Floor Statements

Mr. Speaker, I rise today in strong opposition to H.R. 6757, the Family Savings Act. It is outrageous that, after our markup, a provision was snuck into the bill, behind closed doors, through a manager's amendment that seeks to further an extreme anti-choice agenda and has no place in this tax bill.

Chairman Brady's manager's amendment, offered behind closed doors in the Rules Committee, has added language that would allow parents to open 529 college savings accounts for unborn children. The term ``unborn children'' is defined as a child ``in utero'' at any stage of development carried in the womb. This provision is completely unnecessary because, under current law, parents are already able to open 529 savings plans for future children in their own name, and then change the name of the beneficiary after the birth of their child.

The implications of this insertion, however, is serious. In the landmark Supreme Court decision in Roe v. Wade, the Court declared that ``the word person, as used in the 14th Amendment, does not include the unborn.''

So let me say, there is no ambiguity here. This is a thinly-veiled attempt to circumvent the Supreme Court's decision by inserting the words ``unborn child'' in, of all places, the Tax Code, so that codifies in law a legal concept of the unborn child, therefore, establishing the fetus is protected separately from the mother.

This is the same language that anti-choice advocates tried to insert into the GOP tax scam bill 1.0, but where the language was ultimately stripped out.

At that time, a spokesperson for the anti-choice March for Life group stated that H.R. 1, the GOP tax scam bill, ``. . . we hope that this is the first step in expanding the child tax credit to include unborn children as well.''

This language is, therefore, obviously, an attempt to lay the legal groundwork to undermine a woman's constitutional right to an abortion, plain and simple. Based on this language alone, women's groups NARAL and Planned Parenthood are opposing this bill.

This is nothing more than a political gimmick conducted in secret in order to score political points for Republicans trying to placate their extreme base.

Mr. Speaker, I strongly urge my colleagues to reject this bill and vote ``no''.

Mr. Speaker, I rise today to congratulate Chris Jeffers, a true public servant, on his retirement after a remarkable 38 years serving in local government.

For the past 29 years, Chris has served as City Manager of two San Gabriel Valley cities in my district, Monterey Park and Glendora, where his leadership and dedication have made him a pillar in our communities. As City Manager of my hometown of Monterey Park for 16 years, Chris led an expansion of our library, added hundreds of new housing units for seniors and new residents, and expanded the city's business and retail space. He chaired the American Communities for Cleanup Equity, a nationwide coalition of local governments working with the Environmental Protection Agency (EPA), and coordinated development of the Greater San Gabriel Valley Community Development Corporation, a partnership of local cities and banks created to invest in small business startups.

In 2007, Chris accepted the role of City Manager in nearby Glendora. During his tenure, the city was named the Los Angeles area's most business-friendly city under 65,000 residents in 2014 and was twice recognized by the Public Technology Institute for its adoption of new technologies to streamline the way that the government interacts with citizens and businesses. Glendora has even been awarded best downtown and friendliest city by the San Gabriel Newspaper Group for four years running, and a survey of local small business owners showed that over 80% found the city to be an excellent place to have a business.

Chris's record speaks for itself, and he is proof of the tremendous impact that one can make through dedication to public service. I thank him for his 38 years of contributions to our communities and wish him nothing but the best in retirement.

Mr. Speaker, as Chair of the Congressional Asian Pacific American Caucus (CAPAC), I rise today to honor the life of Laura Efurd, a cherished staffer and public servant who passed away earlier this month at the age of 54 after a hard-fought battle with ampullary cancer.

Laura was born on the Big Island of Hawaii, and raised both in Kona and Mililani, Hawaii. She earned her Bachelor's Degree in Communications and Political Science from Ouachita Baptist University and began her career in Washington, D.C. as a Legislative Assistant to former Congressman Tommy F. Robinson of Arkansas.

After earning her Master's Degree in International Communications from American University, she joined the staff of the late Congresswoman Patsy Mink of Hawaii as her Legislative Director in 1990.

During her time on Capitol Hill, Laura played an instrumental role in elevating the voices of Asian Americans and Pacific Islanders. She was there at the founding of the Congressional Asian Pacific American Caucus in 1994 and served as the Caucus' Principal Staff Member from 1995 to 1999 under the chairmanship of Congresswoman Patsy Mink.

The Caucus began with five Asian American and Pacific Islander Members of the House and two Senators. They hailed from two states and the Pacific Island territories of American Samoa and Guam. Today, CAPAC includes a historic high of 15 Asian American and Pacific Islander House Members and three Senators who represent ten states and territories. There is no doubt that Laura's work helped to build the foundation to give us the voice that we have today. In her quiet way, she helped our Caucus to become twice as loud.

Laura was also one of the founding Members of the Congressional Asian Pacific American Staff Association and was one of the driving forces behind the creation of an internship program for young Asian Americans and Pacific Islanders to pursue careers in public service.

She left Capitol Hill in 1999, when she was appointed by President William Clinton, first to the Office of Congressional and Intergovernmental Affairs at the U.S. Department of Labor, and then as Deputy Assistant to the President and Deputy Director of the White House's Office of Public Liaison.

During her time in the Clinton administration, Laura was instrumental in the creation of the White House Initiative on Asian Americans and Pacific Islanders, which created a coordinated voice within the White House and federal agencies to address issues of critical concern to our American communities.

Outside government service, she joined the executive leadership of ZeroDivide--an organization based in California dedicated to increasing economic and educational opportunities, expanding civic engagement and access to technology, and improving health care for low-income and underserved communities.

She later returned to the U.S. Congress and most recently served as a trusted aide to Senator Mazie K. Hirono of Hawaii, where she

managed the daily operations in Senator Hirono's Honolulu State Office.

Laura also served as a member of the Federal Communications Commission Consumer Advisory Committee, the Center for Women's Policy Studies, and as Chair of the Governor of California's Task Force on Broadband, Community Development, and Public/Private Partnerships. In all of these roles, she worked tirelessly to give a voice to the voiceless.

Her desire to help and uplift others remained a central focus throughout her career. Laura's friends often recount they had a very clear picture of her intelligence, her kindness, and her concern for others--as well as the steel in her spine. They also say she was one of the best listeners they have ever known. She never focused on promoting herself. Instead, she worked behind the scenes to ensure that others had a seat at the table and dedicated her life's work to helping people find their voices. Those were the battles she loved winning.

Even though Laura did not seek the spotlight, she was truly a force of nature who made a lasting impression on the lives she touched. I know that her legacy will live on through her family and friends, as well as the institutions she helped to create and shape throughout her career.

The Members of the Congressional Asian Pacific American Caucus join Laura's family and friends both in mourning her loss and celebrating the historic contributions of a truly great American.

Mr. Speaker, I rise today in strong opposition to H.R. 6311, which, contrary to its name, would do very little to help Americans access quality healthcare coverage. Instead, it would force families to accept low-quality, catastrophic health plans, or junk coverage, that does not meet healthcare needs and leaves ordinary Americans to foot the bill when something goes wrong.

What does a catastrophic and high-deductible plan mean? Well, it is a disaster for many.

Recent studies have shown that 40 percent of Americans cannot afford even a $400 emergency expense, let alone the thousands of dollars necessary for a medical emergency, which could happen to any of us, but that is the plan Republicans are offering. Americans would get a plan that is substandard. No one wants to have health coverage that doesn't actually cover much at all.

What is more, these catastrophic and high-deductible health plans are especially harmful to women. Since 50 percent of the pregnancies in the United States are unplanned, many parents in these plans will not have saved enough to cover these high deductibles or unexpected costs. Furthermore, most pregnancies last 9 months and, thus, span more than one plan year. That means during the course of a single pregnancy, a mother in one of these plans would have to hit her deductible twice.

Maternity care services without complications can average around $10,000 per pregnancy. What would happen in a pregnancy with complications?

The Affordable Care Act was passed so that we could move away from junk plans that offered nothing in terms of coverage and left people with thousands of dollars in medical debt. This bill is just another attempt to undermine the ACA, and we cannot go back.

Mr. Speaker, I rise in strong opposition to H. Con. Res. 119. This resolution is nothing more than an election year stunt by Republicans to distract from the growing list of issues they failed to address this Congress.

Let me be clear: This vote is a sham. If Republicans truly wanted to debate the merits of a carbon tax, they would allow the Ways and Means Committee to hold hearings with expert testimony and robust discussion. In fact, multiple members of our committee have already introduced bills that tackle the ever-pressing issue of climate change, which is impacting the health and well-being of American families and future generations more and more each day.

This is not just a Democratic concern either. There is even a Republican carbon tax bill expected to be introduced in the coming days.

Instead, here we are, wasting what little time we have left this Congress, debating a pointless resolution while there are urgent problems waiting to be resolved. Congress should be passing legislation to address the double-digit increases in healthcare premiums caused by the repeal of the individual mandate by the GOP tax scam or reuniting immigrant children with their parents.

The fact is, Mr. Speaker, this vote is a wasted opportunity and just another example of Republicans placing political expedience over regular order.

As a member of both the Sustainable Energy and Environment Coalition and the bipartisan Climate Solutions Caucus, I would love to participate in a real debate about how we can address climate change. My constituents are clamoring for us to act. But if Republicans are going to continue to ignore and deny the existence of this crisis, the least they can do here, in Congress, is to use this time to legislate, not electioneer.

Mr. Speaker, I rise today to honor the life of Dr. James Bok Wong, who passed away on May 25, 2018 at the age of 96. Dr. Wong was a lifelong leader in his community, an immigrant, a businessman, and a veteran.

Dr. Wong was born in Canton, China in 1922. After immigrating to the United States in 1938, he served with the famous Flying Tigers Air Corps, the first American Volunteer Group of the Chinese Air Force during World War II. Following his service, he earned a Bachelor of Science in Agriculture and Chemical Engineering from the University of Maryland under the G.I. bill, and went on to earn both a Master of Science and PhD in Chemical Engineering from the University of Illinois. An entrepreneur and businessman, Dr. Wong rose to become a distinguished figure in the biochemical industry. He served as chief economist and director of international technologies for Dart Industries, and founded his own company, James B. Wong Associates, Inc., through which he licensed U.S. technologies to spearhead the dairy industry in China.

In 1971, Dr. Wong founded the Chinese American Citizens Alliance Foundation to support the growing Chinese American community in Los Angeles. The foundation has provided educational and leadership opportunities to countless young people and played a key role in encouraging civic engagement. Dr. Wong was also a longtime leader in the Chinese American Citizens Alliance, serving as national marshal, president, and a member of the board of directors. Recognized with an L.A. Outstanding Volunteer Service Award in 1977, Dr. Wong later received a History Makers Leadership Award by the Chinese American Museum in 2014.

Dr. Wong leaves behind an enduring legacy of dedication and service to his country and his community. He is an inspiration to all those who knew him and it is my honor to commemorate his life.

Madam Speaker, I rise today in strong opposition to this cruel, anti-immigrant bill. This bill is so bad, they even want to destroy legal immigration to this country.

For decades, our immigration laws were discriminatory, favoring Nordic and Western Europeans, restricting Italians and Jews, and banning the Chinese completely. Finally, in 1965, during the civil rights era, Senator Ted Kennedy ushered in a fair immigration system based on family reunification.

Because this system brings families together, immigrant households are less likely to rely on public benefits. And immigrants are also buying homes and starting businesses at a faster rate.

But now, with this bill, Republicans are trying to undo that progress and make America White again.

Worse, they are tearing families apart to do this. While Trump and Republicans are ripping parents from children at the border, they are trying to do the same through our immigration laws. This war on families must stop.

Madam Speaker, today, I brought with me two young people: Alcides Guandique, age 11, and Jose Guandique, age 13.

When I look at them, I think of 2 days ago when I visited the Trump detention center at the southern border in San Diego with Members and Leader Pelosi.

There we saw children torn from the arms of their parents under Trump's zero-tolerance policy. We talked to the kids. We talked to the mental health counselors who told us that children are traumatized.

Most of them have come here with their parents because they were threatened with murder and rape by gangs in Central America and Mexico. But because of Trump's policy of separation, these children have lost the one constant person in their lives.

As a psychologist, I took note when the president of the American Academy of Pediatrics visited detained kids. She said that, normally, kids like this are rambunctious and running around. But these kids are either screaming or crying or permanently quiet, and, in fact, that kind of toxic stress can permanently affect their brains.

There is only one way to describe it: government-sanctioned child abuse.

President Trump must own up to the policy that is his and his only. He has the power to stop this terrible cruelty. Instead, he is using these kids as a bargaining chip for $25 billion for a border wall. It is time for him to stop. Stop ripping children from the arms of their parents. America is better than this.

I yield to the gentlewoman from Florida (Ms. Castor).

Madam Speaker, I yield to the gentlewoman from Oregon (Ms. Bonamici).

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

Mr. Speaker, according to the Centers for Disease Control and Prevention, more than 42,000 Americans died from opioid-related drug overdoses in 2016. That is five times more than the overdose rate in 1999.

As we have heard from countless Members in this Chamber, there is no congressional district that hasn't been impacted by the opioid crisis. No town or city is immune from the devastating impact of addiction, and I hope that the steps we take today are the first of many to address the needs of our communities.

The Substance Abuse and Mental Health Services Administration, or SAMHSA, estimated that in 2016, 11.8 million Americans over the age of 12 had misused opioids in the past year and 3.8 million were currently misusing prescription pain relievers.

But while we are seeing news reports of the devastating toll this crisis is taking on our Nation's young people, it is important to note that our seniors are also suffering. From 2005 to 2014, individuals 65 years and older experienced an 85 percent cumulative increase in opioid-related inpatient stays and a 112 percent cumulative increase in emergency department visits, the largest increase of any age group.

Compared to other age groups, individuals 65 and older have the highest rate of opioid-related inpatient stays in 13 States, including my home State of California.

This crisis is especially acute for the nonelderly Medicare population. In 2015, nonelderly Medicare beneficiaries, or those who qualify on the basis of disability, had opioid utilization rates more than twice that of elderly beneficiaries.

The bill before us, H.R. 6110, contains numerous provisions aimed at improving access to treatment for Medicare beneficiaries suffering from opioid use disorders, including access to nondrug opioid alternatives.

While every alternative will not work for every person, when dealing with a crisis of this magnitude, I believe that we must use every tool in the toolbox.

This bill contains two bipartisan provisions I authored with my colleagues on the Ways and Means Committee.

Mr. Speaker, I thank the gentlewoman from Indiana (Mrs. Walorski) for working with me on language that would direct CMS to study barriers to patient access to nondrug alternatives for opioids in chronic care settings.

Studies conducted by the NIH have concluded that alternative treatments, like acupuncture, can be effective in treating conditions like chronic pain. This issue is very important to me, because I have been working to expand access to acupuncture since I first arrived in the California State legislature many years ago. I have heard firsthand what a difference acupuncture can make in the lives of patients.

I remember very clearly when I heard the testimony of a woman who had severe back pain, but did not want invasive surgery and risk possible addiction to morphine.

Instead, she sought acupuncture, and it worked for her. She avoided the risks associated with surgery and certain pain medications.

Furthermore, we know access to physical and occupational therapy also helps alleviate pain and eliminates the need for an opioid prescription.

By asking CMS to examine where barriers to these alternatives exist, we can open the door to more treatment alternatives for beneficiaries.

I am also proud that this bill includes a provision I authored with the gentlewoman from North Dakota (Mrs. Noem) to address the need for more psychologists in the Medicare program. This bill would direct the Centers for Medicare and Medicaid Innovation to examine ways for beneficiaries to familiarize themselves with coverage for psychologist services and request a study from the General Accountability Office on the viability of mental and behavioral health services in the Medicare program.

As one of only two psychologists in Congress, I firmly believe that expanding access to psychologist services in Medicare is one of the most important things we can do to improve the mental health of our senior population.

We know that those who suffer from depression or other mental health disorders are particularly vulnerable to addiction. For those who have already taken the incredibly difficult step of seeking treatment, we need to ensure that they have access to the full range of mental health professionals who can support them on the journey to recovery.

H.R. 6110 also contains a number of provisions from my colleagues on the Ways and Means Committee. Congress Members Levin and Marchant authored a provision to review certain Medicare payments in outpatient settings to determine whether there are financial incentives in the Medicare program to use or prescribe opioids instead of evidence-based, nonopioid alternatives.

Next, the legislation includes a provision introduced by Congress Members Sanchez and Roskam that would direct the Secretary of HHS to evaluate the extent to which Medicare Advantage programs offer medication-assisted treatment, or MAT, and cover nonopioid alternative treatments not otherwise covered under traditional Medicare as part of a supplemental benefit.

Finally, this bill would also include a provision from Congress Members Danny Davis and Rothfus that would provide grants to federally qualified centers and rural health clinics to help offset the cost of training providers to become certified in dispensing medications for opioid abuse dependence.

While the provisions in the bills before us this afternoon will certainly move us in the right direction, we cannot stop here. For example, the Medicaid program pays for the majority of mental health and substance abuse treatments in this country and, yet, we see multiple attempts by Republicans over the past 4 years to slash this program.

We must maintain protections for those with preexisting conditions so that those who sought treatment for their addiction disorders are not punished for trying to get sober.

We must maintain the progress we have made with the Affordable Care Act and work together to bring down the premiums for American families so that, should they need coverage for mental health counseling or substance abuse treatment, no one is shut out because of how much money they make or what State they live in.

So I hope that today represents the first step, and I hope my colleagues on the other side of the aisle will continue to work with us to invest in prevention, treatment, and recovery efforts all across the country.

I encourage my colleagues to support this legislation, and I reserve the balance of my time.

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

Mr. Speaker, I am encouraged to see my colleagues on the other side of the aisle turn their attention to this critical issue. But this is not a new problem, and the coverage expansions under the Affordable Care Act have been among the most significant steps the Federal Government has taken to stem the tide of the opioid crisis. And yet, Republicans in Congress and President Trump have actively worked to repeal this landmark law.

The Medicaid expansion and the increased coverage under the individual market have provided millions of Americans access to health insurance, and research has shown that Medicaid expansion States have seen a greater reduction in deaths from opioids than nonexpansion States.

Again, Medicaid is the biggest payer for substance use disorder treatment in this country. We simply can't afford to go back.

As we discuss this crisis today and in the week to come, we must broaden our understanding of the ways in which we, as a Nation, approach chronic pain. That is exactly what H.R. 6110 does.

While there will always be patients who have a legitimate need for these medications, we need to look beyond a system where an opioid prescription is

the automatic default. This means we need to look to alternative methods of treating pain, whether it be acupuncture or physical therapy or a medical device. It means we must examine existing policies that may have inadvertently incentivized opioid prescribing practices.

But as much as we look forward, we must also address the crisis in front of us. So I am thrilled to see provisions in this bill that would study Medicare Advantage plans already doing groundbreaking work in substance abuse disorder treatment.

I am also glad to see that this bill provides direct resources to the front lines in the form of grants for federally qualified health centers to provide additional training for our providers.

I hope that, in the future, we will work to expand access to alternatives, both within the Medicare program and in the broader population, and ensure that no matter where someone lives or what kind of insurance coverage they have, they are able to seek treatment.

I urge my colleagues to support H.R. 6110, and I yield back the balance of my time.

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

Mr. Speaker, I offer my support for H.R. 5774, the COACH Act, which was introduced by Congress Members DelBene and Curbelo.

This bill focuses specifically on provider education and would require the Centers for Medicare and Medicaid Services to develop a toolkit that provides best practices to hospitals for reducing opioid use.

Every year, approximately 51 million Americans undergo inpatient surgery each year, and 80 percent of those patients receive opioids to treat postsurgical pain after a low-risk surgery. This is an alarming number, as studies have found that an opioid prescription at discharge is an independent risk factor for chronic opioid use. In fact, according to the National Institute on Drug Abuse, approximately 10 percent of patients who are prescribed opioids for long-term use develop an opioid use disorder.

This was the case with my constituent Ryan Hampton, who was a promising young college student when he broke his knee in a hiking accident and received an opioid prescription at discharge. Ryan fell hard into addiction, eventually turning to heroin and becoming homeless.

While Ryan has beaten the odds and is now a national advocate for those in recovery from addiction, many are not so lucky. So it is with people like Ryan in mind that I support this bill today.

We should be giving our providers every tool possible to help them battle the opioid crisis and, hopefully, change behavior in such a way as to limit unnecessary opioid prescriptions.

In my district, the Los Angeles County Department of Public Health, Substance Abuse Prevention and Control program has worked with hospitals, plans, cities and providers to develop a 5-year strategic plan to address the opioid crisis in our country.

We know that not every hospital has the resources or ability to develop such a plan. By providing a centralized toolkit available to all hospitals, under-resourced providers will have the best access to best practices that have helped communities combat the opioid epidemic.

With so many individuals first experiencing opioids via a hospital procedure, it is critical that we give our providers every resource they need to make the best medical decisions for their patients while reducing the number of opioid prescriptions overall.

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

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

Madam Speaker, I offer my support of H.R. 5775, the PROPER Act. This bill, introduced by my colleagues Representatives Paulsen and Kind, would require Medicare Advantage and Medicare part D plans to provide information to beneficiaries on the risks associated with prolonged opioid use, as well as coverage information about alternatives, like nonpharmacological therapies, devices, and nonopioid medications.

It is important to ensure that our providers in hospitals and outpatient settings have up-to-date and accurate information about opioid use. But it is equally critical that this information is provided to beneficiaries.

Additionally, providing information on coverage of alternative therapies could help beneficiaries who may want to try a nonopioid pain management therapy to do so, thus avoiding a prescription where it may not be necessary.

This bill also requires that by January 1, 2019, all pain-related questions be removed from the hospital consumer assessment of healthcare providers and systems survey, with some exceptions.

If hospitals are graded on how much pain patients are feeling, they likely would seek to minimize the patient's pain through pain management drugs like opioids.

In order to properly address this crisis in the Medicare program, we must ensure that beneficiaries have the information necessary to make informed decisions about their pain management plan.

Madam Speaker, just as we are working to improve provider education, we must not leave our Medicare beneficiaries behind.

I support this bill because it would ensure that Medicare Advantage and Medicare part D plans provide their beneficiaries with information on the risks of prolonged opioid use, as well as information about coverage for alternatives for pain management.

Earlier in this debate, I mentioned a woman who testified that although she was experiencing severe back pain, she did not want to risk taking addictive pain medication and instead turned to acupuncture. It worked for her, and she told me that because of her acupuncture treatment, she was able to live pain free.

Now, this is not to say that every alternative will work for every patient, but we should give patients the ability to choose their own pain management therapy. I believe H.R. 5775 is an important step toward this goal.

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

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

Madam Speaker, I am pleased to support H.R. 5773, the PASS Act, introduced by Congress Members Sewell and Roskam.

This bill focuses on policies to help Medicare plans prevent opioid use in the Medicare program without limiting access to needed medications for our seniors.

First, H.R. 5773 requires that Medicare prescription drug plans establish mandatory lock-in programs for seniors who are at risk of opioid overuse.

These programs curb fraud, abuse, and misuse of prescribed medications, while at the same time ensuring that seniors who have legitimate need of these medications can access them.

For example, these controls prevent doctor and pharmacy shopping and will prevent duplicative and medically inappropriate drug therapies that can lead to prescription drug abuse. This bill would also require that any beneficiaries who are at risk for opioid overuse be eligible for the benefits provided under the Medication Therapy Management Program.

This program helps patients understand all of their medications and how they are working together. It allows a pharmacist or other health professional to give beneficiaries a comprehensive review of all of their medications and talk to them about any interactions, risks, or side effects.

This bill would also include a provision introduced by Representatives Mike Thompson and David Schweikert that would streamline the electronic prior authorization system, which is meant to ensure that certain drugs are covered by an insurer before the drug is dispensed.

The PASS Act also includes a provision introduced by Representatives Sewell and Renacci which streamlines communications between the Center for Medicare and Medicaid Services and Medicare part C and D plans regarding program integrity.

Finally, H.R. 5773 would direct the Secretary of the Department of Health and Human Services to annually notify Medicare part D prescribers who are identified as outlier prescribers compared to their colleagues in their specialty and region. This has certain exclusions, for example, patients receiving hospice care, but will be used to help prescribers, who may not realize

that they are an outlier, to reevaluate their practices and make adjustments before any harm is done.

I encourage my colleagues to support this legislation, and I reserve the balance of my time.

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

Our country is truly facing a crisis when it comes to opioids, and the Medicare population isn't immune from this. We must be careful in our approach and ensure that the policies we enact in Congress don't leave out those who have a legitimate medical need for these medications, like those with cancer, those in hospice, or those with genetic conditions like sickle cell disease.

H.R. 5773 is a modest step in the right direction, and I look forward to continuing to work with my colleagues on ways to address the opioid crisis within the Medicare program.

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

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

Mr. Speaker, I am pleased to support H.R. 5676, the SENIOR Communities Protection Act.

The Affordable Care Act granted the Department of Health and Human Services the authority to suspend payments to Medicare's part A and B providers pending investigations into credible allegations of fraud or abuse.

The SENIOR Communities Protection Act would grant that same authority to Medicare part D plans. This bill would only allow plans to suspend these payments if doing so would not cause an access or network adequacy problem for the beneficiaries served by the pharmacies or hinder any law enforcement efforts.

This change would give Medicare an additional tool to help crack down on bad actors who put seniors at risk. For example, this could help plans and Medicare crack down on the practice of

pill dumping, where a small pharmacy receives millions of opioid pills from a distributor that far exceeds the population of patients it serves.

In one case, it was found that a single small town pharmacy received the equivalent of more than 9,000 pills per resident over the course of a decade. In another case, an opioid distributor shipped 9 million pills to a town of 406 residents over just a 2-year period. That is an average of 717 pills per person per year.

While opioid distributors are required to report suspicious activity, congressional investigations have revealed that distributors did not perform sufficient oversight of these shipments. As our communities are flooded with these drugs, it is important that Medicare plans have the ability to stop the bad actors when they are identified.

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

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

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

Mr. Speaker, a 2017 report from the Office of the Inspector General of the Department of Health and Human Services found that about 70,000 seniors on Medicare received prescriptions for what the report described as an extreme amount of opioids during a single year. This means that these seniors were receiving 2.5 times the level the Centers for Disease Control recommends for patients with chronic pain. Another 22,000 beneficiaries were identified as doctor shopping, which means that they received a high number of opioids from multiple prescribers and pharmacies. The opioid crisis is not exclusive to young people.

That same OIG report found that one-third of Medicare part D beneficiaries received an opioid prescription in 2016, which is about 79.4 million prescriptions. While there are certainly individuals who have a legitimate need for these drugs, H.R. 5676 will help Medicare part D plans crack down on the bad actors who are flooding our communities with excessive opioid pills.

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

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

Mr. Speaker, I am pleased to support H.R. 5723, the Expanding Oversight of Opioid Prescribing and Payment Act.

As I mentioned earlier, 80 percent of low-risk surgery patients receive an opioid prescription to treat their postsurgical pain. These prescriptions are certainly necessary for many patients, but with such a high percentage, we must examine if Medicare payment policies are ultimately discouraging the use of nonopioid alternatives.

This bill, introduced by Representatives Suzan DelBene and Claudia Tenney, would require the Medicare Payment Advisory Commission, or MedPAC, to submit a report to Congress detailing how Medicare reimburses pain management treatments in a hospital setting. This report will also examine what incentives exist in the inpatient prospective payment system and outpatient prospective payment system for overprescribing and how prescribing data is tracked and monitored in Medicare claims.

This crisis was not created in a vacuum, and it will take efforts from all aspects of the healthcare system to find a solution, including examining how our hospital payment policies have pushed providers towards prescribing such addictive medications.

I support H.R. 5723 and efforts to determine which policies within Medicare, if any, have contributed to this opioid epidemic. I am also strongly supportive of the directive within this report to realign payment policies to increase access to nonopioid alternatives for pain management.

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

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

Mr. Speaker, I must reiterate that while I support the efforts of this bill to direct MedPAC to examine which structural policies within Medicare are contributing to this opioid crisis, I believe that we need to do more than study the problem. We need to dedicate resources to fixing it.

We need to invest in longer treatment programs and comprehensive recovery programs that provide safe housing, peer support, and mental health services. And while we should absolutely examine the policies that brought us to this crisis in the first place, we need to do more to find long-lasting solutions.

So I implore my colleagues today to ensure that this package of bills is not the end of the discussion. I hope to see more hearings, more proposals, and more testimony from experts on how we can enact Federal policies that will save lives.

I hope that instead of attacking our existing healthcare system, Republicans work with Democrats to improve the Affordable Care Act, increase access to coverage, work to bring down premiums, and invest in the public health of our Nation. Addiction is a disease, not a choice. I look forward to working with my colleagues from both sides of the aisle to eradicate this disease from our communities.

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

Mr. Speaker, I rise today to urge support for H.R. 4684, the Ensuring Access to Quality Sober Living Act.

As we work to address our Nation's opioid crisis, it is important that we address recovery, in addition to treatment and prevention. Addiction is a lifelong condition. After seeking treatment, individuals suffering from addiction need stable living environments, mental health services, and peer support to maintain their sobriety. Recovery is what this bill seeks to address.

I introduced this bill because of my constituent, Ryan Hampton. Ryan was once a promising White House intern who was succeeding in college and who had his whole life ahead of him. But in his early twenties, he broke his knee hiking and was prescribed opiates for the pain. He soon became dependent on prescription drugs. He was labeled a drug seeker and was discharged from medical care.

Unfortunately, this did nothing to address his addiction. Without seeing any other options, he turned to heroin. Within a few months, Ryan was homeless and living on the streets. It wasn't until after he overdosed that Ryan got the help he needed.

After he recovered, Ryan eventually was able to be in a treatment center. He told me that he considered himself one of the lucky ones. By the time I met Ryan, he was a year and a half sober and an active advocate for the recovery community. He used his second chance to speak on behalf of others battling this devastating addiction--people like his friend, Tyler. Tyler was living in a sober living home, or a recovery residence, when he died of a heroin overdose.

Sober homes are great a resource for those newly out of treatment. They provide a safe and stable living environment to help people transition back into their lives without addiction. Sober homes have an added responsibility because the risk of overdose for those individuals can be the highest while in recovery.

Unfortunately, some sober homes can be unequipped to handle at-risk patients or do not employ staff with specialty training for individuals in recovery. Sadly, some of these facilities are bad actors that do not encourage recovery, but exploit vulnerable individuals recently released from treatment in order to collect insurance payments.

For example, Tyler's home didn't have naloxone on site, which is a drug that can counteract an overdose. Outraged and heartbroken, Ryan came to me to seek a solution. People like Tyler, who do everything right to get themselves sober, should know that they can trust the sober living homes and others on whom they rely for support.

Together, we worked on a bill that I introduced to create best practices as well as standards for sober living facilities. I cannot express my pride enough when, just a few years after addiction forced him onto the streets, Ryan appeared before Congress this spring to testify in front of the Energy and Commerce Subcommittee on Health to share his story and to encourage investment in recovery the way that we are investing in prevention and treatment.

That is exactly what H.R. 4684 would do. It would allow the Department of Health and Human Services to establish a set of best practices that sober homes could adopt so that individuals in treatment and their families can help differentiate the bad actors from the good. These benchmarks would take into account existing standards developed by the National Alliance for Recovery Residences, such as requiring that all fees and charges be explained to residents and that naloxone be available and accessible for use in emergency. As Ryan said in his congressional testimony, not having naloxone on hand is like not having lifeboats on a ship.

H.R. 4684 would also provide technical assistance to States that wish to adopt or implement these standards so that the recovery community has the support it needs.

Unfortunately, Tyler's story is not unique. I have heard from advocates in Arizona, Pennsylvania, Missouri, Ohio, and countless others who are concerned

for their friends and neighbors living in unregulated sober living facilities. That is why I am so thrilled to have H.R. 4684 on the floor here today. We need to stand behind those who have done the difficult task of seeking and completing treatment and ensure that the homes in which they live are able to meet their needs.

I would like to thank Representatives Ruiz, Walters, and Bilirakis for joining me as original cosponsors of this bill and for supporting it during their work on the Energy and Commerce Committee.

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