Directing the Joint Committee on the Library to accept a statue commemorating the Hungarian Revolution of 1956 for placement in the United States Capitol, authorizing the use of the rotunda of the Capitol for a ceremony for the presentation of the statue, and directing the Architect of the Capitol to place the statue in a suitable permanent location in the Capitol.

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 601 and ask for its immediate consideration.

Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentlewoman from New York (Ms. Slaughter), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only.

General Leave

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks.

Mr. Speaker, House Resolution 601 provides for the consideration of a critical bill to provide health insurance and healthcare to millions of underprivileged children. This package, which includes two separate bills: H.R. 3922, the Community Health And Medical Professional Improves Our Nation, CHAMPION, Act of 2017; and H.R. 3921, the Healthy Kids Act. This was reported out of the Committee on Energy and Commerce after lengthy deliberation and negotiation and a lengthy markup.

The rule provides for 1 hour of debate, equally divided and controlled by the chair and the ranking member of the Committee on Energy and Commerce.

The rule adopts an amendment from the chairman of the Energy and Commerce Committee, modified by a second amendment by the same author, combining the two bills into the package on the floor today.

Further, the rule waives all points of order and makes in order no further amendments to the legislation. However, the minority is afforded the customary motion to recommit.

The congressionally appropriated stream of funding for the Children's Health Insurance Program expired at the end of September. Funding for other important public health programs, such as community health centers, the National Health Service Corps, and Teaching Health Center Graduate Medical Education, also expired at the end of September.

While every State that receives Federal funding through these programs continues to have adequate dollars to maintain health insurance for every enrolled child, several States are beginning to exhaust their unspent 2017 funds and redistributed funds from the Center for Medicare and Medicaid Services. With November now upon us, waiting any longer will only put more

pressure on those States to begin sending notifications to children and families that they are losing their coverage for those programs; so it is important that we reauthorize funding for the Children's Health Insurance Program and other programs now.

H.R. 3922, the CHAMPIONING HEALTHY KIDS Act, will achieve that important task. It is essential to our efforts to ensuring that these programs continue to meet the healthcare needs of children and families who have come to rely upon them.

Today, more than 8 million low-income children across our country depend on the Children's Health Insurance Program for many of their healthcare services. These include routine doctor visits, immunizations, prescription medicines, and dental care. Through flexible, capped allotments to the States, the program has been able to successfully support these children, while providing States with opportunities to tailor their respective programs as best meet the needs of their respective populations.

The CHAMPIONING HEALTHY KIDS Act would extend CHIP for another 5 years, which is the longest extension since its inception in 1996. An extension through fiscal year 2022 will provide financial stability for every State's CHIP program and certainty for those children and their families who are covered. Additionally, ensuring coverage for CHIP- eligible children will make them less likely to have to enroll in Medicaid or ObamaCare.

This bill also contains and maintains a provision under the Affordable Care Act that provided 23 percent increased matching for 2 years; then that draws down to an increase of 11.5 percent matching in the third year; and then, finally, provides funding at pre-ACA levels for the final 2 years.

These funding levels will provide the States enough time to plan their budgets before returning to the regular CHIP matching rates, thereby restoring the fiscally responsible Federal-State Medicaid partnership.

While reauthorizing CHIP funding is the primary focal point of this legislation, the CHAMPIONING HEALTHY KIDS Act also includes other important provisions relating to our Nation's healthcare. The bill provides a 2-year extension of funding for Federally Qualified Health Centers, community health centers.

One in thirteen individuals nationwide relies upon a community health center to receive healthcare services. The Community Health Center Fund plays an important role in supplementing the services that Federally Qualified Health Centers are able to deliver to underserved communities by providing care to all Americans, regardless of income or ability to pay.

Funding for the Teaching Health Center Graduate Medical Education program is also extended for another 2 years.

The legislation includes a 2-year extension of other important health programs, including funding for the National Health Service Corps, Family-to-Family Health Information Centers, the Youth Empowerment Program, the Personal Responsibility Education Program, the Special Diabetes Program for Type 1 Diabetes, and the Special Diabetes Program for American Indians.

In addition to the important funding streams addressed in this bill, the Committee on Energy and Commerce incorporated a way to help our Nation's territories in a time of need following recent natural disasters. The bill includes more than $1 billion for the Medicaid programs in both Puerto Rico and the U.S. Virgin Islands. This funding should assist our territories in providing care for their populations who have faced substantial devastation from Hurricanes Irma and Maria.

The Medicare funding issue is unique to Puerto Rico and the United States citizens living in the territories. This was a problem that predated the hurricanes, but it was exacerbated by the devastation that the storm brought to the islands. Without a legislative fix from Congress, this will be an ongoing and festering problem until it is properly addressed, and the bill before us today begins to do just that.

Additionally, the bill delays the $5 billion in cuts to many of the hospitals across the country from the Affordable Care Act-mandated Medicaid disproportionate share hospital reductions for fiscal years 2018 and 2019. I am sure that many of my colleagues have heard from hospitals in their districts whose ability to remain operational and to continue to provide care could be jeopardized by these payment cuts.

These cuts are offset in future years, adding an additional $6 billion in reductions in fiscal year 2021, 2022, and 2023. This delays but does not fix a problem that ObamaCare created for safety net hospitals. It is one which we will have to revisit, but it delays the cuts that have already been affected by current law and protects these safety net hospitals which provide care to the neediest citizens in our country.

Not only does the CHAMPIONING HEALTHY KIDS Act reauthorize funding for essential health programs, the bill is fully offset. It will not add to the national debt. The Committee for a Responsible Federal Budget called this a ``responsible health package,'' noting that the $18 billion cost of the bill is fully offset with savings beyond the 10-year budget window.

One of the ways that costs are offset was to alter the qualified health plan grace period so that it would align with State law grace period requirements. This involved changing, in the Affordable Care Act, the grace period for subsidized individuals from 90 days to 30 days unless a State specifically allows otherwise.

It also redirected $6.4 million from the Prevention and Public Health Fund to help pay for the legislation. This fund is required by law to receive $2.5 billion in annual appropriations which must be used for prevention, wellness, and public health initiatives administered by the Department of Health and Human Services. If Congress--let me say it again--if Congress does not direct these funds toward specific efforts, the Secretary of Health and Human Services has the authority to spend the funds however he or she deems fit.

While we are redirecting these taxpayer dollars, the overarching purpose of the funding is still to improve the health and wellness of Americans through existing mechanisms, and community health centers will do just that.

We allow for certain wealthy Medicare beneficiaries with individual incomes of over $500,000 to pay increased premiums in order to offset some of the cost of authorizing these programs. These beneficiaries will be subject to higher premiums, thereby increasing their overall cost, but still their cost will be lower than if they purchased insurance on the exchange.

The CHAMPIONING HEALTHY KIDS Act is a fiscally responsible way to fund some of our Nation's most important public health programs. The bill would ensure continued access to care for children and individuals who rely on the programs for vital healthcare services.

Mr. Speaker, this is a good bill. Mr. Speaker, these offsets are reasonable. For these reasons, I encourage my colleagues to support today's rule and support the underlying bill, and I reserve the balance of my time.

Mr. Speaker, I yield myself 30 seconds in response before yielding to the chairman of the Rules Committee.

It pains me to hear people talk about the 33-day delay in getting SCHIP funding resubmitted. I just want to assure the House of Representatives that Republicans on the Subcommittee of Health in the Energy and Commerce Committee have been ready to go with this legislation. We did our legislative hearings early in the summer, as the gentleman will recall because he was there, and we were ready for our markup in the month of September.

Why was it delayed? Let me reference an article from CQ News, October 23, 2017: ``Democrats do not want a children's health insurance bill to come to the floor this week for a vote, said Frank Pallone, Jr., ranking member of the House Energy and Commerce Committee at a district event. . . .''

`` `The idea is to not have the bill come to the floor this week,' said Pallone. . . .''

I include in the Record a copy of the CQ News article.

[From CQ News, Oct. 23, 2017]

House Democrats Push To Delay Children's Health Vote

(By Sandhya Raman)

Democrats do not want a children's health insurance program

bill to come to the floor this week for a vote, said Frank

Pallone Jr., ranking member of the House Energy and Commerce

Committee at a district event broadcast on Facebook Live on

Monday.

``The idea is to not have the bill come to the floor this

week,'' said Pallone, emphasizing that Democrats still want

to find a bipartisan compromise and will not accept the

changes to Medicare or Medicaid that Republicans want to use

to fund the coverage. He later added, ``This is supposed to

come up Thursday. Hopefully, it won't.''

Pallone suggested that the process could be lengthy if the

House passes a partisan bill and the Senate does not act

quickly to pass their bipartisan measure. The two likely

would have to be reconciled through conference negotiations.

``We're going to just delay this for months, and the end

result could be we don't deal with this until the end of the

year,'' said Pallone, speaking at a community health center.

Democrats disagree with the offsets in House bills to

reauthorize CHIP (HR 3921) and community health centers and

other safety net programs (HR 3922). The CHIP bill's offsets

include increasing premiums for Medicare recipients with

income over $500,000 a year and limiting Medicaid benefits

for lottery winners. In addition, Democrats take issue with

an offset that would bill other insurance before Medicaid for

recipients who use more than one form of coverage.

The offsets for the community health centers include

changes to undermine the 2010 health care law (PL 111-148, PL

111-152) including cutting almost $6.4 billion from the

Prevention and Public Health Fund over 10 years. Republicans

also would allow states to create their own grace periods for

individuals on the exchanges to pay their premiums or use a

default one-month grace period. The current grace period is

three months.

``If you miss it and you don't pay it, you can't get your

insurance. You've got to re-enroll for the next year,''

Pallone said about the grace period.

``The problem is that they haven't been willing to give

much on taking this money from the Affordable Care Act or

Medicare, but why do they even have to come out of health

care at all? Why can't we use another vehicle to pay for

it?'' said Pallone, adding, ``Part of that could be cut back

significantly.''

Democrats also object to the way Puerto Rico's Medicaid

funding in the CHIP bill would be addressed.

``They're still requiring a state match from Puerto Rico,''

said Pallone. ``The bill funds a little bit, but it's totally

worthless if Puerto Rico has to come up with the match.''

The island does not have money to contribute, Democrats

say.

Earlier this month, Committee Chairman Greg Walden of

Oregon asked his Democratic colleagues to suggest offsets

that may be more amenable than those currently in the bill

that the committee passed. Last week, Walden said in a

statement that he had not received any Democratic offers.

Democrats contend they have put suggestions on the table.

One idea would require drug companies to help seniors

better afford their prescriptions by closing a funding gap,

known as the ``doughnut hole,'' in Medicare coverage.

Currently, seniors have to pick up more costs after a certain

spending threshold until they hit another limit when Medicare

resumes paying for coverage.

``We've been making offers back. One of the things we said

is make the drug companies pay for the doughnut hole. We

still have a doughnut hole for Medicare Part D. So if they

pay for the cost of that, that could be used as a payfor,''

said Pallone.

``This bill that may go to the floor next week is going

nowhere,'' said Pallone, stating that it would ``be a totally

partisan vote.''

Federal funding for CHIP expired Sept. 30. The Centers for

Medicare and Medicaid Services has redistributed unused CHIP

funds to nine states and territories including Arizona,

California, Minnesota, Washington, American Samoa, Guam,

Northern Mariana Islands, U.S. Virgin Islands and Oregon. The

funds come from unused CHIP allotments from previous years

and are used to help states that are running low on their

current year funds.

Mr. Speaker, I yield 5 minutes to the gentleman from Texas (Mr. Sessions).

Mr. Speaker, I yield myself 30 seconds for the purpose of a response before I yield to the gentleman from Georgia.

Mr. Speaker, if we are going to tell stories, then ``once upon a time'' should be part of our opening.

This bill merely takes some of the discretion for the Prevention and Public Health Fund away from the administration and returns it to Congress where it is supposed to be in the first place, so we take discretion over some of the Prevention and Public Health Fund dollars away from the executive branch and redirect these dollars to proven public health programs that enjoy broad, bipartisan support in Congress like the community health centers. Every Democrat voted for the Cures for the 21st Century, and it did exactly the same thing.

Mr. Speaker, I yield 1 minute to the gentleman from Georgia (Mr. Carter).

Mr. Speaker, I am pleased to yield 3 minutes to the gentleman from Alabama (Mr. Byrne), who is a fellow member of the House Rules Committee.

Madam Speaker, I yield myself 30 seconds.

First off, the gentleman may not remember that we had a legislative hearing in June on this very bill. It was delayed from June 14. The gentleman may recall there was an unfortunate circumstance of a shooting at a congressional baseball practice. In fact, a member of our committee, Majority Whip Steve Scalise, was in surgery, and most felt we couldn't go through with the hearing that day, but we had it 2 weeks later as soon as we could get the hearing time. So it was done well in advance of the expiration of the funding.

Furthermore, as far as the substitute goes, the minority is afforded the customary motion to recommit. I look forward to the gentleman introducing a substitute at that time.

Madam Speaker, I yield 2 minutes to the gentlewoman from Tennessee (Mrs. Blackburn).

Madam Speaker, I yield an additional 30 seconds to the gentlewoman from Tennessee.

Madam Speaker, may I inquire as to how much time is remaining?

Madam Speaker, I yield myself 2 minutes.

Madam Speaker, I want to address the issue of the Prevention and Public Health Fund.

The bill before us does redirect $8.9 billion for the Prevention and Public Health Fund to support critically important public health programs that expand access to care and improve health outcomes.

The Prevention Fund was established in the Affordable Care Act as mandatory funding for prevention and public health programs to improve health and help restrain the rate of growth in private and public sector healthcare costs.

According to statute, billions of dollars in advanced appropriations are to be used for the broad purpose of supporting programs authorized by the Public Health Service Act for prevention, wellness, and public health activities. However, prevention, wellness, and public health activities are allowable, but no Prevention Fund-specific or generally applicable definitions of these terms are to be found in the Public Health Service Act, the Affordable Care Act, or anywhere else in Federal law.

The Affordable Care Act was not accompanied by committee reports in either Chamber. The Department of Health and Human Services has not published regulations, guidance, or other information to clarify the Department's views about the types of activities that are within the scope of the Prevention Fund.

Annual mandatory appropriations, the Prevention Fund, continue in perpetuity. If Congress does not explicitly allocate the funding, then the Secretary of HHS has the authority to spend these dollars without congressional oversight.

This bill takes discretion over some of the--some, not all--some of the Prevention Fund dollars. It takes it away from the executive branch and redirects these dollars to proven public health programs that enjoy broad bipartisan support in Congress like community health centers, a program that employs 190,000 people and served over 24 million patients in 2015.

This has been supported in the past in other legislation, most recently in the Cures initiative, where Democrats and Republicans supported the redirecting of funding for the Prevention Fund for the specific purpose of preserving public health.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield myself the balance of my time.

I do want to address one of the things that has come up in the discussion, and that is the issue of the language in the underlying bill that supports the citizens, the American citizens in Puerto Rico.

There was a problem in Puerto Rico with their Medicare system, the way people were not automatically enrolled as they were in every other State and territory. There was a problem under the Affordable Care Act where they faced a Medicaid funding cliff.

These problems existed prior to the two hurricanes that hit the island, and a request was made to Chairman Walden and me, on behalf of the people of Puerto Rico, to fix these problems prior to the storms coming ashore, and that is what we fixed in the language of this bill.

I might remind this body that, when Hurricane Katrina came ashore around Labor Day of 2005, a similar problem was encountered. Ultimately, the State's share of that FMAP payment was made. It was made with funds from the Deficit Reduction Act, which were allocated on September 30, 2006, over a year later.

The fact is that there are going to be funds available to Puerto Rico to help offset their part, their match of their State's share of the Federal match, but it will likely come through the money that is appropriated for disaster relief. But we are fixing their underlying problem that existed before the hurricanes. If we don't fix it, it continues to be a problem year in and year out, and the American citizens of Puerto Rico are poorly served by that.

So this body is taking that up today, and I am proud of the fact that our subcommittee and our full committee recognize that and provided that relief.

Madam Speaker, I want to enter into the Record a letter from Texas Health Resources, Mr. Barclay Berdan. I want to quote from this letter: ``We . . . appreciate your leadership on delaying cuts to Medicaid DSH, which took effect on October 1, 2017.''

``Thankfully, H.R. 3922 would eliminate the scheduled Medicaid DSH reductions in fiscal years 2018 and 2019, thus allowing a critical source of funding to continue for safety net hospitals.''

Texas Health Resources,

November 1, 2017.

Hon. Michael Burgess,

House of Representatives,

Washington, DC.

Dear Representative Burgess: As one of the nation's largest

faith-based, nonprofit health care systems, Texas Health

Resources (Texas Health) provides more than 350 points of

access throughout North Texas, including 29 hospitals (acute-

care, short-stay, behavioral health, rehabilitation and

transitional care) and more than 100 outpatient facilities,

satellite emergency rooms, surgery centers, behavioral health

facilities, fitness centers and imaging centers. The system

also includes a large physician group, home health,

preventive and well-being services as well as more than 250

clinics and physician offices to provide the full continuum

of care for all stages of life. I am writing to thank you for

your leadership on the Championing Healthy Kids Act of 2017

(H.R. 3922) to extend funding for the Children's Health

Insurance Program (CHIP). We strongly support a five-year

extension of CHIP funding, along with the elimination of

reductions in fiscal years (FY) 2018 and 2019 to the Medicaid

disproportionate share hospital (DSH) payments.

Texas Health has supported CHIP since its inception, and

the program currently covers 8.9 million children with family

incomes above Medicaid eligibility limits who lack access to

affordable private coverage. The nation's uninsured rate for

children is a record low of 5 percent due in part to Medicaid

and CHIP coverage. While CHIP is authorized by Congress to

operate until October 1, 2019, legislative action is needed

to continue funding beyond FY 2017. Failure to extend CHIP

funding could result in coverage losses for millions of

children and increased financial pressure for states that may

lead to reductions in eligibility and benefits This

legislation safeguards the program by providing for a five-

year extension of funding.

We also certainly appreciate your leadership on delaying

cuts to Medicaid DSH, which took effect on October 1, 2017.

As you know, Medicaid DSH payments support Texas Health's

hospitals in serving north Texas' most vulnerable

individuals--the poor, the elderly, and the disabled.

Congress reduced Medicaid DSH payments in the Affordable Care

Act, reasoning that hospitals would care for fewer uninsured

patients as health coverage expanded. However, the projected

increase in coverage has not been fully realized, and

Congress subsequently delayed the start of the cuts that were

scheduled to begin in FY 2014. As a result, Texas hospitals

will sustain a $148 million cut in vital payments in federal

fiscal year 2018. The cumulative loss for Texas hospitals for

2018 through 2024 is $3.2 billion. Thankfully, H.R. 3922

would eliminate the scheduled Medicaid DSH reductions in

Fiscal Years 2018 and 2019, thus allowing a critical source

of funding to continue for safety net hospitals.

Thank you for your steadfast leadership on addressing these

important programs by supporting H.R. 3922. As Congress moves

forward on these important issues, we appreciate your

continued willingness to work with us to extend funding for

CHIP, eliminate reductions to Medicaid DSH payments, and

safeguard programs critical to hospitals. If we can provide

you or your staff with additional information, please do not

hesitate to contact.

Sincerely,

Barclay Berdan,

FACHE, Chief Executive Officer,

Texas Health Resources.

Madam Speaker, I also have a letter from the Children's Hospital Association, which renews the call for bipartisan CHIP extension: ``Children's hospitals thank Congress for its long-term bipartisan commitment to CHIP and for the children it serves. We look forward to working with lawmakers to maintain a strong CHIP program and strengthen healthcare for children in the future.''

Children's Hospitals Renew Call for Bipartisan CHIP Extension

Children's hospitals urge Congress to protect children and

families by passing a bipartisan five-year extension of the

Children's Health Insurance Program (CHIP) as soon as

possible.

We are pleased that members of the House Energy and

Commerce Committee have developed bipartisan CHIP policies

that reflect the needs of children, including a five-year

extension of the program that provides for robust CHIP

funding, and continue important beneficiary protections such

as the Maintenance of Effort provision, funding for

the Pediatric Quality Measures Program, express lane

eligibility, and outreach and enrollment grants. These

policies are also included in the bipartisan Senate proposal

on CHIP, and we thank the committees of jurisdiction in both

chambers for including these crucial policies.

If CHIP funding is not extended soon, CHIP-enrolled

children may become underinsured or uninsured altogether.

CHIP is an important bipartisan health coverage program for

over 6 million low-income children. CHIP builds off of a

strong Medicaid program by providing age-appropriate and

affordable coverage for children who fall above Medicaid

eligibility levels, but lack access to other health coverage

options.

Concerning reports indicate that states are taking steps to

limit programs in order to address the looming funding

shortfall, despite receiving federal redistribution funds. We

urge Congress to act now and avoid potentially disastrous

consequences caused by further delay by enacting a strong,

bipartisan five-year extension of CHIP.

Children's hospitals thank Congress for its long-term

bipartisan commitment to CHIP and the children it serves. We

look forward to working with lawmakers to maintain a strong

CHIP program and strengthen health care for children into the

future.

Finally, Madam Speaker, I will tell you I am perplexed. I, frankly, do not understand why there is reticence to providing an offset for funding of children's health insurance by income relating to part B premiums for people who earn over $500,000 a year, seniors who earn over $500,000 a year, or a couple who earns over $875,000 a year. This was language that was included in President Obama's budget, so don't tell me it is not bipartisan, because it was bipartisan.

Now, Madam Speaker, today's rule provides for the consideration of an important piece of legislation to maintain the important funding streams for millions of underprivileged children depending on the program.

I want to thank Chairman Walden for his efforts to continually work with the minority on the Energy and Commerce Committee, repeatedly providing the requested extensions by the ranking member in order to continue discussions on the legislation.

The package reflects hours of work to create legislation that will benefit millions of America's children so that they can lead healthier lives. I urge my colleagues to support today's rule and the underlying legislation, the CHAMPIONING HEALTHY KIDS Act

Madam Speaker, I yield back the balance of my time, and I move the previous question on the resolution.

Mr. Speaker, I yield myself such time as I may consume, and I thank the gentleman for yielding me the customary 30 minutes.

Mr. Speaker, 33 days ago, funding for the Children's Health Insurance Program, which 9 million children rely on for their healthcare and well-being, expired after the program was allowed to lapse. States crafted budgets, assuming Federal CHIP funding would arrive on time as it has always done, and they are now scrambling to develop a patchwork solution to keep the program alive.

Six States and the District of Columbia have warned they will run out of funding by December, next month. Thirteen States say they will soon have to tell enrollees they could lose coverage without immediate congressional action. Utah officials have even considered sending letters to enrollees as early as this week letting them know the program is being forced to wind down.

The Kaiser Family Foundation has found that 32 States are expected to run out of funding by March if Congress fails to act. I am glad we are here today with a bill to reauthorize CHIP and other public health programs, but they are woefully inadequate.

This bill is paid for by eviscerating funding from one of the most important parts, again, of the Affordable

Care Act that helps to keep people well: the Prevention Fund. This fund focuses on children's health, expanding access to lifesaving vaccines and reducing the risk of lead poisoning, among many other things.

This is a particularly heartless cut when you consider that many residents of Flint, Michigan, still can't get a clean glass of water from the faucet or bathe in uncontaminated water 3 years after the water crisis began. Children there in Flint will be forced to live for the rest of their lives with impacts ranging from neurodevelopmental damage and behavioral changes to hypertension and anemia, damage caused by a government that failed to act.

If it fails to adequately fund Medicaid for Puerto Rico and the U.S. Virgin Islands as they continue to try to rebuild following the devastating recent hurricanes, that would be a compounding of the tragedy. This bill fails to waive the requirement that both of those islands match Federal investment before they can access any of the Medicaid funding, and we don't deal with that at all, even for CHIP.

Seventy percent of Puerto Rico doesn't even have power 6 weeks after Hurricane Maria hit. I am proud to say that a lot of New York utility workers are down there now, and I am sure we will see results soon. Residents of Puerto Rico are washing clothes and bathing in contaminated streams and rivers, and drinking it as well. A million people there still don't have any running water. They don't have the ability to put up millions of dollars, either, to match these funds because they are struggling to survive. We don't address that. These are American citizens, and we have an obligation to help them.

These reauthorizations are a chance to really work together and deliver, but we are worried about this opportunity because there is no indication that this bill could pass the Senate with the cuts that it has made to the Affordable Care Act. I am referring, of course, to the ones that relate to preventive care. That would be a major tragedy.

As I have already said, so many States are right at the edge of not being able to fund the program at all. Other States are ready to tell both community health services and CHIP that they are no longer providing for them.

This partisan approach will only delay the extension of the programs even further. I consider that a major dereliction of our duties.

Mr. Speaker, I reserve the balance of my time

Mr. Speaker, I yield 3 minutes to the gentlewoman from California (Ms. Matsui), a distinguished member of the Energy and Commerce Committee.

Mr. Speaker, I yield 5 minutes to the gentlewoman from Connecticut (Ms. DeLauro).

Mr. Speaker, I yield the gentlewoman from Connecticut an additional 30 seconds.

Madam Speaker, I yield 5 minutes to the gentleman from New Jersey (Mr. Pallone), who is the distinguished ranking member of the Committee on Energy and Commerce.

Madam Speaker, I yield an additional 1 minute to the gentleman from New Jersey.

Madam Speaker, I yield 2 minutes to the gentlewoman from Texas (Ms. Jackson Lee).

Madam Speaker, I yield an additional 1 minute to the gentlewoman from Texas.

Madam Speaker, I yield myself such time as I may consume.

Madam Speaker, in May, the Republican majority recklessly passed their healthcare repeal bill without any analysis at all from the nonpartisan Congressional Budget Office, finding out a month later that it would have taken insurance away from 23 million people.

I fear the majority is going to make the same dangerous mistake with their tax bill. The New York Times reported that some sections of the bill released today are placeholders that will ``allow Republican leaders to work out the details of a new set of revenue-raisers that would be inserted in the bill before the full House votes on it''--in other words, they will be a surprise.

After the Ways and Means Committee marks up the bill, they will rewrite the bill in a back room and jam it through the House. It is beyond irresponsible to vote on a bill of this magnitude without knowing how it will impact hardworking Americans.

We employ dozens of well-qualified, nonpartisan expert economists and public policy analysts with advanced degrees in the Congressional Budget Office precisely for moments like this, and it appears the majority is again, this year, prepared to move so fast that no Member will have the benefit of their nonpartisan advice.

So if we can defeat the previous question, I will offer an amendment to the rule that will prevent this massive tax cut bill from coming to the House floor unless nonpartisan analysis from the experts at the Congressional Budget Office has been available for at least 2 days.

Madam Speaker, I ask unanimous consent to insert the text of my amendment in the Record, along with extraneous material, immediately prior to the vote on the previous question.

Madam Speaker, I yield myself the balance of my time.

Madam Speaker, we don't have time to spare playing games here with the CHIP program. It is on life support in many States, with officials scrambling to try to keep it alive. This is a program, you have heard before, that 9 million children rely on.

And 2,800 community health centers are at risk of closing their doors if we do not reauthorize the community health centers. That would leave millions of people without healthcare, cost more than 50,000 jobs, and already the centers nationwide have been forced to consider cutting services following the majority's failure to reauthorize the program before it expired on September 30.

Everybody knows that these centers do remarkable work. They deliver quality care at lower cost. More than 330,000 veterans relied on them for healthcare last year alone. They could be reauthorized under a clean bill in seconds. Instead, the majority is putting them at risk through this partisan bill, which seems unlikely to pass the Senate, and we will then be nowhere.

If you want to know why only 13 percent of the public approves of Congress under the leadership, just look at the bill before us today. Republican leaders have turned even the most bipartisan programs into endeavors that seem unlikely to become law.

They have disallowed the Democratic Party to have any substitute with any other ideas that they did not have before so that we can, as Ms. DeLauro mentioned, have an honest debate. We see that time after time in the Rules Committee, the inability for our side to even get amendments passed. But not to allow a substitute bill of this magnitude is, I think, really a dereliction of duty. It speaks volumes about the inability to get things done.

And lastly, Madam Speaker, I want to recognize George Agurkis. He is sitting here with me. George has been on the Rules Committee staff for 9\1/2\ years. He is leaving us at the end of the week to take a wonderful new job and new project. He is a Pennsylvania neighbor we always could count on. He is a lot of fun. We are going to miss that and his aunt, Rose, who works in the cloakroom. And we know that she gives the best birthday parties in the world, and we don't know what we are going to do. We hope that George will come back and celebrate those with us and Rose will once again delight us with every kind of sweet thing in the world.

Madam Speaker, on that I demand the yeas and nays.

Madam Speaker, I want to thank the ranking member of the Rules Committee.

I just want to express the tremendous frustration that I have and that Democrats have in general with the way the Republican leadership has handled the CHIP bill, IPAB, and community health centers, the legislation we are considering today and tomorrow.

First of all, I need to point out that it was over a year ago when I asked

leadership of our committee to try to come up with bipartisan legislation with regard to community health centers and SCHIP, the children's initiative, and all they wanted to do from January until September--9 months--was repeal the Affordable Care Act.

That is all they were interested in. They didn't want to hear anything about CHIP or community health centers, just repeal the Affordable Care Act.

My colleagues on the other side suggested that somehow, because of CHIP, they are very concerned about kids. Well, the fact of the matter is, if you repeal the Affordable Care Act, children--everyone--and community health centers would suffer such damage because they would lose their health insurance or the underpinnings of the community health centers, which have been financed with the Affordable Care Act, that any suggestion that somehow because you are concerned now about CHIP or community health centers is belied by the fact that you spent the last 9 months, through September, trying to repeal the Affordable Care Act. If you really cared about these things, then you would not have sought that repeal.

Once that repeal seemed to be over in September, then the Republicans on the committee and the leadership were willing to talk about CHIP and community health centers. But mind you, the authorization for those two programs ended September 30. So it was literally too late.

Now my colleagues on the other side say: Oh, well, we are bringing this bill up today because we really care about kids and community health centers.

Exactly the opposite. If you did care, in the sense that you wanted to get legislation passed, then you wouldn't bring this bill up today. We all know that if the bill is not bipartisan, which it is not, it will never pass the Senate. What is going to happen is these bills will pass on a partisan vote on Friday and, as a consequence, they will go to the Senate and there will be no action and we will have to deal with this at the end of the year as part of some larger omnibus spending bill or whatever we do at the end of the year.

So anyone who tells you that the Republicans, in trying to pass a partisan bill, are actually moving forward on CHIP or on community health centers, that is simply not true.

Now, what are we facing here with these three bills? And I include IPAB, CHIP, and community health centers. What we are really facing is another effort on the part of the Republican leadership to repeal or sabotage the Affordable Care Act.

All these things are part, in some fashion, of either pay-fors or authorization of the Affordable Care Act. The fact of the matter is, we are now seeing what I would call piecemeal repeal.

You couldn't repeal it outright, so you do a piecemeal repeal. You repeal IPAB. You basically use funding from the Prevention Fund and you gut that so you can pay for the CHIP funding. You change the grace period so something like half a million people lose their health insurance. Meanwhile, the President of the United States is out there every day issuing executive orders to get rid of cost-sharing subsidies to cut back on the outreach program.

If you look at all this, it is nothing more than a piecemeal repeal of the Affordable Care Act. It is sabotaging the Affordable Care Act.

This has not changed. The first 9 months to September, outright repeal. Now, between now and the end of the year, piecemeal repeal. Every day, a different bill.

The real inconsistency, which is the best I can say about what is going on, is to say that we have to come up with offsets to pay for the Children's Health Initiative Program and the community health centers, but we don't have to do it for IPAB. $17.5 million is what it is going to cost, according to the CBO, to repeal IPAB. If you use that money, it would almost pay for the CHIP and the community health centers bill that will be considered the next day.

So, again, we have this total inconsistency suggesting that somehow we care about one thing. What is really go on is robbing Peter to pay Paul. The way that you pay for the community health centers and the CHIP bill, basically, sabotaging the Affordable Care Act, is you shorten the grace period from 90 days to 30 days, when people, if they don't pay their premium, will lose their health insurance. We know that maybe almost 688,000 people, according to the CBO, will lose their health insurance.

Then you have the Prevention Fund, which is used for children's lead poisoning programs, children's vaccines, and for the opioid program that the Republicans say they care so much about. These are going to go away in order to pay for CHIP and community health centers.

What is going on here is unbelievable. I just say to my colleagues: look at what is actually happening. We had a Democratic substitute and the Rules Committee wouldn't even let us consider it.

So it is not just the underlying issue of what is actually happening here in terms of the substance of the bills. It is also the process that is being used. That is why I am glad I am talking during the Rules Committee time.

We had a Democratic substitute that would have had a great piece of legislation that paid for the community health centers, paid for CHIP, without sacrificing other healthcare programs that help kids and other Americans. They wouldn't even let us consider it here today.

So I say to my colleagues: basically, vote ``no'' on the rule. Turn down this rule and let us have another opportunity to actually do something that is important and that is meaningful.

Mr. Speaker, I really appreciate the distinguished gentleman from Lewisville, Texas, Dr. Michael Burgess, who serves several roles in this House of Representatives. First of all, he is chairman of the Subcommittee on Health for the Energy and Commerce Committee--actually, his favorite committee--and then his duties at the Rules Committee, and Mike has spent a good number of years in service to the entire body. I want to thank Dr. Burgess for his personally handling not only this matter, but bringing to Congress a really strong attitude that he has about children.

Dr. Burgess, for a number of years since his early days in Parkland Hospital in Dallas, Texas, as a resident and then becoming an obstetrician-gynecologist who served not only the Dallas area, thousands of people, but he brought to that a love of children, women, and families to give precious life to the United States of America, I want to thank him for his healthy child bill that he brought to the Energy and Commerce Committee.

Mr. Speaker, let me say this. The gentlewoman from New York, the ranking member of the Rules Committee, and the entire committee yesterday spent a great deal of time not only looking at this particular bill, but other very germane issues related to healthcare. My colleagues, including

the gentlewoman from New York, really have the best heart in this. I believe this is an issue where we agree. We agree that children's health is not only an important part of what Congress should be involved in but, actually, resolving the issues.

She is very correct. Several weeks ago it was brought up in the Rules Committee the timeliness of this issue, the appropriateness of the Rules Committee handling this bill to get it to the floor so that we would allow not only the American people to understand what we were doing, but, really, to put it in play so that this could be handled by the United States Senate and the President.

I want to congratulate my colleagues. I think that my colleagues, to a person, understand the importance of this--and certainly Mike Burgess' leadership at Energy and Commerce Committee--but also the Rules Committee. So reauthorizing the Children's Health Insurance Program, or CHIP, as it is known, is vitally important. It is important because there are some 400,000 children in Texas, alone, where Chairman Burgess and I live.

We see not only families, but we see the healthcare community. We see other elected officials and just normal people at home who expect us to get our work done. We are today. In fact, we are not only getting it done, but, as Chairman Burgess has talked about and even as the gentlewoman, Ms. Slaughter, has talked about, there will be States at the end of November that will be running on fumes, be running on empty, and a good number of States are funded until probably February or March. But that is not a reason for us to delay.

So we are here, respectfully, to ask the entire body, Republicans and Democrats, and also to let the American people know that the Children's Health Insurance Program, through the efforts of Mike Burgess and through the efforts of Greg Walden as chairman of the committee, who have worked very diligently to make sure that it not only comes to the floor, but that the new nuances of the bill that will include many, many good bipartisan ideas will be offset, and it will be offset. We are going to have to make sure as we move forward that those are careful instructions that we all understand.

But the bottom line to this is, Mr. Speaker, this Congress, because of the bipartisanship, because of the ability, because of the importance of CHIP, is handling this today.

We are going to ask all Members if they did not have a chance to see what I thought was a robust, distinguished panel that came to us yesterday to talk about this, but also the thoughtful ideas from our Members about the importance of this, I think we can convince this body--this body, Republicans and Democrats--that the underlying legislation helps secure for 5 more years--which is what the goal was, 5 more years--to make sure that we can move forward; and it gives States the authority and the responsibility, gives the American people confidence that what we are doing to take care of this issue has not only been done, but presented in such a way that it will be successful.

That is our job, Mr. Speaker. Our job is to take the work that comes from the committee of jurisdiction--in this case, the Energy and Commerce Committee--and move that through, look at it, vet it, and make sure the best ideas happen. I am pleased and proud to be here today.

Mr. Speaker, I rise to voice my opposition to this rule and to the underlying bill.

First, by the way, my colleague from California (Ms. Matsui) talked about the Democratic substitute. But let's be clear, it is our Republican colleagues, the majority, who would not make a Democratic substitute in order that would allow us to come here to have a debate on their proposal and what we proposed. How about that for democracy in the United States House of Representatives? No Democratic substitute.

So let's leave that aside and focus on what we have here today. Again, opposed to the rule, opposed to the bill.

The Children's Health Insurance Program is vital for millions of our Nation's most vulnerable citizens--our children. The gentleman before spoke about 9 million children. Yes. But do you know how long we have waited for the majority to reauthorize the Children's Health Insurance Program? The length of time is shameful. But even more shameful is how the majority intends to pay for the Children's Health Insurance Program.

This is what the bill does. The bill includes massive cuts to something called the Prevention and Public Health Fund. What is the Prevention and Public Health Fund? It is inclusive of many of the programs that we rely on in order to save lives.

Yes. They are the programs that go to help our community health centers be able to treat people who come to their door. Twenty-three million people in the United States use community health centers. It is often their primary care.

But let me lay out for you what some of these programs are: the Centers for Disease Control childhood vaccines--vaccinations and immunizations for our kids being cut--lead poisoning prevention. You go to any community in this country, and they will tell you whether it is water or whether it is paint. Some of our children have the highest levels of lead, and what we need to be doing is screening them at a very early age so that we can address the issue. They cut this out, also the Centers for Disease Control heart disease program, stroke and diabetes programs, breastfeeding grants for hospitals, childhood obesity prevention, and suicide prevention. We are looking today at an opioid crisis in this Nation that so often results in suicides, and they are willing to cut the heart out of the Prevention Fund programs to fund the Children's Health Insurance Program.

So we are harming children at one end of the spectrum and robbing the money from that end of the spectrum to pay for the Children's Health Insurance Program, which I am a big supporter of. So we are stealing from this prevention program.

Now today, my Republican colleagues have offered a tax cut proposal. Take a hard look at it because the richest, the wealthiest, and those with the most lobbyists are the biggest beneficiaries of these tax cuts, and middle class working families will get the short end of the stick. Those people who make over $1 million--several million dollars-- are going to get the benefit of the tax cut. Why aren't we taking that money and paying to reauthorize the Children's Health Insurance Program rather than taking the money from the Prevention and Public Health Fund?

So instead of providing tax cuts today for the richest 1 percent of Americans, we could have a strong Children's Health Insurance Program, and we could have a strong Prevention and Public Health Fund that does not have to make these egregious cuts.

I think there is one more point that people need to know about this bill. The bill cuts something that was in the Affordable Care Act--the grace period. They cut that back to 30 days. That means if someone misses one health insurance payment, they can lose their insurance for the remainder of the year.

Today, our biggest economic challenge as a nation is that people are in jobs that just don't pay them enough to live on. They can't afford their healthcare. It is cruel, and it is a brazen attempt to undermine the Affordable Care Act, which, quite frankly, has been the majority's agenda for a very long time.

There is no need to play off children's health insurance against the Prevention and Public Health Fund. There is no need to cut back on the grace period for the folks who may miss one health insurance payment.

So I urge my colleagues: don't be cruel; don't be inhumane. To those of my colleagues who will say no to this, you stand on solid ground. You stand with families in this Nation. You stand with children when you say no to cuts that are going to hurt their lives.