▶ 0:13:44Himself for a. An opening statement. Today's markup consists of ten bills addressing a range of important health issues. The legislation before us reflects this subcommittee's efforts to improve public health outcomes, enhance patient access, and modernize our health care delivery system to better meet the challenges americans face. These bills represent thoughtful efforts from members on both sides of the aisle.
▶ 0:14:09Several of the bills before us focus on reauthorizing critical public health programs that support early detection and prevention that expire at the end of the fiscal year. Marking up these reauthorizations gives us the ability to continue to support these initiatives, while also allowing us the opportunity to examine ways we can strengthen these programs. This includes h.r.
▶ 0:14:304348, the kay hagan tick act reauthorization, which supports and enhances programs for tick borne disease research, prevention, and interagency coordination. We will also consider h.r. 54541, the breast cancer education and awareness requires learning young act, or the early act, which supports breast cancer detection and education for young and high risk women.
▶ 0:14:55Additionally, we will mark up the accelerating access and dementia and alzheimer's provider act, or the adapt act, uh reauthorization, which seeks to improve care through provider tools and training initiatives. I also want to highlight h.r. 8205, the accelerating access to critical therapies for als act, which is before us this afternoon. Last month, I had the privilege of speaking with the founders of I am als, brian wallach and sandra abbreviata.
▶ 0:15:27Abbreviata and participating alongside them in a press conference held by representative quigley, who has done great work on this issue. Their testimony before the subcommittee was both moving and insightful, and I especially want to recognize that they had driven all the way from chicago to be at our hearing and advocate for this important program to support those with als. We will also consider h.r.
▶ 0:15:505160, the stem cell therapeutic and research reauthorization act, which extends and funds national programs that facilitate bone marrow and cord blood transplants for patients with blood cancers and other fatal diseases. In addition, we are marking up h.r. 8209 legislation to reauthorize school based health health centers, which aim to strengthen school based health services and mental health access for students.
▶ 0:16:15We also have a couple of fda reform bills before us today, one of which is h.r. 2715, that the destruction of hazardous imports acts, which give act, which gives the fda the authority to destroy imported products that pose a significant public health concern. The other is h.r. 2021, the fda modernization 3.0 act, which directs the fda to fully implement policies established under fda modernization 2.0 to reduce unnecessary animal testing for drug development.
▶ 0:16:47Lastly, we will mark up two bills from our medicare patient access hearing earlier this year, h.r. 1703 the choices for increased mobility act works to expand access to titanium and carbon fiber wheelchairs for medicare beneficiaries, while h.r. 5347 the health care efficiency through flexibility act aims to improve health care reporting for accountable care organizations.
▶ 0:17:11I'm encouraged by the collaborative work that has gone into the legislation before us today, and I want to thank all the members and staff who worked to bring these bills to the subcommittee. I look forward to continuing to work on these policies and bringing them to the full committee, and I'm eager for a production a a productive markup this afternoon. Chairman now recognizes that would be me. I now recognize the ranking member, miss degette, for five minutes for her opening statement. >> thank you, Mr. chairman.
▶ 0:17:38I'm pleased that we're marking up these ten bipartisan bills today, all of which I support, and I encourage my colleagues to support them as well. The early act, led by representative wasserman schultz and miller-meeks reauthorizes, a critical program that helps women learn about detecting breast cancer early, which means we have a more treatable disease.
▶ 0:17:59The destruction of hazardous imports act, led by representatives higgins and carter, will give the fda the ability to mandate that an importer destroy an fda regulated product that's denied entry, keeping our community safe from illegal vapes and unsafe food.
▶ 0:18:17And the act for als reauthorization, led by representatives quigley and calvert, will build on the successes of the original act for als, bringing promising treatments to patients who can't wait, and bolstering the research infrastructure for a cruel disease that has claimed too many lives, including my own father in law, and the testimony at the hearing that we had on this was really, truly moving. Mr.
▶ 0:18:43Chairman, I could go on and and and all of these ten bills are good bills we should pass expeditiously. But I I'm forced to say this is our only our second health subcommittee markup, this congress. And by this point in the 118th congress, we had had five subcommittee markups.
▶ 0:19:02It shouldn't be lost on any of us either, that most of these bills are reauthorizations or a commitment to continuing work that is already happening and should continue to happen. But neither this committee nor this congress seem to be intent on solving the problems that are facing our constituents.
▶ 0:19:22The committee's not taking up legislation to help the estimated 20% fewer people enrolled on the aca exchanges, who are now facing down the prospect of life without health insurance, much less the 80% of enrollees who report report higher health care costs this year, all thanks to the majority's refusal to extend enhanced aca tax credits.
▶ 0:19:48This committee is not taking up legislation to restore the research engine that powers american innovation at the nih, as the administration seeks to cut funding for science and research researchers, the committee is not taking up legislation to address the crisis facing rural hospitals and the people they serve as they await the big bad bill's medicaid cuts.
▶ 0:20:14And this is really the work of a majority just met, intent on doing the bare minimum. This committee's work during the 119th congress is defined by two things taking health care away from millions of americans to line the pockets of the wealthy at the behest of donald trump, and sitting idly by as biomedical research, vaccination, pandemic preparedness, and really public health as a whole, all historically bipartisan
▶ 0:20:45Priorities are dismantled. Right now. As of today, we have vacancies at two of our critical health public health agencies, the fda and the cdc. Now, Mr. chairman, you and I work well together on so many issues, and so many of my colleagues on both sides of the aisle are good friends. When we identify common goals, we do good things for the american people. And I still think we can, and I still think we can in this congress.
▶ 0:21:13So I say it with the desire to work for the american people, that this committee needs to stop waiting for permission from donald trump to do its job. We are article one, the first branch of government, the branch that is most connected to the people. It's our job to set policy and tell the executive branch what to do and make them do it, not by subversive vice versa.
▶ 0:21:39We can also work to solve these problems, which I believe everyone in this room wants to solve. Or we can just simply go through the motions. I promise you the that the democrats, when we take the majority, are not going to shy away from the big issues that our constituents care about, and we hope that we will have some cooperation on the other side of the aisle. But until then, I guess we'll have to settle for these bills today.
▶ 0:22:06And frankly, we do need to reauthorize these programs. We need to send them to the floor where I will work with you to make sure they pass, and that the underlying programs will continue to benefit the american people. And I yield back. >> gentlelady yields back. Now recognize the chairman of the full committee, the gentleman from kentucky, Mr. guthrie, for his five minute opening statement. >> thank you, chairman griffith, thank you so much for your leadership advancing these bills.
▶ 0:22:32And my my good friend the ranking member, to get for saying we work to move these on across the floor today. We're authorizing key programs that are making meaningful differences in the lives of americans. These programs are helping us fight vector borne diseases like lyme disease and malaria. They're preventing breast cancer in young women through targeted education campaigns. They're developing treatments for als, giving hope to patients and families impacted by this devastating disease.
▶ 0:22:56And finally, these programs are improving access to care by meeting patients where they're at through school based health centers, through the use of technology to train, advise, and support clinicians, and seeking to provide specialty care in rural and underserved areas. We're also working up two pieces of legislation that will improve the medicare program for beneficiaries and providers.
▶ 0:23:19One bill would provide greater flexibility and quality reporting methods for providers participating in certain accountable care organizations, reducing red tape for these providers as they transition to value based models of care. The second bill would provide additional flexibility for medicare part b beneficiaries to have the ability to pay for certain wheelchair upgrades. Further, we're marking up a bill to allow the fda to crack down on port shopping, a practice where foreign actors used to push illicit and dangerous products into our U.S. supply chain.
▶ 0:23:48This bill will improve, improve efficiencies at our ports, and make better use of fda's finite resources to protect the american public. All in all, these bills were. Market update would ensure vital programs continue. They offer more flexibility to patients and providers to strengthen the foundation of our health care system, where there's always more to be done. This markup is another critical step toward a safer and healthier future for all americans. Thank you. And I yield back. >> gentleman yields back.
▶ 0:24:16Now recognize the ranking member of the full committee, the gentleman from new jersey, Mr. pallone. >> thank you, Mr. chairman. Today we're considering bipartisan legislation to reauthorize public health programs that improve americans health, spur biomedical innovation and sustained critical research. And these programs are components of our public health infrastructure that help keep americans healthy. From cancer screening programs to disease surveillance networks.
▶ 0:24:43But before I discuss the markup legislation, I wanted to raise concerns about the trump administration's troubling leadership of our public health agencies. The hantavirus outbreak comes at a time when the trump administration has pulled the us out of the world health organization.
▶ 0:25:00The cdc has lost a quarter of its staff and has no senate confirmed leadership, and hhs fired every full time employee at a program to assist the cruise industry in preventing and controlling the spread of illnesses on cruise ships. The national institutes of health continues to drag its feet in, getting critical biomedical funding out the door.
▶ 0:25:22Grant funding from nih to our biomedical researchers is down 44% in fiscal year 2026, compared to the four year average from 2021 through 24. Whether the slow pace of grant disbursement results from malice or incompetence is not clear. But what is clear is this can't continue.
▶ 0:25:44Yesterday, the food and drug administration commissioner mike carey, resigned after a tenure that was marked by chaos, confusion, potential corruption, and trump and congressional republicans are making the affordability crisis worse by cutting trillions from americans health care while refusing to extend subsidies that make health care more affordable for american families. Prices for basic necessities, including health care, gas, utility bills, and groceries continue to skyrocket.
▶ 0:26:13While republicans do nothing to deal with this. And turning to the back to the bills before us, I'm pleased we are considering the school based health centers reauthorization act led by representative tonko, which brings health care directly into schools. Students can access primary care, mental health care, case management, dental care and nutrition education right at school, and this reduces many barriers to care, including transportation challenges and a lack of primary care doctors. The early act reauthorization h.r.
▶ 0:26:424541, led by representative wasserman schultz, addresses breast cancer and women under 50. About 16% of all new breast cancer cases occur in women younger than 50. What's likely to be found at a later stage, and even more aggressive and harder to treat. And this program supports cdc led education outreach to close detection gaps, empower women to take early action, and ultimately save lives. We're also marking up the act for als act.
▶ 0:27:11Now, last month, we heard from the co-founders of I'm als, brian wallach, and sandra, uh, brave. And, you know, on the importance of this law to patients, caregivers, and researchers, especially for advancing scientific understanding of als and other rare neurodegenerative diseases. And as we work towards reauthorization, we hope to address some of the concerns raised by the gao report, including ensuring that the fda has the funds to operate the rare neurodegenerative disease grant program.
▶ 0:27:41We're also considering the destruction of hazardous imports act, which would provide the fda with important authorities to protect americans from harmful products. This bill would grant the fda the authority to require importers to destroy products that pose a significant public health concern, preventing them from being shipped to another port of entry. And these products have included food contaminated with salmonella, listeria, and carcinogenetic, unapproved animal drugs, as well as misbranded medical devices.
▶ 0:28:10It also includes illegal e-cigarette products that are flooding the market from places like china. Because we need to make sure that americans are not harmed by purchasing these products, and this authority will help prevent that. So we're looking into several other reauthorized public health programs to build upon and continue this success, and I look forward to advancing these important bills to the full committee. And I yield back the balance of my time, Mr. chairman. >> gentleman yields back the remainder of his time.
▶ 0:28:39The chair reminds members that pursuant to the committee rules, all members opening statements will be made a part of the record. Are there any further opening statements for today? Recognizing doctor ruiz for three minutes for an opening statement? >> thank you, Mr. chairman.
▶ 0:28:53I'm I'm I echo what the ranking member has just said regarding, uh, dealing with these important bills but not addressing the overall crisis of the, uh, cuts to medicaid and nutritional support and all the cuts to staffing and, and the agencies, uh, within hhs that are responsible to making sure that we keep a healthy community.
▶ 0:29:19I do want to say, though, that as an emergency physician, you know, I've treated patients of all ages with various health conditions. I represent a rural, underserved, medically underserved community. And so I've seen firsthand the needs of kids, the needs of people who go without health care, and they need it. I've seen patients show up in hospitals with advanced illnesses because they couldn't afford to go to the doctor sooner, or they tried, but there was no availability to get them in.
▶ 0:29:46So for our kids, it is especially critical to get timely and regular checkups to support healthy growth and development. That is why the school based health center program is so important in communities where kids might otherwise not have access to medical care. They can receive primary care, behavioral health services, and preventive screenings right at school. You know, according to the national association of community health centers, community health centers serve 18% of all kids in my state in california.
▶ 0:30:13But there's still insufficient access to primary care. With nearly 30% of california's children and teens not getting a preventative checkup, investing in school based care is essential to closing this gap, and that's why I would like to express my support for the h.r. 8209. One of the bills considered today the school based health centers reauthorization act that was introduced when my colleagues, reps. Tom cole and balderson. Uh, this program is instrumental in promoting healthy kids and healthy communities.
▶ 0:30:42It they're a good location because, you know, the communities live around the schools. And if you can put fqhcs community health centers in schools to take care of kids, then oftentimes they're also able to take care of their parents or their grandparent when they go and they pick up the kids with an appointment. So I support this. This is one, uh, very strong vehicle. It works. I've seen it in my district. I've seen it in the school districts and where I serve.
▶ 0:31:10Uh, and so I urge my colleagues to support, uh, and move h.r. 8209 in a bipartisan manner. And I yield back. >> gentleman. Yields back. Are there any other members wishing to do an opening statement? Going, going, gone. Alright. Um. That said, we will now move to calling up bills and the chair will call up h.r. For three, four, eight and ask the clerk to report. >> h.r.
▶ 0:31:404348 a bill to reauthorize the kay hagan tick act and for other purposes, be it enacted by the senate and house of representatives of. >> the um. Without objection, the first reading of the bill will be dispensed with, and the bill will be open for amendments at any point, so ordered. Uh, I now recognize myself for time on the kay hagan tick act. H.r.
▶ 0:32:064348 reauthorizes the kay hagan tick act, a landmark piece of legislation which developed a national strategy for vector borne, uh, diseases, which in this bill you can read as a tick borne disease, diseases like lyme. Representative chris smith from new jersey is the champion of this legislation and has been for years. He's done great work, and I'm glad we are continuing to move this bill.
▶ 0:32:34The bill is named after senator kay hagan, who passed away from complications of tick borne virus called powassan. This bill will continue building on the foundation that was created when the authorization of the bill was first passed in 2019. There are three critical components of this bill that will be reauthorized under the bill. First, it would require hhs to continue their public health strategy and working group to prevent and control tick borne illnesses.
▶ 0:33:02Second, it would reauthorize the regional centers of excellence for another five years. Third, it would continue the cdc grants awarded to certain entities to improve their efforts to combat and collect data on tick borne illnesses. Tick borne illnesses are spreading quickly in our country, and these diseases can have devastating impacts on people's lives. Virginia is one of the top states for lyme disease, with southwest virginia having some of the highest rates of lyme and other tick borne illnesses.
▶ 0:33:31I live with one of those diseases called alpha-gal syndrome, which is from the lone star tick. It causes an allergic condition triggered by a sugar molecule called alpha-gal, which is found in most mammals, but not in humans. There are many tick borne illnesses, and we have only scratched the surface in understanding these diseases. And with that, I yield back and I hope everybody will support the bill. Madam vice chair or excuse me, ranking member. >> thank you.
▶ 0:34:00I move to strike the last word. >> gentlelady is recognized to speak on the bill. >> so. So, Mr. chairman, um, as you accurately pointed out, lyme is no longer a disease of just the northeast united states.
▶ 0:34:15And also, it's not the only tick borne disease, rising cases and geographical creep of tick borne disease mean that health departments and providers across the country, even in my western state of colorado, are facing this growing threat. The cdc place plays an essential role in supporting prevention, diagnosis and treatment of rising cases of lyme and other tick borne diseases.
▶ 0:34:40This bill gives cdc the continuing authority and the resources it needs to improve public awareness and patient care, including through the national public health strategy to combat tick borne diseases. The whole of government approach is a lesser known product of the 21st century cures act, which fred upton and I passed those years ago, and it has been integral in expanding research, improving diagnostics and coordinating efforts across federal agencies.
▶ 0:35:08We have a lot of work to do in lyme and other tick borne diseases, and so it's really great that we're not letting it lapse. I urge support for this bill, and I yield back. >> gently yields gentlelady yields back. Anyone else wishing to speak on the kay hagan tick act? I recognize the gentlelady from washington, miss. Schrier, doctor schrier. >> thank you, Mr. chairman.
▶ 0:35:33I'm really happy that our committee is advancing reauthorization of this kay hagan tick act, which improves research, prevention, diagnostics and treatment for tick borne diseases. Up until a few years ago, it was incredibly rare to see ticks. Just like, uh, ranking member degette just talked about in my home state of washington. So we're going even further west now, or really anywhere in the pacific northwest for that matter.
▶ 0:35:59However, due to warmer winters and climate change, we are seeing ticks expand their habitats and survive in places they hadn't before. Just like we're seeing mosquitoes with mosquito borne illnesses survive in areas where they had never before. And now, coming into the united states, um, we are even getting ticks in parts of washington in areas like the issaquah alps and the olympic peninsula. The numbers speak for themselves.
▶ 0:36:24New cases of americans tick borne disease have multiplied over the past 15 years. And since 1982, there's been a 25 fold increase. And that comes despite the challenge of testing for lyme disease, where there's a high number of false negatives with blood tests at the beginning, and it's mostly clinical diagnosis. Um, because the tests test for antibodies.
▶ 0:36:47So this bill will ensure we have the public health workforce equipped and ready to prevent and treat tick bite bites that we have better testing, better funding for local and state health departments to make sure we're catching these, uh, and, uh, and able to treat them. So I support this bill and urge my colleagues to also vote yes so that americans will not have to deal with this threat. I yield back. >> gentleman yields back. Anyone else wishing to speak?
▶ 0:37:17Seeing none. The question now occurs on forwarding h.r. Four, three, four, eight to the full committee. All those in favor say aye. Opposed? No. The ayes have it. The bill is agreed to and forwarded to the full committee. All right. Now we'll call up 4541 house resolution 4541 with the clerk. Please report. >> h.r.
▶ 0:37:434541 a bill to reauthorize the young women's breast health. Education and awareness requires learning. Young act of 2009, be it enacted by the senate and house of representatives of the united states of america. >> and without objection, the first reading of the bill will be dispensed with and the bill will be open for amendment at any point, seeing no objection so ordered. Does anyone wish to be recognized on the bill?
▶ 0:38:15Alright. Seeing none. It's a good bill. Uh, it's one that we have bipartisan support for, and I hope that all members will support it. Anyone else wishing to speak on the bill seeing none. The question now occurs on forwarding h.r. For five for one to the full committee. All those in favor, say aye. Those opposed? No. The ayes have it. The bill is agreed to and forwarded to the full committee. I now call up h.r. Three. Seven. Four seven and ask the clerk to report.
▶ 0:38:48>> h.r. 3747. A bill to amend the public health service act to reauthorize the project echo grant program to establish grants under such program to disseminate knowledge and build capacity to address alzheimer's disease and other dementias and for other purposes, be it enacted by the senate and house. >> without objection, the first reading of the bill will be dispensed with. Any objection? Hearing none, bill will be open for amendment at any point so ordered. Does anyone seek recognition on this bill?
▶ 0:39:16All right. Seeing no one at this moment wishing to speak on three. Four. Excuse me. Three. Seven. Four seven. I will advise the subcommittee that it's a good bill that has bipartisan support. >> I want to do that. >> and there's an anes. Okay. Uh, Mr. balderson, do you have a names?
▶ 0:39:44That would be the amendment nature substitute for those watching at home. Yes. With the gentleman. Please call up his amendment. >> thank you, Mr. chairman. I have an amendment at the desk with the file name h3747acr eins zero one. >> clerk report please. >> amendment in the nature of the substitute to h.r. 3747 offered by Mr. balderson of ohio.
▶ 0:40:12Strike all after the enacting clause and insert the following section one short title. >> uh the uh eins. The reading of the eins will be dispensed with without objection. So ordered. And the gentleman from ohio, Mr. balderson, is now recognized for five minutes to speak on the ayes. >> thank you, Mr. chairman, for holding this markup today and moving this bill forward.
▶ 0:40:36Today, more than 7 million americans, including more than 236,000 ohioans, are living with alzheimer's disease. As these numbers continue to rise, we need stronger provider training and better access to community based dementia care so families can get answers sooner and connect to care earlier. The adapt act helps give primary care providers the resources they need to help families get that diagnosis sooner.
▶ 0:41:02In rural communities, access to specialists is often limited, and for many families, their primary care provider provider is the first and sometimes only point of contact when cognitive decline begins to appear. Yet too many frontline providers report they do not have the training tools or support they need to confidently identify and manage dementia related conditions. As a result, far too many americans are diagnosed later than they should be.
▶ 0:41:29After valuable time for treatment and planning has already been lost. Adapt act helps address that gap by strengthening and reauthorizing the project. Echo program, a technology enabled training model that connects frontline providers in rural and underserved communities with specialists through virtual mentoring and education networks. This approach gives frontline providers practical training they can apply directly in their communities. The goal is simple patients and families need answers sooner.
▶ 0:41:59As new alzheimer's treatments continue to emerge. We need a healthcare workforce prepared to identify and manage these conditions earlier. I'm proud to lead this bipartisan effort because most of us know someone who has been faced this disease and understand how difficult it can be for patients and families, strengthening the health care workforce and improving access to dementia care are priorities we should all be able to support. I urge my colleagues on both sides of the aisle to support this bill. Thank you, Mr. chairman. I yield back. >> gentleman yields back.
▶ 0:42:29Anyone else wishing to discuss the amendment in the nature of a substitute? Recognize the gentlelady from california, miss barragan. >> thank you, Mr. chairman. I move to strike the last word. I want to also thank the gentleman for his comments and leading on this. The gentleman from ohio. While I support this aims, I am disappointed that it removes the targeted funding for alzheimer's disease and related dementias that was included in the original bill. This specific allocation is critical for many reasons.
▶ 0:42:56Over 7 million americans currently live with alzheimer's disease, and by 2050, the number of people is projected to increase to nearly 13 million americans in 2026. Alzheimer's and other dementias will cost the nation $409 billion, and by 2050, these costs could rise to nearly $1 trillion. Nearly 13 million americans provide unpaid care for people with alzheimer's, valued at more than $446 billion.
▶ 0:43:23These are costs to our health care system, to the economy, and most importantly, it costs lives. As a caregiver for my mother who has alzheimer's, I understand what's at stake, especially with a timely and accurate diagnosis can mean for families. Too often individuals are diagnosed late or not at all. Primary care providers are usually the first place families turn to.
▶ 0:43:48Yet many of these providers report that they don't feel fully prepared to diagnose or manage dementia. 69% received little to no dementia training in medical school, and 39% are not confident enough to make a diagnosis. Now. I remember the time when I took my mother to a doctor. I thought I saw early signs of her dementia or alzheimer's. I went and asked a doctor to say, hey, can she be assessed? Can somebody see if there's something that I can do?
▶ 0:44:19What advice do you have? And I remember being sent with her to somebody who asked her, do you know how you got dressed this morning and proceeded to ask questions that she clearly could still answer. And we walked away with the advice of eat a larger mediterranean diet.
▶ 0:44:39It just goes to show you that we didn't get the advice that we should have gotten, whether it was to do more puzzles, whether it was to be more active with your brain, whatever it is that wasn't given. And I think that's a disservice. And that's why I joined representative balderson to co-lead the adapt act, which would continue access to more specialized education for our primary care providers. Investment in research has led to innovative diagnostic tools and treatment, but this means very little to patients and their families.
▶ 0:45:08If our primary care workforce is not prepared to use them. I urge my colleagues to support this aims, but I hope we can continue to work on dedicated funding. Americans who face this devastating disease should not have to go longer without answers or support, because the health care system was not prepared to meet them where they are. Thank you. And I yield back. >> gentlelady yields back. Now recognize the gentleman from pennsylvania, doctor joyce, for his time.
▶ 0:45:35Five minutes to discuss the amendment in the nature of a substitute. >> thank you, Mr. chairman. I would like to offer my support for an important bill. H.r. 37373747, the accelerating access. Dementia and alzheimer's providing providing training act. This bill reauthorizes grant programs that enable specialists to collaborate with and support the.
▶ 0:46:01So necessary support the primary care physicians need as they are the primary individuals who diagnose and treat patients with alzheimer's disease. We all know our population is aging, and primary care doctors need to be equipped to care for more patients with these devastating diseases.
▶ 0:46:20Programs like project echo that are supported by these grants can help to make sure that, especially in rural areas where access to specialists is often limited, rural patients can have access to the doctors with the knowledge to offer the care that they need and the care that they deserve. In addition, these grant programs also reduce the need for unnecessary referrals and hospitalizations, which are costly and burdensome, burdensome to patients as they are forced to travel far from their homes.
▶ 0:46:49This bill will greatly expand the capabilities of rural health care and allow the early diagnosis for those with alzheimer's and other forms of dementia. I urge all my colleagues to support the aims and the underlying bill. Thank you, Mr. chair, and I yield back. >> gentleman yields back. Is there anyone else? Anyone else wishing to speak to the amendment? The nature of substitute. All right. If there's no further discussion. The vote occurs on the amendment.
▶ 0:47:19In the nature of a substitute. All those in favor signify signify by saying aye. >> aye. >> all those opposed? Nay. The ayes have it, and the amendment is agreed to. All, uh. Any further discussion on forwarding h.r. 3747 to the full committee? Seeing none. All those in favor, say aye. I those opposed? No.
▶ 0:47:46The eye has it, and the bill is agreed to and forwarded to the full committee. I now call up h.r. 8209 and ask the clerk to report it. >> h.r. 8209 a bill to amend the public health service act to reauthorize the school based health centers grant program. >> yeah. Thank you. >> be it enacted.
▶ 0:48:12>> without objection, the first reading of the bill shall be dispensed with and the bill will be open for amendment at any point. Any objection? Seeing none so ordered. Does anyone wish to be recognized on the bill? Recognize the gentleman from ohio, Mr. balderson, for five minutes to speak on the bill? >> thank you, Mr. chairman. I move to strike the last word and speak in support of the bill.
▶ 0:48:34First, I'd like to thank my colleague from new york, congressman tonko, for his leadership on this legislation and working with me to reauthorize the school based health centers grant program. School based health centers help students access broad range of age appropriate health care services in a convenient, familiar, and trusted setting.
▶ 0:48:56The centers primarily serve underserved communities and play an important role in delivering primary care to children and adolescents, including preventive services, dental screenings, and mental health support. Today, more than 2500 school based health centers serve over 6.3 k12k through 12 students nationwide, helping connect families to care in a setting where students already spend much of their day.
▶ 0:49:19Across my district in ohio, families face real barriers to care from provider shortages and long travel distances to transportation issues and limited access to pediatric or behavioral health services, school based health centers help close some of those gaps by bringing preventative and primary care services directly into the community environment that students rely on every day. We also cannot ignore the growing need for youth mental health services.
▶ 0:49:46Schools continue to see increased demand for counseling, behavioral health support and early intervention services. School based health centers can help connect students to care earlier and in a more coordinated way, while still working alongside parents, local providers, and school personnel. Importantly, these centers operate within clear guardrails under federal law, including parental consent requirements, patient privacy protections, coordination with community providers, and compliance with state and local laws.
▶ 0:50:15This bill helps ensure students are healthy enough to learn, attend class consistently, consistently, and succeed in life. It also supports local communities and gives schools additional tools to support students health needs in a practical, accessible way. I believe this legislation will help strengthen access to care for students and families and communities across the country, and I encourage my colleagues to support the bill. Mr. chairman, I yield back. Thank you. >> gentleman yields back. Anyone else wishing to speak on the bill?
▶ 0:50:44Recognize the gentlelady from washington, doctor schrier, for five minutes. >> uh, well, first, thank you, Mr. chairman. I'd like to thank representative balderson, representative tonko, for supporting this bill, introducing this bill. And I'm really glad the committee is, uh, taking this up today. It's a pediatrician. I've seen kids miss out on both wellness and sick care, simply because they didn't have a reliable way to get to a clinic.
▶ 0:51:11Uh, school based health centers help eliminate these hurdles by bringing that high quality care directly to where kids are. In my home state of washington, we have over 70 school based health centers that have provided nearly 17,000 visits to our state's children.
▶ 0:51:27And the advantages of these clinics are clear when care is accessible for kids, we see higher vaccination rates, better diabetes management, access to dental care, counseling and early identification and identification of illness outbreaks that might otherwise go unnoticed. We also see better academic performance for kids because they stay in school, so they have higher class attendance, higher gpas, and fewer, uh, disciplinary incidents.
▶ 0:51:54So I support this bill because it provides long term stability necessary for millions of students who rely on these centers. Uh, we, we cannot expect students to focus on their, their futures or their academics if they are struggling with untreated physical or mental health challenges. So I urge my colleagues to support this bill to make sure every child gets the care they need. Thank you. Yield back. >> gentlelady yields back. Anyone else wishing to speak on the bill? Alright.
▶ 0:52:19Seeing no further discussion on the bill, the question now occurs on forwarding h. Excuse me, h.r. 8209 to the full committee. All those in favor say aye. Those opposed? No. The ayes have it. The bill is agreed to and forward to the full committee. Chair will now call up house resolution 5160.
▶ 0:52:44And ask the clerk to report. >> h.r. 5160, a bill to reauthorize the stem cell therapeutic and research act of 2005 and for other purposes, be it enacted by the senate and house of representatives of the united states of america. >> all right. And without objection, the first reading of the bill is dispensed with, and the bill will be open for amendment at any point. Any objections? Seeing none so ordered.
▶ 0:53:12Does anyone seek to be recognized on the bill? Recognize the gentleman from florida, Mr. bilirakis, for five minutes to speak on the bill? >> thank you very much. I appreciate, Mr. chairman, uh, every thousands of. Again, every year, thousands of americans are diagnosed with devastating diseases such as leukemia and former sickle cell disease and other inherited immune system disorders.
▶ 0:53:41For many of these patients, a bone marrow or cord blood transplant can provide a critical treatment option and in some cases, a path toward long recovery. Finding a compatible donor, however, is often incredibly difficult, particularly for those who do not have a matching donor within their own family. The c.w.
▶ 0:54:07Bill young cell transplantation program helps make these life saving transplants possible by coordinating donor matching transplant resources and patient support through a single national system.
▶ 0:54:22The national cord blood inventory complements that work by supporting the collection and preservation of high quality umbilical cord blood units that can be used for transplantation and research. Cord blood and adult stem cell treatments have already helped tens of thousands of patients, including children with rare genetic and immune disorders who otherwise may have had very little treatment options.
▶ 0:54:52This legislation continues federal support for these proven programs strengthens the national transplant infrastructure and helps ensure patients can continue accessing life saving transplant options. I'm proud to join representatives smith, matsui, pingree, tenney and mfume in introducing this bipartisan legislation, and I want to thank all that participated.
▶ 0:55:20Uh, again, the late, great chairman bill young, uh, actually sponsored this, initially sponsored this legislation. So we'll do this in his memory as well. Thank you very much. And I yield back. Mr. chairman. >> gentleman yields back. Anyone else wishing to speak on the bill? All right. Seeing none. The question now occurs on forwarding h.r. 5160 to the full committee. All those in favor, say aye.
▶ 0:55:50>> aye. >> those opposed? No. The ayes have it, and the bill is agreed to and forwarded to the full committee chair now calls up h.r. 8205 and ask the clerk to report. >> h.r. 8205, a bill to amend the accelerating access to critical therapies for als act to reauthorize the provisions of such act through fiscal year 2031 and for other purposes.
▶ 0:56:17>> and without objection, the first reading the bill is dispensed with and the bill will be open for amendment at any point without objection. So ordered. Does anyone seek to be recognized on the bill to speak to the bill? Recognize the gentleman from florida, Mr. bilirakis, for five minutes to speak on the bill? >> thank you, Mr. chairman. I appreciate it. Als is a devastating disease that gradually takes away a person's ability to move, speak, eat and breathe. And today, there is still no cure.
▶ 0:56:45For many families, time is the greatest challenge. Patients living with als cannot afford to wait through years of. Again, slow research and regulatory timelines, congress recognized the reality when it passed act for als in 2021. The goal was to accelerate research, improve coordination, and expand access to promising investigational therapies.
▶ 0:57:13Since then, the program has helped strengthen collaboration between researchers, regulators, manufacturers, and patient advocates working to better understand and treat als. H.r. 8205 continues that work by extending these programs through 2031, so critical research and access efforts can continue without interruption.
▶ 0:57:38The bill also strengthens oversight by requiring updated fda action plans, additional reporting, and closer review of clinical trial progress. Importantly, this legislation recognizes that advances made in als research may also help patients living with other rare neurodegenerative diseases.
▶ 0:58:01While there is still much work ahead, continue to support research, innovation and access to promising therapies offers hope to patients and families confronting these devastating diseases every day. So I'm proud to co-sponsor this bill and urge my colleagues to support. Thank you very much, and I yield back. Mr. chairman, >> gentleman, gentleman. Yields back. Anyone else wishing to speak on the bill? Seeing none.
▶ 0:58:31The question now occurs on forwarding h.r. 8205 to the full committee. All those in favor say aye. Those opposed? No. The ayes have it. The bill is agreed to and forwarded to the full committee, and I'm going to try to get one more in before we go to vote. Uh, so I will call up h.r. 2715 and ask the clerk to report. >> h.r.
▶ 0:58:542715, a bill to amend the federal food, drug, and cosmetic act to extend the authority of the secretary of health and human services to articles that present a significant public health concern and for other purposes. >> and without objection, the first reading of the bill is dispensed with and the bill will be open for amendment at any point. Seeing no objection so ordered, and I understand we have an amendment that needs to substitute on this one. Mr.
▶ 0:59:20Carter, the gentleman is recognized to call up his amendment in the nature of a substitute. >> thank you, Mr. chairman. I thank the committee for considering my bipartisan bill with my colleague, representative clay higgins. H.r. 2715, the destruction of hazardous imports act. >> all right. Do you want to call that up? >> yes. >> would the clerk please call up the amendment? In the nature of substitute. >> amendment in the nature of a substitute to h.r. 2715, offered by Mr. carter of louisiana. >> all right. And Mr.
▶ 0:59:50Carter is now recognized for five minutes to discuss his amendment in the nature of a substitute. >> thank you, Mr. chairman. This bill authorizes food and drug administration to require an importer to destroy. This bill authorizes the food and drug administration required importer destroy an fda regulated product. Refused entry into the us because it poses a significant public health concerns at the importers expense.
▶ 1:00:20This bill also prohibits the the unauthorized movement of any article designated for destruction by the fda. This amendment, in the nature of a substitute, includes technical assistance edits from the fda to clarify the process for ordering and destructive destruction of hazardous shipments, including a due process provision allowing the owner of the. And articles subject to destruction to appeal.
▶ 1:00:48It also allows the federal government additional time to finalize regulations related to this legislation. I'd like to thank the fda for its partnership in crafting this. These amendments. Our legislative hearing in march, we heard from expert witnesses about the need for these reforms.
▶ 1:01:08Under current law, foreign exporters can ship contaminated or counterfeit products to the to the us, knowing they can withdraw the shipment if flagged by the fda, and try to simply at enter at a different port, a process known as port shopping. Some imported foods, especially seafood, have been found to be contaminated with carcinogenic drugs, pesticides, and other harmful impurities.
▶ 1:01:37This loophole puts american consumers at risk and undermines our food safety system. The problem extends beyond food. There has been a rise in exports of dangerous vape devices, e-liquid e-liquids containing banned substances and excessive nicotine, as well as counterfeit drugs like glp one. This threat is real and is documented. Exporters, especially chinese exporters, have been caught.
▶ 1:02:05Some resubmitting rejected shipments at different ports. This bill closes that loophole, creating a real deterrent for exporters who currently face little consequence for their ill deeds. Providing this authority has been a bipartisan priority for both the biden and trump administrations.
▶ 1:02:25The trump administration's fda, fda asked that asked for this authority in its last legislative legislative priority report granting the fda these authorities has supported has been supported for a broad group of industry organizations, including the southern shrimp alliance, louisiana farm bureau federation, the partnership for safe medicines, the national association of state controlled substance authorities, and the national consumer league, among many others. Mr.
▶ 1:02:54Chairman, I thank you and I urge this committee to adopt this amendment and pass this critical legislation. >> thank the gentleman for yielding back. Does anyone else wish to discuss the amendment in the nature of a substitute? Seeing none. If there's no further discussion, the vote occurs on the amendment. All those in favor signify by saying aye. All those opposed? No. The ayes have it, and the amendment in the nature of a substitute is agreed to. The question now is on.
▶ 1:03:23Forwarding h.r. 22715, as amended, to the full committee. All those in favor say aye. Opposed? No. The ayes have it. The bill is agreed to and forwarded to the full committee. That said, we have two more bills that we are probably going to have to recess now to go vote. We have five votes in the vote series. We will come back and do the remaining two bills.
▶ 1:03:52Oh three okay, yep. You're right. I've only got two. All right. We'll get the three bills remaining done when we get back.
▶ 2:10:37Is why we went off to vote on matters of the day. Uh, the chair would now call up h.r. 2821 and ask the clerk to report. >> h.r. 2821, a bill to require the secretary of health and human services, acting through the commissioner of food and drugs, to publish a final rule relating to non-clinical testing methods. >> and without objection, the first reading of the bill is dispensed with and the bill will be open for amendment at any point without objection. So ordered.
▶ 2:11:07Does anyone seek to be recognized on the bill? Gentleman from georgia, Mr. carter, is recognized to speak on the bill for five minutes. >> Mr. chairman, I move to strike the last word. Many of our families would feel incomplete without the pets and animals that bring unconditional love to our lives. However, there are millions of animals in our country that are forced into inhumane testing for pharmaceutical development.
▶ 2:11:33Yet every year, millions of animals are still subjected to inhumane testing and development of pharmaceuticals. As policy makers, we have a responsibility to protect those who cannot protect themselves. That includes ensuring we embrace modern scientific innovation that can reduce unnecessary animal suffering while advancing medical progress.
▶ 2:11:53That is why, in 2022, I was proud to help lead passage of the fda modernization act 2.0, which for the first time allow drug developers to use modern animal free testing methods as alternatives to traditional animal testing. Congress made its intent clear we wanted to reduce outdated testing requirements and encourage more effective, humane and innovative approaches to drug development.
▶ 2:12:17Unfortunately, the biden administration failed to fully implement that law, limiting its effectiveness and leaving too many animals still at risk. That is why I introduced the fda modernization act 3.0. This legislation ensures that the fda finally carries out the will of congress and the american people by fully embracing modern alternatives to animal testing.
▶ 2:12:38This bill will help reduce and replace the use of animals in non-clinical research, while also improving the efficiency of the drug development process and helping bring life saving treatments to patients faster. This is common sense bipartisan step forward for science, for innovation, and for animal welfare. I urge my colleagues to support the fda modernization act 3.0, and I yield back. >> gentleman yields back.
▶ 2:13:05Is there any other discussion on h.r. 2821? We'll give Mr. carter just a minute. He wants to speak on it, so we'll give him a minute to get set up. >> thank you, Mr. chairman. I move to strike the last word. >> gentleman is recognized to speak on the measure. >> I'm proud to speak in support of h.r.
▶ 2:13:342821, the fda modernization act 3.0, introduced by representative buddy carter, which I'm proud to co-lead with a bipartisan coalition of colleagues. Representative barragan, buchanan, delauro, and harshbarger.
▶ 2:13:51Over three years ago, the fda modernization act 2.0 was signed into law, allowing the fda to approve human drugs without requiring animal testing through modern, often more effective alternatives. However, since then, the fda has not issued updated regulations to phase out animal testing.
▶ 2:14:10This legislation before us required the fda to take those steps to modernize and transfer drug development for the 21st century and accelerating safer, more humane, more effective medical breakthroughs overall. It's a win for patients. It's a win for innovation. It's a win for animal welfare. I ask all my colleagues to join us in supporting this measure in voting yes. Mr. chairman, I yield.
▶ 2:14:42>> gentleman yielded any further discussion on the measure. Seeing none. Question now occurs on forwarding h.r. 2821 to the full committee. All those in favor say aye. Aye. Those opposed? No. The ayes have it. The bill is agreed to and forwarded to the full committee. Chair now calls up h.r. Five. Three. Four seven and ask the clerk to report. >> h.r.
▶ 2:15:105347 a bill to amend title 18 of the social security act to ensure the availability of appropriate collection types for quality reporting under the medicare shared savings program and for other purposes. >> without objection, the first reading the bill is dispensed with and the bill will be open for amendment at any point. Any objection? Seeing none so ordered. Does anyone wish to be recognized to speak on the bill?
▶ 2:15:40Seeing none is there in the nature of a substitute, and I believe there is. And I have an amendment at the clerk's desk. If the clerk could call the amendment up. >> amendment in the nature of a substitute to h.r. 5347. Offered by Mr. griffith of virginia. Strike all after the enacting clause, and insert the following. >> and without objection the reading of the amendment is dispensed with, and I am recognized for five minutes in support of the amendment. The nature of. Substitute this amendment.
▶ 2:16:09The nature of a substitute is a good one that I offer my support for, and it is the health care efficiency through flexibility act, which was introduced by congressman vern buchanan and of which congressman dan crenshaw, a member of the energy and commerce committee, is an original co-sponsor. This legislation would reduce red tape for physicians and other health care providers as they transition to value based models of care, like the medicare shared savings program. H.r.
▶ 2:16:39Five, three, four seven would require the secretary to maintain the availability of certain collection types for accountable care organizations or acos quality reporting under the medicare shared savings program, including electronic clinical quality measures, merit based incentive payment system, or mips clinical quality measures, and medicare clinical quality measures. The bill would also exempt acos from certain data submission requirements.
▶ 2:17:04When a participant within the aco is unable to submit quality data through the collection type selected by the aco for a particular measure, this would only apply when the aco would otherwise meet the data completeness requirements. These reforms will ease administrative burdens for providers participating in acos as providers move towards newer collection types like electronic clinical quality measures and other forms of digital quality measures.
▶ 2:17:28These quality measures, which can often be extracted directly from electronic health records, offer promise to reduce quality reporting burdens and costs. However, some providers, such as smaller physician practices, may not use electronic health record systems that are able to produce the files needed to submit these types of measures. The bill will provide an additional runway or additional runways to these providers to help them continue to move toward value based care.
▶ 2:17:56Management can manage value based care arrangements like acos, while limiting the quality reporting burden. As these technologies and systems develop. Lastly, this legislation would establish a pilot program at cms for digital quality measure reporting through which medicaid, medicare shared savings program, or m, s, s p acos would submit two measures through a digital quality measure collection type.
▶ 2:18:21As noted, digital quality measures are a promising way to report quality data and ideally, reduce the cost and burden of quality reporting. In the longer run, this pilot will help identify challenges that may need to be addressed before these measures are used across m, m, s, s, p and similar programs. I urge passage of the amendment in the nature of substitute and the underlying bill, and I yield back.
▶ 2:18:45Are there others wishing to speak to the amendment in the nature of a substitute, seeing none, we will move to. Uh a vote on the amendment in the nature of a substitute. All those in favor signify by saying aye, aye, opposed nay. The ayes have it. And now the question occurs on forwarding h.r.
▶ 2:19:12Five three, four, seven, as amended, to the full committee. All those in favor say aye. Aye. Those opposed? No. The ayes have it, and the bill is agreed to and forwarded to the full committee. And now we go to what I believe is our last bill, h.r. 1703, and would call the clerk to report the bill. >> h.r.
▶ 2:19:361703, a bill to amend title 18 of the social security act to clarify payment rules for manual wheelchairs under part b of the medicare program. >> and without objection, the first reading of the bill is dispensed with and the bill will be open for amendment at any point. Any objections? Seeing none so ordered, does anyone wish to be recognized on the bill? And does the gentleman from pennsylvania wish to seek recognition on speaking to the measure. >> and then on the amendment.
▶ 2:20:05>> on an amendment in the nature of a substitute? Yes, sir. All right. The gentleman is recognized to call up his amendment. >> Mr. chair, I have an amendment at the desk with the file name h1703scains underscore zero one underscore xml. >> and if the clerk will report. >> amendment in the nature of a substitute to h.r. 1703. Offered by Mr. john joyce of pennsylvania. >> and will dispense with any further reading of the amendment in the nature substitute. Without objection so ordered.
▶ 2:20:34And now the gentleman from pennsylvania, doctor joyce, is recognized for five minutes to speak to his amendment in the nature of a substitute. >> thank you, Mr. chairman. I would like to offer my full throated support for an important piece of legislation before our subcommittee today that would strengthen patient access to care. H.r. 1703.
▶ 2:20:49The choices for increased mobility act clarifies payment roles for manual wheelchairs under medicare part b, and will give individuals with disabilities the opportunity to exercise their own choice when it comes to their medical equipment. Specifically, this bill will allow medicare patients the opportunity to decide whether a titanium or carbon fiber wheelchair is right for them.
▶ 2:21:17Then, patients with medicare part b have the ability to pay out of pocket for wheelchair upgrades if they so choose. The operative word here being choosing on their own. That choice is part of this legislation. This legislation creates two new wheelchair codes and enables upgrades within an existing code, removing the current obstacles in place, and offering the upgraded benefit to end users at no additional cost to cms.
▶ 2:21:50In 2016, the durable medical equipment medicare administration contractors issued a policy that severely limited access to titanium and carbon fiber wheelchairs by preventing the billing of the existing code and allowing the beneficiary to cover the dis the difference of the upgrades. As a result, the only way to obtain a titanium or carbon fiber wheelchair is to pay the entire cost out of pocket by the patient wishing to choose that chair.
▶ 2:22:20This is cost prohibitive to the many beneficiaries and has detrimental effects on access to titanium and carbon fiber wheelchairs. This not only affects the patient, it affects their families who help them, who lift those wheelchairs, it affects their caregivers who push and utilize these heavier wheelchairs.
▶ 2:22:43This subcommittee should be encouraging medicare patients to take full advantage of their health care benefits and more important, giving them a say in the choice that will directly impact their quality of life. This bipartisan legislation will remove the barrier that, since, unfortunately, 2016, has impeded access to lightweight, durable medical equipment for individuals who live day to day with mobility impairments.
▶ 2:23:08I would like to thank the co-sponsor of this bill, especially doctor kim schrier of washington, and urge adoption of the anes and support for the underlying legislation. Thank you, Mr. chair, and I yield back. >> gentleman yields back now recognize. No gentlelady says that she's happy with the bill as is and ready to rock and roll. Anybody else wish to be heard on the measure? Alright.
▶ 2:23:38If no further discussion, the vote occurs on the amendment. All those in favor signify by saying aye. >> aye. >> all those opposed? No. Nay. The ayes have it. The amendment in the nature of substitute is adopted. We now go to the underlying or to the measure as a whole. The question now occurs on forwarding h.r. 1703, as amended, to the full committee. All those in favor say aye. Those opposed? No. The ayes have it, and the bill is agreed to and forwarded to the full committee. And one last thing before we all leave.
▶ 2:24:08Without objection, staff is authorized to make technical and conforming changes to the legislation approved by the committee today. Any objection? Seeing none so ordered. Without objection. Subcommittee is adjourned.