Bernie Sanders

Mr. SANDERS

Mr. SANDERS. Mr. President, this is not a bad budget bill. It is a horrific budget bill, an extremely cruel bill, and the most unfair budget ever presented in the modern history of our country. At a time of massive income and wealth inequality, this budget provides $1.9 trillion in tax breaks for the top 1 percent. At a time when millions of working families are struggling to keep their heads above water, this budget cuts Medicaid by $1 trillion. Fifteen million Americans could lose their health insurance. This is a budget that poll after poll shows the American people do not want. Let us defeat it.

Mr. SANDERS. Mr. President, Chairman Enzi suggests that this is just a ``technical corrections amendment.'' Actually, that is not quite accurate. At a time when the United States spends more on defense than the next 12 countries combined, amazingly, this amendment paves the way for a $91 billion increase in defense spending in fiscal year 2018. This amendment would renew the Republican effort to repeal the Affordable Care Act and throw up to 32 million Americans off of the health insurance they currently have, increase premiums for older workers, and make even more harmful cuts to Medicaid. This amendment includes a provision requiring the use of so-called dynamic scoring, or what President George H.W. Bush appropriately referred to as voodoo economics, allowing the Republicans to claim that their massive tax breaks for the rich will pay for themselves. At a time when the cost of college education is skyrocketing, this amendment calls for dramatic cuts to student financial aid. I urge my colleagues to oppose this amendment.

Mr. SANDERS

Mr. SANDERS. Pursuant to section 904 of the Congressional Budget Act of 1974, I move to waive section 305(b)(2) of that act for purposes of the pending amendment, and I ask for the yeas and nays.

Mr. SANDERS. Mr. President, if we support children and we have the highest rate of childhood poverty of any major country on Earth, we will vote against this budget resolution, but I have no problems with Senator Heller's amendment. What I do want to do is spend a moment on the amendment that will come up next, and that is that it would establish a 60-vote budget point of order to prevent the top 1 percent of Americans--people who are doing phenomenally well--from receiving any future tax cuts. It is not a radical idea to suggest that at a time of massive income and wealth inequality, when the people on top are doing unbelievably well, at a time when the middle class is shrinking, now is not the time to provide hundreds of billions of dollars in tax breaks to the very wealthiest families in this country. Under the Republican proposal with the repeal of the estate tax, the Walton family--wealthiest family in America--would get up to a $50 billion tax break. Does anybody think that is vaguely sane? The Koch brothers, who have enough money to spend hundreds of millions of dollars electing rightwing candidates, will get a $30 billion tax break. I think the American people have been very clear, in poll after poll, saying not only do they not want to give tax breaks to billionaires but they correctly believe the wealthiest people in this country should start paying their fair share of taxes. Today the United States has more income and wealth inequality than at any time since the 1920s. Today the top one-tenth of 1 percent owns almost as much wealth as the bottom 90 percent. Twenty people in America own as much wealth as the bottom half of our country. According to a recent study by the Federal Reserve, the top 1 percent now own 39 percent of the Nation's wealth while the bottom 60 percent own just 3 percent. Since the Wall Street crash a decade ago, 52 percent of all new income has gone to the top 1 percent. If there was ever a time in American history not to be cutting Medicaid and Medicare and giving huge tax breaks to the 1 percent, this is that moment. I ask support for this amendment. I think Senator Wyden wanted to say a word.

Mr. SANDERS. Mr. President, this amendment says no to the cutting of $1 trillion from Medicaid and forcing 15 million Americans off the health insurance they currently have, while at the same time providing a $1.9 trillion tax break to the top 1 percent. This is not what the American people want; it is what the billionaire class wants. I make the radical suggestion that maybe we listen to ordinary Americans and not just wealthy campaign contributors.

Mr. SANDERS. With that, I yield the floor to my colleague from Pennsylvania Senator Casey.

Mr. SANDERS. Mr. President, the amendment from the Senator from Utah speaks about ``strengthening and improving'' Medicaid and Medicare. We don't strengthen and improve Medicaid by cutting it by $1 trillion, and we don't strengthen and improve Medicare by cutting it by $469 billion. That is Orwellian language. We should vote down this amendment and adopt the Sanders amendment which says: Let us give no tax breaks to billionaires while we cut Medicaid.

Mr. SANDERS. Mr. President, let me thank Senator Van Hollen for his very perceptive and comprehensive analysis of this budget proposal, which is designed to give huge tax breaks to people who don't need it and make terrible cuts to millions of families in this country who are struggling to keep their heads above water. I thank him very much for his remarks. For the past 10 months, my Republican colleagues in the Senate have tried and failed to slash Medicaid by hundreds of billions of dollars. Even though the American people have stood up and said ``Don't do it; Medicaid is just too important,'' they keep coming back and back and back. What I want to tell the American people today is, despite the fact that we were able to prevent cuts to Medicaid in the so-called Republican healthcare proposals, they are back again in this budget proposition calling for a $1 trillion cut in Medicaid over the next decade. Meanwhile, as Senator Van Hollen just pointed out, these cuts are designed to provide a $1.9 trillion tax break to the top 1 percent. There may be some people who think it is a good idea to cut healthcare for working families and give tax breaks to billionaires. There may be some people, but I don't think there are a lot of people who think that makes any sense at all. So the amendment I am offering today, along with Senators Casey and Stabenow--which I believe will be voted on at 3 p.m.--is very simple and straightforward. It would simply prevent the Republicans from cutting Medicaid by $1 trillion, and it would be fully paid for by stopping the Republican effort to give the wealthiest people in America another tax break. Plain and simple, this budget resolution is nothing more than a massive transfer of wealth from working families to the very rich, with huge tax breaks for billionaires and terrible cutbacks on programs that working families desperately need. At a time when the middle class of this country continues to shrink, when families in the State of Vermont and all across this country are struggling to make ends meet, struggling to put food on the table, put gas in the car, pay their electric bill, pay their health insurance, maybe put away a few bucks to send their kids to college, it would be highly immoral and bad economic policy to take from these working families, to take from America's senior citizens, to give even more to the wealthiest people in this country--people, by the way, who are already doing phenomenally well. At a time when 28 million Americans have no health insurance and millions more are underinsured with high deductibles and high copayments, at a time when so many of our people cannot afford the prescription drugs they desperately need, cutting Medicaid by over $1 trillion would throw at least 15 million Americans off of the health insurance they currently have. It is beyond my comprehension how anyone with a conscience could support legislation that throws 15 million people off of the health insurance they have. Think for a moment about people who are struggling with cancer, struggling with heart disease, struggling with diabetes, struggling with life-threatening illnesses, and they have Medicaid. Medicaid is their lifeline to the healthcare they need. I hope the Presiding Officer will get up here at some point and tell the American people what happens to those folks when they lose their Medicaid. Have you done any studies as to how many people will die? The truth is, there have been studies that have been done, and the answer is that thousands and thousands of people every single year will die if Medicaid is cut for 15 million people who lose their health insurance. Let me say what happens when you cut Medicaid by over $1 trillion nationwide over a 10-year period. What it means is that not only will thousands of our fellow Americans die, it also means that a child with a severe disability--perhaps with Down syndrome or some other serious problem--will no longer be able to get the healthcare they need to adequately function. An estimated 11 million children--or 15 percent of all kids in the United States--have special healthcare needs. They may have conditions such as cerebral palsy, muscular dystrophy, autism, or one of a host of other serious problems. They may have mental health needs, such as depression, anxiety, or complications from a premature birth. Today, Medicaid covers 5 million--or 44 percent--of these children, providing them with coverage so that many of them can live at home with their families. In addition to standard healthcare services, Medicaid helps these children get special education at school, long-term care, personal assistance from nurses and attendants, and may cover technology that helps them thrive. Medicaid may also cover social workers to help parents of children with special health needs make sense of all the bureaucratic redtape and get the services they need for their kids. Medicaid provides these children with quality care. Ninety-two percent of children enrolled in Medicaid have had a primary care visit in the past year, which is higher than families with private insurance. If Medicaid is cut by $1 trillion over a 10-year period, children with special needs could be left to fend for themselves. What a terrible thing that is to do to families who are struggling today, to tell them that you are going to remove the support they get for their child who has a disability. It is not just the children who will suffer if this bill is passed. It is our parents. It is the senior citizens of this country. What every person should know--and I fear many do not know--is that Medicaid now pays for over two-thirds of all nursing home care. Let's think about this for a moment. What happens if there is a $1 trillion dollar cut over 10 years to Medicaid? What happens to our parents and our grandparents and people with disabilities in America who have their nursing home coverage paid for by Medicaid today? I may be wrong, but I don't recall that there has been one hearing to hear from groups like the AARP, to hear from senior citizen groups, to hear from doctors, to hear from nurses, to hear from nursing homes as to what the implications are of a $1 trillion cut in Medicaid and what it means to the families in this country who have loved ones in nursing homes. There may have been a hearing. I don't believe there has been. My Republican colleagues are going forward with this disastrous cut without even knowing what the implications are, not having heard from one expert about what this legislation would mean. Tragically, all of us know that our country is in the midst of an opioid epidemic, which has hit my State of Vermont very hard, and it is hitting virtually the entire country. This is quite unbelievable, but each and every day, more than 90 people die in our country from an opioid overdose, nearly 4,000 people every day begin abusing prescription painkillers, and--it is almost unthinkable but true-- almost 600 people start using heroin every single day. How horrible is that? Today, Medicaid covers one out of every three Americans who are addicted to opioids. Opioid treatment is difficult. It is expensive. It is not always successful, but I dare say there is virtually not one State in the country--I know my State is trying hard, we do better than most--that can say they now have the treatment capabilities available for people who are hooked on opioids or on heroin. If we cut Medicaid by $1 trillion, there is no question--none whatsoever--that there will be a massive reduction in the kind of care available to people who have opioid or heroin addiction. I find it hard to understand why my Republican colleagues would come up with legislation that would do so much harm to the working families of this country with a $1 trillion cut in Medicaid--and some of my colleagues in a few moments will talk about a proposed $470 billion cut to Medicare and what that would mean--all to give incredibly large tax breaks to billionaires like the Walton family, like the Koch brothers, like the Trump family. I would hope my Republican colleagues understand that what they are proposing is way out of touch with where the American people are. According to a recent Quinnipiac poll, 60 percent of Americans oppose cutting Medicaid. A recent Wall Street Journal/NBC poll finds that only 12 percent of the American people believe the wealthy should receive a tax cut. Twelve percent believe the wealthy should receive a tax cut, while 62 percent believe the wealthy should pay more in taxes. In other words, what this legislation does is exactly the opposite of what the American people want. On the other hand, we must be honest about it and acknowledge that we have an extremely corrupt campaign finance system. As a result of Citizens United--that disastrous Supreme Court decision--our campaign finance system has become even worse than it used to be. You have an example of where the American people say overwhelmingly: Don't cut Medicaid. Don't cut Medicare. Don't give tax breaks to the rich. In fact, ask the wealthy to start paying their fair share of taxes. That is what the American people are saying in poll after poll. There is another group--and we have to be honest about that--who do believe that billionaires should get more tax breaks, and there is a group that believes we should cut Medicare and Medicaid. Unfortunately, those are the people who make hundreds of millions of dollars in campaign contributions to the Republican Party. Those are people like the Koch brothers and a few of their billionaire friends--a small of group people, half a dozen, 10 people--who will contribute $3 to $400 million to elect candidates who represent the wealthy and the powerful, just in this 2-year election cycle--$3 to $400 million. What this debate is about is not what the American people want. The American people are pretty clear about it. It is really about what the billionaire class wants. The billionaire class, despite the fact that their wealth has increased phenomenally, despite the fact that the top one-tenth of 1 percent now owns almost as much wealth as the bottom 90 percent, that is not good enough. The Koch brothers are only worth $90 billion. How are you going to get by on $90 billion? How do you take care of the kids? How do you put gas in the car? Only $90 billion. They need more. If this legislation goes through and if the estate tax is passed--and I know people think I am not telling the truth because it is so unbelievable that anyone would propose this, but I am telling the truth--the Walton family, the wealthiest family in America, worth well over $100 billion, could get up to a $50 billion tax break. The Koch brothers, the second wealthiest family, worth over $90 billion, their family, their heirs will get over a $30 billion tax break. So from their perspective, putting a few hundred million dollars to help elect some Republicans is pocket change if your family is going to get a $30 billion tax break. Let me just say, the legislation brought forth is really quite preposterous. It is based on a trickle-down economic theory of giving tax breaks to billionaires and corporations and seeing all kinds of new jobs being created. It is a theory that is fraudulent, doesn't work, hasn't worked, but it is legislation--legislation we are dealing with here--that does work very well for the billionaire class of America. I have the radical idea--I know it is a radical idea--that maybe, just maybe the U.S. Senate should pay attention to the needs of the middle class, the working class, and lower income people in this country, the vast majority people, and not just a handful of billionaires. Mr. President, I ask unanimous consent that Senator Warren and Senator Bennet be added as cosponsors to my amendment to restore the $1 trillion in cuts to Medicaid, amendment No. 1119.

Mr. SANDERS. Mr. President, this is a very simple and straightforward amendment. It would establish a 60-vote budget point of order to prevent the top 1 percent of Americans, people who are doing phenomenally well, from receiving any future tax cuts. At a time of massive income and wealth inequality in this country, when the very rich are becoming richer while most Americans are seeing a decline in their standard of living, this is not the time to give tax breaks to people who don't need them. I urge a ``yes'' vote on the Sanders-Wyden amendment.

Mr. SANDERS. Mr. President, I ask unanimous consent that Senator Cantwell be added as a cosponsor to amendment No. 1119 and that Senator Stabenow be added as a cosponsor to amendment No. 1120.

Mr. SANDERS

Mr. SANDERS. Mr. President, I ask unanimous consent to be permitted to complete my remarks before the Senate recesses.

Mr. SANDERS. Mr. President, I know that budgets are not particularly sexy and exciting discussions. A lot of people wonder about a trillion here and a hundred billion there and what it all means. It means a lot. What it means is that if this horrific Republican budget is implemented, it will mean an enormous amount of pain for tens of millions of working-class, middle-class, and lower income people in this country. That is what this budget means. After failing to pass a so-called healthcare bill that would throw up to 32 million Americans off of the health insurance they currently have--a bill that was widely opposed by the American people--Donald Trump and the Republican leadership are back again. While I totally disagree with what they are trying to do, I do appreciate their temerity. They are not giving up in terms of trying to protect the interests of the billionaire class against the vast majority of the American people. The Republicans are now pushing one of the most destructive and unfair budget and tax proposals in the modern history of the United States--a plan that would do incalculable harm to tens of millions of working families, our children, the sick, the elderly, and the poor. The Republican budget we are debating on the floor of the Senate this week is the Robin Hood principle in reverse. Robin Hood took from the rich and gave to the poor. What this budget does is take from working people, the middle class, the elderly, and the poor to give massive tax breaks to people who are already living in incredible opulence. Donald Trump and the Republican leadership claim that their plan would provide a ``big league'' tax cut for the middle class. Nothing could be further from the truth. According to the Tax Policy Center, by the end of this decade, nearly 80 percent--underline 80 percent--of the tax benefits of the Republican plan would go to the top 1 percent. Even more incredibly, the top one- tenth of 1 percent would receive some 40 percent of the tax breaks over a 10-year period. A tax proposal which gives 80 percent of the benefits to the top 1 percent and 40 percent of the benefits to the top one- tenth of 1 percent is not a tax proposal benefiting the middle-class or working families of this country; it is a tax proposal designed to benefit the wealthiest people and the campaign contributors of the billionaire class. This budget cuts Medicaid by more than $1 trillion over a 10-year period. That is kind of strange. The United States of America is the only major country on Earth that does not guarantee healthcare to all people. What the American people want, in my view, is to join the rest of the world and understand that healthcare is a right, that we should not have 28 million people without any health insurance and even more underinsured with high deductibles and high copayments. Yet what this budget does, unbelievably, is throw 15 million people off of the health insurance they have with a trillion-dollar cut in Medicaid. I would hope that my friend the chairman of the Budget Committee might at some point during this long debate tell us what happens to somebody today who is struggling with cancer, with heart disease, with diabetes, with a life-threatening illness, who suddenly loses the Medicaid health insurance they have. What happens to that person? I would hope that some of my Republican friends would tell the American people what happens, because study after study tells us what will happen, and that is that thousands of people will lose their lives. They will die because they will no longer have access to the health insurance they had. Further, this budget does what Republicans have not yet attempted to do during the past year in their so-called healthcare legislation, and that is to make a $473 billion cut to Medicare. So it is not only a trillion-dollar cut to Medicaid, it is also a $473 billion cut to Medicare. Interestingly enough, I think many Americans will recall that during his campaign for President, Donald Trump told the American people that he would not cut Social Security, Medicare, and Medicaid. He said that over and over again. On April 18, 2015--this is just one quote of many--Mr. Trump said: Every Republican wants to do a big number on Social Security, they want to do it on Medicare, they want to do it on Medicaid. And we can't do that. And it's not fair to the people that have been paying in for years and now all of a sudden they want to be cut. That is Donald Trump running for President. Well, I would say to President Trump: That is what you told the American people during your campaign, and now I hope you will tell your Republican friends right here in the Senate that they should respect the campaign promises you ran on and that if they pass a budget that cuts Medicare or Medicaid, you will veto that legislation. I hope the President has the integrity to do that. I don't think he will, but I hope he does that. Poll after poll tells us that the overwhelming majority of the American people do not want Congress to cut Medicare or Medicaid. In fact, I think in this country today, if you ask people what their deepest concerns are, they are concerned about jobs, and they are concerned about income. I think even more so they are concerned about the healthcare they have, how much it costs, and whether they are going to have it tomorrow. Poll after poll tells us that the American people do not want Congress to cut Medicare--which, by the way, is the most popular health insurance program in this country--and they don't want to see Medicaid cut either because they know, among other things, that about two-thirds of nursing home dollars come from Medicaid. So if you have a mom or a dad dealing with Alzheimer's or some other terrible illness in a nursing home and massive cuts to Medicaid are made, what is going to happen to your parent who is in a nursing home? People know that. They do not want to cut Medicare and Medicaid. A recent Pew Foundation poll finds that 85 percent of Republicans and 94 percent of Democrats want to either maintain or increase funding for Medicare. Sixty percent of Americans oppose slashing Medicaid, according to a recent Quinnipiac poll. A recent Wall Street Journal and NBC poll finds that only 12 percent of the American people believe the wealthy should receive a tax cut, while 62 percent believe the wealthiest people in our country should pay more in taxes. You have the American people saying: Don't cut Medicare. Don't cut Medicaid. Don't give tax breaks to billionaires. In fact, ask them to pay more in taxes. That, by and large, is where the American people are coming from, whether Democrats, Republicans, or Independents. Then the question arises: Why is the Republican leadership bringing forward a budget that does the exact opposite of what the American people want? The answer to that question, I am sorry to say, is not complicated. It has everything to do with a corrupt campaign finance system that allows billionaires and the wealthiest people in this country to exert their influence over the political process. Increasingly, it is not the ordinary American middle-class worker the Congress listens to, but it is wealthy campaign contributors. Today, we have a corrupt campaign finance system that enables multibillionaires, along with some of the most powerful CEOs in America, to contribute many hundreds of millions of dollars to the political process. Many of us believe that the concept of democracy is one person, one vote. You get a vote, and I get a vote. Sometimes you win; sometimes you lose. The majority wins. That is what we teach the children in the fifth grade and sixth grade: One person, one vote, majority wins. Unfortunately, as a result of the disastrous Citizens United Supreme Court decision, the American campaign finance system has been totally corrupted. We now have a situation where billionaire families can spend unlimited sums of money to help elect candidates who protect their interests, and not only can they spend that money, that is exactly what they are doing. There was a very interesting article in the Boston Globe just the other day, October 14. This is what the article says. The headline is: ``The Koch brothers (and their friends) want President Trump's tax cut. Very badly.'' This is what the article says--but first, I should say a word about the Koch brothers. Not everyone knows who they are. The Koch brothers are the second wealthiest family in America. They are struggling to catch up to the Waltons. They are not quite there. They are worth only $90 billion. They are struggling, but they are getting by, I am happy to tell you. With that $90 billion, what they are doing, along with a few of their friends, is spending hundreds of millions of dollars every campaign cycle to elect people, in this case Republicans, who support their agenda. This is what the article says: The message from the billionaire-led Koch network of donors to President Trump and the Republican Congress it helped to shape couldn't be more clear: Pass a tax overhaul, or else. As the donors mixed and mingled for a policy summit at the St. Regis hotel in midtown Manhattan last week, just a block south from Trump Tower, it came up again. And again. And again. ``It's the most significant federal effort we've ever taken on,'' said Tim Phillips, president of Americans for Prosperity, a Koch-aligned group with offices in 36 States. ``The stakes for the Republicans, I've never seen them this high.'' Many in the Koch network, a vast group of libertarian- leaning nonprofits and advocacy and political organizations, described the upcoming legislative push for a tax overhaul as an inflection point in modern political history, a do-or-die moment that would define whether their efforts over the years will pay off or not. The network leaders plan to dedicate much of their two-year $400 million politics and policy budget to the effort--though they wouldn't give an exact number. That is $400 million in the next two years to pass this piece of legislation. This comes from a family, the Koch brothers, who are pretty upfront about what they believe. They do not want to cut Social Security or Medicare and Medicaid. They will take that, but that is really not their goal. They want to eliminate Social Security, Medicare, Medicaid, and virtually every other Federal program that provides help to the working families of this country. By the way, just in passing, if the estate tax, which is part of the Republican budget, is repealed, we might want to mention that the Koch brothers' family would see a benefit of some $30 billion. If your family is going to get a $30 billion benefit, then putting a few hundred million dollars into seeing that legislation passed is not a difficult idea. This budget makes clear who the Republicans in Congress are listening to, and it is not the middle class or the working families who do not want to see Medicare cut or Medicaid cut and who certainly do not want to see a $1.9 trillion tax break for the top 1 percent. I am afraid that my Republican colleagues are listening to their top campaign contributors who have told the Republican Party, in no uncertain terms, that if they do not get their tax cuts, they will stop providing the Republicans with hundreds of millions of dollars in campaign contributions. How sad is that? Think about the incredibly brave Americans who have fought for democracy over the years. Some of them never return from the battlefields where they have fought for an American democracy that makes us a country where people rule. Abraham Lincoln reminded us that we are a ``government of the people, by the people, for the people,'' not a government of the billionaires, by the billionaires, and for the billionaires. Let's be clear about something else. The entire economic theory that Senate Republicans and President Trump have embraced with this budget is called trickle-down economics. That is what it is. You give tax breaks to billionaires and large corporations, and the benefits trickle down. They improve the economy. This whole theory is a fraud, and when applied, it has been an abysmal failure. Since Ronald Reagan and George W. Bush slashed taxes on the wealthy and deregulated Wall Street, trillions of dollars in wealth have been redistributed from the middle class and working families to a handful of millionaires and billionaires. Today, we have more wealth and income inequality than at any time since the 1920s. Today, the top one-tenth of 1 percent owns almost as much wealth as the bottom 90 percent. This budget would make a bad situation even worse by widening that gap with its trillions in cuts to social programs and gifts to the top 1 percent. The Republican budget we are debating today would make horrific cuts to the needs of working families. Let me give you a few examples. This budget would give the wealthiest family in America, the Walton family of Walmart, a tax cut of up to $52 billion. Does anyone in their right mind think that the wealthiest family in this country needs a tax break of up to $52 billion? They do that by repealing the estate tax. At the same time, however, if you are a low-income senior citizen-- and we have too many of them in the State of Vermont--trying to figure out how to keep warm in a cold winter, you and 700,000 other senior citizens and families might not be able to keep your home warm in the winter because of a cut of about $4 billion to the Low Income Home Energy Assistance Program. This budget says that if you are the second wealthiest family in America, the Koch brothers, your family will see a tax break of up to $33 billion. But if you are a working class kid right now in high school in Vermont or in Texas or in Wyoming and you are scratching your head as to how you can afford to go to college and, in your computations, you are looking at what a Pell grant might mean to you, this budget would cut over $100 billion in Pell grants and other financial assistance programs. This budget gives members of the Trump family a tax cut of up to $4 billion. But if you are a low-income, pregnant woman, you and over a million other new moms, babies, and toddlers may not be able to get the nutrition you need, thanks to a $6.5 billion cut to the Women, Infants, and Children Program, the so-called WIC Program. At a time when millions of working-class families all across this country are paying 40 percent or 50 percent or more for the housing they need, this budget eliminates housing assistance for more than a million families due to a cut of about $37 billion to the Section 8 rental assistance program and other housing programs. At a time when the cost of childcare has skyrocketed, which is a very serious problem in my State, the Republican budget eliminates Head Start services for 25,000 children each and every year by cutting this program by some $3 billion. In total, the Republican budget would cut more than $5 trillion from education, healthcare, affordable housing, childcare, transportation, and other programs that working people desperately need over the next decade. What is alarming is that despite this incredible giveaway for the billionaire class, the Koch brothers and their network say that it is not enough. They want more. Let us be very clear that their eventual goal--not today, not tomorrow, but their eventual goal is to see that programs like Social Security, Medicare, and Medicaid are completely eliminated. Let me conclude by saying that this budget is not a budget for the people of Texas. It is not a budget for the people of Vermont or the people of Wyoming or the people of the United States of America. This is a budget for the billionaire class, which today is already doing phenomenally well. This is a budget for campaign contributors whose greed has no end, who provide millions of dollars to candidates who represent their interests. This is a budget that must be opposed by the American people. I urge the American people to tell their Members of the Senate to vote no on this budget. With that, I yield the floor.

Mr. SANDERS

Mr. SANDERS. Mr. President, after failing to throw 32 million Americans off of the health insurance they currently have last week, the Republicans are continuing their attack against the working families of our country with one of the most destructive budgets in American history. I know the American people today, for very good reason, are preoccupied with the horror of what happened in Las Vegas, and people are horrified about what has happened in Puerto Rico, but I would beg of the American people to please pay attention to the budget proposal and the so-called tax reform ideas brought by the Republican leadership in the Senate, as well as in the House. This proposal would cause devastating economic pain for tens of millions of Americans by, on the one hand, giving incredibly large tax breaks for the wealthiest people in the country, while at the same time making it harder for our children to get a decent education, harder for the families of this country to get the healthcare they need, harder for families, literally, to put food on the table, harder to protect our environment, and harder for the elderly to live their retirement years with dignity. This is the Robin Hood proposal in reverse. The Robin Hood principle in reverse is that instead of taking from the rich to help the poor, this proposal makes massive cuts in programs desperately needed by the middle class and working families of our country, precisely to give unbelievably large tax breaks to the people on top--the people who least need those tax breaks. At a time of massive income and wealth inequality, where we have more inequality today than at any time since the 1920s and more inequality than almost any major country on Earth, where the very, very rich are becoming much richer and we have 40 million people living in poverty and tens of millions of middle-class families are going nowhere in a hurry, this Republican budget, according to the Tax Policy Center, at the end of 10 years, would provide 80 percent of the tax benefits to the top 1 percent. Right now, today, the rich are doing phenomenally well. Everybody understands that. The middle class is shrinking. But according to the nonpartisan Tax Policy Center, by the end of the decade, nearly 80 percent of the tax benefits in the Republican plan would go to the top 1 percent--under this plan, this Republican plan. The top one-tenth of 1 percent, the richest of the rich, would receive a tax break of over $1 million a year. At a time when so many of our families are struggling to put food on the table, struggling to figure out how to send their kids to college, struggling to figure out how to pay for childcare, we have a Republican tax proposal that would provide trillions of dollars in tax breaks to the richest people in this country. This is a budget that would increase the Federal deficit by $1.5 trillion over the next decade. We have heard on the Senate floor my Republican friends talking about how worried they are about the $20 trillion national debt and how high the deficits are. This proposal, designed to give tax breaks to the wealthiest people in this country, would increase the Federal deficit by $1.5 trillion over the next decade, and, by the way, this is a conservative estimate. There are those who think the deficit would go up a lot more than that. This is a Republican proposal that eliminates the estate tax. What is the estate tax? Republicans name it the ``death tax,'' but let us be clear about what this tax is and who benefits from it. Despite Republican efforts trying to find farmers or ranchers who would benefit from it, this is not legislation designed to help farmers or ranchers. This is legislation designed to help the top two-tenths of 1 percent. So 99.8 percent of the American people will not benefit one nickel from the repeal of the estate tax. Only the wealthiest of the wealthy will benefit. If this Republican proposal to repeal the estate tax would go through, the Walton family of Walmart, the wealthiest family in America, would receive a tax cut of up to $52 billion. Does anybody for one second think that, at a time when so many of our people are struggling and when we have a $20 trillion national debt, we should be passing legislation that gives the wealthiest family in this country up to a $52 billion tax break by repealing the estate tax? But it is not just the Walton family, of course. This is a budget that says that if you are the second wealthiest family in America, the Koch brothers--and this, by the way, is just coincidental, no doubt. I know it is amazing how these coincidences take place. The Koch brothers are a family who contributed hundreds of millions of dollars year after year to the Republican Party to elect candidates who represent the wealthy and powerful. Just coincidentally, that family would receive a tax break of up to $38 billion. People ask why the Koch brothers are contributing hundreds of millions of dollars every campaign cycle. That is a huge amount of money. That is a huge amount of money for normal families, but when you are the second wealthiest family and you have a tax break of $38 billion, contributing a few million dollars every campaign cycle is pocket change and is a good investment. This is a budget that will cut Medicare by $450 billion. Right now in this country, we have millions and millions of seniors who are struggling to make ends meet. They can't afford their prescription drugs. They can't afford to keep their homes warm in the wintertime. Yet this Republican budget would cut Medicare by $450 billion. Now, the Republicans tried, time after time, despite massive opposition from the American people, to repeal the Affordable Care Act. In every one of their pieces of legislation, they made devastating cuts in Medicaid. Well, they are back again. Ostensibly, this is not a healthcare piece of legislation. It is a budget. It is so-called tax reform. There is $1 trillion of cuts in the Medicaid Program. So if you were worried last week, 2 weeks ago, and 1 month ago about what the terrific Republican healthcare bills would do, stay worried because this bill will cut $1 trillion over 10 years in Medicaid, resulting in at least 15 million Americans losing their health insurance. Can you imagine a set of priorities that says that we are going to throw 15 million people off of health insurance in order to give tens of billions of dollars in tax breaks to the wealthiest families in this country? Unbelievable. It really is unbelievable. This proposal not only adds to the deficit, not only makes massive cuts to Medicare and Medicaid, it also impacts the American people in many ways. We have a program in this country called the Women, Infants, and Children Program, and at a time when the United States has the highest rate of infant mortality of any major country on Earth, what we do to try to deal with that issue is provide help to low-income pregnant women and their babies after the babies are born. This Republican budget would make about $6.5 billion in cuts to the WIC Program, eliminating nutrition assistance to over 1.2 million pregnant women, new moms, babies, and toddlers in Vermont and all over this country. Here are the priorities: Tax breaks for the Walton family, for the Koch brothers' families, who are billionaires, and cuts in programs for low-income, pregnant women who want to have healthy babies. At a time when the cost of childcare has skyrocketed all over this country--in the State of Vermont, it is a very serious problem; families cannot find affordable childcare--the Republican budget eliminates Head Start services for 25,000 children each and every year by cutting this program by about $3 billion. In total, the Republican budget would cut more than $5 trillion from education, healthcare, affordable housing, childcare, transportation, and other programs the working families of this country desperately rely upon. Let's be clear about something else. This is not me talking; Republican economists are saying the same thing. What is the theory underlying this whole approach of giving tax breaks to billionaires? The theory is that when you give tax breaks to billionaires and large, multinational corporations, somehow or another, they are going to start using the new revenue they acquire to invest in the economy and create decent-paying jobs. This is the so-called trickle-down economic theory, and this is a theory that Senate Republicans and President Trump have embraced with this budget. The fact is that anyone who looks at history understands that whole theory is a fraud. It has always been an abysmal failure. Since Ronald Reagan and George W. Bush slashed taxes on the wealthy and deregulated Wall Street, trillions of dollars in wealth have been redistributed from the middle class and working families to a handful of millionaires and billionaires. That is what trickle-down economics results in--a transfer of wealth from the middle class to the people on top--and that is exactly what this Republican proposal will do. Today we have more wealth inequality than at any time since the 1920s. Unbelievably, the top one-tenth of 1 percent now owns almost as much wealth as the bottom 90 percent. This budget would make a very bad situation worse, and it would increase the level of wealth inequality in America today. As the ranking member of the Budget Committee, I intend to do everything I can to oppose this absurd set of priorities, and when I do that, I am speaking for the vast majority of the American people. Poll after poll after poll tells us that the American people do not think billionaires need more tax breaks. Poll after poll after poll tells us that the American people do not agree with the Republican leadership when they want to throw millions of people off of the health insurance they have. This is not a budget for the American people. This is not a budget for economic growth. This is a budget paid for and fought for by the Koch brothers and a handful of billionaires who will gain very handsomely if this budget were to be passed. I would remind my Republican colleagues--and this is not a very radical idea--that we were elected to the Senate not just to represent a handful of billionaires; we were elected to the Senate to do our best for the middle class and working families of our country. This should not be legislation designed as payback for hundreds of millions of dollars in campaign contributions. We need to pass legislation that protects the interests of working families and the middle class and lower income people. Thank you, Mr. President. (Mr. STRANGE assumed the Chair.)

Mr. SANDERS

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

Mr. SANDERS

Mr. SANDERS. Mr. President, I think I will shock nobody by telling the Chair that I disagree with almost every policy President Trump has brought forth. No, I do not believe that we should throw 23 million Americans off of health insurance and give hundreds of billions of dollars in tax breaks to the top 2 percent. No. I happen to believe that at a time of massive income and wealth inequality, it is high time for the wealthiest people in this country and for large, profitable corporations to start paying their fair share of taxes. No, I do not believe, as President Trump does, that we should cut Pell grants and food stamps and afterschool programs and Medicaid and nutrition programs for pregnant women and heating assistance programs. I believe that in the wealthiest country in the history of the world, we must protect those who are the most vulnerable. No, I do not believe, as President Trump does, that climate change is a hoax. I believe it is the greatest environmental crisis facing our planet and that it is already causing devastating harm throughout our Nation and throughout the world and on and on it goes. There is very little in public policy on which I agree with the President, but there is one area in which my disagreement with President Trump goes much deeper than public policy. The truth is, every President in recent history, including conservative Presidents like George W. Bush and liberals like Barack Obama, has understood that one of the prime functions of being President of the United States is to bring the people of our country together, whether you are Black or whether you are White or whether you are Latino or whether you are Asian American or whether you are Native American. Every President has instinctively understood that one of the prime responsibilities of a President is to bring our people together as proud Americans. Unfortunately and tragically, this is something Donald Trump does not understand. At a time when this country faces so many serious crises, whether it is the high cost of healthcare, whether it is climate change, whether it is the proliferation of low-wage jobs and a starvation minimum wage, whether it is the huge national debt we face, whether it is inadequate educational opportunities, whether it is a broken criminal justice system, instead of bringing our people together to address those important issues and trying to solve them, what this President is doing, uniquely in modern history, is trying to divide us up by the color of our skin, by our sexual orientation, by the country we were born in, by our religion. Instead of bringing us together to solve the many problems we face as a people, he is trying to divide us up in order to gain political support from a segment of our population. He is trying to divide us up based on the color of our skin, which is what his attacks on affirmative action are all about. He is trying to divide us up based on religion, which is what his Muslim ban is all about. We are not supposed to like Muslims. He is trying to divide us up based on sexual orientation, which is what his attacks on transgender individuals serving in the military is about. We are supposed to hate transgender people and discriminate against them, and he is trying to divide us up based on our country of origin and our immigration status. In my view, Trump's decision to end the DACA Program for some 800,000 young people is the cruelest and most ugly Presidential act in the modern history of this country. I cannot think of one single act which is uglier and more cruel. These are 800,000 young people--often exemplary young people--the kind of kids we are proud of. These are kids who know this country--the United States of America--as their only home. In fact, many of these young people know English as their only language. These are young people who today are in college, they are in law school, they are in medical school, and they are proudly serving in the U.S. military. What this President has done is to take away the legal status by which these young people can work and find jobs, go to school, and live without fear. If they don't have that legal status, it means that anytime they walk down the street, they are frightened they could be arrested and deported from this country and separated from their families. This act, on the part of Donald Trump, is an abomination, and Congress must reject Trump's action and pass DACA into law. This is exactly what the American people want us to do. A recent poll--I think it came out yesterday--done by Morning Consult and Politico reports that 76 percent of those who were polled said the government should allow immigrants brought to the United States illegally as children to remain here--76 percent. Eighty-four percent of Democrats support the Dreamers having legal status, while 69 percent of Republicans surveyed also favor such a policy. In another poll in April of 2017, 73 percent of Trump supporters said Dreamers should be allowed to stay in the United States and become legal residents. In other words--and I say this to the young people who are in DACA--please do not think for one moment that you are being deserted by the people of this country. You are not. You are being attacked by a President of the United States who chooses to divide us up, and you are today's victims. Tomorrow it may well be another minority group. So this is a pivotal moment in American history, and we need to tell those young people that we will not see their legal status removed. We will not see them thrown out of the only country they have ever known. We need strong, bipartisan support to pass the Dream Act, and I hope we will do that as soon as possible. Thank you, Mr. President. I yield the floor. I suggest the absence of a quorum.

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

Mr. SANDERS

Mr. SANDERS. Mr. President, I ask unanimous consent that a motion to commit be printed in the Record to instruct the Committee on Finance to report back with changes that ensure that no provision in the bill will reduce or eliminate the amount of Medicaid funding provided to schools under current law.

Mr. SANDERS. Mr. President, I ask unanimous consent that a motion to commit be printed in the Record to instruct the Committee on Finance to report back with changes that ensure the bill includes a provision to lower the eligibility age for Medicare benefits to age 55.

Mr. SANDERS. Mr. President, I ask unanimous consent that a motion to commit be printed in the Record to instruct the Committee on Health, Education, Labor and Pensions to report back with changes that are based on hearings held by the committee.

Mr. SANDERS. Mr. President, I ask unanimous consent that a motion to commit be printed in the Record to instruct the Committee on Health, Education, Labor, and Pensions to report back with changes that ensure the bill includes a provision establishing a robust public health insurance option that is affordable and high quality, that provides comprehensive benefits, and that may be offered on the Federal and State exchanges.

Mr. SANDERS. Mr. President, this is an exciting day. After years and years, some of my Republican colleagues have begun to understand that we cannot continue a dysfunctional healthcare system which allows 28 million Americans to have no health insurance, which forces us to pay the highest prices in the world, by far, for healthcare and even higher prices--outrageously high prices--for prescription drugs. I understand that Senator Daines has offered a Medicare-for-all, single-payer system, and I congratulate him. It sounds to me as though the Republicans are beginning to catch on about the need to transform our healthcare system and join the rest of the industrialized world. So I say to Senator Daines, if he is prepared to vote for this legislation and if he can get maybe five, six more Republicans to vote for this legislation, I think we can win it, and I think the United States can join the rest of the industrialized world and finally guarantee healthcare to all people. So if Senator Daines and five or six other Republicans vote for this, count me in. And we are going to work together, finally, to provide healthcare to all people. But if Senator Daines is just playing a political trick--I ask unanimous consent for 30 more seconds.

Mr. SANDERS. Mr. President, if Senator Daines is just playing a political trick and does not intend to vote for this legislation or have any other Republican vote for it, I would suggest that every Member in the Senate vote present on this bill.

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

Mr. SANDERS

Mr. SANDERS. Mr. President, at last count, I think it was the Gallup poll that found 12 percent of the American people had confidence in the U.S. Congress. I think we are on our way tonight to single digits because in the modern history of this country there has never been a process as absurd as what we are seeing right here. We are talking about legislation that impacts one-sixth of the American economy--over $3 trillion. We are talking about legislation, because it is healthcare, that impacts every man, woman, and child in this country. Mr. President, maybe you can help me. How many public hearings have we had dealing with legislation that is of enormous significance to tens of millions of people? Well, I will help you with the answer: There have been zero hearings. What impact will this legislation have on doctors who are trying to treat us every day? One might think that we would hear from the doctors of the American Medical Association to tell us how this legislation would impact their work. We have not had one public hearing to hear from one doctor. What has the American Hospital Association had to say about how this legislation would impact rural hospitals in America, many of which may close down? They have not had one moment, one opportunity to say one word on this legislation. We are proceeding here with major legislation written behind closed doors by a handful of Republicans. Most Republicans have not been involved in this process, let alone Democrats, let alone the American people. By the way, when we think of the American people, how do they feel about this legislation? Well, the last poll that I saw was USA Today. They had 12 percent of the American people thinking that this legislation makes sense. Well, maybe the American people got it wrong. How do the major healthcare organizations in America feel about this legislation--the people who are on the cutting edge, the people who do the work every day? Well, guess what. The AMA, the American Medical Association, is opposed; the American Hospital Association is opposed; AARP, the largest senior group in America, is opposed because they know the horrendous impact this will have in raising premiums for older workers; the American Cancer Society is opposed; the American Heart Association is opposed; the American Academy of Family Physicians is opposed; the American Academy of Pediatrics is opposed; the American Psychiatric Association is opposed. Virtually every major national healthcare organization is opposed to this disastrous legislation. So the American people are opposed, and the healthcare organizations all across this country are opposed. The bill was written behind closed doors. Yet, under those circumstances, they want to bring it to the floor for a vote. Now, what most Americans are sitting around and thinking--they are saying: Look, the Affordable Care Act has done some good things. Before the Affordable Care Act, we had some 50 million people without any health insurance. The Affordable Care Act provided insurance for about 20 million people. That is no small thing. In the majority leader's own State of Kentucky, the rate of uninsured went from 20 percent down to 7 percent. That is pretty good--not great, but it is pretty good. In West Virginia, the rate of uninsured went way down. We have seen 20 million people gain insurance. We have dealt with the Affordable Care Act under a total obscenity; that is, if somebody had a serious illness--breast cancer, diabetes--they could not get insurance at an affordable cost because of a preexisting condition. How insane is that? The American people said that is nonsense. What is the function of insurance if not to cover us when we need it the most for those illnesses that we have had? We ended that absurdity. That was a good thing. The Affordable Care Act has done other very important things. Have you heard one Member of this body say that the Affordable Care Act is perfect? Have you heard one person here say that the Affordable Care Act does not need to be improved? Of course, it does. Right now, throughout this country--in my State of Vermont and all over this country--deductibles are too high. I have talked to people with $5,000, $10,000 deductibles. They can't go to the doctor when they should. We have to lower deductibles. Copayments are too high. Premiums are too high. I will tell you something else. Donald Trump ran for President, and he campaigned, and he said: I am going to stand with the working people of this country. Prescription drug costs are too high. I am going to take on the pharmaceutical industry. We are going to lower prescription drug costs in America. Today, if you can believe it, one out of five Americans under 65 cannot afford to fill the prescription their doctors write. Today, somebody walked into a pharmacy and found that the cost of the medicine they have been using for 10 years has doubled, maybe tripled, because we have no legislation that stops the drug companies from charging us anything they want. And they will charge us anything they want. The result is, we have the highest prices in the world for prescription drugs. Those are the problems that the American people want answers to: Deductibles are too high, premiums are too high, copayments are too high, and prescription drug costs are too high. We are not doing enough good work in primary healthcare. Too many people, even with insurance, cannot find the doctors they need. There are many other problems. Those are what the American people want us to solve. This legislation only makes a very bad situation worse. How do you improve healthcare in America when you throw 16 million people off of the health insurance they currently have? How do you improve healthcare in America when, according to the CBO, premiums are going to go up 20 percent every year? Let's get that clear: 20 percent on January 1, another 20 percent the following year--that is 40 percent--and another 20 percent the year after. Do you think this is really improving healthcare, bringing freedom to the American people? I think not. So what is the solution? The solution is--I know this is a radical idea--that maybe we should do what the American people want us to do and not what special, powerful interests want, not what billionaire campaign contributors want--whose rightwing ideology wants to end government services for working families all across this country. I hope that we will have the common sense and the decency to sit down, throw the problems on the table, and then resolve them. I think we can do that. That is why we have to end this absurd process. We have to go back to regular order, which simply means go back to the committee. I am a member of the Health, Education, Labor, and Pensions Committee. Let's have that discussion. Let's hear different ideas. Let's solve problems. Let us not make a bad situation worse, and let us not make the American people even feel more contemptuous of this institution than they currently do. Thank you. I yield the floor.

Mr. SANDERS

Mr. SANDERS. Mr. President, let me begin by taking a moment to kind of summarize for the American people where we are in this enormous discussion which is causing a great deal of anxiety all over Vermont and all over America. Several months ago, the Republican-led House passed by, I believe, three votes legislation that would throw 23 million Americans off of the health insurance they currently have--23 million Americans, men, women, and children, people who are struggling with cancer, heart disease, diabetes, and with other life-threatening illnesses. They would simply be thrown off of the health insurance they have. That legislation also cut Medicaid by $800 billion over a 10-year period. That means children with disabilities in Alaska or Vermont who are now on Medicaid might no longer be able to get the help they need in order to survive or to live a dignified life. At a time when Medicaid provides two-thirds of the funding for nursing homes all over this country, it means that if the Republican legislation were to succeed, we don't know, but thousands and thousands of people all over this country with Alzheimer's, with terrible illnesses, who are now in nursing homes would be thrown out of their nursing homes. Where would they go? Nobody really knows. When you cut Medicaid by $800 billion and Medicaid funds two-thirds of nursing home care, needless to say, people in nursing homes would be forced to leave, to go--nobody knows where. Right now in my State of Vermont and across this country, we are dealing with a massive heroin and opioid crisis. Every day, people are dying from heroin, opioid overdoses. It turns out that Medicaid is the major source of funding in terms of treating heroin and opioid addiction. If you make massive cuts to Medicaid, the impact in States like Vermont, West Virginia, Kentucky--States that are struggling with opioid and heroin addiction--would be horrendous. People would no longer be able to get the treatment they need. I recall, during the campaign, Donald Trump said that he was a champion of working families; he was going to stand up for workers, take on the establishment. If the Republican House bill were to be passed, older workers--people who are 60, 62 years of age--would see, in many cases, at least a doubling of the premiums they pay. In many cases, they would go from $4,000 a year today to over $8,000 a year. That is not being a champion or a friend of the working class. My Republican friends, and you hear them even today, talk about freedom, choice. They love choice. They love freedom. People in America should have the right to get healthcare anyplace they want. It should be a right to have any insurance policy they want. Two and a half million women have made a choice. The choice they have made is they want to get quality healthcare through Planned Parenthood. If the Republican bill in the House were to pass, those 2.5 million women would be denied their choice. You have a Republican bill in the House that throws 23 million people off of health insurance. How many of those people will die? My Republican friends get very nervous when I raise that issue because they say--and I understand it--nobody here wants to see anyone die unnecessarily. No Republican does, no Democrat, no American does. According to study after study, including studies done at the Harvard School of Public Health, when you throw 23 million people off of health insurance--people with cancer, people with heart disease, people with diabetes, people with life-threatening illnesses--what do you think will happen? What these studies show is that thousands and thousands of Americans every year will die unnecessarily because they will not have the treatment they need to deal with their life-threatening illnesses. That is the reality. That is not Bernie Sanders talking. That is study after study. PolitiFact backed that up. They looked at all of the studies. They said: Yes, thousands of people will die. That is the result. In the House bill, after you throw 23 million people off of health insurance, raise deductibles, defund Planned Parenthood, after you make older people pay more for healthcare, $800 billion in cuts to Medicaid, what else is in the bill? Oh, there are some people who will do well in the bill--not the children, not the elderly, not the sick, not the poor. But there are some people--and we have to acknowledge that--who would do well under the Republican bill; that is, if you are in the top 1 percent. Congratulations. Republican legislation, after throwing disabled children off of healthcare, congratulations--you are going to get a massive tax break. Who in America believes that it makes sense to throw disabled children off of health insurance and tell people with cancer that they can't continue to get the treatment they need in order to get $300 billion in tax breaks for the top 1 percent and hundreds of billions more in tax breaks for insurance companies and drug companies? Do you know what? My Republican colleagues may think that is a good idea. That is not what the American people believe. The latest poll that I saw, the USA Today poll, had 12 percent of the American people thinking that was a good idea. I can only believe those 12 percent had not really looked at this issue. There is massive opposition from Republicans, Democrats, and Independents to this absurd Republican proposal. It is not just the American people who think that it is absurd to give tax breaks to the rich and throw 23 million Americans off their health insurance. It is not just the American people. It is those people who are most engaged in healthcare in America--the people who know the most. It is important to understand that throughout this process, whether in the House or in the Senate, virtually every major healthcare organization in America--the people who treat us every single day are opposed to this Republican legislation. One might think that maybe my Republican colleagues would say: Well, wait a second. What is going on when those in the American Medical Association--our doctors, the people who treat us--think this legislation is a mistake? Doctors say no. The American Hospital Association says no because they understand that when you make massive cuts to Medicaid, rural hospitals in Vermont and all over this country may go under. Then what happens to a rural community that no longer has its hospital? The American Hospital Association is opposed to this legislation. The American Cancer Society is opposed to this legislation. They know what its impact will be for folks who are struggling with cancer. The American Heart Association, the American Academy of Family Physicians, the American Academy of Pediatrics, the American Psychiatric Association, the Federation of American Hospitals, the Catholic Health Association, the American Lung Association, the Cystic Fibrosis Foundation, the March of Dimes, the National MS Society, and the American Nurses Association--one might think, when virtually every major national healthcare organization in this country is opposed to legislation, that maybe, just maybe, my Republican colleagues might think twice about going forward. In this process, they have not had the opportunity, amazingly enough, to hear from doctors, to hear from hospital administrations, to hear from patient advocates. As you well know, despite the fact that we are dealing with an issue that impacts every single American--which is what healthcare does--an issue that impacts one-sixth of the American economy, over $3 trillion a year, there has not been one hearing, one public hearing on this bill. This bill has been written behind closed doors. Senator McCain the other day made that point. How do you deal with one-sixth of the economy and their desire to transform the American healthcare system without listening to one doctor, without listening to one hospital administration, writing a bill with a few Republican Senators behind closed doors? This is an unprecedented and disastrous process for healthcare. On those grounds alone, what every Member of this Senate should agree to-- and Senator McCain made this point; this process has been awful. Kill it now. Go back to what is called regular process, regular order. Go back to the committee and start this discussion. Please do not throw 22, 23 million people off of health insurance without hearing from doctors, patient advocates, hospital administrators. No, that is not where the Republicans are today. They want to rush this through behind closed doors and get a quick vote on it. Interestingly enough, as I understand it, Senator Daines of Montana today is going to introduce legislation for a Medicare-for-all healthcare system. That is very interesting. I hope this is really a breakthrough on the part of my Republican colleagues. I very much hope they finally recognize that maybe the United States of America should join every other major country on Earth in guaranteeing healthcare to all people as a right and not a privilege. I hope that when Senator Daines comes down here, he will say: No, it does not make sense to throw 23 million more people off of healthcare, but, in fact, we have to move forward, do what Canada does, what Germany does, what the UK does, what France does, what every major country on Earth does, and guarantee healthcare to all people as a right. I hope very much that is what Senator Daines will be saying. Do you know what? I kind of think that is not what he will be saying. I kind of think that in the midst of this discussion in which millions of Americans are wondering whether they are going to continue to have healthcare, what is going to happen to their kids, what is going to happen to their parents, I suspect what Senator Daines is doing is nothing more than an old political trick: trying to embarrass Democrats. Will they support the Medicare-for-all bill introduced by Congressman John Conyers? At a time when we are engaged in a very serious debate about the future of healthcare, I think this is not a time for political games. If Senator Daines is serious about a Medicare-for-all proposal, let's work together, but now is not the time for political games. Senator Daines, as I understand it, is going to offer an amendment, but we don't know what he is amending because we don't even know what is in the legislation the Republicans will bring forward. How do you amend something when we don't even have a base bill to amend? This is, I suspect--I hope I am wrong. I hope Senator Daines has seen the light, but I suspect not, and I suspect it is just a political game. I do hope, by the way, at some point within this debate, if we can--if not, certainly in the near future--to, in fact, be introducing a Medicare-for-all single-payer program. It will be somewhat different than my friend John Conyers' bill in the House, but what it will do is say that in America, if you are rich or if you are poor, if you are a man, woman, and child, yes, you are entitled to healthcare as a human right and not a privilege. As you may or may not know, our current healthcare system is the most expensive, bureaucratic, and wasteful system in the entire world. While the healthcare industry makes hundreds of billions of dollars a year in profits--and in many ways what our healthcare system is about is not providing quality care to all of us but seeing how the insurance companies and the drug companies can rip us off. The truth is, even today, we have some 28 million people who have no health insurance so our goal should be to say to those 28 million: We are going to provide health insurance to you, to all Americans, and not throw 22, 23 million more people off of health insurance. All of us recognize that the Affordable Care Act is far from perfect. What the American people want us to do--and poll after poll suggests this--is they want us to improve the Affordable Care Act, not destroy it. The American people are paying deductibles that in many instances are far too high, keeping people from going to the doctor when they need to. Today, copayments are much too high; premiums, much too high. I do find it interesting that when Donald Trump campaigned for President, he talked about the high cost of prescription drugs. He is right. In this country--and I am going to get into that in a moment--we pay, by far, the highest prices in the world for prescription drugs. That is what the American people want us to deal with in healthcare legislation, not throw 22 million people off of healthcare. They want us to lower the cost of prescription drugs. I have not heard one word from the Republicans about the need to lower the cost of prescription drugs. The United States spends far more per capita on healthcare than any major country on Earth. We often have worse outcomes. If we go back to regular order, if we go back to committee process--which is what we should do--the very first question a Member of the Senate should ask is, How does it happen that here in America we spend far more per capita on healthcare than do the people of any other country? Here is the chart. The United States is spending $9,990 per person on healthcare, almost $10,000 per person on healthcare. What do they spend in Germany? Well, they spend $5,300, almost half of what we spend. What about Canada? I live 50 miles away from the Canadian border. It is a really nice country. They spend $4,533. How does it happen that we are spending more than double per person compared to the Canadians and almost double what the Germans do? The French spend less than half of what we do. Australians spend less than half of what we do. The Japanese spend less than half. The UK spends about 40 percent less. Don't you think the very first question a Member of the Senate might ask is, Why do we spend so much compared to other countries? By the way, all of these other countries guarantee healthcare to all of their people. In many instances, the outcomes, the health outcomes in those countries, are better than our country. They live longer. The life expectancy is longer. Their infant mortality rate is lower. In some particular diseases, they do better in treating their people. Here is a simple truth. The truth is, if we took a hard look at countries around the world--all of which have one form or another of national healthcare programs, all of which said healthcare is a right, whether you are rich or you are poor--maybe we might want to learn something, but, no, we have not had one hearing in order to discuss why we spend twice as much per capita on healthcare and why we pay the highest prices in the world for prescription drugs. You know why we haven't had any hearings on that, fellow Americans? Because it might get the insurance companies a little bit nervous. Insurance companies pour hundreds of millions of dollars in campaign contributions into the political process. The pharmaceutical industry spends a huge amount of money on campaign contributions and lobbying efforts. I say to my colleagues in the Senate, maybe, just maybe, we might want to stand up for working people and the middle class rather than for the owners of the insurance companies and the pharmaceutical industry. It is interesting. One never knows what to expect from the President. Every given day there is another adventure out there, but a couple of months ago, the President met with, I believe, the Australian Prime Minister. That was in May. President Trump said during that meeting: Australia has a ``better healthcare'' system than the United States. That is what Donald Trump said. To my Republican friends here who support President Trump, listen to what he said. On this one instance-- he is not right very often--but I will confess on this issue, he is right. In Australia, everyone is guaranteed healthcare as a right. Australia has a universal healthcare program called, ironically, Medicare, that provides all Australians with affordable, accessible, and high-quality healthcare. While the United States has the most expensive, bureaucratic, wasteful, and ineffective healthcare system in the world, Australia, it turns out, has one of the most efficient. President Trump was right. In 2014, Australia's healthcare system ranked sixth out of 55 countries in efficiency. The United States ranked 44. Not only does Australia guarantee universal healthcare coverage, it spends less than half what we spend on healthcare per capita. In 2015, they spent $4,500 while we spent almost $10,000. While the Australian Government spent 9 percent of its GDP on healthcare, the United States spent nearly double that, 17 percent. Further, many healthcare services are far cheaper in Australia. An MRI costs about $350 in Australia versus $1,100 in the United States. One day in a hospital costs about $1,300 in Australia versus $4,300 in the United States. An appendectomy costs about $5,200 in Australia versus roughly $14,000 in the United States, et cetera. Not only does Australia guarantee universal healthcare, spend less on healthcare per capita, and pay less than we do for many health services, they have better health outcomes. In 2014, the average life expectancy in Australia was 82.4 years compared to 78.8 years in the United States. They live longer in Australia. For context, according to a 2014 report from the World Health Organization, Australian men have the third longest life expectancy and Australian women have the seventh longest life expectancy in the world. The United States doesn't even crack the top 10 for life expectancy, despite spending so much more than any other country on healthcare. What all of this comes down to is the fact that America is the wealthiest country in the history of the world. The question we have to ask ourselves--and I hope Senator Daines will address that question as he introduces his Medicare-for-all bill--is how does it happen that in Canada, every man, woman, and child is guaranteed healthcare? The same is true in the UK, in Germany, France, Australia, Japan, and every other major country on Earth. How does it happen that every industrialized country understands that healthcare is a right of all people, because all of us get sick? All of us have accidents, not just the rich. How does every major country on Earth say healthcare is a right except the United States? How is it today we have 28 million without any health insurance--more who have high deductibles and high copayments, who are underinsured--and the response of our Republican friends is to say: Twenty-eight million uninsured? That is not enough. Let's throw another 22 million people off of health insurance. Our response should be to move forward and guarantee healthcare to all people, not throw another 22 million people off of health insurance. I don't have the time to go into great detail as to why our wasteful and bureaucratic healthcare system ends up spending almost twice as much per capita as systems around the world. That is a subject for a lot of discussion, and I intend to play an active role in that discussion, but let me just give you some examples: because we have such a bureaucratic and complicated system; because hospitals in America have to deal with this person who has a $5,000 deductible, that person who has an $8,000 deductible; this person who has this, that person has that--they have to deal with dozens and dozens of different configurations for insurance. It requires an enormous amount of time, energy, and manpower to deal with those myriad of insurance companies. The result of that is, the United States spends far more on hospital administrative costs than most other countries. These costs accounted for one-quarter of total U.S. hospital spending from 2010 to 2011, more than $200 billion--over twice what was spent in Canada and in Scotland. What I would hope--if we don't sit around just worrying about the profits of the insurance companies--what I would hope is, all of us would agree that when we spend a dollar on healthcare, we want that dollar to go to doctors, to nurses, to medicine. We want that dollar to go to the provision of healthcare, not to advertising, not to profiteering, not to dividends, not to outlandish CEO insurance company salaries but to the actual provision of healthcare which keeps us well. Yet we do that worse than any other major country on Earth. The large health insurance and drug companies are making hundreds of billions of dollars in profits every single year, and they are rewarding their executives with outrageous compensation packages. Once again, the function of healthcare, in my mind, is to provide quality care to all in a cost-effective way, not to make CEOs of insurance companies and drug companies even richer than they are today. In 2015, the top 58 health insurance companies made $24 billion in profits. Should the function of healthcare in America be to allow insurance companies to make huge profits or should we make sure all of our people get quality healthcare? Not only do the insurance companies make huge profits, but their CEOs make outlandish salaries, while 28 million Americans have no health insurance at all, and others have very high deductibles. In 2015, Aetna's CEO made $17.2 million in compensation. Now, Aetna, like every other insurance company, spends half their life trying to tell people they are not covered for what they thought they were covered, but they do manage to find $17 million in salary compensation for their CEO. CIGNA's CEO made $17.3 million in compensation. UnitedHealth Group's CEO made $14.5 million in compensation. Anthem/Wellpoint's CEO made $13.6 million. Humana's CEO made $10.3 million. Is the function of healthcare in America to make CEOs of insurance companies outlandishly wealthy, or is it to provide healthcare to all people? It is not just the insurance companies. If you ask people in my State of Vermont what their major concern is--and I think they would say the same in Iowa and probably any State in America--they would say: I am sick and tired of being ripped off by the drug companies. I go into my pharmacy, have a medicine I have been using for 10 years, and suddenly the price has doubled, tripled, for no particular reason other than the pharmaceutical industry could get away with it. We are the only major country on Earth not to control the prices of the pharmaceutical industry. The result is--and this is an outrage, and it speaks to everything that should be discussed but which is not being discussed in the Republican bill--is that today, one out of five patients under the age of 65 who gets a prescription from their doctor is unable to afford that prescription. How crazy is that? What kind of dysfunctional healthcare system allows somebody to go to a doctor because they are sick, the doctor writes a prescription, and one out of five Americans can't even afford to fill that prescription. What happens to that person? Well, the likelihood is they get even sicker, and then they end up in the emergency room at outrageous costs or, maybe even worse, they end up in the hospital. How crazy is that? I have not heard one word--not one word--from our Republicans about addressing the absurdity of Americans paying by far the highest prices in the world for prescription drugs. I have a chart over here that just deals with half a dozen drugs, but we can list many, many more. Lantus, a diabetes drug, costs $186 in the United States. Diabetes is a very serious problem. Lantus costs $186 in the United States and $47 in France. It is the same drug. This is a healthcare reform debate. I have yet to hear one Republican raise that issue, but I think the people in Iowa and the people in Vermont want us to raise that issue. Crestor, a popular drug for high cholesterol, costs $86 in the United States and $29 in Japan. Advair, which is used to treat asthma--another very serious problem-- costs $155 in our country and $38 in Germany. The list goes on and on and on. That is why millions of people, by the way, are now buying their medicine in Canada and other countries, because they are sick and tired of being ripped off by the pharmaceutical industry--an industry that spends billions of dollars over a period of time on lobbyists here and campaign contributions. You might think--just might--that when we deal with healthcare reform, one Republican--just one--might stand up and say: Well, you know, maybe we might want to stand with the elderly and the sick in this country and not just with the pharmaceutical industry. I have not heard one Republican in this debate talk about that issue. To give an example of the greed of the pharmaceutical industry--and I can go on and on. They are the greediest, maybe with the exception of Wall Street. It is hard to determine which one of these institutions is more greedy, but the pharmaceutical industry certainly can make a claim for being the greediest industry in this country. Out in California a few months ago, there was an effort to lower the cost of prescription drugs in their State. It is called proposition 61. The big drug companies spent $131 million to defeat that ballot initiative--$131 million to defeat a ballot initiative in California that would have lowered the cost of prescription drugs. And all over this country, the American people cannot afford the medicine they need, but the drug companies had $131 million to spend just on one initiative. Meanwhile, while the American people are getting sicker and sicker and sometimes dying because they cannot afford the medications they need, I have received--and I think every Member of the Senate has received--communications from oncologists, people who are dealing with patients who have cancer, who are saying: My patients cannot afford the high cost of cancer medicine. And it is not just cancer, of course. While the American people are getting ripped off by the drug companies, in 2015 the five largest drug companies in America made over $50 billion in profits--five companies, $50 billion in profits. Yet one-fifth of the American people cannot afford to buy the prescriptions they need. How outrageous is that? And my Republican colleagues are telling us they are dealing with healthcare reform without mentioning one word about the high cost of prescription drugs. Give me a break. You are dealing with many things, but you are not dealing with healthcare reform. Again, it is not just the pharmaceutical companies that are making huge profits; we are seeing executives from these large drug companies making outrageous compensation. In fact, in 2015, the top 10 pharmaceutical industry CEOs made $327 million in total compensation. Elderly people walking to the drugstore can't afford the prescription drugs they need, and yet CEOs of major drug companies are making $327 million in total compensation. Former CEO of Gilead, John Martin, became a billionaire because his drug company charged $1,000 a pill for Sovaldi, a hepatitis C drug that costs $1 to manufacture and can be bought in India today for just $4. In this country, it sold for $1,000 a pill, and he became a billionaire as a result of it. That is a healthcare system out of control. I know it is a radical idea here in the Senate, but maybe--just maybe--we might want to represent the American people and not the CEOs of the drug companies and the insurance companies. Some of my Republican colleagues have been spending the last few days using words like ``freedom,'' ``choice,'' and ``opportunity'' to try to convince the American people about their abysmal healthcare legislation. This is the same language that rightwing ideologues, like the billionaire Koch brothers, use when they try to discredit government programs and move to privatize them. What the Koch brothers mean by ``freedom'' is their own freedom. And by the way, they are the second wealthiest family in America, worth some $80 billion. What they mean by ``freedom'' is their own freedom to profit off the misery of ordinary Americans who rely on a wide variety of government programs that make life bearable and, in some cases, even possible. I want to say a word about freedom. This is a 203-foot yacht. This is a yacht owned by a billionaire that costs about $90 million to purchase. Like everybody else, I think, in this Chamber, I think the American people--every American should have the freedom to purchase this $90 million yacht, and I would urge all Americans to go on the internet, find out where the yacht stores are--wherever they sell yachts--and go out there and say: Hey, I got the freedom to buy this $90 million yacht. We all believe in that. You got the money; you buy it. Here is a picture of a home, and this home is worth tens and tens of millions of dollars. It looks to me like it has 30 or 40 or 50 rooms, probably 5, 10 bathrooms. It is a very nice house, and it is owned by a billionaire. You know, I think every American who wants to own a home worth tens and tens of millions of dollars, go to your local Realtor. You go out and you buy that home. What we are talking about today in terms of freedom is not freedom to buy a yacht or freedom to buy a mansion; we are talking about the freedom to stay alive, the freedom to be able to go to the doctor when you are sick, the freedom not to go bankrupt if you end up in the hospital with a serious disease. So when my Republican friends talk about freedom of choice, fine, we all agree: You got the money, you go out and buy any big house you want or buy any big yacht you want. But where there is a serious disagreement is, we say that the children of this country who have serious illnesses have the freedom to stay alive even if their parents do not have a lot of money; that older people who are now in nursing homes should have the freedom to get dignified care in a nursing home even if they have Alzheimer's and even if they don't have a lot of money. Healthcare is not another commodity. Healthcare is not a mansion. Healthcare is not a yacht. Healthcare is whether we stay alive or whether we don't, whether we ease our suffering or whether we don't. And I believe--unlike, unfortunately, many of my Republicans--that right to get healthcare when you need it is something every American should be able to get. Here in the Senate, we have good health insurance. Over the last 10 years, a number of Senators have had serious illnesses, and they have gotten some of the best care in the world. If it is good for the Senate, it is good for every American. Healthcare must be a right of all people, not a privilege. Quality care must be available to all, not just the wealthy. Senator Daines is going to come down here in a while to offer a Medicare-for-all proposal. Again, I hope this is a breakthrough. I hope our Republican colleagues understand that we have to join the rest of the industrialized world. And if Senator Daines comes down here and is prepared to vote for that legislation, prepared to get his other Republican Senators prepared to vote for that legislation, my God, we can win this vote overwhelmingly and move this country in a very different direction. But I have a feeling that is not what Senator Daines has in mind. I think this is another joke, another game, another sham as part of a horrendous overall process. So I will not be supporting that amendment, unless Senator Daines and Republicans vote for it as well. But this I will do: Whether in this debate--and I hope I have the opportunity--or in the very near future, I will offer a Medicare-for-all, single-payer program which finally has the United States doing what every other major country on Earth does--guarantee healthcare to every man, woman, and child in a cost-effective way. And when we do that and when we eliminate the need for families to spend $15 or $20,000 a year for health insurance, we will save the average middle-class family substantial sums of money. I yield the floor.