[Pages S4585-S4588]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED AGENCIES 
              APPROPRIATIONS ACT, 2026--Motion to Proceed

  The PRESIDING OFFICER. The Senator from Arkansas.


                             Appropriations

  Mr. BOOZMAN. Mr. President, I am pleased to join Senators Collins and 
Murray, as well as my Democratic counterpart on the MILCON-VA 
Subcommittee Senator Ossoff in presenting the fiscal year 2026 and 2027 
for the Department of Veterans' Affairs and the Department of Military 
Construction.
  It is important to remember that we followed tradition in crafting 
the bill in a very open and a very bipartisan way. So it is built on a 
strong foundation and deserves the support of our colleagues.
  This bill takes into consideration the needs of our veterans, their 
families, and our servicemembers. And within that framework, we have 
created a thoughtful path--a path forward for both Departments and 
their related Agencies.
  This bill provides $153.5 billion of discretionary spending. Of that 
amount, the Department of Veterans Affairs has provided $133.3 billion 
in discretionary funding. When combined with the $49.8 billion from the 
Toxic Exposures Fund, veterans' medical care will be funded at a total 
of $163.6 billion in fiscal year 2026.
  Our bill funds priority accounts to prevent veteran suicide as well 
as increase rural access to healthcare through significant investments 
for the Office of Rural Health.
  Additionally, we allocated approximately $23 billion to support 
critical mental health issues and programs to prevent veterans' 
homelessness and provide funding for innovative medical research.
  The bill also funds mandatory veterans' benefits, which are earned 
benefits that include disability pensions, employment training 
programs, and educational benefits.
  We also make advanced appropriations for fiscal year 2027 for certain 
accounts, including $122.3 billion for veterans' medical care and 
$262.1 billion for mandatory veterans' benefits.
  In addition, we are delivering $19.8 billion to support military 
construction and family housing units, which are important to both 
readiness and morale. Our bill will give the Department of Defense the 
resources it needs to project power globally, enhance our warfighting 
capabilities, and train our forces.
  Importantly, we provide $1.9 billion to improve housing and quality 
of life for servicemembers and their families.
  I also want to note that the bill includes robust funding for related 
Agencies, which include the American Battle Monuments Commission, the 
U.S. Court of Appeals for Veterans Claims, Arlington National Cemetery, 
and the Armed Forces Retirement Home.
  Funding at these priorities at these levels represents solid 
bipartisan work to provide the resources necessary for our veterans, 
their families, and the servicemembers defending our Nation, which was 
evident with the passage of the measure in the Appropriations Committee 
by a vote of 26 to 3.
  I want to again thank Senator Ossoff as well as Chair Collins and 
Vice Chair Murray for their hard work and collaboration. And also a 
special thanks to our staff who worked so, so very hard to put the bill 
together.
  I yield the floor.
  The PRESIDING OFFICER. The Democratic whip.


                   Unanimous Consent Request--S. 229

  Mr. DURBIN. Mr. President, America is a great nation. Just look at 
the record. When it comes to the discovery of new drugs and 
pharmaceuticals, we lead the world. But we also pay the highest prices 
in the world for the prescription drugs. The very same drugs made in 
the United States is for sale in Canada at a fraction of the cost. The 
same thing is true in Europe.
  What is going on here?
  Our country is producing drugs, paying more for them than other 
customers around the world--the problem is so glaring that even 
President Trump has identified fixing this issue as a priority. 
Bipartisan feeling--change it, reduce the price of drugs.
  Why is the United States such an outlier? One of the major reasons--
if you watch television, you see it every single day. The United States 
is one of only two industrialized countries in the world that allows 
people to advertise drugs on television.

  This is a trivia quiz. What is the other country? New Zealand. Two 
countries in the world that allow advertising of prescription drugs on 
television--you know, the ads with the catchy jingles, flashy images of 
patients rock climbing, golfing, dancing, parading.
  Big Pharma spends $6 billion a year to flood the airwaves with ads 
for the latest wonder drug--$6 billion.
  Why? Why would they spend all this money to advertise drugs and say, 
Talk it over with your doctor? They spend such astronomical sums to 
promote their drugs because it increases their profit margins.
  Big Pharma thinks if they hit you hard enough and often enough with 
ads on television, not only will you be able to pronounce but spell 
Xarelto, but you will also tell your doctor: That is my favorite blood 
thinner. I have seen that ad over and over again.
  Don't take my word for it.
  The American Medical Association said:

       Direct to consumer advertising inflates demands for new and 
     expensive drugs even when these drugs may not be appropriate 
     for your health.

  When President Biden announced 15 drugs that Medicare would negotiate 
for discounts, most Americans knew the names, maybe even knew the 
jingle: Ozempic, Trelegy, Ibrance, Otezla.
  Sound familiar?
  Pharma spends hundreds of millions of dollars each year so you are 
supposed to ``ask your doctor'' about these drugs.
  The result, Medicare spent $22 billion last year alone on these four 
heavily advertised medications--$22 billion. With these advertisements, 
Big Pharma is betting they can squeeze every penny out of you and our 
healthcare system.
  Just last week, I released a report about the new telehealth 
advertising scheme launched by Pfizer and Eli Lilly. With online 
promotions and new websites, Pharma is urging patients to ``click 
here'' if you want to speak with a doctor. But those telehealth doctors

[[Page S4586]]

are handpicked. They have been recruited and paid for by the drug 
companies.
  Pharma is funneling patients to their chosen healthcare providers to 
influence prescriptions for costly drugs. This raises concerns about 
conflicts of interest and inappropriate prescribing of drugs. All of 
this is a result of Pharma's rampant advertising spree.
  Since 2017, I have introduced bipartisan legislation to crack down on 
this TV advertising. Republican Senator Chuck Grassley--now on the 
floor to join me--has been my partner in this effort. When you turn on 
the evening news, one-third--one out of every three--commercials you 
see are for drugs from prescription drug companies. It is the same when 
you stream your favorite show or scroll on social media.
  Americans see an average nine pharmaceutical ads every single day. 
With billions in targeted spending, patients are bombarded with 
information--often at rapid machine gun pace--but kept in the dark 
about one crucial fact that is essential to this conversation: The drug 
companies want to tell you everything, including the warnings as fast 
as they say them, but they don't want you to know one thing. They don't 
want you to know the price.
  Because of outrageous drug prices, millions of Americans are faced to 
ration doses, skip refills, making cost of transparency absolutely 
essential.
  I want to put an ad up here, which some of you may recognize.
  In 2023, Illinois company AbbVie spent $350 million on TV ads for 
Rinvoq, an eczema and arthritis drug. Nowhere in the commercial do they 
tell you the cost as publicized and released by the drug company--
$6,100 a month for this drug.
  A lot of good news, if you are going to go out canoeing and white 
water rafting, but they won't tell you it is $6,100 for Rinvoq.
  It is time to end Big Pharma's secrecy. If they are going to 
advertise a drug, they need to also declare to the American public how 
much it costs.
  It is basic. No gimmicks, no tricks, just the truth by advertising 
the very same drug that the drug companies publish at the fictional 
price.
  Our commonsense plan to require price disclosures in direct-to-
consumer drug ads has already passed the Senate one time before. 
Senator Grassley and I worked together in 2018, because we knew that 88 
percent of the American people support what we are doing--disclosure of 
price and reduction of the cost of drugs to consumers.
  In fact, because of our work, President Donald Trump made a 
statement.

       Big announcement . . .--

  The President said--

     Drug companies have to come clean about their prices in TV 
     ads. Historic transparency for American patients is here. If 
     drug companies are ashamed of those prices--lower them!

  That is what the President said on May 8, 2019.
  Vice President Vance previously cosponsored the measure Senator 
Grassley and I support, while Health Secretary Kennedy has railed 
against drug advertising and suggested our price disclosure policy has 
his support too. So this is a bipartisan undertaking.
  Big Pharma hates being honest with patients about the price of drugs; 
they fear it is going to cut into their profits. Patients in America, 
American citizens and others, deserve lower drug prices.
  The Trump administration has called on Congress to rein in these 
deceptive drug advertisements, but Big Pharma is looking for one 
Senator--if they can just get one Senator to come down here on the 
floor and object to the passage of this commonsense bill. I hope we can 
pass it right now to deliver real relief at the pharmacy counter.
  I am now going to yield to my partner in this effort, Senator 
Grassley, before I make a motion.
  The PRESIDING OFFICER. The Senator from Iowa.
  Mr. GRASSLEY. I want to thank Senator Durbin for his leadership in 
this area the two or three times we have attempted to do this. One 
time, I think we were successful, but it is still not law.
  I would like to put this in the simplest form I can by saying that 
watching television all the time, prices are showing up all the time 
for this product or that product. I don't know how many times I see 
that something costs $9.99 or $19.99 or that the price of an automobile 
is $26,000. But when it comes to prescription drugs, presumably there 
is something very sensitive about this that they don't want to tell us 
what it is going to cost. Of course that irritates me, but most 
importantly, it is not fair to the consumer.
  Today, we have a President, we have a Vice President, and we have a 
Secretary of Health and Human Services all on record supporting this 
commonsense measure to require prescription drug ads to list the price 
of a drug. In fact, I discussed this with the HHS Secretary prior to 
his confirmation, and he told me he thought it could be done by 
regulation. It is my understanding they are studying doing it by 
regulation, and I would say hurry up and get it done because whether it 
is done by law or whether it is done by regulation, this is something 
that should be done.
  I want to say that I think my colleagues know that lowering the cost 
of prescription drugs is a top priority of mine--no more than it is 
Senator Durbin's. Without their prescription medication, millions of 
Americans would not survive.
  As a nation, we are blessed to live in a country where investment and 
innovation unlock cures and treatments--some of them we even refer to 
as miracle cures. But the escalating prices of prescription drugs are a 
consuming concern for millions of Americans, including in my State of 
Iowa, where they bring up this very subject regularly at my county 
meetings.
  There are many reasons for the high cost of prescription drugs. It 
could be the lack of competition and abusive practices. It could be 
opaque and powerful drug middlemen that we call pharmacy benefit 
managers and a lack of transparency on prices.
  By the way, I just mentioned PBMs. There are at least 65 to 70 
Senators that are cosponsors of 1 or more bills--at least 3 bills that 
exist out of 3 different committees--that want more transparency with 
PBMs, and somehow, we ought to be able to get that up. Hopefully, we 
will be successful before this year is out.
  So I am working in all three of these areas I just told you about to 
advance bipartisan solutions. When voluntarily choosing to promote 
medications over the airways, manufacturers are already required to 
disclose safety and side effects. Yet, for many patients, price plays a 
primary role in clinical adherence.
  There is a lot of value in knowing a prescription drug's list price. 
This is the most accessible and standardized price of a drug, which is 
set by the manufacturer itself.
  Despite efforts by Big Pharma to stop our bill, I am confident that 
the American consumer will continue to demand the kind of price 
transparency that they deserve. President Trump, Vice President Vance, 
and Secretary Kennedy will also continue to fight with us.
  If critics have solutions to make our bill better, come to the table, 
present your ideas, and work with us.
  Also, I want to thank the chairman of the Finance Committee. He is a 
friend. He may be against this bill today, but he is very much an 
advocate for PBM reforms.
  I thank you, Senator, for doing that.
  The Finance Committee, along with several other committees in the 
Senate, has a bipartisan PBM reform ready to pass the Senate.
  The President made it clear that he wants to see PBM transparency and 
accountability, and we must tackle the cost of prescription drugs 
through more competition, PBM reform, and, of course, through the 
sunshine on drug prices that Senator Durbin and I are proposing.
  I yield the floor.
  The PRESIDING OFFICER. The Democratic whip.
  Mr. DURBIN. Take a look at the agenda of the U.S. Senate. Tell me an 
issue that 88 percent of the American people agree with. Tell me an 
issue where you have bipartisan sponsorship: Senator Grassley, chairman 
of the Senate Judiciary Committee; I am ranking member of that 
committee--a Republican, a Democrat supporting it. Tell me an issue 
where you have President Trump supporting our position and a Democratic 
Senator like myself on the floor espousing the same position as the 
President of the United States. Tell me an issue that is more timely 
than the affordability of prescription drugs. I can't think of another 
issue that fits that mold.

[[Page S4587]]

  I want to make a motion. I ask unanimous consent that notwithstanding 
rule XXII, the Committee on Finance be discharged from further 
consideration of S. 229 and the Senate proceed to its immediate 
consideration; that the bill be considered read a third time and passed 
and the motion to reconsider be considered made and laid upon the 
table.
  The PRESIDING OFFICER. Is there objection?
  The Senator from Idaho.
  Mr. CRAPO. Reserving the right to object, I am the chairman of the 
Finance Committee, the committee they are trying to pull this bill out 
of. The fact is that I completely agree with the objective of my 
colleagues on the floor today that we need to get transparency in the 
prescription drug pricing system.
  Americans deserve a transparent, affordable, and accessible 
prescription drug market. Far too often, the current system fails to 
meet those needs. It is not only, though, because we haven't got ads on 
TV saying the list price of the drug--I don't have an opposition to 
just doing something like that--but it is much more complex. Vertically 
integrated health plans, pharmacy benefit managers, and other 
intermediaries suppress competition, pocket valuable drug discounts, 
and increase prices for consumers--all unrelated to the list price of 
the drug.
  Last Congress, the Senate Finance Committee, which I chair, advanced 
a number of our bipartisan proposals to reform our broken prescription 
drug supply chain. Senator Grassley has just referenced those 
proposals, and he is a strong ally and advocate of those. These 
policies would ensure that patients, not middlemen, benefit from the 
negotiated price of drugs--not the price you see if you just look at 
the list price, the negotiated price of the drugs. With bipartisan 
support and cooperation, we can pass that package by the end of this 
year, but we need bipartisan support to move forward and do it.
  While well-intended, the proposal before us today risks confusing 
patients further by requiring disclosure of list prices in 
advertisements that no consumer should pay--none. A drug's list price 
includes none of the discounts, rebates, or other price concessions 
found in net prices, which continue to decline even as other prices 
grow.
  Rather than broadcast and validate a list price, Congress should 
ensure that patients can share in the savings reflected in the net 
pricing points, enabling both increased transparency and reduced out-
of-pocket costs at the pharmacy counter.
  What I am saying is that this is complex, and we are working and have 
a working solution. I stand ready to work with the administration and 
my colleagues on both sides of the aisle on an effective method to 
increase transparency and access to relevant information that patients 
need to make important choices about their own health but not to pull a 
bill out of our committee when we are already working in committee to 
get the right and most effective solution put into place.
  For those reasons, I object to my colleague's request.
  The PRESIDING OFFICER. The objection is heard.
  The Democratic whip.
  Mr. DURBIN. The Senator from Idaho is my friend. We have worked 
together in the past; I am sure we will in the future. But I want to 
tell you something. He professes deep concern about whether senior 
citizens are going to get confused if we tell them the actual price 
given by the drug company itself. He thinks it is too confusing for 
them to understand that that price means anything at all.
  Do you know who disagrees with him? The AARP, the American 
Association of Retired Persons. They represent American seniors, and 
they endorse the Grassley-Durbin bill. They believe that seniors can 
understand completely how much the cost of the drug is even if it can 
be discounted under the insurance coverage of your policy as well.
  The list price is the proper method of disclosure because the drug 
companies create the list price. We are not imposing a price on them; 
it is a price they have to publish. It is an objective, factual figure. 
Many patients do indeed pay this price when they don't have copays.
  Let me say a word about what it means in the real world. In 2022, 
19,000 seniors in the State of Idaho paid an average of $570 out of 
pocket on a drug known as Eliquis--a pretty well-known drug. Another 
6,000 seniors in Idaho paid on average $607 out of pocket for Xarelto--
the one that is impossible to explain. Both of these blood thinners are 
among the most heavily advertised medications.
  We are talking about a dose of transparency in the State of Idaho and 
every other State so that 25,000 seniors in Idaho can save money by 
knowing up front what costs they may face and make informed treatment 
choices.
  Why are we afraid to ask the drug companies to disclose a price they 
publish in private--at least to some sources--and not tell the American 
consumer? If they had to do that, we think the American consumer would 
think twice about falling for these ads.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Mr. President, I ask unanimous consent to speak for 6 
minutes prior to the vote.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                             Appropriations

  Mrs. MURRAY. Mr. President, today, I will be voting to move ahead 
with the first spending bill for fiscal year 2026.
  Now, there is no doubt that the path forward on appropriations this 
year has been made extremely challenging by President Trump's flagrant 
lack of regard for Congress and our laws, and it has not been made any 
easier by the unprecedented partisan rescissions package that 
Republicans passed last week. But we cannot afford another slush fund, 
full-year CR, and we cannot accept the draconian cuts being pushed by 
Trump and House Republicans. So we do need to chart a different path 
forward and pass full-year, bipartisan spending bills that invest in 
folks back home and make sure Congress and our constituents have a say 
in Federal spending. The way, of course, to ensure that happens is 
through a bipartisan appropriations process.
  So I am very glad that, thanks to the senior Senator from Georgia, 
working across the aisle with his partner, the senior Senator from 
Arkansas, we were able to negotiate and report out of committee a good 
bill to fund our military construction needs and the Department of 
Veterans Affairs in fiscal year 2026.
  As the daughter of a World War II veteran, the programs we fund in 
the MILCON-VA bill are very personal to me. Doing right by our vets and 
getting them the care they need and the support they were promised is a 
moral obligation, which is why I am pleased to say the MILCON-VA bill 
we are voting on delivers the funding needed to live up to our Nation's 
commitments to our veterans and makes crucial investments to support 
our servicemembers and our national security.
  The bill includes essential funds for VA care, including rural 
health, women's health, medical research, and the caregivers program I 
have long championed, and for the first time, it puts funding levels 
for those important programs in statute. It also expands the pilot I 
started to make sure that childcare is not a barrier to any veteran who 
needs care and increases funding to address veteran homelessness and 
mental health needs.
  When it comes to supporting our servicemembers and their families, 
there are investments for nearly 300 construction projects, including 
new family housing construction and child development centers.
  There are also investments to bolster our footprint in the Pacific 
and support our NATO projects. These are incredibly important to our 
soldiers, to our veterans, and to our national security.
  No doubt there is more I would like to see done in this bill. It is 
not, of course, the bill I would have written on my own. But I do hope 
Republicans will work with us now to consider critical amendments to 
improve the bill and make sure the administration actually delivers for 
veterans, something I think it has certainly failed to do on many 
fronts over the last few months.
  There is also some discussion of adding two other funding bills that 
we have negotiated and reported out of committee to make this a minibus 
package. These are solid, compromised bills that reject the truly 
draconian cuts proposed by President Trump and

[[Page S4588]]

House Republicans, and I would like to see them considered by the full 
Senate.
  Now, for that to happen, I hope Republicans will work with us to 
ensure, once again, that there is an opportunity to debate and amend 
all three bills.
  So I am a ``yes'' vote on moving forward today with debate of the 
MILCON-VA bill, and I hope we can keep this process moving because 
passing our appropriations bills is the best way we can make sure 
Federal spending reflects the needs we are hearing about in our States 
and actually solves problems for people at home.
  No one wants a shutdown, and the way we avoid that shutdown is by 
working together. That is not a secret, not a surprise; it is a reality 
we all know. As the majority leader noted recently, the math tells us 
that it takes 60. It takes bipartisan cooperation. Unfortunately, 
Republicans have been chipping away at that cooperation, especially 
with the rescissions vote last week.
  But, to be clear, if Republicans continue cutting bipartisan deals 
with more rescissions, that is not cooperation. If Republicans try and 
jam through another slush-fund CR, that is not cooperation.
  So for anyone considering the partisan route, you cannot write a bill 
without talking to Democrats and then act surprised when Democrats 
don't support it. You want our votes; you work with us. And this bill 
today that we are considering shows that is possible. So I want to 
applaud the bipartisan work of the senior Senators from Georgia and 
Arkansas to get us to this point, and I hope all of our colleagues can 
take that lesson to heart as we move forward with consideration of this 
bill and our work on bipartisan bills to fund the government and avoid 
a shutdown.
  Let's stay focused on that instead of embracing Russ Vought's vision 
for a Congress that is more partisan, less powerful, and less able to 
make life better for the people we represent.
  I yield the floor.


                             Vote on Motion

  The PRESIDING OFFICER (Mr. Banks). Under the previous order, all 
postcloture time is expired.
  The question is on agreeing to the motion to proceed.
  Mrs. MURRAY. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The senior assistant legislative clerk called the roll.
  Mr. BARRASSO. The following Senators are necessarily absent: the 
Senator from Kentucky (Mr. McConnell) and the Senator from Oklahoma 
(Mr. Mullin).
  The result was announced--yeas 90, nays 8, as follows:

                      [Rollcall Vote No. 428 Leg.]

                                YEAS--90

     Alsobrooks
     Baldwin
     Banks
     Barrasso
     Bennet
     Blackburn
     Blumenthal
     Blunt Rochester
     Booker
     Boozman
     Britt
     Budd
     Cantwell
     Capito
     Cassidy
     Collins
     Coons
     Cornyn
     Cortez Masto
     Cotton
     Cramer
     Crapo
     Cruz
     Curtis
     Daines
     Duckworth
     Durbin
     Ernst
     Fetterman
     Fischer
     Gallego
     Gillibrand
     Graham
     Grassley
     Hagerty
     Hassan
     Heinrich
     Hickenlooper
     Hirono
     Hoeven
     Husted
     Hyde-Smith
     Johnson
     Justice
     Kaine
     Kelly
     Kennedy
     Kim
     King
     Klobuchar
     Lankford
     Lujan
     Lummis
     Marshall
     McCormick
     Merkley
     Moody
     Moran
     Moreno
     Murkowski
     Murray
     Ossoff
     Paul
     Peters
     Reed
     Ricketts
     Risch
     Rosen
     Rounds
     Schatz
     Schmitt
     Schumer
     Scott (FL)
     Scott (SC)
     Shaheen
     Sheehy
     Slotkin
     Smith
     Sullivan
     Thune
     Tillis
     Tuberville
     Van Hollen
     Warner
     Warnock
     Welch
     Whitehouse
     Wicker
     Wyden
     Young

                                NAYS--8

     Hawley
     Lee
     Markey
     Murphy
     Padilla
     Sanders
     Schiff
     Warren

                             NOT VOTING--2

     McConnell
     Mullin
       
  The motion was agreed to.

                          ____________________