21ST CENTURY CURES BILL
(Senate - December 08, 2016)
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[Pages S6913-S6914] From the Congressional Record Online through the Government Publishing Office [www.gpo.gov] 21ST CENTURY CURES BILL Ms. CANTWELL. Mr. President, I wish to address the 21st Century Cures Act legislation, which the Senate passed yesterday with my support. I voted for this bill and support many of its provisions. However, I also have some serious concerns regarding the manner in which the bill is funded. I would like to congratulate two of my Senate colleagues for their remarkable commitment to this bill: the senior Senator from Tennessee, Lamar Alexander, and the senior Senator from Washington, Patty Murray, who worked long hours in good faith to forge a bipartisan compromise on both sides of the Capitol. Washington State is a laboratory for health care innovation. From Spokane to Seattle, my State has a culture of collaboration and inventiveness in which the entire health care community--including researchers, providers, insurers, employers, policymakers, and others-- come together to find better ways of preventing, managing, and treating disease. This collaboration makes my State unique and on the cutting edge of developing innovative health care delivery. That is why Washington is the original home of the Basic Health Plan, a State-run option that gives working people without employer-sponsored health care the negotiating leverage to get a better deal on health insurance. It is why the Boeing Company has partnered directly with health care providers like the Everett Clinic to reduce sick days and improve the health of its workers. It is why community leaders in Yakima and Spokane have banded together to break ground on new medical schools to fill unmet primary care needs in their regions. And it is why so many lifesaving medical discoveries and treatments, including immuno-oncology, dialysis, and the mapping of the brain have their roots in our State. Many of these discoveries started with NIH- supported basic research at public research universities like the University of Washington and Washington State University. The 21st Century Cures legislation gives a big boost to Washington's health care innovators. First, the bill's investment in President Obama's Precision Medicine Initiative will help get the right treatment into the hands of patients, building on the longtime work of renowned [[Page S6914]] researchers like Dr. Leroy Hood and the Institute for Systems Biology. Tools like big data and sophisticated blood analysis can predict effective therapies based on a patient's unique biology, reducing ineffective prescriptions, and lowering health costs over time. Second, the bill's funding commitment to Vice President Biden's Cancer Moonshot will advance groundbreaking research at organizations like the Fred Hutchinson Cancer Research Center. By directing the body's own immune system to attack cancer cells, new cancer treatments can save lives for patients who may not respond to traditional interventions. Third, the bill's support for President Obama's Brain Research through Advancing Innovative Neurotechnologies, BRAIN, Initiative will continue the leadership of organizations like the Allen Institute for Brain Science in unlocking the mysteries of the brain. Neuroscience is one of the final frontiers of medicine, and future revelations in this field hold immense promise to better treat conditions affecting the brain, such as Alzheimer's and traumatic brain injury. In addition to my strong support for research into future medical miracles, many of my constituents need treatment for acute and chronic conditions now. That is why I am encouraged that the 21st Century Cures legislation takes positive steps to combat the dual crises of mental health care and opioid addiction. The legislation includes a $1 billion funding commitment to combat the opioid and heroin epidemic. In recent years Washington has experienced a doubling in heroin-related deaths, according to data from the Washington State Department of Health. Earlier this year, PBS's ``Frontline'' profiled the courageous stories of some of my constituents who are battling addiction, as well as new public responses that municipalities like the city of Seattle are deploying to address this public health crisis. The reality in too many Washington communities is that needed addiction services are simply out of reach for those in the throes of acute withdrawal, relapse, or in need of ongoing recovery supports. The Cures legislation helps by authorizing much-needed State grants for treatment services, prescription drug monitoring, prevention, and health professional training programs, which will bolster efforts by public health departments like the Spokane Regional Health District to meet urgent community needs. This funding is far from sufficient, given that 90 percent of people who need addiction treatment in the United States do not receive it, according to the Substance Abuse and Mental Health Services Administration, SAMHSA. However, given that Senate Democrats have been calling for real money for the opioid epidemic throughout this Congress, the funding in Cures is indeed welcome. The 21st Century Cures legislation also contains positive new policies that aim to improve access to mental health care, including efforts to better integrate mental health and physical health as well as strengthen rules to ensure health insurance companies cover mental and physical health equally. Unfortunately, many of these policies are not funded and require future appropriations. Washington communities continue to confront a severe mental health treatment shortage at all levels of the care continuum, including community clinics and psychiatric units. A 2015 report by Mental Health America, a national advocacy group, ranked Washington State 48th in the Nation when it comes to mental health treatment, due to a high prevalence of mental illness and poor access to care. In the face of overwhelming emergency room admissions and a State legal ruling on psychiatric ``boarding,'' community partnerships like the Alliance for South Sound Health in Pierce County have stepped up to build more treatment capacity. And Governor Jay Inslee and the State of Washington have announced ambitious goals to integrate mental health with chemical dependency and physical health. I will continue to fight for real money for mental health, including policies to ease the Medicaid Institutions for Mental Diseases, IMD, exclusion, an archaic barrier to needed inpatient care for people in crisis, as well as policies to improve mental health delivery. I am also pleased that the 21st Century Cures legislation includes a provision I sponsored, S. 2261, the Rural ACO Provider Equity Act, to drive coordinated health care in medically underserved areas, as well as legislation I have cosponsored to preserve access to vital outpatient therapeutic services at small rural hospitals. Medical facilities in these remote communities--such as Forks, Brewster, and Newport--need our support to keep essential health services accessible in the face of doctor and clinical staff shortages. I thank the senior Senator from South Dakota for his partnership and support on these important issues. While I supported the Cures legislation, the package incorporates troubling budget offsets that are concerning. First, the Cures legislation finances itself in part by selling millions of barrels of oil from the Strategic Petroleum Reserve. The use of this budget offset steadily weakens the energy security of the United States and again uses the reserve as a piggy bank to pay for nonenergy priorities. In its November 29, 2016, Statement of Administration Policy on the Cures legislation, the White House Office of Management and Budget concurred, noting this offset ``. . . continues a bad precedent of selling off longer term energy security assets to satisfy near term budget scoring needs.'' Second, the Cures legislation pays for its investments in part by cutting disease prevention funding. While I appreciate current legislative realities, this policy approach is not sustainable especially in light of dwindling public health resources throughout my State. Third, the final version of the Cures legislation omits a widely supported and bipartisan child welfare reform bill, the Family First Preventive Services Act, which I have been proud to cosponsor with my colleague Senator Ron Wyden. Washington State is currently using a Federal waiver, which I helped secure, to do a better job of keeping families together and reducing unnecessary foster care placements. This approach is better for kids and families, and it can save States money. The Senate's failure, up to this point, to pass this bill is a lost opportunity for children in Washington and throughout the Nation. Last, I note that the funding authorized by the Cures legislation must be appropriated by future Congresses. I will continue to work with my colleagues on the Appropriations Committee to fund these important health care priorities. I view the funding and policies in the Cures legislation as a step forward that continues to support Washington's health care innovation and pave the way for future medical breakthroughs. The mental health and opioid response provisions in the legislation are welcome in addressing these crises, but are far from sufficient. Moving forward, I will work to ensure that appropriators make good on the funding commitments in Cures, and I will fight to open up greater access to health care for Washingtonians.
