1600 Daily The White House • July 10, 2019 President Trump Refuses to Accept the Status Quo on One of America’s Deadliest Diseases

The White House • July 10, 2019 President Trump refuses to accept the status quo on one of America’s deadliest diseases  Across America, 37 million patients suffer from chronic kidney disease. Each year, more than 100,000 begin dialysis to treat end-stage renal disease—50 percent of whom die within five years. That mortality rate is far too high. All told, kidney disease ranks as the ninth leading cause of death in America. The current quality of care for these patients is unacceptable, and the treatment options available to them are far too expensive.   President Donald J. Trump, as with so many other issues confronting America, has refused to accept that awful status quo. At the Ronald Reagan Building and International Trade Center in Washington today, he signed an executive order that takes the biggest step in decades toward advancing American kidney health.  President Trump: It’s time to get “Americans off these waitlists.” “Today we’re taking groundbreaking action to bring new hope to millions of Americans suffering from kidney disease,” he said. Under President Trump’s new order, Medicare will test adjusting payment incentives to encourage preventative kidney care, as well as the use of home dialysis and kidney transplants. Furthermore, the President is directing his Administration to develop a process to get artificial kidneys to patients and expedite the process of kidney matching. And crucially, the President is beginning the process of removing financial barriers to organ donation, including by allowing for the reimbursement of lost wages and childcare expenses faced by organ donors. “For these patients, their loved ones, and for the impacted—all those impacted by kidney disease—I'm here to say: We are fighting by your side, and we're determined to get you the best treatment anywhere in the world,” President Trump said. President Trump’s executive order is a bold new approach to kidney treatment.  President Trump: “We are with you every step of the way.” Ivanka Trump helps secure women’s rights legislation in Ivory Coast  In April, Advisor to the President Ivanka Trump traveled to Africa, where she made the case for advancing women’s rights and legal status across the world. One of the countries she visited, Ivory Coast, today took concrete steps toward that vision by passing legislation encouraged by Ms. Trump. “We are pleased to recognize and applaud the Ivorian government’s recent passage of the marriage law, which supports women’s equal management of household assets,” she said in a statement to The Associated Press. This new legislation paves the way for the economic empowerment of women and sets an example for other countries to follow. Specifically, the updated family code makes the social and political landscape more equitable for women by getting rid of laws that prevented them from owning or inheriting property. Reforms such as these are a top priority for the White House’s Women’s Global Development and Prosperity Initiative (W-GDP), which Ivanka Trump helps lead. W-GDP’s core message is that when women are empowered, both their families and their communities benefit substantially. Launched in February, W-GDP aims to empower 50 million women throughout the world by 2025. Today, U.S. International Development Agency Administrator Mark Green, alongside Ms. Trump, announced 14 new projects in support of W-GDP. These partnerships alone will leverage millions of dollars to reach more than 100,000 women in the years ahead. The Associated Press: Ivory Coast passes legislation encouraged by Ivanka Trump Learn more: President Trump’s W-GDP aims to empower 50 million women   Photo of the Day Official White House Photo by Shealah Craighead President Donald J. Trump signs an Executive Order on Advancing American Kidney Health at the Ronald Reagan Building and International Trade Center in Washington, D.C. | July 10, 2019

President Donald J. Trump Announces Intent to Nominate Personnel to Key Administration Posts

Office of the Press Secretary FOR IMMEDIATE RELEASE July 10, 2019 President Donald J. Trump Announces Intent to Nominate Personnel to Key Administration Posts  Today, President Donald J. Trump announced his intent to nominate the following individuals to key positions in his Administration: Sung Y. Kim of California, to be Ambassador Extraordinary and Plenipotentiary to the Republic of Indonesia. Sung Y. Kim is a career member of the Senior Foreign Service, class of Career Minister, and currently serves as Ambassador to the Philippines.  Ambassador Kim’s extensive history of public service at the Department of State, including as Ambassador to the Republic of Korea, Special Envoy for the Six Party Talks, Director of the Office of Korean Affairs, Special Representative for North Korea Policy, and Deputy Assistant Secretary of State in the Bureau of East Asian and Pacific Affairs.  Earlier in his career, Ambassador Kim served as a Political Officer at the Embassies in Seoul, Republic of Korea, Tokyo, Japan, and Kuala Lumpur, Malaysia.  Ambassador Kim earned his B.A. from the University of Pennsylvania, J.D. from Loyola University Law School, and Masters of Law from the London School of Economics and Political Science.  Ambassador Kim received the Presidential Meritorious Honor Award in 2018, and he speaks Korean and Japanese. Adam Seth Boehler of California, to be Chief Executive Officer of the United States International Development Finance Corporation. Adam Seth Boehler currently serves as Senior Advisor to the Secretary of the Department of Health and Human Services, Deputy Administrator of the Centers for Medicare and Medicaid Services, and Director of the Center for Medicare & Medicaid Innovation.  Mr. Boehler is founder and former CEO of Landmark Health, which provides affordable in-home medical care for 100,000 vulnerable people and employs 1,000 people in the United States and India.  Adam graduated magna cum laude from the Wharton School of the University of Pennsylvania.

July 10, 2019 Executive Order - ADVANCING AMERICAN KIDNEY HEALTH

Office of the Press Secretary FOR IMMEDIATE RELEASE July 10, 2019 Executive Order - - - - - - - ADVANCING AMERICAN KIDNEY HEALTH        By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:      Section 1.  Purpose.  My Administration is dedicated to advancing American kidney health.  The state of care for patients with chronic kidney disease and end-stage renal disease (ESRD) is unacceptable:  too many at-risk patients progress to late-stage kidney failure; the mortality rate is too high; current treatment options are expensive and do not produce an acceptable quality of life; and there are not enough kidneys donated to meet the current demand for transplants.      Kidney disease was the ninth-leading cause of death in the United States in 2017.  Approximately 37 million Americans have chronic kidney disease and more than 726,000 have ESRD.  More than 100,000 Americans begin dialysis each year to treat ESRD.  Twenty percent die within a year; fifty percent die within 5 years.  Currently, nearly 100,000 Americans are on the waiting list to receive a kidney transplant.      Sec. 2.  Policy.  It is the policy of the United States to:      (a)  prevent kidney failure whenever possible through better diagnosis, treatment, and incentives for preventive care;      (b)  increase patient choice through affordable alternative treatments for ESRD by encouraging higher value care, educating patients on treatment alternatives, and encouraging the development of artificial kidneys; and      (c)  increase access to kidney transplants by modernizing the organ recovery and transplantation systems and updating outmoded and counterproductive regulations.      Sec. 3.  Announcing an Awareness Initiative on Kidney and Related Diseases.  Within 120 days of the date of this order, the Secretary of Health and Human Services (Secretary) shall launch an awareness initiative at the Department of Health and Human Services (Department) to aid the Secretary's efforts to educate patients and support programs that promote kidney disease awareness.  The initiative shall develop proposals for the Secretary to support research regarding preventing, treating, and slowing progression of kidney disease; to improve kidney transplantation; and to share information with patients and providers to enhance awareness of the causes and consequences of kidney disease.      Sec. 4.  Payment Model to Identify and Treat At-Risk Populations Earlier in Disease Development.  Within 30 days of the date of this order, the Secretary shall select a payment model to test innovations in compensation for providers of kidney care services based on kidney patient cost and quality outcomes.  The model should broaden the range of care and Medicare payment options available to potential participants with a focus on delaying or preventing the onset of kidney failure, preventing unnecessary hospitalizations, and increasing the rate of transplants.  It should aim at achieving these outcomes by creating incentives to provide care for Medicare beneficiaries who have advanced stages of kidney disease but who are not yet on dialysis.  The selected model shall include options for flexible advance payments for nephrologists to better support their management and coordination of care for patients with kidney disease.      Sec. 5.  Payment Model to Increase Home Dialysis and Kidney Transplants.  Within 30 days of the date of this order, the Secretary shall select a payment model to evaluate the effects of creating payment incentives for greater use of home dialysis and kidney transplants for Medicare beneficiaries on dialysis.  The model should adjust payments based on the percentage of a participating provider's attributed patients who either are on home dialysis or have received a kidney transplant and should include a learning system to help participants improve performance.  Greater rates of home dialysis and transplantation will improve quality of life and care for patients who require dialysis and may eliminate the need for dialysis altogether for many patients.      Sec. 6.  Encouraging the Development of an Artificial Kidney.  Within 120 days of the date of this order, in order to increase breakthrough technologies to provide patients suffering from kidney disease with better options for care than those that are currently available, the Secretary shall:      (a)  announce that the Department will consider requests for premarket approval of wearable or implantable artificial kidneys in order to encourage their development and to enhance cooperation between developers and the Food and Drug Administration; and      (b)  produce a strategy for encouraging innovation in new therapies through the Kidney Innovation Accelerator (KidneyX), a public-private partnership between the Department and the American Society of Nephrology.      Sec. 7.  Increasing Utilization of Available Organs.  (a)  Within 90 days of the date of this order, the Secretary shall propose a regulation to enhance the procurement and utilization of organs available through deceased donation by revising Organ Procurement Organization (OPO) rules and evaluation metrics to establish more transparent, reliable, and enforceable objective metrics for evaluating an OPO's performance.      (b)  Within 180 days of the date of this order, the Secretary shall streamline and expedite the process of kidney matching and delivery to reduce the discard rate.  Removing process inefficiencies in matching and delivery that result in delayed acceptance by transplant centers will reduce the detrimental effects on organ quality of prolonged time with reduced or cut-off blood supply.      Sec. 8.  Supporting Living Organ Donors.  Within 90 days of the date of this order, the Secretary shall propose a regulation to remove financial barriers to living organ donation.  The regulation should expand the definition of allowable costs that can be reimbursed under the Reimbursement of Travel and Subsistence Expenses Incurred Toward Living Organ Donation program, raise the limit on the income of donors eligible for reimbursement under the program, allow reimbursement for lost-wage expenses, and provide for reimbursement of child-care and elder-care expenses.      Sec. 9.  General Provisions.  (a)  Nothing in this order shall be construed to impair or otherwise affect:           (i) authority granted by law to an executive department or agency, or the head thereof; or           (ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.      (b)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.      (c)  This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.                                   DONALD J. TRUMP   THE WHITE HOUSE,     July 10, 2019.

West Wing Reads We Can't Afford to Delay Passage of USMCA Trade Deal

We Can't Afford to Delay Passage of USMCA Trade Deal “China would love nothing more than for Congress to kill the USMCA and stall future trade agreements, so it can promote its own low standards and coercive economic agenda with other countries,” Rep. Michael McCaul (R-TX) writes in The Hill. “The United States has a strategic interest in writing the future rules for trade that support U.S. competitiveness and opens markets to our goods, services and values. Passing the USMCA would kickstart a wave of bipartisan trade wins for the United States that would grow our economy and advance our interests and national security. I urge my Democratic colleagues not to delay bringing this bill forward for a vote as soon as it is sent to Congress.” Click here to read more. President Trump’s “promise of putting American workers and interests first in negotiating trade deals resonated both with the Republican base and with Democrats who felt their party had abandoned them. Making sure our international trading partners were treating us fairly was a chief campaign promise of the president,” Tennessee Lt. Gov. Randy McNally (R) writes in the Times Free Press. “The president is keeping his promise with the United States-Mexico-Canada Agreement (USMCA). It is a measured, careful approach that stays true to free trade principles while making sure our farmers, laborers and white-collar workers are protected.” “Our cumulative trade deficit with Mexico since 1985 exceeds $1 trillion, 98 percent of which came after NAFTA went into effect. This is why we need USMCA,” Commerce Secretary Wilbur Ross writes in The Roanoke Times. The new deal will finally level the playing field across American industries and will create “tens of thousands of more jobs.” “Because of the impact the agriculture industry has on Virginia’s economy, there will be no more important debate in Congress this year than the future of the North American Free Trade Agreement (NAFTA), now called the U.S.-Mexico-Canada Agreement (USMCA),” former Virginia Commerce Secretary Todd Haymore writes in the Richmond Times-Dispatch. “Our elected representatives in Washington must be ready to fight for the passage of the USMCA as soon as possible. Failure to stabilize the United States’ relationships with Canada and Mexico will have negative consequences for Virginia farmers and the national economy at large.” “One industry that the USMCA would benefit the most within Iowa is the dairy industry,” writes Larry Shover, President of the Iowa State Diary Association, in The Courier. Currently, U.S. dairy exports to Canada are heavily limited by the Class 7 pricing scheme and tariff-rate quotas. The USMCA tears down Class 7 pricing and requires more transparency, making the new trade deal vital for the U.S. dairy industry. “We need our members of Congress to ratify the USMCA now.”

PRESIDENT DONALD J. TRUMP IS TAKING A BOLD NEW APPROACH TO ADVANCE KIDNEY HEALTH

Office of the Press Secretary FOR IMMEDIATE RELEASE July 10, 2019 PRESIDENT DONALD J. TRUMP IS TAKING A BOLD NEW APPROACH TO ADVANCE KIDNEY HEALTH  “We believe in giving patients choice and freedom in healthcare, ensuring access to the doctors they want, the treatments they need, and the highest standard of medical care anywhere in the world.” – President Donald J. Trump     ADVANCING KIDNEY HEALTH: President Donald J. Trump signed an executive order aimed at improving kidney health and promoting increased treatment options for American patients.  Today, President Trump is signing an executive order launching a kidney health initiative to improve the lives of Americans suffering from kidney disease. The initiative seeks to: Prevent kidney failure through better diagnosis, treatment, and preventative care. Increase affordable alternative treatment options, educate patients on treatment alternatives, and encourage the development of artificial kidneys. Increase access to kidney transplants by modernizing the transplant system and updating counterproductive regulations. Under the executive order, Medicare will test adjusting payment incentives to encourage preventative kidney care and the use of home dialysis and kidney transplants. President Trump is directing his Administration to develop a process to get artificial kidneys to patients in order to encourage development of such technology. The Administration will take action to streamline and expedite the process of kidney matching in order to help increase transplants. The President is beginning the process of removing financial barriers to organ donation by allowing for reimbursement of lost wages and childcare expenses of organ donors. IMPROVING TREATMENT OPTIONS: The current quality of care for patients with kidney disease is unacceptable and treatment options are far too expensive.    Across America, 37 million patients suffer from chronic kidney disease and more than 726,000 have end-stage renal disease. Current available treatment options are too expensive and fail to provide a high quality of life. The mortality rate for kidney disease is far too high, with kidney disease ranked as the ninth leading cause of death in America. There are nearly 100,000 Americans waiting to receive a kidney transplant. Each year more than 100,000 Americans begin dialysis to treat end-stage renal disease, fifty percent of whom die within five years. TAKING A NEW APPROACH: President Trump has refused to accept the status quo and has taken an innovative approach to deliver new treatment options for major diseases. The President has repeatedly sought to make innovative investments that help patients and ultimately lower costs in the long run. The Trump Administration’s pediatric cancer effort has recognized that we need a different approach to cancer treatment options for children. President Trump’s initiative to fight the HIV/AIDS epidemic over the next decade will improve Americans’ lives and lower healthcare spending in the long run.   The President signed Right to Try into law, which allows terminally ill patients access to potentially lifesaving drugs. ###

Office of the Press Secretary FOR IMMEDIATE RELEASE July 10, 2019 Statement from the Press Secretary on the Visit of His Excellency Imran Khan, Prime Minister of the Islamic Republic of Pakistan President Donald J. Trump will welcome Prime Minister Imran Khan of the Islamic Republic of Pakistan to the White House on July 22, 2019. The visit will focus on strengthening cooperation between the United States and Pakistan to bring peace, stability, and economic prosperity to a region that has seen far too much conflict. President Trump and Prime Minister Khan will discuss a range of issues, including counterterrorism, defense, energy, and trade, with the goal of creating the conditions for a peaceful South Asia and an enduring partnership between our two countries.

1600 Daily The White House • July 9, 2019 See photos from First Lady Melania Trump’s visit with Families Affected by Opioids

The White House • July 9, 2019 See photos from First Lady Melania Trump’s visit with families affected by opioids   First Lady Melania Trump visited Cabell-Huntington Health Department in West Virginia yesterday to promote that community’s efforts to combat the opioid crisis. “We have an opportunity to move the needle to help families and children who have been impacted by opioid abuse,” the First Lady said. “Meeting with federal, state, and local leaders in Huntington, West Virginia, today proved the power of partnerships and community efforts.” In photos: Women of Huntington share their stories with the First Lady After a roundtable with these leaders, Mrs. Trump met with a small group of women who have been affected closely by the crisis. Among the participants were Huntington’s Fire Chief, leadership from the Lily’s Place treatment facility, a representative from a first responder wellness program, a recovery coach, and a recovering mother along with her 5-month-old child. Each one shared stories about their own experiences with America’s opioid crisis, as well as the positive impact the community has had on these families. The First Lady has been an advocate for programs that help change the lives of families who have been hurt by the opioid epidemic. As communities across America have been devastated, the lives of countless children are put in harm’s way. Visits like yesterday’s are a crucial piece of Mrs. Trump’s signature “Be Best” initiative, which focuses on the most pressing issues facing children today. “Through BE BEST, I continue to learn about the many issues and challenges surrounding opioid addiction,” Mrs. Trump said. Using this platform, “we can continue to promote programs and highlight resources available to all those who are seeking help with this national epidemic.” Before departing West Virginia, the First Lady took a moment to visit Ritter Park, where 453 American flags dot a grass field. Each flag represents a child in the foster care system in the Huntington, West Virginia, area—many as a result of the opioid epidemic. Learn more about First Lady Melania Trump’s “Be Best” initiative. President Trump welcomes Amir of Qatar This week, President Donald J. Trump has played host to a special guest: His Highness Sheikh Tamim Bin Hamad Al-Thani, Amir of the State of Qatar. “President Trump, friends: It’s a great honor to join you again in Washington, D.C. Thank you for your continued hospitality,” Qatar’s leader said last night at a dinner hosted by Treasury Secretary Steven Mnuchin. “My visit this week will reaffirm the ideals we share.”  Watch: President Trump meets with the Amir of Qatar in the Oval Office The U.S.–Qatar alliance is more important than ever, both in the fight against global terrorism and as part of President Trump’s efforts to restore fair, reciprocal trade. Today, that relationship got even stronger, with the Amir announcing a series of large airway purchases—including five Boeing 777 freighters. Read the joint statement from President Trump and the Amir of Qatar. Photo of the Day Official White House Photo by Andrea Hanks First Lady Melania Trump participates in an opioids roundtable with state and local community leaders at Cabell-Huntington Health Department in Huntington, West Virginia | July 8, 2019

Office of the Press Secretary FOR IMMEDIATE RELEASE July 9, 2019

President Donald J. Trump Approves Oregon Disaster Declaration Today, President Donald J. Trump declared that a major disaster exists in the State of Oregon and ordered Federal assistance to supplement State, tribal, and local recovery efforts in the areas affected by severe storms, flooding, landslides, and mudslides from April 6 to April 21, 2019. Federal funding is available to State, tribal, and eligible local governments and certain private nonprofit organizations on a cost-sharing basis for emergency work and the repair or replacement of facilities damaged by the severe storms, flooding, landslides, and mudslides in the counties of Curry, Douglas, Grant, Linn, Umatilla, and Wheeler. Federal funding is available on a cost-sharing basis for hazard mitigation measures statewide. Pete Gaynor, Acting Administrator, Federal Emergency Management Agency (FEMA), Department of Homeland Security, named Rosalyn L. Cole as the Federal Coordinating Officer for Federal recovery operations in the affected areas. Additional designations may be made at a later date if requested by the State and warranted by the results of further damage assessments. FOR FURTHER INFORMATION MEDIA SHOULD CONTACT THE FEMA NEWS DESK AT (202) 646-3272 OR FEMA-NEWS-DESK@FEMA.DHS.GOV.

Office of the Press Secretary FOR IMMEDIATE RELEASE July 9, 2019 Joint Statement from the President of the United States Donald J. Trump and His Highness Sheikh Tamim Bin Hamad Al-Thani, Amir of the State of Qatar   Today, as leaders of the United States and Qatar, we committed to further advancing the high-level strategic cooperation between our two countries.  The United States and Qatar share a history of friendship based on common efforts and mutual respect.  For decades, the bonds between our great nations have strengthened, reinforcing an increasingly close strategic and defense relationship focused on countering threats to our security, peace, and prosperity. Together, we applaud the significant advances made by our two countries across a range of commercial and defense opportunities, and we reiterate the importance of continued cooperation.  We both seek to conclude other arrangements necessary to realizing this common vision for enhanced economic, political, and defense cooperation between our nations. We discussed our extensive and increasing economic partnership, including these mutually beneficial transactions: The Qatar Airways purchase of five Boeing 777 Freighters. The Qatar Airways commitment to purchase large-cabin aircraft from Gulfstream. The Chevron-Phillips Chemical Company LLC and Qatar Petroleum agreement to pursue the development, construction, and operation of a petrochemicals complex in Qatar. The Qatar Ministry of Defense’s commitment to acquire Raytheon’s NASAM and Patriot Systems. The selection by Qatar Airways of GE jet engines and services to power its 787 and 777 Aircraft. These are only the most recent examples of what continue to be strong commercial, political, and security ties between the United States and Qatar.  We are committed to continuing the positive partnership between our two countries. ##