[Congressional Record Volume 166, Number 193 (Thursday, November 12, 2020)]
[Senate]
[Pages S6661-S6662]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                             Appropriations

  Mr. BLUNT. Madam President, I am pleased to be here today to talk 
about the 2021 appropriations bill that we filed this week for Labor, 
for Health and Human Services, and for Education.
  Obviously, with what we have gone through this year, those three 
agencies have all experienced dramatic challenges--labor challenges, 
health challenges, education challenges. And while this bill would not 
specifically be a COVID relief bill, it is a bill that funds these 
agencies so they can move forward with their normal work rather than 
have to, in some piecemeal way, try to deal with their normal work 
while they are trying to work with us on the extraordinary 
circumstances of the COVID bill.
  This is the largest bill--Labor, Health, and Education is the largest 
nondefense bill on the discretionary side of the agenda. It is about 30 
percent of all the money left when the Defense appropriations is taken 
off the table.
  There are 11 bills left at that point, but this bill has about 30 
percent of all the money. It has a lot of competing priorities, from 
apprenticeships to biomedical research, to public health and 
preparedness programs, to childcare and special education. National 
service and community service are all in this bill.
  We received 8,352 requests from Senators of things they would like to 
see in the bill. They are not all in there, but we did all we could to 
take the money we had and move forward with priorities that make sense.
  I am disappointed at this point that our Democratic colleagues on the 
Appropriations Committee were unable to support the bill right now, but 
we have worked together in the past. I hope we can continue to work 
together to find a way forward. And, frankly, my view is if 
appropriations bills appear to have a path to the President's desk, 
that is the thing that brings us together most quickly.
  This bill continues in our sixth year of commitment to robustly and 
consistently funding medical research at the National Institutes of 
Health. We provided a $2 billion increase on that research. We target 
funding toward Alzheimer's, toward precision medicine, premature birth 
research, the BRAIN Initiative. In my time as chairman, we have 
actually increased NIH funding by 45 percent in budgets that often had 
virtually no increase at all. We truly had to work together to 
prioritize. We have done that.
  My time as chairman is about 6 years, if you are wondering how long 
it took us to get that 45-percent increase. Six years ago, we hadn't 
had any increase for 12 years. NIH was about 22 percent behind in 
buying power where they had been a decade earlier. We made up that 22 
percent. And actually, now, we are putting real money on the table in 
an environment that has never been better and never been more promising 
in the NIH research area.
  We continue our focus of combating opioids. Between 1999 and 2018, 
nearly 450,000 people in the United States died from opioid overdose. 
These drug overdose deaths in 2018 were four times higher than in 1999. 
The bill provides money to deal with this. With the effort we made in 
this area over the last several years, we saw a consistent decrease in 
opioid overdoses until 2020.
  Of course, the increase in 2020, in many ways, related to the 
pandemic and the isolation. The support structure that appeared to be 
working to move you from dependency was no longer there, and suddenly 
you are back where you were.
  The bill provides a $20 million increase for apprenticeship programs. 
This week, I joined the Missouri Chamber of Commerce in highlighting 
the importance of apprenticeships. Last year, Missouri was the second 
in the Nation in the number of new apprenticeships. First in the Nation 
is California. We are not a small State, but we are not nearly as big 
as California, so I think the leadership in our State--the business 
community, the employers, the Governor, and others--has made a real 
difference there. We fund both registered apprenticeship programs, and 
it allows for industry-recognized programs as well.
  Fourth, the bill invests in education, from early childhood through 
college and career. It increases funding for high-quality early 
childcare and education by more than $150 million. It increases funding 
for elementary and secondary education programs that provide the most 
flexibility to school districts to decide how to best use those limited 
resources. This also includes increased investments in title I; in 
IDEA, the Individuals with Disabilities Education Act; the title IV 
student support and academic enrichment grants; charter schools; and 
Impact Aid. It increases the maximum Pell grant award by another $150, 
or a 2.4-percent increase, at a time when the mandatory money is gone. 
To find that 2.4-percent increase, we have to find it in other 
programs, and some programs are just not able to fund it. If they are 
not working, we shouldn't fund them, and we have seen several years of 
growth in areas in which we have a priority like Pell grants. To do 
that, we had to look carefully at programs that just, frankly, were not 
working.
  Fifth, we continue our focus on closing the care gap between mental 
health and physical health. Approximately one in five adults in America 
has a diagnosable and almost always treatable mental health problem. 
This bill provides an increase of almost $200 million in the mental 
health area.
  I would mention again the excellence of the mental health pilot. We 
have increased that pilot to eight States from two. We are seeing what 
happens in a positive way in people's other health issues when you deal 
with their mental health issues like it was any health issue, and it is 
making a difference. This year, it was reinforced again by 
understanding the need to address disparities in foster care, a greater 
diversity in healthcare, education, and the workforce.
  Many populations across the country, whether defined by race, 
ethnicity, geography, experience higher rates of certain diseases and 
often lack the access to health services. This bill tries to look at 
that in a way that analyzes where those gaps are, and it has programs 
that encourage filling those gaps. Furthermore, the bill continues our 
efforts to ensure that these disparities are addressed through a number 
of programs, including workforce development programs, diverse medical 
community efforts, research initiatives that focus on underserved 
communities, programs that target health disparities, and education-
workforce programs that create opportunity.
  This bill prioritizes programs that provide the most benefit and 
greatest return for all Americans. The bill continues key program 
integrity activities that are aimed at reducing the waste, fraud, and 
abuse of taxpayer dollars. These initiatives have proven to be a 
worthwhile investment in their returning billions of dollars to the 
Treasury and allowing us to look in other places as to how we could 
fund that money in programs that work better and work more 
transparently.
  This bill eliminates eight programs equaling nearly $115 million in 
spending reductions by focusing on programs that are the most efficient 
and cost-effective and with proven outcomes. We all know that budgets 
are tight, but making careful choices about health spending can be one 
of the most valuable investments we make in Congress.
  You don't have to look any further than the recent announcements 
about the record progress we have made in finding a vaccine for COVID-
19. Through the CARES Act and other legislation, Congress provided $18 
billion for research into therapeutics and vaccines, and $12.5 billion 
went to vaccines. It did it in a way that is going to allow us to set a 
record in having a safe vaccine available that meets the highest 
standards. The vaccine that appears to be the first in line for 
approval is 90 percent effective.

[[Page S6662]]

  Now, I am not an expert in vaccines, so my first thought would be, 
well, I want a vaccine that is 100 percent effective. As it turns out, 
no vaccine is 100 percent effective. The measles vaccine that 
schoolkids took for years and that most still take is 90 percent 
effective. It was 9 months ago that healthcare experts said, if we 
could have a vaccine that was 50 percent effective, we should approve 
that vaccine and every other one that was at least 50 percent 
effective.
  We are looking at vaccines that are going to help us move beyond this 
as we look at tests that help us move beyond this, but the fundamental 
foundation of all of that is in the healthcare framework that we 
maintain. You can't look at a pandemic and say that now it is time to 
think about how we do important health research. You can't look at a 
pandemic and say that now it is time to think about having care 
providers in underserved areas. You can't look at a pandemic and say 
that now it is time to begin to think about how you connect childcare 
and work and school altogether. This bill does as much of that as we 
could figure out how to do in the best way we could figure out how to 
do it.
  I hope Congress can pass it. It would be a great gift to the next 
Congress and administration after January 20 to be able to start next 
year with next year's work rather than having to start next year with 
this year's work. Let's get this year's work done. Let's get it done 
now. Let's send the bill to the President that the House and Senate 
have agreed on, and let's get back to looking at these bills in the 
right way at the right time.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Tennessee.