Combating Autism Reauthorization Act

Mr. President, I have come to the floor to pursue a unanimous consent request on something that is critical to families in my home State of New Jersey, which has the highest rate of autism, but is also critical to families across the country who have a loved one who faces--in the spectrum of autism and other developmental issues-- the need to get the help, so their child, their loved one, can fulfill their God-given capabilities.

Last Tuesday morning, a full week ago from today, I sent this bill before the Senate for unanimous consent, and that unanimous consent was cleared on the Democratic side, but it has not been cleared on the Republican side,

which has prevented this bill from passing.

This legislation was reported out of the Senate Health, Education, Labor, and Pensions Committee on September 7 without amendment and with unanimous support, Republicans and Democrats together. This result, the result of a bipartisan effort with Senator Enzi, who is the ranking member of the Health, Education, Labor, and Pensions Committee, is vital to ensuring that the programs created under the landmark Combating Autism Act of 2006 continue.

That bill was signed into law by President George W. Bush after passing the Senate on a unanimous consent. This long history of bipartisan support only adds to my confusion as to why there are colleagues on the other side of the aisle who are currently preventing the bill from passing.

This legislation has unanimous support from Democrats and strong bipartisan support throughout the Senate, including nine Republican cosponsors.

Without Senate approval, the Combating Autism Act will sunset at the end of next week, leaving countless families across our Nation without the support they need in caring for their children with autism.

This bill provides an additional 3 years of guarantees simply in the context of an authorization. Obviously, we would have to go through the appropriations process and there would have to be debate and it would be voted on the floor, but that authorization for 3 years at the fiscal year 2011 appropriated levels for the programs for the Centers for Disease Control and Prevention, the National Institutes of Health, and the Health Resources and Services Administration is vital to continuing our efforts on diagnosing autism spectrum disorder, advancing behavioral therapies to improve social abilities with those with autism, providing families with education and support services to better understand autism, and to coordinating Federal efforts on researching autism.

I have worked closely with Senator Enzi, who has been a cochampion in regard to this legislation and addressing all concerns. Since it cleared the Health, Education, Labor, and Pensions Committee with full bipartisan and unanimous support, I thought we had succeeded in addressing those concerns. I have not been approached or heard a single objection from any Republican as to why they might hold this bill, and I have been open in my willingness to work with the other side in addressing their policy concerns. Having not heard a single objection to the merits of this legislation--which, by the way, is an exact replica of what is being offered by the Republican majority in the House--I have to assume this is for reasons other than policy.

We have had a week to bring this forward. It has caused incredible uncertainty and unnecessary worry for the parents of children with autism as they wait anxiously to learn if the government is going to continue to reauthorize the very essence of the programs that have helped their children be able to fulfill their God-given potential to the maximum ability they can. I have met family after family who tell me this legislation has made an enormous difference in their lives. So I don't understand any reason, considering all the work that has been done, considering the bipartisan support, considering the House Republican majority is offering the same legislation, why we have not been able to pursue this.

Therefore, I ask unanimous consent that the Senate proceed to the consideration of Calendar No. 163, S. 1094, the Combating Autism Reauthorization Act; that the bill be read a third time and passed, and the motion to reconsider be laid upon the table, with no intervening action or debate.

Mr. President, I object.

First of all, I appreciate my colleague's offer and certainly we will take him up on it--to have a discussion to see if we can come to a common understanding because the issue is far more important than anyone's ideological views. I look forward to working with him and others who are concerned.

Let me say, however, there are some inconsistencies. If you do not believe there should be a disease-specific reauthorization, then the CR does exactly that. It will be for a more limited time, but it will, in fact, reauthorize this bill but only to November 18. So whether that debate is about reauthorizing a disease-specific allocation, which is what I was trying to accomplish, or whether in the CR, I assume it will be the thinking of my colleagues to object to the CR on the basis it has a disease-specific reauthorization for a much smaller period of time, until November 18. I am not quite sure how that logic follows at the end of the day.

Secondly, I think it is rather cruel to use an analogy that talks about loan guarantees to some energy entity and talking about autism and families. When I hear the word ``lobby,'' that, of course, creates a pejorative description. What is the lobby here? The lobby here is parents--American citizens, husbands and wives, taxpayers who advocate for their children before their representatives. I thought, in a representative democracy, citizens have the right to go to their elected representatives and advocate for a point of view--even if, admittedly, that point of view is on behalf of the welfare of their child.

So I have a problem when I hear, in this context, the word ``lobby,'' as if it is a negative when a universe of parents in our country who pay taxes are simply trying to accomplish getting their government's attention on a disease that afflicts their children and their ability to function in this society to the maximum potential their God-given abilities give them. I don't care about listening to a lobby. The last time I checked, this is what democracy is all about.

Finally, I would simply say there is no guarantee--I know my colleague suggested there is a guarantee--that research into autism will continue. There is no guarantee of that. There is no guarantee of that. The reason why I objected to the other unanimous consent by my colleague from Oklahoma is because, in fact, we have a set of circumstances, if we read that unanimous consent request, where there would be a diminution of funds at the end of the day. So we either believe in a disease-specific reauthorization, which to some degree would be allowed, but then we take away all the funds.

The whole reason this legislation came to being was to coordinate the very efforts of the Federal Government together to, in essence, meet the challenge of autism.

Even when we listen to debate on disease-specific legislation and the opposition to disease-specific legislation, I would emphasize that while the name would suggest this is only about autism, this improves services for children with many different developmental disorders and conditions--from autism, yes, but Down syndrome, cerebral palsy, spina bifida, intellectual disabilities, and epilepsy.

So it is a program that involves a number of efforts, broadly based, to prevent and detect and improve the health infrastructure for all children who might face any of these developmental disabilities, not just autism.

Every year this program trains thousands of professionals to better care for individuals with a broad range of developmental disabilities, including but not limited to autism spectrum disorders. Given the long waiting lists that families often endure to receive diagnostic and treatment services, these programs are essential in addressing an urgent national health need.

So, Mr. President, I don't quite understand the opposition. It boggles my mind. They are against disease-specific legislation even though this has passed by voice vote in the past? Even though this passed unanimously out of the committee? Even though a disease-specific provision will be in the CR, which I assume they would oppose if they don't want legislation to move forward? Then they tell families they are lobbyists, and they have no right to lobby, that we shouldn't listen to their voices? Then they say there will be--don't worry, there will be money for research, when there is no guarantee? That is cruel, in my view, and there is no reason for it.

I would only hope we can have a change of heart so we can have families who have an incredible challenge and who love their children and want to do everything they can to help them fulfill the maximum of their potential to be able to do so. That is what we have done for several years now under this legislation.

My God, if we can't get things like this passed, I don't know where we are headed in the Senate. But I hope for a better day, and I am going to continue and insist until we achieve this.

I yield the floor.

Mr. President, I thank the Chair for the recognition, and I wish to recognize the good work my colleague, the Senator from New Jersey, has done on this issue.

I have been in the Senate a little over 6 years and I was cajoled into allowing this to pass the last time it passed. I have blocked every other disease-specific piece of legislation, and there is a reason for that. Both the last Director of the NIH and the current one caution against us being specific in what we demand them to do. There is a reason for that. Our science is changing enormously--enormously. We are now at the molecular level, at the genetic level, and at the immune level of thousands of diseases. What we research in diabetes now has prevalence for neurosciences. What we research in neurosciences now has prevalence for tons of other diseases. Dr. Zerhouni has said: Please don't do this.

I am known in this body to be a stickler on spending, but if there were two areas I would increase spending in our budget it would be to the NIH and to the National Science Foundation--both of them--and I recently reported out a report that was somewhat critical of some of the spending on the National Science Foundation. We can do

everything better. But the important aspect is no one who is opposing the reauthorization of this bill right now is opposed to autism research or the ideas behind it. What we are opposed to is tying the hands of the researchers and the Directors at NIH and telling them what they should do and how they should do it.

I would also dispute the fact the money will go away. The CR we are going to consider this week will continue this funding at the level it is until November 18, which gives us plenty of time to work with Senator Menendez to work out some of our problems with this piece of legislation. So we come to this debate in good faith. We recognize the emotional ties associated with such a devastating disease. As an obstetrician and pediatrician, I have diagnosed it. I have treated it. I have sat with the families as they have suffered through the consequences of this disease. I don't take it lightly. But I also don't take lightly our inability to make the clear choices and ratchet around the moneys for the NIH.

What we should do is say: NIH, here is your money. Go where the science helps the most people in the quickest way and where the science leads us. At a time when our country is desperate to get our fiscal house in order, what we want is the most efficient NIH. What we want is nonduplicative grants at the NIH. What we want is no fraud in the grants associated with autism, which have been published and which people are now in jail for. We want that eliminated. We want the oversight on the NIH to be across the board in every area. Are they doing what we are asking them to do to spend the money wisely and what the science would tell them to do, not what any one particular interest group would tell them to do?

So I ask unanimous consent that the Senate proceed to the immediate consideration of S. 1094, the Combating Autism Reauthorization Act, and that my amendment at the desk related to requiring the Secretary of HHS to identify and consolidate duplicative and overlapping autism funding throughout the Federal Government be agreed to, the bill, as amended, be read a third time and passed, the motions to reconsider be laid upon the table with no intervening action or debate, and any statements related to the bill be printed in the Record.

I understand that. My commitment is to work with the Senator from New Jersey to try to solve this problem before any funding would change, and I don't think it is going to change.

I would also note for my colleagues that last year we had over $450 billion appropriated by the appropriators that was not authorized for anything. There were no authorizations at all. So this money isn't going to go away. There is no hurry. There is no tragedy. We can continue, and we can work as colleagues to try to solve our problems as well as meet the demands the Senator from New Jersey thinks must be met.

With that, I yield the floor.

Mr. President, on behalf of myself and several colleagues, I object.

Mr. President, I wish to commend my colleague for his attention to this issue. Autism is a very difficult issue for many families, and the incidence of autism in our country is growing. I am thankful Congress, in its wisdom, a number of years ago, established agencies such as the Centers for Disease Control and the National Institutes of Health, where we have scientists and physicians and many others who are dedicating themselves to researching not just autism but cures for many diseases.

I appreciate again my colleague bringing this up, but I am afraid this is another example of political good intentions having many unintended consequences. The lobby to support autism is definitely very strong, and we appreciate that, but there are many diseases that children and people throughout our country face. We have put experts in place to determine where we can spend the money we allocate for medical research, and we need to leave that to the experts.

We have seen unintended results when our government tries to pick winners and losers. We tried to do it in the solar business 1 year or so ago. There are many companies in the solar business, but we picked one, and we didn't exactly know what we were doing. We gave $\1/2\ billion dollars to an effort that turned out not to be the best place to send taxpayer money.

Autism research will continue, and I think that is something we need to make very clear. The people we have put in charge of doing medical research will continue to do that medical research. The Congress does not have to decide how much we are going to spend on all the different diseases that affect Americans. There are many children facing diseases we don't understand, and they do not have the lobby many other diseases have. We cannot, from a political perspective, in an attempt to demonstrate our compassion, try to direct all the scientific and medical research from the floor of the Congress.

So I wish to make it clear that all of us who object support autism research. We will continue to try to make sure the funding for medical research is there. But it makes absolutely no sense for us, from where we sit, to try to play scientists and physicians and to know where the best outcomes will be and where we get the most for our money. If we are going to do that, we might as well decide what kind of medical equipment is going to be used or what kind of drugs are going to be used, and we certainly don't have that capability.

I am very thankful Dr. Coburn has taken up this issue for years and urged us to leave the decisions for medical research in the hands of those who understand it. Our job, as a Congress, is to continue to appropriate the money, which we will, for medical research. Autism research will continue, as well as research for many other diseases. Hopefully, we can make sure that funding is there because many families are suffering and we need to make sure we do our part in the research area.

So I welcome my colleagues in the majority bringing this bill to the floor for debate. We certainly are not blocking debate on this issue. But passing something such as this, without any debate and without any open vote, is not what Congress should be doing right now.

I thank the Chair, and I yield the floor.

Mr. President, I want to address a very important issue that is currently before the Senate. This past Tuesday I submitted a bill to the Senate--the Combating Autism Reauthorization Act, S. 1094-- for a unanimous consent agreement. Since then, the Republicans have blocked this bi-partisan bill from passing. The Health, Education, Labor and Pensions Committee reported this legislation unanimously on September 7, 2011.

My legislation is a simple 3-year extension of the Combating Autism Act, CAA, of 2006. This original legislation was passed out of the Senate by unanimous consent on December 7, 2006, and signed into law shortly thereafter. This landmark legislation included provisions relating to the diagnosis and treatment of persons with autism spectrum disorders, ASD, and expanded and intensified biomedical research on autism, including a focus on possible environmental causes. Additionally, it provides for detailed surveillance by the Centers for Disease Control and Prevention, CDC, of the increasing prevalence of autism spectrum disorders, ASD. The Act also reconstitutes the Interagency Autism Coordinating Committee to advise the Secretary, coordinate the federal response to autism and develop the annual strategic plan for autism research.

I am greatly disappointed that my colleagues on the other side are playing politics with this bill. On September 30, just a couple of short weeks from now, the programs authorized under the CAA sunset, and with them the myriad programs which have helped families better understand, treat and live with ASD. Now is not the time for politics. Now is the time to reauthorize the Combating Autism Act so families living with ASD can continue receiving the care and support they deserve.

Mr. President, I would like to announce that the Committee on Indian Affairs will meet on Thursday, July 28, 2011, at 2:15 p.m. in Room 628 of the Dirksen Senate Office Building to conduct a hearing entitled ``Enforcing the Indian Gaming Regulatory Act--The Role of the National Indian Gaming commission and Tribes as Regulators.''

Those wishing additional information may contact the Indian Affairs Committee at (202) 224-2251.

Mr. President, I would like to announce that the Committee on Indian Affairs will meet on Thursday, July 28, 2011, at 2:15 p.m. in room 628 of the Dirksen Senate Office Building to conduct a business meeting to consider: S. 546, a bill to extend Federal recognition to the Little Shell Tribe of Chippewa Indians of Montana, and for other purposes; S. 379, a bill to extend Federal Recognition to the Chickahominy Indian Tribe, the Chickahominy Indian Tribe-Eastern Division, the Upper Mattaponi Tribe, the Rappahannock Tribe, Inc., the Monacan Indian Nation, and the Nansemond Indian Tribe; S. 1218, a bill to provide for the recognition of the Lumbee Tribe of North Carolina, and for other purposes; S. 703, a bill to amend the Long-Term Leasing Act, and for other purposes; and S. 636, a bill to provide the Quileute Indian Tribe Tsunami and Flood Protection, and for other purposes, to be followed by an oversight hearing entitled ``Enforcing the Indian Gaming Regulatory Act--The Role of the National Indian Gaming Commission and Tribes as Regulators.''

Those wishing additional information may contact the Indian Affairs Committee at (202) 224-2251.

committee on health, education, labor, and pensions