▶ 0:16:03>>>> the senate health education labor and pension committee please come to order. This committee voted unanimously to pass 14 pro-worker bills. We have passed historic bipartisan package that lowers drug prices, holds drug middlemen accountable, funds primary care, and increases access to pediatric cancer treatments. My focus is cutting through the noise to deliver fort louisiana and the united states of america.
▶ 0:16:34In my practice in medicine I cared for people who were economically vulnerable, living on the edge economically. A lot of families feel that way now. Health care, drug prices, college tuition.
▶ 0:16:52The more that we could do in this committee working together, taking power from giant insurance companies and giving it to patients and so they are in charge of their own health, taking power from parents -- so they could be in charge of their child's education. Workers free to pursue the job arrangement that works best for them and employers the opportunity for retirement.
▶ 0:17:24This hearing is to discuss ideas to do all of those things. A few bills I want to highlight, literacy continues to be a challenge. In particular individuals with learning needs are underserved by the status quo. My 21st century dyslexia act would include strain for those with dyslexia and enhance resources empowering these capable students with the tools they need to improve.
▶ 0:17:53My college transparency act includes families around student outcomes and institutions so they could make the best college decisions for the future. We also have a responsibility to bring stability to businesses and workers to make us competitive in the 21st century economy. Congress has not updated labor laws for almost 100 years.
▶ 0:18:16We have the opportunity to pass legislation and make health and retirement benefits more affordable to meet the needs of today's workers. This should be bipartisan. Part of the american dream is having the financial freedom to retire. I worked with senator kaine on multiple bills including the hoping young americans save for retirement act and the auto reenrollment act of 2025.
▶ 0:18:43Earlier this year the committee and the senate passed a bill that I worked on with the employee ownership act, we also asked senators marshall and kane . Bills expanding esop programs so more workers could benefit from the success of their employer. Let's make health care, higher education a life lesson. I'm looking forward to hearing about areas we worked on together.
▶ 0:19:16Before we begin members on the committee will have three minutes to testify and off committee members will have two member -- minutes. I recognize senator kaine.
▶ 0:19:27Sen. Kaine: I appreciate this opportunity for both on and off committee members to offer bipartisan priorities. I had just a couple I would like to discuss. The first is my bipartisan and bicameral childcare workforce act.
▶ 0:19:47Sen. Kaine: The bill would establish a pilot program to increase the supply of quality services by offering competitive funding to eligible entities that are interested in expanding pay programs for childcare workers. This is an effort that has been successful to increase childcare supply, and reduced turnover. Virginia families face some of the highest childcare costs.
▶ 0:20:15Sen. Kaine: According to the workforce index, 43% of our childcare workers rely on public assistance. We pay a lot for childcare and yet 43% of workers rely on public assistance so something is not working. Research of the D.C. program shows that there were nearly 1500 additional childcare slots available. It would be a major victory for childcare workers and working families.
▶ 0:20:45Sen. Kaine: Second is my bipartisan and bicameral supporting healthy moms and babies. It would eliminate out-of-pocket costs such as co-pays or deductibles associated with childbirth for moms within endpoint -- employer sponsored health care. I sponsored this with vice president vance when he was in the senate.
▶ 0:21:12Sen. Kaine: The average cost associated with pregnancy, childbirth, postpartum care for women enrolled in employer sponsored insurance is about $3000 in out-of-pocket costs. No mom should go without a care because of fear they cannot afford it. Advocates of strong pro-life and pro-choice organizations support this bill. I would urge the committee to consider it.
▶ 0:21:43Sen. Kaine: Lastly, it would help -- the bipartisan help co-pays act ensures patients could access life-saving medication they need by requiring them to count the value of co-pay assistance towards a patient's cautionary requirement. The bill has technical assistance and is ready for markup in committee. Thank you for the opportunity to highlight these priorities.
▶ 0:22:09Chair Cassidy: Senator murkowski.
▶ 0:22:13Sen. Murkowski: Thanks for the opportunity. Thank you. Just to give a heads up to the committee, I am chair of the indian affairs committee and we have been working really hard on the native children's implementation act, this is a bill I will be introducing shortly, a bipartisan bill that crosses multiple jurisdictions and works to improve access to health services, education.
▶ 0:22:47Sen. Murkowski: I'll be looking forward to working with the committee on this. Turning to the bills that I would like to highlight today. The first is the reauthorization for als -- act for als. It expires this year. It has long been a priority for me and moving forward on this reauthorization is a big deal. There is no cure for als, we know that.
▶ 0:23:15Sen. Murkowski: The initial authorization has worked to accelerate drug development and help individuals not eligible for clinical trials to get access. This is an effort that senator coons and I are leaning on. We have a great partnership over in the house and we would like to see this get marked up. The second bill is one that this committee knows well. It is the same step act.
▶ 0:23:39Sen. Murkowski: It places limits on therapy to prevent harm when patients are required to try certain medicines that have previously failed. We outlined five exceptions. We see this before. We had good success last congress when it was included. Hoping that we could get this one.
▶ 0:24:07Sen. Murkowski: Very briefly here, a few other things I am tracking, one is the lgbtq+ youth access directing the secretary of hhs to ensure we have sufficient resources with youth contacting the 988 suicide prevention hotline. Several of my colleagues have been engaged in this.
▶ 0:24:35Sen. Murkowski: Thinking about how we provide supports, mental health, suicide prevention hotline is so key. The last matter is the state-based education loan awareness at. I have introduced this with senators reid, cassidy, shaheen. To introduce low-cost federal loans so we could make smart financial decisions, reduce the cost of our own financial secondary education.
▶ 0:25:04Sen. Murkowski: Another priority we are looking forward to working with you and the rest of the community on this. Thanks for the opportunity to pitch my priorities this morning. >> thank you. I like the way senator murkowski characterizes this. It is cool. I have three to talk about. I will start by discussing the bill that would help women in rural areas who live in maternal health care deserts.
▶ 0:25:35Sen. Murkowski: For women in labor, every minute could obviously count. However, in some areas of new hampshire may take more than an hour to drive to the nearest labor and delivery unit. That's why introduce legislation to help ensure rural hospitals have the equipment and training that they need to treat pregnant or postpartum women who need urgent medical attention.
▶ 0:26:02Sen. Murkowski: This would help small rural hospitals purchase equipment, establish training curriculums and establish a pilot program for a hotline to help clinicians consult with the ob/gyn in urgent situations. I think the committee for working with us and I look forward to their consideration of it at the next possible markup. Families in new hampshire and across the country need access to affordable life-saving medications.
▶ 0:26:32Sen. Murkowski: Pharmaceutical companies exploit loopholes in the patent system in order to build what are known as patent laws around their products. Doing so sometimes blocks low-cost generic versions for literally decades. We have one pharmaceutical company, they had 100 different patent moves on one simple drug.
▶ 0:27:00Sen. Murkowski: My bipartisan bill, the medication of patent integrity act would improve access to generic drugs by closing the coordination between the fda and patent office. They have to share the same information with both so they couldn't claim a patent change. I want to thank chair cassidy and ranking member sanders for your staff's work to reach a bill on this congress.
▶ 0:27:30Sen. Murkowski: It would allow patients to access lower cost magic -- medications and save taxpayers more than $100 million over a decade. I asked the committee to mark this up at the earliest possible time. My final bill is the gateway to careers act.
▶ 0:27:49Sen. Murkowski: This would establish a competitive grant program to build career pathway programs which combine work education and support services to help individuals earn credentials. These programs are rooted in strong local partnerships between workforce partners who develop a clear step that workers could take in order to advance in their career. We are at a time when the economy and workforce are rapidly changing.
▶ 0:28:20Sen. Murkowski: We have to invest in evidence-based models to ensure america's businesses have the workforce to keep up and workforces are not left behind. I thank you for including the gateway to careers act in the bipartisan workforce opportunity act. I look forward to working with the community -- committee to getting this bill across the finish line. >> thank you especially to our committee staff.
▶ 0:28:50Sen. Murkowski: The majority and minority for taking our time. I will present three bills. They are bipartisan. They could make a huge impact. We could be signed into law. Our patients deserve price tags at. I want to thank my cosponsor, senator hickenlooper for his help on this. Americans know the price of milk before they buy it.
▶ 0:29:21Sen. Murkowski: Health care patients are handed a blank price tab. The bill could save families potentially $1000 per month. It could do more to impact health care than any legislation that I am aware of. It could generate over $75 billion in new tax revenue.
▶ 0:29:46Sen. Murkowski: It requires hospital labs and insurance to boast real prices up fun given full claims data, audit rights and then mandates aftercare. Stakeholders have been heard, the text is ready. I asked the committee to make a priority. I ask about the american franchises act. I thank angus king for his friendship and leadership on this.
▶ 0:30:13Sen. Murkowski: There is 800,000 franchise small businesses that employ almost 9 million americans and generate 900 billion dollars in economic output. Franchises, they give women, minorities, veterans a path to their american dream. They have been ripped solid by joint employer standards.
▶ 0:30:39Sen. Murkowski: They have one clear permanent standard ending the chaos and giving small business owners the certainty they need to hire and grow. I urge the committee to give us a chance to markup our american franchises act. Lastly I will talk about prior authorization. Our improving seniors timely access to care act.
▶ 0:31:06Sen. Murkowski: So many people on this committee we share the same priorities and it touches health care in many ways. Prior authorization is the number one complaint I hear from seniors. Nearly three out of four medicare advantage face unnecessary delays in their health care. Not because of the doctor's judgment but because of an insurance company says no. Worsening conditions and irreversible harm.
▶ 0:31:36Sen. Murkowski: This bill has 67 senate cosponsors. 260 house cosponsors. Our bill fixes that and requires prior authorization and full transparency on denial rates. The votes are there, I asked the finance committee to help get this across the finish line and maybe even a chance to consent opportunities with the members of this committee. I yield back.
▶ 0:32:10Sen. Murkowski: >> we thank ranking member sanders and the staff. I will focus on one bill, the one that senator marshall just mentioned. This bill will do something that seems novel but it really shouldn't. We require the publication of real prices for health care procedures. For patients, that is good.
▶ 0:32:38Sen. Murkowski: Also employers who should be able to provide employees with the best prices possible. Co-pays have gone up. This gives everybody a fair shot. It functions in near-total darkness. The lack of transparency is outrageous and something that is almost unique among other services that americans pay for every day. If you go to the grocery store.
▶ 0:33:09Sen. Murkowski: I use the metaphor of buying a car on a used car lot. Imagine if you had no information what the fair market value is for that car, what other buyers were willing to pay in similar markets. I could go on and on.
▶ 0:33:30Sen. Murkowski: It is not just for the health care consumers that this information is so valuable and allows you to make financially sound decisions. The employers who sponsor health care plans total 180 million employees. Think about that. We are talking about 180 millions americans who don't have access and employers who would compare prices and navigate this have no light on this.
▶ 0:34:02Sen. Murkowski: Their power is gone because of the darkness. Purchasing power is being severely diminished because employers aren't able to access health care data for their own employees. They conducted a review of multiple employers including the city and county of denver, I know something about that having been the mayor. They detailed extensive delays.
▶ 0:34:32Sen. Murkowski: This is the kind of gaming and confusion that drive american people nuts. We need to put a stop to it. It will allow patients to become more educated as consumers and shop for the best care at the best price. We have our employers finally having access to the data.
▶ 0:34:54Sen. Murkowski: It will let in much needed sunlight to this system which we believe will have a cascading effect on overall health care spending of preliminary estimates saying statistically derived from this is $75 billion in additional revenue. As prices come down we get the same prices on medicare and medicaid. We appreciate this hearing to put it out there.
▶ 0:35:29Sen. Murkowski: >> staff is very active in getting technical assistance on this. It has reverberated between three different agencies. In terms of the amount of ta you have to have. They change and have to re-review. Thank you all. Senator blunt rochester.
▶ 0:35:53Sen. Blunt: Rochester thank you for the opportunity to share my thoughts for delaware and the american people. As the former state secretary for labor I'm excited to discuss ways we could discuss workforce development, and economic development stronger, smarter, more adaptable and future focus.
▶ 0:36:14Sen. Blunt: One of my top priorities was actually to create advanced research for labor. It gave us the internet that would leverage high-impact r&d to stop our most pressing workforce challenges.
▶ 0:36:36Sen. Blunt: As we face a new world of work from ai, automation, it could address workforce shortages and ensure americans are left behind and give a global competitive edge. We can't future proof our jobs and we shouldn't. We could be future flexible. I also want to urge the committee to advance my bipartisan legislation called the immersive technology for the american workforce act which I am leaving with senator britt.
▶ 0:37:07Sen. Blunt: This would support community colleges and augmented reality and upscaling. My next priority is bipartisan and bicameral national workforce center act, leading with senator tillis, merkley, kramer. I urge my colleagues to ask this bill out of committee to strengthen our workforce.
▶ 0:37:32Sen. Blunt: From up-to-date information to predict emerging trends to best practices, this bipartisan bill will help us address one of our biggest workforce challenges. This is also supported by numerous organizations and received technical assistance under both of the president biden administration and president trump's administration. I would like to discuss a topic that many of the members of this committee are vitally interested in discussing. That is vaccines.
▶ 0:38:04Sen. Blunt: Given the court decision three days ago in which a federal judge temporarily blocked many policy changes it is even more important that this committee join forces to build public confidence in vaccines. The selected members ensure that these members are only removed for specific valid reasons and return to the nonpartisan independent panel of experts serving before the recent
▶ 0:38:34Sen. Blunt: Changes. This is important to all of us. It is about the health of our children, the health of our country and I hope that members will join me in this effort as well. I thank you so much for this opportunity. Considering my priorities, I made the time, I yield back.
▶ 0:38:56Chair Cassidy: Now it has been worked off -- worked out with the staff, senator alsobrooks.
▶ 0:39:05Sen. Alsobrooks: We are working together to find a common ground to advance bipartisan legislation. We made common interest here for prices for americans with lifesaving research and protect americans from public health threats in part by protecting amg -- access in maryland we wat
▶ 0:39:37Sen. Alsobrooks: To be in the forefront of maryland. I appreciate the opportunity to highlight bipartisan bills to support lifesaving research and frontline public health interventions. I know many of us agree with the need to invest in women's health research. We have an obligation to our daughters to combat the conditions with crippling pain or higher risk of chronic disease.
▶ 0:40:04Sen. Alsobrooks: That's why I'm proud to introduce the you fight act and the women's expansion act with senator britt. It is a subject that is not openly discussed or one that the general public is widely aware of. It is four out of five women, they received 0.3% of all nih funding.
▶ 0:40:40Sen. Alsobrooks: The most frequent reason for hysterectomies. They are more likely to have problems during pregnancy and delivery in both the condition and treatment could lead to infertility. So many women have to be their own advocates to seek relief. Patients wait 3-6 years and seek -- see two or more health care providers before they receive a diagnosis underscoring the need for improved awareness and education.
▶ 0:41:07Sen. Alsobrooks: S-2531 would bring a welcome change to the current landscape expanding access to early screening, detection, intervention methods for individuals diagnosed. I'm proud to partner with senator lummis on this legislation that are considered inconsiderate as part of a bipartisan markup very soon. We also know that the heart disease remains the leading cause of death for women across the country. From maryland to alabama.
▶ 0:41:38Sen. Alsobrooks: That's why I was pleased to work closely with senator britt to introduce the heart health expansion act which would reauthorize the wise women program. Wise women provides free cardiovascular risk screenings to reduce the risk for heart health to lower income uninsured, underinsured women. The program provides funding the state departments of health and health consortiums from alaska to louisiana. Current funding levels it is not able to serve every state.
▶ 0:42:09Sen. Alsobrooks: Outdated restrictions are limiting the population it could reach and expand providers and authorizes 250 million to take lifesaving prevention nationwide.
▶ 0:42:20Chair Cassidy: Senator baldwin will go. Everybody else has already spoken.
▶ 0:42:28Sen. Baldwin: Thank you, I appreciate the opportunity to discuss our priorities before the committee today. I started working on the lasting smiles act after hearing the story of aiden avenue it -- abbott. He told me his story of being born with ectoderm all dysplasia. A rare congenital disease that affects the development of hair, teeth, nails.
▶ 0:43:01Sen. Baldwin: This disorder requires intense dental care and oral care as well as reconstructive surgeries throughout his life. Despite having comprehensive health insurance, the abbots were denied coverage for his serious dental care needs. They had to pay thousands of dollars out of pocket for his treatments.
▶ 0:43:26Sen. Baldwin: Unfortunately, his story is all too common in individuals born with congenital anomalies or birth defects. They must have access to the coverage and health treatments that they need and deserve.
▶ 0:43:44Sen. Baldwin: I was proud to introduce my bipartisan insurance act with senator ernst to close the coverage gap and ensure health plans cover all medically necessary services related to a parent. Insurance companies often claim these procedures are cosmetic. They ensure a child could eat, speak, breathe.
▶ 0:44:15Sen. Baldwin: This is coverage that these families already paid for. I simply insurance earns companies don't deny the care that they should be covering. In 2022 this bill passed the house with overwhelming bipartisan support and I believe the senate could do the same this congress. We have 47 bipartisan cosponsors including myself and senator ernst who are gathering more support all the time.
▶ 0:44:47Sen. Baldwin: Any of my colleagues are welcome to join us in this fight any time. I asked that the committee consider this bill in markup as soon as possible. Any help from you and the ranking member in quickly obtaining an updated score would be much appreciated.
▶ 0:45:07Sen. Baldwin: Before I close I wanted to mention one other bipartisan bill that I introduced with senator o, the care and hospice education and training act otherwise known as -- this bill would bolster the care and hospice workforce to meet the growing need for care. I had the pleasure of visiting a community-based palliative care provider in madison last week.
▶ 0:45:37Sen. Baldwin: I know many of my colleagues also have priorities in the workforce space. I hope it will be considered for any future workforce efforts by this committee. Thank you.
▶ 0:45:51Chair Cassidy: Thank you. Now senator ernst.
▶ 0:45:56Sen. Ernst: . I truly appreciate you taking the time to hold this member day hearing. I also appreciate the chance to talk about the bipartisan work that senator baldwin and I have been engaged in helping our folks back home access the care that they need.
▶ 0:46:20Sen. Ernst: As a mother and more recently a grandmother, I'm incredibly thankful that my grandson was born a healthy baby. Not every family is so fortunate. About one in 33 babies born in the united states each year will have a congenital anomaly also known as a birth defect.
▶ 0:46:46Sen. Ernst: Children born with conditions affecting the eyes, ears, teeth, mouth, jaw are not just cosmetic but could affect a child's ability to breathe, eat, speak. Yet insurers still label many of these treatments as noncovered services for cosmetic reasons.
▶ 0:47:09Sen. Ernst: My river to river tour across iowa I met allie steel from dallas county, who had just six years old was diagnosed with ectoderm all dysplasia. Despite having insurance, the family was looking at tens of thousands of dollars in out-of-pocket costs just to provide her with functional teeth. That is why senator baldwin and I have championed the insuring smiles act.
▶ 0:47:39Sen. Ernst: This bill is not an insurance mandate. It simply closes a loophole so families who already pay tens of thousands of dollars each year for health insurance could access the care they were promised. I'm grateful for the strong support of this legislation has received from nearly half of the senate.
▶ 0:48:03Sen. Ernst: Passing would ensure children born with congenital anomalies would receive basic care so they could see, hear, chew, swallow, speak. These are functions we often take for granted but every child deserves them. I hope the committee will consider this bill for its next markup. Thank you for your time and I look forward to get this bill across the finish line.
▶ 0:48:31Chair Cassidy: Now senator lankford. This doesn't happen very often.
▶ 0:48:54Chair Cassidy: For us to be able to come share ideas, I have 45 bills, I might take five minutes for each of them. I really appreciate you doing this. It allows us to speak on the things we are passionate about. The maps act we have done together. It is focused simply on trying to find our pharmaceutical supply chain, where it is coming from and where the sources are from.
▶ 0:49:23Chair Cassidy: This is something we have worked on for a long time. We have worked a long time to be able to find the language that works as we identify this supply chain as we all know. We just want to know where are our weak spots, where are we struggling and where could we do american manufacturing. We have all seen times during covid, the supply chain, we had real challenges, we should learn a lesson from that.
▶ 0:49:55Chair Cassidy: We should be able to get antibiotics, things that were very focal, things that we are dependent on a few agencies internationally. A couple others, the protection act is one we have worked on for a long time. This should not be controversial. Especially nurses and pas and others that are there that may have conscience issues with certain medical procedures.
▶ 0:50:25Chair Cassidy: They are strongly held religious beliefs or basic conscience belief. They want to serve people but they also want to say I don't want to have certain practices. Most of them will say it to a hospital or physician group I want to serve in all areas. Occasionally they will be shorthanded and say sorry I give up on your conscience.
▶ 0:50:50Chair Cassidy: It is already against federal law to be able to violate the conscience rights of a medical provider that it requires the federal government to be the one to step in and enforce that. This gives a private right of action that their conscience rights are protected, they as an individual could step in and do that. U.S. attorneys and folks are incredibly busy and they are seldom protected so they feel like they are not protected. The same for medical residents act.
▶ 0:51:23Chair Cassidy: This is for ob/gyn coming in. I came in to be able to deliver babies, do these things so we could take care of health care. Don't ever plan, that is not my intent. They have to intentionally opt out of that training. There's always a fear in medical school if you choose to opt out of something, that will be a mark to you. This doesn't eliminate the training, it doesn't change anything.
▶ 0:51:52Chair Cassidy: It just sets the medical practice. You often rather than opt out of that training. Those planning to go that direction, they could get that training that doesn't change. Those that say confident -- conscience issues, I'm going to take care of miscarriages, take care of everything else. That is not an area I want to be trained in. It gives them that ability.
▶ 0:52:16Chair Cassidy: The last one deals with campuses and what I would consider that it -- a campus should not discriminate against a student organization because of religious beliefs. There have been times that different entities within the department of education have reached in and said if you will be on campus your campus leadership has to be diverse. To say to a jewish group you have to have non-jewish leaders. I don't think that is right.
▶ 0:52:49Chair Cassidy: Freedom of association is a common right. People should be able to pick their own leaders especially for jewish organizations. Don't impose on them who the leaders have to be. They want to self associate and have their own selection of leaders. Again, this should be a basic american right. It should not be controversial.
▶ 0:53:17Chair Cassidy: If we had conversation, we agree or disagree with this group or this faith. They should not lose the right to be able to select their own leaders on a campus or to have campus control. I'd be glad to get that in the bloodstream and talk about what that would look like. Thank you for holding this.
▶ 0:53:46Chair Cassidy: Senator scott.
▶ 0:53:50Sen. Scott: Thanks for doing this. Thanks for meeting with me last week. I'm here to discuss the clear labels act led by myself and ranking member gillibrand.
▶ 0:54:16Sen. Scott: The bill will inject the level of much-needed transparency into our supply chain. Why shouldn't the drugs we rely on make families better and not have the same level of transparency? Most americans prefer to buy american when they can. By labeling these essential drugs americans will have more information to make well-informed decisions.
▶ 0:54:44Sen. Scott: Country of origin is not a consumer right it is a matter of national security and american pride. This bill is very straightforward. It requires finished drugs to include the pace of business of the original manufacturer so you know where the ingredients come from. That information would then be found on the drug's label through a searchable electronic port. It is a simple bill that creates the transparency american people deserve.
▶ 0:55:13Sen. Scott: All members of the health commit -- health committee to join us in supporting this legislation. Thanks.
▶ 0:55:19Chair Cassidy: Thanks.
▶ 0:55:23Sen. Warnock: . Thank you. Thank you very much, Mr. chair. I sit here is living proof of what good public policy could achieve. Without federal programs that are directly under this committee's jurisdiction, I would not be serving in the united states senate. I am a proud alum of headstart.
▶ 0:55:57Sen. Warnock: I'm a proud alum of trio, which placed me on a college campus, convince the kid growing up in public housing that I belong there. During my summer breaks and on weekends. Without programs I would not have been able to graduate, making me the first college graduate in my family.
▶ 0:56:27Sen. Warnock: These investments in good public policy literally changed the trajectory of my life. What keeps me up at night is the recognition that it would be harder for me to achieve today the things that I achieved all those years ago. I am still fighting for that kid who grew up on cape street.
▶ 0:56:52Sen. Warnock: I remain deeply committed to ensuring others have the same opportunities through policies that bolster the workforce, that are good investments. They give every child a chance and the recognition that a kids outcome should not be based on their parents income. When we do that, not only do we hope that kid, we lift this country towards its greatness.
▶ 0:57:22Sen. Warnock: One such investment that I'm fighting for in light of my own story in my own recognition of these programs make is my bipartisan workforce development bill with senator marshall, the pathways to prosperity's act which would fund partnerships between technical and community colleges and industry partners to work together and develop workforce development programs with real needs of nearby
▶ 0:57:53Sen. Warnock: Industries. Our technical colleges and community colleges I think are vastly underutilized resource. We must ensure students are graduating with technical degrees that are in high demand and that yield good paying jobs.
▶ 0:58:17Sen. Warnock: Last congress committee advances the bill in the workforce development package and I urge the committee to support this legislation and get it passed on the floor. I also encourage you to consider the headway act. My bipartisan bill with senator cap it out -- capito by allowing teachers to teach under supervision while they are working on their degrees.
▶ 0:58:44Sen. Warnock: This bipartisan bill is supported by the national headstart association and would cut red tape to get more headstart teachers in the classrooms right away. I hope this committee will advance this bill that will help teachers and small children get a great headstart.
▶ 0:59:06Sen. Warnock: Finally, I am excited to share that next week senator britt and I will introduce bipartisan legislation to expand access to research grant opportunities for our nations hbcu's, historically black colleges and universities. These schools have historically punched way above their weight. They have been doing so much for so many.
▶ 0:59:33Sen. Warnock: I think too often we as a nation take for granted, I am a graduate of morehouse college. I know firsthand what these schools produce. I hope this committee will take that bill once it is introduced to ensure our students as part of a larger ecosystem of all of our great colleges and universities will have the same opportunities to participate in cutting-edge research that our
▶ 1:00:03Sen. Warnock: Nation needs to remain competitive. It is a bipartisan effort. Keep the american dream, thank you so much.
▶ 1:00:19Chair Cassidy: Thank you.
▶ 1:00:23Sen. Boozman: Thank you Mr. chairman and thanks to the entire committee for hosting this member day. It is an excellent idea. This is a wonderful opportunity to raise awareness about policy solutions that the senate is accurately pursuing to address issues.
▶ 1:00:53Sen. Boozman: Today I would like to speak about an issue that affects many americans including my own family. Everybody in this room probably has a friend or a loved one that is affected that congress could act on the saved lives and the health care costs increasing access to prostate cancer screenings. It is the second leading cause of cancer deaths in the U.S.
▶ 1:01:19Sen. Boozman: With african-american men with a family history being disproportionately affected. The prosthetic position screen for high risk insured demand act is legislation, I am proud along with senator booker to offer coverage for men at high risk importantly our bill does so without imposing cautionary requirements.
▶ 1:01:49Sen. Boozman: The test is a proven tool for detection. We caught the early stage prostate cons -- cancer it is almost 100% survivable. If lummis 237% when discovered at later stage -- it plummets to 37% when discovered at a later stage. High-risk men including deductibles, co-pays, insurance.
▶ 1:02:20Sen. Boozman: It would save lives and save the american health care system dollars in preventative medicine such as early screenings. It is one of the tools in our toolbox that will help tackle chronic diseases and improve the quality of life for patients. It will keep pace with advances in medical screening technology. Democrats and republicans, it is about helping the neighbors.
▶ 1:02:52Sen. Boozman: This is -- thank you very much and thank you to the committee holding this very important hearing.
▶ 1:03:01Sen. Booker: Thank you.
▶ 1:03:06Chair Cassidy: Senator merkley. He's a pastor.
▶ 1:03:24Sen. Merkley: Great idea holding this gathering. Thank you. I have four bills to attempt to prevent -- present to you in two minutes. The first is reauthorization of a title eight, the nursing workforce act. We know nurses like my wife make the world better one bedside at a time. We are in the middle of a nursing workforce crisis.
▶ 1:03:54Sen. Merkley: 130,000 nurses have left the workforce since 2022. The remaining nurses say they will retire within the next four years. That is why senator collins, baldwin, blackburn, myself have introduced a bill to reauthorize title viii nursing workforce programs. We have to do more to retain our existing nurses and train our future nurses.
▶ 1:04:22Sen. Merkley: Second bill, school access in a third bill work to save lives act. According to the cdc opioid fatalities quadrupled from 2018 through 2023. Add in 2023, a bit of a medical miracle, the fda introduced naloxone. They save lives.
▶ 1:04:51Sen. Merkley: To save lives you have to have them in the schools and in the workplaces. Rick scott and I introduced the school access to naloxone act that provides grants to schools -- to stock it and train on administering it. Senator murkowski and I introduced the work to save lives act which requires osha to issue guidance on how to stop the drug and train employees on its use.
▶ 1:05:19Sen. Merkley: Two straightforward ways to take advantage of an incredible medical development that saves lives in our schools edit our workplaces. The fair college for students act. This bill, which I have introduced with senator john kennedy recognizes that courts have struck programs to help people who are the least advantaged gain admission to schools, universities.
▶ 1:05:49Sen. Merkley: They are still in place programs to help the most advantaged students gain admission. It is called legacy programs. Well-qualified children of donors and alumni, they already have all kinds of advantages. In fact, they are four times more likely to get in with a legacy advantage.
▶ 1:06:15Sen. Merkley: The unfair advantage accessing higher education, we introduced the fair quality admissions act to level the playing field. So folks who are not legacy students are not discriminated against in the college admissions process. For good bills, all bipartisan, thank you. I would love to see all four of them marked up.
▶ 1:06:54Sen. Merkley: -- Sen. king: I havo -- Sen. king: I havi would like to discuss. One is called the falls prevention act, falls as you know are one of the leading causes of injury and even death particularly among seniors. They have a serious fall and often those lead to more serious complications.
▶ 1:07:23Sen. Merkley: This is something we could at least make some serious efforts to prevent. It would create a false prevention office within hhs. They develop a national false prevent -- fall prevention plan and put together the advisory committee. One of the problems we have is we pay for the treatment but not for prevention.
▶ 1:07:52Sen. Merkley: They will not pay for the hip repair after a fall. They won't pay $10 for a nonslip bathmat in the tub or a grab bar throughout the house. I believe this is a bill we are not talking about a lot of money. We are talking about saving money. Falls cost $55 billion per year.
▶ 1:08:15Sen. Merkley: I believe this is a place where we could find significant savings not only in money but in the pain and suffering of families and people throughout the country. The second bill is a medication bill. The department of education has a program called --
▶ 1:08:33Chair Cassidy: Who was that last bill with?
▶ 1:08:37Sen. King: Stand strong with falls prevention act is before your committee.
▶ 1:08:46Chair Cassidy: Do you have a republican cosponsor? If not that's ok. I just wanted to know.
▶ 1:08:55Sen. King: Senator rounds. It is sponsored by james lankford, he's my lead cosponsor. There is a program in the department of education providing grants to school districts for what we call constitutional education.
▶ 1:09:25Sen. King: What we are doing is basically saying if you accept one of these grants you have to do civics. We are not mandating it for every school in the country. If you accept one of the grants from the department of education in this area you have to teach about the U.S. constitution, the branches of government, what is the first amendment, how many senators and representatives?
▶ 1:09:53Sen. King: It's obvious to all of us that over the last 30 or 40 years for some reason the education has followed by the wayside in civics. It is not really taught in many high schools. This is an effort to bring that back to american education. We are not talking about a lot of money or any money.
▶ 1:10:17Sen. King: We are just talking about promoting civics education which is I think something lacking in our schools today.
▶ 1:10:25Chair Cassidy: Thank you. I'm mainlining. >> I think senator jeanne shaheen will be joining us.
▶ 1:11:06Chair Cassidy: >> Mr. chairman, thank you so much for giving members the opportunity today to discuss priority bills. Senator shaheen is on her way to join me in discussing the third bill. I thought in the interest of your time I would begin and talk about two of the three bills while we are waiting.
▶ 1:11:36Chair Cassidy: The first is the role of readiness act. I introduced this bill with senator hassan as well as senators britt and smith. It is a fully bipartisan bill. The readiness act will help prepare rural health care facilities that do not have a designated labor and delivery unit to respond to emergencies.
▶ 1:12:08Chair Cassidy: In maine, almost one third of hospitals have closed their units in recent years. That creates real problems. The training opportunities created in this bill are greatly needed. I would like to raise the geriatrics workforce improvement act, which I introduced with our committee colleague.
▶ 1:12:38Chair Cassidy: As the chairman is well aware, a significant shortfall of health care providers who specialize in geriatrics. This is particularly important in a state like mine which has the oldest population by median age in the entire country.
▶ 1:13:01Chair Cassidy: Our bill would reauthorize funding for the geriatrics workforce enhancement program and geriatric academic career awards which operate in 37 states including one program in the state of maine.
▶ 1:13:23Chair Cassidy: Reauthorizing these programs would help ensure that older americans will be cared for by a health care workforce specifically trained to meet their unique and complex health needs. The third bill that I wanted to comment on is the insulin act. I know senator shaheen is on the way.
▶ 1:13:55Chair Cassidy: We are the cochairs of the senate diabetes caucus. One of the priorities is to make it more affordable. Our insulin act would impose out-of-pocket limits for patients with commercial insurance, tackle commercial pharmacy benefit managers and ensure that patients are the ones who are benefiting from the savings that they negotiate and
▶ 1:14:28Chair Cassidy: Encourage competition in order to lower these prices. Our bill also includes provisions to help uninsured americans access affordable insulin. Just this week I met with a young woman who a few years ago ended up in the hospital because she was stretching out her insulin, not taking as much as she was prescribed, because she cannot afford the cost.
▶ 1:15:00Chair Cassidy: When the bill is introduced I would encourage my colleagues to support it. We will be introducing it very shortly. And I hope, Mr. chairman, that you move quickly to market up. Again, Mr. chairman, I salute you for or via -- for inviting members in today to share their priorities.
▶ 1:15:22Chair Cassidy: I have many other bills I am involved in, but I tried to narrow it to just three to stay close to your time limit, and, again, I know that my partner senator shaheen is here to talk about the insulin act. As I have said, we worked together on so many diabetes bills over the years.
▶ 1:15:49Chair Cassidy: And all of them are important, but in the interest of time I thought we would talk about this one today. So, with your permission I will turn it over to my partner, the co-chair of the diabetes caucus, senator shaheen.
▶ 1:16:06Sen. Shaheen: Given this opportunity. Thank you to the committee and thank you to senator collins.
▶ 1:16:26Sen. Shaheen: Hopefully I will not repeat what she has had to say about the insulin act, as she said she and I have cochaired the diabetes caucus since I got to the senate almost 18 years ago, and she was doing it before then, so we have had a chance to work on diabetes and so many pieces of legislation.
▶ 1:16:48Sen. Shaheen: This insulin act, which is the one I'm hoping we can have the committee take up, is one that we have worked on for the last two congresses. We were joined in this effort senators warnock and kennedy, and it really addresses the real bird in so many families face with diabetes and I have seen it personally, because my granddaughter has type one. It is a huge personal issue and it is also a policy issue.
▶ 1:17:16Sen. Shaheen: There are over 40 million people in the united states with diabetes. Over 300,000 of these are children. U.S. families annually facebook or $300 billion in direct medical costs due to the disease. It is the most expensive chronic condition in the united states, as I'm sure you are aware, Mr. chairman, as a physician. In one of the greatest ongoing costs is the daily insulin that people with diabetes need to keep themselves alive.
▶ 1:17:44Sen. Shaheen: Over the course of a lifetime the cost of insulin can add up to hundreds of thousands of dollars. Have already cap insulin for medicare enrollees at $35 a month. This new insulin act, which we plan to introduce next week, will address insulin affordability for children, adults, and those who are uninsured.
▶ 1:18:04Sen. Shaheen: It will do, as the medicare provision does, cap the cost of employer and private insurer coverage at $35 a month, create a pilot program to provide a $35 a month insulin for uninsured diabetes patients, and it is a direct way to help american families facing the economic pressures and will make people healthier in the long run.
▶ 1:18:27Sen. Shaheen: I urge the committee to take up this bill and, as I said, it also has the support from senators kennedy and warnock, so it is very bipartisan. Thank you, Mr. chair.
▶ 1:18:38Chair Cassidy: Senator wilson. >> thank you, chair cassidy. This is a terrific forum to talk about something that matters to everyone. Their health. If you don't have your health you don't know anything.
▶ 1:19:05Chair Cassidy: You know that as a physician, so I appreciate you providing us this opportunity. I have a few bipartisan bills I would like to speak about. My train more nurses act with senator collins directs hhs to do a full review of grant programs related to the nursing workforce and provide recommendations to congress on how to improve and increase nurse faculty. You cannot increase nurses if you don't have nurses to train them, particularly in our underserved areas.
▶ 1:19:35Chair Cassidy: It would also provide more pathways for experienced nurses to become faculty and increase the pipeline of lpn's to become our ends. Like many states, including nevada, we have should be or shortages of -- we have severe shortages of nurses, and this bill passed out of last congress, and I asked the committees support moving it forward again.
▶ 1:20:00Chair Cassidy: My bipartisan supporting our seniors act with senator boozman would create a long-term care commission to provide recommendations to congress each year on how to address the crisis of adequate care for our aging population. I was the caregiver for both my parents and my in-laws, and I know firsthand how gaps in the system -- it just hurts families and makes it so hard to care for our loved ones and ones we -- who raised us in so many cases.
▶ 1:20:30Chair Cassidy: So, I will close with two bills to address the doctor shortage that is facing rural and underserved communities in nevada and across the country. I bipartisan ready act would defer student loan interests for dental students and medical residents while they are still in training. We need to get them into our pipeline, and my bipartisan spark act with senator wicker would create a loan forgiveness program specialists who serve in rural areas with shortages.
▶ 1:20:59Chair Cassidy: I look forward to the committee to move all she bills forward again. Thank you for the opportunity to be heard in this forum is really terrific and I look forward to doing it again.
▶ 1:21:08Chair Cassidy: Thank you, senator rosen. Did I say senator young can -- young? >> you did, but he must have left.
▶ 1:21:34Sen. Young: I think this is a great idea and I'm grateful for my two minutes. My first priority I would like to cling to awareness steel is my national biotechnology initiative act. This bill came out of the work of the national security commission for emerging biotechnology, which you know I chair. To strengthen america's biotech edge and outcompete china. The commission's report offers 50 different recommendations.
▶ 1:22:05Sen. Young: Some to slow china down, others to encourage U.S. biotech innovation, complement and the good work of this committee. A key recommendation of the report is the nbia, which would establish an office within the executive branch to coordinate among the dozen or so federal agencies to streamline strategy and signal that biotech is a national priority to american innovators.
▶ 1:22:32Sen. Young: My second priority I would like to highlight is the merit act, my legislation to end legacy preferences in higher education, through the accreditation process. Too long a lead -- elite institutions have put pedigree and privilege ahead of merit. To be blunt, every american deserves a fair shot at an elite institution, whether born into wealth and connections or into a family working to get ahead.
▶ 1:23:01Sen. Young: This policy would restore fairness and renew public trust in the admissions process. While the merit act has not been reintroduced, I'm working to build substantial bipartisan support for balanced, durable path to reintroduction, including through outside engagement, in collaboration with edward bloom, a longtime advocate for admissions reform. Thank you again, Mr. chairman, for the opportunity to speak this morning, and I yield back 35 seconds.
▶ 1:23:30Chair Cassidy: Thank you. Senator fischer. Ron john? I'm sorry. Ron johnson was scheduled next.
▶ 1:23:54Sen. Jones: And I appreciate the opportunity --
▶ 1:24:02Sen. Jones: In. I have two bills I would hope you would agree with me on. I believe doctors and patients should be at the top of the treatment pyramid. Doctors obviously have the primary responsibility to their patients. I think what has been happening is they are being crushed at the bottom of the. . I have two pieces of legislation that would address that.
▶ 1:24:26Sen. Jones: First one would be -- I would hope you would export the right to try. I had to hold up the user fee bill to get the help committee to work with me, to get big pharma to work with me. We had to water it down quite a bit. Big pharma told us they would not support it, but they would not sabotage it, then they went to sabotage it in the house, and president trump forced the house to take up the senate bill, which is the one that passed.
▶ 1:24:58Sen. Jones: Most important part of the bill is its name, the right to try. But it is not working as well as it should. Congress has repeatedly given the fda, the agencies, the flexibility to allow, particularly patients with rare diseases -- and we are going through this right now. Whether it is muscular dystrophy, we have held hearings on these things, and they are getting turned down. Drugs have been available.
▶ 1:25:29Sen. Jones: The patients are using, they are not going to be having access to. I think it is time to improve the right to try bill with the right to try to point lp are we are working with the agencies to hone the language, but should not be necessary, but something has happened to the fda. We are going to do some investigation system on my subcommittee to find out what is at the heart of all of these disapproval's.
▶ 1:25:53Sen. Jones: There has got to be different regulatory processes for drugs being administered to millions or billions of people versus tens or hundreds or thousands. There has got to be a different approach. The second piece of legislation I would be proposing is the right to treat. You already have a -- have as a doctor for off label prescription rights, but those rights are not being allowed.
▶ 1:26:18Sen. Jones: Licensing boards are threatening pulling of licenses if doctors use drugs that are not approved by big pharma. Through the norm narrative. I think I'm over time, so those are two pieces of legislation near and dear to my heart. As a doctor I hope you would defend the rights of doctors to be -- as I said -- the top of the treatment pyramid.
▶ 1:26:40Chair Cassidy: Thank you. Senator fischer.
▶ 1:26:43Sen. Fischer: Sen. fischer: good morning. Chairman cassidy, I certainly appreciate the opportunity to come before you and this committee and bring an opportunity to speak about an important piece of legislation that I have introduced with senator gillibrand.
▶ 1:27:12Sen. Fischer: It is the childcare modernization act. This bill re-authorizes the childcare and development block grant program, which is -- which has supported working families since 1990. Providing childcare assistance to low income families with children under the age of 13.
▶ 1:27:34Sen. Fischer: Today it delivers 8.8 billion dollars in funding to states and tribes serving primarily young children, while also supporting before and after school care and summer programs. Despite strong bipartisan support over more than three decades this program has not been reauthorized since 2014.
▶ 1:27:59Sen. Fischer: Our bill not only reauthorizes this grant program, it modernizes it to reflect today's childcare realities. It strengthens affordability for families while addressing the operational and workforce challenges that providers face, specifically the bill ensures parental choice by supporting a full range of care options.
▶ 1:28:28Sen. Fischer: Centers, home-based providers, nonprofits, for-profits, and care from family or neighbors. It updates reimbursement rates using a cost estimation model, so providers are based on what they actually take to deliver care in today's economy and it creates a new sub-grant program to expand supply, support innovation, and invest in infrastructure.
▶ 1:28:57Sen. Fischer: I also want to address recent fraud concerns raised in several states, including minnesota. These incidents are serious, and I appreciate this committee's recent hearing focused on program integrity. That discussion made clear two things. First, childcare remains a bipartisan priority. And, second, we must strengthen oversight to prevent fraud and hold bad actors accountable.
▶ 1:29:29Sen. Fischer: Without undermining a program that is essential to both families and providers. Across our states we consistently hear about three core challenges. Limited supply, workforce shortages, and high costs for families.
▶ 1:29:47Sen. Fischer: The childcare modernization act directly addresses each of these, and while there is no single solution to our childcare challenges, this bill builds upon a proven bipartisan program and makes it stronger for families who rely on it. I want to close by emphasizing that senator gillibrand and our cold leads, senators collins and hickenlooper, and I, welcome collaboration.
▶ 1:30:16Sen. Fischer: We invite our colleagues to join us as cosponsors and encourage the committee to consider this bill in a bipartisan markup in the months ahead. Thank you, Mr. chairman.
▶ 1:30:27Chair Cassidy: Thank you, senator fischer. For the people in the audience, we will wait a few minutes because there are a few in the judiciary committee tied up who we think are going to come.
▶ 1:36:44Chair Cassidy: I wish to enter statements from the following senators into the record. Senator durbin, senator reed, senator peters, senator van hollen, senator daines, senator booker, senator coons, and senator king. For any senator wishing to enter additional statements, statements for the record will be due at 5:00 p.m. Thursday, april the second.
▶ 1:37:12Chair Cassidy: Thank you again for the members who came today. Thank you for my staff or the suggestion and their excellent work to make this successful. The committee stands adjourned.