[Congressional Record Volume 165, Number 23 (Wednesday, February 6, 2019)]
[Senate]
[Pages S920-S922]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Ms. COLLINS (for herself and Mr. Cardin):
  S. 349. A bill to require the Secretary of Transportation to request 
nominations for, and make determinations regarding, roads to be 
designated under the national scenic byways program, and for other 
purposes; to the Committee on Environment and Public Works.
  Ms. COLLINS. Mr. President, I rise today to discuss the Reviving 
America's Scenic Byways Act, a bill I have introduced with my colleague 
from Maryland, Senator Cardin. Our bill seeks to revive the long-
dormant process within the U.S. Department of Transportation through 
which some of our Nation's most remarkable roadways can earn the 
prestigious designation of ``National Scenic Byway.''
  The National Scenic Byways Program began as a grassroots effort to 
help recognize, preserve, and enhance selected roads throughout the 
United States based on one or more cultural, historic, natural, 
recreational, and scenic qualities. Today, there are more than 150 
distinct roads nationwide that have been recognized as National Scenic 
Byways--including several which have gained the honor of being named an 
``All-American Road.''
  I am proud that my home State of Maine boasts not only three National 
Scenic Byways, but also the Acadia All-American Road. These roadways 
provide Mainers and tourists alike with spectacular views and memorable 
experiences, while at the same time spurring much-needed economic 
activity in the surrounding areas. The National Scenic Byways program 
represents a true win-win scenario by protecting precious corridors and 
providing tangible benefits for local communities.
  Despite this program's proven value, its nomination process has been 
inactive since the passage of the 2012 surface transportation funding 
bill (also known as MAP-21). As a result, numerous roadways across the 
country have been prevented from pursuing National Scenic Byway 
designation.
  In fact, a recent survey found that at least 44 State scenic byways 
across the country are prepared to seek national designation as soon as 
the program is reopened to nominations. It is critical that we provide 
these local byways the opportunity to seek the Federal designation and 
reap its demonstrated benefits.
  Mr. President, I urge my colleagues to support this bill, which in 
turn supports the preservation of America's

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most unique roadways and the facilitation of increased economic 
activity in the regions that they serve.
                                 ______
                                 
      By Mr. CARDIN (for himself and Mr. Wicker):
  S. 359. A bill to amend the Internal Revenue Code of 1986 to exclude 
from gross income certain Federally-subsidized loan repayments for 
dental school faculty; to the Committee on Finance.
  Mr. CARDIN. Mr. President, I rise today with my colleague Senator 
Wicker to bring your attention to our proposed Dental Loan Repayment 
Assistance Act. This legislation will provide incentives for dental and 
dental hygiene graduates to remain as dental school faculty by 
eliminating certain loan assistance benefits from being counted as 
taxable income. We rely on dental faculty to train the next generation 
of oral health providers, but too often, these educators find 
themselves pushed to work in private practice in order to pay off their 
student loans. The Dental Loan Repayment Assistance Act will ease some 
of this financial burden and allow faculty to stay where they are most 
needed.
  There are currently over 5,000 dental health professional shortage 
areas nationwide--areas where it is hard to find a dental provider even 
with insurance coverage. By 2025, the Department of Health and Human 
Services (HHS) projects that the United States will have a national 
shortage of 15,000 dentists. We can only hope to solve this problem if 
we can recruit and retain enough faculty to train the next generation 
of dentists and dental hygienists. Crippling educational debt should 
not prevent our Nation from having the oral health care providers it 
needs, and this bill will help address that.
  I would also like to take this opportunity to acknowledge that 
February is National Children's Dental Health Month. Since 1981, this 
month has afforded us the opportunity to acknowledge the importance of 
children's dental health. We recognize the significant strides we have 
made, but we also acknowledge the work that remains to be done. I 
invite my colleagues to join me to use this month to renew our 
commitment to ensuring that all children in our country have access to 
affordable and comprehensive dental services. To echo Former U.S. 
Surgeon General C. Everett Koop, ``there is no health without oral 
health.''
  Despite being largely preventable, tooth decay is the single most 
common chronic health condition among children and adolescents in the 
United States. It is four times more common than early-childhood 
obesity, five times more common than asthma, and 20 times more common 
than diabetes. Among children in families living below the federal 
poverty line, 52 percent have cavities. Children with cavities in their 
primary or ``baby'' teeth are three times more likely to develop 
cavities in their permanent, adult teeth, and the early loss of baby 
teeth can make it harder for permanent teeth to grow in properly. If 
tooth decay is left untreated, it not only can destroy a child's teeth; 
it can have a debilitating impact on his or her health and quality of 
life.
  Many have heard me speak before about the tragic loss of Deamonte 
Driver, a 12-year-old Prince George's County resident, in 2007. 
Deamonte's death was particularly heartbreaking because it was entirely 
preventable. What started out as a toothache turned into a severe brain 
infection that could have been prevented by an $80 extraction. After 
multiple surgeries and a lengthy hospital stay, sadly, Deamonte passed 
away--twelve years ago this month.
  Even in less tragic cases, tooth and gum pain can impede a child's 
healthy development, including the ability to learn, play, and eat 
nutritious foods. Recent studies have shown that children with poor 
oral health are nearly three times more likely to miss school due to 
dental pain, and children reporting recent toothaches are four times 
more likely to have a lower grade point average than their peers 
without dental pain.

  Tooth decay and oral health problems also disproportionately affect 
children from low-income families and minority communities. According 
to the National Institutes of Health, approximately 80 percent of 
childhood dental disease is concentrated in 25 percent of the 
population. These children and families often face inordinately high 
barriers to receiving essential oral health care and, simply put, the 
consequences can be devastating.
  In 2009, Congress reauthorized the Children's Health Insurance 
Program (CHIP) with an important addition: a guaranteed pediatric 
dental benefit. Today, CHIP provides affordable comprehensive health 
coverage--including dental coverage--to more than 8 million children. 
Thanks to CHIP, we now have the highest number of children with medical 
and dental coverage in history. In addition, in 2010, Congress included 
pediatric dental services in the set of essential health benefits 
established under the Affordable Care Act.
  I am very proud that my State of Maryland has been recognized as a 
national leader in pediatric dental health coverage. In a 2011 Pew 
Center report, ``The State of Children's Dental Health,'' Maryland 
earned an ``A'' and was the only State to meet seven of eight policy 
benchmarks for addressing children's dental health needs. In addition, 
in the Maryland Health Benefit Exchange, every qualified health plan 
now includes pediatric dental coverage, so families do not have to pay 
a separate premium for dental coverage for their children and do not 
have a separate deductible or out-of-pocket limit for pediatric dental 
services. I am pleased to say that our actions have been working, and 
our numbers are improving. In 2004, nearly 23 percent of all children 
had untreated tooth decay. In 2016, that number dropped down to 13 
percent.
  I urge my colleagues to join Senator Wicker and me in supporting the 
Dental Loan Repayment Assistance Act to help address our critical 
nationwide shortage of dental healthcare providers and especially 
dental faculty. We will not continue to allow crippling graduate 
student debt to deprive the American people of the teachers and mentors 
we need to train the next generation of oral healthcare providers.
                                 ______
                                 
      By Mr. DURBIN (for himself, Ms. Harris, Ms. Smith, Ms. Klobuchar, 
        and Mr. Blumenthal):
  S. 366. A bill to shorten monopoly periods for prescription drugs 
that are the subjects of sudden price hikes; to the Committee on 
Health, Education, Labor, and Pensions.
  Mr. DURBIN. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 366

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Forcing Limits on Abusive 
     and Tumultuous Prices'' or the ``FLAT Prices Act''.

     SEC. 2. REDUCED MARKET EXCLUSIVITY.

       (a) Penalty.--If the manufacturer of a prescription drug 
     approved under section 505 of the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 355) or licensed under section 351 of 
     the Public Health Service Act (42 U.S.C. 262) increases the 
     price of such drug as described in subsection (b), any 
     remaining period of market exclusivity with respect to such 
     drug shall be reduced as follows:
       (1) With respect to any price increase described in 
     subsection (b), such market exclusivity shall be reduced by 
     180 days.
       (2) For every 5 percent price increase over the 10 percent, 
     18 percent, or 25 percent, respectively, threshold price 
     increases described in subsection (b), such market 
     exclusivity shall be reduced for an additional 30-days.
       (b) Price Increase.--A price increase described in this 
     subsection is an increase in the wholesale acquisition cost 
     (as defined in section 1847A(c)(6)(B) of the Social Security 
     Act (42 U.S.C. 1395w-3a(c)(6)(B))) of a prescription drug of 
     more than 10 percent over a 1-year period, more than 18 
     percent over a 2-year period, or more than 25 percent over a 
     3-year period.
       (c) Report on Price Increase.--
       (1) In general.--A drug manufacturer that increases the 
     price of a prescription drug as described in subsection (b) 
     shall report such increase to the Secretary of Health and 
     Human Services (referred to in this section as the 
     ``Secretary'') within 30 days of meeting the criteria for a 
     price increase under such subsection.
       (2) Failure to submit report.--In the case of a drug 
     manufacturer that does not submit a report required under 
     paragraph (1) within the 30-day period described in such 
     paragraph, in addition to the penalty under subsection (a), 
     the period of market exclusivity with respect to such drug 
     shall be reduced by 30 days for each day after the due date 
     of the report until the report is submitted.

[[Page S922]]

       (d) Waiver.--The Secretary may waive, or decrease, the 
     reduction in the period of market exclusivity that would 
     otherwise apply under subsection (a) with respect to a 
     prescription drug if--
       (1) the manufacturer of such drug submits--
       (A) a report under subsection (c)(1); and
       (B) an application for such a waiver, at such time, in such 
     manner, and containing such information as the Secretary may 
     require; and
       (2) based upon the information in such application, the 
     Secretary determines that--
       (A) the price increase is necessary to enable production of 
     the drug, does not unduly restrict patient access to the drug 
     , and does not negatively impact public health; and
       (B) such waiver or decrease constitutes a deviation from 
     the reduction in market exclusivity that would otherwise 
     apply under subsection (a) only to the extent necessary to 
     achieve drug production objectives.
       (e) Period of Market Exclusivity.--For purposes of this 
     section, the term ``period of market exclusivity'' means any 
     period of market exclusivity granted with respect to a 
     prescription drug under clause (ii), (iii), or (iv) of 
     section 505(c)(3)(E) of the Federal Food, Drug, and Cosmetic 
     Act (21 U.S.C. 355(c)(3)(E)), section 505(j)(5)(B)(iv) of 
     such Act, clause (ii), (iii), or (iv) of section 505(j)(5)(F) 
     of such Act, or paragraphs (6) or (7) of section 351(k) of 
     the Public Health Service Act (42 U.S.C. 262(k)).

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