Alzheimer’s Accountability and Investment Act

Mr. President, thanks to Senator Collins for her longtime leadership on this issue.

There is no more important issue in our country than the scourge of Alzheimer's. My mother, like Senator Collins's father, succumbed to Alzheimer's. But today, there are very few families in our whole country that do not have a similar story, some relative who has had Alzheimer's.

My mother was diagnosed, and she was a brilliant woman. She was president of her senior class in high school.

But her mother died--my grandmother--when my mother was 17. She had to be the mother and raise her three younger sisters so she never got to go to college. She ultimately finished raising the first family. Then, at 37, she married my father who was a milkman and then had me at 39 and my two brothers at age 40 and then she raised us.

Now, my mother was a completely brilliant woman. She could do calculus for fun at the table, even though she never had calculus in school. And my father used to say, after my mother contracted Alzheimer's, your mother was a brilliant woman. It was an honor that your mother married me. Your mother is never stepping foot in a nursing home. No one is touching your mother at 2 a.m. in the morning. It was an honor that she married me.

And so at age 80, 82, 84, 86, 88, 90, my father kept my mother in our living room. That is my story. That is my family's story. That is Senator Collins's story. That is the story of millions of families in our country.

Alzheimer's is a scourge that needs to be defeated.

And so I learned a lot from my father and his dedication to my mother. He was a milkman for the Hood milk company. He was 6 feet 1 inch, 265, so he could do it. But many families cannot do it, especially when it is the man who has Alzheimer's and not the woman-- although, two-thirds of all Alzheimer's cases are women. Can I say that again? Two-thirds of all Alzheimer's cases are women in our country. So these families are heroes, but heroes need help.

So in the House, as Senator Collins is leading in the Senate, we were able to pass the first law. And the first law said to the National Institutes of Health: Break down all the silos at NIH and all of your institutes. You all have information on the brain, and you don't even share that information on the brain. The Institute on Aging is not sharing with Infectious Diseases what you know about the brain. Break down all the silos and put together a plan to find the cure by 2025.

I was leading in the House; that was my bill. Senator Collins was doing it in the Senate; that was her bill. That became the law in 2011.

But we realized by 2014 that a vision without funding is a hallucination. Right now in our country between Medicare and Medicaid, our country spends the equivalent of one-third of the defense budget's money every single year just on Alzheimer's patients--one-third of the defense budget.

By the year of 2050, at the pace at which Alzheimer's is advancing, the Alzheimer's budget in our country will equal the defense budget because no one is saying that grandma shouldn't have a nursing home bed because she has Alzheimer's. That is not going to happen in our country. So finding a cure is absolutely not an option.

And so in 2014, we passed another law. And that law said that each year the NIH has to tell the Senate Appropriations Committee and the House Appropriations Committee how much money they needed to find the cure for Alzheimer's by the year 2025. Well, back then, it was about $500 million a year that was spent to fund research.

Last year, because of that law--Senator Collins leading in the Senate, along with me--we are up to $3.7 billion a year because, obviously, prevention is preferable to cure. Let's stop it. Let's try to get this right at its beginnings.

And we made some progress, but we are not going to find the cure by 2025. So what this legislation says is we are extending it out to 2035, and we are going to continue both of these programs to make sure that it gets the focus at the NIH so that we will find the cure because research is medicine's ``field of dreams'' from which we harvest the findings that give hope to families that there will be a cure for the disease which has been ravaging their family for generations. Alzheimer's is the one disease that we all know almost every family in our country has in common.

So President Kennedy created a mission to the Moon in 1961, and our country responded to it. And what these two bills that we are passing today have done is they have created a mission to the mind. They have created a mission to find what is going wrong with the brains of not just people in our country but all around the world because we are going to have to find the cure. And it is our responsibility here to provide leadership in the U.S. Senate, to keep the plan in place, and to find the funding that will have the best, brightest young scientists in America make careers out of finding the cure for Alzheimer's.

The same thing is happening with cancer. The same thing is happening with HIV. But we have to focus here on Alzheimer's and keep that investment rising and rising because patients deserve it; families deserve it; caregivers across our country deserve it.

We have millions of families right now--as Senator Collins just said, 7 million families--who have this disease in their families right now, and there is no cure. The end result is always inexorable. It is always inevitable. It always ends the same way. And so we are the only way in which this can be solved.

So 3.7 billion a year--or 4 billion a year--that is a small price to pay against the disease which will ultimately cost the Federal Government the equal amount as the Defense budget every single year by 2050. So we have to act. And we have come a long way on research. But we have a long way to go.

So here is what we hope: We hope to promote healthy aging; to reduce risk factors; to require the National Alzheimer's Plan to include recommendations on reducing health disparities for Black, Brown, and disabled Americans, because that is all part of this storyline--along with women, they are in a separate and higher risk category than men are--and expanding the National Alzheimer's Advisory Council to ensure a true whole-of-government approach to preventing, treating, and curing Alzheimer's and supporting family caregivers. That is why we can't delay another day.

So I urge my colleagues to celebrate today. We have just passed two historic pieces of legislation. And it sets 2035 as the target date. And we can get this done, but we have to finish the job.

And today's vote is going to clear the path for millions of Alzheimer's patients and their families, for them, their loved ones, and for the communities all across our country.

And so I thank Senator Collins for her great, great leadership on this. And my family and Senator Collins's family, we stand here speaking for the 7 million families. And there will be many more to come if we don't find a cure. And we thank the Members of the Senate for passing this historic legislation today.

With that, I yield the floor.

Mr. President, I rise today to support passage of two bipartisan bills aimed at continuing the significant progress we are making in treating and, one day, preventing and curing Alzheimer's disease.

These bills--S. 133, the National Alzheimer Project Act, or NAPA, as it is referred to, Reauthorization Act, and S. 134, the Alzheimer Accountability and Investment Act would help coordinate the tools of the Federal Government toward reaching these important goals.

And I would note, on the floor is the cochair of the Alzheimer's task force in the Senate, Senator Markey, along with the other two cosponsors we are fortunate to have, Senators Warner and Capito.

When I first joined the Senate in 1997, there really wasn't much of a focus on Alzheimer's in Washington. It was often called senility and was thought of not as a disease but just as part of growing old.

To increase public awareness of Alzheimer's disease, to advance research, and to bring the disease to the forefront of the Congressional agenda, I founded the Congressional Task Force on Alzheimer's in 1999 here in the Senate.

A true milestone in focusing our efforts was the passage of the Bipartisan National Alzheimer's Project Act that I coauthored with then-Senator Evan Bayh in 2011.

Before we passed that legislation, which became known as NAPA, there was no coordinated strategic plan to focus our efforts to defeat this devastating disease and ensure that our resources were maximized and leveraged.

NAPA tackled this problem by convening a panel of experts to create a coordinated strategic plan to prevent and effectively treat Alzheimer's disease by the year 2025, an ambitious goal, to be sure.

The expert council updates its plan annually. While the 2025 goal regrettably will not be met, it was still important to set an ambitious objective in order to spur research and to instill hope.

And, indeed, since then, researchers have made great strides in understanding this complex disease. To put our progress in context, 20 years ago we knew of only four genes that were associated with Alzheimer's disease. Now, researchers have identified more than 70 associated genetic areas, opening multiple new avenues for potential prevention and treatment.

There is another point that helps put this into perspective. In the early 2000s, the only sure way to know whether a person had Alzheimer's was through an autopsy.

Since then, the National Institutes of Health Research has led to the development of imaging techniques, biomarker tests, and data-driven approaches to enable more precise and earlier diagnoses.

And, most recently, decades of NIH research have paved the way for disease-modifying therapies targeting amyloid plaques' role in certain dementias.

After directing this decade of progress, the National Alzheimer's Project Act law is scheduled to expire soon. We must reauthorize the law to ensure that research investments remain coordinated to maximize their impact.

Toward that end, I introduced the NAPA Reauthorization Act with Senator Warner, which would extend NAPA through 2035 and modernize the legislation to reflect the strides that have been made to better understand the disease, such as including a new focus on promoting healthy aging, reducing risk factors, and supporting family caregivers.

The NAPA Reauthorization Act will allow the important work of the expert panel to continue through 2035. Among its provisions, the bill would reauthorize and expand the Advisory Council that assists annually in the development and evaluation of the National Plan. It will also ensure that underserved populations, including individuals with Down syndrome who are at greatly increased risk for Alzheimer's as they age, are included in this important work.

I have also introduced the Alzheimer's Accountability and Investment Act with my colleague from Massachusetts who has been such a leader in this area. It would continue through the year 2035 a requirement that the NIH submit an annual budget directly to Congress, estimating the funding necessary to fully implement NAPA's research goals.

Only two other areas of biomedical research--cancer and HIV/AIDS-- have been the subject of special budget development aimed at speeding discovery. This ``bypass budget'' helps us understand what additional funding is required to find better treatments, a means of prevention, and ultimately a cure.

As cochair along with Senators Warner, Capito, and Markey of the Congressional Task Force on Alzheimer's, I am committed to this effort both on a personal level as well as professionally as a Senator concerned about the impact on our families and our healthcare budgets.

On a personal level, I know just how devastating this disease is. I just recently lost my brother-in-law to the disease. My father, grandfather, and two of my uncles also succumbed to Alzheimer's. It is truly a heartbreaking disease. It is heartbreaking when you talk to a loved one and receive only a confused look in reply.

Alzheimer's disease is also one of the greatest health challenges of our time. It is currently ranked as the seventh leading cause of death in the United States, and nearly 7 million Americans are living with the disease. It is also one of the most expensive diseases for society, costing an estimated $360 billion last year alone.

Reauthorization of NAPA and the Alzheimer's Accountability and Investment Act would ensure our country is maintaining momentum in our fight against Alzheimer's, just as our investments in research are beginning to translate into promising new treatments.

Both laws have no mandatory spending effects, according to the Congressional Budget Office. Both bills are cosponsored by nearly half the Members of this Senate. Both bills have wide-ranging support from national stakeholders, including the Alzheimer's Association, Us Against Alzheimer's, the National Down Syndrome Society, and the National Down Syndrome Congress. And both bills were reported out of the Senate HELP Committee with broad bipartisan support last summer.

In order to change the trajectory of this disease that otherwise is projected to claim the minds of 13.8 million seniors and nearly surpass $1 trillion in annual costs by 2050, Congress has a responsibility to pursue effective public policy.

Ultimately, I think we are going to discover that this is a multifactorial disease, and that is why all of the research that is going on is so critical to finding effective treatments, a means of prevention, and, one day, a cure. And that is the purpose of these two bills.

Madam President, I rise today to introduce two bills aimed at continuing the important progress we are making to prevent and effectively treat Alzheimer's disease. I know how devastating this disease is to our families. My father, grandfather, and two uncles all died from Alzheimer's. I am committed to this effort both as a person whose beloved family members have suffered from this terrible disease, as well as a Senator concerned about the impact on our families and our healthcare system.

When I founded the Congressional Alzheimer's Task Force in the Senate in 1999, there was virtually no focus on Alzheimer's in Washington. Twelve years ago, I coauthored the bipartisan National Alzheimer's Project Act with my colleague Senator Evan Bayh. Before we passed that legislation, there was no coordinated, strategic, national plan to focus our efforts to defeat Alzheimer's. NAPA fixed this by convening a panel of experts to create a coordinated strategic national plan to prevent and effectively treat Alzheimer's disease by 2025. The expert council updates the plan annually.

While the 2025 goal has been elusive, we have made some progress in our efforts to find a treatment and a means of prevention. Nevertheless, Alzheimer's remains the fifth leading cause of death in the United States for people over 65. In addition to the human costs, caring for people living with Alzheimer's and other dementias is one of the costliest conditions to society, costing our Nation an astonishing $321 billion per year, including $206 billion in Medicare and Medicaid spending. If we continue along this trajectory, Alzheimer's is projected to claim the minds of 12.7 million seniors and nearly surpass $1 trillion in annual costs by 2050.

It takes a tremendous toll on families too. In 2021, family caregivers provided 16 billion hours of unpaid care for loved ones with dementia, a contribution to society valued at more than $271 billion. That job is often 24/7 and often harms the health of the caregiver.

The first bill I am introducing today with my colleagues Senators Warner, Capito, Markey, Moran, Menendez, Murkowski, and Stabenow is the NAPA Reauthorization Act. This bill would reauthorize the National Alzheimer's Project Act through 2035 and modernize the legislation to reflect strides we have made in understanding the disease, such as including a new focus on promoting healthy aging and reducing risk factors. The National Alzheimer's Project Act is set to expire in 2025. We need to reauthorize this critical legislation this Congress in order to ensure that our research investments remain coordinated and there are no disruptions as we maximize the impact of our investments.

The second bill I am introducing with my colleagues Senators Markey, Capito, Warner, Moran, Menendez, Murkowski, and Stabenow is the Alzheimer's Accountability and Investment Act. This bill would continue through 2035 a requirement that the Director of the National Institutes of Health submit an annual budget to Congress estimating the funding necessary for NIH to fully implement NAPA's research goals. Only two other areas of biomedical research--cancer and HIV/AIDs--have been the subject of special budget development aimed at speeding discovery, and this ``bypass budget,'' as it is known, helps us to understand what additional funding is needed to find better treatments, a means of prevention, and ultimately a cure for Alzheimer's disease.

Nearly half of baby boomers reaching age 85 will either be afflicted with Alzheimer's or caring for someone who has it. In many ways, Alzheimer's is the defining disease of this generation. We have made tremendous progress in recent years to boost funding for Alzheimer's research, most recently providing $3.74 billion--a $226 million increase--for NIH Alzheimer's research in the fiscal year 2023 government funding bill. This investment holds

great promise to ending this disease that has had such a devastating effect on millions of Americans and their families, but we must keep up this momentum. The two bills I introduce today will make sure that we do not take our foot off the pedal just as our investments in basic research are beginning to translate into potential new treatments. We must not let Alzheimer's define our children's generation as it has ours.

I urge my colleagues to support the NAPA Reauthorization Act and Alzheimer's Accountability and Investment Act, and I thank the Alzheimer's Association and UsAgainstAlzheimer's for their support of this bipartisan legislation to help improve the lives of those affected by Alzheimer's throughout the country.

Madam President, I rise today to introduce two bills aimed at continuing the important progress we are making to prevent and effectively treat Alzheimer's disease. I know how devastating this disease is to our families. My father, grandfather, and two uncles all died from Alzheimer's. I am committed to this effort both as a person whose beloved family members have suffered from this terrible disease, as well as a Senator concerned about the impact on our families and our healthcare system.

When I founded the Congressional Alzheimer's Task Force in the Senate in 1999, there was virtually no focus on Alzheimer's in Washington. Twelve years ago, I coauthored the bipartisan National Alzheimer's Project Act with my colleague Senator Evan Bayh. Before we passed that legislation, there was no coordinated, strategic, national plan to focus our efforts to defeat Alzheimer's. NAPA fixed this by convening a panel of experts to create a coordinated strategic national plan to prevent and effectively treat Alzheimer's disease by 2025. The expert council updates the plan annually.

While the 2025 goal has been elusive, we have made some progress in our efforts to find a treatment and a means of prevention. Nevertheless, Alzheimer's remains the fifth leading cause of death in the United States for people over 65. In addition to the human costs, caring for people living with Alzheimer's and other dementias is one of the costliest conditions to society, costing our Nation an astonishing $321 billion per year, including $206 billion in Medicare and Medicaid spending. If we continue along this trajectory, Alzheimer's is projected to claim the minds of 12.7 million seniors and nearly surpass $1 trillion in annual costs by 2050.

It takes a tremendous toll on families too. In 2021, family caregivers provided 16 billion hours of unpaid care for loved ones with dementia, a contribution to society valued at more than $271 billion. That job is often 24/7 and often harms the health of the caregiver.

The first bill I am introducing today with my colleagues Senators Warner, Capito, Markey, Moran, Menendez, Murkowski, and Stabenow is the NAPA Reauthorization Act. This bill would reauthorize the National Alzheimer's Project Act through 2035 and modernize the legislation to reflect strides we have made in understanding the disease, such as including a new focus on promoting healthy aging and reducing risk factors. The National Alzheimer's Project Act is set to expire in 2025. We need to reauthorize this critical legislation this Congress in order to ensure that our research investments remain coordinated and there are no disruptions as we maximize the impact of our investments.

The second bill I am introducing with my colleagues Senators Markey, Capito, Warner, Moran, Menendez, Murkowski, and Stabenow is the Alzheimer's Accountability and Investment Act. This bill would continue through 2035 a requirement that the Director of the National Institutes of Health submit an annual budget to Congress estimating the funding necessary for NIH to fully implement NAPA's research goals. Only two other areas of biomedical research--cancer and HIV/AIDs--have been the subject of special budget development aimed at speeding discovery, and this ``bypass budget,'' as it is known, helps us to understand what additional funding is needed to find better treatments, a means of prevention, and ultimately a cure for Alzheimer's disease.

Nearly half of baby boomers reaching age 85 will either be afflicted with Alzheimer's or caring for someone who has it. In many ways, Alzheimer's is the defining disease of this generation. We have made tremendous progress in recent years to boost funding for Alzheimer's research, most recently providing $3.74 billion--a $226 million increase--for NIH Alzheimer's research in the fiscal year 2023 government funding bill. This investment holds

great promise to ending this disease that has had such a devastating effect on millions of Americans and their families, but we must keep up this momentum. The two bills I introduce today will make sure that we do not take our foot off the pedal just as our investments in basic research are beginning to translate into potential new treatments. We must not let Alzheimer's define our children's generation as it has ours.

I urge my colleagues to support the NAPA Reauthorization Act and Alzheimer's Accountability and Investment Act, and I thank the Alzheimer's Association and UsAgainstAlzheimer's for their support of this bipartisan legislation to help improve the lives of those affected by Alzheimer's throughout the country.

Mr. Speaker, I move to suspend the rules and pass the bill (S. 134) to require an annual budget estimate for the initiatives of the National Institutes of Health pursuant to reports and recommendations made under the National Alzheimer's Project Act.

Mr. 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 in the Record on the bill.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise in support of S. 134, the Alzheimer's Accountability and Investment Act led by Senators Collins and Markey. The House companion bill, H.R. 620, is led by Representatives Smith of New Jersey and Tonko.

In the United States, health and long-term costs for individuals living with Alzheimer's disease and other dementias are projected to reach $360 billion in 2024. Around 64 percent of these costs are expected to be covered by Medicare and Medicaid with patients on the hook for the other $90 billion in out-of-pocket spending.

This tremendous cost does not even include the value of our unpaid caregivers, which was estimated to be $350 billion in 2023, amounting to over 18 billion hours of care.

In addition, individuals with dementias are more likely to have other chronic conditions, such as heart disease, diabetes, and kidney disease.

This bill would require the NIH to submit an annual budget estimate to Congress so that we may effectively assess the current resources needed to achieve the goals of the National Alzheimer's Project.

Continued investments in research to prevent and treat Alzheimer's disease and dementia will improve the quality of life for millions of Americans, with the simultaneous hope of achieving significant long- term financial savings.

I encourage my colleagues to support this bill, and I reserve the balance of my time.

Mr. Speaker, I have no further speakers, I am prepared to close, and I reserve the balance of my time.

Mr. Speaker, in closing, I encourage a ``yes'' vote on this bill, and I yield back the balance of my time.