Bob Casey

Mr. CASEY

Mr. CASEY. Mr. President, this amendment deals with three basic issues. The first is the issue of preexisting conditions, the second is the issue with regard to discrimination as it relates to health status, and the third issue is with regard to caps on coverage. The first issue is we want to make sure no action is taken in the Senate that would have the effect of limiting access to care for those individuals with preexisting conditions. That is No. 1. No. 2, we want to make sure we don't place any lifetime caps on health insurance coverage for individuals with a disability or with a chronic condition. No. 3, we want to make sure health plans will not discriminate on the basis of either the individual's physical health, their mental health, or their disability status. This is the right thing to do for health care, and I urge an affirmative vote on this amendment.

Mr. CASEY

Mr. CASEY.--on behalf of the children of Pennsylvania.

Mr. CASEY. I vote no--

Mr. CASEY. Madam Clerk, how am I recorded?

Mr. CASEY

Mr. CASEY. Mr. President, I rise this evening to speak about the Republican effort in the Senate, by way of a budget resolution, which includes so-called reconciliation instructions to repeal the Patient Protection and Affordable Care Act, in this case, unfortunately, without any replacement for that legislation we passed a number of years ago. In a word, I think this is a plan for chaos--chaos certainly for insurance markets but more particularly chaos and damage done to middle-class families whose costs will go up. Of course, their coverage will be affected adversely. A repeal act without replacement would raise the price of prescription drugs for older Americans across our country, put insurance companies back in charge of health care, cost our economy millions of jobs, and devastate funding for rural hospitals and rural communities in Pennsylvania and across the country. I think, on a night like tonight, where we are just beginning a long debate about how to bring affordable care to Americans and how to continue that, we should reflect back on where things were before the Patient Protection and Affordable Care Act. Over 50 million Americans were uninsured in 2009--50 million people. People with any sort of medical condition were routinely denied health insurance or were charged exorbitant rates because of their health histories. Women in the United States were routinely charged more than men for their health insurance. This is not an exhaustive list. Finally, individuals who were ill were routinely dropped from their health care coverage because they had reached arbitrary caps on the amount of care an insurer would pay for a given year. So let us talk about what has happened since then. Since the passage of the Affordable Care Act in 2010, we have come a long way. More than 20 million Americans, including almost 1 million in Pennsylvania, have received health insurance as a result of this one piece of legislation. One hundred five million Americans are protected from discrimination due to preexisting conditions. Those are 105 million Americans with preexisting conditions who are no longer barred from treatment or coverage as they were before. Nine million Americans have received tax credits to help them cover the cost of their insurance. Eleven million seniors have saved over $23 billion from closing the Medicare Part D prescription drug plan's so-called doughnut hole. Doughnut hole is a benign way of saying burn a hole--costs that were burning a hole in the pockets of America's seniors. Finally, hospitals in States like Pennsylvania are getting a lot of help due to the legislation. In Pennsylvania, our hospitals have saved $680 million due to reductions in uncompensated care. I think, in the end, most of this is about real people and real families and their real lives and, unfortunately, the real consequences that would adversely impact their lives. Among the 3 million Pennsylvanians with preexisting conditions, there are two remarkable young women whose mother first contacted me in 2009--Stacie Ritter, from Manheim, PA. Stacie is a mother of four children, including twin girls, Hannah and Madeline. That is a picture of Hannah and Madeline a number of years ago. Hannah and Madeline were diagnosed at the age of 4 with a rare and dangerous type of leukemia, at such a young age. Stacie and her husband went bankrupt. They literally went bankrupt trying to pay for their daughters' medical bills. She wrote to me at the time, saying that without health care reform ``my girls will be unable to afford care, that is if they are eligible for care that is critically necessary to maintain this chronic condition. Punished and rejected because they had the misfortune of developing cancer as a child.'' So said Stacie Ritter, one mother in one community in Pennsylvania in 2009. She was talking about her daughters being punished and rejected, as if they had any control over the cancer they were diagnosed with. Fortunately, Hannah and Madeline are healthy young women today. Madeline and Hannah are freshmen at Arcadia University and are doing well. The Affordable Care Act protects them by assuring they will have access to affordable coverage, whether on their parents' plan or on a plan in the market. Because of their medical histories, they have ongoing health care needs, and they don't know what they would do without the Affordable Care Act. Here is a picture of them today, and you can see what a difference health care makes in the life of a child--in this case, the life of two children who are now young women and in college. I don't even want to think about it, but we should think about what would have happened without this legislation. We should not ever put children and their families in that circumstance. If you are talking about a new plan, you better have a plan that would cover children like Hannah and Madeline, and you better be able to pay for it. You can't just talk about it. You can't just promise it. You have to be able to pay for it, as we did in this legislation. While we are on the question of costs, let's talk about it in human terms--human terms meaning young women like Hannah and Madeline. We have heard an awful lot from Republican Members of the Senate and Republican Members of the House of Representatives. They have been promising to come up with a ``better plan'' than the Affordable Care Act since 2010. Since March of 2010, when this passed, you would think that by now they would have a plan--a plan that would replace what they had repealed. That is part one. Part two is a plan that is better, because that is what they promised. They used other words to describe it as well. Now almost 7 years later--and it will be 7 years in March--where is their plan? I don't think anyone has been able to find their plan. Some Members of the Senate on the Republican side of the aisle have said recently that they have a plan but they haven't released it yet, or they have parts of a plan or different plans but they are putting them together, and we will see them soon. Others don't seem to know whether there is a plan or not. So they promised to replace the Affordable Care Act only after they repealed it and only after millions of Americans would lose their insurance. Where is the plan after 7 years? You would think, if you were serious about a matter of public policy--something as substantial and as consequential in the lives of families--that after 6-plus, almost 7 years you would have a plan ready to go, and that plan would be comprehensive, and that plan would cover at least 20 million people, maybe more. That plan would have all the protections that I spoke of earlier. Young women like that, when they were children, would not have their treatment capped. Someone with a preexisting condition would be protected. Women would not be discriminated against. All of those protections, including the coverage, would be part of that plan--you would think. It seems as if to find the Republican plan here in Washington, you would need to hire a really good private investigator to look in every corner of Washington. Maybe it is in some of the desks here. Maybe we just haven't found it yet. So far, there is no plan--no plan. There is a lot of talk and a lot of hot air about repeal but no plan. What does the Brookings Institution say? They say that the number of uninsured Americans would double if the act is repealed. To be precise, that would leave 29.8 million people without insurance. It would go from 28.9 to 58.7 million people. I started tonight talking about 50 million uninsured in 2009. If you repeal this legislation and you don't replace it with something that is very close to comparable, that means you no longer have 50 million uninsured like we did in 2009, you have 58.7 million--let's round it off to 59 million Americans without insurance--despite all the gains we have made in the last number of years. What does that mean for Pennsylvania? Since the bill was passed, 956,000 Pennsylvanians stand to lose their coverage because that is how many have gained it. The Congressional Budget Office, which is the Congress's referee or scorecard, estimates that insurance premiums would rise by 20 percent if the act is repealed without a replacement. The Commonwealth Fund, in a recent report, estimated that repealing the act would cost our economy 2.5 million jobs per year--not over 5 years or 10 years but 2.5 million jobs per year. Pennsylvania is a State where, despite having huge urban areas in both Philadelphia and Pittsburgh and a lot of cities in between, we have millions of people literally that live in so-called rural communities, rural counties. By one estimate of our 67 counties, 48 of them could be categorized as rural counties. We have a lot of people who live in, make their living in, and work very hard in rural communities. One of the headlines that caught my attention last week was from the Fiscal Times. This is from January 5. You can't see it from a distance, but the headline reads: ``Obamacare Repeal Could Push Rural Hospitals to the Brink.'' It is all focusing on rural hospitals and the cost of repeal. We know that a couple of years ago there was a report by First Focus that focused specifically on rural children and their health care. Here is what the conclusion of that report was. As of 2012, the year they examined, Medicaid and the Children's Health Insurance Program covered 47 percent of rural children, compared with 38 percent of urban children. Almost half of rural children, as of this report, received their health care from Medicaid or the Children's Health Insurance Program. Both would be adversely impacted by both the repeal of the Affordable Care Act and the implementation of the House Republican budget, which I think is the most extreme budget ever proposed in Washington. That is the reality just for rural children and their health care and, also, the predictions about what will happen to rural hospitals. A lot of people employed in Pennsylvania--tens of thousands--are employed in rural hospitals in our State. One of the individuals who contacted us to talk about this issue in the context of being in a somewhat rural community but someone who is actually doing farming--and, of course, farming does not occur just in rural areas--is Julia Inslee, from Coatesville, PA. That is in Southeastern Pennsylvania, where we have a lot of farms, as well, just like we do in the middle of the State and in the western, northeastern, and northwestern part of the State. Julia turned her family's hobby farm into a full-time operation. Here is what she wrote to her office in November. I am one of the millions of people who have benefited greatly from affordable access to health care. I work part time as a tutor at a community college and nearly full time as a farmer. Neither one of these jobs provides me with health care, nor do I make enough to pay several hundred dollars in premiums per month. The government subsidy is what makes it possible for me to have healthcare. If Obamacare is taken away, I will most likely have to give up farming, and if anything, we need more farmers, not fewer. That is what she says. ``If Obamacare is taken away, I will most likely have to give up farming.'' Why would we do that? Why would we say that to someone who has achieved success in any profession or any job or any career--but especially something as fundamental to the economy of Pennsylvania? By one estimate, our largest industry is agriculture in Pennsylvania. Why would we say to that farmer: They have this idea to get rid of legislation in Washington. You are just going to have to come up with a new profession. Why would we force people to give up farming in order to meet the demands of some people in Washington? Julia is facing the likelihood, if the act is repealed, of losing her ability to support herself because her insurance would be too expensive. I have to ask: Is this a ``better plan''? Is this what Republicans have come up with? We shall see. Rebecca Seidel is a dairy farmer as well. She is from Douglassville, PA. Rebecca co-owns a herd of dairy cows, and she talked with me just last week about how dangerous farming can be and how scary it is not to have insurance. She says: As the daughter, granddaughter, and great-granddaughter of Pennsylvania dairy farmers, I've seen my share of agricultural catastrophes. Between equipment and large animals, every day comes with potential hazards. Will I break a rib getting between two cows who are fighting? Will a blade come loose from the bedding chopper and hit me? Will my hand be broken through miscommunication with someone operating the skidloader? These are realities with which I live every day and I am able to go about my job bravely because I know none of these events would financially destroy my family. She said the Affordable Care Act allowed her to work, and she wrote: Threats to the ACA are threats to our future, Senator, and to the future of small businesses, agriculture, and families. Rebecca and her husband don't know what to expect with repeal of the law. They want to start their own business, allowing their current employer to hire more people, but they don't know what they will be able to afford in such an environment of uncertainty. Rebecca and her husband don't know if they will be able to realize their plans to start a new business. How is this a better result for them, we would have to ask. Finally, we have a story of a businessman, Anthony Valenzano. Anthony is a small business owner who has been successful with the hard work of one employee who purchases an affordable and comprehensive plan through Pennsylvania's health insurance marketplace. This is what Anthony said as a small business person: It is my opinion that the Affordable Care Act is the best thing the federal government has ever done for a real small business like mine. This bill paved the way for entrepreneurs to strike out on their own, knowing that they have a way to get health insurance. The bill allowed these entrepreneurs to attract professional employees who would otherwise have never left a corporate job to join a small startup. His business relies on his one employee--in this case, he has one who is central to his business--being able to purchase affordable health insurance, since, with only one employee, he cannot get her on employer-sponsored coverage. He said, ``Looking forward, we plan to do even bigger and better things, but she still needs health insurance to do it, and if we lose the Marketplace, iQ Product Design will likely lose its key employee and will be unable to create the next big market- changing product.'' He is asking: What is going to happen? Is there a replacement plan? What happens to his employee? What happens to his business? We have a long way to go to debate these issues. But I have to ask again, if there is such a better idea here after almost 7 years now, where is this replacement plan? We haven't heard one word about the details of it. Where is it? I think that is what a lot of Americans are asking. We know what Republicans want to do: Repeal the Affordable Care Act or patient protections in the Affordable Care Act for all those people with insurance who had much better protections solely because of this legislation. Mr. President, I yield the floor.

Mr. CASEY

Mr. CASEY. Mr. President, today I want to pay tribute to two colleagues who are retiring at the end of this year, Senator Boxer and Senator Mikulski, two remarkable Democratic women Senators leaving the Senate as four new women come in. Barbara Boxer Mr. President, for more than 40 years, Barbara Boxer has committed her life to public service, over 30 of them in Washington, first in the House of Representatives and, since 1993, in the U.S. Senate. When asked what advice she would give to her successor, Senator Boxer said she should not be afraid to fight the good fight every single day. And that is what Senator Boxer has done. Over the past four decades, she has been an advocate for medical research, women, workers, the environment, and infrastructure. As ranking member of the Environment and Public Works Committee, Barbara Boxer urged Congress and the country to confront climate change, creating the Climate Action Task Force with Senator Sheldon Whitehouse. In closing, I am reminded of what Robert Kennedy once said: ``The purpose of life is to contribute in some way to make things better.'' Senator Boxer has told us that, while she is leaving the Senate to return to California, she does not intend to end her life of service. She will continue to work to make things better. We wish her well and we thank her for her public service in the House and here in the Senate. Barbara Mikulski Mr. President, this year we are also saying farewell to our colleague, Barbara Mikulski, the senior Senator from Maryland. Senator Mikulski first entered politics almost 50 years ago when she was elected to the Baltimore City Council in 1971. Five years later, she was elected to the U.S. House of Representatives and, a decade after that, she was elected to the U.S. Senate. Senator Mikulski is the longest serving woman in the history of Congress and is the first woman Senator to be elected in her own right. These achievements are notable, but they are not what inspired Barbara to come to work every day. Senator Mikulski one remarked that, ``Each one of us can make a difference. Together, we make change.'' And that is what Barbara Mikulski sought to do every day. As a member of the Health, Education, Labor and Pensions Committee, Senator Mikulski has championed education, workers' rights, and health care. She has stood up for our children and our seniors. As a member of the Appropriations Committee since she arrived in the Senate, Barbara Mikulski has worked tirelessly to ensure that the programs that advance those priorities receive the funding they need to be successful. Margaret Chase Smith once said, ``Public service must be more than doing a job efficiently and honestly. It must be a complete dedication to the people and the nation.'' Senator Mikulski dedicated her life to the people of Maryland and the country. We will miss her in this Chamber and wish her well.

Mr. CASEY

Mr. CASEY. Mr. President, I want to thank my colleague from West Virginia for his leadership on this issue, going back not just days and weeks but months and even years. I think we should start with the word ``promise'' tonight. We have a matter that came before the Senate that Senator Brown indicated was the subject of a bipartisan consensus that went all the way through the Finance Committee, a vote of 18 to 8 earlier this year. The question before the Senate today and the question before the Senate in 2017 will continue to be: Will the Senate--and I would add will the House of Representatives--keep our promise to these coal miners and their families? It is really not more complicated than that. We have to ask ourselves whether we are going to fulfill our promise. Just to give you a sense of what this means to individuals, I have three letters in my hand. We have all gotten hundreds of them, if not more, maybe thousands at this point. But I have three letters from three different counties from which I will read excerpts. The first one is from Johnstown, Cambria County, with a great history of coal mining but also a great history of a diverse economy. This individual wrote--actually two; it is a husband and wife writing to me--saying: ``We are in our late 70s and desperately need our pension and hospitalization.'' Cambria County, PA, alone has 2,483 pensioners. Just that one county has that many pensioners who happen to be families who had a loved one working in the coal mines. This is one of those families who wrote to me. If you look at the health care issue and you look at it county by county, sometimes the numbers are lower, but it is in the hundreds and hundreds in many counties. The next letter is from an individual in Green County. She is writing about her husband, and she says: My husband was only retired about 1 year when he found he had cancer. One of the reliefs that he had while battling cancer was knowing he had his pension and good health benefits. So it was one less worry. Green County is a small county in Pennsylvania, in the deep southwest corner, right on the corner next to West Virginia and Ohio. In Green County, there are 1,436 pensioners and many depending upon the health care promise that our government made. The third and final letter is from Westmoreland County, from an individual talking about his time in the coal mines. He said: My 33 years in the mining industry are testimony to the fact that I provided a needed service to my country and my family. Then, later in the letter, he goes on to say: Now, thousands face an uncertain future. A promise was made and a promise needs to be kept. In Westmoreland County, PA, there are 1,067 pensioners. Across our State, just on health care, almost 1,400 Pennsylvanians are affected by health care. Some of them have cancer. Some of them have a family where the husband is dead and the wife has cancer. Some face the kind of health care circumstances that none of us can identify with because everyone who works--every Member of the Senate and the House--we have health care. We don't have to worry about next week or next month or next year. So the question becomes, as I said, whether we are going to keep our promise to these coal miners. There is no excuse for putting in the continuing resolution as pathetic a proposal as we got this year in this continuing resolution, which basically says: You have health care for just 4 months, and you are supposed to be satisfied with that. In fact, I think there was one Member of the Senate who said, ``They should be satisfied with that''. They should not be satisfied; coal miners and their families, retired coal miners, nor should anyone here be satisfied with that. Also at the same time, the proposal--or I should say now the policy in the continuing resolution--has no fix at all for pensions, so these counties, just three counties, that have thousands and thousands of pensioners who earned that pension, who gave up a lot to get that pension, who gave up a lot to get those health benefits--there is no fix in the CR, the continuing resolution, for the pension problem. We are supposed to be satisfied, and they are supposed be satisfied, I guess, according to the line of argument from some on the other side--not all, but some who said they should be satisfied. Well, here is a news bulletin. We are not satisfied. These miners and their families are not satisfied. We are not going to stop fighting on this. We feel so strongly about this issue that many of us, including me, will vote no on cloture on the CR, will vote no on the CR itself because we feel that strongly. As the presiding officer knows, usually when a continuing resolution comes before the Senate, it gets overwhelming support. This is how outrageous this is for these families. So you are going to see a number of people on the floor here do something they probably have never done before. They are going to register a protest in a very direct and formal way, to say no to the CR tonight. I know some people will be offended by that. I understand why they might be across the country. But we have to ask ourselves: If it is going to take a no on this resolution to get people to focus on what these miners were promised and what this government has not done to meet that promise, then we are willing to go to that length and to that extent to vote no tonight because we have to keep a focus on this. We are not going away, so for anyone who thinks that tonight is the end of a chapter, we are just getting warmed up. We are just getting warmed up on this because this is a promise we must keep. These miners and their families kept their promise. The miners kept their promise to their family that they would work and work in the depths and the darkness of the coal mines, put their lives at risk every single day. That is the first promise they made--and that they would bring a home a paycheck so their family could eat every night and afford a mortgage. So they kept their promise to their family. Many of them kept their promise to their country. They fought in World War II, they fought in Korea, they fought in Vietnam and beyond, in every war we have had in the modern era. So they kept their promise. It is not too difficult for a Senator or for a House Member to keep their promise. All they have got to do is put their hand up and say aye. I agree with keeping the promise to these miners. It is about time that our government, including everyone here, kept our promise to these coal miners. So we are doing something that many of us have never done. We are going to vote no on a resolution tonight to make it very clear that we don't agree with what is in this continuing resolution with regard to these miners, No. 1, and the other massage we are sending is that we are coming back. We are going to come back week after week, month after month, if not longer, to make sure that they get their health care and they get their pensions. So, this kind of solidarity, at least on this side of this aisle, will remain intact. It will remain fortified and strong going forward. I yield the floor.

Mr. CASEY

Mr. CASEY. Mr. President, today I wish to honor the career of Mr. Bryon J. Young, executive director of the Army Contracting Command--Aberdeen Proving Ground (ACC-APG). Mr. Young will be retiring after 40 years of distinguished service to the country. Throughout his career, Mr. Young has proven himself a true public servant and his leadership will be truly missed. I would like to take this time to send my congratulations to Mr. Young on his retirement and reflect upon his long career, exemplified by his hard work, dedication, and passion. Mr. Young dedicated his career to the defense and service of his Nation and his fellow citizens. A graduate of the University of Delaware and Boston University in the 1970s, Mr. Young went on to complete degrees at the Defense Systems Management College Program manager's course and executive program manager's course, as well as the U.S. Army War College and the U.S. Army Command and General Staff College. Prior to his time with the Army Contracting Command, Mr. Young served for 27 years as an air defense officer in the Army with the 101st Airborne Division and as an ROTC instructor at Princeton University. Throughout his career, Mr. Young has displayed a commitment to excellence, and his numerous commands over the years are a testament to his work ethic and dedication. Among his many commands, Mr. Young has served as director of the U.S. Army Research Development and Engineering Command Contracting Center, director of the U.S. Army Contracting Agency in Falls Church, Virginia, chief of staff to the Army Contracting Agency, commander of the Defense Contract Management Agency Raytheon, and procurement team chief of U.S. Army Missile Command. Mr. Young's years of service and experience have benefited not only those around him, but the Nation as a whole. In his most recent role as executive director of the Army Contracting Command--Aberdeen Proving Ground, Mr. Young managed a geographically dispersed contracting center responsible for executing more than 35,000 contracting actions valued at $11 billion. Mr. Young's dedication to the Armed Services and our country are evident not only from his four decades of service and leadership, but also from his numerous decorations, which include the Defense Superior Service Medal, Legion of Merit, Defense Meritorious Service Medal, Meritorious Service Medal, Army Commendation Medal, and the Army Achievement Medal. Throughout his long and distinguished career in public service, Mr. Young has always placed his community and country first. We are all grateful for his dedicated service which will long be remembered. On behalf of the Commonwealth of Pennsylvania and a grateful Nation, I would like to once again extend my congratulations to Mr. Young on his retirement and thank him for his decades of public service. I wish him all the best in the years ahead.

Mr. CASEY

Mr. CASEY. Mr. President, it is an honor to be here today. I was thinking about what I would say today and making it as brief and as personal as I could. I have to say that on a day like today it is difficult. We all have the privilege of being able to go to this floor on a regular basis to talk about issues, to talk about our country, and to talk about the world, but we also have one of the great privileges to talk about those with whom we have served and for whom we have great respect. This is one of those moments. It is of great significance for me that I am able to stand on the floor of the Senate as a native of and as a resident of the city of Scranton in Lackawanna County to talk about a son of Scranton. I know this is a pretty big day for Delaware--Delaware's No. 1 citizen and on this historic day for Delaware. But I have to say I am so grateful to be able to say on behalf of the people of Scranton and Lackawanna County in Northeastern Pennsylvania how proud we are today to be able to pay tribute to Vice President Joe Biden. There is so much to say about that history, so much to say about what it means to be able to stand on the floor and talk about his record, his life, his achievements, but mostly to talk about who he is. When I consider what he has contributed to our country, to his State, and to the world, it is difficult to encapsulate it. I tried to jot down a few notes to remind myself of how best to encapsulate that life. I guess I would start with the word ``integrity.'' It may be a word that we take for granted, but it is a word that has to be part of the life of a public official. I would say in the case of Joe Biden, he has the kind of integrity that is uncommon--uncommon not because it is a rare trait but uncommon because it is so much a part of his whole life. He was a public official with integrity, and we hope he is again when he might consider public office again. But he is also a person of great integrity when it comes to the fights he has had to wage on behalf of people without power, the work he has had to do as a public official infused with that kind of integrity and, at the same time, the same kind of integrity we expect from a family member and a friend. So I would start with that word. Certainly the word ``compassion'' comes to mind. Every one of us can tell a story. I was hearing stories just yesterday from a colleague about a phone call the Vice President made over the last couple of years to someone who was grieving, who was in the depths of the darkness of grief, and the phone call he made to that person. I have heard stories over the years about not just phone calls but visits with people, stopping into a funeral home for a long lost friend who had lost a loved one, letters he has written. I know a personal friend who lost his wife and his sons had lost their mom and what the Vice President wrote to them just this summer. Over and over again, he has demonstrated that kind of compassion. I can remember my own case in a very personal way. It was only an election loss. I ran for Governor of Pennsylvania in a primary. As many of my colleagues know, primaries are particularly difficult. I lost badly. No one called on Wednesday after Tuesday. One reporter showed up at my door, and I opened the door and I really couldn't say much to this reporter, but I was grateful she was there. But I got one phone call on Wednesday--maybe a couple of family members; I come from a family of eight. I think my wife was talking to me, but other than that, the only person who called me was Joe Biden. He made some kind of grand prediction--I thought he was just being nice--that I would somehow come back. But he was right. And he made me feel much better that day. He may not remember it, but I will remember that for the rest of my life. I think certainly when we think about the Vice President, we could center on another one word: ``justice''--an abiding and enduring commitment to justice. His whole public life could be summarized in that word and the commitment he has had to justice. We could quote from the Bible: ``Blessed are they who hunger and thirst for justice, for they shall be satisfied.'' I am not sure Joe Biden has ever been satisfied yet with justice. He is always pursuing it, always trying to bring justice to a problem or to a situation or to the life of a fellow citizen. We think of what Saint Augustine said about justice a long time ago, but it still bears repeating: ``Without justice, what are kingdoms but great bands of robbers?'' That is what Saint Augustine said hundreds of years ago. Joe Biden has lived his life as a public official and as a man, as a citizen, with that same burning desire to bring justice into the dark corners of our world. And he knows that without that justice, someone is, in fact, robbed of so much--robbed of their dignity, robbed of their safety, robbed of a full life. But I think I would say that maybe the best line, with all due respect to the Scriptures and to Saint Augustine, was one my father said. He wrote it down years ago, but he probably gave maybe the best description of what a public official should be about. I am not sure I have ever attributed this to anyone else but him. He said the most important qualities a public official can bring to their work are two things: No. 1, a passion for justice--which, of course, Joe Biden has in abundance--and a sense of outrage in the face of injustice; that if you have both of those, on most days, you are going to get it right. And his life as a U.S. Senator for 36 years, as Vice President for 8 years, and as a citizen for all of those years and more, has been about that passion for justice and a sense of outrage in the face of injustice. We all know his record; we don't have to recite all of it. From the Violence Against Women Act, which we know is an acronym--VAWA--but it doesn't do justice to the name of what that meant. So many today have talked about how he saved the lives of women and families because of that legislation. So from VAWA to ARRA, as we call it--the American Recovery and Reinvestment Act, the act that helped dig this economy out of the ditch it was in and rescued this country and improved the lives of so many people--he not only worked to get it passed, but then he made sure it was implemented. It might be the most popular piece of legislation 25 years from now when people really appreciate what happened with the Recovery Act. From diplomacy, to law enforcement, to not just supporting our troops, not just working on legislation and supporting them not only when his son was a member of our Armed Forces but long before that, to what he did very specifically to protect our troops--we know the scourge of IEDs, which was the No. 1 killer of our troops in Iraq and in Afghanistan. A lot of those troops' lives were saved because of Joe Biden up-armoring vehicles and doing all the work he did to protect our troops. So whether it was national security or security on our streets, whether it was protecting women who would be the subject of abuse or helping children or improving our economy--on and on--we could talk about that record. But just as you can't just list achievements in a record and encapsulate what it means, so the same is true of a 36-year career in the U.S. Senate and then 8 years as Vice President. Lincoln probably said it best. Lincoln said, ``It is not the years in your life that matters, in the end, it is the life in those years.'' And that is, I think, true of Joe Biden as well. Two more points. One of the best qualities of the Vice President as a man especially but also as a public official is his sense of gratitude. If you knew him for half an hour or for your whole life, you know that almost always he is speaking about people in his life who made him who he is today, whether it is his mother and father or whether it is his whole family, including brothers and sisters and his sons and daughters and, of course, Jill. It is a reminder of how grateful we should be. In so many ways, when you hear Joe Biden speak, his speeches tend to be, on many occasions, a hymn to gratitude, and that comes through all the time. We know how much he suffered with all of the losses he has sustained. I was talking to him recently at an event in Scranton about his son Beau and his life and what a patriot Beau Biden was. I think today we can say the following about the Vice President: This is a man who was a great, great Vice President. This is a man who was a committed and very effective U.S. Senator, but maybe most important, he has been a faithful son, a loving and proud husband and father, and a patriot. Thank you, sir, and God bless you.

Mr. CASEY

Mr. CASEY. Mr. President, today it gives me great pleasure to congratulate Morey and Sondra Myers of Scranton, PA, on their 60th wedding anniversary. Morey and Sondra have dedicated their lives to each other and their family, inspiring all of us through six decades of devotion to one another and have established themselves as true citizens dedicated to philanthropy. I congratulate Morey and Sondra on this anniversary of their lives together. I have had the honor to know both of them for 40 years, and I have benefited greatly from their loyal friendship. Sondra and Morey have come to embody the spirit of public service, and I have no doubt that Pennsylvania and the Nation are better places due to their hard work, dedication, and passion. Sondra and Morey served the people of Pennsylvania during my father's time as Governor of Pennsylvania. Sondra was cultural adviser to the Governor and Morey served as general counsel. The Commonwealth benefited greatly from their hard work and exemplary service. Sondra Myers is currently a senior fellow for international, civic, and cultural projects at the University of Scranton and the director of the Schemel Forum. She has made it her life's work to bring about the integration of culture into public policy and to strengthen the culture of democracy worldwide. She has served as the chair of the Pennsylvania Humanities Council, president of the Federation of State Humanities Councils, and was the founding president of Citizens for the Arts in Pennsylvania and the State Arts Advocacy League of America. Her work ethic and passion were called upon in 1980 when President Jimmy Carter appointed her to serve on the U.S. Commission of Fine Arts and again in 2011 when President Barack Obama appointed her to serve on the Commission on Presidential Scholars. A frequent contributor to the Scranton Times-Tribune's opinion page and the author and editor of several books, Sondra has worked hard to eloquently spread her message of the central role that citizens play in a successful democracy and the crucial role of higher education in preparing an engaged citizenry. Sondra has traveled throughout the world to present programs on democracy and civil society, and through her numerous published works, symposia, lectures, and personal relationships, she has spread her influence to a wide array of countries, cultures, and people. Morey Myers is one of the most respected lawyers in Pennsylvania, with decades of legal experience which began with his graduation from the Yale University School of Law. His career continued to grow through his time as general counsel and remains active today as a partner in the Scranton law firm of Myers, Brier & Kelly LLP, which he helped to found. He has served as adviser and counsel to businesses and governments, leaving his indelible mark on countless lives and causes. His dedication to the rule of law and social justice were forged in the 1960s when, during the Civil Rights movement, he travelled to the South to provide legal services for those taking on the forces of segregation and racism. He has served as consultant to the President's Commission on Campus Unrest, Pennsylvania assistant attorney general, chief counsel to Pennsylvania's Milk Control Commission, and he currently serves as a fellow for the American Bar Association. He has remained active in academia as a visiting lecturer at Yale University, Rutgers University, the University of Scranton, Haverford College, Hamilton College, the University of Wyoming, Lafayette College, and Temple University. This brief overview of the lives of Sondra and Morey Myers cannot fully encompass all they have accomplished, nor adequately describe the depth of their compassion, dedication, and love of community. As a Scrantonian who represents the Commonwealth of Pennsylvania, I am proud to call them neighbors and friends. I would like to once again extend my congratulations to Sondra and Morey on 60 years of marriage and to commend them for their decades of public service. I wish them continued happiness in the years ahead.

Mr. CASEY

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

Mr. CASEY. Mr. President, I ask unanimous consent to speak as in morning business.

Mr. CASEY. Mr. President, in the interest of time, I will limit my remarks. I rise this afternoon to commend and salute three Senators from the Democratic caucus who are leaving the Senate this year. I will have longer written statements for the Record to appropriately pay tribute to their service. In alphabetical order, Senator Boxer of California, Senator Mikulski of Maryland, and Senator Reid of Nevada. Barbara Boxer and Barbara Mikulski I will offer some specific remarks about Leader Reid, in the interest of time, but I do want to commend and salute Senator Boxer for her service to the people of California and to our Nation, as well Senator Mikulski for her great work--two great advocates, two individuals whom we are going to miss terribly here in the Senate. As I said, I will put longer statements in the Record. Harry Reid With regard to Senator Reid, I can't help taking the time to say a few words about him in the remaining minutes we have before we break for the caucus lunches. Mr. President, as many people know, Senator Harry Reid is a son of Searchlight, a small community in the State of Nevada, and he comes from humble beginnings. It is probably best to read his words about his beginnings rather than trying to describe or encapsulate them. Among many things he said about his background and his family, he said this, in short fashion, about his background: My dad was a hard rock miner. My mom took in wash. I grew up around people of strong values. That is a direct quotation from Harry Reid about his background. I think those values have helped him his whole life. Those values, that work ethic, and that strength of character allowed him to go from Searchlight to rise up to become a leader in his home State of Nevada in many positions in State government, to be a Member of the United States House of Representatives, later to be elected to the United States Senate in 1986, and then, of course, to become the Democratic leader--and he remains so until the end of this Congress--but, of course, the pinnacle was his service as majority leader, one of the longest serving majority leaders in our history. That is kind of a summary of his positions in government, important though they are, leading a large and diverse caucus. It is a difficult job whether you are leading that caucus in the majority or leading it as the minority party. So we salute and commend his service to his home State of Nevada and to the people of the United States. But maybe more important than just talking about positions he held is to talk for just a minute about who he is--a fighter. No person has fought harder for workers and for their families than Harry Reid. No Senator, no person I know in public life, has made that such a central part of who they are and a central part of their priorities, also, at the same time, being a fighter for those who often don't have a voice here--people who don't have power ever in their lives or often don't have power on a regular basis. They always had a friend in Harry Reid-- someone who would go to the end of the Earth fighting on behalf of them. Over and over in our caucus, he would say: We have to work on this issue, or we have to get this or that done for people who are hurting. There are so many different examples of that, which we don't have time to enumerate them today. I am recalling today a great line from a great Democratic leader, William Jennings Bryan, who talked about the power of one individual to make a difference and the power of an issue or set of issues to drive that person's success in public life or even beyond public life, as a citizen. William Jennings Bryan once said: ``The humblest citizen in all the land, when clad in the armor of a righteous cause, is stronger than all the hosts of error.'' So said William Jennings Bryan about one citizen clad in the armor of a righteous cause. Harry Reid is a Senator and he has been a leader, but he is also a very humble man at his core. His righteous cause wasn't just one issue, but if you had to encapsulate it or summarize it, the righteous cause for Harry Reid was fighting on behalf of those workers, fighting on behalf of those people who did not ever have power in their lives. His ability to not just articulate their concerns and their struggles but literally their hopes and their dreams was one of the reasons why so many of us have such a high regard for him. We commend and salute his service. We appreciate his commitment to strong values, but we especially appreciate his steadfast support for those who needed his voice, who needed his work, who needed his votes, and needed his leadership. To Senator Reid, we say thank you for your service, thank you for what you did for your home State of Nevada, and thank you for what you did for the United States of America. I yield the floor. I suggest the absence of a quorum.

Mr. CASEY

Mr. CASEY. Mr. President, I ask unanimous consent to speak as in morning business.

Mr. CASEY. Mr. President, I rise to speak tonight about the Miners Protection Act. First, I commend and salute the work that has been done in this Chamber. I especially highlight the Senators on the Democratic side who have been working. I know this will not cover everyone, but I thank Senator Manchin, the senior Senator from West Virginia, Senator Brown of Ohio, Senator Warner of Virginia, and others, including the Democratic leadership, for working on this. I know we have bipartisan support on this issue. I thank our Republican colleagues who have worked on this. Unfortunately, just today we are told that in the negotiations, in the back-and-forth on the continuing resolution, which we should be voting on this week--we are told that Majority Leader McConnell is not going to include the Miners Protection Act in the continuing resolution. That is very bad news, especially when we consider how we arrived at this point in terms of bipartisan support. I will get to that in a moment. Instead, apparently the proposal--or I guess at this point it might be beyond a proposal because it might be in a draft of the continuing resolution. Be that as it may, what has been proposed is 4 months of health care for miners and their families instead of a lifetime guarantee. In a word, that is unacceptable. I will not dwell on that because I want to get to the rest of our arguments on why this is a proposal we cannot accept. A long time ago, before the turn of the last century, Stephen Crane, known mostly for the ``Red Badge of Courage,'' a great novel, died at the age of 28 or 29. But prior to his death, in addition to all that he wrote in a great novel, he wrote for McClure's magazine an essay about a coal mine near my hometown of Scranton in Lackawanna County. I come from a county that had of what they used to call hard coal, anthracite coal. It heated homes across the Nation and across the world, for not just years but generations. Stephen Crane described how dangerous it was to work in a coal mine. He did it with such beauty and such skill, but there were so many horrible images. I, of course, will not read the entire essay, but at one place he described the coal mine as a place of ``inscrutable darkness, a soundless place of tangible loneliness.'' Then he described all the ways a miner could die in the mines. That was in the 1890s. Of course, coal mining today is safer, but still very dangerous. But no matter what the danger level, no matter what the circumstances of today, we owe these miners their health care, their pensions, and we owe their families. What they don't want to hear, what we should not engage in, is the usual horse trading and kind of back-and-forth of Washington. They deserve the Miners Protection Act. It is not some theory, and it is not some idea; it is legislation that was introduced, debated, and then voted on by the Finance Committee, 18 to 8, a bipartisan vote in a place that sometimes cannot agree on the time of day, let alone something as substantive and as important as health care and pension benefits for those who earned them. This isn't some extra thing we are giving, not some gift we are giving; they earned it, in many cases not just for years but for decades they earned this. OK. We owe them this. This country owes them this. This Chamber owes this to these miners. It was a promise a long time ago, in the late 1940s. These miners kept their promise. They went to work every day, year after year and decade after decade, and their families depended upon that promise. Some of them served in wars, including Vietnam, as just one example. They served in Vietnam and then worked in the mines again and worked and worked. So they kept their promise. They kept their promise to their family, they kept their promise to their country, and they kept their promise to their company. Yet here we are once again, and the only ones left out are the miners. The companies will figure out a way to do OK. The country will move forward, the Senate will be just fine, but once again we stand at the precipice or at the threshold of a new time period. People are wanting to get out of here for the holidays, yet coal miners are not asking us to do anything other than keep a promise. We should keep our promise, and the Republican majority leader should keep that promise. It is outrageous that anyone would think it is appropriate to propose temporarily saving benefits when, in practice, these recipients would be notified almost simultaneously that they are both eligible for benefits--temporarily--and that their benefits will terminate. That is not just wrong; that is an insult. It is an insult to them and to their families. Just imagine the stress of this. We cannot imagine it. I will answer my own question: We cannot imagine it. Probably no one in this building could imagine the stress on these individuals and their families. It is completely unnecessary. I know we are limited on time tonight, but I wish to highlight portions of letters that I have received. I know the Senator from West Virginia has received even more because of his great advocacy, his work, and the substantial impact that the mining industry has had on his great State and the work that is done by great miners to this day. To protect people in case we haven't received their permission, I will not use full names. This letter is from Waynesburg, PA, Southwestern Pennsylvania. I will limit it to a son talking about his mom. He said: ``I am writing to you for my mother.'' He is asking us to vote on this bill. In the letter he says his mom is a widow. ``She now lives on a fixed income. Her life depends on this passing,'' meaning, the bill passing. ``She has cancer and will need surgery.'' Her life depends on this bill passing. OK. This isn't just another bill about some far-off issue. That is a son writing to us from Waynesburg, PA, about his mom. This is another letter from a son writing about both his parents, and I will provide just an excerpt. He writes that it would be ``very comforting'' to know his parents could ``continue their current UMWA benefits until they can turn 65.'' He is worried about the fact that two parents are going to turn 65 in 2017, and he wants to make sure that they are protected. The third and last letter I will read an excerpt from is from a miner himself from Johnstown, PA. It is a town I know pretty well in Cambria County. There has been a lot of mining there over many years. He is talking about working the mines for 21 years. He said: ``When you make a promise it should be kept.'' That is what a miner from Johnstown, who worked in the mines for 21 years, reminds us. It is just what I said: ``A promise should be kept.'' It continues, ``This insurance has gotten me and my wife through many health concerns including breast cancer in which my wife still fights today.'' Then he talks about how this would dramatically change their access to doctors and medical care. So we are not talking about some budget number here; we are talking about a family telling us the life of their mother depends upon it; another family member whose mom has breast cancer, her life--or at least her health care at this point--depends upon it. So this isn't theory. This legislation, which passed the Finance Committee, as I said, 18 to 8--all we have to do is have the majority leader stand up and say that we are going to attach this to the continuing resolution and have the House Speaker say the same because they have control. That is all they have to do--attach it to the continuing resolution--and we will finally have kept our promise. Temporary relief is not only insufficient, it is an insult. It is not just insufficient, it is dead wrong. No one here should be playing games with people's ability to pay for medication, pay for their oxygen. That shouldn't be the subject of games or horse trading. We delivered in both parties. We delivered to Majority Leader McConnell everything he asked for--committee consideration, debate and vote in the committee--and now it has come to the floor of the U.S. Senate. It is time for all of us to keep our promise to coal miners and to make the Miners Protection Act permanent law and to keep our promise to those miners and their families. I again commend and salute the Senator from West Virginia, and I yield the floor.

Mr. CASEY

Mr. CASEY. Mr. President, I rise today, along with my colleague from South Carolina, to talk about a bill we have introduced entitled the ``Anti-Semitism Awareness Act of 2016.'' Let me say first that I wish we were living in a time where we would not have to introduce legislation like this, but unfortunately what we have seen over a long period of time--and I think a problem that is getting worse--is the rising tide of anti-Semitism in substantial sectors of our society. We have, in fact, a rise in the incidence of religious discrimination and religiously motivated hate crimes. To say that is unacceptable, even un-American, is an understatement. We have to take action at long last to do what we can in the U.S. Senate, and I hope in the House as well, to not just speak out against anti-Semitism but to take action which will lead to a better strategy to deal with it. What do I mean by that? Well, it is simple. It is about definitions, and it is about making sure that Federal agencies, such as the Department of Education, do their job when it comes to combating anti-Semitism. We know that one piece of legislation is not somehow going to magically eradicate anti-Semitism. We don't have that naive hope. But what we do believe is that if we don't take action, this problem is only going to get worse. Some of the problem, frankly, is on our college campuses, and I know that is true, unfortunately and regrettably, in my home State of Pennsylvania. We don't have time to list every incident, every action, every terrible example of this, but I will just provide one for the record. In September, students at Swarthmore College in Pennsylvania--one of our great institutions of higher education not only in Pennsylvania but across the country--Swarthmore is a great school, but here is what they found. They found swastikas spray-painted in a bathroom in the library. The college leadership did the right thing in swiftly condemning these actions and removing the graffiti, and I am glad they did that. I can only try to imagine--and I can literally only try to understand because I have never been the victim of this kind of hate--the horror that was experienced by those students and their families. A person comes to a college or a university as a place where they are going to learn and grow and live in a community, and then there are people--for whatever reason, and I will never understand the reason anyone would do that--painting those images and using language and taking other actions that discriminate against people because of who they are. We have to be not just concerned about this, as I said, but we have to figure out a way to take action. This particular piece of legislation is aimed at a terrible manifestation of this problem. When anti-Semitic views lead to discrimination against students of Jewish faith or Jewish ancestry, that is the result, and they are the victims of this. The intent here is simple and narrowly circumscribed to make sure we are getting at the problem as best we can to define anti-Semitism at long last--this hasn't been done before--to define anti-Semitism so that the Department of Education can effectively investigate allegations of discrimination motivated by anti-Semitism under the Civil Rights Act. The bill does not infringe on the First Amendment. It does not infringe on those rights of free speech. It is intended to help protect students from discrimination on the basis of their faith. We all agree that religious discrimination has no place on campuses, has no place in our society, and we have to do more than just speak out against it. That is fundamental, but we can do more than just speak out; we can define it and thereby give in this case one Federal Government agency one tool it needs to deal with this issue. This is a bill which is timely not only because of what is happening on college campuses but unfortunately what has happened in too many parts of our society. We want to make sure the Department of Education has at least one of those tools to deal with this problem. Because of the nature of this problem, we have people on both sides of the aisle here who are very concerned about it. I am particularly grateful that I am joined by my colleague from South Carolina, Senator Scott, who is joining with me. We are a Democrat and a Republican from different parts of the country and a different point of view on a lot of issues. On this issue we are unified, and we have a solidarity about not just the problem, but there is a solidarity and a consensus about one of the things we can do to take action on this issue. I am grateful to be joined by my colleague from South Carolina. I yield the floor to him.

Mr. CASEY

Mr. CASEY. Madam President, I wanted to come to the floor today, as I did last week, to speak once again about WillsEye Hospital in Philadelphia. When I was here last week, I was talking about the hospital itself and the truly excellent work that is done at that hospital and, unfortunately, to talk as well about the unfair treatment that hospital is receiving from the Centers for Medicare and Medicaid Services. We know it by the acronym CMS. CMS is using an arbitrary ratio of the number of inpatients and outpatients to make the argument--faulty though it is--that WillsEye is not a hospital and should be an ambulatory surgery center, which could have drastic implications and ultimately force WillsEye Hospital to close down. This hospital is almost 200 years old. Last week, WillsEye Hospital started an online petition on change.org so people could show their support for the hospital. I wanted to share some of those comments today with Members of the Senate. These online postings, of course, don't just come from Philadelphia or Pennsylvania. They come from States across the Northeast and even beyond. Here are just a couple of examples. Jack Croft from Lansdale, PA, which is not too far from Philadelphia, said: I owe my life, my right eye, and my sight to Wills Eye Hospital and its brilliant ocular oncology team. Losing federal designation as a hospital would have a devastating effect on the lives of thousands, many of them children, who desperately need the specialized expertise of Wills. So said Jack Croft. Ayan Chatterjee from Philadelphia said the following: Wills Eye Hospital provides care to so many complex patients from all across the world. It is not just a ``surgi- center.'' State regulators got it right but Federal regulators should revisit this. We continue to hope they will do that--my words, in addition to the comments. Kathleen O'Brien from Vestal, NY--not from Pennsylvania--said: I've needed Wills since 2005 to treat and monitor my ocular melanoma. They are the best in the world for my very rare cancer. Medicare is my primary insurance provider. It makes no logical sense to take away this vital institution to the thousands of children and adults they not only treat but save lives. Erica Roache from Cape May Court House, NJ, said: This hospital provides specialized care not available anywhere else. Doctors at Wills Eye quickly diagnosed and successfully treated my daughter's rare eye condition that had been misdiagnosed for years by other less specialized doctors. The possibility of closing this world class hospital due to senseless bureaucracy is just unthinkable. So says Erica. Here are two more. This is Mike Stanley from Overland Park, KS--half a country away from Pennsylvania: We live in Overland Park, KS, and for the past 2 years have been flying from Kansas City to Philly for treatment for the retinoblastoma eye cancer you refer to. He is referring to comments I had made when I was at WillsEye Hospital. I continue on with Mike Stanley's comments: Thankfully, my daughter is now 4 and in remission and we travel back to Philly next week and Wills. Please let us know what we can do to support CMS changing how they classify Wills Eye so we and others can continue to get the best care in the world. Alexis Butler, from Chelsea, MI, said: I'm signing because as a volunteer at Camp Sunshine at Sebago Lake I've met many children who have been saved by Wills Eye Hospital. Their cases aren't handled much by other hospitals as well as they are at Wills. It needs to survive. So said Alexis from the State of Michigan. I will do one more. The final comments come from Nancy Cotton from Marlton, NJ. Please do not be blinded by rubber stamp bureaucracy. Not everything fits neatly into arbitrary slots--visit Wills Eye and look in the faces of those whose vision was restored, saved, as well as the parents whose children's very lives were saved. This institution fills a desperate need for highly specialized service! Save Wills Eye!! Notice she uses exclamation points--actually two exclamation points at the end. That is how Nancy Cotton from New Jersey ends her comments. So you can see from these comments that these are real people talking about their real lives or that of a family member--sometimes a child-- and commenting from the vantage point of what they had experienced in terms of the benefits that WillsEye Hospital has provided. I hope CMS is listening--and not just to these comments but to the many others that have been sent in. None of these comments are compulsory. None of these comments are part of some organized political effort. People are just responding in a very authentic and substantial way. This is very rare to have this kind of commentary that is so specific about how WillsEye Hospital has made life better for people across the Commonwealth of Pennsylvania, people across the northeastern part of the United States and well beyond that, as we can document from the comments from Kansas. So what we are trying to do is to work with WillsEye and CMS to work this out and to remove a bureaucratic barrier or obstacle in the way of keeping WillsEye Hospital open as a hospital so that it can deliver the kind of eye care--the kind of lifesaving eye care--that not only these people experience but that I experienced myself as a father. My wife and I had a daughter, and, fortunately, she is doing very well now. She is out of college. But she had a moment in time when she was a little girl where she would have lost eyesight in one of her eyes were it not for WillsEye Hospital. That is a fact. That is documented. We know that. So I join in those comments we heard today, and I will continue to make them a part of the Record. We are working to save this hospital. To say it is a world-class institution is a vast understatement. It has affected so many lives, including my own. So CMS got this wrong. They have an obligation to get it right, to fix it, so that WillsEye Hospital can continue into the future. We are grateful so many people are taking the time to go to change.org and focus on all the benefits of WillsEye Hospital. I will continue to make this case a high priority for the work I do, the work our office does. Time is running short now for the hospital. CMS has some work to do to make sure we get the result not only that I want but one that I know people across our Commonwealth and our country want. Madam President, I yield the floor. I suggest the absence of a quorum.

Mr. CASEY

Mr. CASEY. Mr. President, today I wish to speak about S. 1878, the Advancing Hope Act. This is a bill I introduced with the support of my Republican cosponsor, Senator Johnny Isakson. This is a bipartisan bill that brings hope to some of our most vulnerable citizens: children living with rare diseases. Despite significant unmet medical need, private companies seldom pursue new therapies for rare diseases because it requires making an investment in products that will likely not recoup the high costs associated with their research, development, marketing, and distribution. Developing products for children is particularly challenging because of the difficulties associated with conducting clinical trials in this population. So, several years ago, former Senator Brownback authored the Creating Hope Act with Senator Sherrod Brown. In 2011, I became the Senate leader on this bill, which provided an incentive for drug developers to pursue therapies for rare pediatric diseases. The goal was to bring hope to the millions of American children living with a rare disease. Provisions based on the Creating Hope Act were included in the Food and Drug Administration Safety and Innovation Act, which became law in 2012. The new FDA program established three ``priority review vouchers'' that would be awarded to companies who develop a new drug for a rare pediatric disease. A company that earns a voucher can then sell it to another company, which can use the voucher to speed up the FDA's review time for one of its own new drugs. Companies that earn and then sell their vouchers can use that money to fund additional drug development to treat rare pediatric diseases. So far, seven vouchers have been awarded, including on the 19th of this month. However, the pediatric priority review program is due to expire on September 30, just days away. In fact, it would have expired in March of this year, but Congress passed an extension through the end of fiscal year 2016 as the House and Senate worked on legislation to extend and improve the program. In July of 2015, I introduced S. 1878, the Advancing Hope Act, with Senator Isakson, to extend the pediatric priority review program. We had extensive consideration of the bill in the Committee on Health, Education, Labor, and Pensions, which voted favorably on the Advancing Hope Act in April 2016. Thanks to an agreement we reached here in the Senate on September 21, we were able to pass S. 1878 with an extension of the program through the end of this year, which included important policy changes to the program. I would like to thank my colleagues for working with me on this agreement. I hope that we will be able to come to further agreement later this year for a longer extension to the program. The pediatric priority review program is important for families, and a longer extension is warranted. If this program is allowed to lapse, Congress will have broken faith with these children with rare diseases. Last year, I went to the Children's Hospital of Pittsburgh and met with the Rinaldi family. I met Jennie Rinaldi and her daughter Adelyn, who was receiving treatment at the hospital. Adelyn was born with congenital hypophosphatasia, an extremely rare bone disorder. There are only a handful of children in the world with this disease. At the time, Adelyn was receiving an experimental therapy for her condition. That drug, Strensiq, was later approved by the FDA in October 2015, and the drug sponsor received a priority review voucher. Strensiq is the first drug to treat hypophosphatasia. There are no other options. It is now available commercially, and Adelyn continues to receive treatment. Just imagine for a moment the uncertainty that families like the Rinaldis live with every day. We owe it to these families to give them the peace of mind in knowing that this important incentive for drug development will continue. We cannot let this program expire. I am pleased that the House passed S. 1878 yesterday, and I hope that we can continue to work in good faith on a longer-term extension before the end of the year. We need to provide certainty for drug developers so that they can count on this incentive when deciding to invest the time and money into drugs for rare pediatric diseases. We need to provide hope for the other children like Adelyn. On behalf of these children, we must incentivize companies to take on the challenges of developing new treatments for rare pediatric diseases.

Mr. CASEY

Mr. CASEY. Mr. President, I rise this afternoon to talk for a few minutes about a hospital in Pennsylvania, WillsEye Hospital. This is a hospital which is not only critically important to our State but to the Nation as well. It serves people from across our State and across the country. WillsEye Hospital is a public trust that was gifted to the city of Philadelphia and founded in 1832. It was the first dedicated eye hospital in the country, providing care to the blind and the indigent-- something they still do today. They still have that same mission. Unfortunately, if the Centers for Medicare & Medicaid Services--what we know as CMS--has its way, WillsEye Hospital will no longer be able to provide this kind of care. This is world-class care that so many Pennsylvanians and so many Americans can speak to personally. I had a personal experience when my daughter Julia had an eye problem years ago, and WillsEye did great work for her. In this case, CMS is using an arbitrary ratio of the number of inpatients and outpatients to say that WillsEye Hospital is not a hospital and should be what is known as an ambulatory surgery center, which could have drastic implications and ultimately force WillsEye to close. Again, this was an institution founded almost 200 years ago. Last week I went to WillsEye in Philadelphia to talk about this problem and had the opportunity to meet Joey Povio, whose picture is in this enlarged photograph. Joey is 6 years old, and he has retinoblastoma, a type of ocular cancer which, if left untreated, will lead to his death. According to the American Cancer Society, there are 200 cases to 300 cases of retinoblastoma diagnosed each year. In the last fiscal year, WillsEye treated 110 unique individuals with a diagnosis of retinoblastoma, or almost 37 percent to 55 percent of the diagnosed cases in the country. So you can see the impact of just one hospital on a substantial problem that Joey and children across the country have. Fortunately for Joey, he is receiving first-rate treatment, but we have to have ask ourselves: What about the others who have retinoblastoma? What about the children who will have retinoblastoma in the future? What will happen to them without WillsEye Hospital? You can tell from this picture not just how dynamic Joey is--and I can attest to that personally, after having met him--but how focused he is on getting better and how confident he and his family are that he can, in fact, get better because of the great work done at WillsEye Hospital. There are many who might think this is just a unique situation or simply an unfortunate situation, and certainly it is for Joey and his family and for others who have retinoblastoma or a number of other ailments or problems that center on their eyes. Thank God we have WillsEye to treat those problems. But there are other hospitals in the Nation that are dealing with some of these same issues and especially dealing with issues that relate to their interaction with CMS, and these are obviously some great hospitals that I will mention in a moment. In this case, for whatever reason, I think CMS is treating WillsEye Hospital unfairly. I think that is an understatement. In this case, we have a number of institutions that have a bed ratio--that is the interplay between inpatient and outpatient that CMS is focused on in this circumstance--there are some hospitals that have a bed ratio that is lower than the one at WillsEye. Because those numbers are lower, that would mean those hospitals should be the subject of the same kind of action CMS is taking when it comes to WillsEye. When WillsEye was first denied hospital status, their bed ratio was 17 percent. But according to the data provided by the American Hospital Association, the Cleveland Clinic, one of our great institutions, has a ratio of 6.14 percent, which is obviously lower than 17 percent, and Stanford Health Care, another great institution, has a ratio of 10.5 percent, which is again lower than the 17 percent at WillsEye Hospital. As I mentioned, these are the bed ratios. So it doesn't make much sense that CMS is focused on WillsEye and is not taking the same action or similar action as it relates to those other two institutions. Now, no one would doubt that these two premier institutions-- Cleveland Clinic and Stanford--are hospitals. There is no question they are hospitals. Yet CMS is focused on WillsEye in a determination they have made that it is not a hospital. It doesn't make any sense. CMS does not even have a definite ratio that a facility needs to meet in order to have inpatient beds. They simply need to be ``primarily engaged'' in providing inpatient services. So there is no definite ratio, and yet they are taking action that is to the detriment of WillsEye Hospital, and I believe--and I think the evidence in the record is clear--to the detriment of a lot of people in Southeastern Pennsylvania, a lot of people throughout our Commonwealth, and indeed throughout our Nation. In this case, I believe, obviously, CMS has made the wrong decision. One would think, in order to help determine what a hospital is doing, a representative from CMS would visit and would do a thorough review of the hospital that can only be done in person. You can't do that just based upon charts or phone calls. One would think someone from CMS would come and see WillsEye Hospital firsthand. They really haven't done that yet in a manner that is connected to the actions they have been taking. So I have encouraged them to do that. It is not a very burdensome task to get on the train, go to Philadelphia, spend some time in WillsEye Hospital, and use that as part of the basis upon which to make a determination as an agency of government. In this case, unfortunately, CMS has made an arbitrary decision, which is wrong. This decision threatens this world-class hospital, and that is an understatement. In essence, this decision makes no sense. WillsEye is a hospital. It provides great care for people who can't get this care almost anywhere else in the country, especially when it comes to children and especially when it comes to that diagnosis that families get of retinoblastoma. Without the intervention and the great work at WillsEye, those children will die. I will continue to urge CMS to work with me and to work with WillsEye on a solution that resolves this bureaucratic problem. That is basically what this is, a bureaucratic approach that doesn't make sense in the real world--the real world of quality medical care, the real world of the services that WillsEye provides, and the real world of Joey's circumstance and children like him across our region in Pennsylvania but also across the country. Mr. President, I yield the floor. I suggest the absence of a quorum.

Mr. CASEY

Mr. CASEY. Mr. President, first of all, I want to thank my colleagues for being here today to debate these issues. I appreciate Senator Isakson's work with us--Senators Sanders, Warren, and Alexander. I think we agree on two things, believe it or not. No. 1, both sides of the aisle here want to make progress as it relates to curing rare pediatric diseases. That is No. 1. I think there is agreement on that. No. 2, there is agreement to extend the existing program, which has already helped enormously to advance that first cause. We are in agreement to extend that until the end of the year. That is a bipartisan agreement. We will work out the details for that, and we will keep working on these issues when we get back. Mr. President, I yield the floor.

Mr. CASEY. Mr. President, I want to thank my colleague from Georgia for his good work to advance the process. I offer the following consent request: I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 415, S. 1878; that the committee-reported substitute amendment be agreed to; that the bill, as amended, be read a third time and passed; and that the motion to reconsider be considered made and laid upon the table with no intervening action or debate.

Mr. CASEY

Mr. CASEY. Mr. President, I rise to commemorate the National Day of Remembrance for Murder Victims which occurs in just a few days on September 25. In 2007, the Congress passed the resolution designating the National Day of Remembrance and affirming two central truths. First, the murder of a loved one is an exceptionally difficult and devastating experience for that family, and, second, that support services are very important in helping victims' friends and families as they cope with the grief and loss. Today in Washington we have family members who can attest to the devastation of losing a loved one. They are mothers, grandmothers, sisters, and other parts of the family, each of whom have lost a loved one to violence. They have come together to form, in this case, a Philadelphia-based violence prevention group called Mothers In Charge. I cannot imagine the pain they suffer, but the sad truth is, their ranks grow every day in our country, where about 16,000 people are murdered each year, including over 600 just in Pennsylvania, according to the Centers for Disease Control and Prevention. Around two-thirds of these murders are committed with firearms. These families know all the statistics, but the loved ones they lost aren't statistics, they are people and members of their family, and we need to remember that. I came to the floor last week to talk about a particularly violent day in 1 city, Philadelphia, PA, in which 10 people were shot in 1 day and 5 were killed. Over the weekend, 5 more were killed and 14 wounded--just this past weekend. Two of those wounded were police officers who were targeted during a shooting rampage in Philadelphia that left another five wounded at that location. The families and friends of the victims, like those who are with us in Washington today, will never be the same because they lost someone unique and special, someone who was the subject of their love and attention, someone whose future they invested in, believed in, and dreamed about until it was stolen away. The resolution I referred to earlier, designating the National Day of Remembrance for Murder Victims, which passed the Senate in 2007, reminds us of our obligation to recognize the loss these families live with every single day. The great recording artist Bruce Springsteen, after September 11, wrote a number of songs that referred to that horrific day and how the country was dealing with it. One song he wrote was called ``You're Missing.'' I will not go through the lyrics, but the refrain was just that, ``you're missing.'' At one point in the song he says: You're missing when I turn out the lights You're missing when I close my eyes-- And then he says-- You're missing when I see the sunrise. That is the only way I can understand what these families have gone through. That person is missing from their lives every moment of every day, no matter where they are, whether they are falling asleep or waking up or leading their lives. So we have an obligation to remember those they lost and remember those who are in fact missing from the lives of those we think about today. The second part of this resolution credits the support services that help grieving families. Facing pain and loss, families often need lots of help, whether that is counseling or crisis intervention or legal assistance or other services. This is also something the Philadelphia- based group Mothers In Charge know something about. These mothers took their pain and turned it into a force for good. They advocated for those affected by violence, and they provided counseling and grief support for those victims' families. They also work proactively to prevent violence by intervening with at-risk young people and working with elected officials and community leaders to create safer neighborhoods. Today, as we commemorate the National Day of Remembrance for Murder Victims, we also express deep gratitude for the critically important work Mothers In Charge and their allied organizations are doing to prevent future tragedies. As we commemorate the National Day of Remembrance, we must also talk about the types of weapons that took so many lives in the first place and that take more lives every day, firearms. About two-thirds of those 16,000 annual murders are committed using firearms. Tragically, the executive director of Mothers In Charge, Dorothy Johnson Speight, who joins us here today in Washington, knows something about this. Dorothy's son was shot and killed in a dispute over a parking space--a senseless murder of a good and innocent soul. There is no weapon as widely available and as dangerously lethal as a gun, of course, and if Dorothy's work has taught us anything, it is that when tragic murders occur, they are not occasions for grief alone but also a call to action. That is why I will continue to advocate for commonsense gun reform-- from expanding background checks to banning military-style weapons and large-capacity magazines, to the passing of legislation to close loopholes that allow suspected terrorists and violent hate criminals to acquire firearms. All of these measures will make us safer. As Dorothy has often said, gun violence is a public health crisis with more than 33,000 people killed by the pull of a trigger each year in the United States of America. If we are to do our duty on behalf of our constituents, on behalf of hard-working members of Mothers In Charge and the countless others who have lost a loved one to gun violence as we approach the National Day of Remembrance, we must act to make our communities safer. Thank you, Mr. President, and I yield the floor. I suggest the absence of a quorum.

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

Mr. CASEY

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

Mr. CASEY

Mr. CASEY. Mr. President, I ask unanimous consent to speak in morning business.