David Rouzer grew up in Durham and graduated from N.C. State University with degrees in agricultural business management, agricultural economics and chemistry. Before entering Congress, he worked as an agricultural consultant and served two terms in the North Carolina Senate. He lives in Wilmington.
Candidate Q&A
What do you see as the biggest financial and administrative challenge to implementing the work requirements for Medicaid that were included in the One Big Beautiful Bill?
Medicaid is an important resource for Americans who truly need it, and the Working Families Tax Cuts Act strengthens the program by protecting its integrity and ensuring it remains sustainable for those who depend on it. Beginning in January, certain able-bodied adults will be subject to work and community-engagement requirements, along with more frequent eligibility reviews. I am encouraged North Carolina plans to implement these requirements through its enhanced technology system and county Departments of Social Services, giving beneficiaries straightforward ways to submit the necessary documentation. Implementing these changes efficiently, processing documentation, verifying exemptions, and making sure beneficiaries understand what is expected of them will ensure taxpayer-funded benefits are going to those who qualify.
What would be your plan for ensuring the future security/strength of Social Security and Medicare?
Millions of Americans have spent their working lives paying into Social Security and Medicare, and we have a responsibility to protect the benefits they have earned. At the same time, we cannot ignore the long-term financial challenges facing these programs. Protecting current beneficiaries while making responsible reforms can ensure Social Security and Medicare remain strong for future generations. Growing our economy and workforce, strengthening program integrity, eliminating waste, fraud, and abuse, and addressing structural challenges driving rising costs can put these programs on a more sustainable path. Raising taxes on working Americans only places a greater burden on those already paying into these programs. Before asking taxpayers for more, we should take a hard look at how these programs operate, identify opportunities to eliminate waste and fraud, and pursue targeted reforms that improve efficiency and strengthen long-term solvency.
What would you support in Congress as a plan to help control health care/ pharmaceutical costs?
Rather than relying on increasingly expensive premium subsidies to offset the rising cost of healthcare, I support long-term structural reforms to increase competition, expand employer-based coverage, and give individuals more affordable choices. By expanding Association Health Plans and CHOICE Accounts, we can provide lower-cost healthcare options. I also support Pharmacy Benefit Managers (PBMs) reforms to increase transparency, lower prescription drug costs, and protect our independent pharmacies. We must create competition to drive down costs, foster innovation, and preserve America’s leadership in developing life-saving medicines while giving patients greater control over their healthcare decisions.
What steps would you take to improve access to health care in rural areas? How do we make the Rural Health Transformation Program successful in North Carolina?
Rural communities across southeastern North Carolina depend on strong local providers to deliver quality healthcare close to home. The Rural Health Transformation Program will work to strengthen rural hospitals and clinics, expand access, modernize care, and address workforce challenges facing rural communities. We also need to invest in the right areas of healthcare. As co-chair of the bipartisan Primary Care Caucus, I introduced H.R. 8765, the Prioritizing Primary Care Act, which would help Congress better understand how federal healthcare dollars are spent on primary care and identify ways to expand access, particularly in rural and medically underserved communities. Primary care can help patients catch health problems earlier, improve outcomes and reduce costly care down the road. I’ll continue working to ensure Rural Health Transformation Program resources reach our communities while strengthening the primary care workforce and bringing quality are closer to home.
The rollout of AI is moving fast, including in health care, and leaders in that space are calling for things to slow down. What federal moves should be taken to regulate it, if at all?
Artificial intelligence (AI) has tremendous potential to improve healthcare by enabling earlier diagnosis and bringing researchers closer to cures while making drug development and clinical trials faster and more efficient. We should be careful not to put unnecessary government regulations in the way of emerging technologies with the potential to improve patient care and lower costs. At the same time, AI raises legitimate concerns, particularly regarding the misuse of emerging technologies and data security. As a member of the House Committee on Science, Space, and Technology, I have participated in numerous hearings examining both the opportunities and challenges presented by AI. Our discussions have included how emerging technologies can strengthen our national security capabilities while protecting Americans from potential threats. Rather than slowing American innovation, Congress should ensure the United States remains the global leader in AI while putting reasonable protections in place for American families and consumers.
Where do you stand on federal vaccine policy? What should be done to prevent future disease outbreaks?
I believe the decision to receive a vaccine should be made by the individual in consultation with their doctor, not mandated or strong-armed by the federal government, a bureaucrat, or a corporate executive. Patients and their doctors are in the best position to make informed decisions based on their individual circumstances. In fact, in January 2022, the Supreme Court blocked the Biden Administration’s vaccine mandate for private businesses while allowing the mandate to stay in place for employees of healthcare facilities receiving federal funding. Preventing future outbreaks starts with earning public trust through transparent data and clear communication. It also means keeping strong disease surveillance and early-warning systems and making sure patients can easily access care and information, including in rural and underserved areas.
We’ve had some high-profile food contamination outbreaks, yet the federal government is pulling back on regulation of food, air and water. What level of federal regulation do you support and why?
The federal government has an important role in protecting the safety of our food, air, and water, and those protections should be based on sound science and focused on real risks to public health. These regulations should be clear, practical, and avoid unnecessary or duplicative requirements that drive up costs for families, farmers, and small businesses. As someone who represents a state with one of the largest agricultural industries in the country, I understand the importance of maintaining a safe and reliable food supply. Our farmers and producers already operate under rigorous safety standards, and we should make sure our science-based federal regulations are applied consistently. In North Carolina, I have continually worked to address PFAS contamination and expand access to testing and water-treatment technologies, particularly in rural communities. We must maintain strong protections while ensuring regulations are targeted, effective, and do not impose unnecessary burdens.
PFAS contamination is a nationwide issue; how do you address it while balancing public safety and business interests?
PFAS contamination is a serious threat to clean drinking water and public health, particularly here in southeastern North Carolina. Contamination of the Cape Fear River has had lasting impacts on communities throughout our region and addressing these “forever chemicals” must remain a priority. Some communities, including the Cape Fear Public Utility Authority, have invested in expensive filtration systems, such as granular activated carbon and reverse osmosis, to remove PFAS; however, rural communities do not have the same resources. In Congress, I wrote H.R. 4721, the Healthy H2O Act, to help rural communities access safe, clean drinking water by supporting water-quality testing and effective filtration systems. We must continue holding responsible parties accountable while helping communities address contamination. At the same time, we should avoid unnecessary burdens on farmers, manufacturers, and other businesses. Protecting public health and supporting our local economy do not have to be competing priorities.
The building and placement of data centers have become a big issue, particularly in many rural communities. What should be the federal government’s role, if any, in how these are developed?
As AI usage continues to increase, data centers and other infrastructure required to support it naturally increases, raising important policy considerations related to data security, access to resources, energy reliability and affordability. Data centers can place significant demands on our electricity grid and other infrastructure, and those costs should not be paid by families and small businesses. I supported and voted for H.R. 9340, the Ratepayer Protection Act, which would require large-scale data centers to cover the costs associated with their power usage rather than shifting those costs to ratepayers. As we expand our capacity to support emerging technologies, the federal government should promote innovation and investment while ensuring data centers are good partners in the communities where they operate and pay for the infrastructure they require.
Is there anything else you’d like our readers to know?
America spends twice as much on healthcare as other developed nations, yet our health outcomes continue to fall behind others. I founded the Primary Care Caucus to help Congress prioritize primary care and bring care to communities, leading to earlier diagnoses, better prevention, and healthier lives. Continuing to subsidize a broken system is not the answer. I support the House Republican healthcare plan, H.R. 6703, the Lower Health Care Premiums for All Americans Act, because it uses commonsense reforms to lower costs, expand access, and put citizens and employers back in control. I have also supported reauthorizing telehealth, rural healthcare networks, and home health services programs. Healthcare should be affordable, accessible, and centered on the relationship between patients and their doctors. By strengthening primary care and expanding competition, we can lower costs and improve health outcomes.
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