Chairman Alexander: This Congress, HELP Committee Produced 18 Laws Including “Landmark” Opioid Legislation to Combat Nation’s Most Pressing Public Health Crisis

Posted on December 20, 2018

WASHINGTON, December 20, 2018 — U.S. Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-Tenn.) today said, “over the last two years, this committee has produced solutions that will have an impact on the lives of virtually every American.”

Chairman Alexander continued: “Most recently, in October, President Trump signed into law what Senate Majority Leader McConnell called ‘landmark’ legislation to fight the opioid crisis. President Trump said that this new law is ‘the single largest bill to combat a drug crisis in the history of our country.’ That legislation included more than 40 proposals from this committee and contributions from 70 senators, many on this committee.

“In July, President Trump signed the Perkins CTE Act, which we passed through this committee to strengthen the career and technical education programs that train the skilled workers employers tell us they need. And last August, the president signed into law the FDA user fee agreements that will help bring new drugs and devices to patients more quickly.

“We have also passed bills such as the PREEMIE Act, to prevent preterm births and reduce infant deaths, and the Childhood Cancer STAR Act, to encourage pediatric cancer research.  Those are just a few of the important pieces of legislation this committee has worked on and passed.”

Alexander concluded: “While we have accomplished quite a bit working together this Congress, looking towards next year, there are some things I hope to work on. This includes finding real ways to lower the cost of health care for Americans and updating the Higher Education Act to ensure the education students receive is worth their time and money.”

The HELP Committee approved 18 bills that are now public law:

1. Opioid Crisis Response Act of 2018 – Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash) (H.R.6): This bipartisan package of “landmark” legislation to fight the opioid crisis included more than 40 HELP Committee proposals. It deals with the nation’s worst public health challenge by helping to stop deadly fentanyl from coming from China to the United States by mail, finding new non-addictive pain killers, allowing opioids to be dispensed in blister packs, for example a 3- or 7- day supply, and providing more opportunities for treatment.

 

As chairman of the Senate health committee, Senator Alexander was the lead Senate sponsor.

 

When he signed the bill into law, President Trump called it, “the single largest bill to combat a drug crisis in the history of our country.”

 

10 key provisions in the legislation:

  • STOP Act—to stop illegal drugs, including fentanyl, at the border
  • New non-addictive painkillers, research and fast-track
  • Blister packs for opioids, such as a 3- or 7- day supply
  • Extends support for Medicaid patients seeking treatment from 15 to 30 days, covering all substance use disorders
  • TREAT Act—permanently allows more medical professionals to treat people in recovery to prevent relapses and overdoses
  • Prevent “doctor-shopping” by improving state prescription drug monitoring programs
  • More behavioral and mental health providers
  • Support for comprehensive opioid recovery centers
  • Help for babies born in opioid withdrawal and for mothers with opioid use disorders
  • More early intervention with vulnerable children who have experienced trauma

2. Strengthening Career and Technical Education for the 21st Century Act – Sens. Mike Enzi (R-Wyo.) and Bob Casey (D-Penn.) (H.R2353): More than 200,000 students in Tennessee participate in career and technical education programs. This new law updates a nearly $1.2 billion federal program of grants to states that help fund the programs that train the workers we need, for example, a high school student looking to become a computer coder, or an adult going back to school to learn about commercial construction.

3. FDA Reauthorization Act of 2017 – Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) (H.R.2430): This reauthorization of the four Food and Drug Administration (FDA) user fee agreements ensures the FDA has the funding it needs to quickly and safely bring new drugs and treatments to patients and make sure the promising research supported by the 21st Century Cures Act actually reaches patients.

4. Patient Right to Know Drug Prices Act – Sens. Susan Collins (R-Maine) and Claire McCaskill (D-Mo.) (S.2554): This law bans the “gag” clauses that prevented a pharmacist from telling a patient their prescription would be cheaper if they paid with cash instead of using their insurance. 

5. Childhood Cancer STAR Act – Sens. Jack Reed (D-R.I.) and Shelly Capito (R-W.Va.) (S.292): If you’re the parent of a child with cancer, this law encourages pediatric cancer research by building on last year’s RACE for the Children Act and reauthorization of the Food and Drug Administration (FDA) user fee agreements.

6. National Clinical Care Commission Act – Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) (S.920): This law creates a commission of leading experts to study complex metabolic or autoimmune diseases, like diabetes. The commission will recommend improvements to federal programs that work to help prevent diseases like diabetes or educate patients on their condition. 

7. The Early Hearing Detection and Intervention Act – Sens. Rob Portman (R-Ohio) and Tim Kaine (D-Va.) (S.652): If you’re a parent with a newborn, infant, or young child, this law supports state-based efforts to screen them for hearing loss and ensure proper follow-up care, including diagnosis and early intervention.

8. Protecting Patient Access to Emergency Medications Act of 2017 – Rep. Richard Hudson (R-N.C.) and Sens. Bill Cassidy (R-La.) and Michael Bennet (D- Colo.) (H.R.304): If someone is the victim of a life-threatening emergency, like a burn victim or a child experiencing a seizure, this law ensures that he or she will continue to have access to time-sensitive and life-saving treatments under the supervision of a physician.

9. The RAISE Family Caregivers Act – Sens. Susan Collins (R-Maine), Tammy Baldwin (D-Wisc.), Lisa Murkowski (R-Alaska), and Michael Bennet (D-Colo.) (S.1028): This law helps develop a strategy to coordinate federal programs to better support the millions of Americans who are caregivers for a family member.

10. Supporting Grandparents Raising Grandchildren Act – Sens. Susan Collins (R-Maine) and Bob Casey (D-Penn.) (S.1091): If you are a grandparent raising your grandchild, this law helps you navigate that process by creating a task force, made up of federal agencies and grandparents, to coordinate federal resources and information available to you. 

11. Firefighter Cancer Registry Act – Sens. Robert Menendez (D-N.J.) and Lisa Murkowski (R-Alaska) (H.R.931): Firefighters are exposed to a range of harmful toxins, and research has shown a strong connection between firefighting and an increased risk for several major cancers. This legislation creates a national registry for firefighters diagnosed with cancer.

12. Animal Drug and Animal Generic Drug User Fee Amendments of 2018 – Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) (H.R.5554): This reauthorization of the FDA animal drug and animal generic drug user fee agreements helps bring new animal drugs to farmers and ranchers, families, and veterinarians to keep their animals healthy and our food supply safe.

13. Children’s Hospital GME Support Reauthorization Act of 2018 – Sens. Bob Casey (D-Pa.) and Johnny Isakson (R-Ga.) (H.R.5385): This bill reauthorizes the children’s hospital graduate medical education (CHGME) program that provides funding to more than 50 freestanding children’s hospitals around the country, supporting the training of pediatricians and improving children’s access to care.

14. Sports Medicine Licensure Clarity Act of 2017 – Sens. John Thune (R-S.D.) and Amy Klobuchar (D-Minn.) (H.R.302): This law ensures when a sports medicine professional travels with a team outside the state in which they are licensed, they will continue to be covered by their medical malpractice insurance provider.

15. Action for Dental Health Act (H.R.2422) – Sens. Cory Booker (D-N.J.), Bill Cassidy (R-La.), Mazie Hirono (D-Hawaii), and Tim Scott (R-S.C.) (3016): This legislation supports states, dental associations, and community-based oral health programs to help prevent dental disease, and expands efforts to provide care to underserved patients.

16. Prematurity Research Expansion and Education for Mothers who deliver Infants Early Reauthorization Act of 2018 – Sens. Lamar Alexander (R-Tenn.) and Michael Bennet (D-Colo.) (S.3029): In Tennessee, about 11 percent of babies are born preterm. This bill reauthorizes legislation first introduced by Alexander in 2003 to help researchers, doctors, and parents prevent premature births and give more babies the chance for long and healthy lives.

17. Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2018 – Sens. Tim Scott (R-S.C.) and Cory Booker (D-N.J.) (S.2465): At least 100,000 Americans have sickle cell disease, but the exact number is unknown because we do not have sufficient data. This bill will allow the Department of Health and Human Services to study sickle cell disease and other heritable blood disorders so we know how many people are affected by these conditions and implement strategies to help treat these diseases.

18. Improving Access to Maternity Care Act – Sens. Lisa Murkowski (R-Alaska) and Tammy Baldwin (D-Wisc.) (H.R.315): This bill will help bring more doctors and nurses to provide care for pregnant women living in rural areas and other areas where there is a shortage of these health care providers.

The Full Congress has passed five additional bills that are awaiting President Trump’s signature:

1. Maternal Health Accountability Act of 2017 – Sens. Heidi Heitkamp (D-N.D.) and Shelley Moore Capito (R-W.Va.) (S.1112): This legislation aims to support states in reviewing pregnancy-related deaths to identify ways to improve maternal care and reduce maternal mortality in the United States.

2. BOLD Infrastructure for Alzheimer’s Act – Sens. Susan Collins (R-Maine), Tim Kaine (D-Va.), Shelley Capito (R-W.Va.), and Catherine Cortez Masto (D-Nev.) (S.2076): This legislation will create Centers of Excellence to advance public health knowledge and ensure public health professionals, doctors and nurses, and patients and their families have the support and updated information on Alzheimer’s and related dementia diseases they need. 

3. Congenital Heart Futures Act – Senator Dick Durbin (D-Ill.) (H.R. 1222): If you’re the parent of a child who suffers from a congenital heart disease, this reauthorization is important because it will continue to support the research and data collection that is needed to better understand congenital heart disease.

4. Traumatic Brain Injury Program Reauthorization Act of 2018 – Sens. Orrin Hatch (R-Utah) and Bob Casey (D-Penn.) (S.3657): This bill reauthorizes state grants and programs related to surveillance, prevention, care, and research of traumatic brain injuries, and encourages data collection and analysis so we can better understand trends and causes of concussions.

5. State Offices of Rural Health Reauthorization Act of 2018 – Sens. Pat Roberts (R-Kan.) and Heidi Heitkamp (D-N.D.) (S.2278): This law reauthorizes grant programs that strengthen rural health care systems and develop long-term solutions to rural health challenges. 

The Senate has passed an additional five bills awaiting House action:

1. Museum and Library Services Act of 2018 – Sens. Susan Collins (R-Maine), Lisa Murkowski (R-Alaska), Jack Reed (D-R.I.) and Kristen Gillibrand (D-N.Y.) (S.3530): This bill reauthorizes programs for museums and libraries, including the only federal program exclusively for libraries—the Library Services and Technology Act.

2. Emergency Medical Services for Children Program Reauthorization Act of 2018 – Sens. Orrin Hatch (R-Utah), Bob Casey (D-Penn.) and Brian Schatz (D-Hawaii) (S.3482): This bill will ensure that, from the ambulance to the emergency department, emergency health care providers are prepared to treat children, who typically require smaller equipment and different doses of medicine.

3. Strengthening Mosquito Abatement for Safety and Health (SMASH) Act – Sens. Angus King (I-Maine), Richard Burr (R-N.C.), and Marco Rubio (R-Fla.) (S.849): This bill will improve public health preparedness capabilities to help combat the Zika virus and other mosquito-borne diseases that threaten public health by strengthening key programs that support state and local mosquito surveillance and control efforts.

4. Congenital Heart Futures Act – Senator Dick Durbin (D-Ill.) (H.R. 1222): If you’re the parent of a child who suffers from a congenital heart disease, this reauthorization is important because it will continue to support the research and data collection that is needed to better understand congenital heart disease.

5. Traumatic Brain Injury Program Reauthorization Act of 2018 – Sens. Orrin Hatch (R-Utah) and Bob Casey (D-Penn.) (S.3657): This bill reauthorizes state grants and programs related to surveillance, prevention, care, and research of traumatic brain injuries, and encourages data collection and analysis so we can better understand trends and causes of concussions. 

The committee reported an additional two bills to the Senate floor:

1. Over-the-Counter Drug Safety, Innovation, and Reform Act – Sens. Johnny Isakson (R-Ga.) and Bob Casey (D-Pa.) – (S.2315): This legislation would modernize the way over-the-counter medications are regulated and brought to market, to encourage the development of new drugs for patients.

2. Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 – Sens. Richard Burr (R-N.C.) and Bob Casey (D-Penn.) (S.2852): It is crucial we are prepared to face a range of public health threats – including outbreaks of infectious diseases like Ebola, Zika, or the flu; natural disasters, such as hurricanes and the wildfires that swept across East Tennessee in 2016; or deliberate attacks with dangerous agents, like anthrax or nuclear weapons. This legislation strengthens our preparedness and response capabilities so we can better protect Tennesseans and all Americans from 21st century threats.

The HELP Committee approved 50 nominees to carry out President Trump’s agenda:

In the 115th Congress, the HELP Committee approved 50 nominees to carry out President Trump’s agenda.

35 HELP nominees were confirmed by the Senate:

Department of Health and Human Services:

Scott Gottlieb, M.D. – FDA Commissioner

Jerome M. Adams, M.D., M.P.H. – Surgeon General, Public Health Service

Robert Kadlec, M.D. – Assistant Secretary for Preparedness and Response

Elinore F. McCance-Katz, M.D., Ph.D. – Assistant Secretary for Mental Health and Substance Use

Lance Allen Robertson – Assistant Secretary for Aging

Brett P. Giroir, M.D. – Assistant Secretary of Health

 

Department of Education:

Betsy DeVos – Secretary

Peter Louis Oppenheim – Assistant Secretary for Legislation and Congressional Affairs

Johnny Collett – Assistant Secretary for Special Education and Rehabilitative Services

Douglas W. Webster – Chief Financial Officer

Carlos G. Muñiz – General Counsel

James Blew – Assistant Secretary for Planning, Evaluation, and Policy

Brigadier General Mitchell Zais, USA (Ret.) – Deputy Secretary

Kenneth Marcus – Assistant Secretary for Civil Rights

Scott Stump – Assistant Secretary for Career, Technical, and Adult Education

Frank T. Brogan – Assistant Secretary for Elementary and Secondary Education

Mark Schneider, Ph.D. – Director of the Institute of Education Services

 

Department of Labor:

R. Alexander Acosta – Secretary

David Zatezalo – Assistant Secretary for Mine Safety and Health

Kate O’Scannlain – Solicitor

Preston Rutledge – Assistant Secretary for the Employee Benefits Security Administration

Katherine Brunett McGuire – Assistant Secretary for Congressional and Intergovernmental Affairs

Patrick Pizzella – Deputy Secretary

James Edwin Williams – Chief Financial Officer

 

National Labor Relations Board:

Marvin Kaplan – Member

William Emanuel – Member

Peter Robb – General Counsel

John F. Ring – Member

 

National Mediation Board

Kyle Fortson – Member

Gerald W. Fauth III – Member

Linda Puchala – Member

 

Occupational Safety and Health Review Commission:

Heather L. MacDougall – Member

James J. Sullivan – Member

 

Corporation for National and Community Service

Barbara Stewart – Chief Executive Officer

 

National Endowment for the Humanities

Jon Parrish Peede – Chairman

 

The committee approved 15 additional nominations:

 

Department of Education Nominees:

Mark Schultz – Commissioner of the Rehabilitation Services Administration

Robert L. King – Assistant Secretary for Postsecondary Education

 

Department of Labor Nominees:

Dr. William Beach – Commissioner of Labor Statistics

Scott Mugno – Assistant Secretary for the Occupational Safety and Health

Cheryl Stanton – Administrator of the Wage and Hour Division

John Lowry III – Assistant Secretary for Veterans’ Employment and Training

John P. Pallasch – Assistant Secretary for Employment and Training

 

Pension Benefit Guaranty Corporation

Gordon Hartogensis – Director

 

Equal Employment Opportunity Commission Nominees

Janet Dhillon – Member

Daniel M. Gade, Ph.D. – Member

 

Federal Mine Safety and Health Review Commission

Marco M. Rajkovich, Jr. – Member

 

Corporation for National and Community Service

Victoria Ann Hughes – Member

Heather Reynolds – Member

 

National Council on the Arts

Barbara Coleen Long – Member

 

Railroad Retirement Board

Erhard Chorlé – Chair

 

The HELP Committee held 58 hearings to address issues that matter to American families

The committee held seven hearings to hear from doctors, governors, families, addiction experts, and others about steps the federal government could take to help states and communities end the opioid crisis. The committee took their input and turned it into more than 40 proposals included in the opioid package that became law in October 2018:

The Federal Response to the Opioid CrisisThe committee began a series of hearings on the opioid crisis, starting by hearing what the federal government is doing from administration witnesses. Alexander said the crisis is “tearing our communities apart, tearing families apart, and posing an enormous challenge to health care providers and law enforcement officials.”

The Front Lines of the Opioid Crisis: Perspectives from States, Communities, and Providers: The committee held a second hearing on the opioid crisis to hear from those on the front lines how the tools and resources Congress provided when it passed the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act in 2016 are helping states fight the crisis. Alexander said that, “We must ensure the federal government is the best possible partner for states on the front lines of the opioid crisis ravaging our country.”

The Opioid Crisis: An Examination of How We Got Here and How We Move Forward: Author Sam Quinones, who has extensively researched and written about the opioid crisis, testified at the committee’s third hearing. Alexander told Mr. Quinones, “You and I apparently have at least one thing in common: I am a skeptic of Washington’s capacity to solve problems that are essentially problems of communities, families and lifestyles. In your words, ‘I believe more strongly than ever that the antidote to heroin is community.’

The Opioid Crisis: Impact on Children and Families: The committee’s fourth hearing on the opioid crisis focused on the impact on children and families. Alexander pointed out this impact is especially felt in Tennessee, which “is on the front lines as the opioid crisis has caused what the Tennessee Department of Health has described as a ‘sharp increase’ in the number of babies born in opioid withdrawal.”

The Opioid Crisis: The Role of Technology and Data in Preventing and Treating Addiction: At the committee’s fifth hearing, Alexander said that the federal government’s most helpful role in the opioid fight may be supporting the “amazing potential” of data and technology. “As we’ve examined the opioid crisis over the last five months, we’ve learned that strong local communities are key to finding solutions and Washington’s role is to support those efforts. When we look at what the federal government can do, sharing more data and utilizing new technologies may be the most helpful thing that we do.”

The Opioid Crisis: Leadership and Innovation in the States: Governors from Maryland and Oregon testified at the committee’s sixth hearing on the opioid crisis. Alexander said, “States are the ones who come up with the good ideas on how to tackle big problems because they’re on the front lines, and it’s usually the federal government’s role to encourage them and cut the red tape to create an environment so that states can innovate.”

The Opioid Crisis Response Act of 2018: At the seventh hearing, expert witnesses provided feedback on draft opioids legislation. Alexander called the legislation, which would later become the opioid legislation signed into law in October 2018, “the next step in helping end the national opioid crisis.”

Launching a series of hearings to explore what the federal government, states, and private companies can do to reduce health care costs for American families:

How to Reduce Health Care Costs: Understanding the Cost of Health Care in America: In June 2018, the committee launched a series of hearings exploring how to reduce health care costs. Alexander said, “The most obvious fact about health care costs, other than that they’re too high, is that they are indecipherable...”

Reducing Health Care Costs: Eliminating Excess Health Care Spending and Improving Quality and Value for Patients: At the committee’s second hearing on reducing health care costs, a witness testified that 30 percent, and probably more than 50 percent, of what the United States spends on health care is spent on unnecessary tests, procedures, and administrative work.

Reducing Health Care Costs: Decreasing Administrative Spending: The committee’s third hearing examined the administrative burden the federal government imposes. Alexander said the federal government is at fault for some of the administrative burden that the nation’s doctors and hospitals face—which means “more time spent on paperwork, less time actually treating patients, and an increase to the cost of health care.”

Reducing Health Care Costs: Examining How Transparency Can Lower Spending and Empower Patients: The fourth hearing on reducing health care costs looked at why Americans can easily check reviews and prices before purchasing everything from a new coffeemaker to a car, while information on the price and quality of health care has remained in a black box.

Reducing Health Care Costs: Improving Affordability Through Innovation: At the fifth hearing on reducing health care costs, the committee examined how private sector companies are disrupting the health care system to lower costs. At the hearing, Alexander said, “Going forward, I plan to take what we’ve learned today and from our previous four hearings, and ask leading health care policy experts for specific ideas on how the federal government can reduce the cost of health care.”

Examining the price Americans pay when picking up their prescription drugs:

The Cost of Prescription Drugs: How the Drug Delivery System Affects What Patients PayThe committee held the first in a series of bipartisan hearings looking at the price Americans pay when they pick up their prescriptions and where that money goes. Alexander said, “This is a discussion that affects the well-being of every American family. It is important that we work together to conduct this fact finding in a bipartisan way.” 

The Cost of Prescription Drugs: How the Drug Delivery System Affects What Patients Pay, Part II: The committee held the second in a series of bipartisan hearings on what goes into the prices Americans pay when picking up the 4.4 billion prescriptions written every year. At the hearing, Alexander said the focus is to learn the facts on the drug delivery system and its effects on health care costs.

The Cost of Prescription Drugs: An Examination of The National Academies of Sciences, Engineering, and Medicine Report “Making Medicines Affordable: A National Imperative”At the third bipartisan hearing on drug pricing, Alexander told the story of Joseph, a West Tennessean whose family struggled to afford a $150 prescription. The committee met to examine a National Academies report on the prices Americans pay for their prescription drugs.

Perspectives on the 340B Drug Pricing Program: In March 2018, the committee launched a series of hearings on the 340B Discount Drug Program, which was created by Congress in 1992 to help qualifying hospitals and clinics that treat low-income patients, by requiring drug manufacturers that participate in Medicaid to provide discounts on prescription drugs or treatments to these hospitals and clinics. The hospitals and clinics may then provide the drugs at the reduced price to low-income patients or they can sell the drugs at a higher price to patients who have insurance and then keep that money and use it to provide care to low-income patients or for other purposes.

Examining Oversight Reports on the 340B Drug Pricing Program: At the committee’s second hearing on the 340B Discount Drug Program, Alexander said that federal watchdog reports find the program needs better oversight, and the agency in charge may need more authority to conduct that oversight and collect reliable data. “It very well may be that hospitals and clinics are using the savings to benefit low-income patients as intended. But it is hard to know that until we have more information.”

The Cost of Prescription Drugs: Examining the President’s Blueprint ‘American Patients First’ to Lower Drug Prices: In June 2018, the committee continued its series of hearings on the price of prescription drugs, hearing from U.S. Department of Health and Human Services Secretary Alex Azar on the Administration’s blueprint to lower drug prices. At the hearing, Alexander said that the Trump Administration’s comprehensive drug pricing blueprint will bring “help to the one in eight Americans who say it is difficult to afford their prescriptions.”

Effective Administration of the 340B Drug Pricing Program: At the committee’s third hearing on the 340B Discount Drug Program, Alexander said that Congress needs more accurate information to determine how to make the 340B Program work better for patients and hospitals. “There is no consistent data that shows how hospitals and clinics are spending the money they save through the 340B Program. The reason we don’t have much data is because the agency that oversees the program – the Health Resources and Services Administration (HRSA) – may not have the authority to actually collect data and conduct oversight over the program.”

Ensuring promising biomedical research leads to results for patients:

Implementation of the 21st Century Cures Act: Achieving the Promise of Health Information TechnologyAt the first oversight hearing on the 21st Century Cures Act – a law the committee wrote in 2016 to bring new drugs and devices more quickly to patients – Alexander said, “Electronic health records are a critical piece to the future of medical innovation and the success of the 21st Century Cures Act, and I intend to ensure these provisions are implemented properly.”

Implementation of the 21st Century Cures Act: Progress and the Path Forward for Medical InnovationAt a second oversight hearing held on the first anniversary of the 21st Century Cures Act’s Senate passage with Food and Drug Administration Commissioner Scott Gottlieb and Director of the National Institutes of Health Francis Collins, Alexander said, “It is not an overstatement to say that the 21st Century Cures Act has the potential to affect virtually every American family by taking advantage of breathtaking advances in biomedical research.”

Implementation of the 21st Century Cures Act: Responding to Mental Health NeedsThe committee’s third oversight hearing on the 21st Century Cures Act examined the mental health provisions, which updated federal mental health programs for the first time in a decade. Alexander said that early intervention for patients with mental health disorders is critical: “Prior to our work on Cures, the coordination between federal agencies that provide mental health care was not as effective as it could have been. …I look forward to hearing about the progress being made to ensure more people can receive the help they need.”

FDA User Fee Agreements: Improving Medical Product Regulation and Innovation for Patients, Part IThe committee held its first hearing on updating the Food and Drug Administration’s (FDA) user fee agreements that pay a quarter of all FDA’s work to ensure promising new drugs and devices reach patients. Alexander said Congress owes patients and their families a prompt, bipartisan reauthorization of the FDA medical devices and drug user fee agreements.

FDA User Fee Agreements: Improving Medical Product Regulation and Innovation for Patients, Part II: At the second of two hearings on updating the FDA’s user fee agreements, Alexander said a timely reauthorization is “integral to helping patients and delivering on the promise of 21st Century Cures.”

Gene Editing Technology: Innovation and ImpactThe committee held a hearing on gene-editing technology, including CRISPR-cas9, which Alexander said “has the potential to transform human health, when used properly…. CRISPR’s use in humans is more recent, but the possibility of the diseases it could treat and the lives that could be improved is remarkable.”

Improving Animal Health: Reauthorization of FDA Animal Drug User Fees: The committee held a hearing on the reauthorization of the Animal Drug and the Generic Animal Drug User Fee Agreements that Alexander said are “critical to help keep our farm animals and pets healthy, prevent outbreaks of disease, and keep our food supply safe.”

Prioritizing Cures: Science and Stewardship at the National Institutes of Health: At an oversight hearing of the National Institutes of Health, Alexander said, “We often say it is hard to think of a major scientific advancement since World War II that has not been supported by federal funding – but we are not the only country to have figured that out…other countries have seen that investing in basic research can lead to breathtaking new discoveries.”

Exploring how to help Americans lead healthier lives:

Examining How Healthy Choices Can Improve Health Outcomes and Reduce CostsThe committee held the first in a series of hearings looking at the “remarkable consensus that a healthy lifestyle leads to longer and better lives, and reduces the nation’s health care costs.” At the hearing, Alexander said, “If we really want to focus on improving Americans’ health, why not connect the consensus on wellness to the insurance policies that 178 million Americans get from their job.”

Encouraging Healthy Communities: Perspective from the Surgeon GeneralTrump Administration HHS Surgeon General Jerome Adams testified at the committee’s second hearing looking at how to encourage healthier behaviors as a way to lower health care costs. Alexander said that Dr. Adams’ focus on wellness could have a real impact on the lives of millions of Americans, saying “it makes sense for that to be his focus, because there is a remarkable consensus that wellness – lifestyle changes like eating healthier and quitting smoking – can prevent serious illness and reduce health care costs.”

Facing 21st Century Public Health Threats: Our Nation’s Preparedness and Response Capabilities, Part I: The committee held a hearing to discuss the reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA), legislation which helps ensure the United States is prepared for public health threats including natural disasters, bioterror attacks, and outbreaks of infectious diseases.

Facing 21st Century Public Health Threats: Our Nation’s Preparedness and Response Capabilities, Part 2: At the committee’s second hearing on reauthorizing PAHPA, Alexander said, “Tennessee has seen already heartbreaking stories this winter as the flu has spread across the state and this country. …PAHPA provides a medical and public health preparedness framework that ensures we are ready and able to respond to public health threats, encourages research and development of medicines to protect Americans, and enables our hospitals and state and local health departments to be prepared to respond to public health emergencies.”

The Health Care Workforce: Addressing Shortages and Improving Care: At a committee hearing examining the projected shortage of health care workers, Alexander said, “We also know the shortage affects certain populations more than others. Rural areas where 60 million Americans live suffer the greatest impact of the shortage of health care professionals.”

Hearing from governors, state insurance commissioners, and health policy experts on how to stabilize the individual health insurance market:

Obamacare Emergency: Stabilizing the Individual Health Insurance MarketAlexander chaired the committee’s first hearing of the year on the individual health insurance market where 18 million Americans and 350,000 Tennesseans purchase their insurance and invited Tennessee’s state insurance commissioner, Julie Mix McPeak, to testify.  Alexander said, “Without quick action, many of these 18 million Americans may have zero choices for insurance next year.”

Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: State Insurance CommissionersAlexander launched a series of hearings this fall on stabilizing the individual health insurance market and helping 18 million Americans be able to access and afford health insurance in 2018. At this first hearing, the committee heard from state insurance commissioners, including Julie Mix McPeak.

Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Governors: At the second hearing on stabilizing the individual health insurance market, the committee heard from governors, including Tennessee Governor Bill Haslam, on steps Congress could take to make it easier for states to reclaim control of their insurance markets and limit premium increases in 2018.

Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: State FlexibilityAt the third hearing on stabilizing the individual health insurance market, the committee heard from state flexibility experts on ways to allow states to offer more flexible insurance plans. Alexander said waivers from Obamacare regulations could offer states as many options as a Dr. Seuss book titled “Oh, The Place You’ll Go.”

Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Health Care StakeholdersAt the fourth hearing on stabilizing the individual health insurance market, Alexander said, “It’s clear to truly protect patients, we need to stabilize the markets, limit premium increases, and begin to lower premiums in the future."

Exploring how to make college degrees more affordable and worth students’ time and money:

Exploring Free Speech on College Campuses: At a hearing on free speech on college campuses, Alexander said, “Universities should be the place where people of different views may speak, audiences can listen, and many contrasting viewpoints are encouraged… There should be some sensible way to allow speakers to speak and audiences to listen while still protecting freedoms offered by the First Amendment.”

Reauthorizing the Higher Education Act: Examining Proposals to Simplify the Free Application for Federal Student Aid (FAFSA): At the first hearing on the reauthorization of the Higher Education Act Alexander said, “After four years of discussions over how to simplify the Free Application for Federal Student Aid, or the FAFSA, it is time to come to a result to make it easier for students to apply for federal financial aid.” Alexander has said the committee plans to continue its work on updating the Higher Education Act in the New Year to make it simpler and easier for students to attend college.

Reauthorizing the Higher Education Act: Financial Aid Simplification and Transparency: The committee’s second hearing on reauthorizing the Higher Education Act examined how to simplify the federal student aid system of two grant programs, five loan programs, and nine repayment plans. Alexander said, “There is a bipartisan consensus that students looking for federal financial aid to go to college need a much simpler system so that it is not a barrier to college for the very students the aid is intended to help.”

Reauthorizing the Higher Education Act: Access and Innovation: At the committee’s third hearing on reauthorizing the Higher Education Act, Alexander asked, “How can Congress create an environment for colleges to innovate to meet the needs of today’s – and tomorrow’s – students? As the typical university student has changed into a more wide-ranging group, there is a bipartisan consensus that colleges need to be able to offer solutions to meet those students’ diverse needs –flexible class schedules or online learning to accommodate for family and work commitments.”

Reauthorizing the Higher Education Act: Accountability and Risk to Taxpayers: At the committee’s fourth hearing on reauthorizing the Higher Education Act, Alexander said, “I believe Congress should consider new accountability measures that are more effective at holding all individual programs at all colleges and universities accountable for the ability of their students to pay back their loans.”

Reauthorizing the Higher Education Act: Improving College Affordability: The committee’s fifth hearing on reauthorizing the Higher Education Act looked at making college more affordable. Alexander said, “The Appropriations Committee will consider whether Congress should appropriate more taxpayer dollars for student aid, but in the meantime, Congress can also help students afford college by better spending the $28 billion in grants and $92 billion in loans we spend annually. This would mean simplifying student aid, redirecting existing dollars for more Pell grants, helping students complete their degrees more rapidly, and making colleges more accountable for students repaying loans.”

Overseeing the implementation of the Every Student Succeeds Act and ensuring local control of schools:

The Every Student Succeeds Act: States Leading the Way: The committee held an oversight hearing in September, 2018 on the Every Student Succeeds Act (ESSA), a law the committee passed in 2015 to fix No Child Left Behind, to hear from state education chiefs from Nebraska, Delaware and South Carolina about how they are implementing the law. Alexander said that, “States are back in the driver’s seat for decisions on how to help their students.”

The Every Student Succeeds Act: Unleashing State InnovationAt an oversight hearing on ESSA in 2017, Alexander said, “Tennessee, Louisiana, and New Mexico have taken the most advantage of the flexibility we offered under the law in creating innovative state plans…I look forward to seeing ways other states are taking advantage of the freedom to innovate under ESSA.”  

Exploring issues important to American workers:

The Impact of Zero Tariffs on U.S. Autoworkers: At a committee hearing looking at the impact of tariffs, Alexander said the president’s zero tariff goal would help autoworkers in Tennessee, where automotive jobs have nearly doubled since 1994 when the North American Free Trade Agreement (NAFTA) went into effect. Alexander said, “One of the reasons Tennessee has been able to have so much success building cars and SUV’s is because the North American Free Trade Agreement is fundamentally a zero tariff trade agreement.”

Modernizing Apprenticeships to Expand Opportunities: As the economy booms, employers are in need of skilled workers more than ever. The committee held a hearing to examine how federally-administered apprenticeship programs could be modernized to meet the needs of growing industries like health or finance. Alexander said, “The hope is that with a modernized approach to apprenticeships, industries that weren’t around when Paul Revere was training to be a silversmith or even when Elvis was learning to be an electrician would be able to start apprenticeship programs.”

Confirmation hearings on President Trump’s nominees:

Nomination of Sharon Fast Gustafson to be General Counsel of the Equal Employment Opportunity Commission: The committee met to consider the nomination of Sharon Fast Gustafson to serve as General Counsel of the Equal Employment Opportunity Commission, a position Alexander said “is important to our nation’s workers.”

Nomination of John F. Ring to be a Member of the National Labor Relations Board: The committee met to consider the nomination of John Ring to serve as a member of the National Labor Relations Board. Alexander said, “I hope confirming Mr. Ring will continue the trend of returning balance to our labor laws.”

Nomination of Frank T. Brogan to be Assistant Secretary for Elementary and Secondary Education: The committee met to consider the nomination of Frank Brogan to serve as Assistant Secretary of Elementary and Secondary Education. Alexander said, “In this role, Mr. Brogan’s job will be to implement laws as Congress wrote them, including the law we wrote fixing No Child Left Behind… we produced a law that reflected our consensus at the start: Continue the law’s important measurements of academic progress of students but restore to states, school districts, classroom teachers and parents the responsibility for deciding what to do about improving student achievement. This change should produce fewer tests and more appropriate ways to measure student achievement.”

Department of Education and Department of Labor NominationsThe committee met to consider two Department of Education nominees, Ken Marcus to serve as Assistant Secretary for Civil Rights and Johnny Collett to serve as Assistant Secretary for Special Education and Rehabilitative Services, and two Department of Labor nominees, Scott Mugno to serve as Assistant Secretary for Occupational Safety and Health and Dr. William Beach to serve as Commissioner of Labor Statistics.

Nomination of Alex Azar to serve as Secretary of Health and Human ServicesThe committee held a hearing for Alex Azar to serve as Secretary of Health and Human Services. Alexander said that Azar’s “broad experience is a principal asset to leading the Department… you are ready to take advantage of the law Leader McConnell called, the ‘most important piece of legislation,’ the 21st Century Cures Act, which gave new, broad powers to FDA and NIH, and included the first major reorganization of mental health programs in a decade, as well as significant new funding for the opioid crisis.”

Department of Education and Department of Labor Nominees: The committee met to consider two Department of Education nominees, Brigadier General Mitchel Zais to serve as Deputy Secretary and James Blew to serve as Assistant Secretary for Planning, Evaluation, and Policy Development, and two Department of Labor nominees, Kate O’Scannlain to serve as Solicitor and Preston Rutledge to serve as Assistant Secretary for the Employee Benefits Security Administration.

Department of Labor and National Labor Relations Board NominationsThe committee met to consider two Department of Labor nominations and one National Labor Relations Board nomination: Cheryl Stanton to serve as Administrator of the Wage and Hour Division; David Zatezalo to serve as the Assistant Secretary of Labor for Mine Safety and Health; and Peter Robb to serve as the General Counsel of the National Labor Relations Board.

Department of Education and Equal Employment Opportunity Commission NominationsThe committee met to consider two Equal Employment Opportunity Commission member nominees, Janet Dhillon and Daniel Gade, and a Department of Education nominee, Carlos Muniz, to serve as General Counsel.

Department of Health and Human Services Nominations: The committee met to consider five Department of Health and Human Services nominees, including: Lance Allen Robertson to serve as Assistant Secretary for Aging; Dr. Brett Giroir to serve as Assistant Secretary for Health; Dr. Robert Kadlec to serve as Assistant Secretary for Preparedness and Response; Dr. Elinore F. McCance-Katz to serve as Assistant Secretary for Mental Health and Substance Use; and Dr. Jerome Adams to serve as Surgeon General of the Public Health Service.

Department of Labor and Members of the National Labor Relations Board Nominations: The committee met to consider the nomination of Patrick Pizzella to serve as Deputy Secretary of the Department of Labor and Marvin Kaplan and William Emanuel to serve as members of the National Labor Relations Board.

Nomination of Scott Gottlieb, MD, to serve as Commissioner of Food and DrugsThe committee met to consider the nomination of Dr. Scott Gottlieb to serve as Commissioner of the Food and Drug Administration. Alexander said Dr. Gottlieb has “impressive qualifications from nearly every perspective” and is the right person to lead the Food and Drug Administration and its “vital mission” for patients.

Nomination of Alex Acosta to serve as Secretary of LaborThe committee met to consider Secretary of Labor nominee R. Alexander Acosta. Alexander said that the Labor Secretary and Congress’s goal is to create an environment for American workers to succeed in a rapidly changing workplace and that harmful Obama-era labor regulations have only made it harder for Americans to create, find, or keep good-paying jobs. “We are fortunate today to have a presidential nominee for Labor Secretary who understands how a good-paying job is critical to helping workers realize the American dream for themselves and for their families.”

Nomination of Tom Price to serve as Secretary of Health and Human Services: The committee met to consider the nomination of Rep. Tom Price (R-Ga.) to lead the Department of Health and Human ServicesThe committee does not vote on this nomination but does hold a courtesy hearing.

Nomination of Betsy DeVos to serve as Secretary of EducationThe committee met to consider the nomination of Betsy DeVos to serve as Secretary of Education. Alexander said, “Betsy DeVos is on our children’s side.  On charter schools and school choice, she is in the mainstream of those trying to help children succeed and her critics are outside of it.”

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