Lamar Alexander

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, today I honor one of my constituents, Judge Charles D. Susano Jr., who retired in April after 25 years of dedicated service to the State of Tennessee. Judge Susano is the state's longest serving state appellate judge and has led a remarkable life of public service and thoughtful jurisprudence. Judge Susano is a native and lifelong Knoxvillian. Born in 1936, he attended Knoxville Catholic High School before going to the University of Notre Dame where he graduated magna cum laude. Following an honorable discharge from the U.S. Army, Judge Susano returned to his Tennessee roots to attend the University of Tennessee Law School, where he was a member of the Tennessee Law Review and the Order of the Coif. Judge Susano began his legal career clerking for Chief Justice Hamilton Burnett in the inaugural class of clerks to the Tennessee Supreme Court. He practiced law in Knoxville for 30 years, while also giving back to the community as a member of the advisory commission to the Tennessee Supreme Court on Civil Rules, as well as board member of several local nonprofits. In 1994, Governor Ned Ray McWherter appointed Judge Susano to serve as a judge for the Tennessee Court of Appeals, and he won the seat later that same year. Judge Susano would go on to win statewide reelection in 1998, 2006, and 2014, and he served as the presiding judge of the Court of Appeals from 2012-2014. During his time on the court, he has authored over 1,000 legal opinions and received numerous awards including: the Justice Frank F. Drowota III Outstanding Judicial Service Award in 2017; Appellate Judge of the Year from the American Board of Trial Advocates, Tennessee Chapter in 2003; and the Courage in the Face of Adversity Award from the Knoxville Bar Association in 2004. I want to thank Judge Susano for his many years of service to Tennessee. The end of his long tenure in the Tennessee judiciary will certainly be felt by many in the State. I wish him, his wife, and their children all the best as they begin this new chapter in their lives.

Mr. ALEXANDER

Mr. ALEXANDER. I yield the floor.

Mr. ALEXANDER. Mr. President, I thought the Senator from Arizona made a very commonsense proposal. We are in a position here in the Congress that we often find ourselves in: We have different opinions-- dramatically different opinions in some cases. What she said was, while we are working those things out, let's extend the $600 unemployment benefit for 7 days so people aren't hurt. That is a commonsense proposal. I regret that wasn't adopted. I like what the Senator from Ohio said. Instead of starting--when you have a disagreement over several items, my experience is that you don't start with the things that you disagree on the most; you start with the things you agree on the most. There are a number of things in the House-passed bill and in the Senate Republican bill that was introduced on Monday, which the President supports--let me repeat that. The House of Representatives passed a bill. They have a Democratic majority. The Senate has a Republican majority, and we have a Republican President. We have a Republican President and a Republican bill, and we have a House-passed bill, and it is time to see if we can put the two together. That is why we have two bodies. But that requires Senators and Members of the House who are willing to sit down and come to some compromise or some resolution of the issues. There are some things about which we have big differences. One is the dollar figure. As the Senator from Ohio said, we have already spent $3.5 trillion. That is a number so big, most of us couldn't even speak it before we got to this era of the sneaky, dangerous COVID virus. Let's look at the other side. On what might we agree or many of us agree? We don't have 100 percent on either side who are going to agree on most anything. We might start with schools. Schools are starting up in the southern part of the United States, where the Presiding Officer is from-- Florida--and I am from Tennessee. Schools are getting ready to go back, and so are colleges. That means there are 70 million students who would like to go back to school or college--100,000 public schools, 35,000 private schools, and 6,000 colleges. What help do they need? They need help reopening safely so that they can go back with students physically present as consistent with safety as is possible. I talked with the Governor of Tennessee, Bill Lee, yesterday. He said 93 of the 95 counties in Tennessee had schools that were going to reopen in person. Maybe not every student, maybe not every class, but in 93 of the 95 counties, the Governor said they know that children need to be in school and their parents need for them to be in school. Two-thirds of married parents work outside the home. This is a bill for the children, though. I mean, every teacher, every pediatrician, and almost every parent knows that, especially with young children, if they are left out of school for such a lengthy period of time, it damages them; it hurts them. There is a health risk in going back, yes--not very much for young children--but there is a bigger emotional, intellectual, and physical risk if they stay out of school. What have we proposed to do? We proposed to help pay for the schools to open safely and to help pay for the colleges to open safely, which most are doing. The Chronicle of Higher Education said yesterday that 50 percent of our colleges plan to open this fall with students physically present. Thirty-five percent have a mix, with students physically present and online instruction. That means only 13 percent will be all virtual--at least that is their plan. If we could agree on that, why shouldn't we help them? Well, we can agree on it because the House of Representatives bill and the Senate Republican bill have almost exactly the same amount of money in them-- about $1,250 for K-12 schools--that is a lot of money per student; $1,250 per student--and about $1,500 per student for colleges to help them open safely. We could agree on that. I think we can agree on childcare. We ought to be talking about back to school, back to childcare, back to work. It is hard to go back to work if you don't have childcare. There are provisions in the House bill and the Republican bill that aren't so different. Testing. We all believe, I think, that we need maximum advance on testing, especially point-of-care testing--quick, reliable tests. There is money in the Republican bill and in the Democratic bill to advance that effort. Then there are the small business loans, called PPP. That probably was the most successful part of the early CARES bill, but a bipartisan group of Senators has worked on getting rid of some of the problems with it and come up with a proposal to extend that. Those are several major points of which we agree. And I think the Senator from Arizona's suggestion that we pass the unemployment benefit for another week while we work together to get an agreement was a commonsense one. (The remarks of Mr. Alexander pertaining to the introduction of S. 4375 are printed in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'')

Mr. ALEXANDER. Mr. President, I ask through the Chair, does the Senator from Ohio wish to speak further?

Mr. ALEXANDER

Mr. ALEXANDER. I ask for the yeas and nays.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I ask unanimous consent to speak for 10 minutes when the afternoon votes are concluded.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I want to speak for a few minutes about the changes to telehealth during the last five months--one of the most dramatic developments in the delivery of medical services ever--and why we in Congress should make many of those changes permanent. I recently heard from a psychiatric nurse practitioner in Nashville who has been seeing patients during the COVID-19 pandemic using telehealth--which means she uses the Internet to see her patients over video or she calls them on the telephone. She told me about one of her elderly patients who, before the COVID- 19 pandemic, got to her appointments by walking from her high-rise apartment to Gallatin Road, catching a bus, and then walking from the bus stop to the clinic. When the patient got to the clinic, she had to wait for her appointment. Then, when the appointment was over, she had to do all of these steps in reverse to get back home. Because of telehealth, this nurse said that her patient was in tears out of appreciation that she could now have appointments from her own home. She had access to health care without the long journey, and she could still receive her medications. The nurse said that several of her other elderly patients have had similar experiences and have asked if they could continue to have access to telehealth in the future, even after the pandemic. Because of COVID-19, the health care sector and federal and state governments have been forced to cram 10 years' worth of telehealth experience into almost 5 months. In 2016, there were almost 884 million visits nationwide between patients and physicians, according to the Center for Disease Control and Prevention. Almost all of them were in person--online or remote visits were rare. During the last four months, the number of online or remote visits virtually exploded. According to Vanderbilt University Medical Center, Vanderbilt went from 10 telehealth visits a day before the pandemic to more than 2,000 telehealth visits a day across specialties, including primary care, pediatrics, and behavioral health. In less than 3 months, Vanderbilt has provided more than 100,000 telehealth visits. Before COVID-19, approximately 13,000 Americans enrolled in the traditional Medicare program received telehealth services in an average week. In the last week of April, nearly 1.7 million Americans enrolled in traditional Medicare received telehealth services. In total, over 9 million Americans in traditional Medicare received a telehealth service between mid-March and mid-June. The Nashville Journal reports that Tennessee's Centerstone, which provides treatment for mental health and substance use disorders, says it is providing nearly 2,500 telehealth visits per day and 30 percent more of patients are keeping their appointments, which is key to treating these disorders. According to Bob Vero, Centerstone's CEO, ``We've taken away a lot of the reasons people don't follow through with their care.'' Tim Adams, the CEO of Ascension Saint Thomas Health, which has 9 hospitals in Middle Tennessee and employs over 800 physicians, told me that he predicts that 15-20 percent of the system's visits between patients and physicians will be conducted through telehealth in the future. In that 15 to 20 percent holds true across the Nation because of telehealth expansion during COVID-19--it would produce a massive change in our health care system. Congress and the administration reacted to the pandemic by creating a regulatory environment that made the current telehealth boom possible by allowing: in-home virtual visits; telehealth for patients in rural areas at rural health clinics; telehealth from physical therapists, speech language pathologists and other providers; telehealth for many more services including emergency department visits; and allowing Medicare hospice and home dialysis patients to start their care with a virtual visit. Now Congress is beginning to build on what we've learned and make those changes permanent. Here are three steps Congress should take now, as a part of the COVID-19 legislation that we are working on: Step One is to pass the COVID-19 HEALS Act legislation that was introduced Monday, which: Provides telehealth access to part-time and hourly employees; extends the administration's telehealth flexibilities and waivers through the end of the Public Health Emergency, or through 2021; and allows Rural Health Clinics and Federally Qualified Health Centers to continue to provide telehealth to Medicare beneficiaries for 5 years beyond the public health emergency. Step Two is to pass the CONNECT for Health Act. That legislation explores ways to expand telehealth services and begins to permanently remove some of the restrictions on where a patient needs to be for telehealth access. The bill is already supported by a broad coalition in the Senate and the House. Here in the Senate, the CONNECT for Health Act has been led by Senators Roger Wicker (R-MS), Brian Schatz (D-HI), Cindy Hyde-Smith (R- MS), Ben Cardin (D-MD), John Thune (R-SD), and Mark Warner (D-VA)--and today the bill has 38 cosponsors in the Senate. This bill was first introduced in 2016 and these senators deserve great credit for seeing the need to expand permanently telehealth services even before the pandemic forced a massive change in how Americans receive health care from their doctors. Step Three would be to pass the bill I'm introducing today which would go further than either of those first two steps and would make permanent in-home visits and rural telehealth access. The bill would also give the Secretary authority to make permanent other changes that the Administration has made over the last few months. Here's what the bill being introduced today does: Ensures that patients can access telehealth anywhere by permanently removing Medicare's so-called ``geographic and originating site'' restrictions, which required both that the patient live in a rural area and use telehealth at a doctor's office or clinic. Congress temporarily ended these restrictions in the Coronavirus Preparedness and Response Supplemental Appropriations Act that was signed into law on March 6, allowing millions of Americans to talk with their doctor virtually during the pandemic. Making this change permanent will ensure Medicare beneficiaries do not lose that ability when the pandemic ends. Protects access to telehealth for patients in rural areas. The bill makes permanent a change allowing Medicare beneficiaries to continue receiving telehealth services from Rural Health Clinics or Federally Qualified Health Centers. Telehealth access is especially important for patients in rural and other medically underserved areas because they no longer have to travel to see their primary care doctor. Those are two changes that this bill would make permanent. Then it would give the Secretary of Health and Human Services new authorities to do these three things: Help patients continue to access telehealth from physical therapists, speech language pathologists, and other health care providers. The bill gives authority to the Secretary of Health and Human Services to allow Medicare to permanently expand the types of health care providers that can offer telehealth services. Before COVID-19, only doctors, nurse practitioners, physician assistants, and certain other practitioners could deliver telehealth services. Today a much wider range of health practitioners are providing telehealth services. Help give Medicare recipients many more telehealth services. The bill gives authority to the HHS Secretary to give Medicare the flexibility to reimburse for more telehealth services. During the pandemic, Medicare has been reimbursing for 135 telehealth services, more than doubling the number of telehealth services covered before COVID-19. Examples include emergency department visits, home visits, and physical, occupational and speech therapy services. Help Medicare hospice and home dialysis patients begin receiving care through a telehealth appointment. Medicare requires a face-to-face visit when a patient begins hospice and home dialysis care, and this change would provide authority to the HHS Secretary to allow a telehealth visit to fulfill the requirement for an in-person visit. This will provide flexibility to improve access for these patients and account for individual circumstances. This legislation is the result of the Senate Health, Education, Labor and Pensions Committee hearing on June 17, during which senators asked health care experts about the 31 temporary Federal policy changes made in response to the COVID-19 pandemic. The legislation I am introducing today incorporates the recommendations of those experts to make permanent 5 of the most important changes--and helps to ensure that patients do not lose the benefits that they have gained from using telehealth during the COVID- 19 pandemic. This bill would make permanent the telehealth changes in the legislation introduced Monday as well as the CONNECT for Health Act. The best result for the American people would be for Congress to approve all three steps--the changes in the HEALS Act, the CONNECT for Health Act, and my legislation--in the next COVID-19 package so we don't miss the opportunity to support and encourage one of the most important changes in the delivery of medical services ever.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I thank Senator Wyden for his courtesy in allowing me to go next. I will be succinct. The way to get back to work and back to school is to put politics aside and work together, as we have been doing, on the COVID-19 response and see whether we can get a result for the American people in the next couple of weeks. The part of the Safely Back to Work and Back to School Act that I am introducing today does four things. First, if you are one of 43 million Americans with a student loan, it helps you manage your debt. This is the way it does it: If you have no income, you have no monthly payment. If you remember, in March, we said to the 43 million Americans with student debt: You can defer your payment until October 1. Well, that is just around the corner. What we would propose is, you don't have to pay it after October 1 if you have no income. If you do have income, your monthly payment will never be more than 10 percent of your income after deducting the necessities of life, such as rent, mortgage, or food. No. 2, if you are a parent, this bill gives your child more choices of schools, provides scholarships so that your child can return to the private school he or she attended before the pandemic, and gives other students a new opportunity to attend private school. Senator Tim Scott introduced that legislation earlier. I am a cosponsor. No. 3, if you are a working mom or dad, it helps you find childcare so you can go back to work. A lot of our childcare centers operate on a very thin margin. They have reduced revenue because they don't have as many clients these days. Senator Blunt's bill and Senator Shelby's appropriations bill will provide money so that they can stay open and provide safe environments to two-thirds of the children in the United States under age 6 who have parents in the workforce. Finally, our bill--the part I am introducing--improves the Strategic National Stockpile so that we can maintain adequate supplies of masks, gloves, protective equipment, as well as onshore manufacturing capacity for tests, treatments, and vaccines that we are building now. We want to make sure that it doesn't go away and we have to rely on other countries in other parts of the world. This legislation is about children, jobs, and healthcare. As far as schools go, there are 100,000 public schools and 35,000 private schools in our country. There are about 5 million students in the private schools and 50 million in the public schools. Every one of those children is a treasure. I have worked with Senator Blunt to help the country's 135,000 schools and 6,000 colleges have the money they need to open with as many students physically present as is consistent with safety. The Safely Back to Work and Back to School Act poses making $70 billion available for schools; another $30 billion for colleges. That means roughly $1,200 per student for public and private schools across the country. One-third of the money would be distributed automatically to all 135,000 schools. That is probably about $400 a student--a significant amount of money. Two-thirds of the money would go to schools that are opening with students physically present to help pay for the extra costs of providing that instruction in a safe environment. If they are trying to open with students physically present, it makes logical sense to say that if they have to have more buses, if they have to hire more teachers, if they have to have more protective equipment, then those schools need more help paying for that. There will be more funding, as Senator Shelby mentioned, to help contain this sneaky, dangerous virus and give Americans more opportunity for access to healthcare. There is more funding in this overall legislation for testing, for the National Institutes of Health, community health centers, the distribution of vaccines, and to extend the expansion of teleservice activities that has happened during the pandemic. This legislation reflects our Nation's priorities, which are safely back to school, safely back to childcare, and safely back to work. I yield the floor.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, today, Senator Tim Scott of South Carolina and I have introduced the School Choice Now Act, which does two things: It protects students who have been attending private schools from the heartbreaking loss of scholarships, and it gives families more options for their children's education at a time that school is more important than ever. I have been working to find ways to help parents pursue the education that best meets their child's needs for a long time, since 1979, when I began to be the Governor of Tennessee. In 1986, we Governors got together in something called Time for Results. I was chairman of the National Governors Association. The vice chairman was the Arkansas Governor, Bill Clinton, and we devoted the Governors' attention for an entire year to one subject--education. There were six points. One of those points way back then was to find ways to give parents more choices of schools for their children. Then, later on, in 1992, when President George H.W. Bush was in office and I was Education Secretary, I helped the President develop something we called the GI Bill for Kids, which was Federal funds for a $1,000 scholarship to work with cities and States, like Milwaukee in Wisconsin, that were trying to give low-income families more choices of good schools for their children. Then, my last act as Education Secretary was to notice what they call start-from-scratch schools in Minnesota, created by the Democratic- Farmer-Labor Party. There were about a dozen of them, as I remember, and I wrote every school district in the country and asked them to start one of these start-from-scratch schools, which were the forerunners of today's public charter schools. Today, we have 7,500 public charter schools. Then, in 2004, I tried something I called the Pell Grant for Kids, a $500 scholarship that would follow every middle- and low-income child in America to an accredited program of their choosing. Some people said: Wait a minute. You can't call the Pell grant a voucher. I said: That is precisely what the Pell grant is. The Pell grant is a voucher that a college student can take to any accredited college-- public, private, or religious. Why can't we do that for elementary and secondary schools? In 2005, we had a hurricane named Katrina, creating devastation on the gulf coast, and Senator Ted Kennedy and I and Senator Landrieu and others worked together to provide 1.2 billion Federal dollars in one- time emergency assistance for the 2005-2006 school year so students enrolled in public or nonpublic schools--children who were displaced by the hurricane--could enroll in public or private schools while their families recovered. They got scholarships of up to $6,000. And, more recently, I suggested a Scholarship for Kids Act. I said: Why don't we give a State like Tennessee, Ohio, or North Dakota, the opportunity to take most of the Federal dollars and turn them into scholarships for the lowest income students in their State? That scholarship would amount to $2,100 if we just took the existing money we had and spent it that way. So that is the strategy that we followed in this country for many, many years, ever since 1944, with the GI bill for veterans. We all remember what that was. The veterans came home and a grateful nation gave them a scholarship and said: Take it anywhere you want, to any college or accredited school. Take it to Notre Dame, take it to Yeshiva, take it to a historically Black college, take it to Ohio State, take it to Tennessee, take it to the Presbyterian school. And they have done that, and the GI bill may be one of the most certainly successful pieces of legislation ever enacted. Last year, there were over $28 billion in Federal Pell grants and more than $91 billion in Federal loans that followed students to public and private colleges of their choice. Now, the Federal Government also provides vouchers to help pay for childcare. The Child Care and Development Block Grant was negotiated by John Sununu when he was Chief of Staff for H.W. Bush in 1990, and what that does is basically give money to States, and States then give vouchers, just like Pell grants for college, but they give them to working moms, and they can go pick the childcare center that is best for their child. The Federal Government, in 2019, provided $8.7 billion and States another $1.2 to provide vouchers to 1.3 million children. So I think you can see where I am going with this. It is that the idea of giving parents choices of schools is not a new idea. We have done it in colleges since 1944. We do it with childcare. We do it in community colleges. Why not do it for elementary and secondary education? Why not give low-income families more of the same choices of good schools that wealthy families have? Now, during COVID-19, children in all K-12 schools have been affected by the disease. There are 100,000 public schools across our country serving 50 million students. That are another 35,000 private schools serving 5 million students. Many of those schools, public and private, are choosing not to reopen in person this fall. Many schools are failing to provide high-quality distance learning. The students who will suffer the most from this are the low-income children--the children from families where both parents work away from home every day or where the only parent works away from home every day, children with no internet, families who can't afford to put a child in a private school if the public school is not open. These are the parents who have the greatest need and the children who have the greatest need. We should address that need as we think about how to deal with COVID-19. Just as more families need more options, there are fewer scholarships available to help them choose private schools because there has been less charitable giving as a result of the pandemic. So for low-income students attending private schools on a scholarship, that can mean a heartbreaking end to their time at school and a transfer to a new school that may not meet their needs at all. That is why Senator Scott and I and others of us recommend that Congress first provide sufficient funding for all of our schools-- 100,000 public schools and 35,000 private--so they can safely open this fall with as many students physically present as possible. I have suggested that the cost of this to the taxpayers could be as much as $70 billion. The House of Representatives has appropriated $58 billion. If Congress were to agree on the higher number, $70 billion, that would be about $1,200 for every one of the 55 million public and private school students in the country The School Choice Now Act that Senator Scott and I are offering is about the 5.7 million of those 55 million children who attend the 35,000 nonpublic, private, or religious schools. It provides scholarships to students to have the opportunity to return to the private school they attended before the pandemic and gives other students a new opportunity to attend private school by doing two things: One, providing one-time emergency funding for scholarship- granting organizations. These are nonprofits that do the important work of helping students attend private schools in each State. These scholarship-granting organizations will use this one-time funding to provide families with direct educational assistance, including private school tuition as well as homeschooling expenses. No. 2, this act would provide permanent dollar-for-dollar Federal tax credits for contributions to those scholarship-granting organizations. What this means is that any American taxpayer who makes a charitable donation to one of these nonprofits that provide scholarships to students will receive a credit on their Federal taxes equal to the amount the taxpayer donated. The same goes for private companies that make donations to these organizations. The School Choice Now Act is not a Federal mandate. States are free to create their own tax credit scholarship programs that work for the unique needs of students in their States. States that don't want to support scholarships to private schools are not required to accept these funds. They can be returned to the Secretary, and the funds will be redistributed to States that want the funds. This bill is about one of the great principles of what it means to be an American: the principle of equal opportunity. For me, equal opportunity means creating an environment in which the largest number of people can begin at the starting line. When everyone is at the starting line in America, anything is possible. Giving children more opportunity to attend a better school is the real answer to inequality in America

Mr. ALEXANDER

Mr. ALEXANDER. I yield the floor.

Mr. ALEXANDER. Mr. President, I thank the Senator from Ohio for his courtesy, as well as his leadership. I will not be long. (The remarks of Mr. Alexander pertaining to the introduction of S. 4284 are printed in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'')

Mr. ALEXANDER. Mr. President, before the Senator from Colorado leaves the floor, I offer to him my congratulations for his inspired leadership of the Great American Outdoors Act. This is something that good people on both sides of the aisle have worked on, literally, for as much as a half a century. Now, people are used to politicians who exaggerate, but that is no exaggeration, because I have been around along enough to know and to understand that--first, with the Land and Water Conservation Fund, which was first enacted by Congress in 1964. I was the chairman of President Reagan's Commission on American Outdoors and reiterated support for that in 1986. Senator Gardner, Senator Daines, Senator Portman, Senator Warner, Senator Heinrich, Senator Manchin, Senator Cantwell, and a whole parade of Senators on both sides of the aisle have worked very hard to make this happen. And it would not have happened without President Trump's leadership, either. We would not have been able to spend the money the way that it is spent--energy exploration money for conservation purposes--unless the President's Office of Management and Budget had approved that. So it is usually never true that an important piece of legislation is passed by a single Senator. It is usually a parade of Senators. But Senator Gardner has been leading the parade, and I congratulate him for that and salute him on behalf of all of us who want to see our national parks--the 419 different places we have, from the Great Smokies to the Rocky Mountains, to Yellowstone, to Pearl Harbor, to the National Mall--protected, as well as our national forests, our national wildlife refuges, as well as the permanent funding for the Land and Water Conservation Fund. So I wanted to have an opportunity to say that before he left the floor. And I see my friend Senator Portman from Ohio here, who really, along with Senator Warner of Virginia, began the work on the other part of the bill--the bill that would take money from energy exploration and reduce the national park backlog by half over 5 years. That had the support, combined with the Land and Water Conservation Fund, of more than 800 different outdoor recreation, conservation, and environmental groups, as well as the President. People will say: Well, that was easy to do with all that support. It wasn't easy to do. If it had been easy to do, it would have happened 20 or 30 years ago. So it took support from the Senator from North Dakota and leadership from the Senator from Ohio and Senator Warner from Virginia, especially. I came to the floor also to talk about something else, but I see the Senator from Ohio so I think I will yield the floor and then speak on the other subject after he has a chance to speak, if he would like to.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, in March, Congress and the President said to 43 million student loan borrowers that, because of COVID-19, your student loan payments will be deferred until October 1--no monthly payments for 6 months for student loan borrowers. October 1 is just around the corner. So what do we say to those 43 million student loan borrowers today? I propose that we say this: No. 1, if there is no income, there is no monthly payment. In other words, if you have a student loan, your monthly payment is zero--if you don't have any income for whatever reason. No. 2, when you do begin earning income, your monthly payment will never be more than 10 percent of your income after you deduct the necessities of life, such as the cost of housing--rent or mortgage--and food. No. 3, the same generous loan forgiveness that exists today for student loan borrowers will still exist. After 20 years of payments for undergraduate loans and 25 years of payments for graduate loans, if you still have an outstanding loan balance, your loan will be forgiven, and that will include all of the months your payment was zero because you didn't have any income. These same policies--no income, no monthly payment--will be offered to students who take out new loans in addition to these policies being offered to existing student loan borrowers. Under my proposal, new and existing student loan borrowers will be offered one other option for paying back their loans. This option would be like a 10-year mortgage: Make equal principal and interest monthly payments over 10 years until the loan is paid off. Some borrowers may prefer this option because it could mean paying less interest. Every borrower would be eligible to switch from one option--the income-based payment--to the other option The remaining good news in this proposal is that the concurrent bewildering system of nine different ways of paying off your student loan would be thrown in the trash heap and replaced by these two straightforward proposals: No. 1, the income-based repayment option, and No. 2, the 10-year, mortgage-like option. These changes will give some peace of mind to the 43 million current borrowers and the tens of millions of Americans who are expected to sign up for new student loans over the next 10 years. These ideas are neither new nor my ideas. They have been recommended by higher education experts numerous times when having testified before the Senate Education Committee during the past 6 years while we have considered reauthorizing the Higher Education Act. The concepts have also been suggested by many Senators on both sides of the aisle, Democrats and Republicans, including Senators King, Burr, Rubio, Merkley, Portman, Warner, Wicker, Manchin, Shaheen, and Collins. All of them have suggested these concepts. While we are simplifying the student loan repayment system, I propose that we also finish the job of reducing the Federal loan application of grants and loans--which everyone calls FAFSA--from about 108 questions to 20 to 33 questions. This is an enterprise that a number of us, both Democrats and Republicans, have been working on for years, including Senators Murray, Bennet, Jones, King, Collins, Whitehouse, Gardner, Cornyn, Stabenow, Tillis, and Hassan. So, you see, there is an unusual amount of bipartisan support for both of these ideas. Experts before the Senate Education Committee have testified that simplifying the FAFSA in this way would remove obstacles and would make it easier for more low-income Americans to attend college and would increase the number of Pell grants each year. Last fall, Congress and the President took the first step in simplifying the FAFSA by allowing the Internal Revenue Service to answer 22 questions that applicants for grants and loans had already answered on their tax returns. There are 20 million American families who struggle to fill out this essential but unnecessarily complex form each year who will be grateful to Congress if we will complete the job of simplifying the Federal aid application system at the same time we will make it simpler for 43 million Americans to pay back their student loans. There is one more piece of good news in this proposal, and this news is for the American taxpayer. Simplifying the student loan repayment system, as well as the system for applying for student grants and loans, will save taxpayers about $10 billion over 10 years, according to the Congressional Budget Office. This is because the simpler system will also provide more certainty in the repayment of loans. On October 1, 43 million Americans with student loans are going to have to restart making their monthly student loan repayments. Congress deferred student loan payments in March, as I said earlier, when the CARES Act--the COVID-19 relief bill--was signed into law, but that deferment expires on September 30. There has never been a more important time to end the maddening complexity of student loan repayment and make it simpler for Americans to pay off their student loans. Let me briefly review how the Student Loan Repayment and FAFSA Simplification Act will work. It offers student loan borrowers just two options: the standard 10-year repayment plan, just like a mortgage, or the income-based plan that I have described. For borrowers with no income, if they choose an income-based repayment plan, their monthly payments would be zero. If borrowers in an income-based repayment plan earn income, the borrowers' monthly payments would be based on the amounts of those incomes. Let's take an example. The average student loan for a 4-year college graduate today is about $30,000. So someone with $30,000 in student loan debt who makes $52,000 each year would be expected to pay 10 percent of that borrower's discretionary income, which is about $274 per month. So if you have a $30,000 loan debt and you make $52,000 a year, your monthly payment is going to be about $274 under this plan. Borrowers under the plan would never have to pay more than 10 percent of their income that is not needed for necessities. If we don't pass this legislation before October 1, here is what will happen: Because of the confusing repayment system we have today, too many borrowers will end up in an unaffordable, standard 10-year repayment, mortgage-type plan and will have payments so high that they will find themselves in default. When we are through with this pandemic--when the economy improves and when these borrowers are ready to tackle their debts--they will find that their student loan debts may have soared out of control. I and Senator Murray of Washington State, who is the ranking Democrat on our committee, have been working on reauthorizing the Higher Education Act for nearly 6 years. We have held 19 hearings over that time. We are making good progress. In fact, I was hopeful we could mark up the bill this spring, but between impeachment and COVID, that just didn't work out. In January, I saw a consensus emerging. It was for simpler, effective regulations to make it easier for students to pay for college and to pay back their loans. We discussed the complexity of the Federal financial aid system. We heard from many experts. At one roundtable, the president of the University of Tennessee told me it took him months to figure out how to pay off his daughter's Federal student loan--this was from a college president--even with the money in his hand. So this is not a new problem, and the solution I am proposing has been discussed by our committee and many Senators outside the committee for nearly 6 years. It will help both those who face loan payments starting on October 1 and the millions of students who will be graduating with student debt. When it comes time to start repaying those loans, students will have to navigate through a complicated number of options today--nine in total. I don't want to go through them in detail because it would stagger the imagination. For example, there is the 10-year standard repayment. There is the graduated standard repayment. There are two extended repayment options. There are five different programs based on your income: the income-contingent repayment, the original income-based repayment, the revised income-based repayment, the pay-as-you-earn plan, and the revised pay-as-you-earn repayment. Those are all of the different ways you can pay off your student loans, which has confused the 43 million borrowers who have them. Now, if I lost you wandering through that, you can get a sense of how those 43 million borrowers must feel. The Student Loan Repayment and FAFSA Simplification Act ends that confusion. It will reduce those nine repayment plans down to two--one standard payment, like a mortgage, and one payment based on income. In addition, the bill reduces the complexity for borrowers who wish to participate in the Public Service Loan Forgiveness Program, which creates an incentive for borrowers to pursue jobs in public service. Today, not all of the nine current repayment plans are eligible for public loan forgiveness, and borrowers can have a hard time figuring out which plan to choose. Under this legislation, a borrower who wants loan forgiveness can't choose the wrong plan because there are only two and either applies, whether you choose the standard 10-year repayment plan or the income-based repayment plan. By the end of September, in less than 3 months, 43 million student loan borrowers will be required by law to begin monthly payments again on their loans. Many of these borrowers won't be able to afford these payments. I propose that we say to those borrowers: We have a better option for you. No income, no monthly payment--whether because of COVID-19 or for any other reason. In other words, if you have a student loan, you may defer your monthly payment if you do not have any income. When you do begin earning income, your monthly payment will never be more than 10 percent of your income after you deduct the necessities of life, such as the cost of housing--rent or mortgage--and food. Now is the time to reduce the complexity of student loan debt and finish the job of simplifying the FAFSA and at the same time save the taxpayers money. I yield the floor. Additional Cosponsors to S. 4220

Mr. ALEXANDER. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, our great country has developed a dangerous habit when it comes to pandemics. Public health experts call it panic, neglect, panic. In 2007, after the emergence of the Asian flu, former Utah Governor Mike Leavitt, who was then the Secretary of Health and Human Services, put it this way: Everything we do before a pandemic seems alarmist. Everything we do after a pandemic will seem inadequate. This is the dilemma we face, but it should not stop us from doing what we can to prepare. That was Governor Mike Leavitt. Fifteen years ago, then-majority leader of the U.S. Senate, Dr. Bill Frist, told me and told our committee--he made 20 speeches predicting this--that a viral pandemic was no longer a question of if but a question of when. Now, this is in the 2005-2006 era, 15 years ago. He recommended then, Dr. Frist did, what he called a six-point public health prescription to minimize the blow: communication, surveillance, antivirals, vaccines, research, stockpile/surge capacity. Four Presidents of the United States and several Congresses have done some of what needed to be done to prepare for pandemics but not enough of it. There is substantial agreement on all sides about what to do. There is even more agreement that, if we wait until this pandemic is over to do it, we will fall into the familiar cycle of panic, neglect, panic. So the obvious thing for this Congress to do now, this month, while we are in the middle of a pandemic, while we have our eye on the ball, before we lose our focus, while we are spending $4 trillion or more mostly to repair the damage caused by this pandemic, is that we should authorize and spend the few billions that it takes to be prepared for the next pandemic. That is why I am introducing today the Preparing for the Next Pandemic Act, and that would take three of the most obvious steps about which there is near universal agreement: One, make certain that we have and maintain sufficient manufacturing capacity within the United States to produce tests, treatments, and vaccines so that we don't have to rely on manufacturing plants in China and India or any foreign country. Now, how difficult is that to decide? Do we really want our vaccines made in China or India or any other foreign country? So shouldn't we do something now to make sure that--for the next pandemic as well as this one--we produce them here? Two, make sure that Federal and State stockpiles have sufficient protective equipment--masks, gowns--ventilators, and other absolutely essential supplies so that we don't run out during this pandemic or the next one. Now, how controversial could that be? Do we really want to run out of masks and protective equipment in the next pandemic or in what remains of this one? Three, create more authority for the Federal Government to work with private companies to maintain more supplies and manufacturing capacity for products that are needed during a public health emergency. We have the strongest, best, most creative private sector in the world. Why would we not want our government working with it as much as it possibly could to save our lives during this pandemic and the next pandemic? The act also does the one thing that all of the experts with whom we have talked say is essential: Make sure there is a steady stream of money for the next 10 years so there is no lapse in preparedness. I would propose that we do this with 10 years of advance appropriations; in other words, that we appropriate this year $15 billion and spend it over 10 years--that is $1.5 billion a year--so Congress will be able to continue its oversight and make certain that our manufacturing plants onshore are kept up to date and that State stockpiles in Alaska, Tennessee, and every State and the Federal stockpile are not depleted during tough budget times, which we know will surely come, just as surely as we know the next pandemic will come. On June 9, I released a white paper on steps I thought Congress should take before the end of the year in order to get ready for the next pandemic. I am not a medical expert. So the main purpose of my white paper, as chair of the Senate's Health Committee, was to elicit recommendations to Congress from the experts that we could consider and act on this year. We asked the experts to get their ideas in by June 26. I asked for recommendations in five areas: No. 1, tests, treatments, and vaccines; how do we accelerate research and development? No. 2, disease surveillance; expand our ability to detect, identify, model, and track emerging infectious diseases. No. 3, stockpiles, distribution, and surges; rebuild and maintain the Federal and State stockpiles and improve the medical supply surge capacity and distribution; in other words, make sure we have masks and gowns and ventilators so the hospitals are ready if something happens. No. 4, public health capabilities; improve State and local capacity to respond. Most of our public health is taken care of not here but by our State and local public health departments. Finally, who is on the flagpole? That is improving coordination of Federal agencies during a public health emergency. Our committee, the Senate's Health Committee, received 350 responses from leading public health experts around the country. They had many recommendations for short-term and long-term proposals to address future pandemics. As my staff and I reviewed these proposals and other feedback, I asked us to focus on targeted ideas that would generate broad bipartisan consensus and help address some of the most pressing issues that we are facing today. That led us to three strategic areas: One, sustaining onshore manufacturing--22 responses mentioned that. Two, creating and sustaining the State stockpiles--23 mentioned that. Improving the Federal stockpile--24 mentioned that. These are recommendations from public health experts and bipartisan leaders who have convened the experts. Some of those from whom we heard included Dr. Frist; Governor Ridge, who is cochair of the Bipartisan Commission on Biodefense; former Senator Joe Lieberman, cochair of that same commission; Dr. Julie Gerberding, former Director for the Centers for Disease Control and Prevention; Andy Slavitt, who during the Obama administration was the Acting Administrator of the Centers for Medicare and Medicaid Services. They all said basically the same thing when it came to these three priorities. So I introduced today the Preparing for the Next Pandemic Act in three parts: One, onshore manufacturing, which provides new, sustained funding--$5 billion over 10 years, half a billion a year--to maintain sufficient onshore manufacturing for tests, treatments, and vaccines so that, when a new virus emerges, we have a facility in this country ready to manufacture these products as quickly as possible. Two, State stockpiles, which provides new, sustained funding--$10 billion over 10 years; that is $1 billion a year--so States can create and maintain their own stockpiles of supplies, like masks and ventilators, with help from the Federal Government. Now, this would be done with some restrictions because what really happened before was that a lot of the States and some of the hospitals, because they had budget shortages, said: Well, we can deplete our stockpiles and save some money. So they saved some money, but when the next pandemic arrived, we weren't ready, the stockpile wasn't full, and people suffered because of that. Finally, Federal stockpiles. This legislation improves the Federal Strategic National Stockpile by allowing the Federal Government to work with private companies to maintain additional supplies and manufacturing capacity so we are even better prepared for the next pandemic. Now, there is more to do to be ready for any future pandemic, but these are three steps that we ought to do right now, this month, as part of whatever COVID-19 phase 4 legislation we can agree upon. In our Senate Health Committee hearing on June 23, this is what former Senate Majority Leader Dr. Bill Frist had to say about the need for sustained funding to better prepare for the next pandemic: We do have to keep a revenue stream out there, Dr. Frist said, that is dependable, that is sustainable, that is long-term, and that is flexible. What we are really dealing with is a rare but certain event, said Dr. Frist, and the rarity is hard for Congress to deal with because of the attention span of Congress, and that is where it is important to have timelines that are 10 or 15 years out. Markets tend to look day to day, said Dr. Frist. Therefore, this means we are going to have to have some sort of public funding that would guarantee a market over that 10-year or 15-year period when that certain event, that certain pandemic, will occur. Now, there is precedent for what I am proposing today. In 2003, Senator Judd Gregg of New Hampshire--in fact, he used to stand at this desk and make excited and well informed speeches, and I used to sit right there and listen to him, and he was one of our best U.S. Senators--was chairman of the same Health Committee that I am chairman of today. He then recognized, in 2003, the need for a clear, long-term commitment from the Federal Government to prepare for public health emergencies like COVID-19. That year, Congress passed what we called Project Bioshield with the leadership of Senator Gregg, Congressman Hal Rogers, Senator Cochran of Mississippi, and others. The legislation provided $5 billion in advance appropriations to be used over the next 10 years to buy treatments and vaccines for threats like anthrax and smallpox. Reflecting on that experience in an editorial earlier this year, Senator Gregg wrote: ``In this instance, Congress actually anticipated a serious issue and began addressing it effectively.'' ``Congress actually anticipated a serious issue and began addressing it effectively.'' Well, why doesn't Congress do that again? If it worked before, why don't we do it again? Why don't we make sure that the next time we have a pandemic, our manufacturing plants aren't in China or India? We can do that with a very modest amount of money, compared to the trillions of dollars that we are talking about for other things. At our June 23 hearing, speaking about Federal efforts to build manufacturing capacity to respond to a pandemic flu, Governor Leavitt said: ``What I think we did not do adequately as a country, over the course of time, is maintain those manufacturing plants in a way that they were warm and could be stood up quickly.'' In other words, we have had this idea before. We supported building new manufacturing plants, but we lost interest in it--panic, neglect, panic. And they weren't warm, said Governor Leavitt, when the time came that we needed them. Regarding stockpiles, Dr. Frist said, we need ``not the incremental improvement of stockpiles and means of distribution, but the creation of great and secure stores and networks, with every needed building, laboratory, airplane, truck, and vaccination station, no excuses, no exceptions, everywhere, and for everyone.'' That is what Dr. Frist said at our hearing. And he said it 15 years ago. Former Director of the Centers for Disease Control and Prevention, Dr. Judy Gerberding, said at our hearing: In the face of an unprecedented public health crisis like the coronavirus, we have seen the Strategic National Stockpile deliver some promising innovations but at the same time discovered areas where there is room for improvement. . . . The COVID-19 pandemic provides us an opportunity to make pragmatic changes; we must act now to avoid becoming complacent and finding ourselves in the same position when the next pandemic occurs. Panic, neglect, panic. There is also broad agreement about some additional steps Congress needs to take to prepare for the next pandemic, including disease surveillance, restoring support for our State and local public health systems--Governor Leavitt said they have been seriously underfunded for the last 30 or 40 years--and better coordination of pandemic response. I don't propose to deal with those three things today, but I do intend to keep legislation to better prepare for future pandemics on the top of the congressional to-do list until it is done. In this internet age, attention spans are short. Even with an event as significant as COVID-19, memories fade, and attention moves on quickly to the next crisis. That makes it imperative that Congress act on needed changes this year in order to better prepare for next pandemic, which might be in 20 years or might be next year or next month. The only thing we know for certain is that it will come. Let us not succumb to the familiar, dangerous habit of panic, neglect, panic. At least Congress can take these three steps to keep vaccine manufacturing on our shores and stockpiles supplied now while the pandemic has our attention, while we have our eye on the ball. Mr. President, I ask unanimous consent to have printed in the Record a copy of the summary of responses the Health Committee received in response to the white paper that I released on June 9

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, our great country has developed a dangerous habit when it comes to pandemics. Public health experts call it panic, neglect, panic. In 2007, after the emergence of the Asian flu, former Utah Governor Mike Leavitt, who was then the Secretary of Health and Human Services, put it this way: Everything we do before a pandemic seems alarmist. Everything we do after a pandemic will seem inadequate. This is the dilemma we face, but it should not stop us from doing what we can to prepare. That was Governor Mike Leavitt. Fifteen years ago, then-majority leader of the U.S. Senate, Dr. Bill Frist, told me and told our committee--he made 20 speeches predicting this--that a viral pandemic was no longer a question of if but a question of when. Now, this is in the 2005-2006 era, 15 years ago. He recommended then, Dr. Frist did, what he called a six-point public health prescription to minimize the blow: communication, surveillance, antivirals, vaccines, research, stockpile/surge capacity. Four Presidents of the United States and several Congresses have done some of what needed to be done to prepare for pandemics but not enough of it. There is substantial agreement on all sides about what to do. There is even more agreement that, if we wait until this pandemic is over to do it, we will fall into the familiar cycle of panic, neglect, panic. So the obvious thing for this Congress to do now, this month, while we are in the middle of a pandemic, while we have our eye on the ball, before we lose our focus, while we are spending $4 trillion or more mostly to repair the damage caused by this pandemic, is that we should authorize and spend the few billions that it takes to be prepared for the next pandemic. That is why I am introducing today the Preparing for the Next Pandemic Act, and that would take three of the most obvious steps about which there is near universal agreement: One, make certain that we have and maintain sufficient manufacturing capacity within the United States to produce tests, treatments, and vaccines so that we don't have to rely on manufacturing plants in China and India or any foreign country. Now, how difficult is that to decide? Do we really want our vaccines made in China or India or any other foreign country? So shouldn't we do something now to make sure that--for the next pandemic as well as this one--we produce them here? Two, make sure that Federal and State stockpiles have sufficient protective equipment--masks, gowns--ventilators, and other absolutely essential supplies so that we don't run out during this pandemic or the next one. Now, how controversial could that be? Do we really want to run out of masks and protective equipment in the next pandemic or in what remains of this one? Three, create more authority for the Federal Government to work with private companies to maintain more supplies and manufacturing capacity for products that are needed during a public health emergency. We have the strongest, best, most creative private sector in the world. Why would we not want our government working with it as much as it possibly could to save our lives during this pandemic and the next pandemic? The act also does the one thing that all of the experts with whom we have talked say is essential: Make sure there is a steady stream of money for the next 10 years so there is no lapse in preparedness. I would propose that we do this with 10 years of advance appropriations; in other words, that we appropriate this year $15 billion and spend it over 10 years--that is $1.5 billion a year--so Congress will be able to continue its oversight and make certain that our manufacturing plants onshore are kept up to date and that State stockpiles in Alaska, Tennessee, and every State and the Federal stockpile are not depleted during tough budget times, which we know will surely come, just as surely as we know the next pandemic will come. On June 9, I released a white paper on steps I thought Congress should take before the end of the year in order to get ready for the next pandemic. I am not a medical expert. So the main purpose of my white paper, as chair of the Senate's Health Committee, was to elicit recommendations to Congress from the experts that we could consider and act on this year. We asked the experts to get their ideas in by June 26. I asked for recommendations in five areas: No. 1, tests, treatments, and vaccines; how do we accelerate research and development? No. 2, disease surveillance; expand our ability to detect, identify, model, and track emerging infectious diseases. No. 3, stockpiles, distribution, and surges; rebuild and maintain the Federal and State stockpiles and improve the medical supply surge capacity and distribution; in other words, make sure we have masks and gowns and ventilators so the hospitals are ready if something happens. No. 4, public health capabilities; improve State and local capacity to respond. Most of our public health is taken care of not here but by our State and local public health departments. Finally, who is on the flagpole? That is improving coordination of Federal agencies during a public health emergency. Our committee, the Senate's Health Committee, received 350 responses from leading public health experts around the country. They had many recommendations for short-term and long-term proposals to address future pandemics. As my staff and I reviewed these proposals and other feedback, I asked us to focus on targeted ideas that would generate broad bipartisan consensus and help address some of the most pressing issues that we are facing today. That led us to three strategic areas: One, sustaining onshore manufacturing--22 responses mentioned that. Two, creating and sustaining the State stockpiles--23 mentioned that. Improving the Federal stockpile--24 mentioned that. These are recommendations from public health experts and bipartisan leaders who have convened the experts. Some of those from whom we heard included Dr. Frist; Governor Ridge, who is cochair of the Bipartisan Commission on Biodefense; former Senator Joe Lieberman, cochair of that same commission; Dr. Julie Gerberding, former Director for the Centers for Disease Control and Prevention; Andy Slavitt, who during the Obama administration was the Acting Administrator of the Centers for Medicare and Medicaid Services. They all said basically the same thing when it came to these three priorities. So I introduced today the Preparing for the Next Pandemic Act in three parts: One, onshore manufacturing, which provides new, sustained funding--$5 billion over 10 years, half a billion a year--to maintain sufficient onshore manufacturing for tests, treatments, and vaccines so that, when a new virus emerges, we have a facility in this country ready to manufacture these products as quickly as possible. Two, State stockpiles, which provides new, sustained funding--$10 billion over 10 years; that is $1 billion a year--so States can create and maintain their own stockpiles of supplies, like masks and ventilators, with help from the Federal Government. Now, this would be done with some restrictions because what really happened before was that a lot of the States and some of the hospitals, because they had budget shortages, said: Well, we can deplete our stockpiles and save some money. So they saved some money, but when the next pandemic arrived, we weren't ready, the stockpile wasn't full, and people suffered because of that. Finally, Federal stockpiles. This legislation improves the Federal Strategic National Stockpile by allowing the Federal Government to work with private companies to maintain additional supplies and manufacturing capacity so we are even better prepared for the next pandemic. Now, there is more to do to be ready for any future pandemic, but these are three steps that we ought to do right now, this month, as part of whatever COVID-19 phase 4 legislation we can agree upon. In our Senate Health Committee hearing on June 23, this is what former Senate Majority Leader Dr. Bill Frist had to say about the need for sustained funding to better prepare for the next pandemic: We do have to keep a revenue stream out there, Dr. Frist said, that is dependable, that is sustainable, that is long-term, and that is flexible. What we are really dealing with is a rare but certain event, said Dr. Frist, and the rarity is hard for Congress to deal with because of the attention span of Congress, and that is where it is important to have timelines that are 10 or 15 years out. Markets tend to look day to day, said Dr. Frist. Therefore, this means we are going to have to have some sort of public funding that would guarantee a market over that 10-year or 15-year period when that certain event, that certain pandemic, will occur. Now, there is precedent for what I am proposing today. In 2003, Senator Judd Gregg of New Hampshire--in fact, he used to stand at this desk and make excited and well informed speeches, and I used to sit right there and listen to him, and he was one of our best U.S. Senators--was chairman of the same Health Committee that I am chairman of today. He then recognized, in 2003, the need for a clear, long-term commitment from the Federal Government to prepare for public health emergencies like COVID-19. That year, Congress passed what we called Project Bioshield with the leadership of Senator Gregg, Congressman Hal Rogers, Senator Cochran of Mississippi, and others. The legislation provided $5 billion in advance appropriations to be used over the next 10 years to buy treatments and vaccines for threats like anthrax and smallpox. Reflecting on that experience in an editorial earlier this year, Senator Gregg wrote: ``In this instance, Congress actually anticipated a serious issue and began addressing it effectively.'' ``Congress actually anticipated a serious issue and began addressing it effectively.'' Well, why doesn't Congress do that again? If it worked before, why don't we do it again? Why don't we make sure that the next time we have a pandemic, our manufacturing plants aren't in China or India? We can do that with a very modest amount of money, compared to the trillions of dollars that we are talking about for other things. At our June 23 hearing, speaking about Federal efforts to build manufacturing capacity to respond to a pandemic flu, Governor Leavitt said: ``What I think we did not do adequately as a country, over the course of time, is maintain those manufacturing plants in a way that they were warm and could be stood up quickly.'' In other words, we have had this idea before. We supported building new manufacturing plants, but we lost interest in it--panic, neglect, panic. And they weren't warm, said Governor Leavitt, when the time came that we needed them. Regarding stockpiles, Dr. Frist said, we need ``not the incremental improvement of stockpiles and means of distribution, but the creation of great and secure stores and networks, with every needed building, laboratory, airplane, truck, and vaccination station, no excuses, no exceptions, everywhere, and for everyone.'' That is what Dr. Frist said at our hearing. And he said it 15 years ago. Former Director of the Centers for Disease Control and Prevention, Dr. Judy Gerberding, said at our hearing: In the face of an unprecedented public health crisis like the coronavirus, we have seen the Strategic National Stockpile deliver some promising innovations but at the same time discovered areas where there is room for improvement. . . . The COVID-19 pandemic provides us an opportunity to make pragmatic changes; we must act now to avoid becoming complacent and finding ourselves in the same position when the next pandemic occurs. Panic, neglect, panic. There is also broad agreement about some additional steps Congress needs to take to prepare for the next pandemic, including disease surveillance, restoring support for our State and local public health systems--Governor Leavitt said they have been seriously underfunded for the last 30 or 40 years--and better coordination of pandemic response. I don't propose to deal with those three things today, but I do intend to keep legislation to better prepare for future pandemics on the top of the congressional to-do list until it is done. In this internet age, attention spans are short. Even with an event as significant as COVID-19, memories fade, and attention moves on quickly to the next crisis. That makes it imperative that Congress act on needed changes this year in order to better prepare for next pandemic, which might be in 20 years or might be next year or next month. The only thing we know for certain is that it will come. Let us not succumb to the familiar, dangerous habit of panic, neglect, panic. At least Congress can take these three steps to keep vaccine manufacturing on our shores and stockpiles supplied now while the pandemic has our attention, while we have our eye on the ball. Mr. President, I ask unanimous consent to have printed in the Record a copy of the summary of responses the Health Committee received in response to the white paper that I released on June 9

Mr. ALEXANDER

Mr. ALEXANDER. I yield the floor. I suggest the absence of a quorum.

Mr. ALEXANDER. I ask unanimous consent that the order for the quorum call be rescinded.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I thank Senator Blunt and Senator Murray for their cooperation this month in this series of six hearings that we have had on COVID-19. I think it is very important for the American people to know that while there is a vaccine down the road, the tests are coming, the fast tests, and the treatments are coming. They should be here by the fall. That is what the experts say. It is not what I say; that is what the experts who testified before us say. The experts all said the following: If you want to contain the disease, if you want to go back to school and back to college and back to work and out to eat and maybe even see a little football, stay 6 feet apart, wash your hands, and wear a mask. I yield the floor. I suggest the absence of a quorum.

Mr. ALEXANDER. Mr. President, just 3\1/2\ months ago, a sneaky, dangerous virus turned our country and the world upside down. It is hard to believe that it was just 3\1/2\ months ago--mid-March--that we were headed toward March Madness in basketball; that our economy was roaring; that unemployment rates for about every category were as low as they had been in a long, long time. America felt really good about itself. By the time we would have gotten to the Fourth of July, it would have been a terrific celebration except that here came this dangerous, sneaky virus that turned our lives and those in countries all over the world upside down. I want to comment this afternoon on some aspects of where we are in terms of COVID-19 based upon five congressional hearings this month that I have either chaired or attended in our HELP Committee or the one I participated in today in Senator Blunt's Appropriations Committee on Health. Of course, Senator Murray, of Washington State, is the ranking Democrat on both of those committees. Of course, much of the talk is about vaccines. Even though we have appropriated $3 trillion and another astonishing $3 trillion in credit, that is not going to really solve the problem. The only cure for this disease, this virus, will ultimately be through testing, treatments, and vaccines. It is appropriate that we talk about vaccines because our country is moving more rapidly than it ever has in producing a safe and effective vaccine for a new virus. As Dr. Francis Collins--the head of the National Institutes of Health--told our subcommittee this morning, it usually takes, historically, 5 to 10 years to create a vaccine. Here, the goal of the administration's warped speed effort to create a vaccine is to have 300 million doses ready by the first of this coming year--in other words, 6 months from now. That is its aspirational goal. The administration is not sure it will get there, but you don't get anywhere if you don't set high goals. We know that as a country. So it has set an enormously ambitious goal. We are taking steps that are like none we have ever taken before, such as Congress has appropriated money, has approved, and is starting to build a manufacturing plant for a vaccine before we know that it works. Now, we don't do that before we know that it is safe, but we will do it before we know that it works. We can be sure that, in some cases, we are going to lose that money, but it is better to cut 6 months or a year off of the amount of time before the vaccine comes and take that financial risk. I think all of us would agree with that. Instead of talking about vaccines today, which are next year's solution, let me talk about two aspects of COVID-19 that are this year's solution--in fact, that are this fall's solution. One is diagnostic tests to find out whether you have the disease or not, and one is treatments, which is medicine that can be given to you to reduce the chance that you might be seriously ill or will even die. That is appropriate in the first place because, in not very many weeks, America will be headed back to school and to college. In Metro Nashville, TN, public school begins on August 4. All across the country, most colleges and schools will be back in business by Labor Day. There were 75 million students who were casualties of COVID-19. They were sent home from school or college in mid-March--100,000 public schools, 35,000 private schools, and 6,000 colleges. Graduations were canceled. Sports championships and once-in-a-lifetime events were canceled. In our country today, two-thirds of married parents with children work outside the home, and most single parents work outside the home. Suddenly, their children were home. Teachers were not really prepared for such wholescale remote teaching, and parents were not prepared for homeschooling. So ever since mid-March, students have been in limbo. We are looking forward to doing whatever we can to help make sure that those 75 million students in schools and colleges can go back to school and college this fall and go back safely. That is the importance of tests and treatments. That is the first. Now, there is another one, and it is not trivial. This is a sports- hungry country. We love our sports, and everybody has a different sport one likes. The question I asked Dr. Collins this morning was: Are we going to have enough COVID-19 tests so we might be able to watch some football this fall or some basketball this winter? I had read that the National Hockey League was going to test every player every day in the National Hockey League. It is not recommended by the Centers for Disease Control and Prevention. It is not standard for there to be widespread testing at schools and colleges, even though the president of Brown University told our committee she would like to test all students on their way back to Brown. The fact is, if we are going to be able to go back to school, back to college, back to work, out to eat, maybe even watch a sports game, maybe even, in some cases, attend a sports game, we are going to need a lot more quick, reliable tests. Let me talk about those, just for a moment, in terms of going back to school and going out to eat and, perhaps, being able to watch a little football this fall. Admiral Giroir testified this month before our committee that our country has done 30 million tests--more than any other country. We are doing that at about the rate of 500,000 tests a day, and he says that we will have four to five times that many in September. Now, I hear about problems in this place or in that place about people not getting tests or that it takes too long for the results to come back from the labs. The fact is, that what is going on now is every State in the country is developing a plan for July through December on how many tests States like Indiana, Tennessee, and Alaska might need in working with the Federal Government, and the Federal Government has been supplying Tennessee with what Tennessee needs. In our State, for example, which is 1 of the States that is in the top 10 of having frequent testing, the Governor has said: If you want a test, you can have a test. Go down to your public health department, and you will get one for free. Now, whether they will be able to continue that, we will see, but that is what we are doing today. Despite that, when 75 million students try to go back to school and college, I imagine principals and administrators will want to test teachers frequently, older people frequently, and everybody in some classes if one student gets sick, maybe everybody in an elementary school if several students get sick, and maybe the parents and grandparents of the children if the children bring home the disease. So we are going to need a lot more tests. This is why Senator Blunt and I and others worked together in the last legislation to support what we called the shark tank at the National Institutes of Health. This was an unprecedented effort at the National Institutes of Health, led by Dr. Francis Collins, who led the Human Genome Project and is one of the most distinguished scientists in our country. This is a project to see if we can find a new way to create tens of millions of diagnostic tests that are what they call point-of-care tests. That means you can take them instantly; that you can get a result within an hour or so; and that they are inexpensive and reliable. You don't have to ship them off. You would probably do this with saliva. So you might put a lollypop in your mouth and let that saliva on the lollypop indicate, one way or another, whether you have a positive or a negative result. Dr. Collins' goal--and he said this is a very aspirational goal--is to be able to produce a million of those tests a day by Labor Day. This would change our lives in many numbers of ways. This would mean that Brown's president could surely test all students, not just once when they go back but more often. It would mean many sports teams could test every player every day if that is what it required. It would mean that we would probably have more tests than we would need. What would that do? It would, one, help to contain the disease so we could identify who has this disease so we could quarantine them and the people they have exposed instead of quarantining all of us and keeping us from going back to school, out to eat, and going to work. It would contain the disease, and it would build confidence. If you are working in a plant with 500 people and you know that 6 people have had to be tested because they had been tested and were found to have been positive, you are going to worry about that. Yet, if you know that you could get a free test today and any time you wanted and could get the result in an hour, I believe you would have more confidence in going to work or in going to school or in going out to eat or even in playing on a football team whether you are in college or in high school. So we are pulling for Dr. Collins' shark tank and his effort to produce these new ways of testing. They have had an unprecedented outpouring of applications. He said most of them come from smaller companies. They are down to 26, I believe is the number, and they are putting them through this rigorous test. His goal is a million new tests a day. That is important for principals to know and teachers to know and those who are hoping to play a little football and watch a little basketball this fall--that there might be plenty of quick, reliable tests to help contain the disease in your community and to be confident that you are in a safe place. And then what is the second thing we could expect? We heard about treatments. As Senator Kennedy says in his inimitable way, people aren't scared of the virus because they are afraid they might get sick; they are afraid they might die. And they might, particularly if they are in a vulnerable population or older age. There is no medicine for this virus, or at least there wasn't until recently. Now there is one, Remdesivir, which the United States has bought a huge amount of, which has been shown to reduce by 32 percent-- according to Dr. Fauci, who testified at our hearing yesterday--reduce by 32 percent the amount of time it takes you to recover from COVID-19. According to the experts who testified, there are other plasma medicines and steroids that have shown to be helpful. That exists today. So if you are a parent or a grandparent or a teacher or administrator worried about children going back to school, you are probably not very worried about the children catching COVID-19 because, generally speaking, they haven't seemed to get sick from COVID-19--all around the world. It has been older people who do. But the children might come home and bring it to the parent or the grandparent. As I said, this is a sneaky, dangerous virus. You can give it to somebody without showing any symptoms of having it. But if you get it, there are already two or three treatments that your doctors, your hospital can prescribe to shorten the time that you recover and to reduce the chance that you might die. Dr. Collins said that by the time we get to the fall, he expects there will be more of these treatments approved by the FDA. There are different kinds of treatments, and he didn't go into all the specifics, but one kind he mentioned was the so-called antibody cocktail. This was developed during the time of Ebola, and it was approved by the FDA. It helped us get rid of the Ebola disease before it came to the United States and caused a lot of trouble here. This antibody cocktail--``monoclonal antibody'' is the longer name of it--is not approved yet. It is not proved to be safe or effective yet, but because it was once before, there is a cautious optimism that it will be approved for COVID-19--a version of it--and that those will be ready by the fall. If it does work out that this treatment is safe and effective and approved by the Food and Drug Administration, there are several companies that have these antibody cocktails, and they should be able to manufacture large numbers of them. I guess my point is, we talk a lot about vaccines. We spend every day hearing about the deaths, the hospitalizations, and what is going on, and this spike or that spike, but as we think about 75 million students going back to school and college, going back to work, whether we will see some football or maybe basketball later, the two aspects that are needed to determine that are tests and whether the shark tank will produce enough of them and treatments, and both seem to have a good possibility of being there for us in the fall. We had a hearing last week that focused on this question: How do we sustain what we have built in this pandemic? In fact, one Senator lectured me a little bit and said: Why are we worrying about the next pandemic? We are in the middle of this one. And my answer was, because for the last 20 years, we forgot about the last pandemic as soon as it was over, and then we got to the next pandemic, and we weren't as ready as we should be. We have had four Presidents and several Congresses that passed nine laws to try to get us ready, and then here comes this sneaky, dangerous virus, and we find some gaps in our preparation. It is not President Trump's gap. It is not President Obama's gap. It is our gap because we didn't do some of the things we should do. One of the things I believe each of us should do in this Senate is be willing this year, this summer, to take the lessons we have learned and sustain what we built, not just to complete our work on this pandemic but to be ready for the next one. For example, do we have enough manufacturing capacity for the vaccines in the United States? Well, we didn't. Now we are building it. Are we going sustain it? No. 2, what about our stockpiles? We filled them up, and then they were depleted--the stockpile here, the stockpile in the States. Hospitals needed money. They sold off their stocks, and so they were depleted. We have now built them up, but are we going to sustain that for the next pandemic or just say: OK, we beat COVID; let's go and worry about something else. What about data? We are not getting all the data we want in the way we should be getting it from the Centers for Disease Control. Are we just going to forget that, or are we going to do something about that now? Hospital preparedness. Hospitals weren't really ready. They did a magnificent job of getting ready, but we lagged on hospital preparedness. We have built that up again. Are we going to sustain it, or are we going to let it drop off once more? Our State and local public health. Almost all of our public health efforts in this country are State and local. We are not a small European country where everything is centralized. We are a great big, complicated, diverse country where parts of Indiana are very different from parts of Tennessee and Alaska and New York or wherever we are from, and as Governor Leavitt, who testified before us, said, for 30 or 40 years, we have gradually disinvested in our public health system. We are not building that up, but are we going to sustain it? So that is my hope, that when it comes to building up this manufacturing capacity here in the United States, increasing our stockpiles to the levels they should be, beginning to collect the data in the way it needs to be, preparing our hospitals to receive patients, building up our State and local public health--are we going to sustain that while we have our eye on the ball, or are we going to do what we have done for the last 20 years and slide off into a short memory? Senator Bill Frist, who was majority leader of this body, said that he made 20 speeches in 2005 and 2006 about what we needed to do to be prepared for the next pandemic, which he said is surely coming. They did some things, but most of the things that he said needed to be done weren't done. We could do them today if we would just have the resolve to do them. Governor Leavitt said that before a pandemic, those who do what he and Senator Frist did, which was to say we need to do all these things, are called alarmists, and then after a pandemic or in the middle of it, they are called inadequate to the task. Then there is the last point I would like to make, and it is about politics. The COVID-19 virus--this sneaky, dangerous enemy--is a science matter, not a political matter, but it has become too much of a political matter. Take the issue of masks. We have gotten into a situation where whether you wear a mask depends on your attitude toward President Trump. For many Americans, it seems that if you are pro-Trump, you don't wear a mask, and if you don't like Trump, you do wear a mask. I suggested that the President might occasionally wear a mask just to signal to his followers that it is a good idea; recommended by every single health expert to wear a mask--certainly for the protection of everybody else. Another way to say it is that our athletic director at the University of Tennessee, Phillip Fulmer, said: If you really, really want to watch some football, wear a mask. What he means by that is that it would help contain the disease in our area so the football players can play safely. Well, yesterday the President made it clear. He said masks are good, and he is happy to wear them when he needs to. Of course, the fact is, he doesn't need to most of the time. He is tested every day. People around him are tested. And--as I am not wearing one right now--he is speaking most of the time. But there are times when I wear my mask. When I leave the floor, I wear the mask. When I go back down the hall, I wear the mask. When I am in a smaller room, less than 6 feet away from somebody, I wear a mask, and I expect others to do that as well. Every expert who testified in the six hearings I attended this month said there are three things to do: Wear a mask, wash your hands, and stay 6 feet apart when you can. If all of us do those things, we are much more likely to be able to go back to school, back to college, back to work, out to eat, and maybe even watch a little football. Vanderbilt University did a survey in the middle of May, and what they found was surprising. Most of the attitudes of people in Tennessee weren't about male versus female or east versus west or any other difference; it was about Republican or Democrat. Republicans didn't want to wear a mask very much; the Democrats mostly did. Republicans were eager to go out to eat; Democrats were a little slower. Republicans weren't as worried about catching the disease; Democrats were pretty worried. The debate got too politicized. I thank President Trump for what he said yesterday. He has 70 or 80 million people as his social media followers. If they get the idea that wearing a ``Make America Great Again'' mask is good for the country, I bet millions will wear it. If they do, the country will be safer, the economy will be better, and we will be able to go back to school and do the other things we want to do. Mr. President, I ask unanimous consent to have printed in the Record my opening statement from our hearing yesterday

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, it is my honor to be here today to see a marine Presiding Officer and a marine making a speech. We are grateful for Senator Sullivan's service to our country and his service in the Senate as a diligent, patriotic, hard-working, good- humored Member of the Senate. I am glad I had a chance to hear his remarks. I was trying to think of where in the world to go on my 50th birthday, and I went to Anchorage, AK, to go fishing at Halibut Cove. I had a wonderful time and have a great memory. So the Senator represents a really terrific State.

Mr. ALEXANDER

Mr. ALEXANDER. Madam President, I am glad to see my distinguished friend from Vermont of many years, and what I would like to say to him is that we, all together, appropriated a record amount of $3 trillion-- another $3 trillion in credit--most of which, much of which has not even been spent yet, and some of which hasn't been distributed to States yet. We are in the midst of reviewing the spending of that money. I know our own committee has had five hearings this month on COVID and its consequences, and I think the wiser course with the taxpayers' money is to wait until the $3 trillion we have appropriated has been distributed to States, has been spent, and is carefully reviewed. In the meantime, we will work very closely with our friends on the other side to determine what else needs to be done during the month of July. So I object.

Mr. ALEXANDER. Madam President, reserving the right to object.

Mr. ALEXANDER

Mr. ALEXANDER. I yield the floor.

Mr. ALEXANDER. Mr. President, I agree with the Senator from Illinois that there ought to be a legislative solution to the DACA children. In fact, we had one in 2013. We worked on it in a bipartisan way--solved a large number of immigration issues, trying to have a legal immigration system. We sent it to the House, and the House didn't consider it. I am ready to continue to do that. I disagree with one thing that happened today, though, about bringing bills to the floor. He talked about the importance of bringing the DACA legislation to the floor. That is important once we have an agreement either in the committee or among us informally. The second bill that is very important to bring to the floor is the National Defense Authorization Act, which has been enacted for more than 50 years and to which members of the Armed Services Committee have a chance to offer amendments. But Senator McConnell is the majority leader, and because he is, he has one right, really, which is to decide what to bring to the floor. He pushed aside the National Defense Authorization Act, which is important, and said: In these times, I think the important thing for me to do is to bring to the floor legislation on police reform and racial justice and allow the Senate to have an open amendment process. He did that in what would be the logical way. Since he is the majority leader, he offered a majority bill sponsored by Senator Tim Scott and cosponsored by a number of us on the Republican side. The vote we had a little earlier today was, shall we proceed to the issue of racial justice and police reform, starting with the Scott bill, with an open amendment process? Now what does that mean? That means that any Democrat could offer the House bill, or any Democrat could offer any other amendment. Now we have gotten into a bad habit around here, which I know the Senator from Illinois doesn't like either, which is if he offers an amendment and I object to his amendment, and then, if I offer an amendment, he says: Well, you objected to mine; I will object to yours. And so we don't have any amendments. But we should be able to bring an important bill to the floor, whether it is DACA or national defense or whether it is, criminal justice, and say that it is open for amendment, and let's have amendments. I think that has happened so little over the last several years that people have forgotten how to do it. If you don't like the amendment, someone can move to table it. That takes 51 votes, and sometimes it is 60 votes. If we get to the end of the process and the minority side doesn't like the bill the way it is, they can keep it from going off the floor by refusing to give 60 votes. So it was very disappointing when the majority leader has taken a limited number of weeks and said: OK, I will give a week and a half to racial justice and police reform, starting with a majority bill and offering to the entire Senate a chance to amend it. For the other side to say: No, we will not even let you go to the bill, I think is very disappointing. Senator Scott is disappointed, and many of us are, and I don't believe it distinguishes the Senate when that occurs. Pandemic Preparation Mr. President, I came to the floor today to talk briefly about a hearing we held yesterday in the HELP Committee on the next pandemic: What do we need to do to prepare for the next pandemic? That caused at least one Senator to say: What are we doing talking about the next pandemic when we are in the middle of a big one right now and we have a lot of work to do? We do have a lot of work to do, but I want to answer that question. The reason we have to talk about the next pandemic is that we have short memories. Memories fade. We go on to the next issue, and we don't do everything we needed to do. We have had public health emergencies before. Some Senators were here when anthrax drove Senators from their offices. There was SARS and the 2009 flu pandemic. There was Ebola. There was MRSA. Four Presidents-- Bush, Obama, Trump, and Clinton--all reacted to those in the way you would think. They issued reports, and they made proposals. We passed nine laws and many new regulations. We tried to do some things to be ready for the next public health emergency. We built buildings to manufacture vaccines. We created a new structure for managing public health emergency. We changed the way the national stockpile is managed. We did a number of things. One of our witnesses yesterday was Senator Bill Frist, who was the majority leader during the mid-2000s. He said he made 20 speeches on or about 2005 when he said the only question about the next pandemic is not whether it is coming but when it will come. He listed six things that needed to be done back then. Well, the reason we had the hearing yesterday was that we didn't get all of those things done. Now, some people might say: Well, weren't we prepared for this pandemic? And most experts felt that we were pretty well prepared. I read yesterday in the hearing a front-page story from the New York Times on March 1 of this year about COVID-19. Let me just go back. March 1 was 6 weeks after we knew about the disease. At the time, we had about 100 cases in the United States and only 2 deaths. There were many cases around the world. But at that time, the New York Times reported that experts said it is ``far from certain'' that this disease would spread to all parts of the country, especially at the same time, and experts believed that the United States was as well prepared as any country to deal with this pandemic. That was on March 1. Two and one- half weeks later, we began to shut down the whole country by order of the Government. So we were prepared, but we were surprised, too, and we underestimated this virus and how aggressive it is and how contagious it is and the fact that it can travel silently without symptoms. So Dr. Frist was one of the witnesses yesterday. Mike Leavitt, a former Secretary of Health and Human Services, former Governor of Utah, was another. Julie Gerberding, who was former head of the Centers for Disease Control, was yet another. She is now at Merck. Dr. Khaldun, who is the chief medical officer of the State of Michigan was there. We talked about the next pandemic. Why talk about it now? Because of the things that Dr. Frist mentioned 20 years ago and the things that really need to get done, we didn't get that all done in between pandemics. Why? We have short memories. Four or five months ago we were in the middle of an impeachment of the President. That sounds like ancient Roman history today. Our minds go on to the next crisis if we don't get things done. So the time to look at the next pandemic is while we are in the middle of this one and say: What are we lacking? What could we do better? And let's fix it while the iron is hot, while our eye is on it. For example, one of the things that they suggested that we do--all of the witnesses--is that we have a dedicated source of funding for stockpiles and for research. Do you think that is easy to do? I don't think it will be easy to get done. It took us years to pass the outdoor recreation bill, the Great American Outdoors Act, because of those kinds of funding issues. We are more likely to create a dedicated stream of funding for preparedness for the next pandemic if we do it in the middle of this pandemic, when we have our eye on the ball. Another recommendation is that we should have an office in the National Security Council to provide coordination between epidemics and during the next one. That is not easy to do, either. When is the best time to do it? Now, during this pandemic, when we have our eye on the ball. Another proposal that came up very often is that we ought to build manufacturing plants for vaccines that we don't use between pandemics and that we ought to spend the money to keep them ``open and warm,'' in the words of Mike Leavitt, so that they are ready when suddenly a pandemic comes Remember, this one hit us fast. There were not many cases on March 1 and shutting down the government by the end of March. We need those manufacturing plants and that is something we haven't gotten done in the way we should have gotten done--some of it. When is the next best time to do it? Now, while we have our eye on the ball. Strengthening our State and local public health systems--Governor Leavitt said that over the last 40 years, we have consistently underfunded our State and local health systems. They are the leaders in our effort to deal with this or any pandemic, including the next one. When is the next time to get over this bad habit of underfunding our State and local public health systems? Right now, when we see that we need it and we see what deficiencies we might have. Now on stockpiles, in between some of these earlier pandemics, we changed the management of the stockpile, spent some money to ensure protective equipment was in there and the things we need. It turned out not to be sufficient. Why? The problem was that between pandemics, we took our eyes off the ball and budgets got tight and States and hospitals began to save money by getting rid of the things in their local stockpiles. So for all of those reasons, the things that we need to do need to be done now. I put out a white paper a few weeks ago inviting comment from experts around the country on what we need to do now to prepare for the next pandemic. Item No. 1 was tests, treatments, and vaccines. How do we accelerate research and development? We are doing a good job now. Hopefully, we will learn from that for the next pandemic. On disease surveillance, there is a lot of criticism of the Centers for Disease Control's inability to gather all the data it needs to track emerging diseases in the way that it should. Now is the time to deal with that. Stockpiles, distributions, and surges in hospitals. We had to shut down hospitals' elective surgeries, creating enormous costs all across the country. We had to come up with $175 billion just over the last 3 months to try to help hospitals recover that. Can we not do a different job of preparing for the surge of patients that will come with a pandemic? Maybe the best time to do that is while we are in the midst of a pandemic. On public health capabilities, I mentioned strengthening the local public health system. Then, who is on the flagpole? Is there a better way to have a Supreme Allied Commander with all the various agencies that we have today. Those plus the need for dedicated funding are difficult issues. The answer to the question, ``Why in the world are we having a hearing on the next pandemic when we are in the middle of this one?'' is because for the last 20 years, between pandemics, we hadn't gotten the job done on some of the things that needed to be done that Dr. Frist mentioned when he was majority leader in 20 speeches, 20 years ago. So if we can't do it between pandemics, let's do it during a pandemic. That is what our hearing was about. It was a good hearing--terrific witnesses, good suggestions. At the end, I asked all four witnesses to please summarize the three things that each one thought should be done this year if they could. As it turns out, they are all hard to do, and, second, most of them would not only help with the next pandemic, but they will help with the current one that we are in. That was our fourth hearing this month by the HELP Committee. We have had a hearing on going back to college safely. We had one on going back to school safely. Those two hearings made clear to me the need for us to consider if we have another piece of COVID legislation in July, that it needs to include sufficient funds to make sure our 100,000 schools and 6,000 colleges can open safely in the fall. The way to open the economy is to go back to school and back to college and back to childcare. That will get us back to work. Two-thirds of the married families in this country have parents, both of whom work outside the home. Children aren't learning when they are let out of school in March and don't go back to school in 6 months or maybe even in 8 or 10 months, if they don't go back in the fall. So there is some health risk, but if we do our job here to provide sufficient funds in July to make sure our 100,000 schools and 6,000 colleges can open safely, that will be the surest avenue toward normalcy in the year 2020 before we have a vaccine. We also had a hearing last week on telehealth. We have had 10 years of experience crammed into 3 months. We have gone from very little telehealth medical services delivered remotely to, in some cases, 40 percent or 50 percent of the doctor-patient visits being done remotely. Many people think that will level off at 15 to 20 percent. That would probably be the biggest change in delivery of medical services in our Nation's history. I can't think of a bigger one. Hundreds of millions of visits will be done remotely instead of in-person. I recommended that at least the two major changes that we have made temporarily in telehealth be made permanent. Yesterday was what to do about the next pandemic. Next Tuesday will be our fifth hearing this month, and it will include Dr. Fauci, Dr. Redfield, Dr. Hahn, and Admiral Giroir, who will give us an update on going back to school and college and work. Mr. President, I ask unanimous consent to have my opening statement from yesterday's hearing printed in the Record