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Honorable Mark Sanford

Representing the 1st District of South Carolina

Last night, the House passed the 21st Century Cures Act

Dec 1, 2016
Blog Post

Last night, the House passed the 21st Century Cures Act, a biomedical bill that could help many people, while at the same time it would negatively, and critically, impact our country’s bias toward spending. The bill passed 392 to 26, and I was among the 21 Republicans who voted no.

For all the good it did, there is nothing more that I would have wanted than to vote for this bill. It expedited the government approval process for medical products and drugs; our FDA drug approval process is antiquated. It boosted funding for disease research. It put more of a spotlight on federal mental health programs.

When I was in high school, my dad came down with Lou Gehrig’s disease, and the years that followed were tough. There is still no known cure, and whether on this disease or others like it, this bill could help. Close to home, we see progress in cures and care at places like MUSC, as it does work in conjunction with the National Institutes of Health.

So for many reasons, I really wanted to support this bill, but I could not because it brought with it a new disease (Pandora’s box, if you will), regarding the way in which federal programs will be funded in the future.

For the first time ever, discretionary spending in this bill was not subject to the spending caps. This is groundbreaking...and has never before happened. In the past, all ordinary funding is counted again the caps. This funding would not be.

Let me explain. Discretionary spending is all the federal spending that Congress debates each year and authorizes on a yearly basis. This spending is subject to funding caps, which help retrain federal spending. This is in contrast to mandatory spending - all federal spending that is on autopilot, like interest payments on the debt, Social Security, Medicaid, and Medicare...they have no cap.

So, what this bill does is create de facto mandatory spending that is disguised as discretionary spending. If you begin down this road, I don’t know where it stops. What do budget caps mean if you don’t count spending against them?

And once this is done, tradition has a way of reinforcing ideas that allow for more spending rather than less. I believe this new concept will now have a prior government stamp of approval and will lead to more of the same down the road. There were other problems with the bill...it depended on Obamacare funding to pay for parts of it, even though Republicans have pledged to get rid of Obamacare. But to repeat, the overriding problem in this bill was its very creative and new approach to getting around spending caps at a time when our nation needs desperately to adhere to them.

This would have been an easy yes vote. The bill does a lot of good, but we should all be wary of bills that do good in one sphere of our lives and hurt us in another. Such is the case with this bill, good health impact - and bad financial impact...and it is for this reason I had to vote no.