Ensuring Medicaid Continuity for Children in Foster Care Act of 2023

Mr. Speaker, I move to suspend the rules and pass the bill

(H.R. 4531) to reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes, as amended.

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and insert extraneous material in the Record on the bill.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise today to speak in strong support of my bill, H.R. 4531, the Support for Patients and Communities Reauthorization Act.

Over the past 2 years, we have lost over 200,000 Americans to drug overdoses and poisonings. This is a step in the wrong direction, as the United States saw decreases in year-over-year drug overdoses between 2018 and 2019.

Tragically, our best efforts to drive down these overdose rates were disrupted by the COVID-19 pandemic, which left millions of Americans isolated and shuttered from support systems that helped those struggling with substance use disorder stay on track.

These statistics show the policies and programs we enacted in 2018 were working prior to the pandemic. However, since 2018 we have seen the horrors that illicit fentanyl and other illicit substances, like xylazine, have caused our local communities.

In the past 3 years, over 70 percent of all drug overdoses in the Commonwealth of Kentucky have been the direct result of poisonings from fentanyl or fentanyl-related substances.

Earlier this year, I convened an Energy and Commerce Health Subcommittee field hearing in Gettysburg, Pennsylvania, where we heard firsthand accounts from law enforcement and treatment providers about the harsh realities of the crisis.

We heard the heart-wrenching testimony from Michael Straley, who lost daughter, Leah, a few years ago to fentanyl poisoning, underscoring the daily stresses of families with loved ones battling substance use disorder. That work has helped inform the bill before us today.

We are reauthorizing important programs such as State-level prescription drug monitoring programs, residential treatment for pregnant and postpartum women, and other prevention, treatment, and recovery services.

We are also placing xylazine into schedule III of the Controlled Substances Act, while maintaining access for veterinarians and ranchers to use in animals.

Xylazine is an emerging lethal street drug that is a unique threat as it is not an opioid, and so it does not respond to FDA-approved opioid reversal medications.

That said, H.R. 4531 provides even greater access for treatment providers to use Federal funds to purchase over-the-counter opioid overdose reversal medications, which we know have helped reduce opioid overdose rates in communities across the country.

We are also building on important steps we took in 2018 to help those who rely on the Medicaid program access care.

We are permanently requiring Medicaid programs to provide lifesaving medication-assisted treatment. We are permanently codifying the flexibility for States to waive outdated policies that prevent vulnerable individuals from seeking comprehensive wraparound and substance use disorder care. We are also assisting foster care youth by ensuring they do not lose their Medicaid services if they are receiving the behavioral care they need at qualified residential treatment programs.

Finally, the legislation before us today promotes access to long-term recovery and support services like workforce training for individuals in recovery.

In closing, Mr. Speaker, I thank my Democratic colleague, Representative

Ann Kuster, for her help on this important legislation and historical leadership on addressing the opioid crisis.

I also thank all of my colleagues for working with us to ensure the policies of H.R. 4531 are fully offset, which was essential to ensuring this legislation could get to this point.

Again, I thank my colleague from New Hampshire for working with me on this bill.

Mr. Speaker, I urge my colleagues to vote ``yes'' on H.R. 4531, and I reserve the balance of my time.

Mr. Speaker, I yield 2 minutes to the distinguished gentlewoman from Washington (Mrs. Rodgers), who is the chair of the Energy and Commerce Committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Bilirakis).

Mr. Speaker, I yield 2 minutes to the gentleman from Indiana (Mr. Bucshon).

Mr. Speaker, I yield 2 minutes to the gentleman from Georgia (Mr. Carter), my good friend.

Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Pfluger), my good friend.

Mr. Speaker, I yield 2 minutes to the gentleman from Iowa (Mr. Nunn), my friend.

Mr. Speaker, I yield myself the balance of my time.

Mr. Speaker, I appreciate the chair of the committee, the ranking member, and the gentlewoman from New Hampshire (Ms. Kuster) all working together to solve this problem which every American family is facing or knows of someone or has some relation to someone who is. This touches everybody far and wide, urban and rural, suburbs and small towns. Particularly in my home State, the Commonwealth of Kentucky, we have really had families just devastated by this.

We have to close the border. We have to get a handle on what is coming across the border. We have to make sure that we have things in place to prevent people from bringing these to our young people and adults. We are here today, though, to make sure those who have this substance use disorder have access to proper care, the opportunity to not just recover, but to have full and productive lives.

We believe that on both sides of the aisle, and we have worked together for this. I urge my colleagues to vote ``yes,'' and I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I appreciate the gentleman from New Jersey for yielding.

Mr. Speaker, I rise today in support of this legislation. I thank my colleagues and friends, Representative Guthrie and Representative Kuster, for their work on the Support for Patients and Communities Reauthorization Act.

As you may know, I serve as co-chair of the Addiction, Treatment, and Recovery Caucus, or better known as the ATR Caucus.

The ATR Caucus is a bipartisan group of over 70 members committed to advancing bipartisan solutions to the country's multifaceted addiction crisis. Next year will mark the 20th anniversary of the caucus, the first in Congress to recognize that addiction, indeed, is a disease.

As a longtime champion for those facing addiction, I am all too familiar with the devastating impact of the disease for individuals, their families, and their communities. This is a loss many of us know too well--the loss of a daughter, a son, a father, a mother, a sister, or brother. The loss of a neighbor dying much too young and leaving behind a grieving family and communities being ripped apart by poison seemingly beyond their control.

Last year, in our Nation, there was an estimated 109,680 overdose deaths. That is 109,680 lives lost.

Let's think of how many people that is every day needlessly dying and having their lives cut so short. Think of the magnitude of all those impacted by those 109,680 loved ones. For each of those individuals, there is a whole universe of friends, of family, and, of course, communities impacted.

As we consider the SUPPORT Act reauthorization, let me share that clearly there are some good policies we are moving forward. I am glad that we are reauthorizing several programs that have been successful. I am pleased that we are including my Extending Access to Addiction Treatment Act that I was proud to work on with my friend, Representative Armstrong.

As you may know, medication-assisted treatment for addiction significantly reduces the risk of overdose death. However, despite the effectiveness, approximately 87 percent of individuals with opioid use disorder who may benefit from lifesaving medication-assisted treatment simply do not receive it.

My Extending Access to Addiction Treatment Act makes permanent the requirement that Medicaid provide coverage for addiction medication for Americans who need it. I also think we are taking a step in the right direction by requiring States to suspend rather than terminate coverage of Medicaid for justice-involved individuals making it easier to restart those benefits upon release.

We also include a provision to allow pregnant incarcerated individuals who are being detained pretrial to maintain their Medicaid coverage. I fully support the legislation and remind everyone that we have a lot more work to do in order to take the necessary steps to address the deep need of this crisis.

We all know the scale of the devastating disease of addiction. We also know that our justice system is a revolving door for those struggling with addiction and mental health issues. Over one-half of people in State prisons and two-thirds of individuals in jails have substance use disorder, or SUD.

To truly address it, I urge us to take bold action and move forward as soon

as possible with the Reentry Act and the Due Process Continuity of Care Act. By allowing inmates to receive addiction treatment and other services before returning home, my Reentry Act would bring targeted treatment to those at the highest risk of overdose.

The Reentry Act would be a game changer for reducing overdose deaths and suicides by allowing all States to provide prerelease care to Medicaid-eligible individuals up to 30 days prior to release from incarceration.

The Due Process Continuity of Care Act would make certain that pretrial detainees are not kicked off Medicaid prior to even being found guilty of a crime.

Mr. Speaker, we know the human cost of inaction. To be precise, last year it was 109,680 lives we lost. Is that a cost we are willing to bear?

With that in mind, our work is not done, and I hope we can find the will to truly meet the moment.

This legislation is a good step forward, but it is not the end of the road. Again, this disease of despair requires hope, and we can provide that hope to the individuals who look to us to be the agents of that hope.

Mr. Speaker, again, I would urge my colleagues to support this bill.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise to speak in support of H.R. 4531, the Support for Patients and Communities Reauthorization Act. This bill addresses the ongoing public health emergency posed by the opioid and overdose crisis.

The opioid epidemic is still a tragic reality for millions of Americans and their families every day. Last year, nearly 110,000 Americans died from a drug overdose.

Five years ago, Congress worked to enact the SUPPORT Act, bipartisan legislation to address the opioid epidemic, and that legislation expanded access to treatment, invested in public health, and strengthened prevention efforts.

Today, the nature of the opioid epidemic has changed. Where it was once illicit prescription drugs, now it is illicit fentanyl, its analogues, and xylazine that are claiming the lives of too many people every single day.

H.R. 4531 builds on the success of existing law. It extends the programs that have worked, makes commonsense changes to the programs that need to be updated, and includes new policies designed to combat the new reality of the opioid epidemic.

The bill before us today provides critical training to first responders, supports recovery centers, and helps individuals in recovery lead normal lives. It makes important investments in Medicaid to support the treatment of opioid use disorder.

It requires all State Medicaid programs to cover medication-assisted treatment, expands access to coverage to pregnant women in pretrial detention, and makes it easier for incarcerated individuals to regain their coverage after being released.

I must say, I am disappointed that we were not able to include several bipartisan policies that would ensure greater access to Medicaid for justice-involved populations, and I will continue to work to find a path forward on those provisions.

Nevertheless, that said, the bill before us will make meaningful changes to Federal law that will strengthen our ability to respond to the ongoing opioid epidemic.

Mr. Speaker, I thank Chairwoman Rodgers, Subcommittee Chairman Guthrie, and Subcommittee Ranking Member Eshoo for their hard work to advance this important bipartisan bill.

Mr. Speaker, I urge my colleagues to support this legislation, and I reserve the balance of my time.

Mr. Speaker, I yield 4 minutes to the gentleman from New York (Mr. Tonko), ranking member of our Environment Subcommittee.

Mr. Speaker, I yield an additional 30 seconds to the gentleman from New York.

Mr. Speaker, I yield 2 minutes to the gentlewoman from New Hampshire (Ms. Kuster), member of the Energy and Commerce Committee.

Mr. Speaker, I yield 2 minutes to the gentlewoman from Texas (Ms. Crockett).

Mr. Speaker, I continue to reserve the balance of my time.

Mr. Speaker, I continue to reserve the balance of my time. I may have one more speaker, but they are not here at this time.

Mr. Speaker, I yield myself the balance of my time.

This is very important in the ongoing efforts of our committee to continue the battle against opiates and other related illicit drugs that are very dangerous. The number of overdoses, unfortunately, continues to be way out of proportion to what it should be. We need to support this bill and other measures that deal with this crisis that continues to plague the American people.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I thank Chair Guthrie, as well as Chair Rodgers for their work on this bill. I rise in strong support of H.R. 4531, the Support for Patients and Communities Reauthorization Act, the SUPPORT Act.

Looking back, it was originally created in 2018 as a significant investment in overdose prevention. There is an urgent need to actually reauthorize the SUPPORT Act, with nearly 110,000 annual overdose deaths in this country last year. This reauthorization ensures that individuals seeking assistance for substance use disorders have access to critical lifesaving treatments, recovery support services, prevention programming, and long-term recovery services.

I draw attention to an emerging public health concern addressed by this legislation, the illicit use of xylazine. Xylazine is a veterinary tranquilizer that has become drug traffickers' preferred substance for cutting fentanyl. Xylazine's current ease of access--as it can just be purchased online for as little as $6 per kilogram--directly threatens our communities.

DEA Administrator Milgram warned that ``Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier.''

To counter this growing threat, the bill proposes scheduling illicit xylazine under schedule III of the Controlled Substances Act, while safeguarding--and this is important--crucial access for veterinary use and the livestock industry.

The fentanyl crisis has already inflicted severe damage on treatment clinics and public health agencies throughout our entire country. Adding another highly toxic substance to the illicit drug supply only intensifies the crisis. Congress must take action against this emerging threat.

I am pleased that the SUPPORT Act builds upon the collaboration of Congressman Panetta and I with the agricultural and veterinary industries and law enforcement to ensure this legislation cracks down on illicit uses of xylazine while preserving its critical role within agriculture and veterinary medicine.

I urge my colleagues to support the SUPPORT Act. This is not just legislation. It is a response to help save lives within our communities.

Mr. Speaker, every Member here likely knows at least one family in their district whose life has been impacted by someone struggling with addiction.

This comes at a time where companies are also now trying to use the courts to avoid liability and escape having to compensate families for their role in targeting communities and peddling pills all in the name of increasing profits.

Addiction is painful and it is dangerous. It is a dangerous struggle that too many Americans suffer from. Today, this illness is exacerbated by the prevalence of fentanyl. Fentanyl is 50 percent stronger than heroin and 100 times stronger than morphine. Because people can't see, taste, or smell it, those struggling with addiction don't even know when they are putting their life at risk.

To be clear, fentanyl is one of the leading causes of overdose- related deaths today. Now, more than ever, we need to attack this problem from a holistic approach. This is coming from, again, the gentlewoman from the State of Texas. We know that there is not just a one-trick pony on this. We have got to make sure that we address this side of it, as well as our struggles at the border.

Not only do we need more technology at our points of entry to interdict fentanyl, but we will also need to give our constituents the necessary tools to know whether or not they are about to subject themselves to fentanyl. One way to do this is to arm them with fentanyl testing strips.

I am grateful to Representative Gooden, my Republican co-lead, for supporting my bill, the Test Strip Access Act, to Senators Hassan and Cornyn for introducing it in the Senate, and to the Energy and Commerce Committee for incorporating it into the SUPPORT reauthorization.

My bill will allow fentanyl and xylazine testing strips to be purchased

under the overdose prevention programs grants. Access to these testing strips can literally mean the difference between life and death.

Accordingly, I urge my colleagues to vote in favor of the SUPPORT Act so we can give our constituents the tools to be safe and ultimately get them the help they desperately need to treat their illness.