Comprehensive Addiction and Recovery Act of 2016--Conference Report--

Floor Speech

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Mr. CASSIDY. Mr. President, I come as a Senator, but actually I come wearing two different hats right now--two more hats aside from being a Senator. One of them is a teacher. I still teach at the LSU Medical School and have for the last 30 years, so I decided to do a presentation on something wearing my next hat.

In my life as a physician, I have done much work in public health and have learned, by the way, that if you head off illness early, you save a lot of money. You save a lot of money after that. I call it the balloon theory. If you put a balloon up to helium and you squeeze the nozzle, it inflates quickly, but if you pull it off the nozzle, it remains deflated.

Right now, we have something at risk with Zika that will be like that helium balloon--inflating rapidly unless we do that initial thing that pulls the balloon off the helium so that it works.

I am a teacher, so I decided to do something different. If anybody in the audience so chooses, they can put their phone and their QR code reader up to the television or the computer monitor and they can scan this barcode, and they will see the slides we are about to go over. So if you are watching at home and you wish to follow, then you can download these slides, and if you think them important, you can forward these slides to another person. Again, that is my effort as a teacher to try to speak about the spread of Zika.

This is Jose Wesley, born to a Brazilian mother who contracted Zika probably in her first 3 months of pregnancy. When Zika went through the momma's blood when Jose was in her womb, into the amniotic fluid or through the placenta, it entered Jose's body and went to his brain. That virus stayed inside his brain and terribly affected his brain.

Jose was born with microcephaly. You cannot really see from this angle what microcephaly is, but what ``microcephaly'' means is ``small brain.'' Here is a profile of a child with microcephaly. You can see that--unlike the big head babies normally have--this is a very small head. This is associated with severe neurologic deficits and early death. This is a tragedy and potentially a preventable tragedy.

Again, the teacher in me wants to talk a little bit about Zika. The spread of Zika historically gives us insight as to what we must fear now. Zika was first discovered back in 1951 in Africa, Uganda. Then, at some point in the three decades that followed, it spread quickly to Asia, and then from Asia to Yap Island in 2007, which is in the Pacific. In 2013 and 2014, it went to more Pacific islands. In 2015 and 2016, it entered the Americas. At some point, it began to spread rapidly. This is important because it is now in the Americas threatening Americans.

These are States which have cases of Zika. Here is the U.S. Virgin Islands. Here is Puerto Rico. They have the most, but almost every State is affected. Most folks have contracted it elsewhere and brought it back to their State, but there are some folks who received it sexually. So their partner contracted it, perhaps in Brazil, and came back to Texas or Florida or Louisiana, where I am from, and they contracted it sexually.

Nonetheless, the virus is in the United States. It is particularly a problem in Puerto Rico and the U.S. Virgin Islands. These are American citizens. These Puerto Ricans, if they wish, can board a plane and travel anyplace they wish in the continental United States. That is their right as Americans. Similarly, these folks who are infected in these States can travel anyplace they wish.

Why is that important? Well, theoretically, it is important because these are the areas where the mosquitos that carry the Zika virus live in the United States. So theoretically, wherever these mosquitos are-- and Hawaii should be on here someplace--the virus can enter and the virus can be transmitted by the mosquitos to many other Americans.

By the way, though, it is not just that you have to live where the mosquitos are. The first person to die from Zika in the continental United States just died in Utah. She contracted it elsewhere but then died in Utah. So the risk to our country is at least this. I will be perfectly honest. It is particularly a risk for those on the gulf coast because we have the sort of subtropical climate in which Zika flourishes. That is why I am particularly concerned.

But wearing my other hat as a public health doctor, I know we have this moment in time. Either we pull that balloon off so it does not inflate with Zika, damaging our country, creating more Joses here in the United States, or not.

Some of you may have seen the barcode that I held up initially. You may have downloaded that. We will hold up that barcode again if you wish to download these slides, but all of these are on the PowerPoint presentation that you may download should you wish.

Public health emergencies are inevitable. Let's talk about the response to this one. Mr. President, $600 million that was left over from the Ebola fund has been released to CDC and other agencies to mount a response against Zika. Now, $600 million was left over, and only one-fifth of it has been spent. So there are still substantial dollars available, but the CDC and other Federal agencies say they need more.

Republicans have supported $1.2 billion in additional funding to fight Zika. My colleagues on the Democratic side--we have a difference over this. They are opposing this $1.2 billion to fight Zika because they say the Republican bill discriminates against Planned Parenthood.

Planned Parenthood is not mentioned in the bill, and the way it discriminates--I have been in Washington--in the Senate, at least--for 2 years, and sometimes you have to kind of figure out why people are taking offense at something. Even though Planned Parenthood is not mentioned, the reason they object is because we specify that the money needs to go to a public agency, one that sees Medicaid patients, the State or territory Federal program that takes care of the uninsured. Planned Parenthood is not a Medicaid provider.

So it is not that they are not mentioned; it is that they are a private entity that, in Puerto Rico, does not accept Medicaid. So we could carve in and say: If you are a private entity, you can also receive these Federal dollars to provide family planning. It just so happens that in Puerto Rico, Planned Parenthood does not.

So Republicans are trying to release $1.2 billion to pull the balloon off the helium so it does not inflate with all kinds of cases, and one more case of a Jose would be one case too many. But we are caught up in this snafu about Planned Parenthood. It is the craziest thing in the world, but unfortunately it is how Washington, DC, sometimes works.

As a public health physician, I find that incredibly offensive. As a doctor who understands the critical nature of this, I am asking folks on the other side of the aisle to accept that this bill may not be exactly what they want--it is not exactly what I want--but it is something that would give additional resources to the Centers for Disease Control and others to begin to fight the Zika virus before it comes more extensively to our Nation's shores.

We can anticipate that public health emergencies in the future are inevitable. For example, we recently had Ebola. We had the West Nile virus. We have already spoken about Zika. So aside from hoping that my Democratic colleagues will agree to release the $1.2 billion to fight Zika now, there is also something else I am proposing, but I don't want to sound overly partisan because I am doing this particular bill with my Democrats--with Senator Brian Schatz from Hawaii. We are putting forward the Public Health Emergency Response and Accountability Act.

I am from Louisiana. We have had hurricanes. Hurricane Katrina is the one that is the most famous. If there is a hurricane or another natural disaster that hits an American State, then FEMA has a budget that is automatically triggered. It does not have to go through this appropriations process. We don't tie it down in discussions of extraneous matters. It is something that immediately comes to bear to bring relief to those affected by natural disasters.

The other thing that is done is that normal Federal contracting processes are waived. So instead of having to get 10 different signatures--which literally might be the case--for someone to travel from Washington, DC, to Louisiana or Kansas or Florida, it is waived and that emergency response coordinator may immediately go. There is oversight, so this is not carte blanche, but it is a more effective way to bring Federal resources, in partnership with local resources, to bring relief to those affected. We bring that flexibility in the use of funds while retaining accountability.

We call this the Public Health Emergency Response and Accountability Act, and we anticipate entering this in very soon. Senator Schatz has been wonderful to work with in terms of this aspect of what we are doing.

So there are two issues. The $1.2 billion that we should release now, that would immediately go--it is not a perfect bill, but we have to prevent more cases of these children who are tragically born with microcephaly, as well as more deaths, like the woman who recently died in Utah. Then, No. 2, we need to have the response and accountability act, which gets rid of this process we struggle through in order to release those funds to bring the relief we need.

Let me summarize by saying this: This is a baby with microcephaly. I think there have been three children born in the United States already--not conceived here but born here--who have microcephaly. This child's life is limited. She will most likely die at an early age, with severe neurological deficits. If you just want to look at it in a dollars-and-cents approach, this child will be a ward of the State for the entirety of her life and will cost the Federal taxpayer millions of dollars.

We have already had these babies born in Puerto Rico, New Jersey, and Hawaii. There are two pregnant women in Illinois who tested positive for Zika, and we had a death in Utah and Puerto Rico--not children but adults. The question is, Will the Senate work to stop this? And again, if you are watching and you wish, you can scan this barcode, you can download this presentation.

Let me finish by saying this. I just said the Senate should work to stop the spread of Zika. You can do something. We are a representative democracy and we respond to you, the people, and if we don't, by golly, you should vote us out. So I am asking you, if you are watching at home and you think there needs to be a response quickly and efficiently and effectively to combat the spread of Zika, you can either barcode this or not, but whatever you do, call your Senator. Ask your Senator--ask her or him--to support efforts to stop the spread of Zika, to release the $1.2 billion, and to also support the bill Senator Schatz and I are putting forward, the Public Health Emergency Response and Accountability Fund.

Ultimately, we answer to you, the people. That is a good thing. I ask you to perhaps use this tool to help us, to encourage us to answer to you, as we should.

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