(Senate - December 01, 2016)

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[Congressional Record Volume 162, Number 172 (Thursday, December 1, 2016)]
[Pages S6646-S6649]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


  The PRESIDING OFFICER. The Senator from Georgia.

                   filling the supreme court vacancy

  Mr. PERDUE. Mr. President, I rise to discuss the vacancy of the U.S. 
Supreme Court.
  We have been on this issue and what needs to happen next year when 
our next President is sworn in. For months this year, I and other 
Members of this body held our ground in saying that the American people 
deserve a voice in this process. We talked about how the integrity of 
the advice and consent process, clearly outlined in article II, section 
2 of the U.S. Constitution, was at stake. We outlined years of 
precedent against nominating and confirming a Supreme Court Justice 
during a Presidential election cycle.
  The last time a vacancy arose and a nominee was confirmed in a 
Presidential election year was 1932, and 1888 was the last Presidential 
election year in which a Justice was nominated and confirmed by a 
divided government. Confirming a nominee to the U.S. Supreme Court 
should never be distorted by political theater of a Presidential 
election cycle. This is a bipartisan position. Both parties have said 
at different times in the past decade or so what I and many colleagues 
on this floor have said just this year.
  Since day one, I have consistently said that no Supreme Court nominee

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should be considered for the Supreme Court or considered by the Senate 
before the next President is sworn in. That also meant no consideration 
during the lameduck, either, no matter the outcome of the election. You 
can't have it both ways. This was my position before the election. This 
is still my position today. It was and is about the principle, not the 
individual. As an outsider to the political process, this was a logical 
and an easy position to take from the very beginning. The process for 
nominating and confirming a Justice to the U.S. Supreme Court is 
enshrined in our Constitution.

  The hyperpartisanship and politics of a Presidential election cycle 
should have absolutely no place in this process. Confirming any 
individual to a lifetime appointment to the U.S. Supreme Court must 
rise from that kind of political posturing. It must be above any 
political theater.
  Furthermore, as I said previously, the American people deserved a 
voice in this process. Election day was not only about changing the 
direction of our country, but it was also a referendum on the ballots 
of the Supreme Court for generations to come.
  Our decision to withhold consent on any Supreme Court nominee, until 
after a new President is sworn in, protected the integrity of the 
advice-and-consent process from political games in a heated 
Presidential campaign cycle. That decision was entirely within the 
rights and responsibilities of the Senate, as outlined in the 
  We did our job, and next year we are going to continue to do that job 
of advice and consent as we consider the next nomination for the 
Supreme Court. With a new President sworn in, it will be time for the 
Senate to confirm a nominee to the U.S. Supreme Court. The election is 
over. The people have spoken. Americans have elected a new President. 
They chose a new direction.
  I urge Members of this body to listen to them, and I urge this body 
to remember the integrity of the process. I also look forward to 
learning from whomever President-Elect Trump nominates to serve on the 
Supreme Court and having the opportunity to vote on his or her 
  I yield my time.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. MORAN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. MORAN. Mr. President, since my arrival in the U.S. Senate a few 
years ago, I have been a proponent and advocate and have attempted to 
champion an issue many in the Senate care about; that is, the desire to 
increase America's investment in medical research, increase the 
likelihood of outcomes that are desirable in improving every American's 
well-being, and end the pain and heartache that comes with diagnoses 
that often end in difficult lives and ultimately death. We have worked 
hard as a Senate on this issue.
  I serve on the Appropriations Committee with the Presiding Officer. I 
serve on the appropriations subcommittee that funds the National 
Institutes of Health, and from my vantage point, it is clear to me that 
we have made a significant investment in increasing the amount of 
dollars that taxpayers pay to try to find those cures for cancer, 
eliminate the onset of Alzheimer's, help with diabetes and mental 
health issues.
  Leadership has been busy for a number of months, and that hard work 
will culminate with a vote next week on the 21st Century Cures Act. It 
is an important component of this medical innovation I find so 
necessary for the benefit of Kansans, Americans, and for people who 
live around the globe.
  This Cures Act invests in the future of our country by providing a 
significant increase in Federal support for lifesaving biomedical 
research that will simply impact the life of every American--certainly 
every American family. These important investments range from 
increasing the funding at the National Institutes of Health, advancing 
the precision medicine initiative, funding important cancer research 
through the cancer Moonshot, and supporting the BRAIN Initiative to 
improve our understanding of diseases like Alzheimer's.
  There are also provisions that will accelerate the FDA approval and 
drug development process as well as fight opioid abuse and suicides.
  The subcommittee the Presiding Officer and I serve on in the 
Appropriations Committee, or the subcommittee that deals with 
agriculture and the Food and Drug Administration, wants to give the FDA 
the tools necessary to accelerate the process by which lifesaving drugs 
and devices are available for Americans and citizens around the globe.
  Under the 21st Century Cures Act, the National Institutes of Health 
will receive a significant dollar investment increase over the next 10 
years. We know that will drive research forward to develop a greater 
understanding of rare diseases. We often think about NIH as dealing 
with those major afflictions--cancer and Alzheimer's and diabetes--but 
many Americans unfortunately suffer from rare diseases, and we want to 
help find the treatments that are patient-centric that treat rare 
diseases as well.
  This funding will send a message that we acknowledge the benefits of 
NIH research in a strong bipartisan way. This funding will also work in 
tandem with those increases that we have provided at NIH through the 
normal annual appropriations process.
  We have always given NIH the ability to prioritize their research 
that could result in the biggest bang for the buck, the most lifesaving 
opportunities, but obviously the more resources NIH has, the more 
opportunities they have to find those cures and advancements in 
  This effort also supports the best and brightest among us--those 
researchers and scientists. I want young Kansans to have a future, if 
they are interested in science and mathematics and engineering and 
research, and an opportunity to pursue those careers, hopefully in our 
State, but certainly in this country. We want the United States to 
continue to be at the forefront of medical research and within the 
realm of science and engineering as well. This is an economic engine 
for our Nation. It can be and is an economic engine for my State. The 
Cures Act accelerates those opportunities for young people and others 
across the country who want to devote their lives toward a noble cause 
of making life longer, greater longevity, but also with fewer 
challenges and afflictions that come to many people who encounter 
  The burdens of diseases like Alzheimer's, cancer, stroke, and mental 
illness can be lessened through research. A long time ago, well before 
the Affordable Care Act and ObamaCare, I sat down and put my thoughts 
on paper as to what we should do to try to reduce the cost of health 
care in this country. What can we do to reduce the price people have to 
pay to be insured? That list is long. In my view, the way to do this is 
incremental, but one of those increments is to invest in medical 
research. The amount of money that we can save if we can find the cure 
for cancer, if we can find the delay for the onset of Alzheimer's, is 
certainly in the billions of dollars, and the investment in medical 
research helps us to save health care dollars, therefore helping us to 
make health insurance more affordable for all Americans. It certainly 
is an investment in economics, it is an investment in the ability to 
save money, as well as what we know about saving lives and making 
treatments available to people who otherwise would have less life 
enjoyment as a result of disease.
  New scientific findings are what yields breakthroughs that enable us 
to confront the staggering challenges of disease and illness, and we 
can do that through the Cures Act and the efforts we have made over the 
last several years to make certain that NIH has additional resources.
  When it comes to cancer, half of all men and a third of all women in 
the United States will develop cancer in their lifetime. This bill 
includes the Cancer Moonshot provision for $1.8 billion of funding. It 
seeks to combat those statistics to reduce the chances that somebody 
encounters cancer in their lives and to reduce the costs associated 
with it. This research will focus on accelerating cancer research and 
make more therapies more available to

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more people, to a wider range of patients, and improve our ability to 
detect cancers at earlier stages of its development and, hopefully, 
prevent that disease altogether.
  So cancer is front and center with the Moonshot and the Cures Act.
  For the Food and Drug Administration, an agency that I have learned 
more about in the last couple of years and have taken a greater 
interest in, we need to have reforms that are included in the Cures Act 
that target speeding up the FDA's approval of new medicines and medical 
  Pharmaceuticals have become a significant portion of how we treat 
disease. It used to be in the early days of my life, and certainly in 
my parents' lives, that you went to the doctor and you were examined 
and you may be admitted to the hospital. So often today you are 
examined, and you are given a prescription. It is a way now that we 
treat patients. We have today a wider variety of opportunities that 
pharmaceuticals provide, and we need to make certain that the FDA has 
the resources, has the right mentality, the mindset--is not a 
bureaucratic organization--that can advance the production of new drugs 
available to treat Americans with a wide array of options. This 
legislation brings a patient-focused view to drug development that will 
be so relevant in the process of bringing forward the things we need to 
cure and treat Americans.
  Opioids have been a topic of conversation of this Senate for a number 
of months--for the last several years, in fact--and, unfortunately, 
millions across the country struggle with an addiction to opioids. It 
is a heartbreaking reality. The Presiding Officer and I come from rural 
States. We wish we could say that our States are immune, that it is a 
problem for folks in the cities or suburbs or someplace else. But, 
unfortunately, opioids and other drug addictions are a significant 
component of the challenges we face at home. We include in the Cures 
bill additional dollars to address the addiction issue, including 
prevention and treatment, prescription drug monitoring programs, and 
efforts to reform our current system.
  It is important that this legislation pass as a followup to the 
Comprehensive Addiction and Recovery Act, which I voted for earlier 
this year, to try to stop the spread of opioid abuse in communities 
across the country.
  I have started paying more attention to mental health issues at home 
as well, visiting our community mental health centers, visiting our 
State and mental health hospitals. We need to make certain that in our 
efforts to focus on health care, we have an appropriate prioritization 
of mental health as well. The 21st Century Cures Act takes steps 
forward in that regard in providing solutions for more than 11.5 
million American adults who live with mental illness that is considered 
disabling. Important sections of the Helping Families in Mental Health 
Crisis Act, which represents some of the most significant reforms to 
the mental health system in more than a decade, are included in the 
Cures Act. These efforts are aided by establishing a new Assistant 
Secretary for Mental Health and Substance Abuse at the Department of 
Health and Human Services, and we are hopeful that this person will 
help us coordinate direct funding and remove the regulatory barriers 
that hold back our abilities to find treatment and cures and care for 
people who suffer from mental illness.
  Suicides are a significant problem. The Presiding Officer and I serve 
on the Veterans' Committee together, where suicides by veterans are an 
ever-present problem. Twenty-two veterans a day commit suicide. Our 
efforts at focusing research and treatment in regard to mental health 
can help save the lives of those who sacrificed so much for us and 
comfort their families and avoid disasters and tragedies that occur way 
too often.
  There are a couple of provisions that were included in this 
legislation as it works its way through the Senate. I am supportive of 
many of those related to rural health care. For my time in Congress, I 
have been an active member of the rural health care caucus. I represent 
a State that has 127 hospitals in communities across our State. Those 
hospitals provide health care and jobs for people in rural America. 
Rural Kansans have paid into FICA and Social Security taxes and deserve 
to have the attention they need for treating individuals who choose to 
live in rural America, in keeping those hospital doors open, keeping 
physicians in our communities, and keeping the pharmacy open on Main 
Street. Those are things that matter greatly to me.
  Unfortunately, the Centers for Medicare & Medicaid Services, a 
component of the Department of Health and Human Services, often creates 
rules and regulations that make no sense in the places that the 
Presiding Officer and I come from. So I am supporting a couple of 
things in particular that are included in this bill. We had a 
regulation that came from CMS--the Centers for Medicare & Medicaid 
Services--generally called physician supervision. Its enforcement is 
delayed 1 year in the Cures Act. I am the sponsor of legislation to rid 
us of that regulation permanently, but it is a benefit for us to have 
it out of the system for another year as we work to find that permanent 
solution. But the idea that there must be a physician present in 
certain circumstances--it is difficult for us to have a physician on 
site in a room with a patient in every circumstance, and our mid-levels 
and others are important to us in rural communities in particular. That 
delay is something we have worked hard on, and I am pleased to see that 
we were successful in getting it included in this legislation.
  Many of those hospitals that I mentioned in Kansas--127 hospitals in 
our State, 80-plus--90 or so--are what are called critical access 
hospitals, which is a special designation that allows them a so-called 
cost-based reimbursement. When I was in the House of Representatives, I 
authored legislation that created an opportunity to expand the critical 
access hospital designation to hospitals that are slightly larger and 
that wouldn't otherwise meet the criteria, which is 25 beds or less. 
There is a demonstration project, a pilot program that has been 
operating in the country for the last 5 years, trying to determine what 
cost-based reimbursement would mean for hospitals that are slightly 
larger than 25 beds. That demonstration project is expiring. 
Fortunately, language in the Cures Act extends that community health 
demonstration project--something, again, we have worked hard to make 
certain happens. I am pleased that the lead sponsors of this 
legislation were amenable to our request to include these provisions.
  I would conclude by saying the United States has a responsibility to 
continue our leadership in providing medical breakthroughs that will 
help change the world, and certainly change people's lives, to develop 
those cures and treat diseases, and we must commit ourselves to 
significant support for research that is supported in legislation just 
like the 21st Century Cures Act. This legislation has the capacity to 
benefit millions of Americans suffering from chronic diseases. It can 
help our grandparents, our children, our lifelong best friends, and we 
can avoid the tragedy that comes with a diagnosis that often ends in 
death. People's lives depend upon the decisions we make, and this is a 
decision we can make that will benefit many Americans and their 
  Our researchers must be able to rely on consistent, sustainable 
funding support from Congress; otherwise we will lose the best and 
brightest, and we will lose men and women who think maybe they want to 
be a researcher and find a cure for a disease, but because of their 
uncertainty as to whether or not their research might get funded or 
whether the funding is going to be there next year--they get it, but 
they are uncertain as to whether it will continue. We don't want to 
lose those bright minds and noble colleagues, people across our country 
who might enter into the profession of medical research to help find 
ways to meet the needs of Americans and their health care.
  NIH-supported research has raised life expectancy, improved the 
quality of life, and lowered overall health care costs. This 
legislation strengthens that circumstance and allows us to better 
remain globally competitive in the arena of medical research. The 21st 
Century Cures Act is a powerful statement by Congress, but, more 
important than being a statement, it is something that will actually 
make a difference in the future of the people that we care about.

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  I commend the efforts by many Senators and Members of the House to 
make certain that this legislation arrives here in the Senate before 
there is a recess for the holidays. It will be a strong statement, but, 
more importantly, we expect significant results and the improvement of 
people's lives across the Nation and around the globe.
  Mr. President, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. SCOTT. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Cassidy). Without objection, it is so