[Congressional Record Volume 162, Number 172 (Thursday, December 1, 2016)]
[Senate]
[Pages S6643-S6644]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        21ST CENTURY CURES BILL

  Mr. ALEXANDER. Madam President, I come today to the Senate floor to 
offer congratulations to the U.S. House of Representatives because last 
night, in an overwhelming vote, they passed what Senate Majority Leader 
Mitch McConnell has described as the single most important piece of 
legislation the Congress is likely to enact this year.
  I am referring to the 21st Century Cures Act, combined with the 
mental health bill, which is the most significant set of reforms of 
major mental health programs in 10 years. The Cures package is the 
result of bipartisan work over the last 2 years. Its purpose is to move 
cures and treatments through the expensive development process and the 
extensive regulatory process and into the medicine cabinets and 
doctors' offices of America more rapidly and safely at the same time. 
That also helps to lower costs, and we hear a great deal of talk about 
the affordability of prescription medicines. If it takes more than 10 
or 15 years and more than $1 billion to develop a drug, such as a 
treatment for Alzheimer's, that all adds to the final cost. We would 
like to lower that cost and speed that time up as long as we continue 
to do it safely.

[[Page S6644]]

  I wish to especially compliment the chairman of the House committee 
that worked on this, Chairman Fred Upton, as well as Congressman 
Pallone and Congresswoman DeGette, Democratic Members of the House of 
Representatives. They have worked with Senator Murray, the ranking 
Democrat on the Senate's HELP Committee, and with me for the last 2 
years on a very complex but very important bill.
  Part of the bill has to do with money, and one part of that is $1 
billion of funding for State grants for opioids. Now, I suspect one 
reason there was such a large vote in the House of Representatives 
yesterday--only 26 Members voted no and 392 voted yes--was because of 
this $1 billion for opioids. At least in Tennessee--and I am sure it is 
true in most States of the country--there is no more urgent epidemic 
than opioid misuse. It is filling up the courts. It is filling up the 
jails. It is filling up the hospitals. It is causing tragedies in 
families all across America.
  The Senate passed important legislation earlier this year on programs 
authorizing new money, but this is the money for State grants to Iowa, 
to Tennessee, to California, and to every State to help deal with the 
opioid epidemic abuse. So I suspect that one reason so many Members of 
the House voted yes yesterday and so few voted no would be that it 
would be pretty hard to explain a ``no'' vote against $1 billion of 
State grants for opioid abuse.
  There is also $4.8 billion of funding for the National Institutes of 
Health, which Francis Collins, the distinguished Director, calls the 
``national institutes of hope,'' and there is $1.8 billion for the 
Cancer Moonshot led by Vice President Biden. There is $1.4 for the 
Precision Medicine Initiative, or personalized medicine initiative, a 
special project of President Obama, and $1.6 billion is for the BRAIN 
Initiative. There are remarkable advances being made in the ability to 
identify Alzheimer's before symptoms are evident and then to slow its 
progression. It is hard to imagine how much grief that would end and 
the billions it would save if we could do that. So those are other 
reasons why there are only 26 Members of the House of Representatives 
who voted no yesterday and 392 who voted yes.
  The Mayo Clinic has sent a letter to me:

       On behalf of the Mayo Clinic, I write in enthusiastic 
     support of the 21st Century Cures Act and salute your strong, 
     bipartisan leadership on this essential legislation.
       We are pleased to see the inclusion of dedicated streaming 
     funds for the Food and Drug Administration and National 
     Institutes of Health. . . .

  I ask unanimous consent that this letter be printed in the Record 
following my remarks.
  So next Monday the Senate will have a chance to see whether we can do 
as well as the House of Representatives. I ask my colleagues to think 
long and hard about a big vote. We need a big vote. Let me give my 
colleagues one reason especially why. This $6.3 billion that is in the 
21st Century Cures bill is designated for opioids, for precision 
medicine, for cancer, for brain, and for FDA, and it has to be approved 
every year by a vote. That is the way our appropriations process works. 
I would say to my Democratic friends as well as to my Republican 
friends that if you are concerned about whether the $6.3 billion will 
be available next year and the next year, the best way to ensure that 
it is will be to cast a big vote on Monday for it this year, because it 
will be very hard to explain, if you vote for $6.3 billion this year 
spread over the next few years, why you did not vote to support it next 
year and the following year.
  The big vote in the House should give assurance to Democrats as well 
as Republicans in the Senate that these are real dollars, that they are 
provided in a fundamentally responsible way. To Republicans who look at 
the $6.3 billion and say: I like the idea of funding opioids; I like 
the idea of improving funding for the National Institutes of Health, 
let me say that this is done in a responsible way.
  Speaker Ryan, who everybody knows is a conservative budget hawk, 
created the mechanism for this funding. It was approved by Tom Price, 
the House Budget Committee chairman. It goes like this: $6.3 billion 
over the next several years for these dedicated purposes. It can only 
be spent for those purposes. It has to be approved every year. It does 
not increase the overall spending of the budget by one penny because it 
is offset by reductions in mandatory spending on the other side. So 
$6.3 billion up here and $6.3 billion down there over the next 10 
years.
  So this is a compromise, but it is a magnificent compromise. It is, 
as Senator McConnell has said, the most important piece of legislation 
we will deal with this year. The House passed it with a huge bipartisan 
vote: 392 to 26. I hope that we in the Senate do just as well next 
Monday because the real winners will be the American people as they 
look forward to treatments for Alzheimer's, for cancer, a vaccine for 
Zika, a non-addictive pain medicine that will help deal with the opioid 
misuse epidemic, and regenerative medicine, which may help restore 
hearts and perhaps even eyesight in miraculous ways.
  This is truly an exciting time, and this is truly an effective piece 
of legislation that deserves our support by coming to the floor on 
Monday and then by passing it on Tuesday or Wednesday.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                                  Mayo Clinic,

                                 Rochester, MN, November 30, 2016.
     Sen. Lamar Alexander,
     Washington, DC.
       Dear Senator Alexander: On behalf of Mayo Clinic, I write 
     in enthusiastic support of the 21st Century Cures Act and 
     salute your strong, bipartisan leadership on this essential 
     legislation.
       Efforts to advance biomedical innovation and accelerate the 
     development and delivery of cures are of great importance to 
     Mayo Clinic and our patients. We are pleased to see the 
     inclusion of dedicated funding streams for the Food and Drug 
     Administration and National Institutes of Health--including 
     funds for research efforts such as the President's Precision 
     Medicine initiative, the Vice President's Cancer Moonshot, 
     and the BRAIN initiative to speed diagnosis and treatment of 
     conditions such as Alzheimer's disease.
       In addition, provisions to promote administrative 
     streamlining, telehealth efforts and mental health reform are 
     also of critical importance in allowing Mayo Clinic 
     physicians and researchers to provide the best possible care 
     to patients.
       Mayo Clinic is grateful for your leadership, wholeheartedly 
     supports this comprehensive legislation and looks forward to 
     this innovative effort being signed into law, and we pledge 
     to be a committed partner in its implementation. Thank you.
       With best regards,
                                         John H. Noseworthy, M.D.,
                                                  President & CEO.

  Mr. ALEXANDER. Madam President, I thank the Presiding Officer, and I 
yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. COATS. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________