Lamar Alexander

Mr. ALEXANDER

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

Mr. ALEXANDER

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. ALEXANDER. Mr. President, I ask unanimous consent to speak as in morning business.

Mr. ALEXANDER. Mr. President, last year the law everybody wanted to fix was named No Child Left Behind. Despite many different opinions and many different political attitudes, we got it done. I give great credit to the Senator from Washington, Mrs. Patty Murray, and to the members of our Education Committee, 22 Senators of widely divergent political views, for their willingness to do that. I often say if all you want to do is announce your opinion, you can do that at home. You can stand on the street corner and preach or you can get your own radio program, but if you want to be a U.S. Senator, after you announce your opinion, you are supposed to get a result, and that means work with other people to identify common areas of interest and see if you can, and we were able to do that with the bill that fixed No Child Left Behind. Not only did we reach a consensus that needed to be fixed, we reached a consensus on how to fix it. The President signed it on December 10. He called it a Christmas miracle. It passed broadly in this body and it had the effect of reversing the trend toward a national school board, of repealing the common core mandate, and of, according to the Wall Street Journal, being the largest devolution of power from Washington to local control of schools in 25 years. So it was a significant bill, and I would argue that no bill that the Congress enacted last year was more important. This year, I would suggest that if we are successful, that the most important bill that passes this body will be a bill to advance biomedical research, a companion bill to the 21st century cures bill the House of Representatives already passed. That is because this is the opportunity that everybody wants us to take. It is the opportunity to take advantage of the tremendous advances in scientific discovery that have created an environment where we have opportunities to help virtually every American. We are able to cure some cancers instead of just treat cancers. Children with cystic fibrosis are beginning to be actually cured of their disease, a disease that was completely debilitating. Remarkable advances are being made because of genomic research. We have exceptionally talented people in charge of the agencies in dealing with this; for example, Dr. Francis Collins with the National Institutes of Health and now the recently confirmed Dr. Califf at the Food and Drug Administration. So this is the best opportunity we have to make a mark in the Senate this year to help virtually every American, and we have some catching up to do. It is rare that I would admit the House of Representatives is ahead of us, but they are. They called their bill the 21st century cures bill. We have a common objective; that is, to get cures, drugs, and treatments through the regulatory process and the investment process more rapidly and into the medicine cabinets of the doctors' offices so they can help people. They finished their work last year. The President has taken the lead. He has called for a Precision Medicine Initiative. It is one of his major initiatives. I talked with him about it last year. I said: Mr. President, we will help you do that, and the way to do it is through our Biomedical Innovation Initiative. What he wants to do, to begin with, is to get a million genome sequenced so that when the Senator from Arizona is sick--which he rarely is, he is in such good health--or I am sick, the doctor may prescribe medicine that fits our own individual genome and not just a medicine that is, in effect, one-size-fits-all. That is just part of the excitement of precision medicine. And then more recently the President has announced the Cancer Moonshot to try to make further advances in that. There is additional interest on both sides of the aisle in a surge of new funding for the National Institutes of Health, possibly including mandatory funding, if it is properly done, which means replacing other mandatory funding. There is bipartisan interest in that. But none of that will happen unless we move through our committee and on to the floor and to a conference with the House and on to the President's desk our biomedical research bill, our companion bill to the 21st century cures. The only way to get support for the President's Precision Medicine Initiative, the only way to get the Cancer Moonshot, the only way to get a surge of funding that may include mandatory funding for the NIH is to pass this bill. Let's be blunt about it. The good news is, we are making good progress. We are making good progress. I wanted to report to the Senate that this morning we had our second markup, our second meeting of our full committee where we discussed the measure we have been working on for more than a year for our biomedical innovation bill. We have come up with 50 bipartisan proposals that Members have been working on to get patients access to more drugs, cures, and treatments in a safe and effective way. We have held 10 bipartisan hearings on our innovation project, and 6 of those 10 hearings have been on an electronic health care records system. That program, we found, was in a ditch. The taxpayers have spent $30 million on it to try to draw into it doctors and hospitals to use electronic medical records so that you could take--so you know what your records are and the doctors could prescribe and diagnosis more easily. The problem was, it wasn't done very well. Stage one was helpful, most of the hospitals and doctors said to me. Stage two was difficult, and stage three, in their words, was terrifying. Precision medicine will not work unless we have an interoperable electronic health care records system that has as its goal simplifying what happens in the doctor's office or the patient's bedroom in such a way--both with devices and with data--that people can make sense of it. It will improve the practice of medicine. It will reduce the huge amount of time doctors are spending on documentation. Some doctors say they spend 40 or 50 percent of their time doing that. If they are doing that, either they are doing something wrong or the government is doing something wrong, and my guess is we are. That is my guess. So we set out this year to take several steps to change that. The administration--and I will give them credit--has gotten the message as well, and they, including Dr. DeSalvo and Secretary Burwell and Andy Slavitt, the head of CMS, have made a priority of trying to take this electronic medical records system and get it back on track so that doctors and physicians will see it as an opportunity and not as a burden. We have several steps in our legislation that will help make electronic medical records work better. They include giving agencies more flexibility for alliances like the Vanderbilt-Google partnership that was announced the other day. They include dealing with the privacy issues that occur when you get a million genomes sequenced. They include encouraging interoperability and data sharing that is essential to doing this. So we are all working together to do that, but it will be necessary to pass our bill for electronic medical records to move more rapidly, and it will be necessary for the electronic medical records system to work if the President's Precision Medicine Initiative is to work. Last month we had a markup in our committee where we considered 15 of our bipartisan proposals and 7 bills, and we passed them all. The bills will mean better pacemakers for Americans with heart conditions, better rehabilitation for stroke victims, more young researchers entering the medical field, and better access for doctors to their patients' medical records, as I just described. And for the parents of a child suffering from a rare disease like cystic fibrosis, the bill from Senators Bennet, Burr, Warren, and Hatch increases the chances that researchers will find a treatment or cure for your child's disease. That was the good work in the committee last month. Today, we met all morning and we considered 7 more bills, and about 15 more proposals were incorporated in those bills. Each of those bills, the Senators feel, is an important step forward. For example, Senators Casey, Isakson, Brown, and Kirk offered a bill, which was passed, to create drugs to treat or cure rare diseases in children. Senators Burr, Bennet, Hatch, and Donnelly proposed, and it was passed, to create a new system for breakthrough devices that is similar to the breakthrough for drugs that Senator Burr and Senator Bennet and others worked on in 2012, and that has shown such promise and such results. Everyone is pleasantly--I wouldn't say surprised, but maybe surprised by how many new drugs have been approved by the FDA using the breakthrough process from 2012. We hope the same will be true with the breakthrough process for devices. Senators Bennet and Hatch offered a bill that will remove the uncertainty in the definition of ``medical devices'' that was adopted in 1976. Most people didn't even know what software was in 1976. Senators Burr, Casey, Isakson, and Roberts had a bill to spur the development to save the lives of victims of bioterror. Senators Isakson, Casey, Donnelly, and Roberts offered a bill to prevent the promising new field of combination products from getting caught in redtape at the FDA. By combination products, I mean devices and drugs together. A bill from Senators Wicker, Klobuchar, Bennet, Collins, and Franken would increase the say patients would have in the FDA approval process about treatments received in a clinical trial. Senators Franken, Nelson, Isakson, and Brown had a bill to encourage companies to develop a treatment, cure, or vaccine for the Zika virus. These were all adopted, but for these to become law, we have to pass our bill. We have to bring it to the floor this year, and we have to do it in a bipartisan way and pass our bill. At 3 markups--our third one will be in April--we will consider 50 proposals, and every single one of them has bipartisan support. There are two or three areas where we have a difference of opinion. I am glad to see the Senator from Illinois is here because one of the areas we discussed this morning is one where he has been very important, and that is to have a surge of additional funding for the National Institutes of Health. Numbers of us were very proud of the work Senator Murray, Senator Blunt, Senator Durbin, and others did to make sure that we had $2 billion more in the regular appropriations last year for the National Institutes of Health--very important. A number of us believe that it would be appropriate in connection with this innovation legislation to have a surge of additional funding for specific projects at the National Institutes of Health but not at the expense of a steady increase in the regular discretionary funding. There are a variety of reasons for that. I won't go into them all today because the Senator from Illinois may want to speak. But if we are talking about mandatory funding, mandatory funding is already out of control, and the President's new budget has $682 billion of mandatory funding in it. It also has new taxes to pay for it, which the Congress isn't going to adopt. The more responsible proposal would be to reduce mandatory funding by $682 billion. In any event, if we have any mandatory funding, it needs to replace other mandatory funding. And we don't want to create a situation where anyone gets the idea that mandatory funding is a substitute for steady increases in discretionary funding, which has happened before. As Senator Blunt pointed out this week in our appropriations hearing, when the Congress put in the mandatory funding for community health centers and the National Health Service Corps, the discretionary funds started to dry up. So we have different proposals for how to deal with this. The Democratic Senators on our committee have recommended $50 billion over the next 10 years. I recommended an NIH innovation fund which would create a surge of funding for high-priority initiatives at NIH, including the President's Precision Medicine Initiative, the Cancer Moonshot, the BRAIN Initiative, Big Biothink Awards, and a Young Investigator Corps. It would be in addition to discretionary funds, not a replacement for them. So my hope is that Senator Murray and I and our committee can work together over the next 2 or 3 weeks and complete our work on our biomedical research legislation by our markup on April 6. I hope we can come to the floor and present to Senator McConnell, the majority leader, along with that, a bipartisan consensus for an additional surge of funding, including mandatory funding for medical research in the areas I have suggested. I have said that we will need to replace other mandatory funding in order for it to be considered. I hope we can work that way in the committee, and I hope the Senate will look forward to receiving this. I will conclude by simply saying that last year I believe no bill was more important that we worked on in the Senate than the bill to fix No Child Left Behind. It affected 50 million children, 3.5 million teachers, and 100,000 public schools. The only reason it happened was because we had Senators of very different backgrounds and attitudes and political differences who agreed that a result was more important. The same here. The opportunity everybody wants us to take this year is to take advantage of this magnificent scientific revolution and encourage the research and the other steps we need to take to move treatments and cures and drugs into the medicine cabinets and the doctors' offices more rapidly, in a safe and effective way. I believe we can do that. I hope our work is finished by early April. I hope it is bipartisan. I look forward to the opportunity of being able to say later this year that the most important bill the Senate worked on with the House and the President is this 21st century cures idea. The House has done its job. The President is out front. We need to catch up. I am convinced we can. I thank the Presiding Officer. I yield the floor.

Mr. ALEXANDER

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

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President for the information of Senators, the vote will be in about 10 minutes, following my remarks, and I want to make my remarks because of the importance of this nomination. I join the Senator from Washington State in urging our colleagues to vote to end debate on the nomination of Dr. Califf and then tomorrow to vote for him. We are very fortunate to have a man of this distinction accept this position. I congratulate the President for his nomination. I note, as the Senator from Washington said, that his nomination has been widely applauded across this country and received strong bipartisan support in our committee after an intense investigation. I ask unanimous consent to have printed in the Record, following my remarks, a list of 124 organizations that have submitted letters in support of Dr. Califf's nomination to our committee. The list does not include press releases or other statements of support that were not submitted to the committee. Dr. Califf will be in charge of the Food and Drug Administration. That agency is responsible for the safety and effectiveness of our Nation's medicines, devices, and other medical products in protecting our country's food supply. It is not too much to say that this job affects virtually every single American. It is a huge job. The FDA affects nearly every single American and regulates about one-quarter of all consumer spending in the United States--about $4 trillion annually. It is responsible for product areas as diverse as prescription drugs for humans as well as for animals, for medical devices, for biologics, for cosmetics, over- the-counter medications, food, and tobacco. To accomplish this, the FDA employs 15,700 full-time employees worldwide, with an annual total budget of $4.505 billion from funds appropriated by the Congress and user fees paid by the industries it regulates. Managing an enterprise of this size is no small undertaking. It requires strong leadership and a steady hand. Last year, on September 17, the President nominated Dr. Califf. My staff and I reviewed the nomination carefully. I found him to be well qualified to take charge of the FDA. He is one of the Nation's leading cardiologists. He was a professor at one of the Nation's top medical schools for over 30 years. He is an expert on clinical research. He has been recognized by the Institute for Scientific Information as one of the top 10 most cited authors, with more than 1,200 peer-reviewed publications. He has managed large organizations, including the Duke Clinical Research Institute as a founding director. In his current position, he is FDA's Deputy Commissioner for Medical Products and Tobacco, in which capacity he oversees the regulation of products including human drugs, biological products, medical devices, and tobacco. He has conducted scores of important clinical trials and has advised and worked on research with some of the Nation's leading pharmaceuticals and biopharmaceutical companies. In addition, Dr. Califf, like every full-time nominee, has been through an indepth process to review his background. Before the President even announced his nomination, there was an extensive vetting by the White House and the FBI. He submitted paperwork to the Office of Government Ethics, which carefully reviewed that information looking for conflicts of interest. The form he submitted is public and includes every source of income over $200, every asset worth more than $1,000, and every potential conflict that the Office of Government Ethics determined would require a recusal. Before our committee held a hearing, Dr. Califf answered 37 pages of questions from the bipartisan leadership of the committee, including confidential questions on financial information, and he responded to written followup questions. His responses included over 3,000 pages of articles and lectures my staff and Senator Murray's staff reviewed and any Member of the Senate could review. On November 17, the HELP Committee held a hearing on his nomination. He provided testimony and took questions. Afterward, he answered 100 pages of written questions. Throughout this process, we have carefully reviewed everything submitted and not found anything that would call into doubt Dr. Califf's ability to lead the FDA fairly, ably, and impartially. I am pleased to support his nomination. I am pleased the full Senate now will have an opportunity to vote on that nomination in a prompt way. Dr. Califf's nomination comes at an important time for the FDA. For the past year, the FDA has been operating without a confirmed Commissioner. There are important issues there. It needs a confirmed Commissioner to provide the leadership that will carry the agency into the future. One issue that has been on many of our minds is how to make sure American patients have access to affordable drugs. Of course, the FDA's job is not to set drug prices. I am pleased Dr. Califf agreed at his confirmation hearing that he understands the FDA's role is to make sure that drugs are safe and effective, not to regulate their price, but the FDA can help lower drug prices by approving generic drugs and other products as quickly as it possibly can so there is more choice and competition in the market. There are thousands of applications for generic drugs sitting at the FDA awaiting approval. Addressing this backlog, and reviewing new applications as expeditiously as possible, will allow lower-cost drugs to be available to patients. I am confident the FDA can improve its performance. Just last month, our committee held a hearing on this issue and the FDA was optimistic about making progress. We also needed a confirmed Commissioner who can guide the agency to make sure it keeps pace with medical innovation. There has never been a more exciting time in medical research than today. We know more about biology and medicine than ever before, and knowledge is being applied in innovative ways. We are talking about actually curing, not just treating cancers. We are using 3-D printing to help doctors replace knees. In one case the FDA has approved a drug to treat epilepsy that is made by 3-D printing. The President has announced a Precision Medicine Initiative designed to promote personalized treatments to take into account an individual's genes, environment, and lifestyle. These are exciting developments. First, the FDA needs to make sure that regulation is appropriate. Too much regulation could reduce investment. Not enough regulation could lead patients to getting therapies that are not safe and effective. At the same time, the FDA will need to make sure its policies and its procedures, many of which were adopted decades ago, are capable of addressing the technologies of today and tomorrow. Second, as we continue to make medical advances, the FDA will need to keep up with the science and rely on expertise outside the FDA when appropriate. Doing that will require a leader who can manage a large and complex organization--not just on big policies that make headlines but on day- to-day matters such as hiring and training scientists on the core mission and integrating information technology. Medical products take more time and money to discover, develop, and reach American patients than ever before. We hear stories about drugs and devices that are available to patients outside the United States before they become available here, often because it is difficult for manufacturers to navigate the FDA's often unclear approval requirements. It often takes over a decade to develop a drug that gains marketing approval in the United States. According to one recent study, the costs have tripled in the last 10 years. Senator Murray and I are working with our colleagues on our committee on bipartisan legislation to help get safe, cutting-edge drugs, medical devices, and treatments into Americans' medicine cabinets and doctors' offices more quickly. We held a markup on February 9, in which we approved seven important bills with bipartisan support that will help both manufacturers and the FDA to get innovative treatments to patients more quickly. They are all bipartisan bills. Senators Bennet, Warren, Burr, and Hatch offered the Advancing Targeted Therapies for Rare Diseases Act of 2015, S. 2030. If you are the parent of a child suffering from a rare disease like Cystic Fibrosis, this bill increases the chances that researchers will find a treatment or cure for your child's disease. It does that by allowing researchers to reuse good data they have collected, because it is hard to find enough patients for a clinical trial studying a rare disease with multiple genetic mutations. Senators Burr and Franken offered the FDA Device Accountability Act of 2015, S. 1622. If you are one of the millions in our country who will need a medical device such as a pacemaker or knee implant, this bill will help drive the faster development of better devices--cutting unnecessary red tape from the review process for these devices. Senators Baldwin and Collins offered the Next Generation Researchers Act, S. 2014. If you are a smart young scientist who wants to find a cure for cancer, this bill will help the National Institutes of Health create opportunities for you to get funding for your research, so that you don't head to another country or into another field. It will also help you pay back more of your student loans. Senators Kirk, Bennet, Hatch, Murkowski, Isakson, and Collins offered the Enhancing the Stature and Visibility of Medical Rehabilitation Research at NIH Act, S. 800. If you are one of the millions of Americans with disabilities, illnesses and chronic conditions that require medical rehabilitation--maybe you suffered a stroke and need to relearn how to walk--this bill will help ensure that the government is supporting research that will help you have the best chance at rehabilitation. Senators Isakson and Murphy offered the Advancing Research for Neurological Diseases Act of 2015, S. 849. If you are the child of a parent with Parkinson's, this bill will help speed a treatment or cure for your parents' disease by helping researchers have access to more data on neurological diseases. Senator Murray offered the Preventing Superbugs and Protecting Patients Act, S. 2503. If you suffer from something as common as indigestion, or perhaps something scarier like cancer, that requires putting a scope down your throat to diagnose or better understand your ailment, and this bill will help ensure that the scope the doctor uses is clean and doesn't give you an infection. I offered with Senator Murray the Improving Health Information Technology Act, S. 2511. If you are anyone who has ever changed doctors or needs to see a specialist and you want to be sure the new doctor you are seeing knows your medical history so he or she can help you best, this bill takes several steps to get health records flowing between doctors, hospitals, and patients to help realize the promise of health information technology by turning these systems from something that doctors and hospitals dread into something that actually helps patients. We will be taking up more of these proposals in March and in April. The next FDA Commissioner will have a lot of work to do, both to implement the legislation we are passing and to take the existing authority and make sure we help patients as best we can. He will be dealing with one-quarter of the consumer spending in the United States and affecting virtually every American. He is the right person for this job. I strongly encourage my colleagues to vote for Dr. Califf, first today, to end debate on the nomination, and tomorrow, once that has ended, to confirm him in this important position. I yield the floor.

Mr. ALEXANDER. Mr. President, reserving the right to object. The Senator from Washington has 5 minutes to go. I have 10 minutes to go. The vote is at 5:30. So I guess----

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, it is my honor today to congratulate Victor L. Campbell on receiving the Lifetime Achievement Award from the Federation of American Hospitals. Mr. Campbell has devoted 44 years of service to the Nation's health care delivery system and the patients it serves. He has represented the hospital community with distinction and has earned the great respect of his colleagues as a voice of wisdom. He has played a role in shaping Federal health care policy for decades. Mr. Campbell is a three-time chairman and longtime board member of the Federation of American Hospitals. He has also served on the board of the American Hospital Association. Mr. Campbell's commitment and tireless leadership has led to the creation of positive legislative solutions designed to strengthen and improve our Nation's health care infrastructure. He has also developed numerous collaborative initiatives between hospitals and the communities which they serve. As a longtime resident of Nashville, in my home State of Tennessee, Mr. Campbell is also active in various community organizations, which promote innovation, education, and charitable activities. Mr. Campbell, through force of personality, geniality, and dedication, has worked relentlessly to promote market-based, creative approaches to health care delivery which have made difference in the lives of countless patients at community hospitals across our Nation. I sincerely congratulate Mr. Campbell on earning this distinguished award and wish him well.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, the Committee on Health, Education, Labor, and Pensions will meet during the session of the Senate on February 23, 2016, at 10 a.m., in room SD-430 of the Dirksen Senate Office Building, to conduct a hearing entitled ``ESSA Implementation in States and School Districts: Perspectives from Education Leaders.'' For further information regarding this meeting, please contact Jake Baker of the committee staff on (202) 224-8484.

Mr. ALEXANDER. Mr. President, the Committee on Health, Education, Labor, and Pensions will meet during the session of the Senate on February 24, 2016, at 10 a.m., in room SD-430 of the Dirksen Senate Office Building, to conduct a hearing entitled ``Zika Virus: Addressing the Growing Public Health Threat.'' For further information regarding this meeting, please contact Jamie Garden of the committee staff on (202) 224-0623.

Mr. ALEXANDER. Mr. President, the Committee on Health, Education, Labor, and Pensions will meet during the session of the Senate on February 25, 2016, at 2 p.m., in room SD-430 of the Dirksen Senate Office Building, to conduct a hearing entitled ``Nomination of Dr. John King to serve as Secretary of Education.'' For further information regarding this meeting, please contact Jake Baker of the committee staff on (202) 224-8484.

Mr. ALEXANDER

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

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, last summer, by a vote of 81 to 17, the Senate passed a bill to fix No Child Left Behind. The House of Representatives had already passed their version. We had a conference report. We sent it to the President, and it was in December that President Obama signed the Every Student Succeed Acts to fix No Child Left Behind. The President not only signed it in a large ceremony attended by parents, teachers, students, Governors, and people from all walks of life, the President said it was a ``Christmas miracle.'' I think he said that for a couple of reasons. One, it was good news. Miracles are usually good news, and this was good news for 50 million children, 3.5 million teachers, and 100,000 public schools. They had waited 8 years for the U.S. Congress to fix the problems with No Child Left Behind. They knew it was difficult to do, and they looked forward to the result that we achieved because we achieved a consensus. There surely was a consensus if this was a law that everybody wanted fixed, but we also had a consensus about how to fix it. People who don't usually agree in the education world said: We want to keep the tests. We want to keep the 17 federally required, State- designed tests between grades 3 and 12 so we can know how our children are doing, and we want to report that to the parents and the students, but we want to move the responsibility for our children and our schools out of Washington and back to the classroom teachers, back to the local school boards, back to the communities, and back to the Governors. We heard that from the left, and we heard that from the right. We heard that from the Governors, and we heard that from the teachers unions. Because we all had that consensus, we were able to secure a vote of 81 to 17 here, and, as I often said last year, that is not that easy to do. Everyone is an expert on education. We have all had some education. It is like being in the Louisiana State University football stadium or the University of Tennessee football stadium. The stands are filled with 80,000 or 100,000 people who know exactly what the next play to call is because they have all played a little football and they are usually ready to say what it is. So that is what we had to navigate, but we did. As the President said, it was a Christmas miracle and a gift for the children, the teachers, and the parents who care about our public schools. The reason I am on the floor today is to put into the Congressional Record a letter to the Acting Secretary of the U.S. Department of Education, John B. King, Jr. The letter is from a number of those in the coalition of educators and others who helped to pass the Every Student Succeeds Act. Mr. President, I ask unanimous consent to have printed in the Record the letter I am referring to at the conclusion of my remarks. This is a letter from people who don't always work together. In fact, in their letter to the Acting Secretary of Education they say: ``Mr. King, although our organizations do not always agree, we are unified in our belief that ESSA is a historic opportunity to make a world-class 21st century education system. We are dedicated to working together at the national level to facilitate partnership among our members in States and districts to guarantee the success of this new law.'' This letter comes from the National Governors Association, the School Superintendents Association, the National Education Association, and the American Federation of Teachers who all signed this letter. So did the National Conference of State Legislators, the National Association of State Boards of Education, the National School Boards Association, the National Association of Elementary School Principals, the National Association of Secondary School Principals, and the National Parent Teacher Association. I have racked my brain, and I can't think of any significant group in the State or local education world that hasn't signed this letter, except the Council of Chief State School Officers. I have no idea why they have not yet signed it because they were enthusiastically in support of our bill as well, so I hope they are also part of our coalition. But here is the importance of this coalition. The coalition that sent this letter is the same coalition that supported passage of the bill. They know what I know and what Senator Murray of Washington State knows--who was the principal Democratic architect of the bill--that bill isn't worth the paper it is printed on unless it is implemented properly. This bill makes a dramatic shift in policy for elementary and secondary education. The Wall Street Journal called it the largest devolution of power from Washington to the States in a quarter of a century. They are right about that. Both the left and the right had grown tired of a national school board in Washington, in effect, telling teachers and school boards and Governors and legislators what to do about their children and what to do about their schools. Those decisions are best made by those closest to the children. We don't get any wiser by flying from Nashville to Washington each week. In fact, there are a lot of people back in Nashville who think we lose a little bit of our common sense when we come here. So this is important. This is what we usually don't see from Washington--taking large amounts of power and sending it back home where it belongs. That is what all of these organizations say about the new law. Their letter says: ESSA replaces a top-down accountability and testing regime with an inclusive system based on collaborative State and local innovation. For this vision to become a reality, we must work together to closely honor congressional intent. ESSA is clear: Education decision-making now rests with states and districts, and the federal role is to support and inform those decisions. Let me read that again: Education decision-making now rests with states and districts, and the federal role is to support and inform those decisions. That is what the Governors say. That is what the National Education Association says. That is what the American Federation of Teachers says. That is what the superintendents, the legislators, the State boards of education, the school boards, the principals, and the PTA say. And that is what the Senate said, that we are moving power out of Washington and back to the classroom, back to the community, back to the State. Our next year is going to be devoted to making sure that gets done. Our committee--of which the distinguished Senator from Louisiana is a member--will be having six hearings this year with the Department of Education and with many of the people whom I just mentioned to make sure the law is being implemented in the way Congress wrote it. The House of Representatives will do the same thing. Our objectives will be the same that are in this letter--working together to ensure a timely, fair transition to the new law; coordinate with Governors, State representatives, et cetera; promote State and local decision-making--in other words, make sure that what happens is what Congress said should happen. I thank the National Governors Association especially, which took the lead in organizing this coalition. I thank each member of the coalition for organizing this coalition. I will be visiting with the Governors in a week, and I will be suggesting to the Governors--after I thank them for their support for the bill--that every single State organize a coalition just like the coalition represented in this letter. In Tennessee, I think it would be a good idea if the Governor and the superintendent work together with the NEA, the AFT, the legislators, the State board of education, the school boards, the principals, and the PTA to make sure that in Tennessee, the responsibility for the children, the schools, the standards, and the progress is in the hands of those in whom we decided it ought to be vested. And we, at our level in Congress, will keep the spotlight on what is happening here. There was not a piece of legislation more important that passed in the Congress last year. We got a lot of good things done in the last year, but nothing was more important than this, nothing was more difficult than this. I have already mentioned Senator Murray, the Senator from Washington State, who was superb in working with both sides of the aisle to help get a result that had evaded the Senate for 8 years. I welcome the support of this coalition for the very same work we will be doing in the Senate. I hope every State will follow the example of these national organizations. I look forward to a period of innovation and excellence that I am sure will be the result of this new era of accountability, responsibility, and opportunity placed in the hands of those who should have the responsibility for our children and our schools. I thank the president, and I yield the floor.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I thank the Senator from Oregon for his courtesy this morning. I appreciate the senator's remarks on allowing our different points of view to come to the floor and let's vote on it. He is speaking, of course, about the Marketplace Fairness Act, which is a 12-page bill which represents a two-word issue: States' rights. The Majority Leader has said we'll have the ability to vote on that sometime before the end of the year. It is a bipartisan bill. It passed the Senate 2 years ago with 69 votes. It recognizes that States have the right to decide for themselves whether to collect their State sales taxes from all of the people who owe the taxes or some of the people who owe the taxes. It would allow States to do that if they simplify tax administration and exempt small online sellers from collection requirements. It would create a pathway for States and localities across the country to begin collecting an estimated $23 billion annually in uncollected taxes--taxes that are already owed. They can then use that money to balance their budget, to reduce other taxes, to pay for vital services. I don't think Tennessee or any other State should have to play ``Mother, may I?'' with the Federal Government when deciding whether to collect, or not collect, a State tax that is already owed. I can say to our friends on both sides of the aisle, the States are not going to put up with this for very much longer. If Congress continues to be an obstacle to States making their own decisions about their tax structures, governors are going to be suing companies around the country and say, if you are going to sell in our State, you are going to collect the tax that everybody owes. At that point, all those businesses are going to run to us and say: Please pass the Marketplace Fairness Act. I don't think we get any wiser about flying to Washington--one hour in my case--every week than the Governor and the legislature about what our tax structure ought to be. We don't like an income tax in Tennessee, so we have a sales tax. We don't need any incentives from Washington to force us to pass an income tax in Tennessee. Let me say a word about the vote today. I ask the chair, since I noticed the Senator from Michigan is on the floor, to please let me know when all but 30 seconds has expired.

Mr. ALEXANDER. As far as the vote today goes, this distinguished body seems to have developed a case of amnesia. We seem to have forgotten what happened in 1994. 300 Republicans stood on the steps of the Capitol with the Contract with America and said: If we break our contract, throw us out. One goal of that contract was to stop Washington from imposing unfunded mandates on States. One of my most vivid memories is Senator Bob Dole running around the country with a copy of the Constitution and reading the Tenth Amendment to Governors. The Tenth Amendment says: ``The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States. . . . '' He said that. I was there. We were both running for President at the time. The Tenth Amendment was the heart and soul of the Contract with America. Senator Dole was good to his word. The first bill in the Senate after the Republican Revolution in 1994 was a bill prohibiting unfunded mandates. Republicans opposed unfunded mandates then. They should oppose them today. According to the Republican conference rules, ``The Senate Republican Conference believes that Congress should not create new federal unfunded mandates on state and local governments.'' However, today the vote we are about to cast breaks that promise. The Customs bill has a provision that permanently extends the so-called Internet Tax Freedom Act. It prohibits State and local governments from taxing access to the Internet. It tells seven States that are currently collecting a tax that they can't continue to collect. These seven States will lose $100 million in 2020 and several hundred million each year after that. This was not even considered by the House or the Senate when they passed the bill. It was airdropped in violation of rule XXVIII, so the vote we are casting today, a ``yes'' vote, violates the Contract with America, violates the Senate Republican rules, and violates the Senate's rules. I will agree there may be a Federal interest in not taxing Internet access. I agreed with that in the 1990s. Maybe for the first three years there should have been a moratorium when the Internet came along, but where will it end? If you tell States they can't tax access to the Internet, you can also tell them they can't tax access to telephones or food or gas because all of those are important to interstate commerce. It is wrong for Washington to be telling States what their tax structure ought to be. We are not any wiser than the Governor of Tennessee. We're not any wiser than the State legislature in Tennessee. We should leave those decisions to them. That is my objection to the bill today. Instead of voting to oppose another unfunded mandate that tells States what not to do, Congress should consider passing the Marketplace Fairness Act later this year. We should not fall into this bad habit that existed before the Republican revolution of 1994, of assuming that just because we were elected to come to Washington, suddenly we are wiser than all the Governors and all of the legislatures. They are not quite as wise, we are saying. We ought not to be telling them what to do about their tax structure. We ought to leave that to them as the Senate Republican rules say, as the Contract with America said, and as the Tenth Amendment to the Constitution says. Let States do their job, and let us do our job. I yield the floor.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I ask to have printed in the Record a copy of my remarks last week to the National Council of Higher Education Resources. The material follows: National Council of Higher Education Resources I was smiling a little bit when you said that I probably knew more than anybody in Congress about student loans. That is probably true, but that may not be saying very much. This is a complex subject. And although I have been in and around it for a long time, I still spend most of my time listening and learning from you and others who deal with how we help students take advantage of the tremendous opportunities they have in this country. I'm sure some of you were up late last night watching politics. I went to bed early, but 20 years ago I was right in the middle of it. When you have the privilege of running for president, you find out that you spend most of your time hoping nobody says to you what they said to the late Mo Udall--the congressman from Arizona--when he was walking into a barbershop in New Hampshire and he stuck out his hand and said ``I'm Mo Udall running for president,'' and the barber says, ``yeah I know, we were just laughing about that yesterday.'' I watched with interest the results this morning--my sideline view is that Marco Rubio is somebody to watch in the next week. Twenty years ago, about two weeks before the New Hampshire primary, I was at 10 percent in New Hampshire polls, and I came in third in Iowa as Marco did last night. 26% Dole 23% Buchanan and I got 18. That 18 was such a surprise I ended up on the cover of Time magazine and was in first in New Hampshire within the week. So things can change rapidly, and what happens in the 8 days between the Iowa caucuses and the New Hampshire primary should be very interesting--I have no idea what will happen. I do think that 20 years ago it was said to be 3 out of Iowa, and 2 out of New Hampshire. And the financial limits on fundraising were such that it made that come true because you could only raise money from people up to $1000 a person. You can imagine trying to raise millions of dollars at $1000 per person. You can't start a business that way, you can't start a college that way and you can't have a presidential campaign that way. So it was 3 out of Iowa and 2 out of New Hampshire. I think this time they are going to carry 4 out of New Hampshire. And one reason is because the rules have changed about fundraising. So hopefully more Americans will have a chance to participate in the system and will get a chance to run through the southern primaries and on into the convention. So it ought to be an interesting year. I'd like to talk just a minute about higher education and some of the things that I hope we could do. Then I'll be glad to take up to 3 questions you'd like to ask me. I'll be glad and try to respond to them if there's something you want to say to me. First--thank you for the work you do to help students have a chance to participate in what still is the best system of colleges and universities in the world. We have millions of families every year who still fill out their student aid application forms. It's a large number. Here is what our committee, which is the Senate's education committee, will be doing. As Ron said, for the last year our major priority was elementary and secondary education. We tackled fixing No Child Left Behind which was 7 years overdue, and filled with partisan problems. It's like higher education but even more so. In fact--with elementary and secondary education it's like going to a University of Tennessee football game--you've got 100,000 people in the stands and every single one of them played football and is an expert and knows what plays to call and usually wants to call it. Well it's the same thing with elementary and secondary education--you have 50 million students, and 3.5 million teachers and parents. And everybody has got an idea--whether it's transgender bathrooms--they all want to put it in the bill. But all these things could sink the bill in a minute. And I will compliment Senator Patty Murray of Washington because she and I worked together and we got a result and the president to sign the bill. Fundamentally, it was a major change because it basically says ``sure we want to know how the students are doing so the federal government will require you to take 17 tests between the 3rd grade and senior year.'' Then you report that to see how the students are doing. And you disaggregate it so you can see if the African American kids or the white kids or the Latino kids are being left behind. But after that, the decisions about what to do about the results of the tests--if you're a 4th grade teacher in Franklin--that's your business. That's the state of Tennessee's business. So if you want the common core academic standard you can have it. If you don't want it then you don't have to have it. That's not anything the United States Secretary of Education is going to tell you. It's not going to tell you what the test should be, how to evaluate the test, what the accountability system should be and how to evaluate the teachers. People assume that because I have been a big fan of evaluating teachers as Governor that I'll come up here and try to make everybody do it. It's just the reverse with me. I think people are fed up with Washington telling them so much about what to do--whether it's elementary and secondary education or in higher education. My goal with higher education is to try to deregulate it. Try to take the federal rules and regulations which just piled up through 8 different reauthorizations of the Higher Education Act, and simplify them and make them more fair. Several years ago I got an appropriations bill; a study for how to do that with research, and the head of the University of Texas at Austin, chancellor, former chancellor now, had them update me a report. I asked the chancellor of Maryland and the chancellor at Vanderbilt to lead a group of higher education folks to recommend how we could make higher education more simple and effective: 59 recommendations. A few of them the Secretary himself can do. As many as we can, maybe 3 dozen of the rest of those, we hope to put in a piece of legislation that Sen. Mikulski and Bennet from the Democratic side, and Sen. Burr and from the Republican side will introduce. They all will help to save the time and money from this jungle of redtape the study would have. Another simplification we would like to do is with the FAFSA. You know better than almost anybody that it's not necessary to have 108 questions. In fact we had testimony before our committee from people that come from many different directions that said basically you only need 2 questions. One was ``the size of your family?'' and one was ``your amount of income.'' Well, maybe we don't need only 2 questions, but we need a lot fewer questions. I mean you have 20 million families filling that out every year. That's an enormous savings of time and money. And if we simplify and demystify the forms to some degree more students will take advantage of the student aid enrollment. The president of Southwest Community College in Memphis told me he thinks he loses 1,500 students every year just from the complexity of the FAFSA. And so we are experimenting in a whole variety of ways. Parents and grandparents asking, ``why do I have to give this info to the government again, they've already got it on my FAFSA?'' Well, good question. Maybe all you need to do is give permission to the IRS to send it over and you fill out only a few questions. So, simplifying for FAFSA is another thing we have a bipartisan agreement on. We'd like reduce the number of student loans. I'd like to see a single undergraduate loan. I think students would be less likely to over borrow and less likely to make mistakes. And we could use the savings from that to provide another thing that I think would be helpful and that's the year-round Pell Grant. We have ridiculously complex student aid and student aid repayment terms. I saw the other day, Bernie Sanders had some person up there holding up a sign that said she had $90K in student loans and she was paying half of her income to pay it off every year. Well, as an undergraduate loan she doesn't have to do that. If she knew what the existing income-based repayment programs are, she wouldn't have to pay half of her income toward loans, she would only have to pay 10 or 15 % of her income towards it. If she had been working for public service she might have it forgiven. After 20 to 25 years it would be forgiven. So there's a lot of misinformation about student loans and about repayment and our goal is to cut it down to two. To have a 10 year repayment plan and have an income based repayment plan. So you would have two choices. Fundamentally, if students knew what their options were and that they were that simple to understand, we'd probably have a lot more students take advantage of those repayment plans and on the front end a lot more students going to college. There are other steps we'd like to take. The ones I have just described have a lot of bipartisan agreement. We'd like to allow students to use their income from two years ago, called the prior-prior year, to use to fill out their financial aid forms. The administration agrees with us on that. Other areas where we may be able to have a bipartisan agreement on in the Senate are campus safety and sexual assault, accreditation reform, giving institutions more authority to counsel students on how much to borrow as a way to reduce over borrowing. Having institutions have some skin in the game (or risk sharing) as a way to reduce over borrowing. So those are some of the areas where we should be able to have bipartisan support. Now what can we actually get done this year?--My goal is as I've said to the group earlier, the tax payers will pay our salaries this year, and I think we ought to just continue to work. Our number one priority is oversight on the elementary and secondary education bill we passed last year. The bill's not worth the paper it's printed on unless it's implement properly and I don't want the Department of Education granting back to itself all the decision making authority we pushed out of Washington and to the states and classroom teachers. So we're going to be watching that very closely and having a number of hearings. Number two--we have a very important biomedical innovation research bill. There's never been a more important time for scientific research The House has passed, the president's interested in precision medicine and cancer research. We have a genius, Francis Collins, heading the National Institutes of Health. We want to do our part. So that's going to take some time. The third of three top priorities is reauthorization of Higher Education Act. Maybe we can do it all this year. This year is challenging because it's not only an election year, it's a presidential election year. So we have some really interesting proposals on higher education from some of the candidates. You've heard those. And those could box things up in the Senate as we try to deal with them. But we're going to go ahead and take some of these proposals that I've just described, and bring them through our committee, pass them in the House of Representatives, and look for opportunities to bring them to the Senate floor. I'm really proud of what we did in elementary and secondary education. Because I think it's really good policy. It's carefully written, it was vetted by everybody who is involved in the education system, and I think it will govern elementary and secondary education for the next 15-20 years because it will be difficult to change. I'd like to do the same thing for higher education. Over the last eight reauthorizations, the stack of regulations has gone like that. I'd like to start the stack of regulations going downward like that. I'd like your advice as we begin to do it.

Mr. ALEXANDER

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

Mr. ALEXANDER. Mr. President, I ask unanimous consent to speak as in morning business, and will the Presiding Officer advise me when 20 minutes has expired.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, today I would like to report some good news about the work of the Senate that should be of interest to every single American family; that is, that we are moving ahead in the Senate on a package of 50 bipartisan proposals that will help move medical devices, medical cures, and medical drugs through the long, expensive, regulatory process and into medicine cabinets and doctors' offices, where they can help patients. We call this our Innovation Project. It is a companion to work that has been done in the House of Representatives already that they call their 21st Century Cures Act. It is also work that President Obama has talked about in important ways. The reason that the House has already done its work, that the President has talked about this in his State of the Union Address, and that we in our HELP Committee in the Senate have been working for a year to develop 50 bipartisan proposals that we hope to bring to the floor of the Senate is because we have never had a more exciting time in biomedical research in America than today. We are talking about actually curing some cancers, not just treating cancers. We are talking about using 3-D printing to actually help replace knees. I was in a medical device office in Memphis a few weeks ago, and that company told me that in one-third of the cases where it sells knee replacement equipment, it also sells a tool to the doctor made with 3-D printing so that if he or she--the doctor--is replacing the knee of the Senator from Oklahoma, the doctor uses this tool that is just made especially for the knee of the Senator from Oklahoma and virtually eliminates the possibility of a mistake by the doctor in that surgery. The company told me it not only uses 3-D printing in one-third of the cases but that it could easily do it in all of the cases and expects it will soon. At our hearing about 3 weeks ago, I asked Janet Woodcock, the head of the Center for Drug Evaluation and Research at the Food and Drug Administration, if there had ever been a case of a 3-D of printing of a drug, and she said, yes, there had been one. They have used 3-D printing to manufacture a medicine for epilepsy. That is not all. Last year when the President announced his Precision Medicine Initiative, he introduced a young man whose cystic fibrosis had been cured by a new medicine, which he takes every day. While that only benefits some cystic fibrosis patients, the drugs that are used to cure that number of patients are the same kind of drugs they believe eventually will cure every patient with cystic fibrosis. On that day, the President announced what he calls his Precision Medicine Initiative and that he wanted to assemble 1 million human genomes so that if my doctor is prescribing for me a medicine by knowing what my genome is and what that medicine has done in other genomes, he can make a very specific sort of prescription, one that is more likely to help me and less likely ever to hurt me. I attended the President's ceremony. I told him afterward that we would do our best to incorporate his Precision Medicine Initiative into our work in the Senate on our Biomedical Innovation Project. The House was making good progress on its 21st Century Cures project. So I told the President: Mr. President, I can't imagine why we can't get a result in this Congress. Since that time, the President has announced a cancer task force that Vice President Biden is leading to work to speed up treatments and cures for cancer. The House has passed its 21st Century Cures Act. In our committee in the Senate during the past year we have held 10 bipartisan hearings, including 6 on how to improve the electronic medical records systems that hospitals and doctors are using. We have had five bipartisan staff working groups that have met or held briefings more than 100 times in the last year, and the result of their work has been 50 bipartisan legislative proposals. As I said, every single one of those has support from Democrats as well as Republicans on the committee. Today in our committee we debated and approved the first 7 of these bills, which included 12 of the 50 bipartisan proposals I just mentioned. We had an open process. Any Senator who wished to could have offered an amendment. The bills have had so much work on them that there weren't any amendments, but they were important pieces of work. Our committee probably is the most diverse in the Senate. I know that is saying a lot, but if you look up and down the Democratic and Republican aisle, we span the whole spectrum. Last year we worked together, despite our differences of opinion, and produced a bill to fix No Child Left Behind. A lot of people thought we couldn't do that. I expect the same sort of bipartisan effort led by Senator Murray, the senior Democrat on her side, and me as chairman, to work well for us again. We have a second markup of legislation scheduled for March 9 and a third for April 6. My expectation is that after we meet these 3 times and consider 50 legislative proposals, when we are finished it will all add up to bipartisan companion legislation to the House's 21st Century Cures legislation, and our legislation will include important elements of the President's Precision Medicine Initiative in his Cancer Moonshot. The 21st Century Cures Act, the House bill, includes $9.3 billion in so-called mandatory funding over 5 years, mostly for the National Institutes of Health. Several of President Obama's other proposals in his new budget involve mandatory funding, and several Members of our committee have talked to me about mandatory funding for some of the work we need to do. Here is my view about mandatory funding: I don't want to get the cart before the horse. When I was Governor of Tennessee and we needed a new road system, people would say to me: Are you going to raise the gas tax? I said we are not going to talk about the gas tax. There are lots of different ways to pay for the road. You can borrow the money. You can use discretionary money. You can raise the fuel tax. You can build a toll road. We are not going to talk about any of that. First, we are going to decide on what we want to do. What we decided to do was to have three big road programs to attract the auto industry suppliers to Tennessee, and it worked. The decision we made after we decided what we wanted to do was in that case to raise the fuel tax three times because we didn't want any road debt. We have among the best roads in the country and zero road debt, and we have the auto industry. That worked out pretty well for us 30 years ago. I would like to apply the same sort of thinking here. I don't want to talk about how we pay for something before I decide what the something is. Here is the something I am thinking about. I am thinking about something called the NIH--National Institutes of Health--Innovation Projects Fund; five areas, in addition to the things we normally fund and do that require extraordinary support, one-time support for ideas that have a start and a finish. In other words, they are not built into the budget for a long period of time. The National Institutes of Health Director would have the authority to direct allocations of this fund to specific areas of importance. The five areas of importance I have in mind are helping the President launch his Precision Medicine Initiative and an American Young Investigators Corps. We have heard from Dr. Collins, the head of NIH, and many others how important it is to have young investigators have enough money to give them the money to do their research. The BRAIN Initiative, all of us are staggered by the prospect of the personal anguish that Alzheimer's and other brain diseases will cause individuals and their families, and we are excited about the prospect of relieving that anguish. We know how much this is going to cost us--in the tens and tens of billions of dollars. If we can find a way to develop new understandings of neurological disorders, which help discourage Alzheimer's disease or prevent it or deal with it, it saves money as well as saving anguish. A Big Biothink Award--Dr. Collins had suggested this in some of his testimony. During this exciting time, let's let each of the 24 Institutes that fund grant awards at the National Institutes of Health issue a challenge and let them identify the most promising big ideas in the country in their areas and fund it; for example, cancer, mental health. Let's see what comes out of this remarkable country of ours when we challenge them in that way. Then the Cancer Moonshot--now that the President and the Vice President are involved in this way, we want to make sure we do all we can to take advantage of curing some cancers as well as treating some cancers. There may be some aspects of that effort that have a start and a finish that could be part of what I call NIH Innovation Projects Fund. I go into some detail about my Innovation Projects Fund proposal because we may be able to fund these needs in the regular appropriations process, but I am willing to consider using mandatory funding for these five areas because, No. 1, they have a start and a finish. They help jump-start. They are limited. In that sense, they are not subject to being appropriated forever, as appropriations often are. No. 2, I believe we should reduce other mandatory funding in order to use this mandatory funding. We should be about setting priorities in the Senate. I cannot think of a more important priority than biomedical research. I mentioned we have 50 legislative proposals for which we have bipartisan support, but we do not have bipartisan agreement in the Senate committee on how to deal with any of these items that are paid for by mandatory funding, and neither do we have enough money within the jurisdiction of our committee to deal with it. So we will deal with both the Innovation Projects Fund and the mandatory funding--if that is what it turns out to be to pay for it--once the bill comes to the floor. We have to decide first what programs we want and then how to pay for them. We should do that on the floor. We know we will have to have 60 votes to do it in that way that includes mandatory funding. We had some experience with that. Last year we had some very difficult issues with the Elementary and Secondary Education Act. I had one of them that had to do with vouchers. That drives some people on the other side of the aisle up the wall. If I insisted on putting the scholarships for kids proposal that I had on the bill in the committee, the bill may never have gotten to the floor. Senator Franken, on the other hand, had an important piece of legislation to him on discrimination, but if he had gotten that on the bill in the committee, it would never have gotten to the floor. We agreed, since we needed 60 votes to get a result--and a result is what we want and the American people expect us to get--that we would withhold our controversial amendments until the floor and see if we could develop bipartisan support on the floor to have at least 60 votes and get a result. We followed, in our Education bill, the rule that the late Senator Kennedy and Senator Enzi followed when they were the ranking members of this committee, and that was let's find the 80 percent we agree on and work on that first, and let's take the things we disagree on and do those later, but most important, just as Senator Kennedy did with Senator Enzi, just as the full Senate did last year on fixing No Child Left Behind, we kept in our mind getting a result. I said on the floor many times last year that if all you want to do is make a speech or assert your point of view, you can stay home. You can get your own radio program. You don't have to travel as much. There is no need for you to come to the U.S. Senate. You can have your say here, but if you really want to do your job here, you can work with other people and see if we can get a result, especially when we are talking about issues that affect every American family in such an important way. I am determined to get a result. I am delighted I have the opportunity on this committee to work with the Senator from Washington, Mrs. Patty Murray. She is a strong Democrat. She is the leader of the Democratic caucus, but because of her leadership and her interest in getting a result, we were able to succeed last year. I believe, working with her and the other Members of our committee, we will be able to succeed this year. The House of Representatives has done its work. It has passed the 21st Century Cures legislation. The President has made his proposals for precision medicine and for a cancer moonshot. He talked to all of us during his State of the Union Address in the last two sessions. We have worked for a year in our committee to produce 50 bipartisan legislative proposals that should go through the committee and be ready in early April to come to the floor. The majority leader, Senator McConnell, has said to me, and he has said to all of us, that even though this is a Presidential year and we have less time here, he is still looking for important ideas that benefit a large number of Americans that have bipartisan support and that the President will sign into law. I can't think of a single piece of legislation that the Senate could consider this year that fits that definition better than our companion legislation to the House of Representatives' 21st-Century Cures legislation. I wish to say a word about the legislation we passed today. As I mentioned, these were all bipartisan pieces of legislation. The first one was introduced by Senator Bennet, Senator Warren, Senator Burr, and Senator Hatch. It had to do with rare diseases such as cystic fibrosis. This is what Senator Susan Collins of Maine said about that piece of legislation during the debate in our committee: If you ask the parents of sons or daughters--primarily sons--with muscular dystrophy who suffer from Duchenne's, a very rare kind of muscular dystrophy, whether the bill we just approved is important, believe me they will tell you that it is. We approved it unanimously, and it is ready for the Senate to consider. Senator Burr, a Republican, and Senator Franken, a Democrat, offered the FDA Device Accountability Act of 2015. This legislation would help move innovative medical devices ahead--such as artificial knees, insulin pumps for people with diabetes, stents for people who have suffered a heart attack--and new surgical tools that can get bogged down in the FDA. In other words, we want to keep the safe and effective gold standard, but we want to get these devices through the system as rapidly as we can, at the lowest cost we can, so people can afford and use them. Senator Baldwin and Senator Collins--Democrat and Republican--offered a bill called the Next Generation Researchers Act. We know that biomedical research is our best weapon against diseases, illness, and death, and we can't afford to lose young scientists to other countries, so this bill helped to attract young scientists by promoting opportunities at the National Institutes of Health. This is what Senator Collins had to say about that: If you asked Dr. Francis Collins--the head of NIH--whether the bill that Senator Baldwin and I have sponsored is important to attracting and keeping young researchers, believe me he would say yes. Senator Kirk, a Republican, Senator Bennet, a Democrat, along with Senator Hatch, Senator Murkowski, Senator Isakson, and Senator Collins, introduced another piece of legislation, S. 800. This bill will help millions of Americans with disabilities, illnesses, and chronic conditions that require them to go to medical rehabilitation. Senator Kirk, a stroke victim, spoke movingly about the importance of that bill. This morning, Senator Collins said: If you ask stroke victims whether the rehabilitation bill that we passed is important, they would say yes. There were four other bills we enacted. The one by Senator Isakson-- we didn't enact it--we approved it by committee. Senator Isakson and Senator Murphy had legislation on advancing research for neurological diseases. This is what Senator Collins said about that one: If you asked families that are struggling with neurological diseases such as Parkinson's, MS, or Alzheimer's, whether the bill that is on the agenda today is important, they would say yes. Senator Murray offered the Preventing Superbugs and Protecting Patients Act, which is based on incidents that happened in her home State of Washington. Finally, Senator Murray and I offered legislation to improve electronic medical records. Our committee did not set out to deal with electronic medical records, but the more we got into our discussion----

Mr. ALEXANDER. We have used 20 minutes?

Mr. ALEXANDER. I thank the Presiding Officer very much. I will complete my remarks. I see the Senator from Florida is here. Before I yield the floor, I wish to make a brief statement about the legislation Senator Murray and I introduced. The electronic medical record system in this country is in a ditch. Doctors and hospitals that use it have come to dread it. The administration recognizes that there are problems. They haven't taken all of my advice about what to do about it, but I do give them credit. I thank Secretary Burwell, Dr. Karen DeSalvo, the National Coordinator for Health Information and Technology, and the head of CMS, Andy Slavitt, for working with our committee, Senator Murray and me, to try to find ways to make the electronic medical record system something that genuinely helps patients and that doctors look forward to instead of dreading. We have to do this because almost every advance we need to make in biomedical innovation depends upon this. Certainly the President's Precision Medicine Initiative absolutely depends upon our getting electronic medical records right. Perhaps the most important piece of legislation we approved today, among those seven pieces of legislation, was doing what we could do in legislation to get the electronic medical record system out of the ditch and onto a better track so that doctors use it rather than dread it. We are counting on the administration to continue to work with us to finish that job. I believe this is good news for the American people. It means we are on a path, step by step, to do our part of the job. There was some debate in our committee about whether the bills we were passing were important. I ask unanimous consent that following my remarks, Senator Collins' comments, which remind us why each of the seven pieces of legislation is important, be printed in the Record. There was some talk about the fact that we disagreed about the level of mandatory funding or whether to do it at all. We disagreed about that. We don't have bipartisan consensus on it, but we do have bipartisan consensus on 50 legislative proposals that we need to move ahead, and we will move ahead with them. Twelve of the 50 were done today, and the rest will be done in early March and early April. My hope is that by early April, the Senate will be able to join the House of Representatives and President Obama and say: Here is our contribution to the most important step we can take to make the quality of health better for virtually every American family by passing our companion legislation to 21st-century cures. Mr. President, I also ask unanimous consent to have printed in the Record, following my remarks, the summary of each of the seven bills our committee approved today. I thank the Presiding Officer, and I yield the floor.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I ask unanimous consent to have printed in the Record a copy of my remarks to the Senate Committee on Health, Education, Labor, and Pensions.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I urge a ``yes'' vote because I think an important part of a Republican pro-growth policy is support for government-sponsored research. That is how we got 3-D mapping and horizontal drilling that led to unconventional gas and oil. That is how we are going to get the cost of carbon capture low enough to make it commercial. That is how we are going to get solar panels cheap enough to make them useful. We should reduce wasteful spending on subsidies for mature energy technology and double energy research, and this would do that on a conservative path. At 5 percent a year, it would take 10 years to double the $5 billion of energy spending we have today. I urge a ``yes'' vote.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, I ask unanimous consent that a copy of my remarks to the Senate Committee on Health, Education, Labor, and Pensions be printed in the Record.

Mr. ALEXANDER

Mr. ALEXANDER. Mr. President, the Committee on Health, Education, Labor, and Pensions will meet during the session of the Senate on January 28, 2016, at 10 a.m. in room SD-430 of the Dirksen Senate Office Building, to conduct a hearing entitled ``Generic Drug User Fee Amendments: Accelerating Patient Access to Generic Drugs.'' For further information regarding this meeting, please contact Jamie Garden of the committee staff on (202) 224-0623.