We need to make health care more accessible and affordable for families, which means preserving the parts of our health care system that work and fixing the ones that don’t. We can’t accept reckless proposals that would leave thousands of San Diegans without quality, affordable health care, so I will continue to work on bipartisan solutions that ensure San Diegans and Americans don’t lose their health care. This includes keeping our promises to our veterans by improving efficiency, quality, and access of care at the VA. It also means standing up for women’s health care and reproductive rights. Finally, San Diego is leading the way in life-saving research that is finding cures and improving quality of life for patients. Preserving basic scientific research funding through NIH helps San Diego’s life sciences industry continue developing innovative treatments and life-saving care. 

Fixing the Affordable Care Act

Americans deserve affordable, accessible health care. The Affordable Care Act (ACA) has provided millions of people across the country with affordable health coverage. Repealing the ACA would result in many Americans losing access to their health care. I will continue to oppose any efforts that rip health care from San Diegans and also work to drive down health care costs and expand access for all Americans.

• Supported “Solutions Over Politics” to fix the ACA as a member of the Problem Solvers’ Caucus. The plan aims to stabilize the individual marketplace through realistic solutions.
• Developed a step-by-step plan to strengthen the ACA that I laid out in an op-ed in the San Diego Union-Tribune.
• Co-sponsored the Patient Access to Durable Medical Equipment Act (PADME Act), which would preserve patient access to durable medical equipment (DME) in non-competitive bid areas, the majority of which are rural communities. Durable Medical Equipment includes equipment includes wheelchairs, canes, kidney machines, ventilators, oxygen, monitors, and hospital beds. This bill passed the House of Representatives.
• Co-sponsored and helped pass the Protecting Affordable Coverage for Employees Act, which amended the Patient Protection and Affordable Care Act (PPACA) and Public Health Service Act to include employers with 51 to 100 employees as large employers in order to expand the required coverage by employers for their employees. This is now law.
• Co-sponsored the Patient Protection and Affordable Care Act, which would fully repeal a 40 percent tax on high-cost health insurance plans, enacted as part of the Affordable Care Act– nicknamed the “Cadillac Tax”. Due to the 22 trillion-dollar debt, caused in part by the Republican tax bill, a full repeal cannot be done without budget offsetting. Voted against repealing the “Cadillac Tax” because of its failure to replace revenue, corresponding cuts to other spending, or another way to rein in healthcare costs for millions of Americans.
• Co-Sponsored the Protect Medical Innovation Act of 2019, which would repeal the medical device excise tax on the sale of a medical device by the manufacturer, producer, or importer.

Investing In Innovative Care and Treatment

San Diego is home to innovative research institutions and companies that are making groundbreaking discoveries and cures every day. We must support funding to advance medical innovation, more treatment options, and better patient care. This investment will also help boost our regional economic growth and create new jobs.

• Introduced the Ending the Diagnostic Odyssey Act of 2019, which would provide federal funding to states to support the use of whole genome sequencing–an innovative, cost-effective tool that uses DNA–to diagnose children that may have conditions including neurologic, metabolic, and other inherited diseases. It can ensure children receive appropriate treatment as fast as possible and potentially save lives.
• Introduced the Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2019 to ensure adequate Medicare reimbursement to hospitals for procedures that use radiopharmaceuticals for medical imaging to diagnose, evaluate, and treat certain conditions and cancers. The result would be more accurate diagnoses, faster treatment, higher quality care, and lower costs for patients and taxpayers.
• Introduced the Laboratory Access for Beneficiaries Act, which would direct the National  Academy of Medicine and the Centers for Medicare and Medicaid Services (CMS) to study and make recommendations to improve how CMS collects data on lab reimbursements for life-saving lab services. Without a broad and representative collection of data, CMS's current reimbursement methodology could underpay for lab services, causing small labs in rural locations to close and potentially higher costs for seniors.
• Introduced the Postoperative Opioid Prevention Act of 2018, which would incentivize the development of non-opioid painkillers and increase access to these innovative drugs for doctors and patients. It removes an incentive for CMS to prescribe opioids if less addictive non-opioid alternatives can demonstrate a substantial clinical improvement from available drugs on the market. 
• Introduced a bipartisan resolution to designate the first week of May as "National Mental Health No Stigma Week" to reduce the stigma that prevents too many Americans from seeking mental health treatment.
• Introduced the Suicide and Threat Assessment Nationally Dedicated to Universal Prevention Act of 2019, which encourages schools to expand evidence-based suicide prevention training to students in grades 6 through 12. It would assist students and schools with threat identification, triage, and intervention, as well as guidance and protocol for coordinating with local law enforcement using established school threat assessment models.
• Introduced the Adding Middle East Respiratory Syndrome to the FDA Priority Review Voucher Program Act, which would amend the Federal Food, Drug and Cosmetic Act to include Middle East Respiratory Syndrome under the priority voucher program from tropical diseases, which helps accelerate the review of a drug by the FDA and incentivizes sponsors to research and develop treatments for otherwise non-profitable drugs.
• Co-sponsored and helped pass the Action for Dental Health Act of 2018, which provides essential oral and dental health services to underserved communities. The Action for Dental Health Act targets federal funding to provide vulnerable populations, especially children, seniors and those living in rural and urban communities with dental care. This is now law.
• Co-sponsored and helped pass the Preventing Maternal Deaths Act of 2018, which establishes state Maternal Mortality Review Committees to review every pregnancy-related or pregnancy-associated death, and based on those findings, develop recommendations for how to prevent future mothers’ deaths. This is now law.
• Co-sponsored and helped pass the Firefighter Cancer Registry Act of 2018, which requires the Centers for Disease Control and Prevention (CDC) to create a national cancer registry for firefighters. It would monitor and study the relationship between career-long exposure to dangerous fumes and toxins and the incidence of cancer in firefighters to develop better protective gear and prevention techniques. This is now law.
• Co-sponsored and helped pass the RAISE Family Caregivers Act, which directs the Secretary of Health and Human Services to develop a national family caregiving strategy to identify actions efforts of communities, providers, government, and others to recognize and support family caregivers. This is now law.
• Co-sponsored and helped pass the Helping Families in Mental Health Crisis Act of 2016, which aims to expand the influence of psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. This bill passed the House of Representatives.
• Co-sponsored and helped pass the Protecting Our Infants Act of 2015, which authorizes the Department of Health and Human Services (HHS) to plan and coordinate activities related to prenatal opioid abuse and neonatal abstinence syndrome (NAS). It would require the Centers for Disease Control and Prevention (CDC) to expand data collection and surveillance activities and would require the Agency for Healthcare Research and Quality (AHRQ) to study and recommend treatments for prenatal opioid abuse and NAS. This bill passed the House of Representatives.
• Co-sponsored and helped pass the Sports Medicine Licensure Clarity Act of 2016, which would allow licensed athletic trainers and other sports medicine professionals traveling with athletic teams to provide medical services without obtaining licenses to practice in other states. It would require insurers to cover the liability of the trainers when they provide medical services for their athletes outside of their home state. This bill passed the House of Representatives.
• Co-sponsored and helped pass the 21st Century Cures Act, which would accelerate the development of new therapies and treatments to patients who need them faster and more efficiently. It also provides new authority to help FDA recruit and retain scientific, technical, and professional experts and it establishes new expedited product development programs. This bill passed the House of Representatives.
• Co-sponsored and helped pass the Childhood Cancer STAR Act, which would help advance research efforts to discover new therapies and treatments to combat pediatric cancer and improve the overall quality of life for pediatric cancer survivors through enhanced monitoring and treatment systems. This bill passed the House of Representatives.

Strengthening Our Health Care Workforce

Doctors, nurses, social workers, and other caregivers help keep our community healthy and safe. We need to update our laws to protect and uplift employees in the workplace and invest in future talent to retain a strong, ethical workforce. We must provide those who dedicate their lives to caring for others with the support they deserve.

• Co-Introduced and helped pass the Title VIII Nursing Workforce Reauthorization Act of 2019, which would extend advanced education nursing grants to support clinical nurse specialist programs. This bill passed the House of Representatives.
• Co-sponsored and helped pass the Palliative Care and Hospice Education and Training Act, which would authorize several grant programs to educate and train palliative care workers and direct the National Institutes of Health (NIH) to develop a strategy for expanding research in palliative care. This bill passed the House of Representatives.
• Co-sponsored and helped pass the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, which would authorize funding to support national preparedness for public health emergencies and widespread medical emergencies, including acts of bioterrorism, by bolstering readiness, response and recovery programs. This bill passed the House of Representatives.
• Co-sponsored and helped pass the Dr. Benjy Frances Brooks Children's Hospital GME Support Reauthorization Act of 2018, which amends the Public Health Service Act to authorize payments to children’s hospitals for operating training programs that provide graduate medical education (GME). This is now law.
• Co-sponsored and helped pass the Synthetic Drug Awareness Act, which would require the Surgeon General to report to the Congress on the health effects of synthetic psychoactive drugs on children between the ages of 12 and 18. This bill passed the House of Representatives.
• Co-sponsored and helped pass the Veteran Emergency Medical Technician Support Act of 2016, which would direct the Secretary of Health and Human Services (HHS) to award demonstration grants to states to streamline procedures for licensing and certifying emergency medical technicians (EMT) who received similar certifications while serving in the Armed Forces. This bill passed the House of Representatives.
• Co-sponsored and helped pass the Improving Access to Maternity Care Act, which would direct the Health Resources and Services Administration to identify geographic areas experiencing a shortage of health professionals practicing in maternity care. This bill passed the House of Representatives.

Caring For Our Seniors

Seniors in San Diego and across the country have the right to age with dignity. Medicare represents a contract between the government and generations of Americans who worked hard and paid into these programs over a lifetime. For many of our seniors, they are a lifeline and we must ensure they best serve their unique needs. I am committed to increasing comfort, ensuring financial stability, and providing choices for San Diego’s senior community.

• Co-sponsored the Protecting Seniors Access to Medicare Act, which amends the Patient Protection and Affordable Care Act (PPACA) to terminate the Independent Payment Advisory Board (IPAB), which had authority to create proposals to reduce Medicare expenditures that would automatically become law. There were concerns with the authority and constitutionality of the IPAB. This bill passed the House of Representatives.
• Co-sponsored and helped pass the Local Coverage Determination Clarification Act of 2018, which increases transparency of private contractors that develop coverage and payment policies within the Medicare program by allowing public comments on the proposed policies. This bill passed in the House of Representatives.
• Co-sponsored and helped pass the National Clinical Care Commission Act, which would establish a National Clinical Care Commission within the Department of Health and Human Services (HHS) to evaluate federal clinical care programs for individuals with a complex metabolic or autoimmune disease such as diabetes. Within three years, the Commission would be required to issue a report that includes suggested improvements for federally-funded clinical and educational initiatives focused on the targeted populations. This bill passed the House of Representatives.