Christopher Murphy

Mr. MURPHY

Mr. MURPHY. Mr. President, I come to the floor to talk for just a few, quick moments about what the stakes are as we begin this debate over a new swing vote on the U.S. Supreme Court. This is a fairly simple chart listing off a number of preexisting conditions that tens of millions of Americans have. What it says is, the Supreme Court could take away your healthcare if you have a history of cancer, diabetes, heart disease, strokes, cerebral palsy, mental illness, ALS, lupus, epilepsy, Parkinson's--the list goes on. The reason for this is, the new priority for those who oppose the Affordable Care Act and the protections that are built in it for Americans who are sick or have ever been sick--their new strategy is to use the court system as a means to try to invalidate the protections in the law for people with preexisting conditions--protections, by the way, Republicans said they supported during the debate over the Affordable Care Act. The case currently before the district court level, Texas v. United States, has drawn interest because of an exceptional decision by the Trump administration. The Trump administration has decided to weigh in on behalf of the petitioners, abandoning the traditional role of the executive to defend a statute. Traditionally, an executive will defend a statute regardless of whether they politically support it because who else will defend a statute if not the Department of Justice and the U.S. Government? In this case, the Trump administration is going to court to argue the U.S. Congress cannot, under the Constitution, provide protection to people with preexisting condition against discrimination and rate increases from insurance companies. Now, this should freak out the tens of millions of Americans who have preexisting conditions because without the protection in the law today, healthcare will be unaffordable and unavailable to the over 100 million Americans who have any history of disease. Given the importance the Trump administration has placed on this case by weighing in, in this exceptional, unprecedented way on behalf of those who are trying to pull apart protections for people with preexisting conditions, we have to expect, we have to prepare for the fact that this case may move from the district court to the appellate court and eventually to the Supreme Court. If it does, this seat we are about to debate will likely, potentially, be the deciding vote as to whether Americans in this country who have preexisting conditions will continue to be able to get healthcare. So I just wanted to come to the floor, as we start, to set the table for this conversation to make very clear what the stakes are. The Trump administration has taken the exceptional position of arguing against people with preexisting conditions, saying Congress cannot, by law, protect people with preexisting conditions. President Trump, as a candidate, made it very clear that his priority was to put Justices on the Court who would correct for the fatal flaw of John Roberts. He identified that fatal flaw as John Roberts' defense of the Affordable Care Act. He made a promise he wouldn't make that mistake again; that he would not put somebody on the Court who would vote to uphold parts of the Affordable Care Act. You have to take the President at his word. Most of the things he said he would do as President of the United States, when he was a candidate, he has done. A lot of folks here didn't take him seriously-- didn't think he would really try to unwind NATO, didn't think he would really try to ban Muslims from the United States, didn't think he would pursue this crazy idea of a wall. He did all those things. So let's take him at his word when he says he is not going to appoint a Supreme Court Justice who will uphold the Affordable Care Act, and the case that is moving up to the Supreme Court today is a case that would take away protections for people with preexisting conditions. Second, he essentially outsourced the decision over who would be his nominee to these two political groups: the Federalist Society and the Heritage Foundation. We know where the Heritage Foundation is on the Affordable Care Act. They have basically made it their mission, over the course of the last 7 years, to try to destroy the Affordable Care Act. They have essentially written the legislation that has been put before this Congress, on a variety of occasions, to try to replace the Affordable Care Act with something that provides no protections for people with these illnesses, but the Federalist Society is in this game, too, of trying to attack the Affordable Care Act. In one of the main judicial attacks on the Affordable Care Act, NFIB v. Sebelius, one of the lead counsels of record was a Federalist Society member, and 24 other Federalist Society members signed and filed amicus briefs in support of this judicial attack against the Affordable Care Act and the protections for preexisting conditions. The Heritage Foundation and Federalist Society have been in the business of trying to take away protections for people with preexisting conditions from the beginning of this fight. So when you outsource the selection of the Supreme Court Justice to those groups, you know whom you are going to get. You are going to get a Justice who is going to vote to unwind these protections. You don't have to do that kind of supersleuthing because the President effectively already told you he was going to appoint someone who would remedy the fatal sin of John Roberts, which was to uphold at least a central tenet of the Affordable Care Act. I understand what Senator Cornyn is saying; that we should just accept that the nominee, when he comes before the Judiciary Committee, isn't going to answer any questions and that we shouldn't assume anything we don't know, but we have some pretty good evidence thus far. In addition, we have Judge Kavanaugh's writings, Judge Kavanaugh's attacks in his judicial opinions on the Affordable Care Act. Seven-Sky is a really interesting case that came before the DC Circuit Court. It essentially, in the end, upheld the constitutionality of the individual mandate. Judge Kavanaugh dissented. I will admit, it was an interesting dissent, and people should read it, but in that dissent, he goes out of his way to suggest that Congress has gone far afield from its constitutional limitations in adopting the Affordable Care Act. He wrote in his dissent that the individual mandate is ``unprecedented on the federal level in American history'' and predicted that upholding the mandate would ``usher in a significant expansion of congressional authority with no obvious principled limit.'' Those are extraordinary words. It is interesting because if you read the dissent, it, in fact, hints that ultimately the individual mandate can be upheld as a tax. So I acknowledge the subtleties in that dissent, but that is an extraordinary phrase, that upholding the individual mandate would ``usher in a significant expansion of congressional authority with no obvious principled limit.'' The obvious limit is the Constitution, and the idea that judges would decide what the principled limit is, other than the Constitution, I think is something that should be part of our debate. The fact that Judge Kavanaugh went out of his way to talk about his fears as to how broad the Affordable Care Act may be, in addition to his inclusion on the Federalist Society and Heritage Foundation list and in addition to Trump's very clear signaling that he is only going to appoint a judge who is willing to overturn the Affordable Care Act, tells you that if you have any of these conditions, you are in the crossfire right now. One hundred thirty million people in America have preexisting conditions. Let's take a few of these just to give a sense of the scope of the threat. There are more than 15.5 million cancer survivors in the United States today; 23 million Americans have been diagnosed with diabetes; there are about 100 million adults who have high blood pressure, about 100 million more who have high cholesterol; 26 million Americans diagnosed with asthma; 44 million Americans have mental illness; 400,000 diagnosed with multiple sclerosis; and 28 million diagnosed with heart disease. Without the protections in the Affordable Care Act, if you have these diagnoses, you likely will not be offered healthcare. That is what happened prior to the protections for people with preexisting conditions; you just weren't even offered a plan if you had some of these conditions. But if you were offered coverage, you were offered them at rates that were unaffordable. Here is some data based on CMS's calculations around operated risk adjustment methodology. They say that for folks who have diabetes without complication, the increase in rates without protections for people with preexisting conditions could be about $5,600 a year. If you have a drug dependence, if you have an addiction, the increase could be $20,000 a year. If you have had a heart attack or a history of serious heart disease, your increase could be $60,000 a year. If you have metastatic cancer, you could be paying a 3,500-percent premium; that is, $140,000 in additional surcharge a year. Obviously nobody can afford that. That is why, if you have a history of metastatic cancer, you are not getting offered insurance unless you have that protection. Those are the stakes. I want to make people understand that we are going to have a big debate over what Judge Kavanaugh will mean for the future of reproductive choice in this country, women's access to contraception. Those are really, really important debates. But I want everyone to understand that this case is coming; Texas v. United States is moving through the court system. It is moving through the court system, in part, because the Trump administration is trying to get the judicial branch to invalidate protections for people with preexisting conditions. Despite the fact that the President told us he liked that part of the law, he has now instructed his judicial department, instructed the Office of the Attorney General to try to strip away protections for people who have high cholesterol, mental illness, cerebral palsy, multiple sclerosis, and it may mean this seat on the Supreme Court is going to decide that case. I think we can be pretty sure of how Judge Kavanaugh is going to rule. His hostility to the Affordable Care Act in his writings, his inclusion on lists by groups that have worked for years to undo these protections, and the clear signal from the President that he was only going to pick individuals for the Court who would unwind the Affordable Care Act tell you how big the stakes are. The Supreme Court could take away your healthcare if you have any of these diseases, and the likelihood that they will take away your healthcare if you have any of these preexisting conditions is radically increased if Brett Kavanaugh is confirmed. I announced last night that I will oppose his nomination, and I will be on the floor talking at length about many of the reasons this body should reject his nomination. At the outset, I wanted to make clear that this debate over the future of preexisting condition protections for people in this country--130 million people who have preexisting conditions--needs to be at the center of this conversation regarding Brett Kavanaugh's nomination. I yield the floor.

Mr. MURPHY

Mr. MURPHY. Mr. President, I am here to join Senator Daines in recommending the Legislative appropriations bill to our colleagues. I note his history lesson--10 years since we passed a Legislative Branch appropriations bill on the floor of the Senate. During none of those 10 years was Senator Daines chairman of the Appropriations subcommittee on the Legislative Branch. Things are changing here, and it has been a real pleasure and honor to work with Senator Daines on this bill, which we bring to the floor in a bipartisan manner. Let me be brief in not trying to cover the ground that Senator Daines has already covered, but I agree; I think this is a good bill, one that we can all support. Let me add a few pieces to some of the highlights my colleague laid out for you. The first of those is the fact that this bill commits us to finally restoring GAO staffing to its 2011 levels. This is really important because every dollar we appropriate to GAO gets about a $128 taxpayer return because of the efficiencies they recommend that then get adopted. GAO lost about 343 staff from 2002 to 2003 during the sequester. We are putting them back to the place where they can do important work for us. Second, let me reiterate the important investments we are making in the Capitol Police. The threats that we face and our staff face and visitors face aren't imaginary. Again, it was a year ago last week when a gunman came after our colleagues in the House and the Senate at a baseball practice off campus. It is important that this bill recognizes the threats we face are not just on campus but are in other places around the Capitol and has some resources to make sure that both the Capitol Police and the Senate Sergeant at Arms are making sure that Members and staff are protected not only on campus but also at events off campus that may come with certain serious risks. In this bill, CRS is put on a path to restore its 13-percent staff loss. Again, over the course of sequester, a lot of the agencies that serve us took some pretty serious hits. They don't make that up in this bill, but they are set on a path where they can get back to the kind of footing we are putting GAO on in this legislation. A long-needed modernization of the copyright office is kicked off in this legislation. Again, that is a long-term plan, but we are kicking it off. It is very, very much overdue. We are also beginning another process that I think will be really important to the campus. We are beginning the process of exploring options to expand the size of the Senate childcare center. Pretty much every large employer in the country offers some level of childcare services to employees. The Senate barely does that. We have 6,200 employees and just 68 childcare slots. There are actually only nine infant slots in the Senate. Over the course of the last few years, the House has tripled the size of its childcare center. We are going to begin taking a look at what the options might be to expand our capacity as well. Let me end by highlighting, again, this small fund in the bill that will allow Senators to begin paying interns. It is important to note that this is totally optional, so any Senator who wants to use this fund can, only for the purpose of paying interns. If they don't use it, it goes right back to the Treasury. Each of us has our own unique journey as to how we got to be a U.S. Senator; mine started as a Senate intern. I was an intern for Senator Chris Dodd, but there is no way I could have taken advantage of that opportunity had my family not had the resources to be able to send me to Washington for a summer, had I not had the family resources to be able to pay rent for a summer. The fact is, that experience is foreclosed to far too many American children because many Senate offices--not all but many Senate offices-- do not pay their interns. This would at least give the option for Senate offices to do the same. Let me again thank Senator Daines--we worked really well together on this bill--and Chairman Shelby and Vice Chairman Leahy. It is good that we are bringing back regular order, at least for now, on the appropriations process. My view is that the default position on these bills should be to allow amendments to come to the floor and to have a vote; that we shouldn't have to twist so many arms in order to get votes on amendments; that we shouldn't be afraid of putting our vote down on any particular amendment, whether it be an easy one or a tough one. We are beginning to start exercising those muscles on this minibus. I thank Chairman Daines, Chairman Shelby, and Vice Chairman Leahy for their work in allowing us to bring this product to the floor. I yield back.

Mr. MURPHY

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

Mr. MURPHY. Mr. President, I come to the floor to mark a very unfortunate date. We are recognizing the 2-year anniversary of the shooting at Pulse nightclub on June 12, and on Sunday, June 17, we are going to mark the 3-year anniversary of the shooting at a church in Charleston. The killer in Charleston murdered nine people attending a Bible study. The killer in Orlando murdered 49 people who were at a nightclub. I just came from my office meeting with one of the survivors of the Pulse nightclub shooting. About 93 people are killed every day from guns. That is a mixture of suicides, homicides, and accidental shootings. That means that in the 731 days since the Pulse nightclub shooting, we have had somewhere around 70,000 people killed by guns in this country. That is a statistic that has no comparison anywhere else in the world. In the United States, we have about 20 times the number of people on a per capita basis who are being killed by a gun than the average OECD competitor nation. Something is going on here that is different than what is happening anywhere else. As my colleagues know, I try to come to the floor every few weeks to talk about who these victims are to give a sense about the lives that are cut short, all the promise that is erased from this Earth 93 times every single day because of what is happening inside the epidemic of gun violence and to try to relate to people how furious this mounting cavalcade of those left behind is by our inaction. Remember, we have done virtually nothing meaningful since the tragedy in my State at Sandy Hook, and thus the slaughter continues. Melvin Graham's sister, Cynthia Graham Hurd, was murdered in Charleston in that shooting. Earlier this year, he talked about how angry he is that Congress has done nothing meaningful to try to affect the reality of gun violence in this Nation. He said: You would think that this would be the time. Each time something happens, you think, this is the time we're going to get some action, some movement, some unity in Washington to do something. . . . And each time they have let me down, they have failed me. They've shown me . . . that they simply do not care. On the evening of June 17, 2015, Dylan Roof walked into the Emanuel African Methodist Episcopal Church and killed nine people. He had a criminal record and shouldn't have had a gun, but because of a loophole in the background checks law that allows for a gun seller to transfer weapons to someone if the background check takes a long time, Roof was able to get a weapon, immediately go to this church, and kill nine people. The reality is, FBI data indicates that over the last 5 years, 15,000 people have been sold weapons who shouldn't have gotten weapons under this loophole. That means 15,000 people are walking around the United States today with firearms who have criminal records because their background check took 3 or 4 or 5 days. The reason background checks take a long time--most of them take about 10 minutes--is some people have complicated criminal histories, like Dylan Roof did. So it simply belies commonsense to say you are going to give a gun to somebody simply because they have a complicated criminal background and it takes a few days to sort out. This is an example of a crime that may not have been committed had our laws been different. Until October of 2017, the Pulse nightclub shooting, which happened on June 12, 2 years ago, was the deadliest in U.S. history. These massacres that reach that tragic landmark of being the worst in U.S. history don't last for long, given the increasing pace of gun homicides in this country. This was an individual who was known to law enforcement, who had been in the system because of activity on line with respect to his connection with terrorist groups. Had we had a comprehensive no-fly ban in this country that gives the Attorney General the power to put people who are having conversations with terrorist groups on the list of those who can't buy guns, it is also very possible that Omar Mateen, the shooter in this case, would never have been able to buy a gun, killing 49 people and injuring 53 others. This is another example of our laws being inadequate to meet the moment. Unfortunately, this country tends to only pay attention to the issue of gun violence when these mass shootings happen. They are truly soul- crushing, community-changing events. Newtown, CT, is never ever going to recover from what happened there. Every single day, whether or not we see something scrolled across the bottom of our cable news screen about a shooting, there are still upward of almost 100 people dying every single day--people such as Malachi Fryer, who was 6 years old when he walked into a room where a handgun was left unattended on a table. He took the gun back into his bedroom to play with it, and he accidentally shot himself. He was 6 years old, and he had just finished first grade in Elizabethtown, KY. His school principal said: Malachi was special in many ways. He had a smile that warmed your heart, a contagious laugh and a positive attitude. He was a little comedian and the classroom was his stage. He loved people and he didn't meet a stranger. Basketball was his pleasure and joy. Our hearts are heavy because a piece of our New Highland family is gone. Age 6, Malachi is one of the victims of the many accidental shootings that happen in this country. In my State, Antonio Robinson was recently ready to graduate from Stamford Academy. He was a former cocaptain of the Stamford High School football team. He was standing in an overpass, and he was shot to death. His sister said: He never bothered anybody, so he never thought he had to dodge or hide from bullets. He was on his cell phone standing at an overpass. He wasn't even aware he was about to be shot. His former coach and sixth grade teacher said: He wasn't the biggest kid out there [on the basketball court], but he played with a lot of heart and soul. He gave it everything he got. Another one of his football coaches said that he was ``very respectful.'' He was just an ``awesome, awesome kid,'' just 18 years old. Antonio Robinson is gone. Ryan Dela Cruz was 17 years old, from Seattle, WA. He was a senior at Franklin High School. He dreamed of a career in the Marine Corps. He and his friends went to a local park one recent Friday night. They encountered another group, words were exchanged, and shots were fired. Ryan Dela Cruz isn't living any longer. He was described by his high school principal as ``a sweet, thoughtful, inquisitive, and compassionate young man. . . . He was determined to commit his life to the service of others.'' His father didn't want him to go into the Marines. His father was worried about the safety of his son, but, increasingly, you couldn't change Ryan's mind. He was committed to serve this country. What Ryan said to his father sticks with his dad. When he raised the issue of Ryan's safety, Ryan said to his father: Papa, wherever you are, it's God's will. If you die, you die. Ryan Dela Cruz died at age 17. Bob Stone was 64 years old when he died. From South Beloit, IL, he was a community pillar, longtime member of the city council, commissioner of the police and fire department. He and his wife Rebecca were known throughout the community because they had put together a festival every year in town. They were the organizers. It started with Rebecca's parents back in 2006, and they kept it up, something to bring the community together. This story is particularly hard to hear because it is a murder- suicide involving his son Vito. The two of them were in a tent in the backyard. They were spending the night with Vito's two young children. Something happened inside that tent. Vito shot his father and then shot himself. Luckily, the children were unharmed, but for the rest of their lives, they are going to have to deal with the unspeakable, indescribable trauma of that murder-suicide that took the lives of their father and grandfather right in front of their eyes. The young woman I met with today has gone through one of these traumas herself, having survived the Pulse shooting from 2 years ago, and speaks about that same kind of trauma. Her life has been fundamentally changed from that day. Relations with her family members have been ruptured. She lost her cousin inside the nightclub that evening. It is a reminder. Researchers tell us every time 1 person is shot, there are likely 20 other people who experience some kind of trauma from that 1 shooting. Take the average of 93 people every single day and multiply that times 20, and that will give us a sense of just over a 24-hour period the catastrophe that happens in families and communities across the country because of gun violence. Well, today I will not go into the details about all the things we can do to solve this, but I will share a statistic I came upon the other day. My head is full of statistics, trying to explain what is happening when I come to the floor to tell the stories of these victims. Here is an interesting one. I heard some of my friends say to me: Well, America is just a more violent place. Sure, we have more guns than other places have, but there are a lot of things happening in the United States, different cultures living side by side, people with different backgrounds, which may lead to more episodes of violence. Here is a really interesting statistic. Let's go back to the OECD countries, which are what you consider to be the most advanced 20 or so countries in the world. If you look at rates of gun violence, the chart tells only one story. The United States has a rate of gun violence of about 10 people per 100,000 in terms of gun deaths, and there is no comparison. The next highest country is Finland, which has a rate of about 3 per 100,000. The average country is down around 1 per 100,000. We are talking about a rate that is 10 times higher in this country than other countries. Let's go to another measure of violence because some people will say we are just a more violent country. That actually is not true. We are actually, by other measures, a less violent country than all the rest of these. Let's take another measure of violence. Let's take a look at assaults. There is a statistic that measures reported assaults in these same countries. When you look at reported assaults, the United States is actually almost last. We aren't the country with the most assaults; we are close to the country with the lowest number of assaults. Belgium has more; Israel has more; Portugal has more, as does Sweden, France, Netherlands, Italy, Switzerland, Spain, Denmark, Germany, Austria, Norway, Ireland, Finland, New Zealand, Australia, South Korea, and the United Kingdom. Only Japan and Canada report fewer assaults per person per capita than the United States. So it is not that we are a more violent nation. It is that we are, in particular, a nation plagued by one type of violence--gun violence, which tends, of course, to be the most lethal kind, the kind that comes with the greatest degree of cascading trauma. I know we have important business to do today with respect to the Defense authorization bill. I and my State have important equities in that bill that I hope to advance, but I still think it is worthwhile every now and again to come to the floor and remind my colleagues that even if they don't read about an episode of mass violence today, there will still be nearly 100 people who lose their lives. It is an epidemic that happens only here in the United States and is not explained by the United States being a more violent nation in general. It is simply explained by a nation that has more guns per capita and a Congress that is unwilling to make sure that only the right people get their hands on those weapons. I yield the floor.

Mr. MURPHY. Mr. President, we have begun the period of time in the year when insurance companies start to declare what their intention is with regard to rate increases, and the news is not good for American healthcare consumers. I am going to be joined on the floor today by a few of my colleagues to talk about what the impact of these radical increases in premiums is going to be for our constituents. The news is not good, but, frankly, it is no surprise because for a year and a half now, the Trump administration has been waging a very deliberate assault on the American healthcare system, trying to sabotage it as retribution for the country not agreeing to overturn the Affordable Care Act, which now enjoys widespread popularity across the country. This deliberate campaign of sabotage--beginning the first day Trump got into office with an Executive order, leading up to these last 2 weeks in which the Trump Justice Department is trying to rule that protecting people with preexisting conditions is unconstitutional--has had an impact. It has had an impact. I want to quickly run through what we have seen thus far with respect to premium increases all across this country as a result of the Trump administration's and Republicans' campaign of sabotage. First is in Maryland. The highest increase we saw in Maryland--these were announced about a month ago--was one plan announcing a 91-percent increase--in 1 year, one time, a 91-percent increase. It is almost a doubling of premiums for a PPO plan in Maryland that was primarily being used by people with preexisting conditions, people who were sick. The reason this plan is going up by 91 percent is because, as the Trump administration and this Congress take steps to move healthy people off of insurance plans to either no insurance at all or to junk plans, only sick people or people with preexisting conditions are left on plans like the CareFirst PPO plan. A 91-percent increase. Who in Maryland with any kind of middle-class income can afford a 91-percent increase? Virginia is not much better. In Virginia, at about the same time, one plan asked for a 64-percent increase. Again, I don't know many families who are making $30,000 a year who can afford a 1-year, 64-percent increase in premiums. Remember, overall, medical inflation in this country--meaning on a percentage basis, the amount of increase in medical costs from year to year--is about 6 percent. So if you were just passing along the costs to your consumers, the rate should be somewhere in the neighborhood of 5, 6, or 7 percent. Instead, in Virginia, it is 64 percent. Senator Merkley is going to talk about Oregon, but premiums in Oregon are going up by double digits--14 percent. Washington State is looking at a premium increase of 30 percent. The Kaiser plan in Washington is asking for a 30-percent increase. The statewide average is right around 20 percent. Kaiser, in Washington, says: ``The rate changes shown are primarily driven by the claims experience of the single risk pool, medical inflation, and projected changes in the risk profile of the membership due to the elimination of the individual mandate.'' That is the change that Republicans made to the Affordable Care Act. You are actually in decent shape in Maine, so I will give you the good news too. In Maine, you are only seeing a 10-percent increase in premiums--just slightly above the rate of medical inflation. In one of the more popular States in the country, New York, the news is catastrophic--a 39-percent increase in premiums in the largest health insurance plan in New York. Fidelis, which is on the State healthcare insurance exchange, is asking for a 39-percent increase. Let me read to you what the New York Department of Financial Services said about this requested 39-percent increase: With respect to the individual market, the single biggest justification offered by insurers for the requested increases is the Trump Administration's repeal of the individual mandate penalty. The individual mandate, a key component of the Affordable Care Act, helped mitigate against dramatic price increases by ensuring healthier insurance pools. Insurers have attributed approximately half of their requested rate increases to the risks they see resulting from its repeal. It is not as if the Republicans in this body didn't know what was going to happen. The CBO said that rates will go up by at least 10 percent in the first year if you repeal that part of the Affordable Care Act and 13 million people will lose insurance. That is what happens when rates go up by 40 percent. Some people just cannot afford to pay it. So whether the number is 39 or 91 or 64, these rate increases that are happening because of this campaign of sabotage by the Trump administration are simply unaffordable. Before I turn this over to Senator Merkley, let me quickly run through what I am talking about. In January 2017, President Trump signs an Executive order telling all his agencies to dismantle the ACA, despite the fact that Congress didn't repeal the Affordable Care Act and never would appeal the Affordable Care Act. In April of 2017, he cuts open enrollment in half for the Affordable Care Act just to try to make sure that fewer people can sign up for health insurance. In May, Republicans start voting to try to take insurance away from 23 million people. Actually, one of the proposals would have taken insurance away from 30 million people. In December of 2017, they finally settle on legislation that takes insurance away from 13 million people and drives costs up by at least 10 percent. In February of this year, the Trump administration starts to allow insurance companies to expand the use of junk plans. These are plans that cover very little. They might not cover prescription drugs or mental health or addiction care, but they are cheaper, so healthy people tend to move to these plans, leaving the sick people on the plans that are now going up by 39 percent. The final cherry on top is that right now as we speak, the administration is making an argument before the Supreme Court that the remaining scraps of the Affordable Care Act that the Republicans left are unconstitutional. The protection for people with preexisting conditions, which Trump promised over and over and over again to keep--Lesley Stahl pinned him down in a ``60 Minutes'' interview and asked: You are going to keep protection for people with preexisting conditions, right? You are going to keep the part of the Affordable Care Act that is wildly popular, aren't you? He said: Yes, I am going to keep that part. In fact, he has now instructed his Department of Justice to break precedent and argue the unconstitutionality of a statute of the United States, that statute being the portion of the Affordable Care Act that protects people with preexisting conditions. Believe me, insurance companies are paying attention to this unending withering assault on the Affordable Care Act and the American healthcare system. That is why we are seeing these big premium increases. We want to make sure that our colleagues understand what is happening here and that the American public understands what is happening here. These increases in healthcare costs are unprecedented, but they are not surprising, given what this administration and what this Congress have been doing. With that, I yield the floor, seeing that Senator Merkley is ready to speak.

Mr. MURPHY

Mr. MURPHY. Mr. President, I ask unanimous consent that Katie Stana, a Pearson foreign policy fellow in my office, be granted floor privileges for the remainder of the year.

Mr. MURPHY

Mr. MURPHY. Mr. President, starting in January of 2017, extending to today, the President, often with the help of this Republican Congress, has engaged in a very deliberate, very purposeful campaign of sabotage to the American healthcare system. We are now starting to see the very serious consequences of this campaign of sabotage. It started on Inauguration Day when President Trump signed an Executive order that ordered all of his agencies to dismantle the Affordable Care Act. It found its way to the Senate floor when Republicans spent most of 2017 trying to pass legislation that would take insurance away from 23 million people, according to the CBO. The President undertook a number of steps to try to weaken the exchanges where millions of people get their healthcare. He cut the open enrollment period in half. He stopped funding advertising. He pulled funding for the navigators, who are the people who go out and try to help people sort through their healthcare options. There is no reason to do that, to try to stop people from being able to sign up for healthcare, unless your intention is sabotage. There is no public policy reason to give people less time to sign up or to give them less information about their options. Most recently, the Republicans finally succeeded in repealing the individual mandate which the Congressional Budget Office said will, by itself, increase premiums by 10 percent and wipe out insurance for 13 million people. The administration is now trying to expand the sale of what we call junk plans, which are insurance plans that don't have to cover a minimum set of benefits, that don't have to protect people with preexisting conditions or existing sicknesses from higher premium rates. I think I came down to the floor 2 weeks ago to talk about the first two rate filings of the rate filing season. These were in Maryland and Virginia. The rate filings were, quite frankly, catastrophic. While these were the worst of the bunch, all of the rate filings were much higher than the rate of medical inflation. The worst requested increase was when one insurance plan in Maryland asked for a 91-percent increase in premiums. One insurance plan in Virginia asked for a 64-percent increase in premiums. In Maryland, the head of the insurance plan who asked for the 91-percent increase said the reasons for it were the continuing actions on the administration's part to systematically undermine the market and to make it almost impossible to carry out its mission. No one can afford a 91-percent increase in premiums, and no one can afford a 64-percent increase in premiums. Frankly, very few people can afford a 15- or a 20-percent increase in premiums. This week, we received the rate filings from the State of Oregon. In Oregon, the Providence Health Plan, with about 90,000 customers, which is one of the bigger plans in the State, is asking for a 14-percent premium increase. Now, that is not 91 or 64, but there are a lot of families who simply aren't going to be able to afford a double-digit premium increase in Oregon. It is important to note that Oregon put into place a new State-based reinsurance program, and if not for that reinsurance program, this would have been a 20-percent increase. I am just going to keep track of all of these increases so we have a sense of what is happening to consumers as a result of this campaign of sabotage. We will add this rate increase in Oregon of 14 percent, and I will make sure I get it right. The CBO has told us, the repeal of the individual mandate is going to jump premiums by 10 percent. So, in Oregon, you can be relatively sure that had the Republicans not repealed this big part of the Affordable Care Act, you would have been looking at a single-digit increase, something that would have mirrored medical inflation. Yet, because of the actions that had been taken here and because of many of the actions that have been undertaken by this Congress, we are looking at a double- digit increase. Keith Forrester, who is the head of one of Oregon's biggest insurance companies, said our rate increase reflects the expected costs of providing coverage to our members, including the impact of eliminating the individual mandate. Senate Democrats are going to be down on the floor pretty relentlessly over the course of the next few months to make people understand that as you are getting your health insurance bills, as you are seeing these big increases, a big reason will be due to the actions that your elected leaders have taken--this Republican Congress and this administration. Yet the rate increases might be getting even bigger than they already are today. That is because of this expected proliferation of these new junk plans. Again, these are called short-term plans by the administration because they used to be, truly, short-term options. They were 3 months in duration. You would pick up one of these plans in between coverage, and because they were short-term plans, they were not required to cover mental health and maternity, and they could charge you more if you were sick. This administration has decided these plans can now be sold for a full year, meaning they will essentially stand side by side with regulated plans that have minimum benefits and protect people with preexisting conditions. The administration said, only a couple hundred thousand people nationwide might sign up for these plans. The CMS's Chief Actuary says--this is President Trump's CMS, the administration's own Chief Actuary--that is wrong; that, in fact, it will be a million and a half people potentially signing up for these junk plans. It could get as big as 1.9 million by 2022. Who will sign up for these junk plans? It will be healthy people because healthy people aren't going to need all of the coverage. It will be people who don't have preexisting conditions, who don't have addictions or diagnosed mental illnesses. It will leave behind in the exchange plans the people who need the coverage. Those people will not go on the junk plans because they will need insurance plans that cover their illnesses or their diagnoses. What we know is that if you have a sicker population in the exchange-based plans, in the regulated individual market, those premiums will go up. A recent study found, the combination of the individual mandate and the proliferation of these new junk plans will result, on average, in 16-percent increases in premiums all across the country. In Connecticut, that could mean the premiums will go up by $1,155. Now, that is not something the health insurance companies did. That is not because of rising medical costs. That is because of decisions that were made by this Republican Congress and this Republican administration--two decisions. There was one decision to repeal a big part of the Affordable Care Act that protected sick people, that kept their rates lower. Another decision by the administration was to give relatively healthy people access to stripped-down plans. Admittedly, those two changes may offer some benefit to people today who are healthy. I am not going to deny that those two changes may provide a lower insurance rate for a subset of people who are healthy, but we are not supposed to just represent the healthy people. Today you are healthy, and tomorrow you are not. We are supposed to represent all Americans. In fact, we probably should be going the extra mile to make sure people who, through no fault of their own, have serious diagnoses aren't paying an arm and a leg more for coverage, but we are not doing that because of the steps this Republican Congress and this Republican President have taken. On average, insurance rates are going to go up for everybody in Connecticut by $1,100, according to one study, and they are going to potentially skyrocket for people who can't get onto these stripped-down junk plans. I think it is really important we talk about this. As I walked across the State of Connecticut last summer--something I have come to do in the last few years; I take about 5 or 6 days and walk from one side of the State to the other, which is something the Presiding Officer and others probably can't do in States that are a little bit longer across than 110 miles--healthcare was the dominant theme. In their having heard the news that I would be in a certain town during the day, people waited for me who were miles ahead on the road. They waited ahead of me for hours and hours to talk to me about their illnesses and about their fears that this Congress and this President were going to take away their coverage. We were successful in defeating the full repeal of the Affordable Care Act, and that is great news, because the Affordable Care Act is more popular than ever before, but this Congress and this President are trying to ruin some of the most important protections in our healthcare system because they are mad that they lost the repeal vote by one vote. So it is important for us to tell Americans what the consequences of that sabotage campaign are. It certainly means that people are going to get less protection, but it also means that, over the course of the next few months, as rates are filed across the country, you are going to see some devastatingly high premium increases due to the Republican campaign of healthcare sabotage--this week, 14 percent in Oregon; last week or the week before, 91 percent in Maryland, 64 percent in Virginia. This is what happens when you strike blows at the American healthcare system, and it is important for Americans to understand what that means. With that, Mr. President, I yield the floor. I suggest the absence of a quorum.

Mr. MURPHY

Mr. MURPHY. Mr. President, 2 days before the tragic shooting in Santa Fe, which has rightly dominated the news for the last several days, Texas experienced another mass shooting when a man killed his three children, his ex-wife's boyfriend, and himself. Mass shootings are generally characterized as incidents where four or more people are shot at one time. It is a catastrophic event for a community to have four people shot in one instance. That shooting 2 days before the Santa Fe school shooting was the 100th mass shooting in the United States of America in 2018. We average about a mass shooting every single day in this country. In the 3 days following the Santa Fe High School shooting, there were around 88 gun deaths and 222 gun injuries in this country. That is a big number. It is the most in any 72-hour span so far in 2018. Rightly, our attention has been directed toward the community of Santa Fe as they try to recover from the unrecoverable--another targeting of children in a school in this country. It is important to remind ourselves that no matter whether the shooting happens on a street corner, in a school, in a movie theater, or in one's home, the devastation for those who lose their brother or their sister or their husband or their wife is no less or no greater, whatever the circumstances may be. In the 3 days after Santa Fe, as the country could have been deluded into thinking that was the only shooting of any consequence in the country, 88 people lost their lives from guns, and 222 others were shot and survived--part of the 33,000 a year, 2,800 a month, and 93 on average a day who are killed by guns in this country. It is a mix of suicides and accidental shootings, domestic violence incidents, mass shootings, and homicides, but there is no other country in the world in which the number is this big. There have been 5,531 deaths from gun violence in 2018 alone. That is according to Gun Violence Archive. Twelve hundred kids have been killed or injured, and we are not even halfway through the year. Our rate of gun violence in this country is 20 times higher than that of all our other competitor OECD nations. It is not because our schools are less safe. It is not because we have more instances of mental illness. It is not because we have more troubled young men. It is not because we spend less money on law enforcement. You control all of the other factors that people claim to be the reason for these crimes, and it cannot--it does not--explain why this epidemic is happening here and nowhere else. What is different about the United States is that we have the loosest, laxest gun laws of the OECD nations. What is different about the United States is that in shooting after shooting, killing after killing, we do nothing. We do nothing of substance or significance to condemn or change this trajectory of violence. I argue to you that would-be shooters who are contemplating acts of mass violence--who clearly have had something go wrong in their mind to consider such a thing--see our silence as a green light. Of course, we don't mean it that way, but when we refuse to do anything other than make minor tweaks to Federal gun laws year after year, young men who are contemplating doing something like this, seeing no substantial condemnation or change in law, pervert that silence into permission. I think that is what is happening today. That is why I argue that we have become complicit in these murders, whether we think we are or not. We are grieving hard for Santa Fe, but we are grieving hard for all of the other victims. I sat with the President at the White House a few months ago as he told us he was going to fix this problem. He was lying. He wasn't telling the truth. He had no intention of fixing the problem. The President had the gun lobby in the next day, and all of a sudden the discussion evaporated. He talked a lot in that meeting about school safety and arming teachers, but it is important to note that Santa Fe High had adopted really aggressive measures to prevent a school shooting. They had resource officers who were armed, two of them. They had approved a plan to arm teachers, though they had not started to do so. They had gone through a very successful lockdown. They had won an award for that response. In this school they thought they were ready, and they weren't. This has to be about a conversation rooted in data. The data will tell you that more guns will not solve this problem and that for every time a gun you own is used in self-defense, there are four times that a privately owned gun is used in an unintentional shooting, seven times that a privately owned gun is used in an assault or murder, and 11 times that a gun is used in a suicide. The data doesn't back up the fact that more guns are going to solve this problem. Beyond the data, there are these faces, there are these people, there are these lives that were cut short. I want to spend the remaining few minutes telling you a few of their stories. I have tried to do that over the years--to come and put a hole in the data and let you know who these people are whom we have lost. On average, psychiatrists and mental health professionals tell us that when one person is killed by a gun, there are 20 other people who experience trauma or some level of trauma. In Santa Fe, we think a lot today about Cynthia Tisdale. She was 63. She was a substitute teacher for children with special needs. She got married when she was 17 years old, and she took care of her ailing husband. He was very sick for 47 years. He said: She was a good woman. She watched out for me. Her son said: She loved to help children. She didn't have to do it. She did it because she loved it. Cynthia Tisdale is gone at 63. Sabika Sheikh was 17 years old. Unlike the others who were killed in that school, she didn't have any family in the United States. Santa Fe was her adopted community. She was staying with a family. The family she left behind, her adoptive family in Texas, said: ``We loved her and she loved us,'' adding that the ``root of our issues is love because when people love each other, these kinds of things don't happen.'' Sabika dreamed one day of being a diplomat and working to empower women. She died at age 17. Christopher Jake Stone was 17 as well. He was the youngest of three siblings in Santa Fe. He and his siblings were known as the ``three Stones.'' His sister said: Being a brother was his best job. He was always there if someone needed someone to listen to or some cheering up. Definitely the life of the party, and one of the most understanding, open-minded kids I know. She said in a Facebook message: ``He had a lot of heart.'' Two days later, to give you a sense of the scope of this, Kimberly Phillips was in a parking lot at a Shell gas station in Chattanooga, TN, when her ex-husband found her, shot her, and then killed himself afterward. It was a murder-suicide, one of the thousands partner-on- partner incidents of domestic violence that happen in this country. One of her coworkers at the senior living community where she worked said: Today I lost one of the most caring, loving caregivers I have ever had on my team. . . . She loved her residents and took their care very seriously. She was 48 years old. The day before that, Sherrell Wheatley was walking home from feeding one of her neighbor's dogs in Dayton, OH. Her neighbor said that she did this all the time. She cooked a lot, and she would cook all the scraps and take them to feed the neighbor's dog. She was walking home, and she was shot as a bystander in a driveby shooting. She was a mom, grandma, aunt, an active member of her local community, a volunteer in the local elementary school, and a pillar of kindness. Her son, a quadriplegic who relied on her care, said: That was my mom-- She was helping people, even at the moment she died. I loved her. She was my angel, she was my everything, and somebody snatched that away from me. Those are just 5 of the victims who died over a 2- or 3-day period of time--32,000 a year, 2,200 a month, 93 a day--and we are doing nothing. I appreciate some of my colleagues working on a minor adjustment to our background check laws earlier this year. I am not saying that is totally inconsequential, but it doesn't match up to the moment. What is wild is, we are the only ones who don't think we should do anything. Americans have woken up to what is happening, and they are desperate for us to change the laws. In fact, 97 percent of Americans think we should pass universal background checks. By a 2-to-1 margin, people think we should get these assault weapons and military-style killing machines off the streets. People support things like what we did in Connecticut, requiring people to get local police permits for carrying a handgun. These are not controversial outside of the U.S. Senate. Increasingly, Americans have come to realize that no one is safe. In that heartbreaking video, a young woman, I think just hours after the shooting, was asked by a newscaster whether she found it hard to fathom that the school shooting had happened at her school. To paraphrase her answer, she said: No, I wasn't surprised. It happens everywhere, and I just figured it was a matter of time before it happened here. Nicole Hockley, who lost her son at Sandy Hook, says all the time that she never, ever expected to be one of these parents grieving the loss of a child. She reminds everyone she talks to that you don't imagine you will be in that situation either, but if you don't do something about it, if you don't stand up and speak truth to power, it might be you too. I will continue to come to the floor and tell these stories--these voices of the victims who have been silenced through gun violence. Hopefully, at some point, we will wake up to the need for change. I yield the floor. I suggest the absence of a quorum.

Mr. MURPHY

Mr. MURPHY. Mr. President, this week people in Virginia and Maryland are waking up to the first rate filings by private insurance companies in 2018. The numbers are simply stunning. I am coming to the floor today to talk about what is going to be a very unhappy spring and summer for healthcare consumers all across the country, as health insurance companies--having now dealt with a full year and a half of President Trump's sabotage of the American healthcare system--are going to be looking at gigantic, unaffordable premium hikes for private healthcare insurance. I wanted to come down today, as we are starting to get into these rate filings, as our constituents are starting to ask why they are facing premium increases of, in some cases, up to 90 percent--think about that. Think about getting a notice from your insurance company telling you that in 1 year, your premium is going to double. The cost of getting health insurance is going to double. I feel it is time to come down and talk about why this is happening, why you are seeing these radical rate hikes being proposed from insurance companies. I want to walk through, for my colleagues, this very deliberate campaign of sabotage that this administration and congressional Republicans have waged against the Affordable Care Act and the American healthcare system writ large. It starts on January 20. Within hours of being inaugurated, President Trump issues an Executive order in which he directs all of his Federal agencies to use their administrative powers to begin dismantling the Affordable Care Act ``to the maximum extent permitted by law.'' This is before there is any proposal for what should substitute for a piece of legislation that insured 20 million people who didn't have insurance before the Affordable Care Act. It was before we knew that replacement would, in fact, uninsure, not 20 million people but 30 million people and drive up rates by double digits. On the first day, President Trump tells his agencies to start dismantling and attacking the Affordable Care Act. At this point, the Affordable Care Act is so wrapped into the healthcare system of this country that when attacking the Affordable Care Act, you are attacking the entirety of the healthcare system. On January 26, 2017, the administration announces that it will stop advertising the open enrollment period for the Affordable Care Act. The administration says: We are no longer going to tell Americans that they have an option to become insured or to get less expensive coverage through the healthcare exchanges set up around the country or through the national exchange, leaving millions of Americans in the dark. Next, the President starts to threaten insurance companies-- threatening to pull the subsidies that Congress approved allowing for premiums to be reduced for lower income beneficiaries. The Trump administration starts threatening to pull those cost-sharing reduction payments in April of 2017. Eventually, in October of last year, the administration follows through on that threat and ends payments to insurance companies to help reduce cost-sharing for beneficiaries, driving up the cost of insurance all across the country. If you listen to health insurance executives talk to you about why they are passing on these big premium increases, they will tell you that one of the biggest reasons is the end of this program to help defray the costs for lower income individuals. Also, in 2017, about the same time he starts threatening to reduce these payments, the President cuts in half the open enrollment period. There is no reason to cut in half the open enrollment period other than you just don't want people to get insurance. It is a deliberate sabotage. Cutting in half the enrollment period is simply a mechanism to try to deny people the ability to get healthcare. There is no practical or logistical benefit to reducing the amount of time people have to buy healthcare, just as there is no practical benefit to cutting off all the advertising for the healthcare exchanges other than you don't want people to sign up. In July of 2017, the Department of Health and Human Services starts to unveil videos--23 of them in all--featuring individuals explaining how the Affordable Care Act has hurt the American healthcare system. They used their Twitter account to amplify these anti-ACA messages, and they removed any content promoting the exchanges from the website. Once again, it is just a spiteful attack on Americans who want to get health insurance and now will not know about it because of these attacks and removal of that content. Open enrollment outreach funding was reduced in August of 2017 by as much as 90 percent. So the helpful people you used to have trying to figure out whether you qualified for Medicaid or whether you qualified for a subsidy or a tax credit are no longer available because that money was taken away. Then there was the big legislative intervention, the repeal of the individual mandate. The individual mandate was repealed as part of the tax bill, even though CBO told Congress: If you do that, 13 million people will lose insurance. With full knowledge that the repeal of the mandate would result in 13 million Americans losing their health insurance, Congress went forward with it. CBO also said it will result in double-digit premium increases. Congress was told, if you take this step, 13 million will lose coverage, and premiums will go up. Congress still moved forward with it, and it was passed as part of the tax bill, with no Democratic votes. Finally, the President most recently unveiled what he called the short-term health insurance plan rule. These are more commonly referred to as junk plans. These are plans that last up to a year but don't need to comply with Federal regulations; for instance, regulations that require insurance companies to actually give you coverage for things like mental illness or maternity care or regulations that require insurance companies to protect people with preexisting conditions. All of those superpopular benefits in the Affordable Care Act--the ones the Republicans were so nervous to remove--are now no longer available to many Americans. Because of this short-term plan rule, these junk plans are going to be much more widely available. So you have this very coordinated, very deliberate attack on the American healthcare system: the Executive order in January of 2017, directing all Federal agencies to start undermining the American healthcare system; in April of 2017, the cut in the open enrollment period; in May, the votes start happening on the floor of the Senate to take insurance away from 23 million people--one of the bills took away insurance from 30 million people; in December, the repeal of the individual mandate, resulting in premiums going up by double digits; and now this junk plan rule, taking away protections from millions of Americans. The effect of that junk plan rule is also to move healthier patients out of the exchange pools into the junk plans because the junk plans don't have to cover anything, so healthy people will go to those plans, which drives up rates for the plans that people with any kind of preexisting condition would be able to access. You have this very deliberate plan to try to undermine the American healthcare system, and we are now seeing the consequences. As I mentioned, the period of rate filings is beginning across the country, where insurance companies have to announce what their rate increases are going to be. Healthcare inflation, on an annual basis, has been holding steady over the years. It certainly never gets above 10 percent, and for a number of years during the early rollout of the Affordable Care Act, that number was at or lower than 5 percent. So if you are just looking at the amount we are spending on an annual basis above last year on healthcare, that number has not recently been more than 5 percent. Yet one insurer in Virginia--a subsidiary of the big health insurance company, CareFirst--is proposing a 64-percent increase in Virginia. Other rate increase requests in Virginia are 26 percent and 15 percent. Nobody can afford a 64-percent increase in health insurance premiums in Virginia, but it is a consequence of this deliberate campaign of sabotage. Let's take a look at Maryland. There is one insurance company in Maryland that is asking for a 91-percent increase in premiums--again, this is a CareFirst plan--for its broad network PPO plan that currently has about 13,000 people in it. Thirteen thousand people in Maryland potentially are going to get a 91-percent increase in their health insurance premiums because of this deliberate campaign of sabotage. If you are in other CareFirst plans in Maryland, you are getting a 19-percent increase. Your premiums are going up by one-fifth in one single year, in large part, because of this deliberate campaign to undermine the Affordable Care Act because of actions this Congress has taken that would knowingly increase rates for healthcare consumers. My colleagues and I are going to come down to the floor of the Senate, over the course of the spring and summer, to make sure everyone here and every one out there in America understands what the consequences of this American healthcare sabotage campaign is. It starts in Maryland with rate increases that get as big as 91 percent, and in Virginia, where health insurance increases get as big as 64 percent. These numbers will continue to roll out all across the country, and Americans are going to be stunned--stunned--at how much this Republican campaign sabotage is costing them. I will just add one last note, which, to many of my constituents in Connecticut, feels like insult to injury. The tax bill did drive up rates by 10 percent, at least, in the first year. A big chunk of these increases, more than 10 percent, is a result of the repeal of the individual mandate, but the tax bill also gave a windfall to insurance companies and drug companies--some of the biggest players in the healthcare space. I just totaled up the projected 2018 tax savings to eight of the biggest insurance companies in the country, and it is over $4 billion. At the same time that these companies are passing along rate increases of 64 percent or 90 percent, they are getting billions of dollars in tax savings from this Congress. It appears none of the tax breaks this Congress bestowed on the insurance industry is going to consumers. When you look at the drug industry, where we have a little bit more mature information, you know why. One report, I believe released by the Finance Committee, showed that pharmaceutical companies already have announced $50--50--billion in stock buybacks and share buybacks as a result of the tax bill. These drug companies aren't announcing price cuts to insurance companies; these drug companies are not announcing price cuts for consumers; these drug companies are announcing massive share and stock buybacks that will largely benefit the millionaire and billionaire investors in those drug companies. This is insult to injury for the people in my State and people all across the country because they are watching their healthcare insurance premiums skyrocket, while the windfall of the tax bill accrues to the owners of the insurance companies and the drug companies. What a great time to be in the healthcare business today. You get a giant tax break, and you get to pass along gigantic premium increases to consumers all across this country. Think about it. Somebody in Maryland, making $30,000, $40,000 a year and being told the insurance company he does business with is going to get $1 billion in new tax relief from this Congress, and he is going to get a 91-percent increase in his premium. That is outrageous. That is outrageous, and yet it is just going to get worse. As this spring and summer plays out--I think every single week there is a new State or set of States unveiling rate filings--I will come down and update this chart so everybody knows what the numbers are. It starts with rate increases as high--and I am not saying every single increase is this high, but in Virginia it is 64 percent, and in Maryland it is 91 percent. I have a feeling there are going to be a lot of very big numbers on this board, and I want to make sure everybody understands that if you want to know why premiums are going up at the rate they are, you don't have to look any further than this campaign of healthcare sabotage that has been waged by the Trump administration and Republicans in Congress. I yield the floor.

Mr. MURPHY

Mr. MURPHY. Mr. President, I come to the floor to speak on the pending nomination of Mike Pompeo to be the Secretary of State. As a member of the Foreign Relations Committee, I opposed the nomination in committee, and I will oppose it on the floor. I have said publicly that this was not an open-and-shut case for me. Frankly, I would submit that I have probably voted for more of the President's nominees who have come before the Senate than have many of my colleagues. I do believe in giving a substantial amount of deference to the President in the choices that he makes of those who are to serve him in his administration. There have been a number of applicants for Cabinet posts whom I have supported even though I have had grave misgivings about the policies that they were going to be articulating and that they were going to be carrying out. I also believe Director Pompeo when he talks about the morale crisis at the Department of State and his sincere desire to try to remedy that and address it. There was a morale crisis at the Department of State after Secretary Tillerson waged an assault on diplomats in his trying to push out as many as he could for over a year, changing work requirements to make it harder for people to live in very difficult places around the world and continuing a hiring freeze well past the point at which it was justified. There are a lot of people who serve in this country here in Washington and abroad who need to be told that their work is valuable again, and I believe Mike Pompeo when he talks about the need to try to engage in that morale-building project. I think there are check marks on the side of the ledger that would argue for Mike Pompeo's confirmation, but I am going to vote no because, unfortunately, I think there are far more check marks on the other side of the ledger. I want to talk today about the issue of qualifications. I don't argue with the fact that our choices, as those in the Senate, when it comes to those who are picked for the Cabinet, shouldn't really be about policy differences. Sometimes the policy differences will be so serious that Members of the President's opposing party may have to cast a ``no'' vote. By and large, I do think that we should be evaluating candidates based on their qualifications and based on whether their views are at least between the 20-yard lines, within the mainstream conversation about the portfolio of issues that they are going to undertake to oversee. So I want to talk today about my belief that Director Pompeo is not qualified to be our next Secretary of State. I think that is the appropriate conversation for us to be having, and I want to talk about it through the prism of three qualifications that I would argue any Secretary of State has to meet. One is that a Secretary of State who is going to be advising the President on matters of war and peace and on questions of military operations overseas has to believe in his heart or in her heart in the Constitution--in the separation of powers between the executive and the legislative branches--when it comes to war-making. The second is that a Secretary of State has to believe in the value of diplomacy. The Secretary of State is in the national security cabinet in order to represent diplomatic pathways out of very complicated, vexing, and dangerous problems around the globe. You need a Secretary of State who truly believes that diplomacy can be a viable path out of very complicated problems. Third, you need a Secretary of State who is free of prejudice or who is free of a substantial association with prejudice. This is our Nation's chief diplomat, who is going to be representing the United States all over the world, who is going to try to build bridges between our country and those countries with different cultures, different faiths, different backgrounds, and different ways of viewing the world. On these three tests, I don't believe that Director Pompeo measures up. Let me talk about each one of them very briefly. The first is this belief in the separation of powers. If we aren't standing up for article I powers, no one else will. The Founding Fathers were very clear that when it came to military engagement outside of the United States, it was the Congress and only the Congress that had the ability to declare war. Now, admittedly, war is a much fuzzier concept today than it was when armies were marching against each other in open fields and when neat, tidy peace treaties were wrapping up those hostilities. So I will grant my colleagues that declarations of war are a little bit harder today when the enemies never seem to go away and the definition of ``hostilities'' is a little different than it used to be. Yet, at the hearing, I asked a series of questions of Director Pompeo, whose answers did not leave me with any confidence that he understood that there still must be some places in which only the Congress can declare hostilities. Now, I don't believe the President has the ability to take military action against the Syrian regime without having the authorization of Congress. Apparently, there are members of the President's Cabinet who believe the same thing. Media reports suggest that Secretary Mattis counseled the President to go to Congress first before attacking the Syrian regime. So I queried Director Pompeo about this topic. I asked him whether there was any attack that had been launched against the United States from the Syrian regime. His answer was no. I asked him whether there was any threat of imminent attack from the Syrian regime against the United States. His answer was no. I then asked him what the authorization was that allowed the President to take this action. His answer was ``article II authority,'' which is kind of a blanket answer for anybody in an administration who doesn't have an answer. I submit that the Obama administration occasionally relied on article II authority as well, but I tried to give Director Pompeo a way out of that overly broad answer. I asked: Would you identify for me one limiting factor on this broad claim of article II authority. He could not. He could not articulate one definable, articulated restraint on article II military authority before the Foreign Relations Committee. It speaks to what, I think, is a belief inside this administration, which is now being buoyed by people like Director Pompeo and John Bolton, that the President has virtually unlimited authority to begin military operations overseas. If you can attack the Syrian regime without having any authorization from Congress, then why couldn't the President launch a military attack against North Korea without going to Congress in the way that John Bolton had recommended in some of his writings before joining the administration? If a Secretary of State is not prepared to argue that the Constitution requires that authority and cannot even articulate a single restraint on a seemingly limitless power under article II to launch attacks overseas without going to Congress, then who is making that argument? I think a Secretary of State has to have an understanding of the limits of executive power overseas. I don't think Director Pompeo has that belief. Otherwise, he would have answered very differently the questions that he was given in his confirmation hearing. Secondly, I believe that a baseline qualification to be the Secretary of State, to be the Nation's chief diplomat, is to believe in the fundamental power of diplomacy. Over and over, primarily when he was a Congressman, Director Pompeo showed us that he didn't think much of American diplomatic power. He opposed the JCPOA, which is, of course, a mainstream opinion within the Republican Party, but he did so because he thought that military action would involve just a few thousand sorties--American planes flying over Iran, bombing the country into submission. I think that is a pretty naive, uneducated view of how a war with Iran would go down, but it demonstrates an enthusiasm for military options ahead of diplomatic options, the kind that may be better suited for the Department of Defense than for the Department of State. He has further cheered on this President as he has pulled out of the Paris climate accords, as he has attacked multilateral alliances that the United States has long been a part of. This is a candidate for Secretary of State who has a long history of critiquing and criticizing diplomatic paths to solving complicated problems around the world. I want a cheerleader for diplomacy at the Department of State. We have been missing that for the last 1\1/2\ years with Secretary Tillerson. It doesn't seem we are going to remedy that. I think a qualification for Secretary of State is to be a cheerleader for diplomacy. That has not been the reputation or the record of Mike Pompeo. Lastly, I think you need to be free of prejudice or free of substantial association with prejudice, and the reason for this qualification is self-evident. This is the member of the administration who is going to be most often overseas meeting with leaders that come from very different backgrounds, who believe different things than Americans do, who practice different religions than the majority of Americans do, who have different traditions than the majority of Americans do. So one has to have a respect, right? One has to have a love of other people who come from different faiths and different traditions if you are going to take this job. This may be the blackest mark on Director Pompeo's record because there is a vast network all across this country that engages in a kind of Islamophobia, a hatred and bigotry toward the Muslim faith that is completely un-American but is also deeply antithetical to American national security interests because if we really want to make this country safe, then we have to be building constant active bridges to Muslim communities in the United States and to our Muslim partners around the world. When you trade in Islamophobia, a fear of Muslims, you are adding bulletin board material to recruiters who want to write a story about how America is at war with the East, how America is at war with the Islamic faith. For much of his congressional career, Mike Pompeo was deeply intertwined with this network of anti-Muslim organizations. There is a really interesting study that I hope some of you will take a look at that details this network of organizations. They have fairly innocuous- sounding names, like the American Islamic Forum for Democracy, the Middle East Forum, the Investigative Project on Terrorism, Jihad Watch, ACT for America, the Center for Security Policy, the Society of Americans for National Existence. Those sound like things I might be for, but if you really take a look at what they do, they preach intolerance. They try to tell Americans that all Muslims are out to get them and that we are better off if we just shelter ourselves from people of the Muslim faith. That makes us less safe, and it morally weakens us as a nation. It is not coincidental that all of these groups sprang up or began to receive substantial funding after Barack Obama became President of the United States. It wasn't coincidental that as Donald Trump was going on cable news casting doubt on whether the President of the United States was really an American citizen or whether he was a secret Kenyan citizen planted in the United States that all of these organizations started to take root. They gained legitimacy because American political leaders associated themselves with their cause because they were able to lure Members of Congress like Mike Pompeo into their web. Mike Pompeo went on these radio shows that traded in these conspiracy theories about Muslims. He allowed for his name and his office to be associated with their causes. At one point, he actually accepted an award from a group called ACT for America, which is arguably the largest anti-Muslim group in America. They gave him an award saying that ``Representative Mike Pompeo has been a steadfast ally of ours since the day he was elected to Congress.'' This is an organization that the Anti-Defamation League and the Southern Poverty Law Center classify as a hate group. Their founder said practicing Muslims ``cannot be loyal citizens of the United States.'' Let me say that again. The founder of the group that gave Mike Pompeo an award for being a steadfast ally of their cause said that practicing Muslims cannot be loyal citizens of the United States. These anti- Muslim groups became stronger, became more deeply intertwined into the mainstream because they have allies like Mike Pompeo. It wasn't a coincidence when a Presidential candidate stood up and said: If you elect me, I will ban all Muslims from the United States, that he wasn't laughed off the debate stage. He wasn't laughed off the debate stage because this conspiracy of Islamophobia had penetrated the mainstream because of its access to people like the nominee to be Secretary of State. That is disqualifying to me. That is not about Mike Pompeo's views. It is not about my differences with the policies he is going to espouse as a Secretary of State. That speaks to his qualifications. This is one of the most important debates we are going to have. These are exceptional times for both Republicans and Democrats, dealing with an administration that conducts itself very differently from others. When it comes down to it, I don't think that by casting a ``no'' vote I am violating the traditions of this body, which have admittedly given deference to the President in some of these choices for Cabinet positions. I don't think Mike Pompeo really understands the importance of the separation of powers between the Congress and the Executive when it comes to war-making. I don't think this is a Secretary of State who is going to walk into the room when big decisions are being made on foreign policy and argue the diplomacy portfolio. By virtue of his longstanding association with groups that argued values antithetical to a diverse America, arguing that Muslims have no place in this country, I don't think he passes the test when it comes to a Secretary of State who doesn't have an association with prejudice. That would disqualify him from being an effective advocate for us in parts of the world that practice faiths different than ours. So, for those reasons, I am going to be voting no on Mike Pompeo's nomination. At the same time, as I said at the outset, I acknowledge there are arguments for his nomination, and I will hope my fears are unfounded. I will hope that he, if he gets confirmation from this body--which it looks like he will--is an advocate for diplomacy, that he understands the proper role of Congress, and that he represents all Americans when he serves us overseas. I certainly hope that to be the case. I hope I am wrong about my reservations, but I will still cast a ``no'' vote when his nomination comes before the Congress. I yield the floor.

Mr. MURPHY

Mr. MURPHY. It sends a very clear signal to the administration that we are not interested in even having a debate here about complicated questions of legal authority for serious military engagements overseas.

Mr. MURPHY. Mr. President, I am grateful to join for a few moments the cosponsors of this resolution--Senator Lee and Senator Sanders. It is important to pick up on what Senator Lee was just putting down--the notion that this is a limited resolution that speaks to our participation in an unauthorized, illegal partnership with the Saudis to bomb the country of Yemen. It does not affect our partnership with Saudi Arabia and others in the gulf region to continue to confront terror, to continue to confront al-Qaida--a specific carve-out in this legislation that allows for 2001 AUMF authorized activities to go forward. It is also important to note that if you care about the priority of taking on al-Qaida and taking on ISIS in the region, then you should support debating our resolution because all of the evidence suggests that the continuation of this civil war inside Yemen is making ISIS and AQAP, which is the arm of al-Qaida that has the clearest intentions of attacking the homeland, both more powerful. The AQAP controls much more territory inside Yemen than it did in the beginning of this civil war. If you take the time to meet with Yemeni-Americans, they will tell you that inside Yemen, this bombing campaign is not perceived as a Saudi bombing campaign; it is perceived as a U.S.-Saudi bombing campaign. What we are doing is radicalizing the Yemeni people against the United States. Add to this the new information that suggests that some of our partners in the coalition, although not directly working with al-Qaida, are starting to arm some very unsavory Salafi militias inside Yemen that are filled with the types of people--the types of extremist individuals--who could take the training they have received from the coalitions and the weapons they have received from the coalitions and easily turn against the United States. If you care about the mission against terrorism, then you should support debating our resolution. Just to recap the reasons we are here today, we need to have a debate on the lack of authorization for military force because it is time for Congress to step up and do our constitutional duty. The administration wrote in its letter to us that we do not have the authority as the U.S. Congress to weigh in on military activity that is waged by the administration unless there are two armies firing at each other on the ground in an area of conflict. That is the administration's definition of ``hostilities,'' and admittedly that is a definition that has been used by Democrats and Republicans. This is not exclusive to the Trump administration. The problem with that is that it would allow for the United States, through Executive decision only, to wage an air campaign against a country that wipes it out without there being any say from the U.S. Congress. Clearly, what is happening in Yemen today meets the definition of ``hostilities.'' We have shown pictures on this floor before of entire cities that have been wiped out. More than 10,000 civilians have been killed in the largest outbreak of cholera in the history of the world in terms of what we have recorded. Those are hostilities, and the United States is clearly engaging in those hostilities because we are helping with targeting and refueling the planes that are supplying the munitions. If we cede to unlimited Executive authority with respect to this engagement, there will be no end to that. Lastly, let me speak to what is happening on the ground. There is zero evidence that U.S. participation in this coalition has made things better. Civilian casualties are not getting better. The day after Christmas, over 60 civilians were killed in a series of airstrikes. Reports are that last month, the Saudis engaged once again in something called double tapping, by which they targeted an area in which civilians lived, waited for the emergency responders to arrive, and then hit again--something that is not allowed by international humanitarian law. The humanitarian catastrophe itself is getting worse, not better. Maybe most important is that the battle lines inside Yemen are not changing. The Saudis have been telling us for years: Stick with us. If you keep on helping us bomb the Yemeni people, we will win this war. We will get back control of Hudayda and of Sana'a. That is not happening. At the beginning of this war, the Houthis controlled about 70 percent of the population inside Yemen. Today, the Houthis control about 70 percent of the population inside Yemen. If we continue to support this bombing campaign, nothing will change except that more people will die, except that more civilians will be hit by the bombs we help to drop, except that al-Qaida will continue to control big portions of that country. While Senator Lee notes that this resolution is actually not on the merits of our engagement there and that it is whether we have the legal justification to be there, let's admit that if you do consider the merits, other than backing the play of our historic ally, there is nothing to suggest that our participation there is making things better rather than worse. I yield to Senator Sanders.

Mr. MURPHY. By voting to table the consideration of this resolution, you are voting to stop a debate, a conversation, from happening in the Senate about whether proper authorization exists. Let's be honest about what this first vote is. This first vote is, do we want to talk about whether there is authorization to perpetuate this war? By voting to stop debate, by voting to table this motion and refrain from proceeding to a conversation about this topic, we are, in a very clear way, signaling to the administration and to the American public that we are not interested in exercising our article I authority on the issue of war-making.

Mr. MURPHY

Mr. MURPHY. Mr. President, I ask unanimous consent that Senators Coons, Cardin, Lee, Sanders, and I be recognized for up to 5 minutes each and then Senator Corker be recognized for up to 15 minutes prior to the vote.

Mr. MURPHY. I thank the Presiding Officer. Mr. President, I just returned from a trip to a major transatlantic conference in Europe. While the Europeans have spent a lot of time over the course of the last 12 months hand-wringing about whether the United States is committed to Europe, committed to NATO, committed to our common defense, my feeling upon going to Brussels for this particular conference is, they are kind of over the hand-wringing. They are now just making plans to move on without us. They are making plans to protect themselves without us. They are making plans to set the rules of the road economically, politically, and culturally around the world without the United States. The evidence of that was very clear. The Europeans are setting up something called the European Defense Initiative, in which they are going to start doing military planning and purchasing outside of NATO because they are just not convinced, not confident that the United States is going to be seriously engaged in NATO. That compromises our security as the Europeans start to make plans for their defense without us, even though we still have an obligation under the treaty to protect them. Over and over, you see the world moving on as they watch this massive withdrawal of America from the world. The President said at a rally in Alabama a few months ago that the world is starting to respect the United States of America again. That could not be further from the truth. The Pew organization charts other countries' opinions of the United States. It also charts whether other countries believe the United States is going to act in the best interests of the world. The numbers are, frankly, startling. Of the 37 countries they surveyed, only two of them have higher confidence in the United States under Trump than they did under Obama. One is a rather statistically significant increase, that being Russia, which by 42 percentage points is more confident that the United States is going to act in that country's best interests. South Korea had 88 percent confidence under Obama and has 17 percent confidence under Trump. Canada had 83 percent confidence under Obama and has 22 percent confidence under Trump. Germany is 86 to 11. They have come to this belief because, as my colleagues have mentioned, the Trump administration had signaled its unwillingness to try to set a moral tone for the world in the way that it budgets. The budget they presented to us reduces accounts dedicated to countering Russian aggression around its periphery by 63 percent. It is a clear telegraph to Europe that they are on their own, that countries that are trying to fight back against a country that wants to reestablish a new version of the Soviet Empire will have no help from the United States. In this budget, the National Endowment for Democracy is cut by $100 million. It is no secret that countries like Hungary and Poland are starting to slip away from traditional democratic norms. Countries like the Philippines are doing the same because there is not a moral force here in the United States committing to bring them closer to the ideals of participatory democracy. There is a $1.6 billion cut in humanitarian aid, telling the rest of the world: If you want to solve these enormous problems of humanitarian catastrophe--famine and refugee displacement--you can't look to us anymore. You are on your own again. There is a 35-percent cut in overall international narcotics and law enforcement funding, just at a time when record amounts of fentanyl are finding their way into the United States. The moment of panic is over for the world. They have watched this administration walk away from its traditional obligations to try to stand up for the rule of law, to try to promote democracy and human rights, and to try to protect America's interests and our allies. They are simply making other plans. I hope the next administration will be able to correct that, but those plans are hard to break once they are made. I hope Republicans and Democrats will stand up to make sure that America does not become any weaker in the world than it already is today, 15 months into this administration. We are less safe as a nation because of this wholesale withdrawal from the global stage. It is not too late to try to turn it around. I yield the floor.

Mr. MURPHY

Mr. MURPHY. Mr. President, today I wish to honor the life and legacy of a World War II hero: Lt. Rev. Thomas M. Conway, born April 5, 1908, in Waterbury, CT. Father Conway, who was born 110 years ago next month, was an American hero who, after the sinking of the USS Indianapolis, went from lifeboat to lifeboat in shark-infested waters to care for his fellow sailors in a manner far above the call of duty. The courage of the brave men who served on the USS Indianapolis, who delivered critical parts to the first atomic bomb used in combat, helped bring about the end of World War II. After their mission was complete, they were intercepted on their way to join with the rest of the Pacific fleet for the invasion of mainland Japan. Two torpedoes from a Japanese submarine struck the Indianapolis on July 30, 1945, sinking the battleship and immediately killing 300 of the 1,196 sailors aboard. The remaining 900 sailors were left to fend for their lives in the shark-infested Pacific, spending 3 days with few lifeboats or supplies and no way to notify the Navy of their peril. Father Conway, as chaplain, disregarded his own safety by swimming back and forth among the men, administering aid, helping to gather those who had drifted from the mass of survivors, and continuing to minister and organize group prayers. His heroism gave comfort to the dying and helped save the lives of the 321 sailors who were rescued from the sea. Father Conway's acts of bravery took a physical toll, and he succumbed to the elements shortly before rescuers arrived. As one surviving sailor said of Father Conway, ``He was the most visible person keeping the men together, giving them hope and sacrificing himself to keep his fellow sailors united, calm, and alert.'' The legacy of Father Conway continues to inspire his family, fellow sailors, and the people of Connecticut. That is why next month, in recognition of his birthday, we pause to reflect upon and celebrate his courageous actions. His selflessness and bravery are the epitome of an American hero.

Mr. MURPHY

Mr. MURPHY. Madam President, it has been 32 days since the tragedy in Parkland. I think Senator Nelson may be coming to the floor very soon. Frankly, every day since then, there has been a series of tragedies all across this country. On average, 90 people lose their lives every single day to gun violence. There has been, over the course of the last year, a mass shooting, on average, every single day. Most of them aren't covered in the newspaper, but there is an incident in which four or more people are shot, on average, more than once per day in this country. Of course, it has now been more than 5 years since the devastating tragedy in my State, where 20 first graders lost their lives. This is deeply personal to all of us here in this Chamber. It became very personal to me last week when my 6-year old came home from school to tell me about his active shooter drill. He is 6, and he is in kindergarten. In his kindergarten class, they have a small bathroom that all of the kids in the class use. He explained to me that for their active shooter drill, all 25 kids in his classroom--a whole bunch of 5- and 6-year-olds--were shoved inside this tiny, little bathroom together, crunched together, shoulder to shoulder, with the door locked. Imagine how frightening that would be to a 6-year-old child, even if they didn't completely understand why they were there. He said to me when he got home that night: Daddy, I didn't like it. In the most powerful, most affluent country in the world, our children should not have to go through that; never mind those who have actually had to face down someone with a gun inside their classroom or inside their school. What is devastating to the parents in Parkland and Sandy Hook, what is devastating to the parents in Baltimore, in New Haven, and in Chicago is that we refuse to have a debate on the Senate floor about how we can help address this epic mass slaughter, this gun violence epidemic in this country. I have been taking pains over the course of the last 6 months to try to reach out across the aisle and find common ground with my colleagues on some commonsense legislation about changes to our gun laws. I am proud to have worked with Senator Cornyn on a small bill that would encourage States to comply with existing law--the Fix NICS Act. It now has over 60 Republican and Democratic cosponsors, enough that it could overcome a cloture motion. I have come to the floor today to ask that we come to an agreement-- Republicans and Democrats--by which we can have an open debate on the issue of gun violence for the American public before we break for a 2- week Easter recess. We are going to go back to our States and have a wonderful time with our friends and families, while many others continue to grieve all across this country and many others will enter the ranks of those who grieve because, during the 14 days that we will be away, thousands of people will die from gunshot wounds. I just can't imagine that we would make a decision to go home at the end of this week without having had a debate on the Senate floor for the American people to see how we can try to respond to this cry, this call from the American public to do something. These kids have been amazing. Literally hundreds of thousands of children walked out of school last week, and hundreds of thousands more students and their parents will be here in Washington for marches and at 600 other marches all around the country this weekend. The polls tell us over and over again that 9 out of 10 Americans want us to take bold steps forward. Record numbers of American citizens believe the laws that exist today are not sufficient. This isn't a controversial issue outside of Washington. It is controversial only here, inside this Chamber. If we remain silent, if we refuse to have a debate on the Senate floor, we are failing the people who sent us here. I have come to the floor today to propose a very reasonable path forward so that we can have a debate and some up-or-down votes on proposals this week. From what I understand, there is still a lot of discussion happening with respect to the budget. Obviously, we have to get that done by the end of the week, but it is not ready yet, so we have time this week to have a short but meaningful debate on the issue of guns. Here is what I am proposing. I am proposing that we have a unanimous consent agreement whereby we can have a time-limited debate--I would suggest perhaps not more than 6 hours--and at the end of that period of time, we have six votes, three votes propounded by the Democratic side and three votes on measures propounded by the Republican side. I think it is no secret the amendments that Senate Democrats would offer. We would want to see a vote on universal commercial background checks to make sure that commercial sales of guns are subject to background checks. That is something President Trump said he was for at the White House, and he has encouraged the Congress to work on it. Let's have an up-or-down vote on background checks. I think Democrats would clearly want to see the bipartisan compromise, which has been worked out by Senator Blumenthal and Senator Graham with respect to protective orders, red flag orders, come before the Chamber. It simply makes sense that we do what Florida is doing: Pass a law that allows for law enforcement, after a viable court process, to take away weapons temporarily from someone who poses a threat. The problem in Florida was, even if they had done something about this young man, they didn't have the legal ability to take his weapons away, even if he had made those kinds of threats in public. Florida is correcting that with their new law. We should do the same at the Federal level. On our side, there is also interest in talking about the kinds of weapons that are legal and the kinds of weapons that are not. I am a believer, of course, that there is a class of military-style tactical semiautomatic weapons that are best if they are not in the hands of civilians. Obviously, that issue divides our side too. So if that were to come up for a vote, there will be Democrats for it and Democrats against it. On the other two measures, there will be Republicans for them and Republicans against them. Some Republicans are for universal background checks; some aren't. There are many Republicans on record as being for protective orders, and there are others who will not vote for them. We will have no idea, the American public will have no idea, and our constituents will have no idea what we are really willing to do and what we are not willing to do unless we have a debate. This is our last chance before we go home. What I am proposing, I think, is reasonable, practical, and viable. We can get it done--six total amendments to the Fix NICS Act, time limited, perhaps only 6 hours. We could be in and out of that debate in a day. I have talked with my leadership about it. I am confident that Democratic leadership would support that path forward, and I propose it to Republican leadership tonight, as we enter this week, as a means of having this debate that the American public so badly needs. The alternative is unthinkable--going home, letting over a month pass since Parkland, since this outcry for action from kids across America, and not even attempting to get something done here. I understand this issue is still difficult. I don't understand why my Republican colleagues will not support something like background checks, an issue supported by 97 percent of Americans. It is pretty hard to find anything in America that is supported by 97 percent of Americans. Apple pie and Grandma probably don't get 97 percent approval ratings in this country, but universal background checks do. So, yes, I am frustrated that my Republican colleagues don't just come to the floor and agree to pass something that has mind-blowing universal support in the public, but what is more offensive is that we don't even try. What is more offensive to me is that we don't even make an attempt to put these measures on the floor of the Senate and let them be voted up or down. I don't want the gun lobby to have veto power over the legislation that gets passed here, but even worse than that is for the gun lobby to have veto power over what we even debate. I propose a total of six amendments and a total of 6 hours of debate. I would argue that is insufficient to meet the moment, but I get it that time is running out, that there is not a lot of interest from some Members on the Republican side to enter into this debate. So we are very willing to have a short, time-limited debate to see what we can get consensus on and what we can't get consensus on, and whatever moves out of this building, whatever amendments get passed, then we live with it and live to fight another day. It has been 5 years since the tragedy in my State and now 32 days since Parkland. I don't think we should wait one day longer before we have an open debate on the Senate floor about how we, as those entrusted with the safety of our children, do something about the epidemic of gun violence in this country. I yield the floor.

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

Mr. MURPHY

Mr. MURPHY. Mr. President, I join with my colleagues today to give the country a sense of the scope of this epidemic. We have tried every means to move our colleagues to action, but in remembering the names of people who have been lost, it is a reminder that there is a human face behind every single one of these numbers, and behind that victim there is a trail of trauma--family members, friends, classmates--that is difficult to unwind. On December 14, 2012, armed with a tactical semiautomatic weapon with clips of 30 bullets, a gunman walked into Sandy Hook Elementary School in Newtown, CT, and killed 20 children, 6 adults, and himself. Among them were Rachel D'Avino, 29, a teacher's aide; Dawn Hochsprung, 47, the principal; Anne Marie Murphy, 52, a teacher's aide; Lauren Rousseau, 30 years old, a teacher; Mary Sherlach, 56 years old, a school psychologist; Victoria Soto, a 27-year-old teacher. The students were Charlotte Bacon, 6 years old; Daniel Barden, 7 years old; Olivia Engel, 6 years old; Josephine Gay, 7 years old, Dylan Hockley, 6 years old; Madeleine Hsu, 6 years old; Catherine Hubbard, 6 years old; Chase Kowalski, 7 years old; Jesse Lewis, 6 years old; Ana Marquez-Greene, 6 years old; James Mattioli, 6 years old; Grace McDonnell, 7 years old; Emilie Parker, 6 years old; Jack Pinto, 6 years old; Noah Pozner, 6 years old; Caroline Previdi, 6 years old; Jessica Rekos, 6 years old; Avielle Richman, 6 years old; Benjamin Wheeler, 6 years old; Allison Wyatt, 6 years old. I have a 6-year-old, and yesterday he and 24 of his classmates were locked in a tiny bathroom for several minutes for an active shooter drill. When he came home last night, he said: Daddy, I didn't like it. Since Sandy Hook in Connecticut, there have been hundreds more: Lisa Infante, 52, of Shelton; Antoine Heath, 29, of New Haven; Jonathan Aranda, 19, of New Haven; Miguel Arguelles, 22, of Bridgeport; Cameron Chapman, 25, of Waterbury; Sherrie Blount, 31, of Danbury; Ebony Swaby, 22, of Waterbury; Daniel Joseph Caron, Sr., 63, of Bristol; Michael Watkins, 26, of Bridgeport; Keon Huff, Jr., 15, of Hartford; Joshua Rivera, 28, of New Haven; Deon Rodney, 31, of Bridgeport; Khali Davis, 22, of Bridgeport; Norris Jackson, 36, of Bridgeport; Eduardo Anes, 37, of Hartford; Alfanso Anderson, 49, of Bridgeport; Guy Moore, 26, of Waterbury. That is just the tip of the iceberg as to what has happened since Sandy Hook, just in my State of Connecticut--representing only 1 percent of the population. A 6-year-old shouldn't be locked into a bathroom, smushed together with 24 of his classmates, preparing for the day when a shooter potentially walks into his public elementary school. We have a duty to act. I yield the floor.

Mr. MURPHY

Mr. MURPHY. Mr. President, I thank Senator Sanders and Senator Lee for allowing me to step in and say a few words before we have a short colloquy about the resolution we are bringing to the floor. I brought this picture to the floor before, and I hesitate to keep it up for more than a few moments. It is very disturbing to look at, but this is the reality of Yemen today. This is the reality of a country in which thousands and thousands of civilians have been killed by a bombing campaign that the United States is facilitating--facilitating with intelligence sharing, facilitating with targeting assistance, facilitating with midair refueling, facilitating with the sale of munitions that end up being dropped on the homes of families like this. This, as has been stated, is perhaps the worst cholera outbreak in modern history. Let's talk about why that happens. Why are over 1 million people in Yemen today suffering from cholera, a disease that is entirely 100 percent preventable? The reason is that the water treatment facilities inside Yemen have been bombed, have been rendered useless such that there is no means by which they can keep the water that these young children drink clean. Bombs sold to the Saudi coalition by the United States, bombs dropped from planes refueled by the U.S. Air Force, bombs that are directed via targeting centers in which U.S. personnel are embedded hit water treatment facilities inside Yemen, and there is now the worst cholera outbreak in our lifetime. I cannot do a better job than Senator Lee did of explaining to the body why we believe it is so important for Congress to exercise our Article I responsibility to declare war. He laid it out better than I can. The Founding Fathers believed, as he said, that when there were matters of great import to the national security of this country, when there were decisions that the Executive was making with respect to hostilities with other nations that included serious consequences for the United States and the world, that should not be simply an Executive function. Very specifically, as Senator Lee said, that power of declaring war, of entering into hostilities against another nation, is housed here in the Congress. So it is relevant to talk about what is happening in Yemen today. What is the degree of the hostilities, and does it come with serious national security concerns for the United States of America, for the constituents we represent? We are absolutely engaged in hostilities today. There is no way that what we see in these charts could not be categorized as hostilities. The bombs that ruined this entire neighborhood are made in the United States, are dropped by planes refueled by the United States, are directed by a targeting center that involves U.S. personnel. This is clearly an act of hostility that the United States, in partnership with the Saudi coalition, has entered into against the Yemeni people. Remember, this is a civil war inside Yemen. There are not-so-good people on both sides of this civil war. The Houthis have been responsible for major, catastrophic acts in the country, just as the coalition has, but we are only on one side of that, so it makes sense for us to focus on the hostilities that have been entered into by the United States and the Saudi coalition. But let's for a second talk about the other implications for U.S. national security. What has happened inside Yemen as this civil war has persisted? Al- Qaida and ISIS have grown in strength. For a period of time, AQAP--the arm of al-Qaida inside Yemen that has the most direct intention to hit the United States--had captured a major port inside Yemen and was drawing substantial revenue, allowing them to become stronger than ever before. By continuing to feed weapons into this civil war, the United States is helping to expand the reach and the power of the two entities inside Yemen that the administration argues they do have authorization to fight--al-Qaida and ISIS. Many of us would draw issue with the interpretation of an AUMF passed a decade and a half ago as it applies to ISIS, but no doubt the administration has the ability to pursue war against al-Qaida, and al-Qaida is gaining strength because of the continuation of this civil war. If you talk to Yemeni-Americans, they will tell you that inside Yemen, this is not seen as a Saudi bombing campaign, this is seen as a U.S.-Saudi bombing campaign. And what they will further tell you is that Yemenis are becoming radicalized against the United States because there is a U.S. imprint on every bomb that is dropped and every single death inside that country. While we may talk a good game about humanitarian relief and we may enter into occasional efforts to settle this conflict through negotiations, all they know is that for 3 years the United States has been supporting a Saudi bombing campaign that does not end. We have been supporting a Saudi-led coalition that has blocked humanitarian relief from entering this country. We may hear a lot about the money that the Saudis are putting into humanitarian relief, but we don't hear as much about the fact that at one point they completely closed the port through which the majority of humanitarian relief flows. Although now it is technically open, they are still narrowing the channel greatly through which relief supplies get to this country. So nobody should applaud the United States or the Saudis for providing relief to a country that they, indeed, are bombing. I am not setting aside the culpability of the Houthis for substantial atrocities in this civil war as well, but we are only on one side of it. This is clearly covered by the powers vested in the U.S. Congress to make war. If it isn't, it unlocks a horrific Pandora's box. If the President can enter into hostilities against another country so long as all they are doing is providing vast logistical support to a coalition partner, then there is no end to what the President can do so long as he doesn't put a troop on the ground. Our involvement in the Saudi-led coalition has serious national security implications for the United States, aside from the fact that it has resulted in the deaths of thousands of civilians and has set off the worst humanitarian catastrophe the world has seen today. As a member of the Foreign Relations Committee, I just want to bring these consequences to bear for our colleagues to think about--our colleagues who might not think that this rises to the powers vested in the Congress by the Constitution. There are very few more serious conflicts with respect to consequences for the United States than this one. So I guess I would wrap back around that question that Senator Lee posed to Senator Sanders. If the United States doesn't weigh in here, then, when? What is the precedent that is set by Congress's continuing to remain silent even when you have a humanitarian catastrophe and a set of consequences for U.S. national security that are this big?

Mr. MURPHY. Mr. President, I thank Senator Sanders for the question. This is incredibly important to understand. There was great consternation in the beginning of this civil war, when the United States, under the Obama administration, was beginning to support the Saudi-led coalition. The Saudis were only targeting the Houthis, and as the al-Qaida wing inside of Yemen was getting stronger and stronger, no matter how much we asked, no matter how much we pushed, the Saudi-led coalition would not drop bombs on al-Qaida and would not send any of their forces near them. They were only focused on the Houthis. The answer as to why that was happening is very simple. The enemy of your enemy tends to be your ally, and inside Yemen, the Houthis were drawing fire from both the Saudi-led coalition and from al-Qaida. In the early stages of this fight, the policy of the Saudi-led coalition was to have hands off of al-Qaida, and that made al-Qaida stronger and stronger and stronger. Now, admittedly, recently we have been more successful in getting the Emirates, not necessarily the Saudis, to take on targeted missions against al-Qaida, but that is only a recent phenomenon, and it is frankly belied by the fact that we have new information that at the same time that the Emirates are occasionally taking out operations--and sometimes dangerous operations, with risk of life to their forces against al-Qaida--they are also supporting other militias inside Yemen--Salafist militias--that are in many ways just as radical as al- Qaida is and are recruiting the types of recruits that one day may join ISIS and one day may join al-Qaida, targeting against the United States. So this is a very chaotic space in which very purposefully, for a period of time, the coalition allowed for al-Qaida to grow. Even though that policy has changed recently, there are still signs that there are some people who are very dangerous to the United States who are being supported on the ground by members of our coalition. I know Senator Durbin is here, so I want to turn it over to him. I just want to say two more quick things on this point. One is to note that our resolution does continue to allow for the United States to target al-Qaida. We built into this resolution a carve-out for any military activities that are currently authorized by the 2001 AUMF, and the administration interprets that to be al-Qaida and affiliated follow-on organizations. So let's be clear that if you care about the United States targeting al-Qaida, that can continue here. Finally, to Senator Lee's point about this interpretation of hostilities, let's be clear about how narrow a definition that is. There have to be American troops on the ground exchanging fire in order for the War Powers Act to be triggered. That is not what Congress intended because, in fact, that would then allow the administration to perpetuate an unlimited air campaign, dropping unlimited munitions, devastating, ruining a country, without any input from Congress. Even if one would say ``Well, that does involve U.S. personnel flying overhead, so maybe that is potentially putting U.S. troops in the line of fire,'' remember, we are also entering an era of robotic warfare, in which U.S. personnel are going to be less instrumental to hostilities that will still have grave consequences for the United States. Clearly, the notion of war and how you fight it has changed over the years. The Founding Fathers never imagined air campaigns. Yet, the intent and the language of the War Powers Act and of the Constitution are clear. When war is being waged, when hostilities are being entered into, Congress has to have a say. Please, look at any of the pictures that we are putting before you and tell us that the United States is not engaged in hostilities if the effect in the country of Yemen is this. I thank Senator Durbin for joining us on the floor today, and I yield to him.

Mr. MURPHY

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

Mr. MURPHY

Mr. MURPHY. Mr. President, I hope we rise to the moment before us and get something done, over the course of the next week or two, to try to make this country safer. I am glad to be joining the President in a few hours to hear more about his thoughts on how we can put the safety of our kids ahead of any political considerations and try to figure out how to make sure that Parkland is the last. As I have told some of the kids from Parkland who have come into my office, the ripples of grief will never, ever end. Newtown, CT, is a place that has been fundamentally changed. When you lose that many young lives in a short period of time, there is no true recovery. Unfortunately, Parkland will find that as Charleston did, as Orlando did, and as so many did before them. We need to remember that while the country tends to pay attention to the epidemic of gun violence when there is a mass shooting, this is an epidemic that doesn't take a day off. Yesterday, it is likely that 80 to 90 people died from gunshot wounds. The majority of those were suicides. That is an epidemic in and of itself. A chunk of those were accidental shootings, another chunk of those were gun homicides; but the rate of gun deaths in this country just has no parallel anywhere else in the world. There is not another First World nation that has the rate of gun violence we do. In fact, it is not even close. The rate of gun violence in our country is 20 times higher than the average in the OECD. We have to remember that when we try to craft a public policy response, it just cannot be about school shootings. One is much more likely to die from an accidental gunshot than in a school shooting. We have to be comprehensive in our approach, which is why the Fix NICS Act just isn't good enough. I am proud Senator Cornyn and I and many others in this body came together to put forward a piece of legislation that will improve the background check system. It will make sure people who shouldn't buy guns aren't able to buy guns, but it is a modest change. In fact, it is really just about making sure people who are in law enforcement and inside the NICS system comply with existing law. It doesn't actually add any new background checks, it doesn't solve the gun show loophole, and it doesn't solve the internet loophole. So my hope is, we can bring this bill before the Senate, but then we can have a debate on other measures that might enjoy bipartisan support that will do 10 times more than fix NICS to keep this country safe. Let's talk about expanding background checks to make sure everybody who is buying a gun in a commercial sale has to prove they are not a criminal and prove they are not seriously mentally ill. Let's talk about the experience that Connecticut and Indiana has had in allowing courts to use protective orders to take away guns from people who are showing evidence of doing harm to the people around them. Let's have a conversation about whether we think it is right for people to be able to walk into schools with a gun equipped with a 30-round or 100-round magazine. I don't know if any of those measures will get 60 votes, but I think we owe it to the American people to not limit debate, to not shut down debate in the U.S. Senate Chamber. I know it is probably a scary thing for some Republicans that votes are changing. Many of my Republican colleagues have acknowledged they might be thinking about supporting things today that they might not have supported before. Because minds are changing, it behooves us to make sure we have a full debate on the floor of the U.S. Senate. I am supportive of the bill that Senator Cornyn and I have worked on. I hope it can become the foundation of a much more comprehensive set of measures that we take a look at in the coming days. I think we have to pay attention to where the American public is on this issue. I understand polls shouldn't dictate all of the decisions we make here. We pay attention to public opinion, we respond to it more often than not, but it doesn't guide every single decision we make because public opinion changes. On this issue, it has been a slow and steady build, the number of Americans saying the U.S. Congress bears responsibility for the epidemic of mass slaughter in this country because we have not changed a single gun law, except to make them weaker, since Sandy Hook. Remember, the only thing this Congress has done since Sandy Hook is allow hundreds of thousands of seriously mentally ill people to get weapons. That law was passed last year by the President--nothing to restrict guns. In fact, 97 percent of Americans want us to pass universal background checks. Apple pie isn't as popular as background checks are in this country today. No other public policy we are considering gets a 97- percent approval rating from the American public than universal background checks. Let's listen to that. Let's listen to them. I encourage Senator McConnell not to limit debate, not to constrain the Senate. Let's use this week and next week to have a set of measures we can debate and have up-or-down votes on, and let's hope, in the meantime, the President fleshes out what he is for and against. The President tweeted that he is in support of comprehensive background checks. Maybe later today we will find out if that is really true. Comprehensive background checks tend to mean the closing of the loopholes that exist, but hopefully the President can help lead us to a conclusion that is something much more than Fix NICS. As my colleague from Florida who has lived through the last several mass shootings in his State remarked, Fix NICS is simply not enough to meet this moment. I hope we build upon it in the coming days. I thank the Presiding Officer. I yield the floor.

Mr. MURPHY

Mr. MURPHY. Mr. President, as we speak, there is a horrific scene playing out in a high school in South Florida. Turn on your television right now, and you will see scenes of children running for their lives--what looks to be the 19th school shooting in this country, and we have not even hit March. I am coming to the floor to talk about something else, but let me note once again for my colleagues that this happens nowhere else other than the United States of America, this epidemic of mass slaughter, this scourge of school shooting after school shooting. It only happens here, not because of coincidence, not because of bad luck, but as a consequence of our inaction. We are responsible for the level of mass atrocity that happens in this country with zero parallel anywhere else. As a parent, it scares me to death that this body doesn't take seriously the safety of my children, and it seems as though a lot of parents in South Florida are going to be asking that same question later today. We pray for the families and for the victims. We hope for the best. Mr. President, I came to the floor today to talk about immigration. I want to make a specific case to you today, but before I do, I want to talk a little about process. I heard a lot of my friends on the Republican side of the aisle say on this floor and in the Halls of Congress that President Trump has made an immigration proposal and Democrats have been asking for an immigration proposal, so we should just accept his first and only offer. What is the big deal? President Trump gave you something that says ``immigration'' on it. Why aren't you accepting it? It is a terrible proposal. It is bad for America. To his credit, President Trump does attempt to try to deal with these Dreamer kids, but there are 3 million potentially eligible individuals in this country, and it only allows about 1.8 million of them to get through the process. But that is really not the worst part. The worst part is that it cuts legal immigration by 40 percent. It basically abandons this country's commitment to family-based immigration. I wouldn't be here if we only had skills-based immigration. Most Members of this body wouldn't be here if the only way that your parents or grandparents or great- grandparents could have come here is because of a Ph.D. or a degree or a certificate. Most of the people in this Chamber, I would imagine, are here because their parents or great-grandparents or great-great- grandparents came here because they had friends or family here. Let's not reimagine the history of this country. Democrats aren't obligated to accept the first offer from this President if it is not good for America. Negotiation still has to be part of the legislative process, and I am glad there are Members of the Republican and Democratic caucuses who have been trying to do that. We will see where that goes. The President has put this proposal on the table that dramatically cuts immigration into this country because he sees immigration as a core weakness of this country. He views new entrants to America as an economic drain. That is why he wants to potentially kick out 3 million Dreamer kids next month if we don't act. That is why he wants to dramatically cut down the number of people who are allowed to legally immigrate to America. He views immigrants as a problem that needs to be dealt with. And he is not alone. Many Americans agree. I, frankly, hear from them regularly in Connecticut. Frankly, one could also argue that there is nothing more American than being scared of immigrants. Every single new wave of immigrants to our shores has been met with some degree of fear and derision and prejudice. Like clockwork, every generation or two, American politicians denounce immigrants as a threat to the American-born worker. In the 1850s, growing numbers of Catholic immigrants from Ireland--as the Murphys came--and from Germany led to an anti-immigrant party arising in this country that elected more than 100 Congressmen, eight Governors, and thousands of local politicians. They claimed that Catholics could never be Americans because they owed allegiance to the Pope. Starting in the 1880s, hundreds of thousands of Chinese immigrants began to immigrate to the west coast, causing a spike in anti-Chinese sentiment that eventually resulted in the passage of something called the Chinese Exclusion Act. Fearing those who are different from us in skin color or religion or national origin or language is an unmistakable facet of American history, but over and over again, we have overcome these base instincts because our better angels prevail but also because of this bright, straight line that connects America's liberal immigration policy with our economic greatness. I want to take just a couple of minutes to make for you a compact but irrefutable case for the correlation between economic power and American immigrants. From 1870 to 1910, it is no coincidence that America's transformation into a global economic powerhouse occurred during a period of massive influx of human capital. During that time, nearly 15 percent of all Americans were foreign-born. That is a share that our country has never reached since then. This period of unprecedented growth forever dispelled the myth that we still labor under today that the number of American jobs is fixed. Immigrants increase demand, and that increased demand creates jobs. Organizations from the National Academy of Sciences to the conservative Cato Institute have done their own studies on this question and have come to the same conclusion. Cato recently said this: Immigrants add jobs, in part by raising consumer demand. So getting rid of immigrants, such as by deporting unauthorized workers, would most likely destroy jobs and raise native unemployment. That makes sense, right? But if you don't believe that immigrants create growth, there is another, even simpler explanation as to why we need robust immigration. At present birth rates, we don't have enough people born here to fill all the jobs that are going to be created in the next 20 years. It is estimated that, accounting for growth, America is going to need 83 million new workers to enter the workforce in the next 20 years. But here is the problem. Only 51 million new workers will be native-born. That leaves us 32 million short. Unless folks start churning out a lot more babies, immigration is the only way to fix that deficit. Not convinced? Well, think about how the Federal budget works. Most of our budget is social insurance--working-age Americans paying into accounts that pay benefits to older, nonworking Americans. You need a balance between the two in order to not go bankrupt. Many of our competitor nations around the world are spiraling toward this demographic cataclysm. By 2030, the median age in Japan, with strict immigration policies, is going to be over 50. It is extraordinary. Do you want to know why Germany is so interested in bringing refugees into their country? Because without them, their median age in 2030 will be 48. Budgets simply can't work with that many retirees and that few workers. Because of America's liberal immigration policy, our average age, which today is 38, will increase in 2030 to just 39. During that time, China--another country that doesn't really allow immigration-- will go from having a median age that is 2 years younger than that of the United States to 3 years older. In 2010, undocumented immigrants and their employers sent $13 billion to Social Security. Without them, the trust fund would be out of money today. You are not there yet? Let's talk jobs. Just ask your farmers in your State how important lower skilled immigration is to keeping their farms afloat. But let's talk about high-skilled jobs. Would it shock you to know that 31 percent of Ph.D. holders in this country are immigrants? It is amazing. And more than one-quarter of all high-quality patents in the United States are being granted to immigrants. How about a study from 3 years ago that Senator Cortez Masto referred to that found that immigrants are twice as likely as native-born Americans to start a business. That is not good enough for you? Here is a mind blower: 43 percent of Fortune 500 companies in the United States were founded or cofounded by an immigrant or a child of an immigrant. You know who they are. The founder of eBay came to the United States from France, where he was born to Iranian parents. Google's cofounder, Sergey Brin, emigrated with his family from Russia when he was 6. Elon Musk, who started SpaceX, which has 4,000 employees, came from South Africa. Daniel Aaron, who cofounded Comcast, was a refugee of Nazi Germany. Henry Ford was an Irish immigrant. Estee Lauder's family was Hungarian. Herman Hollerith, one of the founders of IBM, had German parents. You don't want Ford or IBM or Google to be part of the American story? Then keep saying immigrants are an economic drain. Margaret Thatcher once marveled of America: ``No other nation has so successfully combined people of different races and nations within a single culture.'' This combination is our definition as a nation, but it is also the story of our economic greatness, of our sprawling leap in under two short centuries from an idea to the biggest, most dynamic economy on the face of the planet. To deny that history or to misremember it would be perhaps an irreversible error. I yield the floor.

Mr. MURPHY

Mr. MURPHY. Mr. President, I come to the floor to express my opposition to the nomination of Alex Azar to be the next Secretary of the Department of Health and Human Services. Let me admit to the Chamber that this, for me, was certainly not as easy a call as was the first vote on the nomination for this position when Congressman Price was up for the job. I want to talk about the reasons for my vote in opposition, but I first want to begin by giving the nominee some credit for, I think, a very important series of exchanges that he had before the committee. One of the biggest potential disasters that would have been visited upon this country by 4 years of Secretary Price would have been the reversal of 8 years of transformation in the way that we pay for healthcare through Medicare, primarily. In 2011, Medicare made almost no payments to providers through what we call alternative payment models. I know this sounds a little weedy, but this is really the way that we drive down healthcare costs in this country, and it is something that Republicans and Democrats should be focused on together. Alternative payment models generally refer to a switch in the way that we pay for healthcare--a move away from reimbursing providers based on how much medicine they practice to a reimbursement system that rewards providers for the outcomes that they achieve--in fact, rewarding hospitals and doctors and clinicians when they keep their patients out of the doctor's office or out of the emergency room or out of the hospital. This is the exact opposite of what the existing system does, which rewards hospital systems and doctors the more that their patients show up in the emergency rooms and the doctors' offices and in the hospitals. In the House of Representatives, Tom Price was the leader of the opposition to what we call value-based payment and was the chief defender of fee-for-service payment. While the Obama administration had made remarkable progress--it had set a goal of moving 30 percent of all Medicare payments over to outcome-based payments, which they achieved by the end of 2016--Secretary Price was in the process of moving all of that backward. The reason I say that my vote here against Mr. Azar was not a slam dunk--it is not a slam dunk--is that I give him credit for his testimony on this question of alternative payments. In answer to a question posed by Senator Whitehouse, he said that one of the greatest legacies of Secretary Burwell's tenure was in the launching of so many of the alternative payment models that we have out there. I would like to keep driving that forward for all of us who care so deeply about reducing costs in our healthcare system, about integration and coordination, and in our just thinking about ways to deliver better for our patients and beneficiaries. There are so many opportunities for bipartisanship here because we share so many of the same goals on this. I applaud Mr. Azar for his seriousness about working with Democrats and Republicans to try to shift our payment system over to something that makes more sense, for his openness about how important the Obama- era reforms were, and for his decision, if he gets this job, to reverse some of the sabotaging of those alternative payment models that Secretary Price began. Unfortunately, my enthusiasm for Mr. Azar's statements on alternative payment models through Medicare are outweighed by his inability to convince the HELP Committee or the Finance Committee that he is going to be a responsible steward of the Affordable Care Act. This is from where much of my worry comes, in part because Connecticut is a State that has efficiently, ably, and responsibly implemented the Affordable Care Act. We have hundreds of thousands of people in our State who now have insurance because of the expansion of Medicaid and because of the successful offering of plans to the uninsured through Connecticut's exchange. It was perplexing to those of us on the HELP Committee that Mr. Azar seemed to defend the administration's decisions to sabotage and undermine the Affordable Care Act. He even went so far as to try to spin those changes as to be a strengthening of the law, which simply does not pass the straight face test. I get it. During a confirmation hearing, it is very hard for a nominee who may serve in the Cabinet to be critical of the Commander in Chief, the person who has chosen him for the job. Yet it is obvious for everybody to see what is happening by the canceling of payments to insurance companies that helped compensate them for the most expensive patients, by eliminating all of the funding for the marketing and advertising of the exchanges, by shortening the enrollment period in half, by constantly going on social media and telling all prospective enrollees of ObamaCare that the ACA is dead even though it is not dead--even though, as we found out, just as many people signed up this year as signed up last year despite the campaign to undermine it. We all know that this is an obvious campaign of sabotage--that President Trump is trying to kill the Affordable Care Act administratively because he can't convince the American public to press Congress to do away with it. The Affordable Care Act has the support of the American public today, and that is the reason Congress could not repeal it. It was very troubling to me that Mr. Azar didn't acknowledge this campaign of sabotage, which leads me to believe he is going to fulfill instructions from the administration, from the White House, to continue it. He went so far during the questioning with me to suggest that shortening the enrollment period actually would help consumers with something that the insurance companies were asking for. That is not true. The insurance companies were not asking for that in Connecticut. That does not help consumers, certainly, when you are also withdrawing all of the money for marketing and advertising that would have been used to tell people that the enrollment period was being shortened. At the same time that I am going to vote no on this nomination because I am deeply worried that as Secretary Mr. Azar is going to continue this campaign of ACA sabotage, I do look forward to working with him in a bipartisan way on payment reform--if he will allow it with those of us who will vote against his nomination. As much time as we spend in the Senate talking about coverage, frankly, the more important, long-term reform is in the changing of how we pay for healthcare because if we fundamentally change the way we pay for healthcare and start rewarding good outcomes rather than just rewarding more medicine being practiced, then we will save enough money to insure everybody in this country through a means that both the Republicans and Democrats can support. I am going to vote no. I encourage my colleagues who care about the effective administration of the Affordable Care Act to vote no. Remember, it is a remarkable success story that 20 million people have insurance. People know the strength of the Affordable Care Act. That is why they pressed Congress not to repeal it. Despite the undermining campaign, just as many people signed up this year as last year, which is, frankly, extraordinary. I would hope that those people here who believe in the Affordable Care Act, as the American people do, will oppose this nomination. At the same time, I hope that there are significant ways, if he is confirmed, that we can work together with Secretary Azar. I yield the floor.