Tuesday, December 17, 2019

Executive Order on Providing for the Closing of Executive Departments and Agencies of the Federal Government on December 24, 2019

Office of the Press Secretary

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    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.  All executive departments and agencies of the Federal Government shall be closed and their employees excused from duty on Tuesday, December 24, 2019, the day before Christmas Day.

    Sec. 2.  The heads of executive departments and agencies may determine that certain offices and installations of their organizations, or parts thereof, must remain open and that certain employees must report for duty on December 24, 2019, for reasons of national security, defense, or other public need.

    Sec. 3.  December 24, 2019, shall be considered as falling within the scope of Executive Order 11582 of February 11, 1971, and of 5 U.S.C. 5546 and 6103(b) and other similar statutes insofar as they relate to the pay and leave of employees of the United States.

    Sec. 4.  The Director of the Office of Personnel Management shall take such actions as may be necessary to implement this order.

    Sec. 5.  General Provisions.  (a)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

    (b)  Nothing in this order shall be construed to impair or otherwise affect:

        (i)   the 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.

    (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

    December 17, 2019.

1600 Daily The White House • December 17, 2019 Dear Madam Speaker

1600 Daily
The White House • December 17, 2019

Dear Madam Speaker

President Donald J. Trump sent a letter to House Speaker Nancy Pelosi today, exposing Democrats’ partisan impeachment crusade for the unprecedented, unconstitutional sham that it is.

A few important excerpts from the President’s letter:
  • “The Articles of Impeachment introduced by the House Judiciary Committee are not recognizable under any standard of Constitutional theory, interpretation, or jurisprudence. They include no crimes, no misdemeanors, and no offenses whatsoever.”
  • “Speaker Pelosi, you admitted just last week at a public forum that your party’s impeachment effort has been going on for ‘two and a half years,’ long before you ever heard about a phone call with Ukraine.”
  • “Before the Impeachment Hoax, it was the Russian Witch Hunt.”
  • “You are the ones interfering in America’s elections. You are the ones subverting America’s Democracy. You are the ones Obstructing Justice. You are the ones bringing pain and suffering to our Republic for your own selfish personal, political, and partisan gain.”
  • “You and your party are desperate to distract from America’s extraordinary economy, incredible jobs boom, record stock market, soaring confidence, and flourishing citizens. Your party simply cannot compete with our record.”
  • “Our Founders feared the tribalization of partisan politics, and you are bringing their worst fears to life.”
Read the full letter from President Trump.

SHAREDemocrats’ unprecedented and unconstitutional abuse of power

President Trump’s next big move to help American students

In the United States, every student should have the chance to earn a high-quality education, regardless of background. This week, President Trump is signing a bill that will make that promise closer to reality than ever before.

The FUTURE Act, which stands for Fostering Undergraduate Talent by Unlocking Resources for Education, accomplishes two major objectives. First, it permanently reauthorizes funding for Historically Black Colleges and Universities (HBCUs), as well as other minority-serving institutions to the tune of $255 million. Second, it will simplify the Free Application for Federal Student Aid (FAFSA) and the loan repayment process for all, significantly reducing the paperwork burden placed on borrowers.

President Trump has made fighting for struggling, historically forgotten communities a hallmark of his Administration. Support for HBCUs has been a key piece of that agenda. Barely a month after taking office, he signed an executive order to move the Federal HBCU initiative back within White House purview. This September, he spoke at the 2019 National Historically Black Colleges and Universities Week Conference.

“Every day of my presidency, we’ll strive to give every child, of every background and every race, religion, color, and creed, the best chance to reach that beautiful American Dream,” he said. “We will never let you down, and we will never stop fighting for you.”

Photo of the Day

Official White House Photo by Shealah Craighead
House Speaker Nancy Pelosi and Democrat Congressional leadership as they ponder how little they’ve done for the American people | October 16, 2019


Office of the Press Secretary

Oval Office

2:16 P.M. EST

     PRESIDENT TRUMP:  Well, thank you very much.  It’s a great honor to have President Jimmy Morales and Mrs. Morales --

     MRS. MORALES:  Thank you.

     PRESIDENT TRUMP:  -- of Guatemala with us.  We’ve had a tremendous relationship over the last two years, on the border.  We’ve signed agreements with Guatemala that have been tremendous in terms of really both countries, but our country, with respect to illegals coming into our country.  We just can’t have it.  And it’s been very much slowed up.  Guatemala has been terrific.  Honduras, El Salvador, likewise, have been excellent.

     And, as you know, we have 27,000 Mexican soldiers on our border right now protecting our border.  So it’s been, really, very good.  The results are very good.

     The wall is being built.  We’re building a very big wall.  We’re up to almost 100 miles already.  And we should have over 400 miles, hopefully by the end of next year, if everything keeps going on the same path, or shortly thereafter.  But we should have pretty close to 400 miles -- maybe more than that -- up by the end of next year.

     So we’re really doing a job in mostly immigration, I would say, with Guatemala, but we also do trade.  They’re also buying some military equipment.  And the relationship is very good.  It’s a very important country from the standpoint of the border and trade.  And we do a lot through Guatemala.  A lot of things run through Guatemala.


     Do you want to interpret?  Yeah.

     INTERPRETER:  (Interprets the President’s remarks.)

     PRESIDENT TRUMP:  Please.

     PRESIDENT MORALES:  (As interpreted.)  For us, it's an honor to be again in the USA, the main partner and ally of Guatemala, both in security and trade.  We have achieved a lot of great success, and we have a great relationship.  We have been able to work with migration, and we’re trying to make it legal, because by no means we can endanger minors or populations, who are vulnerable, to coming to the border illegally.

     We have signed different agreements with the USA, including things related with trade and security.  And we want to be able to negotiate temporary visas both for agriculture and construction sector.

     And we are really honored to be right here at the White House.  Thank you very much.

     PRESIDENT TRUMP:  Thank you very much.

     One of the big things that’s happened with Guatemala -- and Honduras, El Salvador, and some others -- is that, in past administrations, they and others would not take people back.  So if we had very dangerous people in our country and they came from Guatemala, or another country that we now have agreements with -- we never had agreements with anybody -- they just wouldn’t take them back.  But now they have to take them back, and they take them back with open arms.

     And by doing this, we’re getting rid of the most dangerous people.  The people that are most dangerous, we’re getting them out of the United States because they don’t belong here.  They didn’t come from here, and we’re getting them out.  We’re taking them out by the thousands. 

Thank you all very much.  Appreciate it.  Thank you.  Thank you very much.

     Q    Mr. President, what do you say to Americans --

     Q    Are you going to watch -- are you going to watch the House proceedings tomorrow?

     PRESIDENT TRUMP:  I'm not watching.  I have not -- I have not seen it.

     Look, it's a hoax.  The whole impeachment thing is a hoax.  We look forward to getting on to the Senate.  We're not entitled to lawyers.  We're not entitled to witnesses.  We're not entitled to anything in the House.  It's a total sham when you have a guy like Shifty Schiff go out and make up a statement that I've made.  He said, "This is what he said."  But I never said it.  He totally made it up.  In Guatemala, they handle things much more diff- -- much tougher than that.

     And because of immunity -- he has House immunity -- because of immunity, he can't be prosecuted.  He -- he took a statement and totally made it up.  It was a lie.  It was a fraud.  And you just can't do those things.  So, you know, look, this has been a total sham from the beginning.  Everybody knows it.

     I've never seen the Republican Party so united.  We got -- on our last vote, as you know, we got 100 percent of the vote.  I believe the Senate is equally as well united.  I watched Mitch McConnell this morning.  I watched numerous people last night -- senators -- and I think we're equally well united.

     They know it's a hoax.  It's a witch hunt.  And it's just a continuation.  It's been going on now for almost three years.  And it probably started before I even won the election, based on what we're finding out with the insurance policy quotes and other things.  So it's a disgrace.

     Yes, Steve.

     Q    Are you going to let Senator McConnell decide on witnesses and all of that?

     PRESIDENT TRUMP:   Yeah.  He can decide.

     And we'll also have to decide on when we're taking the vote for the USMCA.  A very big -- a very important deal.  A very, very important deal with Mexico, Canada, ourselves.  We're going to have to decide whether or not that comes first or second.  To me, I'd let the Senate decide on that.  

     Q    And, Mr. President, do you take any responsibility for the fact that you're about to be impeached?

     PRESIDENT TRUMP:  No.  I don’t take any -- zero, to put it mildly.  They took a perfect phone call that I had with the President of Ukraine -- an absolutely perfect call.  You know it; they all know it.  Nothing was said wrong on that call.  To impeach the President of the United States for that is a disgrace and it's a mark on our country.

     And I'll tell you what: Other Presidents, in the future -- unless they do something about this, other Presidents are going to have to live with this.  And every time they do something that’s a little bit unpopular or a little bit strong -- even if they're 100 percent right --

     Because I've done a great job, when you look at the kind of jobs we've created, when you look at the economy that we've created, when you look at rebuilding the military, taking care of the vets.  You just take a look at what we've done with Choice -- Veterans Choice; with Accountability and the vets; with what we've done to protect our Second Amendment; and so many other things.  Nobody has done as much as I've done in the first three years.

     Thank you all very much.  Thank you.  Thank you very much.  Thank you.

     Thank you.  Thank you very much.

     Q    Mr. President, on Guatemala -- on Guatemala, are you planning to withhold aid if the new President-elect of Guatemala does not implement your immigration agreement, Mr. President?

     PRESIDENT TRUMP:  Guatemala is terrific.

     Q    But what if they -- the President --

     PRESIDENT TRUMP:   Guatemala has been terrific.  Thank you.

                              END                2:25 P.M. EST 

Letter from President Donald J. Trump to the Speaker of the House of Representatives

Office of the Press Secretary







West Wing Reads Schumer’s Hail Mary Bid to Save Dems’ Disastrous Impeachment Drive

West Wing Reads

Schumer’s Hail Mary Bid to Save Dems’ Disastrous Impeachment Drive

“Senate Democratic leader Chuck Schumer knows his House colleagues bungled their ‘impeachment inquiry’ so badly that they managed to shift public opinion markedly against removing the president. So he’s hoping for a do-over,” the New York Post editorial board writes.

“In other words: do more fishing in hopes of getting something that might damage President Trump.” Here’s the problem: “Schumer is simply supposed to be part of the jury, along with the other 99 senators — and jurors don’t decide the witness list.”

Click here to read more.

MORE: “Support falls for Trump's impeachment, removal from office: CNN poll”
“James Comey has finally admitted some ‘sloppiness’ over the surveillance warrant for former Trump campaign aide Carter Page.” But mere incompetence doesn’t seem to explain it. “Crossfire Hurricane was among the most politically fraught investigations in recent American history,” The Wall Street Journal editorial board writes.
“The stock market has been unstoppable under the influence of President Trump. The Dow Jones Industrial Average crossed 28,332.74 on Monday, meaning it has rallied 10,000 points, or more than 54 percent, since Trump’s election victory on November 8, 2016.” The S&P 500 is up more than 46 percent, Jonathan Garber writes in Fox Business.
“President Trump’s United States-Mexico-Canada Agreement (USMCA) is finally up for a vote this week — just in time for Christmas.” After a long delay from House Democrats, the NAFTA replacement will mean more high-paying jobs and lower prices on many goods, Heritage Foundation President Kay Coles James writes in The Washington Times.


Office of the Press Secretary


Via Telephone

9:04 A.M. EST
     MR. CANTRELL:  Thank you, Operator.  Good morning, everyone.  And thank you for joining this morning's briefing to preview new health proposed -- kidney health proposed rules.

     This briefing will be on the record and conducted by Health and Human Services Secretary Alex Azar, Administrator for the Centers for Medicare and Medicaid Services Seema Verma, Acting Administrator of the Health Resources and Services Administration Tom Engels, and Director of the Domestic Policy Council Joe Grogan.

     If a subject-matter expert speaks during the briefing, he or she will be on background, attributable to a senior administration official.
     We will begin with opening statements and, as time allows, will follow with question and answer.  All information is embargoed until the conclusion of the call.

     With that, we will begin with DPC Director Joe Grogan.

     DIRECTOR GROGAN:  Thank you.  The Trump administration continues to deliver on the President's vision for great health for Americans as we unveil an important milestone in the delivery of the President's July 10 executive order to reform kidney care.

     The Trump administration is committed to ensuring the world’s best healthcare for all Americans and confronting problems in the healthcare system that other administrations ignored -- in many cases, for decades.

     Each month, 3,000 people are added to the kidney waitlist and hundreds pass away while waiting for a transplant.  This is unacceptable.  When President Trump signed the Executive Order on Advancing American Kidney Health in July, he prioritized the 95,000 candidates who are on the waitlist as of today, hoping for a life-giving kidney transplant.  Not since President Nixon expanded Medicare coverage to Americans with end-stage renal disease in 1972 has a President advanced kidney health like President Trump to ensure that no American is forgotten.

     The Organ Procurement Organization -- OPO -- proposed rule modernizes the Centers for Medicare and Medicaid Services Conditions for Coverage with measures to evaluate OPO performance that are objective and enforceable.  This change will support kidney donation, reduce waste, and shorten transplant wait times for years to come.

     Almost 7,000 of the 36,000 organ transplants performed this year came from living organ donors, about one-sixth of transplants.  We are aiming to increase the number of living donors by reducing the barriers to giving an organ.  The Living Donor proposed rule ensures that people generous enough to undergo surgery and give an organ to those in need do not bear the financial expenses alone.

     The Health Resources and Services Administration, HRSA, proposes to allow expenses to be reimbursed by living -- when those expenses are incurred by living donors such as lost wages, childcare, and elder care that result from their organ donation.

     These proposed rules stand to particularly benefit African Americans, the largest minority group in need of organ transplants.  While only 13 percent of the U.S. population is African American, they represent approximately one-third of the candidates on the U.S. waitlist for kidneys.  Increasing the supply of kidneys for transplants will help communities disproportionately affected by kidney disease.

     These proposed rules build on the President's vision and plan to provide all Americans great healthcare through bold initiatives that battle major diseases and save American lives.  We are working on behalf of all those Americans on the organ waitlist to ensure an ample supply of transplants.

     We will always be on the side of patients, and this shift in health vision helps patients get the transplant they need to live.

     The President’s vision for the American health system requires us to widen the aperture from an obsession with Obamacare to a broad commitment to help Americans lead healthy lives.  We are building a healthcare system that delivers more options, better health, longer lives, at lower cost.

     Thank you.

     SECRETARY AZAR:  Hello, everyone.  Alex Azar here.  Thank you for joining us on this call today.

     We’re excited to be announcing proposals today that have the potential to save and transform the lives of thousands of Americans in need of organ transplant.

     Better health is the ultimate goal of President Trump’s healthcare vision.  Tackling impactable health challenges is one of the key areas where we’re delivering on that vision, alongside reforming financing and delivering better value in healthcare.

     There are few more transformative interventions for someone’s health than by replacing a failing organ with a healthy one, and that’s what we’re aiming to make much more common with our proposals today.

     Each year, almost 8,000 Americans die waiting for a kidney or other organ transplant.  Almost 100,000 Americans are on the waiting list for a kidney.  Yet there are thousands of organs that could be available for use, and many Americans who might be willing to become a generous living donor.

     Unfortunately, today, and for decades, we haven’t done everything we can to procure organs from deceased donors, and we haven’t been providing enough support for living donors.

     These challenges around organ donation have been recognized for some time, but they’ve never gotten the full attention they need from the decision-makers in Washington.  President Trump is changing that.  The President is not going to let viable organs be wasted and see lives thrown away.

     Today, under Administrator Verma’s leadership, CMS is proposing to reform how we measure the work of organ procurement organizations -- the federally funded, nonprofit organizations that run organ procurement.  Today, many of these OPOs -- “O-P-Os” -- are doing a great job, but some of them are not.

     Rather than allowing OPOs to report on their own performance, we’re proposing objective, consistent criteria that will hold them accountable.  The President’s proposed OPO reforms have the potential to give tens of thousands of Americans a chance at a better, longer, and healthier life.

     We’re also proposing another rule to support people who become living donors.  Many Americans may be interested in being living donors, like the incredibly generous kidney donor that saved my father’s life, but financial constraints stand in the way.

     So, today, under the leadership of Administrator Engels, through the Health Resources and Services Administration, we are proposing bold steps to break down barriers to living donation by reimbursing for a broader range of expenses, such as lost wages and, potentially, childcare.  When an American wishes to become a living donor, we don’t believe their financial situation should limit their generosity.

     These two new proposals supplement the work already underway at HHS to advance American kidney health, under the President’s executive order, like the work of KidneyX, a public-private initiative designed to drive innovation in kidney care, including measures to improve dialysis and develop an artificial kidney.

     Today’s proposals reflect President Trump’s commitment not only to improving the health of all Americans, but also to tackling neglected health challenges where we have the chance to make a real difference.

     The initiative to advance American kidney health is a broad, HHS-wide effort, and we would not be making the historic progress that we’re seeing without the contributions of leadership and civil servants from across HHS.  So I want to thank everyone involved in this effort for their dedication to this lifesaving work.

     With that, I'd like to turn things over to Administrator Seema Verma to explain the reforms CMS has proposed for OPOs.

     Administrator Verma?

     ADMINISTRATOR VERMA:  Thank you, Mr. Secretary.  And thanks for joining us.

     We are here to announce some major improvements for patients who need lifesaving organ transplants, and we’re doing it (inaudible) President Trump’s visionary leadership.  He's doing everything in his power to repair a broken healthcare system that stands between patients and cures that medical science discovered long ago, realigning government incentives to drive quality and cut red tape.

     The President’s historic executive order on American kidney health is a key part of this vision, and today’s announcement delivers on that directive.  Today’s announcement also is the culmination of President Trump’s historic effort to cut the red tape, which is reflected in major CMS initiatives like Patients over Paperwork and Meaningful Measures.

     Today, CMS is unveiling a bold new rule that aims to increase the short supply of available organs.  You just heard the numbers on our lengthy transplant waiting lists.  To make matters worse, someone is added to one every 10 minutes, and 20 people die every day because they can’t get an organ.  Government’s misaligned regulatory incentives aren’t procuring enough kidneys, hearts, lungs, and other organs to fulfill the demand.  But those 20 deaths each day can be avoided.   And today, CMS takes the first step towards preventing them.

     Our proposals, if finalized, would increase the number of organs by completely and totally overhauling the organ procurement system.  So before we discuss it, it’s important to first understand the status quo and its flaws.

     Organ Procurement Organizations, or OPOs, are not-profit entities that act as an essential link between organ donors and organ recipients.  They procure organs from donors in hospitals and deliver them to transplant centers, where they can save lives.  My agency, CMS, establishes quality metrics for OPOs, which we use to assess them every four years to decide if they will be recertified for participation in Medicare.  There are three current metrics, of which OPOs must meet two.

     Unfortunately, these current measures disincentivize OPOs from trying hard to procure every possible organ in their service areas.  They are also based on self-reported data that is tough to validate and can vary from one OPO to another.

     Finally, the metrics are riddled with exclusions.  They may exclude all but organs from perfect candidates, so OPOs have little incentive to seek imperfect organs -- meaning organs from donors who are less-than-ideal candidates because of a health condition.

     But advancements in medical science have shown us that many organs from individuals with certain conditions can, in fact, be transplanted, resulting in better and longer lives for patients who are struggling through organ donation alternatives like dialysis.  Imperfect organs shouldn’t be discarded when they can save lives and improve quality of life.

     For example, the current rules could exclude a potential kidney donor who’s a bit older than the ideal donor.  These kidneys would be imperfect, but usable.  The current metrics could also exclude an older potential heart donor with a history of high blood pressure.  But again, while that heart is imperfect, it can save a life.

     Moreover, the current measures have encouraged OPOs to seek donors who are donating multiple organs and avoid single organ donors, discarding some potentially transplantable organs.

     These examples show it’s critical that we’re focusing on the right quality measures.  And that’s why CMS has been so focused on our Meaningful Measures initiative.  Whether we’re talking about holding physicians accountable for outcomes or ensuring that imperfect but usable organs aren’t needlessly discarded, it’s critical to patients that we’re measuring what matters: outcomes.

     Our proposed rule represents a fundamental shift in the way we assess OPOs.  It would scrap this inefficient system, replacing the old measures with two simple, vigorous measures calculated with independent data from the CDC.  While this data will exclude potential donors with conditions that would totally preclude them from donation -- like most types of cancer, infectious disease, and sepsis -- it will ensure that imperfect organs are considered for procurement, organs that may be wasted under the current system.

     Using this objective data, we would calculate two simple measures.  The first is an OPO’s donation rate, meaning the percentage of possible donors who become actual donors.  The second is the transplantation rate, meaning the percentage of organs transplanted after procurement.

     These simple yet powerful outcome measures eliminate today’s perverse incentives, and will instead incentivize OPOs to seek as many organs as possible -- perfect and imperfect alike.  Needless to say, patients retain their right to receive robust information on the quality of the organ they are receiving, and the final decision on whether to use a given organ will remain with them and their doctors.  But for countless patients, an imperfect organ is better than no organ at all.  And for someone on a waitlist, that may be the difference between life and death.

     CMS also intends, in the spirit of transparency, to make outcome measures public at each assessment, highlighting OPOs that fall outside of the top 25 percent in donation and transplantation rates.  This system would help OPOs identify weaknesses and give them an opportunity to take swift action to improve in between each four-year recertification cycle.  This increased accountability -- to the public and to CMS alike -- promises to spur OPOs to procure and transplant more organs.

     And, finally, because of the unique statutory limitations on OPOs, our proposed rule does much to ensure that no areas of the country are left without one.  At the end of each recertification cycle, poor performing OPOs could be decertified, but they’d be replaced by better performing one -- a better performing one preventing gaps in service for patients who are in need of organs.

     We hope and expect that key stakeholders -- patient advocates, OPOs, transplant surgeons, nephrologists, and more -- to be pleased with this proposal.  We are eager to hear their feedback so we can collaborate with them to finalize policies that strengthen our organ procurement system.

     Because, today, it is simply not meeting the needs of thousands of American patients that stand in need of new organs. And, once again, President Trump is tackling longstanding -- a longstanding problem in the American healthcare system, because no life-saving organ should go to waste.

     ADMINISTRATOR ENGELS:  Good morning.  I’m Tom Engels and I'm the Administrator of the Health Resources and Services Administration, or HRSA.

     Today, I'm excited to announce that the Trump administration has taken a major step to remove financial barriers for a living organ donation by expanding the scope of reimbursable expenses for living organ donors to include lost wages, and children childcare, and eldercare expenses.

     Today’s notice of proposed rulemaking is a result of the President’s Executive Order on Advancing American Kidney Health, which emphasized that supporting living organ donors can help address the current demand for kidney transplants.

     Living organ donation is an important option for thousands of people on the national transplant waiting list.  Approximately 96,000 individuals are on the national waiting list awaiting an available kidney.  This proposed rule will increase living organ donation by removing financial disincentives for living organ donors.

     It is important to note that living organ donation provides a number of advantages.  Recipients often receive a better quality organ in a shorter time period, which often results in improved survival rates of organ recipients.  In general, recipients of kidney transplants from living organ donors have better clinical outcomes than those who continue on dialysis or those who receive a deceased donor kidney transplant.

     Many potential living organ donors may be willing and available to donate an organ to a family member, friend, or an unknown recipient, but would be unable to afford the loss in income while out of work during the transplant process, which includes the pre-transplant evaluation, surgery, subsequent recovery time, and follow-up appointments.  This proposed rule would remove this potential barrier to living organ donations.

     This notice of proposed rulemaking makes clear that HHS and HRSA are committed to reducing the number of individuals on the organ transplant waiting list by increasing the number of organs available for transplant.

     With that, I’ll turn it back to Austin.

     MR. CANTRELL:  Thank you.  Operator, we can now take some questions.

     Q    Hi, this is (inaudible) with Politico.  Thanks for taking my question.  I was curious, on the OPO rule, if you guys had considered any penalties or fines for OPOs that are either, like, egregiously not meeting their performance metrics or some kind of penalty.

     ADMINISTRATOR VERMA:  There are no penalties proposed.  But the way it would work is, right now, they're being assessed every four years, and what we're proposing here is that we would work with them every year to assess how they're doing on their outcome measures.  And then if there are issues or problems, we would address it at that time -- not waiting every four years.

     Q    Hey, sorry about that.  This is Anne Flaherty with ABC News.  Can you tell us a little bit more about what does it look like for somebody to get reimbursed for lost wages if they donated a kidney?  What exactly is the formula on that, and how does it work?

     ADMINISTRATOR ENGELS:  Well, currently HRSA has a program that reimburses the National Living Donor Assistance Center.  The program currently provides reimbursement for up to $6,000 in expenses, including travel, lodging, meals, and incidentals related to the organ donation evaluation.

     What we’re going to do is add the dis- -- take away a disincentive to include the lost wages, along with childcare and elder care expenses.

     Q    Yes, hi.  Kimberly Kindy with the Washington Post.  I was hoping that you could go over again how the new performance metrics would work.  What would the measurements be?

     ADMINISTRATOR VERMA:  Okay, so before, we had three and now we’re going to be moving to two measures.  One is the donation rate measure, and this is proposing that the donation rate would be the number of actual deceased donors as a percentage of a donor potential, which would be defined as total inpatient deaths in the DSA among patients 75 years of age or younger with any cause of death.  And that would not be an absolute contraindication to organ donation.

     And the second one is the transplantation rate measure.  And we’re proposing that the organ transplantation rate would be the number of organs transplanted as a percentage of the donor potential, which would be defined as total inpatient deaths in the DSA among patients 75 years of age or younger with any cause of death.  And that would not be an absolute contraindication to organ donation.

     Q    Hi, this is Lauren Clason from CQ.  Thanks for holding the call.  I’m just curious, could you go over a couple more examples about an imperfect organ that might be -- that might now be used under these rules?

     ADMINISTRATOR VERMA:  Sure.  So in the past, I think the rules were very strict and they focused on just procuring perfect organs.  But I think the science tells us that we could potentially transplant an imperfect organ and the recipient would still have an increased quality of life and it would extend their life as well. 

     There are still exclusions.  For example, we wouldn’t take an organ from a person that had cancer or some type of a bacterial or viral infection or sepsis.  But we know that there are organs, for example, of somebody that's older in age or somebody that’s had hypertension, that those organs can be successfully transplanted.

     So what we’ve done in this rule is reduce the number of exclusions of the organs that were previously discarded, because we know that we can use imperfect organs successfully.

     SECRETARY AZAR:  And for instance, an organ from an individual who has Hepatitis C -- because we can actually cure Hepatitis C -- would be eligible for transplantation because the recipient could be treated for that.  And, of course, due to legislative change also, an organ from an individual who is HIV-positive could be transplanted to an individual who is also HIV-positive.

     Obviously, all of this is done with full-informed consent and notification from the transplant surgeon to the recipient individual.  But it just dramatically opens up the categories of organs available for transplantation, that we longer allow the perfect to be the enemy of the good when it comes to organ transplantation.  These are individuals where even an imperfect organ can be life altering and life saving.

     Q    Hi.  Joyce Frieden from MedPage Today.  I’m wondering if you can talk about how many more organs you expect to be donated as a result of these changes.  How much do you expect things to improve?

     ADMINISTRATOR VERMA:  We’re expecting almost 5,000 new organs to be successfully transplanted under the new rules.

     MR. CANTRELL:  Great.  Thank you everyone.  This will conclude our call.  Again, remarks were on the record.  As always, direct any further question to the corresponding press office.

     Thank you everyone for joining us this morning. 

                                        END                 9:28 A.M. EST

Statement from the Press Secretary Regarding the Visit of His Excellency Jimmy Morales, President of the Republic of Guatemala

Office of the Press Secretary
Statement from the Press Secretary Regarding the Visit of His Excellency Jimmy Morales, President of the Republic of Guatemala
President Donald J. Trump and First Lady Melania Trump will welcome President Jimmy Morales and Mrs. Hilda Patricia MarroquĂ­n Argueta de Morales of the Republic of Guatemala to the White House tomorrow.  The visit is an opportunity to thank President Morales for being the first Central American leader to sign and implement the historic Asylum Cooperation Agreement with the United States. We will continue to work with Guatemala and our partners in the region to advance economic growth and prosperity. 

Presidential Proclamation on Wright Brothers Day, 2019

Office of the Press Secretary


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     On December 17, 1903, two visionaries, brothers from Dayton, Ohio, ushered in the dawn of the age of aviation on a wind-swept beach in Kitty Hawk, North Carolina.  Wilbur and Orville Wright changed the course of history with the successful maiden flight of a manned, engine-powered aircraft.  On Wright Brothers Day, we honor this remarkable achievement, commend the brothers' ingenuity, innovation, passion, and determination, and celebrate the incalculable contributions of aviation to our Nation and the world.

     When the Wright Flyer safely landed near Kill Devil Hills, it marked the first step of an aviation journey of countless American pioneers to conquer the skies.  In the 116 years since this groundbreaking flight, we have made revolutionary strides in aviation, such as Amelia Earhart crossing the Atlantic and Wiley Post circling the globe.  This same fearless American spirit eventually propelled us beyond Earth's atmosphere into space and even placed humans onto the surface of the Moon in an ongoing pursuit of discovery and exploration.  Earlier this year, our Nation commemorated the 50th anniversary of the Apollo 11 mission and remembered the triumphant courage and patriotism displayed by those intrepid astronauts.  On that remarkable voyage, Commander Neil Armstrong carried a small patch of fabric from the wing of the Wright Brothers' 1903 "Flyer."

     The progress and success of aviation are among our country's greatest achievements.  Aviation connects people, commerce, and industry, not merely across the country but across oceans and continents.  The economic, strategic, and social benefits of aviation are critical to our national security and prosperity.  That is why my Administration is committed to ensuring that the United States remains the world leader in aviation and aerospace innovation.  We are improving the design of supersonic jets, for example, and preparing for their reintroduction to civilian flight while also embracing the growth and potential of unmanned aircraft.  By working with leaders in the industry, we are advancing the exploratory and commercial capabilities of space technology and cultivating ideas that could revolutionize the future of transportation, enhance national security and defense, and increase efficiency in commerce and emergency management.

     Throughout our history, our Republic has been characterized by great men and women, like Wilbur and Orville, who dared to push boundaries, challenge traditional thinking, explore unchartered paths, and embrace the power of possibility.  The Wright Brothers' airborne adventure into the North Carolina sky is one of our Nation's seminal milestones and a shining example of the power of the indomitable American spirit, which continues to fuel the next chapter of our history at sea, on land, and in the skies and beyond.

     The Congress, by a joint resolution approved December 17, 1963, as amended (77 Stat. 402; 36 U.S.C. 143), has designated December 17 of each year as "Wright Brothers Day" and has authorized and requested the President to issue annually a proclamation inviting the people of the United States to observe that day with appropriate ceremonies and activities.

     NOW, THEREFORE, I, DONALD J. TRUMP, President of the United States of America, do hereby proclaim December 17, 2019, as Wright Brothers Day.

     IN WITNESS WHEREOF, I have hereunto set my hand this
sixteenth day of December, in the year of our Lord two thousand nineteen, and of the Independence of the United States of America the two hundred and forty-fourth.

                      DONALD J. TRUMP

1600 Daily The White House • December 16, 2019 Thanks to President Trump, Drug Prices are Actually Falling

1600 Daily
The White House • December 16, 2019

Thanks to President Trump, drug prices are actually falling

President Donald J. Trump’s relentless focus on lowering drug costs is the reason Americans are seeing the largest, most persistent drop in medicine prices in half a century.

American healthcare leads the world on many fronts, including crucial medical innovation that is the envy of patients around the globe. But the high price of prescription drugs has hurt both our senior citizens and working families for far too long.

In the 8 years before President Trump’s inauguration—while Washington focused on government takeovers of healthcare rather than on solving real-world problems—prescription drug prices continued to climb by more than 3 ½ percent year-over-year. Today, prices for those drugs have seen year-over-year declines in 9 of the past 10 months.

What changed? The President. Rather than kick Americans off their health insurance plans or team up with socialists to plot “Medicare for All,” here are a few of the practical steps the Trump Administration took to make medicine prices more affordable:
  • Record generic approvals: The FDA is now approving generic drugs at historic rates, generating savings for patients estimated at $26 billion.
  • Ending unacceptable pharmacy gag clauses: President Trump signed legislation banning pharmacy “gag clauses,” which prohibited pharmacists from telling patients about the best deals on the medications they need.
  • Strengthening Medicare Part D: The Administration finalized changes to Medicare’s payment rate for certain drugs to lower expenses for seniors, as well as provided more tools to demystify out-of-pocket costs for beneficiaries.  
The result of these and other common-sense actions: Just this past June, prescription drug prices saw their largest year-over-year decline in more than 51 years.

Even better, Washington is on the verge of a bipartisan breakthrough to help American patients further. Senate Democrats and Republicans have joined to craft a transformative drug pricing bill that would improve Medicare Part D, hold drug companies more accountable, and save federal taxpayers billions of dollars to boot.

The Grassley-Wyden bill, backed by President Trump, would significantly cut what seniors have to pay for prescription drugs. Under the proposal, for the first time ever, Medicare Part D beneficiaries would have an annual cap on their total drug expenses. The $3,100 limit on out-of-pocket costs—which works out to about $258 per month—would save many seniors thousands of dollars. An inflation cap proposed under the bill would also end arbitrary and often devastating spikes in drug prices.

Congress needs to send drug pricing reform to President Trump’s desk this year. Americans have waited long enough. There’s just one holdup, and it’s a familiar one: House Democrats’ partisan stunts. While Congressional Republicans have tried to push ahead with bipartisan solutions, Speaker Nancy Pelosi cut a deal not with conservatives or moderates but with members of her own party’s far-left Progressive Caucus.

The Pelosi bill is a win for the growing Democrat-Socialist movement. It relies on a bureaucrat to dictate prices for innovative medicines and enforces it with a massive tax that would put companies out of business. The Council of Economic Advisers predicts the far-left bill could erase nearly one-quarter of the anticipated gains in American life expectancy over the next decade.

So instead of joining with Senate Democrats—and Republicans in both chambers—to keep their promises to working Americans, Speaker Pelosi is backing a separate bill that is entirely partisan, unworkable, and in fact deeply harmful to Americans’ health.

It’s no wonder Americans want to drain the Swamp.

The President is ready to sign a bipartisan deal. Where is Speaker Pelosi?

NEW: Forgotten Americans are forgotten no more

WATCH: President Trump attends 120th Army–Navy game

At the 120th Army-Navy football game on Saturday, President Trump was met with thunderous applause as he walked out onto Lincoln Financial Field in Philadelphia.

Before kickoff, the Commander in Chief stood side-by-side with representatives from both service academies, along with Defense Secretary Mark Esper, for the playing of our National Anthem. President Trump also stopped by each locker room before the game to wish players good luck in person.

“President Donald Trump receives rousing welcome from crowd at 120th Army-Navy game”

Photo of the Day

Official White House Photo by Shealah Craighead
President Trump is joined by Defense Secretary Mark Esper and Joint Chiefs of Staff Chairman Gen. Mark Milley during the 120th Army–Navy football game in Philadelphia | November 25, 2019