that the new cures bill has generated more lobbying than almost all of the 1 1,000 bills that have been proposed during this congress. at one point there were about three lobbyists for every single member of congress. and every one of those lobbyists wanted favors, and wow, did they get some doozies here. a provision to make it easier for drug companies to commit off-label marketing fraud, taking pills that are approved for one use and using them for a whole lot of other purposes without any evidence that it's either safe or effective. a provision making it easier for drug companies to hide the gifts they give to doctors who prescribe certain drugs, a giveaway to a major super pac donor who stands to benefit financially from pushing regenerative therapies through f.d.a. even if they don't meet

the f.d.a.'s gold standard for safety and effectiveness. this bill isn't about doing what the american people want. this bill is about doing what drug companies and donors want, and on monday, i made it clear that i oppose this. since then, two things have happened. first, since monday, the public has gotten wind of this deal, and i don't like it. in the last 24 hours, more than 100,000 people have signed petitions calling on congress just to reject the deal. and second, since monday, we've seen the bill change a little. last night, after they got some heat, the house took out the provision letting drug companies hide kickbacks to donors. good. you know, i guess they were having a hard time explaining to anybody why it made any sense to help drug companies cover up bribery. the lobbyists are disappointed about that, but they are still pushing for the bill because even though the kickbacks are

out, legislate -- letting drug companies get away with fraud is still in. now, giveaways are bad in this bill, but that is not the only thing that's a problem with this bill. what's not in the bill also hurts. 70 years ago, congress promised to provide for the health and welfare of american coal miners and their families, and now 120,000 coal miners, their widows and their families will see massive cuts to their health benefits and retirement pensions. why? because the bipartisan mine workers protection act was left out of this bill, and without it, 12,500 coal miners will lose their health insurance on december 31 of this year. another 10,000 will lose their coverage next year, and on and on into the future. mr. president, according to exit polls, 70% of voters say they

think the american economy and the lawmakers who oversee it are owned, owned by big companies and special interests. bills like the 21st century cures act are the reason why. there is so much that we could do with this bill. you know, this congress could step up for thousands of american coal miners. for their entire lives, these coal miners have sacrificed everything, for their families, for their communities and for this country, and they have literally sacrificed their help. they are running out of time, and we could help. this congress could step up to help millions of people who are struggling with exploding drug prices. we could help bring down the cost of drugs. this congress could step up to help the millions of families who have been touched by alzheimer's, diabetes, cancer

and other deadly diseases, and we could help by providing more funding for the research that would generate real cures. this congress could step up to deal with drug companies that think they're above the law. giant corporations that think they can break the rules and then get congress to do special favors for them. we can just say no, that's not what we are in business to do. the american people are not clamoring for the cures bill, at least not this version. tens of thousands of people have asked us not to pass it. even the conservative group heritage action fund for america has come out strongly against this deal. now, i don't agree with all of their objections, but they explain -- quote -- "in washington terms, backroom negotiators have turned the cures bill into a christmas tree loaded with handouts for special

interests, all at the expense of the taxpayer. boy, got that one right. this kind of backroom dealing that helps those with money and connections and leaves scraps for everyone else is why people hate washington, and it is the reason i will oppose this bill. thank you, mr. president. mr. durbin: mr. president? the presiding officer: the senator from illinois. mr. durbin: mr. president, i thank the senator from massachusetts for calling us together on the floor to discuss this important bill, the 21st century cures act. it's a bill that i followed closely because i started off introducing the american cures act. my goal in medical research was inspired by dr. francis collins of n.i.h., and he just told me point blank if you want to increase the output of medical research, find cures for diseases and help innocent people, increase the spending at the n.i.h. by 5% real growth a

year for ten years, and i'll light up the scoreboard. and that's what i set out to do. that's what the american cures act set out to do, including the center for disease control and department of defense medical research. as usually the case in congress, it's no surprise when somebody sees an idea and thinks i can do it a little differently and a little better, and so in the house of representatives, congressman fred upton and congresswoman diana degette introduced the 21st century cures act. theirs was a different approach, and it reflected, i guess, a difference in philosophy. what we see today is what happened to an originally good idea as it worked its way through the house of representatives over a long period of time. the simple concept of increasing medical research spending at n.i.h. by 5% a year has now become a very complicated formula, and it's one that, frankly, i have very mixed feelings over. i look at it and think it would have been so simple for us to

make a national commitment on a bipartisan basis to increase n.i.h. funding by 5% a year, and to do it over ten years, and i know we would see the difference. just to put things in perspective so that we understand them, there are certain diseases now which are costing us dearly. alzheimer's. we know about that, don't we? there is hardly a family in america that doesn't have someone in their family or a friend who has been stricken by alzheimer's. think of this for a moment. an american is diagnosed with the alzheimer's disease once every 67 seconds. once every 67 seconds. 20%, 20% of all the money that we spend on medicare in america is spent for alzheimer's and dementia. one out of five dollars. you add to that one out of three dollars of medicare is spent on diabetes. so between diabetes and

alzheimer's, over half of our medicare budget is going to those victims. so when we talk about the need to develop new drugs, to intervene and with god's blessing to cure some of these diseases, we're talking about not only alleviating human suffering, we're talking about the very real costs of government and health care, very real costs that we bear. as individuals, as families, as businesses and as a government and as taxpayers. now, in this bill are some positive things, in this 21st century bill, and i do want to highlight them because they are worthy of highlighting. the fact that we are now going to commit ourselves to deal with issues like opioids. opioid, heroin epidemic in america is real, and we are not investing in what we need to treat it and to deal with it. we need to have substance abuse treatment, much, much more than we have today. one out of six or eight of people who are currently addicted are receiving treatment. we need to do dramatically better, and this bill puts money into that. it also includes language,

including some parts that i offered as amendments that will deal with mental illness. mental illness and substance abuse treatment are basically on the same track in terms of helping people. this bill addresses that, and i'm glad that it does. i think it is a very positive thing. but what is disappointing about this bill are several things. first, the money that we are spending in this bill largely comes from one source -- prevention, health prevention funding and the affordable care act. how important is that? do you know how that money is being spent? we have something called the 317 vaccination program. what it says is if you come from one of the poorest families in america, we will pay for your children to be vaccinateed so that they don't have to worry about the diseases that can change the life or even take the life of an infant. the 317 vaccine program, half of the money comes from the

prevention funds that we are raiding for medical research. does that make sense? that we are going to take money away from prevention and vaccine naix -- vaccination to invest in new drugs that treat diseases. we can prevent these diseases in the first place with adequate vaccination. it is a warped sense of justice in america that we would eliminate health care prevention funds to pay for health care research funds. it's a zero sum, as far as i'm concerned. and it isn't just a matter of vaccine naixes. -- vaccinations. when you look at the money, 43% of the money that's spent on diabetes in america, prevention of diabetes in america is through the prevention funds in the affordable care act. that figure tells us that if we can invest on getting people to change their lifestyle, sometimes very slightly, or to take certain drugs, they can avoid the onset of diabetes. so we are cutting the prevention funds for diabetes in order to pay for more research for cures

for diabetes. does that make sense? let me ask you about this. tomorrow. a lot of my career in congress has been focused on tobacco. the number one avoidable cause of death in america today. tobacco cessation programs pay off many times over. they are paid for by prevention funds that we are now raiding for medical research. so we are taking away the funds to prevent tobacco addiction, and we are going to put more investment in trying to find cures for lung disease. there is something wrong with this thinking, completely wrong with this thinking. so at the outset, i would say going to the prevention programs to pay for research programs is not clear thinking on the part of the people that are putting this together. we are told, well, you better do it because the republicans will take control of the white house and congress next year, and they're going to wipe out all the prevention funds. they want to do away with the affordable care act. well, we'll pay a heavy price for that, and we're starting to make that payment today.

the second thing i want to say is i am totally underwhelmed by the amount of money in this bill. when you take a look at the amount of money that is being spent here, it has dramatically changed as we have debated this bill. originally, this was a $9.3 billion program for medical research. pretty hefty. over a five-year period of time, it would have had a dramatic impact in a short period of time. well, that changed. it's about half of that now, and it's spread over ten years. so the amount of money actually going to the national institutes of health in a given year is interesting, $400 million, $500 million, but it doesn't match what was originally promised in the 21st century cures act. and the question, of course, is if this money is put in out of prevention funding, will it be additive? will it be more? let me just close by saying thie many who have strong feelings about this bill. i think it is a step in the right direction, but as senator warren has told us, it's at a heavy cost when it comes to some

of the favors included in this bill for people who have friends in high places when it comes to the united states congress. but here's what i can tell you with certainty. we have been able for two successive years in the appropriations process to do something important and historic. let me tip a hat to my colleague from missouri, senator roy blunt, a republican who took up this cause in the appropriations committee and has provided 5% real growth in spending for the national institutes of health last year and would do it again this year if the republican leadership would allow us to bring his appropriation bill to the floor. so we know that we can make substantial new investments at n.i.h. medical research, we have a bipartisan will to achieve it, we have the appropriations committee ready to act, but instead what i'm afraid of is this bill, which is a modest investment in medical research, will be the end of the conversation for many members of congress. when the time comes months from

now, whether this passes or not -- it probably will pass, but when the time comes months from now for us to debate medical research, many will say oh, we already checked that box. we've already done that with the 21st century cures bill. this bill is a pale imitation of the original bill. it is only a fraction of the funding which the appropriations committee has already put in to enhancing medical research at n.i.h. it overpromises and underdelivers. and some of the aspects of it, the troubling aspects, off-label drugs and special favors for contributors when it comes to medical treatment are just out of place in this. if we didn't learn any lesson in this last election about drank the swamp, well, -- about draining the swamp, well, shame on us because the american people told us do it differently, do it openly, bring in transparency and honesty in this effort, and when it comes to medical research, we should expect nothing less. mr. president, i yield the floor. a senator: mr. president? the presiding officer: the senator from oregon. mr. merkley: mr. president, i'm delighted to join my colleagues from massachusetts and illinois

to express strong objections to the 21st century cures bill. a bill that's being considered in the house today and will be considered here in the senate. this bill proceeds to make effective $6.3 billion in cuts to programs, while laying out a vision of what might possibly be spent in the future to assist in medical research. well, this is very much an imbalance. real cuts -- and as i'll point out, those cuts hits things that matter with a promise of some future possible action, action that we've seen these promises made and broken time and time and time again here in this chamber. if you're going to do a real commitment, then why isn't the real commitment in this bill? i ask. my colleagues from across the

aisle, why isn't the real commitment to these programs in this bill? why isn't the spending in this bill? why isn't the spending that's promised to be considered in the future on precision medicine in this bill? why isn't the funding for the cancer moonshot promised to be considered at some point in the future actually in this bill? why isn't the program to help address an understanding and pursue cures to alzheimer's that is actually just a promise to be considered in the future, why isn't that actually in this bill? why isn't the work promised to be considered for the future for adult stem cell research which could have application of multiple cures and multiple

diseases, why isn't that actually in this bill? i'll tell you what is in this bill. what is in this bill is a provision that loosens the rules how -- headache pills for the cure of hair loss. this is what big pharma wants. freedom. freedom to mislead consumers about what drugs actually have been proven to do. i'll tell you what else is in this bill. it allows people to sell untested treatment and drugs without final f.d.a. approval that has demonstrated that the treatments are safe. two big factors deregulating responsible provisions for big pharma are in this bill, but all

those rainbows, all those stars promised, those are for the future consideration to dress up this special interest provisions for big pharma. and i'll tell you what else is in this bill. special interest provisions for big fo -- for big tobacco. taking away $3.5 billion in prevention funds from the public health fund,$3.5 billion real dollars in prevention. now, the tobacco companies, they made prevention programs because they make their money off addicts, so their goal in life is to get people addicted. this prevention fund is to prevent people from getting people addicted -- from getting addicted. all the diseases that stem from the use of tobacco, cancer of

the lungs, cancer of the esophagus, heart disease of one form and another, all kinds of forms of decimation due to those daily inhaling of these toxins, that's what the tobacco industry thrives on and they thrive on it from addiction. here we have a fund designed to help people avoid that addiction that takes away from their quality of life often for decades of their time here on our beautiful blue green planet and instead encourages process through which people will not only suffer personally but have massive medical bills driving up the cost of health care in america for everyone, driving up the cost of insurance for everyone here in america. since its launch in 2012, the tips campaign has helped more than 400,000 smokers quit for

good. it saved, according to the center for disease control, 50,000 lives at a cost of less than $400 for each year of life saved. in public health circles, it's considered a best buy, dollars well spent that improve the quality of thousands of people's lives and reduce costs in the health care system. that's a win-win but what's in this bill? an assault on that win-win to help out the tobacco companies get more addicts. the chronic diseases and unhealthy behaviors that prevention fund is intended to address impose tremendous costs. tobacco use along costs about $17 on billion a year last year in health care expenses. more than 60% of it paid by taxpayers through medicare and medicaid. so we all feel the impact of

this. now, what else gets cut? oh, medicare funding gets cut. if you're for taking apart the preeminent health care system so that our seniors can retire without the stress of worrying about access to health care, then vote for this bill. this is an assault on medicare. big favors for big pharma. big favors for big tobacco, and an assault on medicare. it doesn't trim some medicare programs that maybe aren't as effective as others and help the others be stronger and more effective. no, it just takes away from medicare. those are the things that are in this act but what's not in this act? the mine workers protection act championed by my colleague from west virginia, senator manchin, the mine workers protection act

isn't in here, but the provisions expire for thousands of mine workers in the very near future. 12,500 coal miners will lose their health insurance on december 31. should 10,000 will lose their health insurance next year and on into the future if we don't restore this program. well, if this bill is about health care, why isn't the coal miners provision in here? i think it should be, but it's not. and what else isn't in here? senator wyden's provision to help children who are foster children gain access to programs to help them address mental health and addiction. you know, that was in here yesterday. that would have been a positive talking point for this bill yesterday. but it was stripped out last

night. so this bill isn't ready not just for prime time, is not ready for consideration at all. if we're going to cut real programs to fund other real programs like the moonshot and alzheimer's research, strengthen n.i.h., then get it in this bill. don't just put in the real cuts and then say there's some promise, an invitation to chase a rainbow down the road. put it in the bill. and the things that are in here are powerful, deregulatory giveaways to big pharma and big tobacco making the lives of our citizens worse, not better, and that's why we should kill this bill. thank you.

i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call:

a senator: mr. president? the presiding officer: the senator from virginia. kainmr. kaine: are we in a quorm call call? the presiding officer: we are. mr. kaine: may i ask that it be vitiated. the presiding officer: without objection. mr. kaine: i rise to honor sco scott. he enlisted in the military in 1993 in the navy and had a

distinguished 23-year career, finishing his time in one of the most dangerous jobs in the military, as a bomb disposal expert. he was working in operation inherent resolve and on thanksgiving day was killed. a 42-year-old virginian killed working to dispose of bombs about 30 miles from rakka, syria, one of the two main headquarters of isis. scott dayton was a decorated sailor in his 23-year military career. he won virtually every award there was, including a bronze star. 19 din awards and commendation -- 19 different awards and commendations. because of the fact that it occurred over a holiday weekend, there wasn't a lot of attention to it, but it was something i wanted to come to the floor to talk about because he is the first combat death in syria of

an american service member in operation inherent resolve. i wish we were paying more attention to this, and that's what i want to devote the rest of my comments to. we began the operation inherent resolve, which is a war against isis, on august 7, 2014. president obama announced at the time that we were engaging in targeted airstrikes against isis because of their advanced order in irbil. that was part of the president's inherent powers to defend the nation to protect our consulate. within a very few weeks, we had completely protected american interests. president obama said now is the time to go on offense against isis. he appeared before congress -- before the american public in a televised speech the evening of september 10, 2014, and said we had taken care of the imminent threat to the united states but now had to go on an offensive

war to degrade and destroy the isis state. that has now been broadened in the words of current secretary of defense ash carter to focus on isis' lasting defeat. since the war against isis began in august of 2014, more than 5,000 members of the u.s. military have served in operation inherent resolve either in iraq or syria. and right now just as an example from my home state, there is a carry yes, the u.s.s. eisenhower, that was in the gulf right now as part of operation inherent resolve. the u.s. military has launched over 12,600 airstrikes. we're carrying out special forces operations. we're assisting the iraqi military, syrians fighting against the islamic state in syria, as well as the kurdish peshmerga in the northern part of the iraq. because of the work of the american troops and those

they're working with, we've made major gains against isis in northern iraq. the territory they control in northern iraq has dramatically shrunk. we've made major gains in shrinking their territory in northern syria. that is to be credited to brave folks like chief petty officer scott dayton. but the threat posed by the islamic state continues, and increasingly, as their battle space shrinks in real estate, they undertake efforts off that battleground to try to destabilize us around the world. so this fight against isil, which is key -- a key, maybe the key national security priority involving u.s. combat operations in iraq and syria, will likely continue for the long foreseeable future even after 800 days of operations, an average $8.6 million a day. i began honoring scott dayton,

but he is not the only military member who's lost his life in this war. five have been killed in combat. in total 28 american service members have lost their lives supporting operation inherent resolve. as we speak, there are more than 300 special forces now in syria fighting in a very complex battlefield where turkish, syrian, russian, iranian, lebanese, hezbollah, kurdish forces are operating in close proximity as evidenced by recent developmentedevelopments in theg catastrophe in aleppo. i continue to believe, and i will say this in a very personal way as a military dad, that the troops we have deployed overseas deserve to know that congress is behind this mission. at this war has expanded into two-plus years -, more and moref our troops are risking and losing their lives far from home, i am concerned and raise

again something i've raised often on this floor -- that there is a tacit greement avoid debating this war in the one place it all the to be debated: in the halls of congress. the president maintains that he can conduct this war without a new authorization from congress, relying upon an authorization that was passed on september 14, 2001, when the new congress is sworn in in early january, i think 80% of the members of congress were not here when the september 14, 2001, authorize was passed. so the 80% of us that were not here in 2001 have never had a meaningful debate or vote upon this war against isil. i've been very critical of this president. aim supporter of the president. i am a friend of the president. i respect the office of the president. but i've been very critical of this president for not vigorou vigorously attempting to get an authorization done. when the president spoke about the need to go on offense against isil in september of

2014, it took him six months from the start of hostilities to even deliver to congress a proposed authorization. i actually think that's -- that's the way the system is supposed to work, that the president delivers the proposed authorization. but i've also been harshly critical of the article 1 branch because, regardless of whether or not the president promptly delivers an authorization or not, it is congress under article 16 1 of the constitution that has the obligation to initiate war. the founding documents of this country are so unusual still today in making the initiation of war a legislative rather than an executive function. madison knew that the history of war was a history about make it about the monarchy. but we decided weld be different and that war would only be initiated by a vote of the people's elected legislative

body and that the point would be conducted by only one commander in chief. we've not had the debate. we've not had the vote. this has been ironic because i have for four years been in a congress that's been very quick to criticize the president for using executive action. this is an executive action that most clearly is in the legislative wheel house and yet it has been an executive action that the body -- and i am making this as a bipartisan and bicameral comment -- the body has been very willing a how the president to make. -- to allow the president to make. i introduced a resolution for the first time to get congress to debate and do this job in september of 2014, two days after the president spoik t -- spoke to the nation about the need to take military action against isil. that authorization led to a senate foreign relations committee hearing and a vote in december of 2014 to authorize military action against isil, but that committee resolution never received any debate or vote on the senate floor.

in 2015 working together with a senate colleague from arizona, senator flake, i -- we decided that we really needed to show that our opposition to isil and our belief that appropriate military force from the united states should be used against them was bipartisan, we introduced a bipartisan authorization of military force on june 8, 2015, in an attempt to move forward with some congressional debate on this most important issue. aside from a few informal discussions in the senate foreign relations committee, there's. mr. bennet: a markup, -- mr. kaine: so two and a half years against the islamic state and 15 years now after the passage of the authorization in september 2014, we see that that authorization has been stretched way beyond what it was intended to do. the authorization september 14,

2001, is a 60-word authorization giving the president the tools to go after the perpetrators of the attacks of 9/11. isil didn't exist on september 11, 2001. president obama recently announced that the authorization is now going to be expanded to allow use of military action against a al-shabaab, a dangeros african terrorist group, but it did not begin until 2007. so an authorization authorization that was very specific by this bodied to allow action against the perpetrators of the 9/11attacks is now being used all over the globe against organizations that didn't even exist when the priefl attack occurred. -- when the 9/11 attack occurred. the 2001 authorization has been cited by presidents bush and obama in at least 37 instances to justify sending armed forces to 14 nations and attacking -- and to send military force to 14

nations. the nations where we have currently justified military action pursuant to the authorization to go after the perpetrators of the 9/11 attack, we've authorized military action in the bush and obama administrations in libya, turkey, georgia, yemen, irtrayia, kenya, somalia, and the philippines as well as authorizing military activity in cuba at guantanamo to maintain detainees. just in the last week "the new york times" reported that president obama is expanding the legal scope of the war against al qaeda by easing targeting restrictions against al-shabaab. but again this was a group that since the exist until 2011. i'll just conclude and say, having been very vocal about this issue for a number of years, it's been disappointing but we're all used to not getting our way on all kind of things. it's been disappointing to me

that we haven't been able to take up this matter. i think that a transition to a new administration and congress in early january always gives you the opportunity to review the status of affairs and make a decision about what to do. i believe it is time that we review the progress of the war against non-state terrorist groups -- al qaeda, isis, al-shabaab, bock can a harass ram. it is time to review action against organizations. it is time to redraft the 2001 authorization that has been stretched far beyond its original intent. it is time for us to recognize that this is a continuing threat that's not going away anytime soon. but i guess what i'll say most importantly, it's time for congress to reassert it's rightful place in this most important set of decisions. of all the powers that weld have as congress -- this we would

have as congress, i can't think of any that are more important than the power to declare war. i view that as the most important, the most difficult, the most challenging, the power that we should approach with the most sense of gravity. that is the most important thing that we should do. it should never be an easy vote. it should be a hard vote but it should be a necessary voavment i think the inablght or unwillingness of congress sends a message that'sunfortunate. it send a message of lack of resolve to allies. it might even send a message of lack of resolve to our adversary. but the thing i'm most concerned about are people like chief petty officer scott dayton, people who are serving in the theater of war who are risking their lives in the theater of war who are giving their lives in the theater of war and doing it without the knowledge that congress supports the mission that they are on. the article 1, article 2, as i claude allocation of

responsibilities is not just about what's constitutional. i think it reflects a value. it is this: we shouldn't order people into harm's way unless there is a -- that the mission is worth t everybody that volunteers knows it will be danger. if we're going to order people into combat and order them to risk their lives and even if they're not harmed, they may see things happen to colleagues of theirs that could affect them for the rest of their lives, if we're going to order them to do that, then there should at least be a national political consensus that the mission is worth t and the way the constitution sets that up is the president makes a proposal, but then congress, the people's elected body, votes to say yes the mission is worth it. now that we've had that vote, now that we've had that debate and educated the public about what's at stake and now said the mission is worth it, it is fair then to ask are two million active duty guard and reserve,

folks like chief petty dayton, folks like my son, is it then fair to ask them to risk their lives in a mission like this? but if we're unwilling to have the debate and have the vote it seems to be almost the kind of hide of public immorality to ask people to risk and give their lives for a mission we're unwilling to discuss. i offer these words in honor of a brave virginian who lost his life on thanksgiving day, november 24, and i hope this growing number of people losing their lives in operation inherit resolve will spur us to take this responsibility with more gravity. mr. brown: mr. president? the presiding officer: the senator from ohio. mr. brown: thank you, mr. president. i thank my colleague from virginia who is always speaking out for our men and women in uniform, our nation's veterans and patriotism. mr. president, right now our nation's retired coal miners -- and i know senator kaine and

senator warner care about this too greatly -- our nation's retired coal miners are on the brink of losing the health care and retirement benefits that they have earned over a lifetime of hard work. it is within the power of this congress to stop this, to help the mine workers to do right by these hardworking americans. many of them are veterans. most of them wore their bodies out to give their families a better life. there is no more fitting action that we can take during this holiday season than to honor this promise that the american government has made to our nation's mine workers since harry truman made that promise. the workers held up their end of the bargain. it's despicable that we're not holding up ours and that we're preparing to leave town without lifting a finger to help these workers. the united mine workers of america health care and pension plans cover some 100,000 mine workers, 6,800 live in ohio. if congress fails to act, thousands of retired miners

could lose their health care this year. retirement security, as i emphasized, it's retirement security they worked for, security they fought for, security they sacrificed raised and their own health for. understand this, that too many people that dress in suits and work here and draw good salaries and draw good benefits don't understand what happens at the bargaining table for workers at our country. they often give up raises today to defer that money so that they have retirements and pensions in the future. say that again. people at the bargaining table give up dollars today, rather than take a little higher pay today they're willing to defer that so they have better pensions and health care. this congress, this senate is blocking us from doing that. the senate leadership. these are workers who have worked for decades in the mines, hard, backbreaking work but work that had dignity. i live in a place that some national media people,

including president-elect trump, also have referred to my part of the country as the rustbelt. when they say rustbelt, that's a direct attack on the dignity of work. it demeans their work. it diminishes who they are. it is saying that those people are in the past that work in states like mining and steel workers and others who make things. these mine workers, every year during their work in the mines, they've earned and contributed to a health plan and a pension plan. i met with some of these workers. ohioans like norm skinner and dave dilly. i heard their stories. they knew they were signing up for tough work. they work in the mines, after all. they knew that but they also knew their work had dignity. that work was part of a covenant we used to have in this country that said if you work hard, if you put in the hours, you contribute your retirement, you provide for your own health care in the future, you'll be able to support yourself and your family. it's what built our country,

what created the middle class. but today the value of that work is eroding. we're choosing too often too many major corporations in this country are choosing profits over people. we haven't lifted a finger, frankly. the political agenda here for some people that run this senate, they seem to have some, some kind of -- they simply don't have the respect for the mine workers, for the union. they seem to have some antiunion sensibilities about this. whatever it is, they're not lifting a finger to help these workers who put in the effort and who are in trouble through no fault of their own. there is no reason to believe we shouldn't be going home for the holidays without taking care of 6,800 mine workers in ohio, a number of mine workers in southwest virginia, thousands of mine workers in virginia and eastern kentucky and southwest pennsylvania. this is a bipartisan solution. it won't cost taxpayers a dime. if this bipartisan mine workers legislation was brought to the floor today, it would pass with

majorities in each party. we shouldn't be taking up other legislation. until we do, this should be part of the cures act that we will be voting on later. the cures act has important components to it, good steps on mental health, on hospital reimbursement. the national pediatric act network. it is a 900 page bill negotiated in the house that has major flaws. it does include funding fosh n.i.h. to fight the opioid epidemic. but the funding isn't mandatory. it will be subject to the whims of future congresses. while this is pretty good happy talk, we're saying the right things, we're putting some language in this bill, but it doesn't guarantee the money will be there. it's so important to my state. a new report released this week showed ohio had the most drug overdoses that resulted in death in the country in 2014. not the most per capita. we had more drug overdose deaths than california, three times their population. texas, twice their population. more than illinois and pennsylvania and new york and

florida, all states with more people than we did. more ohioans died of drug overdoses from oxycontin or oxycodone or heroin or the new drugs that, the new synthetic drugs we're seeing more and more. we've got to do more. the billion dollars in grants in this bill are critically important but it needs to be mandatory funding. it can't be that some powerful member of the house or senate stands in the way of this down the road to actually get these communities the money. we can't fight year after year to get these dollars appropriated. the cures act gives significant concessions to big pharma, which is the big drug industry, drug giants in this country, but does absolutely nothing to combat drug prices. we benefit concessions to the big drug companies but we do nothing to fight the high cost of drugs in this bill. we shouldn't be spending time on this flawed bill until we keep our promises to the 12,000 mine workers i mentioned. these miners worked in some of the most dangerous conditions of

any jobs in this country. they deserve the full pension and health benefits they were promised. they worked a lifetime to earn these benefits. they kept faith with us. we must keep faith with them. it's simply irresponsible and immoral for us to leave town and not take care of the mine workers. i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call: quorum call:

quorum call:

a senator: mr. president? the presiding officer: the senator from nebraska. a senator: thank you, mr. president. i ask unanimous consent that we vitiate the quorum call. the presiding officer: without objection. mr. sasse: mr. president, i had not intended to speak today. i was presiding in the chair. but i want to take one minute to associate myself with the comments of the senator from virginia, senator kaine, who just spoke about our war against isis. i think two points that he said are worth underscoring for us in this body. number one, we're obviously at war with isis. we should acknowledge that we are at war with isis. number two, why is it important that we do this? it is important for the troops who are at war, for us to acknowledge the reality of the fact that we're at war. it is important for their families. it is important for debate and deliberation in this body and in the country and more broadly. and frankly, it's important for the future of this body to honor a be -- constitutional intent

that distinguishes between article 1 the legislature and article 2. it is recognized many foreign wars have not made sense in history because many executives get wrapped up in war without broader deliberation about the consequences of their action. to be clear, we should absolutely be at war with isis and we are at war with isis. but in the american constitutional system, it is the obligation of the 535 of us who serve in the congress and particularly the 100 that serve in the senate, to represent our people and to have this debate before the people about the fact that we are at war with isis. and then the commander in chief, as chief executive should prosecute that war in a way that the american people know has the sanction and the validation of both branches and of all the people across 50 states. this is not the action of one president acting unilaterally. it is a bad precedent to set for us to continue to drift and to remain at war now 15 years post

the authorization that was against the perpetrators of the 9/11 attack, now using that old authorization to conduct a war now on a second continent, now in africa as well, bull without any current -- but without current discussion or authorization. the use of military force is something that should be deliberated about in this body, and i again want to associate myself with the comments of the senator from virginia that given that we are at war with isis, we should formally be declaring war against isis. thank you, mr. president. a senator: mr. president? the presiding officer: the senator from wyoming. a senator: thank you, mr. president. i come to the floor today noting that democrats in washington continue to try to understand the results of the election. mr. barrasso: i've heard them blame republicans. i've heard them blame russian hackers. i heard them blame the f.b.i. and i've even heard them blame the press. well, what i've not heard is a single washington democrat admit

that one reason democrats lost on november 8 could be their disastrous health care law. well, the health care law is definitely on the minds of the voters. mr. president, on october 31, just one week before the election day, the milwaukee journal sentinel had an article with the headline -- quote -- "rates for obamacare plans jump in wisconsin." this article said that tens much thousands of middle-class people in wisconsin who don't qualify for washington subsidies -- quote -- "will pay the full cost of double-digit premium increases." the article quoted one insurance broker saying i've talked with people who are exasperated. and they're just at wit's end. that's what the insurance broker said. it's not just the price increases, mr. president. in at least five states there is only one company actually selling plans on the obamacare exchange. my state of wyoming is one of those. people are being told that their

plan will no longer include their doctor or maybe even a hospital near where they live. the average deductible for a silver plan next year is going to be almost $3,600. is the damage that obamacare doing to american families right now people are seeing it. because of the election, and that article was in the wisconsin newspaper, a state that apparently according to the polls, donald trump was running behind. ron johnson was running behind according to the polls but both of them carried the state handily. so here we have an election where people expressed their opinion and the democrats seemed to want to deny the main reason for it. the american people have placed their faith now in republicans and we in turn earned that trust. we'll do it through both executive action and legislative action with regard to the health care law.

first, president trump will have a great opportunity to start making things better for the american people by changing some of the regulations that are a huge part of the health care law. now remember, mr. president, this health care law is 2700 pages long, and within those 2700 pages, there's more than 1800 places where the law gives the secretary of health and human services the power to write different rules and different regulations and different requirements to try to spell out what the 2700-page law says. well, the obama administration absolutely abused that power, and the administration added more than 40,000 pages, mr. president, 40,000 pages of regulations of red tape that were never actually in the law itself. in the trump administration there's going to be a new secretary of health and human

services. he a physician and/or though peedic -- and orthopedic surgeon. once confirmed he will be i believe reinterpret and apply the law in ways that help american families instead of ways that hurt american families because the interpretation in the past favored big government over people. well, this includes a i ply -- applying the law for businesses to provide insurance for people who work for them. it means giving now we are back to the states. the nominated secretary of health and human services is not just a doctor but he's also served in the state legislature and he knows -- he knows that at the state level you can make much better decisions for the people of that state than when washington comes up with a one-size-fits-all decision. republicans want to make sure the power goes back to where it

belongs with the people, the families, the states. that's where it belongs. well, the executive action can start pretty quickly. and it can be a bridge to the important work that then congress is going to have to do. we're going to work hard here in the senate and in the house to undo some of the damages, significant amounts of the damage that obamacare has called. undoing the damage because people all around this country have suffered under this health care law. it means repealing the health care law and wiping the slate clean. mr. president, obamacare can't be fixed by tinkering with it here and there, not with another attempted bailout of the insurance companies which the president has continued to promote. the solution isn't to add more government on top of what we already have. the health care law began collapsing a long time ago, and republicans are now ready to clear away the rubble. then we'll write a new law.

multiple step-by-step process, a law that reforms america's broken health care insurance so patients can get the care they need from a doctor they choose at lower cost, one that puts american families in control of their health care, a law that is simpler, fairer, more effective and more accountable. we've seen the mistakes that the democrats have made with the health care law. we've seen that every state is different so we're going to be looking to push as much authority out of washington and back to the states. we've seen that too many mandates and regulations drive up costs and they drive all the costs without improving the quality of care. we've seen that when washington writes bad laws, the unintended consequences are severe. these are all things that republicans have said since the very beginning. the failure of obamacare has proven the republicans were right. the election has proven that the

american people, mr. president, want a new approach. american families don't want us to tinker with obamacare. they just want affordable health care. so i want to make a couple of things clear. first of all, nobody is talking about taking people off of insurance without a replacement plan in place. we all understand there needs to be a transition over time. people have already been hurt too much when they lost their insurance and when the rates went up because of obamacare and the mandates and the government saying they know better than families across the country. so we'll be working to make the transition as smooth as possible for everyone. that's why we're including a transition period in a repeal bill that congress passed last year and sent to the president's desk. the president, of course, vetoed it. our goal, mr. president, is to do no harm. second, as we write a new health care law, we'll be looking to

make it real reform that is actually centered on patients. now, we can increase the use of health savings accounts. that will give people a chance to actually control how they spend their own money on their health care. we can support innovative insurance plans that pay for prescription drugs that work best for patients and not just ones preferred by insurance companies. we'll be talking abouted whys, ways to -- about ideas, ways to protect people with pre-existing conditions and letting young people stay on their parents' insurance. mr. president, these are important parts of the health care law so republicans are going to consider any ideas, any ideas that can help us to give people what they wanted all along, access to the care they need from a doctor they choose at lower cost. democrats promised that they would listen to other people's ideas, and then they went behind a closed door in an office back there, mr. president, and they wrote the law ignoring all of the suggestions by republicans

and without any republican support at all. we're not going to make that mistake, mr. president. we will be looking for democrats' help. we will be looking for democrats to work with. we will be listening to democrats' ideas, and we'll be working very hard to win democrat votes for any new law. reforming health care in this country is not going to be easy. it's not something that we're going to score doing for the purpose of scoring political points or discredit president obama. it is something, mr. president, it is something we must do to protect american families, and their health as well as their health care. thank you, mr. president. i yield the floor. i suggest the absence of a quorum. the presiding officer: the clerk will call the roll.

quorum call:

quorum call:

quorum call:

quorum call:

add hominem ad hominem quorum

call: quorum call:

a senator: mr. president? the presiding officer: the senator from north dakota. a senator: i ask that the quorum call be vitiated. the presiding officer: without objection. a senator: thank you, mr. president. i rise to speak today and also to respond to comments from some of my colleagues on the dakota access pipeline and the ongoing

protests in my state of north dakota. mr. hoeven: here we have a chart showing the dakota access pipeline. it's 1,172-mile crude oil pipeline from the balkan oil fields near stanley, north dakota. to refineries and terminals that actually connects to atoka, illinois and the crude can go into eastern refineries. it will move 470,000 barrels of oil daily from the balkan in north dakota and montana to eastern markets and to refineries that depend on that crude. this is high quality. this is the lightest, sweetest crude that we produce. so it's very high quality oil of the other thing that's important to understand is this oil is already moving. it's already moving to these markets. but right now it's moving by a rail and it's moving by truck.

so this is oil that is already being moved. what this pipeline does is it actually increases the efficiency and the safety with which we move oil that is already being transported to the eastern markets. furthermore, the projects has undergone years of state regulatory reviews and an extensive federal environmental assessment which found no significant environmental impact. again, the environmental assessment found no significant environmental impact. it's been sties challenge -- twice challenged and twice upheld including the obama administration's own appointees in federal court. the federal courts found that the army corps had followed the appropriate process, that the standing rock tribe was properly consulted and that the project can lawfully proceed.

now, everyone has a right to be heard but it must be done lawfully and peacefully, whether this is during the per moilting process with opportunities for public outcome or disputing the outcome through the court system. that's what we have the court system for. the court system hears grievances and provides dispute resolution. the ongoing protest activities which are occurring in north dakota which at times have been violent are being prolonged and intensified by the obama administration's refusal to approve the final remaining easement at the lake. this inaction has flamed tensions, and most importantly is needlessly putting people at risk, including tribal members, protesters, law enforcement officers, construction workers, and area residents, our farmers and our ranchers who live and work in the area of the pipeline. it's past time that the final

easement is approved and construction is completed. we need to get this issue resolved. it is past time to get this issue resolved. as the record demonstrates it should be done so on its merits through the previously established regulatory and legal process. in other words, follow the law. we're a country of laws. follow the law. further, the federal law enforcement agency should help our state and local law enforcement officers to ensure that the law is followed, prevent violent and unlawful protests, and see that the peace is maintained. our law enforcement officers have worked professionally, diligently, and tirelessly to protect the public. so to further describe the situation, let me provide some backgrounds. now, the company developed the fraught dakota says pipeline beginning in 2014. the current path will run parallel to an existing northern border gas pipeline which was placed into service in 1982 as

well as an existing high voltage electric transmission line. so the point is, in north dakota this is an already established right of way forever infrastructure. you already have an existing gas line that goes through the same route and you have a high voltage transmission line as well. now, 99% of the route for the dakota access pipeline crosses private land, 99% is on private land. only 3% of the work needed to build the pipeline requires federal approval of any kind and only 1% of the pipeline affects u.s. waterways. to date the pipeline is already 98% complete in north dakota. it's 98% done in north dakota, and it's 86% complete overall, all the way from north dakota to illinois. that includes the route around and up to the final two-tenths of a mile portion of the missouri river which is where

most of this protest is occurring. this area of the river known as lake ow owahe requires one remaining federal easement. the segment at the center of this debate is a small section pranked to v.a. verse under the lake which would occur at a depth of 92 to 117 feet below the riverbed. in other words, the pipeline doesn't enter the river at all. it's about a hundred feet below the river. and that's very important to understand. in fact, where it crosses as i say underneath the river, it is a hundred percent adjacent an existing natural gas pipeline. in other words, it follows a pipeline that's already built and is there now, an existing natural gas pipeline. this was done so that any ground disturbances would not harmony cultural or tribal features.

that's why they followed this right of way. okay, so let's put this into perspective a little bit. we've got another chart that helps do that. remember, we're talking about crossing the river in one place, right? we're talking about a pipeline that's going to cross this river in one spot. so let's put that into a broader context, into broader perspective. the congressional research service estimates that there are 38,410 crude oil pipeline river and water body crossings in the united states. so there's more than 38,000 -- in our network of oil pipelines around the country, we cross waters more than 38,000 times. we're talking about doing it one more time here, but we already do it more than 38,000 times all over the cou.