Ed Markey

Mr. MARKEY

Mr. MARKEY. Mr. President, I intend to offer the following motion to H.R. 1628, and I ask unanimous consent that it be printed in the Record.

Mr. MARKEY

Mr. MARKEY. Madam President, I intend to offer the following motion to H.R. 1628, and I ask unanimous consent that it be printed in the Record. The motion is supported by Senators Warner, Brown, Carper, Reed, Blumenthal, Warren, King, Klobuchar, Menendez, and Van Hollen.

Mr. MARKEY. Madam President, I intend to offer the following motion to H.R. 1628, and I ask unanimous consent that it be printed in the Record. The motion is supported by Senators Manchin, Whitehouse, Brown, Blumenthal, Warren, King, Nelson, Warner, and Van Hollen.

Mr. MARKEY. Madam President, I intend to offer the following motion to H.R. 1628, and I ask unanimous consent that it be printed in the Record. The motion is supported by Senators Carper, Warren, Casey, Brown, Hirono, Stabenow, Menendez, and Van Hollen.

Mr. MARKEY

Mr. MARKEY. Thank you, Mr. President. Mr. President, earlier today the Senate voted on a bill to dismantle this country's healthcare--a cruel bill that would affect every single American and one-sixth of our economy; a heartless bill that was crafted in secret, without public debate and without input from the families who will be impacted; an inhumane bill that would make health insurance unaffordable for millions of Americans and leave millions more with no access at all. Despite this legislative malpractice, despite numerous independent analyses and nonpartisan Congressional Budget Office findings that millions of Americans will lose coverage and face increased costs, despite Americans from across the country pleading with Republicans not to rip away their coverage or take a machete to Medicaid, despite all that, President Trump and Republican leadership put politics ahead of people and voted to repeal the Affordable Care Act. That is a travesty. I have often said that the proudest vote of my career was the one I cast in favor of the Affordable Care Act. The second proudest vote is today, voting no on this cruel, heartless, inhumane bill. To all of my constituents in Massachusetts, please know that I vote no with you in mind. Massachusetts is the home of universal healthcare. We have a model for the Affordable Care Act. Because of our belief that healthcare is a right and not just a privilege, 98 percent of Massachusetts residents have healthcare coverage. That was a dream of the great Teddy Kennedy, the lion of this Chamber, and it is a reality in Massachusetts. We cast this historic vote today to proceed to debate on healthcare legislation, but rest assured, the fight to protect the Affordable Care Act is far from over. It is a testament to how divided the Republican Party is over how to replace the healthcare law that we still don't know which version of TrumpCare we will proceed to vote on for final passage. It is not because Republicans haven't had time--they have had 7 years to craft a plan to repeal the Affordable Care Act. Rather, the chaos we have seen so far from Senate Republicans is because millions of Americans are finally benefiting from insurance coverage, many for the first time, and they don't want these protections taken away. In many ways, it doesn't matter which bill they bring up for a vote because all versions of the Republican healthcare bill are terrible. Republicans still have no idea how they will go about protecting those with preexisting conditions and ensure that millions aren't kicked off their current insurance plan. Senate Republicans have so far proposed three bills that would each devastate the healthcare sector, take a machete to Medicaid, and make the poorest in our country pay for tax breaks for the wealthiest. These bills are the bad, the worse, and the ugly. First, the bad. Senate Republicans proposed legislation at the end of June--just a month ago--that would rip away health insurance from 22 million Americans and give the top 400 wealthiest people in our country a tax break worth $33 billion. Then the worse. They introduced yet another bill that would also kick 22 million Americans off of their health insurance and cut Medicaid by $750 billion. They tried to buy Republican votes with a separate opioid fund, but that craven, political Hail Mary was not fooling anyone. Then the ugly. When Republican leadership realized that they did not have the votes for either of these cruel replacement bills, they decided to just repeal the healthcare law without any kind of replacement. This proposal would take coverage away from 32 million Americans and double premiums over the next decade. That is the slate of Republican healthcare bills--the bad, the worse, and the ugly. All of these healthcare proposals have one thing in common: heartlessness. They all reduce coverage. They all increase costs for Americans. They all eviscerate Medicaid, causing irreparable damage to a program that provides coverage for 70 million Americans, and they all hand over billions in tax breaks to the wealthiest in our country, who do not need them or deserve them. Even in Massachusetts, the Republican proposals would mean more than 260,000 people would lose coverage, often the lowest income residents in the State. It would cost the State more than $8 billion by the year 2025. There are no changes, no so-called fixes, no modifications to make any of these bills less cruel. Each of the Republican proposals will just exacerbate the most devastating public health crisis facing the country--the battle against opioid overdose deaths. Leader McConnell said today that he would be thinking about the families who are hurting in Kentucky when he casts his vote to kick at least 20 million Americans off of their health insurance coverage. Yet do you know who will really be hurting? It will be the families of the nearly 1,000 people who died of an opioid overdose in Kentucky last year. In a blatantly craven attempt to make TrumpCare more palatable, moderate Republicans from States that have been ravaged by the opioid crisis included a paltry opioid fund in the most recent version of the GOP replacement fund. Those are crumbs compared to the amount that the Affordable Care Act would likely spend on covering opioid use disorder treatments if we would just leave the law alone to work as intended. This opioid fund is not a fix; it is a falsehood. It is a false promise to the people who are suffering from opioid addiction. It is a false future that will not include critical Medicaid funding for treatment and recovery services, and it is a false bargain that Republicans will make at the expense of families who are desperate for opioid addiction treatment. The American people will not be fooled. They realize that opioid funding in this proposal is nothing more than a public health pittance--a wholly inadequate response to our Nation's preeminent public health crisis. No amount of money in an opioid fund can replicate the access to treatment that is provided through the comprehensive health insurance program that the Affordable Care Act represents. Families of those who suffer from substance abuse disorders have been shouting from the rooftops that cutting Medicaid and hamstringing access to health insurance coverage will only make a difficult situation worse. We should be making health coverage and treatment access more robust, not weaker. Today, only 1 in 10 people with substance addiction receives treatment, and it has been estimated that 2 million people who live with opioid use disorders are not receiving any treatment for their disorders. It should not be a surprise to anyone that the epidemic of opioid abuse will only worsen as long as we have a system that makes it easier to abuse drugs than to get help. These Republican proposals will be a death sentence for millions of people with substance use disorders. A vision without funding is a hallucination. They are cutting the funding for substance abuse. Republicans are turning their backs on their vow to combat the opioid epidemic, and President Trump is beginning to break his own promise from the campaign trail to ``expand treatment for those who have become so badly addicted.'' Instead, they are moving forward with a proposal that threatens insurance coverage for 2.8 million Americans with a substance use disorder--all to give hundreds of billions in tax breaks to billionaires and big corporations--and slashing funding for our Nation's preeminent public health crisis is just part of it. Creating a separate fund for opioid use disorders just further stigmatizes the disease and pushes it back into the shadows. This is not how we treat chronic health conditions in this country, and it is insulting to those 33,000 Americans who lost their lives just last year from opioid overdoses. This latest political maneuver proves yet again that TrumpCare has never been about creating health. It has always been and still is about concentrating wealth--tax breaks for the rich coming from the cuts in healthcare coverage for those who need it the most in our country. They are abandoning hard-working families so that they must fend for themselves while they bestow those gifts of billions in tax breaks to the wealthy. That is shameful. The GOP replacement plan also imposes an age tax on older Americans, allowing insurance companies to charge older Americans five times more than younger Americans for the same coverage. That is unconscionable. The GOP plan reduces access to care for those with preexisting conditions--Americans with cancer, diabetes, women who have had children. They want to force them to pay for a Cadillac, but they then hand over to them a tricycle. That is just plain wrong. On this floor, it is going to be a battle to the very end on this bill, and I am going to keep speaking and keep fighting until my Republican colleagues understand how important these issues are to every single family in our country. The American people who believe in quality, affordable healthcare will not be silenced by today's vote. Instead, we will be invigorated to call out the callousness in any of these bills that would threaten the economic security for low-income and working families in order to fill the already overflowing bank accounts of the 1 percent. Oh, no. This fight is just beginning out here on the Senate floor because the lives of all Americans who would be hurt by the Senate's vote today to begin debate on repealing the Affordable Care Act are simply too important for us to stop fighting. I yield the floor.

Mr. MARKEY

Mr. MARKEY. Mr. President, I am speaking today because proponents of TrumpCare have their heads stuck in the sand. Many of the Republicans in this Chamber are clearly in denial that we live in a country where 91 Americans die each and every day from an opioid overdose; where 1.3 million Americans went to the hospital for an opioid-related issue in 2014; where 2,000 Massachusetts residents died from an opioid overdose just last year, and 69 percent of those cases had the illicit opioid fentanyl in their bodies. If people across the country were dying from overdoses at the same rate as in Massachusetts, that would be 100,000 people per year--two Vietnam wars' worth of deaths every single year. Over 10 years, that would be 1 million people who die if they were dying at the same rate as they are in Massachusetts--1 million people over 10 years dying from opioid overdoses in our country. If these Republicans took their heads out of the sand, they would hear the near-unanimous calls from the experts and the pleas of mothers and fathers to stop this machete to Medicaid which they have brought with their new healthcare reform bill. They would hear the alarm bells Americans across the country are ringing against this cruel and heartless and immoral legislation. These desperate voices should be enough to get Republicans to abandon their efforts to rip away insurance coverage for treatment and recovery services for Americans struggling with substance use disorders, but instead of accepting the truth and listening to their constituents, they have decided to take a cynical path and replace these lifesaving services with a paltry opioid fund of $45 billion over 10 years. There has been a lot of talk from the Republicans about so-called fixes that they can work on with Democrats, but this opioid fund isn't a fix, it is a falsehood. It is a false promise to the people suffering from opioid addiction. It is a false future that won't include critical Medicaid funding for treatment and recovery services. It is a false bargain that Republicans will make at the expense of families desperate for opioid addiction treatment. This opioid fund is a politically craven effort to buy votes from Republicans whose States are being ravaged by the prescription drug, heroin, and fentanyl crisis, but the American people will not be fooled. This opioid funding is nothing more than a public health pittance, a wholly inadequate response to our Nation's preeminent healthcare crisis. In fact, the amount included in this latest version of TrumpCare is not even half of the amount that the Affordable Care Act would have spent on covering opioid use disorder treatment if we just left that law alone to work as intended. Here are the numbers. The Center for American Progress has estimated that the Affordable Care Act would spend $91 billion for opioid coverage alone over the next decade, compared to the $45 billion the Republicans are putting into their bill which they announced today. We already know that access to treatment is a challenge. Only 1 in 10 Americans with substance addiction receives treatment. There are estimated to be 2 million people with an opioid use disorder who are not receiving any treatment for this disorder. It should not be a surprise to anyone that the epidemic of opioid abuse will only get worse as long as we have a system that makes it easier to abuse drugs than to get help for addiction disorders. And the paltry GOP fund that provides less than half of the funding of the Affordable Care Act is only going to accelerate the death sentence for the millions of people with substance use disorders. Sadly, we know that my Republican colleagues who are attempting to jam this immoral and callous TrumpCare bill through this body actually are aware of the crisis facing their States. They speak to the same constituents. They read the same newspapers. They see the same obituaries of Americans who lost their lives to the opioid overdose epidemic. And that is why we have been able to make some bipartisan progress. Last year, we passed the CARA bill. We passed legislation to fund $1 billion for treatment. But support for the TrumpCare bill and this opioid fund is a betrayal of all of that hard-fought progress we were making. Republicans are turning their backs on their vow to combat the opioid epidemic, and President Trump is breaking his promise from the campaign trail to ``expand treatment for those who have become so badly addicted.'' Instead, they are moving forward with a proposal that would rip insurance away from 22 million people and threaten insurance coverage for 2.8 million Americans with a substance use disorder. This bill would eviscerate Medicaid--the leading payer of behavioral health services, including substance use treatment--by nearly $800 billion, and all of this to give billions in tax breaks to billionaires and big corporations. One analysis has found that under the Senate's previous version of TrumpCare, Republicans provided a nearly $33 billion tax break to the top 400 earners, the top 400 billionaires in America, which is the equivalent of ending Medicaid expansion for too many people in our country. Let's look at what they are planning. They are planning to cut from $91 billion down to $45 billion the amount of money we spend on opioid treatment in the United States. At the same time, they have $33 billion that they are going to give in a tax break to the wealthiest 400 billionaires in America. Where is that money going to be better spent in our country over the next 10 years--$33 billion for the 400 wealthiest people or adding that money back in so that we can have treatment for people who have opioid addiction problems in their families? What is going to be better for America? Well, the Republicans say: We need all that money that would go for treatment to give it to the wealthiest people in our country. They can afford their treatment. Their families will have all the healthcare coverage they need if they have problems in their families. But the Republicans don't care. If you kicked this bill in the heart, you would break your toe. That is how bad it is. So, for me, this is without question, at the heart, a simple explanation of what is fundamentally wrong with this Republican bill. There are many other things wrong with it--preexisting conditions, go all the way down the line--but how can you, when we have this plague hitting our country, take all that money away and give it away to billionaires? It is just wrong. There are too many families, too many letters, too many conversations that we have all had with these families. There are too many tears that we have seen. So, for me, there can be nothing that is worse than doing that to families--taking away their hope. This is going to be a battle of monumental proportions. All I can tell you is that for the 2,000 families who had someone who died in Massachusetts last year, we are going to make sure this is a battle that everyone knows because if the American people understood that they are doing this to all of those families who have an opioid problem right now, there would be a revolt that would rise up across this country. Over this next week, the American people are going to learn about what is in the soul of this bill. I yield the floor.

Mr. MARKEY

Mr. MARKEY. Mr. President, I join with the Senator from Hawaii, the Senator from Washington State, and I know the Senator from Oregon is going to be joining us very soon and taking this long, hot summer day in Washington and turning up the heat on the Trump administration and the big broadband companies. Today the internet is having a protest. More than 80,000 websites are participating in today's national day of action on net neutrality to stand up for the fundamental right for a free and open internet. Today's action involves some of the internet's biggest names: Netflix, Twitter, Amazon, Snapchat, Mozilla, Yelp, Airbnb. It also includes many others. My own website and other Democratic Senators and House Members have joined in today's protests. Earlier today, right outside on the Capitol lawn, I gathered with many of my Senate and House colleagues, along with businesses and advocacy, consumer protection, nonprofit, and political organizations to send a singular message: We will defend net neutrality. Net neutrality is the basic principle that says that all internet traffic is treated equally. It applies the principles of nondiscrimination to the online world, ensuring that internet service providers--AT&T, Charter, Verizon, Comcast, among others--do not block, do not slow down, do not censor or prioritize internet traffic. Yet today, the internet--this monumental, diverse, dynamic, democratic platform--is under attack. President Trump and his FCC Chairman, Ajit Pai, are threatening to disrupt this hallmark of American innovation and democracy by gutting net neutrality rules. They have put internet freedom on the chopping block. We are facing a historic fight. If Trump's FCC gets its way, a handful of big broadband companies will serve as gatekeepers to the internet. We cannot let this happen. That is why millions of Americans are standing up and making sure their voices are heard at the Federal Communications Commission. They know the internet--the world's greatest platform for commerce and communications--is at stake. It is net neutrality that ensures that those with the best ideas, not merely the best access, can thrive in the 21st century economy; that a garage-based startup in Malden, MA, can have the same online reach and scope as a major tech firm in Silicon Valley. It is net neutrality that has made the Internet an innovation incubator and job generator for the entire Nation. It is net neutrality that has been the internet's chief governing principle since its inception. Consider that today essentially every company is an internet company. In 2016, almost half of the venture capital funds invested in the United States went toward internet-specific and software companies. That is $25 billion worth of venture capital funding in our country. Half of all venture capital went into that sector, this innovation sector that continues to transform not only our own economy but the whole world's economy. At the same time, to meet America's insatiable demand for broadband internet, U.S. broadband and telecommunications industry companies invested more than $87 billion in capital expenditures in 2015. That is the highest rate of annual investment in the last 10 years by the broadband companies. We have hit a sweet spot. Investment in broadband and wireless technologies is high. Job creation is high. Venture capital investment in online startups is high. That is what we want. We want both the broadband companies and all of these smaller companies--whose names escape us because there are tens of thousands of them--to have a chance to coexist and have the innovation continue, even as the large companies continue to invest in broadband expansion. It is the free and open internet that has allowed us to enter a new phase of the digital revolution--the internet of things era--where our devices, our appliances, and everyday machines now connect with one another. The digital revolution is a global economic engine, and net neutrality is its best fuel. Taking these rules off the books makes no sense. With these net neutrality protections in place, there is no problem that needs fixing. It is working right now perfectly. In May, Chairman Ajit Pai and the Republican FCC voted to begin a proceeding that will effectively eliminate net neutrality protections, allowing a handful of broadband providers to control the internet. Chairman Pai's proposal would decimate the open internet order and the net neutrality rules that are protecting the free flow of ideas, commerce, and communications in our country. Now the big broadband barons and their Republican allies say we need a light-touch regulatory framework. Let's be honest. When the broadband behemoths say ``light touch,'' what they really mean is ``hands off''-- hands off their ability to choose online winners and losers. We are not fooled when AT&T engages in alternative facts and says they support net neutrality and today's day of action. They don't support title II, and they don't support net neutrality. We must shine light on this kind of corporate deception. What the broadband providers really want is an unregulated online ecosystem where they can stifle the development of competing services that cannot afford an internet easy pass. Chairman Pai says he likes net neutrality but simply wants to eliminate the very order that established today's net neutrality rules. That is like saying you want to have your cake and eat it too. It makes no sense. President Trump and his Republican allies are waging an all-out assault on every front that they can on our core democratic values. Whether it is healthcare, immigration, climate change, or net neutrality, they want to end the vital protections that safeguard our families and hand over power to corporations and special interests. We know better. We need to make our voices heard. A political firestorm of opposition will protect our economy, protect our free speech, protect our democracy. We must protect net neutrality as a core principle in a modern 21st century America, in a modern America where the smallest company online can aspire to reach all 320 million Americans in a nondiscriminatory way, where the smallest company can raise the capital in order to accomplish that goal, where the smallest company doesn't have to ask for permission to be able to innovate in our society, where the smallest doesn't have to first raise the money to ensure they can pay to have access to this incredible economic engine of entrepreneurial expression that has been the internet for this last generation, where free speech, the First Amendment, this ability to be able to speak unfettered, uncontrolled by corporate America and whether or not you can afford to speak, is something that continues to be protected in our country. That is what net neutrality is all about. The principles of nondiscriminatory access is what gave us Google and eBay, Amazon and Hulu, YouTube and Etsy, Zulily, Wayfair, TripAdvisor, and company after company that knew they could access every single potential consumer in our country and could, as a result, raise the capital necessary to ensure that engine of economic entrepreneurial innovation could be deployed from their minds in changing fundamentally the economy of our country and the economy of the world. In 2017, every company is an internet company. Every company depends upon free and open access to the internet. That is what we have been transformed into in just the last 20 years. I was the Democratic coauthor of the Telecommunications Act of 1996. In 1996, not one home in America had broadband. Can I say that again? Just 20 years ago, not one home in America had broadband. But we changed the rules to create this chaotic entrepreneurial world where all of a sudden all of these companies whose names are now common household names could be created, transforming our economy. There is no problem. They are trying to fix a problem that does not exist. We need to give the next generation of entrepreneurs the same opportunity to innovate that the last generation had--not to get permission, not to ask: Pretty please, may I reach all 320 million Americans? No, ladies and gentlemen, that is not what this revolution is about. That is not what young people all across this country--with brilliant new ideas to further transform our American economy online-- want to have as an obstacle. What will happen now is you will have an idea, but if you can't raise the money to pay for this fast-lane broadband access, that is going to throttle back your ability to be able to move in this agile way that the internet provides. Instead of agility, it will be hostility that you will be feeling as an entrepreneur, feeling you can't take the risk--you are not sure you can reach your customers; you are not sure you can pay the broadband company--rather than ensuring that you can reach all these consumers for your revolutionary idea. This internet day of action we are having across the country is going to raise from 5 million, to 6 million, to 7 million, to 10 million, to 15 million, to 20 million, the number of Americans who are going to be saying to the Federal Communications Commission and to the U.S. House and Senate that something is fundamentally wrong with this FCC and its potential change of the internet--Open Internet Order. If they do move, we are going to court. If they do move, we are going to be taking this all the way to the Supreme Court of the United States of America because that is how important this issue is. It goes right to the fundamental nature of what has happened to our economy in the last 20 years. And that is all it took. We moved from the black rotary dial phone to a world where everyone is carrying a computer in their pockets. It happened just like that. It could have happened before that, but it wasn't possible because the broadband companies didn't even exist. There were just telephone companies and cable companies that did not have a vision of the future. Their vision of the future is a lot like their vision of the past before that law passed, which is, let's go back to total control by a small handful of companies in our communications cocktail, rather than thinking of the future, as tens of thousands, hundreds of thousands of smaller companies can be started up in dorm rooms and garages across our Nation. This is a dangerous and harmful plan the FCC has on the books today. Today's day of internet action will be increasing as each moment goes by between now and the day they make that decision at the FCC. Mr. President, I yield back the remainder of my time.

Mr. MARKEY

Mr. MARKEY. Mr. President, we have now reached a point where the Senate majority, the Republicans, and President Trump, have been unable to put together the package that allows them to take Medicaid and try to successfully turn it into a shadow of what it once was in our country, to turn it into a debt-soaked relic of what it is today by taking out $770 billion that otherwise would have gone to the families of those in our country who need healthcare services, who need help in providing for those who need it the most within our country. The same thing was true in the House of Representatives when they were moving through their bill over there. People said: Trump doesn't have the votes. The Republicans don't have the votes. They are not going to be able to be successful. However, this TrumpCare Hail Mary that they threw in the House, notwithstanding the remarkable defense put up by the American people--the millions of phone calls, protests, and rallies--they still were able to find the votes to ultimately pass this incredible attack upon the healthcare of tens of millions of Americans. What they did in the House is what they are doing in the Senate. The GOP retreats; they wait for the defense to disperse, but then they plow through to get this bill over the finish line, hoping that a 2-week hiatus will be sufficient for the energy level of the defense against these cuts to so wane that then they can come back and finish off the job on their second try in the same way they did in the House of Representatives. Right now it is only halftime. It is halftime. They are coming back. The ball is in their court. They will attempt again to destroy the healthcare system of our country as we know it today. We have not defeated this bill yet. Now is the time for those who oppose this bill to redouble their energy, to play even tougher defense against this Republican attempt to undermine Medicaid, to undermine access to care to everyone in our country. Their bill is now down, so let's keep it down for the count. Let's make sure this bill cannot get up and come back and haunt us in the middle of July. The Senate proposal right now has $188 billion, which is now going to be within the hands of the Trump administration, in the hands of the Republican leadership as a slush fund to be used to get the votes they need in order to pass their bill. That $188 billion is right now being divided up in a way that will help them to get the votes. What is the ultimate goal of the GOP? The ultimate goal is to take a machete to Medicaid because they harbor an ancient animosity toward Medicaid, and I will throw in Medicare and ObamaCare--all of it. They see this as the best opportunity they have had in two generations to be able to leave these programs as debt-soaked relics of what they are today. When they say: Well, we are going to cap the funding and send it back to the States with more flexibility--when they say ``cap'' the funding, they are talking about decapitating the funding, to cut it in half, send it back to the States, and then say to the States: You figure it out. You try to help those people who are poorest in your State whom you were never able to figure out how to help in the first place, which is why we put the Federal programs on the books in order to help those who are most in need in all of those States. What is their real goal? It is pretty simple: Slash these programs and then turn them into one huge tax break for the richest people in America. That is what this program will do. One little example of that $770 billion--let's take $33 billion of it. That $33 billion gets divvied up by the 400 wealthiest families in America; 400 billionaires walk up and say: Can I please have my $7 million that I get as part of taking away coverage for cancer, coverage for Alzheimer's, coverage for opioid treatment? Can I now get my payoff for the success in your wealth-income transfer program? Because that is what you have. You don't have a healthcare program; you have a wealth care program. The wealth of the wealthiest--please make them even wealthier; that is what their entire plan is about. By the way, that $33 billion would be enough to take care of the healthcare of 700,000 people in our country, but the Republican priority is to give all that money back to the wealthiest people in our country. That is immoral. That is inhumane. It is just plain wrong. The American public has to rise up and fight against the greatest legislative injustice that has been perpetrated or attempted to be perpetrated on the American people in more than a generation. This bill is ``the bill'' of my entire career in the U.S. Congress, which is now 41 years. This is the worst bill. It is the greatest attack upon the well-being of our Nation. This program is of the rich, for the rich, by the rich, and where are they going to take the money from? From the poor, from the sick, from the elderly, from the disabled. It is selfishness on stilts. To think that there is a plan to take healthcare away from the poorest and sickest and most disabled people in our country in order to give a tax break to the wealthiest is the most indecent action that may have ever been perpetrated on the floor of the U.S. Congress. There are billions in tax breaks for those who don't need them or deserve them, paid for by people who cannot afford it. It is healthcare heartlessness; that is what it is. If you kicked these people in the heart, you would break your toe. There is no heart. There is no sense of decency toward those families who are going to see their loved ones' diseases get even worse or to see them ultimately die because of lack of coverage. The Republicans say that their plan--at least they purport it as their plan--is to decrease the deficit by passing this bill, but what do they do with the money that they save? Ah, a tax break for the wealthy. I thought that you were shedding tears about your concerns of subsequent generations having such huge deficits, but we know those are crocodile tears about future generations because you want to pay off this generation of billionaires and this generation of millionaires who need no additional wealth for their families today. So there is no real concern about the deficit. This is, once again, just an attack on the programs that the Republicans have always opposed, and if they combine it as a tax break at the same time, all the better. From my perspective, people are just going to wind up paying more for healthcare, and they are going to be getting less. They are going to be paying for a Cadillac but only getting a tricycle as the people go forward. For too many families, they will not be able to afford anything, and there will be no subsidy to help them get healthcare for their families. The anxiety of suffering from an illness will only be exacerbated by their families' understanding that they cannot even afford the care for their loved ones because of the financial insecurity in their own families. This is going to be a historic 2 weeks in which we must raise our voices as they have never been raised before--in which we stand on the ramparts and let those Republicans know that they are in for the fight of their lives. Cassandra-like, we must warn of the dangers of complacency, of the misunderstanding of what is happening right now. The Republicans have removed the healthcare bill from the Senate floor for consideration. They are not defeated. They are just at halftime. They are now trying to construct a plan that will bring it back as soon as we return and with the votes now secured, from their perspective, in order to pass this bill and send it over to the House of Representatives and then down to President Trump for his signature. These next 2 weeks will be the most important 2 weeks for the healthcare of our Nation in two generations. This battle is the battle to ensure that they are not successful. From my perspective, this is a fight that each and every American has to be a part of because it is your families who are going to be harmed. If we just take opioid addiction coverage in Massachusetts, 2,000 people died from opioid overdoses last year. We are only 2 percent of America's population. If that number were to multiply across the whole country, that would be 100,000 people overdosing and dying. That would be two Vietnam wars of deaths in one year from one disease--a disease that we could begin to reverse if there were the treatment for families and if the prevention were put in place. Yet, if there is no treatment, if there is no prevention, if there is no access, then people, who otherwise would have been able to live normal lives with treatment, will now die. If you have Alzheimer's, if you are in a nursing home, there is a very high probability--since two-thirds of all grandmas and grandpas in nursing homes are on Medicaid, if you slash Medicaid, the care that loved one is now receiving in a nursing home is going to be slashed. Grandma and Grandpa in that nursing home are going to see the services that they otherwise would have been provided not being available to them. That is what this Republican plan is going to do. It says to a kid--a family member--with opioid addiction problems, it says to Grandma and Grandpa in a nursing home, it says to a woman who has cancer, it says to a man who has diabetes: I am sorry. We no longer can afford in America to help you get the healthcare you need. We are better than that. We are a better country than that, and we are definitely a better country than our saying that we are going to take away that healthcare from all of those people and then give it as a tax break to billionaires. We are better than that. That is just wrong. So this is the battle, the most important battle. In 1967, Martin Luther King said that the most important civil right was access to healthcare because health is the first wealth. Without health, you have nothing. That is what we are fighting for right now. We are fighting for that fundamental civil right for everyone. This slashes coverage for those who are disabled in our country. We have made progress over the last generation in reconfiguring how we view the disabled in our country. We have given them access to the help they need so that they can be fuller citizens in our society. This bill slashes the funding to help 20 million disabled in our country live fuller, more functioning lives in order to give a tax break to a billionaire. It is wrong. It must be stopped. We must put up the defense against this bill's ever becoming law. For the next 2 weeks, while they sit and plot to try to find a way of camouflaging what they are doing, the American people must rise up and say: No, America is better than that. We will not allow this to happen. God help us in 2017 in the United States of America. I yield the floor.

Mr. MARKEY

Mr. MARKEY. Mr. President, I would like to thank my friend and colleague Senator Hirono for her words and her willingness to share how this bill could impact the millions of Americans with preexisting conditions. I, along with everyone else in this Chamber, wish her the best and a speedy recovery so she can continue to fight for the people of Hawaii and the people of the United States. After weeks of secret meetings, Senate Republicans released their healthcare legislation last week. In many ways, it is even worse than expected. It is no wonder that the Senate Republicans kept this legislative malpractice hidden behind closed doors. For working families and the elderly, for the disabled and for those suffering from opioid addiction, this legislation is a death sentence. This bill takes a machete to Medicaid. It abandons people with preexisting conditions. It punishes Grandma and Grandpa, who live in a nursing home, and 25,000 seniors in Massachusetts' nursing homes who are on Medicaid. It causes the single greatest rollback of civil rights for people with disabilities in a generation, by taking away the funding for those with disabilities. It creates an age tax for those over the age of 50. It shreds a critical healthcare program for the disabled, working families, and children just to bestow billions in tax breaks for the wealthiest in our country. This is an amazing number. The richest 400 billionaires in the United States will get a tax break of more than $33 billion, which is roughly equivalent to the cuts from ending Medicaid expansion in four States. That is more than 700,000 people in just those four States who could be kicked off of their health insurance coverage to benefit just 400 billionaires in America who do not have to worry about their healthcare or their family's welfare. But for those who are going to lose the coverage--people with cancer, people with Alzheimer's, people who need opioid addiction treatment, people with diabetes--they will have their healthcare coverage slashed so that 400 billionaires can get a tax break, which they don't need and they don't deserve. That is at the heart of this Republican healthcare bill. It is what it is all about. This legislation is of the rich, by the rich, and for the rich. It is a ``wealth care'' bill for the upper 1 percent in our country, and it says to everyone else: Your healthcare is going to suffer in order to take care of that 1 percent with their tax breaks. It is a more than $500 billion tax break to corporations and individuals making $200,000 or more. It is no wonder that President Trump has kept his tax returns secret, because he knew he was about to get a massive tax break through this legislation from slashing healthcare for people with cancer, diabetes, Alzheimer's, heart disease, and substance use disorders. This selfish Senate Republican legislation will increase premiums and out-of-pocket costs, while decreasing the quality of health insurance coverage for most Americans. This bill would result in many Americans--especially those over the age of 50--paying thousands more in premiums for skimpier health plans. It will put insurance companies back in charge of our healthcare by allowing them to waive coverage of the essential health benefits like emergency care, prescription drugs, maternity care, or mental health treatment. That means that someone with a preexisting condition, like a cancer survivor or a child with asthma, might have insurance but not actually be covered for the treatment they need, because under this bill, the anxiety of suffering from an illness or the constant fear of relapse will once again be exacerbated by financial insecurity. Yet some of the most damaging provisions of this legislation are the brutal cuts to Medicaid, which already serves more than 70 million Americans, including, very importantly, two-thirds of all seniors in nursing homes in America, who are on Medicaid. Let me say that again: Two-thirds of all seniors in America are on Medicaid. Half of all seniors over the age of 85 have Alzheimer's, and 15 million baby boomers are going to have Alzheimer's. They are going to need some help. People have a hard time paying $60,000, $80,000, $100,000 a year for a nursing home bed. What are the Republicans planning on doing over the next 15 years? Slashing that funding in Medicaid for seniors in our country who will need that help just to stay in a nursing home, or else they are going to have to go home to their families who will be responsible for providing the care for them. The Senate Republicans doubled down and opted for even steeper cuts in their bill than in the House version. In 3 years, the Senate bill will start the process of kicking millions off of their Medicaid coverage by ending Medicaid expansion in States around the country. It will mean 22 million Americans are kicked off of coverage. Then, as if that wasn't enough, starting in 2025, the plan will institute even more drastic Medicaid cuts that every year become a deeper cut than the year before, and it will literally mean death by a billion cuts for millions of Americans who will lose their healthcare coverage, especially those suffering from substance use disorders. Medicaid covers about one-third of Americans with an opioid use disorder and pays for nearly half of the medication-assisted treatments in Massachusetts. Taking away this treatment would be a death sentence for thousands of Americans. A vision without funding is a hallucination. The Republicans are saying: We will find the will to take care of these people with opioid treatments. Well, you can't will your way to dealing with an opioid crisis. It is a disease. You need funding. You need treatment. And right now, there are millions of Americans who don't have the treatment they need. Medicaid is the way in which it will be provided, but the Republicans are just going to slash it, and the consequences are going to be catastrophic. Now, here is what the Republicans are saying: To make up for the cuts to Medicaid, the Senate Republican healthcare legislation creates an opioid fund of $2 billion for 2018. Compare that to the $91 billion in funding for opioid use disorder treatment that would be provided by the Affordable Care Act over the next 10 years. A $2 billion opioid fund is pocket change for a crisis that took 2,000 lives just last year in Massachusetts and 33,000 lives across the country. And if people were dying from opioid addiction at the rate they are dying in Massachusetts, that would be a 100,000 people a year--two Vietnam wars a year dying from opioid addiction. They are going to slash the funding for treatment for these families. It will be a death sentence for these individuals if they do not have access to the funding. So the formula of this bill is simple: First, increase the cost of care, so working families pay more. Second, decrease the quality of care for seniors and the sick. Finally, hand over the hundreds of billions of dollars in tax breaks to the wealthiest people in our country--billions in tax breaks to people who don't need them, who don't deserve them, paid for by people who can't afford it. It is healthcare heartlessness. To add insult to injury, it will devastate the budgets of already strapped States, which may be forced to raise taxes or cut other benefits, such as education or housing assistance, to make up for the billions of dollars States will lose because of this bill. It is cruel. It is inhumane. It is immoral. It is just plain wrong to cut healthcare benefits for those who need them to give tax breaks to those who do not need them. That is the Republican plan. The Republican leadership is trying to catch a political unicorn with this bill--to make moderate Republicans happy while satisfying the most conservative elements of the Republican Party. But there is no treatment for TrumpCare. It is dangerous for healthcare, and there is no reviving Medicaid if this bill passes. This Republican proposal has never been about policy. It isn't about covering more people or decreasing costs of healthcare or making it more patient-centered. The Republican proposal has always been about slashing healthcare for ordinary Americans to give a massive tax break to the wealthy in our country. That is the Republican policy agenda, not patient-centered care, because this will hand back over the power to insurance companies in our country, not to patients. If Republicans were really concerned about reducing the deficit, then every single dollar in this bill would go to reducing the deficit--the crocodile tears which they shed about the deficit. No, ladies and gentlemen, they are shoving this money straight to the biggest number of billionaire beneficiaries than any tax bill in our country's history. They are, in fact, the party of the wealthy. They are the party trying to make sure that those who are in charge of funding the Republican Party now receive their pay back in the form of tax cuts at the expense of the healthcare of the ordinary people in our country. That is selfish, that is unconscionable, and that is why the Democrats are going to fight this every step of the way this week in order to protect healthcare for every American. Mr. President, I yield the floor.

Mr. MARKEY

Mr. MARKEY. Mr. President, last week, President Trump reportedly told several of our Republican colleagues that the House-passed version of TrumpCare's healthcare repeal of the Affordable Care Act was mean. This week, White House Press Secretary Sean Spicer said that the President would like to see a healthcare bill from the Senate that ``has heart in it.'' What did we get? We got a bill from my Senate Republican colleagues that is identical to and in some cases even worse than the disastrous House-passed American Health Care Act that would rip coverage away from 23 million Americans and gut Medicaid by more than $800 billion. Nothing changes the fact that this undemocratic, secretive process has resulted in legislation that is so mean-spirited, it would make the Wicked Witch of the West cringe. The Senate Republican bill will rip away economic security from young families, make grandma and grandpa pay more for health insurance simply because they are old, tear away coverage for opioid addiction patients desperate for treatment, and punish Americans with preexisting conditions such as cancer, diabetes, and Alzheimer's. For once, I agree with President Trump. This bill is mean. Let's take a closer look about what is really inside of the Senate GOP's proposal on healthcare. Let's start by looking at the lower quality coverage. First, this bill will roll back the clock to the days before the Affordable Care Act, when an insurance card did not guarantee comprehensive coverage. Because of the Affordable Care Act, there are certain things an insurance plan just has to cover--things like emergency services, maternity care, prescription drugs, mental health services. There is security in knowing that if you pay your premiums, this sort of basic minimum coverage is in place when you need it. But Republicans want to rip that away. They want to give States and insurance companies the option to not cover these things. This would make it so that a consumer could easily be faced with an unexpected medical bill for services they had assumed were covered with their healthcare plan. Independent analysis from the Congressional Budget Office estimates that out-of-pocket costs for maternity care or mental health or substance abuse disorder services could increase by thousands of dollars in a given year under TrumpCare. That is not increasing quality, as President Trump promised; that is lower quality. And that just increases inequality between the healthy wealthy, who can pay out of pocket for their care, and providing lower quality coverage for everyone else. That is mean. Second, an age tax. Since the Affordable Care Act became law, the uninsured rate for Americans ages 50 to 64 decreased by one-half. Those are the baby boomers, and it is estimated that more than 28 million of these baby boomers will develop Alzheimer's disease between now and the year 2050. This reduction in the uninsured rates came about because the Affordable Care Act expanded Medicaid and put protections in place to prevent insurers from charging exorbitant prices just because of age. But instead of caring for our family and friends as they age and ensuring they can afford quality coverage on what may be a dwindling income, TrumpCare punishes you for achieving your milestone 50th birthday. Under the Republican healthcare proposal, insurance companies can charge older Americans five times more than younger Americans for the same coverage. That is unconscionable. It doesn't matter if you are a 50-year-old marathoner in the best shape of your life; you will still be paying at least five times more for your insurance than your 40- year-old neighbor who smokes. As a result, Americans over the age of 60 could see their premiums increase by an average of $3,200 or 22 percent. That might not sound like a lot to some people, but for those with decreasing incomes and fewer job opportunities, it is the difference between being able to eat and being kicked out on the street. To add insult to injury, the subsidies in TrumpCare to help individuals purchase insurance are far less generous than what is currently available under the Affordable Care Act. Because that will result in premiums that are higher, the tax credits will not keep pace to help pay for more expensive insurance, and, as a result, this age tax is going to be mean to those who are older in our country. No. 3, Medicaid cuts. Medicaid is a lifeline for families across our country. More than 70 million Americans--nearly half of whom are children--depend upon it. But it is clear that with TrumpCare's cuts to the program, Republicans want Medicaid to flatline. For a program that covers more than one-fifth of the Nation's population, including the sickest, the oldest, and the poorest amongst us, Medicaid is especially irreplaceable. But Republicans harbor an ancient animosity toward Medicaid. Republicans say that we need to restructure Medicaid's financing to help control the program spending and make it more efficient. That is just another way of saying to America's most vulnerable that you are just not as important as those who donate to our campaigns. Raiding the Medicaid coffers achieves two goals. First, it tears holes in a critical social safety net for more than 70 million low- income and working-class Americans. Second, it provides the GOP with an open checkbook to pay back their donors with huge tax breaks. Republicans might want to refer to these changes as capping the Medicaid program, but don't be fooled. What capping really means is decapitating access to primary care, decapitating the ability of grandma and grandpa to secure a nursing home bed, and decapitating access to treatment for substance abuse and mental health conditions. Gutting the Medicaid program--that is mean. Next, they are going to reduce access to care. This one is simple. Less insurance coverage equals less access to care. While it is possible to get a doctor's appointment and treatment without health insurance, it is usually at prices that are impossible to afford for a typical uninsured person. Most working Americans can't conceive of paying more than $150 every time they want to visit a primary care doctor or footing the bill for a couple of thousand dollars in the event they need more specialized care. The best medicines and the most effective treatments are only as good as the insurance coverage people have to help them to access to it. How will these 23 million Americans who lose insurance under TrumpCare get the care which they need? They will not get the care. Unfortunately, when patients do try to access care, it will be because their illness has progressed to the point where it can no longer be ignored. Instead of seeking care with a primary care doctor in a less expensive healthcare setting, most uninsured patients will end up going straight to the emergency room--the most expensive site for care. And the cost of that uninsured patient--well, that is just going to get absorbed by everyone else in our country, as our rates for treatment and insurance coverage increase to make up for this uncompensated care. So reduced access to care--that is mean. Then we move on to higher premiums. Higher premiums are going to be the new rule in our country because that is going to be what happens if the Republicans are successful in repealing the Affordable Care Act. According to the nonpartisan Congressional Budget Office, TrumpCare would increase premiums by an average of 20 percent in 2018. In Massachusetts alone, premiums for next year could increase by $600, threatening coverage for more than 180,000 of my constituents with private insurance. Because of everything else in TrumpCare, even though you are paying more, you will be getting less. It is like paying for a Cadillac, but only getting a tricycle. This will only prevent Americans from securing access to the care and the treatment they need and they deserve. Less care for more cost--that is going to be mean. Premiums are going to go up for everyone. Finally, it threatens all of those in America who have preexisting conditions. For so many Americans, allowing insurance companies to refuse coverage or charge more because of a preexisting condition is inhumane, and it is immoral. Anyone who tried to buy individual health insurance before the Affordable Care Act remembers this problem. Before the healthcare act passed, in most States, if you had a preexisting condition, you could either be denied coverage, charged a much higher premium, or forced to wait potentially for years before receiving treatment for the condition to be covered. For many people, this meant they either had to go without needed care or spend their entire savings. For those with the most serious conditions, it was the difference between life and death. The anxiety of suffering from an illness was only exacerbated by financial insecurity. It was a cruel and unusual form of punishment. Sadly, the Republicans want to take us back to this era. Threatening preexisting conditions--that might be the meanest of them all because protections for families who have preexisting conditions is something that goes right to the heart of what the Affordable Care Act provided as a protection. Why would millions of Americans have to suffer these cruelties, these indignities, these punishments? That is the most outrageous part of all of this. President Trump and the congressional Republicans are proposing this healthcare heartlessness, all so they can give tax breaks to the wealthiest in our country. We heard it from President Trump himself last night when he talked about the people he hired for his Cabinet. ``I just don't want a poor person,'' he said. But who does he want running the government and our economy? He wants the wealthiest people in America. He wants people who are billionaires to be making the decisions as to how we run our economy. President Trump has in place a goal of turning over to the richest people in our country the responsibility for putting together the plan to cut the programs for the poor and the working families in our country. The Republicans and their wealthy planners have put together a very simple one-step program: The rich get richer, and the rest get sicker in the United States. Make no mistake, this healthcare plan is of the rich, by the rich, and for the rich. It is giving billions in tax breaks to people who don't need or deserve them, paid for by people who can't handle or afford it. That is cruel, that is inhumane, that is immoral, that is just plain wrong, and my Democratic colleagues and I will not stand for it. We are standing up to say no to ripping away coverage for millions of Americans. We are raising our voices to say no to increasing costs for middle-class families. We are saying here today that we are going to say no to this legislative malpractice. The health of the American public is too important for us to be so mean, so callous to the people we were elected to serve. This Republican proposal has never been about policy. It has always been about politics, and it is time to stop playing political games with people's lives, with people's healthcare. Healthcare is a right and not a privilege. That is the promise we made to the American people with the Affordable Care Act, and it is a promise we must keep. The President is keeping his promise to the rich in our country. They have now written a healthcare plan for one-sixth of our economy that slashes $800 billion that would be used for the poor, for the sick, for the working class, for senior citizens in nursing homes by $800 billion in order to give an $800 billion tax break to the wealthiest people in our country. That is wrong. This is a critical moment in our country's history, and we, as Democrats, are going to battle every single day here on the Senate floor and across this country to make sure that every person understands what the consequences of this incredibly callous, mean bill will mean--lower quality coverage, an age tax on the elderly, Medicaid cuts that hurt families across our country, reduced access to care, threatening of the protections for preexisting conditions, and resulting in higher premiums for everyone. It will be a disgrace. I yield the floor.

Mr. MARKEY

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

Mr. MARKEY

Mr. MARKEY. Mr. President, last year, nearly 2,000 people in Massachusetts died from opioid overdoses. If the same number had died in America, it would have been 100,000 people. Thank God that because of the Affordable Care Act, many of those people received treatment who otherwise would have passed away last year. The number would have been a much larger number across our State and across the country. Because of the Affordable Care Act, the number was low, but that number was still much too high. I want to be able to tell the people in Massachusetts what the impact of the Republican healthcare bill will be on their families in terms of getting access to the opioid addiction treatment they will need so that the number does not continue to go up but to go down. I want to be able to tell them what that coverage will be before I vote upon it, but the majority will just not let that happen. They are keeping the bill hidden. They do not plan to make it public until the very last minute, with our having less than a day to view it before we vote upon it. That will be catastrophic for those families who need opioid addiction treatment--absolutely catastrophic. Mr. President, I ask unanimous consent that no motion to proceed to Calendar No. 120, H.R. 1628, the American Health Care Act, be in order until the bill has been the subject of executive session meetings in the Committee on Finance and the Committee on Health, Education, Labor, and Pensions, during which amendments from the majority and minority received votes and the bill has been reported favorably from the committees.

Mr. MARKEY

Mr. MARKEY. Mr. President, when I was home in Massachusetts this weekend, I constantly had people coming up to me and asking me about the secret Republican healthcare bill--what is in it and how it is going to affect their families--because, to use Donald Trump's words, they are afraid that it is going to increase premiums, and that would be mean; that it is going to make it possible for insurers to deny coverage for preexisting conditions, and that would be mean; that it would create an age tax for older Americans, and that would be mean; that it would cut Medicaid coverage for grandma and grandpa to get a nursing home bed if they had Alzheimer's, and that would be mean. So the question that kept coming to me all weekend was, is this secret bill really meant to cut all of the funding that goes for the poor, the sick, the elderly, and the disabled so they can give tax breaks to the wealthiest people in America? Can we get that out so people can see that? They also said to me that they didn't want to be fooled, because their fear is that TrumpCare is as much a healthcare bill as Trump University was a college institution and that there really isn't any healthcare in it and that it is cruel, inhumane, and immoral. So we are demanding that the Republicans show us the bill so the American people can see the bill and understand what is in it because the consequences for their family's health are so dramatic. As a result, I ask unanimous consent that Calendar No. 120, H.R. 1628, the American Health Care Act, be referred jointly to the Committee on Finance and the Committee on Health, Education, Labor, and Pensions with instructions to report the bill with changes to eliminate provisions that, No. 1, increase health insurance costs; No. 2, reduce coverage; No. 3, make healthcare less affordable for those with preexisting conditions; and No. 4, reduce tax liabilities for corporations and individuals with incomes over $1 million.

Mr. MARKEY

Mr. MARKEY. Mr. President, when a Pope dies, the cardinals meet in secret to select the next Pope. A white cloud goes up in smoke. When the Senate Republicans meet in secret to craft a healthcare bill, coverage for the sick, the disabled, and the elderly is what goes up in smoke--all of that coverage. The only thing more secret than the Republican healthcare bill is Donald Trump's tax returns. We might need ultimately to have a special counsel to go and to find out what is inside of that healthcare bill because right now the Democrats don't know, the American public doesn't know, and no one knows what is in that bill. While we may not have details on the Republicans' secretive proposal to repeal and replace the Affordable Care Act, we know that they are not completely rewriting the House- passed legislation that eviscerates the Medicaid Program and reduces coverage and increases costs for most Americans and for the individuals, the families, and the communities caught in an opioid crisis. This bill will be a complete calamity, and it is being done totally in secret. Right now, the press is being stifled. The White House didn't even let reporters audiotape the press briefing today. Last week, the Senate Republicans tried to keep the press from asking questions of Senators in the hall. They don't want the press to know about this bill or to cover it. But for families who need treatment for opioids, the Republicans want to take the money from substance use disorder coverage and care and use it to offset a $5.5 trillion tax cut for the healthy wealthy and for massive corporations. That would be cruel. It would be immoral. It would be inhumane. Like President Trump himself has said, it would be ``mean.'' We know the opioid epidemic knows no demographic, economic, or political boundaries. It has ruined the lives of men and women from Lexington, MA, to Lexington, KY. It is an equal opportunity destroyer. That is one of the reasons why, over the last year, combating the opioid epidemic has been a bipartisan issue. Eleven months ago, this body passed and sent to the President's desk the Comprehensive Addiction and Recovery Act. Known as CARA, this bipartisan law strengthens the States' responses to the opioid crisis, and it passed the Senate 92 to 2. Six months ago, the Senate passed the 21st Century Cures Act 94 to 5. This bill quickly became law and allocated $1 billion to States to provide much needed resources to help them address the opioid epidemic on the ground and in their communities. Yet today Senate Republicans are singlehandedly attempting to betray that progress and to erase it from the history books. They are doing so by crafting in secret a bill to gut Medicaid and repeal the Affordable Care Act and replace it with a shell that hides a massive tax break for the wealthiest people in our country--people who do not need or deserve a tax break, especially if it is coming from the healthcare coverage of those people who are sickest, those people who are oldest, those people who are most disabled, those people who are most vulnerable to having an addiction to opioids and need treatment. It would be wrong to take their money for that healthcare coverage and give it as a tax break to the wealthiest billionaires in America, who already have enough money for their healthcare coverage. This would be a death sentence to the 2.8 million Americans with substance use disorders, including 220,000 with an opioid use disorder at risk of losing their insurance coverage altogether in order to ensure that their family member can get treatment. For those who do manage to get insurance coverage, TrumpCare will make it more expensive to get the treatment and the care they need. The Congressional Budget Office explicitly said that out-of-pocket spending on mental health and substance abuse services could increase by thousands of dollars per individual in any one given year. For a disease as critical as an opioid use disorder, any delay in treatment can be the difference between life and death, not to mention that, because TrumpCare reduces protections for people with preexisting conditions, even those with insurance may find out that the coverage they have won't work for them when they need it the most. Under the Republican proposal, a substance use disorder could be classified as a preexisting condition and, therefore, you couldn't get coverage for it. The Congressional Budget Office also said that TrumpCare would slash Medicaid by $834 billion, permanently decapitating Medicaid. They say they are moving to a per capita system. Another way of saying that, if you are an ordinary person, is decapitation of Medicaid for the families across our country who need it. If this becomes law, there is no Narcan for Medicaid. Once it is cut by TrumpCare, it is dead. Those devastating cuts would grind the progress we have made in expanding access to opioid treatment to a screeching halt and kick people currently in treatment to the curb. Medicaid spent $7 billion on substance use disorder treatment alone in 2014. That money facilitated access to care, access to recovery, and access to hope for millions of Americans. Medicaid can cover in-patient detox treatment, care coordination, access to naloxone. Additionally, Medicaid pays for one-third of the medication-assisted treatments in the country, more than any other payer. In Massachusetts, Medicaid pays for nearly one-half of the medication-assisted treatment provided in the Commonwealth. So think about that. One half of the people who get medication-assisted treatment for opioid addiction will lose their coverage, and, then, the Republicans are going to take the money they save and give it to the wealthiest people in our country, who also need the same coverage, leaving them with the money needed for those who are the one-half who won't have it. What happens to those other individuals? It could be a death sentence without treatment. Those of us from States hardest hit by the opioid epidemic hear time and again how Medicaid coverage of those services saves lives. Dawn from Swansea, MA, shared the story of her son, who became addicted to opioids after experimenting with prescription pain pills from a family member. Through Medicaid, he was able to access medication-assisted treatment to help treat his substance use disorder. Dawn said: He has done very well with his recovery so far but I fear that without insurance coverage that will allow him to continue obtaining his medication and counseling . . . he may lose all that he has gained and fall back into the cycle of addiction. His medical insurance is literally his lifeline. Please don't abandon my son and others like him who need Medicaid assistance to continue their fight against addiction. Instead of recognizing the importance of Medicaid for families like Dawn's across the country, Republicans are proposing to starve this lifesaving program from Federal funding through TrumpCare by cutting more than a quarter of its budget. Because that is not enough to fund the massive tax breaks that Republicans want for their donor friends, President Trump has proposed in his budget to cut the program by an additional $600 billion, leaving Medicaid a shell of its former self. Although Republicans refer to the changes as capping the Medicaid Program, for Dawn's son, what that really means is they will decapitate his access to medication-assisted treatment, decapitate his ability to seek counseling, and decapitate the peace of mind Dawn receives in knowing her son is accessing the help he needs. We also have to consider the Affordable Care Act's Prevention and Public Health Fund and its role in the opioid epidemic. It is the Federal Government's single largest investment in prevention. Since 2010, Massachusetts has received more than $95 million through the prevention fund. Importantly for Massachusetts, nearly $4.5 million has been given to the preventive health services block grant that has helped the State respond to the heroin, prescription drug, and fentanyl drug crisis. Eliminating this fund will only hurt our ability to respond to the opioid and other drug epidemics popping up in every one of our communities. We should not be building bridges to recovery with money that is stolen from those programs in order to be spent on a wall that is going to pretend to block the drugs from coming in from overseas. We should be building bridges to recovery, not walls to isolation. Instead of more commissions, we need more commitments from the administration and congressional Republicans to not undo the progress we have made in preventing and treating substance abuse disorder. It is unfortunate that Republicans who touted our progress on opioid issues aren't standing up to the policies in TrumpCare that would negate their hard work. By supporting this, they are betraying the families and communities who have suffered from the relentless grip of substance use disorders. When discussing the opioid crisis, the only thing the GOP stands for right now is Gutting Overdose Prevention. That is the new GOP--Gutting Overdose Prevention. While devastating, this isn't surprising for those of us who have been watching many congressional Republicans salivate over ways to annihilate Medicaid for decades. Republicans harbor an ancient animosity toward Medicaid. Raiding the Medicaid coffers achieves two of their goals: First, it kills a lifeline for more than 70 million low- income and working-class Americans. Second, it provides the GOP a piggybank to aid their donors and pay for these tax breaks for their friends. In fact, TrumpCare alone would provide the wealthiest individuals and national corporations with over $660 billion in tax breaks over 10 years. Included in this figure is the repeal of the health insurance tax, which gives a $145 billion tax break to insurance conglomerations and their CEOs. Millionaires will get a tax break of $50,000 a year--more than three times the income of most Medicaid beneficiaries--and the top 400 highest income earners would save $7 million in taxes annually. All of this comes at the expense of the 23 million Americans who will lose health insurance coverage under TrumpCare. Don't let the GOP fool you--TrumpCare is not about creating health, it is about concentrating wealth in the hands of a small number of Americans. It is about making middle-class and working Americans pay for a tax break for people who need it least. We can do better than this. We owe it to the families of the 33,000 Americans who died from an opioid overdose last year. The proposals under consideration with Republicans is going to only add to the tally of overdose deaths. We are hearing that Senate Republicans could create an opioid fund as a paltry attempt to appease those who have called out the cruelties in this bill. That extra funding would be crumbs. It would be like trading a full-body cast for a bandaid, like trading land for a couple of beads, like trading a Cadillac for a tricycle. We will not be fooled. We know it took Republicans more than 1 year to agree to providing the funding for emergency opioid response in the CURES bill. One can only imagine how long it will take to get any money the Republicans are promoting as a consolation prize out to the communities who need it. We know that a vote for TrumpCare is a vote to perpetuate overdose deaths. Passing this bill will be just aiding and abetting one of public health's most wanted and most notorious serial killers. Americans from both political parties are not fooled by President Trump's tax cut shell game on the backs of families and communities who have been ravaged by opioids. That is why Democrats will continue to be a public megaphone and shout from the rooftops that eviscerating Medicaid to give a tax cut to the healthy and wealthy is mean, inhumane, and immoral, and we are not going to stand for it, and the American people are not going to stand for it. The best vote I ever cast in my political career of 41 years in Congress was for the Affordable Care Act. The second best vote I will ever cast is to block the repeal of the Affordable Care Act because of the good it has done for tens of millions of families in our country who otherwise would not have the coverage they need. Mr. President, I yield back the remainder of my time.

Mr. MARKEY

Mr. MARKEY. Mr. President, I say to Senator Schatz, thank you for organizing our Senate net neutrality champions out here on the floor today so that we can all stand up and add our voices to your voice in speaking on this critical issue. Now, there are people watching the Senate floor right now by watching the live stream on c-span.org or on Facebook Live. They might be engaged citizens, they might be political junkies, or maybe they need something to help them to ensure that their newborn is going to go to sleep this afternoon. That is watching C-SPAN. That helps the family. Let's face it. The action in this most deliberative body can sometimes feel a little slow. Now, imagine just a few companies deciding that c-span.org will be put in a slow lane, that the public interest content streamed out to the world from this Chamber will be sent out at an even more deliberative pace, all while kitten videos get priority in an internet fast lane. When people talk about net neutrality, that is what we are talking about. Instead of an open and free internet where the billions of clicks, likes, and links made by customer and entrepreneurs in their living rooms and offices determines who wins and loses, it will be just a few companies in a few corporate boardrooms deciding who gets into the express lane and who falls behind in an internet traffic jam. That is why we need a true open internet. That is exactly what I heard last month when I hosted a roundtable in Boston with a number of our tech firms--Carbonite, TripAdvisor, Wayfair, iRobot, and others. Their message was clear: Net neutrality impacts businesses across the entire internet ecosystem, and the ever-changing environment of entrepreneurship can be easily disrupted without this ingredient--net neutrality. Today, essentially every company is an internet company. Consider these statistics. In 2016, almost one-half of the venture capital funds invested in this country went toward internet-specific and software companies. That is $25 billion worth of investment. At the same time, to meet America's insatiable demand for broadband internet, U.S. broadband and telecommunications industry giants invested more than $87 billion in capital expenditures in 2015. That is the highest rate of annual investment in the last 10 years. So we have hit a sweet spot. Investment in broadband and wireless technology is high, job creation is high, and venture capital investment in online startups is high. Disrupting that formula now would only create chaos and uncertainty. With strong net neutrality protections in place, there is no problem that needs to be fixed. But the Trump administration wants to upend this hallmark of American innovation and democratization by gutting net neutrality rules. Tomorrow, Chairman Ajit Pai and the Republican- controlled Federal Communications Commission will vote to begin a proceeding that will allow a few powerful broadband providers to control the internet. Now, the big broadband barons and their Republican allies say: We don't need net neutrality. They say: What we really need is a ``light touch'' regulatory framework for broadband. But let's be clear here. When the broadband behemoths say ``light touch'' what they really mean is ``hands off''. They really want hands off of their ability to choose online winners and losers. That is what they really want, to allow AT&T, Verizon, Charter, Comcast, and all of the other internet service providers to set up internet fast lanes for those with the deepest pockets, pushing those who can't onto a slow gravel path. Then, they will just pass any extra costs onto the consumer. What they really want is to sideline the FCC, our telecommunications cop on the beat, and to create an unregulated online ecosystem where broadband providers can stifle the development of competing services that cannot afford an internet E-ZPass. No one should have to ask permission to innovate. But with fast and slow lanes, that is precisely what an entrepreneur will need to do. Right now, the essence of the internet is to innovate and test new ideas first, and if an idea then takes off, the creator can attract capital and expand. Creating internet fast and slow lanes would flip this process on its head. Instead, an entrepreneur would first need to raise capital in order to start innovating, because she would need to pay for fast lane access to have a chance for her product to be seen and to succeed. Only those with access to deep pockets would develop anything new. Imagine the stifling of creativity if startups need massive amounts of money even to innovate. Now, Chairman Pai says he likes net neutrality. But in reality, his proposal would eliminate the very order that established today's network neutrality rules. That is like saying you value democracy but you don't see a need for a constitution. It makes no sense. For Chairman Pai and the ISPs, title II is a bad word. It is some terrible thing. But for everyone else--consumers, activists, and entrepreneurs--title II is a reason to celebrate. Back in 2010, the FCC attempted to put net neutrality rules in place without reclassifying under title II of the Communications Act. The DC Circuit Court invalidated those rules. Then, in 2015, the Federal Communications Commission rightfully adopted the open internet order, which reclassified broadband under title II, and the DC Circuit upheld the rule in 2016. The issue is settled. The FCC should not repeat past mistakes and instead should maintain the successful current regime. Why is title II appropriate? It was Congress's intent to preserve the FCC's authority to forestall threats to competition and innovation in telecommunications services, even as the technologies used to offer those services evolved over time. Now, classifying broadband under title II is just a very fancy way of saying broadband is like telephone service. It is a basic utility that Americans rely on every day to work, to communicate, and to connect. Broadband has become the single most important telecommunications service Americans use to transmit information from one to another. This is common sense to Americans around the country, with the only exception being high-powered telecommunications lobbyists inside the beltway here in Washington. Chairman Pai also claims that he wants internet service providers to voluntarily decide to follow net neutrality principles. That is like asking a kid to voluntarily swear not to stick his hand in the cookie jar. It just won't happen. We know the broadband industry--your cable, wireless or telecommunications provider--can't self-regulate themselves. They struggle to even show up on time to install or fix your service. Do we really trust them to resist using their internet gatekeeper role and putting their online competitors at an unfair disadvantage? This effort on net neutrality is just one piece of the Republicans' effort to dismantle the basic protections safeguarding American families. Instead of protecting our privacy, our healthcare, our environment, or our net neutrality, the Republicans want to give it all away to their friends and allies and big corporations. The FCC has received more than 1 million comments already, and I am sure millions more will flow in the weeks and months to come, as the FCC comment period will stretch until at least August. Those are comments from every corner of the country and from every walk of life. They are standing up to say we need a truly open and free Internet. Openness is the internet's heart. Nondiscrimination is its soul. Any infringement on either of those features undermines the spirit and intent of net neutrality. So I proudly stand with my fellow netizens out on the Senate floor and all across America who oppose any efforts to undermine net neutrality. We are on the right side of history. I am ready for the historic fight to come. Twelve years ago, I introduced the first net neutrality bill in the House of Representatives. In the Senate, the first net neutrality bill was introduced by the Senator from Oregon, Ron Wyden. This has been a long battle, a long struggle coming. We now have America in its sweep spot, with net neutrality on the books for software and broadband companies, which allows for a fair balance in terms of the competition in the marketplace. So I now turn and yield for the Senator from Oregon, Ron Wyden.

Mr. MARKEY. Mr. President, will the Senator from Oregon yield?

Mr. MARKEY. Mr. President, as the Senator from Oregon remembers so well, when he and I started in Congress, there was one telephone company. Did we have innovation? Well, we had a company winning Nobel Prizes in basic research. Did we see applied research out there, new technologies? No. We saw a black rotary dial phone. So AT&T had to get broken up so there would be new companies, new competition, new technologies. Ultimately, because of all of that effort toward deregulation to let more companies in, more innovations, we now have devices that we walk around with, which are just minicomputers in our pocket. We have millions of apps that people sitting in any city and town all across our country can develop and get online to try to make a few bucks. Ultimately, it is still that old AT&T mentality: How do we shut it down? How do we close it down? How do we make it hard for the entrepreneur, hard for the innovator, hard for that new idea to get out there that makes it more productive, easier for the American people to be able to have access to these new programs? I agree with the Senator from Oregon that this is a pivotal time in our country's entrepreneurial history. We have learned this lesson over and over again. The Senator has been a great leader on these issues, and I just want to compliment him on that. I compliment the Senator from Hawaii for his leadership on the issue. I yield back the remainder of my time to the Senator from Oregon.

Mr. MARKEY

Mr. MARKEY. Mr. President, I would like to commemorate National Police Week and the lives and sacrifices of two extraordinary Massachusetts law enforcement officers who fell in 2016: Thomas Clardy, a trooper with the Massachusetts State Police, and Ronald Tarantino, a police officer with the Auburn Police Department. Their names will be inscribed on the National Law Enforcement Officers Memorial here in Washington, DC, in honor of their service. By the end of this year, more than 21,000 names will be on that wall. We will never forget their service and sacrifice to our communities and to our country. With the help of the National Law Enforcement Officers Memorial Fund, we pledge to their families and loved ones that they will have the support and resources they need.

Mr. MARKEY

Mr. MARKEY. Mr. President, I thank our leader for his great leadership on all of these national security and healthcare issues. I think he has injected some common sense into how the American people should be viewing each and every one of those very important issues. His national leadership is greatly appreciated. Let me turn now and yield to the great Senator from the State of New Hampshire, where this opioid epidemic has hit hardest of all, Senator Hassan.

Mr. MARKEY. Thank you, Mr. President. I thank Senator Hassan for all of her great leadership as Governor of New Hampshire and now the Senator from New Hampshire. The epidemic has hit New Hampshire very hard, harder than any other place. Her leadership is absolutely outstanding. I thank her for all of her leadership on this nomination as well. As we look at this issue, we realize that a whole epidemic was being created, but that epidemic was being created because of approvals of ``abuse-deterrent'' opioids since 2010. I put ``abuse-deterrent'' in quotes because it was extremely deceptive because too many people felt ``abuse-deterrent'' meant they could not ultimately become addicted to the medicine. The damage has now been done. The prescription painkiller abuse became rampant across the country. We had become the United States of Oxy, and the opioid issue was well on its way to becoming an opioid epidemic because when those who were addicted to Oxy could no longer afford $60 for a 60-milligram pill, they opted for low-priced heroin, which is why we should not be surprised that of those individuals who began abusing heroin in the 2000s, 75 percent reported that their first opioid was a prescription drug. Taking advantage of the new demand for heroin, an incredibly sophisticated network of drug traffickers from Mexico set up franchises in the United States, and now they are responsible for nearly half of this Nation's heroin supply and are branching out from large urban areas into our suburbs. These systems collided in a perfect storm that has caused the epidemic we are experiencing today: the overprescription of opioid painkillers that were approved by the FDA, the over-the-top sales and marketing programs by a deceptive and deep-pocketed pharmaceutical giant that went unimpeded for years, and an overabundance of heroin flowing into the United States from Mexico and South America. All of that has led us here. We know that nationally opioid overdoses kill more people than gun violence or auto accidents. Every single day in America, we lose more than 91 people to an opioid-related overdose. Nationally, nearly half of all opioid overdose deaths involve a prescription opioid that was approved by the FDA and often prescribed by a physician. In Massachusetts, in 2016, 2,000 people died from an opioid overdose. Who is the typical victim of an opioid overdose? Who is the typical substance abuser? The answer is that there is none. This epidemic does not discriminate on the basis of age or gender or race or ethnicity or economic status. It does not care if you live in a city or in the suburbs. It does not care if you have a white-collar or a blue-collar job. The 50-year-old White male attorney is just as likely to become addicted to prescription drugs or heroin as the 22-year-old Latina waitress. Opioid addiction is an equal opportunity destroyer of lives. Those addicted to opiates are too often stealing from their friends, their families and neighbors, or complete strangers to fuel their addiction. Cars are broken into, and valuable stereo systems are left intact, while a few dollars in change are stolen. Homes are broken into, and flat-screen television sets remain untouched, while children's piggy banks go missing. The impacts of opioid addiction are also causing immeasurable harm to the families of those in the unbreakable grip of opioids. Too often, I hear the stories of parents who have drained their entire life savings to provide the treatment and recovery programs necessary to beat this addiction. Many times, it results in bankruptcy filings that were unimaginable only a few short years ago. The opioid crisis is robbing people of their friends and their families. It is robbing them of their livelihood. It is robbing them of their freedom as they look out from behind prison bars. All too often, it is robbing them of their lives. If we don't act now, we could lose an entire generation of people. As this opioid crisis explodes in my State of Massachusetts and in every State in the country, we need an FDA leader who will understand that universal healthcare does not mean that every American should have access to a bottle of prescription opioids. Last year, more than 33,000 mothers, fathers, children, and loved ones were robbed of their potential when they died of an opioid overdose, but Dr. Scott Gottlieb has openly questioned the value of the Drug Enforcement Administration's enforcement against doctors and pharmacists to prevent prescription opioids from entering the illicit market. The DEA is our prescription drug cop on the beat, but Dr. Gottlieb wants to give that role to bureaucrats at the Department of Health and Human Services, an agency that has consistently failed at any kind of enforcement. At the same time, Dr. Gottlieb has also publicly stated his opposition to the FDA's risk plans, so called REMS--meaning risk evaluation and mitigation strategies--for the use of these opioids. That is what is used to address the safety of opioid painkillers. These vital tools that the FDA has to manage the risk should be made stronger, but Dr. Gottlieb argues that they should not exist at all. Risk evaluation and mitigation strategies--he says they should not exist at all. With the overwhelming majority of heroin users reporting that their addiction began with prescription opioids, Dr. Gottlieb believes drug safety does not need strong oversight. That is simply irresponsible. We are suffering this public health epidemic because Big Pharma pushed pills they knew were dangerous and addictive. The FDA approved them, often without expert counsel, and doctors, because they do not have mandatory education on these drugs, prescribed them to innocent families all across our country. It is a vicious and deadly cycle that has turned this Nation into the United States of Oxy, and it must stop. Dr. Gottlieb's Big Pharma formula is simple: Take away the DEA oversight over prescription opioids and give that authority to the FDA. Then, at the same time, limit the FDA's ability to utilize its full oversight authority over these addictive products. That would leave a mostly unregulated marketplace for big pharmaceutical companies and their opioid painkillers to thrive, while American families pay the highest price they can: the life of someone in their family. Perhaps most alarming is Dr. Gottlieb's connection to a specific pharmaceutical company called Cephalon. Last month, a Washington Post story was published that detailed Dr. Gottlieb's work on behalf of one company, Cephalon, to raise the amount of the addictive opioid fentanyl that the company could market at the same time the prescription painkiller epidemic was exploding. The Washington Post story detailed how Dr. Gottlieb advocated for the DEA--the Drug Enforcement Administration--to raise the quota of fentanyl that Cephalon could manufacture and put on the market, even while the company was under investigation for pushing doctors to prescribe the addictive painkiller for headaches and back pain when it was meant for late-stage cancer patients. These aggressive and off-label promotion tactics were out of the Perdue Pharma playbook that got us into this opioid crisis in the first place. Cephalon ultimately pleaded guilty in 2008 to illegally promoting the fentanyl drug and paid a $425 million fine. This relationship is deeply disturbing. Dr. Gottlieb seems to believe that pharmaceutical profits are more important than the public's health. When the prescription opioid epidemic was taking deadly hold, Dr. Gottlieb advocated to put even more addictive fentanyl onto the market when it was not appropriate or necessary. Dr. Gottlieb said during his confirmation hearing that the FDA unwittingly fueled the opioid epidemic, but he is guilty of intentionally pushing an addictive prescription opioid onto the American public just to benefit one company instead of working to prevent this massive public health crisis. Dr. Gottlieb's actions could have made the opioid crisis worse. Serious questions remain about Dr. Gottlieb's association with Cephalon, which was fined hundreds of millions of dollars for violating FDA rules. After his tenure at the FDA, Scott Gottlieb was then hired by a law firm as an expert witness used to defend the actions of Cephalon in court. In advance of this floor vote, I and a group of other Senators questioned Dr. Gottlieb on this work and the extent of his historical and financial relationship with Cephalon, but we received nothing that shed any light on his relationship with the company. We cannot have a leader at the FDA who has worked on behalf of a company that aided and abetted the prescription drug and heroin epidemic. Sadly, Dr. Gottlieb is yet another example of President Trump's lack of commitment to address the opioid crisis. President Trump believes that if we just build a border wall, well, we will end this opioid crisis. We don't need a wall, President Trump, we need treatment. President Trump's support for the repeal of the Affordable Care Act and the legislation the House passed just last week means coverage for opioid-use disorders for 2.8 million people could be ripped away. President Trump has proposed slashing the research budget of the National Institutes of Health by 18 percent, undercutting our ability to better understand addiction and come up with alternative, less addictive pain medication. If President Trump and his Republican allies are committed to combating the opioid crisis, they should release their plan for addressing this crisis, including committing to quickly release the remaining $500 million authorized last year in the 21st Century Cures Act, and plan for investing more Federal dollars into understanding, preventing, and treating this debilitating disease of addiction. The crisis is wearing families down to the bone and we need to give them hope. That is what a comprehensive strategy to address this crisis is all about, and strong leadership at the FDA is a critical component of any plan. We need the FDA to be a tough cop on the beat, not a rubberstamp approving the latest big pharma painkillers that are the cause of this deadly scourge of addiction in overdoses. We need to stop the overprescription of pain medication that is leading to heroin addiction and fueling this crisis. The United States has less than 5 percent of the world population, but we consume 80 percent of the global opioid painkillers and 99 percent of the global supply of hydrocodone and the active ingredients inside of Vicodin. We also need to ensure that prescribers are subject to mandatory education responsible for prescribing practices. Anyone who prescribes opioid pain medication and other controlled substances must undergo mandatory medical education so we are sure these physicians know what they are doing. The FDA would be in a position to be the primary enforcer of this critical education. We also shouldn't allow companies to continue to promote their opioids as abuse deterrents. It is misleading. Fifty percent of all physicians believe the ``abuse deterrent'' that is on the label means the drug is not addictive. Physicians don't even know this is addictive, and we know through Purdue Pharma that this is just not the case. The FDA is in a prime position to ensure the terminology used for promoting a drug is not confusing or misleading. At this time of crisis, we need a leader at the FDA who recognizes the dangers of prescription painkillers, who will stand up to big pharma and reform the FDA to prevent addiction before it takes hold. Dr. Scott Gottlieb is not that individual. Dr. Gottlieb's nomination signals a continuation of FDA policy that has cultivated and fueled the opioid epidemic. I strongly oppose Dr. Gottlieb's nomination and call on my colleagues to join me in voting no. Mr. President, I yield back the floor.

Mr. MARKEY

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

Mr. MARKEY. Mr. President, I rise today to speak in opposition to the nomination of Dr. Scott Gottlieb to lead the Food and Drug Administration. The FDA Commissioner is our Nation's pharmaceutical gatekeeper, but for years the FDA has granted unfettered access to Big Pharma and its addictive opioid painkillers to the American public. The result is a prescription drug, heroin, and fentanyl epidemic of tragic proportions and the greatest public health crisis our Nation currently faces. At a time when we need its leader to break the stronghold of big pharmaceutical companies on the FDA, Dr. Scott Gottlieb would be nothing more than an agent of Big Pharma. Dr. Gottlieb's record shows that he doesn't support using the tools that the FDA has at its disposal to minimize the risks to public health from the misuse of prescription opioids. The current opioid epidemic is a man-made problem. It was born out of the greed of big pharmaceutical companies and aided by the FDA, which willfully green-lighted supercharged painkillers like OxyContin. But, in order for us to understand this public health emergency and the critical role that leadership at the FDA has played and will continue to play in this crisis, we need a brief history lesson. We need to understand where these opioids come from. In 1898, a German chemist introduced heroin to the world--a reproduction of an earlier form of morphine believed to be nonaddictive. The name ``heroin'' was derived from the German word ``heroisch,'' which means ``heroic.'' That is how men described the way they felt after taking the new drug. In the first decade of the 20th century, doctors were led to believe that heroin was nonaddictive and prescribed it for many ailments. But heroin addiction soon became prevalent, so the government began to regulate its use, including arresting doctors who prescribed it to those who were already addicted, and the medical community began to stop prescribing it. Inevitably, the addicted turned to illegal markets to feed their dependence. Wariness toward prescribing opioid-based painkillers for anything other than terminal illnesses continued through the 20th century, all the way up until the late 1970s and the early 1980s. At that time, the international debate broke out on pain management. The question was asked: Was it inhumane to allow patients to suffer needlessly through pain when opioid-based medications were available? Many advocates for increased use of painkillers pointed to a 1980 letter to the New England Journal of Medicine, which concluded that only 1 percent of patients who were prescribed opiate-based painkillers became addicted to their medication. Known as the Porter and Jick letter because it was named after the two Boston researchers who conducted the research and authored the letter, it fueled a belief that opiate-based prescription drugs were not addictive. It was a belief that began to permeate the medical community. But there was a problem with Porter and Jick's conclusions. They had only collected data on patients who were receiving inpatient care. As you can imagine, the percentage of patients who became addicted to opiates while in the hospital was only a tiny fraction of the patients who received opiate prescription drugs in an outpatient setting. But the medical community was not the only group espousing theories that opiates were not addictive. With the FDA's 1995 approval of the original OxyContin, the original sin of the opiate crisis, we can literally point to the starting point of this epidemic. The FDA approved the original version of OxyContin, an extended-release opioid, and believed that it ``would result in less abuse potential since the drug would be absorbed slowly and there would not be an immediate `rush' or high that would promote abuse.'' In 1996, Purdue Pharma brought OxyContin to the market, earning the company $48 million in sales just that year alone. Purdue Pharma claimed OxyContin was nonaddictive and couldn't be abused, and the FDA agreed. Neither of those claims turned out to be true. Purdue Pharma built a massive marketing and sales program for OxyContin. From 1996 to 2000, Purdue Pharma's sales force more than doubled, from 318 to 671 sales representatives. In 2001 alone, Purdue gave out $40 million in sales bonuses to its burgeoning sales force. These sales representatives then targeted healthcare providers who were more willing to prescribe opioid painkillers. As a result of these sales and marketing efforts from 1997 to 2002, OxyContin prescriptions increased almost tenfold, from 670,000 in 1997 to 6.2 million prescriptions in 2002. Then, in 2007, Purdue Pharma paid $600 million in fines and other payments after pleading guilty in Federal court to misleading regulators, doctors, and patients about the risks of addiction to OxyContin and its potential for abuse. The company's president, top lawyer, and former chief medical officer also pled guilty to criminal misdemeanor charges and paid $34 million in fines. In many cases, the FDA approved so-called ``abuse-deterrent'' opioids, despite warnings from the medical community about the potential for abuse. And when it wasn't turning a blind eye to the warnings of experts, the FDA simply didn't engage them at all in approval of opioids with abuse-deterrent properties. With numerous approvals of so-called abuse-deterrent opioids in 2010, the agency convened advisory committees of outside experts for less than half of them. Mr. President, I note the presence of the minority leader on the floor. At this time I ask unanimous consent to suspend this portion of my statement and to return to it when the minority leader has concluded speaking to the Senate.

Mr. MARKEY

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

Mr. MARKEY. Madam President, in December of 2015, nearly 200 nations gathered in Paris in order to reach an agreement that each country would make a commitment to the reduction of dangerous greenhouse gases that were warming the planet and causing more and more havoc across this entire world. That agreement is something that was hard-won. It took the leadership of the United States because so much of the CO2 that had been sent up into the atmosphere since the dawn of the industrial age was red, white, and blue. It called upon each nation to make a commitment, and they did. The countries making commitments equaled 80 percent of the world's greenhouse gas emitters. The Trump administration has many advisers telling the President that he should pull out of this Paris Agreement, that he should cede leadership to the Germans, to the Chinese, and to other nations rather than having the United States continue to be the leader. That would be very dangerous for our country because we would be ceding leadership in this clean energy revolution to other countries around the planet. There are still many who do not understand the role this clean energy revolution is already playing inside our country. In 2016, we deployed nearly 24,000 new megawatts of wind and solar on our planet. To put it another way, in 2005, the total amount of solar energy that was deployed in the United States was 79 megawatts--79. In 2016, we deployed 14,000 megawatts of new solar power. Wind--last year, we deployed another 8,000 megawatts in our country. We are heading toward a point where we have an incredible number of people who are working in these industries. Remember, there are no more than 65 to 75,000 people who are still working as coal miners in the United States. In Massachusetts alone, we now have more than 100,000 people who work in the clean energy sector. In wind and solar alone in our country right now, we have 360,000 people who work in those sectors. By the year 2020, if we just continue at the pace at which we have been moving over the last several years, there will be 600,000 people working in the wind and solar sector. That is the future. That is where we should be going. Those are the goals we should be trying to reach. Instead, what President Trump is saying is that the United States is a technological weakling, that the United States cannot do it, that the United States can't find the capacity to be able to meet this challenge, that we have to give up. The President says he is going to revive the coal industry, a 19th century industry, instead of trying to have the United States be the leader in this world on the production of clean energy technologies. Last night, I was at the Kennedy Library, and we were celebrating the 100th birthday of President John F. Kennedy. On that occasion last evening, the library presented to Barack Obama his Profile in Courage Award. Amongst other things that were cited was his commitment to dealing with this challenge of climate change that is affecting our planet and the role that the United States can and should play in the solving of that problem. President Obama promulgated last year a Clean Power Plan. That Clean Power Plan was intended to reduce greenhouse gases in the utilities sector by 32 percent by the year 2030. President Trump has already said: We can't accomplish that. We can't figure that out. We don't know how to reduce those greenhouse gases. In 1961, President Kennedy said that we were going to put a man on the Moon in 8 years and return those pilots back to Earth safely. We had to invent new metals. We had to invent new propulsion systems. President Kennedy said that we were not going to do it because it was easy but because it was hard. We were threatened by the Soviet Union for supremacy in outer space. President Kennedy challenged our Nation to respond to the threat of the Soviet Union, and we won. Here we are, nearly 60 years later, with another challenge, a challenge that threatens this planet. President Trump says that as a nation we are not up to the challenge. As a nation, we can't figure out how to solve this problem, even though the solutions are already out there and being deployed across this Nation. Another example of solutions like wind and solar: Elon Musk has a new all-electric vehicle that is going to cost $35,000 and is going to be deployed next year; 400,000 of these vehicles are to be sold. That is a game-changing moment in the history of the automobile, going back to its invention. It is a game changer. To a certain extent, for existing industries, it is a game-over moment unless they get into this all- electric vehicle revolution. What is Elon Musk doing? Elon Musk is creating a Darwinian, paranoia- inducing environment within which all of the rest of these automotive companies are now going to have to operate--go electric or perish economically as a company. This is how far it has come: Right now, Tesla has a market value that for all intents and purposes is equal to Ford and to General Motors. That is how much the American people have given in terms of confidence in this company, in this man. We can do it. It should be the President of the United States who is saying we can do it. The rest of the world expects us to do it. Why do we continue to import oil into our country from Saudi Arabia? Why do we continue to import oil from other countries around this planet? Why can't the President set as a goal that we are going to have 100 percent renewables in our country by the year 2050, that we are going to accept it as a national challenge in the same way that President Kennedy accepted the challenge in 1961 to put a man on the Moon, to control, to dominate in outer space? This is a letter to President Trump, which is in today's New York Times. The full-page ad says: Dear President Trump, As some of the largest companies based or operating in the United States, we strongly urge you to keep the United States Paris Agreement on climate change. What are the names of these companies? Adobe, Apple, Danfoss, Facebook, Gap, Google, Hewlett Packard Enterprise, Ingersoll Rand, Intel, Johnson Controls, Mars Incorporated, Microsoft, Morgan Stanley, National Grid, PG&E Corporation, Salesforce, Schneider Electric, Unilever, VF Corporation. This isn't the President challenging companies in our country to respond to the challenge. These are the companies in America challenging the President to respond to the challenge. It is the Kennedy era on its head; it is like JFK in reverse. He is saying we can't do it when the private sector is saying we can. Ultimately, this challenge to our competitiveness globally is something that Donald Trump is going to forfeit for our workers. This opportunity to create jobs and markets and growth is going to be something that we lose. We need a President who is going to stand up for this stable, practical framework, which is giving an incentive to the private sector to solve this problem. We will be creating jobs while saving all of creation. That is what the winning formula is going to be. This Paris Agreement is going to lead to increased competitiveness in jobs, in economic growth. By remaining a party to the Paris Agreement, rather than retreating, we will give Americans the opportunity to harness that can-do spirit and technical know-how to create new businesses and jobs. We will give our Nation the opportunity to be a leader in the global effort to address climate change. We will give America the opportunity to lead in this century and into the next. I urge the United States to remain in the Paris Agreement. We can either be the leader or the laggard internationally in developing the new clean energy technologies that will drive our economy and help combat climate change. It is a sad day for our Nation when the President of the United States is challenged by the private sector to step up, especially when he calls himself the CEO President of our country. He is turning his back on these innovative companies that want to be able to create jobs here in our country in order to save our planet. I pray for the well- being of our planet and that the President honors this commitment. I think that the French made a huge statement yesterday in electing their new President, Macron. He was saying to the French people: We must engage the rest of the planet. We must work with the rest of the planet. The Paris Agreement was signed in France in December of 2015. That election yesterday, I think, should be taken as a signal that we should not be retreating from our global leadership. I urge this administration to adopt an approach that does unleash further this wind and solar and all-electric vehicle revolution. With that, I yield back the remainder of my time. I suggest the absence of a quorum.

Mr. MARKEY

Mr. MARKEY. Mr. President, this year we mark the 10th anniversary of the untimely passing of our friend Paul Leventhal. Paul was a trailblazer when it came to addressing the dangers of nuclear power and nuclear weapons. I personally relied on Paul's insight to craft my approach to preventing the spread of dangerous nuclear technology and nuclear weapons. As a Senate staffer during the 1970s, Paul made major contributions to our Nation's security by working on two landmark laws. The first was the Energy Reorganization Act, which created the Nuclear Regulatory Commission and the agency that later became the Department of Energy. Before this legislation, a single agency, the Atomic Energy Commission, was responsible for both promoting nuclear energy and regulating the nuclear industry, to the detriment of public safety. Paul was also instrumental for passage of the Nuclear Non- Proliferation Act, which required countries to adopt full-scope safeguards from the International Atomic Energy Agency before they could receive civilian nuclear technology from the United States. This requirement later became an international standard when the Nuclear Suppliers Group adopted it. During the 1980s, Paul played an important role in helping to kill the Clinch River Breeder reactor, which shut down U.S. efforts to develop a full plutonium fuel cycle. Throughout this time, he was also a strong proponent of my efforts to close loopholes in U.S. nuclear nonproliferation law, including tightening nuclear export controls affecting China following Tiananmen Square. He actively worked to ensure House passage of the Nuclear Proliferation Prevention Act, which imposed sanctions on those who knowingly contribute to efforts to acquire unsafeguarded fissile material or nuclear weapons. Paul was ahead of his time in raising alarms about the threat of nuclear terrorism. His warnings about the need to reduce reliance on highly enriched uranium and to limit the use of plutonium for commercial nuclear power later formed the core of the global nuclear security agenda. His warnings about the flaws in nuclear cooperation agreements continue to reverberate in today's debates over the export of nuclear technology. Today's ongoing nuclear challenges remind me of our solemn responsibility to carry out Paul's legacy. The nuclear industry continues to push against stringent safety standards. The Trump administration wants to promote the export of nuclear technology and walk away from the Obama administration's nuclear security mission. The India nuclear deal continues to increase the risk of a nuclear clash in South Asia. Plans for commercial-scale plutonium reprocessing in East Asia threaten to create a new nuclear arms race in the region. All of these challenges will require us to take inspiration from Paul's work to promote nuclear security and nonproliferation. To honor Paul, we must rededicate ourselves to fighting these threats to international peace and human survival.