Water Resources Development Act of 2016

Floor Speech

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Mr. DURBIN. Mr. President, my friend and colleague from Texas came to the floor to describe the budget and appropriations process which we face in this session of Congress. Our fiscal year begins October 1, and it is only a few weeks away. Under the orderly course of business, we would pass 12 different appropriations bills and fund the government for the next fiscal year. To date, we have not passed any of those bills in the Senate.

I would like to say a word in defense of the Senate Appropriations Committee on which I am honored to serve. This committee has had lengthy hearings and has produced 12 appropriations bills. I would say that these bills are good, bipartisan bills and with only a few exceptions are being brought forward in good faith in an effort to meet our constitutional obligation to fund the government.

One of the earliest bills that were brought forward was the Military Construction and Veterans Affairs bill. It is not considered to be a highly controversial bill, and it was understandable that it was one of the first appropriations bills brought to the floor. The Senators who prepared the bill--Republican Senator Kirk from Illinois, my home State, Democratic Senator Jon Tester--brought it to the floor. They added a provision in the bill that the President asked for to deal with the Zika crisis.

Back in February, President Obama asked for $1.9 billion to deal with the public health crisis caused by this mosquito-borne disease, the Zika virus. We have reports from around the world that pregnant women who are infected with this virus by a mosquito or by other means are giving birth to children with terrible birth defects. The President called on us in February to give him the resources to help fight the spread of this mosquito in Puerto Rico, one of the territories of the United States, and in the United States of America and also asked for the resources to help develop a vaccine, which all of us would be interested in seeing as quickly as possible, to protect innocent people from this mosquito-borne disease.

So we took the President's request, and after some debate, Senators Murray and Blunt, a Democrat and Republican, agreed on $1.1 billion of the $1.9 billion asked for by the President. They added it to the Military Construction spending bill. It made sense. When they called it for a vote here in the Senate, the vote was 89 Senators in favor of this Military Construction appropriation bill with the Zika money included. I felt pretty good about that.

On a bipartisan basis, we had responded to the President in May of this year and passed the first appropriation bill to be sent to the House. What my friend from Texas, the Senate majority whip, failed to mention was what happened to that bill once it left the Senate. So 89 Senators, both Democrats and Republicans, supported the bill and sent over what we considered to be a responsible, clean bill. What did the House do? Did it take up this measure and pass it with the emergency provisions to deal with the Zika crisis? No. Therein lies the problem with the appropriation process. The same House Republican majority that ran John Boehner of Ohio out of town as Speaker decided to flex their muscles on this bill. Do you know what they put in the bill? They took this bill that was a bipartisan clean bill and added the most objectionable political issues.

Let me give an example. They added into this bill a question about whether Planned Parenthood would be funded to provide family planning, especially for women who were trying to avoid a pregnancy because of the threat of the Zika virus. They put a prohibition against the funding of Planned Parenthood. Last year, 2 million American women used Planned Parenthood. It is understandable that when they attack Planned Parenthood, it is a controversial issue. I stand in favor of what Planned Parenthood does when it comes to family planning. Others disagree. But why would you add that to a bill on a public health crisis about Zika? Why would you put it in a Military Construction and Veterans Affairs bill that has nothing to do with Planned Parenthood's activities?

Secondly, the House Republicans cut $500 million out of the Veterans' Administration that was being used to expedite the claims of veterans. We know the story back in Chicago and Illinois. A lot of our deserving veterans have been waiting in line for month after wary month for approval of their disability claims. We put in resources to speed that up. The House Republicans took the $500 million out of the Veterans' Administration. That is controversial, unnecessary, and unfair to veterans.

Then, to add insult to injury, there was a third provision. They decided to suspend the authority of the Environmental Protection Agency when it came to the use of certain chemicals to fight the mosquitoes. Well, that carries controversy with it. Clean water is certainly something we all value, and we wouldn't want to compromise it. The House Republicans added that in.

There was one more provision they added to make it clear that this was a political exercise from the House. Listen to this one. There was a ban on the display of Confederate flags at U.S. military cemeteries. The House Republicans removed that ban so that Confederate flags could be displayed at U.S. military cemeteries.

So a bill we passed with 89 votes--a strong, bipartisan bill--a bill that included a bipartisan compromise to deal with the Zika virus in a timely fashion, was sent over to the House of Representatives and was freighted with the most political issues imaginable to be sent back home over here.

If the Senator from Texas wonders why the appropriations process broke down, don't blame the Senate Appropriations Committee. For the most part, they have done their work. Don't even blame the Senate itself. When it came to voting on the Military Construction bill, we voted on a bipartisan basis to go forward. The process fell apart across the Rotunda with the House Republicans.

So if we are going to get this done--and I hope we do--we need a short-term spending bill called a continuing resolution. It will take us through the month of October, a campaign month, through the month of November, when we return and face the Thanksgiving holidays, and into early December. That, to me, is a reasonable thing to do to give us time to finish the appropriations process, but in the meantime, we have to get back on track--and the President joins me in what I am about to say--to take out these controversial political provisions, particularly those originating in the House from the Republican leadership, and get down to the business of funding this government in a responsible fashion.

I will take exception to one statement by the Senator from Texas. He said the Democrats were trying to spend more money. That didn't quite tell the whole story. We have an agreement which says that if we want to increase defense spending--I will vote for that--we have to increase nondefense spending in a similar fashion--same amount, equal amount. Why would we want to increase nondefense spending? Education, Pell grants, student loans, helping children in Head Start Programs, making sure hungry families across America have enough to eat, making certain the FBI is adequately funded--there are a lot of things when it comes to the nondefense side that are important for America's future and for our security. All we are asking for is fair treatment. Increase the Department of Defense, similar increase in nondefense spending--that is it.

If we can get back on track, I think we can, incidentally, get this done. I hope the leadership on the Republican side--and they control the House and the Senate--will decide to give us this short-term CR until early December and put a clean Zika provision in, the same one that passed the Senate. That would be a way to resolve our differences and to address this public health crisis which has taken too many lives across the world and has certainly caused horrible outcomes when it comes to pregnancies of women who are infected. Affordable Care Act

Mr. President, last week a number of my Republican colleagues came to the Senate floor to discuss the Affordable Care Act, otherwise known as ObamaCare. They didn't come to offer the Republican alternative to the Affordable Care Act. They didn't come forward with proposals on how to improve the Affordable Care Act. They came here basically to say they were against it, period. That is no surprise.

Considering that the Republicans have spent the last 6 years attacking the Affordable Care Act, I think it is time that America hears at least some part of the other side of the story. I would like to take a moment to talk about what has happened in this country since the passage of the Affordable Care Act, or ObamaCare.

Since the Affordable Care Act became law, the uninsured rate has declined by 43 percent in America, from 16 percent uninsured in 2010 to 9.1 percent in 2015. To put it another way, the number of uninsured people in the United States has declined from 49 million in 2010 to 29 million in 2015. Stated another way, more than 20 million people have gained health insurance because of this law. For the first time ever, more than 9 out of 10 Americans have health insurance.

Have you ever been in a position in your life when you didn't have health insurance? Have you ever been a father with a brandnew baby who needed the best medical care and you didn't have health insurance? Have you ever wondered how you would take care of your child and your family when you couldn't provide them with health insurance? I have. I went through it. It scared me to death--a brandnew dad, so happy and proud, and then a medical challenge in my family occurred, and we had no health insurance. I went to a local hospital here with my wife and baby, sat in the chair in the ward, and waited for our number to be called. I was a law student and I didn't know what was going to happen next. Luckily, we had good medical care. We paid for it. The care that wasn't covered by insurance cost us quite a bit of money in those days, and it took us a long time to pay it off. But I never felt more inadequate as a father than sitting there without health insurance. Have you ever been there? If you have, you will never forget it. I have been there.

For this country, 20 million people today have the peace of mind of health insurance who did not have it before ObamaCare. This represents the largest decline in the uninsured rate since we created Medicare and Medicaid in the 1960s.

Since the Affordable Care Act became law, Americans no longer have to worry about a lot of discriminatory things that were being done to families before we passed the law. Health insurance companies can no longer refuse to provide you insurance because of a preexisting condition.

Does anybody in your family have a preexisting condition? Certainly in our family, and most. It could be diabetes, a child who survived cancer--think of all the possibilities. In the old days before the Affordable Care Act, they could just say no in terms of covering your family or raise the rates to high heaven to make it impossible to pay for insurance. This provision alone on preexisting conditions protects 129 million Americans, 19 million children. When the Republicans come to the floor to say they want to abolish the Affordable Care Act, what do they say about the 129 million Americans with preexisting conditions? What do they say about the 19 million children with preexisting conditions? Not one word.

These insurance companies can no longer charge women more than men for the same insurance policies. That is right. There was blatant discrimination--charging women more than men for the same health insurance policies. Who is protected by that? Well, 157 million women in America. Did the Republicans suggest, when they abolish ObamaCare, what they are going to do to protect these women? Not a word.

Insurance companies can no longer impose annual or lifetime caps on benefits. Remember those days? People get gravely ill, a diagnosis they hadn't expected, an accident, and then they find out they are in for a long period of care, which is very expensive, and they check and find that their health insurance plan has a cap on how much it will pay. The rest of it was on your shoulders, and for many people that meant a trip to bankruptcy court. This provision alone protects 105 million Americans--including 39.5 million women and 28 million children--who were previously subject to these arbitrary caps. What did these Republican Senators say about protecting these families if they abolished ObamaCare? Nothing.

No longer, incidentally, under ObamaCare, can insurers spend large percentages of your premium dollars on advertising and the salaries of the fat cats who run the company. This has protected 5.5 million consumers who received nearly $470 million in rebates last year. Under ObamaCare, insurers can't impose copays on important preventive health services, such as immunizations, cancer screenings, and birth control.

Because of the Affordable Care Act, because of ObamaCare, Medicare is better for the 55 million seniors who depend on it. There was the dreaded doughnut hole. Do you remember that one? That was when a senior on Medicare would have pharmacy bills. The original Medicare Program for pharmacy didn't cover all expenses. It is a strange thing to explain, but it would cover expenses on the front end of the year, and then they would have to go into their savings accounts. I would say to the Senator from Florida, who knows senior issues better than most, it was called the doughnut hole, and we changed it.

So we changed it. We are filling the doughnut hole. We are closing it and phasing it out. That saves 10.7 million Medicare prescription drug beneficiaries an average of almost $2,000 each. What have we heard from Republicans about replacing that provision? Nothing.

The Affordable Care Act also encourages health care providers to focus on quality of care, not just quantity. As a result, American lives are being saved. Because of the provisions in ObamaCare, hospital-acquired conditions have declined 17 percent in 6 years. Infections, adverse drug events that resulted in patients staying in hospitals longer and even dying have dramatically decreased. That has prevented 87,000 deaths over the last 4 years.

In Illinois, we have seen the benefits as well. Between 2013 and 2015, the rate of uninsured among 18- to 64-year-olds decreased from 17.8 percent to 10.6 percent, a 7.2-percent drop, one of the largest in the Nation. Prior to ObamaCare, the Affordable Care Act, an estimated 1.8 million Illinoisans were uninsured. Today, the number is below 800,000.

In terms of health insurance monthly premium costs, Illinois ranks 15th as one of the most affordable nationwide. Now Republican Senators single out newspaper headlines talking about premium increases. They have claimed ObamaCare is the reason. I am troubled by certain aspects of these rate increases. I think it is important to take a close look at them.

In recent years, there have been a lot of stories in the press about premium increases for some plans, in some cities, for some people. The Republicans have come to the floor to tell all of these stories that they can. It is important to note that premiums for employer coverage, Medicare spending, and health care prices have all grown more slowly under the Affordable Care Act than before.

For employer premiums, the past 5 years included four of the five slowest growth rate years on record. Medicare spending is $473 billion less than was projected before the Affordable Care Act. Health care price growth since the Affordable Care Act became law has been the slowest in 50 years. You don't hear that in the speeches from the other side of the aisle.

Where premium increases have been most prevalent is in the individual market. Out of 350 million Americans, 11 million are in this market. I am troubled by the increases in those markets. But it is important to remember that is a small portion of the overall market. Most people who get coverage through the insurance exchanges of ObamaCare--that is more than 80 percent of them--receive a tax credit to help them pay their premiums. Let's not forget that premium increases were around long before the Affordable Care Act.

In 2005, 5 years before the Affordable Care Act, a Los Angeles Times headline read, ``Rising Premiums Threaten Job-Based Health Coverage.'' In 2006, 4 years before the Affordable Care Act, a New York Times headline read, ``Health Care Costs Rise Twice as Much as Inflation.'' In 2008, 2 years before we passed the law, the Washington Post headline read, ``Rising Health Costs Cut Into Wages.''

Democrats passed the Affordable Care Act to combat these premium increases, which were devastating families, bankrupting individuals, and squeezing employers' budgets. Despite all the anti-ObamaCare rhetoric being peddled by my Republican colleagues, the major aspects of this law are working. More Americans are insured than ever before. We have ended the most discriminatory and dishonorable practices of the health insurance industry, and we have taken important steps to improve and strengthen Medicare.

Is the law perfect? No. The only perfect law was carried down the side of a mountain on clay tablets by Senator Moses. All the rest of our efforts can use a little work. I think Senator Nelson from Florida and I would agree. We supported the bill, but we would sit down with the Republicans tomorrow to find ways to strengthen it, make it fairer, make it better. That is constructive, but that is not what we hear from the other side. The other side says: It must go away. That is no way to bargain.

Instead of working, Republicans have, at every possible opportunity, tried to end the Affordable Care Act. They broke all records in the House of Representatives. We think they voted 60 times to abolish the Affordable Care Act. It almost became the regular vote before they went into recess: Oh, before we leave, let's vote to abolish it--knowing that that wasn't going to happen and shouldn't happen.

What we know now is that we can make this law better. We should work to do it. We have to deal with some of the issues that are before us. If the Republicans would sit down, there are some steps we could take together. The marketplaces are working for the vast majority of Americans. Some 88 percent of enrollees live in a county with at least three choices for health care. There is still more we can do for those who have only one or two choices to face in their areas.

When we debated the Affordable Care Act, many of us on the Democratic side, myself included, said: Why don't we have one Medicare-like public plan that is available across the United States? That could compete with private insurers and bring prices down. There was a lot of fearmongering. People stopped us from our efforts to include a universal Medicare plan as part of it. I would like to return to it.

To help balance the risk pool and attract Americans in the marketplaces, particularly healthier younger people, we should expand financial assistance to help middle-class families better afford coverage. We must address one other issue that we all know is front and center--the price of pharmaceuticals, the price of drugs. This is the elephant in the room when it comes to this conversation. It is one which most Members of the Senate and House are running away from.

When drug companies increase their prices or put new treatments on the market that are exceedingly expensive, insurance companies are forced to come up with the money to cover the cost, and often they pass the cost along in higher premiums. An Illinois insurer recently told me that drug expenses, the cost of pharmaceuticals, used to account for about 15 percent of this health insurance policy cost. The number now, a year later, is up to 25 percent, and there is no end in sight.

We have asked doctors and hospitals and medical device companies and other medical professionals to bring us quality and lower costs, but we put no burden on the pharmaceutical companies. The most recent Medicare Part D data show that 46 percent of the most commonly prescribed drugs had a double-digit price increase in 2014. A recent Reuters report found that prices for 4 of our Nation's top 10 drugs have increased by more than 100 percent since 2011. Six others went up 50 percent. What did that mean for those who use the drugs?

The price for the arthritis drug Humira went up 126 percent. The multiple sclerosis drug COPAXONE went up 118 percent. The asthma drug Advair went up 67 percent. Mylan Pharmaceuticals just increased the price of EpiPens. Did you read about that one? They increased the price of EpiPens from less than $100 for a pack of two in 2007 to more than $600 today. It is the same drug but a 550-percent increase in cost.

This last Friday in Chicago, a young man came to see me. He has been battling diabetes for as long as he has been alive. It is a daily battle; it is an hourly battle to try to ensure that he doesn't succumb to this disease. His mom and dad were with him. He put in front of me a list of what it costs now for insulin and for the basics that diabetics need across America. The costs just keep going dramatically. It is not pinned to the original research cost of the drug at all. Many of these drugs were on the market for years at a reasonable cost, but now the pharmaceutical companies are kiting the costs. Let me be clear. We will not be able to get a handle on rising health care costs if we are unable or politically unwilling to address escalating drug prices.

Something has to be done. I support a wide range of ideas, from requiring drug companies to disclose how they arrive at pricing, to allowing Medicare to negotiate for drug prices, from shortening the monopoly period that drug companies enjoy before generic competition, to ending the pay-for-delay arrangements that necessarily keep generic drugs and lower prices away from consumers. We should also explore imposing a tax on companies that arbitrarily raise their prescription drug prices significantly over the previous year.

I will close. The bottom line is, the Affordable Care Act is working. Twenty million Americans now have health insurance. Being a woman is no longer considered a preexisting condition. Kids can stay on their parent's health care plans up to age 26. Insurers can no longer kick someone off insurance if they get sick or cost too much.

Just as we had to make changes and improvements in Medicare over the years, the Affordable Care Act can work better if we set aside politics and sit down together and work on it. The Affordable Care Act is here to stay. So let's stop trying to repeal it and undermine it. Let's make it stronger and better for the future of America.

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Mr. DURBIN. Mr. President, I will be happy to yield through the Chair.

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Mr. DURBIN. In response through the Chair, the Senator from Florida knows this issue as well as or better than most. He understands the progress that has been made. I am sure he agrees with me that we can do better; we can improve this law. We can make it work better, but only if we do it in a constructive, bipartisan way. I listen carefully when my Republican colleagues come to the floor thinking they want to abolish the Affordable Care Act and replace it with--they never finish the sentence. They don't have a replacement.

So what are we going to say to the 20 million Americans who now have health insurance because of this law? You are on your own again. Sorry, your family is not covered. That is no answer. I would agree with the Senator from Florida that we have come a long way. We can improve this law and make it better and stronger. I think our goal to bring more people under the protection of health insurance and to slow the rate of growth in health care costs has been achieved. But to make it go forward in the right way we need to work together.

I further announce that, if present and voting, the Senator from Virginia (Mr. Kaine) would vote ``yea.''

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