Support for Patients and Communities Reauthorization Act of 2025
Floor Speech
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Mr. PALLONE. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, I rise in opposition to H.R. 2483, legislation that reauthorizes the SUPPORT for Patients and Communities Act.
Last Congress, this bill passed with strong bipartisan support right here on the House floor under suspension of the rules. Today it is coming up under a rule because a lot has changed since last year. There is a new administration, and the Trump administration is attacking mental health and substance use response efforts on every front.
Republicans want to move forward with this legislation at the same time that they are silently watching as the Trump administration dismantles SAMHSA, the very agency that is responsible for carrying out the programs that the SUPPORT for Patients and Communities Act reauthorizes.
Thanks to our efforts in recent years, significant improvements have been made in combating the opioid overdose epidemic that has devastated families in every community throughout our Nation, but those improvements are now threatened as the Trump administration guts the very programs and funding that have helped us turn the corner.
In the past few months, the Trump administration has completely eroded the mental health and substance use treatment landscape as we know it. It has fired hundreds of workers at SAMHSA, including key senior officials, such as the director of the center focused on mental health. The department continues to refuse to respond to my repeated requests about how many SAMHSA employees have been terminated and how many additional firings are planned.
The Trump administration has eliminated entire offices that are responsible for collecting data on mental health and substance use and helping people locate treatment services. These actions will only make it harder for people who are seeking treatment to find care.
The Trump administration is also eliminating SAMHSA altogether without congressional reauthorization. It will be combined with other agencies that the Trump administration doesn't care about under the banner of a larger make America healthy again office.
These critical programs to treat mental health and substance abuse will be deprioritized or eliminated in favor of Secretary Kennedy's pet projects, like destroying Americans' access to vaccines. Congress has received zero--zero--information from the administration about how this new office will work and how the work of SAMHSA to address the mental health and substance use treatments needs of our communities will be prioritized.
The Trump administration is also rescinding more than $1 billion in essential funding that States rely on through block grants. It has also proposed eliminating dozens of different mental health and substance use programs, including eight programs reauthorized by the SUPPORT for Patients and Communities Reauthorization Act of 2025.
This includes programs to train first responders who respond to opioid overdose calls, provide residential treatment to pregnant and postpartum women, and support people on long-term recovery.
If Republicans really support these programs, my colleagues should be opposing the President's budget, which lays out plans to cut the very programs Republican Members claim to care about. In fact, the Trump administration budget goes further and proposes eliminating nearly all of the SUPPORT for Patients and Communities Reauthorization Act of 2025 programs as my colleagues on the other side of the aisle propose to eliminate all of the so-called programs of regional and national significance.
This is the umbrella under which nearly all of the SUPPORT for Patients and Communities Reauthorization Act of 2025 programs reside. My colleagues have also proposed gutting the mental health block grant, the substance abuse block grant, the State opioid response grants, and consolidating them into one program with a deep funding cut.
I will be clear, Mr. Chair. This is not a budget proposal in the traditional sense. This is a roadmap for what the Trump administration plans to do unless the Federal courts prevent them from proceeding.
Their expansive and limitless view of the President's authority knows no bounds. If DOGE wants to cut entire agencies, eliminate programs, and impound funds, they will do it regardless of the law. The Trump administration is making clear that funding treatment and prevention for mental health and substance abuse issues is not a priority.
Unfortunately, Republican majorities of both the House and the Senate silently sit by and watch all of the destruction and illegal actions. House Republicans have not conducted any oversight of this administration.
Let us not forget also, Mr. Chair, that last month, House Republicans passed the biggest cut to Medicaid in history as part of their scheme to fund giant tax breaks for billionaires. As the nonpartisan Congressional Budget Office just announced this morning, the GOP tax scam now cuts 16 million people, up from 13.5 million people, from their healthcare, all to give tax breaks to their billionaire friends.
Medicaid covers 40 percent of all Americans with opioid use disorder. Gutting the program will leave millions of Americans without access to lifesaving care. We can't just go back to business as usual after that devastation was supported and passed by my Republican colleagues.
All of these actions completely undermine the efforts we have made to address substance use disorders in communities across the country. They will have disastrous and deadly consequences on the millions of Americans impacted by substance use disorder. Yet, House Republicans are here on the floor today pretending that we are conducting business as usual here in Washington.
If that were the case, I would join them in supporting the legislation, just as I did last Congress. Yet, this administration is not conducting business as usual, and Republicans are doing absolutely nothing to fight back.
Therefore, Mr. Chair, I can't support this bill while our mental health and substance use treatment infrastructure is being gutted by the Trump administration. There needs to be a functioning agency to implement the programs in this bill. There needs to be actual funding for the agency to carry out these programs. Neither will exist under what Trump has done or is proposing.
If Republicans were really interested in continuing to combat the opioid overdose crisis, they would finally join us in opposing the illegal actions of the Trump administration rather than hiding behind this legislation today.
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Mr. PALLONE. Mr. Chairman, I yield 4 minutes to the gentleman from New York (Mr. Tonko), the ranking member of the Environment Subcommittee.
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Mr. PALLONE. Mr. Chair, I yield an additional 1 minute to the gentleman from New York.
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Mr. PALLONE. Mr. Chairman, I yield myself such time as I may consume.
Mr. Chairman, I have a great deal of respect for the chairman of the Health Subcommittee, but he goes on to talk about how the Republicans are supporting these programs, and it is simply not true.
Mr. Chair, I have in front of me the ``Fiscal Year 2026 Budget in Brief'' that came from the Department of Health and Human Services.
On page 35 to 36 of the document, it says: ``The budget eliminates the following programs to align investments with the administration's priorities. . . . ''
It lists the following programs. First responder training--there are so many. I don't want to read them all. The chairman mentions helping first responders. That first responder training program is eliminated under the budget, right? A pregnant and postpartum women program; building communities of recovery; treatment, recovery, and workforce support; comprehensive opioid recovery centers; and youth prevention and recovery initiatives are all eliminated.
I understand that the President is trying to prevent fentanyl from coming in from across the border. I, obviously, support that. The chairman from Georgia said we still need treatment and education. Of course, we do, but that is not what is going on here.
The budget eliminates these programs, so my Republican colleagues can't just come here on the floor and say that they support all this and then authorize the very programs that are being eliminated, so there is no funding and no staff to carry them out. It is not fair. They are giving the impression to the public that they are doing something that they are not.
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Mr. PALLONE. Mr. Chair, I yield 3 minutes to the gentlewoman from Oregon (Ms. Dexter).
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Mr. PALLONE. Mr. Chair, I yield 1 minute to the ranking member of the Agriculture Committee, the gentlewoman from Minnesota (Ms. Craig).
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Mr. PALLONE. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, I want to talk about not only the SUPPORT for Patients and Communities Reauthorization Act of 2025 but the ineffectiveness of what is going on today with this reauthorized bill, but also the Medicaid cuts, which also affect people who are impacted by behavioral or mental health problems.
I put up the budget before. This is the President's budget. This is the Health and Human Services Department's budget. Again, I don't understand how my Republican colleagues can come here and say they are reauthorizing this program and ask what we are complaining about. The programs that I had mentioned that are cut in the President's budget, I am not going to go through them again, but I mentioned the first responder training, the comprehensive opioid recovery centers, and the youth prevention and recovery initiatives. All these programs are reauthorized by the bill before us today, but in the budget, the President eliminates the programs--no funding, no staff, no nothing.
How do they say that they are doing anything when the Trump administration is publicly laying out its plans to eliminate the very programs that they are reauthorizing? My colleagues on the other side are applauding their efforts to pass this bill even though it is meaningless.
How do they support a bill when the programs it reauthorizes are set to be eliminated by the President of the United States and their own party?
The same thing is true with regard to the Medicaid cuts. I hear my colleague, who I respect, the chairman of our Energy and Commerce Committee, keep saying that the Medicaid cuts in the budget bill that they passed a couple of weeks ago affect only the able-bodied, that it doesn't affect people with substance use disorders or those struggling with mental illness because they are exempt from the work requirements or the paperwork, if you will, that is in this bill, which CBO says is going to result in 16 million people losing their health insurance.
This morning, CBO revised their analysis of the Republican budget bill. They had said it was 13.5 million, but now, because of the changes before the bill went from the Energy and Commerce Committee to the floor, it is now 16 million people who will lose their health insurance, primarily because of all this red tape.
Taking health coverage from 16 million Americans is entirely unacceptable, and there is no amount of rationalizing that Republicans can do to make it any better. They said they have exemptions from this paperwork. Those exemptions have never worked.
We have the example from the State of Georgia, which admitted that there were 300,000 to 400,000 people under expanded Medicaid that were eligible for Medicaid under the State program, but only 4,500 of those 300,000 to 400,000 qualified because of the paperwork.
It doesn't matter what you say. Eliminating these people is simply unacceptable, and it just means they are going to go without health insurance. Then the costs are going to go up for everybody else because now the hospitals and the nursing homes that take them are not going to get paid and then all your private insurance and other insurance bills are going to go up. Your premiums are going to go up. Your deductibles are going to go up.
Mr. Chair, I will use, if I can, two examples from organizations that represent people with disabilities and know that the Republicans are taking away their health coverage, regardless of what they say about the red tape.
This is from a coalition of 425 disability and aging organizations. They say: We strongly oppose Medicaid cuts in any form. Whether it is done by imposing work requirements, repealing the eligibility and enrollment rule, or further eliminating the way States fund their share of Medicaid costs, these proposals all lead to the same result: People with disabilities and older adults will lose care and support that keep them healthy and independent. That is the bottom line. No rationalizing away what is happening here.
This is from the Cystic Fibrosis Foundation. I could give you so many examples. I don't want to use up all the time. The Cystic Fibrosis Foundation says:
While people with chronic illnesses like cystic fibrosis may be exempt from work requirements, we know exemptions for people with disabilities and caregivers do not work. Exemptions may not happen automatically and can require complex paperwork and regular recertification even for those with chronic lifelong conditions.
The bottom line is, it doesn't matter what you say. It doesn't matter how you do it; 16 million Americans are going to lose their health insurance under this legislation, and no amount of rationalizing on your part is going to change that.
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Mr. PALLONE. Mr. Chair, I yield myself 1 minute.
Mr. Chair, I appreciate what the gentleman from California is saying. The bottom line is, if these programs are successful under the SUPPORT for Patients and Communities Act, and I agree they have been, the numbers in terms of people dying, people who are severely impacted by opioid use and overdoses, clearly they have gone down because of the SUPPORT for Patients and Communities Act programs, but that is the very reason why the Republicans should speak out against the administration that is rescinding a billion dollars in grants that are going for these treatment centers. It is why they should speak out against the budget on the part of President Trump that I have cited several times today that eliminates these programs. It is why they should speak out against these cuts in the staff for these programs.
It is the very fact that the programs have been successful is why the administration should prioritize the programs. The Republican leadership on our committee and in the House should say: What you are proposing, what you are doing, President Trump, is not acceptable because it is going to reverse this. It is going to reverse the trend where opioid use and overdose goes down. It is going to reverse it if we don't have these programs. That is why they are successful.
To just say we are going to reauthorize the SUPPORT for Patients and Communities Act, which is meaningless because they are eliminating the programs, that is not the answer. The answer is for all of you to get up, go down to the White House, join us and say: What you are doing, President Trump, is not acceptable. It is going to reverse the progress that we have made.
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Mr. PALLONE. Mr. Chair, may I inquire as to the time remaining.
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Mr. PALLONE. Mr. Chair, I yield myself the balance of my time.
Mr. Chair, I want everyone to understand my opposition to this bill.
While the SUPPORT for Patients and Communities Act was first passed in 2018 with bipartisan support, the idea was to address the opioid crisis by authorizing programs that aimed to prevent substance use disorder and increase access to treatment and recovery, but the Trump administration has unlawfully gutted the agency responsible for carrying out these programs that the SUPPORT for Patients and Communities Reauthorization Act of 2025 reauthorizes. Congressional Republicans are trying to have it both ways. You really can't.
They are trying to have it both ways. They are saying we are going to reauthorize the SUPPORT for Patients and Communities Act, but then they silently stand by as the Trump administration dismantles the very program under SAMHSA or the very agency, SAMHSA, that actually implements the SUPPORT for Patients and Communities Reauthorization Act of 2025.
The Trump administration is moving forward with its unauthorized and illegal plans to eliminate SAMHSA altogether and combine mental health and substance use programs under this unrelated agency called the new Administration for a Healthy America.
Believe me, Secretary Kennedy has not explained in any way what this new administration will do or how it will continue any of the programs under SAMHSA.
What has the administration done? First, they fired hundreds of workers at SAMHSA, including key senior officials such as the directors of centers focused on mental health and substance use treatment. They have eliminated entire offices authorized by this statute, including the National Mental Health and Substance Use Policy Lab and the Center for Behavioral Health Statistics and Quality, which has been opposed by dozens of leading mental health and substance use groups that don't want these agencies eliminated because they actually play a major role in helping people with mental and behavioral health problems.
The Trump administration has rescinded over a billion dollars from State and local behavioral health programs under mental health and substance use block grants. This is the money that goes back to the States, the counties, and the towns to open up the centers, particularly for young people. That is where this all happens. It happens at the local level where people are treated, where the education programs take place. That billion dollars is gone. I am sure it is in the courts and the courts may say you can't do it, hopefully, but they have rescinded it.
Lastly, the Trump administration has disregarded the will of Congress by preparing to eliminate 40 different mental health and substance use programs. I am not going to go through them again. I listed them. They are all in the President's budget. It is terrible. It is things like the centers for youth, the centers for first responders, who are the ones who go and see people that overdose and try to make sure they don't die.
Again, all of this is happening, and the House Republicans say: Oh, don't worry about that because we are going to reauthorize the SUPPORT for Patients and Communities Act, and this is 2 weeks after the biggest cut to Medicaid in history with their GOP tax scam.
My only point is very simple, Mr. Chair, and that is this: The Energy and Commerce Committee is an authorizing committee. Sure, you can get up here and say we are going to authorize this program because we care about all the programs under the SUPPORT for Patients and Communities Reauthorization Act of 2025, but it is meaningless.
It makes no sense for us to authorize or reauthorize a program, whether it is substance use abuse or whatever it is, and give the impression to the public that somehow we are accomplishing something by authorizing or reauthorizing a program where there is going to be no agency to carry it out, no money, no staff.
I just think it is just not fair. It is trying to give the impression that you are doing something when, in fact, you are not. I feel obligated to expose that and to say, no, we are not going to vote for this hollow bill that actually does nothing because it gives the impression that we are doing something that we are not.
Mr. Chair, I yield back the balance of my time.
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Mr. PALLONE. Mr. Chair, I claim the time in opposition.
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Mr. PALLONE. Mr. Chair, I have no statement to make with regard to the legislation. I will yield back after the gentleman closes. I reserve the balance of my time.
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Mr. PALLONE. Mr. Chair, I yield back the balance of my time.
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Mr. PALLONE. Mr. Chair, I claim the time in opposition.
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Mr. PALLONE. Mr. Chair, I have no statement to make at this time. I will yield back after the gentlewoman closes. I reserve the balance of my time.
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Mr. PALLONE. Mr. Chair, I yield back the balance of my time.
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