Floor Statements

Mr. Speaker, Congress, Democrats and Republicans alike, came together to pass the American Relief Act of 2025, securing $12 billion to rebuild communities devastated by disaster. We made a promise to North Carolina, Florida, Texas, and Maui.

Mr. Speaker, that promise isn't just being broken. It is being ripped apart. What a slap in the face for those constituents when that funding to rebuild homes, businesses, and communities gets delayed or even withheld because the Musk-Trump administration plans to gut HUD's Office of Community Planning and Development, the very team responsible for getting billions of relief dollars to where they belong. It will be essentially eliminated. That isn't streamlining or efficiency. That is sabotage.

This week, I am proud to have led a bipartisan letter, signed by 47 Members of Congress, calling on this administration to not cut these critical positions.

We voted for this funding. Now, let's do our jobs and fight to make sure it gets to the people who need it most.

Mr. Speaker, I rise in strong opposition to the House Republican budget resolution, a blatant attempt to strip healthcare and food aid away from everyday Americans.

With up to $2.5 trillion in Medicaid cuts and $230 billion slashed from SNAP, this budget plan would leave millions of families and seniors without essential support. Rural America would suffer the most.

Nationwide, more than 12 million rural Americans rely on Medicaid, and SNAP participation is higher in rural areas than urban ones. In my home State of Hawaii, over 350,000 people rely on Medicaid, and nearly one in five depend on SNAP to eat. Rural Americans, who live in 181 of our congressional districts, red and blue, already face some of the harshest health disparities, living 3 to 10 years less than their urban counterparts. These cuts will only deepen such inequities and leave them with no safety net.

Let me be clear. These cuts will cost lives. These are not just numbers. They are real people. They are our neighbors, our grandparents, and our children. At a time when too many are struggling, Republicans are delivering tax breaks to billionaires on the backs of our working families.

Americans in rural America deserve better. Our country deserves better. I urge my colleagues to vote ``no.''

Mr. Speaker, last week, President Trump issued an illegal and unconstitutional order for the Federal Government to halt the flow of Federal funds. Shortly after, FEMA shut down its online portal used to distribute disaster assistance across the country.

As if that wasn't enough, President Trump wants the Federal Government to dissolve FEMA and push disaster response and recovery to the States.

These policies are not just alarming, they are downright terrifying for communities in Maui, Florida, North Carolina, Georgia, and now California, still trying to recover from recent disasters.

Ending FEMA will be catastrophic for small and rural communities and States across the country that do not have the financial and human resources to quickly and effectively respond to major disasters.

In their times of uncertainty and need, Americans deserve to know that the Federal Government will be there for them, no matter where they live.

They look to their government for help. Instead, Trump wants to abandon them. This is wrong, this is cruel, and I demand my colleagues, especially those representing disaster-impacted communities, oppose any funding freeze or delays and any efforts to dissolve FEMA. Americans deserve better.

Mr. Speaker, I rise today in solidarity and with much aloha for our Nation's Federal workers. As a member of the Labor Caucus, I am proud to stand with these essential employees who keep our government running every single day.

Federal workers care for our veterans, keep us safe when we travel, and make sure our seniors get the Social Security payments that they need to put food on the table and to survive.

Our Federal workers were also the ones who were first on the scene when fires ravaged Maui. They saved lives. They provided food and shelter and replaced documents. They gave our people hope.

Day in and day out, Federal workers are the unseen hands and hearts that guide our Nation through complex challenges and maintain the infrastructure and services that underpin daily life. They give our people hope and help.

When we attack Federal workers, we not only discredit their work, Mr. Speaker, but we cut off the very hands that are holding us up.

Since taking office, President Trump has made it his number one priority to undermine and dismantle our Federal workforce. Over the past 2 weeks, the Trump administration has been bullying Federal workers to resign while making a hollow promise of paying benefits through the end of the year. Now, President Trump is threatening mass layoffs to those who refuse to accept this bogus and deceptive offer.

We have 43,000 hardworking Federal employees in Hawaii. Many of these civil servants have contacted me to express their anger, frustration, and fear.

One constituent who spent his entire career with the Department of Health and Human Services said he had experienced several Presidential transitions but none as demeaning and demoralizing as this one. Once committed to a full career in public service, he now wakes up daily dreading the new abuses and attacks he and his colleagues will face.

Let us be clear: Federal workers are not the problem. They are part of the solution. They don't make decisions based on political whim. They don't serve a single master and his billionaire friends. They serve the people of this country.

The American people deserve a government that works for them, not against them.

To all the Federal employees in Hawaii and across this country: We see you. We hear you. We will fight to protect you. Thank you for your dedication and for your service. You are the quiet force that keeps our Nation strong. You have always had our backs. Now it is time we have yours.

Mr. Speaker, I rise today in strong support of H.R. 375, the Continued Rapid Ohia Death Response Act of 2025.

The ohia lehua tree forms the backbone of Hawaii's forest and watersheds making up 80 percent of our native forests. It is the very first tree that you will see spring up from a recent lava flow. It grows from sea level to 8,000 feet above, and it protects our communities by literally holding up our mountains from eroding, keeping them together.

Ohia lehua also provides critical habitat for Hawaii's federally endangered forest birds and many culturally important species.

These trees are a keystone species in Hawaii's forest, and it is catastrophic to see its decline. It has the potential to trigger major imbalances in our ecosystem that would impact watersheds, cultural traditions, natural resources, and the safety and quality of life of our people.

Because of the vital role they play in maintaining Hawaii's forest canopies and watersheds, rapid ohia death, or ROD, poses an existential threat to the ecological balance of our islands and the everyday life of our people.

Initially reported in 2010, ROD has already spread to tens of thousands of acres and killed over a million trees on Hawaii island alone. If you visited the Big Island of Hawaii where our volcano erupts from time to time, literally, we have lost a million trees just on that island. Large swaths of dead ohia trees leave environments more prone to habitat-modifying noxious weeds and trees like miconia and strawberry guava, all of which are known to harm watershed health and alter ecosystem functions.

Efforts to contain ROD have also failed to prevent its spread to the islands of Oahu, Kauai, and Maui. With no known cure for ROD, it has the potential to kill off ohia trees statewide and devastate our island ecosystems.

In addition to its impacts on delicate native ecosystems, ROD has the potential to create deadly consequences for our local residents and visitors alike. The death of tens of thousands of acres of native forests, turning them into brittle tinder, creates acres of deadly fire fuel for wildfires that pose a growing threat to our communities. One of the things that people love about Hawaii is the greenery and the vegetation in and around our communities. Tragically, we know all too well the risks that come when our greenery and vegetation are no longer green and the consequences that can happen as a result of fire.

Despite the dire implications of ROD on Hawaii's natural resources and communities, Federal support for combating ROD has been extremely limited. For example, the Lyon Arboretum, a local research facility on Oahu, relied on funding through a GoFundMe campaign to further the vital seed banking for ohia lehua.

My bill, the Continued Rapid Ohia Death Response Act, seeks to address ROD and the urgent threat that it presents. The bill requires the Department of the Interior to partner and collaborate with the Department of Agriculture and the State of Hawaii to address ROD. It also supports ongoing detection, prevention, and restoration efforts to combat rapid ohia death. By empowering the U.S. Forest Service and U.S. Fish and Wildlife Service to fully assist the State of Hawaii in its ROD efforts, we can begin to not only more effectively prevent the spread of ROD but move to restoring native forests throughout our State.

Mr. Speaker, I very much thank and send our sincerest ``mahalos,'' ``thanks'' to Chairman Westerman, Ranking Member Huffman, and their staff, especially the Federal lands team, for the support, assistance, and continued prioritization of this very important bill.

We cannot afford to wait. We cannot afford to stand alone and continue to lose our native forests in Hawaii. They protect and sustain our people and provide critical habitat for native species. This bill can also help to turn the tide in the fight against Rapid Ohia Death and, in doing so, protect and preserve ohia lehua and Hawaii's unique ecosystems for our future generations.

Mr. Speaker, I thank again all who have supported our bill, and I urge my colleagues to join me in voting ``yes.''

Mr. Speaker, I rise today to voice my deep concern and disappointment with the passage of H.R. 28.

As a mother of teenagers in public schools, I am appalled that instead of addressing urgent challenges, like the youth mental health crisis, gun violence in our schools, and the growing teacher shortage, this legislation diverts our attention to dangerous and divisive policies.

H.R. 28, under the guise of protecting fairness in sports and safety in schools, risks undermining the rights and dignity of girls and young women. Let me be clear: This bill threatens the very foundation of Title IX, the landmark legislation that, for over 50 years, has protected millions from gender-based discrimination in education.

Patsy Mink, the trailblazing Congresswoman who championed Title IX, understood the deep injustices women face in education and beyond. As a woman and a Japanese American, she fought so that her daughter and all future generations could pursue their dreams without fear of prejudice or exclusion. They fought this hard fight, and for us, this bill betrays her legacy and all of her efforts by turning back the clock on these hard-won rights.

Growing up, I experienced firsthand the pain of being bullied for the way I looked and being judged for not fitting traditional expectations of what a girl should look or act like.

I remember vividly being told by the school administrator: ``Tuck in your shirt, boy.'' I was just a middle schooler, tall for my age, wearing my hair short, and pants, not dresses. The shock and humiliation of that moment stayed with me, and it fuels my resolve that no child should ever be made to feel ashamed of being authentically who they are.

Our students already face incredible pressures and challenges. Instead of making their lives harder by policing their identities and questioning their worth, we should be supporting them, fostering environments where they can grow, thrive, and succeed as their true, authentic selves.

Transgender girls are girls. Transgender women are women. If we truly want to protect girls and women, we must stand for inclusion, dignity, and respect, not division and exclusion.

This isn't just about a policy. It is about our values. It is about ensuring that every student feels safe, seen, and supported. That is how we protect our children. That is how we honor the spirit of Title

Mr. Speaker, over the past 10 days, our Nation has watched with horror and sadness the harrowing scenes coming out of southern California, as these fires tore through homes, neighborhoods, and communities.

On behalf of my constituents who know the terror and trauma of wildfire all too well, I rise today in solidarity with our California and Los Angeles ``ohana,'' ``family,'' and I am outraged over the callous and heartless remarks that conditions should be applied to their aid.

Within days of our Maui fires, teams from CAL FIRE were by our side on the ground to help deliver relief and organize the cleanup.

In our hour of greatest need, they stood by us without expectation of any reward. They simply stepped up for their fellow Americans. They showed us in Hawaii aloha.

That is what we need to do as a nation, as one people. We help each other out in our times of need, regardless of where we come from, our beliefs, or how we vote. We as Members of Congress pledge to do this every single day when we convene for business: one nation, unconditionally, under God.

Now, in California's time of greatest need, the President-elect, the Speaker, and other colleagues here in the House want to impose policy conditions on Federal disaster aid.

Mr. Speaker, this will endanger innocent lives and delay the ability of our fellow Americans to rebuild and recover from this disaster.

Never before in our history has the Federal Government imposed conditions on disaster aid for its own citizens.

This is just more than unprecedented. To deny our fellow Americans the help they need after losing loved ones, their homes, and their businesses in their darkest hour because of political differences, it is not just cruel; it is immoral. It is un-American. It is not who we are as a country.

It is an affront to our most basic values, one that transcends any law or policy and lives at the core of our faith. We should do to others as we would do to us. We must love our neighbor.

Mr. Speaker, I ask my colleagues to join me and our fellow Americans in solidarity in delivering the aid that California desperately needs without political conditions.

In doing so, I urge my colleagues to do the right thing and stand up for our values as a Nation. Let us send the right message to the American people that their government of the people, by the people, and for the people will always stand by them unconditionally, no matter what.

Mr. Speaker, this is my 30th Maui minute. After months of delay, three successive requests from President Biden, and unnecessary anxiety for millions of Americans courtesy of the richest man in the world, Congress will now finally send much-needed disaster recovery funding across the country.

For over a year, I have led bipartisan efforts pushing to deliver this aid to Maui. We have delivered speeches in this Chamber and we have sent letters to leadership to introduce amendments that were blocked.

Finally, we got this done. This disaster recovery package will provide a much-needed boost to meeting all our people's needs. The package will send over $2.1 billion in Federal disaster relief to Hawaii, including about $1.6 billion in the Community Development Block Grant Disaster Recovery Fund, or CDBG-DR, $350 million to rebuild drinking water and wastewater infrastructure, and $72 million to rebuild roads and bridges. It will replenish the Small Business Administration's disaster loans program so homeowners and small businesses can continue to recover.

For my Maui constituents still recovering from the deadly fires, it has been far too long of a wait, but our work will not stop here. We will use these dollars to rebuild housing and infrastructure, restore our `` `aina,'' ``land,'' and bring our Maui `` `ohana,'' ``family,'' home.

Mr. Speaker, I rise today to congratulate my friend, Commander Kevin Dore, on the successful completion of his command of the USS Daniel Inouye. Under his leadership, the USS Daniel Inouye embarked on its maiden deployment, a 9-month tour that demonstrated the strength, skill, readiness, and resilience of our Navy.

Initially deployed to the Pacific, the USS Daniel Inouye's, mission was extended when tensions in the Middle East flared. Commander Dore and his crew rose to the occasion and headed to the Red Sea where they exemplified our Nation's commitment to helping others in need when they provided timely rescue assistance to Iranian mariners in distress.

I wish Kevin fair winds and following seas wherever life may take him. Please know that for all he has done for our State and our country, he will always be a ``son of Hawaii,'' ``kamaaina,'' and Hawaii will always be his home.

I say to Erin and the kids, John-Michael, Andrew, Lily, and Samuel, ``thank you,'' ``mahalo'' for sharing your husband and father with us and for being the rock of support he has always needed to truly go for broke.

Mr. Speaker, the last-minute effort to deny critical healthcare to military children diagnosed with gender dysphoria is a shameful attack on military families who deserve better from their elected Representatives.

Our military families deserve our support for the sacrifices they make, not our intervention into their deeply personal healthcare decisions, and certainly not those involving their children.

For transgender people, gender-affirming care is healthcare. To deny them this care is to deny that they exist. The reality is that they do exist, and there are thousands of military families with transgender children. There are 15,000 transgender individuals who wear the uniform. They deserve, like any child in our country, to be their true, authentic selves and to receive the care that helps them to live freely.

As a mother, I cannot idly stand by and vote to deny healthcare to children who need it, nor can I stand by while my colleagues use transgender people to score cheap political points.

To pass a bill dedicated to the quality of life of military families while stripping away healthcare from their children is not just ironic, but it is twisted, cruel, and plain wrong.

Mr. Speaker, I urge my colleagues to join me in voting against the NDAA so that we can remove this discriminatory provision and truly, truly stand with our military families.

Mr. Speaker, for millions of our fellow Americans, Thanksgiving is about returning home, a time to gather with loved ones in a place both familiar and safe.

On my way back to Hawaii for the Thanksgiving recess, with long delays and packed airports and planes, it hit me for too many of our Maui ``family,'' ``ohana,'' this is but a sliver of what they have been trying to do for the past 16 months. They are just trying to go home.

A week before Thanksgiving, I joined the Folaumoeloa ``family,'' ``ohana'' as they became the first family to move into the new Kilohana Temporary Group Housing Site in Lahaina. By this spring, 167 modular units will house survivors and their families.

While these housing units can never replace what was lost, we hope they will soon be made homes by the people, the love, and the hopes and dreams that will fill the space between these walls.

A big ``thank you,'' ``mahalo'' to FEMA, the Army Corps of Engineers, the State of Hawaii, Maui County, and all our contractors and community partners for their hard work and dedication.

Thanks to them, families like the Folaumoeloas are moving in months ahead of schedule to a place where they can look ahead to the future and to what this community will one day be.

Mr. Speaker, I share Representative LaMalfa's appreciation that last night the Senate finally unanimously passed the bipartisan Federal Disaster Tax Relief Act, sending it to the President's desk.

This bill includes language that I introduced over a year ago to help Maui fire victims deduct their disaster-related losses and keep money in their pockets. This bill will also exempt wildfire disaster settlement payments from being taxed.

As Maui and other fire-impacted communities across the country focus on their recoveries, they deserve certainty that the financial relief they receive will go entirely to them and to their ``family,'' ``ohana.''

For months, this bill and the financial relief it provides to our Maui ``family,'' ``ohana,'' have been among my top priorities in Congress. I am proud to have been part of a majority in the House in signing a discharge petition, forcing a vote on this bill, and passing it overwhelmingly back in May, where it has remained with the Senate.

I am grateful to have been part of this bipartisan effort with my friends: Congressmen Greg Steube, Doug LaMalfa, and Mike Thompson. While this has been a long journey together, I am proud we have gotten this over the finish line, and I hope President Biden will sign this bill into law as soon as possible.

Mr. Speaker, I rise to speak in strong support of H.R. 8909.

In January of this year, The Wall That Heals, a replica of the Vietnam Veterans Memorial on The National Mall made its inaugural visit to the island of Hawaii. It was there in front of West Panel 18 that I met Shirley Kauhaihao, the widow and high school sweetheart of Army First Lieutenant John Kuulei Kauhaihao. She and her daughters were putting flowers and a lei in front of line 40 where his name is etched.

On September 5, 1969, at the age of 27, Lieutenant Kauhaihao, or Lieutenant K, as he was affectionately called, was leading his men on a reconnaissance in force operation in Tay Ninh province when his platoon came under enemy fire. With extraordinary courage, he launched over 30 hand grenades in 15 minutes at enemy bunkers while simultaneously drawing fire on himself, so that his men could sight enemy gunners.

Eventually, he ordered the withdrawal of his platoon and crawled over 100 meters of fire-swept terrain, dragging vital equipment and helping wounded soldiers to safety. While they moved to rejoin their company, Lieutenant K saw an enemy squad moving up on his platoon and quickly moved to engage. He was mortally wounded that day. It was the fourth birthday of his son, Charles.

For his bravery and sacrifice, Lieutenant K was posthumously awarded the Distinguished Service Cross, our Nation's second highest combat award. His fearless and selfless actions at the cost of his life reflect great honor upon himself, his family, and the ``ahupua'a'' ``land division'' of Honaunau where he was born and where he lived.

Naming the post office in the community where generations of Lieutenant K's family lived and still live is more than just honoring and celebrating a fallen ``kama'aina'' ``local resident'' warrior who gave his life for our Nation.

It is a tribute to an entire generation of men and women who served in Vietnam and who came back to a country that took far too long to honor their service and that is still trying to make this right.

It is a reminder of the incredible sacrifices made by those who serve in uniform and the loved ones waiting at home--past, present, and future--to whom we are forever indebted and who allow us to live in freedom today.

That day in Hilo, standing next to Shirley as she pointed out Lieutenant K's name on the wall to me, I couldn't help but feel like he had finally come home.

Mr. Speaker, 55 years have passed since Lieutenant K's death, and his widow, children, and generations of their ``mo'opuna'' ``grandchildren'' have continued to live in service to their community, the island of Hawaii, and the State of Hawaii.

Passing H.R. 8909 to designate the United States Post Office in Captain Cook, Hawaii, as the Army First Lieutenant John Kuulei Kauhaihao Post Office is a tribute to him and the legacy of service that lives on through the lives he saved and through his ``family'' ``ohana.''

Every day when Shirley heads into town or goes to volunteer at the Greenwell Botanical Gardens, she passes by that post office. I hope seeing John's name each time she drives by will make her feel like he is a little closer to home and that he will never be forgotten.

Mr. Speaker, I thank the chair and ranking member of the committee for their work on this bill.

Mr. Speaker, I rise today in strong support of my bill, H.R. 8219, the Lahaina National Heritage Area Study Act.

On August 8, 2023, Hawaii experienced one of its very darkest days when the town of Lahaina was consumed by the worst wildfire in modern American history. We lost 102 members of our ``family,'' ``ohana,'' and we are still searching for 2 more that are missing.

I stand on the House floor today, as I have dozens of times this Congress, to advocate on behalf of those impacted by this tragedy. As we approach the 16-month anniversary of the fires, there is still so much more that needs to be done.

While I will continue to fight for disaster funding and continued Federal assistance for Lahaina and all of our communities touched by disaster, every action that we take to support the rebuilding of our community helps in the healing, which is why I am so grateful that we are here today to debate my Lahaina National Heritage Area Study Act.

Currently of the 62 national heritage areas in the United States, none are in Hawaii. I cannot think of a better place to designate as Hawaii's first national heritage area than Lahaina.

Even before the fires, community-driven efforts led by generational descendants and local leaders were focused on preserving Lahaina's rich history, tradition, and culture for future generations.

My bill would be the first step in ensuring that Lahaina finally gets the recognition that she has long deserved. In consultation with State and local partners, the Lahaina National Heritage Area Study Act would direct the National Park Service to study the feasibility and suitability of this designation for Lahaina.

At this time, I want to thank Chairman Westerman for coming with other Members of the House Committee on Natural Resources to Lahaina literally days after the fire. I will forever be grateful for your compassion, kindness, and support that you showed all of our people. I can honestly say that during this time of grieving, it gave them much hope and helped them start toward that process of healing to have you present there, to offer words of comfort and support.

I know that this bill would not be here today without your leadership and support of this initiative. Mr. Speaker, I say, ``thank you,'' ``mahalo'' to you and to all who came to our islands.

I also want to thank all of my colleagues who cosponsored this bill and supported it throughout the committee process. I especially want to thank members of this committee, including Ranking Member Neguse and Congressmen LaMalfa, Case, Huffman, and Sablan as well for their support and help. It is greatly appreciated

Two weeks ago, I stood inside one of the first transitional homes built by FEMA, looking out at what was once the vibrant and thriving town of Lahaina. For many who see it now, there are only cleared lots stretching from the hills to the sea. If you close your eyes, you can feel the deep pang of loss and grief. It is a pain that we all carry, softened only by the hope that comes with the very first steps towards rebuilding.

In seeking to designate Lahaina a national heritage area, we are daring to look beyond what is in front of us. Beyond the devastation, there is history and culture that predates us all. There was a time when canals and waterways nourished the land, when bread, fruit, and taro flourished, and when our ``kings and queens,'' ``ali'i,'' resided and governed there.

Once known as Lele, before it became Lahaina, this special place was the former capital of the Kingdom of Hawaii. Amid centuries of political and economic change, she has remained a gathering place for our people.

As we work to rebuild Lahaina, my bill seeks to ensure that this is about not just restoring what was lost but

also anchoring our future in the rich history and culture of this sacred place so that they may endure long after we are gone.

With the help of this Congress, we can honor Lahaina's past, while laying the foundation for a resilient and enduring future.

I humbly ask my colleagues to support H.R. 8219, the Lahaina National Heritage Area Study Act.

Mr. Speaker, I rise today to congratulate my friend Captain Joseph J. Ring, the Commander of the Naval Surface Group Middle Pacific on his retirement from the United States Navy after thirty years of service to our Nation.

As Commander of Naval Surface Group Middle Pacific, Captain Ring led the successful transition of the newly aligned MIDPAC team in manning, training, and maintaining all surface ships homeported at Joint Base Pearl Harbor-Hickam. Thanks to Captain Ring's leadership, the U.S. Navy's Hawaii-based ships remain combat ready for sustained operations in the Inda-Pacific and around the world.

Over the course of his career as a Surface Warfare Officer, Captain Ring served in four countries and operated at sea in every Combatant Command theater of operation. At sea, he served as Commander of Destroyer Squadron Three One, Commanding Officer of the USS Hopper (DDG-70), and Commanding Officer of the USS Mustin (DDG-89). Ashore, he served as Flag Aide to the Commander, Navy Region Hawaii; Warfare Systems Advisor to the Royal Australian Navy in Sydney, Australia; Director, Joint Operations Center (J31), United States Africa Command in Stuttgart, Germany; and as Chief of Staff to the Director, Maritime Operations, U.S. Pacific Fleet.

His many awards include the Royal Australian Navy Chief of Navy Gold Medal, Peruvian Naval Medal of Honor for Merit, the Legion of Merit, the Defense Meritorious Service Medal, and various other personal, campaign and unit awards including the Battle ``E'' Excellence Award. He also received the title of Honorary Chief Petty Officer in recognition of his contributions to the Chief Petty Officer community and the enlisted force.

On a personal note, Joe has always been the one who helps ``get me to yes.'' Service above self is a way of life for Joe, and the values we cherish in Hawaii mirrors his own. While his Navy service brought him to Hawaii, we know our islands are a place he loves and protects as his home.

As Joe, Nada, and their entire family transition to a new chapter, I proudly join them in celebrating a tremendous career that will continue to inspire and motivate future generations of leaders. But even more importantly, I wish them all the best in enjoying a well-earned retirement.

Joe, mahalo for all that you have done and given to our country.

Mr. Speaker, as co-chair of the bipartisan Rural Health Caucus, I am proud to lead my colleagues today in celebrating National Rural Health Month.

With 61 million people, roughly 20 percent of the United States population, living across 97 percent of the country's landmass, delivering healthcare to every corner of America has required unique and innovative approaches and remains an ongoing challenge.

As the primary growers and producers of the food, fuel, and fiber that keeps our country running, rural Americans are also quickly becoming older and more ethnically diverse, dealing with the challenges of keeping up with a world increasingly dependent on broadband activity to support all aspects of life, including healthcare delivery, can be a challenge.

Since 2011, National Rural Health Day has been recognized annually on the third Thursday of November--coming up soon, on November 21--to highlight the dedication of healthcare providers and communities in addressing the healthcare needs of rural Americans.

For those of us representing rural and remote parts of this country, every day is Rural Health Day, as we fight to provide access to even the most basic care services and to work to improve health outcomes and the life expectancy of our constituents.

Mr. Speaker, I yield now to the gentlewoman from Illinois (Ms. Budzinski).

Mr. Speaker, I yield to the gentleman from Kansas (Mr. Mann).

Mr. Speaker, I yield to the gentleman from Michigan (Mr. Bergman).

Mr. Speaker, I will now make remarks about this very important month and some of my own experiences I have had in my district.

Coming out of the pandemic, the health workforce shortage crisis in the U.S. remains one of the greatest challenges to healthcare, and we must take immediate transformational action to address it.

Increasing the number of healthcare professionals is critical to expanding access to care in rural areas and keeping rural hospitals and clinics open, just as my colleague was talking about.

One way to address this issue is by ensuring providers are adequately compensated for their services. The Medicare Physician Fee Schedule is fundamentally broken. The Medicare payment rates have fallen by 29 percent over the last two decades, while the cost of running a practice is estimated to have increased by 3.6 percent.

We need longer-term solutions that provide greater stability and certainty to our clinicians. Congress must pass legislation to stabilize Medicare physician pay so that doctors receive adequate reimbursement to cover the actual costs of providing care, especially in areas of rural America where these costs are higher.

For doctors in my district, I am also advocating for increasing geographic adjustments to ensure provider pay more accurately reflects the uniquely higher cost of healthcare delivery in remote areas like Hawaii.

That is why I am introducing the Protecting Access to Care in Hawaii, or the PATCH Act, which would provide a roughly 24 percent increase in Medicare physician payments to Hawaii physicians so that they receive a similar boost to their counterparts in other remote States like Alaska.

For family physicians like Dr. Michelle Mitchell, higher reimbursements could have made the difference with helping her keep her practice in Hawaii and serving the community she cared for and loved.

From 2008 to 2021, Dr. Mitchell owned Hawaii Family Health in Hilo, Hawaii, where she provided primary care services and offered specialty services, like nutrition intervention and behavioral health to meet the needs of her patients.

However, at the end of the day, after covering her overhead, including paying staff, utilities, and rent, she would only bring home enough money to qualify for food stamps, but she persisted. In an effort to lift herself out of poverty, she started conducting telemedicine visits for patients on the continent where reimbursements were much higher, but this was not sustainable.

In the midst of the pandemic, she left Hawaii and moved to Kansas where she can have a more sustainable practice, leaving behind patients who have struggled to find a new doctor to care for them.

In rural places like Hawaii, we lose too many good doctors, and as a result, too many loved ones who can't get the care they need to survive. Nationally, the United States is facing a shortage of 40,000 to 60,000 physicians, and the shortage is expected to grow to 139,000 physicians by the year 2033.

In my home State alone, the shortage of physicians is 757 statewide, and this is only expected to get worse. Over the past year, we have had 42 physicians retire, 4 have passed away, 55 moved away, and 212 decreased their work. Over 22 percent, nearly a quarter, of our physicians are already over the age of 65, meaning they should be retiring soon, or will be retiring soon. The sad reality is that they can't retire because there are too many lives literally at stake to lose even just one more doctor in Hawaii.

Unfortunately, given the low physician reimbursement levels in Hawaii along with the high cost of living and limited affordable housing options, it remains a challenge just to recruit and retain new physicians to our State and encourage our own, quite frankly, our ``children,'' our ``keiki'', to join the profession too.

That is why it is so vital we fix physician payment models for rural places like Hawaii and to really make sure that we support our rural communities throughout this great country.

For my constituents from the island of Lanai, they say it is difficult to be born and to die in the place that they call home, in the place that they love. That is because of their inability to see the appropriate provider and get the care that they need for their health.

I look forward to working with my colleagues to finally fix our Nation's broken Medicare payment system. When we give our doctors a fighting chance to serve, we give their patients, our constituents, a better chance to live and to thrive.

Mr. Speaker, I yield to the gentlewoman from Tennessee (Mrs. Harshbarger), my co-chair for the Bipartisan Rural Health Caucus, an amazing individual, and a leader in the field of health and pharmacy.

Mr. Speaker, as you have seen here today, both Democrat and Republican, it doesn't matter which side of the aisle that we may sit and serve on, but at the end of the day, it is about taking care of all of our constituents and everyone that lives in rural and remote America.

Mr. Speaker, 80 percent of rural America is considered medically underserved and faces significant barriers to care, including geographic distances and lack of reliable transportation, fewer healthcare providers and medical facilities, lack of primary care and specialty services, and limited insurance options. As a result of these barriers, rural residents often experience worse health outcomes than their urban counterparts simply because of their inability to access healthcare.

Rural residents have a higher risk of dying early from cancer, chronic lower respiratory diseases, heart disease, stroke, and unintentional injuries. Many of these deaths are absolutely 100 percent preventable.

In my district, Native Hawaiian and Pacific Islanders experience greater rates of heart disease, hypertension, and diabetes, and Asian Americans often experience higher rates of late-stage cancer diagnoses.

To ensure people living in rural and remote communities have access to quality healthcare, we must do more to keep more rural hospitals and clinics open, increase capacity and support for rural providers, and eliminate barriers to care for our rural patients, all things you have heard from my colleagues today.

Before the end of the year, Congress has a long to-do list for rural health. As we go home to celebrate the Thanksgiving weekend, let's keep a few of these important, critical actions in mind for our constituents.

Number one, extending critical rural health programs.

Congress must pass legislation reauthorizing a number of rural health programs that are set to expire at the end of 2024. This includes extending key programs like: The National Health Service Corps, which helps recruit and train aspiring health professionals to rural and underserved areas;

The Community Health Center Program, which supports 1,400 clinics to provide comprehensive health services to more than 31 million Americans, regardless of their ability to pay; and

The Medicare Flex Program, which provides technical assistance to help struggling, small rural hospitals increase quality of care and improve hospital operations. These programs play an important role in strengthening the rural health safety net.

Number two on Congress's to-do list: Safeguarding telehealth.

During the pandemic, telehealth flexibilities allowed providers to care for their patients remotely through the use of a computer or a telephone.

The utilization of telehealth and telephonic care in rural areas has been vital to reducing the challenges and burdens experienced by both rural patients and their providers. That is why we must support extending COVID-era flexibilities beyond 2024 and even making them permanent so that patients can receive timely access to care beyond brick-and-mortar settings.

We must also take action to prevent an impending 3.37 percent reduction in Medicare reimbursements to patients. If Congress does not act this year, Medicare payments will have been cut by almost 10 percent in the last 4 years alone, which is simply unsustainable and could force providers and medical groups to eliminate services, furlough staff, and implement hiring freezes.

Congress must act to ensure Medicare providers have the financial support they need to care for our Nation's seniors in rural America and across this country.

Mr. Speaker, I have a few more points to make, but at this time it is my pleasure to yield the floor to my colleague.

I yield to the gentleman from New York (Mr. Langworthy).

Mr. Speaker, I yield to the gentlewoman from Illinois (Ms. Kelly).

Mr. Speaker, to continue now my long to-do list for Congress that needs to get done by the end of the year for our rural and remote Americans to make sure that they have the healthcare that they need, number three, we need to fund the government for fiscal year 2025.

The House and Senate appropriation bills contain roughly $730 million for grant programs and initiatives that directly address the growing healthcare crisis in rural America.

Rural health discretionary spending is vitally important for preserving and improving access to care for individuals living in rural America. This funding includes resources to support rural hospitals, cybersecurity, including funding to help small, rural hospitals purchase health IT and equipment and address the growing threats on digital patient records. We read about this every single day in the newspaper. They need the support to be able to safely maintain both their health records and take care of their patients.

This funding also includes funding for community health interventions, including to address the various crises facing rural America in maternal health, as we have just heard from our colleague, opioid abuse, and mental health.

That is why I will keep fighting to ensure we pass a final spending bill that preserves increased funding for rural healthcare programs.

Lastly, number four, Congress needs to pass a disaster aid package. Earlier this week, President Biden submitted a request to Speaker Johnson on urgently needing funding to support the Federal response to Hurricanes Helene and Milton and other natural disasters, including the August 2023 wildfires on my island of Maui.

Over the past year, rural communities in the United States have been inundated by several natural disasters, including 17 storm events, 4 tropical cyclones, 1 wildfire event, and 2 winter storms.

In June, New Mexico faced two major wildfires, and Iowa experienced record flooding from the Big Sioux River, which caused mudslides, washed away roads, and required evacuations. In September, Hurricane Helene caused catastrophic flooding, power outages, and property destruction in North Carolina.

Rural communities are on the front lines of natural disasters, which can have far-reaching effects on health and well-being in the immediate aftermath. In the long-term, generationally, it has impacts and trauma that are felt.

Damage to infrastructure caused by storms can compromise emergency response efforts, limit access to basic needs, and disrupt access to necessary healthcare and prescription medication.

Storms can also have long-lasting mental health impacts. That is why it is critical Congress pass a disaster supplemental package this year.

The President's disaster aid request includes a total of $2.7 billion for the Department of Health and Human Services, of which $260 million would be used to support health center infrastructure and ensure continued access to high-quality healthcare services in impacted areas.

This funding request also includes $244 million to expand substance use and mental health prevention and treatment services and $159 million to restore services needed by people with disabilities and older adults.

Across the country, natural disasters have devastated communities, homes, farms, and businesses and disproportionately impacted rural America, which is why I am urging all of my colleagues to support a disaster aid package that addresses both the immediate and long-term needs of impacted rural Americans.

Mr. Speaker, today, you have heard from our colleagues on both sides of the aisle. The bipartisan Rural Health Caucus is now entering its second year and proudly going into its second Congress, having been restarted by myself and Representative Harshbarger, and proudly boasts 64 members on both sides of the aisle and quickly growing.

In closing, I want to reiterate our shared commitment to ensure rural

health remains a priority as we wrap up this 118th Congress and head toward the 119th Congress in January.

We will continue working with our colleagues to ensure that we finish our to-do list for rural healthcare this year, continue our bipartisan work in the years ahead, and make sure that every Member of this Congress understands the plight, the need, the challenges, but, yes, the opportunity and the hopes of rural America.

Together, we can and must ensure everyone, regardless of where they live, how much money they have, or their life circumstances, has access to high-quality, affordable, lifesaving healthcare.

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