Neal Opening Statement at Markup of H.R. 1691, H.R. 2407, H.R. 8816, and H.R. 4818

(As prepared for delivery)

Mr. Chairman, for many of our members, today's bills are very personal, and it's a great reminder of the gravity of our work and all that's possible from this dais. Ways and Means, in a way no other body in Congress does or can, reflects our values as a people.

Almost 15 years ago, we took that possibility, guided by our values, to unlock a healthier, more prosperous America with the Affordable Care Act.

In 2024's Open Enrollment period, over 21.4 million Americans got access to affordable, quality health insurance through ACA.

Much of this recent success was made possible because of our work to bolster the premium tax credits during the pandemic. We targeted the support to those who need it most, and without this lifeline, the average middle-class family of four could see a premium hike of over $6,000. Pouncing on the cost of extension while ignoring its impact and beginning to grift for the next round of tax cuts to the wealthiest among us is shameful. I want to remind the room: the former president ran up the national debt two-fold to our current president, and that's even when you exclude COVID relief.

Who wouldn't want to build on our success for a healthier nation?

Today is very personal for many of our members. Whether it be through our own lived experiences or through hearing from constituents, we know the heartbreak of when the health care system falls short all too well, which is why it is so imperative that legislation we pass out of Committee is fully vetted and ready for primetime. In this slate, there are still some loose ends to tie up. Starting with the offsets, I'm concerned by the unusual nature of today's mark up, and should these bills move forward, it must be without poison pill offsets.

I am pleased that we are marking up a bill that includes Congresswoman Sanchez' legislation relating to Alzheimer's as well as a demonstration program related to providing medically tailored meals for those post-hospitalization, which Congressmen Evans and McGovern have championed.

Likewise, I am pleased with the improvements we have made to Congresswoman Sewell's bill relating to cancer screening. Most critically, I am glad that the advocacy community is supporting the bill and we were able to ensure that patients would get access to early detection tests tailored to their needs.

Moving on, I continue to hear about the life-changing outcomes from patients on anti-obesity medication. Unfortunately, America is facing an epidemic. Millions of Americans could benefit from these new medications. As with many prescription drugs, Americans are being charged much more than patients in other countries - ten times more in some cases.

As a result, the cost of adding these medications to Medicare would run tens of billions of dollars. Rather than lowering the cost to ensure broad access, the Republicans have decided to ration access in Medicare.

I am concerned about turning Medicare into a program of haves - those who had good private insurance - and have nots. The rationing in the bill under consideration today doesn't align with our goal of unlocking access, regardless of wealth.

I see great benefits in our Medicare beneficiaries getting access to the latest treatments and technologies, but there must be a balance with patient safety. I appreciate the effort that has been made to improve the breakthrough technology bill, but it still overrides Medicare's ability to safeguard beneficiaries and that is unacceptable. Not only do breakthrough devices never have to prove that they've made good on their potential to be "more effective," the program explicitly allows them to be approved with more uncertainty than usual about their safe and effectiveness, which leaves too much to chance.

The personal connections to the legislation under consideration today show how committed Democrats are to doing what we were put in office to do. It's simple, and that's to make life easier for the American people.

With that, I yield back the balance of my time.

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