Floor Statements

Mr. Speaker, I was unable to be present for votes on January 22nd due to unavoidable travel delays. Had I been present, I would have voted ``yea'' on rollcall No. 44 and ``yea'' on rollcall No. 45.

Madam Speaker, I rise in opposition to title III of the Democrats' rules package which, as you have heard, paves the way for Speaker Pelosi to unilaterally take legal action on behalf of the entire House of Representatives in the ongoing court case surrounding the constitutionality of the Affordable Care Act and any future court cases on the ACA as she sees fit. That is a pretty big blank check.

Madam Speaker, first of all, I object to this vote on the grounds of pure common sense. The authority we are voting on today was already given to the Speaker last week under title I of the Democrats' rules package. You can look it up. It is right there, beginning on page 30. You will find it after the provisions that make it easier for House Democrats to increase taxes and to set up automatic debt limit increases. Not to mention, Speaker Pelosi has already filed three motions to the court to intervene in the case since last week's vote.

Moreover, Democratic Attorneys General from intervening States are already defending the law in the case, and the judge's ruling has already been stayed and appealed. So this is an unnecessary waste of time, paper, and ink.

I can only assume part of the reason for today's show vote is to distract from Democrats' real radical views on healthcare.

Madam Speaker, where is the single-payer, $32 trillion government takeover of healthcare bill which ends employer- and union-sponsored healthcare and forces the 158 million Americans who get their healthcare through their job into a one-size-fits-all government-run plan?

A majority of House Democrats supported that proposal--or one very like it--in the last Congress. When will they keep their promise to bring that plan up for a vote?

Madam Speaker, today's vote to repeat the authorities given the Speaker last week is just for show. It is not a serious exercise in legislating. Meanwhile, last week, Republicans brought a powerful but simple amendment to the floor that would have actually called on this body to legislate on something we all could agree needs to be done, and that is to lock in protections for patients with preexisting conditions. But, unfortunately, in a fit of partisanship, Democrats voted that down.

Therefore, I urge my colleagues to reject this unnecessary political theater today and vote ``no'' so we can work together expeditiously to guarantee preexisting condition protections for all Americans, and do so in a manner that can withstand judicial scrutiny.

Mr. Speaker, I thank the gentleman from Illinois and my colleagues on both sides of the aisle.

I spent about a year in Alaska going to college, have been back a number of times, and it is, as the gentleman from Alaska describes, a very unique area. It is unlike anywhere else in America.

When you get out into these remote villages, you may fly in in a small Cessna airplane, land on a gravel strip, as I have done, and get out, and there may only be 25 or 50 people there. That is it.

By the way, in the winter, it can be--what?--50, 60 below. I have seen that. And I have seen it in spring at break where we had to try to take off three different times on a runway because it had begun to soften up. The snow had begun to soften up, and we had to get out of the plane, turn it around, get back in. Eventually, we had to leave one guy behind in order to get off the ground. This is a very unique place.

The poverty that the gentleman from Alaska describes is very real. So, yes, of course, I wish we had had more time to work this out.

And to my colleague from New York, he and I have worked out most of these things along the way quite well. This bill came to us late, and, frankly, we didn't have time to deal with all of the finite pieces. Perhaps we could go back in the next session and do that, but this is before us today. The problem is before us today.

I believe this is a reasonable solution and that we should pass it. So, Mr. Speaker, I encourage my colleagues to approve this bill and send it to the President. I commit to work to make it even better next year.

I won't be the chairman, I understand that, but Mr. Tonko, Mr. Speaker, will be, I think, the chairman of the Environment Subcommittee, and I would work with him and the gentleman from Alaska.

But this is the time, as we know, when things finally get done, and they may not be perfect, but in this case, I would err on the side of passing this bill and then fine-tweak it later if we have to.

This is a real serious issue in these tiny, remote, impoverished villages. I would defer to the gentleman from Alaska, who knows it better than any of us, and encourage passage of this legislation.

Mr. Speaker, I also want to pay tribute, in closing, to our chief counsel on the committee, Karen Christian, who will be leaving us at the end of this Congress. She has been a remarkable member of the staff, engaged in the Oversight and Investigations Subcommittee for years, doing incredible work, and is going off to greener pastures.

After 13 years in the committee, I just want to say to Karen: Thank you for your service. Thank you for your leadership. We are going to miss you. Good luck to you and your family

Mr. Speaker, as Chairman of the Energy and Commerce Committee, I'm convinced we have the best members in Congress and the best staff. In her thirteen years with the Committee, Karen Christian has been one of our finest. At the end of this Congress, Karen will move on, and while we are sad to see her do, we wish her well.

Karen joined the Committee in 2006 as a counsel on our Oversight and Investigations Subcommittee. She's served as both the deputy chief counsel and chief counsel of that subcommittee, and for the last four years she

has served as general counsel of the Committee.

As deputy chief counsel, Karen led several major Committee investigations, including investigations into the Department of Energy's management of the Loan Guarantee Program, including a failed loan guarantee to Solyndra; the stimulus bill, American Recovery and Reinvestment Act; cyber security and critical infrastructure, including an investigation of Huawei Technologies; and the Federal Communications Commission's handling of a license application from LightSquared.

As chief counsel, she led the Committee's investigations into General Motors ignition switch safety failures; the implementation of the Patient Protection and Affordable Care Act, including the failure of HealthCare.gov; the fungal meningitis outbreak due to contaminated drugs; mental health care and treatment, including federal programs related mental health and serious mental illness; the opioid addiction epidemic; and the Environmental Protection Agency's consideration of carbon capture technologies in developing greenhouse gas emissions standards for new power plants.

And as general counsel, Karen has been responsible for overseeing and managing the legislative process for the entire Committee--that includes a 27-hour, marathon markup in March 2017 and regularly battling to preserve the Committee's jurisdiction.

By every measure, Karen's time at the Committee has been a complete success. While we are sad to lose our friend, we look forward to seeing her next accomplishments.

Karen, we wish you and your family--Dave, Christian, Andrew, and Charlotte the very best. We thank you for your service, your hard work, your guidance, and most of all your friendship. Your work made a difference . . . America is better because of your efforts.

Thank you and remember--at Energy and Commerce, the fun never stops.

Mr. Speaker, I move to suspend the rules and concur in the Senate amendment to the bill (H.R. 1222) to amend the Public Health Service Act to coordinate Federal congenital heart disease research efforts and to improve public education and awareness of congenital heart disease, and for other purposes.

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

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

Mr. Speaker, I rise today in support of H.R. 1222, the Congenital Heart Futures Reauthorization Act.

Mr. Speaker, I would like to thank Representative Gus Bilirakis of Florida, who is a valued member of our Energy and Commerce Committee, for bringing this bill forward and for his passion on this very important issue. As one of the original authors of this legislation, he drove this reauthorization forward, and I am proud to stand in support of it once again with Mr. Bilirakis.

As the parent of a child who died from a congenital heart defect, I know how much today's vote gives hope to the parents, infants, and adults across the country who live with the effects of congenital heart disease, the most common birth defect and the leading cause of birth defect-related infant mortality.

This affects 40,000 families every year. Nearly 1 in every 100 babies is born with a congenital heart defect and roughly 25 percent of those will need heart surgery or other significant interventions to survive. Up to 200 each year do not survive. That is why this bill is so important.

Originally passed in 2010, the Congenital Heart Futures Act expanded infrastructure at the CDC and increased research at NIH to better understand and treat patients with congenital heart defects.

The reauthorization before us today ensures continued investment in that research, to identify the root causes of these defects and how to address them from birth to adulthood.

Mr. Speaker, this House passed a version of this legislation earlier this year by a vote of 394-7, and the amended version we will vote on today passed the Senate unanimously.

Mr. Speaker, I urge my colleagues to take this important step for families across the country and to support passage of this bill into law.

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

Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Burgess), the chair of our Subcommittee on Health.

Mr. Speaker, I yield as much time as he may consume to the gentleman from Florida (Mr. Bilirakis), who has worked so diligently and hard on this legislation.

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

Mr. Speaker, I thank the gentleman for his kind comments on this bipartisan legislation. I think it is another fine work product from the Energy and Commerce Committee in the area of healthcare, health research, and helping families cope with these terrible tragedies that befall us.

The Committee on Energy and Commerce, as you know, Mr. Speaker, has done a lot of good work this cycle. I am especially proud of their work on opioids and opioid addiction. Their investigative report now is public--over 300 pages of work--looking at how Americans got hooked on opioids, who is responsible, and what we should do going forward.

This legislation on H.R. 1222, the Congenital Heart Futures Reauthorization Act of 2017, is another very important piece of legislation. It too will save lives and bring hope to American families.

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

Mr. BILIRAKIS. Mr. Speaker, I rise today in support of H.R. 1222, the Congenital Heart Futures Reauthorization Act, as amended by the Senate, which will ensure continued investment in surveillance research to evaluate the lifelong needs of individuals with congenital heart defects, or CHD.

These surveillance efforts will help improve our understanding of CHD across the lifespan, from birth to adulthood. This research will help us learn more about demographic factors such as age, race, gender, or ethnicity.

In addition, the legislation emphasizes the need for continued biomedical research at the National Institutes of Health on the diagnosis, treatment, and prevention of CHD. NIH will further research into the causes of congenital heart defects, including genetic causes, and study long-term outcomes in individuals with CHD of all ages. NIH may study data to identify effective treatments and outcomes, and identify barriers to lifelong care for individuals with congenital heart defects.

CHD is the most common birth defect and the leading cause of birth defect-related infant mortality. For the Down Syndrome Community, about half of children born with Down Syndrome have CHD.

The road ahead may be scary and uncertain for any parent with a newborn who has CHD, but this bill gives hope to those coping with the diagnosis. Nearly 1 in 100 babies are born with CHD and more than five percent will not live to see their first birthday. Despite its prevalence and significance, there are still gaps in research and standards of care for CHD patients. But for the sake of the estimated 40,000 babies who will be born in the next year with CHD, there's more work to be done.

Mr. Speaker, I began on this journey almost ten years ago when then- Congressman Zack Space and I, first introduced the Congenital Heart Futures Act back in 2009. Last Congress, Congressman Schiff and I introduced the reauthorization of the original law.

During this time, I've met a lot of patients with Congenital Heart Defects, and I've been touched by their story. People like:

Trey and Nicole Flynn, a young Floridian couple, who lost their son Holden while waiting for a heart transplant--he was only 2 years old. This bill supports the essential research necessary to make sure another family doesn't have to leave the hospital without their child in their arms.

Lucas Iguina, a young man born with a complex congenital heart defect that essentially left him with half a heart. Despite having three open heart surgeries, and countless doctors' visits and medical procedures, Lucas has hopes and dreams. This bill ensures that the medical research will keep pace with his generation as they grow to be adults with this complex illness.

Jackson Radandt, born with half a heart. He has Hypoplastic Left Heart Syndrome, which means the left side of his heart was underdeveloped. He depended on life-saving research to help his failing heart survive until his heart transplant at age 11. He's about sixteen now and will live his life with a heightened sensitivity for his new heart.

Nicholas B., he was born with a complex heart disease and wasn't getting blood to the lower half of his body requiring heart surgery when he was just two days old. He's now in the top of his class and this bill will ensure that his future remains bright as he navigates this chronic illness through adulthood.

Abigail Adams, a young Florida advocate with Down Syndrome. Roughly half of the babies born with Down Syndrome have a congenital heart defect. Abigail continues to advocate for individuals with Down Syndrome.

My friend, Dave, born with pulmonary stenosis, a condition where a heart valve will not open properly. He had emergency open-heart surgery when he was 2 days old, another surgery at age 10, and many hospital visits and procedures in the meantime. Today, he is a husband and father, but lives with atrial flutter. This bill will continue the surveillance program so we can collect data on children and adults with congenital heart problems.

And Carolyn H., born with tetralogy of Fallot with pulmonary atresia. She had open heart surgery when she was 10 days old to repair her heart, but she will need periodic surgical updates to replace the cadaver artery. This bill continues the NIH research into why these defects occur.

These are just some of the patients that I've met over the years. Lastly, I want to thank some of the advocates that worked with me on getting this legislation passed.

I want to thank David Kasnic, Amy Basken, Dr. Brad Marino, Jessica Chenevert, and Dave Peluso from the Pediatric Congenital Heart Association.

I want to thank Mark Roeder, Danielle Hile, Johanna Gray, and Erika Miller from the Adult Congenital Heart Association.

Additionally, I want to recognize Vince Randazzo, Sara Weir, and Nicole Patton, from the National Down Syndrome Society and all their support.

I also want to thank many of the people that worked quietly behind the scenes, whose names are seldom mentioned, and who never get the recognition they deserve. People like Megan Perez, Kristin Seum, Shayne Woods, Katie Novaria, Adrianna Simonelli, Kristen Shatynski, Paul Edattel, Josh Trent, James Paluskiewicz, Peter Kielty, Karen Christian, Ryan Long, Mike Bloomquist, Ed Kim, Nolan Ahern, Ian Martorana, Macey Sevcik, and Elena Hernandez. This bill is a true team effort.

I urge swift House passage of this life-saving bill.

Mr. Speaker, I move to suspend the rules and concur in the Senate amendment to the bill (H.R. 6615) to reauthorize the Traumatic Brain Injury program.

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

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

Mr. Speaker, I rise in support of H.R. 6615, the Traumatic Brain Injury Program Reauthorization Act of 2018. I thank Representative Bill Pascrell of New Jersey for his good work on this important legislation. I am glad to support his efforts to bring another bipartisan public health bill forward for the full House to consider.

Mr. Speaker, the House unanimously passed a version of this bill just last week, and now that the Senate has made some technical changes, we are here to pass it once again and send it to President Trump's desk so it can become law.

H.R. 6615 will reauthorize the CDC's traumatic brain injury initiatives, and establish a national concussion surveillance system. This surveillance system will be able to accurately determine how many Americans, both children and adults, get a concussion each year, and the cause of that concussion. This data would provide real benefits to public health officials and patients in local communities and States across the country as we seek to better understand traumatic brain injury and best practices surrounding these injuries.

I know all too well from personal experience--I have a brother who was injured in a motorcycle accident and suffered pretty severe TBI--as somebody who has dealt with that, continues to, and works with men and women in uniform and those in my district, this is important legislation. It will help bring hope and better health outcomes for people who suffer from TBI and maybe even prevent a few of those injuries along the way.

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

Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Burgess), the chairman of our Subcommittee on Health, who has done so much work on the cause of good public policy related to healthcare.

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

Mr. Speaker, this is really important work. Again, I commend Mr. Pascrell for his incredible efforts on this initiative. I know it has taken 20 years. I might say, maybe it just took the right chairman of the Energy and Commerce Committee to get it done finally, but it is probably more than that.

But I just want to say, this will bring hope. It will bring better health outcomes and will save lives with this legislation as well.

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

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

Mr. Speaker, I move to suspend the rules and pass the bill (S. 2076) to amend the Public Health Service Act to authorize the expansion of activities related to Alzheimer's disease, cognitive decline, and brain health under the Alzheimer's Disease and Healthy Aging Program, and for other purposes.

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 in support of S. 2076, the BOLD Infrastructure for Alzheimer's Act.

I would like to thank Representative Brett Guthrie from Kentucky for his work to bring this bill to the House floor and for his terrific partnership as a member and real leader on our Energy and Commerce Committee.

Now, the BOLD Act is another bipartisan bill. It will enhance our Nation's public health infrastructure. It will improve lives for patients.

More than 5 million Americans have Alzheimer's. It is the most expensive disease in our country. It costs our health system hundreds of billions of dollars each and every year, and those numbers are only going up.

This legislation before us now will help us address those trends by establishing centers of excellence to improve coordination of care with local

public health departments for patients in our communities. These centers will increase data collection, analysis, and timely reporting to better inform researchers and policymakers across the country.

For patients and their families, early intervention and coordination of care provided at these centers can make the burden of Alzheimer's just a little bit lighter.

I have heard about the importance of the bill from Marya in Medford, who, in 2012, became one of the 180,000 Oregonians who serve as unpaid Alzheimer's caregivers for a loved one. In her case, that loved one was her father.

When her father was diagnosed, she was faced with not only a daunting system and difficult choices to make without information, but also an unexpected cost of care of $342,000, on average.

According to Marya, if passed, the BOLD Act would ensure States such as Oregon have the resources necessary to support earlier detection and diagnosis of Alzheimer's and help healthcare givers like her to grapple with this devastating disease.

Mr. Speaker, on behalf of patients and their families across our Nation, I urge my colleagues to join me in passing this important legislation as well.

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

Mr. Speaker, I want to commend the gentleman from New York for his leadership on this issue as well.

Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Burgess), so that he can speak on the legislation.

Mr. Speaker, I yield 2 minutes to the gentleman from Kentucky (Mr. Guthrie), another leader on healthcare in the Energy and Commerce Committee.

Mr. Speaker, I yield 1 minute to the gentleman from Florida (Mr. Bilirakis) to speak on the legislation.

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

Mr. Speaker, may I inquire as to how much time remains on each side.

Mr. Speaker, I yield such time as he may consume to the gentleman from Georgia (Mr. Carter), who is a pharmacist on our committee and a great leader on health issues on the Energy and Commerce Committee.

Mr. Speaker, I, too, join my friend and colleague from New York and our friends across the building in the Senate in support of the BOLD Act, S. 2076.

Mr. Speaker, I urge our colleagues to support it, and I yield back the balance of my time.

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

Mr. Speaker, I move to suspend the rules and pass the bill (S. 2278) to amend the Public Health Service Act to provide grants to improve health care in rural areas.

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

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

Mr. Speaker, I rise today in support of S. 2278, the State Offices of Rural Health Reauthorization Act led by Senator Pat Roberts and by my Energy and Commerce Committee colleagues Representative Markwayne Mullin of Oklahoma and my fellow Oregonian, Kurt Schrader, here in the House.

This important legislation reauthorizes and enhances Federal grants to States for improving healthcare in rural areas through the operation of State Offices of Rural Health.

Now, in my home State of Oregon, the Oregon Office of Rural Health has been the coordinating body for frontier health since the 1970s. This office partners with the Oregon Health & Sciences University to improve the delivery of statewide resources to rural areas, such as the Second District.

Telehealth, rotational programs for medical students in rural communities, and recruitment of healthcare providers are just a few examples of the Oregon Office of Rural Health's work to help patients in Oregon's rural areas.

I am proud of the great work that they do, and this bill will enhance their ability and those of all State Rural Health Offices to equip communities with the tools they need to strengthen the delivery of healthcare in rural and underserved areas.

So, Mr. Speaker, I strongly support passage of this legislation. I urge my colleagues to vote ``yes,'' and I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to the gentleman from Oklahoma (Mr. Mullin), who is a cosponsor of this very important legislation.

Mr. Speaker, I yield 3 minutes to the gentleman from Texas (Mr. Burgess), the chairman of the Subcommittee on Health.

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

Mr. Speaker, I, too, want to thank Members on both sides of the aisle, my colleagues who have worked so hard on this legislation, and, frankly, our friends in the Senate, as well, who worked with us on this. We are glad to bring this to a conclusion and another very important healthcare bill will make its way to the President's desk.

Mr. Speaker, I ask my colleagues to support this legislation, and I yield back the balance of my time.

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

Mr. Speaker, pursuant to section 1051 of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (P.L. 115-232), I withdraw the appointment of November 13, 2018, and I appoint the following individual to the National Security Commission on Artificial Intelligence:

Mr. Andrew R. Jassy, Seattle, Washington.

Mr. Speaker, I want to talk about the farm bill, the rule that allows us to bring this to the floor, and the lives I want to save in the West and across America, because this bill takes important steps to help improve the management of our Federal forests by extending expedited management tools for insect and disease projects in eastern Oregon and expanding it to hazardous fuels reduction to reduce the threat of fire and smoke. These are real life and safety issues in our communities.

The great tragedies we have seen in California this last summer, in Paradise this last fall, I guess, they are repeating themselves year after year as climate change and drought and higher temperatures and the overgrowth in our forests all come together to create catastrophic wildfires, as pictured here. These are monsters when they fire up. They kill.

It is unfortunate that the provisions that the House passed as part of the farm bill were rejected by the Democrats in the Senate. It is unfortunate because, after these catastrophic fires, we should get in and be able to remove the fuel load so that the next fire doesn't burn even more intensely, which is what happens. It is a bigger threat to the firefighters, because these snags that remain are destined to fall. This year, we lost a firefighter to a snag that fell.

But they rejected that.

While we are expanding CE authorities, categorical exclusion authorities, in some forests, the House provision said we should expand it to all forests so that we can begin to catch up and remove the excess fuel load from our forests, so that when we do get fire, which is a natural part of environment, it does not become so destructive that it burns up entire towns.

Unfortunately, again, Senate Democrats rejected that.

So we are left with a bill that is pretty good. The farm bill provisions are terrific, as the leader has said.

But when we are losing towns, and people and firefighters in our communities are choked with smoke, we can do better.

Last night, in Medford, Oregon, the Jackson County Commission held a public meeting to talk about this fire situation we face. A dad from Jackson County recounted how his daughter with cystic fibrosis had to move away. He told the audience: ``It's been devastating for us as a family. We wish our daughter could live with us.'' Then he went on to say: ``When you can't breathe, nothing else matters.''

So you want to talk about life and safety and health issues in America, we should have done better with the Senate. But we are doing okay with this bill, and I intend to support it.

Today I rise in support of the underlying legislation: the 2018 Farm Bill.

This bill takes steps to help improve the management of our federal forests by extending expedited management tools for insect and disease projects in eastern Oregon and expanding it to hazardous fuels reduction to reduce the threat of fire and smoke.

We've also allowed more local involvement from counties in forest management projects and extended funding for collaborative forest projects.

These all help, but it is unfortunate the Senate Democrats rejected provisions from the House bill that would have greatly reduce the threat of fires and smoke in all of Oregon.

The ability to clean up the burned dead timber after a fire-- responsibly and where it makes sense--and replant a new, healthy forest for the next generation? Excluded.

Providing tools that help manage our forests in western and southern Oregon--where some of Oregon's worst fires have been in recent years? Excluded, even after devastating fires like the Klondike Fire pictured here burned more than 175,000 acres.

People in southern Oregon are tired of choking on smoke every year because of poor management. Recently a dad from Jackson County recounted how his daughter with cystic fibrosis had to move away saying ``it's been devastating for us a family. We wish our daughter could live with us.'' But, as he went on to say, ``When you can't breathe, nothing else matters.''

You can understand people's disappointment when they see little here to help their region, while efforts continue to lock up more southern Oregon forests as more wilderness--a contributor to several large fires in recent years.

As someone from Medford told me last night, if something doesn't change, ``We're gonna get killed.''

Meanwhile, in central Oregon, the 5,000 residents of Crooked River Ranch are worried they will become the next Paradise, California. We've worked together on a simple public safety bill to make a small adjustment to a neighboring Wilderness Study Area so critical fire prevention work can be done to protect the community.

Our bill passed the House unanimously, passed a Senate Committee unanimously, has broad support from the local community, and is ready to be voted on today.

Unfortunately, partisan posturing in the Senate is holding this critical public safety bill hostage over unrelated public lands measures.

The Senate needs to stop playing with fire and the lives of people of Crooked River Ranch, and pass my legislation before the end of this Congress. We do not want to see images of homes turned to ash and lives destroyed in central Oregon all because politics got in the way of protecting lives.

Mr. Speaker, I thank Mr. Barton for his great leadership on the ACE Kids Act. I know this has been something he has been dedicated to for many years, and I am glad we could get this worked out and to the floor today. In fact, Mr. Speaker, these bills add to the 129 that the Energy and Commerce Committee has passed across this House floor.

Mr. Speaker, 92 percent of those bills have been bipartisan. I don't think the American people know that, because when we get along and do things, it doesn't get much coverage. But most of our work, 92 percent of our bills have been bipartisan, plus these today. 28 of those measures have become law.

I rise in strong support of this bipartisan H.R. 7217, which includes a number of different policies to improve and bolster the Medicaid and Medicare programs for vulnerable patients across our country, Mr. Speaker.

I recognize Joe Barton and our colleague, Kathy Castor from Florida, who I know is going to speak in a moment. They have just worked relentlessly on the ACE Kids Act. This is an important bill, and it is included in this package and one I am proud the House will advance forward today.

They both should be commended for their work because, you see, Mr. Speaker, the ACE Kids Act is bipartisan. It is cost-effective legislation. It provides children and their families the treatment and coordinated care they so desperately need and deserve.

Representative Barton, former chairman of the committee, has long been a champion on this issue, and, again, I thank him for his tireless efforts to advocate for improving care for our Nation's sickest children.

This bill also extends two key Medicaid programs: the Money Follows the Person Demonstration Program and the spousal impoverishment rules in Medicaid, both of which were due to expire or be out of money by the end of the year.

I am disappointed we weren't able to secure a longer term extension of these programs. I know many of my colleagues share that disappointment. Both sides negotiated in good faith, though, on how to pay for an extension, and I hope that the bipartisan work on the long- term bill will continue early in the new Congress. Today, we are moving forward with a 3-month extension to prevent these programs from expiring.

Finally, this package includes a small but critically important Medicare fix to ensure disabled seniors have access to necessary mobility devices, and that is fully offset and paid for.

Further boosting our efforts to advance public health, we have four other bills before us today. Collectively, these bills reauthorize several important programs, promote safe motherhood, and improve patient care.

Lastly, we will consider H.R. 6140. That is the Advanced Nuclear Fuel Availability Act. This bill, as you already know, Mr. Speaker, directs the Secretary of Energy to establish a program to make high-assay, low- enriched uranium available for use in the first-of-a-kind advanced nuclear reactor designs. This fuel will enable the development and deployment of a new generation of innovative nuclear technologies.

Nuclear energy is the largest source of emissions-free electricity in the United States, so a strong U.S. nuclear energy policy can ensure a reliable, clean U.S. energy sector for years to come and provide American families and businesses with affordable energy.

In closing, Mr. Speaker, I thank Ranking Member Pallone, Mr. Green, and the other members of the Energy and Commerce Committee. I urge my colleagues to support passage of all of these bills, especially H.R. 7217, on behalf of patients in Oregon and all across our country.

Mr. Speaker, I rise today to recognize Terran Renee Tyler for her poem entitled, Daddy, I Love You, Welcome Home. Terran is from Grants Pass, Oregon, and wrote this poem after joining an Oregon Honor Flight to the nation's capital with a group of World War II and Korean War veterans. She wrote this poem in honor of her father, SPC Tony Ryan Tyler, United States Army, and all veterans who lost their lives in service to our country in uniform. I'd like to include in the the Record the text of the poem.

Dear Stranger, I look around and take a deep breath staring

up at the sky at another sunset. The band starts to play as

another flag is raised over a fallen hero's grave. Nameless,

faceless His story remains untold--Who is this stranger who

died for me at just 28 years old? What were his hopes, his

dreams? What did he have to go through so I could be free? So

I could make my dreams a reality?

Dear Stranger, I may never know who you are, But I want to

thank you from the bottom of my heart, For every trial that

tested your strength, And for every time you've lost your

way, Thank you for all your tears and strife, Now here I sit

at the end of a very hard life, I know there are many others

out there like you, And for each one this word rings true,

*Hero*, For no two stories are ever the same, And you don't

even know many of these people's names, Like you, they are

strangers just the same, Nameless, faceless, Yet driven by

the fear in their eyes, You chose to stand and fight, It

didn't matter that you too were afraid; It only mattered what

was right, A false hero wouldn't have stayed, He wouldn't

have willingly welcomed the grave, Thank you all heroes young

and old, The men and the women, The living and the dead, For

every one of your stories untold. For each hero, a million

tears could be shed, But my dear stranger, I would rather

celebrate you instead.

I finish my letter and tear it up, Then I toss it to the

ground, as the wind picks up, Scattering the pieces. The

sky's grown dark, And the stars are out, My dear stranger,

are you up there now? Are you looking down on me, laughing,

crying, smiling? Gazing out over the cemetery, I suddenly

see, A million buried heroes, standing in uniform by their

beds. They're each smiling, and one by one bowing their

heads. As soon as I blink though, they all fade away, Leaving

one lone hero standing by a grave. He salutes and looks me

hard in the eye, I run to hug him, then start to cry, The

wind whispers his name in my ear, The one etched in my heart,

that I've longed to hear. Though I know I'm really standing

there alone, I can't help but whisper, ``Daddy I love you,

welcome home''.

In memory of SPC Tony Ryan Tyler, United States Army.

I ask my colleagues to join me today in thanking Terran for her thoughtful words recognizing the sacrifice of America's brave service members and their families. We owe them a profound debt of gratitude for their heroism in the defense of the freedoms and liberties we cherish as Americans.

Mr. Speaker, I rise in support of H.R. 6753, the Health Care Fraud Prevention Task Force Act. This bipartisan bill--which I introduced with Ranking Member Frank Pallone, and is supported by Ways and Means Chairman Kevin Brady and Ranking Member Richard Neal--passed the Energy and Commerce Committee unanimously earlier this year. This will be the 132nd bill that our committee has passed this Congress, 92 percent of which have been bipartisan just like this one. I look forward to continuing in that vein over the next two years.

By passing this bill, we will be codifying a program that already works. The Centers for Medicare and Medicaid Services (CMS) currently operates the Health Care Fraud Prevention Partnership--a voluntary collaboration between the federal government, state agencies, law enforcement, private health insurance plans, and anti-fraud associations. Together, this group works to detect and prevent fraud that threatens to undermine our nation's health care system. This program was created by the Obama Administration, and the Trump Administration has recommended codifying it into law. The bill before us today does just that, also strengthening and expanding the scope of partnership's work.

Mr. Speaker, I urge passage of this commonsense, bipartisan bill to improve the integrity of our nation's health care system.

Mr. Speaker, I thank my colleague from Washington State for bringing this rule to the floor and addressing this issue. It is literally one of great importance in my district and in the West.

Mr. Speaker, I rise in strong support of the underlying bill, the Manage our Wolves Act, because we need to clarify the management of wolves in Oregon and put us on a path to follow the locally State- written Oregon wolf plan.

For years, Mr. Speaker, ranchers across my district have watched as wolf packs have grown. They harass cattle herds and they kill livestock and they are brutal.

When you lose a heifer, you don't just lose one cow. You have lost 10 years' worth of calves that will never be born and that will never be able to be sold. Those that aren't killed are harassed, often losing weight and value. They are chased all over by the wolf packs.

The cattle and sheep these ranchers raise are their livelihoods. Every day--sun, rain, or snow--they raise and care for these animals.

When a first-time mom is struggling to feed a new calf, the rancher nurtures them, sometimes even literally bringing them into their own home next to the wood stove to warm them up and keep the calf alive in the winter. That care makes it all the harder to come upon a calf that has been torn apart by wolves.

If you are of young age, or whatever, I would just give you a fair warning that this is a graphic picture of what happens when a wolf gets ahold of a calf.

A rancher wrote me earlier this year that three of her calves were attacked, and she described them as ``wild-eyed with terror after being mutilated by wolves . . .''--just like this one you see here from a calf that was killed by wolves in Wallowa County, ripped apart.

This rancher went on to write, ``the rush of emotions one feels when you see an animal you have nurtured crying for help, panic in their eyes, searching for escape,'' she said no one wants to see that and described it as watching your worst horror movie in slow motion.

Now, the ranchers have done a lot in this effort. They have watched as attacks continue, though, despite their efforts to implement largely ineffective, nonlethal control techniques they were asked to do. Meanwhile, the issue at the heart of this matter is that there are arbitrary lines on a map that created a jurisdictional mess in my State of Oregon where wolves in eastern Oregon are managed by the State, and right across this highway they are managed by the Federal Government.

Today's legislation that we will consider fixes that by ensuring that all wolves in Oregon are removed from the Federal endangered species list. This would then return the management to the State and allow wolves, like other wildlife, to be managed under collaboratively developed Oregon law.

There are still challenges with State management; there is no doubt about that. We have seen times when the Oregon Fish and Wildlife Service has been slow to take action and implement the hard-fought agreements in the wolf plan to help prevent predation and control the wolf packs.

The State needs to step up and uphold thes agreements, but those are issues we can work out as Oregonians. The last thing we need, however, is the Federal Government trying to micromanage wolves from thousands of miles away.

This legislation that, hopefully, we are able to bring up because of this rule will get the Federal Government out of the way, will simplify the jurisdiction, and will place all wolves in Oregon under the State management plan.

Mr. Speaker, I strongly urge my colleagues to join me in supporting the rule and the underlying legislation.

Mr. Speaker, pursuant to section 1051 of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (P.L. 115-232), I appoint Mr. Greg Zerzan of Alexandria, Virginia, to the National Security Commission on Artificial Intelligence.

Mr. Speaker, I move to suspend the rules and agree to the resolution (H. Res. 1099) providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment.

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

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

I have dozens and dozens of letters of support for this legislation; 90 or 100 different letters of support from different groups, 124 names, it looks like, that I will include in the Record.

Statements and Letters of Support from:

U.S. Chamber--Key Vote Alert, American Society of Addiction

Medicine--Statement, Advocates for Opioid Recovery--advocacy

e-mail, Corporate Health Care Coalition--support letter,

First Focus Campaign for Children--statement, National

Association for Behavioral Healthcare--Statement, National

Association of Community Health Centers--Letter, Catholic

Health Association--Letter, American Benefits Council--

Letter, A Coalition letter signed by 124 addiction advocacy

groups:

1. A New PATH, San Diego, California

2. Addiction Policy Forum

3. AIDS United

4. Alabama, Addiction Policy Forum

5. Alaska, Addiction Policy Forum

6. American Correctional Association

7. Arizona, Addiction Policy Forum

8. Association of Prosecuting Attorneys

9. Beyond Addiction Ministry, WI

10. Brave Health

11. CADA of Northwest Louisiana

12. California Consortium of Addiction Programs &

Professionals (CCAPP)

13. California, Addiction Policy Forum

14. Campaign for Youth Justice

15. Caron Treatment Centers

16. CFC Loud N Clear Foundation, Farmingdale, New Jersey

17. Chicago Recovering Communities Coalition, Chicago,

Illinois

18. Colorado, Addiction Policy Forum

19. Community Anti-Drug Coalitions of America (CADCA)

20. Connecticut Certification Board

21. Connecticut Community for Addiction Recovery (CCAR),

Hartford, Connecticut

22. Connecticut, Addiction Policy Forum

23. COPES

24. DarJune Recovery Support Services & Cafe, Green Bay,

Wisconsin

25. Delaware, Addiction Policy Forum

26. Delphi Behavioral Health Group

27. DisposeRx

28. El Paso Alliance, El Paso, Texas

29. Faces & Voices of Recovery

30. FAVOR Low Country, Charleston, South Carolina

31. FAVOR Tri-County, Rock Hill, South Carolina

32. FedCURE

33. Fellowship Foundation Recovery Community Organization,

Margate, Florida

34. Floridians for Recovery, West Palm Beach, Florida

35. Foundation for Recovery, Las Vegas, Nevada

36. Friends of Emmett

37. H.O.P.E.S. Forever

38. Healthcare Leadership Council

39. IC & RC

40. Idaho, Addiction Policy Forum

41. Illinois Association of Behavioral Health

42. Illinois, Addiction Policy Forum

43. Indiana, Addiction Policy Forum

44. Institute for Behavior and Health (IBH)

45. Iowa, Addiction Policy Forum

46. Jackson Area Recovery Community, Jackson, Michigan

47. Kansas, Addiction Policy Forum

48. Kentucky, Addiction Policy Forum

49. Kingston NH Lions Foundation

50. Lifehouse Recovery Connection, San Diego, California

51. Maine Alliance for Addiction Recovery, Augusta, Maine

52. Maine, Addiction Policy Forum

53. Maryland House Detox

54. Maryland, Addiction Policy Forum

55. Massachusetts, Addiction Policy Forum

56. Michigan, Addiction Policy Forum

57. Minnesota Recovery Connection, Minneapolis, Minnesota

58. Minnesota, Addiction Policy Forum

59. Missouri Recovery Network, Jefferson City, Missouri

60. Missouri, Addiction Policy Forum

61. Montana, Addiction Policy Forum

62. National Association of Social Workers (NASW)

63. National Prevention Science Coalition

64. National Safety Council

65. Navigate Recovery Gwinnett, Gwinnett County, Georgia

66. Navigating Recovery of the Lakes Region, Laconia, New

Hampshire

67. Nevada, Addiction Policy Forum

68. New Hampshire, Addiction Policy Forum

69. New Jersey, Addiction Policy Forum

70. New Mexico, Addiction Policy Forum

71. New York, Addiction Policy Forum

72. North Carolina, Addiction Policy Forum

73. North Dakota, Addiction Policy Forum

74. Ohio Citizen Advocates for Addiction Recovery,

Columbus, Ohio

75. Ohio, Addiction Policy Forum

76. Oklahoma, Addiction Policy Forum

77. Oregon, Addiction Policy Forum

78. PEER Wellness Center

79. PEER360 Recovery Alliance, Bay City, Michigan

80. Pennsylvania Recovery Organization, Achieving Community

Together (PRO-ACT), Philadelphia, Pennsylvania

81. Pennsylvania, Addiction Policy Forum

82. People Advocating Recovery, Louisville, Kentucky

83. Phoenix House Recovery Residences

84. PLR Athens, Athens, Georgia

85. Reality Check, Jaffrey, New Hampshire

86. Recover Wyoming, Cheyenne, Wyoming

87. Recovery Communities of North Carolina, Raleigh, North

Carolina

88. Recovery Community Connection, Williamsport,

Pennsylvania

89. Recovery Community of Durham, Durham, North Carolina

90. Recovery Data Solutions

91. Rhode Island, Addiction Policy Forum

92. ROCovery Fitness, Rochester, New York

93. Shatterproof

94. Smart Approaches to Marijuana Action (SAM Action)

95. SMART Recovery, Nationwide

96. Sobriety Matters

97. Solutions Recovery, Oshkosh, Wisconsin

98. South Dakota, Addiction Policy Forum

99. SpiritWorks Foundation, Williamsburg, Virginia

100. Springs Recovery Connection, Colorado Springs,

Colorado

101. Strengthening the Mid-Atlantic Region for Tomorrow

(SMART)

102. Tennessee, Addiction Policy Forum

103. Texas, Addiction Policy Forum

104. The DOOR--DeKalb Open Opportunity for Recovery,

Decatur, Georgia

105. The McShin Foundation, Richmond, Virginia

106. The Moyer Foundation

107. The Phoenix, Nationwide

108. The RASE Project, Harrisburg, Pennsylvania

109. The Solano Project, Fairfield, California

110. Treatment Communities of America

111. Trilogy Recovery Community, Walla Walla, Washington

112. Trust for America's Health

113. Utah, Addiction Policy Forum

114. Vermont, Addiction Policy Forum

115. Virginia, Addiction Policy Forum

116. Voices of Hope Lexington, Lexington, Kentucky

117. Voices of Recovery San Mateo County, San Mateo,

California

118. WAI-IAM, Inc. and RISE Recovery Community, Lansing,

Michigan

119. Washington, Addiction Policy Forum

120. Washtenaw Recovery Advocacy Project (WRAP), Ann Arbor,

Michigan

121. West Virginia, Addiction Policy Forum

122. Wisconsin Voices for Recovery, Madison, Wisconsin

123. Wisconsin, Addiction Policy Forum

124. Wyoming, Addiction Policy Forum

Mr. Speaker, I rise today in support of H.R. 6. This is the SUPPORT for Patients and Communities Act that your Energy and Commerce Committee has worked on diligently for nearly 2 years.

In my own case, in 10 roundtables throughout Oregon, I have heard from everyday people on the frontlines of this fight in our communities. They are the victims. They are the families. They are medical providers and treatment advocates. They are local law enforcement, and they are first responders. They are our neighbors. They are our loved ones.

Each of these people puts a name and a face to what I would say is the worst drug epidemic we have seen in America, the opioid crisis.

I have heard from Oregon families, I have heard from Mike and Winnie, from Grants Pass, who have seen their loved one struggle with addiction. Mike's sister who died, she was a nurse, became addicted, and overdosed. He told me that at a townhall in a community forum. Their son struggles with his addiction to this day from a sports injury starting with opioids, ending with heroin.

We will never know what could have become of the 72,000 Americans who died last year.

Every 24 hours, 1,000 people go to emergency rooms overdosing from opioids. Roughly 115 die.

I heard it from Paula, whose two sons and stepson struggle with their opioid addiction today.

As a parent, I can only imagine what parents of children with opioid addiction must feel every time the phone rings. They think it may be that call.

For the millions of people currently struggling with addiction, please know, don't give up. It is never too late to seek help. We stand with you.

Mr. Speaker, this legislation is a product of months of bipartisan, bicameral work, eight House committees involved, I think probably every Member of this House, five Senate committees, dozen and dozens of Members of Congress.

And the faces that we came to know are the parents and the children whom they lost, Amanda Beatrice Gray being one of them, a beautiful young woman, talented, struggling with her issues, overdosed on heroin heavily laced with fentanyl.

We are here for them, Mr. Speaker. We are here for our neighbors, for our

loved ones, who deal with this crisis every day of their life, and in the great joined cause of those who lost.

Mr. Speaker, because we are going to hear from a lot of our Members who have put so much work into this, I reserve the balance of my time.

Mr. Speaker, I am honored to yield 1 minute to the gentleman from Texas (Mr. Brady), the distinguished and talented chairman of the House Ways and Means Committee.

Mr. Speaker, I yield 30 seconds to the gentlewoman from Indiana (Mrs. Brooks), and concur in my colleague's comments in praise of the staff that we worked with to get this done. The gentlewoman has been a real leader.

Mr. Speaker, it is my great honor and high privilege to yield 1 minute to the gentleman from Wisconsin (Mr. Ryan), the Speaker of the House and my dear friend and classmate from the class of `98.

Mr. Speaker, I yield 1 minute to the distinguished gentleman from Texas (Mr. Burgess). The country is well served by his chairmanship of the Subcommittee on Health.

Mr. Speaker, it is now my privilege to yield 30 seconds to the gentleman from Ohio (Mr. Latta), the very effective chairman of our Digital Commerce and Consumer Protection Subcommittee.

Mr. Speaker, I am privileged to yield 30 seconds to the gentleman from New Jersey (Mr. Lance).

Mr. Speaker, I am privileged to yield 30 seconds to the gentleman from Kentucky (Mr. Guthrie).

Mr. Speaker, I yield 30 seconds to the gentleman from Florida (Mr. Bilirakis) to speak about the legislation.

Mr. Speaker, I yield 30 seconds to the gentleman from Ohio (Mr. Johnson), who is a leader on this issue.

Mr. Speaker, I yield 30 seconds to the gentleman from Indiana (Mr. Bucshon), who is a talented physician on our committee.

Mr. BUCSHON: Mr. Speaker, I rise today in support of H.R. 6, the SUPPORT for Patients and Communities Act.

This bipartisan bill will help our struggling communities to combat the opioid epidemic by increasing access and improving care to those in need and preventing new occurrences of opioid misuse and abuse.

Section 2002, which I authored, would provide screening for chronic pain, address possible non-opioid pain alternatives, and increase early detection of opioid use disorder in seniors as they enter Medicare.

Mr. Speaker, I am proud to have worked with my colleagues on solutions to this serious epidemic, and I urge support of H.R. 6.

Mr. Speaker, I yield 30 seconds to the gentleman from Michigan (Mr. Walberg) to speak on the measure.

Mr. Speaker, I yield 30 seconds to the gentleman from Georgia (Mr. Carter), who is our resident pharmacist on the Energy and Commerce Committee.

Mr. Speaker, I yield 30 seconds to the gentleman from Illinois (Mr. Roskam).

Mr. Speaker, I am honored to yield 30 seconds to the gentleman from Minnesota (Mr. Paulsen), who has worked so hard for these issues.

Mr. Speaker, I yield 30 seconds to the gentleman from Ohio (Mr. Renacci) to speak on the measure.

Mr. Speaker, may I inquire as to how much time each side has remaining?

Mr. Speaker, I yield 30 seconds to the distinguished gentleman from Michigan (Mr. Bishop.)

Mr. Speaker, few States have been harder hit than Kentucky in this effort on opioids, a terrible tragedy.

Mr. Speaker, I yield 30 seconds to the distinguished gentleman from Kentucky (Mr. Barr).

Mr. Speaker, I yield 30 seconds to the gentleman from Pennsylvania (Mr. Barletta). There is a lot of enthusiasm for this legislation, Mr. Speaker. We want to hear from Mr. Barletta about his thoughts on it. He has been a real leader on it.

Mr. Speaker, I yield 30 seconds to the gentlewoman from California (Mrs. Mimi Walters) who is from the West Coast and is a real leader on our committee.

Mr. Speaker, I yield 30 seconds to the gentlewoman from Indiana (Mrs. Walorski), who is also a real worker on this legislation, to speak on the measure.

Mr. Speaker, I yield 30 seconds to the gentleman from Michigan (Mr. Mitchell).

Mr. Speaker, we have heard from doctors, we heard from pharmacists, and we have heard from many family members. Now we will hear from somebody who has a distinguished career in law enforcement.

Mr. Speaker, I yield 30 seconds to the gentleman from California (Mr. Knight) to speak on this legislation.

Mr. Speaker, I yield 30 seconds to the gentleman from Virginia (Mr. Brat) to speak on the measure.

Mr. Speaker, I don't believe I have any other speakers on my side of the aisle pending, so with that, I reserve the balance of my time.

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

Mr. Speaker, before I close, I want to especially thank our staff on both sides of the aisle for their incredible work. They have worked day and night, literally, and all through the weekend--also, the folks at the Congressional Budget Office and Legislative Counsel. But I especially thank our team: Josh Trent, Kristen Shatynski, Caleb Graff, Dan Butler, James Paluskiewicz, Danielle Steele, Adam Buckalew, Melissa Froelich, Bijan Koohmaraie, Ryan Long, Peter Keilty, and Jenn Sherman, and the whole team at the Energy and Commerce Committee on both sides of the aisle.

We worked through a lot of difficult issues, issues where we didn't start on the same side, but we ended on the same page as we listened to each other, as we listened to our constituents at home.

Seldom are there times when you are legislating that you can say what you are doing will actually save lives. This is one of those times. What we are doing here today is saving lives.

We will lift people out of addiction who are trapped there today. We will prevent people from ending up in that emergency room because they overdosed. Maybe they will find a better path. We will go after those who perpetrated this on the country and after those who try to smuggle in the illicit synthetics and fentanyl that are cut with heroin and kill our people.

So today's effort is about people like Amanda, who left this world tragically

at a very young age through an overdose. And it is about her parents. It is about Mike and Winnie. It is about Paula, and it is about her sons and sister. It is about a woman I met in Hermiston who had to travel 5 hours to find a physician who could oversee her treatment on Suboxone because nobody was available. We help fix that in this legislation.

It is about my friends at Winding Waters in Enterprise, Oregon, who I was with last week, and the sheriff and others, who talked about the continuing problems and challenges they face and who have given me great guidance on these and other issues.

From one end of my district to another, from one end of our country to another, we have all listened. We have heard. Frankly, we have cried as we have heard the stories of parents who help their children through addiction, only to drop them off at college and a matter of days later retrieve a body.

That is what brings us together here today, Mr. Speaker. It is their stories that are woven deeply into this legislation. It is because of them that we will make a difference and we will do it right.

We will know that, as we pass this today and the Senate after us, that more work does remain to be done. We are on a journey together, though, and we will find solutions.

Mr. Speaker, I thank my colleagues on both sides of the aisle. I thank our staffs. I thank the American people who have reached out to us, counseled us, and helped us.

Mr. Speaker, I urge my colleagues to strongly support passage of the SUPPORT Act. For patients and for communities, H.R. 6 needs to become law, and it will shortly.

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

Mr. Speaker, I include the following letters in the Record.

Corporate Health Care Coalition,

September 26, 2018.

Hon. Paul Ryan,

Speaker, House of Representatives,

Washington, DC.

Hon. Mitch McConnell,

Majority Leader, U.S. Senate,

Washington, DC.

Hon. Nancy Pelosi,

Minority Leader, House of Representatives,

Washington, DC.

Hon. Charles Schumer,

Minority Leader, House of Representatives,

Washington, DC.

Dear Speaker Ryan, Leader McConnell, Leader Pelosi and

Leader Schumer: The Corporate Health Care Coalition (CHCC) is

writing to commend both the House of Representatives and the

Senate on finalizing the SUPPORT for Patients and Communities

Act (H.R. 6), bipartisan legislation to address the nation's

opioid crisis. CHCC is comprised of companies from varying

industries that compete in the global marketplace and sponsor

health plans for the benefit of our employees and other

beneficiaries. Collectively, CHCC member companies provide

health benefits for nearly 5 million Americans across every

state in the nation.

The depth and devastation associated with the opioid crisis

is being felt by families and communities nationwide. CHCC

therefore applauds lawmakers for working on a bipartisan

basis to reach consensus on H.R. 6, which represents a

critical step forward in providing necessary resources for

treatment and prevention efforts related to opioids.

We urge the House and Senate to pass this important

legislation.

Sincerely,

Corporate Health Care Coalition.

Mr. Speaker, I include the following letters in the Record.

American Benefits Council,

Washington, DC, September 27, 2018.

Hon. Mitch McConnell,

Majority Leader, U.S. Senate,

Washington, DC.

Hon. Chuck Schumer,

Minority Leader, U.S. Senate,

Washington, DC.

Hon. Paul Ryan,

Speaker, House of Representatives,

Washington, DC.

Hon. Nancy Pelosi,

Minority Leader, House of Representatives,

Washington, DC.

Dear Leader McConnell, Leader Schumer, Speaker Ryan and

Leader Pelosi: The American Benefits Council (the Council)

supports the Substance Use-Disorder Prevention that Promotes

Opioid Recovery and Treatment (SUPPORT) for Patients and

Communities Act (H.R. 6). We urge Congress to approve this

measure as an important step toward addressing the nation's

opioid addiction crisis.

The Council is a public policy organization representing

principally Fortune 500 companies and other organizations

that assist employers of all sizes in providing employee

benefits. Collectively, the Council's members sponsor

directly or provide services to retirement and health plans

covering over 100 million Americans.

The opioid epidemic has touched workers and families across

the country and employers have been on the front lines of

this battle, striving to stem the tide of prescription drug

abuse through innovative plan design and outreach. A Kaiser

Family Foundation analysis found that the use of prescription

opioids among people with employer-based health coverage

declined in 2016 to its lowest levels in over a decade.

Nevertheless, the annual cost of treating addiction and

overdoses has increased more than eight-fold since 2004, from

$0.3 billion dollars to $2.6 billion in 2016, and pain-

related conditions have resulted in up to $635 billion in

medical costs and lost productivity for employers.

H.R. 6 makes a number of important improvements to current

law by reducing the use and supply of opioids, encouraging

recovery, supporting caregivers and families and driving

innovation and long-term solutions to the opioid addiction

epidemic. The bill also imposes tighter control on opioid

prescription and treatment under the Medicare and Medicaid

programs while also clarifying FDA regulation of nonaddictive

pain and addiction therapies and allowing for more

flexibility with respect to medication-assisted treatment.

We are particularly pleased that the conference committee

wisely excluded from the bill a harmful, unrelated provision

that would have revised the Medicare secondary payer rules to

require private insurers--including employer plans--to pay

for an additional three months of care for end-stage renal

disease (ESRD) patients before Medicare assumes

responsibility for the payments.

The Council strongly opposed this provision, as employers

already shoulder significant costs for workers and family

members and should not be required to bear unrelated

additional costs by expanding the length of time plans must

cover ESRD.

We applaud Congress for developing legislation that will

make America healthier, including many of the 181 million

people covered by employer-provided health plans.

Sincerely,

James A. Klein,

President.

Mr. Speaker, I include the following letters in the Record.

September 26, 2018.

To The Members of the U.S. House of Representatives: The

U.S. Chamber of Commerce strongly supports the bipartisan

H.R. 6, the ``Opioid Crisis Response Act of 2018.'' The

Chamber will consider including votes related to this bill in

our annual How They Voted scorecard.

The opioid epidemic is ravaging families and destroying the

lives of thousands each year, and it is crippling

communities' and employers' efforts to staff workforce needs,

create new jobs, and expand commerce.

We applaud Congress for crafting comprehensive legislation

to tackle the myriad of causes, such as the flood of illicit

drugs into the United States, while removing a litany of

barriers that inhibit prevention, recovery, and treatment

options.

The Chamber is pleased that H.R. 6 does not include the end

stage renal disease (ESRD) provision included in an earlier

version of the bill. That policy would have burdened

employers already struggling to provide robust health

benefits with hundreds of millions of dollars in additional

health care costs.

While H.R. 6 is important, more remains to be done. The

Chamber urges Congress to address the 42 CFR Part 2 statute

as hundreds of health care organizations have called for.

Congress should align currently conflicting protections and

allow providers access to a patient's entire medical record,

including substance use disorder information, at a patient's

request.

We urge you to support H.R. 6.

Sincerely,

Suzanne P. Clark,

Senior Executive Vice President,

U.S. Chamber of Commerce.

Mr. Speaker, I include the following letters in the Record.

[From the American Society of Addiction Medicine]

Rockville, MD, September 26, 2018.

American Society of Addiction Medicine Applauds Inclusion of Key

Provisions in Historic Opioid Legislative Package

Key Provisions to Teach, Standardize, and Cover Addiction Medicine Will Help Close Treatment Gap and Save Lives, Addiction Medicine Experts Say

The American Society of Addiction Medicine (ASAM) today

applauds US House and Senate leaders for announcing a

bipartisan agreement on an opioid legislative package that

includes key provisions to bolster the country's addiction

treatment workforce, help provide standardized evidence-based

treatment for individuals with a substance use disorder

(SUD), and help ensure coverage and payment models facilitate

comprehensive, coordinated care for patients seeking

treatment for a SUD.

``On behalf of America's addiction medicine physicians and

other clinicians on the frontlines of this crisis, ASAM

applauds our Congressional leaders for working together to

include key provisions that will help close the current

treatment gap, bolster the addiction medicine workforce, and

save more lives,'' said Kelly J. Clark, MD, MBA, DFASAM,

president of ASAM. ``Reversing course on the deadly opioid

overdose crisis requires bold policy solutions that help

teach, standardize, and cover addiction medicine so more

patients benefit from evidence-based treatment. The agreement

reached last night is an important step toward realizing this

critical goal.''

Key provisions in the legislative package to teach,

standardize, and cover evidence-based addiction medicine

include:

Making permanent buprenorphine prescribing authority for

physician assistants and nurse practitioners and allowing

waivered practitioners to treat immediately up to 100

patients at a time (in lieu of 30) if the practitioner is

board certified in addiction medicine or addiction

psychiatry; or if the practitioner provides medication

assisted treatment (MAT) in a qualified practice setting.

Certain qualified physicians would also be allowed to treat

up to 275 patients at a time with buprenorphine, codifying an

existing rule;

Allowing physicians who have recently graduated in good

standing from an accredited school of allopathic or

osteopathic medicine, and who meet the other training

requirements during school to prescribe MAT, to obtain a

waiver to prescribe MAT;

Providing loan repayment relief to addiction treatment

professionals who practice in high-need areas;

Creating a Medicare demonstration program to increase

access to evidence-based outpatient treatment for

beneficiaries with opioid use disorder that includes

medication as well as psychosocial supports, care management,

and treatment planning;

Partially repealing the Institutions for Mental Diseases

(IMD) exclusion and allowing state Medicaid programs to cover

care in certain IMDs that can deliver services consistent

with certain requirements, including evidence-based

assessments and levels of care;

Directing the Departments of Justice and Health and Human

Services to finalize special registration regulations

concerning the prescribing of medications for addiction via

telemedicine within one year of enactment;

Expanding Medicare coverage to include payment for Opioid

Treatment Programs through bundled payments for wholistic

services;

Convening a stakeholder group to produce a report of best

practices for states to consider in health care related

transitions for inmates of public correctional facilities;

and

Requiring the Substance Abuse and Mental Health Services

Administration (SAMHSA) to provide information to SAMHSA

grantees to encourage the implementation and replication of

evidence-based practices.

``Substance use disorder is both treatable and

preventable--but from where we stand today, delivering high-

quality care to the millions of Americans who live with the

disease of addiction will require significant investments in

our workforce, coverage, and payment models that facilitate

coordinated and comprehensive care, and structural changes

that incentivize the use of evidence-based approaches,'' said

Clark. ``And while we celebrate this bipartisan announcement

today, ASAM knows there is still much more work to be done to

ensure all Americans living with a substance use disorder get

the treatment they need. ASAM will continue to advocate for

building an addiction treatment system that fully integrates

mental health, substance use disorder, and primary care

services in order to produce the best patient outcomes. This

includes supporting final passage of legislation that would

more closely align 42 CFR Part 2 with the Health Insurance

Portability and Accountability Act.''

For more information about the American Society of

Addiction Medicine, please visit www.ASAM.org.

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