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Washington, D.C.—Today, Congressman Jim Sensenbrenner (WI-05) introduced legislation to address the shortage of qualified physicians. H.R. 6123, the Physician Visa Reform Act, clears the path for highly-trained foreign physicians to access temporary visas so they can practice in health professional shortage areas. Paired with changes to state law, H.R. 6123 will help residents of rural areas across Wisconsin access life-saving medical care.

Rep. Sensenbrenner: “Every community should be served by well-trained medical staff. This legislation is a commonsense solution to the very real problem of doctor shortages that affects vulnerable populations across the country.”


Our nation’s health care system is becoming increasingly strained due, in part, to a lack of qualified doctors. Each year, more physicians retire while fewer medical students graduate to fill the vacancies. As studies have shown, medical students frequently practice in the area where they completed their residency – often in large cities – because they lack strong incentives to move to a shortage area.

Currently, federal law requires foreign physicians to complete a residency training program in the United States if they wish to practice here. While this policy is appropriate for younger, less experienced foreign doctors, it is unnecessary for highly-experienced and well-trained foreign physicians. For instance, a Canadian physician with 20 years of specialized experience treating cancer patients should not be required to complete the same residency program as a physician who recently graduated from medical school. This current policy is time-consuming, unnecessary, and a disincentive for foreign physicians to relocate to the US.


H.R. 6123 would reform the current visa program to allow highly-trained physicians to live and practice in an area designated by the Department of Health and Human Services (HHS) as having a shortage of health care professionals for three years without having to complete a residency program.

Notably, the legislation maintains states’ rights by allowing each state to maintain its own standards, requirements, and licensing board for physicians. In other words, when a foreign physician applies to work in a particular state, that state’s licensing board will determine, based on its own criteria, if the applicant is qualified and therefore eligible. Such criteria could include: the candidate’s country of origin, where the candidate graduated from medical school, how many years of experience the candidate has, if and what the physician’s specialty is, and other relevant information the state deems appropriate.

Once a state determines that a physician is qualified, a visa may be granted through the same application process that is prescribed under current law.

After three years of service in a shortage area, the physician may apply for permanent resident status after completing the National Board of Medical Examiners Examination (the test that all medical students must pass to graduate medical school and become fully licensed). Upon successful completion of the exam and approval from the Department of Homeland Security, the physician may remain in the U.S. and practice anywhere they are qualified and licensed.

The full text of H.R. 6123, the Physician Visa Reform Act, is available here.

Washington, D.C.—Today, the House passed the Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act. Congressman Jim Sensenbrenner (WI-05) is a co-sponsor of the SITSA Act, which modernizes the Controlled Substance Act by adding a new schedule, Schedule A, to the five existing schedules. It also immediately schedules 13 known synthetic fentanyl compounds to the Schedule A list. In an effort to keep up with ever-evolving drug analogues, the bill would expand the U.S. Attorney General’s authority to add new substances to the Schedule A list as they are discovered.

Rep. Sensenbrenner: “SITSA will help our drug enforcement agencies keep up with the constant development of new deadly street drugs, and I’m proud to cosponsor it. Its passage is a great step in addressing drug analogues that contribute to the opioid epidemic. Congress must build upon this momentum and pass my SOFA Act, which gives law enforcement even stronger tools to combat the opioid epidemic. I am committed to using every legislative tool at my disposal to win the fight against opioid abuse.”

You can read the full text of the SITSA Act here and the SOFA Act here.

By: Americans for Tax Reform

Today, Congressman Sensenbrenner (R- Wisc.) introduced H.R. 2887, the No Regulation Without Representation Act, to address state regulations that tax businesses physically outside the borders of the state.

 In Quill v. North Dakota, the Supreme Court found that states are sovereign only within their own borders and that the Constitution prohibits state regulations from crossing state borders. Despite the Supreme Court’s decision, states have regulated businesses outside the parameters of the state for decades. Sensenbrenner’s bill would codify this requirement in relieving small businesses from the heavy weight of government overreach and overregulation.

The following can be attributed to Grover Norquist, President of Americans for Tax Reform:

"The No Regulation Without Representation Act reigns in government overreach by forbidding any state from 1) imposing a sales tax on businesses physically outside the boundaries of the state, and 2) prohibits any state from exporting regulations onto businesses in other states.

"Regulations can be as abusive as taxes. If the American Revolution was revisited today the slogan would certainly be 'No Taxation and No Regulations without Representation.'

 "I commend Congressman Sensenbrenner for introducing the No Regulation without Representation Act and I urge all members of Congress to support this important piece of legislation. "  

The following can be attributed to Katie McAuliffe, Executive Director of Digital Liberty:

"Over the past few years, state legislatures have crossed their bounds by regulating and taxing businesses physically outside the parameters of their own state.

"Regulations that constrict and tax businesses outside of state borders challenge state sovereignty and federalism while making it incredibly difficult for small businesses to flourish under the backbreaking weight of regulations. I commend Congressman Sensenbrenner for addressing this by introducing the No Regulation without Representation Act."

Washington, D.C.Congressman Jim Sensenbrenner (WI-05) offered the following statement after the House passed thirty-five bipartisan bills to combat the opioid crisis:

Rep. Sensenbrenner: “We are taking action to restore hope to communities and families all across our nation devastated by the opioid epidemic. These bills provide real help for the millions of Americans who are struggling with addiction by providing additional treatment, increasing efforts that prevent people from becoming addicted, and ramping up enforcement to stop the flow of drugs into our neighborhoods.”

The House passed the following bills this week:

1) H.R. 449 – Synthetic Drug Awareness Act of 2018, as amended (Sponsored by Rep. Hakeem Jeffries / Energy and Commerce Committee)

2) H.R. 3331 – To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology, as amended (Sponsored by Rep. Lynn Jenkins / Energy and Commerce Committee)

3) H.R. 4284 –Indexing Narcotics, Fentanyl, and Opioids (INFO) Act, as amended (Sponsored by Rep. Bob Latta / Energy and Commerce Committee)

4) H.R. 4684 – Ensuring Access to Quality Sober Living Act of 2018, as amended (Sponsored by Rep. Judy Chu / Energy and Commerce Committee)

5) H.R. 5002 – Advancing Cutting Edge (ACE) Research Act (Sponsored by Rep. Debbie Dingell / Energy and Commerce Committee)

6) H.R. 5009 – Jessie’s Law, as amended (Sponsored by Rep. Tim Walberg / Energy and Commerce Committee)

7) H.R. 5041 – Safe Disposal of Unused Medication Act, as amended (Sponsored by Rep. Tim Walberg / Energy and Commerce Committee)

8) H.R. 5102 – Substance Use Disorder Workforce Loan Repayment Act of 2018 (Sponsored by Rep. Katherine Clark / Energy and Commerce Committee)

9) H.R. 5176 – Preventing Overdoses While in Emergency Rooms Act, as amended (Sponsored by Rep. David McKinley / Energy and Commerce Committee)

10) H.R. 5228 – Stop Counterfeit Drugs by Regulating and Enhancing Enforcement Now (SCREEN Act), as amended (Sponsored by Rep. Frank Pallone / Energy and Commerce Committee)

11) H.R. 5261 – Treatment, Education, and Community Help (TEACH) to Combat Addiction Act of 2018, as amended (Sponsored by Rep. Bill Johnson / Energy and Commerce Committee)

12) H.R. 5272 – To ensure that programs and activities that are funded by a grant, cooperative agreement, loan, or loan guarantee from the Department of Health and Human Services, and whose purpose is to prevent or treat a mental health or substance use disorder, are evidence-based, as amended (Sponsored by Rep. Steve Stivers / Energy and Commerce Committee)

13) H.R. 5327 – Comprehensive Opioid Recovery Centers Act of 2018, as amended (Sponsored by Rep. Brett Guthrie / Energy and Commerce Committee)

14) H.R. 5329 – Poison Center Network Enhancement Act of 2018, as amended (Sponsored by Rep. Susan Brooks / Energy and Commerce Committee)

15) H.R. 5353 – Eliminating Opioid Related Infectious Diseases Act of 2018, as amended (Sponsored by Rep. Leonard Lance / Energy and Commerce Committee)

16) H.R. 5473 – Better Pain Management Through Better Data Act of 2018, as amended (Sponsored by Rep. Barbara Comstock / Energy and Commerce Committee)

17) H.R. 5483 – Special Registration for Telemedicine Clarification Act of 2018, as amended (Sponsored by Rep. Buddy Carter / Energy and Commerce Committee)

18) H.R. 5582 – Abuse Deterrent Access Act of 2018, as amended (Sponsored by Rep. Buddy Carter / Energy and Commerce Committee)

19) H.R. 5583 – To amend title XI of the Social Security Act to require States to annually report on certain adult health quality measures, and for other purposes (Sponsored by Rep. Yvette Clarke / Energy and Commerce Committee)

20) H.R. 5587 – Peer Support Communities of Recovery Act, as amended (Sponsored by Rep. Ben Ray Luján / Energy and Commerce Committee)

21) H.R. 5685 – Medicare Opioid Safety Education Act of 2018 (Sponsored by Rep. John Faso / Energy and Commerce Committee)

22) H.R. 5800 – Medicaid IMD ADDITIONAL INFO Act (Sponsored by Rep. Fred Upton / Energy and Commerce Committee)

23) H.R. 5812 –  Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies (CONNECTIONS) Act (Sponsored by Rep. Morgan Griffith / Energy and Commerce Committee)

24) S. 916 – Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018 (Sponsored by Sen. Bill Cassidy / Energy and Commerce Committee)

25) H.R. 4275 – Empowering Pharmacists in the Fight Against Opioid Abuse Act, as amended (Sponsored by Rep. Mark DeSaulnier / Energy and Commerce Committee)

26) H.R. 5197 – Alternatives to Opioids (ALTO Act), as amended (Sponsored by Rep. Bill Pascrell / Energy and Commerce Committee)

27) H.R. 5294 – Treating Barriers to Prosperity Act of 2018 (Sponsored by Rep. Louis Barletta / Transportation and Infrastructure Committee)

28) H.R. 5752 – Stop Illicit Drug Importation Act of 2018, as amended (Sponsored by Rep. Marsha Blackburn / Energy and Commerce Committee)

29) H.R. 6029 –  Reauthorizing and Extending Grants for Recovery from Opioid Use Programs (REGROUP) Act of 2018 (Sponsored by Rep. Keith Rothfus / Judiciary Committee)

30) H.R. 5889 – Recognizing Early Childhood Trauma Related to Substance Abuse Act of 2018 (Sponsored by Rep. Dave Brat / Education and the Workforce Committee)

31) H.R. 5890 – Assisting States’ Implementation of Plans of Safe Care Act (Sponsored by Rep. Tom Garrett / Education and the Workforce Committee)

32) H.R. 5891 – Improving the Federal Response to Families Impacted by Substance Use Disorder Act (Sponsored by Rep. Glenn Grothman / Education and the Workforce Committee)

33) H.R. 5892 – To establish an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address the impact of opioid abuse on the workplace (Sponsored by Rep. Jason Lewis / Education and the Workforce Committee)

34) House Amendment to S. 1091 – Supporting Grandparents Raising Grandchildren Act (Sponsored by Sen. Susan Collins / Education and the Workforce Committee)

35) H.R. 2147 – Veterans Treatment Court Improvement Act of 2018, as amended (Sponsored by Rep. Mike Coffman / Veterans Affairs Committee)

By: Alex Gangitano of Roll Call

Rep. Jim Sensenbrenner is the king of town halls.

The Wisconsin Republican, who was first elected to the House in 1978, held the most of any member of Congress last year, when he racked up 115. Since 2011, he has held more than 500 meetings with constituents.

“I can say that generally the crowds at the town meetings are either people who are active in political parties or ideological movements or people who come and are seeking information about something they are confused about,” he said.

But the mood of late can be hostile, and that’s made meetings tougher.

Sensenbrenner said he has noticed that “people’s blood pressure gets up when they’re talking about public policy issues now.”

He cut short two meetings over the last year after things got heated and the crowd began yelling. Before that, he had adjourned only one meeting early — in 2011 — when the group was aggressively discussing a Wisconsin state issue.

“That’s something that concerns me about the future of American politics. If we can’t respect others’ opinions … we’re going to be damaging democracy and we’re going to be damaging the type of respect that’s kept this country together,” he said.

HOH asked him to share some highlights:

Smallest crowdOne. “It worked out just fine. He and I didn’t agree on the issue of net neutrality, but we talked for half an hour on it. I make it a point not only to go to big communities, but also small ones.”

Largest crowd: “During the Clinton impeachment, I had about 500 at town meetings. Last year, because of people both supporting and opposing the Trump agenda, I had about 5,000 attendees [total in 115 town halls].”

Strangest question: “There was one woman who came in complaining bitterly that the mailman wouldn’t put the mail on the top of the stairs but put it in the mailbox. She was too lazy to go downstairs to pick up her mail. Usually I find out when people go off the page like this woman did, the rest of the crowd starts moaning and groaning.”

Youngest participant: “I got a question in Hartford, Wisconsin, on Sunday [June 4] from a grade-schooler relative to a piece of legislation that mandated research at the NIH on a very, very rare disease.”

Recent popular topics: “There was a lot of talk about health care. There were either people who supported Obamacare or people who hated it and wanted it repealed and replaced. As time has gone on, the public has been more ideologically polarized. This is reflective of Congress, as Congress has become more ideologically polarized as well.”

Do you ever not have an answer? “Oh yeah, that happens all the time. If I can’t answer it, I make people sign in on sign-in slips so I have the sign-in slip with name and address [to send them a response].”

Ever have a quiet crowd? “The people who decide to come are rarely quiet.”

By: C.D. Davidsmeyer in the Journal-Courier

In Steve Hochstadt’s recent opinion article, he discusses the Equal Rights Amendment and asks the question: “Why did [C.D.] Davidsmeyer decide to vote no?”

I find it amusing that he could have found out that answer by simply calling me.

While I may not agree with him on many things, I am not afraid to have a conversation with an individual with whom I disagree.

Instead of asking me, he would rather make up a reason in his own mind.

It is not because I wasn’t born during the inequality of the 1960s and prior. It is not because I’m a white male. It’s not because I’m a Republican. And it’s most certainly not because I believe in inequality.

Perhaps Mr. Hochstadt would like to look back into the history of the ERA and the wording that originated in the 1920s. Perhaps he would like to talk about the ulterior motive behind the ERA.

I am pro-life and I am unashamed of that. I don’t rub it in people’s faces and it’s not the only issue that I believe in, but it’s important to me to protect innocent lives.

The ERA was used in the following ways to promote elective abortion:

• In 1998, the New Mexico Supreme Court ruled that the ERA requires the state to pay for all abortions for low-income women.

• The ACLU filed briefs in abortion cases in Hawaii, Massachusetts, Pennsylvania and Connecticut arguing that the ERA requires tax funding for elective abortions because it is classified as a medical procedure.

• The Connecticut Superior Court ruled on April 19, 1986, that the state ERA requires abortion funding.

• And, when Congressman James Sensenbrenner filed an amendment to the ERA to ensure that the ERA was only about equal rights and not about abortion, it was rejected by ERA advocates, proving their ulterior motives.

The examples above tell me that the ERA is not about equal rights, but rather a way to push another agenda.

I am for equal rights for women and I would encourage Congress to pursue an amendment to the U.S. Constitution like the one in Illinois that already constitutionally protects women here.

On another note, Hochstadt decided to refer to me as a follower on the state employee back pay issue. I would encourage him to do some “investigative journalism” or a little “research” to see that on Feb. 11, 2014, I filed HB5451 in the 98th General Assembly to pay the back pay. On May 27-28, I decided to focus on the Democrat version of the bill, HB3764. In those two days, I worked to add another 25 sponsors to the Democrats’ back pay bill, getting it up to 70 in an attempt to force the speaker’s hand. Even with one shy of a super-majority, Madigan would not call the bill.

Then, on Feb. 19, 2015, I filed HB2703 in the 98th General Assembly to pay the back pay. On April 5, 2016, I joined members of the other party as a chief co-sponsor of HB6425, a bi-partisan attempt to pay the back pay. On Jan. 26, 2017, I again filed a bill, HB754, to pay the back pay. On March 1, I joined in support of another bill to pay the back pay — and this time it passed.

Sometimes years of behind-the-scenes work and public support pay off. While it wasn’t my name at the top of the bill, I worked with the sponsor to ensure that the same bill that I filed back in 2014 was finally allowed a chance to be voted on and the state would finally pay the oldest bill held by the state of Illinois.

In the future, false information could be stopped with a simple phone call and conversation.

C.D. Davidsmeyer of Jacksonville is a member of the Illinois House of Representatives.

By: Rick Barrett and Craig Gilbert of the Milwaukee Journal Sentinel

At a recent town hall meeting held by U.S. Rep. Jim Sensenbrenner in Hartford, a local manufacturer complained vehemently about the new steel and aluminum tariffs imposed by President Donald Trump.

“I do recognize this is probably a negotiating tactic … the administration is using, but in the meantime real families are being crushed by these tariffs right now,” said Doug Reigle of Regal Ware, a company with 200 employees in West Bend that makes cookware and small kitchen appliances.

“We ship our products all over the world — 65 percent of our revenue comes from outside the United States …  and the tariffs are hitting us especially hard,” said Reigle, who said his firm has already spent about $150,000 this year to cover the tariffs.

Since June 1, companies that buy steel and aluminum from Canada, Mexico and the European Union have felt the sting of a 25 percent tariff on steel and a 10 percent tariff on aluminum. The tariffs also have triggered countermeasures from U.S. trading partners on a plethora of Wisconsin goods, including Harley-Davidson motorcycles, cheese, yogurt, pork, cranberries, sweetcorn, ginseng, wood, boats, paper and shoes. 

The objective of the steel and aluminum tariffs, according to Commerce Secretary Wilbur Ross, was to reduce the trade deficit and shore up American metal producers. The tariffs, essentially a tax on imported goods, also could be a bargaining chip in renegotiating the North American Free Trade Agreement. 

All of Regal Ware’s aluminum comes from Canada.

“We can’t even buy it in the United States,” Reigle said. “Our competitors, which come from all over the world, aren’t subject to these tariffs … So I’m now at a 25% disadvantage immediately on all those products.”

Every time the U.S. has imposed tariffs, it’s never worked out the way it was intended, according to Reigle.

Sensenbrenner told him that “one of the few things I disagree with the president on is the tariffs.”

The Menomonee Falls Republican said he was among 101 GOP lawmakers who wrote to the White House objecting to the steel and aluminum tariffs. 

Sensenbrenner said he has received an “earful” about them from people in his district involved in manufacturing.

“They’re very, very afraid what’s going to happen is that they’re going to be increasingly non-competitive to goods, particularly the ones that come in from China,” he said.

“Those kinds of tariffs, if they end up being permanent rather than a negotiating tool on Trump’s part, are going to bring about retaliation. They’re going to bring about retaliation against manufactured products from the United States. And with us (in Wisconsin) being number two in per capita manufacturing jobs (in the U.S.), we’re going to get hit harder too.”

U.S. agriculture is bearing the brunt of the countermeasures already imposed by Mexico, equivalent to $2.62 billion of the targeted products.

That includes $387 million in tariffs on U.S. cheese, according to a report from S&P Global Market Intelligence, which tracks global commerce.

About 90 percent of Wisconsin milk is turned into cheese, and 90 percent of that cheese is sold outside of the state's borders. 

Mexico buys nearly a quarter of all dairy products exported by the United States.

Cheese, yogurt, pizza, cucumbers, soups and prepared meals are some Wisconsin food products on Canada’s list of items slated for tariffs.

“We think it’s going to be pretty devastating to us,” said Jeff Schwager, president of Sartori Cheese in Plymouth.

“Uncertainty is the killer. If these tariffs go into place, what will they be? And how long will they last? We are in uncharted territory,” he said.

Sartori, which buys milk from 130 Wisconsin dairy farms, exports products to 49 countries.

U.S. cheese makers were at a trade disadvantage with the European Union even before the threat of additional tariffs, according to Schwager.

“We pay a dollar a pound (of cheese) for import duties into Europe,” he said.

The Mexican tariff on U.S. pork is 10 percent, escalating to 20 percent July 5.

It “eliminates our ability to compete effectively in Mexico,” said Jim Heimerl, president of the National Pork Producers Council.

“The toll on rural America from escalating trade disputes ... is mounting,” he said.

About a quarter of Wisconsin’s pork goes to Mexico, and anything that hurts those sales would be felt by farmers who are already just barely turning a profit.

Food manufacturers, such as Johnsonville Sausage in Sheboygan Falls, also are vulnerable in trade disputes.

Johnsonville ships products to about 35 countries.

Michael Stayer-Suprick, who leads the company’s international business division, says he’s concerned about trade wars.

“However, for where we need to be as a country with our trading partners, to me this is a short-term hurdle that’s well worth us trying to overcome,” he said. “I think this will be short-term pain for, hopefully,a long-term gain in better relationships on both sides of our borders."

Wisconsin manufacturers of lawn and garden equipment also stand to take a hit from the tariffs through reduced sales to Canada and higher steel and aluminum costs that threaten to drive up prices of their products. 

“Who loses? It’s the consumer,” said Kris Kiser, president of the Outdoor Power Equipment Institute, a trade group that represents manufacturers such as Briggs & Stratton Corp., Kohler Co., and Ariens Co. 

 “We are very disappointed with the current tariffs, the back and forth, and the tariff war that doesn’t suit anyone’s interest,” Kiser said. “This is what happens when you interfere in the marketplace.”

Ariens Co., based in Brillion, buys steel made in the U.S. and Canada.

The maker of garden tractors and snow throwers is bracing for higher raw material costs that could place its products at a price disadvantage to equipment made overseas.

“It’s definitely going to be a significant challenge,” said Ariens spokeswoman Ann Stilp.

Last fall, a week after Trump called Canada a “disgrace” for trade policies that hurt Wisconsin dairy farmers, he slapped tariffs of up to 24 percent on Canadian softwood lumber — material that’s used in the building industry.

Canada has since threatened tariffs on U.S. plywood, boards, paper and other wood-based products, including furniture.

Trade disputes drive up building-supply prices and raise housing construction costs. Likewise, disputes over paper products can be damaging. 

Early this year, the Commerce Department imposed steep tariffs of up to 32 percent on newsprint from Canada. That's boosted profits for the few remaining U.S. newsprint mills, but it's raised prices for hundreds of print publications. 

There’s a “fundamental difference” between tariffs on China and tariffs on Canada and Mexico, said Jeff Landin, president of the Wisconsin Paper Council. 

Tariffs on aluminum used for beer cans “does kind of hit home” in Wisconsin, Sensenbrenner said.

American brewers fill and sell about 36 billion aluminum cans and bottles per year. Those cans hold 62 percent of the beer volume sold in the U.S., according to the Beer Institute that represents the industry.

Aluminum cans are the single largest cost in U.S. beer production, according to an analysis from the economic research firm John Dunham & Associates.

“The aluminum tariff is a tax on beer and will have severe consequences for brewers,” John Dunham said.

Beer drinkers will “ultimately” bear the cost of it, he said.

By: Misty Williams of Roll Call

As drug overdoses climb — rising 12 percent between October 2016 and October 2017 — Congress has floated dozens of proposals to combat opioid abuse.

Some lawmakers have deeply personal connections to the epidemic of addiction in America. These are their stories.

Sen. Johnny Isakson

The future finally appeared promising after years of struggle for Isakson’s 25-year-old grandson.

Charley Joyner was poised to graduate summa cum laude with a mathematics degree from Georgia Southern University after getting treatment for drug addiction and remaining in recovery for several years.

But two nights before graduation, Isakson received a 3 a.m. phone call from his son, John, saying the police had found Charley’s body. He died of an opioid overdose.

Isakson said he had noticed personality changes. For years, Charley sought treatment — sometimes doing well, other times backsliding. The family knew there was a problem if Charley didn’t come home or his parents didn’t know where he was.

After Charley’s death, Isakson and his wife started a college scholarship fund in his name.

The family tragedy also helped fuel the Georgia Republican’s legislative efforts to combat the opioid crisis, focusing on prevention to help people avoid addiction in the first place.

“You want to try and help other people to avoid it if possible and help everyone be aware that it can happen in any household, at any time, at any place and to anybody,” Isakson said.

Charley was one of more than 900 Georgians who died of an opioid-related overdose in 2016.

Over the course of one year, the number of prescribed opioid doses surpassed 541 million, the equivalent of roughly 54 doses for every man, woman and child in the state, according to Isakson.

Last year, he supported a bill aimed at allowing the Department of Veterans Affairs to securely share data with state prescription drug monitoring programs for patients prescribed opioids by VA providers. It was signed into law in November.

Last month, he introduced a bipartisan measure, along with Sens. Dean Heller, a Nevada Republican, and Robert Menendez, a New Jersey Democrat, that would require the Department of Health and Human Services and the Centers for Medicare and Medicaid Services to develop a plan to prevent opioid addiction and increase access to medication-assisted treatment.

Charley was doing well in school and working before his death; his family was excited about his prospects, Isakson recalled during a recent Senate Health, Education, Labor and Pensions Committee hearing.

“Addiction is the big problem,” he said. “Charlie was a great kid, as smart as he could be, but he was hooked. And no matter how long you stay out in recovery and free of drugs, it only takes one.”

Rep. Debbie Dingell

Dingell has experienced first-hand the complicated challenges addiction presents for families.

Her father was addicted to opioids, among other drugs, and her little sister died of an overdose at age 44.

But the Michigan Democrat said she believes efforts to limit access to prescription opioids shouldn’t go so far that they prevent patients with legitimate needs from getting the medications to help them.

Dingell’s husband, 91-year-old former Rep. John Dingell, suffers from chronic pain, a result of joint deterioration and numerous surgeries. He is cautious and doesn’t want to take the pills if he doesn’t have to, but he needs relief, she said.

“When I go to the pharmacy to pick up his pills, people say to me, you need to do something. We are demonizing people who are taking pain pills,” she said. “People with legitimate needs need to be able to get their medicine and not feel like a villain.”

Dingell has called on her fellow lawmakers to help spur research into alternative treatments for pain.

In February, she introduced a bill that would give the National Institutes of Health new authorities to better partner with innovative companies exploring new ways to address the opioid crisis and other public health threats. Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander, a Tennessee Republican, and ranking member Patty Murray, a Washington Democrat, have introduced companion legislation in the Senate.

Removing the stigma around mental health is also a priority for Dingell.

People self-medicate with drugs and other substances to deal with conditions like depression and anxiety, yet the country’s mental health system has been systematically destroyed over the years, she said.

She co-sponsored a bill, known as Jessie’s Law, which would allow doctors to better access a consenting patient’s addiction history to inform their treatment. The measure was approved by the House Energy and Commerce Committee in May.

Talking about her personal ties to the overdose crisis is still hard for Dingell, but she sees the need to put real faces on how drugs devastate families across the country.

“I would never have had the courage to talk about this 10 years ago. You just didn’t. It was an embarrassment. It was a stigma,” she said, adding that the world has changed. “I talk about it honestly because we need to help each other.”

Rep. Earl L. “Buddy” Carter

Carter’s unique perspective in Congress as its only pharmacist informs his views as he and fellow legislators work to address opioids.

Before entering Congress in 2015, the Georgia Republican spent 30 years filling prescriptions and running a pharmacy business that grew into three locations around Savannah. As a state senator in 2011, he successfully sponsored a bill to launch a prescription drug monitoring program in Georgia. In the 115th Congress, Carter joined the Energy and Commerce Committee, which oversees health care policy.

During his time behind the pharmacy counter, Carter said he observed a shift in opioid prescribing practices. It became obvious when a patient had been to a doctor running “pill mills” — clinics in which physicians write prescriptions in exchange for cash without delivering any true medical care. Such clinics often flood a community with drugs.

“They’re infamous for dispensing the holy trinity of drug abuse,” he said: oxycodone, the opioid painkiller; Xanax, an anxiety treatment that, when mixed with opioids, can increase the risk of overdose and other harms; and Soma, the muscle relaxant.

Patients would come in with prescriptions for 180 doses of each of those drugs, Carter said.

“You know right then it’s a pill mill,” he said. “You’re not getting any medical benefit from those three prescriptions in that combination in that quantity.”

While those kinds of prescriptions could be a red flag, especially if they came from out of state, Carter said it was not always easy to tell if a prescription was legitimate.

“When you’ve got a prescription just for oxycodone, who am I to say that the long-haired, body-pierced, tattooed guy is not in pain? I can’t profile like that. I don’t know that he’s not in pain. That’s unfair to expect for us to be law enforcement officers,” he said.

That’s why Carter is backing a bill to help train pharmacists on when and how they can reject suspicious prescriptions. It would require the administration to develop training materials on circumstances when pharmacists can decline to fill a prescription for a controlled substance if they suspect it’s fraudulent or is meant to be abused or diverted.

The bill was marked up by the Energy and Commerce Committee in early May and is likely to be in the package of bills the House is aiming to pass this month.

“The only thing worse for me, as a pharmacist, than filling a prescription that’s going to be diverted or abused, is not filling a prescription for a patient who truly needs it,” Carter said. “Now that keeps me up at night.”

Rep. Ann McLane Kuster

When she founded the Bipartisan Heroin Task Force in 2015, Kuster didn’t realize she would eventually join the many families trying to help loved ones struggling with addiction.

At first she thought the painkillers her brother was taking after receiving two hip replacements were fine because doctors prescribed them. But the New Hampshire Democrat became increasingly concerned about the length of time and doses he was taking.

“I had known that the opioid crisis cuts across all demographics, but there is a real feeling of helplessness when it happens to your family,” she said.

The biggest challenge in getting her brother help was finding a treatment program that would take him, Kuster said. Many facilities wouldn’t accept him because he was medically compromised, but the surgeon couldn’t finish the surgeries he needed because he was dealing with a substance use disorder, she said.“It was a Catch-22.”

Eventually, the family connected with a care coordinator and her brother entered a 28-day residential treatment program. But many families aren’t successful in finding effective treatment or long-term recovery for their loved ones, she said.

New Hampshire had the second-highest rate of opioid-related overdose deaths in the nation with 35.8 deaths per 100,000 people in 2016, driven largely by the use of fentanyl and other deadly synthetic opioids, according to the National Institute on Drug Abuse. That’s nearly three times higher than the national rate of 13.3 overdose deaths per 100,000.

On May 8, Kuster and Rep. Carlos Curbelo, a Florida Republican, introduced legislation that would require the Department of Health and Human Services to develop an evidence-based practices toolkit for hospitals that receive payment under Medicare Part A in an effort to help reduce opioid misuse.

The high rate of prescribing has been a factor driving the opioid epidemic, Kuster said.

“This legislation will give prescribers and hospitals access to more information about best practices and alternative pain management techniques that can help prevent people from suffering from substance misuse in the first place,” she said.

Sen. Ron Johnson and Rep. Jim Sensenbrenner

Johnson and Sensenbrenner both found themselves moved by the story of a Wisconsin mother whose 19-year-old son died of a heroin overdose in 2014.

Laurie Badura’s son, Archie, started experimenting with marijuana in high school, but turned to opiates, and ultimately heroin, after he graduated. He overdosed in January 2014 and stayed clean for 77 days, Badura recounted earlier this year on a podcast that Johnson’s office runs.

“He swore he would never do it again, and I believed him. He believed himself,” she said. “This thing just came inside and caught him, and it took us all off guard that terrible morning.”

Badura eventually set out to help other families and their loved ones dealing with addiction by starting a nonprofit called Saving Others for Archie, or SOFA.

Sensenbrenner and Johnson, both Wisconsin Republicans, paid homage to Archie with their companion bills named the Stopping Overdoses of Fentanyl Analogues, or SOFA, Act.

The measures would give the Drug Enforcement Administration authority to deem certain fentanyl analogues as Schedule 1, a classification for drugs such as heroin that have no medical use and a high potential for abuse.

They would also allow the DEA to immediately schedule new fentanyl variations as they pop up, instead of having to first issue a temporary scheduling order, which can sometimes make criminal prosecution difficult.

“It is a big, big deal,” Sensenbrenner said. “Currently, it’s a hole in the law enforcement response to opioids … big enough to drive an 18-wheeler truck through.”

Fentanyl and fentanyl analogues accounted for more than 20,000 deaths in 2016, representing roughly 30 percent of all drug overdose deaths in the U.S. that year, according to the National Institute on Drug Abuse.

Johnson himself lost a nephew to a fentanyl overdose in 2016.

“It’s affecting every community, potentially any family,” he said. “Nobody’s safe.”

Sen. Tammy Baldwin

For years, Baldwin traveled throughout her home state of Wisconsin talking with families devastated by the opioid crisis and thinking how close to home for her those stories hit.

But it wasn’t until 2017 that she began sharing her own story about growing up with a mother who also suffered from drug addiction and mental illness.

“I know how hard this fight is,” she said recently. “And yet, I have been reticent to share my own story because I know that my mother felt the stigma.”

Baldwin shares her story now, in part, to help fight against the shame people feel about drug addiction.

As early as she can remember, the Democratic senator knew her mother struggled. Baldwin’s grandparents raised her in Madison and would take her on Saturdays to visit her mom.

Sometimes she was great; sometimes she would sleep almost the entire time, Baldwin recalled.

“I remember what it was like to come home from school and not be able to get into the house,” she tells viewers in a new TV ad. “I’d pound on the door but my mother wouldn’t answer. She’d be passed out inside.”

Baldwin said her personal experience drove her to focus on helping improve access to substance abuse treatment and promoting prevention in schools.

She also sees the need to give states more flexibility in how to use opioid grant funds appropriated by Congress because the overdose epidemic is larger than just one type of drug.

Methamphetamine and heroin are big problems in Wisconsin, Baldwin said.

“People who overdose have in their system all sort of drugs,” she said.

Baldwin doesn’t believe that a 2016 opioids-related law that Congress cleared did enough to help states and local communities fight broader drug abuse issues, not just those related to opioids.

The treatment for people with an opioid addiction is pretty specific in terms of blocking certain receptors to prevent highs, but those don’t work for meth addicts, she said.

“This can’t be just for opioid addiction,” she said.

By: the Tax Free Insider

If a congressman holds a listening session and only one constituent shows up, is it a failure of participatory democracy or a fine example of the beauty of the democratic process?

Craig Gilbert, a political reporter for the Milwaukee Journal Sentinel, kicked off the question this week when he tweeted this photo of Rep. Jim Sensenbrenner talking with Dave Mantz, the only person who showed up.

Went to GOP Cong. Jim Sensenbrenner’s town hall this morning in the Wisconsin town of Rubicon (pop 2,249) and just 1 constituent showed up. Dave Mantz had the floor to himself. The two politely discussed their differences on net neutrality … then discussed them a little more — Craig Gilbert (@WisVoter) June 4, 2018

Mantz was there to talk about net neutrality, a subject on which he and the congressman disagree.

Sensenbrenner has held 41 meetings with constituents so far this year, according to Gilbert. He’s one of the few Washingtonians still holding them.

“I went to his town hall in Hartford Sunday night that drew 22 people. His town halls in Neosho and Lebanon Monday morning drew four and one respectively, according to an aide, Gilbert writes.

Whether these things do any good at all in the age of big money is debatable.

And this one was held in a small town where people go to work during the day in a district that is about as safe for the incumbent as any.

Still, it feels as though there’s a disconnect between the non-stop political coverage of news organizations 10 weeks before a primary, and the willingness of potential voters to care about any of it.

By: Scott Shackford of Reason

Five years ago The Guardian published the first of what would be a bombshell series of stories about how the United States (and several other Western countries) were engaged in the mass surveillance of their own citizens, collecting millions upon millions of telephone and internet records.

It wasn't the first time the feds' saw some of their secret tech surveillance exposed—you may recall the revelation of AT&T's secret room 641A, for example—but now Americans got provided evidence of how far-reaching this surveillance was. It became very clear that the targets included all of us.

The name of the source behind the story was initially kept secret, but he soon revealed himself to be a government contractor named Edward Snowden.

Since then, Snowden has become a household name—even as he remains stuck in Russia, wanted on espionage charges in the United States. The Guardian and The Washington Post won Pullitzer prizes in 2014 for their reporting based on the documents Snowden provided.

Five years later, it's worth looking at the legacy of Snowden's revelations.

The Snooping Hasn't Really Stopped—But There Have Been Changes: Among the revelations that emerged from Snowden's leaks was how much of the surveillance was based on secret interpretations of federal laws. Section 215 of the PATRIOT Act allowed the Foreign Intelligence Surveillance Act (FISA) Court to grant the feds approval to secretly collect information from third parties during terrorism investigations. The Department of Justice turned out to have secretly interpreted this section of the law as an authorization to collect the metadata records of millions upon millions of Americans.

This interpretation was so far afield of the law's intent that Rep. Jim Sensenbrenner (R-Wis.), who crafted the PATRIOT Act, publicly denounced it. And released reports from the FISA Court indicated it sometimes was not fully aware of how extensive the federal data collection reached. Other courts subsequently ruled that this mass data collection was not authorized.

In 2015, Section 215 of the Patriot Act was set to sunset, and a pack of legislators—most famously Sen. Rand Paul (R-Ky.)—moved to block it from being renewed. They succeeded, and it was replaced by the USA Freedom Act.

The USA Freedom Act did not, unfortunately, eliminate mass metadata collection. But it did set up actual guidelines that required government investigators to use specific search terms when attempting to look at metadata in records collected by phone companies. The new law also called for annual reports that give Americans a sense of how much secret surveillance is happening. The reports are vague and incomplete, but they're more than we were getting previously.

Americans Learned What Metadata Is and Why It Mattered: When Snowden's leaks first started, President Barack Obama and many lawmakers insisted that "Nobody is reading your email." This became a mantra among those trying to downplay Snowden's revelations.

It was a deliberate attempt to distract from the reality that we were all leaving electronic fingerprints everywhere we went and every time we communicated with each other. The government was collecting all our metadata—information about where, when, and to whom we were communicating. They were collecting everything but the conversations themselves.

Back in the days of Ma Bell, we thought of "metadata" as simply information about who we were calling and for how long we were talking. These days we all keep huge chunks of information about our lives on our computers, tablets, and smartphones. Experiments have demonstrated that, based on just your metadata, observers can reconstruct a good part of your life and your relationships with others.

This realization about how much privacy we're losing via our metadata has played out as we worry about government track our social media use—and as we become more aware of the ways that police (and not just federal police) are trying to keep track of our behavior through such tools as license plate readers and facial recognition.

Efforts to Push Forward with Increased Tech Surveillance Get Pushback: Many citizens and even lawmakers aren't accepting the idea that every form of surveillance that the government demands is necessary. Some states have passed laws requiring police to get warrants in order to track cellphone location data. The question of whether this tracking violated the Fourth Amendment is now under review by the Supreme Court.

Senators have warned the Department of Homeland Security about using facial recognition software to scan Americans boarding international flights. In California, lawmakers are currently considering legislation requiring police to get permission from their local government before implementing new surveillance technologies.

But other officials keep pushing and pushing to implement more surveillance tech, even as the public resists. Immigration enforcers want access to the data the feds have collected. Officials want to use facial recognition systems when monitoring protests via drones, and to combine such systems with police body cameras. Police in Miami Beach are willing to cause massive traffic jams in order to scan everybody's license plates while searching people with warrants. New York Gov. Andrew Cuomo wants to use facial recognition tools on cashless toll roads to identify drivers.

There are stories every day about officials wanting to use technology for surveillance. While some of the news coverage may fall on deaf ears, Snowden's information has been valuable to help people grasp that whenever the government starts spying, the surveillance will probably be broader and deeper than they actually tell us.

New Encryption Fights Begin: Back in the 1990s, the feds fretted about encryption on personal computers. Their efforts back then to limit our access to encryptionfailed.

Fears of terrorism having given new life to that old fight against encryption. Officials want access to locked phones or other secured devices belonging to people who have allegedly committed crimes, but encryption makes it harder for law enforcement to get in.

For many officials, the public push has been to try to force tech companies to compromise data security by creating so-called "backdoors" that bypass tech encryption or to otherwise provide access on demand. In the wake of the terrorist attack in San Bernardino, California, the FBI had a court fight with Apple over its efforts to force the company to give it access to an iPhone in one terrorist's possession. While Apple resisted, the FBI managed to get access with the assistance of a third party. It turned out later that the FBI was deliberately looking for a fight to try to establish a precedent.

Privacy and technology experts have warned us over and over that compromising encryption means rendering all of us vulnerable to breaches from anybody who gets their hands on these encryption keys or figures out how to mimic these access mechanisms. Weakening encryption would make everyone susceptible not just to government snoops—ours or those working for malicious foreign governments—but to hackers with identity theft or other crimes in mind.

Many officials demanding an encryption bypass simply refuse to entertain the possibility that this would expose citizens to greater threats. Nor are they understand the ways Snowden's disclosures have made Americans more skeptical about giving them access in the first place.

But tech companies keep pushing for stronger mechanisms to keep users' data secure, regardless of the wishes of government officials. Snowden's own email provider, Lavabit, shut down in 2013 rather than comply with the government's demands for the encryption key that would let it access Snowden's communications. Founder Ladar Levison resurrected the company in 2017 with end-to-end encryption that makes it much harder for the government to force its way in.

The Trumpification of the Surveillance Fight: After Donald Trump became president, the surveillance fight took a strange turn. The FBI had gotten the FISA Court's authorization to snoop on Trump campaign aides in order to probe connections with foreign countries—Russia in particular. As the special investigation plays out, Trump and his supporters have decried the use of these secret surveillance tools against people close to him.

This could have been an opportunity to discuss how the federal government engages in secret snooping against the citizenry in general, how this could be corrupted for political purposes, and why that would be a good reason to limit the feds' surveillance powers.

But that conversation did not happen. Indeed, some of the people crying the loudest that the "deep state" is coming after Trump also believe that Snowden committed treason by exposing federal surveillance. Rep. Devin Nunes (R-Calif.), a conservative lawmaker who frequently insists the FBI's investigation of the president is politically motivated, is a huge fanof government surveillance on you. He just doesn't like it when Trump's the target.

This preference for simply protecting Trump rather than having an actual surveillance debate became clear when Section 702 of the FISA Amendments came up for renewal last year. Section 702 is another law that's been commandeered for domestic surveillance even though its stated purpose is to fight foreign terrorism and espionage. During the debate over renewing it, civil rights activists and privacy-minded lawmakers tried to force reforms. But despite all the yelling about spying on Trump that was taking place at the exact same time, most Republican lawmakers (Nunes included) voted not only to renew Section 702 but to expand its ability to target Americans.

Utlimately, Snowden's biggest accomplishments were to bringing the surveillance debate to the forefront and to encourage tech companies to ramp up their encryption and other security efforts. In the July Reason, Elizabeth Nolan Brown explains how you can encrypt your own communications. The fact that strong encryption tools are becoming more available to average internet users is one thing we can all thank Snowden for.