The presiding officer thank you. Mrs. Feinstein i rise to oppose the nomination of mr. Bress. This is a california seat on the ninth circuit, and the fact is that mr. Bress is neither a California Attorney nor a california resident. In fact, hes not been a resident of the state for over a decade. Hes lived and practiced in the washington, d. C. , area for almost his entire adult life. As california senators, senator harris and i know that the kind of experience and connection to california is really necessary for a ninth circuit judge to be effective on the bench. We know our state, we know our constituents, and we know the challenges they face, and thats why the blue slip is so important. Honoring the blue slip ensures that the senators who understand are and are accountable to their constituents have a say in judicial nominations for their home states. Our blue slips, senator harris and mine, were not returned. Ultimately that symbolizes our objections. I was very disappointed that the white house ignored that and moved forward with mr. Bresss nomination. Senator harris and i worked in good faith with the white house to find nominees acceptable to the president and to us, and during our negotiations, which took place, we informed the white house that we could support several other nominees who were, in fact, selected by the white house. Yet, the white house and the republican members of the Judiciary Committee have claimed we were at an impasse, and thats simply not true. For reasons still unknown to us, the white house abandoned our negotiations and nominated mr. Bress for this seat instead. Im very disappointed that Republican Leadership decided to schedule a vote on mr. Bresss nomination given both of our objections to his nomination and our concerns about a lack of connection to our state. Next i want to discuss what i mean by a lack of connection to our state. The white house has greatly exaggerated mr. Bresss connections to california to justify their decision to move forward with a noncalifornia nominee. I studied mr. Bresss record extensively and id like to run through some of what i a have i have found. Mr. Bress claims to spend a substantial amount of time working in his Law Firm San Francisco office. However, as recently as novembes profile on the kirkland and ellis l. L. P. Website listed him as an attorney working exclusively in the firms washington, d. C. , office. His profile page, likewise, provided contact information, phone and fax, only for the washington, d. C. , office. Just before he was nominated, mr. Bresss kirkland and ellis profile was revised to list him as an attorney in both the washington, d. C. , and san francisco, california offices of the firm. In addition, according to a review conducted by my staff, every public legal filing signed by mr. Bress lists his office as washington, d. C. This includes legal filings submitted in California Courts. Mr. Bress has never had an oral argument before the ninth circuit never had an oral argument before the ninth circuit. The chairman of the Judiciary Committee entered a letter into the record at mr. Bresss hearing identifying 26 cases in California Courts that mr. Bress has been involved in, however, according to mr. Bresss Senate Judiciary questionnaire, 11 of these 26 cases were asbestos lawsuits for a single client, the Chemical Company bass catalyst. The others were lawsuits involving another single client, United Technologies corporation. So thats two clients. This is hardly the wide breadth of California Court experience that one would expect of a ninth Circuit Court appointee. Mr. Breast does mr. Bress does not belong to any legal organizations in california. His children do not attend school in our state. He has only voted once since high school in a california election, and he does not have a california drivers license. Finally, mr. Bress does not own any property in california outside of one share in a Family Business venture. These facts, along with mr. Bresss residency in the washington, d. C. , area, he lives here, his family lives here, make clear to us that hes not a californian nor is he suited for the ninth circuit. So, madam president , this is something we have never experienced before, and that is bringing a judge from one coast to put him into the ninth circuit on the other coast. Some of my republican colleagues have cited past instances when an attorney living and practicing in one state has been nominated and confirmed to a seat in another state. This is highly unusual. Republicans have only been able to provide examples of this occurring four times in the past 20 years, and each case it was with the support of the home state senators. This support does not is just simply not here in this case. This is not the case with this nominee. California is a diverse and complex state. We have over 40 Million People. Its the fifth largest economy in the world, it makes up 14 of the u. S. Economy, 53 fortune 500 companies are based in our state, we have the largest ag industry in the country, we produce more manufacturing revenue than any other state, and California Technology companies produce 53 of all tech revenues in the United States. This vast and diverse nature of californias people and economy means the ninth circuit regularly considers challenging complex issues of fact and law. These cases require not only the sharpest legal minds but lawyers and judges who know and understand the complexities facing the state of california. So we have an imported judge now coming in to the ninth circuit. One of our most critical tasks as senators is to ensure that Lifetime Appointments to the federal courts are well qualified and well suited to the seats to which theyve been nominated. Home state senators are crucial are a crucial part of this evaluation process, and you know this very well, madam president. Im so disappointed that the majority has disregarded this. This disregard of blue slips represents another breakdown of Senate Traditions and its really, really very disturbing because one thing ive learned in over 20 years here is what Goes Around Comes Around and by doing this it is a major violation of a precedent that this senate has followed, i believe, to its absolute. I will vote against mr. Bresss confirmation and i urge my colleagues to do the same. Thank you very much, madam president. I yield the floor. Mr. Reed madam president. The presiding officer the senator from rhode island. Mr. Reed madam president , i rise today to salute a hometown hero, a dedicated journalist, and a trusted newsman, jim taricani who passed away after years of contributions to rhode island. This is just an example of the tribute he won by an enthusiastic population in rhode island. This is the front page of the Providence Journal on the day of his funeral services. He was a gentleman, he was a man of integrity, a man of fairness, the qualities that define a great journalists, in fact, great journalist and jim tar icani arecy none r nonmuss synonymous. He won the edward r. Mur row award. Jim grew up in connecticut and served in the United States air force where he was stationed in europe as a military police officers. He made his mark when he moved to rhode island and was in radio and over 30year career at wjar that spanned from the late 1970s through 2014. Jim began his stint for wjar as assignment reporter, but gained notoriety for covering big stories and covering the truth and went on to found his investigation team. He took on tough stories about organized crime and political corruption, and on reporting on these difficult topics, jims own integrity, selflessness, and fairness to then through every shown through every day, every moment. Indeed, he did not just talk about principles, he lived them. In january of 2001, jim obtained something from a con if i daition ordinary force. It was a case that transfixed rhode island for many months. It marked a significant moment where people could see and hear what corruption looked like. But rather than following a court order to reveal the source of the tape, jim stood up for the First Amendment. Several of jims friends and colleagues wrote letters to the judge on jims behalf, including christina amapora. She noted that jim taught her, in her words, that journalism, when done right is a noble profession. That americas unique commitment to the freedom of the press is vital to public democracy and Holding Public officials to account is imperative of a corruptionfree society. Indeed, thats what jim set out to do through his report and he became a strong advocate for other journal is journalists testifying before congress on freedom of the press and the challenges that journalists face. His help, his actions, his activity spurred action. The senate Judiciary Committee advanced senator schumers bipartisan media shield bill. But the work to protect journalists to responsibly do their job continues. We must find a bipartisan way forward that balances freedom of the press and public safety. Jim was also a tremendous advocate for the american heart association, a survivor of multiple heart attacks, jim documented his own process undergoing a heart transplant from uncertainty to recovery. Heres how the Television Critic described it. Listed, the title refers to words from doctors that every heart transplant candidate longs to here is the most powerful interest story i have seen on local television. It is courageousus firstperson journalism, a story you will never forget. Jim, who kept a diary throughout his hospital stay, wanted to have it videotaped to have a donor awareness video for the american heart association. It was never his intention to broadcast the account. But when it was surgtd that it suggested it would reach a larger audience, they agreed. He was willing to share his story if it could help others. Thoughtful, tenacious, and tough, that was jim taricani. By the way, 32 days after receiving his new heart, jim was back at work, which tells you everything you need to know about how passionate he was about journalism and how much he loved his job. But undoubtedly, the love of his life was his wife lori white, who was a force in her own right and has taken up jims course of freedom of the press and encouraging the next generation of inspiring young journalists to go out and make a difference. She has endowed an election series on First Amendment rights at the university of rhode island in jims honor, which is a fitting tribute. Journalists bring sunlight to the stories that otherwise may stay hidden in the shadow. It is my hope that this election series will continue his legacy of inspiring the next generation of ethical and responsible journalists. She said that. I expect the series will help increase public understanding of the importance of a free press and the First Amendment for decades to come. As a journalist, as a person, nothing stops him from following the facts, uncovering the truth, sharing important stories, and enlightening his audience. We are all in rhode island and across the country deeply saddened by the loss of jim taricani, but his example and legacy endure. That legacy will sustain us and inspire us and continue in our Work Together to build a just and decent country. And for that, for jim, we are all grateful. And, madam president , i would yield the floor to my distinguished colleague from rhode island, senator whitehouse. Mr. Whitehouse madam president , the presiding officer the senator from rhode island. Mr. Whitehouse it is a great honor to join my senior colleague, senator reed, here on the senate floor together to remember someone we both new very well, jim taricani, a Legendary Invest gative reporter who not only we knew well but who so many Rhode Islanders knew well. If there was a rule in rhode island, when jim called, you answered. He was always tough, he was always fair, he was the founder of wjars iteam, a storied Investigative Unit for the nbc affiliate in rhode island. Jim started working as a reporter in the 1970s when the new england mafia was still active on the streets of providence. He became known for segments exposing organized crime and for sniffing out public corruption, and at times a bit of a combination of both. Jims new sense and news sense and his doggedness were legendary. Jim was a rhode island icon. In a small state with more than its share of stories to tell and plenty of larger than life characters, investigative journalists have always had a particular prominence. For more than three decades, jim was among the best of them all. He was brave. When a federal judge ordered jim to die divulge to divulge who had provided him with a tape of a bribe being accepted at providence city hall, he opted for a prison sentence rather than give up his source. The courage of jim taricani made national headlines. He ended up serving four months of home confinement and testified before congress in 2007 in support of a federal shield law to protect the freedom of the press. Rhode islanders felt a personal connection to jim for another reason. Jim needed a new heart in the 1990s, after having suffered two heart attacks in his 30s. He shared this health saga on the air, allowing wjar cameras to follow along as he underwent a heart transplant and navigated his recovery. From living rooms and kitchen tables across rhode island, Rhode Islanders rooted for jim. As his health improved and ultimately he returned to the newsroom. The transplant would give him 23 more years, which he called his bonus. Jim passed away last month at the age of 69. With the free press under more strain than almost any other point in our nations history, jims funeral became a really important moment. The photo that senator reed just showed on the front page of the Providence Journal the next day was a sight to behold. More than 50 journalists showed up to serve as jim taricanis honor guard. The honor guard had dozens of reporters from across rhode island. Not just from wjar but from all of its competitors, too. Journalists came from other parts of the country who had crossed paths with jim at channel 10 during time they spent in rhode island. They had come back to see off a friend, a hero, and a staunch defender of the First Amendment. I join senator reed today in thinking of jims beloved wife lori white and the many friends of theirs who mourn jims passing. He will, madam president , be missed. I yield the floor. Mr. Reed madam president , i note the absence of a quorum. The presiding officer the clerk will call the roll. Quorum call quorum call quorum call quorum call a senator madam speaker. The presiding officer the senator from indiana. A senator i rise today to discuss. The presiding officer if you will suspend, we are in a quorum call. Mr. Young i move to vitiate the quorum call. The presiding officer without objection. Mr. Young i rise today to discuss aaron issue thats very an issue thats very important to me and the hoosiers in need of an organ transplant. That issues the lack of organs for patients in need in our broken Organ Donation system. For more than 30 years our nations Organ Donation system has operated in complete darkness. Groups known as organ procurement organizations or o. P. O. s or responsible for getting organs from the donors to the patients who actually need them. But questions surround the effectiveness, transparency and accountability of these organizations. O. P. O. s are the main link between donor hospitals and organ recipients and performance can be a limited factor in the Organ Donation system. In the last 20 years, no o. P. O. Has been decertified despite serious issues of underperformance. For example, c. M. S. Recently recertified the new york city o. P. O. , despite persistent underperformance for nearly a decade. This problem exists throughout the country. Currently o. P. O. Performance is measured by data that is selfreported, unaudited, and fraught with errors. Many of these errors have been documented by Lenny Bernstein and kimberly kindee at the washington post. And thats why today i introduced legislation that would require organ procurement organizations to be held to metrics that are objective, verifiable and not subject to selfinterpretation. This way there can be meaningful transparency, evaluation, and accountability. Updating these metrics will also enable geographic level donation rates to be evaluated and improved. This is desperately needed for the more than 113,000 americans currently waiting for a lifesaving transplant. The legislation i introduce today is supported by the American Society of nephrogoly, dais sister patients citizens and the dialysis patients citizens and the group organize. This year i wrote to c. M. S. Urging c. M. S. To you happened o. P. O. Me to update o. P. O. Metrics to be objectionable and verifiable. Im hoping to hear from the white house and the department of health and human services. This issue is very personal to me. My friend dave gunny mcfarland from jeffersonville, indiana, died because his heart transplant never came. We served together in the United States marine corps. Over the years ive gotten to know his widow jennifer mcfarland. Jenn has made it her mission to raise awareness about the organ transplant process and to help prevent others from facing a similar situation. Because the system is so complex, most people dont know how it works or if patients are actually being protected. Its time to change that. Todays legislation is the first in a series of bills im working on to reform our Organ Donation system once and for all and help save precious lives. I will not stop until we increase the availability of organs for patients in need. Thank you, semper fidelis, and i yield the floor. And, madam president , i would note the absence of a quorum. The presiding officer the clerk will call the roll. Quorum call quorum call mr. Murphy madam president. The presiding officer the senator from connecticut. Mr. Murphy i ask that we dispense with the quorum call. The presiding officer without objection. Mr. Murphy thank you, madam president. Madam president , im going to be joined here on the floor over the next 45 minutes or so by a number of my colleagues to talk about an Exceptional Court case that is being heard today in new orleans, la. This is a court case that the Trump Administration, along with a number of Republican Attorneys general have brought to obliterate the Affordable Care act, all of it overnight. The case, if successful, would result in a humanitarian catastrophe in this country. Why do i say that . Well, because the plaintiffs in the case, backed by the Trump Administration, are arguing that the court should throw out the entire Affordable Care act with nothing to replace it despite the fact that for almost a decade now i have listened to this president and my republican colleagues in the congress object to the Affordable Care act on the premise that they will have Something Better to replace it with. In President Trumps words a replacement that will ensure more people at lower costs with all the protections that the Affordable Care act has. That plan has not materialized yet because it doesnt exist. It has never existed. It will never exist. The choice today is between the Affordable Care act, which insures over 20 million americans, which guarantees that people with preexisting conditions cannot be discriminated against, and nothing, no protections, no expansion of medicaid, no subsidies for individuals to buy private insurance. And right now with the support of republicans in congress, the Trump Administration today is making the argument that the entire Affordable Care act should be struck down with nothing nothing at all to replace it. This is my friend john from middletown, connecticut. I had breakfast with john last week. That is a picture of john in his younger years. John was 12 years old when he started to have flulike symptoms but was diagnosed, coincidentally on the day of the tragedy in sandy hook, connecticut, with a rare form of soft tissue cancer in the back of his throat. The treatment process for john was, in his words, horrendous, bringing him to as little as 70 pounds for a period of time, rendering him unable to speak, eat, or drink. He was out of school and in and out of the hospital for almost two years. Six years later he can only open his jaw a small fraction of the normal range of motion. He can only chew foods out of one side of his mouth, and he has very limited healing ability for any jaw injury. These issues will never go away for john and he has become an advocate for the Affordable Care act because he knows he knows that if the Trump Administrations lawsuit is successful, his as he knows it is over because once again Insurance Companies would deny him treatment. No Insurance Company would provide john carlson with insurance knowing his history of cancer if they were allowed to make decisions for themselves who gets coverage and who doesnt. The only reason john gets coverage is because we said through the Affordable Care act that were not going to hold you responsible for your Childhood Cancer. Well make sure you get insurance no matter what. These are the stakes right now. These are the stakes for millions of americans like john whose lives will be upended if this heartless, thoughtless, cruel lawsuit proceeds. We should be talking about how to make the Health Care System better, we should talk about ways to lower costs, we shouldnt be talk about going backwards with no safety net. What if the lawsuit is successful . I havent heard a single republican in the senate talk about what they would do. I havent heard what the president would do if his plan is successful. What happens to john . What are you going to do to make sure he gets the treatment that he needs . The answer is you dont know. The answer is you are jumping without a net and you are playing with the lives of millions of americans. John is a remarkable young man also because his eyes were opened when he was in that hospital. I actually want to read you his words. He said this to me a couple of weeks ago. And i asked him to write it down because its really remarkable the capacity of young people to see beyond their own suffering. He said i wanted to take the opportunity to tell one more story about an experience i had while i was in the hospital during my Cancer Treatment. This is a story about a young boy who received Cancer Treatment the same time as me. During my daily physical therapy wawrks around the cancer floor, i noticed a pattern, there was one room directly across from the nurses station with the same patient inside. A small boy no older than 3 years old. I remember asking my parents and nurses, why are that babys parents not with him . I felt so angry that such a tiny child was left alone and forgotten in a hospital room while going through Cancer Treatment. I remember seeing the tiny chemotherapy port embedded in his head through the glass door. Why would they abandon him like that i asked the nurse walking with me that day. She explained to me that he had not been abandoned at all. He was not forgotten. He was not neglected. She explained to me that he was left alone due to pure necessity and desperation. This is john talking, right here. He says, i learned that both of his parents were working day and night to be able to afford his Cancer Treatment. Nobody deserves to go through this, what i went through, says john alone, especially not a 3yearold infant. I share my story so that his story will not continue to take place in america. I shared my story so that patients fighting for their life will no longer be taken advantage of by hospitals and Insurance Companies. What a miracle that this young man, going through his own Cancer Treatments, would think of a 3yearold child that has no parents there with him because his parents are working multiple jobs to be able to afford the Cancer Treatments for their son. Before the Affordable Care act went into effect, 750,000 people in this country went into bankruptcy because of medical costs. That doesnt happen any longer. It doesnt mean our Health Care System is perfect or doesnt need more improvement, but why would we want to go back to the day in which a family lost everything simply because their 3yearold son got cancer . Why would we take this chance with these peoples lives . I once again come to the floor to beg my colleagues to stand with us to stand with us and oppose this lawsuit, this careless, thoughtless lawsuit, and at the very least if you support it, then come to the floor with a real plan for how youre going to take care of john and the millions of americans who rely on the Affordable Care act for coverage. I yield the floor. Mr. Blumenthal madam president. The presiding officer the senator from connecticut. Mr. Blumenthal thank you, madam president. Madam president , im very pleased to follow my colleague from connecticut and to continue his thoughts about the utter chaos and catastrophe that would be caused by success in this lawsuit. Now before court of appeals, chaos and catastrophe that would, in effect, turn back the clock to days that i remember well because i was attorney general when preexisting conditions were used as a ruse to deny lifesaving medical care and coverage to people with cancer and brain tumors and literally lethal diseases. And in those days as attorney general i took their fight and made it my own, even sometimes calling president s of Insurance Companies over weekends to go to bat for those individuals. Those bad old days, the days of no protection against preexisting conditions are over now, but they will come back if this lawsuit is successful. If this lawsuit wins, young people who are now covered by their parents policies up to the age of 26, will be without it. If this lawsuit wins, the annual and lifetime caps on benefits will come back. If this lawsuit is successful, preexisting conditions, again, will come back to haunt people who need and deserve coverage. If this lawsuit wins, millions of people, tens of thousands in connecticut, will be at risk. And one of them is a young man, connor kern, an 8yearold boy in ridgefield, and his picture is right here. I met connor three years ago when he was 5, and his parents noticed he was lagging behind his twin brother. They brought him to the doctor expecting maybe a simple diagnosis. Instead they were told that connor had muscular dystrophy. That is a disease that has no cure. It is lifethreatening injuries. In fact, most people who have the disease dont survive past their mid20s. Connors family wrote to me telling me that their beautiful young sweet child, at the time just 5 and a half and full of life, would slowly lose his ability to run, to walk, to lift his arms. Eventually, they said, hed lose his ability to hug them. Connor needs care complex care from multiple specialists costing tens of thousands of dollars per year, and thanks to the Affordable Care act, theres no denying him coverage. There is no denying him coverage because of his illness and he will receive the care he needs. His family also wrote to me that the reinstatement of lifetime caps, or elimination of essential Health Benefits, will hinder his familys ability to access the care connor needs. In fact, if this lawsuit wins, there will be virtually innumerable obstacles to connor receiving that vital lifesaving care. And if his disease progresses, as seems very possible, he will need access to medicaid in offsetting the costs of living with that disability, but for his family, the question is, will medicaid even be there . If that devastating day comes, will he receive the care that he needs . Now, connors family shared this concern over what will happen if the repeated and reckless attempts to undermine health care succeed and if the repeal of the a. C. A. Becomes a reality. He and his family are not giving up. Theyve come to my office annually, since he was diagnosed, to fight for a cure and for the Affordable Care act. Theyve demonstrated strength and courage, sometimes with tears in their eyes. Theyve raised awareness and fight for their son. And i know they would do it a million times over if it meant that connor could have a long and healthy life. Connor and millions like him are the reason that i am here to fight back against any attempts to repeal the Affordable Care act whether its in congress and the courts make no mistake, this effort in the courts is another means of repealing the a. C. A. The people of connecticut get it. They understand the agenda here. And they want all of us and i think most of our constituents do as well to make sure this kind of care is there for connor and for all of us because all of us will be at risk if the a. C. A. Is repealed, whether its in congress or the courts. In connecticut there are 1. 5 Million People living with preexisting conditions. And that includes 182,000 children like connor. If this republicanbacked lawsuit against the Affordable Care act succeeds, their protections will be eviscerated. They will be lost. Not just for a year or two but likely for their lifetime. The Affordable Care acts ban on Lifetime Coverage caps is so important to kids like connor and if the republicanbacked lawsuit against the a. C. A. Is successful, he will be one of the more than 1. 2 Million People in connecticut who would need a lifetime who would meet a Lifetime Coverage limit and be forced to worry about how and if they can pay for their necessary medical care. In connecticut about 25,000 young people get their health Care Coverage under their parents plans thanks to the Affordable Care acts requirement that children can be covered until the age of 26. If the republicanbacked lawsuit against the a. C. A. Succeeds, these young adults will be left without coverage. In connecticut over a quarter of a Million People have health Care Coverage because of the a. C. A. s Medicaid Expansion. Another 110,000 have coverage through the connecticut a. C. A. Exchange. If the republicanbacked lawsuit against the Affordable Care act succeeds, their health Care Coverage will be gone. And if the republicanbacked lawsuit succeed, the uninsured rate of black connecticut residents would likely double. One in five latinos under 65 will go uninsured. All of these people like connor represent our nation, the best of our nation with their fighting spirit and their dedication to the people they love. They deserve to be heard. Their voices need to be heard here. They are the true faces of the Affordable Care act. Every one of them like connor is a life that will be enhanced by continuing the Affordable Care act and if this republicanbacked lawsuit succeeds, their lives will be at risk and we will be a lesser nation. Madam president , i yield the floor. Mr. Manchin madam president . The presiding officer the senator from west virginia. Mr. Manchin madam president , i come before this body, i come before all of those in america to explain a little bit of what we had before the Affordable Care act and where we are today. I wasnt here in 2009 when they passed the Affordable Care act. I was the governor of the state of west virginia. My beautiful state. And i can tell you the type of health care in a rural state, a rural hardworking state where people have worked hard all their lives and been challenged, but theyve really given so much to this great country. Most of them did not have insurance. A lot of people across america had some really good insurance and but a lot of working people, hardworking people or people of less means, poorer people did not have access. But let me tell you what they used. They used the emergency room. Highest cost, no Preventive Care, nothing at all to maintain your Health Wellness but strictly they could go there in an emergency. So thats what most people had used ha didnt have any insurance that didnt have any insurance. Let me tell you the people that were basically working and could not afford the copays where they worked or wasnt afforded insurance at places they worked. They would they were ill, if they got hurt at home, working, they would go into work on monday and claim a workers comp claim, again a very high cost to all the states. Now, at the end of the year, and i think this is in most states, what they would come to you, every hospital, every rural clinic would come to their governor and their legislature. And we called it dish payments. Disproportionate share. And they would say, boy, governor manchin, if you dont help me with 10 million, 12 million, ive given away 20 million in charity care, were going to have to close. We had to scramble around using taxpayer dollars to keep every rural clinic and hospital open for the people. People would forget about all that. Those who have wonderful access to insurance or offered insurance, that was wonderful. We want to make sure that theyre still having that opportunity. And guess what . We have a way to fix it. There have been two bills sitting on senator mcconnells desk for almost three years that would reduce the cost of what we know whats wrong with the bill, the Affordable Care act. But let me tell you whats right with the Affordable Care act. I wasnt here in 2009. I would have liked to seen changes but now that im here, i know what i had before wasnt working and i know what we have now can be a lot better. And in a bipartisan way weve tried to fix this. Weve tried to find ways to make sure that people that had good insurance is not going to be exor exorbit tantsly charged out of the market. Were doing everything we possible can. Im asking everybody in this please for the sake of humanity, if a person in the First Time Ever gotten insurance and ive told people this. We gave people the greatest wealth card you could ever get which is a health card but we didnt give them one shred of evidence as far as information how to use it, instructions. If you got a box of cracker jacks, you get the prize inside and it would show you how to use that little prize. We never took the time. Now they want to throw it out. Lets make an effort to basically teach people how to live a healthier lifestyle, how to be Preventive Care, how to have a more productive and healthier life. We havent done any of that. But for the first time we know scientifically that if a person is addicted to drugs, if theyre addicted, its basically a health problem. I mean, its an illness. An illness needs treatment. For the first time in a state thats been inundated with opioid addiction and drug addiction, people are able to get treatment, get back into a productive lifestyle and get their life cleaned up. For the first time they want to take that away. 00,000 West Virginians live in my state have some form of preexisting condition because they all worked in the mines and factories. They were hard workers. Now those people, if you ever talked to them, if you ever talked to Rural America in everybodys state and you talked to a person, how you doing, im okay, im okay. How is your health . Well, i dont want to be a burden to my family. Let me tell you what theyre telling you when they say i dont want to be a burden to my family. I cant afford insurance, i dont have insurance, im not going to break my family and put them in bankruptcy to try to keep me alive. So whatever the good lord has planned for me, i will accept. Thats not who we are as americans. Its just not who we are. And this is what were trying to change. We have 20 attorney generals, Republican Attorney generals. These are people i know. I dont think theyre mean spirited but to be this basically insensitive to the real world and whats going to happen, youve got every hospital, every clinic, every provider is going to be in jeopardy of having a job, being able to provide the Services People need. This thing will come unraveled, unraveled. So were fighting and hoping and praying that this is not upheld in the court system. How its gotten this far i do not know because i can tell you reasonable people would not make this type of decision. So when you look at whats going on, let me tell you in a bipartisan way, my republican colleagues have admitted that millions of americans will lose their Health Insurance. The Republican Attorney generals, if they succeed. They admitted it, bipartisan. Because we all have the same challenges. Senator tillis from North Carolina and nine other republicans stated oral arguments in texas versus United States will begin september 5 and if a judge rules in favor of the. The presidinplaintiffs, protect. We know that. Mr. Manchin my good friend senator murkowski from alaska said in her own words said this lawsuit will take away health Care Coverage for people with preexisting conditions. With the uncertainty of the outcome of the upcoming texas v. United states case, this legislation is needed now more than ever to give alaskans and all americans the certainty they need, the protections for those with preexisting conditions will remain intact. My republican colleagues know that if these attorne attorney s win trks will devastate households, our economy and millions and millions of Americans Health. Thats why ive been working with them to fix the problems of the Affordable Care act. I introduced the premium reduction act with my friend senator Susan Collins from maine which would reduce the cost of when Health Insurance in the individual market by supporting and expanding statebased Health Insurance. We owe it to every west virginian with a preexisting condition to fix our Health Care System. Id like to introduce you to Aiden Jackson williams. This is Aiden Jackson williams right here. Aiden is a 6yearold cancer survivor. At nine months old he was diagnosed with optic guy coma and underwent chemotherapy for 16 months. At 2 years old he was in remission. He continues to get m. R. I. s and theres a high chance of recurrence of other tumors in his body due to his condition. With that said, aiden doesnt let it bother him. His parents are proud to say that today aiden is doing great. He and his twin sister reagan both enjoy sports and he moves around just as well as anybody. To this day aiden is their hero and inspiration. Kids like aiden fought and beat cancer. They shouldnt have to also fight to keep their Health Insurance. What were saying if this a. C. A. Goes away, aiden will not have the certainty to be able to have Health Care Insurance, to have the m. R. I. s, to detect early enough to save his life. Thats what were talking about. This is life and death. This is life and death. This is not just a matter of ideological differences that we have. So were going to fight and fight hard and thats why im here for aiden and all West Virginians with preexisting conditions. They are trusting us to do the right thing and along with my colleagues, the republicans and bipartisan in a brarp way to fix what bipartisan way to fix what we basically have to know and do know that can be fixed with the bill we have before us, the Affordable Care act by not throwing the baby out with the bathwater. I hope that each one of my colleagues take this seriously and that theyll work with us in a bipartisan way to fix the health care for americans thats so needed. With that, madam president , i yield the floor. A senator madam president . The presiding officer the senator from washington. Mrs. Murray thank you, madam president. Madam president , today President Trump and Republican Attorney generals are explaining in court why they think people who got their health care through the exchanges or Medicaid Expansion should have it ripped away. Theyre explaining why limits on patients outofpocket costs should go away while limits on their annual and lifetime benefits should come back and why protections for people with preexisting conditions should be struck down. In other words, republicans are once against fighting to take us back to the bad old days to give big Insurance Companies all the power to leave millions of people without any hope of getting the quality Affordable Care they need and to leave patients and families with fewer protections and higher bills. Patients like lilly from gig harbor, washington, my home state. Lilly is a Rising High School sophomore. Shes a rising soccer star, and she is a patient living with Cystic Fibrosis. To stay healthy and stay on the field, lilly needs to take several prescriptions a day. She needs to keep expensive medical devices on hand and visit specialists every other month not to mention the hospital a couple times a year. Even on a good month her health care can cost thousands of dollars. For families like hers, the stakes could not be higher. If republicans win, their their blatantly partisan lawsuit, Insurance Companies could kick patients like lilly off their parents insurance before they turn 26. Meaning instead of worrying whether lilly will continue her soccer career at gone day ga or u. W. Or somewhere else, her family could spend her senior year worrying how to make sure she can get the health care she needs. Because if republicans win, Insurance Companies could also avoid covering essential Health Benefits patients need, things like Prescription Drugs or emergency care. They could remove limits on how much patients have to pay out of pocket and put limits on patients annual and lifetime benefits which is particularly challenging for patients like lilly who need expensive drugs to treat chronic preexisting conditions. And if republicans win, Insurance Companies could discriminate against patients who have preexisting conditions like Cystic Fibrosis by charging them more, excluding benefits, or even denying them coverage completely. And lets be clear. Lilly is just one of 30,000 patients in our country with Cystic Fibrosis and one of over a hundred million patients in our Country Living with a preexisting condition. Like the woman who wrote to me about her severe arthritis which could be debilitating without treatment or her husband whose high Blood Pressure could be deadly without medication or the mom who wrote to me about her sons rare form of epilepsy and how without insurance, the medical costs would crush her family. For these families and so many other Patients Living with a preexisting condition, the lawsuit republicans are bringing today is a matter of life and death. People are watching closely and theyre not going 0 to forget who kept their word to fight for health care, to fight for protections for people with preexisting conditions, and who on the other side blatantly broke that promise by championing a partisan lawsuit that will throw the health care of millions of people out the window. Democrats are not going to stop fighting for families like lillys. Were not going to stop holding President Trump accountable for his Ongoing Health care sabotage, and we are not going to stop pushing for commonsense steps that help women and families get quality, Affordable Health care while pushing republicans to work with us to get the train back on the track and stop pulling up the rails. Thank you, madam president. I yield the floor. Mr. Brown madam president . The presiding officer the senator from ohio. Mr. Brown thank you, madam president. I both concur and applaud concur in and applaud the senior senator from Washington State for her comments, and we saw senator manchin here. I know senator kaine was here, senator murphy was here, senator blumenthal was here. I know there are probably a dozen others, all of whom know people, have talked to people, get out and, as lincoln said, get listen to people and get their Public Opinion baths, and they meet people like the lady from columbus that i will talk about in a few minutes, susan helper. They talk to hem, they meet them. They see that what we do here actually matters in peoples lives. They can play games with the Affordable Care act. Theyve been doing that madam president , for a decade now, literally almost a decade, putting Peoples Health care at risk, scaring people, alarming people, trying to take their Health Care Away, and, you know, these are real people, as thee picture as these pictures show and as these stories show. Back up a minute. A federal judges hearing arguments in a case that will literally yank Health Care Away from millions of americans. I know what that means in my state. Madam president , 900,000 people in ohio have insurance today because of the Affordable Care act. One million ohio seniors have gotten now 100,000 ohio seniors have gotten major savings on their Prescription Drugs through the Affordable Care act. One million ohio seniors have had osteoporosis screenings and diabetes screenings and physicals and no copay and no deductible. Preventable treatment, making their lives better. Yet my colleagues on the other side of the aisle, all of whom have good insurance paid for by taxpayers, with aens to take it away from them. And you can just almost any day you can look down the hall, madam president. You can open this door and walk down the hall, look down the hall, and youll see is the Health Care Lobbyists shall the drug company lobbyists shall the tobacco lobbyists shall the gun lobby the gun lobby lobbyists, youll see one after another go into senator mcconnells, the republican leaders, office. Every one of those lobbyists causes us to spend more dollars on Health Insurance. The Health Insurance lobby, the gun lobby, the tobacco lobby, the alcohol lobby, the spirits lobby coming out of kentucky all of them cost taxpayers more because it means Peoples Health get worse because they dont stand up to these interest groups. So, madam president , we know its happening in texas. A partisan judge, an absolutely partisan hack of a judge ruled in december to strike down the health care law. I know that Justice Roberts say, we dont talk about obama judges or bush judges or clinton judges or trump judges. Yeah, thats what they say. Thats what judge Justice Roberts, Supreme Court chief Justice Roberts says. But we know whats happened here. We know how senator mcconnell is looking for the most extreme and young judges possible to put on the court, to go after labor rights, to go after voting rights, to go after health care in costing our citizens their health and costing citizens billions of dollars. We know the president wants to get rid of the entire Affordable Care act. If President Trump gets his way, if the Court Decides to wipe off the books, take away the entire health care law, heres what happens. Tax credits, tax credits to help you afford your Health Insurance gone. Protections for preexisting conditions gone. Five million five million ohioans right now have a preexisting condition. Most of the rest of us will have a preexisting condition at some time in our lives. Its called aging and people are more likely to develop i illness and get sick. Insurance companies cant deny you insurance and theyll take the insurance away if you happen to get too sick and you cost them too much money, those Consumer Protections built in by obamacare, built in by the Affordable Care act gone. Republicans in this body, President Trump want to take those protections away. The ability to stay on your Parents Health care Health Insurance until youre 26 gone. We know what thats meant to so many families. If my colleagues would leave this building and leave their foreign travel and leave their nice homes in our states most of us have and get out and listen to people, they had aide hear people say, well, my 26yearold sister or my 26yearold daughter, 24yearold son, this is a really important thing to them. Ohios entire Medicaid Expansion that republican governor kasich did gone. More affordable Prescription Drugs for seniors through closing the doughnut hole under the Affordable Care act, if they get their way gone. And the list for free preventive services, mammogram, bone density screenings for medicare beneficiaries, millions of them in my state, hundreds of millions tens of millions of them in the country gone. The list goes on. 5 had million ohioans under 65 have preexisting conditions, half the population of our state. Madam president , im not being alarmist, we know this is what so many of you who were in the house earlier voted on time and time and time again to try to repeal the Affordable Care act. You had no replacement. You said you did, but there was no replacement for the Affordable Care act. It was the repeal of the Affordable Care act, taking away you will of these benefits that tens and tens and tens of millions of americans benefit from. These ohioans have been able to rest a little easier knowing they cant be turned down for Health Coverage for have rates skyrocket but this case puts all of that at risk and president obama has thrown the whole power and all the attorneys, the battery of lawyers in the Justice Department into this case to try to take the Affordable Care act away. Thats what he promised in his campaign. Thats what all these republicans, members of the senate, promised. Thats what all of those republican members of the house promised. Utah know you know what . A lot of them lost last year because they want to take their insurance away. Theyre not doing it through the congress, because that might be politically risky. Theyre trying to do it through the court system and then blame who knows what for this. I met miss halperin. She is a cancer survivor. As a Breast Cancer survivor, a self had of employed, Small Business owner in ohio creating jobs my comments, not hers i depend on the a. C. A. For my health care. Im aware that without the a. C. A. , i would not be able to purchase insurance for any price. Even though my cancer has been in remission force 12 years, i would still not be insured. As senator murray just told from Washington State, that senator kaine told, that senator murphy has told that senator blumenthal told, all cases where people have insurance and a bunch of people in this body, all of whom get insurance paid for by alternation are trying to take away from them. All of these benefits are gone, thanks to the lobbyists lining up in senator mcconnells office, from the gun lobby, the tobacco companies, the Insurance Companies, and the spirits lobby and all of that. Last week in cleveland, i met ms. Zimmerman. I had met her many years ago when she was a student in high school and went to high school with my daughter. I met her at a school event once. She has a rare genetic disorder that one of her children also inherited. She said, i cried the day the Affordable Care act was passed because it meant a safety net for my family. The guarantee of being able to get insurance even if something were to happen to my husbands job. Whether or not my family loses these protections exkeeps me awake at night. Think of the selfishness of my republican colleagues, of President Trump, and the people in his administration, all of these Justice Department lawyers, all these judges. Think about the selfishness. They have a political agenda and theyre keeping ms. Brownzimmerman awake because she worries about her family. She said, i want our elected officials to the remember we want predict when well need to access the Health Insurance system. Not too many people are not able to sleep in this body, madam president. Not too many people that were able to sleep in the house as they were all voting to repeal the Affordable Care act. It crosses the mind of millions of people in detroit, ann arbor, cleveland, and mansfield. Today and tomorrow and the day after, 14 ohioans will die from an overdose. Ohio is in the throes of an addiction crisis like much of the rest of the country, only worse in many cases. We know Medicaid Expansion has been a lifeline to so many ohioans. I was in cincinnati some time ago at talbert house, one of the best Treatment Centers in the country addiction Treatment Centers. I sat with a man and his day. He looked at me and he said, senator, my daughter would be dead if it were not for medicaid. My daughter would be dead if it were not for medicaid. Jet trump aappointed jumps, bushappointed judges, all of whom get Health Insurance from taxpayers, are willing to have that on their conscience. Theyre willing to work to repeal the Affordable Care act, with no real replacement that matters in the lightest of ms. Halbert, that matters in the life of ms. Brownzimmermann that i talked about. The president wants to make it harder for ohioans to get that care. I dont know how members of this congress and this president , all with good things all paid for by taxpayers, can support dismantling this lifeline that so, so Many Americans rely on. I yield the floor. Ms. Stabenow madam president . The presiding officer the senator from michigan. Ms. Stabenow thank you, madam president. I first want to thank my friend and colleague from ohio for his passion and for caring so deeply as we all do in our and our clock is fighting for people with health care. It seems i am owe on the floor every it seems im on the floor every week fighting for the same thing. Health care is personal to every Single Person in michigan. It is not political. Whether or not a senior is able to afford the medication she needs to treat her chronic condition thats personal. Whether or not a single dad is able to take his children to a trusted doctor when they get sick or theyre hurt and keep them on his policy until age 26 thats personal. And whether or not a woman is charged more for the Health Insurance coverage she needs to detect cancer early enough that it can be cured that is personal. Unfortunately, the law that helps seniors afford their prescriptions and ensures children can remain on their parents insurance until age 26 and requires Health Insurance policy to charge women the same as men and to cover lifesaving Preventive Care that law is the currently in the intensive care unit on life support. As we know, since 2010, the senate and House Republicans have voted to repeal or undermine the Affordable Care act more than 100 different times. 100 different times. That didnt set right with families across michigan hand and and across the country. They stood up with us, they fought back with us, and together we won. Now what republicans couldnt do in congress, theyre trying to do through the courts. And literally, today the fifth Circuit Court of appeals begins hearing arguments in the case brought by 18 different Republican Attorneys general and governors. In short, these 18 Republican Attorneys general and governors backed by the Trump Administration and President Trump are trying to take away your health care. If they win, Health Care Reform could be completely overturned and health care taken away. That would take everything away, including Medicaid Expansion which we call healthy michigan. In michigan we have about 700,000 people Getting Health Care now that dont have to pick between working and minimumwage job and Getting Health Care. They can do both. Children staying on their parents insurance plans until age 26 gone. More Affordable Drugs for seniors gone. Protections for people with preexisting conditions gone. In other words, it would put Insurance Companies back in charge of your health care. And we all remember, we all remember what that was like. Women could once again be charged more for coverage, have to get a rider if you want to get maternity Care Coverage, prenatal Care Coverage. Remember when being a woman was considered a preexisting condition . I do. Members of my family do. Families could once again face yearly or lifetime caps on care when they need it the most. When you think about it, so now the Insurance Company, if the Affordable Care act is repealed through the courts, the Insurance Companies would wawns again be able to would once again be able to say to your doctor, you know, i dont think she really needs ten Cancer Treatments or 12 Cancer Treatments. Well pay for five. Or if there was an addiction that needed treatment or Mental Health that needed treatment. I dont think you really need to have more than two sessions if youre an addict. Today the doctor decides with you what you need in terms of number of treatments, and thats the way it should be. Nearly 700,000 people, as i mentioned, in my state are Getting Health Care through healthy michigan, our Medicaid Expansion. And they could lose that. In fact, they would lose that. Our uninsurance uninsured rate has fallen from 12 before the Affordable Care act to 5 . So we had 12 for people that were not insured at all. Now its 5 . I would call that a success. Is there more that should be done . Yes. But that is positive, not negative. The number of people who have been treated without insurance has fallen by 50 in michigan. 50 . And that also is great for all of us. Its certainly great for hospitals who were treating people without insurance before. Someone walks in the emergency room, getting care in the most expensive way. They dont have insurance. And what happens . Everybody elses insurance rates go up. Thats what happens. And so when people have been able to get their own insurance coverage, insurance rates went down, and in fact we had over 400 million in michigan that was put into the State Government as a savings for not paying for people walking into an emergency room without insurance. A record 97 of michigan children can see a doctor now when they get sick. 97 . I would argue that is a great success. Not something to be taken away or played politics with. Michigan seniors are saving money on their Prescription Drugs through Medicare Part d program, something called the doughnut hole, the gap in coverage that we closed. And the more than half of our families in michigan that includes somebody with a preexisting condition are now able to get covered. More than half. The Insurance Companies cant say no or they cant say when you get sick youre going to be dropped. Or cant deny you from getting the coverage you need if you have a preexisting condition. One of those people in michigan is heidi, who lives in cedar springs. She wrote to me in may. Thank you, heidi, for doing that. Heidi had bought Health Insurance for years and almost never needed it because she was healthy. In fact, she only used it, she said, when she gave birth to her daughter. That all changed in 2004 when heidi was diagnosed with Breast Cancer at the age of 45. She since had multiple tests, multiple surgeries, multiple rounds of chemotherapy, all at least partially covered by insurance. Heidi wrote this. My fear every day is that i wont have insurance if these changes are made. Theres no way any company would insure me. My husband has a Life Insurance policy that he bought before we were married. We ask about me, the salesman nicely said that i am not insurable. So my plan b is if i lose my Health Insurance, i will take that money and save it for my funeral. Save it for my funeral since i cant even get a Life Insurance policy for enough for a funeral. Heidi added this, i am lucky that i thought insurance was a good thing and, therefore, paid for it for years through my job. Heidi depends on protections for people with preexisting conditions. Heidi didnt ask to get Breast Cancer. It could happen to any of us at any day something could happen to any of us or someone in our family. And if you have or will have whats called a preexisting condition, your Health Insurance will be taken away if this court case, supported by President Trump, his administration, and the republicans succeeds. A couple of months ago i spoke at the detroit race for the cure which raises money for Breast Cancer research. Its really a wonderful event. We had a beautiful sunny day. And as i stood on the stage and looked out over a crowd of over 10,000 people, mostly women, many wearing pink, i saw women living with preexisting conditions. I saw people like heidi. One woman who was standing on the stage near me asked me a question that ill never forget. Why is it that i have to worry about whether or not ill be able to get insurance in the future . Why . She added, why dont President Trump and other republicans understand that this is my life . This is my life. Its a very good question. It deserves an answer. Why dont republicans in congress, why dont those 18 attorneys general and governors, why doesnt President Trump believe that people like heidi deserve to have health Care Coverage . Why dont they believe that seniors deserve access to more affordable Prescription Drugs . Why dont they believe that women should pay the same for their Health Insurance as men . Why dont they believe that young people should be able to stay on their parents insurance until age 26 . Why dont they believe that families, not Insurance Companies, should make Health Care Decisions . Families with their doctors should be making health decisions, medical decisions. Not an Insurance Company. And if this lawsuit succeeds, were going to go right back to putting your medical decisions in the hands of the Insurance Companies. Health care isnt political. Its personal. Its time to stop playing politics with Peoples Health, for each of us its our life. I yield the floor, madam president. The presiding officer the senator from oregon. Mr. Wyden madam president , i ask unanimous consent that i be permitted to speak for five minutes followed by senator cortez masto for five minutes prior to the series of votes we will have. The presiding officer without objection. Mr. Wyden thank you, madam president. Colleagues, the fourth of july picnics and parades, it is likely that complicated Health Care Policy debates were not exactly a central topic of conversation. Im pretty sure thats the way the Trump Administration wanted it to be. Today lawyers representing the Trump Administration and a number of republican governors are attempting to have the Affordable Care act ripped up and thrown out by a federal court. They were unable to do that in the congress, so now they have headed off to try to get it done in the courts. The case is happening in the fifth circuit in louisiana, and it is not some theoretical exercise. This is an immediate threat to the health care of millions and millions of americans. And i want to be clear at the outset of these remarks what the bottom line is. The bottom line is eliminating protections for preexisting conditions is now the official position of the Republican Party. Thats the centerpiece of what this court case attacks. The ironclad, airtight guarantee at the heart of the Affordable Care act that Insurance Companies cannot discriminate against those with a preexisting condition. And the fact is the Republican Party wants that eliminated. And the fact is this attack on Americans Health care goes way beyond preexisting conditions. What about Prescription Drug costs . Prescription drugs are outrageously expensive right now, and the problem is getting worse under the Trump Administration. Prices are up more than 10 just in the past six months. Americans are forced to make those lifethreatening choices where they really have to balance their food bill against their medicine bill, medicine against other necessities like shelter. In effect, americans selfration because their prescriptions just cost too much. If this lawsuit succeeds, Prescription Drug costs are going to skyrocket even higher. The Affordable Care act is thrown out, that is the end of the requirement that health Insurance Companies have to cover Prescription Drugs. Patients will be forced into junk insurance plans that dont cover the care they actually need. Millions of people of limited means would be kicked off their medicaid coverage. Millions of seniors would face higher drug costs. The bottom line, if this case is successful, it will launch a forced march back to the days of yesteryear when health care was for the healthy and the wealthy. The reason i say that is thats the way it used to be. If you had a preexisting condition in the past, you were just out of luck unless you had an enormous amount of money. The only people who really could benefit were people who remember healthy and people who were wealthy, and the Affordable Care act changed that. More than 100 Million People got a lifeline protection against discrimination if they had a preexisting condition. The biggest winner is if the lawsuit succeeds are going to be the largest of the Insurance Companies and the drug manufacturerrers. They would get the power they need to once again walk all over the American People. So heres the kicker. There is no replacement plan if the Affordable Care act is wiped out. The president keeps saying hes got a big, Beautiful Health care plan, and we always get the sense it reminds you of the movie house in the old days where it would say coming soon. Movies coming soon, but it never actually gets there. Theres never a grand unveiling. And thats because there isnt a backup plan. This is just an ideological crusade to make winners out of the most powerful corporations and losers out of millions of working americans. Democrats in this chamber is proposals ready to go to take a better path, a better approach, and to protect health care of our people. Blocking trumps lawyers from using taxpayer dollars could destroy the Affordable Care act. Banning junk insurance which isnt worth much more than the paper its written on and standing foursquare behind peopling people with a preexisting condition, thats what the senate ought to be working on so that the Trump Administration cant bring on a Health Care Nightmare for millions and millions of americans. One of our most valuable members of the Senate Finance committee has joined us now, senator cortez masto, and im happy to yield to her to close for our time before the votes. The presiding officer the senator from new mexico. Ms. Cortez masto thank you. Madam president , i want to talk today about kyle bailey from sparks, nevada. Kyle is 27 years old, and hes an amazing success story. Kyle was born with Cystic Fibrosis, a condition that affects the lungs and digestive system, making it hard to breathe normally or absorb nutrients. It has no cure so patients spend hours on treatment to keep themselves as healthy as possible with good medical care, he has been able to live a full life, creating music and artwork. He is engaged to be married. He still lives in fear. Hes scared he will lose his Health Insurance and coverage for the treatments that keep him alive. And that could happen if the Republican Party succeeds in its latest attempt to use the courts to take the Affordable Care act and its protections for preexisting conditions. Just today this week in texas, a federal Appeals Court has heard yet more arguments about whether the a. C. A. Is constitutional. On one side are patients like kyle, on the other side are 18 republican states attorneys general who all want the court to strike down the Affordable Care act. Weve seen this before. The republicans have tried to defeat the a. C. A. In congress and the courts over 100 times, and each time they have failed because the American People have raised their voices and said, stop. We want our health Care Coverage. But just because the a. C. A. Survived those attacks doesnt mean its safe and thats especially scary for those who have coverage thanks to the Affordable Care act strong safeguard for patients. One of the most important of the a. C. A. Is its guaranteed protections for people with preexisting conditions. Insurers used to be able to discriminate against people because of their medical history. They would weed out people born with genetic conditions like kyle or those who were seriously ill like this young woman, ivy. She was diagnosed with leukemia, one of the most common Childhood Cancers. She beat the cancer, but she took treatment that affected her legs. She was told she would never walk again. She spent years in wheelchairs. With costly therapy an therapies and therapies, ivy got better. She and her family marched into breakfast with me on capitol hill to advocate for Childhood Cancer research. But ivy has lingering health challenges, she is at high risk of developing Health Conditions over the course of her life and will need careful monitoring until shes 40 years old. Thats why if republicans give Insurance Companies the choice, insurers will refuse to cover people like ivy and kyle or charge skyhigh rates. The a. C. A. Keeps companies are from doing that. If the judge strikes down the a. C. A. , people like ivy and kyle will be in danger through absolutely no fault of their own. Some people may hear stories like kyle an ivy, but think thats sad but it cant affect that many people. But thats wrong, in nevada alone in 2015, 1. 2 Million People under 65 had preexisting conditions. Thats half the nonelderly residents of the state. A preexisting condition could be as rare as Childhood Cancer or as common as pregnancy. That means every other nevadan could face increased insurance rates if the yeas is struck down. Nevadans, like families i met at roundtables across the silver state whose kids are some of the 44,000 nevada children with asthma. Last week in las vegas, i talked to 12yearold joey douglas. His asthma often keeps him home from school and sometimes lands him in the hospital for days. He says he is concerned whether his mom will be able to pay his medical bills. These kinds of worried are worries are the reason why when kyle wrote to me asked me to speak out for people who dont have a voice in Health Care Policy in country, people who are afraid that losing the a. C. A. Could mean losing protections that have allowed them to grow up, start a family, follow their passions and live their lives to the fullest. Today, and every day, im here it for people like carl and ivy and the countless nevadans like them. I have repeatedly urged the pre and the the president and the department of justice to come down on the case and cosponsored legislation to get rid of junk Health Care Plans which allows Health Care Companies to make an end run around people with preexisting conditions and im committed to strengthening the a. C. A. For all americans, but emfor people like kyle, ivy, and joey. So im calling on this president and republicans in congress to do what we can to make sure that the Affordable Care act is not repealed and we are fighting for Health Care Insurance for everyone. Thank you, and i yield the floor. The presiding officer the senator from florida. A senator i ask unanimous consent that the vote following the first vote in the series be ten minutes in length. The presiding officer without objection. The question is on the nomination. Is there a sufficient second . There ands to be. The clerk will call the roll. Vote vote vote the presiding officer are there any senators in the chamber who wish to vote or change their vote . Seeing none, ayes 53. Nays 45. The nomination is confirmed. Under the previous order, the motion to reconsider is considered made and laid upon the table and the president will be immediately notified of the senates actions. 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 the nomination of t. Kent wetherell ii of florida to be United States district judge for the Northern District of florida 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 the nomination of t. Kent wetherell ii of florida to be the United States district judge for the Northern District of florida shall be brought to a close. The yeas and nays are mandatory under the rule. The clerk will call the roll. This is a tenminute vote. Vote vote the presiding officer are there any senators in the chamber wishing to vote or change their vote . Seeing none, ayes 82, nays 16. The motion is agreed to. The presiding officer 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 the nomination of day montana ray leichty of indiana to be United States district judge for the Northern District of indiana. The presiding officer by unanimous consent, the mandatory quorum call has been waived. Is it the sense of the senate that debate on the nomination of day montana ray leichty of indiana to be United States district judge for the Northern District of indiana shall be brought to a close . The yeas and nays are mandatory under the rule. The clerk will call the roll. This is a tenminute vote. Vote vote the presiding officer are there any senators in the chaish who wish to vote chamber who wish to vote or change their vote . If not the ayes are 87. The ayes are 87. The nays are 11. The motion is agreed to. 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 dob hereby move to bring to a close debate on the nomination of j. Nicholas ranjan of pennsylvania to be United States district judge for the Western District of pennsylvania, 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 the nomination of j. Nicholas ranjan of pennsylvania to be United States District Court judge for the Western District of pennsylvania shall be brought to a close. The yeas and nays are mandatory under the rule. The clerk will call the roll. Vote vote the presiding officer are there any senators in the chamber wishing to vote or change hair vote . Their vote . If not, the yeas are 83, the nays are 15. The motion is agreed to. The clerk will report the nomination. The clerk nomination, the judiciary, j. Nicholas ranjan, of pennsylvania, to be the United States district judge for the Western District of pennsylvania. Mr. Thune madam president. The presiding officer the majority whip. Mr. Thune i ask unanimous consent that at 11 00 a. M. On wednesday, july 10, the senate vote on confirmation of the following nominations in the order listed executive calendar 47, 52, and 51, that if confirmed, the motions to reconsider be considered made and laid upon the table, and the president be immediately notified of the senates action. I further ask that at 4 30 p. M. , the senate vote on the pending cloture motions on the king and pallasch nominations, and that if cloture is invoked, the confirmation votes occur at a time to be determined by the majority leader in consultation with the democratic leader on thursday, july 11. Finally, i ask that the cloture motion with respect to the wright nomination ripen following disposition of the pallasch nomination. The presiding officer without objection. Mr. Thune madam president , i ask unanimous consent that the senate proceed to legislative session and be in a period of morning business with senators permitted to speak therein for up to ten minutes each. The presiding officer without objection. Mr. Thune madam president , i ask unanimous consent the senate proceed to the consideration of calendar number 106, Senate Resolution 188. The presiding officer the clerk will report. The clerk calendar number 106, Senate Resolution 188, encouraging a swift transfer of power by the military to a civilianled Political Authority in the republic of the sudan, and for other purposes. The presiding officer is there objection to proceeding to the measure . Without objection, the senate will proceed. Mr. Thune madam president , i ask unanimous consent the committeereported amendment to the resolution be withdrawn, the cruz substitute amendment to the resolution at the desk be considered and agreed to, the resolution as amended be agreed to, the committeereported amendment to the preamble be withdrawn, the cruz amendment to the preamble at the desk be considered and agreed to, the preamble as amended be agreed to, and that the motions to reconsider be considered made and laid upon the table. The presiding officer without objection. Mr. Thune madam president , i ask unanimous consent the banking, housing and urban Affairs Committee be discharged from further consideration of s. 239 and the senate proceed to its immediate consideration. The presiding officer the clerk will report. The clerk s. 239, a bill to require the secretary of the treasury to mint coins in recognition of christa mcaulif mcauliffe. The presiding officer is there objection to proceeding to the measure . Without objection, the committee is discharged and the senate will proceed. Mr. Thune madam president , i further ask that the shaheen amendment which is at the desk be considered and agreed to. The presiding officer without objection. Mr. Thune i know of no further debate on the bill as amended. The presiding officer is there further debate . If not all in favor say aye. Those opposed say no. The ayes appear to have it. The ayes do have it. The bill as amended is passed. Mr. Thune madam president , i further ask that the motions to reconsider be considered made and laid upon the table with no intervening action or debate. The presiding officer without objection. Mr. Thune madam president , i understand that there are two bills at the desk and i ask for their First Reading en bloc. The presiding officer the clerk will read the titles of the bill for the first time en bloc. The clerk h. R. 2740, an act making appropriations for the departments of labor, health and human services, and education and related agencies for the fiscal year ending september 30, 2020 and for other purposes. H. R. 3055, an act making appropriations for the departments of commerce and justice, science ndz related agencies for the fiscal year ending september 30, 2020 and for other purposes. Mr. Thune madam president , i now ask for the second reading and i object to my own request all en bloc. The presiding officer objection having been heard, the bills will receive their second reading on the next legislative day. Mr. Thune madam president , i ask unanimous consent that when the senate completes its business today, it adjourn until 9 30 a. M. Wednesday, july 10. Further, that following the prayer and pledge, the morning hour be deemed expired, the journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, morning business be closed, and the senate proceed to executive session and resume consideration of the wetherell nomination. The presiding officer without objection. Mr. Thune madam president , if there is no further business to come before the senate, i ask that it stand adjourned under the previous order following the remarks of senator casey. The presiding officer without objection. Mr. Casey madam president . The presiding officer the senator from pennsylvania. Mr. Casey madam president , i rise this evening to talk about judicial nominations and in my view the state of play where we are. I wanted to highlight some of the very real impacts these nominations have on americans across the board. Weve had a number of opportunities this year to come together and have agreement on some judicial nominations, but frankly this year for the last several years has been this issue has been the subject of conflict and sometimes rancor and division here on the senate floor and in the committee, the committee of jurisdiction, the Judiciary Committee. Ive raised concerns about the willingness of Senate Republicans to dismantle Longstanding Senate rules but also senate norms, all in a rush to pack the bench with nominees that are often both ideological and also in some cases not in all, but in some cases both too ideological and often unqualified. Early this afternoon the senate voted to confirm Daniel Aaron Bress to a ninth circuit seat in california. Ill talk about his nomination just by way of example, not by way of argument before a confirmation vote, because that has passed. But it is, i think, his nomination and confirmation is another example of the decline of the senates once proud traditions relating to judicial nominations. He was opposed by both of his home state senators, both senator feinstein and senator harris did not return a blue slip for david or, i should say Daniel Aaron Bress. The blue slip, as many people know, is a literally, a single piece of paper where senators sign their name and then check off whether they support or oppose as a way to have consensus between senators from a home state, and its always been accorded respect and deference in this chamber. But that has all changed now. In this case, you had a nomination, a california nomination ill get to that part of it in a moment but a california nomination where, as i said, both senators did not return blue slips, in this case in particular its i think particularly offensive because senator feinstein is the Ranking Member of the committee. And for those who dont Pay Attention to all this terminology, Ranking Member is the top person in one party who is not the Chamber Chairman or chairwoman. So as thetope Ranking Member of the Judiciary Committee, her opposition to judge bress should be an important factor in his nomination and confirmation. Prior to this nomination, the Judiciary Committee had never never held a hearing for a nominee from the Ranking Members home state without his or her support. Again, that has all changed, just recently. Prior rules and norms have not stopped republicans in the senate from pushing extreme and sometimes corporate nominees through the through this process, and especially at the Circuit Court level. In a recent press release, senator feinstein and senator harris explained that they oppose judge bress in part because he had so few connections to california. He lived in california only for one year since graduating from high school. Hes not voted in california in an election for over a decade, and the california barleyses him as a bar lists him as a washington, d. C. Attorney. I mention that because that should be relevant. And when a home state senator, but in this case two home state senators, one of whom is the top democrat on the committee, the Judiciary Committee, i think in that case there should be deference paid to that kind of concern thats raised because after all, they both represent their state. This, as i mentioned earlier, the blue slip process is predicated on the idea that home state senators are more familiar with their states legal community, more familiar than anyone else. I think that goes without saying. They serve an Important Role in nominating individuals to serve and represent the state. Judge bress is an example of why the blue slip process is so important. Hes not part of the california legal community. And despite objections of the senators, he will now sit on the ninth Circuit Court of appeals and decide cases for a state with over 39 million residents at last count. Without blue slips, what will prevent a california judge from being nominated to a court in another state . What would happen if you had someone from a different state who had very little ties to a state be nominated and confirmed, for example, to serve in a state like pennsylvania . It doesnt be make a lot of sense to most people, and it shouldnt its a norm that should not be violated. His nomination illustrates how the blue slip process has been eviscerated especially for the Circuit Courts, which is something that ive had some firsthand experience with. I did not return a blue slip on one nominee who was confirmed. In the second case there was a hearing scheduled over my objections by way of not returning a blue slip. That experience that i had as a senator whose blue slip and the deference that should be paid as part of that blue slip process, that circumstance in my case is at variance with my experience on the District Court level, or i should say for District Court judges. Senator toomey and i, my colleague from pennsylvania, have worked together to jointly recommend experienced consensus nominees for the federal District Courts in pennsylvania. We have three districts. The eastern district, middle district, and Western District. Unfortunately, this bipartisan District Court process has become the exception, not the rule. It used to be, it used to pertain here in the senate where every state had some kind of process by which nominees were presented for confirmation by their home state senators, and the white house, the administration in every case would pay deference to that. That is exceedingly rare today. Im thankful that we have maintained it so far in pennsylvania with regard to the work that senator toomey and i do together and our staffs do together to reach consensus. It doesnt all the work, by the way, but no one hears about the ones that dont work out usually because we keep that to ourselves and we move on to the next person and see if we cant reach consensus. So i appreciate that. I think were either at 19 or 20 judges confirmed since 2011, working together. And i hope we can maintain that so at least, at least the blue slip process would be respected for District Court nominees. I think people elect us in our home states expect that. They expect us to Work Together and to try to reach consensus where we can. Sometimes its not possible, but they do expect us to do that. And if theres an expectation of consensus and bipartisan cooperation that adheres to or is expected of senators, then there ought to be Institutional Support for that here in the senate and by the administration. But as i mentioned, that is not the case today, at least as it relates to the Appeals Court, the Circuit Courts around the country. This has relevance of course not just to process and norms and traditions. That in and of itself is important. It is of greater significance when you consider the courts will deal with. Today there was oral argument in the texas vs. United states case, a monumental case that has the potential to cause millions of americans to lose coverage. We know that because we know that since the Affordable Care act was passed, more than 20 Million People gained coverage. The larger share of that being people who gained coverage through the expansion of medicaid. Those 20 million americans, if this case were to be successful, a case brought by Republican Attorneys general from around the country, then later opposed by democratic attorneys general, if that case were successful as it was at the District Court level, 20 Million People stand to lose their coverage and a much larger number depending on which number is on the record currently. But its at least 150 millionplus americans have protections today because of the Affordable Care act, like the protection if you have a preexisting condition. You could be under the old system, the old rules, the old law, you could be denied treatment or coverage because you had a preexisting condition. That was happening routinely. That is no longer the law today. The law today is if you have a preexisting condition, you can still have coverage. That would be at risk for, as i said, something north of 150 million americans. We know that some of the data tells us that the numbers are equally substantial when it comes to different parts of the law and those who are adversely or potentially adversely affected. I think if you had to step back and summarize where weve been for the last two and a half years now since the Trump Administration came into office, working with House Republicans and Senate Republicans, used a campaign really, a Constant Campaign of what i would argue is a campaign about three things, and maybe not only three but at least three. Ripping away coverage, decimating the Medicaid Program or at least trying to, attempting over and over again, and thirdly sabotage. Sabotage mostly by the administration itself but also supported by republicans here in the congress. That sabotage unfortunately has been successful. We know that as of january, for example, the Gallup Organization released data that said that the number of americans and im reading from the first line of a news story. This is from the publication vox, vox. The headline is under trump the number of uninsured americans has gone up by seven million. The subheadline is even in a Strong Economy americans are losing their Health Coverage. This is an article written by sarah cliff, someone who spends a lot of time writing about and analyzing health care as an issue. Its dated january 23, 2019. But in this particular article, ill read just the first two sentences, quote, the number of americans without Health Insurance has increased by seven million since President Donald Trump took office. New gallup data released wednesday shows. Again, this is a january 2019 story. It goes on from there to say, quote, quo the countrys uninsured rate has steadily ticked upward since 2016, rising from a low of 10. 9 in late 2016 to 13. 7 , a fouryear high, unquote. So at the end of 2016, at the beginning of the Trump Administration, the uninsured rate was 10. 9. At the end of, the latter part of 2018 going into 2019, it stood at 13. 7. So gallup tells us seven million more people do not have health care that had it when the president started his administration. A number of organizations have cataloged recent analyses of the potential threats that could Impact Communities if this texas vs. United states case were successful. Ill mention again for the record, the litigants here, the ones who were bringing the case, these Republican Attorneys general prevailed at the District Court level. Now its on appeal at the Circuit Court, and its probably, in my judgment, more likely than not that theyll prevail at that level too. And then of course the only option would be the Supreme Court, and i dont have a lot of confidence this Supreme Court would rule against that case which would result in chaos. And thats a terrible understatement for what would happen when 20 Million People potentially lose their coverage and tens and tens and tens of millions more lose the protections that they enjoy now, especially those against the denial of treatment or coverage because that individual has a preexisting condition. Here are the numbers, though, just to remind folks. Everyones heard the number nationally, 133 million americans roughly have a preexisting condition. In my home state of pennsylvania, that number is about a little more than 5. 3 Million People. Those numbers are terribly high, but i think the one that is really making an impression upon me, and i hope on others, especially those in pennsylvania, is the number of children in the commonwealth of pennsylvania who have a preexisting condition. 642,700 pennsylvania children have a preexisting condition. 642,700. No action by the United States congress, by the administration, or by a court should ever result in any child being denied coverage or treatment because of a preexisting condition. Any child, but let alone numbers that are so high and so offensive to even consider that that number of children could be denied coverage or any portion of that number could be denied coverage. So the only number ill emphasize tonight is 642,700 pennsylvania children with a preexisting condition. I wont go through all the numbers because i know were here late tonight, but another number that jumps out at me, and this number comes from a document published by protect our care telling us in a publication today that when you consider the doughnut hole coverage, meaning that the Affordable Care act began to fill that coverage gap. When an older american is paying for Prescription Drugs and often paying exorbitant prices for Prescription Drugs, the Affordable Care act began to chip away at that number, so much and in such a substantial fashion that on average the average senior, since the Affordable Care act was passed and this is the period of time between 2010 and 2016 that senior on average gained 2,272 on average, almost 2,300 per senior to help them with their Prescription Drug costs by helping to fill that socalled doughnut hole, which is a very benign way to talk about a terrible coverage gap that burdens a lot of older americans. In pennsylvania, that number is lower, but it was still more than 1,100 per person. All of that is at risk if this case is successful. Just like preexisting conditions are at risk, Prescription Drug coverage for seniors or the support, i should say that has in the recent past for Prescription Drug coverage for seniors, that support potentially could go away completely. So seniors are again footing the bill potentially if this lawsuit is successful. Two more just for the record. Access to treatment would be in jeopardy for some 800,000 people with opioid use disorder issues. We know that there are a huge number of americans that have a Substance Use disorder issue. Often an addiction. A subcategory of that and probably the biggest subcategory are those with an opioid addiction. Its hurt families of all kinds, rich and poor, north and south. No matter where you live, east, west, rural, urban, suburban, it knows no bounds. All of that or a lot of that, i should say, to be more accurate, a lot of that star has come from the support for quality treatment that folks need to lift themselves out of the grip of an addiction. A lot of that support comes from Medicaid Expansion. And whether its the repeal bills that were promoted here on the senate floor over and over again or whether its the lawsuit that could change could have as devastating an impact on health care as any repeal bill would, no matter what it no matter where you turn, in terms of Republican Health care bills and this lawsuit, you can see the adverse impact on Medicaid Expansion. Virtually every one of them not only wanted to cut Medicaid Expansion, in most of the republican bills, they wanted to eliminate it over time, completely eliminate Medicaid Expansion, that somehow it was wrong, and i have to ask why. Why was it wrong that millions of people got their health care through an expansion of medicaid . Why does that why would anyone ever doubt that someone next to you who doesnt have coverage first and foremost and might have an opioid addiction problem, why is that person getting coverage and because they have coverage, insurance coverage, think can get they can get treatment for that terrible scourge that our country is going to be dealing with for decades, why is that the wrong thing to do . Why would taking that coverage away from someone with an opioid problem, why would that advance the interests of the American People . The answer is it wouldnt. It would set back the efforts to deal with a whole host of folks out there that are getting treatment today solely, completely because of Medicaid Expansion. And the last ill mention is our rural areas. I represent the state that had 67 counties and 48 of them were rural, and a lot of the rural hospitals in those communities are teetering on the edge already and have been for years. Not just the last several years. For many years. Teetering on the edge of collapsing. One of the fastest ways to ensure that more rural hospitals will close and collapse is to cut medicaid or to take away medicaid expassengers. That has an adverse impacts the likes of which we cant even begin to calculate because folks in rural pennsylvania will lose coverage if you decimate medicaid, if you take away Medicaid Expansion. But that doesnt end there. A lot of folks in those communities are getting treatment for an addiction issue or something related. They will be adversely impacted. Their families will, their communities will. But it doesnt stop there in a rural area. A lot of these rural areas, in my home state and its true all across the country. The biggest employer, or at least the second and third biggest employer in a rural county is often a hospital. In my state of probably 25 counties where the top employer in those 48 rural counties, about half of them, roughly, the number one or number two employer is a hospital. So cutting medicaid or eliminating Medicaid Expansion or sabotaging the Health Insurance markets or taking away the coverage of the Affordable Care act has health care consequences, has opioid Addiction Treatment consequences, and of course has a job consequence as well. If you cut medicaid in a lot of rural areas, you can lose a lot of jobs. As simple as that, and devastating though it is. So we have a long way to go to make progress on health care, and i hope, i hope that my republican friends would come together with us and work on lowering the cost of health care. Lowering the cost of Prescription Drugs. But they dont seem to be that interested in that. Some are intermittently, once in a while, but they dont seem to be interested because there is an obsession here in the senate on the republican side with decimating the Medicaid Program, ending Medicaid Expansion, and completely wiping out all the gains of the Affordable Care act. Now, that would be bad enough, but its doubly worse or its doubly insulting, i should say, when there is no plan for replacement. So what if a court of law, what if a federal court in the fifth circuit in the next couple of months says that the moving party here, the party that wants to declare the Affordable Care act unconstitutional, what if the Court Declares the moving party is the prevailing party, that they win . And lets say it doesnt go to the Supreme Court, but even if it does, lets say it loses there. What happens then to those 20 Million People who got coverage . What happens to the 150 millionplus who have coverage today, protections today that they did not have before the Affordable Care act . They were paying their premiums for years, if not decades. They had coverage for years, if not decades. Their children were covered, maybe, in their employer sponsored plan. But they didnt have much protection from a preexisting condition, in many cases, maybe not in every. They didnt have protections against lifetime limits or caps on annual the treatment can you get in a year or over a lifetime. And we had the bizarre and insulting and degrading experience where women were discriminated against in insurance because they were a woman. Being a woman was actually, in a sense, a preexisting condition. That made no sense. Are we going to go back to those days . Because a group of attorneys general wanted to change the law . And they couldnt prevail on the senate floor, or they couldnt prevail over time in the house or by way of what the administration would do, so they went into court and theyre going to just wipe out coverage for tens and tens and tens of millions of americans. Is that a good thing for america . I dont think so. I think that sends everything in the wrong direction. But unfortunately, thats not just theory. Some of its already happening. As i said before, gallup tells us seven million fewer people have health care today or at least as of january than did two januarys before then. So we have a long way to go to make progress on health care, but were not going to make much progress around here if we have a continual fight, and i would hope that some would agree to set aside the fight about repeal and lawsuits taking away coverage, and lets Work Together to lower costs, lets Work Together to lower the cost of Prescription Drugs in particular. Because i have to answer to a lot of families. One of them is one man we spoke to today, talked about his children. Matt stephanelli. Matts son has type one diabetes. We are from the same home county. He is worried not only about his own health care but he is worried about his sons health care. We have got to answer or have an answer and the answer, too, is to respond to situations like matts. Madam president , i will at this time yield the floor. The presiding officer under the previous order, the Senate Stands adjourned until 9 30 a. M