▶ 0:14:20Bills that we have across the finish line before they expire. At the end of the fiscal year, the legislative hearing will be held. That we held in july allowed us to hear from expert witnesses and understand the impact of some of these programs. Two very important reauthorizations in front of us serve a vital role for our health care workforce, which are title seven and title eight. Reauthorizations h.r.
▶ 0:14:414262, the empower for health act, championed by representative schakowsky from illinois reauthorizes title seven programs that help bolster our physician community by prioritizing recruitment and retention. This will continue to incentivize more individuals to enter the health workforce and expand access to care in rural and underserved areas. H.r.
▶ 0:15:0453593, the title eight nursing workforce reauthorization act, being led by representative david joyce reauthorizes, title eight of the public health service act, which plays a meaningful role in supporting development of our nation's nurses. This reauthorization includes many important grant programs that help strengthen the nursing workforce and increase educational opportunities for both nurses and faculty at nursing schools.
▶ 0:15:31The program also allows for loan repayment opportunities that are needed to incentivize more people to enter the nursing workforce. We've all heard about the need for more healthcare workers in this country, and the reauthorization of these programs is a step in the right direction towards addressing that need.
▶ 0:15:49Congress will continue to take a close look to ensure these taxpayer funded programs are properly targeted and allocate resources to areas and patients who need it the most. We are also marking up h.r. 2493, the improving care in rural america reauthorization act, an important bill carried by representative carter of georgia.
▶ 0:16:14This bill reauthorizes the rural health services outreach programs, which aim to support and promote health care services in rural areas. This program was signed into law in 2020. Under president trump's first administration.
▶ 0:16:27It promotes innovative solutions that help people in rural communities get the care they need, such as increased access to preventative health services and screenings, chronic care management, and other forms of care that are needed in our rural areas across the united states. Another important bill before us today is h.r. 3419, the telehealth network and telehealth resource centers grant program reauthorization act, led by representative valadao from california.
▶ 0:16:55This bill helps increase education, uh, on the use of telehealth across the country. Very important. Reauthorizing the telehealth resource centers grant program will support our telehealth infrastructure that has become a lifeline for both providers and patients, especially those in hard to reach rural areas. These resource centers serve as the main hub for technical assistance and support for telehealth in their respective regions.
▶ 0:17:22The university of virginia is currently the resource center for my district and for the mid-atlantic region. They have experienced a 24% increase, 24% increase in telehealth visits from their program from fiscal year 24 to fiscal year 25.
▶ 0:17:39This type of increase is happening across the country, and it is likely to continue growing as we look to extend telehealth flexibilities, we must reauthorize these centers to ensure our states are keeping up with the most recent technology and sharing their expertise so patients can have access to the care they need.
▶ 0:18:02Other reauthorization bills that are before us are being led by representative ocasio-cortez from new york and representative morrison from minnesota. These will help reduce the rate of infant mortality, improve perinatal outcomes, and expand access to screenings and services for newborns at risk of for certain disorders. Allowing for early newborn screening can save lives, create better outcomes, reduce long term healthcare costs.
▶ 0:18:27We should, we should, and we should strive to do those things as we must do with every authorization bill that moves through this committee, we must evaluate the impacts these programs have had and not only ensure the money is being spent as it was originally intended, but also ensure patient privacy is protected.
▶ 0:18:48Considering each of these, reauthorizations is an important step forward to ensure each program is working as we intended, and we will continue to examine these programs as we move to full to the full committee. I look forward to moving these bills out of the health subcommittee. And with that, I now recognize the ranking member, miss degette, for five minute opening statement on today's hearing. >> thank you so much, Mr. chairman. Well, um, there are some good bills in this markup today.
▶ 0:19:16Uh, and as you said, these these are programs that are bipartisan, bipartisan bills. They expire by the end of the fiscal year. But however, there are some things that are really missing in this markup.
▶ 0:19:32And I can't, um, I can't help but talk about this again because it's like the majority has forgotten about the bills that we all agreed on that are just as important as these seven bills that we all agreed on in the december health package. And then elon musk and doge, through a tweet, um, told told the majority to take them out, and then they got taken out.
▶ 0:19:57And so, so, uh, these are priorities that we all agree with. And everybody I talked to, including the chairman of the full committee, has said that that, that this these all need to be passed, but for some reason it just drifts along and it never gets done.
▶ 0:20:16Every single republican I've spoken to has told me it's their priority to move these policies, including reauthorizing the preventing maternal deaths act, increasing funding for the special diabetes programs, ensuring kids on medicaid can get care across state lines, and much, much more. In fact, I asked my staff to make me a list of all the bills so that I could read them, but the list is 17 pages long and I only have five minutes, so?
▶ 0:20:45So I'm not. You'll be you'll be happy. I'm not going to read the list, but I would ask unanimous consent to put the list into the record. >> without objection. So ordered. >> thank you. Um, and and furthermore, many of these policies were extended for very, very brief time. Um, after elon musk told you guys to take him out. But now these also expire at the end of this month.
▶ 0:21:13And so, uh, for example, medicare's ability to broadly cover telehealth services expires in two and a half weeks. We haven't even talked about it. And so I really think that we need, since we've already agreed on all of these important issues, they're all bipartisan. Let's just take this package and consider it when we do our full committee markup of these bills next week. Um, changing the topic.
▶ 0:21:40But again, on healthcare last week, every democratic member of this subcommittee sent you, Mr. chairman, a letter asking for a hearing with rfk jr and former cdc director susan monterey.
▶ 0:21:55As you know, doctor monterey was fired after she refused to rubber stamp unscientific and dangerous vaccine recommendations and fired respected senior cdc staff, three senior cdc leaders resigned in protest after her firing. Then last week, secretary kennedy, who was, by the way, not under oath, accused of lying about the circumstances surrounding her fire firing.
▶ 0:22:25Secretary kennedy said again, while not under oath, quote, I told her that she had to resign because I asked her, are you a trustworthy person? And she said, no, I'd like to hear what doctor monterey might say about this laughable statement under oath, and secretary kennedy should as well.
▶ 0:22:44It's the responsibility of this subcommittee to hear from doctor monterey and secretary kennedy about the circumstances surrounding her firing and the current state of cdc and hhs. Now, doctor monterey is set to testify before the senate health committee. We can all agree on one thing.
▶ 0:23:05We should not be ceding our authority as the esteemed energy and commerce committee and the health subcommittee to the senate. We can all agree on that. And so, Mr. chairman, I just want to ask you a couple questions. Number one, did you get our letter? >> I'm advised that I did. >> okay. When are we going to have the hearing. >> that is yet to be determined? >> okay.
▶ 0:23:31Well, um, as you know me well, and I'm going to tell you, we are not going to stop talking about this because the fall flu season is starting. Vaccines are in chaos over there at the cdc, and this is a matter of public health. People will die. And so I hope we have a hearing as soon as possible.
▶ 0:23:54I hope we exert our powers as the us house of representatives, and we make decisions based on ideology rather than data. And with that I yield back. >> gentleman yields back. Now recognize the chairman of the full committee Mr. guthrie for his five minutes for an opening statement.
▶ 0:24:11>> thank you, chairman griffin, for your leadership and advancing these important public health bills before us today and the legislation we're considering here today continues the support for a critical infrastructure within our public health system, including education and training of healthcare professionals, telehealth resource centers, rural outreach programs and programs related to screening newborns for inheritable diseases. The healthcare workforce shortage is a multifaceted issue and is particularly prevalent in rural areas like my district in kentucky.
▶ 0:24:41We must ensure that grant programs designed to address this issue are properly targeted, and that federal dollars are reaching the communities that need it the most. Uh, h.r. 2493, led by my good friend Mr. carter of georgia, presents an opportunity to continue support for rural health infrastructure and increase access to care in these areas.
▶ 0:25:02Additionally, patients patients in areas with less access to health care services can often utilize telehealth to reach medical professionals in a timely and efficient manner. According to the department of health and human services, 96% of hrsa funded health care centers use telehealth to provide primary care services. In 2023, h.r.
▶ 0:25:253419 would reauthorize the telehealth network and resource center programs, which has proven to be a vital component to healthcare delivery in rural areas. Ultimately, by extending these programs, we're working to stabilize and strengthen our public health workforce that supports the health of our fellow americans. I'm looking forward to continuing to work with my colleagues in a bipartisan manner to address these issues. Thank you, mister chair, and I yield back. >> the gentleman yields back. Now.
▶ 0:25:55Recognize the ranking member of the full committee, Mr. pallone, for his five minutes for an opening statement. >> thank you, Mr. chairman. Today we're considering seven health bills that will begin by marking up a few bills that reauthorize the title seven eight health professions development programs at the health resources and services administration. These programs support the recruitment, training, and retention of health professionals across the country, including physicians, nurses, and dentists.
▶ 0:26:20And as we continue to face nationwide shortages in health providers, continuing all of the title seven and eight programs is cret network of providers. These programs also of the health workforce, so that it's actually reflective of the communities they serve. Research has shown that a diverse and representative healthcare workforce improves not only patients perceptions of the care they receive, but also their access to care and their actual health outcomes.
▶ 0:26:49It's crucial that congress continues to authorize and fund these important programs. Eliminating any of them would exacerbate health workforce shortages, and vulnerable communities will be hit the hardest. We'll also consider a few bills that reauthorize important programs that support maternal and infant health. The healthy start program serves populations with the highest rates of infant mortality and women at risk of adverse health outcomes.
▶ 0:27:13This program partners with local providers to improve health outcomes before, during, and after pregnancy, with the ultimate goal of reducing infant mortality and lowering rates of preterm birth and maternal illness. I'm pleased to see it included in this hearing. I want to stress the importance of reauthorizing this program for the future. We're also considering legislation to reauthorize newborn screening programs across hhs.
▶ 0:27:36Every year, 4 million newborns in the united states are screened for genetic conditions as part of a process called newborn screening. The newborn screening program is one of the largest and most successful health promotion programs in the country, with more than 14,000 newborn lives saved or improved each year thanks to early diagnosis and treatment of these genetic conditions.
▶ 0:27:57Reauthorizing this program is crucial to making sure the program continues, but we should also be looking to restore the advisory committee on heritable disorders in newborns and children, which the trump administration has disbanded. This action by the trump administration has left states without clear, evidence based guidance for their newborn screening systems, which is increasing the risk that children with rare with rare but treatable conditions will go undiagnosed. And this is unacceptable.
▶ 0:28:25Congress must show that it stands with families across the country who rely on this essential program. We also have legislation that would grant leave parity to public health service officers, the us public health service commissioned corps is one of the eight uniformed services of the us. However, the us parental leave policy is not aligned with its counterparts.
▶ 0:28:49This disparity affects the recruitment and retention of highly qualified professionals who protect our nation's public health. The bill before us today would codify parental leave for these public health officers and align with its counterparts in the other uniformed service branch. I look forward to removing all of these bills through the subcommittee today, and I hope to advance them out of the full committee soon as well.
▶ 0:29:12But it is important, and I want to stress, I've said this to both our subcommittee chair and full committee chair, that it's important that this committee continue its job while also working to hold the trump administration accountable to implement the legislation that we pass. I always worry that our bills get out of committee on a bipartisan basis, and they didn't go to the floor. So hopefully these will go to the floor and be passed, and we'll work on getting the pass in the senate.
▶ 0:29:41But it's also important to make sure that when we pass bills, particularly new programs, uh, that the trump administration implements them. Otherwise there's no point in passing them. So just a reminder again, that, uh, it's not enough to just have the committee report these bills. They have to pass the house and the senate, and the president has to implement them, which has become a serious problem. And with that, Mr. chairman, I yield back. >> gentleman yields back.
▶ 0:30:07The chair reminds members that pursuant to the committee rules, all members opening statements will be made a part of the record. Are there further opening statements to be delivered live today? And I hope not. Seeing none, we will move forward. Um, alright, let me say this as well. Uh, it's just a point of personal privilege and a parliamentary procedure issue.
▶ 0:30:34The motion to strike the last word is a device used in long, contentious debates, so that somebody may be able to strike again by creating the legal fiction that they're amending. The measure currently currently in front of us, every member is entitled to speak on every measure before us, including amendments. But unless you're making an actual amendment or trying to get a second bite at the apple, the motion to strike the last word is superfluous. All right. Chair calls up h.r.
▶ 0:31:044262 and ask the clerk to report. And I appreciate your patience with me. Um. Without objection. Oh, they gotta start first. I was about to get get rid of you before you started. Go ahead. >> h.r. 4262. >> without objection, the first reading of the bill is dispensed with, and the bill will be open for amendments at any point so ordered. Does anyone seek to be recognized on the bill? We have. >> an amendment at the desk.
▶ 0:31:34>> gentleman has an amendment at the desk. Can you please stay with the amendment? Is the clark. >> amendment in the nature of a substitute to h.r. 4262 offered by Mr. raul ruiz. Strike all after the enacting clause, and insert the following section one short title. This act may be cited as the educating medical professionals and optimizing workforce efficiency and readiness for health act of 2025, or the empower for health act of 2025, section two.
▶ 0:32:03>> without objection, the reading of the amendment is dispensed with and the gentleman is recognized for five minutes in support of his amendment. >> thank you, Mr. chairman. I offer this amendment in the nature of the substitute to congresswoman jan schakowsky, h.r. 4262, to reauthorize programs related to health professions education and for other purposes. This amendment would rename h.r.
▶ 0:32:254262 to the educating medical professionals and optimizing workforce efficiency and readiness for health act of 2025, or the empower for health act of 2025. United states is facing a significant and growing shortage of physicians, with projections indicating a shortage of over 187,130 physicians by 2037. I've been sounding the alarm since I came into congress in 2013.
▶ 0:32:53We are facing alarming shortages in critical physician specialties, including primary care, pediatrics, geriatrics, etc. Widespread physician burnout and retirement, as well as the growing need for healthcare services and the lagging reimbursement rates compared to medical inflation contribute to this gap.
▶ 0:33:17And nowhere is the impact of these shortages felt more acutely than in rural and underserved areas like the district I represent. According to the association of american medical colleges, it is estimated that a shortage of between 20,200 and 40,400 primary care physicians will exist by 2036. The primary care physicians don't just practice in the vacuum.
▶ 0:33:43They also require specialty care for their patients. If left unaddressed, the consequences for patient access and quality of care will be devastating. The empower for health act of 2025 will spur growth in our healthcare workforce and ensure increased funding for several title seven workforce and training programs over the next four years.
▶ 0:34:06This includes funding for the primary care, training and enhancement programs, which create accredited professional training programs, including residency or internship programs in the field of family medicine, general internal medicine, or general pediatrics. The empower for health act of 2025 also allocates funding for the pediatric specialty loan repayment program. The geriatrics workforce enhancement program, and many others.
▶ 0:34:35So we need to invest in our healthcare workforce to ensure access to care for all who need it. I encourage a yes vote on this as well as the underlying bill. Thank you. And I yield. >> the gentleman yield. >> oh yes, I yield to miss degette. >> thank you. >> so much. >> well, I just want to echo the importance of the health workforce development programs under title seven last week.
▶ 0:35:03Last week, I was in colorado springs with our former colleague ed whitfield, who was a member of this esteemed committee for years, talking to some primary care physicians about the shortage that we're going to have and the challenges that they face with physician reimbursement and so many other issues. And this is really going to be a vital piece of legislation for them, um, especially in rural and other underserved areas.
▶ 0:35:28So I strongly support the amendment, and I strongly support the legislation, and I yield back. >> anybody want anything else? No. Okay, I yield back. >> gentleman yields back. Is there any further discussion on the amendment in the nature of a substitute? Miss kelly? Gentlelady is recognized to speak on the measure.
▶ 0:36:00>> I'd like to strike the last word. Thank you, chair griffith and ranking member degette for holding today's markup and including h.r 4262, the reauthorization of title seven health workforce programs. Oral health care is a critical part of our overall health, and preventative dental care can reduce costs for families and help so many people live better lives. Oral disease is a common risk factor with chronic diseases such as cardiovascular diseases, cancers, diabetes, and respiratory diseases. This is why h.r.
▶ 0:36:304262, which has a section for training professionals and dentistry, is so vital. I am grateful to my colleague rep schakowsky for her leadership in this space, and I want to express my support for her bill. I'm also so glad we are talking about oral health programs, because my bill, h.r. 2001, the action for dental health act that I proudly co-lead with rep simpson, will strengthen these supports.
▶ 0:36:55The action for dental health care, would support organizations and strengthen existing resources that provide oral health care to underserved communities, including seniors, children, families living in rural and urban areas. Action for dental health was originally approved by the democratic and republican leaders in each chamber in last year's december spending bill, and yet it was taken down at the last hour.
▶ 0:37:18More people unable to afford dental care than any types of health care children, low income americans, minorities, elderly and those in rural areas are especially at risk for having limited dental care and poorer oral health outcomes. I was just in a county in illinois and someone told me, people just let their teeth fall out because they cannot afford dental care, and they especially can't afford if they need a root canal or anything like that.
▶ 0:37:46We must address the barriers to oral health care services. The more we can address early diagnosis, intervention and prevention, preventative dental treatments, the better off our patients and our health care system will be. Dental health is oftentimes an indication of overall health, and I'm proud to lead this bipartisan effort with my colleague, who's also a dentist. And actually four other dentists helped also all republican for the third time to reduce health care costs for hard working families.
▶ 0:38:14I urge the subcommittee to reauthorize funding for hrsa's hrsa's title seven dental training cluster, along with continued robust funding for action for dental health. Thank you. And I yield back. >> gentleman yields back. Uh, gentleman from louisiana recognized. >> thank you, Mr. chairman, for the recognition. I am proud to speak in support of congresswoman schakowsky's legislation, h.r.
▶ 0:38:414262, to authorize the health care, health resources and services administration nurses title seven, health workforce programs. These programs help serve louisiana's urban, rural, and underserved communities and diversify our health workforce. New orleans is a hub for healthcare, bioscience, and higher education, and healthcare is the largest employer in louisiana.
▶ 0:39:04That's why I'm committed to strengthening our health, health workforce and investing in healthcare systems that reflect the people it serves. This is how we build a stronger, more equitable future in healthcare and ensure access to quality care for everyone. I urge my colleagues to vote yes and support this bill. I yield back. >> gentleman yields back.
▶ 0:39:32Seeing no one else, seeking recognition and no further discussion, the vote occurs on the amendment in the nature of a substitute. All those in favor signify by saying I. I oppose. Nay, motion is agreed to. Sorry. The amendment is agreed to. And now we go to the.
▶ 0:39:54For anybody wishing to seek recognition on the bill itself, seeing none all those in favor of moving the bill to the full committee. Say aye. >> aye. >> opposed? No. Bill is recommended to the full committee. Chair. Calls up. H.r. Five. Excuse me. Three. Five. Nine. Three.
▶ 0:40:23And ask the clerk to report. >> h.r. 3593a bill to amend the public health service act to reauthorize certain nursing workforce development programs and for other purposes. >> without objection, the first reading of the bill is dispensed with, and the bill will be open for amendment at any point so ordered. I turn my mic off. I recognize myself for five minutes on the bill. Uh, I rise in support of h.r.
▶ 0:40:503593 the title eight nursing workforce reauthorization act, led by my colleague, representative david joyce. Nurses are on the front lines of our health care system. We have an ever growing demand for quality health care services, which is particularly acute in rural and underserved communities.
▶ 0:41:10Many of the programs authorized through title eight of the public health service act have helped recruit and retain quality nurses, but we must examine all of these programs to ensure taxpayer dollars are being used efficiently and resources are reaching the communities that are that are most in need of these services. I'm looking forward to working further on this reauthorization with my colleagues. I urge support of this legislation, and unless somebody wants some of my time, I yield back.
▶ 0:41:40Anyone else seeking recognition on this bill? Seeing none, we'll move to a vote. All those in favor of recommending to the full committee passage of this bill say aye. >> aye. >> those opposed. Motion carries. The bill is recommended to the full committee on a20 vote. I'm teasing. Unanimous all.
▶ 0:42:05Chair now calls up h.r 2493 and asks the clerk to report. >> h.r 2493. A bill to reauthorize certain programs regarding rural healthcare. Section one short title.
▶ 0:42:26This act may be cited as the improving care in rural america reauthorization act of 2025, section two rural health care services outreach, rural health network deployment, and small healthcare provider quality improvement grant programs, a rural health care services outreach grant. >> without objection, the first reading of the bill is dispensed with, and the bill will be open for amendment at any point so ordered.
▶ 0:42:52Does anyone seek to be recognized on the bill? Does. For what purpose does the gentleman from georgia seek recognition? >> Mr. chairman, I move to strike the last word. >> the gentleman is recognized to speak on the measure. >> Mr. chairman, I'd like to express my support for the bipartisan improving care in rural america reauthorization act that I've introduced alongside my good friend, senator tim scott.
▶ 0:43:20This legislation would reauthorize critical rural health care services outreach programs that increase access to health care services in rural communities. Rural residents often often encounter barriers to accessing healthcare, including workforce shortages, distance and transportation issues, facility closures, and health insurance coverage.
▶ 0:43:42These roadblocks result in unmet healthcare needs, leading to a 43% higher mortality rate for rural americans compared to those living in cities and suburbs. We must ensure that vitally important health services are able to reach people in rural communities, which is exactly what the rural health care services outreach programs does. In fiscal year 2023.
▶ 0:44:05The outreach program delivered delivered direct services to more than 500,000 individuals in rural communities, many in areas with little to no other local health care infrastructure. The rural health care services outreach programs represent one of the federal government's most successful rural health grant programs. These programs fund locally driven, time limited projects that focus on improving access to care quality improvement, care coordination, and health outcomes in rural areas.
▶ 0:44:35In fact, several recipients in georgia benefit from this program, including the southern healthcare collaboration in baxley and the wellstar health system in marietta. The economic case for extending this program is also clear.
▶ 0:44:50The rural health network development program guaranteed grantees along generated $2 in local impact for every $1 of outreach funding in fiscal year 2023 by reauthorizing rural health services outreach programs. This bill will lead to increased access to health care services and preventative screenings, improved chronic disease management and health outcomes, expanded telehealth services, and reduced emergency department visits.
▶ 0:45:20For the nearly 500,000 individuals who receive direct services for these programs annually. In 2020, president trump signed into law legislation reauthorizing rural health outreach services programs under the 2020 cares act through fiscal year 2025, the improving care in rural america reauthorization act of 2025 will extend these critical programs through 2030.
▶ 0:45:43Further bill changes will ensure that local rural needs are prioritized in grant awards. I applaud senator scott for introducing this bill with me, and I urge my colleagues to support it. Thank you, Mr. chairman, and I yield back the remainder of my time. >> gentleman yields back. Is there anyone else seeking recognition on this bill? Hear recognize doctor ruiz for five minutes. >> I move to strike. The last word, chairman, um. >> has been recognized. Thank you. >> thank you so much. You know, it kind of.
▶ 0:46:13You know, it moves me to hear, uh, my colleague from georgia speak about improving rural health when we just took ten giant steps back with the big ugly bill that cuts medicaid, that cuts funding to rural hospitals, that is going to make rural healthcare devastatingly worse, devastatingly worse.
▶ 0:46:40And so 20% of rural hospitals throughout the whole country, including several in my district, and I'm sure several in georgia are going to close because of that bill. They've been sounding the alarm. They're saying it the american hospital association, they're saying they're going to close.
▶ 0:47:02In addition to that, millions of americans citizens are going to lose healthcare because of this bill, mostly because of the bureaucratic nonsense. In fact, georgia's having a hard time right now trying to recruit medicaid eligible patients under their own work requirement rules. In fact, they've hired a consultant. Only 3% have been found to enroll in medicaid.
▶ 0:47:29So the the funding for rural hospitals are going to go down. States are going to have to pony up. States cannot increase their revenue based on the big ugly bill like they used to with the provider tax and other other programs that are also decreased. So what does that mean?
▶ 0:47:54States are going to have to make hard decisions on physician reimbursements, on eligibility on um, benefits offered through the medicaid program. So what does this mean? Yes, this bill may take a tiny step forward in helping emergency departments, but emergency departments are going to get busier because more people are going to be uninsured.
▶ 0:48:18And when hospitals close and you don't have an emergency department, people are going to have to travel longer to get emergency care. What does that mean? That means if you have a stroke and you can't get to a stroke center within your ten 15 minutes, your risk of permanent injury or death skyrockets. That's not just that's not politics, man. That's medicine. Those are signs. Ask any doctor whether time is of the essence for a stroke or heart attacks.
▶ 0:48:48How many people, you know, potentially my district and in georgia and in all of our districts have an increased risk of dying because they have a stroke, because of their zip code in rural america, because of this big, ugly bill that we just passed. So, yeah, you all are going to say we're improving health care. You know, in the backdrop of kicking healthcare's.
▶ 0:49:13Where people are going to die because of this bill that you just passed ten giant steps back, and now you're going to say, oh, we're going to improving health care. One tiny step forward. Come on. It just irks me because as an emergency physician, I know the pain and suffering that patients are going to experience. My constituents, your constituents, all of our constituents are going to suffer because of this bill.
▶ 0:49:40So look, man, I'm going to vote yes. I'm not going to voice vote no, because this is a common sense bill. It should pass. But spare me the improving health care. When you just rip health care away from millions of people.
▶ 0:50:00And that's just the people that are directly impacted through this, not the millions more that are going to be indirectly because programs at hospitals are going to be closed. So even people with private insurance are not going to have access to those specialties or those programs, and maybe even that hospital in their rural community, I yield back. >> gentleman yields back. Recognize the gentleman from pennsylvania, doctor joyce. >> I speak.
▶ 0:50:29>> in support of this legislation. The improving care in rural america is legislation that accomplishes something that is so important for the constituents that don't have that access to screening, that don't have that access to care, that is important that we reauthorize this. Representative carter and his legislation understands that rural america is often left behind.
▶ 0:50:52This is a bipartisan piece of legislation that addresses that issue, that understands that we have a responsibility to all of our constituents, to all of america. But this is an important piece of legislation that allows screening to allow intervention to occur early, to stop disease and the effects of that. I urge my colleagues to support this legislation here today in the markup, and to continue to support it as it comes to the floor. With that, Mr.
▶ 0:51:21Chair, I yield back. >> gentleman yields back. Anyone else seeking recognition recognize the gentlelady from washington, doctor schrier. >> thank you, Mr. chairman. Thank you, doctor ruiz, for your comments. Uh, I'm happy that the committee is considering the improving care in rural america reauthorization act, which I co-lead with congressman carter.
▶ 0:51:47My district is 10,000mi and includes a lot of rural communities that depend on a very scarce number of providers in, in their areas. And this bill will help expand access. I am happy to support it, but I have to tell you that I would be remiss if I neglected to point out exactly what.
▶ 0:52:07Doctor ruiz also pointed out that nearly all house republicans and every republican in this committee voted just a couple weeks ago to cut $1 trillion from medicaid. And I've said this before, and I will say it again, that trump's so-called one big, beautiful bill, which of course, we refer to as one big ugly bill, is going to close rural hospitals. It's going to close labor and delivery units. It's going to overwhelm emergency departments.
▶ 0:52:37It will increase costs for everyone, regardless of whether you are on medicaid called apple health in my state or not. And republicans are saying that this rural health transformation program is the single largest investment in rural healthcare ever. And that is just plain spin.
▶ 0:52:55I just don't know how you can call 50 billion and investment and the largest investment when with the other hand, you are cutting $1 trillion from medicaid, which is disproportionately important in rural america. So this is my bill, uh, with Mr. carter. I'm absolutely going to vote for this bill today. It is good for my district. I stand up for my district.
▶ 0:53:23But I just have to say that every republican on this committee, uh, betrayed their districts by gutting medicaid in h.r. One. And this is not going to fully undo the damage that they have caused. Thank you. And I yield back. >> anyone else seeking recognition.
▶ 0:53:46I then recognize myself for five minutes, and we just simply say that, uh, we don't agree on all of the assertions made by our colleagues that with that, I yield back. And now, is there anyone else who wishes to be heard on the measure, seeing none. Uh. We will now vote on forwarding to the full committee. H.r. 3593.
▶ 0:54:12All those in favor say aye. Aye. Opposed? No. >> 493. >> oh, sorry. I got the number wrong, I apologize. Let's go back and redo it because the chairman got his numbers wrong. We're on h.r. 2493. We'd already passed the other one. I apologize. Uh, so the question now occurs on forwarding h.r. 2493 to the full committee. All those in favor say aye. Opposed? No. The ayes have it.
▶ 0:54:39Bill is agreed to and forwarded to the full committee. All right. Now we're going to call up h.r. 3419. And I ask the clerk to report saying. >> h.r. 3419, a bill to amend the public health service act to reauthorize the telehealth network and telehealth resource centers grant programs.
▶ 0:55:02Section one reauthorization of telehealth network and telehealth resource centers grant programs. Section 330i queue of the public health service. >> without objection, first reading of the bill is dispensed with, and the bill will be open for amendment at any point so ordered. Does anyone wish to seek recognition on the bill? Gentleman from georgia. For what purpose does the gentleman seek recognition?
▶ 0:55:33>> Mr. chairman, I move to strike the last word. >> gentleman is recognized to speak on the bill. >> Mr. chairman, I rise in support of h.r. 3419, led by my colleague, representative valadao. This bill, reauthorizes telehealth network and telehealth resource centers, grant programs administered by the health resources and services administration.
▶ 0:55:50These programs aim to improve access to telehealth services by providing technical assistance and other support methods to providers and rural and frontier communities, so patients in these areas can more easily access necessary telehealth services. Approximately 22,000 patients across the country have benefited from these programs. We must continue these vital resources to help improve health outcomes in underserved communities.
▶ 0:56:20I urge my colleagues to support the bill and I yield back. >> gentleman yields back. Anyone else seeking recognition on the bill recognize representative dingell for five minutes on on the measure. >> thank you, Mr. chair. I move to strike the last word. Uh, representative bill to reauthorize telehealth grant programs under the public health service act.
▶ 0:56:44The covid 19 pandemic underscored the urgent need to expand access to telehealth services, and they have since become an essential part of our health care system. We must ensure that americans can continue to choose whether they receive their health care in person or through telehealth services that may be more appropriate or convenient for them.
▶ 0:57:06It is a fact that having to physically travel to a doctor's office or hospital can present a serious barrier to care for seniors, people with disabilities, and people who live in rural areas that are far from a health care provider. This bill reauthorizes critical grant programs to help address these barriers.
▶ 0:57:25While reauthorizing this program will be an important step in expanding access to telehealth, I urge the committee to also take action on the telehealth modernization act, a bipartisan bill I co-lead alongside my wonderful colleague buddy carter, to extend telehealth flexibilities for seniors on medicare through fiscal year 2027.
▶ 0:57:49We must continue to think seriously about how we're going to ensure americans can continue accessing telehealth services. I also urge my republican colleagues on this committee who understand the importance of this access to make the case to the trump administration that proposed cuts to erisa will have a negative impact on telehealth services and grant programs. Thank you, Mr. chair, and I yield back. >> gentlelady yields back. Anyone else wishing to seek recognition on the bill?
▶ 0:58:19Seeing none. I now move that or now go to the vote on h.r. 3419 to get the number right this time, Mr. clark. Thank you. Um, on recommending or forwarding that to the full committee. Uh, all those in favor say aye. Opposed? No. The ayes have it, and the bill will be forwarded to the full committee. Now, have h.r.
▶ 0:58:543302. And if the clerk would so report. >> h.r. 3302, a bill to amend the public health service act to reauthorize the healthy start initiative. Section one. Short title. >> without objection, the first reading of the bill is dispensed with, and the bill will be open for amendment at any point. So order. Does anyone seek recognition on the bill? For what purpose does the gentlelady seek recognition? >> um, I would like to speak on the bill. >> gentlelady is recognized for five minutes. >> thank you.
▶ 0:59:24I'd like to thank chairman griffith and ranking member degette for holding this legislative markup and for including our bipartisan bill, the healthy start reauthorization act of 2025, which I lead with representative malliotakis. I've talked about healthy start in this committee before, and I want to take this time to reiterate how essential this program is to families in my district and and to families across the country.
▶ 0:59:49The united states has the highest rate of maternal deaths among all wealthy countries. We also have the highest rate of infant deaths compared to other high income countries. And we are the only wealthy country that does not guarantee health care as a basic human right, which often leaves women without affordable and adequate prenatal and postnatal care.
▶ 1:00:14While there remains work to be done, we have made significant progress in reducing infant deaths over the past three decades. Healthy start is a federally funded, locally driven program whose purpose is to reduce infant deaths and improve the health of babies, pregnant women and new mothers.
▶ 1:00:33There are more than 115 healthy start programs across the country and in all 50 states, including the bronx healthy healthy start partnership, as well as healthy start partnerships in staten island with my co-sponsor, uh, representative malliotakis. Healthy start focuses on communities that need it most. These are communities that have the highest rates of infant mortality, and may have limited or unavailable maternal care. This program has a long history of bipartisanship.
▶ 1:01:03It was created in 1991 by president george h.w. Bush, and since then it has been reauthorized several times, always on a bipartisan basis. In fact, the last time the program was reauthorized was during president trump's first administration. There's a reason healthy start has had such strong bipartisan support. It's because it works. Women in healthy start receive earlier and more frequent prenatal care.
▶ 1:01:31Fathers are more engaged and babies are born healthier. If we continue to reduce infant deaths and improve infant and maternal health outcomes, we need healthy start programs in our our states and districts. Now more than ever, I urge my colleagues on both sides of the aisle to support this common sense and bipartisan bill. And I yield back. >> gentleman yields back. Anyone else seeking recognition on the measure? Seeing none, we will move forward to a vote.
▶ 1:02:02The question now occurs on forwarding h.r. 3302 to the full committee. All those in favor say aye. >> aye. >> those opposed? No. The ayes have it, and the bill is agreed to and forwarded to the full committee. Now have. H.r. 2846. And I would ask the clerk to report the same. >> h.r.
▶ 1:02:272846, a bill to amend title two of the public health service act to include as an additional right or privilege of commissioned officers of the public health service and their beneficiaries. Certain leave provided under title ten, united states code, to commissioned officers of the army or their beneficiaries. >> without objection, the first reading of the bill is dispensed with, and the bill will be open for amendment at any point so ordered. Does anyone seek to be recognized on on the bill? H.r. 2846?
▶ 1:02:56All right. So, houlihan, bill, um, you all heard what the bill does. It is to grant to and and the ranking member of the full committee spoke to this in his opening.
▶ 1:03:17It's to grant to, um, public health service, uh, employees and their beneficiaries certain leave provided under title ten, the united states code, to commissioned officers of the army, uh, the united states public health service, uh commissioned corps officers, protect and promote the health and safety of our nation by serving in a wide range of health related specialties with over 20 federal departments and agencies, public health service officers deployed to to provide public health, emergency response and disaster recovery
▶ 1:03:49Support. The us peace officers are one of eight uniformed services in. This bill would align their authorized leave benefits with those of the other seven uniformed services. I am grateful for the important work that the usphs officers do to keep our nation safe, and I would urge support of the bill. I would tell you that it did a little investigation outside of the talking points I've been handed, uh, previously, because I was curious as to whether or not they could be deployed into combat areas. And the answer is yes.
▶ 1:04:18And they have been in numerous wars of the united states. Further, when there is a disaster, such as a medical issue disaster such as ebola outbreak, they can be sent to areas that may not be in a military conflict, but that have significant, uh, disease, uh, issues. That is helpful both to the united states and to the countries involved in such an outbreak. So I do support the bill. And, uh, we'll now yield back.
▶ 1:04:44Anyone else wishing to speak on the measure, seeing no one else, wishing to be recognized? Uh, the question now occurs on forwarding h.r. 2846 to the full committee. All those in favor say aye. >> aye. >> those opposed? No. The ayes have it, and the bill is agreed to and forwarded to the full committee. All right. The chair now calls up h.r. 4709 and asks the clerk to report same.
▶ 1:05:15>> h.r. 4709a bill to amend the public health service act to reauthorize certain programs under part a of title 11 of such act relating to genetic diseases and for other purposes. >> without objection, the first reading of the bill is dispensed with, and the bill will be open for amendment at any point. Seeing no objection so ordered, does anyone seek to be recognized on the bill? Recognize the gentlelady from washington, doctor schrier, for five minutes. >> thank you, Mr. chairman.
▶ 1:05:47Well, as a pediatrician, I review newborn screen results all the time. And I am so happy that our committee is advancing the newborn screening saves lives reauthorization act, which is legislation that I co-lead with doctor kelly morrison, ob gyn, a little heel prick test that most parents remember and that every newborn in this country gets is a simple, low cost, effective tool in the identification and treatment of so many rare
▶ 1:06:18Diseases. What these have in common is that they are rare and they are horrible. But if you catch them early, you can make a tremendous difference. Life saving difference, developmental difference in kids lives. Um, in fact, I was recently at a food bank in my district, uh, volunteering, and I ran into one of my former patients who was also volunteering. Um, turns out that she, because of newborn screening, was diagnosed with phenylketonuria, or pku, within days of birth.
▶ 1:06:46She is doing so great. She is thriving in high school because of this early detection and treatment with a special diet. It's a difficult diet, but it has saved her life and her development and is remarkable. I will tell you that without newborn screening, she might not have been diagnosed until permanent developmental delays had already occurred, and this was really a godsend for her and for her family.
▶ 1:07:13Um, this is the common denominator for all of these 38 core diseases that are recommended for screening. They are rare, but as I said, early detection and treatment can give most of these kids the gift of a healthy and normal life. Pku managed with dietary changes. So is galactosemia congenital hypothyroidism totally different, by the way, than adult hypothyroidism? Uh, it is disastrous. If not treated.
▶ 1:07:42It is easily treated with medication and cystic fibrosis can now be treated with gene therapy without treatment. These are devastating diseases. So I just want to emphasize how important this newborn screening is, how non-controversial nonpartisan this is. And I encourage all of my colleagues to vote yes. Thank you. And I yield back. >> gentlelady yields back. Anyone else seeking recognition? Seeing no one else, I will recognize myself for five minutes.
▶ 1:08:12Uh, I just have to say it. This is when you love being on health sub, and when you love being on the energy and commerce committee. We have our disagreements, we have our philosophical fights. But when we come together to help children, it just every one of us ought to feel very blessed that we have the opportunity to be here. With that, I yield back. Anyone else wishing to seek recognition? Seeing none, the question now occurs on forwarding h.r. Four 709 to the full committee.
▶ 1:08:41All those in favor say aye. >> aye. >> opposed? No. The ayes have it, and the bill is agreed to and forwarded to the full committee. For all of these bills. Without objection, staff is authorized to make technical and conforming changes to the legislation approved by the committee today. So ordered without objection. Committee stands adjourned.