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Download official Senate Record PDFReturn to issue contextNATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2027—Motion to
Proceed
The PRESIDING OFFICER. The clerk will report the bill by title.
The bill clerk read as follows:
Motion to proceed to Calendar No. 436, S. 4784, a bill to
authorize appropriations for fiscal year 2027 for military
activities of the Department of Defense, for military
construction, and for defense activities of the Department of
Energy, to prescribe military personnel strengths for such
fiscal year, and for other purposes.
The PRESIDING OFFICER. The Senator from North Dakota.
Remembering Lindsey Graham
Mr. HOEVEN. Mr. President, I rise to pay tribute to my colleague but, most of all, to my friend, Senator Lindsey Graham.
it—stunned. It is hard to imagine the Senate without Lindsey. It already seems quieter. We will miss his humor, his advice, and, of course, his friendship.
Nation. He spent nearly his entire adult life in public service, from the military to the South Carolina House, to the past 31 years—31 years—here, both in the House and in the Senate. In having spent 33 years in the Air Force, the South Carolina Air Guard, or the Reserves, Senator Graham was a staunch supporter of our men and women in uniform.
Since 2010, he served as co-chair of the National Guard Caucus. With his help, we were able to successfully convince the Department of Defense to change its policy and allow guardsmen and reservists to concurrently receive their Federal tuition assistance and their GI bill benefits in full.
servicemembers, our national defense, and our military, I liked to call him “Grambo.” For me, that was his nickname, “Grambo”—you know, kind of like “Rambo.” Well, he was “Grambo.” He really was the Senate version of “Rambo” in all things military, and he was relentless, as we saw. I mean, right up until almost the day he died, he was working and advocating for our military, on behalf of American military strength, and our role as, truly, the leader of the free world.
conservative causes that have made our Nation stronger and more prosperous. He helped steer through the Working Families Tax—the One Big Beautiful Bill, or the OB3. It has got a lot of names, but the important point is that it really made a huge difference for our country and for working families. He cared about that. He cared about taking on the big challenges and doing big things.
border security and law enforcement. He was a big part of helping us implement the Trump agenda, and that was so appropriate. Lindsey was really—you know, as they say in sports, he was a triple threat. He was a triple threat. He was a force in our Republican caucus, and he could work with the Democrats.
they truly cared about each other. They were real friends. They worked together, but they truly were friends.
We will miss all of that.
Committee, Senator Graham shaped the Federal judiciary. Think of how impactful that has been from the Supreme Court down to the district courts. He played a central role in the confirmations of Supreme Court Justices, including Justices Alito, Kavanaugh, Gorsuch, and Barrett, while also helping to oversee a massive conservative shift in the Federal judiciary.
what he thought, what he felt in his heart about Justice Kavanaugh was perhaps, if not his finest moment, one of his truly finest moments where he truly stood up and said what he felt was right on the national stage and made an incredible difference, a lasting and important, incredible difference. And it wasn't rehearsed; it was just Lindsey spontaneously being Lindsey, saying what was in his heart. There is that old saying: Speak from your gut and your heart. Boy, did he, and it made a huge difference. That was vintage Lindsey Graham.
Senator Graham was most proud of his family. He was a loyal and loving brother and uncle who once said of his sister:
Of all the things that have happened in my life, her
turning out so well is the highlight of it by far.
It is only fitting that his sister Darline will serve in his place. We extend her a warm welcome to the Senate like Senator Graham did with so many of us.
after the call that night where they talked. Lindsey had gotten back from Ukraine, and the President called him or he called the President. They talked on the phone, and it was shortly after that that Lindsey had his heart attack and died.
Lindsey was able to call President Trump again or President Trump was able to call Lindsey and they talked about, you know, who should replace Lindsey during that period before the election when the people of South Carolina will elect their next Senator to replace Lindsey, and they decided on Darline.
And how fitting. How appropriate. So big thanks to President Trump for recommending to Governor McMaster that he appoint Darline. We are so pleased to have her here, and it is so fitting and appropriate.
My wife Mikey and I are praying for Lindsey and for his whole family. I have to say that my wife Mikey was always a big Lindsey fan. One time, we are at dinner or something, and she just tells Lindsey how much I like and respect Lindsey.
I said to her: Why did you do that?
She goes: Well, because you do. You really like him. You respect him.
But it is true. I think we all did, both sides of the aisle.
We will miss him incredibly. The country, the State of South Carolina will miss him. Our country will miss Lindsey Graham and his incredible service.
May God bless Lindsey and his entire family.
The PRESIDING OFFICER. The Democratic whip.
Mr. DURBIN. Mr. President, I thank my colleague from North Dakota for those kind words about our mutual friend. We are both going to miss him.
(The remarks of Mr. DURBIN pertaining to the introduction of S. 4979 are printed in today's Record under “Statements on Introduced Bills and Joint Resolutions.”)
Mr. DURBIN. I yield the floor.
The PRESIDING OFFICER. The Senator from Texas.
Mr. CORNYN. Mr. President, I ask unanimous consent to enter into a colloquy with the Senator from North Carolina Senator Tillis.
The PRESIDING OFFICER. Without objection, it is so ordered.
Bipartisan Safer Communities Act
Mr. CORNYN. Mr. President, 4 years ago, Congress passed our legislative response to one of the deadliest school shootings in American history. It happened in Uvalde, TX, at Robb Elementary School. Nineteen innocent children and two adults—teachers—lost their lives that day.
It was a devastating—a devastating—occurrence. Unfortunately, it was not
an isolated event. Americans around the country, though, joined in the suffering of these families' experience as they mourned the loss of their loved ones.
halfstaff. We all knew we wanted to do whatever we could do to prevent something like this from happening again if there was anything that we could actually do legislatively.
The much harder question was, What would that look like?
North Carolinians, and folks all around the country—saying that no parent should ever have to send their child to school wondering will that child be safe, and no child should have to go to school wondering if they were going to be a victim of a mass shooting.
and innocent children from the act of pure evil that unfolded on May 24, 2022. But we knew that—Senator Tillis, Senator Sinema, Senator Murphy, and I took on the task of trying to come up with a bill that would actually make a difference, that would save lives.
the U.S. Constitution, but we felt like we could make some progress and save lives.
corners of this Chamber to do things that maybe sounded pretty good, but they wouldn't actually change the results or maybe they would be unconstitutional in depriving law-abiding citizens of their Second Amendment rights.
if we actually wanted to be successful in doing something that would make a difference and save lives, that we couldn't just try to do something that perhaps was a good press release or might make the evening news; we actually had to do something that would be meaningful and that would result in saving lives.
I have long been a champion of Second Amendment rights. That is probably no surprise. Texans believe in the Second Amendment. But some of these proposals, obviously, were unacceptable to me, personally, but they, as I said, failed to address the problems that we have seen in these school shootings in a way that would be meaningful.
come to grips with the mental health crisis in our country and particularly that affecting young people and, in this case, in the wake of COVID and the isolation many of these young people had.
policy changes that would save those lives. So we worked together and passed a bill called the Bipartisan Safer Communities Act, which passed the Senate on June 23 and was signed into law June 25 of 2022, 32 days after the shooting.
can assure you, as we all know, but we wrote this law carefully and deliberately to ensure no law-abiding citizen's Second Amendment rights would be impaired.
weren't a criminal, you would not be affected by this law. That was true then, and it is true today.
and school safety and commonsense measures to prevent dangerous individuals from being a harm to themselves and others.
money; in the case of Texas, hundreds of millions of dollars from this law—more than $312 million, to date, to strengthen our mental health care and school hardening—to make it more difficult for violent individuals to attack soft targets like schools typically have been but no more.
districts to provide training for mental health professionals to support students, and school districts have used these resources to upgrade their security systems, to implement threat alert systems, and improve emergency response plans.
I saw some of these firsthand when I visited R.L. Paschal High School in Fort Worth, which received more than $350,000 for specialized emergency radios and safety upgrades.
behavioral health clinics around the country, which has allowed mental health clinics to expand their coverage to include not only mental health but substance abuse disorders.
treated or provided the resources for people suffering from mental health challenges that are necessary to help them not only get better but prevent them from descending into self-harm or harm to others.
operating in 46 States, and additional States have added to the CCBHC Demonstration Program recently announced by the Health and Human Services Secretary, Secretary Kennedy, that was directly linked to this law that we passed 4 years ago.
the world we live in with social media and officeholders and would-be officeholders running in political campaigns. There is a lot of misunderstanding about what this law did and what it did not do.
which it is not. So, today, together with my colleague—our colleague— Senator Tillis of North Carolina, who is a great partner in this legislation, we want to address some of the widespread misconceptions about the Bipartisan Safer Communities Act and just set the record straight.
that we had passed a red flag law which would make it possible for an aggrieved partner or spouse or family member or maybe even a neighbor to basically turn in somebody and have their firearms confiscated without due process of law.
that No. 1, it was important that there be appropriate due process requirements before they can access any of the resources in this law and, secondly, that there not be a national red flag law—leave this up to the States.
laws because you can't do so and access this money unless you enhance the due process protections that are necessary to protect what is a constitutional right.
will hear more about from Senator Tillis, but I knew that my State, Texas, would never pass a State red flag law, and the last thing I was going to do was to support or embrace a red flag law, national law, that would preempt Texas law. So we wanted to make sure that the funding that was available was available for crisis intervention programs, veterans courts, mental health courts—just to use a couple of examples—that did not have those red flag laws while making sure those States that did could not gain access to this money unless they provided an enhanced due process procedure.
created an incentive for more States to pass new red flag laws, and the statistics bear it out.
flag-related activities—4 percent—in States with existing red flag laws, and those States now had to comply with the law so a stricter due process standard applied.
health programs, veterans courts, as I mentioned, crisis intervention, school safety measures. The only States to implement a new red flag law were two States that already had begun the process to pass one before the BSCA passed.
any State to pass new red flag laws. What we did is made it harder for those laws to be abused in those States that had them by providing for this enhanced level of due process protection of this Second Amendment constitutional right.
media was that we somehow created a mandatory waiting period before somebody could access a firearm if they were going into a store to purchase it for those under 21. Once again, this is false.
have a history of violence, are known to local law enforcement, and are essentially ticking timebombs. That is what happened in Uvalde, TX, 4 years ago. The Uvalde shooter was a deeply troubled young man known by everybody in the neighborhood to be trouble, and there were warning signs that, I think, demonstrated the fact that he was not only a potential danger to himself but also others.
He was isolated, a bully. He self-harmed. He had a history of fighting, threatening fellow students, and abusing animals. He bought weapons and ammunition within days of turning 18 because the juvenile records in Texas were not uploaded into the National Instant Criminal Background Check System like they are for adults.
potentially derogatory or disqualifying information that would have been available at the time of his purchase.
mental health adjudication, it shouldn't matter whether it occurred a day before their 18th birthday. And what the Bipartisan Safer Communities Act allowed law enforcement officials to do was go back and look at those juvenile records. That information must now be available on the National Instant Criminal Background Check System. The BSCA incentivizes States to upload these juvenile records, but it places a strict time limit on how long the review process can take place. If a determination is not made in that window, the purchase proceeds.
are affected by the checks for under 21-year-old buyers that this bill deals with, but yet we know that it has made a real difference.
Nebraska who as a minor made terroristic threats and was placed in a mental institution, or the 20-year-old drug dealer with a juvenile felony adjudication who attempted to purchase a long gun in Arizona. These individuals would have never been discovered before the Bipartisan Safer Communities Act.
soon after the BSCA passed to ensure that juvenile mental health records would be available to the National Instant Criminal Background Check System.
the Department of Justice tools to prosecute individuals for straw purchases. So, for example, if a drug dealer knows that his or her criminal conviction would disqualify them from purchasing a firearm legally, they can't get their boyfriend or girlfriend to buy it for them without violating the law. Straw purchases are the primary way that criminals and illegal aliens arm themselves, and the Trump administration has used these new criminal provisions enacted in the BSCA to target cartel members.
Trump International golf course in September of 2024 acquired the gun via a straw purchase because his prior criminal record would have prevented him from buying it legally.
was lying on their firearms transaction, a minor offense which many prosecutors would not bother to pursue.
The BSCA also created a new firearms trafficking law. Since drug cartel members can't legally purchase firearms, they rely on firearms traffickers to arm them and carry out their violence.
combat cartel violence and prosecute individuals who engage in firearms trafficking. Indeed, the Department of Justice has convicted 459 criminals under the straw purchasing and firearms trafficking laws— 459—while another 716 violent criminals are currently facing charges under this law.
sure that we respect the rights of law-abiding citizens; and no law we would pass restricting the rights of law-abiding citizens, were we to do so, would make a difference. No law-abiding citizen is a threat to their community.
Biden's open border policies which allowed millions of people to come into the country, including some criminals and cartel members. It is the reason why I opposed the “defund the police” movement that left a wave of unchecked violence and crime in America's blue cities.
and Senator Murphy, we made sure we passed a law which actually would invest in mental health resources to identify individuals who were suffering before they became a danger to themselves or others.
law 4 years ago of community-based mental healthcare and made our schools safer for all of our children so they can focus on why they are in school in the first place: to learn.
daughter going to be safe, all the while protecting the Second Amendment rights of law-abiding citizens.
So as I reflect back on my time here in the U.S. Senate, there are a few legislative accomplishments I have made that have helped the people of Texas and our country at large—at least I hope that is the case— but out of all of these, the BSCA was one of the most critical in tangibly making the country safer for families and children.
entrance of their child's preschool that they are actually benefitting from this law, but the BSCA has made a difference, and it will continue to do so.
Sinema and Senator Murphy, that we were able to accomplish this even in the face of organized opposition.
is that there are cottage industries in Washington, DC, that spread misinformation about legislation that is actually challenging to pass because it does involve something like a constitutional right—the Second Amendment—but strictly they do it for the purposes of raising money from their membership for using in political campaigns.
proud to be here is because we are willing to take on some of these hard, complex issues on occasion and to try to come up with tangible results that benefit our constituents and all the American people.
So I yield to Senator Tillis.
Mr. TILLIS. Senator Cornyn, I would describe as probably the ultimate statesman and gentleman here in the Senate. I am not.
stand by them. I should also say he gets special credit for a lot of those provisions because they are in there because of his participation.
I have long said that I don't hold grudges, but I settle scores. And today is a good day to settle a score on another anniversary of the Bipartisan Safer Communities Act.
of in the past, spread a lot of false information about this bill. They said it was going to be a red flag bill.
red flag, for States that have implemented red flag laws. Here is the little secret: not even Republican red flag States satisfy our rigorous standards for due process, which is why they haven't applied for any funding. They wouldn't qualify for it unless they changed their plans.
So this didn't cause a wave of red State laws to be implemented. Quite the contrary, it provided resources in behavioral health and veterans courts and drug courts and family courts to help people that may be in crisis ahead of them.
Those same people who were saying: Send money now, support us because
we are defending your Second Amendment right. I should mention as speaker of the house, we expanded concealed carry rights of North Carolina at levels that people couldn't imagine.
I am a concealed carry permittee. I have more than one gun, but I am a responsible gun owner who also finished the concealed carry class and also hunter safety. And I think we all need to be responsible gun owners.
kid going into a gun store on their 18th birthday, if that is their day to buy a gun.
what the mercenaries were trying to do to raise money and kill this bill.
now, whatever they are doing, if they have got a committal, a behavioral health committal, if they assaulted a police officer, shot at one, got prosecuted for it when they were 16\1/2\ years old or 17 years old, on their 18th birthday, it is like that device in—what was it—“Men in Black,” where you erase that. Can you imagine that?
of a crime or had a serious legal entanglement, when you go to the NICS system, it was as if you were a day old. Does anybody think that really makes sense, that the crime you committed a couple of months, let's say a month, 60 days, 90 days earlier, would have not been relevant? That is absurd.
your life looked like when you were 16 or 17 years old. That is what the enhanced background check was, and yet some of these gun advocacy organizations thought that was horrible. It was going to lead to a mass confiscation of guns. It was a backdoor, I think. It was a backdoor into just taking all of our guns away.
Constitution. I heard them all saying it, saying some of it. Let me tell you what actually happened. All we did was say: If you are under 21, we are going to try and find out as much as we need to know about you for your safety and for the safety of your community.
So all we did was say: We are going to go to local law enforcement. We are going to try and get information out there and encourage States to provide the information to our national center for clearing gun purchases in West Virginia sooner so that those who do not have a bad record can get their gun purchased sooner so that we can in a matter of 3 to 10 days get this done.
going to get any approvals done, that even the good law-abiding over 21s were going to get swept into this somehow.
Well, let me tell you what has happened since June of this year. The NICS system is doing just fine. About 4,000 people who were going to be denied based on the law have been denied.
So look at these numbers again. Talking about mass confiscation, how disruptive this was, how nobody was going to be able to get guns, right? That is what all the people said: Send money, we are defending your Second Amendment right here in Washington.
as of June of this year. About 3,800 of them were denied for reasons that existed before we ever passed this law. What we have done though is found some 1,630 young people that that was not their day to buy a gun.
That was—I could go through a long list. I could talk about people being convicted of assaulting a police officer. I could talk about people who had a long gun after they had been convicted of a crime in their car. I could talk about people who accidentally in North Carolina shot their girlfriend a year before and all of a sudden—at 17 and wanted to get a gun.
I am not talking about a 38-year-old person going in. I am talking about an 18-year-old. I am talking about a 19-year-old. I am talking about a 20-year-old. All we did was say: Guys, let's make sure that this is a safe decision for the child and for the community. That is what this bill did, and that is why this bill has withstood the test of time and not a single—not one scintilla—and I would defy anybody who was against this bill to find one of the things that they predicted and guaranteed would happen have actually occurred.
buying that gun to hurt themselves, maybe to hurt their community— maybe not. But what we know is that day was not the day that we should allow them to leave that gun store with a weapon for their safety and the safety of the community.
This is Congress at its best. It is looking at the people that you generally support—and Senator Cornyn was first among them—and the gun rights community and saying: Guys, I can't take the top-line arguments against this because you all know it is not really true. It is this black-and-white world that we live in here, and it requires the very seldom impactful language like, and legislation like, the Communities Act ever get done because people get afraid of the noise and they back into their corners.
stepping up and doing what he did to make Texas safer, make the country safer, and make these people and their loved ones and their neighbors in the community safer.
red flag laws—including, I believe, the State of the Presiding Officer—let's get those red flag laws consistent with due process and show respect to gun owners because I am not aware of any red flag law, even in red States, that come close to the sorts of protections that we also put into this bill.
So let's give them an incentive to get it right. Let's make sure that every law-abiding citizen who wants to have a gun can—like me and like Senator Cornyn and like so many other people—but let's be smart about it.
when a person applies for a weapon, that they can safely own it, they are going to be safe for themselves and their community, and stop this nonsense of fearing any sort of positive change because of political repercussions.
on. And the thing that is amazing about this bill is, it went from concept to implementation in fewer than 6 weeks. That is what happens when Congress gets together, they set aside their partisan differences, they refuse to listen to the false information trying to kill a bill, and they do something good for their State and their country. That is exactly—on this anniversary of the Bipartisan Safer Communities Act— what we accomplished.
I want to thank Senator Cornyn for his partnership. It was not an easy bill. It was a lot of work, but we got it done. I thank Senator Murphy, and I should have mentioned Senator Gillibrand—or not Gillibrand—wrong Kirsten—Senator Sinema for working together.
I mean, we had people across the political spectrum, folks. Chris Murphy, whom I consider a friend and colleague, about as liberal as anybody in this Chamber—and I think he would admit that. And we have got John Cornyn, who is one of the most conservative. And then you have got me and Sinema probably somewhere in the middle.
We got together, and we got this done. And there are more people safe, and I believe there are people alive today that may not have been if this bill hadn't passed.
So, Senator Cornyn, I appreciate the work that you did on this bill. I believe we have got something that we should be proud of. And I also believe, Senator Cornyn, that the straw purchases, the gun trafficking, all the other things that we didn't spend a lot of time on—we can come down here and do a colloquy and talk about more and more of the positive aspects of this bill. And I appreciate your leadership in moving it.
Mr. CORNYN. Mr. President, I just wanted to say there is one thing that Senator Tillis said that I disagree with, and that is that he said he is not a statesman. He is. And it took a lot of
because we knew that this can be such an emotional issue and so easy to mislead people about what the facts are, that we knew that there would be a political price to be paid in order to take on this challenge.
of a young person who is suffering from mental illness or with a criminal record, a juvenile record of that—I am sure you are aware of this, but I just happened to double-check. The Pew Poll says that 62 percent of the gun deaths in America are suicide.
These are people—perhaps a disturbed young person—
Mr. TILLIS. Purchased later.
Mr. CORNYN.—suffering mental problems who got—who actually then used that gun to kill themselves or harm themselves.
Has that been your—
Mr. TILLIS. That is exactly right.
Mr. CORNYN.—your experience?
Mr. TILLIS. You take a look at the—I spend a lot of time and focus on behavioral health, Senator Cornyn, and the data is compelling.
no question in my mind that we saved the life of somebody who is buying a gun for that purpose. There is no doubt in my mind the numbers stipulate that.
Mr. CORNYN. And one of the things that I learned back, years ago, when I had a protective detail and I was the whip, is my Capital Police officer said there is this phenomenon, which I never fully appreciated before. If you think about it, some of these mass shootings are actually an act of suicide themselves because these shooters go into these situations, knowing—or likely knowing—that they will never make their way out of it. But they don't have the courage to take their own life. They need to take other people down with them, and there is a phenomenon called death by cop, where they know that by engaging a law enforcement officer, that they ultimately will be killed of necessity by the law enforcement officer to prevent causing more harm.
But I want to ask just one last question. Are you aware, has anybody contacted your office, or have you read anything in the press or seen anything on broadcast media that would indicate that a single law- abiding American has been denied access to their Second Amendment rights because of this law?
Mr. TILLIS. No, quite the contrary. That is why I am saying—look, I love saying I told you so, and I believed that that was going to be the case here.
people watching on C-SPAN—and, hopefully, some will cover our statements—I defy anybody—anyone—who opposed this bill, who scored it, who threatened Members to vote against it, I defy them to come to my office and find one example of what they were telling people to oppose this bill that actually came to pass—one.
Here it is: Public challenge. Guys, you who so—you were out there. You were emailing. You were raising money. You were saying the world is going to end, guns are going to be confiscated, that straw purchases were going to destroy—you know, that we weren't going after trafficking, that we were going after law-abiding officers, and their licenses were going to be—all these things, all this noise.
and prove to me that one—one—negative behavior by any State or local government or Federal Government has occurred. This is what happened, folks.
this C-SPAN segment and you want to come to my office and prove that something bad happened, I will take that. My guess is, I will get that hour back, and that is what I mean.
can down the road because we let people off the hook for saying things that are patently untrue and then not hold them to account a year or two later. Well, I am here to tell you: I am here for the next 173 days before I retire. Anybody who wants to come in and prove one bad outcome from this bill, give me a call.
another 173 days. We got—and I say that not because I am counting the days to leave, but I am counting the days that we have to make an impact. And I hope I can continue to work with you on this and other bills to even make it better.
Republicans. But we are smart about it, and we have the courage to step up when we see a change can be made that will keep us true to those values but also keep our communities safer. And I appreciate your leadership on this.
Mr. CORNYN. As I do yours.
We yield the floor.
The PRESIDING OFFICER. The Senator from Louisiana.
Remembering Lindsey Graham
Mr. CASSIDY. Mr. President, I rise, as so many others have, to give tribute to Senator Lindsey Graham.
different backgrounds, beliefs, and positions were. He just focused on getting things done and had the courage to take on issues that others would not.
would have replaced Obamacare with coverage for everyone—literally everyone—but at a lower cost than the Affordable Care Act. I always chuckle when I say the Affordable Care Act.
And we were a good team because we complemented each other. I was a doctor, always thinking about healthcare. He was the politician's politician.
about. At one point, I was talking to him about healthcare. He said: Oh, Bill, don't talk to me about policy. It gives me headaches. But he said he would fight to get it passed. We came up short but not because he did not and I did not fight.
Once he said: I am going to go on “FOX Morning.” If I go on “FOX Morning,” I know the President is watching. And if the President is watching the “FOX Morning” show and I say we should be fighting to replace Obamacare, it will get the President engaged.
He just knew how to find that audience that was important. He knew how to speak to them. He had a great sense of humor, and, again, he knew how to get things done.
Ultimately, that is why somebody comes to Washington. Some people come to Washington to be a Senator. Others come to Washington to do something as a Senator. Lindsey was someone who came to Washington to do something as a Senator.
I speak for myself, but I echo what colleagues have said. Lindsey Graham shall be missed.
Healthcare
Mr. President, we have got to do something about healthcare. Now, I am a physician. You might think I—of course, Bill cares about it. I can tell you who cares about it is the American people.
I was with an Uber driver last night: What do you think—you know, if you were the President, Uber driver, what would you be talking about right now?
Now, that has been echoed.
healthcare is impacting the ability of small businesses to provide health insurance for their employees. The employer-based health insurance system is the most dominant form of providing health insurance for those less than 65, and it is crumbling. The percentage of working-age adults getting health coverage from a job has decreased from 67 percent—oh, about 25 years ago—to about 60 percent now. And the reason why is that premiums are going up so much, particularly for those 62 percent of Americans who get their insurance from a small business.
Government information, if you look at inflation since about 1985, premiums should have
risen about 176 percent. But they have actually risen over 1,000— almost 1,100—percent higher than they should have. To put it this way, if they should have risen 176 percent, they have actually risen about 1,100 percent. These are premiums.
the Affordable Care Act. Indeed, the rise became higher, faster after the passage of the Affordable Care Act.
meet. Businesses contribute to the health insurance of their employees. Typically, they may employ—it depends upon the business, but they may give, oh, 100 percent. They may give 80 percent. They may give 60 percent. But whatever percent that the small business is contributing to their employees is going up.
much, then the employer pays less and less for the employees' health insurance. This can be manifested in a couple ways. Instead of paying 80 percent of the cost of the policy, they may pay only 60 percent. Or the small business may decide to get a less expensive policy, in which case they increase the deductible.
a big business is about $1,700. At a small business, for a single worker, among workers with a deductible, it is now about $2,600.
Now, it may be something like a routine visit, which is covered. They may have preventive care covered, like a mammogram or a screening colonoscopy. But, typically, they have got to put up $2,600, on average, if they go to the emergency room after a car wreck, and only then does the insurance begin to kick in.
Now, why is that important? Because most families have less than $500 of cash in order to pay for their healthcare.
their healthcare expenditures on their credit card. And that credit card debt factors into 60 percent of household bankruptcies. So they have a $3,000 deductible, and they don't have the money in their bank account. Their child gets sick, and they bring them to the emergency room. They don't have the $3,000. So they put it on the credit card, and that credit card debt mounts.
paying upon credit card interest, which means that they are carrying a balance, it has risen from about 1 percent to 3.2 percent. So 3.2 percent of their income is going to pay for interest on credit cards.
forward. So with credit card balances not paid, but being the minimal amount being paid, they are up to $10,000.
Much of this relates back to: How do you pay for healthcare? I don't have the money in my account. So I am going to use my credit card in order to pay for these large deductibles.
Well, I have got a way to address that, Mr. President. We call it the MVP Act. Under our plan, we would give an advance, an income tax credit, to the family—on average, for a family of four, about $2,000— that would go into an account that they use to pay for their benefits.
By the way, this is paid for. This is paid for.
But they would prefund a health savings account.
the money to the insurance company to subsidize the premiums, the insurance company takes 20 percent of it for overhead and for profit. You give it to the individual or family, and they are going to use 100 percent of it for the healthcare that they need.
Now, we have coupled that. So it is money in your pocket. We couple that by adding value, price transparency, so that the family knows the price they pay before they go in for the service. That could be powerful.
I was up here in DC once. Actually, I remember we were having a crawfish boil. Every year, Louisiana people have a crawfish boil. And there was a woman who saw me on the street. She stopped me.
She said: Hey, Dr. Cassidy.
And I said: Yes.
She said: I am from Texas, but I saw that you gave a speech about price transparency, and that if I paid cash, it would be cheaper than if I went through my insurance. So the doctor ordered an MRI on my son's shoulder, and they told me it was going to cost $2,000. Well, my deductible was whatever it was—say a thousand dollars. So I said: How much, if I pay you cash? They said: Well, if you pay us cash, it is only $600.
In this case, paying cash was cheaper than paying her deductible.
So if you know, if you have price transparency, if you say, “Wait a second; I am going to have at least a thousand dollars out of pocket because of my deductible, but if I paid cash right now and don't go through my insurance, it only cost me $600,” you are going to bring value to the patient.
placed into her health savings account. She could have used—in this case, she did it on her own—price transparency to find out the price. So there is money and value for the patient.
insurance company to approve or disapprove of the care that the patient knows that she needs; and, instead, we would give the money directly to her, with the tools of price transparency to bring value to the patient.
Now, we are making steps on this. Right now in the HELP Committee— the Health, Education, Labor, and Pensions Committee—of which I am the chair, we are working on price transparency legislation. We hope to get that passed in the next 2 weeks out of Committee, and we hope this passes on the floor of the Senate. This is how we bring value to the patient, by bringing the power of price transparency, as she chooses what healthcare and where to get her healthcare.
Now, we can get this done. Whenever there is a big idea like this, how do we actually help the American people with affordability? How do we actually put money in their pocket and couple it with tools that would give them the power of price transparency, in order to bring money in their pocket and value for the patient?
People say: Oh, that is too big. We can't get that done—no way.
few years. The No Surprises Act blocks about a million surprise medical bills per month for the American people. A PBM reform bill, which was signed into law by President Trump a few months ago but that was negotiated by Congress—and it was tough, but we actually got it so that the value to the patient in terms of lower drug prices, if you will, cutting out or restricting activities of the insurance company in the middle—we got that through. The administration is working on TrumpRx, which allows patients to buy drugs without hidden costs.
So my challenge to the Senate, to the House, and to the President: Let us come together. Let us get things done. Let us work for the American people.
Ask any Uber driver, ask our constituents: What is the biggest issue right now?
And they will say: Affording life.
Affording life means to be able to afford healthcare.
And, Mr. President, with the MVP health agenda, we help our constituents afford healthcare.
With that, I yield the floor.
The PRESIDING OFFICER (Mr. Curtis). The majority leader.