Pending is a bill citing Defense Department programs for the next budget year. Live coverage now of the senate. [inaudible conversations] the president pro tempore the senate will come to order. The chaplain, dr. Barry black, will lead the senate in prayer. The chaplain let us pray. Holy god, who causes wars to cease, bring peace to our nation and world. Let that peace first begin in our hearts. Use our lawmakers to bring a spirit of concord instead of chaos to our world. May they set aside time each day to be still in your presence. Lord, help them to know that time spent with you is never wasted. Permit this daily contact with you to motivate them to exalt you in their lives, as you use them to provide examples of how people can live if they put their trust completely in you. Lord god of hosts, continue to abide with us in sunshine and shadows. And, lord, be especially with the people of puerto rico. We pray in your sacred name. Amen. The president pro tempore please join me in reciting the pledge of allegiance to our flag. I pledge allegiance to the flag of the United States of america, and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. Mr. Mcconnell mr. President. The presiding officer the majority leader. Mr. Mcconnell last night on television we saw a stark contrast between two different visions of health care in our country. One is an idea thats gaining increasing currency with our friends on the other side of the aisle. Some call it single payer. Others try to test it up with polltested p. R. Labels. But no matter what you call it, at its core heres what it is. A massive expansion of a failed idea quadrupling down on the failures of obama, a system that would Rip Health Care away from even more americans and take even more of their personal health care decisions. The cost of implementing it would be astronomical. The taxes required to pay for it, skyhigh. And yet after years of obamacares failures, its higher costs, diminished choices, collapsing markets, it seems this is the best our democratic friends can come up with. Not a new idea, but quadrupling down on an old one that has already failed. What a contrast with the general approach that senators graham and cassidy and many other republicans have pursued. We think the American People deserve a better way forward like returning more power from the federal government to the states where americans actually live and allowing for reforms that can actually lower costs and improve care and actually moving beyond the growing failures of a failed law on obamacare. So like i said, we saw last night, reminds us of this stark contrast envisioned. It is an important debate for our country. Its one that will certainly continue. On another matter, weve seen all the Serious Problems facing the people of puerto rico and the u. S. Virgin islands as a result of recent hurricanes. This damage has been terrible. The latest hurricane was especially devastating. We want the people of puerto rico and the islands to know that were thinking of them and more importantly, we want them to know that well continue to work with fema, the department of defense, and the rest of the administration to help in the recovery. I expect well hear more soon on what Additional Resources will be necessary in puerto rico and elsewhere in the paths of the storms. The recovery effort is certainly not going to be easy. Its not going to be quick. But were here to do our part. The presiding officer under the previous order, the leadership time is reserved. Morning business is closed. Under the previous order, the senate will resume consideration of the motion to proceed to s. 1519, which the clerk will report. The clerk motion to proceed to s. 1519, a bill to authorize appropriations for fiscal year 2018 for military activities of the department of defense and so forth and for other purposes. The presiding officer the assistant democratic leader. Mr. Durbin i ask consent the quorum call be suspended. The presiding officer the senate is not in a quorum call. The senator is recognized. Mr. Durbin thank you, mr. President. Mr. President , over the last three days, three republican senators have publicly stated that they will vote against the Health Care Repeal bill that may come to the senate this week. In announcing his opposition, one republican senator, john mccain of arizona, issued the following statement, and i quoty stressed, Health Care Reform legislation ought to be the product of regular order in the senate. Last night, senator Susan Collins, republican of maine, stated, and i quote, this is simply not the way we should be approaching an important and complex issue. She went on to say, the fact that a new version of this bill was released the very week were supposed to vote compounds the problem. Mr. President , this should be the end of the grahamcassidy repeal debate. The Republican Leadership should finally scrap this onesided effort to literally change the Health Care System for america. There was a hearing yesterday, the only hearing on the bill were about to vote on. It was a lengthy hearing, but frankly did not entertain all the witnesses or any amendment process so that members could really have input into the bill were going to face. The Congressional Budget Office is supposed to tell us what this critical legislation will do for america. They issued a preliminary finding yesterday that millions of americans would lose their Health Insurance and that those with preexisting conditions and their family, if they could buy insurance, would find it very, very expensive. At the end of this week, funding for our Nations CommunityHealth Care Centers will run out. As does funding for the childrens Health Insurance program. Shouldnt we be focused on those programs, reauthorizing them appropriately in a timely way . And lets allow the help committee, which is the committee of jurisdiction when it comes to health care, to do their work. I have faith in two senators, one republican, one democrat, to do the right thing on this. Senator Lamar Alexander of tennessee, a republican. Senator patty murray of washington, a democrat. They have proven before they can take complex issues like federal funding for education and find a bipartisan compromise. What would america say if we announced at the end of next week or even this week we have a bipartisan compromise to make health care stronger in the United States, its going to pass the senate, were going to send it to the house, were going to get something done this year in the United States senate . Well, first, most americans would be amazed, skeptical, as they should be, but if we can prove that we are going to do it, they would applaud us for finally, finally reaching a point where we do something on a bipartisan basis. That was the process that was under way until last week. Senator alexander was given orders by the leadership step back, lets vote on grahamcassidy, dont do anything more on a bipartisan basis. Well, this is the week for that vote. I hope its the week where that vote ends in a basic defeat of the approach and a return to bipartisan compromise and bipartisan negotiation. I dont know what it will take for the republicans in the senate and the house to end this neverending crusade against socalled obamacare. They have voted 50, 60, 70 times. We know how they feel about it. But the American People have said to them it isnt enough to oppose obamacare. Give us a better alternative, and thats where they have stumbled each time. Over the weekend, rather than making improvements to fix whats wrong with their bill, many republicans doubled down with secret meetings, negotiations and incentives that were built into the newest version of the bill. The latest grahamcassidy repeal measure would slash funding to the states, decimate the Medicaid Program, eliminate protections for people with preexisting conditions, and basically throw our entire Health Care System into chaos. A few special changes were made for special states, but the changes that came to grahamcassidy in the closing days have not really changed the fundamental problem with the bill. It diminishes medicaid coverage. Medicaid is the Health Insurance program which most people say, well, thats for the poor people of america. To some extent, thats true, but its reached far beyond that. Two out of three Senior Citizens in Nursing Homes and other institutional settings rely on medicaid for basic health care. If the cutbacks in medicaid take place that grahamcassidy calls for, what will these seniors do . What will you do for mom, for your grandmother, for your grandfather . When it reaches the point where they cant any longer count on medicaid to help them pay their medical bills. Would American Families have to step up with their own savings . Will they have to look for alternatives, to settings where their parents and grandparents are in today . Thats the stark choice which grahamcassidy will create for many families across america. No one has had time to properly review this latest proposal, in large parts because its been drafted behind closed doors. No input from experts, no support, no support from the medical community. You would think after saying it over and over again that the republicans would challenge the following statement. There is no medical Advocacy Group in the United States of america supporting the grahamcassidy bill. At least in my state, the hospital association, doctors, nurses, surgeons, pediatricians, community health, all opposed to this bill, every single one of them, as they were to the previous versions. It says something when the bill to change americas Health Care System is opposed by the people who provide health care to america. All of them oppose it. Its that bad. Republican leaders want to force a vote this week. Well, if thats what it takes, then we have to move to that vote, but i wish they would save some time. I wish they would move to this bipartisan negotiation which i referred to earlier. The Congressional Budget Office is a nonpartisan agency thats supposed to measure the impact of legislation, so before we vote on it we know if its good or bad for the nation, for the people we represent. Heres what they told us last night in a preliminary review. They havent had time to review this bill in its detail, but in the preliminary review, the c. B. O. Told us, and i quote, the number of people with comprehensive Health Insurance would be reduced by millions each year. How in the world can we as senators make a proposal for the United States of america, which we know will take Health Insurance coverage away from millions of americans . Exactly the opposite of what our goal should be. The c. B. O. Went on to say federal spending on medicaid would be reduced by about 1 trillion. Well, there are some republicans, fiscal conservatives, who say we have got to stop the growth of this program, but not one of them, none of them can address the fundamental issue who will take care in paying for the delivery of babies to lowincome families. Half of the children born in my state of illinois are paid for by medicaid. Their moms are taken care of until the moment of birth by medicaid. What will you replace that with if you eliminate medicaid funding . What about the disabled who count on medicaid as their Health Insurance . If you are blind or face a serious disability, medicaid is the answer for basic Health Insurance for you. If youre going to cut back a trillion dollars out of medicaid, what will you say to those disabled americans who want the same peace of mind of Health Insurance that we all want . School districts all over illinois and all over the nation receive medicaid funds to care for special ed students, counselors, transportation, even feeding tubes. If you take the money out of medicaid, what will we do for those School Districts who are trying their best to give kids a fighting chance, even those with serious disabilities . Thats the reality. C. B. O. Went on to say coverage for people with preexisting conditions would be much more expensive and could become unavailable for many more people. This republican proposal takes us back to that moment in history when Health Insurance was so expensive, so hard to find and almost impossible for those with preexisting conditions. Why would we ever want to go back to that . There is hardly a family in america that doesnt have someone they love, part of their family with a preexisting condition, and let me remind those who dont have that circumstance you are one accident or one diagnosis away from being part of this class of americans who want turns even though their health has not been perfect. In sum, this bill does not do what its authors say it will. They like to tell the American Public that states will magically be able to cover the same number of people to provide the same level of benefits with billions of dollars less in funding. The governors, democrats and republicans, have stepped up and said this is ridiculous. We cant accept accept the burden of Health Insurance for generations to come while the federal government continues to cut the money thats necessary to provide that protection. C. B. O. Rejected the claims that are the basis for this republican bill. Since republicans refused to wait for the c. B. O. To complete its full analysis, we have asked outside Health Experts what they think the impact of this legislation, which is before us this week, would be. Heres what they say. Within a few years, this bill would likely rip Health Insurance away from more than 20 million americans, including one Million People in the state of illinois. A state of 12 and a half Million People that i represent would Lose Health Insurance for one Million People because of this republican proposal before us this week. The average 60yearold person in illinois would see their Health Insurance premiums increase by 11,700 a year, almost 1,000 a month Health Insurance would go up. Why . Because they change a basic formula. In the Affordable Care act, we see the disparity in premiums charged between the highest and lowest will be no more than three to one. They changed the number in their republican bill to five to one. It means those over the age of 50 and under 65 are going to see premium increases estimated at almost 1,000 a month. By 2026, illinois would see its Health Care Funding slashed by 8 billion. By 2036, this number would soar to 153 billion. Medicaid, covering half of all children in illinois, two out of three seniors in Nursing Homes would be devastated, and the Medicaid Expansion which helps us in illinois combat the opioid epidemic, provides coverage for 650,000 illinoisans and brings stability to our hospitals all across the state would be shut down. Heres what the Illinois Hospital Association said about this bill. Illinois cannot absorb additional Financial Burdens and be forced to reduce eligibility, covered services and payments to providers. The magnitude of these cuts and changes to medicaid is staggering. Thats from the Illinois Hospital Association about this republican bill. And lets review what this does to people with preexisting conditions. Republicans say this is all about giving flexibility to states. We hear that over and over again. It sure sounds nice until you realize thats a code word for massive funding cuts and the elimination of basic health protection. In the name of state flexibility, this bill would allow insurers to charge those with preexisting conditions skyhigh premiums the moment they got sick. State flexibility under this bill means reimposing annual and lifetime limits on patients, including infants born with serious medical problems. State flexibility under trumpcare means charging americans over age 50 up to five times more than younger people. Thats exactly why the American Association of retired people, aarp, has steadfastly opposed these republican changes. State flexibility to my republican friends means fossinl health benefits. It guarantees your insurance covers the basic services your family may need. Prescription drugs, maternity care, Mental Health and addiction treatment. I spoke to one of my colleagues the other day and said, what are you driving at here . Are you saying that we can reduce the cost of Health Insurance if we give people the option o