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Neal Opening Statement at Markup of Health Legislation

(As prepared for delivery)

Good morning and welcome. Today, the committee will take bold action to lower drug prices, expand Medicare coverage, and strategically grow our nation’s health workforce. With these bills, Democrats continue to fulfill our promise to the voters who put us here – we are working to ensure all Americans have access to affordable health care and opportunities to climb the economic ladder. 

All of us in this room have heard stories of families that can’t afford their essential prescriptions and of seniors who aren’t able to get the hearing aids or dentures they need.

And we are aware that there are worker shortages in key areas of our health system. I am proud to say that we are taking action today to address these problems.  

The first bill we will consider is H.R. 3398, the Pathways to Health Careers Act. It will fund the final year of the Health Profession Opportunity Grant, or HPOG, demonstration program and then convert it to a grant program available across the country. HPOGs are a proven approach to train workers for in-demand health jobs.  

This legislation will make the program available to workers in all 50 states, in tribal communities, and in the U.S. Territories, including Puerto Rico. 

HPOG demonstration projects combine key work supports like child care and transportation with a career pathway approach to job training.

Ultimately, it’s an investment in addressing health worker shortages while creating opportunities for parents to pursue new careers and work their way out of poverty. 

Next, we will consider H.R. 3, the Lower Drug Costs Now Act of 2019. This legislation is the product of numerous prescription drug pricing hearings, bipartisan drug pricing transparency legislation that was previously passed by this committee, and consultation with our congressional colleagues. As I have said from the beginning, this is a complicated issue and there is no easy fix. But we are all here to tackle these difficult challenges, not shy from them. H.R. 3 is the next, not last, step in our work to lower prescription drug prices.  

Patients in the United States, on average, pay four times as much as consumers in similar countries for the same prescriptions. All the while drug companies continue to bring in tremendous profits. This is outrageous. 

Not only is this an unfair deal for the American people, many Americans simply cannot afford to pay these exorbitant prices for prescription drugs.  

H.R. 3 will finally level the playing field for U.S. consumers by allowing the Secretary of Health and Human Services to negotiate better prescription drug prices in Medicare. And the bill goes even further: it caps Medicare beneficiaries’ out-of-pocket prescription drug spending at $2,000.

The legislation also enhances the low-income subsidy program, which helps with Part D premiums and out of pocket costs for modest-income Medicare beneficiaries. These changes will streamline application and eligibility and increase the number of individuals who can access help.

Taken together, these changes will have wide-ranging, positive effects. When patients have access to affordable prescription drugs, they make fewer hospital visits, and in turn, that provides significant long-term savings to our nation’s overall health system. At the end of the day, it will make individuals and families healthier. 

And all of these improvements will be extraordinarily cost-effective. The Congressional Budget Office estimates that the Medicare provisions in Title one alone will reduce Medicare spending by $345 billion over ten years. And the Office of the Actuary estimates this bill will provide nearly $50 billion in savings to commercial coverage and $158 billion in savings to non-Medicare households. 

Thanks to these tremendous savings, we have an opportunity to make investments that improve millions of Americans’ health care coverage. Improvements like adding vision, hearing and dental to the list of Medicare benefits.  

To that end, we will mark up H.R. 4650, the Medicare Dental Act of 2019, H.R. 4665, the Medicare Vision Act of 2019, and H.R. 4618, the Medicare Hearing Act of 2019.

Together, these three bills  fill in a key gap in Medicare: the lack of dental, vision and hearing coverage. Because Medicare doesn’t cover these services, beneficiaries largely must fund this care out of pocket and experience higher costs. 

We know from decades of research that when beneficiaries cannot afford these costs on their own, they forgo care. And that leads to worse health outcomes. Untreated hearing impairment leads to social isolation. Untreated dental disease affects cardiovascular health, and nutrition. Unaddressed vision issues lead to falls, emergency room visits, and other complications. 

Today, we can lay the groundwork to move forward one of the biggest positive changes to Medicare in a generation. This is a significant step in the right direction to help our nation’s seniors. We have heard from our constituents: the status quo is unacceptable, and we have an obligation to change it for the better.  

The proposals we consider today are not extreme ideas. Quite the opposite. They are common-sense policy changes to provide consumers what they deserve – lower prescription drug prices and more access to quality affordable health care. 

I am immensely proud of the groundbreaking health care innovation that takes place across the United States, and particularly in the Commonwealth of Massachusetts. It has resulted in treatments for numerous diseases and drives local and regional economies. But what is the point of innovation if no one can afford it? Today, we can make it possible for Americans to afford the innovation they need to live healthier lives. 

I encourage my colleagues to join with me in supporting these important bills that will improve Americans’ financial stability, health, and wellbeing. 

And with that I will recognize Ranking Member Brady for purposes of an opening statement.