mind as we work to keep our environment safer. thank you, madam chair. i yield my time. >> thank you, mr. curtis. >> thank you, madam chair, i say thank you to all the panelists. i want to start with miss fennell. in your testimony you stated, as i read that as a close of fiscal year 2018, the number of fields law enforcement officers at each of the four land management agencies has declined since fiscal year 2013 and that decline makes it more difficult to protect employees. can you first elaborate on the impact that the declines have had on employee safety? >> it's one of a number of factors that have-- we are going to leave this hearing at this point. you can see the remainder on

our website, c-span.org, type attacks on federal employees in the search box which you'll find at the top of our home page. the u.s. senate is about to gavel in on this wednesday morning, senate lawmakers plan to resume debates on appealing wavers on states to offer low cost insurance plans with the affordable care act 12:15 eastern toed and lawmakers plan to turn to 2020 federal spending on several departments including agricultural commerce, and housing. now to live coverage of the senate here on c-span2. the u. we offer you today a sacrifice of thanksgiving for we borrow our heartbeats from you. inspire our lawmakers to love discipline and cherish your

word, seeking always to glorify you. may they trust your power and wisdom to supply what is needed to keep our nation strong. have your way, sovereign god. you are the potter. we are the clay. mold and make us after your will while we are waiting, yielded, and still. we pray in your merciful name. amen. the president pro tempore: please join me in reciting the pledge of allegiance i pledge allegiance to the flag of the united states of america, and to the republic for which it stands, one nation under god,

indivisible, with liberty and justice for all. mr. grassley: mr. president. the presiding officer: the senator from iowa. mr. grassley: i'd like to address the senate as if in morning business for one minute. the presiding officer: without objection. mr. grassley: before i read, i want to apologize to the small business women of america because october is national

women's small business month, and my apologies because this speech should be given on october 1 rather than the end of the month. october is national women's small business month, and i want to recognize the many women-owned businesses. they really help make our economy stronger. in iowa, we work hard to inspire women to start businesses and support them in their entrepreneurial journey. according to the american express, iowa ranks eighth out of 50 states for the growth in the number of women-owned businesses as well as in their own growth in employment and revenues. the network growth for women's entrepreneur and access to resources have helped make the difference in these women's

lives and our communities. i hope this growth will continue and we continue to have massive increase in the number of small women businesses in america. i would ask for one further minute. the presiding officer: without objection. mr. grassley: i know you're not going to believe this, what happened in addition to president trump being sworn in, but on january 20, 2017, president trump was sworn into office and became our nation's 45th president. now most presidents enjoy what political scientists refer to as a honeymoon period. during that honeymoon period, these new presidents are given a chance to push their agenda and

partisan politics usually takes a back seat. but not this president. on his inauguration day, january 20, 2017, a "washington post" headline read -- so it had to be coming out even before he was sworn in -- quote, the campaign to impeach president trump has begun. that campaign has been in full swing ever since. so let's make no mistake, this process about concerns over alleged high crimes and misdemeanors as the constitution speaks about the reasons for impeachment, they don't really mean much compared to an effort to impeach this president that started before he ever was sworn in. no, instead this is about the democratic party still bitter

years later trying to undo the 2016 election. i ask unanimous consent to put that part of the "washington post" january 2017 in the record. the presiding officer: without objection. mr. grassley: i yield the floor. mr. mcconnell: mr. president. the presiding officer: the majority leader. mr. mcconnell: tomorrow the senate will vote on funding for the national defense. it will offer a test for our democratic colleagues. will their party's impeachment obsession crowd out even the most basic governing responsibilities?

unfortunately, it seems we already have our answer. the democratic leader said at a press conference yesterday that his party intends to filibuster funding for our armed forces. democrats have plenty of time and energy for their three-year-old journey to impeach the president, but they can't get to yes on funding our service members. that's about as clear a statement of priorities as you can get around here. just a few days ago u.s. special forces executed a daring mission and took out the founder of isis. it was the clearest possible reminder that the national security of the united states and the missions of our service members do not pause for partisan politics. but less than a week later, for political purposes senate democrats said they refused to secure funding for those very same missions. washington democrats have talked up a storm in recent days criticizing the administration's

approach to syria and the middle east. lots of talk, but apparently they're not concerned enough about the middle east and fighting isis to actually vote for the funding that keeps the missions going. and consider this, mr. president. if democrats filibuster this defense funding as they threatened to, they will literally be filibustering the exact kind of military assistance for ukraine over which they are trying to impeach the president. let me say that again. this legislation is what appropriates the money for the ukraine security assistance initiative, precisely the program that democrats are trying to impeach president trump for supposedly slow walking. and yet, tomorrow, right here in the senate, they say they're going to filibuster funding for

the exact same program. only in washington -- only in washington will you see a show like that. they want to impeach the president for delaying assistance to ukraine while they block funding for the program themselves. i'd say it's unbelievable except that's exactly what's happening. look, i think it's pretty clear our democratic colleagues do not have a great affinity for president trump. but the country cannot afford for democrats in congress to take a one-year vacation from any productive legislation just because they'd rather obsess over impeachment. isis and other radical terrorists are not going to hit the pause button because democrats won't fund the u.s. military. strategic competitors like russia and china are not going

to hit pause because democrats would rather hurt the white house than fund our military commanders. look, congress needs to do its work. we need to fund our armed forces. tomorrow's vote will tell us which senators are actually ready to do it. now speaking of impeachment, yesterday house democrats released their much-hyped resolution which was advertised as bringing fairness and due process into speaker pelosi and chairman schiff's closed door partisan inquiry. unfortunately, the draft resolution that has been released does nothing of the sort. it falls way short, way short. as i've said repeatedly, an impeachment inquiry is about the most solemn and serious process the house of representatives can embark upon. it seeks to effectively nullify democratic collection and cancel out the american people's choice of a commander in chief.

for that reason, any such inquiry must be conducted by the highest standards of fairness and due process, but thus far this time around instead of setting a high bar, house democrats seem determined to set a new low. speaker pelosi has initiated a bizarre process, starting with the fact that she began it with a press conference instead of a proper vote of the house. the process seems to be treating chairman schiff as though he were a de facto special prosecutor, notwithstanding the fact that he's a partisan member of congress whose strange behavior has already included fabricating a lengthy quotation and attributing to president trump during an official hearing which he was chairing. house democrats' inquiry thus far has been conducted behind closed doors. they have denied their republican counterparts privileges which democrats received during the clinton impeachment when they were in the minority. and unlike during the inquiries

around both president clinton and president nixon, they have denied president trump basic due process rights and are cutting his counsel out of the process in an unprecedented way. house democrats' new resolution does not change any of that. it does not confer on president trump the most basic rights of due process or seemingly alter chairman schiff's unfair process in the house intelligence committee in any way whatsoever. chairman schiff can contribute -- can continue doing this behind closed doors without the president's participation so long as he holds at least one public hearing at some point. he's not even required to make all the evidence he obtains public. he alone gets to decide what evidence goes in his report. and the resolution doesn't even give the president any rights in the public hearing that it requires chairman schiff to hold.

the resolution merely seems to contemplate that maybe, maybe someday in the future at some other phase of this due process might -- might finally kick in. but only if the house judiciary committee feels like holding hearings and calling its own witnesses. in other words, no due process now, maybe some later, but only if we feel like it. no due process now, maybe some later, but only if we feel like it. well, that's not even close to fair. no due process now, maybe some later, but only if we feel like it is not a standard that should ever be applied to any american and it should not be applied here to the president of the united states. now i understand that many house democrats made up that you -- ur

minds on impeachment years ago but justice does not evaporate just because washington democrats already made up their minds. now on one final matter, our democratic colleagues do apparently have time to push show votes on messaging resolutions with no chance of becoming law. this week's installment is a democratic effort to limit the flexibility that governors of both parties have utilized to lighten the burdens of obamacare. states have jumped at the opportunity to use waivers to reduce the costs associated with obamacare's mandates, and the states that have taken advantage premiums decreased significantly. in 2018 the donald trump expanded this policy with an even more flexible interpretation of this part of obamacare. the goal was to give states even more of what they had been asking for, even more latitude to preserve consumer choice and lower premiums.

but notwithstanding all the evidence that says this is the right direction for the american people, our democratic colleagues want to roll back the trump administration guidance and limit state flexibility. since this position is virtually impossible to explain on its merits, our democratic colleagues have instead turned to a familiar talking point. the false claim that republicans are trying to undercut protections for americans with preexisting conditions. sound familiar? but, of course, that's not true. as senate republicans have said over and over and over again, we support protections for americans with preexisting conditions. and the administration has made it very clear that this waiver program poses no threat, no threat to those protections. the administrator of the centers for medicare and medicaid services has stated, quote, a

section 1332 waiver cannot, cannot undermine coverage for people with preexisting conditions. and what's more is the white house -- as the white house has already made clear, democrats' resolution has zero chance of becoming law. this is just another political messaging exercise with no path to making an impact. so i would urge my colleagues to reject this resolution, keep fighting to lower premiums for the american people, and protect those with preexisting conditions. now, mr. president, i understand there is a bill at the desk due a second reading. the presiding officer: the leader is correct. the clerk will read the title of the bill a second time. the clerk: h.r. 4334, an act to amend the older americans act of 1965 to authorize appropriations for fiscal years 2020 through 2024, and for other purposes. mr. mcconnell: in order to place the bill on the calendar under the provisions of rule 14, i would object to further

proceedings. the presiding officer: objection having been heard, the bill will be placed on the calendar. under the previous order, the leadership time is reserved. morning business is closed. under the previous order, the senate will resume consideration of s.j. res. 52, which the clerk will report. the clerk: calendar number 278, s.j. res. 52, providing for congressional disapproval under chapter 8 of title 5, united states code, and so forth. the presiding officer: the clerk will call the roll. quorum call:

mr. schumer: mr. president, i notice the -- are we in a quorum call? the presiding officer: we are. mr. schumer: i ask that it be dispensed with. the presiding officer: without objection. mr. schumer: even as we consider the package of appropriations bill on the floor this week, we have to think about how both parties can reach an agreement on all 12 bills that need to pass before thanksgiving. it's way past time for democratic and republican appropriators to sit down and hammer out a bipartisan agreement on allocations to the various agencies, known as the 302-b's. that's how we got this done in the past. democrats, republicans in congress have successfully negotiated two budget deals. the key to those agreements was that the president allowed congress to do its work and stay off to the side. i believe that again if left to our own devices, congress could

work out an agreement to fund the government. as everyone remembers, the president's meddling and erratic behavior caused the last government shutdown, the longest in our nation's history. the best way to avoid another shutdown would be for the president to keep out of the appropriations process and for republicans to stop the games and get serious about negotiating in a bipartisan way forward. i believe there was a meeting yesterday and maybe some progress -- i think some progress was made. let's continue moving in that direction. the four corners of the appropriations committee, house and senate, democrats and republicans, and put together an agreement that we can all support. on the whistle-blower, as the house of representatives continues impeachment inquiry into whether the president jeopardized national security by pressuring ukraine to interfere with our 2020 elections, the white house, their allies in congress, and the media have resorted to despicable tactics

to falsely discredit individuals who have provided the house testimony. yesterday, lieutenant colonel alexander vindman, an active duty army officer serving on a detail in the white house, testified before congress. since l.t.c. vindman's testimony was announced and especially in the past 24 hours, he has been vilified by individuals in the media and elsewhere. although he has woifd our country for more than 20 years, although he is recipient of the purple heart after being wounded serving in iraq, he has been called derogatory terms and some have even gone so far as to call him a spy and question his loyalty to the united states. these tacts are outrageous, they are unacceptable, and they are not much -- and they are not much unlike the attacks the president and his allies have levied against the whistle-blower whose account first alerted congress to the president's misconduct with ukraine. the president has publicly

suggested the whistle-blower's treasonous and a spy and separately recent public reports suggest that a republican member of the house intelligence committee is actively trying to expose and leak the whistle-blower's identity. this is so, so wrong. disclosing or causing to be disclosed the identity of a whistle-blower is such a breach of faith with our whistle-blower laws, which are designed to see that the truth gets out. anyone seeking the release of the whistle-blower's identity is frustrating the truth and is potentially in violation of federal law. not only that, the disclosure of the whistle-blower's identity may result in reprisals and threats to their personal safety and the safety of their families. so today i'm sending a letter to the secretary and chief of staff of the army asking them to provide us with what actions the army has taken to ensure that l.t.c. vindman is afforded

appropriate protections, l.t.c. vindman and whistle-blowers like him are standing up for the constitution they swore an oath to defend. their lives and families must not be put in jeopardy by an outrageous attack or disclosure. on health care. today the senate will hold a vote on a resolution to repeal a trump administration rule promoting junk health insurance plans which offer a way around protections for americans with preexisting conditions. the administration has worked to make it easier for states to use taxpayer dollars to subsidize these junk insurance plans, many of which don't cover essential benefits like maternity care and mental health care. these are nothing but a boon to health insurance companies. for nearly three years republicans in congress and the trump administration have sabotaged americans' health care many funding to sign up

americans for health insurance has been eliminated. programs to help low-income americans afford insurance has been canceled. president trump's budgets have threatened deep cuts to medicare and medicaid and now the trump administration is suing to repeal the entirety of the health care law. yesterday -- just yesterday new data shows that 400,000 fewer kids have health insurance now. most who are under 6. innocence, when they have bad health, they need help. that breaks your help. the effect of all this sabotage is very, very real. now think about this issue, about protections with -- for americans with preexisting conditions. think of a mom or dad who has a son or daughter and they discover he or she has cancer. they go to the doctor, the doctor says, look, i have this very expensive medication or

expensive treatment that will help cure your child, but the insurance company -- your insurance policy doesn't cover . it the family doesn't have enough money to pay for it and watch their child suffer. that should not happen in america. we want to prevent it from happening, and that is why we hope our colleagues will join us in this c.r.a. to overturn what the administration has done which would allow that terrible example to go forward. i yield the floor. i have a few more things to say. the presiding officer: the democratic leader. we've got time. mr. schumer: let me continue on health care for a minute. despite making explicit promises

to protect americans with preexisting conditions in campaign ads, i even heard some speak about it as recently as yesterday, republicans have voted to undermine these protections in congress on several indications. there is no getting around the fact that junk insurance plans offer a way around the important protections and drive costs up for everyone else. the republicans want to use taxpayer dollars to fund these junk plans and pad insurance company profits. i hope not. but we'll see today. because today my republican colleagues face a test. they can vote to defend health care protections for americans who need it most or they can stand with president trump and vote to allow these junk health insurance plans with so many devastating effects on so many families flood the market. finally, on syria. we were informed yesterday that after multiple requests, the senate would finally receive an

all-member briefing by the administration on the situation in northern syria this afternoon. i'm glad the briefing is taking place, but it's regrettable that it has even taken this long. secretary pompeo also will not participate, which is profoundly disappointing given that we muss hear from the secretary of state at times and on issues such as this. nevertheless, those members of the administration who will be there today must answer several important questions. what's our strategy moving forward on northern syria? how are we going to protect troops and our national interest? and, most importantly, exactly what is our plan to ensure the enduring defeat of isis and to make sure those who are still imprisoned don't escape and those who have already escaped don't hurt us. these urgent questions go to the heart of america's national security and we need them answered today. now i yield the floor and note the absence of a quorum.

the presiding officer: the clerk will call the roll. quorum call:

mr. thune: mr. president. the presiding officer: the majority whip. mr. thune: is the senate in a quorum call? the presiding officer: we are. i ask unanimous consent that the quorum call be lifted. the presiding officer: without objection. mr. thune: mr. president, isis took a big hit over the weekend when u.s. forces raided isis

leader al baghdady's compound. he died in the raid after he detonated a suicide vest in a final act of coward he's, killing -- cowardess killing three children with him. his second in command was killed hours later, leaving the organization temporarily leaderless. mr. president, over the past few years, isis has spilled a river of blood across the middle east. its brutality set it apart even among other terrorist organizations, torture, rape, enslavement, crucifixes, beheadings, deliberate targeting of whole populations based on religious belief. the world is a safer place today because of al al-baghdadi death. this will only be temporary

unless we dedicate ourselves to ensuring that isis is permanently defeated. mr. president, the successful raid on al-baghdadi's compound is a reminder that our military may be called on at a moment's notice to head half way around the world to fight evil. the men and women of the united states military stand on guard 24 hours a day, 365 days a year ready to pu themselves between us and danger. this past week -- weekend i had the honor of welcoming home army national guard sold yergs of the 197th support company and bravo battery of the field artillery battalion. they were in europe for nearly a year working with our nato allies. as members of congress, we have no more fundamental responsibility than ensuring that our men and women in uniform are prepared to meet any threat. and we do that by providing

timely and adequate funding for the current and future needs of our armed forces. that means funding the military through regular order appropriation bills, not through temporary funding measures that leave the military in doubt about funding levels and unable to start essential new projects. unfortunately, our efforts to fund the military in a timely fashion have been stymied by democrats who blocked the senate from passing the defense appropriations bill in september before the end of the fiscal year. we're now a month into the new fiscal year and democrats are still indicating that they inextend to block this year's defense appropriations bill. let me briefly review, mr. president, what democrats are blocking. they are blocking funding to support a pay increase for our military men and women. they are blocking funding for weapons and equipment that our troops need right now.

they are blocking investment in the equipment and technology that our military will need to meet the threats of future. they are blocking funding for missile defense, for research and development, for ships, planes, and combat vehicles to update our aging fleets. and they are blocking funding for our allies, including $250 million in military assistance for ukraine. let me just repeat that last point, mr. president. democrats who are currently trying to impeach the president for allegedly delaying ukraine funding are currently blocking $250 million in assistance for ukraine. now, i'm pretty sure that that's the definition, if you look it up, of both irony and hypocrisy.

mr. president, towards the end of the summer it looked like democrats might be actually willing to work with republicans to pass this year's appropriations bills. both democrats and republicans agreed to a bipartisan deal laying out funding levels for both defense and nondefense spending. but apparently that wr as senate democrats were prepared to go. now that it's come time to honor the spirit of that agreement and get this year's defense appropriations bill done, senate democrats are blocking. mr. president, democrats would like us to believe that they're serious about legislating, that their years' long obsession with impeaching the president isn't distracting them from doing their job. well, mr. president, they're going to have a chance to prove that in the very near future. if democrats are actually serious about ledges is slating, if -- about legislating, if they're serious about meeting their responsibilities, then they will work with republicans to

move forward on the defense appropriations bill and to get this legislation to the president as soon as possible. i hope that's what they choose to do. as chairman shelby noted on the floor last week, congress' failure to do its job and fund our military is making the military's job more difficult. and that, as chairman shelby noted, is unacceptable. mr. president, it should be unacceptable to all of us. it's time to get our men and women in uniform the funding that they need and the pay increase that they deserve. it's time to get this year's defense appropriations bill done. it's time for the democrats to stop stalling and foot-dragging and blocking and for them to work with us to make sure that our men and women in uniform have what they need to protect americans and to keep us safe. mr. president, i yield the floor and suggest the absence of a quorum.

the presiding officer: the clerk will call the roll. quorum call:

a senator: mr. president. the presiding officer: the mr. alexander: mr. president -- the presiding officer: senator, we are in a quorum call. mr. alexander: i ask that the quorum call be vitiated.

the presiding officer: without objection. mr. alexander: mr. president, at 12:15 the senate will vote on a democratic proposal to overturn a trump administration guidance from the department of health that would lower insurance rates all across america. it seems like a strange thing to do. but to justify that, the democrats have come up with a scary fairy tale that has no basis in truth, that suggests that somehow this effort to lower insurance rates would jeopardize the protection for preexisting conditions that all americans have, according to the law. and of course that can't happen because the law doesn't permit it. so i want to talk about that a little bit today. what the senate democrats want to overturn is a trump

administration guidance using what's called a section 1332 waiver. a 1332 waiver was part of the affordable care act of 2010 that democrats passed. no republican voted for it. so you had the affordable care act, which says, among other things, that every american who has a preexisting health condition is protected. that means that if i have a preexisting health condition and i want to buy insurance, that i have a right to buy it, that i can't be charged any more for it because of my preexisting health condition, and that i'm covered if i get sick. that's what we mean by protection for preexisting conditions. so that's in the federal law. no american can be denied that protection. now, in the very same law, the affordable care act, democrats wrote another provision to give states more flexibility in how

they spend obamacare money with the hope they might be able to lure rates for americans who have health insurance. that would be a good thing because in tennessee or across the country, really, since obamacare passed, rates have gone up 163%. and those especially hurt are people who make a little more than $50,000. say a songwriter in nashville or a farmer like marty that i ran into in a chick-fil-a outside nashville who said i can't afford health insurance. i have to pay $15,000 or $20,000 because i don't get any obamacare subsidy. so states are trying to take advantage of this provision of the affordable care act, obamacare, that says states may have some flexibility in how they spend the money as long as, the law also says, you don't

jeopardize preexisting condition for anybody. now, the best evidence that what we're talking about is a scary fairy tale is that 12 states already have used the 1332 guidance. remember, this was the provision in the federal law that was designed to give states more flexibility in how you spend federal dollars. 12 states have already used that provision to lower rates. these are 12 waivers from states that have been approved by the trump administration. and premiums have gone down in all 12 states as a result of this action. this is what the democrats want to stop. they want to stop states from using this provision that democrats invented in 2010 to lower insurance rates. that's why it's a scary fairy tale that only on halloween anybody would imagine could come up with. now, seven of the 12 waivers

that were approved by the trump administration were under an obamacare definition of section 1332, and five were under this guidance that is the subject of the vote today. now, for any state to get a 1332 waiver, the centers for medicare and medicaid services has to approve it. that's siema verner. she is the administrator of that agency. she has made it very clear, number one, that none of the 12 waivers that have been improved jeopardized preexisting health conditions for anybody. in other words, they did lower rates for some people, but they didn't hurt anyone's ability to buy insurance who had a preexisting condition. just because it helped some people didn't mean it hurt other people.

she went on to say very clearly, to be very clear, the 2018 guidance, the one we're talking about today, does nothing to erode obamacare's preexisting condition provisions, which cannot be waived under section 1332. in other words, the law that the democrats wrote in 2010 do not allow states to waive the preexisting condition. she goes on to say section 32 does not permit states to waive public act service requirements such as guaranteed availability and renewability of health insurance, the prohibition of using health status to vary premiums and the prohibition on existing health exclusions. furthermore, a section 1332 waiver cannot be approved that might not otherwise undermine these requirements. the administration stands committed to protecting people

with preexisting conditions. so the bottom line is 12 states have already used section 1332 waivers to reduce premiums. more states want to come up with other ideas to do the same. in none of the 12 states was preexisting condition jeopardized for one single person. and she says that it can not be under the law in any of the other states with some sort of new proposal, and if there were such a proposal, she wouldn't approve it. there is no doubt there is a good reason why so many governors -- in fact, many of the states already being granted waivers have democratic senators as well as democratic governors. many states are trying to reduce health insurance rates because obamacare has driven those rights so far.

in the health hearings i chaired in the fall of 2017, virtually every witness told our committee that the process of applying for a 1332 waiver was too cumbersome, too flexible and expensive for states to use. in the fall of 2017, provisions to improve that waiver process were included in bipartisan legislation that was proposed by 12 republican senators, 12 democratic senators. at one point, the distinguished senator from new york, the minority leader, senator schumer, said it was such good policy, every democrat ought to vote for it. but in 2018, senate democrats blocked that bipartisan legislation which would have, by the way, lowered insurance premiums by 40% over three years. it became clear democrats were refusing to change even a word of obamacare. so i encourage secretary azar and the administration to take a look at the section 1332 waiver, and within the current law do

whatever they could to give states more flexibility. 14 governors wrote the secretary seeking help to make 1332 waivers work so they could start lowering premiums in their state. so october, 2018, the trump administration issued new guidance with a much-needed flexibility so states can use 1332 waivers. now democrats who vote 1215 to overturn this guidance are taking away their states a tool that has been used in 12 states already and that many other states want to lower health insurance rates, and in every single case without jeopardizing protection for preexisting conditions. that was the hole purpose of the 1332 waiver. that's why democrats put it in the affordable care act. that's dwr 13 states have approved those waivers, and 12

have been approved just for one type of solution called reinsurance. that's when you take some money and put it in a reinsurance pool, take the sickest people in your state, put them there. when you take them out of the other pool, it lowers rates for the people who are left, and you can do that with the same amount of money. you lower the rates for these people in the pool. you make sure the people who are sickest have insurance, and you don't take away anyone's right to buy insurance who has a preexisting condition. in each of the states, health insurance premiums have gone down as much as 43% in some cases. north dakota has seen the average obamacare premium increase 20%, colorado 16%, delaware 13%, montana 8%, rhode island 6%. and you want to overturn a guidance that attempts to give states more of that same kind of

flexibility to lower insurance premiums without affecting the ability of any american to have have -- to buy insurance with preexisting condition protection. there is no reason states shouldn't be able to do that. let me give you an example of what this guidance that we're talking about today would mean. in 2017, iowa submitted a waiver application that would have restructured the premium subsidies. that's the money iowa gets from washington under obamacare. according to iowa governor jim reynolds, iowa's waiver would have given 18,000 to 22,000 iowans access to more affordable insurance. these were iowans who made too much to qualify for federal subsidy and were left behind by obamacare's skyrocketing profits. this might be a farmer in iowa making $55,000 a year.

no subsidy, $15,000 or $20,000 for an insurance policy. the rates would be lower under iowa's proposal. under the old guidance, iowa's innovative waiver couldn't be approved. now, with the new guidance, the one you seek to overturn today, iowa can work with administrator verma to get the kind of creative waiver so 15,000 more iowans can afford health insurance. and to be clear, to emphasize, just as with the other 12 examples that have been approved, no new waiver can be approved that would take away the right of any iowan who has a health insurance to buy insurance and buy it at the same price as if that person didn't have health insurance and to be covered when you're sick. so it's simply a fairy tale, a scary halloween fairy tale.

drummed up by the other side for reasons i can't imagine since so many of their states are benefiting from this 1332 waiver. to take away from states the ability to reduce health insurance. as i said earlier, any waiver that's approved, as 12 already have been, to help some people get lower health insurance cannot hurt another person in that state by taking away their right to buy insurance at the same price that covers their preexisting condition. states with 1332 waivers include these states with democratic senators who will be voting today -- hawaii, maryland, minnesota, new jersey, oregon, wisconsin. do they really want to take away from their state the ability to lower health insurance premiums in a way that doesn't jeopardize preexisting conditions? that's pretty strange.

then colorado, montana, delaware, rhode island, alaska, north dakota, the same. i think this just gets back to the point that democrats have elevated obamacare to the 67th book of the bible, and they can't change a word of it, even though they wrote the 1332 waiver in the affordable care act to give to states flexibility to reduce -- to reduce health care premiums which 12 states now have done. and democrats also wrote in the affordable care act that you cannot take away from any american the right to buy insurance at the same price if you have a preexisting health condition. that's been reaffirmed by the trump administration. it's in the law. to suggest otherwise, as i said earlier is a scary fairy tale dreamed up for halloween, and i hope that all senators, especially from those states who have seen the 12 -- the 1332

waiver work so well, will vote not to overturn the guidance that gives more americans a chance to pay lower health care premiums. mr. president, i yield the floor.

a senator: mr. president. the presiding officer: the senator from wisconsin. ms. baldwin: mr. president, i rise today to join my colleague, senator mark warner, and the entire senate democratic caucus to force a vote on his resolution to protect americans with preexisting health conditions and stop the trump administration from using american taxpayer dollars to promote junk insurance plans that don't even have to cover people who have preexisting

health conditions. the difference between the two sides of the aisle here are really clear. senate republicans have worked with president trump to pass repeal plans that would take people's health care away and allow insurance companies to charge more for people with preexisting health conditions. when their effort failed legislatively, instead of working in a bipartisan way to lower costs -- health care costs for working families, president trump and his administration spent two years working to sabotage our health care system. the trump administration sabotage has made it harder for people to sign up for quality affordable coverage, and today there are more americans uninsured than when president trump took office. the trump administration is even in court supporting a lawsuit to

overturn the affordable care act completely, taking away guaranteed health protections and raising costs for americans with preexisting health conditions. if they succeed, insurance companies will again be able to deny coverage or charge higher premiums for nearly 130 million americans who have a preexisting health condition. mean while, this administration has expanded what we call junk insurance plans. these are plans that can deny coverage to people with preexisting health conditions and don't have to cover essential services like prescription drugs, emergency room visits, and maternity care. i ask my friends on the other side of the aisle to think about this for a moment. president trump supports overturning the law that

provides protections for people with preexisting health conditions while he is expanding these junk plans that don't provide those protections. this shwhat they support. -- this is what they support. this is their plan. last year we forced a vote on my legislation to block president trump's expansion of junk insurance plans that don't have to cover people with preexisting health conditions. the final vote tally was 50-50, with the entire senate democratic caucus and one senate republican voting in support of my legislation. anyone who says that they support health care coverage for people with preexisting conditions should support the no jung plans -- the no junk plan's

act. so today i want to take another vote. i ask unanimous consent the help committee be discharged from further consideration of s. 1556 and that the senate proceed to its immediate consideration, that the bill be considered read a third time and passed, and that the motion to reconsider be made and laid upon the table with no intervening action or debate. the presiding officer: is there objection? mr. alexander: mr. president, reserving the right to object. the presiding officer: the senator from tennessee. mr. alexander: the senator from wisconsin is exactly correct, every senate democrat has voted to take away lower cost insurance option from what the urban institute said is 1.7 million americans, people who can't afford insurance. that is what they took away and that is what she is trying to do

today. i have constituents who can't afford insurance. this kind of insurance was good enough for the george w. bush administration. it was good enough for the clinton administration. it was good enough for the obama administration right up until the last few days, and it should be good enough under the trump administration. all it does is allow -- is give 1.7 million americans, according to the american urban institute an opportunity to buy short-term insurance while they move from one job to another or look for a different situation. according to the urban institute, those 1.7 million americans would otherwise go insured. that's what the democrats are for, so i object. the presiding officer: objection is heard. the senator from wisconsin. ms. baldwin: obviously i'm disappointed with the objection and would point out that these junk plans are often called

short-term plans, but the change that was made by this administration was to go from three month sort of transitional plan, as my colleague indicates that could be used when you're changing employment or other short-term use, and now they are available and renewable for up to three years. these plans do not preserve the protections under the affordable care act to cover people with preexisting health conditions and essential health benefits. and you don't have to take my word for it. we can read directly from the fine print on the actual plans that are being debated. one of these junk plans currently available in my home state of wisconsin from

companion life reads, quote, this plan has a preexisting limitation provision that may apply to medical conditions that existed prior to this plan's effective date. another junk plan from golden rule says that the plan doesn't comply with the guaranteed essential benefits provided by the affordable care act. to quote directly from the plan, the description reads, quote, even if you have had prior golden rule coverage and your preexisting conditions were covered under that plan, they will not be covered under this plan. it's abundantly clear that these plans don't cover protections for people with preexisting conditions. the people of wisconsin did not send me to washington to take away people's health care. i want to protect the guaranteed

health care coverage that millions of americans depend on. i want to help more families get quality affordable health care that they need. and despite the sabotage that i've described from this administration against the affordable care act, in wisconsin this year things are getting better with a new governor thanks to strong leadership from governor evers and the investments his administration is making, wisconsinites will have more choices and more affordable rates for quality health insurance plans this year. wisconsinites in every corner of the state will be able to find health care plans that include essential benefits like prescription drug coverage, maternity care, emergency room visits, and mental health care for more affordable prices.

the governor is providing funding for more health insurance navigators and conducting awareness campaigns in the state so that families in wisconsin will have the information they need to sign up for quality and comprehensive health care plans. that's why enrollment navigators are so important. we need to keep up the funding for navigator programs so that more people can find an affordable health care plan that meets their needs. navigators help millions of americans, including those in rural communities, sign up for quality health care coverage. the governor of wisconsin understands the importance of navigators, but washington has failed to step up. unfortunately, since president trump took office, his administration has slashed federal funding for the navigator program by 84%.

trusted navigator programs like those in wisconsin have had their funding cut by nearly 75% since 2017, meaning fewer people in wisconsin have received the support they need to obtain affordable coverage. that's why i introduced the enroll act this year with my good friend from pennsylvania, senator casey. this bill restores funding for the navigator program and helps ensure that americans have better access to affordable health care coverage that they need and want. the enroll act passed the house of representatives earlier this year. we should pass it in the senate also so that americans can more easily enroll in quality health care coverage. so i ask unanimous consent that the help committee be discharged

from further consideration of s. 1905, than the senate proceed to its immediate consideration, that the bill be considered read a third time and passed, and the motion to reconsider be considered made and laid upon the table with no intervening action or debate. the presiding officer: is there objection? mr. alexander: reserving the right to object. the presiding officer: the senator from tennessee. mr. alexander: navigators were found not cost effective in enrolling people in health insurance. navigators receive over $62.5 million in federal grants while enrolling 86,000 individuals. that is more than those enrolled in the federal exchanges, which comes out to a cost of $767 per enrollee. in other words, the taxpayer is

paying $767 per enrollee for each person enrolled. c.m.s. also found that nearly 80% of navigators failed to reach their enrollment goals. i object. the presiding officer: the objection is heard. the senator from wisconsin. ms. baldwin: i'm disappointed to see my republican colleague again object to legislation that will help more americans access quality private health insurance, medicaid or children's health insurance program. this is especially harmful to families in rural communities who already lack access to in-person assistance for shopping and enrolling in quality affordable health insurance coverage. so let me lay plain for everyone that what we are seeing here from republicans in this administration. republicans today objected to

passing my enroll act, which provides funding for health care enrollment assistance to help people find high-quality affordable plans that actually meet their health care needs. republicans today objected to passing my legislation to stop the expansion of junk insurance plans that don't even have to cover people with preexisting health conditions. republicans are working to make it harder to sign up for high-quality affordable health care. this administration is encouraging americans to buy junk insurance plans that don't provide health coverage that you need and can deny coverage to people who have a preexisting health condition. and, finally, republicans and the trump administration are supporting a lawsuit that would overturn the entire affordable care act and take health care

away from literally millions of american families. mr. president, the choice for the american people could not be clearer. i'm working with my democratic colleagues to help make things better for the american people and, sadly, senate republicans are helping the trump administration make things worse. i will not give up this fight, but for now, i yield the floor. a senator: mr. president. the presiding officer: the senator from wisconsin. ms. baldwin: i would suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call:

the presiding officer: the senator from indiana. a senator: are we in a quorum call? the presiding officer: we are. a senator: can we suspend it? the presiding officer: without objection. a senator: we're going to vote on a c.r.a. later this

afternoon. this has been the issue dominating d.c. it did in my campaign, cost of health care. mr. braun: i'm going to vote against the c.r.a. i'm not going to go into the particulars on it but just tell you how it works on main street u.s.a. and my perspective on how we solve health care in a way that's going to be affordable and last for a long time. just finished visiting all 92 counties in indiana, too talking to -- talking to hoosiers young and old, small businesses to farms. everyone is concerned about where are health care costs going in the future. we don't seem to have a real good plan for t. as a main street entrepreneur that took it on myself many years ago to create a sustainable, affordable plan, most people think it just absolutely can't happen using

free market principles. i'll go into a few details of how that worked in my own business. obamacare was addressing an issue that's been boiling up for a long time. i took on the insurance companies to fix it in my own company back in 2008. covered preexisting conditions. no caps on coverage. but obamacare was a solution that was never going to work. it was big health care in cahoots with big government. never have i seen that result in something less expensive and more effective. i believe in free markets driving the solutions and health care industry is who i blame for being in this pickle. that sounds unusual coming from a free market guy that doesn't

believe in government but not all markets are free. and one of the most disappointing things is when my own republican colleagues mistake the health care industry for being one that is free and transparent. it has evolved over the years to where it's become as bloated and dysfunctional as the federal government that runs trillion-dollar deficits. obamacare decisions are made by industry executives, federal government bureaucrats instead of by patient, employees, and mostly employers who are the only ones that really have skin in the game when it comes to our health care system. i believe the underlying principles of obamacare were right on. no one should go broke because

they get sick or have a bad accident. i believe that you cover preexisting conditions with no caps on coverage. kids staying on the plan until they're 26, fine. but it tint work from the beginning, and it won't be -- but it didn't work from the beginning, and it won't be, because it was the affordable care act. it turned into the unaffordable care act, and it is not a solution in the long-run. the solution will be to get the industry out of the doldrums and to realize that when 80 senators weigh in with an idea of how to fix your business, the cat is out of the bag. you've got a problem. sadly, in place like this, which you can see can get sidetracked in so many different ways and then never really craft solutions that last in the long-run, that's kind of what

we're up against now. the bills that have come through in three different committees -- primarily finance and the one i'm on, health, education, labor, and pensions -- do some good things. senator grassley and i did an op-ed this week about negotiating drug prices in a way that are going to bring them down. these bills have real things that will work. i'm disappointed that they're not aggressive enough, but we need to start somewhere. the drug companies have been notoriously involved in -- after they do such a good job coming up with a solution, the remedy, then hand it over to a broken distribution system that ends up -- and i'll have to tell a little story. when i was uninsured, after i had to get off my great company's insurance that was based upon wellness, not

remediation, that my employees and patients were encouraged on dollar one to shop around and find solutions. that worked. here the industry does everything they can to not make it work. this should have been a simple thing to do. lucky i don't have many prescriptions. i knew it was a generic that should cost $15 to $20, had six or seven places to choose from in my hometown. went to the first one that would have been the most convenient. fumbled around for two, three, four minutes. kept asking me what my insurance plan number was. i said, i have none. i'm uninsured. i want your best deal. came back $34.50. made another call to a place that i know has been on the leading edge, took them ten seconds, $10, and said, by the way, you can have it ready in ten minutes. that's the way things work in the real world. any of us that run businesses

where you've got transparency, competition, take lasik surgery, for instance. it's the only part of health care that actually works. you know why? insurance companies aren't involved. providers deal with patients, consumers. 10, 12 years ago, $10,000, to $2,500 an eye. now you can get it done from $250 to $500 an eye. that's the way things should work. the solution is not more of what we've tried that has failed. it certainly isn't medicare for all. how can that work when if you're honest about how much it's going to cost, it would nearly double the size of our federal government -- double the size of our federal government. plus, why would you turn

something like that over when we can't even get it right in the veterans administration. where about 10 million patients are covered, not 330 million. that would be jumping from the frying pan into the fire. it would be a disaster. we can't afford it. of course, no one around here ever asks the question, how do you pay for anything. we're going to completely exhaust the medicare trust fund in six to seven years. employers and employees have been paying into that since the 1960's. that'll probably be the first reality check this place has, maybe along with the fact that foreign countries and everyone else is not going to keep lending us money to finance trillion-dollar deficits, which, by the way, hit $1.5 trillion in six to seven years, where the interest on the debt is going to

be more than we're paying for defense. in conclusion, our health care system needs radical change. but it needs to be changed in a way that takes the power from the industry and government and gives it back to the patient patient/consumer, like it works in the real world. i'll use the example -- i know in my hometown, if you're buying a big-screen tv, which by the way costs about a fourth or a third of what they did 10 years ago, kind of like lasik surgery. i know people in my hometown who probably drive 50-60 miles to save $1,000 on a purchase. we don't do that. the health care consumer is atrophied. they talk about they love employer-provided insurance. well, that's because the

consumer pace for very little of it. i'll give you a few details of what can happen when you're innovative, when you incooperate the -- incorporate the concepts of skin in the game. in our own plan, people enter their deductible less than what they did 11 years ago because the incentives were put in place. but i found a way to do it uniquely where most c.e.o.'s didn't want to take the risk. i believe in insurance for everyone. i believe in access. and you heard me earlier. in this day and age, preexisting conditions -- that ship has sailed. back that up with actions in my own business. but i don't believe that you can take more of what's proven never to work and try to get it to be where it's twice the size of our current government. republicans can lead on health

care, but only if we stop acting as apologists for a health care industry that's dysfunctional and broken to the core. and then you set yourself up for politicians here and a public that generally falls for it that that's going to be the solution. on our first foray into surrendering that right to the government through obamacare, it yielded what it was predicted to do -- higher costs and fewer options. the only prescription for an ailing health care system is a consumer-driven, transparent competition, and i look forward to unveiling more of those ideas, and that's why i'll vote against the y.r.a. this -- the c.r.a. this afternoon, and i put the challenge and the onus on the back of the health care industry to get with it before you have a business partner that

you're not going to like, the federal government. i yield the floor. a senator: mr. president? the presiding officer: the senator from washington. mrs. murray: thank you, mr. president. i ask unanimous consent to speak as if in morning business. the presiding officer: without objection. mrs. murray: and i ask unanimous consent that my remarks appear at the appropriate place in the record. the presiding officer: without objection. mrs. murray: thank you, mr. president. while i am so sad to be here today, i'm always glad to have the opportunity to recognize senator kay hagan. there are certain people who carry with them a warmth and kindness that lifts up others, even in places that are not always warm or kind and even when the going gets tough. kay was exactly that kind of person. and one of the best examples i can think of. and she wasn't only that, not at

all. as another mom in the senate, i saw how deeply she was dedicated to her family, her husband chip, and her children jeanette and tilden and carrie. kay was smart, she was witty and fierce, and she was an unwavering champion for north carolina families and communities. nine years ago almost to this week, kay came to the floor to advocate for health reform, and she did it, as she always did, by putting north carolinians first. she came here and she shared the story of tim and marilyn, a family from morrisville, north carolina. they had racked up tens of thousands of dollars in debt because marilyn's preexisting condition meant her only option was a high-cost, high-deductible plan, and kay here called powerfully for protections for preexisting conditions. mr. president, nearly a decade has now passed since the affordable care act became law, so not everyone remembers how in that fight every single senate

vote mattered and there were certainly some senators who listened to the pundits and the naysayers at the time who wanted the bill to fail. kay tuned all that out and listened to people from her home state like tim and marilyn instead. and because she did, more than four million north carolinians with preexisting conditions have protections in law today. they have the peace of mind kay wanted so sadly for tim and marilyn and every one of her constituents. democrats are going to be talking a lot about health care this week and in particular we're taking a very important vote on upholding those protections that kay fought so hard for. so especially throughout this week, i'll be thinking about kay and i'll be thinking about the difference her love for her state has made in the lives of people across north carolina and our country. and i will be grateful, as so many others are, for her amazing friendship, her wisdom, and her willingness to stand up for what is right.

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:

a senator: mr. president? the presiding officer: the senator from virginia.

mr. warner: mr. president, is the senate in a quorum call? the presiding officer: it is. mr. warner: i ask the proceedings of the quorum be dispensed with. the presiding officer: without objection. mr. warner: thank you, mr. president. mr. president, it's been just over two years since the senate voted down legislation that would have repealed the affordable care act. and if we'd voted down the affordable care act, that would have also erased the protections for americans with preexisting medical conditions. in the time since then, two things have happened. one, my colleagues from across the aisle have read the writing on the wall. they recognize that the american people support the protections for preexisting conditions on an overwhelmingly bipartisan basis. and, two, the trump administration released the rule

that we're discussing today, a rule that would actually allow taxpayer dollars to subsidize these short-term junk plans that actively undermine the insurance market and jeopardize the one very popular part of the a.c.a., protecting folks with preexisting conditions. the truth is, and i note my colleagues -- i snow senator baldwin was here earlier, senator brown, senator wyden, senator murray have outlined in detail the details of the junk plans wharks some refer -- plans, what some refer to as short-term plans. they don't cover maternity care or other essential benefits and they once again allow insurance companies to discriminate against americans based on their medical history. now, with all due respect to my republican colleagues, you can't

have it both ways. if you support protections for preexisting conditions, you can't sit by and let this administration dismantle them. you have to stand up and defend these protections because as you know, i know folks back in virginia are depending on them and i know constituents in your states are as well. so very shortly, each member of this body will have a chance to go on the record with this resolution of disapproval. mr. president, i fear that some members of the body have forgotten what it was like before the a.c.a., when an unexpected surgery or a diagnosis of a chronic illness could mean a one-way ticket out of the middle class. unfortunately this is not a hypothetical. earlier today a group of us had a press conference where a young

woman from my state came forward. she'd had not only her child have enormous medical condition, her husband was then diagnosed with lymphoma. she was diagnosed with brain cancer. without the protections of the a.c.a., she testified that she would not be able to afford health care coverage. the presiding officer: the senator's time has expired. mr. warner: mr. president, i ask unanimous consent for an additional three minutes. the presiding officer: is there objection? without objection. mr. warner: i'll speed this up, mr. president. let me just also point out. recently one of my constituents, a man named jesse, who received $230,000 medical bill for his back surgery. unbeknownst to him, he purchased one of these so-called short-term junk plans only to discover that he now fell into the category of having a preexisting condition and this plan didn't cover it.

his challenge. jesse is one of the more than three million virginians with preexisting conditions. nationwide, more than 130 million americans have preexisting medical conditions being like diabetes, asthma, or cancer. before the affordable care act, an insurance company had every right to deny these individuals coverage, charge them unaffordable premiums, or terminate their plans. we cannot go back to those days. unfortunately, this administration has used every tool at its disposal to destabilize the market in hopes that it will come crashing down, so they can finally repeal the a.c.a. the rule we're talking about here today is a perfect example, among many others, that this administration has -- they've defunded cost-sharing payments, reduced premiums in the marketplace, cut the budget for outreach navigators. all folks who've helped americans find a plan that works best for them. or look at the recent case, texas v. the united states lawsuit, decided this very week

that could overall strike down the health insurance system as we know it, with no replacement plan in place. the truth is, these protections for people with preexisting conditions, if they're going to survive, we have to have a stable insurance market. now we can and should have legitimate debates about 1332 waivers. certain states have used those in a very productive way. but that's not what we're talking about today. the trump administration's rule is not a good-faith effort to bring down costs or drive innovation. it is a direct effort to undermine the stability of the insurance market and it is an tac on the viability of protections of americans with preexisting conditions. i again know we're going to vote on this c.r.a. action very shortly. i urge my republican colleagues to support it so folks with preexisting conditions can go about their daily lives knowing that they'll be protected. thank you, mr. president. i appreciate the courtesy of my colleagues giving me those extra couple minutes.

with that, mr. president, i yield the floor. the presiding officer: the senator from tennessee. mr. alexander: i ask consent for two minutes. the presiding officer: without objection. mr. alexander: thank you, mr. president. mr. president, i know that it's halloween and that it's time for trick or treat, but i would urge my colleagues not to be tricked by this scary fairytail dreamed up by the democrats that would suggest that is the section 1332 waiver to give states more flexibility, which they wrote, somehow jeopardizes preexisting health care protection, which they also wrote. both are in the 2010 obamacare law. preexisting health conditions are protected. the law says so. the law does not allow any 1332 waiver, which is what we're voting on in a few minutes, to change that. 12 states have had their 1332 waivers approved by the trump

administration and in no case did it affect preexisting conditions. seema verma, who has to approve all of these waiver applications from the department of health and human services, says the law doesn't permit any change in preexisting condition protection, and if somehow a waiver asks for it, she would not approve it. so what my democratic friends are voting for today is to take away a tool from states that has been used to reduce rates by 43% in maryland, 20% in minnesota, 15% in new jersey, it's been used in hawaii, wisconsin, colorado, minnesota, delaware, rhode island, alaska, and north dakota. why would you take away a flexibility option that you wrote to give your own voters lower health care rates? so i know it's halloween, but don't be tricked. don't believe this scary fairy

tale. protection for preexisting protections when you buy health insurance is the law. nothing in the 1332 waiver changes that. i urge my colleagues to vote no. the presiding officer: time has expired. the clerk will read the resolution for the third time. the clerk: calendar number 278, s.j. res. ttackers providing for congressional disapproval under chapter 8 of title 5 and so forth. the presiding officer: question is on passage of the joint resolution. is there a sufficient second? there appears to be. the clerk will call the roll. vote:

vote:

vote:

the presiding officer: are there any senators in the chamber wishing to vote or change their vote? if not, the yeas are 43, the nays are 52. the joint resolution fails on passage. the clerk will report the motion

to invoke cloture. the clerk: cloture motion. we, the undersigned senators, in accordance with the provisions of rule 22 of the standing rules of the senate, do hereby move to bring to a close debate on amendment numbered 948 to h.r. 3055, an act making appropriations for the departments of commerce and justice, science, and related agencies for the fiscal year ending september 30, 2020, and for other purposes, signed by 17 senators. the presiding officer: by unanimous consent, the mandatory quorum call has been waived. the question is, is it the sense of the senate that debate on amendment numbered 948 offered by the senator from alabama, mrt making appropriations for the departments of commerce and justice, science and related agencies for the fiscal year ending september 30, 2020, and for other purposes shall be brought to a close. the yeas and nays are mandatory under the rule. the clerk will call the roll. vote:

vote:

vote:

vote:

the presiding officer: on this vote there are 88 yeas. the nays are 5. three-piff ts of the senators duly chosen and sworn having voted in the affirmative, the motion is agreed to. the clerk will report the bill. the clerk: calendar number 141, h.r. 3055, an act making appropriations for the departments of commerce and justice, science and related agencies and so forth and for other purposes. mr. cornyn: mr. president? the presiding officer: the senator from texas. mr. cornyn: mr. president, i have seven requests for committees to meet during today's session of the senate. they've been approved by both the majority and minority leaders. the presiding officer: duly noted. mr. cornyn: mr. president, the 116th congress so far has been full of a number of dubious measures, i might characterize

them, by our friends across the aisle as it relates to our health care system. for starters, our democratic colleagues in the senate and the house and on the presidential campaign trail are hailing medicare for all as the gold standard for health care in america. i was here during the debates over the affordable care act, and i remember president obama saying if you like your policy, you can keep it. if you like your doctor, you can keep your doctor. well, neither one of those proved to be correct and true, but here our democratic colleagues have simply given up all pretense and have embraced a medicare for all program that would outlaw some 180 million americans' private health insurance policies. in other words, the policy you get through your employer as part of the fringe benefits of

your employment would no longer be available under medicare for all. this is, of course, socialize medicine which ensures long waits for substandard care. yes, it is true i have heard some say well, it's medicare for all who want it. others say no, no, no, i'm for the public option. all of these are a slippery slope into a singl single-payerh care system that will deny consumers the choice that they might prefer to make for themselves rather than to leave the government to make those choices for them. but not only would this trigger a lot of disruption, it would also lead so sharp increases in taxes to fund this roughly $30 trillion pipe dream. last month speaker pelosi managed to take this debate on health care to the next level.

it seems like controlling people's health care alone isn't enough. now they want to run the drug industry, too. forget about choice. forget about competition. forget about innovation. one of the things that is characterized -- has characterized the american health care system is innovation, life-saving innovative drugs. democrats now want to have the federal government determine what the formulary is, what drugs are available to you. they want to set the prices and ensure that bureaucrats rather than families are at the center of our health care system. churning out partisan health care bills one after another, taking their party further and further to the left with every move. i'd like to think that ultimately cooler heads will prevail here in the senate where we've been working on bipartisan bills to bring down health care costs. for example, the senate

judiciary, finance and help committees have each passed bipartisan packages of bills to end surprise billing, to create more transparency when it comes to pharmaceuticals and increased competition. but that doesn't mean that this side of the capitol is immune from some of the politics when it comes to our health care system. rather than following the speaker's lead in introducing partisan bills, the democratic leader in the senate has taken a different tact. and that is blocking bipartisan consensus bills. for example, there's a bill i introduced earlier this year with our colleague from connecticut senator blumenthal to bring down skyrocketing drug prices. now, senator blumenthal is a democrat and i'm a republican. but contrary to what you may see in the media, that doesn't mean that we can't talk to each other or work together in the best interest of our constituents. because senator blumenthal and i

both sit on the judiciary committee, we've been looking at price hikes caused by people gaming the patent system. specifically something called patent thicketting. some drug makers build a web of patents so intricate that it's virtually impossible for competition to come to market, even when the pa patent on the underlying drug has expired or will expire soon. they use these so-called patent thickets to hold competitors at bay and keep prices high for as long as possible. this is something that senator blumenthal and i are trying to stop through our bill, the affordable prescriptions for patients act. this legislation would disarm those patent thickets and drea dreamline litigation by limiting the number of patents companies can use so competition can come to market sooner. this legislation passed the senate judiciary committee in june without a single member on

either side of the aisle voting against it. it was unanimous, something that doesn't happen all that often in the judiciary committee. in the past something with this level of support would have quickly sailed through the full senate, but not today, not on the minority leader's watch. according to a report in "politico," the minority leader is blocking this bipartisan bi bill. with house democrats obsessed with impeaching the president and apparently interested in accomplishing nothing else, the odds of bipartisan legislation getting done around here is getting slimmer and slimmer each day. rather than seizing the opportunity to pass a bill that will provide relief to the folks we represent who are struggling with the high cost of prescriptions, it's politics 24/7. well, i'm disappointed in our

colleagues' single-minded obsession with undoing the 2016 election and removing the president from office. but one of the casualties of that is to prevent us from being able to pass even bipartisan bills to help the american people, the people we represent. so i'd like to ask here publicly today for the minority leader to reconsider his decision to block this bipartisan piece of legislation. but i'm afraid the vote that our democratic colleagues have just forced us to take this afternoon showed just how far they're willing to go to prove a point, even when the point is not well made leaving me with little optimism that the minority leader will have a change of heart. as we've heard the affordable care act has what's known as state innovation waivers. that's part of what we voted on just a moment ago. but it's important to reiterate that these innovation waivers which were a part of the affordable care act enables states to waive some of the

law's burdensome requirements in pursuit of alternative means of coverage. states can apply for these waivers to change how insurance subsidies are used, for example, and select a combination that better fits their states and their citizens' needs. what works in a state as big as mine with 28 million citizens isn't maybe going to work the same way as a smaller state, north dakota or delaware. and washington bureaucrats shouldn't be able to be the ones that decide what my constituents in texas, what sites their needs best. that's why these waivers part of the affordable care act are so important and why last year the administration gave states more flexibility to tailor their insurance plans to suit their constituents' needs. but this does not mean as we've heard that the states have an entirely free hand. it just gives them more flexibility to use federal

dollars where they're needed most. but unfortunately our democratic colleagues are opposed to these expanded innovation options. they claim they forced this vote to repeal the rule because it puts patients' coverage for preexisting conditions at risk. but that's not true. section 1332 does not allow states to waive obamacare's preexisting conditions coverage. in fact, these waivers give states the ability to provide enhanced support for those with preexisting conditions and high health care costs. and so so far 13 states have ben approved for these waivers. it's worth noting on this chart that of the 1332 waivers that have been issued this year, colorado has seen a reduction in premiums by 16%, delaware about 13%, montana by 8%, north dakota a whopping 20% reduction in premiums, and rhode island 6%.

so with preexisting conditions covered and with premiums actually going down, what is there to object to? well, our democratic colleagues are simply waging a war against a problem that does not exist. but i guess if you say it often enough and loudly enough, some people somewhere may just believe that coverage of preexisting conditions is somehow a partisan issue. it's not. they're grasping at straws as their part has unfortunately gone further and further to the left on health care. well, ten of the 13 states that have received waivers are represented by at least one democrat in the senate. why would you vote for a repeal after rule consistent with existing law that would lower premiums for your constituents which requires coverage for preexisting conditions?

unless it's -- your good sense is overcome by, perhaps, politics? our democratic friends make it seem like coverage of preexisting conditions is a partisan issue when it's not. we all agree that patients with preexisting conditions should receive health coverage, period. earlier in year, i cosponsored a bill introduced by our friend from north carolina, senator tillis, called the protect act, which would reaffirm our commitment that no american will ever be denied health coverage due to a preexisting condition. we believe that coverage for preexisting conditions shouldn't hang in the balance of a court decision, and it would finally codify what every member of this body says they agree with -- that all americans deserve access to health coverage, specifically to cover preexisting conditions.

all this rule by the trump administration does is provide states with the flexibility to cater to their citizens' health care needs, and there simile was no reason to overturn it, and we did not. so i would encourage our colleagues to stop daydreaming about pie-in-the-sky ideas like medicare for all -- simply unaffordable, absolutely unworkable -- or a government-run pharmaceutical industry where government sets the prices and says what drugs you or your family can get access to. quit trying to fight the president at every turn and every step he wants to make. try to find places where we can work together. and let's do that by moving bipartisan legislation that will lower out-of-pocket costs for drugs and improve people's quality of life and standard of living. mr. president, i yield the floor.

the presiding officer: the democratic whip. mr. durbin: thank you, mr. president. i listened carefully to the senator from texas, who is my friend and colleague, and we work together, and i want to continue to. there are three things that he failed to mention that i think should be a matter of record. it was a year ago -- maybe even longer -- that the attorney general from his state of texas initiated a lawsuit with more than a dozen other republican attorneys general to eliminate the affordable care act -- all of it, the protection when it came to preexisting conditions, lifetime limits, allowing members of the family to keep their children on their policy until they reach the age of 26. these states attorney general, starting with his state of texas, said get rid of all of this, eliminate it. and then president trump said, we'll join in that lawsuit. let's eliminate it completely. so when i hear threes pleas on the floor that we're all for the affordable care act, not a single republican senator voted

for it and now there is an effort supported by the trump administration to do away with it. is it because they have a better idea? no. if you'll remember, not that long ago when our departed colleague john mccain came to the senate and was the deciding vote to save the affordable care act much the point he made is still valid. the republicans have no alternative. i want to make sure the affordable care act is better. there's some parts of it that need to be improved, but to eliminate it, as this lawsuit would the from the trump administration? that's a step backwards. two other parts that -- points that i'd like to make. when this comes to our current health care system, it has many positive things. some wonderful doctors and hospitals, some amazing technology and medicine. but there are also some built-in flaws in this system. let me give you an example. one simple story -- i met a woman the other day. her sister is an ob-gyn. got married, pregnant, about to have twins, couldn't be happier,

but the babies came early, and so this doctor went to the hospital to deliver her babies, her twins, and they needed to be put in the neonatal intensive care unit of the hospital, which of course she did. good news -- three or four weeks later they're ready to come home. they came home and of course everyone was happy to receive them. but they weren't happy to receive in the mail a few weeks later a bill for hundreds of thousands of dollars. whaps what was it for? it turns out that at the hospital, the doctor was in network for the woman who was delivering the baby. the hospital was in the network for delivering the baby. but the nicu was a separate entity that even this doctor didn't know it wasn't in network. her babies went to this lifesaving intensive care unit in the hospital, and she received a bill for hundreds of thousands of dollars, a surprise

bill. is that right? of course it's not. and here is a professional, a medical professional, who frankly could not ask all the right questions obviously and became a victim of the system. let me tell you one other story. when we talk about the current state of the cost of medicine, i go to rockford, illinois. i meet a young woman and she introduces me to her mother. her mother is a waitress, hardworking lady, never took a day off in her life. but she did have some health insurance and her health insurance covered her daughter until she reached the i am an of 26. then her daughter was on her own. the problem is her daughter is diabetic. and the mother understood that now the cost of insulin, which had been covered by the family health insurance, was an individual, personal burden for her daughter to bear. and the cost of insulin had gone up dramatically during the girl's young life. in the last dozen years or so, the cost of insulin has gone

from $39 for a vial of one of the most commonly used forms of insulin called human a -- humalog. the mother was in a panic. her daughter was working part-time, just getting started, still suffering from diabetes. her mother was frayed that she wouldn't be able to afford the insulin. the mother was putting aside money to buy vials of insulin so if her daughter ever started to run short, she would be able to provide her with the insulin she needed. what's the cost of that same product in canada? $39. $329 in the united states, $39 in canada. what's the difference? it's the same drug. made by the same company in the united states. the difference is the government of canada stepped up and said, we're not going to let you do this. we're not going to let you run the cost of insulin to the high heavens at the expense of people who live in canada.

and eli lilly said we'll play by your rules if that's what the canadian government insists on. so when i hear my friends like the senator from texas get up and talk about the invasion of government into our rights, this mother in rockford would certainly like to have her government, our government, step you and give her a chance to have affordable insulin so she could have peace of mind for her -- for her daughter. it is not too much to ask. mr. president, the reason i came to the floor was to discuss an issue that is truly american. for 528 years now in this place called america, we have had immigrants coming to the shores of our nation, starting with the fellow named christopher columbus, if you buy that side of the story -- and i do -- we've had millions come to our shores and they have become part of america, with the exception of native americans and

indigenous people, they come from every corner of this earth to be part of the united states. you would think with that history that we would have a pretty clear idea of what our policy should be when it comes to immigration. sadly, you're wrong. we have the most broken immigration system imaginable. i've studied it for years and continue to. it's almost impossible to understand all of the twists and turns in our immigration system. seven years ago, there were eight of us -- four democrats and four republicans in the senate, with the leadership of senator mccain and senator schumer, many others -- came together and rewrote the entire immigration code, the entire immigration body of law. it took us months of meeting every single night, hammering out compromises, agreeing to provisions. then we went to the judiciary committee and hundreds of amendments were offered. senator sessions of alabama, i think he offered 100 by himself. he wasn't too happy with the bill. but we went flew that length -- but we went through that lengthy

process. came to the floor of the senate. faced even more amendments. at the end of the day, it passed. we passed comprehensive immigration reform, sent it to the house of representatives, and unfortunately the republican leadership would not even consider it. didn't even bring it up for a debate or for an amendment. so we're stuck today with a broken system, and we're also stuck with a system that is rife with politics. i would say, and i think no one would contradict this, no president -- no president before donald trump -- has really made such an issue of immigration, no one. it's been an issue in the past, but this president from the beginning of his campaign until the current time has hammered away at immigration constantly, calling those who came from mexico murderers and rapists and so many other things that he's done. i could give you the long list, a litany of things that have happened. it's pretty clear that when it comes to the policy of immigration, this administration

is full of venom. it falls short when p it comes to -- when it comes to vision. today i want to address one particular aspect of this. i am the ranking democrat on the subcommittee, the chairman of that subcommittee in judiciary is senator cornyn, who just left the floor. so far this year, ten months into this year, our subcommittee on immigration, despite all of the problems, all of the challenge, has had one hearing -- one hearing. it's a good thing we're not paid for the work that we do because, frankly, we've done little or nothing. and the senate judiciary committee in the same period of time has only voted on one immigration bill. the republican majority limited debate to only one hour and didn't allow a single amendment to be offered. it's hardly an ambitious effort to make a body of law better. it's time for the immigration complete to get back to work. today i sent a letter joined by every democrat on the judiciary committee asking the republican chairman of the immigration subcommittee, the senator from texas, to hold a hearing on one

serious problem in our immigration system -- the green card backlog. in our broken immigration system, there are not nearly enough immigrant visas, legal visas, known as green cards, available each year. as a result, many of the immigrants to this country are stuck in crippling backlogs for years, sometimes decades. close to five million future americans are in line waiting for green cards. many are living around working in the united states on temporary visas, while many are waiting abroad separating from the families that are living in the united states. however, under current law, only 2026,000 -- 226 family green cards and 140,000 employment green cards are available each year. children and spouses of lawful permanent residents count against these caps, which further limits the availability of green cards. the backlogs are really hard on families who are caught in immigration limbo. for example, children in many of

these families age out because they're no longer under the age of 21 by the time the green cards are available. that's why i've asked senator cornyn to hold a hearing on this issue to consider several pending bills dealing with this green card backlog. i've asked him repeatedly. i've asked senator graham, and i've asked senator lee, who is also engaged in this debate. this will help the senate to understand the impact of each of these proposals before us and to try to reach an agreement. that's how the senate incidentally is supposed to work, where the committees gather, have witnesses, debate, open it to debate on the floor. the fact that we've had only 14, 15, 16 amendments this whole year is an indication of a broken senate and a broken system. in 2013, as i mentioned, i was part of a bipartisan group that showed this can work. we need to show it again. our bill went through -- then our bill went through extensive hearings and debate.

unfortunately, the senior senator from utah, my friend, senator lee, has tried to avoid regular order on this question. he doesn't want it to go to committee. i hope he'll reconsider. he's come to the floor several times to attempt to pass his legislation, s. 386, without any debate or chance to offer amendments. because he's chosen this approach, i've come to the floor today to speak about his legislation and mine. my concern with senator lee's bill is simple. the solution to the green card backlog is obvious. increase the number of green cards. but s. 386, senator lee's bill, includes no additional green cards. in fact, it has carve-outs for special interests which are not in the original version of the bill passed by the house, and that will cut the actual number of green cards that are available to reduce the backlog. without any additional green cards, s. 386 will not eliminate backlogs for the immigrants particularly those from india, and there is a large number,

over half a million. the nationality with the most people in the employment backlog, and it is dramatically increase backlogs for the rest of the world, if we go by senator lee's bill. one of the nation's exerts on immigration law took a look at senator lee's bill and said the backlogs will be be are longer and larger because of it. in fact, over 165,000 indian immigrants currently in line for these visas will still be waiting ten years from now. he has also made it clear that the lee bill puts some indian immigrants at the front of the line at the expense of every other country. from 2023 until 2030 there will be zero eb-2 visas for the rest of the world according to him. none for china, south korea, philippines, britain, canada, mexico, every country in europe, and all of africa. none under the lee bill. it would choke off green cards

for every profession that isn't in the information technology field. that will include eliminating green card opportunities for those in health care, for those in medical research, those in basic science, those in engineering, chemists and physicists. that's why dozens of national organizations oppose the bill introduced by senator lee. groups representing arabs, africans, can canadian canadiand many more have come out in opposition to the lee bill. more than 20 of these groups sent a letter in opposition. in light of this attempt to pass the lee bill and the problems it's run into, i'm offering an alternative to this legislation. my alternative is basic and straightforward. it would eliminate the green card backlog and treat all immigrants fairly. the relief act which i introduced with senator pat leahy and senator macy --

senator hirono will treat all fairly. the relief bill is based on the same comprehensive immigration bill i described earlier. it would lift green card country caps, but unlike s. 386, the relief act would increase the number of dpreen cards to clear the backlogs for all immigrants waiting in line for green cards within five years. compare that to s. 386, the lee bill, where more than 165,000 indian immigrants currently in line will still be waiting ten years from now. the relief act will also keep american families together by treating children and spouses of legal permanent residents as immediate relatives as the children of spouses and citizens are so they won't count against the green card gap. my bill would let aging out children qualify based on a parent's immigration status. mr. president, i ask unanimous consent the judiciary committee

be discharged of s. 2603, the relief act, and the senate proceed to its immediate consideration. further, the bill be considered read a third time and passed and the motion to reconsider be considered made and laid upon the table with no intervening action or debate. the presiding officer: is there objection? the majority whip. mr. thune: mr. president, the legislation to which the senator from illinois has referred, senator lee's bill, he is not able to be here to object. so on his behalf, i object. the presiding officer: objection is heard. mr. durbin: mr. president. the presiding officer: the minority leader. mr. durbin: i'm sorry for this objection and i thank the senator from south dakota for coming to the floor on behalf of the senator from utah. i've been in communication with the senator from utah. i hope he'll join me in asking for a hearing. this is an issue which literally affects hundreds of thousands of people living in this country, many of whom have been here for

years and decades. practicing physicians in my hometown of springfield are affected by this debate. they want to know what their future will be and the future of their children. i'm trying to find a reasonable way to work out a compromise on this, and i stand ready to do so. i hope senator lee will join me in asking senators graham and cornyn to have a hearing before the judiciary committee. i want to extend this invasion to senator lee to join senate judiciary committee democrats who have signed a letter with me today requesting this hearing. i'm happy to sit down and discuss this issue with the senior senator from utah or any other senator. if we work together in good faith, i believe we can reach an agreement, a bipartisan agreement on legislation that can pass both chambers and be signed into law. mr. president, i yield the floor. i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

the presiding officer: the senator from iowa. ms. ernst: mr. president, are we in a quorum call? the presiding officer: we are. ms. ernst: mr. president, i ask that we vitiate the quorum call. the presiding officer: without objection. ms. ernst: mr. president, just over a year ago president trump signed into law the most comprehensive and sweeping opioid response package in the nation's history. a piece of legislation which passed this body with overwhelming bipartisan support support, a rarity in gridlocked washington. the reason we came together was simple. opioid abuse is tearing apart families, straining our law enforcement and emergency services, and engulfing our communities. young mothers with precious

babies, young people at the prime of their lives focused on fentanyl rather than finding their path towards success. this crippling epidemic has touched the lives of iowans from all walks of life and from all areas of our state. we've seen the harrowing statistics and the ongoing struggles that many of our loved ones face. in iowa, we also struggle with an ongoing meth epidemic that further threatens our communities. in just one of many statistics, the number of children put into foster care in the united states due to parental drug use nearly doubled from 2000 to 2017. i've heard so many heartbreaking

stories from families who have a loved one battling addiction. a mom from polk shared with me her son's seven-year battle with addiction and how the vicious disease affects all levels of society, including our friends, our neighbors, and in her case, her family. she concluded by pleading with congress to act to end, in her words, this horrific situation and serious threat to our nation's future. families like this are desperate for their loved ones to reach recovery and good health before their story ends in tragedy. as is sometimes quoted, addiction is a family disease.

one person may use, but the whole family suffers. and it's these heartbreaking stories that propelled me and my colleagues to take action. this bipartisan package named the support act, it expanded treatment and recovery options for opioid addiction, created new tools for prevention and enforcement, supported safe disposal of opioids, strengthened first responders' training, and provided for the safe disposal of unused drugs. it has produced real results for iowans and for folks all across the country. just last week i had the chance to join the first lady of the united states, melania trump; secretary of health and human services and a number of other

administration officials to discuss the progress made on opioid abuse including the efforts to reduce the number of women using opioids during pregnancy. folks, this president and this republican-led senate are tackling the opioid crisis in a meaningful and thoughtful way, and i couldn't be prouder to be associated with this work. in iowa alone, for instance, we've seen the number of deaths from opioids decrease by 19%. and in september, the administration announced $932 million in awards for state opioid response grant funding, including over $11 million for iowa. and this past saturday, iowans from across the state participated in another national

take back day to raise awareness and encourage safe disposal of unused prescription drugs. earlier this year, in april, when we had another take-back day, in my home state of iowa, 88 law enforcement officers worked out 135 collection sites throughout the state and collected 11,680 pounds of unused prescription drugs. more than 135,255 pounds of unused drugs have been collected in iowa since the beginning of the drug take-back program. and i'm humbled to say that my bipartisan access to increase drug disposal act which was part of the sweeping package we passed last year led directly to resources being awarded in iowa

for events like these. folks, we should be encouraged by the impact the support act combined with the trump administration's efforts have made in the lives of iowans in just one year. as we continue in our fight, i feel hopeful and i feel determined, hopeful that we can help americans rise above the chains of addiction, and determined all the more to keep making progress on behalf of families across this country. thank you, mr. president, and i will yield the floor. a senator: mr. president. the presiding officer: the senator from ohio. mr. portman: i'd like to thank my colleague from iowa for her comments and also for her organizing this event this afternoon. this is an opportunity for us to talk about some of the things we have done here in the united states congress that are positive in terms of addressing the largest drug crisis we have

ever faced in our country. but also what we need to do going forward and how we need to keep our eye on the ball to be sure that we don't see more addiction coming, we don't see some of these new dangers like crystal meth and other drugs coming up. again, i thank my colleague from iowa. iowa has been hard hit. so has ohio. in fact, in 2017, our opioid overdose rate was about three times the national average. we have unfortunately been in the top five in terms of overdose deaths most of the last ten years. we have had nearly a dozen ohioans dying from these dangerous drugs every single day. this has now surpassed car accidents as the number one cause of death in my home state of ohio. but what's happened is that since 2017, with a lot of work from a lot of people on the ground, with some help from washington, about $4 billion in new funding, that this body has approved and taken the lead on, with some help since 2017, we have begun to make progress. last year in 2018, ohio had a

22% reduction in overdose deaths. this leads the country in reductions and we're proud of that because of the lives that have been saved, but we also realize that we came from such a high mark, high water mark that it's important for us to keep the pressure on to continue to make progress. what's happened in ohio is what's happening around the country, which is the support act which was signed into law by the president just about one year ago and other legislation like the comprehensive addiction recovery act legislation, also the state opioid response grants have started to work. i see the senator from missouri is on the floor here today. what they have done in the appropriations committee to fund these projects is making a huge difference back home. i spend a lot of my time working with the community organizations, talking to addicts and recovering addicts. i have talked to a couple thousand just in the last couple of years alone. i will tell you it's working.

what's working is more innovative programs back home to close some of these gaps. recently, i had the opportunity to go out with the react team in columbus, ohio. they are being funded with about an $800,000 grant from the comprehensive addiction and recovery affordable care act, the cara legislation. this has been funded by the appropriations committee above its authorized level because it's working. they are closing an obvious gap which is that people were overdosing, getting narcan, the first responders were saving their lives and then those people were going back to the community where they were from, back to the same family or group of friends and unfortunately the addiction not having been addressed were overdosing again and sometimes again and again and again. often these first responders will tell you -- these are your firefighters back home, ask thee person time and time again. some of that is still happening. but what the react team does is when there is an overdose and when this narcan is applied, this miracle drug to reduce the effects of the overdose, then there is follow-up.

of course, we should have done it years ago, but we're now doing it. i'm proud to say in my hometown of cincinnati, ohio, much of this was started, but now it's spreading around the country, and the columbus react team is one of the best. they go out with firefighters, e.m.s. personnel, with law enforcement, plain clothes, with social workers, with treatment providers to the family, to the home. and i have gone out with them. i have gone to these homes and i have met with these addicts. they say look, we are here to help. we're not here to arrest you. but we're here to say you need to get into treatment. and unbelievably, because a lot of people are skeptical of this, here is an addict, why would they come forward? in about 80% of the cases in terms of the react team, these individuals say you know what? okay, i'll try it. that's the first step. and that's the critical first step to get into treatment and then longer term recovery, begin to turn that person's life around and that person's family and that person's community because it has devastated all the above. so this is what's happening with the federal legislation funding

innovative projects back home, again to close these gaps and to make a difference. so i am very appreciative of what our team has done here. republicans and democrats alike. in the more recent legislation that was just passed, the support act, we also included something that focuses exclusively on fentanyl. this is really important. it's called the stop act. in my subcommittee, we did an 18-month investigation of this. we spent a lot of time on it. we worked hard to make it bipartisan but also to be sure it was something that would actually work. we found out that fentanyl, which is the worst of the drugs, it's the most dangerous. it's killing more people than any other drug, even today with our success on opioids, this synthetic opioid coming almost exclusively from china, and at the time when we passed the legislation a couple of years ago almost exclusively coming through our u.s. mail system. our u.s. mail system. this deadly drug was coming in to post office boxes and people's homes. what we said to the post office is you have got to put some

screening in place, much like fedex does or d.h.s. or d.h.l. or other private sector entities. and guess what? they are starting to do that, and it's making a big difference. they are now requiring advanced electronic data from these packages showing where it's from, where it's going, what's in it. this allows law enforcement to target those packages and to be able to stop some of this fentanyl coming in. unfortunately, the post office hasn't been doing all they should do. under the legislation, they are supposed to have 100% of packages from china, as an example, being flagged, being screened, and they're not. right now, we think that they are identifying from china about 88% of the packages. it's not 100% yet. let's get to 100%. we also find that the post office, based on a 2019 audit this year by the inspector general, that the posing service identified and pulled about 88% of the packages from china that were flagged, and that leaves, of course, many packages that are not being flagged.

so over 10% of these packages, the post office can't even find. so let's do better, and we can do better. it's critical that we continue to hold the post office accountable because this is the poison coming into our communities. that's in this legislation. one kill i gram of this fentanyl is powerful enough to kill about half a million people. that's how powerful it is and how this is a true life or death issue. we have introduced the fight fentanyl act just in the last week. why? because otherwise fentanyl, which is currently listed as a substance on schedule 1, a schedule 1 drug and therefore illegal, is going to come off that list in february of next year. we can't let that happen. let's put fentanyl on as a scheduled drug permanently. i see more of my colleagues have come to talk about this issue. it i guess is very simple. we have done some great things here in this body to be able to help our governments back home at our state and local level and the nonprofits and the people in the trenches who are doing the

hard work. let's keep it up, let's be a better partner. let's continue to provide support through the comprehensive addiction recovery act, through the opioid grant, through the stop act, through other things to be able to give folks back home the tools they need to push back against this scourge, this addiction that is devastating our families, our communities. now we see with the opioid progress having been made other drugs coming in, particularly crystal meth coming in directly from mexico. it's not just about this. it's about being flexible enough to be able to approach that as well. we have new legislation on meth that we should also be working on to provide that flexibility. in the meantime, again, the appropriations committee is doing its work, sending the funding that's making a difference to save lives in our communities. i yield back my time. mr. blunt: mr. president. the presiding officer: the senator from missouri. mr. blunt: i want to thank senator portman for his comments and what we have done to try to provide the money. being involved in that part of

it before we pass the legislation, nobody more vigorously active than senator portman to try to continue to point out the size of this problem and that something had to be done, and he was out there talking about how big a problem this was for the country before other people were. senator ernst bringing this group together today to talk about this critical issue as we figure out better ways to deal with this terrible scourge of addiction and activity that preys on people who have become addicted. more than 47,000 lives were lost due to opioids in the united states in 2017. 47,000 people. more people died of opioid overdose than died in car accidents. the number one cause of accidental death changed dramatically in the last handful of years, and for everybody who has died, there were hundreds of others who were risking their

lives by misusing prescription drugs or illegal drugs or even worse, illegal drugs that they had no idea what was in them. that fentanyl challenge is so big, so dangerous. it seems to me to be a pretty poor business model to try to have a drug so powerful, a product so powerful that there is a good chance that the person you're selling it to will never be a customer again because they're going to die by taking this drug, trying to get, even often knowing it's this incredibly dangerous moment, but trying to get on a drug-induced high that defies anything that's happened to them before. of course, once you cross that line, there is no other line to cross because you are no longer a customer, your life is gone. your dependency on these drugs, no matter how it began, whether it was a high school cheerleading accident or a car accident or a running accident

or a dental appointment. all kinds of ways in the past decades where people who believe that prescribing these opioids had no danger of addiction, and boy did we find out that was wrong. 3.4% of our entire gross domestic product, almost $700 billion was impacted and lost by the ongoing opioid crisis in 2018. every state has a problem. our state, missouri, has a problem. we have seen this steady increase in the synthetic opioid use over the last several years. this seemed to be moving from east to west, and i was hoping by the time it got to us we would have more information, more thinking about it. i think that actually may have

happened, but still bad. we had a 40% increase in fentanyl-related overdoses from 2016 to 2017. secretary azar from health and human services and i were in kansas city together at the truman medical center to talk about this epidemic. truman medical, our number one provider of uncompensated care in our state. we went to the neonatal area, the neonatal abstinence syndrome that is affecting a number of newborns now to look at how they were dealing with newborns who were born addicted. truman doctors and leaders there as well as leaders in other area health centers in kansas city came and talked to us about how they were dealing with this, and also even in the context of one urban area, that there is not

necessarily a one-size-fits-all way to deal with this, which is why we have tried to focus our money at the federal level on giving states the maximum flexibility they could have to within their state and in their state to come up with what worked in the communities that they were trying to work with. we provided the money. we haven't found every solution yet, but we are on the way i think to doing that. we have included flexibility for the states to use in funding for treatment, funding for prevention, funding for recovery of opioids and other stimulants. in missouri, federal funding in the last year had treated 4,000 people that couldn't have been treated otherwise. narcan, more and more available on -- at workplaces and other

places, but there is just simply more work to do. we need to continue our focus on targeting resources toward opioid addiction but also toward behavioral health issues. i've said a number of times as we have dealt with this, if you don't have a behavioral health problem before you're addicted, you absolutely have one after you're addicted. and, mr. president, one of the things we have found is a big advantage in our state -- we had the good fortune to be part of this eight-state pilot where in a number of locations in our state under excellence in mental health, we're treating behavioral health, mental health like you treat any other health problem, and that means you treat it as long as it needs to be treated. no 14-day limit or 28-day limit. you can be treated just like you would for a kidney problem or another cancer problem or any other problem as long as you need that there, and we're finding great success in

combining not only the medicated assisted therapy with getting off opioids, but also the ability to have that mental health component as long as it needs to be there. and we're hoping to continue to work on the facts that are put together and what happens when you treat behavioral health like the other health care costs that people have. we're hoping to extend that pilot another two years, not to make it a permanent federal responsibility, but to be sure that states and communities in the future will have the level of evidence they need to look at, that there will be enough evidence compiled to show what really happens. everybody understands treating mental health like all other health is the right thing to do. i think these pilot projects are compiling the evidence to show you it is not only the right thing to do but it is the financially responsible thing to do as well. so attacking this problem from

all levels is critical. we're way beyond where we were five years ago. we're not where we need to be yet. states are trying things and sharing things that work and sharing things that don't work and why they didn't work in the communities that tried them. so we're going to continue to move forward with this. i know senator capito is going to speak after me, also one of the early advocates doing something that she saw significant problems develop in her state, and i was grateful to have her advice and her driving this discussion in the way that she did. and, mr. president, i yield the floor. mrs. capito: mr. president. the presiding officer: the senator from west virginia. mrs. capito: thank you, mr. president. and it is very, i think,

impactful for us to be discussing today a problem that hits all of our states. senator blunt, and his great work, not just in the appropriations committee, but for his state of missouri, has been very active. i think we all have. it's a problem that knows no political boundary. and certainly my state of west virginia has one of the deepest and strongest and toughest problems. we do have the highest rate of opioid-related deaths per capita. it's not something that we wear proudly, but it's something that has really forced us to try many innovative things, to try to be the leader in the solutions and that is what i will talk about today, because a lot of what we have seen in the support act from all of our individual states has been incorporated into a national response to what is an epidemic around our country that is frightening, scary, and in my view, could -- could almost lead us to losing a

generation, and this powerful reaction that we've had through the three pieces of legislation is absolutely critical. so we passed the support act. it was signed into law a little bit over a year ago, and that was really as an add on to the comprehensive addiction and recovery act that we passed several years before that. but i want to share today, as my part of this discussion, what the successes that have worked in our state and how i think they've been able to be incorporated around the -- around the country. we realized after kara, while we did great for money with rehab facilities and helping first responders with narcan and more immediate problems, there were other things that we didn't focus on that we needed to focus on to have a comprehensive solution. and that's the children. the children who are impacted in a home of addiction or exposure to addiction and also the jobs

that are being lost because of it. so we went back to the drawing board and came up with the support act, which is landmark legislation that we're seeing real results. for instance, the state of west virginia, the state opioid response grants go to every state in a formula fashion that -- where you are supporting treatment centers, drug courts and other responses to the addiction issue. but under the old rule, the money was divided up according to your population size. i started talking with senator shaheen, of new hampshire, small state impacted more than our state of west west and said that our small states are not getting enough in the opioid response grants to make an impact and be part of the solution. we pushed hard to change the funding so the states that are smaller, like montana, new hampshire, and west virginia, are able to get more funding so

we can attack the problem where it is the deepest and most acute. it helps with our w.v.u. comprehensive opioid addiction treatment, the code program, the model they put together at w.v.u. for medicated assisted treatment and it has had a lot of impacts too on our children and our families. what we found too, like every state here, i'm sure, in the state of arkansas, you probably have more kids in foster care than you have in the past because of this issue. and according to the west virginia bureau of children and families, approximately 82% of the children who are in foster care are there because of parents with substance abuse-related issues. 82% of our children and thousands more in foster care, it is directly attributable to this issue. it doesn't even mention all of the grandparents and great

grandparents in some cases that are raising children. how do we tackle the ripple effects of this issue? you create something that was created in west virginia called the mart innsburg -- martinsburg initiative. it is close to d.c. the berkeley county schools. it is a partnership with the boys and girls club of the eastern panhandle. and this is based on a c.d.c. study that shows that when children have adverse childhood experiences, it's called aces, if you can categorize children that have had adverse childhood experiences, if you can identify those children and pay special attention to them through things like the martinsburg initiative, you can maybe head off the issues that come into their future. so police officers come to the schools. they meet the children at the

boys and girls group. they talk about the positive influence that a police officer combined with the school and combined with a college student can have on a young person's life, and in some cases the most trusting person in their life if it's a home filled with drug addiction and opioid addiction. we saw the success of this and i joined with senator durbin, on the other side of the aisle, to show that it created some of this. we are addressing these issues in the rise from trauma act which would help us to build the trauma-informed workforce, we don't have enough people working in this area and increase those resources in our communities. senator blunt talked about how important it is to work with babies who are born with exposure to drugs. this is -- this is also a solution that's come from a -- a part of the solution that has come from west virginia where you're taking out of the --

taken out of the hospital setting to address the issues of the trauma in the first days of your life to wean you off of the exposure of drugs and to also incorporate the family into this so you can see what kind of pediatric recovery is needed and what the long-term effects might be. you know, senator portman has been an incredible leader in the area of working with trying to get the fentanyl that comes in that's killing over half the people that die die of a fentanyl overdose, trying to get china to work with china and to work with the post office to try to get the tools to prevent illegal fentanyl from entering the country. we had some success, but it's frustrating. it's still getting in. i sub chair the appropriations, it is important for our border

patrol to get it. we passed the interdict act which the president signed which will help the c.v.p. and the post office to detect fentanyl, it comes in little packages because it is so lethal. lots of what we've done is federal funding, but a lot of what we've done is listen to what our local communities are doing, listen to how you're solving the problems in states that are highly affected. one of our communities of huntington has really been a leader in this. one of the most effective strategies that huntington had and they had the highest overdose in our state, is to have the quick response teams. this is when a person comes into the emergency room with an overdose, they are then contacted within 72 hours, a quick response team from the community, a plain-clothes police officer or a social worker and in some cases a faith-based responsibility

enter -- respondent says, are you ready for recovery. when you are ready, this is where you come. we are your community. we want to help you. we understand where you are. we understand your issues and we're -- we're your neighbors and we want to help you. and this has had, really, a very good effect already in -- in the city of huntington in campbell county because the overdose rate in that area has gone down 26% since they instituted the quick response team concept. so it's going across the country and part of that is it is in the support act. so, you know, i have hope for what we've done in west virginia, but there are way too many people and families affected by this. too many lost lives, too much lost time and too much lost love, quite frankly. parents of children who can't sleep at night -- the only night they sleep is when they know their child is incarcerated because they don't know if they are going to wake up the next

morning. story after story of just tragedies. so we're all working together. i think we have a long way to go. i think we hit on good solutions many we need to keep the ones that are working and the once that don't work, send them on down the road. we know there's no one solution to this very difficult program. -- problem. i am going to continue to fight with my colleagues who are here today and all those whose lives are touched by this crisis. we're all touched by it. if i ask for a show of hands in a town meeting and i say, who knows somebody who has been touch by this crisis, it's almost unanimous, everybody raising that his hands. we're going to emerge stronger. i'm optimistic but this is a long fight. i'm pleased to join with so many of my colleagues in this fight. i think my -- i think my colleague from arkansas, who has worked on this as well, is up next. mr. boozman: mr. president. the presiding officer: the senator from arkansas.

mr. boozman: thank you, mr. president, and special thanks to senator capito and all of the things she has done not just in this area, but also in the rural area. she is the chair of the broadband caucus. we appreciate your leadership. our nation's opioid epidemic is unfortunately a subject we've spoken about all too often here and in so many other places. it does feel, however, that the tone and tenor of our remarks reflect a much more hopeful outlook that many of our previous discussions have had. that's because we are making progress in the fight. around this time last year we came together to overwhelmingly pass a comprehensive legislative package that was signed into law by president trump. democrats and republicans working together. there's been a noticeable difference as a result of this comprehensive reform. law enforcement is now better equipped to stop illegal opioids

from reaching our communities and efforts are being stepped up at the border to cut off the influx of fentanyl from china. more first responders have been trade to prevent opioid overdoses from claiming more lives in our communities. most importantly, we save lives by increasing access to mental health and addiction treatment services for those struggling -- struggling to overcome opioid depends. the treatment and recovery aspect of our strategy is key. federal resources are being deployed nationwide to break the cycle of addiction. these grants are invaluable for the facilities that give those struggling with addiction and their families new hope in the fight against opioid abuse. from what i've seen first hand at treatment facilities in arkansas, these efforts are, indeed, making a difference, helping tremendously.

the impact of this national epidemic has been felt acutely in the arkansas. according to the c.d.c. arkansas had the second most prescribing rate, enough for each arkansan to have an opioid prescription in his or her name. it has taken -- the community wants to drive those numbers down by 12% over a four-year period. limiting the amount of pain pills in circulation is a positive and much-needed step but what about all of the unused and unnecessary medications already in circulation? that's where arkansas take back comes in. arkansas prescription take back day. events happen twice a year at locations across the state. these events are an opportunity for arkansans to safely dispose of unused or expired medications

with no questions asked. they also serve as an opportunity to further educate the public on the opioid epidemic and the importance of proper disposal of medications. the 19th arkansas takeback this past weekend was another in a long line of successful events. according to arkansas drug director kirk lane, over 27,000 pounds of pills were collected at the nearly -- in the 200-plus permanent drop boxes across the state. these events are a heavy lift on the part of arkansans. we greatly appreciate the efforts of law enforcement, agencies across the state as well as their partners, roaltry clubs, -- rotary clubs, prevention resources, arkansas department of health and so many others to carry out takeback day events. the hard work to organize these

opportunities, to properly dispose of prescription medications is certainly worthwhile. researchers found that the majority of opioid abusers get their drugs from friends and family often lifting pills from a familiar medicine cabinet. when you tally up the results from the previous events in the state, arkansas ranks third nationally in pounds collected per capita through takeback. that means there are fewer homes in arkansas where unsecured medications can get in the wrong hands. i'd like to thank my colleagues for sharing similar stories, success stories from events in their states. it's important that we highlight these programs. anything we can do to get these dangerous drugs out of circulation certainly can help save lives. it's also a valuable reminder that we will all have a role to play in the fight to end the opioid crisis, prescription drug takeback is an easy way each one

of us can certainly do our part. and with that i yield the floor and appreciate the efforts of my good friend, senator hoeven, and again his leadership which is so very important in this effort. mr. hoeven: i'd like to thank the senator from arkansas for his work and also our other colleagues, both those who have already spoken, the good senator from montana who is going to speak right after me. this really has been an effort on a bipartisan basis to make a difference. and i appreciate all of my colleagues who are here today and who have done so much to advance this work. as well as the senator from kansas who i believe will be speaking here in just a minute. so, mr. president, i join my colleagues today to discuss our nation's effort to battle the opioid abuse epidemic. it's taken far too many lives and affecting communities both large and small.

our first responders, law enforcement officers, health care professionals and medical facilities are fighting this crisis on the front lines. that's why we worked to advance a comprehensive approach that assists these key players and empowers states and localities to combat this public health emergency. last year congress passed and the president signed into law bipartisan legislation, the support act to help families and communities impacted by addiction. this law supports prevention, treatment, recovery, and law enforcement efforts. additionally, the support act contains language that i was able to cosponsor to prevent the sale and shipment of illicit and dangerous drugs. this aligns with the goals of my synthetic illegal synthetic drug safety act which closes a loophole that has enabled bad actors to circumvent the law, to distribute synthetic variations of drugs like the powerful drug fentanyl by labels the drugs as,

quote, not for human consumption, end quote. while these variations are technically different, they hold the same dangerous risks as the original drug. the law also includes the synthetic tracking and overdose prevention or stop act, another measure i cosponsored that requires shipments from foreign countries sent through the u.s. postal service to provide electronic data. this enables c.p.b. to better target illegal substances like fentanyl and prevent it from being shipped into our country from places like china and other countries. these measures are important steps in keeping deadly drugs like fentanyl out of our communities. nevertheless, there's more to do and we continue to work to combat the opioid abuse epidemic if all sides. just this week i coled a letter with senator shaheen encouraging the f.a.a. to work with airlines to get opioid overdose reversal drugs like naloxazone included

in the airlines' emergency medical kits. as chairman of the senate ag f.d.a. appropriations committee, i worked to secure $20 million in our fiscal 2020 funding legislation to support telemedicine grants that will help communities to combat opioid abuse as well. additionally as a member of the senate appropriations committee i've supported the good work of senator blunt, the chair of the labor, h.h.s., education appropriations committee to provide strong support for opioids abuse prevention, treatment, and recovery initiatives through the department of health and human services. the labor, h.h.s., education bill provides $3.9 billion for such efforts, including $800 million for the national institute of health to develop pain management alternatives to opioids as well as to study opioid addiction and $200

million to support the great work done by our community health centers and enable them to expand prevention and treatment services and provide access to opioid overdose reversal drugs. also these bills include language i helped author that places the focus on addressing the challenges facing rural communities struggling with this ongoing crisis. the bill gives states greater flexibility in how they can use opioid abuse funds, including allowing some resources to be used to address stimulants like meth which remain a substance of high concern in many of our rural states, including my own. we need to move forward with the labor-h.h.s. appropriations bill and other funding bills, including the defense appropriations bill which i believe we will be voting on this week. because they're vital to our national security and provide certainty for our military and

our service members. passing these full-year appropriations bills will ensure we fund important priorities from national security to vital support for our ag producers to combating the opioid abuse epidemic that we are talking about here today. we worked hard to pass the support act, to provide our health care providers, first responders and law enforcement with the tools to prevent drug abuse, treat those suffering from addiction, and assist those in recovery. while progress is being made, we need to continue working together to advance full-year funding bills to keep moving the ball forward in the fight against opioid aif buice. -- opioid abuse. we can combat the epidemic, stem its tide and save lives. with that, i want to commend my colleagues and we'll defer to my colleagues from montana and kansas. mr. daines: mr. president? the presiding officer: the senator from montana.

mr. daines: mr. president, just over a year ago president trump signed into law a major bipartisan bill the support act to help combat the opioid and drug epidemic that's devastating this country. i will call that a very good first step in this long fight and now we must continue working to do even more. drug overdoses are now the leading cause of death for those under age 50 in the united states. our country is in the middle of a major opioid and meth crisis and the sad reality is this epidemic isn't slowing down any time soon. it's been said that meth is the next wave of the opioid crisis. and sadly, in my home state of montana, that wave is already reality. meth is destroying montana families and communities. as i travel across montana i

hear too many heartbreaking stories of addiction and tragedy. from great falls to the flat head, across the indian country. the stories are all too real. we need to do more to put an end to the tragic stories that we are seeing in the news. no more stories of babies being born addicted to meth. no more stories of meth breaking up families. no more stories of babies being left in the forest, literally left in the forests because their parents were high on meth. these stories are real and their impacts are real. montana's meth crisis is claiming lives, breaking up families leaving our foster care systems being overcrowded, sometimes overloaded. it's leading to a significant rise in violent crime. in fact, from 2011-2017, there was a 415% increase in meth cases in montana with meth-related deaths rising 375%

during those same years. and in montana, the meth crisis is disproportionately impacting native american tribes. enough is enough. and that's why i fought to include my legislation, the mitigating meth act, which strengthens indian tribes' ability to combat drug use in the support act that was signed into law just last year. that historic and comprehensive legislation was a great first step but there's a lot more work that needs to be done. intangible things can be done. in montana we are a northern border state but we have a southern border crisis. and i say that for a very clear reason. there is no denying the facts that meth that is invading montana, that's devastating montana is mexican cartel meth. it's not home-grown meth

anymore. it's mexican cartel meth, the smug -- that's smuggled across the southern border. mexican meth is cheaper, more potent. in fact, several years ago the meth we saw in montana was homegrown meth. it had potency levels around 25%. today that mexican cartel meth has a potency level of over 90%. that results in a much more dangerous form of meth. it's much more widespread. and the price has dropped. i've met with montanans across our state, whether it's law enforcement, doctors, nurses, treatment facility professionals to come together, to work together to help combat the meth crisis we see in montana. i'm committed to fighting for more resources that gives law enforcement and border patrol the tools they need to fight this epidemic. i'll also continue to advocate for stronger support for treatment and care for our most

vulnerable, those who are addicted to meth. they need help. they need compassion. but one thing we absolutely must do to help combat the drug epidemic is to secure our southern border. because without secure borders, these illegal drugs and meth will continue to come across that southern border. they have easy access into our country and states like montana. i won't stand by and let this be the norm. earlier this summer i was honored to welcome vice president pence and karen pence to billings. they got to see firsthand this crisis. they got to hear directly from law enforcement and montana families impacted by the crisis. i got to see vice president pence and mrs. pence sitting around a table inside a facility that is helping moms who are addicted to meth, who are working with moms and their children to get better.

and they were telling their stories about how they've gotten better through treatment at the rim rock foundation facility there in billings and starting now a much brighter chapter in their lives because of the help that's provided from rim rock. i stand with president trump. i stand with this administration as we work together to secure our borders and protect our communities from illegal drugs and to end this crisis. thank you, mr. president. i yield back. the presiding officer: the senator from kansas. mr. roberts: mr. president, i want to thank all of my colleagues, especially senator daines for pointing out what's happening in rural and smalltown america. as a matter of fact, most of my colleagues, senator hoeven, senator capito, senator daines, senator boozman, senator blunt

all represent large states and we represent cities of course but also rural and small town america. and i thank him for -- owe i thank them for their concerted effort. we've all been working together. i want to thank senator hoeven particularly for his work for funding as he is the distinguished chairman of the senate agriculture appropriations committee. and i want to echo his support of getting these appropriation bills done. i just want to talk and ad to their comments about -- and add to their comments about this national issue of immediate concern, substance abuse and opioid addiction. and i think it's timely because just one year ago, mr. president, the president of the united states signed the support for patients and communities act into law. this was the legislation that was the culmination of months of

bipartisan work. i emphasize that word bipartisan. we talk about it a lot. we seldom see it. this is one effort that we got it done. and this moved across several committees, both chambers of congress, and so it is something that i think we can take great pride in this showing folks back home we can actually do s&l together. -- we can actually do something together. i am proud to be part of this effort on behalf of both the finance and the help committees here in the senate. the legislation included a bill i introduced to encourage the use of electronic prior authorization in medicare part d which will help overcome one of the primary challenges to patients receiving their medications, including treatments for substance use disorders and non-opioid alternatives to treating pain. the support act also included our language that would help shed light on the best practices

and barriers to using telehealth for treating substance abuse disorders in chairman who are covered -- in children who are covered under medicaid. it will also focus on how we can utilize telehealth in rural and underserved areas including how it can be used in school-based settings. all of those who have spoken on this issue have the same problem. in last year's farm bill, the senate agriculture committee, of which i am proud to be chairman, also included provisions to help those suffering from substance abuse disorders primarily in our rural areas. we prioritized funding in the community facilities and distance learning telemedicine programs for projects focused on treating addiction, including opiates. i am proud of these efforts, but there is so much work left to do to combat addiction. this is a real epidemic, as has

been stressed by my colleagues. but real progress starts at the local level, and my home state of kansas, we continue to neat assistance in -- in need assistance in preventing meth use, so eloquently discussed by my colleague from montana, senator daines. we still have use and abuse taking a heavy toll on many communities throughout the state. patients suffering from addiction in rural parts of the country face many challenges in assessing the clinical services that they really need. and we've heard from many kansans who have to travel long distances sometimes across state lines in order to access substance abuse treatments. i recently spoke with many kansas district attorneys. last year they came in, i thought they were going to talk about the criminal justice act that we just passed.

no, they wanted to talk about meth. and i said, well, wait a minute. i thought we made some great progress in eliminating the meth labs in kansas. that's the case. but for a second year in a row, they pointed out again that the meth coming in from mexico that was demonstrated by senator daines and the tremendous concern over this kind of meth that is so much more powerful. and their number-one concern was individuals in many parts of the state who are suffering from addiction and constantly cycling through the court system, clogging up the courts. these individuals often do not have access to substance abuse treatments that could help control their addiction and keep them out of the criminal justice system. that is why i introduced earlier in year the meth addiction act. you can see all of us have individual acts, and we also hope that we can meld them

together. but this is the meth addition act to -- meth addiction act to extend the reach of of these treatments to more people who so desperately need them. our bill would allow our community mental health and addiction treatment facilities to connect patients via telehealth to physicians who are authorized to prescribe the controlled substances that treat addiction. this would help empower local and rural providers to use every tool necessary to combat this epidemic. and in addition last year i had the privilege of attending a drug takeback event in kansas hosted by walgreens and blue cross blue shield of kansas. this is the kind of local initiative that is especially important as we have consistently heard about the importance of preventing diversion as one way of combating this epidemic. at the same time we must be

careful, mr. president, and make sure that's rights to address the problem -- and make sure that efforts to address the problem of denied substances if they have a legitimate and clinical need for these treatments. that is why safe disposal of these medications is such an important tool in solving this very complex issue. this initiative offers people year-round options to help prevent diversion of addictive medications to their friends and loved ones without limiting access to treatment. and finally, i would like to recognize that two weeks from now the city of topeka, kansas, the capital of kansas, is hosting the kansas opiate conference. the people who are truly on the frontlines of the opiate crisis in kansas will be in attendance to address these issues through all sorts of collaborative efforts at the state and the local level. they are the ones that will help

us find the solutions that will help us real and lasting progress against this epidemic. thank you, mr. president. i yield back. and after taking careful note of the senate of the united states, i note there may be a need for -- let me stop at that point, mr. president. i have been handed an important message from a very important staff member. i ask unanimous consent that the senate now recess from 3:00 until 4:00 mammogram -- from 3:00 until 4:00 p.m. today for a briefing. the presiding officer: without objection.

mr. merkley: mr. president. the presiding officer: the senator from oregon. mr. merkley: mr. president, i ask that my intern, antonio bena, ania, be granted privileges of the floor for the balance of the day. the presiding officer: without objection. mr. merkley: mr. president, i was deeply saddened to hear the news on monday of the death of

our former colleague, kay hagan. she is the sister, the wife, the aunt of navy veterans, a daughter-in-law to a two-star marine corps general, daughter of a former florida mayor, niece to a former united states senator, and governor. service was in kay hagan's veins. she spent an early career in financial services, but it was only a matter of time until she decided to get directly engaged in public policy. in office, she was a fierce and unwavering advocate for our men and women in uniform, a staunch fighter for the right of every american to have health care, a warrior for women and children. the people of north carolina and the people of the united states are far better off because of

her years of service in the north carolina senate and here six years in the united states senate. when she was here, she worked on so many different issues. she really immersed herself in trying to assist our military personnel. she was a founding member of the military family caucus. she championed a program that offers education support for military spouses. she cosponsored the repeal of don't ask, don't tell. and she drove the investigation of the contamination of water at camp le jeune and then legislation to rectify that. she introduced a hire a hero act to try to enable our veterans to be able to get jobs and make that transition from military service to civilian life. and she led the effort for

overdue recognition of african american marines who were forced to train at a segregated camp outside camp le jeune, and that led to the awarding to them of the congressional gold medal. when it came to women and children, she was there every day in that fight. the fight for a stronger violence against women act, the fight for lilly ledbetter fair pay act so women could be paid commensurate with their male colleagues. she authored the newborn screenings savings lives act to maintain and continue and support the mandatory screening program for newborns. she fought for workers in middle-class america, manufacturing jobs for america, and for equal opportunity by sponsoring employment nondiscrimination act, which passed on this senate floor six years ago. she proceeded to work on banking and financial issues.

she was the lead on the safe act, confidentiality and privilege enhancement act that had to do with some of the nitty-gritty of mortgage licensing, and she worked to make sure that groups like habitat for humanity could lend the money on a zero-interest loan to their homeowners and be able to do so without violating the legal precepts of american law. issue after issue. but when i think of her journey, i think about a parallel structure between her life and mine in that she ran for the legislature in north carolina, the same year that i ran for the legislature in oregon. i won a seat in the oregon house, and she won a seat in the

north carolina senate. we both spent ten years there. we both then decided that we should attempt to take our philosophy of fighting for the people to the u.s. senate, and we threw our hats into the ring at the same moment, ran long shot campaigns against incumbent senators and we both won. and i recall how every time i checked on how she was doing, she was always doing five to ten points better than i was, and i just kept thinking, i just have to follow kay hagan's example. and then before the campaign was over, she called me up one day. we hadn't actually met much or talked much. and she said, i just want to check in on how you're doing. and we connected and bonded over these parallel paths and the fights we were in, which were just such an intense effort of

campaigning with a desire, a determination to make this country a better place. and of course as i have noted, when she got here, she threw herself into so many aspects of our national life and our legal structure. i was pleased that we were assigned both by senator kennedy to the health, education, labor, and pensions committee and were able to work on the a.c.a. the affordable care act, to try to greatly increase health coverage, make it more affordable and available throughout america, really important for the people of north carolina, the citizens of my state, the citizens across this country. and then we were both assigned to the banking committee, and it was dodd-frank and how do we end some of the predatory lending practices? both of us worked on payday loan predatory actions where interest rates can be 500%. we knew the damage done to our families across the country. we didn't succeed on that

particular piece of legislation, the payday loan piece. but we were stemming in this fight from the same place. and i so applaud her determination to end the predatory practices in lending and many of the things that we were fighting for did get into dodd-frank in terms of fairness in mortgages so that homeownership would be a dream of homeownership that would result in equity for middle-class americans rather than a nightmare of homeownership where the interest rates would double after two years and the family would go bankrupt and they'd foreclose on this, lose their house. so, apart from all that, kay was such a beautiful voice and spirit in this chamber. cheerful, determined, thoughtful, gracious. it just made you enjoy being

here. so i also think about her as when she served the healthiest member of this chamber. she paid a lot of attention to the diet that she ate, the food she ate, how she exercised, how she brought balance to her life. and that too was an inspiration to us. here we find that our journeys on this planet are pretty precarious. we never know what's going to happen on the next day or the next week. i think it's a reminder to all of us to use our moments wisely and treat each other with the sort of graciousness she exemplified, this sort of spirit and fighting for we the people, the people of the united states that she was determined to deploy and champion here on the floor of the senate.

her illness and her death are a real loss to all of us, and it's important that we carry her in our heart. she certainly has a place solidly secured in my heart and i think the heart of everyone who served with her. thank you, mr. president. the presiding officer: under the previous order, the senate previous order, the senate

100th anniversary for supreme court, for those just joined i'm head of the national constitution center in philadelphia and law professor, honored to be