Mr. Speaker, I thank the gentleman for yielding me the customary 30 minutes, and I yield myself such time as I may consume. Mr. Speaker, I rise in opposition to this rule today, one that provides for…
Mr. Speaker, I thank the gentleman for yielding me the customary 30 minutes, and I yield myself such time as I may consume.
Mr. Speaker, I rise in opposition to this rule today, one that provides for consideration of the Protecting Access to Care Act. This bill would significantly alter how families and patients that are injured as a result of medical error are able to hold healthcare providers, facilities, or device makers accountable to make sure that that same thing doesn't happen to other people.
This bill decreases patient safety. It undermines the ability of people who are wrongfully injured by medical malpractice or faulty medical devices to be compensated for their injuries, and it violates the 10th Amendment to our Constitution, the rights reserved to the States.
Before I turn to the merits, or lack thereof, of this bill, I want to discuss the process under which this bill came to the floor.
The Judiciary Committee, which has jurisdiction over this bill, had zero hearings on this legislation, heard from zero experts, and went straight to markup. Despite the overwhelming opposition to this legislation, the Judiciary Committee did not want to hear from groups like the American Bar Association, Patient Safety America, the National Disability Rights Network, or the National Protection Alliance.
When I see the American Bar Association, who the committee refused to hear from--I know my colleague from Colorado is an attorney. I just want to inquire of my colleague from Colorado if he is a member of the American Bar Association, and I yield to the gentleman.
Okay. Well, that is the association which many attorneys, excepting, of course, my friend from Colorado, are a member of.
The supporters of this bill point to its consideration in previous Congresses for hearings, but we have over 50 new Members who didn't hear a word about this bill from any experts before it was rushed to the floor.
We are considering this bill under a very restrictive rule. That means there were 24 amendments filed. This rule only allows the House to debate and vote on five of them. That means 19 of them, amendments offered by Democrats and Republicans, were simply just tossed out in the Rules Committee. That is what this rule does.
If this rule were to pass, it would mean that the efforts of 19 Members to offer ideas to improve healthcare wouldn't even be allowed to be debated or voted upon here on the floor of this House. It is no coincidence that eight amendments filed by Democrats, and not one Democratic amendment was made in order. Only 5 out of 24 ideas from Democrats and Republicans were made in order.
One amendment filed by my colleague, Representative Jackson Lee, would have provided an exception to the bill for any medical-related injury to a child, which seems like common sense. At least have a debate about it. If people disagree, let them disagree. Let's have a vote.
This rule continues this very closed process, where Democrats and Republicans are shut out of participating in the bills that appear fully formed without the opportunity for us to represent our districts and offer amendments to improve and make these bills better, to reduce costs, to improve the quality of care.
What I wonder, Mr. Speaker, is: Where is the open process promised by Speaker Ryan? This Congress hasn't even considered a single piece of legislation under an open rule, and we have had many, many bills brought to the floor under closed rules and without any committee hearings. But, you know, I am beginning to not be surprised so much anymore because secretiveness seems to be the standard that Republicans are setting in this Congress.
How the Republicans have handled their healthcare bill from start through now is a perfect example of the closed-door, secretive process that has become, tragically, the standard operating procedure for this Congress.
The Republican healthcare bill will increase healthcare costs, provide less coverage--22 million fewer people will be covered-- increase costs for those who are lucky enough to keep their current coverage, and reduce access to healthcare for the American people. It puts a burden on small businesses, on the middle class, on rural healthcare providers, while handing hundreds of billions of dollars in tax breaks to big corporations and special interests.
TrumpCare is a billionaire's tax cut disguised as a healthcare bill, and it will be one of the largest transfers of wealth from the middle class and the working families to the top 1 percent of Americans. Effectively, it is removing benefits from people in rural counties and cities across our country and giving those tax cuts mostly to people in New York and Hollywood. That is what Republicans are delivering with this bill.
When the American people were finally given the chance to see the Senate's healthcare legislation, the American people overwhelmingly rejected it. Only 16 percent of the American people approve of the plan. Democrats oppose it; Republicans oppose it; independents oppose it.
The Congressional Budget Office's recent score of the bill says that coverage will significantly decrease under this bill and that the costs of deductibles for patients will go up. Patients will have to spend more out of pocket, those that are lucky enough to even have insurance after this cruel bill.
But there is still time to stop it, and I call upon my colleagues to prevent this bill from moving forward.
The bill that Republicans are trying to ram through Congress is not truly meant to make improvements to our healthcare system but to take money away from the middle class and working families and put it into the pockets of a very few people who benefit from the tax cuts under this bill: for people making millions of dollars a year.
This bill makes it harder for middle-income families and for low- income families to access quality, affordable healthcare, makes it harder for individuals who have preexisting conditions or have genetic disorders or long-term diseases from accessing lifesaving medical attention, and cuts critical healthcare services for disabled children in schools that many of our school districts rely on. And they want to do this all with a closed process.
I offered three amendments to improve healthcare in our Education and the Workforce Committee. All were defeated on a partisan vote.
Every Republican voted not to allow those. No Democrat, as far as I know--certainly not me--has been invited to present our ideas to Republican leadership or President Trump.
Democrats have lots of ideas to improve the Affordable Care Act. I am sure many Republicans do, too. Those ideas are not reflected whatsoever in this bill or in the closed process that prohibits Republicans and Democrats from even offering our suggestions to improve this bill.
So, here we are, debating another piece of healthcare legislation that did not go through an open process. Democrats were shut out of the amendment process completely.
This bill would make it more difficult for victims of medical malpractice to seek or receive compensation for their injuries. It is inconsistent with the 10th Amendment, which reserves these rights to the States that are not enumerated in the
Constitution, and unlike the Democrats' approach to medical malpractice reform in the Affordable Care Act, which provided funding for pilot programs in the States to reduce the risk of medical malpractice liability consistent with the 10th Amendment. Many constitutional experts--I would add, many conservative constitutional experts--believe that this approach is unconstitutional because of the 10th Amendment.
We have learned that this bill does not actually protect access to healthcare but, instead, undermines a State-based tort system, making it more difficult for patients to be compensated from bad actors.
Mr. Speaker, I include in the Record a letter signed by over 60 national and State organizations opposed to H.R. 1215.
June 12, 2017.
Re Groups Urge You to Vote NO on H.R. 1215.
Hon. Paul Ryan,
Speaker, House of Representatives,
Washington, DC.
Hon. Nancy Pelosi,
Minority Leader, House of Representatives,
Washington, DC.
Dear Speaker Ryan and Leader Pelosi: The undersigned
consumer, health, labor, legal and public interest groups
strongly oppose H.R. 1215: The ``Protecting Access to Care
Act of 2017.'' This bill would limit the legal rights of
injured patients and families of those killed by negligent
health care. The bill's sweeping scope covers not only cases
involving medical malpractice, but also cases involving
unsafe drugs and nursing home abuse and neglect.
Even if H.R. 1215 applied only to doctors and hospitals,
recent studies clearly establish that its provisions would
lead to more deaths and injuries, and increased health care
costs due to a ``broad relaxation of care.'' Add to this
nursing home and pharmaceutical industry liability
limitations, significantly weakening incentives for these
industries to act safely, and untold numbers of additional
death, injuries and costs are inevitable, and unacceptable.
The latest statistics show that medical errors, most of
which are preventable, are the third leading cause of death
in America. This intolerable situation is perhaps all the
more shocking because we already know about how to fix much
of this problem. Congress should focus on improving patient
safety and reducing deaths and injuries, not insulating
negligent providers from accountability, harming patients and
saddling taxpayers with the cost, as H.R. 1215 would do.
For example, this bill would establish a permanent across-
the-board $250,000 ``cap'' on compensation for ``non-economic
damages'' in medical malpractice cases. Such caps are unfair
and discriminatory. For example, University of Buffalo Law
Professor Lucinda Finley has written, ``certain injuries that
happen primarily to women are compensated predominantly or
almost exclusively through noneconomic loss damages. These
injuries include sexual or reproductive harm, pregnancy loss,
and sexual assault injuries.'' Also, ``[J]uries consistently
award women more in noneconomic loss damages than men . . .
[A]ny cap on noneconomic loss damages will deprive women of a
much greater proportion and amount of a jury award than men.
Noneconomic loss damage caps therefore amount to a form of
discrimination against women and contribute to unequal access
to justice or fair compensation for women.''
Other provisions in H.R. 1215 are just as problematic. The
proposed federal statute of limitations, more restrictive
than a majority of state laws, lacks complete logic from a
deficit reduction angle since its only impact would be to cut
off meritorious claims, forcing patients to turn to the
government for care. The bill would repeal joint and several
liability even though the Congressional Budget Office says
this could increase, not lower, costs.
H.R. 1215 would overturn traditional state common law and
would be an unprecedented interference with the work of state
court judges and juries in civil cases. Its one-way
preemption of state law provisions that protect patients
(there are some exceptions) makes clear that the intent of
this legislation is not to make laws uniform in the 50
states. Rather, it is a carefully crafted bill to provide
relief and protections for the insurance, medical and drug
industries, at the expense of patient safety. We urge you to
oppose H.R. 1215: The ``Protecting Access to Care Act of
2017.'' Thank you.
Very sincerely,
Some of the groups are the Gerontological Advanced Practice Nurses Association, Justice in Aging, Long Term Care Community Coalition, National Education Association, National Consumers League, National Disability Rights Network, Public Citizen, Public Justice, and many, many other great organizations.
I hope my friend from Colorado is a member of at least two or three of these wonderful organizations. I will furnish the entire list to him.
This bill preempts State tort law that has been developed over the last 200 years and is contrary to the 10th Amendment of our Constitution. It imposes an arbitrary cap on the amount of noneconomic damages a victim can collect under a Federal law coopting the ability of States to do their own medical malpractice laws and hamstringing them with regard to the reforms that they can undertake.
In fact, capping damages also increases taxpayer spending. According to a joint study by Northwestern University and the University of Illinois, they found that capping economic damages actually increases Medicare part B spending.
I would point out another horrible feature of the cruel Republican healthcare bill is that it guts the Medicare trust fund and would lead to Medicare becoming insolvent sooner rather than later by draining the Medicare trust fund of over $100 billion. That is another aspect of this bill.
No wonder they didn't want us to see it, Mr. Speaker. No wonder they kept it in a locked closet from even Republicans who were allegedly writing it, like Ken Buck and my friend, Senator Gardner, who was on the committee writing it and who later said he hadn't seen it. No wonder it was hidden, when you find out it actually leads to Medicare insolvency sooner, when you find that it throws 22 million people off the insurance that they already have, when you find out it raises rates for those who are lucky enough to maintain their insurance, when you find it takes money out of our schools, when you find that it risks throwing our elderly out of their nursing homes who rely on Medicaid.
This bill is a symptom of a problem. I am not a doctor; my friend from Colorado is not a doctor; but when I ask my doctor what you do when there are
symptoms, it is treat the underlying cause.
Let's do that. This bill doesn't do that. This Republican Senate bill that throws people off insurance doesn't do that. Let's begin a process where we get ideas from Democrats and Republicans to work together to reduce costs in healthcare, to expand coverage in healthcare, and to improve the quality of healthcare for American families.
This bill is not focused on protecting patients. It increases the risk to patients. It drains Medicare of additional money. This bill will not reduce costs to patients. In fact, no healthcare bill being debated in Congress right now actually improves patient care or reduces costs to patients.
Those should be two pillars, two goals of healthcare reform: Can we reduce costs, and can we improve patient care?
This bill risks making patient care worse in an unconstitutional way. The Senate bill actually will increase costs to patients, increase deductibles, make more people lose their insurance, make you pay more for insurance you already have if you are one of the people who is lucky enough not to lose it under the cruel Republican bill.
Instead of politicizing and polarizing access to healthcare-- literally a life-and-death issue for American families--let's work together to find solutions that reduce costs, increase coverage, and improve care. The Senate Republican healthcare bill meets none of those three critical criteria that the American people demand in healthcare reform: reducing costs, increasing coverage, and improving the quality of care for ourselves and for our loved ones.
Mr. Speaker, I reserve the balance of my time.
Will the gentleman yield?
Prosecutors are lawyers as well. So I just wanted to be clear that it is not an insult. Being an attorney is a fine profession. There are some attorneys on both sides, both defending as well prosecuting criminals, but they are both attorneys. I just wanted to clarify that.
Mr. Speaker, I yield 2 minutes to the gentleman from Virginia (Mr. McEachin).
Mr. Speaker, I yield myself such time as I may consume.
I was glad my colleague pointed out that it violates the Seventh Amendment. Now we add that to the 10th
Amendment. So there are actually two Amendments. I am not even an attorney, but I know this violates two Amendments to our Constitution. That is pretty impressive for one bill.
Mr. Speaker, I yield 2 minutes to gentlewoman from Illinois (Ms. Schakowsky).
Mr. Speaker, I yield myself such time as I may consume.
I would like to inquire of my friend from Colorado whether recognizing those savings is in fact a Federal responsibility or a State responsibility.
I yield to the gentleman from Colorado.
Mr. Speaker, exactly. What I would further add, then, is whose prerogative is it to institute this kind of cap: States like our own State of Colorado, which has that cap? Or Washington, D.C. insiders behind closed doors?
I yield to the gentleman from Colorado.
Mr. Speaker, reclaiming my time, this effectively co-ops States and forces other States to do the same thing that my colleague's and my State of Colorado has already done. It goes beyond that as well. Under the 10th Amendment of the Constitution, this should be a power reserved for the States.
Mr. Speaker, I would like to shed light on a serious issue facing millions of students nationally and in my home State of Colorado. Every day, 50 million students and 3 million teachers face significant health and safety threats due to inadequate school facilities. I have heard about many in Colorado, school gyms that are closed down because their roofs are falling in, staggering statistics that disproportionately affect high-poverty schools, particularly urban and rural schools, and many schools serving a high percentage of minority students.
Today we have a chance to address this rampant inequality throughout our school districts and to create jobs in the process.
If we defeat the previous question, I will offer an amendment to the rule to bring up Representative Bobby Scott's Rebuild America's Schools Act, H.R. 2475, which I am also a proud co-sponsor of. Mr. Scott's legislation would invest $100 billion in the physical and digital infrastructure needs of our schools, creating nearly 2 million jobs and creating the education infrastructure we need for the 21st century.
Mr. 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.
Mr. Speaker, I yield 4 minutes to the gentleman from Virginia (Mr. Scott), the distinguished ranking member of the Education and the Workforce Committee, to discuss our proposal.
Mr. Speaker, I will be happy to supply those. To be clear, the entire school doesn't close, just the gym closes.
Mr. Speaker, I do have further speakers.
Mr. Speaker, I yield 2 minutes to the gentleman from Nevada (Mr. Kihuen).
Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, when we think about healthcare, we all think about, of course, first and foremost, ourselves and our loved ones and our families. As Representatives of 750,000 people, we also think about constituents that we know, that we have met, for whom healthcare is literally a life-and-death situation.
I think of my friend Debbie and her son Sam. Debbie's son Sam was diagnosed with type 1 diabetes when he was 4 years old. He is now 20 or 21 or so. He was a healthy kid, he ate healthy food, an active young child. As Debbie pointed out to me, it is not that anybody chooses an illness or a condition, the illness chooses you. Through the luck of the draw, her son Sam is afflicted with type 1 diabetes. Like many people with autoimmune diseases, it was not poor choices, it was not lifestyle decisions that gave him the disease or even increased his risk of the disease. He was dealt a bad hand with an autoimmune gene that his family didn't even know that they had.
Because of that, Sam has a costly disease. Thankfully, one that can be treated, if not cured, but he has a costly disease for the rest of his life. There is no cure, and the cost of insulin and other lifesaving technologies is very high.
Sam has what here in Washington people call a preexisting condition. That is what we are talking about. Without insurance, the cost per month would go from about $400, which Debbie and her husband are able to afford and put together for Sam, to $2,500 a month, which they could not possibly afford to do.
Sam is now 20, and because of the Affordable Care Act, he will be on the family's health insurance until he is 26. That is, if the family can keep their health insurance. The family worries, like so many others, that they might be one of those 22 million families that loses coverage under this Republican healthcare bill. It is a lot of families.
It is not going to be any of my colleagues' families. My colleagues have a government health insurance plan from serving in the House of Representatives. Their congressional staff has access to the exchanges, just like we do, to buy insurance. But 22 million people in each and every one of our districts, 435 districts in this country, in each and every one of our districts, not dozens of people, not hundreds of people, but thousands of real people like Deb and Sam, like a story I shared earlier of Marcia and Grace, will actually lose their healthcare. They will be forced to give up their home, become insolvent, go bankrupt, or die. A choice that no American should have to face.
Mr. Speaker, the bill under consideration today is one of many that didn't go through regular order. There were no hearings. Closed process. They cut out all the Democratic amendments that we had to improve the bill. That is how the Republicans have been handling healthcare legislation this Congress. That is why this approach isn't working. It is why this approach is so unpopular. No hearings, shut Members out of the legislative process, bring a bill to the floor that was hidden in some closet, written in secret, widely unpopular, throwing people off healthcare insurance, raising rates for those who are luckily enough to keep their insurance.
This bill is not aimed at protecting patients. This bill before us and the Senate Republican healthcare bill make it more difficult for Americans to deal with real-life healthcare issues that were dealt over the course of life for ourselves and our families.
We need a reset, Mr. Speaker. We need to reset and start real discussions about improving healthcare.
How could Democrats or Republicans work together to reduce costs?
Democrats and Republicans should work together to expand coverage. We shouldn't be talking about whether 22 million people lose coverage or 10 million people lose coverage or 5 million people lose coverage. Let's talk about 5 million people gaining coverage, 10 million people gaining coverage. Let's reset and frame the discussion about how more people can have access to healthcare.
The problem we are trying to solve is not how can we get less Americans to have access to healthcare. That is why this bill is so unpopular. If that is the problem Republicans are trying to solve, they solved it in this bill. Less Americans will have healthcare. But that is not the problem that the American people want us to address in Congress.
More people with healthcare, and people want to save money. They want their insurance rates to be lower, their deductibles to be lower. They want to save money. There are some low-hanging fruit in terms of costs in healthcare, administrative overhead, wasteful and duplicative spending, that we can go after together. These are good ideas, whether you are a Democrat or a Republican.
One of the amendments that I proposed was pricing transparency. One of the problems in the healthcare marketplace is nobody knows how much anybody charges. Different insurers and private payers pay widely different amounts for the exact same procedure. Let's at least disclose the pricing and have transparency so market mechanisms will work to pull down rates by promoting competition.
By not allowing the market into healthcare, we are creating inefficiencies and raising rates. Let's come together on that. Let's come together around a lot of good ideas that Democrats and Republicans have bills on and have amendments on. But, no, they are not even allowed to be debated and not even allowed to be voted on either on
this bill, in which every Democratic amendment was shut down, or in the Republican healthcare bill, in which no process was allowed for Democrats to improve the bill.
We have never even been invited into the secret backroom to figure out what was being debated. We didn't even see the bill until it was presented fully formed days before it had to be voted on, affecting the lives of 22 million Americans, one-eighth of our entire economy, without any hearings, without any expert testimony, and only days to digest this hundred-page bill.
So look, let's reset, let's work together to bring down costs, expanding coverage and improving quality, and create a work product in healthcare reform that we can be proud of as Republicans, as Democrats, and as Americans; one in which Debbie and her son, Sam, don't have to worry about giving up their home or facing death; or one in which Grace and her mother are able to live out their lives without worrying about their preexisting condition.
Mr. Speaker, I call upon my colleagues to reject this closed rule, and I yield back the balance of my time.
Mr. Speaker, on that I demand the yeas and nays.
Mr. Speaker, I demand a recorded vote.
