MR. WALDEN

THANK YOU, MR. CHAIRMAN. I YIELD MYSELF SUCH TIME AS I MAY CONSUME.

THE SPEAKER PRO TEMPORE

WITHOUT OBJECTION.

MR. WALDEN

I RISE IN SUPPORT OF H.R. 6. THIS IS THE SUPPORT ACT. I WAS PROUD TO…

I RISE IN SUPPORT OF H.R. 6. THIS IS THE SUPPORT ACT. I WAS PROUD TO INTRODUCE THIS BILL WITH ENERGY AND COMMERCE RANKING MEMBER, MY FRIEND FROM NEW JERSEY, MR. PALLONE, WAYS AND MEANS COMMITTEE, KEVIN BRADY, AND WAYS AND MEANS RANKING MEMBER, RICH NEAL. THE HOUSE HAS DEDICATED TREMENDOUS AMOUNTS OF TIME AND ENERGY TO SEND A MESSAGE TO THOSE IN THE OPIOID CRISIS, HELP IS ON THE WAY. NOT ONLY ARE WE PASSING LEGISLATION, DOZEN OF BILLS, TELLING THOSE THAT THE UNITED STATES HOUSE OF REPRESENTATIVES, REPUBLICANS AND DEMOCRATS ALIKE, STAND WITH THEM TOGETHER. FOR TOO LONG, EMBARRASSMENT AND STIGMA SURROUNDED THE DISEASE OF ADDICTION. IT'S TIME FOR THAT TO CHANGE. IF YOU'RE STRUGGLING WITH ADDICTION, IF YOU'RE FIGHTING THAT INVISIBLE BATTLE, PLEASE KNOW THAT IT'S OK TO SEEK HELP. OPIOID OVERDOSE TAKE THE LIVES OF MORE THAN 100 LIVES EACH DAY. 1,000 PEOPLE WILL GO TO THE EMERGENCY ROOM IN THE NEXT 24 HOURS SUFFERING AN OVERDOSE FROM OPIOIDS. WE DON'T WANT THOSE PEOPLE TO BECOME PART OF THAT DEADLY STATISTIC. YOU MATTER. YOU'RE WORTHWHILE, AND I PRAY THAT THE VARIOUS LEGISLATION WE VOTE ON HERE TODAY AND WE VOTED ON THROUGHOUT THE LAST TWO WEEKS CAN HELP YOU BEGIN YOUR JOURNEY OF RECOVERY. H.R. 6 INCLUDES SEVERAL BILLS THAT WENT THROUGH REGULAR ORDER IN THE ENERGY AND COMMERCE AND WAYS AND MEANS COMMITTEES. THIS INCLUDES DOZENS OF PIECES OF LEGISLATION THAT RECENTLY PASSED THE HOUSE, MOST UNANIMOUSLY OR WITH VERY, VERY STRONG BIPARTISAN MAJORITIES. YOU SEE, AT A TIME WHEN IT SEEMS WE COULDN'T BE MORE DIVIDED, IT'S CLEAR THAT STRIKING BACK AGAINST ADDICTION IS SOMETHING THAT TRANSCENDS POLITICS AND BRINGS US TOGETHER AS A COMMUNITY, AS A COUNTRY, AND AS A CONGRESS. REMEMBER, THIS LEGISLATION IS NOT THE FIRST ACTION THAT THIS CONGRESS HAS TAKEN TO COMBAT THE OPIOID CRISIS, AND I'M SURE IT WILL NOT BE THE LAST. I GUARANTEE YOU THAT. THE COMPREHENSIVE ADDICTION AND RECOVERY ACT, AND THE 21ST CENTURY CURES ACT THAT WERE SIGNED NEARLY TWO YEARS AGO AND NEARLY $4 BILLION IN RESOURCES FOR STATES AND COMMUNITIES THAT WAS PROVIDED IN THE OMNIBUS APPROPRIATIONS BILL JUST A FEW MONTHS AGO INDICATE WE HAVE BEEN AT THIS FOR A WHILE AND WE WILL BE AT THIS FOR A WHILE LONGER. TAKEN TOGETHER, THIS IS ONE OF THE MOST SIGNIFICANT CONGRESSIONAL EFFORTS AGAINST THE DRUG CRISIS IN OUR NATION'S HISTORY, BUT WE MUST CONTINUE TO LEGISLATE, EVALUATE, CONDUCT OVERSIGHT AND WORK TOGETHER TO PROVIDE NEW SOLUTIONS THAT WE CAN RISE SO -- SO THAT WE CAN RISE TO THIS EVER CHALLENGING SITUATION. TODAY, WE HAVE AN OPPORTUNITY TO CONTINUE OUR WORK, TO COMBAT THIS CRISIS. AN OPPORTUNITY TO SAVE LIVES. WE CANNOT LET IT PASS. THE LEGISLATION BEFORE US WILL HELP ADVANCE TREATMENT AND RECOVERY INITIATIVES, IMPROVE PREVENTION AND EDUCATIONAL EFFORTS, PROTECT OUR COMMUNITIES AND BOLSTER OUR EFFORTS TO FIGHT DEADLY SYNTHETIC DRUGS LIKE FENTANYL. WE OWE IT TO THE FAMILIES WE HEARD FROM. WE OWE IT TO OUR FRIENDS, OUR COMMUNITIES NEED THIS, AND OUR COUNTRY NEEDS THIS TO LIFT OUR PEOPLE OUT OF ADDICTION AND TOGETHER WIN THIS FIGHT. WITH THAT I URGE MY COLLEAGUES TO SUPPORT H.R. 6, THE SUPPORT FOR PATIENTS AND COMMUNITIES ACT, AND I RESERVE THE BALANCE OF MY TIME, MR. CHAIRMAN.

THE CHAIR

THE GENTLEMAN RESERVES. THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED.

MR. PALLONE

THANK YOU, MR. CHAIRMAN. I YIELD MYSELF SUCH TIME AS I MAY CONSUME.

THE CHAIR

WITHOUT OBJECTION.

MR. PALLONE

I RISE IN SUPPORT OF H.R. 6, THE SUPPORT FOR PATIENTS IN COMMUNITIES ACT.…

I RISE IN SUPPORT OF H.R. 6, THE SUPPORT FOR PATIENTS IN COMMUNITIES ACT. THIS BILL IS NOT PERFECT. IT DOES -- THERE ARE PROVISIONS THAT I DID NOT SUPPORT AT THE SUBCOMMITTEE OR FULL COMMITTEE MARKUP, INCLUDING PROVISIONS THAT MOST DEMOCRATS VOTED AGAINST. I'M PLEASED DEMOCRATS WERE ABLE TO SECURE POSITIVE PROVISIONS IN THE FINAL PACKAGE WE'RE CONSIDERING TODAY. H.R. 6 INCLUDES PROVISIONS FROM A BILL INTRODUCED BY REPRESENTATIVE TONKO AND LUJAN THAT WOULD EXTEND ACCESS TO EVIDENCE-BASED MEDICATED ASSISTED TREATMENT. THIS SECTION OF THE BILL WILL ALLOW REGISTERED NURSES, INCLUDING MID WIVES TO HELP PATIENTS FOR OPIOID ABUSE. AND WILL ALLOW NURSE PRACTITIONERS TO TREAT PATIENTS. AND THIS IS A CRITICAL STEP FORWARD IN THE EXPANSION OF TREATMENT. ONE OF THE MAJOR CHALLENGES WE CONTINUE TO FACE IN THE FIGHT AGAINST THIS EPIDEMIC AND I COMMEND REPRESENTATIVES TONKO AND LUJAN FOR THEIR ONGOING LEADERSHIP IN THIS AREA. THIS EXPANDS MEDICARE. METHADONE ARE NOT MEDICARE -- CLINICS ARE NOT MEDICARE PROVIDED. ADDING METHADONE CLINICS WILL ADDRESS AN IMPORTANT COVERAGE GAP IN THE PROGRAM AND MEANINGFULLY EXPAND ACCESS FOR OPIOID USE DISORDERS. THE BILL ALSO IMPROVES COVERAGE FOR VULNERABLE POPULATIONS IN MEDICAID. IT ENSURES COVERAGE FOR FORMER FOSTER YOUTH UP TO THE AGE OF 26 NATIONWIDE AND SUPPORTS STATES EFFORTS TO ENSURE CONTINUITY OF COVERAGE FOR PEOPLE OF SUBSTANCE USE DISORDERS AS THEY LEAVE INCARCERATION. AND PROVIDE MONEY TO HOMES. EXPANDS CAPACITY FOR MEDICAID PROVIDERS AND RAISE REIMBURSEMENT RATES. MANDATES COVERAGE OF MEDICAID OF ALL FORMS OF -- MEDICATION-ASSISTED TREATMENT FOR FIVE YEARS. THE LEGISLATION ALSO MANDATES COMPREHENSIVE SUBSTANCE USE DISORDER BENEFITS IN THE CHILDREN'S HEALTH INSURANCE PROGRAM, BETTER KNOWN AS CHIP. I AM ALSO PLEASED THAT H.R. 3528, THE EVERY PRESCRIPTION CONVEYED SECURELY ACT, AUTHORIZED BY REPRESENTATIVE CLARKE OF -- CLARK OF MASSACHUSETTS IS IN THE BILL. FURTHER, THE BILL GIVES THE SECRETARY OF H.H.S. THE AUTHORITY TO EXPAND THE USE OF TELEHEALTH SERVICES IN MEDICARE FOR SUBSTANCE USE DISORDER TREATMENT TO HELP REACH MORE PEOPLE ACROSS THE COUNTRY. THESE ARE ALL IMPORTANT DEMOCRATIC PROVISIONS AND WAS PUT IN THE FINAL PACKAGE. I THINK IT WILL FIGHT AGAINST THE OPIOID EPIDEMIC. I STILL HAVE CONCERNS WITH SOME OF THE PROVISIONS INCLUDED IN THIS FINAL NEGOTIATED BILL AND THE PROCESS BY WHICH WE ARRIVED HERE. FOR INSTANCE, THERE ARE TWO MEDICARE BILLS THAT I OPPOSED THROUGH THE COMMITTEE PROCESS AND I AM CONCERNED MAY NOT HAVE A MEANINGFUL IMPACT ON THE OPIOID CRISIS. H.R. 5804 WOULD INCREASE REIMBURSEMENT FOR CERTAIN INTERVENTIONAL PAIN INJECTIONS IN THE AMBULATORY AREA. I'VE SEEN NO REASON HOW IT WOULD HAVE A MEANINGFUL IMPACT ON OPIOID PRESCRIBING. WHILE IT'S IMPORTANT CONGRESS FINDS WAYS TO FIND NONOPIOID THERAPIES THAT WILL REDUCE OPIOID PRESCRIBING, THIS BILL INCENTIVIZES INTERVENTIONS THAT MAY NOT BE EFFECTIVE FOR A MAJORITY OF PATIENTS RECEIVING THEM. I ALSO HAVE SOME CONCERNS ABOUT H.R. 5809, WHICH WOULD EXTEND A TEMPORARY PASS-THROUGH PATIENT FOR POSTSURGICAL MANAGEMENT FROM THREE TO FIVE YEARS IN MEDICARE. I DO QUESTION IF THIS BILL WILL HAVE A MEANINGFUL IMPACT ON THE OPIOID CRISIS. I'M ALSO DISAPPOINTED THAT PARTISAN LEGISLATION THAT WOULD DIRECT F.D.A. TO ISSUE GUIDANCE ON HOW THE AGENCY WILL APPLY THE CRITERIA FOR ACCELERATED APPROVAL AND BREAKTHROUGH THERAPY DESIGNATION TO NONADDICTED PAIN AND TREATMENT WAS INCLUDED IN THIS PACKAGE. THIS LEGISLATION WOULD SET THE PRECEDENT OF HAVING THE F.D.A. OPINE ON HOW EXPEDITED PROGRAMS MAY APPLY DIFFERENTLY FOR THERAPEUTIC AREAS. IT REQUIRES THE AGENCY TO HOST A PUBLIC MEETING TO DISCUSS THIS AND OTHER TOPICS BUT PROVIDES NO RESOURCES FOR THE AGENCY TO COMPLETE THESE TASKS. THIS IS NOT LEGISLATION THAT F.D.A. ASKED FOR OR HIGHLIGHTED AS A PRIORITY IN FIGHTING THE OPIOID CRISIS. WHILE THEY MAY NOW BE COMFORTABLE WITH THE CHANGES THAT HAVE BEEN MADE TO THE BILL, I'M NOT COMFORTABLE WITH THE POLICY. FINALLY, MR. CHAIRMAN, I THINK IT'S ESSENTIAL WE KEEP THIS OPIOID PACKAGE IN THE CONTEXT OF A LARGER HEALTH CARE DEBATE IN CONGRESS. AS I STATED BEFORE, MY REPUBLICAN COLLEAGUES ARE INTERESTED IN TAKING CREDIT TODAY FOR SOME POLICIES THAT HELP THOSE AFFECTED BY THE CRISIS WHILE AT THE SAME TIME ACTIVELY THREATENING AND SABOTAGING THE VERY HEALTH CARE COVERAGE THAT MANY OF THE SAME PEOPLE RELY ON IN THE FIRST PLACE. THE ONGOING EFFORTS BY HOUSE REPUBLICANS AND THE TRUMP ADMINISTRATION TO REPEAL OR SABOTAGE THE AFFORDABLE CARE ACT HAVE ONLY HARMED THOSE AFFECTED BY THIS CRISIS. EARLIER THIS MONTH, REPUBLICANS DIRECTED -- DIRECTLY THREATENED THE HEALTH CARE OF PEOPLE WITH OPIOID USE DISORDER WHEN THE TRUMP ADMINISTRATION ASKED A FEDERAL COURT TO STRIKE DOWN KEY PATIENT PROTECTIONS IN THE AFFORDABLE CARE ACT. IF SUCCESSFUL, THE TRUMP ADMINISTRATION'S ACTION WOULD ELIMINATE PROTECTIONS THAT ENSURE MORE THAN 130 MILLION AMERICANS WITH PRE-EXISTING CONDITIONS CANNOT BE DENIED COVERAGE. AND GUESS WHO IS CONSIDERED A PRE-EXISTING CONDITION? OPIOID USE DISORDERS AND PEOPLE WITH IT. REPUBLICANS ALSO CONTINUE WITH THEIR ATTEMPTS TO GUT THE MEDICAID PROGRAM, WHICH IS OUR MOST IMPORTANT WEAPON IN THE FIGHT AGAINST THIS EPIDEMIC. BOTH THE CONSUMER PROTECTIONS OF THE A.C.A. AND MEDICAID HAVE SAVED COUNTLESS OF LIVES THAT WOULD HAVE OTHERWISE BEEN DESTROYED BY THE OPIOID CRISIS. IT'S NICE WE ARE PASSING THIS BIPARTISAN PACKAGE TODAY BUT WE MUST NOT FORGET THE HARM THAT IS INFLICTED ELSEWHERE. I RESERVE THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN RESERVES. THE GENTLEMAN FROM OREGON IS RECOGNIZED.

MR. WALDEN

MR. CHAIRMAN, I HAD YOU A NOW LIKE TO RECOGNIZE THE -- I'D LIKE TO…

MR. CHAIRMAN, I HAD YOU A NOW LIKE TO RECOGNIZE THE -- I'D LIKE TO RECOGNIZE THE VICE CHAIRMAN, THE GENTLEMAN FROM KENTUCKY, MR. GUTHRIE.

THE CHAIR

THE GENTLEMAN FROM KENTUCKY IS RECOGNIZED.

MR. GUTHRIE

I RISE IN SUPPORT OF THE PATIENTS IN COMMUNITIES ACT. KENTUCKY HAS BEEN…

I RISE IN SUPPORT OF THE PATIENTS IN COMMUNITIES ACT. KENTUCKY HAS BEEN HIT BY -- PATIENTS AND COMMUNITIES ACT. KENTUCKY HAS BEEN HIT HARD BY OF THE OPIOID CRISIS. PARENTS HAVE LOST CHILDREN TO OPIOID USE DISORDER. EMPLOYERS ARE HAVING A HARD TIME FINDING EMPLOYEES, AND THE OPIOID CRISIS HAS TAKEN A TERRIBLE TOLL ON OUR COMMUNITIES. LAST CONGRESS I WAS PROUD TO WORK WITH MY COLLEAGUES AS WE CRAFTED THE COMPREHENSIVE ADDICTION AND RECOVERY ACT. WE ALSO PASSED THE 21ST CENTURY CURES ACT. WE HAVE COME TOGETHER TO BUILD ON THOSE TWO LAWS WITH MORE LEGISLATION TO ADDRESS THE ONGOING OPIOID EPIDEMIC. OVER THE PAST TWO WEEKS WE HAVE PASSED OVER 50 BILLS OUT OF THE HOUSE, INCLUDING MY BILL, THE COMPREHENSIVE OPIOIDS RECOVERY ACT. TODAY WE VOTE ON THE SUPPORT FOR THE PATIENTS AND COMMUNITIES ACT. THE CULMINATION OF OUR WORK OVER THE PAST YEAR TO COMBAT THE OPIOID CRISIS. I URGE MY COLLEAGUES TO SUPPORT THIS IMPORTANT BILL THAT WILL HELP ALL AMERICANS AFFECTED BY THIS AWFUL EPIDEMIC. I URGE ITS SUPPORT AND I YIELD BACK.

THE CHAIR

THE GENTLEMAN RESERVES. THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED.

MR. PALLONE

THANK YOU, MR. SPEAKER. I NOW YIELD TWO MINUTES TO THE GENTLEWOMAN FROM…

THANK YOU, MR. SPEAKER. I NOW YIELD TWO MINUTES TO THE GENTLEWOMAN FROM CALIFORNIA,

THE CHAIR

THE GENTLELADY FROM CALIFORNIA IS RECOGNIZED.

MS. ESHOO

THANK YOU, MR. CHAIRMAN. I RISE IN SUPPORT OF H.R. 6, AND I THANK OUR…

THANK YOU, MR. CHAIRMAN. I RISE IN SUPPORT OF H.R. 6, AND I THANK OUR THANK OUR RANKING MEMBER FOR YIELDING TIME TO ME. THERE IS NO QUESTION THAT OUR COUNTRY IS IN THE MIDST OF A DESTRUCTIVE OPIOID EPIDEMIC THAT CLAIMS CLAIMS 142 LIVES EVERY DAY. THIS IS A NATIONAL CRISIS. IT'S OUR DUTY AS MEMBERS OF CONGRESS TO DO EVERYTHING IN OUR POWER TO STEM THE TIDE OF ADDICTION AND THE DEVASTATION THAT THIS EPIDEMIC IS CAUSING. IT'S CLAIMING MORE LIVES THAN WERE LOST IN THE VIETNAM WAR. THEY'RE STAGGERING FIGURES. H.R. 6 INCLUDES POLICIES TO EXPAND THE NUMBER AND TYPES OF PROVIDERS WHO CAN ADMINISTRATOR THE MEDICATION SUCH AS NALOXONE TO OPIOID ADDICTED PATIENTS AND IT ALLOWS MEDICARE TO PAY FOR OPIOID TREATMENT PROGRAMS. THAT'S A VERY IMPORTANT ADDITION TO -- IN THE LEGISLATION. THIS WILL HELP PEOPLE SUFFERING FROM OPIOID USE DISORDER TO GET ACCESS TO THE CRITICAL TREATMENT THEY NEED ON THE DAY THE LEGISLATION IS SIGNED INTO LAW. H.R. 6 ALSO CREATES A PAYMENT STRUCTURE THAT INCENTS RATHER THAN DISCOURAGES THE USE OF NON OPIOID ALTERNATIVES. I THINK THIS IS A VERY IMPORTANT PROVISION IN THE LEGISLATION BECAUSE IT WILL HELP TO DECREASE THE NUMBER OF OPIOIDS PRESCRIBED AND KEEP PATIENTS FROM BECOMING ADDICTED IN THE FIRST PLACE. . YOU -- I WANT TO POINT SOMETHING OUT. THE MAJORITY HAS REPEATEDLY VOTED FOR THE BENEFITS OFFERED BY MEDICAID WHICH IS THE SINGLE LARGEST PAYER OF MENTAL HEALTH SERVICES PROVIDING HEALTH COVERAGE TO 27% OF ADULTS WITH A SERIOUS MENTAL ILLNESS. THE MAJORITY HAS ALSO CONSISTENTLY AND REPEATEDLY UNDERMINED THE AFFORDABLE CARE ACT, INCLUDING REFUSING IT DEFEND THE PROTECTIONS FOR PATIENTS WITH PRE-EXISTING CONDITIONS. MAY I HAVE 30 MORE SECONDS.

MR. PALLONE

ANOTHER 30 SECONDS.

MS. ESHOO

THIS IS VERY SERIOUS BECAUSE THIS WOULD PROVIDE THE CRITICAL ACCESS TO…

THIS IS VERY SERIOUS BECAUSE THIS WOULD PROVIDE THE CRITICAL ACCESS TO TREATMENT FOR SUBSTANCE ABUSE DISORDERS. YOU GIVE WITH ONE HAND AND TAKE AWAY WITH THE OTHER. THESE POLICIES WILL HARM MILLIONS OF VULNERABLE AMERICANS AND LIMIT OUR RESPONSIBILITY TO RESPOND AND RECOVER FROM THIS EPIDEMIC. BUT THIS IS AN IMPORTANT FIRST STEP. WE NEED TO DO MORE TO ADDRESS THE CAUSES OF THE EPIDEMIC AND STEM THE TIED OF ADDICTION AND EXPAND MEANINGFUL ACCESS AND PAY FOR IT SO THAT WE CAN HELP THE VERY PEOPLE THAT --

THE SPEAKER PRO TEMPORE

THE GENTLELADY'S TIME HAS EXPIRED.

MS. ESHOO

I YIELD BACK.

THE SPEAKER PRO TEMPORE

THE GENTLEMAN FROM OREGON IS RECOGNIZED.

MR. WALDEN

THANK YOU, MR. CHAIRMAN. I'D LIKE TO YIELD THE GENTLEMAN FROM WEST…

THANK YOU, MR. CHAIRMAN. I'D LIKE TO YIELD THE GENTLEMAN FROM WEST VIRGINIA, MR. MCKINLEY, WHO HAS BEEN A REAL FIERCE FIGHTTORY RESOLVE THIS ISSUE IN HIS STATE AND COUNTRY. ONE MINUTE.

THE SPEAKER PRO TEMPORE

GENTLEMAN FROM WEST VIRGINIA IS RECOGNIZED.

MR. MCKINLEY

OVER THE PAST TWO WEEKS AMERICA HAS WITNESSED SOMETHING IMPRESSIVE. BOTH…

OVER THE PAST TWO WEEKS AMERICA HAS WITNESSED SOMETHING IMPRESSIVE. BOTH PARTIES HAVE COME TOGETHER, ONCE AGAIN, TO TAKE ACTION ON ONE OF THE MORE CHALLENGING ISSUES OF OUR TIME. THE OPIOID EPIDEMIC. THIS HEALTH THREAT IS NOT UNIQUE. IN THE PAST CONGRESS FACED THE AIDS EPIDEMIC THAT CLAIMED THE LIVES OF HUNDREDS OF THOUSANDS OF AMERICANS AND STAIRED DOWN THE EBOLA NIGHTMARE. CONGRESS RESPONDED METH THOTICALLY AND THOUGHTFULLY BY INVESTING MASSIVE RESOURCES INTO MEDICAL RESEARCH AT N.I.H. AND TREATMENT AND PREVENTION PROGRAMS. THAT'S EXACTLY WHAT CONGRESS IS TRYING TO DO TODAY. IN THIS BILL WE'RE FUNDING N.I.H. TO DEVELOP ALTERNATIVES TO OPIOIDS FOR PAIN MANAGEMENT, INCREASING TREATMENT AND PREVENTION PROGRAMS, AND EEQUIPPING OUR LAW ENFORCEMENT TO STOP DANGEROUS DRUGS LIKE FENTANYL FROM COMING INTO AMERICA. THIS BILL IS GOING TO MAKE A DIFFERENCE IN THE LIVES OF MILLIONS OF AMERICANS. CONGRESS IS BUILDING ON THE WORK THAT IT STARTED WITH CARA, THE 21ST CENTURY CURES, BUT THIS ISN'T THE END. IT'S VITAL TO CONTINUE WORKING TOGETHER. I URGE MY COLLEAGUES TO SUPPORT THE PASSAGE OF H.R. 6 AND YIELD BACK MY TIME. THANK YOU.

THE SPEAKER PRO TEMPORE

THE GENTLEMAN RESERVES. THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED.

MR. PALLONE

THANK YOU, MR. CHAIRMAN. I YIELD NOW TWO MINUTES TO THE GENTLEMAN FROM…

THANK YOU, MR. CHAIRMAN. I YIELD NOW TWO MINUTES TO THE GENTLEMAN FROM CALIFORNIA.

THE CHAIR

THE GENTLEMAN FROM CALIFORNIA IS RECOGNIZED.

>>

THANK YOU, MR. SPEAKER. I THANK YOU TO THE RANKING MEMBER FOR YIELDING. I…

THANK YOU, MR. SPEAKER. I THANK YOU TO THE RANKING MEMBER FOR YIELDING. I WANT TO TAKE A MOMENT TO SAY A SPECIAL THANK YOU TO MR. PALLONE AND HIS COMMITTEE STAFF FOR THEIR TIRELESS WORK TO ADDRESS THIS CRISIS. CRISIS HAS RAVAGED OUR NATION. TWICE BEEN DECLARED A NATIONAL HEALTH EMERGENCY UNDER FEDERAL LAW. MORE THAN 100 PEOPLE WILL DIE FROM AN OVERDOSE TODAY. THAT'S WHY A BIPARTISAN EFFORT TO ADDRESS IT IS SO IMPORTANT. CERTAINLY WORK TO BE DONINGS, BUT I'M HAPPY LEGISLATION I WORKED ON WITH MY COLLEAGUE IS INCLUDED IN THE BILL AND AIMS TO STOP ADDICTION WHERE IT FREQUENTLY BEGINS, AFTER SURGERY. MILLIONS OF AMERICANS ARE PRESCRIBED OPIOIDS FOLLOWING ROUTINE SURGERIES BECAUSE THEY ARE CHEAP AND ACCESSIBLE, AND NEARLY 70% OF PILLS GO UNUSED. OUR BILL REVERSES THAT INCENTIVE. IT ALLOWS INNOVATORS TO RECEIVE EXTRA COMPENSATION FOR NONADDICTIVE OPIOID ALTERNATIVES IF THEY CAN SHOW THEIR ALTERNATIVE THERAPIES HAVE SUBSTANTIAL CLINICAL BENEFITS. IN THE SHORT TERM, THE POLICY REDUCES TO THE INCENTIVE TO SIMPLY USE THE CHEAPEST POST SURGICAL PAIN TREATMENT, AND IN THE LONG TERM IT WILL SPUR INNOVATION BY PROVIDING ADDITIONAL COMPENSATION FOR THE FUTURE DEVELOPMENT OF NONADDICTIVE ALTERNATIVES. THAT MEANS AS LONG AS THIS CRISIS TAKES TO SOLVE, THERE WILL BE A INCENTIVE TO CONTINUE DEVELOPING NONOPIOID ALTERNATIVES. ACCESS-S ISN'T ENOUGH. THESE TREATMENTS MUST ALSO BE AFFORDABLE. WE'LL CONTINUE TO WORK WITH C.M.S. AND F.D.A. TO ENSURE THAT SAFER, MORE EFFECTIVE NONOPIOIDS ARE AFFORDABLE FOR THE PEOPLE WHO NEED THEM MOST. WE MUST FIND BETTER WAYS TO TREAT THIS PROBLEM WHERE IT STARTS. I URGE MY COLLEAGUES TO SUPPORT THE BILL. I YIELD BACK.

THE SPEAKER PRO TEMPORE

THE GENTLEMAN RESERVES. THE GENTLEMAN FROM OREGON IS RECOGNIZED.

MR. WALDEN

THANK YOU --

THE CHAIR

THE GENTLEMAN RESERVES. THE GENTLEMAN FROM OREGON IS RECOGNIZED.

MR. WALDEN

THANK YOU, MR. CHAIRMAN. I NOW RECOGNIZE THE GENTLEMAN FROM FLORIDA, MR.…

THANK YOU, MR. CHAIRMAN. I NOW RECOGNIZE THE GENTLEMAN FROM FLORIDA, MR. BILIRAKIS, FOR ONE MINUTE.

THE CHAIR

THE GENTLEMAN FROM FLORIDA VIRGINIA TECH.

MR. BILIRAKIS

THANK YOU, MR. CHAIRMAN. I RISE TODAY IN SUPPORT OF H.R. 6, THE SUPPORT…

THANK YOU, MR. CHAIRMAN. I RISE TODAY IN SUPPORT OF H.R. 6, THE SUPPORT FOR PATIENTS AND COMMUNITIES ACT. A BIPARTISAN IS RECOGNIZED.

MR. WALDEN

BILL THAT WILL AID OUR OVERALL EFFORTS TO COMBAT THE OPIOID CRISIS. I'M…

BILL THAT WILL AID OUR OVERALL EFFORTS TO COMBAT THE OPIOID CRISIS. I'M PROUD THAT TWO PROVISIONS OF MINE ARE INCLUDED IN THE FINAL PASSAGE OF THE BILL. THESE PROVISIONS WOULD ESTABLISH A MANDATORY DRUG MANAGEMENT PROGRAM FOR AT-RISK BENEFICIARIES IN MEDICAID AND MEDICARE. THIS BIPARTISAN EFFORT SHOWS THAT WE CAN DO THINGS WHEN WE PUT PARTISAN POLITICS ASIDE AND WORK TOGETHER. I WANT TO THANK CHAIRMAN WALDEN FOR ALL OF HIS HARD WORK OVER THE PAST YEAR AS WE CRAFTED THIS BILL. HE LED THE CHARGE AND I APPRECIATE IT, MR. CHAIRMAN, SO MUCH. I ALSO WANT TO THANK CONGRESSMAN BEN RAY LUJAN, MY DEMOCRATIC COLLEAGUE AND FRIEND, FIVE YEARS AGO WE DEVELOPED THE FIRST DRUG MANAGEMENT PROGRAM IN MEDICARE, AND NOW WE DEVELOP A DRUG MANAGEMENT PROGRAM IN MEDICAID. I ENCOURAGE MY COLLEAGUES TO SUPPORT THIS BILL. I YIELD BACK.

THE CHAIR

THE GENTLEMAN RESERVES. THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED.

MR. PALLONE

THANK YOU, MR. CHAIRMAN, I YIELD TWO MINUTES TO THE GENTLEWOMAN FROM…

THANK YOU, MR. CHAIRMAN, I YIELD TWO MINUTES TO THE GENTLEWOMAN FROM MASSACHUSETTS, MISS CLARK -- MS. CLARK.

THE CHAIR

THE GENTLEWOMAN FROM MASSACHUSETTS VIRGINIA TECH.

MS. CLARK

THANK YOU TO THE RANKING MEMBER -- MASSACHUSETTS IS RECOGNIZED.

MS. CLARK

THANK YOU TO THE MASSACHUSETTS, MISS CLARK RANKING MEMBER. RECOGNIZING…

THANK YOU TO THE MASSACHUSETTS, MISS CLARK RANKING MEMBER. RECOGNIZING THIS AND TO TALLLY FUND ACCESS TO HEALTH CARE SO WE CAN CURB THIS HORRIBLE EPIDEMIC IN MEANINGFUL WAY. ONE OF THE MANY FACTORS THAT CONTRIBUTES TO THE OPIOID CRISIS IS THE SHEAR VOLUME OF OPIOIDS IN CIRCULATION. ACCORDING TO THE C.D.C., OVER 214 MILLION PRESCRIPTIONS WERE WRITTEN FOR OPIOIDS IN 2016. AND WE CAN SEE THAT IN OUR OWN FEDERAL PROGRAMS. A 2016 STUDY SHOWED THAT ONE IN THREE MEDICARE PART D RECIPIENTS RECEIVED OPIOIDS. THAT IS ALMOST 80 MILLION PRESCRIPTIONS FOR A COST OF $41ST BILLION. THE SHEAR VOLUME MAKES IT HARD TO PREVENT ABUSE ADDICTION, WASTE, AND FRAUD. ALMOST 90,000 BENEFICIARIES OF MEDICARE ARE AT SERIOUS RISK FOR ABUSE AND OVERDOSE, RECEIVING OVER 2 1/2 TIMES THE RECOMMENDED DOSING. THIS STUDY ELIMINATED ANYONE WHO WAS ON HOSPICE CARE. ADDITIONALLY, 70,000 RECIPIENTS RECEIVE AN EXTREME AMOUNT OF OPIOIDS. THAT IS THE EQUIVALENT OF 24 VIKO CONTINUE EVERY SINGLE DAY. -- VICK CONTINUE EVERY SINGLE DAY. -- VICODIN EVERY SINGLE DAY. I HAVE A BILL THAT WILL REQUIRE EVERY PRESCRIPTION WRITTEN FOR MEDICARE PART D BENEFICIARY BE PRESCRIBED ELECTRONICALLY BY 2021. WE KNOW THIS TECHNOLOGY WILL SAVE LIVES BY MAKING IT HARDER TO FORGE PRESCRIPTIONS, 2021. EASIER FOR DOCTORS TO KNOW IF A PATIENT IS DOCTOR SHOPPING, AND BE ABLE IT PREVENT FRAUD AND SAVE THE GOVERNMENT MONEY. THIS IS A COMMONSENSE BILL THAT CAN CAN HELP FIGHT THE OPIOID CRISIS. I'M VERY GRATEFUL TO CHAIRMAN WALDEN AND THE RANKING MEMBER FOR INCLUDING IT IN THIS PACKAGE. THANK YOU, I YIELD BACK.

THE CHAIR

THE GENTLEMAN FROM NEW JERSEY RESERVES. THE GENTLEMAN FROM OREGON IS…

THE GENTLEMAN FROM NEW JERSEY RESERVES. THE GENTLEMAN FROM OREGON IS RECOGNIZED.

MR. WALDEN

I WANT TO THANK MS. CLARK AND MS. MULLIN FOR BRINGING THAT TO OUR…

I WANT TO THANK MS. CLARK AND MS. MULLIN FOR BRINGING THAT TO OUR ATTENTION. I YIELD TO THE GENTLEMAN FROM INDIANA, ONE OF OUR DOCTORS ON COMMITTEE,

THE CHAIR

THE DRAFMENT INDIANA IS RECOGNIZED.

MR. BUCSHON

I RISE TODAY FOR H.R. 6. THIS BILL WILL HELP OUR STRUGGLING COMMUNITIES BY…

I RISE TODAY FOR H.R. 6. THIS BILL WILL HELP OUR STRUGGLING COMMUNITIES BY FOCUSING ON PROVIDING CARE TO THOSE IN NEED WHILE ADDRESSING OPIOID MISUSE AND ABUSE. I'M PROUD OF TWO PIECES OF LEGISLATION INTRODUCED ARE INCLUDED IN H.R. 6 AS SECTIONS 202 AND 203. SECTION 202 WHICH I WORKED CLOSELY WITH REPRESENTATIVE PETERS ON TO INTRODUCE WOULD INCENTIVIZE THE DEVELOPMENT OF NONOPIOID PAIN ALTERNATIVES FOR POST SURGICAL PAIN. SECTION 303 WOULD INCREASE SCREENING FOR CHRONIC PLANE PAINE, ADDRESS POSSIBLE NONOPIOID PAIN ALTERNATIVES AND -DIRNL' PROUD TO HAVE WORKED WITH MY COLLEAGUES ON SOLUTION THOSE THIS SERIOUS CRISIS AND URGE MY COLLEAGUES TO SUPPORT H.R. 6. I YIELD BACK.

THE CHAIR

GENTLEMAN FROM OREGON RESERVES. THE GENTLEMAN FROM NEW JERSEY IS…

GENTLEMAN FROM OREGON RESERVES. THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED.

MR. PALLONE

THANK YOU, MR. CHAIRMAN. I YIELD THREE MINUTES TO THE GENTLEMAN FROM NEW…

THANK YOU, MR. CHAIRMAN. I YIELD THREE MINUTES TO THE GENTLEMAN FROM NEW YORK, MR. TONKO.

THE CHAIR

THE GENTLEMAN FROM NEW YORK IS RECOGNIZED.

MR. TONKO

I THANK GENTLEMAN FROM NEW JERSEY FOR YIELDING. I RISE IN SUPPORT OF H.R.…

I THANK GENTLEMAN FROM NEW JERSEY FOR YIELDING. I RISE IN SUPPORT OF H.R. 6, THE SUPPORT FOR PATIENTS AND COMMUNITIES ACT. THE SUPPORT FOR PATIENTS AND COMMUNITIES ACT INCORPORATES LEGISLATION THAT I INTRODUCED ALONG WITH MY GOOD FRIEND AND COLLEAGUE, REPRESENTATIVE BEN RAY LUJAN OF NEW MEXICO, WHICH WILL PROVIDE MEANINGFUL EXPANSION TO ADDICTION TREATMENT ACROSS OUR COUNTRY. ESPECIALLY IN RURAL AREAS AND FOR VULNERABLE POPULATIONS LIKE PREGNANT AND POSTPARTUM WOMEN AND 13,000 BABIES BORN ON AVERAGE EACH YEAR WITH NEONATAL ABSINENCE IN SYNDROME. OUR LEGISLATION INCLUDES THREE MAIN POLICY CHANGES TO EXPAND ACCESS TO TREATMENT. FIRST, IT ELIMB 2345EU9S THE CURRENT SUNSET PROVISION THAT WOULD PROHIBIT NURSE PRACTITIONERS AND PHYSICIANS ASSISTANTS FROM TREATING PATIENTS WITH ADDICTION MEDICINE AFTER 2021. BY ENDING THIS SUNSET, WE CAN PROVIDE CERTAINTY TO OUR HEALTH CARE COMMUNITY AND ENCOURAGE MORE P.A.'S TO BECOME PART OF THE ADDICTION TREATMENT WORK FORCE. SECOND, THIS LEGISLATION WOULD EXPAND THE CLASSES OF PRACTITIONERS ELIGIBLE TO PRESCRIBE TO OTHER ADVANCE NURSING PROFESSIONALS TO INCLUDE NURSE MIDWIVES, CLINICAL NURSE SPECIALIST, AND CERTIFIED REGISTERED NURSE ANECESSARY AT THISCIESES. THIS WAS INCLUDED BASED ON FEEDBACK MY OFFICE RECEIVED FROM MEDICAL GROUPS SUCH AS THE AMERICAN SOCIETY FOR ADDICTION MEDICINE AND THE AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS WHO ARE ON THE FRONTLINES OF THIS CRISIS WHO HAVE MADE THE CASE THAT ADDING ADDITIONAL CLASSES OF HIGHLY SKILLED NURSES CAN HELP MORE PEOPLE ACCESS TREATMENT AN FIND THAT IMPORTANT ROAD TO RECOVERY. IN MANY RURAL AREAS, ADVANCED PRACTICE NURSES PLAY AN OUTSIZED ROLE IN PROVIDING CARE, AND THIS LEGISLATION WILL HELP EXPAND ADDICTION TREATMENT CAPACITY IN THESE RURAL AREAS WHERE IT IS MOST NEEDED. IN ADDITION, THESE ADVANCE PRACTICE NURSING PROFESSIONALS ARE ALREADY PROVIDING PRIMARY CARE FOR SOME OF OUR MOST VULNERABLE POPULATIONS. BY ALLOWING THESE KILLED PROVIDERS TO PROVIDE ADDICTION TREATMENT AS WELL, WE CAN BOLSTER CONTINUITY OF CARE FOR OUR MOMS AND FOR OUR BABIES. FINALLY, OUR LEGISLATION WOULD MAKE A TECHNICAL CHANGE THAT WOULD ALLOW DATA 2000 WAIVER PROVIDERS TO TREAT UP TO 100 PATIENTS IF THEY POSSESS ADDITIONAL CREDENTIALING OR PRACTICING IN A QUALIFIED PRACTICE SETTING. TAKEN TOGETHER, THESE THREE CHANGES WILL MAKE A MEANINGFUL DIFFERENCE IN MOVING TOWARD A SYSTEM OF TREATMENT AND DEMAND FOR INDIVIDUALS STRUGGLING WITH THE DISEASE OF ADDICTION. TO THOSE WHO O WOULD SAY WE NEED MORE DATA, WE NEED TO BE CAUTIOUS ABOUT EXPANDING ACCESS TO TREATMENT, I WOULD RESPOND THAT MORE AND MORE PEOPLE ARE DYING IN OUR STREETS EVERY DAY. WE DON'T HAVE TIME TO DRAG OUR FEET ANY LONGER. TIMELY, I WANT TO THANK RANKING MEMBER PALLONE AND CHAIRMAN WALDEN AND THEIR STAFFS FOR THE CONTINUED EFFORTS ON THESE PROVISIONS THROUGH MANY MONTHS OF BACK AND FORTH. IN A PERSONAL WAY AND VERY UP FRONT WAY, LET ME THANK REPRESENTATIVE PALLONE, OUR RANKER, AND HIS OUTSTANDING STAFF FOR THE INTELLECT AND ENERGY THEY POURED INTO THIS BECAUSE IT TRULY MADE THIS A BETTER BILL. IT'S GOING TO SAVE LIVES. WITH THAT I URGE MY COLLEAGUES TO SUPPORT H.R. 6 AND I YIELD BACK.

THE CHAIR

THE GENTLEMAN FROM NEW JERSEY RESERVES. THE GENTLEMAN FROM OREGON IS…

THE GENTLEMAN FROM NEW JERSEY RESERVES. THE GENTLEMAN FROM OREGON IS RECOGNIZED.

MR. WALDEN

IT IS MY GREAT HONOR, MR. CHAIRMAN, TO RECOGNIZE THE MAJORITY LEADER OF…

IT IS MY GREAT HONOR, MR. CHAIRMAN, TO RECOGNIZE THE MAJORITY LEADER OF THE UNITED STATES HOUSE OF REPRESENTATIVES, WHO HAS BEEN EXTRAORDINARILY HELPFUL IN OUR EFFORTS TO MOVE THIS ENTIRE BIPARTISAN PACKAGE FORWARD TO SAVE LIVES AND HELP PEOPLE IN ADDICTION. THE GENTLEMAN FROM CALIFORNIA, MR. MCCARTHY, FOR SUCH TIME HE MAY CONSUME.

THE CHAIR

THE GENTLEMAN FROM CALIFORNIA IS RECOGNIZED.

MR. WALDEN

MR. MCCARTHY

I THANK THE GENTLEMAN FOR YIELDING. I WANT TO CONGRATULATE THE GENTLEMAN…

I THANK THE GENTLEMAN FOR YIELDING. I WANT TO CONGRATULATE THE GENTLEMAN FOR HIS WORK, HIS TIRELESS EFFORT, AND HIS PASSION FOR THOSE WHO HAVE BEEN INFLICTED WITH THE ADDICTION. MR. SPEAKER, I RISE TODAY TO URGE THE PASSAGE OF H.R. 6, WHICH CONTAINS MORE THAN 50 OPIOID RELATED BILLS WHICH WE HAVE CONSIDERED THE PAST TWO WEEKS. WE IN THIS BODY HAVE THE OPPORTUNITY NEARLY EVERY DAY TO APPROVE LEGISLATION OF GREAT CONSEQUENCES TO MILLIONS OF PEOPLE. BUT RARELY DO THE CONSEQUENCES FEEL SO IMMEDIATE, SO VITAL, AS THEY DO FOR THE OPIOID PACKAGE WE'RE CONSIDERING. THIS IS BECAUSE THIS LEGISLATION HAS TO DO WITH THE DEADLIEST DRUG CRISIS IN OUR NATION'S HISTORY. THE GRIM TRUTH IS THIS, MORE AMERICANS HAVE DIED FROM DRUG OVERDOSES SINCE THE TURN OF THE CENTURY THAN THEY DIED IN THE CIVIL WAR. YES, YOU HEARD IT RIGHT. IN LESS THAN TWO DECADES MORE THAN 630,000 PEOPLE HAVE DIED BECAUSE OF DRUGS. HALF OF THOSE DEATHS HAD TO DO WITH OPIOIDS. . NOW, IN MY HOMETOWN OF BAKERSFIELD HAS BEEN DEVASTATED BY ILLEGAL DRUGS, MOSTLY HEROIN AND METH. IN 2016 ALONE, 54 PEOPLE IN MY COUNTY DIED OF AN OPIOID OVERDOSE. THAT'S A STATISTIC MADE UP OF 54 STORIES OF UNIMAGINABLE SADNESS, STORIES OF HAPPY FAMILIES TORN APART BY DECEIT, ABUSE AND DEATH. STORIES ABOUT PARENTS ROBBED OF CHILDREN. CHILDREN ROBBED OF PARENTS, AND FRIENDS ROBBED OF FRIENDS. MY LOCAL NEWS TALKED TO ONE MAN IN BAKERSFIELD WHO LOST FOUR FRIENDS TO OVERDOSE IN THE PAST FEW YEARS ALONE. OF COURSE, THESE TRAGIC EVENTS ARE NOT CONFINED TO JUST MY DISTRICT. THEY ARE HAPPENING EVERYWHERE ACROSS THE COUNTRY, COAST TO COAST. SO I'D LIKE TO TELL YOU ANOTHER STORY. THIS TIME FROM THE OTHER SIDE OF THE COUNTRY. IT IS THE STORY OF AMON ERIC CALANAN, AGE 28. AMON DID NOT LIVE TO SEE AGE 29. AMON CAME FROM A FAMILY WITH DEEP ROOTS IN ROCHESTER, NEW YORK. ONE OF THE GREAT -- ONE OF HIS GREAT GRANDFATHERS WAS THE CHIEF OF POLICE IN ROCHESTER. HIS GRANDFATHER WAS A JUDGE, AND HIS PARENTS ARE ATTORNEYS. THEY WERE THE VERY DEFINITION, IN OTHER WORDS, OF LAW-ABIDING FAMILY, BUT IN EARLY 2012, A SERIES OF EVENTS TOOK PLACE THAT SENT AMON DOWN A DIFFERENT PATH AND STOLE HIM FROM HIS FAMILY FOREVER. YOU SEE, AMON AT AGE 25 HURT HIS BACK, A STORY THAT MANY IN AMERICA HAVE SEEN WHILE HE WAS ON HIS JOB. HE BEGAN TAKING OPIOID PAINKILLERS IN RESPONSE TO HIS PAIN. AND WHEN THE PILLS BECAME TOO EXPENSIVE, AMON, LIKE MANY AMERICANS, SWITCHED TO HEROIN. BEFORE LONG, THE LOYAL, GOOFY KID HIS FAMILY ONCE KNEW WAS GONE. DRUGS HAD DAMPENED THE BEAUTIFUL MUSIC OF HIS LIFE AND TURNED IT INTO A SORROWFUL ECHO. AMON ERIC DIED OF A DRUG OVERDOSE ON JUNE 8, 2016. LAST WEDNESDAY MARKED THE TWO-YEAR ANNIVERSARY OF HIS FUNERAL. IN MANY RESPECTS, AMON'S STORY IS NOT UNIQUE. HE WAS ONE OF 169 PEOPLE IN HIS COUNTY. 42,000 PEOPLE IN OUR COUNTRY TO DIE OF OPIOIDS -- OPIOID OVERDOSE THAT YEAR. AMON WAS JUST ONE BODY IN A GRIM TIDE OF OVERDOSE DEATHS. SO WHY AM I TELLING YOU THIS STORY? I'M TELLING IT TO YOU TO REMIND YOU THAT EACH ONE OF THOSE VICTIMS HAD A NAME AND A LIFE AND FRIENDS AND FAMILY WHO THEY LOVED AND LEFT BEHIND. ONE OF THOSE PEOPLE THAT AMON LOVED AND WHO LOVES HIM DEEPLY IN RETURN IS ACTUALLY SITTING IN THIS CHAMBER RIGHT NOW. HER NAME IS ERIN. SHE IS AMON'S SISTER AND SHE'S MY PRESS SECRETARY. ERIN WAS 24 DAYS FROM HER WEDDING WHEN SHE LEARNED THAT SHE WOULD NEVER SEE HER BROTHER AGAIN. THAT HE WOULD NOT BE THERE TO CELEBRATE WITH HER ON ONE OF HER HAPPIEST DAYS OF HER LIFE. LET THAT BE A LESSON TO ALL OF US. THERE IS NO EVENT SO JOYFUL, NO PLACE SO SAFE THAT IT IS NOT UNTOUCHED BY THE DRUG CRISIS. EVEN A WEDDING CHAPEL. EVEN HERE IN THE HALLS OF POWER. EVEN IN MY OFFICE. MR. SPEAKER, IF WE HOPE TO DEFEAT THE DEADLIEST DRUG CRISIS IN HISTORY, WE NEED THE BIGGEST RESPONSE IN HISTORY. REST ASSURED THAT THE RESPONSE IS ALREADY UNDER WAY. LED BY THIS ADMINISTRATION AND THIS CONGRESS. WE ARE WRAPPING UP BY VOTING ON MORE THAN 50 BILLS TO HELP MILLIONS OF AMERICANS AFFECTED BY THE OPIOID CRISIS. WE'RE ABOUT TO VOTE ON A PACKAGE THAT CONTAINS ALMOST ALL OF THOSE BILLS IN H.R. 6. AMONG OTHERS IT CONTAINS A BILL BY CONGRESSMAN MIKE BISHOP THAT WILL REDUCE THE FLOW OF CHINESE FENTANYL IN OUR COUNTRY BY GIVING LAW ENFORCEMENT NEW TOOLS TO DETECT SUSPICIOUS PACKAGES IN THE MAIL. IT INCLUDES A REFORM TO THE SO-CALLED I.M.D. EXCLUSION, AN OUTDATED REGULATION THAT REDIRECTS MEDICAID FUNDING FOR LARGE IN-PATIENT TREATMENT PROGRAMS, PROGRAMS WITH POTENTIAL TO HEAL SUBSTANCE ABUSE PATIENTS LIKE AMON. THOSE ARE JUST TWO OF THE IMPORTANT BILLS THAT ARE PART OF THIS PACKAGE. IT IS NO EXAGGERATION TO SAY THAT THEY CAN SAVE LIVES AND SAVE FAMILIES FROM THIS IMMEASURABLE GRIEF OF LOSING A LOVED ONE TO AN OVERDOSE. YES, I AM CONFIDENT THAT THESE BILLS WILL HELP STEM THE TIDE OF DRUG ABUSE, BUT I WILL END ON A NOTE OF CAUTION. IF DEFEATING THE OPIOID CRISIS IS LEFT TO GOVERNMENT ALONE, THEN WE WILL SURELY FAIL. HEALING THE WOUNDS OF DRUG ABUSE WILL TAKE MORE THAN JUST THIS BODY CAN PROVIDE. IT WILL TAKE THE COMMITMENT BY EVERY CITIZEN TO FULFILL OUR DUTIES TO ONE ANOTHER. WE'VE BEEN TOUCHED BY THIS TRAGEDY SO WE ALL HAVE A PART TO PLAY IN ITS RESOLUTION. THAT MEANS SUPPORTING PEOPLE NEAR US WHO ARE STRUGGLING WITH DRUG ADDICTION. IT MEANS REBUILDING FAMILIES AND TOWNS TORN APART BY ISOLATION, ADDICTION, DISTRUST AND DEATH, AND IT MEANS SUPPORTING THE MANY CHARITIES, MINISTRIES, AND NONPROFITES THAT ARE ALREADY HEALING THE SICK IN OUR COMMUNITIES. IN BAKERSFIELD, THAT MEANS GROUPS LIKE A CHRISTIAN CHARITY I VOLUNTEER AT. THE MISSION SUPPORTS AN ADDICTION RECOVERY PROGRAM, KNITTING FAMILIES THAT ARE TEARING AT THE SEAM. A HUSBAND AND WIFE WITH FIVE CHILDREN OVERCAME THEIR PAST OF DRUG ADDICTION AND DRUG DEALING. THEY DID IT TOGETHER. THEN THEY CONVINCED THEIR NIECE TO GET CLEAN TOO. WE NEED MORE STORIES LIKE THAT. IN THE DAYS AHEAD, THIS HOUSE HAS A CHANCE TO DO ITS PART TO ENSURE MORE STORIES OF ABUSE AND DESPAIR HAVE THEIR OWN HAPPY ENDING. WE WILL WORK TO DO THIS FOR THE HEALERS AND PROTECTORS, FOR THE SUFFERING, FOR ALL THOSE LIKE AMON WHO ARE NOW AT REST. I YIELD BACK.

THE CHAIR

THE GENTLEMAN FROM OREGON RESERVES.

MR. WALDEN

I RESERVE.

THE CHAIR

THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED.

MR. PALLONE

MR. CHAIRMAN, CAN I ASK HOW MUCH TIME REMAINS ON BOTH SIDES?

THE CHAIR

THE GENTLEMAN FROM NEW JERSEY HAS FIVE MINUTES.

MR. PALLONE

I YIELD NOW TWO MINUTES TO THE GENTLEWOMAN FROM CALIFORNIA, MS. BASS.

MS. BASS

MR. SPEAKER, I RISE TODAY IN SUPPORT OF H.R. 6 AND THE FOSTER YOUTH WHO…

MR. SPEAKER, I RISE TODAY IN SUPPORT OF H.R. 6 AND THE FOSTER YOUTH WHO WILL BENEFIT FROM ITS PASSAGE. ONE OF THE MOST POPULAR PROVISIONS OF THE AFFORDABLE CARE ACT ALLOWS YOUNG ADULTS TO STAY ON THEIR PARENT'S HEALTH INSURANCE UNTIL THEY TURN 26. IT'S ONLY FAIR THAT YOUNG ADULTS WHO AGE OUT OF FOSTER CARE SHOULD KEEP THEIR COVERAGE UNTIL THEY TURN 26 TOO. BUT WHEN THE A.C.A. WAS IMPLEMENTED, THE DEPARTMENT OF HEALTH AND HUMAN SERVICES GAVE STATES THE OPTION OF THIS. FOR EXAMPLE, IF A YOUNG ADULT AGED OUT OF THE SYSTEM AT 18 AND HAD COVERAGE IN CALIFORNIA BUT THEN MOVED TO NEW YORK, NEW YORK WOULD HAVE THE OPTION TO COVER THEM UNDER MEDICAID UNTIL THEY TURNED 26 OR NOT. THIS EXTENDED COVERAGE WAS NEVER SUPPOSED TO BE OPTIONAL. AFTER ALL, FORMER FOSTER YOUTH SHOULD HAVE EVERY OPPORTUNITY TO MOVE FREELY WITHOUT THE FEAR OF LOSING THE LIFESAVING HEALTH INSURANCE. THAT'S WHY I INTRODUCED THE HEALTH INSURANCE FOR FORMER FOSTER YOUTH ACT. LAST MONTH, OVER 100 FORMER FOSTER YOUTH WERE ON THE HILL AND SHADOWED THEIR MEMBERS OF CONGRESS. WE CELEBRATED THAT MANY OF THE YOUNG ADULTS HAD BEEN ACCEPTED TO COLLEGE. SOME OUT OF STATE. THIS BILL WILL ENSURE THAT WHEN FORMER FOSTER YOUTH AGE OUT OF THE SYSTEM THAT THEY CAN KEEP THEIR HEALTH CARE COVERAGE UNTIL 26 NO MATTER WHERE THEY LIVE. THIS IS ABOUT FAIRNESS. FORMER FOSTER YOUTH SHOULD BE TREATED THE SAME WAY AS WE TREAT ALL YOUNG PEOPLE. I'M GRATEFUL TO MY COLLEAGUES ON BOTH SIDES OF THE AISLE FOR INCLUDING MY BILL IN THIS BIPARTISAN OPIOID PACKAGE. JUST THIS WEEK, THE HILL REPORTED THAT STATES HARDEST HIT BY THE OPIOID EPIDEMIC HAVE SEEN THE NUMBER OF CHILDREN IN FOSTER CARE OR STATE CARE INCREASE DRAMATICALLY. AGAIN, I THANK MY COLLEAGUES FOR WORKING WITH ME TO CLARIFY THIS LAW AND I THANK CHAIRMAN WALDEN AND RANKING MEMBER PALLONE FOR YOUR LEADERSHIP ON THIS ISSUE. I YIELD THE REMAINDER OF MY TIME.

THE CHAIR

THE GENTLEMAN RESERVES. THE GENTLEMAN FROM OREGON.

MR. WALDEN

THANK YOU VERY MUCH, MR. CHAIRMAN. I WANT TO THANK MY COLLEAGUE FROM…

THANK YOU VERY MUCH, MR. CHAIRMAN. I WANT TO THANK MY COLLEAGUE FROM CALIFORNIA FOR BRINGING THIS ISSUE TO OUR ATTENTION AND HELPING US HELP THESE KIDS WHO NEED THIS ASSISTANCE. NOW IT'S A TERRIFIC PRIVILEGE TO RECOGNIZE THE GENTLEMAN FROM WISCONSIN, THE SPEAKER OF THE UNITED STATES HOUSE OF REPRESENTATIVES, FOR ONE MINUTE.

THE CHAIR

THE SPEAKER

I THANK THE GENTLEMAN FOR YIELDING. I WANT TO FIRST START BY THANKING THE…

I THANK THE GENTLEMAN FOR YIELDING. I WANT TO FIRST START BY THANKING THE CHAIR AND RANKING MEMBER. FOR A MOMENT I WOULD LIKE TO ADDRESS ANOTHER ISSUE. I WANT TO PAUSE TO HONOR THE LIFE OF DR. CHARLES OUT HIEMER. -- KRAUTHIMER. HE WAS A WIDELY WISELY THINKER. HE WROTE THE MOST VIGOROUS COMMENTARY OF OUR AGE. HE WAS A HARVARD EDUCATED PSYCHIATRIST. HE HAD THE PERFECT TRAINING TO ANALYZE OUR POLITICS. HE PASSED AWAY YESTERDAY. HE LEFT A FAMILY THAT LOVED HIM. HE LEFT COLLEAGUES THAT ADMIRED HIM AND HE LEFT READERS LIKE MYSELF. IF I HAD YOU TO THINK ABOUT THIS. , CHARLES WAS A GOOD FRIEND OF MINE. HE HAD A BEAUTIFUL MIND. AND HE HAD A WONDERFUL WAY ABOUT HIM. SIMPLY PUT, I LOVED THIS MAN. I LOVED HIS WORK. I WOULD MARVEL NOT OVER JUST WHAT HE SAID BUT HOW HE WOULD SAY IT. HE HAD THIS UNIQUE ABILITY TO TAKE THE ISSUE OF THE MOMENT AND PLACE IT PERFECTLY IN THE CONTEXT OF JUST BIGGER THINGS. AMERICA IS THE ONLY COUNTRY FOUNDED ON AN IDEA, HE WOULD SAY. AND HIS VOCATION WAS THE DEFENSE OF THAT IDEA. AS GREAT AS HIS INTELLECT WAS, THERE WAS ABSOLUTELY NO ARROGANCE ABOUT HIM. HE WAS GOOD COMPANY. HE WAS GRACIOUS. HE WAS CURIOUS. YOU TAKE ANY TOPIC AND HE HAD ALREADY THOUGHT THROUGH HIS ARGUMENT, YOUR ARGUMENT, AND ALL OF THE COUNTERARGUMENTS BEFORE YOU EVEN GOT STARTED TO THINK. HE WAS ALWAYS WILLING TO ENJOY THE FIGHT BUT WITH GOOD SHEER AND HE REVELED IN IT, EXCELLED IN IT. HE USED THAT GIFT TO CONTRIBUTE TO OUR CIVIC DISCOURSE. AND HE DID IT CIVILLY, AND WE ARE ALL THE BETTER FOR IT. WE WILL BE WISER FOR WHAT HE'S DONE FOR US, AND I ONLY HOPE AND PRAY THAT WE CAN TRY TO EMULATE HIS SPIRIT AND HIS SENSE OF WONDER AND HIS SENSE OF CIVILITY. THE HOUSE AND THIS NATION ARE IN HIS DEBT AND OUR PRAYERS ARE WITH HIS FAMILY. NOW, MR. SPEAKER, I RISE TO EXPRESS MY WHOLEHEARTED SUPPORT FOR THIS EFFORT, FOR H.R. 6. OUR NATION IS FIGHTING A GRAVE OPIOID EPIDEMIC. IT IS A THREAT TO A GENERATION OF YOUNG PEOPLE, THE VERY FABRIC THAT HOLDS OUR COMMUNITIES TOGETHER. BUT TO ME, THIS LEGISLATION -- THIS LEGISLATION IS ABOUT HOPE. I GOT THE HONOR OF SPEAKING WITH AND KNOWING THREE BRAVE WISCONSIN FAMILIES WHO HAVE DEALT WITH THIS, FAMILIES THAT I'VE GOTTEN TO KNOW OVER THE COURSE OF TIME. CAL IS A GUY I KNOW FROM JANESVILLE. HE HAD AN ANKLE INJURY TREATED WITH OPIOIDS. HE DEVELOPED A DEPENDENCY AND HE EVENTUALLY TURNED TO HEROIN. HE IS NOW CLEAN AND HE WORKS WITH NONPROFITS IN JANESVILLE TO ENCOURAGE OTHERS TO SEEK TREATMENT. HE'S HELPING MAKING SURE PEOPLE DON'T MAKE THE MISTAKES HE MADE. AND HE'S MAKING A HUGE DIFFERENCE. MICHELLE HAS TWO SONS, FORMER HIGH SCHOOL ATHLETES WHO BECAME ADDICTED TO HEROIN, AND THEY ARE IN RECOVERY. SHE UNDERSTANDS THE LONELINESS THAT COMES WITH BEING A MOTHER IN THIS SITUATION. SHE UNDERSTANDS HOW ISOLATING IT CAN ALL FEEL, AND NOW SHE ADVOCATES FOR MORE RESOURCES TO FIGHT THIS EPIDEMIC AND SHE SUPPORTS OTHER FAMILIES SO THEY DON'T FEEL LIKE THEY'RE FACING THIS FIGHT ALONE LIKE SHE DID. JASON WAS A MARINE WHO SERVED OUR COUNTRY. HE WENT TO THE V.A. HOSPITAL LOOKING FOR HELP FOR HIS ANXIETY. HE WAS OVERPRESCRIBED OPIOIDS AND HE LOST HIS LIFE. HIS FAMILY MADE IT THEIR MISSION THAT OTHERS DON'T EXPERIENCE THE SAME FATE. THIS IS THE HEART OF AMERICA. AFTER SUFFERING SUCH PAIN, THESE FAMILIES SUFFERED UNSPEAKABLE PAIN BUT THEY OVERCAME AND NOW THEY'RE MAKING IT THEIR MISSION IN LIFE TO MAKE SURE OTHERS HAVE A PLACE TO TURN TO. THAT OTHERS DON'T HAVE TO GO DOWN THE PATH THAT THEY WENT. BECAUSE ASKING FOR HELP, THAT'S NOT A SIGN OF WEAKNESS. IT'S ACTUALLY A SIGN OF STRENGTH. WE ALL HAVE A ROLE TO PLAY IN THIS AND IT BEGINS BY REACHING OUT, IT BEGINS WITH LISTENING AND BEING THERE FOR ONE ANOTHER. ALL OF OUR INSTITUTIONS AT EVERY LEVEL SHOULD EMULATE AND ENCOURAGE THIS KIND OF FELLOWSHIP. WE SHOULD MAKE SURE AND MAKE IT CLEAR THAT NO ONE IS ALONE, THAT EVERY LIFE MATTERS. WELL, THIS BILL IS TITLED WITH THE PERFECT TITLE. THE SUPPORT FOR PATIENTS AND COMMUNITIES ACT. IT'S BIPARTISAN. IT'S HIGH TIME WE DO IT. IT IS A VERY, VERY STRONG AND GOOD STEP IN THE RIGHT DIRECTION. IT WILL ADVANCE TREATMENT AND RECOVERY. IT WILL IMPROVE PREVENTION. IT WILL GIVE RESOURCES TO COMMUNITIES, AND IT WILL FIGHT DEADLY DRUGS LIKE FENTANYL. SO I WANT TO THANK CHAIRMAN WALDEN AND I WANT TO THANK CHAIRMAN BRADY AND I WANT TO THANK MR. PALLONE AND MR. NEAL. I WANT TO THANK ALL THE MEMBERS, ALL THE MEMBERS OF THE ENERGY AND COMMERCE COMMITTEE AND THE WAYS AND MEANS QUE. LET'S NOT STOP HERE. LET'S NOT STOP UNTIL WE HAVE INSTALLED THE SENSE OF HOPE IN ALL THOSE WHO MAY BE STRUGGLING. LET'S NOT STOP UNTIL WE HAVE ENDED THIS EPIDEMIC. I URGE THE ENTIRE HOUR TO VOTE YES, AND I YIELD BACK. .

THE CHAIR

THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED.

MR. PALLONE

MR. CHAIRMAN, I YIELD TWO MINUTES TO THE GENTLEMAN FROM CALIFORNIA.

THE CHAIR

CALIFORNIA.

MR. CARDENAS

THANK YOU VERY MUCH FOR YIELDING TIME. I'D LIKE TO THANK THE AUTHORS FOR…

THANK YOU VERY MUCH FOR YIELDING TIME. I'D LIKE TO THANK THE AUTHORS FOR ALL THE HARD WORK THAT CAME TO THIS MOMENT TO GET THIS BILL ON THE FLOOR, THIS VERY IMPORTANT BILL. I RISE TODAY TO SAY HOW GLAD I AM THAT MY BILL, THE AT-RISK YOUTH MEDICAID PREVENTION ACT, HAS BEEN INCLUDED IN TODAY'S OPIOID PACKAGE. ACCORDING IT A JUNE, 2017 REPORT, THE OPIOID EPIDEMIC DISPROPORTIONATELY AFFECTS MEDICAID BENEFICIARIES, THEREFORE STATE MEDICAID PROGRAMS ARE TAKING THE LEAD IN IDENTIFYING AND TAILORING STRATEGIES TO PREVENT AND TREATMENT OPIOID USE DISORDER. AMONG THOSE AFFECTED ARE OUR MOST VULNERABLE, AMERICAN POPULATION, OUR YOUTH. CURRENTLY MOST CHILDREN WHO ARE COVERED BY MEDICAID AND COME INTO CONTACT WITH THE MEDICAL CRIMINAL JUSTICE SYSTEM END UP HAVING THEIR ENROLLMENT TERMINATED BY STATES. WHILE SOME STATES ARE BEGINNING TO SUSPEND INSTEAD OF TERMINATE THEIR ENROLLMENT, ONLY A FEW STATES AND JUSTICE SYSTEM END UP HAVING THEIR ENROLLMENT THE DISTRICT OF COLUMBIA SUSPEND THEIR ENROLLMENT FOR THE EXACT DURATION OF THE ININCARCERATION. THIS RESULTS IN UNNECESSARY COSTLY DELAYS. I SAY AGAIN, WHEN SOMEBODY IS TERMINATED RATHER THAN SUSPENDED, THIS RESULTS IN AN UNNECESSARY COSTLY DELAY. DELAYING THEIR COVERAGE AND PREVENTING THEM FROM RECEIVING TIMELY AND MUCH NEADED HEALTH AND MENTAL CARE UPON THIS -- NEEDED HEALTH AND MENTAL CARE UPON THE CHILDREN'S RELEASE. THE AT-RISK YOUTH MEDICAID PROTECTION ACT WOULD REQUIRE STATES TO AUTOMATICALLY RESTORE THE CHILD'S MEDICAID ENROLLMENT UPON THEIR RELEASE. FURTHER, STATES WOULD BE REQUIRED TO PROCESS APPLICATIONS FOR MEDICAL ASSISTANCE BY OR ON BEHALF OF THE CHILD AND MAKE ACCESS TO MEDICAL ASSISTANCE FOR CHILDREN UNDER FOSTER CARE CONSISTENT WITH THE AFFORDABLE CARE ACT BY EXTENDING THE AGE OF ELIGIBILITY TO AGE 26. MR. CHAIRMAN, MR. SPEAKER, WE OWE IT TO THE AMERICAN PEOPLE TO DO EVERYTHING IN OUR POWER TO DECREASE THE ALREADY 64,000 FAMILIES BROKEN BY THIS EPIDEMIC. AND RESTORE FAITH IN OUR GOVERNMENT SYSTEM. WHILE THIS PACKAGE COVERS MANY FRONTS, THE INCLUSION OF THIS COMMONSENSE BILL OF THE AT-RISK YOUTH MEDICAID PROTECTION ACT EXTENDS THE EFFORT TO ATTACK THIS EPIDEMIC FROM ALL ANGLES MODIFYING PACKAGES FOUNDATION. I YIELD BACK.

THE CHAIR

THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM NEW JERSEY RESERVES…

THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM NEW JERSEY RESERVES HIS TIME OF THE THE GENTLEMAN FROM OREGON IS RECOGNIZED.

MR. WALDEN

THANK YOU. I WANT TO THANK MY COLLEAGUE FROM CALIFORNIA FOR WORKING WITH…

THANK YOU. I WANT TO THANK MY COLLEAGUE FROM CALIFORNIA FOR WORKING WITH US. WE WERE HAPPY TO INCLUDE HIS BILL IN THIS COMPANION -- COMPILATION LEGISLATION. I'D LIKE IT RECOGNIZE A RESIDENT PHARMACIST IN THE UNITED STATES CONGRESS AND ON THE ENERGY AND COMMERCE COMMITTEE, THE GENTLEMAN FROM GEORGIA, MR. CARTER, FOR ONE MINUTE.

THE CHAIR

THE GENTLEMAN FROM GEORGIA IS RECOGNIZED FOR ONE MINUTE.

MR. CARTER

I THANK THE GENTLEMAN FOR YIELDING. MR. SPEAKER, I'D LIKE TO THANK MY…

I THANK THE GENTLEMAN FOR YIELDING. MR. SPEAKER, I'D LIKE TO THANK MY COLLEAGUES FOR INTRODUCING THIS CRITICAL LEGISLATION. SINCE THIS COMMITTEE BEGAN TACKLING THE OPIOID EPIDEMIC, I HAVE SAID THERE ARE THREE MAJOR PARTS TO THE CRISIS. PREVENTION, TREATMENT, AND LAW ENFORCEMENT. THIS LEGISLATION TOUCHES ALL THREE PRONGS OF THE OPIOID CRISIS WITH A NUMBER OF CREATIVE SOLUTIONS IN ADDITION TO PROVIDING OFFSETS TO ENSURE THAT SOLVING A PUBLIC HEALTH CRISIS DOES NOT LEAD TO A FISCAL ONE. I VOTED FOR MANY OF THESE BILLS WHEN THEY CAME BEFORE THE COMMITTEE FOR MARKUP, AND I WANT TO OFFER MY FULL SUPPORT FOR THIS LEGISLATION. THANK YOU, MR. SPEAKER. I YIELD BACK.

THE CHAIR

THE GENTLEMAN FROM GEORGIA YIELDS BACK. THE GENTLEMAN FROM OREGON…

THE GENTLEMAN FROM GEORGIA YIELDS BACK. THE GENTLEMAN FROM OREGON RESERVES. THE GENTLEMAN FROM NEW JERSEY.

MR. PALLONE

I WANT TO ENTER IN A THE RECORD MY EXTENDED REMARKS REGARDING A PROVISION…

I WANT TO ENTER IN A THE RECORD MY EXTENDED REMARKS REGARDING A PROVISION INCLUDED IN H.R. 6 THAT DOES NOT ENJOY BIPARTISAN SUPPORT. SECTION 301 WAS PASSED OUT OF THE ENERGY AND COMMERCE COMMITTEE ON A PARTY-LINE VOTE. HAD A COMMITTEE REPORT BEEN FILED, I WOULD HAVE FILED DISSENTING VIEWS I'M NOW SEEKING TO HAVE ADDED TO THE RECORD.

THE CHAIR

WITHOUT OBJECTION.

MR. PALLONE

WITHOUT OBJECTION.

THE CHAIR

I RESERVE.

MR. BALLEDEN

MR. WALDEN

I RECOGNIZE MR. LANCE FOR ONE MINUTE.

THE CHAIR

GENTLEMAN FROM NEW JERSEY IS RECOGNIZED FOR ONE MINUTE.

MR. LANCE

THANK YOU, MR. SPEAKER. I RISE TODAY IN SUPPORT OF THIS BIPARTISAN PACKAGE…

THANK YOU, MR. SPEAKER. I RISE TODAY IN SUPPORT OF THIS BIPARTISAN PACKAGE H.R. 6. ENERGY AND COMMERCE COMMITTEE UNDER THE LEADERSHIP OF CHAIRMAN WALDEN HAS AGAIN DELIVERED FOR THE AMERICAN PEOPLE ON THE PRESSING PUBLIC HEALTH CHALLENGES FACING THE NATION. I'M COMBATING CHILDHOOD CANCER TO IMPROVING MENTAL HEALTH CARE AND THE SCOURGE OF DRUG ADDICTION, THE ENERGY AND COMMERCE COMMITTEE PRODUCES RESULTS. THE MENACE OF DRUG ABUSE AND ADDICTION HAS MANIFESTED ITSELF IN OPIATES. EVERY CORNER OF THIS COUNTRY HAS KNOWN THE HEARTACHE. LOSING A LIFE FROM THIS TERRIBLE PROBLEM. CONGRESS HAS ACTED BEFORE WITH PASSAGE OF THE COMPREHENSIVE ADDICTION AND RECOVERY ACT. BUT CARA NEEDS REINFORCEMENT AND 46R DELIVERS MORE RESOURCES, TREATMENT, AND MITIGATION TOOLS TO FIGHT OPIATE ADDICTION. INCLUDED IN THIS PACKAGE IS THE ELIMINATING OPIATE RELATED INFECTIOUS DISEASES ACT. LEGISLATION I HAVE AUTHORED WITH MY COLLEAGUE ON THE ENERGY AND COMMERCE COMMITTEE, CON MAN JOSEPH P. KENNEDY III. INFECTIOUS DISEASES COMPOUND AND COMPLICATE THE LIFELONG PATH TOWARD RECOVERY FROM SUBSTANCE ABUSE AND THREATEN THE LIVES AND SAFETY OF THE LOVED ONES OF THOSE ADDICTED, ESPECIALLY CHILDREN. THIS IS HOW CONGRESS IS SUPPOSED TO WORK. BOTH SIDES COMING TOGETHER TO CONFRONT A NATIONAL CRISIS GOING THROUGH THE COMMITTEE PROCESS WITH BIPARTISAN BILLS, AND GETTING TO THE ROOT OF THE COUNTRY'S CHALLENGES. I URGE A YES VOTE AND YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN YIELD BACK. THE GENTLEMAN FROM OREGON RESERVES HIS TIME. THE…

THE GENTLEMAN YIELD BACK. THE GENTLEMAN FROM OREGON RESERVES HIS TIME. THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED.

MR. PALLONE

I HAVE NO ADDITIONAL SPEAKERS. I'M GOING TO RESERVE.

THE CHAIR

THE GENTLEMAN FROM OREGON.

MR. WALDEN

I RECOGNIZE THE GENTLEMAN FROM MICHIGAN, MR. WALBERG, WHO HAS BEEN VERY…

I RECOGNIZE THE GENTLEMAN FROM MICHIGAN, MR. WALBERG, WHO HAS BEEN VERY INVOLVED IN THIS EFFORT AS WELL. ONE MINUTE.

THE CHAIR

THE GENTLEMAN IS RECOGNIZED FOR ONE MINUTE.

MR. WALBERG

I THANK YOU, MR. CHAIRMAN. I'M GRATEFUL FOR YOUR LEADERSHIP AND THE WORK…

I THANK YOU, MR. CHAIRMAN. I'M GRATEFUL FOR YOUR LEADERSHIP AND THE WORK MY COLLEAGUES NO THE ENERGY AND COMMERCE COMMITTEE ARE DOING TO--- TO TACKLE THE OPIOID CRY SIS. I RISE TODAY IN SUPPORT OF H.R. 6, THE SUPPORT FOR PATIENTS AND COMMUNITIES ACT. EVERYWHERE I GO AROUND MICHIGAN I HEAR ABOUT THE WALDEN: I RECOGNIZE THE GENTLEMAN FROM MICHIGAN, MR. WALBERG, WHO OPIOID CRISIS PLAGUING OUR STATE AND COUNTRY. IT'S A DEEPLY PERSONAL AND PAINFUL ISSUE FOR MANY OF OUR FRIENDS AND LOVED ONES, INCLUDING THE FAMILY OF JESSIE GRUB WHOSE LIFE WAS CUT SHORT. HER FAMILY GRIEVES THAT. A MISTAKE THAT WAS MADE THAT BECAUSE OF OUR LEGISLATION HOPEFULLY WILL NEVER HAPPEN AGAIN. OVER THE PAST TWO WEEKS THE HOUSE HAS CONSIDERED OVER 70 BILLS TO ENHANCE TREATMENT AND RECOVERY PROGRAMS, INCREASE SPREENGS EFFORTS, PROTECT COMMUNITIES, AND FIGHT THE SYNTHETIC DRUG FENTANYL. THESE MEASURES INCLUDE TWO BIPARTISAN BILLS I INTRODUCED WITH CONGRESSWOMAN DEBBIE THE SYNTHETIC DRUG FENTANYL. THESE MEASURES DINGLE. THEY HAVE BEEN INCORPORATED INTO THE LEGISLATION WE'RE VOTING ON TODAY, INCLUDING JESSIE'S LAW. THIS IS AN URGENT CRISIS AND I URGE THE SENATE TO TAKE SWIFT ACTION AND ADVANCE THESE SOLUTIONS. NOT A MOMENT TO WASTE. I YIELD BACK.

MR. PALLONE

CONTINUE TO RESERVE.

THE CHAIR

CONTINUES TO RESERVE.

MR. WALDEN

CONTINUES TO RESERVE.

THE CHAIR

THE GENTLEMAN IS RECOGNIZED FOR ONE MINUTE.

MR. ALLEN

THANK YOU, MR. SPEAKER. I RISE TODAY IN SUPPORT OF H.R. 6, THE SUPPORT FOR…

THANK YOU, MR. SPEAKER. I RISE TODAY IN SUPPORT OF H.R. 6, THE SUPPORT FOR PATIENTS AND COMMUNITIES ACT. I WANT TO THANK CHAIRMAN WALDEN AND ENTIRE ENERGY AND COMMERCE COMMITTEE FOR THEIR WORK ON THIS IMPORTANT LEGISLATION. THE SUPPORT FOR PATIENTS AND COMMUNITY ACT IS YET ANOTHER BIPARTISAN EFFORT AIMED AT PREVENTING FURTHER OPIATE ABUSE AND ASSISTING THOSE CURRENTLY DEALING WITH THIS ADDICTION. THIS LEGISLATION WILL STRENGTHEN OUR EFFORTS TO ADVANCE TREATMENT AND RECOVERY ISSUES, IMPROVE PREVENTION, PROTECT OUR COMMUNITIES, AND BOLSTER THE FIGHT AGAINST DEADLY ILLICIT DRUGS. WE HAVE MADE MEANINGFUL PROGRESS IN OUR FIGHT AGAINST THE OPIATE EPIDEMIC THROUGHOUT THE COUNTRY BY PASSING OVER 50 BILLS IN THE HOUSE. BUT OUR WORK IS FAR FROM OVER. NO COMMUNITY IS IMMUNE FROM THIS CRISIS. IN 2016 ALONE, OVER 1,300 GEORGIANS LOST THEIR LIVES TO OPIATE ABUSE. MANY OF THEM IN MY COMMUNITY, MY CLOSEST FRIENDS HAVE HAD TO DEAL WITH THIS. OUR SENATE COLLEAGUES SHOULD TAKE NOTE OF THIS IMPORTANT WORK THAT WE HAVE DONE HERE IN THE HOUSE. OVER THE PAST TWO WEEKS TO COMBAT THIS PROCESS. I URGE ALL OF MY COLLEAGUES TO SUPPORT H.R. 6. WITH THAT I YIELD BACK.

THE SPEAKER PRO TEMPORE

THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM OREGON IS RECOGNIZED.

MR. WALDEN

MR. CHAIRMAN, DON'T BELIEVE WE HAVE ANY OTHER SPEAKERS OTHER THAN MYSELF…

MR. CHAIRMAN, DON'T BELIEVE WE HAVE ANY OTHER SPEAKERS OTHER THAN MYSELF TO CLOSE. I RESERVE.

THE CHAIR

THE GENTLEMAN IS READY TO CLOSE. GENTLEMAN FROM NEW JERSEY IS RECOGNIZED.…

THE GENTLEMAN IS READY TO CLOSE. GENTLEMAN FROM NEW JERSEY IS RECOGNIZED. IS RECOGNIZED.

MR. WALDEN

MR. PALLONE

I WANT TO THANK THE STAFF THAT WORKED SO HARD ON H.R. 6 AND THE OPIATE…

I WANT TO THANK THE STAFF THAT WORKED SO HARD ON H.R. 6 AND THE OPIATE BILLS IN GENERAL. DEMOCRATS WORKED TO MAKE H.R. 6 A BETTER BILL EVEN THOUGH WE HAVE CONCERNS ABOUT THE OVERALL IMPACT OF THE OPIATE PACKAGE. I ASK MY COLLEAGUES TO SUPPORT THE LEGISLATION. I YIELD BACK.

THE CHAIR

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE GENTLEMAN FROM…

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE GENTLEMAN FROM OREGON IS RECOGNIZED FOR THE REMAINDER OF HIS TIME.

MR. WALDEN

THANK YOU, MR. CHAIRMAN. I YIELD MYSELF SUCH TIME AS I MAY CONSUME. I WANT…

THANK YOU, MR. CHAIRMAN. I YIELD MYSELF SUCH TIME AS I MAY CONSUME. I WANT TO THANK MY COLLEAGUES ON O BOTH SIDES OF THE AISLE. WE HAVE HAD INDIVIDUAL MEMBERS COME TO THE FLOOR TODAY FROM BOTH PARTIES. TOGETHER WE HAVE BROKEN THROUGH WHAT OTHERS MIGHT SEE AS DYSFUNCTION IN WASHINGTON TO ACHIEVE A COMPREHENSIVE LEGISLATIVE PACKAGE THAT WILL PROVIDE TREATMENT, SAVE LIVES, STOP ILLEGAL FENTANYL FROM COMING INTO THIS COUNTRY, AND IN NO SMALL MEASURE MOVE AMERICA FORWARD IN A MUCH BETTER DIRECTION. I WANT TO SHARE DIRECTION. I WANT TO SHARE WITH YOU, MR. SPEAKER, A LETTER THAT WE RECEIVED TO THE SPEAKER AND TO MS. PELOSI, BOTH URGING US TO SUPPORT H.R. 6. IT COMES FROM NOT ONE OR TWO BUT LITERALLY 161 DIFFERENT GROUPS THAT ARE VERY INVOLVED IN THE RECOVERY EFFORT. I WANT IT SHARE A COUPLE COMMENTS, MR. CHAIRMAN. THEY TALK ABOUT SUBSTANCE USE DISORDER NOT ONLY IMPACTS THE INDIVIDUAL BUT THE FAMILY AND COMMUNITY AS WELL. ACCORDING TO THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION, APPROXIMATELY NINE MILLION CHILDREN ACROSS OUR NATION LIVE IN A HOME WITH AT LEAST ONE PARENT WHO USES AN ILLICIT DRUG. TRAGICALLY THEY WRITE, CHILDREN IN THESE HOMES ARE AT INCREASED RISK FOR DEPRESSION, SUICIDE, POVERTY, DELINQUENCY, SUBSTANCE ABUSE DISORDER. IN ADDITION WHILE OUR NATION MADE SIGNIFICANT STRIDES IN BOTH OUR UNDERSTANDING AND RESPONSE TO THE DRUG CRISIS, IT IS CLEAR THAT TOO MANY COMMUNITIES ACROSS OUR NATION STILL HAVE FRAGMENTED PREVENTION TREATMENT AND RECOVERY INFRASTRUCTURE. INTRODUCED BY MYSELF AND MR. PALLONE AND MR. NEAL, MR. BRADY THEY WROIT THE SUPPORT FOR PATIENTS AND COMMUNITY ACT, THIS BILL, WOULD STRENGTHEN KEY FEDERAL LOW-INCOME ASSISTANCE AND SENIOR HEALTH INSURANCE PROGRAMS TO BERT RESPOND TO OUR NATION'S DRUG CRISIS N ADDITION TO SERVING AS THE VEHICLE THAT WILL ADVANCE MANY OTHER SIGNIFICANT PROPOSALS ALREADY CONSIDERED IN THE HOUSE, THIS LEGISLATION WOULD GIVE CRITICAL FEDERAL SAFETY NET PROGRAMS MORE TOOLS TO PREVENT AND HELP TREAT SUBSTANCE USE DISORDER. THEY WRITE, WE APPLAUD THE CHAMPIONS OF 6 FOR TREATING ADDICTION LIKE DISEASE IT IS AND BOLD LEADERSHIP IN THEIR RESPECTIVE COMMITTEES AND ON THE HOUSE FLOOR TO ADVANCE SO MANY INNOVATIVE, BIPARTISAN PROPOSALS THAT WILL HAVE AN IMMEDIATE AND POSITIVE IMPACT TO ADDRESS ADDICTION. WE RESPECTFULLY URGE THE FULL HOUSE TO IMMEDIATELY CONSIDER AND PASS H.R. 6 WHICH REPRESENTS A SIGNIFICANT STEP TOWARD BUILDING THE COMPREHENSIVE RESPONSE NEEDED IN OUR NATION SO THAT FEWER LIVES ARE LOST TO SUBSTANCE USE DISORDER. THIS COMES FROM THE PEOPLE WHO LIVE THIS EVERY DAY, WHO HELP OUR NEIGHBORS, OUR FRIENDS, OUR FAMILIES, AND OUR AMERICAN CITIZENS TO IT GET THE HELP THEY NEED TO BEAT THE DISEASE OF ADDICTION AND TO RECLAIM THEIR LIVES AND THEIR FAMILIES AND THEIR FUTURE. WITH THAT, MR. CHAIRMAN, I URGE MY COLLEAGUES TO SUPPORT PASSAGE OF H.R. 6. I YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN FROM OREGON YIELDS BACK THE REMAINDER OF HIS TIME.

THE CHAIR

THE GENTLEMAN FROM TEXAS, MR. BRADY, IS RECOGNIZED FOR 10 MINUTES.

MR. BRADY

THANK YOU, MR. SPEAKER. I YIELD MYSELF SUCH TIME AS I MAY CONSUME.

THE CHAIR

THE GENTLEMAN IS RECOGNIZED FOR AS MUCH TIME AS HE WISHES TO USE.

MR. BRADY

THANK YOU, SIR. THE OPIOID CRISIS HAS IMPACTED EVERY COMMUNITY IN AMERICA…

THANK YOU, SIR. THE OPIOID CRISIS HAS IMPACTED EVERY COMMUNITY IN AMERICA AND ROBBED COUNTLESS INDIVIDUALS OF THEIR POTENTIAL. RECENT POLL FOUND THAT MORE THAN FOUR OUT OF 10 AMERICANS WERE YOUNG IN THEIR 20'S AND 30'S, PERSONALLY KNOW SOMEONE WHO HAS DEALT WITH OPIOID ADDICTION. IT'S A STAGGERING NUMBER AND SHOWS THIS CRISIS TOUCHES A HUGE PART OF OUR SOCIETY. ALL TOO OFTEN WE HEAR STORIES OF LOVED ONES EXPOSED TO OPIOIDS THEN QUICKLY ADDICTED FROM ROUTINE SURGERIES THAT MAY NOT HAVE REQUIRED OPIOID TREATMENT IN THE FIRST PLACE. BUT THIS CAN BE PREVENTED. SO I RISE TODAY IN SUPPORT OF H.R. 6, KNOWN AS THE SUPPORT FOR PATIENTS AND COMMUNITIES ACT. THIS BILL, WHICH INCORPORATES LEGISLATION RAE CENTLY IMPROVED BY THE WAYS AND MEANS COMMITTEE ADDRESS THIS IS CRISIS BY PUTTING IN PLACE MANY SCOMMENS MEASURES TO REDUCE THE UNNECESSARY PRESCRIPTION OF OPIOIDS AND ALSO HELP THOSE WHO HAVE BECOME ADDICTED. ONE IMPORTANT POLICY WITHIN H.R. 6, WHICH HAS BEEN CHAMPIONED BY CONGRESSMAN PETE ROSKAM, WHO LEADS OUR HEALTH SUBCOMMITTEE, WILL PREVENT ABUSE BY MAKING SURE FOLKS AREN'T ABLE TO GAME THE SYSTEM BY VISITING MULTIPLE DOCTORS OFFICES TO RECEIVE AN OPEN OYOID. H.R. 6 ENSURES THAT PATIENTS HAVE SELECTED PROSCRIBERS IN PHARMACIES WHO WILL BEST BE ABLE TO ADDRESS THEIR NEEDS. ANOTHER IMPORTANT MEASURE EXPANDS ACCESS TO MORE FORMS OF REALLY BROAD HOLISTIC TREATMENTS FOR ADDICTION THROUGH THE USE OF MEDICATION ASSISTED TREATMENT. AMERICANS STRUGGLING WITH ADDICTION MUST BE ABLE TO FIND TREATMENT THAT WORKS FOR THEM. WHILE WE STILL HAVE A LONG WAY TO GO TO SOLVE THIS CRISIS, THIS BILL WHICH IS MADE UP OF MANY COMMONSENSE REPUBLICAN, DEMOCRAT PROPOSALS TAKES MEANINGFUL STRIDES TO HELP MILLIONS OF AMERICANS RECAPTURE THEIR LOST HOMES AND DREAMS. I'D LIKE TO THANK REPRESENTATIVES MIKE BISHOP, DAVE REICHERT, CARLOS CURBELO, AND JACKIE WALORSKI AND OTHERS FOR THEIR LEADERSHIP ON THIS IMPORTANT ISSUE. THANKS TO ALL OUR COMMITTEE MEMBERS, REPUBLICANS AND DEMOCRATS, FOR THE HARD WORK ON THIS IMPORTANT LEGISLATION. I LOOK FORWARD TO WORKING WITH THE SENATE TO ENSURE WE SEND THIS IMPORTANT BILL TO THE PRESIDENT'S DESK. MR. SPEAKER, I RESERVE THE BALANCE OF MY TIME. .

THE CHAIR

THE CHAIR RECOGNIZES THE GENTLEMAN FROM MASSACHUSETTS, MR. NEAL, FOR 10…

THE CHAIR RECOGNIZES THE GENTLEMAN FROM MASSACHUSETTS, MR. NEAL, FOR 10 MINUTES.

MR. NEAL

THANK YOU, MR. CHAIRMAN. I YIELD MYSELF FOUR MINUTES.

THE CHAIR

THE GENTLEMAN IS RECOGNIZED FOR FOUR MINUTES.

MR. NEAL

THANK YOU. MR. CHAIRMAN, I RISE IN SUPPORT OF H.R. 6. IT'S TOO CLEAR THAT…

THANK YOU. MR. CHAIRMAN, I RISE IN SUPPORT OF H.R. 6. IT'S TOO CLEAR THAT THE ONGOING OPIOID EPIDEMIC HAS GRIPPED THE NATION'S FAMILIES AND COMMUNITIES. IT'S A PUBLIC HEALTH, SAFETY AND ECONOMIC CRISIS AS WELL. IN MASSACHUSETTS IN 2016 THERE WERE 2,083 CONFIRMED OF OPIOID-RELATED OVERDOSE DEATHS. THIS IS A 26% INCREASE SINCE 2015 AND 54% INCREASE SINCE 2014. THERE WAS A STRONG NEED TO ADDRESS THIS DEVASTATING TREND. THIS WEEK THE HOUSE HAS CONSIDERED OPIOID BILLS IN COMMITTEE AND ON THE FLOOR AND SOME OF THESE IN FACT WILL EXPAND TREATMENT OPTIONS FOR THE CARE THAT IS NECESSARY. HOWEVER, A NUMBER OF THE DEMOCRATIC PRIORITIES IN HERE I THINK PROVIDE REAL INVESTMENT AND OPPORTUNITY. FOR EXAMPLE, IT INCORPORATES A BILL THAT I INTRODUCED THAT WOULD EXPAND MEDICARE COVERAGE FOR OPIOID TREATMENT PROGRAMS. CURRENTLY, MEDICARE DOES NOT COVER THIS SORT OF TREATMENT. THIS WOULD GIVE MEDICARE BENEFICIARIES ACCESS TO A BROAD RANGE OF TREATMENT OPTIONS LEADING TO OPPORTUNITIES FOR LASTING RECOVERY. ALTHOUGH MANY THINK OF OPIOID USE DISORDERS IS A PROBLEM FACED BY YOUNG PEOPLE, MANY MAY BE SURPRISED TO LEARN IT'S RAPIDLY GROWING AMONGST OUR MEDICARE BENEFICIARIES. MEDICARE PART D, SPENDING -- OUTPATIENT ENROLLMENT GROWING FROM 150% FROM 2016 TO 2015. IN 13 STATES, THE OVER 65 POPULATION HAS THE HIGHEST RATE OF OPIOID-RELATED IN-PATIENT STAYS. H.R. 6 ALSO EXPANDS COVERAGE OF MEDICATION ASSISTED TREATMENTS AND HAVE NURSES TO DISPENSE OPIOID DRUGS. THE MEASURE ALSO PROVIDES CONSISTENT MEDICAID COVERAGE FOR AT-RISK YOUTH AND EXPANDS MEDICAID COVERAGE FOR FOSTER YOUTH UNTIL THE AGE OF 26. THESE BILLS ARE PIECES OF A LARGE COMPLEX PUZZLE. WE NEED TO FIND REALISTIC SOLUTIONS WITH LONG-TERM OUTCOMES. PART OF THIS APPROACH IS TO PROTECT AND STRENGTHEN MEDICAID AND THE AFFORDABLE CARE ACT. THE A.C.A. GUARANTEES PARITY AND NONDISCRIMINATION. THANKS TO THE A.C.A., MILLIONS OF PREVIOUSLY UNINSURED ADULTS NOW HAVE ACCESS TO HEALTH INSURANCE, AND, I MIGHT ADD, THE EXPANSION OF MEDICAID. THERE ARE MANY EFFORTS HERE, I THINK, TIME AND AGAIN TO DISMANTLE THE MEDICARE PROPOSAL AS WELL AS CUTTING BACK ON MANY OF THE INITIATIVES THAT WE HAVE PROPOSED IN THE PAST. INSTEAD OF STRENGTHENING AND ENSURING A SUSTAINABLE FUTURE FOR A.C.A. AND MEDICAID, SOME OF MY COLLEAGUES WANT TO CUT TO PAY FOR A $2.3 TRILLION TAX PLAN. EFFORTS TO SABOTAGE THE A.C.A., COUPLED WITH PREMIUM HIKES, SLASHING PRE-EXISTING CONDITION PROTECTIONS, INCREASING DRUG PRICES, IT WILL LEAD TO MORE UNCERTAINTY. IT WILL DAMAGE ANY PROGRESS THAT WE'RE MAKING TODAY WITH THE OPIOID CRISIS. IT WOULD ALSO INCREASE HEALTH CARE COSTS AND LOWER COVERAGE AND QUALITY OF LIFE FOR AMERICANS AND THEIR FAMILIES. SO I URGE OUR COLLEAGUES TO RECOGNIZE MANY FAMILIES WHO ARE DEVASTATED BY ADDICTION ARE GOING TO NEED THE OPPORTUNITIES THAT WE ARE EMBRACING TODAY. THE IMPACT OF THE OPIOID CRISIS ON LABOR PARTICIPATION RATES IN AMERICA SHOULD CONCERN ALL OF US. ACCORDING TO A RECENT REPORT, THE ECONOMIC BURDEN FROM OPIOIDS WAS ESTIMATED AT $95 BILLION. THE AMERICAN PEOPLE ARE FACING TWO-PRONGED OBSTACLE HEALTH CHALLENGES, UNCERTAINTY REMAINS ONE OF THEM. WE WANT TO MAKE SURE WE DON'T SABOTAGE THE A.C.A. AND PART OF THE PATH FORWARD TODAY IS HIGHLIGHTED BY THE ACHIEVEMENT WE ARE ALL ABOUT TO RECOGNIZE.

THE CHAIR

THE GENTLEMAN RESERVES HIS TIME. THE GENTLEMAN FROM TEXAS IS RECOGNIZED.

MR. BRADY

MR. SPEAKER, I'M PROUD TO YIELD TWO MINUTES TO THE LEADER OF THE HEALTH…

MR. SPEAKER, I'M PROUD TO YIELD TWO MINUTES TO THE LEADER OF THE HEALTH SUBCOMMITTEE, THE GENTLEMAN FROM ILLINOIS,

THE CHAIR

THE GENTLEMAN FROM ILLINOIS IS RECOGNIZED FOR TWO MINUTES.

MR. ROSKAM

THANK YOU, MR. SPEAKER. I WANT TO THANK CHAIRMAN BRADY FOR HIS LEADERSHIP…

THANK YOU, MR. SPEAKER. I WANT TO THANK CHAIRMAN BRADY FOR HIS LEADERSHIP ON THIS. I'VE DONE A LOT OF WORK OVER THE PAST SEVERAL MONTHS, AS I KNOW WE ALL HAVE, OF LISTENING TO MY CONSTITUENTS IN SUBURBAN CHICAGO, AND HERE'S WHAT I HEARD. THEY WANT US TO TAKE A MULTIFACETED APPROACH. ONE OF THE THINGS THAT I'M DOING THIS MORNING IS HIGHLIGHTING A PORTION OF THIS BILL THAT MR. BRADY MENTIONED IN HIS OPENING STATEMENT AND THAT IS A LOCK IN PHENOMENON. HERE'S THE STORY. THE POWER OF THIS MOLECULE, WHEN IT GETS INTO OUR BODIES, IS BREATHTAKING. AND IT'S SOBERING. HERE'S ONE STATISTIC THAT SHOULD MAKE US SHOULDER. ONE-THIRD OF PART D MEDICAID PARTICIPANTS WERE PRESCRIBED AN OPIOID. ONE-THIRD OF MEDICAID PART D PARTICIPANTS WERE PRESCRIBED AN OPIOID. THERE'S NOTHING GOOD GOING ON WITH THAT. WE ARE SAYING WE NEED TO RESIST PHARMACY SHOPPING. WE NEED TO RESIST DOCTOR SHOPPING. WE NEED TO MAKE SURE PEOPLE WHO ARE -- WHO CAN BE IDENTIFIED WHO HAVE A PREDISPOSITION TOWARDS THIS ADDICTION. AND SO WHAT THIS BILL DOES, WHAT PART OF THIS BILL DOES IS IT SAYS, NOW MEDICARE PART D PROGRAMS, THEY DON'T JUST HAVE THE OPTION OF REQUIRING A LOCK-IN PROGRAM. WE'RE NOW LOCKING IN ON LOCK-IN. WE'RE SAYING, YOU'VE GOT TO DO THIS. SO UNAMBIGUOUSLY IT'S A MANDATE, IT'S A GOOD MANDATE, IT'S SOMETHING THAT'S BEEN A LONG TIME COMING. TRICARE USES THIS. A NUMBER OF OTHER DISTRIBUTION SYSTEMS USE IT IS BUT THE TIME IS RIPE AND WE ABSOLUTELY GOT TO GET THIS DONE. IT'S PART OF A HOLISTIC APPROACH THAT I THINK IS WELCOMED. I WANT TO THANK MR. LEVIN, THE RANKING MEMBER, MR. BILIRAKIS, MR. LUJAN, ALSO, WHO SIMILARLY WORKED ON THIS LEGISLATION. I'M CONFIDENT THAT IN 10 YEARS' TIME OUR COUNTRY, BASED ON THE WORK THIS HOUSE IS DOING NOW, IS GOING TO REFLECT BACK AND IT'S GOING TO SAY, AMERICA RESPONDED, WE DID IT ON A BIPARTISAN BASIS, AND WE'RE GOING TO BE HAVING A BETTER AND DIFFERENT CONVERSATION. I YIELD BACK.

THE CHAIR

THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM TEXAS RESERVES. THE…

THE GENTLEMAN'S TIME HAS EXPIRED. THE GENTLEMAN FROM TEXAS RESERVES. THE GENTLEMAN FROM MASSACHUSETTS IS RECOGNIZED.

MR. NEAL

THANK YOU, MR. CHAIRMAN. I WANT TO YIELD FOUR MINUTES TO THE GENTLEMAN…

THANK YOU, MR. CHAIRMAN. I WANT TO YIELD FOUR MINUTES TO THE GENTLEMAN FROM ILLINOIS, CONGRESSMAN DAVIS.

THE CHAIR

THE GENTLEMAN FROM ILLINOIS IS RECOGNIZED FOR FOUR MINUTES.

MR. DAVIS

THANK YOU, MR. CHAIRMAN. I WANT TO THANK MR. NEAL FOR YIELDING. I SUPPORT…

THANK YOU, MR. CHAIRMAN. I WANT TO THANK MR. NEAL FOR YIELDING. I SUPPORT H.R. 6 AS A STEP TO THE PUZZLE TO ADDRESS SUBSTANCE ABUSE. HOWEVER, I THINK WE NEED TO EXPAND THIS BILL IN AN IMPORTANT WAY AS IT MOVES FORWARD. TO PREVENT OPIOID ADDICTION, WE MUST ADDRESS THE SOCIAL AND EMOTIONAL HARM CAUSED BY TRAUMA THAT OFTEN UNDERLIES OPIOID USE. RESEARCH DEMONSTRATES THAT EXPOSURE TO FOUR OR MORE ADVERSE CHILDHOOD EXPERIENCES, SUCH AS NEGLECT, EXPERIENCING A PARENT BATTLING ADDICTION, WITNESSING VIOLENCE OR OBSERVING DOMESTIC VIOLENCE MAKES AN INDIVIDUAL 10 TIMES MORE LIKELY TO MISUSE ILLICIT NARCOTICS. THESE DRUGS SERVE AS A COPING RESPONSE TO TRAUMATIC LIFE EXPERIENCES. THE SENATE'S BIPARTISAN OPIOID CRISIS RESPONSE ACT INCLUDED PROVISIONS FROM MY TRAUMA INFORMED CARE ACT WITH SENATOR DURBIN TO HELP IMPROVE THE FEDERAL RESPONSE TO TRAUMA TO HELP PREVENT OPIOID ABUSE. THESE PROVISIONS WOULD EXPAND THE WORKPLACE CAPACITY TO HELP CHILDREN EXPOSED TO TRAUMA. THEY WOULD IMPROVE OUR UNDERSTANDING OF TRAUMA BY IMPROVING FEDERAL DATA AND BEST PRACTICES. THEY WOULD INCREASE SERVICES FOR CHILDREN EXPOSED TO TRAUMA TO HELP THESE YOUNG PEOPLE HEAL. OUR EFFORTS FEDERAL DATA TO PREVENT OPIOID CRISIS WILL BE INSUFFICIENT UNLESS WE ADDRESS THE ROLE OF TRAUMA IN IT, WHICH IS WHY 28 ORGANIZATIONS SUPPORTED MY EFFORT TO AMEND H.R. 6 TO FOCUS ON TRAUMA. ORGANIZATIONS LIKE THE CHILD WELFARE LEAGUE OF AMERICA, THE JEWISH CHILD AND FAMILY SERVICES, THE NATIONAL ASSOCIATION OF SOCIAL WORKERS, PARTNERS FOR OUR CHILDREN WITH THE UNIVERSITY OF WASHINGTON, AND THE YWCA U.S.A., BUT MY AMENDMENT WAS NOT MADE IN ORDER. THE SCIENCE IS CLEAR THAT TRAUMA HAS DEVASTATING EFFECTS ON CHILD'S HEALTHY DEVELOPMENT WELL INTO ADULTHOOD. WHEN CHILDREN EXPERIENCE TRAUMATIC EVENTS, STRESS ALTERS THE DEVELOPING BRAIN WHICH HARMS THEM PHYSICALLY AND MENTALLY. AND I ASK UNANIMOUS CONSENT TO SUBMIT TO THE RECORD THIS OUTLINE OF THE RESEARCH BY THE SOCIETY FOR COMMUNITY RESEARCH AND ACTION DOCUMENTING THE HARM CAUSED BY TRAUMA AND PARENTAL SEPARATION. THAT IS WHY THE ADMINISTRATION'S INTENTIONAL INFLICTION OF TRAUMA ON CHILDREN BY SEPARATING THEM FROM THEIR PARENTS IS SO CRUEL AND INHUMANE, CAUSING INTENTIONAL HARM TO CHILDREN IS A HUMAN RIGHTS VIOLATION AND IS UN-AMERICAN. WE MUST STOP THIS APPALLING POLICY IMMEDIATELY. REUNITE PARENTS AND CHILDREN WITHOUT DELAY AND PROVIDE INTENSIVE SERVICES TO HELP THESE FAMILIES HEAL. I SUPPORT AND YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN'S REQUEST WILL BE COVERED UNDER GENERAL LEAVE. THE GENTLEMAN…

THE GENTLEMAN'S REQUEST WILL BE COVERED UNDER GENERAL LEAVE. THE GENTLEMAN FROM TEXAS IS RECOGNIZED.

MR. BRADY

PROUD TO YIELD TWO MINUTES TO THE GENTLEMAN FROM MICHIGAN, MR. BISHOP.

THE CHAIR

THE GENTLEMAN FROM MICHIGAN IS RECOGNIZED FOR TWO MINUTES.

MR. BISHOP

I WANT TO TAKE THIS OPPORTUNITY TO THANK CHAIRMAN BRADY FOR HIS STEADFAST…

I WANT TO TAKE THIS OPPORTUNITY TO THANK CHAIRMAN BRADY FOR HIS STEADFAST LEADERSHIP AND FINDING A SOLUTION TO THIS CRISIS. I RISE IN STRONG SUPPORT FOR H.R. 6, THE SUPPORT FOR PATIENTS AND COMMUNITIES ACT. I'M PLEASED WE'RE VOTING ON THIS LEGISLATION TODAY WHICH INCLUDES IMPORTANT REFORMS TO MEDICARE AND MEDICAID POLICIES TO HELP COMBAT THE OPIOID CRISIS IN OUR COUNTRY. MR. SPEAKER, THE OPIOID CRISIS HAS AFFECTED EVERY SEGMENT OF OUR NATION'S POPULATION. EVERY MEMBER OF THIS CHAMBER HAS A COMMUNITY IN CRISIS. EVERY DAY 115 AMERICANS DIE FROM OPIOID OVERDOSES. WE'RE TALKING ABOUT VALUED MEMBERS, FATHERS, MOTHERS, CHILDREN WHO WAY -- LEFT WAY TOO EARLY BECAUSE OF THE OPIOID CRISIS. I HEAR FREQUENTLY FROM CONSTITUENTS ABOUT THE CRISIS IN TOWN HALLS AND ROUNDTABLES I HOSTED. I HEARD ABOUT THE DEVASTATING IMPACT AND THE CRISIS IT'S HAPPENING IN SOUTHEAST MICHIGAN. I HAVE MET WITH OFFICIALS ACROSS THE DISTRICT, FIREFIGHTERS, POLICE OFFICERS, EMERGENCY RESPONDERS, MEDICAL PROFESSIONALS, AND THEY ALL WANT ME TO DO SOMETHING AND DO IT URGENTLY. AND CONGRESS TO BE INVOLVED. WHILE THERE IS NO SILVER BULLET TO ADDRESS THE ISSUE, I'M PLEASED OVER THE LAST SEVERAL WEEKS THE CONGRESS PASSED THE LEGISLATION I AUTHORED, THE STOP ACT, STOP THE FLOW OF SYNTHETIC OPIOIDS INTO THE COUNTRY, AND H.R. 6 WILL DO MORE THAN THAT. IT WILL EXPAND MEDICARE COVERAGE FOR OPIOID TREATMENT SERVICES LIKE COUNSELING, INDIVIDUAL AND GROUP THERAPY, MEDICATION ASSISTED TREATMENT, AND THESE REFORMS WILL EMPOWER THE AMERICAN -- OUR AMERICANS TO OVERCOME ADDICTION AND ONCE AGAIN BECOME PRODUCTIVE MEMBERS OF SOCIETY. ONCE AGAIN, I WANT TO THANK CHAIRMAN BRADY AND CHAIRMAN WALDEN FOR THEIR LEADERSHIP, FOR CRAFTING THIS LEGISLATION AND FOR THEIR STEADFAST LEADERSHIP TO ADDRESS THE OPIOID CRISIS. THANK YOU, MR. SPEAKER, I YIELD BACK.

THE CHAIR

THE GENTLEMAN YIELDS BACK. THE GENTLEMAN FROM TEXAS RESERVES HIS TIME. THE…

THE GENTLEMAN YIELDS BACK. THE GENTLEMAN FROM TEXAS RESERVES HIS TIME. THE GENTLEMAN FROM MASSACHUSETTS.

MR. NEAL

THE CHAIR

RESERVES. THE GENTLEMAN FROM TEXAS IS RECOGNIZED. THE GENTLEMAN FROM TEXAS…

RESERVES. THE GENTLEMAN FROM TEXAS IS RECOGNIZED. THE GENTLEMAN FROM TEXAS IS RECOGNIZED.

MR. BRADY

MR. SPEAKER, PROUD TO YIELD TWO MINUTES TO THE GENTLEMAN FROM NORTH…

MR. SPEAKER, PROUD TO YIELD TWO MINUTES TO THE GENTLEMAN FROM NORTH CAROLINA,

THE CHAIR

THE GENTLEMAN FROM NORTH CAROLINA IS RECOGNIZED FOR TWO MINUTES.

MR. HOLDING

MR. SPEAKER, I'D LIKE TO HIGHLIGHT THE IMPORTANCE OF MEDICATION-ASSISTED…

MR. SPEAKER, I'D LIKE TO HIGHLIGHT THE IMPORTANCE OF MEDICATION-ASSISTED TREATMENT IN COMBATING THE OPIOID EPIDEMIC. THIS EPIDEMIC HAS PERVADED ALL POPULATIONS, INCLUDING OUR SENIORS. MEDICARE BENEFICIARIES HAVE THE HIGHEST AND FASTEST GROWING RATE OF OPIOID USE DISORDER, YET, THEY DO NOT CURRENTLY HAVE COVERAGE FOR THE MOST EFFECTIVE TREATMENT. THE SUPPORT ACT, WHICH I -- WHICH WILL BE BEFORE THE HOUSE TODAY, WOULD CHANGE THAT. THIS BILL PROVIDES FOR FULLY COORDINATED BUNDLED CARE MODEL THAT WILL HELP PATIENTS THROUGH MEDICATION-ASSISTED TREATMENT WHICH COMBINES THE USE OF MEDICATION WITH COUNSELING, GROUP THERAPY, AND DRUG TESTING. JUST THIS WEEK THE N.I.H. RELEASED A STUDY THAT FOUND DELIVERING MEDICATION-ASSISTED TREATMENT TO PATIENTS FOLLOWING AN OPIOID OVERDOSE DROPPED THE DEATH RATE BY 59%. THE PRESIDENT'S COMMISSION ON COMBATING DRUG ADDICTION AND THE OPIOID CRISIS ALSO CITED THE VALUE OF MEDICATION-ASSISTED TREATMENT IN REDUCING OVERDOSES AND RELAPSE AS WELL, RETAINING THE PATIENTS IN A TREATMENT PROGRAM. FOR EXAMPLE, A CONSTITUENT NAMED JEFF FROM NORTH CAROLINA, BECAME DEPENDENT ON OPIOIDS AFTER A BACK SURGERY. HE TRIED TO STOP COLD AND WENT INTO WITHDRAWAL AND RELAPSE. HE WAS ABLE TO RECEIVE TREATMENT WHERE HE WENT THROUGH COUNSELING. HIS PROGRESS WAS MONITORED AND MONTHLY DRUG SCREENINGS KEPT HIM ACCOUNTABLE. HE, JEFF, NOW SAYS HIS LIFE HAS CHANGED 100% FOR THE BETTER. EVERY MEMBER OF THIS HOUSE HAS CONSTITUENTS JUST LIKE JEFF WHO HAVE STRUGGLED WITH ADDICTION BUT CAN REGAIN THEIR LIFE WITH THE RIGHT TREATMENT. WHILE THERE'S NO SILVER BULLET TO THIS CRISIS, WE NEED TO ENSURE PATIENTS AND DOCTORS HAVE ALL OPTIONS AT THEIR DISPOSAL TO COMBAT THE OPIOID EPIDEMIC. THANK YOU, MR. SPEAKER, AND I YIELD BACK.

THE CHAIR

MR. NEAL

I CONTINUE TO RESERVE, MR. SPEAKER.

THE CHAIR

THE GENTLEMAN FROM TEXAS.

MR. BRADY

I YIELD TWO MINUTES TO A LEADER ON THE OPIOID CRISIS, THE GENTLELADY FROM…

I YIELD TWO MINUTES TO A LEADER ON THE OPIOID CRISIS, THE GENTLELADY FROM INDIANA, MRS. WALORSKI.

THE CHAIR

THE GENTLEMAN FROM TEXAS ONLY HAS A MINUTE AND A HALF REMAINING.

MR. BRADY

I YIELD ONE MINUTE.

THE CHAIR

THE GENTLELADY IS RECOGNIZED FOR ONE MINUTE.

MRS. WALORSKI

THANK YOU. I RISE IN SUPPORT FOR THE SUPPORT ACT. AND IT INCLUDES MY BILL.…

THANK YOU. I RISE IN SUPPORT FOR THE SUPPORT ACT. AND IT INCLUDES MY BILL. H.R. 6 IS ALSO VITAL FOR EQUIPPING THOSE ON THE FRONT LINES WITH IMPORTANT TREATMENT AND RECOVERY INITIATIVES. THIS INCLUDES PEOPLE IN MY DISTRICT LIKE AARON LACOURT AT VICTORY CLINICAL SERVICES IN SOUTH BEND. IT PROVIDES COMPREHENSIVE TREATMENT FOR THOSE WITH SUBSTANCE USE DISORDERS. BUT H.R. 6 WILL HELP THEM EXPAND THOSE SERVICES TO INCLUDE SENIORS. THIS BILL WILL ALSO HELP JUSTIN PHILIPS WHO FOUNDED OVERDOSE LIFELINE, WHICH IS DEDICATED TO HELPING THOSE EFFECTED BY ADDICTION ASSIST MORE HOOSIERS. SOLVING THE EPIDEMIC -- THE OPIOID EPIDEMIC REQUIRES EVERY ONE OF US TO WORK TOGETHER. I WANT TO THANK AARON, JUSTIN, ALL THE OTHER HARDWORKING HOOSIERS IN MY DISTRICT WHO DESERVE RECOGNITION AND TO LET THEM KNOW WE HAVE NOTICED THEIR HARD WORK. I ASK SUPPORT AND YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLELADY YIELDS BACK. THE GENTLEMAN FROM TEXAS RESERVES. AND THE…

THE GENTLELADY YIELDS BACK. THE GENTLEMAN FROM TEXAS RESERVES. AND THE GENTLEMAN FROM MASSACHUSETTS.

MR. NEAL

MR. CHAIRMAN, I'M PREPARED TO CLOSE.

THE CHAIR

THE GENTLEMAN FROM MASSACHUSETTS IS PREPARED TO CLOSE. THE GENTLEMAN FROM…

THE GENTLEMAN FROM MASSACHUSETTS IS PREPARED TO CLOSE. THE GENTLEMAN FROM TEXAS IS APPARENTLY PREPARED TO CLOSE AS WELL. THE GENTLEMAN FROM MASSACHUSETTS IS RECOGNIZED.

MR. NEAL

THANK YOU, MR. CHAIRMAN. I YIELD MYSELF THE BALANCE OF THE TIME.

THE CHAIR

THE GENTLEMAN IS RECOGNIZED FOR THE REMAINDER OF HIS TIME.

MR. NEAL

MR. CHAIRMAN, I WANT TO CLOSE BY THANKING CHAIRMAN KEVIN BRADY AND…

MR. CHAIRMAN, I WANT TO CLOSE BY THANKING CHAIRMAN KEVIN BRADY AND ACKNOWLEDGING CHAIRMAN WALDEN AND RANKING MEMBER PALLONE FOR THEIR HARD WORK ON WHAT IS REALLY A GOOD STEP FORWARD. AS I SAID EARLIER IN MY REMARKS, THIS BILL WILL NOT SOLVE THE OPIOID CRISIS TOMORROW, BUT IT DOES INCLUDE A NUMBER OF IMPORTANT PROVISIONS THAT WILL EXPAND ACCESS TO TREATMENT AND RECOVERY OPTIONS FOR ALL AMERICANS. . WE KNOW MANY WHO NEED TREATMENT NOW CAN CAN THE NOT ACCESS IT. THIS BILL WILL TAKE SIGNIFICANT STEPS TO CHANGE THAT. I WANT TO THANK JESSICA AND CARL FROM THE HOUSE LEGISLATIVE COUNSEL FOR THEIR HOURS OF WORK IN HELPING US TO PUT TOGETHER H.R. 6. THE STAFF OF THE CENTERS FUNDRAISE MEDICARE AND MEDICAID, OFFICE OF LEGISLATION. IN PARTICULAR IRA AND JENNIFER. AND THE STAFF OF THE CONGRESSIONAL BUDGET OFFICE, INCLUDING REBECCA AND LAURA. FINALLY I WANT TO THANK THE WAYS AND MEANS REPUBLICAN STAFFERS LED BY EMILY MURRAY, THE ENERGY AND COMMERCE DEMOCRATIC STAFF LED BY TIFFANY, AND THE ENERGY AND COMMERCE REPUBLICAN STAFF AND MY OWN DEMOCRATIC STAFF AT THE WAYS AND MEANS, WHICH IS ALWAYS SUPERB, LED BY AMY. MELANIE AND RACHEL. A LOT OF HARD WORK GOES INTO THIS SORT OF LEGISLATION. A LOT INCLUDING OF COMPLEXITIES HAVE TO BE ADDRESSED DURING THE PROCESS. OFTENTIMES THAT IS NOT THE SORT OF INFORMATION THAT FINDS ITS WAY TO THE PUBLIC LIGHT. BUT ACKNOWLEDGING HERE THOSE PEOPLE WHO HELPED TO PUT THIS TOGETHER AS WELL AS THE MEN AND WOMEN OF THE COMMITTEE, I THINK FREQUENTLY IS MISSED AND WE -- AND WE WANT TO DO THAT SO THAT THEY RECEIVE THE DUE PRAISE THAT THEY ARE ENTITLEMENTED TO. I HOPE THAT THIS WILL QUICKLY BECOME LAW. ONE OF THE THINGS THAT UNITES EVERY ONE OF US IN THIS CHAMBER IS THAT WE ALL KNOW SOMEBODY, A FAMILY MEMBER, SOMEBODY WHO LIVES DOWN THE STREET, OR A CO-WORKER WHO HAS AN OPIATE ADDICTION. I THINK THAT CONGRESS TAKING THIS STEP TODAY IN THIS DIRECTION WILL PROVIDE SOME SENSE OF HOPE FOR THOSE FAMILY AND FRIENDS WHO FIND THEMSELVES FOR A VARIETY OF REASONS SUFFERING FROM THE PAIN, ECONOMICALLY AND PHYSICALLY, THAT COMES FROM OPIATE ADDICTIONS. I THINK THAT AS WE CLOSE HERE THIS IS A GOOD DAY FOR THE WAYS AND MEANS COMMITTEE, ENERGY COMMITTEE. I THINK FOR THE MEMBERS AND STAFFERS WHOSE WORK IS REFLECTED IN THIS PRODUCT.

THE CHAIR

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE GENTLEMAN FROM…

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE GENTLEMAN FROM TEXAS IS RECOGNIZED FOR THE REMAINDER OF HIS TIME.

MR. BRADY

THANK YOU. MR. SPEAKER, I AGREE WITH MR. NEAL. REPUBLICANS, DEMOCRATS THAT…

THANK YOU. MR. SPEAKER, I AGREE WITH MR. NEAL. REPUBLICANS, DEMOCRATS THAT COME TOGETHER, WAYS AND MEANS COMMITTEE AND ENERGY AND COMMERCE TO HELP MILLIONS OF AMERICANS THROUGH PREVENTION OF OVERPRESCRIBING EDUCATION FOR PATIENTS AND PRESCRIBERS AND ACCESS TO TREATMENT. THIS IS A MAJOR STEP FORWARD. I URGE CONGRESS TO PASS THIS BILL AND LOOK FORWARD TO GETTING IT TO THE PRESIDENT'S DESK. I YIELD BACK.

THE CHAIR

ALL TIME FOR GENERAL DEBATE HAS EXPIRED. PURSUANT TO THE RULE, THE BILL A…

ALL TIME FOR GENERAL DEBATE HAS EXPIRED. PURSUANT TO THE RULE, THE BILL A MAJOR STEP SHALL BE CONSIDERED FOR AMENDMENT UNDER THE FIVE-MINUTE RULE. THE AMENDMENT IN THE NATURE OF A SUBSTITUTE CONSISTING OF THE TEXT IT OF RULES COMMITTEE PRINT 115-76, MODIFIED BY THE RULES COMMITTEE PRINT 115-78, AND THE AMENDMENT PRINTED IN PART A, HOUSE REPORT 115-766, SHALL BE CONSIDERED AS ADOPTED. THE BILL AS AMENDED SHALL BE CONSIDERED AS AN ORIGINAL BILL FOR THE PURPOSE OF FURTHER AMENDMENT UNDER THE FIVE-MINUTE RULE AND SHALL BE CONSIDERED AS READ. NO FURTHER AMENDMENT TO THE BILL AS AMENDED SHALL BE IN ORDER EXCEPT THOSE PRINTED IN PART B, HOUSE REPORT 115-766. EACH SUCH FURTHER AMENDMENT MAY BE OFFERED ONLY IN THE ORDER PRINTED IN THE REPORT, BY A MEMBER DESIGNATED IN THE REPORT, SHALL BE CONSIDERED AS READ, SHALL BE DEBATABLE FOR THE TIME SPECIFIED IN THE REPORT EQUALLY DIVIDED AND CONTROLLED BY THE PROPONENT AND AN OPPONENT. SHALL NOT BE SUBJECT TO AMENDMENT, AND SHALL NOT BE SUBJECT TO A DEMAND FOR DIVISION OF THE QUESTION. IT IS NOW IN OR TO CONSIDER AMENDMENT NUMBER 1 PRINTED IN HOUSE REPORT 115-766. FOR WHAT PURPOSE DOES THE GENTLEMAN FROM OREGON SEEK RECOGNITION.

MR. WALDEN

MR. CHAIRMAN, I HAVE AN AMENDMENT AT THE DESK.

THE CHAIR

THE CLERK WILL DESIGNATE THE AMENDMENT.

THE CLERK

AMENDMENT NUMBER 1, PRINTED IN PART B OF HOUSE REPORT NUMBER 115-766,…

AMENDMENT NUMBER 1, PRINTED IN PART B OF HOUSE REPORT NUMBER 115-766, OOFERED BY -- OFFERED BY MR. WALDEN OF OREGON.

THE CHAIR

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEMAN FROM OREGON, MR. WALDEN,…

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEMAN FROM OREGON, MR. WALDEN, AND A MEMBER OPPOSED, EACH WILL CONTROL FIVE MINUTES. THE CHAIR RECOGNIZES THE GENTLEMAN FROM OREGON.

MR. WALDEN

THANK YOU, MR. CHAIRMAN. I APPRECIATE ALL THE WORK THAT'S BEEN DONE ON…

THANK YOU, MR. CHAIRMAN. I APPRECIATE ALL THE WORK THAT'S BEEN DONE ON THIS BILL UP TO THIS POINT. THE GREAT BIPARTISAN WORK, THE BIGGEST EFFORT I THINK CONGRESS HAS EVER UNDERTAKEN TO ADDRESS THIS TERRIBLE, TERRIBLE ADDICTION PROBLEM OF OPIOIDS EAFER THE GREAT BIPARTISAN WORK, EVERYTHING RELATED TO IT -- AND EVERYTHING RELATED TO IT. THIS AMENDMENT BEFORE US IS A BIPARTISAN MANAGER'S AMENDMENT. FILED BY CHAIRMAN AND RANKING MEMBERS OF THE COMMITTEES ON ENERGY AND COMMERCE AND WAYS AND MEANS. THIS AMENDMENT MAKES SIMPLY TECHNICAL CORRECTIONS AND CONFORMING CHANGES TO THE UNDERLYING H.R. 6 BILL THAT THE LEADERS OF OUR TWO COMMITTEES INTRODUCED LAST WEEK. AS HAS BEEN NOTED, THE POLICIES IN H.R. 6 WERE MOVED THROUGH REGULAR ORDER IN OW TWO COMMITTEES. SO I APPRECIATE THE BIPARTISAN COOPERATION AND TEAMWORK OF MY COLLEAGUES AND OUR TERRIFIC STAFFS WHO HAVE JOINED ME IN INTRODUCING H.R. 6. I URGE ADOPTION OF THE AMENDMENT.

THE CHAIR

THE GENTLEMAN RESERVES. DOES ANY MEMBER SEEK TIME IN OPPOSITION? THE…

THE GENTLEMAN RESERVES. DOES ANY MEMBER SEEK TIME IN OPPOSITION? THE GENTLEMAN FROM OREGON.

>>

MR. CHAIR, I HAVE AN AMENDMENT AT THE DESK.

THE CHAIR

THE CLERK WILL DESIGNATE THE AMENDMENT. CLOIM AMENDMENT NUMBER 2, PRINTED…

THE CLERK WILL DESIGNATE THE AMENDMENT. CLOIM AMENDMENT NUMBER 2, PRINTED IN PART B OF HOUSE REPORT NUMBER 115-766, OFFERED BY MR. DUNNE OF -- DUNN OF FLORIDA.

THE CHAIR

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEMAN FROM FLORIDA, MR. DUNN,…

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEMAN FROM FLORIDA, MR. DUNN, AND A MEMBER OPPOSED WILL EACH CONTROL FIVE MINUTES. THE CHAIR RECOGNIZES GENTLEMAN FROM FLORIDA, MR. DUNN.

MR. DUNN

THANK YOU, MR. CHAIR. I RISE IN SUPPORT OF MY AMENDMENT TO H.R. , I AM…

THANK YOU, MR. CHAIR. I RISE IN SUPPORT OF MY AMENDMENT TO H.R. , I AM GRATEFUL FOR THE OPPORTUNITY TO SPEAK ON T MY AMENDMENT STRIKES LANGUAGE THAT WOULD EXPAND THE CLASSES OF HEALTH CARE WORKERS WHO WOULD BE AUTHORIZED TO DISPENSE NARCOTICS FOR NARCOTIC TREATMENT. LET BE ME CLEAR AT THE OUTSET, H.R. 6 IS IN CHARGE PART A GREAT BILL. HOWEVER AS CURRENTLY WRITTEN IT ALLOWS NURSE SPECIALISTS, NURSE MIDWIVES, TO PRESCRIBE BY PRONOR FEEN. I BELIEVE THIS IS A BIG OUTSET, H.R. 6 IS IN CHARGE PART A GREAT BILL. HOWEVER AS CURRENTLY WRITTEN IT AND IMPULSIVE EXPANSION OF PRESCRIBING AUTHORITY, ALLOWING MORE PROVIDERS WITH LESS CLINICAL EXPERIENCE TO PROVIBE THIS HIGHLY ADDICTED OPIOID OPENS UP DANGEROUS NEW POTENTIAL FOR INCREASED OPIOID ABUSE. THE POINT IS TO DECREASE OWE YOIPPED ABUSE. THIS PROVISION INCREASES THE 30E TENSION FOR ABECAUSE AND VASTLY INCREASES THE SUPPLY OF A DANGEROUS OPIOID. THAT'S ONE OF THE MAJOR CAUSES OF OPIOID OVERDOSE AND DEATH. I APPRECIATE OPPORTUNITY TO BRING THESE TO LIGHT IN THIS AMENDMENT. I RESERVE THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN FROM FLORIDA RESERVES HIS TIME. DOES ANY MEMBER SEEK TIME IN…

THE GENTLEMAN FROM FLORIDA RESERVES HIS TIME. DOES ANY MEMBER SEEK TIME IN OPPOSITION?

MR. WALDEN

I CLAIM TIME IN OPPOSITION TO THE AMENDMENT.

THE CHAIR

THE GENTLEMAN FROM OREGON IS RECOGNIZED.

MR. WALDEN

I THANK THE GENTLEMAN. I CERTAINLY APPRECIATE DR. DUNN AND THE GOOD WORK…

I THANK THE GENTLEMAN. I CERTAINLY APPRECIATE DR. DUNN AND THE GOOD WORK HE'S DONE ON MANY OF THESE ISSUES. I ALSO APPRECIATE HIS WILLINGNESS TO WITHDRAW HIS AMENDMENT. AS A RESULT OF OUR COMMITTEE PROCESS AND VARIOUS MEMBER CONVERSATIONS WE HAVE HAD, WE HAVE REACHED BIPARTISAN COMPROMISE ON THE UNDERLYING BILL ON THE ISSUE OF CONCERN OF MR. DUNN. I UNDERSTAND THE THOUGHTFUL MEMBERS CAN FIND THEMSELVES ON DIFFERENT SIDES OF AN ISSUE AT THIS TIME -- DIFFERENT TIMES, AND I CERTAINLY RESPECT THE GENTLEMAN'S POSITION. THAT BEING SAID, WE BELIEVE OUR UNDERLYING POLICY REPRESENTS A FAIR MIDDLE GROUND AND IT ENSURES RIGOROUS ANALYSIS ON THE ISSUE GOING FORWARD. I APPRECIATE THE GENTLEMAN FROM FLORIDA WITHDRAWING THE AMENDMENT.

THE CHAIR

AMENDMENT.

MR. DUNN

--

MR. WALDEN

I NOW RECOGNIZE THE GENTLEMAN FROM NEW YORK, MR. TONKO, FOR 2 1/2 MINUTES.

THE CHAIR

THE GENTLEMAN FROM NEW YORK IS RECOGNIZED FOR 2 1/2 MINUTES.

MR. TONKO

THANK YOU, MR. SPEAKER. I THANK THE CHAIR FOR YIELDING. ALTHOUGH I KNOW MY…

THANK YOU, MR. SPEAKER. I THANK THE CHAIR FOR YIELDING. ALTHOUGH I KNOW MY COLLEAGUE'S PLAN TO WITHDRAW, I RISE IN OPPOSITION TO THIS AMENDMENT THAT I JUST WANTED TO ARTICULATE A BIT OF MY REASONING. I THINK MY COLLEAGUES AND I BOTH SHARE THE SAME GOAL OF SAFELY EXPANDING ACCESS TO ADDICTION TREATMENT. WHERE WE DIFFER IS THAT I BELIEVE THAT THE PROVISIONS OF H.R. 6 EXPENDING BY PRENOR FEEN MEET THE TEST. WE KNOW THERE IS A DIRE FEED FOR EXPANDED TREATMENT CAPACITY TO MEET THE DEMANDS OF THIS CURRENT EPIDEMIC. AS MANY AS 40% OF COUNTIES ACROSS THE COUNTRY LACK EVEN A SINGLE PROVIDER THAT IS ABLE TO OFFER BUPRENORPHINE. ADVANCED PRACTICE NURSES PLAYED AN OUTSIDE ROLLED IN PROVIDING CARE IN RURAL AMERICA. AND H.R. 6 WILL HELP EXPAND ADDICTION TREATMENT CAPACITY IN THESE COMMUNITIES WHERE IT IS MOST NEEDED. EXPANDING THE PRESCRIBING PRIVILEGES TO APRN'S IS SUPPORTED BY MEDICAL GROUPS THAT SERVE ON THE FRONTLINE OF THIS EPIDEMIC SUCH AS THE AMERICAN SOCIETY FOR ADDICTION MEDICINE AND AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS. ALL NURSES WHO WISH TO PROVIBE THIS WOULD HAVE TO RECEIVE A SPECIAL WAIVER FROM THE D.E.A. AND HAVE TO UNDERGO THREE TIMES AS MUCH TRAINING AS THEIR PHYSICIAN COLLEAGUES. IN ADDITION N. ORDER TO RECEIVE A WAIVER, PRACTITIONERS ARE REQUIRED TO BE ABLE TO PROVIDE APPROPRIATE COUNSELING AND ANCILLARY SERVICES THAT ARE THE HALLMARK OF HIGH QUALITY ADDICTION TREATMENT. ALL APRN'S WOULD STILL BE SUBJECT TO STATE LAWS RADDING PRESCRIPTION AUTHORITY, SCOPE OF PRACTICE, AND COLLABORATION OR SUPERVISION REQUIREMENTS WITH A PHYSICIAN. WHILE I UNDERSTAND THAT PROVIDING ADDICTION TREATMENT THE IS A COMPLEX AND NUANCED AREA OF MEDICINE WITH POTENTIAL COMPLICATIONS IF DONE POORLY, I WOULD POINT OUT WE DON'T RESTRICT ADVANCE PRACTICE REGISTERED NURSES IN FEDERAL LAW FROM PROVIDING SUCH HIGH-RISK SERVICES AS DELIVERING BABIES, ADMINISTERING ANESTHESIA OR PRESCRIBING AS MANY OPIOIDS AS WE WISH. WHY WOULD WE WANT TO MAINTAIN AND OUTDATESED BARRIER IN FEDERAL LAW THAT PREVENTS THESE PRACTITIONERS FROM BEING PART OF THE SOLUTION. IN CLOSING I APPRECIATE MY COLLEAGUES ARE WITHDRAWING THIS AMENDMENT TODAY AND I URGE AS WE MOVE FORWARD TOWARD A POTENTIAL CONFERENCE COMMITTEE THAT WE CONTINUE TO RECOGNIZE THE ROLE THAT ADVANCED PRACTICE NURSES CAN PLAY IN ADDRESSING THIS EPIDEMIC. WITH THAT I YIELD BACK.

THE CHAIR

THE GENTLEMAN FROM NEW YORK YIELDS BACK HIS TIME. THE GENTLEMAN FROM…

THE GENTLEMAN FROM NEW YORK YIELDS BACK HIS TIME. THE GENTLEMAN FROM OREGON.

MR. WALDEN

I RESERVE THE BALANCE OF MY TIME.

THE CHAIR

RESERVES. THE GENTLEMAN FROM FLORIDA.

MR. DUNN

THANK YOU, MR. CHAIR. I NOW YIELD ONE MINUTE MOVE FORWARD TOWARD TO THE…

THANK YOU, MR. CHAIR. I NOW YIELD ONE MINUTE MOVE FORWARD TOWARD TO THE CHAIRMAN OF THE VETERANS' AFFAIRS COMMITTEE, DR. PHILLIP ROE.

THE CHAIR

THE GENTLEMAN IS RECOGNIZED.

MR. ROE

I THANK THE GENTLEMAN FOR YIELDING. AS A PRACTICING PHYSICIAN FOR OVER 30…

I THANK THE GENTLEMAN FOR YIELDING. AS A PRACTICING PHYSICIAN FOR OVER 30 YEARS I HAVE INCREDIBLE RESPECT FOR NURSES AND THE WORK THEY DO. I MARRIED A NURSE. SOME OF THE BEST EMPLOYEES I WORKED WITH WERE NURSES. I COULD NOT APPRECIATE THE JOB THEY DO MORE, MR. SPEAKER. INCREDIBLE RESPECT FOR NURSES AND THE WORK THEY DO. I MARRIED A I CARE FOR PATIENTS IS BETTER DIRECTED WITH PHYSICIAN OVERSIGHT, EVEN WITH MY TRAINING WE NEED FEWER DOCTORS LIKE ME WRITING THESE PRESCRIPTIONS AND MORE PHYSICIANS TRAINED IN PAIN MANAGEMENT. THE AMERICAN SOCIETY OF ADDICTION MEDICINE IS ESTABLISHING APPROVED FELLOWSHIPS IN TRAINING AND ADDICTION MEDICINE TODAY. EXPANDING THE SCOPE OF PRACTICE FOR NONPHYSICIAN PROVIDERS AND DISPENSE OF DRUGS GOES IN THE WRONG DIRECTION IN MY OPINION. THERE ARE MANY FACTORS THAT CONTRIBUTE TO THE EXPLOSIVE GROWTH IN OPIOID USE, BUT CLEARLY A BIG FACTOR WAS A LACK OF KNOWLEDGE ABOUT OPIOIDS ADDICTIVE QUALITIES. I WOULD ARGUE THAT WE HAVE A SIMILAR LACK OF KNOWLEDGE ABOUT THE DRUG TODAY AND ALLOWING PROVIDERS WHO HAVE LESS TRAINING AND KNOWLEDGE ABOUT THESE SUBSTANCES EXPO TENSION ANYINCREASES THE CHANCES OF ABUSE. IF WE REMOVE THE MOST HIGHLY TRAINED SPECIALIST FOR THE DISTRIBUTION OF BUPRENORPHINE I FEEL --

THE CHAIR

THE GENTLEMAN IS RECOGNIZED FOR ONE MORE MINUTE.

MR. ROE

IT IS A GOOD BILL. BUT SECTION 303 IS NOT ONE OF THEM. I ENCOURAGE MY…

IT IS A GOOD BILL. BUT SECTION 303 IS NOT ONE OF THEM. I ENCOURAGE MY COLLEAGUES TO SUPPORT THE AMENDMENT AND I YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE GENTLEMAN FROM…

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE GENTLEMAN FROM FLORIDA RESERVES. THE GENTLEMAN FROM OREGON.

MR. WALDEN

I CONTINUE TO RESERVE, MR. CHAIRMAN.

THE CHAIR

THE GENTLEMAN FROM FLORIDA.

MR. DUNN

MR. CHAIRMAN, I WOULD LIKE TO YIELD ONE MINUTE TO MY COLLEAGUE FROM BIG…

MR. CHAIRMAN, I WOULD LIKE TO YIELD ONE MINUTE TO MY COLLEAGUE FROM BIG BEN, KANSAS, DR. ROGER MARSHALL.

THE CHAIR

MR. MARSHALL

THANK YOU, MR. DUNN, FOR LEADING THIS AMENDMENT. I HAD A GREAT WORKING…

THANK YOU, MR. DUNN, FOR LEADING THIS AMENDMENT. I HAD A GREAT WORKING RELATIONSHIP WITH PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS. I BELIEVE ONE OF THE SECRETS TO THAT GREAT WORK THAT WE DID WAS THE COLLABORATION BETWEEN US AND HOW WE WORKED TOGETHER. I FIRMLY BELIEVE WHENEVER NARCOTICS ARE INVOLVED, THERE NEEDS TO BE A CLOSE RELATIONSHIP BETWEEN THE SUPERVISING PHYSICIAN AND THESE OTHER GROUPS AND SOCIETIES. AZNAR KOTYK AND OPIOID ABUSE HAS BECOME A NATIONAL CRISIS, WE NEED TO WORK TOGETHER. THANK YOU, MR. CHAIRMAN. I YIELD BACK.

MR. WALDEN

I RESERVE.

THE CHAIR

THE GENTLEMAN FROM OREGON. THE GENTLEMAN FROM FLORIDA IS RECOGNIZED.

MR. DUNN

BUPRENORPHINE WAS INTRODUCED IN FINLAND IN 1997 AND HOW IT HAS BECOME THE…

BUPRENORPHINE WAS INTRODUCED IN FINLAND IN 1997 AND HOW IT HAS BECOME THE MOST WIDELY ABUSED OPIOID IN THAT COUNTRY. BUPRENORPHINE CAN KILL PEOPLE. IT DOES KILL PEOPLE. OFFICE SPACE PRACTICES NEARLY PRESCRIBING BUPRENORPHINE RUN A LARGE RISK HARMING PATIENTS, NOT HELPING THEM RECOVER. IN CLOSING, I WANT TO THANK YOU FOR WORKING WITH ME ON THIS AMENDMENT AND I THANK CHAIRMAN WALDEN FOR HIS GRACIOUS COMMITMENT TO CONTINUE TO EXAMINE AND I ASK UNANIMOUS CONSENT TO WITHDRAW MY AMENDMENT AND YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

WITHOUT OBJECTION, THE AMENDMENT IS WITHDRAWN. THE GENTLEMAN FROM OREGON.

MR. BARTON

MR. SPEAKER, I HAVE AN AMENDMENT AT THE DESK.

THE CHAIR

THE CLERK WILL DESIGNATE THE AMENDMENT.

THE CLERK

AMENDMENT NUMBER 3 PRINTED IN PART B OF HOUSE REPORT 115-766 OFFERED BY…

AMENDMENT NUMBER 3 PRINTED IN PART B OF HOUSE REPORT 115-766 OFFERED BY MR. BARTON OF TEXAS.

THE CHAIR

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEMAN FROM TEXAS, MR. BARTON,…

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEMAN FROM TEXAS, MR. BARTON, AND A MEMBER OPPOSED, WILL EACH CONTROL FIVE MINUTES. THE CHAIR RECOGNIZES THE GENTLEMAN FROM TEXAS.

MR. BARTON

I THANK THE DISTINGUISHED SPEAKER FROM TEXAS. MR. SPEAKER, WE HAVE A GREAT…

I THANK THE DISTINGUISHED SPEAKER FROM TEXAS. MR. SPEAKER, WE HAVE A GREAT PIECE OF LEGISLATION BEFORE US TODAY. CHAIRMAN WALDEN AND RANKING MEMBER PALLONE HAVE BEEN GREAT LEADERS IN SHEPHERDING DOZENS OF OPIOID BILLS, OPIOID-RELATED BILLS THROUGH THE ENERGY AND COMMERCE COMMITTEE. THIS PARTICULAR BILL, H.R. 6, IS THE CROWN JEWEL OF ALL THAT LEGISLATION. WE ALL KNOW WHAT A SCOURGE THE OPIOID EPIDEMIC IS. SINCE 2015, MORE AMERICANS HAVE DIED ANNUALLY FROM OPIOID OVERDOSES THAN FROM THE AIDS CRISIS -- AIDS EPIDEMIC AT ITS PEAK. THE AMENDMENT THAT'S BEFORE US TODAY IS VERY SIMPLE. IT REQUIRES THE F.D.A., AFTER CONSULTATION WITH ALL THE STAKEHOLDERS IN OPEN MEETINGS AND WORKSHOPS TO DEVELOP SOME OPIOID PRESCRIPTION GUIDELINES BASED ON HARD EVIDENCE. THIS AMENDMENT GIVES THE F.D.A. TWO YEARS TO DEVELOP THESE GUIDELINES. IT REQUIRES THE F.D.A. TO POST THE GUIDELINES ON THEIR WEBPAGE, TO SEND THE GUIDELINES TO THE ENERGY AND COMMERCE COMMITTEE IN THE HOUSE AND TO THE EDUCATION AND WORK FORCE -- SENATE EDUCATION AND WORK FORCE COMMITTEE OVER IN THE SENATE. IT'S A BIPARTISAN AMENDMENT. CONGRESSWOMAN ANNIE KUSTER OF NEW HAMPSHIRE AND CONGRESSMAN MARK MEADOWS OF NORTH CAROLINA HAVE BOTH WORKED WITH MYSELF AND OTHER MEMBERS OF THE COMMITTEE TO DEVELOP THIS AMENDMENT. OPIOIDS ARE A LITTLE BIT DIFFERENT THAN SOME OF THE OTHER DRUGS THAT ARE ABUSED AND LEAD TO ADDICTION, AND MOST PEOPLE ARE EXPOSED TO OPIOIDS THE FIRST TIME BECAUSE OF A PRESCRIPTION. THEY HAVE SOME SORT OF ACUTE PAIN THAT OPIOIDS CAN HELP MANAGE. IN PRIPING THESE OPIOIDS, THE DOCTORS -- IN PRESCRIBING THESE OPIOIDS, THE DOCTORS ARE TRYING TO HELP ALLEVIATE THE PAIN, BUT EVERYONE REACTS TO OPIOIDS SOMEWHAT DIFFERENTLY. SOMETIMES WHAT IS ACCEPTABLE IN TERMS OF A DOSAGE FOR ONE INDIVIDUAL IS NOT ACCEPTABLE WITH ANOTHER INDIVIDUAL. THESE GUIDELINES WILL, AGAIN, BE BASED ON FACTS, BE BASED ON EVIDENCE. THEY ARE ADVISORY ONLY. WE ARE NOT TRYING TO INTERVENE IN THE DOCTOR-PATIENT RELATIONSHIP. IT WILL STILL BE UP TO THE DOCTOR TO DETERMINE WHAT'S BEST FOR THE PATIENT, BUT AT LEAST THE DOCTOR WILL HAVE SOME FACT-BASED GUIDELINES WITH WHICH TO MAKE THE DECISION ON WHAT LEVEL TO PRESCRIBE THESE OPIOIDS, IF IN FACT THE OPIOIDS ARE NECESSARY. TO QUOTE THE HEAD OF THE F.D.A. , DR. SCOTT GOTTLIEB, WITHOUT GUIDELINES AT THE POINT OF CARE TO PERFORM RATIONING PRESCRIBING, WE ARE AT SERIOUS RISK OF UNDERTREATMENT SOME PATIENTS WHO COULD BENEFIT FROM OPIOID THERAPY AND OVERTREATING A LOT OF PATIENTS WHO ARE PLACED AT HIGHER RISK OF ADDICTION, END QUOTE. I WILL SAY THAT THE AMENDMENT HAS DRAWN SOME CONCERN OR AT LEAST INTEREST FROM THE STAKEHOLDERS AND THE CHAIRMAN AND THE RANKING MEMBER AND MYSELF AND OTHERS ARE COMMITTED TO WORKING AS THIS GOES THROUGH THE PROCESS. IF WE CAN FINE TUNE THE AMENDMENT IN SOME WAY, WE ARE WILLING TO AT LEAST CONSIDER IT. AS IT IS CONSTRUCTED TODAY, MR. SPEAKER, THIS IS A GOOD AMENDMENT AND I HOPE THAT THE BODY WILL ADOPT IT. WITH THAT I'LL RESERVE THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN RESERVES HIS TIME. WHO SEEKS RECOGNITION?

MR. PALLONE

MR. SPEAKER, I'D LIKE TO REQUEST TIME AND SPEAK IN FAVOR OF THE BILL. THE…

MR. SPEAKER, I'D LIKE TO REQUEST TIME AND SPEAK IN FAVOR OF THE BILL. THE AMENDMENT.

THE CHAIR

DOES ANYONE CLAIM TIME IN OPPOSITION?

MR. WALDEN

WELL, I'LL CLAIM TIME IN OPPOSITION ALTHOUGH I AM NOT OPPOSED TO THE…

WELL, I'LL CLAIM TIME IN OPPOSITION ALTHOUGH I AM NOT OPPOSED TO THE AMENDMENT. I'LL YIELD TO MY FRIEND FROM NEW JERSEY A SECOND. I DO ASK UNANIMOUS CONSENT TO CLAIM THAT OPPOSITION. I RISE IN SUPPORT OF THIS AMENDMENT AND I WANT TO THANK REPRESENTATIVES BARTON AND MEADOWS AND KUSTER. THEY'VE REALLY WORKED HARD ON THIS. IT'S A GOOD AMENDMENT. THERE'S WIDE VARIATION IN THE WAY ACUTE SHORT DURATION OF PAIN IS TREATED WITH OPIOIDS AND PATIENTS MAY BE OVER OR UNDERPRESCRIBED TO TREAT THAT PAIN. THIS AMENDMENT WILL DIRECT THE F.D.A. COMMISSIONER TO DEVELOP HIGH-QUALITY, EVIDENCE-BASED OPIOID PRESCRIBING GUIDELINES FOR TREATMENT OF ACUTE PAIN. WE CAN GIVE THEM MORE OF THE TOOLS THEY NEED TO TREAT PATIENT'S PAIN WITHOUT OVERPRESCRIBING ADDICTED MEDICATIONS. THE INTENT IS THAT EVIDENCE-BASED GUIDELINES WOULD ADD TO THE UNIVERSE AVAILABLE DATA IN A WAY THAT WILL EMPOWER DOCTORS, PATIENTS, CAREGIVERS, OTHERS, TO MAKE DETERMINATIONS ABOUT TREATMENT IN A MORE INFORMED MANNER. I UNDERSTAND THAT SOME STAKEHOLDERS HAVE RAISED SOME CONCERNS ABOUT LIMITATIONS ON HOW THESE EVIDENCE-BASED GUIDELINES WILL BE USED. AS WE CONTINUE TO WORK ON THESE POLICIES WITH OUR COUNTERPARTS IN THE SENATE, WE WILL MAKE SURE THAT THE LANGUAGE WILL BE -- I URGE ADOPTION OF THE AMENDMENT AND I YIELD TO MY FRIEND FROM NEW JERSEY, MR. PALLONE, SUCH TIME AS HE MAY CONSUME.

THE CHAIR

THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED FOR AS MUCH TIME AS HE WISHES…

THE GENTLEMAN FROM NEW JERSEY IS RECOGNIZED FOR AS MUCH TIME AS HE WISHES TO USE.

MR. PALLONE

THANK YOU, MR. CHAIRMAN. I RISE IN ORDER TO SPEAK ON THE AMENDMENT. F.D.A.…

THANK YOU, MR. CHAIRMAN. I RISE IN ORDER TO SPEAK ON THE AMENDMENT. F.D.A. COMMISSIONER GOTTLIEB TESTIFIED BEFORE THE ENERGY AND COMMERCE COMMITTEE ABOUT THE WORK THE AGENCY IS DOING CURRENTLY TO ANALYZE AND ASSIST OPIOIDAGE GEEZIC USE FOR -- OPIOID ANALGESIC PRESCRIBING GUIDELINES FOR TREATMENT OF ACUTE PAIN. IT WILL HAVE INDICATORS, ENSURINGING IT ALIGNS WITH CLINICAL NEED. I BELIEVE THIS GOAL WE ALL SUPPORT WHICH I SUPPORT GIVING F.D.A. AUTHORITY TO CONDUCT SUCH WORK SO AS TO INFORM POLICIES THAT WILL BETTER PROTECT PUBLIC HEALTH AND HELP REDUCE THE UNNEEDED OPIOIDS FROM REACHING INDIVIDUALS THAT ARE AT RISK FOR ADDICTION. SINCE THIS AMENDMENT HAS BEEN FILED, WE HEARD SOME CONCERNS FROM STAKEHOLDERS ABOUT THE AMENDMENT POSSIBLY IMPEDING THE USE OF F.D.A.'S EVIDENCE-BASED GUIDELINES IN MAKING DECISIONS RELATED TO DISPENSING OR COVERAGE OF OPIOID PRESCRIPTIONS. I BELIEVE THAT SUCH DECISIONS SHOULD BE INFORMED BY EVIDENCE-BASED GUIDELINES, SUCH AS THOSE DEVELOPED BY F.D.A., AND HOPE WE CAN WORK WITH THE AMENDMENT'S SPONSORS AND THE CHAIRMAN TO ADDRESS THESE CONCERNS MOVING FORWARD. WITH THAT I'D YIELD BACK.

THE CHAIR

THE GENTLEMAN YIELDS BACK. THE GENTLEMAN FROM OREGON.

MR. WALDEN

WITH THAT I HAVE NO FURTHER SPEAKERS ON THIS MATTER. AGAIN, I THANK MY…

WITH THAT I HAVE NO FURTHER SPEAKERS ON THIS MATTER. AGAIN, I THANK MY FRIEND, THE FORMER CHAIRMAN OF THE FULL COMMITTEE, MR. BARTON, FOR HIS GOOD LEADERSHIP ON THIS EFFORT, ALONG WITH OTHER MEMBERS ON BOTH SIDES OF THE AISLE. I ENCOURAGE OUR COLLEAGUES TO SUPPORT THIS AMENDMENT, AND I'D YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN YIELDS BACK. THE GENTLEMAN FROM TEXAS IS RECOGNIZED.

MR. BARTON

CAN I INQUIRE HOW MUCH TIME I STILL HAVE?

THE CHAIR

THE GENTLEMAN FROM TEXAS HAS ONE MINUTE.

MR. BARTON

ONE MINUTE. WELL, I'M GOING TO YIELD THAT ONE MINUTE TO THE GENTLELADY…

ONE MINUTE. WELL, I'M GOING TO YIELD THAT ONE MINUTE TO THE GENTLELADY FROM NEW HAMPSHIRE, WHO IS AN ORIGINAL CO-SPONSOR OF THE AMENDMENT, WORKED VERY HARD ON IT, CONGRESSWOMAN KUSTER.

THE CHAIR

THE GENTLELADY FROM NEW HAMPSHIRE IS RECOGNIZED FOR ONE MINUTE.

MS. KUSTER

THANK YOU, MR. SPEAKER. MR. BARTON, I APPRECIATE IT. I RISE IN SUPPORT OF…

THANK YOU, MR. SPEAKER. MR. BARTON, I APPRECIATE IT. I RISE IN SUPPORT OF THE AMENDMENT. THIS WOULD REQUIRE THE F.D.A. TO CREATE HIGH-QUALITY, EVIDENCE-BASED GUIDELINES FOR ACUTE PAIN. TAKEN TOGETHER, THESE GUIDELINES WOULD FINALLY PROVIDE PROVIDERS EVIDENCE-BASED RECOMMENDATIONS ON BEST PRACTICES FOR ALL TYPES OF PAIN. WHILE THE OPIOID EPIDEMIC HAS MANY ORIGINS, IT'S UNIVERSALLY AGREED UPON THAT THE TREATMENT OF PAIN OVER THE LATTER HALF OF THE CENTURY -- 20TH CENTURY IS A CONTRIBUTING FACTOR. EFFORTS BY TCHONG AND THE PUBLIC TO RECONCILE ADDICTION AND CHRONIC PAIN HAS HAD A REAL AND POSITIVE IMPACT. ONE OF THE MOST IMPACTED COMMUNITIES ARE VETERANS. IN JUST THE LAST FEW YEARS, THE V.A. REPORTED A REMARKABLE DECLINE IN OPIOID PRESCRIPTIONS. YET, THE FOCUS UNTIL VERY RECENTLY HAS BEEN ON CHRONIC PAIN. ACUTE PAIN IMPACTS MORE PEOPLE AND IS RESPONSIBLE FOR A MASSIVE SHARE OF OPIOID PRESCRIPTIONS. THE COUNTRY NEEDS EVIDENCE-BASED GUIDANCE ON TREATMENT OF ACUTE PAIN. THANK YOU, MR. SPEAKER, I YIELD BACK.

THE CHAIR

THE GENTLELADY YIELDS BACK HER TIME. ALL TIME HAS BEEN USED. THE QUESTION…

THE GENTLELADY YIELDS BACK HER TIME. ALL TIME HAS BEEN USED. THE QUESTION IS ON THE AMENDMENT OFFERED BY THE GENTLEMAN FROM TEXAS. THOSE IN FAVOR SAY AYE. THOSE OPPOSED, NO. IN THE OPINION OF THE CHAIR, THE AYES HAVE IT. THE AMENDMENT IS AGREED TO. IT'S NOW IN ORDER TO CONSIDER AMENDMENT NUMBER 4 PRINTED IN HOUSE REPORT 115-766. FOR WHAT PURPOSE DOES THE GENTLEMAN FROM UTAH SEEK RECOGNITION?

MR. CURTIS

MR. CHAIRMAN, I HAVE AN AMENDMENT AT THE DESK.

THE CHAIR

THE CLERK WILL DESIGNATE THE AMENDMENT.

THE CLERK

AMENDMENT NUMBER 4 PRINTED IN PART B OF HOUSE REPORT 115-766 OFFERED BY…

AMENDMENT NUMBER 4 PRINTED IN PART B OF HOUSE REPORT 115-766 OFFERED BY MR. CURTIS OF UTAH.

THE CHAIR

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEMAN FROM UTAH, MR. CURTIS, AND…

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEMAN FROM UTAH, MR. CURTIS, AND A MEMBER OPPOSED, WILL EACH CONTROL FIVE MINUTES. THE CHAIR RECOGNIZES THE GENTLEMAN FROM UTAH, MR. CURTIS.

MR. CURTIS

MR. CHAIRMAN, I RISE TODAY TO OFFER AN AMENDMENT TO IMPROVE RESEARCH AND…

MR. CHAIRMAN, I RISE TODAY TO OFFER AN AMENDMENT TO IMPROVE RESEARCH AND PUBLIC AWARENESS OF OPIOID USE DURING PREGNANCY. I INTRODUCED THE POPPY STUDY ACT EARLIER THIS YEAR. THIS ISSUE -- TO ADDRESS THIS ISSUE, AND I'M PLEASED THAT IT'S BEING CONSIDERED HERE TODAY IN THIS FORUM. WE ALL KNOW THAT OPIOID EPIDEMIC HAS WIDESPREAD AND DEVASTATING EFFECTS. NEARLY ALL OF US KNOW SOMEONE WHO'S BEEN AFFECTED BY THE CRISIS, AND MANY OF US HAVE GRIEVED THROUGH THE HEARTBREAK OF LOSING LOVED ONES TO ADDICTION. SADLY, THE IMPACT THIS HAS HAD ON UTAH HAS BEEN OVERWHELMING. IN MY STATE, SIXTH UTAHANS DIE EVERY WEEK -- SIX UTAHANS DIE EVERY WEEK AS A RESULT OF THE OPIOID OVERDOSE AND WE RANK HIGHEST IN THE NATION FOR OVERDOSE DEATHS. WE HAVE ONE OF THE MOST OPIOID DISPENSED NATIONWIDE. UTAH LEADS OUT PRESCRIBING THE MOST OPIOIDS TO PREGNANT WOMEN. ACROSS THE NATION, ONE IN FIVE WOMEN RECEIVE AN OPIOID PRESCRIPTION DURING PREGNANCY, BUT IN UTAH, THAT NUMBER IS DOUBLED. OF COURSE, OPIOID USE DURING PREGNANCY CAN HAVE DRAMATIC CONSEQUENCES FOR A MOTHER AND HER UNBORN CHILD. NEO NATAL ABSTINENCE SYNDROME PRESENTS. CONSTANT SCREAMING, SHAKING, VOMITS, DIFFICULTY SLEEPING AND EATING. THIS REQUIRES LONG AND EXPENSIVE HOSPITALIZATION. FOR MEDICAID COVERED BABIES, THIS SYNDROME COSTS OVER $460 MILLION IN 2014 ALONE. TRAGICALLY FROM 2004 TO 2014, THE RATE OF INFANTS DIAGNOSIS WITH OPIOID WITHDRAWAL SYMPTOMS INCREASED OVER 400% NATIONWIDE. ACROSS THE NATION, WOMEN HAVE BEEN DISPROPORTIONATELY IMPACTED BY THE OPIOID EPIDEMIC AND LITTLE IS KNOWN ABOUT THE EFFECTS THIS HAS HAD ON PREGNANT WOMEN. THERE IS SIMPLY TOO MUCH WE DON'T KNOW ABOUT WHY PREGNANT WOMEN ARE BEING PRESCRIBED OPIOIDS AND WHAT POSSIBLE ALTERNATIVES MIGHT PROVIDE BETTER HEALTH CARE OUTCOMES FOR MOTHERS AND THEIR UNBORN CHILDREN. MY AMENDMENT CALLS FOR INCREASED RESEARCH ON CURRENT OPIOID PRESCRIBING PRACTICES DURING PREGNANCY. MORE DATA ON PRESCRIPTION OPIOID MISUSE DURING PREGNANCY, AND EVALUE WAITS AND ENCOURAGES NONOIPT PAIN MANAGEMENT THERAPIES THAT ARE SAFE AND EFFECT -- NONOPIOID PAIN MANAGEMENT THERAPIES THAT ARE SAFE AND EFFECTIVE. I APPLAUD THE CHAIRMAN, RANKING MEMBER, MEMBERS OF THE COMMITTEE FOR THE WORK THEY HAVE DONE TO FIGHT THIS CRISIS. I ENCOURAGE MY COLLEAGUES TO SUPPORT THIS VITAL AMENDMENT AS WELL AS THE UNDERLYING BILL THAT WILL HELP US BETTER SERVE OUR SUFFERING COMMUNITIES. I RESERVE THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN RESERVES. DOES ANYONE SEEK TIME IN OPPOSITION?

MR. WALDEN

MR. CHAIRMAN, ALTHOUGH I AM NOT OPPOSED TO THE AMENDMENT, I ASK UNANIMOUS…

MR. CHAIRMAN, ALTHOUGH I AM NOT OPPOSED TO THE AMENDMENT, I ASK UNANIMOUS CONSENT TO CLAIM TIME IN OPPOSITION.

THE CHAIR

WITHOUT OBJECTION, THE GENTLEMAN IS RECOGNIZED FOR FIVE MINUTES. .

MR. WALDEN

I RISE TO SPEAK IN SUPPORT OF THE AMENDMENT AND TO THANK MR. CURTIS FOR…

I RISE TO SPEAK IN SUPPORT OF THE AMENDMENT AND TO THANK MR. CURTIS FOR HIS VERY THOUGHTFUL HARD WORK ON THIS LEGISLATION. YOU HAVE HEARD HIM DELINEATE THE TRAGIC RISKS SUCH AS PREMATURE BIRTH, NEONATAL ABSTINENCE SIN COME. -- SYNDROME. WHILE THERE IS INCREASING AWARENESS, INFORMATION ABOUT THEIR USE IN PREGNANT PATIENTS AND UNIQUE CONSIDERATIONS OF MOTHER AND CHILD ARE SIMPLY LACKING. SO THIS AMENDMENT REQUIRES THE DEPARTMENT OF HEALTH AND HUMAN IN PREGNANT SERVICES TO REPORT ON THE OPEN YAD PRESCRIBING PRACTICES AND OPIOID MISUSE DURING PREGNANCY AND EVALUATE NONOPIOID ALTERNATIVES TO PAIN MANAGEMENT DURING PREGNANCY. THIS WILL COMPLEMENT THE EFFORTS OF THE PROTECTING OUR INFANTS ACT WHICH REQUIRED A REPORT ON PRENATAL OPIOID EXPOSURE AND N.A.S., PRESENTING A STRATEGY AND CLINICAL RECOMMENDATIONS FOR PREVENTING AND TREATING INFANT WITHDRAWAL. I ENCOURAGE MY COLLEAGUES TO O SUPPORT THIS AMENDMENT. I'D NOW LIKE TO RECOGNIZE MY FRIEND, A VERY IMPORTANT MEMBER NOT ONLY OF U.S. HOUSE OF REPRESENTATIVES AS OUR WHIP, BUT A VERY INFLUENTIAL AND EFFECTIVE MEMBER ON OUR ENERGY AND COMMERCE COMMITTEE, THE GENTLEMAN FROM LOUISIANA, MR. SCALISE, FOR SUCH TIME HE MAY CONSUME.

THE CHAIR

THE GENTLEMAN IS RECOGNIZED.

MR. SCALISE

THANK YOU, MR. CHAIRMAN, FOR YIELDING AND FOR LEADING ON THIS IMPORTANT…

THANK YOU, MR. CHAIRMAN, FOR YIELDING AND FOR LEADING ON THIS IMPORTANT ISSUE. I RISE IN STRONG SUPPORT OF MY FRIEND FROM UTAH'S AMENDMENT. AS HE MENTIONED, MR. SPEAKER, YOU LOOK AT THIS CRISIS IN OUR COUNTRY, I'M SO GLAD THAT CONGRESS IS TAKING A WIDE ARRAY OF ACTION TO ADDRESS THE OPIOID CRISIS IN OUR COUNTRY, BECAUSE IT DOESN'T JUST AFFECT ONE COMMUNITY OR ANOTHER. EVERYBODY MIGHT THINK MINE IS THE ONLY PROBLEM. THEN YOU TALK TO OTHER MEMBERS OF CONGRESS FROM AROUND THE COUNTRY AND FIND OUT THEY ARE EXPERIENCING THE SAME KIND OF CRISIS. IT'S WIDESPREAD. IT'S KILLING PEOPLE EVERY SINGLE DAY. BUT AS WE'RE TALKING ABOUT ON THIS AMENDMENT, MR. SPEAKER, WE'RE TALKING ABOUT CHILDREN. CHILDREN THAT ARE BORN TO A MOTHER THAT'S ADDICTED TO OPIOIDS. I HIGHLIGHT A YOUNG BOY FROM MY DISTRICT IN LOUISIANA. HE WAS BORN ADDICTED TO OPIOIDS BECAUSE HIS MOTHER, WHILE HE I HIGHLIGHT WAS PREGNANT, WAS ADDICTED TO OPIOIDS HERSELF. NOW, I WISH THAT THIS WAS THE ONLY TIME THAT IT HAD HAPPENED. FORTUNATELY FOR ALL OF US, HE'S NOW A HEALTHY YOUNG BOY, BUT HE SPENT HIS FIRST 11 DAYS OF LIFE IN THE HOSPITAL FIGHTING TO BEAT A DRUG ADDICTION. THAT WAS NOT CREATED, OF COURSE, ON HIS OWN. WE LIKE TO THIS IS SOMETHING THE CENTERS WE LIKE TO THINK THIS MIGHT BE AN ISOLATE THE EXAMPLE, BUT, MR. SPEAKER -- AN ISOLATED EXAMPLE, BUT, SPREEBLING, FOR DISEASE CONTROL HAS NOTED. THAT IS ONCE EVERY 25 MINUTES IN AMERICA A BABY IS BORN ADDICTED TO OPIOIDS. ONCE EVERY 25 MINUTES. THAT'S HOW WIDESPREAD IT IS, JUST FOR BABIES THAT ARE BORN. WHEN WE TALK ABOUT THIS ENTIRE PACKAGE OF BILLS AND TODAY H.R. 6 IS GOING TO PULL TOGETHER 50 DIFFERENT BILLS COVERING MANY DIFFERENT PARTS OF THIS PROBLEM. AND IT'S AN INCREDIBLY BIPARTISAN EFFORT. I KNOW, MR. SPEAKER, SO OFTEN WE HEAR ABOUT THE PARTISAN RANGELING IN -- RANKLE -- WRANKLING IN WRONG. BUT THIS IS AN ISSUE WHERE REPUBLICANS AND DEMOCRATS HAVE COME TOGETHER. AND I WANT TO THANK MY FRIENDS FROM BOTH SIDE OF THE AISLE FOR RECOGNIZING THIS PROBLEM AND COMING TOGETHER WITH A BIPARTISAN WAY TO SOLVE IT. THIS IS GOING TO GIVE REAL TOOLS TO OUR COMMUNITIES SO THAT THEY CAN COMBAT THIS AT EVERY DIFFERENT LEVEL WE'RE SEEING IT, INCLUDING TREATMENT, INCLUDING LAW ENFORCEMENT TO STOP THESE DEADLY DRUGS FROM GETTING ON THE STREETS SO THAT MORE BABIES LIKE KEMPER ARE NOT BORN ADDICTED TO OPIOIDS. I ENCOURAGE MY COLLEAGUES TO SUPPORT THIS AMENDMENT AND UNDERLYING PACKAGE OF BILLS. I YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE GENTLEMAN FROM…

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE GENTLEMAN FROM OREGON RESERVES. THE GENTLEMAN FROM UTAH -- THE GENTLEMAN FROM UTAH RESERVES.

MR. WALDEN

MR. CHAIRMAN. WE HAVE NO OTHER SPEAKERS ON OUR SIDE. I THINK SEEKING…

MR. CHAIRMAN. WE HAVE NO OTHER SPEAKERS ON OUR SIDE. I THINK SEEKING RECOGNITION ON THIS AMENDMENT. I URGE PASSAGE AND I YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

SPEAKERS ON THE GENTLEMAN FROM UTAH. MR. YOU. MR. CHAIRMAN, I'D LIKE TO…

SPEAKERS ON THE GENTLEMAN FROM UTAH. MR. YOU. MR. CHAIRMAN, I'D LIKE TO THANK THE GENTLEMAN FROM LOUISIANA AND CHAIRMAN FOR THEIR SPEAKING OUT IN SUPPORT OF THIS IMPORTANT BILL. MR. CHAIRMAN, THIS AMENDMENT IS ESSENTIAL IN HELPING US IMPROVE OUR UNDERSTANDING OF THE IMPACT OF USING OPIOID PRESCRIPTION DURING PREGNAN SANE ULTIMATELY PREVENTING OPIOID USE DISORDER ENTIRELY. IT IS VITAL THAT WE HAVE SOUND AND ACCURATE RESEARCH TO GUIDE US IN THE BEST WAYS TO HELP PREGNANT WOMEN SUFFERING FROM ADDICTION. THIS IS A CURTIS: THANK CRITICAL AMENDMENT AND I URGE MY COLLEAGUES TO SUPPORT IT. MR. CHAIRMAN, I YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE QUESTION IS ON THE…

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE QUESTION IS ON THE AMENDMENT OFFERED BY THE GENTLEMAN FROM UTAH. SO MANY AS ARE IN FAVOR SAY AYE. THOSE OPPOSED, NO. IN THE OPINION OF THE CHAIR, THE AYES HAVE IT. THE AMENDMENT IS AGREED TO. IT IS NOW IN ORDER TO CONSIDER AMENDMENT NUMBER 5 PRINTED IN HOUSE REPORT NUMBER 115-766. FOR WHAT PURPOSE DOES THE GENTLEMAN FROM MASSACHUSETTS SEEK RECOGNITION.

MR. KEATING

MR. CHAIRMAN, I HAVE AN AMENDMENT AT THE DESK.

THE CHAIR

THE CLERK WILL DESIGNATE THE AMENDMENT.

THE CLERK

AMENDMENT NUMBER 5, PRINTED IN PART B OF HOUSE REPORT NUMBER 115-766.…

AMENDMENT NUMBER 5, PRINTED IN PART B OF HOUSE REPORT NUMBER 115-766. OFFERED BY MR. KEATING OF MASSACHUSETTS.

THE CHAIR

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEMAN FROM MASSACHUSETTS, MR.…

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEMAN FROM MASSACHUSETTS, MR. KEATING, AND A MEMBER OPPOSED, EACH WILL CONTROL FIVE MINUTES OF THE THE CHAIR RECOGNIZES GENTLEMAN FROM MASSACHUSETTS.

MR. KEATING

THANK YOU, MR. CHAIRMAN. I RISE IN SUPPORT OF MY AMENDMENT THAT WITH…

THANK YOU, MR. CHAIRMAN. I RISE IN SUPPORT OF MY AMENDMENT THAT WITH DIRECT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO ISSUE AND EXPAND GUIDELINES FOR MEDICAL PROVIDERS FOR PRESCRIBING NALOXONE TO PREFLECT A MAJOR SHIFT -- REFLECT A MAJOR SHIFT THAT'S OCCURRED IN THE OPIATE HEALTH CRISIS WE CONTINUE TO WORK TO COVER TODAY. EARLIER THIS YEAR I SAT IN A ROOM WITH MY COLLEAGUES AND BIPARTISAN HEROIN TASK FORCE AND LISTENED TO A DOCTOR AND THE N.I.H. LEADERSHIP PRESENT DATA VEELING HOW WE'RE SEEING A N.I.H. LEADERSHIP PRESENT DATA VEELING HOW WE'RE SEEING A SHIFT IN THE OPIOID CRISIS. FOR THE FIRST TIME WE LEARNED THAT OPIOID OVERDOSES FROM PRESCRIPTIONS OF OPIOID DRUGS HAVE DROPPED. THAT'S GOOD NEWS. THE SHOCKING NEWS WAS THAT OVERDOSE RATES FOR ILLICIT OPIOIDS, HEROIN AND FENTANYL, HAD RISEN AT AN ALARMING RATE. IF WE'RE GOING TO SAVE LIVES OF PEOPLE OVERDOSING FROM INCREASINGLY PREVALENT AND INCREASINGLY UNPREDICTABLE ILLICIT COMPOUNDS, WE NEED TO MAKE SURE NALOXONE GETS IN THE RIGHT HANDS. MY AMENDMENT WOULD PROVIDE NECESSARY GUIDANCE TO PATIENTS, PROVIDERS, PUBLIC HEALTH PROFESSIONALS, FIRST RESPONDERS, AND LOVED ONES ON THE ABILITY TO OBTAIN EFFECTIVE DOSES OF NALOXONE TO COMBAT OVERDOSES OF ALL TYPES OF OPIOIDS, PRESCRIPTIONS OR OTHERWISE. IT'S SO CRUCIAL THAT PEOPLE DEALING WITH THIS BRAIN DISEASE KNOW HOW TO USE NALOXONE IN AN EMERGENCY AND IMPORTANTLY UNDERSTAND THAT IT'S OK TO HAVE NALOXONE IN THE HOME. I WAS PROUD THAT I AND THE GENTLEMAN FROM PENNSYLVANIA, MR. ROTHFUS, WHO ALSO JOINS ME AS A CO-SPONSOR OF THIS BIPARTISAN AMENDMENT, WERE ABLE TO INSERT LEGISLATIVE LANGUAGE ON PRESCRIBING GUIDELINES INTO THE COMPREHENSIVE ADDICTION AND RECOVERY ACT THAT PASSED CONGRESS AND BECAME LAW LAST YEAR. BUT GIVING H.H.S. THE OPTION TO ISSUE GUIDELINES DIDN'T GO FAR ENOUGH. THIS AMENDMENT BEFORE US IS FIRM IN ITS REQUIREMENT. I BELIEVE MY AMENDMENT WILL MORE EXPLICITLY AND MORE EXPANSIVELY DIRECT AND YIELD NECESSARY CHANGE. I CONCLUDE BY REAFFIRMING OUR COMMITMENT TO ENDING THIS DEVASTATING EPIDEMIC THAT TAKES THE LIVES OF 115 PEOPLE EVERY DAY ON AVERAGE IN OUR COUNTRY. I SHARE THIS COMMITMENT WITH THE MEMBERS OF THE HOUSE AND I PLEDGE TO WORK WITH YOU-ALL TO SEE THIS AMENDMENT'S PASSAGE AND EFFECT NECESSARY CHANGE THAT REFLECTS THE EVER SHIFTING LANDSCAPE IN THIS BATTLE. I NOW YIELD TWO MINUTES TO THE CO-SPONSOR OF THIS AMENDMENT, MR. ROTHFUS.

THE CHAIR

THE GENTLEMAN FROM PENNSYLVANIA IS RECOGNIZED FOR TWO MINUTES.

MR. ROTHFUS

I THANK THE GENTLEMAN FOR YIELDING. I RISE TO URGE MY COLLEAGUES TO…

I THANK THE GENTLEMAN FOR YIELDING. I RISE TO URGE MY COLLEAGUES TO SUPPORT THIS AMENDMENT TO H.R. 6. I WANT TO THANK MY COLLEAGUE, MR. KEATING FROM MASSACHUSETTS, FOR HIS WORK ON THIS EFFORT. WE HAVE WORKED BEFORE ON THIS ISSUE OF NALOXONE AND IT'S GREAT HE'S BRINGING FORTH THIS AMENDMENT. I'M HAPPY TO BE CO-SPONSORING IT WITH HIM. THE HOUSE HAS BEEN DOING AMAZING WIDE RANGING WORK OVER THE LAST TWO WEEKS TO COMBAT THE OPIOID CRISIS. I'M PROUD TO HAVE ASSISTED WITH THESE EFFORTS. THE AMENDMENT THAT I HAVE CO-JOINED WITH CONGRESSMAN KEATING TODAY IS SIMPLE. CONTINUE STRUCTS THE SECRETARY OF HEALTH AND HUMAN SERVICES TO GIVE ADDITIONAL GUIDANCE TO PRESCRIBING NALOXONE. NALOXONE IS A DRUG USED TO REVERSE OPIOID OVERDOSES. A SITUATION THAT FAR TOO MANY AMERICANS HAVE FOUND THEMSELVES AND ACROSS THE COUNTRY AND WESTERN PENNSYLVANIA. OPIOID ADDICTION IS TEARING FAMILIES APART. UNFORTUNATELY AN OVERDOSE IS FREQUENTLY THE GRIM END TO A LONG STRUGGLE. IF WE CAN HELP SOME OUR FELLOW AMERICANS COME BACK FROM THE BRINK WITH INCREASED KNOWLEDGE TORE R FOR OUR NATION'S MED CALENDAR PROFESSIONALS, I SEE NO REASON NOT TO DO T I URGE MY COLLEAGUES TO SUPPORT THIS AMENDMENT. I AGAIN THANK CONGRESSMAN KEATING FOR HIS LEADERSHIP ON THIS. I YIELD BACK THE REMAINDER OF MY TIME.

THE CHAIR

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE GENTLEMAN FROM…

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. THE GENTLEMAN FROM MASSACHUSETTS RESERVES. THE GENTLEMAN FROM OREGON, FOR WHAT PURPOSE DOES DO YOU SEEK RECOGNITION.

MR. WALDEN

ALTHOUGH I AM NOT OPPOSED TO THE AMENDMENT, I ASK UNANIMOUS CONSENT TO…

ALTHOUGH I AM NOT OPPOSED TO THE AMENDMENT, I ASK UNANIMOUS CONSENT TO CLAIM TIME INP O SIGNIFICANCE.

THE CHAIR

WITHOUT OBJECTION, THE GENTLEMAN IS RECOGNIZED.

MR. WALDEN

I RISE TO SPEAK IN SUPPORT OF THE AMENDMENT THAT REQUIRES THE DEPARTMENT…

I RISE TO SPEAK IN SUPPORT OF THE AMENDMENT THAT REQUIRES THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO ISSUES GUIDELINES FOR PRESCRIBING OVEROID OVERDOSE REVERSAL DRUG T WILL COVER DOSAGE SAFETY, STANDING ORDERS, AND OTHER EDUCATION AND DISTRIBUTION MEASURES. IN APRIL THE SURGEON GENERAL ISSUED AN ADVISORY CALLING FOR MORE PEOPLE TO CARRY NALOXONE. EXPANDING THE USE OF THIS LIFESAVING DRUG IS A KEY PART OF THE PUBLIC HEALTH RESPONSE TO THE OPIOID CRISIS, ALONG WITH EFFECTIVE PREVENTION, TREATMENT, RECOVERY PROGRAMS FOR SUBSTANCE USE DISORDER. I CAN TELL YOU, MR. CHAIRMAN, FROM MY OWN DISTRICT, I HAVE HAD MULTIPLE ROUND TABLES IN EVERY CORNER OF THE DISTRICT. I MET WITH FAMILIES WHO HAVE BEEN AFFECTED. I MET WITH ADDICTION TREATMENT SPECIALISTS. I MET WITH MEDICAL PROVIDERS. I HAVE ALSO MET WITH LAW ENFORCEMENT. AND IN OREGON WE LEAD IN A LOT OF THIS RECOVERY EFFORT BUT ALSO IN MAKING SURE NALOXONE IS AVAILABLE. THIS IS THE ANTIDOTE. YOU KNOW, MR. SPEAKER, THESE FENTANYLS COMING TO OUR COUNTRY ILLEGALLY, IF HI A LITTLE SALTSHAKER HERE AND PUT OUT A HALF DOZEN, DOZEN GRAINS OF SALT AND YOU PUT YOUR HAND ON IT, YOU WOULD LIKELY ABSORB THAT THROUGH YOUR SKIN AND PASS OUT. IF SOMEBODY IN THIS CHAMBER DIDN'T HAVE NALOXONE OR THE MEDICAL PEOPLE NEARBY DIDN'T GET TO YOU IN TIME, YOU WOULD BE ONE OF THOSE 115 PEOPLE THAT WILL DIE IN THE NEXT 24 HOURS. OR ONE OF THE THOUSAND THAT WILL SHOW UP IN OUR EMERGENCY ROOMS. MOVING FORWARD WITH GUIDELINES FOR PRESCRIBING OPIOID OVERDOSE REVERSAL DRUG REALLY MAKES SENSE. MOVING FORWARD WITH NALOXONE MAKES SENSE. WE WILL SAVE LIVES WITH THIS MOVING FORWARD WITH GUIDELINES FOR PRESCRIBING AMENDMENT. I COMMEND MY COLLEAGUES FROM MASSACHUSETTS AND PENNSYLVANIA FOR THEIR GOOD WORK ON THIS. WE'RE HAPPY TO ACCEPT IT AS PART OF H.R. OF. -- H.R. 6. I YIELD BACK THE BALANCE OF MY TIME.

THE CHAIR

THE GENTLEMAN FROM MASSACHUSETTS IS RECOGNIZED.

MR. ROTHFUS

THANK YOU, MR. CHAIRMAN. IN CAPE CODE THE ISLANDS AND SOUTH SHORE AND…

THANK YOU, MR. CHAIRMAN. IN CAPE CODE THE ISLANDS AND SOUTH SHORE AND SOUTH COAST OF MASSACHUSETTS, THE REAL CAUSE OF DEATH IN OVERDOSE IS FENTANYL. IT'S BEING MIXED WITH COCAINE. IT'S BEING MIXED WITH MARIJUANA. AND THIS IS VERY IMPORTANT. THIS AMENDMENT, THIS BIPARTISAN AMENDMENT WILL SAVE LIVES. I WANT TO THANK CHAIRMAN WALDEN. I WANT TO THANK CHAIRMAN BRADY. I WANT TO THANK MY CO-SPONSOR, MR. ROTHFUS. I WANT TO THANK RANKING MEMBER PALLONE AND RANKING MEMBER NEAL FOR THEIR WORK IN AN AMENDMENT THAT WILL TRULY SAVE LIVES. I YIELD.

MR. WALDEN

WOULD THE GENTLEMAN YIELD. YOU RAISE THE ISSUE OF THE SYNTHETICS ON OTHER.…

WOULD THE GENTLEMAN YIELD. YOU RAISE THE ISSUE OF THE SYNTHETICS ON OTHER. WE HAVE TALKED A LOT ABOUT FENTANYL BEING CUT INTO HEROIN OVER THE COURSE OF THIS DEBATE OVER TWO WEEKS. WE HAVEN'T TALKED AS MUCH ABOUT THESE SYNTHETICS BEING SPRAYED ON MARIJUANA OR OTHER THINGS THAT YOU GO, THAT'S NATURAL, MOM. I CAN SMOKE THAT. WHAT THESE EVIL PEOPLE ARE DOING IS TAKING THESE DEADLY SYNTHETICS AND LITERALLY CREATING A LIQUID OR SPRAY AND THEN SPRAYING IT. AND I TALKED TO A FATHER THE OTHER DAY WHOSE DAUGHTER DIED OF A HEROIN OVERDOSE. WHEN THEY DID THE AUTOPSY THEY DISCOVERED IT WAS 100% FENTANYL.

THE CHAIR

THE GENTLEMAN'S TIME HAS EXPIRED.

MR. KEATING

I YIELD BACK.

THE CHAIR

THE QUESTION IS ON THE AMENDMENT OFFERED BY THE GENTLEMAN FROM…

THE QUESTION IS ON THE AMENDMENT OFFERED BY THE GENTLEMAN FROM MASSACHUSETTS. SO MANY AS ARE IN FAVOR SAY AYE. THOSE OPPOSED, NO. IN THE OPINION OF THE CHAIR, THE AYE VS. IT. THE AMENDMENT IS AGREED TO. NOW IN ORDER TO CONSIDER AMENDMENT NUMBER SIX PRINTED IN HOUSE REPORT 115-766. IT IS NOW IN ORDER TO CONSIDER AMENDMENT NUMBER 7 PRINTED IN HOUSE REPORT NUMBER 115-766. FOR WHAT PURPOSE DOES THE GENTLEWOMAN FROM CALIFORNIA SEEK RECOGNITION. IN ORDER TO

MS. WATERS

I HAVE AN AMENDMENT AT THE DESK.

THE CHAIR

THE CLERK WILL DESIGNATE THE AMENDMENT.

THE CLERK

AMENDMENT NUMBER 7 PRINTED IN PART B OF THE HOUSE REPORT NUMBER 115-766.…

AMENDMENT NUMBER 7 PRINTED IN PART B OF THE HOUSE REPORT NUMBER 115-766. OFFERED BY MISS MAXINE WATERS OF CALIFORNIA.

THE CHAIR

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEWOMAN FROM CALIFORNIA, MS.…

PURSUANT TO HOUSE RESOLUTION 949, THE GENTLEWOMAN FROM CALIFORNIA, MS. WATERS, AND A MEMBER OPPOSED, WILL EACH CONTROL FIVE MINUTES. THE CHAIR RECOGNIZES THE GENTLEWOMAN FROM CALIFORNIA.

MS. WATERS

THANK YOU VERY MUCH, MR. CHAIRMAN. I WOULD LIKE TO SAY I APPRECIATE THE…

THANK YOU VERY MUCH, MR. CHAIRMAN. I WOULD LIKE TO SAY I APPRECIATE THE BIPARTISAN WORK OF THE BILL SPONSOR, CHAIRMAN GREG WALDEN, AND OF COURSE CHAIRMAN BRADY, AND OUR CO-SPONSORS, FRANK PALLONE, AND CO-SPONSOR RICHARD NEAL ON THIS BILL H.R. 6. THE SUPPORT FOR PATIENTS AND COMMUNITIES ACT. THE BILL AS DRAFTED INCLUDES MANY POSITIVE PROVISIONS AND EXTENDS WELL INTENDED LEGISLATIVE EFFORTS TO ADDRESS THE OPIOID CRISIS IN THIS COUNTRY. THAT SAID, AS WE ALL KNOW IN THE UNITED STATES, PEOPLE SUFFER FROM A WIDE RANGE OF SUBSTANCE USE DISORDERS. INCLUDING ALCOHOLISM AND THE ABUSE OF ILLEGAL DRUGS LIKE HEROIN. METHAMPHETAMINE, CRACK, AND OTHER FORMS OF COCAINE. . LIKEWISE, THERE ARE A RANGE OF ENTITIES THAT PROVIDE DIFFERENT TYPES OF SUBSTANCE ABUSE TREATMENT SEVERS. THE PURPOSE OF MY AMENDMENT IS TO ENSURE THAT WE HAVE A CLEAR UNDERSTANDING OF THE SUBSTANCE ABUSE TREATMENT SERVICES AVAILABLE, THE COMMUNITIES AND THE POPULATIONS THAT ARE BEING SERVED, THE TYPES OF SUBSTANCE USE DISORDERS BEING ADDRESSED, AND ANY UNMET NEEDS OR INADEQUACIES IN THE WAY WE ARE ADDRESSING SUBSTANCE ABUSE ISSUES. MY AMENDMENT WOULD DIRECT THAT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES CONDUCT A NATIONWIDE SURVEY OF ENTITIES THAT PROVIDE SUBSTANCE USE DISOFFERED TREATMENT SERVICES. -- SUBSTANCE USE DISORDER TREATMENT SERVICES. MY AMENDMENT DIRECTS H.H.S. TO DEVELOP AND SUBMIT TO CONGRESS A PLAN TO DIRECT APPROPRIATE RESOURCES IN ORDER TO ADDRESS INADEQUACIES IN SERVICES OR FUNDING IDENTIFIED THROUGH THE SURVEY. THE SURVEY CALLED FOR -- IS INTENDED TO COMPLIMENT EXISTING EFFORTS BY THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION, THAT IS SAMHSA. TO EXAMINE SUBSTANCE ABUSE TREATMENT SERVICES IN ORDER TO DEVELOP A CONCRETE PLAN TO ADDRESS UNMET NEEDS. AND SO, MR. CHAIRMAN AND MEMBERS, LET ME JUST SAY THAT I APPRECIATE THE INFORMATION THAT WAS SHARED BY MAJORITY WHIP SCALISE WHEN HE TALKED ABOUT THE BABY THAT WAS BORN ADDICTED. AND WE'RE GOING TO HAVE A LOT OF THAT. AND I HAVE ONE REGRET, HAVING WORKED ON THE ISSUE OF CRACK COCAINE, THAT WE DID NOT DO SOMETHING TO DO THE RESEARCH THAT WAS NECESSARY ON THESE BABIES THAT ARE BORN ADDICTED, TO FIND OUT WHAT HAPPENS TO THEM LATER ON IN LIFE. AND WHETHER OR NOT THESE CHILDREN ARE HANDICAPPED AND DISABLED IN SOME WAYS, HAVE LEARNING DISABILITIES, ON AND ON AND ON. SO I WOULD LIKE TO WORK WITH MR. SCALISE TO DO THE FOLLOW-UP FOR THE RESEARCH THAT IS SO NECESSARY. AND WITH THAT, I YIELD BACK THE BALANCE OF MY TIME.

THE SPEAKER PRO TEMPORE

FOR WHAT PURPOSE DOES THE GENTLEMAN FROM OREGON SEEK RECOGNITION?

MR. WALDEN

ALTHOUGH I AM NOT OPPOSED TO THE AMENDMENT, I ASK IN ADDITION CONSENT TO…

ALTHOUGH I AM NOT OPPOSED TO THE AMENDMENT, I ASK IN ADDITION CONSENT TO CLAIM TIME IN OPPOSITION. I RISE TO SPEAK IN SUPPORT OF THIS AMENDMENT. AND TO THANK MY FRIEND, MS. WATERS, FOR HER WORK ON THIS INITIATIVE. AND BEFORE I GO THROUGH, THAT I JUST WANT TO SAY, WE ARE MORE THAN HAPPY TO TEAM UP WITH YOU ON THIS ISSUE OF CRACK COCAINE AND ITS EFFECT. AND I'M SURE THE WORK -- I'M SURE THAT MR. SCALISE, ALTHOUGH I CAN'T OFFICIALLY SPEAK FOR HIM, I'M SURE HE WOULD WORK IN PARTNERSHIP WITH YOU. YOU'VE RAISED AN ISSUE THAT WE HAVE DEALT WITH IN OTHER PARTS OF THIS LEGISLATION, BUT NOT IN THE PART YOU HAVE BROUGHT TO US. AND WE'RE HAPPY -- THERE WILL BE MORE GOING FORWARD, I ASSURE YOU. AND WE'D BE HAPPY TO WORK WITH YOU ON THAT. MR. RUSH BROUGHT AN AMENDMENT ON THE I.M.D. ISSUE TO MAKE SURE THAT THOSE SUFFERING FROM COCAINE AND CRACK COCAINE ADDICTION ALSO COULD GET TREATMENT UNDER EXPANSION IN THE I.M.D. AND SO WE'D BE HAPPY TO WORK WITH YOU ON THAT. THIS AMENDMENT DIRECTS THE SECRETARY OF HEALTH AND HUMAN SERVICES TO CONDUCT A SURVEY OF ORGANIZATIONS THAT PROVIDE SUBSTANCE ABUSE TREATMENT SERVICES AND THEN DEVELOP A PLAN TO DIRECT RESOURCES TO ADDRESS ANY IDENTIFYIFIED GAPS IN SERVICES FOR SPECIFIC TYPES OF SUBSTANCE USE DISORDERS. THIS INFORMATION WILL HELP US BETTER UNDERSTAND HOW OUR FEDERAL DOLLARS ARE INVESTED IN ADDICTION TREATMENT AT THE LOCAL LEVEL. AND WHAT MORE CAN BE DONE WITH FEDERAL RESOURCES TO YIELD EVEN BETTER RETURNS AND REDUCING THE DRUG-RELATED CRIMES, OVERDOSES AND DEATHS. I APPRECIATE THE GENTLELADY'S WORK ON THIS EFFORT. IT IS IMPORTANT WORK THAT WILL HELP SAVE LIVES AND BRING ABOUT THE KIND OF TREATMENT WE NEED IN OUR COMMUNITIES. AND I ENCOURAGE ADOPTION OF THE AMENDMENT. WITH THAT, MR. CHAIRMAN, I HAVE NO OTHER SPEAKERS. I ENCOURAGE ADOPTION OF THE AMENDMENT AND I YIELD BACK THE BALANCE OF MY TIME.

THE SPEAKER PRO TEMPORE

THE GENTLEMAN YIELDS BACK THE BALANCE OF HIS TIME. --

THE SPEAKER PRO TEMPORE

FOR WHAT PURPOSE DOES THE GENTLEMAN FROM OREGON SEEK RECOGNITION?

MR. WALDEN

THANK YOU, MR. CHAIRMAN. I SEEK RECOGNITION IN OPPOSITION TO THE MOTION.

THE SPEAKER PRO TEMPORE

THE GENTLEMAN IS RECOGNIZED FOR FIVE MINUTES.

MR. WALDEN

THANK YOU, MR. CHAIRMAN. LIKE A LOT OF OUR WORK HERE THAT'S BEEN…

THANK YOU, MR. CHAIRMAN. LIKE A LOT OF OUR WORK HERE THAT'S BEEN BIPARTISAN, WE WOULD HOPE GOING FORWARD THIS TOO COULD BECOME BIPARTISAN. BECAUSE WE BELIEVE THAT GETTING PRESCRIPTION DRUG PRICES DOWN IS ESSENTIAL. THE TRUMP ADMINISTRATION BELIEVES THAT AS WELL. IT'S DOING SOME THINGS ADMINISTRATIVELY. WE'LL BE WORKING ON THIS IN THE COMMITTEE. WE A.L.S. ALSO AGREE THAT THIS UNMET WORK -- WE ALSO AGREE THAT THIS UNMET WORK FORCE NEED IS IMPORTANT AS WELL. OVER THE COURSE OF FIVE HEARINGS, FULL MARKUP IN SUBCOMMITTEE, TWO FULL MARKUPS IN THE FULL COMMITTEE, THIS ISSUE WAS NEVER FULLY BROUGHT AND VETTED. THERE IS MORE WORK TO BE DONE HERE AND WE'RE COMMITTED TO DOING WORK ON BOTH THE CREATES ACT AND ON THE WORK FORCE ACT. AND AS THE GENTLEMAN FROM NEW YORK, MY FRIEND, KNOWS, WE HAVE WORKED OUT OUR DIFFERENCES ON MANY, MANY ISSUES, ON THIS AND OTHER TOPICS. AND WE INTEND TO MOVE FORWARD. IT'S JUST THAT THE AGREEMENT WE HAVE TODAY, MR. CHAIRMAN, IS ALL ABOUT ALL OF US COMING TOGETHER WITH BILLS THAT WERE READY FOR PRIMETIME, THAT WOULD NOT SOMEHOW CAUSE PROBLEMS WITH THE UNDERLYING DOCUMENT. AND THIS PROPOSAL, WHILE WELL INTENDED, AND FRANKLY ON THE BIG SCOPE OF THINGS MAKES A LOT OF SENSE, IT'S JUST NOT READY AND AGREED TO YET. THE GENTLEMAN FROM KNOWS THAT -- THE GENTLEMAN KNOWS THAT. WE KNOW THAT. WE APPRECIATE HIS PASSION ON THIS ISSUE. WE SHARE IT. BUT I HAVE TO RELUCTANTLY OPPOSE THE MOTION TO RECOMMIT BECAUSE WE HAVE AGREEMENT THAT ONLY ISSUES WE ALL AGREE ON ARE GOING INTO THIS BILL. THAT'S REPUBLICANS AND DEMOCRATS AT THE TOP OF BOTH COMMITTEES. SO I TAKE THE SIGNAL THAT HE REMAINS COMMITTED TO THIS EFFORT TO FULL THE -- FILL THE GAP. WE WILL WORK WITH HIM AND OTHERS GOING FORWARD BECAUSE WE HAVE A LOT MORE WORK TO DO, MR. CHAIRMAN. THIS ONE'S JUST NOT READY FOR PRIMETIME. I URGE OPPOSITION TO THE MOTION TO RECOMMIT AND I YIELD BACK THE BALANCE OF MY TIME.

THE SPEAKER PRO TEMPORE

WITHOUT OBJECTION, THE PREVIOUS QUESTION IS ORDERED ON THE MOTION TO…

WITHOUT OBJECTION, THE PREVIOUS QUESTION IS ORDERED ON THE MOTION TO RECOMMIT. THE QUESTION IS ON THE MOTION TO RECOMMIT. THOSE IN FAVOR SAY AYE. THOSE OPPOSED, NO. THE AYES HAVE IT.