December 11, 2019 - Issue: Vol. 165, No. 198 — Daily Edition116th Congress (2019 - 2020) - 1st Session

[Pages H10096-H10117]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    LOWER DRUG COSTS NOW ACT OF 2019


                             General Leave

  Mr. PALLONE. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material on H.R. 3, the Elijah E. Cummings Lower 
Drug Costs Now Act.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  The SPEAKER pro tempore. Pursuant to House Resolution 758 and rule 
XVIII, the Chair declares the House in the Committee of the Whole House 
on the state of the Union for the consideration of the bill, H.R. 3.
  The Chair appoints the gentleman from New Jersey (Mr. Payne) to 
preside over the Committee of the Whole.

                              {time}  1818


                     In the Committee of the Whole

  Accordingly, the House resolved itself into the Committee of the 
Whole House on the state of the Union for the consideration of the bill 
(H.R. 3) to establish a fair price negotiation program, protect the 
Medicare program from excessive price increases, and establish an out-
of-pocket maximum for Medicare part D enrollees, and for other 
purposes, with Mr. Payne in the chair.
  The Clerk read the title of the bill.
  The CHAIR. Pursuant to the rule, the bill is considered read the 
first time.
  General debate shall not exceed 4 hours, with 3 hours equally divided 
among and controlled by the respective chairs and ranking minority 
members of the Committee on Energy and Commerce, Committee on Ways and 
Means, and Committee on Education and Labor, and 1 hour equally divided 
and controlled by the majority leader and the minority leader or their 
respective designees.
  The gentleman from New Jersey (Mr. Pallone), the gentleman from 
Oregon (Mr. Walden), the gentleman from Massachusetts, (Mr. Neal), the 
gentleman from Texas (Mr. Brady), the gentleman from Virginia (Mr. 
Scott), and the gentlewoman from North Carolina (Ms. Foxx), the 
majority leader or a designee, and the minority leader or a designee 
each will control 30 minutes.
  The Chair recognizes the gentleman from New Jersey (Mr. Pallone).
  Mr. PALLONE. Mr. Chair, I yield myself such time as I may consume.
  Mr. Chair, this week, we will fulfill a promise we made to the 
American people to make prescription drugs more affordable. No American 
should be forced into choosing between putting food on the table for 
their family and taking a lifesaving drug, but, all too often, that is 
exactly what is happening.
  The American people are getting ripped off because drug companies 
have a monopoly on their drugs until generics come to market. They can 
charge Americans whatever they want, and they do.
  H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, finally 
gives the Federal Government the power to negotiate lower prescription 
drug prices for the American people. Other developed countries 
negotiate with the pharmaceutical companies, and prices in those 
countries are four or five or ten times less for the exact same drugs. 
This simply isn't fair, and the American people are rightfully fed up.
  It is time that we finally level the playing field and empower the 
Federal Government to negotiate a better deal. These negotiations will 
not only lead to lower prices for consumers, it will also result in 
significant savings to the Federal Government. H.R. 3 takes the 
resulting $500 billion in savings and reinvests it in the American 
healthcare system and the search for new cures.
  We cap out-of-pocket costs for seniors in the Medicare Part D program 
for the first time, giving seniors the peace of mind of knowing that 
their drug cost will not bankrupt them or empty their retirement 
accounts.
  We make transformational investments in the Medicare program--adding 
for the first time benefits for dental, hearing, and vision coverage. 
These new benefits are going to make a huge difference in the lives of 
our Nation's seniors.
  We invest $12 billion in the search for new cures and treatments by 
boosting funding for the National Institutes of Health and the Food and 
Drug Administration. NIH, as we know, plays a critical role in the 
research and development of new drugs, and this investment will ensure 
that these cures and treatments become a reality. We also invest in 
combatting the opioid crisis, community health centers, and maternal 
healthcare. And finally, beyond the negotiation, we are holding 
pharmaceutical companies accountable for when they jack up prices, 
bringing much-needed transparency to the process.
  Mr. Chairman, the status quo is simply unacceptable and 
unsustainable. It is time to negotiate a better deal for the American 
people. It is time to pass H.R. 3.
  Mr. Chair, I reserve the balance of my time.
  Mr. WALDEN. Mr. Chair, I yield myself such time as I may consume.
  Mr. Chair, let me be clear: Drug costs in America are too high. 
Republicans believe this, and so do Democrats. We all should work 
together, though, to lower drug costs for consumers. We all

[[Page H10097]]

should work together to stop anticompetitive actions of pharmaceutical 
companies that try to game the system and delay access to lower cost 
alternative medicines. And we should all work together--together, Mr. 
Chair--to pass legislation that both lowers drug costs, without killing 
off medical innovation.
  Unfortunately, H.R. 3 fails on this count. And that is not just my 
conclusion, Mr. Chair. The great American innovators who are working 
day and night to find cures to Alzheimer's, to cancer, to ALS, to 
Parkinson's, and the hundreds of other diseases and life-changing 
therapies are pleading with us for a ``no'' vote to H.R. 3--the 
Democrats' plan.
  Mr. Chair, 138 different biotech companies signed a letter to 
Congress 5 days ago. After reading the bill, they wrote: ``This extreme 
proposal will upend the ecosystem of U.S. biomedical innovation, 
destroying our ability to attract private sector investment.''
  These are the companies who develop the new innovations in medicine. 
They said H.R. 3 will shatter the dreams of patients hoping for 
lifesaving cures.
  Mr. Chair, I include in the Record the letter in support from those 
companies.
                                                 December 5, 2019.
     Hon. Nancy Pelosi,
     Speaker of the House,
     Washington, DC.
     Hon. Kevin McCarthy,
     House Republican Leader,
     Washington, DC.
       Dear Speaker Pelosi and Republican Leader McCarthy: We 
     represent the community of emerging biotechnology companies 
     whose researchers and scientists strive daily to develop 
     innovative life-changing therapies and cures for patients. We 
     take pride that we are providing hope to patients and their 
     families and changing the world through medical 
     breakthroughs. These dreams will be shattered if H.R. 3, the 
     Lower Drug Costs Now Act, if passed.
       We are at an incredible inflection point in science and 
     technology that is bringing forth transformative treatments 
     and even cures for cancer, infectious diseases, and a myriad 
     of other serious and rare diseases. These advancements are 
     benefiting lives of millions of patients and alleviating 
     human suffering, while helping to reduce other more expensive 
     parts of our health care system, such as hospital spending. 
     Our continued success depends on maintaining an environment 
     that supports investment in tomorrow's discoveries.
       Unfortunately, H.R. 3 is an unprecedented and aggressive 
     government intervention in the U.S. market of drug 
     development and delivery that will limit patient access to 
     these extraordinary advancements in health care. This extreme 
     proposal will upend the ecosystem of U.S. biomedical 
     innovation, destroying our ability to attract private 
     investment dollars that allow us to develop new treatments 
     and change the course of healthcare delivery for so many 
     patients.
       We strongly urge you to abandon H.R. 3. Further, in order 
     to keep pace with this biomedical revolution and ensure 
     America remains the world leader in innovation, we hope that 
     you will pursue bipartisan, holistic policies that modernize 
     our health care payment system and lower drug costs for 
     patients.
           Sincerely,
       Adelene Perkins, Chair & CEO, Infinity Pharmaceuticals, 
     Inc.; Adrian Gottschalk. President & CEO, Foghorn 
     Therapeutics; Alden Pritchard, CEO, Kaio Therapy, Inc.; Alex 
     Nichols, PhD. President & CEO, Mythic Therapeutics; Amit 
     Munshi, President & CEO, Arena Pharmaceuticals, Inc.; Andre 
     Turenne, President & CEO, Voyager Therapeutics. Inc.; Aprile 
     Pilon, PhD, President & CEO, Trove Therapeutics, Inc.; 
     Armando Anido, Chairman & CEO, Zynerba Pharmaceuticals; Axel 
     Bolte, Co-Founder, President & CEO, lnozyme Pharma; Barry 
     Quart, President & CEO, Heron Therapeutics; Bassil Dahiyat, 
     President & CEO, Xencor, Inc.; Bill Enright, CEO, Vaccitech, 
     Ltd.; Bill Newell, CEO, Sutro Biopharma; Blake Wise, CEO, 
     Achaogen, Inc.; Bonnie Anderson, Chairman & CEO, Veracyte, 
     Inc.; Bradford Zakes, President & CEO, Cerevast Therapeutics; 
     Brandi Simpson, CEO, Navigen, Inc.; Brian Windsor, CEO, Lung 
     Therapeutics, Inc.
       Briggs W. Morrison, MD, CEO, Syndax Pharmaceuticals; Bruce 
     Clark, PhD, President & CEO, Medicago, Inc.; Casey Lynch, 
     CEO, Cortexyme; Cedric Francois. Co-Founder, CEO & President, 
     Apellis Pharmaceuticals; Chris Gibson, Co-Founder & CEO, 
     Recursion; Christopher Barden, CEO, Treventis Corporation; 
     Christopher Burns, PhD, President & CEO, VenatoRx 
     Pharmaceuticals, Inc.; Christopher Schaber, President & CEO, 
     Soligenix, Inc.; Ciara Kennedy, PhD, CEO, Amplyx 
     Pharmaceuticals; Clay Seigall, President, CEO & Chairman, 
     Seattle Genetics, Inc.; Craig Chambliss, President & CEO, 
     Neurelis; David Baker, President & CEO, Vallon 
     Pharmaceuticals; David Bears, Founder & CEO, Tolero 
     Pharmaceuticals; David de Graaf, PhD, President & CEO, Comet 
     Therapeutics, Inc.; David Donabedian, PhD, Co-Founder & CEO, 
     Axial Biotherapeutics; David Lucchino, President & CEO, 
     Frequency Therapeutics, Inc.; David Mazzo, President & CEO, 
     Caladrius Biosciences.
       David Meeker, CEO, KSQ Therapeutics; Doug Kahn, Chairman & 
     CEO, TetraGenetics, Inc.; Douglas Doerfler, President & CEO, 
     MaxCyte, Inc.; Dr. Elizabeth Poscillico, President & CEO, 
     EluSys Therapeutics, Inc.; Eric Dube, PhD, CEO, Retrophin, 
     Inc.; Eric Schuur, President & CEO, HepaTx Corporation; Erika 
     Smith, CEO, ReNetX Bio; Franciso LePort, Founder & CEO, 
     Gordian Biotechnology; Gail Maderis, President & CEO, Antiva 
     Biosciences; Gary Phillips, President & CEO, Orphomed, Inc.; 
     Geno Germano, President & CEO, Elucida Oncology, Inc.; George 
     Scangos, CEO, VIR Biotechnology; Gil Van Bokkelen, Founder, 
     Chairman & CEO, Athersys, Inc. Greg Verdine, President & CEO, 
     LifeMine Therapeutics, Inc., FOG Pharmaceuticals, Inc.; Imran 
     Alibhai, CEO, Tvardi Therapeutics; James Breitmeyer, 
     President & CEO, Onctemal Therapeutics, Inc.; James Flanigon, 
     CEO, Honeycomb Biotechnologies.
       James Sapirstein, President & CEO, AzurRx BioPharma; Jay 
     Evans, President & CEO, Inimmune Corporation; Jeb Keiper, 
     CEO, Nimbus Therapeutics; Jeff Cleland, PhD, Executive Chair, 
     Orpheris, Inc.; Jeff Jonker, President & CEO, Ambys 
     Medicines; Jeff Kindler, CEO, Centrexion Therapeutics; Jeremy 
     Levin, Chairman & CEO, Ovid Therapeutics, Inc.; Joe Payne, 
     President & CEO, Arcturus Therapeutics, Inc.; John Crowley, 
     Chairman & CEO, Amicus Therapeutics, Inc.; John Jacobs, 
     President & CEO, Harmony Biosciences; John Maraganore, CEO, 
     Alnylam Pharmaceuticals; Julia Owens, President & CEO, 
     Millendo Therapeutics, Inc.; Justin Gover, CEO & Executive 
     Director, Greenwich Biosciences; Keith Dionne, CEO, Casma 
     Therapeutics; Keith Murphy, Founder, CEO & President, 
     Viscient Biosciences; Ken Mills, CEO, REGENXBIO, Inc.; Ken 
     Moch, President & CEO, Cognition Therapeutics; Kent Savage, 
     CEO, PhotoPharmics, Inc.
       Kevin Gorman, CEO, Neurocrine Biosciences; Kiran Reddy, MD, 
     CEO, Praxis Medicines; Lawrence Brown, CEO, Galactica 
     Pharmaceuticals; Lorenzo Pellegrini, Founder, Palladio 
     Biosciences; Marc De Garidel, Chairman & CEO, Corvidia 
     Therapeutics; Marilyn Bruno. PhD, CEO, Aequor, Inc.; Mark 
     Leuchtenberger, Executive Chairman, Aleta Biotherapeutics; 
     Mark Pruzanski, MD, President & CEO, Intercept 
     Pharmaceuticals, Inc.; Mark Timney, CEO, The Medicines 
     Company; Markus Renschler, MD, President & CEO, Cyteir 
     Therapeutics; Martin Babler, CEO, Principia Biopharma; 
     Melissa Bradford-Klug, CEO, Mayfield Pharmaceuticals; Michael 
     Clayman, MD, CEO, Flexion Therapeutics; Michael J. Karlin, 
     Co-CEO, Ibex Biosciences, LLC; Michael Raab, CEO, Ardelyx, 
     Inc.; Mike Narachi, President & CEO, Coda Biotherapeutics; 
     Ming Wang, PhD, President & CEO, Phanestra Therapeutics, 
     Inc.; Morgan Brown, Executive VP & CFO, Lipocine.
       Nancy Simonian, CEO, Syros Pharmaceuticals; Olin Beck, CEO, 
     Bastion Biologics; Pam Randhawa, President & CEO, Empiriko 
     Corporation; Pat McEnany President & CEO, Catalyst 
     Pharmaceuticals, Inc.; Paul Bolno, MD, CEO, Wave Life 
     Sciences; Paul Boucher, President & CEO, Parion Sciences, 
     Inc.; Paul Hastings, CEO, Nkarta Therapeutics; Paul Laikind, 
     President & CEO, Viacyte; Peter Savas, CEO & Chairman, 
     LikeMinds, Inc.; Rachel King, Founder & CEO, GlycoMimetics, 
     Inc.; Randy Milby, Founder & CEO, Hillstream BioPharma, Inc.; 
     Rashida Karmali, PhD, President & CEO, Tactical Therapeutics, 
     Inc.; Richard Markus, CEO, Dantari Pharmaceuticals; Richard 
     Pascoe, Chairman & CEO, Histogen, Inc.; Richard Samulski, 
     President, Asklepios BioPharmaceutical, Inc.; Rick Russell, 
     President, Minverva Neurosciences; Rick Winningham, Chairman 
     & CEO, Theravance Biopharma; Rob Etherington, President & 
     CEO, Clene Nanomedicine.
       Robert Goodwin, PhD, CEO, Vibliome Therapeutics, Inc.; 
     Robert Gould, PhD, President & CEO, Fulcrom Therapeutics; 
     Robert Bernard, President & CEO, Ichor Medical Systems; 
     Robert Wills, Chairman, CymaBay Therapeutics. Inc.; Roger 
     Tung, President & CEO, CoNCERT Pharmaceuticals; Ron Cohen, 
     Founder, President & CEO, Acorda Therapeutics, Inc.; Russ 
     Teichert, PhD, CEO, Scintillant Bioscience; Russell Herndon, 
     President & CEO, Hydra Biosciences, LLC; Samantha S. Truex, 
     CEO, Quench Bio; Sandy Macrae, President & CEO, Sangarno 
     Therapeutics, Inc.; Scott Koenig, President & CEO, 
     MacroGenics, Inc.; Sean McCarthy, President, CEO & Chairman, 
     CytomX; Sharon Mates, Founder, Chairman & CEO, Intra-Cellular 
     Therapies; Shawn K. Singh, CEO, VistaGen Therapeutics, Inc.; 
     Stan Abel, President & CEO, SiteOne Therapeutics, Inc.; 
     Stanley Erck, President & CEO, Novavak.
       Stephen Farr, PhD, President & CEO, Zogenix, Inc.; Stephen 
     R. Davis, CEO, ACADIA Pharmaceuticals; Stephen Yoder, CEO, & 
     President, Pieries Pharmaceuticals; Sue Washer, President & 
     CEO, AGTC; Sujal Shah, President & CEO, CymaBay Therapeutics, 
     Inc.; Ted Love, CEO, Global Blood Therapeutics; Terry Tormey, 
     CEO, Kibow Biotech; Thomas Wiggans, Founder, President & CEO, 
     Dermira, Inc.; Tia Lyles-Williams, Founder & CEO, LucasPye 
     BIO; Tim Bertram, CEO, inRegen & TC Bio; Timothy Walbert, 
     President & CEO, Horizon Therapeutics; Todd Brady, CEO, 
     Aldeyra Therapeutics; Vipin Garg, PhD, CEO, Altimmune;

[[Page H10098]]

     Wendye Robbins, MD, President & CEO, Blade Therapeutics; Will 
     DeLoache, CEO, Novome Biotechnologies; Zandy Forbes, CEO, 
     MeiraGTx.
  Mr. WALDEN. Mr. Chair, the Congressional Budget Office, they also 
looked at H.R. 3, Speaker Pelosi's bill, and they said it would kill 
off more than 38 new medical innovations--38.
  The Council of Economic Advisers, they looked at it and said they 
thought it would be more like 100 new medicines that would be lost. It 
is no wonder that President Trump, the country's strongest advocate for 
lowering drug prices, said even he could not support H.R. 3, and would 
have to veto it.
  Mr. Chair, I include in the Record the Statement of Administration 
Policy.

                   Statement of Administration Policy


h.r. 3--the elijah e. cummings lower drug costs now act--rep. pallone, 
                        d-nj, and 106 cosponsors

       The Administration opposes passage of H.R. 3, which 
     contains several provisions that would harm seniors and all 
     who need lifesaving medicines. Nevertheless, as Congress 
     follows the President's lead on reducing prescription drug 
     costs, the Administration welcomes bipartisan efforts to 
     enact legislation that provides additional prescription drug-
     cost relief for American families.
       In its current form, H.R. 3 would likely undermine access 
     to lifesaving medicines. The bill creates a statutory scheme 
     for ``negotiation'' between the Secretary of Health and Human 
     Services and pharmaceutical manufacturers regarding the price 
     of prescription drugs, but the penalty for failing to reach 
     agreement with the Secretary is so large that the Secretary 
     could effectively impose price controls on manufacturers. 
     Moreover, this price-fixing mechanism places price controls 
     on drugs available under Medicare and commercial plans, and 
     imposes devastating fines on manufacturers, raising serious 
     concerns under the Fifth Amendment's Takings Clause and 
     Eighth Amendment's Excessive Fines Clause.
       This bill would also compromise the health of Americans by 
     dramatically reducing the incentive to bring innovative 
     therapeutics to market. The preliminary Congressional Budget 
     Office (CBO) analysis indicates that the bill would reduce 
     the number of new medicines coming to market. The Council of 
     Economic Advisers (CEA) finds that H.R. 3's price controls 
     would affect as much as one third of drugs under development, 
     meaning that out of 300 projected new medicines that would 
     otherwise be approved over 10 years by the Food and Drug 
     Administration, 100 could be severely delayed or never 
     developed. As a result, CEA estimates H.R. 3 would erase a 
     quarter of the expected gains in life expectancy in the 
     United States over the next decade.
       The preliminary CBO analysis of H.R. 3 does not account for 
     the additional costs that would burden families and the 
     Federal Government due to the unavailability of lifesaving 
     and cost-reducing medicine that would otherwise exist. For 
     example, an Alzheimer's cure, or new treatments for site 
     specific cancers or diabetes, may be delayed or never 
     developed under the regime imposed by H.R. 3. Thus, the cost 
     of caring for a growing and aging population with direct 
     care, skilled nursing, and home health could be substantially 
     greater than the drug-cost savings estimated by CBO. More 
     importantly, the effects of these cost increases on 
     individuals and their families will be significant, personal, 
     and long-lasting.
       This legislation does include important policies championed 
     by the Trump Administration to lower prescription drug costs. 
     These include establishing a cap on out-of-pocket expenses 
     for all beneficiaries in Medicare Part D and simplifying and 
     improving that program. H.R. 3 also would limit annual price 
     increases of certain drugs in Medicare to the rate of 
     inflation, protecting beneficiaries and taxpayers from 
     excessive price hikes. These provisions reflect the 
     Administration's priorities, although modifications should be 
     made to strike a better balance in protecting beneficiaries, 
     taxpayers, and innovation.
       The Administration strongly prefers the Prescription Drug 
     Pricing Reduction Act of 2019, which was reported out of the 
     Senate Finance Committee on a bipartisan basis. This 
     legislation offers a sound approach to delivering relief to 
     seniors from high prescription drug costs while safeguarding 
     the ongoing development of life-saving and sustaining 
     medicines.
       Additionally, H.R. 19, the Lower Costs, More Cures Act, 
     shares many of the same bipartisan elements of the 
     Prescription Drug Pricing Reduction Act and is also a far 
     better approach to lowering drug prices and discovering life-
     saving cures than H.R. 3.
       The President believes there is a path forward to enacting 
     bipartisan legislation that lowers prescription drug costs 
     for American families. The Administration remains committed 
     to working with both parties to pass legislation that will 
     lower drug costs while encouraging innovation in the 
     development of lifesaving medicines.
       If H.R. 3 were presented to the President in its current 
     form, he would veto the bill.
  Mr. WALDEN. Mr. Chair, my friends on the other side, the Democrats, 
ignore these facts. Some have even said--can you imagine this--that it 
is ``worth it'' to forego cures.
  Seriously? That it is worth it to never have a cure for Alzheimer's?
  Is it worth it to never have a cure for ALS?
  What about Huntington's Disease, or Parkinson's, or rheumatoid 
arthritis? The answer for me is ``no,'' because one lost cure is one 
too many.
  The Independent Congressional Research Service also read through H.R. 
3. They said it is unconstitutional, most likely because of the huge 
and punitive club that it hands the government. You see, if an 
innovator, under the bill on the floor today that the Democrats have, 
if an innovator does not agree with the price that the government 
demands, then the government can take 95 percent of that company's 
revenues for the sale of that drug--95 percent.
  Oh, by the way, it is actually higher than that because you can't 
deduct it and they have to pay tax. Democrats call that a negotiation. 
I call that a mugging, Mr. Chair, a mugging.
  Their scheme is based on what happens with drugs in six other 
countries. And they ignore that in these referenced countries and other 
countries around the world, people are actually denied access to 
lifesaving medicines that Americans have access to. So this is the 
tradeoff here.
  If you remember nothing else, it is that we first get access to 
medicines, and in the countries the bill would emulate and copy and 
bring the process here, you don't get access to some of these 
lifesaving drugs that Americans do here. That is your trade.
  Let me tell you about the family of Katie Stafford:
  She is a child living with cystic fibrosis in the United Kingdom. She 
was told by officials she cannot receive the medicine that her doctor 
determined would be the best chance at treating her life-threatening 
condition, because they don't cover it in the United Kingdom under 
their system.
  Let me tell you about Andre and Joshua: They are Canadian brothers, 
tragically both suffering from cystic fibrosis. Their parents had to 
beg the Canadian Government to cover treatment for their sons as they 
slowly lose their lung function. Now, their oldest son is enrolled in a 
clinical trial that the youngest son is ineligible for. So they must 
watch as one child gets help and the other child's health declines.
  Fortunately, Mr. Chair, American children have access to this new 
medicine. We cannot allow this to happen in the United States. Denial 
of care is not an American value.
  But I want to be clear: We all agree that Americans do pay too much 
for prescription drugs, and we need to come back together as 
Republicans and Democrats to help solve this issue. There is a better 
way, because we can reduce the cost of drugs. We can improve 
healthcare, and we can lower long-term costs, but we don't have to do 
it at the expense of great American innovation while restricting 
patient's access to lifesaving medicines.
  There is a way to do this. In fact, Members will have an opportunity 
to support, really, the only bipartisan legislation to come to the 
floor, H.R. 19. You will see it as a substitute, the Lower Costs, More 
Cures Act, which we will offer as a substitute amendment, is the 
bipartisan solution. It can be signed into law this year--this year--
not vetoed, not never gain attention in the Senate like H.R. 3 will 
find itself, if it gets there, but this can become law.
  This is where we can join together and immediately begin to provide 
relief to patients and seniors from high prescription drug costs. This 
bill lowers out-of-pocket spending, protects access to new medicines 
and cures, strengthens transparency and accountability, and champions 
competition and innovation. And most importantly, every single 
proposal, Mr. Chair, every single proposal in H.R. 19, the substitute, 
is bipartisan work--Democrats and Republicans. We give you this option.

                              {time}  1830

  This is a serious proposal. It has been described that way. It could 
be signed, would be signed into law by the President by the end of this 
year. So let's not force a partisan plan that, frankly, puts politics 
over progress, that kills medical innovation and cures.
  Instead, can't we come together and pass meaningful bipartisan 
legislation,

[[Page H10099]]

get it across the finish line and actually find lower costs and more 
cures for Americans?
  Mr. Chair, I reserve the balance of my time.
  Mr. PALLONE. Mr. Chair, I yield 3 minutes to the gentleman from South 
Carolina (Mr. Clyburn), our majority whip.
  Mr. CLYBURN. Mr. Chair, I thank the gentleman for yielding me the 
time.
  Mr. Chair, I rise in strong support of H.R. 3, the Elijah E. Cummings 
Lower Drug Costs Now Act.
  Martin Luther King, Jr., once said: ``Of all the forms of inequality, 
injustice in healthcare is the most shocking and inhumane.'' I believe 
my dear friend, Elijah Cummings, would agree that H.R. 3 is a giant 
step toward addressing injustice in healthcare.
  This landmark legislation gives Medicare the power to negotiate 
directly with drug companies and extends those negotiated prices to 
Americans with private insurance, also. This is a huge win for the 
American consumer.
  In the United States, our drug prices are nearly four times higher 
than in similar countries. This legislation provides real price 
reductions that would put significant money back in consumers' pockets. 
A portion of those savings will be reinvested in researching new cures 
and treatments.
  These cost savings will also extend Medicare benefits to cover 
dental, vision, and hearing, and caps out-of-pocket prescription drug 
costs at $2,000 for those on Medicare.
  In addition, these savings will allow $10 billion to fund provisions 
that are in my community health center's legislation to enhance those 
facilities that serve 28 million Americans, half of which are in rural 
communities.
  The bill includes a $5 billion funding boost for capital improvements 
and construction to expand the footprint of community health centers, 
and an additional $5 billion in funding over 5 years for community 
health center grants.
  Providing consistent funding for and building on the success of 
community health centers is critically important to making quality 
healthcare more accessible and affordable.
  In my district, where four rural hospitals recently closed, there are 
eight federally funded community health centers working to serve almost 
190,000 patients.
  Mr. Chair, I urge strong bipartisan support for H.R. 3, a piece of 
legislation that will contribute to the ending of injustice in 
healthcare and help move us closer to making the greatness of America 
accessible and affordable for all.
  Mr. WALDEN. Mr. Chair, I yield 1 minute to the gentleman from Ohio 
(Mr. Latta).
  Mr. LATTA. Mr. Chair, I rise today, agreeing with Americans that drug 
prices are too high. Congress must act, and we have done so in the 
Energy and Commerce Committee by passing bipartisan solutions.
  H.R. 3 is bad policy, a partisan sham, and will result in more than 
100 fewer cures. Plus, it is dead on arrival in the Senate.
  What if that one new drug is the cure for Alzheimer's or cancer?
  Under the leadership of Ranking Member Walden, we have solutions that 
deliver lower costs and more cures to Americans. Our bill is entirely 
bipartisan.
  H.R. 19 lowers the costs of prescription drugs and caps seniors' out-
of-pocket costs. It encourages innovation and will increase 
competition, while enhancing transparency and getting more generic 
medicines to market faster.
  The American people deserve solutions that will be signed into law. I 
encourage my colleagues across the aisle to deliver the American people 
more cures, not fewer, and to support H.R. 19.
  Mr. PALLONE. Mr. Chairman, I yield 2 minutes to the gentlewoman from 
California (Ms. Eshoo), who is the chairwoman of our Subcommittee on 
Health.
  Ms. ESHOO. Mr. Chair, I rise in support of the Elijah E. Cummings 
Lower Drug Costs Now Act.
  This is in your name, Elijah, and I think that you are listening.
  This bill is the most transformational change to Medicare since 
President Johnson signed Medicare into law in 1965. Why? Because it 
allows Medicare to directly negotiate the price of the most expensive 
drugs in our country, including insulin. The lower price will not only 
apply to seniors who are enrolled in Medicare, but across all private 
insurance policies.
  Manufacturers will no longer be able to hike prices faster than the 
rate of inflation. And, very importantly, it caps the out-of-pocket 
cost to seniors for their prescriptions at $2,000 a year. That is going 
to be a godsend to seniors.
  Something else that will be a godsend to seniors is, with the savings 
in this legislation, seniors in Medicare will have additional benefits 
that they have been clamoring for for a very long time: coverage for 
vision, dental, and hearing, as well as colonoscopies and lymphedema 
treatment.
  Very importantly--very importantly--I hear a lot about innovation 
here. This legislation increases funds for the National Institutes of 
Health to research and develop new cures. It provides almost $3 billion 
for the FDA to ensure the safety of our drugs--very important that all 
the committee members know that.
  It invests in our community health centers, and it directs $10 
billion to address the opioid crisis in our country.
  So what is the difference between what the Republicans are saying and 
what the Democrats are saying? At the core of this bill, H.R. 3, is 
that there will be direct negotiations with the drug manufacturers to 
bring the price of drugs down. Our Republican friends do not support 
that.

  And we know it works, direct negotiations in the VA, direct 
negotiations in TRICARE, which is the healthcare system for all of our 
fellow Americans that wear a uniform and their families.
  So this legislation is sensible. Millions of Americans are not only 
going to save money, they will finally, finally, finally have the peace 
of mind that they will be able to afford the prescription drugs that 
they need for treatment, or those treatments that keep them alive.
  I am so proud of the work that the committee has done, and I 
recommend this bill to every single Member of the House--Republicans, 
Democrats--because of the substance of it and what it will bring into 
people's lives.
  Mr. WALDEN. Mr. Chairman, I include a list of the drugs not covered 
by the VA into the Record. They only cover 24 of the top 50 nonvaccine 
Medicare part B drugs on the VA formulary. I also include a list of 
available medications in H.R. 3 reference countries.

  Top Medicare Part B Drugs NOT Covered by the VA (excluding vaccines)


                        brand name/generic name

       Remodulin/Treprostinil Sodium
       Provenge/Sipuleucel-T/Lactated Ringers
       Soliris/Eculizumab
       Synvisc/Hylan G-F 20
       Tyvaso/Treprostinil
       Abraxane/Paclitaxel Protein-Bound
       Actemra/Tocilizumab
       Advate/Antihemophil.FVIII, full Length
       Aloxi/Palonosetron HCL
       Brovana/Arformoterol Tartrate
       Budesonide/Budesonide
       Entyvio/Vedolizumab
       Erbitux/Cetuximab
       Faslodex/Fulvestrant
       Injectafer/Ferric Carboxymaltose
       Kadcyla/Ado-Trastuzumab Emtansine
       Neulasta/Pegfilgrastim
       NPlate/Romiplostim
       Orencia/Abatacept
       Prolia/Denosumab
       Remicade/Infliximab
       Simponi Aria/Golimumab
       Xolair/Omalizumab
       Yervoy/Ipilimumab
                                  ____


       Availability of Medications in H.R. 3 Reference Countries


      medications currently unavailable in all reference countries

       Aliqopa--relapsed follicular lymphoma
       Balversa--advanced or metastatic bladder cancer
       Calquence--cell lymphoma
       Copiktra--third-line follicular lymphoma
       Daurismo--acute myeloid leukemia
       Elzonris--blastic plasmacytoid dendritic cell cancers
       Exondys--Duchenne muscular dystrophy
       Gamifant--hemophagocytic lymphohistiocytosis
       Idhifa--elapsed or refractory acute myeloid leukemia
       Libtayo--metastatic cutaneous squamous cell carcinoma
       Lumoxiti--hairy cell leukemia
       Luxturna--Leber's congenital amaurosis (severe vison loss)
       Nerlynx--breast cancer
       Pigray--advanced breast cancer
       Polivy--diffuse large B-cell lymphoma

[[Page H10100]]

       Surfaxin--infant respiratory distress syndrome
       Talzenna--breast cancer
       Tibsovo--relapsed or refractory acute myeloid leukemia
       Trogarzo--HIV/AIDS


                               Australia

       Percent of new medicines available (compared to the United 
     States):
       All new medicines: 41%
       Cancer medicines: 50%
       Diabetes medicines: 70%
       Respiratory medicines: 50%
       Cardiovascular medicines: 40%

       Average delay in approval (compared to the United States):
       All new medicines: 19 months
       Cancer medicines: 15 months

       Average delay in public plan coverage (compared to the 
     United States):
       All new medicines: 32 months
       Cancer medicines: 37 months

       Currently unavailable medicines:
       Brineura--first approved treatment for Batten disease
       Caprelsa--medullary thyroid cancer
       Farydak--multiple myeloma
       Idelvion--hemophilia Type B
       Imfinzi--extensive-stage small cell lung cancer
       Jivi--hemophilia type A
       Kymirah--B-cell acute lymphoblastic leukemia
       Lartruvo--advanced soft tissue sarcoma
       Lorbrena--non-small cell lung cancer
       Lutathera--neuroendocrine tumors affecting the digestive 
     tract
       Mepsevii--Sly syndrome
       Nuwiq--hemophilia Type A
       Obizur--hemophilia Type A
       Ocaliva--primary biliary cholangitis (rare liver disease)
       Portrazza--metastatic squamous non-small cell lung cancer
       Potiga--epilepsy
       Revcovi--a form of severe combined immune deficiency
       Rixubis--hemophilia Type B
       Rubraca--ovarian, fallopian tube, or peritoneal cancer
       Rydapt--acute myeloid leukemia
       Symdeko--cystic fibrosis
       Unituxin--second-line treatment for children with high-risk 
     neuroblastoma
       Victrelis--hepatitis
       Vizimpro--non-small cell lung cancer
       Vraylar--schizophrenia, bipolar mania, and bipolar 
     depression
       Yescarta--large B-cell lymphoma that's failed conventional 
     treatments
       Zaltrap--Colorectal cancer
       Zejula--ovarian, fallopian tube or primary perineal cancers


                                 canada

       Percent of new medicines available (compared to the United 
     States):
       All new medicines: 52%
       Cancer medicines: 60%
       Diabetes medicines: 90%
       Respiratory medicines: 67%
       Cardiovascular medicines: 80%

       Average delay in approval (compared to the United States):
       All new medicines: 14 months
       Cancer medicines: 13 months

       Average delay in public plan coverage (compared to the 
     United States):
       All new medicines: 31 months
       Cancer medicines: 36 months

       Currently unavailable medicines:
       Brineura--first approved treatment for Batten disease
       Caprelsa--medullary thyroid cancer
       Cometriq--second line treatment for renal cell carcinoma
       Farydak--multiple myeloma
       Idelvion--hemophilia Type B
       Imfinzi--extensive-stage small cell lung cancer
       Jivi--hemophilia type A
       Kymirah--B-cell acute lymphoblastic leukemia
       Lartruvo--advanced soft tissue sarcoma
       Lorbrena--non-small cell lung cancer
       Lutathera--neuroendocrine tumors affecting the digestive 
     tract
       Mepsevii--Sly syndrome
       Nuwiq--hemophilia Type A
       Obizur--hemophilia Type A
       Ocaliva--primary biliary cholangitis (rare liver disease)
       Odomzo--basal-cell carcinoma
       Orkambi--cystic fibrosis
       Plegridy--relapsing forms of multiple sclerosis
       Portrazza--metastatic squamous non-small cell lung cancer
       Potiga--epilepsy
       Revcovi--a form of severe combined immune deficiency
       Rixubis--hemophilia Type B
       Rubraca--ovarian, fallopian tube, or peritoneal cancer
       Steglatro--type 2 diabetes
       Symdeko--cystic fibrosis
       Unituxin--second-line treatment for children with high-risk 
     neuroblastoma
       Vizimpro--non-small cell lung cancer
       Vraylar--schizophrenia, bipolar mania, and bipolar 
     depression
       Yescarta--large B-cell lymphoma that's failed conventional 
     treatments
       Zaltrap--Colorectal cancer
       Zejula--ovarian, fallopian tube or primary perineal cancers


                                 france

       Percent of new medicines available (compared to the United 
     States):
       All new medicines: 53%
       Cancer medicines: 67%
       Diabetes medicines: 30%
       Respiratory medicines: 50%
       Cardiovascular medicines: 50%

       Average delay in approval (compared to the United States):
       All new medicines: 19 months
       Cancer medicines: 20 months

       Average delay in public plan coverage (compared to the 
     United States):
       All new medicines: 27 months
       Cancer medicines: 29 months
       Currently unavailable medicines:
       Brineura--first approved treatment for Batten disease
       Cometriq--second line treatment for renal cell carcinoma
       Farydak--multiple myeloma
       Idelvion--hemophilia Type B
       Imfinzi--extensive-stage small cell lung cancer
       Jivi--hemophilia type A
       Kymirah--B-cell acute lymphoblastic leukemia
       Lartruvo--advanced soft tissue sarcoma
       Latuda--schizophrenia and depression associated with 
     bipolar disorder
       Lorbrena--non-small cell lung cancer
       Mepsevii--Sly syndrome
       Ocaliva--primary biliary cholangitis (rare liver disease)
       Orkambi--cystic fibrosis
       Portrazza--metastatic squamous non-small cell lung cancer
       Potiga--epilepsy
       Revcovi--a form of severe combined immune deficiency
       Rubraca--ovarian, fallopian tube, or peritoneal cancer
       Rydapt--acute myeloid leukemia
       Steglatro--type 2 diabetes
       Symdeko--cystic fibrosis
       Unituxin--second-line treatment for children with high-risk 
     neuroblastoma
       Victrelis--hepatitis
       Vizimpro--non-small cell lung cancer
       Vraylar--schizophrenia, bipolar mania, and bipolar 
     depression


                                germany

       Percent of new medicines available (compared to the United 
     States):
       All new medicines: 67%
       Cancer medicines: 73%
       Diabetes medicines: 50%
       Respiratory medicines: 83%
       Cardiovascular medicines: 80%

       Average delay in approval (compared to the United States):
       All new medicines: 10 months
       Cancer medicines: 11 months

       Average delay in public plan coverage (compared to the 
     United States):
       All new medicines: 10 months
       Cancer medicines: 14 months
       Currently unavailable medicines:
       Latuda--schizophrenia and depression associated with 
     bipolar disorder
       Lutathera--neuroendocrine tumors affecting the digestive 
     tract
       Revcovi--a form of severe combined immune deficiency
       Rexulti--schizophrenia and major depression
       Yescarta--large B-cell lymphoma that's failed conventional 
     treatments


                                 japan

       Percent of new medicines available (compared to the United 
     States):
       All new medicines: 48%
       Cancer medicines: 56%
       Diabetes medicines: 70%
       Respiratory medicines: 58%
       Cardiovascular medicines: 70%

       Average delay in approval (compared to the United States):
       All new medicines: 19 months
       Cancer medicines: 24 months

       Average delay in public plan coverage (compared to the 
     United States):
       All new medicines: 19 months
       Cancer medicines: 24 months
       Currently unavailable medicines:
       Brineura--first approved treatment for Batten disease
       Cometriq--second line treatment for renal cell carcinoma
       Kymirah--B-cell acute lymphoblastic leukemia
       Lartruvo--advanced soft tissue sarcoma
       Latuda--schizophrenia and depression associated with 
     bipolar disorder
       Lutathera--neuroendocrine tumors affecting the digestive 
     tract
       Mepsevii--Sly syndrome
       Nuwiq--hemophilia Type A
       Obizur--hemophilia Type A
       Ocaliva--primary biliary cholangitis (rare liver disease)
       Odomzo--basal-cell carcinoma
       Orkambi--cystic fibrosis
       Plegridy--relapsing forms of multiple sclerosis
       Portrazza--metastatic squamous non-small cell lung cancer
       Potiga--epilepsy
       Rubraca--ovarian, fallopian tube, or peritoneal cancer
       Rydapt--acute myeloid leukemia
       Steglatro--type 2 diabetes
       Symdeko--cystic fibrosis
       Unituxin--second-line treatment for children with high-risk 
     neuroblastoma
       Victrelis--hepatitis
       Vraylar--schizophrenia, bipolar mania, and bipolar 
     depression
       Yescarta--large B-cell lymphoma that's failed conventional 
     treatments
       Zejula--ovarian, fallopian tube or primary perineal cancers


                             united kingdom

       Percent of new medicines available (compared to the United 
     States):

[[Page H10101]]

       All new medicines: 64%
       Cancer medicines: 70%
       Diabetes medicines: 90%
       Respiratory medicines: 75%
       Cardiovascular medicines: 80%

       Average delay in approval (compared to the United States):
       All new medicines: 11 months
       Cancer medicines: 11 months

       Average delay in public plan coverage (compared to the 
     United States):
       All new medicines: 20 months
       Cancer medicines: 26 months
       Currently unavailable medicines:
       Brineura--first approved treatment for Batten disease
       Caprelsa--medullary thyroid cancer
       Jivi--hemophilia type A
       Kymirah--B-cell acute lymphoblastic leukemia
       Lorbrena--non-small cell lung cancer
       Lutathera--neuroendocrine tumors affecting the digestive 
     tract
       Mepsevii--Sly syndrome
       Ocaliva--primary biliary cholangitis (rare liver disease)
       Odomzo--basal-cell carcinoma
       Orkambi--cystic fibrosis
       Plegridy--relapsing forms of multiple sclerosis
       Portrazza--metastatic squamous non-small cell lung cancer
       Revcovi--a form of severe combined immune deficiency
       Rexulti--schizophrenia and major depression
       Rixubis--hemophilia Type B
       Rubraca--ovarian, fallopian tube, or peritoneal cancer
       Symdeko--cystic fibrosis
       Unituxin--second-line treatment for children with high-risk 
     neuroblastoma
       Vizimpro--non-small cell lung cancer
       Yescarta--large B-cell lymphoma that's failed conventional 
     treatments
       Zaltrap--colorectal cancer
  Mr. WALDEN. Mr Chairman, I yield 1 minute to the gentleman from North 
Carolina (Mr. Hudson).
  Mr. HUDSON. Mr. Chairman, Republicans and Democrats agree: Americans 
pay too much for prescription drugs. We agree we need to do something 
about it. We agree our friends and loved ones need access to lifesaving 
cures and treatments.
  Americans want us to work together in a bipartisan way to get things 
done; yet, today, we are considering Speaker Pelosi's partisan bill. 
This is an exercise in futility. Not only will it stop an estimated 100 
new lifesaving drugs, it has no chance of being signed into law.
  I care about the millions of Americans, like my late grandmother, 
living with Alzheimer's and the thousands of Americans diagnosed with 
cancer every single day and the children who face life-altering 
diagnoses, like spinal muscular atrophy, epilepsy, or cystic fibrosis. 
I want them to have hope, and I want them to have access to the very 
best medicine. That is why we introduced H.R. 19, bipartisan 
legislation that could be signed into law by President Trump this year.
  So let's stop the partisan theatrics and get serious about the 
problem that people are begging us to fix.
  Mr. PALLONE. Mr. Chairman, I yield 2 minutes to the gentlewoman from 
Illinois (Ms. Schakowsky).
  Ms. SCHAKOWSKY. Mr. Chairman, since 2003, the pharmaceutical 
companies have had free rein to gouge sick people. They forced into law 
language that prohibited the Federal Government from negotiating with 
the drug companies for lower prices, which already the Veterans 
Administration does and has done for decades.
  We know that negotiating for fair prices actually is the only way 
that we are going to be able to lower prices, and that is what H.R. 3 
is going to do. Even Donald Trump has said that, when he was a 
candidate: When it comes to negotiating the cost of drugs, we are going 
to negotiate like crazy.
  That was then, and this is now.
  The Congressional Budget Office says we are going to save about half 
a trillion dollars when we negotiate in the most effective way to 
protect seniors and families and anyone who has insurance, and we are 
going to be able to use that money to finally help senior citizens who 
need help with their eyeglasses, with their hearing aids, with their 
dental care. We are going to be able to make such a difference in their 
lives.
  Ninety percent of Democrats, 87 percent of Independents, and 80 
percent of Republicans say they support allowing the Federal Government 
to negotiate for prices. The time is absolutely now for us to pass this 
legislation.
  H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act of 2019, is 
the solution that we have been waiting for, a historic step forward in 
our fight to solve the problem of the prescription drug pricing crisis 
that we face in this country.
  I look forward to seeing it pass into law and the President of the 
United States keeping his promise and not breaking it by signing 
negotiation into law.
  Mr. WALDEN. Mr. Chairman, I yield 1 minute to the gentleman from 
Illinois (Mr. Shimkus), an incredible, important member of our 
committee.
  Mr. SHIMKUS. Mr. Chairman, do you want 10 new drugs, 30 new drugs on 
the market, 100 new drugs on the market or zero? H.R. 3 removes 
research and development investments, which will hinder innovation.
  Innovation doesn't always mean higher cost. Take hepatitis C, which 
lowers, reduces healthcare costs in the long run.
  Technology and innovation have always had the potential to reduce the 
time and costs of identifying and developing new therapies, which lower 
the cost of drugs.
  Incorporation of innovative genomic analysis means drug developers 
can reduce the amount of guesswork in identifying candidate molecules 
for further research.
  This same technology is being used by drug manufacturers today to 
help streamline and expedite the process of conducting trials.
  And investments in precision medicine will mean that you don't 
prescribe drugs that will not work or, in some cases, make people 
sicker.
  That is why I support H.R. 19, the Lower Costs, More Cures Act, which 
is composed entirely of bipartisan provisions and could become law 
right now.
  Mr. PALLONE. Mr. Chairman, I yield 2 minutes to the gentlewoman from 
California (Ms. Matsui), a member of our Energy and Commerce Committee.

                              {time}  1845

  Ms. MATSUI. Mr. Chairman, I thank the gentleman for yielding.
  I rise today in support of H.R. 3, the Elijah E. Cummings Lower Drug 
Costs Now Act, the most transformational expansion of Medicare since 
its creation.
  As co-chair of the House Democrats' Task Force on Aging and Families, 
I am fighting for the nearly 9 in 10 seniors taking a prescription 
drug, because when our system puts profit over patient health, 
beneficiaries pay the price.
  With this landmark legislation, we are delivering on the promise to 
lift up older Americans and their families. H.R. 3 negotiates lower 
drug prices. It expands Medicare to include vision, dental, and hearing 
coverage. It caps out-of-pocket costs, and we extend low drug prices to 
all Americans with private plans.
  While there are many reasons to support H.R. 3, mine is Tony from 
Sacramento. Tony has type 2 diabetes. She is a single mom and works 
part-time to care for her child, all while managing multiple chronic 
conditions.
  Over the last decade, the price of insulin has increased 197 percent, 
and those increases make it harder and harder for a family to get by.
  Under H.R. 3, drug price savings will be passed on to families like 
Tony's. Tony could pay as little as $34 per month, giving her family 
the relief they need for other expenses.
  For seniors, for families, and for all Americans who desperately need 
to lift the burden of high drug prices from their everyday lives, I ask 
that my colleagues support this bill.
  Mr. WALDEN. Mr. Chairman, I yield 2 minutes to the gentleman from 
Texas (Mr. Burgess), the top Republican on the Health Subcommittee of 
the Energy and Commerce Committee.
  Mr. BURGESS. Mr. Chairman, I thank the gentleman for yielding.
  In the early days of my medical practice in the 1980s, I would sit 
around with other doctors and kvetch that there were treatments 
available in Europe that were not available in the United States. But 
Congress acted and enacted the prescription drug user fee agreements in 
1992, sped up the regulatory process, and broke the regulatory 
bottleneck. The drug approval process over the past four decades has 
significantly improved to the point that American doctors now have more 
tools at their disposal to alleviate human suffering than at any time 
in the Nation's past.
  The President weighed in right around Thanksgiving with what he

[[Page H10102]]

thought would be the correct path forward. Indeed, in the Rules 
Committee last night, we received the Statement of Administration 
Policy from the President that said he would veto H.R. 3 if presented 
in its current form. But he goes on to say that H.R. 19 is a far better 
approach to lowering drug prices and discovering lifesaving cures. The 
President believes there is a path forward. The administration remains 
committed to working with both parties to pass legislation.
  What H.R. 3 represents to me is a lost opportunity. It was an 
opportunity to work together. The President wanted to work together. 
But it is a lost opportunity to bring down drug costs for American 
patients. We can vote against H.R. 3. We can support the amendment in 
the nature of a substitute. H.R. 19 could become law this year, in 
2019.
  Mr. PALLONE. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman 
from California (Mr. McNerney), a member of our committee.
  Mr. McNERNEY. Mr. Chairman, I thank the gentleman for yielding and 
for bringing this bill forward. I rise in support of H.R. 3, the Elijah 
E. Cummings Lower Drug Costs Now Act.
  We are here today to debate an issue that shouldn't need any 
discussion from Members of this body. We have all heard from 
constituents back home forced to choose between critical medications 
and basic needs because prescription drugs are just too expensive.
  Just this week, one of my constituents, Marta, shared her story with 
me. Marta suffers from an autoimmune disease that causes her own body 
to attack her muscles, and without medication, she struggles to see. 
Even the slightest movement feels like a colossal feat, including her 
breathing.
  The prescription drug she needs in order to walk or even just to 
breathe was once available for free, but the medication she is now 
taking costs an outrageous $375,000 a year. Who can afford that?
  While Marta's insurance covers some of the cost, it is a constant 
fight for her to get the medication she needs to be able to live her 
life.
  What good are miracle drugs if people can't afford them?
  As Members of Congress, we must do everything in our power to ensure 
that people can afford lifesaving and life-changing drugs. Under H.R. 
3, the government would be empowered to negotiate directly with the 
drug companies to lower prices for the American people.
  I urge my colleagues to support H.R. 3 for Marta and the millions of 
Americans burdened by skyrocketing prescription drug costs.
  Mr. WALDEN. Mr. Chairman, I yield 1 minute to the gentleman from 
Kentucky (Mr. Guthrie), the top Republican on the Oversight and 
Investigation Subcommittee of the Energy and Commerce Committee.
  Mr. GUTHRIE. Mr. Chairman, I thank the gentleman for yielding. I rise 
today in opposition to H.R. 3.
  Two of the issues that I often hear about back home are robocalls and 
drug prices. Last week, despite ideological differences on both sides 
of the aisle, we came together to address robocalls. I am disappointed 
that the same cannot be said for drug prices.
  Republicans, Democrats, President Trump, doctors, pharmacists, 
patients, we all want lower drug prices. Yet, the Democrats have chosen 
to pursue partisan poison pill legislation that will go nowhere.
  I was proud to cosponsor the Lower Costs, More Cures Act, a bill that 
includes only bipartisan solutions to lower drug prices. My Democratic 
colleagues have agreed to these provisions in the past. The Lower 
Costs, More Cures Act will allow the continuation of lifesaving 
innovation in healthcare research while lowering drug prices for 
Kentuckians.

  Mr. Chairman, I oppose H.R. 3, and I urge my colleagues to support 
the Lower Costs, More Cures Act.
  Mr. PALLONE. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman 
from Vermont (Mr. Welch), a member of our committee.
  Mr. WELCH. Mr. Chairman, I thank the gentleman for yielding.
  We have done in our committee some bipartisan work that attacks 
patent abuse and will help bring down the costs of drugs, but there is 
a question. It is not a partisan question. It is really a judgment. Can 
we stop pharma from what has been relentless price increases--I would 
call it price gouging--without the government intervening on behalf of 
the consumer? We are the only country where the government sits on its 
hands while pharma boosts the prices.
  President Trump told Elijah that is a rip-off. That is what the 
President told Elijah, and the President said he would be okay with 
bringing in safe drugs from abroad for price negotiation, or as the 
President called it, getting a better deal.
  The President's idea, which is a good one and incorporated in the 
bill, was to have an international reference price so we don't pay 
four, five, six times what they pay in Europe. That is a good idea.
  But bottom line, the question is, will pharma stop killing us if we 
don't step up with governmental authority for consumers? That is not 
partisan. That is a judgment. It won't happen without us asserting that 
authority, as is done in this bill.
  Then, the benefits are extended to employers who are struggling to 
pay health insurance for their folks and can't give them a raise, to 
seniors, and to every individual.
  Mr. WALDEN. Mr. Chairman, I yield 1 minute to the gentleman from West 
Virginia (Mr. McKinley), an important member of our committee.
  Mr. McKINLEY. Mr. Chairman, I thank the gentleman for yielding.
  Let's be frank, Senate leadership has already said they are never 
going to vote on H.R. 3. Earlier today, President Trump made it clear 
that he would veto it. So what are we doing here?
  If lowering the costs of prescription drugs were really a priority 
for Democrats, they would vote to adopt H.R. 19, the bipartisan 
alternative, instead of this politically charged bill. H.R. 19 has 35 
bipartisan provisions that passed out of the House committee. It 
includes 90 percent of the bipartisan Grassley-Wyden bill in the 
Senate.
  H.R. 19 will not only lower drug prices, but it will protect 
innovation and research into new medicines and cures for diseases like 
Alzheimer's, rheumatoid arthritis, ALS, diabetes, and Parkinson's.
  The Congressional Budget Office and the Council of Economic Advisers 
have both concluded that H.R. 3 will prevent hundreds of new cures from 
entering the market. Therefore, I have to ask the supporters of H.R. 3: 
Which cures for our loved ones are you willing to sacrifice?
  Mr. PALLONE. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman 
from Oregon (Mr. Schrader), a member of our committee.
  Mr. SCHRADER. Mr. Chairman, I thank the gentleman for yielding. I 
rise today to speak on behalf of H.R. 3, the Elijah E. Cummings Lower 
Drug Costs Now Act of 2019.
  The bill before us today will finally allow Medicare to negotiate the 
price for prescription drugs to get a better deal for our seniors, a 
task that has long been successful by the Department of Veterans 
Affairs, Medicaid, the Department of Defense, and, frankly, in 
commercial insurance plans.
  Why not allow our seniors to negotiate the best price for their 
costly drugs? It can save the taxpayers a lot of money. Americans 
support negotiation.
  I will point out that while I appreciate the efforts to expand 
service, the Medicare trustees report has shown that the Medicare 
hospital insurance trust fund is projected to be depleted by 2026, a 
mere 6 years from now. At the same time, Medicare per capita spending 
is supposed to grow at a rate of over 5 percent a year.
  The savings from the drug negotiation portion of this bill, at least 
a big portion of it, should be put toward ensuring that our seniors 
will continue to have access to Medicare.
  We cannot keep spending money we do not have. As we continue to have 
conversations around expanding access to healthcare and lowering costs 
of prescription drugs, I urge my colleagues to be mindful that they 
need to address the solvency of our healthcare safety net systems.
  This is a good bill. I urge support.
  Mr. WALDEN. Mr. Chairman, I want to say that we cannot lose sight of 
how anti-innovation H.R. 3 is. We cannot lose sight of how many cures 
will never come around as a result. These aren't my conclusions. They 
are, but they are also the conclusions of the Congressional Budget 
Office and the Council of Economic Advisers.

[[Page H10103]]

  Hundreds of new drugs will never come to market. Medicines will never 
be created. We know that 10 percent fewer drugs will enter the market 
every year in the 2030s and every year thereafter as a result of H.R. 
3.
  This bill will leave people behind. It will result in earlier deaths 
than otherwise should happen.
  Mr. Chairman, I yield 1 minute to the gentleman from Virginia (Mr. 
Griffith).
  Mr. GRIFFITH. Mr. Chairman, I thank the gentleman for yielding.
  In committee, I raised issues of unconstitutional takings in H.R. 3. 
Ninety-five percent of gross revenues are taken from a manufacturer 
unless they agree to the price the government offers.
  It is not negotiation. It is an offer you can't refuse. It is 
confiscatory. Accordingly, it is unconstitutional.
  But you don't have to believe me. The nonpartisan Congressional 
Research Service says H.R. 3 likely violates the Fifth and Eighth 
Amendments of the United States Constitution.
  Mr. Chair, I took an oath to support the United States Constitution 
when I entered this body. To support the Constitution, you must vote 
``no'' on H.R. 3. To fix drug pricing, you should vote ``yes'' on the 
Walden amendment in the nature of a substitute.
  Mr. PALLONE. Mr. Chairman, I yield 2 minutes to the gentleman from 
California (Mr. Ruiz), a member of our committee.
  Mr. RUIZ. Mr. Chairman, I thank the gentleman for yielding.
  We already have hundreds of drugs in the market that millions of 
Americans do not have access to and cannot get because they are not 
affordable. Seniors in my district are walking out of the pharmacy 
without their medication after seeing the out-of-pocket costs and 
saying to themselves they can't afford it.
  Many seniors are choosing between eating and buying their groceries 
versus taking their medications. They are not taking the medicine that 
they need, which puts their health and their lives at risk.
  I have heard from seniors in my district who face up to $6,000 a 
month in out-of-pocket costs for their medicine. To quote one 
constituent of mine: ``Prescription and healthcare costs are an 
astronomical burden.'' To quote another: ``Necessary medication should 
not be treated as a luxury.''
  We must bring down the outrageous out-of-pocket costs plaguing our 
seniors and families. H.R. 3, the Elijah E. Cummings Lowering Drug 
Costs Now Act, finally answers the call to bring down out-of-control 
costs.

                              {time}  1900

  It does so by empowering Medicare, for the first time ever, to 
negotiate lower drug prices with Big Pharma, which will lower costs for 
not only seniors, but also American families with private health 
insurance.
  It does so by limiting out-of-pocket costs to no more than $2,000 a 
year for seniors--very important to seniors needing expensive 
medication.
  It does so by strengthening Medicare, delivering vision, dental, and 
hearing benefits for seniors across this country.
  Every Member of the House should do the right thing for seniors and 
American families: pass H.R. 3.
  Senate Majority Leader McConnell should do his job and bring this 
legislation up for a vote immediately so that we can strengthen 
Medicare for seniors and lower the cost of medicine for American 
families.
  Mr. WALDEN. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, I would point out that the Republican alternative also 
caps costs for seniors, again, for the first time. We believe there is 
a place where that needs to happen for our seniors.
  In the committee, Republicans offered up an amendment that would have 
taken all the middleman profits, the rebates, and put them toward 
making insulin at no cost for seniors at the pharmacy counter. 
Unfortunately, every Democrat on the committee voted against that. Why, 
I do not know, but they did.
  We want more cures and we want lower costs. We can have both.
  There is no dispute among us, Republicans and Democrats, that drugs 
are too high. The question is: Can we find a scheme that is 
constitutional, and does it eliminate cures for diseases that people 
are relying on and shut down innovation in America?
  I think we can, by the way. I think that is H.R. 19. We will deal 
with that later.
  Madam Chair, I yield 1 minute to the gentleman from Ohio (Mr. 
Johnson).
  Mr. JOHNSON of Ohio. Madam Chair, Americans see a Congress paralyzed 
by impeachment and other distractions.
  We should change course, do our job, and put our constituents before 
partisan politics. Reducing prescription drug prices is a way to do 
that.
  My friends across the aisle brag about ``affordable'' healthcare in 
other countries, but they don't mention the hidden costs.
  Look at a young boy from Canada, Ashton Leeds, who, in 2018, was 
stricken with an aggressive form of thyroid cancer. Treatments approved 
by the Canadian health system failed, and his life was saved when his 
family brought him to America for a cutting-edge treatment unavailable 
in Canada.
  This isn't an isolated instance. As my Republican colleagues have 
described today, the data shows that H.R. 3 takes us in the wrong 
direction--stifling innovation and reducing future cures.
  Madam Chair, Americans are desperately looking for relief at the 
pharmacy counter, and we can give it to them with H.R. 19, a bipartisan 
proposal with a real chance of becoming law, and I urge my colleagues 
to support it.
  Mr. PALLONE. Madam Chair, may I inquire how much time remains on each 
side.
  The Acting CHAIR (Ms. Wexton). The gentleman from New Jersey has 
12\1/2\ minutes remaining. The gentleman from Oregon has 12 minutes 
remaining.
  Mr. PALLONE. Madam Chair, I yield 1\1/2\ minutes to the gentleman 
from Texas (Mr. Veasey), a member of our committee.
  Mr. VEASEY. Madam Chair, I thank the chairman for really helping 
deliver on the promise to work for the people by bringing down the 
costs of prescription drugs for all Americans.
  This is a historic and much-needed piece of legislation, and I am 
proud to be a member of the Energy and Commerce Committee and Congress 
to bring this bill to the floor.
  This past summer, William from Arlington, Texas, came into my 
district office because, like so many Americans, William was enrolled 
in a Medicare plan and was concerned with the price of his lifesaving 
prescriptions. William was worried about the price of his generic 
cholesterol medicine. He had been paying $600 a month--$600 a month--
when he went to his local pharmacy to fill his prescription.
  I am hearing all this whooping and hollering about all these other 
things, protecting these pharmaceutical drug companies, but why is no 
one talking about people like William who are having a hard time making 
ends meet and they just want some relief when it comes to these 
prescription drug prices? That is who we need to be taking care of and 
defending in this debate.
  Many seniors across the country are living like William. They are on 
fixed incomes. They are really having a hard time making ends meet, and 
forcing them to choose between paying for their prescription drugs and 
their daily necessities is really unacceptable in our country.
  That is why I am proud to stand here with my colleagues today to 
voice support for H.R. 3, the Elijah E. Cummings Lower Drug Costs Now 
Act. I am proud this legislation will ensure Medicare beneficiaries 
will be covered on things like vision, dental, and hearing benefits.
  The Acting CHAIR. The time of the gentleman has expired.
  Mr. PALLONE. Madam Chair, I yield an additional 30 seconds to the 
gentleman from Texas.
  Mr. VEASEY. Madam Chair, I thank the chairman very much for yielding 
me additional time.
  Again, I am just proud that the version of this bill that will help 
our low-income residents all across this country will be passed into 
law.
  There are so many other things that I could talk about, but I just 
have to tell you, in closing, there are people who are out there 
hurting. They are making life-and-death decisions every day and having 
to choose between whether or not they are going to eat or

[[Page H10104]]

pay for their prescription drugs. This is unacceptable in this country.

  Mr. WALDEN. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, I just want to point out a couple of things.
  First of all, what is really unacceptable is to kill off American 
innovation in this space. We know from the biotech people who are doing 
this innovation, they have written us saying it will shatter the hopes 
and dreams of Americans waiting for cures. It will completely upend the 
ecosystem of innovation.
  America is where the innovation occurs. We don't think that has to 
happen to bring down the costs of drugs, which we also support.
  We also don't think you should end up in a system like this where, in 
these countries that they want to emulate, like Australia, Canada, 
France, Germany, Japan, and the United Kingdom, all new medications 
that we have here, they only have between 30 and 60 percent.
  In fact, in cancer, there are 27 to 50 percent fewer cancer drugs in 
these countries. There is a range here, Madam Chair, that are 
available. So, if you get cancer, if you were in America here, you 
might get a drug that would prolong your life or cure your cancer. In 
these countries, you have a run of 27 to 50 percent chance you won't 
get that drug; diabetes, 10 to 50 percent fewer; respiratory, 17 to 50 
percent fewer.
  They, in part, control their costs because they deny access to care 
of the lifesaving new cutting-edge drugs that we innovate.
  Madam Chair, I yield 1 minute to the gentleman from Michigan (Mr. 
Walberg), a very important member of our committee.
  Mr. WALBERG. Madam Chair, I thank the gentleman for yielding.
  Madam Chair, as I travel across Michigan, I constantly hear about the 
high cost of prescription drugs. Hardworking families are simply paying 
too much. That is why we need to tackle this issue in a bipartisan way, 
not try to score political points.
  Sadly, H.R. 3 is a partisan, heavy-handed approach that has no chance 
of becoming law.
  Let's be honest: Government doesn't negotiate; they dictate.
  This drug pricing scheme will ultimately hurt families, stifle 
innovation, and prevent lifesaving cures from becoming available to our 
friends, our neighbors, and families.
  There is a better approach, a plan that is patient-focused and filled 
with bipartisan provisions that enjoys support in the Senate as well. 
It is H.R. 19, the Lower Costs, More Cures Act. This bill will 
strengthen transparency, encourage medical breakthroughs, and make 
medications that families rely on more affordable.
  If the other side is serious about getting something done, then we 
should be voting on the Lower Costs, More Cures Act this week.
  Mr. PALLONE. Madam Chair, I yield 2 minutes to the gentleman from 
Florida (Mr. Soto), my colleague.
  Mr. SOTO. Madam Chair, back in central Florida, we had a townhall 
where we had everyone from Bernie Sanders supporters supporting 
Medicare for all to Donald Trump Make America Great Again, red hat-
wearing Trump supporters, and all of them, regardless of the political 
spectrum, could not believe Medicare can't negotiate. ``What a sham'' 
is what they said.
  Well, today is the day. We are going to end the ban on Medicare 
negotiating.
  So you can wring your hands, contort the facts, but then you are 
going to have to go home and explain why you campaigned on ending the 
ban on Medicare negotiating and then you voted ``no,'' and then you 
voted to keep this sham system in place where we don't even allow the 
government to negotiate for lower drug prices.
  This bill caps out-of-pocket costs at $2,000. That saves $1,196 per 
senior for the over 124,000 seniors in my district. It also applies to 
the 550,000 people who have private insurance.
  What do we do with the $500 billion we save? We finally crack that 
injustice for seniors to get dental, vision, and hearing coverage.
  We hear scare tactics: Hundreds of drugs aren't going to be improved. 
Try 8 to 15, while 300-plus drugs, according to the CBO, will be 
improved over the next 10 years. So let's stop the scare tactics.
  And is it worth it? Of course it is worth it.
  Hundreds of new cures; finally giving dental, vision, hearing 
coverage--of course it is worth it.
  $1,196 in savings per senior in my district. Of course it is worth 
it.
  America put us in the majority because they think it is worth it, so 
it is time to pass the Lower the Drug Costs Now Act.
  Mr. WALDEN. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, we have heard this refrain before that it is worth it, 
worth it not to have a cure. A cure for what? We don't know.
  We know that there are 100 drugs that will never be developed because 
of H.R. 3. That is what the Council of Economic Advisers said. The 
Congressional Budget Office says 38 in the next 20 years will never be 
developed.
  Is that the cure for Alzheimer's? Is that the cure for Parkinson's? 
Is that the cure for ALS?
  Madam Chair, the gentleman says it is worth it to upend the entire 
ecosystem of innovation in America. That is what we just heard. We 
heard it in committee too: It is okay. We don't need a cure for this, 
that, or the other thing.
  138 of these great American innovators wrote us and said it is not 
worth it. This bill is going to shatter the hopes and dreams of people 
who are hoping that there will be a cure for cystic fibrosis or sickle 
cell anemia or SMA.
  Oh, by the way, we are developing those cures, but this bill, H.R. 3, 
kills innovation in America, and that means people will die because 
they didn't get those drugs because they were never invented.
  We don't have to do that to bring down the cost of drugs. There are 
bipartisan ways to bring down the cost of drugs without destroying 
medical innovation in America, and we want to work with you to do this.
  H.R. 3 is the purely partisan bill on the floor.
  The proposal we have is all bipartisan, Republican and Democrat ideas 
put together that will have a positive effect on bringing down drug 
prices. It will stop the gaming of the system, and it will result in 
more cures.
  Madam Chair, I yield 2 minutes to the gentleman from Georgia (Mr. 
Carter), Congress' only pharmacist, an outspoken advocate for our 
legislation and doing the right thing for patients, whom he greeted at 
the pharmacy counter every day.
  Mr. CARTER of Georgia. Madam Chair, I thank the gentleman for 
yielding.
  You know, I find myself in a situation here where I am both excited 
and I am sad. I am finally getting the opportunity to address something 
that was one of my major initiatives coming to Congress, and that is to 
do something about prescription drug pricing.
  As the ranking member noted, I am the one, for over 30 years, who was 
at the front counter telling patients how much their medication was 
going to be.
  I am the one who watched a mother in tears because she couldn't 
afford her child's medication.
  I am the one who watched a senior citizen try to decide between 
buying medication and buying groceries.
  Yet, never did it enter into my mind that this was a Republican or a 
Democrat thing. No. It never was, and it should not be now. This is 
about Americans and about Americans trying to get medications.
  Now, I will tell you, in my career, in my pharmacy career, I have 
witnessed nothing short of miracles in the way of new drugs.
  I can remember a time when, if you were diagnosed with hepatitis C, 
you were going to die. That is all there was to it. Now, think about 
it. We can actually cure it with a pill. How phenomenal is that? That 
is what research and development has done for us.
  Now, do pharmaceutical manufacturers need to do a better job with 
their pricing? Yes, they do. But I am here to tell you where the real 
problem lies. I have been saying it ever since I have been here for 5 
years, and that is in the middleman, in the fee PBMs, the pharmacy 
benefit managers, the ones who hide behind the curtain and are causing 
this, that bring no value whatsoever to the system. Yet H.R. 3 is going 
to do away with research and development.

[[Page H10105]]

  And, yes, you have heard it. Even if it is 8, even if it is 15, even 
if it is 100, even if it is 1, that is one too many that doesn't come 
to market. What if it is the one for Alzheimer's?
  The Acting CHAIR. The time of the gentleman has expired.
  Mr. WALDEN. Madam Chair, I yield an additional 15 seconds to the 
gentleman from Georgia.

                              {time}  1915

  Mr. CARTER of Georgia. Madam Chair, this is too important. This 
should not be partisan.
  Thank goodness we have H.R. 19, a bipartisan bill. Everything that is 
in H.R. 19 is bipartisan--everything. And it brings down the cost of 
medication without stymieing innovation, without ruining research and 
development.
  Madam Chair, I encourage Members to support H.R. 19.
  Mr. PALLONE. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, this is a historic piece of legislation before us this 
evening. H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, is 
the critical action we need to lower prescription drug prices for 
Americans across the United States.
  Unfortunately, my Republican colleagues this evening continue to 
peddle Big Pharma's talking points and say that this bill will stifle 
innovation. Even the Trump administration's Health and Human Services 
Secretary Alex Azar, who was a drug company executive himself, 
acknowledged that drug companies like to claim that ``if one penny 
disappears from pharma's profit margins, American innovation will grind 
to a halt.''
  Frankly, I am appalled by this argument, Madam Chair. It is the 
Federal Government and the American taxpayers who are the largest 
investors in innovation.
  In fact, the National Institutes of Health, which has long enjoyed 
bipartisan, bicameral support, is the largest public funder of 
biomedical research in the world. For decades, publicly funded research 
has laid the foundation for the treatment and cures that patients use 
today.
  Research shows that many patented prescription drug products were 
first discovered through taxpayer-funded NIH research and grants.
  According to a report by the National Academy of Sciences, NIH-funded 
research contributed to the development of all 210 new drugs approved 
by the FDA between 2010 and 2016.
  The impact is clear: Americans are living longer, healthier lives; 
heart disease, stroke, and diabetes are less deadly; cancer mortality 
rates are also, overall, on the decline.
  The Elijah E. Cummings Lower Drug Costs Now Act, H.R. 3, will 
strengthen innovation--I stress, strengthen innovation--by investing 
$10 billion of direct funding to continue this momentum. This money is 
delivered to the agency over 10 years to provide sustained, predictable 
investments to our Nation's brightest researchers at our world-class 
universities and medical research centers.
  This bill will advance research in cancer, rare diseases, 
regenerative medicine, and antibiotic resistance, among others. It also 
provides additional funding for phase 2 and phase 3 clinical trials.
  History shows us that investments like these will pay dividends for 
patients.
  Madam Chair, I am just so tired of hearing the Republican claim that 
H.R. 3 will kill new drug development and innovation. It is just the 
same tired fearmongering that the big pharmaceutical companies have 
used in an effort to lower their out-of-control drug prices.
  We, as Members of Congress, work for the American people, not Big 
Pharma. And now is the time for us to act and deliver our promise to 
patients who rely on prescription drugs to live long and meaningful 
lives by lowering their drug prices.
  Madam Chair, I reserve the balance of my time.
  Mr. WALDEN. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, I can't help but just respond. Our information is based 
on fact, not rhetoric. It comes from the independent Congressional 
Budget Office that works for all of us. And when they evaluated H.R. 3, 
they are the ones--at CBO, the Congressional Budget Office--that said 
that the Democrats' plan, the Pelosi plan, would result in fewer new 
drug products being developed and coming to market.
  CBO is the one, not Big Pharma. You can throw that around all you 
want, but it is the Congressional Budget Office that said 38 new cures 
that could be developed in the next 20 years would be lost in 
development because of this bill--38. Up to 38.
  It was the Council of Economic Advisers that said upwards of 100 new 
cures, new medicines, would not come to market because of H.R. 3.
  The great American innovators wrote to the Speaker and wrote to the 
Republican leader and said the dreams of life-changing therapies and 
cures for patients would be ``shattered'' by H.R. 3. They said that, 
unfortunately, H.R. 3 is an unprecedented and aggressive government 
intervention in the U.S. market of drug development and delivery that 
will limit patient access to these extraordinary advancements in care.
  These are the people that--when they get a cure for cystic fibrosis; 
when they develop a cure for sickle cell; when, hopefully, they develop 
a cure for diabetes--we will all rush out to say, ``We helped. We 
funded NIH. They did an important role.''
  And NIH funding is extremely important, but it is these innovators 
that do the actual development of the drugs. In fact, the Congressional 
Budget Office said, when it comes to H.R. 3 spending for NIH, that the 
effects of the new drug introductions from increased Federal spending 
under the bill on biomedical research would be modest--modest. Okay.
  We have all supported increases in additional research at NIH. It is 
an important element of this. But it is actually the innovators spread 
all across the country and these tiny little startups, in some cases, 
that are begging us not to blow up the system to get drug prices down.
  We can get drug prices down. We are willing to work on both sides of 
the aisle to do that. You don't have to destroy innovation in America 
and lifesaving cures for patients to get there. H.R. 3, independent 
analyses show, would do exactly that.
  Madam Chair, I yield 1 minute to the gentleman from Ohio (Mr. 
Stivers).

  Mr. STIVERS. Madam Chair, I thank Ranking Member Walden for yielding, 
and I commend him for his efforts to limit drug prices and continue 
innovation.
  I have a concern about the increased costs that both H.R. 3 and H.R. 
19, as well as Senate proposals, could have on small manufacturers 
through the part D redesign.
  These small manufacturers often serve the Low-Income Subsidy 
population that are our most vulnerable, and it would 
disproportionately affect their access to lifesaving and life-changing 
medications, such as drugs for mental illness and addiction. H.R. 3 is 
catastrophic to this population.
  Madam Chair, I ask to enter into a colloquy with the gentleman from 
Oregon and seek his commitment to ensure small manufacturers and the 
LIS population are not inadvertently penalized as this process moves 
forward of our alternative.
  Mr. WALDEN. Madam Chair, I thank the gentleman from Ohio for his 
remarks. I am hopeful that, after this political exercise of H.R. 3 is 
done, we can work on a bipartisan basis on needed part D modernization 
like we were doing before the Speaker, unfortunately, shut down these 
discussions.
  When we do so, I look forward to working with the gentleman from Ohio 
to ensure that the vulnerable LIS population is not unintentionally 
adversely impacted.
  The Acting CHAIR. The time of the gentleman has expired.
  Mr. WALDEN. Madam Chair, I yield myself such time as I may consume. I 
appreciate the gentleman for bringing up this important issue.
  Madam Chair, I reserve the balance of my time.
  Mr. PALLONE. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, the Republicans keep saying that they want to work with 
us. We have suggested to them that the only way to reduce prices, that 
I know of--and they haven't suggested anything else--is by having some 
kind of negotiation.
  We are talking about the drugs for which there is a monopoly. These 
are

[[Page H10106]]

the brand-name drugs for which there is no competition, no generic 
alternative. Every other country, the six that we have mentioned as 
part of this bill that we are looking at, because we subsidize them as 
the American people get ripped off, Australia, Canada, Japan, United 
Kingdom, and France bring prices down considerably by negotiating.
  When you have all these Medicare beneficiaries, if you will, you have 
a tremendous amount of power, if you will, to negotiate with the drug 
companies because they want to sell their drugs to bring the prices 
down. If you don't do that, which is what the Republicans refuse to do, 
then you have no effective way of bringing prices down. We know that.
  Now, this is why, when Medicare part D was established--I was here 
how many years ago--the Republicans insisted that they put in this 
clause in part D that said that the government can't negotiate prices.
  So that is why we have to pass this bill, because right now the 
government has no power to do that.
  Why not give the government that ability? So far, they refuse to do 
it.
  So, I know they keep saying they want to work with us on a bipartisan 
basis, but they have refused to do any kind of negotiated prices, to 
get rid of that clause that says that the Department of Health and 
Human Services can negotiate prices.
  The American public is getting ripped off. We are subsidizing drugs 
that are being sold in this other country. It is not fair. It is not a 
fair playing field.
  Why should we let the drug companies continue with this monopoly? 
That is why we are moving H.R. 3. That is the basis for H.R. 3.
  Madam Chair, I reserve the balance of my time.
  The Acting CHAIR. The gentleman from Oregon has 2 minutes remaining.
  Mr. WALDEN. Madam Chair, I yield to the gentleman from Georgia (Mr. 
Allen) for 1 minute.
  Mr. ALLEN. Madam Chair, we all agree here that prescription drug 
prices are skyrocketing, and Congress must act. That is something that 
we all agree on. The question is how do we go about it.
  A couple of facts:
  One, H.R. 3 is a radical government takeover of the pharmaceutical 
industry, and it ultimately will prevent Americans from accessing 
potentially lifesaving cures.
  Fact 2: According to the White House Council of Economic Advisers, 
H.R. 3 will prevent as many as 100 fewer drugs from entering the U.S. 
market in the next decade.
  Fact 3: Countries that have adopted similar drug pricing schemes, as 
proposed under this legislation, have experienced a decrease in access 
to innovative new medicines, increased wait times for treatment, and 
supply shortages for in-demand drugs.
  Americans will not stand for this. We have an alternative: H.R. 19, 
the Lower Costs, More Cures Act.
  I urge Members to work together in a bipartisan way on H.R. 19.
  Mr. WALDEN. Madam Chair, may I inquire how much time is remaining.
  The Acting CHAIR. The gentleman from Oregon has 1 minute remaining. 
The gentleman from New Jersey has 3\1/2\ minutes remaining.
  Mr. WALDEN. Madam Chair, I yield myself such time as I may consume.
  Let's go through this really quickly.
  Democrats have said it is worth it not to have future cures. That is 
point one. They have said that: worth it not to have future cures.
  Congressional Budget Office tells us up to 38 cures will not come 
about because of H.R. 3.
  They have said we want to model America after foreign countries, and 
the facts show that in foreign countries you have less access to 
lifesaving drugs for cancer, diabetes, respiratory issues, and 
cardiovascular.
  The chart on the far side here lists those drugs individually. We are 
not making this up. This is fact. We can do this better. We can work 
together.

  The Congressional Budget Office said, when we created Medicare part 
D--which I was here for and supported--that having the government in 
charge of pricing would have a negligible effect in terms of the 
savings. I think they believe that today.
  But if you want to restrict access to drugs, if you want to deny new 
cures to patients, if you want to go on a system where you die because 
the medicine is not available in your country, then vote for H.R. 3.
  If you don't, if you want to have lower drug prices, stop the gaming 
by the pharmaceutical companies and have more cures, then support our 
alternative.
  Madam Chair, I yield back the balance of my time.
  Mr. PALLONE. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, with H.R. 3 we are one step closer to fulfilling our 
promise of making prescription drugs more affordable for the American 
people.
  Today, here in the United States, drug companies can charge whatever 
they want because there is no competition until a generic comes to 
market and because the Federal Government has no ability to negotiate 
drug prices.
  The American people are getting ripped off. The status quo is 
unacceptable and unsustainable.
  In other countries negotiations occur, and prices in those countries 
are substantially lower than here in the United States. For years the 
American people have been subsidizing prescription drugs for the rest 
of the world, and we are fed up with paying 3, 4, or 10 times as much 
for the exact same drug as someone in a similar developed country.
  Under H.R. 3, those days are over. We are finally empowering the 
Federal Government to negotiate lower prices with the drug 
manufacturers.
  Now, what we are doing with the savings that come from this bill is 
we are providing additional benefits to seniors.
  H.R. 3 adds Medicare part B comprehensive dental coverage for the 
first time. It adds a new dental benefit to Medicare part D and will 
provide coverage for screening and preventive services. It adds a new 
vision coverage. H.R. 3 adds new vision benefits that would cover 
routine eye exams, contact lens fitting, and glasses or contact lenses 
once every 2 years.

                              {time}  1930

  It adds a comprehensive hearing benefit. It adds new hearing benefits 
that provide hearing aid coverage for individuals with severe, profound 
hearing loss.
  The list goes on. We are investing more money to go to NIH. We are 
providing more money for community health centers. The bottom line is, 
we are also trying to save seniors' out-of-pocket costs by capping out-
of-pocket costs at $2,000.
  We are doing all this at the same time that we are lowering 
prescription drug prices through negotiation by the Secretary of Health 
and Human Services, or the Federal Government. Understand that once 
that price is set for Medicare, that price is also available in the 
rest of the market for those with insurance coverage.
  This is a win-win situation for the American people. I don't 
understand how the Republicans on the other side could say that there 
is any other way to lower prescription drug prices, and they, frankly, 
haven't given us any suggestion in that respect.
  I ask my colleagues, please, this is a transformational piece of 
legislation. Please support us. This should be supported on a 
bipartisan basis.
  Madam Chair, I yield back the balance of my time.
  The Acting CHAIR. All time for the Energy and Commerce Committee has 
expired.
  The gentleman from Massachusetts (Mr. Neal) and the gentleman from 
Texas (Mr. Brady) each will control 30 minutes.
  The Chair recognizes the gentleman from Massachusetts.
  Mr. NEAL. Madam Chair, I yield myself 4 minutes.
  Madam Chair, I rise in strong support of H.R. 3, the Elijah E. 
Cummings Lower Drug Costs Now Act.
  I am delighted to have been asked to join with my colleagues Mr. 
Pallone and Chairman Scott in authoring this historic legislation. It 
delivers on a Democratic promise to meaningfully stabilize and lower 
the very high costs of prescription drugs in the United States.
  As a recent Ways and Means Committee report details, Americans pay, 
on average, four times more for the same prescription drugs as patients 
in

[[Page H10107]]

other similarly developed countries. An overwhelming majority of 
Americans, 95 percent, believe this disparity is unacceptable. I 
certainly agree with them.
  H.R. 3 will level the playing field for patients and taxpayers by 
giving the Health and Human Services Secretary the power to negotiate 
better prescription drug prices in Medicare and throughout the private 
market. It also caps Medicare beneficiaries' out-of-pocket prescription 
drug spending at $2,000.
  According to CBO, H.R. 3 will save American taxpayers over $500 
billion. We will vigorously reinvest these tremendous savings into 
unprecedented dental, vision, and hearing Medicare coverage expansions.
  These are benefits that are directly associated with positive short- 
and long-term health outcomes, and seniors deserve meaningful access to 
them.
  H.R. 3 also expands eligibility to low-income subsidy programs so 
that seniors can get help to lower their out-of-pocket costs. These 
changes ensure seniors can afford lifesaving medications, protect 
Medicare beneficiaries with preexisting conditions from discrimination, 
and give older Americans access to commonly needed and life-
transforming health services. Millions of Americans will see 
improvements to their quality of life and to their financial security.
  I have long believed that we need to look at ways to reinvest in 
healthcare across the spectrum, and H.R. 3 does that by doubling our 
investment in maternal, infant, and early childhood home visiting 
programs, a proven tool to reduce maternal mortality and morbidity.
  The bill also builds on the successful Health Profession Opportunity 
Grant demonstration projects to provide a leg up for low-income adults 
to fill good-paying healthcare jobs currently unfilled because of a 
lack of trained workers. Expanding HPOG programs will help low-income 
adults gain new skills, earn good jobs, and help address health worker 
shortages that exist across our 50 States, in the U.S. territories, and 
in American Indian communities.
  I am pleased and proud of the medical innovation and research that is 
undertaken daily around the Nation, especially in the Commonwealth of 
Massachusetts. But I am concerned that this innovation is becoming out 
of reach for consumers who simply cannot afford its discoveries.
  H.R. 3 gives patients the ability to benefit from and afford 
innovative drugs. In addition, the legislation reinvests savings from 
lower drug prices back into a very important part of the Massachusetts 
economy, the National Institutes of Health, to fund additional 
groundbreaking, lifesaving research.
  The Elijah E. Cummings Lower Drug Costs Now Act, is a commonsense 
proposal that will allow Americans to live healthier lives and save 
money as they move along the way.
  I urge my colleagues to support this legislation, and I reserve the 
balance of my time.
  Mr. BRADY. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, why should patients have to choose between affordable 
medicines and a lifesaving cure for Alzheimer's, ALS, Parkinson's, or 
cancer? Why should parents with sick children be forced to wait longer 
for the newest breakthroughs that can save their lives? Why should 
Americans face shorter lives because the costliest and most painful 
drug is the one that is never created?
  At the depths of Nancy Pelosi's drug bill is a dangerous tradeoff of 
lower drug prices in the short term but fewer lifesaving cures in the 
future, and not just a few cures lost, but many, according to the 
independent Congressional Budget Office and the Council of Economic 
Advisers, up to 38 cures lost, according to the Congressional Budget 
Office, and up to 100, according to the CEA.
  The California Life Sciences Association predicts nearly 9 of 10 new 
drugs would never be available--never--from their research and small 
biotech companies if the Pelosi bill becomes law. This is a cruel 
and false choice, which is why this bill would quickly die with no real 
bipartisan support in the Senate.

  As Republicans, we believe we need to do both, lower drug prices and 
accelerate new lifesaving cures. Our bill, the Lower Costs, More Cures 
Act, lowers out-of-pocket costs for Americans by cracking down on 
overpriced drugs and empowering seniors to choose the right place to 
get medicines, which can cut the cost of chemotherapy in half, pulling 
back the curtain on those who set drug prices, forcing drug companies 
to justify their increases and list their prices in their ads.
  We accelerate, not kill, lifesaving medical cures. We permanently 
make it easier for Americans to deduct high medical expenses from their 
taxes. We allow them to use their health savings accounts for over-the-
counter medicines, including feminine hygiene products, and save 
seniors over $300 each year on their medicines in the popular Medicare 
prescription drug program.
  All of these proven ideas are bipartisan. All of these can be passed 
by Congress. All of these can be signed by President Trump this year if 
Democrats abandon their partisan games and recontinue what was our 
bipartisan work that got shelved for the Pelosi drug bill.
  I will finish with this. As a member of the Ways and Means Committee, 
we in the Republican Congress joined with President George Bush in 2003 
to create an affordable drug plan for seniors. At the time, Speaker 
Pelosi and Democrats tried their best to kill it. She famously 
predicted that trading the crucial part D prescription plan for the 
elderly would end ``Medicare as we know it.''
  Can you imagine how many seniors' lives would have been lost if she 
had succeeded in stopping the affordable Medicare drug program that 43 
million seniors have come to depend upon today?
  Nancy Pelosi and Democrats were dangerously wrong then. Can Americans 
afford the pain and risk when they are dangerously wrong again?
  Madam Chair, we have an alternative that lowers costs and accelerates 
cures in H.R. 19. That is the solution.
  I reserve the balance of my time.
  Mr. NEAL. Madam Chair, I yield 2 minutes to the gentleman from Texas 
(Mr. Doggett).
  Mr. DOGGETT. Madam Chair, there is only one problem with this 
bipartisan plan that the Republicans have embraced: It will not lower 
manufacturers' prescription drugs prices by a penny.
  As to the phony argument that there are some cures out there that 
will be lost by this legislation, it also does not stand the test of 
analysis. The suggestion is that 8 out of 200 drugs over the next 10 
years may not be presented. Not new cures, but in many cases, if we 
look at the current market, these are simply reformulations of existing 
drugs that manufacturers use to extend their monopoly positions.
  All of this about a bill that, frankly, I am not all that 
enthusiastic. I think this legislation was originally advanced as a 
narrow approach to win over Republicans, and that doesn't appear to 
have been too successful this evening.
  For that purpose, it may have merit. But as a model for comprehensive 
future legislation on prescription price gouging by government-approved 
monopolies, this narrow measure does not. Its negotiation scope is 
restricted to insulin and certain high-cost, high-volume drugs.
  Despite our pledge to repeal the Republican-imposed prohibition of 
Medicare negotiation, it still remains illegal, a violation of Federal 
law to negotiate lower prices for two-thirds of the medications covered 
by Medicare. That includes EpiPens and many other treatments.
  No negotiation for lower prices is assured even when the taxpayers 
paid for much of the research to develop the drugs.
  Price gouging is not limited to one disease or one class of drugs. 
This bill also does not provide any guarantee to 30 million uninsured 
Americans that they will get any lower prices.
  I look forward to a new Congress with a President who wants to follow 
the campaign promises that President Trump has ignored, to provide 
relief for all Americans with a comprehensive solution to contain this 
Big Pharma monopoly power.
  Mr. BRADY. Madam Chair, I am pleased to yield 2 minutes to the 
gentlewoman from Indiana (Mrs. Walorski), one of our key members on the 
Ways and Means Committee.

[[Page H10108]]

  

  Mrs. WALORSKI. Madam Chair, I rise today in strong opposition to H.R. 
3.
  This misguided, partisan legislation was written behind closed doors. 
It will result in fewer cures, less innovation, and worse health 
outcomes. We all agree that prescription drug affordability is a vital 
issue for the American people. However, we shouldn't be sacrificing new 
cures in the process. The bill tells patients with cancer, Alzheimer's, 
and other terrible diseases to keep waiting for the cures they so 
desperately need.
  That is why I support H.R. 19, the Lower Costs, More Cures Act. This 
bipartisan bill will lower out-of-pocket spending while also protecting 
access to new medicines and cures.
  Madam Chair, we have an important opportunity to work in a bipartisan 
fashion for the American people. But here we are again, considering a 
partisan bill that has no path forward in the Senate. This has become 
such a disturbing trend.
  I urge my colleagues to vote against this flawed legislation so we 
can work together on a bipartisan solution.
  Mr. NEAL. Madam Chair, I yield 2 minutes to the gentleman from Oregon 
(Mr. Blumenauer).
  Mr. BLUMENAUER. Madam Chair, I appreciate the gentleman's courtesy, 
and I appreciate his leadership.
  I strongly urge that my colleagues reject the cynical approach that 
is being advanced by our Republican friends. Think about it for a 
moment. We are talking about challenging the monopoly that the 
Republicans gave, making it illegal to negotiate drug prices.
  As a result, we have heard already in the course of this debate that 
our constituents pay four times more, on average, than other countries. 
Sometimes it is 67 times as much.
  What would happen if we were able to slightly restrain that monopoly 
power and have a little competition? The Republicans are so cynical 
that they say the first thing the drug companies will do is not cut 
executive bonuses, not cut back on stock buybacks, not cut back on 
bizarre advertising. The first thing the pharmaceutical industry would 
do, in the vision of the Republicans, is cut back on vital research.

                              {time}  1945

  Give me a break. They already spend less on research than they do on 
the items that I have mentioned.
  I really believe that, even though we have big differences with 
them--and I think we settled some of those scores in the recent trade 
negotiations--I have a hard time believing that they would make 
patients suffer instead of cutting back a little bit on executive 
compensation or stock buybacks.
  I am proud that we have stood firm against Big Pharma in our trade 
negotiations, and I hope my colleagues will vote in favor of this 
legislation that will lower prescription drug prices by almost $2,000 
per average family.
  It will have savings that will expand Medicare benefits to include 
dental, vision, and hearing--critical benefits for the older 
constituents whom we all represent.
  It reinvests the savings in Federal health programs, drug innovation, 
and medical research.
  The Acting CHAIR. The time of the gentleman has expired.
  Mr. NEAL. Madam Chair, I yield the gentleman from Oregon an 
additional 15 seconds.
  Mr. BLUMENAUER. Madam Chair, reject this cynical view that the drug 
companies will punish consumers before they will restrain some of the 
excesses if we finally take back part of the monopoly powers that the 
Republicans gave to the pharmaceutical industry.
  Mr. BRADY. Madam Chair, I yield 3 minutes to the gentleman from 
Arizona (Mr. Schweikert), who is one of our leaders in technology in 
healthcare.
  Mr. SCHWEIKERT. Madam Chair, this is one of those, the tyranny of the 
clock as we have talked about, 3 minutes.
  There are so many things here we agree upon about the rage we feel 
when we see the pricing mechanisms and those things. But there are so 
many things also being said here that are absolutely wrong, from what 
is happening in Big Pharma to the new biologics that are coming from 
the small research companies, that I believe, actually, H.R. 3 is going 
to do incredible violence to our society.
  Madam Chair, you have to understand. We are living in the time of 
miracles. There are cures coming that would not happen under H.R. 3.
  The single shot that cures hemophilia, one of most expensive diseases 
in our chronic population, that single shot is going to be outrageously 
expensive; but it is actually dramatically cheaper than just 3 or 4 
years of living with the disease.
  Madam Chair, here is actually one of my incredible concerns.
  You do understand the pricing efficiency you are importing. This is a 
reference pricing bill.
  Madam Chair, what is a year of your life worth? Madam Chair, what is 
a year of your life worth if you are healthy? One year of healthy life, 
what is it worth to you, Madam Chair?
  Because, Madam Chair, if you are in Great Britain, it is $37,000. If 
the drug comes in at $37,001, it is not purchased. That is the 
efficiency you are about to import into our country. You are going to 
do this.
  There are countries here where, if a pharmaceutical breakthrough is 
$19,000 and it would give you 1 year of healthy life, they don't buy 
it. That is what you are importing. You are importing this type of 
cruelty.
  You get to look at someone's face and say: Look, we imported that 
European model that basically said that your life is not worth that to 
us for you to be healthy for another year.
  We are better than this. We can do better.
  We both passionately agree the pricing mechanisms are crappy. The way 
capital is moved around is unfair. But H.R. 3 is going to do so much 
more damage.
  And I think I can build you a financial model that says that you will 
lower some people's drug prices and you will raise the cost of, 
functionally, healthcare in our country because the cures that are 
coming don't come anymore.
  Madam Chair, do you really want to import that type of cruelty into 
our society?
  Mr. NEAL. Madam Chair, if the gentleman asked me what a year of my 
life was worth, I would have said: An awful lot.
  But I am appreciative of the fact that you were mute on that issue, 
Madam Chair.
  Madam Chair, I yield 2 minutes to the gentleman from New Jersey (Mr. 
Pascrell).
  Mr. PASCRELL. Madam Chair, I want to thank Frank Pallone, Richard 
Neal, and  Bobby Scott for all their hard work on the Elijah E. 
Cummings Lower Drug Costs Now Act.
  The science and innovation behind lifesaving drugs is light-years 
beyond our wildest imagination.
  As the medicine chest of America, New Jersey leads the way in 
biopharmaceutical research, which is integral to discovering lifesaving 
treatments. But with the blessing of living longer, the curse of high 
costs lingers. After too many years of inaction, it falls on us to 
address exploding costs in the health system.
  Pharmaceutical innovation demands the best science, not the highest 
prices. But if medications are not affordable for all, how can they be 
lifesaving?

  H.R. 3 is landmark legislation that helps us address the cost crisis 
by allowing Medicare to negotiate fair prices for American families.
  We talked about this in 2009. The minority rejected it then, too. We 
should have done it then.
  Medicare beneficiaries, our seniors, will save $150 billion in lower 
premiums and out-of-pocket costs. On top of that, Medicare part D 
beneficiaries will see an average discount of nearly 55 percent on 
current prices of the first drugs chosen for negotiation.
  Our seniors will ultimately benefit from lower premiums, cost 
sharing, and a cap on their out-of-pocket expenses.
  By the way, Medicare would finally, at long last, cover dental, 
hearing, and vision care services to help our seniors stay healthy--
instead of bumper stickers and empty promises.
  This legislation requires drug manufacturers to justify price 
increases and launch prices for drugs. By making this information 
public, manufacturers will be accountable.
  This bill also includes a reauthorization of the Health Profession 
Opportunity Grants program, or HPOG, to

[[Page H10109]]

provide education and training to low-income individuals for health 
occupations that are in high demand or are experiencing labor 
shortages.
  Mr. BRADY. Madam Chair, I yield 4 minutes to the gentleman from 
Pennsylvania (Mr. Kelly), who is a small business person who has always 
offered quality healthcare for his workers.
  Mr. KELLY of Pennsylvania. Madam Chair, I am going to read a letter 
from a family back in Pennsylvania, the Stewarts, Sara, Michael, and 
their three daughters: Maddie, Gilly, and Daphne. It start off this 
way:

       Dear Congressman Kelly, my name is Sara Stewart, and I am 
     from Saint Petersburg, Pennsylvania. It is my understanding 
     that the House Ways and Means Committee is having a public 
     hearing on H.R. 3, the Lower Drug Costs Now Act of 2019.
       Now, it appears this legislation does not have bipartisan 
     support. It needs to take a more balanced approach. The 
     balance is needed for patients like my 10-year-old daughter, 
     Maddie.
       Maddie suffers from a rare mitochondrial deletion condition 
     called Pearson syndrome, which is a disorder that occurs as a 
     result of mutated genes in the body. These genes impact 
     mitochondria of her cells that prevent them from producing 
     enough energy for the body to function properly.
       Pearson syndrome is difficult to diagnose because it 
     affects each individual differently. Maddie's symptoms 
     through the years have included being blood transfusion-
     dependent for several years, the inability to heal after heat 
     and Sun exposure, becoming type 1 diabetic, progressively 
     losing her hearing and her vision, kidney failure, and 
     several other daily complications, including developmental 
     delays from having a body that runs on limited energy. It has 
     been truly heartbreaking to see her endure this disease, but 
     she continues to defy the odds.
       My message is simple to you, Mr. Kelly, and to the rest of 
     the committee: There is no cure or treatment for Pearson 
     syndrome. There isn't any right now. Each day is a struggle 
     to keep Maddie balanced so her body is able to better cope 
     with the symptoms of this terrible disorder.
       All we have--as well as many other families across the 
     world--is hope. Please don't let partisan bickering impact 
     the ability of researchers to discover and innovate new 
     therapies that could save Maddie's life one day. The clock is 
     ticking, and Maddie is waiting.

  Madam Chair, I went to visit the Stewarts. I saw this adorable child, 
and her mom told me: She has so much energy today, and we are really 
excited that she is feeling this way when you came to see her.
  When I looked at the Stewart family, when I looked at Maddie, when I 
looked at her sister Gilly, and when I looked at her sister Daphne, I 
thought: This isn't fair. She has never had a chance to live her life. 
She has already doubled the chances of what the life expectancy is. The 
mom is saying please don't let political bickering stand in the way of 
developing and innovating a new source that could save Maddie's life.
  Last year, there were 80-some children who had the same condition as 
Maddie. This Christmas, hopefully, the 40 who are left will have the 
chance to celebrate it.
  Now, I don't know how the Stewarts are registered. I don't know if 
the Stewarts vote, and I don't care. But I do know how the Stewarts 
pray, and they pray every night not just for Maddie, but for all the 
rest of the children who have this horrible disease.
  The other thing they pray for is that, in the people's House and on 
the floor of the people's House, we don't look at each other as 
Republicans and Democrats, that we look at each other the way we really 
are: We are moms and dads. We are grandmas and grandpas and aunts and 
uncles.
  If we cannot come here and agree that the hallmark of America has 
always been her ability to develop, to innovate, and to be the savior 
of the rest of the world, then what are we doing?
  Do we really want to make this a political battle, or do we want to 
start developing policy that is about people and not political power?
  The Acting CHAIR. The time of the gentleman has expired.
  Mr. BRADY. Madam Chair, I yield the gentleman an additional 1 minute.
  Mr. KELLY of Pennsylvania. Madam Chair, do we really want to look in 
the eyes of a 9-year-old or a 10-year-old and say to that child: It is 
not just in the cards right now because we can't get together as adults 
and do the right thing for the right reasons and let good things 
happen.
  No. We have allowed ourselves to be so damned political and so damned 
divided that we turn our backs on the people who sent us here.
  Maddie Stewart can't develop the drug herself. Mr. and Mrs. Stewart 
can't develop the drug themselves. The people of Saint Petersburg, 
Pennsylvania, can't help Maddie develop a drug. But we can. We can by 
passing legislation and looking not at H.R. 3, because you know it 
stops innovation.

  Forget all the rest of the talk. It is all about innovation. It is 
about something new, something better, and something great that is 
going to save somebody's life.
  Let's look at H.R. 19. Let's talk about the substitute, the Lower 
Costs, More Cures Act.
  I wish we all had unlimited time to speak on this issue, but we 
don't. The clock is ticking. It is ticking for Maddie Stewart in Saint 
Petersburg, Pennsylvania.
  Please do the right thing for the right reasons, and good things are 
going to happen.
  Mr. NEAL. Madam Chair, a reminder that our bill will invest $10 
billion in the National Institutes of Health for new and innovative 
cures.
  Madam Chair, I yield 2 minutes to the gentleman from Chicago, 
Illinois (Mr. Danny K. Davis).
  Mr. DANNY K. DAVIS of Illinois. Madam Chair, I rise in strong support 
of H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act. It is the 
solution whose time has come.
  According to the CBO, this bill will save $448 billion from Medicare 
alone, which can be used to provide other services to seniors and 
people with disabilities.
  I thank the Democratic leadership for including my bills to reduce 
maternal mortality and morbidity by doubling the MIECHV program and by 
expanding the successful Health Profession Opportunity Grants program 
to train low-income individuals to help relieve the health shortage 
that exists in this country.
  Madam Chair, Elijah Cummings would be proud of this bill to carry his 
name, and I urge its passage.

                              {time}  2000

  Mr. BRADY. Madam Chair, I yield 2 minutes to the gentleman from 
Illinois (Mr. LaHood), who is a dynamic member of the Ways and Means 
Committee.
  Mr. LaHOOD. Madam Chair, and I rise tonight in opposition to H.R. 3, 
the fewer cures and more government price control act.
  While everyone recognizes that the overall cost of prescription drugs 
is too high, and that there are some bad actors in the system, I wonder 
why we are here tonight debating this legislation that essentially puts 
in place an arbitrary government price setting system. We should be, 
instead, finding ways to encourage more companies to engage in research 
for cures and drive competition for lower costs.
  During consideration of H.R. 3 in our Ways and Means Committee, I 
authored a commonsense amendment to exempt any drug or biological 
product used to treat or cure Alzheimer's from the definition of 
``negotiation eligible drug,'' essentially ensuring through this 
amendment that Alzheimer's research remains intact, so that the 
scientists and the researchers and the Ph.D.'s that are working hard 
every day to find a cure can continue to do that uninterrupted. 
Unfortunately, the amendment was defeated.
  We already know from a CBO estimate that 38 cures will not come to 
market because of the legislation over the next two decades. It 
essentially cuts off at the knees innovation and deters the work that 
goes on today. The impact of future treatments and cures for diseases 
like Alzheimer's and dementia is unacceptable. An impact on even one 
cure is one too many, let alone 38.
  Instead, we have an alternative. The House should support H.R. 19, 
the Lower Cost, More Cures Act, which consists of over 40 bipartisan 
provisions that President Trump may actually sign to help lower the 
cost of prescription drugs for all of our constituents.
  It is disappointing that Democrats won't work across the aisle to 
solve this problem, and instead, are pushing a bill that will stifle 
innovative healthcare solutions and result in fewer life-saving cures 
and the research that goes into Alzheimer's.
  I urge my colleagues to oppose H.R. 3.
  Mr. NEAL. Madam Chair, I yield 2 minutes to the distinguished 
gentlewoman from Alabama (Ms. Sewell).

[[Page H10110]]

  

  Ms. SEWELL of Alabama. Madam Chair, I rise today in support of H.R. 
3, the Elijah E. Cummings Lower Drug Costs Now Act.
  I am particularly proud of a provision that I worked on with Speaker 
Pelosi to improve a provision in the original bill that caps out-of-
pocket spending for Medicare part B beneficiaries at $2,000 annually.
  My proposal further protects seniors by allowing them to pay these 
out-of-pocket costs in equal installments over 12 months, rather than 
all at once.
  The final version of H.R. 3 also includes a bill I introduced earlier 
this month, H.R. 4669, the Maximizing Drug Coverage for Low-Income 
Seniors Act.
  This is smart and innovative legislation that will ensure seniors are 
enrolled in the best Medicare part D program for their individual 
needs, not just randomly assigned.
  This will save them money on out-of-pocket costs as well as improve 
access to their needed medication, while also generating savings in 
overall Medicare spending that can be reinvested in the program.
  Madam Chair, in the richest Nation in the world, every American 
should be able to afford their life-saving medication.
  I urge my colleagues to support this groundbreaking legislation and 
to vote for H.R. 3.
  Mr. BRADY. Madam Chair, I reserve the balance of my time.
  Mr. NEAL. Madam Chair, I yield 2 minutes to the gentlewoman from 
California (Ms. Judy Chu).
  Ms. JUDY CHU of California. Madam Chair, I rise today in support of 
H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act.
  Americans are sick and tired of getting fleeced by Big Pharma and 
have had enough of skyrocketing prescription drug prices.
  In my district, an uninsured patient with diabetes has to pay $655 
for a monthly supply of Novolog Flexpen, a popular brand of insulin. 
But, in Canada, that same supply of insulin can be purchased for just 
$47.
  This is outrageous. Why should Americans have to pay so much more 
than any other developed country for the exact same medications? Why 
should my constituents have to plan trips to Mexico and Canada to get 
the medications they need to stay alive? Because even with the cost of 
travel, it is still cheaper to buy their insulin abroad. And why are 
drug company profits soaring while patients go bankrupt? This is simply 
not right.
  H.R. 3 is a landmark piece of legislation. It gives Medicare the 
power to negotiate for lower prices directly with the drug companies. 
It makes those lower prices available to those with private insurance. 
Seniors will not have to pay more than $2,000 out-of-pocket for their 
drugs. And drug companies can no longer rip off Americans while 
charging other countries less for the same drug.
  This bill is an important first step in addressing the skyrocketing 
cost of prescription drugs. I am proud to stand here today as a 
cosponsor of H.R. 3. And I am committed to continuing our work for the 
people to bring down the cost of prescription drugs for all Americans.
  Mr. BRADY. Madam Chair, I reserve the balance of my time.
  Mr. NEAL. Madam Chair, I yield 2 minutes to the gentleman from 
Pennsylvania (Mr. Brendan F. Boyle).
  Mr. BRENDAN F. BOYLE of Pennsylvania. Madam Chair, I thank the 
chairman and all the colleagues of mine on both sides of the aisle and 
my committee, the Ways and Means Committee.
  What a perfect illustration of the difference in priorities between 
the two parties. The major health initiative of the opposite party, 
when they were in power 2 years ago, was to repeal the Affordable Care 
Act, which would have taken away healthcare from more than 20 million 
Americans.
  Yet, now the House, under Democratic leadership, is considering a 
major priority on this side of the aisle, H.R. 3. A bill that, 
according to the Congressional Budget Office, will save on drug costs 
of $500 billion for the American people.
  Now, there are many reasons why I support H.R. 3, and I am proud to 
do so, but I want to highlight, especially, just one of them. This 
legislation would generate $10 billion to fight the opioid crisis, 
setting aside resources for the localities that have been impacted the 
most. That includes many rural areas in our country, but it also 
includes urban areas as well, especially in my district, in my hometown 
of Philadelphia.
  I am proud to stand here and support H.R. 3. This is one of the most 
important things we can do for the American people: save prescription 
drug costs.
  Madam Chair, I urge its support.
  Mr. NEAL. Madam Chair, I yield 2 minutes to the gentleman from 
Pennsylvania (Mr. Evans).
  Mr. EVANS. Madam Chair, I am proud to stand before you and offer my 
support for H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act.
  One issue that has a significant impact on my constituents is the 
skyrocketing cost of insulin. Across Pennsylvania, more than 1 million 
people live with diabetes and can spend anywhere from $1,200 to $20,000 
on insulin medication each year. Over the past decades, the price of 
insulin has increased 197 percent.
  When I think about the impact that these price hikes have on my 
constituents, the first person that comes to my mind is a young man by 
the name of Chase. Chase is from Philadelphia. He was diagnosed with 
Type 1 diabetes at the age of 3. He came to my office not long ago.
  Chase told me that he and his mother needed Members of Congress to do 
something about the cost of insulin because he was worried about the 
burden it was placing on his mother, even though his illness was 
brought on through no fault of his own.
  Chase walked me through each step of his journey with his illness. He 
told me what he and his mother do on a daily basis to manage the 
diabetes. He is strong in his message that we need to do something 
about this rising cost. Chase is 10 years old. He did not choose this, 
and neither did the other 30 million Americans across the country.
  Under H.R. 3, there will be a reduction in insulin. It is important 
that I stand with my colleagues today and support H.R. 3, which 
includes my bill.
  It is important that this bill will help seniors afford healthcare 
costs by increasing the number of them who are eligible for the 
Medicare Savings Programs. No one chooses to be sick, and no one 
chooses illness for their children.
  Madam Chair, I urge my colleagues to vote in favor of this 
legislation. It is time to act.
  Mr. NEAL. Madam Chair, I yield 2 minutes to the gentleman from 
Illinois (Mr. Schneider).
  Mr. SCHNEIDER. Madam Chair, today the House is taking long overdue 
action in fulfilling our promise to the American people to lower the 
cost of prescription drugs. Medical research has fueled lifesaving 
advancements in medicine, but these innovations remain out of reach for 
too many due to exorbitantly high costs.
  Tragically, 3 in 10 adults reported not taking their medicines as 
prescribed at some point because of the cost. Even those who can afford 
their prescriptions are charged prices many times higher than in other 
developed countries. This is simply unacceptable.
  H.R. 3 puts us on a path towards a more equitable healthcare system 
where cost is no barrier to getting the care patients need. In 
particular, I want to highlight my legislation, the Protecting Medicare 
Beneficiaries with Preexisting Conditions Act, now included in H.R. 3 
as Section 801.
  More than 13 million beneficiaries have a supplemental insurance 
policy known as Medigap. Medigap helps lower out-of-pocket costs, but 
some 30 million more Americans are unable to buy a Medigap plan without 
being charged more for a preexisting condition. Specifically, disabled 
Americans under 65 and Medicare Advantage enrollees are not afforded 
the same coverage guarantees as nearly every other American.
  The Affordable Care Act rightly eradicated discrimination for 
preexisting conditions in the individual market. We need to finally 
right this wrong for Medicare beneficiaries as well, and that is 
exactly what this bill does.
  I look forward to this Chamber passing H.R. 3 to give more Americans 
peace of mind when buying their insurance and standing at the pharmacy 
counter. I hope all my colleagues on

[[Page H10111]]

both sides of the aisle will join me in supporting this bill.
  Mr. BRADY. Madam Chair, I yield myself 1 minute.
  Madam Chair, the Republican alternative to Lower Cost, More Cures Act 
is based on both parties working together. In fact, we were doing so 
until Speaker Pelosi blew this up with H.R. 3, written in secret, 
without any Republican input.
  Our bill contains 36 different provisions that passed unanimously out 
of the Committee on Ways and Means and the Committee on Energy and 
Commerce. Madam Chair, 17 provisions that passed out of the House of 
Representatives also with bipartisan support; 28 different provisions 
that passed out of 3 different Senate committees with bipartisan 
support, and 21 of these provisions from the Grassley-Wyden Drug 
Pricing Package.
  When this partisan bill dies, H.R. 3, we Republicans will be ready to 
take up these bipartisan measures because we agree--Democrats and 
Republicans--we need to lower drug prices, and we need to accelerate 
these cures.
  Madam Chair, I reserve the balance of my time.
  Mr. NEAL. Madam Chair, I yield 2 minutes to the gentleman from New 
York (Mr. Suozzi).
  Mr. SUOZZI. Madam Chair, I thank Chairman Neal for yielding me time.
  Madam Chair, I rise in strong support of H.R. 3. I think this is one 
of the most important issues facing America today. The American people 
are hungering for a solution to this problem.

  On January 11, 2017, President-elect Trump said, when referring to 
the pharmaceutical companies, ``these guys are getting away with 
murder.''
  For too long, Big Pharma has cashed in because our government, the 
largest purchaser of prescription drugs in the world, has been 
prohibited from negotiating lower drug prices. Americans pay nearly 
four times as much for prescription drugs as people in other countries.
  H.R. 3 will finally give the United States Government the power to 
negotiate lower prices. It will stop unjustified price hikes and put a 
cap on Medicare part D beneficiary out-of-pocket costs.
  The $500 billion in cost savings will be used to create historic 
Medicare improvements, such as dental, vision, and hearing benefits. 
This bill will also provide financial support for more Medicare 
beneficiaries, will boost funding for scientific innovation, will 
invest in community health centers, and will provide more money to 
fight the opioid epidemic.
  I thank Chairman Neal for also including a provision I wrote to help 
protect seniors that will require Medicare prescription drug plans to 
publicly disclose information about when beneficiaries are denied at 
the pharmacy counter.

                              {time}  2015

  I want to thank Congressman Reed for helping in that legislation. I 
am honored to cosponsor this historic piece of legislation.
  Mr. BRADY. Madam Chair, I am pleased to yield 2 minutes to the 
gentleman from Kansas (Mr. Estes), one of our new members of the Ways 
and Means Committee who is really thoughtful on healthcare.
  Mr. ESTES. Madam Chair, I rise in opposition to H.R. 3, a bill that 
should be called the fewer cures and more government price controls 
act.
  My colleagues know this partisan bill is another that is dead on 
arrival in the Senate, but it didn't have to be this way. I truly wish 
that my colleagues across the aisle had not abandoned the good faith, 
bipartisan negotiations on a realistic, workable solution to fix 
soaring drug prices.
  Instead, H.R. 3 was changed after it was passed out of committee to 
please extreme voices on the left and become a giveaway for radical 
policies.
  Even the nonpartisan Congressional Budget Office said H.R. 3 will 
result in fewer cures and fewer drugs coming to market, and current 
drugs being pulled from the market.
  That means that, while H.R. 3 may lower drug prices today, it comes 
at the expense of fewer cures being developed in the future and more 
government controls.
  We should not be forced to choose between lower prices or less 
innovation, just like no one should have to choose between paying for 
groceries or paying for their medication.
  We must address this issue. But instead of H.R. 3, I encourage my 
colleagues to join me in supporting an amendment before us based on 
H.R. 19, the Lower Costs, More Cures Act.
  This amendment, and the H.R. 19 bill, will use bipartisan reforms to 
lower prices, protect access to new medications, strengthen 
transparency with drug companies and PBMs, and allow competition to 
thrive.
  I know this will help people across our country, like a community 
pharmacist I heard from in a rural area in my district. Unfortunately, 
retroactive and unpredictable fees to PBMs totaling $45,000, just in 
2018 alone, have left it hard for this business to stay afloat and to 
serve patients in this rural community.
  Unlike H.R. 3, our bipartisan solution will help give him and other 
community pharmacists, particularly in rural areas, the needed 
stability and predictability.
  This is just one way today's amendment and H.R. 19 will help patients 
lower their out-of-pocket-costs and help keep more cures coming to 
market.
  And furthermore, unlike H.R. 3, this measure could be passed and 
delivered to the President's desk this year and provide real relief to 
our seniors.
  Mr. NEAL. Madam Chair, I yield 2 minutes to the gentleman from Nevada 
(Mr. Horsford).
  Mr. HORSFORD. Madam Chair, I thank the chairman for his steadfast 
leadership.
  I rise today to speak in support of H.R. 3, the Elijah E. Cummings 
Lower Drug Costs Now Act of 2019.
  I support this bill because of one of my constituents, Steven 
Pastrone, who lives with multiple sclerosis. He shared: ``My whole 
right side of my body was weaker than my left and I had a hard time 
cognitively doing anything.''
  Steven was not able to access his medication, which cost $35,000 per 
treatment, more than many Nevadans earn annually, so he had to rely on 
a cost-assistance program from the drug manufacturer.
  So many people in our country are in Steven's position and cannot 
access their lifesaving medications outright. Chairman Elijah Cummings 
would say: ``We are better than that.''
  My constituents who stop me at church and at recreation centers don't 
tell me that they are Democrat, Republican, or Independent. They tell 
me that they have diabetes; they have cancer; they have heart disease; 
they have asthma; and they want this Congress to do something, to act.
  So this week, we finally tell Americans across this country that we 
value your health more than Big Pharma profits, and we will pass H.R. 
3, to lower drug costs now.
  I want to thank the chairman and the Members of this body, my 
colleagues, for working so hard. This is one of the most important 
issues that this Congress can act on, and I am proud to be a sponsor of 
this important legislation.
  Mr. BRADY. Madam Chair, I am prepared to close, and I reserve the 
balance of my time.
  Mr. NEAL. Madam Chair, I have no further speakers, and I am prepared 
to close.
  I reserve the balance of my time.
  Mr. BRADY. Madam Chair, I yield myself such time as I may consume.
  Patients or politics--that is really the choice we have today when we 
vote on these different drug pricing bills.
  There is a path forward that chooses politics. This path takes a 
partisan approach and throws away months of Republicans and Democrats 
working together to lower drug prices.
  Experts tell us this will delay or eliminate medical breakthroughs 
and lifesaving cures for American families.
  This piece of legislation is potentially unconstitutional, one that 
leads to patient access restrictions while giving more power to foreign 
bureaucrats to set prices for American patients right here.
  And at what cost?
  To save a few dollars in the short term for a dramatically worse 
landscape in America that discourages science, research, and discovery.
  So I think of Representative Kelly's young girl, Mattie Stuart, St. 
Petersburg, Pennsylvania. She has a Facebook page, Mattie's Followers. 
Go to that page. Understand how patients are waiting for us, for those 
new cures.

[[Page H10112]]

  I think of my friends in my neighborhood. We had a neighbor who died 
from a rare brain cancer. I have another who is fighting a 
glioblastoma; another neighbor, a very dynamic friend, who is now 
struggling with Parkinson's; two friends who have died from ALS; and my 
friends, acquaintances, coworkers who they or their parents struggle 
with dementia and Alzheimer's.

  This bill, from Speaker Pelosi, in my view, just rips hope, robs hope 
from people waiting and praying for those cures. There is no way there 
are not fewer cures.
  The Congressional Budget Office estimates that up to $1 trillion will 
be taken away from research and science and revenues that are invested 
in drugs and new discoveries.
  Some say, well, the drug companies--and everyone seems to hate them--
but the drug companies can just not do as many ads, can just shift some 
money around.
  But let me put it in perspective. Drug companies could not spend a 
dime on any advertisement for the next 25 years; they couldn't make up 
what is taken from this bill.
  We could zero out National Institutes of Health for a quarter 
century. That is what $1 trillion in research and discovery investment 
does.
  You are in denial if you don't know there will be fewer cures--
whether it is 38, whether it is 100, whether it is something in 
between. No one can tell us that cure that is lost won't be the one for 
Alzheimer's, ALS, Parkinson's, or for cancer.
  This is the path Republicans reject. We believe that is too high a 
price to pay for this bill, because we think there is a bipartisan road 
right in front of us that we can take together, one that chooses 
patients and their needs. And I am convinced Democrats believe, with 
us, that we can do both.
  I believe, with goodwill and good ideas, we can do this Lower Costs, 
More Cures Act. It sets out what Chairman Richie Neal and I set out to 
do in February of this year. We wrote that now is ``the time to take 
meaningful action to lower the cost of prescription drugs in the U.S.''
  We said we are committed to working together to end this cycle while 
preserving access to lifesaving innovations. I believe we can do that.
  I believe the solution isn't in H.R. 3. That is as dead as can be. I 
think the solution is H.R. 19 and working together to fine-tune it even 
better by accelerating, not killing, lifesaving medical cures; by doing 
what we have already said is bipartisan: driving out-of-pocket costs 
down; expanding health savings accounts; deducting medical expenses; 
letting people use their FHAs more; saving seniors by redesigning part 
D; forcing drug companies to justify their increases, to pull that 
curtain back on how they price those drugs; everyone along the system, 
making them, forcing them to pay more of the drug burdens in Medicare 
part D.
  And together, we can tell families suffering from Alzheimer's, ALS, 
Parkinson's, cancer, and so many other illnesses that we are committed 
together to finding a cure.
  My vote today will be on behalf of patients. It will be on behalf of 
bipartisan solutions. It will be cast with the hope that a future cure 
for cancer can be discovered and developed right here in America, 
sooner rather than later.
  I know my Republican colleagues will join with me in that fight as 
well, and I ask my friends, my Democrat colleagues, to do the same.
  Let me be clear on that. I think there are Democrats who have come 
here to solve problems but find themselves boxed out by the Speaker's 
top-down approach. My simple request is, join us in fighting for a 
bipartisan solution, H.R. 19, no matter how you will eventually vote on 
H.R. 3.
  Send a signal that it is not too late for the Matties of the world. 
It is not too late. We can deliver a bipartisan win for lower drug 
prices and that cure we all pray for for our families and loved ones.
  Madam Chair, I yield back the balance of my time.
  Mr. NEAL. Madam Chair, I yield myself the balance of my time.
  Addressing the rising cost of prescription drugs is a complicated 
issue, as Mr. Brady has noted, and it needs a thoughtful approach. H.R. 
3 is a critical step toward a long-term, sustainable solution.
  A lot of hard work went into crafting this measure and, indeed, 
bringing it to the floor. And there are a number of staff to thank.
  From the Legislative Counsel's Office: Jessica Shapiro, Karl 
Hagnauer, Lisa Castillo, Adam Schilt, Fiona Heckscher, James Grossman, 
and Henry Christup.
  From CBO: Tom Bradley--who, I might add, is retiring after long and 
distinguished service, and we thank him for that--Paul Masi, Rebecca 
Yip, Lara Robillard, Chad Chirico, Alice Burns, Stuart Hammond, Lori 
Housman, Jennifer Gray, and Leo Lex.
  From the Joint Committee on Taxation: Tom Barthold, Vivek 
Chandrasekhar, Shelley Leonard, Chia Chang, Lin Xu, and James Elwell.
  From CMS: Manda Newlin, Maia Larsson, Ira Burney, Lisa Yen, Jen 
Druckman, Stacy Harms, Leigh Feldman, and Jenny Keroack.
  And, of course, as always, I want to thank the staff of the Ways and 
Means Committee, who, as usual, have worked tirelessly and effectively 
on this legislation. The legislation before this House today is in no 
small part because of their expertise and their commitment to improving 
the healthcare for all members of the American family.
  I thank Amy Hall, Sarah Levin, Melanie Egorin, Rachel Dolin, Orriel 
Richardson, Neil Patil, and Morna Miller.
  As we have heard today on the floor, there are a lot of views on how 
to lower prescription drugs, and I am open to suggestions. One policy 
is not going to be the final fix, but this legislation is an important, 
impactful first step, and I welcome continued dialogue on both sides of 
the aisle.
  I urge my colleagues to join me in supporting this historic 
legislation, and I yield back the balance of my time.
  The Acting CHAIR (Ms. Davids of Kansas). The time of the Committee on 
Ways and Means has expired.
  The gentleman from Virginia (Mr. Scott) and the gentlewoman from 
North Carolina (Ms. Foxx) each will control 30 minutes.
  The Chair recognizes the gentleman from Virginia.

                              {time}  2030

  Mr. SCOTT of Virginia. Madam Chair, I yield myself 2 minutes.
  Madam Chair, I would first like to thank Chairman Neal, Chairman 
Pallone, the Speaker of the House, and other Democratic leaders for 
their leadership in lowering skyrocketing drug costs.
  The Elijah E. Cummings Lower Drug Costs Now Act is a historic 
proposal to improve the health and well-being of all Americans. Not 
only does this legislation lower drug costs for taxpayers and seniors 
on Medicare, but it also reduces drug costs for businesses and families 
across the country, allowing employer-sponsored plans to access the 
same cost savings negotiated for Medicare.
  In fact, according to the Centers for Medicare and Medicaid Services, 
H.R. 3 will save households and businesses more than $160 billion over 
the next 10 years. In my district, this means savings for approximately 
600,000 people in public and private health insurance programs.
  H.R. 3 will save the taxpayers hundreds of billions of dollars, and 
these savings will be reinvested in healthcare priorities. These 
priorities include funding new cures through the National Institutes of 
Health; funding community health centers, which serve 29 million 
Americans across the country; and combating the opioid epidemic.
  Simply put, the Elijah E. Cummings Lower Drug Costs Now Act will 
lower prescription drug costs for workers today while investing in a 
healthier future for all Americans. I urge my colleagues to support 
this legislation and deliver on our bipartisan promise to lower 
healthcare costs for the American people.
  Madam Chair, I reserve the balance of my time.
  Ms. FOXX of North Carolina. Madam Chair, I yield myself such time as 
I may consume.
  All of us in this Chamber have heard the troubling stories of mothers 
and fathers, grandmothers and grandfathers, friends, and colleagues who 
suffer every day because they can't afford

[[Page H10113]]

their medications. That is why Congress started a collaborative and 
bipartisan process to tackle this issue earlier this year.
  In October, this bipartisan collaboration was cut abruptly short by 
Speaker Pelosi with the introduction of H.R. 3, which was written in 
secret without Member input or the regular committee process.
  Instead of a bipartisan solution, we are left with H.R. 3, which is 
nothing more than a Democrat downpayment on a government-run healthcare 
system that would eliminate private insurance and implement government-
controlled rationing of prescription drugs.
  I serve as the senior Republican on the Education and Labor 
Committee. H.R. 3 is the latest string in a series of radical 
Democratic bills that I have seen in the committee and in the House 
that promote unprecedented government interference in private markets 
and increased regulatory red tape. Proposals that can and should be 
bipartisan, such as addressing the skills gap, pension reform, and now 
drug pricing, are being rewritten by Democratic leadership, which is 
held hostage by their most leftwing Members.
  An amendment adopted during our committee markup proves just that 
point. Representative Pramila Jayapal's amendment pushes this radical 
bill even further to the left by requiring the Secretaries of Labor, 
Health and Human Services, and the Treasury to study and issue 
regulations on extending government price controls to private 
healthcare plans.
  The mandate for additional price controls suggested in this amendment 
tells private companies how much they can increase their prices each 
year or forces them to pay a fine. House Democrats aren't satisfied 
with only setting prices in government programs, and they continue to 
find ways to expand the already radical scope of H.R. 3 to the private 
market as well.
  Since the Education and Labor Committee markup, this issue has been a 
key area of disagreement between moderate and progressive Democrats, 
but Speaker Pelosi, yet again, caved to the demands of her Progressive 
Caucus and agreed to keep the amendment in the final bill.
  The flawed and extreme approach taken by H.R. 3 includes troubling 
and unprecedented government interference in private market 
negotiations. Governments don't negotiate; they dictate. So this 
radical scheme will eliminate choice and competition and jeopardize 
innovation, investment, and access to future cures.
  Breakthrough cures for diseases like Alzheimer's, cancer, sickle-cell 
disease, and others will be at risk. In fact, if we pass H.R. 3, the 
nonpartisan Congressional Budget Office says we could see up to 
approximately 38 fewer cures for deadly diseases over the next 20 
years, and the Council of Economic Advisers says up to 100 fewer cures 
over the next 10 years.
  If those estimates aren't concerning enough, just look at real-world 
examples for proof. Countries that have adopted drug pricing systems 
like those included in H.R. 3 face decreased access to innovative new 
medicines, increased wait times for treatment, and supply shortages for 
in-demand drugs.
  Democratic supporters of this bill have said fewer cures in exchange 
for government control prices is ``worth it.'' This is shameful. 
Democrats may be okay with fewer cures. I am not, and neither are my 
colleagues.
  The American people deserve better from Congress. They deserve a real 
solution that will lower the costs of prescription drugs without 
jeopardizing access to new treatments and cures.
  That is why House Republicans have introduced H.R. 19, the Lower 
Costs, More Cures Act. This bill contains measures that have bipartisan 
support in the House and the Senate, and it can become law this year.
  Specifically, H.R. 19 will help lower out-of-pocket costs, protect 
access to new medicines and cures, strengthen transparency and 
accountability, and champion competition. Yet, House Democrats are 
ignoring this bipartisan, commonsense legislation. Clearly, they prefer 
politics over progress.
  Madam Chair, I reserve the balance of my time.
  Mr. SCOTT of Virginia. Madam Chair, I yield 3 minutes to the 
gentleman from Connecticut (Mr. Courtney), a distinguished member of 
the Committee on Education and Labor.

  Mr. COURTNEY. Madam Chair, I thank the gentleman for yielding and for 
his leadership on this issue.
  Madam Chair, the Chamber can see the chart on my right, which was 
prepared by the Organization for Economic Cooperation and Development, 
which shows that the American people pay far more for prescription 
drugs than any other country in the world by wide, unacceptable 
margins. Per capita, the United States spends 25 percent more on 
prescription drugs than Switzerland, the country with the next highest 
drug costs.
  Specific examples of this outrageous disparity abound. A vial of 
insulin in the U.S. is $300. The same vial in Canada is $32. In the 
U.S., an EpiPen two-pack has a list price of $608, in the U.K., $69.
  About one-quarter of Americans say that it is difficult for them to 
afford their prescriptions. Seventy-nine percent of Americans think the 
costs of prescription drugs is unreasonable. Approximately one-third of 
Americans say they haven't taken their medicine as prescribed because 
of trouble affording it.
  This week, Congress will vote finally to use the leverage Medicare 
has to get U.S. drug prices in line with the international price index 
for developed countries whose standard of living is comparable to the 
U.S. and whose life expectancy in many cases actually exceeds the U.S.
  As CBO confirmed, this bill will save patients millions of dollars 
and will ensure that this chart changes for the better.
  Crucially, this bill is unique from other proposals by lowering drug 
costs not just for Medicare but also for the 50 percent of Americans 
who receive their health insurance through work.
  This bill directs the Secretary of HHS to negotiate lower drug prices 
and extends that price voluntarily to employer-sponsored health plans, 
reducing the relentless increase in healthcare costs that is driving 
premiums higher for large employers, small employers, and the self-
insured.
  According to the Connecticut Department of Insurance, the portion of 
healthcare premiums attributable to prescription drug coverage has 
increased from 15 percent to 23 percent of every premium dollar since 
2010, which eats up wages and salaries.
  In a nutshell, this bill will put billions of dollars into the 
pockets of working Americans and their families, at the same time not 
using a limited formulary, at the same time preserving a research and 
development tax credit, and at the same time boosting support for 
pharmaceutical research at the National Institutes of Health.
  This bill is the most significant healthcare proposal in a decade. It 
is time for us to listen to the American people, who in 2018 listed 
healthcare costs, specifically prescription drug care costs, as their 
number one concern in exit polls in the highest voter turnout for a 
midterm election since 1914. This is the bill that responds to that 
loud signal from the American people. I urge passage of H.R. 3.
  Ms. FOXX of North Carolina. Madam Chair, I yield 3 minutes to the 
gentleman from South Dakota (Mr. Johnson).
  Mr. JOHNSON of South Dakota. Madam Chair, I thank the gentlewoman for 
yielding.
  Americans want lower drug prices. I want lower drug prices. My 
colleagues want lower drug prices.
  We have been told tonight that H.R. 3 is the proper vehicle to 
accomplish that goal. I regret to inform the body that it is not. H.R. 
3 is not a bipartisan attempt to find common ground. Make no mistake 
about it, it will not become the law of the land.
  But for those of us who came to Congress to solve problems, there is 
some good news. There is a better way.
  H.R. 19, which was introduced by 111 of my colleagues and me this 
week, is markedly better than H.R. 3, and it can become law. I want to 
highlight four components of H.R. 19.
  First, it would end abuse of the patent system, and it would end the 
pay-for-delay agreements that allow generic manufacturers to actually 
be paid by their competitors to keep drugs off the market.
  Secondly, it would, for the first time ever, place a cap on seniors' 
out-of-pocket drug costs. That is supported by 75 percent of Americans.

[[Page H10114]]

  Third, it would establish a new negotiator within the Office of the 
United States Trade Representative, allowing us to push back against 
countries that expect that the U.S. should subsidize their drug costs.
  Finally, it would increase transparency in the doctor's office and at 
the pharmacy. That will be welcome news for the 90 percent of Americans 
who want to see more transparency in the drug pricing system.
  Madam Chair, with agreements this week on the U.S.-Mexico-Canada 
Agreement and the National Defense Authorization Act, we have some 
bipartisan momentum building in this town. Oh, my, perhaps it is a 
Christmas miracle.
  With that in mind, we should set aside the partisan H.R. 3 and 
instead apply that reemerging bipartisan spirit to lowering drug 
prices.
  Mr. SCOTT of Virginia. Madam Chair, I yield 2 minutes to the 
gentlewoman from California (Ms. Davis), the distinguished member of 
the Committee on Education and Labor and chair of the Subcommittee on 
Higher Education and Workforce Investment.
  Ms. DAVIS of California. Madam Chair, I thank the gentleman for 
yielding, and I thank Chairman Scott for his leadership on this bill.
  This bill is named after the late Congressman Elijah Cummings for his 
great work fighting for affordable healthcare and prescription drugs.
  He fought for people like a constituent of mine who wrote to me 
regarding the absurdly high cost of insulin. He explained in this 
letter that his brother had been diagnosed with type 1 diabetes, which 
requires him to take an insulin injection four times a day. My 
colleagues are probably familiar with that, people they know. A single 
bottle of insulin costs $400. He tells me that some people skip 
needles. Others let themselves stay at harmful blood sugar levels so 
that they can make their insulin last longer.
  Madam Chair, no one should have to suffer this indignity, especially 
when in many places around the world, insulin is as low as $8.
  With H.R. 3, Medicare will be able to negotiate drug prices for 
seniors and beneficiaries, and our constituents won't be plagued by 
such high costs for such a common drug.

                              {time}  2045

  And thanks to this bill, the NIH will have more resources to 
encourage more research and more experimentation. The savings can be 
used for large projects and for new pilot initiatives to assist the 
development of new cures and treatments, and this can really be 
groundbreaking for all of us.
  I supported this bill in committee because it boosts the economy by 
saving both American workers and businesses billions of dollars. We all 
know what that can mean.
  Madam Chair, I encourage my colleagues to vote for the underlying 
legislation.
  Ms. FOXX of North Carolina. Madam Chair, I yield 3 minutes to the 
gentleman from Texas (Mr. Wright).
  Mr. WRIGHT. Madam Chair, I thank Ms. Foxx for yielding.
  Madam Chair, I rise in opposition to H.R. 3.
  This Congress, we have seen on multiple occasions that Democrats and 
Republicans are able to agree on and move powerful and beneficial 
legislation when we put aside politics in favor of bipartisan 
pragmatism.
  Members on both sides of the aisle agree that rising drug prices are 
a major concern for all Americans, and you would think we would be able 
to deliver for the American people on this issue.
  Unlike the radical bill before us, H.R. 19, the Lower Costs, More 
Cures Act, contains bipartisan solutions and has a real chance of being 
signed into law. Sadly, we are wasting the taxpayers' time debating a 
hapless Federal takeover of America's innovative biotech industry that 
will result in more harm than good.
  H.R. 3 represents the first step of a government takeover, all under 
the guise of helping. But threatening companies is not helping; 
restricting future cures is not helping; threatening the jobs of 89,000 
Texans employed by the biotech industry is not helping.
  This bill would slap manufacturers with a 95 percent excise tax for 
not negotiating its prices with the Federal Government. That is not 
negotiating; that is dictating.
  Speaker Pelosi's price-setting legislation gives manufacturers a 
stark choice: comply or exit the U.S. market entirely.
  Doctors take the Hippocratic Oath to do no harm. Public officials 
should do the same.
  If one thing is clear to me, it is that H.R. 3 will absolutely do 
harm. This bill has one assured outcome: the stifling of medical 
innovation here in the United States.
  Experts from the Congressional Budget Office, the Council of Economic 
Advisers, and the California Life Sciences Association have all warned 
of the disastrous impact H.R. 3 will have on future cures. 
Specifically, they warned that up to a third of new cures could be lost 
over the next 10 years.
  Fortunately, we don't have to rely solely on expert estimates about 
the impact of government price setting. We can look at the real-time 
results in other countries.
  Between 2011 and 2018, 89 percent of new treatments introduced were 
available to Americans, compared to 62 percent in Germany and 60 
percent in the United Kingdom.
  We have seen, to the United States' benefit, the migration of R&D 
activity from Europe in the aftermath of their price controls.
  Now is not the time to slow down medical innovations in the United 
States. We must stop this radical government overreach.
  Mr. SCOTT of Virginia. Madam Chair, I yield 3 minutes to the 
gentlewoman from Pennsylvania (Ms. Wild), a distinguished member of the 
Committee on Education and Labor.
  Ms. WILD. Madam Chair, I rise in support of H.R. 3, the Elijah E. 
Cummings Lower Drug Costs Now Act. In his name, the days of putting 
profits over people must come to an end.
  Madam Chair, to my colleagues across the aisle, why do they consider 
this to be a partisan idea?
  Drug companies owe a fiduciary duty to make profits for their 
shareholders, but as Members of Congress, we have a much more important 
shareholder: the American people.
  When we try to pass good bills to drive down drug prices, Big Pharma 
throws the weight of its lobby to kill them. They talk about innovation 
and research and development without disclosing that they spend more on 
marketing than they do on innovation, without disclosing that they 
could lose $1 trillion in sales and still be the most profitable 
industry.
  One vial of insulin in America should not cost 10 times what it costs 
in Canada. People like my constituents Danielle Thrapp and her son 
Brandon should not have to worry about the price of insulin.
  People like my constituent Mitchell Lenett shouldn't have to worry 
whether his 14-year-old daughter Carly, who has type 1 diabetes, will 
be able to afford her insulin when she is no longer on his health 
insurance plan. That is why this bill is so important.
  The Secretary of HHS must be able to negotiate lower drug prices for 
the highest cost prescription drugs, something other countries with far 
lower drug prices have long been able to do.
  The Congressional Budget Office tells us that H.R. 3 will lower 
prices and increase the availability of prescription drugs. The CBO 
score says that this bill will reduce Federal spending for Medicare by 
at least $345 billion.
  This will free up funding for some of our other priorities, like my 
bill to increase funding for child abuse prevention and treatment 
services and for expanding trauma-informed education practices in our 
schools and for mental health services.
  Madam Chair, I call on my colleagues to put people over profits, 
finally, and pass this bill.
  Ms. FOXX of North Carolina. Madam Chair, I yield 3 minutes to the 
gentleman from Michigan (Mr. Walberg).
  Mr. WALBERG. Madam Chair, I thank the gentlewoman for yielding.
  Madam Chair, as I travel across Michigan, I constantly hear about the 
high cost of prescription drugs. Hardworking families are simply paying 
too much.

  We agree on this, and that is why we need to tackle this issue in a 
bipartisan way, not try to score political points like, Madam Chair, I 
am hearing tonight.
  Sadly, H.R. 3 is a partisan, heavy-handed approach that has no chance 
of becoming law.

[[Page H10115]]

  Mr. Chair, let's be honest: Governments don't negotiate; they 
dictate. This drug-pricing scheme will ultimately hurt families, stifle 
innovation, and prevent lifesaving cures from becoming available to our 
friends, our neighbors, our families.
  Approximately 100 lifesaving drugs, according to the Council of 
Economic Advisers, won't come to fruition if H.R. 3 passes.
  Mr. Chair, I would dearly love to ask my colleagues: Which of those 
cures would we do away with? Alzheimer's? Parkinson's disease? 
Childhood cancers? Which ones would we give up for H.R. 3?
  There is a better approach, a plan that is patient-focused and filled 
with bipartisan provisions that enjoys support in the Senate, and, oh, 
by the way, the President would sign. It would become law. It would 
reduce the costs and increase innovation. It is H.R. 19, the Lower 
Costs, More Cures Act.
  Mr. Chair, this bill will strengthen transparency, encourage medical 
breakthroughs, and make medications that families rely on more 
affordable.
  If the other side is serious, Mr. Chair, about getting something 
done, then we should be voting on the Lower Costs, More Cures Act this 
week and move it forward for our people and provide cures at lower 
cost--and many more than the other countries that you are talking about 
tonight.
  Mr. SCOTT of Virginia. Mr. Chair, I yield 2 minutes to the 
gentlewoman from Washington (Ms. Schrier), a distinguished member of 
the Committee on Education and Labor, who, prior to her service in 
Congress, was a practicing physician.
  Ms. SCHRIER. Mr. Chair, I thank everyone who worked so hard on the 
Elijah E. Cummings Lower Drug Costs Now Act.
  As so many of my colleagues have said already, this is a 
groundbreaking bill.
  Medicare is the biggest purchaser of medications in the world, and it 
should absolutely have the power to negotiate costs, and we should not 
continue to pay three to four times more than the rest of the world for 
our medications.
  With negotiation, this bill saves hundreds of billions of dollars, 
and we are going to use that money well. Part is for research, but one 
of the ways is my bill, included in H.R. 3, that requires Medicare to 
cover vision care.
  Medicare part B covers cataract surgery and yearly glaucoma tests, 
but it does not cover routine eye exams, glasses, or contact lenses, 
and this is a tremendous gap in coverage for our seniors.
  We want to make sure seniors can live independently for as long as 
possible, and part of this is making sure they can see well enough to 
drive to appointments, walk safely around the house, and carefully read 
their prescription bottles. Also, poor vision can limit physical 
activity and increase isolation, leading then to deteriorating health.
  As a doctor, I am concerned about the number of older Americans who 
have not had an eye exam in well over a year and might have undiagnosed 
eye conditions. By expanding Medicare part B to cover vision care, we 
will ensure that older Americans will be able to access affordable 
care.
  Ms. FOXX of North Carolina. Mr. Chair, I yield 3 minutes to the 
gentleman from Pennsylvania (Mr. Keller).
  Mr. KELLER. Mr. Chair, I thank Ms. Foxx for yielding me time.
  Mr. Chair, I urge my colleagues to join me in opposing H.R. 3.
  While we can all agree that Americans pay too much for healthcare and 
that the rising cost of prescription medicine needs to be addressed, 
H.R. 3 is not the bill to accomplish those goals.
  Traveling across Pennsylvania's 12th Congressional District, I have 
met with patients and medical professionals who have told me that the 
best way to address rising prescription drug costs include patient 
reforms that will include patent reform to get generics to market 
faster, price transparency so consumers know the actual cost of the 
medication they are purchasing, and incentivizing innovation to help 
find new cures.
  Contrary to these goals, H.R. 3 would turn a blind eye to good 
bipartisan work done on this issue throughout 2019 that can provide 
real savings for our seniors and our families.
  H.R. 3 would lead to more government control over a private industry, 
putting this country on the road to socialized medicine. And H.R. 3 
would lead to fewer cures, with some estimates saying up to 100 fewer 
cures would be found as a result of this legislation.
  Mr. Chair, we have a bipartisan plan that has the support of doctors 
and patients alike. H.R. 19 would provide for more cures, create price 
transparency, and get generics to market faster.
  These are bipartisan solutions backed by doctors and pharmacists in 
Pennsylvania's 12th Congressional District, in the Commonwealth of 
Pennsylvania, and across our country.
  While Americans struggle to pay for the high cost of prescription 
drugs, we have real legislation that can help solve this real problem. 
We should not be wasting our time debating something that harms 
Americans by providing fewer cures and will never become law.
  Mr. Chair, again, I urge my colleagues to oppose this socialist 
fantasy in H.R. 3 and encourage us to work on the real bipartisan 
solutions in H.R. 19.
  Mr. SCOTT of Virginia. Mr. Chair, I yield 2 minutes to the 
gentlewoman from Connecticut (Mrs. Hayes), a distinguished member of 
the Committee on Education and Labor and a former National Teacher of 
the Year.
  Mrs. HAYES. Mr. Chairman, I rise in support of the Elijah E. Cummings 
Lower Drug Costs Now Act, a bill that would take power wielded and 
weaponized by massive drug companies and put it back in the hands of 
the American people.
  It is beyond unacceptable that families in my district and around the 
country are price gouged at the pharmacy counter and forced to make the 
impossible decision to either pay for their medication or put food on 
their table.
  H.R. 3 will save my constituents in Connecticut's Fifth suffering 
from diseases like diabetes, asthma, and arthritis, hundreds--even 
thousands--of dollars per year.

                              {time}  2100

  But perhaps the thing I am most proud of in H.R. 3 is that it 
includes a bill that I sponsored, the Supporting Trauma-Informed 
Education Practices Act. This bill will put drug companies who share 
responsibility for the opioid crisis on the hook for part of the 
solution.
  My bill would direct $100 million of the savings from drug pricing 
negotiations to grants that would improve trauma support services and 
mental healthcare for children and schools.
  As a Member of Congress who has spent a career in the classroom, I 
have seen the painful reality of too many schools having too few 
counselors and psychologists to tackle the complex needs of students 
suffering from abuse, neglect, and trauma.
  We need to commit to investing and implementing ongoing supports and 
wraparound services for every student who is affected, for every 
student who has faced loss or has been separated from their parents as 
a result of the opioid crisis.
  Drug companies are prioritizing profits over human lives in their 
cruel business calculus. Communities like Waterbury, Litchfield, and 
New Britain in my district desperately need help to fight this opioid 
crisis, which mirrors the crisis that consumers are currently facing 
with rising drug costs.
  I am proud that this bill also includes legislation I cosponsored 
that would lower drug costs for some of the most vulnerable members of 
the population.
  The Acting CHAIR (Mr. Levin of California). The time of the 
gentlewoman has expired.
  Mr. SCOTT of Virginia. Mr. Chair, I yield the gentlewoman from 
Connecticut an additional 30 seconds.
  Mrs. HAYES. The bill would also save older adults with limited 
incomes money and improve access to their needed medications.
  Mr. Chairman, my constituents cannot wait for change. Patients in 
rural communities cannot wait for change. The 22,000 Connecticut 
residents diagnosed with cancer each year cannot wait for change. The 
student in Meriden who has suffered as a victim of the opioid crisis 
cannot wait for change.
  I urge my colleagues on both sides of the aisle to recognize that our 
constituents need us. I urge my colleagues to vote in support of H.R. 
3.

[[Page H10116]]

  

  Ms. FOXX of North Carolina. Mr. Chairman, I yield 3 minutes to the 
gentleman from Wisconsin (Mr. Grothman).
  Mr. GROTHMAN. Mr. Chair, I also rise to speak against H.R. 3.
  To me, there are two segments of society in which the costs have gone 
out of control and are really broken. One is the secondary education 
system, and the other is the medical situation.
  It is not surprising that the two areas that prices have spun out of 
control since I was a child are two areas in which the government has 
been most involved; and, therefore, we should be very measured before 
we become involved in a lot more government prescription or mucking 
around the medical industry.
  And I say that as somebody who is no friend of the drug companies. I 
think their behavior has become absolutely deplorable.
  Nevertheless, we have to remember that, when it comes to new drugs 
right now on the market, other countries have a lot less access than we 
do in America. In that regard, America is still number one.
  Only 36 percent of the new drugs are allowed into Australia, 46 
percent in Canada, and under 60 percent in the U.K. We are still the 
envy of people in other parts of the world there.
  Of new cancer drugs launched in the last 8 years, 95 percent are 
available in the United States, 74 percent in the U.K., and less than 
50 percent in Japan.
  The thing to remember which is so frequently true: Government 
involvement can be good, but a lot of times government involvement can 
make things worse.
  The next frustrating thing about this bill is there are good things 
that both sides could agree on and could pass right away.
  We have heard a lot about H.R. 19 right now. One of their folks was 
talking about the high cost of insulin. We are doing things, or people 
would do things in H.R. 19, to rush more biosimilars to insulin to the 
market. They could have that victory tomorrow.
  But, for some reason, rather than vote on a bill they know will pass 
and will do a great deal to reduce the cost of prescription drugs, the 
other side has elected to bring forth a bill that they know will not 
pass, which comes down to the third point I am going to make: Why are 
they not passing a bill that would collect the vast majority of 
Republicans in the House and has a good chance of passing the Senate 
and being signed by President Trump?
  I reluctantly conclude that, one more time, they don't want to have a 
victory in these 2 years, for whatever motivation. And that is truly 
sad because these drug costs are out of control, and there are 
victories that can be taken today.
  But instead of passing a bill, given political reality, that can be 
brought to the floor, they will pass a bill on the House floor that 
they know is going to go nowhere in the Senate and that they know is 
going to delay the relief that people need.
  The Acting CHAIR. The time of the gentleman has expired.
  Ms. FOXX of North Carolina. Mr. Chairman, I yield the gentleman from 
Wisconsin an additional 30 seconds.
  Mr. GROTHMAN. They know it will delay that relief for at least 
another year.
  I have a bill I am going to talk about, myself, a little bit later.
  Mr. SCOTT of Virginia. Mr. Chair, I yield myself such time as I may 
consume.
  Mr. Chair, I just want to comment about a letter that we received 
from the American Federation of State, County and Municipal Employees. 
This letter states, in part: ``Enactment of H.R. 3 is needed because:
  ``It directs our government to stand on the side of all Americans and 
protect us from price gouging by directly negotiating for lower 
prescription drug prices.
  ``It creates a new $2,000 out-of-pocket limit on prescription drugs 
for people on Medicare.
  ``It reinvests Federal savings into much-needed new Medicare benefits 
to cover dental, vision, and hearing.
  ``The cost of inaction is too high. It is calculated in the suffering 
of individuals who are forced to ration their medicines or choose 
between buying medicines or paying for housing and groceries. 
Prescription drug companies must be made accountable. We urge you to 
send a clear message that Congress is on the side of all Americans by 
directing the government to directly negotiate for lower prescription 
drug prices. Please vote in support of H.R. 3.''
  Mr. Chair, I reserve the balance of my time.
  Ms. FOXX of North Carolina. Mr. Chairman, I yield 3 minutes to the 
gentlewoman from West Virginia (Mrs. Miller).
  Mrs. MILLER. Mr. Chairman, I rise today to oppose H.R. 3.
  Every single person in our country deserves lower prescription drug 
prices. Congress needs to act. But the bill on the floor today is not 
the answer.
  With this legislation, my colleagues across the aisle have decided 
that, once again, government should be in the business of healthcare, 
picking winners and losers, taxing lifesaving cures, and ignoring that 
private innovation is the main driver in advancing healthcare.
  House Republicans have a bipartisan solution, one which will deliver 
the transparency, affordability, and predictability we need: H.R. 19, 
the Lower Costs, More Cures Act.
  With this bill, we can make sure that every person--the parents of a 
newborn baby, a young adult with a chronic illness, a coal miner coping 
with black lung disease, or a senior citizen taking their daily pills--
has access to the drugs they need at the affordable, predictable prices 
they deserve.
  We need the innovators to be at the forefront of creating new, better 
drugs to improve quality of life for all Americans in need. H.R. 19 
delivers this. We can have it all. That is why I oppose H.R. 3.
  Mr. SCOTT of Virginia. Mr. Chairman, I yield myself such time as I 
may consume.
  Mr. Chair, I want to comment on a letter we received from the AFL-
CIO, a legislative alert. It says, in part, that ``3 in 10 adults 
report that they were unable to take their medicines as prescribed at 
some point in the past year because of the cost, often worsening their 
medical condition, according to the Kaiser Family Foundation. Yet 
according to AARP, the average annual cost of prescription drugs rose 
nearly 58 percent between 2012 and 2017. Prices in 2019 increased for 
3,400 drugs on the market, with an average price increase of 10.5 
percent, a rate roughly five times the inflation rate. . . . `'
  ``The Lower Drug Prices Now Act takes bold action to address this 
relentless rise in drug prices. . . . `'
  ``H.R. 3 reinvests the estimated $500 billion in Federal savings in 
historic improvements to Medicare benefits and other important 
healthcare programs. Medicare part D prescription drug coverage is 
substantially improved by the addition of a $2,000 out-of-pocket 
maximum. Medicare benefits are further expanded by the inclusion of 
vision, dental, and hearing benefits. To help low-income seniors, the 
legislation expands subsidy eligibility to make premiums and out-of-
pocket costs more affordable.
  ``Other investments in healthcare include $7.7 billion to support 
community responses to the opioid crisis and $10 billion for National 
Institutes of Health biomedical research toward the discovery of 
breakthrough drug therapies.
  ``The Lower Drug Prices Now Act will provide crucial assistance to 
working families who are currently unable to afford the medicines they 
need, while simultaneously making important investments to address 
other healthcare priorities. We urge you to vote for this bill.''
  Mr. Chair, I reserve the balance of my time.
  Ms. FOXX of North Carolina. Mr. Chairman, I yield 3 minutes to the 
gentleman from North Carolina (Mr. Murphy).
  Mr. MURPHY of North Carolina. Mr. Chairman, I rise tonight in 
opposition to H.R. 3.
  As a practicing surgeon for the last 30 years, I believe I give 
somewhat of a unique perspective on the unbearable high price of 
prescription drugs, an issue that all Americans can agree upon.
  I have seen patients and continue to see patients who simply cannot 
afford their medications. We all agree on this problem. Unfortunately, 
however, H.R. 3 is, while well intentioned, a poorly executed solution.

[[Page H10117]]

  Healthcare economics are unique, a fact that many here do not 
realize. Price controls do not work in healthcare. There is evidence to 
show that, in countries that implement price controls, only a fraction 
of medicines that come to market are actually available.

  I should know. I have worked across the globe. I have worked in 
places where I have tried to prescribe medications that I thought were 
best for patients, only to have government prevent me from doing so.
  In Australia, for example, only 36 percent of new drugs released 
between 2011 and 2018 were available. Canada and the United Kingdom 
hardly fared better with 46 and 59 percent.
  The American public does not deserve to be shortchanged.
  In my 30 years as a practicing surgeon, I have seen new drugs and 
treatments become available that 20, 10, and even 5 years ago patients 
could have only dreamed of. But curative therapies do not occur 
overnight. They occur by innovative and dedicated scientists who 
continue to be on the cutting edge of research and development.
  Yet it takes financial risks to develop these drugs. At present, less 
than 1 in 100 drugs that are being discovered actually ever come to 
market.
  H.R. 3 will gut companies with a 95 percent tax if they do not 
succumb to the government's strong-arm negotiation.
  As a urologist, I can personally attest to the leaps and bounds that 
have been made in drugs that treat advanced prostate cancer. In just 
the last 5 years, more progress has been made in metastatic prostate 
cancer than in the preceding 70 years. I can now talk to patients about 
outliving their cancers rather than succumbing to them.
  We can control drug costs. H.R. 19, the Lower Costs, More Cures Act, 
is a much better path. We should cut the billions spent on direct-to-
consumer advertising or the billions spent on pharmacy benefit 
managers. We need a surgical approach to cure this disease, not a 
heavy-handed hatchet job by an overreaching government.
  H.R. 19 leads to decreased costs while, at the same time, providing a 
pathway for the cures that so many patients desperately seek.

                              {time}  2115

  Mr. SCOTT of Virginia. Mr. Chairman, I yield myself such time as I 
may consume.
  I will point out that the question of availability of drugs in the 
United States came up at a hearing we had on this legislation. It was 
pointed out that the target negotiated price will be approximately 120 
percent of the international average. That is a lot better than the 
two, three, five, as much as 60 times higher Americans are paying for 
the same drugs here than in other countries.
  At that price, at 120 percent, that will be the highest price, and we 
will be the biggest market. They certainly won't take a drug away from 
the biggest market paying the highest price, so we don't have to worry 
about availability.
  I reserve the balance of my time.
  Ms. FOXX of North Carolina. Mr. Chairman, I yield myself such time as 
I may consume.
  Mr. Chairman, House Democrats have once again decided to pursue 
politics over progress and advance a radical drug pricing scheme that 
will eliminate choice and competition, and jeopardize innovation, 
investment, and access to future cures, putting breakthrough treatments 
for diseases like Alzheimer's, cancer, sickle-cell, and others at risk.
  As many as 100 lifesaving drugs--and that needs to be repeated, Mr. 
Chairman, as many as 100 lifesaving drugs--could be kept from Americans 
desperately in need because of Speaker Pelosi's socialist drug-pricing 
scheme. This is unacceptable.
  We shouldn't be pursuing policies that will harm the health and well-
being of American patients, and we shouldn't destroy a system that 
allows the U.S. to lead the world in new cures and treatments.
  Bottom line, this radical legislation offers fewer cures, and 
American families will suffer because of it.
  I strongly urge my colleagues to vote ``no'' on this seriously flawed 
bill, and I yield back the balance of my time.
  Mr. SCOTT of Virginia. Mr. Chair, I yield myself the balance of my 
time.
  Mr. Chair, last year, Congress made a promise to lower skyrocketing 
drug costs and strengthen our healthcare system for Americans. H.R. 3, 
the Elijah E. Cummings Lower Drug Costs Now Act, delivers on that 
promise. The legislation not only lowers the costs of prescription 
drugs for taxpayers and those enrolled in Medicare, but it also lowers 
the costs for workers, businesses, and families.
  It improves the quality of healthcare by expanding Medicare benefits 
to include vision, dental, and hearing benefits, and it limits the out-
of-pocket copays and deductibles to $2,000.
  It strengthens public health by investing in community health 
centers, and it provides historic funding for evidence-based student 
trauma services and the Child Abuse Prevention and Treatment Act. Both 
of these initiatives will help support children who have suffered abuse 
or trauma related to substance use disorder and the opioid crisis.
  The Elijah E. Cummings Lower Drug Costs Now Act is a long-overdue 
step to improve healthcare and the lives of Americans across the 
country, both today and for decades to come.
  Again, I thank Chairman Pallone, Chairman Neal, Speaker Pelosi, and 
other Democratic leaders for bringing this legislation to the floor, 
and I urge all of my colleagues to support this priority for the 
American people.
  Mr. Chairman, I yield back the balance of my time.
  The Acting CHAIR. The time of the Committee on Education and Labor 
has expired.
  Mr. SCOTT of Virginia. Mr. Chairman, I move that the Committee do now 
rise.
  The motion was agreed to.
  Accordingly, the Committee rose; and the Speaker pro tempore (Mrs. 
Hayes) having assumed the chair, Mr. Levin of California, Acting Chair 
of the Committee of the Whole House on the state of the Union, reported 
that that Committee, having had under consideration the bill (H.R. 3) 
to establish a fair price negotiation program, protect the Medicare 
program from excessive price increases, and establish an out-of-pocket 
maximum for Medicare part D enrollees, and for other purposes, had come 
to no resolution thereon.

                          ____________________