21st Century Cures Bill
Floor Speech
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Mr. ALEXANDER. Madam President, I come today to the Senate floor to offer congratulations to the U.S. House of Representatives because last night, in an overwhelming vote, they passed what Senate Majority Leader Mitch McConnell has described as the single most important piece of legislation the Congress is likely to enact this year.
I am referring to the 21st Century Cures Act, combined with the mental health bill, which is the most significant set of reforms of major mental health programs in 10 years. The Cures package is the result of bipartisan work over the last 2 years. Its purpose is to move cures and treatments through the expensive development process and the extensive regulatory process and into the medicine cabinets and doctors' offices of America more rapidly and safely at the same time.
That also helps to lower costs, and we hear a great deal of talk about the affordability of prescription medicines. If it takes more than 10 or 15 years and more than $1 billion to develop a drug, such as a treatment for Alzheimer's, that all adds to the final cost. We would like to lower that cost and speed that time up as long as we continue to do it safely.
I wish to especially compliment the chairman of the House committee that worked on this, Chairman Fred Upton, as well as Congressman Pallone and Congresswoman DeGette, Democratic Members of the House of Representatives. They have worked with Senator Murray, the ranking Democrat on the Senate's HELP Committee, and with me for the last 2 years on a very complex but very important bill.
Part of the bill has to do with money, and one part of that is $1 billion of funding for State grants for opioids. Now, I suspect one reason there was such a large vote in the House of Representatives yesterday--only 26 Members voted no and 392 voted yes--was because of this $1 billion for opioids. At least in Tennessee--and I am sure it is true in most States of the country--there is no more urgent epidemic than opioid misuse. It is filling up the courts. It is filling up the jails. It is filling up the hospitals. It is causing tragedies in families all across America.
The Senate passed important legislation earlier this year on programs authorizing new money, but this is the money for State grants to Iowa, to Tennessee, to California, and to every State to help deal with the opioid epidemic abuse. So I suspect that one reason so many Members of the House voted yes yesterday and so few voted no would be that it would be pretty hard to explain a ``no'' vote against $1 billion of State grants for opioid abuse.
There is also $4.8 billion of funding for the National Institutes of Health, which Francis Collins, the distinguished Director, calls the ``national institutes of hope,'' and there is $1.8 billion for the Cancer Moonshot led by Vice President Biden. There is $1.4 for the Precision Medicine Initiative, or personalized medicine initiative, a special project of President Obama, and $1.6 billion is for the BRAIN Initiative. There are remarkable advances being made in the ability to identify Alzheimer's before symptoms are evident and then to slow its progression. It is hard to imagine how much grief that would end and the billions it would save if we could do that. So those are other reasons why there are only 26 Members of the House of Representatives who voted no yesterday and 392 who voted yes.
The Mayo Clinic has sent a letter to me:
On behalf of the Mayo Clinic, I write in enthusiastic support of the 21st Century Cures Act and salute your strong, bipartisan leadership on this essential legislation.
We are pleased to see the inclusion of dedicated streaming funds for the Food and Drug Administration and National Institutes of Health. . . .
I ask unanimous consent that this letter be printed in the Record following my remarks.
So next Monday the Senate will have a chance to see whether we can do as well as the House of Representatives. I ask my colleagues to think long and hard about a big vote. We need a big vote. Let me give my colleagues one reason especially why. This $6.3 billion that is in the 21st Century Cures bill is designated for opioids, for precision medicine, for cancer, for brain, and for FDA, and it has to be approved every year by a vote. That is the way our appropriations process works.
I would say to my Democratic friends as well as to my Republican friends that if you are concerned about whether the $6.3 billion will be available next year and the next year, the best way to ensure that it is will be to cast a big vote on Monday for it this year, because it will be very hard to explain, if you vote for $6.3 billion this year spread over the next few years, why you did not vote to support it next year and the following year.
The big vote in the House should give assurance to Democrats as well as Republicans in the Senate that these are real dollars, that they are provided in a fundamentally responsible way. To Republicans who look at the $6.3 billion and say: I like the idea of funding opioids; I like the idea of improving funding for the National Institutes of Health, let me say that this is done in a responsible way.
Speaker Ryan, who everybody knows is a conservative budget hawk, created the mechanism for this funding. It was approved by Tom Price, the House Budget Committee chairman. It goes like this: $6.3 billion over the next several years for these dedicated purposes. It can only be spent for those purposes. It has to be approved every year. It does not increase the overall spending of the budget by one penny because it is offset by reductions in mandatory spending on the other side. So $6.3 billion up here and $6.3 billion down there over the next 10 years.
So this is a compromise, but it is a magnificent compromise. It is, as Senator McConnell has said, the most important piece of legislation we will deal with this year. The House passed it with a huge bipartisan vote: 392 to 26. I hope that we in the Senate do just as well next Monday because the real winners will be the American people as they look forward to treatments for Alzheimer's, for cancer, a vaccine for Zika, a non-addictive pain medicine that will help deal with the opioid misuse epidemic, and regenerative medicine, which may help restore hearts and perhaps even eyesight in miraculous ways.
This is truly an exciting time, and this is truly an effective piece of legislation that deserves our support by coming to the floor on Monday and then by passing it on Tuesday or Wednesday.
There being no objection, the material was ordered to be printed in the Record, as follows:
Mayo Clinic,
Rochester, MN, November 30, 2016.
Sen. Lamar Alexander,
Washington, DC.
Dear Senator Alexander: On behalf of Mayo Clinic, I write in enthusiastic support of the 21st Century Cures Act and salute your strong, bipartisan leadership on this essential legislation.
Efforts to advance biomedical innovation and accelerate the development and delivery of cures are of great importance to Mayo Clinic and our patients. We are pleased to see the inclusion of dedicated funding streams for the Food and Drug Administration and National Institutes of Health--including funds for research efforts such as the President's Precision Medicine initiative, the Vice President's Cancer Moonshot, and the BRAIN initiative to speed diagnosis and treatment of conditions such as Alzheimer's disease.
In addition, provisions to promote administrative streamlining, telehealth efforts and mental health reform are also of critical importance in allowing Mayo Clinic physicians and researchers to provide the best possible care to patients.
Mayo Clinic is grateful for your leadership, wholeheartedly supports this comprehensive legislation and looks forward to this innovative effort being signed into law, and we pledge to be a committed partner in its implementation. Thank you.
With best regards,
John H. Noseworthy, M.D., President & CEO.
Mr. ALEXANDER. Madam President, I thank the Presiding Officer, and I yield the floor.
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