[Congressional Record Volume 164, Number 30 (Thursday, February 15, 2018)] [Senate] [Pages S1131-S1136] From the Congressional Record Online through the Government Publishing Office [www.gpo.gov] BROADER OPTIONS FOR AMERICANS ACT The ACTING PRESIDENT pro tempore. Under the previous order, the Senate will resume consideration of H.R. 2579, which the clerk will report. The senior assistant legislative clerk read as follows: A bill (H.R. 2579) to amend the Internal Revenue Code of 1986 to allow the premium tax credit with respect to unsubsidized COBRA continuation coverage. Pending: Grassley amendment No. 1959, in the nature of a substitute. McConnell (for Toomey/Cruz) amendment No. 1948 (to amendment No. 1959), to ensure that State and local law enforcement may cooperate with Federal officials to protect our communities from violent criminals and suspected terrorists who are illegally present in the United States. Schumer modified amendment No. 1958 (to the language proposed to be stricken by amendment No. 1959), of a perfecting nature. Durbin (for Coons/McCain) amendment No. 1955 (to amendment No. 1958), to provide relief from removal and adjustment of status of certain individuals who are long-term United States residents and who entered the United States before reaching the age of 18, improve border security, foster United States engagement in Central America. Recognition of the Majority Leader The ACTING PRESIDENT pro tempore. The majority leader is recognized. Parkland, Florida, School Shooting Mr. McCONNELL. Mr. President, I wish to begin this morning by sharing the shock and sorrow that all of us in this body felt as we learned of yesterday's shooting at Marjory Stoneman Douglas High School in Parkland, FL. To say that such brutal, pointless violence is unconscionable is an understatement. Schools should be places where children can learn, and faculty and staff can work without fear of violence. My colleagues from Florida will carry home the prayers of the whole Senate for victims and their families, for the community of Parkland, and for the first responders who bravely charged into harm's way on behalf of others. For the information of all Senators, the Senate will observe a moment of silence at 12 noon. Now, Mr. President, on an entirely different matter, the entire week has been set aside, as I assured it would be, for votes on the DACA issue, border security, and other issues pertaining to the subject of immigration. At this point, we should be wrapping up a lively week of debate, amendments, and numerous votes, but that is not what has happened. Instead, we are here on Thursday morning and have yet to vote on a single amendment--not one amendment all week on what was offered: an open debate. Remember, our Democratic friends wanted this debate. They actually shut down the Federal Government for 300 million Americans, unnecessarily, to guarantee that we could have this debate and at this particular time--this week. They have spent months insisting that DACA is a top priority for them [[Page S1132]] and telling their constituents they would do everything they could to resolve it. But when the rubber meets the road, they have yet to bring forward a single proposal that gives us a realistic chance to make law; that is, to pass the Senate, pass the House, and earn the President's signature. All they have done so far is to slow the process as much as possible. It turns out that they didn't want a fair, open, freewheeling amendment process after all. Yesterday evening, I filed cloture on all four pending amendments. At a minimum, under regular order, we could make sure that at least they receive a vote by Friday morning. I hope the Democratic leader will finally consent to hold these votes on amendments today. Our Democratic friends say they want resolution for illegal immigrants who were brought into the country as children. The President put forward a framework that would do exactly that. His reasonable proposal offers a more than generous resolution for 1.8 million individuals in that category. But the DACA issue is just a symptom of our broken immigration system. So the President has made clear, and I strongly agree, that any legislation must also treat the root causes and reform legal immigration, and it must also include commonsense steps to ensure the safety of the American people. Several Senators, led by Senator Grassley, the chairman of the Judiciary Committee, have crafted legislation that accommodates the major interests of all sides. It fulfills the stated goals of our Democratic colleagues and--and--conforms to the President's requirements. Their bill provides funding to secure the border. It reforms extended chain migration and the visa lottery program. It fixes the loophole that forces us to release thousands of criminal aliens who were rejected by their own home countries. It enacts Kate's Law to put criminals who illegally and repeatedly cross our borders behind bars. It gets tougher on violent and dangerous criminals such as drug smugglers, human traffickers, repeat drunk drivers, gang members, and sex offenders. And, yes, it offers a generous--extremely generous-- resolution to the DACA issue. The President, in my view, has gone more than half way to meet the Democrats and resolve this matter. If they are actually interested in finding a solution, it is time they take yes for an answer so that 1.8 million people are eligible for citizenship. Because my Democratic friends were stalling for time, they spent 3 full days making political points instead of making law. I hope today can be different. Tax Reform Mr. President, on a final subject, it has only been 55 days since the President signed historic tax reform into law. Already, it has led to bonuses, raises, and new benefits for millions of American workers, and the long-term signs are just as promising. Hundreds of companies have announced significant commitments to plant deeper roots in the American economy. We know the Tax Cuts and Jobs Act is pro-worker and pro-business, but tax reform is also, at its core, pro-family. It doubles the standard deduction, meaning a young married couple effectively gets a new zero- percent tax bracket for the first $24,000 they earn. If that couple decides to purchase a home, their mortgage interest will be eligible for a deduction. Contrary to what many predicted, the historic tax cuts we delivered didn't jeopardize the middle-class deduction. We preserved it. When that couple starts a family, they will benefit from the fact that we doubled the child tax credit, thanks to the fine work of Senator Heller and others throughout the committee process. At its new level, that credit will save a two-child household $4,000 every year--$4,000--to help them with back-to-school costs, to kick off a college fund, or to help them afford summer camp tuition and a family vacation instead of choosing one or the other. Thanks to the tireless work of my colleague from Nebraska, Senator Fischer, the Tax Cuts and Jobs Act encourages more employers to provide paid family leave. That is good news for millions of American families who will welcome a child this year. My Democratic colleagues like to speak about the importance of paid leave, but not a single one of them voted with us--not one. Every Democrat in the House and in the Senate voted against the bill that included Senator Fischer's paid family leave incentives. Every one of them voted against a bill that included a bigger standard deduction and the doubling of the childcare credit and lower income tax rates. Fortunately, we passed this historic achievement despite their efforts to stop it. Thanks to every Republican who voted for tax reform, both Walmart and Lowe's have announced expansions of both maternity and paternity leave. CVS is creating an entirely new parental leave program. In Wisconsin, where only one of two Senators voted for reform, American Family Insurance is expanding its family leave benefits. So is Broadridge Financial Solutions in New York, despite both Senators from New York voting against it. This is only the beginning. My Democratic colleagues said tax reform would bring about ``Armageddon.'' They said nothing in our bill would help American workers. But the proof is in the pudding. The evidence is piling up. Middle-class families all over the country are glad their Congress and their President made tax reform a reality. I suggest the absence of a quorum. The ACTING PRESIDENT pro tempore. The clerk will call the roll. The senior assistant legislative clerk proceeded to call the roll. Mr. SCHUMER. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. The ACTING PRESIDENT pro tempore. Without objection, it is so ordered. Recognition of the Minority Leader The Democratic leader is recognized. Parkland, Florida, School Shooting Mr. SCHUMER. Mr. President, I rise with a heavy heart for the people of Parkland, FL, and Stoneman Douglas High School, where yesterday 17 Americans were killed in the deadliest school shooting since Sandy Hook. It was the 18th school shooting this year, and we are only halfway through February. Again, yesterday the scourge of gun violence visited an American school, a place where our kids should be able to learn free from the shadow of violence and mayhem. Again, we all watched the scenes with children running for their lives. Again, a twisted soul got ahold of an assault rifle and unleashed carnage on the innocent. Even though we didn't see it, in millions of bedrooms and living rooms in Americans' homes last night, 10-year-old, 8-year-old, 12-year- old children were saying: Mom, Dad, what happened? What do I do if this happens in my school? I address this Chamber knowing there are no words that could ease the anguish and the sorrow felt by the parents of those 17 Americans, by their friends and siblings, their neighbors and teachers. As we remember the words of Scripture that tell us ``Blessed are those who mourn, for they will be comforted,'' let us resolve to do something--something--about the epidemic of gun violence in this country. Mr. President, on an entirely different matter, Senators from both parties engaged in negotiations for months to find a solution that would allow the Dreamers to stay in the United States as well as provide border security. On several occasions, those discussions have yielded results, including last night, when a bipartisan group of moderate Senators reached a breakthrough agreement. The spotlight now turns to the rest of the Senate and especially to President Trump, who throughout these negotiations has not been constructive. President Trump has shown a remarkable ability to snatch defeat from the jaws of victory. President Trump, since he created the problem by terminating DACA last August, has stood in the way of every single proposal that has had a chance of becoming law. He turned his back on not one but two bipartisan immigration proposals earlier this year. I went so far as to put the President's wall on the table, and still the President would not take yes for an answer. Now President Trump seems eager to spike the latest bipartisan compromise, potentially with a veto. Why? [[Page S1133]] Because it isn't 100 percent of what the President wants on immigration? That is not how democracy works. You don't get 100 percent of what you want in a democracy--maybe in a dictatorship. You have to give and take. You have to compromise in order to make progress. We have tried to do that in Congress, to solve a problem the President has created. Yet, time and again, he has frustrated our efforts. If the American people want to know why Congress can look so dysfunctional, they ought to look to the other end of Pennsylvania Avenue. If the President had been quiet, if the President had let us do our work, a bipartisan compromise would have already passed this Chamber with 65 votes, maybe more, and we would have a solution to protect the Dreamers. But here we are. Let's hope it happens. If President Trump rejects another bipartisan compromise, there is no question that the American people will blame President Trump and no one else for the failure to protect Dreamers. With an obstinate President and a fractious House, I hope today the Senate rises to the occasion. The Dreamers are watching this debate right now because their futures depend on it. If we don't succeed, they face deportation to countries they don't remember. They have lived in this country their entire lives, pledged allegiance to our flag, built families, careers, served in our military. They didn't break any laws. They were brought here through no fault of their own. And despite their status, despite the fear that comes with living in the shadows, they strived hopefully to make a successful life in this country, which they love. What can be more American than that? We owe it to them to find a solution that can pass this body of Congress. The only solution, unfortunately, that my friend the Republican leader has offered is the very partisan Grassley bill--no input from Democrats, no effort to compromise. We Democrats, on the other hand, have supported several bipartisan agreements on the table. We are ready to vote on them, including the genuine, bipartisan compromise that moderates, Democratic and Republican, reached last night. There are plenty of things for everybody not to like in this bill. There is a lot I don't like in it, believe me. I think the wall will not accomplish anything. It will be an enormous waste of money and will be a terrible symbol of our America, replacing the beautiful lady who stands in the harbor I represent. But compromise is compromise. Democrats and Republicans will find provisions they don't want and wouldn't include if they had written it. But we have to do our jobs today. We have to rise above our differences, admit that no one will get everything they want, and accept the painful compromises that come with democratic government. That is what the Senate has done through the centuries. It has been hard. People have anguished. In the past, the Senate has risen to the occasion. Can it do it today? I say that to my colleagues on both sides of the aisle. No one else seems willing to do it--not the House, not the President. It is the Senate--what President Washington famously called the cooling saucer for our politics--that can show the Nation how to lead, that can show the Nation what bipartisanship looks like, what compromise looks like, what progress looks like. The Senate can do that today. Let's do our job. Let's rise to the occasion. And by the end of today, let's say to the Dreamers that the Senate believes America has a place for them too. I yield the floor. The ACTING PRESIDENT pro tempore. The Senator from Oklahoma. Parkland, Florida, School Shooting Mr. LANKFORD. Mr. President, I join with many others who are praying for the families in Florida today as they grieve--an overwhelming grief that most parents would never contemplate--because they do not have the opportunity to take their kids to school today because their lives were taken yesterday. I continue to pray for, engage in, and help in any way that we can through this process. I know so many of the schools in my State have taken active steps over the past many years to provide greater security in the schools, with lockdown access and other things that they have done intentionally to provide greater and greater security. There is no explanation for an individual who is a former student of a school to return to the school with a gun and with who knows what motivation. So we will continue to pray, engage, and work with schools on security, as we have done from this body in the past, as well as to provide financial resources to help schools and their security systems, to help provide advice and counsel--to do what can be done. We will pray along with the families who struggle deeply, and we will walk with them through their incredible, inexplicable grief. Mr. President, this is a week that has been set aside for the immigration debate, but today is the first day there has been any real immigration debate on the floor. It is Thursday. All week, this floor has sat mostly empty. For months, there has been the preparation to put immigration bills on the floor, but as of earlier this week, there had only been one bill that had actually been proposed--the President's bill--to be able to say: Here is a middle-ground position. After months of negotiation and the White House meeting with everybody--both sides of the aisle from the House and the Senate--the White House laid out a proposal and said: Here is a middle ground. I would say that the White House has moved a tremendous amount in this and has dropped a tremendous number of issues. Over the course of the past several months, the White House has moved away from a lot of things. First, it moved from legal status to saying: OK, let's do citizenship. It is not citizenship for just the 690,000 individuals who are currently in DACA, but the White House opened this up--and I agree--to 1.8 million individuals who are not only DACA students but to those who are also DACA-eligible, those who did not sign up for the process but who could have been eligible for it. Interestingly enough, the President even moved from President Obama's position. President Obama's position for DACA was that you had to be in the country by 2007. President Trump has moved that and said he will be more open. You will have had to have been in the country by the time President Obama announced the program in 2012. That was a significant concession which has opened up the program for almost 1 million more individuals. The trade-off was pretty straightforward. He had a long list of items to be able to provide border security--both interior enforcement and border security. Yet, over the past couple of months, the President has backed up and said OK. The Democrats have said they absolutely do not want any interior enforcement of any immigration laws added in any way, so the President backed up and said: Let's start with border security. We want to do interior enforcement in the days ahead, but let's start with border security. The President wanted to address the issue of sanctuary cities, but that is not addressed in this bill. He has dropped that. The President wanted to deal with asylum reform, but he has dropped that issue from his proposal. There is no conversation about refugees and changing how that structure would work. There is no conversation about the H visa programs. He has dropped a lot of issues that were important to the White House and has said: OK. We will deal with those on a different day. Let's limit the issues to this narrow group of four issues, and that is all we will deal with. He dropped a lot of other issues for it. Border security, dealing with citizenship for those individuals who are in DACA or who are DACA- eligible, dealing with the issue of family migration and how that works together, and then dealing with the issue of the diversity lottery-- that is it. Everything else dropped away. It is not comprehensive--it is small--but border security had very clear definitions. Border security is not just a wall. I have heard some individuals say, even on this floor today, that a wall will not accomplish anything. I would say the President agrees with that. A wall by itself doesn't accomplish anything. A wall is needed in some sections of the border to slow down illegal crossings, especially in urban areas, where there are urban areas on both sides of the border. It is [[Page S1134]] needed in those areas, but a wall by itself doesn't accomplish anything. You can go around it, and you can go over it eventually. What you need are additional agents. What you need are additional enforcement authorities. What is needed is to be able to break down some of the legal loopholes. Some proposals that have come out in the last few hours have said they want to strike a bipartisan compromise and say: OK, we will provide for wall funding, and we will allow for the large legalization and naturalization of individuals who are DACA and DACA-eligible. That is a fair trade-off, they say. The problem is when you read the fine print of what that means. I go back to the same statement: If they say a wall doesn't accomplish anything, and all they provide is really a wall and a few technical things around it, then the question remains, What is missing? What would make the difference? What would make the difference are some very basic things to be able to close legal loopholes. That is what is in the President's proposal-- none of them onerous, none of them out of line. They are just dealing with the basic legal loopholes. We all have to admit, when you see the records from the Department of Homeland Security and from Customs and Border Protection, that there are individuals who cross the border, both adults and unaccompanied minors, who are coached by coyotes as they move through Mexico: When you cross the border, here is what to say. If you say these things, then you will get access into the government. They know that if they say certain phrases, they are in. I hate to say that is actually true, and it is unaddressed in any of these bipartisan compromises. I don't think it is unrealistic to say that if you go around one of the barriers or even through one of the gated entrances and cross through and immediately get caught by someone on the other side but say the magic phrases, you are in. We have to resolve that, and there are some basic ways to resolve it. If you come in and have a credible claim of fear or a claim of asylum and cross the border and immediately speak those words, currently you are allowed into the country for 2 or 3 years while your trial goes through the process. Only about 30 percent of those are actually successful. That 30 percent number is significant. What do we do to resolve it? Why don't we add additional judges and additional courts, and instead of waiting 3 years before you have that hearing, you have that hearing within 3 weeks? No evidence has changed in that time period. You are still allowed to have counsel, and you are still allowed to have insight. But we actually resolve it instead of allowing people to come into the country for 3 years and telling them ``Here is a court date and a court location to appear,'' and you do not know if they appear. In fact, the majority of them do not appear for their court dates, but they are somewhere, at a location unknown, in the country. It is not unreasonable to resolve this issue; yet it is unresolved in all of these bipartisan proposals. There is no fix to deal with criminal aliens or those individuals who come into the country who are gang members. It is a small minority, but there are those individuals, and there seems to be no fix for those things at all. There is no dealing with the issue of the hiring process for the Department of Homeland Security. If you are in remote areas on the northern border--there are requests to add additional compensation to some of these areas or to give additional benefits to some of these Customs and Border Protection folks because they work in very remote areas along the border. They ask for this year after year after year, and there is nothing addressed in the bipartisan agreement. It is just the wall and asking: Shouldn't that be enough? It is not. There is no dealing with drugs like fentanyl and trying to interdict those in the border areas. It doesn't provide any deterrence for the visa overstays. About 40 percent of the individuals who are illegally in this country right now came on a tourist visa or on some other kind of visa and just overstayed it. We have to resolve those issues as well. That seems to be an obvious issue. There is no dealing with some of the basic statements. What do I mean by that? Under some of the bipartisan bills that are coming out, you prove yourself to be a DACA-eligible individual by your own verbal statement that you are eligible. No documentation is required. I think that is an obvious loophole. If you are DACA-eligible, even, in fact, under President Obama's proposal, you have to show documentation that you are DACA-eligible. Yet, in these new proposals, you don't. You just have to say that you are eligible, and suddenly you are eligible. That is a major problem. The structure of how some of the bipartisan agreements have come out has also become a big issue for me because it doesn't really deal with just this 10-year. In one section of the bill, it says it is a 10-year path toward citizenship. I have no issue, if we can do border security, with having a 10-year path toward citizenship. It allows us to have 10 years to deal with the basic border security things. It gives certainty to those individuals who are in the country that they are headed toward citizenship. I have absolutely no problem with that, but the bipartisan agreement that has come out doesn't do that. In one section, it says a 10-year path to citizenship. In another section, it gives the recipients the opportunity to get legal permanent residency--green cards--much faster, which then moves them on to a much faster track. It is a little bit of a sleight of hand that we say 10 years in one part and in another part say that it is actually 5 to 7 years. Say what you mean. Don't try to say two different things and have two different paths. I was also interested in a change that was slipped in at the very back of the bipartisan bill that makes an enormous change to the status of every single individual in the country. Let me just read this. It is being said that this bill is just about a wall and just about DACA, but let me read this section in the back of the bill: In carrying out immigration enforcement activities, the Secretary shall prioritize available immigration enforcement resources to aliens who have been convicted of a felony, a significant misdemeanor, three or more misdemeanor offenses, pose a threat to national security or public safety, or are unlawfully present in the United States, and--that is an important word in there, ``and''--they arrived in the United States after June 30, 2018. Do you know what that says? That says the Department of Homeland Security can't go after anyone in the country illegally who arrives here before June 30, 2018. In other words, the race is on. If you can get into the country and across the border before June 30 of this year, you are in, and you have amnesty--for millions. That is not about DACA; that is every single individual in the country unlawfully present. If you are in the country unlawfully present before June 30 of this year, according to this bill, you are in until you commit a felony. As long as you don't do that, you will never have any enforcement of any type. I was stunned to see that slipped into the back of the bill. This was dropped last night, and we still have the opportunity to go through it, but I am quite surprised at the number of people who have pushed back on the President and have either not read his proposal or have ignored what he put on the table. It is not an unreasonable proposal. It is a straightforward, commonsense proposal. I would encourage those folks who oppose it to read it first and to see what it actually says. There has been pushback on the issue of chain migration or family reunification. Let me set this in context. Right now, we have a 20-year backlog for individuals coming into the country legally. That is an incentive not to do legal immigration because if you are going to wait in the line 20 years long, many are just not going to go through the process. Unless we reform how we do the family integration, once 2 million additional people are added to this in the 10-year time period, I have no question we will move from a 20-year backlog to a 25-year backlog as family members also reconnect with those individuals coming in. What happens at that point? A bad situation gets even worse in our immigration policy. The issue of family reunification and the proposals that were laid out have not been partisan proposals in the past, [[Page S1135]] but suddenly because President Trump put it out there, it is suddenly an unrealistic partisan proposal. May I remind everyone that this issue was also dealt with in the 2013 Gang of 8 bill that got around 70 votes in the Senate--this very similar issue of family reunification and how this would work. In 1995, during the Clinton administration, a proposal was made by Democratic House Member Barbara Jordan, leading the Commission on Immigration that made almost the exact same proposal in 1995. This was just not a partisan issue until now. For some reason, because President Trump wants to propose it, it is an angry Republican issue. It has been a bipartisan, commonsense issue for a long time on how to deal with an obvious issue in our immigration reform. I would encourage my colleagues to read the bill and see what is in it, not what is being said in the media about it. See what is really in it, and if there is a question and a dialogue about it, let's amend it. Let's go through it because it is a very unique and powerful opportunity to set it right for those individuals who are in the DACA and DACA-eligible population to finally not be in limbo but to finally have permanence and to know they are home in this country where most of them have grown up; that they are not just long-term guests, they are home. This is the way to resolve this but at the same time do what Americans have cried for, for a long time--actually secure our borders and start the process of reforming our immigration system in a way that makes sense for everybody--for the immigrant, for the born citizen of the United States, for the naturalized citizen, and to make sure it is fair for everyone. That is not unreasonable. In fact, it is a good idea. If it were only proposed by someone else, I think a lot of folks on both sides of the aisle would agree with it. Take the politics out of it and look at the policy. Let's resolve this for the country. I yield back. I suggest the absence of a quorum. The ACTING PRESIDENT pro tempore. The clerk will call the roll. The senior assistant legislative clerk proceeded to call the roll. Ms. STABENOW. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. The PRESIDING OFFICER (Mr. Sullivan). Without objection, it is so ordered. The Senator from Michigan. CHANGE Act Ms. STABENOW. Mr. President, we have so many issues in front of us that are critically important to families. I want to speak about an issue today that is extremely important to so many Michigan families and to families across the Nation. It is estimated that 5.5 million Americans are living with Alzheimer's disease, including 1 out of 10 people over the age of 65. That number is growing. To put that in perspective, that is about the same number of people who live in Wisconsin or Minnesota or Colorado. By 2050, it is estimated that as many as 16 million Americans may be living with Alzheimer's. That is more people than live in Pennsylvania or Illinois. From Alaska to Alabama, to New Mexico, to Maine, no State is immune, as we know. In my own State of Michigan, the number of people living with Alzheimer's disease is expected to rise from about 180,000 today to 220,000 in the year 2025, which is not very far away. That is an increase of about 22 percent in less than 7 years. The cost of providing healthcare and long-term care for people affected by Alzheimer's is astronomical and growing. In fact, one out of every five Medicare dollars goes to Alzheimer's disease. It is estimated that last year, for the first time, the United States spent more than a quarter of a trillion dollars on Alzheimer's-related care. Without better treatments or a cure, those costs could surpass $1.1 trillion by 2050. Of course, much higher than the dollar cost is the human cost. As anyone who has lived with the disease or anyone who has had a family member live with the disease can tell you--and this really is the ultimate family disease--Alzheimer's and related dementias are thieves. They steal everything--memories, personalities, even lives. No price tag could ever be put on the suffering they cause patients and their families and the strain they place on caregivers. There are 15 million people in the United States caring for a family member with Alzheimer's. While many of them consider caring for a loved one a sacred duty, this duty still exacts a physical and mental toll on them. Caregivers suffer higher rates of heart disease, cancer, and depression than those in the broader population, and many are forced to quit their jobs or reduce the hours they work, creating additional personal and financial stresses. Lauren Kovach of Brighton, MI, learned what that is like when her grandma--she calls her Chupe--was diagnosed with Alzheimer's. Lauren's mom was a caregiver. She and Lauren made a pact that they would never put Chupe in a nursing home because she, in Lauren's words, ``lived her life for her family and to take care of us--of course we were going to do the same for her.'' That required a lot of sacrifices. Lauren's mom retired early. Lauren withdrew from college and moved in with her mom to provide a ``loving home full of laughter,'' as she said. They received no help with caregiving or living expenses. Lauren wrote: My mom is single-handedly the best person I know. She needs help. We need help. Many hundreds of families like mine need help. Lauren's beloved grandma passed away last June, but Lauren is still fighting, and I am proud to be fighting alongside her. She wrote: I go to Lansing each year for Advocacy Day--I will talk to anyone and everyone about this disease that is ruining millions of lives, including mine. Alzheimer's unfortunately isn't going anywhere anytime soon, but neither am I. This fighting spirit is what keeps caregivers like Lauren going, and they deserve to know that we are, in fact, fighting alongside them. That is why Senator Capito and I have introduced legislation that will help give families in West Virginia, Michigan, and all across the country new tools to cope with an Alzheimer's diagnosis and the life that follows. I would like to thank my friend from West Virginia for partnering with me on this important bill. The CHANGE Act builds on my HOPE for Alzheimer's Act, which was implemented beginning last year and supports parents and their families by requiring Medicare to pay for an individual care plan when a family member is diagnosed. This encourages more doctors to feel there is a reason to have early diagnosis because there is something they can do for people. It is certainly something that families need in order to have a plan, an action plan, once they receive that diagnosis. The CHANGE Act approaches this disease from a number of different directions and builds on the HOPE for Alzheimer's Act. First, it encourages early assessment and diagnosis. This is not happening as much as we would like. The Alzheimer's Association polling has indicated that a very high number--35 percent to 40 percent--of physicians are not doing early diagnosis. Oftentimes, they have said it is because they don't know what to do about it. There is no cure. There is not something to offer families other than fear. We want to make sure there is early diagnosis because there is a lot going on right now with medications that actually will help early. We want to make sure that patients have more time to make their own healthcare decisions, to access community-based support services for their family truly to be able to plan. Through HOPE for Alzheimer's, we now have a caregiving plan that the physician will be reimbursed for coordinating and bringing together. But there is much more that we need to do. Early diagnosis also gives patients and their families additional opportunities to participate in clinical trials. There is great research going on in Michigan and across the country that really does provide hope. I am encouraged and hopeful about the additional dollars we just agreed to in the budget agreement last week. I was proud to be one of those pushing for additional research dollars for the National Institutes of Health. Hopefully, those opportunities and cures will come even faster. Second, the CHANGE Act would improve care by testing what types of programs most help patients, their [[Page S1136]] families, and caregivers. We know that case management, coordination of care, and caregiver support services can make a big difference both in the quality of life for patients and caregivers and in participation in clinical trials. In addition, the CHANGE Act would offer States the opportunity to test programs that help Alzheimer's patients to remain in the community--which is so important--by reducing the financial burden on family caregivers. Finally, the CHANGE Act would help uncover regulatory and legislative changes that would help accelerate Alzheimer's disease research, which is so critical right now. Families in Michigan and across the country have been waiting long enough. They have been waiting too long. They need a cure. Until that day comes, they need better treatments and more support. Just ask Nora Ann Reid-LeZotte of Kalamazoo. Only a few months after her father's death, her mom started to show signs of Alzheimer's. Nora Ann was determined to care for her mom at home. Given that she is a nurse practitioner, Nora Ann figured she was perfectly prepared to assume the role of caregiver--and then, she says, she wasn't. ``My days, then weeks, then years became more overwhelming than I could have imagined,'' Nora Ann said of the 6 years she spent caregiving. Nora Ann and her husband moved in with her mom to care for her and rented out their own house to make ends meet. Caregiver support would have made a huge difference, Nora Ann said, yet none was available until her mom's condition deteriorated enough that she needed IV infusions to stay hydrated. Nora Ann said: I was exhausted. I lost my own identity, my friends, and my life for that timeframe. My family suffered and sacrificed so I could care for my mom with dignity and safety. She added: I would do it all again because she was my mom. I can certainly identify with that, as I know all of us can. Nora Ann put her own life on hold to make her mom's final years as comfortable as possible. People like Nora Ann deserve our praise. Even more than that, they deserve our support and action on their behalf. It is time for a change. Let's pass this legislation as quickly as possible to help patients, support caregivers, and find better treatments and a cure. Families across Michigan and the country are waiting. I yield the floor. I suggest the absence of a quorum. The PRESIDING OFFICER. The clerk will call the roll. The legislative clerk proceeded to call the roll. Mr. NELSON. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. The PRESIDING OFFICER. Without objection, it is so ordered. ____________________