[Congressional Record Volume 164, Number 193 (Thursday, December 6, 2018)]
[Senate]
[Pages S7339-S7340]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                                  TANF

  Mr. President, once widely viewed as successful, our Nation's primary 
welfare-to-work program is now broken. It will soon expire. I rise to 
highlight my efforts to get it working again.
  The Temporary Assistance for Needy Families Program--it is also 
called TANF--was created with bipartisan support back in 1996. In fact, 
at its core, it recognized that finding and maintaining a job is the 
most effective way for healthy, working-age parents to go from 
government dependency to self-sufficiency.
  After TANF became law, welfare caseloads plummeted, child poverty 
declined, and employment among low-income, never-married parents went 
up.
  As we debate modernizing the TANF Program, we should not forget the 
doom and the gloom predicted by some liberals when the original 1996 
reforms were debated. Perhaps most famously, our former colleague, 
Senator Daniel Patrick Moynihan, predicted that TANF would result ``in 
children sleeping on grates, picked up in the morning frozen.''
  Let me tell you something: Those critics were wrong--very wrong.
  Yet more than 20 years after the historic 1996 reforms, we should be 
clear-eyed that the TANF Program suffers from neglect and loopholes, 
both of which are undercutting its fundamental work requirements.
  Today, very few States are meeting the work participation rate that 
is required by law. My State of Montana is one of the many that is 
falling short. The law calls for 50 percent of welfare enrollees to be 
engaged in work. In Montana, they are reaching only one-third.
  In addition, many States are using TANF dollars for purposes 
unrelated to work, and the program lacks the transparency and the 
accountability metrics that are critical to its success. Because of 
these shortfalls, too many low-income parents are not finding 
sustainable jobs, and too many children are at high risk of suffering 
the hardships of poverty.
  Part of the problem is that TANF has been significantly reformed only 
once since President Clinton signed it into law. In 2006, Congress 
reauthorized and strengthened the program, thanks to the hard work of 
then-Finance Committee Chairman Chuck Grassley and his Republican 
counterparts in the House. Since its expiration in 2010, however, TANF 
has received a whopping--this is so DC--24 short-term reauthorizations. 
Talk about kicking the can down the road. Efforts to address the 
persisting concerns about the program have not crossed the finish line. 
This must change.
  For starters, revitalizing TANF is important to sustaining our most 
robust economy. Right now, there are 7 million job openings that remain 
unfilled--7 million job openings that are unfilled. The good news is 
that employers across our country are clearly looking to hire, jobs are 
being created, and the economy is strong. But as my good friend, House 
Ways and Means Committee Chairman Kevin Brady, has said: ``We have gone 
from a country asking, `Where are the jobs?' to one asking, `Where are 
the workers?'''
  A big part of the answer is that millions of able-bodied, working-age 
Americans are completely on the sidelines. A strong, revitalized TANF 
Program is urgently needed to close this jobs gap and empower more 
Americans to find work. This is exactly what my bill, the JOBS Act, 
would do.
  Building on legislation that passed the Ways and Means Committee 
earlier this year in the House, the JOBS Act demands positive work 
outcomes rather than simply meeting ineffective participation rules. It 
requires States to engage with every work-eligible individual and 
establish a plan that will result in a sustainable job. It holds States 
accountable for their work outcomes, not activities--we are talking 
about outcomes, about results--and it bolsters the transparency of 
every State's performance.
  It doesn't just demand work; it enables work. It substantially 
increases funding for childcare services that would be essential to 
holding a job. It provides struggling beneficiaries with additional 
time to get the mental health or substance abuse treatment they need 
before holding a job and making that a realistic goal. It adds 
apprenticeship as a permissible work activity, alongside job training, 
getting more education, and building job readiness skills.
  My bill targets funds to truly needy families by capping 
participation to families with incomes below 200 percent of the Federal 
poverty level.
  The JOBS Act is built on the recognition that there is dignity in 
work. A job can start low-income parents down the path toward achieving 
lifelong dreams. A job can create opportunities that are simply out of 
reach without one. A job can be the springboard to higher wages and 
upward mobility. A job can rescue young children from the challenges of 
poverty and despair. In short, finding sustainable work can create 
better lives for low-income parents and children alike.
  Last, my bill extends marriage promotion and fatherhood initiatives 
because healthy, intact families are also part of the solution.
  There are approximately 4,000 families in Montana who are currently 
on TANF. Over 90 percent of them are from single-parent or zero-parent 
homes.
  I cannot speak more highly of the single families and the extended 
family members who are tirelessly taking care of their children on 
TANF. But we should continue to encourage voluntary participation in 
local marriage support programs; we should continue to encourage 
fathers to step forward and be the men that their children strongly 
need. The reason is simple: Healthy families remain the bedrock to 
strong communities and a flourishing society.
  The JOBS Act equips and empowers low-income families toward a better 
future.
  I urge my colleagues to reclaim the bipartisanship that created 
historic reforms a generation ago and support this important 
legislation to make our largest welfare-to-work program actually work 
again.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Iowa.


                        Right Rebate Act of 2018

  Mr. GRASSLEY. Mr. President, today I raise an important issue for my 
colleagues that impacts many families in Iowa but also throughout the 
country. You hear it everywhere. It is about high prescription drug 
costs. I am not going to address that issue across the board, but I am 
going to do it in a narrow way for one part of it.
  One contributing factor that has played a part in how much money the 
government and taxpayers pay for some drugs is a government program 
called the Medicaid Drug Rebate Program.
  On Tuesday I introduced bipartisan legislation with Senator Wyden of 
Oregon. The bill, called the Right Rebate Act of 2018, would close a 
loophole in that program that causes the problem I am addressing.
  As a condition for participation in the Medicaid Program, drug 
companies must pay a rebate--or some people might call it a discount--
to the Federal Government and to the various States for the drugs they 
offer. Generally speaking, the rebate dollar amount is less for a 
generic drug than for a brand-name drug.

[[Page S7340]]

  The rebate program hasn't worked as designed. Some drug companies 
have been able to game the system to boost their bottom line, and they 
do so at taxpayers' expense. Some drug companies have paid smaller 
rebates to the government. When that happens, that means taxpayers are 
footing a bigger burden.
  One example, in particular, highlights the main issues we aim to 
solve with this legislation.
  During the Obama administration--it could have been a Republican 
administration as well--because of the problems in this program, Iowans 
regularly contacted me by phone, email, and at my annual 99 county 
meetings about the difficulties they faced paying the rapidly rising 
prices of EpiPen. EpiPen is an emergency medicine used to treat severe, 
life-threatening allergic reactions. EpiPen is distributed by a company 
called Mylan. In 2007 a pack of two EpiPens cost $100. By 2016, the 
cost of that two-pack of EpiPens exploded to more than $600. That is a 
very substantial price increase. Nobody is going to argue with that. 
Many would argue that it is an unjustified price increase, especially 
considering the gut punch to taxpayers who foot the lions' share of the 
Medicaid bill for families. They happen to be families in need. I 
listened to the concerns of my constituents and began an investigation 
about how the drug rebate program was working.
  In a nutshell, Mylan had classified the EpiPen as a generic drug in 
the Medicaid Program, when it should have been classified as a brand 
drug. That means Mylan misclassified EpiPen, and CMS let it happen.
  Because of this incorrect classification, Mylan paid a much smaller 
rebate than it should have. I asked the Health and Human Services 
inspector general to look into these classification practices. The 
inspector general found that taxpayers may have overpaid for the EpiPen 
by as much as $1.3 billion over 10 years because of the incorrect 
classification. Eventually, Mylan settled a False Claims Act case with 
the Justice Department for $465 million.
  Now, don't ask me why the Justice Department didn't go after the 
other probably $700 million. I don't know, and I haven't found out why, 
but upon learning of that settlement, I expressed my disappointment 
that it didn't seem that taxpayers had been made whole. That is quite 
obvious, right?
  We shouldn't have had to depend on lawyers and lawsuits to get the 
taxpayers' money back. This deception should never have happened in the 
first place. That is common sense. Government Agencies should have, as 
an initial matter, been responsibly overseeing the programs they are in 
charge of.
  Because of insufficient attention to the problem by the Center for 
Medicare and Medicaid Services--or CMS, as I have been using--Mylan 
escaped accountability for a long period of time, costing taxpayers 
hundreds of millions--eventually billions--of dollars.
  But it is not just Mylan, and it is not just EpiPen. In a December 
2017 report, the inspector general found that 885 drugs may have been 
potentially misclassified. Specifically, the inspector general found 
that, from 2012 to 2016, Medicaid may have lost $1.30 billion in 
rebates for 10 potentially misclassified drugs with the highest total 
reimbursement.
  So where do we go from here? It is clear that the law must change to 
provide clarity. So let's establish clear lines of authority to hold 
the government bureaucracy and also the private sector accountable. 
Taxpayers demand and deserve accountability. Simply said, 
accountability will bring cost savings.
  The Right Rebate Act, which Senator Wyden and I introduced, will shut 
down this loophole used by drug companies. This legislation will 
prevent the misclassification of drugs in the first place and protect 
taxpayer dollars. It does this by requiring CMS to enforce penalties on 
drug companies that knowingly misclassify drugs in the Medicaid 
Program.
  The legislation also provides remedies for States that are 
shortchanged by drug companies. It requires an annual report to 
Congress by CMS to make sure the Agency is doing all it can to protect 
taxpayer dollars and to keep drug expenditures down.
  This is commonsense legislation. It would close a loophole used by 
drug companies to keep prices artificially high--much higher than they 
should be--and it grants the Secretary of HHS the authority to properly 
enforce the law.
  The Right Rebate Act is only one step in the fight against high 
prescription drug costs, but it is the right step, and there are a lot 
of other steps that must be taken. I look forward to working with 
Senator Wyden in the 116th Congress on many issues important to 
Americans, including the high cost of prescription drugs.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. CASEY. Mr. President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.