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Mr. PALLONE. Mr. Speaker, pursuant to House Resolution 1191, I call up the bill (H.R. 7666) to amend the Public Health Service Act to reauthorize certain programs relating to mental health and substance use disorders, and for other purposes, and ask for its immediate consideration in the House.
The Clerk read the title of the bill.
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Mr. PALLONE. 7666.
Mr. Speaker, I rise today in support of H.R. 7666, the Restoring Hope for Mental Health and Well-Being Act of 2022, and I thank Ranking Member Rodgers for working with me these past few months to develop this comprehensive legislation that will help address the mental health and substance use disorder crisis facing millions of Americans.
This bill is needed today more than ever. Americans report rising anxiety and depression and increased use of alcohol, opiates, and other substances. One in five adults are battling a mental illness. Suicide is now the second leading cause of death for children ages 10 to 14, and earlier this year the Centers for Disease Control and Prevention released a report finding that 4 in 10 high school students said they felt persistently sad or hopeless during the COVID-19 pandemic. The opioid crisis also continues to devastate families and communities all around the Nation. 108,000 people lost their lives due to drug overdoses just last year alone.
The Restoring Hope for Mental Health and Well-Being Act will help restore hope for millions of Americans. The bill strengthens and expands more than 30 critical programs that collectively support mental health care and substance use disorder prevention, care, treatment, and recovery support services in communities across the Nation.
As the Nation prepares for the launch of the 988 National Suicide Prevention Lifeline dialing code next month, H.R. 7666 provides key crisis response efforts, establishing the Substance Abuse and Mental Health Services Behavioral Health Crisis Coordination Office and requiring the development of crisis response best practices. The legislation also continues investments in critical mental health and substance use services block grant funding to States, territories, and Tribes.
The Restoring Hope Act includes crucial provisions to meet the challenges of the Nation's opioid epidemic, expanding and ensuring timely patient access to lifesaving treatment for opioid use disorders through the elimination of barriers to treatment. It includes Representative Tonko's MAT Act, which eliminates the X-waiver, a burdensome registration requirement that establishes arbitrary caps on the number of patients a provider can treat for opioid use disorder using buprenorphine.
This bill also establishes a one-time, 8-hour training requirement on treating and identifying substance use disorders that providers must complete before their first registration or renewal of a license to dispense controlled substances.
H.R. 7666 also helps bolster the behavioral health workforce capacity and training. It also increases access to mental health and substance use disorder care and coverage by applying the mental health parity law to State and local government workers, such as teachers and frontline workers.
The legislation also supports the mental health of children and young people. It continues investment in the integration of behavioral health into pediatric primary care through Pediatric Mental Health Access Grants and enhances research at the National Institutes of Health on the cognitive, physical, and socioemotional impacts of modern technology and multimedia on infants, children, and adolescents.
I can't stress enough that this is an epidemic that focuses a lot on children and adolescents. Older youth need help with suicide prevention and other mental health support and substance use disorder services. Students in higher education need that help, and they get it through a program called the Garrett Lee Smith Memorial Act.
The bill also ensures that State Medicaid programs have resources to implement and strengthen school-based mental health services while preserving the continuity of coverage for justice-involved youth. These important provisions will increase children's access to care.
Mr. Speaker, the scope and reach of this bipartisan legislation--and I stress that. This was reported out of the Energy and Commerce Committee unanimously, Mr. Speaker. It is truly bipartisan. It is going to help to support the mental health and well-being of millions of Americans, their families, and communities for years to come.
I thank Members on both sides of the aisle, not only Ranking Member Rodgers, but the subcommittee leadership as well, both Democrat and Republican.
The reason that we try to do this on a bipartisan level and get everybody's support is because we have a good chance of passing this in the Senate, which is also acting on similar legislation. We are hopeful that as a result of a large vote today, that will spur the Senate into action, and we can actually get this bill signed into law.
Mr. Speaker, I urge my colleagues to support the bill, and I reserve the balance of my time. House of Representatives, Committee on the Judiciary, Washington, DC, June 10, 2022. Hon. Frank Pallone, Jr., Chairman, Committee on Energy and Commerce, House of Representatives, Washington, DC.
Dear Chairman Pallone: This letter is to advise you that the Committee on the Judiciary has now had an opportunity to review the provisions in H.R. 7666, the ``Restoring Hope for Mental Health and Well-Being Act of 2022,'' that fall within our Rule X jurisdiction. I appreciate your consulting with us on those provisions. 7666, with the understanding that we do not thereby waive any future jurisdictional claim over those provisions or their subject matters.
In the event a House-Senate conference on this or similar legislation is convened, the Judiciary Committee reserves the right to request an appropriate number of conferees to address any concerns with these or similar provisions that may arise in conference.
Please place this letter into the Congressional Record during consideration of the measure on the House floor. Thank you for the cooperative spirit in which you have worked regarding this matter and others between our committees. Sincerely, Jerrold Nadler, Chairman. ____ House of Representatives, Committee on Energy and Commerce, Washington, DC, June 13, 2022. Hon. Jerrold Nadler, Chairman, Committee on Judiciary, Washington, DC.
Dear Chairman Nadler: Thank you for consulting with the Committee on Energy and Commerce and agreeing to be discharged from further consideration of H.R. 7666, the ``Restoring Hope for Mental Health and Well-Being Act of 2022,'' so that the bill may proceed expeditiously to the House floor.
I agree that your forgoing further action on this measure does not in any way diminish or alter the jurisdiction of your committee or prejudice its jurisdictional prerogatives on this measure or similar legislation in the future. I would support your effort to seek appointment of an appropriate number of conferees from your committee to any House-Senate conference on this legislation.
I will ensure our letters on H.R. 7666 are included in the report for this bill and entered into the Congressional Record during floor consideration of the bill. I appreciate your cooperation regarding this legislation and look forward to continuing to work together as this measure moves through the legislative process. Sincerely, Frank Pallone, Jr., Chairman.
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Mr. PALLONE. Schakowsky), who chairs our Subcommittee on Consumer Protection and Commerce.
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Mr. PALLONE. Kuster), a member of the Energy and Commerce Committee.
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Mr. PALLONE. Schrier), a member of the Energy and Commerce Committee.
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Mr. PALLONE. Jackson Lee).
Ms. JACKSON LEE. Mr. Speaker, I thank the chairman for yielding. As I begin--I am going to ask the chairman to enter into a colloquy--but, first, let me express my strong support for H.R. 7666 and the work that has been done in a bipartisan manner by both the chairman and the ranking member, and the importance of the issue of dealing with opioid addictions and other addictions that require this additional work. I am gratified to rise to support that.
I thank Chairman Pallone, and ask, as I said, that he engages in a colloquy with me on the need to support the mental health needs of trauma victims impacted by trauma and, yes, mass shootings. I think I have been here in the United States Congress during Columbine, Virginia Tech, Sandy Hook, Mother Emanuel, Santa Fe, Parkland--and the list goes on--and tragically Uvalde with 19 children, 2 adults, and 1 individual who died of heartbreak. I was in Uvalde, and I saw the impact on our children, to see 9-year-olds--9-year-olds-- crying and saying that because I spoke to them, they said you are making me happy because you spoke to me, and you said you care. Out of the mouth of a 9-year-old.
So we know there is a mental health crisis as relates to the trauma of those who certainly are survivors and those who are in the community.
We also know that too many families and children in this country are hurting from the preventable epidemic of gun violence, shootings, and mass casualty events. These tragic events have lasting scars on the families, friends, and communities. I have seen this pain with my own eyes. And so I am interested in--as my amendment that I withdrew indicated--is there a prioritization of those children who are impacted by trauma?
Madam Speaker, I would like to be able to work with Chairman Pallone on this issue. Will the gentleman yield for the purpose of a colloquy?
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Mr. PALLONE. Madam Speaker, I just wanted to stress that H.R. 7666 includes programs focused on supporting youth mental health.
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Mr. PALLONE. I thank the gentlewoman for her leadership on this issue. In fact, H.R. 7666 includes programs focused on supporting youth mental health including due to such traumatic events that were mentioned by the gentlewoman.
The SAMHSA Garrett Lee Smith State/Tribal Youth Suicide Prevention and Early Intervention Program, for instance, and HRSA's Pediatric Mental Health Care Access program, which helps integrate behavioral health into pediatric primary care, extends resources to support Project AWARE, building student, families, and school behavioral health resiliency. Further, the bill provides support to complement SAMHSA's launch of the new 988 National Suicide Prevention Lifeline dialing code next month that will expand access to crisis care support through call, text, or chat functions for millions of Americans.
Madam Speaker, I yield an additional 1 minute to the gentlewoman from Texas (Ms. Jackson Lee).
Ms. JACKSON LEE. I thank the chairman for answering my questions regarding the Restoring Hope Act that there will be provisions for mental health care and services for children, families, and communities who experience these traumatic and violent events.
I look forward working with the chairman on these vital resources. With your partnership I would like to continue to work with you and the administration to ensure that when this legislation is enacted, the needs of the vulnerable victims and those closest to them are in the front of our minds.
Will the gentleman commit to working with me on this matter?
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Mr. PALLONE. Let me just add, I am pleased to work with the gentlewoman from Texas on this critical matter.
I thank her for her support in ensuring children and families have access to the mental health support and services they need to lead healthy and hopeful lives.
Madam Speaker, I yield an additional 30 seconds to the gentlewoman from Texas.
Ms. JACKSON LEE. Madam Speaker, I thank the chairman for his support. I will support this legislation.
Mr. Speaker, I rise as a staunch advocate for mental health services to speak in favor of the Restoring Hope for Mental Health and Well- Being Act of 2022.
This bill amends the Public Health Service Act to reauthorize critical mental health programs for those dealing with mental health or substance abuse disorders.
H.R. 7666 works to mitigate some of the most pressing issues of our time by designating grants, expanding the availability of high-quality recovery housing, reauthorizing treatment programs, and combatting substance abuse.
In 2019, an estimated 10.1 million people in the U.S. aged 12 or older misused opioids in the past year. Specifically, 9.7 million people misused prescription pain relievers and 745,000 people used heroin.
The bill eliminates a key restrictive classification of opioid addiction so that access to treatment programs is expanded.
These issues disproportionately impact tribal communities. According to the American Addiction Centers, 10% of Native Americans have a substance use disorder.
H.R. 7666 specifically funds the prevention and treatment of mental health and substance use disorders for tribal populations.
This is a needed step in protecting a community with a history of being mistreated by the Federal government.
This bill's expansion of access to mental health care services, most importantly of all, would make these services much more available to children and adolescents, who must always be our top priority.
For example, this bill increases mental health services for our youth by integrating behavioral health into public education in primary schools and creating a grant for pediatric mental health services.
This legislation also addresses another pressing issue that afflicts young Americans: eating disorders. As many as 10 in 100 young women suffer from an eating disorder.
H.R. 7666 provides federal funding for the identification and treatment of eating disorders.
But, above all, Mr. Speaker, who among all of our children, need mental health services more than those who have just experienced the unconscionable? Senseless shootings leave our students, some as young as five years old, devastated and vulnerable.
As adults, the thought of having our peers murdered in front of us is disturbing. How much more traumatizing would that be for pre-school students?
This bill acts as a conduit for protecting children who are victims of a mass shooting or mass casualty event.
Mass shootings, especially school shootings, can leave lethal and obvious physical wounds on victims.
However, the long-lasting and subtle mental trauma is the invisible scar left on many survivors. Friends, family, and classmates often suffer with extreme guilt and sadness.
There have been 278 mass shooting in this year alone. Firearms are now the leading cause of death for children and teens.
In addition to those tragically killed, millions more are left behind, coping with these deaths. An estimated 3 million children in the US are exposed to shootings per year.
Since Columbine, there have been 337 school shootings and 311,000 students have experienced gun violence at school. Even more disturbing, just since Uvalde, there have been 65 mass shootings.
This is not a one-state issue. From the 28 killed at Sandy Hook in Connecticut, to the 17 killed at Marjorie Stoneman-Douglas in Florida, to the 10 killed at Red Lake in Minnesota, to the 22 killed at Robb Elementary in my home state of Texas, school shootings have become a disgusting norm.
Children exposed to violence, crime, and abuse are more likely to abuse drugs and alcohol; suffer from depression, anxiety, and posttraumatic stress disorder; fail or have difficulties in school; and engage in criminal activity.
These children don't stay children forever. These mental health struggles translate to a life of pain and suffering where crime, drug use, and suicide are more likely.
This trauma has real consequences: in the year following the 2018 massacre at Stoneman-Douglas High school, two students took their own life after suffering with the mental anguish of the events they had lived through.
Passage of this bill will not solve the gun crisis or mass shootings in this country. Only common-sense gun-control will do that.
However, this bill will set a foundation for the government to address the toll of gun violence on children's mental health.
Additionally, enactment of this legislation demonstrates Congress' support of victims of mass casualty events by prioritizing access to mental health services.
Children are the future of our country. Far too many of them have their hopes and dreams stripped away by senseless shootings.
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Mr. PALLONE. Madam Speaker, I yield 1 minute to the gentleman from California (Mr. Levin).
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Mr. PALLONE. Madam Speaker, I yield 1 minute to the gentleman from Rhode Island (Mr. Cicilline).
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Mr. PALLONE. Madam Speaker, I have no additional speakers. I am prepared to close.
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Mr. PALLONE. Madam Speaker,
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Mr. PALLONE. Madam Speaker, I yield myself the balance of my time.
Let me just reiterate what the ranking member said. This was really a bipartisan bill. I thank Mrs. Rodgers, Mr. Guthrie, Ms. Anna Eshoo, and all the staff that worked so hard on this legislation.
It is important that we have as big a vote as possible because this bill has a real chance of passing the Senate and getting to the President's desk and will really address the mental health and substance abuse concerns that we have and the crisis that we have. So I urge everyone to vote ``yes.''
Madam Speaker, I yield back the balance of my time.
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Mr. PALLONE. Madam Speaker, pursuant to House Resolution No. 1191, I rise to offer amendments en bloc No. 1.
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Mr. PALLONE. Madam Speaker, I yield myself such time as I may consume.
Madam Speaker, I rise in support of the eight mental health amendments under this en bloc consideration. Collectively, these amendments further strengthen the bipartisan nature of the underlying comprehensive bill, the Restoring Hope for Mental Health and Well-Being Act of 2022.
I thank my colleagues for their leadership and contributions to furthering the health of the American people and wish to speak in strong support of their adoption into H.R. 7666.
Many of these amendments, Madam Speaker, include provisions from bills that previously passed the House this Congress on suspension that the Senate has yet to act upon.
I am pleased that we have the opportunity to, once again, emphasize their importance by including them in this crucial legislative package.
The amendment offered by Congressman Bera and Congressman Fitzpatrick is just such an amendment. Like the bill it reflects, the HERO Act, which passed the House last year, it will improve data collection and services to ensure our first responders and public safety officers receive the mental health care services they need.
Additionally, Congresswoman Napolitano and Congressman Katko submitted an amendment which extends and revises SAMHSA's Project AWARE program providing school-based mental health services, including screening, treatment, and outreach programs, provisions that likewise passed the House last year in H.R. 721, the Mental Health Services for Students Act of 2021.
Representatives Katko and Napolitano were also joined by Congressmen Beyer, Raskin, Cardenas, and Fitzpatrick in offering an additional amendment that includes provisions from H.R. 2981, the Suicide Prevention Lifeline Improvement Act of 2021, which also passed the House last year.
The amendment extends funding for SAMHSA's Lifeline--crucial in this Nation's moment of mental health crisis, supporting crisis care response and support as we prepare for the launch of the new 988 dialing code next month.
I appreciate the additional focus on the particular needs of certain communities in our country that several amendments add to the underlying bill.
I thank Representatives Reschenthaler, Morelle, Wild, and Dean for their amendment requiring a study to determine the true cost of untreated serious mental illness on families, healthcare systems, public housing, and law enforcement in America.
In addition, we certainly cannot do enough to support the men and women who have valiantly served our Nation in the Armed Forces.
I thank Congressman Joyce for his amendment that requires the Department of Defense to carry out a 2-year pilot program aimed at preventing suicides amongst Active-Duty members of the Armed Forces.
I also appreciate and support the amendment submitted by Congressman Feenstra requiring the new Behavioral Health Crisis Coordinating Office established within SAMHSA by H.R. 7666, to provide technical assistance and support to the Veterans Crisis Line.
Further, Madam Speaker, I support the mental health and well-being of those who are pregnant or postpartum. The amendment offered by Congresswoman Moore makes important improvements to the Maternal Mental Health Hotline authorization to ensure those implementing the hotline consult with appropriate State, local, and Tribal public officials and those working with low-income people.
I am particularly pleased that H.R. 7666 would establish a new authorization for a Maternal Mental Health Hotline, and I appreciate Representative Moore's amendment that will serve to improve the underlying legislation.
Finally, Madam Speaker, while we know children in this country are facing a mental health crisis, unfortunately, we know that all too many also experience other chronic health challenges.
I am grateful to Representative Pressley for her amendment requiring the Secretary of Health and Human Services conduct a study on the rates and risks of suicidal behaviors among youth with chronic illnesses and to provide Congress with recommendations for ways to provide early intervention, best practices, and strategies to address disparities.
I am pleased to support these amendments and encourage my colleagues to do the same.
Madam Speaker,
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Mr. PALLONE. Madam Speaker, I yield 4 minutes to the gentlewoman from Massachusetts (Ms. Pressley), who has one of the important amendments included in this en bloc.
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Mr. PALLONE. Madam Speaker, I have no additional speakers, and I yield back the balance of my time.
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Mr. PALLONE. Madam Speaker, pursuant to House Resolution 1191, I rise to offer amendments en bloc No. 2.
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Mr. PALLONE. Madam Speaker, I yield myself such time as I may consume.
Madam Speaker, I rise in support of this en bloc amendment. This package includes bipartisan bills and policies that will increase access to substance use disorder prevention, treatment, and recovery support services.
The amendment introduced by Representatives Rodney Davis, Bilirakis, O'Halleran, Wagner, and Kuster reflects H.R. 2355, the Opioid Prescription Verification Act of 2021, which has previously passed the House. The amendment, like the bill it is drawn from, encourages the use of e-prescribing for opioids and incentivizes States to maintain and utilize prescription drug monitoring programs.
Likewise, the amendment offered by Representatives Andy Kim and Davids also reflects a previously House-passed bill, H.R. 2364, the Synthetic Opioid Danger Awareness Act. Their amendment requires the Department of Health and Human Services to conduct a public education campaign about synthetic opioids, including fentanyl and its analogues, and disseminate information about synthetic opioids to healthcare providers.
Continuing the theme of bipartisanship, Representatives McKinley and Dingell introduced an amendment that amends the Controlled Substances Act to clarify the process for registrants to exercise due diligence upon discovering a suspicious order. Like the prior amendments, this, too, is drawn from a prior House-passed bill, H.R. 768, the Block, Report, And Suspend Suspicious Shipments Act of 2021.
Further, the amendment offered by Representatives Trone, Armstrong, and Sherrill also draws from a prior House-passed bill extending a critical authorization for the State Opioid Response grants and Tribal Opioid Response grants for 5 years.
Another amendment introduced by Representatives Dean, Spartz, Scanlon, and Fitzpatrick reflects H.R. 5950, the Improving Patient Access to Care and Treatment Act. This amendment increases the time from 14 to 60 days that healthcare providers can hold long-acting injectable buprenorphine before administering it to a patient, giving patients and practitioners greater flexibility when accessing opioid use disorder treatment.
Finally, this amendment package includes an amendment offered by Representative Gottheimer that would ensure that veterans are included within the crisis response continuum of best practices included in H.R. 7666.
I thank the sponsors of these provisions. These bipartisan amendments provide strong tools to address the ongoing overdose crisis and will save lives. I urge my colleagues to support this package of amendments and include them in the overall bill.
Madam Speaker,
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Mr. PALLONE. Madam Speaker,
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Mr. PALLONE. Madam Speaker, I yield back the balance of my time.
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Mr. PALLONE. Madam Speaker, on that I demand the yeas and nays.
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Mr. PALLONE. Madam Speaker, I claim the time in opposition to the amendment, but I do not oppose the amendment.
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Mr. PALLONE. Madam Speaker, I yield myself such time as I may consume.
Madam Speaker, I rise in support of this amendment. Like the bill that passed the House last year, H.R. 2877, and other House-passed provisions we hope to include through amendment into the Restoring Hope Act, this bipartisan amendment is part of the bipartisan approach Ranking Member Rodgers and I have taken since day one with this critical bill.
This amendment requires the Secretary to consult with a range of experts, including mental health and education professionals, to develop best practices for schools and universities to establish behavioral intervention teams to identify concerning behaviors and manage risks among students. The guidance must determine how these teams can operate effectively while relying on evidence-based, objective protection of the constitutional and civil rights of students and staff.
Madam Speaker, I understand that some disability and civil rights organizations have concerns about the provisions of this amendment and opposed the original bill. I agree that we must be sensitive to the concerns of these organizations and not inadvertently perpetuate a false association of psychiatric disability and gun violence, nor promote the preemptive use of law enforcement to address problematic student behaviors, particularly among students with disabilities and/or students of color, who are already disproportionately excessively disciplined compared to their peers.
At the same time, I think there is merit to the idea of teams of behavioral health specialists working in concert with educators to identify youth and college students who may be at risk of harming themselves or others and making sure they get the support they need.
This bill has passed the full House twice, as I said, on suspension, both this Congress and last Congress. My understanding is that the bill's sponsors have made changes when reintroducing the bill this Congress to address some of the stakeholders' concerns by including more robust privacy protections and inappropriate referral protections. I think these changes improve the bill.
I understand the stakeholders would like to see additional changes, and as I have indicated in the past, I am committed to examining ways to address these concerns and add additional guardrails as the bill progresses through negotiations with our Senate counterparts, including this amendment for consideration for adoption into H.R. 7666, but we need to pass the amendment to allow those kinds of negotiations with the Senate.
I look forward to working closely with stakeholders, Congressman Ferguson, and the other original leads of H.R. 2877, and, of course, our ranking member, to strike the right balance that protects the health, privacy, and rights of all students.
Madam Speaker, I yield back the balance of my time.
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Mr. PALLONE. Madam Speaker, on that I demand the yeas and nays.
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Mr. PALLONE. Madam Speaker, I claim the time in opposition to the amendment.
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Mr. PALLONE. Madam Speaker, I yield myself 2 minutes.
Madam Speaker, I thank the gentleman from Virginia for expressing his concerns relating to the MAT Act, but I respectfully disagree with his proposal.
First of all, I take issue with some of his characterizations regarding buprenorphine. Buprenorphine is not broadly available to all Americans who need it. In fact, only 1 in 10 individuals with opioid use disorder receive medications for their condition, including buprenorphine.
Over half of all rural counties in the United States do not have a single waivered buprenorphine provider, and 40 percent of all counties in the United States don't have a single waivered provider, according to the HHS-OIG.
This is a huge treatment gap. A treatment gap for opioid use disorders means lives are lost every day unnecessarily when there is treatment available. This is tragic and not acceptable.
Second, the gentleman has made the argument that buprenorphine is not effective against fentanyl, but that is not accurate. Buprenorphine is proven to reduce fentanyl use and overdose deaths, according to the National Academies of Sciences Consensus Report on Medications for Opioid Use Disorders and the United States Commission on Combating Synthetic Opioid Trafficking.
Delaying the elimination of the X waiver to 2024 means extending the time in which a barrier to treatment is in place, leading to an increased risk of overdose and death.
It is clear that we are experiencing record numbers of overdose deaths in America. This is a public health emergency and needs to be addressed immediately.
Buprenorphine is a proven, evidence-based treatment for opioid use disorder. Buprenorphine prevents painful withdrawal symptoms, reduces opioid cravings, and cuts the risk of overdose in half. This is due to buprenorphine's ceiling effect, which makes it nearly impossible to overdose on the medication. For these reasons, it is considered safer than commonly prescribed medications like insulin and blood thinners.
Madam Speaker, eliminating the X waiver is a cornerstone of the Restoring Hope Act. The MAT Act amendment to this package was adopted at markup by a vote of 45-10. It received support from the majority of Republicans and Democrats on the committee.
Further, nothing in this bill limits the ability of States to prepare and act on the overdose crisis.
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Mr. PALLONE. Madam Speaker, I yield myself an additional 30 seconds.
To the contrary, this legislation empowers States to determine the appropriate training, licensing requirements, and tools for providers who dispense controlled substances and treat patients with substance use disorders. All the MAT Act does is remove an unnecessary and outdated Federal barrier to States effectively addressing the opioid overdose crisis.
If we don't act now, we risk tens of thousands of additional overdoses and unnecessary loss of life. I urge my colleagues to reject this amendment, and
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Mr. PALLONE. Madam Speaker, I yield such time as he may consume to the gentleman from New York (Mr. Tonko).
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Mr. PALLONE. Madam Speaker, I yield back the balance of my time.
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