Susan Collins

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today to introduce the Clean Cooking Support Act. I am pleased to be joined in this effort by my friend and colleague, Senator Durbin. Our bill aims to address a serious global public health and environmental issue where leadership by the United States can make a real difference. Today, close to 3 billion people, or one-third of the global population, rely on ``dirty cooking,'' such as open fires or inefficient, polluting, and unsafe cookstoves that use agricultural waste, coal, dung, wood, charcoal, or other solid fuels, to cook their meals. The majority of people using these types of cookstoves and fuels are in developing countries in Asia, Africa, and Latin America. Exposure to smoke from these traditional cooking methods and open fires, referred to as ``household air pollution,'' causes chronic and acute diseases such as lung cancer, heart disease, and stroke. Alarmingly, the household air pollution caused by traditional cookstoves and open tires causes 4 million premature deaths annually, including 400,000 children younger than 5 years of age, most of whom live in sub-Saharan Africa. Women and girls are disproportionately affected, as they spend hours cooking, inhaling toxic smoke, and collecting fuels. These cookstoves also create serious environmental problems. Household air pollution does not remain in the home; it contributes to more than 10 percent of global ambient air pollution. According to the EPA, greenhouse gas emissions from nonrenewable wood fuels for cooking amount to 2 percent of the global CO2 emissions, on par with the global CO2 emissions from the aviation or shipping industries. In 2019, more than 600,000 deaths were attributed to ambient air pollution stemming from the household combustion of solid fuels. These cookstoves should be replaced with modern alternatives to reverse these alarming health and environmental trends. Since 2010, the Clean Cooking Alliance, an innovative public-private partnership hosted by the United Nations Foundation, has supported the adoption of clean cooking worldwide, with the goal of achieving universal access to clean cooking by 2030. Recognizing the serious health and environmental issues posed by traditional cookstoves, the Alliance aims to save lives, improve livelihoods, empower women, and combat pollution by creating a thriving global market for clean and efficient household cooking solutions. In April, President Biden announced that the U.S. is resuming and strengthening its commitment to the Clean Cooking Alliance, and during a recent presentation at the 2021 United Nations Climate Change Conference that covered clean cooking and household energy, EPA Administrator Michael Regan reaffirmed this undertaking as well. Our legislation reinforces our country's policy on promoting clean cookstoves and seeks to take a whole-of-government approach to address household air pollution. Specifically, the Clean Cooking Support Act would create an interagency working group, with representatives from at least six different Federal agencies, committed to increasing access to clean cooking fuels and technologies worldwide. Our legislation explicitly spells out the role of each Federal agency in the advancement of clean cooking as well. The Department of Energy, for instance, is tasked with research and development to spur the production of low-cost, low-emission, and high-efficiency cookstoves, while the Department of State is directed to engage in diplomatic activities across the globe to support the clean cooking and fuels sector. Finally, our bill would authorize funding for the U.S. Government to continue such activities through 2027, to ensure that these important efforts to prevent unnecessary illness and reduce pollution around the globe continue. Our legislation would directly benefit some of the world's poorest people, including the women and girls who are disproportionately affected, and reduce harmful pollution that affects us all. I urge my colleagues to join me and Senator Durbin in supporting the Clean Cooking Support Act.

Ms. COLLINS

Ms. COLLINS. Thank you. Thank you very much. Thank you. (Applause, Senators rising.)

Ms. COLLINS

Ms. COLLINS. Madam President, I ask unanimous consent that the remaining votes be 10 minutes in length.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today with my colleague, Senator Tina Smith, to introduce the Medicare Mental Health Inpatient Equity Act, legislation that eliminates Medicare's arbitrary 190-day lifetime cap on inpatient services in psychiatric hospitals. Given the steps that Congress has already taken to establish parity and improve coverage of mental health services, this change is long overdue, particularly as the COVID-19 pandemic has worsened the already alarming trends in the mental health of some Americans. Notably, an estimated 13.1 million adults aged 18 or older in the United States are living with serious mental illness, representing 5.2 percent of all adults nationwide. These illnesses, such as schizophrenia and bipolar disorder, are chronic conditions that require ongoing treatment and care over a lifetime. When left untreated, they can be some of the most debilitating and destructive illnesses afflicting Americans. Unfortunately, our current mental health system is fragmented, and these individuals all too often lack access to the care that they need. That is why I have worked to improve mental health services across the lifespan and break down barriers to treatment. The legislation I am introducing today eliminates another barrier in Medicare, the 190-day lifetime cap on inpatient services in psychiatric hospitals. Most Medicare beneficiaries treated in inpatient psychiatric facilities qualify because of a disability. As such, this current restriction disproportionately impacts non-elderly Medicare beneficiaries--mainly those living with schizophrenia and bipolar disorder who may be diagnosed at a younger age and stay on Medicare longer as a result. Sadly, it is young adults aged 18 to 25 years who currently have the highest prevalence of serious mental illness of any age group. Furthermore, no other Medicare inpatient service has these types of arbitrary caps, which is why elimination of Medicare's lifetime cap was a recommendation of the 2016 White House Mental Health and Substance Use Disorder Parity Task Force. While I recognize that this cap was originally intended to limit the Federal Government's role in paying for long-term custodial support of the mentally ill, keeping a cap on inpatient days at psychiatric hospitals--particularly for patients who have been living with serious mental illness from a young age-- undermines patient treatment options and can lead to disruptive transitions of care. During their life, people with serious mental illnesses may need repeated psychiatric inpatient hospital stays to manage their condition and regain quality of life in their community of choice. The 190-day lifetime limit can hurt people by arbitrarily ending coverage and can disrupt care from a provider who is most familiar with the patient. Moreover, when individuals with mental illness cannot receive care in the right setting, they often end up in hospital emergency rooms, in jails, or on the streets--leading to worse long-term outcomes for the individual, more pain and suffering for family members, and a greater cost to the taxpayer. Outside a psychiatric inpatient hospital, it is difficult for many healthcare facilities to meet the treatment needs of those suffering with severe mental illness. Many general hospitals lack psychiatric care capacity, and there are countless examples of psychiatric boarding in emergency departments. Skilled nursing facilities may also not be best suited to provide the complex and specialized psychiatric care these beneficiaries need. Finally, too many patients find themselves receiving care in prisons, or not at all, if they are on the streets or are on long waitlists for care. As one local sheriff in Aroostook County recently told me, ``Law enforcement is not equipped to handle individuals with mental health challenges and yet we are faced with that reality every day.'' Similarly, a behavioral health provider in Presque Isle, ME, said, ``Imposing a limit may appear to reduce cost; however, the true cost-and toll-on community resources is far greater than any savings incurred by Medicare.'' On top of all of these existing challenges, it is clear the COVID-19 pandemic has increased stress and isolation, disrupted care services, and dramatically changed everyday life and even living environments for many Americans. With research pointing to greater psychological distress during the pandemic for people with mental illnesses, already a particularly vulnerable population, I fear we will be trying to make up for lost strides in behavioral health care for years to come. Now more than ever, we must work on commonsense reforms that provide parity between behavioral and physical health care, as well as strive to increase access to support and improve care coordination. As the American Hospital Association, which endorses this bill, said, ``As we work to further integrate physical and behavioral health to better address the nation's behavioral health needs, one major obstacle to parity remains in the Medicare program--the 190-day lifetime limit on coverage for certain inpatient psychiatric treatment. With the nation's population aging and an increasing number of seniors and people with disabilities seeking inpatient care to address their behavioral health needs, now is the time to repeal this discriminatory policy and ensure that Medicare beneficiaries can receive necessary inpatient psychiatric care.'' The pandemic may have had a disastrous effect on the mental health of the Nation, but it has also led to more visibility and the understanding that individuals with serious mental illness, their families, and the communities in which they live do not have access to the care and resources they need. I hope we can use what we have learned throughout the pandemic as an opportunity to reduce stigma and make overdue reforms like removing the 190-day lifetime cap on inpatient services in psychiatric hospitals. Our legislation, the Medicare Mental Health Inpatient Equity Act, is supported by a wide range of organizations, including the American Hospital Association and the Mental Health Liaison Group, a coalition of 57 national organizations representing consumers, family members, and mental health and addiction providers. This includes support from the National Association of Behavioral Healthcare, the American Psychiatric Association, the American Psychological Association, the National Alliance on Mental Illness, and Mental Health America. I urge my colleagues to support this important critical legislation to bring greater mental health parity to the Medicare Program and give those suffering with serious mental illness access to the care they so desperately need. Mr. President, I ask unanimous consent that the material be printed in the Record.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today with my colleague, Senator Tina Smith, to introduce the Medicare Mental Health Inpatient Equity Act, legislation that eliminates Medicare's arbitrary 190-day lifetime cap on inpatient services in psychiatric hospitals. Given the steps that Congress has already taken to establish parity and improve coverage of mental health services, this change is long overdue, particularly as the COVID-19 pandemic has worsened the already alarming trends in the mental health of some Americans. Notably, an estimated 13.1 million adults aged 18 or older in the United States are living with serious mental illness, representing 5.2 percent of all adults nationwide. These illnesses, such as schizophrenia and bipolar disorder, are chronic conditions that require ongoing treatment and care over a lifetime. When left untreated, they can be some of the most debilitating and destructive illnesses afflicting Americans. Unfortunately, our current mental health system is fragmented, and these individuals all too often lack access to the care that they need. That is why I have worked to improve mental health services across the lifespan and break down barriers to treatment. The legislation I am introducing today eliminates another barrier in Medicare, the 190-day lifetime cap on inpatient services in psychiatric hospitals. Most Medicare beneficiaries treated in inpatient psychiatric facilities qualify because of a disability. As such, this current restriction disproportionately impacts non-elderly Medicare beneficiaries--mainly those living with schizophrenia and bipolar disorder who may be diagnosed at a younger age and stay on Medicare longer as a result. Sadly, it is young adults aged 18 to 25 years who currently have the highest prevalence of serious mental illness of any age group. Furthermore, no other Medicare inpatient service has these types of arbitrary caps, which is why elimination of Medicare's lifetime cap was a recommendation of the 2016 White House Mental Health and Substance Use Disorder Parity Task Force. While I recognize that this cap was originally intended to limit the Federal Government's role in paying for long-term custodial support of the mentally ill, keeping a cap on inpatient days at psychiatric hospitals--particularly for patients who have been living with serious mental illness from a young age-- undermines patient treatment options and can lead to disruptive transitions of care. During their life, people with serious mental illnesses may need repeated psychiatric inpatient hospital stays to manage their condition and regain quality of life in their community of choice. The 190-day lifetime limit can hurt people by arbitrarily ending coverage and can disrupt care from a provider who is most familiar with the patient. Moreover, when individuals with mental illness cannot receive care in the right setting, they often end up in hospital emergency rooms, in jails, or on the streets--leading to worse long-term outcomes for the individual, more pain and suffering for family members, and a greater cost to the taxpayer. Outside a psychiatric inpatient hospital, it is difficult for many healthcare facilities to meet the treatment needs of those suffering with severe mental illness. Many general hospitals lack psychiatric care capacity, and there are countless examples of psychiatric boarding in emergency departments. Skilled nursing facilities may also not be best suited to provide the complex and specialized psychiatric care these beneficiaries need. Finally, too many patients find themselves receiving care in prisons, or not at all, if they are on the streets or are on long waitlists for care. As one local sheriff in Aroostook County recently told me, ``Law enforcement is not equipped to handle individuals with mental health challenges and yet we are faced with that reality every day.'' Similarly, a behavioral health provider in Presque Isle, ME, said, ``Imposing a limit may appear to reduce cost; however, the true cost-and toll-on community resources is far greater than any savings incurred by Medicare.'' On top of all of these existing challenges, it is clear the COVID-19 pandemic has increased stress and isolation, disrupted care services, and dramatically changed everyday life and even living environments for many Americans. With research pointing to greater psychological distress during the pandemic for people with mental illnesses, already a particularly vulnerable population, I fear we will be trying to make up for lost strides in behavioral health care for years to come. Now more than ever, we must work on commonsense reforms that provide parity between behavioral and physical health care, as well as strive to increase access to support and improve care coordination. As the American Hospital Association, which endorses this bill, said, ``As we work to further integrate physical and behavioral health to better address the nation's behavioral health needs, one major obstacle to parity remains in the Medicare program--the 190-day lifetime limit on coverage for certain inpatient psychiatric treatment. With the nation's population aging and an increasing number of seniors and people with disabilities seeking inpatient care to address their behavioral health needs, now is the time to repeal this discriminatory policy and ensure that Medicare beneficiaries can receive necessary inpatient psychiatric care.'' The pandemic may have had a disastrous effect on the mental health of the Nation, but it has also led to more visibility and the understanding that individuals with serious mental illness, their families, and the communities in which they live do not have access to the care and resources they need. I hope we can use what we have learned throughout the pandemic as an opportunity to reduce stigma and make overdue reforms like removing the 190-day lifetime cap on inpatient services in psychiatric hospitals. Our legislation, the Medicare Mental Health Inpatient Equity Act, is supported by a wide range of organizations, including the American Hospital Association and the Mental Health Liaison Group, a coalition of 57 national organizations representing consumers, family members, and mental health and addiction providers. This includes support from the National Association of Behavioral Healthcare, the American Psychiatric Association, the American Psychological Association, the National Alliance on Mental Illness, and Mental Health America. I urge my colleagues to support this important critical legislation to bring greater mental health parity to the Medicare Program and give those suffering with serious mental illness access to the care they so desperately need. Mr. President, I ask unanimous consent that the material be printed in the Record.

Ms. COLLINS

Ms. COLLINS. Mr. President, it is with a great deal of hometown pride that I rise in strong support of the confirmation of Darcie McElwee to be the new U.S. attorney for the State of Maine. Both Darcie and I are natives of the northern Maine community of Caribou. Since 2002, Darcie has been an assistant U.S. attorney, and she has served as the Project Safe Neighborhoods coordinator for that office since 2005. She primarily has prosecuted violent crime cases, including those involving sex trafficking, interstate domestic violence, and child sexual exploitation, as well as firearms and arson cases. Darcie served as assistant district attorney for Penobscot County and Piscataquis County from 1998 to 2002. Darcie is a member of the Maine Trial Lawyers Association and a past president of the Cumberland Bar Association. She has also served as an adjunct professor at the University of Maine School of Law and at the Maine Trial Lawyers College of Advocacy. Darcie received her J.D. degree from the University of Maine School of Law in 1998, and her undergraduate degree from Bowdoin College. Throughout her career, Darcie has worked tirelessly to keep Mainers safe from violent crime and to achieve justice for victims. She is an intelligent, experienced, and highly competent law enforcement professional. Her extensive track record as a career prosecutor makes her ideally suited for this important position. Based on her experience and her character, as well as her Caribou roots, I have every confidence that Darcie will faithfully uphold our Nation's laws and work to ensure public safety and order. Throughout her distinguished career, she has demonstrated a strong commitment to public service, and I know that she will serve the State of Maine and our Nation extremely well as Maine's next U.S. attorney. I am absolutely delighted that the Senate, without dissent, tonight confirmed Darcie McElwee for this important position.

Ms. COLLINS

Ms. COLLINS. Mr. President, I ask unanimous consent that, following my remarks, Senator Lankford and Senator Scott of South Carolina be recognized to speak and to complete their remarks prior to the vote.

Ms. COLLINS

Ms. COLLINS. Mr. President, the debate on President Biden's massive plan to expand social programs has focused primarily on its enormous cost. Remarkably, little attention has been paid to the content of those policy changes. Yet the expensive entitlement programs the administration is proposing would have profound implications for people's lives and for the values that are among the pillars of our society, for they would break the connection between work and a brighter future. From antiquity to our time, great thinkers have observed that work is about more than just putting food on the table, important though that is; it has a profound value that enables people to build lives of self- reliance and meaning. As Dr. Martin Luther King, Jr., once said: No work is insignificant. All labor that uplifts humanity has dignity. Under the President's plan, assistance checks sent from Washington would have no requirement that a recipient work, or pursue education or training, or participate in programs to remove barriers that prevent him or her from working. These unconditioned checks would sever the link between government assistance and work, education, or other requirements. No one would help a family identify obstacles to a better life. In essence, the Biden administration would reverse the pledge and reality of President Clinton's reforms when he promised to ``end welfare as we know it.'' Robert Doar, who oversaw assistance programs both for New York Governor George Pataki and New York City Mayor Michael Bloomberg, described what has long been a bipartisan consensus. He said: . . . the way to help people escape poverty is through a combination of work and government aid--not work alone and not government aid alone. But the two together. Why is that combination so powerful and so successful? Government assistance provides a hand up and aids families who are struggling to overcome barriers to a better life. Work not only provides the economic pathway out of poverty, but--also equally important--imparts dignity, self-reliance, and confidence. It allows people to provide for their own families. It instills a sense of belonging and pride. It strengthens our communities. Let me give you two examples. I first met Adais when she was enrolled in the Federal Job Corps program in Limestone, ME. As a teenager, she had been homeless and wanted to get as far away as possible from the terrible circumstances in her life--thus her choice of the Job Corps in northern Maine. After completing this program in Limestone, Adais earned her degree in nursing from Husson University in Bangor. Today, due to her own perseverance, hard work, and government support during a very difficult time, she has a good life working as a nurse and providing for her three sons. She can take much pride in the life that she has built for herself and her family. The second example involves women I met at the Aroostook County Community Action Program. They have benefited from a holistic approach to poverty, one that focuses on the needs of both the children and their parents--a two-generation-together approach--in order to end intergenerational poverty. This two-generation approach identifies obstacles to work and financial independence, and then provides the necessary coaching and supports to help parents succeed in their goals while also meeting the needs of their children. These mothers recounted to me with great pride their very moving stories of climbing the economic ladder out of poverty and into the workforce, providing a much better life for themselves and their children. What these stories have in common is the dignity of work. As Stephen Hawking observed, ``Work gives you meaning and purpose.'' Securing the skills and support to get good jobs changed the lives of these parents and the lives of their children. Now, let me be clear that I have supported providing additional help to assist low-income working families. For example, I worked with Senator Rubio to successfully double the child tax credit and expand its refundable portion as part of the 2017 tax reform act, but this credit was tied to work until the Biden administration changed the rules of the American Rescue Plan earlier this year. Given the pandemic, that may well have been justified as a temporary measure. But now, the administration wants to jettison the work requirement permanently, and the House Democrats' bill removes all means testing for a new childcare entitlement program so even very wealthy families would qualify. Shouldn't we look carefully at the consequences of sending checks from Washington untethered to any work or other requirements? Shouldn't assistance prioritize those with the greatest needs but in ways that position them to achieve self-reliance? There are certainly times when it is appropriate for government to step in, and no one is arguing that people who cannot work, who may have disabilities, for example, should not receive government assistance--of course, they should. And in a time of crisis, certainly, we should do all we can to help those who are in need, through no fault of their own, and that is what happened during the pandemic. There were many temporary programs that were instituted to help as our economy shut down and people were laid off. I, along with three of my colleagues, authored one of them--the Paycheck Protection Program. The rationale was to allow employers to receive funding so that they could continue to pay their employees and keep intact that bond between employers and employees so that the workers could return to the workplace once the economy reopened. That program was successful and temporary. But that is not what this administration is proposing. Rather, it is creating entitlement programs untethered to work that would fundamentally change incentives for our families, our communities, our society, and our economy, depriving people of their dignity and eroding their ability to provide for themselves and their families. Absent a pandemic or other crisis, Washington should not simply write monthly checks, creating dependency among those who could have a better life. The Federal Government's obligation is not fulfilled by simply sending a check, washing its hands of any responsibility to actually help people achieve self-sufficiency. It appears that this administration is moving toward the left's proposal for a guaranteed minimum income, regardless of one's ability to work. Never forget that the first version of the Green New Deal included a guaranteed income for those ``unable or unwilling to work.'' We must not go down that path. We will not build a more prosperous, just, and equitable society, characterized by opportunity, dignity, and meaning, just by issuing government checks. The time-tested way to achieve those goals for American families is by supporting and rewarding work. It is by recognizing the dignity of work. And that is the tradition that we must continue to embrace.

Ms. COLLINS

Ms. COLLINS. Madam President, at long last, tomorrow morning, I expect that the Senate will approve the bipartisan Infrastructure Investment and Jobs Act. For far too long, any discussion of transportation infrastructure in this country has been accompanied by the adjective ``crumbling.'' The backlog of needed repairs and upgrades and replacements in my State of Maine and throughout our country is simply enormous. Americans know far too well the consequences of the chronic underinvestment in our infrastructure. Poor road conditions cost them, on average, hundreds of dollars each year in vehicle repairs and wasted gasoline due to congestion. Structurally deficient bridges often require lengthy detours when they have to be posted. Slow or nonexistent internet connections create barriers to work, healthcare and education. The recent pandemic has certainly laid bare inequities to high-speed internet in our country. Every administration in recent memory has identified improving our infrastructure and transportation networks as a priority, but time and time again we have seen those ambitious goals thwarted by partisanship. Well, the Senate has finally broken through the political gridlock and is on the merge of passing a landmark infrastructure package that amounts to a major victory for the American people. I worked with my colleagues from across the aisle and across the country to produce this legislation. It will be the most significant investment in American infrastructure since the establishment of the Interstate Highway System in the 1950s. This bill will provide concrete benefits for American families, as well as for our economy, by making historic investments in our Nation's roads; highways; bridges; airports; seaports; waterways; rail; water treatment systems; and, of course, broadband. This is important not only for American families; it is important for America's place in the world. Many other countries on a per-capita basis invest far more than our country does in infrastructure, including China. So this bill will help to improve our competitiveness, create jobs, and improve our productivity. It represents the culmination of months of bipartisan negotiations and truly is transformational. For example, the package includes $110 billion to address the growing backlog of deficient bridges and roads. This includes $40 billion to improve our Nation's bridges. In my State of Maine, there are 315 deficient bridges and nearly 1,500 miles of poor roads. This package provides $25 billion, as well as the flexibility, for our airports so that they can pursue the projects such as rebuilding or extending runways and taxiways or expanding their terminals. This funding will benefit airports of all sizes The package also bolsters our rail network by including funding for programs that support crucial capital and rail safety projects. We also included funding for Amtrak's National Network to help address its deferred capital needs and to bring new train cars to State-supported routes, like the Downeaster in Maine. I am also excited that the bill provides an additional $95 million to support the University Transportation Centers program. This program harnesses the research and development expertise at our institutions of higher education to improve our infrastructure. The University of Maine, I am proud to say, participates in this program. It is leading the way by pioneering cutting-edge materials to build more durable, environmentally friendly roads and bridges at a lower cost. I recently participated in a bridge dedication that used the new materials and techniques that had been developed at the University of Maine. This bridge will last far longer. Because of the materials that were used to build it, it has a far lower carbon footprint and is a really exciting development. This program will be better supported by the funding in our bill. The energy title of our bill will provide critical investments in clean energy demonstration projects and help to protect and harden our electric grid. Notably, $355 million is included for an energy storage pilot program, which was authorized through a law I authored known as the BEST Act. I am really excited about this because I believe that energy storage technology will be the breakthrough that we need in the fight against climate change as far as allowing us to integrate new renewables, such as wind and solar, into the electric grid. That will, in turn, help to reduce emissions, but it will also improve the resiliency of our electric grid. The funding for coastal resiliency included in this bill will help protect our Nation's coastline and coastal communities from rising sea levels, including those in the State of Maine. There is funding that is included for NOAA's Coastal Resilience Fund to help mitigate the impact of storms on our communities and lessen flooding that has been so devastating in many areas of the country. To further address the infrastructure needs for our ports and waterways, $7 billion is included for the Army Corps of Engineers to address the large backlog of authorized projects that have yet to receive funding. There is also $2.25 billion for the Port Infrastructure Development Program. Maintaining access to clean, reliable drinking water is essential to protecting the health of our public, our environment, our families, our economy. Our agreement includes investments in drinking water and wastewater infrastructure. Although Maine is home to some of the cleanest sources of water in the country, the increasing and troubling prevalence of pollutants, like PFAS chemicals--the so-called forever chemicals--require action to keep our drinking water safe. There has been contamination in Maine in both public and private water systems from PFAS. That is why I worked so hard with Senator Shaheen of New Hampshire to provide funding to help clean up this source of pollution. Finally--and, in my view, one of the most important features of this bill--is the broadband investment. I want to reiterate the significance of our historic $65 billion investment in broadband. Senator Shaheen and I worked, literally, night and day to negotiate this section with our colleagues here in the Senate and with the administration, particularly Secretary Raimondo at the Department of Commerce. This will make a real difference in the lives of Americans, particularly those living in rural areas who do not have access to internet service at all in some areas or who have access only to unreliable, very slow service. It has become increasingly clear in recent years, and especially in light of the pandemic, that broadband is no longer a luxury; it is a necessity. And I can't tell you how many people I have talked to in Maine about this problem. I talked to a selectman on Swan's Island, who was telling me that the residents of Swan's Island were unable to participate in the telemedicine programs during the height of the COVID pandemic because they simply lacked access to high-speed internet. That is an example where healthcare is affected. There were families in other rural areas of the State where schools had a hybrid system where families had to drive their children to the library to find a hotspot in order to connect with the internet for online education. One family in northern Maine told me it would cost them $15,000 to be connected to the internet. They can't afford that. Most people in my State would be unable to afford $15,000 to be connected to the internet. I also talked to town managers who told me of employers who had decided to locate their businesses and employ people elsewhere because of the absence of high-speed, reliable internet service. This is why that $65 billion investment is so important and will have such an impact on people's lives. We have both a deployment section and an affordability section, and both are a necessity. Ultimately, this bill is about reinforcing the connections that make our country more united. The investments in our roads and bridges will better connect our communities. The investments in our airports will better connect rural and urban regions. The investments in our highways and seaports will better connect manufacturers and their customers and their workers. The investment in high-speed internet will better connect families, friends, coworkers, employers, healthcare providers, students, and educators. This investment package is good for America. It represents a far too rare example of the two parties working together to produce real results for the American people. I want to take just a final moment to thank those who were particularly involved. I want to thank all of my colleagues for their contributions, but particularly I want to laud the work of Senator Rob Portman and Senator Kyrsten Sinema, who led our group of 10 Senators--5 Democrats, 5 Republicans. The other Republican Members, in addition to myself, were Senators Murkowski, Cassidy, and Romney. On the Democratic side, in addition to Senator Sinema, were Senators Manchin, Shaheen, Warner, and Tester. All of us worked very hard, and we are grateful for the ideas and the input that we had from so many of our colleagues. I also want to thank our staffs. We couldn't have done it without them. They, too, were here night and day. They haven't had a weekend off in a very long time. It is essential that we make this historic investment, and I urge all of my colleagues in voting tomorrow morning for final passage of this long-awaited, much needed, bipartisan legislation. I yield the floor.

Ms. COLLINS

Ms. COLLINS. Thank you. Vote on Amendment No. 2210

Ms. COLLINS. Madam President, first, let me offer to work with both Senators from Louisiana to secure the funding that their State so desperately needs, in my capacity as ranking member of the Transportation, HUD Appropriations Subcommittee. Louisiana has been particularly hard hit, experiencing three hurricanes almost back to back, and, certainly, the need for disaster assistance is clear. But we also have other States that have been affected: Alabama, California, Florida, Iowa, Michigan, Oregon, Puerto Rico--a Territory, not a State, obviously. But they need help too. What I would propose is that we work together on an emergency disaster supplemental that will take care of all these needs, including the needs of the people in hard-hit Louisiana. I pledge my personal help and support to both of my colleagues and friends from Louisiana to bring this about. Finally, let me just say, I am surprised that the administration has not submitted a request for supplemental disaster assistance. And I look forward to see--

Ms. COLLINS

Ms. COLLINS. I suggest the absence of a quorum.

Ms. COLLINS

Ms. COLLINS. Mr. President, while we are awaiting others to come to the Senate floor, let me express my deep sorrow about learning of the deaths of two more police officers who responded to safeguard all of us in the Capitol on January 6. My heart goes out to their families and their fellow officers, both here on Capitol Hill and also in the District of Columbia police force. I am wearing a button that was given to me several years ago after the Capitol Police, once again, acted heroically. It says: ``Thank you, Capitol Police.'' I hope each and every one of us will take time today to thank these courageous men and women who are working so hard to keep us safe and many of whom still bear the physical injuries and the emotional trauma of that dark day in our Nation's history.

Ms. COLLINS. I suggest the absence of a quorum.

Ms. COLLINS

Ms. COLLINS. Mr. President, let me begin my remarks this evening by expressing my appreciation to Senators Portman and Sinema for their extraordinary leadership of our group, our bipartisan group, of 10 Senators, who have labored so hard to bring before the Senate the bipartisan Infrastructure Investment and Jobs Act. This legislation represents the most significant investment in our infrastructure since the construction of the Interstate Highway System. Think about that. For generations, for decades, we have talked about the need to rebuild our roads and our bridges, our airports, our seaports, our waterways, our water treatment systems, and, today, to expand high-speed internet access to Americans throughout our country no matter where they live--whether they are in the northern regions of Maine or an inner city neighborhood--and that is exactly what this legislation would do. I want to just quickly give an example from my own State of Maine. Maine has 315 bridges and nearly 1,500 miles of roads that are rated as being in poor condition. Now the State of Maine will have the funding that will enable it to make major investments in the repair and replacement of this critical infrastructure. I am particularly pleased that the legislation includes $65 billion to expand access to broadband. And I want to thank my colleague Senator Jeanne Shaheen, who worked so closely with me. We were partners in this endeavor, and this is going to make such a difference to students who are doing online courses, to seniors who want access to telemedicine, to individuals who are able to work from home, but none of that is possible without access to high-speed internet services. I am very pleased to be part of this group, and I am also delighted to demonstrate to the American people that we can work across the aisle in a bipartisan way to achieve real results that matter to the people of this country. I yield to the Senator from New Hampshire.

Ms. COLLINS

Ms. COLLINS. Mr. President, first, let me thank my good friend and the leader of the Senate Intelligence Committee, Chairman Warner, for paving the way for this legislation. He cares deeply about our country's response to these terrible cyber attacks and intrusions, and I am so grateful for his leadership and for his working with me to produce the Cyber Incident Notification Act of 2021. As the chairman has mentioned, this is a bipartisan bill that is broadly supported. It would strengthen our response to cyber attacks and, thus, help to prevent future cyber intrusions. It would require government Agencies, Federal contractors, and critical infrastructure entities, which are overwhelmingly owned and operated by the private sector and other important sectors, to notify the U.S. Government if they become the victims of a significant cyber attack or intrusion. This effort is a direct outgrowth of our work on the Senate Intelligence Committee and reflects our longstanding concern regarding the lack of timely notification of cyber attacks that can lead to extremely serious consequences for our economy, for our national security, and for our individual privacy. In September of 2019, for example, Russian hackers gained access to the SolarWinds' software. This resulted in a supply chain compromise that was downloaded by up to 18,000 of its customers. These hackers then conducted follow-on operations that compromised 9 Federal Agencies and 100 private-sector networks. We did not become aware of this hack until more than a year later and only then because a cybersecurity firm called FireEye voluntarily notified the Federal Government and the public. Just to reiterate that important point, FireEye was under no legal obligation whatsoever to tell us that the software had been compromised, even though it affected nine Federal Agencies. We are grateful that FireEye told us about this hack, but the fact that companies are not mandated to do so leaves our economy and national security vulnerable to future attacks and lessens our ability to respond effectively when such intrusions do occur. Where would we be right now if FireEye had not voluntarily disclosed the intrusion? Would the Russians' operation still be ongoing? How much sooner would we have become aware of these Russian cyber operations if key sectors were required to report cyber incidents to the U.S. Government? As the Senator from Virginia very kindly and generously noted, I have long been concerned about this problem and focused on it. In 2012, when I was the ranking member of the Senate Homeland Security Committee, I joined with my chairman and dear friend former Senator Joe Lieberman of Connecticut in introducing a bill called the Cybersecurity Act of 2012. That bill would have, among other things, addressed this gap in cyber incident reporting. Unfortunately, our bill did not become law. How much more prepared we would be today if it had been enacted. My 2012 bill would have led to improved information sharing between the private sector and the Federal Government that likely would have reduced the impact of cyber incidents on both the government and the private sector. Having a clear view of the dangers the Nation faces from cyber attacks is necessary to enable both the public and the private sector to mitigate and reduce the threat. We have just recently seen the impact of an attack on a major pipeline. Just think what the consequences would be of an attack that crippled our electric grid. What we are proposing in the Cyber Incident Notification Act is common sense and long overdue. Our bill recognizes the additional burden that this reporting requirement places on parts of the private sector, and so it, therefore, provides additional liability protection for companies reporting cyber incidents and requires the government to harmonize these new mandates with any existing reporting requirements to help avoid duplication. The bill also requires the government to produce analytic updates for the government and industry practitioners regularly so that they are aware of cyber incidents taking place and targeting their sectors. This should be a two-way street of the exchange of information. Let us not delay any longer in passing a robust cyber incident notification requirement. Failure to pass this bill will only give our adversaries more opportunity to gather intelligence on our government, to steal intellectual property from our companies, to compromise our personal privacy, and, most of all, to harm our critical infrastructure. Again, my thanks to the Senator from Virginia, the chairman of the Intelligence Committee, for his hard work on this bill. Let's get the job done. I yield the floor. I suggest the absence of a quorum.

Ms. COLLINS

Ms. COLLINS. Mr. President, the right to vote is the hallmark of a democracy. It is what distinguishes us from authoritarian regimes where elections are tainted, if they are held at all, where the free and fair elections that define America do not exist. President Abraham Lincoln once said elections belong to the people. Voting is an action we choose to take to exercise a fundamental freedom our Constitution grants to the people. So when we hear of a bill entitled ``For the People,'' we naturally would assume at first that it must be enhancing our democracy, but a closer examination suggests otherwise. In fact, S. 1 would take away the rights of people in each of the 50 States to determine which election rules work best for their citizens. Let's start with some indisputable facts. This legislation was first introduced in 2019, prior to last year's Presidential election. It was not considered in the Senate. It did not become law. Nevertheless, according to the Census Bureau, the 2020 election saw the highest voter turnout in the 21st century. Equally significant, Asian Americans and Hispanic Americans voted in record-high percentages, and there was higher turnout across all racial groups, including Black Americans, than in 2016. The Census Bureau also asked eligible, nonvoting Americans why they didn't vote in 2020. The majority of respondents said that they were not interested, didn't like any of the candidates, were too busy, or simply forgot. The point is, with the record-high turnout in 2020, it is very difficult to make the case that this bill is necessary, as some have said, to save our democracy. This is a bill that was introduced to enhance partisan messaging, not to enhance participation in our elections, as the over-the-top rhetoric about this bill highlights. Consider, for example, the debate over Georgia's new election law. In many ways, Georgia's election law actually makes it easier for citizens to vote than in other States that have not been subject to the same backlash. Georgia allows no-excuse absentee ballots. Delaware, New York, Massachusetts, and Connecticut do not. Georgia's new law provides a minimum of 17 in-person early voting days. Delaware, New Jersey, and Connecticut had no in-person early voting days at all in 2020. Although New Jersey enacted a new law to allow early voting earlier this year, to great fanfare, it actually has 8 fewer early voting days than Georgia. Despite having these and many other different election rules, Delaware, Connecticut, and Georgia had very similar levels of Black voter turnout in the 2020 election. Massachusetts, by contrast, had just more than half the Black voter turnout of Georgia. This information contradicts the underlying premise in S. 1 that we must overturn the laws of every State in our Nation in order to preserve the right to vote. This legislation would force numerous changes to laws in States that have been successfully conducting elections for a very long time. Let me use the State of Maine as an example--a State that consistently ranks at or near the top of the Nation in voter participation, I am pleased to report. Maine does not have early voting. Maine does not allow ballot harvesting. Maine does not count absentee ballots that arrive after the polls close on election night. Maine does not allow voters to receive absentee ballots automatically without requesting them. Yet, in 2020, 71 percent of Mainers cast a ballot. That is 4\1/2\ percentage points above the national average. These results further demonstrate that, absent a compelling need, the Federal Government should not be preempting the election laws of all 50 States. Now, let's examine the burdensome list of Federal mandates that advocates of this bill would impose on each and every State. Allow me to highlight just a few of the significant flaws. The bill would require States to allow ballot harvesting, where third parties, usually political operatives, collect ballots from voters. This raises obvious and significant concerns about voter intimidation, coercion, and ballot security. The bill would prohibit voter ID, overturning existing law in 35 States. It would require that absentee ballots be accepted up to 7 days after the election, which could lead to chaos and distrust, particularly in close races. The bill would transform the Federal Election Commission into a partisan entity, which would jettison the requirement for bipartisan agreement on significant issues and lead to partisan enforcement. Another problem with this bill is that it would allocate billions of Federal dollars to congressional campaigns, forcing Americans to subsidize the campaigns of politicians with whom they vigorously disagree or simply dislike. Even very wealthy officeholders would be eligible for public financing. Do we really need more money in political campaigns when Federal funds could be used to combat the opioid epidemic or to reduce hunger among children or to spur economic development and the creation of more jobs? Now, Mr. President, there are, of course, times when it is compelling and appropriate for Congress to intervene. The Voting Rights Act of 1965 is an excellent example. It was passed at a time when many Americans, particularly Black Americans, faced overwhelming barriers designed to prevent them from voting. Section 2 of the Voting Rights Act is still in effect today. It prohibits voting practices and procedures that are discriminatory. It also allows the Department of Justice to sue any State or local government to enforce this provision. Certainly, there are improvements that can be made in our election laws. For example, I support efforts to disclose dark money in campaigns. I support mandatory reporting to the FBI if a foreign government contacts a political campaign with an offer of assistance. And I have worked with my colleagues on both sides of the aisle to provide generous grants to States so that they could better secure their voting infrastructure against cyber threats and foreign intrusions. Unfortunately, S. 1 is not legislation that could ever form the basis of a reasonable, bipartisan elections reform bill. And it is far more likely to sow more distrust in our elections than to ease the partisan divisions in our country. For the reasons that I have discussed, I shall cast my vote against this flawed bill.

Ms. COLLINS

Ms. COLLINS. Mr. President, first, let me thank my colleague from New Hampshire, Senator Shaheen, for her extraordinary commitment and leadership as my fellow cochair of the Senate Diabetes Caucus. We are introducing a bill to improve access to innovative diabetes technologies for our seniors and other Medicare beneficiaries. Our bill would create a special task force at the Department of Health and Human Services to examine and resolve barriers that seniors face in accessing the latest diabetes management technologies. New diabetes technologies, such as the artificial pancreas and implantable continuous glucose monitoring systems, allow those who are living with diabetes to better manage their glycemic levels, assess needed therapy on a timely basis, and adhere better to treatment regimes. These technological advances make diabetes easier to manage and therefore improve the health of people with diabetes. The market arrival of cutting-edge diabetes technologies is something we all celebrate; however, oftentimes we are finding that patients do not realize the full benefits because many of our Nation's seniors find the new technologies to be difficult or impossible for them to afford. I have heard from numerous seniors who, when transitioning from employer-provided insurance to Medicare, were shocked to learn that the technologies they had relied upon for years to manage their diabetes are no longer covered because they now have lost their employer- provided insurance, which did cover these technologies, and instead are being covered by Medicare. For example, one Mainer unfortunately had to face the reality that Medicare's coverage denial of a particular sensor that he needed for his insulin pump meant paying up to $8,000 out-of- pocket each year if he wants to continue with his current treatment. He wrote: Because I am now 65, I am denied care that was available when I was 64. He continued: This approach not only puts me at risk but is quite likely not cost effective. While the sensors are expensive, the cost of ambulance calls and hospitalizations . . . is certainly more. I could not say it better. It makes no sense for this individual, who has aged into the Medicare system, to lose coverage that he had and relied upon and used successfully to control his diabetes. To better support the adoption of these technologies, our bill would require HHS to create a special task force on coverage and payment for innovative diabetes technologies that would bring all stakeholders-- from patients to device manufacturers, to government officials and healthcare professionals who are making coverage decisions--to the table. The task force would identify and plan for changes in Medicare coverage and payment policies to ensure that Medicare beneficiaries have access to the latest treatments, to the innovations that are currently available, as well as those that are in the pipeline. The task force would also be tasked with developing strategies for supporting adoption of these technologies. This effort builds on our past advocacy to improve the day-to-day life of individuals with diabetes. In January 2017, in response to the bipartisan effort that Senator Shaheen and I have led, CMS first approved the use of continuous glucose monitors. We also successfully urged CMS last year to support the use of smartphone apps in conjunction with continuous glucose monitors. These are proven lifesaving devices that are relied upon by people with diabetes to provide them with realtime measurements of their glucose levels. This information is key to preventing costly--sometimes deadly--diabetes complications. While I am pleased that our advocacy has helped spur these policy changes, I remain frustrated that too often Medicare lags behind commercial insurers. Greater adoption of these new diabetes techniques can help address the explosive growth in the financial and human toll of diabetes. Diabetes accounts for an extraordinary one-in-three dollars in Medicare spending. It is paramount that we encourage HHS to adopt a more cost-effective and compassionate approach to treating this chronic disease that affects more than 30 million Americans. The Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act encourages a proactive approach to diabetes coverage and payment. I encourage my colleagues to support our efforts. Again, thanks to my partner Senator Shaheen for her leadership in this area.

Ms. COLLINS

Ms. COLLINS. Under the previous order, the question is, Will the Senate advise and consent to the Fox nomination?

Ms. COLLINS. I ask for the yeas and nays.

Ms. COLLINS

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

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today to introduce the No PFAS in Cosmetics Act. I am pleased to be partnering with Senator Blumenthal on this important legislation. Our bipartisan bill seeks to ban the inclusion of Per- and polyfluoroalkyl substances (PFAS) in cosmetics products, such as make-up, moisturizer, and perfume. PFAS are a class of man-made chemicals, which includes PFOA, PFOS, and GenX. These chemicals can bioaccumulate in our bodies over time and have been linked to cancer, thyroid disease, liver damage, decreased fertility, and hormone disruption. First developed in the 1940s, PFAS are traditionally found in food packaging, nonstick pans, clothing, furniture, and firefighting foam. Unfortunately, Maine has experienced considerable PFAS contamination, which has not only threatened our water supply, but adversely affected the livelihoods of farmers. Several dairy farms in Maine recently discovered serious levels of PFAS in their operations, with milk containing as high as 1,420 parts per trillion. This is more than twenty times EPA's established health advisory level for drinking water. In addition to these agricultural and water supply contaminations, we now also know that PFAS appear in products across the spectrum-- including cosmetics. A new peer-reviewed study led by the University of Notre Dame published in Environmental Science and Technology Letters found high fluorine levels--indicating the probable presence of PFAS-- in just over half of 231 makeup products tested, including waterproof mascara, liquid lipsticks, and foundations. A subset of 29 samples was studied further to identify specific PFAS chemicals. Between four and 13 specific PFAS were identified in each of the 29 samples, some at high concentrations. Remarkably, only one of these 29 products listed any fluorochemical ingredients on the product's label. While some of these PFAS may be present in trace quantities as impurities in the manufacturing process, those found at high concentrations are likely being used intentionally to impart performance characteristics to the product. Since fluorinated chemicals are not disclosed on the labels, this study suggests that consumers unknowingly are being exposed to PFAS in their cosmetics. The findings of this study are particularly alarming, as many of these products are subject to direct human exposure. For example, lipstick is often inadvertently ingested, and mascara is sometimes absorbed through tear ducts. In addition, during the cosmetic product manufacturing process, workers are exposed to the chemicals that are used, and discarded products with PFAS can cause the potential for additional human exposure if drinking water sources are contaminated. PFAS pose an unnecessary and avoidable risk to human health and do not belong in our cosmetic products. The Federal Food, Drug, and Cosmetic Act defines cosmetics as ``articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body . . . for cleansing, beautifying, promoting attractiveness, or altering the appearance.'' This definition includes skin moisturizers, perfumes, lipsticks, fingernail polishes, eye and facial makeup preparations, cleansing shampoos, permanent waves, hair colors, and deodorant, as well as other similar products. Our legislation would direct the FDA to issue a proposed rule banning the intentional addition of PFAS in cosmetics, as defined by the FDA, within 270 days of enactment, and require a final rule to be issued 90 days thereafter. The FDA should act now to ban the addition of PFAS to cosmetics products to help protect people from further contamination. I urge all of my colleagues to join me in supporting the No PFAS in Cosmetics Act.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today to introduce the No PFAS in Cosmetics Act. I am pleased to be partnering with Senator Blumenthal on this important legislation. Our bipartisan bill seeks to ban the inclusion of Per- and polyfluoroalkyl substances (PFAS) in cosmetics products, such as make-up, moisturizer, and perfume. PFAS are a class of man-made chemicals, which includes PFOA, PFOS, and GenX. These chemicals can bioaccumulate in our bodies over time and have been linked to cancer, thyroid disease, liver damage, decreased fertility, and hormone disruption. First developed in the 1940s, PFAS are traditionally found in food packaging, nonstick pans, clothing, furniture, and firefighting foam. Unfortunately, Maine has experienced considerable PFAS contamination, which has not only threatened our water supply, but adversely affected the livelihoods of farmers. Several dairy farms in Maine recently discovered serious levels of PFAS in their operations, with milk containing as high as 1,420 parts per trillion. This is more than twenty times EPA's established health advisory level for drinking water. In addition to these agricultural and water supply contaminations, we now also know that PFAS appear in products across the spectrum-- including cosmetics. A new peer-reviewed study led by the University of Notre Dame published in Environmental Science and Technology Letters found high fluorine levels--indicating the probable presence of PFAS-- in just over half of 231 makeup products tested, including waterproof mascara, liquid lipsticks, and foundations. A subset of 29 samples was studied further to identify specific PFAS chemicals. Between four and 13 specific PFAS were identified in each of the 29 samples, some at high concentrations. Remarkably, only one of these 29 products listed any fluorochemical ingredients on the product's label. While some of these PFAS may be present in trace quantities as impurities in the manufacturing process, those found at high concentrations are likely being used intentionally to impart performance characteristics to the product. Since fluorinated chemicals are not disclosed on the labels, this study suggests that consumers unknowingly are being exposed to PFAS in their cosmetics. The findings of this study are particularly alarming, as many of these products are subject to direct human exposure. For example, lipstick is often inadvertently ingested, and mascara is sometimes absorbed through tear ducts. In addition, during the cosmetic product manufacturing process, workers are exposed to the chemicals that are used, and discarded products with PFAS can cause the potential for additional human exposure if drinking water sources are contaminated. PFAS pose an unnecessary and avoidable risk to human health and do not belong in our cosmetic products. The Federal Food, Drug, and Cosmetic Act defines cosmetics as ``articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body . . . for cleansing, beautifying, promoting attractiveness, or altering the appearance.'' This definition includes skin moisturizers, perfumes, lipsticks, fingernail polishes, eye and facial makeup preparations, cleansing shampoos, permanent waves, hair colors, and deodorant, as well as other similar products. Our legislation would direct the FDA to issue a proposed rule banning the intentional addition of PFAS in cosmetics, as defined by the FDA, within 270 days of enactment, and require a final rule to be issued 90 days thereafter. The FDA should act now to ban the addition of PFAS to cosmetics products to help protect people from further contamination. I urge all of my colleagues to join me in supporting the No PFAS in Cosmetics Act.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today to introduce the ``Ending the Diagnostic Odyssey Act.'' This legislation gives States the option of providing whole genome sequencing (WGS) clinical services through edicaid for children with a disease that is suspected to have a genetic cause, at an enhanced Federal matching rate for three years. I am pleased to be joined by Senators Kelly and Menendez. Children with rare diseases will spend on average five to seven years on a diagnostic odyssey, and 30 percent of those children will not survive beyond the age of five years old. The average patient sees seven different physicians in that time. The wait to find a cause--never mind a cure--can be excruciating. Parents try to project a calm and reassuring presence for their child while facing a whirlwind of doctor appointments, hospital visits, and unanswered questions. Undeniably, we are making progress in both accelerating research funding for rare diseases as well as in the development of diagnostics. In 2014, the National Institutes of Health (NIH) launched a program called the Undiagnosed Disease Network (UDN). In its first 20 months, the UDN accepted 601 participants undiagnosed by traditional medical practices. Of those who completed their UDN evaluation during this time, 35% were given a diagnosis. Many of these diagnoses were rare genetic diseases including 31 previously unknown syndromes. In May 2019, the Director of the National Institutes of Health, Dr. Francis Collins, wrote a blog post on how whole genome sequencing-- combined with artificial intelligence (AI)--can now be used to diagnose genetic diseases in seriously ill babies in fewer than 24 hours. Dr. Collins writes ``I would submit that there is no other technology in the history of planet Earth that has experienced this degree of progress in speed and affordability.'' For parents of children with an undiagnosed illness, answers cannot come soon enough. There are approximately 7,000 rare diseases known today. Approximately 80 percent of rare diseases are genetic, and about one-half of all rare diseases affect children. For example, Alstrom syndrome is an extremely rare and complex genetic disorder. Approximately 1200 affected individuals have been identified worldwide, which makes a obtaining a correct diagnosis challenging. Characteristics of Alstrom syndrome include vision disturbances, sensorineural hearing impairment, cardiomyopathy, obesity, kidney dysfunction, and diabetes. Robin Marshall, Executive Director of the Alstrom Syndrome International, located in Mount Desert Island, Maine, has said that ``Whole Genome Sequencing has changed the lives of those we represent by enabling earlier and more accurate diagnosis, fostering more timely and appropriate medical care, and unlocking a host of social services to combat the educational and psycho-social complications that our children confront.'' By giving states an incentive to provide whole genome sequencing for eligible children through Medicaid, my legislation will ensure that more children and their families can obtain the right diagnosis and treatment from the start. The ``Ending the Diagnostic Odyssey Act'' has the support of more than one hundred patient advocacy organizations, including Alstrom Syndrome International, the Genetic Alliance, the Personalized Medicine Coalition, and many others. I urge my colleagues to support this legislation.

Ms. COLLINS

Ms. COLLINS. Madam President, I rise today to applaud the swift, unanimous Senate passage last night of the Helping American Victims Afflicted by Neurological Attacks Act, or the HAVANA Act. This bill will provide much needed assistance to the employees of the Intelligence Community, the State Department, and other Federal Agencies who have suffered from often debilitating brain injuries at the hands of our foreign adversaries. Too often, these injured public servants have had to battle the bureaucracy to receive the medical care they desperately require. I am very pleased today to be joined on the Senate floor by the Chairman of the Senate Intelligence Committee, Senator Warner. He has been relentless in his pursuit of care for these injured public servants who risk their lives for us, who serve in difficult and dangerous environments. Senator Warner and the vice chairman of the Senate Intelligence Committee, Senator Rubio, and Senator Shaheen of New Hampshire worked with me to draft the bill that the Senate unanimously cleared last night. We are very pleased that the following Senators cosponsored our legislation: Senators Cornyn, Bennet, Burr, Gillibrand, Blunt, Heinrich, Sasse, Feinstein, Cotton, King, Risch, Durbin, Scott, Menendez, Blumenthal, and Hassan. I mentioned those cosponsors to show the breadth of concern in the Senate about these injured employees. For several years, American personnel serving our country in Cuba, China, and elsewhere have experienced unexplained, serious medical harm, including, in some cases, permanent brain injuries. Their conditions are believed to be the consequence of a mysterious, directed energy weapon used by an adversary. As we investigate the source of previous attacks and seek to prevent future ones, the bill that passed the Senate last night would provide additional medical care and financial compensation to Americans who continue to experience debilitating symptoms as a result of these heinous attacks. The injuries that many of these victims have endured are significant and life-altering. I have talked with many of these victims. They have described debilitating headaches, a loss of vision, a decreased ability to hear, dizziness, and many other symptoms as well, including a decline in their cognitive abilities. In some cases, they have been forced to medically retire. In other cases, they somehow continue on while coping with these symptoms. I have spoken several times to CIA Director Burns and the Director of National Intelligence, Haines, about these attacks, and I am heartened by the commitments that they have made to me and to other members of the Senate Intelligence Committee to care for the victims and to identify the perpetrators and the weapon used in these attacks. We can speculate. We have our suspicions. But the fact is, we do not know exactly what the weapon is nor who is wielding it. We need a whole-of-government approach to identify the adversary who is targeting our American personnel, and I am grateful to the chairman and vice chair of the Senate Intelligence Committee, who I know are committed to getting to the bottom of these attacks. I hope, when President Biden meets with President Putin, that he will ask President Putin about these attacks, that he will grill him about them to see if the Russians are responsible. At this point, we don't know. The public servants who work in our embassies and consulates overseas make many personal sacrifices to represent America's interests. They deserve our unwavering support when they are harmed in the line of duty, just as we care for soldiers who are injured on the battlefield. Last night, we took an important step in that direction.