[Congressional Record Volume 170, Number 5 (Wednesday, January 10, 2024)]
[House]
[Pages H39-H44]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 POLICY SOLUTIONS TO THE BORDER CRISIS

  The SPEAKER pro tempore (Mr. Bean of Florida). Under the Speaker's 
announced policy of January 9, 2023, the gentleman from Utah (Mr. 
Moore) is recognized for 60 minutes as the designee of the majority 
leader.


                             General Leave

  Mr. MOORE of Utah. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days in which to revise and extend their 
remarks and include extraneous material on the topic of this Special 
Order.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Utah?
  There was no objection.
  Mr. MOORE of Utah. Mr. Speaker, before I yield time to my colleague 
from Utah, I want to quickly highlight and reiterate the importance of 
what we are doing here as the House GOP.
  House Republicans, during the holiday break, took the time, over 60 
of us, to go down to the border to be able to share what is truly going 
on. We get to hear, hopefully, today a little bit more about this.
  At no point in our Nation's history has the situation on the southern 
border reached the levels of policy failure, humanitarian disaster, and 
security threat that it has under the Biden administration.
  Many of my House Republican colleagues witnessed firsthand the 
tragedy at our border last week. It is out of control, and the Biden 
administration has completely dropped the ball on this issue and 
threatened the safety of every American community in the process. The 
issue is, it is more simple than this.
  To President Biden, the gig is up. You took office and thought: Let's 
just reverse everything that the Trump administration had been doing. 
Let's not necessarily evaluate whether it was successful, whether it 
was the right policy. Let's just kind of use our executive pen to 
reverse everything.
  It is very simple to consider Migrant Protection Protocols, the 
remain in Mexico policy, catch and release. These are simple policy 
changes that would have an immediate positive impact.
  Many of my colleagues were able to see this, to witness this, again, 
firsthand this past week, and I look forward to hearing from 
Representative Burgess Owens from the great State of Utah for more on 
this issue.
  Mr. Speaker, I yield to the gentleman from Utah (Mr. Owens).
  Mr. OWENS. Mr. Speaker, I recently joined Speaker Johnson and more 
than 60 colleagues to visit the southern border at Eagle Pass, Texas, 
one of the busiest Border Patrol entry points. What I witnessed was 
nothing short of an invasion, an invasion facilitated by the purposeful 
policies of the Biden administration.
  It was my second trip to the border since the spring of 2021, and 
regrettably, the situation has only gotten worse.
  Two years ago, I encountered a heart-wrenching tragedy of an 
unaccompanied autistic 7-year-old child, a little girl who was 
trafficked by the Mexican cartel. My guess is the Biden administration 
is clueless as to the status of this vulnerable young lady. My guess 
also is that she is now 1 of the over 100,000 unaccompanied children 
who have been trafficked through the Biden administration's open border 
and now lost. The 100,000 innocent children lost to our system 
highlight the heartless administration that does not care about the 
innocents.
  The crisis doesn't end here. Over 100,000 Americans, primarily aged 
between 19 and 48, have fallen victim to fentanyl, a deadly weapon 
shipped from China to Mexico, processed, and then smuggled across our 
borders. More Americans have lost their lives in a single year than the 
two 20-year wars in Vietnam and Afghanistan combined.

  As these Americans are being poisoned across our country--by the way, 
this is across party lines. It doesn't matter what our race, creed, or 
color might be. Take one, and we have lost another child.
  As we are losing Americans, over 100,000, at this one port of entry, 
Eagle Pass, they are making over $34 million per week through this 
trafficking of fentanyl.
  President Biden did not inherit this crisis at our southern border. 
He purposely created it by rolling back the successful Trump policies 
and then refusing to enforce U.S. immigration laws. In his first 100 
days, he took 94 executive actions on immigration, resulting in 1.8 
million illegal crossings since January 2021.
  That is why I joined my House Republican colleagues to pass the 
Secure the Border Act of 2023 7 months ago, which offers commonsense 
solutions to the Biden border crisis. This legislation demands the 
completion of the border wall, an end to catch and release, an increase 
in Border Patrol agents, a halt to the flow of deadly fentanyl, and 
protection of our innocent children from human traffickers. It places 
the safety of the American people first, a sentiment shared by citizens 
throughout our country who are tired of Washington's inaction. However, 
the Senate Democrats refuse to bring it to the floor for a vote.
  Mr. Speaker, I urge the Senate to immediately pass H.R. 2, send it to 
the President's desk, and stand up for the safety, security, and sacred 
laws of our great Nation.
  Mr. MOORE of Utah. Mr. Speaker, I thank Representative Owens for his 
firsthand look.
  I spent time at the border--I believe it was in the late spring--and 
the same situation continues on. The solutions are right in front of 
us, and we just need the Biden administration to recognize that.
  Mr. Speaker, I yield to the gentleman from California (Mr. LaMalfa).
  Mr. LaMALFA. Mr. Speaker, I appreciate the time to be able to weigh 
in on these issues in a little more relaxed manner here and spend some 
time.
  I want to talk a little bit about legislation we are working on here 
known as S.J. Res. 38. In this case, it would ensure our taxpayer 
dollars are used to buy American-made products, something that has had 
bipartisan support, nonpartisan support, in the past around here.
  Certainly, when we are talking about having something domestically 
produced or buying it from a foreign competitor or ally, one thing we 
shouldn't be doing is buying more and more things from China.
  What is the sense of exporting so many of our dollars over to 
somebody who is such an adversary in so many things on the world front, 
with the funding of countries that are helping to sponsor terrorism and 
the unrest they are helping fund in the Middle East? There are constant 
threats to Taiwan and the other islands in the South

[[Page H40]]

China Sea that are possessions of Japan and others, constant aggression 
on that. They sink many other smaller countries into huge debt by 
dangling out loans they know they can't repay, and pretty soon, they 
can take over the resources of that country.
  As the United States of America, we can produce anything we want 
here. We can produce it well, usually of the best quality, using the 
best practices, by far, yet what are we doing? We are hamstringing our 
own ability to strengthen our own economy with the energy we need to 
produce in order to do that, with environmental policies that 50 years 
ago were well intentioned but have been completely weaponized against 
industries and farming, mining, and timber. The West burns each year 
massively. In California and Utah, it is endless.
  A lot of this currently comes from Biden administration policies, and 
I jump back 3 years to 8 years to the Obama-era policies that have put 
us in this spot.
  Currently, President Biden wants to shoot down the waiver to 
eliminate the buy in America requirements for, in this case, electric 
vehicle chargers. That is what this bill, S.J. Res. 38, is about, which 
would be purchased under the Infrastructure and Jobs Act, another 
boondoggle itself.
  If the money is going to be forced to be spent, and we have to buy 
these electric chargers for electric cars, at least can we have them be 
American produced, American made.
  Don't get me mixed up with the electric car crowd. I don't think we 
should be forcing that on anybody. At the same time, they are tearing 
down the California power grid with the dams they are removing on the 
Klamath River up in the north part of my district and one across the 
border, and then threatening the Snake River farther up and one down in 
Mendocino County.
  It is just one thing after another, getting rid of hydroelectric 
power and also the ability to store water and for the water to be 
retained during flood control season and for some recreation--yes, even 
water available to let out for fish when they need to. When they tear 
these dams out, we lose that green, renewable, clean, CO2-
free power by these policies.
  An addendum to that, CO2 is not a problem. It is only 0.04 
percent of our atmosphere. The left wants to keep playing these games 
like we are talking about here. They want to export jobs to China to 
build these electric car chargers. They want to tear down the dams that 
produce CO2-free, green, renewable power and try and build 
even more batteries and more windmills that chop up the birds and only 
run when there is a little bit of wind and the solar plants that only 
run during the daytime when it is not a cloudy or rainy or snow-covered 
day. It is amazing how dumb these ideas are.
  In 2021, the Democrats included $7.5 billion of taxpayer money for 
electric vehicle charging stations in their pie-in-the-sky idea that we 
are going to electrify everything in the next few years. This is the 
Infrastructure and Jobs Act.
  I don't support the forced purchase and proliferation of electric 
vehicles, but doggone it, if we are going to do this, we need to buy 
American.
  Why do we have to steamroll our own laws? Why is the administration 
backstabbing our American manufacturers and sending billions over to 
China and other Asian markets?

  In the process, it also destroys our immigration laws and fosters 
more chaos at the border when we have this continued policy by the 
Biden administration of basically ignoring the border.
  As mentioned earlier, 64 of my colleagues went to the border. I have 
paid a couple of visits myself in Arizona and California and such. It 
is indeed chaos. They are just walking right past you when you go visit 
the border. Some of these are nice folks from Central America, families 
and such. We keep putting out the magnet, the green light to come 
across.
  We have talked many times about the numbers coming across the border, 
like 10,000 per day just in the month of December, 300,000 for a month.
  The burden is being borne even by our Democrat-run cities, even they 
are starting to cry uncle. We have the Governor of New Jersey saying we 
need to check with these bus companies and see where they are all 
coming from. No, you need to check over here at 1600 Pennsylvania 
Avenue. That is where the policy is coming from. It isn't bus companies 
from Texas or Florida or something. That is who you need to be talking 
to because that is where the problem is.
  Indeed, the administration is shifting from pushing our jobs overseas 
to then having our jobs here filled by people who are coming here 
illegally. It is the chaos they have had at the border coupled with 
these other policies and fentanyl coming across the border.
  Who knows what kind of terror cells are being built by people coming 
across the border illegally and the gunrunning and everything else that 
can happen? It has even resulted in the housing of illegal immigrants 
in our National Park System, including a national park right there in 
New York City, so people can't use it.
  Now, you have seen the stories more and more recently that they are 
going to be housing them in schools. Kids are getting kicked out of 
schools in New York right now because they have a supposedly temporary 
problem where they have to house them in the gym. The kids can go 
online, back to Zoom learning, like during the height of COVID, which 
was manipulated in my own home State of California, which took an extra 
year to allow kids back into school.

                              {time}  1545

  What a mess. Why are these people entrusted with power?
  When you talk to the American public, this is all preventable. We 
don't have to live like this, when we are talking energy, when we are 
talking domestic production. No, we would rather export it, I guess, 
and have kids in Africa mine the products in order to have your 
electric car and electric gadgetry.
  The National Park Police have testified that these encampments on our 
National Park lands endanger the people that would normally enjoy and 
use them. Also, in the wintertime, these areas can end up being a 
floodplain, like the one in New York City, endangering the illegal 
immigrants that are being attracted--until recently, when it seems 
maybe the light is starting to turn around for the Governor of New York 
and the mayor of New York City and such.
  I don't know. I don't know.
  Mr. Speaker, we have a porous border. We have a massive problem with 
the encounters that we have at the border here that are overwhelming 
our demoralized Border Patrol folks. How are they supposed to do their 
job?
  On my visit down to Arizona, they actually had, and still have today, 
government-provided vans go over and just pick people up at the gaps in 
the border and get them to the processing center sooner. We know that 
85 percent of them are not going to be heard at their asylum trial any 
time soon.
  One thing after another is wrecking our economy, wrecking people's 
confidence in government, and the ability just to conduct their own 
lives. There is no reason we need to have such costly ways of doing 
business with energy, with procuring food; everything else that is 
happening under this Biden administration.
  Mr. Speaker, just 3 years ago, things were looking pretty good on the 
cost of fuel, cost of groceries, and employment until they used COVID 
as a weapon to attack our economy at that time and tried to make it 
look bad in order to win the 2020 election.
  We have a lot of complex issues, but the solutions really aren't that 
tough when you get down to it: enforce the border laws that we have.
  We don't need comprehensive immigration reform. We already know what 
we are supposed to do about the border. We just need to enforce the 
laws that we have and have common sense applied to asylum.
  At the same time, let's not exploit American jobs that we could be 
doing if we have to produce these electric vehicle charging stations. 
At least let Americans produce them instead of sending them to China.
  Mr. MOORE of Utah. Mr. Speaker, I thank the gentleman from California 
for speaking very plainly and very simply. These solutions are right in 
front of us.
  Mr. Speaker, I yield to the gentleman from North Carolina (Mr. 
Murphy).
  Mr. MURPHY. Mr. Speaker, I rise today in opposition to the CMS' 
proposed Medicare cut of 3.37 percent.

[[Page H41]]

  Just to put this in perspective, when a physician sees a Medicare 
patient, they do it because they care about patients. They do not do it 
for money, because it doesn't make financial sense.
  Let me give an example here.
  You own a hardware store and you want to sell hammers. It costs you 
$1 for each hammer. Say, the hammer is on Medicare, or you have to buy 
the Medicare, and you have to sell it for 60 cents.
  How long do you stay in business? It doesn't make sense.
  So as we move time and time and time again, the number of physicians 
who are able to take Medicare patients, out of the goodness of their 
heart, is falling and falling. You actually lose money on Medicare or 
Medicare patients that has to be taken up through cost shifting for 
regular insurance.
  When I ran a private practice, I stayed up many, many nights, 
Saturday nights, searching for paper clips, making sure that I knew 
where every penny went. I just had to make sure that my staff and the 
bills got paid before I ever got paid.
  My practice was heavily Medicare, so I did not take a salary many, 
many times because the numbers did not work. In fact, adjusted for 
overinflation for the last 20 years, Medicare physician fee schedules 
have dropped 20 percent, and this is in light of the massive inflation 
we have had over the last 2 years; even worse.
  Mr. Speaker, what other profession expects to get a pay cut every 
year?
  This has to stop.
  These are the people who are actually up in the middle of the night 
taking care of your grandmother who has appendicitis, taking care of 
your daughter, taking care of your child with a broken arm. They are 
the ones doing this, and here we are rewarding them because they 
basically have to take government pay patients by cutting and cutting 
and cutting.
  One of ObamaCare's directives was to starve private practices to 
force physicians to work in hospitals or big conglomerations.
  How did they do this? They cut their pay every year while hospitals, 
although not as much so, got raises every year.
  So what does this do? It pushes physicians out of private practice 
because they can't pay the bills.
  Mr. Speaker, I left my private practice when my partner said: We 
can't do this anymore. We are going to be acquired by a hospital.
  Mr. MURPHY: We can't provide the care to the patients that they need.
  Why is it a bad model? Private-practice physicians are different 
birds than employed physicians. It is just very simple. It is a well-
known fact in medicine. Those employed physicians tend to be less 
efficient, cost more, and tend to work more on the clock.
  Those who are in private practice put a taproot down in a community. 
They have stayed there, and they are someone's doctor for 20, 30 years 
or more. This is not happening now. They have made transitory medicine 
the rule, not the exception.
  The cuts that are going to the Medicare fee schedule absolutely need 
to stop. This is why I introduced H.R. 6683, the Preserving Seniors' 
Access to Physicians Act.

  This legislation will stop this year's cuts while we work on a 
permanent solution. This is not something that needs to happen year 
after year after year where we are cutting and cutting the people who 
actually take care of patients.
  Mr. Speaker, I came to Congress to help work with my colleagues to 
help fix Medicare. We are facing an absolute calamity with the shortage 
of doctors, especially surgeons, in the next 3 to 5 years. Those who 
are reaching retirement age, instead of working like most physicians 
do, are finally throwing up their hands and saying, we are done.
  Sadly enough, the ones coming out of medical school now--because of 
some of the processes now were not working hard enough--are not nearly 
coming out in the numbers and the efficiency to take the place of those 
retiring.
  Every day, we now add 10,000 new patients to the Medicare rolls. You 
are expecting doctors to continue to take more and more Medicare, 
earning less and less and less. They are going to go out of business or 
have to go into employment, which we all know is a worse way of taking 
care of patients.
  Mr. Speaker, I ask my colleagues to support H.R. 6683 and help us try 
to keep medicine back on track.
  Thank you.
  Mr. MOORE of Utah. Mr. Speaker, Dr. Murphy and I sit on the same 
committee, Health in the Ways and Means Committee, and if his remarks 
seem personal, it is because they are. He has had such a close 
experience with this, and no one makes the point better that all of our 
providers' costs continue to go up because of bad the monetary policy 
that we have seen, particularly in the last few years. When we 
constantly tell these providers, You are going to have to do more with 
less, they have to make decisions, and this is ultimately the worst 
possible thing for our patients.
  The crowding-out effect that we have going on in our economy right 
now, particularly with things related to government funding, there is 
no situation where it is worse than this. The inability for us to get 
after our true debt and deficit drivers will continue to crowd out, so 
these types of cuts are forced on providers, and we have to be willing 
and adult enough to be able to figure that out.
  So thank you for that, Dr. Murphy.
  Mr. Speaker, I yield to the gentleman from Indiana (Mr. Bucshon).
  Mr. BUCSHON. Mr. Speaker, I thank the gentleman for yielding.
  I am rising today to advocate for America's patients and their 
physicians.
  Over the past 3 years, doctors across the Nation have more than 
stepped up to the challenges that they have encountered, COVID, often 
risking their own health and safety to protect our communities. That 
not only includes the physicians; that includes the nurses, the 
technicians, and everyone in America's hospitals. However, when 
Congress left town in December, we once again let down America's 
doctors by allowing a 3.37 percent Medicare payment cut to hit January 
1.
  As a cardiothoracic surgeon for 15 years, I have seen firsthand the 
consequences of cuts like these. What are the consequences? Access to 
quality healthcare for rural America that I represent, underserved 
urban America, the American people.
  The payment cut to physicians will impede patients' access to care 
while increasing the gap between physician expenses and reimbursement 
rates.
  I want to associate myself with Dr. Murphy's comments. Costs are 
dramatically going up, and, if that continues, more and more of 
America's physicians will not take Medicare. I didn't say Medicaid. I 
said Medicare.
  Given the existing shortage of physicians in the United States, the 
combination of declining reimbursement and rapidly rising costs 
threatens to drive more doctors out of the profession, particularly, as 
I mentioned, in rural and underserved urban America.
  It has led to a lot of consolidation, as Dr. Murphy mentioned--
physicians being consolidated into a large medical practice or employed 
by large hospital systems.
  Fortunately, we have a window of opportunity to right this wrong and 
support the thousands of hardworking men and women serving millions of 
Medicare beneficiaries. We must stop the bleeding and eliminate the 
full 3.37 cut by January 19.
  Congress must also implement a permanent solution that will halt the 
downward spiral of physician reimbursement and provide much-needed and 
deserved stability for America's doctors. Again, if we want access for 
America's seniors to the Medicare program, we have to act. We have to 
act soon.
  Again, it is not just physicians out there not taking Medicaid. They 
are not taking Medicare. I have elderly in-laws and an elderly mother. 
They have experienced this.
  In fact, we had a hearing in the Committee on Energy and Commerce a 
couple of weeks ago. There was an economist there. He couched it in a 
way that was positive. He said, Well, 60 percent of America's seniors 
are not having trouble finding a primary care physician.
  When it came around time for my questioning, I said, Well, I want to 
rephrase that. Forty percent of America's seniors are struggling to 
find a primary care doctor. That is a big number, folks. Forty percent 
of America's seniors are struggling. Their physician retires. Their 
physician moves.

[[Page H42]]

Trying to find a new primary care doctor is a big challenge. We cannot 
let this continue--again, urban America and underserved areas, rural 
America that I represent.
  In 2023, for a more permanent solution, I introduced the bipartisan 
Strengthening Medicare for Patients and Providers Act, which would tie 
the annual physician fee schedule updates to inflationary measurements, 
the Medicare Economic Index, or MEI. That is both fair and efficient. 
It has been promoted. Almost every medical society in America thinks 
this is a good idea.
  I don't have the graph in front of me but let me just tell you what 
it shows. Outpatient and inpatient hospital care gets an update based 
on inflation every year. Providers do not. As Dr. Murphy outlined, it 
has been at least a 20 percent cut just based on that in the most 
recent history, and even more if you factor in the massive inflation--
which thankfully is down--that we had last year and the year before.

  The current path toward further consolidation, physician burnout, 
closure of medical practices must be corrected. If we don't correct 
this, the problems I outlined are going to continue.
  I urge congressional leadership to address this critical issue, and I 
will continue to advance patient-centered solutions that empower 
patients and support innovation to ensure that all Americans have 
access to quality, affordable healthcare.
  Mr. MOORE of Utah. Mr. Speaker, I thank the gentleman, Dr. Bucshon, 
for another incredible perspective on this looming issue that seems to 
just be year over year over year, and we cannot continue to put our 
medical providers in this situation.
  Mr. Speaker, I yield to the gentleman from Tennessee (Mr. Rose).
  Mr. ROSE. Mr. Speaker, I thank the gentleman from Utah, Vice Chairman 
Moore, for yielding and for claiming this time this afternoon to 
discuss these important issues facing our Nation.
  Mr. Speaker, as the music note dropped in Nashville and Americans 
rang in the new year on January 1, we woke up in the morning to 
horrifying news. 302,000 illegal immigrant encounters had occurred at 
our southern border, the most in any single month ever, in December 
2023. To put this number into perspective, that is more than the entire 
population of Knoxville, Tennessee, which is the third largest city in 
my home State of Tennessee.

                              {time}  1600

  Keep in mind, Mr. Speaker, that out of the 302,000 illegal immigrants 
encountered at the southern border, none of these includes the illegal 
immigrants who successfully evaded our Customs and Border Patrol 
agents.
  Nevertheless, Mr. Speaker, it is actually much worse. In fact, in 
fiscal year 2023 which ended on September 30, so it doesn't include the 
record-breaking month of December, Customs and Border Protection 
reported 2.48 million illegal immigrant encounters, and there were over 
1.1 million known got-aways. That includes 169 people who were stopped 
trying to cross the border in fiscal year 2023 whose names appear on 
the terrorist watch list, which is more than in fiscal years '17, '18, 
'19, '20, '21, and '22 combined. Or to put it another way, the entire 
Trump Presidency plus Biden's first 2 years.
  Additionally, border officials seized 27,293 pounds of fentanyl in 
fiscal year 2023. That is a whopping 464 percent increase from 2020 
and, obviously, points out the failure of the White House and the 
Department of Homeland Security to enforce our Nation's laws.
  Their desire for open border policies is wreaking havoc on an entire 
generation of young people in my home State and across our country who 
are dying from fentanyl overdose at an alarming rate.
  From halting border wall construction to ending the successful remain 
in Mexico program implemented during the Trump administration to ending 
title 42 powers that kept illegals out of the country, the White House 
continues to send a message to the world that our borders are wide 
open.
  Thankfully, there is a solution that would make for a great new 
year's resolution. The House Republicans passed H.R. 2, the Secure the 
Border Act of 2023. It would end the catch-and-release policy, pay more 
for Border Patrol agents, restart important border wall construction, 
and strengthen and streamline the asylum process.
  The bottom line is we must enforce the laws already on the books and 
pass new ones that put an end to the skyrocketing illegal immigration 
disrupting every corner of America, including my home State of 
Tennessee. Unfortunately, until then, every town in President Biden's 
America will be a border town.
  Mr. MOORE of Utah. Mr. Speaker, I thank the gentleman from Tennessee 
for his remarks.
  Mr. Speaker, I echo the gentleman's sentiments, and I will continue 
to speak on it today. The solutions at the border are simple. We have 
got actual data that can just be reimplemented and we can get rid of 
the politics involved and just do something right by our Nation. We 
look forward to an opportunity to leverage this moment to get this 
border policy through. The things in H.R. 2 make absolute sense.
  I am looking forward now to the remarks of my colleague from 
Pennsylvania (Mr. Joyce).
  Mr. JOYCE of Pennsylvania. Mr. Speaker, I thank the vice chairman for 
yielding to me.
  Mr. Speaker, last week, I joined the largest congressional delegation 
in history to visit our southern border. What we saw is absolutely 
alarming. It is alarming to me personally and will be alarming to every 
American. We saw a Border Patrol station that has been under constant 
siege for months. We saw a community in Eagle Pass dealing with the 
strain of over 300,000 migrants crossing the border in the past 30 
days. We saw an emboldened cartel that continues to smuggle drugs and 
human trafficking into every community in America.
  Speaking to Border Patrol agents and local sheriffs, it is clear that 
President Biden's open border policies have led to this national 
security crisis.
  In the past 3 years, we have seen the number of attempted entries by 
individuals on the terrorist watch list skyrocket to over 100 a year 
with 1.5 million got-aways reported by the Border Patrol. That number 
is surely larger. We have seen an increase in drug smuggling with 
substances like fentanyl, methamphetamine, and heroin entering our 
Nation at record levels.
  Moreover, we have seen reports of public schools being used as 
holding facilities for migrants instead of being used for American 
students who are already suffering from historic learning losses after 
the COVID pandemic.
  All of this amounts to a pattern of failure brought on by the Biden 
administration's refusal to address the border crisis head-on.
  Half measures will not keep Americans safe. It is time for the Senate 
to pass H.R. 2, the Secure the Border Act, and begin working in good 
faith to protect our communities.
  For far too long, my constituents have been poisoned by fentanyl 
analogs that are created in China, made into pills in Mexico, and 
brought into the United States through an open southern border.
  It is time to enforce our laws. It is time to reinstate the remain in 
Mexico policy. It is time to give Border Patrol agents the tools and 
the resources that they need to protect our border and to protect the 
sovereignty of our country. It is time to secure our Nation.
  Mr. MOORE of Utah. Mr. Speaker, I thank Dr. Joyce for coming down 
over the holiday break.
  Mr. Speaker, I yield to the gentleman from Georgia (Mr. Carter).
  Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for 
yielding, and I thank him for hosting this Special Order.
  Mr. Speaker, I rise today to discuss CMS' Medicare physician fee 
schedule which threatens seniors' access to healthcare, exacerbates 
vertical consolidation within the market, and will further drive 
patients toward higher cost sites of service.
  Physician costs are growing, but their reimbursements are shrinking 
yet again.
  In America, we all want the same thing when it comes to healthcare. 
Whether you are a Republican, a Democrat, an Independent, or whatever, 
you want accessible, affordable, and quality healthcare. Everyone wants 
that.
  This is causing all three to suffer. Accessibility is decreasing. 
More physicians and more physicians are no

[[Page H43]]

longer accepting Medicaid and are no longer accepting Medicare.

  The issues are accessibility, affordability, driving patients to 
higher cost sites, and, of course, quality.
  Quality goes down when we lose quality physicians, and we are losing 
them. They are getting out of the practices because they can't afford 
to stay in the practices. In fact, Medicare doctor payments have been 
cut by almost 10 percent over the last 4 years. This is simply 
unsustainable.
  Fortunately, we have a window of opportunity to right this wrong and 
support the thousands of hardworking men and women serving millions of 
Medicare beneficiaries. Over the holidays, I spoke with doctors in my 
district who are preparing to make painful decisions including service 
reductions and hiring freezes.
  For patients, this means an inability to get even basic healthcare 
services close to their homes or longer wait times as overwhelmed staff 
race to keep up.
  That is why I am working closely with my bipartisan colleagues on a 
permanent solution, but we need to stop the full 3.37 percent cut and 
ensure that physicians have the financial support necessary to care for 
our seniors.
  This is the United States of America. We have the greatest healthcare 
system in the world, and we are ruining it.
  Again, I don't care if you are a Republican, Democrat, Independent, 
red, blue, or green. I don't care. We all want the same thing. We want 
accessible, affordable, quality healthcare. This is ruining it. We have 
got to compensate our physicians.
  Mr. MOORE of Utah. Mr. Speaker, I thank the gentleman from Georgia 
for his remarks emphasizing the need for good healthcare.
  I hear this from several of my friends, family, and constituents back 
home. I think one of the most alarming things that we are seeing right 
now in the healthcare provider world is that--when I grew up, a lot of 
my friends' parents were physicians. They would always encourage their 
child to go into medical school and pursue a career that they loved so 
much. This may just be an anecdote, but I am literally seeing that next 
generation of current providers saying: Try something different.
  Again, that may just be my experience. I don't think it is because I 
have heard a lot of it from other colleagues of mine. We can't look 
back at this time and say we didn't address this issue of not doing 
right by our providers, by our rural healthcare and making sure that 
they have what they need to be able to navigate the costs that are 
continually increasing and being able to provide for their patients.
  As Dr. Murphy also talked about, we have to have private practices 
being able to stay nimble and focused on their specific community and 
not just build big conglomerates. Small business is the backbone of our 
Nation, and that needs to exist also in our healthcare market.
  As I close here, let me just turn to the other topic that we talked 
heavily about today which is the border. I spent some time at home the 
last few weeks, and as I met with and had different forums back home 
with constituents, I explained to them that one of the biggest problems 
is the way that policy works in Washington, D.C.
  It is in a very partisan and difficult circumstance back here. I 
don't think anybody on either side of the aisle would disagree with me 
that it becomes very difficult. When we factor in the Senate that 
requires a 60-vote threshold--every bill needs to be bipartisan in the 
Senate--that requirement isn't here in the majoritarian rule House, but 
that is what we live with. Particularly when there is split government, 
then we have difficult decisions and difficult things to navigate.
  The point that I made to them was that with my Democratic colleagues, 
we often can find the first three or four provisions of a particular 
issue that we agree with, but then that is when it becomes difficult 
because if Democrats want the fifth, the sixth, and the seventh item, 
then they will say, no, we are not going to vote on any of the things 
we agree on until we get some of these things we want, even though we 
agree on the baseline.
  We do it too. We have certain things that we want to make sure we get 
so we are going to leverage that so we don't get the basics done.
  I can't think of a scenario where this applies more than our border 
crisis right now. I don't want to make this political. I remember a 
little while ago when there were 34-odd migrants that suffocated in the 
back of a truck. It was like a blip on the news feed. It was so quick. 
It came out as a news cycle. That is the danger of what is going on 
right now. We have empowered the cartel networks that we should be 
united against. We have empowered the cartel networks to own the 
border.
  I heard a staggering statistic--I don't have the number in front of 
me--on what we have calculated on how much money those cartels are 
making on a weekly to monthly basis. It is terrifying because that 
number is going directly into the drug trade.
  The fentanyl crisis is one of the biggest impacts this has on our 
community. I held this huge roundtable back in Utah with the 
caretakers, law enforcement, and advocacy groups. It was a very 
nonpartisan conversation, and it was so, so concerning on what was 
going on.
  This is what I want to tell the American people: We actually agree 
that we should do a lot of the elements in H.R. 2. We should shore up 
that protection and border security. However, then we need to make sure 
we streamline the visa process, and we need to make sure we get a 
stronger workforce here.
  I am here to tell you, Mr. Speaker, we actually largely will agree on 
that aspect of a comprehensive immigration reform.

                              {time}  1615

  My biggest criticism of President Biden and his administration has 
been that he immediately removed or reversed the Migrant Protection 
Protocols, the remain in Mexico policy that the Trump-Pence 
administration had done. ``Well, we are a new administration. We have 
to reverse all those things.''
  A lot of the energy things were done by executive order. It was also 
this border policy. I think we are seeing now it is okay to have made a 
mistake if you are willing to be the adult and say: ``Look, we actually 
should reimplement some of this stuff.''
  It is what the American people need. It is what the polling will tell 
us. It is what we largely agree, that there are some basic things that 
we can get done.
  I think not telling the cartels: ``Hey, if you just get folks to the 
border and get them across, they are going to get lost in the system. 
You are going to be in there, and you are going to be fine.'' That is 
what they are telling them. The immigrants who are coming here, it is 
not the experience they are having because they get lost in the system 
and then are forced to go into the drug trade or forced to be part of 
the workforce of the Sinaloa cartel once they rush the product through 
the borders however they get it, whether it is a port or nonport. I 
don't care how it comes through.
  Once that product gets here, then these individuals get leveraged to 
do that because they have no other options because they were lied to by 
the cartels.
  If we can agree on some basic stuff, let's implement it. If we shore 
up and get back to times that we saw in previous Presidencies, we can 
then go and actually work on some of the other immigration policies 
that also need reform.
  I am committed to doing that, and I hope that we can address that. If 
we leave the border with this type of policy that we have seen create a 
beacon for these cartels, then we will not be able to accomplish 
anything.
  If it has to be done all in one bill, that is unrealistic because it 
is just a bigger beacon. It is just more opportunity for the cartels to 
try to get more people through, and it is nonsensical.
  I hope for every opportunity to tell the Biden administration that 
this is actually better for you politically. I hate to say it, but this 
is what the American people need.
  That is what my colleagues are trying to emphasize. That is why over 
64 of my colleagues last week spent time down there. The same things 
that I saw months ago when I visited Eagle Pass are continuing. They 
are not getting better. There has to be policy change.
  Mr. Speaker, I appreciate my colleagues for attending today's Special

[[Page H44]]

Order and sharing their thoughts on these very important issues, and I 
yield back the balance of my time.

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