Floor Statements

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1839) to amend title XIX to extend protection for Medicaid recipients of home and community-based services against spousal impoverishment, establish a State Medicaid option to provide coordinated care to children with complex medical conditions through health homes, prevent the misclassification of drugs for purposes of the Medicaid drug rebate program, and for other purposes, as amended.

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks and include extraneous material on H.R. 1839.

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

Mr. Speaker, I am humbled to rise in support of H.R. 1839, the Medicaid Services Investment and Accountability Act, a bill that will strengthen our healthcare system by putting patients first.

I am an emergency physician, and as a doctor I have treated patients who, because they couldn't afford the care they needed, slipped through the cracks, worsening their quality of life, harming themselves and their families, and sometimes ending up in the emergency department for lifesaving care.

This bill makes five essential reforms to Medicaid that put patients first, helping children and individuals with mental health issues access the care that they need.

The bill's first reform reflects the hard work and tireless efforts of my friend, Representative Dingell, who has led the fight to extend Medicaid spousal impoverishment protections. Thanks to Representative Dingell's advocacy, patients will be able to afford treatment and services without bankrupting their spouses.

Without this important protection, families would face a terrible choice between either unnecessary institutionalization or impoverishing themselves to ensure that their loved one receives the care that they need.

I would also like to thank Congressman Upton for championing this important policy.

Second, my bill would provide additional funds to the successful Money Follows the Person demonstration. This funding will help more individuals transition from institutions to the communities they call home. I wanted to thank Representatives Dingell and Guthrie for their advocacy on behalf of the patients and families who continue to benefit from this successful program.

Third, this bill includes the Advancing Care for Exceptional Kids Act, bipartisan legislation that gives States the flexibility to coordinate the most effective care for children with medically complex needs. The ACE Kids Act would not be possible without the sustained advocacy and hard work of Congresswoman Castor.

Representative Castor is an incredible advocate for some of our most vulnerable children and their families and has spent years championing this bill. I also want to thank my friend, Representative Bilirakis, for continuing to fight to ensure that our sickest kids have access to health homes.

Fourth, this bill contains important program integrity improvements to Medicaid, fixes that will save money and make Medicaid run more efficiently and effectively without sacrificing quality of care for patients.

That includes legislation championed by Representatives Schrader and Welch to crack down on drug companies cheating the Medicaid program by not paying proper rebates on their drugs. The bill also gives the Department of Health and Human Services the tools it needs to hold ill- intentioned pharmaceutical companies accountable, while ensuring that patients who depend on these drugs continue to have access to them.

Fifth, and finally, this bill extends funding for the Excellence in Mental Health Act, so that people who are struggling with mental health and substance use disorders can continue receiving the treatment they need. The extension will help Congress find a longer-term solution so that this program can continue providing care to the people who need it.

I would like to thank Representative Matsui for her continued hard work to support this demonstration. In brief, this bipartisan bill strengthens Medicaid by putting patients first. It was the approach I took as a doctor in the emergency department, and one I am continuing to take in Congress.

I know this bill will make our healthcare system stronger and more equitable, and I am proud to lead this critical effort.

I urge my colleagues to support the passage of H.R. 1839, the Medicaid Services Investment and Accountability Act of 2019, and I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to the gentlewoman from California (Ms. Matsui).

Mr. Speaker, I yield 2 minutes to the gentlewoman from Florida (Ms. Castor).

Mr. Speaker, I yield 2 minutes to the gentlewoman from Michigan (Mrs. Dingell).

Mr. Speaker, I am ready to close.

Mr. Speaker, I urge my colleagues to support this bipartisan bill, H.R. 1839. I really thank all the Members who put their heart and soul into their pieces of legislation. I thank the staff of the Energy and Commerce Committee, both Democratic and Republican, who have come together to work to plug a hole, to fill in the cracks, and to make sure that services continue, that value is given, and that healthcare puts our patients first, our kids first, so that we can give them the appropriate care that they deserve, no matter where they are from or whether or not they can afford it.

This is why I am so humbled to carry the water on this bill. On behalf of myself, my staff, and my office, I thank everybody involved in this bill.

Mr. Speaker, I urge support for this bipartisan bill, H.R. 1839, and I yield back the balance of my time.

Mr. Speaker, I thank Chairman Takano and his staff for all their work on this. They have done a great job. I thank them for fighting for this bill and for their tireless work in support of our veterans.

Mr. Speaker, I also thank the ranking member, Dr. Phil Roe, for his support of veterans who have been exposed to burn pits, and a special shout-out to my good friend Congressman Dr. Brad Wenstrup, who is the colead on this bill. We have worked together on this and numerous bills, and we are also leading the efforts in the bipartisan Burn Pits Caucus to really give answers to our veterans who have been exposed.

My bill, the Burn Pit Registry Enhancement Act, will help our government better understand the health effects of toxic burn pits on our men and women in uniform.

As a nation, we have a responsibility to provide our veterans with the benefits that they have earned and deserve and to keep them safe to the best of our ability when they are in the field.

We bear that responsibility even more heavily when the actions of our own government--in this case, its use of toxic burn pits--are causing veterans to develop severe pulmonary illnesses, cancers, autoimmune diseases, and chronic conditions that are making young, otherwise very healthy veterans, extremely ill, permanently oxygen-dependent, and totally disabled--and, in some cases, leading to their death.

This is what happened to Jennifer Kepner, a constituent of mine, a mother of two young children, and a veteran of the United States Air Force. Despite being only 39 years of age, living an active lifestyle, very healthy, not having any other risk factors, Jennifer developed a very aggressive pancreatic cancer that ultimately took her life.

Jennifer's oncologist conducted an extensive genetic and environmental risk assessment and found that the only probable and most probable cause of her cancer was her exposure to burn pits. These are acres, sometimes 10 acres big, of open burn pits where they burn everything and anything, like that garbage open burn pit with jet fuel, that exposes our servicemembers to hundreds of toxic chemicals and carcinogens, with huge clouds of black smoke that traverse long distances.

So while Jennifer was fighting bravely against her cancer, she also had to fight tooth and nail to get the healthcare and benefits that she had earned. Even then, the VA did not recognize her cancer's connection to burn pit exposures.

I was there in her final days, and she wanted us to do something. She called it our generation's Agent Orange. She wanted us to do something to prevent this and to help other veterans.

There is a principle I use as a doctor and a public health expert, and that is, when there is a high enough suspicion of an agent that can cause a severe enough health consequence, then we have to act on that suspicion. In this case, we do have enough suspicion, given the information that is out there, that burn pits are essentially toxic and causing health problems and even death, so it is definitely severe enough.

We need to do something. There are four prongs that we need to pursue, four pillars of a framework.

One is stop the use of burn pits.

Two is outreach to veterans and providers to educate them about their risks.

Three is to make sure that we take care of our veterans by providing healthcare and some of the benefits that they have earned.

Also, do more research so that we can fully understand the full health effects of being exposed to these burn pits.

This bill and the burn pit registry will help with two of those prongs. One is that it is a vehicle for the VA, DOD, and our government to communicate with veterans who have been exposed to burn pits, and their family members, about any recent health topics, research, or policy change that they may be interested in.

It also helps them grab samples of veterans for future research so that we can better understand with more robust scientific research the full effects of burn pits in their lives, which could lead to a better understanding, better healthcare, better outreach, and more benefits for our permanently disabled veterans.

It is very important that veterans who have been exposed to burn pits register in the Airborne Hazards and Open Burn Pit Registry and build this communication vehicle with the VA, our government, and those of us who are strong advocates for our veterans.

My bill will allow an entry with the cause of death in the Airborne Hazards and Open Burn Pit Registry after a veteran passes away. For example, right now, if a veteran passes away, there is no way to update this burn pit registry with their cause of death. This allows a spouse or a designee to enter that cause of death.

Mr. Speaker, those causes of death could be brain cancer, esophageal cancer, pancreatic cancer, autoimmune diseases, lymphomas, leukemias, constricted bronchiolitis, COPD, and others.

Mr. Speaker, I urge each Member of this Chamber to support this bipartisan bill, which will help our Nation uphold its commitment to serving our veterans. Together, we are taking a crucial first step toward honoring Jennifer Kepner and improving and saving

the lives of countless veterans. I thank the chairman for his support.

Mr. Speaker, two names have been lost in months of government shutdowns and threats of national emergencies: Jakelin Caal Maquin and Felipe Gomez Alonzo. Those were the children who died in December while in the custody of our Federal Government.

Let me tell you a bit about Jakelin's story and how, in the next 48 hours, we will take a historic first step to forever change how our Nation treats children fleeing violence.

Jakelin Caal Maquin was 7 years old. She joined her father in fleeing the extreme danger and poverty of her village, San Antonio Secortez in Guatemala. Together, they dreamed of new opportunities, of new safety, of a home free from violence and discrimination where they could build a life and support their loved ones at home.

Jakelin and her father chose the same destination that asylum seekers, immigrants, and refugees have sought for centuries: the United States of America.

But the conditions I saw at the Border Patrol facilities where Jakelin and her father were held were not worthy of our American ideals. The conditions did not demonstrate respect for the human dignity of the individuals in our Federal Government's care.

Look, I am a doctor. I know what a functioning emergency medical response protocol looks like and how it should operate, and this was not it.

I saw women, infants, toddlers, and the elderly packed and even piled on top of each other, open toilets in crowded cells without any privacy, visibly sick people, children coughing on one another, and I immediately saw that the Border Patrol agents did not have the resources to respond to a life-threatening medical emergency.

Mr. Speaker, let me put this into perspective. I traveled to Haiti days after the devastating 2010 earthquake, where I served as the medical director of the country's largest camp of internally displaced people. The conditions I saw at the New Mexico Border Patrol facilities were worse than those I saw in Haiti, the most impoverished country in the Western Hemisphere, after their most challenging and devastating disaster.

Here we are, the greatest nation on our planet, and we are putting children in cages and denying them free access to food, water, and a private toilet.

Then and there, I committed myself to creating humanitarian standards that are worthy of human dignity: real solutions, not empty promises, that will save the lives of children at the border.

I introduced legislation that makes it clear Congress expects CBP to implement three crucial reforms as soon as possible:

First, provide meaningful medical examinations of individuals entering our borders. A basic physical exam would have shown warning signs of Jakelin's septic shock and most probably saved her life. A child who dies from septic shock does not look normal 8 hours beforehand.

Second, invest in essential medical equipment and trained medical personnel available to respond to life-threatening emergencies. When medical care is far away, agents need the resources, equipment, and knowledge to care for each other and the individuals in their custody.

Third, provide basic humane living conditions that are safe and hygienic, where individuals can access adequate food, water, and showers.

These are straightforward reforms. They move us closer to a system that is safe, humane, and aligns with our fundamental ideals as Americans.

Our work is not done, but we have reached an important milestone. We are beginning to address the humanitarian crisis at our border, not with rhetoric and political showboating or grandstanding, but with real, life-saving solutions.

This week, we will not just pass a bill that averts a government shutdown; we will pass a bill that provides funding for, and holds CBP accountable to, implementing the humanitarian standards included in my legislation, H. Con. Res. 17. These reforms will save lives and help restore our legacy as a nation that recognizes the dignity and fundamental rights of every human being.

So, Mr. Speaker, I will speak the names of those two children again: Felipe Gomez Alonzo and Jakelin Caal Maquin. We must have the courage to recognize their humanity.

Madam Speaker, I rise today in honor of the late Norman Pollom, a constituent of mine who led a full and inspiring life defined by his compassion for others.

As a young man, Mr. Pollom served his country in the U.S. Navy during World War II. After returning to civilian life, he brought his leadership to the football field, where he had a long and successful career.

Mr. Pollom was a member of the University of Washington Huskies' Rose Bowl-winning team in 1960. He went on to have a decorated career as a college coach and NFL scout, helping to build a Los Angeles Rams team that won seven straight Western Division Championships. He later moved to the Buffalo Bills, helping to draft Hall of Famers Jim Kelly, Bruce Smith, and Andre Reed. Mr. Pollom is widely regarded as one of the best NFL scouts of all time.

While Mr. Pollom's professional accomplishments were impressive, his conduct off the field deserves the highest praise. After his son passed away from cancer, Mr. Pollom established the Mike Pollom Scholarship Foundation in his memory. His foundation helped students from underrepresented and underprivileged backgrounds go to college and pursue their dreams. Many students' lives have been forever changed by his kindness and generosity.

While I did not know Mr. Pollom personally, those who did remember a man who always saw the best in people and encouraged others to follow their dreams. His charm and contagious laughter helped brighten every room he was in. As a veteran, a coach, and a good Samaritan, Mr. Pollom exemplified the spirit of service and empathy that make our nation great.

Mr. Pollom died as he lived: eating a burger, drinking scotch, and watching the Alabama-Clemson National Championship. He is survived by his wife of 34 years, Bonnie, and their three daughters, two stepsons, six grandchildren, and three great-grandchildren. His legacy will live on in their hearts, and in the memories of the many friends and neighbors whose lives he touched.

Mr. Speaker, I rise today to recognize and honor Mayor Greg Pettis, a leader and devoted advocate for our desert communities in California's 36th Congressional District, who unexpectedly passed away recently on January 15.

I had the privilege of working with Mayor Pettis to fight for equality and social justice for the people of the Coachella Valley.

Mayor Pettis set an example as a public servant committed to protecting the rights of all his constituents.

During his decades of service to our communities, Mayor Pettis never wavered in his advocacy for civil rights, improved transportation, and access to healthcare.

As Cathedral City's first openly gay public servant and longest serving council member, Mayor Pettis was a trailblazer and a role model.

Every day, Mayor Pettis brought his passion for helping others to the call to public service. He helped our valley build a public library, combat drug addiction, and expand affordable housing.

Through his leadership and kindness, Mayor Pettis will live on in the memory of his brothers, Stephen and David Pettis, and the friends, neighbors, and families whose lives he touched.

Recognizing Supervisor Marion Ashley

Mr. Speaker, I rise today to recognize Supervisor Marion Ashley on his retirement after more than 35 years of public service.

Supervisor Ashley has served the people in Riverside County since 2002 with leadership, integrity, respect, and enthusiasm. He grew up in Riverside County, California, and like me, has had the privilege of returning home to serve.

To see his positive impact on the cities of Banning, Beaumont, Calimesa, and others, you only need to look around. You will see medical centers, public parks, wildlife conservation areas, and fire stations that exist thanks to his advocacy.

In retirement, I hope Supervisor Ashley will enjoy spending more time with Mary, his wife of more than 60 years, and their 6 children, 19 grandchildren, and 9 great-grandchildren.

On behalf of communities across Riverside County, it is my honor to congratulate Supervisor Ashley on a well-earned retirement.

Madam Speaker, I rise today to recognize the Martin Luther King Commemorative Committee of the Coachella Valley for their dedication to celebrating the life and legacy of Dr. King.

Since 1986, the MLK Commemorative Committee has kept Dr. King's commitment to civil rights, nonviolence, and grassroots activism alive. Every year, they have demonstrated to our Desert community that the values Dr. King preached--justice, love, respect--are as important today as they were during his lifetime.

This committee was born from the vision and service of Mr. Joseph Beaver, a lifetime civil rights advocate and community leader. Answering the call to service during World War II, Mr. Beaver was one of the first African Americans to join the Marine Corps.

We are blessed by Mr. Beaver's advocacy for social justice, which has inspired and enriched our valley. To this day, he remains on the frontlines fighting for civil rights here in our community. In 2014, it was my honor to present Mr. Beaver with the Congressional Gold Medal for his accomplishments as a service member and civil rights leader.

While the manifestations of racism and prejudice may have changed, the injustice Dr. King battled endures today. Racism endures. Inequality endures. Dr. King prophesized that the arc of history bends toward justice, but the road there has never been smooth.

As we remember Dr. King, we cannot relegate him to the history books. To keep his legacy alive, we must stand up to hatred, white supremacy, and the systematic racism that continues to plague our nation. In doing so, we embrace the values Dr. King lived: justice, equality, and the courage to do what is right.

That is the mission of the Commemorative Committee: not to simply remember Dr. King once a year, but to inspire us to carry on his spirit in our hearts and enact his vision of love and equality. It's a message of freedom that, through their efforts, rings across the Coachella Valley and every valley, hill, and stream across our nation.

On behalf of the residents of California's thirty-sixth congressional district, I congratulate the Martin Luther King Commemorative Committee of the Coachella Valley for their commitment to celebrating the life of Dr. Martin Luther King. I thank them for their service to our community.

Mr. Speaker, I rise to celebrate a very special and personally meaningful victory for residents in the Coachella Valley in my district.

I rise to celebrate the passage of Measure BB and the expansion of the Desert Healthcare District.

You see, when I was a young boy growing up in a farm-worker trailer park in Coachella, I saw the dignity of

good, humble people who loved God, worked hard, and struggled to make a better life for themselves and their children.

I also saw their needless pain and suffering due to their poverty and lack of healthcare resources.

I vowed at the age of four to become a doctor and serve them.

As a freshman pre-med student at UCLA, I stayed awake at night on the top bunk bed of my tiny dorm room thinking about the difference I would one day make.

After graduating from Harvard's medical, government, and public health schools, I returned home as an emergency medicine physician as promised.

I rolled up my sleeves, organized, and went to trailer parks, rural community parks, and the poorest communities to help.

I saw familiar faces with familiar stories of suffering still living in poverty and resource-poor communities.

That is why I founded the Coachella Valley Healthcare Initiative in 2010, along with my wife, Monica, and our good friend Chauncey Veatch, to address our local healthcare access crisis.

We produced a report and a strategic improvement plan. Our most important solution was the expansion of a healthcare district.

Today, I am very happy to celebrate the passage of Measure BB and the expansion of the Desert Healthcare District to cover all medically underserved communities in the valley.

It is significant, because the district has an annual multimillion dollar budget that funds healthcare and public health programs that improve the public's health.

That means more providers caring for more patients and providing much-needed services like pediatric specialty care, mental health, veterans' health, senior services, and provider pipeline programs.

It is proof that good things happen when good people come together to do good work.

I would like to thank California Assemblyman Eduardo Garcia for answering the call and stepping up to be a champion for the expansion of the district.

He got the bill to put expansion on the ballot passed into law, and together, we helped build local support by putting out fires and persuading others of the big idea.

I also want to thank Riverside County Supervisor Manuel Perez. When the expansion of the healthcare district was under threat, Supervisor Perez and I worked closely to convince other county supervisors how much our communities would gain in both improved health outcomes and increased economic activity.

The Riverside County Board of Supervisors voted unanimously in favor of the expansion.

There were many other champions who pulled their weight and got the job done.

Thank you to the leadership of the Desert Healthcare District itself, including the President of the Board of Directors, Dr. Les Zendle, previous CEOs Kathy Greco and Herb Schultz, and Interim CEO Chris Christensen.

Thank you to board members Dr. Jennifer Wortham, Kay Hazen, and Carole Rogers, who voted in favor of expansion, and the many, many other staff members who have helped ensure this advocacy ran smoothly.

Several key healthcare organizations were instrumental in this success.

As the largest provider for the east valley, Tenet Healthcare has been enormously supportive by prioritizing the health of their patients above all else.

Thank you to Borrego Community Health Foundation for your generosity and leadership to help create this victory.

Thank you to Planned Parenthood for your tireless work, and thank you to Building Healthy Communities, Clinicas de Salud Del Pueblo, and Eisenhower Medical Center.

Thank you to James Williamson, who led the campaign.

Thank you to Barbara Fields, Juan Armenta, Mary English, Walter Clark, Oscar Armijo, Richard Meyer, and Jack Marco, whose generosity never wavered throughout this journey.

Thank you to the voters who approved the expansion measure by an incredibly large margin.

Thank you for helping to make the dream I had as a boy from a farm- worker trailer park a reality.

Together, we are improving lives and making a difference.

Madam Speaker, I rise today to recognize Supervisor Marion Ashley on his retirement after more than twenty-five years of serving in elected office.

Since 2002, Supervisor Ashley has been a tireless advocate for Riverside County's Fifth District, bringing his energy, leadership, and enthusiasm to the cause of serving his constituents. As we have worked together over the years, I've known Supervisor Ashley to be a man of integrity and compassion, always

ready to put the interests of others before his own.

Supervisor Ashley grew up in Riverside County, and like me, has had the privilege of returning home to serve the community that helped raise him. To see his positive impact on towns like Banning, Beaumont, and Calimesa, you only need to look around. You'll see medical centers, public parks, wildlife conservation areas, and fire stations that exist thanks to his advocacy.

During his decades of public service, Supervisor Ashley has demonstrated his strong commitment to positioning Riverside County as a leader in environmental conservation and renewable energy. He has helped Riverside County protect our Desert habitats and wildlife and become a national leader in wind and solar energy. He has personally donated hundreds of acres of land in pursuit of those goals.

Throughout his tenure, Supervisor Ashley has shown a willingness to work on a bipartisan basis. He has welcomed innovative ideas and treated opponents and allies with respect.

In retirement, I hope Supervisor Ashley will enjoy spending more time with Mary, his wife of more than sixty years, and their six children, 19 grandchildren, and 9 great-grandchildren. On behalf of communities across Riverside County, it is my honor to congratulate Supervisor Ashley on a well-earned retirement.

Mr. Speaker, I rise today to recognize the thirtieth anniversary of Lideres Campesinas and to congratulate the incredible women of the Coachella Valley who founded it.

For three decades, Lideres Campesinas has empowered farm working women across California to advocate for themselves, their families, and their communities in a struggle for equality.

I was 16 when Lideres Campesinas was founded by friends and neighbors I've known my whole life.

These were women who looked out for me and fed me tamales.

One of the members even gave me the affectionate nickname, ``mi chaparrito,'' Mexican slang for short guy.

Actually, she still calls me chaparrito.

These women have deep connections to our community, but as farmworkers, they endure many hardships.

Farmworkers don't share the same protections under our labor laws, and they often face difficult working conditions and wage discrimination.

On top of that, women farmworkers face higher rates of domestic violence and sexual assault, and a severe lack of legal resources and women's health services.

The founders of Lideres Campesinas experienced those hardships firsthand, so to fight for themselves and their community, they decided to organize.

Maria Aguirre Rosales De Banuelos was one of those founders.

Maria migrated to the U.S. in 1977, and she held a demanding agricultural job for twenty years.

After being trapped in an abusive marriage for most of her life, Maria met with some of her farmworking neighbors in the Coachella Valley.

In that room, she realized she was not alone: many of the women she spoke to had also experienced domestic abuse, and like her, finally felt the freedom to share their experiences with others.

That realization gave Maria the strength to free herself from an abusive relationship, and to help create an organization that would connect and empower women in the Coachella Valley.

That's how Lideres Campesinas was born.

Out of community.

Out of compassion.

And those are the values to which it has stayed true.

Lideres Campesinas has since grown to include chapters across California.

By providing women with health education services, they are helping women live healthy and productive lives.

By educating their communities about workplace harassment and labor exploitation, they have helped women stand up for their rights.

And by connecting women with legal and social services, they have helped women remedy the discrimination they face.

Maria Aguirre passed away earlier this year, but she will forever be remembered as an empathetic, kind-hearted leader of our community.

To the women of Lideres Campesinas, thank you for your service to our community.

A todas las mujeres de Lideres Campesina, gracias por su servicio a nuestras communidades.

Mr. Speaker, I rise today to recognize the communities affected by the Cranston fire, one of the largest wildfires my congressional district and eastern Riverside County has ever seen.

While the Cranston fire was contained in August, many of my constituents are continuing to piece their lives back together, and anytime severe rain is forecasted, they once again go into high alert for mudslides from the burn scar.

The Cranston fire started on July 25, 2018, and within a matter of a few hours residents of Idyllwild and the mountain communities were immediately forced to evacuate from their homes. Without hesitation, first responders from the Idyllwild Fire Department, the Idyllwild Volunteer Fire Company, CAL FIRE, the California Highway Patrol, the U.S. Forest Service, and countless others from all over the Nation sprang into action.

Thanks to their efforts, no lives were lost and the fire was fully contained by August 10, having burned more than

13,000 acres. Months later, I am left with the image of police officers walking through smoldering neighborhoods with megaphones, making sure no one was left behind.

Today, Idyllwild continues to embody that spirit of community and togetherness. They are rebuilding homes, clearing debris, and preparing for the next wildfire that threatens our communities. Friends and neighbors continue to support one another, and I continue to be inspired by their compassion and determination.

Throughout this rebuilding, our communities have expressed something profound: gratitude. Rarely have I seen such an outpouring of support for our first responders.

I have seen fences papered with handwritten signs thanking the firefighters and countless tributes to their courage and sacrifice at local festivals and benefits.

The affected communities could not have made it this far without the support of religious groups, nonprofits, local businesses, and generous neighbors. During the fire, volunteers with the American Red Cross and the FIND Food Bank delivered food to evacuation centers. So did local restaurants, including Idyllwild Bake Shop & Brew, Cafe Aroma, Coyote Red's, the Mile High Cafe, and many others.

The Ace Hotel, V Palm Springs Hotel, and Grand Idyllwild Lodge were just a few of the businesses that generously opened their doors to displaced residents.

That generosity extended to our four-legged friends, too. I visited the San Jacinto Valley Animal Campus, where staff provided shelter for more than 160 local pets.

Their legacy of compassion lives on through community organizations like Young Idyllwild, who hosted a music festival and benefit to raise money for neighbors still struggling to piece their lives together.

I was particularly moved by the generosity of local musician Ernesto Ale and his family, who lost their home in the fire. In the midst of this hardship, Ernesto found the strength to perform, bringing music to his community and raising money for neighbors who, like him, lost so much in the fire.

Ernesto is proof of the kindness and strength exhibited by every neighbor, firefighter, police officer, and business owner who pitched in after the Cranston fire.

Government should follow the example of communities it serves, pulling together in times of crisis and lending a hand to those in need.

Mr. Speaker, it is my privilege to acknowledge November as Eye Donation Month, dedicated to increasing awareness of the need to register as an eye, organ, and tissue donor.

Since 1983, the Eye Bank Association of America, EBAA, and each of its 75-member eye banks across the U.S. have dedicated this month to honoring the Nation's eye donors and their families, and to celebrate the transformative impact of corneal transplants on the lives of their recipients.

With a 97 percent success rate, corneal transplants are the Nation's most successful organ transplant procedures. Since the Association's founding in 1961, nearly 2 million corneal tissue recipients have regained their sight.

In 2017, EBAA member eye banks recovered 135,203 corneas from 68,565 donors across the United States. This made it possible to provide the gift of sight to approximately 51,000 men, women, and children in the U.S., and over 26,000 recipients internationally. These eye banks also provided more than 24,000 corneas for research and educational purposes.

My home State of California is served by eight eye banks that recovered nearly 8,000 corneas last year, making it the largest source of corneal tissue for transplant and research in the country. These donations allowed thousands of Californians to regain their vision and resume the lives they had planned on living before disease or injury deprived them of their sight.

In addition to improving their recipients' quality of life and giving comfort to donor families, corneal transplants also have a considerable economic impact on America's healthcare system. A recent EBAA analysis found that the net lifetime economic benefits of cornea transplants performed in 2017 will exceed $6 billion, due to the elimination of medical expenses related to vision care and the increased productivity of both the cornea recipients and their caregivers.

I thank the Eye Bank Association of America for its decades-long dedication to the restoration of sight. I thank all of those who list themselves as an organ donor on their driver's license. I thank all of those who are willing to give of themselves for others. I want to reassure and thank their loved ones, because those who have passed have done a great good for society, for people who have lost their sight, and for future generations who will one day benefit from the research they have contributed to by donating their corneas.

I encourage my colleagues to join me in urging all Americans to give the selfless gift of vision and life by registering to become eye, organ, and tissue donors.

Mr. Speaker, I rise today to recognize Idyllwild's ``Jazz in the Pines'' festival, a celebration of music, art, and community in my congressional district.

Jazz in the Pines is one of my family's favorite traditions. It's a chance to marvel at the handiwork of local artists, catch up with friends, and listen to the sweet, sweet sounds of smooth jazz. Every year, we join our neighbors in the San Jacinto Mountains to celebrate the natural and cultural beauty that makes Idyllwild unlike any other place on earth.

The proceeds of this yearly celebration benefit the Idyllwild Arts, a foundation that teaches adults and children of all ages to realize and develop their artistic talent. Through summer camps and college preparatory courses, Idyllwild Arts is enriching the lives of students from Idyllwild and across the country.

This year's Jazz in the Pines is particularly special. Not only does it mark the festival's twenty-fifth year--it comes in the wake of and in spite of the largest wildfire to threaten the community of Idyllwild in nearly five years.

The Cranston fire burned more than 13,000 acres, destroying buildings, closing major roads, and forcing thousands from their homes. But no matter how large the fire grew, our mountain community's passion for celebrating music and the arts burned brighter.

We owe this year's festival to the incredible first responders who risked their lives to protect Idyllwild, Pine Cove, Mountain Center, Fern Valley, and many surrounding communities. I am also grateful to the hundreds of musicians, artists, and volunteers who made this year's event possible.

Jazz in the Pines was born from conversations around a kitchen table. Today, it demonstrates what we can achieve when neighbors, local businesses, and non-profits work

together. That community spirit helps us bounce back from every challenge. It's a lesson in resiliency that I am proud to share with my daughters.

Mr. Speaker, the military burns their trash, including computers, plastic, and medical waste, in open-air burn pits, creating smoke with toxic chemicals like metals and carcinogens that pose serious health risks to our troops.

Our servicemembers and veterans are developing severely debilitating pulmonary diseases, like pulmonary fibrosis and constrictive bronchiolitis, leaving them oxygen-dependent. And other young veterans are dying from rare cancers in the brain, pancreas, blood cells, and other locations.

I am an emergency medicine physician and a public health expert. In public health and in medicine, it is practice that if there is a high enough suspicion of a harm that causes a severe enough illness, then we need to act on that suspicion, remove the harm, and treat the person.

We can't wait 10 or 20 years for the perfect research study. We must act now. We must do that by simultaneously and immediately addressing these 4 points: First, stop our troops' exposure to dangerous burn pits out in the battlefield.

Second, educate doctors, veterans, and servicemembers to help doctors understand the risks of being exposed to burn pits, and to help veterans and servicemembers understand the early signs of potential serious illness so they can get treatment early.

Third, take care of burn pit exposed veterans and servicemembers at the VA and DOD, and ensure illnesses caused by burn pit exposure are recognized in their claims for disability benefits.

Fourth, do more research that is needed to identify all the different health impacts exposure to burn pits can cause.

The conference report for Fiscal Year 2019 National Defense Authorization Act includes two of my amendments

that will help address the first 2 points: Stopping the use of burn pits. And educating veterans and their caregivers about the health risks that could be connected to exposure to burn pits.

My first amendment directs the Department of Defense to conduct a feasibility study on ending the use of dangerous burn pits by using incinerators and other technology.

My second amendment requires the Department of Defense to conduct an annual education and outreach campaign to veterans exposed to burn pits and who are qualified to enroll in the burn pit registry.

The burn pit registry will improve our understanding of the different health effects of exposure to burn pits and help our ability to communicate with veterans and increase their awareness of subtle changes in their health so that they could understand the early signs of potential serious illness.

The Government must acknowledge the dangers of burn pits and the suffering of burn pit exposed veterans with severe illnesses. The Government has a responsibility to immediately provide them with the care and benefits they have earned while defending our freedoms.

I want to thank the conferees and the ranking member and chairman of the Armed Services Committee for their support of my amendment and for including these amendments in the final conference report.

Congress must continue to work together to provide solutions for our veterans and servicemembers exposed to these dangerous chemicals, toxins, carcinogens, and the smoke of burn pits.

Mr. Speaker, premiums are skyrocketing across the country, caused by this administration's sabotage of the Affordable Care Act. Just listen to the insurance company CEOs who are directly stating that not funding cost-sharing reductions for point of care for patients who are struggling to pay their bills will increase premiums. And also, by not outreaching to more people and low-risk individuals to come into the insurance pool, they are also increasing the premiums for everybody else.

But rather than making healthcare more affordable for all middle class families, this Congress is focusing on making healthcare more affordable for the wealthy few.

Instead of protecting the 130 million Americans with preexisting conditions, this Congress is sitting idly by as this administration once again allows insurance companies to sell junk plans that don't even cover basic healthcare services.

At a time when we should be stabilizing premiums by supporting risk- adjustment transfers and ACA enrollment outreach, the majority is refusing to act, simply ignoring the anticipated 18 percent increase in premiums for hardworking Americans throughout our country because, rather than help the American people, the majority would rather sabotage the Affordable Care Act for their own political gain.

This is wrong. So I offer the majority and all the Members of the House this choice: Members can support the previous question, ignore the people who will be priced out of healthcare, and ignore all the politically motivated actions by this administration to undermine access to affordable healthcare in our Nation; or Members can defeat the previous question so that we can bring up my bill, H.R. 6479, the Stop Junk Health Plans Act, which will lower costs and will ensure that Americans continue to have access to high-quality, affordable health plans. It is that simple.

You see, in general, there are three out-of-pocket or more than three out-of-pocket costs; in fact, one is the premiums, two is the deductibles, three is the co-pays, and four is the out-of-pocket costs Americans will have to pay if their health insurance doesn't cover those specific services.

So only focusing on premiums is a message deception. You see, with junk plans, that will increase out-of-pocket costs for patients because these junk plans may offer Americans a less expensive premium; however, the deductibles will be too expensive.

Also, if the majority goes after the essential health benefits and allows insurance companies not to cover things like emergency care, mental health, or prescription drugs, then they will be responsible for those out-of-pocket costs.

Also, if the majority does not defend the protections of people with preexisting illness--and insurance companies are now able to discriminate against those with diabetes, heart conditions, asthma, et cetera--then those individuals will have to pay more overall out-of- pocket costs either because they were denied or because health insurance companies will be able to charge them an exorbitant amount of money.

So this is why it is so important to keep patient out-of-pocket costs in perspective and not just focus on the political messaging tools of narrowly focusing on premiums, because someone can buy a low-cost premium health insurance, but, again, if it doesn't cover mental health, prescription drugs, emergency care, or other forms of guaranteed coverage under the Affordable Care Act, then they are going to have to pay that completely out of pocket.

If the majority doesn't protect patients with preexisting illness, then that is 180 million people in this country who have preexisting illnesses who are going to have to pay more out of pocket.

So, therefore, we must focus and stabilize the health insurance market; we must lower insurance costs by increasing enrollees into the insurance market by low-risk individuals; we must protect essential coverage and protect people with preexisting illness; and we must lower drug prices and the cost of overall care.

I urge all my colleagues to make the right choice--the only choice-- that supports the American people, in this case, the out-of-pocket costs.

Mr. Speaker, I urge Members to defeat the previous question. I urge Members to do the right thing, to think strategically, and to think about the overall out-of-pocket costs.

Mr. Speaker, the United States Constitution defines Tribes in our Nation as sovereign governments with a unique relationship with the United States Federal Government. Many treaties and Supreme Court cases show legal precedent that they are sovereign nations, and the United States has a trust responsibility to ensure they have Social Services like healthcare in exchange for taking their land.

The Trump administration is not recognizing the legal right Tribes have. They are solely considering Tribes as a racial group as their justification to impose Medicaid work requirements that we know will disproportionately result in less healthcare for Native Americans. This is wrong, illegal, and a dangerous precedent.

What happened to the treaties our government signed? What happened to the Federal trust responsibility? And what other social and legal responsibility will they negate next?

I will not stand by and watch the sovereignty of our Nation's first people attacked, and neither should you, Mr. Speaker.