[Congressional Record Volume 171, Number 194 (Tuesday, November 18, 2025)]
[House]
[Pages H4765-H4767]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 CELEBRATING NATIONAL RURAL HEALTH DAY

  (Under the Speaker's announced policy of January 3, 2025, Ms. Tokuda 
of Hawaii was recognized until 10 p.m. as the designee of the minority 
leader.)


                             General Leave

  Ms. TOKUDA. 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 in the Record.
  The SPEAKER pro tempore (Mr. Hurd of Colorado). Is there objection to 
the request of the gentlewoman from Hawaii?
  There was no objection.
  Ms. TOKUDA. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, today we celebrate National Rural Health Day here on the 
House floor, standing shoulder to shoulder with our colleagues in the 
Bipartisan Rural Health Caucus. I am very humbled and honored to be 
here with my friend and fellow co-chair, Representative Diana 
Harshbarger.
  A big mahalo, as we have just heard from Members on both sides of the 
aisle, who took to the floor to raise up the needs, the challenges, the 
hopes, and the dreams for healthcare in rural America.
  Mr. Speaker, at this time I yield to the gentlewoman from Tennessee 
(Mrs. Harshbarger).
  Mrs. HARSHBARGER. Mr. Speaker, I rise today to honor National Rural 
Health Month and to honor the men and women who keep healthcare alive 
in America's small towns and rural communities.
  As co-chair of the Congressional Bipartisan Rural Health Caucus, I am 
proud to join my colleagues in leading an effort to ensure the millions 
of Americans who live in rural areas, including the hardworking people 
of Tennessee's First District, receive the same quality of care as 
anyone else in the Nation.
  In northeast Tennessee, rural healthcare is a lifeline to people, 
especially those who live in remote areas and are limited or have no 
mode of transportation. They depend on a nurse to drive during the 
night and before dawn to check on a patient or the pharmacist who knows 
every family by name and stretches every dollar to keep medicine 
affordable. It is the doctor who stays late to see one more patient 
because there is no one else to take the next shift.
  These are the people who form the backbone of our rural healthcare 
communities, and they deserve a system that works as hard for them as 
they do for us.
  The truth is, rural healthcare has always faced an uphill battle. 
When a rural hospital shuts down, it just doesn't take away healthcare. 
It takes away jobs, stability, and peace of mind.
  It means longer drives for emergency care, fewer options for 
expectant mothers, and limited access for seniors and veterans who 
depend on those services the most.
  The systems that are supposed to support them is too often buried in 
bureaucracies.
  Pharmacy benefit managers are manipulating drug prices, restricting 
choices, and squeezing out small-town pharmacies that are fighting just 
to survive.
  These PBMs never see a patient, but they control what medicines 
people can get and at what cost.
  That is wrong, and I have been proud to lead bipartisan legislation 
to bring transparency, accountability, and fairness to that system 
because patients and pharmacists alike deserve better.

                              {time}  2150

  I have made it my mission to champion these policies that put people, 
not politics, first. Under President Trump's leadership, we signed the 
Working Families Tax Cuts Act into law this year. This critical 
legislation included the single largest investment in rural healthcare 
in history. That is $50 billion for a Rural Health Transformation Fund 
to reinvest Federal savings directly into the communities that need it 
most, expanding telehealth, and recruiting and retaining rural 
healthcare workers.

[[Page H4766]]

  We are committed to ensuring telehealth remains an option for those 
living in rural communities. Telehealth provides expanded access to 
specialists, closes the distance between patients and providers, and 
gives families faster, more reliable care.
  I have legislation, the Rural Physician Workforce Production Act, 
that would help bring more doctors to rural communities by giving rural 
hospitals the resources they need to train and retain more physicians.
  I have fought to strengthen our Nation's drug supply chain by 
supporting domestic pharmaceutical manufacturing, including facilities 
like USAntibiotics in Bristol, Tennessee, where we are proving that 
these lifesaving antibiotics can and should be made right here in the 
United States and not halfway around the world.
  Mr. Speaker, these aren't abstract policy debates. They are about 
real people and real places. They are about the mom who drives an hour 
to find a pediatric specialist. They are about the veteran who can't 
get his prescription filled because his local pharmacy closed. They are 
about the nurse who works back-to-back shifts because there aren't 
enough hands to go around.
  Those stories are what drive my work every single day. That is why I 
have joined my co-chair, Representative Tokuda, in introducing a 
resolution to recognize November 20, 2025, as National Rural Health 
Day. This resolution recognizes the challenges we face, but more 
importantly it affirms our commitment to solving them.
  I thank Representative Tokuda for her continued commitment on working 
together to address the pressing healthcare issues facing our rural 
communities. We must fight for a healthcare system that serves 
patients, not big insurance companies; that values rural providers, not 
red tape; and ensures no community, no matter how small or remote, is 
left behind.
  We thank the doctors, nurses, pharmacists, and first responders who 
keep rural America healthy. Their work saves lives. Their compassion 
gives hope, and their dedication holds our communities together.
  As long as I have the privilege to serve the people of Tennessee's 
First District, and as co-chair of the Rural Health Caucus, I will 
continue that fight. We are united in our shared mission to strengthen 
rural healthcare, protect patient access, and preserve the small-town 
values that make this Nation strong.
  Ms. TOKUDA. Mr. Speaker, National Rural Health Day is a chance to 
honor the communities that keep this country moving: the farmers, 
teachers, ``seniors,'' ``kupuna,'' health workers, first responders, 
small business owners, and families who fuel our local economies and 
preserve our way of life. It is also a moment for Congress to recognize 
that rural communities face challenges that are different not because 
they are less but because they are often asked to survive systems that 
were not built for them.
  What some in Washington call innovation is really rural America being 
forced into a constant state of adaptation, forced to make do, to 
improvise, and stretch thin resources even thinner simply to maintain 
basic access to healthcare.
  Every day in Hawaii, I see mobile clinics reaching isolated 
communities, school-based health centers stepping up for low-income 
children, and community health workers bridging cultural and geographic 
divides. Rural communities everywhere are pioneering models of 
behavioral health integration in telemedicine, not from a place of 
creativity or convenience but necessity and survival.
  We have proven we can adapt to impossible situations, but 
extraordinary flexibility cannot and must not replace true investment. 
Ingenuity cannot replace Federal partnership, and resilience cannot 
continue to be a substitute for resources.
  We have unfinished business here before us in Congress, but what 
gives me hope is that we have allies and advocates on both sides of the 
aisle ready to lead.
  Across the country, from the volcano-lined communities in my district 
of Ka'u to the farming slopes of Upcountry Maui, to the taro patches 
that I see on Kauai, one truth is crystal clear: Rural America is tired 
of being resilient.
  When people call us resilient, what they are really saying is we have 
been forced to survive hardship. Resilience means we are struggling. 
Resilience means we are being asked to endure what no community should 
ever be asked to endure.
  Our people cannot survive on resiliency alone. Rural America is tired 
of being tired. Rural America is tired of jumping from one difficult 
situation to another. Rural America is tired of learning to bend 
without breaking due to a lack of resources, investment, and support.
  What rural America needs is an immediate, revolutionary, 
transformational investment, a historic top-to-bottom overhaul that 
rebuilds the healthcare system from the inside out. Rural America needs 
a profound change on a scale that we have not yet seen before and, most 
importantly, rural America, where we all live, needs a chance to be 
known as more than just resilient. It deserves a chance to thrive.
  We cannot rely on Band-Aids, small steps forward, and short-term 
pilot projects, especially when we know families are driving hours or 
having to even get on a plane for care. Hospitals are closing, 
behavioral health crises are going untreated. When the difference 
between life and death is the difference between one rural town and the 
nearest city, this is unacceptable. Our people will literally die 
without bold, immediate, systemic action on rural health.

  Today, we still lack long-term stability for community health 
centers, teaching health centers, and the National Health Service 
Corps. Critical workforce and training programs remain stuck in 
reauthorization limbo, and bipartisan bills to strengthen EMS capacity, 
expand telehealth, and improve behavioral health access still await 
action.
  We said these issues were urgent last year when we were on the floor. 
They are even more urgent today. Rural communities cannot afford 
another year of waiting. That is why we are pushing forward with real, 
bipartisan solutions that simply cannot wait another Congress to be 
enacted into law.
  My rural health clinic modernization package, including the Rural 
Behavioral Health Improvement Act, cuts red tape and strengthens 
reimbursements so rural clinics can stay open.
  The HEALTH Act protects telehealth access, including audio-only 
visits for families who lack broadband or live hours away from their 
care.
  The Community TEAMS Act and Strengthening Pathways to Health 
Professions Act rebuild the rural workforce pipeline, supporting 
students and providers and keeping scholarships and loan repayment 
programs accessible and tax free.
  The Rural Health Care Technical Assistance Act gives rural facilities 
the tools they need to prevent closures and stay financially stable.
  These are practical, bipartisan solutions built for lasting impact, 
not another short-term fix to grab a headline. That is why caucuses 
like ours, the Bipartisan Rural Health Caucus, and Special Order hours 
like the ones that you have seen tonight matter. They remind America 
and this Congress that despite everything going on in our politics, 
there is still a path forward. There is still work we can only 
accomplish together.
  In closing, I thank all of my colleagues who joined us tonight to 
give their speeches and to the over 70 Members, Republicans and 
Democrats, who make up our caucus. Their presence sends a clear 
message: Rural communities matter.
  The voices of my constituents in Hawaii and rural Americans across 
this great country keep us grounded. Every nurse, doctor, EMT, 
pharmacist, community health worker, and small clinic team show us both 
the urgency and the solutions every single day. This work is not just 
policy. It is people. It is families. It is the future of rural 
America.
  Let's continue to listen, to act, and deliver together because when 
rural communities thrive, all of America thrives.
  Mr. Speaker, I yield back the balance of my time.

[[Page H4767]]

  

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