health benefits so we deal with mental health and addiction. It has done a lot of really good things, but, yes, we could improve it. There has never been a major law passed without us going back and revisiting. Why haven't Democrats been part of this process? Well, we could not get engaged in this process because the way this bill came to the floor, it didn't come through the Health, Education, Labor, and Pensions Committee, it didn't come in through the Finance Committee, the two committees of jurisdiction that deal with the healthcare system in this country. Instead, it came in through the majority leader using the rule XIV process to bring out a reconciliation bill that can be jammed through, with limited time and no open amendment process, from the point of view that amendments have to be germane to the reconciliation instructions so we don't have an opportunity to fix this bill. We weren't part of the process to develop the bill. You are not giving an opportunity for the democratic system to work. There was no on-ramp for Democrats to get engaged in the process. About 2 weeks ago--maybe 3 weeks ago now--I filed legislation and sent letters to my Republican colleagues telling them: I want to work with you. I do. I have worked with Republicans in the Finance Committee on healthcare bills. We have gotten some good things done. Democrats and Republicans want to work together, so let's work together. The legislation I filed dealt with the two major problems that I hear about, as I travel throughout Maryland, regarding what we need to fix on the Affordable Care Act and how we can make it better. Problem No. 1, we need more stability and competition within the individual marketplace. Yes, we have seen large proposed increases in premiums in the individual marketplace--not in the group plans where most Americans have their insurance but in the individual marketplace. Why? Because we don't have enough people who have signed up in the exchanges. Younger, healthier people, because there really hasn't been a penalty imposed, have chosen not to join. They will say: Look, we will join if we have a need. We have also found that with President Trump indicating he may not fund the cost-sharing provisions that go directly to the insurance carriers that keep the premiums low and the deductibles and copays low, this also has a lot of insurance companies nervous. As a result, the premium increases are larger than what we had anticipated. We need to do something about it. How can we keep those premium increases at a more reasonable growth rate rather than what we have seen? One way we could do it is a proposal that, I believe, has bipartisan support; that is, deal with what is known as reinsurance. Reinsurance is a way we spread the risk over a greater group of people, therefore dealing with those high-risk pools in a way in which their premium costs are much more affordable. Another way we can do it is by Congress mandating that the President fund the cost-sharing with the insurance carriers so we don't have the threat that they are going to pull out those funds that are used to keep copays and deductibles low. Another way we can do it is to increase our support for those who are of modest income and the funds they have to lay out for their premiums because we know you can make a good salary, but because of the cost of healthcare, if you don't have an employer providing part of those benefits, it is very hard for you to be able to afford that without some help. We can do all of that. Another thing we could do is bring more competition into the individual marketplace. We have had those who have suggested a Medicare for all. We have had those who have suggested Medicare for the near elderly--the 55 to 65 age group or something similar to that. We have others who have suggested that we have a public option under the exchanges. All those, to me, make sense because it just brings in more competition. There is no additional government cost here because they are not subsidized any differently than any other insurance plan, but it gives more options, more choice, more competition, and therefore more stability in the individual marketplace. We could do all that and all that can help. The other thing we really need to deal with is to deal with the overall cost of healthcare. Here, again, Democrats and Republicans have had ideas. Why don't we take on the pharmaceutical industry? Why do Americans pay twice what Canadians pay for the same medicines that are manufactured here in the United States? Why don't we have rebates in the Medicare system like the rebates we have in the Medicaid system? Why don't we organize our purchasing power in a larger pool so we can get greater discounts for the government taxpayers? All those things will bring down the cost of prescription medicines. The President has talked about it. Democrats and Republicans have talked about it. It is time we act. We have acted in several areas to try to deal with more value-based reimbursements in our healthcare system, recognizing we should treat the person, not the particular disease. Many people have more than one ailment, and they have to go back to the doctor multiple times. Why don't we have a more coordinated, integrated care model? I talked on the floor about 2 weeks ago about the coordinated care model between Sheppard Pratt Hospital in Baltimore and Mosaic, which deals with behavioral health issues and how they deal with it in an integrated, coordinated care model, which saves money. It saves money. There are fewer tests, more timely interventions. How can we use telemedicine? They are using telepsychiatry. How can we use that to bring down the cost of care? When I am asked in my district, asked in my State as to what I can do--where is my plan, and how can we fix the Affordable Care Act--my answer is quite simple: I am proud of the progress we have made under the Affordable Care Act. I invite Democrats and Republicans through our committees to work together to improve it. Yes, we can improve it. We can provide more stability in the individual marketplace. We can bring down the high annual growth we have seen in premiums in the individual marketplace. We can continue to bring down the growth rate of healthcare costs by working together on some of these commonsense approaches in order to deal with healthcare in America. All of this I think we can do, with Democrats and Republicans working together. But the first order of business--and I urge my colleagues--the first order of business is to stop this process of trying to jam a repeal of the Affordable Care Act and a replacement that would cost tens of millions of people in this country their health coverage and would move in the wrong direction on how we should improve healthcare in America. Let's get that off the table. Let's reject this motion to proceed that the majority leader is talking about voting on later this week. Let's do what Senator Alexander, the chairman of the Health, Education, Labor, and Pensions Committee has suggested. Let's have hearings in our committees. Let's work together, and let's bring legislation that stabilizes the Affordable Care Act and deals with the two major problems that the people in this country are talking about; that is, bringing down the growth rate of premium costs and bringing down the overall growth rate of healthcare costs in America. I believe we can do both by working together. There are suggestions I have made, and I am sure other Members have. Let's work on those. Let's work together and get it done. Let's do what is in the best interest of the people in this country. I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, a few weeks ago, I joined Senators Barrasso, Capito, Klobuchar, Boozman, and Baldwin in introducing S. 1514, the Hunting Heritage and Environmental Legacy Preservation-- HELP--for Wildlife Act. This bill represents a more than $100 million annual Federal investment in the protecting the bay. The bill has several provisions, one of which reauthorizes the programs at the heart of restoring and maintaining the health of the Chesapeake Bay watershed. S. 1514 reauthorizes the U.S. Environmental Protection Agency's, EPA, Chesapeake Bay Program through 2022 at $90 million per year, which is more than the program has ever been funded in its history. This unique regional partnership, managed by EPA through the Chesapeake Bay Program office in Annapolis, helps program partners collaborate to achieve the goals of the voluntary, bipartisan Chesapeake Bay agreement. Because this program expired in 2005, reauthorizing the program is critical to secure necessary appropriations and reject the Trump administration's proposal to eliminate the program. S. 1514 also reauthorizes the Chesapeake Bay gateways and watertrails network and the Chesapeake Bay Gateways Grants Assistance Program, which provides $6 million per year throughout the watershed in technical and financial assistance to State, community, and nongovernmental partners to increase access to the Chesapeake Bay and its tributaries. The bill also reauthorizes the National Fish and Wildlife Foundation, NFWF, until 2023. As the Nation's largest conservation grant-maker, NFWF has been instrumental in completing conservation projects in Maryland and around the Chesapeake Bay. In 2016, the State received nearly $5 million in funding for projects protecting and restoring habitat for fish and wildlife. S. 1514 also reauthorizes the North American Wetlands Conservation Act, NAWCA, which provides grants to increase and protect wetlands which not only provide habitat for wildlife, but also reduce the severity of flooding and coastal erosion, and improve water quality. In the 2014 to 2015 grant period alone, Maryland received $1 million from the NAWCA program, which was leveraged with nearly $3 million in additional contributions by outside partners to protect 1,600 acres of wetlands in the State. The bill reauthorizes the Neotropical Migratory Bird Conservation Act for another 5 years and authorizes $6.5 million to be spent each year on conservation projects that protect more than 350 different species of birds which summer in the United States and winter in the tropical regions. Twenty-one different State birds are neotropical migrants, including Maryland's famous and beloved Baltimore Oriole. S. 1514 codifies the National Fish Habitat Partnership, a collaboration between public agencies, private citizens, and nonprofits for promoting fish conservation. America is home to more than 3,000 species of fish, and 22 percent of the stream miles in this country are at high or very high risk of current habitat degradation. Over the past few years, $175,000 in funds from this program were used in Maryland to rehabilitate three different streams, funding which was 27 matched by $843,000 from private investors. The partnership estimates that the improved habitat in the three streams for brook trout provided a total socio/economic impact of $9.2 million. I am proud that S. 1514 contains so many provisions to help the Chesapeake Bay and the State of Maryland. I would like to speak for a minute about the importance of reauthorizing these programs and the ``power of the purse.'' As my colleagues in the Senate well know, the ``power of the purse'' is the two-step process of authorizing and appropriating. Authorizing legislation can establish, continue, or change programs and activities, and it signals to the appropriators that they should fund these programs. The budget process is not complete until the appropriations process provides the actual funding for the activities and programs established through the authorization process. Office of Management and Budget Director Mick Mulvaney has said that President Donald Trump is sending a deliberate message to Congress about spending money on unauthorized programs. With the President putting an emphasis on boosting defense spending without adding to the deficit, administration officials are looking closely at expired authorizations. By reauthorizing these programs, we are sending our own clear message back: these programs matter to our constituents and to us. Mr. Mulvaney said lawmakers too often ignore the ``regular order'' process of approving a budget, authorizing specific programs, and then appropriating the money for those programs. ``We actually spend a lot of money in the federal government on programs that aren't authorized at all,'' he said. ``Either they used to be authorized and they lapsed, or they were never authorized in the first place. They simply were appropriated without any authorization. It's the wrong way to do it.'' Because of President Trump and Director Mulvaney's position, it is more important than ever that the essential programs contained in S. 1514 be reauthorized. None of these reauthorizations are more important to Maryland than EPA's Chesapeake Bay Program. In 1987, Congress ratified the Chesapeake Bay Program, a voluntary partnership among the watershed States and the EPA, under the Clean Water Act. The 1987 legislation supported cleanup efforts with a program of grants and scientific research. In 2000, Congress directed the EPA to ``ensure that management plans are developed and implementation is begun'' to meet the goals of the Chesapeake Bay Agreement. In June 2014, the Governors of the six States in the watershed signed a new voluntary Chesapeake Bay watershed agreement to work in partnership with the Federal Government through the Chesapeake Bay Program. The watershed agreement has ten goals to improve water quality in local rivers and streams and the Chesapeake Bay by 2025. The program office is housed within the EPA, which provides staff and funding. Primary funding for the program comes from State governments. Federal funding was first authorized at $40 million annually from fiscal year 2001 to fiscal year 2005 to fund environmental studies and grants that support restoration activities in the Chesapeake Bay. Congress has appropriated funds for the Program since the authorization for appropriations expired in fiscal year 2005. In fiscal year 2017, for instance, Congress appropriated $73 million for the program. The President's fiscal year 2018 budget eliminates funding for the program and cuts other programs that also benefit the bay across several Federal agency partners' budgets. A healthy bay means a healthy economy, and this recovery cannot be accomplished without a strong Federal commitment. At a time when we have seen nutrient levels dropping and water quality improving, I am deeply disappointed President Trump is intent on turning the clock back to a time when a swath of the Chesapeake Bay in mid-summer was a hypoxic low-oxygen zone or ``dead zone''. The most recent State of the Bay report, issued biannually by the Chesapeake Bay Foundation, evaluates the progressing and overall health of the Bay for 2014 to 2016. The Chesapeake Bay's health was given a grade of C-minus, a slight improvement from the previous State of the Bay report in 2014. This progress is due largely to the continued implementation of the Chesapeake Clean Water Blueprint. This improvement, though modest, was hard-won. It is the result of countless hours of grueling work by State and Federal public servants and nonprofit workers, as well as citizens' actions across the watershed. A grade of C-minus is hardly an acceptable endpoint. To reach an A, which would represent a saved and comprehensively healthy Bay, we will need redouble and accelerate our efforts. I am determined to pass on a vibrant and healthy Chesapeake Bay to the next generation, for the sake of public health and the local economies that depend on a clean and bountiful bay. This is all the more reason that we need to reauthorize the Chesapeake Bay Program and make sure that it is fully funded in this year's appropriations bill. Many Marylanders and national wildlife organizations are happy about the HELP for Wildlife Act. The Choose Clean Water Coalition and Blue Water Baltimore have issued statements of support. The Chesapeake Bay Foundation will testify in support of this bill next week in a legislative hearing the Environment and Public Works Committee is holding. The National Wildlife Federation's Collin O'Mara said the bill ``represents a great bipartisan effort to conserve America's outdoor heritage for hunters, anglers, campers, hikers, and wildlife enthusiasts, while helping to restore America's wildlife populations.'' The Theodore Roosevelt Conservation Partnership said the bill is ``the strongest legislative package of sportsmen's priorities in years.'' As S. 1514 moves out of the Environment and Public Works Committee and to the Senate floor in the coming weeks, I urge my colleagues to support this bill that is critical not only to the Chesapeake Bay and the State of Maryland, but to conservation efforts in every State across the Nation.

Mr. CARDIN

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

Mr. CARDIN. Mr. President, I take this time to share with my colleagues the experiences I had in the State of Maryland during our most recent work period and shortly before that, when I took the opportunity to meet with different groups with regard to the healthcare debate. I had a townhall meeting this past week at Atrium Village, which is a senior living place in Baltimore County. We had a robust discussion primarily with seniors, but not just seniors, about their concerns as to whether the changes in the healthcare law would affect their ability in the Medicare system as well as relating to long-term care and Medicaid. A little bit earlier than that, I had a townhall meeting at one of our local hospitals where we had a chance to talk with lots of people. It was an open townhall meeting, and a lot of people from the community showed up. They expressed their concerns about what would happen under the changes being suggested in healthcare on coverage and quality of coverage, and we had a very robust discussion. I also had a chance to meet with leaders of the faith community as we talked about our responsibility to make sure healthcare is a right and not a privilege in the United States. I met with the leaders of the community health centers in Park West, in Baltimore City, to talk about the impact on the viability of health centers if the Medicaid Programs were cut. I had a chance to visit with Mosaic Behavioral Health Center, which deals with behavioral health in Baltimore, and their concern is, if we eliminate the essential health benefits of mental health and addiction, what impact that would have on access to care. There was a consistent message from each of the places I met with, with regard to whether we would be able to maintain coverage--under the Affordable Care Act, we expanded coverage by tens of millions--and whether that coverage would be compromised under the legislation being considered in the Senate. We also had a chance to talk about whether there would be a weakness in what benefits would be covered. I already mentioned mental health and addiction. There were also concerns expressed about reductions of benefits regarding obstetrics and how it would affect women, and pediatric dental care, which is a particular concern in Maryland after the tragic death of Deamonte Driver. They also raised many issues concerning discrimination in healthcare that was present before the Affordable Care Act and whether these conditions would be returning. A young father told me a story about how his daughter was born prematurely and, as a result, the baby was in the neonatal intensive care unit for 4 months. When his daughter was 4 months old, she had reached her lifetime limit of what the insurer would pay for healthcare if we returned to lifetime limits. Whether we would be returning to the predatory-type practices of the insurance companies that were present before the Affordable Care Act and whether we would be returning to preexisting conditions or doing that indirectly through what benefits would be covered--that was expressed at several of my healthcare meetings. I already mentioned the concerns that the elderly expressed, including the discrimination of the near elderly, if we go to a 5-to-1 ratio on health premiums, so that those who are 60 or 62 years of age paying five times higher premiums than younger people are paying. All of that was brought out during my townhall meetings. The one message I just wanted to leave with my colleagues is that there was a strong interest that we work together--Democrats and Republicans--because we all acknowledge that the Affordable Care Act can be made better. We don't want to repeal it. We want to improve it. Before we left for the July 4th break, I introduced legislation that deals with some of these issues. The legislation would improve competition by putting the so-called public option in the exchanges so that we know there would be at least one governmental option without subsidies, without any additional breaks over private insurance companies, to guarantee more competition in the marketplace. I also included in my legislation a solution to deal with the two major problems that we have under the Affordable Care Act. For some people, the insurance premiums are too high. Why? Well, I asked CareFirst, which is the major health insurer in Maryland, about the uncertainty as to whether President Trump is going to fund the cost- sharing issues. My legislation makes it clear that those funds will be made available, as was anticipated under the Affordable Care Act. I also provide predictable subsidies for lower income families, up to 400 percent of poverty, so that we can help bring down the cost of premiums in that marketplace, and we reimpose the reinsurance program so that we can spread the risk so the insurance companies know that they have a more predictable risk when they set their premiums. All of this would make a big difference. CareFirst said that, in the individual marketplace in Maryland, if you do that and endorse the individual mandate, we could reduce our premium increases by 50 percent. So I am trying to work, I hope with Democrats and Republicans, to deal with the problems that have been brought to our attention on higher premiums and then to deal with healthcare costs generally. More and more people talk to me about bringing down the costs of prescription drugs. It is outrageous that Americans pay twice what our friends in Canada pay for the same medicines that are manufactured here in the United States. So why don't we have a more competitive marketplace? Why don't we have the rebates that we have in the Medicaid and the Medicare systems, and why don't we allow for more collective bargaining for prices in the pharmaceutical industry? My legislation would do that, and I know there is bipartisan support for that. Lastly, we deal with more integrated care. I mentioned Mosaic, a behavioral health facility in Baltimore City. They have an integrated care model. If you come into their community health center, they will treat whatever your problems are. They are not going to say: Well, come in one day and we will deal with diabetes, and the next day we will deal with high blood pressure. Let's deal with the whole patient in a coordinated and integrated care model, and that would help save on costs. My bottom line is this. No, I am not going to support weakening the Affordable Care Act. I am not going to support legislation that would diminish those who currently have coverage or the quality of their coverage. Let's work together--Democrats and Republicans--to deal with the real problems of bringing down costs in our healthcare system-- everybody benefits from that--and to make sure there is more competition in our exchanges and to make sure there is better premium support for those who cannot afford their premiums. If we do that, then, I really think we would be carrying out what the people of Maryland were asking me to do during the recess; that is, not to go back on the progress we have made under the Affordable Care Act. Let's build on that. Let's make healthcare more affordable, and let's deal with more competition on the premium costs. With that, I yield the floor.