[Congressional Record (Bound Edition), Volume 161 (2015), Part 8]
[House]
[Pages 11117-11126]
[From the U.S. Government Publishing Office, www.gpo.gov]




     PROVIDING FOR CONSIDERATION OF H.R. 6, 21ST CENTURY CURES ACT

  Mr. BURGESS. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 350 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 350

       Resolved, That at any time after adoption of this 
     resolution the Speaker may, pursuant to clause 2(b) of rule 
     XVIII, declare the House resolved into the Committee of the 
     Whole House on the state of the Union for consideration of 
     the bill (H.R. 6) to accelerate the discovery, development, 
     and delivery of 21st century cures, and for other purposes. 
     The first reading of the bill shall be dispensed with. All 
     points of order against consideration of the bill are waived. 
     General debate shall be confined to the bill and amendments 
     specified in this resolution and shall not exceed one hour 
     equally divided and controlled by the chair and ranking 
     minority member of the Committee on Energy and Commerce. 
     After general debate the bill shall be considered for 
     amendment under the five-minute rule. In lieu of the 
     amendment in the nature of a substitute recommended by the 
     Committee on Energy and Commerce now printed in the bill, an 
     amendment in the nature of a substitute consisting of the 
     text of Rules Committee Print 114-22 shall be considered as 
     adopted in the House and in the Committee of the Whole. The 
     bill, as amended, shall be considered as the original bill 
     for the purpose of further amendment under the five-minute 
     rule and shall be considered as read. All points of order 
     against provisions in the bill, as amended, are waived. No 
     further amendment to the bill, as amended, shall be in order 
     except those printed in the report of the Committee on Rules 
     accompanying this resolution. Each such further amendment may 
     be offered only in the order printed in the report, may be 
     offered only by a Member designated in the report, shall be 
     considered as read, shall be debatable for the time specified 
     in the report equally divided and controlled by the proponent 
     and an opponent, shall not be subject to amendment, and shall 
     not be subject to a demand for division of the question in 
     the House or in the Committee of the Whole. All points of 
     order against such further amendments are waived. At the 
     conclusion of consideration of the bill for amendment the 
     Committee shall rise and report the bill, as amended, to the 
     House with such further amendments as may have been adopted. 
     The previous question shall be considered as ordered on the 
     bill, as amended, and on any further amendment thereto, to 
     final passage without intervening motion except one motion to 
     recommit with or without instructions.

  The SPEAKER pro tempore. The gentleman from Texas is recognized for 1 
hour.
  Mr. BURGESS. Mr. Speaker, for the purpose of debate only, I yield the 
customary 30 minutes to the gentleman from Massachusetts (Mr. 
McGovern), pending which I yield myself such time as I may consume. 
During consideration of this resolution, all time yielded is for the 
purpose of debate only.


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, House Resolution 350 provides for a rule to 
consider a critical bill that will help millions of Americans and their 
families who are suffering from diseases for which there is no cure.
  The rule provides for 1 hour of debate, equally divided between the 
majority and the minority of the Energy and Commerce Committee, and 
makes eight amendments from Members of both parties in order so that 
the House may fully debate the merits of this legislation.
  As is custom, the minority is offered a final motion to recommit the 
bill prior to its passage.
  I am pleased the House is considering this bipartisan legislation. 
The Energy and Commerce Committee has spent
14 months working to bring our healthcare innovation infrastructure 
into the 21st century.
  Today, there are 10,000 known diseases or conditions, and we have got 
cures for 500. There is a gap between the innovation and how we 
regulate our therapies. It is not unheard of to have a company take 14 
years and spend $2 billion to bring a new device or drug to market.
  Members held nearly 20 roundtables and events around the country to 
ensure that we involved patients, advocates, researchers, innovators, 
and investors that have firsthand experience and help understand the 
gaps in our current system.
  H.R. 6 touches each step of the healthcare innovation process: 
discovery, development and delivery. This bill attempts to close the 
gap between the fast pace of innovation and our current, often 
burdensome regulatory process.
  The bill provides exciting new tools to uncover the next generation 
of treatments and cures. H.R. 6 is, indeed, transformative--
transformative of the way that doctors and researchers study diseases, 
develop treatments, and deliver care.
  It encourages innovation. It fosters the use of data to further 
research. It modernizes clinical trials and takes steps toward the 
future of personalized medicine.
  Not only does this bill take a major step forward in bringing more 
cures to patients, this bill addresses our Nation's ever-increasing 
healthcare spending. This bill establishes a temporary innovation fund 
which is fully offset, including permanently reforming our entitlement 
programs.
  Beyond the budget window, these reforms in Medicare and Medicaid are 
established to yield at least $7 billion in additional savings for 
taxpayers; but make no mistake. The biggest cost saver--the biggest 
cost saver--will be finding cures to some of America's most deadly and 
costly diseases.
  I am thankful to have worked on many parts of this bill. The 
legislation contains five bills that I have introduced and other 
provisions that I helped with the authorship. I would like to take a 
minute to talk about a few of the sections where I have personally 
worked on them.
  While thousands of Americans are affected by multiple sclerosis, 
Parkinson's, and other neurologic diseases, very little accurate 
information exists to assist those who research, treat, and provide 
care to those suffering from these diseases.
  H.R. 6 actually includes H.R. 292, that I introduced, with Mr. Van 
Hollen of Maryland, to advance research for neurologic diseases. H.R. 6 
will

[[Page 11118]]

allow for surveillance systems for tracking key neurologic diseases, 
which may then be used to help us further understand these devastating 
diseases and deliver their cure.
  We are improving patient access to needed treatments by supporting 
expedited approval for breakthrough therapies and actually making it 
easier to seek approval for new indications of approved therapies.
  Currently, the Food and Drug Administration approved drugs may be 
only promoted for the approved indication, even if the sponsor 
determines that the drug is an effective treatment for another 
indication.
  H.R. 6 includes another bill, H.R. 2415, which I introduced with Mr. 
Engel of New York, and would formally establish a program within the 
Food and Drug Administration, which would allow companies with approved 
drugs or biologics to submit clinical data summaries for consideration 
of a new indication.
  This would reduce the time to approval and reduce resources required 
to approve new indications of drugs, drugs that have a well-established 
knowledge base and well-established safety information.
  I introduced H.R. 293, with Representative DeFazio of Oregon, to 
protect continuing medical education, which plays a vital role in our 
healthcare system. This improves patient outcomes, facilitates medical 
innovation, and keeps our Nation's medical professionals up-to-date.
  With the inclusion of this provision in H.R. 6, we will ensure that 
doctors continue to have access to these vital tools.

                              {time}  1415

  The provision simply enforces current law, which states that 
educational materials were explicitly excluded from reporting 
requirements in the Affordable Care Act.
  Unfortunately, the Center for Medicare and Medicaid Services has 
acted in conflict with the law, but we correct that in H.R. 6 and 
ensure that physicians have access to materials and information to keep 
us informed and up to date on medical innovation. With its inclusion in 
H.R. 6, we will ensure that doctors continue to have access to these 
vital tools.
  We ensure that Americans have access to their critical health 
information by identifying barriers to achieving fully interoperable 
health records.
  Mr. Speaker, the United States taxpayer has spent well over $30 
billion to ensure that healthcare providers obtain an electronic record 
system. However, the investment has not resulted in access to 
information in those records and patients across the healthcare 
spectrum.
  While we have seen widespread adoption of electronic health records, 
our Nation continues to maintain a fragmented healthcare system, making 
it difficult to ensure the continuity for evidence-based care for 
patients.
  The 21st Century Cures Act would finally set the United States on a 
path toward achieving a nationwide interoperable health information 
system. This will be transformative for research and for medical 
treatment.
  Finally, along with Mr. McCaul and Mr. Butterfield, we aid patients 
by requiring companies to clarify availability of expanded access 
programs.
  Further, with the inclusion of H.R. 2414, which I introduced with Mr. 
Schrader of Oregon, we are requiring the Food and Drug Administration 
to issue guidance on the dissemination of up-to-date, truthful, 
scientific medical information about FDA-approved medications.
  This legislation passed out of Energy and Commerce's Subcommittee on 
Health on May 19 on a voice vote, and it passed the full committee on 
May 21, 51-0, the second time in 3 years that the committee has had a 
51-0 vote, the previous one being on the repeal of the sustainable 
growth rate formula.
  I encourage all of my colleagues to vote ``yes'' on the rule and 
``yes'' on the underlying bill. 21st Century Cures would not only 
deliver hope to the millions of American patients living with 
untreatable diseases, but it will help modernize and streamline the 
American healthcare system.
  I reserve the balance of my time.
  Mr. McGOVERN. Mr. Speaker, I yield myself such time as I may consume.
  I want to thank the gentleman from Texas (Mr. Burgess) for yielding 
me the customary 30 minutes.
  Mr. Speaker, before I speak on this bill, I want to thank Leader 
Pelosi for leading today's efforts to hold House Republicans 
accountable for their divisive Confederate flag amendment.
  You know, it is stunning to me that my Republican friends decided to 
refer the minority leader's resolution to committee so we could not 
have a debate.
  The legislature in South Carolina could have a debate, but my 
Republican friends here in the House of Representatives ensured that we 
in Congress cannot have that debate.
  And the fact is that Americans, I think, are ready to leave behind 
the discrimination and hate symbolized by the Confederate flag, but my 
friends on the other side of the aisle seem to have a different idea.
  Last night House Republicans introduced an amendment to the Interior 
Appropriations bill that simply has no place on this House floor.
  It would undo the successful Democratic amendment adopted by voice 
that would have barred the display of Confederate flags in Federal 
cemeteries and barred the National Park Service from doing business 
with gift shops that sell Confederate flag merchandise.
  Simply put, while South Carolina voted this week to take the 
Confederate flag down, Republicans in Congress were ready to put it 
back up.
  And even more troubling, House Republicans tried to sneak this 
amendment into the bill late last night, hoping that nobody would 
notice. We noticed. The American people noticed.
  And I am ashamed that, in 2015, Congress would even consider a 
measure that seeks to perpetuate the hate and racism that the 
Confederate flag represents.
  Now, my friends on the other side of the aisle, especially the 
leadership, seem to be in a little bit of disarray.
  The Speaker of the House is trying to distance himself from the 
measure, notwithstanding that the Republican chairman of the House 
Appropriations Interior Subcommittee who offered the amendment said 
that he did so at the request of the Republican leadership.
  The Confederate flag is a symbol of racism and a reminder of one of 
our Nation's darkest periods of division. It has no place in America's 
National Parks. Congress should not promote this symbol of hate.
  And now is the time to come together. I am proud to join with my 
colleagues who are standing up today for all Americans united against 
hate.
  I will be asking my colleagues to vote ``no'' on the previous 
question so that we can bring up the Pelosi resolution before all of us 
here and have that debate and have that vote. I hope my Republican 
friends will join with me.
  I just want to say one final thing. The fact that the Interior 
Appropriations bill was pulled from consideration on this House floor 
by my Republican friends because they believed that, without this pro-
Confederate flag amendment, that they could lose up to 100 of their own 
Members, is stunning to me.
  It never ceases to amaze me. Just when I think that this institution 
can't sink any lower, then something like this happens.
  So, Mr. Speaker, I would urge my colleagues to stand with me and vote 
against the previous question so we can actually have this debate, a 
debate I think the American people would want us to have.
  Now, Mr. Speaker, on the underlying bill before us, H.R. 6, the 21st 
Century Cures Act, I just want to say that this is the product of 
bipartisan hearings, stakeholder meetings, drafts and redrafts.
  I am proud to be a cosponsor of the version of H.R. 6 that was passed 
by the Energy and Commerce Committee by a vote of 51-0. A vote like 
that doesn't happen often, especially in this Congress.
  I want to commend Chairman Upton and Congresswoman DeGette for 
leading this initiative and tirelessly working to get H.R. 6 to the 
floor.

[[Page 11119]]

  I think it represents the kind of investments that we should be 
making to help families stay healthy and to grow our economy.
  It provides $8.75 billion in mandatory funding over the next 5 years 
to the National Institutes of Health to spur scientific innovation and 
discovery by the country's premier medical researchers and scientists.
  During the Clinton administration, Congress doubled the NIH budget 
and made a real commitment to keeping America on the front lines of 
scientific research. That investment led to exponential advances in 
medicine.
  We should continue that progress by once again giving NIH the 
resources they need to make new advances in medicine. We shouldn't let 
our politics limit our ambition.
  As Members of Congress, we were elected to be leaders, and this is an 
opportunity to ensure America continues to lead the way on new 
breakthroughs in health.
  Now, I would have preferred to see the original $10 billion in NIH 
funding that was included in the bill that passed out of the Energy and 
Commerce Committee, and I hope that we can increase NIH funding back to 
that level as the bill moves forward.
  We know without a shadow of a doubt that basic medical research 
produces results. In fact, NIH-funded research at institutions like the 
University of Massachusetts Medical School in my hometown of Worcester 
has been the single greatest contributor to advances in health in human 
history.
  Today the average American lives 6 years longer than in the 1970s 
largely because of pioneering NIH investments.
  All across the country, NIH-supported researchers are forging a path 
toward treatment and cures for debilitating diseases that impact 
patients everywhere.
  But their success depends upon us. Our decision to invest in NIH is 
imperative to their success in improving health for all Americans.
  Just consider UMASS Medical School as one example. For years, UMASS 
has been in the forefront of medical innovation because of investments 
from NIH.
  In 2006, Dr. Craig Mello received the Nobel Prize in medicine for his 
groundbreaking discovery of RNA silencing, which, in layman's terms, 
means shutting off bad cells.
  UMASS has researchers working toward finding cures for AIDS, Down's 
Syndrome, and Lou Gehrig's disease. All of this is possible because of 
our investment in NIH.
  But I hear over and over again from scientists and medical 
researchers that they worry about the uncertainty of NIH funding 
because of crazy things that we do, like sequestration. They worry 
about our commitment to advancing basic medical research.
  Fewer and fewer research grants are being funded. Countries like 
China, India, and even Singapore are luring away the best and brightest 
American researchers because they are committing to making meaningful 
investments in medical research.
  21st Century Cures helps to reverse that trend, but I worry it is not 
enough. I am pleased to see that H.R. 6 takes a number of steps to 
modernize clinical trials, improve how the Food and Drug Administration 
approves new drugs and devices, and encourages the development of next 
generation treatments through the use of precision medicine, which 
President Obama highlighted in his State of the Union speech.
  Just last week we saw the approval of a major new drug that will 
improve the quality of life for more than 10,000 people living with 
cystic fibrosis. The investments included in 21st Century Cures will 
help us to make more of these kinds of groundbreaking advances a 
reality.
  Mr. Speaker, for all of the bipartisanship and positive aspects of 
this bill, I would be remiss if I didn't point out one glaring 
inconsistency.
  Despite numerous hearings, round tables, and forms on this bill, a 
controversial policy rider that restricts access to abortion was added 
to the bill that came before the Rules Committee.
  It is like the majority couldn't help themselves. They couldn't 
resist an opportunity to add a contentious rider to an otherwise 
bipartisan package to advance medical research.
  I am pleased that the committee made in order an amendment offered by 
my friends Barbara Lee, Jan Schakowsky, and Yvette Clarke to strike 
these controversial policy riders.
  Unfortunately, the committee prohibited a number of other amendments 
from coming to the floor for debate. Out of the 36 amendments submitted 
for consideration, only eight will be considered on this floor during 
debate on this legislation.
  Many of our colleagues came to the Rules Committee last night to 
testify on their amendments. They raised important issues and made 
suggestions as to how we can improve this legislation.
  So while I support the underlying bill, I urge my colleagues to vote 
``no'' on the rule, which prohibits debate on a number of amendments 
worthy of consideration.
  I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Oregon (Mr. Walden), a member of the Energy and Commerce Committee.
  Mr. WALDEN. Mr. Speaker, I want to thank the chairman of the 
committee, Fred Upton, and Diana DeGette for their great bipartisan 
work. And we all put a shoulder to the wheel here to get this done.
  This is really big, 21st Century Cures. All of us have known someone 
afflicted by deadly diseases. Most of us have seen people in our own 
families.
  My mother passed away as the result of ovarian cancer. My sister-in-
law had brain cancer. I lost a son to a congenital heart defect. My 
mother-in-law had rheumatoid arthritis from a very early age. My 
stepmother died of a stroke. We are all affected.
  Investing in cures, investing in treatments, investing in innovation 
and doing it right here in America is the best step forward.
  This legislation would modernize the Nation's biomedical innovation 
infrastructure and streamline the process for how drugs and medical 
devices are approved in order to get new treatments to patients and get 
it to them faster.
  To do this, we solicited input from some of the best scientists in 
the world, including Dr. Brian Druker of OHSU, Oregon Health Sciences 
University, Knight Cancer Research Center, a true pioneer in the fight 
against cancer.
  This initiative would give hope to countless Oregonians. Like my 
friend Linda Sindt, a close friend in southern Oregon, she lost her 
husband Duane to pancreatic cancer. She said this legislation will put 
us on a path to improved survival for pancreatic cancer.
  Nancy Roach, a colon cancer advocate in my hometown of Hood River, 
praised the bill, saying, ``Investing in 21st century science by 
boosting funding for the NIH makes sense.''
  Colton and Tiffany Allen are residents of Talent, Oregon. They said 
this bill will give hope, hope, to individuals like Colton, who 
struggles with ALS.
  We owe it to people like Linda, Nancy, Colton, Tiffany, to our 
families, to all Americans and literally people around the globe to 
pass this legislation, to tackle these diseases that have no treatment 
or cure, to develop new innovative treatments, provide better health 
technology, and ultimately bring hope and better lives for all.
  Mr. McGOVERN. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
New York (Ms. Slaughter), the distinguished ranking member of the 
Committee on Rules.
  Ms. SLAUGHTER. Mr. Speaker, this is a very important day for me, as a 
member of the Rules Committee. Rules, as you know, is the process 
committee. I want to spend my time discussing the process that has been 
going on here.
  The process that rules have in the House is to really make certain 
that fairness is presented to all parties.

                              {time}  1430

  Whether you are a majority or a minority, you have your rights, but 
they have been trampled on and abused with increasing regularity under 
this majority, and we have two glaring examples of that just today. We 
have glaring examples every day, but let me bring up these two.

[[Page 11120]]

  Mr. Speaker, this bill is critically important to all of us, and as 
everybody has spoken before makes it clear--and we all agree on the 
importance of putting more money into major research in the United 
States--we are falling behind other countries in finding the cures and 
the innovation for which we have been known for centuries. This is an 
important step that we are taking. This is a critically important bill, 
but process matters.
  Mr. Speaker, after the committee had voted out this bill unanimously, 
major changes were made with no committee input at all. They include 
reduction of the amount of money that the committee had said would be 
put into the National Institutes of Health by $1.025 billion, a very 
substantial sum.
  They added some policy riders that literally made no sense. Why in 
the world would you put an abortion rider on a thing for medical 
research? As far as I know, the NIH and most medical universities doing 
this research do not perform abortion procedures. It was simply a way, 
again, to mollify people and make somebody think that, if they vote for 
this bill, they are doing something that is impossible to do. But like 
Alice in Wonderland, we are all trained here to try to believe six 
impossible things before breakfast because we are confronted with them 
daily.
  Another one is that they changed the pay-fors, which is critically 
important to everything that we do.
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Mr. McGOVERN. I yield the gentlewoman an additional 1 minute.
  Ms. SLAUGHTER. So, Mr. Speaker, despite the importance of this bill, 
despite the fact that it came out of committee unanimously, despite the 
fact that so many people have worked on it, and despite the fact that 
good things were in it, the process was completely changed after it was 
over by rewriting major portions of it. That doesn't appear anywhere in 
the rules of the House.
  Now, not only that, let's think about what happened here this 
morning. Last night on the Interior bill, which is an open rule, after 
the Democrat who was up, Betty McCollum of Minnesota, had yielded back 
her time, after the time had been yielded on both sides and the vote 
had been taken, suddenly another amendment appears at the request, as 
Mr. McGovern has said, of the Republican leadership. So they suddenly 
come up with this. Ms. McCollum was not informed in any way. She had 
absolutely no knowledge of what was going to happen. That may not break 
a specific rule of the House, but it sure does break etiquette. You do 
not come out onto the floor to try to fool people who are on the other 
side.
  The SPEAKER pro tempore. The time of the gentlewoman has again 
expired.
  Mr. McGOVERN. Mr. Speaker, I yield the gentlewoman an additional 1 
minute.
  Ms. SLAUGHTER. Mr. Speaker, what happened here this morning, 
obviously, I think Mr. McGovern has stated it precisely. Without the 
ability to have that amendment, without that crazy amendment, frankly, 
that resolution--as far as I am concerned, once you send them back to 
committee, you are sending them to interment--we will never see that 
one again. But they had to have that in order to get the votes to pass 
the bill. That is the kind of horse trading and all the things that go 
on here. After all the process and procedure that belongs to the 
Congress of the United States, and has for centuries, has been 
absolutely abused, as I said earlier, and trampled on on a regular 
basis, Mr. Speaker, it is time we stopped it. Nothing happened here 
today except to make this place look stupid.
  I was born in a border State, in Kentucky. All my life I have lived 
there. I was educated there, and I was married there. I never saw a 
Confederate flag in all the years of my life. These battle flags that 
they are putting up appeared in the South after the civil rights 
legislation. They were the products of Strom Thurmond and the 
Dixiecrats. That is when they started to bloom all over. It is a symbol 
of pure hate and revenge or whatever else they want to call it. It 
needs to go.
  The SPEAKER pro tempore. The time of the gentlewoman has again 
expired.
  Mr. McGOVERN. Mr. Speaker, I yield the gentlewoman an additional 10 
seconds.
  Ms. SLAUGHTER. It is the equivalent to my having the German 
Government flying the swastika over the Bundestag.
  Mr. BURGESS. Mr. Speaker, at this time, I yield 1 minute to the 
gentleman from Florida (Mr. Bilirakis), a valuable member of the Energy 
and Commerce Committee.
  Mr. BILIRAKIS. Mr. Speaker, I rise today in support of the rule for 
H.R. 6, the 21st Century Cures Act.
  The 21st Century Cures Act is one of the best things Congress has 
done in a long time in my opinion. H.R. 6 is a holistic reform of how 
we can get cures and treatments to patients who need them. That is what 
this bill is all about, patients, our constituents, Mr. Speaker.
  One provision I was particularly proud to author will establish a 
drug management program which prevents at-risk beneficiaries from 
abusing controlled substances. This program will help protect our 
seniors. It is a fix to Medicare part D, that is a program that is 
really desperately needed. This commonsense measure has been 
recommended by GAO and IG, and it is also recommended by CMS.
  Mr. Speaker, it is utilized by private industry, TRICARE, and State 
Medicaid programs. This bill makes strides to prevent prescription drug 
abuse and promote a healthier America.
  I urge support for the rule and the underlying bill as well.
  Mr. McGOVERN. Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman 
from California (Ms. Matsui), a member of the Energy and Commerce 
Committee.
  Ms. MATSUI. Mr. Speaker, I thank the gentleman for yielding me time.
  Mr. Speaker, I rise in support of the rule to consider the 21st 
Century Cures Act on the floor. On the Energy and Commerce Committee, 
we worked tirelessly with our colleagues on the other side of the aisle 
to get this bill to a place that we could all agree upon, a place where 
we provide new mandatory funding for NIH to do the critical research 
that is a foundation for cures, a place where we tweak FDA processes 
and provide FDA with additional resources to do the new things that 
will help get treatments and cures to patients faster.
  As we worked together to find ways to accelerate innovation, patients 
with rare diseases have been at the forefront of our conversations. It 
is often more difficult to research and develop cures for rare disease 
patients due to their small populations. However, finding cures for 
rare diseases is not just of the utmost importance to the patients with 
those rare diseases and their families, it is important to all of us. 
You never know where a cure might come from, and often research and 
drug development on one disease may turn out to be fruitful for 
another.
  Mr. Speaker, we all need to work together to advance cures and 
treatments. A provision of this bill would encourage public-private 
partnerships to foster better utilization of patient registries that 
generate important information on the natural history of diseases, 
especially rare diseases for which other types of research can be 
difficult.
  I also applaud the efforts in this bill to advance the President's 
Precision Medicine Initiative to accelerate discoveries that are 
tailored to individual patients' needs.
  The telehealth language in 21st Century Cures recognizes telehealth 
is the delivery of safe, effective, quality healthcare services by a 
healthcare provider using technology as the mode of delivery, and the 
interoperability provision makes great strides toward ensuring that our 
health IT systems can communicate amongst each other and with patients.
  Mr. Speaker, I don't claim that this bill is perfect. Compromises 
have been made. I am disappointed that the amount of NIH funding has 
been recently reduced from $10 billion to $8.7 billion. I am also 
disappointed that policy riders, such as the Hyde amendment language, 
have been inserted

[[Page 11121]]

after we voted this out of committee, and I look forward to voting for 
the amendment offered by my colleagues Barbara Lee, Jan Schakowsky, and 
Yvette Clarke to strike the policy riders language. With that, Mr. 
Speaker, I do, however, support the 21st Century Cures legislation.
  Mr. BURGESS. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman 
from Texas (Mr. McCaul), the chairman of the Homeland Security 
Committee.
  Mr. McCAUL. Mr. Speaker, I commend Dr. Burgess and Chairman Upton for 
a bill that is truly visionary that will actually save lives, something 
we can rarely say we do up here in this place, but I believe this will 
provide cures for the next century.
  Mr. Speaker, there are two provisions I am very pleased to see in the 
bill. One is the Andrea Sloan CURE Act, which expands compassionate use 
to those who have life-threatening diseases and gives them greater 
access to lifesaving medications. Andrea is a friend of mine who, on 
her deathbed, asked me to try to make sure that this didn't happen to 
other people.
  And finally, I am pleased to see the reauthorization of the Creating 
Hope Act, which has now led to the second childhood cancer drug 
approved since the 1980s and the first FDA-approved drug to treat high-
risk neuroblastoma.
  Mr. Speaker, I believe that with the passage of this bill we will see 
greater cures in the future, and we will not only save adults from 
cancers, but also children from this dreaded disease in the future.
  Mr. McGOVERN. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
California (Ms. Speier), a member of the Armed Services Committee.
  Ms. SPEIER. Mr. Speaker, I thank the gentleman from Massachusetts.
  Mr. Speaker, coming out of committee, H.R. 6 was a bipartisan huge 
leap forward in our efforts to accelerate the development of lifesaving 
cures through medical research. Yet somehow, between the committee and 
the floor, the majority once again has tacked on antiabortion Hyde 
amendment language, which makes no sense at all.
  It is like the Republicans are cheap stage magicians attracting our 
attention with the promise of critically needed medical advances, all 
the while stuffing the same old, flea-bitten Hyde provision rabbit into 
their hat. We are tired of this tedious stage show. NIH is already 
subject to the Hyde provisions in appropriation bills. This is just a 
way to continue politics as usual.
  If H.R. 6 passes under a mantle of bipartisanship, they will pull out 
the rabbit, wave it around, and say, Look how amazing and wonderful we 
are.
  I, for one, am sick of the House being run like a boardwalk magic 
show. Adding this type of language between open, transparent committee 
consideration and open, transparent floor consideration makes a mockery 
of representative government. Adding an antiabortion rider to bills in 
the dead of night through sleight of hand turns the substantive 
bipartisan work that is crafted in H.R. 6 into a pathetic imitation of 
cooperation.
  Since the 114th Congress began, the House has taken 37 actions to 
restrict abortion access. While I don't agree with this paranoid focus 
on women's private and legal medical decisions, it is the majority's 
right to set the agenda; but I cannot stand by while these provisions 
are slipped into an otherwise excellent bill through underhanded 
maneuvers that run contrary to our democratic process. When similar 
provisions were slipped into a human trafficking bill, we said no. Why 
aren't we saying no today?
  I am a cosponsor of the original version of H.R. 6, but I cannot let 
the people's House become the people's House of smoke and mirrors.
  Mr. BURGESS. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman 
from Tennessee (Mr. Roe), the chairman of the House Doctors Caucus.
  Mr. ROE of Tennessee. Mr. Speaker, I stand before you today someone 
who, 45 years ago, graduated from medical school. My first pediatric 
rotation was at St. Jude Children's Hospital. At that time, a majority 
of all those children that I saw as a young medical student died of 
their disease. Today, almost 90 percent of those children live.
  Back in the 1950s, we had a polio vaccine. It was developed with the 
help of government funding, and today that would be scored as a cost to 
the taxpayers. Does anyone think the prevention of polio was a cost to 
the taxpayers? It was one of the greatest miracles of the 20th century.
  Just 4 short months ago, my wife died of stage 4 colon cancer. And I 
know right now that everyone in this Chamber who is listening and 
everyone who is outside watching this has had a close family member or 
a friend or a relative who has experienced something similar.
  Mr. Speaker, it is time now we as a nation got serious about curing 
the major diseases, not treating the disease, but curing the major 
diseases that are affecting this country and affecting us personally. I 
am more passionate about this bill and excited about passing the 21st 
Century Cures bill than anything I have voted on since I have been in 
the Congress.
  Mr. Speaker, I strongly encourage my colleagues to support this rule 
and the underlying bill.
  Mr. McGOVERN. Mr. Speaker, I am pleased to yield 2 minutes to the 
gentlewoman from Florida (Ms. Castor), a member of the Energy and 
Commerce Committee.
  Ms. CASTOR of Florida. Mr. Speaker, I thank my friend, the gentleman 
from Massachusetts, for yielding the time.
  Mr. Speaker, I rise to support the rule and in strong support of the 
21st Century Cures bill that was voted unanimously, in a bipartisan 
fashion, out of my Energy and Commerce Committee.

                              {time}  1445

  America is the world leader in medical research, and we have got to 
work to keep it that way. That has been at risk lately because of 
congressional budget battles. The resources that our researchers need 
to find the cures and treatments of the future have been at risk. Our 
commitment to medical research has eroded over the years, but this 21st 
Century Cures bill would put us now on a stronger path forward.
  I have advocated for more NIH research dollars for many years to 
boost our patients back home suffering from the debilitating diseases. 
I have offered amendments in the Budget Committee to shift money from 
discretionary to mandatory because it is mandatory in America that we 
respond and we research the cures of tomorrow, such as precision 
medicine like they are doing at the Moffitt Cancer Center in Tampa, 
Florida.
  Now that we have mapped the human genome, we can find and provide 
precise cures and treatments to our neighbors and family members with 
cancer.
  I am disappointed that the amount of money has been eroded. I am very 
disappointed that the Hyde rider was added at the last minute behind 
closed doors; it was not voted on in committee, but simply stated, this 
bill is too important not to pass it.
  I would like to thank my colleague Chairman Upton and my good friend 
Diana DeGette from Colorado for leading the charge. We are firmly with 
you, and we are with the patients and the researchers in America that 
will benefit from this terrific piece of legislation.
  Mr. BURGESS. Mr. Speaker, may I inquire to the time remaining?
  The SPEAKER pro tempore. The gentleman from Texas has 17 minutes 
remaining. The gentleman from Massachusetts has 11 minutes remaining.
  Mr. BURGESS. Mr. Speaker, I yield myself 30 seconds for the purpose 
of the introduction of my next speaker.
  Mr. Speaker, it is really a great privilege to recognize the next 
speaker on our side, the chairman emeritus of the Energy and Commerce 
Committee. In fact, the last reauthorization for the National 
Institutes of Health occurred under Joe Barton's watch, one of the last 
things we did at the waning hours of the 109th Congress.
  Mr. Speaker, he did provide additional funding to the NIH; he 
provided an increase of 5 percent a year for the lifetime of that 
reauthorization. Unfortunately, it was never appropriated to that level 
after the Democrats took charge in the 110th Congress.

[[Page 11122]]

  I yield 3 minutes to the gentleman from Texas (Mr. Barton), the 
chairman emeritus of the Energy and Commerce Committee, for his 
observations.
  Mr. BARTON. Mr. Speaker, I want to thank the Member from Texas for 
that generous introduction.
  Mr. Speaker, 4 years ago, I went to then-Majority Leader Eric Cantor 
and committee chairman Fred Upton and asked permission to create a task 
force, a bipartisan task force--equal numbers of Republicans and 
Democrats from the Energy and Commerce Committee and the Appropriations 
Committee--to work with outside groups and experts to see if there were 
not some ideas that we could put forward in legislation to improve the 
ability to find and implement cures for all the various diseases that 
afflict our Nation.
  Mr. Upton and Mr. Cantor approved that task force. We had a task 
force of 24 members. We had an outside group that included several 
Nobel prize winners, leaders from Johns Hopkins and MD Anderson, former 
directors of NIH and FDA. That morphed in the beginning of this 
Congress to a task force that Diana DeGette and Chairman Upton led 
themselves. That has led to a bipartisan bill that, as has been pointed 
out, came out of committee 51-0.
  That is an amazingly extraordinarily positive accomplishment to have 
total unanimity in support of this type of a bill. We haven't 
reauthorized NIH since 2006, and that lapsed in 2009. This bill does 
that. We have taken every innovative idea in the medical community that 
makes any sense at all and put it into this bill.
  We are increasing the authorization for spending for NIH. We have the 
innovation fund, which is a mandatory program for 5 years. It puts a 
little under $2 billion a year that is offset; it is paid for; it does 
go away at the end of 5 years, but for 5 years, it is specifically 
going to innovation research that is a fast track to find the cures 
that are most applicable to the marketplace today.
  This bill is a revolutionary bill. We need to pass it, Mr. Speaker. 
There are lots of problems. There are things that are not in the bill 
that I wanted in the bill, but this is a huge step forward. It rarely 
happens that Congress can work together to do something that is totally 
for the benefit of the American people. This is one of those times.
  We need to vote for the rule, and then we need to vote for the bill, 
and we will move forward, united, to find the cures for the 21st 
century for all Americans and, really, to some extent, for all the 
world.
  I thank the gentleman for the time.
  Mr. McGOVERN. Mr. Speaker, I yield myself such time as I may consume.
  I am going to urge that we defeat the previous question. If we defeat 
the previous question, I will offer an amendment to the rule to allow 
for consideration of Leader Pelosi's resolution, which basically says 
that any State flag containing the Confederate battle flag would be 
prohibited from the House wing of the Capitol.
  Given what the Republicans, our leadership, tried to do on the 
Interior Appropriations bill yesterday, I think this is especially 
timely. As I mentioned earlier, while South Carolina voted this week to 
take the Confederate flag down, Republicans in Congress appear ready to 
put it back up.
  Mr. Speaker, I yield 2 minutes to the gentleman from Georgia (Mr. 
Lewis), the distinguished ranking member of the Ways and Means 
Subcommittee on Oversight.
  Mr. LEWIS. Mr. Speaker, I want to thank my friend Mr. McGovern for 
yielding.
  Mr. Speaker, I must tell you, my heart is heavy. I am saddened by 
what has happened here in America. I thought that we have come much 
farther--much farther--along.
  Growing up in rural Alabama, attending school in Nashville, 
Tennessee, now living in Georgia, I have seen the signs that said White 
and Colored--White men, Colored men, White women, Colored women, White 
waiting, Colored waiting.
  During the sixties, during the height of the civil rights movement, 
we broke those signs down. They are gone. The only place that we will 
see those signs today will be in a book, in a museum, or on a video. If 
a descendant of Jefferson Davis could admit the Confederate battle flag 
is a symbol of hate and division, why can't we do it here? Why can't we 
move to the 21st century?
  Racism is a disease. We must free ourselves of the way of hate, the 
way of violence, the way of division. We are not there yet. We have not 
yet created a beloved community where we respect the dignity and the 
worth of every human being.
  We need to bring down the flag. The scars and stains of racism are 
still deeply and very embedded in every corner of American society. I 
don't want to see our little children--whether they are Black, White, 
Latino, Asian American, or Native American--growing up and seeing these 
signs of division, these signs of hate.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. McGOVERN. I yield the gentleman an additional 1 minute.
  Mr. LEWIS. As a Nation and as a people, we can do better. We can lay 
down this heavy burden. It is too heavy to bear. Hate is too heavy a 
burden to bear. We need to not continue to plant these seeds in the 
minds of our people.
  When I was marching across that bridge in Selma in 1965, I saw some 
of the law officers and sheriff deputies wearing on their helmet the 
Confederate flag. I don't want to go back, and as a country, we cannot 
go back.
  We must go forward and create a community that recognizes all of us 
as human beings, as citizens, for we are one people, one Nation; we all 
live in the same House, the American House.
  Mr. BURGESS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Kansas (Mr. Yoder).
  Mr. YODER. Mr. Speaker, I rise today to join the chorus of Americans 
who are calling out for support and research and innovation to cure 
diseases that affect every family and neighborhood in America.
  The rule that we have before us would allow us to debate the 21st 
Century Cures bill forwarded by the Energy and Commerce Committee on a 
unanimous, bipartisan vote.
  What this bill would do would increase, by over $8 billion, research 
over the next 5 years to be conducted by the National Institutes of 
Health. Each year, we spend over $700 billion on care for seniors 
through Medicare; yet we spend just $30 billion a year, roughly, 
annually, on curing or researching the cures for every disease that 
plagues our country: Alzheimer's, Parkinson's, cancer, heart disease, 
diabetes.
  In all those diseases combined, we spend just $30 billion a year on 
research; yet we spend trillions on health care. We know, each year, 
600,000 people will die of cancer. We know, each year in the United 
States, 700,000 people will die of Alzheimer's. These are real people, 
real families that are in anguish over these and many other diseases.
  It is not just a moral issue; it is an economic issue. By 2050, 
estimates are that our country will spend $1.1 trillion annually to 
treat health care for people with Alzheimer's alone, over $1 trillion 
annually; yet we spend just $562 million a year researching a cure for 
Alzheimer's, a true definition of penny wise and pound foolish.
  This 21st Century Cures bill increases our commitment to curing 
disease, as I said, by over $8 billion over the next 5 years.
  Each of us has a family member or a friend with a tragic story about 
one of these diseases. These diseases know no party affiliation; they 
don't know center of aisle versus the left or right side of the aisle. 
They know no State; they have no regional boundaries. They don't know 
the difference between mandatory and discretionary spending.
  To cure these diseases is a moral imperative for these families, but 
to cure these diseases is also an economic imperative. If we cure one 
of these diseases, our investment will pay for itself a thousand times 
over. The CBO can't score that; the CBO can't make any recognition of 
that. This is a savings bill.
  The SPEAKER pro tempore. The time of the gentleman has expired.

[[Page 11123]]


  Mr. BURGESS. I yield the gentleman an additional 1 minute.
  Mr. YODER. I have a 20-month-old daughter, and this isn't just about 
curing the disease for our generation; it is about curing the disease 
for her generation and every generation to follow.
  Supporting the 21st Century Cures bill bends the cost curve on 
entitlements; it saves our country from going into bankruptcy, and it 
helps us balance our budget. These investments are not just necessary 
for our moral imperative to save lives, but they are also an economic 
imperative.
  All those things together means we ought to have a robust, large vote 
in this House to pass this rule and to ensure that the 21st Century 
Cures bill goes forward.
  I strongly support it, and I ask my colleagues to do the same.
  Mr. McGOVERN. Mr. Speaker, I yield 1 minute to the gentleman from 
Georgia (Mr. Johnson).
  Mr. JOHNSON of Georgia. Mr. Speaker, the Southern strategy was and is 
a Republican strategy of gaining political support for its political 
candidates by appealing to regional and racial tensions in this country 
based on the history of slavery, the history of the Civil War, racism, 
and segregation. That is a history that is indefensible, and so is the 
Confederate battle flag which represents those attitudes.
  I call upon my fellow colleagues in the Republican Party to denounce 
this Southern strategy once and for all and to do what it takes to 
affirm the tide of this country, which is to do away with that symbol 
of oppression and racial animist, the Confederate battle flag.
  Let's remove that flag from our national cemeteries, from our Park 
Service, places of purchasing memorabilia.

                              {time}  1500

  Mr. BURGESS. Mr. Speaker, I yield myself 1 minute.
  We do have before us today a unique opportunity. We have an 
opportunity to lay the groundwork for the future. We have the way to 
lead in the 21st century in providing 21st century cures.
  To be sure, we are providing additional funding to the National 
Institutes of Health and we are providing additional funding to the 
Food and Drug Administration, but we are also placing requirements upon 
those institutions.
  We all know we have to do things faster, better, cheaper, smarter and 
that we have to do more with less. That is what the 21st Century Cures 
bill lays before us, and that is why this rule is so crucial and 
critical today and why I urge its passage.
  I reserve the balance of my time.
  Mr. McGOVERN. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Connecticut (Ms. DeLauro), the ranking member of the Appropriations 
Subcommittee on Labor, Health and Human Services, Education, and 
Related Agencies.
  Ms. DeLAURO. Mr. Speaker, I rise in opposition to this rule and the 
underlying bill.
  The bill provides for an increase of $1.75 billion per year in the 
budget for the National Institutes of Health. I applaud all efforts to 
increase funding for the NIH.
  I am a survivor of ovarian cancer, and I am alive today because of 
the grace of God and biomedical research. So I appreciate biomedical 
research.
  Unfortunately, this increase is not nearly enough to restore the 
NIH's lost purchasing power. Since fiscal year 2010, the National 
Institutes of Health has seen its budget erode by about $3.6 billion in 
real terms, an 11 percent cut. If we are serious about funding life-
saving medical research, we must raise our level of ambition.
  This bill also sets aside $500 million of the increase to be spent in 
certain specified areas of research. I think that this is a wrong 
approach.
  The people best placed to decide which scientific avenues are worth 
pursuing are scientists, not politicians. We should not substitute our 
judgment for theirs.
  I am also concerned that the bill will lower standards for medical 
device approval at the Food and Drug Administration and create a new 
pathway for antibiotic approval that, in my view, involves less 
rigorous testing requirements. Again, I think that this is a wrong 
approach.
  It is our duty to protect the public from potentially unsafe devices 
and drugs. We do not do that by reducing standards.
  Finally, the majority is yet again using this bill as a vehicle for 
anti-choice Hyde amendment language. Since January, the majority and 
its counterpart in the other Chamber have sought to restrict access to 
abortion no fewer than 37 times.
  The bottom line on this issue is that we need to trust women and that 
we need to trust the choices they make. We have to trust women. 
Politicians have no business meddling in those decisions.
  For these reasons, I believe that we should reject this bill, and I 
urge a ``no'' vote.
  Mr. BURGESS. Mr. Speaker, I yield myself 1 minute.
  I would point out that once again reauthorization of the National 
Institutes of Health occurred in this Congress in the waning days of 
the 109th Congress in December of 2006.
  Mr. Barton reauthorized the NIH at a $31 million base to increase by 
5 percent per year. We were told at the time that that was not enough 
and, with biomedical inflation at 8.8 percent a year, that it was, in 
fact, a cut.
  Mr. Speaker, in fact, what happened was then, of course, the 
Democrats took control of the House and the Senate the following year, 
and they never appropriated the NIH to that 5 percent figure.
  Now, this is not about Republicans and Democrats. This is about 
finding cures for the 21st century. The gentlewoman is correct in that 
we do direct some of the research dollars within the NIH.
  You will recall, when the stimulus bill passed in 2009, $10 billion 
went into the NIH right then to be spent that year.
  We ended up filling up and filing paperwork from leftover projects, 
but we got very few deliverables out of that. This directs that 
research into high-risk, high-reward areas. We need the deliverables 
from the NIH.
  I reserve the balance of my time.
  Mr. McGOVERN. Mr. Speaker, I yield 1 minute to the gentlewoman from 
Colorado (Ms. DeGette), the ranking member of the Energy and Commerce 
Subcommittee on Oversight and Investigations.
  Ms. DeGETTE. Mr. Speaker, I rise today to give my thanks to Fred 
Upton for recruiting me to help cosponsor this bill with him, and I 
give my thanks to all of our colleagues on both sides of the aisle for 
working together on finding cures from the lab into the clinics for so 
many diseases that we don't have any treatments for right now. This 
really is an extraordinary effort that we have made, and it really is 
Congress at its best.
  I do want to mention that I was disappointed when, after the bill 
passed in the Energy and Commerce Committee 51-0, that in the manager's 
amendment the annual riders from the Labor-HHS bill were put into the 
bill. I think it is unnecessary, and I think that it distracts our 
attention from the important mission this bill brings.
  I will be voting for the Lee amendment, but I would urge all of our 
colleagues, no matter how you vote on the amendments that are made in 
order in these rules, to please vote ``yes'' for the patients of 
America.
  Mr. BURGESS. Mr. Speaker, I yield myself 1 minute.
  This past weekend, in an op-ed piece that was published online, Mr. 
James Pinkerton wrote:

       As Abraham Lincoln said a century and a half ago, the 
     Federal Government should only be doing things that people 
     can't do for themselves.

  Medical cures are a great example of something people can't do for 
themselves at home. That is what we are about this afternoon, providing 
the rule to allow for the consideration for the cure of the 21st 
century.
  It is an important rule, and the underlying bill is important. I urge 
all Members to support both the rule and the underlying bill.
  I reserve the balance of my time.
  Mr. McGOVERN. Mr. Speaker, I yield 1 minute to the gentlewoman from 
Texas (Ms. Jackson Lee).

[[Page 11124]]


  Ms. JACKSON LEE. I thank the gentleman from the great State of 
Massachusetts for yielding.
  Mr. Speaker, this is an emotional time for many of us. This is an 
important bill. But we have just gone through an emotional time on this 
floor, again, raising up the ugliness of the rebel flag.
  I stand again to try and educate both the public and our colleagues 
about the damage that this flag has done to so many, for under that 
flag many were killed in the name of slavery.
  Interestingly, this is the 150th year of the elimination of slavery. 
I think about health care, and I spoke last evening about lupus, sickle 
cell anemia, and triple-negative breast cancer all falling 
discriminantly on minority populations. In life, there are still issues 
that face you because you are different.
  I call upon this House to recognize that, although we have many 
issues to debate, when you pierce the heart of someone because you 
believe he is inferior or different--when you want to coddle and 
protect the rebel flag--I hope we will get to the point between now and 
next week, as I introduce H. Res. 342 as a privileged resolution to ban 
all signs of hate, that we will rise to be unified together and stand 
under the American flag.
  Mr. BURGESS. Mr. Speaker, may I inquire as to the time remaining?
  The SPEAKER pro tempore (Mr. Womack). The gentleman from Texas has 
8\1/2\ minutes remaining, and the gentleman from Massachusetts has 2 
minutes remaining.
  Mr. BURGESS. Mr. Speaker, may I ask of the gentleman from 
Massachusetts if he has additional speakers?
  Mr. McGOVERN. Just I.
  Mr. BURGESS. Mr. Speaker, I reserve the balance of my time.
  Mr. McGOVERN. Mr. Speaker, I yield 30 seconds to the gentleman from 
Texas (Mr. Veasey).
  Mr. BURGESS. I yield 1 minute to the gentleman from Texas (Mr. 
Veasey).
  Mr. VEASEY. Mr. Speaker, I just wanted to speak about the importance 
of our acting now to do the right thing in regard to the Confederate 
flag.
  Many of you may not know, but this year marks 100 years of the 
viewing and the premiere of the film that really sparked the re-
emergence of the Confederate flag, ``The Birth of a Nation.'' We know 
that film was bigger than ``Star Wars'' and ``Jaws'' and any major 
blockbuster motion picture.
  That is what ``The Birth of a Nation'' was. It revived the 
Confederate flag. It made the Confederate flag the symbol of hate that 
it is today. It actually helped the re-emergence of the second Ku Klux 
Klan in this country. We know that that is what the Confederate flag 
ultimately stands for.
  It doesn't have anything to do with the Civil War and with the 
battle, like Mr. Clyburn had pointed out earlier, because that was a 
completely different flag. It has to do with segregation and keeping us 
in the past.
  We need to be able to move past it, Mr. Speaker. I would ask that my 
Republican colleagues do the right thing and join us in moving forward 
and in letting the past be the past.
  Mr. BURGESS. Mr. Speaker, I yield 3 minutes to the gentleman from 
Michigan (Mr. Upton), the chairman of the Energy and Commerce Committee 
and the author of the Cures legislation.
  Mr. UPTON. Mr. Speaker, as we all know, we launched this bipartisan 
effort about a year and a half ago, and with tomorrow's House vote, we 
mark a very important milestone in our quest for 21st century cures, 
one step closer to the finish line.
  There have been so many individuals throughout our 18-month journey 
who have helped us get to where we are today: patients across the 
country, advocates, researchers, innovators, experts, academics, 
regulators, some of the Nation's brightest minds, even Nobel Prize 
winners. To all, we say thank you.
  Thank you, too, to the hard-working staff, again, on both sides of 
the aisle, who took the meetings, who did the research, who drafted the 
language, and who sat at the negotiating table for countless hours to 
help us develop this incredible product: Gary, Joan, Alexa, Clay, Paul, 
Josh, Robert, John, Carly, Katie, Adrianna, Graham, Sean, Noelle, 
Macey, Mark, Tom, Bits, Marty, Tim, Jeff, and Tiffany.
  And to the Democratic staff, the staff of our Members, thank you all.
  Thanks to the House legislative counsel and the CBO for your efforts 
and dedication in working through many, many weekends.
  Thank you to the Members of both parties, who really did bring their 
best ideas, who partnered with one another to make their cases, and who 
delivered so many of the policies that we welcome today because we 
listened.
  I also want to thank Chairman Hal Rogers and his staff. The 
Appropriations Committee has been a critical partner in this effort for 
the last number of months, working with us and developing the right 
approach to achieve our shared goal of helping patients in a fiscally 
responsible way.
  I especially want to highlight my partner, Diana DeGette, in her 
effort from day one. She came to my district in Michigan, and I have 
traveled to Colorado. We have been on a number of road trips for Cures 
across the country, and I look forward to the next journey down 
Pennsylvania Avenue.
  I also want to thank Chairman Pitts, Mr. Pallone, and Mr. Green for 
their really strong partnership. We have made great strides, but our 
work continues, and we are not going to stop until the ink is dry.
  I thank Chairman Pete Sessions, Dr. Burgess, and members of the Rules 
Committee for making sure that this legislation has gotten to the floor 
in a timely fashion.
  I also want to give a hearty thanks to a young boy named Max, the 6-
year-old ambassador for Cures. Yes, although he is faced with the 
challenges of Noonan syndrome, he has been a little warrior in that 
effort.
  He joined us when we had a 51-0 vote back on May 21 in the committee, 
and I am delighted that Max will be by our side tomorrow on the House 
floor for its final passage.
  Helping Max and others like him is why we are here, and helping my 
friends Brooke and Brielle, which will be part of my general debate 
discussion, is why we are here.
  With a resounding vote tomorrow, we will send a signal to the Senate 
loud and clear that the time for Cures 2015 is now.
  I look forward to working with my Senate counterparts on both sides 
of the aisle to continue the momentum of getting this bill to the 
President's desk. We have a chance to do something big, and this is our 
time.

                              {time}  1515

  Mr. McGOVERN. Mr. Speaker, I yield myself the balance of my time to 
close.
  Mr. Speaker, the 21st Century Cures bill is a good bill. I want to 
thank Mr. Upton and Ms. DeGette for working in a bipartisan way to come 
up with this product. It invests in NIH. It invests in lifesaving 
medical research. It makes it more possible that we will find cures to 
diseases like cancers and Alzheimer's and Parkinson's, diabetes, HIV, 
and so many other terrible diseases that afflict so many of our fellow 
citizens.
  This is important stuff. Who knows, maybe we will even find a cure to 
the disease that resulted in so many in this House voting for the 
destructive sequestration initiative that, by the way, cut medical 
research and put off the day of some of these lifesaving cures. We need 
to do better than this, but this is an important start, an important 
step in the right direction, and I hope that my colleagues in a 
bipartisan way will support it.
  Secondly, as I mentioned before, I want to urge my colleagues to vote 
against the previous question.
  I ask unanimous consent to insert the text of the amendment I would 
offer in the Record if we defeat the previous question, Mr. Speaker.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Massachusetts?
  There was no objection.
  Mr. McGOVERN. If we defeat the previous question, we will bring up 
again the Pelosi resolution that my colleagues on the other side of the 
aisle chose not to debate. The reason why

[[Page 11125]]

this is important, the reason why we should do this is very simple: 
because it is the right thing to do. Every once in awhile we ought to 
come together in this Chamber and do the right thing. The Confederate 
flag is a symbol of hate; it is a symbol of division; it is a symbol of 
so many things that we all abhor. The time has come to follow some of 
the other States in this country and here in Congress do something the 
American people can be proud of.
  I urge my colleagues to vote ``no'' and defeat the previous question. 
Vote ``no'' on the rule because it is restrictive.
  I yield back the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time to 
close.
  Mr. Speaker, this is a momentous bill that will be before us today. 
This is analogous to the time back in the 1970s when the National 
Cancer Institute was authorized by Congress in the Nixon 
administration. This is an opportunity to take that leap forward and 
perhaps deliver some of those cures that so many of our constituents 
have waited for for so long.
  Mr. Speaker, we all value institutions and institutional knowledge 
and institutional learning, but, Mr. Speaker, we also acknowledge that 
there are times when we have got to be disruptive. There are times that 
you have to forget the past and move into the future, and this is one 
of those times. We are all familiar with the fact that, yeah, the 
neighborhood bookstore may be gone, but we can order stuff online from 
Amazon.
  Disruptive technology is as important in medicine as it is anywhere 
else. This bill is paid for. This bill is offset. It sunsets in 5 
years' time. But, as I was reminded by my colleague, the gentleman from 
Maryland, Dr. Andy Harris, a few days ago, while this bill is offset, 
while we are paying as we go for the increases for the National 
Institutes of Health and the FDA, what if--what if--one of those 
moonshots succeeds?
  In May of 2012, Glen Campbell came and played a concert at the 
Library of Congress. This is him and his daughter Ashley. They were on 
the stage. Glen Campbell went public with the knowledge that he has 
Alzheimer's disease. He struggled at several points during that 
concert. It was, in fact, amazing to watch him play his instrument. At 
times he couldn't remember the words to the song, and Ashley would help 
him.
  This is a shot where they did ``Dueling Banjos''--very, very 
accomplished and skilled instrumental work that they both did on their 
instruments that they were playing. What if? What if we were to deliver 
that moonshot and provide that cure that would have prevented Glen 
Campbell from falling into the recesses of Alzheimer's illness? What if 
that cure were within our grasp? What is worse is what if that cure is 
on a shelf or in a test tube somewhere and we just haven't quite gotten 
around to its evaluation? This is important stuff.
  Glen Campbell narrated the soundtrack of my life as I was growing up, 
from Delight, Arkansas, a gentleman of our generation who was so 
important to so many of us as we were growing up, and he shared with us 
there on the stage his story and his daughter's story. You can see his 
daughter Ashley looking at her dad. If we could preserve her ability to 
smile at her dad for a little longer, wouldn't that be worth some of 
the fighting that we do here?
  This bill is offset. This bill is paid for.
  Mr. Speaker, today's rule provides for consideration of this critical 
bill, a bill that will transform and advance the discovery, 
development, and delivery of treatments and cures.
  I applaud all Members who have worked on this thoughtful piece of 
legislation, along with Energy and Commerce staff on both sides of the 
aisle. All members of the Committee on Energy and Commerce were asked 
to bring their ideas to the table, and we worked to include as many as 
we possibly could.
  I want to express my sincere thanks to all the great attorneys at the 
Legislative Counsel who worked around the clock to deliver us the 
legislative language. I want to thank Chairman Upton, Representative 
DeGette, as well as Chairman Pitts and Ranking Members Pallone and 
Green for their leadership throughout.
  I want to thank all of the staff who have worked so hard over the 
past year; really, literally, all hands were on deck. There is not one 
staffer of the Subcommittee on Health of the Committee on Energy and 
Commerce that does not have their fingerprints all over this bill. I 
certainly want to thank J.P. Paluskiewicz, Danielle Steele, and Lauren 
Fleming from my office, who have put in that additional effort to help 
deliver this product.
  Mr. Speaker, this is an important piece of legislation in front of us 
today. We do, unfortunately, have a lot of distractions, but let us not 
be distracted from providing the tools for the next generation of 
doctors, a generation that will have more ability to alleviate human 
suffering than any generation of doctors has ever known because of our 
actions here on the floor of the House today.
  Ms. SLAUGHTER. Mr. Speaker, I am the Ranking Member of the Rules 
Committee. Rules, as you know, is the process committee.
  Whether you are a majority or a minority member, you have rights, but 
they have been trampled on and abused with increasing regularity under 
this majority, and we have two glaring examples of that just today.
  Mr. Speaker, this bill is important to all of us, and we all agree on 
the importance of putting more money into major research in the United 
States, we are falling behind other countries in finding the cures and 
the innovation for which we have been known for centuries. This is an 
important step that we are taking. This is a critically important bill, 
but process matters.
  Mr. Speaker, after the Energy and Commerce Committee had voted out 
this bill unanimously, major changes were made with no committee input 
at all. They include a reduction of the amount of money that the 
committee had said would be put into the National Institutes of Health 
by $1.250 billion, a very substantial sum.
  They added some policy riders that literally made no sense. Why in 
the world would you put an abortion rider on a bill for medical 
research? As far as I know, the NIH and most medical universities doing 
this research do not perform abortion procedures. It was simply a way, 
again, to mollify members and make them vote for this bill.
  Mr. Speaker, despite the importance of this bill, despite the fact 
that it came out of committee unanimously, despite the fact that so 
many people have worked on it, and despite the fact that good things 
were in it, the process was completely changed after it was over by 
rewriting major portions of it. That doesn't appear anywhere in the 
rules of the House.
  Now, let's also think about what happened here last night during the 
debate on the Interior bill, which was considered under an open rule. 
After the Ranking Member, Betty McCollum of Minnesota, had yielded back 
her time, a new amendment was offered at the request of Republican 
leadership in order to pick up enough votes to ensure final passage. 
This new amendment sought to undo two already adopted amendments that 
would restrict the display of the Confederate flags in National Park 
Service cemeteries. These amendments were initially noncontroversial--
as they should have remained. In fact, they were adopted by voice vote. 
However, following a revolt by Members of the Republican Conference, 
Republican leadership offered this new amendment without any warning in 
order to gain more votes. In the end, the Majority pulled the entire 
bill in order to avoid taking a vote on their effort to place 
Confederate flags in U.S. cemeteries.
  Mr. Speaker, and then this morning the Majority chose to send Leader 
Pelosi's resolution to committee in order to avoid taking a vote on it. 
Her resolution would have required the removal of state flags 
containing the Confederate battle flag from the House wing of the 
Capitol, unless the flag is flown by an individual Member. Mr. McGovern 
stated quite precisely that the resolution will die in committee--we 
will never see that one again. Unfortunately, that's what happens here, 
but Mr. Speaker, it is time it was stopped.
  I was born in a border State, in Kentucky. I lived there most of my 
life. I was educated there. I never saw a Confederate flag in all those 
years. These battle flags that they are putting up appeared in the 
South after the civil rights legislation. They were the products of 
Strom Thurmond and the Dixiecrats. That is when they started to bloom 
all over. It is a symbol of pure hate or fear. It needs to go.
  The material previously referred to by Mr. McGovern is as follows:

[[Page 11126]]



  An Amendment to H. Res. 350 Offered by Mr. McGovern of Massachusetts

       At the end of the resolution, add the following new 
     sections:
       Sec. 2. Immediately upon adoption of this resolution, it 
     shall be in order to consider in the House the resolution (H. 
     Res. 355) raising a question of the privileges of the House 
     if called up by Representative Pelosi of California or her 
     designee. All points of order against the resolution and 
     against its consideration are waived. The previous question 
     shall be considered as ordered on the resolution and preamble 
     to adoption without intervening motion except one hour of 
     debate equally divided and controlled by the proponent and 
     the Majority Leader or his designee.
       Sec. 3. Clause 1(c) of rule XIX shall not apply to the 
     consideration of H. Res. 355.
                                  ____


        The Vote on the Previous Question: What It Really Means

       This vote, the vote on whether to order the previous 
     question on a special rule, is not merely a procedural vote. 
     A vote against ordering the previous question is a vote 
     against the Republican majority agenda and a vote to allow 
     the Democratic minority to offer an alternative plan. It is a 
     vote about what the House should be debating.
       Mr. Clarence Cannon's Precedents of the House of 
     Representatives (VI, 308-311), describes the vote on the 
     previous question on the rule as ``a motion to direct or 
     control the consideration of the subject before the House 
     being made by the Member in charge.'' To defeat the previous 
     question is to give the opposition a chance to decide the 
     subject before the House. Cannon cites the Speaker's ruling 
     of January 13, 1920, to the effect that ``the refusal of the 
     House to sustain the demand for the previous question passes 
     the control of the resolution to the opposition'' in order to 
     offer an amendment. On March 15, 1909, a member of the 
     majority party offered a rule resolution. The House defeated 
     the previous question and a member of the opposition rose to 
     a parliamentary inquiry, asking who was entitled to 
     recognition. Speaker Joseph G. Cannon (R-Illinois) said: 
     ``The previous question having been refused, the gentleman 
     from New York, Mr. Fitzgerald, who had asked the gentleman to 
     yield to him for an amendment, is entitled to the first 
     recognition.''
       The Republican majority may say ``the vote on the previous 
     question is simply a vote on whether to proceed to an 
     immediate vote on adopting the resolution . . . [and] has no 
     substantive legislative or policy implications whatsoever.'' 
     But that is not what they have always said. Listen to the 
     Republican Leadership Manual on the Legislative Process in 
     the United States House of Representatives, (6th edition, 
     page 135). Here's how the Republicans describe the previous 
     question vote in their own manual: ``Although it is generally 
     not possible to amend the rule because the majority Member 
     controlling the time will not yield for the purpose of 
     offering an amendment, the same result may be achieved by 
     voting down the previous question on the rule. . . . When the 
     motion for the previous question is defeated, control of the 
     time passes to the Member who led the opposition to ordering 
     the previous question. That Member, because he then controls 
     the time, may offer an amendment to the rule, or yield for 
     the purpose of amendment.''
       In Deschler's Procedure in the U.S. House of 
     Representatives, the subchapter titled ``Amending Special 
     Rules'' states: ``a refusal to order the previous question on 
     such a rule [a special rule reported from the Committee on 
     Rules] opens the resolution to amendment and further 
     debate.'' (Chapter 21, section 21.2) Section 21.3 continues: 
     ``Upon rejection of the motion for the previous question on a 
     resolution reported from the Committee on Rules, control 
     shifts to the Member leading the opposition to the previous 
     question, who may offer a proper amendment or motion and who 
     controls the time for debate thereon.''
       Clearly, the vote on the previous question on a rule does 
     have substantive policy implications. It is one of the only 
     available tools for those who oppose the Republican 
     majority's agenda and allows those with alternative views the 
     opportunity to offer an alternative plan.

  Mr. BURGESS. Mr. Speaker, I yield back the balance of my time, and I 
move the previous question on the resolution.
  The SPEAKER pro tempore. The question is on ordering the previous 
question on the resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. McGOVERN. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this question will be postponed.

                          ____________________