Executive Session

Floor Speech

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Mr. DURBIN. Madam President, I listened as the Republican leader came to the floor and announced the business of the Senate for this week. Highlighted in the business will be tax treaties--tax treaties with Spain, Switzerland, Japan, and Luxembourg. According to the Republican leader, these are critical to economic development in the United States. I don't question their importance, but I will tell you that, routinely, these are done by voice vote. We don't spend the time of the Senate to come to the floor and talk about our relationship with Luxembourg.

When you look at the issues that most American families expect us to address, I would say the tax treaty with Luxembourg would be low on the list. What might be high on the list and should be considered in the Senate this week is the No. 1 concern of families across America-- Democrats and Republicans. The highest concern and the No. 1 issue when asked about the economy of the United States is the cost of prescription drugs.

The United States Senate has the authority to do something about the cost of prescription drugs. We will not be doing it this week. We will be dealing with a tax treaty with Luxembourg.

What kind of issues, when it comes to the cost of prescription drugs, might be important? Let's start with one that I have started focusing on back home.

Did you know that there are 30 million Americans who suffer from diabetes, type 1 and type 2 diabetes? Did you know that 7.5 million Americans use insulin every single day to stay alive? Four of them were in my office last week from Illinois. They were between the ages of 10 and 17. Talk about amazing young people. Three young women and a young boy talked about their lives and what had happened to them since it was discovered that they had juvenile diabetes.

Their lives have been changed a lot. Each one of them is hooked up to a CGM--I believe that is the proper term, a continuous glucose monitor--that measures whether they need additional insulin, which is pumped in another device on their arm. They talked about how this was a commitment around the clock to make sure their insulin levels were appropriate.

One little girl talked about what it meant to her family for her to be a type 1 diabetic. This beautiful young lady started talking about it. Then she got to the point where she said: It has changed our family; my diabetes has changed our family.

Then she started crying.

She said: We can't do things in our family that others do. We can't take the same vacations that my cousins take, and we can't rent that house out on the lake because of the cost of my drugs, the cost of my insulin.

I turned to her mother, and I said: Tell me, what does it come down to?

Her mom said: We are lucky. We have health insurance. Our health insurance covers prescription drugs. However, there is an $8,000 deductible. So we start each year buying the insulin for our daughter until we have spent $8,000 out of our savings. Then the health insurance kicks in. Usually it is about 3 months.

She is paying, or she is being charged, about $3,000 a month for insulin.

Let's look into this for a minute as we consider why the U.S. Senate thinks a tax treaty with Luxembourg is more important than this issue. Let's look into the fact that insulin was discovered almost 100 years ago in Canada, and the researchers who discovered it came to the United States and said: We have the patent rights to this lifesaving drug for diabetics. We never want to see anybody make a profit at the expense of this lifesaving drug.

The Canadian researchers surrendered their patent rights to insulin for $1--gave it up. I recall that when it came to the Salk vaccine for polio, he did the same thing. He said that no one should ever make a profit on a drug that eliminated polio. These two Canadian researchers felt the same about insulin.

What happened then? Insulin was produced in the earliest stages in a rather crude way but in an effective way to save the lives of people with diabetes. Over the years, that process was improved. There is no question about that.

Today there are three major pharmaceutical companies that make insulin products for the United States--Eli Lilly of Indianapolis, IN, is one of them; Novo Nordisk is another; Sanofi is another. I know a little bit about the Eli Lilly product. It is called Humalog. Humalog was introduced in the American market in 1996, an insulin product. The charge was about $20 to $30 for a dosage--a vial, I should say, and was used as a dosage for those with type 1 diabetes, type 2 diabetes. It was about $21.

Here we are 20 years later, and how much is that same vial? It is $329. Remember, this was a drug discovered almost 100 years ago. Remember, those who could have capitalized and made a fortune off of it surrendered their patent rights.

How did we reach the point where this drug, in 20 years, is 10 times more than it cost when it was introduced? It is the same drug from the same company. Why has it gone up so much in price? Because they can do it, because these pharmaceutical companies have the power to raise their prices, and people like that little girl in my office from Jerseyville, IL, who broke down in tears, can't control how much that price would be. They need this to survive.

Now you must ask yourself: What are other countries paying for exactly the same drug made by the same American pharmaceutical company, Eli Lilly?

We don't have to go very far to find out. All we need to go to is Canada--Canada. The $329 Humalog vial in Canada costs $39. Why? It is exactly the same drug and is a fraction of the cost in Canada. It is because the Canadian Government stands up for the people of that country and says: You cannot gouge, you cannot overprice these drugs. You are going to be paid a reasonable amount so that you make a profit, but you aren't going to do it at the expense of our families in Canada.

They care. They have done something about it.

We care about a tax treaty with Luxembourg. I am sorry, but as important as that may be in that small part of the world, it is more important for us to deal with the issue of prescription drugs and to ask ourselves why this U.S. Senate, this empty Chamber, is not filled with Senators of both political parties doing something about the cost of prescription drugs.

There is one traffic cop in this Chamber. He just spoke. The Republican leader decides what comes to the floor of the Senate. He has decided we are not going to consider prescription drugs. Maybe he will change his mind, but I think he will need some persuading to reach that point.

What I am hoping is that the 30 million Americans and their families will speak up when it comes to the cost of lifesaving insulin for diabetes. I hope they will do the same when it comes to other drugs--so many of them.

Senator Grassley of Iowa, a Republican, was just on the floor a few minutes ago when we opened the session. He and I are working on a bill, which is just a first step--and I underline, only a first step and not the answer to the problem. But it comes down to this: You can't turn on the television these days without seeing a drug ad. If you haven't seen drug ads on television, you must not own a television. They are on all the time. All of the information we are given about drugs with long names that are hard to pronounce and remember--all of that information is given to us over and over again so that we know much more than we ever dreamed we would know about XARELTO. We can even spell it. We know what different drugs are supposed to do to improve the lives of individuals. Those ads are being thrown at us so that eventually we have that name in our head and take it into the doctor's office and ask for that expensive drug as opposed to a generic drug. That is running up the cost of healthcare.

Senator Grassley and I put in a bill, and the bill is pretty basic. With all of the things they tell you on television about the drugs, it wasn't until just 2 weeks ago--the first time I have ever seen it--that one of these companies disclosed the cost of the drug.

You say to yourself, maybe that is an important part of speaking to consumers across America. Senator Grassley and I have a bill that will require price disclosure on these pharmaceutical companies' advertising. It is not the total answer, but I am hoping it will in some way at least slow down, if not embarrass these companies from the runups in cost that these drugs are going through.

That is part of the answer, but it is not the total answer by any means. There is a long list of things we can do and should do that are a lot more important than a tax treaty with Luxembourg, which should pass by a voice vote without taking the time of the Senate. Healthcare

Madam President, thanks to the Affordable Care Act, 20 million Americans gained health insurance--including more than 1 million in IIlinois. Thanks to the law, the uninsured rate in Illinois has been cut in half. People with preexisting conditions can no longer be denied health insurance coverage or be charged higher premiums. This protects 5 million people in Illinois with a preexisting condition. Insurance companies are no longer allowed to impose annual or lifetime caps on benefits or deny coverage for maternity care, mental health treatment, prescription drugs, or hospitalizations. Young people are allowed to stay on their parents' health plans until age 26 and seniors in the dreaded Medicare donut hole are saving money on their prescription drugs. Thanks to the law's Medicaid expansion, rural hospitals in Illinois have found a critical lifeline to help alleviate economic challenges. Yet, just last week, the Trump administration and 18 Republican-led States argued in a Federal court that the entire law should be thrown out--ruled unconstitutional. If President Trump is successful, more than 600,000 people in Illinois will lose their health insurance. Nearly 5 million Illinoisans with preexisting conditions will, once again, be at risk of discrimination.

Two years ago, President Trump tried to convince Congress to repeal the Affordable Care Act. He failed. So what President Trump couldn't do with a Republican-controlled House and Senate--eliminate health insurance for 20 million Americans--he is now trying to do through the courts. That is right. Rather than defending the law of the land, President Trump's Department of Justice is arguing before the U.S. Court of Appeals for the Fifth Circuit that the entire law is unconstitutional. Protections for people with preexisting conditions? President Trump wants them struck down as unconstitutional. A prohibition on insurers imposing annual or lifetime caps on benefits? President Trump wants that ruled unconstitutional. Tax credits to help people afford health insurance? Unconstitutional, according to our President. If you thought that the U.S. President would be on the side of Americans with preexisting conditions--women in need of maternity and newborn care, young adults just out of college, or seniors with high drug costs--well, you would be wrong. Instead, President Trump's administration is arguing that every single one of these protections should be eliminated. If President Trump and Republicans have their way in court, insurers will once again be able to discriminate against patients with preexisting conditions and impose arbitrary caps on benefits, millions will be thrown off health insurance, and families nationwide will pay more.

Earlier this year, the Democratic-controlled House of Representatives said: Not on our watch. That is right. On a bipartisan basis, the House passed the Protecting Americans with Pre-existing Conditions Act. This bill would prevent President Trump from once again allowing health insurance companies to discriminate against people with preexisting conditions. The House didn't stop there. They also passed a bill to restore funding to programs that help people sign up for health insurance, and they passed a bill to limit the sale of junk plans.

Why is the Affordable Care Act so important? Why are these House- passed patient protection bills so important? Why is this court case so important? They are important because of people like Nathan from Sleepy Hollow, IL, who recently wrote to me about his brother. Nathan wrote:

My 12-year old brother has Crohn's Disease and his treatments are very expensive. . . . I worry about whether he will be able to still have insurance if the ACA is overturned. . . . Please do everything you can to help.

To Nathan and his brother, I say this: The House of Representatives is attempting to help you. Unfortunately, the Republican-controlled Senate is not. What is the Senate, under McConnell's watch, doing instead? Nothing. Rather than address the existential threat facing America's health care system, the Senate HELP Committee advanced legislation that is stunningly silent on protections for preexisting conditions. Republicans are abdicating their legislative duty to preserve healthcare in America. As my colleague, Senator Chris Murphy, said during the HELP Committee markup, we are applying a bandaid to one arm, while the other is being sawed right off. Republicans on the HELP Committee announced grand plans to lower prescription drug costs and shield patients from surprise medical bills, but all they really did is tinker around the edges of the problems. Similarly, the Senate Judiciary Committee was slated to tackle the outrageous cost of prescription drugs. Yet what emerged from committee was the bare minimum of legislative action. When will Congress get serious about going after drug companies that are gouging the American public? When will congressional Republicans stop tweeting and issuing press releases about preexisting conditions and instead do something--anything--to help protect people in need? Talk is cheap, but, unfortunately, it is all congressional Republicans know how to do. Immigration

Madam President, I went to Chicago on Friday. I went to the northwest side of the city, and I met with a group called Communities United. It was a meeting I am not going to soon forget. There were about 20 people in the room. Most of them were women with their children, and a couple of us were politicians. They talked about the fear that is running through their community with President Trump's threat of mass arrests and mass deportations. Each one of them had an important thing to say. The one that stuck with me was a young lady--I will give just her first name. Guadalupe was her first name. She is a high school student in that section of Chicago. She started to read from a little piece of paper on which she had written down the feelings of her family about what was happening with the threats of these raids.

You see, one of her parents is undocumented. She is a citizen of the United States, having been born here, but her mother is not so lucky.

Guadalupe said: I am tired of living in fear. I am tired of being afraid that the next knock on the door means our family will be torn apart; that my mother, who has been here for almost 20 years, will be forced to leave.

She has never committed a crime. She has worked hard every single day for the family, to bring a little money home, taking jobs that most of us don't want to take, being paid low wages in the hope that her daughter Guadalupe and others would have a better life in the years ahead.

I remember that meeting because that was just the beginning of a weekend filled with meetings just like those all across that great city of Chicago, particularly among the Hispanic population--a genuine fear that ICE would start knocking on doors. People are being told their rights, their legal rights, if ICE comes to the door. Most of them are being told: Don't open the door unless there is a real search warrant from a real judge, not an ICE administrative warrant.

These people, I am sure, will find it hard to make that distinction, but it really is a question of whether they may be able to stay in the United States or cannot.

Keep in mind that we are not talking about people who have been convicted of a serious crime. As far as I am concerned, if you come to this country and you are undocumented and you commit a serious crime, you have forfeited your right to stay here. I am not making any defense of those people, but they are a tiny, small percentage of those who are here undocumented. The vast majority came to this country, some undocumented when they came, others who have overstayed a visitor's visa, a work visa or student visa, and started a life and started a family.

These are the people who have become a major part of our economy. Of the 11 million who are undocumented in this country, 8\1/2\ million actually work. They are employed. They pay taxes. They are not officially or legally part of our economy. Yet they are all subject to the mass arrests and deportation that President Trump has threatened.

As a Presidential candidate, Donald Trump regularly used inflammatory anti-immigrant language. You will remember most of these quotes because they were said over and over again.

Donald Trump said:

The Mexican government is forcing their most unwanted people into the United States. They are, in many cases, criminals, drug dealers, [and] rapists.

Donald Trump said that a Federal judge was biased against him because the judge was ``a Mexican.'' He called for a ``total and complete shutdown of Muslims entering the United States.''

He attacked a family I have come to know, Khizr and Ghazala Khan, the Muslim American parents of the American soldier who was killed in the line of duty. This Gold Star family gave their son to this country in defense of it and were ridiculed because they disagreed with President Trump.

For the last 2\1/2\ years, President Donald Trump has continued to use divisive language. On January 11, 2018, I heard it personally. In a meeting in the Oval Office that I will never forget, the President used a crude term to refer to Haiti and African countries.

This weekend, President Trump sunk to a new low. His tweets saying four Democratic Congresswomen should ``go back'' to their countries were racist and reprehensible comments. Elected officials of both parties should condemn the President's statement.

It is important to understand the President's hateful language is also reflected in his policies. The Trump administration has shown unprecedented cruelty on the issue of immigration, especially to children and families.

The Muslim travel ban created chaos at airports across the country and continues to separate thousands of American families.

The cruel repeal of DACA threatens 800,000 young immigrants with deportation to countries they barely remember.

The termination of temporary protected status puts more than 300,000 immigrants at risk of deportation to dangerous conditions. Imagine this for a moment. We have a travel advisory that says to American families: Do not--do not--go to the country of Venezuela. It is too dangerous.

But for those Venezuelans who are in the United States and should qualify for temporary protected status, this President has said: We are returning you to Venezuela.

Really? It is too dangerous for Americans, but, Venezuelans, we are going to force you to go back to the horrible situation in that country.

The disastrous separation of thousands of families at the border has done permanent damage to these families and especially to their children. Under what was known as the zero-tolerance policy announced by then-Attorney General Jeff Sessions, over 2,880 infants, toddlers, and children were separated from their families at the border.

What was even worse, they were cast into this bureaucratic no-man's- land, and they couldn't be located to be reunited with their parents until a Federal judge demanded it. We still have some who have not been reunited with their parents over a year later.

The inhumane overcrowding and migrant detention facilities that the DHS inspector general found was ``an immediate risk to the health and safety of detainees and DHS employees'' was so bad that after I personally witnessed it, I joined with more than 20 other Democratic Senators writing to the International Red Cross and asking for them to send in a team to investigate American detention facilities. I never thought I would do that.

This President's threatening, and now mass arrests and deportations, of millions of immigrants who have committed no crime and pose no threat--no threat--to the security and safety of this country has created rampant fears, as I mentioned, in Chicago and across the Nation.

Now, today, the Trump administration has put in place a new rule which will block nearly all asylum claims at the southern border from nationals of any country except Mexico, including families and children fleeing persecution.

The UNHCR, the refugee Agency for the United Nations, said this rule proposed by the Trump administration ``will endanger vulnerable people in need of international protection from violence or persecution.''

How did we reach this point? During World War II, we made a fateful decision in the United States to turn away hundreds who were fleeing Europe. Many of them were people of the Jewish religion who believed the Holocaust, which Hitler had initiated, would eventually reach their families and take their lives. There were 700 or 800 of them who were on a ship called the USS St. Louis. They came to the United States and asked for refuge here, asylum here, to escape the Nazis. Sadly, our government turned them away. They went back to Europe, and 200 died in the Holocaust. After that, after that horrible experience, we said we were going to do this differently from this point forward.

Since World War II, the United States has led the world in accepting refugees and asylees. Other countries have done more than their part. I think of Jordan immediately. We have tried to be a leader among developed countries in accepting refugees and asylees, and we have done it. When you look at all of the Cubans who came to the United States to escape communism under Castro--we have three Cuban Americans serving in the U.S. Senate whose families were part of that exodus from the island of Cuba. We did the same thing with Jews who were facing persecution in the Soviet Union. We did it, as well, after the Vietnam war, when those Vietnamese who had stood by American soldiers and risked their lives were given refuge to the United States. The list goes on and on, and it reflects who we are as a nation. We screen those who come in, but we say our doors are open to give them a second chance in life and the protection of the United States.

That was what we did from World War II until the election of Donald Trump as President of the United States. Now he has turned back the clock. We are back in the USS St. Louis era, where we are turning away refugees who are simply coming here trying to find some safe place to be.

America is better than this. We can keep our Nation safe and respect our heritage as a nation of immigrants. We can have a secure border and abide by our international obligations to protect refugees fleeing from persecution, as we have done on a bipartisan basis for decades.

The reality is President Trump's cruel and ineffective policies on immigration have made our southern border much less secure than when he took office. The President's obsession with his almighty border wall to be paid for by the Mexicans, as he suggested, led to the longest government shutdown in the history of the United States--35 days, paralyzing agencies and the government, ironically paralyzing immigration courts that were supposed to process the people presenting themselves at the border. More refugees have been driven to our border because the President has shut down legal avenues for migration and blocked all the systems to stabilize Northern Triangle countries in El Salvador, Guatemala, and Honduras.

There is also a gaping leadership vacuum at the Trump administration's Department of Homeland Security. In less than 2\1/2\ years, there have already been four different people heading this Department. Every position at the Department of Homeland Security with responsibility for immigration or border security is now held by a temporary appointee, and the White House has not even submitted nominations to fill these positions.

The Republicans have tried to blame Democrats for the President's failure to secure the border, but Democrats have tried to work on a bipartisan basis to solve this crisis. In February, after the President finally agreed to end the longest government shutdown in history, Congress passed an omnibus appropriations bill that included $414 million for humanitarian assistance at the border. When I hear Vice President Pence and others saying they were begging the Democrats to give them money for the border, we did--$400 million in February.

Then, last month, Congress passed an emergency supplemental appropriations bill with $4.6 billion of additional funding to alleviate overcrowding at detention facilities and provide the basics-- food, supplies, and medical care.

Last year, before the border crisis began, Senate Democrats supported a bipartisan agreement--bipartisan agreement--from centrists in both caucuses that included robust security funding and dozens of provisions to strengthen border security. We put this together last year. It was a compromise. I didn't like parts of it, but it is the nature of the Senate that you can't get everything you want; you have to do the best you can to solve a problem. We had a bipartisan solution. This was a chance last year for the President to step up and accept a bipartisan approach. The President rejected it. He threatened to veto it. Instead, he wanted to push for his hardline, get-tough immigration reform instead. The Senate rejected the President's bill, his proposal, with a strong, bipartisan supermajority. It was that unpopular and unworkable.

In 2013, 6 years ago, I was part of a gang of eight Senators--four Democrats and four Republicans--who wrote comprehensive immigration reform legislation. It passed the Senate 68 to 32. Unfortunately, the Republicans who controlled the House of Representatives refused to even consider the bill.

The acting DHS Secretary, Kevin McAleenan, recently said that if our 2013 bill had been enacted into law, ``We would have a very different situation. . . . We would be a lot more secure at our border.'' That is what he says now about a bill we passed 6 years ago.

Republican Senator Lamar Alexander of Tennessee, who supported the 2013 bill, said: ``If that bill became law, most of the problems we're having today we'd not be having.'' There are ways to deal with this in a sensible, bipartisan way. Our comprehensive bill did that.

Getting tough, threatening a wall, and cutting off foreign aid has backfired on this President. It has created failure when it comes to immigration.

The Democrats have introduced the Central American Reform and Enforcement Act as a comprehensive response to our current border crisis. Let me tell you the highlights.

It addresses root causes in the Northern Triangle countries that drive migrants to flee. It cracks down on traffickers who are exploiting migrants. It provides for in-country processing of refugees and expands third-country resettlements so migrants can find safe haven without making that dangerous and expensive trip to our border. It eliminates immigration court backlogs so asylum claims can be processed quickly. It expands the use of proven alternatives to detention, like family case management, so immigrants know their rights and show up for court.

Democrats stand ready to work on smart, effective, and humane border security policies, but we need our Republican colleagues to condemn President Trump's cruel campaign against families and children and to work with us on a bipartisan basis.

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