Transcripts For CSPAN2 U.S. Senate U.S. Senate 20240713

Vote vote vote the presiding officer are there any senators in the chamber wishing to vote or change their vote . If not the yeas are 83. The noes are 9. The motion is passed agreed to. Mr. Grassley madam president . The presiding officer the senator from iowa. Mr. Grassley ive got a couple of issues i want to speak on. One would be trade and section 232 issue. That would be my second one. The first one, i want to speak about commonsense entitlement reform. In the past year weve seen a flurry of drug pricing proposals. Im encouraged by efforts from my colleagues here in the senate, especially Ranking Member wyden, colleagues in the house that agree in the house of representatives who agree with this effort to reduce drug prices and the president of the United States who has already been involved for a year and a half in lowering drug prices. All have made lowering Prescription Drug costs one of the Core Principles of our efforts and particularly a core principle for this administration. Ive paid attention to each of the pieces of legislation that have been proposed and looked at their pros and cons closely. However, so far theres only one bipartisan proposal that cuts Prescription Drug prices, protects innovation, lowers what Senior Citizens will pay at the pharmacy counter, and also brings along with it entitlement reform. The Prescription Drug pricing reduction act of 2019 is the bill im talking about. It responsibly reduces Medicare Part d costs. But as with any widely encompassing piece of legislation, there have been some spirited debates around the different provisions of our bill. So im here today hoping to clear up some of the confusion surrounding a phrase that ive heard thrown around in this debate, price setting. Opponents of the legislation criticize the bill for price setting. The scare tactic associated with this claim is centered on one particular policy in our bill, matching the growth of government subsidies at drug manufacturer that drug manufacturers receive to the rate of consumer inflation. When i set out at the beginning of this year to create a piece of Bipartisan Legislation that had real and meaningful change, i knew that the focus had to be on individual americans. Thats why we kept outofpocket costs so that seniors can see relief. Thats why we banned spread pricing which games the Health Care System to the detriment of the beneficiaries and the taxpayers. Thats why we created a new way of paying for lifesaving but very costly medicare drugs. And thats why we kept the growth of subdis in Medicare Part d subsidies in Medicare Part d to the rate of inflaiption. Unlike other proposal, the finance Committee Policy does not tie the launch price to an artificially low price. The bill doesnt stop a drug company from recouping their research and Development Costs leading to more innovation. What the part d inflationary rebate does is really quite simple. After launching if a drug manufacturer chooses to raise the price above the rate of inflation, it has to return the difference for the drugs paid by medicare. This policy limits government subsidies to provide predictability for the Medicare Program and at the same time provide protection for the american taxpayer. Thats simply all it does. Any subsidies that the pharmaceutical companies would have received from an exorbitant raise in price is then returned to americans, not to line phar pharmas pockets. The inflation rebate incentivizes companies to stabilize their pricing and the taxpayers money is used more prudently and more efficiently. Youve all heard of the Organization Research organization and policy organization. Its one of the nations leading lib taition tearian and free market organizations. It praised the bill for its significant cost savings for the taxpayers. Now, does anyone really think a Libertarian Organization would endorse price controls. Its analysis of the bill, it said that this bill, quote, would not impose price controls. End of that quote. And a further quote, would reduce wasteful medicare spending. Cadol also acknowledged that these commonsense tweaks and im quoting from them these commonsense tweaks to a bloated Entitlement Program are encountering strong oppositions mostly from those who would not make quite as much money off of the taxpayers. End of quote. We all know that medicares finances are worsening. The program is projected to become insolvent within the next six years if we continue down this very same path. So getting back to my bipartisan bill, the grassleywyden bill will ensure that the federal government is using medicares budget to pay for lifesaving treatments in a fiscally responsible manner. This goal is not without precedent, so for those who say were acting in a nonprecedent way, were doing what they say is setting prices and i say it isnt setting prices, they forget that throughout the american Health Care System the government has at one time or another set up different ways to constrain high and rising costs. For example, states are not allowed to pay medicaid providers at a rate that is higher than medicare. Another example is in the Medicare Program. Medicare part a pays for the operating costs associated with acute inpatient care using the inpatient prospective Payment System or what is referred to as ipps. Congress enacted the perspective Payment System to constrain the growth of medicares inpatient hospital payments by providing incentives for those facilities to provide care more efficiently. Congress also requires that the concept of budget neutrality be applied to a number of medicare Payment Systems, including provider payments. In other words, its this simple. The government says if one provider gets an increase, another provider is reduced. Finally, the senate the center for medicare and Medicaid Innovation within c. M. S. Is required by statute to enforce financial controls on total medicare spending. The center for innovation can only test different ways to pay for services in medicare and medicaid if theyre expected to lower costs while maintaining quality. So this idea of using taxpayer dollars responsibly and in a targeted manner exists in many facets of the american Health Care System. So my point is this. While some call the inflationary rebate in part b a price control, i urge all of these members to consider how congress is using measures to contain costs currently. And isnt it the fiscally responsible thing to do when federal taxpayer dollars are being spent by those of us in congress. Shouldnt we do what we can to contain costs . After all, its not what hospitals, doctors, and pharmaceutical Companies May charge. It is about what the american taxpayer will pay for services. That doesnt fall into the category of price controls. At the markup of my Prescription Drug bill, the director of the independent Congressional Budget Office even agreed with me. I can continue to give examples of budgetary tools in the toolbox that congress uses in an attempt to fiscally to be fiscally responsible on medicare and medicaid. And i could also continue to provide examples of outrageous drug costs, but the bottom line of this bill is that the Prescription Drug pricing reduction act of 2019 is a win for americans across the board. Seniors will pay less out of pocket, taxpayers will know their money is being used appropriately, and drug manufacturers will continue to be able to innovate. That is why Ranking Member wyden and i strove to achieve these things in the very beginning, and i would urge my colleagues to take these considerations to their mind and hopefully my colleagues will support this legislation as a way of answering the concerns that constituents express in almost every state, at least in my 99 county meetings that i hold in iowa every year. Doing something about the pricing of Prescription Drugs comes up. Its got to be that way all over the country. Now i want to turn to trade legislation and i wont be as long on this point as i was on Prescription Drugs. When i resumed the chairmanship of the Senate Finance committee in january, i laid out my Top Priorities for the committees work. For international trade, my agenda included reviewing section 232 of the trade expansion act of 1962, which allows a president , without any input from congress, to impose tariffs in the same of National Security. For 11 months now ive been working with other finance Committee Members on both sides of the aisle to establish a separation of powers and checks and balances in the section 232 process. These two basic principles of our system of government are sorely lacking from section 232 as it stands today. Two of my colleagues on the finance committee, senators toomey and portman, each filed reform bills that are well thought out and both happen to be bipartisan. A full quarter of the senate has cosponsored one or more of their bills, including ten democrats, 14 republicans, and one independent. Many other senators have told me they too want to see section 232 reforms reported out of the finance committee. With a strong bipartisan mandate like that, ive been optimistic that Ranking Member wyden and i can reconcile the toomey and portman bills and hold a markup. More than once ive spoken publicly about my intentions to do just that, however, every time we get close to marking up a section 232 bill, senator wyden hears from stakeholders who are profiting from tariff production, meanwhile i get calls from colleagues who Say Something like this, and im paraphrasing, mr. Chairman, the president wont like us taking away his tariff law, and we dont want to make the president upset. Well, we hear that a lot, whether weve got republican or democrat president s on a whole lot of other issues, but we dont have to listen to the president of the United States. Were members of an independent branch of government to do our own thing, work with the president when we can and not worry about the president when we cant. Well, allow me to set the record straight on a few things i just set before you so far. First, as i said before, reforming section 232 is not about President Trump. Reforming section 232 means acknowledging that the 87th congress handed president jack kennedy enormous authority over trade in 1962 at the height of the cold war. President trump was merely following that 1962 law. In the process, he alerted us to the fact that congress has been too negligent in the past of protecting our constitutional responsibility of lawmaking. Our Founding Fathers were explicit in taking congress tasking congress with a responsibility over international trade, and its time now to rebalance section 232 in line with the Founding Fathers clear intentions. Secondly, ive been clear that im generally not a fan of tariffs, but i also want to make clear that ive agreed to senator wydens request to introduce a chairman or Ranking Members mark that does not unwind section 232 measures on steel and aluminum. Many problems with those tariffs and quotas have been well documented, but ive been in the senate long enough to know that getting things done requires compromise. Third, and to to all of my colleagues and everyone listening, i dont view 232 reforms as weakening the power of the chieftive. I view them as chief executive. As the Supreme Court told president truman, the office of president and the president himself is strongest when he has congress behind him. We need reforms to section 232 that make it clear where Congress Stands on National Security and trade. Such reforms would also make it clearer to our trading partners that when section 232 is used, congress sands with the president. Now, with these points cleared up, i hope to Ranking Member wyden, members of the finance committee, and our house colleagues will be ready to reform section 232. We have a strong bipartisan mandate to get to work, and this is likely just the beginning of a great deal of work that needs to be done to review our trade laws. Senator wyden and i have reported bipartisan bills out of the committee successfully in the past, and hopefully we can do it again for section 232. I yield the floor. A senator madam president. The presiding officer the senator from illinois. Mr. Durbin i ask consent to speak in morning business. The presiding officer without objection. Mr. Durbin madam president , i come to the floor today to discuss an issue that is important to my state, and i think every state. Illinois, which i represent, proud to represent, is a state with a Great American city of chicago, but many other towns and cities of variety and different sizes. I actually was born in downstate illinois, 300 miles away from chicago. And between the great city of chicago and the rest of our state, there are many small towns and rural areas. When you go into these areas and talk about the quality of life and living in small town Rural America, there are many challenges. Last week i was in calhoun county. One of the smallest in the state. We had an assembly of middle school and grade school and we had an announcement that the cooperative would bring the internet which they have been waiting for a decade or longer. It took longer to reach there. Im glad that the electric cooperative. Historically the electric cooperative brought electricity to america, and now they are bringing highspeed internet to Rural America. Its critically important for the students to learn that many People Living in the big cities take for granted. There are comments about people in small town america about access to health care. Because, you see, across our state we have millions of people who live in smaller towns, rural towns, who dont have the same Quality Health care nearby, whether its a hospital, doctor, or even a dentist. Across illinois five Million People live in areas with shortages, two million live in areas without a dentist, almost all of them live in an area without Mental Health providers, counselors, psychologists. The consequences speak for themselves. Only one in ten people with Substance Abuse disorders get the care that they need in these areas. 43 of Rural Americans do not have access to dentists 43 . Well, theres a federal program thats been addressing it for a long time and coincidentally the presiding officer from tennessee is the cosponsor of legislation which im going to address at this moment. Today theres a federal program in place called the National Health Service Corps. It provides loan forgiveness to entice doctors and other Health Care Professionals to serve in places of health care needs. In total, 10,000 doctors, dentists, Behavioral Health specialists, and nurses use the National Health Service Corps and treat 11 million americans each year in hospitals and community clinics. We entice them to come to these underserved areas to pay off their loans and you probably know doctors, dentists, nurses and others graduate with a lot of student loans. Illinois has 550 of these health nervous clinicians. But fewer than 75 serve in rural areas. As we face an Opioid Epidemic that touches every corner of america, no city too large, no tune small too small, no county too wealthy to escape it. We need that kind of help across the board in rural and urban areas and thats why i teamed up senator blackburn of tennessee with legislation called the Rural America health care act. Our bill will expand the current Corps Program to provide new loan forgiveness, funding providers for those who will serve in rural areas in tennessee, illinois, and across the nation. It provides funding for five years rather than the usual two to ensure doctors, dentists and nurses plant their roots in Rural America. With the National Health corps up for reauthorization this year, senator blackburn and i are pleading with our friend, senator alexander of tennessee and senator murray of washington to promote this rural focus. It isnt the only thing i looked at when it comes to Rural America. I recently introduced a bill with senator roberts of kansas. He is the chairman of the Senate Agriculture committee. He agreed to include in the farm bill something called the siren act. The siren act provides funding to support rural fire and e. M. S. Agencies with training an recruiting staff and purchasing equipment. Everything from naloxone to power stretchers. I recently visited a county in illinois, navue illinois, which is where a man named mr. Kennedy came forward, and told me about the need for new modern equipment in this area of hancock county. Because of what he told me, the bill passed and we will make this available for the emergency analysts to have the right training and equipment when needed. This is important for Rural Health Care, but we also have to maintain the structure of our key health programs. Thankfully illinois has expanded the Medicaid Program through the Affordable Care act, which has provided a funding lifeline to keeple many of our rural hospitals from the brink of closure. It also expanded Health Insurance to one Million People in illinois. Ten years ago, when we passed obamacare, the Affordable Care act, too Many Americans did not have Health Insurance. If you have ever been at a moment in your life where you were the father of a sick child who desperately needed medical care and you had no Health Insurance, you will never forget it as long as you live. I know. Ive been there. It made an impression on me as a young father that i have never forgotten. So when this halved, Affordable Care act passed, Affordable Care act, i knew it would give people access to Quality Health care. This week marks the opening of the open enrollment for the Affordable Care act which ends on december 15. It is vital that everyone signs up at healthcare. Gov. Most patients will find their premiums are less than 100 a month. And if youre in certain categories youll get a lot of help making that payment. What i hear from constituents has nothing to do with what i mentioned. I listened to my friend from iowa, the republican senator Chuck Grassley talking about an issue that each of us runs into in every state in the union. Heres the question, if you ask the American People what is the issue that youre concerned about from an economic viewpoint that you think the congress can do something about, 90 of democrats, 90 of republicans, 90 of independents all come back with the same answer. You know what it is . The cost of Prescription Drugs. People understand that these Prescription Drugs are so expensive, theyre beyond the reach of many people who desperately need them. Now there was a senator from wisconsin years back named william proxmire, and he used to issue monthly recognitions of the most flagrant, excessive examples of waste in federal government. He called it the golden fleece. Earlier this year i launched a series of awards to carry on senator proxmires work with a focus on the pharmaceutical industry, the people who make the drugs. This month i have this sign produced as a way of notifying the world. This month the pharma fleece award is going to the drug industrys trade group pharma and the trump administration, im afraid, for a giveaway in the new nafta trade bill. What does the trade bill have to do with pharma or the price of Prescription Drugs . It turns out that pharma boy, theyre good managed to sneak in a provision in this trade bill that most members of congress are not even aware of. This new trade agreement, as you might expect, involving canada, mexico, and the United States, covers a wide range of issues. My farmers are very excited about it. The men and women in labor unions are concerned about it. But it falls far short when it comes to labor and environmental protections. Theres a lot of work that needs to be done. But the one provision that i want to highlight today is tucked inside this sprawling document. Its a provision that guarantees monopoly protection for pharmaceutical companies by blocking competition, generic drug competition. And it means that these companies can continue to call for skyhigh Prescription Drug costs. This is just another example of an issue that the president said during his campaign was a high priority, and we all talk about it on the floor of the senate, as being sneaked into this new nafta trade bill. Lets remember the top four Drug Companies avoided paying 7 billion in taxes last year. 7 billion. And were able to buy back another 30 billion in stock, thanks to President Trumps tax reform package. Compass very kind it was very kind to pharma, not that they need it. Americans already pay the highest prices in the world for Prescription Drugs, four times whats paid in canada or europe. So why would the administration agree to put a provision for pharma to guarantee high prices into the new nafta trade bill . Listen to the story. In 2017, for example, canadians could purchase a years supply of humira. Recognize the name . You should. Its the most heavily advertised Prescription Drug on television. Humira, made by a company in illinois. Its used for a disease of psoriatic arthritis. Canadians can buy a years supply for 20,000, not cheap. You know what americans pay for exactly the same drug by the same company . Over 40,000, more than twice as much as the canadians. Why . The canadian government cares. They said to ad vee, were going to protect our families and our Health Care System. The United States often doesnt. Often pharma charges as much as they can get away with by eliminating patent and exclusivity drugs for competition. Drugs known as humira, patuxen are made from living organics. They make up 2 of all the prescriptions sold but they account for 37 of the cost of Prescription Drugs. Very expensive drugs. Those three biologics have all been on the market for more than 17 years, and yet they are still the top seven highest grossing drugs in america. Due to the fortress of monopoly protections that pharma has created. Now listen closely. Under u. S. Law, buy logics, like buy low jibbings are given a 12 year exclusivity period. What does that mean . No one can compete with them. They own the market. They set the price. That means that a cheaper generic competitor cannot be approved by the food and Drug Administration in the United States for more than ten years while the branding company is free to charge whatever it wants. Wonder why prices are high . Theres no competition. I believe the standard is too high, and ive cosponsored legislation to reduce this period to no more than seven years. Canadas exclusivity period is eight years. Mexico doesnt even have one. But now lets go to the new nafta trade agreement. Lets look closely at the fine print that pharma included in that. The administration wants to enshrine our pharma friendly laws by setting a tenyear exclusivity floor for all three countries. Its a virtual guarantee that pharma, when it comes to biologics will be able to charge whatever they wish for ten years or more in canada, mexico, and the United States. Why is that in the trade agreement . If all of us agree that Prescription Drug prices are too high, why are we putting into this nafta trade agreement a sweetheart deal for pharma so that they can charge higher prices not just in the United States, but in canada and mexico . This new nafta has provisions that would encourage Drug Companies to obtain excessive numbers of secondary patents that delay generic competition and keep prices high. So when my farmers come to me and say why arent you for nafta . I say if it were just about farmers it would be a pretty easy call, but its about american families, canadian families, families even in mexico paying higher prices for Prescription Drugs because of a trade agreement that the president wants us to approve. We should be working to bring lower cost products to go markets sooner, not allow pharma to sneak a payday into a trade package at the expense of american families. It should come as no surprise that the Main Coalition running ads supporting the approval of nafta is the pharmaceutical industry of the United States. In fact, pharma and bio, the two largest pharmaceutical associations, have already spent 30 million lobbying congress to pass this new nafta. Now we know why. For all the president s talk, this provision in this trade agreement is a trojan horse giveaway to big pharma at the expense of american patients. I guess we shouldnt be surprised, but ill say this. If members of congress, democrats and republicans, house and senate, are listening to the people they represent back home about the cost Prescription Drugs, they wont fall for this new pharma fleece. Madam president , i yield the floor and suggest the absence of a quorum. The presiding officer the clerk will call the roll. Quorum call the presiding officer the senator from alabama. Mr. Jones madam president , i ask that the quorum call be suspended. Unanimous consent. The presiding officer without objection. Mr. Jones thank you, madam president. Madam president , it is not often in floor remarks that we can often hit a trifecta on topics that are uniquely connected, but i am fortunate enough to have that privilege today, and they all center around the glorious peanut. To start with, i want to honor the National Peanut festival currently being held in dothan, alabama, which recognizes the importance of the peanut industry to the state of alabama and to the United States. Every year dothan hosts the nations largest peanut festival to honor local peanut farmers and to celebrate harvest season. The festival began in 1938 and has been held annually each year except for about five years during the hiatus during world war ii. This years festival is a tenday long extravaganza with food, fun, entertainment. You name it, you can find it in dothan during the peanut festival. It is one of the most popular events in alabama each year. In 2017, the festival broke attendance records with over 200,000 people joining the fun. Unfortunately my schedule has forbidden me from being down there this week, but i wish i had been there. I wish i could go for the end of this because it is a glorious time. Last week i introduced a resolution here in the senate to pay tribute to the National Peanut festival and to the importance of peanuts in the state and the entire country. Over 400 Million Pounds of peanuts are produced every year in alabama alone. Nearly half of all the peanuts in america are grown with 100 100mile radius of dothan, alabama, where most of those peanuts are processed. It is no wonder that the city of dothan in southeastern alabama in the corner, on the border of georgia and florida, is known as the peanut capital of the world. The peanut industry is a critical part of alabamas economy. In 2018 alone, the 400 Million Pounds of peanuts produced by Alabama Farmers was valued at 118 million. The farm value of the nations peanut crop is over 1 billion. Like all farmers, peanut farmers have their share of challenges. But year after year the peanut farmers in alabama and across the country persevere, providing a crop whose importance is often simply taken for granted as, well, as peanuts, as it pertains to our overall economy. But the peanut is an important staple to the agriculture and food industry, thanks in large part to the amazing and extraordinary work of a scientist, an African American scientist, an adopted son of alabama, dr. George washington carver, who did his work at one of alabamas great hbcu, Tuskegee University. Dr. Carver was born into slavery but raised by his former master once slavery was abolished. He was forced to attend segregated schools until 1891, when he was accepted as the first black student at iowa state university. Only five years later, in 1896, dr. Carver was hired by the great booker t. Washington to head the Agriculture Department at tuskegee institute, now known as Tuskegee University in tuskegee, alabama. At that point peanuts werent even recognized as a crop in the United States. But because of a serious threat to the souths cotton crop from boll weevil infestation, dr. Carver suggested Alabama Farmers start growing peanuts in an alternate year which he believed would restore and add knew tree yents to the knew tree yents to the soil. It worked. He ended up inventing over 300 products made out of peanuts, including peanut milk, peanut paper, peanut milk, although he did not invent my favorite, peanut butter, but 300 different types of products made from peanuts. In 1921, in a highly unusual circumstance in the era of jim crow, dr. Carver testified regarding the value of peanuts before the ways and Means Committee of the United States house of representatives. An African American scientist in front of the United States house in 1921. In 1938, again during the jim crow era in alabama, dr. Carver was the featured speaker at the first peanut festival in alabama. Peanuts became more and more popular and by 1990 they became one of the top six crops in the United States, all in large part due to the work of dr. Carver at Tuskegee University. It is not an overstatement to say that dr. Carver, Tuskegee University, and the peanut helped save the economy of the south. And this, my friends, is just one example of the extraordinary contributions that hbcus have made to our country over the years and continue to make today. But as weve talked about for some time, including with my friend senator cardin earlier today, those contributions are threatened because of the expiration of federal funding that occurred at the end of september. Ive been pushing for the passage of my bill, the future act, which would renew funding for hbcus and other minority serving institutions that expired at the end of september. We need to continue to invest in these institutions and ensure that they have consistent funding. We have worked with this bill, the future act, to make sure that the concerns of others, particularly those that might object to the u. C. That weve asked for on the future act, to make sure that this is not some federal budget gimmick. We very answered those concerns. Weve answered all the payfor concerns, and all were asking for is consistent funding because planning is as important as the money now. Yes, the department of education has told hbcus that the funding would be there through september, but by the spring those institutions have to start planning. They have to make sure they have the necessary resources for the fall and beyond and if they are funding is set to expire at the end of next year, they cant make those plans with their teachers as well as their infrastructure. We need to continue to make sure that those hbcus are funded consistently and appropriately. So lets make sure we put aside any differences and make hiewr those funds are available to that our great hbcus and minority education institutions can continue to plan. We need to honor the legacy of dr. Carver which is why i was so proud to introduce a resolution honoring the peanut industry in the state of alabama its a testament to the importance of the peanut and its time to celebrate its history for our state and the peanut farming way of life. Im hoping with the advancement of peanuts, allergy research, that we make sure that more people can enjoy what so many of us can. I understand that peanut allergy is a real problem for people around the country and around the world. But advances in research that are going on right now right now can make sure that we break through and that all who want to can enjoy the value and the taste of those wonderful peanuts. I am not going to go through specifics. I can name all manner of products. I wont do that here today, madam chairman, but i thank you for this opportunity and i yield the floor. A senator madam president. The presiding officer the senator from wyoming. Mr. Barrasso thank you, madam president. Madam president , i come to the floor today to discuss the global fight to end poverty. And specifically the problem of Energy Poverty. Now, the numbers paint a very grim picture. Worldwide 840 Million People are living without electricity. They cant cook or heat their homes safely or repliably. In reliably. In fact, three billion people worldwide rely on wood and waste for household energy. So what should the United States do to help . Well, first and foremost, i believe we should push Multilateral Development banks, like the world bank, to invest in Affordable Energy products which will help these people. The world banks mission is to plift people out of poverty to lift people out of poverty. Thats their mission. Specifically it seeks to end extreme poverty while promoting shared prosperity. So for 75 years the United States has been working with the world bank to help developing countries grow. The United States remains the world banks largest contributor. Every u. S. Dollar at the world bank should make a difference for people in the developing world. The world banks new policies, however, lead me to call for a review a review by the United States of how u. S. Dollars are being used. Several years ago the world bank decided to stop financing certain projects, specifically oil, gas, and coal projects. So im concerned that the world bank is now blocking Affordable Energy development, energy thats needed to make a positive difference for so many people in the developing world. Traditional fuels are a vital tool for escaping Energy Poverty, yet, with the policy change at the world bank only Energy Renewable projects qualify for funding. It seems they are putting their liberal agenda ahead of our antipoverty mission. So the question is, does the World Bank Still want to help the People Living in poor nations today . Thats the question. And, if so, they should be helping with the use of abundant and Affordable Energy resources. If not, then the United States, i think, must reevaluate our support for the world bank. Heres a case in point. The bank restricts the financing of high power efficiency fuel stations with coal. They failed to honor its commitment to kosovo. They pulled their funding from the state of the art facility there. They dont have enough energy to grow the way they are prepared to do. Kosovo has the fifth largest coal reserves in the world and kosovo desperately needs to retire its older facility. I saw this first hand, madam president , last month when i visited members of the wyoming National Guard stationed in kosovo. This is unacceptable. So what are other countries doing . China and russia, let me tell you, mawd they are increasing in carbonbased energy projects. So the world bank is saying, go ask china and russia. South after is d africa is working with china on their coal powered plants. They are dependent on these countries and undue political influence. Now, a number of members of the senate share my concern. On thursday i led a group of a dozen senators in urging the world bank to lift these harmful restrictions. My letter to the president of the world bank was cosigned by boozman, enzi, hoeven, johnson, kennedy and thune. Together we are pressing the world bank to recommit to an alloftheabove energy strategy. Developing countries desperately need affordable, reliable energy. And, as we say in our letter, People Living in poor and developing nations, they want and they need a Stable Energy supply. They are looking for Power Generation that provides energy security, that helps create jobs, and that improves their lives. The people back home in wyoming know first hand the benefits of developing Abundant Energy resources. The United States is a top Global Energy producer. Wiej has played a wiej has played a key role in this success. We have created millions of new jobs. People who are struggling worldwide to strive an survive in developing countries deserve that opportunity. As an energy powerhouse, america can help empower our allies and our energy exports. As global philanthropist bill gates has said, quote, increasing access to electricity is critical to lifting the worlds poor out of poverty. Let me repeat. Increasing access to electricity is critical to lifting the worlds poor out of poverty. Ultimately, the solution to Energy Poverty doesnt lie in limiting options, but in using all available options. In pursuit of its mission, the World Bank Must embrace, not seclude abundant exclude Abundant Energy resources. So lets work together, madam president , to end Energy Poverty now for the 800 Million People on the planet living without electricity. I yield the floor and suggest the absence of a quorum. The presiding officer the clerk will call the roll. Quorum call quorum call a senator madam president . The presiding officer the senator from kansas. Mr. Roberts madam president , i would ask if we are in a quorum call. The presiding officer we are. Mr. Roberts i would ask unanimous consent to vitiate the quorum call. The presiding officer without objection. Mr. Roberts thank you. Madam president , about a month ago, the headline here in one of the one of the publications that people Pay Attention to, Senate Republicans amp up pressure for an omscut vote. Omscut is an acronym on the new trade agreement between mexico and canada and the until. I initially thought it was United States marine corps always but thats not the case. About nine of us came to the floor and pointed out this was imperative. And that if we were going to have a new trade agreement to replace nafta, if we can get at least some price recovery and also make some progress with regards to canada, mexico, historically great trading partners, it might be a good thing to get usmca passed. That was a month ago. We were ensured that particular time by voces in the house of representatives, our colleagues over there, they would do everything in their power to see if we couldnt get it done. Its not done. Still is not done. Stale farmers and ranchers and growers and everybody connected with agriculture and for that matter trade is certainly been waiting and waiting and waiting and waiting and times in farm country as i think most people know are pretty rough these days. At least passing usmca would be something everybody could agree to. So i rise today in support of the United Statesmexicocanada again one month later. It is time to move forward and pass this important legislation now. Now. Thats my acronym for right away, yesterday. As chairman of the Senate Agriculture committee, i want to talk about my producers in kansas but all producers throughout these United States and across the country. Time and time again we have asked why there is a delay and farmers tell me that time and time again they wonder what on earth is going on back here. Thats obvious to everybody with the i word over in the house. But even with that, this is a situation where both the administration, house members, both sides of the aisle if that were brought up to a vote it would pass. More especially since our trade ambassador Robert Lighthizer has been working with my colleagues across the aisle over there in an effort to settle labor issues and also environmental concerns. Ive been down that road before. The honorable lagarza, the late lagarza but a wonderful man who was chairman of the house agriculture committee, i was the Ranking Member there, became the chairman, and we worked on nafta, writing that bill. So we would revert to that bill but after months and months and months and months and finally agreement between canada, mexico, and the United States and we were ready to do this, it has to go to the house of representatives. Ambassador lighthizer, bob, used to work for bob dole, good friend of mine, has been working with democrats over time on these two issues and tells me that hes pretty close to a deal. Except that were not. Now, ambassador lighthizer on behalf of the administration is not going to send this deal, if you will, or this trade agreement to the house unless that there is a clear intention that it will be brought up. Doesnt want to be held hostage. So the house has to move. I just want to continue to point out that usmca, the trade agreement, will not only increase Market Access for farmers and provide new new opportunities for dairy, for poultry, for ag producers, for all commodities we talk about, wheat, corn, et cetera, but it will also address longstanding that will help our farmers export wheat to canada. It used to be the case to mexico. The kansas winter wheat once harvested would get on the kansas city railroad, down to mexico and sell the wheat to mexico where they sorely needed it. It was a Good Business exchange, an agreement. That has pretty much dried up. Let me go back to 2017. Thats probably too far. Im thinking probably 2018 might be better except we have had some problems with our entire trade policy. At that at that tinge time, particular time 110,000 jobs were supported by canada and mexico. While many of those jobs are spread across all sectors of the economy, many are tried to tied to the agriculture value chain. Thats what we say from farmers, ranchers, and growers to the consumer. In total kansas exports 4 billion of products to canada and mexico each year, 800 million from agriculture alone. It is nearly impossible for me to state the importance of this to my home state of kansas. We are not going to experience this were in a lot of trouble in farm country. The least we could do is consider usmca where we know we have the votes to pass it in both chambers, both in the house and the senate. In fact, the call for congress to get moving on this trade deal as united more people from different political and professional backgrounds than almost any other issue in recent memory, including organized labor. I recently started a web series, if you will, trade tuesday, to give a platform to the many constituents who have voiced their support to me, pat, mr. Chairman, where on earth is the usmca bill . We featured farmers and manufacturers from around kansas including rich felts, a great friend of mine, the president of the kansas farm bureau. And rich hit the nail on the head. He said, we are an exporting state. We produce much more than we are ever going to consume in kansas, and if we want to grow our economy, specifically our economy in the state, we have to export the excess commodity. I think its easy to say we want trade. We dont want aid, and this is going to be a step in that direction if we can get this passed by congress. I could not agree more. With rich on the importance of this trade deal to farmers and producers in kansas. Its just not only the agriculture industry interested in getting usmca across the finish line. Weve also featured jason cox, the president of cox machine inc, a Small Company based in wichita, kansas. He said recently, and im quoting here, trade is very important to our business, both on the raw material supply side as well as the selling side. This new trade agreement is important for us to help lower the cost of raw material that we buy and pass that savings along to our customers so we can produce more work and produce more goods and also jobs. Look, my colleagues, its been nearly a year since President Trump and the leaders of mexico and canada signed this new trade agreement. November 30, 2018. We are running out of time to get this deal done for folks like rich and jason, many other workers whose livelihoods depend upon trade. There are deadlines, we get past the deadline and go back to the original nafta bill, which i look back and my public career was helpy to work with the former chairman of House Ag Committee in helping to write nafta at that time. As a result, the ag sector has grown by leaps and bounds, and not only producing enough food and fiber and other markets to our consumers, but to a troubled and hungry world as well. We need this new trade agreement. I sincerely hope my friends in the house can quickly come to an agreement with the administration so that we can all do whats right by our constituents and get this bill passed this year. I will point out that the ag chairman in the house is a veteran, hes a friend of mine, and mike conway is the Ranking Member, same thing. They are for usmca. Its a bipartisan thing in the ag committee over there. I would also give a shoutout to Robert Lighthizer, who is our ambassador, who has been meeting constantly day in, day out trying to iron out any labor or environment portions of this trade agreement where we have some holdup. Were not going to go anywhere if we can if we continue to insist on these kind of requirements, madam president. Its that you know, these are sovereign countries. These are our neighbors. For us to try to dictate labor standards and Environmental Standards for them is little much, but i understand thats where we that thats what we have to do. I i dont know here what more we can do. I could come to the floor every day. That would be probably not really appreciated by a lot of folks. But i can say that we had nine senators here before. I think we could get a mutual agreement to say, hey, lets get this thing done. Lets separate it out from all the goings on that is happening in the house of representatives today. I hope speaker pelosi, she knows about this. California depends on this big time, and as speaker and representative of the entire United States, im not trying to lecture her or point fingers at her, but she knows exactly what the situation is. If she would just send a signal to ambassador lighthizer and we would send that trade pack up and get a vote, i think it would pass overwhelmingly. And at least we would have something that we could claim that we are doing on behalf of our farmers, ranchers, and growers and everybody that is supported by the agriculture industry. Madam president , i yield my time. The presiding officer the senator from west virginia. Mr. Manchin madam president , i come again to speak about what i think the inequities and the unfairness in the system that we have to American Workers. American workers, businesses, and the economy are the envy of the world many we are in the United States and have been throughout the history of our country our citizens have believed that through hard work and dedication, they could achieve the american dream. Unfortunately, that is not always the case, as we know. For millions of americans they worked hard, played by the rules and trusted the companies they worked for to keep their end of the bargain. That is the pension. These peg pensions are these pensions are modest. For 1. 5 million americans, that security has been pulled out from under them. While after working hard for years an forgoing a portion of their paycheck, this is their money matching their employers for their pensions, they either lost or got their pensions cut in half. How does this happen . Every paycheck, which is 10. 6 million americans, put a portion of their paycheck into a pension account with a promise and trust that it will be there when they retire. The same people forgo pay raises, bonuses and personal retirement accounts because they believe their pensions will be there until needed. Unfortunately that trust is often broken when investment firms swoop in during the bankruptcy process. They cherry pick at the remains of a company, cannibalizing its most lucrative assets and putting the profits before the people. Through no fault of workers in america, companies are able to use their pension money for whatever they want when they declare bankruptcy. Think about that. All of your life youve been working, 20, 30, years or more and you thought it was secure and all of a sudden through the bankruptcy laws, they are able to take your money and use it for whatever they want to now because they declared bankruptcy and gone through a proceeding. Under current law when companies declare bankruptcy, they can use their companys Pension Funds to pay legal costs and debt. I will repeat that. They have the ability to use the workers pension, your money, workers money, to give the executives, who should be held responsible for the company doing as poorly as it has done, to get bonuses to pay for legal costs and debt. For the last few decades investment firms have ma lip lated manipulated chapter 11 to skirt pension obligations to maximize profits. Under current law investment firms can target companies through chapter 11 bankruptcies, sell off all of the companys valuable assets and live the pension plan in a worthless corporate shell while paying handsome bonuses to their executives. While congress has allowed the exploitation to occur through bankruptcy, millions of workers have lost their retirement security. Workers and retirees did not set the amounts that each company contributes to their pension plans, the terms of the plans or the loopholes in the bankruptcy laws. Those actions were done here in the halls of congress. As such, it is now the responsibility and duty of congress to stop the Financial Engineering and close of the loopholes of our bankruptcy code. Let me just talk about one company that affects my state vastly is the last week the largest private coal company in the United States, murray energy, filed for bankruptcy, making it the eighth coal company in the past 12 months to do so. Like so many Coal Companies did before, they planned to skirt their pension object qaition gaitions, give their executive bonuses and pay off legal fees. They even named coal miners as liabilities. I dont know about you, but i dont know how any company could label their employees as liabilities. Murray energy has contributed 97 going into the fund annually with murray bankruptcy filing, their pension fund will become insolvent even faster. Once the u. M. A. Pension fund becomes insolvent, this crisis will snowball and impact every other pension fund in america. Im going to talk about a couple of cases to put it in perspective. I think everyone will be able to follow this much easier. I will talk about sears and robuck that we all knew growing up and we used to do most of our shopping there. And this information im giving you, and im going to explain, comes from a complaint filed by sears itself in the Southern District of new york in january of 2019. This is the old sears filing against the new sears, the takeover sears. This type of Financial Engineering and ex exploitation occurred at sears over the last couple of years after merging with kmart, sears started to buy back its own shares instead of investing in its already run down stores. Lambert transferred 245 parcels of sears most valuable real estate to an Investment Trust and then leased the properties back to sears. In 2017, sears paid the Investment Trust owned by mr. Lambert 117 million in rent for use of its former property. Under lambert and e. S. L. , sears closed over 3,500 stores, slashed roughly 250,000 jobs, and saw its Share Price Fall from 193 a share in 2007 to less than 1. I repeat 193 a share in 1997 to less than 1 a share. In 2018, sears no longer possessed enough assets to pay off its creditors, especially the pension obligations. Those pensions are in the hands of the pension guarantee corporation, and it owes the ppgc more than 1. 5 billion. Recently Sears Holding corporation, the corporation, filed a lawsuit against former c. E. O. Lambert alleging that he transferred more than 2 billion of cash and real estate to himself and other shareholders in the years leading to the retailers bankruptcy. Thats all been done what they consider legal. This is friendlys. Friendlys an ice cream corporation. And this comes from the pbgc complaint opposing their plan for reduction. This is the pension that rerun in this country, the federal government and they put this complaint against their restructuring, the same scheme played out with them in early 2000. In 2007, sun capital partners, a private equity firm, purchased friendlys for 337 million, trying to weather the great recession. S suns forced friendlys to close 36 stores and take a loan. At at that point sun capital was the owner and major creditor friendlys. That gave the firm loanch in its bankruptcy firm much of its bankruptcy to sell its assets to one sun capitals affiliates. At the end of the bankruptcy, most were owned by sun capital affiliate free and clear of any pension claims. Those unfunded pension obligations totaled 115 million and are being assumed by you and i, the taxpayers. Theres nothing fair about nil of this that i just any of this that i just explained no matter how small or how large. Weve allowed this to happen. Back in the 1980s when the bankruptcy laws were changed, i dont think there was a member here that intended for this type of shenanigans, this type of robbery and thievery to go on in america. Its happened for far too long and we have a chance to change it. As the bankruptcy laws continue to allow this exploitation, there remains a lowprofile Government Agency that is pivotal to the federal governments efforts to protect the pension benefits for thousands of American Workers and retirees. The Pension Benefit Guaranty Corporation collects insurance premiums from companies that offers pensions and provides a portion of the loss benefit to affect retirees when a pension fund runs out of money. Its insurance background that the federal government has backed up and the companies are paying into that thinking theyre going to be in good standing. Overall the bbbg covers the benefits for about 44 Million People, 44 million workers. However, the p bbc has come under financial pressure as more shed their pension debts through the bankruptcy code. There is a 90 chance that the Union Insurance program will run out of money by 2025. Leaving it unable to protect pensioners in need. If the exploitation continues and ppgc is left holding the check for bankrupt companies, taxpayers will for the first time in history, we taxpayers will be for the first time in history be on the hook for pensions that were evasively disregarded in exchange for Investment Company profit or robbery. If the ppgc becomes insolvent, taxpayers will be on the hook. Listen to this figure. We as taxpayers will be on the hook for 479 billion over the next 30 years if we allow this to continue. Thats why im introduce have introduced legislation that will reform our bankruptcy laws. Its called the slap act, stop lewding americas pensions and thats exactly what weve allowed to happen for so long. It will ensure that companies can no longer exploit loopholes in the bankruptcy code, to skirt their pension obligation to workers and retirees. My bill will change bankruptcy laws to increase the priority of workers during the bankruptcy proceedings of the workers proceedings. The workers are the first priority. What were doing for the first time is making sure the wage easterner, the worker is at the front of the line, not the back of the line. If bankruptcy occur, i guarantee you all the different reorganization groups that come in, all the different financial groups will be on the front line and the worker is left with nothing. This reverses that procedure. So its a sad day when American Workers across the country for decades put their life into a company and are denied their pensions due to corporate greed. Madam president , i keep hearing c. E. O. s talk about Corporate Responsibility and im so thankful to hear that word, Corporate Responsibility. Well, this is a step towards putting those words into action. I would like to see the responsible corporate heads of american industry step forward and help us with this needed change. We have to put our workers at the front of the line. And i would like to see that done sooner than later. Sol i thank you, madam president. So i thank you, madam president. I yield the floor. A senator madam president . The presiding officer the senator from utah. Mr. Lee madam president , i rise today to honor one of utahs valiant citizens, to honor Major General jeff burton. Adjutant general of the utah National Guard and pay tribute to him for his many years of devoted service to our nation and to the great state of utah. As general burton closes a long chapter of 37 years of military service, he leaves behind a tremendous legacy as an American Patriot and as a true servant leader. So id like to take a moment to talk about general burton today. From a young age general burton knew that he wanted to follow in the footsteps of a number of his family members by serving both his faith and his country. He served a mission for the church of jesus christ of latterday saints on a canadian indian reservation, braving harsh conditions that would well prepare him for his future of military service. As soon as he returned home, he enrolled at Brigham Young university where he enlisted in the National Guard as an artillery field soldier. He joined the rotc program receiving a commissioner as Second Lieutenant in 1984. He completed tours with the u. S. Army military police corps in alabama with the Fourth Infantry Division at fort carson, colorado, and with the 7th u. S. Corps in germany where he witnessed the fall of the berlin wall. In 1991 general burton left the army and returned home to join the utah National Guard where he served in a variety of distinguished leadership positions over the next decade. Chief among them was a position that involved commanding the 1457th engineer combat battalion during Operation Iraqi freedom as part of the initial ground war in that conflict. He and his troops were tasked with searching for and eliminating explosive device, improvising and improving whenever necessary, figuring out ways to strengthen security in and around the u. S. Embassy. And of course responding to bombings and other acts of terror. They were often the first ones on the scene of an explosion. In honor of his Heroic Service there, he was awarded the bronze star. General burton was appointed special assistant adjutant general of the utah National Guard in 2008, promoted to Brigadier General just a few months later and then made Major General and adjutant general in 2012. In this role general burton has trained and equipped more than 7,000 soldiers under his command and helped them prepare to respond to challenges in both military life and in their personal lives. Hes prepared them not only to fight our nations wars and provide military support to our troops throughout the world but to combat wildfires, respond to natural disasters, and ensure law and order in our communities. Under his leadership theyve performed at an absolutely remarkable and indeed exceptional cal bar. When the 100,000 soldier surge in afghanistan ended in 2012, he was also responsible for overseeing the needs of the soldiers returning home from war. He rose to the challenge tending both to the physical and emotional needs of those warriors and to their families with utmost care. As he himself has once said, may we make a silent promise to keep the faith with our battle buddies and wingmen. May we i strong for one another and unashamedly rush to those in need of aid. May we never forget those who have given the ultimate sacrifice within our formations so that we might live in freedom. Close quote. General burton has lived by these words over his long and dedicated career. Every day he keeps a note tucked in the band of his hat. And that note contains the lists of the soldiers who were killed in combat or during 9 11 under his command. Hes led by example. Never asking of his soldiers something that he himself has not done. And hes led in order to serve, striving always to protect the welfare of his command, of our country, of the United States constitution, and of the freedoms that it protects. And so its only fitting that we honor him today. On behalf of our nation and all utahans, i thank general jeff burton for the sacrifices he and his family have made to secure the freedoms that we hold dear. I congratulate him on this occasion and wish him many happy years ahead with his wife and their children. Thank you, madam president. I yield the floor. A senator madam president . The presiding officer the senator from utah. Mr. Lee i wish to speak briefly regarding a tragedy that occurred just in the last 48 hours. A tragedy that occurred in the northern mexican state of sonora, a tragedy in which a handful of u. S. Citizens, the precise number of victims are still not known but a number of u. S. Citizens were murdered in cold blood. This attack was afflicted in a most grew so manner and was carried out against a group that included men and women and children. My thoughts and prayers go out to the families and loved ones of the victims. My thoughts and prayers are also extended to the administration of president Lopez Obrador in mexico whose inauguration i attended just a few months ago. This is a sobering task to have to identify the source of such a heinous and barbaric crime. I have every expectation, every hope and every confidence in those who were assigned on both sides of the border to investigate this crime, figure out who did it, and to bring those responsible to justice. Mexico is a Good Neighbor to us. Weve got about 1. 6 1. 6 billion or 1. 7 billion every day that crosses over our shared southern border. Mexico has been a Good Neighbor, a solid trade partner, and a country with which we share many interests. It is a country that desperately needs our prayers right now and our help and our assistance. Its been publicly reported that President Trump and his administration are eager to help president Lopez Obrador in combating and detecting whoever was responsible for this heinous crime and bringing them to justice. I hope and implore the Lopez Obrador administration to accept President Trumps generous offer to help. This is not an easy task. If in fact this was an act as it appears quite possible to have been of a mexicanbased drug cartel, this is a big problem. Its a big problem either way. These drug cartels are no small threat to the safety and security not only of the people of mexico but also of the people of the United States. Think, madam president , about what would happen, imagine someone sees in their nextdoor neighbors backyard a poisonous snake, a poisonous snake thats big and is headed toward its property. Is that neighbor going to stop and ignore the snake . In many circumstances that neighbor is going to take action. He might not wait until his neighbor comes home and gives his go ahead to take care of that snake. Why . Because the snake is headed towards his own backyard where his own children are playing. This is not something that we can trivle with. This is a matter of utmost serious for the safety and security not only of the mexican people but also of the people of the United States. I applaud the Lopez Obrador administration for its efforts to root out corruption and to bring justice to the drug cartels. This brazen attack within the last 48 hours signals a need to do more. This is why im so grateful that President Trump, that he was willing to reach out and offer the assistance that can be provided by the United States. I urge president Lopez Obrador to accept it and to do so very soon. Thank you, madam president. A senator madam president . The presiding officer the senator from north dakota. Mr. Cramer thank you, madam president. First of all ive never come to the floor of the senate or the house previously as ilprepared as i am for this. I want to follow up on something that my colleague from utah just spoke about. That was the attack on these innocent people in the last 48 hours. When i learned of it last night, i was stunned. But i just got off the phone a few minutes ago with the brother and sister of one of the victi victims. A young mother, nita miller was killed along with her four children. They were in the first s. U. V. That was shot up and burned. They were on their way to phoenix to pick up their dad from north dakota, howard, who was working on an oil rig as this occurred. I just talked to howards brother kenny and his sister heather. All of the millers and the la barons that were victims of this have many, many family members in north dakota. They have lots of businesses in the state of north dakota. Theyre hardworking, faithful people. It was a hard phone call to make. This is a hard message to deliver. And i dont know what to deliver, except i wanted them to know that the people of their country and the United States are hugging the people of their country, mexico. And that what theyve experienced is certainly the personification of evil in the form of these thugs from this cartel. For sure, theyre people who kill with reckless abandon, no regard for life, even the life of innocent children. But that we serve a god who personifies pure good and that the greatest response to pure evil is pure good. Kenny and i had a particularly long talk about his family, what theyre experiencing, whats going on. They wanted me to know that they support the United States as well as their country. They wanted me to tell the president that they support what hes doing and appreciate his offer of help to the mexican government. And i told him, theres lots much time for talking about of time for talking about the response of one government on behalf of another, working with another. But that right now, grief grief is sort of the meigs of the moment. Sort of the emotion of the moment. And remembering their loved ones is important and that we would be doing us both as a congress, as an administration, as a country as a state of north dakota who embraces these people who we know and love so much, that we will do what needs to be done understand that we stand and that we stand ready, first of all, to hold them up in prayer and to share their burden with them. I wanted to express as much as anything that their burden is ours today and that to the degree that you can share a burden like this, were sharing it. And then well react, well respond in whatever way is appropriate, in whatever way we can. And i join senator lee in gratitude to President Trump for his reaching hard and his offer of assistance. It cant be easy to live in a country where or even to rule a country where the cartels are so powerful, where they have as good a weapons if not better weapons than the police and maybe even the military. It cant be easy to stand up to that. But with good friends and lice and neighbors and allies and neighbors, perhaps now, perhaps this event, perhaps the grief of the of these families will be the thing that brings two countries together to fight this evil. But i will end, as i began, and look forward to future days when we can speak more thoroughly about it, when theres more information known. But to remind perhaps ourselves as much as anything that the only real Effective Response to pure evil is pure love. And as people of faith, we know that pure love is personified in our lord, and so tonight my message to the families in mexico and north dakota, utah is that we love them, that we love them. I yield the floor. I note the absence of a quorum. The presiding officer the clerk should call the roll. Quorum call mrs. Blackburn mr. President . The presiding officer the senator from tennessee. Mrs. Blackburn thank you, mr. President. I wanted to speak for a few minutes the presiding officer senator, we are in a quorum call. Mrs. Blackburn i ask that we suspend the quorum call. The presiding officer without objection. Mrs. Blackburn i wanted to speak for a a few minutes today to talk a little bit about Rural Health Care and to ask my colleagues for help in he can prosecuting the 20 of for help in protecting the 20 of americans who live in rural areas and are in danger of losing or may have lost entirely access to health care in their communities. Since 2010, 118 rural hospitals have shut their doors, 14 of those facilities are in my state of tennessee. Medical practitioners are paying attention to this trend and more often than not choose stability in the cities and suburbs over the uphill battle that comes with practicing medicine without access to the funding and modern resources many clinics now take for granted. As a result, rural patients are left to suffer through illnesses or emergencies or sacrifice time, money, and mileage for even the chance of a diagnosis. This system is broken, but this year ive been able to work with my colleagues on each side of the aisle to kind of pick up the pieces around this. Ive got a threebill Rural Health Agenda which comes at the direct request of smalltown mayors and local leaders who are struggling in my state to keep these communities afloat. Last week my fellow tennesseans, congressman kustoff and roe introduced house companions to all three pieces of legislation, and ill tell you, i have been talking to tennesseans, and they want my colleagues here in the senate to know what we should do about this issue. Now, if youve never lived in a rural area, hearing someone talk about driving 20 or 30 minutes to the nearest doctor probably really doesnt seem like a problem to you. But in the country, 30 minutes away translates into miles of driving through isolated areas. Chances are good you wont even have cell service for part of that drive. There are no e. M. T. s or Rapid Response teams, and if there is a local doctor, he or she may not have any specialized expertise, which could spell disaster for patients dealing with a complicated diagnosis. The first component of the agenda is the telehealth across state lines act, which would lead to the creation of Uniformed National best practices for the provision of telemedicine across state lines. And set up a Grant Program to expand existing telehealth practices and incentivize the adoption of tellly health by medicaid and Medicare Programs. But implementation of telehealth will not eliminate the need for facetoface interactions between patients and doctors. This leads us to another problem Rural Communities keep themselves afloat on strapped budgets which means that plans to open as much as a barebones urgentcare facility can be derailed by all the startup costs. The Rural Health Innovation arctic the second part of it the agenda, features two Grant Programs. The first one will fund the expansion of existing Health Care Centers such as local Nursing Homes into urgentcare walkin clinics. Facilities will be able to use grant money to purchase equipment, hire physicians, physician assistants, nurse practitioners, and other essential staff. A second Grant Program will expand rural Health Departments to meet urgent care and triage needs. See, this is using programs that already exist, tailoring them to the needs of Rural America. Of course, this points out the third issue expanded facilities are useless if there are no medical personnel. Ive been working on this problem with my friend from illinois, senator durbin, and he spoke about this on the floor a few minutes ago. We recognize from the beginning that throwing money and equipment at an updated facility wont convince medical professionals to establish a rural practice. So we wrote the Rural America health corps act to encourage practitioners to set up shop in rural areas. The bill creates a new Student Loan Repayment program that doctors and other medical professionals can take advantage of in exchange for those loan payments, they will have to agree to serve for at least five years in a rural area with a Health Professional shortage. But the benefit comes taxfree. Mr. President , ive spoken to Rural Communities all across my state. I know senator durbin has talked across the state of illinois, and i will tell you that these bills dont simply address a matter of convenience. My fellow tennesseans and my colleagues want my colleagues to know that they arent just frustrated with the long drives and unanswered questions. Theyre worried that that childs cough will turn into pneumonia before they are allowed a full day off of work to drive to a pediatrician. They have no idea what they would do if they were diagnosed with an illness that requires continuous care. They do you however, they do, however, know what would probably happen if someone they love suffered a heart attack or had another major emergency. Mr. President , they are very fareful. But if these bills pass, they will no longer have to live with the knowledge that they have been abandoned by our Health Care System. They will have access to health care in their communities. I ask my colleagues to let these people know yes, indeed, somebody is listening, and i ask them to do so by cosponsoring senate bills 2406, 20408, and 2411. I yield the floor. Mrs. Blackburn mr. President , i ask unanimous consent that if the tapp nomination is confirmed, the the motion to reconsider be considered made and laid upon the table and the president be immediately notified of the senates action. The presiding officer without objection. The presiding officer is there a sufficient second . There appears to be the yeas and nays are ordered. Vote the presiding officer all time is expired. The question is on the tapp nomination. The yeas and nays were previously ordered. 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, the ayes are 85. The nays are 8. 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 action. 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 danielle j. Hunsaker of oregon to be United States circuit judge for the ninth circuit signed by 17 senators. The presiding officer by unanimous consent, the manned it tore quorum call has been waived. The mandatory quorum call has been waived. The question is is it the sense of the senate that debate on the nomination of danielle j. Hunsaker of oregon to be the United States circuit judge for the ninth circuit shall be brought to a close. The yeas and nays are mandatory under the rule. The clerk will call the roll. Vote vote vote the presiding officer is there any senator in the chamber wishing to vote or change their vote . If not, the yeas are 75, the nays are 18. The motion is agreed to. The clerk will report the nomination. The clerk nomination, the judiciary, danielle j. Hunsaker of oregon to be United States circuit judge for the ninth circuit. A senator madam president. The presiding officer the senator from tennessee. Mrs. Blackburn thank you, madam president. This weekend, thousands of tennesseeans and of course millions across this nation are going to pause and give thanks for our veterans. And quite frankly, this is something that we should be doing every single day. And i just am amazed and so grateful that, madam president , there are men and women like you who have worn the uniform, who have served. Great men and women who wake up every day in some of the most dangerous places on the face of the earth. You do a job that would bring many of us to our knees. We would look at this and say it is basically impossible. And when our veterans have done their part and they come home, they find themselves facing another set of struggles. The challenges the veterans face are well documented, and we hear about them. Long waits and long lines at v. A. Hospitals and clinics, long recoveries from battle wounds that they have suffered and severe emotional and Mental Health struggles that if left untreated, those could end in tragedy. There are systems in place to help our returning heroes. We just need to be using these correctly. Earlier this year, the v. A. O. I. G. , office of Inspector General, released a report showing that the agencys system for keeping track of controlled prescriptions had almost entirely broken down. Now, think about that. Were in the middle of an Opioid Crisis in this country. There is a system in place, but the v. A. s system for keeping track of this, of all of these prescriptions had almost entirely broken down. This is truly unacceptable and pretty much what was happening is this the stateoperated Prescription Drug monitoring programs or pdmps contain valuable information about what drugs veterans are being prescribed outside of the v. A. Health care system. V. A. Clinicians are supposed to check this database before prescribeing opiatebased and other controlled medications to make sure that their patients, that patient in front of them, that veteran in front of them is not receiving too many pills from multiple sources. Now, get this that office of Inspector General report, the o. I. G. Report showed that 73 of our v. A. Patients who were prescribed opioids walked out of the pharmacy, medication in hand, without a v. A. Clinician ever having performed the minimum required checks. So the system is there. It could be utilized, but what happens . The clinician gives the prescription that never checks the database in 73 of the cases. This failure to follow through put 19 of those patients at risk for problems with their care coordination, and almost half of those v. A. Patients were under longterm care for chronic pain and were at a higher risk for opioid use disorder and overdose. We hear about these reports time and again, and we say how in the world could this possibly happen . How could this be acceptable, and its not. And we look at how it happened, and heres what we found out. It happened because the v. A. Didnt make the rules clear enough. Officials highly recommended get this they highly recommended that clinicians submit a pdmp query but they didnt explicitly state that it was required under existing v. H. A. Directives, and there were no National Oversight controls to act as a backstop. So the rule is there, but a bureaucrat, a clinician says well, they recommend it, but its not required, so ill skirt that. Along with their report, the o. I. G. Handed the v. A. A laundry list of recommendations, including directives to develop National Oversight programs, better train their clinicians that one should be an imperativd accountability checks into the Technology Used to track patient care. V. A. Officials have submitted nowapproved corrective action plans, and we thank the v. A. Secretary for this, and its our job to make sure that they do follow through with this. The lack of organization that turned v. A. Clinics into unwitting pill pushers has made it almost impossible for veterans to seek help during times of mental and emotional distress. In september, the v. A. Published a report that confirmed our worst fears. As of 2017, there has been no significant change in veteran suicide rates. In 2017, the suicide rate for veterans in tennessee hit 32. 6 , which is significantly higher than the Overall National suicide rate. It will take more than one day of recognition to fix this. It is going to take commitment and an allhandsondeck approach. Im an original cosponsor of the improved wellbeing for veterans act which will help vets connect to the over 50,000 existing Suicide Prevention programs that are ready and waiting to be helpful. The bill will also give regulators a tool to measure how effective these programs are. Its a good start. Its not enough. Earlier this year, President Trump launched the prevents initiative, and we thank him for this attention to the needs of our veterans. Prevents established a cabinetlevel task force responsible for finding the root causes of disconnect between veterans and Helpful Services from the v. A. And private organizations. Their job is to develop a strategy for federal, state, and Community Leaders to engage with veterans, improve research, and access to resources and work from the ground up to prevent suicide. Heres the caveat. This will only work if we remain in Constant Contact with veterans back home and use those interactions to find the cracks that veterans continue to fall through. You know, madam president , for years, we have listened to frustrated complaints from Agency Officials insisting that untangling the v. A. s procedural knots is an exercise in futility sometimes you hear, well, it just cant be done. We do things this way because we have always done things this way. Thats not necessarily true. We do them because oversight has not been exercised. But its time for all of us, not just lawmakers and rulemakers to finally accept that honoring their service, honoring the service of these heroes means helping these heroes heal when they need it and not leaving them at the mercy of a broken and bloated bureaucracy. I yield the floor. The presiding officer the majority leader. Mr. Mcconnell i ask unanimous consent that notwithstanding rule 22, the cloture votes on the rudofsky and wilson nominations occur at 12 00 noon on wednesday, november 6. I further ask consent that the confirmation vote on the hunsaker nomination occur at 4 00 p. M. On wednesday, novembeg disposition of the hunsaker nomination, the senate vote on the motion to invoke cloture on the n. R. A. Denyi nomination. Finally, i ask consent that if cloture is invoked on rudofsky, wilson, and n. R. A. Nardini, the confirmation votes occur at a time in consultation with the majority and democratic leader on thursday, november 7. The presiding officer is there objection . Without objection, so ordered. Mr. Mcconnell i ask unanimous consent the senate proceed to legislative session, 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. Mcconnell i have five requests for committees to meet during todays session of the senate. They have the approval of the majority and minority leaders. The presiding officer duly noted. Mr. Mcconnell i understand there is a bill at the desk and i ask its first reading. The presiding officer the the presiding officer ed clerk will read the title of the bill. The clerk an act to authorization the secretary of state to provide funds for a United States pavilion at expo 2020 did you bye and for other did you buy dubois and for other purposes. Mr. Mcconnell i ask for its second reading and under to place it on the calendar, i object to my own request. The presiding officer the objection having been heard, the bill will receive its second reading on the next legislative day. Mr. Mcconnell i now ask consent the committee on the judiciary be discharged from further consideration of h. R. 724 and the senate proceed to its immediate consideration. The presiding officer the clerk will report. The clerk h. R. 724, an act to revise section 48 of title 18 United States code and for other purposes. The presiding officer is there objection to proceeding to the measure . Without objection, the committee is discharged. The senate will proceed. Mr. Mcconnell i ask unanimous consent the bill be considered read a third time and passed and the notion reconsider be considered made and laid upon the table. The presiding officer without objection. Mr. Mcconnell i ask unanimous consent the senate proceed to the immediate consideration of s. Res. 407 which was submitted earlier today. The presiding officer the clerk will report. The clerk Senate Resolution 407 congratulating the Washington Nationals on winning the 2019 Major League Baseball world series. The presiding officer is there objection to proceeding to the measure . Without objection. Mr. Mcconnell i further ask the resolution be agreed to, the preamble be agreed to, and the motions to reconsider be considered made and laid upon the table with no intervening action or debate. The presiding officer without objection, so ordered. Mr. Mcconnell i ask unanimous consent that i be added as a cosponsor. The presiding officer without objection. Mr. Mcconnell i ask unanimous consent that when the senate completes its business today, it adjourn until 10 00 a. M. Wednesday, november 6. 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 rudofsky nomination under the previous order. The presiding officer without objection. Mr. Mcconnell so if theres no further business to come before the senate, i ask it stand adjourned under the previous order. The presiding officer the Senate Stands adjourned until Senate Stands adjourned until including the combination to the judge of the u. S. Court of federal flames. Followed life Senate Coverage when they return. Here on cspan two. Earlier today, senate Party Leaders held their weekly note news conferences. Are the remarks. Starting with the republicans,. I am really beyond frustrated as our inability to get the defense bill up. They suffered on continued resolutions that went out we had an agreement the