Tim Kaine

Mr. KAINE

Mr. KAINE. I yield the floor.

Mr. KAINE. Is it the Senator's position today that you do not object to them individually but there are other Members of your caucus who individually object to them?

Mr. KAINE. On all three?

Mr. KAINE. My question was: I believe, in the Armed Services Committee, these three individuals, you supported their nominations for reporting to the floor. And I just want to make sure that I am accurate about that.

Mr. KAINE. Will the Senator yield for a question?

Mr. KAINE. I would be very happy to amend my motion to that, if you would find that acceptable.

Mr. KAINE. Mr. President, I rise and thank my colleague from Hawaii for stating plainly the qualifications of these candidates. As a member of the Armed Services Committee, I have had a chance to review their qualifications. And as the father of a U.S. marine, I agree wholeheartedly with the Senator's contention that these three positions would be very important to fill at a time when the United States has so many security challenges. Anticipating a productive dialogue with my colleague from Missouri, I would like to ask unanimous consent that the Senate consider the following nominations en bloc: Calendar Nos. 779, 780, 781; that the Senate vote on the nominations en bloc without intervening action or debate; that the motions to reconsider be considered made and laid upon the table; that any statements related to the nominations be printed in the Record; and that the President be immediately notified of the Senate's action.

Mr. KAINE. Mr. President.

Mr. KAINE. Mr. President, if my colleague from Missouri would yield for a series of questions, I want to make sure that I understand the objection. I certainly understand the objection as indicated with respect to seeking accountability for Afghanistan. I understand that point. Is it correct that in the committee, however, you supported each of the three nominations who are proffered on the floor today?

Mr. KAINE

Mr. KAINE. Mr. President, as we continue our battle with COVID-19, we must acknowledge the healthcare healers that are serving in our rural communities. In particular, I would like to highlight the work of the Health Wagon in Virginia. The Health Wagon is the oldest mobile clinic in the Nation. Their mission is to provide compassionate, quality healthcare to medically underserved people in Appalachia. The Health Wagon works to mitigate barriers to healthcare access, taking healthcare into the community, into places like grocery stores, food banks, workplaces, and providing communities in southwest Virginia with access to primary, specialty, dental and vision care. Health Wagon originated 40 years ago with Sister Bernadette Kenny of the Catholic order Medical Missionaries of Mary. Sister Bernie traveled on rural mountain roads in her Volkswagen Beetle to deliver healthcare to individuals in southwest Virginia. Now, the organization employs more than 50 staff members across four clinics and four mobile units. Their average patient is 41 years old, with 100 percent of patients being uninsured or underinsured. Over the last year, the Health Wagon has served 10,857 individual patients and documented 35,250 patient encounters. The Health Wagon has also been vital in the fight against COVID-19. Since March 2020, the Health Wagon has provided more than 18,000 COVID- 19 tests, provided 19,567 COVID-19 vaccinations, and administered over 5,500 monoclonal antibody treatments. They do not bill for services, and their programs are sustained by grants and donations from individuals, corporations, and foundations. The Health Wagon is led by president and CEO, Dr. Teresa Tyson. Dr. Tyson has served with the Health Wagon for 30 years, and under her leadership, the organization has received national recognition for its innovative projects in telehealth space. The Health Wagon was the first to deliver a virtual wound care clinic and conducted the first FAA-approved drone delivery of medications in the United States. Dr. Tyson led the largest health outreach of its kind in the Nation, as well as providing the first telecytoscopy in the world in partnership with University of Virginia. Dr. Tyson leads a group of caring and committed providers. Rural communities are the backbone of our country, and the Health Wagon has served the Appalachia community admirably. I thank them for their service.

Mr. KAINE

Mr. KAINE. Mr. President, biologics, or complex large molecule drugs typically derived from living organisms, play a critical role in our healthcare system, treating a range of conditions such as diabetes, arthritis, and cancer. Yet spending on these products accounts for an alarming and significant portion of overall drug spending in the United States. In 2018, biologics accounted for 40 percent of spending on all prescription drugs, with spending on biologics growing twice as quickly as overall drug spending since 2015. Biosimilars are drugs that are highly similar to existing biologics, and interchangeable biosimilars are biosimilars that can be substituted for a biologic product without the intervention of a healthcare provider. Biosimilars and interchangeable biosimilars can play a significant role in reducing drug spending. For example, Medicare Part D spending for both beneficiaries and the program is less than spending on reference biologic products even as the use of biosimilars increases with increased availability. As of April 2022, there were 33 biosimilar products on the market including interchangeable biosimilar products. Food and Drug Administration, FDA, approval of additional interchangeable biosimilars could provide patients with more treatment options, increase competition, and lower costs. We must take steps to provide clarity around the FDA's review process for interchangeable biosimilars to facilitate development of these products, bringing them to market faster. That is why I am proud to join my colleague, Senator Collins, in introducing the Interchangeable Biologics Clarity Act, legislation that would make key improvements in the FDA's review process for interchangeable biosimilars. Specifically, this bill would clarify the FDA's authority to tentatively approve a second or third interchangeable before the end of the first interchangeable's exclusivity period, allowing additional products to enter the market more efficiently when that exclusivity period ends. This legislation would also specify that two interchangeable biologics approved on the same day could share an exclusivity period. These provisions would allow the FDA to issue additional guidance around the review of interchangeable biologic products and ensure increased transparency about the exclusivity periods for interchangeable products. I look forward to working with my colleagues to pass these important improvements to the FDA's biosimilar review process that will increase patients' treatment options and help foster competition.

Mr. KAINE. Mr. President, the Food and Drug Administration's ``Purple Book'' provides patients, providers, and public health experts with key information about FDA-licensed biological products. Providers rely on accurate and up-to-date information from this searchable online database to make crucial decisions regarding the treatment of their patients. The ``Purple Book'' provides transparency on the availability of biological products. This can help inform public health decision- making and increase competition among manufacturers to lower prices. Improvements to the ``Purple Book'' clarifying when biological products leave the market would allow the FDA and the public to monitor the availability of these key medications. That is why I am proud to join my colleagues, Senators Marshall, Hassan, and Cassidy, in introducing the Biologics Market Transparency Act, legislation that would extend to biological products certain reporting and transparency requirements that already exist for small molecule drugs. This is the Senate companion to legislation introduced by Representatives Kathy Manning and Richard Hudson in the House. It would require manufacturers of biological products to confirm that their products listed in the ``Purple Book'' are available for sale. This bill would also require manufacturers to report to the Secretary of Health and Human Services when their products are withdrawn from the market. These updates to the ``Purple Book'' would provide patients and providers with real-time access to changes in drug availability, allowing physicians to make informed decisions about the best treatment for their patients. These changes would also improve the ability of the FDA to respond to and anticipate drug shortages. I look forward to working with my colleagues to pass these commonsense reforms to strengthen public health and increase transparency for patients and providers.

Mr. KAINE

Mr. KAINE. Mr. President, I rise to just share candid emotions about yesterday's tragic shooting of schoolchildren who were 2 days from the end of the school year in Texas--19 deaths of little ones and 2 teachers and others injured. This is rough. I don't have any notes because I am really emotional about it. These shootings kind of give me PTSD, I have to admit. I was the mayor of Richmond, and our city had the second highest homicide rate in the United States. At a much younger period of my life, I found myself going to too many funerals, to too many wakes, to maybe the most memorable crime scenes, then also to homicide victims' family support group meetings in church basements in my city. Then I got to be the Governor of Virginia. In April of 2007, my wife and I landed in Japan while leading a trade mission, and we went to a hotel and immediately got a phone call saying that there was a shooting underway on the campus of Virginia Tech University and that I should turn on CNN, which I did, in Japan. As I saw the events unfold, I said: Take us right back to the airport. We had flown 14 hours. We were in the hotel for about an hour but went right back to the airport and flew all the way back home to what was the worst day of my life in trying to comfort 32 family members who had lost kids or their spouses who were faculty members--and that process went on for years--in the days right after the horrible tragedy but then commissioning a study about what went wrong and then trying to find an appropriate settlement with these families that would honor their loved ones. I had to deal with State police officers--hardened, hardened law enforcement veterans--who walked into the classrooms at Virginia Tech, to find carnage and on each body a cell phone ringing because a parent had seen it on television and wanted to call to make sure it wasn't one of their children who had been killed. My law enforcement officers talked about how those rings that would never be answered just haunted them, haunted them. So when there are these shootings at a school, at a nightclub, at a concert, in a grocery store, in a church, in a synagogue, I feel like I am back in April of 2007, experiencing those emotions for the first time. I was analyzing my own emotions for the first time last night. Why have I not been able to reach a point of more--I don't know--emotional equilibrium about this after 15 years? I realized that the reason was that my emotional reaction that is kind of a PTSD thing is not just because of the shootings, not just because of the deaths, not just because of the promising lives cut short; it is compounded by a realization that, here in this body, we have done nothing. It would be bad enough to experience the violence and be reminded of that most painful time in my life, but to experience it as a U.S. Senator, as a Member of a body, and to say, ``Well, what have we done? We didn't do anything at the Federal level after Virginia Tech, and we didn't do anything after Pulse, and we didn't do anything after Las Vegas, and we didn't do anything after Sandy Hook, and we didn't do anything after one tragedy after the next,'' then that compounds in some ways, and that is the thing that makes the emotional reaction a reaction that is as fresh today as it was in April of 2007. It is a wound that can't heal until we do something to heal the injury, to heal the problem. I was thinking about this last night, and I was trying to, you know, think, what is some wisdom that I can derive to make me feel less down and less despondent? And I just thought of two things that I wanted to share. One is a spiritual insight, and the other is a practical reason not to lose hope. So, as a spiritual insight, a few years ago, Pope Francis was kicking off a yearlong effort to encourage the revitalization of parish life-- not the life of the big, universal church but the life of parishes. He challenged parishes, but this challenge could go for people, and it certainly could go for political leaders. He challenged parishes to be (statement made in Spanish) ``islands of mercy in the midst of a sea of indifference,'' and I thought, what an interesting challenge. The thing about that challenge that I thought was so beautiful and a little bit unexpected is he didn't counterpose mercy to evil or mercy to cruelty or mercy to hatred; he contrasted mercy with indifference-- with indifference. There is evil in the world, and there is hatred in the world, and there is cruelty in the world. Yet usually those forces are not strong enough to succeed for very long unless--unless--there is widespread indifference. We are challenged not to be indifferent. If we assess why the Senate, this great deliberative body, has been unwilling to act for 15 years, I don't think it is cruelty or evil; it is indifference. It is the very thing that Pope Francis was warning us to avoid. We should be merciful. We should not be indifferent. Evil doesn't thrive for very long absent indifference. Yet, despite what we often say after tragedies like this, with our thoughts and our prayers and our sincere emotions, if we don't demonstrate by more than just words that we are touched by these tragedies, then we are committing the sin of indifference. I hope very much that the tragedy of these little children's deaths may push us out of the indifference that we have been sunk in at least on this issue. I really hope that it will. Then, finally, there is a practical reason I am not going to give up hope that it will. I mentioned that I was the mayor of Richmond, dealing with a homicide problem, and that I was the Governor during what was at the time the worst mass shooting in the history of the United States. Sadly, it has been eclipsed. The Virginia Tech shooting is no longer the most tragic shooting in history. Others have eclipsed it in terms of the numbers of those killed. I felt that same despair then, and I threw myself into trying to make changes. I made the changes in the Virginia laws that I could make as the Governor by executive action, but there are some things I couldn't do by executive action. I needed the support of my legislature to do a comprehensive background check bill because, in the case of the Virginia Tech shooting, Seung-Hui Cho, the disturbed 19-year-old who committed that crime, was legally barred from owning a weapon, but weaknesses in the background check system didn't catch that, and he was able to get the weapons that led to that carnage. I couldn't get my legislature, even in the aftermath of the worst shooting in the history of the United States, to be willing to take action, but we never gave up. We kept pushing. We kept pushing in Virginia, the headquarters' State of the National Rifle Association. We kept pushing and pushing and pushing, and in 2019, 12 years after the tragedy at Virginia Tech, my legislature passed a set of commonsense gun safety rules: one handgun a month, a ban on certain kinds of weapons that nobody needs, a comprehensive background check, mental health support--a series of initiatives. My legislature did pass it in 2019, and my State is safer as a result, but 12 years was a long time to wait. There were a lot of tragedies that happened between 2007 and 2019. Thank God for the Virginia Tech family members and for the other advocates who said: We will wait. We are not going away. We are patient. We are discouraged. Each loss we feel afresh, but we are not stopping until we make that happen. In my first months in the Senate, we voted on the floor on a comprehensive background check bill. I think that was the last time we had a meaningful debate about gun safety policy on the floor of this body--9 years ago. It is like there is a gag rule here. You know, it used to be, in Congress, you were not allowed to have debate or to vote about issues dealing with slavery during the 1830s. It is like we have a gag rule about debating gun safety on the floor of this body. But I remember voting that day, and it was on the anniversary of the shooting at Virginia Tech that we voted on a bipartisan background check bill in this body in 2013. The Sandy Hook families were sitting in the Galleries, and many of the Virginia Tech families had come up to join them to offer them support. I was reminded of the Scripture and the letter of Paul to the Hebrews being surrounded by a great cloud of witnesses. And here we were on the floor, trying to respond to this tragedy and do something to ease their grief, and we fell a couple of vote shorts. We couldn't get to 60. I think we had 57 votes that day for a background check bill. That was painful. It was painful. It was especially painful to fall short in the view of all of these grieving family members. But I draw hope from this. If we can make progress on this issue in Virginia--the headquarters of the NRA--we can make it in the U.S. Senate. It may not happen as quickly as I want, and it may not happen while I am still here to see it, but there is no reason to give up. If we can do this in Virginia, we can do this in the U.S. Senate, and we ought to. There is nothing we can do to bring back the lives of these young people, but if we can act to decrease the chance that this will ever happen again, they will at least have the ability to grab on and say: Our advocacy made a difference, and kids who go to school will be safer in the future. This is the last thing I will say, and I will sit down. I was walking around the building this morning, and because I am fluent in Spanish and people around here know it--a lot of the Capitol staffers are Latinos, and they talk to me in Spanish--I passed by a longtime Capitol staffer who said in Spanish: Senator, what is going on? What is going on with this country? I said: I know what you are asking me about, and it is such a tragedy. Then she said this to me. She is from El Salvador. She said: My country is a mess, and the violence is awful, and the homicide rate is unacceptable, but no children in schools feel unsafe. No people going to church services feel unsafe. What is going on, Senator? I didn't have a good answer for her. I didn't have a good answer for her. I yield the floor.

Mr. KAINE

Mr. KAINE. Mr. President, biologics, or complex large molecule drugs typically derived from living organisms, play a critical role in our healthcare system, treating a range of conditions such as diabetes, arthritis, and cancer. Yet spending on these products accounts for an alarming and significant portion of overall drug spending in the United States. In 2018, biologics accounted for 40 percent of spending on all prescription drugs, with spending on biologics growing twice as quickly as overall drug spending since 2015. Biosimilars are drugs that are highly similar to existing biologics, and interchangeable biosimilars are biosimilars that can be substituted for a biologic product without the intervention of a healthcare provider. Biosimilars and interchangeable biosimilars can play a significant role in reducing drug spending. For example, Medicare Part D spending for both beneficiaries and the program is less than spending on reference biologic products even as the use of biosimilars increases with increased availability. As of April 2022, there were 33 biosimilar products on the market including interchangeable biosimilar products. Food and Drug Administration, FDA, approval of additional interchangeable biosimilars could provide patients with more treatment options, increase competition, and lower costs. We must take steps to provide clarity around the FDA's review process for interchangeable biosimilars to facilitate development of these products, bringing them to market faster. That is why I am proud to join my colleague, Senator Collins, in introducing the Interchangeable Biologics Clarity Act, legislation that would make key improvements in the FDA's review process for interchangeable biosimilars. Specifically, this bill would clarify the FDA's authority to tentatively approve a second or third interchangeable before the end of the first interchangeable's exclusivity period, allowing additional products to enter the market more efficiently when that exclusivity period ends. This legislation would also specify that two interchangeable biologics approved on the same day could share an exclusivity period. These provisions would allow the FDA to issue additional guidance around the review of interchangeable biologic products and ensure increased transparency about the exclusivity periods for interchangeable products. I look forward to working with my colleagues to pass these important improvements to the FDA's biosimilar review process that will increase patients' treatment options and help foster competition.

Mr. KAINE

Mr. KAINE. And that is what my point is. We are not fast-tracking these without a vote. This is a motion to allow a vote en bloc on the floor. So you will have an opportunity to vote against Mr. Chaudhary or all of these. This is not a motion to immediately approve them without a vote. It is just a motion to bring them up so that you and others can vote on these nominees. That is all I am seeking. And so my request, basically, would guarantee you a vote on all of these nominations if you drop your objection.

Mr. KAINE. It would be a--yes. It would be en bloc, but it is a recorded vote, is my understanding. And, again, Madam President, just to clarify, my motion is only that the Senate be allowed to vote on these nominees: Alex Wagner for Assistant Secretary of the Air Force; Ashish Vazirani for Deputy Under Secretary of Defense; Christopher Lowman, Assistant Secretary of Defense; Lester Martinez-Lopez, Assistant Secretary of Defense; Agnes Schaefer, Assistant Secretary of the Army; Franklin Parker, Assistant Secretary of the Navy; Musetta Tia Johnson, Judge of the U.S. Court of Appeals for the Armed Forces; and Ravi Chaudhary, Assistant Secretary of the Air Force. I understand my colleague will vote no, but all I am moving is for the Senate to be able to have a vote on these nominees.

Mr. KAINE. My motion is to consider them, yes, en bloc; but it would be a recorded vote, is my understanding.

Mr. KAINE. I appreciate the objection being heard, and I would just say to my colleague, I hope we could work out a deal that would enable us to have a floor vote where my colleague could vote as he chooses on these nominees. This was not an attempt to bypass a vote; it was just an effort to have a vote where everybody can be recorded on the nominees. I hope we can work that out.

Mr. KAINE. Madam President, in a moment, I am going to make a motion by unanimous consent to call up, and hopefully confirm, significant appointments in the Department of Defense. We are in the midst of a war in Europe right now. It is hard to imagine that, and yet it is the case. Every day we see atrocities committed by Vladimir Putin's illegal invasion of Ukraine, but every day we also see the concerted effort of the United States and NATO allies and other nations to provide dramatic support for the Ukrainian defense force and the Ukrainian people. We honor the Ukrainians' resolve and heroism, and we feel proud of the role that the United States and other nations are playing in providing defense. And I hope we will take additional defense support up on the floor in the days to come. However, this is not easy work to do. One of the positions that I am going to be seeking a UC on is the DOD Assistant Secretary for Sustainment, Christopher Lowman, who is a Virginian. He and his family live in Fredericksburg. Mr. Lowman is, according to the committee, completely noncontroversial and very much desired in this position. He was born in Germany, in a military family, grew up in Virginia, went to college in New Jersey. He was a U.S. marine beginning in 1984, and then after his Active Marine service, entered the Army civil service as an Army maintenance management intern in 1989. And he has been with the Army ever since. His specialty is logistics. So this Assistant Secretary of Sustainment is kind of the peak logistics officer in the Pentagon. He previously was the Acting Principal Deputy Assistant Secretary of the Army for Acquisition, Logistics, and Technology. OK. That is a title that is--you know, what does that actually mean? I will tell you what it means. When the United States is trying to get historic amounts of military aid across a contested border from allied countries into a war zone, we need people who know logistics. It may not be the sexiest part of the military mission, but it is part of the mission that is absolutely critical, and it is part of the mission where the U.S. military is second to none in the world. If you wonder why the Russian military's grand plans to topple Ukraine in just a couple of days came to naught, you first say it is Ukrainian heroism, and you second say it is the support of our allies, but, third, you have to point out the Russian military has demonstrated that they haven't mastered logistics. The inability to maintain supply chains, the inability to do proper maintenance of tanks and other vehicles is one of the reasons that the Russians have not been able to accomplish their aims. So what this war in Europe is demonstrating is militaries that have the capacity to do logistics and provide supplies to people on the front end of the fight are critical to success. Given the fact that the United States is the key to pulling together the international effort to provide support to the Ukrainian defense force, and given the fact that that mission depends upon having the best logistics in the world, why would we leave the chief logistics official at the Pentagon position vacant in the middle of a war when the United States is playing this heroic role? For that reason, Madam President, I ask unanimous consent that the Senate proceed to executive session to consider the following nominations en bloc: Calendar Nos. 477, 599, 777, 779, 780, 781, 861, and 886; that the Senate vote on the nominations en bloc without intervening action or debate; that the motions to reconsider be considered made and laid upon the table; that any statements related to the nominations be printed in the Record; that the President be immediately notified of the Senate's action and the Senate resume legislative session.

Mr. KAINE. Yes.

Mr. KAINE. Yeah.

Mr. KAINE. Yeah. I mean, I know you will vote no. You have made it plain. But if I can guarantee you would get a vote, will you drop your objection?

Mr. KAINE. Madam President, will the Senator yield for a question?

Mr. KAINE. Will the Senator yield for a question? It strikes me that the Senator's objection is you do not want to have this candidate--the bloc of them advanced without a vote. If I can guarantee that you get a vote on these nominations, will you drop your objection?

Mr. KAINE

Mr. KAINE. I yield back all time on the Democrats' side. Vote on Motion