En Bloc Nominations

Floor Speech

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Mr. KAINE. Mr. President, I rise to talk about the reality of the shutdown that we are in and the efforts underway to find a path out, which I am optimistic we can, particularly after discussions among so many colleagues of both parties today on the floor of the Senate.

This is the third time during my nearly 13 years in the Senate that I have been involved in a shutdown. The first occurred in the fall of 2013. I had been in the Senate for less than a year. Senator Cruz sort of forced us into a shutdown mode over the Affordable Care Act. Interestingly enough, many years later, that Affordable Care Act is still central to this discussion. In late 2018 and 2019, President Trump forced us into a shutdown of part of the government--the part of government dealing with the Department of Justice and other justice- related Agencies--over border wall funding.

The first shutdown lasted for about 2 weeks. The second shutdown-- again, of part of government, not all of government--lasted for about a month. And they are horrible. The consequences for those affected, whether they be Federal workers or the citizens who need services, are horrible.

No one relishes that in this body, and I am completely confident that all 100 Senators feel the same way in that this is not a good thing and that there needs to be a path forward. In Virginia, we feel it pretty strongly. We have the second-most Federal employees of any State in the country, and we have an awful lot of Federal contractors whose livelihoods are affected as well.

We have also seen in the first nearly 9 months of this calendar year other actions taken, whether it is the cancelation of research grants or the backtracking on economic development proposals or the withdrawal of $400 million from the Virginia Department of Health that was critical to our agency's ability to do contact tracing and help stop the spread of infectious disease.

So we have seen since the beginning of January a whole series of actions that have already affected Virginians pretty significantly. We had an unemployment rate that was low by national standards but went up every month for 6, 7 months in a row, largely because of these Federal layoffs. As we reach this moment, it is not a clean break or something new from what was seen earlier in the year; it is sort of a continuation of something that has been a pretty painful chapter in Virginia.

So what are we hoping for or, rather, maybe, not to put words in anybody's mouth, what am I hoping for out of this?

The House prepared a short-term continuing resolution under instructions from the President: Do not deal with Democrats. And the House, with a simple Republican majority, was able to do that and pass a bill that then came to the Senate.

Once we saw that instruction--do not deal with Democrats--Senate Democrats, under the leadership of Senator Murray, the lead Democratic appropriator, said: Well, let's prepare an alternative, not a nonnegotiable demand but an alternative.

We put that alternative on the table on September 18. We didn't wait until the 29th of September or the 30th. We felt like, to be fair to the public, to be fair to our colleagues, let's put an alternative on the table with enough time for us to kick the tires on it and have a negotiation before the deadline that we reached at midnight last night.

What is the Democratic alternative compared to the Republican alternative? Actually, much of it is the same. But I would say the two elements in the Democratic alternative that are different are two: One, protecting people's healthcare; and, second, protecting the simple notion that everybody understands that a deal is a deal.

Let me explain both of these.

On the healthcare side, the reconciliation bill that was passed in June, together with some other actions of the administration-- particularly unilateral actions of Secretary Kennedy and the President in withdrawing healthcare funds from Virginia and unilateral actions thrusting uncertainty into areas like vaccines--they have created a huge healthcare challenge for Virginians and for Americans.

Again, not to speak for anybody other than Virginians, but I did a lot of travel around the State in April as some of these proposals were on the table. I did a lot of travel in July, a lot of travel in August, and I just did a good bit of travel last week around Virginia. And on the healthcare side, here is what my constituents are saying to me about what is now happening:

The effect of the reconciliation bill in Virginia is estimated to cause about 330,000 Virginians to lose their health insurance. Our population is about 8.8 million; 330,000 people losing health insurance is not a small number. This is a big--big--deal. That number of people who lose their health insurance is essentially what I call the top layer of a five-layer cake of consequences to these healthcare bills. That is consequence one, people lose insurance.

Consequence two is people who have insurance see their premiums go up dramatically. Premium notices are coming out from insurance companies in Virginia, and they are suggesting that premiums this year in Virginia will go up by at least 20 percent.

Why does that happen? There are two reasons: The reconciliation bill that was passed by the Republicans in June phased out premium support for low- and middle-income people buying health insurance on the exchanges. The Republican bill extended tax cuts for the wealthiest but phased out premium support for low- and middle-income people buying health insurance. So that causes premiums to go up.

The second thing that causes premiums to go up is when you increase the number of people with no insurance, they go to the emergency room, and they are not able to pay. So providers provide treatment, but then they have to charge that off to somebody, and it tends to get charged off to people who have health insurance.

So the combined effect of ACA premium support going away and a whole lot of free care that has to be paid for by somebody causes insurance rates to increase. This is happening in Virginia, and it is happening around the country.

That is the second layer of the five-layer cake of consequences of what happens when the reconciliation bill passes.

The third layer is this, and this is a really, really troubling one: Providers close down. Hospitals and clinics close down when Medicaid is affected; particularly hospitals, for whom Medicaid is a huge portion of the revenue stream coming into the hospital, find that they can't make it work.

A national organization that looks at hospital fiscal soundness has put about 300 hospitals in the United States on a list of hospitals that are in danger because of the Medicaid cuts. Six of those hospitals are in Virginia, and they are all in rural Virginia. Rural Virginia tends to be a little bit older than the rest of Virginia and tends to have a little bit higher Medicaid population than the rest of Virginia. So the hospitals that are in danger by the reconciliation bill are rural hospitals.

It is not just hospitals that are on the list of potential closure. Within the last month, a prominent health provider in the Shenandoah Valley of Virginia--a rural part of our State--announced that they were closing three primary care clinics in small Virginia communities because of the reconciliation bill. The cuts made to Medicaid in the reconciliation bill made them realize that they could no longer keep these clinics open.

So the third consequence of this reconciliation bill is, we have got people losing insurance; we have got premiums going up; and now we have providers closing.

The fourth consequence is pretty obvious: When providers close, people get fired, so people lose their jobs. Frontline healthcare workers who are doing good work in the communities and having people rely on them, they lose their jobs. That is consequence four.

Then, consequence five is one that I know well as a former mayor and Governor. I kind of call it the loss of your future. It is one thing to lose your health insurance; it is one thing to pay more; it is one thing to lose your provider; it is one thing to lose your job, but if you are a mayor or a chairman of a county board of supervisors or a Governor, for that matter, and you are trying to encourage economic development, a new business to move into a part of the State or a business that is in a part of the State to expand, a question you are going to get asked is: Tell me about the healthcare network in this community. I may be moving executives here. I may be trying to hire people here.

And if you have to look them in the eye and say: We used to have a hospital, but we don't now or we had primary clinics that have closed down and now you have to drive farther to get primary medical care, I can tell you, I have been in economic development discussions with businesses over the course of my 31 years in public life and seen the lights just go out in their eyes: You know, you have just told me something that has convinced me I may not know where I am going, but I know where I am not going.

One the quickest things you can do to turn that light off is to make a prospect worried about whether the employees and executives and their families will have access to good healthcare.

So on the healthcare piece of this, what Democrats are asking for by way of an alternative--not a nonnegotiable but by way of an alternative--is let's go into the changes that were made in the reconciliation bill and fix them.

I have Republican colleagues who say: We don't want to completely reverse them because there are some things about the ACA premium tax subsidy we don't like. We would like to design them differently. We would like to negotiate.

I am completely open to that, but I do think we ought to try to fix them.

I am heartened that a number of Republican colleagues have said: You are right. We should do that.

I have said to my Republican colleagues: Coming up with a fix, even if both sides want a fix, I know this is not going to be a snap decision. There are details. You have to dot the i's. You have to cross the t's. You have to analyze what the downstream consequences of any changes in the fix are. I know that that is a substantive discussion where the details matter. I am not expecting that we would all reach an agreement immediately.

So on the first point, where the Democratic proposal is different than the Republican proposal, I fully expect that this would be a negotiation that would take some time. We needn't wait to open the government until that negotiation is completely done. We should commit to the negotiation and get in the middle of it and sit around the table and figure it out. But we needn't wait, in my view--again, this is me, not the caucus, not anybody else. This is me. We needn't solve the entire problem in order to reach a position where we fund the government and reopen it. We can do it over the course of a time period that I think is being discussed in this body.

The second feature of the Democratic proposal that is important to reach an accord on, I believe, is a simple notion that a deal is a deal. A deal is a deal. If we reach a funding agreement--and some have characterized the Republican proposal as a clean CR, but I would actually say it is not a clean CR unless you are guaranteed that the parties will honor it.

Whatever we do--if we do something for 30 days or if we do something for 45 days--I think it is only fair to ask that a deal be a deal; that Congress fully live up to it but the White House fully live up to it as well.

We have seen, throughout this year already, congressional deals undone by the President unilaterally: tens of thousands of people fired, economic development projects that had been announced and celebrated canceled, funds to public health Agencies taken back. Again and again and again, we have seen, in Virginia, unilateral actions taken by the President that, in our view, undo what Congress and the White House had agreed to in previous budget resolutions. So it is not unreasonable for us to say: Well, if we are going to do a short-term CR to try to find the path for a full-year appropriations bill, we would just want an agreement during that 30 or 45 days--whatever it is--that a deal is a deal; that we not write it, agree to it, celebrate reopening the government, and then have President Trump on day two start to fire a whole lot of people or claw back more money from the Virginia Department of Health or cancel more economic development projects in Virginia. Let's just say a deal is a deal. Congress will live by our piece of it, and the White House would live by its piece of it.

Virginians get this. I was traveling around this weekend, and Virginians do not want the government to be closed. They want it open. They said to me: Keep the government open.

I said: We want to get that deal just like you do. We want to get a deal.

But if I said to Virginians: And on that deal, Congress should live up to it, right?

Right.

And on that deal, the President should live up to it, right?

Right.

People get that a deal is a deal. It is not a complicated theory of government or an argument about democracy; it is just basic fairness that when parties reach an agreement and shake hands, that both parties have to honor it.

So what I am looking for very significantly in these discussions is an agreement from the White House that whatever the short-term period is, they will not take punitive actions against my State, against the State of Indiana, against the city of New York, or against anyone, or against any particular program that is part of a congressional appropriations bill that is already in process; that they will not selectively pick out programs to attack or individuals to fire during the course of that agreement.

I think we have to have that longer discussion about an alternate yearlong appropriations bill, about a deal is a deal, but all I am looking for here and all Virginians are looking for here is that we would reach that agreement during the pendency of some short-term CR as we try to negotiate a full-year agreement.

We can do this. We can do this. We ought to do it.

For a reason of fiscal conservatism, during the last shutdown in 2018-2019, I was able to sort of strategically put a bill on the floor on a day much like today, a Thursday during the shutdown, and get colleagues to unanimously agree with the principle that in the event of any shutdown, Federal employees would get backpay.

It used to be, in the old days, if there was a shutdown, you had to fight about backpay after, but now there is a backpay guarantee. When there is a shutdown, people are guaranteed backpay. So that makes shutdowns really foolish, like, you are going to shut down; you are going to lock people out of their office; you are going to tell them they can't do the work; and then you are going to write them a paycheck anyway.

The fiscally conservative answer, when there is a backpay guarantee, is to end this quickly so people can go back in their office and serve their fellow Americans.

The fact that we, I believe, have narrowed the point of division down to can we find a path forward to negotiate healthcare fixes, even if we don't agree on all the details right now, and can we reach an agreement that a deal is a deal, which is a reasonable request--I believe those are the two issues that are on the table. And they are issues that we are eminently capable of solving and solving very soon. And I am going to do everything I can with my colleagues on both sides of the aisle to make sure we do.

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