[Congressional Record Volume 162, Number 169 (Monday, November 28, 2016)]
[Senate]
[Pages S6508-S6510]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        21ST CENTURY CURES BILL

  Ms. WARREN. Madam President, 3 weeks ago Americans went to the polls. 
Voters were deeply divided on whether Democrats or Republicans should 
be in charge. Donald Trump is the President-elect, missing the popular 
vote by more than 2 million people. But there is one thing Americans 
are not divided on, one issue on which they sent out a message loud and 
clear. According to exit polls, 70 percent of voters said that they 
think the American economy and the lawmakers who oversee it are owned--
owned--by big companies and special interests. That is 70 percent of 
everyone--Republicans, Democrats, and Independents.
  In the closing days of this Congress, Big Pharma has its hand out for 
a bunch of special giveaways and favors that are packed together in 
something called the 21st Century Cures bill. It is on track to get a 
vote in the House this week and then get rammed through the Senate. I 
have been taking a look at the details, and when the American voters 
say that Congress is owned by big companies, this bill is exactly what 
they are talking about.
  Now we face a choice: Will this Congress say ``Yes, we are bought and 
paid for'' or will we stand up and work for the American people?

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  For more than 2 years, Congress has been working on legislation to 
help advance medical innovation in the United States. Medical 
innovation is powerfully important, and I have spent as much time 
working on this issue as anything I have worked on since I joined the 
U.S. Senate. From the beginning, I have emphasized one obvious fact: 
Medical breakthroughs come from increasing investments in basic 
research. Right now, Congress is choking off investments in the NIH. 
Adjusted for inflation, Federal spending on medical research over the 
past dozen years has been cut by 20 percent. Those cuts take the legs 
out from under future medical innovations in America.
  We can name a piece of legislation the ``Cures'' bill, but if it 
doesn't include significant, meaningful funding for the National 
Institutes of Health and the Food and Drug Administration, it won't 
cure anything. That is why months ago Senate Democrats said any so-
called Cures legislation must have significant investment in medical 
research, and that is why Senate Republicans publicly committed to do 
exactly that. But now they have reneged on their promise and let Big 
Pharma hijack the Cures bill.
  This final deal has only a tiny fig leaf of funding for NIH and for 
the opioid crisis, and most of that fig leaf isn't even real. Most of 
the money won't be there unless future Congresses pass future bills in 
future years to fund those dollars.
  So why bother with a fig leaf in the Cures bill? Why pretend to give 
money to NIH or opioids? This funding is political cover for huge 
giveaways to giant drug companies. There are more examples than I can 
count in this bill. But I am going to talk about three.
  First giveaway: Legalize fraud. You know, it is against the law for 
drug companies to market drugs for uses not approved by the FDA. Now, 
some drug companies find this rule annoying. After all, they can make a 
lot more money selling a headache pill as a cure for everything from 
hair loss to cancer. But pushing treatments without scientific evidence 
that they work is fraud--fraud that can hurt people. It also undercuts 
the development of real cures.
  That is why some of the largest law enforcement actions against big 
drug companies over the past 15 years have involved off-label 
marketing. Drug companies have paid billions of dollars in penalties. 
Now, one solution would be for those companies to follow the law. But 
they prefer plan B: Cozy up to enough people in Congress to pass this 
Cures bill that would shoot holes in the anti-fraud law. In other 
words, make it easier for drug companies to get away with fraud.
  Second giveaway: Cover up bribery. Right now the law requires drug 
companies to disclose the buckets of money they shower on doctors and 
hospitals to encourage them to prescribe certain drugs. It is, by the 
way, all published on a government Web site. You can go look up your 
doctor and your hospital right now online, if you want to do that.
  Now, the drug companies could have responded by ending kickbacks to 
doctors. But instead, they have chosen plan B again: Cozy up to enough 
people in Congress to pass this Cures bill, which would let drug 
companies keep secret any splashy junkets or gifts associated with so-
called medical education and make it harder for enforcement agencies to 
be able to trace those bribes. Senator Grassley, a Republican from 
Iowa, says he is outraged by this provision. I have to say that I am 
with Senator Grassley on this one.
  Third giveaway: Hand out dangerous special deals to Republican 
campaign contributors. According to news reports, a major Republican 
donor stands to benefit financially from selling cellular and 
regenerative medical therapies. If this guy had it his way, he would be 
able to sell them to desperate people without a final FDA determination 
that those therapies were either safe or effective.
  Of course, that would be against the law right now. So this megadonor 
has poured millions of dollars into Mitch McConnell's personal campaign 
coffers, and into his Republican super PAC, and now he wants his 
reward. The Cures Act offers to sell government favors. It delivers a 
special deal so that people can sell these treatments without meeting 
the FDA gold standards for protecting patient safety and making sure 
that these drugs actually do some good.
  Keep in mind that people could die from using unproven treatments. In 
fact, people have already died during carefully controlled research 
experiments on these types of treatments. Congress should not be in the 
business of selling FDA favors to the highest bidders, risking people's 
lives to enrich political donors. Let's be clear. What the Republicans 
are proposing is corrupt, and it is very, very dangerous.
  There is more. Republicans decided to hand out gifts for other 
special interests. The Cures Act, a bill that is supposed to be about 
medical innovation, has a giveaway to the gun lobby. The bill cuts 
Medicare funding. It raids money from the Affordable Care Act. It takes 
health care dollars that should have gone to Puerto Rico. It makes it 
harder for people with disabilities to get Medicaid services. There is 
a lot of bad stuff in this bill--a lot of bad stuff.
  But not everything in the bill is bad. Republican leaders are playing 
a crafty game here, trying to buy off Democratic votes, one by one, by 
tacking on good, bipartisan proposals that Senators in both parties 
have worked on in good faith for years.
  There is a bipartisan mental health bill. There are bipartisan 
provisions protecting the genetic privacy of patients and bipartisan 
provisions to give some very limited funding for important priorities, 
such as the national opioid crisis. There is the Vice President's 
Cancer Moonshot. There is a proposal in here to improve foster care.
  I support most of these proposals. I have worked on many of them for 
years. I even wrote some of them myself. If this bill becomes law, 
there is no question it will contain some real legislative 
accomplishments. But I cannot vote for this bill. I will fight it 
because I know the differences between compromise and extortion. 
Compromise is putting together commonsense health proposals supported 
by Democrats, by Republicans, and by most of the American people, and 
passing them into law.
  Extortion is holding those exact same proposals hostage unless 
everyone agrees to special favors for campaign donors and giveaways to 
the richest drug companies in the world. Compromise is when Senators--
Democrats and Republicans--find a way forward on issues that matter to 
their constituents. Extortion is telling those same Senators to forget 
what their constituents want. We will do nothing with the skyrocketing 
costs of prescription drugs and nothing to increase medical research.
  Instead, every important commonsense bipartisan bill on mental 
health, genetic privacy, opioid addiction, foster care, and anything 
else will die today unless Democrats agree to make it easier for drug 
companies to commit fraud, to give out kickbacks, and to put patients' 
lives at risk. This demand is enough to make me gag.
  Scientists who invent new cures should be celebrated, along with the 
companies that support them. But let me be perfectly clear. While the 
drug industry may get a seat at the table, they do not own the table. I 
do not care how many armies of lawyers and lobbyists they send out. I 
do not care how many campaign contributions they dump into 
congressional pockets. I do not care how painful they can make life for 
politicians who oppose them.
  I will not be their lackey. I will work for the hundreds of thousands 
of scientists and doctors who are committed to saving lives and who are 
waiting for Congress to fund their work. I will work for the millions 
of families that have been touched by Alzheimer's, diabetes, cancer, 
and other deadly diseases who are counting on this research.
  I will work for the 70 percent of voters who are sick of a Congress 
that is owned by big donors and giant corporations. Republicans are 
taking over Congress. They are taking over the White House. But 
Republicans do not have majority support in this country. The majority 
of voters supported Democratic Senate candidates over Republican ones. 
The majority supported a Democratic Presidential candidate over a 
Republican one.
  The American people did not give Democrats majority support so we can 
come back to Washington and play dead. They did not send us here to 
whimper, whine, or grovel. They sent

[[Page S6510]]

us here to say no to efforts to sell Congress to the highest bidder. 
They sent us here to stand up for what is right. Now they are watching, 
waiting, and hoping--hoping that we will show some spine and start 
fighting back when Congress ignores the message of the American people 
and returns to the old ways of doing business.
  Republicans will control this government, but they cannot hand that 
control over to big corporations unless Democrats roll over and allow 
them to do so. It is time for Democrats--Democrats and Republicans, who 
should be ashamed by this kind of corruption--to make it clear exactly 
who they work for. Does the Senate work for Big Pharma, which hires 
lobbyists and people who make giant campaign contributions, or does the 
Senate work for the American people who actually sent us here?
  I yield the floor.
  The PRESIDING OFFICER (Mr. Coats). The Senator from Texas.

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