Floor Statements

Mr. Speaker, I rise today in support of H. Res. 981, and to condemn the Ortega regime's escalating, brutal campaign against its own people.

Ortega has now been in charge of Nicaragua for 22 of the last 39 years. After years of consolidating power by installing his wife as vice president, and gradually chipping away at the power of the judiciary and congress, Ortega has now dropped all pretense of being anything other than an authoritarian leader.

More than 300 people have now died in Nicaragua for having the courage to speak out against his and his wife's dictatorial rule. Ortega has now shown himself willing to target members of the clergy for fulfilling their sacred duty to recognize the value of human life, and for putting themselves in harm's way to try to protect their people.

This should be unacceptable to the U.S. and to the international community. I commend my colleague Rep. Ros-Lehtinen for taking a stand, and I encourage the executive branch to use all non-military means available to hold Ortega accountable for these deaths and to stop the carnage in Nicaragua.

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

Mr. Speaker, I rise in support of H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness Act, the EMPOWER Act.

I thank the main sponsors of the bill--Representative and Chair Michael Burgess, Representative Jan Schakowsky, and Representative Larry Bucshon--for their work on this important bill.

This legislation will reauthorize title VII health professional workforce programs under the Public Health Service Act that support loan repayment and provider training experiences in primary care, dentistry, rural, and underserved areas.

These programs include the Centers of Excellence, the Health Professions Training for Diversity Program, Primary Care Training and Enhancement grants, and Training in General, Pediatric, and Public Health Dentistry grants.

Investing in these programs helps ensure the availability of providers who are increasingly in demand across the country. These grants help support the health professional workforce by improving the diversity and distribution and supply of health professionals with an emphasis on primary care and interdisciplinary education and training.

This legislation will also boost training for geriatric providers who are needed to respond to our aging workforce.

I ask my colleagues to join me in voting for this important piece of legislation that will continue support for our Nation's health professions workforce programs.

I yield back the balance of my time.

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

Mr. Speaker, I rise today in support of H.R. 5385, the Dr. Benjy Frances Brooks Children's Hospital GME Support Reauthorization Act of 2018.

I am proud to introduce this legislation that will reauthorize the Children's Hospital Graduate Medical Education program with our subcommittee chairman, Congressman Michael Burgess. The CHGME program was created by Congress in 1999 to provide payments to children's hospitals to support medical residency training programs.

The Children's Hospital GME program is necessary due to how hospitals typically receive support for GME through Medicare, and these payments are based on hospitals' Medicare patient volume. Because the Medicare program is used primarily by people who are over the age of 65 and children's hospitals treat, primarily, people below the age of 18, children's hospitals have low Medicare patient volume and receive few Medicare GME payments.

Children's Hospital GME funds go toward training our Nation's pediatric workforce, including pediatricians and pediatric subspecialists, as well as other physician types in nonpediatrics, focused specialists that may rotate through children's hospitals for a period of time during their residency.

Since its creation, the Children's Hospital GME program has made it possible for thousands of pediatricians to receive training, including at Texas Children's Hospital in Houston, home of one of the largest academic pediatric departments in the United States, which has a number of clinics in our Houston area district.

Physicians receiving training in one of the 58 freestanding children's hospitals in 29 States go on to serve in the rural and other underserved areas, helping to alleviate the pediatric workforce shortage impacting communities throughout America.

The CHGME program is needed now more than ever to help train the pediatric workforce that will be required to meet the needs of our children and our grandchildren. Our legislation will reauthorize the CHGME program for 5 years at $325 million, and a $25 million increase over current levels. The current authorization will expire at the end of September, so it is imperative that we reauthorize this important program.

Our bipartisan legislation has 57 cosponsors, nearly equally divided between Democrats and Republicans. In addition, this legislation has strong support from outside stakeholders, the American Hospital Association, and the Children's Hospital Association.

I thank Dr. Burgess and all our colleagues on the Energy and Commerce Committee for their hard work and support for this important legislation, and I ask for all Members to join us in support of the Dr. Benjy Frances Brooks Children's Hospital GME Support Reauthorization Act of 2018.

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

Mr. Speaker, we have no further speakers,

and I yield back the balance of my time.

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

Mr. Speaker, I rise today in support of H.R. 1676, the Palliative Care and Hospice Education and Training Act.

Mr. Speaker, I thank my colleague and our committee member, Congressman Eliot Engel, for introducing this important legislation. I would also like to thank other cosponsors: Congressman Buddy Carter, also a member on our committee, and Representative Tom Reed for their work and support on this legislation.

Palliative care complements efforts to treat or cure illness by focusing on patients' quality of life. It is appropriate for patients with serious illnesses, starting at the point of diagnosis through treatment, and onward through hospice and the end of life.

Palliative care entails communication with patients and their families to coordinate care, determine patient preferences, and assist with medical decisionmaking.

A growing body of research has documented the benefits of high- quality palliative and hospice care for patients in hospitals and payers, and the healthcare system as a whole.

Palliative and hospice care have been associated with enhanced quality of life for patients, reduced hospital expenditures and lengths of stay, and other positive outcomes, including longer patient survival time.

Despite the benefits of palliative care, many Americans aren't aware of the supports available to them. There is also a shortage of educated providers who can offer quality palliative care.

The Palliative Care and Hospice Education and Training Act will address these issues.

This legislation will help create an infrastructure to improve palliative care training for healthcare providers, encourage the National Institutes of Health to expand its research on palliative care and pain management, and ensure Americans have an understanding of how palliative care may benefit them and their loved ones.

I am a proud cosponsor of this legislation. In fact, this bill has 285 cosponsors, two-thirds of the entire House of Representatives.

I ask my colleagues to join me in supporting this important legislation that will expand our Nation's research and infrastructure on palliative care and pain management.

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

Mr. Speaker, I yield 4 minutes to the gentleman from New York (Mr. Engel), a member of our Energy and Commerce Committee and cosponsor of this bill.

Mr. Speaker, we have no further speakers, and I yield back the balance of my time.

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

Mr. Speaker, I rise in support of H.R. 959, the Title VIII Nursing Workforce Reauthorization Act.

I thank the main sponsor of the legislation, Representative David Joyce, and original cosponsors including: Representative Doris Matsui, Representative Kathy Castor, and Representative Tulsi Gabbard for their hard work on this important legislation.

An estimated 10,000 people are turning 65 years old in America every day. That trend will continue through the end of the decade. In addition to an aging population, the United States faces rising healthcare costs, prevalent chronic diseases, and the rise in substance abuse disorders. In order to meet this increased need for care, we need to grow the largest group of healthcare providers in our Nation: nurses.

The title VIII programs bolster nursing education at all levels, from entry-level preparation through graduate study, and provides support for institutions that educate nurses for practice in rural and medically underserved communities. This program is designed to address specific needs within the nursing workforce and America's patient population.

This legislation will reauthorize title VIII of the Public Health Service Act that provides Federal resources toward nursing workforce development programs, including the recruitment, retention, and advanced education of skilled nursing professionals.

This bill extends advanced education nursing grants to support clinical nurse specialists, clinical nurse leaders, defines nurse- managed health clinics, adds clinical nurse specialists to the National Advisory Council on Nurse Education and Practice, and reauthorizes loan repayments, scholarships, and grants for education, practice, quality, and retention.

This bipartisan legislation passed the Energy and Commerce Committee on voice vote earlier this month. I ask my colleagues to join me in supporting this important legislation to expand and strengthen our American nursing workforce, and I reserve the balance of my time.

Mr. Speaker, I yield 2 minutes to the gentlewoman from Hawaii (Ms. Gabbard), who is a cosponsor of this bill.

Mr. Speaker, we have no further speakers, and I yield back the balance of my time.

Mr. Speaker, Russia is not our friend; Russia is our adversary.

We witnessed our President side with an autocrat and adversary of our country over his own intelligence community and blame the USA for our relationship with Russia.

From separating families at the southern border to embracing Putin over the protection of U.S. interests, Mr. Trump has thrown out that values that our country is founded on.

Putin may be Mr. Trump's friend, but he is not America's. Our President forgets that the U.S. interests go beyond his own personal interests and relationships. If Putin wants to return to the days with no pushback from the U.S., that is one thing. If our President wants to return to those days, rather than defend America and our allies, that is another.

It shouldn't matter whether you are a Republican or a Democrat. If the President of the United States won't defend our interests before those of our adversaries, Congress must.

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

Mr. Speaker, I rise in support of S. 490. This bipartisan legislation, sponsored by Senators Steve Daines, Jon Tester, and Jim Risch, would reinstate and extend the deadline for the construction of a hydroelectric project on the Gibson Dam in Augusta, Montana. Congressman Gianforte of Montana introduced companion legislation last year.

The Federal Energy Regulatory Commission licensed the project in 2014, but the developer was unable to commence construction before the statutory deadlines passed.

S. 490 is substantially similar to legislation that, during the previous Congress, was reported unanimously by the Energy and Commerce Committee and passed the House with 410 votes. I know of no objections to the bill on this side of the aisle, and I ask my colleagues to join me in voting in support of S. 490.

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

Mr. Speaker, I have no further speakers, and I yield back the balance of my time.

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

Mr. Speaker, I rise today in support of H.R. 5333, the Over-the- Counter Monograph, Safety, Innovation and Reform Act.

I am a proud original cosponsor of this legislation that will strengthen the Food and Drug Administration's ability to oversee the over-the-counter drug market and establish a user fee program for this market for the first time.

H.R. 5333 is legislation that enjoys bipartisan support and would reform the current monograph system that is relied upon by industry to legally market over-the-counter drugs in response to concerns raised by both the FDA and the industry that the current system is outdated and burdensome.

Under current law, the safety and effectiveness of over-the-counter drugs is established through conformance with a monograph. Monographs serve as a type of rule book outlining the conditions of use for a particular drug ingredient, including the dosage form, patient population, labeling and warnings, and other requirements. This rule book is established currently through a three-phase rulemaking process and is very resource and time intensive.

This process has made it difficult for the FDA to finalize, revise, or update monographs to reflect innovations, changes in science, or to respond to safety issues.

We also have heard from the industry that the current process inadvertently discourages innovation, as it is not nimble enough to respond to evolving science and technology.

The legislation we are considering today would address these concerns by transitioning the monograph system from rulemaking to administrative order, create a procedure for the FDA to respond to the needs for safety label changes, and establish an innovation pathway.

These reforms can only be successful if it is also accompanied by stable and reliable funding that more appropriately represents the growth and science of the over-the-counter industry.

Today, the over-the-counter monograph program oversees more than 100,000 products with a staff of about 30 people and a budget of just over $8 million. The user fees provided in this bill would help the FDA transition the monograph program from rulemaking to administrative order, provide for additional staff capacity, and enable the FDA to respond to innovation and safety changes in the current market.

I want to thank my colleague from Ohio, Congressman Bob Latta, for introducing this legislation and for working with me and other members of our committee. I would like to thank the original cosponsors of the bill, Representative Diana DeGette, Representative Debbie Dingell, Chairman Mike Burgess, and Representative Brett Guthrie for their dedication and hard work on this important issue.

I ask all my colleagues to join me in supporting the Over-the-Counter Monograph Safety, Innovation, and Reform Act.

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

Mr. Speaker, I yield 3 minutes to the gentlewoman from Michigan (Mrs. Dingell).

Mr. Speaker, I yield 3 minutes to the gentlewoman from Colorado (Ms. DeGette), my colleague and a member of our committee.

Mr. Speaker, I have no other speakers, and I yield back the balance of my time.

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

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Oregon (Mr. Schrader), our colleague from the Energy and Commerce Committee.

Mr. Speaker, I have no further speakers, and I yield back the balance of my time.

Mr. Chairman, I thank my longtime friend, Congressman Young, our dean of the House, for yielding me the time.

Mr. Chairman, I rise in support of H.R. 200, the Strengthening Fishing Communities and Increasing Flexibility in Fisheries Management Act. This bipartisan bill reauthorizes one of the most successful conservation programs in Magnuson-Stevens in a way that recognizes many of the successes of the program.

Magnuson-Stevens was established in 1976 with one primary goal: to reduce overfishing. With a successful update in the 1990s and 2000s, we have now met many of the goals the program was established to meet.

Compared to when the law was established, 84 percent of the stocks are no longer overfished, according to the National Oceanic and Atmospheric Administration. Yet we still treat many of these healthy fish stocks as if nothing has changed.

I am an avid sportsman. I have hunted and fished with both my son and my grandchildren. There is no one who

cares more about conservation and protection of endangered species than hunters and recreational fishers. It is time that Magnuson-Stevens reflects a healthy balance between commercial and recreational fishermen.

All too often, recreational fishers take a backseat to the commercial interests. This bill recognizes the unique space that recreational anglers occupy and gives them the certainty they need to enjoy our natural resources.

Saltwater anglers contribute $70 billion annually to the Nation's economy and support jobs all over the country, and there is no one who cares more about the health of our oceans either. In 2016, anglers, through excise taxes, contributed $628 million in support of conservation programs and resource management.

This bill will set catch limits in 3-year time periods to give anglers certainty so they know when to plan trips. All too often, arbitrary changes to seasons have caused problems up and down the Gulf Coast of Texas.

This bill recognizes that technology has advanced in many ways in measuring the health of our fish stocks. State agencies, universities, and local conservation groups have come with up with many innovative ways to measure the health of fish stocks. I am glad that this bill includes language that I worked on to make sure that we had the most scientifically accurate data possible when it comes to determining the number of certain stocks.

Mr. Chair, I am proud to be a cosponsor to this bill and urge all of my colleagues to support it. I thank the gentleman from Alaska for the time.

Mr. Speaker, I rise today to speak out against the awful situation that has transpired over immigration in our country. When President Trump asked Congress to come to a legislative solution over DREAMers in our country, it should never have come to a point where our country no longer treats immigrants with compassion and respect. Families and children should have never come in the cross fire of politics, and our nation should have never witnessed a humanitarian crisis on our own land.

President Trump, since the beginning of his term, has issued a number of executive orders on immigration, refugees, and border security. These actions include President Trump's border wall, extreme deportation policies against undocumented immigrants, three bans on refugees and travelers from predominately Muslim countries, and a rescission of the Deferred Action for Childhood Arrivals (DACA). President Trump has created fear and uncertainty for many that legally reside in our country, including thousands of legal immigrants in our district in Houston and Harris County, Texas. Congress has offered several bipartisan legislative solutions, including the DREAM Act and the USA Act, but it is the President who refuses to work with Congress until all of his unreasonable demands are met.

Today, our chamber is left with only two choices: H.R. 4760 and H.R. 6136. These bills are not only bad policy, but they also only make matters worse. The so-called Securing America's Future Act, H.R. 4760 offers no path to citizenship for Dreamers, removes protections for all unaccompanied minors, and harms our communities. This bill absolutely fails to help fix actual immigration problems in our country and instead pushes the propaganda that immigrants are criminals and a burden to our society. This is false. The 29th District of Texas is home to one of the largest immigrant populations in the country. I have seen with my own eyes how they bring innovation, entrepreneurship, and hard work that have been an integral part of making Houston a world- class city.

The Border Security and Immigration Reform Act, H.R. 6136 is being sold as a compromise, but this is a sham. This bill limits the eligibility criteria for DACA, cutting off most Dreamers and many DACA recipients. For those that will be eligible, this legislation does not guarantee citizenship, as the participants will be pitted against each other in a point system to obtain permanent residence. The administration must stop treating Dreamers as pawns--their lives are not ours to play with. The Border Security and Immigration Reform Act will also fund an expensive and arbitrary border wall. Even worse, the problems this legislation seeks to solve, such as family separation, are exacerbated. It will eliminate requirements for children in confinement that ensures they are safe, sanitary, and appropriate for children.

In a few months, the President has led our country into a manufactured humanitarian crisis. We have mistreated children and family members as they come to our borders seeking asylum. President Donald Trump's ``zero tolerance'' policy is inhumane, cruel and un- American. President Trump's Executive Order on June 20th creates a dangerous situation for the future requiring children to be detained for prolonged periods, resulting in dangers for their health and mental well-being, and there is no solution for over 2,000 children that have already been separated from their parents.

Mr. Speaker, I ask Congress to think about the children and families' lives that we are destroying. Many will still not be able to reunite--a travesty that I am sad to say is because of our President. The separation of families has never been an option for any other administration and it is unthinkable that it is a choice today. We must come together to address how to create an immigration system that is humane and honors our nation's history and traditions. We are America and we must start acting like it.

Mr. Speaker, my prayers are with the immigrant families who were being separated at the border. The administration's actions were inhumane, and I am glad the President reversed these actions.

As the children are sleeping on the floor behind a cage wishing they would hear from their mom and dad, the administration and Republican majority are working silently, chipping away at the Affordable Care Act.

The Trump administration released a rule that would greatly expand association healthcare plans, which are exempt from the Affordable Care Act's essential healthcare benefits, including maternity care, mental healthcare, and prescription drugs. This new loophole will bring back junk, or fake, plans that provide little or no health coverage.

Repeal of the Affordable Care Act didn't happen, but the Republicans' sabotage of our Nation's healthcare system continues, and our uninsured Americans continue to grow.

These junk plans will siphon off young, healthy people, damaging the ACA marketplaces and leaving everyone else with higher premiums. The fake insurance may not cover emergency room treatment or other terrible illnesses.

Americans need healthcare, not fake insurance.

Mr. Speaker, I was unable to vote on Tuesday, June 19, 2018, due to cancellations and delays to my scheduled return flights to Washington.

If I had been able to vote, I would have voted as follows:

On H.R. 5687, the SOUND Disposal and Packaging Act, I would have voted ``yea.''

On H.R. 5676, the SENIOR Communities Protection Act, I would have voted ``yea.''

On the Journal Vote, I would have voted ``nay.''

Mr. Speaker, I was unable to vote on Friday, June 15, 2018, due to changes in the floor vote calendar.

If I had been able to vote, I would have voted as follows:

On the Thornberry Amendment to H.R. 2851, the Importation and Trafficking of Synthetic Analogues Act, I would have voted ``nay.''

On final passage of H.R. 2851, I would have voted ``nay.''

Mr. Speaker, 115 people in America die from opioid overdose every day--115. While we are spending the next 2 weeks passing bipartisan legislation to combat the opioid crisis, President Trump's Department of Justice is abandoning the Affordable Care Act and its popular rule that protects Americans from preexisting conditions like opioid addiction. According to the Department of Health and Human Services, nearly 130 million adults under the age of 65 have preexisting conditions.

This action taken by the Justice Department is bad policy, and it will do more harm to Texas, which already has the highest population of uninsured in the Nation.

In fact, it will add more uncertainty to the Affordable Care Act markets at a time when Americans throughout the country will witness double-digit rate increases for the ACA plans next year. We can't combat the opioid crisis if we deny treatment and access to care for Americans with substance abuse.

I urge my colleagues to do the right thing, speak out, and oppose the huge health insurance premium increases.