Ron Wyden

Mr. WYDEN

Mr. WYDEN. Mr. President, I know both sides are working on trying to get an arrangement for the vote. Mr. President, I also want to tell my colleague from Texas that I listened very carefully to his remarks with respect to transparency in government. He has had a long interest in the Freedom of Information Act and the like. I noted that he made a comment about the Bay of Pigs, about which information is still classified, and I know something about this because my dad wrote a book about the subject. My hope is that my friend from Texas and his interest in transparency will also extend to some other areas. As I indicated, I am very familiar with my colleague's record with respect to Freedom of Information Act issues, which really is impressive. I hope to get him involved in some other areas of transparency--perhaps in campaign finance reform and the issue I am going to be speaking about today, that of getting the American people the information--after 6 years of stonewalling--on how many lawful Americans are getting swept up in what will be Dan Coats' top priority, that of the reauthorization of the Foreign Intelligence Surveillance Act. I want my colleague to know, in my being very much aware of his good work on the Freedom of Information Act issues, that we are going to try and conscript them into some other transparency issues as well.

Mr. WYDEN. Mr. President, of course. I will tell my colleague, as to what the majority and the minority have agreed to, as soon as those consent requests are ready, then we will take a time out from my remarks and make sure that matter is resolved. As we wait for the matter Senator Cornyn has mentioned, I will begin the discussion of the nomination of Dan Coats to be the Director of National Intelligence. I have known Senator Coats for many years. He has been the lead cosponsor of the bipartisan Federal income tax reform proposal, which has been a special priority of mine. I do not know of a single U.S. Senator who does not like Senator Coats. He is honest, a straight shooter, and gracious. My remarks are not about my personal affection for Senator Coats. The reason I am voting against the nomination is due to the matter I just touched upon with the Senator from Texas, which is, for 6 years, it has been impossible to get the intelligence community to provide the Congress and the American people information that is absolutely critical to the debate on reauthorizing the Foreign Intelligence Surveillance Act. For 6 long years, Democrats and Republicans, both in this body and in the other body, have been trying to get this information. So this morning, given the fact that this legislation would be the top priority of Senator Coats, as he said in the Intelligence Committee, I want the Senate and the country to understand why this issue is so important. First, I am happy to yield to my friend from Texas.

Mr. WYDEN

Mr. WYDEN. I thank my colleague. Now, as we consider the nomination of Senator Coats, and recognize that his top priority, by his admission, would be the reauthorization of the Foreign Intelligence Surveillance Act--particularly section 702--I want to begin this discussion by saying that it is because the intelligence community has stonewalled Democrats and Republicans in both this body and in the other body for 6 years on the information that we need to do good oversight that I have come to the floor to outline what I think the central issue is all about. I am going to begin my remarks by way of saying that, at a time when Americans are demanding policies that give them more security and more liberty, increasingly, we are seeing policies come from both this body and the other body that provide less of both. A good example would be weakening strong encryption. Weakening strong encryption is bad from a security standpoint, and it is bad from a liberty standpoint. When government creates policies that give the American people less of both--less security and less liberty-- obviously, the American people are not going to react well. My view is that when the government--particularly intelligence agencies--don't level with the American people about large-scale surveillance of law-abiding Americans, our people are justifiably angry. When the government tries to keep this information secret--as I have pointed out on this floor before--in America, the truth always comes out. Leveling with the American people is the only way for agencies to have the credibility and the legitimacy to effectively do their jobs. They have critically important jobs in keeping our people safe from threats. Now, with respect to Senator Coats, at his confirmation hearing, since he said the Foreign Intelligence Surveillance Act would be his top priority, I asked our former colleague how many Americans-- innocent, law-abiding Americans--have actually been swept up in the surveillance program known as section 702 of the Foreign Intelligence Surveillance Act. Under section 702, the government conducts warrantless surveillance of foreigners who are reasonably believed to be overseas. It does this work by compelling telecommunications companies and internet service providers to provide the content, phone calls, and emails, and other individual communications. Now, there are several different ways this happens, and I will get to that in the course of these remarks. What we are talking about--what I want people to understand--is that this goes to the content of communications. This is not about metadata collection. Congress, as the Senate knows, reformed that in the USA FREEDOM Act. This is surveillance without any warrants, and once the FISA Court signs off on the overall program, the details are up to the government. Now, this was not always the case. For decades, individual warrants were required when the government needed the assistance of the country's telecommunications firms. Then the Bush administration created a secret, but legal, warrantless wiretapping program. After the program was revealed, the government then went to the Foreign Intelligence Surveillance Act Court to get approval. But when the government ran into some trouble with the court, the Bush administration argued that the Congress should create the current program. It was first passed in 2007 under the name Protect America Act. That became the Foreign Intelligence Surveillance Act Amendments Act of 2008. Now, fortunately, the Congress included a sunset provision, which is why it was up for reauthorization in 2012, and that is why it is up for reauthorization this year. This year it is Senator Coats' top priority, if confirmed. Whoever is the head of the intelligence community will be the point person for this legislation. I want it understood that the reason that I am going through this background is that I believe the American people deserve a fully informed debate about the Foreign Intelligence Surveillance Act reauthorization. You cannot have that debate--you cannot ensure that the American people have security and liberty--unless you know the impact of section 702 of that bill on the constitutional rights of law- abiding Americans. So for 6 years, in this body, Democrats and Republicans--and in the other body, Democrats and Republicans--have been asking the same question: How many law-abiding Americans are having their communications swept up in all of this collection? Without even an estimate of this number, I don't think it is possible to judge what section 702 means for the core liberties of law-abiding Americans. Without this information, the Congress can't make an informed decision about whether to reauthorize section 702 or what kind of reforms might be necessary to ensure the protection of the individual liberties of innocent Americans. At Senator Coats' nomination hearing before the Senate Intelligence Committee, I asked Senator Coats whether he would commit to providing Congress and the public with this information. I will say, because of my respect for Senator Coats and our longtime cooperation on issues like tax reform and a variety of others, I hoped that Senator Coats would be the one--after 6 years of struggling to get this information-- to make a commitment to deliver it to the Senate Intelligence Committee before work on the reauthorization began. Instead, Senator Coats said: ``I will do everything I can to work with Admiral Rogers at the NSA to get you that number.'' If confirmed, I hope that happens. But after asking for the number of law-abiding Americans who get swept up in these searches for years, and getting stonewalled by the executive branch, hoping to get the information we need to do real oversight is just not good enough. The problem--the lack of information on the impact of this law on the privacy of Americans--goes all the way back to the origins of the authority. In December of 2007, the Bush administration, in its statement of administration policy on the FISA Amendments Act, stated that it would likely be impossible to count the number of people located in the United States as communications were reviewed by the government. In April of 2011, our former colleague Senator Mark Udall and I then asked the Director of National Intelligence, James Clapper, for an estimate. In July of that year, the Director wrote back and said: ``It is not reasonably possible to identify the number of people located in the United States whose communications may have been reviewed under the authority of the Foreign Intelligence Surveillance Act.'' He suggested reviewing the classified number of disseminated intelligence reports containing a reference to a U.S. person, but that is very different than the number of Americans whose communications have been collected in the first place. And that is what this is all about: How many law-abiding Americans--innocent, law-abiding Americans--are getting swept up in these searches? It will be an increasingly important issue as the nature of telecommunications companies continues to change, because it is now a field that is globally interconnected. We don't have telecommunications systems just stopping at national borders. So getting the number of Americans whose communications have been collected in the first place is the prerequisite to doing real oversight on this law and doing our job, at a time when it is being reauthorized and the American people want both security and liberty and understand that the two are not mutually exclusive. So Director Clapper then suggested reviewing the classified number of targets that were later determined to be located in the United States. But the question has never been about the targets of 702, although the mistaken targeting of Americans and the people in our country is another serious question. The question that Democrats and Republicans have been asking is about how many Americans are being swept up by a program that, according to the law, is supposed to only target foreigners overseas. So let me repeat that. That is what the law says. The Foreign Intelligence Surveillance Act says that the targets are supposed to be foreigners overseas, and Democrats and Republicans want to know how many law-abiding Americans, who might reside in Alaska or Oregon or anywhere else, are getting swept up in these searches. (Mr. SULLIVAN assumed the Chair.) So this bipartisan coalition has kept asking. In July of 2012, anticipating the first reauthorization of section 702 of the Foreign Intelligence Surveillance Act, I and 11 other Senators from both parties wrote to Director Clapper. This bipartisan group wrote: We understand that it might not be possible for the intelligence community to calculate this number with precision, but it is difficult for us to accept the assertion that it is not possible to come up with even a rough estimate of this number. If generating a precise estimate would require an inordinate amount of labor, we would be willing to accept an imprecise one. We asked about imprecise estimates, just a ballpark: How many law- abiding Americans are getting swept up in these searches that the law says are designed to target foreigners? We asked about orders of magnitude: Is the number closer to a hundred or a hundred thousand or a hundred million? We still got no answer, and section 702 was reauthorized without this necessary information. So last year, looking at the prospect of the law coming up, there was a renewed effort to find out how many law-abiding Americans are getting swept up in these searches of foreigners. In April 2016, a bipartisan letter from members of the House Judiciary Committee asked the Director of National Intelligence for a public estimate of the number of communications or transactions involving U.S. persons collected under section 702 on an annual basis. This letter, coming from the House--Democrats and Republicans--again asked for a rough estimate. This bipartisan group suggested working with Director Clapper to determine the methodology to get this estimate. In December, there were hints in the news media that something might be forthcoming. But now, here we are, with a new administration, considering the nomination of the next head of the intelligence community, who has said that reauthorizing section 702 is his top legislative priority, and there is no answer in sight to the question Democrats and Republicans have been asking for over 6 years: How many innocent, law-abiding Americans are getting swept up in these searches under a law that targets foreigners overseas? Having described this history, I want to explain why this issue is so important, starting with the many ways in which innocent Americans can be swept up in section 702 surveillance. The first are targeting mistakes in which, contrary to the law, the target turns out to be an American or someone in the United States. The full impact of these mistakes on law-abiding Americans is not readily apparent. The most recent public report on section 702 noted that there were compliance incidents involving surveillance of foreigners in the United States and surveillance of Americans. This is in violation of the law, and it happens. The second way in which Americans can be swept up in section 702 collection is when they communicate with an overseas target. This is usually called incidental collection and is often mischaracterized. I have heard many times that the program is intended to find out when Americans are communicating with ``bad guys''--and I want it understood, I am not interested in some kind of ``bad guys caucus.'' I know of no Senator who is not interested in protecting our country from those kinds of threats. If a known terrorist overseas is communicating with someone in the United States, we ought to know about it. But section 702 is not just a counterterrorism program. The statute requires the collection be conducted ``to acquire foreign intelligence information.'' As implemented, the standard for targeting individuals under the program is that the government has reason to believe those persons possess, are expected to receive, or are likely to communicate foreign intelligence information. Obviously, that is broad. It doesn't even require that a target be suspected of wrongdoing. So if someone tells you that your communications will be collected only if you are talking to al-Qaida or ISIS, that is just factually wrong. It is also important to note that the government is prohibited from collecting communications only when the sender of an email and everyone receiving that email are in the United States. So an American in the United States could send an email to another American in the United States, but if the email also goes to an overseas target, it is going to be collected. That then brings us to the different kinds of collection under section 702 and how they affect the liberties of our people in different ways. In one form of collection known as PRISM, the government orders an internet service provider to provide the government with messages to and from a specific email address. Then there is something known as upstream collection, which is when the communications are collected off the telecommunications and internet backbones. In other words, phone calls and email messages are collected in transit. This kind of collection raises a number of other reasons to be concerned about how many law-abiding Americans are getting swept up. For one, it is through upstream collection that the government can collect emails that are neither to nor from a target. The email merely has to be about a target, meaning, for example, it includes a target's email address in the content. In other words, the government can collect emails to and from Americans, none of whom are of any interest to the government whatsoever, so long as the target's email address is in the content of the email. The law requires only that one of the parties to the communication, who, again, could be another American, is overseas, and even that requirement is harder for the government to meet in practice. The implications here ought to be pretty obvious. You don't even have to be communicating with one of the government's targets to be swept up in Foreign Intelligence Surveillance Act collection. You don't even have to be communicating with a foreigner. You or somebody emailing you just needs to reference a target's email address. I have now mentioned that this target is not necessarily a terrorist because the law allows for surveillance ``to acquire foreign intelligence information.'' That has been interpreted to allow the targeting of individuals who the government has reason to believe possess, are expected to receive, or are likely to communicate foreign intelligence information. It is a broad standard, and the government could then collect the communications of all kinds of foreigners around the world. Think about how easy it would be for an American business leader to be in contact with the broad set of potential targets of this program. Consider how easy it would be for Americans, communicating with other Americans, to forward the emails of these people. All of this could be collected by the government. The upstream collection also includes the collection of what are called multicommunications transactions. This is when the NSA collects an email that is to, from, or about a target, but that email is embedded among multiple other communications that are not. These communications may have nothing to do with the target, but the government just kind of, sort of ends up with them--and some of them are sent and received entirely within the United States. These are the ways in which law abiding Americans--innocent, law- abiding Americans who have done absolutely nothing wrong, both overseas and in the United States--can have their communications collected under the Foreign Intelligence Surveillance Act. These are law-abiding Americans, innocent Americans, not necessarily suspected of anything, and it is their privacy and their constitutional rights that have caused Democrats and Republicans in this body and in the other body to seek the actual numbers of how many law-abiding Americans are getting swept up in these searches that are supposed to target foreigners overseas. The reason this is important is that the program is getting bigger and bigger. The exact numbers are classified, but the government's public reporting confirms steady increases in collection. At some point, the size of the program and the extent to which Americans' communications are being collected raises obvious concerns about our Fourth Amendment. The question is not if the program raises constitutional concerns, but when. And that gets to the heart of what our bipartisan coalition has been concerned about: If it is not possible for the Senate to know as part of reauthorizing this law how many Americans are being swept up by this program, we cannot determine whether the government has crossed a constitutional line. The Privacy and Civil Liberties Oversight Board, an agency the Congress has tasked to look at these issues, has raised the very same concerns I am outlining this morning. In the 2014 report by the Board-- the nonpartisan organization tasked by the Congress--concluded that the lack of information about the collection of the communications of law- abiding Americans' communications under section 702 ``hampers attempts to gauge whether the program appropriately balances national security interests with the privacy of U.S. persons.'' They went on to say: The program [is] close to the line of constitutional reasonableness. At the very least, too much expansion in the collection of U.S. persons' communications or the uses to which those communications are put may push the program over the line. They recommended exactly what our bipartisan coalition has been calling for--that the government provide to the Congress and, to the extent consistent with national security, that the public and the Congress get data on the collection of these communications of law- abiding Americans. The most frequently heard argument against what our bipartisan group of House and Senate Members has been calling for is that, whatever number of communications are being collected on law-abiding Americans, it is minimized, which implies that information about Americans is hidden. This is a particularly important issue. I have heard my colleagues on the other side say frequently: Well, if law-abiding Americans are having their communications swept up, we shouldn't get all concerned about that because this array of Americans' communications is being minimized. Somehow that means it is not getting out; it is being hidden. That is not necessarily what happens. To begin with, all that collection does not stay at the National Security Agency. All the emails collected through the PRISM component of section 702 go to several other agencies, including the CIA and the FBI. Then we have those three agencies, in particular, authorized to conduct searches through all the data for communications that are to, from, or about Americans: Look for an American's name, telephone number, email address, even a key word or phrase. They can do that without any warrant. There doesn't have to be even a suspicion--even a suspicion-- that an American is engaged in any kind of wrongdoing. The FBI's authorities are even broader. The FBI can conduct searches for communications that are to, from, or about an American to seek evidence of a crime. Unlike the National Security Agency and the Central Intelligence Agency, the FBI doesn't even report how many searches for Americans it is conducting. Moreover, neither the FBI nor the CIA reports on the number of searches for Americans that it conducts using metadata collected under section 702. The authority to conduct searches for Americans' communications in section 702 data is new. Before 2011, the FISA Court prohibited queries for U.S. persons. I am going to repeat that. Under the Bush administration and in the first 2 years of the Obama administration, it was not possible to conduct these backdoor, warrantless searches of law-abiding Americans. Then the Obama administration sought to change the rules and obtained authority to conduct them. In April 2014, the Director of National Intelligence's response to questions from me and Senator Mark Udall publicly acknowledged these warrantless searches. By June the House voted overwhelmingly to prohibit them. That prohibition didn't become law, but I can tell you that it is sure going to be considered in the context of this reauthorization. The House voted overwhelmingly to prohibit these warrantless searches. So the question really is this: What exactly is the privacy impact of these warrantless searches for Americans? In 2014, I managed to extract from the intelligence community some, but not all, necessary information about how many Americans had been subject of the searches. That was a step forward, but what the data doesn't tell us is who the subjects of these searches are. More to the point, it doesn't tell us how many Americans are potentially the subject of these searches. If the number is small, the potential for abuse, obviously, would be smaller. If the number is large, the potential for abuse is much greater. Without an understanding of the size of the pool from which the government can pull the communications of law-abiding Americans, there is just no way of knowing how easy it would be for the government to use this law as a means to read the emails of a political opponent, a business leader, a journalist, or an activist. I now want to turn to the ultimate form of abuse, and that is something called reverse targeting. It is prohibited by law and defined as collection ``if the purpose of the acquisition is to target a particular, known person reasonably believed to be in the United States.'' This prohibition also applies to U.S. persons. The question, though, is how this is defined and how the public can be assured it is not happening. If you look at the language, you can see why there has been bipartisan concern. The collection is only prohibited if the purpose is to get the communications of Americans. The question obviously has risen: What if getting the Americans' communications is only one of the purposes of collecting on an overseas target? What is actually acceptable here? This issue was concerning in 2008, when the Foreign Intelligence Surveillance Act Amendments Act passed with a prohibition on reverse targeting. But that was before the country knew about the collection of emails that are only about a foreign target and that could be to and from Americans. That was before the Obama administration sought and obtained authority to conduct warrantless searches for communications to, from, and about Americans out of section 702 PRISM collection. That makes an important point to me. This bipartisan coalition--of which I have been a part--has fought back against executive branch overreach, whether it is a Democratic administration or a Republican administration. I cited the fact that President Obama brought back something with the great potential for abuse and that President Bush said he wanted no part of. As we look at these issues, it is important to understand exactly what the scope of the problem is. Each of the agencies authorized to conduct these warrantless searches--the NSA, FBI, CIA--are also authorized to identify the overseas targets of section 702. The agencies that have developed an interest in Americans' communications, which are actually looking for these communications, are the same agencies that are in a position to encourage ongoing collection of those communications by targeting the overseas party. I believe our bipartisan group believes that there is very substantial potential for abuse. Because of these decisions taking place in the executive branch without any judicial oversight, it is possible that no one would ever know. To quote the Privacy and Civil Liberties Oversight Board: ``Since the enactment of the FISA Amendments Act of 2008, the extent to which the government acquires the communications of U.S. persons under Section 702 has been one of the biggest open questions about the program, and a continuing source of public concern.'' The Board noted that the executive branch has responded with any number of excuses for why it couldn't provide the number of how many innocent law-abiding Americans get swept up in these searches. One excuse has been the size of the program. But as Members--Democrats and Republicans--have said repeatedly, an estimate, perhaps based on a sample, is sufficient. Nobody is dictating how this be done. Another excuse has been that determining whether individuals whose communications have been collected are American would itself be invasive of privacy. Now this is something of a head-scratcher. I will just say that, as to the value of knowing how many law-abiding Americans get swept up in these searches, privacy advocates have stated that this far-fetched theory, this far-fetched excuse for not furnishing it, doesn't add up in terms of the benefit of finding how many Americans are swept up in these warrantless searches. The government is genuinely concerned about the privacy implications of calculating the number. I and many of my colleagues, both Democrats and Republicans, have been willing--and we renewed this in the last few weeks--to have a discussion about the methodology under consideration. In the months ahead, the Senate is going to be debating a number of issues relating to this topic, such as U.S. person searches, reverse targeting, and the collection of communications that are just about a target. The Senate is going to discuss how to strengthen oversight by the Foreign Intelligence Surveillance Court, the Congress, and the privacy board. The Director of National Intelligence will be right in the center of the debate. There is more information that the American people need. There is more information that this body needs in order to carry out its responsibility to do real oversight here. The center of these discussions about the reauthorization of the Foreign Intelligence Surveillance Act involves one question: How many innocent, law-abiding Americans have been swept up in this program that has been written and developed to target foreigners overseas? Congress's judgment about the impact of section 702 depends on getting this number. An assessment of the program's constitutionality rests on the understanding of the impact it has on Americans. A full grasp of the implications of the warrantless searches of Americans requires knowing how many Americans' communications are being searched through. Countless questions related to the reauthorization of the program all require that the public have this information. I am just going to close by way of saying what those questions are because if you want to do real oversight over a critically important program, you have to have the information to respond to these questions. The questions are these: Should there be safeguards against reverse targeting? Should Congress legislate on ``upstream'' collections and the collection of communications about targets, which raises unique concerns about the collection of the communications of law-abiding Americans? Are the rules related to the dissemination, use, and retention of these communications adequate? Should there be limits on the use of these communications by the FBI for non-intelligence purposes? Just think about that one for a minute. What does it mean to people in our part of the world where people feel that liberty and security are not mutually exclusive, but they are going to insist on both? What does it mean to them on the question of whether there ought to be limits on the use of this information by the FBI for non-intelligence purposes? That is exactly the kind of question that people are going to ask. I am heading home today for townhall meetings in rural areas, and those are exactly the kind of questions that Oregonians ask. People understand this is a dangerous time. That is not at issue. I serve on the Intelligence Committee, along with Senator Feinstein, and I have been one of the longer serving members. The fact that this is a dangerous world is not a debatable proposition. There are a lot of people out there who do not wish our country well. But what I say to Oregonians and what I will say again this weekend is this: Any politician who tells you that you have to give up your liberty to have security is not somebody who is working in your interest because smart policies give you both. That is why I started talking about the benefits of strong encryption--critically important for security. These questions are ones that I don't think are particularly partisan. That is why a big group of Democrats and Republicans here and in the other body have been seeking the information about how many law-abiding Americans get caught up in these efforts to target a foreigner overseas. We are now at a critical moment. A government surveillance program, with very obvious implications for privacy and constitutional rights, is up for reauthorization by the end of the year. While more information may be part of the answer, we have to have the best possible estimate to answer those questions that I just outlined. The American people want Congress to get to the bottom of questions that go right to the heart of our having policies that promote both their security and their liberty. I think the public expects a full debate. You can't have a full and real debate over the Foreign Intelligence Surveillance Act unless you have some sense of how many law-abiding Americans are getting swept up in these searches of foreigners. I believe the American people expect serious oversight over it. They want assurances that their representatives in Congress have a sense of what is actually being voted on. After years of secret surveillance programs being revealed only in the news media, I think the public has rightly insisted on more openness and more transparency. So getting the information that I have described today, which will deal with Senator Coats' top priority of reauthorizing the Foreign Intelligence Surveillance Act, is a critical first step. Once the Senate knows the impact of this program on Americans, then you can have a full and real discussion--a real debate in Congress--with the public and with the Director of National Intelligence. I took the view in the committee, despite very much liking Dan Coats and his being the bipartisan cosponsor of what is still the only Federal income tax reform proposal we have had in the Senate since the 1986 law was authored, I said that I cannot support any nominee to be the head of national intelligence if that nominee will not guarantee that before this reauthorization is brought before the Senate and brought before the Intelligence Committee, that we have the information needed to do our job, to do real oversight, to show the American people it is possible to come up with policies that promote security and liberty. For that reason, despite my friendship with Senator Coats, I cannot support the nomination. I yield the floor.

Mr. WYDEN

Mr. WYDEN. I suggest the absence of a quorum.

Mr. WYDEN

Mr. WYDEN. Mr. President, the Senate has been digging into the legal quagmire of drug testing the unemployed. I would like to begin by saying that no matter where a Senator comes down on the issue of drug testing, my view is that this measure before us is simply bizarre. If, like me, you believe that drug testing is ineffective and mean- spirited, you ought to oppose this measure because it simply vilifies unemployed workers who are actually less likely to use drugs than the general population. For those Senators who support drug testing, this measure blows up what has been a bipartisan compromise and a Labor Department rule allowing select testing to go forward. The result of this measure passing would actually be to block testing from going forward. The fact is that the courts have ruled that suspicionless drug testing violates the Fourth Amendment's protection against unreasonable searches and seizures. That is why there is now actually a rule that is narrow. We have the courts expressing skepticism about this, and there is actually a rule that is narrow so that, in effect, States that are doing this drug testing have what amounts to guardrails to avoid running afoul of the Constitution. If you pass this measure, you will throw out the guardrails, opening up, in my view, the possibility of yet more litigation on Fourth Amendment grounds. Now, as I touched on in my opening comments, there isn't evidence that unemployment insurance recipients use drugs any more frequently than the general population. In fact, studies actually indicate that they are less likely to use illegal drugs than the general population. So this idea that somehow there is a presumption of irresponsible conduct and guilt is just baseless. To be eligible for unemployment insurance, workers have to have substantial recent work experience. They have to be unemployed through no fault of their own. Workers can only collect unemployment benefits if they are actively searching for work and available to work. For States that have implemented drug testing policies, there is evidence that the costs dwarf the potential savings. The costs of operating drug testing programs are charged to State health and human services accounts, and I think we all understand that those have been squeezed mightily by the effort to treat opioid addiction. In my view, instead of wasting money by drug testing Americans who are looking for jobs, the States ought to be putting those very same dollars toward substance abuse treatment, given the fact that opioid addiction has hit our country like a wrecking ball. Moreover, we have said that fighting opioid addiction ought to be a bipartisan cause. If Republicans wanted to do everything possible to fight addiction, they shouldn't be going forward with TrumpCare, a bill that would be a disastrous setback when it comes to fighting opioid addiction. The fact is that colleagues on the other side of the aisle here in the Senate--colleagues not from my side but colleagues from the other side--have expressed their concern about what TrumpCare means for the fight against opioid addiction. The hard numbers are actually out now on TrumpCare, and they show that the majority is going into overdrive to pass a bill that strips millions of Americans of their access to treatment for substance abuse. Today Medicaid is strengthening our mental health network, expanding access to substance use disorder treatment, and is at the forefront of some promising new work to fight opioid addiction. So TrumpCare hits the cause of treating opioid addiction in a devastating way. It slashes the healthcare safety net, and, in my view, it would inflame the epidemic of drug abuse deaths across the country. At the same time, there is this partisan effort to slash funding for addiction treatment. Republicans have dredged up an old head-scratcher of an argument that drug testing Americans and denying them earned benefits somehow just magically helps to overcome addiction. This is an important point. Just like Social Security, unemployment insurance is an earned benefit. It is an earned benefit that ought to be there for workers who fall on hard times. So what the majority is pushing for in this debate looks to me like light years away from what was discussed last year when there was discussion before the election about helping Americans in every part of the Nation who are struggling with opioid addiction. You have to ask this question: What earned benefits are my colleagues on the other side of the aisle going to crusade against next? Is the drug testing crusade going to turn next to Social Security and Medicare recipients as an excuse to deny seniors benefits that they have earned--earned benefits that they worked hard for through a lifetime of work? I am going to wrap up by way of saying that, if this measure passes, I think States are just going to be thrown into bedlam. The current law, based on a compromise--a bipartisan compromise reached in 2012-- says States can drug test recipients of unemployed benefits in two cases: first, if the unemployment insurance recipient lost their job for drug-related reasons and, second, if the unemployment insurance recipient is applying for a type of occupation that requires drug testing, as defined by the rules of the Department of Labor. Let's say, for example, that two unemployment benefits recipients are specifically applying for jobs as schoolbus drivers or air traffic controllers. The rule that is on the books now says that States can drug test those individuals because they are applying for work in occupations that require drug testing. Now, as far as I can tell, my colleagues on the other side of the aisle want to eliminate the rule that defined those occupations. States would be blocked from performing any occupation-based drug testing for unemployment recipients, and the States would just be walking into a legal minefield if they wanted to go ahead with testing programs anyway. Make no mistake about it. When this passes--if it does--drug testing policies go on hold until the Congress passes a new law, rather than our continuing a carefully put together bipartisan compromise of just a couple of years ago. I have been trying to see this from my colleagues' perspective. I have listened to the arguments from the other side. I just find this a baffling, bizarre kind of analysis. All this measure does is create a huge amount of new uncertainty. That doesn't strike me as a good way to reduce bureaucracy and make government more efficient. If the majority decides to take another crack at this issue down the road, I can only guess at what kind of new ideas they might have that would, again, miss the point of making sure we had a narrow, defined, and bipartisan approach to deal with this issue. My view is that this is an ill-conceived campaign against working people built on a completely false premise. The premise is that if you are looking for work, you are guilty of drug use until proven innocent. My view is that we ought to keep trying, as I have said, on major issues involving health and taxes and infrastructure and trade. When you are dealing with important questions, we should work to find the common ground. It is not about taking each other's bad ideas. It is about taking each other's good ideas. My view is that what was done a few years ago was a good and narrowly tailored bipartisan idea. What the Senate may choose to do is basically to throw that in the trash can, create bedlam, and make it impossible for States to move because they are in a sort of legal limbo. I don't see how that meets the test of sound policy. This measure before us today sets back the cause of strengthening the unemployment insurance system. It sets back the cause of advocating for Americans struggling with addiction. I urge my colleagues to vote against this measure when we vote here in a little bit. I yield the floor. I suggest the absence of a quorum.

Mr. WYDEN

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

Mr. WYDEN. Madam President, the hard numbers are now in on TrumpCare, and there is no sugarcoating them for the American people, as 24 million Americans get kicked off their insurance plans, as $880 billion is slashed from Medicaid in the first decade, and as a payday worth hundreds of billions of dollars goes out to the wealthiest and the special interests. That is what is going to be dropped on Ms. Verma's plate if she is confirmed and if the bill passes. It is her nomination that is up for debate right now, and we should make no mistake that she is going to be in charge of the specifics. If TrumpCare passes, under section 132, the new Administrator would be able to give States a green light to push sick patients into high- risk pools when the historical record shows that these high-risk pools are a failure when it comes to offering good coverage that is affordable. The new Administrator would be in charge of section 134 and could decide exactly how skimpy TrumpCare plans would be and how many more Americans would be forced to pay out-of-pocket for the care they need. The new Administrator would handle section 135, which paves the way for health insurers to make coverage more expensive for those who are approaching retirement age. That is just the start. The fact is that TrumpCare is about enormous tax breaks for the fortunate few, financed by raiding Medicare, gutting Medicaid, and hurting older people and the sick and those who are of modest income. Ms. Verma would have the job of implementing all of this at the Centers for Medicare and Medicaid Services. My view is that the Senate cannot debate this nomination without debating the matter of the TrumpCare program itself because it will be a very huge part of the job. Today, I am going to walk through some of the specifics with regard to TrumpCare, beginning with the scheme that I call ``Robin Hood in reverse.'' If you look at the funds, it is clear that this is an eye-popping transfer of wealth away from older people, from women and kids--from the most vulnerable--directly into the wallets of the fortunate few. No part of the TrumpCare bill shows this more clearly than the fact that it steals from the Medicare trust fund to pay for a tax cut that goes only to the most fortunate--only to those who make a quarter million dollars or more per year. Everybody in America who brings home a paycheck has a little bit taken out each and every time for Medicare. It is right there on the pay stub. It is automatic. Under TrumpCare, the only people who are going to see a Medicare tax cut are the people who need it the least. I want to repeat that. Everybody in America, when one gets a paycheck, sees a Medicare tax, and everybody pays it, and we understand why it is so important. There are going to be 10,000 people turning 65 every day for years and years to come. The only people who are going to get that Medicare tax cut are the people who need it the least, and that tax cut that is going to go to the fortunate few will take 3 years off of the life of the Medicare Program, depleting the program in 2025 instead of in 2028. That particular cut breaks a clear Trump promise not to harm Medicare. All through the campaign, then-Candidate Trump was very, very firm in his saying that he would do no harm to Medicare. He said: You can't get rid of Medicare. Medicare's a program that works . . . I'm going to fix it and make it better, but I'm not going to cut it. The promise not to cut Medicare lasted about 6\1/2\ weeks into the Trump administration before it was broken. The bottom line is that TrumpCare raids Medicare. It raids Medicare and causes harm to Medicare in violation of an explicit Trump promise during the campaign, and it brings Medicare 3 years closer to a crisis to pay for a tax cut for the wealthiest in America. So you have this enormous, eye-popping transfer of wealth from working people, seniors, and people of modest means to the most fortunate. Yet, somehow, people have the chutzpah to say it is a healthcare bill? I do not think so. It is a huge, huge tax windfall for the fortunate. There is also the tax break on investment income. Once again, this is a break that is going to only go to the most fortunate among us, and, with the investment tax break, the overwhelming majority of the benefit--nearly two-thirds of it--will go to the top one-tenth of one percent of earners in America. That looks like an awful lot of money that is going to be going to the fortunate few, but we are not even done there. On top of all of this, there is yet another juicy tax--this time for health insurance executives' salaries. It is another juicy tax cut for executives who are making over $500,000 per year. It is not just Medicare that is getting raided under this proposal. Some of those who are hit the hardest by TrumpCare are those who are approaching retirement age. If you are an older American and are of modest income--55 or 60--and you have to get insurance in the private market, TrumpCare is going to cause your prices to go through the stratosphere. In parts of my home State, especially in rural areas, a 60-year-old who brings home $30,000 a year could see his insurance costs go up by $8,000 or more. Much of this is due to what we call an age tax. It is a key part of TrumpCare. It is another key part of what Ms. Verma will be in charge of implementing. The bill would give health insurance companies the green light to charge older people five times as much as they charge younger people. If you are a person of modest means, are a few years away from qualifying for Medicare, and your insurance premiums jump by $8,000, that means you are just out of luck. You are going to be locked out of the system. You are, basically, going to have to hope that you just do not get sick before you are eligible for Medicare. Those tax credits that you hear so much about from TrumpCare advocates are not going to be of much consolation to you. That is because TrumpCare puts a hard cap on your tax credit as an older person--just $4,000--and the odds are good that it would not come close to covering the expense of a decent insurance plan. Now, I am going to turn to Medicaid because TrumpCare does not just make little changes around the margins. It does not strengthen or preserve this program that covers 74 million Americans. TrumpCare hits Medicaid like a wrecking ball, and it has particular implications for seniors. I am going to walk through those. The Medicaid nursing home benefit is very much at risk now because of the TrumpCare cuts as it relates to Medicaid. Medicaid picks up the bill for two out of three nursing home patients. These are the people who have worked a lifetime, raised kids, put them through school, and scrimped and saved all they could. These are the people who, in Kansas and in Oregon and across the country, never went on the special vacation, who never bought a boat. All they did was to try to scrimp and save and educate their kids. The fact is that growing old in America is pricey, and after a few years of balancing the rent bill against the food bill and the food bill against the medical costs, what happens is that a lot of seniors just exhaust their savings. When I was director of the Oregon Gray Panthers, what I saw in my State--and it is duplicated everywhere--was older people walking every single week on an economic tightrope. They were balancing the food bills against the medical bills and the medical bills against the rent bills, and they just couldn't keep up. They burn through all of their funds and they burn through their modest savings, so when it is time to pay for nursing home care, they have to turn to Medicaid. Today in America, the Medicaid nursing home benefit is a guarantee that those vulnerable older people--the people who are walking on that economic tightrope--are going to be taken care of. TrumpCare breaks the Medicaid nursing home guarantee, and it goes even further than that. A lot of States--mine is one--worked hard to give more care choices to seniors as well as those with disabilities. Maybe instead of living in a nursing home or an institution, they would rather be in the community. Maybe they would rather live at home where they are most comfortable. TrumpCare could mean that those home- and community-based choices could disappear as well. So what we are talking about is that with these cuts in Medicaid, at a time when, in Kansas and in Oregon and across the country--what we have tried to build for older people is a continuum of services. There would be help at home. There would be help in terms of long-term care facilities. There would be a wide array of choices. And because of Medicaid, there was enough money to fund these choices, to fund this continuum of care for vulnerable older people. Now, as a result of the Medicaid cutbacks, my concern is that there is not going to be enough money for any of these choices--not going to be enough money for the nursing home benefit, not going to be enough money for home- and community-based services. Suffice it to say that my own home State has indicated to me that they are very concerned about the cutback in home- and community-based services. Nobody wants to see older people get nickled and dimed for the basics in home care they rely on and good nursing home benefits. Yet, when it comes to Medicaid, TrumpCare would effectively end the program as it exists today, shredding the healthcare safety net for older people and millions of others in our country. It puts an expiration date on the Medicaid coverage that millions of Americans got through the Affordable Care Act. For many, it was the first time they had health insurance. It brought an end to an era where those individuals could turn only to emergency rooms for care. And now TrumpCare is going to cap the Medicaid budget and just squeeze it and squeeze it and squeeze it some more until vulnerable people will not be able to get care. The program is particularly important for seniors and the disabled, and I want to make sure that people understand what it means for children as well, for those in the dawn of life as well as those in the twilight of life. Medicaid pays for half of all births, and kids make up half of Medicaid's enrollees. It is important to remember that in many cases, these are kids who already have the odds stacked against them. They are from low-income families. They are foster kids. They are kids with disabilities. We know they are already facing an uphill climb. Medicaid, though, has been there now with the Affordable Care Act to make sure they could see family practitioners and even pediatric specialists. That was just unheard of for these youngsters before the Affordable Care Act. And when a kid needs emergency care, Medicaid is what makes it affordable. TrumpCare puts that in danger. I have talked about what it means for older people and what it means for the disabled and what it means for kids, and I am just going to keep on going because now that we have the hard numbers in--the hard numbers have arrived here in real time from the budget office that is charged with giving us this analysis--it is important to talk about what it means, because budgets are not just facts and figures and cold sheets of paper; they are about people's hopes and aspirations. And the hopes and aspirations that I have had since those days when I was director of the Oregon Gray Panthers were to make sure that people had affordable, quality, decent healthcare choices because in America, if you don't have your health, you really are missing much of what makes life so special in our country. The bill also takes an enormous toll in other areas, and I want to mention next opioid abuse. By slashing Medicaid, TrumpCare is going to make America's epidemic of prescription drug abuse-related deaths even worse. The papers this morning had accounts about how families were losing most of their children to opioid addiction--most of their children lost to opioid addiction--on the front pages of the papers. Medicaid is a key source of coverage for mental health and substance abuse disorder treatment, particularly after the Affordable Care Act, but this bill takes away the coverage for millions who need it. Republican State lawmakers, to their credit, have spoken out about this issue. Frankly, it just ought to be a head-scratcher for anybody who remembers the last Presidential race when, in the primary race, a parade of candidates rolled through State after State that had been hit hard by the opioid crisis, and all of those candidates were trying to outpromise the one who had spoken previously in terms of how they would help solve the opioid crisis. Then-Candidate Trump was one of the most outspoken on saying that he would fix the opioid crisis. He said he was the guy who could end the scourge of drug addiction and get Americans the help they need. Instead, what we have is TrumpCare, which makes the opioid crisis worse, and there is no getting around it. TrumpCare puts States in the unimaginable position of having to decide whose Medicaid to slash. Are they going to tell seniors that the nursing home benefit is no longer a guarantee and they are going to have to get in a long waiting line for an opportunity to get a place in the local nursing home? Should they tell pregnant women that births are no longer covered? What about telling mothers and fathers that their kids are cut off and they will have to hope for the best or make their way back to the emergency room? I also want to touch on a final point that really deserves some discussion and hasn't gotten much, and the finance staff has been looking at it; that is, how TrumpCare really creates a disincentive to work, because I think TrumpCare and Ms. Verma's role implementing it are going to have a substantial effect on American workers and entrepreneurs. It is my view that TrumpCare creates a substantial, significant disincentive to work. Today, if you are on Medicaid, you are able to pick up a few extra hours at work or go out and accept a higher paying job without the fear that you will lose access to care. That is because under the Affordable Care Act, low-income Americans get the most help when it comes to paying insurance premiums. A lot of persons can get health insurance for less than $100 a month. Let's compare that with the TrumpCare approach. Under the TrumpCare plan, those who are walking an economic tightrope, bringing home barely more than the minimum wage, don't get the most help. They don't get the most help, and they could see their insurance costs go up by thousands and thousands of dollars each year, which would effectively mean they would be locked out of the healthcare system. So for millions of persons, staying on Medicaid would suddenly look a lot more attractive. Making a little more money and losing your Medicaid coverage could mean losing your access to high-quality healthcare altogether. So my view is nobody has been able to counter this. TrumpCare, in effect, would keep Americans trapped in poverty. Entrepreneurs and Americans who want to go back to school to pursue a degree would face the same dilemma. Somebody who wants to quit their job and pursue their dream of starting their own business ought to be able to do it without a fear that they won't be able to any longer afford healthcare. The same goes for those who want to go back to school full time to pursue a degree or certification. TrumpCare makes insurance unaffordable for those persons. TrumpCare is going to be the big issue on Ms. Verma's plate if she is confirmed this afternoon in the Senate to administer this office. We all understand that this bill has been taking a pounding from all sides. Moderate Republicans and those who consider themselves conservative Republicans are against it. Governors from both parties are against it. Democrats are united. The AARP, the American Hospital Association, the American Medical Association, and the American Nurses Association have all come out against the bill--not any surprise to me. I don't think these groups think that healthcare and healthcare legislation is primarily about ladling out big tax breaks for the fortunate few, but that is what this so-called healthcare bill does. And it is financed by raiding Medicare, by gutting Medicaid, and by hurting older and sicker and lower income Americans. There has been a lot of happy talk about why we ought to support this bill, but what I have tried to do this afternoon is lay out the broken promises. This weekend, for example, the new Secretary of Health and Human Services said: ``I firmly believe that nobody will be worse off financially in the process that we're going through, understanding that they'll have choices, that they can select the kind of coverage they want for themselves and for their family.'' That statement from the Secretary of Health and Human Services is disconnected from the facts. The simple math shows that TrumpCare forces millions of people-- particularly older people and less affluent people--to pay thousands of dollars more for their health insurance. The OMB Director, Mick Mulvaney, was pressed on why TrumpCare breaks the President's promise of ``insurance for everybody.'' His response was that TrumpCare is about access, and the bill ``helps people get healthcare instead of just coverage.'' But we all understand that access doesn't mean a lot if people can't afford to get coverage. That is the future that TrumpCare is going to bring for millions of Americans. I asked Ms. Verma the most basic questions during her confirmation hearing so we could get even a little bit of an insight into how she would approach these issues. I asked for one example--these are not ``gotcha'' questions; these are the questions you ask if you want to know about running a program involving $1 trillion. I asked Ms. Verma for one example of what to do to bring down the cost of prescription medicine. I gave her three or four to choose from. I particularly would like to see more transparency by lifting this cloud of darkness surrounding how medicines are priced. She didn't have any answers to any of these questions. So here is where this nomination stands. Ms. Verma gave the Finance Committee and the public virtually nothing to go by in terms of how she would approach this job, but the fact is that, if confirmed, she would be one of the top officials to implement TrumpCare--a bill that raids Medicare, slashes Medicaid, and kicks millions of Americans off their health plan to pay for a tax cut for the wealthy. I am unable to support this nomination, and I urge my colleagues to oppose it. Mr. President, over the past decade, the Trump administration's nominee to be CMS Administrator, Seema Verma, has demonstrated a conflicting pattern of working directly for the State of Indiana on its health programs while also contracting with a handful of companies that provided hundreds of millions of dollars in services and products to the very same programs she was helping the state manage. Those companies are Hewlett Packard, Health Management Associates, Milliman, Inc., Maximus, and Roche Diagnostics. All were vendors to the State's Healthy Indiana Program agencies, while Ms. Verma helped design and direct that Program--first for Governor Daniels and then for Governor Pence. As she describes her role on her company's website, ``Ms. Verma is the architect the Healthy Indiana Plan (HIP), the Nation's first consumer directed Medicaid program under Governor Mitch Daniels of Indiana and Governor Pence's HIP 2.0 waiver proposal. Ms. Verma has supported Indiana through development of the historic program since its inception in 2007, from development of the enabling legislation, negotiating the financing plan with the state's hospital association, developing the federal waiver, supporting federal negotiations and leading the implementation of the program, including the operational design.'' Ms. Verma collected more than $6 million from Indiana taxpayers while overseeing the State's Medicaid reform and ACA implementation. At the same time, while under contract with the State as a consultant, Ms. Verma also collected more than $1.6 million from Milliman Actuaries, more than $1 million from Hewlett Packard, $300,000 from Health Management Associates, and tens of thousands of dollars from Roche Diagnostics and Maximus. All while these companies held important contracts with the State. In addition to being on ``both sides of the table,'' in at least two cases involving her contracts with Hewlett Packard and Health Management Associates--her duties for the State of Indiana overlapped directly with the tasks those firms were also billing the state to complete. While there are questions about Ms. Verma's work for the several companies above, I want to focus for the moment on what I believe to be the clearest conflict: her work on behalf of Hewlett Packard. Hewlett Packard Conflicts. In 2014, the Indianapolis Star newspaper reported: ``Verma's work has included the design of the Healthy Indiana Plan, a consumer-driven insurance program for low- income Hoosiers now being touted nationally as an alternative to Obamacare. In all, Verma and her small consulting firm, SVC Inc., have received more than $3.5 million in state contracts. At the same time, Verma has worked for one of the state's largest Medicaid vendors--a division of Silicon Valley tech giant Hewlett-Packard. That company agreed to pay Verma more than $1 million and has landed more than $500 million in state contracts during her tenure as Indiana's go- to health-care consultant.'' While this in and of itself is deeply concerning, Indiana state contract records show that Ms. Verma was instrumental in helping the state determine this contract was even necessary in the first place. Let me say that again: Ms. Verma, in her role of advising Indiana, helped the state determine there was a need for the services of a vendor like Hewlett Packard. She then joined the company on a bid to provide those services, received a contract, and was ultimately paid more than $1 million. Hewlett Packard bought the company that originally contracted with the state, Electronic Data Systems in 2008. That company, in a January 2008 press release characterized the Indiana contract in this way: `` `The EDS solution will provide Indiana with enhanced transparency as it implements Gov. Mitch Daniels' package of Medicaid reforms such as the Healthy Indiana Plan . . .' `At the conclusion of the procurement process, it was evident that EDS was able to bring great value and experience to the taxpayers of Indiana,' said Mitch Roob, Family and Social Services Administration Secretary. `The technology and insight that EDS has to offer will be a tremendous asset as we continue to make great strides in new, innovative programs, such as the Healthy Indiana Plan.' '' Ms. Verma helped Indiana outline Medicaid reform policy goals as State contractor before joining a vendor in its bid to fulfill those duties--and then remained a paid participant on both sides. Furthermore, it appears that Ms. Verma was billing Hewlett Packard and Indiana, in some cases, for the same work she was already performing under her own contracts with the State. In written responses for the record to the Finance Committee, Ms. Verma provided a 2013 presentation from Hewlett Packard and herself to Indiana health program executives. The presentation identified several functions that Ms. Verma would provide to the State through the Hewlett Packard contract. Many of those duties are exceptionally similar to duties the State had already contracted with her directly to provide in 2012 and 2013. For example, that 2013 presentation outlined specific duties HP was paying her to perform that included: monitoring the Federal regulatory environment, providing Medicaid policy expertise, and supporting Indiana's State Plan Amendment waivers and process. These were things Verma was already under contract to provide the state directly. On February 21, 2012, Verma's firm was contracted by the State to review Federal regulations that would impact Indiana's Healthy Indiana Plan. On May 13, 2013, she was contracted to provide the State with advice on the impact of new ACA regulations related to Medicaid. To me, that sounds a lot like monitoring the federal regulatory environment in the HP presentation. Under the February 21, 2012 contract, Verma's firm was contracted by the State to provide general policy expertise to the Healthy Indiana Program--also known as Indiana's Medicaid program. To me, that sounds a lot like providing Medicaid policy expertise in the HP presentation. Under this same February 21, 2012 contract, Verma's firm was contracted by the State to develop State Plan Amendments and waivers-- these are the agreement between the State and Federal Governments that ensures the State adheres to Federal rules for Medicaid and CHIP. To me, that sounds a lot like supporting Indiana's State Plan Amendment waivers and process in the HP presentation. Ms. Verma has not addressed how being paid twice for what appears to be largely similar work was ethical. She has, however, consistently denied that any conflicts of interest existed while she worked both sides of these deals in Indiana. During her confirmation hearing before the Senate Finance Committee on February 16, 2017, Ms. Verma claimed she had her staff recused themselves when potential conflicts arose: ``When there was the potential or when we were working on programs, we would recuse ourselves. So we were never in a position where we were negotiating on behalf of HP or any other contractor with the state that we had a relationship with.'' That all sounds well and good but that claim has been disputed by the former head of Indiana's Family and Social Services Agency. As first reported in 2014 by the Indianapolis Star, ``Verma's arrangement with HP also came as a surprise to former FSSA Secretary Debra Minott, who said she learned about it sometime in 2013. `We had delayed paying an HP invoice because of an issue we were trying to resolve, and HP sent Seema to our CFO to resolve the issue on their behalf,' Minott said. `I was troubled because I thought Seema was our consultant.' '' Ms. Minott made this allegation again just last month in a February 14, 2017 story by the Associated Press about Ms. Verma's conflicts, ``There was at least one instance where Verma crossed the line in Indiana when she was dispatched by HP to help smooth over a billing dispute, said Minot. `It was never clear to me until that moment that she, in essence, was representing both the agency and one of our very key contractors,' said Minot, who was removed as head of the agency by Pence over her disagreements with Verma. `It was just shocking to me that she could play both sides.' '' Additionally, in response to questions for the record that I submitted to Ms. Verma, she said that her firm worked directly with HP for the state, and that representatives from SVC participated in meetings between the state and HP, ``SVC worked with the State of Indiana and its vendors, including HP, to design systems for implementation of the Healthy Indiana Plan. We helped vendors translate the policy and waiver language into system operations. We did not oversee HP or any other vendor in this regard, and did not negotiate or participate in change orders or contract amendments. To the best of my recollection, State officials participated in all meetings with HP regarding the Healthy Indiana Plan work at which SVC representatives were also present.'' That sounds to me like Ms. Verma and her team were in meetings with both HP and the State discussing issues where her duties clearly overlapped and when she was being paid by both parties. In fact it sounds like the only safeguard in place was that State officials sat in on these meetings between her firm and HP. Finally, with regard to her claim that she always recused herself, I specifically asked her to provide for the record any documentation that she had of the process for determining when she needed to recuse herself and documentation of the recusals actually taking place. She replied that there were none. Consequently, it's hard to believe Ms. Verma was truly able to avoid very real conflicts of interest while she and/or her firm were guiding HP's work on behalf of the State and sitting in on meetings with both the state and HP while being paid by both. In the case of Health Management Associates, Verma also had contracts with the state that covered the exact same work HMA was separately being paid by Indiana to fulfill and while she was also being paid by HMA. For example, in 2007, the State awarded Verma's firm a non- competitive contract to develop the Request for Proposal for a company to implement the Governor's Healthy Indiana Program. On the same day, Indiana gave HMA its own non-competitive contract to develop the very same proposal. This occurred while HMA was also paying Verma's firm on a separate but related contract. Again, as in the case of HP, she was helping the State manage key programs while being paid by contractors performing work for those programs. In this case, what she was doing for the State was essentially the same thing that the contractor was being paid to do--develop a Request for Proposal to implement the Healthy Indiana Plan. Ms. Verma claims there was no conflict because she did not directly oversee these two contractors--HP and HMA--in her role with State. She also points to the fact that in 2012 she received an opinion from the Indiana Ethics Commission that stated her work for HP was not in violation of state conflict of interest laws because she was a consultant, not a State employee. I do not believe that her work for the State and her work for these contractors was a true arms-length relationship. As the Associated Press recently highlighted, Ms. Verma maintained an office in the State government center and that the AP characterized her work as ``usually reserved for state administrators.'' The existence of this opinion, in my view, does not absolve Ms. Verma from what look to be very clear and obvious conflicts of interest. I am not alone in this opinion, as President George W. Bush's ethics lawyer Richard Painter--hardly a liberal partisan--said Ms. Verma's consulting arrangement in Indiana, ``clearly should not happen and is definitely improper.'' Ms. Verma helped the State decide it needed a vendor like HP, and then went to work for HP on the resulting contract. She was also under contract with yet a third company--Health Management Associates--which was being paid to develop the Request for Proposal for the same contract. That certainly seems like a conflict of interest to me. When I asked her in writing whether she had obtained similar ethics opinions with regard to her work for any of the other state contractors who had hired her--Milliman, Roche Diagnostics, Maximus, or Health Management Associates, she said she hadn't. All of these companies continue to do business with the State of Indiana and with other State and Federal health programs that will be under Ms. Verma's purview at CMS. Maximus, for example, is the largest provider of enrollment services for these programs in the U.S. Just because Indiana chose to play fast and loose with conflicts of interest doesn't mean that these practices were right. I have no confidence that Ms. Verma will take her responsibilities to avoid such conflicts at CMS any more seriously than she did in Indiana. Mr. President, I ask unanimous consent to have the following documents printed in the Record.

Mr. WYDEN. Mr. President, I yield the floor.

Mr. WYDEN. Mr. President, I ask for the yeas and nays.

Mr. WYDEN

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

Mr. WYDEN. Mr. President and colleagues, today the Senate turns to consider the nomination of Seema Verma to be the Administrator of the Centers for Medicare and Medicaid Services. I would be the first to say that in coffee shops across the land, people are not exactly buzzing about the office known as CMS, but the fact is, this is an agency that controls more than a trillion dollars in healthcare spending every year. Even more important and more relevant right now, if confirmed, and if TrumpCare somehow gets rammed through the Congress over loud and growing opposition, this is going to be a major issue on her plate right at the get-go. I thought it would be useful to just give one example of the connection involved in this legislation. TrumpCare cuts taxes for the special interests and the fortunate few by $275 billion, stealing a chunk of it from the Medicare trust fund that pays for critical services to the Nation's older people. If TrumpCare passes and Ms. Verma is confirmed, under section 132 of the bill, she would be able to give States a green light to push the very frail and sick into the high-risk pools that have historically failed at offering good coverage to vulnerable people at a price they can afford. Under section 134 of TrumpCare, Ms. Verma would be in charge of deciding exactly how skimpy TrumpCare plans would be and how much more vulnerable people would be forced to pay out of their pockets for the care they need. Under section 135 of the bill, if confirmed, Ms. Verma could be paving the way for health insurers to make coverage more expensive for older people approaching retirement age. Given all that, I want Members to understand there is a real link between this nomination and the debate about TrumpCare, and this is, in effect, the first discussion we have had about TrumpCare since these bills started to get moving without any hearings and getting advanced in the middle of the night. The odds were against Republicans writing a single piece of legislation that would make healthcare more expensive, kick millions off their coverage, weaken Medicare and Medicaid, and produce this Robin Hood in reverse, this huge transfer of wealth from working people to the fortunate. Nobody thought you could do all of that at the same time, but somehow the majority found a way to do it. Republicans are rushing to get it passed before the American people catch on. As part of this debate about Seema Verma, we are going to make sure people understand this nomination is intertwined with what happens in the discussion about TrumpCare and how these particularly punitive provisions with respect to Medicare and Medicaid would affect our people. For 7 years, my colleagues on the other side have pointed to the Affordable Care Act as pretty much something that would bring about the end of Western civilization and, at a minimum, would basically continue a system responsible for every ill in our healthcare system. That was the argument. The Affordable Care Act is responsible for just about every ill and will practically be the end of life as we know it. Their slogan was to ``repeal and replace,'' and it was a slogan they rode through four elections to very significant success. The only problem was, it was really repeal and run, and that replacement was nowhere in sight. Now the curtain has been lifted. The lights are shining on TrumpCare, and it sure looks to me like there are a lot of people not enjoying the movie. TrumpCare goes back to the days when healthcare in America mostly worked for the healthy and the wealthy. We have a lot of debate ahead, so we are not going to just lay it all out here in one shot. I do want to mention some key points on the roll that Ms. Verma, if confirmed, would play. I want to start by addressing what this means in terms of dollars and cents. If you look at the fact that the Medicare tax, which everybody pays every single time they get a paycheck, and that money is used to preserve this program that is the promise of fairness to older people-- the Medicare tax would be cut for only one group of Americans in this bill. I find this a staggering proposition. The people who need it the least, couples with incomes of over $250,000, people who need it the least would be given relief from the Medicare tax--not working families, just the wealthy. As I indicated, we are talking all told about $275 billion worth of tax cuts to the special interests and the fortunate few, and it is largely paid for by taking away assistance to working people to help, for example, pay for their premiums. I brought up the ACA Medicare payroll tax for a reason because I think when Americans look at their next paycheck--if you are a cop or a nurse and you get paid once or twice a month and you live, say, in Coos Bay, OR, or in Medford, another Oregon community, you will see it on your paycheck. If you are a cop or a nurse, no tax relief for you, but if you make over $250,000--on a tax that is used to help strengthen Medicare's finances, at a time when we are having this demographic revolution--the relief goes to people right at the top, and you reduce the life expectancy of the trust fund for 3 years. The first thing I will say with respect to what this means, the provision I have just outlined breaks a clear promise made by then- Candidate Trump not to harm Medicare. I remember these commercials--we all saw scores and scores of them-- Candidate Trump said to America's older people--many of whom voted for him, I think, to a great extent because they heard this promise--he said: You know, you have worked hard for your Medicare. We are not going to touch it. We are not going to mess with it. When the President was asked about cutting Medicare, here is what he said: Medicare is a program that works. People love Medicare, and it is unfair to them. I am going to fix it and make it better, but I am not going to cut it. The President of the United States said he is not going to cut it. Well, that promise not to harm Medicare lasted 6\1/2\ weeks into the Trump administration so the wealthy--the wealthy--could get a tax reduction, the fortunate few who need it least, and the effect would be to cut by 3 years the life of the Medicare trust fund. I think that ought to be pretty infuriating and concerning for people who work hard--cops and nurses and people who are 50, 55, 60 today. They are counting on Medicare to be around when they retire, but because TrumpCare made it a focus to give tax relief to the fortunate few, that tax relief cuts 3 years off the life of the Medicare trust fund. If that wasn't enough, people who are 50, 55, 60, before Medicare, they are going to get another gut punch. This one is in the form of higher costs. In parts of my home State--particularly in rural areas like Grant County, Union County, and Lake County--I am sure I am going to hear about this. I have townhall meetings in each one of my counties. A 60- year-old who makes $30,000 a year--now those are the people we have long been concerned about, particularly people between 55 and 65 because they are not yet eligible for Medicare. A 60-year-old, in communities like I just mentioned, who makes $30,000 a year, could see their costs go up $8,000 or more. The reason that is the case is a big part of TrumpCare. It is based on something we call an age tax. Back in the day when I was the director of the Oregon Gray Panthers-- and I was really so fortunate at a young age to be the director of the group for close to 7 years--we couldn't imagine something like the hit on vulnerable older people that this age tax levies. Republicans want to give the insurance companies the green light to charge older Americans five times as much as they charge younger Americans. The reality is that older people are going to pay a lot more under TrumpCare. That is what we were trying to prevent all those years with the Gray Panthers. We didn't want to see older people pay more for their healthcare, the way they are going to under TrumpCare if they are 50 or 55 or 60. I think the real question is whether they are going to be able to afford insurance at all. The reality is that a lot of those older people whom I have just described--and I have met them at my townhall meetings--every single week they are walking on an economic tightrope. They balance their food costs against their fuel costs and their fuel costs against their rent costs. Along comes TrumpCare and pushes them off the economic tightrope where they just won't be able to pay the bills, particularly older people in rural areas. So the reality is that it is expensive to get older in America, and we ought to be providing tools to help older people. But what TrumpCare does is, instead of giving tools to older people to try to hold down the costs, TrumpCare basically empties the toolbox of assistance and basically makes older people pay more. Next, I want to turn to the Medicaid nursing home benefit. Working with senior citizens, I have seen so many older people--the people who are on an economic tightrope, who are scrimping and saving--even as they forego anything that wouldn't be essential, burn through their savings. So when it is time to pay for nursing home care, they have to turn to Medicaid. The Medicaid Program picks up the bill for two out of every three seniors in nursing homes. Now, today the Medicaid nursing home benefit comes with a guarantee. I want to emphasize that it is a guarantee that our country's older people will be taken care of. All of those folks--the grandparents whom we started working for in those Gray Panther days--had an assurance that grandparents wouldn't be kicked out on the street. TrumpCare ends that guarantee. You could have State programs forced into slashing nursing home budgets. You could see nursing homes shut down and the lives of older people uprooted. We could, in my view, have our grandparents that are depending on this kind of benefit get nickeled and dimed for the basics in home care that they have relied on. When it comes to Medicaid, TrumpCare effectively ends the program as it exists today, shredding the healthcare safety net in America. It doesn't only affect older people in nursing homes. It puts an expiration date--a time stamp--on the Medicaid coverage that millions of Americans got through the Affordable Care Act. For many of those vulnerable persons, it was the first time they had health insurance. So what TrumpCare is going to come along and do is to put a cap on that Medicaid budget and just squeeze them down until vulnerable persons' healthcare is at risk. If low-income Americans lose their coverage through Medicaid, it is a good bet that the only TrumpCare plans they will be able to afford are going to be worth less than a Trump University degree. I want to move next to the effects of the bill on opioid abuse. Clearly, by these huge cuts to Medicaid, TrumpCare is going to make America's epidemic of prescription drug abuse-related deaths even worse. Medicaid is a major source of coverage for mental health and substance use disorder treatment, particularly after the Affordable Care Act, but this bill takes away coverage from millions who need it. We have had Republican State lawmakers speaking out about this issue as well as several Members of the majority in the Congress. Colleagues, just about every major healthcare organization is telling the Congress not to go forward with the TrumpCare bill--physicians, hospitals, AARP--that is just the beginning. But the majority is just charging forward, rushing to get this done as quickly as possible. We are going to have more to say about these issues. I see my colleagues here. To close, just by intertwining, how this appointment is going to be a key part of the discussion of TrumpCare revolves around the questions we asked Ms. Verma. For example, I was trying to see if this bill would do anything to help older people hold down the cost of medicine. Now we have heard the new President talk about how he has all kinds of ideas about controlling the cost of medicine. Here was a bill that could have done something about it. I see my colleagues, Senator Stabenow and Senator Cantwell. I said to the nominee: I would be interested in any idea you have-- any idea you have--to hold down the cost of medicine. On this side we have plenty of ideas. We want to make sure that Medicare could bargain to hold down the cost of medicine. We have been interested in policy to allow for the importation of medicine. We said: Let's lift the veil of secrecy on pharmaceutical prices. I asked Ms. Verma: How about one idea--just one--that you would be interested in that would help older people with their medicine costs. She wouldn't give us one example. I am going to go through more of those kinds of questions, because the reality is--and I see Senators Stabenow and Cantwell here--that what we got in the committee was essentially healthcare happy talk. Every time we would ask a question, she would say: I am for the patients; I want to make sure everybody gets good care. So I thank my colleagues, and I yield for Senator Cantwell.

Mr. WYDEN. Of course.

Mr. WYDEN. My colleague from Washington is ever logical. When I looked at this, I thought of it as an innovation desert because I was looking for some new, fresh ideas. We have seen some of them from Senator Cantwell's State, and I think the Senator from Washington makes a very important point with that poster because the reality is that this is a cap. This is a limit on what States are going to get. As I touched on in my comments, I think what is going to happen is this cap is not going to be enough money for the needs. I think this is going to slash the help for nursing home care under Medicaid, which pays two-thirds of the bill, and I think the nursing home care under this flawed TrumpCare proposal is going to get nickeled and dimed. My colleague from Washington is right. I tried to read section by section, and we have read it several times. But we wanted to make sure to look--to my colleague's point--for innovation, and this proposal is an innovation desert.

Mr. WYDEN. If I can add this, because I think my colleagues are making a very important point. If you look at the demographics, there are going to be 10,000 people turning 65 every day for years and years to come. Senators Stabenow and Cantwell are making a point about flexibility. The reality is, if I look at the demographic picture, we are going to need more out of a lot of care options--institutional care, community-based coverage. But I think the point Senator Cantwell started us on is that, at a time when we have a demographic where we are going to need more for a variety of care options--a continuum of care--what my State is basically saying is that we are going to get less of everything. There is going to be less money for the older people who have nursing home needs. I am looking at a new document from the Oregon Department of Human Services, and it indicates that we are going to lose substantial amounts--something like $150 million for community-based kinds of services. So I appreciate the point my two colleagues are making.

Mr. WYDEN. I would only add that what we learned in our hearings and in our discussion is that women, particularly the women served by the Medicaid Program, are really dealing with the consequences of opioid addiction as well. In our part of the world, I would say to Senator Stabenow and Senator Casey--in Oregon and Washington--we feel like we have been hit with a wrecking ball with this opioid problem. Again, when Senator Cantwell talks about shifting the costs, she is not talking about something abstract. This is going to take away money for opioid treatment. So I am very pleased that my colleague is making these points, and I look forward to the presentation.

Mr. WYDEN

Mr. WYDEN. Mr. President, here we are, with our colleagues on their way home, and I thought it would be helpful to take a minute and give an assessment of where the TrumpCare debate is at this point because we have seen the two major committees in the House act. Some $300 billion was slashed from safety net health programs, while insurance company executives making over $500,000 annually were given a juicy tax break as a bonus. To put this into perspective, this tax break that the insurance companies' CEOs seem to have after two committees in the other body have acted on TrumpCare--the amount of the bonuses for the insurance company executives would be enough to cover the TrumpCare-created shortfall in Oregon's community-based services for the elderly and the disabled two or three times over. What we are talking about is how hundreds of billions of dollars in tax breaks are going to the fortunate few and special interests, while some of the money is coming from stealing a chunk of those dollars from the Medicare trust fund. And this is very much intertwined with the nominee's work because she would be overseeing Medicare payments to rural hospitals in places like Louisiana and Oregon. What I am going to turn to now is what TrumpCare, based on these two committees, means for rural areas. And, of course, it repeals the Medicaid expansion. It caps the Medicaid Program. In my own view, and I know the Senator from Louisiana knows a lot about healthcare, in rural communities--and most of our towns are under 10,000 in population. I am from southeast Portland. I love southeast Portland. The only regret is I didn't get to play for the Portland Trail Blazers. Most of the communities in our State are under 10,000 in population. As the Senator from Louisiana knows, we are talking about critical access facilities. We are talking about sole community hospitals. We are talking about the facilities that deal with acute care. During the last major break over the President's holiday, I started what is going to be a yearlong effort for me, and I called it the rural healthcare listening tour. It is eye-popping to have those rural healthcare providers who in my State have worked so hard to find ways to get beyond turf and battles, to work together--the hospitals, the doctors, the community health centers, and the like. They have built an extraordinary effort that helps to wring more value out of scarce dollars. Their programs are based on quality, not on volume. By the way, they are a huge source of economic growth and jobs for our rural communities. I spent the President's Day recess, and the next major recess as well getting out and listening to them. The verdict from Oregon's healthcare providers, who have worked very hard at being innovative, trying to make better use of what are called nontraditional services, said these kinds of cuts are not an option if you want to meet the needs of so many who have signed up as a result of the Medicaid expansion. TrumpCare ends the Medicaid expansion, rolling back Federal matching funds in 2020. The rural hospitals in my State are frequently the only healthcare provider available for hundreds of miles. The Medicaid expansion helped these hospitals keep their doors open. I don't think it is hard to calculate why the hospitals are speaking out against the flood approach of TrumpCare. They have a lot of facilities in rural areas that are already on tight margins. If these communities lose the ability to cover needy people, some of the essential hospitals--and I just described three types of them--are going to have to close, and the reality is going to be that patients aren't going to have any doctor anywhere nearby. Understand, if the majority insists on ramrodding TrumpCare through-- and at this point we have, I believe--staff just told me that there aren't any budget estimates. As of now, the Congressional Budget Office is tasked with providing accurate assessments of the budget implications. There are not any budget implications. So here is the latest. It comes from media that I think is not considered by many Trump supporters to be a purveyor of fake news. This comes from FOX News. They said: Unknown in the new healthcare plan, unknown in TrumpCare--the cost. How many lose or gain insurance? I am very pleased that my colleague from New Hampshire has come to join me because some of this, I would say to my friend from New Hampshire, leaves you incredulous because this comes from FOX News. FOX News is hardly a source for what many Trump supporters would consider fake news. FOX News is asking the question because they are saying it is unknown. It is unknown in the new healthcare plan, Senator Shaheen, according to FOX News. The cost is unknown, and how many lose or gain insurance is unknown. I would say to my colleagues, because my friend from Louisiana has joined the Finance Committee, and I remember welcoming him and Senator McCaskill, our new members. My colleague from Louisiana is a physician and is very knowledgeable about these issues. I don't know how you have a real healthcare debate in America--and I have been working on this since I was director of the Gray Panthers at home back in the days when I had a full head of hair and rugged good looks. When we would start a debate, nobody would consider starting it without having an idea of costs or how many lose or gain insurance. How much more basic, I say to Senator Shaheen, does it get than that? Are these ``gotcha'' questions? Are these alternative facts? Are these people who are hostile to conservatives? I think not. FOX News--unknown in the new healthcare plan. I have been outlining what this means in terms of the transfer of wealth from working families in New Hampshire and Oregon to the most fortunate in our country--people who make $250,000 or more. They are actually going to be the only people in America who get their Medicare tax cut. So you have this enormous transfer of wealth, what I call the reverse Robin Hood: taking from the working people and giving to the fortunate few. After two committees have now acted in the other body--two committees have acted--FOX News says the big questions are outstanding. The Senator from New Hampshire knows a lot about rural healthcare. I was just outlining to my colleagues what this means for critical access hospitals, sole community hospitals, acute care facilities. These are the centerpieces of many rural communities, the essence of rural life. You can't have rural life without rural healthcare. Here we are on Thursday afternoon--with many of our colleagues out there tackling jet exhaust fumes heading home--and the big questions, according to FOX News, are outstanding. I am very pleased the Senator is here. As usual, she is very prompt and appreciated. I look forward to her remarks.

Mr. WYDEN. My colleague is making a very important point. I think we all know the Senate budget process is a lot of complicated lingo. People in the coffee shops in New Hampshire and Oregon don't follow all the fine points of reconciliation. As the Senator has just said, what they are using is a process that is known as reconciliation. That is the most partisan process you can come up with. There is no more partisan kind of process, and we were talking about the tally. As of this afternoon, two committees in the House have acted. The Senator from New Hampshire just mentioned, I think, there were 11 Republican amendments in just one of the committees.

Mr. WYDEN. As of this afternoon at 4, after hours and hours of debate, I am of the impression that not a single significant Democratic amendment has been adopted--so the Senator's point of highlighting the difference in the process, where we had all of the hearings and all of the opportunities that you have to have to get a good, bipartisan bill. As my colleague knows, I don't take a backseat to anybody in terms of bipartisan approaches in healthcare. I have worked with Republicans-- Chairman Hatch, chronic care. Senator Bennet and I worked on a bill with eight Democrats and eight Republicans. I appreciate your making this point. As of this afternoon, as far as I can tell, no Democratic amendment has been adopted. You highlighted 11 Republican amendments getting adopted in just one committee. As we indicated, FOX News--not exactly hostile to some of the ideas being advanced by the majority--has certainly called them out on this.

Mr. WYDEN. Mr. President, before my colleague from New Hampshire leaves, does she have a quick minute for a question?

Mr. WYDEN

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

Mr. WYDEN

Mr. WYDEN. I thank her for her presentation. It was factual and very specific, and I think it really highlighted so many of the concerns that we have at this point. I want to see if I could get this straight on the opioid issue. Here you all are in New Hampshire, right in the center of the Presidential campaign. All of the candidates are coming through, and they are practically trying to outdo each other in terms of their pledges to deal with this wrecking ball that is the opioid addiction that has swept through New Hampshire and, of course, my own home State as well. I remember then-Candidate Trump being particularly strong and assertive about how he was going to fight opioids. I think what my colleague said--and I am curious, so I am going to ask a couple of questions because I don't think folks even in my home State are aware of some of these things. So I am going to ask my colleague about it. Are folks in New Hampshire aware at this point--my colleague put up that Trump chart, showing how the people didn't know what was being cut and how much it was going to cost and all the rest. Are people in New Hampshire at this point aware of the fact that this is essentially after a campaign in their home State, which certainly put out a lot of TV commercials and campaign rhetoric in the fight on opioids? I think my colleague said that when people unpack this, they are going to see that this is a major broken promise, that TrumpCare is a major broken promise on opioids because, in terms of the time sequence, they all had debates and commercials, then we finally got some money in order to have treatment. And I think what my colleague said is that now, as a result of TrumpCare and the cap on Medicaid, there will not be the funds to get the treatment to people who are so needy. Is that what this is going to be about in New Hampshire?

Mr. WYDEN. I think my colleague's point is well taken. As we have been saying, this is very much intertwined with the Seema Verma nomination because what we learned in the committee is, in Indiana, where she touts her pioneering work, if somebody had an inability to pay for a short period of time, they would be locked out of the program. So in terms of Medicaid, this is going to cause a real hardship. I had already outlined that it is going to cause a hardship in another program that is important to New Hampshire, and that is Medicare, because we are implementing what is called the MACRA, the new reimbursement system for doctors. We asked her questions about rural care, and she didn't know the answer either. I particularly wanted my colleague to walk us through this situation with respect to how New Hampshire residents are going to see TrumpCare as it relates to opioid addiction after they have all these grandiose promises and the many debates and commercials. I thought I would ask if my colleague has time for one other question. In New Hampshire, as in Oregon, we have a lot of seniors. It looks to me as if somebody who is, say, 58 years old or 62 years old is just going to get hammered by what we call the age tax because in these bills, which are now moving like a freight train with the House already moving in two committees, Republicans want to give insurance companies a green light to charge older people five times as much as they charge younger people. So I cited a number of my small, rural counties--Grant County, Union County, Lake County--and how a 60-year-old who makes $30,000 a year can see their insurance costs, because of the age tax, go up something like $8,000 a year. I don't have the numbers as of now--Finance staff is still working on that for every single State--but obviously that tax sure looks like it is going to hit somebody in New Hampshire, an older person, people before they are eligible for Medicare, and particularly in that 55-to- 65 bracket. It looks like it is going to hit them very hard. How is that going to be received, because in my time in New Hampshire, we talked about it, and a lot of those people really are walking on economic tightropes. They are balancing their food bill against their fuel bill and their fuel bill against their rent bill. I know my colleague spends a lot of time trying to advocate for them, help them through small business approaches. How are they going to be able to absorb what is clearly going to be thousands of dollars in new out-of- pocket health costs?

Mr. WYDEN. I thank my colleague. We have heard Republicans say repeatedly that anything they are going to do with Medicare is not going to hurt today's enrollees or people nearing retirement. The fact is, TrumpCare hurts both. It is going to shorten the life expectancy of the Medicare trust fund, and those older people--I will be curious, when my colleague returns--I will be very interested to hear what seniors in New Hampshire who are 56 to 68 and are walking on that economic tightrope are going to say. I thank my colleague from New Hampshire for the excellent presentation.

Mr. WYDEN. I thank my colleague, and we are going to prosecute this cause together. I see that the chairman of the Finance Committee has arrived. He graciously said I could take another 5 minutes or so of our time. Before we wrap up this part of our presentation, I want to point out that we have outlined how people who are dealing with the consequences of opioid addiction would be hurt by TrumpCare. We have outlined how seniors who are not yet eligible for Medicare are going to be hurt and how seniors who are now on Medicare are going to certainly be hurt by reducing access to nursing home benefits. Now I would like to wrap up by going to the other end of the age spectrum and talk for a moment about children. Nearly half of Medicaid recipients are kids, and the program of the Republicans--now that we have two committees in effect out of chute with their proposals--restructures the program in the most arbitrary way, using these caps, shifting costs to States. And the reality is that Medicaid is a major source of help for children. There is early and periodic screening, diagnosis, and treatment benefits. But with reduced funding, the States are going to be forced to make difficult decisions about which benefits they can keep providing. States are going to be forced to reduce payments to providers, particularly for kids, providers such as pediatric specialists, and limit access to lifesaving specialty care. My own sense is that this is shortsighted at best, and it is like throwing the evidence about children and their health needs in the trash can. Children receiving Medicaid benefits are more likely to perform better in school, miss fewer days of school, and pursue higher education. Before I yield the floor to my good friend and colleague Chairman Hatch, I want to come back to what disturbs me the most about all of this. All of these dramatic changes to Medicare and Medicaid that strip seniors and some of our most vulnerable citizens are being made at the cost of hundreds of billions of dollars to these programs while, in effect, there is an enormous transfer of wealth given to the most fortunate in America in the two bills that were passed by the other body today in the committee. In effect, for example, people who make over $250,000 will not have to make the additional payments under the Medicare tax. If ever there were a group of people in America who doesn't need additional tax relief, it is those people. As we wrap up this portion of the presentation, I want people to just think about looking at their paycheck. Every time you get a paycheck in America, there is a line for Medicare tax. Everybody pays it. It is particularly important right now because 10,000 people will be turning 65 every day for years and years to come. What the tax provisions of this legislation mean--and they are part of hundreds of billions of dollars of tax cuts--for insurance executives making over $500,000 annually, there are yet additional juicy writeoffs, while seniors and those of modest means are going to bear the brunt of those reductions. Nothing illustrates it more than cutting the Medicare tax, colleagues. I don't know how anyone can go home in any part of the country and say: You know, we are going to have to charge older people between 50 and 65 a lot more for their coverage, and by the way, insurance company executives making $500,000 a year are going to get more tax relief. I don't think it passes the smell test in America. It is reverse Robin Hood. There is no other way to describe it. It is transferring wealth from working families and those who are the most vulnerable. When working Americans see their paycheck and see the Medicare tax, I hope they remember that in this bill, the Medicare tax is reduced for only one group of people--people making more than $250,000 a year. I want tax reform. The chairman of the Finance Committee knows that. I have introduced proposals to do that. But I don't know how we get tax reform when they are giving the relief to the people at the top of the economic ladder and it is coming out of the pockets of working people and working families. Everybody is going to be able to see it right on their paycheck, right there with the Medicare tax. I think we will continue this debate, but on issue after issue, with the nominee on the floor, Ms. Verma, what she will do if confirmed is directly related to TrumpCare. For example, we told her in the committee that we wanted her to give one example--just one--of an idea to hold down pharmaceutical prices, which is something else that is important to older people. TrumpCare, by the way, could have included proposals to try to help hold down the cost of medicine. Guess what, folks. On pharmaceutical prices, there is no there, there either. It doesn't do anything to help people. This vote we will have on Tuesday is the first step in the discussion of how this particular nominee would handle the implementation of TrumpCare. Her job oversees Medicare payments to hospitals. It is really intertwined, this nomination and TrumpCare, and we couldn't get any responses to how she meets the needs of working families, as I just mentioned, with respect to pharmaceuticals, and we are pretty much in the dark with respect to how she would carry out her duties. As of now, we don't see how she is going to do much to try to eliminate some of the extraordinary harm that is going to be inflicted on the vulnerable and seniors on Medicare and Medicaid as a result of TrumpCare. I reserve the remainder of my time, and I yield the floor.

Mr. WYDEN

Mr. WYDEN. Mr. President, today I am reintroducing a bill honoring two Oregon legends--Frank and Jeanne Moore--who have spent their lives together on the North Umpqua River as fishers, stewards of the land, and hosts to visitors from across the world at the famous Steamboat Inn. The North Umpqua River runs through the Umpqua National Forest in Southwest Oregon. The river is a destination for rafters and kayakers, and is home to some of the best steelhead runs in the world, making it a fly-fishing haven. Frank and Jeanne Moore founded the Steamboat Inn in 1957, and spent years introducing visitors to the beauty of the Umpqua National Forest and the North Umpqua River. Frank, a decorated WWII veteran and a recent inductee into the Freshwater Fishing Hall of Fame, was the fishing guide for the Inn's visitors, and has now been fishing this river for 70 years. The Steamboat Inn's website paints a wonderful picture of how Frank and Jeanne welcomed visitors to the North Umpqua River: ``Each night, Jeanne Moore cooked evening meals for as many as sixty road construction crew members, who ate in shifts, before turning her attention to feeding her lodge guests. Frank pitched in, helped with the cooking, and also made a policy decision that would henceforth guide the Fisherman's Dinner: From then on, anglers could fish until the last light disappeared on the river. Dinner would be served one half hour after sunset!'' In the 1960's, the river and its tributaries experienced significant degradation, and Frank Moore has worked tirelessly ever since to rehabilitate the river and the steelhead populations. Frank served on the State of Oregon Fish and Wildlife Commission and has received the National Wildlife Federation Conservationist of the Year award and the Wild Steelhead Coalition Conservation Award. He works with his neighbors and local organizations to monitor the river, and just about everyone he comes across on his drives along the river knows his name and knows his work. Frank and Jeanne have opened their door to visitors and have taken great care of this Oregon treasure. The Frank and Jeanne Moore Wild Steelhead Special Management Area will stand as a tribute to the Moore's and their dedication to protecting this special place in Oregon and preserving the hard work they've put in to ensure that Oregonians and visitors alike will have a healthy river, full of steelhead, to visit for decades to come. It is my honor to reintroduce this bill today with my colleague from Oregon, Senator Jeff Merkley, on behalf of these extraordinary Oregonians. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.