Richard Durbin

Mr. DURBIN

Mr. DURBIN. I announce that the Senator from Nevada (Ms. Cortez Masto), the Senator from New Jersey (Mr. Menendez), and the Senator from Vermont (Mr. Sanders), are necessarily absent.

Mr. DURBIN

Mr. DURBIN. Mr. President, let me thank my colleague from Connecticut. He sponsored a filibuster on this issue, I believe it was last year. I participated in it, as did many Members of our caucus. Both he and Senator Blumenthal bring a special perspective to this issue of gun violence, representing the State of Connecticut and the families who lost their first graders. I believe they were first graders who were shot down, 20 of them killed in their classrooms. I remember, when I heard that story on how those children died and their teachers died, I thought to myself: This must be the moment that will motivate America to finally do something if innocent, first grade children can be shot down in their classrooms in this fashion. The honest answer is that we have spoken a lot about the issue, but we have done little or nothing to change the circumstances that led to their death. If that were the only case, it would be bad enough, but the Orlando nightclub--I believe 49 were killed there. Some crazed person went there and killed innocent people gathered at that nightclub. As Senator Murphy has said, when you go through the litany, it is an endless litany of victims of gun violence--and last night in Las Vegas, NV, the worst gun crime in the modern history of the United States of America, the worst. Estimates now, which I saw as I came to the floor, are that 58 have died and over 500 were seriously injured. I don't know what the ultimate numbers will be, but those numbers, in and of themselves, are incredible. Last night, we witnessed what was the worst mass shooting to date in the Nation. This gunman, supposedly, at 10 p.m. last night in Las Vegas local time, began firing from a room on the 32nd floor of a hotel into a crowd of people gathered for a country music festival. He supposedly was holed up in his hotel room with at least 10 guns and obviously fired hundreds of rounds of ammunition. As I mentioned, 58 people have been reported to have died, and over 515 injured. Those are staggering and horrifying numbers. There are literally hundreds of families tonight and communities who have been changed forever by this horrendous crime. Our prayers, obviously, naturally, go out to them in this moment of loss and uncertainty. During and after the shooting--as we expect but should never take for granted--law enforcement, first responders, acted like the heroes that they are, working to stop the shooter, securing the scene, helping the victims, saving lives. We are grateful to these first responders, who so often are called to run to the sound of gunfire to keep us safe, not to run away. It is unthinkable that this type of shooting tragedy could happen in the United States of America, but I am sorry to say it is becoming a regular occurrence. This was the worst, but yesterday, October 1, was also the 2-year anniversary of the mass shooting in Roseburg, OR, when a gunman killed eight students and a professor at a community college. Also, this past weekend, at least 33 people were shot in the city of Chicago. At least four died. The relentless toll of gun violence never seems to stop. The American Medical Association has declared that gun violence is a public health crisis in America. On an average day, 300 Americans are shot. On an average day, 300 Americans are shot. About one-third of them will die from that gunshot. Mass shootings, as Senator Murphy said earlier, have become a daily occurrence. If our critics would say ``Please, don't exploit the event of a mass shooting by speaking on the floor,'' as Senator Murphy has made clear, then we wouldn't be able to speak any day of the year because they are so common. We can't let this become the new American normal. We can't just shrug our shoulders when we see over 30,000 Americans shot and killed year after year after year. We can't sit back and do nothing while hundreds of our fellow Americans are shot in one night simply because they went out to hear a music concert. Just this last week, I was at a concert in Nashville, TN, at the Ryman, the site of the Grand Ole Opry; 2,000 people gathered there. They were mainly folks from the Midwest, many of them retired, who love country music, I am sure, as the people in Las Vegas did. When I heard about what happened in Las Vegas, I thought: Well, what if someone had walked into that theater and opened fire? It could have, sadly, happened there. What are we going to do about it? Certainly, there will be outrage at the death. There will be grief over the loss. But then what? That is what Senator Murphy challenges us to think about. We serve in the U.S. Senate. We are not just casual observers of this violence. We are supposed to pass laws to make America safer. What will we do because of what happened in Las Vegas last night? That is the question that brings me to the floor this evening. If we have a responsibility to keep our families and America safe, what are we prepared to do? For the gun deaths in Chicago, there are some things that I would do instantly. Background checks--I don't believe we should be able to walk into a gun show and buy a firearm or more than one, incidentally, and take them out of the back door without somebody asking: Who are you? Do you have a criminal record? Would you be disqualified from buying these same guns at a licensed gun dealer? Currently, the law is riddled with loopholes, and those loopholes lead to death, death on the streets of Chicago. We also have these purchases being made by straw purchasers. In other words, the girlfriend, who has no criminal record, who walks into the gun shop in the suburbs of Chicago and buys the gun for her boyfriend outside in the car, who is going to use it that night to shoot up a rival gang member or some other criminal activity. Those are two very obvious things I would push for instantly: Close the gun show loophole; make sure we do something about straw purchasers so that the penalties are serious enough that they will never do it again. There is more. This morning, I was on a radio show in Chicago, one of the most famous ones, I guess. I listened to a fellow named Steve Cochran celebrating his 1,000th show on the air. This was the topic we talked about. Steve asked me: Well, what can we do? I said: Steve, we have to rely on people who honor the Second Amendment and believe it is an important part of our Constitution to stand up and lead. I am talking about members of my family who are hunters and sportsmen. I have been out hunting myself. We have to have people who are concerned about guns for self-defense stand up and say: We have to draw a reasonable line. There is no reasonable line under the Second Amendment that would allow what happened in Las Vegas last night. To think that someone could injure over 500 people and kill 58--what kind of weaponry did he use? We will know. We will find out the details, but it certainly goes beyond any reasonable weaponry needed for self-defense, sport, or hunting purposes. Can we not at least appeal to those who honor the Second Amendment to join us in drawing a reasonable line so combat and military-style weapons that can lead to such carnage are not considered to be normal or acceptable? Decades ago we did when it came to machineguns. Decades ago we said this is a weapon no one should have, period, except for the military and perhaps law enforcement. Can we return to that conversation? We are going to need the leadership from people who believe in the Second Amendment to make it happen. We have seen Democrats and Republicans join together to pass meaningful laws to deal with public health crises like opioid addiction. We have to do the same for this public health crisis. I am sorry to report that a recent nominee for Surgeon General of the United States was almost denied that opportunity because he was bold enough to say that gun violence is a public health crisis. It certainly is. There is no single law or policy that will prevent every tragic shooting, just as there is no single law or policy that will end heroin overdoses, but let's start working together to do something. We can't stop the shootings that have already happened in Las Vegas, Chicago, Roseburg, OR, and across the Nation. We failed to respond in time for those victims and their families. But if we work together, we can stop shootings in the future. That is something we should all strive to do. We must do all we can to spare families the unimaginable pain so many in Las Vegas are feeling today in the aftermath of this horrible tragedy. I hope we will. Mr. President, I yield the floor.

Mr. DURBIN

Mr. DURBIN. I announce that the Senator from Minnesota (Mr. Franken) and the Senator from New Jersey (Mr. Menendez) are necessarily absent.

Mr. DURBIN

Mr. DURBIN. I announce that the Senator from New Jersey (Mr. Menendez) is necessarily absent.

Mr. DURBIN

Mr. DURBIN. I announce that the Senator from New Jersey (Mr. Menendez) is necessarily absent.

Mr. DURBIN

Mr. DURBIN. I announce that the Senator from Indiana (Mr. Donnelly), the Senator from New Jersey (Mr. Menendez), and the Senator from Maryland (Mr. Van Hollen) are necessarily absent.

Mr. DURBIN

Mr. DURBIN. I announce that the Senator from Indiana (Mr. Donnelly) and the Senator from New Jersey (Mr. Menendez) are necessarily absent.

Mr. DURBIN

Mr. DURBIN. Mr. President, textbook costs are one of the most overlooked barriers to college affordability and access, and they are continuing to get more expensive. Over the last decade, 2006 to 2016, the Bureau of Labor Statistics Consumer Price Index shows that consumer prices for college textbooks increased almost 90 percent. It means students have to spend more every year. In 2016 to 2017, the College Board recommended that students budget an average of $1,250 for their books. A survey released by the Student Public Interest Research Group reported that 65 percent of students decided not to buy a textbook because of the cost, and 94 percent of those students worried it would hurt their grade. This week, I joined with Senators Al Franken and Angus King and Representatives Jared Polis and Kyrsten Sinema to reintroduce the Affordable College Textbook Act. This bill would establish a grant program to encourage the creation and use of high-quality open textbooks which are free to use. Greater access to and widespread use of these open textbooks can save each student who uses one hundreds of dollars, and, long term, it puts pressure on the traditional college textbook market to come up with affordable alternatives. My home State of Illinois provides an example of how this bill would work. The University of Illinois used $150,000 in Federal money to pilot an open textbook project at its main campus. The university, working With faculty, developed an open textbook, ``Sustainability: A Comprehensive Foundation.'' This textbook was published electronically for free and open use. You can go online today and find it. Instead of a student having to shell out $150 or more for his or her introductory environmental sustainability class, he or she can use this free online book. That is a direct savings to a student every time a professor assigns this text in place of a traditional textbook. Today it is saving students money in Illinois, but also across the country at other colleges and universities where it has been adopted by faculty into their curriculum. I would again like to thank my colleagues, Senators Al Franken and Angus King, for joining me in this effort I would also like to thank the wide variety of organizations that support this bill, including the U.S. PIRG, SPARC, National Association of Big Ten Students, National Association of College Stores, American Association of Community Colleges, United Negro College Fund, and others. Mr. President, I hope that my colleagues in Congress will join us in supporting this bill to create a program at the Federal level to encourage the creation and adoption of these materials. In the meantime, I hope students across the country will reach out to their professors and have this conversation with them. Ask them to adopt these free, quality materials that are available today.

Mr. DURBIN

Mr. DURBIN. Mr. President, over the last few days, three Republican Senators have publicly stated that they will vote against the healthcare repeal bill that may come to the Senate this week. In announcing his opposition, one Republican Senator, John McCain of Arizona, issued the following statement: ``As I have repeatedly stressed, healthcare reform legislation ought to be the product of regular order in the Senate.'' Last night, Republican Senator Susan Collins of Maine stated: ``This is simply not the way that we should be approaching an important and complex issue.'' She went on to say: ``The fact that a new version of this bill was released the very week we are supposed to vote compounds the problem.'' This should be the end of the Graham-Cassidy repeal debate. Republican leadership should finally scrap this one-sided effort to literally change the healthcare system for America. There was a hearing yesterday--the only hearing on the bill we are about to vote on. It was a lengthy hearing, but it, frankly, did not entertain all of the witnesses or any amendment process so that Members could really have input into the bill we are going to face. The Congressional Budget Office is supposed to tell us what this critical legislation will do for America. It issued a preliminary finding yesterday that millions of Americans would lose their health insurance and that those with preexisting conditions, as well as their families, if they could buy insurance, would find it very, very expensive. At the end of this week, funding for our Nation's community healthcare centers will run out, as will funding for the Children's Health Insurance Program. Shouldn't we be focused on reauthorizing those programs appropriately in a timely way? Let's allow the HELP Committee, which is the committee of jurisdiction when it comes to healthcare, to do its work. I have faith in two Senators--one Republican and one Democrat--to do the right thing on this. Senator Lamar Alexander of Tennessee, a Republican, and Senator Patty Murray of Washington, a Democrat, have proven before that they can take complex issues such as Federal funding for education and find a bipartisan compromise. What would America say if we announced at the end of next week or even this week that we have a bipartisan compromise to make healthcare stronger in the United States, that it is going to pass the Senate, that we are going to send to it the House, and that we are going to get something done this year in the Senate? First, most Americans would be amazed and skeptical, as they should be, but if we can prove that we are going to do it, they would applaud us for finally reaching a point at which we do something on a bipartisan basis. That was the process that was underway until last week. Senator Alexander was given orders by the leadership: Step back. Let's vote on Graham-Cassidy. Don't do anything more on a bipartisan basis. Well, this is the week for that vote, and I hope it is the week in which that vote ends in the basic defeat of the approach and a return to bipartisan compromise and bipartisan negotiation. I don't know what it will take for the Republicans in the Senate and the House to end this never-ending crusade against so-called ObamaCare. They have voted 50, 60, 70 times. We know how they feel about it, but the American people have said to them: It is not enough to oppose ObamaCare; give us a better alternative. And that is where they have stumbled each time. Over the weekend, rather than making improvements to fix what is wrong with their bill, many Republicans doubled down in secret meetings, negotiations, and with incentives that were built into the newest version of the bill. The latest Graham-Cassidy repeal measure would slash funding to the States, decimate the Medicaid Program, eliminate protections for people with preexisting conditions, and basically throw our entire healthcare system into chaos. A few special changes were made for special States, but the changes that have come to Graham-Cassidy in the closing days have not really changed the fundamental problem with the bill in that it diminishes Medicaid coverage. Medicaid is the health insurance program about which most people say: Well, that is for the poor people of America. To some extent, that is true, but it has reached far beyond that. Two out of three senior citizens in nursing homes and other institutional settings rely on Medicaid for basic healthcare. If the cutbacks in Medicaid take place that Graham-Cassidy calls for, what will these seniors do? What will you do for Mom, for your grandmother, or for your grandfather when it reaches a point at which they cannot any longer count on Medicaid to help them pay their medical bills? Will American families have to step up with their own savings? Will they have to look for alternative settings to those in which their parents and grandparents are today? That is the stark choice Graham-Cassidy will create for many families across America. No one has had time to properly review this latest proposal, in large part because it was drafted behind closed doors--no input from experts, no support from the medical community. You would think, after saying it over and over again, that the Republicans would challenge the following statement: There is no medical advocacy group in the United States of America who supports the Graham-Cassidy bill. That is the case in my State. The Illinois Hospital Association, doctors, nurses, surgeons, pediatricians, and community health are all opposed to this bill, every single one of them, as they were to the previous versions. It says something when the bill to change America's healthcare system is opposed by the people who provide healthcare to America. All of them oppose it. It is that bad. Republican leaders want to force a vote this week. If that is what it takes, then we have to move to that vote, but I wish they would save some time. I wish they would move to this bipartisan negotiation I referred to earlier. The Congressional Budget Office is a nonpartisan agency that is supposed to measure the impact of legislation so that, before we vote on it, we know if it is good or bad for the Nation and for the people we represent. Here is what it told us last night in a preliminary review, but it has not had time to review this bill in detail. In a preliminary review, the CBO told us: ``The number of people with comprehensive health insurance . . . would be reduced by millions each year.'' How in the world can we as Senators make a proposal for the United States of America which we know will take health insurance coverage away from millions of Americans--exactly the opposite of what our goal should be? The CBO went on to write: ``Federal spending on Medicaid would be reduced by about $1 trillion.'' There are some Republicans, fiscal conservatives who say that we have to stop the growth of this program, but none of them--not one of them-- can address the fundamental issue: Who will then take care in paying for the delivery of babies to low-income families? Half of the children who are born in my State of Illinois are paid for by Medicaid. Their moms are taken care of by Medicaid until the moment of birth. What will you replace that with if you eliminate Medicaid funding? What about the disabled who count on Medicaid as their health insurance? If you are blind or face a serious disability, Medicaid is the answer for basic health insurance for you. If you are going to cut $1 trillion out of Medicaid, what will you say to those disabled Americans who want the same peace of mind that we all want in having health insurance? School districts all over Illinois and all over the Nation receive Medicaid funds to care for special ed students--counselors, transportation, even feeding tubes. If you take the money out of Medicaid, what will we do for those school districts that are trying their best to give kids a fighting chance, even those with serious disabilities? That is the reality. The CBO went on to write: ``Coverage for people with preexisting conditions would be much more expensive . . . and could become unavailable for many more people.'' This Republican proposal takes us back to that moment in history when health insurance was so expensive and so hard to find--almost impossible for those with preexisting conditions. Why would we ever want to go back to that? There is hardly a family in America who does not have someone they love, who is part of the family, who has a preexisting condition. Let me remind those who do not have that circumstance that you are one accident or one diagnosis away from being part of this class of Americans who wants health insurance even though the health of those Americans has not been perfect. In sum, this bill does not do what its authors say it will. They like to tell the American public that States will magically be able to cover the same number of people and provide the same level of benefits with billions of dollars less in funding. The Governors--Democrats and Republicans--have stepped up and said: This is ridiculous. We cannot be asked to accept the burden of health insurance for generations to come, while the Federal Government continues to cut the money that is necessary to provide that protection. The CBO rejected the claims that are the basis for this Republican bill. Since the Republicans refuse to wait for the CBO to complete its full analysis, we have asked outside health experts what they think the impact would be of this legislation which is before us this week. Here is what they say: Within a few years, this bill would likely rip health insurance away from more than 20 million Americans, including 1 million people in the State of Illinois. In a State of 12\1/2\ million people, which I represent, 1 million people would lose health insurance because of this Republican proposal that is before us this week. The average 60-year-old person in Illinois would see his health insurance premiums increase by $11,700 a year. Almost by $1,000 a month his health insurance would go up. Why? Because they change a basic formula. In the Affordable Care Act, we see that the disparity in premiums charged between the highest and lowest will be no more than 3 to 1. They change the ratio in their Republican bill to 5 to 1. It means that those over the age of 50 and under 65 are going to see premium increases estimated to be almost $1,000 a month. By 2026, Illinois would see its healthcare funding slashed by $8 billion. By 2036, this number would soar to $153 billion. Medicaid, which covers half of all children in Illinois and two out of three seniors in nursing homes, would be decimated. Also, the Medicaid expansion in Illinois, which helps us to combat the opioid epidemic, provide coverage for 650,000 Illinoisans, and bring stability to our hospitals all across the State, would be shut down. Here is what the Illinois Hospital Association said about this bill: Illinois cannot absorb additional financial burdens and would be forced to reduce eligibility, covered services, and payments to providers. The magnitude of these cuts and changes to Medicaid is staggering. Let's also review what this does to people with preexisting conditions. The Republicans say that this is all about giving flexibility to States. We hear that over and over again. It sure sounds nice until you realize that it is a code word for there being massive funding cuts and the elimination of basic health protection. In the name of ``State flexibility,'' this bill would allow insurers to charge those with preexisting conditions sky-high premiums the moment they get sick. Under this bill, ``State flexibility'' means reimposing annual and lifetime limits on patients, including infants who are born with serious medical problems. Under TrumpCare, ``State flexibility'' means charging Americans over the age of 50 up to five times more than younger people. That is exactly why the American Association of Retired Persons, the AARP, has steadfastly opposed these Republican changes. To my Republican friends, ``State flexibility'' means tossing out essential health benefits, which is the guarantee that your insurance will cover the basic services your family may need--prescription drugs, maternity care, mental health and addiction treatment. I spoke to one of my Republican colleagues the other day and asked: What are you driving at here? Are you saying that we can reduce the cost of health insurance if we give people the option of saying that they will not buy coverage for mental illness and substance abuse treatment? He said: Yes, that is one thing they can do. I said: Then what happens next month when you discover that your daughter, a sophomore in high school, is now taking opioids and may move to heroin next? You want to intervene. You want to do it, but now you have to pay out of pocket because you didn't buy the essential coverage of mental illness and substance abuse treatment. It is a shortsighted game to reduce premiums and give up basic essential benefits, but that is what Republicans propose. That is why this measure is opposed by every major medical provider and patient organization nationwide: AARP, the American Hospital Association, the American Medical Association, the American Academy of Pediatrics, nurses, disability groups, the American Heart Association, the American Lung Association, the American Diabetes Association, and the Alzheimer's Association--the list goes on and on. But guess who also came out in opposition to this bill? Insurance commissioners and Medicaid directors. These are the officials who would actually have to implement these cuts. They agree with the Congressional Budget Office that you can't slash the healthcare budget by 20 to 30 percent and expect that States will have ``flexibility'' to make up the difference. The bipartisan association representing every Medicaid director in the country--every one of them--stated that Medicaid cuts would ``constitute the largest transfer of financial risk from the federal government to the states in our country's history.'' Show me a State that can cover as many people with the same benefits if one-third of the money is taken away. That is what the Republican bill does. Here is what Governor Sandoval, a Republican Governor in Nevada, said: Flexibility with reduced funding is a false choice. . . . I will not pit seniors, children, families, the mentally ill, hospitals, care providers, or any other Nevadan against each other because of cuts to Nevada's health system proposed by Graham-Cassidy. This is a Governor speaking in the same clear terms as Governors of both political parties about the impossible dilemma that would be created by this bill. Enough is enough. The law that we passed, the Affordable Care Act, helped 20 million people get health coverage. People with preexisting conditions were finally protected. Women are no longer discriminated against when it comes to health insurance. Americans get free preventive healthcare, such as cancer screenings. Is it a perfect law? Not by any means, but at 3 percent of the individual market, we need to do better, and we can. We need to improve that market. First, the Trump administration must do its best to help us, not hurt healthcare in America. If they are setting out to sabotage this healthcare system, they can do it, but I hope they will not. The President will not suffer if they do, but a lot of innocent American families will. It will make it harder for people to enroll in insurance groups. It will slash funding for outreach. It will actively discourage insurers to offer health plans to individuals. Mr. President, I am going to yield the floor to the Democratic leader. In closing, I ask unanimous consent that the September 22, 2017, article in the New Yorker by Dr. Atul Gawande be printed in the Record.

Mr. DURBIN. Mr. President, I ask unanimous consent that the statement of A.J. Wilhelmi, president and CEO of the Illinois Health and Hospital Association also be printed in the Record.

Mr. DURBIN. Finally, I ask unanimous consent that the statement by the National Association of Medicaid Directors, to which I referred, be printed in the Record.

Mr. DURBIN. Mr. President, what America wants is to solve problems, not create them. The Graham-Cassidy bill will create problems for every American family. Let's do something right. On a bipartisan basis, let's sit down and work out improvements to our healthcare system. Let's stop the partisanship when it comes to healthcare. Let's come together now. We each have our grievances against one another, one party or the other. The American people are tired of our grievances. They are expecting us to do something positive. We can do it. Let's return to the bipartisan negotiation process. I think that Senators Lamar Alexander and Patty Murray, Republican and Democrat, can lead us to a good path to strengthen our healthcare system. I yield the floor. Recognition of the Minority Leader

Mr. DURBIN

Mr. DURBIN. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. DURBIN

Mr. DURBIN. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. DURBIN

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

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

Mr. DURBIN. I announce that the Senator from New Jersey (Mr. Menendez) is necessarily absent.

Mr. DURBIN

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

Mr. DURBIN. I announce that the Senator from New Jersey (Mr. Menendez) is necessarily absent.

Mr. DURBIN

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

Mr. DURBIN. Mr. President, what is the business of the Senate this morning?

Mr. DURBIN. I ask unanimous consent to speak as in morning business.

Mr. DURBIN. Mr. President, I wish to say that the comments made by the Democratic leader, the Senator from New York, really touched me because they go to the heart of this institution. It was only a few weeks ago, in a dramatic moment, when Senator John McCain returned from Arizona to come to the floor of the Senate and cast a historic vote to move forward on the debate on healthcare. He asked for 15 minutes after that vote to say a few words about his experience as a person and his observations as a Senator, and I stayed in my chair because I wanted to hear him. John McCain came to the House of Representatives the same year I was elected. Our careers have at least been close or parallel in some respects, though I couldn't hold a candle to him in terms of his personal life experience and his experience in the military, as well as being a candidate for even higher office. I listened carefully as he reminded us of what it takes for the Senate to work. What it takes, of course, is the determination of both political parties to solve a problem. He reminded us that means sitting down in committee, with experts, working through some of these issues, particularly the more complex issues--the give-and-take of the legislative process. He pointed specifically to the effort to repeal ObamaCare as a failure by those standards. He used as an example the fact that ObamaCare, during the period of Republicans' efforts to repeal, was actually gaining popularity in this country--exactly the opposite of what the other party might have expected. It was an indication to him that we needed to do things better in Senate. Just a few days later, he cast a critical vote to stop what was a flawed process on the Republican side--to repeal ObamaCare without a good alternative, without a good substitute. I remember that vote early in the morning, right here in the well of the Chamber, and I remember what followed when I saw Senator Lamar Alexander and Senator Murray behind me in front of the cloakroom in a bit of a huddle after that historic vote. I later learned that they had decided it was their turn to step up on a bipartisan basis and find a way to strengthen our healthcare system, not what we had just seen but a different way--a way that kind of relied on experts at State levels to give us advice and experts in Washington to really cull through the ideas to find the very best. They invited other Members of the Senate to join them, even those of us not on the committee. Senator Alexander and Senator Murray have had several meetings, which I have attended and which were very productive meetings--bipartisan gatherings over coffee and donuts with insurance commissioners from States all across the Nation, commissioners from both political parties, bipartisan meetings of Governors from States all across the United States. They were basically sitting down and saying: What can we do now? What can we all agree to do, regardless of party, that will reduce the increasing costs of health insurance premiums, provide coverage for more people, and provide better healthcare--quality care? It was a good-faith effort, and it was encouraging, after 7 wasted months of political debate on the floor of the Senate. I went to those meetings and came away feeling very positive. It was clear that some very basic ideas were emerging from all over the United States. One of the ideas was cost-sharing reduction so that health insurance companies that took on sicker, older patients and had worse loss experiences would be able to be compensated so they could reduce premium costs, bring the cost of health insurance down, and make sure more people had it available. Another proposal was reinsurance. That is the same basic idea. Let's find a way to make the increase in health insurance premiums slow down. I remember the commissioner from the State of South Carolina, a Republican, who said that his experience was that in the next year, health insurance premiums in the individual marketplace were going up 30 percent. He said that, if you bring in the cost-sharing reductions, which the Federal Government can do, it would only be 10 percent. Ten percent is bad enough. Thirty percent is painful. Here is something we can do on a bipartisan basis to reduce the cost of health insurance premiums. It struck me as obvious that this is what we should be doing as the Senate. I applauded Senator Alexander personally and publicly, and Senator Murray, as well, for doing what the Senate was supposed to do. Little did I know that at the same time they were making this bipartisan effort, there was another Republican effort under way to derail them, to stop them, to end the bipartisan conversation that was under way in the HELP Committee. The Cassidy-Graham proposal, which may come to the floor as early as next week, is an effort to repeal ObamaCare, but it is a flawed effort. Earlier this morning, the Republican leader came to the floor and spoke of the debate that we have had over and over about what we are going to do in the future, and he talked about the failed ideas of the past. I can tell you that the Cassidy-Graham proposal is a return to failed ideas--ideas rejected once by the Senate but certainly by the American people. In this morning's Chicago Tribune, one of the business writers, Michael Hiltzik, wrote an article entitled ``The GOP's last-ditch ObamaCare repeal bill may be the worst one yet.'' Mr. President, I ask unanimous consent to have printed in the Record this article in its entirety.

Mr. DURBIN. Let me quote a few sentences from this article because I think they make the case dramatically about how bad the Cassidy-Graham substitute would be. Here is what he said: Compared with its predecessors, the bill would increase the ranks of America's medically uninsured more--by millions of people--cost state governments billions more and pave the way for the elimination of all protection for those with preexisting medical conditions. He goes on to say: Among the biggest losers of federal funding would be the states that had the foresight to expand Medicaid under the Affordable Care Act and the resolve to reach out to lower- income residents [and provide health insurance] coverage. He goes on to say that, under this Cassidy-Graham bill, ``they'd be punished with draconian cuts in healthcare funding.'' He goes on to write: Among the big winners would be the states that have done nothing of the kind for their residents--refusing the Medicaid expansion and interfering with outreach efforts [to bring more people into health insurance coverage]. They would be rewarded, perversely, for doing the wrong thing. He writes: Over the last week or so, reviews of the measure have been pouring in from healthcare experts, and they're almost unanimously negative. Major health provider and consumer organizations have turned thumbs down, as have analysts looking at its economic effects. He talks about the impact of this bill beyond increasing Federal funding for States that did not help their residents and cutting Federal funding for States that did. The bill provides no replacements for the tax credits available for small businesses and the subsidies for health insurance premiums currently in the law beyond a capped block grant to States. He writes: In effect, it's a repeal-and-no-replace bill. The Congressional Budget Office, as it happens, analyzed that approach in July in connection with a different bill. It found that by 2026 the number of uninsured Americans would increase by 32 million, compared with under current law. That's about 50% more people uninsured than it estimated for other Republican repeal-and-replace measures, which the budget office said could cut enrollments by 20 million to 22 million. Honestly, can my colleagues on the other side of the aisle in good conscience go home to their States and say: I voted to repeal ObamaCare and you are going to lose your health insurance as a result of it. I can tell you what it means in my State. A million people would lose their health insurance because of this Republican repeal effort. I don't know how Members of Congress--House or Senate--from Illinois could in good conscience vote to take health insurance away from massive numbers of Americans. We are blessed here. Those of us who serve in Congress have access to good health insurance. It is not cheap. It shouldn't be. But it is there. It is always there, and we don't have to worry about it. Some Members are wealthy enough that they take care of it in other ways. For most Members of Congress, we use the insurance marketplace and pay our share of the premiums. The government pays a share of it, just as it does for Federal employees. We have access to health insurance. How then could we turn and say to the people we represent: I just voted for a bill to take away your access to health insurance. That is what this Cassidy-Graham bill does. That to me is hard to imagine--that a Member can believe they were elected to the Senate for that purpose. What does it do to the States with this capped block grant in terms of their loss of Federal funds? It is amazing. Some States would lose as much as 60 percent of what they currently receive under the current law. According to the numbers crunched by the Center on Budget Policy Priorities, among the states that went all-in on Obamacare, including expanding Medicaid and mounting aggressive enrollment support for the marketplaces, California would get $27.8 billion less in federal funding in 2026, New York $18.9 billion less, and Massachusetts $5.1 billion less. I looked at the list for my State of Illinois. It would lose $1.4 billion in Federal funding by 2026. Just to show the contrast, as for the State of Texas, which did not expand Medicaid and which did not cover low-income individuals with health insurance, what would the Cassidy-Graham bill do for the State of Texas? They wouldn't lose a penny. They would add in Federal funding $8,234 million. They would be big winners because they turned their back on low- income individuals and didn't expand Medicaid or increase the number of enrollees. What a perverse incentive for Governors and governments on a State basis to turn down coverage knowing that at some point they will be rewarded for that approach. Another provision of Cassidy-Graham that is significantly worse than its predecessors is the latitude it gives states to eviscerate consumer-protection rules in the Affordable Care Act. One of the most important parts of the Affordable Care Act was a reform that said: If you are going to buy health insurance, it is going to be there when you need it. First, you will be able to buy it, even if you have someone in your family with a preexisting condition. That is one of the first casualties of Cassidy-Graham--going back to a failed idea in the past, which said if you have a sick baby or if you have a spouse who survived cancer, you either can't buy health insurance or you can't afford it. We got rid of that once and for all. At least we thought we did. Cassidy-Graham brings it back to life. It says: Let the insurers decide if they want to cover you or not. Another thing we said is that the disparity in premium costs between the most expensive policy and the least will be 3 to 1. Cassidy-Graham tosses it out and says it is 5 to 1. What it means--and AARP knows this better than any other organization--is that senior citizens are going to end up paying more for their health insurance under Cassidy-Graham than they currently do under the Affordable Care Act. When you look at the other protections that we built in to provide that your policy, when you bought it, would cover mental illness and substance abuse treatment, that is considered revolutionary but important. Finally, after all of these years in America, we are looking at mental illness as an illness rather than a curse. We are looking at it as something that can be successfully treated. Yet here comes Cassidy-Graham tossing out that requirement as well. Let the insurers decide what they want to offer. I was talking to one of the Republican Senators the other day, and he said: Well, you know, some people just may not want to buy certain coverage. I can understand that, but I can also understand the reality of life. Who can predict that next year or next month you would learn that perhaps your high school daughter has been taking opioids and now is addicted to heroin? You didn't know it before, not when you bought your health insurance policy. Now that you know it, who is going to cover the substance abuse treatment? Under the Affordable Care Act, it is built into your health insurance policy. Under the Cassidy-Graham approach, it is an option. Try it if you like it. It doesn't work in a lot of circumstances. We buy insurance for things we pray will never happen, but we want to be covered in case they do. Cassidy-Graham walks away from that. They are for what they call ``flexibility.'' It is flexibility to buy insurance that isn't there when you really need it. When you look at the litany of all of the States that are winners and losers under Cassidy-Graham, you have to shake your head. Why would we be richly rewarding States that have not done their part to expand Medicaid coverage? Why would we devastate the Medicaid Program, which is so important for so many people? Medicaid is a program that many people didn't understand until we got into this debate, but it is a program that is essential if you have a disabled child. A woman in Champaign, IL, with a young son in his twenties suffering from autism told me that without Medicaid coverage he would have to be institutionalized, and there is no way her family could afford it. We know that Medicaid is there for that family and for many low- income families when it comes to pregnancies, to make sure that mom has a successful pregnancy and that the baby is born healthy and ready to thrive. Is that an important asset? Of course it is, and it is an important element of Medicaid. The one thing that costs the most in Medicaid is something the Republicans don't want to acknowledge, and that is the fact that two out of three people in nursing homes--seniors who are under medical care--rely on Medicaid. Without that Medicaid assistance, who is going to pay that bill? The family reaching into their savings? Some can, but most will not be able to afford it. How will the Republicans explain that away as just one of the benefits of flexibility--that Medicaid is not there when your parent or grandparent desperately needs it? So now we have this debate before us, which will come up by the end of next week, and it is one that really will affect a lot of people across America. I, for one, will do everything I can to stop this. Any program that is going to take health insurance away from a million people in Illinois and up to 30 million nationwide is a bad start, a bad idea, a failed idea. I yield the floor. I suggest the absence of a quorum.

Mr. DURBIN

Mr. DURBIN. Mr. President, I rise in opposition to the nomination of Noel Francisco to be the Solicitor General of the United States. The Solicitor General--often called the ``tenth Justice''--argues on behalf of the United States in the Supreme Court. It is a critical position in our government, and it is critical that we have a Solicitor General with the independence to tell the President when the position he wants the United States to take before the Court is indefensible. Mr. Francisco already had a troubling tenure as Acting Solicitor General earlier this year. He led the effort to defend the original version of the President's controversial travel ban. That Executive order was blocked repeatedly in Federal courts and was then withdrawn. In defending this unconscionable order, Mr. Francisco argued that there should be no judicial review when a President makes decisions on immigration policy on the basis of his national security assessment. The Ninth Circuit stated that ``there is no precedent to support this claimed unreviewability, which runs contrary to the fundamental structure of our constitutional democracy.'' If he is confirmed, Mr. Francisco would likely be called upon again to defend President Trump's latest iteration of the travel ban when it is considered by the Supreme Court in October. When he was under consideration by the Judiciary Committee, I asked Mr. Francisco many questions to give him the opportunity to show his independence from President Trump. For example, I asked him if he agreed with President Trump's absurd claim that 3 to 5 million people voted illegally in the 2016 election. He refused to answer the question. I asked him if he believed it was appropriate for a President to ask an FBI Director to pledge loyalty to him. He declined to comment. I also asked him about the Constitution's Emoluments Clause, which prohibits government officials from accepting gifts or benefits from foreign states without Congress's consent and which many legal scholars believe President Trump has violated. Mr. Francisco actually had written an opinion on the Emoluments Clause when he was in the Justice Department's Office of Legal Counsel. I asked him what he believed the Founding Fathers intended this clause to mean. His response? ``I do not have any well-formed views on the scope of the Emoluments Clause.'' It is puzzling that an originalist like Mr. Francisco would not comment on the original meaning of a constitutional provision, but he clammed up when it came to this particular clause which is directly relevant to President Trump's behavior. While Mr. Francisco has been reluctant to demonstrate independence from President Trump, he has been willing at many points in his career to demonstrate loyalty to special interests. For example, Mr. Francisco gave a speech at the 2015 annual conference of the Community Financial Services Association, better known as the trade association for the payday lending industry. Here is what he said: ``The payday lending industry is facing the challenge of a lifetime. It is essential that, as an industry, you be prepared to respond on all fronts, and it has been my privilege to assist you in doing this over the last few years. This includes the legislative front, the regulatory front, and--my favorite--the legal front.'' Let's be clear. We don't need a Solicitor General who thinks it is a privilege to assist payday lenders. Mr. Francisco also was a prominent lawyer for the tobacco industry. His advocacy on their behalf prompted a number of national antismoking and health organizations to call for Mr. Francisco to recuse himself from tobacco-related litigation matters if he were confirmed. I asked Mr. Francisco if he would commit to recuse himself from tobacco litigation, but he would not make that commitment. Mr. Francisco has been eager to position himself alongside rightwing groups like the Federalist Society and the Heritage Foundation. He made this particularly clear at a speech he gave to the Heritage Foundation on May 19, 2016, when he said: ``We live in an era where our views, traditional views, are under constant attack. Our adversaries have not even really tried to beat us through the democratic processes, but instead go straight to the courts, where they often win not by asserting that our views are legally wrong, but that they are so fundamentally illegitimate that the Constitution prohibits them. And they now have an increasingly compliant Judiciary that agrees with their policy views and that is unconstrained by legal principle.'' This is a troubling characterization, to claim that people who do not share the views of the Heritage Foundation are ``our adversaries.'' It is just as troubling to claim that the Judiciary is acting ``unconstrained by legal principle'' whenever it disagrees with the views of the Heritage Foundation. Comments like this raise serious questions about the ideology Mr. Francisco would bring to the Solicitor General's office. Make no mistake--President Trump is likely to keep the Supreme Court busy. It has never been more important to choose a Solicitor General who displays independent judgment and who is willing to say no if the views the President wants to execute are improper or unlawful. In my questions to him, I repeatedly gave Mr. Francisco the opportunity to display that independent judgment, but he did not do so, and what I have seen in his speeches and his advocacy concerns me. In short, I do not believe Mr. Francisco has demonstrated that he can be the Solicitor General that our Nation needs. I will oppose his nomination.