Debbie Stabenow

Ms. STABENOW

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Ms. STABENOW

Ms. STABENOW. Mr. President, I want to indicate before the distinguished majority whip leaves that what is being talked about here is like having a hole in the roof of your house. Instead of patching it, they want to burn down the house. What we are not willing to participate in is burning down the house. We are more than happy and, in fact, have proposals and are anxious to work with the majority to improve healthcare--not rip it apart, not take tens of millions of people's healthcare away, but improve it. Before asking a question of the majority whip, I also want to indicate for all those listening that we have the bill. We can actually read pretty quickly, and it has been out. Even though it is considered a discussion draft--we don't know what it is at this point--we have it. We are analyzing it. What our leader, the Democratic leader, indicated is what we have been able to read in this discussion draft, which is not only more of the same but is worse for seniors, those in nursing homes, and children in Michigan and across the country. That is what is in this, which we now have, whatever it is called. I would ask the majority whip, instead of burning down the house at this point in terms of ripping apart the healthcare system, would you join with us in putting forward a bill that would allow Medicare to negotiate prescription drug prices for seniors, which my hospitals and insurance companies tell me are one of the driving forces that are raising the costs of healthcare? Would you be willing to work with us on a bill to lower prescription drug prices and allow Medicare to negotiate drug prices on behalf of America's seniors?

Ms. STABENOW. Mr. President, to the distinguished leader, I simply would say I am proposing that instead of this, which is essentially burning down the house in America in terms of healthcare, that you instead join with us in what you have admitted is one of the top drivers of healthcare costs in this country, which is what we want to tackle. We want to bring down the costs. We want to bring down the cost of prescription drugs, the out-of-pocket costs for everyone whose copays and premiums are too high. That is what we want to do. Taking away nursing home care, taking away the ability for a parent to take their child to the doctor or someone with cancer to get the treatment they need or a small business owner being blocked from getting healthcare because of a preexisting condition--we consider that burning down the house. We are opposed to that. Frankly, we would love to have a ceremony and light this on fire and come back together and work together on the No. 1 driver, which is the cost of prescription drugs.

Ms. STABENOW. Mr. President, in conclusion, I wish to make one other comment, and that is, the people in Michigan who are purchasing on the private exchange--over half of whom are able to get a policy today for their families for less than $100--I would say they would have a different perspective. We need to fix those things that are not working, but for the 97 percent of the children in Michigan who can now see a doctor because of what has been done; for the hospitals that now see 50 percent fewer people walking into the emergency room without insurance, raising the costs for all policies; for the savings the State of Michigan is going to have in its budget next year of $432 million in savings to taxpayers because they did the right thing by allowing children to go to a doctor instead of getting sick and going to the emergency room, I would suggest this is the wrong direction.

Ms. STABENOW

Ms. STABENOW. Mr. President, first, I want to thank the Senator from Nevada. We are so pleased that she is here and her voice is so strong for the citizens of Nevada and appreciate very much her comments this evening. I am rising this evening to talk about an issue that affects every single person, every single family in Michigan and all across the Nation, and that is healthcare. I feel very confident that I can say that each one of the 48 members of the Democratic caucus--each and every one of us would love to be on this floor working with Republican colleagues across the aisle to lower the costs of prescription drugs, to lower the out-of-pocket costs of healthcare, to create more competition and more insurance choices for people in the insurance pools than are there now--to basically fix the problems. I am proud to be with colleagues tonight because we are not willing to support anything that unravels the healthcare system, raises costs, takes away healthcare for people, and, on top of that, gives a tax cut to the wealthiest Americans, insurance executives, and pharmaceutical companies with the dollars that are cut. So here we are. The House has passed a bill that, in fact, raises costs, takes away healthcare, gives the tax cuts I talked about. Now we are in the Senate. The Republicans have a healthcare bill, but they will not let us see it. I am the ranking Democrat on the Health Subcommittee of the Finance Committee. You would think someone would have reached out to have conversations with me and members of our subcommittee--members of our whole committee--but that has not happened. They are letting the Trump administration see it, but not the American public. They are letting K Street lobbyists see it. That is probably where I will get a copy first--through lobbyists--but not the American public, who will lose their healthcare and pay more. If you have cancer and you are not going to be able to get coverage, if you are going to potentially be dropped or have preexisting conditions or get caps put on the number of cancer treatments you can receive, I believe you have a right to see this bill. If you have epilepsy and will lose your insurance, you have a right to see this bill. If you are a woman who will be charged more for insurance and be considered to have a preexisting condition just because you are a woman, you have a right to see this bill. If you are senior whose rates are going to go skyrocketing upward, you have a right to see this bill. But the sad fact is, Republicans don't think the American people have a right to know or to see this bill or to review it or to comment on it-- to have a chance to give their opinion on it. The difference in process couldn't be more clear between the way the Affordable Care Act was originally worked on for about 18 months and then passed and what is happening right now. In 2009, Republicans called for a fair, collaborative, and deliberative legislative process. I agree. In fact, we all agree. From 2009 to 2010, the Senate Finance Committee held more than 53 hearings on health reform--hearings, open committee meetings, work sessions. As a new member of Finance at that time, I was involved in every single one of those, with hours and hours of listening, deliberating, people sharing their opinions, and debating. Counting the HELP Committee deliberations, there were 100 hearings and committee meetings before the bill was finalized and debated to be reported out of committee. The Republicans have had no hearings--zero hearings. They have had no public meetings--zero public meetings. During the Finance Committee markup, when we were working through and voting out the bill, we considered 135 amendments, often late into the night. The final Senate bill included 147 Republican amendments. In the end, we were trying to do everything we could to get bipartisan support, when it was clear that politically there was not a desire-- even with 147 Republican amendments in the bill--to have a bipartisan healthcare bill. Republicans will not even allow us to see the bill, let alone amend it. Our position is very clear. If there is no hearing, there is no vote. We need them to show us the bill. There is, I think, a really good reason they will not show us the bill. They will not let us see it because it is a disaster for the American people. It is a disaster for the people in Michigan whom I represent. From the House bill, we know that 14 million fewer people will be insured after the first year; 23 million fewer people will be insured after 10 years. This may change somewhat back and forth. We have no idea. But we know the general framework the Senate is working in is the same general framework as the House. We know that in 2026, according to the Congressional Budget Office, 51 million people under the age of 65 will be uninsured--no insurance. We are told that premiums would go up 20 percent next year, and States would be allowed to opt out of key insurance laws that protect consumers. To really understand what that means--that means all of the decisions about your care go back to the insurance companies, not your doctor. Laws that protect people with preexisting conditions are gone. Rules that prevent women from being charged more are gone. Laws that prevent seniors from being charged more are gone. And the way it used to be is that if you got sick, the insurance company could decide to drop you. It was the insurance company that said how many cancer treatments you were able to receive or mental health visits, if any, you would receive. You always paid more than for physical health--the same with addiction. This all goes away with what is being talked about here. In other words, costs are going to go up, and care is going to go down. To add insult to injury, all of this is going to go to tax cuts for multimillionaires and billionaires, to drug companies and insurance companies--while someone is losing nursing home care, cancer treatments, maternity care, and children will be unable to go to the doctor and parents forced to go back to using the emergency room. I want to share with my colleagues what these changes would mean for people in Michigan. There are so many people I have talked to, so many stories I have heard. I received a letter from a woman named Amy who owns a small retail business in Michigan. She has health insurance through her husband's job--a small business owner. Amy has chronic myeloid leukemia. It is managed with a medication that costs $20,000 a month--not a year, a month. After her deductible and 10-percent copay, she said she quickly reaches the maximum out-of-pocket expense on her insurance each year. Amy wrote: Preexisting conditions, maximum out-of-pocket costs and lifetime cap costs are important to me. . . . [Without them] I could never afford my health care. Without the ACA, I could quickly bankrupt my family and still die. . . . Please consider my situation when deciding your vote on any changes to the ACA. I need your help. I want and need to stay alive and raise my children. Healthcare reform allows Amy to stay on her husband's insurance plan and pay for the cancer treatments that are keeping her alive. The Republican plan would put people with preexisting conditions like cancer at the mercy of health insurance companies. Here is another way the Republican plan would hurt American families. Thanks to the Medicaid expansion, 650,000 people are newly covered under what we call the Healthy Michigan Plan. The good news is, 97 percent of Michigan children can now go to the doctor. They don't have to wait and go to the emergency room. If they have a cold, their mom or dad can take them to a doctor. They can get preventive care, rather than waiting until something awful happens and going to the emergency room. What is the good news for the State of Michigan out of that? Michigan will end up, this year going into next year, with $432 million more in the treasury. Taxpayer dollars aren't going to have to be used on healthcare because the right thing was done--creating a way for children to see a doctor. What has happened? We have a 50-percent reduction on folks who don't have insurance going into the emergency room, and it saves money when you do that. The number of people treated has gone down 50 percent--the number of people treated without insurance. The great thing about healthcare to understand is that if we ignore it, it doesn't mean people don't get sick, that they don't get cancer, that they don't need a nursing home or that their child doesn't get sick. If you just ignore it, the costs go up because people ultimately use the most expensive ways to get treated. If you actually plan it out and do the right thing on the front end and people can see a doctor and they can get the checkups and the care they need and the treatments they need, you actually save money. That is the example of the State of Michigan. The Republican plan would end the Medicaid expansion. Healthy Michigan would go away. One young man in Michigan only 19 years old shared his story of living with his single mom when he was diagnosed with testicular cancer. He was working, but his employer didn't offer health insurance. He didn't have transportation to get to his appointments or treatments. Thanks to Healthy Michigan, he got insurance and treatment at Munson Healthcare in Traverse City. He is now free from cancer, has a job with benefits, and is engaged to be married, and we wish him well. Healthy Michigan and the Medicaid expansion saved this young man's life. The Republican plan would end the Healthy Michigan plan, ripping coverage from 650,000 people in Michigan, including cancer patients. And for what? And for what? To pay for tax breaks for drug companies and the ultrawealthy one more time. This means Michigan families will be unable to care for their loved ones when they need it most. In January, I led a forum on Secretary Price's healthcare policies, and a woman came from Michigan to tell her story. Ann was diagnosed with multiple sclerosis when she was 40 years old, and she has very limited use of her arms and legs. We are so grateful that she made the trip to DC to share her story. Medicare and secondary insurance cover most of the cost of her medication, which costs an astonishing $75,000 a year. That is nearly her entire household income, including Social Security benefits. Ann had been caring for her aging mom when her mom's dementia worsened. Ann didn't know where she would find the $6,000 a month for nursing home care. How many families are in that situation? Fortunately, Ann's mom qualified for Medicaid. By the way, three out of five seniors in Michigan are able to get their nursing home care through Medicaid. Three out of five are getting nursing home care because of Medicaid, including Ann's mom. This nursing home care paid for the final 3 years of her life. Here is what Ann said: It was only because of Medicaid that she was able to get the help that she needed at the end of her life. I don't know how I could have cared for my mother on top of managing my own care. My family would have lost our home and all our savings in trying to keep up with their bills. Medicaid helped Ann care for her mom at the end of her life. This is a good thing. Again, the Republican plan would cut Medicaid by $834 billion. That is the House plan coming over. We don't know how much would be cut here, but we know whatever will be cut will be used to pay for tax breaks for drug companies, insurance CEOs, millionaires, and billionaires. How does that reflect American values? In conclusion, Republicans are hiding their bill because they know it is a bad deal for American families. It is a bad deal. The President of the United States called it ``mean.'' I agree with him. It is mean, and it is definitely a bad deal for the people I represent in Michigan. Costs go up and care goes down, all to cut taxes for millionaires and billionaires. We are better than this as a country. Our Nation is better than this. It is time for Republicans to show us the bill so we can work on it together. Give us a chance. Give the American people a chance to have input, to say what they think before it is forced on them in a secret process that is rammed through this floor. It is time to move beyond partisanship to get something done for the American people. Again, I know that the 48 Democratic Senators in this Chamber want to work on lowering the cost of prescription drugs, reducing out-of-pocket costs, helping small businesses that want to provide coverage for their employees, and making the healthcare system better. Let's stop this bad bill and work together on behalf of the American people. I yield the floor.

Ms. STABENOW

Ms. STABENOW. Madam President, as a senior member of the U.S. Senate Finance Committee, which held more than 50 hearings, roundtables, and walkthroughs on health care reform--we spent 8 days just marking up the bill in committee, considered more than 130 amendments, and more than two dozen Republican amendments were agreed to at that time in the committee--a committee that posted their legislation online for 6 days before the original committee markup; a committee that spent, with the Senate, 25 consecutive days in session on health reform--the second longest consecutive session in the history of the U.S. Senate. In total, the Senate spent more than 160 hours considering the healthcare reform legislation. Based on that, Madam President, I ask unanimous consent that no amendments be considered in order to Calendar No. 120, H.R. 1628, the American Health Care Act, until the bill is referred jointly to the Committee on Finance and the Committee on Health, Education, Labor, and Pensions and reported favorably from the committees. This means no hearings, no bill.

Ms. STABENOW

Ms. STABENOW. Mr. President, due to a memorial service in Michigan, I was unable to attend today's rollcall vote on the nomination of Kenneth P. Rapuano to be Assistant Secretary of Defense. Had I been able to attend, I would have supported his nomination.

Ms. STABENOW

Ms. STABENOW. Mr. President, it is with very great sadness today that I honor the life of my longtime staff member and dear friend, Barbara Wise McCallahan. Barb passed away on May 26, 2017. Barb has worked in my congressional and Senate offices for over 20 years, joining my team on my very first day in Congress in 1997. She was a volunteer on my campaign for the U.S. House and worked many subsequent campaigns. She staffed my Howell and Flint Township offices when I served in the U.S. House. Over the years, she represented me in Livingston, Washtenaw, Monroe, Wayne, and Oakland Counties as a regional manager in the Senate. For over 20 years, she has been an anchor for me in southeast Michigan. Barb loved to tell the story of when she first walked into my campaign office to volunteer when I ran for the U.S. House of Representatives. Coming from the hometown of my opponent, she would laugh that my team suspected that she was a spy. This couldn't have been further from the truth. Barb has been fiercely loyal and steadfastly protective of me for over two decades. I cannot think of anyone who has spent more time over the years driving in a car with me. We have survived blizzards, avoided countless speed traps, identified the fastest drive-through restaurants, and I have never seen anyone who could bypass construction better than Barb. The countless hours we spent together over the years deepened my appreciation for her resolve and determination and cemented a lasting friendship. Barb was a fighter. She faced many challenges early in her life. She took that fighting spirit and tenacity and fought throughout her career for so many individuals, families, and communities she helped represent. She was committed, tough, proud, and resilient. I watched Barb struggle with the debilitating effects of Parkinson's disease in recent months and, along with her family, friends, and coworkers, was deeply affected by her losses earlier this year. While we will all continue to mourn her death, we also celebrate her life, her accomplishments, and her enduring spirit. Barb is an example of the amazing and talented professionals who commit themselves to congressional service. She has served the State of Michigan and her country with distinction and honor. No tribute to Barb can be done without including her family. I remember many community events and parades over the years with Barb and her young sons. Although a private person, Barb would light up when talking about her family; she was especially proud of her boys Patrick, Ian, and Brian and her grandson, Shane. On behalf of all of Team Stabenow, you will always be part of our family. Please join me and countless others as we honor the life of my longtime staff member and dear friend, Barbara McCallahan.

Ms. STABENOW

Ms. STABENOW. Mr. President, I want to first thank my friend and colleague, the senior Senator from Minnesota, Ms. Klobuchar. She is a very important part of our Senate Agriculture, Nutrition, and Forestry Committee. She provides tremendous leadership. We both come from great ``M'' States. So it is always great to have an opportunity to be part of sharing remarks on such an important topic. I am also pleased to state that Senator Heitkamp will be joining us today, as well, from another very important rural State. Michigan small towns and rural communities embody much of our State's way of life and drive our economy forward. I grew up in one of those small towns, in Clare, in Northern Michigan. I believe that towns like mine should be celebrated and strengthened. We want young people to go to college and feel that there is a future to come home to, either back to the farm or the small business or participating in the community or maybe working at the local hospital, but being part of continuing this important way of life. People in our communities deserve every opportunity to be able to raise their families with well-paying jobs and a high quality of life, like everyone in every part of Michigan and all across the country wants to have, but many rural areas and many small towns face unique challenges in developing and maintaining infrastructure. Broadband. We now need to make sure that the farm at the end of the road is connected with high-speed internet. At one point in our country's history, it was the telephone. It was electric poles and being able to connect the farm at the end of the road to the rest of the community. Now it is high-speed broadband, and it is critically important that that happen. Providing high-quality health services and education. My mother was a nurse--the director of nursing--at the small hospital in Clare for many, many years. So I know how important not only healthcare was and making sure there were doctors in our town but also making sure there were jobs, because one of the top employers in our community was the hospital. That remains true today. When the Trump administration released its budget proposal at the end of the month, frankly, I was shocked to see the kinds of disinvestments and sharp cuts that would hurt small towns like Clare and rural communities all across Michigan and all across the country. No matter which part you look at, President Trump's budget is bad for rural Michigan, and it is bad for rural America. First, the budget calls for a 21-percent cut to the U.S. Department of Agriculture, which is our second largest industry. One out of four jobs in Michigan is connected to agriculture and the food economy. In the President's budget, it was decided that the third largest cut to any Federal agency would be in the Department of Agriculture. This will dramatically reduce and eliminate very key rural development services. The budget would zero out funding for water and sewer infrastructure projects, which is amazing to me. I can drive from one end of Michigan to the other and see communities in which rural development has made all the difference in supporting the ability to have clean water and water and sewer systems, as well as other important infrastructure. This program has improved nearly 6,000 rural water systems, including many in Michigan. There is an extremely high demand for upgrading water and sewer systems across the country. Right now, the USDA has a backlog of nearly 1,000 applications from small towns that need to improve their water systems. President Trump's answer, as part of his infrastructure package, is to say that this will come from not supporting rural communities ourselves but leaving it up to Wall Street investors or, maybe, foreign countries to invest in our water systems, like Saudi Arabia or China. The fact is that Wall Street investors are not investing in rural communities. I would argue that that is not a good strategy anyway. We know that, when you depend on that kind of a strategy--foreign country investor or Wall Street investor efforts-- those investments are not being done in small towns like the one in which I grew up. Towns with populations of a few hundred people cannot afford the high interest rates--or the toll roads, by the way--that come with a lot of the projects in this kind of approach. The budget also undermines rural jobs and businesses in communities in which unemployment is already too high. The USDA's small business loans are eliminated under the President's budget. Again, I can go from community to community around Michigan and see wonderful small businesses operating with the support of rural development loans. These are programs that have saved almost 800,000 jobs and have helped finance more than 107,000 businesses in the last 8 years alone. This proposal that the White House put out also jeopardizes what I talked about earlier, which is rural broadband, or high-speed internet, for communities in order to access education, rural healthcare, and telemedicine, as well as addressing issues like resources to curb the opioid epidemic. Last year, the FCC found that 39 percent of rural Americans--that is, roughly, 23 million people--lack access to high- speed internet service. This is astounding to me when we look at this as a challenge that we have in 2017. President Trump's budget also targets the farm bill directly for $231 billion in cuts. We work together on a strategy for a 5-year economic development plan. We do it on a bipartisan basis. It will be time to bring that up again next year. That 5-year process gives certainty to our farmers and communities and those interested and committed to conservation and bioenergy and all of the other provisions in the farm bill. To see--outside of this 5-year period and our bipartisan process--the Trump administration come in and target these funds for a cut of $231 billion, again, is shocking to me. If that were to pass, it would be impossible for us to write the next farm bill next year. Cutting crop insurance by $29 billion would take away critical support for farmers right at a time of low commodity prices. We moved from subsidies to risk management in crop insurance in the last bill, saving taxpayer dollars. We made a commitment to farmers purchasing insurance, where they are writing a check for the insurance bill instead of getting a subsidy during good times, but you have the insurance if there is a weather event, if commodity prices are low, if there is another challenge like we are seeing today for our farmers. Our farmers also need export opportunities in order to sell their products, which are in high demand around the world. We have to be able to sell agricultural products. The budget eliminates important market- access programs to help our farmers sell. Simply put, cuts to these programs mean lower economic growth, less development, less opportunity, and a lower quality of life in small towns in Michigan and all across rural America. Our small towns and rural communities deserve better, and we are standing here today as advocates and voices for them. We know, as farm prices are down nearly 50 percent from their highs just a few years ago and producers are struggling to make ends meet, that these are challenging times, and we need to understand that. We need to write a farm bill and focus on those areas to support our farmers and growers. We know there are those like our dairy farmers, in particular, who are in challenging times, and we need to make sure we are addressing their concerns as well. Rural America is the economic backbone of the country. Somebody has to grow something, and somebody has to make something. Otherwise, you do not have an economy. That is what happens in rural Michigan and rural America. Yet we also know that too many communities are still struggling to recover from the great recession. From my perspective, I join with the 500 groups from every part of agriculture, the food economy, nutrition, and conservation groups-- everyone involved in the food economy--in saying that we cannot afford additional cuts to agriculture, rural communities, and other parts of the farm bill that support our ongoing economy. It is critically important that we stand with those in every small town in Michigan and across our country in saying that we understand and are partners with you in making sure that, when you work hard, you have the quality of life for yourself and your family that you deserve, and we are going to do our part to make sure that support is there. I thank the Presiding Officer.

Ms. STABENOW

Ms. STABENOW. Madam President, I rise to support the nomination of former Georgia Governor Sonny Perdue to serve as Secretary of Agriculture. Since the beginning of the Trump administration, the Department of Agriculture has been left without leadership. Based on President Trump's decisions over the past few months, it is clear, unfortunately, that agriculture and small towns like those all over Michigan have been an afterthought. It didn't help that Governor Perdue was the very last Cabinet Secretary to be nominated by President Trump. The White House then took 7 weeks to submit the official nomination paperwork to the Senate, which further delayed our hearing process. Despite unprecedented delays from this administration, the Agriculture Committee acted in a swift and bipartisan fashion to approve Governor Perdue with overwhelming support. Governor Perdue grew up on a dairy and crop farm in a small town in Georgia. He worked as a veterinarian and served as a two-term Governor. He has the confidence of nearly 700 agricultural stakeholder groups that represent farmers, ranchers, conservationists, landowners, and the food and nutrition communities. He understands that the Agriculture Department has a profound impact on nearly every community across the country and certainly every family. Whether it is bringing broadband to small towns, supporting lifesaving agricultural research, feeding our children, our families, our veterans, or protecting our forests, our land, our water, and our air, the Agriculture Department plays a vital role in almost every aspect of American life. Governor Perdue's leadership is desperately needed by farmers, families, and all Americans who rely on the USDA. For months, rural America has not had a voice in this administration, and frankly it shows. President Trump's budget proposal makes it clear that rural America is not a top priority for his administration. His proposal cuts USDA funding by 21 percent, the third largest cut to any Federal agency. To examine the impact these proposed cuts would have on our country's small towns and rural communities, I released a report that highlights how President Trump is turning his back on rural America. This report demonstrates how the Trump budget would eliminate-- eliminate--the rural water and sewer program that repairs crumbling water infrastructure that is depended upon in communities all across America and certainly all across Michigan. This would leave thousands of communities across the country without the ability to provide clean water. USDA business loans are also slated to end, undermining the creation of new jobs in areas where unemployment is already too high. Again, I can go from community to community in Northern Michigan or in the east or the west and talk with people who have been able to start their small business with the support of USDA rural development business loans, creating jobs, communities, and really helping to form the lifeblood of small towns all across Michigan and the country. Many more critical services for rural Americans are also on the chopping block. Our farmers and our families, frankly, deserve better. We need a Secretary of Agriculture who will be a relentless advocate for our Nation's farmers and the important services USDA provides. That is why I am supporting Governor Perdue. It is important to stress again that American agriculture and our rural communities are already doing more with less. In the last farm bill, we made responsible, bipartisan reforms that cut $23 billion in Federal spending, and we now know that the 2014 farm bill policies are actually predicted to save tens of billions of dollars more than we originally had expected. The budget cuts the Trump administration has proposed are frankly irresponsible and show a stunning disregard for the current state of the farm economy. Farm prices are down nearly 50 percent from their highs just a few years ago, and producers are struggling to make ends meet. Rural America is the economic backbone of our country, and too many small towns are still struggling to recover from the great recession. Over the last 8 years, USDA has made important investments in rural communities, and we are beginning to see small towns across the country on the road to recovery, but there is more to do. Now is not the time for the Trump administration to turn its back on people who live in rural America. We need a strong voice to insist that the President listen to the 500 groups that are saying that agriculture, conservation, food assistance, and other farm bill services are critical to our economy and should be maintained. Rural America has waited long enough for a leader at the USDA. I am pleased the Agriculture Committee worked together promptly and thoroughly to review Governor Perdue's qualifications. After multiple conversations and questions, I am confident that Governor Perdue has the experience, the judgment, and the commitment to lead this important Department. In this Congress, we also have a farm bill on the horizon. I am confident Governor Perdue will be a strong partner as we develop a bipartisan, comprehensive bill that works for farmers and families across our country. In my conversations with Governor Perdue, it is clear that he understands the challenges farmers are facing, from continued low prices, especially our dairy producers who are struggling because unfortunately the safety net that was put in place has not worked as intended, and it needs to be fixed. I am pleased he is committed to looking for creative solutions in the short run as well as the long run. Now more than ever, we need the next Secretary of Agriculture to be a champion for all those families across our country who live in small towns and rural communities. I believe Governor Perdue will look past regional divides and partisan pressures to do what is best for the people we serve. I urge colleagues to support the nomination of Governor Sonny Perdue, and I also urge this administration to start supporting the small towns and rural communities that make our country great. Madam President, I yield the floor.

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

Ms. STABENOW

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

Ms. STABENOW

Ms. STABENOW. Mr. President, I rise this evening to talk about an issue that will affect families all across Michigan, which is the nomination of Judge Gorsuch to the Supreme Court. He has a long record of siding with special interests and institutions instead of hard- working Americans, and this is of great concern to me. That matters. I am concerned with his rulings that fail to protect children and students with disabilities in schools, and I am worried that he will limit access to critical healthcare for women and that he is not a mainstream candidate. I can't support a nominee whom I believe is disconnected from the challenges faced by families in Michigan and across America every day. There is one important example which relates directly to someone from Michigan that Judge Gorsuch has ruled on. People from Michigan have been hurt by Judge Gorsuch's narrow judicial philosophy. In 2009, a Michigan truckdriver named Alphonse Maddin was trying to complete a shipment driving all night, and his brakes froze in subzero temperatures--which we have. The heater in his cab broke as well. He called his company to report the issue and waited for help to arrive. While he was waiting for hours in the freezing subzero temperatures, he realized he was having trouble breathing and his body was going numb. He called his company to report that he needed to get somewhere warm, but they told him he needed to either wait for the repair person, or drag his trailer even though the brakes were frozen. Worried he might freeze to death, he finally unhitched the trailer from his truck. Mr. Maddin drove off to seek help, returning in just 15 minutes with assistance. He did what any of us faced with a life-threatening situation would do. A week later, Mr. Maddin was fired from his job, even though he was transparent in his actions and completed his delivery. He completed his delivery, despite the issues caused by his frozen brakes and the broken heater. Two different entities within the Department of Labor ruled that what the trucking company did was illegal, and that Mr. Maddin was protected under Federal law because his life was in danger. Thankfully, a majority of the Tenth Circuit judges agreed. Judge Gorsuch, however, disagreed, arguing the law did not protect workers who drove away to avoid freezing to death. According to Judge Gorsuch's interpretation, Mr. Maddin would have had to choose between his job and his life. What is deeply concerning to me is that when he was asked at his nomination hearing what he would have done, he said he really hadn't thought about it. Judges should think about what is happening to people in situations as they are ruling in a fair and impartial way. This does not look like the ruling of a mainstream nominee. His rulings don't only affect Michigan workers. I am very concerned about Judge Gorsuch's rulings on legal protections for individuals with disabilities. We passed the Individuals with Disabilities Education Act to make sure that children with disabilities got the education they deserved, and that the education would be free and available to all children. Luke, a young boy from Colorado with autism, was not able to receive the education he needed from his public school. His parents were able to enroll him in a private residential program specializing in children with autism that was more suitable for his needs so he could get what he needed for his development. His parents applied to the school district for reimbursement, as was appropriate, but the school district refused. His parents went to court, and an administrative judge and a district judge both ruled that the school did not provide Luke with the necessary education to meet the needs that IDEA required. However, Judge Gorsuch ruled in favor of the school district, saying that all the school district had to do was provide an education that was more than just the bare minimum--just the bare minimum. He set a very low bar for Luke and for students like Luke, like my nephew Barry. Just to show how disconnected Judge Gorsuch is from the lives of everyday Americans, look at the Supreme Court ruling which occurred at the same time as Judge Gorsuch's confirmation hearings. In a different case on the very same issue, the Supreme Court challenged and rejected the standard and interpretation that Judge Gorsuch believed should be provided for children and students with disabilities. They unanimously rejected the standard that he approved. This is not the view of a mainstream nominee. This is not the view of a mainstream nominee. I am also deeply concerned about Judge Gorsuch's opinions and how they could affect women's access to healthcare. In the Tenth Circuit's Hobby Lobby decision, Judge Gorsuch endorsed the idea that corporations can deny their employees access to essential healthcare services, including birth control. His concurring opinion suggested that he supported the notion that for-profit corporations have the right to deny women insurance coverage or any form of contraception an employer disagrees with. This is both alarming and unacceptable. It once again shows how disconnected Judge Gorsuch is from what women in Michigan and around the country experience. Judge Gorsuch did not recognize the impact of denying coverage to women employees and their families, and putting those decisions in the hands of their employers. Women in Michigan should not have to pay higher costs for healthcare than men, and they should not be denied essential healthcare services. These dangerous interpretations will continue to take us down a path of permitting and protecting discrimination by corporations and institutions over the rights of workers and consumers. Again, that is not a mainstream nominee. When it comes to supporting women--not just in healthcare, but in the workplace--Judge Gorsuch has had some extremely troubling rulings. In 2003, a woman named Betty Pinkerton experienced several instances of disgusting sexual harassment from a male supervisor at the Colorado Department of Transportation. Every time she made it clear his comments were not acceptable in any way, they continued over the course of months. She went to her office's civil rights staff and submitted a written complaint, and he was removed as her supervisor. She was fired about a week later. She sued. But Judge Gorsuch upheld a ruling that claimed she waited too long--she waited too long to report harassment--and believed that Pinkerton's firing was performance based--How often do we hear that in these situations?--despite not being able to produce any real evidence that this was the case. He ruled that she couldn't go to trial and present her case in front of a jury. So when it comes to protecting women in the workplace, we know that Judge Gorsuch has come up short. This is not a mainstream position and not acceptable, in my judgment, for any Supreme Court nominee, and not acceptable for what I want to see happen for the people in Michigan. I wish to end my speech on the importance of consensus because that is what we should do here. That is how we get things done. For decades, we have confirmed our Supreme Court nominees with consultation and consensus. We have said--and I think it is the right thing--that we should have to have more than just a simple majority to confirm judges to the highest Court in the land for a lifetime appointment. So it makes sense that we come together to do that. In fact, seven of the eight current U.S. Supreme Courts Justices on the bench today received 60 votes or more somewhere in their process--both President Bush's and President Obama's nominees, as well, those now on the Court. President Clinton, President Bush, and President Obama talked to Senators from both parties about their picks to get input as to whom would likely be supported and not supported. This did not happen with Judge Gorsuch. President Trump had a list chosen by very narrow special interests and did not ask opinions of key people on our side of the aisle as to what would make sense to get the consensus to get 60 votes. I do not believe Judge Gorsuch will be fair and impartial, giving a fair shot to the workers and families in Michigan as well as around the country. My test is very much about what is best for the people I represent in Michigan. Who will be fair and impartial and give them a fair shot? Because I do not believe he can do that, I cannot support his nomination. He is not the right choice for this vacancy. We can come together. I urge my colleagues to go back to the drawing board and bring in a consensus mainstream nominee. In the past, we have basically had a practical rule of saying if the nominee cannot get 60 votes, we change the nominee. We don't change the rules. It is extremely concerning that this would not be the approach at this time. I urge that we come together, get a mainstream nominee, and be able to work together to get this done.

Ms. STABENOW

Ms. STABENOW. I suggest the absence of a quorum.

Ms. STABENOW. Mr. President, just yesterday, the White House held a forum on empowering women. Sean Spicer said the President made women's empowerment a priority throughout the campaign, but earlier today, Vice President Pence traveled to the Capitol to cast a tie-breaking vote to move ahead on a resolution to undermine women's access to preventive healthcare. That doesn't sound like women's empowerment to me. Title X was enacted in 1970. It passed the Senate unanimously at that time and was signed into law by a Republican President. Title X is the only Federal healthcare program dedicated solely to providing comprehensive family planning and other related preventive healthcare services so important to women, as well as preventive services for men. Last year alone, 4 million women and men at 4,000 health centers all across our country got basic care because of title X funding--critical Pap tests to head off cases of cervical cancer, counseling to help women plan for a healthy pregnancy, contraception, breast exams, HIV testing, vaccinations. These services prevented 87,000 preterm or low birth weight babies and 2,000 cases of cervical cancer. These health services also save money. The taxpayer saves $7 for every $1 invested in preventive healthcare. For more than 2 million people, the title X funded clinic is their only source of healthcare. This matters to small towns and rural communities all across Michigan, as well as all across the country. Title X funds clinics in three-fourths of all the counties in the United States. In Michigan, you can benefit from the services in the beautiful Upper Peninsula of Michigan, where I will be this weekend, where funds support the health department in Iron County, or the Planned Parenthood clinic in Marquette--at the opposite end of the State, down in the southeastern corner--where funds support the health department in Monroe County. So what are we voting on today? Plain and simple, this is an effort to take away women's family planning and other healthcare services. Right now, title X funds are awarded solely based on the provider's ability to serve the patient, as it should be. Republicans want to discriminate against certain family planning services, certain providers, and reduce access to this care, frankly, based on politics or their own personal beliefs. The vote this afternoon is very simple: It is about basic healthcare for women. A ``yes'' vote is a vote against women in Michigan and all across our country. A ``yes'' vote will take away healthcare. A ``yes'' vote will take away healthcare for millions of Americans. I strongly urge my colleagues to vote no.

Ms. STABENOW

Ms. STABENOW. Mr. President, before the distinguished Senator from Maryland leaves the floor, I want to thank him for his powerful advocacy on behalf of his citizens. And I would only say ``amen'' as he was speaking because there is so much at stake for the moms and dads and kids and grandpas and grandmas in Michigan and Maryland. And that is why we are on the floor speaking out so strongly and fighting so hard to defeat a very bad proposal. Let me start by indicating that what is being debated right now in the House, the TrumpCare proposal, is not what President Trump promised. It is just not what he promised. He said it would be great. He said that people would get as good healthcare or better healthcare and that it would cost less. We know that is simply not true. According to a FOX News report on the increase of people who would no longer have healthcare, be able to get medical care, be able to go to a doctor under the new TrumpCare plan, 14 million people would lose their healthcare, be unable to take their children to a doctor, just in the next year, by next year. People will have to go to the emergency room rather than a family doctor. Rather than being able to take care of a cold or something minor for their children, chances are that it would become something very serious before they would be able to be in a position to take them to a doctor or, more likely, an emergency room. We know that in the next 10 years, we are talking about 24 million Americans--moms, dads, grandpas, grandmas, kids who would no longer be able to see a doctor and no longer have health insurance. TrumpCare would also cost 7 million people who have an employer right now who is providing them health insurance so that they can get to the doctor and care for their family--7 million people would lose the insurance they have through their employer right now. That is not making things better. There would be 7 million people in that situation. This is really a triple-whammy for middle-class families across our country and certainly for people in Michigan. There would be higher costs, less coverage, and more taxes. I believe we need to join with AARP and our doctors, hospitals, nurses, people who treat cancer, Alzheimer's, breast cancer, juvenile diabetes, and all of the other people who care for and advocate on behalf of loved ones or themselves, people who need to be able to see a doctor and get healthcare coverage. We need to say no to the TrumpCare plan that is being proposed in the House. One thing that is really outrageous in this proposal is a senior tax that allows insurance companies to hike up rates on older Americans. It is right in the budget report. This is in the budget report we have now received. They are saying that in 2026--in 10 years--a single woman or man 64 years of age making $26,500 a year who currently pays $1,700 for their health insurance would suddenly get a bill for $14,600. So under this plan, that 64-year-old is going to go from $1,700 out-of-pocket to see a doctor to get their treatments, to be able to get the care they need, to $14,600. If you compare that to somebody who is 64 and makes $3.7 million a year, the good news for them is that they are going to get a $200,000 tax cut. Unbelievable. Unbelievable. Most people in Michigan work hard every single day, get up and go to work, maybe take a shower after work, maybe take a shower before work, but most of the people I represent don't make $200,000 a year. Yet we are talking about a $200,000 tax cut for multimillionaires, which is in this proposal. That is why the AARP, a nonpartisan organization representing millions of people across the country, is actively working to defeat this. We also know that this creates what I call a voucher under Medicaid, meaning that instead of paying for whatever nursing home care is needed--if your mom or dad has Alzheimer's, Parkinson's disease, or they are simply in a nursing home for a variety of reasons, right now they get whatever care they need. There is not a cap on the amount of care. There is not a limit on the amount of care. Under this proposal, there would be X amount of dollars put aside for your mom or dad or grandpa or grandma, and if the care they needed because of their Alzheimer's disease was more than that, you would pay for it or your elderly parent in some way would have to figure out how to pay for it. This is outrageous. Medicaid for families and for seniors in nursing homes has been a critical part of making sure people can get the medical care they need. I, frankly, celebrate today the fact that under the Medicaid expansion, under the Affordable Care Act, 97 percent of the children in Michigan can see a doctor. Imagine that. Ninety-seven percent of the children, almost all of our children, can go to a family doctor. Their moms and dads know that they are going to be able to take them to the doctor when they get sick. I don't want to roll that back, but that is what the TrumpCare proposal does. We also know--because this was reported on FOX News as well--that the new plan would add a 15- to 20-percent premium increase for individuals starting next year--a 15- to 20-percent premium increase for individuals starting next year at the same time as big tax cuts for multimillionaires. I have to say, as somebody who worked very, very hard on the women's healthcare provisions and authored the maternity care provisions, I find it outrageous that the TrumpCare proposal would mean that maternity care is not covered as part of basic healthcare for women. Prior to the Affordable Care Act being passed, only 12 percent of the plans in Michigan--12 plans out of 100--offered maternity care. If you tried to buy maternity care as part of the basic coverage, you would have to get a rider. You would have to pay more. Let's say maybe you gambled. Well, you weren't planning on getting pregnant and you weren't sure what was going to happen, so you didn't pay extra. Then you get pregnant. Guess what. You had a preexisting condition, and you couldn't get insurance. We don't want to go back to the time where being a woman was, in fact, a preexisting condition. And speaking of preexisting conditions, this plan puts them back in the hands of the insurance companies and creates penalties for people. The truth is, under the Affordable Care Act, we made sure that when you purchase insurance, it is a real plan. It is not a junk plan. You can't get dropped when you get sick. If you have a preexisting condition, they can't block you. If you are a woman, you don't have to pay more. If you have a mental illness rather than a physical illness, you don't have to pay more. If you need cancer treatments, the insurance company can't tell your doctor how many treatments you are going to get or how much they will pay for your treatments. Everybody has benefited from that. Everybody who has insurance in this country has benefited from that. One of the most important provisions relates to preexisting conditions, and that, in fact, is not continued, as it should be for American families. Finally, let me just say that while we are talking about people paying more, getting less coverage, middle-class families paying more in taxes, guess what. Wealthy people do not. So if you are a multimillionaire, you are going to get big tax cuts in this provision, and the middle-class family, the working family, is going to pay for it. They are going to pay for it in higher premiums. They are going to pay for it in less healthcare for their family. That is absolutely unacceptable. In addition to that, there is a tax break for insurance company CEOs so that they can, in fact, get a raise up to $1 million. So in this proposal, very wealthy people--insurance and drug companies' CEOs--are taken care of. Vast amounts of money are put back in their pockets, while money is taken out of yours. Absolutely unacceptable. That is why we, as Democrats, are fighting so hard to make sure this does not happen, is not passed, and that, in fact, we will work together to strengthen our healthcare system. We know there are areas where premiums are too high, copays are too high, and we need to work together on a bipartisan basis to fix that. But unraveling our entire system, ripping it apart, creating chaos, more cost, less ability to go to the doctor, and less medical care for people is absolutely unacceptable. The bottom line is that TrumpCare means more money out of your pocket and less healthcare for you and your family. That is just wrong in the greatest country in the world. Recognition of the Minority Leader

Ms. STABENOW

Ms. STABENOW. I thank the Senator very much. I will say this briefly and then turn to our colleague from Pennsylvania, who has been such a champion for children. I would say first--again, as I said a moment ago--that, because of Medicaid, because of the healthcare expansion, 97 percent of the children in Michigan now can see a doctor. That means moms who are pregnant and babies, and moms and dads are less likely to be going to bed at night and saying: Please, God, do not let the kids get sick, because they can actually go to a doctor. It reminds me, though, of the other thing happening on the floor and the larger question of the nominee for the Centers for Medicare and Medicaid Services. In the larger context, I asked her about whether or not maternity care and prenatal care should be covered as a basic healthcare requirement for women. I mean, it is pretty basic for us. She wouldn't answer the question. Essentially, she said women can buy extra if they want it. The new Secretary of Health and Human Services said that we, as women, can buy extra coverage for basic healthcare coverage for us. So it all comes together--Medicaid, the nominee on the floor, and what the House is doing to take away maternity care. It is really just bad news for moms and babies.

Ms. STABENOW. Mr. President, as Senator Wyden's colloquy comes to an end, I will make a few comments in addition to those of my colleagues, and I very much appreciate all of their work. There are so many different things to talk about as it relates to how healthcare impacts people. As Senator Casey said, this is very personal; it is not political. There are a lot of politics around this, but it is very, very personal. In Michigan, when we are talking about healthcare, in Medicaid alone we are talking about 650,000 people who have been able to get coverage now. Most of them are working in minimum wage jobs, and they now are able to get healthcare but couldn't before, as well as their children. That adds to the majority of seniors who are in nursing homes now, folks getting long-term care, folks getting help for Alzheimer's and other challenges and who are relying on Medicaid healthcare to be able to cover their costs. I want to share a letter, as well, from Wendy, a pediatric nurse practitioner from Oakland County in Michigan. We have received so many letters--I am so grateful for that--and emails. She writes: As a pediatric nurse practitioner, I have seen so many of my patients benefit from the Affordable Care Act. Physical exams for the kids are now covered in full, with no co-pay. This means the kids are in to see us, which means we catch healthcare issues and early problems with growth or development that otherwise might be undetected and left untreated until it became a much bigger problem. Isn't that what we all want for our children, to catch things early? Immunizations are covered, which keeps everyone safer. Screening tests are covered, so potential problems are caught while they can still be managed. This better care keeps kids healthier and happier and prevents longer term care costs. She goes on to write: The Medicaid expansion means even more kids are covered, keeping not only those children healthier but keeping everyone around them healthier. Previously, parents of children who did not have insurance coverage would not seek care until the children were so ill that they could not see another option. Frequently, these children then utilized emergency room care-- Which, by the way, is the most expensive way to treat health problems-- [it was] not only a missed opportunity for complete and preventative healthcare but at a cost passed on to the community. On a much more personal level, in 2015, our granddaughter, at age 3, was diagnosed with epilepsy related to a genetic condition . . . which made her brain form abnormally. On top of the epilepsy, she has developmental delays and autism, all related to her double cortex syndrome. Although our daughter and son-in-law are fully employed (teacher and paramedic), she qualifies for Children's Special Health Care (under Medicaid). This has been a huge blessing for us, and without it our family would have been financially devastated. We are hopeful that my granddaughter will continue to have good seizure control and will develop to reach her full potential, but without the care that her private insurance and Children's Special Health Care provides, she would not have much of a chance of getting anywhere near her potential. I do not want to even consider how it will affect her future if insurance companies can refuse to cover her care due to her preexisting condition. She concludes: Please do not let partisan politics take precedence over doing what is right and what is best for the health of every U.S. citizen. I know we are all getting hundreds of thousands of letters and emails and phone calls of very similar stories because healthcare is personal to each of us--to our children, our grandchildren, our moms, and dads, and grandpas and grandmas. It is not political. I am very grateful for my colleagues' being here today. I want to speak not only about the importance of expansion under Medicaid but also about the person who would be in charge of that very, very important set of services. That is the nomination in front of us, that of Seema Verma to be the Administrator of the Centers for Medicare and Medicaid Services. This is a critical position, especially given the ongoing efforts that we are seeing right now to repeal healthcare--the Affordable Care Act--and replace it with legislation that would literally rip away coverage for millions of people and pull the thread that unravels our entire healthcare system. The decisions of the Administrator, both as an adviser to the President and as someone with the authority to make large changes in the implementation of existing law, will have far- ranging consequences for all of us--certainly, for the people whom we represent and especially for those who need healthcare, have begun receiving it, and now may very well see it taken away. In the Finance Committee, when I asked Ms. Verma about Medicaid, I found that her positions would hurt families in Michigan, would hurt seniors in nursing homes, and would hurt children. And looking at her long record as a consultant on Medicaid, we know that Mrs. Verma's proposals limit healthcare coverage and make it harder to afford healthcare coverage, putting insurance companies ahead of patients and families once again. I am also very concerned about her position on maternity coverage. During the hearing, I asked Ms. Verma whether women should get access to basic prenatal care and maternity care coverage as the law now allows--I am very proud of having authored that provision in the Finance Committee--or whether insurance companies should get to choose whether to provide basic healthcare coverage for women. I reminded her that before the Affordable Care Act, only 12 percent of healthcare plans available to somebody going out to buy private insurance offered maternity care--the vast majority did not--and that the plans that did often charged extra or required waiting periods. Her response indicated that coverage of prenatal and maternity care should be optional-- optional. We as women cannot say our healthcare is optional. The next CMS Administrator should be able to commit to enforcing the law requiring maternity care to be covered and commit to protecting the law going forward for women. Being a woman should not be a preexisting condition. Getting basic healthcare should not mean we have to buy riders or extra coverage because being a woman and the coverage we need is somehow not viewed as basic by the insurance company. We have had that fight. Women won that fight with the Affordable Care Act. We should not go backward. I followed up with Ms. Verma, along with many colleagues, but have not received a response. Over 100 million Americans count on Medicare and Medicaid. They need a qualified Administrator who puts their needs first, and I cannot vote for a nominee who does not guarantee that she will fight for the resources and the healthcare that the people of Michigan count on and need.

Ms. STABENOW. If I might lend my voice on this and thank both of my colleagues. Senator Cantwell has been the leader in so many ways on innovation in the healthcare system as we debated next to each other in the Finance Committee on the Affordable Care Act. I wanted to share that in Michigan, where we expanded Medicaid, because of changes that have been made and work that is being done in the budget going forward in the new year, there is now close to $500 million more in the State of Michigan budget than was there before because of Medicaid expansion and the ability to manage healthcare risk. People have more healthcare coverage. We actually have 97 percent of the children in Michigan who can see a doctor today, which is incredible. At the same time the State is going to save close to $500 million in the coming year's budget.

Ms. STABENOW

Ms. STABENOW. Mr. President, I want to speak about the healthcare bill that has been laid out in the House now--introduced in the House of Representatives. I have great concern about the proposal as it relates to the people of Michigan, whom I represent, as well as to the people across the country. This proposal--or whatever passes--will be judged based on whether or not people pay more for their coverage, if they can find it, and whether they are going to be able to get the healthcare they need. Healthcare is very personal. Despite the politics here in Congress and in the White House, healthcare is not political; it is very personal. Can you go to a doctor? Can you take your child to a doctor? Can your parents or grandparents get the nursing home care they need? Are you going to be able to find insurance after you have had a heart attack or cancer or if your child has juvenile diabetes and, therefore, has a preexisting condition? I am deeply concerned after the initial look I have had, and we will continue to look at more and more of the details as they come out. This proposal is going to create chaos in the healthcare system. Frankly, I would say this is a mess. It is going to create a big mess as it relates to the families whom I represent and whom we all represent in our home States. This was written in secret. We have all seen the stories of the Senator from the other side of the aisle who was running around trying to get a copy of what was going on. Everything was done in secret, and now that it is out, we find out that there is no cost attached to it. We do not know what the overall cost will be to taxpayers. We also do not know how many people are going to be able to get healthcare, who is going to be able to be covered. What I have seen really falls in the category of creating a mess for families--higher costs for middle-class families, higher costs for poor families, but less coverage--such a deal. This is not the kind of deal that the people of Michigan want to have for themselves and their families. To add insult to injury, it cuts taxes for the wealthiest Americans, while it makes most Americans pay more. It makes seniors pay more, and we have heard people calling it the ``age tax'' or the ``senior tax.'' The reality is, in a number of different ways, in how we rate, which is based on age and other costs, seniors will pay more. It is my understanding that, in the middle of this, there is actually a sweetheart deal for the CEOs of big insurance companies that will give them pay raises. This whole thing is stunning to me, which is being put forward with a straight face. On top of everything else, it removes the guarantee for preexisting conditions. It is very unclear what will happen to someone who has had a heart attack. I have a new, little, baby grandniece who has had two heart surgeries already, and there is another one that she will have to have in another year. While she is doing great--and my niece and nephew deserve incredible admiration for taking care of little Leighton--she is going to have a preexisting condition her whole life. She is going to have a reconstructed heart that is going to cause her various challenges. Without the current guarantees that we have that she gets with her insurance, her folks are going to have a hard time, and little Leighton is going to have a hard time her whole life. When we look a little bit more into the details of all of this, we see, in fact, that this bill provides tax increases for millions of families. It repeals the tax credits in 2020 that help working families afford insurance. By the way, even though things do not happen immediately, in their knowing it is coming, the insurance companies are certainly going to find themselves making different kinds of decisions, and, certainly, families will make different kinds of decisions. I would expect the insurance system to be destabilized immediately. We are already seeing problems with insurance companies pulling out just based on the debate about repealing healthcare. When we look at the tax credits--or help--for buying healthcare, it goes from helping those from low-, moderate-, and middle-income families being able to afford insurance to changing the whole thing. It is based on your age and your income. So the higher the age and the higher the income, the more taxpayer dollars you get, which makes no sense. A 55-year-old with a higher income will get more taxpayer funding than will a 30-year-old who is working a minimum wage job and has the toughest time in trying to find insurance that he can afford. This is not the set of values or perspectives that make sense for people in Michigan, as well as for people across the country. While that 30-year-old who is working a minimum wage job is going to be paying more and hoping that he does not have a preexisting condition because he may not be able to find insurance at all, we see that there is a $300 billion--with a ``b''--tax cut for the wealthiest Americans. Picture this: Somebody in a minimum wage job who could very well see his health insurance go completely away will have that happen, while someone who makes more than $3.7 million a year will save over $200,000 a year. So $200,000 a year is what he will get back now in the form of a tax cut, which is more than what most people make. Certainly, the majority of people in Michigan make less. They work very, very hard, but they make less than $200,000. Just to underscore, this is the first bill out of the gate here in which we are talking about any kind of tax cuts. We are already seeing Republicans cutting taxes for the wealthy while raising taxes on the middle class and raising their healthcare costs if they can find healthcare. These tax cuts are just the start. Wait until we get to tax reform, when we are going to see this whole debate happen again. My guess is that middle-income people are going to end up paying the bill--paying more--and the wealthy people are going to get another round of tax cuts. To add insult to injury again, there are the sweetheart deals so that the CEOs of the biggest insurance companies can get pay raises--can get more money--while people will pay more if they work or are poor or middle class. There are tax cuts for prescription drug companies of $30 billion, but the bill does nothing to lower the cost of prescription drugs. This, certainly, is not healthcare for the majority of Americans. This, certainly, is not healthcare for those who need to have access to affordable healthcare. Then it is back to our seniors, who will pay more because of the changes in how healthcare costs will be rated. We will, essentially, see older people having twice the tax credit but five times more the cost. I am not sure exactly how it is being proposed for preexisting conditions. We are still working through that. I do know that the bill has a penalty. If you have health insurance and, for some reason, there is a crisis in your family and, for some reason, you cannot continue it and you drop that insurance and then you reenroll again, there is a 30- percent late enrollment surcharge. You will be paying 30 percent more for your health insurance if you have a preexisting condition. There are just two other items that are very important. I know that the distinguished Presiding Officer shares the concern about this as well, which is the fact that we have been able to create more access to healthcare by expanding Medicaid, which is critically important. One of the great success stories in Michigan today is that 97 percent of our children in Michigan can now see a doctor--97 percent. We do not want to go backward. Every child should have the ability to see a doctor--every mom, every dad, every grandpa, every grandma. Right now, in Michigan, 97 percent of children can see a doctor because of the work that we did on the Affordable Care Act, including in the expansion of Medicaid. This goes away. It takes a couple of years, but that goes away. Instead, what is proposed, essentially, is a voucher, but it has been called a lot of names. There used to be folks talking about a block grant to the States. Now they call it ``per capita.'' Yet it is really simple. Just like there have been proposals by Republicans for years to have a voucher for Medicare, now this is, essentially, a voucher for Medicaid of X number of dollars. If you need more for your nursing home care, then you are on your own. There are X number of dollars for your child, for a family. If you have something happen and you get sick and you need surgery or if you have cancer and it goes above that voucher, you are on your own. It completely changes Medicaid from an insurance system to a system of, essentially, a voucher. Millions and millions and millions of children, of families, of seniors--the majority of seniors in nursing homes get their coverage through Medicaid--and our moms, dads, grandpas, and grandmas, who right now get quality nursing home care because of Medicaid, will be severely impacted by this voucher that caps how much care they will be able to receive. Finally, for over half of the population--for those of us who are women--we will see a return, essentially, to a woman being a preexisting condition. Essential services for women--maternity care, which I was at the front of the line in fighting for, and prenatal care--are not available in the majority of private plans a woman tries to buy without her paying more. You can get maternity care, but it is not viewed as basic. It may be basic to you, as a woman, but insurance companies say: Sure, we will cover maternity care, but you have to pay more. Forever, women have been paying more for their basic healthcare. Under the Affordable Care Act, that changed when we said: Do you know what? As a woman, you should not have to pay more for the basic care you need. Now all of that goes away under the House proposal. Just to make sure that we see women's healthcare taken away, Planned Parenthood is defunded. Yet 97 percent of what they do is basic care--mammograms, getting to see your doctor, OB/GYN, prenatal care, and all of the things you need for annual visits and so on. That is completely defunded. I congratulate everyone who has been involved in the effort to make sure that birth control is affordable for women, and under the Affordable Care Act, we have done that. This is an economic issue; this is not a frill for women or for men or for families or for those who have worked hard to make sure we can lower unintended pregnancies in this country. The good news is that we are at a 30-year low in unintended pregnancies, a historic low in teen pregnancies, and at the lowest rate of abortions since 1973--1973. Why is that? That is because women have been able to get the healthcare they need. They have been able to get affordable birth control to be able to manage their healthcare, as well as seeing the economy improve. But we are seeing more and more where more information is being made available, costs for basic preventive care is down, and women having access to what they need in healthcare allows them to be in a situation where we are seeing these historic lows on unintended pregnancies, teen pregnancies, and abortions. I know in Michigan we have a number of counties across Michigan, particularly in rural communities, where the Planned Parenthood clinic is the only provider of basic healthcare. It is the only provider for family planning and for cancer screenings and basic healthcare for women and for many men. It may be the only provider in the community. More than half of Planned Parenthood health centers are in rural and underserved communities. About one-third of all of the women living in those communities where Planned Parenthood is available find that this is the only healthcare provider available to them. So support for women, preventive healthcare, and Planned Parenthood funding are cut completely in this bill. Access to maternity care, prenatal care, and other basic essential services is eliminated. If you want that, you can pay more as a woman. On top of that, we are seeing essential services like mental health and substance abuse services and other basic comprehensive services that we said for the last several years should be available--healthcare above the neck as well as healthcare below the neck should be viewed as essential services for people across America. All of that goes away with this proposal. So, in my judgment, this is a mess. It is going to create a mess, with more costs, less service, shifting taxpayer dollars to the wealthy, while asking the middle-class and low-income families to pay more. This is simply not a good deal. I would welcome the opportunity to work with colleagues on something that makes sense. Let's put aside this whole effort of repeal. Let's focus on how we can bring costs down, including prescription drugs, and continue to move forward, but let's not go back. When 97 percent of the children in my State can see a doctor today, that is worth keeping. That represents the best of our values. We can't go backward. The proposal we are seeing in the House would take us back to a place that would hurt the majority of Americans, and I strongly oppose it. Thank you, Mr. President.

Ms. STABENOW

Ms. STABENOW. Mr. President, let me say first that I join with the distinguished Senator from West Virginia in expressing concern about our water infrastructure and water issues. As many of us know, we have had terrific challenges in Flint, MI, with an entire water system being unable to be used because of lead poisoning and the terrible decisions made, primarily at the State level. I was very concerned--when I speak about Mr. Pruitt and his nomination--that when asked by Senator Cardin if he believes there is any safe level of lead that can be taken into the human body, particularly a young person, he said that this is something he hasn't reviewed and doesn't know anything about. That is deeply concerning to me--that the person who would be heading the EPA would not know anything about lead poisoning and what that means, first of all, in a child's body, where it is poisoned and affects their development throughout their life. It is critically important for us in Michigan-- and there are many, many places where there are serious water quality issues that need to be addressed--that we have someone who understands the science and the need for clean water rules and protecting our waters so that any family, any community can have the confidence of turning on the faucet and knowing that there is going to be clean water coming out into their sink in their home. It is very concerning to me that we have a nominee who indicated that he really didn't know anything about this issue. So for that and a number of reasons--many, many reasons--I am joining with so many colleagues in opposing Scott Pruitt to be the next Administrator of the Environmental Protection Agency. The EPA Administrator is a very important position. As I indicated, to those of us in Michigan, surrounded by the beauty of the Great Lakes, having the responsibility for protecting the Great Lakes, this is a very, very important position. After examining Mr. Pruitt's record on a broad range of issues, as well as his views about the Agency he has been nominated to lead, I have significant concerns about the direction and the priorities the EPA would take if he becomes Administrator. Now, this is not based on partisan politics. When George W. Bush was President, I joined 98 of my colleagues to vote to confirm Christie Todd Whitman to be EPA Administrator. Two years later, I was among 87 other Members of the Senate to vote to confirm Michael Leavitt to succeed her at the EPA. But the facts are--the evidence is--that Scott Pruitt does not have the requisite experience and track record to successfully lead an Agency that plays such a critical role in protecting the health and the well-being of the American people, and, certainly, the people that I represent in the great State of Michigan. As I mentioned before, we are very, very familiar with the importance of clean water and the consequences of environmental mismanagement. We need an EPA that will act quickly when there is a crisis like the one that happened in Flint, which is, unfortunately, still going on. This was a manmade crisis inflicted by the State of Michigan's actions on a number of different levels that created a situation where the State would rather save $100 a day than treat the water for lead corrosion. So $100 a day they wanted to save rather than treat the water to prevent children and families from being exposed to lead- tainted water. This was a State decision. Mr. Pruitt has made it clear that it is his intention to defer as much as possible to States--to States like Michigan, which didn't treat the water, then didn't tell the truth, then covered it up, and still has not done--despite Congress and the President together acting to support that community, the State still has not stepped up to meet their responsibilities. After more than 2 years, people still cannot turn on the faucet and have confidence that they are going to have clean water. Yet Mr. Pruitt says the State ought to be the one making these decisions. While I firmly believe an effective EPA is one that works closely and often in concert with State and local communities, we must also be sure we have leadership at the EPA that is willing and capable of providing the oversight necessary to ensure environmental and public health standards. We also need an EPA Administrator whom we can trust to protect and preserve our amazing Great Lakes. Critical to this objective is a grant program administered by the EPA called Great Lakes Restoration Initiative. I was very pleased to champion and help launch this in 2010 with strong support from the Obama administration. This accelerates efforts to protect and restore the Great Lakes by providing grants to clean up contaminated areas; prevent and control invasive species, things like Asian carp, which we are constantly having to focus on to push back these fish from destroying our fisheries and boating operations and environments in the Great Lakes; to address harmful algae blooms and restore habitat; and to protect native species. Scott Pruitt's long record of opposing nearly all Federal environmental programs raises serious questions to me about his commitment to the Great Lakes Restoration Initiative and all of the efforts we have worked on in a bipartisan, bicameral way to make sure we are protecting 20 percent of the world's freshwater, 30 million people's drinking water, and a huge economic engine called the Great Lakes. I always like to say the Great Lakes are in our DNA, and that is very true for all of us who live in Michigan and certainly around the Great Lakes because we understand that this great natural resource supports more than 1.5 million jobs and nearly $62 billion in wages tied to jobs and industries, and, frankly, it reflects our wonderful quality of life in Michigan. I also have great concerns about Mr. Pruitt's long-running opposition to the landmark renewable fuel standard, which puts him at odds with the Agency that administers the program. The President promised us a farmer-friendly EPA. Yet this nominee to lead the Agency wants to dismantle one of the most successful economic drivers in rural America. Mr. Pruitt has repeatedly spoken out against the renewable fuel standard, calling the program flawed and unworkable. Mr. Pruitt heading up EPA, coupled with former ExxonMobil executive Rex Tillerson at the State Department and oil refinery owner Carl Icahn advising the White House, may well be the end of the RFS as we know it. That is, frankly, bad news for biofuels producers in Michigan, bad news for Americans who care about creating economic growth and jobs in rural communities, and bad news for small towns and communities throughout Michigan. Mr. Pruitt's record of siding with polluters over sound science puts him outside the mainstream of what we should expect from our EPA Administrator. It is for these reasons that I intend to vote against his nomination, and I urge my colleagues to do the same.

Ms. STABENOW

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

Ms. STABENOW. Mr. President, the Secretary of the Treasury is one of the most powerful positions in our government, as we know. The Treasury Secretary has broad responsibilities--for the economy, for our tax system, trade, our pensions, housing, and so much more. It is critical that anyone who holds that position use their power to help working people. It is clear to me that Mr. Mnuchin's policies will, in fact, hurt middle-class families and working people. There are also serious ethical concerns that neither he nor my Republican colleagues have been able to address. As a result, I will be voting no on his nomination. I would like to talk about something that has not received the focus that I think it deserves and certainly that the people of Michigan feel it deserves, and that is the question of pensions and what is happening to pensions in our country. Mr. Mnuchin has a history of fighting against working people and profiting off their misfortune. As we know, pension funding can have a significant impact on a company's bottom line. But losing a pension can destroy a family's bottom line, and it seems that Mr. Mnuchin doesn't know this. When serving on the board for Sears, Mr. Mnuchin played a critical and direct role in how to fund the company's pensions. So what happened? Sears routinely underfunded the company's plan throughout his tenure. Analysts predicted that Sears ``massively underfunded'' their pension plan. They said their ``massively underfunded'' pension plan was ``a ticking time bomb'' that could even hasten or bring down the financial collapse of the company. The company used investment return projections that were too optimistic, along with accounting gimmicks so they could avoid paying into the pension fund. They inflated their earnings on paper while contributing less to the pension. Sears did such a bad job managing their pension fund while Mr. Mnuchin was on their board, that the fund only made a return of 1.5 percent, putting their fund in the bottom 5 percent of all the pension funds over $1 billion. Is this the kind of result the American taxpayers want when he manages their money? Already, Sears has been cutting its employees' pensions. In 2014, the company eliminated the monthly health care subsidy that helped its retirees afford their health care premiums. That saved Sears and Kmart about $6.2 million a year. I have received a lot of letters from Michigan families a lot from families who are very concerned about their pensions. One of my constituents who worked in the trucking industry said: We took small raises on our paycheck each contract so the company could put more in the pension fund-- That is what people do. They take less every month in their paycheck so they can have more in the pension fund. I know in the Presiding Officer's State and my State, that is what they do. He continued-- and [we] were told we would receive a certain amount for the rest of our lives. That is what we based our retirement on. Through no fault of ours, over the years, government deregulation of the trucking industry, passing trade agreements and other laws that have devastated the economy, have made our pensions become doubtful. Can you imagine paying all your lifetime? My brother drives a truck and counts on the fact that he is working hard every day and putting money into a pension fund for his family when he retires, and it is supposed to be there, right? The pension is a promise that is supposed to be there. Another woman from West Michigan wrote in worried about her Central States Pension Plan. That is the pension plan my brother is in as well. She said: My husband retired from Grocers Baking Co. of Grand Rapids and has a pension in Central States Pension Fund. As you know, that pension fund is in critical status and the Treasury Department turned down a plan to save all the pensions. My husband is 74 and I am 78 and we rely on that pension and Social Security to live on. We try to save, but it is difficult. We are hoping that the pension will last more than 10 years, but who knows. I also hear from people in Michigan all the time about how little accountability there is when it comes to the management of people's pensions. One man wrote in from Macomb County about his own pension plan: Why are none of the trustees being held accountable for the bad investments or failure of the plan? I'm sure they all have their golden parachutes in place for when they retire. Why do we, the hard workers, have to suffer because of their incompetence? I am just an average guy hoping that you can help protect the benefits that are due to me, so I can enjoy retirement when my time comes. The Treasury Secretary nominee sat on the Sears board when they were making changes that created the investments that were not as good as they should have been, when they underfunded their pension system, cut back on help for health care, and he is asking for a promotion. I wonder what my constituents in Macomb County will be saying about that. The Treasury Secretary plays a very important role in the security of our pension system--one of the basic tenets in our country, the way we support each other, the way people have trust in the system, you know that when you pay into the pension and then when you retire you get the pension. The Treasury Secretary oversees implementation of the Multiemployer Pension Reform Act and serves on the board of directors of the pension overseers. I asked Mr. Mnuchin in committee: What is your position on the Multiemployer Pension Reform Act, which Treasury is responsible for administering? How do you propose to shore up our multiemployer pension system and protect people who are counting on their pensions? His answer was: ``You have my commitment to work with you to find solutions to the multiemployer pension crisis.'' That is it. I resubmitted the question, hoping for a more detailed response. His response was: ``If confirmed, I will consult with you and other interested parties on the Multiemployer Pension Reform Act of 2014.'' That is not much of an answer for the people whom I represent, who want to know how he feels and what he is going to do to protect their pensions. The American people deserve a better answer than that. People are struggling, retirees are struggling after trusting the system and paying into their pensions their whole life--the whole time they have been working, paying in, counting on having that dignity in retirement. We need a Treasury Secretary who understands that a pension is a promise. Mr. Mnuchin's actions have not demonstrated that he understands that. Even when it comes to something as basic as Social Security, during our Finance Committee hearing, Mr. Mnuchin couldn't tell me the average monthly benefit when I asked him, which, by the way, one-third of our seniors virtually rely on that alone, and the rest are putting together a small pension, and most seniors are counting on Social Security and their pension to have dignity and a quality of life in their retirement. The Treasury Secretary is a key overseer of the laws and management process and accountability for both of those systems. So for me this is a very big deal who is in this spot, in terms of how this affects working people, middle-class families, and retirees. I didn't mention earlier that when I asked him what the average Social Security payment was--which he could not answer--he also couldn't tell me what he meant about a ``cut'' in Social Security; if he wasn't going to cut, what that meant. Did that mean putting in place a lower cost of living? What did that mean? He did not answer that. Let me talk about another pretty basic area. Pensions are critically important so is the ability to have a home. Up until the financial crash, the disaster in 2008 and 2009, most families' savings for retirement, savings to put their kids in college, were through the equity in their home. In 2008 and 2009, for millions of Americans, that disappeared. Mr. Mnuchin has made his career profiting from the misfortunes of working people, and let me talk about the financial crisis and how he benefitted from that as well. During the financial crisis, he put together a group of investors to purchase IndyMac Bank, which was renamed OneWest. During that time, OneWest was notorious for taking an especially aggressive role in foreclosing on struggling homeowners. OneWest Bank pushed people into foreclosure and made their last-ditch efforts to save their homes through a mortgage modification or other means all but impossible. When their voices were not allowed at the hearing on this confirmation, I was pleased to join with colleagues in putting together a forum where homeowners who had been impacted could share their experience. We held this forum for homeowners who were repeatedly given hope by OneWest that they might be able to avoid foreclosure, only to have it snatched away every time. One small business owner at the forum told us her story of how OneWest defrauded her and ultimately foreclosed on her. She told us that ``despite how difficult OneWest made the process, I did everything I was told, because I wanted to keep my home.'' Twice she applied for a loan modification. She submitted two checks with her new modification offer. OneWest cashed the checks--they cashed the checks--but told her that both offers were never received. Wait a minute. What is that? They cashed the checks, then told her the offers were not received, and therefore the offer was void. Eventually, she said: ``I received a knock on my door and a man introduced himself as the owner of my house.'' Unbelievable. Shortly thereafter she had to leave her home. OneWest was Mr. Mnuchin's company. This is one of the many stories about OneWest's abusive conduct. When OneWest Bank sold, Mr. Mnuchin and other investors made about $3 billion off the backs of folks who lost their home and many were like the women we heard from who tried desperately to work it out to keep their home. I wonder if the checks they cashed from her after they said they didn't get them were a part of that $3 billion. Finally, I want to express my concern over statements that Mr. Mnuchin made at the Finance Committee hearing that just don't line up with the facts; particularly, Mr. Mnuchin was asked whether his bank, OneWest, robo-signed foreclosure documents. To be clear on what this is, the banks, during the foreclosure crisis, had sworn documents robo- signed, automatically signed so they could foreclose on homeowners quickly without anyone even reading the documents. They just signed the papers--signed the papers--nobody reviewed whether they added up or whether they were right, whether they could help them. They just had the machine signing, signing, signing, foreclose, foreclose, foreclose. Mr. Mnuchin said in the hearing his bank didn't do that. He said his bank didn't do that. The Columbus Dispatch did an investigation that found that OneWest did do that in Ohio. A source in Texas reported that OneWest did do it in Texas. New Jersey temporarily banned OneWest from foreclosing on homeowners at all in New Jersey because of its history of robo-signing documents. Sign, sign, sign--don't look at it, just sign away. We heard the story of one woman who lost her house because of a 27-cent difference. I wonder if she was in one of those piles they just signed away. Mr. Mnuchin said they didn't do that. There is evidence to the contrary. Mr. Mnuchin also forgot to disclose to the committee that he owned a company organized in the Cayman Islands. When I asked him about that, his best defense was that ``I did not use a Cayman Islands entity in any way to avoid paying taxes myself.'' At the time, I said: Oh, so you just helped other people avoid paying their taxes. We find out now he did use it to help foreign investors avoid paying U.S. taxes. I have a funny feeling that he made money by helping those investors avoid paying their U.S. taxes. He also forgot to disclose that he owned $95 million in real estate in various locations. I forget that all of the time. I have so many houses all over the place, it is easy to forget. So $95 million in property that he ``forgot'' to disclose. He said he didn't know his real estate was an asset. He didn't know his real estate was an asset. That is alarming. I don't mean to be flip, but this is so shocking when I listen to some of this. The idea that we would believe someone who says this, that it somehow is making sense--that is why we as Democrats on the Finance Committee, before this final confirmation vote, asked that he be required to come back in and answer questions, because these are serious questions. This nominee has not been properly vetted. He supports policies that do not have the interests of the working men and women in Michigan at heart or people across the country. He adheres to policies that don't protect the pensions of hard-working men and women in Michigan and across the country or people's retirement systems. I don't know where he really is on Social Security, which is the other big piece of the promise we made as Americans, where people pay into Social Security and are counting on that being there. He has personally profited off the misfortune of those who need help the most. I urge my colleagues to join me in voting no.

Ms. STABENOW

Ms. STABENOW. Mr. President, today I wish to honor a champion for Detroit and for Michigan, Mike Ilitch. Everyone from Michigan knows his life story: the son of Macedonian immigrants, he founded Little Caesars Pizza, one of the largest pizza chains in the world, and rebuilt both the Detroit Tigers and the Detroit Red Wings into world class, winning franchises. He led the Red Wings to four Stanley Cups and brought the Tigers to the World Series twice. The story of Mike Ilitch is the story of never doing anything halfway. He embodies the American dream: he served as a marine, built a business empire, and had an eye for perfection that led him to incredible success. For him though, it wasn't enough to be satisfied with success in business or sports; it was all about giving back. He said it himself: ``I was raised in Detroit. I came from zero. This community helped make me. It's nice to give something back.'' He loved Detroit and worked to revitalize the city while maintaining its cultural history. His company, Olympia Entertainment, purchased the Fox Theater and restored it in 1988. He built Comerica Park, home to the Tigers. His recent $40 million donation to the Wayne State University School of Business will help build their state-of-the-art facility on Woodward Avenue, next to the new home of the Red Wings and the Pistons, Little Caesars Arena. Detroit is better off because of the work that he did. And the people of Detroit are better off because of his work. From his philanthropic organization that has given to those in need and the program he started through Little Caesars that helps honorably discharged veterans get employed, Mike Ilitch gave people a chance to succeed and to thrive. Mike will be sorely missed by all of us. His legacy is shared by his loving wife of over 61 years, Marian, and his seven children, but it is also shared by everyone in Michigan and all of those who love Detroit. Thank you.

Ms. STABENOW

Ms. STABENOW. Thank you very much, Mr. President. The decisions made by the next Secretary of Health and Human Services will affect all of us, and that is why we are here. That is why we have spent so much time and will continue to talk about the issues. This is not personal with the individual, this is about everyone in our country and how they are impacted by the ideas and the policies of this individual as well as the person who has nominated him. This particular individual has a very clear record as to what he believes should happen as it relates to Medicare and Medicaid, and our entire health care system. More than 100 million people rely on programs like Medicare--seniors, people with disabilities on Medicare. With Medicaid, the majority of money spent through the Medicaid health care system goes to seniors in nursing homes. That is where the majority of dollars go, long-term care for seniors. So Congressman Price's ideas, his proposals, the things he has pushed in the House matter because they show us what he believes should happen to Medicaid and to Medicare. We need to make sure the next Health and Human Services Secretary will fight for the health care of families in Michigan--at least I need to be sure. That is where my vote goes, based on what is best for families in Michigan. That is what is best for our communities, rural communities, where the hospital, like where I grew up in Clare, was the largest employer in the community, greatly affected and impacted by what happens to Medicare and Medicaid funding. If the hospital is not there, chances are the doctors aren't there either or the nurses. Our larger communities are where, obviously, our hospitals are critically important as well. So when we look at communities and hospitals and doctors, families, children, seniors, and the broad economy--and, by the way, one-sixth of the whole economy in our country is connected to health care. So who is in charge as Secretary of Health and Human Services is a big deal. That is why we have focused so much on this individual, his policies, his ideas, and his own background as well. As we have gone through the confirmation process, it is clear to me that Congressman Price's policies do not--do not--have the best interests of the people I represent in Michigan at heart, which is why I will be voting no on his confirmation. I have heard from thousands of people around Michigan. I have heard from people who like our hospitals and live in the community, and businesspeople and nurses and doctors with great concerns. I have also heard from people around the country and have helped to lead a forum for people to come and speak, people who were not invited into the actual hearing for the confirmation hearing. I thought it was important, as did my Democratic colleagues, to have a forum where people could speak about the ideas, the bills, the policies that Congressman Price has passed in the House of Representatives. So we heard a lot of stories and, overwhelmingly, people were opposed to this nominee. One of the people who shared her story was from Michigan. I was very appreciative that she came in from Michigan. Ann was diagnosed with multiple sclerosis when she was 4 years old. It resulted in functional quadriplegia. She has limited use of her right arm and no use of her left arm. She was fortunate to have strong employee benefits and to be covered until she went on Medicare at 65. By the way, this nominee thinks the age should go up--66 or 67, I am not sure how far. But Ann made it to 65 and, like so many people I know, was holding her breath to get there so she could have comprehensive quality health care that she paid into her whole life called Medicare. Over the course of the last few decades, the price of her prescription drugs have skyrocketed and would cost her tens of thousands of dollars a year without Medicare and Medicaid. For her, the decision about our Health and Human Services Secretary makes an enormous impact on her life. She told us: Without Medicare and Medicaid, things would have been very different for my family. I don't know how I could have cared for my mom on top of managing my own care. My family would have lost our home, all of our savings, trying to keep up with the bills. So many families are squeezed like ours, having to afford care for their aging parents and their own care, or childcare at the same time. But with support, we don't have to suffer to just be alive. If these programs are cut, if we see the kinds of proposals on Medicare and Medicaid that Congressman Price has put forward in the House, in the Budget Committee, people will face more catastrophes than ever before. Our new President campaigned on a promise not to cut Medicare and Medicaid. He said himself: ``I am not going to cut Social Security like every other Republican, and I am not going to cut Medicare and Medicaid.'' But it doesn't square with the person he has nominated for this critical position, who will be making administrative decisions as well as leading his efforts on health care. So actions speak louder than words, at least that is what we say in Michigan. Just this fall, Congressman Price said he expects Medicare to be overhauled--overhauled within the first 6 to 8 months of Trump's administration. He also believes the age of eligibility needs to increase--his words--and that ``the better solution is premium support.'' What does that mean? That is another word for voucher. Some people say privatization. But basically instead of having an insurance card and a health care system where you can go to the doctor and know that you are covered with insurance, you get some kind of a voucher or an amount of money, and then you would be able to go find your own insurance, I guess, or figure out a way to pay for your insurance. Before Medicare, seniors were trying to figure that out and couldn't find affordable insurance in the private market, which is why, in 1965, Medicare was created. There is no way in the world I will support going backward to that kind of approach. As chair of the Budget Committee, Congressman Price proposed a budget that would have cut Medicare by nearly $500 million, not counting what he wants to do with Medicaid, the majority of which goes to fund senior citizens in nursing homes. We need to have a Secretary who supports making it easier and more affordable for people to get care, not less. Let's talk about health care for a moment in the broader sense. We know more and more people--some 30 million people--would be affected, their health insurance ripped away, if the repeal is passed that has begun--the process has begun by Republicans in the House and in the Senate. The Affordable Care Act has provided health care and the opportunity for people to get care for children to be able to see a doctor. There are parts of the country where we need more competition, where prices are too high. I want very much to work on that. I am committed to working to make that system better, and we can do that without ripping the entire system apart. There is also another part of the Affordable Care Act that affects every single person with insurance--things that I know have made a tremendous difference to anybody with employer-based insurance; first of all, being allowed to have your child on your insurance until age 26; secondly, knowing that if you get sick, you can't get dropped by your insurance company, and if you have a chronic disease, something has happened to your health, you can't be blocked from getting insurance; and we also know things like making sure you can get all the cancer treatments your doctor says you need, not just those up to the cap that the insurance company will pay for. I had pediatric cancer physicians tell me they have been able to save children's lives who have cancer because there was no longer a cap on the amount of care. Mental health and substance abuse services, where if they were covered at all before the Affordable Care Act, it always cost more money: higher copays, higher premiums. Now you can't do that. You have to have the same kinds of copays and the same kinds of premiums. So many patient protections have basically said to insurance companies: You don't get, just based on profits, to decide what is going to happen; that when you buy insurance, you actually get health care. And that is something true for everyone today. So we have a Secretary nominee who supports doing away with all that, changing all that, who is not someone who is interested in having a basic set of services identified in health care, like maternity care. I talked with him, questioned him in the Finance Committee. This is an area I had championed when we passed the Affordable Care Act to make sure that basic services for women were viewed as basic services in health care, and it starts with prenatal care and maternity care. Prior to the Affordable Care Act, it was very hard to find private insurance that covered maternity care, unless you wanted to pay for--some 70 percent of the plans out in the private market require women to pay more. So I asked Congressman Price, did he believe maternity care was a basic service and should be covered under basic insurance. He said: Well, women can purchase that if they need it, which is exactly what happened before--which is, no, it is not basic care, but you can purchase it on top of your regular premium, if you need maternity care. So right now the law says you can't discriminate and charge women more than men, and in fact being a woman is no longer a preexisting condition. But the person whom the President has nominated for Health and Human Services would take us back there, and he would take us back there on a whole range of areas that create access for people to be able to have the care they need. Here is an example from a doctor in west Michigan who wrote me regarding just basic medical care for someone in need. He said: In December, a young man arrived in our emergency room with a badly mangled hand from a machining accident. He knew the hand was seriously injured and was willing to allow his coworker to bring him into the hospital so that it could be stitched up. When our physician studied the wound, they knew he needed surgery to repair the bone and blood vessel damage. The patient refused, thinking the only thing he could possibly afford was stitches. They then connected this man with a financial services specialist who took a few minutes to find out that he was eligible for Medicaid, working; now, because of the expansion, able to receive health care under Medicaid. He was then able to get the surgery he needed. Beaumont physicians said that if the surgery hadn't happened, the man could have had an open wound for an indefinite amount of time, been prone to infection, and possibly lost his hand entirely, making him unable to ever work at his job or maybe any job again. Expanding Medicaid health care to working people is a good idea, and millions of people have been impacted and have been able to get the care they need for themselves and for their children. Access to health care saved this man's arm and possibly his life, and that is really what is at stake here, both with this nominee and the larger debate on where we are going to go in our great country on the whole issue of health care. We all know that the advice of the Secretary of Health and Human Services will be a strong influence on the President's decision to promote, to sign, to veto legislation. We know he has the ability administratively to do a number of things--to cut off care, to cut off access to women's health care, to change the system that we have now, to destabilize it so that the Affordable Care Act will not work. I am extremely concerned that because of Congressman Price's record and his actual proposals and decisions and votes, he will be willing to actually do that. Whether it is cutting Medicare or Medicaid or removing some of the critical policies that keep people healthy and care affordable, I am deeply concerned about the decisions this nominee will make and the recommendations he will make to the President of the United States. Again, we don't have to speculate about this. He has put these plans on paper. He has supported them. He has passed them. It is very clear. We don't have to guess where he wants to go: to dismantle Medicare as we know it, to gut Medicaid, most of which goes for seniors in nursing homes, and to unravel the entire health care system and the patient protections that every American who has insurance has right now that allow them to get the health care they are actually paying for. I need to raise one other thing because this is very serious and goes to serious issues surrounding conflicts of interest and likely ethics violations that relate to this nominee. There are a lot of unanswered questions and serious concerns related to Congressman Price's investments in health care and pharmaceutical companies. Frankly, he misled the Finance and the HELP Committees with answers to questions, and just the night before he was to have a confirmation hearing and vote, we learned from company officials that he got a privileged offer to buy stock at a discount. In other words, he got a special deal on health care stock. He told us he had not; they had paid fair market value, even though it was already an issue that he had purchased stock and then put legislation in related to similar companies or the same companies involved. But then we found out it was even worse because he got a special deal. As Democrats, we asked for answers. We did not want to move forward without asking the Congressman to come back before us so we could ask questions about what he had said to the committee versus what the business that sold him the stock said afterwards. Unfortunately, that did not happen, requiring the Finance Committee to be in a situation where the rules ended up being broken and the nomination was forced through the committee without having bipartisan participation. I have a number of concerns related to the ethics and possible legal violations of this nominee. On multiple occasions, he did purchase stock within days of introducing legislation that would have affected that company's bottom line and his investment. Despite multiple requests over several weeks, we still don't have the answers and, more importantly, the American people don't have the answers from the person who will oversee health insurance, oversee Medicare, Medicaid--the entire system. Someone who has invested and then helped the same companies indicated he didn't get a special deal, and now we have information that says otherwise. I think that is very concerning and should have been addressed before we were asked to vote on this particular nominee. There are a number of reasons--policy, track record, questions that have been raised that I find extraordinary that they haven't been answered and shocking that folks haven't felt they should be answered at this point. But for many reasons, it is my intention to vote no on behalf of the people in Michigan who care deeply about a strong, effective Medicare system, about making sure Medicaid is there for our children as well as our seniors and nursing homes, and for everyone who believes that in this great country, all should have the ability to see a doctor and get the medical care you need for your child or yourself. Mr. President, I yield the floor.