Markup of Ten Pieces of Legislation

On the mike, Morgan. Subcommittee will come to order, the Chairman now recognizes himself for a an opening statement. Today's mark-up consists of ten bills addressing a range of important health issues. The legislation before us reflects this subcommittee's efforts to improve public health outcomes, enhance patient access, and modernize our health care delivery system to better meet the challenges Americans face. These bills represent thoughtful efforts from members on both sides of the aisle. Several of the bills before us focus on reauthorizing critical public health programs early detection and prevention that expire at the end of the fiscal year. Marking up these reauthorizations gives us the ability to continue to support these initiatives while also allowing us the opportunity to examine ways we can strengthen these programs. This includes H R four three four eight, the Kay Hagen Tick Act reauthorization, which supports and enhances programs for tick-borne disease, research, prevention and inter-agency coordination. We will also consider H R five four five four the Breast Cancer Education and Awareness Requires Learning Young Act or the Early Act, which supports breast cancer detection in education for young and high risk women. Additionally, we will mark up the Accelerating Access and Dementia and Alzheimer's Provider Act or the Adapt Act, uh, reauthorization which seeks to improve care through provider tools and training initiatives. I also want to highlight H R eight two zero five, the Accelerating Access to Critical therapies for ALS act which is before us this afternoon. Last month I had the privilege of speaking with the founders of IMALS, Brian Wallach and Sandra Abrevia Abrevia and participating alongside them in a press conference held by Representative Quigley who has done great work on this issue. Their testimony before the subcommittee was both moving and insightful and I especially want to recognize that they had driven all the way from Chicago to be at our hearing, and advocate for this important to support those with ALS. We will also consider H R five one six zero, the Stem Cell Therapeutic and Research Reauthorization Act, which extends and funds national programs that facilitate bone marrow and cord blood transplants for patients with blood cancers and other fatal diseases. In addition, we are marking up H R eight two zero nine legislation to reauthorize school-based health c health centers, which aim to strengthen school-based health services and mental health access We also have a couple of FDA reform bills before us today, one of which is H R two seven one five, the destruction of hazardous imports acts, which give act which gives the FDA the authority to destroy imported products that pose a significant public health concern. The other is H R two zero two one, the FDA modernization three point O act, which directs the FDA to fully implement policies established under FDA modernization two point O to reduce unnecessary animal testing. for drug development. Lastly, we'll mark up two bills from our Medicare patient access hearing earlier this year, H R seventeen O three. The choices for increased mobility act works to expand access to titanium and carbon fiber wheelchairs for Medicare beneficiaries, while H R five three four seven, the Health Care Efficiency through Flexibility Act aims to improve health care reporting for accountable care organizations. I am encouraged by the collaborative work that has gone into the legislation before us. And I want to thank all the members and staff who worked to bring these bills to the subcommittee. I look forward to continuing to work on these policies and bringing them to the full committee and I'm eager for a production a a productive mark-up this afternoon. The Chairman now recognizes, that would be me, I now recognize the ranking member, Ms. DeGette, for five minutes for her opening statement.

Thanks, Mr. Chairman. I'm pleased that we're marking up these ten bipartisan bills today, all of which I support and I encourage my um colleagues to support them as well the early act led by representatives wasserman schultz and miller meeks reauthorizes a critical program that helps women learn about detecting breast cancer early which means we have a more treatable disease the destruction of hazardous imports act led by representatives higgins and carter will give the fda the ability to mandate that an importer destroy an fda regulated product that's denied entry keeping our safe from illegal vapes and unsafe food. And the act for ALS reauthorization, led by representatives Quigley and Calvert, will build on the successes of the original act for ALS, bringing promising treatments to patients who can't wait and bolstering the research infrastructure for a cruel disease that has claimed too many lives, including my own father-in-law. And the testimony uh at the hearing that we had on this was really, truly moving, Mister Chairman. I could go on and and and all of these ten bills are good bills we should pass expeditiously. But I I'm forced to say this is our only our second health subcommittee mark-up this Congress. And by this point in a hundred and eighteenth Congress, we had had five subcommittee mark-ups. It shouldn't be lost on any of us either that most of these bills are reauthorizations, or a commitment to continuing work that is already happening and should continue to. But neither this committee nor this Congress seem to be intent on solving the problems that are facing our constituents. The committee's not taking up legislation to help the estimated twenty percent fewer people enrolled on the ACA exchanges who are now facing down the prospect of life without health insurance, much less the eighty percent of enrollees who report hi- report higher health care costs this year, all to the majority's refusal to extend enhanced a c a tax credits. This committee is not taking up legislation to restore the research engine that powers American innovation at the NIH, as the administration seeks to cut funding for science and sensor research researchers. The committee is not taking up legislation to address the crisis facing rural hospitals and the people they serve as they await the big bad bills, Medicaid cuts. And th- this is really the wo- work of a majority just mi- intent on doing the bare minimum. This committee's work during the hundred and nineteenth Congress is defined by two things, taking health care away from millions of Americans, to line the pockets of the wealthy at the behest of Donald Trump, and sitting idly by as biomedical research, vaccination, pandemic preparedness, and really, public health as a whole, all historically bipartisan priorities, are dismantled. Right now, as of today, we have vacancies at two of our critical uh health public health agencies, the FDA and the CDC. Now, Mister Chairman, you and I work well together on so many issues, and so many of my colleagues on both sides of the aisle are good friends. When we identify common goals, we do good things for the American people. And I still think we can, and I still think we can in this Congress. So, I still say it with the desire to work for the American people that this committee needs to stop waiting for permission from Donald Trump to do its job. We are article one, the first branch of government, the branch that is most connected to the people. It's our job to set policy and tell the executive branch what to do and make him do it, not vice versa v- v- vice versa. We can also work to solve these problems, which I believe everyone in this or we can just simply go through the motions. I promise you the maj- that the Democrats, when we take the majority, are not going to shy away from the big issues that our constituents care about, and we hope that we will have some cooperation on the other side of the aisle. But until then, I guess we'll have to settle for these bills today. And frankly, we do need to reauthorize these programs, we need to send them to the floor, where I will work with you to make sure they and that the underlying programs will continue to benefit the American people. And I yield back.

Gentlelady yields back now. Recognize the chairman of the full committee, the gentleman from Kentucky, Mister Guthrie, for his five-minute opening statement.

Thank you, Chairman Griffith. Thank you so much for your leadership advancing these bills and my my good friend the ranking member to get for saying we'll work to move these on, across the floor. Today we're authorizing key programs that are making meaningful differences in the lives of Americans. These programs are helping us fight vector-borne diseases like They're preventing breast cancer in young women through targeted education campaigns. They're developing treatments for ALS, giving hope to patients and families impacted by this devastating disease. And finally, these programs are improving access to care by meeting patients where they're at, through school-based health centers, uh, through the use of technology to train, advise and support clinicians, and seeking to provide specialty care in rural and unders underserved areas. We're also working up two pieces of legislation improve the Medicare program for beneficiaries and providers. One bill would provide greater flexibility in quality reporting methods for providers participating in certain accountable care organizations, reducing red tape for these providers as they transition to value-based models of care. The second bill would provide additional flexibility for Medicare Part B beneficiaries to have the ability to pay for for certain wheelchair upgrades. Further, we're marking up a bill that will allow the FTA to crack down on port shopping, a practice where foreign actors and dangerous products into our US supply chain. This bill will appr- improve efficiencies at our ports and make better use of FTA's finite resources to protect the American public all in all these bills were marketed up they would insure vital programs continue to offer more flexibility to patients and providers to strengthen the foundation of our healthcare system. Where there's always more to be done, this mark-up is another critical step towards a safer and healthier future for all Americans thank you and I yield back.

Gentleman yields back now, recognize the ranking member of the full committee, the gentleman from New Jersey, Mister Polon.

Thank you, Mister Chairman. Today we're considering bipartisan legislation to reauthorize public health programs that improve Americans' health spur biomedical innovation and sustain critical research and these programs are components of our public health infrastructure that help keep Americans healthy from cancer screening programs to disease surveillance networks but before I uh the mark-up legislation i wanted to raise concerns about the trump administration's troubling leadership of our public health agencies the hanta virus outbreak comes at a time when the trump administration has pulled the us out of the world health organization the cdc has lost a quarter of its staff and has no senate confirmed leadership and hhs fired every full-time employee at a program to assist the cruise industry in preventing and controlling the The National Institutes of Health continues to drag its feet in getting critical biomedical funding out the door. Grant funding from NIH to our biomedical researchers is down forty-four percent in fiscal year two thousand twenty-six compared to the four year average from two thousand twenty-one through twenty-four whether the slow pace of grant disbursement results from malice or incompetence is not clear but what is clear, is this can't continue yesterday, The Food and Drug Administration Commissioner, Mukherjee, resigned after a tenure that was marked by chaos, confusion, potential corruption. And Trump and congressional Republicans are making the affordable crisis worse by cutting trillions from Americans' health care while refusing to extend subsidies that make health care more affordable for American families. Prices for basic necessities, including health care, gas, utility bills and groceries continue to skyrocket, while Republicans do nothing to deal with it. And turning it back to the bills before us, I'm pleased we are considering the school-based health centers reauthorization act led by representative Tonko which brings healthcare directly into schools. Students can access primary care, mental health care, case management, dental care, and nutrition education right at school. And this reduces many barriers to care, including transportation challenges and a lack of primary care doctors. The early act reauthorization, H R four five four one, led by a addresses breast cancer in women under fifty. About sixteen percent of all new breast cancer cases occur in women younger than fifty where it's likely to be found at a later stage and even more aggressive and harder to treat and this program supports CDC-led education and outreach to close detection gaps empower women to take early action and ultimately save lives. We're also marking up the Act for ALS Act. Now last month we heard from the co-founders of IMALS, Brian Wallach and Sandra uh Abreyev and you know on the importance of this law to patients, caregivers and researchers, especially for advancing scientific understanding of ALS, another rare neurodegenerative diseases. And as we work towards reauthorization, we hope to address some of the concerns raised by the GAO report, including ensuring that the FDA has the funds to operate the rare neurodegenerative disease grant program. We're also considering the destruction of hazardous imports, which would provide the f. d. a. with important authorities to protect americans from harmful products. This bill would grant the f. d. a. the authority to require importers to destroy products that pose a significant public health concern preventing them from being shipped to another port of entry. And these products have included food contaminated with salmonella, listeria and carcinogenic unapproved animal drugs, as well as misbranded medical devices. It also includes illegal e-cigarette products that are flooding the market from

Chairman yields back the remainder of his time. Chairman yields back. The remainder of his time, The chair reminds members that pursuant to the committee rules, the chair reminds members that pursuant to the committee rules, all members' opening statements will be made a part of the record. all members' opening statements will be made a part of the record. Are there any Are there any

Thank you, Mr. Chairman. I'm I'm I uh echo what the uh ranking member uh has just said regarding uh dealing with these important bills but not addressing the overall crisis of the uh cuts to Medicaid and nutritional support and all the cuts to staffing, and and the agencies uh within HSAs. that are responsible to making sure that we keep a healthy community. I do wanna say, though, that as an emergency physician, you know, I've treated patients of all ages with various health conditions. I represent a a rural underserved, medically underserved, uh, community, and so I've seen firsthand the needs of kids, the needs of people who go, uh, without health care, and they need it. I've seen patients show up in hospitals with advanced illnesses because they couldn't afford to go to the doctor sooner or they tried, there was no availability to get them in. So for our kids, it is especially critical to get timely and regular checkups to support healthy growth and development. That is why the school-based health center program is so important. In communities where kids might otherwise not have access to medical care, they can receive primary care, behavioral health services, and preventive screenings right at school. You know, according to the National Association of Community Health Centers, community health centers serve eighteen percent of all kids in my state, in California, but there is still insufficient action to primary care with nearly thirty percent of california's childrens and teens not getting a preventative checkup investing in school-based care is essential to closing this gap and that's why i would like to express my support for the hr eighty-two O nine one of the bills considered today the school-based health centers reauthorization act that was introduced by my colleagues reps tonko and balderson uh this program is instrumental in promoting healthy kids and healthy communities it they're a good location because

Okay. Mm.

Uh, when they go and they pick up the kids with an appointment. So, uh, I support this. This is one veh- uh, very strong vehicle. It works. I've seen it in my district. I've seen it in the school districts in where I serve. Uh, and so I urge my colleagues to support, uh, and move HRA two zero nine in a

Jim yields back. Are there any other members wishing to do an opening statement? Going, going, gone. All right. Um That said, we will now move to calling up bills and the chair will call up HR four three four eight and ask the clerk to report.

HR forty three forty eight, a bill to reauthorize the Kay Hagan tick act and for other purposes. Be enacted by the Senate and House of Representatives of the United States of America.

All right. The um Without objection, the first reading of the bill will be dispensed with. And the w- bill will be open for amendments at any point point, so ordered. Uh, I now recognize myself for time on the K Hagen-Tick Act. H R four three four A reauthorizes the K Hagen-Tick Act, a landmark piece of legislation which developed in national uh, diseases, which in this bill you can read as a tick-borne disease, diseases like Lyme. Representative Chris Smith from New Jersey is the champion of this legislation, and and has been for years. He's g- done great work, and I'm glad we are continuing to move this bill. The bill is named after Senator K Hagan, who passed away from complications of the tick-borne virus called Powassan. This bill will continue continue building on the foundation that was created when the authorization of the bill was first passed in twenty nineteen. There are three critical components of this bill that will be reauthorized under the bill. First, it would require HHS to continue their public health strategy and working group to prevent and control tick-borne illnesses. Second, it would reauthorize the Regional Centers of Excellence for another five years. Third, it would continue the CDC grants awarded to certain entities to improve their efforts to combat and collect data on Tick-borne illnesses are spreading quickly in our country and these diseases can have devastating impacts on people's lives. Virginia is one of the top states for Lyme disease, with Southwest Virginia having some of the highest rates of Lyme and other tick-borne illnesses. I live with one of those diseases called alpha-gal syndrome which is from the lone star tick. It causes an allergic condition triggered by a sugar molecule called alpha-gal, which is found in most mammals but not in There are many tick-borne illnesses and we have only scratched the surface in understanding these diseases. And with that, I yield back and I hope everybody will support the bill. Madam uh Vice Chair, or excuse me, Ranking Member.

Thank you. I'll move to strike the last word.

And the lady is recognized to speak on the uh bill.

Thank you. So, so, Mr. Chairman, um, as you accurately pointed out, Lyme is no longer a disease of just the Northeast United States, and also it's not the only tick-borne disease. Rising cases and geographical creep of tick-borne disease mean that health departments and providers across the country, even in my western state of Colorado, are facing this growing threat. The CDC plays p- plays an essential role in supporting prevention, diagnosis, and treatment of rising cases of Lyme and other tick-borne diseases. This bill gives CDC the continuing authority and the resources it needs to improve public awareness and patient care, including through the national public health strategy to combat tick-borne diseases. The whole of government approach is a lesser known product of the twenty-first century Cures Act which Fred Upton and I passed those years ago, and it has been integral in expanding research, improving diagnostics, and coordinating efforts across federal agencies. We have a lot of work to do in Lyme and other tick-borne diseases, and so it's really great.

Gentle yields yield gentle lady yields back. Anyone else wishing to speak on the Kay Hagan tick act? I recognize the gentle lady from Washington, Miss Schreier, Doctor Schreier.

Thank you, Mister Chairman, I am really happy that our committee is advancing reauthorization of this Kay Hagan tick act which improves research uh prevention diagnostics and treatment for tick-borne diseases. Uh up until a few years ago it was incredibly rare to see ticks, just like uh, Reiki member Deget just talked about, uh in my home state of Washington, so we're going even further west now, or really anywhere in the Pacific Northwest for that matter. However, due to warmer winters and climate change, we are seeing ticks expand their habitats and survive in places they hadn't before, just like we're seeing mosquitoes uh with mosquito-borne illnesses survive in areas where they had never before and now coming into the United States. Um, We're even getting uh uh ticks in uh parts of Washington in areas like the Issaquah Alps and the Olimp- Olympic Peninsula. The numbers speak for themselves. New cases of Americans with tick-borne disease have multiplied uh over the past fifteen years and uh since nineteen eighty-two there's been a twenty-five uh fold increase. And that comes despite the challenge of testing for Lyme disease, where there's a a high number of false negatives with blood tests at the beginning and it's mostly a clinical diagnosis. uh because the test uh test for for antibodies so this bill will insure we have the public health workforce equipped and ready to prevent and treat tick bites that we have better testing better funding for local and state health departments uh to make sure we're catching these uh and uh and able to treat them so i support this bill and urge my colleagues to also vote yes so that americans will not have to deal with this threat i yield back

Chair, that yields back. Anyone else wish Seeing none, the question now occurs on forwarding H R four three four eight to the full committee. All those in favor say aye.

Aye.

Opposed, no. The ayes have it. The bill is agreed to and forwarded to the full committee. All right. Now we'll call up forty five forty one. House resolution forty five forty one. Would the clerk please report?

H R forty five forty one. A bill to reauthorize the Young Women's Breast Health Education and Awareness Requires Learning Young Act of two thousand nine, viewed and acted by the Senate and House of Representatives of the United States of America.

And without objection, the first reading of the bill will be dispensed with, and the bill will be open for amendment at any point. Seeing no objection, so ordered. Does anyone wish to be recognized on the bill? All right.

Aye. Aye.

Those opposed, no. The ayes have it and the bills agreed to and forward to the full committee. I now call up H R three seven four seven. And as the

H R three seven four seven. A bill to amend the Public Health Service Act to reauthorize the Project ECHO grant program, to establish grants under such program to disseminate knowledge and build capacity to address Alzheimer's disease and other dementias, and for other purposes, be enacted by the Senate and House of Representatives.

All right. Without objection, the first reading of the bill will be dispensed with. Any objection? Hearing none. Bill will be open for amendment at any point. So ordered. Does anyone seek recognition on this bill? All right. Seeing no one at this moment wishing to speak on three four no, excuse me, three seven four seven. I will advise the subcommittee that it's a good bill, it has bipartisan support.

We need the Ains after this.

Don't wanna do the Ains.

And there's an Ains, okay. Uh.

Balderson.

Mister Balderson, do you have an Ains?

Yes.

That would be an amendment in nature of substitute for those watching at home.

Yes.

Would the gentleman please uh call up his amendment.

Uh. Thank you, Mister Chairman, uh, I have an amendment at the desk with the file name H three seven four seven SCR Ains O one.

Uh, clerk will report please.

Amendment in the nature of a substitute to HR thirty seven forty seven, offered by Mister Balderson of Ohio. Strike all after the enacting clause and insert the follow.

Section one, short title. Uh, the the uh aims, the reading of the aims will be dispensed with without objection. So ordered. And the gentleman from Ohio, Mister Balderson, is now recognized for five minutes to speak on the aims.

Thank you, Mister Chairman, for holding this mark-up today and moving this bill forward. Today, more than seven million Americans, including more than two hundred and thirty-six thousand Ohioans are living with Alzheimer's disease. As these numbers continue to rise, we need stronger provider training and better access to community-based dementia care so families can get answers sooner and connect to care earlier. The ADAPT act helps give primary care providers the resources they need to help families get that diagnosis sooner. In rural communities, access to specialists is often limited, and for many families their primary care provider provider is the first and sometimes only point of contact when cognitive decline begins to appear. Yet, too many front-line providers report they do not have the training tools or support they need to confidently identify and manage dimension-related conditions. As a result, far too many Americans are diagnosed later than they should be, after valuable time for treatment and planning has already been lost. The ADAPT Act helps address that gap by strengthening and reauthorizing the Project ECHO program, a technology-enabled training model that connects front-line providers in rural and underserved communities with specialists through virtual mentoring and education networks. This approach gives front-line providers practical training they can apply directly in their communities. The goal is simple, patients and families need answers sooner. As new Alzheimer's treatments continue to emerge, we need a healthcare workforce prepared to identify and manage these conditions earlier. I'm proud to lead this bipartisan effort because most of us know someone who has been faced with this disease and understand how difficult it can be for patients, and families. strengthening the health care workforce and improving access to dementia, care are priorities we should all be able to support. I urge my colleagues on both sides of the aisle to support this bill. Thank you, Mister Chairman, I yield back.

Gentleman yields back. Anyone else wishing to discuss the amendment in the nature of a substitute? Uh, recognize the gentlelady from California, Miss Baragon.

Uh, thank you, Mister Chairman. Um, I will distract the last word. Um, I want to also thank the gentleman, um, for his comments in leading on this, uh, the gentleman from Ohio. While I support this aims, I am disappointed that it removes the targeted funding for Alzheimer's disease and related dementias that was included in the original bill. This specific allocation is critical for many reasons. Over seven million Americans currently live with Alzheimer's disease, and by twenty fifty the number of people is projected to increase to nearly thirteen million Americans. In twenty twenty six, Alzheimer's and other dementias will cost the nation four hundred and nine billion dollars, and by twenty fifty, these costs could to nearly one trillion dollars. Nearly thirteen million Americans provide unpaid care for people with Alzheimer's valued at more than four hundred and forty-six billion dollars. These are costs to our health care system, to the economy, and most importantly, it costs lives. As a caregiver for my mother who has Alzheimer's, I understand what's at stake, especially what a timely and accurate diagnosis can mean for families. But too often individuals are diagnosed late, or not at all. Primary care providers are usually the first place families turn to. Yet many of these providers report that they don't feel fully prepared to diagnose or manage dementia. Sixty-nine percent receive little to no dementia training in medical school, and thirty-nine percent are not confident enough to make a diagnosis. Now, I remember the time when I took my mother to a doctor. I thought I saw s- early signs of her dementia or Alzheimer's. I went and asked the doctor to say, " Hey, can she be assessed? Can somebody see if there's something that I can do, what advice do you have?" And I remember being sent with her to somebody who asked her, do you know how you got dressed this morning? And proceeded to ask questions that she clearly could still answer. And we walked away with the advice of eat a larger Mediterranean diet. It just goes to show you that we didn't get the advice that we should have gotten, whether it was to do more puzzles whether it was to be more active with your brain, whatever it is that wasn't given, and I think that's a disservice. And that's why I joined Representative Balderson to co-lead the ADAPT Act, which would continue access to more specialized education for our primary care providers. Investment in research has led to innovative diagnostic tools and treatment. But this means very little to patients and their families if our primary care workforce is not prepared to use them. I urge my colleagues to support but I hope we can continue to work on dedicated funding. Americans who face this devastating disease should not have to go longer without answers or support because the health care system was not prepared to meet them where they are. Thank you and I yield back.

Gentlelady yields back. Now I recognize the gentleman from Pennsylvania, Doctor Joyce, for his time, uh, five minutes to discuss the amendment and the nature of its substitute.

Thank you, Mr. Chairman. I would like to offer my support for an important bill H R thirty seven thirty seven thirty seven forty seven, the accelerating access dementia and Alzheimer's providing training act. This bill reauthorizes grant programs that enable specialists to collaborate with and support the so necessary support the primary care physicians need, as they are the primary individuals who diagnose and treat patients with Alzheimer's disease. We all know our population is aging and primary care doctors need to be to care for more patients with these devastating diseases. Programs like Project ECHO that are supported by these grants can help to make sure that especially in rural areas where access to specialists is often limited rural patients can have access to the doctors with the knowledge to offer the care that they need and the care that they deserve. In addition, these grant programs also reduce the need for unnecessary referrals in hospitalizations, which are costly,

Gentleman yields back.

Thank you.

Is there anyone else anyone else wishing to speak to the amendment in nature of substitute? All right. If there's no further discussion, the vote occurs on the amendment and the nature of its substitute. All those in favor signify by signify by saying aye.

Aye.

All the all those opposed nay.

Mm.

The ayes have it, and the amendment is agreed to. All right. Um Any further discussion on forwarding HR th three seven four seven to the full committee? Seeing none, all those in favor say aye.

Mm. Aye.

Those opposed, no. The aye has it. And the bill is agreed to and forwarded to the full committee. I now call up H R eight two zero nine and ask the clerk to report it.

H R eighty two O nine. A bill to amend the Public Health Service Act to reauthorize the school-based health centers grant program.

Yeah, just wanted to be on. Yeah, thank you.

Be it enacted.

Without objection, the first reading of the bill shall be dispensed with,

Thank you, Mister Chairman, I move to strike the last word and speak in support of the bill. First, I'd like to thank my colleague from New York, Congressman Tonko, for his leadership on this legislation and working with me to reauthorize the school

Mm.

School-based health centers help students access broad range of age-appropriate health care services in a convenient, familiar and trusted setting. These centers primarily serve underserved communities and play an important role in delivering primary care to children and adolescents, including preventative services, dental screenings and mental health support. Today, more than twenty-five hundred school-based health centers serve over six point three K twelve K through twelve students nationwide, helping connect families, to care in a setting where students already spend much of their day. Across my district and Ohio, families face real barriers to care, from provider shortages and long travel distances to transportation issues, and limited access to pediatric or behavioral health services. School-based health centers help close some of those gaps by bringing preventative and primary care services directly into the community environment that students rely on every day. We also cannot ignore the growing need for youth, Schools continue to see increased demand for counseling, behavioral health support, and early intervention services. School-based health centers can help connect students to care earlier and in a more coordinated way, while still working alongside parents, local providers, and school personnel. Importantly, these centers operate within clear guardrails under federal law, including parental consent requirements, patient privacy protections, coordination with community providers, and compliance with state and local This bill helps ensure students are healthy enough to learn, attend class consistent consistently, and succeed in life. It also supports local communities and gives schools additional tools to support students' health needs in a practical, accessible way. I believe this legislation will help strengthen access to care for students and families and communities across the country, and I encourage my colleagues to support the bill. Mr. Chairman, I yield back. Thank you.

The gentleman yields back. Anyone else wishing to speak on the bill? Recognize the gentlelady from Washington, Doctor Schreier, for five minutes.

Uh, well first, thank thank you, Mister Chairman. I'd like to thank Representative Balderson, Representative Tonko, for uh supporting this bill, uh introducing this bill, and I'm really glad the committee is uh taking this up today. As a pediatrician, I've seen kids miss out on both wellness and sick care simply because they didn't have a reliable way to get to a clinic. Uh, school-based health centers help eliminate these hurdles. by bringing that high quality care directly to where kids are. Uh, in my s- home state of Washington we have over seventy school-based health centers that have provided nearly seventeen thousand visits to our state's children and the advantages of these clinics are clear. Uh, when care is accessible for kids, we see higher vaccination rates, better diabetes management, access to dental care, counseling, and early identifi- and identification of, uh, illness outbreaks that might otherwise go unnoticed. uh we also see better academic performance for kids because they stay in school, so they have higher class attendance, higher GPAs and fewer uh disciplinary incidents. So I support this bill uh because it provides a long-term stability necessary for millions of students who rely on these centers. Uh we we cannot expect students to focus on their their futures or their academics if they are struggling with untreated uh physical or mental health challenges so I urge my colleagues to support this bill to make sure every child gets the care they need thank you. Yield back.

Gentlelady yields back. Anyone else wishing to speak on the bill? All right. Seeing no further discussion on the bill, the question now occurs on forwarding H uh, excuse me, HR eight two zero nine to the full committee. All those in favor say aye.

Aye. Aye.

Those opposed, no. The ayes have it, and the bill is agreed to and forwarded to the full committee. Chair will now call up house resolution five And ask the clerk to report.

H R fifty one sixty, a bill to reauthorize the Stem Cell Therapeutic and Research Act of two thousand five, and for other purposes, be enacted by the Senate and House of Representatives of the United States of America.

All right, and without objection, the first reading of the bill is dispensed with, and the bill will be open for amendment at any point. Any objection? Seeing none, so ordered. Does anyone seek to be recognized on the bill? Recognize the gentleman from Florida, Mister Bill Arrakis, for five minutes to speak on the bill.

Thank you very much. I I appreciate it, Mr. Chairman. Uh, every thousands or again every year, thousands of Americans are diagnosed with devastating diseases, such as leukemia, lymphoma, s- uh, sickle cell disease, and other inherited immune system disorders. For many of these patients, a bone marrow, or cord blood transplant can provide a critical treatment option, and in some cases a path toward long recovery. Finding a c- a compatible donor, however, is often incredibly difficult, particularly for those who do not have a matching donor within their own family. The CW Bill Young Cell Transplantation Program helps make these lifesaving transplants possible by coordinating donor matching, transplant resources, and patient support through a single national system. The national cord blood inventory complements that work by supporting the collection and preservation of high-quality umbilical cord blood units that can be used for transplantation and research. Cord blood and adult stem cell treatments have already helped tens of thousands patients, including children with rare genetic and immune disorders, who otherwise may have had very little treatment options. This legislation continues federal support for these proven programs, strengthens the national transplant infrastructure, and helps ensure patients can continue accessing lifesaving transplant options. I'm proud to join Representatives Smith, Matsui, Pingree, Tenney, and in introducing this bipartisan legislation, and I wanna thank uh all that participated. Uh again, the late uh great chairman, uh Bill Young, uh actually sponsored this initially sponsored this legislation. So we'll do this in his memory as well. Thank you very much and I yield back, Mr. Chairman.

Gentleman yields back. Anyone else wishing to speak on the bill? All right, seeing none, the question now occurs, Aye.

H R eighty two O five, H R eighty two O five. a bill to amend the accelerating access to critical therapies for ALS act A bill to amend the accelerating access to critical therapies for ALS act to reauthorize the provisions of such act through fiscal year twenty thirty one, and for other purposes.

And they, without objection, the first reading of the bill is dispensed with, and the bill will be open for amendment at any point. Without objection, so ordered. Does anyone seek to be recognized on the bill to speak to the bill? Recognize the gentleman from Florida, Mister Bilirakis, for five minutes to speak on the bill.

Thank you, Mister Chairman. I appreciate it. ALS is a devastating disease that gradually takes away a person's ability to move, speak, eat and breathe. And today there is. still no cure. For many families, time is the greatest challenge. Patients living with ALS cannot afford to wait through years of uh again slow research and regulatory timelines. Congress recognized the reality when it passed ACT for ALS in twenty twenty one. The goal was to accelerate research and pro coordination and expand access to promising investigational therapies. Since then, the program has helped strengthen collaboration between researchers regulators manufacturers and patient advocates working to better understand and treat als hr eighty-two O five continues that work by extending these programs through twenty thirty one so critical research and access efforts can continue without interruption the bill also strengthens oversight by requiring updated fta action plans additional reporting and closer review of clinical trial progress. Importantly, this legislation recognizes that advances made in ALS research may also help patients living with other rare neurodegenerative diseases. While there is still much work ahead, continuing to support research innovation and access to pr- uh promising therapies offers hope to patients and families confronting these devastating diseases every day. So I'm proud to cosponsor this bill and urge my colleagues to support. Thank you very much and I yield back, Mr. Chairman.

Gentleman gentleman yields back. Anyone else wishing to speak on the bill? Seeing none, the question now occurs on forwarding HR eight two zero five to the full committee. All those in favor say aye.

Aye.

Those opposed, no. The ayes have it and the bill is agreed to and forwarded to the full committee.

H R two seven one five, a bill to amend the Federal Food, Drug and Cosmetic Act to extend the destruction authority of the Secretary of Health and Human Services to articles that present a significant public health concern and for other purposes.

And without objection, the first reading of the bill is dispensed with and the bill will be open for amendment at any point. Seeing no objection, so ordered. And I understand we have an amendment in the nature of substitute on this one. Mister Carter, the gentleman is recognized uh to p call up his amendment in the nature of a substitute.

Thank you, Mister Chairman, and thank the committee for considering my bipartisan bill with my Louisiana colleague Representative Clay Higgins. H R twenty seven one five, the destruction of hazardous imports act.

All right. Do you wanna call that up?

Yes.

Would the clerk please call up the amendment in the nature of substitute?

Amendment in the nature of

All right, and uh, Mister Carter is now recognized for five minutes to discuss his amendment in the nature of a substitute.

Thank you, Mister Chairman. This bill authorizes Food and Drug Administration to require an importer to destroy This bill authorizes the Food and Drug Administration to require an importer to destroy an FDA-regulated product refused entry into the US, because poses significant public health concerns at the importer's expense. This bill also prohibits the the unauthorized movement of any article d- designated for destruction by the FDA this amendment in the nature of substitute includes technical assistance edits from the FDA to clarify the process for ordering and destructing destruction of hazardous shipments including a due process provision along the owner of the and articles subject to destruction to appeal. It also allows the federal government additional time to finalize regulations related to this legislation. I'd like to thank the FDA for its partnership in crafting this these amendments. Our legislative hearing in March, we heard from expert witnesses about the need for these reforms. Under current law, foreign exporters can ship contaminated or counterfeit products to the, yeah, knowing they can withdraw the shipment if flagged by the FDA, and try to simply add, enter at a different port, a process known as port shopping. Some imported foods, especially seafood, have been found to be contaminated with carcinogenic drugs, pesticides, and other harmful impurities. This loophole puts American consumers at risk and undermines our food safety system. The problem extends beyond food. There has been a rise in exports of dangerous vape devices, e-liquid e-liquids containing banned substances and excessive nicotine, as well as counterfeit drugs like GLP-ones. This threat is real and is documented. Exporters, especially Chinese exporters, have been caught resubmitting rejected shipments at different ports. This bill closes that loophole, creating a real deterrent for exporters who currently face little consequence for their ill deeds. Providing this authority has been a bipartisan priority for both the Biden and Trump administrations. The Trump administration's FDA FDA asked that, asked for this authority in its last legislative legislative priority report. Granting the FDA these authorities has supported has been supported for a broad group of industry organizations, including the Southern Shrimp Alliance, Louisiana Farm Bureau Federation, the Partnership for Safe Medicines, the National Association of State-controlled Substance Authorities, and the National Consumer League, among many others. Uh, Mr. Chairman, I thank you and I urge this committee to adopt this amendment and pass this critical legislation.