    [House Hearing, 114 Congress]
    [From the U.S. Government Publishing Office]

                  MIXED MARTIAL ARTS: ISSUES AND PERSPECTIVES

    =======================================================================

                                    HEARING

                                   BEFORE THE

               SUBCOMMITTEE ON COMMERCE, MANUFACTURING, AND TRADE

                                     OF THE

                        COMMITTEE ON ENERGY AND COMMERCE
                            HOUSE OF REPRESENTATIVES

                        ONE HUNDRED FOURTEENTH CONGRESS

                                 SECOND SESSION

                                   __________

                                DECEMBER 8, 2016

                                   __________

                               Serial No. 114-179

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

          Printed for the use of the Committee on Energy and Commerce
                            energycommerce.house.gov

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                        COMMITTEE ON ENERGY AND COMMERCE

                              FRED UPTON, Michigan
                                     Chairman
    JOE BARTON, Texas                    FRANK PALLONE, Jr., New Jersey
      Chairman Emeritus                    Ranking Member
    JOHN SHIMKUS, Illinois               BOBBY L. RUSH, Illinois
    JOSEPH R. PITTS, Pennsylvania        ANNA G. ESHOO, California
    GREG WALDEN, Oregon                  ELIOT L. ENGEL, New York
    TIM MURPHY, Pennsylvania             GENE GREEN, Texas
    MICHAEL C. BURGESS, Texas            DIANA DeGETTE, Colorado
    MARSHA BLACKBURN, Tennessee          LOIS CAPPS, California
      Vice Chairman                      MICHAEL F. DOYLE, Pennsylvania
    STEVE SCALISE, Louisiana             JANICE D. SCHAKOWSKY, Illinois
    ROBERT E. LATTA, Ohio                G.K. BUTTERFIELD, North Carolina
    CATHY McMORRIS RODGERS, Washington   DORIS O. MATSUI, California
    GREGG HARPER, Mississippi            KATHY CASTOR, Florida
    LEONARD LANCE, New Jersey            JOHN P. SARBANES, Maryland
    BRETT GUTHRIE, Kentucky              JERRY McNERNEY, California
    PETE OLSON, Texas                    PETER WELCH, Vermont
    DAVID B. McKINLEY, West Virginia     BEN RAY LUJAN, New Mexico
    MIKE POMPEO, Kansas                  PAUL TONKO, New York
    ADAM KINZINGER, Illinois             JOHN A. YARMUTH, Kentucky
    H. MORGAN GRIFFITH, Virginia         YVETTE D. CLARKE, New York
    GUS M. BILIRAKIS, Florida            DAVID LOEBSACK, Iowa
    BILL JOHNSON, Missouri               KURT SCHRADER, Oregon
    BILLY LONG, Missouri                 JOSEPH P. KENNEDY, III,
    RENEE L. ELLMERS, North Carolina         Massachusetts
    LARRY BUCSHON, Indiana               TONY CARDENAS, California
    BILL FLORES, Texas
    SUSAN W. BROOKS, Indiana
    MARKWAYNE MULLIN, Oklahoma
    RICHARD HUDSON, North Carolina
    CHRIS COLLINS, New York
    KEVIN CRAMER, North Dakota
               Subcommittee on Commerce, Manufacturing, and Trade

                           MICHAEL C. BURGESS, Texas
                                     Chairman
                                         JANICE D. SCHAKOWSKY, Illinois
    LEONARD LANCE, New Jersey              Ranking Member
      Vice Chairman                      YVETTE D. CLARKE, New York
    MARSHA BLACKBURN, Tennessee          JOSEPH P. KENNEDY, III,
    GREGG HARPER, Mississippi                Massachusetts
    BRETT GUTHRIE, Kentucky              TONY CARDENAS, California
    PETE OLSON, Texas                    BOBBY L. RUSH, Illinois
    MIKE POMPEO, Kansas                  G.K. BUTTERFIELD, North Carolina
    ADAM KINZINGER, Illinois             PETER WELCH, Vermont
    GUS M. BILIRAKIS, Florida            FRANK PALLONE, Jr., New Jersey (ex
    SUSAN W. BROOKS, Indiana                 officio)
    MARKWAYNE MULLIN, Oklahoma
    FRED UPTON, Michigan (ex officio)

                                 C O N T E N T S

                                  ----------
                                                                       Page
    Hon. Michael C. Burgess, a Representative in Congress from the
      State of Texas, opening statement..............................     1
        Prepared statement...........................................     3
    Hon. Leonard Lance, a Representative in Congress from the State
      of New Jersey, opening statement...............................     3
    Hon. Janice D. Schakowsky, a Representative in Congress from the
      State of Illinois, prepared statement..........................     4
    Hon. Markwayne Mullin, a Representative in Congress from the
      State of Oklahoma, prepared statement..........................     6
    Hon. Fred Upton, a Representative in Congress from the State of
      Michigan, prepared statement...................................    43

                                   Witnesses

    Hon. Jeff Denham, a Representative in Congress from the State of
      California.....................................................     7
    Jeff Novitzky, Vice President, Athlete Health and Performance,
      Ultimate Fighting Championship.................................     8
        Prepared statement...........................................    11
    Lydia Robertson, Treasurer, Association of Boxing Commissions and
      Combative Sports...............................................    14
        Prepared statement...........................................    16
    Ann McKee, M.D., Professor of Neurology and Pathology,
      Alzheimer's Disease Center, Boston University, Neuropathology
      Core, Boston University........................................    18
        Prepared statement...........................................    20
    Randy Couture, President, Xtreme Couture.........................    25
        Prepared statement...........................................    27

                               Submitted material

    MMA contract.....................................................    45
    Article entitled, ``UFC antitrust lawsuit: Inside Bellator's
      contracts and the effect on plaintiff fighters,'' Bloody Elbow,
      March 4, 2015..................................................    69

                  MIXED MARTIAL ARTS: ISSUES AND PERSPECTIVES

                                  ----------

                           THURSDAY, DECEMBER 8, 2016

                      House of Representatives,
    Subcommittee on Commerce, Manufacturing, and Trade,
                              Committee on Energy and Commerce,
                                                        Washington, DC.
        The subcommittee met, pursuant to call, at 10:57 a.m., in
    room 2322, Rayburn House Office Building, Hon. Michael C.
    Burgess, M.D., (chairman of the subcommittee) presiding.
        Present: Representatives Burgess, Lance, Guthrie, Mullin,
    Schakowsky, Kennedy, Rush, and Welch.
        Staff Present: Grace Applebe, Staff Assistant; Graham
    Dufault, Counsel, Commerce, Manufacturing, and Trade; Blair
    Ellis, Digital Coordinator and Press Secretary; Melissa
    Froelich, Counsel, Commerce, Manufacturing, and Trade; Giulia
    Giannangeli, Legislative Clerk, Commerce, Manufacturing, and
    Trade; A.T. Johnston, Senior Policy Advisor; Paul Nagle, Chief
    Counsel, Commerce, Manufacturing, and Trade; Dan Schneider,
    Press Secretary; Olivia Trusty, Professional Staff, Commerce,
    Manufacturing, and Trade; Dylan Vorbach, Deputy Press
    Secretary; Michelle Ash, Minority Chief Counsel, Commerce,
    Manufacturing, and Trade; Lisa Goldman, Minority Counsel,
    Commerce, Manufacturing, and Trade; Chris Knauer, Minority
    Staff Director, Oversight and Investigations; Elizabeth Letter,
    Minority Professional Staff, Oversight and Investigations; Dan
    Miller, Minority Staff; Caroline Paris-Behr, Minority,
    Commerce, Manufacturing, and Trade; and Matthew Schumacher,
    Minority Press Assistant.

    OPENING STATEMENT OF HON. MICHAEL C. BURGESS, A REPRESENTATIVE
                  IN CONGRESS FROM THE STATE OF TEXAS

        Mr. Burgess. The subcommittee on Commerce, Manufacturing,
    and Trade will now come to order.
        The chair recognizes himself for 5 minutes for the purposes
    of an opening statement.
        And good morning to all of our witnesses. We appreciate you
    being with us this morning.
        Before we turn to the matter at hand, I do want to make
    note of the fact that this is our last hearing before the 114th
    Congress. I certainly want to thank my vice chairman, Chairman
    Lance of New Jersey, and Ranking Member Schakowsky of Illinois
    for their hard work and the hard work of all of our members.
        The Energy and Commerce Committee itself is probably one of
    the most productive committees on Capitol Hill. The Commerce,
    Manufacturing, and Trade Committee has justifiably earned the
    reputation as the think tank of the Energy and Commerce
    Committee. And I would just note to the members on the dais
    that we have passed over two dozen pieces of legislation from
    members on both sides of the dais over the past 2 years, one of
    the most productive legislative accomplishments for this
    subcommittee in several years.
        So, thanks to the participation of all of our members, I
    believe, no pun intended, we have been punching above our
    weight. And I am happy to close out this Congress with my
    colleagues on the Commerce, Manufacturing, and Trade Committee
    and look forward to a busy agenda for next year.
        Once more, we turn our attention to something where this is
    plowing new ground for Congress. As broad and varied as our
    jurisdiction is, mixed martial arts, especially the industry of
    mixed martial arts, is probably a new concept to some of us. In
    fact, it is to your chairman.
        As the industry continues to evolve swiftly, it seems that
    now is the time to bring Congress up to speed on mixed martial
    arts and understand if there is a role that Congress should be
    playing in this multibillion-dollar industry. I want to thank
    Congressman Mullin for making sure this issue was on the
    subcommittee's agenda.
        The latest major mixed martial arts event drew a little
    under 2 million viewers and around 1.5 million pay-per-view
    buys. It generated $18 million at the gate, $1.5 million of
    which went to the State of New York in taxes. Perhaps most
    importantly, since about half of the mixed martial arts fan
    base is comprised of millennials, the event created 14 billion
    social media impressions, which Nielsen now tracks.
        The winner at the top of the fight card made $40 million.
    That doesn't match what a top boxing championship fight brings,
    but there is no longer a doubt that mixed martial arts is ready
    for prime time, and there is certainly no doubt that it is an
    economic driver.
        In our previous sports hearings, we have grappled primarily
    with athlete safety and the implications of safety rules on
    youth sports. The safety of MMA fighters is of importance, and
    this will figure into our broad discussion of how the industry
    works and how it is regulated at the State level.
        The politics around combat sports are tough. To some
    degree, fighters assume risks. All 50 States have legalized
    mixed martial arts and regulate it to some degree. State
    athletic commissions have generally promulgated rules that
    prohibit certain maneuvers in the ring, require certain
    equipment, and provide for athlete drug testing. Some States
    are stricter than others, depending upon a State's resources,
    how popular the State is as a venue for mixed martial arts.
        As with boxing, fighters must generally obtain a license to
    fight. States and the major promotions also require physicians
    to be present and make certain that the fighters are healthy
    before, during, and after a bout.
        I thank the panelists, who represent a variety of interests
    and perspectives, for their participation today. I certainly
    look forward to a lively and interesting discussion.
        And I would like to yield then to the gentleman from New
    Jersey for his opening statement.
        [The prepared statement of Mr. Burgess follows:]

                 Prepared statement of Hon. Michael C. Burgess

        Good morning and welcome to our hearing on Mixed Martial
    Arts.
        Before we turn to the matter at hand I note that this is
    our last hearing of the 114th Congress. I'd like to thank Vice
    Chairman Lance and Ranking Member Schakowsky for their hard
    work and the work of all of our Members. Thanks to the
    participation of all of our Members, we've been punching above
    our weight. I'm happy to close out the Congress with my CMT
    colleagues and look forward to next year's busy agenda.
        Once more we turn our attention to something Congress has
    not focused upon before. As broad and varied as our
    jurisdiction is, mixed martial arts-especially the industry of
    MMA-is probably a new concept to some of us. As the industry
    continues to evolve swiftly, now is the time to bring Congress
    up to speed on MMA, and understand if there is a role Congress
    should be playing in this multi-billion dollar industry. I also
    want to thank Congressman Mullin for making sure this issue is
    on the committee's agenda.
        The latest major MMA event drew a little under 2 million
    viewers and around 1.5 million pay-per-view buys. It also
    generated about $18 million at the gate, $1.5 million of which
    went to New York in taxes.
        Perhaps most importantly-since about half of MMA's fan base
    is comprised of millennials-the event created 14 billion
    ``social media impressions,'' which Nielsen now tracks.
        The top ticket only received, combined, $4 million. That
    doesn't match what a top boxing championship fight brings, but
    there's no longer a doubt that MMA is ready for primetime or
    that it is an economic driver.
        In our previous sports hearings, we grappled primarily with
    athlete safety and the implications of safety rules on youth
    sports.
        The safety of MMA fighters is of utmost importance and this
    will figure into our broad discussion of how the MMA industry
    works and how it is regulated at the state level.
        The politics around combat sports are tough. To some
    degree, fighters assume risks. All 50 states have legalized MMA
    and regulate it to some degree. State athletic commissions have
    generally promulgated rules that prohibit certain maneuvers in
    the ring, require certain equipment, and provide for athlete
    drug testing.
        Some states are stricter than others, depending on the
    state's resources and how popular the state is as a venue for
    MMA.
        Just like with boxing, fighters must generally obtain a
    license to fight. States and the major promotions also require
    physicians to be present and make sure fighters are healthy
    before and during a bout.
        I thank the panelists, who represent a variety of interests
    and perspectives, for their participation today and look
    forward to a lively and interesting discussion.

     OPENING STATEMENT OF HON. LEONARD LANCE, A REPRESENTATIVE IN
                 CONGRESS FROM THE STATE OF NEW JERSEY

        Mr. Lance. Thank you, Mr. Chairman.
        In my three terms serving on the Energy and Commerce
    Committee, this has been by far the most productive session for
    the Commerce, Manufacturing, and Trade Subcommittee, due in
    large part to the leadership of Dr. Burgess and the hard work
    of the committee staff.
        Through the highly successful ``disruptor'' series, CMT has
    asserted itself as the principal subcommittee supporting the
    technological innovations our economy needs to thrive. We have
    acted on the information learned from these educational
    hearings by passing bipartisan, targeted legislation and
    beginning the first legislative update to the Federal Trade
    Commission in 20 years.
        We have also passed legislation to help consumers,for
    example, to review their experiences without businesses
    engaging in retribution. Under Dr. Burgess's leadership, CMT
    has also provided vigorous oversight of the Takata airbag
    recall, the largest safety recall in automotive history.
        Congratulations, Dr. Burgess, on an exceptionally effective
    session, and I look forward to continuing our work on these
    important issues and other issues in the full committee next
    Congress.
        I also take a moment to recognize outgoing Chairman Fred
    Upton of the full committee. And today is a historic and
    important day, as the 21st Century Cures Act goes to the
    President's desk.
        At this season, I wish everybody a Merry Christmas and a
    peaceful new year, and particularly safety to our troops, our
    magnificent troops across the globe, who protect us and the
    American people in general.
        And, Mr. Chairman, I yield back the balance of our time.
        Mr. Burgess. The chair thanks the gentleman for his
    remarks. Notes the gentleman went a little bit over, but since
    his remarks seemed so important and you were thanking the
    chairman, I would ask unanimous consent that the gentleman be
    allowed to do that.
        And, of course, I want to thank the ranking member of the
    committee, Ms. Schakowsky from Illinois, for being here, as
    well, and for a very productive 2 years on the Commerce,
    Manufacturing, and Trade Subcommittee and recognize you for 5
    minutes for the purpose of an opening statement.

           OPENING STATEMENT OF HON. JANICE D. SCHAKOWSKY, A
         REPRESENTATIVE IN CONGRESS FROM THE STATE OF ILLINOIS

        Ms. Schakowsky. Thank you, Mr. Chairman. And I want to
    thank you too. It has been a very interesting and, I think,
    productive session of Congress. And it has been a personal
    pleasure to be able to serve with you as the chairman and
    myself as the ranking member.
        I also want to wish everyone a Merry Christmas and a Happy
    Hanukkah, which actually happen to fall at the same time.
        And then to the business of the morning.
        When I first heard that we would be having a hearing on
    mixed martial arts, I was surprised. I confess I am not an MMA
    fan. Aren't you shocked? I have had to learn a little more
    about MMA in preparation for the hearing, and I don't think
    that it is going to be my new hobby. However, you don't have to
    be an MMA fan to recognize the need for greater negotiating
    power and stronger protections for MMA fighters.
        Our colleague Congressman Mullin used to be an MMA fighter.
    I chatted with him about his sport, and yesterday I met with
    other MMA fighters in my office. The lack of leverage that they
    have in their contract negotiations is, frankly, pretty
    shocking. And that comes through when you look at differences
    in pay and benefits between MMA and other sports.
        Congressman Mullin comes to this issue as an MMA fighter; I
    come to it as a fighter for workers' rights and safety. But
    today I think that puts us on the same side. When I saw what
    MMA is, the mother in me came out a little bit. I don't know
    why you would do that to yourself, but MMA fighters love their
    sport, and they should be able to fight. I do, however, want to
    make sure that they aren't put at unnecessary risk.
        Safety for fighters and the structure of MMA are very
    interlinked. Generally speaking, fighters only get paid if they
    are in a match. They have to secure their own health insurance,
    because the promoters' insurance just covers injuries within a
    match, not the injuries that frequently happen in weeks of
    training beforehand. That forces fighters to push themselves,
    sometimes at great personal risk.
        MMA can involve blows to the head, and, for me, that
    immediately raises concern about brain injury, which we have
    seen in other contact sports. Two months ago, 25-year-old
    Jordan Parsons became the first MMA fighter to be diagnosed
    with chronic traumatic encephalopathy, CTE. This should not be
    surprising. Research has shown that repetitive hits to the head
    have cumulative long-term effects on brain function and
    physiology and may increase the risk of CTE.
        CTE is not new to members of the Energy and Commerce
    Committee. Last March, in response to a question I raised, a
    National Football League representative admitted for the very
    first time a definite link between football and CTE. Dr. McKee,
    who we will hear from today, was at that roundtable.
    Representatives Frank Pallone, Gene Green, and Diana DeGette
    and I have also been pressing the National Hockey League to do
    more to reduce the risk of head injuries. MMA is just the
    latest sport where CTE is an issue.
        We have seen some progress at the state level already. New
    York State included a provision in its MMA legislation that
    recognizes the risk of brain trauma and requires MMA promoters
    to carry insurance to cover treatment of life-threatening brain
    injuries.
        If, knowing the risks, adults still want to be part of MMA
    fights, I guess that is all right, but fighters and promoters
    should take some basic precautions, and fighters should have
    the leverage to stand up for their own safety.
        In Dr. McKee's written testimony, she provides some
    recommendations on the risk of brain injuries in MMA, how they
    can be reduced. We also need to support further research on the
    connection between CTE and contact sports so that adults know
    the risk.
        Research is especially critical, given the risk to young
    athletes. According to ESPN, an estimated 3.2 million kids 13
    and under now participate in MMA. Kids can start classes as
    early as 6 years old. Some leagues ban head hits for younger
    fighters. However, Dr. Rebecca Carl from the American Academy
    of Pediatrics' Council on Sports Medicine and Fitness warns
    that kids don't need to be hit in the head to experience brain
    injury. ``The force of being thrown to the ground is enough to
    injure the brain.'' That is a quote. And to continue the quote,
    ``I don't think there is enough data available to say that MMA
    is safe for children.''
        I want to explore how MMA can be safer and fairer for
    fighters of all ages.
        I want to thank the witnesses for being here today, and I
    look forward to your testimony.
        I yield back.
        Mr. Burgess. The gentlelady yields back. The chair thanks
    the gentlelady.
        The chair now recognizes the gentleman from Oklahoma, Mr.
    Mullin, 5 minutes to summarize your opening statement, please.

    OPENING STATEMENT OF HON. MARKWAYNE MULLIN, A REPRESENTATIVE IN
                  CONGRESS FROM THE STATE OF OKLAHOMA

        Mr. Mullin. Thank you, Mr. Chairman.
        And real quick, maybe you misspoke in something you said a
    while ago, that the top card, the top fighter received over $40
    million in payout. Wasn't even close, which I know is just
    misspoken. The top ticket only received, combined, $4 million.
    Compared to boxing, it is a big difference. I just want to make
    sure that everybody understands the difference on that one.
        Mr. Burgess. The chair thanks the gentleman. We will
    correct the record.
        Mr. Mullin. Thank you, Mr. Chairman, for holding this
    important hearing to examine a growing sport that I am
    passionate about like MMA. I also want to thank Chairman Upton
    for his help in getting us to this point. This informational
    hearing is vital to educate the members of this committee and
    the public on the history, current status, and the future of
    MMA.
        As we look at varying issues, from contracts to health,
    from anti-doping to conflicts of interest, I hope we can keep
    one thing in mind: It is the fighters. Without them, there is
    no UFC, there is no Bellator, there is no sport. The promoters
    have done so much to grow the sport, but the fighters are what
    make this sport so compelling and so great to watch.
        The sport is much different than when I was younger. There
    is more media, more money, and with that brings more fans. As
    MMA continues to grow, we need to make sure we keep it growing
    with everybody.
        Before I yield back, I want to highlight my bill, the
    Muhammad Ali Expansion Act. Although it is not the focus of
    this hearing, it is certainly relevant. And I look forward to
    hearing the perspectives of our witnesses on the legislation,
    on the issues it addresses with fighters' contracts, the
    ranking system, and the role of managers and promoters.
        It is my hope that all members of this committee leave this
    hearing with a better understanding of MMA and will continue
    working in the next Congress on the issue that affects all
    parties in this room, especially the fighters.
        Thank you, Mr. Chairman. I yield back.
        Mr. Burgess. The chair thanks the gentleman.
        We will conclude now with member opening statements, seeing
    no other members wishing to offer an opening statement. The
    chair would remind members that, pursuant to committee rules,
    all members' opening statements will be made part of the
    record.
        We do want to thank all of our witnesses for being here
    today, taking time to testify before the subcommittee. Today's
    witnesses will have an opportunity to give opening statements,
    followed then by questions from members.
        Our witness panel for today's hearing includes the
    Honorable Jeff Denham from the State of California, the 10th
    District,thank you for being here this morning, Representative.
    Mr. Jeff Novitzky, the vice president of athlete health and
    performance at the Ultimate Fighting Championship; Ms. Lydia
    Robertson, treasurer at the Association of Boxing Commissions
    and Combative Sports; Dr. Ann McKee, professor of neurology and
    pathology at Boston University School of Medicine; and Mr.
    Randy Couture, president at Xtreme Couture.
        We appreciate each of you being here today. We will begin
    our panel with Representative Denham.
        And, Representative Denham, you are recognized for 5
    minutes for an opening statement, please.

        STATEMENTS OF THE HON. JEFF DENHAM, A REPRESENTATIVE IN
      CONGRESS FROM THE STATE OF CALIFORNIA; JEFF NOVITZKY, VICE
     PRESIDENT, ATHLETE HEALTH AND PERFORMANCE, ULTIMATE FIGHTING
    CHAMPIONSHIP; LYDIA ROBERTSON, TREASURER, ASSOCIATION OF BOXING
    COMMISSIONS AND COMBATIVE SPORTS; ANN MCKEE, M.D., PROFESSOR OF
      NEUROLOGY AND PATHOLOGY, ALZHEIMER'S DISEASE CENTER, BOSTON
     UNIVERSITY, NEUROPATHOLOGY CORE, BOSTON UNIVERSITY; AND RANDY
                   COUTURE, PRESIDENT, XTREME COUTURE

                   STATEMENT OF THE HON. JEFF DENHAM

        Mr. Denham. Thank you, Mr. Chairman.
        I would like to thank the chairman and the ranking member
    for allowing me to testify today. I also want to thank
    Representative Mullin for bringing this issue to the forefront.
    It is an important issue to address and make sure there are
    some minimum mandatory requirements as we move forward with
    this great sport.
        I had the opportunity to enjoy another great sport, boxing.
    I spent a lot of time in and around the ring but also saw the
    challenges and the damage that a very difficult sport can have,
    the lasting impacts on those that engage in it.
        I believe that we need to have some minimum standards,
    because, oftentimes, if the health of a fighter is not
    addressed, you can have a fighter that gets back into the ring
    early or before they are completely healed. If that happens,
    that also lends itself to have irreparable long-term damage as
    well. And I have seen the lasting impacts of friends that have
    gotten back into the ring too early or before they were
    completely healed.
        So I do believe that the boxing industry has changed. In
    1996, the Professional Boxing Safety Act did make some changes.
    It focused on the physical well-being of boxers by establishing
    the minimum health and safety standards for professional
    boxing, with limited Federal oversight by the Department of
    Justice and the Federal Trade Commission. I don't want to see
    Congress insert itself so much that it really interferes with
    the great sport, but I do believe that there needs to be some
    minimum mandatory requirements.
        I also believe that, as any business, you hire people, you
    expect them to operate on your behalf. So I hire a manager,
    much like I would hire a chief of staff or somebody to manage
    my company, I expect them to operate on my behalf. And so I
    think there needs to be some transparency between the manager
    and any type of payment, outside of the fighter, that they may
    be receiving.
        In the Ali Act in 2000, after the 1996 initial act, the Ali
    Act addressed that issue. It also addressed some consistency
    across the States to make sure that boxing commissions across
    every State had those minimum contracts as well.
        And much like boxers, MMA fighters also receive a card, but
    I think that it is important that we have a consistent health
    inspection for the safety of the fighter to make sure that they
    are prepared to go back into the ring, back into the battle,
    and they are fully healthy and prepared to do so.
        So those minimum standards, I think, are very important
    across the country, making sure that our State boxing
    commissions or, in this case, MMA fighters also have that same
    safety, health inspection, a clearance to get back into the
    ring so that their future is safe as well.
        There are other experts up here that will talk about the
    rankings and contract negotiations. I think those are important
    discussions to have right now, but I don't think that there is
    anything more important than the health and safety of the
    individual that is engaging in an incredible, great sport. I
    want to see MMA continue to flourish. I am a big fan. But, as a
    former boxer, I also know that the safety that can go with that
    sport needs to be addressed as well.
        So I am proud to be a coauthor of this bill and look
    forward to working with you as we have future hearings and
    future amendments and go through the continued process. This is
    something that I think is not only exciting to address, but it
    is something that is critically important to address. And,
    again, I want to thank Mr. Mullin for bringing this issue to
    the forefront.
        Thank you for allowing me to testify.
        Mr. Burgess. The chair thanks the gentleman.
        Mr. Novitzky, you are now recognized for 5 minutes for an
    opening statement.

                       STATEMENT OF JEFF NOVITZKY

        Mr. Novitzky. Thank you, Mr. Chairman, members of the
    committee. It is an honor to be up here today with my fellow
    witnesses. My name is Jeff Novitzky. I am the UFC's vice
    president of athlete health and performance. I would like to
    thank you for holding this hearing. I think it is important to
    recognize the significance we all place, and to mirror what
    Representative Denham just said, on the most important issue
    that we will talk about today, athlete health and safety.
        I would like to start off by giving the committee a brief
    history of my experience outside of the UFC and what ultimately
    led me to the UFC last year.
        In April of 2015, I retired from 22-plus years in Federal
    law enforcement in the United States. In 2002, I opened an
    investigation on a company known as BALCO Laboratories for the
    illegal distribution of athletic performance-enhancing drugs,
    or PEDs.
        While the case and subsequent cases that I worked in this
    arena focused on the illegal distribution of PEDs and not the
    athletes that used them, nevertheless the BALCO Laboratories
    investigation ended up involving some of the biggest names in
    sport in the world at the time who were athlete clients of
    BALCO: Barry Bonds, Marion Jones, dozens of Olympic athletes,
    boxers, NFL athletes, and several Major League Baseball
    players.
        The high-profile nature of the investigation steered many
    investigative leads my way over the course of my career and led
    me to subsequent investigations involving the distribution of
    PEDs to high-profile athletes. And finally, I conducted an
    investigation on professional cycling, including the United
    States Postal Service Cycling Team, whose members included
    Lance Armstrong.
        I estimate that throughout my career I spoke with between
    150 and 200 professional athletes who chose to use PEDs, and I
    always took the opportunity to ask them why they made that
    choice. And more often than not, the answer came down to one
    word, and that word was ``trust.'' They didn't trust that their
    teammates, who they were competing for playing time and
    contracts, weren't using. They didn't trust that their
    competitors weren't using. And, most importantly, they didn't
    trust that their sports organization really cared about the
    issue, and that doping was allowed to fester because there were
    not sufficient programs in place to catch as well as deter
    athletes from ultimately harming themselves and others.
        When I was first approached by the UFC to develop and
    implement their new anti-doping program, I saw this as an
    opportunity to change that tide in sentiment. The more I talked
    with UFC executives, I quickly realized that their passion and
    commitment to athlete health and safety was paramount. They
    told me repeatedly, ``We want the best anti-doping program in
    the world. We want to be the gold standard for not just combat
    sports but for all sports.'' I realized I could be part of a
    program within a sports organization that its athletes could
    trust and could be a positive influence toward athlete health
    and safety for not just the UFC but for all professional
    sports.
        I can confidently state that in the year and a half since
    our anti-doping program has been up and running, the UFC has
    put together the most comprehensive, robust anti-doping program
    in professional sports in the world.
        A major pillar of our program is the outsourcing of the
    administration of the program to the United States Anti-Doping
    Agency, or USADA, who is widely considered the most reputable
    anti-doping organization in the world.
        Earlier this year, the UFC renewed our commitment, a 5-year
    commitment, $1 million commitment, to the Professional Fighters
    Brain Health Study that is being conducted through the
    Cleveland Clinic. This commitment makes UFC the largest combat
    sports contributor to the study. We currently have 88 current
    and former UFC fighters enrolled in the study. It is done over
    longer periods of time to develop ways to improve safety in
    combat sports, along with other professional athletes exposed
    to repetitive head trauma.
        Another big development relating to fighter health and
    safety is the construction of the UFC's new Athlete Health and
    Performance Center. The goal of this state-of-the-art facility
    will be to provide our athletes, free of charge, with the best
    training, rehabilitation, nutrition education, and injury
    prevention practices available in the world. We will team with
    universities to conduct studies on our athletes to learn best
    practices as it comes to training, rehabilitation, brain
    health, nutrition, and weight management practices. We will use
    these studies to not only help UFC athletes but all
    professional athletes. The center is scheduled to be completed
    in the spring of 2017.
        As you can see, the UFC has taken concrete steps towards
    increasing safety standards and protocols, not just within our
    organization, not just throughout mixed martial arts and combat
    sports community, but across the board in the professional
    sports landscape.
        From our anti-doping program, which has been recognized by
    the media as the best anti-doping program in professional
    sports, our continuing education of athletes on topics relating
    to their health and safety, safer weight management guidelines
    and practices, our participation in brain studies through the
    Cleveland Clinic, and our new Athlete Health and Performance
    Center, we have made great strides to ensure all of our
    athletes compete on a level playing field, take proactive steps
    to protect their health and safety, and enable to them to lead
    fulfilling lives both in and out of competition.
        As an organization, we are not only looking to lead combat
    sports in this area but take a leadership role and set an
    example for all of professional sports.
        Thank you.
        [The prepared statement of Mr. Novitzky follows:]

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        Mr. Burgess. The chair thanks the gentleman.
        Ms. Robertson, you are recognized for 5 minutes, please,
    for an opening statement.

                      STATEMENT OF LYDIA ROBERTSON

        Ms. Robertson. I am serving as treasurer of the Association
    of Boxing Commissions. And just a little background on the
    organization: In the late 1980s, a group of concerned
    commission representatives got together in the hopes that they
    could standardize some safety regulations for the professional
    boxing industry. And, shortly thereafter, the bill known now as
    the Mohammed Ali Act came into being, and it helped unify those
    various States. So more and more states joined, because in the
    Muhammad Ali Act it specifies that if you do not have an
    authorized regulatory body from within the state, that you must
    use a different recognized organization. And every state wanted
    to participate.
        Not too long after that, the law was amended and now
    includes a lot of tribal governments. So we have about 75
    members that are housed within the U.S. borders and about
    another 70 members from outside our borders.
        The ABC, which is what we call the Association of Boxing
    Commissions is a 501(c)(3) nonprofit and maintains a Web site
    and offers continual training courses to enhance uniformity and
    skill among professional boxing and MMA referees and judges.
        Roughly 8 years ago, the ABC began working on uniform,
    standard safety rules for MMA, just had been done for boxing,
    and they were updated this past summer in 2016.
        The ABC receives no funds from the Federal Government but
    exists on the dues collected from state and tribal commissions
    and from registration at the annual educational and training
    symposium. The ABC has no employees; we have no contract help
    other than the occasional CPA. I am here on my own time. And
    ABC President Mike Mazzulli had hoped he could be here, and
    there is a brief statement from him included in the comments.
        The ABC's interest is always focused on fighter health and
    safety: How do we protect fighters, sometimes from themselves,
    and yet let them participate in the sports of their choosing?
    The interest on the fighters, the fair treatment of the
    fighters, and their future is always uppermost. Without these
    brave athlete souls, this meeting wouldn't even be held. And
    without the promoters putting on those shows, this meeting
    wouldn't be held. There is a delicate balance between the two.
        The Association of Boxing Commissions expanded their name
    this past summer to Association of Boxing Commissions and
    Combative Sports, as, clearly, the ABC is ready and willing to
    accept more responsibility of the Ali Act or some other bill
    directed at safety and to benefit the fighter passes.
        The ABC, among its many members, possess unique and
    valuable perspectives. I was actually a promoter for years. One
    of our board members was a fighter at one point. Another state
    commissioner that I know of trained fighters. This five-member
    board of directors for the ABC currently has 90 years'
    experience just between us, some of it regulatory, some
    participatory.
        Unlike some laws with good intentions, the Muhammad Ali Act
    has greatly contributed to competition standards in title
    fights, altered the way contracts are entered into between
    managers, promoters, and athletes. The simple fact is that if a
    bill will reduce MMA exploitation and enhance fighter safety
    and if it is something the fighters are ready for, the ABC,
    after seeing the final bill, will probably support the bill.
        The ABC does not concern itself with promoters and their
    needs regardless of whether they are a multibillion-dollar
    promoter or a small one found in the State of Alabama. It is
    the fighters with whom the ABC is most concerned.
        In closing, I would like to remind everyone that the small
    local promoter will also be required to adhere to changes in
    any law. The ABC's goal is uniform enforcement of protections.
        And my last comment would be, there is a balance between a
    business model and a sports model. I am not an expert enough to
    tell you what that is, but I think, with all of the committee's
    experience and dedication, you will arrive at those decisions.
        And the ABC is so grateful to be a part of this. Thank you
    for allowing me to testify.
        [The prepared statement of Ms. Robertson follows:]

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        Mr. Burgess. The chair thanks the gentlelady.
        The chair recognizes Dr. McKee, 5 minutes for your opening
    statement, please.

                      STATEMENT OF ANN MCKEE, M.D.

        Dr. McKee. Mr. Chairman and members of the committee, thank
    you for the invitation today to testify on mixed martial arts
    issues and perspectives.
        My name is Dr. Ann McKee. I am a professor of neurology and
    pathology at Boston University School of Medicine. I am chief
    of the neuropathology service for the VA Boston Healthcare
    System, and I am director of the CTE Center at Boston
    University. My testimony today reflects my personal
    professional opinion. I am not speaking officially on behalf of
    the Department of the Veterans Affairs or Boston University
    School of Medicine.
        CTE, or chronic traumatic encephalopathy, is a major
    problem in contact sports, such as boxing and football, and any
    other sport that involves a high number of head impacts, such
    as mixed martial arts. Even though there is not much research
    available on the long-term consequences of MMA, we know it has
    a high concussion rate and, importantly, it has a high
    subconcussive impact rate.
        CTE is a neurodegenerative disease triggered by repetitive
    head trauma that causes buildup of an abnormal protein called
    tau in the brain. The abnormal tau is toxic to nerve cells and
    causes a progressive brain deterioration over time. Symptoms of
    CTE include memory loss, confusion, impulse control problems,
    aggression, depression, and dementia.
        CTE was originally described in boxing and now has been
    found in many other sports. We found evidence of CTE in the
    only MMA fighter we examined, a 27 year old who took his own
    life, and there is good reason to believe that a significant
    portion of other MMA fighters are at risk for CTE. This is
    because exposure to repetitive head impacts is the major risk
    factor for CTE, and MMA fighters experience substantial head
    trauma during their fights as well as during their training and
    sparring sessions.
        There has been a primary focus on concussions in the
    development of CTE. Even the movie about CTE was named
    ``Concussion.'' Yet all of our research to date points to the
    fact that CTE is associated with prolonged exposure to
    repetitive small impacts, the subconcussive hits that are
    asymptomatic.
        In sports like MMA, the risk for CTE is not directly
    related to concussions; rather, the risk for CTE is related to
    the cumulative exposure to subconcussions that occur with every
    blow to the head. The longer you play contact sports, the
    higher your exposure to repetitive head impacts and the higher
    the risk for CTE.
        Starting a contact sport at a young age often leads to a
    longer playing career and greater exposure to head trauma, but
    another factor that contributes to enhanced risk for young
    athletes is that the developing brain is more susceptible to
    damage from repetitive trauma.
        There is a lot of skepticism regarding the significance of
    CTE. For years, people have said that CTE was not a real
    disease. They say there is confusion and debate among
    scientists, that CTE cannot be distinguished from Alzheimer's
    disease or aging and epilepsy. But there is no scientific
    confusion about whether CTE exists. CTE not only exists, it is
    definitively diagnosed by neuropathologic examination of brain
    tissue.
        In 2015 and 2016, a panel of expert neuropathologists,
    convened by the National Institute of Neurologic Diseases and
    Stroke, determined that CTE was a unique disease that could be
    easily distinguished from other tau-based diseases. And they
    even went on to say there is a pathognomonic lesion for CTE--a
    brain lesion that is found in CTE that is not found in any
    other disorder and is specific for CTE.
        The other misinformation about CTE is that it is very rare,
    it has only been diagnosed in a few hundred people, and
    millions of people have played contact sports. But CTE is not
    rare. We would not be able to find 218 cases of CTE in 291
    athletes over the past 8 years if it were rare. If you don't
    look for something, don't know how to look for something, and
    don't find it, that doesn't mean that something is rare; it
    means it is underrecognized. Recent brain bank studies have
    shown that CTE is present in 5 percent of the general autopsy
    population.
        Now, if you were to ask me how to limit risk for CTE in
    MMA, in addition to the minimum standards previously suggested
    by Representative Denham, I would say: Don't allow children and
    young adults to participate in full contact with head strikes;
    educate fighters to limit their exposure so as to not allow
    head strikes in training and sparring; limit the number of head
    strikes during a match; and reduce the number of full-contact
    matches per season.
        CTE is a big problem from contact sports, and what we know
    today is very likely the tip of the iceberg. While we recognize
    the importance of contact sports to an athlete's physical and
    psychological well-being, CTE is a known and preventable
    consequence.
        There is great urgency for funding for CTE research and the
    risks associated with sports like MMA and military service. We
    need to bring hope to the players and veterans who are in the
    beginning of stages of CTE and showing signs of memory loss,
    behavioral changes, and depression. We need to develop
    effective interventions and treatments for CTE so that all
    individuals can continue to participate in the sports that they
    love but also live long, healthy, productive lives.
        Thank you.
        [The prepared statement of Dr. McKee follows:]

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        Mr. Burgess. The chair thanks the doctor.
        Mr. Couture, you are recognized for 5 minutes for an
    opening statement, please.

                       STATEMENT OF RANDY COUTURE

        Mr. Couture. Thank you, Mr. Chairman, and thank you to the
    members of the committee for having me here as a representative
    of Mixed Martial Arts Fighters Association, or fighters, and to
    give a mixed martial artist's perspective on a great sport.
        I have been a combative sports athlete since the age of 10,
    for over 40 years. I wrestled at Oklahoma State University. I
    was a three-time All American there and received a degree, a
    Bachelor of Arts, in foreign language and literature.
        I started my mixed martial arts career in 1997 as a
    wrestler, rolling years of wrestling experience into mixed
    martial arts. My first title fight was that year, in December
    of 1997. I am a six-time world champion in the sport of mixed
    martial arts through the UFC most of my career and fights took
    place.
        As an athlete, I want to give our perspective on what is
    going on in the sport and the things that we are up against.
        I think we fill out the same paperwork and are governed by
    the same regulatory committees in each state, the athletic
    commissions we fill out much of the same paperwork as boxers.
    There is one difference that is going on in mixed martial arts
    and a flaw in the structure, and that is that the regulatory
    promoter and the sanctioning body are one and the same person
    in mixed martial arts, which isn't the case in boxing.
        Independent sanctioning bodies are formed in boxing and
    licensed by the athletic commission to create rankings and
    titles for boxing. In mixed martial arts, the promoter does
    both of those jobs. He promotes the fights; he also creates
    those rankings and those titles for those fighters. That gives
    him an unfair advantage and reduces the ability of the fighter
    to negotiate a fair value in the marketplace.
        An obvious example of that is that recently the UFC,
    through Zuffa, sold for $4.25 million. If you do the simple
    math of the 16 years that they owned the company and how much
    they put out to the fighters during that time period, it is
    literally less than 10 percent of that amount.
        This is a significant problem. It creates a conflict of
    interest, where they create the titles and the rankings for us
    as fighters. If we want to participate, we have to sign a
    contract basically signing away a lot of our ancillary rights
    and abilities in sports that a lot of other athletes and the
    protections of the Ali Act give boxers.
        So what we are trying to accomplish is to get the Ali Act
    amended simply by changing the definition of what a boxer is to
    a combative sports athlete. Under those provisions, it
    standardizes contracts across the board, creates a separate
    independent agency to determine rankings and titles, and it
    allows us a free and open market for the promoters then to bid
    on those top fights and gives us a chance to estimate our fair
    value in the market and get our fair share of the revenues that
    are generated.
        Right now, the number-one promotion in the sport is the
    Ultimate Fighting Championship. They are garnering over 90
    percent of the income that comes from the sport. There are
    other promotions that are using this same, exact flawed model,
    creating their own titles and their own rankings, but obviously
    on a much smaller scale.
        We obviously realize this is a process, but it is our hope
    that you will consider amending the Ali Act to encompass and
    incorporate mixed martial arts and other combative sports that
    fall under it, just like boxing.
        Thank you guys very much for giving us a voice here.
        [The prepared statement of Mr. Couture follows:]

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        Mr. Burgess. The chair thanks the gentleman and thanks all
    of our witnesses for your testimony.
        I was going to excuse Representative Denham, but he has
    already excused himself. So noted.
        We will begin with the question-and-answer part of the
    hearing, and I am going to go first to Mr. Mullin of Oklahoma.
        Five minutes for your questions, please.
        Mr. Mullin. Wow, I never get to go first.
        Mr. Burgess. It is my last chance to let you go first.
        Mr. Mullin. It is your last chance. Well, we are ending the
    year with a bang.
        Hey, thank you, and thank for the witnesses for all showing
    up. I really do appreciate it.
        Appreciate, Ms. Robertson, you coming in here on your on
    behalf and representing the entity that we are looking for to
    maybe help with the ranking system. So we appreciate that.
        Dr. McKee, you are bringing a perspective that we all know
    about. We all know that the sport is violent, and it is a sport
    that we love, though, and why we look forward to working with
    you. We understand that, and that is part of what we are trying
    to do here. Because we feel like if we can negotiate better
    contracts, we don't have to fight as much.
        Randy, I want to go back to your testimony that you just
    said. Can you explain a little bit more about how the ranking
    system works, how it currently works and how it manipulates the
    fighters into basically seeing a take-it-or-leave-it attitude
    when it comes to getting a chance to fight for the title?
        Mr. Couture. Well, there is a definitely a take-it-or-
    leave-it attitude that comes from the promoters. And a perfect
    example of that is, as you mentioned, the first show in Madison
    Square Garden in New York. And the number-one fighter and
    probably the most popular fighter right now on that card was
    Connor McGregor. He was the 145-pound champion for the Ultimate
    Fighting Championship. He was in that particular fight fighting
    for the 155-pound title belt. He would be the first athlete to
    hold two belts at the same time. He also is interested in
    pursuing a match with Floyd Mayweather in boxing.
        Because that kind of went against the grain with the
    Ultimate Fighting Championship, they stripped him of his belt
    at 145 pounds even though he had not been defeated in that
    weight class and hadn't actually competed in that weight class
    in a little while because he was attempting to do something
    historic in winning two championship belts at the same time. He
    was stripped of that title, and not only stripped of the title
    but dropped out of the top 10 rankings in that weight class
    even though he had not been defeated or competed there.
        So they in essence used their rankings and their titles to
    manipulate the fighters to toe the line, to do the things that
    they want them to do. And there are other examples of that. I
    am living proof of a similar thing and the kind of closed
    market that exists in our sport right now. I pursued in the
    height of my career as what most people considered the number-
    two heavyweight in the world, I wanted to fight the number-one
    heavyweight in the world. How do you be considered the best in
    your sport? You fight the best guy out there. I was unable to
    see that fight happen through the Ultimate Fighting
    Championship and pursued that fight myself outside of that
    contract and was prevented. In fact, injunctions were filed and
    everything else to keep me from making that fight happen.
        At some point, I just had to recognize that I was in my
    forties and the clock was ticking and just went back and
    continued the rest of my career, but never got the chance to be
    considered the number-one fighter in the world based on the
    outcome of that fight.
        That conflict of interest gives the promoter a ton of power
    to manipulate the fighters, to manipulate the rankings. For
    them, it is just business. They are trying to get the most pay-
    per-views sold and the most people to buy tickets, and they
    will do whatever they need to do to manipulate that ranking
    structure and those titles to do that.
        Mr. Mullin. Mr. Novitzky--did I say that last name right?
        Mr. Novitzky. Correct.
        Mr. Mullin. You talk about the anti-doping program, thank
    you so much. When I was fighting, it was very rare that anyone
    got tested. How long has the UFC implemented these rules with
    the doping?
        Mr. Novitzky. Our anti-doping policy went into effect last
    July 1, 2015.
        Mr. Mullin. 2015. And you guys are being real strong on
    that? You are not letting anything pass? I mean, you are making
    people make sure they test?
        Mr. Novitzky. Yes, well, actually, we have the United
    States Anti-Doping Agency, which is the officially recognized
    anti-doping agency of the United States for Olympic and
    Paralympic sports, administer our program. So that is one of
    the beauties of our program. The, I think, pillar of strength
    of our program is that we don't police ourselves. We have an
    independent authority.
        Mr. Mullin. Then tell me, how did Brock Lesnar get a pass
    just this past July to not have to test before a fight? He was
    waived, a 4-month waiver that when you are coming out of
    retirement, you are supposed to test for 4 months before you
    are able to come out of retirement, take a fight. However, he
    was waived, he didn't have to.
        Mr. Novitzky. Well, that is not accurate, that he had a
    pass in terms of testing.
        Mr. Mullin. Yes, I believe it is. And I can submit the
    article for the record, if you don't mind, Chairman.
        Mr. Novitzky. I would be happy to clarify what the
    situation was.
        Mr. Mullin. OK. And maybe we can do that, because I am
    running out of time.
        Before I run out of time, Mr. Chairman, I have a copy of
    the standard MMA fighter and promotional contract from the UFC
    that I would like to enter in the contract, just to make sure
    that the body understands what type of contracts our fighters
    are currently against and how three--being the promoter, being
    the contract holder, and being the person who controls the
    ranking is a direct conflict in interest for the fighters.
        Mr. Burgess. Without objection, so ordered.
        [The information appears at the conclusion of the hearing.]
        Mr. Mullin. I yield back.
        Mr. Burgess. The gentleman yields back. The chair thanks
    the gentleman.
        The chair recognizes the gentlelady from Illinois, Ms.
    Schakowsky, 5 minutes for your questions, please.
        Ms. Schakowsky. Thank you.
        I want to follow up on head injuries. And, of course, they
    are inherent in mixed martial arts. We have heard all the
    dangers of concussions, but I wanted to underscore the threat
    posed by repetitive hits to the head, known as subconcussive
    hits, that do not result in concussions and often show no
    symptoms. My understanding is that subconcussive hits can be
    quite dangerous, as has been discussed.
        So, Dr. McKee, can you tell us what the evidence shows thus
    far in terms of the effect of the subconcussive hits on the
    brain? And have subconcussive hits, even in the absence of a
    concussion diagnosis, been linked to decreased cognitive
    functioning or changes in brain chemistry?
        Dr. McKee. Oh, absolutely. Subconcussions or just exposure
    to repetitive impacts, that is usually measured in exposure
    years to the sport, so the length of the playing career of a
    football player, a hockey player, that has been significantly
    associated with long-term cognitive impairment, apathy, and
    depression, not CTE, because those are living individuals. But
    we have also seen it in our brain autopsy series, where the
    longer a football player plays, the higher the risk for CTE.
        We know that in high school athletes, if you follow them
    for a single season in football, hockey, and soccer, even in
    the absence of a concussion, you will see MRI evidence of brain
    damage at the end of that season, not related to concussion,
    because none of those athletes had a concussion. So that is the
    subconcussive injury sustained by those amateur high school
    athletes in a single season showing up as brain damage on MRI
    and also some neuro-psych exams.
        Ms. Schakowsky. Now, you said because the players were
    living that it is hard to find out if they have CTE. What is
    the status right now of being able to diagnose CTE in living
    people?
        Dr. McKee. Well, there is a tremendous interest in that.
    Obviously, that is one of the stumbling blocks for really
    understanding how common the disease is. There is a tremendous
    interest.
        Many academic centers, Mt. Sinai, Boston, Mass General,
    UCLA, many centers are looking at diagnosing CTE using what
    they call a PET tau ligand, or a way to image tau in the brain
    just with an injection. And that is looking very promising.
    There have been some case reports reported, and we are looking
    now for the big series of being able to confidently say this is
    CTE in living individuals.
        There has also been a lot of advance in blood biomarkers,
    looking at things like ratio of hyperphosphorylated tau to tau
    in the blood and in the plasma; different biomarkers like
    something called neurofilaments.
        So we are really on the verge, I think in the next 2 to 5
    years we are going to nail this down. There have been
    tremendous, explosive advances.
        Ms. Schakowsky. Well, I would suggest that Members of
    Congress who are really interested in these kinds of sports,
    and especially because of youth sports and the exposure of kids
    who see these athletes as role models, that we really push for
    that kind of research so that we could make sure that we know
    more before someone dies.
        Dr. McKee. Yes, absolutely.
        And I think we also need long-term perspective studies of
    thousands of amateur athletes, high school athletes, following
    them so that we can learn what those subtle symptoms are in the
    very beginnings of this disease so we know when to intervene,
    to maybe develop some therapies that would make it less likely
    that they would develop CTE.
        Right now, we are really operating in the dark. We don't
    have any diagnosis except after death. There is a huge need to
    understand the effects of sports trauma. We know that sports
    are important; we don't want our kids to stop playing sports.
    But we have to understand the risks, and that is going to
    require funding for some of these long-term projects.
        Ms. Schakowsky. Thank you.
        Mr. Couture, we have heard that the structure of the MMA
    system does not give fighters sufficient bargaining power with
    regard to their contracts. I am concerned about the effect that
    has on the health and safety of fighters. If a fighter is hurt,
    does he have pressure to fight again instead of waiting to heal
    because he needs to fight to get paid?
        We have talked that injuries can occur in the lead-up to
    the fight, but there is no compensation, there is no health
    insurance, there is no nothing until you actually fight. So are
    they pressured into the fight?
        Mr. Couture. Well, there is certainly some pressure
    involved in that. You are not going to get paid for all the
    training and everything you did leading up to fight night. So
    if you were injured or any of those things in the course of
    that training, obviously, if you are unable to compete, you
    have done all that for nothing, you are not going to get paid.
        So that is certainly, I don't know a single fight that I
    didn't walk into that I didn't have some nagging injuries,
    whether it be a sprained thumb from sparring or a sore ankle or
    whatever. But certainly something like a knockout or something
    like that is a rare occasion in fighting. That is why we have
    great teams, guys that we trust that we train with, and we
    train very, very hard. It is still a contact sport. But that is
    an important piece of the puzzle.
        So I definitely think there is some pressure there. You
    want to get to fight night, and you are going to do whatever
    you need to do to get to go out there on your opportunity and
    show what you have trained to do.
        I think we fall under the same guidelines as boxing, where
    CT scans and blood tests and all of the medical procedures to
    ensure that we are healthy going into that fight are taking
    place. We are getting the physicals the day of weigh-ins and
    all those things, just like boxers and other combative sports
    athletes.
        And if you get knocked out in a fight or you are injured in
    a fight, the first place you go is to the hospital. You are
    getting a CT scan to make sure there is nothing seriously wrong
    going in there that stemmed from that competition.
        And then there are mandatory suspensions. Those things are
    a regular practice, mandatory. If you get knocked down or
    knocked out, you are going to get a 90-day suspension right off
    the top. And then, depending on the outcome of that CT scan
    from that night, they are going to determine if that needs to
    be a little longer, if it needs to be extended to give you more
    time to heal up before you even spar again, let alone compete
    again.
        So I think there are safety procedures in place that are
    implemented and regulated by the athletic commissions that put
    on combative sports across the country. Do we need----
        Ms. Schakowsky. But not in MMA, you are saying.
        Mr. Couture. Well, those same things happen in MMA. The
    difference is, if I was Floyd Mayweather, making the kind of
    money he made as a boxer, he could fight one time a year. He is
    only in training camp for that 2- or 3-month period to fight
    that one time a year. And he may not have to fight for a year
    or two, until he wants to again, frankly. In mixed martial
    arts, I don't really have that luxury if I want to make a
    decent living in the sport that I love.
        Ms. Schakowsky. Thank you.
        I yield back.
        Mr. Burgess. The gentlelady yields back. The chair thanks
    the gentlelady.
        The chair recognizes the gentleman from Massachusetts, Mr.
    Kennedy, 5 minutes for questions, please.
        Mr. Kennedy. Thank you, Dr. Burgess. I want to thank you
    for having this hearing, along with the ranking member as well.
        I want to thank the witnesses for being here, particularly
    Dr. McKee and all the work that you do up back home for me at
    Boston University. Thank you. Thank you for being here.
        And I know he has been recognized by a couple other of my
    colleagues here so far, but we wouldn't be here, obviously, if
    not for the efforts of Mr. Mullin. And I know his passion for
    this stems from his experience with it. So I want to thank my
    colleague from Oklahoma for his leadership on this.
        MMA promoters have been criticized for imposing restrictive
    contracts and not allowing fighters the ability to negotiate
    terms of those contracts.
        I want to start, Mr. Couture, with you. Can you expand on
    the issue? I know some of this has already been touched on; I
    know you have touched upon it a bit. But why don't fighters
    have more bargaining power when they enter contracts with
    promoters?
        Mr. Couture. There is no transparency from the promoter in
    what is actually made off of the particular bout that you are
    in, so then you have no real way to judge what your true value
    is in that particular fight. And they control the rankings and
    who gets shots at the titles.
        Mr. Kennedy. So talk to me a little bit about that. What
    value would an independent ranking system have for you, and how
    would that help fighters gain bargaining power?
        Mr. Couture. An independent ranking structure would create
    an open market where promoters across the board from whatever
    promotion could then bid on making that independent rank and
    those top fights for those best athletes happen regardless. It
    would eliminate the exclusivity of the contracts.
        Right now, every promotion is forcing athletes to sign a
    contract that is exclusive to that promotion. What if Wimbledon
    forced all the top tennis players to sign an exclusive contract
    to compete in Wimbledon for that title? That is in essence what
    the UFC does right now. They are that Wimbledon, the U.S. Open,
    the Australian Open, the French Open, they would all dwindle
    and go away, because they would no longer have access to those
    top athletes that are forced to sign that exclusive contract.
        Mr. Kennedy. And so, focusing on the ranking system there,
    can you also talk to me a little bit--and I heard a little bit
    about this yesterday, but the typical payment structure for MMA
    fighters. And I know you touched on this a little bit.
        Mr. Couture. The payment structure?
        Mr. Kennedy. Yes.
        Mr. Couture. Right now, it is something that your manager
    and you negotiate with a promoter to get. The top 5 percent of
    the athletes in our sport make a pretty decent living. Is it
    compared to what Floyd Mayweather and other boxers and other
    athletes in other sports make? Not even close.
        Mr. Kennedy. What about the 95 percent?
        Mr. Couture. But there is 95 percent of the athletes in our
    sport that are struggling to make a living and can't----
        Mr. Kennedy. What is ``struggling to make a living''?
        Mr. Couture [continuing]. Can't compete. Well, the lower-
    tier fighters are making $5,000 and $5,000--$5,000 to show up
    and fight, $5,000 if they win that fight. How many times do you
    have to fight in a year, when a training process takes 10 to 12
    weeks, to make a decent living when you are making $10,000 off
    that fight?
        Mr. Kennedy. And how many fights does a typical MMA fighter
    go through, given what you know and----
        Mr. Couture. In a given year?
        Mr. Kennedy. Yes.
        Mr. Couture. I think between----
        Mr. Kennedy. And to do in a way that is safe for you and--
    --
        Mr. Couture. Well, I mean, it takes me 10 to 12 weeks to
    prepare for one fight. If I fought three or four times through
    the course that year, that is 48 weeks that I am in training,
    preparing, in a 52-week year. So there are some fighters that
    are more active than that and fight more than that, but that is
    a pretty good indication of----
        Mr. Kennedy. And talk to me a little bit about
    endorsements. How does the endorsement structure work?
        Mr. Couture. Well, the endorsement structure has changed
    with that particular promotion to UFC. We used to be able to go
    out and develop relationships, and I had people that have
    sponsored me since I first started fighting, that grew with me
    through the exposure that they got from my success as a
    fighter. Much of that went away with the UFC and fighters that
    are under contract with the UFC when they forced the fighters
    under contract for them to wear uniforms made by Reebok. They
    signed a deal with Reebok for $70 million, and that requires
    all athletes to wear that uniform, and no longer are they able
    to go out and garner their own sponsors in the various niche
    supporters of the sport.
        Mr. Kennedy. So that would be supplemental income that you
    had on top of the 5 and 5 that you said was the lower range.
        Mr. Couture. Actually, many of those mid- and lower-tier
    fighters could make just as much from going out and garnering
    sponsorship for the exposure they are going to get in that
    particular fight as they were getting for their fight purse in
    the first place, and that went away for them.
        Mr. Kennedy. And that limited doing that.
        I have about 30 seconds left. I want to build off of what
    Ms. Schakowsky touched on and you touched on. My understanding
    is that for injuries suffered during a fight, that that is
    covered from the health care that is provided from the league,
    if you will.
        What about injuries suffered during training? What happens
    there? How does that work? I would imagine that, as you said,
    you often--if you are sparring for 10 to 12 weeks per fight, I
    imagine that is pretty physical.
        Mr. Couture. Well, obviously, if you are injured during the
    course of the night, the insurance rider for that fight, for
    that competition, covers whatever happens.
        Through my dealings with the UFC, because I have had
    several contract disputes over ancillary rights and other
    things with the company, out of that, one of my complaints was,
    what about these guys that get injured in the course of
    training getting ready for a fight? Now they can't fight. Not
    only do they not get paid because they couldn't make it to the
    fight, but now they are responsible, because of lack of
    insurance for most fighters, to take care of whatever that
    injury was.
        The UFC right now is the only promotion that does this, but
    they have implemented an accident insurance policy. So if there
    is an accident, now, if you are sick or got the flu or
    whatever, you are still on your own. But if there is an
    accident in training, that accident policy is in place. It is
    not a great policy, but at least it is better than nothing.
        Mr. Kennedy. What is an accident? Like, you would break my
    rib?
        Mr. Couture. Something like that.
        Mr. Kennedy. I would imagine.
        Mr. Couture. It is a contact sport. Sometimes those types
    of things happen. You get cut. Sometimes you get cut.
        Mr. Kennedy. So is that covered?
        Mr. Couture [continuing]. A head clash, you might need
    stitches. Who is going to pay for those stitches?
        Mr. Kennedy. I don't normally head-butt all that often in
    my business here. I try not to, anyway.
        Mr. Couture. But as a sport, on the whole, that is the only
    accident policy that is in place. Fighters, on the whole,
    across the board, are on their own.
        Mr. Kennedy. Sounds like a strong endorsement for
    ObamaCare, Mr. Chairman.
        Thank you very much.
        Mr. Burgess. I have a different interpretation.
        The chair would recognize Mr. Rush for 5 minutes for
    questions, please.
        Mr. Rush. I certainly want to thank you, Mr. Chairman.
        And I want to thank all the witnesses who are before us
    today.
        I want to direct my questions to Ms. Robertson.
        You are the treasurer of the Association of Boxing
    Commissions, plural. Tell me a little bit about the boxing
    commissions. I want to know, what is that?
        Ms. Robertson. Those are the regulatory bodies spread
    across the Nation, almost always a state agency. My personal
    state is housed under the Arkansas Department of Health. Some
    are under Commerce, some are under Licensing and Regulation.
        And each state has created a commission so that they can
    have a department that enforces the Muhammad Ali Professional
    Boxing Act. And that includes tribal governments as well. Not
    every tribal government promotes or hosts MMA or boxing, but if
    they do, there is a real push for them to be part of our
    training symposiums, our officials' training.
        Mr. Rush. So, in terms of governance, do they have any
    teeth, power in terms of governance? Do they really call the
    shots?
        Ms. Robertson. I can't speak for every state, but, yes, the
    ones that I am familiar with. California has an excellent
    program, and they control every item of it. In my home State of
    Arkansas, no matter what violation, the way the law is written
    in Arkansas, nothing that a licensee does is a felony, but they
    are very fineable misdemeanors.
        So, yes, to the best of my knowledge, all of them have a
    hammer that they can require enforcement of the minimum
    standard rules.
        Mr. Rush. Yes. I was a proponent and worked on the Muhammad
    Ali Act, and I certainly am supportive of it. And I am
    supportive of expanding these protections.
        In your testimony, you mentioned MMA fighter exploitation.
    And I think that we heard some testimony today that would bring
    attention to fighter exploitation. Is that a pervasive problem
    now in the industry?
        Ms. Robertson. I think that if you talked to the
    participants, the answer is: Most definitely. I think that if
    you speak to various other components, they would say: Not so
    much. It is really a question, whatever legislation is passed
    will be enforced on a local level for a small promoter just as
    it would be enforced all the way up the chain to whatever major
    promotion there is.
        In my State of Arkansas, we have never had the benefit of
    one of the major MMA shows, so I have never actually held a
    contract in my hand. I would like to be able to speak first-
    person on that, so I really can't address that. The fighters
    that I hear from, they do talk about exploitation.
        Mr. Rush. Does anybody else on the panel have more of a
    direct experience with exploitation that you want to highlight
    here before this committee?
        OK. Well, moving on, because my time is running out, this
    Congress is like a 10,000-pound elephant, moves around quite
    slowly. How can we help you? What do you suggest? What are you
    thinking? How can we be of assistance to you?
        Ms. Robertson. The Association of Boxing Commissions and
    Combative Sports welcomes the idea of having more authority or
    aiding in the enforcement of proper regulations. We already
    have passed minimum standard rules for MMA. We have fouls, we
    have training, we are there. We just don't have any teeth to do
    any other kind of enforcement.
        In boxing, as I think Representative Denham alluded to, in
    boxing, when it comes down to making the contract, the ABC
    actually recognizes the sanctioning bodies. They have to make
    application; that has to be published. The fighters know what
    the standards are. And we don't have those kind of teeth in the
    MMA industry.
        So we even expanded our name this year so that we could
    make sure everyone knows, we are here for all combative sports.
    So it is the Association of Boxing Commissions and Combative
    Sports.
        Mr. Rush. Thank you, Mr. Chairman. I yield back.
        Mr. Burgess. The chair thanks the gentleman.
        The chair does wish to recognize that, in a true sense of
    harmony in the season, and I allowed every other member to go
    first because I wasn't sure when we were going to call votes.
    So I will recognize myself, 5 minutes for questions.
        Ms. Robertson, first, it is an unrelated question, but you
    are a graduate of Arkansas Tech. Is that correct?
        Ms. Robertson. I am.
        Mr. Burgess. My wife graduated from Arkansas Tech.
        Ms. Robertson. Go, Wonder Boys.
        Mr. Burgess. There you go.
        Let me just ask you and Mr. Novitzky, Dr. McKee provided us
    in her testimony four items, and I would just like to go
    through those individually and have both of you respond to
    whether or not these are something that could possibly happen
    with whatever regulation occurs through UFC and through the
    commissioners.
        Don't allow children and young adults to participate in
    full contact with head strikes. Mr. Novitzky, is that something
    that UFC could live with?
        Mr. Novitzky. Absolutely, we would be in favor and we are
    favorable of that.
        Mr. Burgess. Ms. Robertson?
        Ms. Robertson. Generally, the Association of Boxing
    Commissions has taken a position against youth pankration.
    Manipulating joints is also very dangerous. And we also are
    concerned right now about the cultism of weight loss, which has
    been proven to contribute to the head injuries.
        Mr. Burgess. Yes, we might get into that a little bit more,
    with the trickle-down effect of role models.
        The second item was to educate fighters so that they learn
    the greatest opportunity to limit exposure and not allow head
    strikes in training and sparring exercises.
        Mr. Novitzky?
        Mr. Novitzky. Absolutely. And I think we are seeing a lot
    more of that in training techniques and definitely with our UFC
    fighters.
        And that is one of the things, as I talked about in my
    opening statement, with the under-construction Athlete Health
    and Performance Center, where the idea is we would bring in
    athletes, free of charge, to come in and learn training
    techniques and be educated in areas about avoiding
    subconcussive hits during training and then be able to take
    that back out to their gyms, not only in the United States but
    throughout the world, and educate and allow fighters to train
    in a much smarter level and safer level.
        Mr. Burgess. Very good.
        Ms. Robertson, from the commissioners' standpoint?
        Ms. Robertson. To the best of my knowledge, very few states
    in America have the resources to foray into regulation of
    boxing or MMA gyms. I know in my home state that is out of the
    purview of the law.
        Mr. Burgess. Let me just interrupt for a second, because I
    don't think she was asking for a regulation, just educating
    fighters to learn the greatest opportunity to limit exposure as
    to not allow head strikes.
        That seems fairly straightforward. Would the commissioners
    be in favor of that?
        Ms. Robertson. Yes, the ABC would be in favor of that.
        Mr. Burgess. Her third recommendation is to limit the
    number of head strikes in a match.
        Mr. Novitzky, you are probably the best person to speak to
    that. Is that done now, or is that possible?
        Mr. Novitzky. Yes. We have some of the best referees in the
    world in MMA, which, their job within the octagon is to look
    out for the fighter. And so you regularly see fights stopped
    when there are multiple head hits on a fighter.
        Mr. Burgess. What is the magic number?
        Mr. Novitzky. I don't know if there is a magic number.
        Mr. Burgess. OK.
        And then the fourth item is to reduce the number of full-
    contact matches per season, which Mr. Couture already spoke to
    that, of course, is an income-limiting event.
        But just in general, UFC would be OK with that?
        Mr. Novitzky. Yes. And Mr. Couture also spoke about
    mandatory medical suspensions, and that is something that MMA
    has, I think, better than any other sport. Somebody who is
    concussed in a match can get up to 6 months' mandatory medical
    suspension, where they can't have any contact for that period
    of time. So, depending on the damage that a fighter takes----
        Mr. Burgess. Well, let me just interrupt you for a second
    because I am going to run out of time too, and I hate to cut
    myself off.
        But, Dr. McKee, you said this is not necessarily related to
    a concussion. It is the repetitive small-volume injuries or
    small percussive injuries that occur. Is that correct?
        Dr. McKee. I did, but I didn't want to minimize the fact of
    concussion as a brain injury as well. So I do think they should
    be removed from the sport if they have a concussion and not
    allowed to return until they are fully recovered. I am just
    trying to eliminate these smaller asymptomatic hits that we
    know accumulate over time.
        Mr. Burgess. And do you have a quantitative number for us
    on the number of head strikes that should be allowed with any
    given match or any given year or any given career?
        Dr. McKee. No.
        Mr. Burgess. Well, I appreciate all of your answers on
    that.
        Dr. McKee and Mr. Couture, my understanding, and I realize
    it is fairly rudimentary of the sport, but my understanding is
    the specific equipment required of the athlete is fairly
    minimal. Is that correct, Mr. Couture?
        Mr. Couture. The equipment required at the professional
    level is a cup and gloves. Obviously, the gloves are for us to
    allow grip and grappling. But I don't think those are really
    the issue.
        Mr. Burgess. So there is no helmet involved in this sport?
        Mr. Couture. Well, we wear headgear.
        Mr. Burgess. Oh, you do.
        Mr. Couture. In training, not in competition. It is a
    professional sport like boxing. And the diversion of amateur
    boxing versus professional boxing, amateur boxers wear headgear
    when they compete, professionals do not. Same thing is true in
    our sport.
        Mr. Burgess. Oh, I didn't know that. That is interesting.
        Dr. McKee, do you have an opinion as to whether or not that
    would make a difference?
        Dr. McKee. Well, I think improvements can always be made
    with headgear. It won't eliminate the problem, but we can
    certainly mitigate it or reduce the injury with headgear.
        Mr. Burgess. OK.
        And I know my time has run out, and I want to be respectful
    of everyone else's time. But, Ms. Robertson, I just need to ask
    you on this whole notion of the independent sanctioning, is
    that something that the commissioners have looked at, that the
    person who promotes the boxer shouldn't be the one who is, or
    not the boxer, but the athlete should not be the one who is
    then controlling the endorsements and the number of matches and
    whether or not they are on a card?
        Ms. Robertson. That was set forth in the Muhammad Ali Act,
    and it did not require input from me. Is it something that we
    favor? I believe, personally, I am not speaking for the
    association, I believe that the Muhammad Ali Act did enhance
    anti-exploitation of their contract, but it also greatly
    reduced the number of events.
        Mr. Burgess. Right, which gets to the difficulty that Mr.
    Couture talked about, the difficulty in earning a living when
    your number of events are restricted.
        Mr. Couture. Yes, sir.
        Mr. Burgess. But the limitation on your endorsements, that
    is also a significant impediment to income. Is that correct?
        Mr. Couture. Some of that goes hand-in-hand with the power
    and basic monopoly that that particular promotion has in the
    sport, because they are allowed to set their own rankings and
    create their own titles, which isn't done in boxing and which
    is governed by the Muhammad Ali Act, which is why we are
    seeking to get the act expanded to include mixed martial
    artists and combative sports athletes from other sports.
        Mr. Burgess. OK. And I do, of course, acknowledge this is
    not a legislative hearing; this is an informational exercise.
    But Mr. Mullin's language is language that is favorable to what
    you seek?
        Mr. Couture. Yes, sir.
        Mr. Burgess. Does anyone have a different opinion, the
    language in Mr. Mullin's bill would be detrimental to the sport
    or to the athlete?
        Mr. Novitzky. I have a concern about the open ranking
    system that involves other promotions as it relates to health
    and safety, in that if a UFC fighter who is under the most
    stringent, comprehensive, robust anti-doping program in
    professional sports in the world is forced to fight a fighter
    from another promotion that may not have any out-of-competition
    anti-doping program, that is clearly a health and safety risk
    to our fighter.
        Mr. Burgess. And a competitive disadvantage.
        Mr. Novitzky. Correct.
        Mr. Burgess. So recognized, which you alluded to, I think,
    in one of your statements. People who do use performance-
    enhancing drugs do so because they see it as a defensive
    posture, because, doggone it, everybody else is doing it, and
    if I don't, I will get hurt.
        Mr. Novitzky. Absolutely.
        Mr. Burgess. Well, I want to thank everybody. Seeing no
    other members wishing to ask questions, I do want to thank our
    panel. It has been an illuminating discussion this morning.
        Before we conclude, I would like to include the following
    documents to be submitted for the record by unanimous consent:
    a fighter contract submitted by Mr. Mullin; an article
    explaining the contract; a letter from the ABC.
        [The information appears at the conclusion of the hearing.]
        Mr. Burgess. And pursuant to committee rules, I remind
    members that they have 10 business days to submit additional
    questions for the record. I ask the witnesses to submit their
    responses to those questions within 10 business days upon
    receipt of the question.
        And, without objection, the subcommittee is adjourned.
    Thank you all.
        [Whereupon, at 12:12 p.m., the subcommittee was adjourned.]
        [Material submitted for inclusion in the record follows:]

                     Prepared statement of Hon. Fred Upton

        Many of us remember the major boxing matches of the
    century. Ali v. Frasier and Tyson v. Holyfield immediately
    spring to mind and were two of the most talked-about sporting
    events of their time.
        Soon, we may be looking back on major mixed martial arts
    contests and trading stories about where we were when a
    heavyweight MMA title went down.
        But right now, we are in a transition. MMA has not
    surpassed major boxing events in ratings, but looks to one day
    be a contender. Some state regulators know as much about MMA
    already as they do about boxing. Others are catching up.
        When a phenomenon goes mainstream, Congress needs to be
    informed, especially when health and safety are involved. So
    I'm happy to kick this off and set the table for next Congress.
        As a die-hard fan of the Chicago Cubs, I understand the
    importance of competition. On the field or in the ring, sports
    bring us together and bring out the best in us. They have an
    extraordinary impact on our lives from childhood through
    adulthood and represent many threads in the fabric of American
    life.
        This is why it's so important to ensure the safety of
    competitors, whether they're fighters or players. If Congress
    is to play a role in MMA, we must understand the industry. We
    must understand the politics and we must understand the sport
    itself.
        We must begin to answer the questions around MMA. What
    lessons did we learn from boxing that can be applied to MMA?
    Are states adequately equipped to regulate the sport or is
    there a federal role? What are the problems plaguing various
    players in the industry and are policymakers well equipped to
    solve those problems?
        I think the witnesses for their participation today and
    look forward to working through these and other questions.
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