▶ 0:15:13Good morning. The committee will now come to order. Before we begin, I want to take a moment um to honor the life and memory of Charlie Kirk. Many of us on this committee knew Charlie and we admired his courageous example of open debate and advocacy he showed to our country's next generation. Charlie not only modeled how to engage in the public square, he modeled faith and family values.
▶ 0:15:41To spend time with him or attend a campus event or watch one of his videos was to know his abiding faith in his savior. The boldness of Charlie's faith helped him to point the way for an entire generation. Charlie Kirk is gone too soon. His wife Erica and two two small children will remain in our prayers.
▶ 0:16:04I would also like to take this opportunity to acknowledge two of our valued colleagues who recently announced that they would be departing Congress at the end of next year. Um Danny Davis and Mr. Dwight Evans. Representative Davis has been a consistent voice for America's most vulnerable for decades, children, the poor, and the sick.
▶ 0:16:34He was a gracious host for one of our field hearings last year in Chicago in his district in a homeless shelter. Um, Congressman Evans leaves behind a long legacy of fighting for the people of Philadelphia. Block by block, he's been representing um the folks back home, and we will all miss you both um in your service on this committee.
▶ 0:17:01We still have some time, but um we definitely uh will miss you. I'd love to yield to the ranking member u Mr. Neil for any
▶ 0:17:10Thank you, Chairman. uh beginning with the notion that I think we all share and that is the political violence has become a cancer on our society. It has no place in our democracy and is the obligation of leaders to dial back some of the rhetoric and to ensure that this is not treated as a partisan issue. We may all hold strong and passionate views, but our disagreements should be settled through dialogue, debate, and the ballot box, not through violence.
▶ 0:17:37The American people deserve leaders who set an example of civility and respect to safeguard our institutions and indeed their neighbors. We honor the lives lost and commit ourselves to building a better tomorrow grounded in mutual respect for one another, our laws, and the democratic ideals that should unite In addition, we have two esteemed members of the committee who have announced their plans for next steps.
▶ 0:18:01First worker and family support subcommittee ranking member Danny Davis has been a friend, a partner, and a true force for good in the Congress for these decades. No one has fought harder for kids, families, or for the people of Chicago's west side than our esteemed colleague. We're going to miss his wisdom, his laugh, and I will miss that perfect voice. Grateful for the legacy he leaves on this committee and indeed in our lives.
▶ 0:18:28Second, of course, Congressman Dwight Evans, who has been a dedicated public servant for more than 45 years. His deep record of achievement from the Pennsylvania House allowed him to hit the ground running on health care, hospital access, economic renewal, and more. Both of these leaders have brought a passion and moral compass that we all should choose to emulate. Look forward to continue working with all of them during the course of this Congress and wish them the best in their future challenges. and indeed endeavors.
▶ 0:18:58And with that, I yield back my time.
▶ 0:19:00Thank you. Um, turning to today's markup, the bills before us reflect the numerous opportunities that the Ways and Means Committee has to work together to improve the lives of fellow Americans. To start, we will consider four healthc care bills.
▶ 0:19:18The first, the Nancy Gardner SUL Medicare Multicancer Early Detection Screenings Coverage Act from Representatives Arrington and SU honors the life of Mrs. Soul's late mother by providing multic-cancer early detection screenings for seniors. Over the next 10 years, the US government is projected to spend close to a trillion dollars treating cancer.
▶ 0:19:4875% of that will be spent on latestage cancer. If we can detect and treat cancer earlier, we can not only help Americans live longer, but also bring down the cost of fighting this disease. Next, we will consider two bills introduced by Health Subcommittee Chairman Mr. Buchanan.
▶ 0:20:11The Hospital and Patient Services Modernization Act, also led by Congressman Evans, continues the successful hospital at home program for another 5 years. Hospital care provided at home cuts mortality rates, reduces the risk of falls and infections, and it lowers recovery times.
▶ 0:20:35When we had a hearing on this topic, a woodworker from rural North Carolina credited his complete medical recovery to this program. More Americans need the same opportunity to receive hospital care in the comfort of their home. The Healthc Care Efficiency Through Flexibility Act co-led with Representative Panetta helps medical providers use technology when reporting patient quality measures.
▶ 0:21:05Digital reporting generally helps medical providers save time caring for patients and reduces administrative burden and cost. However, not all providers have the back office technology needed for digital reporting. These rules must change so providers like small and rural providers lacking digital technology aren't unfairly penalized.
▶ 0:21:32This bill clarifies the quality measure reporting process and creates a pilot program to test better ways to incorporate technology in this process. Moving forward, our last health care bill will give seniors access to new breakthrough medical devices sooner.
▶ 0:21:53These devices are FDA certified as being both safe and offering better treatments for serious diseases than currently available alternatives. Unfortunately, Medicare is slow to cover these new technologies for seniors. Patients can wait up to five years to use these devices after they have been dee deemed safe and effective.
▶ 0:22:18This bill from representatives Moore and Delben, the ensuring patient access to critical breakthrough products act gives seniors faster access to breakthrough products by providing an immediate four years of Medicare coverage. Again, getting the latest technology breakthroughs in the hands of America's seniors will result in better outcomes, healthier lives, and lower cost.
▶ 0:22:48Our next two bills protect taxpayers from government abuse. The first, introduced by Representatives Moran and SU, strengthens taxpayer rights in judicial proceedings before the tax court. The second continues the committee's work to refocus the IRS on serving taxpayers. Last year, the IRS changed the rules so that it has never been easier for the agency to charge excessive or arbitrary penalties.
▶ 0:23:16Now, agents are permitted to both obtain their supervisor's approval for penalties at any point in the process and from virtually anyone above them, not just their immediate supervisor. This has resulted in sign off on penalties after they have already been levied on taxpayers.
▶ 0:23:37This bill from Congressman Rothman provides fair treatment to taxpayers at the IRS by effectively repealing this anti-axpayer rule. Last on the agenda are three social security bills that help Americans maximize their benefits and fight identity theft. Representative Smucker and Buyers Claiming Age Clarity Act better informs seniors of the consequences of claiming Social Security benefits at different ages.
▶ 0:24:08We will also consider the Social Security Protection Act from Congressman Smucker and the Improving Social Security Service to victims of identity theft act from Congressman Kustaf. Both bills protect Americans, especially children, from the harm of identity theft. And both policies passed this committee last Congress with total support. The bills we are considering today are common sense, bipartisan ideas.
▶ 0:24:38I understand there are many issues in front of Congress at the moment that are hotly debated on both sides of the aisle and I urge this committee to remain focused on the bills in front of us today which protect patients, seniors and taxpayers. All of these are bipartisan and all help the American public and folks we were elected to serve. I'm now pleased to recognize the ranking member from Massachusetts, Mr. Nil, for his opening
▶ 0:25:05Thank you, Chairman. In the last few months, we've seen what is likely the most destructive, blatant attack on healthcare in America's history. Our Republican colleagues have amassed absolute power over all three branches of government and have wielded it with a reckless disregard for the well-being of the people and our public health. From the big ugly law, which strips away health care from 15 million Americans to a secretary of health who puts conspiracy theories ahead of science.
▶ 0:25:34I wonder if as those of us of a certain age would recall what a lung machine was like for those who did not have a polio vaccine. To go backward on that front alone should be enough to call for his The rejection of science being hellbent on the idea that you can strip health care from 15 million Americans through legislation that just a few weeks ago as offered in this committee was described as the big beautiful bill.
▶ 0:26:03so big and so beautiful, they're now trying to figure out how to change the name of it because it polls with a 31% approval rating with the American people. In addition, it's particularly rich for our colleagues on the Republican side to talk about bringing new cures to patients. In just eight months, they have decimated science and innovation. The setbacks in cancer research are unbelievable that that could be entertained at this time in our history. Thousands of staff at the NIH and the FDA have been eliminated.
▶ 0:26:33CBO confirms that cuts to NIH and FDA will result in 53 fewer prescription drugs coming to market. That's 53 fewer new cares being available to patients. Millions of dollars of research funding that has been underway for years has been pulled. Those are not serious actions from this party. And I know my colleagues on the other side, most of them don't even believe this.
▶ 0:26:57This controlled that has wre chaos and havoc upon the essential basic services that Americans should re rely on under the heading of the big beautiful bill. 15 million Americans I repeat will lose healthcare. They're determined that it is now acceptable to sacrifice the basic needs of our neighbors so that the wealthiest among us can get even bigger tax breaks.
▶ 0:27:23Meanwhile, we're still waiting for proof of concept on trickle down economics. What we have seen is that families are left bankrupt after a trip to an emergency room. Parents are forced to choose between groceries and prescriptions. Prices keep going up. People left without access to any care at all as hospitals across the country are sure to close because of that legislation.
▶ 0:27:47These are the folks that people on the Republican side are willing to sacrifice to keep favor with this White House. Let's be clear. The record is clear. There are no progress that is being made. And they are attempting to rewrite it today. They've declared war on our health, on government, and on fact many people. And for what? To make it harder to access these services, harder to qualify, harder to pay for. That's the cycle of this governance.
▶ 0:28:16gut a program, make it harder to use, drive up frustration, then point to the damage as justification for deeper cuts, and then always at 7:30 during the evening from the White House, a declaration of victory. Republicans have contributed to this problem, and it's on them to fix it. Enough with the tiny tweaks in search of cover. Prices are up. Unemployment is rising. The markings of the economy are failing the people who need the help the most.
▶ 0:28:44We should be focused on that work and reversing the cuts that took place from the big quote ugly bill. With that, Mr. Chairman, I yield back my time.
▶ 0:28:54Thank you. Our our first order of business is HR 842, the Nancy Gardner SUL Medicare Multicancer Early Detection Screening Coverage Act. The legislation before us should be familiar to the members of this committee. We successfully approved this legislation last Congress with unanimous support. Unfortunately, the legislation was not brought before the full House of Representatives for consideration last Congress.
▶ 0:29:25However, thanks to the tireless advocacy on the part of our colleagues, Representatives Arrington and Soul, whose late mother this bill is named after, we have another opportunity here to advance bipartisan policy that saves lives.
▶ 0:29:44By expanding seniors access to multi-cancer early detection screening test, this legislation builds a bridge to a future where our nation seniors can catch and treat this devastating disease before it progresses. The survival rate for cancers that are diagnosed early is nearly 90%.
▶ 0:30:10and early detection leads to better outcomes and lower costs to the Medicare program. Access to multi-cancer early detection screenings will be particularly beneficial to those seniors living in rural communities where the rate of cancer mortality is 30% higher than those in urban settings.
▶ 0:30:34As chairman of the House Budget Committee, Representatives Arrington, Representative Arrington is always looking out for the American taxpayer. With Medicare projected to spend an estimated 1 trillion on cancer care over the next decade, finding a way to reduce cost is critical.
▶ 0:30:54And we know that early detection of cancer not only results in four times better outcomes for the patients but also leads to seven times lower health care cost in the long run. I commend the sponsors of this legislation as well as those with us here today that are advocating in the blue shirts in the crowd. Um we welcome you to the Ways and Means Committee and we appreciate your advocacy.
▶ 0:31:23um for such an important cause. And I'm pleased to recognize the gentleman from Texas, Mr. Arington, for his opening
▶ 0:31:31Thank you, Mr. Chairman, Ranking Member Neil, uh and for the kind words you spoke of in the effort to make this bill become law and save lives and improve the quality of lives of the millions of people who've been infected by this insidious disease. Uh, but let me give credit where credit's due.
▶ 0:31:54It's the tireless champions and warriors in the blue shirts out there and all across this great country who've been fighting the war against cancer for many years, long before I showed up here in Washington. God bless you all for your great efforts. Mr.
▶ 0:32:14Chairman, we have uh we enjoy um on the substance and merit of this bill, not because of me or Terry, but we enjoy the most popular uh or the most broad support from members of Congress, uh 300 co-sponsors in the House, 60 in the Senate, and again over 500 uh again some of whom are here today.
▶ 0:32:39Um this bill is uh about early stage um early stage diagnosis and we named it obviously after um my colleague and our friend Terry Su's mother Nancy Gardner Su and I think that is more than appropriate. Um she was Miss Su was a devoted educator, respected civic leader, a tireless advocate herself for children.
▶ 0:33:08She dedicated her life to promoting childhood literacy, inspiring young people to engage in local government and uplifting the promise of the next generation. Uh but we know her greatest legacy is right here in this room and uh in the good, kind, and courageous leader who we call our friend Terry Su. So Terry, it's a honor to work with you and alongside of you on this uh awesome project and great cause.
▶ 0:33:38Um your your mother passed away at 81. I think yesterday was her heavenly birthday. Just read a scripture verse in Revelation about heaven said, "No more tears, no more pain, no more mourning." Um and so we'll I look forward to meeting your mother one day. Um but uh in the meantime, let's fight. Let's go and let's push this over the uh over the goal line here. Uh people know the stats.
▶ 0:34:0620 million people impacted by cancer currently. 2 million people are expected to be diagnosed with cancer this year. I'm the budget chairman. So this is most importantly affecting people's lives and the quality of lives and their families and friends. But it has a disastrous effect on our uh fiscal affairs. In Medicare, a trillion dollars has been spent on on latestage cancer over the last 10 years.
▶ 0:34:3475 cents on the dollar is spent on latestage cancer. 70% of cancer deaths occur with patients who did not get proper screening. But when they do, they have four times better chance of surviving. and we get a 7x reduction in cost. One estimate the University of Michigan uh says that preventive cancer screenings have saved us cumulative $6.5 trillion over the last 25 years.
▶ 0:35:03So it makes sense for all the reasons that we've discussed. Uh, our legislation gives CMS the authority to cover multi-cancer early detection tests that have been approved by the FDA and demonstrate clinical benefits for It ensures our nation seniors have access to groundbreaking innovation that will transform the way we treat, diagnose, and prevent the spread of Um it's a triple this this is the triple threat that we're always looking for that oftentimes
▶ 0:35:33only innovation allows and that is to improve access outcomes and bend the curve on the cost of health care. Uh if we win this war and we will on cancer and defeat this common enemy um we we can do it but we'll only do it if we unleash the power of innovation. That's exactly what this bill does. Again, Terry, it's an honor.
▶ 0:35:59We urge our colleagues to support HR842 again, but we urge you to support it with such a big push that we get it across the transom to the Senate and on the president's desk and and and make it the reality of of life in this country and hope for cancer patients all across the United States. I yield. I now recognize ranking member um from Massachusetts, Mr. Neil.
▶ 0:36:26Thanks uh Mr. Chairman and thanks to Chairman Arrington and to uh Miss Su for their sponsorship of this legislation. I spent three days in Alabama with Terry and her mom a few years ago and I knew the earnestness with which he approached this this measure. And with that, I'd like to yield my time to her.
▶ 0:36:41I want to thank the ranking member for yielding his time. My colleagues, cancer affects everyone. Today's markup represents a result of dedicated work towards one common goal, providing a coverage pathway for innovative cancer screening. This markup is of the utmost importance given the impact that cancer continues to have on our closest colleagues.
▶ 0:37:07A latestage cancer diagnosis stole our nation's champion and our dear Ways and Beans colleague John Lewis. Cancer diagnosis in the latter stage also took the life of Speaker Mike Johnson's 63-year-old father just three days before he was sworn in. Last Congress, our colleague Sheila Jackson Lee shared her diagnosis of pancreatic cancer before her death.
▶ 0:37:34And this Congress, we have already lost three colleagues to cancer. Congressman Sylvester Turner, Raul Guava, and Gerald Connley to the battle of cancer. Cancer indeed knows no bounds. It can and does affect everyone. This fight against cancer is personal to me. A latestage diagnostic of pancreatic cancer took the life of my mother.
▶ 0:38:04I want to thank my colleague Jodie Arrington for being a champion of this bill and for surprising me last Congress by naming this bill after my mom. My mom Nancy Gardner Su. Who was she? She was a devout Christian, a pastor's kid who lived her life of faith and hope. An exemplary educator and librarian special media specialist.
▶ 0:38:33She served in the Selma public school system for 36 years where she shaped minds, uplifted our children, and as a librarian, she was a strong advocate of reading and literacy and a champion for reading is fundamental riff. She brought that program not only to the state of Alabama in 1973, but she also extended her e efforts in Mississippi and Tennessee as well.
▶ 0:39:01It is a program that through a mobile unit delivers books to needy kids all throughout the southeastern region. And that program still exists today. It still provides kids in Selma, Dallas County, and Alabama's rural black belt with books. Nancy Gardner Su was a trailblazing civic leader.
▶ 0:39:24She became the first African-American ever elected African-American woman ever elected to the Selma City Council and she stood as a role model for so many women in politics. I can truly say that I get to walk the halls of Congress and represent my home district as Alabama's first black congresswoman because my mother forged that trail. Her favorite saying was bloom where you're planted.
▶ 0:39:51You can make a difference right where you are and she made a big difference in the lives of so many of the people that she touched. My mom though represents only one of millions of people who have lost their battle to cancer. and my personal story represents one of millions of loved ones who have had to endure such a horrible loss.
▶ 0:40:13It is our duty to do whatever we can to rid this nation of the scourge of cancer by giving coverage and access to as many people as we can to the latest and greatest diagnostic Therefore, I hope that you all will join Jod and I in supporting HR842, the Nancy Gardner SU Medicare Multicancer Early Detection Screening Coverage Act.
▶ 0:40:39Currently, as Jod said, this bill has overwhelming bipartisan support in both chambers, over 300 co-sponsors in the House, and as of today, 62 sponsors in the Senate.
▶ 0:40:54I am also overwhelmed by the support this bill has earned from cancer advocacy groups such as the American Cancer uh the American Cancer Society Cancer Action Network, the Prevent Cancer Foundation, the National Minority Quality Forum, the Association of Community Cancer Centers, and so many other groups. Over 600 advocacy groups and counting.
▶ 0:41:20I know that in the audience in their blue shirts are the people who are here for the annual flyin for the American Cancer Society Cancer Action Network. If you stand, we'll give you another round of applause. It is because of your tireless tireless commitment that we are here today.
▶ 0:41:49Again, I want to say thank you. And Mr. Chairman, I request unanimous consent to enter into the 20 to enter into the record the 2025 letter of support from the Prevent Cancer Foundation listing nationwide every organization that has signed on to this legislation supports
▶ 0:42:09Like so many Americans, my mother received her diagnosis late. The pancreatic cancer had already spread and eight weeks after diagnosis, we lost her. New cancer screening tools have the potential to change this. Multic-cancer early detection test can screen uh over a dozen cancers with one vial of blood. This means that we can catch cancer in their early stage, giving patients their best chance at beating this disease.
▶ 0:42:39This year, more than 600,000 Americans will die from cancer. This number could easily be reduced with early detection tools. For Congress, this means ensuring that Americans have access to the most effective tool to help combat this disease. Medicare laws do not currently provide for timely coverage of these technologies, but we can make a difference right here today by passing this bill.
▶ 0:43:06We must promote steps to create a pathway for coverage and access for early detection. Mstead bill will do this. This MSEL bill will do this. But like so many similar pieces of legislation we must pass, we must do everything we can to defeat cancer. In closing, my mother believed in community. She believed that knowledge mattered. She believed that no one should be left behind.
▶ 0:43:33And she strove to build bridges and tear down walls of injustice. Her life's work was about service, public service, about caring, about making sure that people had what they needed to flourish. I say to you, my colleagues, let's unanimously pass this bill one more time. And let us be tireless in our efforts until we get this bill passed in the Senate and on the desk of the president and signed into law. With that, I yield back the balance of my time.
▶ 0:44:04And again, I say thank you.
▶ 0:44:06Thank you, Miss Soul. um uh you definitely follow followed your mother's advice and you bloomed where you were planted. So um pretty amazing. Um thank you. The committee will now proceed to consideration of HR842 the Nancy Gardner SUL Medicare Multicancer Early Detection Screening Coverage Act. Without objection, the measure will be considered as read and open for amendment at any point.
▶ 0:44:34At this time, I offer an amendment in the nature of a substitute which was distributed in advance along with a green sheet explaining it. Without objection, the amendment in the nature of a substitute shall be considered as read, open for amendment at any point, and considered base text for purpose of amendment. I will now turn to Patrick Duma, staff director of the subcommittee on health to provide a technical description of the amendment in the nature of a substitute with an emphasis on the changes made since introduction.
▶ 0:45:04I ask that members hold their questions until after his presentation.
▶ 0:45:08Thank you, Chairman Smith, Ranking Member Neil. HR 842, the Nancy Gardner SUL Medicare Multicancer Early Detection Screening Coverage Act contains two sections. Section one provides for the short title of the bill. Section two amends section 1861 of the Social Security Act to create a new coverage category under Medicare for multicancer early detection screening tests. The amendment in the nature of a substitute amends the eligibility criteria of the coverage.
▶ 0:45:38This concludes the technical walkthrough and I'm happy to answer any questions you may have.
▶ 0:45:42Thank you. Are there any technical questions about the amendment and the nature of a substitute?
▶ 0:45:48Mr. Schwher.
▶ 0:45:53Thank you, Mr. Chairman. Um, Mr. Damas, um, in the legislation, are we agnostic? Um, because my understanding there's the current real breakthroughs are sequencing, you know, a a cancer cell throws off a dead DNA strip. Um, you know, this isn't old school tighter type tests.
▶ 0:46:12Is there anything in the legislation that will um um impair the movement towards the sequencing style of tests? They're expensive, but they really are the future.
▶ 0:46:28Thank you for the question. The the legislation does specifically uh allow for coverage of genomic sequencing blood or blood product tests.
▶ 0:46:36Okay. Um thank you, m Mr. Chairman. Um, look, right now those are expensive. They're going to crash in price, but the benefit of that is it will see if we get the sensitivities up, it sees And that's actually the miracle future because we got seven years and the Medicare trust fund is empty.
▶ 0:47:04In the next seven years, we go from 1 trillion to two trillion. is our spend in Medicare. Does this give us the chance to do the morality of the good economics of we cure people sooner because we saw it sooner and also get the benefits of that both society and the cost. So with that
▶ 0:47:27will the gentleman yield
▶ 0:47:29of course.
▶ 0:47:30Yeah. So this uh this particular screening testing and this bill doesn't limit future uh innovation and creation. instead it complements the existing screens that we currently have. And I have to tell you that um we do this bill was draw was a replica of the uh CA colon cancer screening uh coverage uh test which um as we all know once colon cancer screening was available and available widely through Medicare the
▶ 0:48:00cost of the innovation went down and in fact it encouraged others to get into this space and now we can go to CVS and get colard so the whole hope and dream is that We create a pathway to uh testing and screening now, but we promote the innovation uh that will generate uh future and save lives.
▶ 0:48:20And as you know, many of the work that we has has led to getting us here was actually funded through NIH uh and uh the uh National Science Foundation. All of which come from public funds. So we the public should benefit from these innovations. Thank you. And I yield back to you. A and actually um a couple of the university labs and actually remarkably private labs um have created some of the new breakthroughs on the dramatically faster sequencers.
▶ 0:48:50And I don't mean to geek out, but um it's it is the revolution that's going to change our lives. And with that, I yield back.
▶ 0:48:57Are there additional technical
▶ 0:49:02Seeing none, we'll move to strike the last word. Um, are there any members that wish to strike the last word?
▶ 0:49:10Mr. Smith.
▶ 0:49:12Thank you, Mr. Chairman, and uh, colleagues for this important time here as we address some uh, very important issues. Certainly, I want to associate myself with comments made uh, toward Miss Su and uh, your mother. Appreciate this opportunity to reflect on many important things to us. I'm glad the committee is taking this up.
▶ 0:49:37As screening technologies have advanced in recent years, it's become abundantly clear that we can save lives and and taxpayer dollars at the same time by encouraging earlier screenings for and more successful treatments of many common cancers. Almost none of us can say that we haven't had a close family member or friend affected by cancer. Just in this calendar year, 2025, the National Cancer Institute estimates two million people will be diagnosed with cancer.
▶ 0:50:04With that number in mind, I want to take a moment to point out how early diagnosis and positive outcomes also require access to treatment, whether that be surgery, chemotherapy, radiation, or some combination of these. And certainly to keep in mind new technologies that do exist on the horizon. In my district in Nebraska, we've been fortunate to see investments in cancer treatment in rural areas which have never had this kind of access to specialist services before.
▶ 0:50:30I'm proud to say the University of Nebraska's new cancer center in Carney, for example, in my district represents another crucial in infrastructure expansion, building out the chain from screening to diagnosis to treatment and hopefully a cure. But at the end of the day, we need the entire diagnostic and treatment process to be accessible.
▶ 0:50:49Both successful screening and cost-effective testing are products of economies of scale and making sure our seniors have access to this new form of testing under Medicare will encourage wider adoption and ultimately lower per person and overall treatment costs. I'm proud to be a co-sponsor of this of this legislation we are considering. I hope all my colleagues on this committee will vote to advance this important priority for our seniors. I yield back.
▶ 0:51:13Thank you, Mr. Dogget.
▶ 0:51:15Thank you very much, Mr. Chairman. Uh, it is good to see so many terrific advocates here in support of this bill, including my fellow Austinite, Nicole Wright. I have long co-sponsored this legislation because it is important uh to asssure that nearly half of Americans who are expected to develop cancer benefit from early detection and life-saving treatment. Going to uh the cancer society relay for life in many parts of Texas.
▶ 0:51:43I h have however uh been particularly moved by those who are survivors of cancer and uh have noted that there is one very big factor in the ability to survive cancer that always comes up that you don't need to see an oncologist to learn about and that is whether you have health insurance. And the uh the data is so strong ranging from 30 to 60% chance of dying if you do not have health insurance.
▶ 0:52:14I think of the the woman who came to see my doctor daughter at a public health clinic and who had waited too long and she was not able to provide her uh the hope uh that all of us have for overcoming this dread disease.
▶ 0:52:28And so as we consider this legislation this morning, as important as it is, it is important to note how many Americans will not be able to take full advantage of it because they are losing their access to health insurance under the legislation Republicans have approved this year. 15 million Americans. Think about the impact on those lives.
▶ 0:52:52Think about those who may be getting treated for cancer today and who suddenly find themselves without access to their physician, to their oncologist, to the other health care they need. And then the other very great concern going on at the same time that Americans are being denied access to health insurance is what is happening to medical research.
▶ 0:53:14Anyone who is concerned about the war on cancer, I would direct to the cover story in the New York Times magazine this past Sunday. Its subtitle was six months of wreckage ended a 50-year war on cancer, exposing the damage being done when Donald Trump suddenly interrupted clinical trials and other studies and research to give us new cures, new hope in the war on cancer.
▶ 0:53:42to see that destroyed in a mindless rejection of research not only for cancer but for Alzheimer's and a wide range of other Today, I think that Americans who go out to buy a pound of coffee or a pound of ground beef or maybe just a cup of coffee or hamburger, they see the results of the failed Trump Republican policies and they feel it in their pocketbook as prices go up and up and
▶ 0:54:13But I think if they consider the harm done by these policies, it's nothing compared to what lies ahead in the next couple of months with reference to health insurance. Because under the terms of the Republican legislation, the failure to uh extend really to take away the necessary tax credits for people who turn to the marketplace to get their their access to a family physician. Premiums are set to go up by an astounding 75%.
▶ 0:54:45That's the increased cost that Americans who are relying on a marketplace health insurance plan will face when they go out in November to get that plan. a huge increase, an unnecessary increase solely as a result of the decision made in this committee and throughout the Republican control Congress to refuse to extend to take away the the credits that are there to make health insurance affordable.
▶ 0:55:12And in my state of Texas, uh we will see almost 2 million people lose their coverage because of this huge increase in the premiums, the coverage they need for cancer and for just ordinary treatment uh and care of their families to avoid disease and to be able to go to work uh in a healthy condition.
▶ 0:55:33Uh in addition to those Texans who lose their coverage, everyone on their health insurance policy is going to see premium increases as a result of these policies. An additional uh 15 in Texas, actually it's three million uh Texans will lose their coverage who rely on Medicaid, another vital service.
▶ 0:55:55So, while I'm pleased we can make this progress today, if we're looking at the overall need to address the problem of cancer that afflicts so many of us that we've heard about today, we need to be concerned with the research budget and we need to be concerned with insurance access and those are not being addressed today. They are critical to our future for healthcare in this country and I yield
▶ 0:56:19Mr. Arrington,
▶ 0:56:20Mr. Chairman, I'll make it brief. uh from the American Cancer Society from A to Z, a organization by the name of Zero Prostate Cancer. There are 586 uh organizations striving with us for this very purpose today. And I just want to make sure that they're recognized. And uh for the record, I submit this to you. Without objection,
▶ 0:56:52I yield.
▶ 0:56:53Mr. Thompson.
▶ 0:56:54Thank you, Mr. Chairman, and thank you for holding this mark up today. And I want to both thank and and congratulate uh Miss Su and Mr. Arrington for their good work on this very very uh important bill. And I know your mom's smiling down on you and uh as she should. Um healthc care is one of the top issues that I hear about when I'm home in my district meeting with my constituents.
▶ 0:57:17And one of my constituents is here today, uh, one of the blue short shirt warriors, uh, Jazzy from Davis, California is in the audience today. And, uh, where is he? Stand up, Jazzy. Jazzy has a pretty powerful story to tell. He's 18 years old and he's a cancer survivor.
▶ 0:57:44Jazz is a former athlete who spent his high school years not on the field nor in the pool, but in bed and in the hospital. In between relearning to walk, graduating from high school, and getting accepted to UCLA, Jazzy also finds time to be an advocate for cancer research. The same research that our colleague, Mr.
▶ 0:58:09Dogget pointed out was ripped away from incredible uh universities across the country who were doing great work looking for cures uh for cancer. Jazzy talked about the need uh for better treatments and cancer research when we met. And Mr. Chairman.
▶ 0:58:29Yeah, I I am very proud to to have voted for the Affordable Care Act, which ensures people with pre-existing conditions just like Jazzy could never be denied health care because of the cancer u diagnosis that he received. And I was proud to support President Biden's call for a cancer research uh moonshot. And it's because cancer affects everyone.
▶ 0:58:56everyone in this room and everyone across every one of our districts, either ourselves personally, a family member, a friend or a constituent. And like everyone on this side of the dis like hell to oppose the big ugly bill, which sadly is now the big ugly law, which is kicking 15 million Americans off their health care. It's going to close hospitals. It's going to make it harder for people to get care.
▶ 0:59:26And I know that um we'll all fight on this side of the aisle to overturn the devastating funding freezes and the politicalization of the NIH and the CDC healthc care research grants. Jazz is an 18-year-old and he told me that his treatment was the same treatment given to patients 20 years before he was born.
▶ 0:59:53Our health care system, ladies and gentlemen, is going in the wrong direction. We need to reverse the big ugly laws health care cuts, stop the interference at the NIH, and fully commit to the cancer research that will finally bring a cure. I'm glad the committee is considering the Nancy Gardner SU bill today. It's important. It'll go a long way. But we've got much longer way to go.
▶ 1:00:22We need to restore the cancer research cuts. We need to fix the underlying health care system and we need to keep facilities open to ensure that people have the coverage that they need and will be able to get the treatments that they need. Mr. Chairman, I yield back. Miss Miller.
▶ 1:00:43Thank you, Mr. Speak. Mr. Chairman, I do move to strike the last word. Coming from a rural state, it is extremely difficult for some patients to even get to the doctor. Between the long distances and the unforgiving terrain, a lot of patients simply don't think the trip is really worth the while to the doctor. They just go, "I'm okay. I'm okay. I'll be all right." That's why rural America is so affected by high rates of chronic diseases.
▶ 1:01:09Many patients don't keep up with their health enough to realize that they're sick until it's too late. Early screenings for all diseases, but specifically for cancer, are absolutely life-saving for rural patients. Catching cancer early ensures patients are in control of their own health and can properly plan for a routine check-in with their physician or oncologist.
▶ 1:01:33This bill is a muchneeded step in providing coverage for multi-cancer early detection screening and I look forward to its passage through committee. Thank you and I yield
▶ 1:01:45Mr. Davis.
▶ 1:01:49Thank you, Mr. Chairman. And let me thank you and ranking member Neil for your kind remarks uh relative to my service on this committee. It's been fun. It will continue to be fun for another year and a half. So I thank both you gentlemen very much.
▶ 1:02:08I want to commend Representative Soul and Arrington for their steadfast work on healthc care and especially cancer prevention and treatment. Over the years I've had five staff members who have succumbed to cancer as well as many family members. So all of us directly know and have had experiences with cancer.
▶ 1:02:38We know that early screening and detection are lifesavers and to have them added to the Medicare benefits package will go a long way towards saving lives and making life more meaningful for individuals who experience it.
▶ 1:02:56But just as we are changes in health care and we are cancer treatment and prevention, making it better and making it more hopeful that individuals can and will survive.
▶ 1:03:17I also hope we will add in our minds the idea of restoring some of the Medicaid cuts that we have experienced and especially research monies to continue to research illness and come up with modalities and treatments that would do better. And so I commend again my colleagues.
▶ 1:03:45Uh just happens that Terry's mother and my wife have the same maiden names and so it's a great bill. I support it and I yield back.
▶ 1:04:02Dr. Murphy.
▶ 1:04:04Thank you, Mr. Chairman. I want to commend um Representative Su and Arrington for bringing this forward. This is a tremendous step. I've diagnosed patients with cancer for 35 years and every time I walk into a patient's room and they are riddled with cancer, there's just always a gut punch. Why didn't we catch this earlier? Why couldn't we have done something better? Because often times un less today uh this is the beginning of the end for for those individuals.
▶ 1:04:32I've actually now been a two-time survivor of two different types of tumors uh myself and uh early detection is the reason I'm here such among people's um resistance. Regardless, um I I do have some questions and I I I think it's important that we understand this with any test. We have things called false positives where people are told that they may have something when they really don't.
▶ 1:04:56So, uh, Patrick, I just want to question, are we giving the FDA any directives as to what parameters will be used for particular tests?
▶ 1:05:11Uh, the the coverage for this test is dependent upon FDA clearance and
▶ 1:05:17All of FDA's parameters would apply to any tests being covered under this.
▶ 1:05:20So, we're not saying anything to the FDA about covering them. We're just basically urging them that they look at these types of things. Correct.
▶ 1:05:28The this legislation would provide Medicare coverage for any early detection screening test that is FDA approved which has rigorous standards of
▶ 1:05:36Okay. All right. Um I just I always have that small caveat because I think this will do obviously much much much more um good than harm. We just don't want people to be harmed if they're finding things unnecessarily. Sadly enough, now in the age of CAT scans where everybody gets one when they come in the emergency department or people can go by from their CAT scans, we pick up things that are clinically irrelevant and um people end up harmed.
▶ 1:06:02And this is actually where um good tests really lower that number tremendously. So I applaud our authors for putting forth this legislation. Thank you. I yield back.
▶ 1:06:16Miss Soul.
▶ 1:06:17Thank you, Mr. Chairman. I move to strike the last word. Today's markup represents a pivotal moment in the fight against cancer within our country. Not only does this markup come one day after my mother's birthday, uh but this week we are blessed to have so many representatives who for who have flown in for the leadership summit for the American Cancer Society Cancer Action Network. What a symbolic moment this week represents for the fight against cancer.
▶ 1:06:47For many of us like myself who have a personal story related to the can to cancer multi-cancer early detection screening coverage act provides an opportunity to catch cancer early when it is less deadly. When it comes to cancer we know that early detection is our best protection and that's exactly what our bill is all about. It's about ensuring that those who are most at risk can catch cancer early and stop it before it spreads.
▶ 1:07:17Not only would our bill save lives, but it would also it's also fiscally sound. By catching cancer early, we can reduce the tens of billions of dollars that we spend treating latestage cancer diagnosis in America.
▶ 1:07:32It is in the spirit of turning my pain into passion following the death of my mom that I immersed myself in the fi in finding out about the most promising research efforts, the top scientists and doctors in oncology and I educated myself on leading trials and innovation in early detection. Until now, early detection tools have been limited.
▶ 1:07:54But thanks to cuttingedge advancements, new blood-based cancer screenings are emerging with the promise of catching cancer earlier so that we can treat it before it spreads. This bill provides a coverage pathway for Medicare beneficiaries to have access to these MSID technologies.
▶ 1:08:15Starting in 2029, Medicare beneficiaries 50 to 65 can receive one early detection test a year until the United States Preventative Task Force issues Each year, the upper age limitation will increase by one year. So while this is narrowly focused now partly to reduce the cost um at the sunrise um access to these tests will increase each year.
▶ 1:08:44The median edge age for cancer diagnosis in America is 66. So this legislation provides access to a key demographic of patients. Make no mistake about it. This legislation will save lives. it. That is why this bill currently enjoys bipartisan support. Over 300 House members and 62 senators are in support as well as over 600 endorsing uh organizations.
▶ 1:09:13I would like to pause and acknowledge a constituent of mine, Miss Kimberly Alexander, whose sister Valencia I believe may be in the Kimberly was a dedicated patient advocate for the American Cancer Society Cancer Action Network who lost her battle to lung cancer last year.
▶ 1:09:37I met Kimberly last year right here in this committee room during the last annual Kimberly was here to advocate advocate before us so that we could pass this bill out of committee. Sadly, over the time last year, she lost her life to lung cancer.
▶ 1:10:03It is her courage, compassion, and dedication that is at the heart of the mission of the cancer advocacy network. So, I want to let all of us know that what we do in this committee room is important. It's important not only to our blue shirt warriors who are here, but to the families that they represent as well.
▶ 1:10:27Kimberly serves as an example of a patient who would have greatly benefited from life-saving early detection measures. Last year, she wrote a powerful note to me, and I want to share her words with this committee today. Quote, "I am a nine-year survivor," she said. But I still go every six weeks for imunotherapy for maintenance.
▶ 1:10:53I've been through chemotherapy twice, radiation twice, oral therapy twice, and now I wholeheartedly believe all of these treatments would have been avoided if they caught my cancer early. Please do something about it." End quote.
▶ 1:11:15I believe no family should have to experience the sting of advanced cancer So, we in this committee have an opportunity to do something about it. As Kimberly asked, let's unanimously pass this bill out of committee. Let's support its efforts as it goes over to the Senate and let's get it on the desk of the president to be signed into law. Thank you and I yield back.
▶ 1:11:41Mr. Fitzpatrick.
▶ 1:11:43Thank you, Mr. Chairman. I move to strike the last word and I want to both thank and congratulate um our colleagues, Miss Su, Miss Mr. Arrington and all the others who have worked on this bill. Um, it is so important and uh, Miss S, I echo uh, all the words of the gentleman from Texas that only a gentleman from Texas could so eloquently state. I know your mom is so proud of you today and I'm glad to see you wearing the same color as she was wearing in that beautiful photo. And um, Mr.
▶ 1:12:09Chairman, there are so many personal cancer stories uh, in this Congress and across the country. And I know everybody here, all the advocates uh, had their stories as well. Um, my predecessor here, Mr. chairman was my big brother Mike. Um we lost him to cancer in 2020 due to a late cancer diagnosis. Um he was not just my brother, he was my best friend, my role model and a very very dedicated public servant.
▶ 1:12:36Um and I really want to urge all my colleagues not just to support this bill in committee, not just to support it on the floor, but to make sure that we all do our part to get this fully across the finish line um and onto the president's desk for signature. uh we must accomplish this mission not just for the stories uh that so many represent here today but for the countless people across America who are fighting this disease.
▶ 1:13:00Um as has been mentioned this bill will ensure Medicare coverage for multi-cancer early detection tests. Uh early detection is the key to survival. Uh as Dr. Murphy had just indicated, uh, research shows that early detection through preventive screenings is 1,000% the best way, the best pathway to beating cancer. Uh, it's been our family story as well.
▶ 1:13:23And I encourage my colleagues, I urge them to support this proactive, forward-thinking legislation to spare families like ours, like Terry's, and like so many across America uh from the pain of losing a loved one far too soon. Uh, with that, Mr. Chairman, I yield back. Miss Moore.
▶ 1:13:49Thank you, Mr. Chairman. And I will be brief. Uh I like so many others uh have experienced the benefits of early detection in cancer and I'm living with cancer today as I speak.
▶ 1:14:04Um, I I want to say that uh the thing that I appreciate about this bill, the observations that that have been already been made, I just want to double down on and associate myself with them, that this bill saves money for government. Certainly fighting cancer at those last stages is very expensive um and and a loss to our American economy when early detection would have prevented some of the costly treatments.
▶ 1:14:34It saves lives. It saves lives to have early detection. the uh there's nothing more painful than the, you know, the natural state of death being interrupted by a death too soon that could have been prevented with early detection. And I just want to double down on the notion that this reduces disparities in rural areas and communities of color.
▶ 1:15:04I just want to lift up one example. I remember a period of time my sister who had been a flight attendant seems like every week she was losing one of her friends to breast cancer and I thought is there some sort of gene genetic marker or something with black women who seemed to be succumbing to cancer uh and it always was that these were people who had been in a layoff situation with the airline
▶ 1:15:34uh didn't have healthare care and um and didn't get the early detection and really died within weeks of their diagnosis. And so um I think that uh that I have seen close up and personal how uh disparities among people of color occur with the inability to get an early um treatment and diagnosis. And so with that, I would yield the rest of my time to Miss Soul if she wants it.
▶ 1:16:01I just wanted to say that um I know that your fight uh against breast cancer is ongoing, but we I think I speak for the whole committee are behind you supportive of you, love you, and know that you will beat this. I I want to say to the rest of my colleagues, thank you so much for sharing your constituent stories, your own personal stories about cancer. Uh let's get this done. Thanks.
▶ 1:16:25Thank you, Mr. Leood.
▶ 1:16:30Thank you, Mr. Chairman, and I want to thank you for bringing this legislation before the committee today. And I obviously want to acknowledge the tremendous work from Congresswoman Su and Chairman Arrington. And let me also acknowledge uh all of the blue shirts and the army of blue shirts that have been on Capitol Hill. I met with my group from Illinois yesterday. Just thank you for your commitment and dedication for raising awareness on this issue and what you've done here on Capitol Hill and across the country to continue to raise awareness.
▶ 1:16:58Cancer is a disease that does not discriminate. As we've heard this morning from many of our speakers, it affects every community, every family. Most disturbing of all, many cancers are detected only once symptoms appear, often long past the point where treatments are most effective. Early detection saves lives. It improves outcomes. It lessens suffering. And it can reduce long-term costs for patients and for our health care system.
▶ 1:17:28As was said earlier, it saves money in the long run for our constituents in Illinois, across the Midwest, and nationwide. This bill holds particular promise. Seniors in rural communities in underserved urban neighborhoods and on fixed incomes often have less access to advanced healthcare technologies.
▶ 1:17:48By ensuring that MCEDs are covered under Medicare once appropriately vetted, we close gaps in detection that too often lead to late stage diagnosis, higher costs, and tragic outcomes. Moreover, this legislation honors the memory of Nancy Gardner Su, whose life and loss remind us how cruel and indiscriminate cancer can be. And there's been many stories shared here today.
▶ 1:18:18And um hopefully this legislation will lead to a lot less of those stories happening across the country. I applaud my Ways and Means colleagues for taking a strong look at common sense solutions that will help deliver highquality patient centered innovative care. That's what this legislation does. In closing, I urge my colleagues to support this bill. Let us give our seniors the best chance at detecting cancer early. Let us reaffirm our commitment to innovation in health care that works for everyone.
▶ 1:18:48And I yield back.
▶ 1:18:49Thank you, Mr. Byer.
▶ 1:18:51Thank you, Mr. Chairman. Mr. Chairman, I'd like to strike the last word. And I too would like to thank all my colleagues for their efforts to expand access to early cancer screening, especially Congresswoman Su, Congressman I know this is a deeply personal issue for all of us here, the majority of American families who've been directly affected by cancer. I lost my mother, my sister. I've been deeply interested in improving diagnosis for some time.
▶ 1:19:16More than a million Americans have a di misdiagnosis every year that results in death or disability. There's a bill out there that we work on together to help with that. This is a good bill. But yesterday, the Annals of Internal Medicine released a systemic review of the very class of screening tests under consideration today. The conclusion, and I quote, "No controlled studies are completed that report benefits of screening with multic-cancer detection tests.
▶ 1:19:45Evidence was just insufficient to evaluate harms and accuracy. Accuracy varies by test and study design. Period. And this variance is why it's essential that this bill includes the provision regarding the United States Preventive Services Task Force. It's very important because the preventive services task force ensures that the medical care beneficiaries get access to the best and the most accurate tests for them. So the access to these tests helps rather than harms a Medicare patients cancer diagnosis journey.
▶ 1:20:15But look, I'm deeply worried that the task force won't be able to validate and support access to the multi-detection cancer tests if it doesn't exist. The entire Department of Health and Human Services reportedly has developed plans to fire the entire preventive services task force and this would leave a huge hole in the long-term plan laid out by this legislation.
▶ 1:20:39This bill shows that there's clear bipartisan recognition that the task force is the body best equipped to understand these tests and issue recommendations on how they should be used. So I look forward to working with my friends and colleagues to ensure a smooth path forward to deliver the benefits promised by this important bill and thank my colleagues for their leadership. Guild back.
▶ 1:21:00Are there additional members that wish to strike the last word? Seeing none, we will move to amendments. Are there any amendments to the amendment in the nature of a substitute? Seeing none, um the question is on the adoption of the amendment in the nature of a substitute. All those in favor signify by saying I.
▶ 1:21:23Those opposed say no. In the opinion of the chair, the eyes have it and the amendment in the nature of a substitute is agreed to. I will now recognize Mr. Buchanan for the purpose of offering a
▶ 1:21:34Mr. Chairman, I move the committee favorably report HR 842 as amended to the House of Representatives. The question is on the motion to favorably report HR 842 as amended to the House of Representatives. The clerk will call the
▶ 1:21:50Mr. Buchanan?
▶ 1:21:51Mr. Buchanan? Yes. Mr. Smith of
▶ 1:21:57Mr. Kelly?
▶ 1:21:58Mr. Kelly? Yes. Mr. Swikert?
▶ 1:22:02Mr. Swikert? Yes. Mr. Leood?
▶ 1:22:08Mr. Arrington? Mr. Estus. Mr. Estus. Yes. Mr. Smucker. Mr. Smucker. Yes. Mr. Hearn.
▶ 1:22:20Mr. Hearn. Yes. Mrs. Miller. Mrs. Miller. Yes. Dr. Murphy.
▶ 1:22:27Dr. Murphy. Yes. Mr. Kustoff.
▶ 1:22:31Mr. Kustoff. Yes. Mr. Fitzpatrick.
▶ 1:22:35Mr. Fitzpatrick. Yes.
▶ 1:22:37Mr. Stwie.
▶ 1:22:38Yes. Mr. Stwie. Yes.
▶ 1:22:41Miss Tenny.
▶ 1:22:42Miss Tenny. Yes.
▶ 1:22:45Miss Fishbach.
▶ 1:22:46Miss Fishbach. Yes. Mr. Moore.
▶ 1:22:50Mr. Moore. Yes. Miss Vanine. Miss Vanine. Yes. Mr. Fenstra. Mr. Fenstra. Yes. Miss Malotakus. Miss Malotakus. Yes. Mr. Carrie. Mr. Carrie. Yes. Mr. Yakam.
▶ 1:23:08Mr. Mr. Yakam. Yes. Mr. Miller. Mr. Miller. Yes. Mr. Bean.
▶ 1:23:15Mr. Bean. Yes. Mr. Moran.
▶ 1:23:19Mr. Moran. Yes.
▶ 1:23:21Mr. Neil.
▶ 1:23:23Mr. Neil. Yes. Mr. Dogget.
▶ 1:23:27Mr. Dogget. Yes. Mr. Thompson.
▶ 1:23:30Mr. Thompson. Yes. Mr. Larson.
▶ 1:23:34Mr. Larson. Yes. Mr. Davis. Yes,
▶ 1:23:38Mr. Davis. Yes, Miss Sanchez. Miss Su
▶ 1:23:45in memory of Nancy Gardner. Su. Yes,
▶ 1:23:48Miss Su. Yes, Miss Delben. Miss Delenet. Yes, Miss Chu.
▶ 1:23:54Miss Chu. Yes. Miss Moore.
▶ 1:23:58Miss Moore. Yes. Mr. Boille.
▶ 1:24:02Mr. Boille. Yes. Mr. Byer.
▶ 1:24:05Mr. Byer. Yes, Mr. Evans. Mr. Schneider.
▶ 1:24:13Mr. Schneider. Yes, Mr. Petta. Mr. Panetta. Yes, Mr. Gomez.
▶ 1:24:20Mr. Gomez. Yes, Mr. Horsford. Miss Plask.
▶ 1:24:26Miss Plask. Yes. Mr. Swazy. Mr. Smith of Nebraska. Mr. Smith of Nebraska. Yes. Mr. Le Hood.
▶ 1:24:41Mr. Leood. Yes. Mr. Arrington. Mr. Arrington. Yes. Miss. Sanchez. Mr. Evans. Mr. Evans. Yes. Mr. Horford. Mr. Swazy
▶ 1:25:21German Smith.
▶ 1:27:53How is Mr. Swazy recorded?
▶ 1:27:56Mr. Swisy is not recorded. Mr. Swazy. The clerk will report the vote.
▶ 1:28:18The yeses are 43 and the nos are zero.
▶ 1:28:21There being 43 yeses and zero nos, the motion is agreed to and HR842 as amended is ordered favorably reported to the house. Without objection, I ask that staff be authorized to make technical and conforming changes to HR842 and that members have two additional days to file with the committee clerk supplemental additional dissenting or minority views.
▶ 1:29:09I want to thank you all for joining us again today. I especially want to thank um a constituent from God's country, a friend of mine, Miss Holly Lintner, who is a cancer survivor. She has been a friend for more than 15 years. So, it's it's a pleasure to see you out there.
▶ 1:29:25Our next order of business is HR4313, the Hospital and Patient Services Modernization Act, introduced by the vice chair of the Ways and Means Committee, Representative Buchanan, and our colleagues, Representative Evans. Often the highest quality of care a patient can receive comes not in a hospital, but in their home.
▶ 1:29:49Care administered in the home comes with a lower cost and a built-in level of comfort and convenience that cannot be provided in the clinical setting. This legislation would extend the hospital at home program, a unique model of care delivery for another 5 years.
▶ 1:30:08as a chairman of the Ways and Means Health Subcommittee with roughly 200,000 seniors living in his district and 23 hospitals in the state of Florida participating in the hospital at home program. Representative Buchanan working with Representative Evans is building a strong bipartisan and biccameal consensus around this important policy and I encourage this committee to follow their lead. I'm pleased to recognize the gentleman from Florida, Mr.
▶ 1:30:37Buchanan for his opening statement.
▶ 1:30:39Thank you. And Terry, I'd like to also thank thank you for your leadership. I lost my mother short in a short period of time in the same scenario. So, thank you. God bless you. And we appreciate you having your fans here and the team here today. I'd like to thank Chairman Smith for moving forward with my legislation allowing hospitals to treat Medicaid Medicare patients who need impatient care safely in their home.
▶ 1:31:05During the pandemic, CMS established a hospital at home waiver to provide hospitals with a flexibility care for patients from the comfort of their home and convenience of their home. A hospital at home program has been very successful. A recent report from CMS showed allowing p uh patients to be treated more when a more familiar environment accelerates recovery time, lowers mortality rates, and reduces the risk of infections and falls.
▶ 1:31:34Without congressional action, the temporary waiver authority will be waved at the end of September. I'm thrilled to say that my bill would extend the the success of the of the program hospital at home program for an additional 5 years and require vigorous uh study to make sure that we're moving clearly in the right direction.
▶ 1:31:53An extension of this program would ensure more than 200 hospitals and 34 uh states, including 23 hospitals in Florida, can continue to provide quality care to the patients at home. More than 140 leading health care organizations, including hospitals, health systems, provider groups, and patients have submitted letters of support uh for this important piece of legislation. Mr. Chairman, I ask to enter the letters into the record. Without objection,
▶ 1:32:23I want to thank Mr. Smucker and Mr. Evans for their leadership and working together for their bipartisan leadership on this important uh bill bill. Also, it's budget neutral, which I was excited about. I look forward to advancing hospital at homes through the committee and ultimately to the president's desk. Thank you.
▶ 1:32:41Thank you. I now recognize the ranking member from Massachusetts, Mr. Neil, for his opening statement.
▶ 1:32:46Thank you, chairman. Let me yield to our very distinguished colleague, one of the authors of this legislation, Mr. Evans from Pennsylvania.
▶ 1:32:56Mr. Chairman, I move to strike to the last word. Mr. Chair, I'd like to thank you and the ranking member for the comments made. I greatly appreciate being on this committee. So again, I want to thank you for that. I'm happy to be co-leading this bill with Chairman Buchanan and Congressman Smoker. I'm happy at home. The home hospital program providing hospital level services in the safety and comfort of people's homes.
▶ 1:33:23This type of treatment creates positive patient interactions with our health care system, improves health care outcomes, and saves hospital money. For example, the Philadelphia area redeemer hospital health hospital program includes frequent visits from nurses and doctors, home delivery meals and and service to even more hospitals in my district. More interest in implementing the hospital home program.
▶ 1:33:56Five-year extension provides stability for hospitals, allowing them to invest in in the program. This critical especially as hospitals are facing difficult changes to create healthc care's funding. This bill provides include comprehensive views so we can learn from the good work being done and make improvements in the program.
▶ 1:34:19I look forward to the hospitals at home program increasing innovative reaching many more seniors and Medicaid beneficial. Again, I'd like to thank particularly the members and the ranking members for the recognition. Again, thank you very much.
▶ 1:34:43Thank you. The committee will now proceed to consideration of HR4313, the Hospital and Patient Services Modernization Act. Without objection, the measure will be considered as read and open for amendment at any point. At this time, I offer an amendment in the nature of a substitute, which was distributed in advance along with a green sheet explaining it. Without objection, the amendment in the nature of a substitute shall be considered as read, open for amendment at any point, and considered base text for purpose of an amendment.
▶ 1:35:12I will now turn to Patrick Duma um staff director of the subcommittee on health to provide a technical description of the amendment in the nature of a substitute with an emphasis on the changes made since introduction. I ask the members hold their questions until after his
▶ 1:35:27Thank you, Chairman Smith, Ranking Member Neil. HR 4313, the hospital inpatient services modernization act contains three sections. Section one provides for the short title of the bill. Section two amends section 1866G of the Social Security Act to extend the acute hospital at home initiative through fiscal year 2030.
▶ 1:35:50Section three also amends section 1866G of the Social Security Act to provide for a study on the hospital at home initiative to better inform outcomes and effect effectiveness of the initiative. The amendment in the nature of a substitute makes a technical correction to the bill. This concludes the technical walkthrough and I'm happy to answer any questions you may have.
▶ 1:36:10Thank you. Are there any technical questions about the amendment in the nature of a substitute? Miss Moore,
▶ 1:36:21thank you. Thank you so much. I just have a brief question. Is there any in this bill or recommendations toward uh funding associated with it?
▶ 1:36:32This bill does not contain any funding, but as Mr. Buchanan noted it does not have a CB a significant CBO scoring
▶ 1:36:39Okay, thank you. I yield back.
▶ 1:36:43Are there additional technical questions? Dr. Murphy.
▶ 1:36:46Yeah, thank you, Mr. Chairman. Um Patrick, real quick question because we've seen a problem uh with feif for service Medicare being discharged to sniffs versus they're immediate. they're not having to go through the nonsense of pre-authorization through the absolute abyss morass and ex in insanity for Medicare advantage of being discharged. Is there any delineation between the fee for service for Medicare advantage in
▶ 1:37:10Uh there's no delineation between uh fee for service or Medicare advantage. The initiative allows for participating hospitals to treat patients at home. Uh and their coverage would be covered by fee for service and as coverage standards go any beneficiaries that are covered by Medicare Advantage um would the MA plans would have to cover this for them as well.
▶ 1:37:32All right. So we're assuming that Medicare Advantage plans would still go through their pre-authorization um for discharge for this just like they do for a sniff. Is that the assumption? The assumption is that uh discharge or transfer requirements would likely be treated the same uh whether this patient is being treated in a hospital or in their home.
▶ 1:37:54Okay. Thank you.
▶ 1:37:56Are there additional technical questions in the amendment of the nature of a substitute? Seeing none, we'll move to strike the last word. Are there members that wish to strike the last word? Mr.
▶ 1:38:08Thank you, Mr. Chairman. I appreciate uh you bringing this bill up for consideration. I want to thank uh Mr. Buchanan, Mr. Evans for uh their leadership. I was pleased to be able to co-sponsor uh this bill. Uh this is a really important bill for my community and for uh patients in my community.
▶ 1:38:28have seen firsthand uh patients who uh were able to receive treatment in the comfort and convenience of their homes uh which rather than in a facility which is what they preferred and I think they received better care as a result of being able to do it in their homes. Um over 31,000 patients um received acute level care in their homes as of October 2024.
▶ 1:38:54Uh and then besides this is what consumers uh patients want. The studies show that hospital systems achieve savings of 19% on those patients because they required a shorter average length of stay and use fewer fewer unnecessary services. Um certainly a number of hospitals in my district have used this waiver the hospital at home waiver uh with really great results.
▶ 1:39:20For example, one system uh with a hospital in my community has accepted more than 800 patients across all of their facilities, freeing up more than 1,500 hospital bed days and saving in their estimation approximately $1.1 million. So, I really think this is a great program. We should be encouraging more programs like this which allow medical providers to innovate and care for their patients with better quality care that decreases costs over the long run.
▶ 1:39:51And of course, at the end of this month, if we do not extend this, the hospital at home waiver will expire. Uh but taking action this week uh would prevent that. So by extending the waiver for five years, it would give hospitals the certainty that they need to be able to continue to build out programs uh like this and continue to serve their patients in a holistic way. So uh again, thanks uh to Mr. Buchanan, Mr. Evans. Thank you, Mr. Chairman, for bringing this up.
▶ 1:40:20I really encourage all of my colleagues to vote yes on this important legislation. Um thank you, Mr. Chairman. I yield back.
▶ 1:40:26Thank you, Miss Delben. Thank you, Mr. Chairman. I move to strike the last word. Um, I think it's great that we're here today working in a bipartisan way on bills to improve our health care system and continue to lead the way in developing cuttingedge medical research.
▶ 1:40:46But I can't help but notice the irony that we're doing so after Republicans made the biggest cut to Americans health care in history. These bills we're going to consider have strong bipartisan support, but the impact they're going to have will almost be totally eclipsed by the 15 million Americans who are going to have their Medicaid and ACA health coverage taken away because of Trump's mega bill.
▶ 1:41:12That's not to mention how the administration is systematically dismantling our public health infrastructure, withholding funding from life-saving medical research, and actively spreading misinformation about vaccines that keep our communities healthy. I sat in this hearing room along with many of you through the night as my Republican colleagues rejected amendment after amendment that Democrats offered to improve the health of Americans and lower their health care bills.
▶ 1:41:43One of those amendments was to extend the enhanced affordable care act premium tax credits that are set to expire at the end of the year. Re Republicans voted against that The expiration of these credits will result in enormous premium price hike on millions of Americans.
▶ 1:42:03In my home state of Washington, people who receive the subsidies are going to pay 65% more next year for their monthly insurance premiums if Congress doesn't continue these enhanced subsidies. That skyrocketing price increase is going to force 80,000 Washingtonians off of their healthcare coverage. Remember the kinds of people who get affordable care act coverage, small business owners, part-time and gig workers, and younger Americans.
▶ 1:42:34I was with a small business owner from my district last week talking about the importance of these subsidies. She talked about having exchange coverage allowed her to focus on growing her successful business. She has a family and a business partner. She wants to stay healthy and for her family and business partner to stay healthy. But if these subsidies expire, her premiums are going to double and she'll have to dip into her retirement just to afford her monthly payments.
▶ 1:43:03These are the kinds of people who will be hurt if we allow this to happen. And if you think this is about saving money, you're completely wrong. There's a massive cost to everyone when people lose access to care like this. ER rooms fill up with uncompensated care, facilities close, and everyone else pays the bill.
▶ 1:43:27When people can get preventative and primary care, we save money and lives across the country. So, while these bills we're discussing today are important, this markup is missing the mark. I'm disappointed the Republican majority is so at ease letting their constituents health care coverage become unaffordable. I'm going to keep pushing to extend them and make them permanent. Those subsidies are critically important. Thank you and I yield back.
▶ 1:43:58Are there additional members that wish to strike the last word? Mr. Hearn.
▶ 1:44:05Thank you, Mr. Chairman. Premiums rose every year under Democrat control. Even with these subsidies in place, the average Obamacare premiums are up 80% since 2014. While Obamacare premiums are projected to increase by 15 to 20% next year, only 4% only 4% is due to the expiration of expanded subsidies. by the way that my colleagues across the aisle said were for COVID relief and only did for two years.
▶ 1:44:32The remaining increases due to rising health care costs fueled by hospital consolidation and chronic disease. Extending these CO area subsidies cost more than $400 billion and benefit wealthy families making as much as $600,000 per year. Republicans are supporting patients directly, expanding HSAs for more workers so they can save for care tax-free, and investing $50 billion for rural providers and communities as part of the working family tax cuts.
▶ 1:45:02I yield
▶ 1:45:05Miss Chu, Miss Chu, I move to strike the last word. It is hypocritical to talk about improving health care and saving money when Republicans have just cost Americans the greatest devastation to health care in our nation's history. In fact, today's markup is happening in the middle of the greatest attack on working families in a generation.
▶ 1:45:33Right now, long-term unemployment is at its highest point since the pandemic, and the American people are paying more for just about everything due to Trump's reckless tariffs. The price of coffee is up 22%. Gas prices are up over 13%. And the price of eggs is up 11%.
▶ 1:45:56And although twothirds of the cost of these tariffs is falling directly on American families, Republicans voted this week to lock in these disastrous tariffs for six more months. And the pain doesn't stop there. It was just two months ago when Trump and Republicans enacted the largest cut to health care in history, slashing $1.5 trillion dollar from our health care system.
▶ 1:46:25Their big ugly bill decimates Medicaid and guts the Affordable Care Act, leaving 15 million Americans without coverage. At the same time, Republicans are taking food out of the mouths of the poor to feed the rich, handing out $5 trillion in tax cuts for the wealthiest, but doing it on the backs of workingclass families who will be worse off because of this awful
▶ 1:46:55bill. And now, Republicans are choosing to drag us to the brink of a government shutdown instead of working with Democrats to stop the looming healthc care crisis. By refusing to extend the ACA tax credits that keep coverage affordable for 22 million Americans, Republicans are guaranteeing doubledigit premium heights.
▶ 1:47:21Starting January 1st, families will pay more and cancer patients will be priced out of lifesaving treatment and hospitals will be forced to shoulder the costs.
▶ 1:47:36And at the Social Security administration, the Trump administration has cut thousands of staff at the agency, resulting in a customer service crisis that is threatening the monthly benefits that millions of Americans rely on.
▶ 1:47:53And most recently, a shocking whistleblower report came out about how Doge uploaded all our social security data to an unsecured cloud server, jeopardizing the privacy and security of every single American. Yet, my Republican colleagues have done nothing to exercise any oversight over these destructive actions. So, let's be absolutely clear.
▶ 1:48:23As we mark up these bills today, President Trump and Republicans are waging an allout attack on the economic security of the American people. Instead of siding with billionaires and slashing the programs millions rely on, I urge my Republican colleagues to join Democrats in fighting to lower costs, protect and expand healthc care coverage, preserve Medicare and Social Security,
▶ 1:48:54and build an economy that actually works for working people. I yield back. Are there additional members that wish to strike the last word?
▶ 1:49:08Miss Moore.
▶ 1:49:15Thank you so much, Mr. Chairman. And let me say, I spend a lot of time correcting my grandchildren, making sure that they when someone asks you how you feel, you tell them you're feeling well. You don't say, you know, I'm feeling good. But this is a feel-good moment here uh to be passing unanimously legislation for breakthrough cures. Um but I I I tell you it's a bittersweet moment for me.
▶ 1:49:46Um because what we have done here today is undermining everything that we can find. Um it's true. Here right now we're discussing hospital inpatient services act and everybody knows that being able to stay at home is is is very is a very very good health method.
▶ 1:50:12But the very that allows people to stay at home is And we've cut trillions of dollars out of Medicaid. So it just feels good to be passing this today. We passed the Nancy Gardner SUL act.
▶ 1:50:34And yet we've cut NIH funding so that these breakthrough invention of these great uh breakthrough research projects can't be And yes, just yesterday, I had a personal story come to my office about an African-American constituent who had tried for months to get into a clinical trial and her access was limited because of course it was DEI
▶ 1:51:06and so that trial had been cancelled. I just want to point out that there are diseases that are particular to races like cickle cell anemia or the uh the bracka one or two genetic mutation for Jewish women for breast cancer. You know men are the one that are afflicted by hemophilia and it's legitimate to have research on specific demographic group.
▶ 1:51:35It's just stupid that we have um eliminated these grants. You've hobbled the institutions like the CDC and FDA funding and staff and as my colleagues have mentioned the health care premiums are going up because we have not in our wisdom with the one beautiful ugly bountiful billionaire bill did not continue the
▶ 1:52:05Affordable Care Act premiums in my state. I've been told by health care insurers that our premiums are going to go up by a minimum of 75%. And in Wisconsin, there are over 270,000 people who benefited from these advanced premium credits, the ACA, and they're I can tell you when you're insured, that's how you get access
▶ 1:52:38uh uh breakthrough breakthrough treatments. But if you don't have any health care, you're probably not going to go to the doctor. You'd be like so many friends that I mentioned earlier that found that went to the hospital once they became symptomatic and would were and they were dead within weeks.
▶ 1:52:58No, we cut health care to 17 million And now here we're feeling good that will have absolutely no funding or research to back it up. And with that, Mr. Chairman, I thank you for your indulgence and I yield back the balance of my time.
▶ 1:53:25Mr. Schwiker.
▶ 1:53:26Um, thank you, Mr. gentlemen and and I beg my friends on the left side could you guys at least coordinate your lives because it's 17 then it was 15 then one it was 11 just just so we have common math and no I'm not yielding let me
▶ 1:53:41will you yield
▶ 1:53:42I will not let me finish then the real number is zero
▶ 1:53:45let chairman let me finish
▶ 1:53:50hey you guys are the ones who keep making up numbers um second of all um for those of us who actually are fixated. I am a huge fan of of research, but we also cannot seem to have um scientific journals can't keep up with the fake papers. Wall Street Journal um hundreds of suspicious journals um flagged AI tools, Nature, I'm sure all of you like I have a subscription to Nature and read it.
▶ 1:54:17The fact of the matter is we're being flooded by fake journals, which actually is a real problem if you're doing generative AI and it's mining it. And I wish we could actually have conversations. I'm a big fan of um National, you know, Foundation for Research. I've helped those things, but I could never get them to actually start to do the discipline of the amount of fake peer review that the peer review views are fake.
▶ 1:54:43The second thing, actually, third thing here is how do I culturally help our brothers and sisters on this committee stop thinking that financing is healthcare? Work with me on this. ACA is a finance bill. Who gets subsidized? Who pays? Our Republican alternative was a finance bill. Little better actuarial distribution, but a finance bill. Medicare for all is a finance bill.
▶ 1:55:15the first bill we passed here has a cost and yet if you actually model it out it may save money. The morality of cures instead of what this committee so often has done in the past is the financing of maintaining people's misery. It's a revolutionary and it's not Republican or Democrat. It's just understanding some of the science.
▶ 1:55:40In my state of Arizona, the amount of fraud in my Medicaid system, we had a 2.8 billion dollar um sober living home fraud where they exploited Native Americans. We just had, I think, a and I'm still tracking the story, a half a million of fraud that was sent overseas. um the ability.
▶ 1:56:04This morning we met with um a wearable company that actually their technology is getting almost good enough it could prescribe. Are you going to help me do the AI prescribe bill where we can actually crash the price of I beg of you and and this is for anyone listening Medicare goes from 1 trillion to two trillion in the next seven years as our spend. In seven years, the trust fund is empty.
▶ 1:56:35Stop having a finance discussion and start having the morality discussion of how do we make our brothers and sisters healthier. If um Milin a couple years few years ago did a major study that said obesity and I know we're not supposed to ever use that word is 47% of US healthcare.
▶ 1:56:55Now here's a crazy thought. Maybe we could actually have a a love January 1st, Ozmpic goes off patent in Um, Florida's allowed to reimpport. Colorado's allowed to reimpport. What would happen if this 33 billion of additional subsidies for insurance companies is what you're asking for? You took a portion of that money and said, "We're not going to subsidize insurance companies.
▶ 1:57:25We're going to help our morbidly because we know multi-chronic in Medicare um Indian health services and so many things is is the predominant What would happen if we actually did something to make our help our brothers and sisters actually be healthier with this money instead of the sub subsidies to insurance companies where how much of the money ends up on the insurance company's books instead of taking and look I represent
▶ 1:57:55one of the wealthier districts in America. I have people who are in the few hundred,000 a year income who are getting 4,000 5,000 subsidies. Was that really the Democrats vision when they set up the insurance sub uh subsidy system in the ACA? Is that really what you want?
▶ 1:58:19is this is an insurance subsidy system instead of we're going to find a way to actually lower the cost and broaden the access to health care. And we're not doing that. We're too busy talking around each other because our political consultants have given us our talking points. That I yield back.
▶ 1:58:39Thank you, Mr. Larson.
▶ 1:58:43Um, thank you, Mr. Chairman. move to strike the last word and uh I'm always happy when my colleague speaks because I do enjoy listening to him etc talking about lies and especially talking about morality. Uh I have to ask though in speaking of numbers and and lies etc. How many employees at social security are there that are uh been hired by Doge?
▶ 1:59:12How many are in Doge currently? I'm sure all of you know because you pay such great attention to detail. And let me ask, how many times has Doge come before this committee, speaking of morality, to testify?
▶ 1:59:32So here we have a group of people that are unvetted, and who have never come before this even though we've asked, even though we sent resolutions of but because Elon Musk and President Trump have decided that they're going to operate outside of
▶ 2:00:02the Congress and there's no moral backbone on this side of the aisle to say no, we're a co-equal branch of government and they should be here in front of us and they should testify so that if we're so concerned about getting to the truth and adhering to the numbers, then why aren't they here? Why do they are they above the law?
▶ 2:00:29Is that if is that the morality we're talking about that we have a group of people that are above the law who are excused from coming before Congress and having to testify upon the impact of over 300 million fellow Americans. That's the issue here.
▶ 2:00:51Don't go on about this stuff about facts and figures and then claim that we want morality when the very people that are making the decisions are not the United States Congress. It's the President of the United States and Doge and they were never accountable to anyone. They've never been vetted and they've never been in front of this committee. That's the truth. It's great.
▶ 2:01:21that we were able to have a dinner the other night and I thank the chairman. I think it's a noble gesture that when we're able to sit down together and communicate and talk.
▶ 2:01:34I think it's also a noble gesture to start this hearing off talking about a tragedy that happened with another But it is an abomination and it is more than hypocritical to have hearings, especially today on health care when we're taking it away from 16 million fellow Americans and taking food out of the mouths of children and the disabled.
▶ 2:02:05How can that possibly be fair to give billionaires more of a tax cut? These are the things and the group that should be in front of us. And if there is all this fraud and abuse that they've uncovered, well, my god, don't you think they would be in front of us and the American people so that they could see in public? Well, where is this fraud and truth?
▶ 2:02:34Where are the numbers that would allow my colleague to say, "Oh, yes, now we have the facts and figures and numbers in front of us." The fact is that they're not here. The fact is that what they're out to do, and all of you know it, is to privatize Social They're out to do that because they're dissembling the Social Security Administration from within.
▶ 2:03:007,000 people laid off, phone services cut, can't get any information, long lines, and now in the spirit of bipartisanship, you want us to rubber stamp what Doge is doing? That's absolutely unfair and wrong. I yield back.
▶ 2:03:25I would um like to remind all members of the committee um let's try to be courteous um to each other and to please um refrain from any personal attacks whenever you're in your five minutes. Um Mr. Kelly
▶ 2:03:46thank you Mr. Chair and it's nice when we can get together and talk about all these bipartisan bills. Um so turning down the temperature a little bit. I'm going to give my time to Mr. Smucker. we did have a wonderful dinner the other night and we when we're all together and not on on a dis, we talk about how much we want to work with each other. It's just unfortunate when things like this are being televised that we make it an issue of making sure we get our time to whatever it is we need to do.
▶ 2:04:12Uh the country's been through an awful lot the last couple days and as much as we uh we agree that it was a horrible event. It's just a matter that uh it would be it'd be much better if we could carry it not just from our private offices and from our dinners together into when we're actually sitting at the dis and talking to each other about things that are critical to the American people. Mr. Smucker, you have the rest of my time.
▶ 2:04:34Thank you u Mr. Kelly. Um I appreciate Mr. Larson's fervor. Uh but it does not change the fact that Mr. Schwher is correct. We are hearing lies from the other side about the bill that we passed. And I'll I'll quote uh Miss Moore said uh we cut trillions of dollars out of Medicaid. Exact quote.
▶ 2:05:00Uh Miss Delbeni I think it was said we've decimated Medicaid in the bill. This she said this bill decimates Medicaid. Both are absolutely false. Let's look at the figures to this year. This fiscal year, this the federal government is spending over 650 billion in reimbursements uh to states for their Medicaid costs. 650 billion.
▶ 2:05:26That number will increase next year and will increase every year over the next 10 years by more than the rate of inflation. You cannot look at this bill and say that we are cutting trillions of dollars in Medicaid. It's an outright lie. Uh other uh charges that were made. Uh M. Delany said it was this bill was the greatest attack on working families in a generation.
▶ 2:05:56Are you kidding me? The greatest attack on working families in a generation. Now, we don't even need to talk about how working families were impacted during the Biden years with the inflation. And you talk about inflation over there, and you do it with a straight face after seeing the inflation that we saw during the Biden administration. Remember this, the core of this bill was a tax cut at all levels.
▶ 2:06:24So, working families, who you said, it's the greatest attack on working families. working families. We are ensuring that their taxes stay at the levels they are today rather than a large increase in taxes. That's more money in their pockets. Maybe your working families don't think that's important, but in my district, they sure do. And I think if you would talk to your families, you would think that that you would find they think it's important there as well.
▶ 2:06:53So again, complete lie about the bill. Greatest attack on working families in a generation. Another lie. Uh, someone said this guts ACA. Guts ACA. Are you kidding me? You know what it does on ACA? It ensures that people are following the proper uh enrollment procedures and that states are implementing the proper enrollment procedures so that they're truly qualified for ACA.
▶ 2:07:23That's all this bill does on ACA. So don't tell me that this bill got the ACA. That has nothing to do with the discussion we're going to have about continuing some of the higher levels that were put in place with COVID. That's true. We'll have that discussion, but the bill we passed does not come close to gutting ACA. So, I I can't just sit here and listen to these lies. They're false. Uh any American who looks at the figures will will see that they're false. It's easy uh it's easy to see that.
▶ 2:07:53I'm proud of what we did for working families. I'm proud for what we did to ensure the the the um uh the the the Medicaid that Medicaid can be sustainable for future generations because you also here's here's another lie you've all put forward. You said 15,000 or 15 million 16 million 17 million people will lose their Medicaid. And Dave's right. Uh get your facts get your lies straight.
▶ 2:08:24Uh because CBO has said none of that. You know what CBO has said? CBO has said people who are losing their Medicaid first, they're people who maybe were double enrolled. We're ensuring that in this bill again that the enrollment procedures are being put are are in place and that we're doing that twice a year. Who can be against that? We should we should want to be sure that everyone who relies on these government programs is eligible for those benefits. You're arguing against that.
▶ 2:08:53So the Dr. came before this committee and said that they've already found millions of people who were double enrolled. You don't care about that. And that's some of the millions of people that CBO supposedly say is going to lose coverage. Non-citizens. Maybe you all want to have non-citizens uh covered, but my constituents don't. They don't want their taxpayer dollars to be used for people here here illegally. We may may disagree on that.
▶ 2:09:22And we should expect a very large number of the American people believe that if you can you should. And if you're going to access taxpayer dollars and you can do your part, then you should. So asking them to work 80 hours a week, you kidding me? My constituents love it and every one of your constituents should love it as well. I'm I'm Thank you for I'm sorry if I went over time, but thank you for giving me the time.
▶ 2:09:50Thank you, Mr. Schneider. Thank you chairman. I move to strike the last word. Um I I want to uh join the conversation and and share how not how I see the numbers. These are are from others and I'll just pick uh Mr. Smunker. This is from the Hospital Health System Association of Pennsylvania. Not my words, their words.
▶ 2:10:14And there it's estimated that 34% of rural hospitals in Pennsylvania are at risk of closing. And context that matters. Quote, "This the analysis comes alongside a federal reconciliation bill that destabilizes hospitals in the communities that rely on them." Again, not my words. This is your hospital association in Pennsylvania.
▶ 2:10:37And it wasn't one side of the aisle saying that making up numbers that uh the one big bad bill was going to cut Medicaid. It was the Congressional Budget Office who said it would cut and early estimates were as high as 17,000.
▶ 2:10:53So to my colleague from Arizona, the reason the numbers have moved is because we've heard different numbers, but as of August 27th, um CBO is estimating that upwards of 15 million people are going to lose their insurance because of the this bill. 10 million uh according to CBO because of uh cuts to to Medicaid and the Affordable Care Act. Another 4.2 million because of the failure of Congress to address uh premium tax credits.
▶ 2:11:22The reasons are clear. Congress took steps in the one big bad bill to make it harder for Americans to get health insurance, harder to access the care they need, harder for people with pre-existing conditions, harder for people to afford it. According according to the Kaiser um or KFF uh their analysis in Arizona, and again, these aren't my numbers. I'm not saying this. This is KFF who did a study.
▶ 2:11:49420,000 additional uninsured people in Arizona. A 5% increase because of the one big bad bill. And that's 290,000 losing their Medicaid coverage. Another 120,000 losing coverage or access through the ACA. And 12,000 because of the cuts, 500 billion dollars of cuts to Medicare because of actions taken in the the one big bill. All while raising the country's debt by $4 trillion.
▶ 2:12:20We talked about taking steps to be fiscally responsible. This committee has as much responsibility to focus on the fiscal responsibility, fiscal health of this nation. We should be working together on this and talking about the real numbers that are in in this bill. So, and I look at a family and you know, um, Mr. Smucker, you and I are close in in age.
▶ 2:12:42I look at a family who is five maybe 10 years away from retirement, making $80,000 a year, making ends meet, but certainly not getting rich. And because of the cuts to Medicaid, because of the failure of what we're doing, what Congress is failing to uh extend the premium tax credits, that family is looking at an $18,000 increase in their health insurance. We can do better than this. These are not madeup numbers.
▶ 2:13:08These are numbers from people who are objectively looking at the consequences of the one big bad bill. I yield back.
▶ 2:13:16Mr. Smith, thank you, Mr. Chairman. Uh really appreciate this opportunity that uh it's designed to have an exchange on a way forward with some good pieces of legislation that both sides have worked on. I I uh appreciate uh this immensely, especially a hospital at home. Thank you to Mr. Buchanan for taking up this issue. Uh knowing that care at home and when you can stay home you can often times get a better outcome.
▶ 2:13:46Um I myself am also working on skilled nursing at home on similar concept of being able to keep folks at home and and deliver better results not not just for taxpayers but for the patients themselves. You know, it's interesting if if we actually used data of health outcomes. I wonder how much polic, you know, how how different policies would look and and we can yell and scream about various things that frustrate us.
▶ 2:14:15Or we can have an exchange here focusing on the future, focusing on new technologies, focusing on the fact that we want the American people to be And you know, my colleagues are frustrated. I get it with, you know, the the concern about perhaps a number of Americans being harmed financially from some bad policies formed at the federal level.
▶ 2:14:42I would hope that we could work together to fix those and in, you know, instead of just throwing more and more and more money at it, as my colleague Mr. Schwiker pointed out that ends up reaching a place that doesn't result in better outcomes healthwise. In fact, it encourages even higher cost insurance. We can do better. The American people expect us to do better.
▶ 2:15:09They deserve that we give them better policies out of Washington rather than this scenario of throwing money at a problem. I think we can all agree that there's a problem that exists and that's high-cost health Um we I'll uh refrain from some other comments I'd like to make, but fact of the matter is uh let's work together for solutions that actually help people
▶ 2:15:40that removes barriers to care. I'm concerned that we have barriers to care that exist in many places across health care and that new technologies will come about if they aren't already available or new that prochial interests stand in the way of and block that here here and there.
▶ 2:16:00So let's uh let's do what the American people want us to do and that's find solutions to the problems uh we know exist uh because uh they deserve that. Thank you. I yield back.
▶ 2:16:11Mr. Gomez.
▶ 2:16:15Thank you, Mr. um uh chairman. First, um I just want to focus on how the Republican majority wants the public to forget that they just pass Trump's one big beautiful bill to an extent that they went to the White House a few a few short weeks ago trying to come up with a strategy to rebrand it because the American people know
▶ 2:16:46that they're getting ripped off in that bill. They know it and it pulls so poorly that they're all running from it. So, I'm glad to see that they're doubling down and saying, "Nope, we love that bill. We're for that bill. We're glad we gave uh tax breaks to the richest Americans and the largest corporations at the expense of workingclass people." I'm glad that they're saying that because that's what they believe and that's what they actually did.
▶ 2:17:14And yes, they cut Medicaid by almost $1 trillion, impacting up to 15 million Americans. And that will limit access to workingclass people to seek cancer screenings to make sure it's early detected early. that make sure that they actually have a fighting chance against that disease.
▶ 2:17:36Because we know we know that the longer somebody waits to get screened and diagnosed means a later stage of cancer, probably stage four, that impacts their survival rate. That most likely will mean a death sentence to millions of Americans. Medicaid is that lifeline. So, yes, when you actually cut Medicaid, you hurt people that need to get treatment.
▶ 2:18:06My dad was uh uh got diagnosed with pancreatic cancer um in 2004, He was diagnosed late. He was stage He was going to a community clinic, which was better than nothing. But in the end, he had they gave him a death sentence of three months. He was diagnosed in January and passed on April 1st in 2005.
▶ 2:18:35So that's what's going on when you cut Medicaid. Real life consequences for real people. And who of course Donald Trump's billionaire cabinet is not going to notice because they don't have to worry about that. They can buy probably buy a hospital if they wanted to buy the best uh physicians, buy the best So, so this is what we're talking about. We know that Medicaid expansion saved lives.
▶ 2:19:04We know that it helped people get access. We know that it gave them a fighting chance. So, to try to say otherwise is just BS. It's just not accurate. And that's why we're going to keep talking about it because we know that just because you pass one bill one day doesn't mean that you can ignore it the next day and say, "You know what?
▶ 2:19:24Damn the consequences." Because it's going to have a detrimental effect on We're going to keep talking about it because it is about life and death. It is about de uh that it's going to devastate families. So, Republicans should join Democrats, bring up our bills to restore Medicaid, tax billionaires to pay for it, and lower the cost of living for all Americans once and for all. With that, I yield
▶ 2:19:54Mr. Horford,
▶ 2:19:58Mr. Chairman, I move to strike the last Uh, first I want to thank my colleague and dear friend, Congresswoman Su, uh, for her work on advancing the Nancy Gardner SUL Medicare Multicancer Early Detection Screening Coverage Act and the other bills that are being considered. I'm thrilled to work with her to help advance this bill.
▶ 2:20:25Um, and I wish that we could just be focusing on the benefits that this bill would provide. But unfortunately, at the same time that we're advancing this bill, the Trump Vance administration has taken office.
▶ 2:20:42The Senate Health Committee now estimates that the National Institute of Health has lost $2.7 billion in research grants during the first three months of this year, and their grant rejections have more than doubled. These are cuts that have direct impact on our ability to find those groundbreaking cures to cancer that we were just on the cusp of funding.
▶ 2:21:11And I know that there are many of us on this committee that really would like to find uh the opportunity to reverse these uh ill-conceived cuts. But my larger is really what are we doing in this What exactly are we even doing here in this committee today?
▶ 2:21:36We have five legislative days, five before Republicans who control the White House, the Senate, and the House of Representatives shut down the federal Why? because they refuse to come to the table and negotiate for lower costs for everyday Americans. Something that they claim they want to do, but in fact, their policies are doing the exact opposite.
▶ 2:22:04They're making it harder and more expensive for Americans. And we're asking them to come to the table and to reverse those policies. Let me repeat, Republicans hold the power and they are still walking us straight into a shutdown. And yet, if you looked at today's agenda, you would have no clue that we we are standing on the edge of chaos.
▶ 2:22:30You would have no idea that 20 million Americans are at risk of losing critical help paying for their health insurance. You would have no idea that Republicans just passed the largest tax giveaway in history, helping to the ultra handing millions to the ultra wealthy and corporations while working people get left with the bill.
▶ 2:22:56You would have no idea that political appointees, the so-called Doge Bros, just exposed the personal data of 300 million of America million Americans, putting social security at the center of a national data breach. So I I'll ask again, what exactly are we doing here Can I tell you what you are not doing in this committee room today?
▶ 2:23:25You are not fighting to lower the cost for families in America. You are not working to expand health care coverage for those who need it the most. You are not protecting people's data. You are not advancing policies to cap out-ofpocket costs for prescription drugs or to invest in mental health and substance abuse disorder.
▶ 2:23:49You are not working to advance investments in community health centers or to end the medical debt as a barrier to health care. You are not working to protect or expand reproductive health care access. You are not working to reform PBM practices or to preserve and expand teleaalth flexibilities. You are not working to advance cickle cell disease prevention or treatment.
▶ 2:24:18These are measures that affect our health care system, just like the cuts to Medicare and Medicaid and the Affordable Care Act that are included in your big ugly bill. And you are not meeting the moment. 5 days. That's what we have left. 5 days before millions of people feel the pain of your inaction.
▶ 2:24:415 days before Republicans walk us into another crisis entirely of their own doing. The clock is ticking. 5 days. Let's get serious about the work of the American people and let's put healthc care at the center of that work. I yield back.
▶ 2:25:03Mr. Sisi,
▶ 2:25:05Mr. Chairman, uh, Ranking Member Neil, I want to applaud the both of you for putting before us today nine bills that I think will garner tremendous bipartisan support. I plan to vote for each of these bills today. Uh, but the number one issue, uh, if you poll the American people, what are the most important issues facing our country? They say it's affordability. Included in the top five issues are healthcare. And healthc care affordability is a major problem.
▶ 2:25:34It's been a major problem for a long time and the expiration of the premium tax credits at the end of this month are going to cause an increase in people's health insurance premiums. My good friend Kevin Hearn uh just pointed out that uh the rates will go up because of this. He said it's a small percentage, but he admits the fact that the rates are in fact going to be going up in part because of the expiration of the premium tax credits.
▶ 2:26:03Uh we got a serious problem with health care costs in our country and it's going to get worse. I was just met with uh the president of a major insurance company uh just literally within the past hour. Uh I said, "Listen, you guys are perceived as the bad guys.
▶ 2:26:20A lot of bad stuff going on with people's health insurance premiums and rates and we've got to try and figure out a comprehensive solution to this, but you're seen as being a big part of the problem." and he pointed out that letting the uh the premium tax credits expire will cause an increase in the rates and people are going to be hearing about that on November 1st. So, we really have to act quickly on this to address it.
▶ 2:26:42Now, this may not be the answer that is satisfactory for the Republicans uh in the long term, but in the short term, we should be trying to stop this pain from being delivered to the American people. And if we extend the premium tax credits, there's a currently a bipartisan bill to extend them for a year. I'd like to see it longer than a year. There are some people that are going to be advocating very strongly to be permanent. I doubt that we'll get the Republicans to agree to that, but I wish they would.
▶ 2:27:12But let's buy some time for us to actually do the real work necessary to reduce health insurance premiums, health insurance cost, health care cost in the United States of America. reiterating all the different things that Mr. Horseford just talked about, everything from the PBMs and what's happening with them and them gaming the system. The prescription drugs, the president says we should negotiate the presc prescription drug prices. We did that under the Biden administration for a limited number of drugs.
▶ 2:27:42We should do it for a lot more drugs. Let's work together to figure out how to really make America healthy and try and do preventative things to address the problems of smoking and drugs and alcohol and food additives that are unhealthy for you and exercise and obesity. Let's work together on those things.
▶ 2:28:01Let's work together to try and address the real drivers of health care costs that are happening in our country where we spend 75% of the health care dollars in the last 6 months of people's lives. Let's deal with long-term care insurance for people, but let's work together to try and get to a place where we can really address the real problems that the American people face, which if you ask them, they will say affordability and health care are in the top issues that they face.
▶ 2:28:31So, let's take the uh the cue from today's meeting where we just saw a vote of 43 to zero that we worked together on a very important issue. But there are bigger issues that affect people every single day that we can work together. We came to this body because we want to make the world a better place to live in. The Democrats want that. The Republicans want that. People run for office because they want to make the world a better place. They want to help people.
▶ 2:29:00And it's not going to happen if all we do is yell and scream at each other. Let's work together. Let's find common ground. and let's figure out how to take on the tough fights that exist out there with some very powerful interests to try and reduce the health care costs of the American people to make them healthier and to make their lives better. We can do it. There's such amazing talent on both sides of the aisle up on this day.
▶ 2:29:27But as it stands right now, because of the refusal to work together on the big tough issues, people are going to see a tremendous burden in their lives get even worse because their health insurance premiums are going up and they're going to be notified it of it on November 1st. Unless people are going to buy insurance and when they don't buy their insurance because they can't afford it, then that's going to cause the prices to go up even more. So, this is a no-brainer. Let's work together.
▶ 2:29:57Extend the health insurance premium tax credits. Buy some time and let's sit down together and work together in this committee to solve this problem. Thank you, Mr. Chairman. I yield back.
▶ 2:30:07Mr. Dogget is recognized for five
▶ 2:30:08Thank you, Mr. Chairman. With an estimated 15 million Americans on the brink of losing all access to health care, with millions of our country members experiencing enormous insurance price spikes, and communities dreading the looming closure of hospital and physician practices, our Republican colleagues in lock step with President Trump are leading us toward a true health care crisis.
▶ 2:30:37a crisis in which we end up with as many Americans denied access to health care as existed before the Affordable Health Care Act was ever adopted. The Affordable Health Care Act that these Republicans tried in this committee and elsewhere over 60 times to repeal. And so now they are repealing it for some Americans and leaving it barely hanging on for others.
▶ 2:31:01This crisis is preventable like so many of the health care complications that will result in increased emergency room visits when people are denied health care and forced to wait until the last possible moment to seek help that's more expensive and likely to be less successful. Who we talking about? Diabetics that are forced to ration or forego insulin. High blood pressure going untreated until someone has a stroke or a heart attack.
▶ 2:31:30a cancer diagnosis that is received too late to put a stop to the cancer. This does not have to become the reality of 15 million Americans. But if these Republicans continue to refuse to reach reasonable negotiation on our future of healthcare, that's exactly what will happen.
▶ 2:31:51And there are already some of the nation's leading experts that have analyzed what will be the true cost of this Republican University of Pennsylvania researchers have told us and their estimate is that American lives will be lost every year as a result of this cut back. This 15 million Americans that are denied access to health care.
▶ 2:32:17This does not even include the lives that are lost by the way Trump has slashed research without regard in a mindless way without regard to the impact. closing clinical trials of treatments that might save someone from a death from cancer or other dread The investment that has been cut in medical research, just like the investment that has been cut in access to a family physician, is deadly for Americans, 51,000
▶ 2:32:47per year. And so today we gather here as Republicans attempt to cover with a bipartisan gloss on the very partisan the very deadly action that they have taken this year. Sure it's fine to approve all of these bipartisan bills that will in some cases provide modest relief in some cases provide only marginal relief. But it does not go to the core issue of access.
▶ 2:33:16It does not go to the core issue of slashing medical research that is so vital to our hope to overcome dread diseases. It does not go to those issues. But because Republicans needed those cuts to medical research, to healthc care access to help pay for Elon Musk and the billionaire class to get even more tax breaks. That was their trade-off.
▶ 2:33:38They had a choice to make and they chose to go with their billionaire backers instead of to go with the millions of Americans who will suffer directly and some of whom will die as a result of their actions. For Texans, Medicaid is a lifeline for three million children, for twothirds of nursing home residents, and nearly a million adults with complex disabilities. These are the vulnerable individuals that Republicans have abandoned.
▶ 2:34:04They were put on the chopping block so a few billionaire donors could store yet another tax break. Under the big ugly bill, burdensome reporting requirements rushed through in about a year's time will result in fully qualified individuals losing their access to a family physician. Deep funding cuts to safety net hospitals will result in closures and communities losing the only place where someone can receive care.
▶ 2:34:31Now, Republicans are planning to take away coverage from 1.7 million Texans, almost two million, as they eliminate uh the tax credits as they take them away from Texas families. This open enrollment for marketplace plans begins in just another six weeks, and the notices are going out now about those premium spikes that will discourage some families from even applying.
▶ 2:34:55So much is at stake here, so much more than any of the bills being considered today because we need to protect the health care of our fellow American citizens and it's not being done in any of the bills that occur today when it comes to access and medical research. I yield back. Mr. Thompson is recognized for five
▶ 2:35:16Thank you, Mr. Chairman. I'd like to yield my time to Miss Moore.
▶ 2:35:19Miss Moore. Uh, thank you for yielding, Mr. Thompson. And um, you know, I'm sure that the uh, clips of Mr. Smucker, Mr. SM Swiker kind of calling me a liar have gone viral by now. And so I do feel that it's incumbent upon me to lower the temperature of this discussion a little bit. I'll start off by acknowledging Mr.
▶ 2:35:53observation that I said that trillions of dollars were cut from Medicaid and I that should not have been plural but it was over $1 trillion that was cut in I also want to acknowledge that I did utter earlier uh CBO reports of 17 million people being kicked off healthc care because of the one big beautiful bill. And I should have acknowledged as Mr.
▶ 2:36:21Swiker pointed out in his brilliance that that was that that the estimate was lowered by CBO to only 15 million being kicked off. So, I do want to acknowledge um was the truth, but I I'm not going to allow this to distract me from the fact um that uh you know, combination of things in the one big beautiful bill
▶ 2:36:52um like the 11 uh uh uh million people cutting off Medicaid or the 4 million off the ACA, that's not going going to distract me from what the what the bill did. That it lowered uh provider tax credits, that it cut Medicaid, that uh according to some reports, we're going to see almost half uh million employees in the health care system lose their jobs.
▶ 2:37:23hospitals are going to have to pay like $25 billion dollar a year extra in in costs uh uncompensated care. I do have something, Mr. Chairman, uh put in the the record without uh with with no objection.
▶ 2:37:38I'm not going to be um uh by my error um in in presenting the facts that in fact these bills that we're passing today feel real good but in fact uh the fact that we are taking away NIH grants um uh is a problem. Now I do want to acknowledge some of the things that my good friend Mr.
▶ 2:38:06Swager said because he is a good friend of mine. I rely on him as a partner in important legislation on this committee. He talked about the finance bill versus a healthc care bill. Well, it is impossible really to present these great cures without NIH funding.
▶ 2:38:25And I'll just reiterate that it's um without Medicaid coverage and hospital coverage u to be able to um really actualize some of the good feelings that we have in the bills that we're passing today. And I do want to reiterate uh on the bill that we're currently debating if I'm if I'm not mistaken that it's it's about being able to stay at home and receive treatments at home.
▶ 2:38:54With regard to that, the the biggest payer, the biggest risk to people being able to stay at home is in the Medicaid cuts because Medicaid is not mandatory as in medic as Medicare is. And so even though that's not our jurisdiction, I just want to say that uh I agree with the bill that we passed earlier. I think this bill could be very helpful.
▶ 2:39:23Uh and uh I do apologize for my misstatements. I also want to say to Mr. Smucker, I agree with you that 47% to quote use to make sure I don't get it wrong of our health care and Medicaid care expenses could be cut if we pass that obesity bill. You and I know this is a bill that um that I have pending. I've worked with you.
▶ 2:39:52Uh I don't see you here present, but I would be happy to work with you on getting the OB obesity bill passed because obesity is driving uh huge costs. We could really bid the health care costs if we were to deal with the obesity crisis. But all of this requires the financing mechanism of Medicaid, Medicare, NIH grants. And with that, I would uh thank Mr. Thompson for his time. and I would yield back to him.
▶ 2:40:24Mr. Petta,
▶ 2:40:26thank you, Mr. Chairman. I move to strike the last word. I want to thank you and ranking member Richie Neil for this bipartisan markup and I absolutely believe that these healthc care measures are definitely worth considering and I echo the sentiments of my colleagues on this side that are very concerned about potential health care cuts and the damage that they will do. However, this markup comes as my constituents are being crushed right now by high costs.
▶ 2:40:52And I believe it's due to this administration's incoherent, inconsistent, and incompetent tariff policy. A policy that has led to a tariff rate of 18%, the largest rate since the Great Depression. It's a tariff policy that has led to four-fifths of the tariffs having been borne by the American consumer and American businesses. Every day I'm receiving uh questions and comments from constituents who are all getting crushed by high prices right now.
▶ 2:41:22From constituents and small businesses, from people going to the grocery store to contractors going to the lumber yards, from my farmers to my semiconductor producers, and from car dealers to car buyers. These are people in businesses that don't have the margins to survive these tariff policies, who don't have access to the Oval Office to cut backroom deals for relief. These are people and producers that are having to personally pay the high prices that are directly being affected by these high costs.
▶ 2:41:50Now, the tariffs have not only caused high prices, they've caused uncertainty that's destroyed what was once a strong jobs market. In July, the economy added only 73 73,000 jobs. In August, just 22,000. That's a horror show that led to the president's firing of the Bureau of Labor Statistics and politicized that data which we need to rely on for governing responsibly.
▶ 2:42:16When it comes to manufacturing, that industry that was supposed to benefit for from reshoring, it's tanking as the cost of inputs are increasing and markets are becoming impossible to predict. Diplomatically, the president's tariff policy is causing consternation amongst our biggest trade partner is and allies and it's contributing to diplomatic crisis. Legally, the president's tariffs are hanging on by a thread after a federal court found that their claims of emergency power is dubious at best.
▶ 2:42:43So, the reality is that the president's trade policies that are based on his 40-year fetish with tariffs is bad for Americans, is bad for American foreign policy, and it's bad for our American constitution. Yet in the 119th Congress, this majority is allowing this president to not just bulldoze over the well-being of our constituents. Speaker Johnson is allowing this president to run roughshot over our constitutional authority.
▶ 2:43:08Now more than ever, with these high prices, our communities, our constituents need us to reclaim our constitutional powers over trade and live up to our responsibilities as a check, as a balance on this executive branch. It's time to repeal the various tariff powers that Congress has granted the executive branch over the past few decades.
▶ 2:43:28I'm just I'm not just talking about AIPA, but these other sections that we've afforded the executive branch because it's those author authorities that this president is using to capricciously and whimsically impose his tariffs that are causing great damage to our economy and creating a crisis with these high costs that all of us are facing. That's why this committee that has purview over trade should defend that jurisdiction, should defend our independence, and we should defend our duty to the American p American public.
▶ 2:43:58It is our job. It is our responsibility. And let me tell you, when it comes to trade authority, it's our time to take it back. That's the least we can do for country, for this Congress, for our constitution, and yes, for our constituents. Thank you, Mr. Chairman. I yield back. Are there additional members that wish to strike the last word? Seeing none, are there any amendments to the amendment in the nature of a
▶ 2:44:26Mr. Horford.
▶ 2:44:30Yeah, Mr. Chairman, I reserve a point of
▶ 2:44:32A point of order has been reserved.
▶ 2:44:36Thank you, Mr. Chairman. I have an amendment at the desk.
▶ 2:44:39Would the gentleman suspend while the amendment is um distributed? Gentlemen, proceed.
▶ 2:44:55Thank you, Mr. Chairman. I cannot in good conscience sit here and allow my colleagues on the other side to pretend that this is business as usual. a he a health care markup that ignores the looming advanced premium tax credit. A tax credit is not a subsidy.
▶ 2:45:18Just like you just gave tax cuts to the billionaires, tax credits for working people is a tax credit, not a subsidy. is set to expire and it pre uh presents a very serious threat to the livelihoods and the affordability of the people that I represent and people all across this country.
▶ 2:45:42That is why I am offering this amendment similar to the one that I offered during the markup of your so-called one big beautiful bill which is now law. A law that is so unpopular you are now trying to rename it and reclassify it as something that it is not. My amendment protects millions of hardworking Americans from losing their health coverage and prevents health care costs from skyrocketing.
▶ 2:46:10In Nevada alone, 85,000 people rely on these tax credits to lower their monthly premiums and to make comprehensive quality health insurance affordable. I want to share two examples from Neadans who came to my office recently. Shawn, a small business owner, uses the Nevada Health Exchange to cover himself and his family. Both his wife and daughter live with chronic diseases.
▶ 2:46:38The advanced premium tax credit is what makes their coverage affordable. Without it, his family's cost could triple, forcing impossible financial choices and threatening the future of his business. Another constituent, Ellie, shared that the tax credit saves her family $450 a month.
▶ 2:47:01That is critical support as they navigate their daughter's cancer diagnosis, something that we just honored earlier in this hearing. If the credit expires, her family will face an additional $500 a month uh in cost. That's not just a number. It's the cost of a car payment, of groceries, or other essentials. For her and her family, it would mean losing access to the care that they desperately need.
▶ 2:47:31So my question again is why would we prioritize tax cuts for the very wealthy and for billionaires and not for Ellie and Shawn and millions of Americans like them who also deserve tax credits to afford their healthcare. These stories are not unique. Millions of Americans are at risk of losing coverage if Congress fails to act.
▶ 2:47:58And if Republicans fail to negotiate in good faith and extend the advanced premium tax credit, the consequences are clear. More than four million people will lose coverage. Out-of-pocket premium costs will rise by an average of 75%, doubling for many. Working families could see their annual premiums jump by $4,000 or more. And for older Americans and families, increases could run into the tens of thousands.
▶ 2:48:28Before I close, let me address one final point. My colleagues on across the aisle like to invoke fiscal responsibility, but let's be clear, extending the advanced premium tax credit is the fiscally responsible choice. It prevents an avalanche of uncompensated care that would strain our health care system and increase costs for everyone, regardless of how you get your healthare.
▶ 2:48:58And it stands in stark contrast to HR1, your one big beautiful bill, their deficit busting tax giveaway to the wealthy, which no one on their side seemed to question at the time. We shouldn't be treating the superw wealthy better than working and middle class families. The advanced premium tax credit needs to be extended and made permanent.
▶ 2:49:25And that is why I'm bringing forward this amendment as I did previously and I yield back.
▶ 2:49:32Does the gentleman from um Florida insist on his point of order?
▶ 2:49:37Mr. Chairman, I made a point of order against the amendment. Did I speak on the amendment? Mr. Chairman.
▶ 2:49:44So you maintain the point of order.
▶ 2:49:46Yeah. Mr. Chairman, the amendment uh offered by the gentleman uh from Nevada is not gerine to the understand underlying resolution under clause seven of the rule 16. An amendment is not germanine if it's if if it subject matter is different from that of the underlying resolution. The subject matter of is measured before us hospital waiverss the subject matter is more related to tax credits. Therefore, the amendment is not germanine.
▶ 2:50:13and I urge the chair to substain the the motion of order. Point of order
▶ 2:50:19does the I I'll I'll go to you with respect, ranking member.
▶ 2:50:23Thank you, Mr. Chairman. Uh this is an excellent amendment and it would be similar where there's an opportunity in a card game to show your If this amendment were put on the floor of the House of Representatives, there are 50 Republicans that would vote for it and everybody here knows it. The idea that you can shut down debate on this legislation is a mistake.
▶ 2:50:50If the arguments are so honest that we've heard today and in other circles, then let's have a vote on this amendment. We can address the issue of cancer research. We can address the issue of whether or not it's 15 million or 17 million Americans who are going to be denied health insurance because of the big ugly bill. This is a clear opportunity for people right here to offer an argument.
▶ 2:51:20If the other side is so certain about this tax credit expansion and so certain about the posture that they took with borrowed money for a tax cut for wealthy people, this could clear it all up. We are going to end up in the House at some point with a vote on these tax credits, and everybody knows it.
▶ 2:51:47We are not going to sit by on our side for a one-year extension, a contrived matter that lets the majority get past the next election. People have come to depend upon healthcare. And there's an old adage that we all know is clear. when you start taking a benefit away, there's a huge political consequence. And thank you for allowing me that time, Mr.
▶ 2:52:11Thank you. Does the gentleman um want to withdraw his amendment?
▶ 2:52:15Um the chair is uh ready to rule on that. The amendment is not germanine.
▶ 2:52:29Are there any other amendments? the ruling.
▶ 2:52:32I appeal I appeal the ruling of the chair. We're going to take a vote on my
▶ 2:52:36Perfect. Mr. Buchanan.
▶ 2:52:44I table the motion.
▶ 2:52:50The gentleman from Florida has tabled the gentleman from Nevada's motion to appeal the decision of the chair.
▶ 2:52:57Point of information. What's your what's your information?
▶ 2:53:01Just to ask for clarity. So by tableabling the motion, the amendment which would allow us to consider extending the tax credits would not be allowed to be considered by this uh committee at this time.
▶ 2:53:20So what's before us? You had an amendment that's not germanine. I rolled on it and it's being tabled. So if it was gerine to the bill at hand, then it could be offered. I would assume that some point that there's going to be an opportunity for a valid amendment in regards to that
▶ 2:53:40and not on this bill.
▶ 2:53:42From a point of information, the the ruling on the uh indication that this is not gerine is based on what provision of the underlying bill? Isn't Isn't this a healthc care bill?
▶ 2:53:57We're already past that point. You've already appealed the decision of the chair and we're going to a vote. The clerk will call the role.
▶ 2:54:03Thanks for shutting me down.
▶ 2:54:06Mr. Buchanan,
▶ 2:54:07yes to table.
▶ 2:54:08Mr. Buchanan? Yes. Mr. Smith of
▶ 2:54:12Mr. Smith of Nebraska? Yes. Mr. Kelly?
▶ 2:54:16Mr. Kelly? Yes. Mr. Swikert.
▶ 2:54:20Mr. Le Hood.
▶ 2:54:22Mr. Mr. Le Hood. Yes. Mr. Arrington.
▶ 2:54:26Mr. Arrington. Yes. Mr. Estus. Mr. Smucker. Mr. Smucker. Yes. Mr. Hearn. Mr. Hearn. Yes. Mrs. Miller. Mrs. Miller. Yes. Dr. Murphy. Dr. Murphy. Yes. Dr. Kristoff.
▶ 2:54:48Mr. Fitzpatrick.
▶ 2:54:50Mr. Fitzpatrick. Yes. Mr. Stwie.
▶ 2:54:54Mr. Stwie. Yes. Miss Tenny. Miss. Tenny. Yes. Miss. Fishbach.
▶ 2:55:04Miss Fishbach. Yes. Mr. Moore.
▶ 2:55:08Mr. Moore. Yes. Miss Vanine. Miss. Van. Yes. Mr. Fenstra. Mr. Fenstra. Yes. Miss
▶ 2:55:18Miss Malotakus. Yes. Mr. Carrie.
▶ 2:55:22Mr. Carrie. Yes. Mr. Yakam.
▶ 2:55:25Mr. Yakam. Yes. Mr. Miller.
▶ 2:55:30Mr. Miller. Yes. Mr. Bean.
▶ 2:55:32Mr. Bean. Yes. Mr. Moran.
▶ 2:55:36Mr. Moran. Yes. Mr. Neil.
▶ 2:55:40Mr. Neil. No. Mr. Dogget?
▶ 2:55:44Mr. Dogget? No. Mr. Thompson?
▶ 2:55:47Mr. Thompson? No. Mr. Larson? Mr. Davis,
▶ 2:55:55Mr. Larson. No. Miss Sanchez. Miss Su Miss Delben. Senet. No. Miss Chu Miss Chu. No. Miss Moore.
▶ 2:56:12Miss Moore. No. Mr. Bole.
▶ 2:56:16Mr. Boille. No. Mr. Byer.
▶ 2:56:19Mr. Fire. No. Mr. Evans.
▶ 2:56:22Mr. Evans. No. Mr. Schneider. Mr. Schneider. No. Mr. Panetta. Mr. Panetta. No. Mr. Gomez. Mr. Gomez. No. Mr. Horsford. Mr. Horford. No. Miss Plaska. Mr. Swazy. Mr. Swazy. No. Mr. Schwikert. Mr. Schwikert. Yes. Mr. Estus.
▶ 2:56:53Mr. Estus. Yes. Mr. Davis. Miss Sanchez, Miss Su, Miss Plask, Chairman Smith. Chairman Smith. Yes.
▶ 2:57:39Will the clerk report the vote? The yeses are 26 and the nos are 15.
▶ 2:57:50There being 26 yeses and 15 nos, the motion to table um was adopted. We'll move on to further further amendments.
▶ 2:58:00Mr. Thompson.
▶ 2:58:03Thank you, Mr. Chairman.
▶ 2:58:04Mr. Chairman, I'm going to I want to reserve point order.
▶ 2:58:07Hold on.
▶ 2:58:09A point a point of order has been reserved. Would the gentleman suspend while the amendment is distributed?
▶ 2:58:15Thank you.
▶ 2:58:18Thank you.
▶ 2:58:28Would the gentleman proceed for five
▶ 2:58:31Thank you, Mr. Chairman. Uh, my amendment would extend the Affordable Care Act tax credits for one year. At a time when the Trump administration's trade policies are driving up prices for everything, our constituents can't afford to pay thousands more each year for their health care. According to the president, record amounts of tariff taxes are being charged hardworking Americans.
▶ 2:59:00According to economists at the Yale Budget Lab, American families are making the least are um are making the least or paying an extra $1,300 a year for that care. And Mr. Chairman, I would like to request that the uh Yale Budget Lab data be entered into the
▶ 2:59:23Mr. Chairman,
▶ 2:59:24Mr. Thompson.
▶ 2:59:26So ordered. Thank you. Americans see the t the Trump taxes at the grocery store. They see them when they're buying their kids school supplies and when they're getting their medical care. Mr. Chairman, the ACA healthc care coverage is a big deal. 24 million people get their health care coverage through the ACA exchange.
▶ 2:59:51And according to the CBO, 4.2 2 million of those will lose their coverage if we don't take action. This amendment is that action in my district and I doubt it's much different than anyone else here on the dis 28,000 people are covered by the ACA.
▶ 3:00:11Without this amendment, a 60-year-old earning just over $80,000 would see their cost rise 526% and have to spend 34% of their income on health insurance premiums alone. I supported the enhanced tax credits to expand health care coverage during the pandemic and I voted to extend them in the inflation reduction act.
▶ 3:00:40When Republicans ripped health care away from millions in their big ugly law, they rejected our calls to extend this lifesaving coverage. Life saving coverage. My amendment extends the tax credits for one year and provides a little breathing room for millions of Americans who can't live without health care. I ask that this amendment be Does the gentleman continue to reserve his point of order?
▶ 3:01:14Mr. Chairman, I make a point of order. I made a point of order against the amendment. Mr. Chairman, the amendment offered by the gentleman from California is not gerine to the underlying resolution under clause 7 rule 16. An amendment is not germanine if the subject matter is different from the underlying resolution. Subject matter of the measure before us is hospital home care. The subject matter of the amendment is related to tax credits. Therefore, the amendment is not germanine. I urge I urge the chair to sustain the point of order.
▶ 3:01:45Does the gentleman wish to be heard on his amendment and the point of order?
▶ 3:01:50Yes, Mr. Chairman. Um I believe it is in order. Um I believe it's in order for every one of us on this dis to do everything we can to ensure that the people that we represent have access to quality affordable health care and that's what this does. This provides an opportunity for people to be able to reclaim their health care health care that was mercifully taken away from them and putting them at great risk.
▶ 3:02:17And I uh challenge the uh finding. So, um, is the gentleman wanting to withdraw or move forward?
▶ 3:02:28All right. The chair is, uh, is ready to rule that the amendment is not germaine. The amendment that was presented by Mr. Thompson, um, amends the tax code. The tax code is not mentioned one bit in this bill. So, it is absolutely not ask for a roll.
▶ 3:02:50The ruling of the chair.
▶ 3:02:54Does a gentleman appeal the ruling of the chair?
▶ 3:02:56Yes, I do.
▶ 3:02:56All right. The gentleman appeals the ruling of the chair.
▶ 3:03:00Mr. Chairman, I move the table.
▶ 3:03:02The gentleman from Florida moves to table. Um, clerk, call the role.
▶ 3:03:09Mr. Buchanan.
▶ 3:03:12Mr. Buchanan. Yes. Mr. Smith of Mr. Kelly. Mr. Kelly. Yes. Mr. Schwikert. Mr. Schwikert. Yes. Mr. Le Mr. Arrington. Mr. Arrington. Yes. Mr. Estess. Mr. Estus. Yes. Mr. Smucker. Mr. Smucker. Yes. Mr. Hearn. Mr. Hearn. Yes. Mrs.
▶ 3:03:43Dr. Murphy.
▶ 3:03:45Dr. Mr. Murphy. Yes. Mr. Kristoff.
▶ 3:03:48Mr. Kristoff. Yes. Mr. Fitzpatrick.
▶ 3:03:52Mr. Fitzpatrick. Yes. Mr. Stwie.
▶ 3:03:56Mr. Stwie. Yes. Miss Tenny. Miss. Tenny. Yes. Miss. Fishbach.
▶ 3:04:03Miss Fishbach. Yes. Mr. Moore. Mr. Moore. Yes. Miss Vanine. Miss. Vanine. Yes. Mr. Fenstra. Mr. Mr. Fenstra. Yes. Miss Maliaakis. Miss Maliaakis. Yes. Mr. Carrie.
▶ 3:04:21Mr. Carrie. Yes. Mr. Yakam.
▶ 3:04:24Mr. Yakam. Yes. Mr. Miller.
▶ 3:04:28Mr. Miller. Yes. Mr. Bean.
▶ 3:04:32Mr. Bean. Yes. Mr. Moran.
▶ 3:04:35Mr. Moran. Yes. Mr. Neil.
▶ 3:04:39Mr. Neil. No. Mr. Dogit.
▶ 3:04:42Mr. Dogget. No, Mr. Thompson. Mr. Larson, Mr. Larson. No, Mr. Davis. Miss Sanchez. Miss Su. Miss Delben. Miss Delben. No. Miss Chu,
▶ 3:05:08Miss Chu, no. Miss Moore,
▶ 3:05:11no. Miss Moore, no. Mr. Boille,
▶ 3:05:15Mr. Boille, no. Mr. Byer,
▶ 3:05:18Mr. Byer, no. Mr. Evans.
▶ 3:05:21Mr. Evans, no. Mr. Schneider,
▶ 3:05:25Mr. Schneider, no Mr. Panetta. Mr. Panetta, no. Mr. Gomez, Mr. Gomez, no. Mr. Horford, Mr. Horford, no. Miss Plask.
▶ 3:05:42Miss Plasket. No. Mr. Swazy.
▶ 3:05:45Mr. Swasy. No.
▶ 3:05:49Mr. Smith of Nebraska.
▶ 3:05:53Mr. Smith of Nebraska. Yes.
▶ 3:05:55How is Miss Miller recorded?
▶ 3:05:59Miss Miller is not recorded. Miss Miller. Yes.
▶ 3:06:04Mr. Leood.
▶ 3:06:05Mr. Le Hood. Yes. Mr. Thompson.
▶ 3:06:14Mr. Thompson. No. Mr. Davis.
▶ 3:06:18Mr. Davis. No. Miss Sanchez. Miss Su.
▶ 3:06:27Chairman Smith.
▶ 3:06:29Chairman Smith. Yes. the clerk report the vote?
▶ 3:06:44The yeses are 26 and the nos are 17.
▶ 3:06:47There being 26 yeses and 17 nos, the motion to table has been adopted. Are there additional amendments?
▶ 3:06:55Yes. I have an amendment at the desk.
▶ 3:06:58Would the lady suspend while um
▶ 3:07:00Mr. Chairman, reserve a point of order? A point of order has been reserved and um um distribute the amendment.
▶ 3:07:34Republicans big ugly bill has already done enormous damage to our health care system, slashing $1.5 trillion dollar, gutting Medicaid, and undermining the Affordable Care Act by failing to extend critical tax credits that keep care affordable for millions. But one dangerous consequence we haven't focused enough on is the devastating impact this bill will have on Medicare.
▶ 3:08:00Because of the reckless way Republicans wrote their bill, it will trigger statutory payo. This is the provision in our budget process that requires that items that increase the deficit over a 5 or 10 year period require a cut to balance the budget. And that means unless Congress acts, Medicare providers will face a 4% acrosstheboard cut.
▶ 3:08:28According to the Congressional Budget Office, that adds up to $45 billion in cuts to Medicare in 2026 and nearly half a trillion dollar more over the following decade. I hear from my doctors and hospitals in my district all the time. They are already barely keeping their doors open. A cut of this magnitude would force many to slash services or shut down entirely.
▶ 3:08:55And this pain would be felt, especially in rural and underserved communities. And seniors and people with disabilities who rely on Medicare will be left without care. My amendment simply undoes this harm.
▶ 3:09:12It protects Medicare, the lifeblood of our health care system, and ensures that more than 60 million Americans are not punished for Republicans disastrous bill. We cannot let this administration continue to sabotage our health system and put the most vulnerable at risk.
▶ 3:09:34I urge my colleagues to join me in supporting this amendment, and I yield Gentleman from Arizona is recognized.
▶ 3:09:46Mr. Chairman, um the amendment is outside the ways and means jurisdiction. It actually is functionally a budget um amendment.
▶ 3:09:58Does the gentle woman wish to be heard on her on the point of order? Well, this is an item that is important to 60 million Americans who could lose their essential health care coverage. They rely on Medicare. It is the lifeblood of our health care system and that is why it should be in this bill.
▶ 3:10:24The chair is prepared to rule. Um the the gentleman from uh Arizona uh makes the point of order that the amendment proposed is not germanine as it is outside of the Ways and Means Committee Rule 10 jurisdiction. The point of order is sustained and the amendment is not in
▶ 3:10:42Mr. Chair, I appeal the ruling of the
▶ 3:10:46Mr. Chairman, I move to table the
▶ 3:10:50Uh the gentleman from Arizona has moved to table. The clerk will call the role.
▶ 3:10:55Mr. Buchanan. Mr. Smith of Nebraska. Mr. Kelly, Mr. Schwiker, Mr. Schwikert. Yes, Mr. Le Hood. Mr. Le Hood. Yes, Mr. Arrington. Mr. Estus, Mr. Smucker, Mr. Smucker. Yes, Mr. Hearn. Mr. Hearn, yes.
▶ 3:11:25Mrs. Miller
▶ 3:11:28Dr. Murphy
▶ 3:11:30Dr. Murphy yes Mr. Kustoff
▶ 3:11:33Mr. Kustoff yes Mr. Fitzpatrick
▶ 3:11:37Mr. Fitzpatrick yes Mr. Stwie
▶ 3:11:41Mr. Stwie yes Tenny Miss Tenny yes Miss
▶ 3:11:48Miss Fishbach yes Mr. Moore
▶ 3:11:51Mr. Moore. Yes, Miss Vanine. Miss Vanine. Yes, Mr. Fenstra. Mr. Fenstra. Yes, Miss Malotakus. Miss Malotakus. Yes. Mr. Carrie.
▶ 3:12:05Mr. Carrie. Yes. Mr. Yakam.
▶ 3:12:09Mr. Yakam. Yes. Mr. Miller.
▶ 3:12:13Mr. Miller. Yes. Mr. Bean.
▶ 3:12:16Mr. Bean. Yes. Mr. Moran.
▶ 3:12:19Mr. Moran. Yes. Mr. Neil. Mr. Neil. No. Mr. Dogget. Mr. Dogget. No. Mr. Thompson. Mr. Thompson. No. Mr. Larson. Mr. Larson. No. Mr. Davis. Mr. Davis. No. Miss. Miss Su. Miss. Delenny. Miss. Albennet. No. Miss Chu. Miss Chu.
▶ 3:12:49No. Miss Moore, Mr. Bole,
▶ 3:13:00Mrs. Moore is not recorded.
▶ 3:13:03Mrs. Moore, no.
▶ 3:13:06Mr. Bole,
▶ 3:13:07Mr. Bole, no. Mr. Byer,
▶ 3:13:10Mr. Byer, no. Mr. Evans,
▶ 3:13:14Mr. Evans, no. Mr. Schneider,
▶ 3:13:17Mr. Schneider, no. Mr. Mr. Petta, Mr. Gomez,
▶ 3:13:24Mr. Gomez, no. Mr. Horsford, Miss Plask,
▶ 3:13:31Miss Plask, no Mr. Swisy,
▶ 3:13:34Mr. Swisy, no Mr. Buchanan.
▶ 3:13:40Mr. Buchanan, yes. Mr. Smith of
▶ 3:13:44Mr. Smith of Nebraska. Yes. Mr. Kelly.
▶ 3:13:48Mr. Kelly. Yes. Mr. Arrington.
▶ 3:13:52Mr. Arrington. Yes. Mrs. Miller.
▶ 3:14:00Mrs. Miller. Yes. Miss Su Mr. Petta. Mr. Horford.
▶ 3:14:13Mr. Horford. No.
▶ 3:14:17Chairman Smith. Yes,
▶ 3:14:19Chairman Smith. Yes.
▶ 3:14:31The clerk will report the vote.
▶ 3:14:33The yeses are 26 and the nos are 16.
▶ 3:14:36There being 26 yeses and 16 nos. The motion to table has been adopted. Are there additional amendments? Mr. Byer, Mr. Snyder.
▶ 3:14:45Uh, thank you, Mr. Chairman. I have an amendment at the desk.
▶ 3:14:49Mr. Chairman, reserve a point of order.
▶ 3:14:51There's been a point of order reserved. Will the gentleman suspend while the amendment is distributed?
▶ 3:14:55Do I have a choice?
▶ 3:15:05Thank you.
▶ 3:15:12Proceed, Mr. Schneider.
▶ 3:15:14Thank you, Mr. Chairman. And let me uh emphasize uh I'm grateful that we're having this chance to come together uh both Republicans and Democrats working in good faith. I will always support a bipartisan good faith good faith effort to benefit the healthc care of my constituents and the American people. And I I'm proud to support the underlining bill HR 4313 that amends the Social Security Act.
▶ 3:15:41My amendment would ensure that millions of Americans enrolled under part B or part D of title 18 of the Social Security Act are able to get the vaccines that the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention recommended in 2024 and to do so without burdensome cost sharing. The underlying bill talks about the quality of care furnished to individuals and this amendment specifically relates to the care Americans deserve.
▶ 3:16:12That said, I find it difficult to speak to the success of the proposed legislation today while the Trump administration is conducting a full-fledged assault on public health, including vaccine development and coverage. So, here's my question.
▶ 3:16:27How is Congress going to address the chaos created by Secretary Kennedy that threatens the health and safety of all Americans, including the stack stacking of critical vaccine advisory committees with vaccine skeptics replacing them and science deniers. Barricading vaccine access does not make America healthy. It makes us sicker.
▶ 3:16:50The Trump administration has even ignored expert consensus and is restricting access to the CO 19 vaccine. Just the latest attack on public health. Millions of Americans are now unsure if they qualify for the shot or whether their insurance will cover it. This is creating an unnecessary burden on patients and providers alike. Vaccines work. They save millions of preventable deaths. They prevent millions of preventable deaths worldwide.
▶ 3:17:21The COVID vaccine alone is estimated to have prevented more than 20 2.5 million deaths, over 90% of which would have been seniors. I was proud to vote for the inflation reduction act in 2022, which made sure that vaccines would be covered without any out-of- pocket costs to Medicare beneficiaries.
▶ 3:17:40This this provision is projected to save over 234 million in out-of- pocket costs a year for the American people with potential changes to vaccine recommendations because of Secretary Kennedy's pseudocience fear fear-mongering. Patients access to vaccines is at risk and out-ofpocket costs will go up.
▶ 3:18:04Without insurance coverage, a COVID vaccine costs around $140, a price that many cannot afford to pay in Trump's failed economy. Let us not forget that in June, Secretary Kennedy fired all 17 members of the CDC's Advisory Committee on Immunization Practices and and then appointed new members, members who are known vaccine skeptics.
▶ 3:18:27This committee's recommendations have a significant significant impact on insurance coverage as the CDC adopts these views into its official vaccine schedule, triggering no cost coverage. This committee is now set to meet this week to determine vaccine recommendations. It is expected that it will result in numerous recommendations that contradict science and will put more vulnerable Americans at risk while raising the cost for consumers who want and deserve protection.
▶ 3:18:54Any changes in the advisory committee recommendations will not only be dangerous, but it's just the latest price hike Republicans are forcing on Americans. First, the tariff taxes, then their big ugly bill, now health insurance premiums, which are skyrocketing, and their solution is to make people pay hundreds of dollars for vaccines to save lives. President Trump, Secretary Kennedy, and congressional problem Republicans just keep making Americans sicker and raising the costs on hardworking families.
▶ 3:19:24That's why this amendment is so important because it will ensure access to vaccines continue to be recommended by physician organizations like the American College of Physicians. I cannot in good faith stand by and watch Americans suffer from preventable diseases while a simple vaccine could protect the health of all Americans, including seniors, pregnant women, and children. I urge my colleagues to support this common sense amendment, and I yield back.
▶ 3:19:51Mr. Swikert is recognized.
▶ 3:19:53Mr. Chairman, um the amendment offered by the gentleman is not gerine under under resolution under clause 7, rule six. The amendment is not germanine if the subject matter is different. Um underlying bill is um part um part A. This would be financing part B and D. Therefore, it is not Germaine.
▶ 3:20:17Mr. Snyder, would you like to speak on the point of order?
▶ 3:20:19Um the underlying bill is about social security. It's about the quality of care of Americans. The amendment I believe does uh reflect it is uh directly addressing that um people who have um uh coverage under the social security act maintain that coverage without uh co-pays. So I think it is germanine.
▶ 3:20:41Did the chair prepared to rule that it is not germanine
▶ 3:20:45further amendments?
▶ 3:20:47Mr. uh chair I I uh would ask for a vote on that.
▶ 3:20:51Mr. Chairman, move to table.
▶ 3:20:52Repeal the amendment. Appeal the ruling.
▶ 3:20:56Mr. Chairman, move to table.
▶ 3:20:58Move to table. The clerk call the role.
▶ 3:21:01Mr. Buchanan.
▶ 3:21:03Mr. Buchanan. Yes. Mr. Smith of
▶ 3:21:07Mr. Smith of Nebraska. Yes. Mr. Kelly. Mr. Schwiker. Mr. Schwiker. Yes. Mr. Le Hood. Mr. Le Hood. Yes. Mr. Arrington. Mr. Mr. Estus. Mr. Estess. Yes. Mr.
▶ 3:21:28Mr. Smucker. Yes. Mr. Hearn.
▶ 3:21:31Mr. Hearn. Yes. Mrs. Miller.
▶ 3:21:34Mrs. Miller. Yes. Dr. Murphy. Dr. Murphy. Yes. Mr. Kustoff.
▶ 3:21:42Mr. Kristoff. Yes. Mr. Fitzpatrick.
▶ 3:21:45Mr. Fitzpatrick. Yes. Mr. Stwie.
▶ 3:21:48Mr. Stwie. Yes. Miss Tenny. Miss Tenny, yes. Miss Fishbach,
▶ 3:21:56Miss Fishbach, yes. Mr. Moore,
▶ 3:21:59Mr. Moore, yes. Miss Vanine, Miss Vanine, yes. Mr. Fenstra, Mr. Fenstra, yes. Miss Malotakus, Miss Malotakus, yes. Mr. Kerry,
▶ 3:22:12Mr. Kerry, yes. Mr. Yakam, Mr. Yakam, yes. Mr. Miller,
▶ 3:22:21yes. Mr. Miller, yes. Mr. Bean,
▶ 3:22:24Mr. Bean, yes. Mr. Moran,
▶ 3:22:27Mr. Moran, yes. Mr. Neil,
▶ 3:22:31Mr. Neil, no. Mr. Dogget, Mr. Dogget, no. Mr. Thompson, Mr. Thompson, no. Mr.
▶ 3:22:41Mr. Larson, no. Mr. Davis, Mr. Davis, no. Miss Sanchez. Miss Su. Miss Su. No. Miss Delben. Miss Delben. No. Miss Chu.
▶ 3:22:56Miss Chu. No. Miss Moore.
▶ 3:23:00Miss Moore. No. Mr. Bole.
▶ 3:23:03Mr. Boille. No. Mr. Byer.
▶ 3:23:06Mr. Byer. No. Mr. Evans. Mr. Evans. No. Mr. Schneider. Mr. Schneider. No. Mr. Petta. Mr. Mr. Petta, no. Mr. Gomez, Mr. Gomez, no. Mr. Horford, Mr. Horseford, no. Miss Plask. Miss Plask. No. Mr. Swazy. Mr. Swasy. Mr. Kelly. Mr. Kelly. Yes. Mr.
▶ 3:23:42Miss. Sanchez. Chairman Smith.
▶ 3:23:48Chairman Smith. Yes. Clerk will report the vote.
▶ 3:24:02The yeses are 25 and the nos are 18.
▶ 3:24:05There being 25 yeses and 18 nos, um the motion to table has been adopted. Are there additional amendments? Seeing none, the question is on the adoption of the amendment in the nature of a substitute. All those in favor signify by saying I. I.
▶ 3:24:22Those opposed say no. In the opinion of the chair, the eyes have it and the amendment in the nature of a substitute is agreed to. I will now recognize Mr. Buchanan for the purpose of offering a
▶ 3:24:33Mr. Chairman, I move the committee favorably report HR 14 4313 as amended for the House of Representatives. The question is on the motion to favorably report HR4313 as amended to the House of Representatives. The clerk will call the
▶ 3:24:48Mr. Buchanan,
▶ 3:24:50Mr. Buchanan, yes. Mr. Smith of
▶ 3:24:53Mr. Smith of Nebraska, yes. Mr. Kelly,
▶ 3:24:57Mr. Kelly, yes. Mr. Schwikert.
▶ 3:25:02Mr. Le Hood?
▶ 3:25:05Mr. Leood? Yes. Mr. Arrington? Mr. Estus.
▶ 3:25:13Mr. Estus. Yes. Mr. Smucker.
▶ 3:25:16Mr. Smucker. Yes. Mr. Hearn.
▶ 3:25:19Mr. Hearn. Yes. Mrs. Miller.
▶ 3:25:22Mrs. Miller. Yes. Dr. Murphy.
▶ 3:25:26Dr. Murphy. Yes. Mr. Kristoff.
▶ 3:25:30Mr. Kristoff. Yes. Mr. Fitzpatrick.
▶ 3:25:33Mr. Fitzpatrick. Yes. Mr. Stwie.
▶ 3:25:36Mr. Stwie. Yes. Miss. Miss Tenny. Miss Tenny. Yes. Miss Fishbach. Miss Fishbach. Yes. Mr. Moore.
▶ 3:25:46Mr. Moore. Yes. Miss Vanine. Miss. Vanine. Yes. Mr. Fenstra. Mr. Fenstra. Yes. Miss Malotakus. Miss Malotakus. Yes. Mr. Kerry.
▶ 3:25:59Mr. Kerry. Yes. Mr. Yakam. Mr. Yakam. Yes. Mr. Miller.
▶ 3:26:06Mr. Miller. Yes. Mr. Bean,
▶ 3:26:09Mr. Bean, yes. Mr. Moran,
▶ 3:26:12Mr. Moran, yes. Mr. Neil,
▶ 3:26:16Mr. Neil, yes. Mr. Dog, Mr. Thompson.
▶ 3:26:25Mr. Larson?
▶ 3:26:28Mr. Thompson? Yes. Mr. Larson? Yes.
▶ 3:26:32Mr. Davis?
▶ 3:26:33Mr. Davis? Yes. Miss Sanchez? Miss Su,
▶ 3:26:39Miss Su, yes. Miss Delben,
▶ 3:26:43Miss Delben, yes. Miss Chu,
▶ 3:26:47Miss Chu, yes. Miss Moore,
▶ 3:26:50Miss Moore, yes. Mr. Bole, Mr. Byer,
▶ 3:26:56Mr. Byer, yes. Mr. Evans. Mr. Schneider.
▶ 3:27:03Mr. Schneider. Yes. Mr. Panetta. Yes,
▶ 3:27:07Mr. Panetta. Yes, Mr. Gomez. Mr. Horford, Mr. Horford. Yes, Mr. Miss Plask.
▶ 3:27:19Miss Plasket. Yes, Mr. Swazy.
▶ 3:27:22Mr. Swazy. Yes. Mr. Schwiker. Mr. Schwikert. Yes. Mr. Arrington. Mr. Arrington. Yes, Mr. Dogget. Mr. Dogget. Yes, Mr. Davis.
▶ 3:27:47Miss Sanchez.
▶ 3:27:50How is Mr. Davis recorded?
▶ 3:27:52Mr. Davis is not recorded.
▶ 3:27:53He said yes.
▶ 3:27:55Mr. Davis. Yes.
▶ 3:27:59Mr. Boille.
▶ 3:28:01Mr. Boille. Yes. Mr. Evans. Mr. Gomez.
▶ 3:28:14Mr. Gomez. Yes.
▶ 3:28:18Chairman Smith.
▶ 3:28:19Is Mr. Dogget recorded?
▶ 3:28:28How's Mr. Evans recorded?
▶ 3:28:30Mr. Evans is not recorded. Mr. Evans. Yes.
▶ 3:28:39Chairman Smith.
▶ 3:28:40Chairman Smith. Yes. The clerk will report the vote.
▶ 3:29:06The yeses are 44 and the nos are zero.
▶ 3:29:09There being 44 yeses and zero nos, the motion is agreed to in HR 4313 as amended is ordered favorably reported to the house. Without objection, I ask that staff be authorized to make technical and conforming changes to HR4313 and that members have two additional days to file with the committee clerk supplemental additional dissenting or minority views.
▶ 3:29:31The committee will now consider HR 5347, the healthc care efficiency through flexibility act introduced by health subcommittee chairman Buchanan and our committee colleague representative Panetta. Accountable Care Organizations or ACOs serve over 11 million traditional Medicare beneficiaries and have saved Medicare over 12 billion by delivering better patient outcomes and reducing expected cost.
▶ 3:29:59technology can empower these ACOs to more efficiently report their quality um data, but not all providers have the resources needed to perform expensive upgrades to their reporting systems, especially smaller rural providers. While we should all support the goal of moving providers to digital reporting of quality measures, a reliable transition framework is needed to provide clarity.
▶ 3:30:27Health Subcommittee Chairman Buchanan and Representative Petta are committed to ensuring stability for ACOs while testing a pilot program on best practices for adopting new technology. Our colleagues are once again joining forces to improve the quality of health care in this country just as they did in shephering legislation successfully through the House earlier this year to expand access to treatments for chronic diseases.
▶ 3:30:55I appreciate their leadership on healthc care issues before this committee and I urge my colleagues to support this legislation and I'm pleased to recognize a gentleman from Florida, Mr. Buchanan for an opening statement.
▶ 3:31:05I would like to thank the chairman Smith for moving forward on this legislation that supports a transition from fee to service fee fee for service to value based care. A the AC acco or accountable care organizations are groups of health care providers who offer valuebased quality care to Medicare beneficiaries. ACOs serve over 11 million beneficiaries and have saved Medicare more than 12 billion dollars.
▶ 3:31:33To save Medicare money, ACOs's must uh report patients information to the CMS is very burdensome and this will help clean up some of that. I'm thrilled to say that my bill would reduce excess regulation burdens, acco a a more stable and efficient process for reporting electronic quality measures and allow providers to focus on delivering highquality valuebased care.
▶ 3:32:01This bill is supported by many uh outside organizations. I have a uh a bunch of letters and support here. I'd ask for unanimous consent to enter into the file the record
▶ 3:32:12without objection. So ordered. The bill is supported by uh a lot ACOs and as well as many outside organizations. I'd like to also thank uh Mr. Panetta as a bipartisan leader on this. He mentioned he had some concerns a few minutes ago, but uh I'll let him talk to that. And and also I want to just say it's budget neutral and I look forward to advancing valuebased care through this committee. Thank you and I yield back.
▶ 3:32:37I now recognize the ranking member from Massachusetts, Mr. Nil, for his opening statement. Uh, thank you and let me yield my time to the distinguished gentleman from California, Mr. Petta.
▶ 3:32:45Thank you, Ranking Member Neil, and thank you, Mr. Chairman, and of course, thanks to my good friend and colleague, Representative Buchanan for his leadership on this bill. Um, of the many issues we cover on Ways and Means Committee, there's one issue where I and Dr. Murphy as well have consistently found common ground on uh with many of you, and that's reforming our Medicare payment uh repayment system. As my colleagues on this committee know, because they've heard me say it, that's the number one health care issue in my district, which is access to Medicare.
▶ 3:33:16Practices can't take new patients. Seniors can't get an appointment, and patients don't have that access to health care. All because Medicare just isn't paying enough. So, they can't stay in business. They can't expand to meet the needs of the people that I represent. Now, accountable care organizations have been a critical step in addressing that crisis by grouping together practices to coordinate care and deliver value while maintaining choice for patients.
▶ 3:33:42As of 2023, more than 640,000 Californians receive their care through a Medicare acco. That's about one out of every 10 Medicare beneficiaries in California. Nationwide, this number is even higher. In 2020, more than 10.3 million Americans were served by a provider in one of these common sense programs. Now, California is home to 151 ACOs, more than any other state, and with good reason.
▶ 3:34:11These innovative, cost-saving programs stretch our health resources to achieve better outcomes with lower cost. The bipartisan bill before us today reaffirms that commitment, our commitment to a common sense model by preserving the current quality measure system for ACOs while the Centers for Medicare and Medicaid Services roll out new long-term reporting measures.
▶ 3:34:36We're preserving the system, preserving what works, and it will allow our providers to focus on what we know works. That's caring for our parents, our neighbors, our constituents who rely on Medicare to deliver reliable care in our communities. The bill is bipartisan, as you heard from my friend, Mr. Buchanan. It has no cost and in my opinion, it's a nobrainer. So, I urge my colleagues to join Representative Buchanan and myself and pass this legislation. Thank you, Mr. Chairman.
▶ 3:35:06I yield back. Thank you. The committee will now proceed to consideration of HR 5347, the Healthc Care Efficiency Through Flexibility Act. Without objection, the measure will be considered as read and open for amendment at any point.
▶ 3:35:31At this time, I offer an amendment in the nature of a substitute, which was distributed in advance along with a green sheet explaining it. Without objection, the amendment in the nature of a substitute shall be considered as read, open for amendment at any point, and considered base text for purpose of amendment. I will now turn to Patrick Dumas, staff director of the subcommittee on health to provide a technical description of the amendment and the nature of a substitute with an emphasis on the changes made since introduction. I ask that members hold their questions until after his presentation.
▶ 3:36:01Thank you, Chairman Smith, Ranking Member Neil. HR5347, the Healthcare Efficiency Through Flexibility Act, contains three sections. Section one provides for the short title of the bill. Section two amends section 1899 of the Social Security Act to clarify availability of certain Medicare quality reporting methods and data completeness requirements.
▶ 3:36:25Section three amends section 1899 of the Social Security Act to establish a pilot program to test the feasibility of reporting digital quality measures for the Medicare shared savings program. The amendment in the nature of a substitute makes technical corrections to the bill. This concludes the technical walkthrough and I'm happy to answer any questions you may have.
▶ 3:36:47Thank you. Are there any technical questions about the amendment in the nature of a substitute? Seeing none, we will move to strike the last word. Um, does any member wish to strike the last word?
▶ 3:37:01Mr. Davis.
▶ 3:37:04Thank you, Mr. Chairman. And although I support this legislation, I think our committee has to quickly advance legislation to protect millions of Americans from the skyrocketing health insurance costs and loss of health insurance altogether.
▶ 3:37:25While our economy is crumbling and families face steep price increases due to chaotic Republican tariffs and massive cuts to the federal workforce and funding.
▶ 3:37:38Our committee must lead by extending the ACA enhanced premium tax credits to prevent over 4 million Americans from losing health coverage and to prevent millions of small business employees, individuals, and families from steep premium increases. In my district, there are around 19,000 people with premium subsidies.
▶ 3:38:02If Republicans fail to extend the premium tax credits, subsidized enrolles in my district will see an average premium increase of about 57%. Further researchers estimate that my home state of Illinois will lose over 1.8 million jobs if the enhanced premium tax credit expire due to the direct and indirect cost of the loss funded.
▶ 3:38:32These losses are astounding and wrong. Small business owners and self-employed entrepreneurs make up about 30% of all marketplace enrolles. In 2022 alone, 2.7 million are 82% of the 3 million small business owners and self-employed entrepreneurs enrolled in the ACA marketplace claim
▶ 3:39:02the premium tax credit. With all the Medicaid and other ACA marketplace changes, premium tax credits are more important than ever to these hardworking small businesses and employees.
▶ 3:39:17And so, yes, I support this bill, but I also believe that we need to continue to go forth and make sure that extenders and other premium opportunities that exist for individuals to receive health care are available to us. I thank you, Mr. Chairman, and you're back the balance of my time.
▶ 3:39:40Thank you. Additional members wish to strike the last word. Mr. Gomez.
▶ 3:39:47Mr. Chairman, I move to uh strike the last word. Um families across America are struggling. Not because uh we can't budget, not because we're not working hard enough. It's because Donald Trump and the billionaire establishment passed the largest transfer of wealth in the history of this country by stealing from working-class Americans to give tax breaks to the ultra wealthy and the largest corporations in this country.
▶ 3:40:14Trump promised promised to lower the cost of living in this country on day one. On day one, it's day 260. 260. Unemployment is up. Inflation is up. coffee, clothing, fruits, and vegetable all up. Everything is up. Families are stretched thin, and we need to focus on their problems.
▶ 3:40:38But let's not forget that under the so-called big, beautiful bill, according to their own tax brackets, that people on the lower end of the economic ladder are going to get screwed. people who are uh working class, making less than 15,000, making less than 30,000 in uh when these provisions end, they're could be paying up to 56% of their income or 50% 56% more in taxes.
▶ 3:41:09This is just unbelievable because one of the things we need to do is focus, focus, focus. But nope, my Republican colleagues don't want to focus on the bill that they just passed because they know that it actually hurts working people. While the rich get richer, the rest of us are getting screwed.
▶ 3:41:32And we want to make sure that people understand that it's not their fault that they can't get by because they are working harder and harder than ever. We need to make sure that they understand that is the Republicans and Donald Trump that is hurting the average American. The fact that they're going to struggle and struggle and struggle. They're not going to be able to save for college, start a small business, uh take care of their parents.
▶ 3:42:01That's what we're talking because and yes, we're gonna keep talking about it over and over and over again because we believe that there are issues that are extremely important for the American people to address. So, here's the thing. Even even Trump's own um increases uh the cost.
▶ 3:42:24According to uh our numbers, Trump's big ugly law steals from the poor to give to the ultra uh wealthy, the ultra rich. There's also an article that basically says that Trump's tariffs, if you get a tax uh tax break, some Americans do, it's going to get wiped out by the increasing cost of tariffs. But they don't want to re in Donald when it comes to tariffs. A few years ago, they were the party of free trade.
▶ 3:42:54Now, they're they're the party of isolationism and beating up on your to try to raise a few dollars out of the backs of working Americans. So, here's the thing. We know that they're going to keep trying to rebrand this big, beautiful bill, but they can't run. They can't hide. This is something they're going to have to live with for the rest of their lives and through 2026 and to and 27, 28, and 29.
▶ 3:43:23We need to bring back some common sense to Congress. That's why I'm calling on them to bring up legislation that lowers the cost of living. I have a bill that would uh build housing by converting office space to commercial real estate. It's a bipartisan bill. We should bring that up. We have a bill to actually help average Americans buy their first home.
▶ 3:43:47We should build up bring up a bill that will create a tax credit for starter homes, create the the biggest housing boom since the 1940s. We should be tackling the issues that the American people sent us for, the high cost of living, and then taking on the establishment, the billionaire establishment to do it. That's what I want to work on because right now they're they're they're fiddling while America burns. With that, I yield back.
▶ 3:44:15Thank you. Are there additional members wish to strike the last word? Seen uh Miss Miss Moore, ranking member Thank you so much, Mr. Chairman. And of course, I just want to congratulate the bipartisan authors of this legislation bringing it before us.
▶ 3:44:36And I just want to say we just turned down an amendment uh to make sure that Medicare was not uh to the budget control act, which would uh would would would cut a half trillion dollars from the program.
▶ 3:44:53So, while we're busy making sure that there are accountable collection processes and types for Medicare, I wonder how they're going to process a half trillion dollar cut made during the uh be because of the passage of the one great beautiful bill act. And so, it's just just saying and I yield back.
▶ 3:45:18Thank you. Are there additional members that wish to strike the last word? Seeing none, we'll move to amendments. Are there any amendments to the amendment in the nature of a substitute?
▶ 3:45:31Mr. Chairman, I have an amendment at the
▶ 3:45:33Mr. Chairman, I reserve a point of
▶ 3:45:34A point of order has been reserved. Would the uh general lady um suspend while the amendment is distributed?
▶ 3:45:56Thank you, Mr. Chairman. I offer an amendment to exclude accountable care organizations from the new Medicare wiser model. I along with Representative Kelly and several of our colleagues on this committee have spent years discussing the abuse of prior authorization in Medicare Advantage. This is not a partisan issue. Just this summer, the Trump administration celebrated a pledge by the health insurance industry to curtail prior authorization abuses.
▶ 3:46:24And yet, not a week later, CMS announced an expansion of prior authorization practices into traditional Medicare via the wiser model. Traditional Medicare has rarely utilized prior authorization. And in fact, many seniors chose this option because they don't want their care dictated by their insurance companies.
▶ 3:46:46Now, under this model, providers in six states, including my home state of Washington, will be forced to submit prior authorization requests for patients with traditional Medicare. The administration touts this model as voluntary, but it's only voluntary for the private companies, including Medicare Advantage plans, who will be paid to deny care and manage this priorization process. Patients and providers in these six states have no choice.
▶ 3:47:17Priorization increases provider burden. It takes time away from patients, limits patients access to lifesaving care, and creates unnecessary administrative burdens. Multiple Health and Human Services um Office of the Inspector General reports have found priorization abuses.
▶ 3:47:39One 2018 report found that 75% of denied prior authorization requests were overturned upon appeal, suggesting inappropriate initial denials were Why would we want to expand this problematic process into traditional Medicare? I've urged the administration to cancel the model and put seniors care before insurers profits.
▶ 3:48:06This amendment is a step in the right direction by excluding accountable care organizations from this damaging model. I urge all of my colleagues to ensure that Medicare beneficiaries have access to the care that they need by voting in favor of this amendment and I yield back.
▶ 3:48:23Further discussion on the amendment? Seeing none, um the question is on agreeing to the amendment. Uh the clerk will call the role.
▶ 3:48:33Mr. Buchanan. Mr. Buchanan. No. Mr. Smith of Nebraska.
▶ 3:48:42Mr. Smith of Nebraska. No. Mr. Kelly. Mr. Kelly. No. Mr. Schwikert. Mr. Schwher. No. Mr. Le Hood. Mr. Arrington. Mr. Estus. Mr. Estus. No. Mr. Smucker. Mr. Smucker. No, Mr. Hearn. Mrs. Miller.
▶ 3:49:11Mrs. Miller. No.
▶ 3:49:13Dr. Murphy.
▶ 3:49:18Mr. Kristoff. Mr. Kristoff. No. Mr.
▶ 3:49:23Mr. Fitzpatrick. No. Mr. Stwie.
▶ 3:49:26Mr. Stwie. No. Miss. Tenny.
▶ 3:49:32Miss Fishbach.
▶ 3:49:33No. Miss Fishbach, no. Mr. Moore,
▶ 3:49:37Mr. Moore, no. Miss Vanine. Miss Vanine, no. Mr. Fenstra,
▶ 3:49:43Mr. Fenstra, no. Miss Malotakus.
▶ 3:49:49Mr. Carrie. Mr. Carrie. No. Mr. Yakam.
▶ 3:49:54Mr. Yakam. No. Mr. Miller.
▶ 3:50:00Mr. Bean.
▶ 3:50:02Mr. Bean. No. Mr. Moran.
▶ 3:50:05Mr. Moran. No. Mr. Neil. Mr. Neil. Yes. Mr. Dogget. Mr. Dogget. Yes. Mr. Mr. Larson. Mr. Davis. Mr. Davis. Yes. Miss Sanchez. Miss Su. Miss Su. Yes. Miss Delben.
▶ 3:50:35Miss Delenet. Yes. Miss Chu. Miss Chu. Yes. Miss Moore. Miss Moore. Yes. Mr. Boille.
▶ 3:50:46Mr. Boille. Yes. Mr. Byer.
▶ 3:50:49Mr. Byer. Yes. Mr. Evans. Mr. Schneider. Mr. Schneider. Yes. Mr. Petta. Mr. Panetta. Yes. Mr. Gomez.
▶ 3:51:06Mr. Gomez. Yes. Mr. Horsford. Mr. Horford. Yes. Miss Plask.
▶ 3:51:13Miss Plask. Yes. Mr. Swazy.
▶ 3:51:16Mr. Swazy. Yes. Mr. Le Hood. No.
▶ 3:51:22Mr. Le Hood. No. Mr. Arrington.
▶ 3:51:27Mr. Arrington. No. Mr. Hearn. Dr. Murphy. Miss Tenny. Miss Tenny. No. Miss Malotus. Mr. Miller. Mr. Thompson. Mr. Thompson. Yes.
▶ 3:51:58Mr. Larson. Mr. Larson. Yes. Miss Sanchez. Mr. Evans. Mr. Evans. Yes.
▶ 3:52:20Chairman Smith.
▶ 3:52:21Chairman Smith. No. How is Mr. Miller recorded?
▶ 3:52:36Mr. Miller is not recorded. Mr. Miller, how are you voting?
▶ 3:52:46Mr. Miller, no. How's Dr. Murphy recorded?
▶ 3:53:06Dr. Murphy is not recorded. Dr. Murphy, Clerk will report the vote.
▶ 3:53:29The yeses are 18 and the nos are 24.
▶ 3:53:33There being 18 yeses and 24 nos, the amendment is not agreed to. Are there additional amendments? Seeing none, the question is on the adoption of of the amendment in the nature of a substitute. All those in favor signify by saying I.
▶ 3:53:52Those opposed say no. The opinion of the chair the eyes is have it and the amendment in the nature of a substitute is agreed to. I will now recognize Mr. Buchanan for the purpose of offering a
▶ 3:54:02Mr. Chairman, I move the committee favorably report HR 5347 as amended to the House of
▶ 3:54:10The question is on the motion to favorably report HR 5347 as amended to the House of Representatives. The clerk will call the role. Mr. Buchanan.
▶ 3:54:20Mr. Buchanan. Yes. Mr. Smith of
▶ 3:54:26Mr. Kelly. Mr. Kelly. Yes. Mr. Schwiker. Mr. Schwiker. Yes. Mr. Le Hood. Mr. Arrington. Mr. Estess. Mr. Estess. Yes. Mr. Smucker. Mr. Smucker. Yes. Mr. Hearn.
▶ 3:54:53Mrs. Miller.
▶ 3:54:55Mrs. Miller. Yes. Dr. Murphy.
▶ 3:55:01Mr. Kustoff.
▶ 3:55:03Mr. Kristoff. Yes. Mr. Fitzpatrick.
▶ 3:55:08Mr. Fitzpatrick. Yes. Mr. Stwie.
▶ 3:55:12Mr. Stwie. Yes. Miss. Tenny. Miss. Tenny. Yes, Miss Fishbach.
▶ 3:55:19Miss Fishbach. Yes, Mr. Moore.
▶ 3:55:22Mr. Moore. Yes, Miss Vanine.
▶ 3:55:25Miss Vanine. Yes, Mr. Fenstra.
▶ 3:55:29Mr. Fenstra. Yes, Miss Malotakus.
▶ 3:55:33Miss Malotakus. Yes, Mr. Kerry. Mr. Kerry. Yes. Mr. Yakam.
▶ 3:55:40Mr. Yakam. Yes. Mr. Miller.
▶ 3:55:44Mr. Miller. Yes, Mr. Bean.
▶ 3:55:48Mr. Bean. Yes, Mr. Moran.
▶ 3:55:51Mr. Moran. Yes, Mr. Neil. Mr. Neil. Yes, Mr. Dogget.
▶ 3:56:00Mr. Dogget. Yes, Mr. Thompson.
▶ 3:56:04Mr. Thompson. Yes. Mr. Larson.
▶ 3:56:07Mr. Larson. Yes. Mr. Davis.
▶ 3:56:11Mr. Davis. Yes. Miss Sanchez. Miss Su, Miss Su, yes. Miss Delen, Miss Oen, yes. Miss Chu,
▶ 3:56:25Miss Chu, yes, Miss Moore, Miss Moore. Yes, Mr. Bole.
▶ 3:56:33Mr. Boille. Yes, Mr. Byer. Mr. Byer. Yes. Mr. Evans, Mr. Evans. Yes. Mr.
▶ 3:56:43Mr. Schneider. Yes. Mr. Panetta.
▶ 3:56:47Mr. Panetta. Yes. Mr. Gomez.
▶ 3:56:50Mr. Gomez. Yes. Mr. Horseford. Mr. Horford. Yes. Miss Plask. Miss Plask. Yes. Mr. Swasy.
▶ 3:57:04Mr. Smith of Nebraska.
▶ 3:57:08Mr. Smith of Nebraska. No. Mr. Smith of Nebraska. Yes.
▶ 3:57:16Mr. Leood.
▶ 3:57:18Mr. Leood. Yes. Mr. Arrington.
▶ 3:57:22Mr. Arrington. Yes. Mr. Hearn. Dr. Murphy.
▶ 3:57:31Dr. Murphy. Yes. Miss Sanchez. Mr. Swazy.
▶ 3:57:44Mr. Swazy. Yes.
▶ 3:57:52Chairman Smith.
▶ 3:57:54Chairman Smith. Yes. Clerk will report the vote.
▶ 3:58:17The yeses are 43 and the nos are zero.
▶ 3:58:20There being 43 yeses and zero nos, the motion is agreed to in HR 5347 as amended is ordered favorably reported to the House. Without objection, I ask that staff be authorized to make technical and conforming changes to HR5347 and that members have two additional days to file with the committee clerk supplemental additional dissenting or minority views.
▶ 3:58:43Our next piece of legislation is HR 5343, the ensuring patient access to critical breakthrough products act. I appreciate Representative Moore for his leadership on this bill and working in a bipartisan fashion with Representative Delben to continue driving forward on expanding access to innovative treatments for seniors.
▶ 3:59:07Delays in Medicare approval for breakthrough medical treatments and devices threatens the quality of care available to America's seniors and can stifle innovation in the development of new products and services that will ultimately improve and save lives.
▶ 3:59:25Representatives Moore and Delben clearly recognize the value of expanding access to new and innovative medical services, which will not only help Americans live healthier lives, but also result in important cost savings to seniors and taxpayers.
▶ 3:59:42In fact, we heard firsthand about the importance of unleashing medical innovation during a field hearing hosted by Representative Moore at a at a testing center in his home state of Utah's um Silicon um slope. I hope um their leadership and I applaud their leadership and hope this legislation will once again receive strong bipartisan support in our committee.
▶ 4:00:11I'm pleased to recognize a gentleman from Utah, Mr. Moore, for an opening statement.
▶ 4:00:16Thank you, Mr. Chairman. Uh thank you for again uh including the Ensuring Patient Access to Critical Breakthrough Products Act in today's markup. We should all be very proud that the United States is a global leader in medical device innovation. Since the 1990s, America has been responsible for half of the world's medical technology breakthroughs, introducing treatments that improve the lives of those who need care.
▶ 4:00:39I'm personally proud that Utah has become a hub for this innovation with successful partnerships between industry and the University of Utah, which is in my district. This bill is significant because it opens the door to the most cuttingedge medical technology available for Medicare patients and gets them the treatments they need sooner. There is no reason this should be a partisan issue in any way. In fact, this committee passed a version of this bill last Congress with strong bipartisan vote.
▶ 4:01:06I'm thankful to the gentleoman from Washington, Representative Delen, for working with me to get this bill to a place where we can deliver these results, and I look forward to continuing to work with her to resolve the inclusion of diagnostics in this policy and ensuring there is no abuse of this pathway. Our bill creates a streamlined pathway for temporary Medicare coverage of FDA designated breakthrough devices while ensuring that safety and efficacy are not compromised.
▶ 4:01:33This bill strikes the balance between previous proposals by allowing manufacturers to participate in a voluntary application process that reduces duplicative reviews at CMS that delays patient access. I'd also like to thank Novacore, Advimed, and other stakeholders who have signed on as supporters of this legislation. Without objection, I would like to submit their statements for the record.
▶ 4:01:57Without objection. So,
▶ 4:01:58thank you, Mr. Chairman. All of us should have the same bipartisan goal here. Helping Americans have the best chance at leading full lives by ensuring that they can get the most advanced and innovative treatments industry has to offer. I urge my colleagues to support this bill and yield back the remainder of my time.
▶ 4:02:13I now recognize a ranking member from Massachusetts, Mr. Nil, for his opening
▶ 4:02:17Thank you. And with that, Mr. Chairman, let me yield my time to Susan Delben.
▶ 4:02:22Thank you, Mr. Chairman. Thank you, Mr. Ranking Member. And thank you uh to Congressman Moore for his partnership on this legislation. Um there are nearly 69 million Americans on Medicare, all of which deserve timely access to medical innovations. Our bill creates a new coverage pathway for FDA breakthrough devices, which by definition are devices that must provide more effective treatment or diagnosis of life-threatening or debilitating diseases.
▶ 4:02:53have no approved alternatives or offer significant advantages over existing options. Unfortunately, even after a breakthrough device is deemed safe and effective by the FDA, seniors experience multi-year delays before the device receives Medicare coverage.
▶ 4:03:11The Stanford University buyer center for biio design has found that on average it takes nearly six years after the FDA approves or clears these devices for Medicare to cover them. That means that if the FDA approves a breakthrough device in the same month a senior turns 65 and begins receiving Medicare coverage, that senior could be 71 before they had access to that device.
▶ 4:03:38What if that device could have helped them at 66 or 67? This process creates needless delays. Delays that matter for patients whose lives could be made better by these devices. That same study from Stanford found that the biggest factor in predicting how long CMS takes to approve a novel device is the size of the company that manufactures the device, not the strength of the clinical evidence.
▶ 4:04:06If a company has more resources to vote to this time-consuming coverage process, they tend to get their products covered faster. This harms smaller innovators while seniors pay the price. Medicare beneficiaries should not be forced to use less effective treatments, take on financial risk, or experience delays in life-saving care because Medicare is too slow to cover a more effective FDA approved product.
▶ 4:04:33That's why I introduced bipartisan legislation to speed up coverage and increase access for seniors. And I'm happy to work on this bill with two of my colleagues on this committee. Representative Moore and Su in addition to Representatives Billist Tran and Yakam. My colleagues know just as well as I do. We have a better we we have to do better for Medicare beneficiaries and we've been working to do just that.
▶ 4:04:59Versions of our bill have been introduced since 2016 when it was first sponsored by ranking member Neil and Rep. Bustani. I thank the ranking member, the chairman, and their staffs for working on this bill with us. I'm proud of how far this legislation has come. Last Congress, it passed out of committee with 36 votes in favor, and I hope to keep that momentum going. Under our legislation, eligible breakthrough devices could apply to CMS for four years of temporary coverage.
▶ 4:05:29To be eligible for coverage, devices must be approved and or cleared by the FDA, provide sufficient clinical data that includes the Medicare population, and be determined by the secretary that the device does not present risk of harm. And if during that four-year period of coverage, the secretary determines that the device is at risk to cause harm, they have the authority to terminate the coverage.
▶ 4:05:55The bill also provides 10 million per year for dollars per year for the next six years for CMS to build out this new program and includes provisions that aim to prevent fraud, waste, and abuse. I understand that some of these provisions may need a bit more work and I'm committed to working with my colleagues to ensure that this bill provides coverage for life-saving devices without opening the doors to any bad actors. And in the past, we've also tried to include diagnostics in the coverage pathway.
▶ 4:06:25They weren't included in this iteration, but I'd like to continue working to find a path forward. I want to remind my colleagues again, these are not just any run-of-the-mill medical devices. These include novel devices that can significantly reduce bleeding complications during open heart surgeries, diagnose skin cancer in real time, ease tremors and stiffness for patients with Parkinson's disease, and significantly decrease blood sugar levels.
▶ 4:06:53I should also note that while I'm glad we are applauding American innovation, we cannot forget where funding for this innovation comes from. We must bolster federal investments in medical research and disease prevention. If we continue the path that we're on, the cures of tomorrow will get further and further away. I hope that with the right investments, we will continue to see more life-changing devices that can help seniors.
▶ 4:07:19Until then, we are talking about a very limited group of devices, less than 200, that can make lives better. And Medicare does eventually cover these devices. It just takes many years, years that seniors could be living healthier, fuller lives. So instead, seniors are forced to pay ridiculous out-ofpocket costs for these devices or choose to go without them because they can't take on the financial risk. Let's think about that for a second.
▶ 4:07:47I urge my colleagues to vote yes on this important legislation. And I yield back.
▶ 4:07:52Thank you. The committee will now proceed to consideration of HR 5343, the Ensuring Patients Access to Critical Breakthrough Products Act. Without objection, the measure will be considered as read and open for amendment at any point. At this time, I offer an amendment in the nature of a substitute which will be distributed in advance along with the green sheet explaining it.
▶ 4:08:15Without objection, the amendment in the nature of a substitute shall be considered as read, open for amendment at any point, and considered base text for purpose of amendment. I will now turn to Patrick Dumas, staff director of the subcommittee on health to provide a technical description of the amendment in the nature of a substitute with an emphasis on the changes made since introduction. I ask that members hold their questions until after his presentation. Thank you, Chairman Smith, Ranking Member Neil.
▶ 4:08:41HR 5343, the Ensuring Patient Access to Critical Breakthrough Products Acts, contains two sections. Section one provides for the short title of the bill. Section two amends section 1862 of the Social Security Act to establish a transitional coverage pathway under Medicare for safe and effective breakthrough medical devices to ensure quicker coverage for seniors and provides guaranteed coverage decision timelines after the 4-year transitional period.
▶ 4:09:11The amendment in the nature of a substitute instills additional guard rails for the transitional coverage pathway to grant the Secretary of Health and Human Services robust measures to ensure patient safety and Medicare program integrity. This con concludes the technical walkthrough and I'm happy to answer any questions you may have.
▶ 4:09:29Thank you. Are there any technical questions about the amendment and the nature of a substitute? Mr. Dog.
▶ 4:09:34Uh, thank you very much, Mr. Chairman, Mr. Duma. Uh I certainly salute the good intentions of the sponsors of this legislation and I'm pleased to hear the willingness to work to uh improve it because I think it needs significant improvement. In fact, uh as one who questioned this legislation when it was considered last year, uh my concern today is that it's gotten worse instead of better.
▶ 4:09:57Uh you mentioned the Department of Health and Human Services and you've heard from that department this morning with its objections to this bill as it's currently written, haven't
▶ 4:10:08Uh with this bill, the HHS Office of Inspector General uh sent concerns about waste, fraud, and abuse, which was different from this legislation.
▶ 4:10:17Well, I'm I'm going to ask you specifically about the differences. Uh but as you know, I've had long-standing concern about Medicare fraud. I've introduced legislation, several bills in this committee to fight Medicare fraud, have been unable to secure a hearing, but I'm concerned today that this not only does not fight fraud, but it makes more opportunities for fraud.
▶ 4:10:39And let me just ask you about that communication that uh has come from the Office of Inspector General of the Trump administration questioning this bill and what it will do with reference to fraud. Uh, and let me just ask if if I'm if my reading of this is correct, and I'll only take a couple of sentences out of it. The Inspector General wrote to this committee on behalf of the Trump administration. We are concerned that the draft legislation poses risk of fraud and abuse.
▶ 4:11:09across Medicare benefits. Our enforcement experience is that fraud follows the money and so we expect uh an uptick if fraud of fraud if there is a transitional period of payment for breakthrough devices. Was that one of the conclusions of the inspector general?
▶ 4:11:28Uh Congressman, that was on a previous version of the draft legislation. We we'll talk about the the differences, but the the objections that they raise, and I'll go through those are objections that absolutely apply to to this today, and the changes you made were very recent, and their objection has been long-standing.
▶ 4:11:47And did they also say, sir, that without a reasonable and necessary standard for payment, it may be more difficult for the government to investigate and enforce against fraud that is likely to occur in this breakthrough device sector as more Medicare money becomes available. Was that one of the conclusions of the inspector general, the person who's responsible for fighting fraud for this
▶ 4:12:12on a previous version of this letter?
▶ 4:12:14Yes, sir. And with reference to this specifically on the reasonable and necessary standard, does this bill override Medicare's authority to only cover devices that are reasonable and necessary for Medicare beneficiaries? You just give me a simple yes or no.
▶ 4:12:31It provides a transitional coverage
▶ 4:12:33Yes, sir.
▶ 4:12:34It does not permit Medicare in the future to apply a reasonable and necessary standard, does it? After the four-year transitional period, the normal Medicare coverage process would uh apply to
▶ 4:12:46the next four years. There will be no reasonable and necessary standard if this bill is adopted. Right.
▶ 4:12:53This bill pres pro provides a separate pathway for coverage for breakthrough
▶ 4:12:57That separate pathway the inspector general does not think is sufficient because it overrules the reasonable and necessary standard as I was just reading from their letter Trump administration to you today. Right.
▶ 4:13:12This bill provides a separate pathway.
▶ 4:13:14Yes, sir. It does. That separate pathway is less and does not meet the standard that the inspector general, the Trump administration official in charge of fighting fraud in Medicare says is necessary. He did suggest a number of other things that you could do to establish stronger guidelines than this bill does. In fact, he gave you about 10 different guard rails that could be applied to protect taxpayers from the fraud that he says will follow the money that will be available for these kind of devices.
▶ 4:13:44And let me ask you about how well this bill covers those guardrails. Does this bill require a signed patient physician order including the patients diagnosis before coverage?
▶ 4:13:57The coverage pathway only applies to medical devices. Is the answer to that yes or no?
▶ 4:14:02A a prescription would need to be provided for medical devices.
▶ 4:14:06Does this bill require a face-to-face encounter with an ordering physician before the device is furnished?
▶ 4:14:11It does require a prescription for the medical devices.
▶ 4:14:15Does it require a face-to-face meeting or not? Yes or no?
▶ 4:14:18The normal Medicare requirements would apply under this.
▶ 4:14:21Is the answer no or yes? Are you unable to answer that question?
▶ 4:14:25The normal Medicare requirements. Well, let me just ask you my question. Not your question, but my question one more time. Does the bill require a face-to-face encounter with an ordering physician before the device is furnished? Yes or no?
▶ 4:14:38The bill provides coverage.
▶ 4:14:40You can't answer the question yes or no. Just incapable of doing that.
▶ 4:14:44It provides coverage for
▶ 4:14:45I see I see you are incapable of answering it. May be that there's no yes or no answer you can provide me. But I've got some more questions on which I would seek that if I'm able to get some more time. Gentleman's time has expired. Are there are there others uh with technical questions? Mr. Thompson.
▶ 4:15:04Thank you, Mr. Chairman. I yield to Mr.
▶ 4:15:08Does does the bill require data collection to ensure CMS can ensure devices are only being provided to those who need them? Yes or no?
▶ 4:15:17Yes, the bill does require a report on the pathway as well as clinical data to be reviewed for devices to be approved under this pathway. Does the bill require the manufacturer pursue clinical trials or hit FDA milestones in a timely
▶ 4:15:32All devices covered under this bill must be FDA approved and CMS.
▶ 4:15:36That's not my question. That may be your question, but I'm answering asking you to please and and I'll try to be as courteous as possible, but just to please answer my questions. Uh, and what this bill does is does not require clinical trials, does it? It requires a clinical data review which
▶ 4:15:54clinical data is not clinical trials. Again, you want to substitute your question for my question. Yes or no. Does this bill provide require clinical
▶ 4:16:04It requires clinical data which
▶ 4:16:06so the answer is no. Does not require clinical trials though you seem incapable of answering the question.
▶ 4:16:13Does the bill cap the number of devices that be can be considered each year?
▶ 4:16:19The bill does not provide for a cap. The answer is no.
▶ 4:16:22Is that right?
▶ 4:16:23The bill does not require a cap on
▶ 4:16:25I understand you just can't answer yes or no, but uh I'm going to keep asking you the questions uh because the inspector general who's in charge of fighting fraud posed each of these as ways to prevent fraud? Does the bill require there be Medicare claims evidence that a particular patient has received services of treatment related to the item being prescribed? Could you repeat the question, sir?
▶ 4:16:50Does the bill require there be Medicare claims evidence that a particular patient has receive services or treatment related to the item,
▶ 4:17:01related to the device that's being paid for under this? the Medicare will only pay for devices that are um that a patient receives a doctor's prescription for
▶ 4:17:12th this bill uh as best I can tell from what the inspector general said does not require that evidence that a particular patient had received services or treatment related to the item. Does the bill provide authority for the secretary to add these kind of requirements for coverage and payment of breakthrough devices if they determine that that fraud is a problem?
▶ 4:17:34Uh the bill requires this pathway to be set up over an 18-month period which would require a notice and comment rulemaking period during which the secretary may require
▶ 4:17:44is the answer no to the question does the bill provide authority for the secretary to add requirements? The secretary may develop the pathway through rulemaking as he sees fit.
▶ 4:17:55There there's no provision in this bill for the secretary to add requirements because of fraud. Does the bill require CMS to audit payments with any frequency
▶ 4:18:05to audit payments under this pathway?
▶ 4:18:07Yes, sir. There's no requirement in this bill for audits to prevent fraud.
▶ 4:18:12It requires a report on the pathway. Um but there is nothing prohibiting the secretary from auditing payments under this pathway. Does the bill include recommended guard rails from the inspector general clarifying that actions can be taken against misused uh AI technologies?
▶ 4:18:29It does not prohibit that.
▶ 4:18:30It does not.
▶ 4:18:32These are just some of the ways that the inspector general suggested uh that uh we could limit the amount of fraud that is likely to occur as you open up this new opportunity for fraud. Uh my understanding is that Medicare without changing the law at all already covers breakthrough devices through the transitional coverage for emerging technologies. Using this pathway, Medicare is already covering two devices and two others are under review. Isn't that correct?
▶ 4:19:03That is a a separate pathway that exists under Medicare.
▶ 4:19:06So they there already is a mechanism for covering these innovative devices. They've used it. They've covered two and they have two others under review. It's a pathway that has been in effect and was finalized last August. And under the existing pathway, CMS must first determine whether a device is reasonable and necessary for Medicare coverage. This analysis may identify a need for additional evidence to determine the appropriateness of coverage, whether there's going to be whether this is a fraudulent device.
▶ 4:19:37As I understand it, this bill would eliminate the reasonable and necessary standard for breakthrough devices. It would weaken CMS authority. That's why the inspector general's concern and would require automatic coverage if, and this is the magic language that you add instead of uh reasonable and necessary. you have potential clinical benefit, not proven benefits, not benefits that we determine as a result of clinical trials, but that a potential benefit outweighs any risk.
▶ 4:20:07Is that correct?
▶ 4:20:09Uh, the secretary must
▶ 4:20:11time expired.
▶ 4:20:13Yes, the gentleman's time has expired. Are there others wishing with technical
▶ 4:20:18I'll wait till Susan finishes. Go ahead,
▶ 4:20:20Mr. Del Benning.
▶ 4:20:21Thank you, Mr. Chairman. Um first uh the FDA breakthrough designation is separate from the approval process. Is that
▶ 4:20:29Correct. Breakthrough designation is separate from FDA approval.
▶ 4:20:32And the FDA breakthrough devices are held to the same safety and efficacy standards as all other FDA cleared or approved devices.
▶ 4:20:41A breakthrough designated device approval is held to the same standards as all other device approvals. And just to reiterate, um, are these devices, uh, uh, um, products that have to be prescribed by a patient's physician?
▶ 4:20:57All of these medical devices would need a prescription. Correct.
▶ 4:21:00Um, and then, um, does the bill require clinical data, which can also include clinical trial data?
▶ 4:21:06Correct. The legislative text specifically says may include clinical trial data. And um I wondered if you could also talk about which provisions in the bill are what provisions there are in the bill to prevent fraud.
▶ 4:21:20Uh so the amendment in the nature of a substitute includes provisions that would prohibit the secretary from or Medicare from paying for devices under this program uh if they are prescribed more frequently than the indication uh approved by FDA or if there is an aberant billing pattern for physicians um prescribing such uh medical device.
▶ 4:21:44Additionally, at any point this based on a review of clinical data, the secretary may uh remove a breakthrough medical device from this program if the clinical data proves that the safety out uh negative safety effects to a beneficiary outweighs the potential positives.
▶ 4:22:01And then finally, is it accurate to say that the coverage under this pathway is only for the breakthrough indication?
▶ 4:22:08Correct. If a medical device receives multiple indications for for treating multiple uh diseases, only the breakthrough indication for that device would be approved under this transitional pathway.
▶ 4:22:19Thank you. Um I appreciate it. I yield back, Mr. Chairman.
▶ 4:22:22Thank you. Are there other members with technical questions? I would also remind membersh to keep decorum in mind as our witness is based on the text that uh is available utilizing his insight and uh all decorum is appreciated
▶ 4:22:41for the others with technical questions. Miss Chu
▶ 4:22:49uh yes I'd like to yield my time to Mr. Docket. Let's be clear under this bill as written the new this version uh Medicare can be required to pay for uh various things with absolutely not a single clinical trial. Correct.
▶ 4:23:07It would only apply to devices that are FDA approved.
▶ 4:23:10Uh that's not again that may be your question. It's not my question. The my question is, is it not true, sir, that Medicare under this bill, as written, if adopted and signed into law, will require Medicare to pay for things that have never undergone a single clinical
▶ 4:23:29It it would cover devices that undergo clinical trials.
▶ 4:23:32The answer is yes, it would. And it changes things because clinical data is not the same thing as clinical trial, though it's easy to confuse people by saying it is. And isn't it true that you are in this bill eliminating the reasonable and necessary standard and substituting a weaker standard that uses potential clin clinical benefit outweighing any undue risk.
▶ 4:23:59The this pathway is a separate pathway for coverage.
▶ 4:24:02Yes, sir. A separate and lower one. so separate and lower that the inspector general of the Trump administration, I'd ask my Republican colleagues to take note today because I think this is the first time this year on any significant matter that I've agreed with the Trump administration on anything.
▶ 4:24:20And yet this need to fight fraud is so real that without adopting some of the 10 recommendations that have been recommended by the administration and even then by eliminating the reasonable and necessary standard by saying that there's no clinical trial that is necessary before you put these products out there and make Medicare pay for it. It's not the same as FDA approval. Medicare is using taxpayer dollars, not private dollars.
▶ 4:24:48taxpayer dollars and we have seen an immense amount of fraud in Medicare. Uh in fact, the president has talked about it at great length. I propose things to do about it that because they run into various special interests. This committee has been unwilling to set them for a hearing or a markup. But this one, the Trump administration has come out clearly today with objections to what's being done. We are risking a substantial amount of fraud here.
▶ 4:25:17and what the rush is to get this through without making the changes and adopting them in the committee. I don't understand and I've gotten no explanation of it today. And so I I will save further remarks for striking the last word, but I'm I'm troubled by your answers and your refusal to answer a number of my questions and I yield back.
▶ 4:25:38Thank you to the witness for answering the questions I think very directly. Are there others wishing to ask technical questions? Mr. Mr. Chairman,
▶ 4:25:48Mr. Moore,
▶ 4:25:48thank you, Mr. Chairman. Mr. Jamal, I appreciate your answers. Actually, look, if you want to answer yes or no, I welcome that. But you're the tech, you're here for technical assistance, for technical guidance. If you have more to expound, please do so. This is the time we get with you. Oh, yes or no. One just like yes or no. Yes or no. That's for cable news. If you've got actual context, we would love to hear it. So, thank you very much.
▶ 4:26:08Is it your understanding that um that um the exempting so the the reasonable and necessary that that language needed need exempting this pathway from reasonable and necessary is needed because CMS's reasonable and necessary process takes on average 5 years which means it can be much longer than that. And is it your is it your understanding that that's a that's a timeline that that is accurate that I'm I'm sharing that it's on average 5 years to be able to get something approved?
▶ 4:26:39Yes, sir.
▶ 4:26:40Thank you. Um the uh and as I as I heard from other comments that this bill that we're voting on today contains provisions to combat fraud, waste, and abuse. Is that also correct?
▶ 4:26:54There are multiple provisions in this bill that would prevent fraud, waste, and abuse of the pathway.
▶ 4:26:59Oh, some context here. Inspector General. Love that they're pushing it. They're they're pushing. There's the back and forth. We accept that conversation. We accept that dialogue all the time. OIG's response is not based off the language in this bill to combat fraud, waste, and abuse. Is that
▶ 4:27:15Correct. Their comments were on an earlier version of legislation that uh did not include all of the ways to address fraud, waste, and abuse that this legislation before us has. But the inspector general has has recommended that we have additional guardrails to combat fraud fraud, waste, and abuse. And do you also agree that this legislation includes guard rails be able to address fraud, waste, and abuse?
▶ 4:27:37Correct. especially beyond their initial analysis of the bill such as uh ensuring that the medical devices are being done within frequency limitations related to their approved indication as well as that physicians are not prescribing these medical devices in an apparent pattern. So, the same administration. Well, we're going to talk about CMS now. Um, do you agree?
▶ 4:27:59Is it accurate to say that that CMS technical assistance has provided the policy within this text of this bill and is what the agency felt would give them the tools necessary to combat this type of a potential abuse?
▶ 4:28:13Yes, the CMS and uh and their administration has shown that there's a robust availability for them to combat fraud, waste, and abuse with this legislation. I'll also add that the inspector general also notes in their technical assistance that no single legislative language in any situation, including reasonable and necessary, solves all fraud, waste, and abuse.
▶ 4:28:35The language of forest represents good faith efforts to work with CMS to combat fraud, waste, and abuse, and there is bipartisan commitment to continue to do Anything else to add based off my
▶ 4:28:48Uh, no. I I think that was a fair assessment of the bill. Thank you. I yield back.
▶ 4:28:53Thank you. Others with technical Seeing none, we'll now move into strike the last word. Does anyone wish to strike the last word? Mr. Yakam is recognized.
▶ 4:29:12Mr. Larson is recognized.
▶ 4:29:20Thank you, Mr. Chairman. Um, Mr. Chairman, um, first and foremost, let me u say that uh these hearings are always informative and we should uh and they're important and significant and especially because they allow us to get to the heart of the matter and the truth.
▶ 4:29:44I can think of no better examples of getting to the heart and the truth than Miss Delbenny and Mr. Moore and all those who support this legislation. And yet I can also completely understand the frustration of Mr. Dogget at not being able and through no fault of Mr.
▶ 4:30:11dumises but through fault of the committee not having in front of us and that is the issue. The issue is and these these the photo of the people behind me are going to benefit tremendously from this and they've been in my office and my and I believe that these are workable things and I take and it's not done often.
▶ 4:30:40I take my colleagues at their word when we can work bipartisanly in this area. But Mr. Dogget is absolutely right to pursue the hardline questions.
▶ 4:30:55Questions that often times are created we haven't been able to get the people that are actually responsible to come before us and answer questions that this committee might have.
▶ 4:31:19And so it becomes incredibly frustrating and it breeds distrust where there shouldn't be. You know, Carara and CC Satalino, she suffers from cystic fibrosis and she's d she was diagnosed at 12 And part of what's happening here is going to provide the opportunity for healing and curing something
▶ 4:31:51the Congress ought to think about as as well in terms of the very process that we're under. Uh I'm going to support this legislation and I previously had similar questions that Mr. Dogget has raised. They still have those questions, but I've heard my colleagues give their their word.
▶ 4:32:14But Peter Finley Dunn would always say, "Trust everyone, but cut the cards." And the cutting the cards that those that have the information and that could easily come before us and give us those yes or no answers are with the administration. And you heard Mr. dog talk about hey this is one of the few times where he might be aligned with them.
▶ 4:32:41I'm still a gasast by that but uh nonetheless that is what this should be about. I commend our colleagues for working so hard to produce this kind of work and they are both thorough and competent as is Mr.
▶ 4:32:58dog it and this is what a democracy should be about and committee hearings should be all about but the cloud that hangs over this is that we've never had anyone from Doge and Mr. Dumis, as you know, they were appointed. They and they have no none. Zero. And they have access to all kinds of data and information.
▶ 4:33:27That is an enormous problem for the American people, not only in terms of what's happening in this committee today, but long-term over information and data that's being compromised. And I'll have more to say about that later on. And I yield back.
▶ 4:33:49Gentleman yields back. Recognized to strike the last word, Mr.
▶ 4:33:54Thank you, Mr. Chairman. I'm proud to co-lead HR 5343, the Ensuring Patient Access to Critical Breakthrough Products Act with my Ways and Means colleagues Blake Moore, Susan Delben, and Terry Suall. This bill is critical to ensuring Hooser seniors have access to the best and most advanced medical devices Currently, after the FDA approves a new medical device, it must go through a separate coverage determination process by CMS before it will be covered by Medicare.
▶ 4:34:24This can create multi-year delay, multi-year delays for treatment options for seniors facing devastating conditions or life-threatening illnesses. This common sense bill establishes a pathway that allows groundbreaking medical devices to receive temporary Medicare coverage while they go through CMS's coverage process. Faster access to these treatment options can be the difference between life and death in some cases. Innovation is essential to driving down health care costs and increasing quality and access to care.
▶ 4:34:55This bill helps foster innovation by removing burdensome red tape and getting groundbreaking medical devices to seniors faster. Mr. Chairman, thank you for including this important bipartisan bill in today's markup. I look forward to voting for it and urge my colleagues on both sides of the aisle to do the same. Thank you and I yield back.
▶ 4:35:13The gentleman yields back. I now recognize to strike the last word, Mr. Dockett for five minutes.
▶ 4:35:19Uh thank you, Mr. Chairman. We all want access to cutting edge treatments and technologies as quickly as we can possibly get them. But we don't want false hope created by defective products. We don't want false hope created by fraudsters. When suffering from a dreaded condition, the promise of relief is invaluable, but innovation is only as valuable as the ability to access and afford it.
▶ 4:35:47We're considering this bill in the context of significant uh in access and significant interference with the work of federal agencies including the fed the food and drug administration. Uh it's important to recognize that when this bill was considered previously we heard from a number of the medical specialty groups that are most engaged with new medical devices.
▶ 4:36:15The American Association of Neurological Surgeons expressed concern about denying Medicare the authority to demand clinical trials. The Society of Thoracic Surgeons shared similar concerns and emphasized the importance of ensuring patient safety with clinical trials and reasonable guidelines.
▶ 4:36:36The American College of Cardiology offered additional critique and made a point that is directly responsive to the claim that if FDA FD FDA approves it, don't worry about it. The American College of Cardiology, and I quote, "Evidence exists that FDA mandated postmarket studies are not reliably completed." And keep in mind, this is a comment they made before President Trump began wrecking the FDA, dismissing and encouraging
▶ 4:37:07some of the most experienced leadership in the FDA to depart. It's that FDA upon which we would be relying under this bill. This the American College of Cardiology continues, "This provides good reason to support explicit assessment of effectiveness and safety of Medicare beneficiaries without consequences. is it is uncertain such assessment will consistently be completed.
▶ 4:37:33The committee has heard similar concerns from researchers at Yale, from the Medicare Rights Center, and the Center for Medicare Advocacy. And today, it heard from the Trump administration itself. And we've heard no explanation of why the rush to have this bill go out of committee. In fact, there should have been a thorough hearing on each of the concerns that have been raised.
▶ 4:37:56I want innovation, but I want innovation that solves problems, that help people that suffer from sickness, from dread diseases, and does not offer false hopes. There's been some discussion today about which version of the bill the f the uh Trump administration was responding to. Well, they responded today to the most recent version that they had.
▶ 4:38:20But whether there have been minor tweaks to the bill since they made that observation, there are two key points that despite the difficulty of getting a straight answer on it are very applicable. Number one, the reasonable and necessary standard has been removed from this bill. That's at the core of what these medical specialty groups and the Trump administration have said is necessary to prevent fraud.
▶ 4:38:44But even more importantly, as the specialty groups indicate, it is important to prevent uh harm to patients, medical safety for patients because safety is right up there with preventing fraud as a top concern.
▶ 4:38:59And the second thing again clearly while it's easy to confuse the terminology clinical data and clinical trial there is zero trial not a single medical trial clinical trial out in the field to see how the product actually works is required by this bill that's removed from the bill and that's why I say this bill is worse than the one that we considered last year that I had concerns about. My aim isn't to condemn all these medical devices.
▶ 4:39:28In fact, uh, Austin, black Utah, is a place where innovation is central, where many medical devices are being developed. I want to see them come to market as quickly as possible. But the other thing we learned through the questions uh is that Medicare already has a system in place for encouraging innovation. They've already approved through that system to uh medical devices and they have two more under current review.
▶ 4:39:57Why that system can't be used with some modification has never been explained. So, I sympathize and support the intent of the bill, the good intentions of the authors of the bill. We all share the gold of ensuring that those on Medicare can receive innovative technologies just as quickly as possible. But we must do more in a careful manner that safeguards patient health and well-being and protects taxpayers from fraud.
▶ 4:40:24It's for that reason, the failure of the bill that and the rushing it through without the safeguards that I have no choice but to vote no against uh with regard to it again today. I yield back.
▶ 4:40:36The gentleman yields back. I now Miss Chu for five minutes to strike the last word.
▶ 4:40:42I move to strike the last word. I would very much like to accelerate access to promising new technologies for Medicare patients, but I remain concerned that by passing this bill, Medicare will be deprived of their responsibility to prove safety and effectiveness for patients over 65. The FDA has no such mandate for their approval.
▶ 4:41:06And so by automatically granting coverage to every device with an FDA breakthrough designation, Medicare will no longer have that ability to zero in on the safety of these devices for seniors. Therefore, I will reluctantly vote no.
▶ 4:41:24The is what CMS put in place last year with their pathway that speeds access to new devices but still requires them to meet the reasonable and necessary standard and undergo postmarket evidence collection. That process protects beneficiaries from harm and prevents the program from being exploited by manufacturers charging inflated prices. Now I have to also address the larger context.
▶ 4:41:53I have serious concerns about my Republican colleagues using this legislation to present themselves as champions of medical innovation. But you cannot champion innovation while dismantling the very institutions that make it possible.
▶ 4:42:09Over the last nine months, the Trump administration has gutted our health agencies by firing Food and Drug Administration scientists, slashing the National Institutes of Health budget, disbanding advisory panels, and undermining the very experts who ensure that medical products are safe and effective. Those attacks will only make the risks of this bill even greater.
▶ 4:42:34What's more, in July, the Congressional Budget Office released a report showing that a 10% cut to the NIH and a 9-month delay in Food and Drug Administration review times would lead to 53 fewer new drugs approved for patients.
▶ 4:42:52That's 53 fewer lifelines for patients waiting on treatments for cancer, Alzheimer's, cardiovascular disease, and rare But the Trump administration is not proposing a 10% cut. They are proposing a nearly 40% cut to the NIH budget. a cut so deep that CBO's own model cannot even calculate the devastation.
▶ 4:43:23So, let's be clear. You cannot gut the NIH, fire the FDA scientists, the Department of Health and Human Services, and then claim to care about I yield back. Are there others wishing to strike the last word? Seeing none, are there any amendments to the amendment in the nature of a substitute?
▶ 4:43:57The question is on agreeing to the All those in favor signify by saying I. Those no. The opinion of the chair, the eyes have it.
▶ 4:44:26Is there a request for roll call vote?
▶ 4:44:35The clerk will call the role.
▶ 4:44:39Mr. Buchanan?
▶ 4:44:40Mr. Buchanan? Yes, Mr. Smith of
▶ 4:44:45Mr. Smith of Nebraska. Yes, Mr. Kelly.
▶ 4:44:49Mr. Kelly. Yes, Mr. Schwikert.
▶ 4:44:52Mr. Schwikert. Yes, Mr. Lehood.
▶ 4:44:56Mr. Le Hood. Yes, Mr. Arrington. Mr. Arrington. Yes. Mr. Estus. Mr. Smucker. Mr. Smucker. Yes. Mr. Hearn. Mr. Hearn. Yes, Mrs. Miller. Mrs. Miller. Yes, Dr. Murphy.
▶ 4:45:16Dr. Murphy. Yes, Mr. Kristoff. Mr. Kristoff. Yes, Mr. Fitzpatrick.
▶ 4:45:23Mr. Fitzpatrick. Yes, Mr. Stwie.
▶ 4:45:27Mr. Stwie? Yes. Miss Tenny, Miss Tenny? Yes. Miss Fishbach?
▶ 4:45:33Miss Fishbach? Yes. Mr. Moore. Mr. Moore. Yes. Miss Vanine. Mr. Fenstra. Mr. Fenstra. Yes. Miss Miss Malotakus. Yes. Mr. Kerry.
▶ 4:45:52Mr. Kerry. Yes. Mr. Yakam.
▶ 4:45:55Mr. Yakam. Yes. Mr. Miller.
▶ 4:45:59Mr. Miller. Yes. Mr. Bean.
▶ 4:46:02Mr. Bean. Yes. Mr. Moran. Mr. Moran. Yes. Mr. Neil. Mr. Mr. Neil. Yes. Mr. Dogget. Mr. Dogget. Mr. Thompson. Mr. Thompson. Yes. Mr. Mr. Larson. Yes. Mr. Davis. Mr. Davis. Yes. Miss Sanchez. Miss Su.
▶ 4:46:33Miss. Delenny. Miss Deleny. Yes. Miss Miss Chu, no. Miss Moore. Miss Moore. Yes. Mr. Bole.
▶ 4:46:48Mr. Boille. Yes. Mr. Byer. Mr. Evans. Mr. Schneider. Mr. Petta. Mr. Panetta. Yes. Mr. Gomez. Mr. Mr. Horzford. Mr. Horford. Yes. Miss
▶ 4:47:12Miss Plask. Yes. Mr. Swazy.
▶ 4:47:16Mr. Swazy. Yes.
▶ 4:47:21Miss Su is not recorded. Miss Su. Yes.
▶ 4:47:27Mr. Estus.
▶ 4:47:32Miss Vanine. Miss Vanine. Yes. Miss Sanchez, Mr. Byer, Mr. Evans, Mr. Schneider, Mr. Gomez,
▶ 4:48:00Chairman Smith.
▶ 4:48:02Chairman Smith. Yes. How's Miss Moore? Miss Moore.
▶ 4:48:14Miss Moore. Yes.
▶ 4:48:18Miss Moore. No.
▶ 4:48:32Mr. Gomez.
▶ 4:48:32Mr. Gomez is not recorded. Mr. Gomez. Yes.
▶ 4:49:29comes the fire power.
▶ 4:49:50How is Mr. Evans recorded?
▶ 4:49:53Mr. Mr. Evans is not recorded.
▶ 4:49:55Mr. Evans.
▶ 4:49:57Mr. Evans. Yes.
▶ 4:50:31clerk will report.
▶ 4:50:34The yeses are 38 and the nos are three.
▶ 4:50:38There being 38 yeses and three nos, the amendment in the nature of a substitute is adopted. I will now recognize Mr. Buchanan for the purpose of offering a
▶ 4:50:46Mr. Chairman, I move the committee favorably report HR 5343 as amended to the House of Representatives.
▶ 4:50:54Question is on the motion to favorably report HR 5343 as amended to the House of Representatives. The clerk will call the role.
▶ 4:51:03Mr. Buchanan,
▶ 4:51:05Mr. Buchanan, yes. Mr. Smith of
▶ 4:51:08Mr. Smith of Nebraska, yes. Mr. Kelly,
▶ 4:51:13Yes. Mr. Kelly, yes. Mr. Schwiker, Mr. Schwikert, yes. Mr. Leood. Mr. Arrington. Mr. Arrington. Yes. Mr. Mr. Smucker. Mr. Smucker. Yes. Mr. Hearn. Mr. Hearn. Yes. Miss Miller. Mrs. Miller. Yes. Dr. Murphy.
▶ 4:51:41Dr. Murphy. Yes, Mr. Kustoff, Mr. Kustoff. Yes, Mr. Fitzpatrick. Mr. Fitzpatrick. Yes, Mr. Stwie.
▶ 4:51:53Mr. Stwie. Yes, Miss Tenny. Miss Tenny. Yes, Miss Fishbach.
▶ 4:52:01Miss Fishbach. Yes, Mr. Moore.
▶ 4:52:04Mr. Moore. Yes. Miss Vanine. Miss Vanine. Yes. Mr. Fenstra. Mr. Mr. Fenstra. Yes. Miss Malotakus.
▶ 4:52:15Miss Malotakus. Yes. Mr. Kerry.
▶ 4:52:19Mr. Kerry. Yes. Mr. Yakam.
▶ 4:52:22Mr. Yakam. Yes. Mr. Miller.
▶ 4:52:26Mr. Miller. Yes. Mr. Bean.
▶ 4:52:29Mr. Bean. Yes. Mr. Moran.
▶ 4:52:33Mr. Moran. Yes.
▶ 4:52:35Mr. Neil. Mr. Neil. Yes. Mr. Dogget. Mr. Dogget. No. Mr. Thompson.
▶ 4:52:44Mr. Thompson. Yes. Mr. Larson. Mr. Larson. Yes. Mr. Davis. Miss Sanchez. Miss Su. Miss Su. Yes. Miss Delben. Miss Delben. Yes. Miss Chu. Miss Chu. Yes, Ms. Moore
▶ 4:53:13Ms. Moore. No,
▶ 4:53:15Mr. Boille.
▶ 4:53:16Mr. Boille. Yes, Mr. Byer. Mr. Evans Mr. Evans. Yes, Mr. Schneider. Mr. Panetta, Mr. Petta. Yes, Mr. Gomez. Mr. Mr. Horzford. Mr. Horford. Yes. Miss Plask. Miss Plask. Yes. Mr. Swasy.
▶ 4:53:47Mr. Swazy. Yes. Mr. Le Hood. Mr. Le Hood. Mr. Mr. Le Hood. Yes. Mr. Estus. Mr. Dogget. Mr. Dogget. No.
▶ 4:54:20Mr. Davis. Mr. Davis. Yes. Mr. Byer. Mr. Schneider, Mr.
▶ 4:54:40Gomez, Chairman Smith, how is Miss Chu recorded? Miss Chu is recorded as yes. Miss Chu, no.
▶ 4:55:28Clerk will report the vote. The yeses are 38 and the nos are three.
▶ 4:55:38There being 38 yeses and three nos, the motion is agreed to and HR 5343 as amended is ordered favorably reported to the House. Without objection, I ask that staff be authorized to make technical and conforming changes to HR 5343 and that members have two additional days to file with the committee clerk supplemental additional dissenting or minority views.
▶ 4:56:01Our next order of business is HR5349, the Tax Court Improvement Act, introduced by Representative Representatives Moran and Su. The bill strengthens taxpayer rights during judicial proceedings before the US Tax Court.
▶ 4:56:18As a former judge, Congressman Moran knows the importance of fully protecting the rights of taxpayers in the courtroom and I appreciate his leadership and that of Representative Su on this issue and I'm pleased to recognize the gentleman from Texas, Mr. Moran for an opening statement.
▶ 4:56:36Thank you, Mr. Chairman, Ranking Member Neil. Today, I urge my colleagues in the Ways and Means Committee to support the Tax Court improvement act, bipartisan legislation that addresses key issues in our nation's premier forum for taxpayer Special thanks to my de Democratic co-sponsor Terry Su for her hard work and partnership on this important bill. For too long, the tax court has operated under outdated procedural rules that limit its its ability to efficiently serve the American taxpayer.
▶ 4:57:05This bill addresses those limitations head-on with four key reforms that will improve access to justice, reduce delays, and increase transparency and public trust in our tax system. First, the bill updates the tax court's authority to issue subpoenas. Under current law, parties subpoenaed to produce documents must appear in person, even if their physical presence is entirely entirely This not only imposes burdens on taxpayers and witnesses but also wastes valuable court time.
▶ 4:57:35In contrast, other article one courts like the f the court of federal claims already can simply accept documents without requiring physical appearances. This legislation corrects that imbalance by restoring the tax court's ability to decide when a party needs to appear and when documents alone will suffice. Second, the bill empowers special trial judges who are experienced, highly capable legal professionals to help relieve the court's growing backlog.
▶ 4:58:04Right now, only active judges, those appointed by the president and confirmed by the Senate, can preside over certain types of proceedings or issue final decisions. And there are only 19 of these such judges across the land. This bottleneck has contributed to a backlog of hundreds of cases delaying justice for taxpayers. Under this legislation, special trial judges will be authorized to do three key things.
▶ 4:58:29Hear certain cases with the consent of the parties involved, issue final judgments in certain cases, and exercise contempt authority to maintain order in their courtrooms. Much like the use of federal magistrates in other federal matters, taxpayers will have the option to consent to having their case heard more quickly without compromising judicial integrity and empowering special trial judges with the ability to enforce the law in their courtrooms is essential for maintaining decorum and respect for the judicial
▶ 4:58:59process. Third, the bill introduces long overdue ethical safe safeguards by establishing grounds for disqualification of tax court judges and special trial judges. While article 3 judges and magistrates are already subject to these standards, tax court judges are not. Codifying these ethical rules reinforces public confidence in the impartiality and the independence of the court.
▶ 4:59:25Finally, the bill clarifies that the tax court has the authority to apply equitable tolling in deficiency cases, allowing it to extend filing deadlines when reasonable. Currently, if a taxpayer misses a 90 or 150day deadline due to illness, disaster, or the court has no clear power to grant relief. That's not justice. This legislation ensures that meritorious cases are heard and resolved on their substance, not dismissed because of inflexible technicalities.
▶ 4:59:55Taken together, these reforms will make the tax court more efficient, more responsive, and more just. This is a bipartisan common sense proposal that strengthens taxpayer rights and brings the tax court into alignment with modern judicial practices. I urge my colleagues to support this critical and necessary legislation. Let's improve the tax court process so that it better serves the individual taxpayer and the public interest at large.
▶ 5:00:21More improvements are certainly needed, but this is an important and substantial step in the right direction. Mr. Chairman, before yielding, I ask unanimous consent to submit for the record the following three letters from the SBE Council, the National Taxpayers Union, and the Taxpayers Protection Alliance in support of this legislation.
▶ 5:00:40Without objection.
▶ 5:00:41Thank you. I yield back.
▶ 5:00:43Thank you. Um, I now recognize the ranking member from Massachusetts, Mr.
▶ 5:00:47Thank you, Mr. Chairman. Let me yield my time to the distinguished gentle lady from Alabama, Miss Su.
▶ 5:00:53Thank you so much for yielding your time, Ranking Member Neil. I am proud to be the lead democratic co-sponsor of the Tax Court improvement act with my colleague or our colleague, Representative Moran of Texas. The tax court has a very real world impact on everyday Americans. It provides individuals and businesses with an opportunity to be heard in court and challenge the IRS before paying a disputed tax.
▶ 5:01:25Our constituents deserve a tax court that is efficient, fair, and transparent. However, some enhancements can be made to make the court work better for everyone. As a former county judge, I know that Representative Moran agrees with me and would be uh and is well suited to provide those enhancements.
▶ 5:01:47The Tax Court Improvement Act will strengthen tax court procedures and practices by accelerating the collection of documents, expanding the types of cases assigned to special trial judges, holding tax court judges to the same recusal standards as other federal judges, and allowing the deadline for petitions to be extended under cir certain circumstances.
▶ 5:02:10These improvements to the tax court will have a tangible impact on the thousands of taxpayer and small businesses that utilize the court every year. Again, I'd like to thank Representative Moran for leading the Tax Court Improvement Act, and I urge all of my colleagues to support this legislation. I yield back the balance of my time.
▶ 5:02:30Thank you. The committee will now proceed to consideration of HR5349, the Tax Court Improvement Act. Without objection, the measure will be considered as read and open for amendment at any point. At this time, I offer an amendment in the nature of a substitute, which was distributed in advance along with a green sheet explaining it. Without objection, the amendment in the nature of a substitute shall be considered as read, open for amendment at any point, and considered base text for purpose of the amendment.
▶ 5:02:56I will now turn to Tom Bartold, chief of staff for the joint committee on taxation to provide a technical description of the amendment and the nature of a substitute with an emphasis on the changes made since introduction. I ask that members hold their questions until after his presentation.
▶ 5:03:14Thank you, Mr. Chairman. The members of the committee have before them three joint committee documents, JCX40, JCX 41, and JCX 43, which describe the underlying legislation, the chairman's amendment, the nature of a substitute, and provides the joint committee staff's uh estimated budgetary effects of the uh of the legislation. The chairman's amendment, the nature of a substitute, makes clerical corrections to the uh introduced legislation.
▶ 5:03:41And just by brief review, the underlying uh legislation has uh uh four uh four main provisions. It authorizes the tax court to sign subpoenas to produce information for the purpose of prehering discrepancy, expanding the use of subpoena author uh authority that they presently have.
▶ 5:04:00It expands the proceedings in which the chief judge of the tax court may appoint special trial judges and permits those special trial judges to render uh decisions for the trial court I mean for the tax court independently. It also permits the uh special judges to order punishment for contempt uh subject to certain limitations. Uh as noted it applies the mandatory rec recusal provisions applicable to all federal courts.
▶ 5:04:28And lastly, it addresses uh disperate treatment of equitable tolling which has arisen uh both interpretation of the underlying statute and through decisions that have varied across different federal districts.
▶ 5:04:44Uh all these provisions would be uh effective on the date of enactment and the joint committee staff has estimated that the net budgetary effect of these provisions would be to increase revenues by $6 million over the budget period fiscal years 2026 through 2035. That concludes my brief description. I'd be happy to answer any questions that the members might have.
▶ 5:05:07Thank you. Are there any technical questions about the amendment and the nature of a substitute? Seeing none, we'll move to strike the last word. Does any member wish to strike the last word?
▶ 5:05:18I do.
▶ 5:05:19Mr. Dogget.
▶ 5:05:21Mr. Chairman, uh I appreciate and acknowledge the good intent of this bill and the leadership of the sponsors because it is important to increase fairness for taxpayers and improve administration of the tax code. Uh the national taxpayer advocate uh has said that legislative ambiguity has created uncertainty both for taxpayers and for the IRS.
▶ 5:05:42Indeed, last year the Treasury Department indicated that the ambiguity was uh so significant that it led some courts in many cases to bar the IRS from assessing penalties for tax avoidance. Uh, however, invoking, as this bill does, the twin issues of fairness and administration of our tax code, I cannot help but point out the elephant in the room, the Republican elephant in the room, and that is the Republican efforts in this Congress to
▶ 5:06:13systematically empower wealthy tax cheats. It's not enough for Republicans to slash taxes for large corporations and billionaires, as they have done in Trump's big ugly bill. They are working to ensure that what little tax those at the top are now required to pay never gets collected.
▶ 5:06:32According to a 2021 Treasury Department report, it's estimated that the top 1% of Americans fail to pay as much as 163 billion in taxes owed each year. $63 billion. Trump and the Republicans have been very successful in empowering wealthy tax cheats and ensuring that their numbers grow. Trump certainly has some familiarity with tax avoidance himself.
▶ 5:07:01Just last week, the New York Times detailed the latest move in their war on high-end tax cheats. It's entitled, "The Trump administration halts IRS crackdown on major tax shelters. The Treasury Department is rolling back efforts to shut down aggressive strategies used by America's biggest multinational companies and America's wealthiest people. Mr. Chairman, I would move to enter that story into the record by unanimous
▶ 5:07:28Without objection,
▶ 5:07:29the IRS crackdown started under the Biden administration on tax shelters being abused by big business. It was projected to raise over a hundred billion dollars over 10 years. Now, this effort has been shut down by the Trump administration. That's revenue lost. That's larger debt incurred. As a result, Americans who pay their tax in full must shoulder a larger percentage of the tax burden.
▶ 5:07:55Republicans would due to IRS funding in their annual funding bill more of the same. This partisan legislation passed out of the appropriation committees slashes IRS in fund enforcement funding by almost half. This is the exact opposite approach that we Democrats had when we had a majority two Congresses ago. We reversed a decade's worth of targeted enforcement budget cuts.
▶ 5:08:23Republican budget cuts that led to audit rates for large corporations that declined by half and audits rates for those earning $1 million per year dropped by 70%. That's what I mean in talking about empowering tax cheats. The data released by the Trump IRS this year shows that we were successful previously. Mr. Chairman, I would ask unanimous consent to include another report.
▶ 5:08:50IRS upheld a Biden pledge more audits but only on the
▶ 5:08:55Without objection,
▶ 5:08:56Mr. Chairman, that story explains that these claims that jack booted IRS thugs would be going through, rampaging through the country and and dealing with uh taxpayers uh of middle class status and small businesses had no merit at all. Uh the tax Americans who are paying their taxes are themselves being cheated by those who avoid their taxes at the top.
▶ 5:09:22Republicans have rescended uh the vast majority of the funding that was dedicated to restoring high-end IRS enforcement. And these cuts weren't bad enough. Elon Musk and Doge doubled down on the damage with their cuts in the IRS workforce to fairly administer our tax code. They took a chainsaw to the IRS, losing 26,000 valuable civil servants.
▶ 5:09:48Although this bill today would marginally improve the IRS ability to administer our tax code, it pales in comparison to the damage that has been done this year by Republicans to fairness and to our ability to collect the taxes owed by the largest corporations and the wealthiest few Americans.
▶ 5:10:07I urge the committee to turn its attention to the area in which it can have the largest effect on our country's finances, avoid encouraging more uh in incurring more uh national debt and on fairness in our tax code, ensuring that large corporations and the wealthiest view cannot escape paying the tax that they owe. And I yield back.
▶ 5:10:29Additional members that wish to strike the last word? Seeing none, are there any amendments? Seeing none, um the question is on the adoption of the amendment in the nature of a substitute. All those in favor signify by saying I. I.
▶ 5:10:49Those opposed say no. In the opinion of the chair, the eyes have it and the amendment in the nature of a substitute is agreed to. I now recognize Mr. Smith for the purpose of offering a motion.
▶ 5:11:07Mr. Chairman, I move that the committee favorably report HR5349 as amended to the House of
▶ 5:11:14The question is on the motion to favorably report HR 5349 as amended to the House of Representatives. The clerk will call the role.
▶ 5:11:22Mr. Buchanan.
▶ 5:11:26Mr. Smith of Nebraska.
▶ 5:11:28Mr. Smith of Nebraska. Yes. Mr. Kelly,
▶ 5:11:32Mr. Kelly, yes. Mr. Schwikert,
▶ 5:11:35Mr. Schwikert, yes. Mr. Leood,
▶ 5:11:39Mr. Le Hood, yes. Mr. Arrington, Mr. Estus. Mr. Smucker. Mr. Smucker. Yes. Mr.
▶ 5:11:56Mr. Hearn. Yes. Mrs. Miller.
▶ 5:11:59Yes. Mrs. Miller, yes. Dr. Murphy. Dr. Murphy. Yes. Mr. Kristoff. Mr. Kristoff. Yes. Mr. Fitzpatrick. Mr. Fitzpatrick. Yes. Mr. Stwie.
▶ 5:12:15Mr. Stwie. Yes. Miss. Tenny. Miss. Tenny. Yes. Miss. Fishbach.
▶ 5:12:22Miss Fishbach. Yes. Mr. Moore.
▶ 5:12:26Mr. Moore. Yes. Miss. Vanine Miss Vanine Yes Mr. Fenstra Miss Malotakus Miss Malotakus yes Mr. Carrie
▶ 5:12:42Mr. Kerry yes Mr. Yakam
▶ 5:12:45Mr. Yakam yes Mr. Miller
▶ 5:12:50Mr. Miller yes Mr. Bean
▶ 5:12:53Mr. Bean yes Mr. Moran
▶ 5:12:56Mr. Moran. Yes, Mr. Neil. Mr. Ne Neil. Yes. Mr. Dogget. Mr. Dogget. Yes. Mr. Thompson. Mr. Thompson. Yes. Mr. Larson.
▶ 5:13:11Mr. Larson. Yes. Mr. Davis. Mr. Davis. Yes. Miss Sanchez. Miss Su. Miss Su. Yes. Miss Delben. Mr. Alen, yes. Miss Chu, Miss Chu, yes. Miss Miss Moore. Yes. Mr. Boille.
▶ 5:13:36Mr. Bole. Yes. Mr. Byer. Mr. Evans.
▶ 5:13:43Mr. Evans. Yes. Mr. Schneider. Mr. Petta.
▶ 5:13:51Mr. Panetta. Yes. Mr. Gomez. Mr. Horsford Mr. Horseford. Yes. Miss
▶ 5:14:02Miss Plask. Yes. Mr. Swazy.
▶ 5:14:07Mr. Swazy. Yes. Mr. Buchanan.
▶ 5:14:11Mr. Buchanan. Yes. Mr. Arrington.
▶ 5:14:17Mr. Arrington. Yes. Mr. Estus. Mr. Fenstra,
▶ 5:14:25Mr. Fenstra, yes.
▶ 5:14:29Miss Sanchez, Mr. Byer,
▶ 5:14:36Mr. Schneider, Mr. Gomez, Chairman Smith.
▶ 5:14:46Chairman Smith. Yes. The clerk will report the vote.
▶ 5:15:10The yeses are 40 and the nos are zero. There being 40 yeses and zero nos, the motion is agreed to and HR5349 as amended is ordered favorably reported to the House. Without objection, I ask that staff be authorized to make technical and conforming changes to HR 5349 and that members have two additional days to file with the committee clerk supplemental additional dissenting or minority views.
▶ 5:15:37Our next order of business is HR5346, the Fair and Accountable IRS Reviews Act, introduced by Representative Gothman. He is an unyielding advocate for taxpayers and introduced this bill to ensure IRS employees follow the law when leving penalties and fines on taxpayers.
▶ 5:15:59Currently, the IRS permits agents to obtain a supervisor's approval at any point in the penalty process, including after a penalty has already been levied on a taxpayer. This undermines the no signature, no penalty principle. At the same time, agents can seek approval from higherups that are not their direct supervisor. Representative Rothman's bill will help protect taxpayers during this procedure process.
▶ 5:16:27It will reinforce a fair treatment of the taxpayers at the IRS. I urge my colleagues to join me in supporting this common sense legislation. I now recognize the ranking member from Massachusetts, Mr. Nil, for his opening statement.
▶ 5:16:39Thank you, Chairman. Uh, on this bill, uh, I tend to give a lot of credence to the recommendations of the taxpayer advocate, but it's hard to take Republican tax administration seriously when you consider how they've treated the IRS. Under their watch, it's been marked by uncertainty and a lack of leadership other than a frontal assault on the IRS. They weakened customer service with mass firings only to realize they needed the dedicated staff to carry out basic functions and work.
▶ 5:17:09Then you will recall the year they spent hollowing out the IRS both with staff and resources. I'll never understand what at one time was a certain bipartisan agreement here over the IRS. When people think that there are not audits taking place, all that means is that they're paying more because somebody else is paying less. The lack of enforcement efforts actually have offered great peril to the IRS.
▶ 5:17:38At this time, we be raising billions of dollars from people that should be paying their fair share. They gutted direct file, which would have eased the filing season for millions of Americans. Just this week, we found out that the Trump administration halted efforts that were cracking down on tax shelters. For the life of me, I don't understand why we can't be cracking down on those tax shelters.
▶ 5:18:02Once again, they sided with the wealthiest and most powerful amongst us in an effort to help them evade paying their fair share. So, yes, as it relates to tax collections, Rome is burning. Our colleagues can only muster actions on the wing of a knat. their priorities are misplaced and it's hurting taxpayers. And with that, I yield back the balance of my time.
▶ 5:18:27Thank you. The committee will now proceed to consideration of HR5346, the Fair and Accountable IRS Reviews Act. Without objection, the measure will be considered as read and open for amendment at any point. At this time, I offer an amendment in the nature of a substitute, which was distributed in advance, along with a green sheet explaining it. Without objection, the amendment in the nature of a substitute shall be considered as read, open for amendment at any point and considered base text for purpose of amendment.
▶ 5:18:55I will now turn to Tom Bartal, chief of staff for the joint committee on taxation to provide a technical description of the amendment in the nature of a substitute with an emphasis on the changes made since introduction. I ask that members hold their questions until after his presentation.
▶ 5:19:10Thank you, Mr. Chairman, Mr. Neil. The members of the committee have before them two joint committee documents JCX39 and JCX42 which describe the underlying legislation and the chairman's amendment the nature of a substitute. The chairman's amendment in the nature of substitute makes certain clerical corrections to the underlying legislation HR5346. By way of background, as was noted, determination of penalties uh must be approved within the IRS before assessed.
▶ 5:19:41Through time, litigation has created different standards across the federal circuits regarding when an initial determination and the timing of a required supervisory signature uh or the appropriate signatory has been approved.
▶ 5:19:58The underlying legislation, as amended, would make much clearer lines that the supervisory approval of a penalty required under the code is timely only if the IRS employee proposing that penalty obtains the required approval in writing prior to any written communication to the taxpayer with respect to the penalty being uh uh being assessed.
▶ 5:20:24The legislation also defines the term immediate uh supervisor. The uh document JCX uh 39 has an error that uh I regret. It reports that the effective date of this legislation was date of enactment. Uh is it would be date of enactment. That is incorrect. My my fault. I apologize. Uh the effective date is for notices issued, penalties assessed after December 31st of 2025.
▶ 5:20:54that error uh that uh made in recording also means that the reported revenue estimate in uh uh in the document uh is incorrect. The correct revenue estimate for the budget period of fiscal years 2026 through 2035 is that we estimate that it would raise a 117 million uh over that budget period. I apologize for those two errors. Uh and that concludes my brief description.
▶ 5:21:23I'd be happy to answer any questions that the members might have.
▶ 5:21:26Thank you. Are there any technical questions about the amendment and the nature of a substitute?
▶ 5:21:32Seeing none, we will move to strike the last word. Does any member wish to strike the last word? Mr. Thompson.
▶ 5:21:44Thank you, Mr. Chairman. I move to strike the last word. I support efforts to make the IRS more efficient and responsive to the American people. That should be a bipartisan goal. Unfortunately, my Republican colleagues in this administration are not serious about improving the IRS and delivering real tax relief for hardworking families.
▶ 5:22:07Instead, my Republican colleagues are advancing a spending bill that slashes the IRS budget by 23%. And through those, this administration fired thousands of dedicated IRS employees. And interestingly, now they're begging many of them to come back, to return to work because they've uh created such a problem in that uh in in the IRS with budget cuts and short staffing.
▶ 5:22:37This means longer waiting times when you call for help. Means more delays for families waiting for their refunds. Money that goes to pay rent, groceries, or medical bills. And it means more loopholes and fewer audits for the ult ultra wealthy and the well-connected who already have armies of lawyers and accountants. Mr. Chairman, while the Republicans claim they're fighting for working families, the American people can see through this.
▶ 5:23:07They know what's happening. This agenda, your agenda, will cut health care for millions of Americans. It will send children to school hungry and put them to bed with empty stomachs. It will destroy hundreds of thousands of goodaying, clean energy jobs, jobs that are building the economy of our future. And on top of all that, it will saddle our nation with $5 trillion more in debt. And for what?
▶ 5:23:36To hand out massive tax breaks to the wealthiest corporations and those already at the very top. To reward the welloff and well-connected while working families are left behind. I hear every day from people in my district who need help. They're not asking for any special carveout. And they're not asking for any favors. They're asking for fairness. They want a fair shot at the American dream. They want to be able to afford a home.
▶ 5:24:06They want to put food on the table and provide for their kids. They want to send their kids to college without a mountain of debt. And they want to be able to retire with dignity after a lifetime of hard work. That's what this debate should be about. That's what Democrats are fighting for. That's what I'm fighting for on behalf of my constituents and the American people. We can choose to invest in families.
▶ 5:24:33We can choose to invest in our children, in the middle class, or we can choose to hand over more tax breaks to billionaires and big corporations. My Republican colleagues have made their choice. I'm proud to stand on the other side with America's working families. I yield
▶ 5:24:53Does any other member wish to strike the last word? Miss Chu,
▶ 5:24:58I move to strike the last word.
▶ 5:25:00We simply cannot act like this is business as usual. While we agree that this bill provides common sense improvements in the IRS's process of facilitating and notifying taxpayers of their penalties, Republicans are ignoring the elephant in the room. We can't talk about bettering IRS processes for taxpayers without talking about the fact that Donald Trump and Republicans are systematically destroying the agency that they claim they want to improve.
▶ 5:25:31After Democrats secured $80 billion in historic funding for the IRS in the inflation reduction act, Republicans made it their mission to punitively claw back the progress and put the IRS in a significantly worse position than before.
▶ 5:25:47And that's despite the fact that the Treasury Department itself confirmed that the funding Democrats secured would deliver far more revenue than it would cost, raking in over half a trillion dollars in revenue that our national checkbook so desperately needs.
▶ 5:26:04But instead of building on that work, Republicans are tearing it apart, making obsolete over half of the $80 billion in funding that Democrats secured, causing lost revenue, and greenlighting tax evasion from the nation's wealthiest. And Republicans aren't just slashing IRS funding.
▶ 5:26:24They're pushing out thousands of hard-working IRS employees, including at least 31% of the AY's revenue agents who are responsible for auditing the returns of highincome tax evaders who play a key role in the IRS's penalty process. The result, $500 billion dollar in lost revenue and even more wealthy tax evaders dodging the system. And it doesn't end there.
▶ 5:26:53With their big ugly bill, the Republican party just handed over the largest transfer of wealth from the poorest Americans to the richest. At the same time that Republicans are ripping 15 million Americans off their health insurance, they are skewing the tax system so that the wealthiest benefit on the backs of the poorest.
▶ 5:27:14Their bill will give an average tax cut of 309,000 per year to the top.1% while those earning less than $50,000 get 68 a day. So let's not pretend that this is standard procedure. It's not. The Republican party is dismantling our country's ability to raise revenue through tax compliance and enforcement and make it easier for the wealthiest to continue cheating the system.
▶ 5:27:44Middle class families are left to pay even more while billionaires get even richer. It's despicable and I yield back.
▶ 5:27:56Does anyone else wish to strike the last Seeing none, we will move to amendments. Does any member have amendments? Seeing no amendments. The question is on the adoption of the amendment in the nature of a substitute. All those in favor signify by saying I.
▶ 5:28:17Those opposed say no. In the opinion of the chair, the eyes have it and the amendment in the nature of a substitute is agreed to. I will now recognize Mr. Buchanan for the purposes of offering a
▶ 5:28:28Mr. Chairman, I move the committee favorably reports HR 5346 as amended to the House of Representatives.
▶ 5:28:37The question is on the motion to favorably report HR 5346 as amended to the House of Representatives. The clerk will call the role.
▶ 5:28:46Mr. Buchanan,
▶ 5:28:47Mr. Buchanan, yes. Mr. Smith of
▶ 5:28:51Mr. Smith of Nebraska, yes. Mr. Kelly,
▶ 5:28:55Mr. Kelly, yes. Mr. Schwikert.
▶ 5:28:59Mr. Schwikert.
▶ 5:29:02Mr. Le Hood.
▶ 5:29:05Mr. Arrington.
▶ 5:29:09Mr. Estus. Mr. Estus. Yes. Mr. Smucker. Mr. Smucker. Yes. Mr. Hearn. Mr. Hearn. Yes. Mrs. Miller.
▶ 5:29:21Mrs. Miller. Yes. Dr. Murphy. Mr. Kustoff Mr. Kustoff Yes. Mr. Fitzpatrick. Mr. Fitzpatrick. Yes.
▶ 5:29:35Mr. Stwie. Mr. Stwie. Yes. Miss Tenny. Miss Tenny. Yes.
▶ 5:29:44Miss Fishbach.
▶ 5:29:45Miss Fishbach. Yes. Miss Moore.
▶ 5:29:50Sorry. Mr. Moore.
▶ 5:29:53Mr. Moore. Yes. Miss Vanine.
▶ 5:29:57Miss Vanine. Yes. Mr. Fenstra.
▶ 5:30:01Mr. Fenstra. Yes. Miss Malotakus.
▶ 5:30:04Miss Malotakus. Yes. Mr. Carrie.
▶ 5:30:08Mr. Carrie. Yes. Mr. Yakam.
▶ 5:30:11Mr. Yakam. Yes.
▶ 5:30:15Mr. Miller.
▶ 5:30:17Mr. Miller. Yes. Mr. Bean.
▶ 5:30:20Mr. Bean. Yes. Mr. Moran.
▶ 5:30:23Mr. Moran. Yes, Mr. Neil.
▶ 5:30:27Mr. Neil. Yes, Mr. Dogget.
▶ 5:30:34Mr. Dogget. Yes, Mr. Thompson.
▶ 5:30:39Mr. Larson.
▶ 5:30:41Mr. Larson. Yes, Mr. Davis.
▶ 5:30:44Mr. Davis. Yes. Miss Sanchez.
▶ 5:30:49Miss Su.
▶ 5:30:50Miss Su. Yes. Miss Delben. Miss Doen, yes. Miss Chu, Miss Chu, yes. Miss
▶ 5:31:01Miss Moore, yes. Mr. Bole,
▶ 5:31:05Mr. Boille, yes. Mr. Byer,
▶ 5:31:08Mr. Byer, yes. Mr. Evans.
▶ 5:31:12Mr. Evans. Yes.
▶ 5:31:14Mr. Schneider.
▶ 5:31:15Mr. Schneider.
▶ 5:31:17Yes. Mr. Panetta.
▶ 5:31:19Mr. Petta. Yes. Mr. Gomez.
▶ 5:31:23Mr. Mc Gomez. Yes. Mr. Horford.
▶ 5:31:27Mr. Horford. Yes. Miss Plask.
▶ 5:31:30Miss Plasket. Yes. Mr. Swazy.
▶ 5:31:34Mr. Swasy. Yes.
▶ 5:31:37Mr. Le Hood.
▶ 5:31:39Mr. Le Hood. Yes. Mr. Arrington.
▶ 5:31:43Mr. Arrington. Yes. Dr. Murphy.
▶ 5:31:48Dr. Murphy. Yes. Mr. Thompson. Mr. Thompson. Yes. Miss
▶ 5:32:03Chairman Smith.
▶ 5:32:05Chairman Smith. Yes. The clerk will report the vote.
▶ 5:32:24yeses are 44 and the nos are zero.
▶ 5:32:26There being 44 yeses and zero nos, the motion is agreed to and HR 5346 is amended as ordered favorably reported to the house. Without objection, I ask that staff be authorized to make technical and conforming changes to HR5346 and that members have two additional days to file with the committee clerk supplemental additional dissenting or minority views.
▶ 5:32:49Up next, we are considering HR 5284, the Claiming Age Clarity Act, a bipartisan bill led by Representative Smucker and Byer. This legislation is simple but powerful. It updates the language the Social Security Administration uses to describe when American workers can claim their retirement benefits.
▶ 5:33:10This will be incredibly helpful to the nearly 100,000 citizens nearing retirement age in Representative Smucker's district and the over 80,000 in Representative Byer's district who would be better informed thanks to this legislation. Right now, many of the terms being used by the SSA can be confusing or misleading. Many Americans end up claiming benefits earlier than is optimal, often without fully understanding the financial consequences.
▶ 5:33:40As a result, many of today's seniors are missing out on substantial income over the course of their retirement. This legislation is supported by ARP, the Bipartisan Policy Center, and the Association of Mature American Citizens. This is a common sense, bipartisan step to empower seniors and strengthen retirement security. I urge my colleagues to support it, and I'm pleased to recognize a gentleman from Pennsylvania, Mr. Smucker, for an opening statement.
▶ 5:34:10Thank you, Mr. Chairman. I appreciate you bringing this bill up for consideration and great comments and describing uh the bill. Um, and I I um want to thank Mr. Byer who I've had the opportunity to work with on this, my good friend from Virginia. Uh, and so I appreciate very much his uh leading of this bill as well. Um, and we do have multiple Republicans and Democrats uh on the bill. Uh, multiple members of this committee from both side have signed on to this bill.
▶ 5:34:39And I think um that's a testament to um the fact that we all think it's very important that uh older Americans have the information that they need to make good financial decisions in their retirement. Um it's also why um the uh bipartisan policy center AARP and AMAC have all endorsed the bill. And in fact, Mr.
▶ 5:35:02Chairman, I'd like to submit their letters of support into the Without objection.
▶ 5:35:11Thank you. Um and Mr. Chairman, as you described so well, retired Americans um receive a monthly social security uh benefit that is adjusted uh based on uh the starting age at which they begin to claim that benefit. Uh and the adjustments currently are based on three ages.
▶ 5:35:34uh in particular the uh at 62 it's called the early eligibility age and then the full retirement age which is at 66 or 67 depending on when the individual is born and then the age of 70 it's called delayed retirement credits uh and they're capped uh at at the higher amount at that point and if you're having any trouble following that don't worry a lot of older Americans do not really understand uh what those um terms mean so you're not alone if that's hard to follow um in In fact, studies have
▶ 5:36:04shown that the current terms uh used by the Social Security Administration confuse people. Um and some beneficiaries may not fully understand that if they're claiming their benefits earlier, they're going to see they're going to have a reduced amount for their lifetime.
▶ 5:36:19And so, um, and and another study showed that, you know, if if Americans can wait until they're 70, some can obviously choose to do that, um, it could cut the, um, poverty rate for Americans over the age of 70 in about a half if people could waited for that higher amount. So, Mr.
▶ 5:36:40Chairman, that's Claiming Age Clarity Act simply changes the terminology used by the social uh security administration uh to describe uh to use better terms at the different ages at which an anid individual can uh begin claiming their benefits. So instead of early retirement age at the age of 62, the bill would refer to that age as the minimum benefit age.
▶ 5:37:08full retirement age would become the standard benefit uh age and age 70 would would be referred to as the maximum benefit age. So minimum standard and maximum uh that's much easier to understand uh in my view and the view of everyone who's endorsed this bill uh and more clearly reflects the the the design of the claiming of social security. So I um urge my colleagues I hope my colleagues support this bill and thank you again Mr. chairman for bringing it
▶ 5:37:38Thank you. I now recognize the ranking member from Massachusetts, Mr. Neil.
▶ 5:37:42Let me yield my time, Mr. Chairman, to our distinguished colleague from Virginia, Mr. Byer. Thank you, Chairman Smith and Ranking Member Neil. I'm proud to lead this simple bill with my Pennsylvania friend, Mr. Snow Grecker, the Claiming Age Clarity Act. This bill remedies terminology confusion to help communicate plainly to beneficiaries the differences in Social Security benefits at different claiming ages. I think Congressman Smucker's done a good job of explaining it.
▶ 5:38:05I just think back to when I turned 65 trying to understand when I should sign up and I didn't realize that under the current structure and jargon a worker that claims social security at age 62 for example who makes monthly benefit of $1,400 if they waited just one year it' be $1,500 for the rest of their life or if they waited two years it' be $1600 plus the adjustments.
▶ 5:38:28So those who are able to postpone claiming their benefits are almost always better off when they do so, but not only increases the expected payout over their lifetime. It also provides better protection against outliving one's savings. Not all workers can do this, but it demystifies the process. It's very helpful to change the language. A very helpful update. A small fix to provide clarity and transparency for those able to postpone claiming. It doesn't do everything.
▶ 5:38:54We still have to deal with solveny with data privacy, customer service, the staffing disaster, but it will help on the margins. And I'm proud that I got I'm pleased that I got to work with Congressman Smucker on this. And I thank Lloyd for his partnership. I urge my colleagues to vote yes on this bill.
▶ 5:39:10Thank you. The committee will now proceed to consideration of HR 5284, the Claiming Age Clarity Act. Without objection, the measure will be considered as read and open for amendment at any point. At this time, I offer an amendment in the nature of a substitute which was distributed in advance along with the green sheet explaining it. Without objection, the amendment in the nature of a substitute shall be considered as read, open for amendment at any point, and considered base text for the purpose of amendment.
▶ 5:39:39I will now turn to Ben Ritter, tax and social security policy adviser to provide the technical description of the amendment in the nature of a substitute with an emphasis on the changes made since introduction. I ask the members hold their questions until after his
▶ 5:39:54Chairman Smith, Ranking Member Neil, and members of the committee. As introduced by Representative Smucker of Pennsylvania and Byer of Virginia, HR 5284 would direct the Commissioner of Social Security to modify the terms used by the Social Security Administration to describe certain ages at which a worker may claim retirement benefits. The terms early eligibility age would be replaced with the term minimum monthly benefit age.
▶ 5:40:20The terms full retirement age and normal retirement age would be replaced with the term standard monthly benefit age. And any reference to age 70 as a maximum age up to which delayed retirement credits can be received would be replaced with maximum monthly benefit age. As described on the green sheet distributed yesterday, the amendment in the nature of a substitute modifies the effective date to ensure the commissioner of social security has no less than one year following date of enactment to adhere to the bill's requirements.
▶ 5:40:52Thank you, Mr. Chairman, ranking member Neil and members of the committee. This concludes my walkthrough and I welcome any questions related to the technical nature of the amendment and the nature of a substitute.
▶ 5:41:01Thank you. Are there any technical questions about the amendment and the nature of a substitute? Mr. Larson? Yes. Thank you uh Mr. Chairman and let me uh also thank the uh members for their very thoughtful uh uh proposal. I think that it's vitally important and uh but I do have some questions u uh for Mr. Riddler. U uh Mr.
▶ 5:41:27Do you uh are there millions of deb people including those over the age of 150 who receive social security benefits?
▶ 5:41:38Sorry, can you can you repeat that, sir?
▶ 5:41:40Are there people over the age of 150 who receive social security benefits?
▶ 5:41:46Sir, I'm I'm here to answer questions concerning the technical nature of of of the bill uh before us. I' I'd defer that question to the members. Well, the bill is about misinformation, I believe. And um is it uh is that correct information uh that people over the age of 150 are receiving social security benefits?
▶ 5:42:10Again, sir, I'm I'm here to answer questions related to the technical nature of the amendment and the nature of a substitute. I I defer that question
▶ 5:42:17Okay. Do American seniors still uh have to pay taxes on social security
▶ 5:42:27Sir, again uh I'm here to talk about the techn tech answer questions uh technical questions related to the amendment.
▶ 5:42:35Uh try another one. Do undocumented immigrants drain the social security trust funds by receiving benefits? Again, sir, I'm I'm here to answer questions uh technical questions related to the amendment substitute.
▶ 5:42:51Uh has the federal government rated social security trust funds to pay for other things?
▶ 5:42:59Sir, again, I'm here to answer questions uh technical questions related to the amendment in the nature of substitute.
▶ 5:43:05Okay. Uh let me
▶ 5:43:09Larson, do you have a technical
▶ 5:43:11Yeah, I do.
▶ 5:43:12Well, then ask it. Sounds like you're in a rush and I don't I have a staffer.
▶ 5:43:20He's a staffer and I want to make sure that his duty is to answer technical questions, not policy questions.
▶ 5:43:25I wish we didn't have a staffer here. I actually wish we had Elon Musk or anyone from Doge who this committee should call in front of us and be able to ask them questions. Forgive me, Mr. Riddler and I have all the greatest respect for you and me. No ill will whatsoever.
▶ 5:43:42But these are questions especially when you're dealing with a bill that had that seniors ought to be aware of and the myths that abound out there about social security and the lies that are perpetuated even by the president of the United States on the floor of the House of Representatives.
▶ 5:44:00Will the gentleman need to be answered?
▶ 5:44:02Will the gentleman yield?
▶ 5:44:04All right. Thank you for your comments and we understand your passion and how you feel about this and you have questions and I feel as if you should direct them to people who are sitting on the deis and not a staffer. He is here for technical questions. Mr. Larson, I have been a staffer for the majority of my time before I was a member of Congress. Okay,
▶ 5:44:25Thank you. I'm here. But it speaks volumes about a person how they treat staff and you know what you're doing right now. I respectfully if you want to ask questions that are technical. So you're saying those aren't questions?
▶ 5:44:36Will the gentleman allow me to finish?
▶ 5:44:38They are questions but not meant for this forum. They are technical questions. You are a very smart man. You know that if you have questions about the piece of legislation, I'm happy to talk to you offline. But all you are doing is making a political stunt out of the very serious committee. I ask the gentleman to respectfully
▶ 5:44:55well without you know reclaiming my time. Political stunt. A political stunt is not having people before the committee that should come before the committee. That's the political stunt. I yield back. Are there additional technical Seeing none, we will move to strike the last word.
▶ 5:45:24Um, do members wish to strike the last word? Mr. Bean.
▶ 5:45:27Thank you very much, Mr. Chairman. I move to strike the last word. Good afternoon to you. Good afternoon, Ways and Means Committee. I have something that we can all agree on. Can we not agree that the most confusing language out there is your cell phone bill? It's tough to be a consumer when we're trying to figure out how to compare or what we're paying for. Some will say that uh equally confusing, maybe not equally confusing, but uh but it is confusing is uh making decisions regarding your social security.
▶ 5:45:57Well, there's uh two representatives and I am joining them as uh part of the co-sponsor that says we can do better. We can make better language, clearer language, easier language to uh allow Americans to make better decisions. Far too many Americans claim Social Security early, often at age 62, settling for a lower monthly benefit and on average thousands less in total lifetime benefits.
▶ 5:46:22So, I'm proud to join Representative Byer and my good friend, Representative Smucker, who say there's a better way, easier language, clearer language to allow all Americans uh a pathway to make better decisions for themselves.
▶ 5:46:36So, I support the language that says, "Hey, we should uh use uh minimum benefit age, standard benefit age, maximum benefit age, so it's much clearer what you're doing when you make these decisions." And so members, I urge you to uh I urge everybody to vote yes on this bill and let's uh let's give Americans all the information they need to make big decisions. With that, Mr. Chairman, I yield back.
▶ 5:47:00Mr. Davis. Thank you, Mr. Chairman. I'm in favor of this bill. However, I think the committee fails.
▶ 5:47:22I think we fail the American people if we do not lead in protecting Social Security and Americans who have been affected by the Social Security data President Trump promised Americans that he would not cut Social Security.
▶ 5:47:44But one of his first acts was to allow inexperienced and aggressive Doge staffers to hack into SSA's most beneficiary data, cut thousands of experienced staff, and disrupt customer so so much that seniors and those close to retirement age are justifiably worried
▶ 5:48:14that they will not receive the benefits they've worked for all of their lives. Despite the essential role that Social Security plays in protecting Americans, Republicans have repeatedly tried to cut Social Security benefits, raise the retirement age, rip benefits away from sick and disabled children, and
▶ 5:48:44privatize Social Security. All steps to undermine beneficiaries Recently, the Treasury Secretary quoted about how the recently created Trump accounts represent the first step to privatizing Social Security. There not enough workers to meet the needs of retiring baby boomers.
▶ 5:49:12Yet Republicans refuse to fund Social so that it can protect children, people with disabilities, and retirees. These Americans are already struggling from higher cost and the threat of losing their jobs. The ideas and actions are anti- people, anti- opportunity.
▶ 5:49:42anti-service enhancing. We can be better than that. Thank you, Mr. Chairman, and I yield back.
▶ 5:49:51Thank you, Mr. Schwikert.
▶ 5:49:54Thank you, Mr. Chairman. Um, strike the last word. Um, look, if you read the Social Security Actuary report, I was going to be sarcastic and said we all did it, but um, some of us don't have a life and we have a 10 hours a week on an airplane.
▶ 5:50:09If you read through it, there was actually a surprise within there um in two or three places where it actually talked about that there was a surprise of how many of our brothers and sisters who are turning 62 are choosing to take the benefit and it's actually actually had an effect on the actuarial life. Um that it actually shortened life of a couple months because they're out of the labor force.
▶ 5:50:32And um now some of that may be the fear that hey you know the when the fund um I is when the trust fund is empty it's 24% cut. Um so are they being logical or do they have enough information to make that decision to take it at 62. So look if this makes the language more understandable um terrific.
▶ 5:50:55Um because we do know we're having more of our brothers and sisters take retirement at 62 than we originally expected at 65 or or even the encouragement to go to 70. Um for a
▶ 5:51:09So you're on to something,
▶ 5:51:12but recall that a lot of what you've just described happened in the midst of the pandemic when people lost their jobs. um to the um ranking members. He's absolutely correct. And we we saw it during the pandemic and we if you actually go back to the social actuary report, there's commentary in there that we expected it to fade down and it didn't. It it continued. So, um you're right, this has been sort of a baseline for about five years now. And each year, once again, a mistake from the actuaries.
▶ 5:51:42They kept saying, "Hey, we think this will go back to norm normal." And it didn't. Um, look, I care tremendously about this and it's one of my rages. Um, and I'm mad at everyone, so just accept that. Um, but 2033, the f first full year, our math is somewhere in the $500 billion a year is just that year's shortfall.
▶ 5:52:06And then if you take in um Medicare, which is also gone in 2032, that's about another 140 billion. If if you go to 2033, the full year, you know, you're looking at something the six hund six and a half 600 billion dollar the scale what's coming at us in the next seven years.
▶ 5:52:30one day we're going to figure out how to have a adult conversation without trying to write script for each side's political consultants that are going to beat the crap out of us on the issue because this is an actuarial problem. If this actually just helps create a slightly better informed public, fine. It's a terrific bill. And with that, yield back. Mr. Larson.
▶ 5:53:00Yes. Thank Yes. Thank you, Mr. Chairman. And u let me say to Mr. Miller who referred to my questioning as a as a political stunt, I don't think the five million people who get below poverty level checks from the wealthiest nation in the world's number one insurance program think that that's a stunt. I think they think it's an injustice.
▶ 5:53:29I think that when 70 million plus Americans haven't seen an increase in Social Security since 1971 because Congress hasn't acted. I don't think that that's a stunt. I think that there are questions that need to be asked. And the stunt is when a committee won't do its responsibility. I find it interesting that the gentleman
▶ 5:53:59talk about bipartisanship uh when it uh when it's when it's social
▶ 5:54:06but when it's taxes, it's okay to be
▶ 5:54:10Well, the gentleman
▶ 5:54:10and you can take all the tax cuts that you want and pass them partisanly. But when it comes to social security, it's got to be bipartisan. Where is Who are these individuals? The gentleman
▶ 5:54:28that have been appointed.
▶ 5:54:30I'll make you quick.
▶ 5:54:31Where have they been appointed?
▶ 5:54:33Mr. Larson, I'm
▶ 5:54:34sorry. I yielded you time before you called it a stunt. I'll take my time
▶ 5:54:41Chairman, point of order.
▶ 5:54:42Where are these uh where are these so-called Doge people? The fact of the matter is that they've been appointed by the administration. They have been they are unaccountable and they sit within various agencies including social security. And as I as my colleague Mr.
▶ 5:55:04Davis said also, and everybody ought to be concerned about this, not just Democrats and Republicans, but every American, that they have stolen the information and placed it in a cloud that's unsecure. And if that's not the truth, and if that's wrong, well, then why aren't they here before this committee? Why don't they come in and testify before the committee as to what has happened? What is the big secret?
▶ 5:55:33What's the big mystery here that they can't come before our committee and answer direct questions? Are they above the law? What special status do they have because they're part of Where in the Constitution does it give them that protection? When is Congress going to do its job and responsibility?
▶ 5:56:02When are we going to answer to the general public as to where that information and that data? What gives them the right to look at anyone's personal data and comb through it? For what purposes are they doing it? And if it's because of fraud, abuse, and waste, well, then why aren't they here in front of the committee talking about it?
▶ 5:56:30Why aren't they here expressing that point of view? Why aren't they telling us why they have placed all of this personal data in a cloud? Why don't we have the whistleblower here for us? Oh, I get it. We only have the whistleblower here before us when it's Hunter Biden or it's Hillary Clinton.
▶ 5:56:55then we're in a rage to make sure that we get a whistleblower here. But when someone talks about the American people, the 300 million people whose documents have been stolen now and are vulnerable, we're silent. And if that's not the well then let's prove it. Let's have them.
▶ 5:57:19I asked the chairman again, let us bring Doge employees before us. Have them answer the questions before this committee. What have we got to I yield back.
▶ 5:57:40Mr. Estus.
▶ 5:57:42Thank you, Mr. Chairman. I move to strike the last word. Um, I really have some words I want to talk about the Claiming Age Clarity Act. But before I get into that, I want to make some responses to some of the charges and allegations that have been made. You know, the Ways and Means Committee Republicans take a strong and have a strong record of taking whistleblower complaints seriously, and the committee will treat the whis the recent whistleblower allegations with similar care.
▶ 5:58:09As with all whistleblowers, the committee's taken allegations seriously and will continue coordinating with the whistleblowers council to ensure all information regarding the disclosures investigated thoroughly. Along that same line, Mr. Mr.
▶ 5:58:21Chairman, I'd like to submit to the record a uh a letter as a response from Commissioner Vizinano uh to uh uh Senator Crapo in response to some of his questions uh dealing with the uh the data and and the data accessibility at at Social Security. And I I I'll read a couple of paragraphs out of that.
▶ 5:58:42Um, one paragraph in the letter was that uh the commissioner can confirm based on the agency's thorough review that neither the new database nor any of its data had been accessed, leaked, hacked or shared in any unauthorized fashion. Social Security Administration continuously monitors its systems for any signs of unauthorized access or data compromise and that we have not detected any such incidents involving the num numadent database.
▶ 5:59:10uh in in addition in response to the first question that uh Senator Crapo would ask uh one of the responses part of the response is that the acting uh chief information security officer assessed the allegation that the new data was stored in an unsecured cloud environment and determined it was unfounded. The location referred to in the whistleblowers allegation is actually a secured server in the AY's cloud infrastructure which historically has housed this data and is continuously monitored and overseen.
▶ 5:59:40SSA standard practice SSA adhered to the defined agency's data security practices while which includes following the national institute of standards and technology and federal information security modernization act guidelines. Um I'd like to submit this to the record
▶ 5:59:55without objection.
▶ 5:59:56Thank you Mr. Mr. Chairman, and you know, when Americans are planning for retirement, the last thing they need to be confused about is by government bureaucracy. HR5284, the Claiming Age Clarity Act, aims to make Social Security terminology simpler and easier for people to understand how their decisions affect their monthly benefits. For most Americans, waiting until after age 62 to claim benefits can be very financially advantageous.
▶ 6:00:20However, age 62 still remains the most common claiming age, representing roughly 23% of new benefit claims in 2023. Studies show that people are confused by the current SSA terms and are generally uninformed about how their claiming decisions affect their pays. As a result, many seniors are missing out on substantial retirement income due to suboptimal claiming decisions.
▶ 6:00:44In fact, I believe it's critical for those nearing retirement age to know that if they choose to claim retirement benefits at age 62, it's not just the minimum benefit. It's in fact a reduced benefit that they would be entitled to. Our seniors and constituents near retirement age deserve clarity and that starts with youth and right language. Also, when an American social security number is compromised, the last thing they need is to be trapped in a maze of red tape.
▶ 6:01:09Uh, two of these common sense bills that we're introducing or talking about today take direct aim at the problem by making social security services more efficient, more responsive, and better equipped to protect families from the lasting damage of identity theft. Improving Social Security service to victims of identity theft act and the Social Security Child Protection Act of 2025 work hand in hand to protect American families.
▶ 6:01:33These bills cut through bureaucracy by giving victims a single accountable point of contact at the SSA and allowing parents to protect their children with a new social security number when confidentiality is compromised. Both bills uh reflect exactly what government should be doing, making services simpler, faster, and more efficient for the people we serve.
▶ 6:01:52I want to thank my colleagues for introducing these bills and urge the committee to pass the claiming age clarity act, the improving social security service to victims of identity theft act and the social security child protection act of 2025 today. With that, I yield back.
▶ 6:02:06Thank you. Additional members wish to strike the last word. Miss Plask.
▶ 6:02:16Thank you. Uh Mr. Chair, I am in favor of this legis of this um bill. However, I did want to point out some matters uh because of course in the Virgin Islands, our social security as well as how we are treated is quite different than it is in the contiguous United States in the States.
▶ 6:02:38And the higher cost of living in an island territory creates additional financial pressure on retirees in particular with goods and services typically costing 20 to 30% more than mainland averages due to import dependencies.
▶ 6:02:53Economic impacts from hurricanes affect long-term financial planning with the storms like Irma and Maria in 2017 which destroyed savings, disrupted employment, and forcing residents to use retirement funds for recovery. The change from early eligibility age to minimum benefit age better reflects the economic reality that claiming early results in permanently reduced benefits.
▶ 6:03:21critical information for islanders who may face decades of higher living stand. Excuse me, Mr. Chair. I can't hear myself for the talking that's in the back. If you would just
▶ 6:03:32Yes, please. Um, you know, be respectful to the member's discussion.
▶ 6:03:36I don't think he's there even listening to you, but um, thank you. Island residents facing higher cost of living need clearer information about the financial implications of claiming decisions as reduced benefits have greater impact when basic necessities cost significantly more than mainland prices.
▶ 6:03:56Better terminology helps residents understand that waiting to claim can provide crucial additional income security in high-cost territory where Medicare supplements, prescription drugs, and imported goods strain fixed incomes.
▶ 6:04:12Hurricane recovery experiences have shown that many residents exhaust their savings during disasters, making maximized social security benefits essential for long-term financial stability and climate vulnerable benefit territories.
▶ 6:04:28So the bill replacing the term with minimum age benefit, standard age benefit and maximum age benefit to better reflect social security claiming design and how the program works is something that will be beneficial to the people of the territory. Um I urge my colleagues to support this legislation and I yield back. Thank you very much, Mr. Chair, for stopping the sound. My ADD was just going off on that talking
▶ 6:04:55I hear you. I completely understand, Mr.
▶ 6:04:58Thank you, Mr. Chairman. I want to thank my colleague uh Mr. Larson uh for your passion and for your emotion. I I very much appreciate it, but if you are screaming, you are losing. I'd like to remind the committee that today we are discussing HR5284, the Bipartisan Claiming Age Clarity Act, which simply ensures Social Security beneficiaries have clear and accurate information when making decisions about when to claim their benefits.
▶ 6:05:24This is a goodfaith effort to provide transparency and help Americans plan for their retirement. I remain committed to working in a bipartisan manner and I hope we can rise above harsh rhetoric to focus on what matters, the best interests of the American people. Thank you, Mr. Chairman. I back.
▶ 6:05:40Are there additional members that wish to strike the last word? Seeing none, we will move to amendments. Are there any movement amendments to the the bill? Mr. Larson.
▶ 6:05:57Mr. Chairman, I reserve a point of
▶ 6:05:59A point of order has been reserved. Um, would Mr. Larson suspend while we distribute the amendment?
▶ 6:06:12Proceed, Mr. Larson.
▶ 6:06:15Thank you, Mr. Chairman. Uh what we're asking for is very simple and uh a publicly available resource that debunks about social security, including any that even comes from the president I urge everyone to support my amendment uh as we continue to push for the answers and transparency
▶ 6:06:45from social security. Uh I believe the administration has said that it's the most transparent administration ever. And so I I think that it's vitally uh important that uh if that's the case that we make that happened.
▶ 6:07:07Also, I would just uh wanted to comment on the uh fact that uh a letter was uh sent by uh Senator Crapo to uh and he received a response. Uh why don't we have them come before the committee and respond to us?
▶ 6:07:37What is what is the big secret? What is the mystery here? Here we have the nation's number one insurance program. We have 10,000 baby boomers a day that become eligible.
▶ 6:07:57Every member of this committee has on constituents that receive social 300 million plus Americans are impacted by the action of Doge. Is that not important enough?
▶ 6:08:25When a whistleblower comes forward and is seeking information, who who has validly presented a case and substantiated it that he ought to be questioned or do we just take the administration's word for it? Because God only knows. They've been honest and straightforward about Social Security. You know, look at all those 350 year old people that are still around.
▶ 6:08:57Let's be honest. Let's get them before this or be honest about what the attempt is. If you got a better idea for Social Security and you want it to privatize it, as is obvious by what you're doing, breaking the system down from within, laying off employees, dealing with an inadequate phone service, closing regional
▶ 6:09:27offices, humans, people getting on the phone and not being able to talk to a human being. All of you have constituents that are impacted by this. I can go down the list of how many you have in every district. I don't want to do that. All I want is us to fix a problem that's been going on for over 54 years.
▶ 6:09:58If you got a better way of fixing it, then put it on the table. But minimally, especially as it deals with information, shouldn't we have the very people that are in charge of this that have been specifically put there by the president of the United States, come before the committee and testify?
▶ 6:10:25Or are you saying when you're when you're put there by President Trump, you're above the law and you don't have to testify before Congress. We're a co-equal branch of government.
▶ 6:10:39And while you control the presidency in both are you going to give up that right for us to ask questions of people that oversee and are in a committee and are taking people's personal information and data. I know you guys well enough to know that you know that that's wrong.
▶ 6:11:08And if this were Hillary Clinton or Hunter Biden, you bet we'd have that whistleblower in here. I yield back. Further discussion on the Seeing none, the question is on agreeing to the amendment offered by Mr. Larson. The clerk will call the role.
▶ 6:11:28Mr. Buchanan. Mr. Buchanan. Mr. Mr. Smith of Nebraska.
▶ 6:11:36Mr. Smith of Nebraska. No Mr. Kelly
▶ 6:11:40Mr. Kelly. No Mr. Schwikert. Mr. Leood Mr. Arrington.
▶ 6:11:51Mr. Arrington. No. Mr. Estus.
▶ 6:11:55Mr. Estus. No. Mr. Smucker.
▶ 6:11:58Mr. Smucker. No. Mr. Hearn. Mr. Hearn. No. Mrs. Miller. Mrs. Miller. No. Dr. Murphy,
▶ 6:12:10Dr. Murphy, no. Mr. Kustoff,
▶ 6:12:14Mr. Kustoff, no. Mr. Fitzpatrick,
▶ 6:12:18Mr. Fitzpatrick, no. Mr. Stwie,
▶ 6:12:22Mr. Stwie, no. Miss Tenny,
▶ 6:12:25Miss Tenny, no. Miss Fishbuff, Miss Fishbach, no Mr. Moore.
▶ 6:12:33Mr. Moore, no. Miss Vanine. Miss Vanine. No. Mr. Fenstra.
▶ 6:12:44Mr. Fenstra. No. Miss Malotakus. Miss Malotakus. No. Mr. Carrie.
▶ 6:12:52Mr. Carrie. No. Mr. Yakam.
▶ 6:12:55Mr. Yakam. No. Mr. Miller.
▶ 6:12:59Mr. Miller. No. Mr. Bean.
▶ 6:13:02Mr. Bean. No, Mr. Moran
▶ 6:13:08Mr. Neil.
▶ 6:13:10Mr. Neil. Yes, Mr. Dogget.
▶ 6:13:13Mr. Dogget. Yes, Mr. Thompson.
▶ 6:13:17Mr. Thompson. Yes, Mr. Larson.
▶ 6:13:21Mr. Larson. Yes, Mr. Davis.
▶ 6:13:25Mr. Davis. Yes, Miss Sanchez.
▶ 6:13:29Miss Su,
▶ 6:13:31Miss Su, yes. Miss Delben. Miss Delben. Yes. Miss Chu
▶ 6:13:38Miss Chu. Yes. Miss Moore.
▶ 6:13:45Miss Moore. Yes. Mr. Bole.
▶ 6:13:48Mr. Boille. Yes. Mr. Byer. Mr. Evans. Mr. Evans. Yes. Mr.
▶ 6:14:00Mr. Schneider. Yes. Mr. Panetta.
▶ 6:14:03Mr. Panetta. Yes. Mr. Gomez.
▶ 6:14:07Mr. Gomez. Yes. Mr. Horford.
▶ 6:14:12Mr. Horseford. Yes. Miss Plask.
▶ 6:14:15Miss Plasket. Yes. Mr. Swazy.
▶ 6:14:19Mr. S Swazy. Yes. Mr. Schwikert. Mr. Schwikert. No. Mr. Le Hood. Mr. Le Hood. No. Mr. Moran, Miss Sanchez, Mr. Byer.
▶ 6:14:48Chairman Smith.
▶ 6:14:50Chairman Smith. No. Clerk will report the vote.
▶ 6:15:08The yeses are 17 and the nos are 25.
▶ 6:15:13Yeses were 17 and the nos were 25. The amendment is not adopted. Is that the correct number?
▶ 6:15:23But would you repeat the tally?
▶ 6:15:35the yeses are 17 and the nos are 25.
▶ 6:15:37Okay, good. I just wanted to make sure that that was correct. Um the amendment is not adopted. Are there additional Seeing none, um the Seeing none, the question is on the adoption of the amendment in the nature of a substitute. All those in favor signify by saying I. I.
▶ 6:16:02Those opposed say no. In the opinion of the chair, the eyes have it. In the amendment in the nature of a substitute is agreed to. I will now recognize Mr. Buchanan for the purpose of offering a
▶ 6:16:12Mr. Chairman, I move the committee favorably report HR 5284 as amended to the House of Representatives. The question is on the motion to favorably report HR 5284 as amended to the House of Representatives. The clerk will call the role.
▶ 6:16:30Mr. Buchanan?
▶ 6:16:31Mr. Buchanan? Yes. Mr. Smith of Mr. Kelly. Mr. Kelly. Yes. Mr.
▶ 6:16:42Mr. Schwikert. Yes. Mr. Leood.
▶ 6:16:46Mr. Leood. Yes. Mr. Arrington. Mr. Estus. Mr. Estus. Yes. Mr. Smucker. Mr. Smucker. Yes. Mr. Hearn Mr. Hearn. Yes. Mrs. Miller. Mrs. Miller. Yes. Dr.
▶ 6:17:06Dr. Murphy. Yes. Mr. Kustoff. Yes.
▶ 6:17:10Mr. Kustoff. Yes. Mr. Fitzpatrick.
▶ 6:17:14Mr. Fitzpatrick. Yes. Mr. Stwie.
▶ 6:17:18Mr. Stwie. Yes, Miss Tenny, Miss Tenny. Yes, Miss Fishbach.
▶ 6:17:28Miss Fishbach. Yes, Mr. Moore. Mr. Moore. Yes, Miss Vanine. Miss Vanine. Yes, Mr. Fenstra. Mr. Fenstra. Yes. Miss Malotakus. Miss Malotakus. Yes. Mr.
▶ 6:17:47Mr. Carrie. Yes, Mr. Yakam.
▶ 6:17:51Mr. Yakam. Yes,
▶ 6:17:53Mr. Miller.
▶ 6:17:55Mr. Miller. Yes,
▶ 6:17:57Mr. Bean.
▶ 6:17:58Mr. Bean. Yes, Mr. Moran.
▶ 6:18:04Mr. Neil. Mr. Neil. Yes. Mr. Dogget.
▶ 6:18:09Mr. Dogget. Yes. Mr. Thompson.
▶ 6:18:14Mr. Thompson. Yes. Mr. Larson. Mr. Larson, no. Mr. Davis, Mr. Davis, yes. Miss Sanchez, Miss Su, Miss Su, yes. Miss Delben, Miss Delben, yes. Miss Chu, Miss Chu, yes. Miss Moore, Miss Moore. Yes. Mr. Bole.
▶ 6:18:44Mr. Boille. Yes. Mr. Byer, Mr. Evans, Mr. Evans. Yes. Mr. Schneider, Mr. Schneider. Yes. Mr. Petta, Mr. Panetta. Yes. Mr. Gomez. Mr. Gomez. Yes. Mr. Horford. Mr. Horford. Yes. Miss
▶ 6:19:11Miss Plask. Yes. Mr. Swasy.
▶ 6:19:15Mr. Mr. Swazy. No.
▶ 6:19:20Mr. Smith of Nebraska.
▶ 6:19:22Mr. Smith of Nebraska. Yes.
▶ 6:19:25Mr. Arrington.
▶ 6:19:26Mr. Arrington. Yes.
▶ 6:19:31Mr. Moran.
▶ 6:19:38How is Mr. Suazi recorded?
▶ 6:19:41Mr. Swazy? No. Mr. Swazy. Yes. Mr. Moran. Miss Sanchez.
▶ 6:19:59Mr. Byer.
▶ 6:20:04Chairman Smith.
▶ 6:20:06Chairman Smith. Yes.
▶ 6:20:48Clerk will report the vote.
▶ 6:20:53The yeses are 40 and the nos are one.
▶ 6:20:57There being 40 yeses and one no. The motion is agreed to in HR 5284 as amended is ordered favorably reported to the house. Without objection, I ask that staff be authorized to make technical and conforming changes to HR 5284 and that members have two additional days to file with the committee clerk supplemental additional dissenting or minority views.
▶ 6:21:18Our next bill is HR the improving Social Security's service to victims of identity theft act introduced by Representative Kustoff. This legislation addresses the growing problem of the theft and misuse of social security numbers. In 2024 alone, there were over 3,000 reported data breaches and over half of them were included of them included social security numbers.
▶ 6:21:47For victims, the fallout can be overwhelming. Instead of finding clear guidance at the Social Security Administration, too many folks are bounced from one office to another, receiving conflicting instructions and spending months trying to resolve what should be a straightforward issue.
▶ 6:22:05During a pre previous hearing of the Ways and Means Social Security subcommittee, we heard directly from a mother who testified to how a single point of contact at the SSA would have been beneficial to helping her deal with the fallout from her daughter's social security number being compromised. This bill provides a simple and common sense fix and received unanimous bipartisan support in committee last Congress. Protecting Americans from identity theft is not a partisan issue.
▶ 6:22:35In fact, the committee previously approved this legislation by a vote of 43 to0. It then went on to pass the House floor by a simple simple voice vote of complete support. It is a matter of trust, security, and service. I urge my colleagues to remain consistent and once again support this important legislation. I'm pleased to recognize a gentleman from Tennessee, Mr. Kustoff for an opening statement.
▶ 6:23:02Thank you, Mr. Chairman. It uh was glad to introduce this bill HR5345, which is the improving social security service to victims of identity identity theft act. I think we all know and recognize that identity theft continues to be a problem and a serious problem here in our nation. And we know that bad actors are becoming increasingly Mr.
▶ 6:23:29Chairman, more and more Americans identities are being stolen through data breaches and the use of new technology like AI. Mr. Chairman, you you cited this uh the numbers actually 3,158 data breaches last year and that almost 2,000 social security numbers. Mr.
▶ 6:23:55Chairman, the social security number is an attractive target for identity thieves because social security numbers are used so widely and unfortunately they are still used by some for identification purposes.
▶ 6:24:12As members of Congress, we've all heard from our constituents not only about identity theft, but uh but the problems when they have to contact the Social Security it can be a bureaucratic nightmare trying to get through to Social Security.
▶ 6:24:32This bill creates a one-stop shop for those trying to protect themselves from identity Having a single direct point of contact at the Social Security Administration will undoubtedly streamline the process. It'll make it easier and it'll make it faster for victims to get relief. If I could, Mr.
▶ 6:24:59Chairman, uh today, as a matter of fact, the AARP September 17, 2025 sent a letter to you and to ranking member Neil. And if I could if I could read just from a portion of the letter. A AARP supports efforts to strengthen assistance for Americans whose social security numbers are stolen or misused.
▶ 6:25:23Identity theft cost Americans an estimated 47 billion in 2024 and victims often face a confusing and burdensome process to reclaim their identities. Improving the Social Security Administration's ability to help victims navigate recovery is an important step towards restoring confidence and security.
▶ 6:25:47The legislation before the committee would require the Social Security Administration to provide more effective assistance to individuals whose Social Security numbers are stolen or misused. By strengthening support for victims, the bill will make it easier for Americans to recover from fraud.
▶ 6:26:07We note that this policy also passed the House with overwhelming bipartisan support in and we urge its enactment as well. Mr. Chairman, if I could, I'd like to submit for the record that letter that I just read from from AARP dated September 17th, 2025. For the
▶ 6:26:30without objection.
▶ 6:26:32Mr. Chairman, if I could, also, I'd like to submit a letter uh from AAC that also supports the legislation. I'd like to submit that for the record.
▶ 6:26:42Without objection.
▶ 6:26:44Mr. Chairman, we uh we as members of Congress often have to deal with legislation that is complicated and This bill is neither. It is uh it's strongly supported by all sides and I would urge its adoption. And with that, Mr. Chairman, I will yield back.
▶ 6:27:04I now recognize the ranking member from Massachusetts, Mr. Nil, for his opening
▶ 6:27:08Thank you, Chairman. Let me uh yield my time to the gentleman from Connecticut, Mr. Larson. Uh thank you Mr. Neil and thank you uh Mr. chairman and let me say to my colleagues as uh while both on the previous bill and uh this bill as well as I think all of you are well aware of my uh deep and abiding concern about social security as
▶ 6:27:38I believe uh you are as well as you may know I was the proud co-lead of improving social Security Service of Victims Identity Theft Act in the last and work with our former colleague uh Dr. uh Drew Ferguson to pass it on the House on a bipartisan basis.
▶ 6:28:03Uh, identity theft scams are on the rise and I still believe that this bill a common sense solution. But as lot has in a year. And I cannot vote for this bill as it stands. As I said before, identity theft is on the rise.
▶ 6:28:24And it uh should shock everyone that we have an administration looking the other way while every American's data has been put at risk. This bill aims to provide a single point of contact at Social Security Administration to assist victims of identity theft.
▶ 6:28:48However, the current biggest threat to Americans identity is Doge, and we've repeatedly asked for them to come before this committee. And to date, we've heard crickets.
▶ 6:29:06Last month, thanks to a brave whistleblower, Charles Borges, that came forward, we now know that Doge copied private and sensitive information from Social Security to a vulnerable cloud.
▶ 6:29:23That should alarm not just people on Social Security, but That includes the names, addresses, birth dates, and social security numbers of more than 300 million Americans. And we have no clue where the data is. Last week, I asked Chairman Estes if we could bring the whistleblower forward for a hearing, and he couldn't commit to it.
▶ 6:29:52In June, when the Supreme Court allowed Doge to step in and access Americans personal records, Democrats warned that everyone's privacy was at I wrote Chairman Smith demanding an immediate markup on our bill protecting Americans Social Security Data Act. Our bill to block unvetted Doge minions from assessing these sensitive records.
▶ 6:30:23Do we really want to tell our constituents that we are allowing their data to be put at risk to identity I I you know it's great that uh we'll give you a single point contact to help deal with a lifewrecking fallout.
▶ 6:30:45It's great that we can put something toward forward to help victims of identity theft, but how is it going to reassure the American people when those just put 300 million of them at risk with identity theft? 300 million. Well, Mr. Chairman, what do you think?
▶ 6:31:11If we don't investigate this whistleblower complaint as hard as we did Hunter Biden's laptop, what are we doing here? I know discussing Hillary Clinton's emails was very popular, but I guess taking action to protect our constituents is not.
▶ 6:31:33We should be taking up my resolution of inquiry to compel answers about why vulnerable cl why why the vulnerable cloud was built and what information has been assessed. I intend on introducing it as an amendment and at the same time they are copying your data. Elon Musk has also been cutting 7,000 staff at SSA.
▶ 6:32:05The point of contact should be a real person, not an AI chatbot. I yield back. Thank you. The committee will now proceed to consideration of HR5345, the improving Social Security's service to victims of identity theft theft act. Without objection, the measure will be considered as read and open for amendment at any point.
▶ 6:32:34At this time, I offer an amendment in the nature of a substitute which was distributed in advance along with the green sheet explaining it. Without objection, the amendment in the nature of substitutes shall be considered as read, open for amendment at any time and considered base text for the purposes of amendment. Now I turn to uh Ben Ritter uh tax and social security policy adviser to provide the technical description of the amendment and the nature of the substitute with an emphasis on the changes made since introduction.
▶ 6:33:02I ask that members hold their questions until after his presentation.
▶ 6:33:07Thank you, Mr. Chairman, Ranking Member Neil, and members of the committee. is introduced by Representative Kustoff of Tennessee, would require the Social Security Administration to provide victims of identity theft with a single point of contact to the agency when the misuse of their Social Security number results in the need to resolve an issue or issues with the Social Security As described on the green sheet distributed yesterday, the amendment in the nature of a substitute additionally requires the Social
▶ 6:33:37Security Administration to provide a single point of contact to an individual when the loss of his or her Social Security card while being mailed by the Social Security Administration to his or her address results in the need to resolve an issue or issues with the agency. Thank you, Mr. Chairman, Ranking Member Neil, and members of the committee. This concludes my walkthrough and I welcome any questions related to the technical nature of the amendment and the nature of a substitute.
▶ 6:34:04Thank you. Are there any technical questions about the amendment and the nature of the substitute?
▶ 6:34:12M Mr. Larson. So again, how many Doge employees are there at Social Security? Sir, as as I've answered before, I'm here to answer technical questions on the amendment and the nature of a
▶ 6:34:35Okay. So I see where we're going with this you know it's very disturbing that uh when so much is at risk for the country.
▶ 6:35:01300 million Americans rely on Social a group of unvetted, unaccountable individuals have created a cloud and taking the and placed it in a cloud that is uns secure
▶ 6:35:32and vulnerable and we can't get answers. Mr. Riddler, it's not you of course that doesn't have the answer. And yes, you are correct in terms of technically answering, but tell this members to the to your constituents that it's a technical issue.
▶ 6:36:01Your social security that you rely on is a technical issue. 30 million people who this is the only benefit that they have that hasn't been extended and they feel is currently threatened in more than 50 years.
▶ 6:36:31We're the committee of cognizance. We're the committee that's supposed to act on social security. Will the gentleman suspend? I just want to remind members that the technical question portion of the markup is reserved for questions about changes made during the amendment in the nature of the substitute. Discussions of policy uh and decisions is in order during strike the last word portion of the markup.
▶ 6:36:58Uh with that, I'd let you continue if you have technical
▶ 6:37:03Well u Mr. Chairman, I thank you and you're absolutely correct and I don't have a technical question. What I have is great disappointment that this will not perform. It's duly responsible for performing obligation to call in front of it people who could answer questions that we have.
▶ 6:37:34I yield back. Thank you. Does anyone else have uh technical questions? Does anyone wish to strike the last
▶ 6:37:52Mr. Gomez, recognize you for five minutes to strike the last word.
▶ 6:37:57Thank you, Mr. Chairman. If you're rebranding, you're losing. Let me say it again. If you're rebranding, you're losing. And that's what my Republican colleagues have tried to do ever since they passed that one big beautiful bill. They've been trying to rebrand. And I keep mentioning it and I have blank looks on the other side of the aisle from the Republicans like, "What are you talking about?
▶ 6:38:23That's not true." Well, let's kind of go over some headlines to show what they were trying to do.
▶ 6:38:29Break it down, Jamie.
▶ 6:38:30New York Times Trump team urges GOP to rebrand signature policy law. Top campaign officials told House Republicans they should rebrand the measure the the president dubbed one big beautiful bill in a nod to its unpopularity with voters. Sounds like they're losing. Here's another article. Republicans try to rebrand their far-right mega bill, but reality is stubborn. Sure is.
▶ 6:38:59When people are getting screwed, they're going to be they're going to be a little stubborn about it. Here's another one. West Virginia attempts to rebrand the big beautiful bill won't fool West Virginiaians. That's not even a Democratic state. Here's another one. Trump aids from Politico push a mega bill rebrand as some House Republicans bristle.
▶ 6:39:24Quote, "There there seems to be some recognition that we're in trouble," said a House Republican. End quote. Here's another one. Trump is having second thoughts about one of his major I would too. when you're basically raising taxes on the lower income individuals, you're taking away their Medicaid, then you're not um expanding uh ACA subsidies, and then you're in the and people are not dumb.
▶ 6:39:54So, here's another one. There's another one. Political uh Trump mega bill's name not good for explaining what it does. He's right. What it does, it's the largest transfer of wealth in the history of this country. stealing from workingclass Americans to give tax breaks to the billionaires and the largest corporations. That's what it does. So, here's the thing. If you're rebranding, say it with me, you're losing. With that, I yield back.
▶ 6:40:24Thank you. I now recognize the representative from New York, Miss Aliotakus, for five minutes.
▶ 6:40:31Thank you, Mr. Chairman. It's been a pleasure to work with my colleague, Mr. Kustaf on common sense measures to protect our constituents who are falling victim to criminal enterprises organized crime.
▶ 6:40:49And we've worked earlier this year to pass legislation, the recovery of stolen checks act, which is waiting considerate awaiting a consideration in the Senate that would protect many of our constituents from stolen Treasury checks.
▶ 6:41:06We saw the Trump administration also take action to phase out paper checks because we know that mail theft is where this is taking And the DOJ under this administration has also been taking action uh as it relates to not just stolen checks but stolen identity.
▶ 6:41:28So we are seeing many common sense steps to uphold law and order to go after the perpetrators to protect our constituents. And the legislation before us today is a way that we can improve that customer service experience.
▶ 6:41:47while we're doing whatever we can to deter criminal offenses and protect the the benefits that our constituents are receiving. Um, obviously the criminals are very creative and so uh it's always an everchanging problem that evolves.
▶ 6:42:14And so what we're doing today is saying that if you are a victim of identity theft, we're not going to put you through a rigomearroll and the bureaucracy and the red tape for you to resolve this issue. It's something that needs to be resolved quickly to prevent further damage to you and your family and to your your money, your savings, your benefits.
▶ 6:42:41Uh, and so creating a single point of contact at the Social Security agency makes complete sense and it should have been done a long time ago. Many of us, we get calls all the time from constituents who have getting through the system and I'm happy that the new Social Security Commissioner has put in place some efficiencies to streamline that process.
▶ 6:43:08And we've seen already how call wait times have decreased. We're also seeing appointment weight times decreasing. That is great. In fact, I thank him for coming to my district and visiting one of my customer service centers. Uh and you know, c customers are being readily helped. Even if they walk in, they don't necessarily even need an appointment, they will they will help them as quickly as possible. And so that is good news for the people that I represent in Staten Island and Brooklyn.
▶ 6:43:37And this is great news uh for the people across the country. We have to continue to look for ways to be creative to make not only the customer service experience better, but to also make sure that the perpetrators of these crimes don't get away with it. We got to make it difficult for them.
▶ 6:43:56But we also need to make sure that they see the consequences for their actions, that they are they are prosecuted and they are held accountable and that they serve jail time. And so, you know, we're doing a small step today uh that continues to put us on that path to improve the experience for our constituents. And I look forward to passing more legislation within this committee and in the House um to get the job done. Thank you, and I yield back.
▶ 6:44:24Thank you. Does anyone else wish to strike the last word?
▶ 6:44:29Miss Plask.
▶ 6:44:31Miss Placetic, you're recognized for five minutes to strike the last word.
▶ 6:44:33Thank you, Mr. Chair. Um, I think that this bill does some good work in terms of supporting uh those individuals who have to deal with social security. You know, in the Virgin Islands, mail delivery vulnerabilities create additional risk for document theft. Identity compromises during Social Security Administration correspondence.
▶ 6:44:59Limited internet connectivity and technology infrastructure can complicate online identity verification processes that and sometimes mainland residents can easily access. A single point of contact is especially valuable for Virgin Islands residents who cannot easily coordinate between different mainland locations during identity theft resolutions.
▶ 6:45:24So having this legislation and the work that it's going to do is something that is a good thing. Identity theft in the Virgin Islands often space extended resolution times due to communication delays with mainland offices. But I cannot um forget to not appine on the days when I was on the oversight committee when I first came to Congress.
▶ 6:45:50Um, that's now over a decade when the left and the right, as we like to call ourselves now, not party affiliations, but extremes, um, when Republicans and Democrats both did oversight together on government agencies, working together to resolve whistleblower complaints.
▶ 6:46:13And it's not lost on me that while we're concerned about identity theft, we have a whistleblower in a chief data officer who's making a shocking complaint alleging about Doge and its highly sensitive copying of social security data of 300 million people from secure federal databases into vulnerable cloud environment. That's something that we should be looking at as well.
▶ 6:46:43And while for all of these bills I've been they just eat around the edges of what is really important to the American people. And I know that people are going to hold up this legislations, these these bills, and say, "See, we're working in a bipartisan way to work on keeping people's health care, while behind the back is the sledgehammer getting rid of all of it.
▶ 6:47:13So, I will support the amendment and support, I'm sorry, this this bill, but it's not lost on me that it's doing little for the larger scheme of our retirees and our most vulnerable Americans in terms of what is happening in each one of these bills, each one of the ones that we're putting forward, there's so much more and much grander work that we could be doing to support the American people
▶ 6:47:43in these pieces of legislation. I yield back.
▶ 6:47:47Thank you. Does anyone else reach to strike the last word?
▶ 6:47:52Seeing not, are there any amendments in the to the amendment in the nature of a
▶ 6:47:59I have an amendment. Mr.
▶ 6:48:01Mr. Chairman, I reserve a point order.
▶ 6:48:03Mr. Larson has an amendment. If you'll suspend until we get the amendment passed out.
▶ 6:48:55The gentleman can continue. Thank you, Mr. Chairman. Uh, Mr. Chairman, uh my amendment would uh require the administration and Doge to turn over all information they have regarding the copying of Americans private social data to a vulnerable cloud.
▶ 6:49:23Let me be clear, this is a good bill. I helped co-lead this bill in the last Requiring SSA to provide a single point of contact for victims of identity theft is common sense reform. However, there is currently a glaring to America's identity.
▶ 6:49:52A brave whistleblower came forward and revealed that Doge has copied the names, addresses, and social security numbers of 300 million Americans and placed it on a vulnerable cloud. They have put the private information of every American at risk.
▶ 6:50:22Are we really going to tell the American people, our constituents, that we are going to allow their names, their social security numbers, and their addresses to be put at risk of identity theft? I don't think that's the way to go, Mr. Chairman.
▶ 6:50:47While many Americans may have been born at night, they weren't born last night. I will not be rubber stamping this administration in Doge's actions at SAA by voting in favor of this bill while they obsc with the Americans people's private data. And more importantly, Mr.
▶ 6:51:15chairman, why we can't as a committee bring them in front of us to ask them those questions. We cannot allow them to continue to mine our constituents data.
▶ 6:51:31We need hearings and accountability Doge must come before our committee and explain why they built this cloud and what they have assessed and why. everyone on this committee should vote for this amendment.
▶ 6:51:58If you are against protecting your constituents privacy, then you better be able to explain why. I'm not just going to sit idly by and let them continue to invade my constituents privacy or any American's privacy for that matter.
▶ 6:52:23Everyone watching at home ought to be outraged that Congress is just willing to sit here and let Doge and all their minions do as they please so they don't upset President Trump.
▶ 6:52:47This is a democracy and in a democracy you have the right to stand up and say when you don't agree. And as elected members we actually have the responsibility to act on behalf of our constituents. So rise up Republicans.
▶ 6:53:14Where's your responsibility to privacy to the constituents that you serve? Is it okay that Doge takes their data and information and puts it in a vulnerable cloud? I don't believe you believe that. I believe it's time for us to stand up together and act as this committee should.
▶ 6:53:44the oldest continuous committee that we celebrated just the other night here because of our independence and how we stood up and now in face of what Doge has done with 300 million people's information and data needs this committee to act.
▶ 6:54:14I'll call on Mr. Hearn.
▶ 6:54:16Mr. Chairman, I insist on a point of order. Uh the amendment is not gerine to the underlying resolution. The subject matter of the resolution is service delivery. The subject matter of this amendment is a request for the production of information. I would ask the chair to sustain my point of order. Thank you, Mr. Hearn. Mr.
▶ 6:54:37Mr. Chairman, Mr.
▶ 6:54:40Yes. I
▶ 6:54:40I object uh to any attempt to deny this amendment to be considered as not germanine. This is specifically gerine to the underlying bill, which I support, which the Democrats on this committee support.
▶ 6:54:59But to suggest that a credible whistleblower, the chief data officer at the Social Security Administration who has reported that Doge copied the private social security data of nearly every American onto No, I will not onto an insecure cloud.
▶ 6:55:19Mr. Harshford, are you
▶ 6:55:20I will not I will not suspend.
▶ 6:55:23You have a point of order. I have a point of order that this is germanine and we will speak about it.
▶ 6:55:29My point was to recognize Mr. Larson if he wanted to respond to the chairman's point or to the gentleman's point of
▶ 6:55:35you guys have objected to every amendment that we have brought today from healthcare to protecting families to social security we cannot allow you to obstruct the rights of this minority to bring forward our amendments and that is what you've done
▶ 6:55:53Mr. Mr. Hzford, I recognize you have an
▶ 6:55:56Put me out of committee. Throw me out.
▶ 6:55:59My point as the chairman is to allow Mr. Larson, who raised the amendment, to make his response to the point of order.
▶ 6:56:06And then I would like to be recognized.
▶ 6:56:07Mr. Larson, would you like to respond to the point of order?
▶ 6:56:10I yield my time to Mr. Horse.
▶ 6:56:13Thank you. Responding to the point of
▶ 6:56:16I am responding to the point of order that this amendment that Mr. Larson has offered speaks directly to the alarming whistleblower report that shows how the Trump Vance administration has recklessly compromised the personal data of over 300 million individuals. This is the largest breach of data in US history.
▶ 6:56:46Identity theft is a public safety risk. This breach includes the names, birth dates, citizenship, race, addresses, phone numbers, parents' names, and social security numbers, as well as potentially sensitive medical information, including disability status, everything a hacker would need to commit mass identity theft.
▶ 6:57:13The whistleblower warned that this creates a substantial and specific threat to public health and safety with the potential to jeopardize health care, food benefits, and force the government to reissue new social security numbers to every American. How is that not This is not a minor administrative er error. It's not a systemic failure. It's an abuse of authority.
▶ 6:57:43It's a gross mismanagement with consequences for every household in America. Yours in your district and those of the people that I represent in mine. And yet my colleagues have chosen silence, have chosen some procedure uh procedural move to deny this amendment to be considered in an order. They received the whistleblowers report and refused to even comment on it or to bring them before this committee.
▶ 6:58:14While my colleague, Congressman Larson and Democrats on the Ways and Means Committee are fighting to protect the entrance of the public. We've introduced legislation. We've demanded hearings. And we called for transparency. And yet my Republican colleagues on the other side have voted down our efforts or done these pro procedural maneuvers to deny them going forward. They've blocked resolutions of inquiry and rejected calls for accountability.
▶ 6:58:45Why? Why are they afraid to bring forward this whistleblower and to ensure that that information is made available to this committee? And the amendment speaks directly to that. All documents, records, and other communications related to whistleblower allegations of
▶ 6:59:05Mr. Horsford, you're out of order.
▶ 6:59:06I have time.
▶ 6:59:07Respond to me. Suspend.
▶ 6:59:09No, Mr. Chairman. He yielded. It's my
▶ 6:59:12Do you have any response to the point?
▶ 6:59:15It's my time, Mr. Chairman. about the germaniness of the social of HR 5345 which is the social security service victim's identity
▶ 6:59:25theft 5345 the amendment under consideration by Mr. Larson that is gerine. There is no basis for denying the the gerineess of this underlying amendment. We support the underlying bill.
▶ 6:59:42If if you do not have anything to talk about the bill
▶ 6:59:45this is exactly about the bill. The bill is about
▶ 6:59:48doge is not mentioned in the bill.
▶ 6:59:50I didn't say doge. I said the
▶ 6:59:52and the whistleblower is not mentioned in Mr. Chairman. I'm talking about the sensitive information of 300 million
▶ 7:00:00and you want to improve that service and that's what the bill is approach to
▶ 7:00:04and how can you improve the service if people's identity has been breached how can you do that Mr. Mr. Chairman,
▶ 7:00:14how can the underlying bill achieve
▶ 7:00:15we recognize the people's identity has already been breached over the years?
▶ 7:00:19this is the largest breach in US history. You're going to talk about some breach in 2024. This is the breach that just happened this year.
▶ 7:00:28U Mr.
▶ 7:00:29and there's a whistleblower report that will allow this committee to do its job. We have a job here. I was a I don't work for the federal government. I work for 750,000 people in Nevada who elect me to do a job and my constituents seniors who rely on their social security.
▶ 7:00:48It's very good that you work for the individuals in your district that you want to represent. The the issue
▶ 7:00:53I do represent and I'm here to fight on their behalf. I'm not going to be silenced. I'm not going to deny my colleagues from having their amendments to be considered. I'm not going to be talked down to or shouted over. I you will be this amendment considered. We all should be manners of following decorum. I mean this is a committee that has been mentioned before is in the constitution.
▶ 7:01:20It's the longest serving committee in Congress and we should talk about the issues at hand and not just
▶ 7:01:25the issues at hand is that this is the largest data breach in US history that there's a whistleblower who is information's time brought before this committee. Gentleman's time is that has jurisdated over social security. They want to silence us. They don't want the truth to come forward. What are they hiding? Why don't they want this information to be released?
▶ 7:01:49I'm ready to rule. The amendment's not germaine. Point of order is sustained. The amendment's not in order. All right. The question is on agreeing to the amendment offered by the gentleman from Connecticut, Mr. Larson. All those in favor signify by saying
▶ 7:02:10All those opposed.
▶ 7:02:14Oh, never mind. If it's not in order, I I retract that because if it's not Germaine, we won't vote on the amendment. I apologize, Mr. Larson, for misusing that.
▶ 7:02:25Well, every now and again you make an honest mistake.
▶ 7:02:27Yeah. Thank you, sir. Yeah. All right. Um are there any additional amendments? If there's no further amendments, question in the adoption of the nature amendment and the nature of the substitute. All those in favor sign.
▶ 7:02:47You have another amendment.
▶ 7:02:48Yes, I do.
▶ 7:02:50All right. Will the gentleman suspend while the amendments passed out?
▶ 7:02:55Mr. Chairman, I move.
▶ 7:03:02Mr. Chairman, I I reserve a point of
▶ 7:03:04Thank you.
▶ 7:03:59Are you amazing? All right, gentlemen, proceed.
▶ 7:04:07Well, thank you, uh, Mr. Chairman, but I can't help but uh acknowledge and thank my colleague from It's rare in a body when people speak truth to and do so with such fervor and eloquence. It's a pretty simple.
▶ 7:04:37It's a pretty pretty pretty pretty simple
▶ 7:04:44to call people before us who have stolen data, placed it in a and have made 300 million Americans our amendments are ruled There's no discussion.
▶ 7:05:13I asked the chair, we called doge before us? Mr. Chairman, do you want to respond? So the answer is no. I asked my colleagues on the other side, are you going to will you call Doge before us?
▶ 7:05:36So, I I can respond. Do you have any comments on your amendment?
▶ 7:05:39Yes, I do.
▶ 7:05:39Um, okay. I appreciate that.
▶ 7:05:42Yeah. Well, uh, we also want to ask you if you'll uh join with us so that we return the staffing levels. There's great concern here today about Social Security, but very little about the 7,000 employees that were cut off. that were eliminated. Look, I've been saying this for months and months and years.
▶ 7:06:10If you're out to privatize Social Security, just say it. Don't Well, where's your bill then? I'm not going to stop. I'll tell you for the same reason the gentleman the point he raised before as well. We have over 70 million people that rely on social security. We are the committee of cognizance.
▶ 7:06:39It hasn't been enhanced in more than 54 years. There are 10,000 baby boomers a day that become eligible for social security. And you guys laugh and smile and wonder why we're upset. Go ahead, laugh and smile. Tell your constituents that.
▶ 7:06:59You can be as smug as you want up here and as a majority, you can prevent us legislatively from calling these issues to a vote, but the American people know what's going on here.
▶ 7:07:14This is a blatant attempt by the Trump administration to privatize Social Security that stops, as was pointed out before by my colleague, by dealing with the brand, by trying to dismantle Social Security from within. That's why they laid off 7,000 employees. What other agency in the federal government has an administration administrative cost of under 1%?
▶ 7:07:44There's no one in the private let alone the public sector that even remotely comes close to that and also ensures over 70 million Americans. It's your citizens, it's your fellow Americans that are at risk here.
▶ 7:08:05and why I ask in this amendment in a very simple manner to restore the staff at SAA so they can actually do their job. Or maybe you'll go home and tell them that no, we've got it all covered. We have AI that's stepping in for us that's going to take over that spot. Close more regional offices.
▶ 7:08:28Language on it.
▶ 7:08:29Do away with more staff. Have a phone service that doesn't work. How about a human being on the other end of the And how about we do something very simple here? How about we just have a on our proposal
▶ 7:08:51to enhance Social Security for the first time in 54 I yield back.
▶ 7:09:09All right. There's a amendment before us. Uh are there is there discussion on the amendment? Mr. Hearn.
▶ 7:09:14Thank you, Mr. Chairman. Mr. Chairman, uh my Democrat colleagues um seem to be scaremongering our seniors to score political points, but the facts are not on their side because let's give the Social Security administration some due credit here. They're serving more Americans than ever. In July, they successfully served over 5.2 million individuals over the phone alone. That is 2 million more Americans served than during the same period in the Biden administration.
▶ 7:09:43They also shortened the field office wait times by nearly 30% compared to last summer. Disability claims weight times were rising before President Trump took office, but now have fallen by over 20 days since the beginning of this year. Under President Trump, the Social Security admin administration is now more accessible than ever to its customers with expanded online service hours, increased self-service options, and a more reliable phone system. I yield back.
▶ 7:10:14Is there other debate on the amendment? Seeing none, the question is on agreeing to the amendment offered by Mr. Larson. All those in favor signify by saying
▶ 7:10:31Those opposed, no.
▶ 7:10:33In opinion of the chair, the nos have it. I
▶ 7:10:36ask for recorded vote. Mr.
▶ 7:10:38Recorded votes been called for. Clerk will call the role.
▶ 7:10:42Mr. Buchanan,
▶ 7:10:43Mr. Buchanan, no. Mr. Smith of Nebraska,
▶ 7:10:47Mr. Smith of Nebraska, no.
▶ 7:10:49Mr. Kelly,
▶ 7:10:50no. Mr. Kelly, no. Mr. Schwikert. Mr. Le Hood. Mr. Arrington. Mr. Arrington. No. Mr. Estus.
▶ 7:11:05Mr. Estus. No. Mr. Smucker. Mr. Smucker. No. Mr. Hearn. Mr. Hearn. No. Mrs. Miller. Mrs. Miller. No. Dr. Murphy.
▶ 7:11:18Thank you. Mr. Kristoff.
▶ 7:11:22Mr. Kristoff. No.
▶ 7:11:25Mr. Fitzpatrick.
▶ 7:11:27Mr. Fitzpatrick. No. Mr. Stwie.
▶ 7:11:30Mr. Stwie. No. Miss. Tenny. Miss. Tenny. No. Miss. Fishbach. Miss Fishbach. No. Mr. Moore. Mr. Moore. No. Miss. Van. Miss. Van. No. Mr. Fenstra. Mr. Fenstra. No. Miss Malotakus. Miss Malotakus. No. Mr. Carrie. Mr. Carrie. No. Mr. Yakam. Mr. Yakam. No. Mr. Miller.
▶ 7:12:01Mr. Miller. No. Mr. Bean.
▶ 7:12:04Mr. Bean. No. Mr. Moran.
▶ 7:12:07Mr. Moran. No. Mr. Neil. Mr. Neil. Yes. Mr. Dogget. Mr. Mr. Dogget. Yes. Mr. Thompson. Mr. Thompson. Yes. Mr. Larson. Mr. Larson. Yes. Mr. Davis. Mr. Davis. Yes. Miss Sanchez. Miss Su. Miss. Delben. Miss Delben.
▶ 7:12:38Yes. Miss
▶ 7:12:40Miss. Chu. Yes. Miss. Moore. Miss. Moore. Yes. Mr. Boille.
▶ 7:12:46Mr. Boille. Yes, Mr. Byer.
▶ 7:12:50Mr. Byer. Yes, Mr. Evans.
▶ 7:12:53Mr. Evans. Yes, Mr. Schneider. Mr. Panetta, Mr. Gomez,
▶ 7:13:04Mr. Gomez. Yes, Mr. Horseford. Mr. Horford. Yes, Miss Plask.
▶ 7:13:11Miss Plasket. Yes, Mr. Swazy. Mr. Schwikert. Mr. Schwikert. No. Mr. Le Hood. Dr. Murphy, Miss Sanchez, Miss Su, Mr.
▶ 7:13:41Schneider, Mr. Panetta Mr. Schwis. Chairman Smith. Chairman Smith. No.
▶ 7:14:36clerk will report the vote.
▶ 7:14:40The yeses are 14 and the nos are 24.
▶ 7:14:45There being 14 yeses and 24 nos, the amendment is not agreed to. Are there any additional amendments? If there are no further amendments, the question is on the adoption of the amendment in the nature of the substitute. All those in favor signify by saying yes.
▶ 7:15:07All those opposed, no.
▶ 7:15:10In the opinion of chair, the yeses have it and the amendment in the nature of the substitute is agreed to. I'll now recognize Mr. McKennon for the purpose of offering a motion.
▶ 7:15:18Mr. Chairman, I move the committee favorably report HR 305 5345 as amended to the House of Representatives.
▶ 7:15:26The question is on the motion to favorably report HR 5345 as amended to the House of Representative. The clerk will call the role.
▶ 7:15:36Mr. Buchanan,
▶ 7:15:37Mr. Buchanan, yes. Mr. Smith of Nebraska. Mr. Smith of Nebraska, yes. Mr. Kelly, Mr. Kelly, yes. Mr. Mr. Mr. Le Hood Mr. Arrington Mr. Arrington yes Mr.
▶ 7:15:57Mr. Estess Yes Mr. Smucker Mr. Smucker yes Mr. Hearn Mr. Hearn yes Mrs. Miller Mrs. Miller yes Dr. Murphy Mr. Kustoff yes
▶ 7:16:13Mr. Kustoff yes Mr. Fitzpatrick. Mr. Fitzpatrick. Yes. Mr. Stwie.
▶ 7:16:20Mr. Stewie. Yes. Miss. Tenny. Miss. Tenny. Yes. Miss. Fishbach.
▶ 7:16:27Miss. Fishbach. Yes. Mr. Moore. Mr. Moore. Yes. Miss. Van. Miss. Van. Yes. Mr. Fenstra. Mr. Fenstra. Yes. Miss. Miss. Maliaakis. Yes. Mr. Carrie.
▶ 7:16:44Mr. Carrie. Yes, Mr. Yakam. Mr. Yakam. Yes, Mr. Miller. Mr. Miller. Yes, Mr.
▶ 7:16:54Mr. Bean. Yes, Mr. Moran.
▶ 7:16:58Mr. Moran. Yes, Mr. Neil. Mr. Neil, yes, Mr. Dogget. Mr. Dogget. Yes, Mr.
▶ 7:17:09Mr. Thompson. Yes. Mr. Larson. Mr. Larson. No, Mr. Davis. Mr. Davis. Miss Sanchez. Miss Su. Miss. Doen. Miss Oenet. Yes. Miss Chu.
▶ 7:17:37Miss Chu. Yes. Miss Moore. Miss Moore. Yes. Mr. Bole. Yes,
▶ 7:17:44Mr. Boille. Yes, Mr. Byer. Mr. Byer. Yes, Mr. Evans.
▶ 7:17:51Mr. Evans. Yes, Mr. Schneider.
▶ 7:17:54Mr. Schneider. Yes, Mr. Panetta. Mr. Gomez,
▶ 7:18:01Mr. Gomez. Yes, Mr. Horford. Mr. Horford. Yes. Miss Plask. Miss Plask. Yes. Mr. Swasy. Mr. Swazy. Yes. Mr. Schwikert. Mr. Schwikert. Yes. Mr. Le Hood. Dr.
▶ 7:18:24Murphy, Miss Sanchez, Miss Su, Mr. Panetta. Chairman Smith. Chairman Smith. Yes.
▶ 7:19:18clerk will report the vote.
▶ 7:19:20The yeses are 39 and the nos are one. There being 39 yeses and one no, the motion is agreed to and HR 5345 as amended is ordered favorably reported to the House.
▶ 7:19:35Without objection, I ask that staff be authorized to make technical and conforming changes to HR 40 5345 and that members have two additional days to file with the committee clerk supplemental, additional, dissenting, or minority next order of business is HR5348,
▶ 7:20:06the Social Security Child Protection Act for 2025. A bill led by Representative Representative Smucker. This legislation addresses a problem that far too many families face. the misuse of children's social security numbers due to the loss or theft of a social security card. Every year, more than a million children become victims of identity fraud.
▶ 7:20:33Current SSA policy makes it extremely difficult for families to get a new social security number for a child, even when the original number was compromised through no fault of their own. As previously mentioned, we heard direct testimony from a mother who had to battle with the Social Security Administration when her infant child social security number was compromised and she was denied a new number. This is a straightforward solution that will help protect children from a lifetime of financial harm.
▶ 7:21:03I urge my colleagues to support this bill as they did last Congress by a committee vote of 43 to0 so we can continue to stand together to better safeguard the identities of America's kids. I'm pleased to recognize the gentleman from Pennsylvania, Mr. Smucker for an opening statement.
▶ 7:21:21Thank Thank you, Mr. Chairman, again for uh bringing this bill up for consideration. Um there are uh in 2022 roughly 1.7 million children who were the victims of identity fraud and the the uh current standard for reissuing a social security number is the child must have been victimized by actual fraud.
▶ 7:21:44So what happens is they may be aware that the number was stolen but or they may not be aware I should say uh for years and down the road when they go to open an account or um do some other business that that um requires a social security number they find that there's been a long-standing fraud occurring.
▶ 7:22:03And so we want the Social Security Administration to uh change the point at which they would be issuing um uh a new card, a new number. And that is when they learn and verify that the number has been stolen or if the card if it's been lost, if the card's been lost. And so, uh, this bill would require the social security to issue a new different social security number, uh, as soon as it's verified as lost or stolen.
▶ 7:22:33Um, so again, Mr. Chairman, as you had mentioned as well, this this is a bill that was passed out of the committee in the last session of bipartisan support. Um, it's a great bill. It's about, uh, protecting, uh, kids. So, I ask uh Oh, and by the way, I have um I'd like to submit for the record uh two letters, one from ARP and one from AAC uh indicating their support for the bill.
▶ 7:23:00Without objection.
▶ 7:23:01Thank you. And I ask uh for members consideration and supporting yes for this bill. Thank you, Mr. Chairman.
▶ 7:23:07Thank you. I now recognize the ranking member from Massachusetts, Mr. Neil, for his opening state.
▶ 7:23:11Thank you. Let me yield my time to the gentleman from Connecticut, Mr. Larson.
▶ 7:23:16Thank you, Mr. Neil. And uh thank you, Mr. chairman and let me commend Mr. Smucker as well and uh the premise of the Social Security Child Protection Act is a good one. I think I and everyone on this committee wants to protect children from identity theft as I'm sure everyone on this committee uh agrees. No one should have their identif identity or financial well-being jeopardized by bad actors.
▶ 7:23:47Social Security is the number one anti-O poverty program for the elderly and it's also the number one anti-poverty program for children until of course we renew the expanded child tax credit. Social Security alone lifts more than 900,000 children out of And yet Congress hasn't enhanced it in more than 54 years.
▶ 7:24:16If this was really about protecting children's social security benefits, we would be discussing our plan to protect Social Security from Trump's privatization scheme. And we would be expanding benefits, not handing them over to an unvetted, so-called Doge.
▶ 7:24:41Since President Trump took office, 7,000 staff have been cut from Social Is there even going to be anyone left to issue these numbers to children who have been impacted? Or will it be outsourced to AI chatbots? And what about Doge's meddling with data at Social Security?
▶ 7:25:08While I support the effort this bill is attempting to make and was proud to support it before, I cannot vote for it in the current form knowing that it does nothing to address the data being put at risk as at social security as we speak. We need answers and accountability from Doge and Social Security.
▶ 7:25:31They may say that everything is safe and secure for now, but I want to have them come before this committee and tell me under oath. I would think that everyone on this committee would want that. We cannot afford to play it safe.
▶ 7:25:49The American people deserve to see their elected officials taking action and acting and asking all the tough questions and protecting their benefits and information from abuse. I've been sounding the alarm on this issue for months and introduced a bill in March blocking doge from accessing Americans data at social security.
▶ 7:26:17That's why I'm introducing it as an I implore all of my colleagues to join me in this effort to block those from accessing their constituents I yield back. The committee will now proceed to consideration of HR5348, the Social Security Child Protection Act of 2025.
▶ 7:26:47Without objection, the measure will be considered as read and open for amendment at any point. At this time, I offer an amendment in the nature of a substitute, which was distributed in advance along with a green sheet explaining it. Without objection, the amendment in the nature of a substitute shall be considered as read, open for amendment at any point, and considered base text for purpose of amendment. I will now turn to Ben Ritter, tax and social security policy adviser to provide the technical description of the amendment and the nature of a substitute with an emphasis on the changes made since introduction.
▶ 7:27:17I ask that members hold their questions until after's Chairman Smith, ranking member Neil, and members of the committee. As introduced by Representative Smucker of Pennsylvania, HR 5348 would require the Social Security Administration to issue issue a new social security number or SSN to any child under the age of 14 when that child's parent or guardian demonstrates that the child's social security card has been stolen or lost while being mailed
▶ 7:27:47by the Social Security Administration to his or her address. As described on the green sheet distributed yesterday, the amendment in the nature of a substitute makes a technical change replacing a reference to the social social security card with a social security card. Thank you, Mr. Chairman, ranking member Neil, members of the committee. This concludes my walkthrough and I welcome any questions related to the technical nature of the amendment and the nature of a
▶ 7:28:15Thank you. Are there any technical questions about the amendment and the nature of a substitute? Seeing none, does anyone wish to strike the last word?
▶ 7:28:26Mr. Smucker.
▶ 7:28:29Thank you, Mr. Chairman. I just wanted to respond to uh Mr. Larson's comment. If I heard them correctly, he heard him correctly. He said he would not be supporting the bill. U which I I'm disappointed in. I find that unfortunate unfortunate. He mentioned it was because of Doge. And I want to remind him that he not only voted for this bill, I think he supported in or he he spoke in support of the floor uh of the bill on the House floor.
▶ 7:28:57Um and that was during the Biden administration when when Biden was president and during that his presidency, the Social Security weight uh leng time length of people waiting uh to call into the administration for uh you know, we all had it in our districts. um we we saw weight periods have come down significantly um since then. That was true for initial social security and disability decisions as well.
▶ 7:29:24Um so uh you know I don't understand why Mr. Larson would have been willing to vote for the bill at that point but uh not now when Social Security is running better than it was during the Biden administration. do you yield back? Yo back, Mr. Chairman. Sorry,
▶ 7:29:46Mr. Mr. Neil.
▶ 7:29:47Yeah. So, to the gentleman's point, I don't think it's necessary to impugn the integrity of the individual who decided to change their vote. There are always attending circumstances. There are speeches that are made on the House floor. People come back and alter based upon perhaps additional information or qualifying information.
▶ 7:30:08Not yet. And why the reference to the Biden 7,000 employees have been laid off. There is a legitimate query that Mr. Larson and others have raised about the role that Doge has played in this. That's something that the committee ought to attend to. But to suggest that somehow Mr.
▶ 7:30:29Larson who has changed his position on this because questions that he has raised have not been answered would not be unlike what happens in this institution every single day when members seek additional information they find qualifying data they come across evidence perhaps a hearto for had not been offered why if the gentleman just wished to say I don't understand why Mr. Larson has changed his position on this. That would have been enough.
▶ 7:31:00Would a gentleman yield?
▶ 7:31:04Additional members wish to strike the last word. Mr. Hearnd.
▶ 7:31:10Mr. Chairman, I'd like to yell my time to Mr. Smucker. Respond.
▶ 7:31:16I just want to say I I appreciate the ranking members comment. I did not impugn the res uh the reputation of Mr. Larson. didn't um mean to do that if it came across in that way. That's not what was intended. I just simply said that I was disappointed uh that that decision had been made. Uh and I was uh just simply pointing out that when he last voted for it, the situation of the Social Security Administration was worse than it is now despite what he's saying about Doge.
▶ 7:31:45And so I was just disappointed this we should all be interested in protecting uh kids. Um, and it was disappointing to me that this was done unanimously and I heard from Mr. I was surprised that uh at least one member of the Democrat side will not be supporting this bill.
▶ 7:32:04Thank you.
▶ 7:32:05I go back.
▶ 7:32:06Additional members uh strike the last Seeing none, we will move to amendments. Are there amendments to the bill? Mr. Mr. Chairman, I reserve a point of
▶ 7:32:24A point of order has been reserved. Will the gentleman suspend while the amendments distributed?
▶ 7:32:48Proceed. Uh thank you, Mr. Chairman. Mr. Chairman, uh my amendment would uh strip Doge of Social Security's uh Uh the gentleman asked why I would uh change my vote from last this year.
▶ 7:33:16And uh if I haven't made it clear yet today, then let me be very clear about it that I think what's happening at the Social Security Administration is an That I think laying off 7,000 employees.
▶ 7:33:42that I think that when we have a situation where five million of our fellow Americans get below poverty level checks from a government that's the wealthiest in the world and a committee can't even call before the very people that have been placed
▶ 7:34:12there by this administration to steal information and place it in a cloud. Now, if you've got information on if you've got facts that dispute that, well, then let's have them here under oath and tell us.
▶ 7:34:42That's what I'm upset about and I think needs and deserves to be addressed. Now, if you guys don't agree with that, But that's what upsets me to the core. And that's why even on something as important as this and a bill that I supported, why can't support it now?
▶ 7:35:13Not only are those children's identities at risk, but 300 million Americans identities are at risk. And if we don't ask the tough questions, if we don't have them before this committee, who will? Or I guess it's that we're just supposed to take President Trump's word for it.
▶ 7:35:44Maybe it's time that we ask Elon Musk It really disturbs me that people feel that they're above the and aren't answerable to the United States Congress and don't have to come before this committee.
▶ 7:36:10and even more disturbing that this committee would not demand that they do so. I uh think this amendment is important.
▶ 7:36:33I believe that DOE should be stripped of duties that it's done and how it's hurt the American people and how it's put so 300 million people's information is jeopardized and if you choose not to act on that so be it.
▶ 7:37:03Uh that's your prerogative. You're in the majority. You have the presidency in both houses. We understand that. I have my own suspicions and have made that very clear that I think this is all part and parcel of an attempt to privatize Social Security again. And so, Mr.
▶ 7:37:32Chairman, with that I yield back.
▶ 7:37:36Further discussion on the amendment. Seeing none, um the question seeing none, um the question is on agreeing to the amendment offered by Mr. Larson. The clerk will call the role.
▶ 7:37:52Mr. Buchanan.
▶ 7:37:55Mr. Buchanan, no. Mr. Smith of Nebraska,
▶ 7:37:59Mr. Smith of Nebraska, no. Mr. Kelly,
▶ 7:38:03Mr. Kelly, no. Mr. Schwikert,
▶ 7:38:06Mr. Schwikert, no. Mr. Le Hood,
▶ 7:38:10Mr. Le Hood, no. Mr. Arrington, Mr. Estus, Mr. Estus, no. Mr. Smucker. Mr. Smucker. No. Mr. Hearn. Mr. Hearn. No. Mrs. Miller. Mrs. Miller. No. Dr. Mr. Kustoff. Mr. Kustoff. No. Mr.
▶ 7:38:37Mr. Fitzpatrick. No. Mr. Stwie. No.
▶ 7:38:41Mr. Stwie. No. Miss Tenny. Miss. Tenny. No. Miss. Fishbach. Miss. Fishbach. No. Mr. Moore. Mr. Moore. No. Miss. Van. Miss. Van. No. Mr. Fenstra. Mr. Fenstra. No Miss Malotakus. Miss Malotakus. No Mr. Carrie. Mr. Carrie. No Mr. Yakam. Mr. Yakam. No Mr. Miller.
▶ 7:39:12Mr. Miller. No Mr. Bean. Mr. Moran. Mr. Neil. Mr. Neil. Yes. Mr. Dogget. Mr. Dogget. Yes. Mr. Thompson. Mr. Thompson. Yes. Mr. Larson. Mr. Larson. No. Mr. Davis. Mr. Davis. Yes. Miss Sanchez.
▶ 7:39:43Miss Su. Miss. Delben.
▶ 7:39:49I know.
▶ 7:39:50Miss Delbenai. Yes. Miss Chu.
▶ 7:39:54Miss Chu. Yes. Miss Moore. Miss Moore. Yes. Mr. Boille.
▶ 7:40:02Mr. Boille. Yes. Mr. Byer.
▶ 7:40:05Mr. Byer. Yes. Mr. Evans.
▶ 7:40:09Mr. Evans. Yes. Mr. Schneider.
▶ 7:40:12Mr. Schneider. Yes. Mr. Petta.
▶ 7:40:16Mr. Panetta. Yes. Mr. Gomez.
▶ 7:40:20Mr. Gomez. Yes. Mr. Horford. Mr. Horford. Yes. Miss. Plask. Miss. Plask. Yes, Mr. Swazy.
▶ 7:40:32Mr. Swazy. Yes.
▶ 7:40:36Mr. Chairman, how Oh, I'm sorry.
▶ 7:40:39Go ahead.
▶ 7:40:40How have I been recorded?
▶ 7:40:42How is Mr. Larson recorded?
▶ 7:40:44Mr. Larson is a no.
▶ 7:40:46Should have been a yes.
▶ 7:40:50Mr. Larson, yes. Mr. Arrington,
▶ 7:40:55Mr. Mr. Arrington. No. Dr. Murphy. Mr. Bean.
▶ 7:41:07Mr. Bean. No. Mr. Moran.
▶ 7:41:10Mr. Moran. No. Miss Sanchez. Miss Su.
▶ 7:41:26Chairman Smith.
▶ 7:41:27Chairman Smith. No.
▶ 7:41:42Clerk will report the vote. The yeses are 17 and the nos are 25.
▶ 7:41:49There being 17 yeses and 25 nos, the amendment is not agreed to. Are there additional amendments?
▶ 7:41:57Seeing none, the question is on the adoption of the amendment in the nature of a substitute. All those in favor signify by saying I. I.
▶ 7:42:05Those opposed say no. In the opinion of the chair, the eyes have it and the amendment in the nature of a substitute is agreed to. I will now recognize Mr. Buchanan for the purpose of offering a
▶ 7:42:15Mr. Chairman, I move the committee favorably report HR 5348 as amended to the House of Representatives.
▶ 7:42:22The question is on the motion to favorably report HR 5348 as amended to the House of Representatives. The clerk will call the role.
▶ 7:42:30Mr. Mr. Buchanan,
▶ 7:42:32Mr. Buchanan, yes. Mr. Smith of Nebraska. Mr. Smith of Nebraska. Yes. Mr. Kelly,
▶ 7:42:41Mr. Kelly. Yes. Mr. Schwikert. Mr. Schwikert. Yes. Mr. Leood. Mr. Le Hood. Yes. Mr. Arrington. Mr. Arrington. Yes. Mr. Estus. Mr. Estus. Yes. Mr. Smucker. Mr. Smucker. Yes. Mr. Hearn. Mr. Hearn. Yes. Mrs. Miller. Mrs. Miller. Yes. Dr. Murphy. Mr.
▶ 7:43:11Kustoff.
▶ 7:43:13Mr. Mr. Kristoff. Yes. Mr. Fitzpatrick.
▶ 7:43:17Mr. Fitzpatrick. Yes. Mr. Stwie.
▶ 7:43:21Mr. Stwie. Yes. Miss Tenny. Miss Tenny. Yes. Miss Fishbach. Miss Fishbach. Yes. Mr. Moore.
▶ 7:43:30Mr. Moore. Yes. Miss Vanine. Miss Vanine. Yes. Mr. Fenstra. Mr. Fenstra. Yes. Miss Malotakus. Miss Malotakus. Yes. Mr. Kerry. Mr. Kerry. Yes. Mr. Yakam. Mr. Yakam. Yes. Mr. Miller.
▶ 7:43:51Mr. Miller. Yes. Mr. Bean.
▶ 7:43:55Mr. Bean. Yes. Mr. Moran.
▶ 7:43:58Mr. Moran. Yes. Mr. Neil. Mr. Neil. Yes. Mr. Dogget.
▶ 7:44:05Mr. Dogget. Yes. Mr. Thompson. Mr. Thompson. Yes. Mr. Larson. Mr. Larson. No. Mr. Davis.
▶ 7:44:16Mr. Davis. Yes. Miss Sanchez. Miss Su. Miss. Doen. Miss. Doen. Yes. Miss. Chu. Miss. Chu. Yes. Miss. Moore.
▶ 7:44:33Miss. Moore. Yes. Mr. Boille.
▶ 7:44:36Mr. Boille. Yes, Mr. Byer.
▶ 7:44:40Mr. Byer. Yes, Mr. Evans.
▶ 7:44:43Mr. Evans. Yes, Mr. Schneider.
▶ 7:44:47Mr. Schneider. Yes, Mr. Petta.
▶ 7:44:50Mr. Panetta. Yes, Mr. Gomez.
▶ 7:44:54Mr. Gomez. Yes. Mr. Horford. Mr. Horford. Yes. Miss Plask. Miss Plask. Yes. Mr. Swazy. Mr. Swazy. Yes. Dr. Murphy. Dr. Murphy. Yes. Miss Sanchez.
▶ 7:45:17Miss Su.
▶ 7:45:18Miss Su. Yes.
▶ 7:45:22Chairman Smith.
▶ 7:45:24Chairman Smith. Yes.
▶ 7:45:30The clerk will report the vote. The yeses are 45 and the no are 44 and the nos are one.
▶ 7:45:41There being 44 yeses and one no, the motion is agreed to and HR5348 as amended is ordered favorably reported to the house. Without objection, I ask that staff be authorized to make technical and conforming changes to HR 5348 and that members have two additional days to file with the committee clerk supplemental additional dissenting or minority views. Our final order of business today is consideration of the Ways and Means Committee budget views and estimates for fiscal year 2026.
▶ 7:46:09As someone who once led Republicans on the budget committee, I understand this is more than just a procedure step. It is a chance for this committee to set the tone for the year ahead to make clear where we stand and um and where we are headed.
▶ 7:46:24This committee has done important work to clear the backlog of expired authorizations under our jurisdiction, including the first reauthorization and reforms of important child welfare programs in almost 20 years through the Supporting America's Children and Families Act. We will continue that work in fiscal year 2026. I hope to work together with my colleagues across the aisle this year to advance solutions to key priorities.
▶ 7:46:50We will consider policies targeted at improving health outcomes and access to care in rural and underserved communities as well as policy solutions to lower cost for Americans across the board through increased choice, transparency, and competition while modernizing and personalizing health care. These reforms, like the ones this committee approved today, will help Americans live healthier lives and reduce the burdens chronic disease is putting on the long-term fiscal health of our healthcare system.
▶ 7:47:21In addition to providing oversight of state unemployment insurance programs to combat waste, fraud, abuse, and inefficiencies, the committee has laid the foundation for upcoming reauthorizations in the work and welfare subcommittee space through numerous hearings and site visits. We will also work to ensure seniors and disabled workers can count on Medicare and the Social Security remain strong for those who currently rely on the program to make ends meet as well as generations of future retired and disabled workers.
▶ 7:47:50The committee will continue to prioritize tax policies that support American workers, families, farmers, and small businesses, as well grow our economy to the benefit of all. We will work to improve the effectiveness of US trade laws, to address unfair trade practices, and demand a level playing field from our trading partners for American farmers, ranchers, and manufacturers.
▶ 7:48:12We will continue to oversee trade negotiations and protect the constitutional role of Congress to defend American jobs and producers, open new markets, ex especially for US agriculture, and increase economic opportunity for all Americans. I want to thank my colleagues for their dedication to the work of this committee, including our important oversight responsibilities. Together, we will continue to put American workers, families, farmers, and job creators first. I'm pleased to recognize the ranking member from Massachusetts, Mr.
▶ 7:48:40Thank you. After our well done bipartisan dinner, I think we are reminded of what actually happens in this room. It's where Medicare and Medicare Medicare and Medicaid were born, where the promise of Social Security was drafted. It's within these walls that we took leaps to make sure the Affordable Care Act passed, the Civil War was financed, and the 1986 Tax Act was constructed.
▶ 7:49:04This is the room that moved us through the pandemic better than any country on earth, and our rebound was much better than the rest of the world. We can still do big things in this committee and I hope that will lift the American people from poverty and the opportunity to afford medicines in many quarters that they need. That's what we as Democrats will insist we continue to do.
▶ 7:49:27Our colleagues have chosen too much to go alone, use their legislative authority that will strip millions from health care, funnel money to people who really weren't asking for it and don't need it. They've abandoned a role by capitulating to a president whose illegal tariffs have turned a blind eye, additionally to Doge, and the people's data is in jeopardy.
▶ 7:49:49I want to say, as the chairman just noted, everybody on this side of the aisle is prepared to restore the congressional role in international trade agreements. That should be a minimal guarantee that we can all This letter outlines the committee's commitment to lowering health care costs, fighting for the uninsured, and pursuing strong and fair trade that protects the American workers. I urge a yes vote and yield back.
▶ 7:50:18Thank you, Mr. Nil. The committee will now proceed to consideration of the Ways and Means Committee budget views and estimates for fiscal year 2026. Without objection, the measure will be considered as read and open for amendment at any point. At this time, I offer an amendment in the nature of a substitute which was distributed in advance along with a green sheet explaining it. Without objection, the amendment in the nature of a substitute shall be considered as read, open for amendment at any point, and considered base text for purpose of amendment. Does anyone wish to strike the last word?
▶ 7:50:49See none.
▶ 7:50:50No, Danny.
▶ 7:50:52Mr. Davis,
▶ 7:50:53thank you, Mr. chairman and and I enjoyed actually reading the letter projecting what we ought to be doing, what we're going to do, what we're going to try to do. I just always remember being told that what you do is a little bit more than what you say. And I think it is said great and I hope that we will do it.
▶ 7:51:22I thank you and yield back.
▶ 7:51:25Additional members wish to strike the last word. Seeing none, are there any amendments? Seeing none, the question is on if there are no amendments, the question is on the adoption of the amendment in the nature of a substitute. All those in signify by saying I.
▶ 7:51:47Those opposed say no. In the opinion of the chair, the eyes have it. and the amendment in the nature of a substitute is agreed to. I will now recognize Mr. Buchanan for the purpose of offering a
▶ 7:51:56Mr. Chairman, I move the committee adopts and transmits the Ways and Means Committee budget views and estimates on fiscal year 2026 budget as amended.
▶ 7:52:07The question is on the motion to adopt the Ways and Means Committee budget views and estimates for fiscal year 2026 as amended. All those in favor signify by saying I. I.
▶ 7:52:16Those opposed say no. In the opinion of the chair, the eyes have it and the amendment in the nature of a substitute is agreed to. Without objection, I ask that staff be authorized to make technical and conforming changes to the views and estimates and that members have two additional days to file with the committee clerk supplemental additional dissenting or minority views. There being no further further business before the committee, the committee stands adjourned.