▶ 0:11:09On that important legislation, but also, um, despite some of our disagreements. Ranking member paul and I found several ways to work together on committee priorities to deliver solutions for the american people. And this is bipartisan is a deep tradition of our committee. I want to thank my colleagues, um, for before us today for coming before the committee to share your ideas and your perspectives and your legislative ideas.
▶ 0:11:32We know the matters you are presenting to the committee are not only important to you, but also to the hundreds of thousands of people you represent. Uh, the committee looks forward to listening and learning from you today as we all work together. Uh, on behalf of the american people, I thank you. And I will recognize vice member of the full committee, representative fletcher, for five minutes for an opening statement. >> thank you, Mr.
▶ 0:11:55Chairman, and welcome to all the members who are joining us this morning here in the energy and commerce committee. This committee, as the chairman said, has a long history of working together to address the issues that matter most to the american people and will make a meaningful difference in their lives.
▶ 0:12:12It's what this committee does at its best, and it's why it's so important that we hear from our colleagues today that represent communities across the country to learn more about what they're hearing and what the people that they represent need from us. I know when I go back home, what I hear most from people in my district are deep concerns about the cost of living, the cost of health care, and the cost of energy and electricity.
▶ 0:12:42In short, we are in a national affordability crisis and people need our help. Addressing rising costs shouldn't be a partizan issue. In fact, on the campaign trail, president trump promised over and over and over again that he was going to lower costs. But nearly a year into this administration, costs are higher than ever. Now, president trump has, I think we all know, recently dismissed affordability as a democratic hoax. But what, from what I'm hearing from my constituents at home, it's not. And it's fear.
▶ 0:13:14Fear that they won't be able to afford their electric bill. Fear that they're not going to be able to keep their health insurance. Fear that they're not going to be able to see a doctor when they need to. Fear that they're not going to be able to afford groceries this christmas, or presents for their families for the holidays, fear that they are not going to be able to do the things that they need to do. This is fear. This is not a hoax. It's people's lives and they need our help.
▶ 0:13:42Unfortunately, much of this congress has been spent making things worse for hardworking american families rather than helping them. We have spent the vast majority of this year addressing budget issues that have made things worse, not better, for families across the country, and have taken away health care from nearly 15 million people, leaving millions more with premiums and costs that they cannot afford.
▶ 0:14:08People need to come together, and they need congress to come together to lower costs with common sense proposals like extending the affordable care act premium tax credits, which would help lower premiums for millions of families. Instead, this congress is choosing to spend its time taking health care away and making it more expensive for those who manage their care to keep their coverage.
▶ 0:14:33Today, we have an opportunity to listen to our colleagues about rising costs and how they're a real threat to american families. And I hope that we will work together, the majority and the minority, to work together to address those concerns, and that no one in congress will dismiss them as a hoax. So I look forward to hearing from the members who are joining us today. And I thank you all for taking the time to be here. And with that, Mr. chairman, I will yield back. >> thank you.
▶ 0:15:02We now conclude with opening statements. And the chair, I would like to remind members that pursuant to the committee rules, all members opening statements will be made part of the record. Uh, we want to thank our fellow members for taking time to testify before the committee. You'll have the opportunity to give a five minute statement. And, uh, I would say from a beautiful part of the country, but all of you from beautiful parts of the country. So I'll just say that for everybody, and I.
▶ 0:15:27And I really mean that because I think I've been to every part of your in this year, as a matter of fact, in your district. So, uh, not your district, but your state's probably, uh, so, representative costa, you're recognized for five minutes. Well, thank you very much, Mr. chairman. Um, guthrie and ranking member fletcher for your your comments. And, uh, to follow on that opening, uh, three pieces of legislation I will speak to you on are bipartisan pieces of legislation.
▶ 0:15:51And I think they deal with america's safety net and affordability, uh, because every american feels near and dear to ensure that they have adequate and cost effective health care that's accessible to them and their families. I mean, as my mother used to say, jim, if you don't have health, you don't have anything. Um, the first piece of legislation is a touching one for me and my staff. H.r. 5355. Uh, ian. Uh, calvin. Calvin. Uh, legislation.
▶ 0:16:23It deals with pediatric liver cancer and early detection and screening act and expanding the medical education act. Uh, is the second piece of legislation. And the third piece of legislation is the national plan for epilepsy. This follows in the effort of preventive health care for eons. Uh, piece of legislation is personal. Uh, he came into our offices an intern, uh, from ucla with all sorts of aspirations and optimism.
▶ 0:16:52But as a earlier child, he was diagnosed with liver cancer. As a young teenager, he survived thanks to a life saving liver transplant. Unfortunately, the cancer returned a few years later. But ian cared deeply about giving back, and while he was sick, he took an opportunity to be an intern in our office here at capitol hill, he said. I want to make a difference now.
▶ 0:17:16And he used his time here to advocate for early diagnosis and treatment for children with liver diseases. Sadly, ian passed away, uh, during his time as an intern in my office this last summer at the tender age of 20 years. Um, this bipartisan bill, which I lead with congresswoman van dine, honors his courage and advances the reforms he fought for.
▶ 0:17:38It would direct health resources and services administration hrc, with input from centers for disease control and prevention, cdc to lead a national public education effort to recognize early warning signs and understand the options like living liver donations, which are critical.
▶ 0:17:57Uh, it also would require government accountability office to review the pediatric liver waitlist outcomes and value the adding of liver screening to state of newborn screening panels. This would use existing resources at the department of health and human services. That is the first piece of legislation for named, appropriately, after this young intern who had so much inspiration and hope. Uh, the second piece of legislation, h.r. 2106, expands the medical education act.
▶ 0:18:27The medical education act responds to physician shortages that we have throughout our country and underserved areas. All the members, I suspect, of this committee have challenges in their own constituencies with a shortage of physicians, especially in our rural and underserved areas. The san joaquin valley, one of those areas, has the lowest supply of doctors in california, where we have 47 doctors per 1000 100,000 residents. That's way below the national average.
▶ 0:18:57This bill would provide grants to health resources and services administration, hrsa to help establish and expand medical schools and underserved communities in areas where there is no medical school and a minority serving institution, so we can train more doctors where we need them and where they're more likely to stay. We are in that process of establishing a new medical school in the san joaquin valley for that very reason. H.r. The last measure, h.r.
▶ 0:19:231189, the national plan for epilepsy act, is another bipartisan piece of legislation, a plan for epilepsy, which I lead with congress member greg murphy, uh, who he and his family have have had their own experiences with epilepsy. As many of us know, family and friends. This responds to a condition that affects 3.4 million americans. For too many patients, current treatments do not work and the federal response is fragmented.
▶ 0:19:51This would attempt to correct that the bill would direct the secretary of health and human services to create and maintain a coordinated national plan for epilepsy, guided by a national epilepsy advisory council that brings together federal agencies, clinicians, researchers, advocates and people living with epilepsy to set goals, track progress, and get the most out of every federal dollar, which I think we all share in common for preventive health care maintenance, which is really what these three pieces of legislation are all about.
▶ 0:20:20Let me close by saying the three efforts have a common purpose to give every family a fair shot, whether that's living with cancer detection, being able to see a doctor close to home or living with epilepsy, and hopes of having better care. Mr. chairman, I also submitted written testimony to support h.r. 1395, the third act, with the attached idph, a letter of support. I respectfully ask that they be included in the record with unanimous consent as a part of today's proceedings.
▶ 0:20:50That is my presentation. Mr. chairman, members of the committee, thank you for your good work and certainly would appreciate your support on all these pieces of legislation. >> thank you. Without objection. So ordered for the inclusion. And I said, I've been all states. You were my 50th state and I went to 49th. Miss salinas, representative salinas, and you were my 50th. So beautiful places. So representative, you recognize for tokuda. I'm sorry for five minutes for opening statement. >> thank you. Aloha. Mr. chair.
▶ 0:21:20Miss fletcher, members of the committee, thank you for hosting this member day hearing in the house energy and commerce committee. As the co-lead of the bipartisan rural health caucus. My colleague diana harshbarger serves on this committee. I know I saw her a little bit. I can tell you that rural america is at a breaking point from hawaii's neighbor islands to small towns across the country, families are driving hours for basic care, clinics are shuttering, and providers are stretched past their limits.
▶ 0:21:47When a rural hospital closes, as we know it isn't just a health care loss, it literally guts an entire local economy, drives families away, and threatens the future of their communities. Rural health care for us is not an option. It is absolutely essential. It's the infrastructure that keeps rural america alive. And our communities, quite frankly, cannot wait any longer. We need action that reflects the urgency and scale of the crisis before us.
▶ 0:22:14That starts with the people, to me, on the front lines that show up for everyday americans in rural america. This week I introduced the bipartisan care for first responders act to expand access to specialized support for emts, firefighters, law enforcement officers, 911 dispatchers, and others who are often the only responders available in rural america and across the country during emergencies. In rural communities, they are on the front lines, and sometimes they are the only lines of help.
▶ 0:22:41If we fail to take care of those who take care of us, rural health care collapses before the patient even gets to a hospital. We also need to give rural providers the flexibility to actually serve their communities. The rural health clinic burden reduction package, which I co-introduced with tracey mann of kansas, removes outdated restrictions, modernizes supervision rules to reflect today's scope of practice standards, and empowers clinics to offer the full range of primary and behavioral health services.
▶ 0:23:11These reforms mean faster care, broader access, and fewer families forced to leave home just to see a provider. You know, in hawaii, distance is a barrier in itself, where a routine appointment can sometimes mean taking an airplane to get to where you need to go. My patch act corrects chronic medicare underpayments so providers are compensated fairly. And by ensuring outpatient quality for rural states.
▶ 0:23:35At co-led by nick begich, gives cms the authority to account for the higher cost of care in remote states like hawaii and alaska. If we don't fix the formula, we will continue losing providers faster than we can recruit them. We must also protect the programs that are holding rural health care together. Today, many of the hhs extenders advanced by this committee are set to expire next month.
▶ 0:24:02Letting them lapse would be absolutely devastating and avoidable blow that would accelerate clinic closures and deepen shortages. That's why I co-lead with carol miller of west virginia, the bipartisan reauthorization of the rural residency and planning development act, the single most effective tool we have to train, recruit and retain rural providers. And none of this works to me. Without telehealth, rural patients cannot afford uncertainty about virtual or audio only care. I co-lead the health act with g.t.
▶ 0:24:31Thompson to make these authorities permanent for fqhcs and rural health clinics, so that distance never determines whether a patient can be treated, whether they live on a remote island, up a mountain road or hours from the nearest doctors. They deserve care. Now, I know these bills won't solve every challenge that we face, but together they move us toward a system where every american, no matter their zip code, can get the care they need when they need it.
▶ 0:24:58If we want rural communities to survive, let alone thrive, we must fight for the hospitals, for the clinics and providers that literally keep them alive. We must invest in local care, strengthen the workforce rooted in these communities fixed payment inequities, and ensure no family is forced to choose between groceries, rent or life saving treatment.
▶ 0:25:19Rural health care is in a state of national emergency, and with your partnership with your effort, your work and your commitment, we can finally bring stability, dignity and that long needed access to the americans who have waited too long. Mahalo for this opportunity to speak with you today. I look forward to working with all of you to pass this much needed legislation. Um, and again, at any time, please come to hawaii. It's great for your health, I yield. >> it is stunningly beautiful.
▶ 0:25:48And I have cousins in albuquerque. My uncle had asthma and they had to move west in the late 1960s. And so jim and dave got jim got he's in the racing scene there. He raced in the indy few indy 500. So, uh, so representative stansberry, you recognized for five minutes and I learned to appreciate christmas chilis there. Oh, wonderful. >> we'll get you some chili. >> okay. You're recognized for five minutes. >> thank you so much. Chairman, ranking member and members of the energy and commerce committee.
▶ 0:26:14I'm really honored to be able to appear today to talk about the priorities for new mexico and for the communities that I represent. And I also want to say thank you for your commitment to bipartisanship and to advancing the issues that are important to the american people. I'm going to outline three broad areas that we have a number of bipartisan bills that we are working to try to get passed through this committee and the priorities that are very important to new mexico.
▶ 0:26:39The first is ensuring high quality health care and behavioral health to our communities. The second is around energy and affordability, and to ensure that every person has access to affordable energy and that their homes are warm and safe. And the third is around cleaning up environmental issues, especially in our tribal communities. So health care, of course, is the big one. I want to thank this committee for your work to expand access to health care.
▶ 0:27:06We have a whole slew of bipartisan legislation before this committee to address health care. But let me be clear, like others have been in their opening statements, that we know health care is in crisis, particularly in new mexico, where many of our communities struggle to access care. In the short term, we believe that that means extending the affordable care act to ensure that our communities do not face a fiscal crisis. As we know, on january 1st, their health insurance will skyrocket.
▶ 0:27:35In the medium term, it means fixing a broken system, investing in health care providers and the pipeline for practitioners, especially in rural and tribal areas, lowering costs for prescription drugs, bolstering the indian health service, and addressing the fentanyl and addiction crisis that is ravaging our communities. And over the long term, I believe it means moving towards a universal care system, because I believe health care is a human right.
▶ 0:28:02Let me talk about some of the bills that we have before the committee that we believe will help to advance these. The first is a public health nursing act that would dramatically increase the number of nurses working in the public health workforce by funding, recruitment, training and support for public health nurses. The second is an indian health service provider expansion act.
▶ 0:28:26This is legislation to create a pipeline for individuals who are interested in serving in tribal communities to end up in the indian health service under the rubric of health costs. Obviously, we need to lower drug costs, and so I'm proud to co-sponsor legislation by ranking member pallone to do that. Also similar to my colleague to my right, addressing connectivity and rural health through telehealth is vital.
▶ 0:28:55And so I'm proud to carry h.r. 6070, which is the community connect grant program. Um, and also in new mexico, because we have a high number of individuals who are on medicaid and medicare, addressing the reimbursement rates of our practitioners is vital. I am currently carrying a bipartisan bill that I worked on with Mr.
▶ 0:29:16Burgess to expand the reimbursement rates for medicare, and we would like to work with the committee to address medicaid reimbursement rates as well, under the rubric of behavioral health. I have bipartisan legislation, and I'm a member of the bipartisan fentanyl caucus to try to stop the influx of fentanyl into our communities by regulating the manufacturing of fentanyl bills to make bill pills. Excuse me.
▶ 0:29:44I have a head cold right now, um, coming into our communities, and we ask for your support. I also have a large body of legislation around energy and ask for the committees, um, consideration of a number of bills, uh, that are ultimately designed to lower the costs for our communities.
▶ 0:30:02Uh, I am in support of representative castor's bill to revoke the executive orders that the president has put forward that are advancing, um, soon to be outdated forms of energy at the expense of cheaper and cleaner energy sources, as well as representative tonkas weatherization act, which is vital for new mexico because so many of our low income families rely on extra support to heat their homes and to upgrade their appliances.
▶ 0:30:30Finally, we have a crisis across our communities a contamination superfund sites, across tribal communities, and in many cases, this is the result of federal activities, including federal supported mining activities like uranium mining as well as the dropping of munitions. We're working across all agencies as jurisdiction to address these issues, and would love to work with this committee to address them through cercla. So with that, Mr.
▶ 0:30:58Chairman, I know it's a lot and a mouthful, but I appreciate your support and thank you for the opportunity. >> thank you. Thank you for being here. Representative salinas, you're recognized for five minutes for your statement. >> well, thank you, chair. Um, guthrie and members of the committee, um, for holding this member day, I'm here to present my bipartisan bill, h.r. 5557, the mental health services for students act. Our children and young people are really struggling today.
▶ 0:31:23The united states is in the midst of a mental health crisis, and our youth are really bearing the brunt of this. Last year, over 20% of children aged 12 to 17 reported at least one major depressive episode in the preceding year, and 15% of youth who experienced a major depressive episode reported that their ability to function at work, school and home was impacted.
▶ 0:31:48In 2023, more than 20% of high school students seriously considered attempting suicide. That's 1 in 5 that is not okay, and I know that's not okay to every single member of this committee. As co-chair of the bipartisan congressional mental health caucus, I've spent a lot of time engaging with families, children and providers to understand exactly what it is that our children need to thrive.
▶ 0:32:15This past may, the mental health caucus hosted a roundtable with children and young people from across the country to hear their frustrations with mental health services that don't truly meet their needs. And they were very articulate. They knew the ins and outs of our system. There's no great mystery about what it takes to help these children. It's quite simple. They need resources and they need those resources to meet them where they are in their schools.
▶ 0:32:42Currently, over half of our public schools nationwide report struggling to provide adequate mental health services to their students, and things will likely only get worse. The next decade will bring half $1 trillion in medicaid cuts, as well as cuts to the department of education and substance abuse and mental health services administration, samhsa we're going in the wrong direction toward meeting the needs of our students and children. The mental health services for students act helps move us in the right direction.
▶ 0:33:09It will help get providers into schools, proactively help students build resiliency, and equip them with the tools they need to thrive throughout their life. Put us on the right path to meet this mental health crisis head on, and hopefully actually reduce the next generation of substance abuse and mental health crises. More specifically, my legislation expands samhsa's project aware program, project aware, or advancing wellness and resiliency in education program.
▶ 0:33:36Develop sustainable infrastructure for school based mental health programs and services. Project aware focuses on three tiers of mental health funding. First, the program prioritizes universal prevention and mental health promotion to keep kids healthy and give them the tools to manage life's ups and downs. This is no different than how we promote healthy eating and exercise to mitigate chronic disease.
▶ 0:33:57So for those who are already well, second, project aware devotes funding to intervention services through school based screenings to identify those who are at risk and provide services to youth experiencing distress, trauma, bereavement or other issues. And finally, the program focuses on children who are already exhibiting mental health and substance use disorders, so it ensures that they have the right supports to get on the path of recovery. And we know that project aware is effective.
▶ 0:34:24In fact, my friend representative grace napolitano advocated for nationalizing and expanding project aware during her time here in congress. Because this program has been working in los angeles and in her district since 2001, the youth suicide prevention program serves 35 schools in the la area, and has proved tremendously successful in helping students overcome mental health issues. In oregon, we've invested 5.4 million into the community care development project and we've seen some similar success.
▶ 0:34:52It's time to expand on the success of programs. Students can benefit and families can too. Investing in our children is the healthy and fiscally right choice. That's why so far, this bill has garnered over 60 bipartisan co-sponsors and counting in the 118th congress, congressman woman napolitano introduced this legislation with 130 bipartisan co-sponsors in the 117th congress.
▶ 0:35:15This bill actually passed the house floor twice, once as a standalone bill and once as part of the restoring hope for mental well-being act. This bill also enjoys support from countless mental health and education associations. It's clear that healthy children who have the tools to care for their mental and physical health become high functioning, independent adults and lead the next generation in similar, similar behaviors.
▶ 0:35:42This bill gives them the tools, which is why I ask this committee to work with me to advance this bill. Thank you so much for your time. >> thank you. Appreciate your testimony. Representative andre, you're recognized for five minutes for your statement. >> thank you. Chairman guthrie, vice ranking member fletcher, for the opportunity to testify today on two common sense measures that I believe would meaningfully reduce costs and improve peace of mind for american families.
▶ 0:36:09As a physician, I witnessed I've witnessed firsthand the financial strain that surprise medical bills place on patients. The no surprise act, which was enacted during president trump's first term, banned the practice of surprise medical billing, which is when patients unknowingly receive out-of-network care and are left with unexpected medical bills. While the law established penalties for providers who improperly balance bill patients, it did not establish parallel penalties for insurers.
▶ 0:36:39And over the past few years, insurers have abused this imbalance. Bloomberg reported earlier this year that after the arbitration process set up by the no surprises act, some insurers are sending an updated medical bill to patients to make up the difference. We've even seen insurers refuse to cover out of network services altogether, including childbirth, anesthesia and neonatal resuscitation, even though under the law, patients should only pay what they would owe if the provider were in network.
▶ 0:37:09Insurers that violate the no surprises act should face analogous penalties to those faced by providers. That is why my my friend greg murphy filed this bill, h.r. 9710, and I'm I'm proud to be a co-lead the no. The no surprises enforcement act applies the same penalties currently applying to providers to insurers who break the law. And I am excited to close this loophole and protect patients.
▶ 0:37:41Um, the committee also has before it several proposals that would make health care more affordable. And I am happy to say h.r. 4710 is one of them. And I urge its passage. Another issue of significant concern to families and businesses in my district is access to affordable and reliable energy. That is why I strongly support h.r. 3619, the energy choice act. The bill is simple.
▶ 0:38:07It prevents state and local governments from restricting or banning energy services based on the type of energy being used. It stops heavy handed mandates that would eliminate affordable energy options for working families. It ensures that americans, not bureaucrats, decide how to heat their homes, cook their meals and power their small businesses.
▶ 0:38:30Missouri's third congressional district, which I represent, is home to one of the most diverse and reliable energy portfolios in the country, including the state's only nuclear power plant, strong hydropower resources, abundant natural gas, and affordable coal power. This balanced mix has created something that is increasingly rare. Rare energy costs that are 30% below the national average, while still ensuring excellent reliability.
▶ 0:38:56This affordable and dependable energy supply is a key reason why manufacturing continues to grow in our region, and why national companies continue to invest in our communities. But all of this is at risk when government tries to ban traditional energy sources or enforce a one size fits all electrification mandate. These top down policies might be popular in some cities, but they don't make sense for rural and suburban america, which I represent in missouri.
▶ 0:39:26These mandates would raise costs, strain our grid, and penalize hard working families. And electric only requirement doesn't make a home more modern. It makes it more expensive. As congress works to strengthen american energy independence, h.r. 3699 should be part of that effort. It supports consumers, safeguards local businesses, and make sure that communities like mine can keep building on our strong, diverse energy foundation.
▶ 0:39:53Missouri's third district is ready to lead an energy production, manufacturing and economic growth. But we can only succeed if families and employers have access to affordable energy. Thank you once again for the opportunity to appear before your committee. I look forward to working with the committee on these issues that matter deeply to the families I represent. >> thank you. Thank you for your your opening statement. Are there any questions? Do you have any questions? Seeing none.
▶ 0:40:23Any questions on this side. Seeing no questions. Thank you so much for taking the time to present to our committee. We appreciate it very much. And we'll call up the next panel. We have representative rivas eskamani, representative davis cleaver and wasserman schultz.
▶ 0:40:53>> okay, good. >> thank you all for being here today. We would like to thank you for being here.
▶ 0:41:21And we will give each one will have five minutes for their statement. We'll begin with representative rivas. You're recognized for five minutes. Thank you for being before our committee today. >> sorry. Thank you. Chairman guthrie and ranking member pallone. Uh, and committee members for hosting today's member's day hearing. Uh, my name is luz rivas. I'm a electrical engineer, stem educator, and nonprofit leader.
▶ 0:41:51But of course, my most meaningful job is representing the district I was born in and grew up in california's 29th congressional district. The district, once represented by former energy and commerce member tony cardenas and the one we both call home is in the san fernando valley of los angeles. It's home to hospitals, a pipeline of a young, diverse technological workforce and energy facilities. However, for too long, communities like mine have been forgotten.
▶ 0:42:18We have been forced to store the debris and waste from polluters. We have been forced to witness firsthand how polluters put corporate profits over people. This has impacted my neighborhoods access to clean air and safe drinking water. It has led to many of my constituents living with generational health problems at disproportionately higher rates than the surrounding areas, including higher rates of asthma and other respiratory diseases.
▶ 0:42:48This administration wants to empower polluters to continue using our backyards as their playgrounds, with no consequences. I refuse to let that happen. I'm here in congress because communities like mine deserve a voice and someone who will fight for them against this administration's polluter first agenda.
▶ 0:43:06Next week, I will be introducing legislation to ensure that we have the data and tools needed to identify disproportionately burdened communities and prioritize resources accordingly. My environmental justice screening tool act will be an important resource in helping communities impacted by environmental, climate change, human health, and economic factors.
▶ 0:43:31This legislation will help make sure that the federal government can properly and equitably prioritize funding to environmental justice communities like mine. I hope to continue working with the committee on the key issues that are impacting environmental justice, like those in the san fernando valley of los angeles.
▶ 0:43:51I also hope to continue working with this committee on another issue that has become increasingly important, not just in the san fernando valley, but across the country. And that's artificial intelligence. Through my experience as an engineer, I've seen stem, how stem and technology evolves at an unprecedented speed. And this includes ai.
▶ 0:44:14Ai is here, and it's quickly reshaping how we work, how we learn, and how we communicate at the rate at which ai and other emerging technologies evolve, we cannot afford to wait before any action is taken. That's why I was particularly concerned around the continued efforts by the majority and the trump administration on enacting an ai moratorium that would limit states ability to regulate ai.
▶ 0:44:42These attempts would have prevented states from writing or enacting their own ai laws. For ten years. House republicans tenure ai moratorium provision would leave us unprepared to tackle these challenges as they arise. I'm proud to have worked with this committee to lead efforts on the house side to remove the ai moratorium here from h.r. One, and continued partnership with committee democratic leaders on recent effort.
▶ 0:45:08Um, as someone with a stem background in congress and alongside um rep neal dunn, I also serve as co-chair of the stem education caucus. As technology continues to grow, I hope to work with the committee to ensure that all communities have access to this technology, but also the ability to learn how to effectively use it.
▶ 0:45:32Starting at a young age, we have a prime opportunity to make sure our future workforce is prepared to work with ai and other emerging technologies. We have a duty to empower communities across the country with the tools that they need to work with ai in a safe, responsible and ethical way.
▶ 0:45:50By understanding how ai has evolved and is expected to evolve, we can be better prepared to embrace the opportunities that ai presents and address the challenges that can and will arise in the future. We need to make sure that the united states remains a leader in innovation for generations to come.
▶ 0:46:09Thank you, and I look forward to working with members of the energy and commerce committee, this congress, to increase access to technology and improve the environment and well-being of our constituents constituents. Thank you. And I yield back. >> thank you, representative rivas. Representative cisco, you're recognized for five minutes for your statement. >> thank you, Mr. chairman.
▶ 0:46:31Um, I have to I come here to briefly testify in support of two different bills, and we'll begin with my own. First, I want to take this opportunity to highlight my bipartisan bill, h.r. 1598, the ensuring access to medicaid buy in programs act. Since coming to congress, I've made it a priority to advance policies that benefit individuals who have disabilities.
▶ 0:46:57No working adult with a disability or other such barrier to employment should ever have to choose between earning a paycheck and keeping the essential healthcare benefits they rely on by lifting the age limit for medicaid buying programs, we can ensure that individuals with disabilities over the age of 65 who depend on these programs can continue to work if they choose, while also maintaining the vital medicaid benefits that they need.
▶ 0:47:26This legislation closes the gap in benefits and will allow these individuals to stay in the workforce, contribute to, and also engage with their own communities, and receive a paycheck while receiving the benefits that they also deserve. Last congress. This bill passed unanimously, and I look forward to working with you to do that again, this congress. Thank you.
▶ 0:47:53Now, the second bill I wanted to I want to come and voice here is in support of h.r. 2902, the supplemental oxygen access reform, or soar act, in beautiful and sunny arizona. We have people from all over the country who choose to live, work and retire, especially due to the weather and quality and air quality necessary for the nearly 60,000 patients in arizona who have cardiac or lung conditions.
▶ 0:48:23Currently, too many of these individuals do not have access to the types of supplemental oxygen they need to sustain an adequate quality of life. They have to plan each day around outdated oxygen systems that often keep them homebound and out of their community.
▶ 0:48:40This bill will help continue to provide access to supplemental oxygen for these individuals by ensuring medicare takes a patient centric approach that they receive support from respiratory therapists, while also reforming coverage to ensure access to products and services like liquid oxygen. I am proud to co-sponsor of this legislation. Thankful also for my colleague, representative david valadao for leading this effort. And with that, Mr. chairman, I yield back. >> thank you.
▶ 0:49:09Thank you for your testimony. Uh, representative davis, you're recognized for five minutes for your opening statement. >> thank you so much, Mr. chair. Chairman guthrie, um, also to the ranking member pallone and to the vice ranking member, fletcher, uh, for allowing me to speak on the issues that are important to eastern north carolina. Health care has been one of my highest priorities. Uh, while h.r.
▶ 0:49:31One, the one big beautiful bill act, included some provisions I personally supported, it also included $1 trillion of cuts in medicaid over the next decade. North carolina, especially our rural communities, where one hospital has closed since the last time I testified before you, uh, will bear the brunt of all of this passing. My top health care priority is h.r. 4277, the rural emergency hospital financial stability act.
▶ 0:50:00And this is vital congress passed legislation authorizing the h model to stem the tide of hospital closures. Still, adoption has been slow because regulatory agencies are preventing medicaid from paying for services in the way that congress intended. Without proper medicaid reimbursement rates, models simply ineffective. Your committee can help by passing a bipartisan bill, h.r.
▶ 0:50:264277, the rural emergency hospital financial stability act, which would increase the medicaid reimbursement rate for, refers to the outpatient hospital level from the health clinic level. Beyond championing the cause of rural hospitals, we must also bring down drug prices for patients as rising costs persist. H.r.
▶ 0:50:471244 reducing drug prices for seniors act, ensures coinsurance rates are tied to the net price of a drug, rather than its list price, creating parity and lower out of pocket expenses for medicare recipients. We must also preserve access to drugs covered by medicare for future generations. Part of the effort to do so includes h.r. 1492, the epic act, and h.r. 1672.
▶ 0:51:17The maintaining investments in new innovations act. While the ra included many important policies that lower patient costs, it unfairly penalize small molecule therapies, which often come in the form of capsules or tablets.
▶ 0:51:34Patients prefer pills and tablets, which are easier than injections by removing artificial government disincentives against small molecule therapies developed with genetic genetically targeted technology, the act keeps cutting edge treatments available for those who need them most at low cost. I would urge the committee to take up h.r.
▶ 0:51:582707, the protecting american families and service members from anthrax act legislation to preserve a national stockpile of anthrax countermeasures. Anthrax remains the single most dangerous biological threat to the american people, and our adversaries are working overtime to manufacture it. So we must act to prevent the worst case scenario.
▶ 0:52:22Next, north carolina's first congressional district would benefit significantly from common sense, bipartisan permitting reform. As broadband and energy demands increase. We need to change our from the status quo. Since I entered congress, one of my top priorities has been expanding broadband and improving affordability. Much of eastern north carolina's rural and has significant infrastructure needs.
▶ 0:52:48Broadband will significantly improve the lives of families and businesses across eastern north carolina. For energy. Our communities care about reliability and affordability. Any reduction in reliability only puts seniors and children at risk of blackouts, leaving them to face grueling heat waves or frigid cold spells. We will not meet the growing energy demand in eastern north carolina, across the state or across this country without permitting reform.
▶ 0:53:16We need more energy generation sources online and connected to the grid. The committee must pursue an all round energy approach, a combination of traditional and renewable energy sources paired with timely permits. As necessary, we must deliver energy independence, reduce energy costs and increase reliability. To achieve these goals, we must ensure broadband and energy projects are completed by bringing rural communities online and reduce their utility costs.
▶ 0:53:44To that end, I urge the committee to pursue true common sense policies across health care and permitting reform that can improve the lives of eastern north carolinians and the american people. Thank you, Mr. chair, I yield back. >> thank you. Thank you for your statement. And Mr. representative cleaver, your represented. You're recognized for five minutes. Your statement. Good morning. Thank you, chairman guthrie and ranking member pallone in absentia.
▶ 0:54:11Uh, and, uh, miss fletcher here in person. I appreciate the opportunity to testify today about a major priority for my congressional district. And to be sure, it should be a priority for the entire nation in 2022, when congress passed the inflation reduction act, one of the most exciting provisions for myself and the members of my community was the $7 billion investment to expand the deployment of solar energy for working
▶ 0:54:42Families. My excitement was high because with those dollars, we could respond to the fact that energy prices, particularly electricity, are increasing significantly across the us due to natural gas costs, grid upgrades, inflation and extreme weather. This program, known as solar for all, would have lowered electricity bills, created thousands of good paying jobs, boosted american manufacturing, and strengthened our electric grid.
▶ 0:55:10The epa projected that it would bring solar energy to 900,000 households and save americans an estimated $350 million every year on energy costs.
▶ 0:55:23At a time when families are struggling to keep up with rising utility bills, including electric prices that have climbed more than twice as fast as inflation, this investment in residential solar would have provided meaningful relief to my constituents and families across the country, and that is why I was so offended that without communicating with congress, the administration
▶ 0:55:53Captured all of those funds that were approved by the article one institution and signed into law by the president, and the impact would have been felt most by low income and disadvantaged households who've been most affected by soaring energy costs, and are often the first to face consequences of environmental degradation.
▶ 0:56:18In my community back in missouri, people don't see investments like this as a republican issue or a democratic issue. Uh, the people that I talk to in western missouri see investment in their communities and don't think about politics.
▶ 0:56:34I've not once heard a kansas city or someone from independence say, well, that's a democratic bridge, or that's a republican road to my constituents, whom I have also served as eight years as mayor. Uh, infrastructure is above politics. A newly paved road is simply a safer way to get to work.
▶ 0:56:56A repaired bridge is a lifeline to small businesses in communities like marshall, missouri, and a solar farm means lower electricity costs for all of us. I would expect any lawmaker in my seat to try to bring money back home to invest in our communities, regardless of partizan label.
▶ 0:57:14And to be clear, these investments were supporting families and workers in states like missouri and mississippi just as much as they were in states like new york or new jersey, which is why I am imploring this committee to remove the partizanship from politics from this system so that we can do policy making. And that's why I'm also encouraging this committee to revive the solar for all program that will bring tremendous benefits to all our communities.
▶ 0:57:43When missouri was designated to receive $156 million to deliver residential solar energy across our great state, my district quickly jumped into gear to figure out how to best take advantage of the federal investment. We expected and planned investments like this, uh, excited our labor community, the business community, and everybody in between because they bring benefits to families, workers, small businesses and all of the above.
▶ 0:58:13They lowered costs, boost wages, generate economic activity, and make our communities healthier by combating pollution. When the news broke that these promised investments were being revoked, we were all deeply disappointed. But I refuse to give up on these communities and the benefits they were set to receive.
▶ 0:58:36As this committee continues to organize the priorities that will consume your attention in the coming year, I encourage you, please, to reauthorize and restore the solar for all program, as well as the investments that were taken from communities like mine. Uh, comedian george carlin said that electricity was no more than organized lightning, but lightning has become extremely expensive. Thank you, Mr. chairman. >> what did george carlin say?
▶ 0:59:0867% of all statistics are made up so that he didn't say that. Uh, whatever number you want to use that. Right. Well, thank you for your testimony. I, I'm, I don't hear many people quote george carlin, so that's good. So, uh, representative debbie wasserman schultz, I'm sorry, representative wasserman schultz, you're recognized for five minutes for your statement. >> thank you, Mr. chairman. And to the ranking member, congresswoman fletcher, uh, for this chance to present two critical bills that will continue to keep young people safer from two major public health threats breast cancer and drowning. First is h.r.
▶ 0:59:384541, the bipartisan early act co-led by congresswoman miller-meeks. Because the timing is urgent right now, securing quality, affordable health care may soon be priced out of reach for millions of americans and for women, that access is vital, especially because breast cancer, more than any other form of this deadly disease, always lurks as a threat in our lives. 1 in 8 of us will get it, and 42,000 will likely lose their lives from it this year. But the earlier it's caught, the more women will survive.
▶ 1:00:05I and millions of other women have heard those devastating words that no one wants to hear. You have breast cancer. My journey to survivorship inspired me to write a more hopeful chapter for the millions of us who will hear those chilling words, and we know what works. In 2010, the early act became law and has helped thousands of young women since to pay attention to their breast health and to catch breast cancer early. We know that early detection and treatment saves lives, and that's that starts with education and awareness.
▶ 1:00:33This is especially true for younger women and ethnic and racial populations, who more often face aggressive forms of breast cancer or are more likely to catch it later. For instance, black women are 40% more likely to die from breast cancer than white women, but breast cancer has a 99% survival rate if it's caught in its early localized stages. Yet that number dips to 31% when the cancer spreads to our lungs, liver or bones. And this is where the early act plays such a critical role.
▶ 1:01:02My own journey speaks to this early detection urgency. I was diagnosed with breast cancer and the brca2 genetic mutation at age 41, after 15 months of surgeries. I've been cancer free for 18 years now. And finally, thank you and and finding it early save. I can't say that without a smile and finding it early saved my life. Discovering our family's brca2 mutation may also prove to be life saving for my daughters as well.
▶ 1:01:30But millions of young women need those early detection and awareness tools, and reauthorizing the breast cancer education and awareness requires learning. Young act, or the early act, delivers that. It has consistently been reauthorized since it became law, and it's central to a larger strategy to save lives. One is to ensure that all of us can access quality, affordable care, but we also need to ensure that all women know the threats, warning signs and available resources that they have to battle breast cancer. That's what the early act does.
▶ 1:01:59It centers around vital programs handled by the centers for disease control or the cdc. One component is the bring your brave campaign, which amplifies stories that raise awareness of breast cancer and young women between the ages of 18 and 44, and encourages them to understand their risk and the signs and symptoms which are different for younger women. Very often. The early act also funds the young breast cancer survivors program, which provides grants to nonprofits aimed at delivering supportive services and resources to increase patient survival and improve their quality of life.
▶ 1:02:30So I'd love this committee's support to reauthorize the early act to help ensure these resources continue. Because breast cancer in young women has been rising and this law is needed now more than ever. Next, I'd appreciate the committee's help on h.r. 4751, my bipartisan virginia graham baker pool and spa safety reauthorization act. This law has also been consistently reauthorized, and I'm joined by miller-meeks and judge carter as my lead co-sponsors.
▶ 1:02:55Drowning and near drownings and pools and spas pose a significant public health risk, and they remain the leading cause of unintentional death for children aged 1 to 4. In my home state of florida, we're on pace to set a tragic record for drownings in 2025. But with increased education and the added layers of protection in the law, we can reverse that and keep more innocent children safe. This law does that by helping to decrease drowning through sensible outreach, education and prudent precautions.
▶ 1:03:23And it's done through three principal elements carried out by the consumer product safety commission. First, it requires every public pool to install safe jane covers that prevent suction entrapment. Since vgb became law in 2007, there has not been a single suction drain entrapment death anywhere in the us. Second, it includes a grant program to incentivize states, municipalities, and indian tribes to adopt their own pool and spa safety laws and education efforts.
▶ 1:03:50Third, it includes pool safety, a national education campaign to raise awareness about drowning prevention. Working together, all of these efforts prevent families from ever suffering one of the worst tragedies imaginable. And that's what both bills do. They add layers of education and prevention to keep all of our families safer and cancer free. I hope you'll join me, Mr. chairman and ranking member, and making that possible. Thank you again for the committee's time and consideration. >> thank you. Now we have time for questions and I will just start.
▶ 1:04:19I'm not going to do five minutes. I just want to comment. Thanks for your courage and and what you've done to to. I know you often talk to me on the floor of the house about these issues. I know it's passionate and and my guess is when you showed up in congress, you didn't think this is going to be your number one issue, but life changes things and and making it where it's going to help others. And we're interested in your legislation that with all of your legislation we've talked about, I know we specifically talked about yours and we're very interested. Is anybody else have any comments or questions.
▶ 1:04:48And then I'll go to since I went first I'll go democrat and republican served as a bodyguard. >> thank you, Mr. chairman. I just want to thank our witnesses for being here today and to do it on a fly out day at that. Um, I wish it wasn't on a fly out day. So, um, we could have the most participation, but I just wanted to to comment on a couple of areas, things that I heard. Um, I want to start with luz rivas. Uh, miss rivas, thank you for your work on ai and stem. We need more voices on stem. Um, in those in your background.
▶ 1:05:17Uh, so thanks for your work on that. Um, Mr. davis, you said something that resonated with me. Um, I'm somebody who, um, I see needles and I'm afraid of instantly, and I run. So when you say patients prefer pills over injections, I couldn't agree with you more, um, than that. And, um, Mr. cleaver, solar for all is something that's near and dear to me. Um, my district is a majority district where you have air pollution, where electricity prices are skyrocketing.
▶ 1:05:46They continue to do so under this administration. This is a way to lower cost for consumers directly in their pockets. It's making sure they have access to programs like solar for all to bring electricity prices down. So thank you for your continued advocacy. Know that I will continue to do that too, as this administration undoes, um, programing that's been funded and approved by this congress.
▶ 1:06:10And, um, miss wasserman schultz, for your ongoing commitment to breast cancer awareness and fighting in early detection. Um, we all know it's a bipartisan effort. Of course, it's done every year. And the congressional softball game as well. We should follow through and making sure we're supporting that effort with legislation. Uh, so so thank you all for your time and for being here and for this opportunity. With that, I yield back. >> thank you for yielding back. I'll point out my friends, also a good baseball player too. She does both. She does both.
▶ 1:06:39So the gentleman from alabama is recognized for five minutes. >> thank you, Mr. chairman. Um, representative wasserman schultz, I really appreciate you being here. Uh, I just wanted to point out something that was in the working families tax cut bill was $50 billion for rural health care. And while the frequency for breast cancer is lower in rural areas, the mortality rate is considerably higher.
▶ 1:07:04One of the things that I hope each of you will do when you go back to your states is encourage your states to really focus on early detection mobile units for breast cancer detection, and other diagnostics because it's absolutely critical, um, for a lot of women, particularly older women in rural areas. And, and again, I appreciate, uh, what what you've done in this area. Uh, it's really encouraging. I yield back.
▶ 1:07:33>> gentleman yields back and no one else seeking recognition. So thank you for our panel for being here. I'll let the committee members know ten minutes to the hopefully to the second or close to the second from the time the last vote is gaveled. So the call of the last vote gives you five minutes to vote and get back here. Five minutes. So we'll start ten minutes after the last vote is called. So, uh, we'll recess through vote until after votes.
▶ 1:49:42For being here today, all our colleagues for being here. And I will give a five minute. Everyone will have five minutes to give their opening statement. So, Mr. barrett, you're recognized for five minutes. >> thank you, Mr. chairman. And thank you for allowing me the opportunity to testify in front of your committee today.
▶ 1:49:59Um, as we continue to work through this open enrollment period for, uh, health care plans that so many americans are facing, millions are faced in being told again that their health insurance premium costs are going to spike again next year. Rising health care costs and our health care system continue to put a real strain on hardworking families and small businesses in michigan, especially in the communities that I represent here in congress.
▶ 1:50:25The bottom line is that obamacare has failed americans excessive regulations, mandates, and other just inefficiencies. Ignore the needs of patients and drive up costs. The solution by some has been to throw more money at the problem, most recently by subsidizing insurance companies with oversize so-called tax credits that are checks under the guise of the covid 19 pandemic relief. I'll remind your committee, sir, that the covid 19 pandemic was almost six years ago.
▶ 1:50:54Now, despite its name, these are not real tax credits. They don't go to patients, but instead flow directly to the big health insurance companies. Covid is long over, thankfully, and a blanket extension of these subsidies is not the answer, especially since rampant waste, fraud and abuse has been continued to be uncovered. Right now, high income households earning more than a half $1 million a year are eligible to benefit from covid era tax subsidies going to insurance companies.
▶ 1:51:23And perhaps most troubling of all, the government accountability office, our own internal auditing arm of the federal government, set up fake health insurance accounts to test fraud prevention in this program. All but two of those fake accounts received taxpayer subsidized coverage through the premium tax credits, showing just how bad this problem is.
▶ 1:51:48It explains how 12 million obamacare enrollees have never filed a claim against their insurance plans. Just last year alone, this means 12 million health care plans were never used at the health insurance companies, pocketed more than $35 billion in subsidies anyway, and those costs continue to rise. Premiums for obamacare coverage have also risen by 75% just since 2020.
▶ 1:52:11It's clear that insurance companies have no incentive whatsoever to keep obamacare costs low, prove claims, mitigate fraud or anything else when taxpayer subsidies mean higher revenues for them all while denying more claims for ordinary, uh, ratepayers. If things stay the way they are, coverage plans will continue to offer poor care. Patients will face higher co-pays and narrower networks, and taxpayers will still be funding the bill.
▶ 1:52:38Obamacare, along with the covid era tax credits, represents a deeply and fundamentally flawed approach to health care policy. We are spending more on coverage around actual health care. There's an urgent need for real reform and accountability in our health care system. We must make significant reforms along the way as we deliver health care in this country. And it starts with both, both sides coming together with some honest conversations about the problems we face.
▶ 1:53:03And we must explore every avenue to restoring affordability and health care and not just doing the same thing we've always done. That means correcting the obamacare medical loss ratios that directly benefit the insurers, but don't actually lower premium costs. It means taking significant steps to mitigate fraud in our health care system, so that those that are ineligible or over income are not receiving taxpayer funded benefits.
▶ 1:53:26And it also means expanding access to accounts like fsa and hsa, allowing those to be used to pay for premium costs and empowering individuals to make the best decisions for themselves and for their families. There are ways that we can empower individuals to make decisions that are the appropriate decision for them to make, without the government telling them how to manage their own health care. Time for actions. Now. We can't afford to wait any longer. We can't perpetuate the status quo.
▶ 1:53:54That is a broken system, and we can't continue down this unsustainable path. Thank you again, Mr. chairman. With that, I yield back. >> thank you. The gentleman yields back. Thank you for your your statement and your representative, gluesenkamp perez. You're recognized for five minutes. >> thank you chairman. Thank you. Ranking member for having me. Um, and I wanted to talk a little bit today about a subject that will not surprise you. Right. To repair. It's one of the primary reasons that I ran for office.
▶ 1:54:21And, um, you know, I ran an auto repair machine shop with my husband before coming here. And, um, you know, a lot of us feel in this country that we are being turned into a class of permanent renters without the agency to fix our own stuff, to be, um, to be stewards of the things that we rely on.
▶ 1:54:37Um, and I it's it's why I support the repair act that that we own and tort law going back to the 1400s affirms that when you buy something, you have the right to fix it and to have the tools and the access and, um, you know, you often have like, staff kind of help prepare remarks and they, they kind of talk about, um, how there there are so many mechanics winning and winning and that's, that's true. But I also want to urge that this is, um, there's a long tail effect here.
▶ 1:55:04If we do not affirm that you're able to, um, have your car fixed or fix your car yourself or your tractor or your, um, washing machine, any of these things, um, you you will see a slow and, and, you know, um, hollowing out of the industry, um, you will see mechanics choose, you know, younger mechanics choosing not to go into this field because they have been so winnowed out, um, of the authorized dealership repair track.
▶ 1:55:33And, you know, if you're a young mechanic, um, and you are thinking about how you're going to start a business, you are going to you're going to think about neighborhood. You're going to think about the rigs that are in a neighborhood or in a community. You're not just going to try and make a living serving toyotas or fords or whatever it is from the last five years. Those are always going to go to the dealership. Um, and you will see a real loss of agency in the trades.
▶ 1:55:58The reason that so many young people today are seeing the trades as a viable career path, um, for, you know, having agency in their lives is, is because, um, they're able to work across many manufacturers. And as we see this, um, march towards, um, monopolies, duopolies, whatever it is, um, you're going to see people choose to stay out of this. And that's why we need action. Now. We cannot wait for this.
▶ 1:56:21Um, which brings me a little bit into a sort of tangential issue, which is, um, you know, we saw such a crisis with chips, um, and a real demand to have more chips. Um, but we didn't ask ourselves why they why why the demand for chips has gone up so much. Did anyone ask for a washing machine that plays tchaikovsky? They did not. My washing machine is from 1997. Think about how much wealth that's created. The average appliance today. Um, I think the data is like life life expectancy of three years.
▶ 1:56:51And so do not turn the american country into a nation of beggars petitioning for their right to fix their own stuff, affirm that we are a nation of people who make things, who are skilled and believe in agency. Um, affirm the rights that we've always had, because time is running out on this issue. And I and I'd also like to point out that when you only have the manufacturer approved dealerships and shops working on these cars, there is no independent check on the material quality.
▶ 1:57:19And I have seen everyone who's touched a car can tell you that, like the gauge of wire on a wire, harnessing is shrinking and shrinking, and you're seeing more failures. And without having independent shops having access to those materials, to those vehicles, there's no outside check on material quality and saying, hey, look, I wouldn't buy that car. I wouldn't keep going with this manufacturer because they are shortchanging you on the actual physical material quality of the car.
▶ 1:57:46Um, and just to, uh, you know, um, one thing that I think a lot of americans have affirmed is that headlights are too damn bright. This is a serious problem when you look at, um, the old halogen lights, like, they max out around, I think it's 600 lumens. The new leds, it's like they can go up to like 12,000 lumens. They are blinding. And not only that, um, but when I used to do, I used to be able to do headlights for, like literally my cost for a light bulb was six bucks.
▶ 1:58:15Four bucks. Now these new like, these new headlight assemblies are like $1,200 repair. And it is nickel and diming the middle class of its existence. So not only do you affirm the right to repair, to actually work on these and not just have, uh, you know, be a part swapper, but actually be able to repair, and this is a serious environmental impact when we're not able to actually get in. Um, it's a serious risk to life and safety when we're not able to see after another car has passed us.
▶ 1:58:43Um, you know, all these little clips are just failing and you can't properly adjust them or they don't stay adjusted. Um, and for headlights, the, uh, the standards have not changed since before I was born. They have not changed since 1985. And it's something that we all see. And I think part of the way that you depolarize the nation is by saying, actually, we are living in the same water as you. Um, we are going to address the issues and prove our utility. So thank you for your time. Thank you for your attention. Sincerely.
▶ 1:59:13>> and we thank you for your time too. Representative gluesenkamp perez, I intend to address the panel with you about your remarks afterwards in a very positive way. So, uh, thank you, thank you. That's not right. Got it. Out of order. Yes. Oh, okay. Mr. well, that's all right. >> Mr. swanson's next. >> I can't read it for me. >> I know Mr. swanson, Mr. swanson. >> Mr. sorensen, you're recognized. >> thank you very much.
▶ 1:59:43Uh, to chair guthrie and ranking member pallone. It's an honor to testify before you here today. I'm here today to speak on several common sense bills that I've introduced before the committee. Legislation that lowers costs, protects consumers, and improves the well-being of families in my district and around the nation, in central and northwestern illinois.
▶ 2:00:04There's one issue that I hear about the most, and I actually learned about it before I was in congress by having a conversation with my pharmacist. It's prescription drugs. The pharmacist at my jewel-osco in moline, illinois, told me many years ago that the worst part of her job is when a senior citizen pushes back an orange pill bottle back to her because they're too expensive, and it happens because of the games that big pharma plays to
▶ 2:00:36Keep generics out of the hands of the people we serve. My bill, the stop games act, addresses that tactic. Stop games cracks down on citizen petitions that are filed not to improve safety, but just to delay competition.
▶ 2:00:56Often filed at the last minute, these duplicative and unsupported petitions stall the generic approval process for years, all the while keeping the prices high for those seniors at the osco pharmacy, but keeping also the profits high for the corporations.
▶ 2:01:15Stop games gives the fda clear authority to quickly reject petitions whose primary purpose is to delay, and my bill will help put lower cost, life saving medicines into patients hands. At the pharmacy counter. Affordability challenges extend well beyond health care. Many families face impossible choices each month to pay their utility bill or to put food on the table.
▶ 2:01:43No one should have to sacrifice their health or their stability just to keep their tap water running. Access to clean, safe and affordable water is not a luxury, and it shouldn't be in this country. It's a basic necessity for every household, every family, in every community.
▶ 2:02:00My bipartisan, low income household water assistance program establishment act, which we call life, is a practical and compassionate solution to ensure that essential water services remain within reach to lower income households. Now is modeled after the highly successful low income household energy assistance program called liheap, which provides block grants to states to ensure low income and vulnerable populations never lose access to heating and cooling services.
▶ 2:02:31And I'll tell you, the weather back home. High temperature of five degrees both days this weekend after its creation lie in 2021 helped more than a million households across the country, including 80,000 families in the land of lincoln. But lie swap was created as a temporary program. Its funding expired in 2023, and so it ended critical assistance.
▶ 2:02:53Even as families continue to struggle today by helping families stay current on their bills, we reduce the shutoffs, we prevent costly emergency interventions and support utilities in maintaining the infrastructure that we all rely on. And of course, lowering costs isn't just about health care and utilities. It's about protecting people from new threats that drain their wallets.
▶ 2:03:16Just a couple of weeks ago, the stephenson county, illinois sheriff told me that scam robocallers and robo texts are getting even more sophisticated with artificial intelligence, scammers have no limit to what they do to trick seniors out of their savings. I want to thank ranking member pallone for your partnership and your leadership on this issue. My bipartisan quiet act would double the fines for ai driven scams and required disclosure. When ai is used in a phone call.
▶ 2:03:45Robocalls hit a six year high in 2025, so the time to act is right now. I urge this committee to support the quiet act and help protect families across illinois and this ♪great country. The three bills that I discussed today stop games, lie and quiet. I'll reflect my commitment to lowering costs, protecting consumers, and improving the lives of everyday americans.
▶ 2:04:11And these should be able to we should be able to come together in this committee from both sides of the aisle on all three of these issues. So thank you. I look forward to working with the committee to advance these important solutions and I yield back. >> thank you very much for your comments. Mr. sorensen. The chair now recognizes representative vasquez for five minutes for his comments. >> thank you chairman. Thank you, ranking member pallone, for the opportunity to be before your committee today.
▶ 2:04:35Um, today, I want to talk about an issue that's incredibly important to this country, but also to many new mexicans. And that is patient debt. That is the ability to go to a doctor, go to a hospital, uh, when you need to, uh, when you are in your car, when you're at home and you start to feel something, it doesn't feel right and you are scared to go to the doctor because you know that the last time that you did that, bill collectors were harassing you. Uh, perhaps you had a lien on your home. Uh, or perhaps you left something untreated.
▶ 2:05:04Uh, that is the reality for many, many new mexicans and many americans. Uh, that that shouldn't be it. Having health care in this country shouldn't be a luxury. Nearly 23 million americans have crushing medical debt. More than 40% of adults in the country are struggling with medical bills. The data is not just figures on a on a stat sheet. It represents the pain and the stress for millions of americans that wake up every single day wondering if they can afford to go to the doctor.
▶ 2:05:33And so the burden of medical debt falls especially hard on people with chronic illnesses, blue collar workers, our rural communities, our native american communities, and families already struggling to make ends meet. Now in new mexico, medical debt is crushing us. At least 18% of our population currently faces medical debt, averaging more than $2,000. Now, behind each of these numbers is a human story. Mounting medical bills don't just strain a household budget, they reshape the way that we live our lives.
▶ 2:06:03Patients delay treatment because they fear another bill that they can't pay. Let me talk to you about this. When your credit score is destroyed in this country, it limits your opportunity to buy a house, to buy a new car, to do just about anything. And so when you are forced to go through medical bankruptcy or have your credit score ruined just because you chose to go to the doctor, I don't believe that as the wealthiest country in the world, those are situations that we have to face today.
▶ 2:06:27So when this financial stress compounds with worsening health and your daily life, you get trapped in a cycle. It deepens inequity in this country. It erodes the stability of entire communities. And you know what this is? When people turn to more unhealthy ways as they cope with this stress. And so too often these hardships persist. When people do everything right, even with insurance, the coverage is often too little.
▶ 2:06:50A single hospital visit, an unexpected diagnosis, or ongoing treatment for a chronic condition can leave even insured patients with the same debt as those without coverage. I know this because the people in my family have gone through this deductibles, surprise bills, opaque pricing, push pushes from hospitals that push families into crises. This is why our current patchwork of protections falls short. States like new mexico have taken important steps, but those protections can't reach everyone, and enforcement is uneven.
▶ 2:07:20Hospitals and debt collectors continue to pursue patients who should be eligible for financial assistance. Families continue to fall through the loopholes that leave them vulnerable to aggressive and predatory billing practices. And so, despite the state's best efforts to protect patients, including legislation at the state level to curb aggressive collection practices, new mexicans are targeted by lawsuits, wage garnishment, long lasting financial harm. They lose their homes. Sometimes they lose their families and their friends. We need action.
▶ 2:07:48This is why I put forward the patient debt relief act. This bill would create a federal grant program that gets get this. It allows nonprofits to purchase and forgive outstanding medical debt because our insurance company and our current hospital billing practices are forcing nonprofits to raise money for folks out there.
▶ 2:08:10Now, you've seen those gofundme accounts when somebody gets sick that reach up to $1 million because somebody has a great story, is that the way we should be handling health care in this country? I don't think so. However, when nonprofits can step up and be able to pay for those, uh, for for those outstanding bills, uh, that is a step forward. So that's what the patient debt relief act does. It tackles medical debt crisis at its roots.
▶ 2:08:32Uh, it pairs both strict patient protections with a new federal debt relief program because old medical debt is sold on the market, as we know, for pennies on the dollar. So every $1 in grant funding can erase up to $100 of debt, $100 million investment could wipe out billions in burdensome medical bills for families that are already struggling to get by.
▶ 2:08:55And we know for those of us who have gone through this, that sometimes after you get that $800 or $8000 medical bill and you can't pay it, eventually the collector says, you know what? We'll let you pay it for $100. We'll let you pay it for $400. How is that possible? With these funds, a nonprofit partner could identify individuals whose medical debt exceeds 5% of their income, or whose earnings fall below $62,000.
▶ 2:09:19So I urge this committee to take, uh, to take this, this really important bill and this very important issue, which, mind you, is a temporary fix, but it's one that new mexicans and americans desperately need so that they can pay for their medical bills. Again, that is the patient debt relief act, I yield back. Thank you, Mr. chairman. >> thank you very much for your comments, Mr. vazquez. Now we turn to representative mannion. You have five minutes for your comments. >> thank you, Mr. chairman and ranking member, members of the full committee, I appreciate the opportunity to testify today.
▶ 2:09:47Uh, today, I want to share what I've been hearing from my constituents in new york, 22, regarding the health care crisis and energy affordability across central new york and the mohawk valley. People are afraid of what these rising health care costs mean for them and their loved ones. If congress doesn't act quickly and in a bipartisan way, seniors and working families will soon have to choose between the medications they need or paying their bills and putting food on the table.
▶ 2:10:18Small business owners who want to do right by their employees are afraid they'll no longer be able to keep the lights on. It's a shame that over the past year, the house majority has been laser focused on passing the largest cuts to health care in our country's history. And now it seems that they are poised to let the subsidies that help millions of americans make ends meet and afford their health coverage will expire at the end of this year.
▶ 2:10:44The cuts will impact all of us when essential services are gutted, health centers face insurmountable shortfalls, people are forced to drop their coverage and everything gets more expensive. We all end up paying more for less before congress adjourns for the holidays. Let's extend the enhanced premium tax credits to prevent premiums from spiking and give individuals and small businesses some certainty so we can avoid the health care crisis.
▶ 2:11:14The president and the majority party here in congress have inflicted unnecessarily upon the american people. I'd also like to speak today about the need to address rising energy costs, and urge the committee to work on creative solutions to expand access to more affordable energy for consumers. On average, new york state residents have experienced a $190 annual increase in electricity spending over the past year.
▶ 2:11:40In my congressional district, ny 22 utility bills have recently increased by more than 10%, and it's expected that the average household will see a $600 annual increase over the next three years. I'd like to share with you some of my concerns that have come to our office from my constituents, and they've shared with me recently. Michelle from cortland wrote to me that my husband and I are paying the equivalent of a mortgage to keep heating our home.
▶ 2:12:09Our friends and neighbors are also paying somewhere between $700 and $1000 per month in electricity, even with similar or decreased usage, owen from cazenovia wrote, over the last year, my electricity costs have surged. Despite making every attempt to minimize use and leverage smart technologies such as connected thermostats, installation of heat pumps, switching to led bulbs, and more.
▶ 2:12:36Despite incurring the expense associated with these upgrades, we have also seen our bills rise with no end in sight. Kelly, from waterville, has seen her bill go up by $115 in september to $713 in november, as more data centers and energy intensive projects get added to the grid, we cannot let consumers get stuck with the tab.
▶ 2:13:03I urge this committee to keep consumers and their rising energy costs in mind as it considers legislation, or provides feedback to the administration on regulatory action. Americans need more affordable energy options, and I urge this committee to work with members on creative solutions that will both support us energy dominance and independence, but also lower costs for consumers.
▶ 2:13:27Americans deserve clean, affordable, consistent, reliable energy systems, and they need to be innovative. We should continue to invest so that we can meet the challenge across the global markets as it relates to energy generation and transmission. And with that, I yield back. >> thank you. The gentleman yields back. And I want to thank you for your comments.
▶ 2:13:53Uh, I'd like to thank all of our fellow members again for being here today. And we're just going to take a few minutes to reset the table for the next panel of members. In the meantime, I'll recognize myself for just a few minutes, five minutes, to make a comment on, uh, the last panel, uh, especially close to my heart. And I know that representative pallone knows this is the right to repair act. We've been working on that for a number of years.
▶ 2:14:20Representative gluesenkamp perez did a very eloquent job of presenting the case for, uh, the right to repair, not just for vehicles, but across all manufacturing sectors. And she is right. It's a very insidious problem. And we're losing ownership of our manufactured goods. And I think we really need to pay attention to that. And I, I thank her for bringing that perspective to the committee today.
▶ 2:14:47We're resetting the table now, and we'll have the next panel in just a moment.
▶ 2:15:38All right. We're back in order. And, uh, and I want to once again, thank the members for coming to present their ideas to the energy and commerce committee today. We, uh, it's important that we communicate with each other. Uh, let me start by recognizing representative amo for five minutes on his comments. >> thank you, Mr. chairman. Thank you, Mr. ranking member and distinguished members of the committee, thank you for the opportunity to testify today.
▶ 2:16:01It's a great honor to work together to protect consumers, strengthen health care, and improve the lives of all rhode islanders and all americans. First, I want to speak to the persistent crisis of healthcare affordability. I hear from constituents that healthcare costs are skyrocketing. We all do. It's one of the most urgent challenges facing families.
▶ 2:16:23Republicans slashed over $1 trillion from our healthcare system and ripped away health insurance from more than 39,000 rhode islanders in their big, ugly law. It will have devastating consequences. These cuts hurt everyone. When people lose coverage and providers are forced to do more with less. The stability of our entire healthcare system is at risk and everyone, everyone pays more.
▶ 2:16:49I look forward to working with this committee to ensure our constituents have access to reliable, affordable healthcare. Second, we must defend robust, sustained investment in scientific and medical research through the national institutes of health.
▶ 2:17:05Last year alone, researchers in rhode island received more than $256 million in nih support for work on alzheimer's disease, dementia, heart disease, diabetes prevention and many other conditions, along with over $21 million dedicated to student training. This research and training will save lives, the nih director named training future biomedical scientists as a top priority.
▶ 2:17:34Yet president trump's nih funded 896 fewer early career grants this year, supporting the lowest number of researchers in nearly ten years. The united states leads the world in biomedical research because of consistent nih investment. When trump underfunds the nih, we delay cures, stall promising treatment pipelines, and risk losing an entire generation of researchers.
▶ 2:18:01That's why I led a letter with representatives to get sanchez, fletcher and houlihan joined by a majority of house democratic members opposing trump's illegal slashing of the reimbursement rates for cutting edge research. I urge this committee to defend robust nih funding and reject proposals that put life saving research at risk. Third, I want to highlight my bipartisan having overdose protection equipment act, the hope act.
▶ 2:18:31New england has been struck hard by the opioid crisis, while harm reduction tools like naloxone have helped reduce fatal overdoses in rhode island by 36% in recent years, there is still more work to do. That's why I introduced the hope act. Just like putting aeds in schools and libraries has saved countless americans from cardiac arrest, putting naloxone in public places, more public places will save lives and restore hope.
▶ 2:18:57This bill would make it easier for states to make naloxone available in public spaces, so bystanders can step up and use this life saving intervention if they see someone experiencing an overdose. I look forward to continuing to work with this committee, including congressman tonko, a co-sponsor of the bill, to advance this bipartisan legislation.
▶ 2:19:21Finally, I want to address the growing threat of scams targeting the american people. Scams have become a nationwide crisis, increasingly sophisticated, tech driven and devastating for families, seniors and small businesses in every community, including rhode island. The impact of scams is deeply personal. When people are scammed, they don't just lose money, hard earned savings, they lose confidence and independence is taken away from them.
▶ 2:19:49Seniors are often hit the hardest with money stolen from older, older americans, soaring from $600 million in 2020 to $2.4 billion in 2024. That's why I helped launch the bipartisan stop scams caucus with my fellow co-chairs, congressman sharif raskin, and none to strengthen enforcement, expand public education, and ensure americans have the tools and resources to stay safe. Stay safe.
▶ 2:20:18I also introduce a bipartisan, bicameral national strategy for combating scams act to bring together over a dozen federal agencies and the private sector to create a national strategy for combating scams and standardized definitions of and reporting standards. I urge the committee to support moving this bipartisan bill so that we can crack down on scams and protect consumers.
▶ 2:20:44In closing, I look forward to continuing our work together to lower health care costs, champion scientific research, combat the opioid epidemic through the hope act, and protect americans from scams. I appreciate your great partnership in delivering on these priorities for my constituents in rhode island and those across the country. And with that, I yield back. Thank you. >> gentleman. Yields back. We thank him for his comments. We now turn our attention to the gentlewoman from oregon.
▶ 2:21:12Uh, representative biden, you're recognized for five minutes for your comments. >> good morning, chairman guthrie and ranking member pallone, thank you so much for holding this hearing and giving an opportunity for off committee members to share our priorities in your committee's jurisdiction. So I am here today to talk with you about h.r. 4486, the microplastics safety act.
▶ 2:21:36So when I started working on this issue, my staff told me a pretty shocking fact that most of us have a spoon's worth of microplastics in our brains. And what was even more shocking to me was how those plastics are potentially getting into our system. And the answer is it's because microplastics are everywhere.
▶ 2:22:00So some of us may think of it coming from polluted water or something like that, but in fact, it's when you're heating up food in the microwave. Uh, microplastics from the serving ware could be entering your system. If you're doing laundry. The air you're breathing is full of plastic particles due to synthetics and the fabric. And even something as simple as brushing your teeth. I learned from my daughter's dental school class.
▶ 2:22:26Uh, microplastics are in the toothbrush that you should be using multiple times a day. So bottom line is that they're everywhere, and the evidence is growing that they're posing a serious threat to our health and our safety. Now, I'm also an engineer, and I know that we can innovate our way out of any problem. But what I also know is that we can't do that without data.
▶ 2:22:51So there's simply not enough data out there right now to begin solving the problems of microplastics. And that's where my bill comes in. My microplastics safety act would require the fda to conduct its first ever study on the human health of microplastics in food, water and other products.
▶ 2:23:10And by requiring the fda to report back to congress on how exposure is affecting human health, we will have the data we need to start putting forth some solutions to help keep americans safe and healthy. And I'm proud to say that my bill has very strong bipartisan and bicameral support. I want to thank my republican partner, representative greg steube, and our senate leaders, senators jeff merkley and rick scott.
▶ 2:23:39This bill also has 12 bipartisan house co-sponsors, including energy and commerce committee members, congresswoman debbie dingell and commerce, manufacturing and trade subcommittee chairman gus bilirakis. And in fact, a september 2025 report released by hhs and the trump administration lists microplastics as one of the chemicals of highest concern for children and calls on our health agencies to evaluate the risks from human exposure to
▶ 2:24:10Microplastics. So here's what we know. So far, studies have shown a 50%. That's 50% increase in the levels of plastic in human brain samples when compared to 2016. And in a sample of 30 rivers in my home state of oregon, microplastics were found in 100% of them.
▶ 2:24:30So what's so concerning about that is that studies have also linked plastic exposure to things like cancer, endocrine disruption and chronic illness. So I believe we can't take a wait and see approach here. It's time to be proactive. And I don't want to be looking back 20 years from now with cancer rates skyrocketing, wishing we had done something sooner.
▶ 2:24:55So that's why I've come here today to urge this committee to take up my microplastics safety act, h.r. 4486. Let's make some progress. For the sake of our children, our families and all americans. Health. Thank you. And I yield back. >> the gentlelady yields back. Uh, thank you for your comments. We now turn our attention to the gentleman from puerto rico, representative hernandez, you're recognized for five minutes for your comments. >> thank you. Chairman guthrie. Uh, ranking member pallone.
▶ 2:25:26Esteemed colleagues, I come here with a simple, single, straightforward, bipartisan ask medicaid parity for puerto rico. This is something that my predecessor and current republican governor of the island, jenniffer gonzalez-colon, has long advocated for. And it is a fight that I am continuing on behalf of my people. Puerto rico has a 3.2 million residents and approximately 1.5 million. Almost half of the island's population benefits from medicaid.
▶ 2:25:56Yet while states receive an annually adjusted fmap that reflects their per capita income and economic conditions, puerto rico's fmap is written into statute. And during the past few years, starting in 2023, congress established a statutory fmap of 76%, but that expires in fiscal year 2027.
▶ 2:26:20And if it goes back to pre 2023 levels down to 55%, it would entail a reduction of billions of dollars for our health care funding. The island would fall into catastrophic health care, into a catastrophic healthcare crisis, into a catastrophic fiscal crisis.
▶ 2:26:42Now, this is inherently unfair because puerto rico has 3.2 million american citizens that deserve fair and equal treatment in federal programs. We fight in us wars. We have a significant amount of veterans residing in our island, and we contribute to the nation as a whole. Other territories have a permanent fmap written into law, but puerto rico remains the only jurisdiction without a durable, long term solution.
▶ 2:27:13Now, every extension buys time, but only parity buys stability. So I urge you once again to save puerto rico from a health care and fiscal catastrophe and to enact a permanent solution to puerto rico's medicaid funding challenges. It is a matter of simple fairness. It is a matter of justice, and it is a matter of economic opportunity.
▶ 2:27:42So I thank you all for your interest on this matter. I look forward to working together to solve this problem, and I will be back with the governor fighting for the people of puerto rico. In a matter that goes beyond political partizan affiliations. Thank you. >> thank you. And I just want to pause for the confusion of us switching chairs while you were talking. I apologize. You have two artillerymen, so we it's hard for us not to be quiet when we talk to each other.
▶ 2:28:12>> you can make it up with parity for puerto rico's medicaid program. >> thank you. I you're you're well, I know we have time to discuss after, but we're well aware and and worked both of us in in the fix that's currently in place. So yeah we are well aware. So thanks for understanding the priority. So representative rendell, you're now recognized for five minutes for your opening or your statement. >> thank you so much, chairman guthrie and ranking member pallone for the opportunity to testify before energy and commerce today.
▶ 2:28:38I'd like to start by sharing with you what drives my personal interest and passion in building an equitable health care system. My sister, olivia was born with microcephaly, a condition where her brain could not fully develop, leading to a life long health challenge. Complications, disabilities. Expensive medical care.
▶ 2:29:01My dad worked a civilian job at the department of defense, and even with his good government insurance, the care olivia needed to grow and live for 19 years would not have been possible without one thing medicaid. Specifically, the washington state legislature's decision to expand medicaid the very year olivia was born in 1993. Olivia's journey taught me something important when government recognizes what people need, it has the power to help them.
▶ 2:29:30Olivia's life fueled my career in public service, fighting to ensure families like mine can access the care and support that every person deserves. And I want to make one thing clear to me to so many of my constituents, health care is a human right. No person in the richest country in the world should be denied care because of their income, their zip code, or their immigration status. In the state legislature.
▶ 2:29:55I worked every day to protect and expand health care access, including leading washington's effort to expand postpartum medicaid. Our law, like the many states that followed, ensures individuals can access medicaid services for the full 12 months after their pregnancy ends, giving families stability during a critical period. This law is a perfect example of why I'm passionate about health care policy.
▶ 2:30:20When we meet people where they are, we can ensure that they have the tools that they need to keep themselves, their families and their communities healthy and thriving. That's why I'm a strong supporter of medicaid expansion. Thanks to the affordable care act, states can choose to expand medicaid like washington did, providing millions of low income americans access and coverage. In states that expanded medicaid, the numbers of uninsured dropped dramatically, giving families peace of mind and access to preventative care.
▶ 2:30:52In my state, the average monthly enrollment pre aca was 1,117,576. Because of medicaid expansion, total monthly enrollment reached an all time high of more than 2 million individuals in 2022, a 94% increase, nearly double the number of people who could count on health care. Medicaid expansion doesn't just help individual families, it keeps entire communities afloat across the country.
▶ 2:31:20Medicaid is the single largest payer for rural hospitals, including in my district. When states expand medicaid, hospitals stay open. When states don't, hospitals close. It's that simple.
▶ 2:31:33But the cuts to medicaid in the big ugly law, in addition to tariffs on medical equipment and the unwillingness to extend affordable care act tax credits for those who rely on them, will severely impact rural hospitals by threatening vital services and limiting access to care. Of my district's five rural hospitals, all are facing tough decisions about what services they can continue to provide. When republican policy makes their jobs nearly impossible.
▶ 2:32:00They may not be closing their doors, but they have to decide will they cut labor and delivery? So someone has to drive two hours to give birth? Will they cut cancer care neuro services? I spoke with james in aberdeen, washington, who shared the impacts of h.r. One on his family. He's the primary caregiver for his wife, who's battling late stage parkinson's and who relies on regular hospital visits and specialized care through medicaid.
▶ 2:32:26These cuts will make it nearly impossible for him to secure what his wife needs, leaving their family facing devastating uncertainty and hardship. I don't think any of us on either side would say that the system that we have is perfect, or working exactly as it was intended to.
▶ 2:32:42I do, however, have real concerns about saying that because it's not perfect, we should cut medicaid or not reinstate these affordable care act tax credits actions that will result in millions more americans losing their health care and leaving the system even more broken. What we need is fundamental reform. We need universal health care. We need to remove layers of profit and bureaucracy. We need a system where every person can go to the doctor, receive the care they need, and leave without worrying if they can afford it.
▶ 2:33:10The west coast has banded together to study and design such a system, efforts I supported by creating washington state's universal health care commission. These efforts show that practical, practical, achievable steps towards universal coverage are possible, but only if we work together and commit to the work ahead. I'm eager to work with the members of the energy and commerce, including you, ranking member and you, mister chair. And thank you so much for the time and opportunity to testify. >> thank you.
▶ 2:33:36Thank you for your statement, representative young kim you recognize recognized for five minutes for your statement. >> thank you, chairman guthrie and ranking member pallone for holding today's hearing and allowing me to testify. As a father of three beautiful children, I think that most parents would certainly agree that when you bring that first child home, those initial days can be terrifying.
▶ 2:33:55Whether it's having to deal with the fact that there are no nurses there to help, sometimes you may have a little bit of family in town, but ultimately it's now on you to keep this child that god has entrusted you with alive. And you're also doing a lot of learning on the job. Of course, there are sleepless nights, not just because of feedings or a child who's up in the middle of the night crying, but also because of the threat of sudden infant death syndrome, or sids.
▶ 2:34:24It always lurks in the back of your mind. Sids is the unexplained death of a healthy baby under one year old. It typically occurs during sleep. According to the cleveland clinic, about 2500 infants die from sids annually. That's 2500 families that have to endure the unbelievable heartbreak of losing a child. The causes for sids are largely unknown, and prevention options are often limited to sleep practice safe sleep practices.
▶ 2:34:52However, over the past decade, there have been advancements in in-home infant cardiorespiratory monitors. These devices are typically worn on an infant's foot and track the infant's heart rate, blood oxygen levels, and other vitals, and can notify parents or caregivers if vitals drop. I wish we had some of these new technologies when my kids were newborns. While this technology is promising, there are limited studies on its effectiveness and thus limited insurance coverage.
▶ 2:35:23That's why I'm proud to lead hr 2001 68, the baby observation act, or bill. This bill directs the secretary of health and human services to conduct a study and submit a report to congress on home cardiorespiratory monitors for infants. This report would include evidence on effectiveness, performance, and accuracy of such devices.
▶ 2:35:48Additionally, it would include criteria and recommendations for public and private health insurance coverage of such devices if they are proven effective. Bozak is named after bo newton from lakeville, and that is in my district. And, uh, it's a family and definitely a child who's certainly greatly benefited from this technology. His parents have become strong advocates for helping other families access this technology. This technology can be life saving.
▶ 2:36:16It's important that we fully study its capabilities and expand access as necessary. No parent should have to endure the immense pain of losing a child, and these types of devices can make all the difference. Chairman guthrie and ranking member pallone I would like to work with you and your staff to advance this important bill through committee and across the house floor. Thank you for your time and consideration and I yield back. >> thank you. The gentleman yields back. Is there anybody seeking recognition for questions? Mr. thank you.
▶ 2:36:48Appreciate you being here. Thank you for your statement. And now we'll call up the next panel. I thank all the organizers are coming today. So that's great. Is that the right word? Oregonian. Oregonian. Oh, there is one. That's a nice mountain, too. >> it's really nice. >> not only is a nice guy, I should say that too. I think we have all oregonians on this. That's not on the committee.
▶ 2:37:16Everybody, every oregonian on the committee, I think, has been here or has been here or is coming. So. There's a lot of interest in our. The. >> thank you.
▶ 2:37:46>> all right. Now we have the new panel and pounded. And so, uh, representative bonamici, who's been my great colleague on the workforce committee and worked on a lot of bills together. So thanks for being before energy commerce today. And you're recognized for five minutes. >> well, thank you very much. Chairman guthrie, ranking member pallone, uh, thank you for the opportunity to be here and to share our thoughts about priority legislation for the committee. I am here today to advocate for a bill. This committee should once again make a priority.
▶ 2:38:15The bipartisan alan reinstein ban asbestos now bill, which is house resolution 5373. It is dangerous and unacceptable that the united states still allows the importation, manufacturing and distribution of asbestos. It's a known carcinogen that has claimed too many lives in our country and around the world.
▶ 2:38:38We know that asbestos exposure continues to cause devastating health effects, particularly those working for those working in conditions where this deadly material is or was present. Tens of thousands of americans die from occupational asbestos exposure each year, and thousands of people are diagnosed with mesothelioma, a deadly form of cancer. Mesothelioma is caused by exposure to asbestos.
▶ 2:39:03It has been used in insulation and fireproofing material in homes and commercial buildings, and common products such as paint and construction materials, and mesothelioma is also disproportionately affects first responders, with firefighters at much higher risk of developing this deadly cancer compared with the general population.
▶ 2:39:25The bipartisan alan reinstein ban asbestos now act, which is named for a husband and father who lost his life at the age of 66 after a four year battle with this deadly disease, would ban the commercial use of all six recognized asbestos fiber types. We have worked hard to focus this bill on addressing the use of asbestos in commercial products.
▶ 2:39:47The scope of the bill applies only to the manufacture, processing, use and distribution in commerce, including implementation of commercial asbestos. In the rare instances where asbestos may be used in a commercial product for national security purposes, this bill has an exception that allows the president to grant an exemption from the ban, and the bill also guarantees that the ban does not inadvertently create liability for natural impurities that occur.
▶ 2:40:16Occur in commercial activities for other substances. We've worked very hard on this. The bill states explicitly that it has no effect on regulating cosmetics, as under the federal food and drug cosmetics act, as you all know. Finally, the bill provides the chlorine industry, which is the top importer of asbestos in the united states, until january 2030, to phase out their use of asbestos in manufacturing.
▶ 2:40:39So back in the 116th congress, this committee did advance the bill through, uh, through committee with a vote of 47 to 1. And, uh, as a reminder, uh, both you, Mr. chairman, Mr. chairman, guthrie and ranking member pallone supported it. Um, didn't get through the senate, but we came very, very close in that congress. Since then, we've worked very hard to improve the bill and update it. We continue to have bipartisan support.
▶ 2:41:07We also worked with stakeholders, uh, to address concerns. And we now have support from a broad coalition of stakeholders in public health and wellness industry. Key supporters of this legislation include the american cancer society, cancer action network, the international association of firefighters, the national stone sand and gravel association, olin corporation, the american federation of state, county and municipal employees, the american public
▶ 2:41:37Health association, and the asbestos disease awareness organization. So now is the time for congress to finally address this issue and permanently ban asbestos. And I tell you, Mr. chairman and ranking member, when I speak with people, colleagues about this, the first response when I'm telling them about the bill is, do you mean it's still legal in the united states?
▶ 2:41:57It is, unfortunately, and although administrations have attempted to address this issue through regulation, a bill signed into law would be the strongest action to protect public health and bring closure and justice to all of the victims of this horrible carcinogen and their families. So, chairman guthrie and ranking member pallone, thank you for your time today. Thank you for your past support of this bipartisan legislation. I look forward to continuing to work with you both to advance this important life saving bill. >> thank you.
▶ 2:42:26Thank you for your statement. And we also are going to have every wyoming to testify before us today. So my good friend from wyoming recognized for five minutes. >> thank you, chairman guthrie and ranking member pallone, thank you so much for the opportunity to testify today. I appreciate your leadership on this committee. As a committee member, I also enjoyed working with you on on the work related to the one big beautiful bill this summer.
▶ 2:42:51Today I want to discuss two priorities within your jurisdiction combating fentanyl counterfeiting and prioritizing oversight and reform of section 230 of the communications decency act. I have introduced alongside representative stansbury, the fight illicit pill presses act and senators cornyn and are our bipartisan senate partners in this fight.
▶ 2:43:13As our nation addresses the fentanyl crisis, we hear tragic overdose overdose stories where americans are unknowingly exposed to lethal doses of fentanyl. Contributing to this issue is the cartels illicitly using pill press machines that are also used by pharmaceutical companies so that they can disguise fentanyl as prescription and other drugs to facilitate their entrance into our country.
▶ 2:43:38This bill would add a serialization requirement for pill presses and punches, and it would prohibit the removal or alteration of these serial numbers or the distribution of machines with tampered serial numbers. The dea and other federal law enforcement agencies believe that serial serializing pill presses will better help solve crimes, and specifically help investigators identify crucial links in the chain to trace the pill presses back to the cartels. Turning to section 230. I have two primary concerns.
▶ 2:44:09First, it lacks. It lacks a sunset to require reauthorization. And second, the broad grant of immunity for the removal of content that the tech companies define as otherwise objectionable. Technological advancement is a defining characteristic of america, but we have the unique challenge of legislating in the internet age, where the pace of technological advancement moves much faster than ever before and certainly faster than the federal government baked into the house rules, our general oversight responsibilities to analyze and evaluate the
▶ 2:44:40Effectiveness of federal law. Section 230 civil liability shield is an area where we have not adequately exercised such oversight effectively, which I contribute to the lack of sunset in these authorities. I have long been a proponent for including sunsets in almost all bills, uh, granting government authority, and believe we commit legislative malpractice when we don't do so.
▶ 2:45:03This principle is especially true when federal law covers technology, which will always evolve more quickly than government. And the drafters of the bill, at a certain point in time can predict, I can I can point to no better example of this issue than section 230 immunity for the removal of content that is allegedly otherwise objectionable. Otherwise objectionable is an undefined standard in the statute.
▶ 2:45:28The social media giants companies that the authors of section 230 could have never anticipated at the time of its drafting have instead defined that standard for us, basing immunity for content removal on the standard of what is objectionable. Objectionable is not an appropriate standard because it is not shared among our citizens.
▶ 2:45:47What is objectionable to me may not be for others, and today, what is considered objectionable is an ever moving target defined by big tech, and one of which the 118th congress has oversight. Work was defined with a liberal silicon valley bias that collaborated with the federal government for one of the largest threats to our first amendment rights in us history.
▶ 2:46:09Therefore, I believe we must add a a sunset provision to section 230, not for the purpose of allowing it to lapse entirely, but to force this chamber to consider its purpose, application and role in the future of our nation. If and when we get to the reconsideration of section 230, we must also reconsider the otherwise objectionable standard on the internet, on social media, and with artificial intelligence, we have seen the dangers the online world can pose, especially to our children.
▶ 2:46:40Social media companies can play a major role in protecting our children if they are allowed to remove this harmful content content, and that is why I believe this liability shield must shift from objectionable conduct content to unlawful content to propose legislative solutions to address these issues, I will soon introduce a bill to sunset section 230 with the within the 119th congress.
▶ 2:47:04And I am also a proud co-sponsor of representative ghost stop the censorship act, which would implement this unlawful standard in place of the otherwise objectionable standard. As this committee builds its agenda for the second session, I strongly urge that section 230 be on the list of priorities. Thank you again for the opportunity to testify today and I yield back. >> thank you for being here. I appreciate that the gentleman from ohio, five minutes for your statement.
▶ 2:47:33>> thank you, chairman guthrie and ranking member pallone, for giving me this opportunity to speak today. And thank you for all the hard work this committee does. I represent a very rural appalachian district in southern ohio, and I'm here today to talk about two issues that are vitally important to the people who call southern ohio home broadband coverage and prescription drug prices. From the beginning, my top priority as a member of congress has been expanding rural broadband.
▶ 2:47:55The district I represent is not only one of the most disconnected in the country in terms of broadband, but also one of the most impoverished. I believe those two stats are unquestionably linked. Those who have broadband access inherently have an advantage in the modern economy over those who don't. That's why it's been my top mission in congress to try to get folks connected to broadband. Now, not 10 or 20 years from now. I come before the committee to highlight one of the bills that I think could help achieve that goal for those who need it most.
▶ 2:48:23I was proud to lead the bridging the broadband gap act, which I introduced earlier this year. This bill would simply add a provision within the $42.5 billion program to allow states to offer discounted prices for low income individuals for both the equipment and the monthly cost to get connected to satellite broadband or fixed wireless. I believe fiber is the gold standard of broadband, but the people of southern ohio cannot afford to wait for it to get to them.
▶ 2:48:49The cost of getting connected is oftentimes a major impediment, and this bill would help people help get people connected. Now, while fiber is being built out. And as we continue to discuss affordability, allowing states to offer a discounted price with drastically lower costs in rural america, several states will also have a significant amount of money left over after their initial planning, and this could be a great use of those dollars. I also want to flag that we've heard from our experts in ohio, the need for a skilled workforce to deploy all of this broadband funding.
▶ 2:49:18Uh, so I'm happy to work with the committee to figure out the best path forward on that. I applaud the states already offering discounted prices under the bead program, and I hope that by passing my bill, we can get all states to offer a program to make broadband more affordable while truly bridging the gap between now and when fiber gets to the homes. I'm happy to work with this committee and the administration to make this a reality, and I appreciate your consideration. And now moving on to another important topic price transparency and health care.
▶ 2:49:46It's no secret that prescription drug costs are through the roof. We've all seen drug commercials on tv, probably lots of them by now. You see everything in those commercials, from people flying kites to people running on the beach. The one thing you never really see, though, is the price of the drug. Because of a lack of price transparency, patients often don't know how much their prescription drug could cost them until they are rung up at the pharmacy counter. When drugs can cause hundreds or thousands of dollars. That's important information for a family to know.
▶ 2:50:14During the first trump administration, hhs recognized this issue needed to be addressed to promote price transparency. They drafted a rule that would have required pharmaceutical companies to include the list price of the drug in their advertisements. Unfortunately, a federal court blocked the rule, stating hhs did not have the authority to institute that requirement and congress would need to act. I believe we need to give them that authority, and that's why I introduced the drug price transparency for consumers act.
▶ 2:50:42This bill would do exactly what the first trump administration was trying to do, required direct to consumer pharmaceutical advertisements to include the list price of the drug. Polling shows that 88% of americans support this policy. Presumably, the other 12% is made up of people who didn't understand the question and pharmaceutical executives. The policy is widely supported by both republicans and democrats, patients and providers, young and old. The price of health care shouldn't be a secret. Obviously, there's a lot of partizan divide right now on health care issues.
▶ 2:51:11And I get it. Health care is a very important issue. It's an issue that congress needs to get right. But I think requiring price transparency and drug advertisements is an issue we have wide agreement on in this country. I hope we have an opportunity to make good on people's wishes in this congress. I thank congresswoman schakowsky for co-sponsoring the bill with me, and I would love to work with you, Mr. chairman, to bring about price transparency with this bill. Thank you again, Mr. chairman and ranking member, for giving me this opportunity to speak here today.
▶ 2:51:39I'm looking forward to me and my staff working with you on all these important issues, and I yield back. >> thank you for your testimony. Your your predecessor, president johnson of youngstown state. Uh, we had a hearing. My friend conducted a hearing remotely in the same issue about broadband connectivity. I don't know if you remember this, but I couldn't help but comment. I said, you're driving around. He was in his car. You're driving around your district talking about how your district not connected. I know in certain areas aren't. Most areas are, but I thought that was a it was kind of a funny thing.
▶ 2:52:09He was talking about connectivity while he's driving in his district. Uh, like to pick on him sometimes. So thank you for your testimony, Mr. style, from gentleman from wisconsin. You recognized for five minutes. >> chairman guthrie, ranking member pallone, thanks for having me in to talk about two important topics to the state of wisconsin. State of wisconsin's, the dairy state. So if you were guessing that the first topic I wanted to talk about involved cheese, you would be right. I want to talk to you about the curd act, h.r.
▶ 2:52:351394, codifying useful regulatory definitions act, wisconsin's america's dairyland. We have 1200 licensed cheese makers. We produce 25% of the nation's cheese and have more than 600 different styles. In my opinion, wisconsin's cheese is the best cheese in the world, but that's not relevant to the curd act per se.
▶ 2:52:55The curd act would amend the food, drug, and cosmetic act to codify a clear definition of natural cheese based on long established us cheese making standards. The definition would help consumers and industry clearly distinguish natural cheese from processed cheese. Processed cheese is already defined, as you may know, under federal regulation, but natural cheese still appears without a clear definition.
▶ 2:53:22Providing this clarity ensures customers know exactly what they're buying and gives cheese makers consistent, predictable labeling standards. The curd act was first considered in congress in 2017, when an advanced in the senate with unanimous consent.
▶ 2:53:37In the house, we passed this nonpartisan bill, but has been pending before the energy and commerce committee since 2019, and during that time, it's received two legislative hearings without significant objection, and has undergone four rounds of fda technical assistance. The bill is strongly supported by state and national dairy association.
▶ 2:54:02Given his record of bipartisan support and extensive vetting, I appreciate the committee's attention to this legislation and encourage you to include the curd act during the next appropriate hearing opportunity and move it forward as soon as possible. The second issue, I want to talk to you. That's important in my home state of wisconsin is about targeted fixes to the clean air act.
▶ 2:54:24Right now, as you may know, communities and manufacturers in wisconsin are being punished for pollution that's originating from outside the state of wisconsin, in places like chicago. That'd be like holding folks in bowling green accountable to pollution that's generated in memphis, or holding folks in middlesex county responsible for pollution that's occurring in philadelphia. It's not right. It's counterproductive.
▶ 2:54:48And if we're serious about strengthening american manufacturing and competing with china, we need to reform this bill instead of focusing on the real source of the problem. Current law piles costly compliance requirements on communities that are already doing the right thing under the clean air act, when an ozone nonattainment area misses its attainment deadline, it automatically bumps up to a higher nonattainment classification.
▶ 2:55:16That reclassification triggers stricter permitting requirements and additional regulatory burdens, even when local sources are not the primary driver of the concern. So in wisconsin, that's when we see this coming from maybe chicago or outside of our state. It's placing the burden on residents in the state of wisconsin. The same challenge is often faced in both of your respective states.
▶ 2:55:39To my understanding, the wisconsin department of natural resources has tried to work with the epa to address this from an administrative standpoint. However, our feedback from the epa has emphasized that these automatic reclassifications are set by statute and that a durable solution will require legislative action. In its current form, the clean air acts reclassification process does not adequately account for interstate ozone transport.
▶ 2:56:08I believe that we can rightsize this regulation while continuing to reduce emissions and keeping our air clean. This can be achieved, in my opinion, by making targeted reforms to the clean air act to fully account for ozone transport. I look forward to working with the committee with you, Mr.
▶ 2:56:28Chairman, with you, ranking member, to develop a practical, targeted solution that supports our workers american manufacturing while still maintaining the clean air standards we all want. I thank you both for having us in today. Uh, I hope you take into consideration both of these two important topics, and I yield back. >> thank you. I appreciate you being here. I like to I don't know if you were punting or not, but the styles of cheese. That was good.
▶ 2:56:55So, uh, representative bean, you're now recognized for five minutes for your opening statement. >> oh, thank you, thank you, chairman guthrie. Uh, ranking member pallone, thank you so much for the honor to come before this committee, this committee room. Let's be let's be honest, much bigger than it looks like on c-span. So it's an honor to be here live. I want to talk about what everybody's talking about. And that's health care.
▶ 2:57:21Uh, it's a topic that, uh, people are talking about around their dinner table and whatnot. Let's go back and look at history. 15 years ago, when the affordable care act was signed into law, uh, we were told it was going to bend the price curve downward. You could keep your doctor. Turns out the neither one of those things are true. Uh, costs then 14,000 for premiums.
▶ 2:57:45Today, 15 years later, those same premiums are $25,000, 78% increase in just 15 years. Uh, much higher than the traditional rate of inflation. History also teaches us, chairman, anytime government dumps large sums of money into any program, that is the root cause of inflation.
▶ 2:58:08So what it happened in the 70s when we started guaranteeing student loans, and we saw that same massive inflation take place during covid, where we put a lot of money into the inflation reduction act, ironically, which really caused inflation to to skyrocket. So the answer can't be of healthcare. Let's just dump more money into it. That's the wrong answer. I think.
▶ 2:58:30What, uh, what I believe is a bill that I'm happy to sponsor with mister pfluger of texas is to give more choice and invite more competition. Uh, rather than give these monies directly to the insurance companies, let's give it to individuals through an hsa savings account. Let them make the best decision of where to go individually. I also believe that we need to enhance more competition.
▶ 2:58:58Let's erase the state lines that are traditionally set up where companies can only sell in their state. What if what if we could have florida blue compete with kentucky uh, blues or the blues in kentucky or all across america, where you could go to a robust marketplace? Now we will need transparency. That's also part of the make affordable coverage act, uh, part of that whole pie. So I look forward to working with you and with Mr.
▶ 2:59:24Uh, pfluger, we've also have seen that during the affordable care act, when you have zero pay premiums, what happens? People and the fraudsters are out to steal our money. We had millions of people in this program get signed up without their knowledge. Never made a claim. Let's fix that. Being has a bill. It's skin in the game bill where everybody should have to pay something. Maybe even $5.
▶ 2:59:53A $5 bill which acknowledges I am signed up, I signed myself up, and I am participating in this program rather than the taxpayers waste this money and, uh, pay the premiums without the individual knowledge. Here's another problem that we have to address. And it's third party payers. Uh, do you have a constituent or maybe it happened to your family? Hey, I just got sent ten boxes of covid tests. I didn't order them, but we know the taxpayer is paying the bill.
▶ 3:00:23Being has what's called the prompt act, which says, hey, uh, can we at least give out bills for your account of what did you order or reconcile? I know you're not paying for it, but americans need to know what's on their tab and call it out. If you didn't order the covid test, which you didn't, uh, but you're still paying for it, then we need to track that down and make sure that every dollar, every dollar that goes into healthcare, every tax dollar, is a precious dollar. It needs to go further and continue, continue out.
▶ 3:00:52And by the way, americans are sick and tired of fraudsters, people stealing our money. So I sat on a small business committee and we saw the fraudsters come out with the pgp loans and the other types of recovery loans. There was at one time the previous administration, well, there's so much fraud. Let's just let it go. I say, no, I know everybody here says no. So we've introduced multiple we want our money back acts, which says let's not let it go.
▶ 3:01:21Let's continue to hunt down these fraudsters that stole our money. Let's get it back and let's put it in there. As a member of the ways and means committee, I look forward to working with this committee on solving health care and so many of our problems.
▶ 3:01:35Uh, it's an honor to be, I shouldn't say problems, let's say challenges, let's say opportunities, because this crossroads that we find ourselves in right now gives us an opportunity to, to to realign and empower individuals to, to do what's best for themselves. With that, Mr. chairman and ranking member pallone bean yields back. >> dean yields back. Is there any you have any questions. Seeing none. Thank you all for presenting today. We really appreciate you being here.
▶ 3:02:04So we'll go to the next panel. >> yeah. >> good job. >> all right glenn.
▶ 3:02:27I said earlier we've had every order I said or gander to before say oregonians I've been corrected today. So yeah. So I think we've had all of you guys. So for cliff the cliffs on the committee. So. Yeah. Exactly. Get everybody situated.
▶ 3:03:15>> alright. I guess he shows up. >> okay. So we're so thank you all for being here today. This is our fourth panel I think third or fourth panel. But we appreciate you being here for energy and commerce. Uh, our love the day we get to have our good colleagues come in and talk to us. And so, uh, we will start, and everybody's gonna have five minutes for their statement. And so, miss morrison, our representative morrison apologize is recognized for five minutes. >> thank you very much. Chair guthrie and ranking member pallone, I appreciate the opportunity to testify before you today.
▶ 3:03:45I'd like to begin by thanking the committee for advancing my bill. The newborn screening saves lives reauthorization act of 2025 out of the health subcommittee. This bipartisan legislation would renew and strengthen vital federal support for newborn screening programs, helping ensure lab quality informed parents and expand screening. Newborn screening has been an essential public health initiative that allows for life saving, early diagnosis, and treatment.
▶ 3:04:09Each year, approximately 4 million newborns are screened in the us, and about 12,000 infants are identified as having a condition and benefit from these critical early diagnoses. The long history of bipartisan collaboration and support for the newborn screening program has been instrumental in helping improve diagnostic tools, expand screening access across states, and even support the development of rare disease treatments and therapies.
▶ 3:04:34This week, I had the privilege of meeting with the father of one of the many families personally impacted by a rare disease. Newborn screenings could help identify and treat. Despite the tragic loss of their daughter, darcy in 1995, to mld, metachromatic leukodystrophy and their devoted caregiving to their daughter lindy.
▶ 3:04:54Also battling mld, dean sawyer and his wife taryn have been dedicated to making sure other families don't suffer through the isolation and pain they faced during their nearly seven years long search for an accurate diagnosis for their daughter. Thanks to the dedicated work of fierce champions like the sewers, along with other rare disease advocates, researchers and physicians, we've seen incredible advances in the field of newborn screening.
▶ 3:05:19I'm honored to represent minnesota's third congressional district, and in minnesota, we're proud to be a hub for pioneering research and a leader in studying rare disease diagnoses and interventions, recent developments and advances in cell and gene therapies show how investing in these programs can transform long term health outcomes.
▶ 3:05:37When we invest in newborn screening, we're protecting the most vulnerable among us, giving babies the best chance at a healthy start and helping spare families the pain and exhaustion of searching for a diagnosis. After having cared for patients. As an obgyn myself for over two decades, I can't emphasize enough how transformative and consequential it is to identify and, when possible, treat conditions at the earliest possible moment.
▶ 3:06:05Parents already face so many challenges when they welcome a new baby into their family. The peace of mind and clarity that life saving newborn screening can deliver is priceless. I've been so inspired by the courage and resilience of the families I've cared for as a doctor and met with as a legislator. They persist, regardless of the at times all consuming caregiving responsibilities they have.
▶ 3:06:29And despite the heartbreaking losses some endure, they push past barriers unwaveringly committed to getting every baby in america, the access to the timely diagnosis and treatment they need. The energy and commerce committee has the opportunity to continue the progress we've made over the last 22 years to help transform their dream of a world where every child has access to an accurate diagnosis and effective treatment into a reality.
▶ 3:06:55To honor the dedication and sacrifice of these families and the memories of their loved ones, I implore the committee to take the critical step of advancing this bill to full committee consideration. In the spirit of recognizing devoted advocates, I would also like to request the committee's consideration of the edina act while it sleepaway camp in 2022. A constituent of mine, edina toggle, was rushed to the hospital following a severe allergic reaction to a prescribed medication.
▶ 3:07:23Since the incident, edina and her family have been fighting to make sure no other family has the same frightening experience. The edina act would require pharmaceutical companies to clearly label label major allergens and gluten present in their medications, bringing greater transparency, protecting patient safety, and delivering peace of mind to families like adina's and so many others.
▶ 3:07:45With an estimated 3.4 million americans presenting to the emergency room annually for a food allergy reaction, this bill could help families avoid costly medical bills and alleviate emergency room caseload. I look forward to continuing to work with the committee to advance policies that protect our children's health and safety, and with that, I yield back. >> thank you for your statement, my friend. The gentleman from wisconsin is recognized for five minutes for his statement.
▶ 3:08:17>> I knew chairman guthrie when he was just a back in the back row with the rest of us, um, chairman guthrie, ranking member pallone, and distinguished members of the committee. Thank you for an opportunity to testify on some issues important to wisconsin's economy and to the nation's broader goals of regulatory certainty, scientific integrity and public safety. I'll focus on two key issues before the committee.
▶ 3:08:42First, the urgent need to address the ozone non-attainment challenges in southeast wisconsin along lake michigan. And second, the importance of advancing my own legislation, the no iris act. First of all, let's look at ozone. Uh, due to certain scientific reasons, ozone collects along a body of water when the sun is out.
▶ 3:09:06Uh, and ozone can also be affected by pollutants coming from other areas. Uh, we have a double whammy in wisconsin and that milwaukee and the counties north and south of it are, uh, have occasionally, very occasionally higher than average ozone, in part because of all the pollutants coming up from chicago. Nothing we can do to prevent that.
▶ 3:09:33Um, while wisconsin continues to work towards meeting the 2015 national ambient air quality standard for ozone, our region's ability to achieve compliance is uniquely hampered by the factors outside of wisconsin's control. Much of the ozone in wisconsin comes from pollution transported from illinois and indiana, as well as from mobile sources.
▶ 3:09:57And by the way, when I was growing up in a county along lake michigan, the amount of ozone was much more than now. We never cared. But that's just another matter. Under the current regulatory framework, local actions alone cannot bring wisconsin into attainment. And by the way, wisconsin is the number one manufacturing state in the country on a per capita basis. People don't know that.
▶ 3:10:22Uh, but the current situation is why the clean air act includes a good neighbor provision, which requires upwind states to take responsibility for emissions that significantly contribute to downwind attainment. Unfortunately, the current implementation of this provision has not adequately addressed the real world impact of transported pollution on wisconsin's air quality.
▶ 3:10:46As the result, wisconsin communities continue to face stricter regulatory burdens for pollution they didn't even create, which of course, transfers into spending a lot more money, which makes southeastern wisconsin, to a degree, not as competitive when it comes to our manufacturers. This reclassification would significantly lower permitting thresholds and impose new requirements on manufacturers and employers who are already working to comply.
▶ 3:11:14These strict standards that the epa is trying to impose, uh, would create new costs, restrict business expansion and jeopardize economic development in my state. Fortunately, on september 5th, the seventh circuit court of appeals issued a stay of the epa's action preventing these requirements from taking effect while litigation proceeds. The situation.
▶ 3:11:41This situation approach, one that recognized trans, recognizes transported pollution and ensure states like ours, underscores the need for a more workable federal wisconsin, uh, are not penalized for emissions they did not generate. I appreciate your continued attention to ozone transport issues and encourage bi partizan collaboration to strengthen the regulatory framework and get us out from this mess.
▶ 3:12:10The other thing really quickly, in addition to addressing nonattainment, I have legislation, h.r. 1415 called the no iris act. For decades, the epa has issued is relied on the integrated risk information system to develop chemical hazard assessments, even though the provision was never even authorized by congress.
▶ 3:12:31Iris has faced long standing criticism for its lack of transparency, inadequate reliance on peer reviewed science, and flawed methodologies. Recent regulatory actions have relied on iris derived values that many experts consider scientifically unsound.
▶ 3:12:49If we're going to make america great again, we can't push our chemical industries to places like india and china because of foolish behavior out of the iris. One example is epa's assessment of ethylene oxide, which said exposed thresholds tens of thousands of times lower than the ones naturally occurring in present in in in levels present in the human body.
▶ 3:13:17In other words, they're asking my poor companies to make things cleaner than our own body. The no iris act simply assures that epa cannot use iris assessments to finalize or implement regulatory actions unless congress authorizes the program to. Bill currently has 20 co-sponsors, including five members of your own environmental subcommittee. >> thanks. I think we're getting low on time here. >> okay. That's fine.
▶ 3:13:48>> we're doing questions at the end, but I want you didn't bring up any concerns with your neighbor to the due west? I know wind blows west to east. You didn't bring anything up about. >> we don't have a problem with the wind from the west. I know we got a problem coming up from the south. >> I was just trying to be in sarcastic with your friends. That next. >> to you. I can't blame her. I can't blame her. >> I thought you were just playing nice with the viking fan. >> friendly neighbor. >> the gentleman yields back. Thank you for your statement. The gentleman from georgia is recognized for five minutes. >> thank you, Mr. chair.
▶ 3:14:17It's an honor to be here today. Before you, I want to take special privilege just to point out that a two seats to my left, uh, there will be some contentious moments in the next couple of days I want to address right now just by saying, uh, go navy beat army. Uh. >> gentleman's time has expired. So. I know. >> uh, on a serious note, I appreciate this time to come before you guys. There's some.
▶ 3:14:41The fda approval process is something that it can be very reasonable at times, and at other times can be inhibitive of growth and reasonability when it comes to drug approvals. And at this time, I wanted to kind of talk about highlighting an urgent issue that could affect about 1.5 million people's lives here in america. On august 6th, 2025, the fda sent notification to the industry with the intention to remove animal derived desiccated thyroid extract.
▶ 3:15:12I'll call it dte products from the market by august of 2026. This announcement and subsequent statements have created significant confusion and uncertainty for healthcare providers, patients and domestic pharmaceutical manufacturers. This action would hurt patients who depend on dte as a treatment option for hypothyroidism and threatens jobs in my district.
▶ 3:15:39As a physician, I can tell you this is a natural substance that's created through through animals, that's then derived, that we can use just like we do with insulin, uh, as opposed to a synthetically produced thyroid substitute that helps people with their health and their maintenance of health, which is very important to people. Um, for some reason or another, though, they said they were going to disapprove it and take it off the market without giving good justification.
▶ 3:16:02In my opinion, there are at least two current dte manufacturers diligently working on fda approval currently, and their projects as biologics. And if this goes through, they can't even get that approval, obviously, for continued usage by the american public, which goes flies in the face of capitalism, fair competition and choice in medical treatments.
▶ 3:16:24Uh, it is essential the fda to issue follow up guidance that provides a clear and constructive path forward that continues to enforce the discretion. Excuse me, discretion through approval for dte manufacturers who are doing the right thing, not the right thing, the wrong thing, but actually going through the approval process just the way any other product would be.
▶ 3:16:47But that will be taken off the market won't even be an option, which is unfair both to the patients who are being treated, as well as the manufacturers who put a lot of time and effort into this. Such guidance is needed to protect patients access, preserve domestic investments and operations, and help achieve fda's goal of first ever approved dta. Dte product. Dte medication should remain on the market until fda approved production is available to all these patients.
▶ 3:17:16I encourage the committee to direct the fda to ensure relevant stakeholders are being engaged as it prepares on follow up guidance. I'm ready to assist in coordinating those conversations to ensure patients have access to these life saving medications.
▶ 3:17:29Uh, with my remaining time, I just wanted to also point out that one of my colleagues, miss green, is going to be bringing something to the floor next week on transgender, uh, policy and not treating youth with basically surgeries that mutilate them or hormones that affect them for the rest of their lives. This can be a very contentious issue.
▶ 3:17:53I think it's important that we we come to a good conclusion medically that we we morally approach this, that, that it makes sense to the american people. We don't let people get tattoos or smoke cigarettes or buy alcohol or a certain age. Certainly anything that's transforming children should be looked at very seriously with the with an eye towards not allowing a decision to be made that will affect you for the rest of your life. When you're in your adolescence, your brain hasn't even developed. You haven't even decided you're going to be a cowboy or an indian.
▶ 3:18:22I mean, these are harrowing times, but I think her bill is greatly flawed. We have alternatives out there. My protects act, which is h.r. 742, is one of those. It's not going to put doctors in jail, but it's going to do the right thing. You also have one by doctor onder, two physicians that want to approach this from a common sense standpoint of looking after children and doing the right thing for the health care prevention. Let's not get carried away because of a promise made for a vote to vote for the wrong bill. We have two really good options out there.
▶ 3:18:51Let's do the right thing when it comes to putting the right bills in the right places to succeed and do the right thing for american people and its youth. With that, I yield. >> thank you, Mr. yield. And you can't respond. Navy. Another oregonian is with us again. Representative dexter, you're recognized for five minutes for your statement. >> thank you. Chairman guthrie, ranking member pallone and members of the committee for this opportunity to participate in member day. My name is maxine dexter.
▶ 3:19:17I am a mother, a physician, and the proud representative of oregon's third congressional district. Before coming to congress, I spent 20 years caring for patients who struggled every single day just to breathe. I have seen firsthand how smoke, dust, and pollution ravage our lungs and steal years of healthy life in the exam room. I patients were never democrats or republicans. They were parents, workers, children, neighbors, and above all, people who deserved a real chance to live a healthy life.
▶ 3:19:49Our federal government has not lived up to its responsibility to protect them, to give them this chance, this committee, this institution can change that. Outdoor air quality is worsening with increasing wildfires, deregulation of tailpipes and industry, and is leading to real, measurable harm to our health and our economy. It is egregious that this administration is stepping back from protecting our air, both outdoors and equally importantly, indoors.
▶ 3:20:15Since arriving in congress, I've been working on solutions to address these challenges, drawing on the stories of my patients who were harmed by wildfire smoke, and in collaboration with wonderful staff from this committee, I am developing a bill to establish a grant program to ensure public health authorities have the resources they need to respond during smoke events. Our physicians, nurses, nurses and frontline health workers deserve stronger support and our communities deserve timely and effective public health protection.
▶ 3:20:43This policy is grounded in recommendations from the bipartisan wildland fire mitigation and management commission report. Protecting the health of our communities should never be a partizan issue, but addressing wildfire smoke and outdoor pollution are only part of the challenge. The next frontier in this space is indoor air quality.
▶ 3:21:02This year, I had the privilege of attending an event at the un general assembly on healthy indoor air, and the message was clear when we prioritized the air in the places where we live, work and learn, everyone benefits. We already have broad agreement around policies that would help better ventilation standards, stronger air quality monitoring, and clear guidance for schools and workplaces on how to keep our people safe.
▶ 3:21:26As we look ahead, we have real opportunity to build on the strong foundation set by the clean air act. The clean air act passed with overwhelming bipartisan support because members on both sides of the aisle understood that clean air is essential to health and life. We should be thinking about how we strengthen and modernize these protections that saved so many lives. And I hope to be your partner in that work. As the only pulmonologist in congress, I have unique perspective to offer on air quality issues.
▶ 3:21:55And as a physician, I also know that our larger health care system is at a crisis point that cannot go unaddressed. The us spends more on health care than peer countries, but our life expectancy is below that of our peer nations. This is due in large part to our failure to incentivize keeping people healthy in our system. Right now, the way we pay for care, rewards, volume, how many procedures or tests we perform, not the actual value provided by our health care professionals.
▶ 3:22:24We need a system that pays physicians for quality and outcomes. It's about putting doctors back in the driver's seat and paying them to keep people healthy, not just to treat them when they're sick. And it means stripping away the administrative burden that prevents them from delivering the care they know the patient in front of them needs. In this pursuit, we must focus on primary care and the essential preventative services it encompasses.
▶ 3:22:47These services are our first line of defense in keeping people healthy, yet they are chronically undervalued and in some instances, unreimbursed entirely. I look forward to continued work with those on this committee to better support and improve pay for high quality primary care.
▶ 3:23:01As a working class kid who is the only person in my family to graduate college and certainly medical school, I also know that we have to be investing in foundational programs like the national health service corps, that make medical school a possibility for kids like me, while bringing critically needed primary care providers to our most unserved, underserved communities.
▶ 3:23:22I look forward to continued collaboration with this committee to secure increased multiyear funding for this program, while giving it the tools it needs to for to be truly competitive with other options. Overlaying all of this is the need to address the most pressing question in front of us today. How to make health care affordable for americans.
▶ 3:23:43I am proud to support congresswoman lauren underwood's efforts to extend the enhanced aca premium tax credits and ensure that working families in oregon and across the country are not forced to make the impossible choice between keeping their health insurance or putting food on the table. I believe we have the opportunity to boldly reimagine how health care works. I look forward to working with each of you on long term, durable policy change that ensures every american gets access to the health care that they deserve. I'm grateful for your time today, and I yield back. Thank you, Mr. chair.
▶ 3:24:15>> thank you. Thank you for being here today. And to my colleague and fellow army, go, army. Mr. davidson, you're recognized for five minutes. Thank you. Chair. I apologize, everybody, if you went to one of the service academies. Army, navy weeks a big deal. So anyway, thank you, chairman. And definitely there is no substitute for victory. Go, army. Be navy. Uh, this morning I'd like to speak briefly on the need to pass the bipartisan repair act. Freedom means owning what you buy. And today's landmark.
▶ 3:24:42And in today's landscape, automakers are looking are locking our constituents out of tools, software and know how for repairing vehicles that they've purchased. The repair act requires manufacturers to share the tools, data and information for an individual, uh, or their local mechanic to be able to fix their own vehicle. This gives our constituents the ability to choose when and where they get their cars repaired.
▶ 3:25:07Right now, over 60% of repair shops struggle with routine fixes because automakers withhold data jacking up repair costs by over $3 billion annually. It's your car, and it should be your data. But right now, automakers remain in control of the data. The repair act ensures transparency without compromising safety or intellectual property. Independent repair shops employ nearly 5 million americans and are a vital resource in many of our communities.
▶ 3:25:36The national federation of independent businesses says. Says 90% of its members support the right to repair. The repair act has 43 co-sponsors from 23 states, rural and urban districts, republicans and democrats. Importantly, this bill will bring down repair costs for working families. I'm proud to co-sponsor this bipartisan, bicameral legislation, and I urge this committee to give us a vote. Let's get this thing to the floor.
▶ 3:26:02The second in related to that is I broad jurisdiction here in the committee, uh, deals with privacy and the data privacy in particular. Congress should establish a clear national standard. You know, we don't need europe's privacy laws, but we don't need somalia's either, which is no privacy laws. Uh, we're seeing data harvested, sold, data brokers selling virtually everything possible.
▶ 3:26:30Uh, and as we confront an era of ai, uh, it is important that we get privacy, right? Privacy is really the base layer for ethical artificial intelligence. So congress must pass legislation that reflects the fundamental reality that you own your own data. This means that individuals control how their data is collected, accessed and used. Um, and with artificial intelligence coming, I think it is important that we have preemption. The president's executive order gets that right.
▶ 3:26:58But we should have thoughtful legislation to address it. I yield back. >> the gentleman yields back. I want to thank all the members of the committee for their comments. Do you have. >> I just wanted to say that, um, you know, I appreciate this panel and the others as well. Um, all of you come up are concerned about, uh, practical problems that affect the average american. And, you know, that's so important.
▶ 3:27:26I worry so much that oftentimes our committee focuses on, you know, kind of things in the cloud that are not necessarily impacting people in their daily lives. And, and I just, uh, that I just appreciate the fact, you know, I heard what representative dexter said about the worrying about pollution, whether it's wildfires, air quality, and how that directly impacts the health of americans, which is what I hear all the time.
▶ 3:27:53And then the data privacy, the need for a national standard. Representative davidson is really so important. We've been struggling this with this for years. But one of the things that I like about the energy and commerce committee is that so many of our so many issues that impact people's lives directly every day come before us. And so it's really good to hear some, uh, possible solutions for those. Thank you. Thank you so much. >> the gentleman yields back.
▶ 3:28:23Thank you very much. Uh, we are going to take a moment of recess to reset the table for the next panel.
▶ 3:30:01Other representative kagan's thank you for for coming. I'm not sure if the rest of the panel is on the way or not, but, uh. >> I'll give it one minute. One minute. >> okay. We're going to give one minute. And then, uh, with ranking members permission, I think we'll just go ahead and one minute.
▶ 3:30:46Committee will come to order. We'll represent. We'll recognize the gentlelady from virginia, representative higgins, for five minutes for her comments. >> thank you, Mr. chair. It's a privilege to be here today. Before I start, I just wanted to set the record straight about go. Navy beat army this weekend. Uh, and with that, Mr. chair, ranking member and distinguished members of the committee, thank you for the opportunity to speak today.
▶ 3:31:10I'm here to bring awareness to the committee about my bill to care for military kids, act as the proud representative of virginia's second congressional district, home to one of the largest active duty military navy populations in the united states. Advocating for those who serve our country and their families is one of my top priorities. Along with my past life as a navy helicopter pilot, I was also a board certified nurse practitioner.
▶ 3:31:33I most enjoy when I get to work on policy that marries these two careers and passions, and they care for military kids act does just that. Unlike civilian families, military families often need to move every 2 to 3 years not by choice, but by obligation. When relocated to another state, service members uproot their whole lives to answer the call to serve, and their families often sacrifice a great deal for service members who have dependents with disabilities. The sacrifice can greatly impact their livelihoods.
▶ 3:32:00Most service members and their families get health insurance via tricare, but tricare does not cover long term care services. This means children with disabilities covered by tricare through their parents military service cannot receive the care they need unless they sign up for medicaid. People with disabilities often need long term care services to help them every day with everyday activities such as eating, walking, and medical equipment management.
▶ 3:32:25Unfortunately, with every move, dependent children must reenter entirely new state health systems with new medicaid rules, new waiver programs, new provider networks, and long wait lists, service members and their families already sacrifice a great deal to defend our country. They should not have to sacrifice the health and well-being of their families.
▶ 3:32:45The care for military kids act would amend the social security act to ensure that any dependent of an active duty service member currently receiving long term care services through a state administered medicaid plan will remain eligible should their family be stationed outside of that state. Ensuring our service members do not have to choose between serving their country, moving and getting their children the critical care they need.
▶ 3:33:08I was grateful for the work with then chair mcmorris rodgers in this committee last congress did, to pass this legislation in the house on a bipartisan basis. I look forward to doing the same again, this congress. Thank you. And I welcome your questions. >> uh, the gentlelady yields, uh, we thank her for her comments. Now, I'd like to turn our attention to the gentleman from california, representative valadao. You're recognized for five minutes. >> thank you, Mr. chairman.
▶ 3:33:36I appreciate the opportunity to be here today to discuss the supplemental oxygen access reform act or the soar act, which I introduced this congress. The soar act eliminates barriers to that. Over 1.5 million medicare beneficiaries with chronic conditions face, including many of my constituents in the central valley when trying to access life saving supplemental oxygen.
▶ 3:34:00This legislation makes critical reforms to ensure that patients, especially those living in rural and underserved communities, can receive reliable and life saving oxygen support. Since 2011, cms has implemented a competitive bidding process for supplemental oxygen, causing payment rates for all types of oxygen to drop substantially.
▶ 3:34:21While the competitive bidding program has generated payment reductions in medicare savings, these reductions too often come at the expense of access to essential oxygen equipment and respiratory care services. Given the inadequate reimbursement rates, many individuals who require supplemental oxygen do not receive the level or type of treatment their condition needs.
▶ 3:34:44Medicare also does not currently reimburse for the services of respiratory therapists, which are vital, especially when the patient is given a new oxygen prescription. If patients are unable to access equipment or respiratory support, they risk, uh, their risk of emergency room visits increase and their chronic condition may worsen. I was also encouraged by cms's announcement last month that supplemental oxygen will not be included in the next round of competitive bidding program.
▶ 3:35:12Locking in past savings is a meaningful first step, but more has to be done. That's why this, uh, that's why it's critical. This congress works to ensure long term stability in the program, which saw act, provides the soar act as a competitive is a comprehensive legislation that removes all oxygen and oxygen equipment, including stationary and portable devices, from the medicare competitive bidding. It also gives cms the authority to create a new payment rate for liquid oxygen, to help address the loss of access for the to this modality nationwide.
▶ 3:35:44The legislation further strengthens program integrity by enhancing fraud and abuse protection, ensures respiratory therapists are reimbursed when medically required, and implements additional patient protections. I look forward to working with the chairman to advance the soar act, and to secure its inclusion in the next medicare package. Thank you, Mr. chairman, and I yield back. >> the gentleman yields back. Thank you very much for your comments. Uh, that seems to bring the panel to a close. Does the ranking member have any comments?
▶ 3:36:12Well, in that case, I want to thank all of the members who came and testified before the committee and all the members who, uh, who participated. I ask unanimous consent to insert in the record the documents included on the staff hearing list without objections. That is so ordered. I would like to thank you all again for being here. Without objection, the committee is adjourned. Thank you very much.