Natural Resources Management Act--Motion to Proceed

Floor Speech

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Mr. CORNYN. Mr. President, on Tuesday of this week, the Senate Finance Committee had a very important hearing on the skyrocketing costs of prescription drugs, something the Presiding Officer knows a lot about.

In 2017, a study found that more than half of Americans regularly take some form of prescription medication. Modern medicine has made living with chronic health conditions that would have once been debilitating or fatal--like diabetes, high blood pressure, or asthma-- modern medicine has made living with those conditions manageable. That is a blessing for which we are all grateful.

I know, at the same time, many of my constituents and many Americans struggle to buy prescription drugs to treat common health problems, not because they aren't widely available but because they simply are unaffordable. For many higher cost, brand-named drugs, generic alternatives are available at a lower price. For example, I happened to take a drug called Lipitor, which previously was covered by a patent. As a result of that patent, the cost of the drug was higher because the producer of the drug had a monopoly. We grant that monopoly for a period of time--I believe it is 12 years--in order for them to recoup their research and investment dollars. Unfortunately, many of these efforts to come up with lifesaving drugs are unsuccessful. So in order to encourage innovation and lifesaving discoveries, we have to find a way to allow drug companies to recover their sunk costs and make a profit.

Generic drugs have really been a lifesaver for many people. That same Lipitor that I take now is off of patent and is available for a few dollars for a 30-day supply. That is just one example. One study found that 93 percent of generic prescriptions are filled at $20 or less, with the average cost being just more than a little over $6, but for many drugs, there are no low-cost alternatives, and people are increasingly struggling to cover the rising costs of their medication.

One witness from Indiana, Kathy Sego, I think, speaks for a lot of parents who have children suffering from diabetes needing insulin, and I think her story was emblematic of that problem across the country.

In her case, she is a wife, a mother of two, and a choir teacher. Her son Hunter is one of the more than 30 million Americans who suffer from diabetes, and he relies on insulin to manage his blood sugar.

Kathy told us that when her son Hunter started college, he started to go to the pharmacy to pick up his insulin prescription himself. That is when he discovered that it cost $1,700 a month, even with health insurance. The copay--the part they were responsible for and had been paying for Hunter, unbeknownst to him--is $1,700 a month. Kathy assured him that, unfortunately, that cost was correct; $1,700 only covers a 1- month supply.

Over the next few weeks, their family began to notice a change in their son Hunter. He was losing weight, falling behind in school, and was depressed--a far cry from what she said was his normally positive and energetic self. Unbeknownst to his parents, Hunter had only purchased one vial of insulin when he needed four, and he began rationing his supply of the drug. To try to counterbalance that, he began skipping meals--which is dangerous for a diabetic to do, let alone an incredibly active college football player like him. Fortunately, in time, his family realized what had happened, and they intervened, avoiding what could have been fatal consequences, but her family still battles with the expense of this insulin.

Kathy says she worries about what happens when Hunter graduates from college, noting that his life choices are contingent upon his ability to pay for the medicine he needs to keep him alive. She wondered at our hearing: Can he afford an apartment, utility bills, and repay his student loans? Hunter, she said, needs insulin to live, but should that need for insulin keep him from living?

About 1.5 million Americans have type 1 diabetes like Hunter, where their body produces no insulin to deal with the blood sugar, but as I mentioned earlier, 30 million Americans, according to the Centers for Disease Control, have diabetes, and about 3 million of those 30 million are in my State of Texas. Three million Texans have diabetes for which insulin is a required treatment.

While we know it is common to see higher drug prices for new drugs that have recently completed the costly research-and-development phase, that is not the case for insulin, which has been around for nearly a century and is a type of biologic drug which is generally more expensive to produce.

I hope Kathy and Hunter's story--which could be told millions of times by other families across the country--impels us to investigate the causes for these unreasonable costs for some of these prescription drugs. I hope we find a solution--and I am confident we will if we try hard enough--that will allow families like Kathy's to live without the burden of wondering how to pay for their healthcare costs, particularly when it comes to prescription drugs.

At Tuesday's hearing, I also questioned our witnesses about a phenomenon known as rebates and the way pharmacy benefit managers deal with pharmaceutical companies.

I noted that, ordinarily, it was a crime to kick back money to a provider. For some reason that nobody could justify, there was an exclusion for these rebates by pharmacy benefit managers to pharmaceutical companies.

In the case of prescription drug pricing, rebates and discounts provided by manufacturers could mean the difference between a drug being covered by your insurance plan or not, and, certainly, whatever the net price is after the rebate is not transparent to anybody, much less to the consumer, or returned directly to the consumer. Not only does this drive up the list price and out-of-pocket cost of lifesaving drugs, but it makes it impossible for Congress or anybody to determine where each dollar goes.

I find this lack of transparency alarming. It shouldn't take an advanced degree to figure out where your money is going when you buy prescription drugs or how to shop for the most effective drug at the right price. When it comes to prescription drugs, we need to promote transparency first and foremost, and we need to streamline and eliminate regulations and laws that allow the middlemen to unnecessarily drive up prices. We know we have the opportunity to do that in the coming months.

We shouldn't require people suffering from chronic diseases to subsidize the healthcare costs of healthy people. There is something strangely wrong about this picture. I am glad we had the opportunity to listen to witnesses on this topic, and I thank them for taking the time to share their insights.

I look forward to continuing to work with all of our colleagues on the Finance Committee and generally to identify ways to make prescription drugs more affordable and accessible to the American people.

As the Presiding Officer knows, given his background in healthcare, I am confident he can be an important part of that solution, as well. Tribute to Susan Pamerleau

Mr. President, switching gears just a bit, I want to share a quick good-news story of two outstanding Texans who blazed the trail for women in public service.

While I was in San Antonio, my hometown, a couple of weeks ago, I had the chance to congratulate our new U.S. marshal for the Western District of Texas, Susan Pamerleau. Over the years, she has held many impressive titles--general in the Air Force and sheriff--and now she is a U.S. Marshal. In addition to each of those, I have always been proud to know her under a different title--as a friend.

At Susan's ceremonial swearing-in, Chief Judge Orlando Garcia opened by noting the historical significance of her being the first female marshal ever in the Western District of Texas, which was established in 1857.

Susan's long and impressive career began at Lackland Air Force Base in Texas, where my dad happened to have been stationed at one time, where she received her commission through officer training school. Over the course of her 32-year career in the Air Force, she rose through the ranks and retired, ultimately, as an Air Force major general in the year 2000.

When she returned to Texas, Susan joined USAA as a vice president and later became senior vice president. It wasn't until 10 years later that her career in law enforcement began when she was elected sheriff of Bexar County, TX, which is the 11th largest sheriff's office in the Nation.

Susan was the first woman to hold that role as well, but she said:

It was not about being the first woman. It was really about redefining the role of what the Bexar County sheriff does.

Over the years, I have had the opportunity to work with her on a number of issues impacting my constituents and our constituents, including mental health and law enforcement reforms. I think she has made an enormous contribution to both of those areas.

Needless to say, I was thrilled when the President nominated Susan to be the new U.S. marshal for the Western District of Texas and when she was confirmed last fall. Her integrity, leadership, and management skills are critical to the Western District of Texas, which comprises 68 counties and more than 6 million people.

I wish, once again, to congratulate my dear friend Susan Pamerleau on becoming the U.S. marshal, and I look forward to continuing to work with her as we serve together the people of Texas Remembering Mary Lou Robinson

Mr. President, finally, when you talk about women opening doors in Texas, you can't leave out Mary Lou Robinson, who sadly passed away last weekend at the age of 92.

Her long and distinguished legal career began at the University of Texas School of Law, where she met her husband, A.J. After law school, they returned to Amarillo, TX, where they opened up the firm appropriately named Robinson & Robinson.

In 1955, she left the private practice of law when Potter County commissioners appointed her judge of the Potter County Court at Law, making her the first in a series of firsts for this remarkable woman.

Judge Robinson found her passion, and she was hooked. In the coming decades, she became an advocate for women's rights, and she helped to promote the passage of the Texas Equal Rights Amendment, a constitutional amendment voted on by the people in 1972.

Over the course of her remarkable 63-year judicial career, Judge Robinson served as the 108th District Court judge, followed by associate and then chief justice of the 7th Court of Appeals, located in Amarillo.

In 1979, she was appointed by President Jimmy Carter to be a judge of the U.S. District Court for Northern District of Texas, where she served for nearly 40 years.

Her career is impressive, not only for its length but for its quality. One attorney practicing before Judge Robinson noted: ``Lawyers may disagree on a lot of things, but almost all agree that she treats everyone equally and fairly.'' That is high praise for a district judge.

Judge Robinson will be remembered as an inspiring and devoted judge, an early advocate for women's rights, and a beloved member of her community.

Last summer, Senator Cruz and I introduced a bill to rename the Federal building and courthouse in Amarillo the J. Marvin Jones Federal Building and the Mary Lou Robinson United States Courthouse.

This lasting testament to her judicial career will live on for generations, and I am proud that Senator Cruz and I were able to cement this legacy for this legal pioneer.

While our family sends our prayers to the family of Mary Lou Robinson, we can all be proud of her distinguished career of service, not only to her beloved community in Amarillo but to the State of Texas and to the Nation as a whole.

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