Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024

Floor Speech

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Ms. BOEBERT. Mr. Chair, I rise today to offer my amendment that will transfer funds from government bureaucracy to the Small Rural Hospital Improvement Grant Program.

The rural hospital closure crisis continues to intensify. Unfortunately, over 138 rural hospitals have closed since 2010 and over 450 additional facilities are vulnerable to closure.

While recent innovations in healthcare, such as the implementation of telehealth technology, show promise to rural communities, rural America is facing crises that are leading to dwindling access to essential care.

Competitive grant programs like the Small Rural Hospital Improvement Grant Program play a large role in ensuring that Americans living in rural communities can access quality, cost-effective healthcare.

This program supports small rural hospitals in meeting value-based payment and care goals for their respective organizations through purchases of hardware, software, and training.

While current spending for rural health discretionary programs is relatively small in the largest discretionary spending bill, it plays a critical role in solidifying the fragile healthcare infrastructure and workforce in rural communities.

Americans, especially in rural communities, continue to struggle with affordable coverage, yet Joe Biden has done nothing to actually lower costs.

Let's empower our rural communities to keep providing high-quality healthcare and eliminate red tape and useless bureaucracy that is standing between doctors and patients. This amendment takes an important first step to accomplish both of these goals.

Mr. Chair, I urge my colleagues to support my amendment that will transfer funds from the HHS bureaucracy to the Small Rural Hospital Improvement Grant Program. Again, I urge colleagues to support this amendment, and I yield back the balance of my time.
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Ms. BOEBERT. Mr. Chair, I rise today to offer my straightforward amendment that seeks to provide more resources in the bill for telehealth services for veterans in rural areas.

Colorado's Third Congressional District has over 100,000 veterans who call our beautiful State home. I am committed to ensuring that our veterans receive the care and respect they have earned for their service and sacrifice.

That is why I am here today to talk about the importance of telehealth for veterans in rural areas. Telehealth is the use of technology to deliver healthcare services remotely, such as through video, phone, or online platforms.

Telehealth can help veterans access quality care from the comfort and convenience of their homes or nearby locations without having to travel long distances or face transportation barriers.

Telehealth is especially important for veterans who live in rural or highly rural areas like many of the veterans in my district.

According to the Department of Veterans Affairs, there are 2.8 million rural veterans who are enrolled in and rely on VA healthcare systems. However, these veterans often face challenges in accessing timely and quality care due to provider shortages, limited facilities, and geographical isolation. These challenges can result in poor health outcomes, such as higher rates of chronic diseases, mental health issues, and, unfortunately, even suicide.

For instance, rural veterans are more likely to be diagnosed with diabetes, high blood pressure, and heart conditions than veterans living in more urban areas. Rural veterans are also 65 percent more likely to die from suicide than those residing in urban areas.

These statistics are unacceptable. They are absolutely heartbreaking. Our veterans deserve better. They deserve to have access to the best care possible regardless of where they live.

I will continue to advocate for these programs and for the expansion of telehealth access for rural veterans. I believe that telehealth is not only a matter of convenience, but a matter of necessity. It is a matter of honoring our veterans and fulfilling our promises to them.

Let's pass my amendment so we can increase telehealth services for veterans in rural areas.

Mr. Chair, I yield back the balance of my time.
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Ms. BOEBERT. Mr. Chair, I rise today to offer my amendment that will transfer funds from the Federal bureaucracy to the Rural Emergency Hospital Technical Assistance Program. Programs like the Rural Emergency Hospital Technical Assistance Program play a large role in ensuring that Americans living in rural communities can access quality, cost-effective healthcare.

The program works to ensure rural hospitals and the communities they serve have the information and resources needed to make informed decisions as to whether rural emergency hospitals are the best model of care for their communities and facilitate a successful implementation of REH requirements for those hospitals converting to this new provider type.

This program provides hospitals and rural communities considering this new model assistance across a broad range of issues, including financial analysis, workforce or staffing planning, establishment of referral relationships and processes, determining REH service lines, community health needs, and impact on the community health system including emergency medical services.

I will keep working for responsible healthcare policies that respect the dignity of individuals, support rural communities, decrease healthcare costs, and restore free market competition to the healthcare industry.

Let's empower our rural communities to keep providing high-quality healthcare and eliminate red tape and useless bureaucracy that is standing between doctors and patients. This amendment takes an important step to accomplish both of these goals.

Mr. Chair, I urge my colleagues to support my amendment that will transfer funds to the Rural Emergency Hospital Technical Assistance Program, and I yield back the balance of my time.
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Ms. BOEBERT. Mr. Chair, I rise today to offer my amendment that will transfer funds from government bureaucracy to the Rural Residency Planning and Development Program to support physician workforce expansion in rural areas.

On top of closures, the healthcare workforce shortages continue to plague rural communities. Over 75 percent of rural counties are designated Health Professional Shortage Areas.

Programs like the Rural Residency Planning and Development Program support the development of new rural residency programs in family medicine, internal medicine, and psychiatry to address the physician workforce shortages and challenges faced by rural communities.

Rural residency programs are accredited medical residency training programs that train residents in rural settings for greater than 50 percent of their total time in residency and focus on producing physicians who will practice in rural communities.

This program also contributes jobs to rural economies, provides access to a range of medical services, and strengthens communities throughout rural America.

Competitive grant programs, like the Rural Residency Planning and Development Program, play a large role in ensuring that Americans living in rural communities can access quality, cost-effective healthcare.

Let's support our rural communities instead of handicapping them with one-size-fits-all mandates as the Biden administration has done.

In September, the Centers for Medicare and Medicaid Services proposed a rule to mandate increased nursing home staff ratio which will put nursing homes, particularly in rural areas, in an impossible dilemma as they grapple with how to manage current occupancy levels with the insufficient workforce available to meet the requirements.

Rules like this fail to adequately balance the needs of both patients and healthcare staff in rural communities in the face of the current staffing shortage gripping our Nation.

This is why we should focus on giving our rural communities the resources and support that they need to provide low-cost, high-quality healthcare.

I urge my colleagues to support my amendment that will transfer funds to the Rural Residency Planning and Development Program to support physician workforce expansion in rural areas.

Mr. Chair, I yield back the balance of my time.
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Ms. BOEBERT. Mr. Chair, I yield myself such time as I may consume.

I rise today to offer my amendment to redirect $2 million in this bill to the Office of Inspector General to combat waste, fraud, and abuse.

As a proud member of the House Committee on Oversight and Reform, I am a firm believer in holding our government accountable to the people we serve. Honest, hardworking American citizens should be able to trust that their tax dollars are being spent responsibly. To achieve this goal, the Office of Inspector General must have the funding they need to ensure that the Department of Health and Human Services is using our tax dollars efficiently and for their intended purpose.

Inspectors general across the Federal Government have saved taxpayers billions of dollars and exposed numerous instances of criminal wrongdoing. According to the most recent report from the HHS on healthcare fraud and abuse: ``In FY 2021, investigations conducted by HHS's Office of Inspector General (HHS-OIG) resulted in 504 criminal actions against individuals or entities that engaged in crimes related to Medicare or Medicaid, and 669 civil actions, which include false claims and unjust enrichment lawsuits filed in the Federal district court, and civil monetary penalty (CMP) settlements. HHS-OIG also excluded 1,689 individuals and entities from participation in Medicare, Medicaid, and other Federal healthcare programs. Among these were exclusions based on criminal convictions for crimes related to Medicare and Medicaid or to other healthcare programs, for beneficiary abuse or neglect, and as a result of State healthcare licensure revocations.''

Mr. Chair, the American people believe the government is corrupt and rife with fraud. The only way to address these concerns is to promote accountability in the Federal Government and ensure that their tax dollars are used responsibly for their intended purpose.

My commonsense amendment will ensure that the HHS Office of Inspector General has the funding and resources they need to keep this agency in line. Two million dollars is a small sum to pay to restore faith in our institutions and to potentially uncover billions and billions in fraud.

Mr. Chair, I urge my colleagues to support my amendment to promote accountability and oversight in the Department of Health and Human Services, and I yield back the balance of my time.
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Ms. BOEBERT. Mr. Chairman, I rise to urge all of my colleagues to support this amendment, which would provide for additional funding reductions for NIH.

If we have learned nothing else from the executive branch's involvement and handling of the COVID-19 pandemic, at the very least, we learned just how corrupt and money hungry the NIH as an organization truly is.

It has been over 3\1/2\ years since the initial COVID lockdowns and the NIH continues to cover up and downplay its gain-of-function research at the Wuhan Institute of Virology.

Earlier this year, the Inspector General's report found that between 2014 and 2021, the NIH did not adequately follow its policies with respect to three grants totaling about $8 million to the EcoHealth Alliance.

The EcoHealth Alliance had a relationship with the Wuhan Institute of Virology in which it subawarded $600,000 to research coronaviruses in the years leading up to the COVID-19 pandemic.

The NIH terminated the EcoHealth grant in April of 2020, then later reinstated it, only to suspend it again after setting conditions for resumption that EcoHealth claimed it could not meet.

The NIH permanently terminated the award in August 2022 for compliance issues, including the Wuhan Institute of Virology's failure to provide NIH with laboratory notebooks related to the funded experiments.

Then again, in May of this year, the NIH reinstated grants to renew its ``collaborative research to understand the risk of bat coronavirus spillover emergence.'' Seriously?

In late last year, the NIH issued a new grant to EcoHealth Alliance for a project titled: ``Analyzing the Potential for Future Bat Coronavirus Emergence in Myanmar, Vietnam, and Laos.'' The grant provides EcoHealth Alliance with $653,392 covering a period until August 31, 2027.

Why is an organization that failed to comply with reporting requirements continuing to receive more and more American tax dollars?

Even more disturbing, earlier this year, the acting director of NIH, Dr. Tabak, testified before the House Appropriations Committee. I asked him whether gain-of-function research was conducted at the Wuhan Institute of Virology, and he responded ``no.''

In an October 20, 2021, letter to then-Oversight and Reform Committee Ranking Member James Comer, the NIH admitted to funding gain-of- function research on bat coronaviruses at the WIV. Ironically, Mr. Tabak authored this letter in which he stated that the limited experiment tested whether spike proteins from naturally occurring bat coronaviruses circulating in China were capable of binding to the human ACE2 receptor in a mouse model. This is classic gain of function and this is unacceptable.

Americans deserve to know the truth, especially when their tax dollars are funding these dangerous practices.

As if that were not enough evidence to justify a budget cut, the Biden administration has also inappropriately used the NIH as an extension of the President's radical, unethical policies. For instance, in April of 2021, the NIH reversed restrictions governing Federal- funded research to allow the use of fetal tissue obtained from elective abortions.

I am grateful the underlying bill includes several guardrails for fiscal year 2024, such as prohibiting funding for unethical human embryo and aborted fetal tissue research, prohibiting any support to the Wuhan Institute of Virology, and prohibiting gain-of-function research in an adversarial country. These are good provisions, but they are simply not enough.

I recognize that the underlying bill has reduced the NIH's funding by about 12\1/2\ percent, but I strongly believe a larger cut is warranted if we want the NIH to realign its priorities with congressional intent.

Not only would a larger budget cut force the NIH to eliminate irresponsible spending and research, but it would also send a strong message to the Biden administration that Congress does not approve the NIH's actions.

Mr. Chairman, I yield back the balance of my time.
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Ms. BOEBERT. Mr. Chair, I rise today to offer my amendment that transfers funds from government bureaucracy to charter school grants.

As a mom raising four boys, I understand that families across this country want the best education possible for their children. One size does not fit all when it comes to education and our Nation's youth, and education matters are best handled at the State, local, and especially family levels.

Charter schools are an important part of the public education landscape because they empower parents to choose a high-quality educational environment for their child regardless of income or ZIP Code. The unique educational experience of attending charter schools ensures more children have a chance to achieve the American Dream.

During the first two full school years of COVID, nearly 240,000 additional students enrolled in public charter schools. Charter schools were the only sector of public education to grow during the COVID lockdowns. They also serve our Nation's marginalized children.

A 2021 analysis of research on charter school effects and competitive influence by the National Bureau of Economic Research highlighted trends from three decades of research on charter schools. They found that charter schools boost student test scores, particularly for Black, Hispanic, and low-income students, and that attending charter schools increases college enrollment and civic engagement.

The competitive impact of charter schools on traditional public schools suggests a beneficial influence on neighboring schools' student achievement.

The Charter Schools Program is the only program at the Department of Education that supports school choice and allows parents to place their children in a school that works for their unique needs. Parents know how to raise their children better than government bureaucrats and teachers' unions.

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Ms. BOEBERT. Mr. Chair, I also have an amendment to add funding to the IG's account, and this amendment takes no funds from public schools. This is simply giving more choice to families throughout our Nation.

Transparency is good, and the argument that we just heard was not so good. Parents know how to raise their children better than government bureaucrats and politicians. We certainly experienced that during the COVID lockdowns. The restrictions that we saw to our children's education and the educational experiences that were lost during those 2 years or more of COVID lockdowns were a travesty.

I cannot reiterate enough that parents know how to raise their children better than politicians, better than bureaucrats, better than teachers' unions. We want to strengthen the Charter Schools Program, and that is what this amendment does.

Mr. Chair, I urge adoption of my amendment, and I yield back the balance of my time.
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Ms. BOEBERT. Mr. Chair, I rise today to offer my amendment that transfers funds from the Department of Education bureaucracy to support the Rural Education Achievement Program, REAP.

Most of the country's poorest counties are rural and are often disconnected from the nonprofits and social service agencies that fill the gaps in urban and suburban schools.

After decades of population loss and divestment by State governments, many rural communities are struggling to keep up when it comes to educating our children and are being forced to close. When these schools close, children are forced to travel additional hours to get to school. Closures and consolidations also force teachers, administrators, and educators out of their jobs.

Yet, America has continued to turn a blind eye, leaving our rural communities helpless. More than 9.3 million children attend rural schools. This makes up nearly one-fifth of public school students across the country.

Rural children had an especially hard time keeping up when Democrats shut down our schools for 2 years and required students to learn via Zoom. Many of our children in rural communities don't have access to the internet, and some don't even have cell phone service. They deserve better than this.

The Rural Education Achievement Program initiatives are designed to help rural districts that may lack the personnel and resources to compete effectively for competitive Federal grants.

There are two dedicated programs funded by this account that aim to assist rural school districts with improving teaching and learning in their schools. The Small, Rural School Achievement Program provides funds to rural districts that serve a small number of students. The Rural and Low-Income School Program provides funds to rural districts that serve concentrations of poor students regardless of the number of students served by the district.

Our children deserve a proper education no matter what their ZIP Code is, and it is our duty to build a better future for them.

Mr. Chair, I urge my colleagues to support my amendment that transfers funds from the Department of Education bureaucracy to the Rural Education Achievement Program.

Mr. Chair, I yield back the balance of my time.
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Ms. BOEBERT. Mr. Chair, I rise today to offer my amendment on behalf of the thousands of Native Americans who deserve a quality education that respects their culture, history, and identity. These students face unique challenges and opportunities in their communities, and they need our support to achieve their full potential.

The Federal Government has a trust responsibility to provide educational services to Tribes and their members as established by treaties, statutes, and court decisions. However, for far too long, this responsibility has been neglected and underfunded, resulting in poor outcomes and inequities for Native students.

According to the Office of Indian Education, there are 183 bureau- funded elementary and secondary schools located on 64 reservations in 23 States, serving approximately 42,000 Native students. These schools are often in remote and rural areas with limited access to resources, technology, and qualified teachers. Many of these schools are also in dire need of repair and renovation, posing health and safety risks to students and staff.

Mr. Chair, I believe that education is the key to empowering opportunity and prosperity for all Americans. I also believe that we have a moral and legal obligation to honor our commitments to Tribes and their members and to respect their sovereignty and self- determination.

By redirecting wasteful spending in this bill to Native Americans' education, we can make a difference in the lives of Native students and in the strength and resilience of Tribal communities.

Mr. Chair, I urge my colleagues to support my amendment to transfer funds from the Department of Education bureaucracy to the Indian Education account.

Mr. Chair, I yield back the balance of my time.

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