Bill Cassidy

Mr. CASSIDY

Mr. CASSIDY. I now ask for a second reading, and in order to place the bill on the calendar under the provisions of rule XIV, I object to my own request.

Mr. CASSIDY

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 Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. CASSIDY

Mr. CASSIDY. Mr. President, I rise today with a heavy heart to honor the life of Mandeville police officer Captain Vincent ``Vinnie'' Liberto, Jr., who was killed in the line of duty last week. Captain Liberto will be remembered for his life of service to the community and country. After graduating from Brother Martin High School in New Orleans, he joined the U.S. Marine Corps, where he ultimately served 10 years as sergeant. Captain Liberto had a combined 30 years of law enforcement service, 5 with the Orleans Parish Sheriff's Department and 25 years with the Mandeville Police Department, where he was recognized as officer of the year. The captain had a brilliant mind for law enforcement. He graduated from the FBI National Academy and ran the Mandeville Police Department's Criminal Investigations Division, where he worked as a polygraphist and was responsible for the Department's enforcement functions. Those who knew him best describe him as a gentle giant, polite, upbeat, reasonable, and fairminded--all qualities that make a great police officer. In his yard flies the Marine Corps flag, and mounted on the front door are twin wreaths, one for the marines and one for the police. Captain Liberto is survived by his wife, Tracey, and seven children. He was 58 years old. His passion for service was so strong that he inspired several of his children to follow in their dad's footsteps by entering the military and law enforcement. That is the definition of setting a great example for children. Captain Liberto's death is a painful reminder that our law enforcement officers put their lives on the line to keep our community safe. He died during a gunfire exchange when a routine traffic stop turned into a tragedy. The other officer, Ben Cato, was also injured but thankfully has returned to work. Like Captain Liberto and Officer Cato, our law enforcement officers report to work every day knowing that they might not come home at night. They do it for us all, and for that we should always be grateful. I ask those who are listening to say a prayer for Tracey, their kids, and the officers of the Mandeville Police Department, and for their entire community that is grieving the loss of one of their own. Vincent Liberto made Louisiana a better place and our country a better place, and he will be sorely missed. I yield the floor. I suggest the absence of a quorum.

Mr. CASSIDY

Mr. CASSIDY. Mr. President, if there is no further business to come before the Senate, I ask that it stand adjourned under the previous order.

Mr. CASSIDY

Mr. CASSIDY. Madam President, I ask unanimous consent that when the Senate completes its business today, it adjourn until 9:30 a.m., Wednesday, September 11; further, that following the prayer and pledge, the morning hour be deemed expired and the Journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, morning business be closed, and the Senate proceed to executive session and resume consideration of the Akard nomination under the previous order.

Mr. CASSIDY

Mr. CASSIDY. Mr. President, I ask unanimous consent that my new press assistant, Cole Avery, be granted privileges of the floor.

Mr. CASSIDY

Mr. CASSIDY. Madam President, I ask unanimous consent that the Commerce, Science, and Transportation Committee be discharged from further consideration of S. 1881 and the Senate proceed to its immediate consideration.

Mr. CASSIDY. Madam President, I ask unanimous consent that the bill be considered read a third time and passed and that the motion to reconsider be considered made and laid upon the table.

Mr. CASSIDY

Mr. CASSIDY. Madam President, I ask unanimous consent that notwithstanding rule XXII, the postcloture time on the Akard, Cabaniss, and Byrne nominations expire at 11 a.m. on Wednesday, September 11, and that if the nominations are confirmed, the motions to reconsider be considered made and laid upon the table and the President be immediately notified of the Senate's action. I further ask that notwithstanding rule XXII, following disposition of the Byrne nomination, the Senate resume consideration of the Bowman nomination and that at 2:45 the Senate vote on the cloture motions for the Bowman, Feddo, and Nordquist nominations. Finally, I ask that following the cloture vote on the Nordquist nomination, the Senate vote on the Haines, Brown, Grimberg, Seeger, McElroy, and Gallagher nominations as under the previous order.

Mr. CASSIDY

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

Mr. CASSIDY

Mr. CASSIDY. Madam President, I rise today to recognize the Eastbank Little League team from River Ridge, LA, for winning the 2019 Little League World Series. Everybody is glad when kids do well, but you are particularly glad when they are your kids, and these are Louisiana's kids. It is the first time in history a Louisiana team has won the Little League tournament, and we are still celebrating. Egan, Reece, Marshall, William, Gavin, Jeffrey, Ryan, Derek, Connor, Ryder, Alton, Peyton, Stan, and coaches Scott Frazier, Kevin Johnson, and Donald Abadie, you have made us proud. The real story may not be the championship itself but how they won. After losing their first game to Hawaii, the defending world champions, the Louisiana team went on to outscore opponents 44 to 8. They averaged almost as many runs per game as their opponents scored in total during this streak, and that is amazing. One of those wins included fending off a comeback in a rematch against Hawaii for the American championship. I commend the Hawaii team for their impressive season, which is after an impressive season last year, but this year it was the Louisiana team's moment. After the Hawaii victory, they then went on to shut out the Caribbean team 8 to 0 to bring the world championship home to Louisiana and to the United States. Louisianans are known for resiliency. That inborn never-give-up attitude is why these kids are champions. These young folks from River Ridge faced adversity they conquered. They demonstrated character and sportsmanship throughout the ups and downs. Their wins should make all Americans proud. They certainly make all of Louisiana proud. I yield the floor. I suggest the absence of a quorum.

Mr. CASSIDY

Mr. CASSIDY. Madam President, I ask unanimous consent that the Commerce, Science, and Transportation Committee be discharged from further consideration of S. 2035 and the Senate proceed to its immediate consideration.

Mr. CASSIDY. Madam President, I further ask unanimous consent that the bill be considered read a third time and passed and that the motion to reconsider be considered made and laid upon the table with no intervening action or debate.

Mr. CASSIDY

Mr. CASSIDY. Madam President, I ask unanimous consent that the Senate proceed to legislative session and be in a period of morning business, with Senators permitted to speak therein for up to 10 minutes.

Mr. CASSIDY

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

Mr. CASSIDY

Mr. CASSIDY. Mr. President, I, too, come to speak today regarding pharmaceutical costs and what we can do to make lifesaving medications--and sometimes these medications make our lives a little bit better--more affordable to the average American. I happen to be a doctor, and I will approach these remarks as a fellow who has seen medicine evolve, who has seen the incredible, positive benefits of pharmaceutical innovation, but also as a doctor who sometimes saw that patients were unable to afford innovation. The question in my mind is, How do we give the patient the power to afford these innovative medicines, because if she cannot afford them, it is as if the innovation never occurred, and for her, it never did occur. So give the patient power. Let me make some remarks about pharmaceutical companies. There are some incredible examples. When I was in medical school, cutting away a part of one's stomach-- not the belly but part of the stomach; as I would tell patients, where the food goes after you swallow it--cutting away a part of the stomach because of ulcerative disease was one of the most common procedures done in surgery. Then histamine blockers came along, H2 blockers. Cimetidine was the first. All of a sudden, a surgery that was done multiple times a week was scarcely ever done. Those medicines are now sold over the counter. This morning, I got a little bit of arthritis, so I took my nonsteroidal anti-inflammatory, which used to be sold by prescription and now is over the counter, along with my H2 blocker, my Pepcid, which used to be sold by prescription but now is over the counter. I take them in the morning, and my back feels better. All of these are medicines that are generic, routine, and we almost--in fact, we indeed take the innovation for granted. I can go on. I am a liver doctor. Hepatitis C used to be an incurable disease which, in a certain percentage of those affected, would lead to cirrhosis, vomiting blood, liver cancer, and death. Now hepatitis C is cured by taking pills for several weeks. Amazing. Human immunodeficiency virus, AIDS. When I was in residency, if you got HIV, you died. There was no cure whatsoever. Now people live with it for decades. It is a disease you live with but do not die from. We speak of actually now developing cures for HIV. That is the promise of a vibrant pharmaceutical industry--people who not only live when otherwise they would have passed away but who also have a better quality of life. Now, that said, if the patient doesn't have the power, the patient has no leverage in this situation. I was recently with others in a conversation with the new head of the Congressional Budget Office. The CBO head said: You know, everybody has leverage in the healthcare marketplace except the patient. Everybody has leverage but not the patient. That is so true. Let me give some examples of how the patient lacks leverage in the pharmaceutical marketplace. First, I will say, if I go to church--and I do go to church regularly--and there is a Bernie Sanders supporter yanking on this lapel and a Donald Trump supporter yanking on this lapel and they are complaining about the same thing, they are talking about either surprise medical bills or the high cost of drugs. It is something that touches each American, but it doesn't have to be that way. Consumer Reports did an article over 1 year ago now in which they sent secret shoppers out to retail pharmacies to buy five generic medications, a prescription for each type--again, generic, like the over-the-counter pills I am taking. They went, and they paid anywhere from $66 to $900 for the same five drugs. Now, we can assume that the acquisition cost was about 60 bucks, because you could buy it someplace--an independent pharmacy or online--for $66, but three or four chain pharmacies were charging $900 for medications that they could acquire for less than $60. You could argue, why did the patient pay? Because we have so little advertising, if you will, cost competition, on what a generic medicine would cost. So imagine you have a health savings account, and you are going to buy your prescriptions, and you get charged $900 for something that should cost $60. This is the situation in which the patient has no leverage. By the way, you can ask, why didn't insurance cover it? It is because these patients were posing as uninsured. So the chain pharmacy figured out that it is the uninsured who do not have somebody working on their behalf who are going to be the most ripe for the picking for the high prices. The uninsured are the ones we are going to exploit, the ones paying cash. That is wrong. That is not the patient having the power; it is the patient being used as a victim. There are other things we can see. One is called evergreening. You have a drug, and you make just a little bit of a tweak to it that doesn't improve its importance or the efficacy of the drug--no clinical benefit--but it extends the intellectual property protections. Now laws that were conceived of and passed by Congress to reward innovation and to encourage creativity are instead being used to stifle competition and to extend patent lives so that we, the patients and the taxpayers, have to pay more--not for innovation but, rather because, somebody figured out how to evergreen it. So on the one hand, I am going to praise pharmaceutical companies for lifesaving drugs that have meant so much to me, my family, and everyone who is listening today, but I must also ask, why should we reward that which is not innovative but which is merely arbitraging laws meant to encourage innovation? We should not encourage arbitraging laws. There are other issues, such as patent abuse, where companies file large numbers of patents on parts of their drugs that are not innovative but are byproducts of the production process in order to keep out competition; citizen petitions, which typically come on 6 months before a drug is about to become generic, so all of a sudden, we have all these petitions that must be navigated by the companies seeking to introduce the generic; and the rebate system, which works to preserve market share but also to increase prices and to keep them high so patients do not benefit from competition. If we are going to say the patient should have the power in order to have lower prices, we can say right now that the system seems to be aligned against the patient. What can we do? Well, my office and others have several proposals in the current pieces of legislation going through, such as the so-called real-time benefit analysis. A prescription is ordered for a patient. The patient scans a barcode, and it would say: At this point, with your deductible and your copay, this is how much this drug is going to cost you, but there is a generic available, and you can get that generic instead. That would be a real-time benefit analysis that would save the patient money. We just talked to the folks at Blue Cross California. They are coming up with so-called gainsharing. If a patient selects a lower cost medication, the patient receives some of the savings that would otherwise have all gone back to the insurance company--another great idea. Senator Braun was speaking about the patient having skin in the game. In this case, there will be skin in the game because the patient shares the benefit with the payor for being cost-conscious. That is the patient having the power. We can also add value-based arrangements, which pharmaceutical companies, to their credit, have proposed. If you are the pharmaceutical company, you get paid only if the medicine works. If the medicine doesn't work, you don't get paid. If it does work, you do. That is a value-based arrangement. We have a bill with Senator Warner that would do that. I would also mention attempting to cap Part D exposure. If there is a senior citizen who is in the catastrophic portion of her policy, then you can cap the amount the senior might be exposed to. Under current law, she might be paying 5 percent of $100,000 worth of medicine. She is taking an essential drug to treat cancer, and she is paying 5 percent of that $100,000, in addition to 5 percent of the other medications she is receiving. This is something many seniors cannot afford and this is something we as Congress can find mechanisms by which we can cap that exposure but still hold taxpayers whole. We have to enhance existing markets. As you might guess, my theme is that we should enhance it in terms of giving the patient the power, but we also have to preserve the innovation that has led to the great drugs I spoke about earlier. If all we do is steal intellectual property from the pharmaceutical companies, we will lose these innovative drugs. But, again, we need to have the drugs affordable for the patients. This is the tension--promote innovation but ensure affordability. We have a number of solutions, such as those I have just mentioned, in the HELP Committee and now in the Finance Committee. Republicans have solutions. My office continues to work on those. I look forward to working with my colleagues on their implementation. Mr. President, I yield the floor.

Mr. CASSIDY

Mr. CASSIDY. Mr. President, today I wish to acknowledge the 150th anniversary of the founding of Tangipahoa Parish in my home State of Louisiana. It is a parish filled with hard-working and patriotic citizens who work day in and day out to better our State and our Nation. Tangipahoa Parish is located in the section of the State known as the Florida Parishes. The word Tangipahoa means ``those who gather corn'' and refers to a sub-Tribe of Native Americans called the Acolapissa. The parish is 823 square miles, with the Mississippi State line serving as its northern border and Lakes Maurepas and Pontchartrain at its southern border. This part of our State is rich with history. The Natives used this area as part of a route to travel between Mobile and Pensacola and through Pass Manchac to Illinois and the Great Lakes. The Acolapissa Tribe also led Bienville and Iberville through Manchac, where they named two nearby lakes ``Maurepas'' and ``Pontchartrain'' to honor the French finance ministers who supported the New World colony, which Bienville named New Orleans. The French and Spanish controlled their Louisiana territory for some time. However, the British controlled the Florida Parishes. The Louisiana Purchase gave Louisiana to the United States, but the Florida Parishes were not a part of the purchase. It was an international boundary between the Spanish and the United States until 1812 when Louisiana was named a State. In the mid-1800s, the railroad industry brought development into the area. However, people felt inconvenienced by the distance they had to travel to conduct business in the nearby parishes. To solve this, citizens carved out their own parish from the four surrounding parishes. The boundaries were solidified by law in 1869, which created Tangipahoa Parish. Tangipahoa Parish is home to the State's third largest public university, Southeastern Louisiana University. It is also known for its many festivals, including the Strawberry Festival, the Sicilian Heritage Festival, the Italian Festival, and the Oyster Festival. The pop icon Britney Spears is from the town of Kentwood, in Tangipahoa Parish. Happy 150th anniversary to Tangipahoa Parish. You are etched in our colorful and rich history. Thank you for all of your contributions to our beautiful State that we are fortunate to call home.

Mr. CASSIDY

Mr. CASSIDY. Mr. President, I rise today in celebration of First Lieutenant John Stillmon Willis, Jr.'s 100th birthday and to speak on his extraordinary life and accomplishments. Mr. Willis has served his Nation honorably, and put his life on the line for the values that we hold dear as Americans. For this, we are forever grateful. Mr. Willis was born on June 2, 1919, and was raised in Doyline, LA. He attended Louisiana State University from 1937-1940 and graduated with a degree in agronomy. Shortly after the bombing of Pearl Harbor, Mr. Willis, a member in the army infantry reserve as a lieutenant in the U.S. Army, volunteered for pilot training. He was then transferred to the Army Air Corps, in grade, as a second lieutenant, and assigned to the 452nd Bomb group in Deopham Green Airbase in Atleborough in Norfolk, England. While there, he piloted a B-17 Flying Fortress and hit strategic targets in Germany and supported ground forces across Europe after the D-Day invasion. He would later be promoted to first lieutenant. After the fighting stopped, Mr. Willis credited the survival of his crew and himself to the fact that the ``good Lord has his arms around them.'' After the war, he worked in his father's lumber business for 20 years. Mr. Willis would go on to marry Lillian Mae Life and have one daughter, Martha Lou Willis, who gave them 3 grandchildren. The Willises enjoyed a beautiful 54 year marriage. Mr. Willis worked for another 20 years at his father-in-law's business, Webb Hardware, in Minden, LA. Mr. Willis recently celebrated his 100th birthday at St. John's Episcopal Church in Minden, where he has been a lifelong member. It is because of his long list of accomplishments and beautiful life that we celebrate First Lieutenant John Stillmon Willis Jr.'s 100th birthday. We honor and thank him for a lifetime of service to our State and country and wish him the happiest of birthdays.

Mr. CASSIDY

Mr. CASSIDY. Mr. President, I ask unanimous consent that the remaining votes in this series be 10 minutes in length.

Mr. CASSIDY

Mr. CASSIDY. Mr. President, today I rise in recognition of seersucker manufacturers and enthusiasts across the United States. I wish everyone a Happy National Seersucker Day. This uniquely American fashion has a storied history dating back to 1909. Louisiana is proud to have played an important part in introducing the country to seersucker apparel. The first seersucker suit was designed by Joseph Haspel at his Broad Street facility in New Orleans, LA. This lightweight cotton fabric, known for its signature pucker, has been worn and enjoyed by Americans across the country during the hot summer months. Mr. Haspel said it best, ``Hot is hot, no matter what you do for a living.'' In the 1990s, Seersucker Day was established by Members of this Chamber to honor this unique American fashion. I proudly resumed this tradition in 2014 in the U.S. House of Representatives by designating Wednesday, June 11, as National Seersucker Day. I have continued this tradition in the U.S. Senate and wish to designate Thursday, June 13, as the sixth annual National Seersucker Day. I encourage everyone to wear seersucker on this day to commemorate this iconic American clothing.

Mr. CASSIDY

Mr. CASSIDY. Madam President, this month is Mental Health Awareness Month, and the goal of Mental Health Awareness Month is to recognize the importance for personal well-being, the need for research and education, dispelling the stigmas associated with mental illness, and to improve mental healthcare to ensure that care is available to ensure that the first episode of mental illness is the last. A goal with Mental Health Awareness Month is the awareness that is necessary for the programs to be implemented so that that young person with their first episode is returned to wholeness, and, again, as I said earlier, the first episode is the last. It recognizes that mental health is a societal issue associated with homelessness, crime, suicide, physical health, and public health issues. Now, when you speak of mental health, it is a little bit almost like: Oh, my gosh, this is going to be a futile issue. It is so difficult for someone who has serious mental illness to return them to wholeness. It is so difficult that sometimes the individual, their family, and society throws up their hands and says: There is nothing to do, so why try. You see manifestations of that with the homeless people walking around this city and every city in the United States, many of whom are mentally ill; yet there can be hope. I called a person back home from Baton Rouge, LA, and asked her for a story, if you will, of how someone with mental illness issues can be returned to wholeness, so let me tell you about Mary. When you walk with Mary, you can't help but feel happy, happy, happy. That is because Mary radiates the joy of how Capital Area Human Services helped change her life. Mary says: I go out and help the community every day. I became successful in my life because of my faith in God and because of the wonderful people at Capital Area Human Services. Today I give back to the community what Capital Area has given to me. It wasn't always this way. For nearly 20 years before being referred to Capital Area Human Services, Mary lived in group homes and was dependent upon others for basic needs. I am now quoting Mary: I weighed 340 pounds. I was sick all the time, was in and out of hospitals. I was barely able to function. I was on so many medicines I could not keep track. When Mary came to Capital Area Human Services in 2006, she was first helped at the Margaret Dumas Center at the Government Street location. She eventually entered the total health program, and even more dramatic changes began. Now, let me point out as a physician--I am a doctor--I have learned from folks such as the people I am quoting now that mental health is often associated with physical health problems. So someone who is seriously mentally ill is more likely to die in their 50s than they are in their 80s with untreated hypertension, diabetes, or perhaps, because they are homeless, subject to violence on the streets. So let me now go back to Mary's story. When she entered the total health program, she lost nearly 100 pounds, no longer needed to take blood pressure medicine, changed her diet, participated in fitness programs, and continued to attend mental health therapy sessions. Today Mary is a different person. She lives independently in her own apartment, attends Sacred Heart of Jesus Catholic Church, walks 2 hours every day to volunteer for various duties at the St. Agnes Catholic Church soup kitchen, where she also sings for the attendees. Mary credits the nuns at St. Agnes for teaching her how to cook, prepare meals, and serve. Also, Mary is a regular volunteer at the Society of St. Vincent de Paul and at the Baton Rouge General Hospital chapel, where she reads Scriptures for some of the services. Mary said she loves Capital Area Human Services, tells everyone she knows about the people who helped her, particularly Kesha, John, the staff at Margaret Dumas, the staff at the Government Street location, and former total health employees Roy and Ricky. She says: I was motivated and didn't give up. It made me happy to do this for myself. I proved that I could do it, and I'm doing it. It's winter, but I'm out there anyway. Now, I give that kind of personal story to give an example of someone with serious mental illness returned to wholeness. Now, I love that because I always tell folks when I speak that we in Washington, DC, can propose legislation, but unless there is local leadership, nothing good happens. In 2016, I collaborated with Chris Murphy, as well as Eddie Bernice Johnson and Tim Murphy in the House, to pass the Mental Health Reform Act. It increased access to mental healthcare for adults and children, it strengthened leadership and accountability for Federal mental health and substance abuse programs, and it established new programs for early intervention. It was called by Senator Alexander the largest reform to our mental health system in decades. I continue to work with President Trump's administration to implement these reforms. Now, none of this Federal legislation makes a difference unless there is State and local leadership, as was demonstrated in the story which I gave. Last October, I held a mental health summit in Baton Rouge and brought together Federal, State, and local leaders, and the purpose was to discuss proven methods in how to work together to improve the provision of mental health services in both Louisiana and the United States. There is still important work to do. If we are going to return these folks to wholeness, these folks--our family members, our neighbors, our fellow Americans. The Mental Health Parity bill became law 10 years ago, but patients still have trouble accessing mental healthcare in the same way they access physical healthcare, caused by, among other things, the lack of mental health providers, prior authorization requirements, and reimbursement rate setting. I am committed to ensuring patients have access to the treatment so they return to wholeness. We need the story of Mary not to be something so unusual that it is read upon the Senate floor, but something which is so common that we know it to be true. Instead of throwing up our hands--kind of, oh, my gosh, serious mental illness; there is nothing to do--instead we look to hope with a future for someone who could be returned to wholeness so that her first episode of mental illness is her last episode of mental illness. I yield the floor.

Mr. CASSIDY

Mr. CASSIDY. Madam President, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 46, S. 406.

Mr. CASSIDY. I ask unanimous consent that the committee-reported amendment be agreed to; that the bill, as amended, be considered read a third time and passed; and that the motion to reconsider be considered made and laid upon the table.

Mr. CASSIDY

Mr. CASSIDY. If there is no further business to come before the Senate, I ask unanimous consent that it stand adjourned under the previous order following the remarks of Senators Durbin and Casey.

Mr. CASSIDY

Mr. CASSIDY. I ask unanimous consent that the concurrent resolution be agreed to, the preamble be agreed to, and the motions to reconsider be considered made and laid upon the table.