21st Century Cures Bill

Floor Speech

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Mr. MURPHY. Mr. President, I wish to thank Senator Cassidy and Senator Alexander for being such amazing partners in bringing this legislation from its introduction last summer to the floor of the House and soon to the floor of the Senate. I will say a little bit more about them and their teams, but it really has been a pleasure. I have learned a lot, especially from Senator Alexander, about how to overcome some tough obstacles and pitfalls while bringing something this big and this meaningful through the process.

I accept the premise that there is something fundamentally broken about the way things work here in Washington, DC. Cable news fame and getting ready for the next election all matter way too much here, and it means that there are a lot of big issues, like immigration reform and entitlement reform and infrastructure, that don't get done because politics get in the way. But there are, frankly, a lot more breakthroughs that happen here than most Americans know about, and a lot of them happen on the HELP Committee. There are, more often than one would think, moments where politics get put to the side or temporarily squeezed out of the way and something really important happens here. This is one of those moments.

Senator Cassidy really explained the contours of this bill very well.

So I want to provide just a little bit of the context for it. I have been working on this issue of mental health since I was 25 years old, in the Connecticut State legislature, and I ran for Congress in part because I knew that I couldn't fix what was broken in Connecticut's mental health system without addressing the myriad of Federal funding sources, laws, and regulations that create today what is kind of currently a dystopian web of uncoordinated, misaligned behavioral health care in this country.

The consequences of this failed health care system are all around us, and they are just increasingly impossible to ignore. Senator Cassidy spoke about some of them. But it is personal because every single one of us knows someone in our family or our next door neighbor who suffered from a serious mental illness and failed to get the care they need. All of us recognize that this suicide crisis is spiraling out of control.

We have seen a 25-percent increase in suicides in just the last 15 years. When we visit our hospitals, no matter what State we are in, we all notice that one of the major building campaigns that is happening is additions to the emergency departments to take care of this tsunami of mentally ill patients who are walking into these Ers because they have absolutely nowhere else to go.

Lastly, for as much back-patting as we have done for ourselves in the last 50 years because of our decision to close mental institutions all across the country, we have essentially just recreated these institutions all over again. They are now called prisons. A recent article in the Boston Globe by the now famous Spotlight investigative team found that prisoners in that State essentially had to self- mutilate themselves in prison in order to get any mental health care.

The Spotlight team concluded that ``there may be no worse place for mentally ill people to receive care than prisons.'' Yet we have essentially decided in this country to exchange the old insane asylums for new ones.

Mainly, though, I stay awake thinking about a meeting that I had earlier this year with moms--with a bunch of mothers in West Hartford, CT. These were moms that were at their wit's end. They were fairly affluent. They were well educated. They had learned the ins and outs of this broken system. Yet they still had no answers about what to do with their deeply mentally ill children. Many of them were adults. So, technically, they were not under the supervision of their parents any longer. They were petrified--petrified that their kids would end up in those prisons or, worse, that they would end up dead because there was no way for them to find proper care for their children's mental illness. These moms told the story dozens of times, courageously so.
They wept and they trembled with me as they were telling these horror stories.

Yet, of course, for all of the disaster that exists in our under- resourced, uncoordinated behavioral health system, there is lots of hope. Why? Because recovery is possible. Check that, actually. It is not possible, it is actually probable, if you can find the right therapy, the right set of supports, and perhaps the right set of medications needed.

Over the last 20 years of public service, I have met plenty of people who have beaten this disease, who have trained their minds to work differently, and who are leading full and happy lives. The simple problem is that the resources here are just too far out of reach and sometimes nonexistent for millions of constituents living with mental illness.

So that brings us to this moment and how this place actually does work for good sometimes. Two years ago, I approached Senator Cassidy right here on this very floor, just days after his swearing in, and I told him that I had heard that when he was a House Member, he would come to hearings on mental illness in the House with a dog-eared, wornout copy of a book called ``Crazy'' by Pete Early. I don't agree with everything in that book, but it is a story of a father who had the same story to tell as all of those moms in West Hartford. I asked Bill if his enthusiasm for this book meant that he was interested in working on mental health policy, and he said:

Absolutely. For the next 6 months, he and I worked together to meet with everybody we could find, both nationally and in our States, who could tell us what was wrong with our mental health system, and we decided to do something big.

A lot of us work with Members of the other party on small bills. They are meaningful pieces of legislation, but they are kind of one-offs.

They fix one problem here or there. We decided to write a big, sweeping bill--one that would tackle as many problems in the behavioral health system as we could all at once. We had a head start because of our friend in the House of Representatives, Representative Tim Murphy, had already introduced a comprehensive reform bill. So in August of that year, after hundreds of these meetings and forums, we introduced our own version of Tim Murphy's bill--the Mental Health Reform Act. Today, about 16 months after introduction, the House is going to pass this bill as a major component of the Cures package, as Senator Alexander said. My hope is that we will have a bipartisan vote here some time very soon.

Senator Cassidy and I will be the first to admit that it doesn't come close to solving all the problems that people with mental illness confront. Most importantly, it doesn't include new Medicaid or Medicare money to address some of these huge shortages that patients and families face. But it does require insurance companies to stop discriminating against people with mental illness by rejecting claims for mental health at a rate that is much higher than they do for physical health. This strengthening of our Nation's mental health parity law is probably the bill's most important provision in my mind.

I am convinced it is going to result in hundreds of millions of dollars in new care for people with mental illness. I wish to thank Senator Alexander and Senator Murray for supporting this provision, even though it was at times controversial.

The bill also elevates the place of mental illness within the Department of Health and Human Services by creating a new assistant secretary who is going to oversee all of this funding that often is done in a really uncoordinated way. It creates new programming to assist young children who show the first signs of mental illness. We get at it early. It reauthorizes important suicide prevention programs that have been shown to work, and it clarifies that parents don't need to be totally cut out of their adult child's care--that doctors can share information with parents if it is in the best interests of the patient to do so.

Frankly, that is just the tip of the iceberg. Senator Cassidy went much deeper. There are a lot of other provisions in this bill that will make it less likely that people with mental illness face continued barriers to care.
Over the past 2 years, this bill has faced a lot of uncertain moments, and that is where Senators Alexander and Murray come in. They have really helped us navigate through some tough waters. I give a lot of credit as well to Senator Cornyn. Senator Franken contributed a big section of this bill that reforms the way the mentally ill are treated in the criminal justice system. Senator Cornyn, in particular, helped us overcome a major hurdle in this bill this fall.

Finally, I just want to thank all of the staff people who have worked on this. I want to thank Brenda Destro in Senator Cassidy's office. I want to thank Mary Sumpter Lapinski and Laura Pence in Senator Alexander's office; Evan Schatz, Nick Bath, and Colin Goldfinch in Senator Murray's office. First and foremost, I want to thank Joe Dunn in my office, who in many ways is the parent of this bill from beginning to end, and all the people in our office who worked underneath him.

When and if the Senate approves this bill and the President signs it into law, maybe the most important thing that will happen here is that we will show that this place can work together to address a big problem that really has no partisanship to it. Mental illness doesn't care if you are a Republican or if you are a Democrat. Mental illness doesn't care if you voted for Hillary Clinton or Donald Trump, and it doesn't care if you think you are not the kind of person who could suffer from mental illness. It doesn't discriminate. Yet we do. We continue to push those with mental illness into the shadows. Our unwillingness to fund the better coordinated care system that we know we need is a clear message to these patients that they are something less inside our health care system.

That begins to change with the passage of this legislation. I think, accurately described by Senator Alexander, it is probably the most significant piece of mental health legislation we have passed in over a decade. I can say that maybe there is nothing I have worked on in my 20 years of elected office of which I am more proud. I commend this bill to all of my colleagues.

I yield the floor.

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