▶ 0:01:03Oh my god.
▶ 0:14:33statement. Today's markup is yet another important opportunity for our committee to advance legislation that supports the most vulnerable Americans by by reauthorizing key programs to combat substance use disorder and safeguarding seniors access to prescription drugs. We reaffirm our commitment to strengthening our health care system and expanding access to care for patients and their families.
▶ 0:14:56Last Congress, each of the six bills being considered today advanced through this committee unanimously and passed the House with strong bipartisan support. Our members devoted countless hours collaborating with healthc care providers, policy experts, and patients to develop these pieces of bipartisan legislation, and I look forward to moving all of them forward.
▶ 0:15:15Once again, the Support Act for Patients and Communities Reauthorization Act, which I am co-leading with Congresswoman Patterson, has received widespread support from over 160 vital substance use disorder treatment and recovery organizations, as well as patient provider advocacy groups.
▶ 0:15:34This legislation reauthorizes key public support programs focused on prevention, treatment, and recovery for patients with substance use disorder that were established in the original support act, which was signed into law in 2018. Similarly, the Soore to Health and Wellness Act led by Representatives Carter and Cohen will continue vital resources so local communities can help support individuals who have have experienced trafficking. Another important measure, the Charlotte Woodward. Wave your hand.
▶ 0:16:03Uh, welcome. Welcome back. I should say you sat through the long markup the other day. We're glad to have you back and have this move forward today. So, thank you for your uh patience and your persistence. We really appreciate you very very much. Um, so this has been this the bill that you're here to support is led by Representative C.
▶ 0:16:25Kamik, Dingle, Isa, Washerman, Schultz and ensures access to life living life live life lifesaving care by preventing discrimination against individuals with disabilities including Down syndrome with the organ transplant system.
▶ 0:16:40The Shandra Aizena Act, Human Cell and Tissue Product Safety Act, led by Representatives Mulinar and Dingle, will support provider and patient education awareness, as well as strengthen standards and oversight related to tissue transplants to prevent future outbreaks and preventable tragedies. In addition, the Women and Lung Cancer Research and Preventive Service Act aims to accelerate research, improve early detection methods, and expand access to preventive services to address the rising rates of lung cancer.
▶ 0:17:10Lastly, the Seniors Access to Critical Medications Act, led by Representative Harshburgger and Washington Schultz increases access to care by allowing Medicare beneficiaries to receive their prescriptions either by mail or by having a family member or caregiver pick up the medication on their behalf. All of these bills reflect our commitment to improving Americans health, protecting the most vulnerable, and strengthening our health care system. I'm grateful today to all of my colleagues who have supported this legislation.
▶ 0:17:38Thank you for all your hard work and I look forward to advancing these important bills out of committee. I will now recognize the gentleman from New Jersey, Representative Palone, the ranking member for five minutes for an opening statement. I yield back my time and recognize the chair. Thank Thank you, Mr. Chairman. Today, committee Republicans are bringing up six health bills that we were supposed to mark up earlier this month. Republicans continue to schedule committee markups as if these are normal times, but they're anything but normal.
▶ 0:18:06The daily chaos and illegal activity that we're seeing from the Trump administration is not business as usual. And yet, committee Republicans are looking to move the Support Act today while the Trump administration is simultaneously dismantling the very agency that is responsible for supporting substance use prevention, treatment, and recovery. A few weeks ago, the Trump administration fired hundreds of staff across the Substance Abuse and Mental Health Services Administration, or SAMA.
▶ 0:18:36administration refuses to tell us exactly how many people were fired, but we know that key senior officials, including directors of the Center for Mental Health Services, the Center for Substance Use Prevention, and the Center for Substance Abuse Treatment, were reportedly terminated. The administration is eliminating entire offices, including the offices responsible for collecting data on mental health and substance use and helping people locate treatment services.
▶ 0:19:01By eliminating these offices, the administration is making it harder for people seeking treatment to find to find care. And the Trump administration is also taking back essential funding that states rely on for mental health and substance use programs through block grants. This committee has taken a lot of bipartisan action over the last decade to combat the drug overdose crisis. But it's deeply disappointing to watch as Republicans silently stand by as the Trump administration slashes a billion dollars in mental health and substance use funding.
▶ 0:19:31These dollars were already promised to states and rescending them arbitrarily will wreak havoc on their efforts to address the overdose crisis. Now, some states will not be able to fill the funding gap. Providers will go unpaid and Americans will suffer. And yet, this does not seem to matter to the Trump administration or to congressional Republicans. So, let me be clear. These funding decisions will have disastrous and deadly consequences on the millions of Americans impacted by substance use disorder.
▶ 0:19:59And to make matters worse, a leaked internal budget proposal showed that the Trump administration intends to eliminate eight of the programs that the Support Act reauthorizes. This includes programs to train first responders who respond to opioid overdose calls, provide residential treatment to pregnant and postpartum women, and support people in long-term recovery, among others.
▶ 0:20:21So again, it's Congress's job to ensure that Department of Health and Human Services and SAMA can continue their critical work and that authorized programs are not being arbitrarily and illegally slashed. The support act reauthorizes important programs to address substance use, but it will not support but I can't, frankly, Mr.
▶ 0:20:42Chairman, I can't support the reauthorization of the support act because I have no confidence that my Republican colleagues will actually stand up to President Trump and prevent him from taking additional illegal actions that undermine the support act. To date, committee Republicans have not conducted any oversight of this administration. And that's a glaring dereliction of their duty in my opinion, and it's long past time for Republicans to begin conducting the oversight necessary to ensure that these programs are faithfully implemented.
▶ 0:21:12Once again, congressional Republicans are showing that they're willing to overlook just about anything, including creating chaos across the federal government and decimating programs they claim to care about in order to appease this unhinged administration. Even worse, reports suggest that my Republican colleagues want to pass a bill to codify these cuts. Republicans are literally turning their backs on the American people while communities continue to battle the opioid epidemic to fund tax cuts. All this obviously to fund tax cuts for billionaires.
▶ 0:21:41And so my Republican colleagues are also moving the support act while simultaneously undertaking massive efforts to gut Medicaid to pay for tax breaks for billionaires and big corporations. Medicaid is the single largest payer in the country for behavioral health services, covering 40% of all Americans with opioid use disorder. The cuts being proposed will leave billions of Americans with substance use disorder without access to life-saving care and so many other Americans doing their best to get by with very little.
▶ 0:22:11So, I believe if my Republican colleagues want to actually support substance use disorder response efforts, they will stop all efforts to cut Medicaid. We'll see what happens, Mr. chairman. But in any case, I can't support the reauthorization of the support act for all these reasons and I yield back the balance of my time. Thank you. The gentleman yields back and the chair reminds members that pursue it. To the committee rules, all members opening statements will be made part of the record. Are there further opening statements?
▶ 0:22:40Seeing none on the Republican side, on the Democrat side. Seeing none, oh, excuse me. Gentleman from New York, you're recognized for three minutes. Thank you, Mr. Mr. Chair, um following the uh firings of probationary workers at SAMA, I heard from about 50 SAMA employees who were fired and reached out to me with concern for the communities that they serve.
▶ 0:23:04For weeks, I reached out to the administration and still have received no answers on which divisions were impacted and how the work at SAMA will continue. As of this month, we have lost 50% of SAMA staff. And it's not HHS and it's not the Trump administration who shared that with Congress. We only have confirmation from the press and from the former SAMA employees. That I believe is totally unacceptable. Currently, we have not received answers from HHS to key questions.
▶ 0:23:34How many people remain at the Office of Recovery? What about the 988 hotline? What about the Center for Mental Health Services? What about the Center for Substance Use Prevention? the center for substance abuse treatment, the regional offices. What programs have they had to cut in local communities, the lock zone access, in suicide prevention? As the energy and commerce committee that has jurisdiction over SAMA, how do we not have these answers?
▶ 0:24:02This affects every community in the country and our first action should be finding out these answers. If the administration refuses to come in, then let's bring in the fired employees. These people are some of the most dedicated public servants who did this work for all of the right reasons and they've served an incredible need. That need is even growing. On behalf of all Americans, I thank all of the fired SAMA employees for their service to our nation. You deserved better.
▶ 0:24:31And frankly, all Americans deserve better. Our loved ones should have access to effective addiction treatment, to prevention and recovery support, to behavioral health support and services. The recent actions of this Trump administration are betraying the goal of access to behavioral health treatment and support. Like everyone on this committee, I support the programs in this package.
▶ 0:24:53But it's completely disingenuous and frankly outrageous that Republicans are here today trying to pat themselves on the back as doing something meaningful for those struggling with addiction. While the entire agency we are authoring programs for is being dismantled, the people doing the work we are authorizing have all been fired and the administration is proposing even more draconian cuts for mental health and substance use programs in the 2026 budget. Give me a break. It's like we're trying to heal a bullet wound with a band-aid.
▶ 0:25:24So, I'm regrettably regrettably going to have to vote no and would respectfully ask my Republican colleagues to pause today's markup and instead focus our intention on responding to what is an actual crisis at SAMA. With that, Mr. Chair, I yield back. Thank you. And the gentleman yields back. Any Republican members? Any further Democrat members? If the committee would indulge me for a minute, it reminded me when I saw Mr. Tonko speak. Uh, we were elected together in 2008 along with Jerry Connelly.
▶ 0:25:53And I just want to bring the attention I think some of you saw that Jerry may be having to step down and I just want to say thoughts and prayers of this committee and all of us are what what a wonderful man he is and we're all thoughts and prayers are with him right now. So um God bless him. So having said that, I'll seeing no further opening statements.
▶ 0:26:17Um the chair calls up HR2483 and ask the clerk to report HR 2483 a bill to reauthorize certain programs that provide for OP. Without objection, the first reading of the bill is dispensed with and the bill would be open for amendment at any point. So ordered and we will discuss the AIS. So the chair has an amendment at in the nature of a substitute at the desk and the chair cler clerk will report the Amendment in the nature of a substitute to HR 2483 offer. Without objection, the reading the amendment is dispensed with and the chair is recognized for five minutes in support of the amendment.
▶ 0:26:48And I want to recognize myself to speak on the ANS which makes technical changes to the underlying bill. For far too long, Americans have witnessed the unprecedented rise in drug overdoses and substance use disorders creating an imminent need for prevention, treatment, and recovery services. The support for patients and communities reauthorization act has longstanding priority for me and all the members of this committee and this bill would reauthorize essential public health programs focus on prevention, treatment and recovery for patients with substance use disorder.
▶ 0:27:18Last Congress, we had opportunities to hear from experts on the importance of this legislation along with countless family members affected by substance use disorder. I remember hearing from a father who had the strength to testify before the committee about the passing of his daughter following an opioid overdose and the foundation that he and his wife established in her name. Too many of our constituents have similar stories and these stories matter. These patients matter and these families matter.
▶ 0:27:47I am very proud of the bipartisan work that went into crafting this vital legislation which includes priorities for members on both sides of the aisle. We also received support from more than 100 advocacy organizations who use our collective voice to prioritize prevention, expand treatment options, and enhance recovery services for individuals with substance use disorder. The Senate is prepared to take action on this bill, and I am glad that our bipartisan efforts will bring muchneeded support to the states, organizations, and families fighting this epidemic.
▶ 0:28:18Our efforts should not stop here. We should build off this momentum to continue helping families with substance use disorder, and co-occurring behavioral health conditions like serious mental illness, suicidal uh prevention, gambling addiction, among others. Our constituents are counting on us and urge my colleagues to support the underlying bill and the amendment and the underlying bill. And I yield back and recognize the ranking member for five minutes to speak on the Hannes. Thank you, Mr. Chairman.
▶ 0:28:46And you know, I don't want to take away from your efforts to be bipartisan, but I'm sure you heard from both my opening statement and what Mr. Tonko said that we cannot support moving the support act while the Trump administration de decimates SAMA. I mean, literally firing hundreds of workers, leaving entire offices without staff, cutting essential funding to states for mental health and substance use services, and dismantling the AY's entire structure.
▶ 0:29:14So, I have to ask you, um, chairman, the Trump administration intends to cut many of the programs and support act, including the comprehensive opioid recovery centers, which is a program that you led the reauthorization for. So, what are you going to do to hold the Trump administration accountable and ensure that these programs are actually funded? Otherwise, I don't see the point of moving the bill today. What what what are you going to do to address these? So, general yield. Yes. So, so thanks for that. and and we're these are bipartisan priorities.
▶ 0:29:44It's the priorities of of of all of us to make sure these are implemented and move forward. If the administration can present to us a way they can do it more efficiently and better, I think we're all open to government efficiency. We want to hear from them.
▶ 0:29:57But what I will tell you, we are going to use our oversight because now we're talking about what, you know, proposals that aren't out yet, proposals that may come out soon, but we want to make sure that that we pass the legislation we need to pass and we will have oversight to make sure it's done effectively and if they can do it more efficiently, uh, support that, but we're going to make sure that that these services are there. We'll have oversight of that. Well, is that a commitment to holding a hearing and having the secretary testify as to why he's proposing these changes? I'd like that commitment from you.
▶ 0:30:28Well, we are we do like in every time a budget is presented, we have secretaries testify and we we have plans to do that. Right. But I mean that's not the same thing as holding a hearing specifically on SAMA. That's what I'm asking about. I mean look, you guys on the Republican side and you know constantly talk about how you want to address this. If the kinds of things that we're hearing happen, I would expect you'd have a hearing and ask the secretary to testify about these SAMA cuts. That's what I'm asking for.
▶ 0:30:57Well, so I know that in previous hearings you've talked about his NIH issues and other things that they had and so we plan to have him before so we can talk about any everything you asking questions on on any of your concerns, not just SAMA, but we do expect him to testify. Well, can I ask you, do you think that the president has the authority to simply cut programs or not fund programs that Congress has provided funding for like SAMA? What's your view on that?
▶ 0:31:21our our work is to put this into law and have oversight and if they can do it more efficiently they can and see their legal basis for doing it but we will conduct oversight. One of my commitment is what have what we have in this bill we want implemented and make difference in people's lives and we'll conduct oversight to make sure that happens. But you see I I disagree strongly with your response at this level.
▶ 0:31:44I do think that what the president is doing is simply cutting these programs and not funding these programs the way Congress has provided for. And I don't think that he has the authority to do that. I think we do need more accountability because the administration's actions are illegal. The courts in most cases have overturned a lot of their actions and Congress as a co-equal branch of government has to conduct oversight over whether these actions are lawful or not in addition to whether or not he wants to reorganize.
▶ 0:32:15But look, I would just urge my you, Mr. Chairman, and my Republican colleagues to join us and support Democratic amendments that would address this administration's unlawful and harmful cuts to SAMA, which we're going to propose today. uh the dismantling of the agency without congressional approval and unauthorized cuts to the mental health and substance use abuse block grants and the programs reauthorized and support.
▶ 0:32:40All these actions by the administration I think are illegal and these amendments that we're going to propose would provide much needed oversight of the Trump administration which unfortunately so far my Republican colleagues are not willing to do that oversight uh even as the administration you know makes these changes. So again, I uh I'm going to continue to ask for your support for what I consider a real oversight that would come from these amendments. And with that, I yield back the balance of my time, Mr. Chairman.
▶ 0:33:10Thank you. The gentleman yields back. Is there further discussion? Is there further discussion? The gentle lady from Colorado recognized for five minutes to discuss the AS. Thanks, Mr. Chairman.
▶ 0:33:25Um, as I said in the last time we attempted to mark up these bills, I think it's disgraceful that we're considering just one piece of the bipartisan biccameal healthc care package that was included in the um in the CR last fall and then stripped out unceremoniously by Elon Musk and leaving the rest behind. um when Democrats offered an opportunity to move the the package in this committee on April 8th, the Republicans voted it down.
▶ 0:33:56And I want to speak on behalf of every dedicated advocate who has tirelessly worked on bipartisan legislation that we all care about like the Give Kids a Chance Act to improve the reach of the Special Diabetes Program, reauthorized the Preventing Maternal Death Act, and so many other bills that I haven't really been able to ascertain why we're not taking up.
▶ 0:34:22Now, every earlier this month, the majority of this committee voted against every single one of these priorities. And I don't know why I don't know why. We just can't take the health package that this committee passed in a bipartisan way, pass it out of committee, put it on the floor. We all agreed on it. So, let me talk about this bill for a minute. The support act reauthorization, which I and most people on this committee did support as part of the December healthc care package.
▶ 0:34:53I'm confused that we're working on the support act while the administration is actively working independently of Congress to undermine its aims. Meanwhile, as as Mr. Palone just said Republicans on this committee aren't remotely interested in holding a hearing conducting oversight on the reckless and unlikely law unlawful activities of Doge and of President Biden or President by President Trump. Donald Trump, Elon Musk and RFK Jr.
▶ 0:35:23have now, as Mr. Tonko said, gutted SAMA and hollowed out its workforce. The agency is now reduced to about half of what it was before Donald Trump took office. We don't know how many dedicated public servants the agency lost because RFK's Department of Health and Human Services, the least transparent in my 28 years in the US Congress, refuses to tell us. SAMA had been succeeding.
▶ 0:35:52In President Biden's final years in office, overdose death declined by 17%. Overdose death declined by 17%. He inherited a drug crisis from Donald Trump where overdoses were increasing 31% from year to year.
▶ 0:36:11So now because of Doge and RFK Junior's actions that that progress seems to be reversing and it seems to be um undermining the very programs that the support act reauthorization seeks to do. So I don't know. It's it truly is fiddling while Rome burns. Why are we marking up this legislation while we're not having any desire to see if the underlying programs are actually being carried out by the administration?
▶ 0:36:41So, it's not just the administration undermining the support act and its goals. As at the same time as we mark up the legislation today, they're also working to cut Medicaid, which is the dominant payer for behavioral health services, including substance abuse disorder services nationwide. 35% of all Medicaid recipients have a mental illness, including substance use disorder. So when we cut Medicaid, that imperils their care.
▶ 0:37:10In fact, a major impediment to making substance use disorder care accessible to everybody is 10 states refusals to expand Medicaid. So let me be clear, the support act is good legislation. I expect most of us will vote for it today.
▶ 0:37:27But while the majority is holding a bipartisan deal hostage, refuses to hold the administration accountable or provide any oversight whatsoever and actively guts works to gut Medicaid, which is the backbone of substance disord use disorder treatment. I've got to say we got to get back to regular order to be true to our words and to stand up truly in actions, not just in words, for our constituents. and I yield back.
▶ 0:37:58Thank you. The gentle lady yields back and the chair will recognize the gentle lady from Iowa, Dr. Miller Meeks, for five minutes to speak on the AIS. Uh Mr. Chairman, I move to strike the last word. Uh thank you, Mr. Chairman. Um I'm proud to see the energy and commerce committee marking up the support act which has had tremendous impact on opioid and mental health epidemic in America. And let me also say that the uh number of overdose deaths reach their zenith under the Biden administration.
▶ 0:38:25And in fact, let's be true to our words and stop saying things like some people are trying to gut Medicaid, which we know is not happening and is not true and is a myth. So, having said that, I'd like to highlight a bipartisan initiative I've been working on for two years to complement this bill's efforts. According to the CDC, we lost more than 110,000 Americans to drug overdose deaths in 2022.
▶ 0:38:50It's estimated that 75% of these deaths involved opioids, meaning that 226 Americans died every day to opioids. While many cases of drugrelated deaths are poisoning where the individual does not know that the product they're about to use is laced with another substance like fentinil or synthetic fentinel, more needs to be done to prevent addiction, including minimizing unnecessary exposure to opioids.
▶ 0:39:1690% of acute pain patients receive opioids to manage their pain, whether or not they need them. Between 2011 and 2019, opioid prescriptions decreased by 40% from approximately 250 million to 150 million prescriptions dispensed. This is a true across this is true across most payer audiences, Medicaid, private, and cash payments. However, among Medicare patients, opioid prescribing has actually increased.
▶ 0:39:45Furthermore, Medicare's share of opioid prescribing during this time has increased substantially from approximately 20% of the country's opioid prescriptions in 2011 to 35% in 2019. This represents a 75% increase in just under a decade. We clearly have work to do in Medicare to make sure that patients have access to effective pain relief agents while also not unnecessarily exposing them to narcotic painkillers.
▶ 0:40:12One way to do this would be to increase access to nonopioid pain management medications or other entities which I'm seeking to accomplish with my legislation, the alternatives to pain act. This legislation, which I thank Congresswoman Baragun for co-leading, would decrease barriers to accessing nonopioid pain management alternatives that are FDA approved. I ask that the chair commit to working with me on this legislation to continue the great opioid use reduction work this committee has accomplished.
▶ 0:40:41Uh, I fully support the support act and thank you, Mr. Chair. I yield. Gentle lady, yield. Um, I'll yield. I thank the general lady for yielding. Thank you, Mr. Chairman. I wish to add my support for this important legislation before the subcommittee today. The support for patients and communities act is a comprehensive and bipartisan piece of legislation that provides support and builds on previous success.
▶ 0:41:08This legislation also includes a provision that mirrors the Mental Health Improvement Act, which I co-introduced with Representative Sykes last Congress, reauthorizing section 756F of the Public Health Service Act, which provides important grant funding for our behavioral health force.
▶ 0:41:27Investments like these in workforce development are crucial as communities across our country worked to tackle the scourge of addiction and the devastation it leaves behind in its wake. We worked extensively on this bill last Congress, including when this subcommittee went to Gettysburg, Pennsylvania, where we heard powerful and important testimony from my constituents. And I would again like to thank Mike Strawley, Chief Saraveola, and Dr.
▶ 0:41:54Crawford for their input and for ch for sharing their firsthand knowledge and experiences with opioids and with the addiction crisis that we are currently facing. We must continue this important work now by passing this bill through committee and getting it to President Trump for his signature into law. I urge the support of this bill and I yield back to the gentle lady. Thank you, Mr. Chair. I yield back. Gentle lady yields back. That is there anyone seeking further discussion?
▶ 0:42:25Gentle lady from New York, Miss Clark, you're recognized for five minutes to discuss the ins. Thank you very much, Mr. Chairman. I move to strike the last word. The leaders of this committee along with a biccameal group of congressional leaders negotiated a bipartisan endofear package which would have included this common sense legislation as a number of other as well as a number of other bills being considered at today's markup.
▶ 0:42:53Members of both parties were ready and willing to pass this package of bills, most of which went through the regular order in December of 2024. However, I am perplexed that we are even in a position to take these bills up today. Bills that should have been passed by both chambers of Congress and signed into law at the end of last year.
▶ 0:43:15Unfortunately, our colleagues across the aisle, whether due to fear or blind feely, killed the bipartisan bill negotiated by the leaders of this committee and many others on the orders of one man, Elon Musk. one tweet from the world's richest man and Donald Trump's biggest financial supporter and Republicans shriveled up right up and meekly allowed a weaker bill to pass. And now we are expected to sit here today and pretend everything is normal.
▶ 0:43:45It's not. It is not. Republicans want to use markups like this one to show the American people they are addressing the opioid epidemic and fighting to protect access to quality affordable health care, but won't say a word about the nonsensical decision to cut tens of thousands of employees at the Department of Health and Human Services.
▶ 0:44:10We can no longer sit back, excuse me, and trade support for each other's bills. let House GOP leadership use that bipartisan support to fill up the suspension calendar with only Republican bills and then simply hope that Elon Musk or whichever billionaire is calling the shots for Republican leadership on a given day will deem to permit Democratic bills to move forward.
▶ 0:44:38I'm done waiting on Republican leadership to magically grow the backbone they've been lacking since Donald Trump rose to power. I'm done letting my support for common sense legislation at the committee level be used as cover to advance Republican priorities while Democratic bills and priorities are routinely ignored and subject to the whims of the oligarch class. We can no longer act like it is business as usual here in Washington DC. That time is over.
▶ 0:45:05We are in a crisis and it's past time we start acting like it. Which is why even though I support these bills, I will be voting no. This time has come. The time has come to put an end to the business as usual approach we have taken to this point. And with that, Mr. Chairman. Thank you. And I yield back the balance of my time. The gentle lady yields back. Anyone seeking further discussions? Gentleman from California, Mr. Oonulti, is recognized for five minutes. Mr.
▶ 0:45:35Chairman, I move to strike the last word and speak. Gentleman is recognized. Uh, Mr. Mr. Chairman, I rise in strong support of the support act. This is a bipartisan bill that contains many of the policy priorities that have been passed by this committee over the last 12 months. And I'd like to thank you for including my bill, the 988 lifeline cyber security responsibility act in this package. As I think everyone on the dis here knows, the 988 lifeline has saved uh unquestionably thousands of lives since it's been instituted.
▶ 0:46:03It's fielded over 10 million calls uh in it its short lifetime. uh and yet that lifeline has been taken down recently by a cyber security attack. This uh provision in the bill would uh shore up the cyber security of the lifeline by improving coordination and communication between various reporting entities. This is a common sense piece of legislation and I'd like to thank you uh for including it. And just to make the point this is most of the the bills we're considering today are bipartisan. They're common sense.
▶ 0:46:32Folks, this is not a referendum on one's support for the Trump administration. And I've served on this committee in the majority and the minority in the White House. And uh I think we need to focus on voting on the policy and focus on the things we can agree on. And uh it really hurts my heart to see uh some of the the bickering that's going on here. And I wish we would just uh be able to focus on the things we can accomplish together. With that, I yield back. The gentleman yields back. Anyone seeking further discussion? Gentleman from New Jersey, Mr.
▶ 0:47:01Mendez, is recognized for five minutes to speak on the Ames. Thank you, chairman, and I want to join the ranking member and so many of my colleagues uh on the Democratic side of the aisle who who agree we want to work on issues together in a bipartisan way. But what's challenging for us is is the silence and the refusal to to demonstrate the harm that this administration's causing uh with respect to HHS, with respect to the restructuring and limiting of SAMA.
▶ 0:47:28And you it's almost like living in dual realities, right? where you can see what this administration is doing and not say a word and then come to committee and say we should do things in a bipartisan basis. But that would be sending more legislation that's to the administration to be chopped up and disregarded.
▶ 0:47:44And that's what we find so challenging in this moment is there were a whole host of bills as other members have spoken to that were agreed to on a bipartisan basis that because one person objected to we walked away from and now we're back with only one bill from that health package. And we just want to know why. and why we can't work together again on that full set of bills and why we have to be stuck with just one bill that we're worried this administration won't implement. And that's a challenging moment that we're in.
▶ 0:48:12And I think we would just like to see our colleagues across the aisle join us to call out the harm that this administration is doing to so many bipartisan things that have already been passed into law. Uh because I think that's what the American people really want us to do. And when I was home for the last two weeks, that was the clear message that was sent to me. And I just wish our friends across the aisle heard it as well. And with that, I yield back. Gentleman yields back. Any further discussion on the Republican side? Seeing none. Any further discussion on the Democrat side? See, are there any amendments?
▶ 0:48:42Gentleman from New Jersey. Are you recognized? Mr. Tonko, you have an amendment. Does Mr. Tonko, what persons gentleman from New York seek recognition? Mr. Chair, I have an amendment at the desk. Gentleman is recognized. Thank you, Mr. Chair. As a committee, we have worked together hand inand on a bipartisan basis to pass the support act. And I believe I'm sorry, Mr. Ter, would you call up the amendment?
▶ 0:49:04We need the It is um AMD01 XML. And Mr. Chairman, may I reserve a point of order at this time? Point of order is gentleman reserves a point of order. Can you describe the amendment? Describe the amendment so we can Yes. You have the amendment. You report the Amendment to the amendment in the nature of a substitute to HR 2483 offered by Mr.
▶ 0:49:33Tonko at the end of the without objection. The amendment reading of the amendment is dispensed with. We want to make sure we got which amendment? What number amendment do you have? 20 2020 AMD 01 XML. Got it. Okay. Without objection, the re amendment is dispensed with and the gentleman's recognized for five minutes in support of his Thank you, Mr. Chair. As a committee, we have worked together handinand on a bipartisan basis to pass the support act.
▶ 0:49:59And I do believe we all understand the importance of SAMA to our nation's overdose crisis as well as the behavioral health crisis. The expertise and funding that flows through SAMA are life-saving. Every community in this nation has experienced the overdose crisis and the mental health crisis. Every member should know the value of SAMA to their district in terms of lives saved. Every state has SAMA funding that supports the response to these crises.
▶ 0:50:24In New York, in Georgia, in Kentucky, in every state, our communities benefit from this funding. Whether it's training providers on evidence-based addiction medical treatment or providing life-saving lenoxone or launching prevention or recovery efforts or supporting 988, we get it. SAMA is working to save lives. I think everyone in this room likes what SAMA does, which is why I'm baffled. Why are we allowing SAMA to be decimated? Why are we sitting here discussing anything else other than how do we stop the gutting of SAMA?
▶ 0:50:5550% of staff at SAMA were just fired. A billion dollars of life-saving funding was just yanked away from states. The administration has said that this funding was terminated due to its connection to the CO 19 pandemic. But nothing in the law limits these dollars to CO purposes or for only during a public health emergency. Congress recognized that the impacts of the pandemic would reach well beyond an emergency period and chose not to condition the funding on whether there was an active public health emergency in place.
▶ 0:51:26So the administration's decision to terminate these grants goes against congressional intent and is wreaking havoc on state and local opioid response efforts. This was funding that Congress approved and wanted to be used for the overdose and behavioral health. By revoking the availability of these funds, the money remaining will be returned to the Treasury and will not necessarily be reinvested into actions to address the addiction and behavioral crisis. This is tragic.
▶ 0:51:56We need to ensure that the Trump administration reverse its course on this immediately. Everyone in this room should be demanding that this recklessness be stopped and stopped today. States need more time to allocate these resources given the important need. These are critical funds supporting mental health, addiction prevention, treatment, and recovery. These funds can and should be fully invested in a systematic way. The pandemic caused massive trauma to many Americans of all ages for many different reasons.
▶ 0:52:25While the pandemic may be over, the mental health and addiction reverberations are not. These funds are crucial for states and communities in continuing to care for these Americans. We need to finish the job or real impacts will be felt. In New York State alone, more than 350 organizations across the state are impacted by the canceled health grant funding.
▶ 0:52:46For SAMA in particular, this funding directly supported mental health treatment providers, SUD treatment providers, crisis centers, and 988 call centers. Among just 32 organizations that responded to a survey in New York, 8,200 New Yorkers will lose access to care as a result of the early CO 19 grant cuts. Let's remember that 350 organizations were impacted by the full health cuts in New York State so that the loss of services and access is even wider.
▶ 0:53:16Several organizations have already reported suspending or shutting down programs, many of which are critical lifelines for individuals in treatment. These disruptions threaten to derail recovery, worsen health outcomes, and in some cases may even be lifethreatening. Reports of staff layoffs have also begun to surface.
▶ 0:53:35In my district, I recently heard that the Troy Drug-Free Community Coalition was notified that they lost their funding and that obligated grant funds have been terminated effective immediately and that any further expenditures related to these contracts will not be reimburseable. Do we really want to cut off funding for drug-free communities? In New York, organizations have overwhelmingly stated that the early termination of federal COVID grants would lead to significant cuts starting with prevention services.
▶ 0:54:03Outpatient programs, including medication assisted treatment and ontrack along with residential and crisis stabilization services, are also at risk. Do we really want to cut funding for MAT for Matt? What about residential and crisis stabilization services? Do we want to cut funding for existing recovery community services such as recovery community centers and youth club houses?
▶ 0:54:25Do we want to cut funding for transitional housing to help provide short-term housing and case management for individuals leaving residential treatment or correctional facilities who cannot otherwise access permanent housing? Do we want to cut care coordination in the provision of transportation assistance to ensure access to treatment, recovery, and other basic services? Do we want to cut these programs? I don't think so. Because of all of these being cut, all these cuts being made, the nation will are is getting impacted because of these clawbacks.
▶ 0:54:54When do we come together on a bipartisan basis and say enough? This is not acceptable. We should be ashamed that as a committee, we have not all come together to demand that these senseless cuts immediately be restored. I ask all of my colleagues to support my amendment to restore the state's ability to access this life-saving funding so it can reach our communities as intended by Congress. If we want to call it a crisis, let us act accordingly. With that, I yield back. Gentleman yields back and the chair recognizes the gentleman from Georgia, Mr.
▶ 0:55:24Carter, for five minutes. Oh, gentle Mr. Gri. Okay. Gentleman from Virginia is recognized for five minutes. Thank you, Mr. Chairman. I find this amendment kind of interesting. I'm sitting here looking at the language and um it it as it reads and I look look for my colleague to tell me if I'm reading it wrong.
▶ 0:55:44as it reads, all of these good things in the support act won't come into play unless president in the administrative branch of government takes action to release funds. So, as I understand it, because we don't like the cutting of funds or the withholding of programs by the administration, and I'm not saying that's accurate, I'm just saying that's what is purported.
▶ 0:56:12We're going to refuse to allow the support act to go forward unless we agree. We're giving the secretary this power. Why would we give the secretary the power to do exactly what he wants to do and and then gut another program that it is Congress's will, I believe, to have become law. This just seems to me to be illogical, Mr. chairman that we would give the secretary the power to gut a congressional intent.
▶ 0:56:42It's one of my concerns in Congress in general that over the last decades long before any of us got here started. We keep giving the secretary the power to do this or the secretary to make this determination or to do that. And whenever you do it, whichever p whichever party's in control of the white house gets to say what they want done and what they don't want done. seems to me we ought to make these congressional actions.
▶ 0:57:05And so I can't support this amendment just from a basic philosophical standpoint that we're giving the secretary not only the power over this bill, but encouraging them to not pass or not to deal with our bill because they can control the life of the support act by refusing to do what the gentleman wants them to do. So it seems to me be illogical. I will the gentleman yield. I I will yield because if I read it wrong, I invite her to tell me.
▶ 0:57:34So my so so some of us are a little confused about what you're saying and because we also agree that if Congress uh says that that the administration should do something in legislation then then they should do it. So would you would you agree with Mr.
▶ 0:57:52Palone's suggestion that we do oversight to see if in fact the secretary of HHS has overstepped his authority by rescending some of these programs and and expenditures that Congress has made. It it's interesting you asked that question because when Mr. Mr.
▶ 0:58:09Palone was making the point I thought about last year when the White House was controlled by a different party and to his credit the then secretary of HHS when I raised concerns in our regular hearing and the chairman said we're going to have our regular hearing uh with the secretary as we normally do is on budget etc where you can talk about all kinds of things. I brought up a problem I was very concerned with with O as you will recall. Yeah and he agreed to come to a special oversight meeting while he was here in that regular meeting.
▶ 0:58:36So I think step one is to have our regular our regular meeting with the secretary as we would with any administration and then we can ask that administration representative in this case the secretary of HHS to come back for an oversight hearing. I hope he will agree to that. I think that's appropriate and I think we should conduct oversight over all agencies within our jurisdiction.
▶ 0:58:58If I if I may, um um I sent a letter with along with all the other Democrats on the House Subcommittee back in January asking the secretary to meet with us and then we made an effort to get him to meet with us again before this last recess and we've heard zero back. So, if you can help us to if you can help to ensure we get this meeting soon and I say this in all, as you know, Mr.
▶ 0:59:23and I say this in all in all honesty and nonpartisanship is I'm really worried about these cuts particularly at NIH, FDA, CDC, but also also like with the support act and SAMA, I'm I'm worried about those. So, the sooner we can get the secretary in here, I think the better it would be for the health of our Americans.
▶ 0:59:44But I appreciate you indulge and and I would say to the gentle woman that we need to uh look in the mirror and we need to look uh across time and stop giving so much power to the executive branch by allowing secretary to do this or the secretary to do that. That's where we get into problems. And just as I was frustrated when there was a Democrat administration because they wouldn't answer my questions and because as we give this power away, we don't have the ability to call these people in as much because we've given the power away.
▶ 1:00:14And unfortunately, this amendment gives more power to the secretary. I know it wasn't the intent of the sponsor of the amendment, but that's what what it does. And I just think as a body, not looking at ours and D's, but as a body, we need to stop giving so much power to any executive branch, no matter who is in the White House. Thank you. Gentleman yields back. The chair recognizes a gentleman from New Jersey for five minutes, Mr. Palum. Regular member Palum. Thank you, Mr. Chairman. I I support uh Mr.
▶ 1:00:41Tonko's amendment because I think it's necessary given all the things that the Democrats have already discussed today. I mean, I appreciate um the gentleman's from Virginia's comments, but um I don't think it matters. Look, you know, the the bottom line is um the secretaries don't have authority to do anything. I mean, the decision to cut to freeze the funds that are already obligated, decisions to fire people, these are all being made by Elon Musk, right? He comes in with Doge.
▶ 1:01:10He tells them what to do. Who knows if uh RFK uh even knows what's going on there. He's just dictated to by Elon Musk in my opinion. But, you know, I appreciate your comments, but I don't think it really matters. The the what really matters here is what Mr. Tonko is trying to do. We know that um we've had these obligated funds that were going to go to the states, the block grants. Uh they were illegally uh frozen. Funds are obligated. You don't have the right to say that.
▶ 1:01:40uh take them back once they're obligated. It's a contract. Okay. So, again, this gets into the whole issue of what's happening here and what's legal and what isn't, which is why uh we need uh an oversight hearing. Um the same thing with rational. You know, the chairman Guthrie said, well, maybe some of these things have some rational basis.
▶ 1:02:01Well, I don't know how anything can, you know, how cutting a block grant to states and then, you know, not spending the money on on SAMA and uh and treatment uh has any rational basis or has any reorganization nature that's actually going to help people that have substance abuse disorders. Um, but again, if you believe that, which I don't, but if you do, then you should have a hearing.
▶ 1:02:28We should have a hearing on whether or not these uh take it back obligated funds is legal or not, whether or not um there's any rational basis for cutting the funds and firing people. Um that's why we need a hearing. Um and and I don't hear anything coming from the chair or from the general for Virginia specifically saying that we're going to have this hearing. A budget hearing is one thing. You might be able to ask a question maybe, but we really need a hearing on this issue.
▶ 1:02:57um and drag the secretary in here and and make him explain what the rationale is. He doesn't explain the rationale. He just says we're doing it because Doge tells him he has to. He doesn't give any reason. I've never heard any reason for from him about any of these cuts at HHS. But in any case, I yield back, Mr. Chairman. Gentleman yields back. The chair recognizes a gentleman from Georgia, Mr. Carter, for five minutes. Mr. Chairman, I I rise in opposition to this amendment.
▶ 1:03:25And you know, I appreciate my colleagues interest in supporting individuals with substance use disorder and mental health conditions, but this amendment would unnecessarily delay the implementation of this critical bill. A bill that I I think it's worth noting would garnered wide bipartisan support just last Congress. In fact, unanimous from this committee. Unanimous from this committee.
▶ 1:03:48And it's currently being supported by over 160 stakeholder The funding that's in question from the American Rescue Plan Act that was appropriated over four years ago, over four years ago. And we need to be focused on targeting spending to address our nation's problems. And it's clear that the excess spending from the American Rescue Plan Act was too much to actually be spent in a meaningful fashion.
▶ 1:04:14On on the other hand, the approach taken by the original support act and this reauthorization is targeted to meet program pro programmatic needs. My colleagues on the other side of the aisle have talked a lot about not getting this critical bill done in December. But now want to add an unnecessary administrative delay. I don't get it. I don't understand that we should reject this amendment which would unnecessarily prevent much needed resources from reaching our communities.
▶ 1:04:42I urge my colleagues to oppose this amendment and I yield back. Gentleman yields back. Any further discussion on the amendment? Okay. Any further? Seeing none, the act the question now occurs on the amendment. A roll call vote has been requested and the clerk will call the Mr. La. No. Mr. La votes no. Mr. Griffith. Mr. Griffith votes no. Mr. Billis Mr.
▶ 1:05:11Billis votes no. Mr. Hudson Mr. Carter of Georgia Mr. Carter of Georgia votes no. Palmer Mr. Palmer votes no. Mr. Dunn, Mr. Krenshaw, Mr. Joyce. Mr. Joyce votes no. Mr. Weber Mr. Weber votes no. Mr. Allen, Mr. Balderson, Mr.
▶ 1:05:41Balderson votes no. Mr. Fulture, Mr. Fluger, Miss Harshburgger, Mrs. Harshburgger votes no. Mrs. Miller Meeks, Mrs. Kamik, Mrs. Kamik votes no. Obernolulti, Mr. Obernulty votes no. Mr. James, Mr. James votes no. Mr. Mr. Bence, Mrs.
▶ 1:06:13Hchen, Mr. Fry, Mr. Fry votes no. Miss Lee, Miss Lee votes no. Mr. Langworthy. Mr. Langworthy votes no. Mr. Kain Mr. Kane votes no. Mr. Roelly. Mr. Evans. Mr. Goldman. Mr. Goldman votes no. Mr. Vidor check. Mr. Palone. Mr. Palone votes I. Mr. Gette.
▶ 1:06:43Mr. Get votes I. M Shakowski I. Miss Shakowski votes I. Miss Matsui I. Miss Matsui votes I. Miss Caster. Mr. Tonko. I. Mr. Tonker votes I. Miss. Clark. Miss. Clark votes I. Mr. Ruiz Mr. Ruiz votes I. Mr. Peters Mr. Peters votes I. Mrs.
▶ 1:07:15Dingle Mr. Vzy Mr. Vzy votes I. Miss Kelly Miss Kelly votes I. Miss Bagon Miss Bagon votes I. Mr. Sodto Miss Shrier Miss Shrier votes I. Miss Treyan Miss Trean votes I. Miss Fletcher Miss Fletcher votes I.
▶ 1:07:43Miss Okasio Cortez Miss Okaziocortez votes I. Oenclaus. Mr. Arinclaus votes I. Mr. Carter of Louisiana. Mr. Mr. Menendez. Mr. Mendez votes I. Mr. Mullen. Mr. Mullen votes I. Mr. Lansman. M. Mlelen. M. Mccullen votes I.
▶ 1:08:13Chairman Guthrie. No. Chairman Guthrie votes no. So, how is Dr. Dunn recorded? Dr. Dunn is not recorded. How's the gentleman from Texas record? Mr. Prince. Mr. Krenshaw votes no. Mr. Allen votes no Mr. Allen votes no. Mr. Fulker Mr. Fulture votes no. Dr. Miller Meeks Dr. Miller Meeks votes no.
▶ 1:08:43Miss Ford Miss Fedorek votes no. Mr. Sto Mr. Sto is not recorded. Mr. Stoodto votes I. Is there anyone seeking to answer the roll call? Clerk, do you have a report?
▶ 1:09:17Chairman Guthrie, on that vote, there were 20 eyes and 24 nos. Amendment is not agreed to. Will the clerk uh are there any further What purpose is a gentle lady from Thank you, Mr. Chairman. I have an amendment at the desk titled for hand 009. The clerk will report. And Mr. Chairman, if I could reserve a point of order. Point of order is reserved.
▶ 1:09:48Clerk will report. Amendment to the amendment in the nature of a substitute to HR 2483 offered by Mr. Han of Massachusetts. Without objection, the reading amendment is dispensed with and the gentle lady from Massachusetts is recognized for five minutes in support of her amendment. After years of relentless escalation, we're finally seeing the first signs of progress in reducing overdose deaths. That's welcome news. But let's be clear about why it's happening.
▶ 1:10:18Many public health experts agree that this decline is largely due to the increased availability of nlloxxone or Narcan. It's not because the crisis has ended. It's because we've made it easier for people to access the tools that can reverse an overdose in real time. That's why my amendment is so important.
▶ 1:10:39It makes clear that no restructuring of HHS and no reduction in FDA staffing should be allowed to delay, disrupt or defi defund the FDA's work on overdose reversal and treatment. It protects the research, the review and the approval of new formulations of Nlloxxone, whether they're over-the-counter, long acting, or faster acting.
▶ 1:11:03It safeguards access to medications for opioid use disorder and it preserves the FDA's ability to carry out the oversight and regulatory work that ensures these treatments are safe, effective, and available when people need them. This is not theoretical. We are watching this administration push forward a reorganization of HHS with zero hearings, zero transparency, and no clear plan to protect essential public health work.
▶ 1:11:32Meanwhile, critical positions at the FDA, positions that support efforts to combat opioid addiction, are being eliminated or left vacant. We simply cannot afford to backslide at this moment. This amendment doesn't tie the administration's hands. It doesn't block reform. It just demands accountability.
▶ 1:11:51It says, "If you're going to make structural changes that affect the FDA, you need to certify that those changes won't slow down approvals for overdose treatments, won't drain resources from addiction treatment review, and won't undermine public health strategies that are finally saving lives. Over the past few years, we've seen a troubling uptick in elicit fentinyl laced with xylazine, a combination that today's Narcan simply cannot reverse.
▶ 1:12:19This highlights the urgent need for future iterations of Narcan and medication to treat opioid use disorder to be effective against the unknown substances flooding our drug supply. We need to be able to respond quickly to these evolving threats. But gutting our regulatory agencies like the FDA will make that impossible. If we reduce FDA's capacity to swiftly approve new treatments or maintain rigorous oversight, we risk reversing the hard one progress we've made in addressing this crisis.
▶ 1:12:50And we cannot afford to take steps backward when lives are on the line. As policymakers, it's our responsibility to ensure that the FDA and other regulatory bodies can continue their vital work without being undermined by arbitrary cuts or Now, everyone on this committee should be committed to protecting the tools and resources necessary to save lives and address the opioid crisis head on.
▶ 1:13:14So, I urge my colleagues to support this amendment so we can preserve our ability to respond effectively to the evolving challenges that we face. Thank you. I yield back. Gentle lady yields back and the chair recognized gentleman for Georgia and Mr. Carter for five minutes to speak on the amendment. Mr.
▶ 1:13:29Chairman, as we all know, the support act for patients and communities reauthorization act of 2025 continues critical support for individuals battling addiction and marks a significant step toward step forward in addressing the national opioid opioid epidemic. Something that we all agree on, something we all understand needs to be done. That's why I'm I'm having trouble understanding again this amendment would unnecessarily delay the implementation of this critical bill.
▶ 1:13:59Why would we want to do that? Just as I asked on the last bill, I support access to life-saving overdose reversal medications as we all do. I don't think there's any question about that. In fact, many provisions included in the support act continue resources for states, first responders, treatment providers, and community organizations to access and administer opioid overdose reversal medications.
▶ 1:14:24My colleagues on the other side of the aisle have talked a lot about not getting this done in December, which I I understand, but now they want to add an unnecessary administrative delay. I don't understand that we should reject this amendment which would prevent much needed resources from reaching our communities. I urge my colleagues to oppose this amendment and I yield back. The gentleman yields back. Is there any further discussion on the amendment? Roll call.
▶ 1:14:51Seeing the no further discuss. The vert occurs only amendment. There's a roll call vote requested and the clerk will call the Mr. Lada, no. Mr. Lada votes no. Mr. Griffith, Mr. Griffith votes no. Mr. Bill Rockus Mr. Bill Rockus votes no. Mr.
▶ 1:15:24Hudson. Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Mr. Palmer. Mr. Palmer votes no. Mr. Dunn, Mr. Krenshaw. Mr. Joyce. Mr. Joyce votes no. Weber Mr. Weber votes no. Mr. Allen.
▶ 1:15:55Mr. Balderson. Mr. Balderson votes no. Mr. Mr. Fulture, Mr. Fluger, Mrs. Harshburgger, Miss Harshburgger votes no. Miss Miller Meeks, Miss Miller Meeks votes no. Mrs. Kamik, Mrs. Kamik votes no. Mr.
▶ 1:16:26Obernolulti, Mr. James. Mr. James votes no. Mr. Bence Mrs. Hchin Mrs. Hchin votes no. Mr. Fry Mr. Fry votes no. Mrs. Lee. Ms. Lee votes no. Mr. Langworthy. Mr. Langworthy votes no. Mr.
▶ 1:16:56Kane. Mr. Kane votes no. Mr. Roelly, Mr. Evans, Mr. Goldman, Mr. Goldman votes no. Mrs. Fedorch, Miss Fedorch votes no. Mr. Palone, Mr. Palone votes I. Mr. Dat Mr. Gat votes I.
▶ 1:17:26Miss Shakowski I Miss Shakowski votes I. Miss Matsui I. Miss Matsui votes I. Miss Caster I. Miss Caster votes I. Mr. Tonko I. Mr. Tonko votes I. Miss Clark. Miss. Clark votes I. Mr. Ruiz. Mr. Ruiz votes I. Peters.
▶ 1:17:56Mr. Peters votes I. Mrs. Dingle. Mr. Vzy. Miss. Kelly. Miss. Kelly. Votes. I. Badon. Miss Bagon. Votes. I. Mr. Sodto. I. Mr. Sodto. Votes I. Miss Shrier. Miss Shrier votes I.
▶ 1:18:24Tran Miss Tran votes I. Miss Fletcher Miss Fletcher votes I. Miss Cortez Miss Okasiocortez votes I. Mr. Oenclaus. Mr. Oenclaus votes I. Mr. Carter of Louisiana. Mr. Mendez. Mr. Mendez votes I.
▶ 1:18:54Mullen Mr. Mullen votes I. Mr. Mlen Miss Mlen votes I. Chairman Chairman Guthrie votes no. Mr. Clerk, how is Dr. Dunn recorded? Dr. Dunn is not recorded. Mr. Krenshaw Dr. Dunn votes no. Mr. Krenshaw M Mr. Krenshaw votes no. Mr. Mr.
▶ 1:19:24Allen votes no Mr. Obernulti Mr. Obernulti votes no Mr. Fulture Mr. Fulture votes no Mr. VC Mr. Vy is not recorded. Mr. Vzy votes I. Is there any others seeking the roll call? The clerk will report.
▶ 1:19:59Mr. Chairman, on that vote there were 21 eyes's and 25 nos. The amendment is not agreed to. Are there further amendments? Are there any further What did he have next? Gentle lady from Florida. Gentle lady, Miss Caster, you have Okay. I'm sorry. Oh, okay. Okay. Miss Kelly, I thought you said Cer. Okay. I'm sorry. I knew which one. I was just pointing to the wrong one.
▶ 1:20:28Uh, Miss Gentle from Illinois, Miss Kelly, you're What purpose? Gentle lady from Illinois seek recognition. I have an amendment at the desk. Clerk will report. Mr. Chairman, could the gentle lady please specify the amendment? Sure.
▶ 1:20:44It's H24H I'm H2483_up support 2025 FCD AMD U 11_XML and Mr.
▶ 1:20:59Chairman if I could reserve a point of order order has been reserved by gentleman from Virginia clerk will report Amendment to the amendment in the nature of a substitute to HR 2483 offered by Miss Kelly. Without objection, the reading amendment is dispensed with and the gentle lady is recognized for five minutes in support of the amendment. Thank you, Mr. Chair.
▶ 1:21:29My amendment makes clarifying changes to the underlying bill to put a stop to Elon Musk Department of Government efficiency from unlawfully restructuring HHS and its vital agencies. These are far from normal times. We're now meeting a third time on healthc care bills that should have advanced months ago under an agreement reached by this committee and leadership last year. We cannot allow some to push forward a reckless and illegal plan to dismantle essential public health agencies without congressional input.
▶ 1:21:58Despite these repeated attempts, they have yet to offer a coherent path forward. Their most current attempt, which was leaked, details their sweeping and unauthorized reauthorization of HHS, including the elimination of multiple key programs under the Support Act and reckless reduction in force of personnel, none of which were previously reviewed or approved by Congress.
▶ 1:22:20The reorganization plans put forward by the Trump administration without proper due process and an astonishing lack of transparency have raised significant concerns about the stability and effectiveness of the AY's task for protecting the health and well-being of Americans. The proposed changes that include illegally eliminating the total number of public service jobs to 20,000 for cutting about 25% of employees threatens to destabilize these essential functions at a time when they are most needed.
▶ 1:22:49This amendment does not oppose modernization, but demands thoughtful reorganization with clear oversight. Congress has a duty to hold the Trump administration accountable, particularly when proposals like dismantling SAMA threatened to deepen the ongoing mental health and substance use crisis.
▶ 1:23:07Eliminating the directors of critical agencies such as the Center for Mental Health Services, the Center for Substance Abuse Prevention, and the Office of Minority Health would jeopardize vital services, reduce expert guidance, and slow coordination across programs. These cuts represent just a fraction of the broader risk posed by the proposed overhaul.
▶ 1:23:28And now under the guise of cutting waste, fraud and abuse, the shutdown of regional offices like San Francisco, Boston, New York, Seattle, and our very own region 5 in Chicago. They all have something in common. These closures would cause major disruptions, delays, and a sharp decline in essential services. I want to thank the staff of Ranking Member Palone uh for working with me on this language.
▶ 1:23:54I also urge my colleagues, particularly my Republican colleagues, to join in the call for greater accountability for this administration. The American people deserve a government that works without compromising essential services in the pursuit of a misguided agenda. This amendment is a step toward that goal. As chair of the Congressional Black Caucus Health Brain Trust, I will continue to work on course correcting the harmful impacts of these reckless decisions and ensure that health equity is at the center of federal health policy.
▶ 1:24:24Thank you and I yield back. Gentle lady yields back. The gentleman from Georgia seek recognition to speak on the amendment. Mr. Chairman, I I speak in opposition to this amendment. I truly am confused here. This amendment would unnecessarily delay the implementation of this critical bill, which everyone seems to agree should have been implemented earlier, should have been implemented last year.
▶ 1:24:50I I'm I'm not understanding why we're delaying these things here. It's my understanding that many of the programs outlined in the amendment have not been impacted by the HHS reduction in force. This amendment would simply result in delaying the allocation of important resources, prevention, treatment, and recovery for individuals suffering from substance use disorder. I don't think anyone on this committee wants to see that happen.
▶ 1:25:15These patients deserve our help and getting the support for patients and communities reauthorization act signed into law is one way we can assist these individuals and families. That's why I urge my colleagues to oppose this amendment. And I yield. Gentlemen, yield to me. Yes, I yield. I just want to say real quick, I I've been kind of rattled today on the news of Jerry. And so I text him to let him know we're all praying for him. And my last text to him that laughter through tears is the best emotion they always say, but I last time I text him was uh Valentine's Day.
▶ 1:25:43I noticed to warn him about getting a Valentine's gift for his wife because the year before he had forgotten to the last minute his staff said, "You got something for Smitty?" Everybody knows Smitty. She's a wonderful lady. Takes a beautiful box that somebody had given him, wrapped it up, gives it to his wife. She opens it up and says, "Thanks for the Valentine's gift. Was this a regift?" And only Jerry could tell it. The way Jerry's drama, as we know, he's like, "Oh, of course not. You know, I love you.
▶ 1:26:07I would never do that to you." And she says, "Well, why do the cookies say Matsui Valentine?" So he he regift he regifted Doris's cookies and uh he said, "Doris put her name on the cookies. Why would she do that?" So anyway, he was out. So anyway, so that's uh so I'm sorry. I'm a little rattled on Jerry, but let's keep him in our prayers. I'll yield back to the gentleman from Georgia. I yield. Gentleman yields back. Any further discussion on the amendment. Mr. Tonko. We're elected together with Jerry. So, Mr.
▶ 1:26:37T, you recognize quite the class too. Yeah. Yeah. Thank you, Mr. Chair. I move to strike the last Thank you. Since day one, this administration has launched a relentless assault on the very programs that states depend on to keep our communities running. This isn't streamlining government. It's sabotaging the systems that support everyday Americans. We're watching a slow motion demolition of our government's ability to serve the American people.
▶ 1:27:04And if we don't stop it now, we'll all pay the price in delayed benefits, weakened security, and crippled services. AHA is no exception to this reckless mentality. The whole reason Congress moved SAMA into an independent agency was to ensure that behavioral health was prioritized despite the long-standing stigma.
▶ 1:27:25Instead, AHA would take us back to the time that behavioral health is tucked away in another agency and The firing of 50% of SAMA staff, which means a huge loss in capacity and expertise, coupled with the looming budget cuts, makes clear that behavioral health is not a priority for this administration. I beg my colleagues on the other side of the aisle, let's reverse course.
▶ 1:27:52We have reauthorized SAMA through this very committee multiple times with bipartisan support. We have an obligation to protect SAMA's mission and all of our constituents who SAMA, which CA Sama serves. I urge everyone to do the right thing and support this amendment. Folks are counting on us doing the right thing, the compassionate thing, the sensible thing. With that, I yield back. Gentlemen yields back. Anyone else seek recognition?
▶ 1:28:26Seeing none, we shall vote on the amendment. And a roll call has been requested. Mr. La Mr. La votes no. Mr. Griffith Mr. Griffith votes no. Mr. Bill Rockus Mr. Billis votes no. Mr. Hudson.
▶ 1:28:56Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Palmer Mr. Palmer votes no. Mr. Dunn, Mr. Krenshaw, Mr. Joyce. Mr. Joyce votes no. Mr. Weber. Mr. Weber votes no. Mr.
▶ 1:29:28Allen Mr. Allen votes no. Mr. Balderson Mr. Balderson votes no. Mr. Fulture. Mr. Fluger. Mr. Fulture votes no. Mr. Harshburgger. Mrs. Harshburgger votes no. Mrs. Miller Meeks Mrs.
▶ 1:29:58Miller Meeks votes no. Mrs. Kamik Mrs. Kamik votes no. Mr. Obernolulti Mr. James Mr. James votes no. Mr. Bence Mrs. Mr. Houchin Mrs. Houchin votes no. Mr. Fry Mr.
▶ 1:30:27Fry votes no. Mrs. Lee Ms. Lee votes no. Mr. Langworthy. Mr. Langworthy votes no. Mr. Kain. Mr. Kane votes no. Mr. Roelly. Mr. Evans. Mr. Goldman. Mr. Goldman votes no. Miss Fedorek. Miss Fedorek votes no.
▶ 1:30:58Mr. Palone gets Mr. Palone votes I. Mat votes I. Micowski. Miss Shikowski votes I. Miss Matsui. Miss Matsui votes I. Miss Caster I. Miss Caster votes I. Mr. Tonko I. Mr. Tonko votes I. Miss Clark.
▶ 1:31:28Miss Clark votes I. Mr. Ruiz. Mr. Ruiz votes I. Mr. Peters. Mr. Peters votes I. Mrs. Dingle. Mr. Vzy. Kelly Miss Kelly votes I. Miss Baragon Miss Bagon votes I. Mr. Sodto Mr. Sodto votes I.
▶ 1:31:59Miss Shrier Miss Shrier votes I. Miss Treyan. Miss Treyanne votes I. Miss Fletcher. Miss Fletcher votes I. Miss Miss Okaziocortez votes I. Mr. Oenclaus. Mr. Oenclaus votes I. Mr. Carter of Louisiana. Mr. Mendez. Mr.
▶ 1:32:28Mendez votes I. Mr. Mullen. Mr. Mullen votes I. Mr. Lansman. Mr. Landman. Lansman votes I. Mlen. Miss. Mlen. Votes. I. Chairman Guthrie, no. Chairman Guthrie votes no. How's Mr. Hudson recorded? M Mr. Hudson's not recorded. Mr. Hudson votes no. How's Mr. Dunn recorded? Mr.
▶ 1:32:58Dunn is not recorded. No. Mr. Dunn votes no. How's Mr. Joyce Mr. Joyce is recorded as no. Mr. VC, how's Mr. VC recorded? Mr. Vzy is not Mr. Vzy votes I. How is Mr. Obernulti Mr. Obernolulti votes no.
▶ 1:33:31Mr. Krenshaw. Mr. Krenshaw is not recorded. Mr. Krenshaw votes no. Anybody else? right. The clerk will report to roll Mr.
▶ 1:33:59Chairman, on that vote there were 22 eyes and 26 nos. Could you repeat that, please? Yes, sir. There were 21 eyes's and 26 Nose have it. The amendment is not agreed to. I now recognize Miss Caster for the purposes of presenting an amendment. Well, thank you, Mr. Chairman. Mr. Chairman, I'm going to call this the whistling past the graveyard amendment.
▶ 1:34:26Um, the first 100 days of the Trump administration have been extremely costly. Uh, Miss Caster, I will call the amendment up first. Uh whistling pass the graveyard amendment please. It's support 2025 fed amendment 14.
▶ 1:34:47Amendment to the nature amendment to the amendment the nature of a substitute to 2483 offered by Miss Caster and a uh a reservation on a point of order is recognized and will be held by me. Miss Caster, you're recognized to speak on your amendment. Thank you, Mr. Chairman. Again, they I'm going to title this the whistling past the graveyard amendment. Um because that's what's happening with our Republican colleagues today on a very important topic.
▶ 1:35:18Uh the first 100 days of the Trump administration have been so costly and chaotic. Uh, we've watched Elon Musk take a chainsaw to so much of what makes America great. And that includes all of our progress on on bolstering Americans health, everything across the health enterprise, scientific research.
▶ 1:35:42Um, longtime health experts that have devoted their lives to public service and finding treatments and cures have been unceremoniously fired without any reason at all. Congressional directed funding has been illegally frozen. That's those are dollars that go to our research institutes, posttocks, people trying to find the cures for cancer, Alzheimer's, ALS or more.
▶ 1:36:09Did you all know that they have in many places frozen clinical trials? That's going to cost lives. Uh, Inspectors General were fired. They're the ones who help root out waste, fraud, and abuse. Personal data and information is being inappropriately accessed. U, they're doing great harm to everything we do to help people save money and protect their health and protect the public health.
▶ 1:36:38Um, now the president and the Republicans are charging ahead with their plan to make America more expensive and less healthy. But it gets worse because two weeks ago, the HHS Secretary Kennedy proposed a budget for Health and Human Services.
▶ 1:36:57It's a six, if you haven't seen it, it's a 64page document that is simply a gut punch to patients, to researchers, to providers, and families all across America. It is a breathtaking betrayal of everything that we have worked on in this committee to build to keep Americans healthy and well, cancer research, Alzheimer's, ALS, and mental health.
▶ 1:37:27and substance use disorders. Particularly important to today's debate, their budget proposes eliminating the experts and initiatives at the Substance Abuse and Mental Health Services Administration, SAMA, instead of funding proven initiatives built by this committee and partners and experts all across America decades to battle America's opioid epidemic, uh, over
▶ 1:37:57overdose and suicide crisis. is mental health emergencies. President and Republicans have different priorities. That their priority is to make sure that billionaires get a tax cut. That the wealthy and the well-connected get more and more and more that Medicaid uh people, our neighbors who we love the most who rely on Medicaid, they're on their own.
▶ 1:38:24But the billionaires, maybe they'll have another yacht or another special place for their vacation. Okay. So, in this budget specifically, here's what they want to they propose to eliminate. training for first responders, youth prevention and recovery efforts, residential treatment programs for pregnant and postpartum women, comprehensive opioid recovery centers, peer support and community-based initiatives,
▶ 1:38:55evidence-based research into trauma informed care, and grants to help individuals living with substance use disorders live independently and participate in the workplace. This is incredibly costly.
▶ 1:39:12It's it really is a betrayal of of so much of the progress that we have made for patients especially that that grapple with behavioral health needs and for what to scrape together every penny to be found to give massive tax breaks and giveaways to billionaires. So my my amendment is simple.
▶ 1:39:33U it says this version of the support act could not go into effect until the Trump administration and Republicans in halt all of the damage that they are doing to our health enterprise. Because this committee does not operate in a vacuum.
▶ 1:39:52As much as the support act needs to be reauthorized, how do my Republican colleagues expect it to work under proposals where no one will be home to actually do that work? You're whistling past the graveyard in more ways than one.
▶ 1:40:12I urge my colleagues to join me in support this Gentle lady yields back. Recognize gentleman from Alabama. Thank you. It's interesting. I reserve the um the last word. Um strike the last word.
▶ 1:40:42It's interesting. And what would that word be? Just teasing. Well, I was may proceed. I I was concerned that you didn't know who I was there for a moment that kind of threw me off. Well, I was trying to decide you or Georgia and I I went with you, but um you're at by right recognized to have five minutes. Thanks, sir. Um and I move strike the last word.
▶ 1:41:06I just think it's interesting that that so many of my Democratic colleagues are uh opposing a a federal program for substance abuse while they supported President Biden's wide open border that allowed fentanyl to flow across our borders in unprecedented killing over 100,000 Americans.
▶ 1:41:30I also think it's uh interesting that they would use the terminology whistling past the graveyard when there are American citizens buried in graveyards all across the country. Lincoln Riley, Ruby Garcia, Rachel Morren, I could go on that were killed by people who crossed our borders illegally.
▶ 1:41:52I've not heard a single Democratic member of this committee acknowledge the success of President Trump in securing our border and interdicting illegal drugs. Um I just I think it's interesting, Mr. Chairman, that we're having this discussion about a program that that they supported just a few months ago. It's also interesting that they keep raising this issue of tax cuts for billionaires.
▶ 1:42:22Mr. Chairman, you have any idea how many billionaires there are in the United States at any given time? It's somewhere between 750 and 800. In the last election, there were 135 billionaires that that were actively engaged in the election. 82 of those supported the Democratic candidate Kla Harris. That'd be 62.8%. 53 supported President Trump.
▶ 1:42:50So I would think if you want to look at it proportionally, it's the Democratic party that has a billionaire problem, not the Republicans. I yield back. Gentlemen y now recognize Miss Matsui. Thank you um very much, Mr. Chairman, for yielding. I move to strike the last word in support of the caster amendment the whistling past the graveyard amendment.
▶ 1:43:18The support act reauthorizes critical programs at hersa sama and CDC to address the opioid overdose epidemic. While it would have been better if support was already signed into law as it could have been as part of the end of the year package is timely we're discussing it right now. Last month, Secretary Kennedy renewed the declaration of a nationwide public health emergency due to the crisis.
▶ 1:43:49Yet, at the very same time, Kennedy and the Trump administration are actively attacking and dismantling the federal health infrastructure, the very infrastructure we need to fight the opioid crisis and implement the programs in this bill.
▶ 1:44:08Earlier this month, HHS announced drastic restructuring, including massive personnel cuts, the consolidation of 28 divisions into 15, and the closing of five regional offices.
▶ 1:44:25Secretary Kennedy announced that 10,000 full-time employees would be This is on top of around 10,000 jobs eliminated. In total, almost a quarter of HHS has been indiscriminately fired.
▶ 1:44:48Some employees only learned their jobs were terminated when they tried to use their badges to access their workplace. Shameful. Is this how we treat civil servants dedicated to public As members of Congress, we should be receiving briefings on such an extreme overhaul of agencies in our jurisdiction.
▶ 1:45:12Yet, there is little to no transparency from the administration on which employees these layoffs affect. In the one briefing HHS offered to our staff, they said the riff impacted personnel, not programs, and all critical programs would continue.
▶ 1:45:34But how can that be true when at SAMA, directors of the center for mental health services, center for substance abuse prevention, and substance use treatment were terminated. Entire offices were How is SAMA to carry out its essential work to improve substance use disorder and mental health treatment services, including implementing the programs in this bill when it is in a tail spin due to losing
▶ 1:46:04key leadership? To top this off, the administration's leaked HHS budget has given us a window into their thinking. And it seems their slash and burn strategy is not limited to personnel.
▶ 1:46:19After all, their wish includes entirely eliminating multiple support act programs, including youth prevention and recovery, first responder training, comprehensive opioid recovery centers, and residential treatment for pregnant and postpartum women. Mr. Chairman, Mr.
▶ 1:46:43Guthrie, as this is your bill, I hope your office has had better luck contacting administration to find out who will be around to implement the support act and whether HHS plans to ignore Congress's direction to carry on programs. So, I can't pretend we are in the same place we were last year.
▶ 1:47:05It's hard to understand why we are even discussing the support act when the administration is planning to eliminate multiple programs that this bill seeks reauthorize. As members of Congress, especially on ENC, we need to have oversight over the programs we all care about. We need to know the impacts of these reckless and aggressive cuts. That's why I support this amendment and I urge my colleagues to do the same.
▶ 1:47:35With that, I yield the balance of my time. Gentle lady yields. Now recognize the gentleman from Georgia for 5 minutes. Mr. Chairman, I rise once again in opposition to this amendment. Just like all the other amendments, this amendment would unnecessarily delay the implementation of this critical bill. a critical bill that we all agree needs to be done, needs to be passed.
▶ 1:48:04It's my understanding again that none of the programs outlined in the amendment have been impacted by the HHS reduction in force. Yet, this amendment would simply result in delaying the allocation of important resources for prevention, treatment, and recovery for individuals suffering from substance use disorder.
▶ 1:48:23These patients deserve our help and getting the support for patients and communities reauthorization act signed in law is one way we can fully assist these individuals and families. I urge my colleagues to oppose this amendment and I want to yield right now to the gentleman from Alabama, Mr. Palmer. I thank the gentleman for yielding. Mr. Chairman, I just want to point out that um SAMS is not being eliminated.
▶ 1:48:52It's being merged into a newly formed administration for a healthy America. This is part of the Trump administration's efforts to make government more uh transparent um more effective in and meeting the needs of the American public and and and less costly.
▶ 1:49:10So, I keep hearing my Democratic colleagues say that that this program, this agency is being eliminated when the fact of the matter is uh it it's being merged into a a a new um administration for a healthy America. Mr. Mr.
▶ 1:49:29Chairman, I would like to enter into the record an article from behavioral health uh that that makes that point that it's being merged into a a new administration. Without objection, uh gentleman from I yield back to the Georgia and I yield. Oh, without objection. That's it. that is entered into the record and now recognized the the gentleman have yielded back and now recognize the ranking member for his five minutes.
▶ 1:49:59U Mr. Chairman, I just want to uh ask unanimous consent also to enter into the record uh three documents which I mentioned before but they all point out well let me start with that. Is there an objection? Tell us what they are. Uh we mentioned it already. one.
▶ 1:50:17These are all documents that talk about the extent of Trump's and DOA's cuts to HHS uh in terms of uh both the amount of money uh in terms of the staff and I see that one of them is from Politico and one what are the other two? Politico um what is this?
▶ 1:50:39Washington Post and uh what's Um I think this one is from uh I don't know what publication is. You could look at it before decide but I'd like to enter them into without objection. Um hearing none they're subitted for the record. Thank you.
▶ 1:51:02But what I was trying to point out in response here is that it's clear that HHS is making major cuts in funding uh not only in terms of what Mr.
▶ 1:51:14Tonko mentioned before uh in terms of uh money that's going to the states that was obligated in block grants but also in the various programs uh in SAMA uh and while the gentleman is saying that SAMA's you know being you know put in a different area of HHS the bottom line is um that many of these programs are being eliminated completely regardless of how SAMA's being reorganized many of the programs are completely completely eliminated.
▶ 1:51:45And the level of cuts is about $40 billion, one-third of the department's discretionary budget, and that includes a significant number of cuts in SAMA and overdose uh treatment and substance abuse treatment programs. And again, as I pointed out in my opening remarks, there's nothing in here that suggests that um somehow this reorganization is going to, you know, end up with more treatment.
▶ 1:52:13I mean, less money, less people, uh less treatment. uh and and the the secretary who's doing most of the speaking here doesn't suggest in any way a rational basis for all this or suggest in any way that um that the result of these changes of reorganization is going to mean uh a better program or one that helps people reduce uh overdoses or reduce dependent on drugs.
▶ 1:52:42I I'm not I wouldn't argue that it's important to stop the flow of drugs into the country. Uh but that's not what we're discussing today. We're discussing uh what's within our jurisdiction, which is SAMA, treatment programs, program, educational programs, ways of helping people that are using drugs. I mean, it's certainly better if the drugs aren't available, but as you know, the drugs continue to be available uh you know, with whatever means people get them.
▶ 1:53:10Um, so to me, this this idea that you would oppose an amendment by Miss Caster that requires the secretary to halt all efforts to eliminate programs reauthorized by the support act. Your opposition doesn't make any sense. All we're really saying here is that these cuts, these um layoffs, all these things should cease. And if they don't, there really isn't any point in our reauthorizing this bill. What what's the point?
▶ 1:53:41The secretary continues to make the cuts, the money doesn't flow to the states and uh the people suffer or as Miss Castra said, people die. I mean, we really are talking about people who are going to die here because of these cuts. But with that, I yield back. Mr. Chairman, gentleman yields back. I have anybody else on the Republican side that wishes to speak? Seeing none, recognize uh the gentleman from New Jersey, Mr. Mendez.
▶ 1:54:11Uh thank you. I just want to quickly respond to the comment that uh my colleague from Alabama mentioned about an administration's impact on the health and specifically the mental health of Americans. And this is again the silence of Republicans because imagine the mental health of parents who send their children to a Head Start program who hear the president's thinking about cutting that program.
▶ 1:54:34Imagine the mental health of federal judges who are constantly attacked by this administration because they disagree with a court's ruling. Imagine the mental health of federal employees who one day told they are being let go, who then are rehired, who have no certainty, and many of whom live in our districts.
▶ 1:54:52Imagine the mental health of Ukrainians here under U4U or TPS who were sent an email saying that they were going to have to self-deport and then the administration admitted that email was sent by accident. Every single day, this administration is causing immense harm to all of our constituents, not just those that Democrats represent, but all of our constituents.
▶ 1:55:16And that's why the Republican silence with respect to the harm that this administration is causing is so difficult for us to comprehend. So, we should speak out when an administration is hurting our constituents. We should speak out when they're impacting their mental health. But it seems to me that you all will be silent in this moment. And that's just what frustrates so many of us, not just here, but throughout the country. With that, I yield back. Gentlemen yields back. Any further?
▶ 1:55:46May I respond? U you need to get somebody to ask for time and yield to you. Gentleman from where are you from? South Carolina. Oh my goodness. Sorry. I'll never get for that one. I yield to the gentleman from Alabama. I think that my colleagues on the Republican side and I have um great compassion for people um and and their mental health.
▶ 1:56:15What I don't understand is my Democratic colleagues idea that there's not a single federal employee that uh that that doesn't need to be employed. I mean, I was laid off three times. The last time I had $500 in the bank, I understand that and I I understand what people are going through.
▶ 1:56:41But I also think that we've got $37 trillion in debt and what a crushing blow that's going to be to uh future generations of America. And when that comes due, you want to talk about a mental health crisis, you'll have one then. The other thing is is I think it's patently unfair to to attack us on our motives. We're trying to do what's best for the country.
▶ 1:57:08We're trying to make some some difficult but but necessary decisions. I mean, I've sat here the entire hearing listening to my Democratic colleagues talk about that we're eliminating sense of when that's just not true. It's been there's a reorganization taking place. uh enrolling these a lot of these agencies in into one um administration within the Department of Health and Human Services.
▶ 1:57:38Um I I just think when you talk about mental health issues, you you need to think about some of the people who lost loved ones to drug overdoses as a result of the border not being secured, being left wide open. uh the number of families who lost loved ones killed, murdered, or killed by a drunk driver, by someone who's here illegally because the border was left wide open. I just think that that we need to stick to facts.
▶ 1:58:08We need to focus on these things together. I really do think that we're we're facing a fiscal crisis in the country. You keep talking about tax cuts billionaires. That's a total misrepresentation of of what's going on We're trying to get our physical house in order. We're we're we're focused on the future of the country, what's best for our children and grandchildren. So, I mean, you can continue this type dialogue if you want to, and it's not going to get get us anywhere.
▶ 1:58:38It's going to make things harder make it harder for us to get things done, the things we need to get done. I mean, I we could go back and talk about the mental health of of President Biden, his mental acuity. I think in some respects that's un that's unfair. That's what's in the past. I I think he was mistreated by his party. But let's focus on what we need to do.
▶ 1:59:05Let's quit exaggerating things and and try to get some things done that matter for the American people. I yield back to the gentleman from South Carolina. Thank you for yielding. I yield back to the chairman from New Fair point. Gentleman yields back and recognize uh the gentle lady from California for five minutes. Uh thank you, Mr. Chairman.
▶ 1:59:35I wasn't going to speak, but I feel compelled to say something uh responsive to what my colleague just talked about because the hypocrisy is just hard to just sit and listen to without saying anything.
▶ 1:59:52Um my colleague wants to talk about fiscal responsibility and the Yet under this president, under this administration, with House Republicans, they are the ones who help blow up the debt. And they want to do it again. They're looking to add trillions and trillions of dollars to the debt. Don't take my word for it. Just go look at the clip that Senator Ran Paul had on the Senate floor the other day.
▶ 2:00:22So don't come and lecture us about the debt when that is exactly what you are doing. And two, why why are you doing it? Who are you going to help? It's not people who need mental health services. It's billionaire donors. Oh, and my colleague made a comment how Democrats have a problem with billionaires.
▶ 2:00:48I will just remind the American people, Elon Musk spent almost a quarter billion dollar to elect this president. And what did he get in return? He's gotten complete control over the White House, over cutting programs. Even House Republicans have yielded their power, have yielded their oversight power on the billionaire Elon Musk. So, don't tell us we have the problem.
▶ 2:01:18The problem, and the American people see it, is House Republicans bending the knee. It's House Republicans giving in and saying, "We're going to let this billionaire do whatever he wants." I've been to town halls in my district. I've been to town halls in Republican districts. And this is a concern of the American people. And don't be gaslighted when Republicans say they're not giving tax cuts to the billionaires because that's exactly what is happening. It's in writing.
▶ 2:01:48These proposals are out there. And then next week in this committee, we're going to have a hearing on where we're going to find $880 billion to cut. Why? So they could give tax cuts to their billionaire friends. And what do you have to touch to get there? The math tells you you've got to touch Medicaid. You've got to touch health care for people that are disabled, people that need it, and many of these people are already working.
▶ 2:02:19You've got to do it. So, I'm looking forward to having this conversation. But this is really corruption at its finest in government right now in selling basically power away to a billionaire who has a seat at the cabinet meeting tables when he's not even a cabinet member who won't come into the Congress to be held accountable. As a matter of fact, there is no oversight.
▶ 2:02:42Every day we see House Republicans not lowering to uh bring cost down, which is exactly what the American people thought they were going to get, but prices are going up. And House Republicans in the Congress, what are they doing? They're passing rules. So, we can't have any oversight, so we can't have any inquiries. So, don't be fooled by the rhetoric. Go look at the actions. Go look at the actions. And with that said, there should be an investment in mental health services.
▶ 2:03:12Okay. My colleague also wants to talk about immigration. Let's talk about that just for a second. US citizens are being deported from this country. You don't think that the American people, even US citizens, are having mental health impacts on what is happening in this country right now?
▶ 2:03:29US So don't come and lecture us about mental health when you are standing silently, saying nothing, doing nothing because you're too afraid and because a billionaire is making these calls and you're okay with that and you're saying, "Well, this guy's rich, so he must know what he's doing." And nobody thinks that one federal worker shouldn't be laid off.
▶ 2:03:58That is a total lie. like total misrepresentation. That's not what they're doing. This was a sledgehammer approach, saying we're just going to cut all these employees. We're not going to do any review. We're not going to look at any programs. We're just going to take the sledgehammer approach. And with that said, I yield back. Gentle lady yields back. Is anybody on the Republican side that wishes to speak? Seeing none, is there anyone else? Miss uh Mlullen of Virginia.
▶ 2:04:30Thank you, Mr. Chair, I just want to also comment on this notion that Democrats don't want layoffs. What we don't want is for the administration to put in the hands of an billionaire with no federal government experience.
▶ 2:04:58Hiring a group of people with no federal government experience who have no idea what the agencies do where they're instituting mass layoffs. to go in and give people 15 notice that they're being fired.
▶ 2:05:18Fire by accident the workforce that prevents the spread of Ebola and then laugh about it in a cabinet meeting and say, "Oops, mistakes were made." The private sector doesn't operate like that. No other institution treats people like that.
▶ 2:05:43They go through and figure out agency by agency or department by department what functions are essential and which ones are not. None of that happened here. And all of these firings impact our state and local partners in Virginia.
▶ 2:06:05The firings at HHS, over a fourth of its workforce, trickled down and impacted firings at our Department of Health, our local departments of health, putting programs that keep people in rural Virginia, urban Virginia, and everywhere in between healthy and safe at risk.
▶ 2:06:28They happen at the same time that the administration illegally dismantles the Department of Education and says, "Well, the functions that they do dealing with students with disabilities or providing services to atrisisk students will just be done by the department of HHS, which has no expertise or training or experience dealing with children with And who's going to do it when a fourth
▶ 2:06:58of their workforce is being fired? It is cavalier, in some cases downright cruel way that our federal employees first were traumatized, which is what Russell Vaugh said he wanted to do, and he's done it.
▶ 2:07:16They've been traumatized, dehumanized, thrown away like trash with no regard not only for the impact on them and their families, but the impact on the critical services like addressing substance abuse disorders that we're trying to address.
▶ 2:07:35And I think what the I think what the what I won't speak on the whole I won't speak for the whole Democratic party but what I want to see is some compassion, some thought, some foresight and some honesty about what Doge and Elon Musk and the least qualified Secretary of Health and Human Services I've ever seen in my lifetime are doing not just to our workforce,
▶ 2:08:05but to the vital services the American people want us to provide as a federal government to keep them alive. That's what we want to see. And to say, well, we're doing this because we have to get the the debt control. It was the first Trump administration that blew a hole in the debt, adding over eight trillion dollars to it.
▶ 2:08:33and it was your side of the aisle that voted for a budget plan that would increase the debt even more. So, let's let's talk about what's happening and let's try to throw a little bit of compassion in as we try to figure out how to keep Americans safe. Thank you. Gentle lady yields back. Any further speakers? Seeing none, uh let's move to a vote on the amendment.
▶ 2:09:02And we have a roll call requested. Mr. Lada. Mr. La votes no. Mr. Griffith Mr. Griffith votes no. Mr. Bill Rockus. Mr. Hudson. Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Mr. Palmer.
▶ 2:09:33Mr. Palmer votes no. Mr. Dunn. Mr. Krenshaw. Mr. Joyce. Mr. Joyce votes no. Mr. Weber. Mr. Weber votes no. Mr. Allen. Mr. Allen votes no. Mr. Balderson. Mr. Balderson votes no.
▶ 2:10:03Mr. Fulture Mr. Fulture votes no. Mr. Fluger. Mrs. Harshburgger. Mrs. Harshburgger votes no. Mrs. Miller Meeks. Mrs. Miller Meeks votes no. Mrs. Kamik Mrs. Kamik votes no. Mr. Mr. Obernolulti Mr. James Mr.
▶ 2:10:32James votes no Mr. Ben Mr. Ben votes no Mrs. Hchin Mrs. Hchin votes no Mr. Fry Mr. Fry votes no Mrs. Lee Ms. Lee votes no Mr. Langworthy. No. Mr. Langworthy votes no. Mr. Kaine Mr.
▶ 2:11:02Kaine votes no. Mr. Roelly Mr. Evans. Mr. Goldman. Mr. Goldman votes no. Mrs. Mrs. Fedorek votes no. Mr. Palone. Mr. Palone votes I. Mr. Digette. Mr. Get votes I.
▶ 2:11:32Miss Shakowski I. Miss Shakowski votes I. Miss Matsui. Miss Matsui votes I. Miss Caster. Miss Caster votes I. Mr. Tonko. I. Mr. Tonko votes I. Miss. Clark. Miss Clark votes I. Mr. Ruiz. Mr. Ruiz votes I. Mr. Peters. Mr.
▶ 2:12:02Peters votes I. Mrs. Dingle. Mrs. Dingle. Votes I. Mr. Vzy. Mr. Vzy votes I. Miss. Kelly. Miss. Kelly. Votes. I. Miss Bettergon. Miss. Better. votes I. Mr. Sodto, Mr. Sodto votes I.
▶ 2:12:28Miss Shrier, Miss Shrier votes I. Miss Trey, Miss Treyanne votes I. Miss Fletcher. Miss Fletcher votes I. Miss Miss Okaziocortez votes I. Mr. Mr. Mr. Aenclaus votes I. Mr. Carter of Louisiana I.
▶ 2:12:58Mr. Carter of Louisiana votes I. Mr. Mendez I. Mr. Mendez votes I. Mr. Mullen. Mr. Mullen votes I. Lansman. Mr. Lansman votes I. Mlullen M. Mlen votes I. Chairman Guthrie.
▶ 2:13:28Chairman Guthrie votes no. Mr. Bill Rockis votes no. Mr. Hudson Mr. Hudson votes no. Mr. Krenshaw votes no. Dr. Dunn is not recorded. Dr. Dunn votes Mr. Obernulti votes no.
▶ 2:14:06Seeing no other president for the roll call, the clerk will report. Chairman Guthrie, on that vote, there were 24 eyes and 27 nos. The amendment is not agreed to. Are there further amendments? Little gentle lady from Texas, Miss Fletcher. For what purpose do you seek recognition? Uh, Mr. Chairman, I have an amendment at the desk. The clerk will report. Mr. Chairman, could the gentle lady please specify her amendment? Uh, yes.
▶ 2:14:34I have an amendment specified H2483 AMD_1_XML. And if I could reserve a point of order, Mr. Chairman, court order is observed by the gentleman from Virginia. Clerk will report. Amendment to the amendment in the nature of a substitute to H. Without objection, the reading amendment is dispensed with and the gentle lady from Texas is recognized for five minutes in support of the amendment. Well, thank you, Mr. Chairman.
▶ 2:15:02Um, I have uh this important amendment uh on an issue that's squarely before this committee today and that will be again and again. But before I get into that amendment, I do want to associate myself with the comments from ranking member Palone and oversight ranking member Clark. Um because we cannot remove the work that this committee is doing from the context that we are doing it in, which is what my colleagues on the other side of the aisle keep suggesting we do today.
▶ 2:15:31This isn't bickering as Mr. Obernolulti suggested. It is objecting. It is objecting to using this committee and this Congress in a charade that obscures what the Trump administration is doing what it is actually doing. Cutting the programs that we're authorizing and cutting the funding that we're appropriating to make them possible. And on this bill for example, we just heard from Representative Caster.
▶ 2:15:58Um, we know that the White House Office of Management Budget Management Budget has shared its budget proposal eliminating the support act programs that we are here talking about reauthorizing. And so, you know, it's really important that we understand the bigger context in which this is happening. And these cuts are continuing. And that's what my amendment is about. Uh, my amendment is about cuts to Medicaid.
▶ 2:16:22And more than 70 million people in every state in this country rely on Medicaid to receive the health care they need, including mental health care. In my home state of Texas, Medicaid provides healthcare to more than 3.8 million people. Um, and Texas has very narrow eligibility for Medicaid coverage. Adults under 65 who are not disabled or raising a child are ineligible for Medicaid, no matter how much they make.
▶ 2:16:52no matter how low their income is. And th those that do qualify, the formula is based on the federal poverty level, as we all know. And as a reminder, what is the federal poverty level this year? For a single person, it is income of $15,650 a year. For a family of four, $32,150. So many people in Texas don't even qualify for Medicaid.
▶ 2:17:20But for the people who do, it is children, adults with disabilities, people living in nursing homes, and moms who've just given birth. And I should add, as we look ahead to the proposals we anticipate coming to this committee, 57% of the adults in Texas, of those adults I just identified, who receive Medicaid are working.
▶ 2:17:40Despite Texas's narrow limits, in my district, more than 85,000 of my constituents rely on Medicaid and more than 60,000 of them are children. And I've looked at the most recent tables. Um I'm sorry that many of my Republican colleagues from Texas um are not in here to hear this, but um many of most of my Republican colleagues on this committee from Texas have more constituents relying on Medicaid in their districts than I do. And of course, Mr.
▶ 2:18:10Chairman, I looked at Kucky's second district, and as I'm sure you know, there are more than 211,000 people in that district relying on Medicaid. This matters. This matters to the people who are relying on Medicaid for their critical health care, including their mental health care. It matters to the people that we are here to represent.
▶ 2:18:32They are relying on Medicaid for access to treatments, for access to the devices and the care that we spend so much time on this committee working on, trying to enable, trying to make possible. And there is just no way that you can cut billions of dollars from Medicaid without hurting all of our constituents. And you don't have to just take my word for it.
▶ 2:19:00The CBO said so on March 5th. I have the letter from the CBO here uh responding to a request from ranking member Palone and Mr. Bole. I would like to submit it for the record. Um this says that you cannot cut from the budget from our committee um without Medicaid. I'd like to submit that for the record. Mr. Mr. Chairman, without objection. So thank you.
▶ 2:19:29It's just there is not a single congressional district that's going to come out unscathed from cuts to Medicaid. Our constituents depend on us to stand up for them in this room and in this body.
▶ 2:19:44So, I have an amendment at the desk in this markup to ensure that we do that by preventing the Department of Health and Human Services from taking actions that would reduce eligibility, reduce enrollment, reduce covered benefits, increase cost sharing, or reduce federal funding for medical assistance for people eligible for Medicaid or CHIP. Simply put, it prohibits the administration from making cuts to the Medicaid program.
▶ 2:20:12And I hope that my colleagues on both sides of the aisle understand the damage this is going to do to all of our constituents, to people across this country, and to the work that we have been doing on this committee to help get people get access to the health care, the treatments that they need um including mental health care. So I hope that uh everyone on this committee can come together to protect the people we represent. And with that, I will that gentleoman yield to me. Would the gentleman? Yes.
▶ 2:20:41Yes, you mentioned um the gentlewoman mentioned the OM budget that proposes to cut eight of the support act programs and I'd like to submit that for the record, Mr. Chairman, if I could. The budget without objection to order. Thank you. I yield back to the gentleoman. Thank you. And I yield back, Mr. Chairman. Gentle lady yields back. The gentle gentleman from Pennsylvania, Dr. Joyce, is recognized for five minutes on the amendment. Mr. Chairman, I move to strike the last word. is recognized.
▶ 2:21:12Mr. Chairman, I speak in opposition to the amendment and while I appreciate my colleagues interest in supporting individuals with substance use disorder and mental health conditions, this amendment is unnecessary. The support act that we are considering today proposes no changes to Medicaid. As evidenced by the bill under consideration today, Republicans have made it clear that this committee will continue to focus on substance use disorder.
▶ 2:21:39This work will build on the inroads Congress made last year, which includes reforms to lift the IMD exclusion for substance use disorder treatment in Medicaid and to expand access to Medicaid's coverage of addiction treatments, including policies to subst suspend coverage for beneficiaries while they're incarcerated so that the coverage can resume immediately upon their re-entry into the community.
▶ 2:22:07We have made it clear that we want Medicaid programs to focus on the most vulnerable populations among us, including those with substance use disorders. Again, I will note that today's bill does not make any changes to Medicaid, and this amendment is unnecessary. I yield back. The gentleman yields back. The chair, the ranking member wants his own time, so I will yield to the ranking member. Thank you, Mr. Chairman.
▶ 2:22:35the a lot of discussion in the context of this amendment about Medicaid. And you know, it's been reported, Mr. Chairman, that next week we're going to consider, and I don't know that it's been officially noticed, but it's been reported that next week we'll consider the majority's reconciliation bill in the Energy and Commerce Committee, which has been instructed to cut at least 880 billion in federal funding. And the Congressional Budget Office has made clear there's no way to get to this number without hundreds of billions of dollars and devastating cuts to Medicaid.
▶ 2:23:05This is what Miss Fletcher said. But the problem that I have is that House Republicans continue to claim that there will not be cuts to Medicaid or that these cuts won't result in people, including their own constituents, losing benefits. the speaker has essentially said that and so has President Trump and and um even um a lot of members of Congress on the Republican side.
▶ 2:23:28So, chairman, you said in the press, and I quote, that there is an opportunity to not take away any benefits," unquote. So, I wanted to ask you, does this mean that the reconciliation bill, which is likely going to be released next week, will not cut benefits for the workingclass Americans who rely on Medicaid for their health care? Are you basically taking the position that we're not going to cut Medicaid benefits? That's my question.
▶ 2:23:57Well, we are still working as a committee uh as on the Republican side on what a reconciliation bill working with uh other members of the House and and the in the in the White House. And we are set, if you know, Medicaid is scheduled to grow from about a $700 billion program to to a trillion dollar program. And we believe there's opportunity uh in the growth to Medicaid, but we'll still I will tell you, we'll still still spend more money each and every year on Medicaid over the next 10 years.
▶ 2:24:24Well, you know, I I I do appreciate your honesty, I think, in that you have suggested that there may be Medicaid cuts, and so I appreciate you being honest and saying that, although obviously I oppose the Medicaid cuts, but at least you're suggesting that there may be uh and being honest about it. I I don't know what the speaker or the president are doing because they're suggesting otherwise.
▶ 2:24:46But given the breadth of the cuts uh by this committee that I think will happen to Medicaid, when do you expect we'll actually see the text of of the bill? Will the Democrats and the American public be afforded only the 36 hours prior to the markup or are we going to have more time? When will we get this text? I don't believe that uh I've ever used the word cut. I do say that there's an opportunity to restrain the growth and modernize the program. Uh we are still working through.
▶ 2:25:14We're trying to we will obviously meet the notice requirements of the committee and uh we'll look forward to hopefully getting to the point we're ready to go forward. Well, I would hope that we get more than the 36 hours. I know that that's all that's required, but I think given the magnitude of this, however you describe it as cuts or not cuts, we should be able to see the text more than 36 hours. So, I would ask I would ask that uh that be the case. We'll see.
▶ 2:25:41Um, you know, I expect this bill is going to cut people off their health coverage, decimate the benefits they receive, uh, balloon Americans out-of- pocket costs of medical debt, and slash payments to an already strapped Medicaid provider program and and gut access to care. And so, I I I do want to stress that, however you call it, the bottom line is um that we're going to see cuts to Medicaid and people throwing off off their healthcare coverage.
▶ 2:26:10And so I think it's important that this document get out well before um the committee reconciliation markup. Uh I know some members had suggested that next week would be a hearing, but I want everyone to understand there's not a hearing. This is going straight to markup. And so there's not going to be a hearing. All the more reason why I think we should get the bill well before the 36 hours. And the bottom line is that all this is being done.
▶ 2:26:36All these cuts are being proposed just to pay for tax cuts for billionaires and large corporations. That's what it's all about. But in any case, Mr. Chairman, I yield back. The gentleman yields back. The chair needs Republican members seeking recognition. Gentleman from Florida, Mr. Sto is recognized for five minutes to speak on the amendment. Thank you, Mr. Chairman. I rise to oppose cuts to CHIP. Uh kid Care is what's known in Florida.
▶ 2:27:05About 50% of kids under six years old in my district uh are on this program. It's been a hundred days since President Trump took office as of today. And I know what you're thinking. It's felt like a year. Uh he's garnered the lowest approval rating of any president in 80 years, which is not a surprise because he wrecked a good economy in a 100 days. And the reasons are obvious.
▶ 2:27:33International trade and tourism critical to places like Central Florida and decline because he's attacking our allies. His tariffs are causing costs to rise. Unemployment is up. Retirement plans are down. And some of our workforce is being deported. In Florida, about a third of our workforce are immigrants in tourism, agriculture, construction, and service industry.
▶ 2:27:57And Trump is barreling us towards a recession, the most avoidable recession in my lifetime. Back home in the district for the last two weeks, I heard from small businesses who are seeing less customers, manufacturers in theme parks who are seeing their workers deported, and hotels with bookings dropping like a rock. It's no wonder a majority of Americans have already lost faith in President Trump in record time.
▶ 2:28:24Now add in your proposal to cut Medicaid by 880 billion dollars. That markup's coming next week. Massive cuts to kidare, massive cuts to nursing home care. That'll mean 4 billion dollar for Florida's Medicaid program next year. That's about a 10% cut to the program, kicking off seniors and nursing home uh seniors and and kids during what could potentially be a recession. Uh you'll see kids get kicked off kidare.
▶ 2:28:54You know, I visited our state capital last week and they are dumbfounded about the prospect of having to cut that much from the state budget. And for what? For tax cuts for billionaires and a $20 trillion addition to the national debt. And if there is a recession, god forbid, that'll leave us broke and unable to be able to handle it to get us out of it. All this considered, I'm supporting this amendment because this gives us an opportunity to all say no. We're not going to cut kidare care. We're not going to cut nursing home care for seniors.
▶ 2:29:25We're not going to do this for billionaire tax cuts and a massive increase to the national debt. And this amendment gives you the opportunity to stop these Medicaid cuts, too. And I yield back. The gentleman yields. For what purposes? Does a gentleoman from Virginia wish to be recognized? Thank you, Mr. Chair. Um, while this bill may not include cuts to Medicaid, as the as Mr.
▶ 2:29:48Palone, ranking member Palone has pointed out, the math doesn't work for this committee to reach the $880 billion that it has been told to cut without cuts to Medicaid. The Congressional Budget Office has confirmed that. And we've seen Republican proposals floated that would impose per capita caps, eliminate the 90% federal matching rate for Medicaid expansion, and implement burdensome work reporting requirements.
▶ 2:30:15And I want to focus a bit on what happens if we eliminate the 90% federal matching rate and how it relates to addressing uh mental health and substance use disorders. Medicaid is the largest payer for behavioral health services, including treatment for substance use disorders, and covers nearly 40% of Americans living with an opioid use disorder.
▶ 2:30:42Now, in Virginia, there were over 133,000 Medicaid beneficiaries with an identified substance use disorder. Virginia is one of nine states that have trigger laws that state all of the individuals covered under expansion would immediately lose access to their health care and therefore substance use treatment if cuts to Medicaid include cuts to that 90%
▶ 2:31:12match. In rural areas, community health centers play a critical role in treating substance use disorders and cuts to Medicaid could close rural hospitals. When we expanded Medicaid in Virginia, a big reason why Republicans in rural areas supported it was because it would keep their hospitals open. And we have seen estimates that every hospital west of Charlottesville, Virginia could close if we unwind Medicaid expansion.
▶ 2:31:42Our community health centers serve patients with at over 200 service sites in Virginia, 44% in rural areas that would be at risk if Medicaid is unwound. And so I think it's important to look at this bill in the larger context of what is happening in this Congress, what is happening with this administration. And the goal here, I think we all agree, is we want more Americans to be healthy.
▶ 2:32:09And Medicaid patients actually are healthier than private pay patients in many cases because they are connected to medical homes for the first time sometimes in their life. And when they show up for medical visits, they're often less expensive than private pay providers. So, let's look at the big picture and look at what as we pass a bill to address the opioid and substance use disorder.
▶ 2:32:41Let's look at what would happen and how useless this bill will be if there are Medicaid cuts that come out of this committee as early as next week that unwinds the very services being used to provide opioid or substance use disorder treatment to 40% of Americans. Thank you and I yield back. The general lady yields. Is there any further discussion?
▶ 2:33:07Seeing no further discussion, a roll call vote has requested. The clerk will call the role. Mr. Lada. Mr. Lada votes no. Mr. Griffith Mr. Griffith votes no. Mr. Billis Mr. Billis votes no. Mr. Hudson. Mr. Mr.
▶ 2:33:36Carter of Georgia. Mr. Carter of Georgia votes no. Palmer. Mr. Dunn. Mr. Dunn votes no. Mr. Krenshaw. Mr. Krenshaw. Mr. Krenshaw votes no. Mr. Joyce. Mr. Joyce votes no. Mr.
▶ 2:34:07Weber Mr. Allen Mr. Allen votes no Mr. Balderson Mr. Balderson votes no Mr. Fulture Mr. Fulture votes no Mr. Fluger Mrs. Harshburgger Mrs. Harshburgger votes no Mrs. Miller Meeks Mrs.
▶ 2:34:38Kamik Mrs. Kamik votes no Mr. Obernolulti Mr. James Mr. James votes no Mr. Bence Mr. Ben votes no Mrs. Hchen Mr. Fry Mr. Fry votes no. Mrs. Hchin. Miss Hchin votes no.
▶ 2:35:08Miss Lee. Ms. Lee votes no. Mr. Langworthy. Mr. Langworthy votes no. Mr. Kaine. Mr. Kane votes no. Mr. Roelly. Mr. Evans Mr. Goldman Mr. Goldman votes no Mrs. Fedorch Mr.
▶ 2:35:38Fedorch votes no. Mr. Palone. Mr. Palone votes I. Miss Dette. Hi. Miss Dette votes I. Miss Shakowski. I. Miss Shakowski votes I. Miss Matsui. I. Miss Mass Masoule votes I. Miss Caster I. Miss Caster votes I. Mr. Tonko I. Mr.
▶ 2:36:08Tonko votes I. Miss. Clark. Miss. Clark votes I. Mr. Ruiz. Mr. Ruiz votes I. Mr. Peters. Mr. Peters votes I. Mrs. Dingle. Mrs. Dingle votes I. Mr. Vzy. Mr. Vzy votes I. Miss Kelly. Miss Kelly votes I.
▶ 2:36:38Miss Bagon. Miss Baragon votes I. Mr. Sodto. Mr. Sodto votes I. Miss Shrier. Miss Shrier votes I. Miss Trey. Miss Treyanne votes I. Miss Fletcher. Miss Fletcher votes I. Miss Okaziocortez. Miss Okaziocortez votes I. Aenclaus.
▶ 2:37:09Mr. Aenclaus votes I. Mr. Carter of Louisiana. Mr. Carter of Louisiana votes I. Mr. Mendez. Mr. Mendez votes I. Mr. Mullen. Mr. Mr. Mullen votes I. Mr. Lansman. Mr. Lansman votes I. Miss. Mlen. Miss. Mlen votes I. Chairman Guthrie. No. How is Mr. Weber?
▶ 2:37:39Chairman Guthrie votes no. Weber. Mr. Weber is not recorded. Mr. Weber votes no. Hudson. Mr. Hudson. Mr. Hudson votes no. Dr. Miller Meeks Dr. Miller Meeks is not recorded. Dr. Miller Meeks votes no. Oberoni. Mr. Obernoli votes no.
▶ 2:38:08As all So, anybody else seeking recognition for the roll call? Seeing none, the clerk will report. Chairman Guthrie, on that vote, there were 24 eyes's and 26 nos. The amendment is not agreed to. Is there further amendment? Are there further amendments? The gentle lady from Massachusetts, Miss Tran, you, what purpose do you seek recognition? Mr.
▶ 2:38:38Chairman, I have an amendment at the desk titled Tran_011. The clerk will report the amendment. Mr. Chairman, I would reserve a point of order. There's a point of order reserved by the gentleman from Virginia. The clerk will report the Amendment to the amendment in the nature of a substitute to HR24. Without objection to the reading amendment is dispensed with and the gentle lady from Massachusetts is recognized for five minutes for support of the amendment. Oh, thank you, Mr. Chairman.
▶ 2:39:08My amendment narrow narrowly focuses on the health and well-being of millions of Americans who depend on Medicaid for life-saving substance use disorder and mental health services. Now, as has been said, my Republican colleagues are pushing to cut 880 billion from programs under our committee's jurisdiction.
▶ 2:39:30Uh we know that those details will not be shared with us or the American people until you know hours before we're back in this room next week. But we know that such reduction or that level of reduction would severely impact families and children who rely on Medicaid for essential care. Uh we know Medicaid serves as a lifeline for individuals battling addiction and mental health conditions.
▶ 2:39:56It provides coverage for a significant portion of those seeking treatment, ensuring the services are accessible regardless of income. The proposed cuts threatened to dismantle these vital services, potentially leaving countless individuals without the support that they need to recover and lead fulfilling lives. And I know what my colleagues are going to say because this markup is, you know, it's just been an exercise in avoiding the $880 billion elephant in the room.
▶ 2:40:24But you can appreciate the position that we're in passing a bill that is largely bipartisan only to have the rug pulled out from under the people we represent week. This amendment ensures that any funding reductions do not compromise the coverage of substance use disorder and mental health treatments or restrict the eligibility of individuals requiring these essential services.
▶ 2:40:51Now, my Republican colleagues want Americans to believe that cutting Medicaid is about rooting out waste. But in reality, it means eliminating coverage for people who are just trying to recover. Protecting these services isn't just about coverage. It's about making sure that people can actually get the care that helps them get back on their feet. It's about real lives, real families, and making sure that we don't abandon people when they're at their most vulnerable. And I I just want to be clear about this.
▶ 2:41:21You know, if House Republicans move forward with these level of cuts, they are threatening the very foundation of our country's response to the opioid and mental health crisis. Medicaid is what makes treatment possible for millions of people. Gutting it will mean fewer treatment beds, longer wait times, more people slipping through the cracks, and more preventable deaths. It means more empty seats at the dinner table.
▶ 2:41:48Lives lost not because we couldn't help, but because Republicans in Congress chose not to. Every member of this committee should vote to protect the core programs that we oversee. I urge my colleagues to support this amendment because it is proactive. We don't want to lose ground in the fight against addiction and so we have to keep Medicaid strong for the people who need it most. Thank you. I yield back. Thank you. The gentle lady yields back. The chair recognized gentleman from Georgia, Mr.
▶ 2:42:18Carter, for five minutes. Mr. Chairman, while I appreciate my colleagues interest in supporting individuals with substance use disorder and mental health conditions, this amendment once again is unnecessary. The support act we are considering today proposes no changes whatsoever to Medicaid. As evidenced by the bill under consideration today, Republicans have made clear that this committee will continue to focus on substance use disorder.
▶ 2:42:44This work will build on the inroads Congress made last year, which includes reforms to lift the IMD exclusion for substance use disorder treatment to Medicaid and to expand access to Medicaid's coverage of addiction treatments, including policies to suspend coverage for beneficiaries while they're incarceration so that the coverage can resume immediately upon their re-entry into the community.
▶ 2:43:08We've made it clear that we want the Medicaid program to focus on the most vulnerable populations among us, including those with substance use disorders. Again, I will note that that today's bill does not make any changes whatsoever to Medicaid, and this amendment again is unnecessary. I yield back. Will the gentleman yield? I yield.
▶ 2:43:32I this has kind of played out all day where we say it's unnecessary because of the bill before us that we all you know many of us support. I don't see the problem with voting for an amendment that would safeguard the very bill that we are passing from future threats that could be coming. Maybe they won't.
▶ 2:43:56Maybe you're right and you're not going to touch Medicaid for people who are struggling with substance use disorder and mental health, but why wouldn't you give the insurance to the American people by fi by voting on that amendment and safeguarding that coverage for folks? Mr. Chairman, reclaiming my time. If we tried, Mr. Chairman, to to guard against everything that might happen, we'd be here forever.
▶ 2:44:25We've made commitments that this is not going to happen. So I I just find it unnecessary to have this amendment once again as I found the others unnecessary as well. And I yield back. Thank you. The gentleman yields back. Further discussion. Gentleman from New York. What purpose do you seek recognition? Mr. Chair, I move to strike the last. Gentleman is recognized.
▶ 2:44:45Well, listening to the comments, um, House Republicans are seeking massive, devastating cuts targeted squarely at our most vulnerable communities and putting vast numbers of children, seniors, and people with disabilities at risk of losing their Medicaid coverage. These reckless cuts are so much more than just numbers on a page. They threaten the lives, they threaten the livelihoods of real people across America.
▶ 2:45:10In my district of New York 20, Medicaid ensures more than individuals. Millions of Americans would suffer if Trump and Musk achieve their goal of slash slashing these programs. Medicaid is also the single largest payer for behavioral health services. So that any cuts would mean gutting access to health care for mental health and substance use disorders. Is that is that really what we want to cut?
▶ 2:45:39Repealing Medicaid expansion would rip coverage away from millions of insured individuals, individuals that are struggling with addiction and behavioral health needs as we speak. Additionally, Medicaid coverage can play an integral role in preventing a mental health crisis and in preventing substance use disorder.
▶ 2:45:59So if Medicaid cuts were put in place, states would be forced to take on more of the burden and shift further resources away from other services, including prevention, including treatment, and including recovery. So we must stop Medicaid from being decimated so that our loved ones living with the disease of addiction or living with a mental health disorder can access needed care. This is about doing preventative therapy here.
▶ 2:46:26It's making certain we make a statement and make make a a vote certain that these programs won't be at risk. These are people that are very vulnerable with these cuts. And with that, Mr. Chair, I yield back. Gentleman yields back. Is there any further Seeing none, the question is on the amendment and the clerk will call the Mr. Lada.
▶ 2:46:56No. Mr. La votes no. Mr. Griffith. Mr. Griffith votes no. Mr. Bill Rockus. Mr. Bill Rockus votes no. Mr. Hudson. Mr. Hudson votes no. Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Palmer. Mr.
▶ 2:47:27Dunn. Mr. Dunn votes no. Mr. Krenshaw. Mr. Krenshaw votes no. Mr. Joyce. Mr. Weber. Mr. Allen. Mr. Allen votes no. Mr. Balderson. Mr. Balderson votes no. Mr.
▶ 2:48:01Fulture. Mr. Fulture votes no. Mr. Fluger. Mrs. Harshburgger. Mrs. Harshburgger votes no. Mrs. Miller Meeks. Mrs. Mr. Kamik Mrs. Kamik Mrs. Kamik votes no Mr.
▶ 2:48:31Obernolulti Mr. Obernulti votes no Mr. Mr. James votes no Mr. Benz Mr. Ben votes no Mrs. Hchin Mrs. Touchin votes no. Mr. Fry. Mr. Fry votes no. Miss Lee. Miss. Lee votes no. Mr. Langworthy. Mr.
▶ 2:49:00Langworthy votes no. Mr. Kaine. Mr. Kane votes no. Mr. Roelly. Mr. Mr. Evans, Mr. Goldman, Mr. Goldman votes no. Mrs. Fedorek, Mr. Fedorch votes no. Mr. Palone, Mr. Palone votes I. Mette. Mr.
▶ 2:49:30Dette votes I. Miss Miss Mass Masouie. I. Miss Mass Masouie votes I. Miss Caster I. Miss Caster votes I. Mr. Tonko I. Mr. Tonko votes I. Clark. Miss. Clark votes I. Mr. Ruiz. Mr. Ruiz votes I. Mr. Peters.
▶ 2:50:01Mr. Peters votes I. Mrs. Dingle. Mrs. Dingle votes I. Mr. Vzy. Mr. Mr. Vzy votes I. Miss Kelly. Miss Kelly votes I. Miss Bagon. Miss Bagon votes I. Mr. Sodto. Mr. Sodto votes I. Miss Shrier.
▶ 2:50:30Miss Shrier votes I. Miss Trean. Miss Trean votes I. Miss Fletcher. I Miss Fletcher votes I. Miss Miss Okasiocortez votes I. Mr. Oenclaus, Mr. Oenclaus votes I. Mr. Carter of Louisiana. Mr. Carter of Louisiana votes I. Mr.
▶ 2:51:02Mendez. Mr. Mullen. Mr. Mullen. Votes I. Mr. Mr. Lansman. Mr. Lansman votes I. Miss Mlen. Miss Mlen votes I. Chairman Guthrie Chairman Guthrie votes no. Mr. Palmer is not recorded. Mr. Palmer votes no. Mr. Weber votes no. Mr.
▶ 2:51:31Weber votes no. Dr. Joyce Dr. Dr. Joyce votes no. Mr. Mr. Balderson, are seeking any Mr. uh Mr. Menendez? Mr. Menendez is not recorded. Mr. Menendez votes I. M Shakowski votes I. Any see anyone present for the roll call?
▶ 2:51:58Seeing none, the clerk will Chairman Guthrie on that vote there were 24 eyes's and 26 nos. The amendment is not agreed to. Is there further are there further amendments? The gentle lady for what purpose? Gentle lady from New York. Miss Kasio Cortez seek recognition. Mr. Chair have an amendment at the desk. The clerk will report. What amendment. You name the amendment. It's uh H2483.
▶ 2:52:31Okay. What is it? Underscore underscore is it underscore3? Yes. Yes. Okay. Underscore three. And Mr. Chairman, I will continue to reserve. Clerk will report. The gentleman from Virginia reserves a point order. Amendments to the amendment.
▶ 2:53:00nature of a substitute to HR 2483 offered by without objection the reading amendment is dispensed with and the gentle lady from New York is recognized for five minutes in support of our amendment. Thank you Mr. Chair. Uh this amendment would uh require HHS, Health and Human Services to examine the impact on coverage, access to care, and health outcomes among pregnant women, parents, and infants if Medicaid expansion funding to states is reduced or if
▶ 2:53:30enrollment of such individuals decreases following changes to federal requirements that may make it more difficult uh for people to enroll. And I know that uh around many of our uh around Medicaid, there have been a lot of commitments that are made that no one will be cut from Medicaid.
▶ 2:53:49I don't know if $880 billion in cuts necessarily squares with um I mean, we know that the math doesn't square with everyone being able to preserve their Medicaid coverage and people being eligible being able to preserve their Medicaid uh coverage.
▶ 2:54:06So I think it's important for us to assess um what those health outcomes and impacts would be especially among some of our most vulnerable people like um pregnant pregnant women, parents and also in infants that could be affected.
▶ 2:54:20Now, we've heard throughout this markup, we heard just recently uh with Congressman Tran's amendment that we don't need any of these amendments to take our word that the word has been given that Medicaid is going to be protected to that to trust us that no one is going to be affected by this. But as a woman, the word was given to me that my rights would not be taken away by the Supreme Court. And that wasn't true.
▶ 2:54:48uh as an American uh the word was given that our you know our first amendment uh protections would be in place for everyone including green card holders and people who are lawfully here in this country that didn't end up to be true. So I think we should um ensure that if the word here is that we will be deliberative and in assessing uh who would be affected and to ensure that people would be protected then I think we should make those assessments.
▶ 2:55:19Um, we know that 96 to 98% of people who currently rely on Medicaid are either working, taking care of a family member in school, retired, or can't work due to an extreme disability.
▶ 2:55:32And we've also known from increased paperwork requirements that were eventually overturned or rescended in Arkansas and states like Georgia, um, tens of thousands of people were kicked off of Medicaid roles who were eligible due to clerical errors and other administrative errors.
▶ 2:55:51We also know that when the state of Georgia implemented these increased paperwork uh requirements, 90% of that spending went to administration of this paperwork instead of actually giving health care to people who are eligible for it.
▶ 2:56:08So, I think it's important that we assess the impacts of um rescending Medicaid expansion and adding uh bureaucratic paperwork requirements on top of people who are already proven to be eligible. Um and that's what this amendment seeks to accomplish. Thank you. General Lady yields.
▶ 2:56:28The chair recognizes himself for five Again, nothing in this bill touches Medicaid. Nothing in this bill touches Medicaid. That wasn't actually the case when we marked this bill up in committee for the first time two years ago, but it is the case now.
▶ 2:56:48There was bipartisan agreement to support Medicare Medicaid care by lifting the IMD exclusion, improving access to care for foster youth in crisis, and supporting care for those in incarceration and re-entering their communities. Why aren't those in the bill today? We actually got them signed in the law. They don't need to be in the bill today. Medicaid funding for substance use disorder treatment is a bipartisan issue.
▶ 2:57:15So to say that we need to study funding cuts when there are none in this bill and when we've already worked to actually increase Medicaid spending for substance use disorder in our original committee product is just unnecessary. And I yield back. Anyone wanting to speak on this bill, on this amendment? Excuse me. Republicans?
▶ 2:57:44If not, a roll call bill, a roll call vote has been has been requested. The clerk will call the role. Ladder. Mr. Lada votes no. Mr. Griffith Mr. Griffith votes no. Mr. Billis Mr. Billis votes no. Mr.
▶ 2:58:16Hudson. Mr. Hudson votes no. Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Palmer. Mr. Palmer votes no. Mr. Dunn Mr. Dunn votes no. Mr. Krenshaw Mr. Joyce Mr. Joyce votes no.
▶ 2:58:46Mr. Weber Mr. Weber votes no. Mr. Allen Mr. Allen votes no. Mr. Mr. Balderson. Mr. Balderson votes no. Mr. Fulture Mr. Fulture votes no. Mr. Fluger. Miss Harshburgger.
▶ 2:59:14Miss Harshburgger votes no. Miss Miller Meeks. Mrs. Kamik. Mrs. Kamik votes no. Mr. Mr. Obernulti Mr. Obernolulti votes no. Mr. James Mr. James votes no. Mr. Bence Mr. Bence votes no. Mrs. Hchen Mrs.
▶ 2:59:43Hchen votes no. Mr. Fry Mr. Fry votes no. Miss Lee Ms. Lee votes no. Mr. Mr. Langworthy. Mr. Langworthy. No. Mr. Langworthy votes no. Mr. Kaine Mr. Kaine votes no. Mr. Roelly, Mr.
▶ 3:00:13Evans, Mr. Goldman, Mr. Goldman votes no. Mrs. Fedorek, Miss Fedor votes no. Mr. Palone. Mr. Palone votes I. Mr. Deette Mat votes I. Miss Shakowski. Miss Shakowski votes I. Miss Matsui. Miss Matsui votes I.
▶ 3:00:42Miss Caster. Miss Caster votes I. Mr. Tonko. Miss. Clark. Miss. Clark votes I. Mr. Ruiz. Mr. Ruiz votes I. Mr. Peters. Mr. Peters votes I. Mrs. Dingle. Mr. Vzy. Mr. Vzy. Votes.
▶ 3:01:12I. Miss. Kelly. Miss. Kelly. Votes. I. Miss. Baragon. Miss. Vagon. Votes. I. Mr. Sodto Mr. Sodto votes I. Miss Shrier Miss Trean Miss Trean votes I. Miss Fletcher. Miss Fletcher. Miss Fletcher votes I.
▶ 3:01:42Miss Okaziocortez. Miss Okaziocortez votes I. Aenclaus. Mr. Okinclaus votes I. Mr. Carter of Louisiana Mr. Carter of Louisiana votes I. Mr. Mendez. Mr. Menendez votes I. Mr. Mullen. Mr. Mullen votes I. Mr. Lansman. Mr. Lansman votes I. Ms.
▶ 3:02:13Mlen. M. Mlen votes I. Chairman Guthrie. Chairman Guthrie votes no. Mr. Krenshaw is not recorded. Mr. Krenshaw votes no. Mr. Tonko is not recorded. Mr. Tonko votes I. Miss Shrier. M. Shrier votes I.
▶ 3:02:51We okay? Yeah. Okay. The clerk will report the results. Mr. Chairman, on that vote, there were 23 eyes and 26 nos. The amendment is not agreed to. Are there further amendments? Chair recognizes the gentle lady from Virginia. For what purpose does she seek recognition? Thank you, Mr. Chair. I have an amendment at the desk labeled support 2025 amendment 8. And Mr.
▶ 3:03:20Chairman, if I could reserve a point of order. Gentleman from Virginia Thank you. Point of order. Will the clerk please report the bill the amendment? Excuse me. Amendment to the amendment in the nature of a substitute to HR 2483 offered by Miss McCullen. At the end of the bill, add the following. Prohibition of certain removals of employees for centers for disease.
▶ 3:03:47Without objection, the reading of the amendment is dispensed with and the general lady is recognized for five minutes in support of the amendment. Thank you, Mr. Chair. This amendment addresses uh mass layoffs at the CDC would prevent implementation of further uh layoffs or similar actions that would result in cuts to over 3% of the AY's employees within a 60-day period.
▶ 3:04:10And before I go any further, um I do want to take a quick point of personal privilege to wish my daughter Samantha a happy 10th birthday today. Um and that's because we both almost died when she was born by emergency C-section after my placenta ruptured. And that experience furthered my commitment to addressing the horrendous maternal mortality crisis in this country.
▶ 3:04:38And that led me to further understand the intersection between substance use disorder and maternal mortality. Now, thanks to CDC data and analysis relied upon by the Virginia Department of Health, specifically from the pregnancy risk assessment monitoring system or pram, I came to understand that the underlying causes of maternal death, many of which are preventable.
▶ 3:05:05An accidental overdose is a leading cause of pregnancy associated death and is the leading cause of death for white women Virginia for pregnancy associated deaths.
▶ 3:05:19But now the entire pram's team is gone as part of the cuts to nearly one quarter of the workforce announced earlier this month by Secretary Kennedy at the Department of Health and Human The pram's team was part of the 2,400 employees cut at the CDC and a recently leaked HHS budget document indicates that CDC funding could be further cut by over 40% on top of these
▶ 3:05:49firings. And the devastating impacts of these cuts have become clear as the CDC divisions not only support addressing the maternal mortality crisis and the substance abuse crisis, but workforce safety, injury prevention, HIV, and more. Now, following Secretary Kennedy's announcement, I introduced a bill to prevent these reckless workforce cuts at HHS.
▶ 3:06:17And that's because I find it unfathomable and deeply hypocritical for the Trump administration to claim that it wants to make Americans healthier and safer while dismantling the very agencies, workforce, and programs that do that. I'm perplexed that we are authorizing public health programs here today as critically important as much as I support them.
▶ 3:06:44And yet my colleagues on the other side of the aisle have remained silent about the firing of the very staff needed to carry them out. So this amendment would prevent the CDC from implementing further mass layoffs. Now in addition to its critical role in addressing the maternal mortality crisis, the CDC provides critical public health information, including on substance abuse disorders. It monitors trends to better understand and respond to the epidemic.
▶ 3:07:12Advances research by collecting and analyzing data on opioid overdoses. Improves data quality to better identify areas that need assistance and to evaluate prevention efforts through the division of overdose prevention. That's on top of all of the other important critically important roles the CDC plays protecting Americans from infectious diseases and etc.
▶ 3:07:36That's clear that Secretary Kennedy, Elon Musk, and Doge don't understand how the CDC or any any of our agencies function. The critical role they play in addressing the interconnected crises like maternal mortality and the opioid crisis, the critically important partnership they provide to our state, local, nonprofit, public, and community-based health systems. And these attacks on the CDC's workforce have severe long-term consequences.
▶ 3:08:06They are not only destroying today's workforce, they are damaging the pipeline for the next generation of public health professionals. This is not leadership. This is not making Americans healthier And on this day that I am reminded of how fragile life is for pregnant and postpartum women, I ask that you support this amendment to help
▶ 3:08:37stop the gutting of critically important partners to ensuring we address the intersection between maternal mortality and the opioid crisis. Thank you and I yield back. General Lady yields. The chair now recognizes himself for five minutes. Again, I rise in opposition to this amendment. First, this amendment is largely is largely chan general to the discussion here today. Republicans are here to talk about the critically important policies included in this previously bipartisan bill.
▶ 3:09:08A bill that would provide crucial resources for prevention, treatment, and recovery for patients suffering from our from substance use disorder. patients that are our constituents, our friends, our family members. But it seems all the other side wants to talk about is federal agency employment. Our constituents, our friends, our family members deserve more than this political theater. I urge my colleagues to oppose this amendment and I yield back.
▶ 3:09:37Anyone seeking to speak on this bill? Roll call. A roll call vote has been requested. The clerk will call the role. La. Mr. La votes no. Mr. Griffith. Mr. Griffith votes no. Mr. Billis. Mr.
▶ 3:10:05Billis votes no. Mr. Hudson. Mr. Hudson votes no. Mr. Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Mr. Palmer Mr. Palmer votes no. Mr. Dunn Mr. Dunn votes no. Mr. Krenshaw. Mr.
▶ 3:10:34Krenshaw votes no. Mr. Joyce Mr. Joyce votes no. Weber Mr. Weber votes no. Mr. Allen Mr. Allen votes no. Mr. Balderson Mr. Balderson votes no. Mr. Fulture Mr.
▶ 3:11:03Fulture votes no. Mr. Fluger Mrs. Mrs. Harshburgger Mrs. Harshburgger votes no Mrs. Miller Meeks Mrs. Miller Meeks is not recorded Miss Miller Meeks votes no Mrs. Kamik Mr.
▶ 3:11:34Obernulti Mr. Obernulty votes no Mr. James. Mr. Bence. Mr. Bence votes no. Mrs. Hchen Mrs. Houchin votes no. Mr. Fry. Miss. Lee. Miss. Lee votes no. Mr.
▶ 3:12:05Langworthy. Mr. Langworthy. Mr. Langworthy votes no. Mr. Kaine, Mr. Kane votes no. Mr. Roelly, Mr. Evans, Mr. Goldman, Mr. Goldman votes no. Mrs. Fedorek, M. Fedorch votes no. Mr. Palone, Mr.
▶ 3:12:35Palone votes I. Miss Deette. Mr. Deette votes I. Miss Shakowski. Miss Shicowski votes I. Miss Matsui. Miss Mass Masui votes I. Miss Caster. Miss Caster votes I. Mr. Tonko. Mr. Tonko votes I. Miss. Clark.
▶ 3:13:06Miss. Clark votes I. Mr. Ruiz. Mr. Ruiz votes I. Mr. Peters. Mr. Peters votes I. Mrs. Dingle. Mr. Vzy. Mr. Vzy. Votes. I. Kelly. Miss. Kelly. Votes. I. Miss Bagon. Miss Bagon votes I. Mr.
▶ 3:13:37Sodto. Mr. Sodto votes I. Miss Shrier. Miss Shrier votes I. Miss. Tran. Miss. Trean. Votes. I. Miss. Fletcher. Hi. Miss. Fletcher. Votes. I. Miss. Okasiocortez. I. Miss. Okasiocortez. Votes. I. Mr. Aenclaus. Mr. Arinclaus votes I. Mr. Carter of Louisiana.
▶ 3:14:08Mr. Carter of Louisiana votes I. Mr. Mr. Menendez votes I. Mr. Mullen. Mr. Mullen votes I. Mr. Lansman. Mr. Lansman votes I. Miss. Mlen. Miss. Mlen votes I. Chairman Chairman Guthrie votes no. How's Miss Kamik recorded?
▶ 3:14:39Miss Kamik is not recorded. Miss Kamik votes no. Anyone else? The clerk will report the role.
▶ 3:15:15Mr. Chairman, on that vote there are 23 eyes and 25 nos. The amendment is not agreed to. Are there further amendments? The general lady from Virginia is recognized. Thank you, Mr. Chair. I have an amendment at the desk labeled support 2025 amendment nine. Clerk will report the amendment. Got a number. And Mr.
▶ 3:15:44Chairman, if I could reserve an and the gentleman from Virginia reserves amendment to the amendment in the nature of a substitute to HR 2483 offered by Miss McCullen. At the end of the bill, add the following section prohibit. Without objection, reading of amendment is dispensed with and the general lady is recognized for five minutes in support of the amendment. Thank you, Mr. Chair.
▶ 3:16:10This amendment would prevent uh the Substance Abuse and Mental Health Services Administration from implementing further harmful and irresponsible mass layoffs. And rather than being political theater, this is an effort to keep the very constituents, friends, and family who perform the important work that keep our constituents, friends, and family safe healthy.
▶ 3:16:36SAMA leads efforts to address our nation's mental health crises, including focused initiatives to reduce the rates of suicide and drug overdose. But on March 7th, Secretary Kennedy announced that SAMA would essentially cease to exist as employees are fired or absorbed into a consolidated and smaller office.
▶ 3:16:56And without an agency dedicated to behavioral health, addressing suicide, overdose, and youth mental health, they're likely to be priorit unlikely they're less likely to be On April 1st, Secretary Kennedy fired nearly half of SAMA's remaining staff, including its director for the Center for Mental Health Services. Secretary Kennedy also fired the entire Office of Population Surveys.
▶ 3:17:23This is the team that oversees the National Survey on Drug Use and Health, our only national survey focused specifically on drug use and mental health. Now, I don't know who, if anybody, will take on these crucial tasks of tracking drug use and mental health across the country.
▶ 3:17:41In recent years, we've made progress in reducing overdose deaths in large part due to SAM's programs addressing substance use, but overdose deaths remain the leading causes of death for younger adults, underscoring the need to ensure that this progress continues. And I remind you, overdose deaths are one of the leading causes of death for pregnancy related deaths, including the number one cause of death for white women.
▶ 3:18:10The reckless firing of SAMA staff without cause, deals a devastating blow to our efforts to prevent overdose deaths and related maternal deaths. SAMA also administers grants that support the 988 National Suicide Prevention Lifeline. In its first year, 988 received four million calls, a 33% increase in people reaching out for help. But in February, a quarter of the 988 lifeline team at Sama was fired.
▶ 3:18:39And these critical mental health programs are not effective without a first workforce to implement them. SAMA's pregnant and postpartum woman substance use disorder treatment program which funds parent child residential treatment and critical workforce training programs will be nearly eliminated with approximately 92% in cuts in Virginia.
▶ 3:19:02Samson grants fund programs like tackling substance use, mental illness, grief, trauma, and challenges faced by individuals with mental health or substance use concerns, many of whom lack stable housing. The Henriiko Area Mental Health and Development Services receives SAMA funding for their programs which serve con constituents in my district, including supportive permanent housing programs for pregnant and parenting women.
▶ 3:19:29And a participant shared in the local press that this program helped her maintain sobriety and secure stable housing, which allowed her to be reunited with her child. And as we stated, these attacks on SAMA are not happening in isolation.
▶ 3:19:44But combined with the proposed drastic cuts to Medicaid mandated by a plan that tells this committee to find $880 billion in cuts would devastate Virginiaians and Americans receiving treatment for substance use disorders, particularly in rural areas whose access to substance use dis treatment through community health centers depend on Medicaid to stay open.
▶ 3:20:08So when you combine these workforce cuts to funding freezes to Medicaid cuts, we are going to have a very difficult time actually addressing the opioid and substance use disorder crisis in this country and the related crises like maternal mortality. So I urge support for this amendment to prevent the further gutting of SAMA at this critical time. Thank you and I yield back. Chair recognizes himself for five minutes.
▶ 3:20:37I rise in favor of this amendment. Just kidding. I'm see if y'all are attention. Geez. I rise in opposition to this amendment. First, this amendment is largely changenial to the discussion here today. Republicans are here to talk about the critically important policies included in this previously bipartisan bill. A bill that would provide crucial resources for prevention, treatment, and recovery for patients suffering from substance use disorder.
▶ 3:21:05patients that are our constituents, our friends, our family members. But it seems all the other party wants to talk about is federal agency employment. Our constituents, our friends, our family members deserve more than this political theater. And I urge my colleagues to oppose this amendment and I yield back. Anyone seeking to speak on this chair recognizes the gentle lady from Massachusetts.
▶ 3:21:36Thank you, Mr. Chair. I yield to the congresswoman from Virginia. Thank you, Mr. Chair. Would the chair yield for a question? Sure. Mr. Chair, without federal employees, how are we going to put into effect the act that we are addressing in this As the general lady well knows, we have federal employees and we're going to have federal employees.
▶ 3:22:03We'll have enough to handle this situation as we will with almost any situation. Thank you, Mr. Chair. I think part of what I'm taking issue with is you're saying that that Democrats only care about federal employees. I think the point is is that federally employees are critically important to implementing the policies that Congress puts in place and your remarks denigrating our concern for
▶ 3:22:33employees. That's a there's a disconnect there for me and I and I just did not want to let that go. We cannot implement these policies without a sufficient workforce. We cannot have a sufficient workforce if we if we traumatize them. If we fire them and then traumatize the rest. And that is what is happening. That is what is happening right now.
▶ 3:22:54I have literally received texts from federal employees saying, us." I have literally seen federal employees themselves. I was on a call with one this weekend who dedicated 20 years of her life serving people in a healthcare agency summarily
▶ 3:23:24fired and it has affected her mental health as she now questions you know I don't think people understand how much of your identity for many people your job becomes especially after 20 years when you dedicate your life to serving public.
▶ 3:23:41So yes, we are concerned with our federal employees because without them, no one would be there to do the job that Congress says is important on policy and to be attacked for only caring about federal employees. I don't only care about federal employees, but I care about them a great deal.
▶ 3:24:04And I would just ask the chairman and my colleagues on the other side of the aisle to recognize humanity and show a little compassion for people who have dedicated their lives to serving our friends, our family, and our constituents. I yield back. The gentle lady yields. Any other any other member wanting to be recognized on this hearing? None.
▶ 3:24:32A roll call vote has been requested. The clerk will re The clerk will call the role. Mr. La. Mr. La votes no. Griffith. Mr. Griffith. No. Mr. Griffith no. Mr.
▶ 3:24:59Bill Rockus, Mr. Hudson, Mr. Carter of Georgia. From Louisiana, Mr. Carter of Georgia votes no. Mr. Palmer, is he almost answered? Mr. Palmer votes no. Mr. Dunn. Mr. Krenshaw. Mr. Krenshaw. Mr. Mr. Krenshaw votes no.
▶ 3:25:29Mr. Joyce Mr. Joyce votes no. Mr. Weber Mr. Weber votes no. Mr. Allen Mr. Balderson Mr. Balderson votes no. Mr. Allen Mr. Allen votes no.
▶ 3:25:59Fulture Mr. Fulture votes no. Mr. Fluger Mrs. Harshburgger Miss Harshburgger votes no. Miss Miller Meeks Miss Miller Meeks votes no. Mrs. Kamik Miss Kamik votes no. Mr. Mr. Obernolulti, Mr.
▶ 3:26:30James, Mr. Bence, Mr. Bence votes no. Mrs. Houchin Mrs. Houchin votes no. Mr. Fry. Miss Lee. Miss Lee votes no. Mr. Langworthy. Mr. Mr. Langworthy votes no. Mr. Kaine, Mr. Kane votes no. Mr.
▶ 3:27:01Roelly. Mr. Evans. Mr. Goldman. Mr. Goldman votes no. Mrs. Fedorch. Mrs. Fedorch votes no. Mr. Palone. Mr. Palone votes I. Mr. Mr. Gette Mr. Get votes I. Miss Shakowski I Miss Shakowski votes I. Miss Mass Masui.
▶ 3:27:31Miss Mass Matsoule votes I. Miss Caster I. Miss Caster votes I. Mr. Tonko I. Mr. Tonko votes I. Miss Clark. Miss Clark votes I. Ruiz Mr. Ruiz votes I Mr. Peters Mr.
▶ 3:28:01Peters votes I. Mrs. Dingle Mr. Vzy Mr. Vzy votes I. Miss Kelly. Miss Kelly votes I. Miss Bagon. Miss Bagon votes I. Mr.
▶ 3:28:33Sodto. Mr. Sodto votes I. M. Shrier. M. Shrier votes I. Miss Treyan. Miss Treyan votes I. Miss Fletcher. Miss Fletcher votes I. Miss. Okaziocortez.
▶ 3:29:02Miss Okaziocortez votes I. Mr. Okenclaus. Mr. Aenclaus votes I. Mr. Carter of Louisiana. Mr. Carter of Louisiana votes I Mr. Menendez. Mr. Mendez votes I. Mr.
▶ 3:29:34Mullen. Mr. Mullen votes I. Mr. Mr. Lansman. Mr. Lansman votes I. Ms. Mlen. M. Mlen votes I. Chairman Guthrie. Chairman Guthrie votes no. Mr. Hudson. Mr. Hudson votes no. Mr. Bill Rockus.
▶ 3:30:04Dr. Dunn. Mr. Miller Rockus votes no. Dr. Dunn Dr. Dunn votes no. Mr. Griffith is recorded as no. You have any others to be recorded? How's Miss Kem recorded?
▶ 3:30:37Miss Kemik is recorded as no. Dr. Miller Meeks. Dr. Miller Meeks is recorded as no. Did anyone How Miss Dingle have she Mrs. Dingle votes I.
▶ 3:31:07Anybody sing in recognition for the roll call? Seeing none, the clerk will Chairman Guthrie, on that vote, there were 24 eyes and 24 nos. with a tie. The agendment is not agreed to. Are there further amendments? Mrs.
▶ 3:31:36What purpose is a gentle lady from California's better gun seek recognition? Mr. Chairman, I have an amendment at the desk titled 09B A R A G_017. The clerk will report. And if I could reserve a point of order, Mr. The gentleman from Virginia reserves a point of order. Clerk will report.
▶ 3:32:03Amendment to the amendment in the nature of a substitute to HR 2483 offered by Miss Baragon of California. Without objection, the reading of the amendment is dispensed with and the gentle lady from California is recognized for five minutes in support of her amendment. Uh thank you, Mr. Chairman. Um Mr. chairman.
▶ 3:32:19Um I heard my colleague say that um he was looking for an amendment or would support amendments that were bipartisan that were about substance abuse and that were for our friends, our constituents, and our family members. Those were his words. This is that amendment.
▶ 3:32:40This amendment will include Tyler's Law in the Support Act, a bill sponsored by my colleagues, Representative Tedlu and co-sponsored co-led rather by Representative LA um co-sponsored by Miss Miller Meeks, co-sponsored by Mr. Bill Rockus, Mr. Crenshaw and other Republicans on Democrats on both sides of the aisle.
▶ 3:33:09Tyler's Law would provide guidance to hospitals to test for fentanyl when an overdose patient comes into the emergency room. Tyler's Law is named for Tyler Shamish, a teenager who lost his life to a fentanyl overdose because he was not tested for fentanyl when he checked into the emergency room. Now, Tyler's mother, Julie, has been a fierce advocate for this bill and has shared her son's story so that others don't have to go through the same tragedy.
▶ 3:33:39Unfortunately, Tyler and Julie's story is just one example of how fentanyl has devastated our families and communities. Fentanyl and other synthetic opioids are responsible for more than twothirds of lives lost to overdose. Earlier this year in February, my Republican colleagues in this committee held a hearing focused on how fentanyl is the deadliest drug threat in the history of the United States and discuss what Congress can do to combat our country's illegal drug crisis.
▶ 3:34:10And just earlier this month, President Trump released his drug policy priorities, which lists reducing the number of drug overdose deaths with a focus on fentanyl as the first priority. Under the priority, it says, and I'm quoting, to combat the drug crisis and the opioid epidemic, largely driven by fentanyl. The administration will expand access to overdose prevention education in life-saving opioid o overdose reversal medications.
▶ 3:34:39We will raise awareness about overdose prevention through public health and educational campaigns." End quote. Yet, in his budget that was leaked two weeks ago, Trump proposed slashing several programs focused on prevention and recovery for substance use including the youth prevention and recovery program that is funded by the support act legislation that Congress passed
▶ 3:35:10and Trump himself had signed into law. Now, part of the youth prevention and recovery program is aimed at raising awareness of the risk of fentanyl among youth. If Republicans are serious about fighting the overdose crisis in our country, they would not stay silent when the Trump administration rips away the critical tools that help lower the number of deaths from This is not a political game.
▶ 3:35:41It was said a little while ago that this was a political show. This is not a political show. And we can show that this is not just political smoke and mirrors.
▶ 3:35:54If every member of this committee takes meaningful steps toward preventing overdose deaths from fentanyl by supporting this straightforward, bipartisan amendment that is for our friends, our constituents, and our family members, and is about substance abuse. I yield back. Gentle lady yields back. The gentleman from Ohio, Mr. Ladder, is recognized for five minutes. Oh, thank you, Mr. Chairman. Move to strike the last word. Gentleman's recognized.
▶ 3:36:24Thank you very much. I appreciate the gentle lady speaking to the importance of this bipartisan legislation in this amendment. Currently, many drug screenings that are available in emergency rooms only test for certain drug classes and do and often do not include synthetic opioids like fentanyl. This is this unfortunately turned fatal for 19year-old Tyler Shamoose. The night before Tyler died from consuming fentanyl, he was sent to the hospital of a suspected overdose.
▶ 3:36:53The hospital staff conducted the routine drug screening, came back negative. After he passed away, Tyler's family found out the screening did not detect fentanyl because is a synthetic opioid. Had the drug screening detected fentanyl, he may have been able to receive higher level of care instead of the sober living room where he passed This amendment would take the language of Tyler's law which directs HHS to conduct a study on the frequency in which hospitals test for fentanyl in patients
▶ 3:37:23experiencing overdose and inserts it in the underlying text. While I support this policy, I must oppose the amendment because it does not receive proper commi committee consideration. We're here today to consider the support act and several other bills that have previously gone through significant regular order in this committee. These M bills must be sent to the president's desk and this is the most secure path forward.
▶ 3:37:48Is my desire that Tyler's law will receive the same consideration this Congress because I believe this is common sense policy that can save lives. And Mr. Chairman, I oppose the amendment and I yield back. Gentleman yields back. Is there further discussion? Seeing none, the question occurs on the amendment. A roll call being requested. The clerk will call the role. Mr. Lada, no. Mr.
▶ 3:38:17Lada votes no. Mr. Griffith Mr. Griffith votes no. Mr. Bill Rockus Mr. Bill Rockus votes no. Mr. Hudson, Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Mr. Palmer. Mr.
▶ 3:38:46Palmer votes no. Mr. Dunn. Mr. Krenshaw. Mr. Joyce. Mr. Joyce votes no. Mr. Weber Mr. Weber votes no. Mr. Allen, no. Mr. Allen votes no. Mr. Balderson Mr.
▶ 3:39:16Balderson votes no. Mr. Fulier Mr. Fulture votes no. Mr. Fluger. Mrs. Harshburgger. Mrs. Harshburgger votes. No. Mrs. Miller Meeks. Mrs. Miller Meeks votes no. Mrs.
▶ 3:39:47Kamik Mr. Obernolulti Mr. James Mr. Ben Mr. Ben votes no. Mrs. Houchin Mrs. Miss Hchin votes no. Mr. Fry. Ms. Lee.
▶ 3:40:16Miss Lee votes no. Mr. Langworthy. Mr. Langworthy votes no. Mr. Kaine. Mr. Kaine votes no. Mr. Mr. Roelly Mr. Evans Goldman Mr. Goldman votes no Mrs.
▶ 3:40:47Fedorek Mrs. Fedorch votes no. Mr. Palone I Mr. Palone votes I. Migette. Miss Deette votes I. Miss Shakowski I. Miss Shakowski votes I. Miss Matsui. The next bill. Miss Matsui votes I. We got to pass that bill.
▶ 3:41:15We got Miss Caster I. Miss Caster votes I. Mr. Tonko I. Mr. Tonko votes I. Miss Clark. Miss Clark votes I. Mr. Ruiz. Mr. Ruiz votes I. Mr. Peters. Mr.
▶ 3:41:45Peters votes I. Mrs. Dingle. Mrs. Dingle votes I. Mr. Vzy. Mr. Vzy votes I. Miss Kelly. Miss Kelly votes I. Miss Bagon. Miss Bagon votes I. Mr. Sodto. Mr. Sodto votes I.
▶ 3:42:14Miss Shrier. Miss Shrier votes I. Miss. Miss Treyan votes I. Miss Fletcher. Miss Fletcher votes I. Miss Okasiocortez. Miss Okasiocortez votes I. Mr. Oenclaus.
▶ 3:42:45Mr. Oenclaus votes I. Mr. Carter of Louisiana. Mr. Mr. Carter of Louisiana votes I. Mr. Mendez. Mr. Mendez votes I. Mr. Mullen. Mr. Mullen votes I. Mr. Lansman. Mr. Lansman votes I.
▶ 3:43:15Miss McClen. Miss McClullen votes I. Chairman Guthrie, no. Mr. Hudson, Chairman Guthrie votes no. Mr. Hudson. Mr. Hudson votes no. Tim to stay close. Mr. Dunn votes no. Mr. Krenshaw. Mr. Krenshaw votes no. To stay close.
▶ 3:43:46How has Miss Kemick recorded? Mrs. Kamik is not recorded. Miss Kamik votes no.
▶ 3:44:18Mr. Chairman, on that vote there were 24 eyes's and 24 nos. The amendment is not agreed to. Are there any further amendments? Seeing none, if there are no fur and there's no further discussion, the vote occurs on amendment in the nature of sub. So we're going to adopt the AIS and I know you probably want to roll you want a roll call. Not the not on the Okay. So, we're adopt the AS.
▶ 3:44:43So, uh if no further discussion, the voter occurs an amendment in the nature of a substitute. All those shall signify by saying I. I. All those opposed? No. No. The eyes have it. And the amendment is agreed to. The question is The question now occurs on adopting HR2483 as amended and a roll call vote has been asked.
▶ 3:45:12So a roll call has been requested. So the clerk shall call the role. Mr. La Mr. Lada votes I. Mr. Griffith Mr. Griffith votes I. Mr. Bill Rockus. Mr. Bill Rockus votes I. Mr. Hudson.
▶ 3:45:42Mr. Hudson votes I. Mr. Carter of Georgia. I. Mr. Carter of Georgia votes I. Mr. Palmer. Mr. Palmer votes I. Mr. Mr. Dunn. Mr. Dunn votes I. Mr. Krenshaw. Mr. Krenshaw votes I. Mr.
▶ 3:46:12Joyce. Mr. Joyce votes I. Mr. Weber. Mr. Weber votes I. Mr. Allen I. Mr. Allen votes I. Balderson Mr. Balderson votes I. Mr. Fulture Mr. Fulture votes I. Mr.
▶ 3:46:45Fluger Mrs. Harshburgger Mrs. Harshburgger votes I. Mrs. Miller Meeks Mrs. Kamik Mrs. Kamik votes I. Mr. Obernolulti Mr. Obernolulti votes I. Mr.
▶ 3:47:14James Mr. Bence Mr. Bence votes I. Mrs. Houchin Mrs. Houchin votes I. Mr. Fry. Lee Miss Lee votes I. Mr. Langworthy Mr. Langworthy votes I. Mr. Mr.
▶ 3:47:44Kane votes I. Mr. Roelly Mr. Evans Mr. Goldman. Mr. Goldman votes I. Mrs. Fedorch. Mrs. Fedorch votes I. Mr. Palone. Mr. Palone votes no. Miss Dette. Mr. Dette votes no.
▶ 3:48:13Miss Shakowski. Miss Shakowski votes no. Miss Miss Mass Matsoule votes no. Miss Caster. Miss Caster votes no. Mr. Tonko. Mr. Tonko votes no. Miss Clark. Miss. Clark votes no. Mr. Ruiz. Mr.
▶ 3:48:43Ruiz votes I. Mr. Peters. Mr. Peters votes I. Mrs. Dingle. Mrs. Dingle passes. Mr. Vzy. Mr. Vzy votes no. Mrs. Kelly. Miss Kelly votes no. Miss Bagon. Miss Bagon votes I. Mr.
▶ 3:49:13Sodto. Mr. Sodto votes I. Miss Shrier. Miss Shrier votes I. Miss. Treyan. Miss Treyhan votes I. Miss Miss Fletcher votes no. Miss Okassio Cortez. Miss Okasiocortez votes no. Mr. Oenclaus. Mr. Oenclaus votes I. Mr. Carter of Louisiana.
▶ 3:49:44Mr. Carter of Louisiana votes I. Mr. Mr. Mendez votes no. Mr. Mr. Mullen. Mr. Mullen votes no. Mr. Lansman Mr. Lansman votes I. Miss Mlen Miss McClen votes I. Chairman Guthrie I. Chairman Guthrie votes I. Miss uh Ding.
▶ 3:50:13Miss Dingle. How's Miss Dingle recorded? Mrs. Dingle was recorded as a Mrs. Dingle is off pass on I. Dr. Miller Meeks. Dr. Miller Meeks is not recorded. Dr. Miller Meeks votes I. Anybody else seeking recognition for the purpose of the role? The clerk will report and we'll break and come back after votes for the other bills. We will do her bill. Is she next?
▶ 3:50:44We will make a call and bring her up next. We'll do that. You are next. You are next. Clicker report. Two amendments on the next. What are you doing? She's next. Chairman Guthrie. On that vote, there were 36 eyes and 13 nos. The the bill is agreed to. The eyes have it and the bill is agreed to.
▶ 3:51:13The committee will be in recess until 10 minutes after the final vote.
▶ 4:33:51Heat. Heat.
▶ 4:38:09Committee will come to order. The chair calls up HR 1520 and asks the clerk to report HR1520, a bill to prohibit discrimination on the basis of mental or physical disability in cases of organ transplants. Be it enacted by the Senate and the House of Representatives of the United States of America in Congress assembled.
▶ 4:38:37Without objection, the first reading of the bill is dispensed with and the bill will be open for amendment at any point. So ordered. Does anyone seek to be recognized on the bill? Chair recognizes the gentle lady from Florida, Representative Kamik, for five minutes. Thank you, Mr. Chairman. Uh I am so proud to see our bill, the Charlotte Woodward Organ Transplant Discrimination Prevention Act, included in today's markup.
▶ 4:39:06This is a long time coming. This legislation is named in honor of Charlotte Woodward, a remarkable young woman who is here with us today with Down syndrome who received a life-saving heart transplant more than 12 years ago. Charlotte is here with us today, as I mentioned, and one day she's going to be a member of Congress. That's what I'm putting my money on.
▶ 4:39:36But her presence here today is a powerful reminder that every life has value and potential regardless of disability. Unfortunately, too many families have been told otherwise. Bobby and Josh Serento, constituents of mine from Ocala, Florida, lost their infant son, Baby Zion, who was born with Down syndrome and in need of a heart transplant. At just 6 months old, baby Zion was denied that chance.
▶ 4:40:05His family was told that his life didn't hold the same value simply because of his disability. They were told by doctors, hospital systems, and others that they couldn't quote waste a heart. That is unacceptable. That is why this bill matters. It ensures that individuals with disabilities are not denied access to organ transplants based solely on their diagnosis.
▶ 4:40:31It provides a path for families to seek timely intervention through HHS. The text before us is identical to the version that passed this very committee and the House last Congress with broad bipartisan support. I extend my gratitude to my colleague and friend, Congresswoman Dingle, for her steadfast leadership, courage, and collaboration on this issue. And I urge my colleagues to support this bill once again. Mr. Chairman, I yield.
▶ 4:41:03Gentle lady yields. Is there any further discussion on the bill? The chair recognizes the gentle lady from Michigan, Representative Dingle, for five minutes. Thank you, Mr. Chairman. I move to strike the last word. Is that okay? Thank you. In strong support of HR1520, the Charlotte Woodward Organ Transplant Discrimination Act bill.
▶ 4:41:26As co-chair of the bipartisan disabilities caucus, I am proud to co-lead this bill alongside my dear friend Cat Kamik. I thank her for her partnership on this vital bill named after the incredible Charlotte Woodward who I have had the great privilege of getting to know. And by the way, for all of you, she has sat more patiently through the markups of this committee than the members of this committee.
▶ 4:41:56But it's because she cares. From new members of the committee, you just heard from Cat her story. She was born with Down syndrome and a heart condition. Due to this heart condition, she successfully underwent a life-saving heart transplant in 2012. And in the years since, she's become a tremendous advocate, sharing her story to educate and advocate for others with disabilities.
▶ 4:42:22In Charlotte, you have taught so many you can do and be whatever you want to be if you try to achieve that dream. In Charlotte's honor, this important bill prohibits discrimination against people with disabilities in the organ transplant system. Specifically, it prohibits eligible individuals from being denied a life-saving transplant procedure based solely on their disability status.
▶ 4:42:50It's unthinkable that people with disabilities are passed over for life-saving transplants based on discriminatory and subjective assumptions about their ability to comply with post-operative care. With this legislation, we can take action to ensure that all Americans, regardless of disability status, receive equitable access to the care they need. Thank you to Chair Guthrie and all my colleagues.
▶ 4:43:18Cat and I are happy that we're finally going to be able to move this bill for Charlotte out of the committee. I urge all my colleagues to support this important bill and yield back the balance of my time. General lady yields. There any further discussion on this bill? Any amendments? Hearing none. The question now occurs. Mr. Chairman, sorry. Want to go first?
▶ 4:43:50Who do you want? Okay. The g the chair recognizes a gentle lady from Illinois, Representative Shakowski, for an Thank you, Mr. Chairman. I do have an amendment at the desk. It's uh three, no, six. What?
▶ 4:44:16two two clerk will report the amendment amendment to HR 1520 offered by Miss at the end of the bill add the following with section conditional effectiveness this act shall be made effectively only if the secretary of health and human services at the secretary's own initiative or at the initiative of the United States do service commonly referred to as the department of government official.
▶ 4:44:46Without objection, the reading of the amendment is dispensed with and the gentle lady from Illinois is recognized for five minutes in support of the amendment. Thank you, Mr. Chairman. Um, and thank all of you. Um, okay. Happy to uh join in the legislation that will be coming up that is uh certainly a bipartisan one. I hope this would be as well.
▶ 4:45:14Um, we've seen a lot of nos um from the uh colleagues uh on the Republican side and I'm hoping that we could move forward.
▶ 4:45:28Um, I wanted to um bring up a um a piece of legislation um that is represented by the administration administration for living living for community living.
▶ 4:45:47This is um a piece of legislation that has been around for many years that helps senior citizens for a number of different kinds of activities in in their life. Um, this is something that would help them with their transportation, with their Meals on Wheels.
▶ 4:46:13Everybody knows about Meals on Wheels that helps people that need some food to be uh delivered. Um, and so this is a a bill that's been around for a very long time. And guess what? Now, most of the people that have worked there for years and years have fired, and I'm very concerned um about that. And it looks like this is going to be now taken away.
▶ 4:46:42The workers um are are not being able to to work right now. And it just seems to me that this is something that has been so helpful to older Americans. This is not one of the huge bills. It's significant, but it is something that has been so helpful. And now these people are out of work, out of a job. But let's not talk about them. Let's talk about the seniors.
▶ 4:47:12We've heard too much today about, oh, this is just about another job for somebody. No, this is something that has made a life for many older Americans. think about the the wheels the meals on wheels and how important that is when those get delivered.
▶ 4:47:34And so I am hoping that something like that that has been working so well that is so important to older Americans could be in the yes category. And with that I yield back. Gentle lady yields. The chair now recognizes himself for five minutes. I rise in opposition to this amendment. This bill ensures access to life-saving care by preventing discrimination against individuals with disabilities.
▶ 4:48:04Do my friends on the other side of the aisle really want to delay the implementation of this important policy based on a proposed reorganization that we are still awaiting more details on. This amendment is an attempt to play political games that would unfortunately have a very realworld impact on patients and our constituents. patients who deserve our help and support by getting this bill signed into law in a timely fashion with no delays. I urge my colleagues to oppose this amendment and I yield back.
▶ 4:48:34Any further discussion on amendment? Chair recognizes gentle lady from California for five minutes. Thank you, uh, Mr. Chairman. Um, I support the bill, but this amendment here would stop this administration's efforts to dismantle the administration on community living, which administers essential programs for older constituents and constituents with disabilities.
▶ 4:48:58Last week, I visited ACC Senior Services, an agency in my district supporting seniors to age in place. One of the major programs they support is meals on wheels. Often these meals aren't just a source of nutrition. They're a source of companionship for seniors who don't see another person all day. I listen to older constituents and volunteers alike who share that these programs were life-changing.
▶ 4:49:24My district also houses one of the university centers for excellence and developmental disability at UC Davis Mind Institute. In my district and across the country, these programs help to train clinical and community service providers, researchers, and people with developmental disabilities and their families to help them better support the people in their lives with disabilities. They provide resources to help people with disabilities engage in the community.
▶ 4:49:51One of my constituents wrote me to share that these programs have changed her life and her family's life. They are terrified this administration's slashes resources. It will not only hurt their families but families in the future who are struggling to navigate their children's disability and help them integrate into the community. Now, my Republican colleagues will say that this administration didn't cut any of these programs when they dismantled the administration for community living.
▶ 4:50:19But again, there's no staff left to administer these programs. If the experts have been dismissed, how do we expect these critical functions to continue uninterrupted? And though my colleagues would like to ignore it, the evidence in is in the leaked budget memo, the programs I mentioned and more programs that support older Americans and people with disabilities in all our districts on administration's chopping block.
▶ 4:50:44We cannot sit idly by and let the administration callously play with the lives of millions of Americans served by ACL. I urge my colleagues to support this amendment. I yield the balance of my time. Gentle lady yields. Any further discussion? The chair recognizes the gentle lady from Florida, Representative Kamik for 5 minutes. Thank you, Mr. Chairman. I move to strike the last word. Without objection. I'm I'm just at a loss. I am at a complete loss.
▶ 4:51:13The word spoken directly before I was recognized was to stop playing games with people's lives. What do you think that you're doing by including amendments that have absolutely nothing to do with what we are talking about in this bill? This is an anti-discrimination bill preventing hospital systems from discriminating against individuals with disabilities.
▶ 4:51:35We all support seniors, but this amendment that you have introduced is about seniors and has nothing to do with the actual underlying text of the bill that we are here to debate. Our constituents are expecting better of us as Americans, not Republicans versus Democrats. And we all just sat here and clapped for Miss Charlotte Woodward who has been here patiently, not just for hours today, but hours weeks ago.
▶ 4:52:01And let us not forget last year when she sat in this room for hours and has been fighting tirelessly to get this legislation across the finish line. There is a time and a I would respect all of my colleagues so much more if you could put the politics aside and recognize that we are all trying to do something for the community. We can get this done in a bipartisan manner.
▶ 4:52:30So, let's put the politics aside and let's focus on the issue at hand. If you want to introduce this amendment as a standalone bill, I will welcome the debate, but there is a time and a place and it is not right now. With that, Mr. Chairman, I yield. Gentle lady yields. Any further discussion on this amendment? Hearing none, a roll call vote has been requested. The clerk will report will record the report the call the role.
▶ 4:53:03Mr. La. Mr. La votes no. Mr. Griffith. Mr. Mr. Griffith votes no. Mr. Bill Rockus. Mr. Bill Rockus votes no. Mr. Hudson. Mr. Hudson votes no. Mr. Carter of Georgia. No. Mr. Carter of Georgia votes no. Mr.
▶ 4:53:37Palmer. Mr. Palmer votes no. Mr. Dunn Mr. Dunn votes no Mr. Krenshaw Mr. Joyce Mr. Weber Mr. Weber votes no Mr. Allen Mr.
▶ 4:54:06Balderson Mr. Mr. Balderson votes no. Mr. Fulture Mr. Fulture votes no. Mr. Fluger Mrs. Harshburgger Miss Harshburgger votes no. Miss Miller Meeks Mrs. Kamik Mrs. Kamik votes no. Mr.
▶ 4:54:36Obernolulti Mr. James, Mr. Bence, Hchen, Mrs. Hchin votes no. Mr. Fry, Mr. Fry votes no. Bless you. Miss Lee, Miss Lee votes no. Mr. Langworthy, no. Mr. Langworthy votes no. Mr.
▶ 4:55:04Kaine Mr. Kaine votes no. Mr. Evans. Mr. Goldman. Mr. Goldman votes no. Mrs. Fedorch. Mrs. Fedor votes no. Mr. Palone. Mr. Palone votes I. Mr. Digette. Mr. Dette votes I. Miss I.
▶ 4:55:35Miss Shakowski votes I. Miss Masoule I. Miss Mass Masui votes I. Mrs. Caster I. Miss Caster votes I. Mr. Tonko I. Mr. Tonko votes I. Miss Clark. Miss. Clark votes I. Mr. Ruiz. Mr. Ruiz votes I. Mr.
▶ 4:56:04Peters, Mrs. Dingle, Mrs. Dingle votes I. Mr. Vzy, Miss Kelly, Miss Vaggon, Mr. Sodto, Mr. Sodto votes I. Miss Shrier, Miss Shrier votes I.
▶ 4:56:31Miss Trey, Miss Treyanne, votes I. Miss Fletcher, Miss Fletcher votes I. Miss Cortez, Miss Okasiocortez votes I. Mr. Okenclaus, Mr. Aenclaus votes I. Mr. Carter of Louisiana. Mr. Mendez. Mr. Mr. Mendez votes I. Mr.
▶ 4:57:03Mullen. Mr. Mullen votes I. Mr. Lansman. Mr. Lansman votes I. Ms. Mlen. Miss. Mlen votes I. Chairman Guthrie. Chairman Guthrie votes no. How's Mr. Krenshaw? Mr. Krenshaw is not recorded. Mr. Krenshaw votes no. How is Dr. Joyce recorded?
▶ 4:57:33Dr. Dr. Joyce votes no. How's Mr. Allen recorded? Mr. Mr. Allen votes no. How's Mr. Obernulti Mr. Obernolulti votes no. How's Mr. Bence recorded? Mr. Bence votes no. How's M Mr. Peters is not recorded.
▶ 4:58:05Mr. Peters votes I. How's Mr. VC recorded? Mr. VZ is not recorded. Mr. Vy votes I. Anybody else? Clerk will report the results. Mr.
▶ 4:58:32Chairman, on that vote there were 21 eyes and 25 nos. The amendment is not agreed to. Are there four further Chair recognizes the gentle lady from Washington, Dr. Sri for five minutes. Thank you, Mr. Chairman. Uh, I have an amendment at the desk. You have an amend amendment number one.
▶ 4:58:58The clerk for report amendments to HR 1520 offered by Miss Shrier. Add at the end the following new section. Without objection, reading amendment is dispensed with and the gentle ladies recognized for five minutes in support of the amendment. Thank you, Mr. Chairman.
▶ 4:59:18Uh, as a pediatrician, I know firsthand the importance of vaccines in protecting people from devastating preventable infectious diseases, including measles, which is continuing to spread in our country. Uh, vaccines are especially critical to protecting people with compromised immune systems. And this includes people like Charlotte who have received organ transplants.
▶ 4:59:40My amendment to the Charlotte Woodward Organ Transplant Discrimination Prevention Act states the importance of vaccination for transplant recipients who have weakened immune systems and are at higher risk of getting sick from vaccinereventable diseases for the rest of their lives. Imagine for a moment a person receiving a lung transplant, then getting infected with measles because of someone whose parent opted not to vaccinate and then dying despite getting this transplant. And this is a very real possibility.
▶ 5:00:10Measles is already spreading as I mentioned very widely in this country. It's one of the most contagious diseases known and thanks to widespread vaccination. It is also one of the most preventable. In fact, it was declared eradicated from this country over 20 years ago but has made a resurgence. And the reason for that resurgence and now measles has infected about 900 people this year alone. Um and this is three times the number of cases last year.
▶ 5:00:39The reason is that people are listening to people like our HHS secretary RFK Jr. A majority of those 900 people are children. Nearly all are unvaccinated. Over 10% have been hospitalized. Three have died. And every one of these cases could have been prevented. Um now let's imagine for a second that maybe some of my colleagues don't know a person getting an organ transplant. So this doesn't quite hit home. Although we've all just had the privilege of meeting Charlotte.
▶ 5:01:08Thank you for being here Charlotte and Mrs. Woodward. Now consider other people with suppressed immune systems like people with cancer on chemotherapy or people on imunosuppressants for MS or rheumatoid arthritis or inflammatory bowel disease people who are born with immune disorders. Most of us have friends with at least one of these. And every time a parent falls under the influence of our new HHS secretary RFK Jr.
▶ 5:01:36and decides not to vaccinate their child, it puts these people along with infants who are too young to have been vaccinated at Americans in our souls, we are good people. We look after our neighbors in fires and hurricanes. We show up and we rescue and we feed and house. And I look at getting vaccinated as the same sort of thing. You're looking out for your friends and your neighbors and people like Charlotte.
▶ 5:02:06And I just want to encourage parents out there to not listen to the noise or the propaganda and to vaccinate their children because vaccinations are safe and effective and could have prevented every one of these 900 cases. This amendment simply makes clear that as we support organ transplantation and fight against uh in terms of choosing who gets those organs that we also support immunizing communities to protect those vulnerable patients.
▶ 5:02:36I encourage my colleagues to vote for this amendment and I yield back. Chair recognizes himself for five minutes. I rise in opposition to the amendment. This bill ensures access to life-saving care by preventing discrimination against individuals with disability. This amendment is not related is not related to the underlying bill at hand. While I understand and appreciate my colleagues support to ensure access to vaccines.
▶ 5:03:02This amendment is an attempt to play political games that would unfortunately have a very realworld impact on patients and our constituents. Patients who deserve our help and support by getting this bill signed into law in timely fashion with no delays. I urge my colleagues to oppose this amendment and I yield back. Any further discussion on this amendment? Roll call vote. I'm sorry. I I the gentle lady from Florida is recognized.
▶ 5:03:32I I had a question for the amendment sponsor. Just a point of clarification because I don't have the text of your amendment because I guess it was just filed in the last few minutes. Is your amendment requiring organ transplant recipients to have a vaccine, a particular vaccine? No, not at all. Vaccinated? No, not at all.
▶ 5:03:55It it was filed several weeks ago and it is expressing a sense of Congress that as we are looking out for our communities, as we are looking out for patients, as we are addressing the well-being of people who have received um organ transplants, that we also recognize that one of the ways that we all can do our part as a community to protect them is for ourselves to get vaccinated. And that is just creating a circle of protection around people like Charlotte.
▶ 5:04:23And Charlotte's mom is nodding right now. But people probably in this room right now who might take medications that leave them immunosuppressed or people like me who have type 1 diabetes and would be at higher risk for getting sick. It's part of all of our collective responsibilities. It's a sense of Thank you for clarifying, but I mean I I think you will find that pretty much everyone is pro uh choice when it came when it comes to to vaccines.
▶ 5:04:50Um and again I don't think that your amendment has anything to do with the underlying text of the bill that this is again you're not it's not gerine to the conversation that we're having about anti-discrimination efforts for organ transplant recipients. So just that I yield just for clarification um and thank you for yielding.
▶ 5:05:08Um, when when you use the word pro-choice in a context such as vaccination, that's the problem that schools require vaccinations in order to protect people. And I'm sorry to keep doing this to you, Charlotte, but to protect people like Charlotte, to protect the kiddo in my son's class who has leukemia, it's to protect one another. That's why this is a requirement.
▶ 5:05:35That's why our current Secretary of Health and Human Services, RFK Jr., is such a danger to our public health. Even though he is charged with protecting our public health because he is looking at all of this as though it is just an individual choice, it's not individual. This is a collective decision and schools in their wisdom require that children come to school vaccinated so they don't put their other friends in danger. Mr. Mr.
▶ 5:06:04Chairman, gentle lady is recognized. Thank you, Mr. Chairman. Again, I just want to reiterate, you've made my point that your amendment has nothing to do with the underlying text of the bill that we are here considering. We are trying to prevent discrimination against individuals with disabilities as it relates to organ transplants. I am happy to have the discussion and the debate regarding vaccines with you at any other time, but there is a time and a place. Mr. Chairman, I yield my time back to you. Thank you. General lady yields.
▶ 5:06:33Any further discussion on this amendment hearing? None. A recorded vote has been requested. The clerk will call role. Mr. La Mr. Griffith Mr. Griffith votes no. Mr.
▶ 5:06:54Bill Mr. Bill Rockus votes no. Mr. Hudson, no. Mr. Hudson votes no. Mr. Carter of Georgia, no. Mr. Carter of Georgia votes no. Mr. Palmer.
▶ 5:07:25Mr. Palmer votes no. Mr. Dunn. Mr. Dunn votes no. Mr. Krenshaw. Mr. Krenshaw votes no. Mr. Joyce. Mr. Joyce votes no. Mr. Weber. Mr. Weber votes no. Mr. Allen. Mr.
▶ 5:07:55Balderson. Mr. Mr. Balderson votes no. Mr. Fulture. Mr. Fulture votes no. Mr. Fluger. Mrs. Harshburgger. Mrs. Harshburgger votes no. Mrs. Miller Meeks. Mrs. Kamik. Mrs. Kamik votes no. Mr. Mr.
▶ 5:08:25Obernolulti Mr. Obernolulti votes no. Mr. James Mr. Bence Mr. Bence votes no. Mrs. Houchin Mrs. Houchin votes no. Mr. Fry Mr. Fry votes no. Lee Miss Lee votes no. Mr.
▶ 5:08:54Langworthy Mr. Langworthy votes no. Mr. Kaine Mr. Kane votes no. Mr. Roelly Mr. Roelly votes no. Mr. Evans Mr. Goldman Mr. Goldman votes no. Mrs. Fedorch Mrs. Fedor votes no. Mr.
▶ 5:09:25Palone Mr. Palone votes I. Mr. Dette. Mr. Dette votes I. Miss Shakowski. Miss Shakowski votes I. Miss Matsui. Miss Matsui votes I. Miss Caster Miss Caster votes I. Mr. Tonko I. Mr. Tonko votes I.
▶ 5:09:55Miss Clark. Miss Clark votes I. Ruiz. Mr. Ruiz votes I. Mr. Peters. Mr. Peters votes I. Mrs. Dingle. Mrs. Dingle votes I. Mr. Vzy, Mr. Vzy votes I.
▶ 5:10:21Miss Kelly, Miss Vaggon, Mr. Sodto, Mr. Sodto votes I. Miss Shrier. Miss Shrier votes I. Miss Treyenne. Miss Trey votes I. Fletcher Miss Fletcher votes I.
▶ 5:10:48Miss Cortez Miss Okassiocortez votes I. Mr. Mr. Aenclaus votes I. Mr. Carter of Mr. Carter of Louisiana votes I. Mr. Mendez. Mr. Menendez votes I. Mr. Mullen Mr.
▶ 5:11:18Lansman Mr. Lansman votes I. Ms. Mlen Miss McClen votes I. Chairman Guthrie Chairman Guthrie votes no. Is Mr. Ladder reported? Mr. Ladder is not recorded. Mr. Ladder votes no. Mr. Allen. Mr. Allen is not recorded. Mr. Allen votes no. Anybody else?
▶ 5:11:51Mr. Mullen. Mr. Mullen votes I anyone else? Miss Faragon. Missagon is not recorded. Spidergon votes I. Clerk will report the result.
▶ 5:12:23Mr. Chairman, on that vote there were 23 eyes and 26 nos. The amendment is not agreed to. Are there further amendments? He has an amendment on this. H. For what purpose does the um gentleman from Louisiana seek recognition? Mr. Chairman, I have an amendment at the desk. H clerk will report the amendment.
▶ 5:12:54Could the gentleman please specify his amendment? H1520 AMD01. Amendment to HR1520 offered by Mr. Carter of Louisiana. Add at the end the following new section. Without objection, a reading amendment is dispensed with and the gentleman is recognized for five minutes in support of the amendment. Mr.
▶ 5:13:17Chairman, my amendment HR1520 the to the Charlotte Woodward Oregon Transplant Discrimination Prevention Act would prohibit HHS from cutting Medicaid for people with disabilities by reducing their eligibility, cutting enrollment, slashing their benefits, or increasing their out-ofpocket cost.
▶ 5:13:37It would also prevent reductions if in federal Medicaid funding for people with I wish that these types of cuts were something no member of this committee would ever have to imagine supporting. Republicans are actively supporting plans to rip Medicaid from the hands of people who rely on it most. Congressional Republicans have made their plans to cut Medicaid by at least 880 billion dollars very clear.
▶ 5:14:05Under their plan, this committee will be forced to make cuts to Medicaid that would be devastating to millions of children and adults with disabilities who rely on Medicaid. Republicans are saying that the cuts that the cuts they're planning won't impact people with disabilities, but we know that is untrue and the disability community has made it clear that they know it isn't true and they are frightened.
▶ 5:14:32over half of Medicaid spending is on people with who are eligible for Medicaid because of old age or disabilities. And that that that does not even capture the many people with Medicaid coverage who qualify for Medicaid under other eligibility pathways.
▶ 5:14:50In fact, people with Medicaid who have disabilities qualify because of eligibility pathways like the Medicaid expansion established by the Affordable Care Act, ACA, not the quote unquote disability pass pathway.
▶ 5:15:06Yet Republicans include including those on this committee are falsely referring to this diverse eligibility group as abled body while spinning false narratives about fraud, waste, and abuse for which we all support rooting out.
▶ 5:15:24The reality is that there that no one is so able-bodied as to need health care and there's no way to protect people with disabilities from hundreds of billions of dollars in cuts to Medicaid.
▶ 5:15:39Medicaid is the reason that people with disabilities can access home and community-based services that enable them to live in their homes and communities with support they need, including bathing, medication management, and food preparation. These are the types of services that no other payer typically covers and will be cut if Republicans gut Medicaid funding. I hope and pray that my colleagues would join me in supporting this amendment.
▶ 5:16:09It is imperative that we protect Americans with disability from cuts to Medicaid and to do so not just in word but also in deed. I yield back. Gentleman yields. The chair now recognizes himself for five minutes. I oppose this amendment because this bill has nothing to do with reducing Medicaid coverage for people with disabilities. This committee has a rich history of supporting Medicaid care for people with disabilities.
▶ 5:16:35This committee worked in a bipartisan way last Congress to invest billions of dollars and new funding for people with disabilities and home and community based services. I know that bill didn't get done in December, but I'm confident if we continue to work together on these issues, we will get it done this Congress. We have made clear that we want the Medicaid program to focus on the most vulnerable populations among us, including supporting people with disabilities.
▶ 5:17:01Again, I will note that today's bill does not make any changes to Medicaid and this amendment is unnecessary and I yield back. Any further discussion on Chairman, will you I'll yield. Is that a commitment, sir, that we will not cut Medicaid to the most vulnerable people who need it most? I've heard it said before, but I think the American people need and deserve to hear it said as many times as possible.
▶ 5:17:31It is not our intention to cut Medicaid to the most vulnerable population. It is our intention to stabilize it, to save it, to secure it. Would the gentleman yield? Yield. There has there is no proposal that I have seen anywhere that anybody that is eligible for Medicaid that is disabled will have lose their benefit. Any further discussion? Roll call, please.
▶ 5:18:00Hearing none, a roll call vote has requested. The clerk will call the role. ladder. Mr. Griffith Mr. Griffith votes no. Mr. Biller Rockus Mr. Billis votes no. Mr. Hudson, Mr.
▶ 5:18:30Hudson votes no. Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Palmer. Mr. Palmer votes no. Mr. Dunn. Mr. Dunn votes no. Mr. Krenshaw. Mr. Krenshaw votes no. Mr. Joyce. Mr.
▶ 5:18:59Joyce votes no. Mr. Weber. Mr. Weber votes no. Mr. Allen. Mr. Allen votes no. Mr. Balderson. Mr. Balderson votes no. Mr. Fulture Mr. Fulture votes no. Mr. Fluger. Mrs.
▶ 5:19:30Harshburgger. Mrs. Harshburgger votes no. Mrs. Mrs. Miller Meeks, Mrs. Kamik, Mrs. Kamik votes no. Mr. Obernolulti, Mr. James, Mr. Bence, Mr. Ben votes no. Mrs. Hchen, Mrs.
▶ 5:20:00Houchin votes no. Mr. Fry. Mr. Fry votes no. Miss Lee. Miss Lee votes no. Mr. Langworthy. Mr. Langworthy votes no. Mr. Kaine. Mr. Kane votes no. Mr. Roelly. Mr. Roelly votes no. Mr.
▶ 5:20:32Evans Mr. Goldman Mr. Goldman votes no Mrs. Mrs. Fedor votes no Mr. Palone Mr. Palone votes I. Mr. Dette, Mr. Get votes I. Miss Shakowski I Miss Shakowski votes I. Miss Matsui. Miss Matsui votes I.
▶ 5:21:02Miss Miss Caster votes I. Mr. Tonko I. Mr. Tonko votes I. Miss. Clark. Miss. Clark votes I. Ruiz Mr. Ruiz votes I. Mr. Peters Mr. Peters votes I. Mrs. Dingle Mrs. Dingle votes I. Mr.
▶ 5:21:31Vzy Mr. Vzy votes I. Miss Kelly. Miss Bagon. Miss Bagon votes I. Mr. Sodto. Mr. Sodto votes I. Miss Shrier. Miss Shrier votes I. Miss Treyan. Miss Treyan votes I. Miss.
▶ 5:22:00Miss Fletcher votes I. M. Okasiocortez. I. Miss. Okasiocortez votes I. Mr. Mr. Oenclaus votes I. Mr. Carter of Louisiana Mr. Carter of Louisiana votes I. Mr. Mendez Mr. Menendez votes I. Mr. Mullen Mr. Mullen votes I. Mr.
▶ 5:22:32Lansman Mr. Lansman votes I. Miss Mclen Mclen votes I. Chairman Guthrie. Chairman Guthrie votes no. Mr. Lada is not recorded. Mr. Lada votes no on your side. Anyone seeking recognition? No, we're all good.
▶ 5:23:00So, clerk will Uh, Mr. Chairman, on that vote there were 23 eyes and 25 nos. Amendment is not agreed to.
▶ 5:23:28Are there further Gentleman from Louisiana, what purp you see recognition? Mr. Chairman, I have amendments that HR 1520 FCD AMD 0. clerk will report. Mr. Chairman, I could preserve a point of order. Oh, reserve report of order is reserved. Is there a uh clerk report? Amendment to HR1520. Without objection, read the amendment is dispensed with and the gentleman is recognized for five minutes in support of his amendment.
▶ 5:23:59Mr. Chairman, my amendment to HR1520, the Charlotte Woodward Organ Transplant Discrimination Prevention Act, is simply a sense of Congress reiterating the importance of immunompromised children such as organ transplant recipients or cancer patients to continue to have access to medical care and treating physicians. There are no coverage mandates in this amendment and no poison pills.
▶ 5:24:26This is about supporting our children humanely, especially those with vulnerable health status. Unfortunately, due to recent illegal actions by the president, a mother with young children with stage 4 cancer was unable to coordinate or even alert treating physicians before their swift removal from Louisiana to Honduras last week. This is unconscionable.
▶ 5:24:52We're talking about a sick child and a terrified mother who are potentially coerced into an unimaginable situation. It's also about been reported that ICE was unaware of the child's medical needs and still did was aware rather of the children's the child's need and did nothing to ensure the child or to make sure that this US citizen had even the basic care necessary
▶ 5:25:22before the They sure could en ensure that they had a ticket and a plane ready rapidly to transport one woman and three children, but they didn't have time to ask the question of the health of the children or to allow due process when her lawyer was in the waiting room.
▶ 5:25:45For my colleagues who priority prioritize priorities side with the illegal removal of US citizens from the country without due process, let me explain what stage 4 metastatic metastatic cancer is. It is the most severe stage of cancer with the highest risk of mortality.
▶ 5:26:06Children with stage four cancer are typically treated at specialized children's cancer centers where they have access to the most upto-date treatment available. And what's even more shocking, that is at least the second time the Trump administration has deported a child suffering from cancer. Last month, US citizen and a 10-year-old child with brain cancer was deported from Texas to Mexico. Don't look away. Don't be fooled.
▶ 5:26:36Don't act as if this is normal. This amendment is about compassion for our neighbor, our children, our citizens. Take note today who will vote against reinforcing a basic sentiment and hold them accountable. In closing, this language doesn't change any of the provisions or the timelines within this needed legislation.
▶ 5:26:58It merely makes it This is simply saying that we this committee supports the immuno immuno compromised population and agree with the basic tenant that children's medical care deserves a constant collaborative environment with their treated treating physicians. I've heard said multiple times today that there is no intention to cut Medicaid. But may I remind you what many of you have heard many times before.
▶ 5:27:29The road to hell is paved with good Let's not let this be another one of those good intentions that took us to hell or any of our loved ones or our citizens or our children that are suffering from cancer who may be deported even though they're US citizens without taking into account that this child will probably die without the needed attention, medical attention that I dare say they will only get in
▶ 5:27:59America as a US citizen. I yield back my time. Gentleman yields back. Gentleman from Georgia is recognized. Mr. Chairman, I rise in opposition to this amendment. First, I want to recognize Charlotte Woodward again for being here and I want to thank you for being here. Charlotte, I grew up with an aunt who had Down syndrome and she was very special to me and I want to shout out her name. Her name was Jean Ford and she was a very, very special person, a very special part of my life for so many years.
▶ 5:28:30Charlotte, I I also want to apologize to you for on behalf of this whole committee. We pride oursel on being part bipartisan. In fact, I often say this is the most bipartisan committee in Congress, and I still feel like it is. But today, we seem to be struggling with that. We're better than this. I I'll tell you that we must we've got to move this legislation and and Charlotte, just hang with us. I promise you, we're getting there. I promise you, we'll be there in just a little while.
▶ 5:28:57With that said, while I appreciate my colleagues prioritization of healthc care access, this amendment does not have anything whatsoever to do with the underlying text of this bill and I urge my colleagues to oppose it. The Charlotte Woodward Act organ transplant discrimination act would prohibit discrimination against people with disabilities in the organ transplant system. We as a legislative body need to stay focused on the task at hand.
▶ 5:29:23We should not delay the passage of this bill any more than what my colleagues on the other side of the aisle have done. And I yield back. Gentlemen yields back. Is there further discussion? none, the question is on the amendment. A roll call has been requested. The clerk will call the role. La. Mr. Griffith. Mr.
▶ 5:29:53Griffith votes no. Mr. Bill Rockus. Mr. Billis votes no. Mr. Hudson. Mr. Hudson votes no. Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Mr. Palmer. Mr. Palmer. Mr. Palmer votes no.
▶ 5:30:23Mr. Dunn, Mr. Krenshaw. Mr. Joyce. Mr. Joyce votes no. Mr. Weber. Mr. Weber votes no. Mr.
▶ 5:30:54Allen Mr. Allen votes no. Mr. Balderson Mr. Balderson votes no. Mr. Fulture Mr. Fulture votes no. Mr. Fluger. Mrs. Harshburgger. Mrs. Harshburgger votes no. Mrs. Miller Meeks Mrs. Kamik Mrs. Kamik votes no Mr.
▶ 5:31:26Obernulti Mr. James Mr. Bence Mr. Ben votes no. Mrs. Hchen Mrs. Houchin votes no. Mr. Fry Mr. Fry votes no. Miss Lee, Miss Lee votes no. Mr. Langworthy. Mr. Langworthy votes no. Mr.
▶ 5:31:55Kain Mr. Kane votes no. Mr. Mr. Wrley votes no. Mr. Evans. Mr. Goldman. Mrs. Fedorch Mr. Palone Mr. Palone votes I. Mr. Dette.
▶ 5:32:26Mr. Dette votes I. Miss Shakowski. I. Miss Shakowski votes I. Miss Matsui. I. Miss Mass Matsoule votes I. Miss Caster Miss Caster votes I. Mr. Tonko I. Mr. Tonko votes I. Miss Clark. Miss Clark votes I. Mr.
▶ 5:32:57Ruiz. Mr. Ruiz votes I. Mr. Peters. Mrs. Dingle. Mrs. Dingle votes I. Mr. Vzy Mr. Vzy votes I. Miss Kelly. Miss Bagon. Miss Bagon votes I. Mr.
▶ 5:33:29Sodto. Mr. Sodto votes I. M. Shrier. M. Shrier votes I. Treyan. Miss Treyan votes I. Miss Fletcher. Miss Fletcher votes I. Miss. Okasiocortez. Miss Okasiocortez votes I. Oenclaus. Mr.
▶ 5:33:59Aenclaus votes I. Mr. Carter of Louisiana. Mr. Mr. Carter of Louisiana votes I. Mr. Mendez Mr. Mendez votes I. Mr. Mullen Mr. Mullen votes I. Mr. Lansman. Mr. Lansman votes I. Miss. Mlen.
▶ 5:34:30Miss. Mlen. Votes I. Chairman Guthrie. Chairman Guthrie votes no. Mr. Lada is not recorded. Mr. Lada votes no. Dr. Dunn votes no. Mr. Krenshaw votes no.
▶ 5:35:02Mr. Goldman votes no. Miss Fedorek votes no. Weber is recorded as no. Mr. Peters votes I.
▶ 5:35:43overnight. Sorry. How's Mr. Oberneli recorded? M Mr. Oberoni votes no. Is there any other person present asking for the roll call? Seeing none, the clerk will report. Mr.
▶ 5:36:12Chairman, on that vote, there were 23 eyes and 26 nos. The amendment is not agreed to. Are there further amendments? Seeing no further amendments of further discussion? Seeing none, in the honor of Miss Charlotte Woodward, who's been here for two days, I will in her honor, I will ask the question will now occur on HR1520. And I will in the honor of Charlotte Woodward ask the clerk to call the role.
▶ 5:36:44Mr. La I. Mr. La votes I. Mr. Griffith, Mr. Griffith votes I. Mr. Bill Rockus. Yeah. Mr. Bill Rockus votes I. Mr. Mr. Hudson votes I. Mr. Carter of Georgia. Mr.
▶ 5:37:15Palmer. Mr. Dunn. Mr. Dunn votes I. Mr. Palmer votes I. Mr. Krenshaw. Mr. Krenshaw votes I. Mr. Joyce. Mr. Joyce votes I. Mr. Weber. Mr. Weber votes I. Mr. Allen I.
▶ 5:37:45Mr. Allen votes I. Mr. Balderson. Mr. Mr. Balderson votes I. Fulture, Mr. Fluger, Mrs. Harshburgger. Mrs. Harshburgger votes I. Mrs. Miller Meeks. Mrs. Kamik. Mrs. Kamik votes I. Mr. Obernulti.
▶ 5:38:16Mr. Obernulti votes I. Mr. James Mr. Benz Mr. Benz votes I. Mrs. Howchin Mrs. Howin votes I. Mr. Fry Mr. Fry votes I Miss Lee. Miss Lee votes I. Mr. Langworthy. Mr. Langworthy votes I. Mr.
▶ 5:38:47Kaine. Mr. Mr. Kane votes I. Mr. Roelly Mr. Roelly votes I. Mr. Evans. Mr. Goldman. Mr. Goldman votes I. Mrs. Fedorch. Mrs. Fedorek votes I. Mr. Palone. I. M. Mr. Palone votes I. Mr. Dat. Hi. Mr. Dat votes I. Miss Shakowski.
▶ 5:39:17I Miss Shakowski votes I. Miss Masui I. Miss Matsui votes I. Miss Caster I. Miss Caster votes I. Mr. Tonko I. Mr. Tonko votes I. Miss. Clark. I. Miss. Clark votes no. Mr. Ruiz. Mr. Ruiz votes I. Mr. Peters. Mr. Peters votes I. Mrs.
▶ 5:39:48Dingle. Mrs. Dingle votes I. Mr. Vzy. Mr. Vy votes I. Miss Kelly. Miss Bagon. Miss Bagon votes I. Mr. Sodto. Mr. Sodto votes I. Miss Shrier. Miss Trean. Miss Shrier. guys. So, Miss Shrier votes I. Miss Trean.
▶ 5:40:17Miss Trean votes I. Miss Fletcher. That's what she's doing. Miss Fletcher votes I. Mr. Aassiocortez. Miss Okassiocortez votes I. Mr. Okenclaus. Mr. Aenclaus votes I. Mr. Carter of Louisiana. Mendez. Mr. Mendez votes I. Mr. Mullen. Mr. Mullen votes I. Mr.
▶ 5:40:48Lansman Mr. Lansman votes I. Miss Mlen. Miss Mlen votes I. Chairman Guthrie I. Chairman Guthrie votes I. How is Mr. Carter recorded? Mr. Carter of Georgia is not recorded. Votes I. Mr. Carter votes I. Anyone on either side? Seeing no one here to answer the role, uh, the clerk will report.
▶ 5:41:22I love to speak like that, but it's here just to be just me. I mean, so much so, and it should Mr. Chairman, on that vote there were 46 eyes and one no.
▶ 5:41:45With 46 eyes and one no, the bill is agreed to unanimous
▶ 5:42:22consent. We'll uh take a However you want to do it. You're the millennial. I can't figure it out. You're not even millennial. She's See, I guess we should stay.
▶ 5:42:44I think we're these Gen Xers know how to do that. I don't Jenzers Jenzers Jenzer I'm sorry. Charlotte, you're a great example of citizenship. Thank you very much. Thank you. appreciate it. Thank you.
▶ 5:43:16Feel free if you guys want to take pictures. I'm We'll We'll indulge for sure. That's great. That's great. Thank you. Um the chair now calls up HR2319 and asks the clerk to report HR 2319, a bill to direct the Secretary of Health and Human Services to conduct a review to evaluate the status of research on. Without objection, the first reading of the bill is dispensed with and the bill will be open for amendment at any point. So ordered. Does anyone seek to be recognized on the bill?
▶ 5:43:47Seeing none, are there any Well, the gentle lady from California seek recognition. Mr. Chairman, I have an amendment at the desk. The clerk will report. Mr. Chairman, can the gentle lady please specify her amendment?
▶ 5:44:04It's uh 2319 Amendment to HR 2319 offered by without objection reading the amendment is dispensed with and the gentle lady from California is recognized for five minutes discuss our amendment. Thank you Chairman. First I'd like to thank my colleague Mr. Bole for introducing this important bill which focuses on researching lung cancer in women and underserved populations.
▶ 5:44:32Unfortunately, in the context of what's happening at NIH, I'm worried the kinds of research discussed in this bill might not even be possible. The administration has been attacking NIH on all fronts. First, they attempted to illegally cut indirect costs to researchers, which would have resulted in a $4 billion cut across the agency. They announced the massive layoffs across HHS with around 1,200 jobs cut at NIH.
▶ 5:45:02They've canceled hundreds of millions of dollars in active research grants because they allegedly did not serve the priorities of this administration. This includes anything the administration deemed DEI DEI related taboo words being flagged including women and underserved populations. And now the leak HH budget revealed that the administration is planning drastic cuts to NIH overall budget and disruptive utilization of institutes.
▶ 5:45:33The document proposes a 40% cut to NIH reducing the budget from 47 billion to 27 billion. NIH's 27 institutes and centers would be consolidated into just eight. Some institutes are being eliminated This includes the National Institutes on Minority Health and Health Disparities.
▶ 5:45:57The real world impacts of aggressively and indiscriminately restructuring NIH, eviscerating its annual budget and eliminating critical research are absolutely devastating. Unfortunately, has become a trend for this administration to attack science and public health. And they're not just targeting attacks on our efforts to tackle health disparities. They're attacks on basic science that impacts all of us.
▶ 5:46:26In my district, a UC Davis study on factors that influence the development of dementia was cut by NIH. Why? Because it focused on a diverse population. A pediatric cancer study focused on precision oncology was terminated because it focused on reducing cancer disparities in Hispanic and black children. Again, this is this isn't about DEI.
▶ 5:46:55These projects are seeking answers about some of our most pressing health issues and focus on the populations that are actually the most vulnerable. Examining health outcomes in different racial, ethnic, or gender groups to optimize every patient's health isn't a liberal scam. It's just science. But these terminated grants are just the beginning.
▶ 5:47:21If the administration is successful, the threats of these cuts are injecting uncertainty into the research ecosystem. The United States has long been at the forefront of scientific innovation and research. This administration's actions are jeopardizing our leadership. We're losing a whole generation of scientists because of the uncertainty around NIH funding.
▶ 5:47:46Grad schools are rescending offers and telling curtain students they don't have the funding to sustain them. In fact, my own granddaughter, who was looking forward to starting a PH PhD program this fall, has had her future plans impacted by the administration's chaos. And as the administration dismantles our global leadership in science, other countries, both friend and foe, are waiting to fill the vacuum created.
▶ 5:48:14We are at risk of brain drain with all our talented bright minds leaving the United States and seeking education and opportunity abroad in countries that still prioritize and protect science.
▶ 5:48:29So, while I support this bill, I think if my Republican colleagues are supportive of the research goes of this bill or really research on any of the issues they care about, they should be speaking up about the extreme attacks of the administration on the NIH and science more broadly. My amendment would provide real accountability on the impacts of these attacks. And with that, I urge my colleagues to support my amendment and I yield back the balance of my time.
▶ 5:48:59Gentle lady yields back. Is there any further discussion? Gentleman from Mr. Chairman, I rise in opposition to this amendment. This bill aims to accelerate research, improve early detection methods, and expand access to preventative services to address the rising rates of lung cancer. These are important policy goals, very important, particularly if you have lung cancer. So, let's keep the focus on the bill at hand and avoid political posturing over guidance that is currently caught up in the courts.
▶ 5:49:30Look, if my friends on the other side of the aisle want to continuing to review these this bill for changes and pull it from the markup today, that's fine. Let's just pull it. If y'all still want to make changes to it, we're happy to entertain that discussion. We'll pull it today. We'll do it some other time. I I remind you it is one of your colleagues who is a sponsor of this bill.
▶ 5:49:56However, let me just remind you that this will remain Republicans position that patients deserve our help and support by getting this bill signed in law in a timely fashion with no delays. I urge my colleagues to oppose this amendment and I yield back. Gentleman yields back. Further discussion. Gentleman from Massachusetts Mr. Chairman, I move to strike the last Thank you.
▶ 5:50:23Uh, our Republican colleagues keep encouraging us to focus on the bills at hand and ignore the context of the situation that we're in. And frankly, ignoring the context of today would be reckless for us. Uh, the Republicans are putting forward reasonable bills right now, much of whom are are bipartisan and and thoughtful.
▶ 5:50:47Actually, the administration just issued an executive order on drug pricing that had some reasonable ideas in there, whether it was regarding uh 340B or examining PBM's relationships with brokers. The challenge is we look at these policies and it's hard to take them seriously or substantively when we also see the Secretary of Health and Human Services and his top aids engaged in corrupt, chaotic, and incompetent behavior that undermines the public health and safety
▶ 5:51:17of Americans. Right now we have RFK uh a committed lifelong conspiracist and quack surrounded by individuals who are running businesses on the side that are actually regulated and reimbursed by the agencies they're in charge of. So understanding that context, we have to be drawing attention to the fact that our Republican colleagues are refusing to do anything about it.
▶ 5:51:41They are rubber stamping actions by by the secretary and his henchmen that are degrading our gold standard regulatory uh culture and institution at the food and drug administration that are undercutting science at the national institutes of health and that is turning CMS into an institution meant to uh cater frankly to Brad Smith's own side businesses or Cali mean's own side businesses.
▶ 5:52:09These are things that need to be addressed by our colleagues on the other side of the aisle for us to take seriously their policy proposals. And as we are doing this, as we are undercutting basic research, as we are harassing and bullying the immigrant scientists who make up so much of our eds and enterprise, as we are degrading regulatory clarity and predictability for our biotech enterprise, the country that's taking advantage of this is China.
▶ 5:52:35And this I know my Republican colleagues care about because I served with them on the Select Committee on China for the last two years. And Republicans actually issued a report on China in the 116th Congress that called for doubling United States science and technology spending, which I think is a great idea. I'd love to do it. Let's work on that. Right now, you're doing the exact opposite.
▶ 5:52:55China has been spending hundreds of billions of dollars on its eds and meds research, on commercialization, on manufacturing, and they're watching us right now in a massive effort of counterproductive, self-defeating actions that are going to delay new cures, that are going to uh erode America's global standing, and that are is going to give China the lead in biotech, quantum, AI cyber,
▶ 5:53:25the areas that help define our national security and standards of living for our constituents going forward. On that, I yield back the balance of my time. Jim Muno's back. Is there further discussion on the Republican side? Seeing none, gentle lady from Virginia, Miss McClen is recognized. Thank you, Mr. Chair. Move to strike the last word. Thank you. Um, this amendment is actually directly related to this underlying bill.
▶ 5:53:51The bill requires HHS to conduct an inter agency review of the status of and identify research related to women and underserved populations with lung cancer. Part of that that study needs to be comprehensive or else what's the point?
▶ 5:54:08And part of one of the issues that is impacting research related to lung cancer as well as other cancers, pediatric disease, maternal health, mental health, and Alzheimer's disease, is the president's attempt to put a cap on the indirect costs of NIH grants, which is not a new idea.
▶ 5:54:30In speaking with a former Republican uh colleague of yours before I got here, this idea has been floated around Congress before and has been thoroughly rejected on a bipartisan basis. And whether the courts strike down the president unilaterally doing it or not, my guess is it's probably coming back because the Heritage Foundation is the one that keeps coming up with this idea. And so far, everything the president has done has been in line with the Heritage Foundation's ideas.
▶ 5:55:00But the that cap has a direct result on the ability of research institutions to do the research because it is they use shared resources um that cannot be allocated to one particular clinical trial or one particular research project. And while some universities have the endowments or other sources to make up that funding, others don't.
▶ 5:55:28And I've talked to a lot of research institutions in Virginia and asked directly, can you give me an example of a clinical trial you are currently doing that you are worried will have to stop if this cap takes effect? And the first example I got was a clinical trial related to treatments for metastatic brain tumors. Metastatic brain tumors are not the ones formed from brain cancer.
▶ 5:55:58It is when other cancers like lung cancer or kidney cancer or any other metastasize leading to brain tumors and ultimately it's the brain tumor that kills that person not the underlying original organ uh failure that was subject to the cancer. That's exactly what happened with my father.
▶ 5:56:18And so if we're going to research the of research related to women and underserved populations with lung cancer, that also has to include the effect of actions of the administration or this Congress on the ability of that research to happen. And so this amendment is directly related to this um bill. It shouldn't delay it.
▶ 5:56:46It should be I don't understand why we wouldn't want a comprehensive study. And if we're not going to adopt this amendment, which I'm under no illusions about where the math is here, I would hope that my colleagues would at least want to ask those questions of the research institutions in their states and get a better idea about the realworld implications of the of the cap on indirect costs that the president unilaterally imposed.
▶ 5:57:14And with that, I Gentle lady yields back. Is there any discussion on the Republicans? I seeing any gentle lady from Washington seeks recognition. Recognized for five minutes to speak on the amendment. Thank you, Mr. Chairman. I just wanted to uh sort of double click on what my colleague, Representative Mlen, just said about these cuts to NIH research funding.
▶ 5:57:38And there, you know, these were very cleverly labeled cuts to indirect spending, which to the casual consumer of those words sounds like fluff, sounds like extra stuff. It sounds like overhead. But let me just explain exactly what indirect costs are. And maybe that starts with explaining what direct costs are. Let's say you are a major university and you are doing research.
▶ 5:58:01The direct costs are uh the costs associated only with that research project, only with getting the patients, bringing them in the say the chemotherapeutic agents that you're trying out. Um that's direct costs. Now indirect costs, if you're at a whole university, then we're talking about the building, maybe a lab that you use for multiple studies. Maybe it's the refrigerator you use for multiple studies. Maybe it's the pathologist who looks at samples for multiple studies.
▶ 5:58:30Maybe it's the infusion center. And so when we're talking about indirect costs, these are important costs. They're just not ones that are isolated to just one project. And so, and I also want to clarify that a, for example, 50 to 70% indirect cost means that for every $1 spent on research, 50 to 70 cents is spent on indirect costs.
▶ 5:58:55And so I just want to really kind of condemn the the language um that is is used to insinuate that these are unimportant costs that can be trimmed. This is not fat. This is what funds our research institutions, our universities and scientific advancement in this country. And I also want to agree with my co colleague Mr.
▶ 5:59:18Aenclaus about how by gutting research in this country which has always been the at the forefront of the world's research it is the reason that people come here to the United States to our institutions from all around the world to study and advance uh science and technology. We're now yielding that to China.
▶ 5:59:41And you know, this administration should be ashamed at itself for undermining US excellence and yielding that ground to an adversary. So with that, I want to support this amendment. Uh and I yield back. Gentle lady yields back. Is there further discussion? Seeing none, the question now occurs on adopting the amendments.
▶ 6:00:07The question uh roll call has been recorded requested and the clerk will call the role. Mr. La Mr. Griffith Mr. Griffith votes no. Mr. Bill Rockus Billy Rockus Mr. Bill Rockus votes no. Mr. Hudson Mr. Hudson votes no. Mr. Carter of Georgia.
▶ 6:00:38Mr. Carter of Georgia votes no. Mr. Palmer Mr. Palmer votes no. Mr. Dunn Mr. Dunn votes no. Mr. Krenshaw. Mr. Joyce. Mr. Joyce votes no. Mr. Weber Mr. Weber votes no. Mr.
▶ 6:01:08Allen Mr. Allen votes no. Mr. M. Mr. Balderson votes no. Mr. Fulture. Mr. Fulture votes no. Mr. Fluger. Mrs. Harshburgger. Mrs. Harshburgger votes no. Mrs. Miller Meeks.
▶ 6:01:39Kamik, Mr. Obernolulti, Mr. James, Mr. Bence, Mr. Bence votes no. Mrs. Houchen, Mrs. Houchin votes no. Mr. Fry, Mr. Fry votes no. Miss Lee Miss Lee votes no. Mr.
▶ 6:02:08Langworthy Mr. Langworthy votes no. Mr. Kaine Mr. Kane votes no. Mr. Roelly Mr. Roelly votes no. Mr. Evans Mr. Goldman Mr. Goldman votes no. Mrs. Fedorek, Mr. Palone, Mr. Palone votes I.
▶ 6:02:39Mr. Dette, Mr. Get votes I. Miss Shicowski, Miss Shakowski votes I. Miss Mass Matsoule. Miss Mass Masoule votes I. Caster. Miss Caster votes I. Mr. Tonko. Mr. Mr. Tonko votes I. Miss Clark. Mr. Ruiz. Mr.
▶ 6:03:09Ruiz votes I. Mr. Peters. Mr. Peters votes I. Mrs. Dingle. Mrs. Dingle. Votes I. Mr. Vzy. Mr. Vzy. Votes I. Kelly, Miss Bagon, Miss Bagon votes I. Mr. Sodto, Mr.
▶ 6:03:39Sodto votes I. Miss Shrier, Miss Shrier votes I. Miss Treyan. Miss Trean votes I. Miss Fletcher. Miss Fletcher votes I. Miss Okassio Cortez Cortez Miss Okasiocortez votes I. Mr. Aenclaus Mr. Oenclaus votes I. Mr.
▶ 6:04:06Carter of Louisiana. Mr. Mendez Mr. Mendez votes I. Mr. Mullen Mr. Mullen votes I. Mr. Lansman Mr. Lansman votes I. Miss Mlullen M. Mlen votes I. Chairman Chairman Guthrie votes no. Mr. Lad is not recorded.
▶ 6:04:36Votes no. Mr. Lada votes no. Mr. Gleman, are you Mr. Miss Fedorek votes no. Mr. Krenshaw. Mr. Krenshaw votes no. Mrs. Kamik. Miss Kamik votes no. Anyone else seeking recognition for the answer to the roll call? Seeing none, the clerk will report.
▶ 6:05:17Mr. Chairman, on that vote there were 21 eyes's and 25 nos. The amendment is not agreed to. Is there are there further amendments? Little gentle lady from California, Miss Better. What what purpose do you seek recognition? Mr. Chairman, I have an amend amendment at the desk. The clerk will report. You name the amendment H2319- AMD_1.
▶ 6:05:42The clerk will report amendment to HR 2319 offered by Miss Bagan. Without objection, the reading amendment is dispensed with and the gentle lady is recognized for five minutes in support of her amendment. Uh thank you, Mr. Chairman. This amendment requires that the study established by the women and lung cancer research and preventive services act look at the impact of Medicaid coverage for people with lung cancer. It also requires a study to examine the role that Medicaid plays in access to clinical trials.
▶ 6:06:12Lung cancer is the third most common cancer in the country and more people die from it than from any other form of cancer. My district in Los Angeles County suffers from some of the highest levels of traffic related air pollution in the country which increases the risk of lung cancer and other diseases.
▶ 6:06:30Medicaid covers the often overwhelming costs of cancer prevention and treatments such as physician visits, diagnostic tests, hospital stays, and other clinical services that patients need to be able to join a clinical trial. Medicaid doesn't just support patients, it fuels progress in research on lung cancer as it supports participation in clinical trials. It makes absolutely no sense to claim support better access to lung cancer prevention and treatment while you cut Medicaid.
▶ 6:07:00And yet, every Republican on this committee voted for a budget resolution that lays the groundwork to cut at least 880 billion dollar from Medicaid. Medicaid increases access to cancer screenings and preventive services, leads to earlier stage diagnosis, ensures timely treatment, and boost survival rates.
▶ 6:07:23Renee Shikmeer from Milwaukee, Wisconsin, is one of many who have expressed fear over Republican plans to get Medicaid. Renee has incurable stage 4 breast cancer that has led to tumors in her brain, her liver, and lungs. Without Medicaid, Rene is afraid she'll have to ration or forego cancer treatment, forced with a lower chance of survival or higher risk of bankruptcy. Unfortunately, Renee is not alone in these fears.
▶ 6:07:53Medicaid covers one in 10 adults with the history of cancer and one in three children with cancer. As someone who's watched my sister fight and beat cancer, I know exactly how critical this care is and how devastating it would be to take it away. We should be working to expand Medicaid, not gut it. States have expanded their program.
▶ 6:08:15Um, expanded their Medicaid programs have achieved better cancer survival rates compared to states that have refused to expand their Medicaid programs like Florida, Georgia, and South Carolina. States are able to expand their Medicaid program thanks to the Affordable Care Act, which guaranteed states enhanced federal matching funds to support the expansion. And yet, one of my Republicans leaked budget schemes to cut Medicaid would slash these federal matching funds.
▶ 6:08:40This would shift significant financial burdens onto the states, several of which have automatic trigger laws that would end their Medicaid expansion entirely if their federal matching decreases. Estimates show that if Congress shrinks the enhanced federal matching funds and the states are forced to eliminate their Medicaid expansion, people will lose their health insurance and the number of uninsured people will increase in every congressional district. Medicaid is not optional. It's a lifetime.
▶ 6:09:10It's a lifeline. And unlike my colleagues across the aisle in this committee, I refuse to stand by while Republicans try to rip away the health care that millions of Americans desperately rely on. I urge every member of this committee to do what's right and to support this straightforward amendment. Um and with that said, um just recently there was a cut in the program uh to actually fund lung cancer research, the lung cancer research project. Um and the White House is now seeking to to cut that even more.
▶ 6:09:40So if we're talking about actually supporting lung cancer research, then let's actually do that and speak out when these programs are being cut. I yield back. Anybody gentleman from Georgia, Mr. Carter? Mr. Chairman, I rise in opposition and amendment. I know you find that hard to believe, but I do indeed rise in opposition to this amendment.
▶ 6:10:05This bill aims to accelerate research and improve early detection methods and expand access to preventative services to address the rising rates of lung cancer. They are important policy goals, as we said before. Let's keep the focus on the bill at hand. Please, ladies and gentlemen, let's stay focused. Let's avoid political posturing over an unrelated ask.
▶ 6:10:30Again, if my colleagues on the other side of the aisle that if they want to continue to review this bill for changes and pull it from the markup today, let's do that. Let's let's we all got other things we can do. We we're we're willing to do that. We certainly understand if that's what you want to do. However, let me make clear that it still remains Republicans position that patients deserve our help and support by getting this bill signed into law in a timely fashion with no delays.
▶ 6:10:58I urge my colleagues I urge my colleagues to oppose this amendment and I yield back. Gentleman yields back. The gentleman from California, Mr. Mullen, seeks recognition. Thank you, Mr. Chair. Gentleman's recognized. supporting my California colleague, Representative Baragon's amendment and want to make clear my strong opposition to the Trump administration's illegal cuts to funding and personnel at NIH.
▶ 6:11:21These actions threaten to undo decades of life-saving research on diseases like cancer and Alzheimer's, slowing progress when we can least afford it. In my district, home to top research institutions and a thriving biotech se sector, the birthplace actually of biotechnology, over $200 million in NIH funding has been awfully unlawfully rescended.
▶ 6:11:44Slashing these investments will shutter labs, lay off thousands of researchers and bring groundbreaking research to a halt right at the moment when we are poised to make once in a generation advances against can cancer, Alzheimer's, and other diseases. The US leads global innovation, but these cuts invite other nations to surpass us. Echoing some of my colleagues concerns, our competitors are rapidly investing in advanced technologies and are eager to attract top scientists to dominate the next generation of breakthroughs.
▶ 6:12:15We hand them the advantage on a silver platter by gutting the NIH. Congress must stand firm against this short-sighted policy. Investing in medical research saves lives, strengthens our economy, and ensures our country remains a global leader in innovation. I urge my colleagues to protect NIH funding, gentlemen. I reject these damaging cuts. I yield back. Will you yield? Yielding to my colleague. Thank you.
▶ 6:12:44Um, well, I just want to add to to what you're saying about the importance of this research and and I would say to my friends on the other side of the aisle, I can surely understand why you are uncomfortable talking about the proposed cuts to Medicaid that that we hear you're about to do uh try to do next week when you bring up the budget reconciliation bill. And I point out to you, Mr. Mr.
▶ 6:13:09chairman that um that these amendments are all germanine to all of these all of these bills and the re and therefore they're they're not irrelevant. The reason they're all gerine is when you look at issues like bre like like lung cancer or other types of cancer. So many Americans rely on their treat on payment for their treatment with Medicaid.
▶ 6:13:33So, if we're taking people off of Medicaid, if we're if we're limiting our our um expansion of Medicaid, if we're limiting the the benefits people can do, it's going to affect millions of patients in this country. And and so I can see, you know, we we sort of call it fiddling while Rome burns.
▶ 6:13:55It's great that that these smaller bipartisan bills are up today, but they're really going to be meaningless if people can't get the services that you're talking about. And that's why we are trying to amend these bills to reassure our constituents and your constituents who rely on Medicaid that if they get lung cancer, if they get any of these other diseases, then they will be able to get the treatment that they need.
▶ 6:14:25So, it's it's not like we're taking the focus away. We're surely not trying to make partisan remarks. We're just pointing out that people should not be under any misconception that if they if if we vote for this bill that it's going to get them the treatment that they need. I thank my colleague for yielding and I yield back. Gentleman yields back. Back. There. Any further discussion? none.
▶ 6:14:55Roll call. There's for the gentle from Florida receive recognition. Uh to strike bless. Gentle is recognized. Uh, thank you, Mr. Chairman. Uh, I support the Bearon amendment, but it was a it was in the recent debate on the last bill where I don't know if you heard it, I did, like red sirens and flashing red lights when you said, Mr.
▶ 6:15:19Chairman, that there is no proposal that you've seen anywhere that anybody is eligible for Medicaid that is disabled would lose their benefit and then went on to talking about restraining the growth of Medicaid. And throughout the debate today, there's been reference to maybe a work requirement or per capita caps. You've certainly talked about that over the past um few months as we barrel towards this horrendous uh markup next week.
▶ 6:15:49And people need to know what this coded language really means for their healthcare. And there's no better example than all of these letters that are pouring in from across the country opposing the Medicaid cuts.
▶ 6:16:07These are just a few samples from many aging and disability organizations pleading with this committee to not rip away their health care to give massive tax cuts to billionaires. They have consistently voiced their strong concerns with proposals like per capita caps, cutting the the matching rate uh for states, the FMAP um and imposing work requirements.
▶ 6:16:36They're all policies that you've talked about and people need to know what it really means. It means less care for the people we love the most. Um for example, the Alliance for Aging Research, this is a a long group of organizations that help u millions of Americans every day.
▶ 6:16:56They say, "We are concerned about the negative impact these deep cuts will have on all Americans living with chronic disease and other disabilities, how devastating they will be on those with with Alzheimer's disease and related diseases." They say work requirements would take away coverage and have outsized impacts on this community and they're they're problematic.
▶ 6:17:19the the disability and collaborative representing 400 plus aging disability and allied organizations from every state, 17 million people with disabilities and older adults. They said Medicaid is already lean and efficient. Funding cuts, caps, or changes that limit eligibility or make it harder to enroll in or maintain coverage threaten the long-standing Medicaid guarantee for people with disabilities, older adults and their families.
▶ 6:17:48We strongly oppose any budget resolution that calls for leads to Medicaid cuts as well as any efforts to pro impose Medicaid uh per capita caps, block grants, work requirements, restrictions on eligibility, barriers to enrollment because that's what they are. Just take a look at what happened in Arkansas a few years ago when they instituted work requirements.
▶ 6:18:11What happened was 18,000 people from that state were kicked off the roles and a federal judge had to intervene to say you're not following the law and providing the care you need. And I don't want I don't want my Republican colleagues to fall into the same trap. But I think that it's it's fair for the rest of the world to know what's really going on here as we barrel towards this markup next week. And we will as Mr.
▶ 6:18:39As uh ranking member Palone pointed out early, we're not going to have the text for uh the Medicaid cuts until maybe 10 p.m. on Monday night. And then you have to watch because then an amendment could come in. They could they could post the text and then there they're likely to be amendments and changes on that. So this is an all hands- on deck moment. This is a time when the siren should be going off. The red lights are flashing.
▶ 6:19:10We've heard at home from millions of Americans. They don't think that it's worth ripping away care to the people we love the most to provide a massive tax cut to billionaires. But that's the the coded language, the red alert that that should be going out here today. While um again, we yes, we're focused we're we're focused on this.
▶ 6:19:33You can say we're we're very focused on the health of the people we love the most and we intend to fight for them today, tomorrow, next week, every single day. And I yield back my time. Thank you. The gentle lady yields back. Is there further discussion? Seeing none, the the vote occurs on the amendment. The roll call being requested. The clerk will call the role. No.
▶ 6:20:04Mr. Lada votes no. Mr. Mr. Griffith votes no. Mr. Bill Rockus. Mr. Bill Rockus votes no. Mr. Hudson Mr. Hudson votes no. Mr. Carter Georgia. Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Mr. Palmer. Mr. Palmer votes no. Mr.
▶ 6:20:35Dunn Mr. Dunn votes no. Mr. Krenshaw Mr. Joyce Mr. Joyce votes no. Mr. Krenshaw votes no. Mr. Weber Mr. Weber votes no. Mr. Allen Mr. Allen votes no. Mr. Balderson. Mr. Balderson votes no. Mr.
▶ 6:21:05Fulture. Mr. Fulture votes no. Mr. Fluger. Mrs. Harshburgger. Mrs. Harshburgger votes no. Mrs. Miller Meeks. Mrs. Kamik. Mr. Obernolulti. Mr. Obernolulti votes no. Kamik Mrs. Kamik votes no.
▶ 6:21:35Mr. James Mr. Bence Mr. Benz votes no. Mrs. Hggin Mrs. Hggin votes no. Mr. Fry Mr. Fry votes no. Miss Lee Miss Lee votes no. Mr. Langworthy Mr. Langworthy votes no. Mr. Kaine. Mr. Kaine votes no. Mr.
▶ 6:22:08Roelly. Mr. Evans. Mr. Goldman. Mr. Goldman votes no. M. Fedorch. M. Fedorch votes no. Mr. Palone. Mr. Palone votes I. Mr. Gat. Mr. Gat votes I. Miss Shakowski. Yes. Miss Shakowski votes I. Miss. Massouie. I.
▶ 6:22:38Miss. Massoule. Votes. I. Miss Caster. Hi. Miss Caster votes I. Mr. Tonko. I. Mr. Tonko votes I. Miss. Clark. Mr. Ruiz. Mr. Mr. Ruiz votes I. Mr. Peters Mr. Peters votes I. Mrs. Dingle. Mrs. Dingle votes I. Mr. Vzy.
▶ 6:23:09Miss Kelly. Miss Bagon. M. Spagon. Votes I. Sodto. Mr. Sodto votes I. Miss Shrier. Miss Shrier votes I. Miss Treyan. Miss Trean votes I. Miss Miss Fletcher votes I. Miss Okasio Cortez.
▶ 6:23:38Miss Okassiocortez votes I. Mr. Okenclaus. Mr. Oenclaus. Mr. Oenclaus votes I. Mr. Carter of Louisiana. Mr. Carter of Louisiana votes I. Mr. Mendez. Mr. Mendez votes I. Mr. Mullen. Mr. Mullen votes I. Mr. Lansman.
▶ 6:24:08Mr. Lansman votes I. Miss. Mlen. Miss. Mlen votes I. Chairman Chairman Guthrie votes no. Anyone seeking to answer the roll call? Good. Anybody on the Democrat side looking to answer the roll call? Seeing none, the clerk will report.
▶ 6:24:41Mr. Chairman, on that vote there were 21 eyes and 25 nos. The amendment is not agreed to. Seeing are there any further amendments? Further discussion? Seeing none, the question now occurs on HR2319. All those in favor say I. I. All the post, no. The eyes have it. The chair calls up HR 1669 and ask the clerk to report.
▶ 6:25:15HR 1669, a bill to amend the public service. Without objection, the first reading of the bill is dispensed with and the bill will be open for amendment at any point. So ordered. Does anyone seek to be recognized on the bill? Is there further discussion on the bill? Are there any amendments to the bill? No amendments. No amendments. Seeing none, there are no purposes. No amendments to the bill.
▶ 6:25:45If there's no further discussion, the vote occurs on the bill. Wait, question now occurs on adopting HR 1669. All those in favor say I. I. Those opposed, no. The eyes have it and the bill is agreed to. The chair calls up HR 1082 and ask the clerk to report HR 1082, a bill to require the Secretary of Health and Human. Without objection.
▶ 6:26:12The first read of the bill is dispensed with and the bill will open for amendment at any point. So ordered. Does anyone seek to be recognized on the The gentle lady from Michigan seeks recognition on the bill. Thank you, Mr. Chair. I'm move to strike the last word in strong support of HR 1082, the Shandra Asena Human Cell and Tissue Product Safety Act.
▶ 6:26:38I'm proud to lead this important bill alongside my good friend and colleague from Michigan, Representative John Mulliner. Last summer, I was contacted by the medical director of the county tuberculosis clinic who was treating a patient, Shandra Asena, for a severe postsurgical tuberculosis infection. Shandra was Rep. Molinar's constituent, but being treated at a medical facility in my district.
▶ 6:27:06After a month battling a severe TB infection in the intensive care unit, Shandra unfortunately died. Since Shandra's passing, it's been discovered that her death was indeed linked to contaminated bone graft material produced by Azo Biologic. She was one of 36 patients who received material from the contaminated lot.
▶ 6:27:30And as of today, this latest outbreak is linked to the deaths of two patients, including Shandra. This bill requires the Department of Health and Human Services to conduct research and education campaigns to prevent TB outbreaks caused by contaminated human cell and tissue product donations.
▶ 6:27:51Through the markup process, we also included an important provision to allow the federal government to pursue civil penalties from providers who cause an outbreak of an infectious disease. Patients deserve to know the risks associated with tissue donations and companies that make and distribute contaminated products must be held accountable for their actions. I just want you all to think about it.
▶ 6:28:19ever gone had a implant gotten bone graft that material is not subject right now to what it should be subject to. You too could be exposed to TB. We need to fight that. I thank the energy and commerce chair Guthrie and ranking member Palone for fighting for this important piece of legislation. I want to thank Rep. Mullinar for being a great bipartisan partner.
▶ 6:28:44We owe it to Shandra, her family, and every other patient who's been affected by contaminated bone grafts to ensure we're doing everything to prevent these unnecessary tragedies from happening again. I urge my colleagues to vote yes on this important bill and yield back the remainder of my time. Thank you. The gentle lady yields back for purpose. Gentleman from Texas, Mr. Krenshaw. You're recognized for five minutes to speak on the bill. I move to, Mr.
▶ 6:29:11Chairman, I move to strike the last I'm happy we're marking up the uh Shandra Isanga bill, a human cell and tissue product safety act today. Uh thank you uh representatives Molinar and Dingle for for sponsoring this. This bill is named for Shandra who tragically passed away from tuberculosis in 2023. Became sick after receiving a contaminated bone graft during surgery. Something that no patient or family should ever have to to go through.
▶ 6:29:36These cells and tissue products can save lives, but we have to ensure that standards are clear, that providers and patients are educated on the risks and benefits. This bill will do a couple of key things. First, it will educate patients, providers, and industry. It will also ensure that the FDA has the most up-to-date guidance so that industry can properly screen for pathogens like tuberculosis. Second, the bill includes important bipartisan policies that I'm proud to have worked on with Representative Baragon, but policies that encourage innovation and regenerative regenerative medicine.
▶ 6:30:05You might also ask what regenerative medicine is. Well, it's when we use the human body to heal disease. And in some cases, we're quite literally using a patient's own body, their own cells to cure that disease. It's it's a great medical miracle of our time. But in order to succeed, we have to make sure that the regulatory environment encourages innovation. So, here's what the bill does. It encourages more FDA communication with innovators. And this bill also moves us closer to a new pathway so that we are not applying a one-sizefits-all regulation to some of the most life-changing cell therapies.
▶ 6:30:34This is something I plan to continue working on with the FDA because the wrong regulation can quite literally mean the difference between innovation that saves lives and patients that are left out in the cold with no options. And I ask everyone um to vote in support of this bill. Thank you and I yield back. Gentleman yields back. Is there further discussion on the bill? Seeing none, are there any amendments to the bill? Seeing none, the question now occurs on adopting HR1082.
▶ 6:31:03All those in favor say I. I. Those opposed, no. The eyes have it and the bill is agreed to. The chair calls up HR 2484 and ask the clerk to report. HR 2484 bill to amend title 18 of the social security act to establish. Without objection, the first reading of the bill is dispensed with and the bill will be open for a minute at any point. So ordered. Does anyone seek recognition on the bill? The gentle lady from Tennessee. for our purpose.
▶ 6:31:32You seek uh to support the bill. You're recognized to speak on the bill. Okay. Thank you, Mr. Chair. I urge my colleagues to support this important bipartisan legislation that I introduced with uh Representative Desi Debbie Wasserman Schultz. And I want to thank chair Guthrie and Carter and ranking member Palone and Dette for working with me to advance this critical importance in the way of Medicare seniors can obtain their uh part D prescription drugs.
▶ 6:32:02This would provide continuation of prepandemic era flexibilities for specialty physicians and other healthc care providers to be able to deliver oral medications uh to patients by mail delivery or courier. or it would allow a designated caregiver or family member to pick up these medications instead for the patients.
▶ 6:32:21It's critically important for the well-being of cancer patients and others with serious diseases who are too sick to pick up their medications in person who live in rural areas uh distant from their physicians or who simply do not have transportation. A version of this legislation was advanced out of the full energy and commerce committee in the 118th Congress and it was passed by the house without objection in September 2024.
▶ 6:32:47The updated bill before us is a result of bipartisan bicameal negotiations with the Senate Finance Committee and additional technical assistance from CMS toward the end of last year as well as feedback from the healthc care stakeholder HR2484 is the physician self-referral law to permit Medicare patients to receive Medicare Part D prescription drugs via caregivers picking up drugs on the patients behalf or via mail or couriers delivering
▶ 6:33:17delivering those drugs to the patient and this will begin on January 1st 2026 and continue for five years. These flexibilities would be permitted in instances when a provider prescribes a drug to be dispensed by a pharmacy that falls under the self-referral laws definition of an inoffice ancillary service.
▶ 6:33:37While the bill does not mod modify any program requirements under Medicare Part D, it puts in place common sense guard rails for these flexibilities by requiring within one year prior the Medicare beneficiary must have a face-to-face encounter with the prescriber and only if the Medicare beneficiary has an ongoing pre-existing relationship with the prescriber.
▶ 6:33:59These health care flexibilities are safely managed by licensed pharmacy professionals and integrated within the special care team and patients treatment plans. This approach which is widely utilized in private commercial health insurance as longured patients receive coordinated highquality medical care including patient education, monitoring, real-time treatment adjustments and medication safety measures.
▶ 6:34:23In addition, these practices are well resourced and qualified to handle the complex supply chain dynamics required of cancer and other sensitive specialty medications from acquisitions to proper storage and delivery. Medicare patients will benefit from these enhanced flexibilities that will allow them to better maintain access to care and regular uptake of their prescribed medications.
▶ 6:34:45The legislation also provides that within three years after enactment, the US Government Accountability Office will conduct a study and issue a report to Congress on a number of metrics, including the prescribers and pharmacies participating in these flexibility arrangements, their contracting features and business structures, and any changes in part D drug prescribing and dispensing volumes. The very minimal cost of these reforms would be fully paid for and offset by transferring funds from the Medicare improvement fund.
▶ 6:35:13And I ask the uh committee's consent to include in the record copies of four letters to support for this bipartisan bill from the community oncology alliance, from the nonprofit medical association lugpa, from the American medical association, and from the US oncology network. Is that okay? Without objection, orders. Okay. Thank you, sir. And I urge my colleagues to support this crucial bipartisan bill.
▶ 6:35:39We shouldn't be forcing patients, especially our seniors, to take an arduous journey or have uh their access to life-saving medicines threatened. And the seniors access to critical medications act will modernize Medicare, promote patients safety, and ensure that seniors, cancer patients, and those suffering from serious illness are able to receive the medications they need when they need them. Thank you, Mr. Chairman, and I yield back. The gentle lady yields back and the chair recognizes the ranking member, the gentleman from New Jersey for five minutes to speak on the bill.
▶ 6:36:09Thank you, Mr. Chairman. I I supported this bill last Congress because I believed it was narrowly tailored to address a simple problem that's allowing for patients to be able to get their prescriptions mailed to them by their doctor. But I am concerned that recently I've heard from both pharmacists and other members of Congress that the bill could actually incentivize significant consolidation and vertical integration in physician practice by drug wholesalers.
▶ 6:36:35So under this bill, there could be further incentives for wholesale drug distributors to purchase physician practices and steer their providers to prescribe treatments based on whatever makes their doctor the most money. And I know members on both sides are troubled by the trend of greater consolidation in our health care system. So this raise raises concerns that HR2484 was significantly weaken the Stark law, paving the way for more fraud and abuse in the Medicare program.
▶ 6:37:05Patients deserve access to treatment that is medically appropriate for them. And the Stark law ensures that patients receive care based on medical necessity and not based on whatever treatment makes their doctor the most money. So given these news concerns that were not raised at the time that this bill was considered in the last Congress, I I can't continue to support the bill that may result in greater consolidation in our healthcare system and thereby raise health care costs for seniors. And I yield back the balance of my time, Mr. Chairman. Thank you.
▶ 6:37:34The gentleman yields back. Is there any discussion? The gentleman from Georgia seeks five minutes for discussion. Recogniz All right. The gentleman from Georgia does not seek recognition. I do. You had recognition. Somebody Does gentleman from Florida seek recognition and yield to the gentle lady? I yield to the gentle lady from Tennessee. Thank you. Thank you, Mr. Feracus.
▶ 6:37:59Um, you know, I think there's some misunderstanding or mis uh information from some of those entities from the largest PBMs in the country. They're worried about losing market share. That's the concerns that they're promoting because this bill passed unanimously out of this committee and through the house. And uh whenever it draws scrutiny like that, you know, we must be doing something right with this bill. And it's a very simple bill. It deals with drug delivery.
▶ 6:38:27And it removes any barriers that these cancer patients may have to treatment and anybody with serious diseases from getting their treatment. And you know, uh it may well upset these mega companies with um you know, PBM financial affiliations. And we're here to do what's right and to put the patients over process uh over profits. And that's what this bill does.
▶ 6:38:52It clarifies the Stark law to where those patients will have un uninhibited access to the drugs they need to provide the outcomes that they should have. so they won't miss doses and uh the outcomes will end up being the best for that patient. And I yield back with that. Gentleman from Florida yields back. I yield back. The chair recognized a gentleman from from Massachusetts. I had stand up first. Let me go to you first. The gentleman from California rank California seniority. Uh Dr. Ree. Thank you.
▶ 6:39:22I appreciate that. It's been 13 years to be able to be on this top diet. So I appreciate you you calling me here. So uh look um you know I I support this bill. So, I do have concerns about consolidations. I'm uh but I don't have those concerns as as much as others on uh on this side. Uh as a physician, I know it's very hard uh sometimes for our patients, especially underserved and and in in communities to be able to drive every day to get the medications from their from their doctors.
▶ 6:39:52But um since we're on the topic of Medicare and access to the Medicare, uh one of the things that concerns me is the coming cuts to the Medicaid. A lot of people don't dis don't link the Medicaid to Medicare. Uh but many many patients, in fact, 12.2 2 million patients in the United States, 1.7 million in California are dual eligible enrolles with Medicare and Medicaid.
▶ 6:40:23And we know that this uh committee has been instructed uh through the Republican budget framework to cut 880 billion under the energy and commerce jurisdiction. And we have seen reports that if they zero out everything other than Medicaid, they would be able to cut 200 billion. That leaves 680 uh billion left uh to find ways to cut from the Medicaid program.
▶ 6:40:51Uh and you know, we've heard different uh ways that they intend to do that. Uh one is to create work requirements. The other is to cut the provider tax or the MCO tax, which is sort of a matching fund the states use to help pay for the Medicaid program. The other is putting caps on uh per capita caps, other ways reducing the federal share of the the Medicaid costs.
▶ 6:41:18All of these will end up with lowering the usage of Medicaid. So, in other words, it's figuring out ways to to cut the enrollment or cut the people who use Medicaid. In other words, it's a cut to Medicaid.
▶ 6:41:34Uh, and we can use different words and trickery like saying, "Well, but we're not going to touch the benefits." No, because none of these are specifically about benefits, but you know that if you cut people off of Medicaid, they're not going to be able to enjoy those those benefits. Uh nearly 30% of Medicaid dollars support Medicare enroles. So any cuts to Medicaid will particularly hurt our dual eligible constituents.
▶ 6:42:00Medicaid provides premium assistance for Medicare enroles, helping over 10 million seniors and people with disabilities. Medicaid fills the gap in coverage and affordability that Medicare beneficiaries face like out-ofpocket costs, long-term care stays, and transportation to medical appointments.
▶ 6:42:20So, you know, all these big cuts to Medicaid could lead to people getting kicked off their Medicaid coverage cuts would lead to fewer benefits, more out-of- pocket costs. And you ask how? Well, if you put more of the owners on states, they're going to start doing those cuts and eligibility. So, I see I've ran over my time. The chairman has been very gracious in giving me such extra time. I yield back. Thank you. Thank you. The gentleman yields back.
▶ 6:42:46The gentleman, anyone on this side of the gentleman from Massachusetts is recognized for five minutes. Speak on the bill. Mr. Chairman, I move to strike the last Uh the Seniors Access to Critical Medications Act is a well-intentioned and thoughtful bill and this issue is really complicated.
▶ 6:43:09But I cannot support this bill as written for the simple reason that it it fails what I think of in my head as the United Health Group test. What this bill does is it undermines conflict of interest laws and it opens up the ability for a vertically integrated corporation to purchase physician practices, oncology clinics as they are already doing and then establish a centralized
▶ 6:43:39mailing facility even out of state. And the problem with that is that for the last 50 years, corporations like United Health have been taking advantage of exactly these types of well-in well-intentioned laws and regulations to find choke points that they can take advantage of to inflate prices.
▶ 6:44:01And I worry that what will happen with this bill as currently drafted is it's going to induce more of the acquisition of oncology practices by the vertically integrated health insurers, United Health Group, Sigma, CVS.
▶ 6:44:17They are going to set up centralized mailing facilities and they are going to continue their self-deing and profiteering that has already now so badly hurt our independent pharmacists that has so badly hurt our independent physicians practices and now could actually further hurt our oncology practices.
▶ 6:44:36Um, so I'm going to propose at a later time here when when it's appropriate an amendment that I think would resolve some of these uh these loopholes in this legislation because I do want to get to the end state here. I there's a real problem this bill is addressing which I appreciate. I think the bill is proposing some things that could make it more convenient for patients. I appreciate and respect that.
▶ 6:44:59But we have to be on guard against the vert the the insatiable appetite for vertical integration by the corporate health insurance companies and I think this bill gives them a lane. Uh I will yield back. Gentleman yields back. Is there further discussion? Well, I wanted the gentleman to yield if he would. Would the gentleman yield? You have Yes, I would. Okay. All right. Thank you, sir. You know, I appreciate your concern and I'd be more than willing to work with you after this markup.
▶ 6:45:29Uh, but I think it's important to state this clearly for the record. You know, this legislation enjoys bipartisan support. Uh, doesn't alter any existing state laws, create new dispensing authorities for providers, or impact patients safety. All it does is it makes it easier for seniors to get the medications they need. And hey, you know that I work with you on PBM legislation.
▶ 6:45:55Um, and it's important to keep places from vert vertically integrating, but these are the very ones that are are are lobbying against this bill because it's going to cut into their profits. And it's something I've dealt with for almost 40 years. But like I say, I'd be willing to talk to you after this market. I appreciate that. I'll claim back some of my time here.
▶ 6:46:17I do need to note that it's while we're focused here on the oncology element of this and again I am recognizing a real problem that this bill is meant to address and I think people I know that patients can appreciate the mail order option optionality it actually applies to all of part D though it's all part D drugs not just cancer drugs right and when you combine that really wide scope of drugs that are subject to this with the with the fact that it's a centralized mailing facility is now legalized you you can see the same playbook
▶ 6:46:48playing out here. I understand that the existing PBMs are the ones who are worried about this and it is an odd place for me to be. Trust me. Uh I think that they and and those who have concerns about this bill are arriving at it from this from a very different place. I just want us to be on guard against unintended consequences of which there are so many in healthcare prescript particularly the prescription drug supply chain. I yield back, Mr. Sure. Gentleman yields back.
▶ 6:47:17Further discussion on the Republicans. I see none for the Democrat side. You okay? See no further discussion. Are there any amendments? Gentle lady from Colorado is recognized. Uh well, what purpose gentle lady from Colorado have recognition? Um Mr. Chairman, I have an amendment at the desk. H A R S H B O2- AMD1. The clerk will report and if I could uh reserve a point of order. Report of order is reserved by the min gentleman from Virginia.
▶ 6:47:48Clerk will report. Amendment to HR 2484 offered by Mystica of Add at the end of the without objection. The reading of the amendment is dispensed with and the gentle lady is recognized for five minutes in support of her amendment. Well, I want to um thank my colleague for offering this bill, my co-member of the Congressional Diana Caucus, and I have an amendment that will make this bill, this excellent bill, even more excellent.
▶ 6:48:1563% of Americans are concerned about DOA's access to sensitive information. And frankly, they're right to be worried. The Department of Health and Human Services is entrusted with sensitive health and personal information about more than 66 million Americans enrolled in Medicare Medicare.
▶ 6:48:35Just this week, we found out that Doge has illegally accessed sensitive personal information systems at HHS, including a CMS database containing the social security numbers, phone numbers, and medical records of patients and healthcare providers. But let me be clear. RFK Jr. gave Elon Musk and his legion of young Doge staffers access to your social security number, phone number, and medical records.
▶ 6:49:05Mr. Chairman, I'd like to enter an article from Wired magazine into the record which shows that Jo Doge now has access to 19 sensitive systems at HHS. Without objection, so ordered. Thank you. This includes Highglass, the central accounting system for CMS and CMS's integrated data data repository cloud, which contains medical records.
▶ 6:49:31I don't trust Doge at all, but I really don't trust them to not to use people's sensitive information to interfere with their care. The only way to ensure the rogue Doge enterprise cannot continue to interfere with Americans health care is by limiting access to sensitive Medicare data due to apo data to apolitical civil servants who have demonstrated they are worthy of the public trust.
▶ 6:49:57So today um as this amendment is a version of my bill, the data of government and health entities must be protected from overreach by unelected non-secure disruption or doge pound act as an amendment to HR2484. This amendment would ensure that Elon Musk and his corrupt Doge um uh employees cannot interfere with Medicare beneficiaries healthcare.
▶ 6:50:23It only makes sure that Medicare sensitive systems are accessible only by trusted a-political civil servants. Be really honest, the American people did not elect Elon Musk and they certainly do not trust Elon Musk with their personal health information. I urge my colleagues to vote in favor of this amendment and I urge them to vote for the underlying bill and I yield back. Is there discussion on the amendment?
▶ 6:50:52Is there any further discussion on the amendment? Seeing none, the question occurs on the recorded vote. The gentleman requests a recorded vote and the clerk will call role. Mr. La Mr. La votes no. Mr. Griffith Mr. Griffith votes no. Mr. Bill Rockus. Mr. Hudson. Mr. Mr.
▶ 6:51:22Hudson votes no. Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Palmer Mr. Palmer votes no. Mr. Dunn Mr. Dunn votes no. Mr. Krenshaw. Mr. Joyce. Mr. Joyce votes no. Mr. Weber Mr. Weber votes no.
▶ 6:51:52Mr. Allen. Mr. Allen votes no. Mr. Balderson. Mr. Balderson votes no. Mr. Fulture. Mr. Fulture votes no. Mr. Fluger. Mrs. Harshburgger. Mrs. Harshburgger votes no. Mrs. Miller Meeks. Mrs. Miller Meeks votes no. Mrs.
▶ 6:52:22Kamik, Mr. Obernolte, Mr. Oberoni votes no. Mr. James, Mr. Bence, Mr. Ben votes no. Mrs. Hchen, Mrs. Hchin votes no. Mr. Fry, Mr. Fry votes no. Miss Lee, Miss Lee votes no. Mr. Mr. Langworthy. Mr. Langworthy votes no.
▶ 6:52:52Mr. Kaine Mr. Kane votes no. Mr. Roelly Mr. Evans Mr. Goldman Mr. Goldman votes no. Miss Fedorek. Mr. Fedorek votes no. Mr. Palone Mr. Palone votes I. Mr. Get Mr. Get votes I.
▶ 6:53:19Miss Shakowski I Miss Shakowski votes I. Miss Matsui I. Miss Mass Matsoule votes I. Miss Caster. Mr. Tonko. I. Mr. Tonko votes I. Clark. Mr. Ruiz. Mr. Ruiz votes I. Mr. Peters. Mr. Peters. votes I. Mrs.
▶ 6:53:51Dingle, Mr. Vzy, Mr. Vzy votes I, Miss Kelly, Miss Badon, Miss Bagon votes I, Sodto. Mr. Sodto votes I. Miss Shrier, Miss Shrier votes I. Miss Trean. Miss Treyan votes I. Miss Fletcher.
▶ 6:54:21Miss Fletcher votes I. Miss Okaziocortez. Mr. Kaziocortez votes I. Oenclaus. Mr. Oenclaus votes I. Mr. Carter of Louisiana. Mr. Mendez. Mr. Mendez votes I. Mr. Mullen. Mr. Mr. Mullen votes I. Mr. Lansman. Mr. Lansman votes I. Miss. Mlen.
▶ 6:54:52M. Mlen votes I. Chairman Guthrie. Does anyone see an answer to the roll call? Mr. Bill Rockus. Mr. Bill Rockus is not recorded. Mr. Mr. Mr. Bill Rockus votes no. Mr. Mr. Krenshaw votes no. Mrs. Kamik. Miss Kamik votes no. Anyone else seeking recognition for the roll call? Anyone on your on the Democrat side?
▶ 6:55:20Seeing none, the clerk will Clerk report. Mr. Chair, what's it? I have an amendment at the Oh, you have Well, we'll finish the amendment. All right. Thank you. Okay. Clerk will report. Uh, Mr. Chairman, on that vote there were 19 eyes's and 26 nos. The amendment is not agreed to.
▶ 6:55:50Are there further amendments? Mr. Lens. Thank you, Mr. Chair. I have an amendment at the desk. Clerk will Would you state your amendment? Uh, it is 002. Does that help? that And if I could uh reserve point of order on point of order is reserved against the amendment on the amendment. Yeah. Gentle gentleman will report.
▶ 6:56:20Mr. Chairman is at 002 PBM. Yep. You got it. Thank you. Okay. General Curt report. Amendment to HR 2484 offered by Mr. Lansman. Without objection, the reading amendment is recognized. Excuse me. is is dispensed with and the gentleman from Ohio is recognized for five minutes in support of the amendment. Thank you, Mr. Chairman.
▶ 6:56:44My amendment would insert into the underlying bill our bipartisan biccameal agreement that was included in the endofyear uh funding bill that would rein in PBM practices under Medicaid Medicare sorry part D. This is a piece of legislation that we all support uh and is obviously germanine to the underlying bill.
▶ 6:57:12The amendment is the language of our agreement what was in the end ofear spending bill verbatim. Now it will capture about $400 million in savings. So, this is money that was intended to uh support further expansions of Medicare.
▶ 6:57:37Uh if we are saving Medicare and Medicare recipients, seniors, millions and millions of dollars, hundreds of millions of dollars. And the worry is that if we don't pass this now, separate from the budget bill, uh those savings will be erased from Medicare. Uh money that should have gone to seniors.
▶ 6:58:04A few weeks ago, we were going to take up the PBM and ranking member Palone got on record, wanted to lay down a marker that the PBM reforms would be included, would be taken up on the House floor and then we adjourned. Then we were going to come back and take up the PBM bills. That never happened.
▶ 6:58:32Uh the other thing that didn't happen and I'm new so this was very very surprising maybe this happens all the time but it was also uh there was also a commitment that we would take up the PBM bills again bipartisan support we all want to get it done uh that we would take them up alongside of the bills we had already passed that morning but last night we passed one of those bills the take it down bill.
▶ 6:59:00So, we're are already out of step uh of of that commitment. So, the question is I guess I would pull this if was a commitment that we're going to take this up. It will be separate from the reconciliation bill.
▶ 6:59:16But I think it's better that we just pass it so that the PBM reforms that we all care about get done, that they get sent to the floor, and that the savings, the hundreds of millions of dollars for Medicare and seniors stay with Medicare and seniors. So, uh, with that, Mr. Chair, I uh I know you as a leading advocate for this reforming the PBM's practices uh and and really the entirety of this committee.
▶ 6:59:46I urge all of our members to support this amendment, support the full endofear package uh which should have already become law, but we can take care of that now. Thank you and I yield back. Thank you. The gentleman yields back. Is there any discussion? Gentleman from Georgia seek recognition. Move the strike. Last word. Gentleman's recognized. I want to thank the gentleman first of all for for his advocacy of PBM reform. I appreciate this very much.
▶ 7:00:15As as everybody knows, nobody has worked harder for PBM reform than I have. And while I support the nature of this amendment, this would exceed the scope of the very of this very narrow policy. And that's why I oppose its inclusion. It's been said that there's a time and a place for everything. Well, and that's true. This is not the time nor the place for for what we want to do in PBM reform and what we are going to do in PBM reform.
▶ 7:00:40We've worked across the aisle to policies, excuse me, we've worked across the aisle to support policies such as the amendment offered by my Democratic colleague. In fact, we unanimously passed out of the Energy and Commerce Committee last Congress PBM policies in Medicare Part D and in Medicaid that would save seniors and vulnerable patients money at the pharmacy counter while ensuring taxpayer dollars are spent effectively. I hope to send this policy to the president's desk for his signature in the near future.
▶ 7:01:11Now having said that this would fundamentally change the nature of the underlying policy which has been negotiated in good faith over the course of 18 months. For that reason I would urge my colleagues to vote no on the amendment and I yield back. Gentleman yields back. Is there fur further discussion? Gentleman from New Jersey. You're recognized to speak on the amendment for five minutes. Thank you, Mr. Chairman. Just a quick point because in speaking against the amendments today, Mr. Carter has said we need to move things forward in a timely fashion with no delays.
▶ 7:01:40With respect to PBM reform, how much longer do you want to wait? These are already delays that we've encountered because of this administration. And I don't think we should wait anymore, which is why I absolutely support Mr. Lansman amendment. So we can start to see the real progress that has already been agreed to by this committee that was supposed to be put forth before the entire Congress.
▶ 7:02:01But which was pulled and at that time there's no I didn't hear anything from our Republican colleagues about saying we need to get this done without delay because that's exactly what happened what we continue to have to deal with uh when we're we're here in committee. With that I yel back. Ment yields back. Is there further Seeing none, the question now occurs on the amendment. All in favor will say I. Roll call. The roll call has been requested. The clerk will call the role.
▶ 7:02:31Mr. La. Mr. La votes no. Mr. Griffith. Mr. Griffith votes no. Mr. Billis. Mr. Billis votes no. Mr. Hudson. Mr. Mr. Hudson votes no. Mr. Carter of Georgia. Mr. Carter of Georgia votes no. Palmer. Mr.
▶ 7:03:02Dunn. Mr. Palmer. Mr. Palmer votes no. Mr. Dunn. Mr. Dunn. Mr. Dunn votes no. Mr. Mr. Krenshaw. Mr. Krenshaw votes no. Mr. Joyce Mr. Joyce votes no. Mr. Weber Mr. Weber votes no. Mr.
▶ 7:03:31Allen Mr. Allen votes no. Mr. Balderson. Mr. Balderson votes no. Mr. Fulture. Mr. Fulture votes no. Mr. Fluger Mrs. Harshburgger Mrs. Harshburgger votes no Mrs. Miller Meeks Ms. Miller Meeks votes no Mrs. Kamik Mrs. Kamik votes no Mr.
▶ 7:04:02Obernulti Mr. Obernolulti votes no Mr. James Mr. Ben Mr. Ben votes no Mrs. Mr. Hggin Mrs. Hggin votes no. Mr. Fry Mr. Fry votes no. Miss Lee Miss Lee votes no. Mr.
▶ 7:04:33Langworthy. Mr. Kain. Mr. Kain votes no. Mr. Roelly. Mr. Evans. Goldman Mr. Goldman votes no. Mrs. Fedorch Mrs. Fedorek votes no. Mr. Mr. Palone votes I. Mr. Dette. Mr. Digette votes I. Miss Shakowski. I.
▶ 7:05:04Miss Shakowski votes I. Miss Matsui I. Miss Matsui votes I. Miss Caster, Mr. Tonko I. Mr. Tonko votes I. Miss Clark, Mr. Ruiz. Mr. Peters. Mr. Peters votes I. Mrs.
▶ 7:05:34Dingle. Mr. Vzy. Mr. Vzy votes I. Miss Kelly, Miss Bagon, Mr. Sodto, Mr. Sodto votes I. Miss Shrier, Miss Shrier votes I. Miss Trean, Miss Trean votes I. Miss Fletcher. Miss Fletcher votes I.
▶ 7:06:03Miss Zukaziocortez. Miss Zukaziocortez votes I. Mr. Oenclaus Mr. Aenclaus votes I. Mr. Carter of Louisiana Mr. Menendez Mr. Menendez votes I. Mr. Mullen Mr. Mullen votes I. Mr. Lansman. Mr. Lansman votes I. Miss Mlullen. M.
▶ 7:06:32Mlen votes I. Chairman Guthrie. No. Is there anyone seeking got three votes? No. Mr. Mr. Dr. Ruiz Dr. Ruiz is not recorded. Dr. Ruiz votes I. Is anyone seeking recognition for the roll call? Miss Betagon, how's she recorded? It's not recorded. Miss Pagon votes I. Are there any others seeking recognition? The clerk will report.
▶ 7:07:06I'm probably gonna get the flu. Mr. Chairman, on that vote there were 19 eyes's and 25 nos. The amendment was not agreed to. Are there further amendments? Gentleman from Massachusetts. What purpose do you seek recognition? Mr. Chairman, I would like to offer an amendment. You clerk will report. Would you state the amendment?
▶ 7:07:37I don't have the amendment. You have the amendment that he's referring to. We report if you have the amendment. Mr. Chairman, is this AAN_00009? Amendment to HR 2484 offered by Mr. Aenclaus of Massachusetts. Without objection, the reading of the amendment is dispensed with and the gentleman from Massachusetts recognized for five minutes. To support the amendment, the gentleman from Virginia reserves a point of order. Point of order. Gentleman's recognized. Massachusetts is recognized. Uh Mr.
▶ 7:08:07Chairman, the as I said earlier about the uh this bill, the Senior's Access to Critical Medications Act, I think it's a well-intentioned bill that is is solving an actual problem. But as proposed, it may unintentionally harm patient safety and uh exacerbate anti-competitive market practices for Part D medications.
▶ 7:08:29The Stark law prohibits physicians and physician practices from steering high-cost drugs to entities with which they have a financial interest while steering less financially beneficial drugs to traditional dispensing entities. The any erosion of the Stark law is an opening for the health insurance corporations because steering is exactly what they have done best under vertical integration.
▶ 7:08:56So what my bill does is it basically closes the vertical integration loophole. It does that in four ways. One, it narrows the scope to apply just to cancer drugs and not all Part D drugs as per the original bill's intent. Two, it prohibits prescription dispensing by entities wholly owned uh by the prescribing physician or practice. Three, it requires accreditidation to dispense and mail specialty drugs and reporting on the practices of physician dispensers.
▶ 7:09:26And four, it restricts mail services to once per calendar year to ensure patients are seen in person to provide management care. Many of these drugs are complex and managing those the interplay between the medications particularly for high needs cancer patients is a critical part of a pharmacist's job. Um, now I recognize that the bill has a legislative record of passing this committee. So, I will withdraw my amendment.
▶ 7:09:51However, I wanted to lodge not only my concerns with the bill as drafted, but also some I think relatively narrow, tightly scoped improvements to the bill that could get more of us to yes and prevent health insurers from taking advantage of its good intentions. Uh, I yield back the balance of my time. Gentleman yields back. Is there any further discussion?
▶ 7:10:16Seeing none, the if there's no further discussion, the vote occurs on the amendment. Chairman, I withdrew. Oh, I'm sorry, Richard. So, the gentleman has withdrawn his amendment. So, the question now occurs on adopting 2484 and a roll call has been requested. So, the clerk will call the role. Mr. La. I. Mr. La votes I. Mr. Griffith, I. Mr. Griffith votes I. Mr. Bill Rockus.
▶ 7:10:46Mr. Bill Rockus votes I. Mr. Hudson. Mr. Hudson votes I. Mr. Carter of Georgia. Palmer. Mr. Dunn. Mr. Dunn votes I. Mr. Krenshaw. Mr. Joyce. Mr. Joyce votes I. Mr. Weber. Mr. Weber votes I. Mr. Allen. Mr. Allen votes I. Mr. Balderson. Mr. Mr. Balderson votes I. Mr. Fulture. Mr.
▶ 7:11:16Fulture votes I. Mr. Fluger. That's the vote. Mrs. Harshburgger. Mrs. Harshburgger votes I. Mrs. Miller Meeks. Mrs. Miller Meeks votes I. Mrs. Kamik. Mrs. Kamik votes I. Mr. Oonulti. Mr. Oblti votes I. Mr. James. Mr. Bence. Mr. Bent votes I. Mrs. Mrs. Houchin votes I. Mr. Fry. Mr. Fry votes I.
▶ 7:11:46Miss Lee. Miss Lee votes I. Mr. Langworthy. Mr. Langworthy votes I. Mr. Kaine. Mr. Kane votes I. Mr. Roelly. Mr. Evans. Mr. Goldman. Mr. Goldman votes I. Mrs. Fedorch. Mr. Fedorek votes I. Mr. Palone. Mr. Palone votes no. Mr. Dette. Miss Dette votes I. Miss Shakowski.
▶ 7:12:18Miss Shakowski votes no. Miss Masouie, no. Miss Massie votes no. Miss Caster. Mr. Tonko. No. Mr. Tonko votes no. Miss. Clark. Mr. Ruiz. Mr. Ruiz votes I. Mr. Peters. Mr. Peters votes I. Mrs. Dingle. Mr. Vzy Mr. Vzy votes I.
▶ 7:12:45Miss Kelly Miss Bagon Mr. Sodto Mr. Sodto votes I. Miss Shrier Miss Shrier votes I. Miss Treyan. Miss Trean votes I. Miss Fletcher. Miss Fletcher votes I. Miss. Okasiocortez. Miss Okaziocortez votes I. Mr. Ainclaus.
▶ 7:13:14Yes, ma'am. Mr. Okaziocortez is off eye and on no. Mr. Aenclaus. Mr. Aenclaus votes no. Mr. Carter of Louisiana. Mr. Mendez. Mr. Menendez votes no. Mr. Mullen. Mr. Mullen votes I. Mr. Lansman. Mr. Lansman votes I. Miss. Mlen. Mlen votes I. Chairman Guthrie.
▶ 7:13:47Chairman Guthrie votes I. Mr. Carter. How's he recorded? Mr. Carter of Georgia is not recorded. Carter votes I. Mr. Carter Palmer I. Palmer. Mr. Palmer is not recorded. Mr. Palmer votes I. Mr. Krenshaw. Mr. Mr. Krenshaw votes I. Miss Better. Miss Bagon is not recorded. Miss Bagon votes I.
▶ 7:14:11Is anyone else seeking the clerk You
▶ 7:14:54got a lot done. Mr. Chairman, on that vote there were 38 eyes and seven nos. The bill is adopted. Without objection, staff is authorized to make technical and conformity changes to the legislation approved by the committee today. So ordered. Without objection, the committee stands adjourned. All right.