Benjamin Cardin

Mr. CARDIN

Mr. CARDIN. Mr. President, the point I was starting with is that in Maryland, yes, there are 400,000 people who now have coverage who didn't have coverage before, and they are benefiting by being able to get preventive health care and get affordable care, but it is all Marylanders who are benefiting because there is less use of emergency rooms and fewer people who use our health care system who don't pay for it, the uncompensated care. Many of my colleagues have read letters that they have received from constituents, or phone calls, and I am going to do that during the course of my discussion. I am going to tell you a story that I heard from a 52-year-old who lives in Harford County who frequently used the emergency department prior to the adoption of the Affordable Care Act. This is what this Harford County resident told me: After the passage of the Affordable Care Act, I began working with Healthy Harford Watch Program and shortly after was insured. I have been successfully linked to community health services and no longer depend upon the emergency room as my only source of health care. I can give many more accounts of people who had to use the emergency rooms and are now getting preventive health care and are getting their health care needs met. We also now have been able to eliminate the abusive practices of insurance companies. As I said, over 2 million people have private health insurance in Maryland. They are all benefiting from the Affordable Care Act. If Mr. Price has his way and we repeal the Affordable Care Act, every Marylander will be at risk. They will be at risk because of the protections that we put in the Affordable Care Act against abusive practices of insurance companies. To me, probably the most difficult thing to understand by my constituents was the cruel preexisting condition restrictions that were placed in the law prior to the Affordable Care Act. Simply put, if you had a preexisting condition, the insurance company would restrict coverage for that preexisting condition. So exactly what you needed the health care system to pay for, your insurance company didn't pay for it. They said: Look, you had this heart condition before you were insured; we are not going to pay for your heart needs. You had cancer; we are not going to pay for your cancer treatment in the future. You have diabetes, and that leads to a lot of different health care needs. We are going to restrict your insurance coverage and not pay for diabetes care. That is a thing of the past with the Affordable Care Act. Once again, we are now talking about repealing the Affordable Care Act. We don't know what it will be replaced with, if at all. Mr. Price, in the House, has not given us a satisfactory explanation during the confirmation process of how we are going to be able to guarantee that everyone who has insurance and everyone who has a need for coverage with preexisting conditions will be able to get insurance that won't discriminate against that person because of preexisting conditions. Another aspect that was an abusive practice before the Affordable Care Act is that our insurance policies had caps on how many claims you could make in a year over the lifetime of your policy, and that would kick in exactly when people who have chronic needs need insurance the most. Let me give an example. Juanita, who lives in Hyattsville, MD, told me about her son. She said her son seemingly was in perfect health, had graduated from Harvard with a master's degree and was working at a nonprofit. Then he was diagnosed with a rare cardiovascular disorder. He didn't know he was going to have that. Well, that required him to have multiple operations, and it would have fully exceeded his lifetime cap in hospital stays, and he would not have been able to afford the care. Thanks to the Affordable Care Act, Juanita's son has full coverage. That is another example of a person who is at risk if Mr. Price is able to carry out what he said--repeal the Affordable Care Act--and we don't have a way to guarantee that insurance companies must take all comers and must eliminate the caps that we have seen in the policies before. Another area which I think has been a pretty popular part of the Affordable Care Act and which I heard many of my colleagues on both sides of the aisle say they want to keep is allowing 26-year-olds to stay on their parents' policies--under 26 years of age. That is a very popular provision. I heard many of my colleagues speak in favor of it. Remember, when you repeal the Affordable Care Act, that will be repealed. Unless we have adequate replacements, unless we have an improvement, that is at risk as well. I want to talk about another provision that was in the Affordable Care Act. I authored the provision. It is called a prudent layperson standard for emergency care. Let me take you back before the Affordable Care Act. This is why it is important for Congress to be careful as to how we pass laws. And if we repeal laws, we can go back to these types of practices. Before the Affordable Care Act, if you had chest pains and shortness of breath, you would do what I would think any reasonable person would do: You would be taken to the emergency room as soon as possible to see whether you are having a heart attack. Those are classic signs of a heart attack. Yet there were insurance policies that said that if you went to a hospital that was out of network, they weren't going to pay the full amount even though you went to the closest hospital because you had an emergency situation. That makes no sense at all, but that was the case. You went to the hospital. You did the right thing, and you found out you didn't have a heart attack. You went home. You were happy until you got the bill, and your insurance company said you didn't need to go to the emergency room because you didn't have a heart attack. Then you do have a heart attack because you can't pay the bill. That was the circumstance that existed before the Affordable Care Act, and we put into the Affordable Care Act, for all insurance companies, the prudent layperson standard. If it was prudent for you to go to the nearest emergency room, your insurance plan must cover that cost. That is the standard today, and I wonder whether, if we repeal the Affordable Care Act, we will be going back to those types of abusive practices. Before the Affordable Care Act, women in some circumstances were in and of themselves a preexisting condition. Are we going to go back to those days? Let me go on to another point that worries me about Mr. Price's position if we were to repeal the Affordable Care Act, and that is affordability. It is one thing to say people can buy insurance--you know, there is insurance out there; just buy it. It's another thing whether you can afford the insurance coverage. One of the benefits of the Affordable Care Act that I don't think has been fully explained to the American people is that since the passage of the Affordable Care Act, we have been able to keep the growth rate of health care costs below what we had seen before the passage of the Affordable Care Act. We have reduced costs for all individuals and companies that have health policies. The rate of growth has been at a slower rate because of the Affordable Care Act. And I have already alluded to one of the reasons--we reduced uncompensated care because more people are paying their bills. We kept the growth rate down. But there are other aspects to the Affordable Care Act that have helped bring down the costs, and that is, we have premium tax credits. In 2015, 70 percent of those who were enrolled in the Maryland Health Connection--that is our exchange in the State of Maryland--received some form of a credit. That was provided in the Affordable Care Act. We recognize that not everyone can afford the premiums, so we provided credits. If you repeal the Affordable Care Act, we may very well not have affordable policies for those individuals who have been able to get credits under the Affordable Care Act. I want to talk about a situation that was brought to my attention at several of the roundtable discussions I have held in Maryland with interest groups on health care, and that has to do with small businesses. Before the Affordable Care Act was passed, if I had a forum on small businesses--and I did. I have been a member of small businesses and entrepreneurship committees since I first came to the Senate. I believe in the importance of small businesses. That is where job growth and innovation takes place. It is critically important that we help small businesses. Before the passage of the Affordable Care Act, the No. 1 issue that would come up at roundtable discussions I had with small business leaders of Maryland was the affordability of health coverage for their employees. It is no longer an issue that they talk about because the Affordable Care Act has allowed small companies to have competitive premium costs with larger companies. Before the passage of the Affordable Care Act, if you were a small business owner and you had maybe 10 people in your employ on your health policy and one of those individuals unfortunately had a major health episode during that year, you knew that the next year you were going to get a major premium increase because you were rated on your own experiences as a small group. That is a thing of the past under the Affordable Care Act. Now, under the Affordable Care Act, you are in this big pool, and you are not discriminated against because you happen to have someone in your employ who needs health care. It also enables small business owners to hire people who have particular health needs. They are not going to be discriminated against because they hire somebody who happens to have the need for health insurance. Before that, small companies were very reluctant to hire individuals who had health needs because they knew it would affect their health policy. I want to mention one other factor that is pretty telling. Let me read from a letter I received from Nancy of Silver Spring. This is something that really gets to me, something I think we have to be very careful about, because the repeal of the Affordable Care Act is going to hurt our economy. Nancy of Silver Spring is a 60-year-old freelance writer/editor and depends upon the Maryland Health Connection exchange for her health insurance and the tax credit that helps reduce her premium. She is a healthy 60-year-old, but no insurance company will write her an individual policy, she knows--she tried. One of the big factors that helped Nancy get the courage to leave her salaried, full-benefits job and go out on her own was the fact that the ACA was right on the horizon when she made the leap in 2012. Nancy writes: You want a world-class work force? How about giving everyone access to affordable health care so we can keep ourselves functioning? You want job creation? How about keeping the ACA so freelancers, gig workers, and startup entrepreneurs don't have to split their energy between the jobs they are creating and some soul-sucking ``day job'' just for the sake of keeping our health insurance? This is a real problem. You repeal the Affordable Care Act, people become what is known as job-locked. They don't like where they work, they know they can do better, but they can't afford to leave and lose their health coverage. It may be their spouse, it may be their child, may be their self, but they are job-locked because they don't have the protection of knowing they can get affordable coverage if they give up the insurance they currently have. That hurts our economy. That hurts the entrepreneur spirit. That hurts innovation. And it is something that is critically important that we solved in the Affordable Care Act. Mr. Price talks about the repeal and we will have something to replace it with. That is not an easy one to fix. That is not one that you can just say we will take care of because you have to have pools for individuals in small companies that are competitive. If we don't have the type of comprehensive coverage we have under the Affordable Care Act, it is very difficult to understand how that can, in fact, be done. So that gives me great heartburn with someone who espouses the repeal of the Affordable Care Act. We have many stories, many letters here from people who literally would have had to go through bankruptcy. In Laurel, MD, Mark tells me about his son Timmy, who developed a rare genetics syndrome called Opitz G/BBB. Timmy's medical expenses would have reached his family's lifetime maximum of $1 million when he turned 3 months old. When Timmy finally made it home, the ACA covered and continues to cover his cost of medical equipment. The law covers all of Timmy's specialist appointments, surgeries, and hospital stays. Recently, Timmy was sick and coughing up blood. Mark and his wife took him to the emergency room without fear that he would incur debt he would never be able to pay. Without the Affordable Care Act, Mark's family would likely be in bankruptcy. Go back before the Affordable Care Act. Look under bankruptcies. Look up what the major reason was for bankruptcy. It was people's inability to pay their medical bills in the United States of America. That is something we don't want to go back to. I started my comments by talking about pediatric dental. The Affordable Care Act provides essential health benefits so that every person who is insured, every person who is in our system, is guaranteed certain benefits. That affects nearly 3 million Marylanders who are protected by the essential health benefits in the current law. They include such things as maternal benefits and newborn health care, mental health and addiction. Mr. President, you have been the leader of this body on dealing with mental health services and addiction services, and I applaud you for your efforts, but quite frankly, if we lose the essential health benefits, private insurance companies aren't going to cover these costs. We have an epidemic nationwide on drug addiction. We have seen opioid misuse lead to heroin, lead to fentanyl. The death rate in Maryland is up about 20 percent every year. We have doubled and quadrupled the number of ODs the last 5 or 6 years, and the numbers are still going up. We need coverage so that we can, first and foremost, stop people from using it in the beginning--an education program, a prevention program; we have to do more of that. We also have to keep people alive and get them into treatment and save their lives, and the Affordable Care Act helps us get that done. You repeal these essential health benefits, I really worry as to whether--mental health and drug addiction have never been a priority for private insurance companies or, for that matter, the Medicaid system. So we have to make sure that we maintain that type of coverage, and the repeal of the Affordable Care Act puts all of that at risk. One of the areas I worked on very carefully when I was in the House, and now in the Senate, was preventive health care services. Immunization, cancer screenings, contraception--those types of services are critically important. We had a meeting at lunch today. I found out that unwanted pregnancies are at a historically low level. Are we going to go back to the day where women cannot afford contraceptive services? That makes no sense at all. It is counterproductive to what we all agree we need to do. I want to talk about one or two other issues which I think are important which are also in jeopardy with the repeal the Affordable Care Act or policies that have been espoused by Mr. Price. One is the Medicaid expansion. The Medicaid expansion covers our most vulnerable. These are people who don't really have a strong voice in our political system. They are people who really depend upon us, every one of us in the Senate, to protect their health care needs. These are people who are desperate, who can't afford health care other than through our medical assistance program, the Medicaid Program. Yet there has been talk about block- granting that program to the States. Have you looked at State budgets recently? Do you really believe our States have the financial capacity to deal with the Medicaid population without a partnership with the Federal government? Maryland has been a pretty strong State with Medicaid expansion. My Governor is doing the right thing. I am proud of what Maryland has done, but if you withdraw the Federal partnership, the Governor doesn't have that type of flexibility in the budget to make up the difference. It is going to hurt. It is going to hurt our health care system, hurt our most vulnerable. It has been estimated that a block grant--that by 2019, Maryland will lose close to $2 billion. We can't make that up. Would we still cover substance abuse under Medicaid? We didn't before. If we don't cover that, are we going to now be denying those centers that are located for substance abuse? All this is put at great risk. We know that Mr. Price, in his fiscal year 2017 budget proposal, looked at this proposal, and I believe it was at $1 trillion at that time. There is a provision in the Affordable Care Act that I authored that sets up Offices of Minority Health and Health Disparities within all our health departments and sets up the National Institute for Minority Health and Health Disparities. We elevated it in the Affordable Care Act. I would certainly hope that we would not be repealing that, although it is in the Affordable Care Act. But I can tell you that the mission of Minority Health and Health Disparities will be severely restricted if we repeal the Affordable Care Act or we block-grant the Medicaid Program because it is the minority population who had been discriminated against historically in our health care system who are most at risk. I can give you one example of that: our qualified health centers. We significantly increase the resources in the qualified health centers as part of the Affordable Care Act. I have been to our qualified health centers in Maryland, and I have seen that they now have dental services that they didn't have before the Affordable Care Act. They now have mental health facilities. It is one thing to have third-party coverage but another thing to have access to a facility. We know that in rural areas, it is very challenging. In poor neighborhoods, it is also challenging. Qualified health centers help fill that void. I was talking to our qualified health centers in Maryland. I said: What happens now if we repeal the Affordable Care Act? They literally told me that they can't stay in business because they would lose so much of their reimbursement because it is now being reimbursed under the Medicaid system because these people enrolled; that it would jeopardize their ability to provide the types of services they are providing today. So you are not only denying people third-party reimbursement, you are denying them access to care by the repeal of the Affordable Care Act. Lastly, let me talk about our Medicare population. Medicare was part of the Affordable Care Act. We don't hear too much talk about that today. We extended the solvency of Medicare as a result of the Affordable Care Act. We brought down the cost of Part B premiums as a result of the Affordable Care Act. And we are closing the doughnut hole coverage gap for prescription medicines within the Medicare system. Before the Affordable Care Act, how many times would we go to a senior center and someone would tell us they didn't pick up their prescriptions from the counter because they didn't have the money to pay for the cost because they were in the doughnut hole? Well, that is coming to an end. It has already closed enough so people are not in that vulnerable situation. But it is now coming to an end as a result of the passage of the Affordable Care Act. So I take this time today because of Mr. Price's nomination. I care deeply about the principle Senator Van Hollen talked about and others have talked about; that is, health care in America should be a right not a privilege. The Affordable Care Act has helped us in achieving that. Somehow I believe that if we ask the American people, some would say: Well, we don't like this ObamaCare, but we like this Affordable Care Act. Let us be honest with the American people. Let us recognize that this bill has changed the landscape of health care in America for the better: reduced costs, extended coverage, more quality coverage, insurance companies now have to spend at least 80 percent of their premiums on benefits. So much of that has been done as a result of the Affordable Care Act. Can we do it better? Absolutely. Let's work together, Democrats and Republicans, to improve the health care system in this country without scaring Americans that they are going to lose the benefits they already have. For those reasons, I believe Mr. Price does not represent what we need, and I will, unfortunately, be voting against his confirmation. With that, I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, I rise in opposition to the nomination of Senator Jeff Sessions to be the next Attorney General of the United States and to head the U.S. Department of Justice. I have had the privilege to serve with Senator Sessions in the U.S. Senate for nearly a decade. I have served on several committees with him, including the years that I was on the Judiciary Committee. I no longer serve on that committee, but I served there with Senator Sessions. I was listening to Senator Klobuchar's explanations of her concerns. Senator Sessions is a person whom we work with, but it is his views and his record that give me great concern. Just looking back at the first 2 weeks of the Trump administration, I think a growing number of Americans understand the importance of the Constitution, the rule of law, the system of checks and balances, the separation of powers, and the critical importance of the position of the Attorney General of the United States. Over the years, the Justice Department has grown into one of the largest Cabinet departments, with over 100,000 employees, which touches just about every aspect of life in America today. It is known as the world's largest law office and the chief enforcer of Federal laws. Just think about the work every day to keep America safe undertaken by the Federal Bureau of Investigation, the Drug Enforcement Administration, the Bureau of Alcohol, Tobacco, Firearms and Explosives, the Bureau of Prisons, the U.S. Marshals Service, and the U.S. Attorneys in every State and territory. Think about the work of the National Security Division that tackles some of the toughest terrorism and intelligence challenges we face every day. All of that comes under the Department of Justice. All of that comes under the Attorney General. Think about the work of the Civil Rights Division to protect all Americans, regardless of their background, to ensure that every American--every American--enjoys full constitutional rights and privileges. Think about the work of the Environmental and Natural Resources Division, the Antitrust Division, and the Tax Division, and so many other offices within the Department of Justice. It is the direction of all of those agencies that come under the Attorney General of the United States. These hard-working employees of the Justice Department keep America safe every day while protecting American lives, and some of them put their lives on the line to do so. We need an Attorney General that will strengthen, not weaken, the Justice Department and will help carry out its important missions. The Justice Department is charged with ``[enforcing] the law and [defending] the interests of the United States according to the law,'' ``[ensuring the] public safety against threats foreign and domestic,'' as well as ``[ensuring] fair and impartial administration of justice for all Americans.'' That is their mission. That is their responsibility. The Attorney General is not the President's lawyer; he or she is the people's lawyer. After carefully examining Senator Sessions' record-- including his Senate service, confirmation hearing, and advocacy on the campaign trail for Mr. Trump--I am not convinced that he would be independent and impartial to the President and Federal agencies. I am not convinced he would enforce the law fairly and protect the civil liberties and civil rights of all Americans. Let me discuss some of my concerns with Senator Sessions' nomination. In this debate, I do want to mention my resolution calling on President Trump to divest his interest and sever his relationship to the Trump organization. My resolution was first introduced last year. It is intended to uphold the value and strictures of one of the most sacred documents: the Constitution, the instrument that the President took an oath to preserve, protect, and defend. It makes clear that Congress will consider all transactions by foreign governments and their agents with the Trump organization as potential violations of the emoluments clause of the Constitution. The Attorney General is likewise sworn to uphold the U.S. Constitution and provide legal advice to President Trump and the various Cabinet departments. He must exercise independent judgment. I am concerned as to whether Senator Sessions would, in fact, advise the President, as he should, that by holding on to Trump enterprises--by not divesting or setting up a blind trust--he is putting himself at risk of violating the Constitution of the United States. It is not what the President wants to hear; it is what he must hear. We need an independent Attorney General in order to make that recommendation to the President of the United States. Senator Sessions has strongly supported restrictive voter ID laws that have had the effect of disenfranchising many otherwise eligible voters and are frankly modern-day poll taxes. He has called the Voting Rights Act intrusive as it seeks to protect minority voters. He praised the Supreme Court's ruling in Shelby County v. Holder, which gutted a key part of the Voting Rights Act, saying that it was ``a good day for the South'' when the decision was handed down. Our next Attorney General should be working on how to expand the franchise, not restrict it. Now President Trump has said he will direct Vice President Pence to lead a task force or commission to examine so- called voter fraud in the 2016 Presidential election. We need an independent Attorney General. Why is President Trump taking this action? Because Hillary Clinton won the popular vote by nearly 3 million votes, and that gets under his skin. He feels slighted. He feels his legitimacy is brought into question. It doesn't matter that he won the electoral vote. So the President will direct the Vice President, and presumably his next Attorney General, to investigate these bogus claims of voter fraud. Instead, the new Attorney General should examine voter suppression and disenfranchisement in the elections. I fear this new study on widespread ``voter fraud'' is simply a pretext to impose more onerous restrictions on the right to vote--to try to keep a certain segment of Americans--making it more difficult for them to vote because they may be more likely to vote for someone other than Mr. Trump. That is not what the Attorney General should be doing. Based on his record, Senator Sessions would work with the Trump administration to further restrict the right to vote and roll back the clock on this cherished civil right, which is protected by our Constitution. On the issue of immigration, Senator Sessions has a long record where he has fought against bipartisan, comprehensive immigration reform in the Senate. He led the efforts in 2007 and in 2013 to defeat bipartisan legislation in the Senate. He used the untruthful ``amnesty'' tag to describe the tough-but-fair pathway to citizenship in this legislation, which passed by a 68-to-32 vote in 2013. He has opposed relief for the DREAMers and has opposed the Delayed Action for Childhood Arrivals-- DACA--program. He supported anti-immigration State laws in Arizona and elsewhere that the Supreme Court has struck down as unconstitutional. During the Presidential campaign, Mr. Trump issued a press release ``calling for a total and complete shutdown of Muslims entering the United States.'' Several days later, Senator Leahy offered a resolution in the Judiciary Committee that stated, ``It is the sense of the Senate that the United States must not bar individuals from entering the United States based on their religion, as such action would be contrary to the fundamental principles of which this nation was founded.'' The vote was 16 to 4 in favor of the Leahy resolution. Senator Sessions voted no and spoke against the resolution for nearly half an hour and concluded by stating that the Leahy resolution ``goes beyond being unwise. It is reckless. It is absolute and without qualification. It could have pernicious impacts for decades, even centuries to come. It may be even a step from the concept of the nation-state to the idea of `global citizenship.' '' Barring a religious test of people coming into our Nation would create that type of a Nation? That is who we are as a Nation. Those are our core values. We embrace diversity. Senator Sessions' views are far outside the mainstream and would unsettle many years of law and precedent that protect individual religious beliefs. I am gravely concerned about how an Attorney General Sessions would advise President Trump on the lawfulness of a Muslim ban. He recently issued his Executive order, which a district court has put on hold and is now being challenged in the Ninth Circuit. I cosponsored legislation to rescind President Trump's discriminatory Executive order barring immigrants from Muslim-majority countries and suspending the U.S. refugee program. I am also concerned as to how Attorney General Sessions would advise the President on matters of immigration. Former Acting Attorney General Sally Yates was fired and her conduct was called shameful by President Trump, simply because she was upholding the Constitution, giving her advice. The President has criticized the ``so-called judge'' who temporarily stayed his travel ban with an ``outrageous'' decision, and said that the judge would be blamed if a terrorist attack occurred in the United States. The Attorney General has to be able to stand up to even the President with these reckless words and actions. We need an independent Attorney General who will uphold the Constitution and recognize that he is not the President's attorney, he is the people's attorney. I am not convinced that Attorney General Sessions would be that type of person. Senator Sessions led the opposition to the nomination of my fellow Marylander Tom Perez to be the Assistant Attorney General for the Civil Rights Division at the Department of Justice when President Obama nominated him in 2009. At the time, Senator Sessions said: I am also concerned Mr. Perez will not be committed to fully enforcing our Nation's immigration laws, some I have worked hard on. We need to create a lawful system of immigration. . . . He previously served as the President of the Board of CASA of Maryland, an immigrant advocacy organization that has taken some extreme views and been criticized by a number of people in the media. CASA of Maryland issued a pamphlet instructing immigrants confronted by the police to remain silent. CASA also promotes day labor sites. This is where people, often without lawful status, come and seek work . . . and [they] oppose restrictions on illegal immigrants receiving drivers' licenses. He was President of the Board. That was Senator Sessions' quote. Senator Sessions also commented on Mr. Perez directly: I am concerned where Mr. Perez will be in this [running the Department of Justice Civil Rights Division]. He has been pretty active politically. When he ran for the Montgomery, MD, county council he responded to a question asking, `What would you like the voters to know about you?' Mr. Perez said: `I am a progressive Democrat and always was and always will be.' This is a free country and that is all right. I am just saying, in all fairness, that statement makes me a little nervous. Again, quoting from Senator Sessions. The Senate did right by my friend and colleague Tom Perez. He was confirmed by the Senate to the Civil Rights Division of the Department of Justice by a 72-to-22 vote. Now, I understand people may have a reason to vote one way or the other, but the reasons stated by Senator Sessions in regard to Mr. Perez caused me great, great concern. Senator Sessions again opposed Mr. Perez when he was later nominated to be Secretary of Labor. In both of these cases, Senator Sessions' views were far outside the mainstream on Mr. Perez. As the senior Senator from Maryland, I know CASA of Maryland. I have been there. I have seen the people they service. They do extraordinary work to help the immigrant community. They are not a fringe advocacy group. While Mr. Perez is a progressive, he is a dedicated public servant, having been elected by the people of Maryland to the Montgomery County Council and appointed by President Obama to run the Civil Rights Division at the Justice Department and later the Labor Department. Mr. Perez worked to expand the right to vote, protect the rights of all Americans, and ensure American workers had a decent wage and employers treated their employees with fairness and respect. I fear Attorney General Sessions would turn back the clock on so many civil and worker rights that we hold dear as Americans. Senator Sessions opposed the Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act. Senator Sessions supported a constitutional amendment to ban same-sex marriages, opposed the repeal of don't ask, don't tell in the military, and harshly criticized the Supreme Court's recent decision legalizing same-sex marriages across the country. He harshly criticized the Court for redefining a ``sacred and ancient institution,'' and called the ruling ``part of a continuing effort to secularize, by force and intimidation'' the Nation. Once again, I fear an Attorney General Sessions would turn back the clock on LGBT rights to a time when individuals would no longer have the legal right to marry the person they love. Senator Sessions voted against the Lilly Ledbetter Fair Pay Act, the Paycheck Fairness Act, title X funding for contraception, breast screening, and health services for low-income women, and reauthorization of the Violence Against Women Act. He voted to defund Planned Parenthood. I am concerned whether Senator Sessions would enforce equal rights and protection for women as our next Attorney General. Senator Sessions has consistently fought against criminal justice reform in the Senate and led the effort to defeat the recent bipartisan proposals that would modestly reduce sentencing disparities and ease ex-offenders' reentry into society. Senator Sessions opposed my Ramos and Liu blue alert act due to fiscal concerns, even though the legislation cost was scored at nominal or less than $1 million for implementation by CBO. Law enforcement agencies strongly supported my legislation, which was signed into law by President Obama in 2015. Blue Alert helps our law enforcement officers, those who are threatened or endangered or where there has been an incident. It gives law enforcement the opportunity to apprehend the suspect in a timely way. It scored nominal or less than $1 million, and was used by Senator Sessions to block this important tool to help our law enforcement officers. Senator Sessions has generally condemned the Department of Justice's use of its power to investigate law enforcement agencies accused of misconduct and a ``pattern and practice'' of violating civil rights, calling consent decrees that mandate reform following these investigations ``an end run around the democratic process.'' That causes me concern because that is an important part of what we are doing in my hometown of Baltimore. We had a major problem in the Freddie Gray episode. We requested a pattern and practice investigation. We are now working with the consent decree. The people of Baltimore and the people of Maryland are anxious to get this matter moving forward and are anxious to see this consent order bring a successful conclusion to that recommendation and investigation. Senator Sessions led the opposition to Senator Mikulski and my recommendation of Paula Xinis to be a U.S. district judge for the District of Maryland in the Judiciary Committee and on the floor. The Alliance for Justice provided an account of Paula Xinis' confirmation hearing, which I will quote from at length here. ``Turning to the nominee of the District Court of Maryland, Paula Xinis, Senator Sessions unleashed a line of accusatory questions suggesting that Xinis' career as a public defender and civil rights lawyer showed an `agenda' that she would invariably `bring to the bench.' The questions were absurd and unfounded, but they could not be dismissed as such. Instead, Mrs. Xinis had to patiently explain that protecting the rights of America's most vulnerable and disenfranchised had not left her tainted with disqualifying bias.'' ``Senator Sessions felt compelled to verify that someone with Mrs. Xinis' professional background--which also includes time as a complaint examiner in the DC Office of Police Complaints--would not be biased against police officers. After asking her whether `police have a responsibility to try to maintain an orderly and safe environment for the people who live in a city' and whether a judge `should show empathy for the difficulties that police officers face as well as' for those who allege that police have violated their civil rights. Senator Sessions closed with this:'' ``Can you assure the police officers in Baltimore and all over Maryland that might be brought before your court that they'll get a fair day in court, and that your history would not impact your decision-making? And I raise that particularly because I see your firm [Billy Murphy] is representing Mr. Freddie Gray in that case that's gathered so much attention in Maryland, and there's a lot of law enforcement officers throughout the state and they want to know that they don't have someone who has an agenda to bring to the bench--can you assure them that you won't bring that to the bench?'' ``The implication is clear: If you defend people against criminal prosecutions, and especially if you represent people in civil rights cases against police, there is a presumption of bias that you must rebut before the Judiciary Committee. One wonders whether Senator Sessions has asked a prosecutor if she would bring to her judicial role an `agenda' against indigent criminal defendants or if a corporate defense lawyer would be biased against employees who allege unlawful discrimination or unpaid wages. I doubt very much he would ask that same question in that circumstance.'' ``The depth of this double standard is underscored by Senator Sessions' invoking Freddie Gray in particular. Freddie Gray, of course, was fatally injured in Baltimore police custody after being arrested without cause. His death led to grand jury indictments for six officers on homicide and assault charges, and the Department of Justice opened a civil rights investigation. Under these circumstances, representing Mr. Gray's family hardly seems like an act of radical subversion that would call into question one's ability to be fair, but in Senator Sessions' view, any challenge to police authority can be done only in pursuit of some extralegal `agenda.''' Senator Sessions led the floor opposition to Paula Xinis. I am pleased to report she was confirmed by the U.S. Senate, and she is now one of our distinguished members of the District Court of Maryland, where she serves with great distinction. Senator Sessions was one of only nine Senators to vote against the Detainee Treatment Act, which contained the McCain-Feinstein amendment that prohibits ``cruel, inhumane, and degrading'' punishment for individuals in American custody. He has left the door open to reinstating waterboarding as needed. He has opposed shutting down Guantanamo Bay. These issues are critically important because we got word of a draft Executive order that would bring back these types of torture centers-- which are not only a stain on America's reputation, they are counterproductive and against our values and our law. We expect the Attorney General of the United States to speak out against such reprehensible types of proposals. Thomas Jefferson wrote: ``The most sacred of the duties of government [is] to do equal and impartial justice to all of its citizens.'' This sacred duty remains the guiding principle for the women and men of the U.S. Department of Justice, according to the Justice Web site. I would urge all of us to keep that in mind. I regret I do not have confidence that Senator Sessions will carry out this task so I must oppose his nomination. Mr. President, I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, as the Senate deliberates the nomination of Betsy DeVos to be Secretary of Education, I have heard from more than 4,200 Marylanders who have called my office, more than 3,700 Marylanders who have emailed me, and countless others who have sent me messages via Twitter and Facebook, and, as Senator Carper has indicated, those who have just stopped me on the streets and urged me to oppose her nomination. They have contacted me to express their strong support for public education, and they are concerned about whether Mrs. DeVos is equally committed to public schools. I share their concern. Marylanders and I agree that our children deserve an advocate in this position who will work to strengthen the ability of public school educators to serve our children. As a proud graduate of the Baltimore City Public Schools, I understand the transformative powers that quality public school education can provide a child. The education I received at city schools has allowed me, the grandchild of immigrants, to represent Maryland in the Senate. I owe that to my public education, my public school education. Maryland has made a commitment to providing adequate funding for public education over the past decade. Consequently, Maryland has consistently been a national leader in student performance and student outcomes. Each day, our State's nearly 880,000 students make their way to classrooms of more than 60,000 and thousands of more support personnel and education leaders in over 1,400 Maryland schools. I appreciate the service of Maryland educators, not only from the perspective of a lawmaker, a father, and a grandfather but also as a husband of a former school teacher. Mrs. DeVos appeared before the Senate Health, Education, Labor, and Pensions Committee to articulate her view on how to best serve our students as Secretary of Education. I found several of Mrs. DeVos's answers to the committee questions to be troubling, particularly what appeared to be her tepid support for our Nation's public schools; her failure to recognize the critical Federal civil rights safeguards for children with disabilities; her inability to offer an opinion on longstanding debates within the education community that she would be expected to join as Secretary of Education; her support for President Trump's dangerous campaign promise to eliminate gun-free school zones; and her overall lack of response on how to provide students and their families with affordable higher education. Maryland families know and understand the value of a high quality public school education. Since 2008, enrollment in our State public schools has increased by nearly 36,000 students to a record enrollment of approximately 880,000 students for the 2016-2017 school year. While enrollment has continued to increase at a record pace, I am proud that Maryland public schools have consistently ranked among the top five public school systems in the country. I worry that Mrs. DeVos's enthusiastic support for private school choice programs could hamper the progress in State and local education in Maryland and could prevent us from providing the highest quality level of education for our public school students. School choice programs that shift Federal fund dollars from public schools to defray tuition at private schools weaken the ability of Maryland's hard- working public school professionals to deliver college- and career- ready education for Maryland's diverse students. Certainly private schools play an important role in our education system. As Senator Carper points out, he supports, I support, charter schools within our public school system. I support the role that public schools play. But we mustn't forget that more than 91 percent of American children attend public schools. They and their families deserve a Secretary of Education who will fight to strengthen public as well as private education. School choice programs are not one-size-fits-all solutions to strengthen education in the United States. They leave out students in our rural communities, for instance, and have been shown in Maryland for the most part to support students who are already enrolled in private schools. I urge our Secretary of Education nominee--if she is confirmed--to work to provide our public school teachers with the training, tools, and resources necessary to provide all children with a high-quality education. I was particularly concerned by Mrs. DeVos's apparent unfamiliarity with critical Federal civil rights safeguards for children with disabilities, guaranteed under the 1975 Individuals with Disabilities Education Act, IDEA. IDEA ensures that every child with disabilities is afforded a free appropriate public education. Across my State, more than 100,000 children receive federally funded services under the IDEA to help them succeed academically. Mrs. DeVos did not seem to know that States must follow this critical civil education rights law if they accept Federal funding. Parents across the country advocate for their children on a daily basis, utilizing the protections afforded to their children under the IDEA. They deserve a Secretary of Education who understands her responsibilities and the Federal Government's responsibilities to children with disabilities. Last year's enactment of the bipartisan, bicameral Every Student Succeeds Act was a true success. This was an incredible accomplishment put together by Senators Alexander and Murray. For the first time in 14 years, Congress reauthorized the Elementary and Secondary Education Act, legislation that was first enacted 50 years ago as part of the civil rights era to ensure that all of our children are able to attain a high-quality education. That act eliminated the outdated and ineffective accountability system of adequately yearly progress and now provides States with the flexibility to decide their own accountability system to identify, monitor, and assist schools in need of improvement to best educate their students. We gave local flexibility but maintained accountability. That was a major improvement in the Elementary and Secondary Education Act. The modifications allow States to move away from reliance on a collective set of test scores to measure students' proficiency. Now, States will be able to design accountability systems that take into account student growth over the course of a school year. As Secretary of Education, Mrs. DeVos would be tasked with leading the Federal implementation and review of the State development accountability systems. But in a hearing before the committee, she struggled to understand the definition of proficiency versus growth and had to have committee members help her define those terms. Maryland educators oppose the high-stake testing requirements under the previous Federal accountability system. They deserve a Secretary of Education who understands the basic concepts of Federal involvement in our public schools, so they can effectively advocate for more accurate accountability systems that better show student growth in the classroom. Mrs. DeVos's expressed support for President Trump's misguided pledge to eliminate gun-free schools zones is deeply concerning. Maryland's families have made it loud and clear to me that this approach is wrong and would unnecessarily put our students in harm's way in the very classrooms in which they are expected to learn. Since 2000, there have been four school shootings across my home State. One shooting in a school anywhere in our country is too many. Each of those incidents is a tragedy, and I do not wish to see more students and educators put at risk of additional tragic incidents of gun violence by allowing firearms in our classrooms. Rather than support the Federal programs developed under the Elementary and Secondary Education Act to provide additional funding for school-based mental health resources in our national public schools that can provide assistance for those who may commit gun violence at schools, Mrs. DeVos would spend those tax dollars on school choice programs and open up our classrooms to potential violence. In the coming months, future college students and their families will sit at their family kitchen tables to apply for financial aid to pay for college and await the news of their acceptance to the college of their choice. I have talked to so many Marylanders who are struggling with allowing their children to go to schools of higher education so that they can be best prepared, but they are looking at the realities of the cost involved in higher education. This is an exciting time, yet an increasingly anxious time for parents and students as the cost of attending college continues to rise. Mrs. DeVos needs to demonstrate that she is familiar with the process, the steps necessary to apply for Federal financial student aid, and appreciates the enormous burden families increasingly undertake to gain a foothold in the middle class through higher education. Mrs. DeVos appears willing to roll back protections for student borrowing and to allow taxpayer funds to be put at risk of failing for- profit schools that do not provide students with the educational skills necessary to join the workforce. At a minimum, I would expect her to be an advocate to make sure that Federal funds are not used for these schools that are not being held accountable for what they do. I would like to hear Mrs. DeVos voice her support for America's College Promise plan to provide academically successful students with the ability to earn the first 2 years of their college degree tuition free at a community college. So far I don't think she has said anything. That is the most efficient way to try to educate our children. I appreciate Mrs. DeVos's willingness to serve, and I believe she is sincere in her beliefs, but I am concerned that those beliefs, if enacted, would harm the capability of America's public education system to serve the vast majority of students across the Nation and pile on needless costs to students, their families, and the American taxpayer. Therefore, I will stand with Maryland's students, teachers, and parents in opposing Betsy DeVos for Secretary of Education. With that, Mr. President, I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, I wish to oppose the resolution of disapproval on the stream protection rule. Each Congress has an opportunity to promote having cleaner air and cleaner water. Our job description shouldn't include hollowing out the protections for clean air and clean water which previous Congresses have provided. Clean air and clean water are vital not just to human health and the environment, but to our economy as well. The number of premature deaths due to poor water quality affects our economy. The number of school or work days missed due to health problems affects our economy. The ability of industries to have access to clean water affects our economy. Like many of my colleagues, I am proud to represent part of Appalachia, in the western part of Maryland. I have enjoyed skiing, hiking, and simply enjoying one of the most beautiful places in our country. Recreational activities along the Appalachian Mountains depend upon clean air and clean water. And recreation is a huge part of expanding economic opportunities in Appalachia. Over the years, I have met with many people directly affected by the mining practice known as mountaintop removal, and I have worked very hard to address their concerns in a bipartisan manner. For instance, in the 111th Congress, I introduced S. 696, the Appalachia Restoration Act, with the senior Senator from Tennessee, Mr. Alexander, to help protect streams and rivers. The stream protection rule updates 33-year-old regulations to implement the Surface Mining Control and Reclamation Act. The update establishes clear requirements for responsible surface coal mining that will protect 6,000 miles of streams and 52,000 acres of forests over the next two decades, preserving community health and economic opportunities, while meeting the Nation's energy needs. The stream protection rule includes reasonable and straightforward reforms to revise three-decades-old coal mining regulations to avoid or minimize harmful impacts on surface water, groundwater, fish, wildlife, and other natural resources. There are a number of very positive, reasonable, and economically feasible changes in the proposed stream protection rule that make it an improvement over the existing regulations. The rule incorporates the best available science, technology, and modern mining practices to safeguard communities from the long-term effects of pollution and environmental degradation that endanger public health and undermine future economic opportunities for affected communities. The final Rule gives regulators more tools to measure whether a mine is designed to prevent damage to streams outside the permit area. The rule would require companies to avoid mining practices that permanently pollute streams, destroy drinking water sources, increase flood risk, and threaten forests. It would also require companies to restore streams and return mined areas to the uses they were capable of supporting prior to mining activities and replant these areas with native trees and vegetation, unless that would conflict with the implemented land use. To help mining companies meet these objectives, the rule requires testing and monitoring the condition of streams that might be affected by mining before, during, and after their operations to provide baseline data that ensures operators can detect and correct problems and restore mined areas to their previous condition. Using the Congressional Review Act, CRA, to attack a rule that protects people and communities from harmful impacts of irresponsible coal mining operations, such as buried streams, floods, and subsidence, will benefit coal companies that cut corners at the expense of the people who live in Appalachia. And if the resolution is passed, agencies will be prohibited from promulgating any other ``similar'' rule, unless Congress passes enabling legislation. Opponents of the rule call it a ``job killer.'' That is myth. The regulatory impact analysis, RIA, for the rule estimates that, overall, employment will increase by an average of 156 full-time jobs. According to the RIA, the rule will create more than twice as many jobs as it will eliminate by requiring operators to perform more duties for reclamation, including stream monitoring. Likewise, the impact on an average household's monthly electricity bill is slight: just 20 cents per month. Coal miners and their families need jobs, and they need clean water. The two aren't mutually exclusive. What they don't need is this attempt to gut a reasonable rule designed to protect them from an environmental disaster, which is much more likely to occur if the Senate passes this resolution of disapproval.

Mr. CARDIN

Mr. CARDIN. Mr. President, let me thank Senator Leahy for his comments. Ten years ago, I was privileged to be elected by the people of Maryland to represent them in the U.S. Senate. I came to the Senate with Senator Brown at that time. It was our first year. Senator Brown had the opportunity to serve on the Banking Committee. I had the opportunity to serve on the Senate Foreign Relations Committee. Today I hold the position on the Senate Foreign Relations Committee that Senator Lugar held when I first went on the committee; that is, the ranking member of the committee. I remember one of the very first hearings we had in the Senate Foreign Relations Committee on resource, curse or blessing. It was a matter of concern to every single member of the Senate Foreign Relations Committee, Democrats and Republicans. We saw the faces of people from nations in Africa who had a resource wealth, but they had the resource curse. The people were living in horrible poverty. Yet the country had mineral wealth--gas and oil--that was being exploited but not for the benefit of the people. It was being used to obtain income for their leaders to funnel corrupt practices. Senator Lugar, in October of 2008, authored a committee report of the Senate Foreign Relations Committee entitled ``The Petroleum And Poverty Paradox: Assessing U.S. And International Community Efforts To Fight The Resource Curse.'' We went through the regular legislative process as to how we could deal with the circumstance that we knew the United States must exercise leadership. As Senator Brown has pointed out the whole history and the importance of it--and all of the details--I just want to fill in some of the details as to how this came about because we were looking for a way in which we could turn the wealth of a nation to its people and cut off the corruption that it funded. The corruption was not just the obscenity of wealth being used by their leaders--as Senator Brown pointed out in Equatorial Guinea--it was also the fact that this wealth that was coming to these leaders was also being used for criminal activities, to finance illegal drug activities and to finance terrorism. I take issue with my friend from Oklahoma and his comments. There has never been an effort in this legislation to affect the supply of any source of energy here or anywhere around the world. That is being done. The question is, Where does the money go that is being used to exploit these resources? Do they go to the people of the country where the resource is located or do they go for corruption? That is what we attempted to do--Senator Lugar and I and others. I thank Senators Leahy and Durbin, who was on the floor earlier and was one of our early leaders, Senators Menendez and Wicker. We did this not only in the Senate Foreign Relations Committee at the time I was chairman of the Senate U.S. Helsinki Commission--the Helsinki Commission, and Senator Wicker was helping, we worked in that organization to see how we could deal with transparency and how the American leadership could help the international effort to end the resource curse. As a result, legislation was authored and introduced in order to try to deal with this issue. Senator Lugar and I authored a bill, a bill that said we want to know where the money is going so we can track the money. We wanted to be able, for the people of that nation, to say: We know money is coming in now. Our leaders show us where the money is going. That legislation was introduced. It was debated. It became part of the Dodd-Frank law. Quite frankly, it was supported in a rather bipartisan way, and it became law. Ever since its enactment, it has been fought by the American Petroleum Institute. I am not sure why because today other countries have adopted similar standards. This information is readily available as far as the way it is compiled by companies. Many oil and mineral companies today are supplying this information with no complaints, no problems, but it was fought. Tonight we are debating the use of the Congressional Review Act. It was pointed out earlier tonight that before today, it only had been used once since its 1996 enactment. The reason is because it is a sledgehammer approach to dealing with issues that should be dealt with by a scalpel, but here is the real abuse. We are using the Congressional Review Act--which is supposed to be used when an agency goes rogue, when they start to do things that were never intended by Congress, were never authorized by Congress. Section 1504 was passed by Congress, and it has taken the SEC almost a decade to get the rules out. And we are saying they abused their power? Maybe they abused their power by delay, but they certainly haven't abused their power with what they have come forward with. They are carrying out congressional mandate as they should. It was never the intent of the CRA to be used for this type of a process. So I just urge my colleagues to recognize that this is not the right way we should be proceeding. In September 2009, with Senator Lugar's help, I introduced legislation. It was bipartisan. Senators Merkley, Wicker, Schumer, Leahy, Durbin, Feinstein, Menendez, and others joined in that effort. The SEC was directed to develop rules on oil, gas, and mining companies as to how the disclosures could be made on the U.S. stock exchange so they could disclose their rights and payments made to foreign governments. That is what we mandated. Why do we want to know that? Because these royalties and payments were basically bribes to government leaders because it never went to the people. It was in the U.S. interest, not only because of how those funds were used against our principles and not only did it finance illegal activities, but it could have been a source for stable governments, which was important for U.S. interests that we have stable governments. It helps us in our foreign policy and national security. It also gives us a stable source of oil, gas, and minerals. Investors have the right to know. They have the right to know in what countries their companies are investing their stockholder investments. It was a reasonable request by Congress. One of my colleagues indicated that it was held to be inappropriate by our courts. That was on a process issue. It was not on a substantive issue. That was corrected. A new rule has come out, and now we are using a CRA in order to block it. The rule, as it is currently worded, provides for a reasonable period for enforcement. So it is not even going into effect immediately because we are allowing the companies to have ample time in order to comply with the rule. I just want to make this point. It creates a level playing field. It does not put American companies at a disadvantage. This is a level playing field. Thirty countries already require this. The EU requires this. Canada requires this. Do you want to know why they did it? Because the United States led. We passed the law. I met with the Europeans. I met with the Canadians. They said: This is a good bill. You are our leaders. You are doing it. We are going to do it also so they did it. It is in effect in these countries. Oil companies and mineral companies have complied with it. They are fine. Guess what. It wasn't difficult. Shell, BP, France's Total, Russian's Rosneft, Lukoil, Gazprom--their huge giant--all have reported. It has not caused any competitive problems. They are not losing any proprietary rights, as has been suggested. There has been no harm done. When I listen to the cost-benefit analysis and listen to our distinguished chairman talk about the data is not really available, the reason the data is not available is because we don't have disclosure. If we get the information, then we will be able to tell exactly how we can deal with the problems in Ghana or Nigeria or in Equatorial Guinea or problems in so many countries where the people are hurting with some of the worst poverty rates in the world. We will be able to find that information out, but if we don't know what is being paid by U.S. companies, how do you do a cost-benefit analysis? I don't know how you could possibly do it. I heard the numbers, the cost of compliance, and I would challenge that. I would challenge the cost of compliance numbers because this information is already available. Companies know where their money is going. It is a normal business issue. I heard it is going to cost hundreds of millions of dollars of contracts. I don't want to minimize the cost, but as a percentage of the business they are doing, it is minor. The benefit we get if the money can go to the people and deal with these horrible conditions that we see in these resource-wealthy countries, then it is certainly worth the effort. That is part of our effort in dealing with other countries, to try to lift up the standard of living in so many of these countries. So when we look at, again, what is at stake--what is at stake? And that is to allow the wealth of a country to go to its people for its stability. I have heard my colleagues say: Well, we are not against this. The law is still there. All we are talking about is this regulation. Once we pass this CRA, we are going to go back to work with the SEC and bring in a new rule. Do you really believe that? Do you really believe that if we pass this CRA, that we are going to see a new rule come out of the SEC? It has taken us 9 years to get to where we are right now. Do you really believe that with the law saying that the SEC cannot bring out a rule that is substantially the same in form, unless authorized by a subsequent law of Congress--do you really believe that will not be challenged in the courts with lengthy litigation before we will ever see another rule take effect? Let us be clear about this. I am going to continue to do everything I can to make sure that the people of these nations get the wealth of their country. I am going to do everything I can. I am going to work with all my colleagues on both sides of the aisle. I really do believe in the sincerity of my colleagues, that they believe in this transparency. It is going to be tested. I am going to come back and see where we can make sure that 1504 is enforced because if I heard my chairman--and I respect him greatly, we work on a lot of issues together--when the chairman says that he is going to make sure the SEC complies with all congressional mandates--this is a congressional mandate--and it is our responsibility to make sure the SEC complies with Section 1504. If our colleagues pass this CRA--and I hope you don't--it is our responsibility to make sure the SEC complies with 1504. I am going to be here urging in every way I can to make sure that happens. Mr. President, I ask unanimous consent that the statement from Publish What You Pay, which talks about a lot of the different aspects and myths that have been said, be printed in the Record.

Mr. CARDIN. Let me conclude, for years, Congress has been fighting to shine a light on the billions of dollars paid by extracted companies to foreign governments. By taking away one of the only tools we have to shine a light on extracted payments' associated corruption, we are sending a message to corrupt leaders around the world that the United States does not care about corruption; that we won't hold them accountable, and that they should continue with business as usual: Exploiting their own people, and perhaps even funding terrorist organizations with some of their secret proceeds. It is not in our national interest to stop an anticorruption rule that bolsters America's national security, advances our humanitarian and anticorruption goals, and demonstrates U.S. moral leadership. I urge my colleagues to join me in voting against this resolution of disapproval. I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, I rise in support of the Medicare Access to Rehabilitation Services Act, which I am introducing today with my colleagues Senators Collins, Casey, and Heller. This important bill repeals the monetary caps that limit Medicare beneficiaries' access to medically necessary outpatient physical therapy, occupational therapy, and speech-language pathology services. Limits on outpatient rehabilitation therapy services under Medicare were first imposed in 1997 as part of the Balanced Budget Act. The decision to impose limits on these services was not based on data, quality-of-care concerns, or clinical judgment--its sole purpose was to limit spending in order to balance the Federal budget. Since 1997, Congress has acted 12 times to prevent the implementation of the therapy caps through moratoriums and an exceptions process. While these short-term actions have provided necessary relief to our seniors, a long-term solution is essential to bring permanent relief and much- needed stability for both patients and providers. We need a full repeal of the existing caps on physical therapy, occupational therapy, and speech-language pathology services. These annual financial caps limit services often needed after a stroke, traumatic brain injury, or spinal cord injury, or to effectively manage conditions such as Parkinson's disease, multiple sclerosis, and arthritis. Arbitrary caps on these vital Medicare outpatient therapy services are simply unacceptable. They also discriminate against the oldest and sickest Medicare beneficiaries, who typically require the most intensive therapy, and disadvantage Medicare beneficiaries who live in regions with higher health care costs. In a 2009 report issued by the Medicare Payment Advisory Committee, MEDPAC, it was estimated that the therapy cap, if enforced without an exceptions process, could negatively impact 931,000 Medicare beneficiaries. Arbitrarily capping outpatient rehabilitation therapy services would likely cause some beneficiaries to delay necessary care, force others to assume higher out-of-pocket costs, and disrupt the continuum of care for many seniors and individuals with disabilities. I urge my colleagues to join me and Senator Collins in supporting the Medicare Access to Rehabilitation Services Act to ensure that our seniors have access to the outpatient rehabilitation therapy services that they need. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. CARDIN

Mr. CARDIN. Mr. President, I rise in support of the Medicare Access to Rehabilitation Services Act, which I am introducing today with my colleagues Senators Collins, Casey, and Heller. This important bill repeals the monetary caps that limit Medicare beneficiaries' access to medically necessary outpatient physical therapy, occupational therapy, and speech-language pathology services. Limits on outpatient rehabilitation therapy services under Medicare were first imposed in 1997 as part of the Balanced Budget Act. The decision to impose limits on these services was not based on data, quality-of-care concerns, or clinical judgment--its sole purpose was to limit spending in order to balance the Federal budget. Since 1997, Congress has acted 12 times to prevent the implementation of the therapy caps through moratoriums and an exceptions process. While these short-term actions have provided necessary relief to our seniors, a long-term solution is essential to bring permanent relief and much- needed stability for both patients and providers. We need a full repeal of the existing caps on physical therapy, occupational therapy, and speech-language pathology services. These annual financial caps limit services often needed after a stroke, traumatic brain injury, or spinal cord injury, or to effectively manage conditions such as Parkinson's disease, multiple sclerosis, and arthritis. Arbitrary caps on these vital Medicare outpatient therapy services are simply unacceptable. They also discriminate against the oldest and sickest Medicare beneficiaries, who typically require the most intensive therapy, and disadvantage Medicare beneficiaries who live in regions with higher health care costs. In a 2009 report issued by the Medicare Payment Advisory Committee, MEDPAC, it was estimated that the therapy cap, if enforced without an exceptions process, could negatively impact 931,000 Medicare beneficiaries. Arbitrarily capping outpatient rehabilitation therapy services would likely cause some beneficiaries to delay necessary care, force others to assume higher out-of-pocket costs, and disrupt the continuum of care for many seniors and individuals with disabilities. I urge my colleagues to join me and Senator Collins in supporting the Medicare Access to Rehabilitation Services Act to ensure that our seniors have access to the outpatient rehabilitation therapy services that they need. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. CARDIN

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

Mr. CARDIN. Mr. President, I rise today as the Senate begins consideration of the nomination of Mr. Rex Tillerson to serve as the 69th Secretary of State of the United States of America. I thank Mr. Tillerson for his willingness to serve our Nation and for his participation in a lengthy, wide-ranging hearing before the Senate Foreign Relations Committee, where I have the honor of being the senior Democrat, the ranking Democrat on the committee. Earlier today, I thanked Chairman Corker for the courtesies he showed during the hearing process. However, as I stated yesterday, I remain concerned that Mr. Tillerson's demonstrated business orientation in his responses to questions during the confirmation hearing would prevent him from being a Secretary of State who forcefully promotes the values and ideals that have defined our country and our leading role in the world for more than 200 years. I, therefore, will not be supporting his nomination. Given the events over the weekend, I believe it is important that I begin today's debate by painting a picture for the American people of the unstable, reckless foreign policy that Mr. Tillerson is going to be asked to carry out under President Trump. It is painfully obvious that when the President says ``America first,'' the cumulative result of his vision would actually lead to America alone and America at risk. From time to time, in our Nation's history, we have heard the calls of isolationism, but isolationism did not work then and it will not work now. It is an approach that our history has taught us, time and time again, undermines our interests, makes us vulnerable to those who wish us harm, betrays our values, and leaves us less secure and less prosperous. America's leadership, rooted in our values, makes the world a better place for all, but the first 10 days of the Trump administration shows that the President is intent on compromising our values, abandoning our allies, and using a sledgehammer instead of a scalpel to conduct the detailed, careful work of safeguarding our Nation. Some of his supporters chalk it up to inexperience. My own chairman has said on numerous occasions that he wishes the President had more flushed-out ideas on foreign policy space. What the American people witnessed in the last 10 days goes beyond inexperience. There is a willful, dangerous campaign underway by forces in this administration to bend or potentially even break the law. More than ever, we need to reaffirm and adhere to the values that make our country so strong and so stable, the city on the hill that others look to for leadership. In order to do that, we need leaders who will not shy away from our values, who will sound a certain trumpet for human rights, the rule of law, and bedrock American values. Mr. Tillerson's timid equivocation on American values throughout his confirmation process, his trumpet's uncertain sound was alarming because he will be working for a President clearly willing to compromise America's values at every turn. There are many individuals who have served in both Republican and Democratic administrations who recognize this Executive order for what it is. I have in my hand a letter from over 100 former Cabinet Secretaries, senior government officials, diplomats, military servicemembers, and intelligence community professionals who have served in the Bush and Obama administrations. The letter, to the heads of the Departments of Homeland Security, Justice, and State, expresses deep concern that the Executive order issued over the weekend jeopardizes tens of thousands of lives, has caused a crisis here in America, and will do long-term damage to our national security. It strongly recommends the President rescind this order. I ask unanimous consent that this letter be printed in the Record. There being no objection, the material was ordered to be printed in the Record, as follows: January 30, 2017. Hon. John F. Kelly, Secretary, Department of Homeland Security, Washington, DC. Hon. Sally Yates, Acting Attorney General, Department of Justice, Washington, DC. Hon. Thomas A. Shannon, Acting Secretary, Department of State, Washington, DC. Secretary Kelly, Acting Attorney General Yates, Acting Secretary Shannon: As former cabinet Secretaries, senior government officials, diplomats, military service members and intelligence community professionals who have served in the Bush and Obama administrations, we, the undersigned, have worked for many years to make America strong and our homeland secure. Therefore, we are writing to you to express our deep concern with President Trump's recent Executive Order directed at the immigration system, refugees and visitors to this country. This Order not only jeopardizes tens of thousands of lives, it has caused a crisis right here in America and will do long-term damage to our national security. In the middle of the night, just as.we were beginning our nation's commemoration of the Holocaust, dozens of refugees onboard flights to the United States and thousands of visitors were swept up in an Order of unprecedented scope, apparently with little to no oversight or input from national security professionals. Individuals, who have passed through multiple rounds of robust security vetting, including just before their departure, were detained, some reportedly without access to lawyers, right here in U.S. airports. They include not only women and children whose lives have been upended by actual radical terrorists, but brave individuals who put their own lives on the line and worked side-by-side with our men and women in uniform in Iraq now fighting against ISIL. Now, because of actions taken by this White House, their lives have been disrupted and they may even be in greater danger if they are sent home. Many more thousands going through the process will now be left behind. More broadly, tens of thousands of other travelers, including dual citizens and, at one point, legal U.S. residents face deep uncertainty about whether they may even travel to the United States or risk leaving and being barred reentry. Many of us have worked for years to keep America safe from terrorists. Many of us were on the job working for our country on 9/11 and need no reminder just how vital it is to destroy terrorist networks and bring partners to our side in that global effort. Simply put, this Order will harm our national security. Partner countries in Europe and the Middle East, on whom we rely for vital counterterrorism cooperation, are already objecting to this action and distancing themselves from the United States, shredding years of effort to bring them closer to us. Moreover, because the Order discriminates against Muslim travelers and immigrants, it has already sent exactly the wrong message to the Muslim community here at home and all over the world: that the U.S. government is at war with them based on their religion. We may even endanger Christian communities, by handing ISIL a recruiting tool and propaganda victory that spreads their horrific message that the United States is engaged in a religious war. We need to take every step we can to counter violent extremism, not to feed into it by fueling ISIL propaganda. Perhaps the most tragic irony of this episode is that it is unnecessary. We do not need to turn America into a fortress to keep it secure. Since the 9/11 attacks, the United States has developed a rigorous system of security vetting, leveraging the full capabilities of the law enforcement and intelligence communities. This vetting is applied to travelers not once, but multiple times. Refugees receive even further scrutiny. In fact, successive administrations have worked to improve this vetting on a near continuous basis, through robust information sharing and data integration to identify potential terrorists. Since 9/11 not a single major terrorist attack has been perpetrated by travelers from the countries named in the Order. The suddenness of this Order is also troubling. The fact that individuals cleared for admission were literally in the air as the Order went into effect speaks to the haste with which it was developed and implemented. We are concerned that this Order received little, if any scrutiny by the Departments of State, Justice, and Homeland Security or the Intelligence Community. Now that some of these individuals are here in the United States, and thousands of others are stranded, our government's response has appeared disorganized and chaotic. As lawyers take steps to protect their clients who have been detained here or stranded at many other airports, the U.S. government will continue to face a flurry of legal challenges, which could have been avoided. Additionally, by banning travel by individuals cooperating against ISIL, we risk placing our military and diplomatic efforts at risk by sending a clear message to those citizens and all Muslims that the United States does not have their backs. Already, the international push-back has been immense, and threatens to jeopardize critical counterterrorism cooperation. Fortunately, there is a way out of this self-made crisis. We know that your agencies did not create this situation and we particularly respect that many of you are working to mitigate its damage. Effective immediately, you can apply the discretion given to you under the President's Order to admit into the country the men, women and children who are currently still stranded in airports. The process for doing this is well known to the security professionals within your departments. We urge you to execute it. While it is good to see the withdrawal of the application of the Order to legal permanent residents of the United States, your Departments can immediately work to allow other classes of people into the country, and remove the discriminatory prioritization implicit within the Order. Most critically, we urge you to draw on the insight of the professionals in your departments to recommend that the President revisit and rescind this Order. Blanket bans of certain countries or classes of people is inhumane, unnecessary and counterproductive from a security standpoint, and beneath the dignity of our great nation. Dr. Madeleine K. Albright, Former Secretary of State; Janet Napolitano, Former Secretary of the Department of Homeland Security; Susan Rice, Former National Security Advisor to the President of the United States; Dennis Blair, Former Director of National Intelligence, Admiral, USN, Retired; Michael Hayden, Former Director, Central Intelligence Agency; Samantha Power, Former United States Ambassador to the United Nations; Bill Richardson, Former Governor of New Mexico and United States Ambassador to the United Nations; Tony Blinken, Former Deputy Secretary of State; William Burns, Former Deputy Secretary of State; Bruce Andrews, Former Deputy Secretary of Commerce; Richard Clarke, Former National Coordinator for Security, Infrastructure Protection and Counterterrorism for the United States; Rudy DeLeon, Former Deputy Secretary of Defense. Heather Higginbottom, Former Deputy Secretary of State for Management and Resources; Thomas Nides, Former Deputy Secretary of State for Management and Resources; James Steinberg, Former Deputy Secretary of State; Michael Morrell, Former Acting Director, Central Intelligence Agency; Matthew Olsen, Former Director of the National Counterterrorism Center; Rand Beers, Former Acting Secretary of the Department of Homeland Security; John B. Bellinger III, Former Legal Advisor to the Department of State. Ambassador (ret.) Nicholas Burns, Former Under Secretary of State for Political Affairs; Eliott Cohen, Former Counselor, Department of State; Michele Flournoy, Former Undersecretary of Defense for Policy; Marcel Lettre, Former Undersecretary of Defense for Intelligence; James Miller, Former Undersecretary of Defense for Policy; Wendy Sherman, Former Under Secretary of State for Political Affairs; Suzanne Spaulding, Former Undersecretary for National Protection and Programs, Department of Homeland Security; Michael G. Vickers, Former Undersecretary of Defense for Intelligence; Tara Sonenshine, Former Under Secretary of State for Public Diplomacy and Public Affairs. Clara Adams-Ender, Brigadier General, USA, Retired; Ricardo Aponte, Brigadier General, USAF, Retired; Alyssa Ayres, Former Deputy Assistant Secretary of State for South Asia; Donna Barbisch, Major General, USA, Retired; Jamie Barnett, Rear Admiral, USN, Retired; Jeremy Bash, Former Chief of Staff, Department of Defense; Daniel Benjamin, Former Coordinator for Counterterrorism, Department of State; Charles Blanchard, Former General Counsel, United States Air Force; Janet Blanc Former Deputy Special Representative to Afghanistan and Pakistan; Barbara Bodine, Former United States Ambassador to Yemen; Richard Boucher, Former Assistant Secretary of State for South and Central Asian Affairs, Mike Breen, Retired United States Army Officer; John G. Castellaw, Lieutenant General, USMC, Retired; Wendy Chamberlin, Former United States Ambassador to Pakistan. Derek Chollet, Former Assistant Secretary of Defense for International Security Affairs; Christopher Cole, Rear Admiral, USN, Retired; Bathsheba Crocker, Former Assistant Secretary of State for International Organization Affairs; Abe Denmark, Deputy Assistant Secretary of Defense for East Asia; Paul Eaton, Major General, USA, Retired; Mari K. Eder, Major General, Retired, USA; Dwayne Edwards, Brigadier General, USA, Retired; Robert Einhom, Former Assistant Secretary of State for Nonproliferation; Evelyn Farkas, Former Deputy Assistant Secretary of Defense for Russia, Ukraine, Eurasia; Gerald M. Feierstein, Former United States Ambassador to Yemen; Daniel Feldman, Former Special Representative to Afghanistan and Pakistan. Jose W. Fernandez, Former Assistant Secretary of State for Economic, Energy, and Business Affairs; Jonathan Finer, Former Director of Policy Planning, Department of State; Robert Glace, Brigadier General, USA, Retired; Philip Gordon, Former Special Assistant to the President and White House Coordinator for the Middle East, North Africa, and the Persian Gulf Region; Kevin P. Green, Vice Admiral, USN, Retired; Caitlin Hayden, Former National Security Council Spokesperson; Richard S. Haddad, Major General, USAF, Retired; Gretchen Herbert, Rear Admiral, USN, Retired; Mark Hertling, Lieutenant General, USA, Retired; Christopher P. Hill, Former United States Ambassador to Iraq; David Irvine, Brigadier General, USA, Retired; Arlee D. Jameson, Lieutenant General, USAF, Retired; Deborah Jones, Former United States Ambassador to Libya; Colin Kahl, Former National Security Advisor to the Vice President of the United States; Claudia Kennedy, Lieutenant General, USA, Retired. Gil Kerlikowske, Former Commissioner, United States Customs and Border Protection; Charles Kupchan, Former Special Assistant to the President for National Security Affairs; Jonathan Lee, Former Deputy Chief of Staff, Department of Homeland Security; George Little, Former Assistant Secretary of Defense for Public Affairs; Donald E. Loranger Jr., Major General, USAF, Retired; Kelly Magsamen, Former Principal Deputy Assistant Secretary of Defense for Asian and Pacific Security Affairs; Randy Manner, Major General, USA, Retired; Thomas Malinowski, Former Assistant Secretary of State for Democracy, Human Rights, and Labor; Brian McKeon, Former Acting Undersecretary of Defense for Policy. Philip McNamara, Former Assistant Secretary for Partnerships and Engagement, Department of Homeland Security; John G. Morgan, Lieutenant General, USA, Retired; Suzanne Nossel, Former Deputy Assistant Secretary of State for International Organizations Affairs; James C. O'Brien, Former Special Envoy for Hostage Recovery; Eric Olson, Major General, USA, Retired; Rick Olson, Former Special Representative to Afghanistan and Pakistan; W. Robert Pearson, Former United States Ambassador to Turkey; Glenn Phillips, Rear Admiral, USN, Retired; Gale Pollock, Major General, USA, Retired; Amy Pope, Former Deputy Assistant to the President for National Security Affairs; Steve Pomper, Former Special Assistant to the President for National Security Affairs. Michael Posner, Former Assistant Secretary of State for Democracy, Human Rights and Labor; Anne C. Richard, Former Assistant Secretary of State, Population, Refugees & Migration; Leon Rodriguez, Former Director, U.S. Citizenship and Immigration Services; Laura Rosenberger, Former Chief of Staff to the Deputy Secretary of State; Tommy Ross, Former Deputy Assistant Secretary of Defense for Security Cooperation; John M. Schuster, Brigadier General, USA, Retired; Eric Schwartz, Former Assistant Secretary of State for Population, Refugees, and Migration; Stephen A. Seche, Former United States Ambassador to Yemen; Robert Silvers, Former Assistant Secretary for Cyber Policy, Department of Homeland Security, Vikram Singh, Former Deputy Assistant Secretary of Defense for South and Southeast Asia; Elissa Slotkin, Former Acting Assistant Secretary of Defense for International Security Affairs; Jeffrey Smith, Former General Counsel, Central Intelligence Agency; Julianne ``Julie'' Smith, Former Deputy National Security Advisor to the Vice President of the United States; Michael Smith, Rear Admiral, USN, Retired. Matthew Spence, Former Deputy Assistant Secretary of Defense for Middle East Policy; Andrew W. Steinfeld, Former Senior Foreign Policy Advisor to the Chairman of the Joint Chiefs of Staff; Seth M.M. Stodder, Former Assistant Secretary of Homeland Security for Border, Immigration & Trade Policy; Jake Sullivan, Former National Security Advisor to the Vice President of the United States; Loree Sutton, Brigadier General, USA, Retired; Antonio Taguba, Major General, USA, Retired; Jim Townsend, Deputy Assistant Secretary of Defense for European and NATO Policy; David Wade, Former Chief of Staff, Department of State; George H. Walls, Brigadier General, USMC, Retired; William Wechsler, Former Deputy Assistant Secretary of Defense for Counterterrorism and Special Operations. Catherine Wiesner, Former Deputy Assistant Secretary, Bureau of Population, Refugees, and Migration; Willie Williams, Lieutenant General, USMC, Retired; Johnnie E. Wilson, General, USA, Retired; Tamara Cofman Wittes, Former Deputy Assistant Secretary of State; Moira Whelan, Former Deputy Assistant Secretary of State for Public Affairs; Jon Brook Wolfsthal, Former Special Assistant to the President for National Security Affairs; Lee Wolosky, Former Special Envoy for Guantanamo Closure; Stephen N. Xenakis, M.D., Brigadier General, USA, Retired.

Mr. CARDIN. Mr. Tillerson needs to answer whether he supports Mr. Trump's decision this weekend to ban Muslims, to keep green card holders out of the country, and state his view on the chaos that ensued from the terrible implementation of this terrible policy. We asked Mr. Tillerson during the confirmation hearing whether he supported a Muslim ban. He would not give us a clear answer, and he did not speak out against an unconstitutional Muslim ban. Just today, I have sent a letter, as the ranking Democrat on the Senate Foreign Relations Committee, to Mr. Tillerson asking his specific views on the President's Executive order, what impacts that will have on America's credibility, what impact that will have on America's ability to work with our strategic partners around the world. I hope he will respond to us so we know his views on the President's Executive order before we are called upon to vote on his nomination. I ask unanimous consent that a copy of that letter be printed in the Record.

Mr. CARDIN. Mr. President, it remains to be seen whether Mr. Tillerson has the moral compass necessary to counsel the President toward a coherent U.S. foreign policy that advances our national security and embraces our values and ideals or if he will be another yes-man, enabling the risky, chaotic whims of a demagogue President, who is leading us on a march of folly. The American people deserve to know because if the last 10 days are any indication, the Trump administration is on a track to be the most dangerous and divisive in history. Nothing so painfully illustrates that point as Friday's Executive order banning refugees and certain Muslim immigrants from entering the United States. As a citizen of this great Nation, I am deeply offended by and ashamed of the President's Executive actions. When the news of this developed over the weekend, I happened to be attending a family wedding in the Miami area, a city rich in its immigrant character and its welcoming nature to people of many faiths and backgrounds. Miami was also the city where one of the most shameful episodes in our history transpired, where in 1993, the St. Louis, filled with Jewish refugees trying to flee the horrors of Nazi Germany waited for days, seeing the lights of the city ashore, seeking shelter and refuge. Shamefully, we turned the St. Louis away and condemned many of its passengers to death in the Holocaust. We say never again. Yet fear and uncertainty was palatable this weekend in Miami and across the country. I have heard from constituents who were temporarily detained and arrested or whose loved ones had scheduled legal travel to the United States but were unsure if they should board their planes for fear of being arrested or turned around once they arrived. I am aware of students studying legally here in the United States who suddenly found their entire future in jeopardy because of their nationality. Maryland is proud to host world-class universities like Johns Hopkins and the University of Maryland, colleges that are enriched by the contributions and perspectives of foreign citizens. Permanent legal residents who endured a lengthy process to acquire their green card and make the United States their home were suddenly unsure if they belonged. I was particularly troubled when two Iraqi citizens, who have played critical roles in supporting America's forces in Iraq, and were traveling on valid visas, were denied entry into New York. What do they get for helping our brave men and women with translation and security services? A big ugly ``Not Welcome'' sign at JFK Airport. Adding insult to injury, their immediate families were already here in the United States. The cumulative effect of this Executive order is enough to make your stomach churn because what President Trump tried to do was legalize discrimination based on religion and nationality. As President Trump said, giving preference to Christians is going to be OK. As Trump adviser Rudy Giuliani said, this is a way to legalize a Muslim ban. So I was relieved when Federal judge Ann Donnelly issued a stay on Saturday evening to stop the madness, at least temporarily. Other judges around the Nation acted accordingly as well, affirming certain rights of green card holders and legal permanent residents, but too many innocent people remain in limbo. My staff's communications with Cabinet agencies over the weekend were extremely troubling. The left hand did not know what the right hand was doing in the Trump administration. In the zeal to play politics and inflame the fears of Americans who feel threatened, the White House revealed how little they knew or cared about governing. It was reported that Secretary Kelly did not have a proper opportunity to view the Executive order before it was issued, a sobering lesson I hope Mr. Tillerson has paid close attention to. The Department of Homeland Security has now belatedly begun to engage on issuing guidance, but I fear the damage has been done. Clearly, the Department of Justice was not part of developing the Executive order, as Acting Attorney General Sally Yates said, boldly, that she was not convinced that the Executive order was lawful. As a result, President Trump fired her--the Monday night massacre. Our voice must be loud and clear. Mr. Trump, this is our country, a country that stands for the highest principles, supported by the rule of law. If Ms. Yates' firing is any indication as to how President Trump will handle different views, our Democratic institutions of checks and balances will indeed be challenged. The White House Press Secretary, Sean Spicer, said that foreign service officers using the dissent channel to express their views on the immigration Executive order should ``either get with the program or they can go.'' The dissent channel was set up during the Vietnam war as a way for foreign service officers and civil servants to raise concerns with upper management about the direction of U.S. foreign policy without fear of retribution. It is for ``consideration of responsible, dissenting and alternative views on substantive foreign policy issues that cannot be communicated in a full and timely manner through regular operating channels or procedures.'' This process for the use of dissent channels was codified in the Foreign Affairs Manual in 1971, which dictates that dissent cables are sent to the Departments' policy planning directors who distribute them to the Secretary of State and other top officials who must respond within 30 to 60 days. There are typically about four or five each year. Freedom from reprisal from dissent user channels is strictly enforced, but the President's Press Secretary said they can go. What type of free discussion do we want to have in this country? Where are the checks and balances? Where is the willingness to listen to different views? The President also put a 4-month freeze in place on all refugees entering the United States, singling out refugees from certain Muslim- majority countries for extra screening, failing to acknowledge or speak about the thorough 18- to 24-month screening process that refugees from dangerous countries, such as Iraq and Syria, already endure before they come to our Nation. We have the toughest screening now. I am not sure what the President is talking about when he says additional screening. We already have the toughest screening. They already go through the United Nations. They are already interviewed. Their background is checked. Moving forward, the number of refugees entering the United States will fall by 50 percent. It is clear that the President of the United States has a fundamental misunderstanding of America's leading role on refugee resettlement. Today, I will meet with King Abdallah of Jordan, a nation that has accepted 650,000 Syrian refugees. And President Trump is holding our program to accept approximately 10,000 Syrian refugees, placing it on hold. Jordan is one of America's global partners in fighting extremism. It will be interesting to see the reactions we get from our partners. If we close our doors to refugees, we will not only close our doors to U.S. humanitarian values but also severely damage America's global credibility on universal values. The United States is a nation of immigrants and refugees from all and no faiths. We learned from our mistake with the St. Louis, and we are the Nation that received refugees from the Holocaust after the Second World War. We are the Nation that opened our doors to hundreds of thousands of citizens fleeing conflicts and political oppression in El Salvador, Cuba, Vietnam, and Cambodia. The United States must continue to lead by example, but President Trump's cruel Executive order on immigrants and refugees undermines our core values and traditions, threatens our national security, and demonstrates a complete lack of understanding of our strict vetting process--the most thorough in the world. It is a dangerous and shortsighted policy that erodes our moral leadership and harms our national security as well as our alliances and partnerships worldwide. This is not the kind of America that Americans deserve. Also over the weekend, President Trump spoke with Russian President Vladimir Putin. There has been perhaps no other issue that has so pitted President Trump against the interests of the United States than Russia. Reflexively, the President will not utter basic truths about Mr. Putin's Russia, such as these: The annexation of Crimea, Ukraine, is illegal; they committed war crimes in Syria; and they sought to create doubt about and potentially influence the election that saw him elected President, as our intelligence community has now overwhelmingly confirmed. There is no more fundamental interest that we have as Americans than our democracy. Let's be clear: Just as with Pearl Harbor or September 11, in this past election, the United States was attacked by a foreign power. President Trump does not even seem to care that we were attacked or, worse, does not seem to believe that we need to stand up and defend our democracy and our form of government. I find that unfathomable. The phone calls this weekend came against the backdrop of President Trump and his aides floating the idea of lifting our current sanctions on Russia. So Russia has invaded Ukraine, has committed war crimes in Syria, has attacked our free democratic system, and we are talking about easing sanctions on Russia? It is such a miscarriage of justice and accountability that they do not understand or won't acknowledge the gravity of what Russia seeks to do here in our country and around the world. It is, therefore, incumbent on Congress to act. I am pleased to have bipartisan support for my effort to impose additional sanctions on Russia as well as require the President to seek congressional approval before he rolls back current sanctions. Sanction relief can only come when Russia has changed its behavior, and I see no indication that that will come any time soon. The unclassified reports released by the intelligence community earlier this month says that Russia's intelligence tried to access multiple State or local election boards. They also confirmed that Russia has researched U.S. electoral procedures and related technology and equipment, though they were clear in their assessment that there was no evidence at this time that Russia interfered in the actual vote tabulation. An America that becomes passive or willfully blind to a resurgent Russia is not the kind of America that the American people deserve, and it is imperative that the administration understand this and act accordingly. What the American people don't need is the White House focusing on a trial balloon last week that fell like a lead ball. Some in the administration thought it would be a good idea to bring back the notorious black sites--secret prisons--from a decade ago, where our intelligence picked up foreign nationals suspected of terrorism connections, hid them, and, in some cases, tortured them or allowed the prison's host country to torture them. Perhaps nothing did more harm to our credibility and boost terrorist recruitment during the early years of the Iraq war than the dangerous, amoral practice of rendition, secret detention, and interrogation by torture. We cannot go back to those practices if we value maintaining the perception and the reality of the United States of America as a beacon of justice, law, and human rights for the world. Make no mistake, this approach, like the immigration Executive order, endangers American citizens and personnel abroad and is a boon to ISIS and like-minded groups. It validates their propaganda, aids their recruitment and incitement of homegrown terrorism in the United States and the West, and encourages attacks against America abroad. General Mattis gets it; why can't the President? President Trump must never let this Executive order see the light of day. This is not the kind of America that the American people deserve. Let me turn now to our relationship with our neighbors, our most important international relationships. Since entering the political arena 18 months ago, candidate Trump was consistent in his treatment of Mexican immigrants and refugees, referring to them on day one of his Presidential campaign as drug users, criminals, and rapists. So Mr. Tillerson's job was shaping up to be difficult enough. It got even harder last week. In the last 5 days, President Trump has insulted the Mexican President and people with his Executive orders on border wall construction and the treatment of immigrants and refugees at our border, as well as stoked fear throughout sanctuary and welcoming cities in the United States that resources could be cut and innocent people could be apprehended, breaking up and devastating families. The President's new Secretary of Homeland Security said pointedly that a wall will not work, and Mr. Trump missed a real opportunity at the outset of his Presidency to advance both comprehensive immigration reform and border security, which go hand in hand. We did that a few years ago. That is what the President should have come in with and used his Presidency to pass comprehensive immigration reform, as we did. Instead, he wants to build a wall. Turning away legitimate asylum seekers at the border or requiring mandatory detention of families and children will do nothing to make America safer. Such cruel actions will inevitably bring harm and potential death to survivors of violence and torture, including many women and children, while undermining America's values and damaging our relationships with our allies. Why the President would deliberately pick a fight with the President of Mexico is truly puzzling. Not to be outdone after being embarrassed by the President of Mexico's cancellation of his visit to Washington, the President doubled down and had the audacity to suggest that the cost of constructing a border wall should be passed on to the hardworking American families, not once but twice. The first is by inserting it in the budget. That is taxpayer dollars paying to build a wall that won't work. The second is through a tax on Mexican imports which will, in turn, be paid for by American consumers. All the while, he continues to blow smoke and say that we will continue to find a way for Mexico to ultimately pay for this dream wall. It won't happen. This is not the kind of America that the American people deserve. Lastly, I want to point out that, in his third day of office, just one day after the 44th anniversary of the landmark Roe v. Wade Supreme Court decision, President Trump reinstated the controversial global gag rule that would cut off U.S. family planning funding to any nonprofit group overseas that provides any information about abortion in their health care services for women and families in need. In other words, this is not about U.S. money supporting abortion services. It is about working with organizations. Now, Republican Presidents routinely reinstate this harmful rule, but President Trump's global gag order is even more extreme. It massively expands his already harmful policy to threaten all U.S. foreign aid assistance to nonprofit groups engaged in health in the developing world. That will significantly increase the jeopardy of cutting off U.S. funding to international health efforts. We are talking about millions of more women and families. Without funding these organizations, we will not be able to provide HIV prevention, care and treatment services to those in need, provide integrated maternal health care with contraceptive services, or counsel women on the potential risk of Zika infection, among many other activities. This is very counterproductive to U.S. goals and interests. This is not the kind of America the American people deserve. The American people deserve leadership that will make them safer and more secure, that will increase our prosperity, and that will advance our values and serve as an example to the world. That America, Mr. President, is also an America that can lead the world and that the world will want to work with. The state of world affairs has been precarious for some time now. Almost single-handedly, President Trump is inflaming previously simmering situations, while creating new problems where they previously did not exist. World leaders are chastising us. Innocent people are looking at us in fear. Terrorists are gearing up to use Trump's hate-mongering in their recruitment and anti-American propaganda. We will be less safe, not safer. He will be putting Americans at risk here at home and those traveling abroad. As we do debate Mr. Tillerson's nomination, we cannot lose sight of the fact that he will be carrying out the foreign policy of the most dangerous, unstable, thin-skinned, and inexperienced President we have seen on foreign policy issues and other issues. Is he up to the job? Will he be a voice of reason and stability when times call for reason and stability? Will he resist the forces of war that so easily call out, rather than engage in the hard but necessary work of diplomacy and negotiation? These are critical questions that we must ask and seek answers to as we debate and vote on the most important official in the President's Cabinet. It is clear to me that, unfortunately, Mr. Tillerson will not be that voice of stability, reason, and diplomatic experience that the United States so desperately needs at this time of uncertainty and instability. I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, I yield 15 minutes under my control to the Senator from Massachusetts, Ms. Warren.

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

Mr. CARDIN. Mr. President, as I indicated earlier, this afternoon I had an opportunity to meet with King Abdallah of Jordan. During that conversation with Members of the Senate, there was a good deal of discussion about foreign policy challenges that are very much a part of this debate on Mr. Tillerson. It was interesting to listen to King Abdallah of Jordan talk about his country's commitment to refugees. They have taken in refugees from many parts of that region--from Iraq, Yemen, and other countries. They have taken in over 600,000 refugees from Syria. I think King Abdallah used a number. If you wanted to use a comparable number of refugees coming into America, it would be equivalent to about 60 million refugees coming into our country. Let me remind you that in Syria, President Obama committed to 10,000. It is literally a drop in the bucket compared to what Jordan has done in accepting refugees. It just underscores even more how wrong President Trump's Executive order over the weekend was, which put a hold on our refugee program and restricted travel to the United States. The vetting that goes forward in Jordan in regard to refugees is under the auspices of the United Nations, and of those who are seeking refugee status, a very small percentage--I understand it is less than one percent--will actually ever get a chance to be considered for refugee status here in the United States. Let me remind you that we are talking about, generally, women and children who are fleeing persecution, who have established themselves as refugees. They go through several screening procedures. Their background is thoroughly checked. They check all of the different indices as far as different agencies are concerned to make sure that they have no concern. Then a small percentage of that number actually ever gets to the United States. It takes 18 to 24 months. To date, there hasn't been a single episode of terrorism from a Syrian refugee. We have a pretty strong vetting process--the strongest in the world--that very much puts American security first. It was disheartening for me to listen to King Abdallah talk about the sacrifices his country has made. Of the 650,000 refugees that Jordan has taken in from Syria, the King indicated that about 90 percent are integrated into the Jordanian society. They are not in camps. They are in their schools, in their communities. They have been able to make sure that the refugees are well cared for. It is a huge part of the budget. I think the King indicated that maybe 20 percent of the Jordanian budget deals with refugees. That is a country that understands their regional responsibilities and international responsibilities. The United States has been the leader in the global community, recognizing that the flight of people--the refugees--represents not only a humanitarian requirement for the global community but also security issues. We have to have an orderly process for those who are fleeing persecution, and the United States has always been in the leadership. We have been in the leadership in opening our borders. We are proud of the refugees that came to this country after World War II, from Cambodia, Vietnam, and Cuba. There is a long list of those who have escaped persecution coming here to the United States and helping to build this great country. We recognize that diversity is our strength. This made us the great Nation that we are. For all those reasons, it was very disheartening to hear President Trump's Executive order, where he really questions whether America is committed to its traditional values, whether we are going to maintain our international leadership, whether we are going to be credible when we deal with other countries around the world to take on the responsibilities of dealing with the flight of people who are escaping persecution. I mentioned all this because the Secretary of State is the key diplomat that we have for America and to use America's power of persuasion, of using diplomacy, of using the tools at our disposal under the Department of State, including development assistance for how we can, in fact, promote those values. We need someone who is going to be able to speak out about these policies that were announced over the weekend because they weaken America. They make us less safe. I brought this out: In reality what you are talking about is how do you engage other countries around the world to help us in our war against terror when we tell them that Muslims aren't really welcome here in America and it is a majority-Muslim country? How does that work? How do we protect Americans who are traveling abroad who may be subjected to physical danger because of the statements that have been made by our President? How do you protect this country from the concerns about homegrown terrorism, which might, in fact, be encouraged by the recruitment of terrorists as a result of what the President has done in his Executive order? For all those reasons, it is even more important for us to have as the next Secretary of State a person who is committed to the core values of this country--that it is part of their gut, and that they will be a strong advocate for those issues. I have already indicated during the questioning in the Senate Foreign Relations Committee that we did not see that moral clarity in regard to Mr. Tillerson and in regard to those values. The second issue that came up in King Abdallah's meeting was very interesting. We had a long discussion about Russia and about Russia's influence. We know about Russia's influence in Ukraine. We had a little discussion about Russia's desires in regard to the Baltics and whether the Baltics could be the next Ukraine, as far as Russia's aggression. We know that Russia is already in Georgia. Russia is already in Moldova. Russia is in Ukraine. Do they have their sights now set for Lithuania or Latvia or Estonia or Poland, where there is a large Russian-speaking population? Interesting observations were made that if Russia sees that we don't have resolve, they will use that opportunity to expand their influence. We saw that in the Middle East. We saw how in the Middle East Russia, which a few years ago had very little influence in the Middle East, now has a growing influence in the Middle East--not only in Syria but in other countries in that region where you see Russia's active engagement. So this is not theoretical. Russia's interests are different than our interests. Make no mistake about that. They don't share our values. They are not our friends. They are trying to compromise our democratic institutions. We have seen that over and over--not only the attack on our election system here in the United States, not only the attack on the system in Montenegro in parliamentary elections, but the concern now in Western Europe, as they are entering into the election season. We see over and over what Russia has done in denying space for civil society, in compromising dissent in their own country, in the way that corruption has been established as part of government. All of that is just against the principles that we believe in, that we believe the global community has accepted, and that leads to the stability in nations and advances America's national security interests. I must tell you that there are Democrats and Republicans all talking about the fact that we have to stand up to Russia. We have to be stronger on Russia. Yes, we have been able--thanks to the leadership of the Obama Administration--to take the sanctions that were passed by Congress. We passed the sanctions. The leadership and Members of the Senate and the House have brought about the stronger sanctions regime here in the United States. I congratulate my colleague, Senator Menendez, who was one of the principal leaders to get stronger sanctions here in regard to Russia, and other members of our committee who worked on that. We were able to get stronger sanctions. At the same time, we were able to get Europe to join us in these sanctions, and that helped us. But now there is a concern as to whether these sanctions will remain. President Trump at least has raised that question as to the continuation of sanctions. The question becomes this: Should we be maintaining those sanctions until Russia complies with the Minsk agreement that are relevant to its invasion into Ukraine? But we should also be strengthening those sanctions because of Russia's illegal activities in attacking our country and in what they are doing in Syria in perpetrating war crimes. We should be looking at stronger sanctions against Russia. I mention all of that because the person who can lead us in that effort is our next Secretary of State. We look at Mr. Tillerson and his record as the CEO of ExxonMobil, their relationships in Russia, and his answers to questions as to whether we should consider additional sanctions. Over and over he says: Well, there are multiple considerations. To me, that was a red flag that indicated that maybe there is some business interest here. Maybe, if there is a business interest, we shouldn't let that be more important than the human rights advancements and the other areas that we are concerned about. In reality, we saw that in the way ExxonMobil lobbied against the original sanctions that were imposed against Russia. They lobbied against it because they said it didn't create a level playing field for U.S. companies. The reason it didn't create a level playing field is that the United States is always the leader on sanctions. We always set the international bar as to what we need to do, and then the rest of the world follows us. But if we take the lowest bar, we will never have a tough enough stance against Russia. We need, as the next Secretary of State, a person who is going to be a leader in saying: We are going to use every one of our diplomatic tools to isolate Russia if they continue this activity of interfering with our elections, threatening to interfere with European elections, interfering with humanitarian assistance in Syria, or if they continue their illegal occupation of Crimea. We need that type of leadership. That is one of the reasons we have been so much engaged in this debate. There are many other issues about which we talked with King Abdallah that dealt with foreign policy challenges, including moving forward with broader coalitions against ISIS in the region. All of that requires the use of all the power we have. We know that our military is very strong. We are very proud of our Department of Defense and very proud of the men and women who serve in the military. They are the guardians of our freedom. We thank them every day for the sacrifices they make on behalf of our Nation. We owe it to them to make sure our military is only used as a matter of last resort, that we use all of our diplomatic skills in order to prevent the unnecessary use of our military, that we only use the military when it is absolutely essential and it is a matter of last resort. We must have as our chief diplomat a person who will carry out that strong commitment to our diplomatic skills and agenda in order to make sure that we only use the military when necessary. We have heard this before. But it was General Mattis who said: If you don't fund the Department of State, if you don't give them the resources they need for development assistance, you are going to have to give me a lot more soldiers. Our diplomats can very much keep us safe, and they can do it with less risk to our men and women who serve in the military and at less cost. I suggest the absence of a quorum.

Mr. CARDIN

Mr. CARDIN. Madam President, shortly we are going to be taking up the cloture motion in regard to the confirmation process of Mr. Tillerson to be the Secretary of State for our country. I had the opportunity, as the ranking Democrat on the Senate Foreign Relations Committee, to meet with Mr. Tillerson. I had a chance to talk with him concerning his vision for America. I participated in a lengthy committee hearing, where not only I had a chance to ask him questions but every member of the committee had a chance to ask questions and then had the opportunity to present questions for the Record and look at his responses to questions for the Record. I wish to say, at the outset of this debate before the U.S. Senate, Mr. Tillerson is a successful businessperson. I am certain he has great negotiating skills, as he has shown as the CEO of ExxonMobil, and I think that is an important ability to have if he were confirmed as Secretary of State. I do think he wants to serve our Nation, and he has put forward his ability to serve as Secretary of State for the right reasons. However, I have serious reservations, as a result of this process, this confirmation process, that leads me to the conclusion that I cannot support his nomination, and I will be voting against his nomination. I wanted to at least start this debate by giving some of the reasons I will not be supporting Mr. Tillerson to be the Secretary of State. Mr. Tillerson's business orientation and his lack of moral clarity to questions that were asked during the confirmation hearing, to me, compromises his ability to forcefully promote the values and ideals that defined America's leading role in the world for more than 200 years. When I am referring to the values, they are the values of good governance, the values of standing up for human rights, the values of speaking up for a free press, the values of recognizing the importance of civil societies, which is lacking in so many places around the world. When Mr. Tillerson was asked the question as to how he would characterize what Russia is doing in Syria in supporting a regime that has attacked humanitarian convoys, whether that should be considered as war crimes, Mr. Tillerson was less than clear as to how he would characterize Russia's conduct in Syria. When I asked Mr. Tillerson how he would characterize Philippine President Duterte's extrajudicial killings--this is a President who has authorized individuals to be killed on site without judicial process, which has been well-documented--whether that was a gross violation of human rights, Mr. Tillerson was less than clear as to whether that in fact would elevate to a serious human rights violation. When I asked the question, whether under any circumstances we could have a national registry for any group of religious or ethnic minorities in America, his answer was not as clear as I would have hoped it to be. The answer should have been a simple ``no,'' but he did not give that answer in that moral clarity. For all those reasons, I have serious concern as to whether he will speak with a strong voice on American values or whether that will be compromised for narrow business interests or for other considerations that should not take priority to the values that have made America the great Nation it is. I was concerned about this before what has happened in recent days, but when I take a look at President Trump's first 10 days in office and I look at the Executive orders he has issued as President of the United States, it is even more critical that the next Secretary of State speak with moral clarity as to the values of America. The gag order that was reimposed by President Trump wasn't the same gag order that other administrations have imposed. It is far broader and could prevent U.S. participation with health workers around the world to stop the spread of HIV-AIDS or to deal with the Zika virus or to deal with issues concerning global health issues, maternal health. I want someone, as Secretary of State, to say that America stands for providing the leadership we need on global health issues. More recently, when President Trump announced his Mexican policy; that it would build a wall, he not only asked the taxpayers to pay for it once but to pay for it twice, to build the wall, which almost anyone will tell you will not work. We do have tunnels that we already know could go under walls. It will be expensive, but he is also asking Americans to pay for it twice because he is going to impose a tariff, at least that is under consideration, that middle-income families will end up paying--starting a trade war with Mexico. And why? Why would you start this? Mexico is working with us to stop illegal immigration. They are working with us to stop the illegal trafficking of drugs. They are working with us to build a regional, natural economy that benefits both countries. Why would we pick a fight with our neighbor? It makes no sense whatsoever. The last thing that was done over this weekend points out even more clearly why we need a Secretary of State who will speak with moral clarity, and that was this outrageous, reckless, and dangerous Executive order that would ban certain individuals from coming to America. It would put a hold on our refugee program and would establish a religious test for people coming to America--a Muslim ban. That is not what America stands for. I believe that Executive order is illegal. I know that Executive order will put Americans at risk. I would like to know from our Secretary of State how he, if he is confirmed, would respond when other countries ask: Why should we help you when you will not allow people from Muslim countries the right to visit your country? Why should we give you that information? How will Americans, who are traveling abroad, be treated? It puts all at risk. Our next Secretary of State has to have that credibility to deal with other countries with moral clarity. Time and time again, when confronted with questions, Mr. Tillerson was not clear. Let me give you one example that may sum up my concern on his moral clarity issues, and that is with Russia. We had asked several times whether he would support the existing sanctions, would he support stronger sanctions. After all, the sanctions were put on because Russia invaded Ukraine. They are still there. They are still in Crimea. They are still interfering with eastern Ukraine. Unless they comply with the Minsk agreement, our European allies are looking for America to say no way would we ever weaken our sanctions as long as Russia is violating its commitment in Ukraine. Since that, they have been doing other things. I already mentioned the war crimes they are committing in Syria, but they also attacked America. They attacked us through cyber, trying to bring down our democratic system of government, free elections. I would certainly have hoped Mr. Tillerson would have shown some compassion for increasing sanctions against Russia. Instead, we asked him a question about Cuba, and Mr. Tillerson was very clear when he talked about Cuba. He said: Look, if we do business with Cuba, we are allowing a repressive regime to have greater resources. Why would we want to support a repressive regime? Mr. Tillerson didn't show the same concern about Russia. He has no compulsion at all about doing business with Russia, even though that business is allowing the Putin repressive regime to carry out their activities of attacks against our allies, attacks against us, interfere with what is going on in Syria, and to do all the activities they are doing. I would have hoped that we were seeing a greater sense of moral clarity from our Secretary of State nominee. There are other issues I am concerned about. I know we will have a chance to talk about it if this issue is still on the floor tomorrow, as I expect it will be. We will have a chance to talk about issues regarding his quick use of military power versus diplomacy. We asked him several times about external events and how he will respond to them. His answer was too quick about using our military and not quick enough about using our diplomacy. The use of military must be a matter of last resort. I want to make sure our next Secretary of State is very sensitive to that particular issue. Then we get to the concern about the ethical issues. I need to mention this because when we asked him questions about his knowledge of ExxonMobil, he was less than forthcoming to the committee, not aware of ExxonMobil's lobbying on certain issues, and very unclear about how its activities were in Sudan, Syria, Iran, and other countries that have horrible human rights records. And his willingness to recuse himself from anything affecting Exxon for 1 year, not for the entire length of term that he would be Secretary of State if confirmed by the Senate--he should not deal with ExxonMobil for the entire length of his time as Secretary of State. He is a person who has substantial wealth as a result of his working at ExxonMobil. None of us criticize him for that, but it disqualifies him from dealing with ExxonMobil. We are going to be involved in a lengthy debate on the next Secretary of State, as we should, but I just wanted to share with my colleagues my concern about Mr. Tillerson and why I am opposing his nomination. And I would just indicate that I think the events particularly over the weekend with this immigration policy really point out the need for the next Secretary of State to be willing to stand strong for American values, and I have serious questions in that regard on Mr. Tillerson. With that, I yield the floor.

Mr. CARDIN

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

Mr. CARDIN

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

Mr. CARDIN. Mr. President, shortly we will be voting on the U.S. Ambassador to the United Nations, Nikki Haley. She went through her confirmation hearings at the Senate Foreign Relations Committee, and I had a chance during those confirmation hearings to ask her a series of questions. I have also had an opportunity to meet with her and talk personally about her vision of the United Nations and the United States' role in how she would conduct her leadership at the United Nations. I must say, originally there was some concern because of her lack of foreign policy experience, but I must tell you, I was extremely impressed about her competency as Governor of South Carolina--the work that she did, dealing with some very difficult issues, including a tragedy that occurred in her State, as well as dealing with the Confederate flag and removing it from the State Capitol. She handled these issues with real professionalism and sensitivity to all communities, and during her confirmation hearing, she displayed a willingness to reach out, to understand more about world affairs, and to become fully knowledgeable in these areas. She exercised, I thought, a commitment and passion for the commitments that are important to this country--good governance, human rights, and democracy. I was impressed during the confirmation hearing about her commitment to the importance of the United Nations and the important work that it does. The United Nations, as we all know, does do work as peacekeepers to try to avoid conflicts but also does an incredible job on humanitarian needs with refugee assistance, as well as the sustainable development goals that provide help to people around the world, increasing maternal health, reducing infant mortality, dealing with women's education needs. These original Sustainable Development Goals-- originally the Millennium Development Goals, now the Sustainable Development Goals--have saved millions of lives. I must tell you, Governor Haley was very mindful of this and very committed to the United Nations and the work that it does and the U.S. participation in the United Nations. She recognized that it is important that we engage the international community in the work that is done within the United Nations. When she was questioned about whether she thought it was a good idea to slash funds to the United Nations in order to make a point about votes that we thought were unpopular, she said no. She opposed that slash-and-burn strategy; we need to engage and find ways to leverage our participation to get more favorable results. I might tell you, she was very strong about her sensitivity that the United Nations has not been fair to one of our key allies, Israel, and she would be a strong voice to make sure those types of issues are dealt with and the United States uses all the tools at its disposal to fight against those types of bias and prejudice within the United Nations. We have talked a great deal in our committee about moral clarity from our nominees, so there is no misunderstanding anywhere in the world that the United States stands for human rights, that the United States stands against abuses that take place around the world, and that it will fight for democracy in all parts of the world and support those causes through our diplomacy, through our development assistance, through our tools. She was very clear about the moral certainty issue. Just to give a few examples, we talked a great deal about Russia and its conduct and what it is doing in the United States about the attack on our free election system. She was very clear about how outraged she was with that type of conduct--what Russia has done in Ukraine, its occupation of Crimea. She acknowledged that Crimea is not Russian, that it belongs to Ukraine, and she spoke very strongly about defending Ukraine's rights and sovereignty. We talked specifically about what was happening in Syria and Russia's support for the Assad regime and the atrocities that have taken place in that country, most recently in Aleppo. When we asked if she would characterize that type of conduct as war crimes, without any equivocation she said: Absolutely--that this was a matter that required international accountability. I also brought up with her what was happening in the Philippines, one of our allies, where the President of the Philippines, Mr. Duterte, has done extrajudicial killings and how she would characterize that as gross violations of human rights. She agreed that type of conduct cannot be tolerated, that we need to speak to whether they are friend or foe when they commit this type of conduct, that this is wrong and the United States must stand up for our principles. I was impressed by the way that she spoke to those types of issues. One of the more telling questions that we asked was whether she would support any registry for any subgroup of ethnic or religious Americans, and she said: Absolutely not. We had, I thought, moral clarity in her response to some of the most important questions. I think all of us feel that she has the passion to represent the United States and our views well at the United Nations. What was particularly important to us is how she would speak out to power within the United Nations; that she had no problem in dealing with Mr. Putin and calling his conduct exactly what it was and would not be intimidated by Mr. Putin saying ``Well, you need me for some other issue''; that we have to be clear that we will not tolerate that type of conduct that violates basic human rights. She gave us confidence that, on behalf of the American people, she would speak up in the Cabinet room with Mr. Trump and the Cabinet as to these values. For all those reasons, it was a comfortable vote for me to support her nomination and confirmation. I do want to relay the fact that she does represent the American story. She is a daughter of immigrants who came to this country at great risk in order to seek a better life for their children. She experienced some of the discrimination against immigrant communities as she grew up in this country and tried to participate in the business and political sphere. She overcame all of those types of challenges and is extremely sensitive, I think, to all the needs of Americans. For all those reasons, I am proud to recommend her to our colleagues on both sides of the aisle. I hope we will support her confirmation. I think she is the right person now to represent us at the United Nations. For all those reasons, I will support her nomination. With that, I suggest the absence of a quorum.

Mr. CARDIN

Mr. CARDIN. Mr. President, today I would like to pay tribute to a dear friend, the Honorable Aaron A. Baer, who died yesterday, just 2 days shy of what would have been his 103rd birthday. He was the oldest living judge in Maryland. Judge Baer was known to his family as the ``centennial cowboy'' who had ``a great ride,'' as his family put it. He was a Baltimore native, the son of a Russian immigrant who worked in a clothing factory and became a tailor. Judge Baer graduated from the University of Baltimore Law School in 1937. He supported himself and paid for law school by repairing and replacing tar roofs. Judge Baer practiced real estate law for several years before becoming an assistant Baltimore City solicitor, an assistant attorney general, and a State senator for the 5th District in 1959. He was appointed to the Municipal Court of Baltimore City in 1961 by then- Governor J. Millard Tawes. In 1971, he was appointed to the newly created District Court of Maryland by then, Governor Marvin Mandel. He retired as a district court judge in 1981 at the age of 67. Judge Baer was married to Judy Weinberg for 66 years before her passing in 2007. He and his wife had two daughters. The older daughter is Susan Reichmister, who is married to Dr. Jerome Reichmister. They have two children: Beth, who is married to Bart Casper, and Jodi, who is married to Craig Kessler. The younger daughter is the Honorable Barbara Baer Waxman, who is administrative judge of the District Court of Maryland for Baltimore City. She is married to Dr. Carl Waxman. Judge Baer had four great-grandchildren: Nicole, Sloane, Mitchell, and Blair, and numerous nieces and nephews. The Cardin family is friends with many members of the Baer family. Judge Baer and my parents were close friends. It has been a great privilege to know Judge Baer, to receive his counsel, and to count him not just as a close friend of my father's, but as my close friend, too. Judge Baer lived an exemplary life devoted to public service, the community, and to his family. He started riding Indian motorcycles as a youth and then became an avid horseback rider until he turned 100, which is how he earned the nickname ``centennial cowboy.'' He did have ``a great ride,'' and I am grateful for having been along for some of it. My wife, Myrna, and I send our deepest condolences and prayers to his family.

Mr. CARDIN

Mr. CARDIN. Mr. President, I have said many times that the Senate is a family, and today we are a family in mourning. Tim Mitchell, the assistant Democratic secretary and a 25-year Senate staffer, lost his battle with brain cancer this past Saturday night. It was a battle he waged with uncommon courage and grace. We are disconsolate that such an outstanding person in the prime of his life has been taken from his family and from the Senate. We send our deepest condolences and prayers to his beloved wife Alicia; his cherished son Ben; his father, the Reverend Dr. Philip Mitchell; his sister Christi; and the rest of his family and many, many friends. While Tim spent part of his formative years in Binghamton, NY, he was born in Boston and also grew up in New Hampshire, so he ultimately pledged his sports allegiance to Boston and New England. He called himself a P-K--a preacher's kid. He earned his undergraduate degree from the State University of New York at Fredonia. He earned his juris doctor degree at night while he worked here in the Senate, from Catholic University's Columbus School of Law. Tim loved his family most of all, but he also loved the Senate, and he loved the Boston Red Sox-- I am not sure of the order there; maybe they were tied. He actually acquired two seats from Fenway Park and put them in his basement for when he wanted to watch a game. They were just part of his extensive collection of Red Sox memorabilia, hats, ties, and the like. I don't think any other fan was as excited and as proud as Tim was when the Red Sox won the World Series in 2004, ending an 86-year drought. Tim started his Senate career following his junior year in college as an intern for then-Senator Don Riegle from Michigan. He returned to the Senate after he graduated to work as a staff assistant in Senator Riegle's office, where he quickly displayed his talents and work ethic and was promoted to a job on the Senate Banking Committee. Later, he worked on the special Whitewater Committee. He also worked for former Democratic Leader Tom Daschle, on his personal staff and on the Democratic Policy Committee, before joining the floor staff in 2001. As a member of the floor staff, Tim was intimately involved in every bill, every nomination, every accomplishment of the Senate. Throughout it all, he was always calm, always patient, always courteous, and always exhibiting his innate sense of decency and fairness. He was a parliamentary expert and a trusted adviser. I hope Tim's wife Alicia, his son Ben, and his other family members know just how much Tim was loved and respected here in the Senate. Given the partisan nature of his job, that is, perhaps, the best testament to the type of person Tim was. Our hearts, like theirs, are broken. I hope they may find some solace in these words written by the Reverend Henry Scott Holland, originally as a sermon, but usually reprinted as a poem: Death is nothing at all. It does not count. I have only slipped away into the next room. Nothing has happened. Everything remains exactly as it was. I am I, and you are you, and the old life that we lived so fondly together is untouched, unchanged. Whatever we were to each other, that we are still. Call me by the old familiar name. Speak of me in the easy way which you always used. Put no difference into your tone. Wear no forced air of solemnity or sorrow. Laugh as we always laughed at the little jokes that we enjoyed together. Play, smile, think of me, pray for me. Let my name be ever the household word that it always was. Let it be spoken without an effort, without the ghost of a shadow upon it. Life means all that it ever meant. It is the same as it ever was. There is absolute and unbroken continuity. What is this death but a negligible accident? Why should I be out of mind because I am out of sight? I am but waiting for you, for an interval, somewhere very near, just round the corner. All is well. Nothing is hurt; nothing is lost. One brief moment and all will be as it was before. How we shall laugh at the trouble of parting when we meet again!

Mr. CARDIN

Mr. CARDIN. Mr. President, civilian control of our military is one of the bedrock principles of American self-government. The National Security Act of 1947, U.S.C. Title 10 Section 113(a), stipulates that an individual ``may not be appointed as Secretary of Defense within seven years after relief from active duty as a commissioned officer of a regular component of an armed force.'' President-Elect Donald Trump's choice of retired U.S. Marine Corps General James N. Mattis violates that provision since he has only been out of the uniform for 3 years; thus, Congress will need to pass a waiver so that he can serve if confirmed. I have considered this issue carefully, and I have listened to Gen. Mattis's testimony earlier today before the Senate Armed Services Committee. I believe Gen. Mattis is committed to the principle of civilian control of the military. I was reassured by his testimony this morning, and I will vote to grant the waiver. There is a precedent: in 1950, the Senate voted to confirm General George C. Marshall's as Secretary of Defense, despite the fact that he had been retired for only 5 years. Former Secretaries of Defense Donald H. Rumsfeld, Robert M. Gates, and Leon E. Panetta have expressed bipartisan support for Gen. Mattis. I am willing to vote for the waiver, as long as one nomination does not turn into a trend. There are particular times and circumstances in which granting the waiver may be appropriate, but the bedrock principle of civilian control of our military must not be eroded.

Mr. CARDIN

Mr. CARDIN. Mr. President, on behalf of the people of Maryland, I vote no.

Mr. CARDIN

Mr. CARDIN. Mr. President, may I ask my colleague to yield for just one moment?

Mr. CARDIN. Mr. President, first I want to thank Senator Durbin for his comments about the policy of repealing the Affordable Care Act and not knowing what comes next, the impact it is going to have on people from Illinois. I am going to talk about people in Maryland. I have received similar letters showing that people are going to be adversely impacted. I want to share with my colleagues the conversation I had with the secretary of health from Maryland. Maryland has Governor Hogan, a Republican Governor, and his secretary of health met with me several weeks ago to express his concerns about the impact on the people of my State of Maryland if the Affordable Care Act were repealed. What I heard from the secretary of health of Maryland was similar to what I heard from many of the health care stakeholders from the hospital association to physician groups, to health care advocates, to ordinary Marylanders who have contacted me about their concerns about what happens if we see a repeal of the Affordable Care Act. Let me just give you some examples of how the Affordable Care Act is working in my State and, as Senator Durbin indicated, in his State. The uninsured rate in Maryland has dropped from 12.9 percent to 6.6 percent. That is about a 50-percent drop in the uninsured rate. That benefits all Marylanders--all Marylanders. Yes, 400,000 Marylanders now have health coverage who didn't have health coverage before, and for those 400,000, that is a big deal. That means they can see a doctor and get a physical examination. If they are ill, they can get treated and know there are doctors and hospitals that will want to take care of them because they have third-party reimbursement. They no longer have to show up in emergency rooms because that is the only place they could get to. They can now go to a doctor and get a physical examination. Mr. President, it benefits more than just those 400,000 Marylanders, who, thanks to the Affordable Care Act, have health coverage. It affects all Marylanders because we no longer have the amount of cost shifting of those who have health insurance paying for those who don't have health insurance because they use the system and don't pay for it. That dislocation has been dramatically changed in my State. So all Marylanders are benefiting from having 400,000 Marylanders who now have health coverage, but it goes beyond that. Many Marylanders who had health insurance didn't have adequate health insurance. They had restrictions on preexisting conditions. They had caps on their policies. It didn't cover preventive health care. They now have quality health coverage. All of that is at risk. All of that is at risk because of what we are talking about doing, if I understand correctly. Quite frankly, I am still trying to figure out what the Republicans are doing to the Affordable Care Act, but if I understand it, they are going to repeal it, and they are not going to tell us right now how they are going to replace it. So everything that is included in the Affordable Care Act is at risk. I will give you one more example of costs because I think this is an important point. Under the Affordable Care Act, if an insurance company wants to increase rates more than 10 percent, there are certain procedures they have to go through, certain public disclosures. We have a much more public process, but the number of claims of those who wanted to increase their policies by 10 percent have dropped from 75 percent before the Affordable Care Act to now 14 percent nationally. We have seen one of the lowest growth rates in health care costs in modern history. Yes, the Affordable Care Act has helped us do that. Why? Because individuals who had insurance now have coverage for preventive health care and are saving us money. Those who didn't have health care coverage now have health care coverage, and they are seeing doctors, and they are saving us money because if they have a disease, it is being caught at an earlier stage, being treated in a more aggressive way, and they are saving more intensive health care costs. All that is benefiting the people of Maryland and our country. Senator Durbin mentioned several people in his State--a person in his State--and letters. I want to talk about people in Maryland whom I have talked to over the last several years about the impact of the Affordable Care Act and why they are so concerned about the policy now of repealing the Affordable Care Act. I want to go back to 2007. That is a date that Marylanders know very well. I want to go back to a 12-year-old, Deamonte Driver. Deamonte Driver was a 12-year-old who lived about 10 miles from here. His mom tried to get him to a dentist, but he had no insurance coverage, and she couldn't find a dentist. She couldn't find a dentist who would take care of him. Deamonte Driver needed about $80 of oral health care. He had an abscessed tooth that needed to be removed. It would have cost $80, and he couldn't find care in 2007 in the wealthiest country, in America. As a result, his tooth became abscessed and it went into his brain. He had thousands of dollars of health care costs, and he lost his life. As a result of that incident, I, along with other members of Congress, took up the cause of pediatric dental care to make sure every child in America has access to pediatric dental care. That is included in the Affordable Care Act as an essential health benefit. Before the Affordable Care Act, very few health policies included pediatric dental; therefore, families were at risk as to whether they would actually use dental services because they did not have the money to pay for them. That was changed under the Affordable Care Act. That is at risk. That is at risk because, if I understand what is being suggested here, we are going to repeal the Affordable Care Act and the essential health benefits. We can't allow any more tragedies like Deamonte Driver in America, and yet we will be putting our children at risk if we repeal the Affordable Care Act. There was another provision I worked very hard to get into the Affordable Care Act that I think is extremely important. We now have a National Institute of Minority Health and Health Disparities at the National Institutes of Health. We have agencies that deal with minority health and health disparities in all of our health care agencies thanks to the Affordable Care Act. That means we are now acknowledging that historically we have not done right for minority health in America. We looked at a lot of the research dollars; they were not spent in areas that minorities were impacted by. We see that access to care in certain communities is much more challenging because of minority status. We are looking at these issues and taking action. The Institute sponsored a study in my home city of Baltimore. That study showed that depending on what ZIP Code you live in, your life expectancy could be as different as 30 years--a generation. Just your ZIP Code. We are taking steps to change that in Baltimore thanks to the National Institutes and the Institute on Minority Health and Health Disparities. Are the Republicans telling us that is not needed anymore, that we are going to repeal our efforts to look at minority health and health disparities? That is unconscionable. Yet, if I understand correctly, that is the course we are going to follow. Mental health parity is another area we have talked about at great length here. We know we still have not reached that goal to make sure mental health receives the same attention as any other health need, but in the Affordable Care Act, we did amazing things to expand access to coverage for mental health and drug addiction. By expanding the Medicaid population, we have 1.6 million Americans who now have expanded coverage for mental health and substance abuse. We have had great discussions in this body. I am very proud of the Cures Act, where we expanded coverage for drug addiction. Now Republicans are talking about taking a major step backward by repealing Medicaid expansion that allows access to coverage for mental health and drug addiction. To me, that is something that is unthinkable. Yet we are moving on that path by the legislation that is before us. Let me share a letter I received from Lillian from Baltimore. In 2008 she lost her job. She has a history of abnormal mammograms. She could not get coverage. She could not get an insurance company to cover her because of the preexisting concerns. She wrote: The Affordable Care Act has worked. I have coverage. No preexisting conditions. No longer is being a woman considered a preexisting condition in America. Are we now going to turn our backs on the women of America and allow these discriminatory practices that existed before the Affordable Care Act to come back? I will tell you, I am going to fight to do everything I can to make sure that does not happen, and I would hope my colleagues on both sides of the aisle feel the same. But you are marching down a path that puts women at risk, that puts Americans at risk. We know about the caps that were in the law before the Affordable Care Act. What do I mean by caps? That is the maximum amount your health insurance policy will pay you. Some 2.25 million Marylanders had caps on their policies before the Affordable Care Act--not just the 400,000 new people who have come into the system, 2.25 million Marylanders will be impacted if we eliminate the protection against arbitrary caps. The tragedy about caps is that when you really need coverage, that is when you are impacted. You get insurance to cover you. You discover you have cancer. It is extremely expensive to treat cancer in an aggressive way. All of a sudden, you are in the middle of treatment and you reach your cap. What do you do? What do you do? There are real, live examples from before we passed the Affordable Care Act. We are going to go back to those days in the United States of America? That is what repealing the Affordable Care Act means for 2.25 million Marylanders who are being put at risk. Rebecca from Baltimore told me about her daughter Eva, who is 18 months of age and has severe congenital heart defects and has gone through numerous operations. If caps are in place, she cannot get adequate care for her 18-month-old daughter. Those are real, live examples of people who are impacted by the Affordable Care Act. She also told me: Thank you for the 26-year-old provision where you can stay on your parent's policy. At least she knows Eva will be able to stay on her policy until she is 26. I heard from Nichole, who is a 22-year-old student at Towson University. She could not get affordable health coverage and was able to stay on her parents' policy. That is an important provision which is being repealed by the Affordable Care Act. I helped work on the provision in the Affordable Care Act that provides preventive care coverage--immunizations, cancer screening, contraception, no cost sharing. That saves money. Preventive health care saves money. It makes our health care system more cost-effective. That is why we decided to put a focus on preventive health care and expand it dramatically. Now, 2.95 million Marylanders benefit from the preventive health care requirements of the Affordable Care Act that is included in every health policy. That will be repealed, if I understand correctly what the Republicans are attempting to do on their repeal of the Affordable Care Act. We don't have a replacement. We don't know what it is going to look like. It is not easy to figure out how to put the pieces back together again. There is a provision in the Affordable Act that deals with prevention and public health funds and that provides dollars to deal with some of the real challenges we have out there--obesity, tobacco abuse. My State is getting funds so that we can deal with healthy eating that will not only provide a better quality of life for those who have weight issues but also lead to a more cost-effective health care system. That will be gone with the repeal of the Affordable Care Act. Let me talk for a moment about health centers because I know we made that a priority in the Affordable Care Act. Qualified health centers are centers that are located in, in many cases, challenging communities where it is hard to get doctors and hospitals to locate. We provide access to care for people who have limited means. The Affordable Care Act did two things that are extremely important in regard to health centers. First, it provided some significant new direct resources for those programs. Secondly, because they are in challenging neighborhoods, they have a much higher number of people who have no health coverage who go into these centers; therefore, their third-party reimbursement is much lower than other health centers that are located in better neighborhoods or more affluent neighborhoods. The Affordable Care Act has worked in expanding dramatically the capacities of these qualified health centers. We have 18 that are located in Maryland. I could talk about all of them, but I have been to the Greater Baden Medical Services center several times. It is located in Prince George's County. They also have a center in St. Mary's County. I have been to them many times. I have seen their new facilities thanks to the Affordable Care Act. I have seen the building in which they provide mental health services and pediatric dental care and actually adult dental care also. They provide those services to the community thanks to the Affordable Care Act. They told me that in the very first year alone of the Affordable Care Act, they were able to reduce their uninsured rates by 20 percent, meaning they get a lot more money coming in and they can provide many more services. All of that will be gone if the Affordable Care Act is repealed. I can't be silent about that. This center is providing incredible services. It is one thing to have third-party coverage; it is another thing to have access to care. We provided both in the Affordable Care Act. We are not going to go back. I heard Senator Durbin talk about Medicare. I just want to underscore this. This is not just about those under 65. It is about our seniors. It is about those on disability who are covered by Medicare. We heard about the doughnut hole. We all understood. We were getting numerous letters from people who fell into that doughnut hole. Guess what. Those letters are tailing off dramatically. Why? Because the Affordable Care Act closes the doughnut hole for prescription drug coverage. In my own State of Maryland, 80,000 Marylanders benefited in 2014 from the Affordable Care Act and better coverage for prescription drugs, amounting to $82 million, averaging over $1,000 per beneficiary benefit. Those over 65 have better coverage for prescription drugs. You repeal the Affordable Care Act, and all of a sudden seniors figure out they have to pay another thousand dollars a year for prescription drugs. In my State, they don't have the money to do that. You are going to again hear about prescription drugs left on the counter at the pharmacy because of the repeal. Guess what. It even does more than that. The Affordable Care Act provided greater solvency for the Medicare system. I have heard my Republican colleagues say: We are not going to do anything to hurt Medicare. Repealing the Affordable Care Act hurts Medicare. It hurts the coverage and it hurts the solvency. I don't want to be part of that. I would hope my colleagues don't want to be part of that. Yet repealing the Affordable Care Act does that. Let me talk for a moment about affordability. It is one thing to have coverage; it is another thing whether you can afford that coverage. We heard all of these stories about the increased premiums, and we know, of course, that insurance premiums in America have gone up at a slower growth rate than they did before the Affordable Care Act. That is a fact. But we do hear about the individual market within the exchanges and how that has gone up by a significant amount, mainly because of the way it was originally rated. We have heard about that. But perhaps what many people don't know is that in my State and around the Nation, 75 percent of the people who qualify for private health insurance within the exchanges are eligible for credits. In other words, we are helping them with the affordability of their health care. In my State, that was $200 million a year to help Marylanders pay for health insurance. That will be gone with the repeal of this Affordable Care Act. That is wrong. I received many letters from small business owners. One of the proud parts of the Affordable Care Act is that it helped our small business owners. Why? If you ran a small business, you wanted health insurance for your employees because you wanted to keep them well. You were discriminated against before the Affordable Care Act. You didn't have a big pool. God forbid one of your employees gets really sick during the year; your insurance premium goes through the roof. That is what was happening before the passage of the Affordable Care Act. Are we going to go back to the days where we tell small companies: You really can't get health insurance because if someone gets sick, you lose your policies basically. That is what we are talking about. Annette of Bel Air, MD, wrote to me. She said she has saved significant money as a small business owner as a result of the Affordable Care Act. Tim from Laurel, MD, told me that in his small business, he saved $7,000 a year thanks to the Affordable Care Act. The reason is simple: You have broader pools, and you get the same type of rates larger companies get now. You will lose that with the repeal of the Affordable Care Act. Let me tell you about one of the tragedies of this that will happen immediately, affecting America's competitiveness and entrepreneur spirit. We know that a lot of people who work for big companies have great ideas, and they want to start out on their own. I have seen that over and over again in the biotech industries of Maryland. I go down the 270 corridor, the 95 corridor. I see small entrepreneurs who used to work for one of the giant defense contractors, and now they are pulling out and coming up with new ideas, doing things in a great way. That is what makes America a great nation. That is how we create jobs and how we deal with innovation. Here is the situation. You are a 30-something-year-old, ready to leave that company and go out on your own. Your spouse has cancer. What do you do? You are not going to be able to get coverage. You are locked into that job. That will be a consequence of the repeal of the Affordable Care Act. We are dealing with real people and real people's lives. It is irresponsible to repeal the Affordable Care Act and not tell that young entrepreneur what he or she can expect. That is what is at stake. There is one last point I want to talk about, and that is the Patients' Bill of Rights. I helped draft the Patients' Bill of Rights. It was not easy to pass the Patients' Bill of Rights. We were able to get it in the Affordable Care Act. We were able to get in the right that--you go to an emergency room. Under a prudent layperson standard, you did the right thing. You find out you didn't have that heart attack even though you had chest pains. Then you wake up the next morning and find out your insurance company is not paying the bill because you didn't have that heart attack. We changed that in the Affordable Care Act. Are we going back, eliminating those protections, the right to appeal decisions or are we going to repeal that part of the Affordable Care Act? Are we going to go back to medical loss ratios, where insurance companies can make obscene profits and not rebate those excess profits to their policyholders when we have millions of people receiving rebates today? All of that is gone with the repeal of the Affordable Care Act. Mr. President, I could go on and on, but I see my colleague Senator Kaine is here and others who want to speak on this issue. Let me conclude with this. This is the wrong way to go about this. I heard the leader say that for 6 or 7 years--for 6 or 7 years--Democrats have been trying to work with Republicans to make the law even better. We have never passed a major law that didn't need to be revisited. We understand that. We have been working to try to improve the law--not repeal it--improve it, build on it, make it better, and we have gotten no help from Republicans, not any help whatsoever. Republicans have blocked efforts to improve this law. Instead, they are stuck on this repeal without knowing what the replacement is going to be. That is wrong. We should be working together to improve our health care system, but to pass a repeal, to put Americans at risk will lead to uncertainty, which will lead to insurance companies abandoning the market, giving consumers less choice rather than more choice. To hurt millions of Americans is wrong, and I urge my colleagues to reject this approach. I yield the floor.