Congressman Sam Liccardo is honest, direct, and refreshingly optimistic. Formerly the mayor of San Jose, he was elected to represent California’s 16th congressional district nearly two years ago. He recently visited Fogarty Innovation to host “From Silicon Valley to Capitol Hill,” a wide-ranging Lunch & Learn conversation moderated by our longtime physician leader, Fred St Goar, MD.
Following are some of the key learnings that emerged:
The knowledge gap
Congress does not currently possess enough technical understanding of medtech, biotech, AI, and the life sciences – which accounts for much of the disconnect between what innovators need and what federal policymaking delivers. According to Liccardo (whose own education was in law and political science), most members of Congress do not have technical or scientific backgrounds and instead rely on a relatively small number of colleagues and staff who deeply understand these fields. That knowledge gap creates an opportunity for industry leaders to help educate policymakers. As one example, Liccardo described a bipartisan group of freshman members of Congress he hosts that is focused on learning more about AI. The group regularly invites tech CEOs in to explain emerging issues. “We have a lot of work to do to educate Congress,” he said.
Bipartisan Support
There are some encouraging bipartisan efforts underway. Liccardo emphasized that there is generally bipartisan support for federal investment in basic science and research. He noted that Congress has resisted large, proposed cuts to NIH, NSF, and related research programs, instead continuing to fund them at roughly historic levels, and that SBIR was also reauthorized.
However, despite this consensus, there are implementation problems: although Congress successfully appropriates funding for grant programs, executive agencies are administering them inconsistently. “We have a real problem getting dollars out the door, particularly to folks who don’t embrace the administration’s version of what ‘science’ is,” he said wryly. Given that the only remedy currently available for impoundment (when the executive branch withholds or delays spending money that Congress has approved and appropriated), requires both chambers to vote together, Liccardo is working on legislation that would allow private parties to go to court to compel federal agencies to disburse funding mandated by Congress.
Liccardo also noted that there is a bipartisan reimbursement bill (H.R. 5343, the Ensuring Patient Access to Critical Breakthrough Products Act) focused on aligning CMS reimbursement with FDA-designated breakthrough status that has advanced through House Ways and Means but is caught in a committee-jurisdiction dispute. While he regards legislation of this type as promising, he believes Congress currently lacks the appetite for wholesale reimbursement reform.
Asked what the innovation community can do to help, Liccardo had several suggestions, including the following:
Lead with Savings
The politically persuasive argument, in his view, is cost savings. “That is what resonates across the aisle,” he said. Accordingly, medtech companies should demonstrate not only that a technology produces better clinical outcomes, but also how it reduces costs for patients, Medicare, Medicaid, hospitals, or the healthcare system as a whole. Innovation, he said, needs to be framed around how it helps families who are struggling with healthcare bills and rising insurance premiums.
Tell Your Story
Liccardo called on healthcare innovators to tell their stories — who they are, why they entered the field, what problems they are solving, whose lives could improve, and what they are sacrificing to develop new technologies. These stories can help distinguish “medtech” from “tech,” which is increasingly associated with a polarizing handful of extremely wealthy executives rather than the scientists, engineers, physicians, founders, and entrepreneurs taking substantial risks in order to solve important problems affecting human health.
“It’s not a secret that Silicon Valley doesn’t have a great brand right now,” Liccardo said. He argued that innovators need to be made more visible, noting that many people in the room could make more money and have an easier time designing the next AI product than they will designing a device or therapy that could save a child with a rare disease. “We need to lift up the innovators,” he said, “so people stop just seeing the oligarchs.”
Think Broader
Liccardo also challenged the audience to reach beyond the local representatives who already understand the value of innovation and engage scientific, medical, entrepreneurial, and business communities in politically diverse districts. “In the Bay Area, we believe wholeheartedly in the value of innovation — but that doesn’t necessarily extend to other parts of the country where advocacy needs to happen,” he said. Liccardo’s advice was to build relationships with scientific and medical communities in other states and districts, since members of Congress listen to their own constituents far more than they listen to outside advocates.
Liccardo pointed to his own Innovation for Good initiative as an example of that philosophy in action. The program seeks to strengthen the relationship between the Democratic Party and the innovation economy while familiarizing lawmakers from other districts with Silicon Valley and its innovators. It brings Democratic members from battleground districts — including areas of upstate New York, Michigan, and rural Pennsylvania — into direct contact with the innovation community.
Reflections
Liccardo also offered a candid assessment of Congress itself. “This is probably the least productive Congress in modern history,” he said. “And I would argue that’s a feature, not a bug of this administration.” He noted that, with a handful of exceptions, few members of Congress engage deeply in policy issues. Instead, the relevant conversations are happening at the staff level. As a result, he often finds himself directing his arguments toward chiefs of staff and other congressional aides because they are the ones doing the detailed analysis. “This is our reality,” he said.
Despite those challenges, Liccardo expressed optimism about the potential for progress. “I’m trying to educate my colleagues about tech and innovation generally,” he said. “Innovation for Good is part of what we’re trying to do on the Hill in a bipartisan way to bring people around. I think a lot of tech issues, and particularly in the healthcare space, should be bipartisan or nonpartisan. We should all believe in saving lives.”
Liccardo closed by thanking the audience of innovators for the work they do every day.
“I know that you were facing really steep challenges two years ago, and you’re facing even steeper challenges now in many ways. Thank you for following your passion. Thank you for the lives that you’re saving. Thank you for inspiring those of us who care, and I can tell you there are more of us than you might think.”