Tim Kaine

Mr. KAINE

Mr. KAINE. Mr. President, I rise to talk about a topic that is consuming much attention--our efforts to improve healthcare for Americans. Before the passage of the Affordable Care Act in 2010, Americans with preexisting conditions faced serious barriers. Since 2010, the rate of uninsured Americans has declined to a historic low, with 20 million more Americans--the combined population of 16 or 17 States--getting access to health insurance coverage. Over 410,000 Virginians have received care through individual marketplaces just last year. An additional 400,000 would be eligible to receive Medicaid if Virginia ever chooses to expand it. Since being put on the HELP Committee or being notified I would be put on it in December, I visited community health centers, medical schools, behavioral treatment centers, nursing programs all across Virginia talking to people about their healthcare needs. I am committed to working together with my colleagues to improve the healthcare of Virginians and Americans. There is a right way and a wrong way to do it. After there was the failure of an effort in late July or early August to pass a partisan repeal and replacement of ObamaCare using the budget reconciliation process, the success of which would have taken health insurance away from 20 million Americans, I am disappointed that we haven't learned the lesson about the right way to do this and are apparently poised to explore yet again doing it the wrong way. There is a proposal on the table that is designated the Graham- Cassidy proposal, and it is just as threatening as the ACA repeal we voted on just 2 months ago. It restructures traditional Medicaid funding using per capita caps and block grants. The core of this bill is an effort to dramatically go after, restructure, and shrink Medicaid, which is critical to so many people. It ends protections for people with preexisting conditions by allowing States to essentially rewrite essential health benefits. It would eliminate Medicaid expansion and the Affordable Care Act subsidies and replace them with a block grant that would be insufficient to cover the needs of Virginians. Even that block grant funding would end after 2026--as if the need to help low- and moderate- income people afford coverage would dramatically disappear overnight. The proposal is new and is newly on the floor. There isn't a full CBO analysis of it, but initial indication has led groups like the American Medical Association and the AARP to come out against it. They are worried it will leave insurance out of the reach of millions of Americans. In Virginia alone, more than 301,000 marketplace enrollees would have their tax credits to help them afford insurance jeopardized. What would it mean for the healthcare system? We are not completely sure. At least on the earlier versions we voted on, we had CBO scores telling us how many millions might lose insurance. There seems to be a desire to rush this through prior to a full CBO analysis. I can't understand why. But we do know it would be devastating to those on Medicaid. Sixty percent of those on Medicaid in Virginia are children, but the majority of spending on Medicaid is for our parents and grandparents, the elderly, and folks with disabilities. I was just in Bristol, VA, on the Virginia-Tennessee border this weekend. I heard very palpable requests for the need for better healthcare, especially in rural Virginia. Here is what we know about the Graham-Cassidy proposal, at least based on the analysis of it thus far by my State healthcare officials. We will see a $1.2 billion cut in Medicaid under this plan over the next number of years, and the cuts would impact families like those I visit as I travel around Virginia. I recently had a roundtable in Northern Virginia with parents of children with severe disabilities who, though they have disabilities, are doing some remarkable things because they receive support from Medicare for assistive technologies and in school programs. A mother, Corinne, told me about her son Dylan. Dylan has a very rare neuromuscular condition SMARD--spinal muscular atrophy with respiratory distress. He has a tracheostomy tube and relies on a ventilator to breathe. He also gets all of his nutrition through a G-tube. He requires in-home skilled nursing services, and he also requires a nurse to attend school with him. But he goes to public school, and he is a successful student because Medicaid funding enables him to go. Medicaid helps reimburse the school system for the services they provide him. ``For us, affordable and quality healthcare means that Dylan can lead a fairly normal life despite his medical issues.'' That is what his mom said. He can lead a fairly normal life on a ventilator with a tracheostomy tube in a wheelchair with a nurse. He can lead a fairly normal life, despite his medical issues. He can live at home, go to school, and participate in activities any kid his age enjoys. Without the assistance of Medicaid, he wouldn't be able to do those things. Reducing Medicaid spending would limit States' abilities to provide waivers for medically complex kids. The mother adds that ``the possible return of lifetime caps and limitations on preexisting conditions would be devastating.'' I also met with a mother, Amy, from Richmond, who has a son, Declan. Medicaid covers her son's care, therapy, and medical supplies. Medicaid helps her son have the best quality of life possible and helps him with the prospect she prays deeply for--that one day, despite his medical condition, he can live independently as a productive adult. The Graham- Cassidy funding cuts to Medicaid could take away this protection for countless Virginians, especially these children. Here is what I ask for: Why don't we have an open process to truly debate improvements to our healthcare system, instead of a rushed, closed, secretive process that threatens mothers like Amy and children like Declan? After the efforts last summer, I hoped that the colleagues in the world's greatest deliberative body would stop a secretive, harmful rush and, instead, embrace dialogue, hearing from experts and witnesses as we would improve healthcare, attempting to stabilize the individual marketplace, lower premiums, and expand care rather than reduce it. We gave a standing ovation on the floor of the Senate in late July when our colleague, Senator John McCain, returned from a very difficult diagnosis of brain cancer. We gave him a standing ovation after he spoke to us, and here is what he said. He talked about the fact that we had a challenge on healthcare. He talked about the skinny repeal bill that was on the floor of the Senate. He said: We've tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them it's better than nothing, asking us to swallow our doubts and force it past a unified opposition. I don't think that is going to work in the end. And it probably shouldn't. Why don't we try the old way of legislating in the Senate, the way our rules and customs encourage us to act. If this process ends in failure, which seems likely, then let's return to regular order. Let the Health, Education, Labor, and Pensions Committee under Chairman Alexander and Ranking Member Murray hold hearings, try to report a bill out of committee with contributions from both sides. Then bring it to the floor for amendment and debate, and see if we can pass something that will be imperfect, full of compromises, and not very pleasing to implacable partisans on either side, but that might provide workable solutions to problems Americans are struggling with today. To my great satisfaction, after the skinny repeal bill went down--and this body decided that it didn't want to precipitously take healthcare away from 20 million people--that is the course that this body embraced. It is what our heroic colleague suggested that we embrace. The HELP Committee--which, as a member of this, I am very aware had refused to hold a hearing on any of the proposals in the House or in the Senate around the repeal of ObamaCare--decided finally to do what the HELP Committee should do. The ``H'' is for ``Health.'' To pass a bill reorienting one-sixth of the American economy around the most important expenditure that anybody ever makes in their life without letting the HELP Committee hear from it was foolish to start with. So now we have embraced doing it the right way. Under the leadership of Senator Alexander and Senator Murray, we have had four robust bipartisan hearings. We invited Governors to come from around the country. They had to turn their schedules topsy-turvy to do it-- insurance regulators, insurance executives, patients, doctors, hospitals. There were four hearings, each with multiple witnesses. We turned their schedules topsy-turvy. We had them here. We had coffees before each hearing and invited all Members of the Senate, not just those on the HELP Committee, to interact and hear from these experts. We have gotten advice from them on what we need to do to stabilize the individual insurance market and what we can do in the long term to make healthcare better for everyone. We should take advantage of those recommendations. When the fourth hearing was completed last week, the chairman of the Committee, Senator Alexander, and the ranking member, Senator Murray, with the support of this very diverse committee--left, right and center, Democrats and Republicans--have embarked on a bipartisan process to find, after a full and transparent airing of the issues, a way to stabilize the individual insurance market. We are on the verge of doing that. Yet what we are told is, instead of going through our committee process and hearing and airing it before the public, now there is a new bill that has just recently come out with no full CBO score. The idea is to force that through, with no CBO score, with no full committee process that would enable us to hear from witnesses, with no opportunity for members of any of the committees--Finance or HELP--to offer amendments, with no meaningful floor debate, and with no opportunity for amendments on the Senate floor. Why did we give Senator McCain a standing ovation just 6 weeks ago when he suggested that when it comes to something as important as healthcare, we should treat it with seriousness, so we can get it right and not rush and get it wrong? I stand here--and I hope I am on my feet a good bit more between now and the end of the month--to ask this question: Why backslide? Why go backward when we had embraced a process of bipartisan discussion? I am fully aware that as a Member of the minority party, I have no power except my ability to convince Republicans that I actually have a good idea. But a one-party process on the floor that tries to end run the relevant HELP Committee is guaranteed to fail. It might pass, but it is guaranteed to fail because it is guaranteed to hurt people. It is guaranteed to have some consequences that are harmful and known and other consequences that are harmful and unknown because it has been rushed, and it hasn't been done in the view of the public with the ability to fully listen to them. Just think about it this way: What does it say about your commitment to your legislation if you are not willing to have it subjected to a normal review by the committees that have jurisdiction over it? The Graham-Cassidy bill has some provisions in it that are relevant to the Finance Committee's jurisdiction, but Finance is apparently not going to do a markup of the bill, and they are not really going to hear from experts about the bill. There are other provisions in Graham-Cassidy dealing with essential benefits that are squarely within the jurisdiction of the HELP Committee, but the HELP Committee isn't going to have a hearing either. So in spite of the good recommendation we were given by our senior colleague who was just on the floor--who was characteristically here to talk in kind words about the public service of someone who has worked with his staff for 30 years--we gave him a standing ovation, and we are prepared to violate everything that he just suggested we do. As I conclude, I will just say this. This isn't about healthcare. Healthcare is important enough. No one ever spends a dollar on anything that is more important than their health. It is the most important thing that anyone ever spends a dollar on--health, my health, the health of my family. I think we can all share that. Nothing is more important. It also happens to be one of the largest sectors of the American economy. Between 15 and 20 percent of America's GDP is healthcare. This is a very important issue. If you are trying to reorient one-sixth or one-fifth of the economy, if you are touching the expenditure of priority that is the single most important priority in anyone's life, that is important enough. I would argue, in closing, that there is something I think is equally important; that is, this body. We celebrated the 230th anniversary of the Constitution this past Sunday. James Madison and others in Philadelphia, tried to figure out how this government should work. They made a very unusual decision that would be different from the decisions that are made in many countries; that is, they put the legislative branch first. There are three coequal branches. In most societies, the executive is first, but not here--first among equals. We are meant to really play an A game. We are really meant not to be an article-II-and-a-half branch reacting to a Presidential tweet or encouragement; we are supposed to be an article I branch. In the legislative branch in article I, the Senate is given a very particular role. We are called the world's greatest deliberative body. We are the saucer into which the partisan heat of the day is poured and allowed to cool, so the decisions made in the Senate are supposed to be more careful and more deliberate. This is a great body that has been sadly hobbled by partisan gridlock, and we have not achieved what the Senate should achieve. We learn in math as we grow up that the whole is equal to the sum of the parts, but what you find in life is that often the math doesn't work out. Sometimes the whole can be equal to or greater than the sum of the parts in life if teams work well together. But sometimes--and this describes the Senate now--there are 100 wonderful, accomplished people in this body. Yet again and again, and now for years, the whole has been equal to less than the sum of the parts. We have done very little of meaning, very little of substance. Yet now we are poised to tackle the most important issue that most affects people and the biggest sector of the American economy. If we get it right, we can send a message to the public that the Senate will once again be the Senate. We will once again be a deliberative body. We will once again do what we are supposed to do. I think this country now needs to see some adults in the room, some group of people willing to work together--Democratic and Republican--to solve problems and do the right thing for the American public. If we do this right, we can send that message. If we do it wrong, we will hurt people, and we will also hurt the credibility of this institution in a way that I think will last for years. We have a choice. It is up to us. We either follow the advice that our colleague gave us on the floor 6 weeks ago, which we gave him a standing ovation for, and we gave him the ovation because we knew he was right--we either follow that advice or we decide to ignore it and continue the downward spiral of a great body. With that, I yield the floor.

Mr. KAINE

Mr. KAINE. Mr. President. Far too many students leave our Country's classrooms ill-equipped to keep up with the demands of the 21st century job market. Many enter high school and postsecondary education uninformed of the range of careers available to them. For our Country's continued success, it is essential that our young people have exposure to the vast range of available work and career options early in their academic careers so that, by the time they begin high school, they are more knowledgeable about future paths and what they need to do to pursue them. Wherever I travel through Virginia I hear the same thing from business owners, manufacturers, and plant managers: there are good paying jobs out there, we just need to train our students with the skills to fill them. Middle school is a time for students to begin thinking about what they want to pursue in life. Helping them explore how their coursework could support those interests can make a valuable difference down the road. Programs that focus on career and technical education (CTE) allow for students to explore their own strengths and passions, as well as how they match up with potential future careers. But limited funding for middle school CTE programming often requires students to wait until high school for access to this type of experience. This is why I am pleased to introduce today the Middle School Technical Education Program Act, or Middle STEP Act. This bipartisan legislation creates a pilot program that allows for middle schools to partner with colleges and local businesses to develop and implement CTE exploration programs that give students access to apprenticeships or project-based learning opportunities. Additionally, middle school CTE programs funded through the Middle STEP Act would give students access to career guidance and academic counseling to help them understand the educational requirements for high-growth, in-demand career fields. Programs would assist students in drafting a high school graduation plan that demonstrates what courses prepare them for a given career. The programs must also provide a clear transition path from the introductory middle school program to a more narrow focus of CTE study in high school, and must be accessible to students from economically disadvantaged, urban and rural communities. I believe this meaningful legislation can propel young students toward the careers of the future, and help to fill workforce shortages across the Commonwealth and the Nation. I strongly encourage my colleagues to consider this legislation to allow for students to have opportunities to explore potential career choices and pathways early on in their academic careers. Their futures depend on it.

Mr. KAINE

Mr. KAINE. Mr. President. Far too many students leave our Country's classrooms ill-equipped to keep up with the demands of the 21st century job market. Many enter high school and postsecondary education uninformed of the range of careers available to them. For our Country's continued success, it is essential that our young people have exposure to the vast range of available work and career options early in their academic careers so that, by the time they begin high school, they are more knowledgeable about future paths and what they need to do to pursue them. Wherever I travel through Virginia I hear the same thing from business owners, manufacturers, and plant managers: there are good paying jobs out there, we just need to train our students with the skills to fill them. Middle school is a time for students to begin thinking about what they want to pursue in life. Helping them explore how their coursework could support those interests can make a valuable difference down the road. Programs that focus on career and technical education (CTE) allow for students to explore their own strengths and passions, as well as how they match up with potential future careers. But limited funding for middle school CTE programming often requires students to wait until high school for access to this type of experience. This is why I am pleased to introduce today the Middle School Technical Education Program Act, or Middle STEP Act. This bipartisan legislation creates a pilot program that allows for middle schools to partner with colleges and local businesses to develop and implement CTE exploration programs that give students access to apprenticeships or project-based learning opportunities. Additionally, middle school CTE programs funded through the Middle STEP Act would give students access to career guidance and academic counseling to help them understand the educational requirements for high-growth, in-demand career fields. Programs would assist students in drafting a high school graduation plan that demonstrates what courses prepare them for a given career. The programs must also provide a clear transition path from the introductory middle school program to a more narrow focus of CTE study in high school, and must be accessible to students from economically disadvantaged, urban and rural communities. I believe this meaningful legislation can propel young students toward the careers of the future, and help to fill workforce shortages across the Commonwealth and the Nation. I strongly encourage my colleagues to consider this legislation to allow for students to have opportunities to explore potential career choices and pathways early on in their academic careers. Their futures depend on it.

Mr. KAINE

Mr. KAINE. Mr. President, sexual assault is a major issue on our Nation's college campuses. Too many young people are sexually assaulted while in school. Alarmingly, the majority of these crimes will go unreported. The consequences of these crimes are often destructive to a student's mental, physical, and emotional well-being. In addition, the trauma of the assault and its aftermath drives many survivors to drop out of school. Sexual assault survivors deserve access to a safe and supportive educational environment. I have met with students in Virginia and across the Country who have expressed the need for someone on campus to turn to for unbiased advice and guidance following an assault. Given the prevalence of this issue, it is clear that our federal higher education policy must do more to prevent sexual assaults and ensure that survivors have access to and can navigate through a plethora of resources. This is why I am pleased to introduce today the Survivor Outreach and Support Campus Act of 2017 or SOS Campus Act. The SOS Campus Act requires universities that receive Federal funding to establish an independent, on-campus advocate for survivors of sexual assault. The advocate will help students access all of the resources available to them, both on and off campus, in the wake of a sexual assault and will guide them through the process of reporting their assault if they choose to do so, acting always in the interests of the victim, not the university. The SOS Campus Act requires that the confidential advocate is responsible for ensuring that survivors, regardless of whether they decide to report the crime, have access to emergency and follow-up medical care, guidance on reporting assaults to law enforcement, medical forensic or evidentiary exams, crisis intervention, and information on their legal rights. The advocate will also conduct a public information campaign on campus to inform students of their services, and train other university staff to provide information to students about the advocate. I am proud to introduce this legislation that would ensure all college students across our Country have access to a supportive advocate following a sexual assault on campus. I strongly ertdourage my colleagues in the Senate to consider this legislation to help protect our students from sexual violence and its damaging impact.

Mr. KAINE

Mr. KAINE. Mr. President, I rise to speak about the pending NDAA. In particular, I rise to speak about an amendment that has been previously discussed on the floor that is being offered by the Senator from Kentucky, Mr. Paul, that deals with the current authorizations for use of military force that are justifying American military action in Afghanistan, Iraq, Syria, and numerous other countries. The authorizations that currently support military actions were passed in 2001 and 2002. About a quarter of us were here and voted on those. Three-quarters of us have joined either the Senate or the House since those authorizations have been voted on. What that means is that we have American troops who are deployed in harm's way, that thousands have been killed, that thousands have their lives at risk right now, and that three-quarters of Congress has never voted to support the military operations that are currently underway. Many of us support them or support them with recommendations or reservations or qualifications, but three-quarters of us have never cast a vote. These authorizations are, respectively, 15 and 16 years old. The authorizations have, essentially, been interpreted in a very broad way--first, by the Bush administration; second, by the Obama administration; and now by the current Trump administration. I would argue that the current interpretation of the authorizations would essentially allow, without any approval from Congress, an American President to wage war anywhere against any terrorist group for however long he wants to. That was not the intention of the authorizations when they were originally drafted. If you were to go back and talk to those who had been here and cast their votes in 2001 and 2002, they would say that it was completely beyond their contemplation that what they were voting for then, which was going after those who had attacked the Pentagon--9/ 11 was yesterday--and the World Trade Center, would 16 years later still be used to support military action in a total of 14 countries in 35 separate instances having been declared by the last three administrations. Senator Paul has an amendment on the table, and the amendment is this: to sunset the 2001 and 2002 authorizations in 6 months as a mechanism for forcing Congress to finally do the job of having a debate and defining the legal authority of the military mission that we are currently engaged in and putting a senatorial and congressional thumbprint on the mission so that those who are risking their lives know that they are doing so with a political consensus by the American political leadership here in Congress. I am supporting Senator Paul's amendment. I think it is way past time for Congress to take this up and for everybody to be on the record. I think that our allies need to know whether Congress supports the American military missions that are currently underway. I think that our adversary needs to know that there is a congressional resolve, not just an Executive resolve. Most importantly, I think that the American troops who are deployed in harm's way every day deserve an answer to the question of whether Congress is behind them. I came to Congress being very focused on this and to the Senate in January of 2013. I gave my first speech about it on the floor in the summer of 2013, when President Obama expanded the military action against al-Qaida to also incorporate military action against ISIS, which did not form until 2 years after the 9/11 attack. I filed my first military authorization, seeking to get Congress on board and to send to the troops the message that we supported them. That was now almost 3 years ago. I was once able to get a vote on an authorization in the Foreign Relations Committee. It passed out of committee but died for lack of any action on the floor. Since 2015, out of a thought that we should try to be at least as bipartisan as we could in putting support behind the troops and carrying out our article I responsibilities, Senator Jeff Flake of Arizona and I have worked together, first, in introducing in 2015--and then in reintroducing this year--an authorization for use of military force. We have a pending authorization that we filed in June, which has been pending in the Foreign Relations Committee, to set forth a military authorization with certain conditions to undertake and legally justify military action against al-Qaida, ISIS, and the Taliban. That has been pending in the Foreign Relations Committee, but there has been no particular motive or forcing mechanism that has made the committee take this up, bat it around, hear from experts, debate it, amend it, and send it to the floor. I think, of all of the powers that Congress has, the one that we should most jealously guard is the power to declare war. James Madison was the drafter of the Constitution, and he gathered great ideas from others. The 230th anniversary of the drafting of the Constitution is this Sunday, September 17--Constitution Day in Philadelphia. The Constitution was a great collection of wonderful ideas, many that had been tried out in other nations, but the genius of it was the way in which we got the best of the best and tried to put them together in the document. It has been said by many historians that there were only about two items in the Constitution circa 1787 that were truly unique and that we were doing for the first time. One was the protection of the ability of the people to worship as they pleased without preference or punishment, which had been drawn from a statute that had been passed in Virginia in 1780, the Statute for Religious Freedom. The second idea that was very unique to our country and was, really, an effort by the Framers of our Constitution to change the course of human history was the idea that war should only be initiated by Congress and not by the Executive. The Framers of the Constitution knew in 1787 about Executives and Executive overreach, especially in matters of war. They knew Kings, Emperors, Monarchs, Sultans, and Popes, and they knew that that was how war started. Madison decided that we were going to do it differently, and the Framers and those who voted in Philadelphia agreed with him. The Constitutional Convention's minutes that were taken by Madison and others demonstrated what they were trying to do. Madison explained it in a letter to President Jefferson about 10 years later, when Jefferson was grappling with questions of war. Madison wrote in the letter that our Constitution supposes what the history of all governments demonstrate--that it is the Executive that is most interested in war and, thus, is most prone to war. For this reason, we have, with studied care, placed the question of war in the legislature. Madison was trying to change it so that war could not be initiated without a vote of Congress. In my view--and I was tough on a President of my own party about this--when President Obama decided to initiate offensive military action against ISIS in August of 2014, I said: You must come to Congress. When President Trump used military might--in this instance, weapons against Syria--to undertake the laudable step of punishing the use of chemical weapons against civilians, I said: I will support you with a vote, but you cannot do that without Congress. That is because there is nothing in the authorizations that are currently pending that allow the United States to take military action against the Government of Syria. Yet we have gotten so sloppy about this. Frankly, we have been sloppy about it just about since 1787. If I can be blunt, throughout our history, regardless of party--Whig or Federalist, Democrat or Republican--Members of Congress have often concluded that a war vote is a very difficult vote and that, if we could allow the President to initiate it without a vote, we might be politically insulated from the consequences of the vote. That has been a uniform trend, and it has been a nonpartisan one. That is one of the reasons that we are where we are right now in Congress's being reluctant to take up war votes. These are difficult votes. I have been on the Foreign Relations Committee since January 2013 and have cast two votes for military action--first, against Syria for using chemical weapons in the summer of 2013 and, second, in the matter that I mentioned earlier in voting for a war authorization against ISIS in December of 2014. I will say that there is no vote that you will ever cast that is harder. I come from a State with a great military tradition. More people in Virginia are connected to the military--either as Active Duty, veteran, Guard, Reserve, DOD civilian or military contractor or military family--than in any other State. One of my children is a Marine infantry commander. Any war vote--if not immediately, then prospectively--affects him and the people whom he works with and cares deeply about. These are very, very hard votes. They are supposed to be hard, but that is no reason to duck them. Congress is supposed to take this up, not hand any President of any party a carte blanche to go to war without a vote of Congress. Even against bad guys like ISIS or even against a Syrian dictator who is using chemical weapons against civilians, we are not supposed to be at war without a vote of Congress. So I am here to support Senator Paul's amendment, which would take these old and outdated authorizations and sunset them within 6 months. I view his amendment as being an attempt to force Congress to do what it should do, which is to have a debate anew after 16 years and come up with a crafted legal authority and appropriate strategy for carrying out military actions against nonstate terrorist groups. I applaud my colleague from Arizona, Senator Flake, because he and I have worked together very hard on this issue. We have a matter that is pending. If Senator Paul's amendment passes, the result of his amendment will be that the Senate Foreign Relations Committee and this body will have to grapple with what is an appropriate authorization circa 2017 to replace the authorizations from 2001 and 2002. We shouldn't be afraid of that discussion. We should relish it and protect the power of Congress to decide when we will and will not be at war. I believe the version that Senator Flake and I have introduced, that was introduced in June, is a good-faith effort to listen to all and craft a compromise going forward. I will close and say what I have said already. I think Congress should not only do this because we are constitutionally required to-- and waging war without an authorization poses all kinds of legal challenges that I think are significant; that it is constitutionally required should be enough--but I actually really like the reason. I like the reason for the constitutional provision. Madison and the Framers concluded that we should not order men and women into combat, where they are risking their lives and their health, if there is not a political consensus by the elected leadership of the country that the mission is so worth it that we can fairly ask them to risk their lives. If we are afraid to cast a vote because, oh, it is too unpopular or it could be too challenging, how can we stand up and say we are going to duck that responsibility when the consequence of war is that volunteers are being deployed and potentially injured and killed? I will close and just say it seems to me that the sacrifice of the millions who serve Active, Guard, and Reserve--of the thousands who are deployed overseas in theaters of war right now--their sacrifice should call upon us to have a debate and do the job we are supposed to do. If the Paul amendment passes, I look forward to working especially with my colleague from Arizona and my colleagues on the Armed Services Committee and colleagues on this floor to have a debate, have a vote, and send a strong message to terrorist groups, to our allies--but especially to our troops--that the article I branch of the U.S. Government has a resolve and supports them. With that, I yield the floor.

Mr. KAINE

Mr. KAINE. Mr. President, sexual assault is a major issue on our Nation's college campuses. Too many young people are sexually assaulted while in school. Alarmingly, the majority of these crimes will go unreported. The consequences of these crimes are often destructive to a student's mental, physical, and emotional well-being. In addition, the trauma of the assault and its aftermath drives many survivors to drop out of school. Sexual assault survivors deserve access to a safe and supportive educational environment. I have met with students in Virginia and across the Country who have expressed the need for someone on campus to turn to for unbiased advice and guidance following an assault. Given the prevalence of this issue, it is clear that our federal higher education policy must do more to prevent sexual assaults and ensure that survivors have access to and can navigate through a plethora of resources. This is why I am pleased to introduce today the Survivor Outreach and Support Campus Act of 2017 or SOS Campus Act. The SOS Campus Act requires universities that receive Federal funding to establish an independent, on-campus advocate for survivors of sexual assault. The advocate will help students access all of the resources available to them, both on and off campus, in the wake of a sexual assault and will guide them through the process of reporting their assault if they choose to do so, acting always in the interests of the victim, not the university. The SOS Campus Act requires that the confidential advocate is responsible for ensuring that survivors, regardless of whether they decide to report the crime, have access to emergency and follow-up medical care, guidance on reporting assaults to law enforcement, medical forensic or evidentiary exams, crisis intervention, and information on their legal rights. The advocate will also conduct a public information campaign on campus to inform students of their services, and train other university staff to provide information to students about the advocate. I am proud to introduce this legislation that would ensure all college students across our Country have access to a supportive advocate following a sexual assault on campus. I strongly ertdourage my colleagues in the Senate to consider this legislation to help protect our students from sexual violence and its damaging impact.

Mr. KAINE

Mr. KAINE. Mr. President, I rise to speak briefly about the news this week that the President is terminating the Executive action protecting DACA recipients--Dreamers as we know them--but also putting the burden on the shoulders of this body, the article I branch, to find an appropriate solution. The President often said as a candidate--and even in his early days as President--that he understood some things about these youngsters. He called them incredible kids, and he also said they would be fine. He did not use that language often in talking about immigrants so those were positive phrases that led many to hope he would continue the DACA Program. Many in his administration wanted him to. Others in this body--this speaker wanted him to continue the program, but he announced he was terminating it in 6 months and asked Congress to step up. I wanted to just tell you about a couple of youngsters I was with last week. I had a roundtable on DACA at Northern Virginia Community College, which is one of the largest and most diverse community colleges in the United States. I held that this last week. I had eight students. They were a fascinating mixture of young men and women. I just wanted to come and share some things about their stories because it demonstrates how these young people, these Dreamers, are a source of strength for our country and that we need to accommodate them. Renata was one of my youngsters. She came to Virginia when she was 3 years old with her parents, her older brother, and sister. She graduated high school with an advanced diploma. Some of us know the International Baccalaureate diploma, which is rigorous. Now, with DACA, she is studying at George Mason, getting a degree in clinical psychology. She does brain injury research. She wants to do that research to hopefully help people like returning veterans who suffer from brain injuries. Giancarla is a DACA recipient from Virginia. She came here a decade ago to be reunited with her parents. She hadn't seen her parents in 7 years. She received DACA in 2012. She went to Radford University and graduated with a bachelor's degree in international economics. Giancarla described how she is so appreciative of where DACA has gotten her in life, but she told me the night before we met, she had a conversation with her sister. Her sister was in high school and calling her big sister to describe how scared she was about what would happen if DACA was taken away. She talked about her little sister as a hard- working and studious kid, and she is worried she will not be able to go to college anymore and may be separated from family. Min is a young man who is a Korean-American born in Korea and a DACA recipient who is at George Mason studying cyber. He talked about his desire to serve the United States and help us with cyber expertise but how the removal of DACA could hurt his studies and could hurt his ability to get security clearances to be able to offer his talents to the country. Gloria, the fifth of these examples--there were eight students there--is an interesting young lady from Nigeria. She was born in England to Nigerian parents and brought here as a youngster. She will be the first DACA recipient in Virginia to graduate from law school, William and Mary Law School. She wants to graduate in December and help new Americans with immigration issues. We talked about all kinds of concerns they have: deportation of themselves or family members, ability to get a driver's license, the ability to lawfully work and pay taxes--and all of these young people work and pay taxes right now--the ability to get instate tuition, which for many is the difference to being able to get a higher education. We talked about all of it, but we also talked about their love for this country, and the fact that for these young students, this country is all they know. Deportation back to a place they don't know is not really an option. I was also happy to have at this roundtable--because we talked about there is no such thing as a DACA recipient without a DACA ally-- parents, teachers, family members, attorneys. They have a support group, and it is really important to acknowledge them too. We had officials from George Mason University, a public, comprehensive university in Virginia; Northern Virginia Community College, one of our community colleges; Marymount College; Catholic University in Northern Virginia--all of these allies, as well as representatives from other groups. The former publisher of the Washington Post, Don Graham, came. He is funding, with others, a scholarship program to help Dreamers cover cost gaps if they have to pay out-of-State tuition, and this is working to help hundreds of Dreamers across the country. We talked to them and expressed our thanks to them for what they are doing. I also read stories this week--and I will say this and conclude-- about other students. Juan is a 2017 graduate of Virginia Tech and now makes Blacksburg his home. He came to Virginia at age 5 and he said this: It's really hard for me to think of myself as anything but a Virginian and an American. It's really hard to have that part of my identity detached from me. That is how he views the reversal on DACA. Guadelupe from the Shenandoah Valley--one of Virginia's very rural areas but has a significant number of DACA recipients. She started her freshman year at Bridgewater College, a small private college in the Valley. She says: This is the only country I've ever known . . . I've pledged my allegiance to the stars and stripes every day. This is the country to which these young people pledge their allegiance, owe their allegiance, want to express and act to demonstrate their allegiance. They are doing it already. They are making us proud. We need to step up. It was my great pleasure in June 2013 to join with the Senators from New Mexico, from Vermont, and nearly 70 others on the floor to do a comprehensive immigration reform that included many things but included a protection for these Dreamers. It was part of the education of a naive, young Senator who was in my first year to think: Great, we did something in the Senate. I am sure the House will do something, but 4 years later, not only did they not ever take up our bill even in committee, they didn't even pass anything by way of comprehensive immigration reform that we could put in a conference together. Now the weight of this is on our shoulders with 6 months. Talented students like these 800,000 nationwide, between 12,000 and 13,000 in Virginia, have that fear, that anxiety: Are we going to be forced back into the shadows or, worse, are we or our family members possibly going to be deported? I will close and say these youngsters again pledge their allegiance to the United States, and they are demonstrating every day that we are richer as a nation because of them. Why would we not want to have these talented young people pledge allegiance to us rather than elsewhere? America has always succeeded because we have been a great magnet for talent--growing our own talent and celebrating it but willing to attract talent from around the world. The society that attracts talent in the 21st century is going to be the society that succeeds. The most precious resource in life right now is not oil. It is not water. It is talent. These Dreamers have it, and we should want it. I hope my colleagues will work together in a bipartisan way, both Houses, to provide a protection. With that, I yield the floor and notice other colleagues here waiting to speak on the same topic.

Mr. KAINE

Mr. KAINE. I will yield the floor for a question.

Mr. KAINE. I ask unanimous consent for 2 minutes to close, Mr. President.

Mr. KAINE. Mr. President, I also rise with my colleagues, tremendously moved by the powerful words of my friend from Hawaii: Why can't you show compassion to others that you showed to me? That is a haunting question, and I hope people will hear that not just with their ears but with their hearts. I also support the motion to do what we should have done in January-- to commit this important topic to the committee that has jurisdiction over it. A few years ago, there was a popular thing to do, and that was to wear a button or bracelet with the letters WWJD. That button and bracelet stood for ``What would Jesus do.'' I was on the floor the other night, and I don't think that is a very hard question because in Matthew 25, he basically tells us: I was sick and you cared for me. In different translations: I was sick and you looked after me. I was sick and you visited me. I was sick and you took care of me. I think the answer to WWJD is pretty straightforward tonight. I am going to talk about a different John McCain. John McCain, based on the tremendously moving presentation he made on the floor the other day, one that led us to a standing ovation because he talked about how this body should work, he said that things weren't working here as they should for the American public. He said we needed to fix the Senate and be an example for the public. We needed to restore confidence, and the way to do that would be to return to operate as the Senate should operate, with putting bills in committees and having hearings and listening to the public and, most importantly, listening to each other. That is the process John McCain's committee just used, the Armed Services Committee, to get a unanimous defense authorizing bill to the floor, which I hope we will take up in the next few days. I just want to spend a few minutes talking about if that is what we should do. If those words led us to leap to our feet in a standing ovation, why are we standing here 2 days later preparing to break every suggestion and recommendation he made to us? When should we start the process of listening to each other and listening to the American public? Should we start on an inconsequential issue that doesn't matter? I think now is the time to start. I think we all know it is the time to start. If we didn't believe in our heart that now was the time to start fixing this place, we wouldn't have leapt to our feet and given Senator McCain a standing ovation. This is the time, and this is the issue to start fixing this place and doing what we do with the spirit that is worthy of the American people who sent us here. Why is now the right time? First, because this issue is so important to people. You heard moving--moving--words from our friend from Hawaii and our friend from New Jersey. We have all spent months going from town to town in our States having people come plead with us for solutions. I shared stories about being in the medical clinic in Appalachia a week ago tomorrow and seeing the tremendous need in this richest and most compassionate Nation on Earth. There is nothing about a person's life that is more important than their health. There is no expenditure that a human being ever makes that is as important as an expenditure they make for their health. This is the right issue to start fixing this place because it is important to people. It is important to the economy. This is the largest sector of the American economy. We are proposing to reorient one-sixth of the American economy on a snap vote, in the middle of the night, without having a single hearing or listening to a single expert. It is an important issue because we definitely need to hear from the public. You know, committee hearings sound kind of wonky. We haven't had a committee hearing. What does that mean? What it means is, we haven't had a witness table where a patient or a doctor or the American Cancer Society or others could stand up and share their points of view. We need to listen, and if we don't listen, we will not get this right.

Mr. KAINE. Mr. President, if I could just pick up on the comments of my colleague from Hawaii, we had a comical discussion 2 days ago in the Democratic caucus lunch. Comedy isn't that unusual in a caucus with Al Franken, but the comic discussion was about how we would describe to the American public what a skinny repeal is. It was kind of phraseology that we might understand; how do we describe that to the American public? We took about half an hour to try to figure out how to do it, but about 2 hours ago, one of our Republican colleagues did it in 5 seconds. He said--and this is the Senator from South Carolina--that the skinny repeal is a fraudulent disaster. That is what Senator Graham said--the skinny repeal is a fraudulent disaster. He did such a better job than we did of describing what the bill is, and it is a fraudulent disaster because it hurts people. It takes health insurance away, according to the CBO, from 16 million people, and it would jack up premiums in a compounding 20 percent this year, then an additional 20 percent--40 percent the next year. That is why it is a fraudulent disaster. But some Members, as was described by my colleague from Hawaii, are entertaining that: Even though we call it a fraudulent disaster, we can vote on it because, don't worry, the House will create an opportunity for us to fix it and make it better. But the comments of the Speaker, which had to be clarified a few minutes later by his press spokesperson, have made absolutely plain that if this bill passes out of the Senate, it is intended to be passed by the House ASAP, and the President's spokesperson has said: We like this bill, and the pen is in hand--we are ready to sign it. So no one in this body should have any illusions: If the skinny repeal--otherwise known as the fraudulent disaster--passes, it is not to continue a process; it is to take health insurance away from 16 million people, and it will raise premiums dramatically. And that is what the intent of this vote would be. With that, Mr. President----

Mr. KAINE. The time is right because the consequences are so severe: 16 million people lose insurance, 20 percent premiums compounding over the years, insurance markets skyrocketing and unstable, and Planned Parenthood defunded--the healthcare provider of choice for 3 million women. The final reason we should do this the right way, not the wrong way, is what was said by Senator Graham just a few hours ago. He described the bill that is now on the floor, the skinny repeal, the skinny bill, as a policy is a disaster as a replacement for ObamaCare. It is a fraud. Is ``fraudulent disaster'' the best that the United States Senate can do now? Is that now the bar we have to get over? If we can say something is a fraudulent disaster, it is suddenly good enough to vote for? That is salt in the wound of a family that is worried about their sick child. That is salt in the wound of anybody who is worried about what would happen to their family tomorrow. Will they lose insurance? Will they pay more? Will they be blocked from going to Planned Parenthood? If this body passes a bill that even Members who vote for it claim is a fraudulent disaster, how do you think the American public will view this body? How will they view the degree of care and concern we exhibit to them? This is not the best the Senate can do. We can do much better than this, we must do much better than this, and I ask my colleagues to send this to committee where we can listen to one another and get this right. Thank you, Mr. President. I yield the floor.

Mr. KAINE. Well, to respond, Mr. President, to my colleague from Oregon, one of the things we have seen in the first half year of this administration is, whatever job report comes out month to month--comes out at the beginning of each month, we are not seeing wage growth. We are not seeing wage growth. So imagine that continuing forward-- essentially no wage growth and 20 percent increases in premiums that then compound to 40 percent next year, 60 percent the year after that. This will be devastating. So if you put together the CBO consequences--16 million losing insurance, the 20 percent compounding increases in premiums, a likely dramatic destabilization of the insurance market, and then other features that we hear are in the skinny bill--for example, if you take funding away from Planned Parenthood--and 3 million women have decided that is their choice, that is where they are going to get healthcare, including many working women and women in working-class families--the premium effect is going to be absolutely dramatic, and it will be devastating to Virginians and Oregonians. With that, Mr. President, I yield the floor.

Mr. KAINE

Mr. KAINE. Mr. President, I thank my colleague from Wisconsin and also my colleague from Vermont. Their words have been very powerful. I also rise to talk about healthcare. We are told in the Senate that tomorrow we vote, but we don't know what we will be voting on. We will bring up a House bill that, by virtually every account, is not going to be the bill that we will be voting on, but we don't yet know which version of healthcare we will be voting on if we proceed to the debate. It is like a three-card monte game. There are all sorts of different versions that are out there on the table. One version would take health insurance away from 22 million people, one from 25 million, and one from 32 million, and we are not being told which one we will vote on. When I was a kid, there was a TV show we used to watch, ``Let's Make a Deal.'' One of the features of the show was this: What is behind door No. 1, and what is behind door No. 2? The contestants would have the opportunity to pick. One would be great, and one would be a disaster. That was the fun of the game show: What is behind door No. 1? What is behind door No. 2? But this isn't about a game show. We are not participating in a game show. We are participating in a decision about the most important aspect of any person's life--their health--and about the most important expenditure they ever make with a dollar--a healthcare expenditure--and about the largest sector of the American economy--healthcare. Instead of treating the issue with the gravity it deserves, there is a secret plan and a mystery vote without any hearings, shutting out the committees, including the HELP Committee, where I serve, shutting out the minority party, which represents 48 of the 100 Senators in this body, and, most importantly, shutting out the public. As the Senator from Vermont mentioned, in this body, the greatest deliberative body in the world, we have not had a single hearing. We have not heard from a single doctor, a single patient, a single hospital, a single nurse, a single insurance company, or a single medical innovator. We are about to take a vote on the most important expenditure in anyone's life and the largest sector in the American economy following a completely closed process where it has been the will of the majority to keep the door shut. This isn't a game show. Let me tell you how real this is. I did something on Friday that I often do. I started doing this in 2002. I live in Richmond, but I drive a number of hours to Wise County, VA, which is a county on the border between Virginia and Kentucky. It is a county where my wife's family is from. She grew up in Roanoke, but her dad is from Big Stone Gap, VA, in Wise County, right across the border from Pike and Hazard Counties in Kentucky. There is a fairground in Wise--the Virginia-Kentucky fairgrounds. Back in the late 1990s, a Catholic nun, Sister Bernie, and two other wonderful nurses who have become friends--Teresa and Paula--decided to try to offer healthcare for people who didn't have health insurance at this county fairground. They just set up with a few volunteers, and they said: If you live in Appalachia, if you don't have health insurance, if you need medical care or dental care, just come and we will see what we can do. They do this every July, for one weekend a year. Here is what this has grown into. I first went when I was Lieutenant Governor in 2002. People start to arrive. I have talked about this on the floor. I just did it Friday, and I want to share some stories. They start to arrive Tuesday or Wednesday in cars. They camp in the campground. Now, it is July, and this weekend was the hottest weekend in the summer. They start camping with their kids, often in cars. Some are sleeping in cars. Some are throwing blankets out on the lawn next to a chain-link fence. They wait in the tens, in the dozens, in the fifties, in the hundreds. Then they open the door at 6 a.m. It is Friday morning, and the people who have waited for days come in and get a number to see if they can get healthcare on Friday, Saturday, or Sunday from volunteer doctors in the richest Nation and the most compassionate Nation in the world. When they opened the door on Friday morning, I was down there. I do what I do. I go and I work the registration booth, and I talk to people and register them so they can get healthcare. I got there a little late. They had opened the door at 6 a.m., and I got there 8 a.m. They had already given out numbers to 1,200 people in the first 2 hours. Over the course of the weekend, they serve thousands of people. They come in to get dental care. For most of them, their teeth are too far gone. So it is just a matter of pulling their teeth. Some come in to have most of their teeth pulled, and then they can get dentures. They get an eye exam and find out: Wow, I should have gotten glasses 5 or 10 years ago. No wonder I have been such a poor student all the way through school, or no wonder I have had such a hard time on my job. I needed glasses. They get a cancer screening. Sometimes they get something caught early, and sometimes they get something caught very late. It is an amazing spectacle. It is uplifting because of the volunteers who turn out--doctors, dental hygienists, nurses, and the Lion's Club, which comes to do vision screenings. That is uplifting. It is depressing and it is heartbreaking to see people sleeping up against chain-linked fences and sleeping crunched over in their car for days so that they can get a little bit of free healthcare in the richest Nation on Earth. When I work the registration booth, I have to ask people a series of questions so that they know who they can go see when they are there. I worked the booth for about an hour and a half. Here is a question you ask everybody: How long has it been since you have seen a doctor? How long has it been since you have seen a doctor? I had a mother of four kids. The kids were 12 and under, and they were sort of buzzing around. The mom was sitting in a chair. You know what happens if you are a mom with kids that young. Your kids pick up something in school. They bring it home, and you get sick. This is what happens to parents. I have a colleague here with young kids, and he knows what I am talking about. I asked the mother: How long has it been since you have seen a doctor? I am not really sure. So I was kind of going through my checklist. Have you seen a doctor within the last year? No, not within the last year. Have you seen a doctor within the last 2 years? Not within the last 2 years. Have you seen a doctor within the last 3 years? I might have seen a doctor in the last 3 years. That was a mother of four young kids. I had somebody sitting across from me, and I asked her another common question: Are you employed? You ask everybody this. Part-time? Full- time? I am not employed, but I am about to get my nursing license back. Well, that is interesting. So you are in healthcare. Well, I used to be. I am about to get my nursing license back. Well, what happened? Now, this wasn't on the questionnaire, but I couldn't resist asking her: What happened? Well, I was a nurse. I had a great career. I had a great life. But then a doctor prescribed me opioids for arthritis, and the bottom fell out of my life. I got addicted to opioids, and I lost my license, and I lost virtually everything in my life. Now I am unemployed, but I am working as a counselor at a church, trying to help people who are also opioid addicted. I am about to get my license back, but I am not working yet, and I don't have insurance yet, and that is why, even though I am a nurse and I am a healthcare professional, I have waited in line for a couple of days to come get healthcare. There was a woman from Maryland who had been laid off as a supervisor at McDonald's a number of months ago. She was unemployed. She had horrible dental problems that were way past being solved. She just needed to get a bunch of her teeth pulled to ease her pain. So get what this woman did. This is about an 8 or 9 hour drive from her house. When her teeth got so bad and so painful after her firing and she needed to have her teeth pulled, she couldn't go anywhere. She didn't have anybody to do it. She said: I think there is this free clinic in Appalachia. Now, it is a couple of months out. So I am going to have to suffer through the pain for a while, but I also have to save up some money. She saved up her money like most people would try to save money for a summer vacation. She saved up her money so she could put enough gas in the car and pay for one night at a hotel and so she could drive for 9 hours to Wise County, VA, and wait in the line for days and come and get a bunch of her teeth pulled in the richest and most compassionate Nation on Earth. By the way, I had another guy, and I asked him the question: What are you here for? Are you here for medical services, are you here for dental services or are you here for vision services? He said: I am actually here for all three, but the problem is, it is the hottest day of the year. It is 95 and humid, and I am so sick, I can't sit out in the Sun all day. So I got to do two out of three. I can't do all three. I said: Which are the two worst, is it the medical and dental or vision and dental or vision and medical? He said: Look, I will do dental and medical, but even though I have glasses and I need to get an upgrade, I can't wait around because I am so sick out in the hot Sun for so long. So you are just going to have to give me two out of the three. I can't wait all weekend. I can't wait all day in this dusty fairground on the 21st of July to get healthcare. These people need us. They need us to be at our best. They need us to be thinking about them. The first time I went to this clinic in Wise, I was struck by the magnanimity of the volunteers, I was struck by the need, but what really hit me was when I went into the parking lot. I expected to see cars from Virginia and Kentucky because Kentucky is 10 miles away from the fairgrounds. I might have expected to see cars from West Virginia, which is 100 miles away, or Tennessee, which is 40 miles away, but North Carolina is 150 miles away, South Carolina is 350 miles away, Georgia is 400 miles away, Alabama is farther, and Oklahoma is farther. People drive from all over the Southeast in the United States, in the richest nation on Earth, in the most compassionate Nation on Earth, to wait for days in a dusty campground in the heat of the hottest part of the summer so they can have their teeth pulled because they don't have healthcare. The Affordable Care Act has cut the uninsurance rate to one of the lowest in recorded history, but we haven't gone far enough. We have to do better by these people who are sleeping in their cars or up against chain-link fences, who are traveling for 9 hours to get their teeth pulled, not worse. We want to have fewer people like this and fewer folks who need to do this, not more. The vote we are going to have about whether it is 22 million or 25 million or 32 million people who lose health insurance, that is going the wrong way. We have to go a different way. We have to do better, not worse. Most of the things we talk about in this Chamber are about issues. This isn't about issues, this is about who we are. This is about who we are as Senators. This is about who we are as Americans. This is about who we are as thinking, feeling, breathing, believing human beings. It is about who we are. A great teacher, a great teacher once laid out the yardstick: ``I was sick and you took care of me.'' That is one version of the New Testament. There are other phraseologies from the 25th chapter of Matthew: I was sick and you visited me. I was sick and you cared for me. I was sick and you looked after me. The Teacher basically says, the way you treat someone who is sick is the way you treat the Creator. It is important to be compassionate to somebody who is sick, and anybody who is hearing these words, you don't have to think for a second to think about somebody in your family who is suffering from cancer or dementia or mental illness or who has been the victim of an accident. There are faces appearing in your minds right now because we all have this in our families. The way we treat people who are sick is not just a measure of us, it is a measure of what we think about the Creator. When a great teacher said, ``I was sick and you took care of me,'' he was giving an instruction to us about the way we should behave. In the last week, I am struck by the fact that this body has been jolted by the news about two of our colleagues, both of whom who have had cancer diagnoses. Last week, we were shocked and saddened to hear about our colleague from Arizona, Senator McCain, who is my chairman on the Armed Services Committee who is suffering a very tough form of cancer, and cancer is going to find a match in Senator McCain. This touches us in this body. A week or two before, we heard about another colleague on the Armed Services Committee who sits next to me at every committee hearing, Senator Hirono, who just announced she has kidney cancer and just underwent surgery. I was chatting on the floor with her earlier tonight. I don't think she would mind me saying, she is strong and she is a fighter, like Senator McCain is a fighter, but she is worried about it just like Senator McCain would be. This touches everyone. It touches the powerful, it touches the powerless. It touches the wealthy, it touches the poor. It touches men, it touches women. It touches the young, it touches the old. It touches everyone, and the way we treat people who are sick, the way we treat people who are anxious about their health is the way we treat the Creator. That is what we are taught. So let's live up to that standard. Why would we do otherwise? Why are we here? Why did we run? Why do we serve? What do people expect of us? I was sick, and you cared for me. I was sick, and you visited me. I was sick, and you looked after me. I was sick, and you took care of me. Is it that hard? Is it so important to rush it through and not have hearings and not have committees and not engage the Democrats and not listen to the people sleeping against chain-link fences or driving 9 hours to get their teeth pulled? We can't afford to get this wrong, and the talent of the people in this body convinces me beyond a shadow of a doubt that if we take the time, we can get this right. If we can get this right, why will we not take the time to get this right? So I would plead with my colleagues, let's stand together on behalf of the sick, let's stand together on behalf of those who are counting on us. Another part of the New Testament is the Letter of Paul to the Hebrews: ``Because we are surrounded by such a great cloud of witnesses, we have got to do the right thing.'' We are surrounded by a great cloud of witnesses who want us to do the right thing, and I know we can, and I pray we will. With that Mr. President, I yield the floor.

Mr. KAINE

Mr. KAINE. Mr. President, the U.S. infrastructure system is in critical need of an upgrade. The American Society of Civil Engineers recently graded the U.S. system a D+ given its capacity, condition, funding, future need, operation and maintenance, public safety, resilience and innovation. Any investment to improve our Country's infrastructure system would create millions of new jobs, requiring millions of skilled workers to fill them. A recent study by the Center of Education and the Workforce at Georgetown University estimated that a $1 trillion infrastructure investment would create 11 million new jobs. Nearly half of these would require training past the high school level. Even without a significant investment, though, infrastructure industries are already struggling to meet workforce demands. Workers in infrastructure industries are expected to retire at a 50% higher rate than the general workforce. And historic inequities that have limited women and people of color from accessing these jobs have further constrained the pipeline of potential workers. To ensure infrastructure investments benefit businesses, workers and the economy, the U.S. must invest in the creation of a diverse pipeline of workers with skills necessary to access in-demand opportunities. Industry and sector partnerships are a proven strategy for helping workers prepare for middle-skill jobs and helping businesses find skilled workers. Congress requires States and local areas to support the development of these partnerships under the Workforce Innovation and Opportunity Act (WIOA), but no dedicated funding has been provided for these activities. Work-based learning strategies, such as apprenticeships, are common pathways to skilled jobs in infrastructure industries. Many small and medium-sized businesses shy away from developing high-quality work-based learning programs, however, because of real or perceived costs associated with the strategy. This is why I am pleased to introduce with my colleague, Senator Portman, the Building U.S. Infrastructure by Leveraging Demands for Skills Act or BUILDS Act. The BUILDS Act creates a grant program that would support industry and sector partnerships working with local businesses, industry associations and organizations, labor organizations, State and local workforce boards, economic development agencies and other partners engaged in their communities to encourage industry growth, competitiveness and collaboration to improve worker training, retention and advancement in targeted infrastructure clusters. Specifically, the bipartisan BUILDS Act would leverage sector partnerships to engage businesses in work-based learning programs. Businesses and industries would be incentivized to work with the greater community to create on-the-job training programs to fill the jobs necessary to expand the Country's infrastructure system. Additionally, businesses and education providers would be connected to develop classroom curriculum to complement on-the-job learning. Workers on the other hand, would receive support services such as mentoring and career counseling to ensure that they are successful from the pre- employment to placement in a full-time position. Our Country desperately needs improvements to critical infrastructure like our roads and bridges, however to do that work we must have a trained workforce that's ready to fill these good-paying jobs. Virginia businesses in the transportation, construction, energy, and information technology industries continue to tell me they have trouble finding job applicants with the necessary skills. This bill will help workers get the job training they need to be hired. I hope that my colleagues on both sides of the aisle consider the BUILDS Act as a necessary component to any investment in our Nation's infrastructure.

Mr. KAINE

Mr. KAINE. Mr. President, the U.S. infrastructure system is in critical need of an upgrade. The American Society of Civil Engineers recently graded the U.S. system a D+ given its capacity, condition, funding, future need, operation and maintenance, public safety, resilience and innovation. Any investment to improve our Country's infrastructure system would create millions of new jobs, requiring millions of skilled workers to fill them. A recent study by the Center of Education and the Workforce at Georgetown University estimated that a $1 trillion infrastructure investment would create 11 million new jobs. Nearly half of these would require training past the high school level. Even without a significant investment, though, infrastructure industries are already struggling to meet workforce demands. Workers in infrastructure industries are expected to retire at a 50% higher rate than the general workforce. And historic inequities that have limited women and people of color from accessing these jobs have further constrained the pipeline of potential workers. To ensure infrastructure investments benefit businesses, workers and the economy, the U.S. must invest in the creation of a diverse pipeline of workers with skills necessary to access in-demand opportunities. Industry and sector partnerships are a proven strategy for helping workers prepare for middle-skill jobs and helping businesses find skilled workers. Congress requires States and local areas to support the development of these partnerships under the Workforce Innovation and Opportunity Act (WIOA), but no dedicated funding has been provided for these activities. Work-based learning strategies, such as apprenticeships, are common pathways to skilled jobs in infrastructure industries. Many small and medium-sized businesses shy away from developing high-quality work-based learning programs, however, because of real or perceived costs associated with the strategy. This is why I am pleased to introduce with my colleague, Senator Portman, the Building U.S. Infrastructure by Leveraging Demands for Skills Act or BUILDS Act. The BUILDS Act creates a grant program that would support industry and sector partnerships working with local businesses, industry associations and organizations, labor organizations, State and local workforce boards, economic development agencies and other partners engaged in their communities to encourage industry growth, competitiveness and collaboration to improve worker training, retention and advancement in targeted infrastructure clusters. Specifically, the bipartisan BUILDS Act would leverage sector partnerships to engage businesses in work-based learning programs. Businesses and industries would be incentivized to work with the greater community to create on-the-job training programs to fill the jobs necessary to expand the Country's infrastructure system. Additionally, businesses and education providers would be connected to develop classroom curriculum to complement on-the-job learning. Workers on the other hand, would receive support services such as mentoring and career counseling to ensure that they are successful from the pre- employment to placement in a full-time position. Our Country desperately needs improvements to critical infrastructure like our roads and bridges, however to do that work we must have a trained workforce that's ready to fill these good-paying jobs. Virginia businesses in the transportation, construction, energy, and information technology industries continue to tell me they have trouble finding job applicants with the necessary skills. This bill will help workers get the job training they need to be hired. I hope that my colleagues on both sides of the aisle consider the BUILDS Act as a necessary component to any investment in our Nation's infrastructure.

Mr. KAINE

Mr. KAINE. Mr. President, I also take to the floor to talk about healthcare. I appreciate my colleagues who are here, earnestly pleading with all of our colleagues to be about a process--Democrats and Republicans and the committee process that we have in the Senate--that does the work that we are supposed to be doing, which is listening to the American public and improving our healthcare system. Let me tell you about my first meeting of the day. It was an amazing one. I had a mom, Rebecca, and her 5-year-old daughter, Charlie, in my office. They had asked for the opportunity to meet with me to talk about healthcare. Here is their story. Charlie is just about 5 years old. She starts kindergarten in the Charlottesville public schools in September. She was born at 26 weeks, or about 14 weeks early. She weighed 1 pound and 11 ounces at birth. She went through the NICU and had great care. When she was released to go home, the doctors thought she would be fine, but within a couple of months, it was pretty clear that she had some significant challenges as she has the diagnosis of cerebral palsy, and she gets 80 percent of her food through a feeding tube. This family has many, many needs. Charlie, from a cognitive standpoint, is very, very sharp and is excited about starting school, but she has significant needs. Her mother Rebecca said that Charlie is like the case study for why a repeal of the ACA would be a disaster. Charlie has a preexisting condition because of the CP and her challenges. Charlie has already hit all of the lifetime caps that would have rendered her unable to get insurance pre-ACA. In the hospital, because of her dramatically low birth weight, Charlie was the recipient of Medicaid funds that would be cut under the current bill. Charlie is currently the recipient of a Medicaid waiver, which will help her afford supplies for her feeding tube. When she starts kindergarten in the Charlottesville public schools, Charlie will be given an individualized education plan under the Individuals with Disabilities Education Act, and some of those expenses are being compensated by Medicaid. The preexisting condition, lifetime caps, and Medicaid cuts all affect this dynamic, young 5-year-old, who is as entitled as any of us to try to be all she can be. If we persist on the path that we are on now with regard to the bill that is being proposed, we will hurt families like these, and we do not need to do that. Instead, we can help them. Before the passage of the Affordable Care Act, we know that Americans, like Charlie, who had preexisting conditions faced unfair barriers to accessing health coverage. There are challenges that we need to fix, but let's celebrate a few things. Since 2010, the rate of uninsured Americans has declined to a historic low. More than 20 million people have gained access and have healthcare coverage--many for the first time in their lives. Another statistic that is interesting is that the number of bankruptcies in our Nation has been cut in half. Pre-ACA, medical costs had driven up bankruptcies, but the ACA has brought the bankruptcy rate down. We have to move forward to make healthcare stronger, not to destroy it. The Republican bill that is being discussed right now, because of its reductions of coverage, slashing Medicaid, and increases to premiums for seniors, would make the matter worse. The proposed amendment by the Senators from Texas and Utah has led insurance companies to come out and say that this will create a two-tiered system that will punish those with preexisting conditions. The latest plan, which was discussed this morning by the majority leader, would just be a straight repeal of the Affordable Care Act with a promise that we would fix it in a couple of years. It has been scored by the CBO, and the CBO says that it would cause 32 million Americans to lose their coverage and would dramatically increase premiums. Yet we do need to find improvements, and we should be working on that together. There have been some actions taken by this administration that have compounded challenges. In January, the President signed an Executive order that directed relevant agencies not to enforce key elements of the Affordable Care Act. They terminated components of outreach and enrollment spending. The administration has also threatened to end cost-sharing reduction payments. These actions and additional inactions have created such uncertainty in the individual marketplace that rates have been unstable, and, in some areas, companies are not writing individual policies. The amendment I discussed earlier, from the Senators from Texas and Utah, would make these problems even worse. There is a better way. There is a way forward, and I am here to just briefly reference a bill that Senator Carper and I have put on the table that we think will do a good job and should have strong bipartisan support. It is the Individual Health Insurance Marketplace Improvement Act. One of the ways to address uncertainty in the individual market is to establish a permanent reinsurance program that will stabilize premiums and will give insurance companies some stability so that they can stay in markets, but it will also enable those companies to write premiums at an average level and not have to take into account the high-cost claims. We think it could reduce premiums dramatically all over the country. Now, the idea of reinsurance should not be controversial. We use it in other programs--flood insurance, crop insurance, and Medicare Part D. A key part of Medicare that was achieved under the Bush administration includes a reinsurance provision. The Affordable Care Act had a reinsurance in its first 3 years, but it expired. That reinsurance helped to maintain stable premiums. This is an idea that is not a Democratic idea. It is an idea that is tested. Senator Carper and I introduced the bill to the Senators on the Finance Committee. I am on the HELP Committee. We are just waiting for the opportunity to be able to present it and get a hearing for it. We ought to be able to work together on reinsurance, on the cost-sharing guarantees that Senator Shaheen has proposed, and on a variety of other ideas. Senators Cassidy and Collins have a bill in that uses auto enrollment, which is an interesting concept that we should be tackling. I am just going to conclude and tell you how naive I am. I was a mayor and a Governor before I got here to the Senate. When you are a mayor and a Governor, what you know is education and healthcare. We have a Governor here and a Governor here and a Governor here. We have four former Governors who are sitting on the floor. What you know is education, which was your biggest line item, and your second biggest line item is Medicaid--healthcare. I tried to get on the committee when I got to the Senate, and I was not put on the committee. I was very disappointed. For 4 years I tried to get on the HELP Committee. I got on it on January 3. I was so excited. Finally, I am working on something that I know about. I got a group together of 13 Democratic Senators. Within 48 hours of getting on that committee, on January 5, I wrote a letter to my committee chair, Senator Alexander, a great committee chair, as well as to the Finance chair, Senator Hatch, and to the majority leader, Senator McConnell: If you want to fix healthcare, we are here to sit down with you right now and fix it. I was naive enough to think that, because I was on the HELP Committee, I might be included in a discussion about healthcare. We have had hearings in our committee-- many hearings--on nominees, on pensions, on higher ed, on the FDA, but there has been one taboo topic on the HELP Committee since I got on it in January. We are not allowed to have a hearing about healthcare. We haven't had a hearing about the House bill. We haven't had a hearing about Senate proposals. We are being told that we are not going to have a hearing, that we are just going to rush whatever we do to the floor either on a House proposal, a Senate proposal, or a Senate repeal. We are going to completely skip the committee. Now, you know a little bit about this committee. We have a doctor on the committee, Senator Cassidy from Louisiana. Our chair of the committee, Senator Alexander, was a Governor. He had a Medicaid Program. He was the president of the University of Tennessee. He had a hospital. He had a medical school. He had physician practice groups. There are people on the HELP Committee who know something about healthcare. There are people on the Finance Committee, which covers Medicaid and Medicare, who know something about healthcare, but we have not been allowed to have a hearing about this. When you have a hearing, you bring people up to the witness table, patients like Charlie, who was in my office this morning, and doctors and hospitals. You ask them what works, what doesn't work, and what can be fixed. We haven't had the opportunity to hear from folks. So why wouldn't we do exactly what Senator McCain said yesterday? Senator McCain said: We have gone about this the wrong way. We should be the U.S. Senate. We should take advantage of the Senate procedures and the expertise on the Senate committees, including staff expertise, and we should assign these various bills to the relevant committees and have hearings and then come forward with a proposal that will actually improve healthcare for this country. I am completely confident that if we let the committees do the work they are supposed to do, we will find improvements that can get bipartisan support and that will help Virginians and help Americans. That doesn't seem too much to ask. I hope my colleagues will consider that, and I hope we will be engaged in those discussions soon. With that, I yield the floor.

Mr. KAINE

Mr. KAINE. Mr. President, on behalf of myself and the senior Senator from Virginia, Mark Warner, we want to commemorate an important, early step in our Nation's emergence as a world leader in flight, space exploration, and atmospheric science. One hundred years ago today on July 17, 1917, NASA's Langley Research Center was founded in Hampton, VA. What was once a quiet expanse of farmland and marsh on a riverbank near the Chesapeake Bay has helped transform our Nation's transportation system and the world's understanding of our universe. That date in 1917 represents the beginning of a journey that would eventually take Americans to the moon and American technology to Mars and beyond. Born in the days of the National Advisory Committee for Aeronautics, the precursor to NASA, Langley was the agency's first field center and our Nation's first civilian aeronautics laboratory. The groundbreaking and sky conquering research conducted during Langley's early days led to major advances in aeronautics and, in the years after World War I, helped our Nation cement its status as a pacesetter in flight research. Langley's important work also served as a foundation for America's burgeoning aviation industry. Langley won the first of its seven Collier trophies, awarded for the highest achievements in aeronautics or astronautics in our Nation, in 1929. That trophy, won for development of cowling for radial air-cooled engines, honored a high level of technical excellence that Langley has maintained ever since. Over the decades, Langley has evolved into a research center supporting all of NASA's areas of emphasis, from human space exploration to Earth science and from aeronautics to technology development. NASA Langley's legacy of discovery and innovation is truly remarkable. Researchers at the center helped refine technologies and designs across all flight regimes--subsonic, transonic, supersonic, and hypersonic--revolutionizing the shape and performance of today's aircraft and spacecraft. This year, we all witnessed some of NASA Langley's contributions to the space race through the lens of the Oscar-nominated film, ``Hidden Figures.'' The film told the story of the many contributions of NASA Langley employees, especially African-American women, to the Mercury 7 mission involving America's first astronauts. Beyond that, Neil Armstrong and other Apollo astronauts learned how to land on the moon by training at Langley's Lunar Landing Research Facility, now known as the Landing and Impact Research Facility. Langley led the first successful robotic landing on Mars with the Viking 1 mission, which gave humanity its first glimpse of the landscape of another world. The center's technical expertise in a field called Entry, Descent and Landing--the study of how a spacecraft can safely move through a planet's atmosphere and reach the surface--has been a key to every fully successful robotic landing on the surface of Mars. Those are just a few highlights among many, many accomplishments. Over the decades, NASA Langley has contributed technologies that have improved people's lives around the globe. For example, the grooved pavement that makes our highways safer evolved from research into runway surfaces at Langley. The winglets-- the upturned tips of wings seen on commercial aircraft--have saved fuel and reduced pollution for years. Their use is a result of research done by Richard Whitcomb, one of Langley's legendary aerodynamics experts. Based on what we have seen when visiting the center, we predict this legacy of excellence and innovation will continue--even accelerate-- over the next 100 years. We have been proud to work closely with the center on improving the safe use of unmanned aerial vehicles, better known as drones. We have also proudly partnered with the center's efforts on groundbreaking materials research, including the Advanced Composites Initiative, to work toward developing lighter, safer, and more fuel- efficient vehicles for air and space. We have seen Langley's critical involvement in development of the Orion crew module, which was tested at Langley's Landing and Impact Research Facility to ensure that astronauts can safely splashdown in the ocean after future missions. Langley's test facilities are being used by companies who have partnered with NASA through its Commercial Crew Program. By working with Boeing and Space X, Langley is helping to boost our Nation's growing space industry. Other current projects include new aircraft designs intended to change the sonic boom to a sonic thud, opening the way for a revolutionary new generation of faster aircraft that will bring vast improvements for the traveling public. When it comes to serving the public's interest, Langley's work studying the Earth's atmosphere and how it absorbs and radiates heat tops the list. It is critical that NASA's work in earth science research continues. Wise policy decisions rely on high-quality data. Without solid data, we are essentially flying blind in the area of environmental policy. Coincidentally, the Hampton Roads area of Virginia--where Langley is located--is second only to New Orleans in susceptibility to sea-level rise. NASA Langley is one of many national assets--including military, industrial, and academic institutions--located there. It is an important region of our Nation and Langley's work to study earth's atmosphere will safeguard Hampton Roads, as well as our planet as a whole. When you consider exciting new capabilities offered by the center's Measurement Systems Laboratory, now under construction, and its Katherine G. Johnson Computational Research Facility, which is set to open later this year, it is clear that we can expect to see more improvements and discoveries from NASA Langley. As Virginia's Senators, we take great pride in the fact that NASA's original field lab--sometimes called the agency ``Mother Center''-- resides in the great Commonwealth of Virginia. We firmly believe that the boundary-pushing spirit displayed over the last 100 years represents some of the best traits of our national character: innovation, exploration, hard work, and the quest to make life better for us all. We look forward to seeing more amazing innovations from Langley and NASA as our Nation continues its push to solve the great problems of our age and as we extend humanity's reach ever deeper into the universe. NASA Langley is a remarkable place--and has been for 100 years. As a center for aerospace innovation, technological discovery, and scientific inquiry, Langley continues to lead the way. We should all cheer them on as they pass this big milestone and rocket ahead into a bold, new century.

Mr. KAINE

Mr. KAINE. Mr. President, I also rise to talk about the healthcare proposal on the floor, and I thank my colleague from Oregon and all my colleagues who have taken the floor on this issue. I will just state at the top a punch line: I will vote for any healthcare bill that meets President Trump's promises. He said that in his replacement, no one would lose coverage, no one would pay more, no one would get kicked around because of a preexisting condition, and he wouldn't cut Medicaid. And any bill that meets those criteria, I am voting for, but I won't vote for a bill that shatters all those promises, and that is what this current proposal does. There is a lot to talk about with the bill, and I just want to talk about one thing--the proposed cuts to the Medicaid Program and especially the effect of those cuts on children. In the current Senate proposal, which is being sort of adjusted and modified, there is a slashing of Medicaid by about $770 billion over 10 years. And if you add to that additional cuts to Medicaid proposed by the President's budget, we are now north of $1 trillion of cuts to Medicaid in the next 10 years. Who receives Medicaid? In Virginia, between 50 and 60 percent of those who receive Medicaid are children. In Virginia, 600,000 young people are Medicaid recipients. If you go to school and you are receiving an individualized education plan because you have a designated disability, Medicaid is paying for it. About 50 percent of childbirths in Virginia are paid for by Medicaid. If you are a kid who is doing everything right, but your family is dysfunctional and a juvenile court judge has to decide whether to keep you with your family or put you in a group home, if the judge decides to send a social worker to your house 5 hours a week, Medicaid pays for that. If you are a child with autism and you are getting services for your autism after school so you can succeed in school, Medicaid pays for that. In Virginia, 600,000 children receive Medicaid. We recently had the administration's OMB--Office of Management and Budget--Director, Mick Mulvaney, before us, and I asked him about these Medicaid cuts. These cuts are catastrophic. How can you say these cuts are a good thing? This is his quote: We are no longer going to measure compassion by the number of programs or the number of people on programs like Medicaid. We are going to measure compassion . . . by the number of people we get off those programs and back in charge of their own lives. So the philosophy that drives this is, we want to get people off Medicaid and back in charge of their own lives--600,000 kids. I had a roundtable yesterday in Springfield, VA, here in Northern Virginia, and I had five families, parents and children, come to talk about what Medicaid cuts would mean to them. Angie and Anna are from Haymarket, VA. Anna is a little 5-year-old and, her mom says, typical in so many ways. She loves to play with her brothers, and she loves to play with dolls. But she has cerebral palsy and tracheal bronchial malacia and subglottic stenosis and chronic lung disease. In 2014, she developed a condition that caused her to have 30 bone breaks in 18 months. Anna is in school. Anna is in school with a wheelchair that Medicaid pays for. Anna is in school with some home health that Medicaid pays for. Medicaid enables this child who has so many needs to actually go to school so she can be all that she can be. Her family has TRICARE through the military because the dad is in the military, but they couldn't make it without Medicaid. Jen and Cailyn are from Sterling, VA, also in Northern Virginia. Cailyn is about 9\1/2\. Within a week after she was born, the family knew there were some things wrong. She was finally diagnosed at age 3\1/2\ with a very rare, noninherited genetic anomaly. The family was able to get her qualified for a Medicaid waiver when she was about a year old. And this is secondary insurance. The family works and they have private insurance, but it doesn't cover a wheelchair, a hospital bed, and things that she needs to succeed. Again, this little girl who is 9\1/2\--and her mother testified that she functions on about the range of a 6-month old--she is able to go to school because Medicaid can pay for some of the technology she needs. Kim and Isaac are from Ashburn, VA, in Loudoun County. Isaac is a youngster, a very active kid, but he has a tracheotomy. He is feeding- tube dependent. His family has private insurance, but they couldn't get along without Medicaid. He is in the Loudoun County schools succeeding because of Medicaid. Dylan is another kid in Loudoun County schools. Corinne is his mother. Dylan has a rare neuromuscular disease called spinal muscular atrophy with respiratory distress. He has a tracheotomy tube. He relies on a ventilator to breathe. Little Dylan was at this meeting. The family has private insurance, but they couldn't succeed without Medicaid. Dylan is able to go to school because of Medicaid. Finally, there is a family from Richmond--Amy is the mom, and the son is Declan. Declan is not in school because he is only 18 months old. He has cerebral palsy, and his medical needs are intense. With Medicaid, he is able to get some home nursing help, and he is able to get some machinery at home that helps him succeed. These are beautiful parents, one of whom had adopted her child--first as a foster care and then adopted knowing the special needs of this child. This was Angie and Anna. These parents are the saints of the world, and these kids are fighting so hard. They are fighting so hard just to try to develop every talent they have, every capacity they have, but with Medicaid cuts, they would be in deep, deep jeopardy. Why would we vote for a bill that slashes Medicaid to families like these when President Trump said we are not going to cut Medicaid? Why would we vote for a bill that shatters those promises, that takes health insurance away from 20 million people, that increases premiums for seniors, that subjects those with preexisting conditions to being cast in the shadows yet again? That is what this bill would do. I had a conclusion written, but I will tell you, one of my moms yesterday gave me a better one. She gave me a better conclusion. We had this roundtable with five families. We had some great folks from the American Academy of Pediatricians who were there, too, saying what a bad bill this would be for kids. After the hearing was over, one of the moms looked at me and said: You know, they kind of picked the wrong group of people to fight with-- talking about this bill. I said: What you do mean by that, wrong group of people to fight with? She said: Parents of kids with disabilities. I said: I don't get where you are going. And this is what she said to me: From the moment our children are born, all we do is fight. We fight so that our kids can survive. We fight so that our kids can have as normal a life as possible. We have to fight with hospitals. We have to fight with insurance companies. We have to fight with school systems. We have to fight with cultural stigmas about people with disabilities. If you are a parent of a child with a disability, from the day they are born, all you do is fight. And if they think that we are going to pass a bill to cut Medicaid to these kids and their families and that we are not going to fight about it, that we are not going to stand up and be heard, they have seriously underestimated us. I think we can do the right thing, as my colleagues have said, if we will get together. I am on the HELP Committee, Health, Education, Labor, and Pensions, and the only topic that has been taboo on my committee this year is health. We have had hearings about nominees. We have had hearings about the FDA. We have not been allowed to have a hearing about this health proposal--either the House bill or the Senate bill. Let's have a hearing, listen to patients, listen to parents, listen to hospitals, listen to doctors, listen to people who are worried about their premium costs, listen to insurance companies, and listen to medical innovators. If we listen, we will get this right. But if we shut down a process, if we don't allow the public in, don't listen, don't have hearings, and rush it through, we will get it wrong. This is the biggest sector of the American economy, and it is the most important expenditure that anybody ever makes in their life. On behalf of the 600,000 children in Virginia and the 30 million children in this country who receive Medicaid, let's get this right. Mr. President, I yield the floor.

Mr. KAINE

Mr. KAINE. Mr. President, I also rise with my colleagues to speak in favor of commonsense solutions. I think the GOP leadership made a wise decision--and I thank them for it--to pull the vote on their healthcare bill this week when the CBO came out and said that 22 million people would lose health insurance, 15 million in the first year, and Medicaid cuts would be significant. Obviously, the public was very concerned, and I am glad the GOP has taken a step back. I think we now have a chance to get this right. I want to tell a personal story about my own involvement in this in the last few months. The story, to me, exemplifies an important principle, and that is a bad process will produce a bad product. This bill was the subject of a very bad process. The bill that was put on the floor was a bill that ignored and shut out all Democrats from participating. More importantly, it shut out the committees from participating. Most importantly, it shut out the public from participating. That led to a bill that was destined to be bad. So we ought to fix it. Our Democratic leader is just exiting the Chamber. He asked me after I came back from the national ticket--as a consolation prize, I guess-- can you be on the HELP Committee? This is the committee I have wanted to be on since I came to the Senate--Health, Education, Labor, and Pensions. I have been a mayor, and I have been a Governor. I have been in local and State government for 60 years. Education is the biggest line item, and health is the second biggest line item. This is what I actually know something about. I was so thrilled to join the committee. But, boy, was I naive. I assumed that being on the HELP Committee meant we would get to have a hearing about a healthcare bill. I got on the committee on the 3rd of January. On the 5th of January, with many of my colleagues, we wrote a letter to the Republican leader and to the Republican chair of Health and Finance--13 of us; we had been on the committee for 2 days--and said: If you want to talk about improving healthcare, we have ideas. We want to sit down with you right now and talk about improvements to healthcare. I guess I am a naive 58-year-old. I thought, now I am on the committee. Now I am where things will happen, and we will get to actually fix healthcare. But instead, since I have been on the committee--and I have committee colleagues here who will attest to this--we have had hearings on higher ed, we have had hearings on Cabinet nominees, we have had hearings on FDA reform issues. But the one taboo topic on our committee is that we are not allowed to have a hearing about the healthcare bill. We asked for one after the House passed their bill; we couldn't have a hearing. The Senate bill has been put on the floor; we haven't had a hearing, and as far as we know, there will be no hearing. So those of us who are focused on this issue have no opportunity, but, more important--it is not about committee Members. For those watching this and wondering what a hearing is about, a hearing is about hearing from the public. You have a witness table. You get a patient and a doctor and a nurse. You get an insurance executive and a pharmaceutical executive. You get a small business having a hard time buying health insurance. You get them all to sit there and tell you what they like, what they don't like, and what can be fixed. All of that--all of that--has been shunted aside in this process, so the public isn't heard and the committees can't do their work. Our ranking member on this committee, the Senator from Washington--I had watched her as the Budget chair when I was a Budget Committee member work out a great bipartisan budget deal in December of 2013, with then-House Budget chair, now-House Speaker Paul Ryan. We worked it out. It was bipartisan. I watched our ranking Democrat on the HELP Committee work with the chair on the HELP Committee, Lamar Alexander, 2 years ago to do something most people thought was impossible: have hearings and rewrite No Child Left Behind into the Every Student Succeeds Act. It was 7 years past the reauthorization date because it was too controversial. But I watched them use the committee process, entertain ideas from both sides, hear from the public, rewrite the bill, then conference with the House, and then get it to the President for signature. Why is healthcare taboo on the HELP Committee? Let the committees do their work. Let the greatest deliberative body in the world deliberate. Let the Senate be the Senate, and let us work together. My colleagues have mentioned that I put an idea on the table. It is not a fix-everything idea, but it is a particular idea with a lot of bipartisan cred, and it is the notion, as some of my colleagues have said, of reinsurance. Senator Carper and I have introduced the Individual Health Insurance Marketplace Improvement Act, and it is going to a very particular problem that I think Democrats and Republicans recognize as a significant challenge in the current healthcare law. President Trump, from the beginning of his administration, has injected uncertainty: We are not going to continue enrolling people--or we will reduce the market for enrollment. We are not sure we are going to pay the cost sharing. Maybe we should let ObamaCare crash and burn-- a tweet that he did recently. Because this has happened, the individual market has become very unstable, and many insurers pulling out of the market are citing this unpredictability as contributing to an instability in the individual market. Here is what Senator Carper and I proposed, and we have numerous cosponsors: We take the tool that Senator Nelson was describing, reinsurance, a tool that provides a backstop against very high-cost claims, and we put it into the Affordable Care Act as it was for the first 3 years of the Affordable Care Act. The Affordable Care Act in its first 3 years had a reinsurance mechanism to backstop high-cost claims. If an insurance company knows there is a backstop, they can actually set premiums at a lower and more affordable level for everybody. Having that backstop also gives some certainty, so you can actually write a plan in a market where, if you don't have certainty, you might choose not to write it. In the first 3 years of the Affordable Care Act, this reinsurance provision worked out very well, held premiums down, and kept insurers in the marketplace. It expired. But we actually know reinsurance works because it is part of a great bill that was passed during a Republican Presidency with overwhelming Republican support. Medicare Part D was passed during the administration of President George W. Bush. Reinsurance was made a permanent part of that bill to do exactly the same thing: to cover high-cost claims, seniors who had multiple high- cost medications. Because reinsurance was included in that bill--it was put in the original bill, authored by Republicans--it enables pricing to be more affordable for our seniors who are on Medicare, and it enables pricing actually to be more affordable for the public treasury. Reinsurance is just one of a number of ideas that are out there, but it is an idea that has bipartisan bona fides. It has been demonstrated to work. You are not going to put reinsurance in this bill and have an unintended consequence that you didn't think would happen. We know how reinsurance works, and we know how it will work here. I would just conclude and say that I hope we will take a bad process, which produced a bad product, set that aside, and engage in a good process to find a good product on the most important expenditure anyone ever makes in their life--on their health--a good product in the largest sector of the American economy; one-sixth of our economy is health. The right process is this: When the Republicans get to the point that they think this bill is all they would want it to be, why not just put it in the Finance Committee, put it in the HELP Committee, and let's be the U.S. Senate. Let those of us who are on the committees do what we want to do. We have good committee chairs in these committees: Senator Hatch and Senator Wyden, the chair and ranking on Finance; Senator Alexander and Senator Murray on HELP. Put it in the committees; let's hear from the public about what works, what doesn't, and what can be fixed. Then let's dialogue and listen to one another and come up with solutions--just as in that budget deal, just as in the rewrite of No Child Left Behind. The Presiding Officer knows the next thing I am going to say, I bet. I am in the minority on those committees. I have some amendments like reinsurance that I want to put up, but I can't get them accepted unless I can convince some in the Republican majority that it is a good idea. I have to convince Republicans it is a good idea for my amendment to be accepted. Shouldn't I have that opportunity? Why would anybody be afraid of being open to an idea that might actually improve the bill? Just this morning, I came out of a markup that the Presiding Officer is very familiar with, the markup of the NDAA. We finished it this morning on Armed Services. We went back and forth across the table, 27 Democrats and Republicans. We traded amendments, we voted some up, and we voted some down. We had Senator McCain and Senator Reed leading us in that. We got to the end of the day, and we had a committee vote. After that discussion and listening to one another across the table, back and forth, the committee vote was 27 to 0--27 to 0. We got all the Dems on board. I will not be naive enough to think healthcare is going to be simple and noncontroversial. I am sure we will have some tough discussions. I am sure I will offer an amendment that will be turned down. Maybe I will offer one that will be accepted. But we are much more likely to produce a good product and help people's healthcare if we actually will sit down in the committees that have jurisdiction and dialogue and amend before we bring this thing to the floor. It is just not worth rushing, because it is life and death. We have a chance to get it right. The step-back this week enables us to take that chance, and we should seize it and work together. I yield the floor.

Mr. KAINE

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

Mr. KAINE. Mr. President, I rise today to talk about the healthcare bill that is currently pending before us. Now that I have had a chance to look at it a little bit, I can see why there has been a lot of secrecy surrounding this process. Before talking about how I think this bill would hurt Virginians, let me talk about the process itself and how flawed I think it is. But the good news is that it is a process that can be fixed. This morning, when the bill was first described on the floor, I was interested when my friend the senior Senator from Texas, the majority whip, said we were doing it this way, through a budget reconciliation process, because Democrats didn't want to work together. I took offense at that comment. As the Presiding Officer knows, I am a member with him on the committee. I was just added to the committee in January. I have been in the Senate for 4 years. I have had great committees, but this is the committee I always wanted to be on because, as a former mayor and Governor, the two biggest line items in the budget I have had to deal with have been education and health. So, finally, I am on the committee I most want to be on. I believe this session of the Senate started on January 3. That was my first day on the committee. I have a letter I wrote on January 5. I had been a committee member for 2 days, and I wrote a letter to my chairman, whom I hold in the highest regard, Senator Alexander; the Senate majority leader, Senator McConnell; and the chairman of the Finance Committee, Senator Hatch, which has jurisdiction over Medicaid and Medicare issues. I wrote a letter on January 5, and I got 13 Democrats, including me, to sign this letter. The gist of the letter is this: We would like to work with you. We would like to work with you to find solutions that would improve our healthcare system, whether that be within the Affordable Care Act or, more broadly, Medicare, Medicaid, and Medicare Part D. We want to work together. That was on January 5, 2 days after I had been added to the committee. As a member of the committee, I have been given no opportunity--not one--to work on this bill. The committee we serve on works productively. We work productively on pharmaceutical issues. We work productively on educational issues. In the committee the Presiding Officer and I serve on, we have passed legislation through our committee and sent it to the floor. Some of the legislation we have sent has already gone off the floor to the House. This is a committee that has a great bipartisan track record, and I am convinced that bipartisan track record is going to continue. But there has been one topic which has been taboo, and that has been to allow meaningful bipartisan discussion about this healthcare bill. When the House bill passed--now a number of weeks ago--it was our expectation that we would have hearings in the HELP Committee and in the Finance Committee about the bill. We haven't. The Democrats on the HELP Committee got a little riled up one day. We were having a hearing about something else, and a lot of us said: Wait a minute. We are not talking about the biggest topic in domestic politics in the country right now, which is this House health bill. We should be doing that in this committee. If we are not doing it in this committee, we are really not doing it. Why does it matter to have hearings in the committee? It is the committee hearing process where you put witnesses at a table and ask them questions. We would have patients, we would have hospitals, we would have doctors, we would have nurses, and we would have pharmaceutical companies and insurance companies, and we would ask them: What is good and what is bad about this bill? What is good and what is bad, and what needs to be fixed about healthcare in this country? That is what you do in hearings, but we haven't had one hearing, and the Finance Committee hasn't had one hearing either. We haven't had hearings in the committee on the House bill. We have had no willingness to hold hearings on the Senate substitute that was revealed today. The effort to draft the bill was closed-door. The notion that Democrats wouldn't participate--we weren't invited to the meetings. We didn't know where they were. We didn't know when they were. We had no chance to participate. Now we are being told that this bill described this morning--and we thought we were reading it online-- no, that is a discussion draft, not the bill itself. So I don't know whether the bill is going to be different, or is it the same? The notion is to rush it to the floor and then essentially to close off debate with a very meager amendment process. The Presiding Officer knows this, but I just want to explain for the public. By not having committee hearings where you can talk to witnesses and hear from the public and then discuss and propose amendments, this is what it will be on the floor: 20 hours of debate about the most important topic in anybody's life--their health. Twenty hours and then you finish the debate. Then, the majority leader indicates there is an unlimited amendment process, but the amendment process under budget reconciliation is as follows: An amendment will be considered, and there will be 1 minute of debate allowed for each side--1 minute. We are talking about healthcare. We are talking about life and death. I have a number of bills I filed that I want to offer as amendments, but for us to truly debate it and for the American public to truly understand it, 1 minute is ridiculous. But that is apparently going to be the rule for us next week. I think it is an outrage for a body that is known as the greatest deliberative body in the world to take up such an important topic and be told that it is in such a constrained way. So I just want to object to the characterization of the process this morning, that Democrats refuse to work together. I have evidence to the contrary. Within 48 hours of being put on this committee, I asked for an opportunity to participate in this debate. I think I am entitled to respect as an elected Member of this body and a member of the HELP Committee to be engaged on matters dealing with healthcare. But thus far, I have not had this opportunity, and that is so out of character for the HELP Committee, I might add. I am going to be discussing this bill tomorrow with stakeholders in Richmond, where I live. Let me tell you what I see that really troubles me about the Senate bill. I think this bill hurts Virginians-- especially seniors, children, people with disabilities, and working families--and it hurts them all to deliver giant tax breaks, largely to the wealthiest Americans. It also shifts costs from the Federal budget to the States, and as a former Governor, that worries me. This bill would slash traditional Medicaid, which is a program that more than 1 million Virginians rely on. It is really important to point out that, when you are cutting Medicaid by potentially more than $1.3 trillion over 10 years, that is what the House bill cut out in Medicaid--the House bill plus President Trump's proposed budget, $1.3 trillion in cuts to Medicaid--and this bill could cut Medicaid even deeper by our reading of it. You have to ask yourself, you cut Medicaid by that much--who are Medicaid recipients? In Virginia, nearly 60 percent of Medicaid recipients are children. Kids who are in public schools receiving special education, many of their services are paid for by Medicaid. A youngster undergoing a cancer operation at Children's Hospital of King's Daughters in Norfolk, a lot of that is being paid for by Medicaid. A kid who has autism and is getting a couple of hours of autism- related services to help them be successful in school is paid by Medicaid. A child in a dangerous household who might have to get institutionalized--not because the child is doing something wrong but because there aren't parents in the household who are helping the household stay together, they are in danger of being institutionalized--Medicaid can send services a few hours a week into the household to stabilize the family so the child doesn't have to be institutionalized, and that is being paid by Medicaid. When you cut Medicaid, that is whom you are affecting; 60 percent are children, 15 to 20 percent are people with disabilities. That is who is on Medicaid in Virginia; 10 to 15 percent are parents and grandparents in nursing homes and pregnant women. That is who is on Medicaid in Virginia. The Medicaid cuts in this bill are even steeper, even more significant than the cuts in the House bill. The bill would continue to allow something that I think is very challenging and that was a carryover from the House bill and may even be worse, which is the ability to charge older adults in the 55- to 64-year-old age range as much as five times higher than younger enrollees in the marketplace. When most people are in the 55- to 64-year-old range, they are not necessarily at the peak of their earnings. Their earnings are often starting to come down a little bit. If you let their rates rise that dramatically, you are really hurting people who can't easily go back and reenter the marketplace and the workforce at the same level they could have when they were younger. This is a bill that will hurt 22,000 Virginians who rely on Planned Parenthood for lifesaving healthcare. That is how many women in Virginia use Planned Parenthood as their primary doctor, as their primary physician--22,000, and this bill would hurt it. This bill would weaken health benefits by reducing the essential health benefits contained in the Affordable Care Act, and that affects pregnancy, that affects mental health, that affects opioid treatment programs, and it would force States to make very difficult budget choices. If you cut Medicaid by that much, you are going to make Governors and mayors decide: Wow. OK. Whom do I cut? Do I cut the kids? Do I cut the disabled? Do I cut the elderly? Do I cut all three or do I raise taxes? You are just pushing this off on the shoulders of States. There is good news. I want to finish with good news. I always try to finish or find some good news. There is good news. We can do this right. We don't have to do this wrong. It is actually really simple. When the Senate bill is truly ready, and it is not just a discussion draft but a real bill and it is put on the floor, all we have to do is refer the bill to the two committees--the Finance Committee and the HELP Committee. Let the committees hear from the public, from providers, patients, doctors and nurses, and hospitals. Let members of the committee-- Republicans and Democrats--ask questions. Let us propose amendments. Let us improve it. This doesn't have to be a complete up-or-down. Why can't we have a meaningful discussion and ask questions and propose amendments in a deliberative way and improve the bill? It is not as if the Democratic minority can just roll over you. We are the minority in this body, and we are the minority on both the HELP and Finance Committees. Unless I can put an amendment on the table and convince some Republicans it is a good idea, my amendment is going to be voted down. If I can't convince somebody around the table this is a good idea, I will take it, and my amendment will be voted down. At least, let's have a meaningful discussion about the most important expenditure anybody ever makes in their life and the largest sector of the American economy. What would be wrong, what could be wrong in letting the HELP Committee take a look at the healthcare bill? What would be wrong, what could be wrong with letting the Finance Committee take a look at a bill that affects Medicaid and Medicare, which is in their jurisdiction? What would be wrong, what could be wrong with allowing public witnesses to come to these committees and testify what they like and what they don't like? I may learn some things about the bill that I like after listening to some witnesses. What would be wrong, what could be wrong with allowing this to happen in this great deliberative body? I guarantee it would improve the outcome. It would improve the product. More minds looking at this and debating and in dialogue will improve it, if what we want is an improved healthcare system. Maybe that is not what we want. Maybe doing our best job is not what we want. Maybe what we want is the ability to put something through only with votes from one party and with the other party completely shut out of it. What I think we should want is to do the best job for the most people when it comes to the most important thing in their lives, their health. I will conclude and say that we can get this right. We can take advantage of the work product of the Republicans, who have been working on this draft by putting it in the HELP and Finance Committees and allowing the body to treat it as any other piece of legislation and improve it before we are forced to vote for it in a rush vote on the floor. With that, I yield the floor. I suggest the absence of a quorum.

Mr. KAINE

Mr. KAINE. Mr. President, I also rise to talk about the healthcare of every American. This is critically important to every person and every family in this country. It is critically important to every local, State, and Federal budget in this country. It is also critical to the economic productivity of our Nation. In a purely partisan move, the House barely passed a bill that would take health insurance away from 23 million American people over the next 10 years, dramatically increase premiums to seniors, jeopardize coverage of people with preexisting conditions, and impose huge burdens on States. One of the reasons the House bill was so bad--condemned even by President Trump, who labeled it ``mean''--was because it flowed from a bad process. The House held no hearings on the final bill. There was no meaningful testimony from patients or healthcare providers. They did not accept any amendments from Democrats. They rushed the bill through to vote before the Congressional Budget Office could score the bill. So no wonder. No wonder the House bill is opposed by the American Medical Association, the AARP, nurses, hospitals, patient organizations, Democratic and Republican Governors. Yet the Senate is poised to make exactly the same mistake--preparing a secret bill, with no testimony, no public scrutiny, no opportunity for meaningful amendments, no opportunity for Democrats to participate. We have the opportunity to get this right, and we have the responsibility to get this right. There are so many problems with the House bill. As a member of the HELP Committee, I went on Friday to the Culpeper Free Clinic about 75 miles from here to talk about the need for real improvement in our healthcare system, not a repeal that would hurt vulnerable people. At this clinic, which is celebrating its 25th year, I saw dedicated staffers and volunteers, and I talked to patients. I talked to them about how this organization has provided compassionate care to working people in this region of Northern Virginia who don't have health insurance. The fact that Virginia has refused to expand Medicaid is one of the reasons the need for their care is so significant. Fully 70 percent of the free clinic patients in Virginia would be eligible for Medicaid if the State would just join the 35 other States that have expanded Medicaid. What I heard at the Culpeper Free Clinic is that they are already bursting at the seams because we haven't expanded Medicaid. If there are additional cuts to Medicaid, it would overwhelm the ability of the 60 free clinics in Virginia to provide compassionate care. Just a few hours ago, earlier today, I went to Albemarle County near Charlottesville and had a roundtable session with educators, families, and children's advocates to highlight another key problem with the Republican approach. By dramatically cutting Medicaid, who is the most likely victim? Children. The most numerous victims of Medicaid cuts are children. In Virginia and nationally, nearly 60 percent of the recipients of Medicaid are kids. Yet the President, through the TrumpCare bill and the President's submitted budget, proposes to cut Medicaid by $1.3 trillion over the next 10 years--$1.3 trillion over the next 10 years-- and this deeply frightens parents, educators, and kids I talked to today. I heard from parents of kids with cerebral palsy and autism, parents whose kids are receiving support through Medicaid to buy a wheelchair or get services so they can learn to adjust with autism. This will help them grow into adults who have a chance of living independently. These parents had heartbreaking stories, often telling me: I had no idea of the challenges of parenting a disabled child until I had one myself. They view Medicaid as absolutely critical to their children's educational and life success. They talked about the current shortfalls in the Medicaid funding that leave their kids on waiting lists for services. One mom has been on a waiting list for a developmental disability waiver. I asked her what they told her about the waiting list, and this was her quote: ``They have told me my child will die before he is off the waiting list.'' And that is under the current program, before $1.3 trillion is cut out of it. I heard from school administrators who talked about the importance of Medicaid funding for their programs that serve students and special ed teachers who are worried about the effect on their work if Medicaid is slashed. Local superintendents and school board members talked about the difficult challenges of funding their school budget if Medicaid funding is cut. They posed it as a difficult choice. If the Feds cut $1.3 trillion out of Medicaid, do they reduce their funding for their students with disabilities, or do they take local funds away from other important programs to backstop those programs, or do they have to raise their own State and local taxes to make up for the Federal cuts? I heard from child service advocates today who would see their program slashed if Medicaid is cut. Here is an example. Many of them serve court-involved young people--not kids charged with crime but kids who are in court because of difficult home lives and challenging situations with their parents or guardian, and they are in danger of being pushed into the foster care system or into institutions because of problems at home. Medicaid pays for support services to help stabilize their family lives. If these services are reduced and more children get institutionalized, how does that help anyone? How does it help these kids? How does it help society? How does it help our budget? It is much more expensive to put a child in a group home or an institution than to provide a few hours of Medicaid services in their home once a week. The 60 percent of Virginia Medicaid recipients who are children and the parents and teachers and nurses and others who worry about them and help them don't see this as a partisan issue. It is fundamentally an issue of compassion. We will and should be judged by how we treat our children. Why slash funds that are used to help our kids? Is it really important to cut Medicaid by $1.3 trillion, hurting millions of children, so we can give a few adults a $900 billion tax cut? I am on the Budget Committee. We had a hearing recently with OMB Director Mulvaney, within the last 2 weeks. Director Mulvaney tried to reassure us in his opening statement that the Medicaid cuts were really about doing people a favor--about doing people a favor. He testified: We are no longer going to measure compassion by the number of programs or the number of people on programs like Medicaid; we are going to measure compassion by the number of people we get off these programs and back in charge of their own lives. I want to repeat that, from the President's chief budget official: We are going to measure compassion by the number of people we get off these programs and back in charge of their own lives. What a cruel thought. That reads like something a villain in a novel by Charles Dickens would say, but that is the philosophy of this administration and this effort. Will we now tell a kid who loses the wheelchair that is partly paid for by Medicaid ``You are now back in charge of your own life''? Will we tell a single mom whose child is receiving services to help with autism but now loses access to these services ``Guess what. You are back in charge of your own life''? Will we tell a teenager in a broken home whose Medicaid services are the only difference between staying in the community and being put in an institution ``Guess what. You are now back in charge of your own life''? Since Medicaid also provides funding for our parents and grandparents who can no longer care for themselves and have to be cared for in nursing homes, will we go to those seniors who lose places in nursing homes and say ``Guess what. Now you are back in charge of your own life''? Slashing Medicaid isn't about putting anyone back in charge of their own life. Medicaid enables kids to go to school and succeed. Medicaid enables disabled people to function well enough to go to work and pay taxes. Medicaid enables seniors to receive compassionate care when they can't care for themselves, and cutting Medicaid jeopardizes the ability of people to live with independence and dignity. No, folks, let's not kid ourselves. This is not an effort to empower anyone. It is about casting them aside because they are too young or too old or too sick or too poor, and it is about giving a tax break to some people with the very funds we are taking away from the most vulnerable members of our society. That is why I oppose this ``mean'' effort by the majority as a secretly crafted bill to repeal the ACA. We can improve healthcare if we work together. Let the Finance and the HELP Committees discuss any bill, hear from patients and providers, allow amendments and debates before rushing anything to a vote that would so cruelly affect the lives of millions and millions of people. With that, Mr. President, I yield the floor.

Mr. KAINE

Mr. KAINE. Mr. President, I applaud the bipartisan work that my Senate colleagues have put into legislation to impose sanctions on Russia. Russia's interference in the 2016 election represents an assault on our democracy that, until this point, has gone largely unanswered by the Administration and Congress. Russia has also conducted cyber attacks on allies and illegally invaded and violated the sovereignty of Ukraine and Georgia. I know that my colleagues take this issue very seriously, and I support the bipartisan compromise, which will maintain existing sanctions on Russia for its cyber and military intrusions in Ukraine and require additional mandatory sanctions on Russia's energy sector, those providing arms to Syrian troops, corrupt Russian oligarchs and their networks, and human rights abusers. We cannot allow Russia's hostile actions toward Western democracies to go unchecked. This legislation sends an important message to Russia and the world that the United States stands strongly against Russia's anti-democratic actions. At the same time, the original version of the legislation would have had unintended consequences for our nation's civil and commercial space sectors. National Aeronautics and Space Administration, NASA, and commercial space missions are critical to space exploration, weather data, and sending U.S. astronauts to the International Space Station, as well as supplying them with cargo and instruments for scientific research. Under the original legislation, these missions would have been threatened or prevented from moving forward. In response, Senator Gardner introduced an amendment that would exempt NASA and commercial space-related launch activities from the sanctions bill. I was proud to cosponsor this amendment. In addition to our defense assets, Virginia is at the epicenter of the Nation's civil space program and commercial space industry. For more than 70 years, NASA's Wallops Flight Facility has served as a key national asset to the U.S. space program, an economic driver for the Eastern Shore, and an invaluable benefit to the Commonwealth. The Mid- Atlantic Regional Spaceport at Wallops Island serves as a leader in commercial space, partnering with Virginia-headquartered Orbital ATK to launch critical cargo to the International Space Station. Finally, research projects at NASA Langley Research Center and Virginia's superb academic institutions are developing tomorrow's innovative technologies and scientific discoveries. As Governor and now Senator, I have remained a strong supporter of Virginia's booming industry, research, and launch services. Without Senator Gardner's amendment, some of these activities in Virginia would cease to exist. To be clear, I stand in agreement with my Senate colleagues on the issue of Russian sanctions. I also believe that our space program must transition to American-made rocket engines and parts, and I know that U.S. companies are working hard in conjunction with NASA toward that goal. But we need time for that transition to occur, and this important amendment would make it possible without hurting our current capabilities. In addition, while the Department of Defense has been afforded the opportunity to develop new technologies while maintaining the status quo, it is only fair that we provide the same chance to civil and commercial space entities. For these reasons, I was proud to cosponsor Senator Gardner's bipartisan amendment to S. 722. I look forward to working with my colleagues in the future to enhance and expand our Nation's space program.

Mr. KAINE

Mr. KAINE. Madam President, I rise to speak about the ongoing debate in the body concerning the next chapter in healthcare and what we can do about it together and, especially, to address one part of the healthcare market--the individual market. As most know--and this has been an item about which we are deep into discussions, the people and the Members of this body--before the passage of the Affordable Care Act, Americans with preexisting conditions faced unfair barriers to accessing health insurance coverage, and healthcare costs had risen rapidly. Prior to the passage of the Affordable Care Act, my own family, which is probably like the healthiest family in America because the five of us have only had three hospitalizations for three childbirths--all for my wife--we had twice been turned down for insurance coverage for at least one member of our family because of preexisting conditions. Since 2010, the rate of uninsured Americans has declined to a historic low. More than 20 million Americans have gained access to health insurance coverage--many for the first time in their lives. In Virginia, over 410,000 Virginians have accessed care on the individual marketplace and another 400,000 would be eligible if Virginia decided to expand Medicaid. Many Virginians use the individual market, and they have shared their stories with me on my website. I have on my Senate website ``ACA Stories,'' where I encourage people to share their stories. The individual marketplace, as folks know, is if you are buying health insurance, not through an employer, and you are buying individually--you may or may not be qualified for a subsidy--that particular marketplace is really important for people who aren't employed by companies that offer group plans, but it also has its challenges. One of my stories was from Lauren Carter, who lives in Lovingston, VA, in Nelson County. She wrote in to say: My 39-year-old son has cerebral palsy and a blood clotting disorder. His ``pre-existing conditions'' started at conception. Three years ago, he lost his full time job with health insurance benefits. The ACA allows him to continue receiving medical care and purchase his life saving medications. He supports himself through multiple part time jobs-- This young man with cerebral palsy-- employer based insurance is not an option for him at this time. Laura Kreynus from Mechanicsville, VA, near Richmond wrote: My daughter was diagnosed with Crohn's Disease in April of 2013. That September, my husband was diagnosed with Parkinson's Disease. We are farmers, we raise the food for America. As such, we are independently insured. They have no large employer to cover them. Prior to finding a plan through the ACA in January 2015, our monthly insurance premiums were to increase to nearly $3,000 a month . . . yes, each MONTH! On top of that, our health insurance had an annual cap on prescription coverage of $5,000. The Humira that my daughter takes to combat her Crohn's Disease retails for $3,800 a month, and that is not the only medication she requires. So basically, after one month, we reached the prescription coverage cap, meaning we would have to pay $3,800 a month for medication on top of $3,000 a month premiums. Who has an extra $6,800 a month to pay for this? That is way more than we earn monthly as farmers. With the health insurance plan we got through the ACA, our premiums for 2015 were $1,500 a month, less than half of what we would have been paying under the previous plan. But the real saving grace was no prescription cap, so my daughter's medications are covered with a copay after we reach the deductible. This is still a lot of money, but at least we can treat our daughter's disease and hopefully keep her healthy. And even though our premiums have gone up to nearly $2,000 a month from $1,500 a month under the ACA, at least we can still have insurance. For families like Lauren's and Laura's, the individual marketplace is critical. But like Laura said, premiums are frequently too high. You have to have robust enrollment, competition, and certainty for premiums to come down. Unfortunately, there has been increasing uncertainty in the individual market due to actions taken by the current administration. On January 20, 2017, President Trump signed an Executive order directing relevant agencies not to enforce key provisions of the Affordable Care Act. Later in January, the administration terminated components of outreach and enrollment spending, including advertising to encourage people to enroll in the individual marketplace. The administration has also repeatedly threatened to end cost-sharing reduction payments, which reduce costs for approximately 6 million people with incomes below 250 percent of the poverty level. These actions, these statements, these inactions, and this uncertainty have created uncertainty in the individual marketplace, leading to instability for insurance carriers, higher premiums, and reduced competition. In Virginia, we have seen Aetna and United leave the individual marketplace, and they have cited this uncertainty created by this administration as the principal reason. In other States, there are counties that are at risk to have no insurers offering coverage on the marketplace in particular States or sometimes in regions in the States. So this is a problem we can address, and we don't have to repeal the Affordable Care Act to do it. We just need to improve the Affordable Care Act, using a tool that has had bipartisan support in this body for some time. So yesterday Senator Carper and I introduced the Individual Health Insurance Marketplace Improvement Act, and I want to thank the other original cosponsors of the bill: Senators Nelson, Shaheen, and Hassan. One way to address uncertainty is to use a common insurance tool, reinsurance--a permanent reinsurance program to help stabilize premiums and increase competition. The Affordable Care Act originally had a reinsurance program. It was temporary. It lasted for the first 3 years of the program, and it did hold premiums down. What we would do is that we would take that idea, which worked, and we would make it permanent. We would make it permanent and modeled after a very successful and bipartisan program: Medicare Part D. Medicare Part D provides a prescription drug benefit for seniors. It was passed with bipartisan support during the administration of President George W. Bush, now more than a decade ago, and the reinsurance program has helped hold down costs. This reinsurance program would provide funding to offset larger than expected insurance claims for health insurance companies participating in State and Federal marketplaces. It would encourage them to offer more plans in a greater number of markets, thereby improving competition and driving down costs for patients and families. Basically, if reinsurance can cover high costs, an insurance company will know it has a backstop, which gives it a measure of stability, and also can set premiums at a more reasonable level for everyone. The bill would also do one other thing that is important. It would provide $500 million a year from 2018 to 2020 to help States improve outreach and enrollment for the health insurance marketplaces, especially to draw in new members and educate the public--especially young people who are maybe moving just past their 26th birthdays and can no longer be contained on family policies--about the need to be insured. The outreach funding prioritizes counties where there are limited insurers left in the marketplace. This is not the only improvement that is needed for our healthcare system. We need to do more to keep costs down, figure out a way to have prescription drugs be more affordable, and we can certainly use technology and data to drive better health outcomes, but this is a fix. It is a fix of an important part of our system, the individual market. It is a fix using an idea that has already worked and has already compelled the support of both Democrats and Republicans--reinsurance in Medicare Part D. This should be something Democrats and Republicans can agree to. My worry is that we are participating now in a secretive effort to write a healthcare bill behind closed doors and possibly put it on the floor for a vote without hearing from a single patient, without hearing from a single provider, a hospital, a business that has a hard time buying insurance for its employees, an insurance company, or pharmaceutical company. We ought to be debating these bills in the world's greatest deliberative body and proposing amendments and hearing from stakeholders and then doing the best job we can when we are dealing with the most important expenditure that anybody ever makes in their life, healthcare. Healthcare is also one of the largest segments of the American economy, one-sixth of the economy. Why would we want to pass a bill in secret? Senator Carper, my colleagues, and I have introduced this bill as a good faith effort to say what I actually said when I first got on the HELP Committee in early January of 2015. There is a huge group of us just waiting for the door to open so that we can have a meaningful discussion about moving our system forward, and I believe this bill could be a very good part of stabilizing and improving the individual market and bringing relief to many Americans. With that, I yield the floor. I suggest the absence of a quorum.