Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. Mr. President, this is the first time in 11 years that the chairman of the Labor, Health and Human Services, and Education Subcommittee has had a…
Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.
Mr. President, this is the first time in 11 years that the chairman of the Labor, Health and Human Services, and Education Subcommittee has had a chance to stand on the floor and present a bill. It is a subcommittee that I am honored to chair. As a subcommittee member, I am honored to get to serve on that committee with the Presiding Officer. It is a subcommittee that is led on the other side by Senator Murray from Washington, the ranking member on this committee.
This is not a bill that either Senator Murray nor I would have drafted on our own, but our job was not to draft a bill that I thought was the perfect bill for me to vote for or the perfect way for all of these agencies to be run. There is a reason that this bill has not been on the floor in 11 years. It is big. It is complex. It can be contentious. But Senator Shelby, the chairman of the full committee, and Senator Leahy, the lead Democrat on the full committee, have made an incredible, good-faith effort to come to the floor with a bill that focuses on how we spend the money.
There is not much new in this bill about all of the things we could try to determine about social policy and about issues that all of us feel strongly about, but there are other committees whose principal job is to do that. Our committee's principal job is to decide how we establish the priorities for the country and how we spend the money.
Senator McConnell and Senator Schumer have also both had to agree that if we are going to get these appropriations bills on the floor, if we are going to have all of the Members of the Senate--for the first time, in the case of this bill--get a chance to debate this bill for the first time in 11 years, that is not going to happen if we try to have a big authorizing bill and a big appropriating bill all wrapped into one.
I see the ranking member has come to the floor right after I praised him and Senator Shelby for the unique leadership they have had that has allowed us to get this bill on the floor.
This bill deals with everything from medical research to home energy assistance, to employment opportunities, training programs, and Pell grants for people who are trying to go to college who don't have the resources that would allow them to do that otherwise. It is the largest of the nondefense discretionary bills. About 30 percent of all of the nondefense spending is in this one bill.
We take that bill and add it to the defense spending bill, and suddenly we are looking at roughly 62 percent of all of the spending of the Federal Government. That still sounds like a pretty big bill, but it is the first time in the case of the Labor, Health, Human Services, and Education Subcommittee--and then we have that unique add-on, ``and Related Agencies,'' just to get the footprint even a little bigger--in over a decade that Members have been able to come to the floor and say: No, we would like you to spend the money here rather than here.
By the way, as the Presiding Officer understands, to do that, that Member also has to say: Here is where we are going to take the money from to pay for it.
So it is not just on the floor and you get to make up all of the spending you want to that those of us on the appropriating committee didn't have a chance to do. There is still a finite amount of money.
So for the Presiding Officer's amendment, the Kennedy amendment, which will be offered right after we finish this morning's discussion and go to votes, he had to come up with an amount of money to pay for that.
I am fully supportive of the amendment that he and Senator Reed came up with to deal with the pressing issue of suicide prevention and the disturbing suicide rates. In my State of Missouri, suicide rates have increased by 36 percent above where they were in the year 2000--a 36- percent increase. Too many of those are our veterans. Too many of those are people who serve on the frontlines of homeland security, police, and veterans. All of that is something we need to look at. Here is the Presiding Officer's opportunity, which he took, to say: No, I think there is a better way to spend some of this money than how the committee spends it. That is what we missed for the last 11 years, when 69 of the Senators didn't have any say as to what the 31 of us who serve on the Appropriations Committee need to debate and talk about.
So we now bring this bill to the floor. There were 6,164 ideas that came to Senator Murray and me--6,164 Member requests of ideas as to how this could be the best possible bill. I think most of those are reflected in what we did.
In this bill, we talk about fighting the opioid epidemic. We talk about promoting college affordability, strengthening the workforce, and having people better prepared for the jobs that are out there to be filled than they would otherwise see.
Now, both sides would approach drafting this bill differently. We would both start out with some significantly different sets of priorities. We have
been able to reach an agreement that neither of us would have drafted on our own, but that is not the job that we were given. We have been able to present a bipartisan bill to the full committee and have that bill referred out of the full committee with 30 ``yes'' votes and 1 ``no'' vote, and now we are bringing that bill to the Senate floor.
It represents a compromise on both sides. It represents taking a step back on issues that authorize on both sides, which we can deal with at a later time. I certainly appreciate not just the leadership of Senator Leahy and the leadership of Senator Shelby but also the leadership of Senator Murray in helping to determine what those priorities would be and should be.
I see Senator Leahy is standing on the floor, and I am glad to yield to him for a comment.
Mr. President, I thank the Senator from Vermont for his leadership. Again, this is the first time in over a decade for the 69 people who aren't on the Appropriations Committee to get to come to the floor and offer amendments and think about what this bill does.
Let's talk about some of the things it does. We worked really hard over the last 4 years to do the kinds of things we ought to do in healthcare research. This bill, for the first time, reaches a long-held goal of the national plan to address Alzheimer's disease, of getting those annual research dollars up over $2 billion--in fact, $2.34 billion, exceeding what had been a long-term goal. The goal should not be how much money we spend. It should be finding a way to solve this problem. This is a significant increase over last year. It quadruples where we were 4 years ago. We spent 277 billion tax dollars a year on Alzheimer's and dementia-related care. A lot more private money is spent than that--three times that amount in private money--and there is lost work as caregivers step back to help people with these terrible diseases of dementia and Alzheimer's. But here is $277 billion. So this bill does about 1 percent of that in research to try to solve a problem that taxpayers are overwhelmed by. It is a problem that by 2050, if we don't find a solution, we will be spending about twice today's defense budget on Alzheimer's care, twice today's defense budget--$1.1 trillion of today's dollars being spent on Alzheimer's care if we don't do what we need to. This is the only leading cause of death that doesn't have a treatment, doesn't have a cure, doesn't have a way to prevent it, and, obviously, the right kind of discovery, the right kind of medical advancement that can change the lives of millions of American families now and in the future if we do this.
I am pleased to see we are making that investment. I am also pleased to see that after a 12-year period, when there wasn't any increase in healthcare research spending at all, we continue to find money, in many cases by eliminating programs that weren't working, to where we had a 30-percent increase in NIH funding over the last 4 years. What a 4 years to be doing that--understanding the things we know now about the human genome, understanding how each of us is different than all the rest of us and that, in fact, each of us has a different capacity to fight disease than any other person does. If you can figure out how to maximize that, such as things like immunotherapy in cancer, where many cancers that 5 years ago were largely untreatable--and if they were treatable, they were treatable with radiation and chemotherapy--are now treatable by just simply figuring out how, in your own system, you can maximize your ability to fight back. That is the NIH healthcare research kind of victory we need to now continue to find out why it works on some cancers and why it doesn't work on others.
This kind of research and commitment to NIH not only helps individuals and helps families but, frankly, at a time when healthcare is dramatically changing, has the ability to help our economy. The economy that figures out new ways to be in this healthcare fight is also going to be the economy that has the job opportunities and the transformational opportunities to be part of that.
Not only are we looking at healthcare research, but we are also looking at research as it relates to the opioid epidemic. The opioid cost to the economy is now anticipated to be about $500 billion a year in lost work time and other costs related to the opioid epidemic.
This bill provides a significant, targeted opioid funding. This is the fourth year in a row we have increased our funding. Again, this is only the second time we have had any more money to do it with. We have had to look at programs that weren't working and cut, reduce, and combine those programs to fight back on the opioid epidemic, which is now, and for a couple of years has been, the No. 1 cause of accidental death in the United States. It is the No. 1 accidental cause of death in my State of Missouri. The 73,000 people who died last year with overdoses exceed the number of people who died in car accidents, which for decades had been the No. 1 cause of accidental deaths until opioids replaced it.
We have $1.5 billion available for State opioid response grants. Understanding that every State is different, and frankly the more things we try to do in different ways, the more likely we are to find the things that work. We have that.
There is more money for community health centers to expand behavioral health and substance abuse disorder services. There is an increase in the ability to improve surveillance and prevention efforts in the illicit drug space or the drug abuse space, more money to research pain management. Part of the NIH money, at half a billion dollars, is designed to find more ways to research for better pain management and better ways to, if you have become addicted to drugs and opioids specifically, end that addiction in an effective way. There is more money for the hardest hit rural communities. Some of our Members have advocated strongly for a drug problem that is more of a rural drug problem on a per capita basis than it is an urban drug problem.
There is more money for children and families who are put at risk by opioids. I saw a news report just this week focusing on kids being raised by their grandparents because their parents wound up with an opioid addiction problem that drove their life in a way their children were not only in danger and ignored but had to go somewhere else.
This bill prioritizes education programs through a student's life, focusing on programs that provide the most flexibility for States and communities that meet the needs of families, children, and their workforce in their State.
There are increases for Head Start, increases for title I support for low-income schools to help them meet academic challenges. There is more money to meet the goal the Federal Government set decades ago, where individuals with disabilities are assisted within the school context, as the Federal Government determined they had to be, but the Federal Government has been wanting and coming up with the money that was committed to do that
decades ago. We continue to make steps in the right direction there, and I think there are substantial steps in this bill.
There is flexible spending so schools can look at more science, math, and STEM education, more computer science education, and more ability for schools to take some of their funds and look at school safety. Nobody wants to see kids go to school in an environment that is not as safe as we can possibly make it. This allows more flexibility for local administrators and local school boards to decide how they are going to meet that school safety need.
We looked at impact aid, charter schools, and programs that create both competition and fairness in a way I think people we work for will like.
This bill maintains the significant investments made last year on college access. The best way to minimize college debt is to get done, finish. Year-round Pell is something we returned to after several years of having only the normal traditional school year Pell. Year-round Pell is maintained in this as part of our Federal commitment to have people going to school. If you are an adult going back to school, if you are somebody who is a first-time college attender in your family, if, for whatever reason, you are paying for your own school, the most likely way to get done is don't interrupt a pattern that is working. This bill allows that to continue.
We also do things that I think better prepare our workforce for the workplace. It is a bill to look forward to working with Members to see how it can be improved, just like the amendment we will be voting on soon that deals with suicide prevention in ways Senator Kennedy and Senator Reed have suggested, and I support.
With that, I will conclude my remarks.
I ask unanimous consent that there be 2 minutes of debate, equally divided in the usual form, prior to the vote on the Kennedy amendment.
I yield the floor.
Vote on Amendment No. 3773
I ask for the yeas and nays.