Providing for consideration of the bill (H.R. 3922) to extend funding for certain public health programs, and for other purposes.

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, pursuant to House Resolution 601, I call up the bill (H.R. 3922) to extend funding for certain public health programs, and for other purposes, and ask for its immediate consideration in the House.

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

Mr. Speaker, we are here today to consider a very, very important public health bill, H.R. 3922, the CHAMPIONING HEALTHY KIDS Act. This legislation funds a 5-year extension of the Children's Health Insurance Program, known as CHIP, along with a 2-year extension of community health centers and numerous other critically important public health programs.

This bill will deliver quality healthcare and peace of mind to millions of Americans. The patients and families helped by this legislation are our neighbors and our friends. More than 8 million children receive CHIP-funded coverage, and more than 25 million patients are served by our community health centers and other important programs.

This 5-year funding of CHIP marks one of the longest extensions of the program since it was created 20 years ago. The policy we are considering mirrors the bipartisan policy that has been introduced and voted out of our sister

committee in the United States Senate.

Funding for these important programs expired September 30. The committee worked on a bipartisan basis well before this deadline to try and reach a bipartisan agreement on a range of policies to offset the costs of this very critically important funding extension.

Three times, at the request of the Democrats, we delayed committee action--three times. We tried to find offsets that were agreeable as we have always been able to do before. Unfortunately, that was not the case this time. These delays meant Congress went past the deadline of September 30.

While States still have rollover CHIP funds available and the next wave of community health center funds won't go out until next year, we cannot wait any longer. Patients cannot wait any longer. Patients need care, these critical programs need funding, and we must move forward.

In my district alone, there are 12 federally qualified health center organizations, with 63 delivery sites. They leverage $41 million in Federal money in order to serve more than 240,000 patients in Oregon's Second District. These health centers--and I have visited many of them--are prevention and public health in action, often serving as the main provider of care for people for hundreds of miles around.

We are also extending the National Health Service Corps and the Teaching Health Center Graduate Medical Education program. Now, Mr. Speaker, these are really important workforce programs that place qualified providers into some of the most underserved areas of our country.

In addition to community health centers and the workforce programs, this bill extends the funding for the Special Diabetes Program and the Family-to-Family Health Information centers, the Personal Responsibility Program, and the Youth Empowerment Program. These locally based, patient-centered organizations provide comprehensive services to those most in need.

Moreover, this legislation eliminates 2 years of the across-the-board cuts to Medicaid allotments called for under the Affordable Care Act, ObamaCare. We delay those cuts for disproportionate share hospitals for 2 years. Medicaid DSH funding represents an important component of many State Medicaid programs and is particularly relied upon by many States to help provide additional resources to key safety net providers.

Now, while this relief is only temporary and does not address the larger structural challenges under ObamaCare, it would give Congress time to explore what budget-neutral approaches there might be to allocate existing DSH dollars on a more equitable and fair basis. In my State alone of Oregon, hospitals have told me this relief in this bill, just for them, represents $6.8 million over the next 2 years that they can use to help low-income people get access to hospital care.

Now, in paying for this package--and this is the area where we have the most disagreement with the Democrats--we have taken a fiscally responsible approach, like using existing funding streams for prevention and public health efforts, ensuring high-dollar lottery winners are removed from the Medicaid program so its limited resources can be prioritized for the most vulnerable, and stopping individuals on the Affordable Care Act's exchanges from gaming the system.

The bill also asks Medicare's wealthiest 1 percent, people who are retired and making $40,000 a month--not a year, a month--to pay about $135 more for their Medicare just on parts B and D that is already subsidized by 75 percent, just a little more so we can fund children's health insurance for 5 years.

While it was not ultimately possible, unfortunately, to reach consensus on some of the policies to offset the new funding in this bill, there is broad bipartisan agreement on the core policies contained in this legislation, and I believe there is bipartisan support for many of the reasonable and fiscally responsible offsets contained in H.R. 3922.

Mr. Speaker, this is good legislation. This is long-overdue legislation. It reflects the good work done by your House Energy and Commerce Committee, and I urge my colleagues to put politics aside today and ensure these vital programs get the funding extensions they need. We are over the deadline. It is time to act.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, before I call on my next person to say something here, there are 17,000 children in Mr. Pallone's district and 14 health centers that, if he votes ``no,'' he will be voting against.

By the way, the offset he recommended, people who are watching this need to know, would violate statute and it would be a PAYGO violation. That is why it was not acceptable.

See, this is the problem we faced. We delayed three times at their request only to be offered up a pay-for that violates statute and violates our PAYGO rules. We could not accept that. We have to operate within the law like everyone else in America.

Mr. Speaker, I yield 4 minutes to the gentleman from Texas (Mr. Burgess).

Mr. Speaker, I yield myself such time as I may consume to respond.

Mr. Speaker, my friend, and she is my friend from California, obviously was not aware of the fact that it was her party, her leader, who asked us on three occasions to delay bringing this to the floor, including you could look at the CQ article from October 23 where Mr. Pallone says he hopes it doesn't come to the floor.

This was a bipartisan agreement not to bring it until we could try to work these things out. We were all trying to figure out how to get this done.

When it comes to Medicare, remember, we are talking about people making $40,000 a month paying $135 a month more. We can fully fund children's health insurance for millions of children.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from Washington (Mrs. McMorris Rodgers), the conference chairwoman.

Mr. Speaker, I would point out there are about 50,000 kids that Mr. Green may be voting against today in the Houston area if this goes down and we can't get this over to the Senate and work it out with them. Twice he has voted to cut the Prevention Fund and use it for other purposes.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from New Jersey (Mr. Lance).

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Texas (Mr. Olson), a very important member of our committee.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Florida (Mr. Bilirakis), an incredible advocate for children and healthcare in America.

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

Before I call on my next colleague, I just want to point out that, in Ms. Schakowsky's district, all we are talking about here is seniors making $41,000 a month--a month--would pay an extra 135 bucks so we can fully fund children's health insurance, community health centers. All these programs in here are funded. We use the Prevention Fund, which is not allocated out in the out-years. It is just a pot of money you can use for prevention and wellness. We actually use that to fund this as well.

This is why we have been unable to reach agreement with the Democrats. It is sad they have made this partisan.

I yield 1 minute to the gentleman from California (Mr. Costa).

Mr. Speaker, there they go again: delay, delay, delay; and vote against kids, vote against their hospitals, and vote against their doctors. That is why we couldn't get agreement.

I yield 1\1/2\ minutes to the gentleman from Indiana (Mr. Bucshon).

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

I appreciate the gentleman's sincerity. We work well together on lots of issues. He has also voted to use this Prevention Fund for other purposes in the past, as have I.

We don't touch the Prevention Fund for 2018, and there is $400 million left in 2019, and billions thereafter for the very important programs the gentleman has articulated. We don't use all the money. We leave money behind for these other purposes.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I do think it is important to note that my friend, and he is my friend from New Jersey, has twice voted to use this Prevention Fund for other purposes, including the 2012 middle class tax cut.

I yield 1\1/2\ minutes to the gentleman from Texas (Mr. Barton).

(Mr. BARTON asked and was given permission to revise and extend his remarks.)

Mr. Speaker, before I yield to the gentleman from Michigan, I would just point out that when Democrats joined Republicans in voting for the 2012 middle class tax cut, we used $6.3 billion out of the Prevention Fund they now say they never touched, yet they have.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Michigan (Mr. Walberg).

Mr. Speaker, once again, my dear friend from California has twice voted to use these Prevention Funds for other things. By the way, when we use them for community health centers, they are doing this work on the ground, helping people with opioid addictions and other healthcare issues.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Georgia (Mr. Carter).

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

Mr. Speaker, sabotaging the Affordable Care Act; what we are doing is putting off planned cuts to our hospitals that take care of low-income people that those cuts called for under the Affordable Care Act. We are putting those off so they can serve these low-income people. That, in their language, is sabotaging the Affordable Care Act.

On the issue of using the Prevention Fund, my friend from California who just spoke, has twice voted to use the Prevention Fund, including for tax cuts in 2012 and for the 21st Century Cures Act last year. Now we are using it for community health centers and children's health insurance programs. This is an appropriate use of a fund that gets replenished by law every year.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from Puerto Rico (Miss Gonzalez-Colon), whose constituents and herself have suffered such damage, such destruction as a result of the hurricanes.

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

How cynical what we just heard. How cynical.

Ms. Velazquez has 43,000 children in CHIP, $2 billion in DSH cuts in her district, 43 health centers, and she is going to vote against $1 billion for the citizens of Puerto Rico and the Virgin Islands because that is not enough.

Yes, we need to do more, so her answer is vote ``no'' today and deny $1 billion.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from South Carolina (Mr. Norman).

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

Wow. We are fully funding CHIP for 5 years. We are fully funding our community health centers for 2 years. We are taking care of programs for our citizens who have diabetes. And the pay-for that they are objecting to most is we are asking the wealthiest seniors in America, those making $40,000 a month, to pay $135 more for their Medicare so we can do this work that is so important.

How ironic. How cynical. This is a pay-for that has been used before for other programs. President Obama himself suggested in a budget that, instead of the top earners, the $480,000 a year, a couple making over $800,000 a year pay a little more as we do here, take it all the way down to $80,000 a year.

We didn't do that. We just said, if you are making $480,000 a year, roughly $40,000 a month, you will pay $135 more. They will not vote for that cut to fund children's healthcare. We will.

That is what is going on here. This is where we could never get them off dead center to make this bipartisan. It is a tragedy this is not a bipartisan bill as it always has been. I, three times, delayed moving this forward, including crossing the deadline of September 30, to try to find common ground that would be bipartisan, and we could never get there because they would never yield in a way where we could find common ground.

So we must go to the Senate from here and we must get our work done for the American people.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, may I get a time count, please, on how much each side has remaining?

Mr. Speaker, I will just point out that the gentleman who just spoke has voted to cut the Prevention Fund before to use it for other purposes.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, let's get this back where it belongs. We are fully funding the Children's Health Insurance Program for 5 years and community health centers for 2 years. The only sabotage of the Affordable Care Act going on here today is stopping cuts for hospitals in our districts that serve low-income people that would otherwise occur under the Affordable Care Act. We do that for 2 years.

The Democrats don't think seniors making $40,000 a month--$40,000 a month--should pay an extra $135 for their part B and part D Medicare so we can take care of our community health centers and children who need health insurance.

We delayed this bill coming to the floor at a bipartisan request to find a bipartisan solution that was elusive, sadly. We have never had this problem before, but we have it today. We must act.

Mr. Speaker, I urge a ``yes'' vote on this legislation, and I yield back the balance of my time.

Mr. Speaker, I reserve a point of order against the motion to recommit.

Mr. Speaker, I withdraw my reservation of a point of order.

Mr. Speaker, I claim the time in opposition to the motion to recommit.

Mr. Speaker, today, Members of this House can deliver peace of mind to parents of over 8 million low-income children who depend on the Children's Health Insurance Program. The House can extend funding for important public health programs, including resources for the critical work community health centers do in our communities and in my district and yours. This bill will help deliver much-needed healthcare resources to our friends and fellow citizens in the Virgin Islands and in Puerto Rico.

Yet we have heard complaints about how this package is paid for. Well, let us be clear how this bill funds healthcare for kids and important public health priorities like community health centers.

In paying for this package, we have taken a fiscally responsible and reasonable approach. Our bill funds kids' healthcare by allowing States to dis-enroll lottery winners--these are winners making $80,000 or above--from the low-income Medicaid program. We ensure high-dollar lottery winners are removed from the Medicaid program so that those resources can go to Medicaid-eligible, low-income people in our districts.

Our bill directs funding from the Prevention and Public Health Fund to finance important prevention and public

health needs, like funding the National Health Service Corps, Teaching Health Center Graduate Medical Education, Family-to-Family Health Information Centers, and community health centers. If these are not important programs for prevention, wellness, and public health, I don't know what are.

Our bill before us today, which I predict will have bipartisan support, directs funds from the Prevention Fund for important public health priorities that have long had bipartisan support. We are using a bipartisan fund to pay for bipartisan healthcare support for health and wellness, which was its intent from the beginning.

Most recently, nearly every House Republican and Democrat supported this idea just a year ago. Just a year ago, when we passed the 21st Century Cures Act, we said: Here is a health and wellness fund and a Prevention Fund that makes sense for cures, make sense for, we believe today, our community health centers, and for Children's Health Insurance.

Our bill also asks the wealthiest among us, the 1 percent of beneficiaries, those making $40,000 a month, over half-a-million dollars a year--that is an individual--to pay a little more to help fund health insurance for low-income children. I think they are willing to do that, and I think we should be as well.

On multiple budgets, President Obama said this is a reasonable way to pay for other priorities. That was bipartisan. It is bipartisan today.

These reasonable pay-fors have been opposed by some in the Democratic leadership. Some House Democrats want to use children's healthcare and funding for community health centers as a bargaining chip for a bigger end-of-the-year goulash, yet kids and our frontline providers can't wait any longer.

In just a few weeks, States like Minnesota run out of funding for the Children's Health Insurance Program. At the request of my colleagues on the other side of the aisle, we have agreed to postpone it time and again, but time has run out. The negotiations did not end as we all hoped they would.

But we can't wait any longer. It is time for this House to deliver peace of mind to the families that rely on these critical programs. It is time to vote ``yes.''

Mr. Speaker, I urge my colleagues to vote ``no'' on the motion to recommit and to approve the underlying bill, and I yield back the balance of my time.

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

Mr. Speaker, I rise today to speak in opposition to H.R. 3922, a partisan bill to reauthorize the Children's Health Insurance Program, or CHIP, as well as community health centers and other public health programs.

It pains me to be here today, because this should not be a partisan bill. I have tried for months to negotiate with Republicans to develop a bipartisan compromise, but House Republicans chose to spend the first 9 months of this year trying to repeal the Affordable Care Act. They failed, but now House Republicans are using the reauthorization of CHIP and community health centers as a way to once again sabotage the ACA.

Make no mistake, Mr. Speaker: if Republicans can't repeal the ACA outright, they will cripple it any time they can.

This time, Republicans are risking the healthcare of nearly 9 million children and the care of families all around the country that use community health centers. They are risking that care because this partisan bill has no chance of ever becoming law.

By taking this route, Republicans are guaranteeing that CHIP and community health centers will not be reauthorized until the end of the year, and that is extremely unfortunate.

Mr. Speaker, I strongly support CHIP, our community health centers, and all of our public health programs that are extended in this bill. These programs have traditionally been bipartisan, but the bill before us extends these programs by taking billions of dollars away from the Affordable Care Act and undermining Medicare.

In short, this Republican bill offers a false choice. On one hand, it strips healthcare away from upwards of 680,000 Americans and guts the Prevention Fund, which pays for immunization and vaccines, lead poisoning prevention, opioid treatment, and many other important programs; on other hand, it reauthorizes these important programs. Democrats strongly support reauthorization of these programs, but we reject the way Republicans are paying for them.

Mr. Speaker, there are so many other policies that save money, countless alternatives that Democrats have offered to Republicans for months. Yesterday I offered an alternative that would have provided a robust reauthorization and extension of these important programs, and it was paid for in a commonsense way.

My alternative would have changed the timing of payments to Medicare Advantage Plans. This approach was recommended by both the GAO and the Office of the Inspector General, but Republicans rejected it in the Rules Committee. They wouldn't even allow it to come before the full House for a vote. And why is because they would rather use reauthorization of CHIP and community health centers as another way to sabotage the Affordable Care Act.

I simply reject that approach and strongly urge a ``no'' vote.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from California (Ms. Eshoo).

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

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

Mr. Speaker, it is the ultimate absurdity for my colleague, the chairman of the Energy and Commerce Committee, to suggest that somehow I control when a bill comes to the floor of the House of Representatives.

The only reason that the Republicans ever delayed bringing this vote to the floor is because they know and I know that, if this bill is partisan, it will

never become law. It will go to the Senate, and it will sit there, and the only way that it is going to become law is if it is a bipartisan effort that actually accomplishes something and gets most people to support it.

We could keep listening to the other side all day say: Oh, the Democrats delayed the vote. The Democrats delayed the vote.

The vote shouldn't be held today. The vote should be delayed today because this is going nowhere. This bill is going nowhere. They know it. You want to keep saying it? You can say it all day for the next hour, but it is the ultimate of absurdity.

Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Gene Green), who is the ranking member of our Health Subcommittee.

Mr. Speaker, I yield 1\1/2\ to the gentleman from New York (Mr. Engel).

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from Colorado (Ms. DeGette), the ranking member of our Oversight Subcommittee.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from Illinois (Ms. Schakowsky).

Mr. Speaker, I yield 2 minutes to the gentlewoman from Florida (Ms. Castor), the vice ranking member of our committee.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Vermont (Mr. Welch).

I yield the gentleman from Vermont an additional 30 seconds.

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

The bottom line is, when you start cutting money from the Prevention Fund, you are cutting prevention programs for kids, adults, the disabled, and, most importantly, the opiates.

CDC spends a significant amount of money from the Prevention Fund dealing with the opiate crisis, so don't tell me that somehow this is okay. You are taking money away from opiate prevention. You are taking money away from kids programs like lead poisoning and vaccines. It is unbelievable how much is actually going to be lost from the Prevention Fund because of this bill.

I am not interested in what happened in the past. I want to know what is going to happen in the future. We have an opiate crisis. Don't take money away from the Prevention Fund that is used to deal with that crisis.

I reserve the balance of my time.

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

Mr. Speaker, I just wanted to talk about this use of the Prevention Fund. Democrats have never supported the type of drastic cuts to the Prevention Fund that is in this proposal today. In fact, when faced with such cuts, we voted ``no'' nine times. In the two cases where we voted in favor of using some of the Prevention Fund as an offset, neither cut placed the CDC programs and efforts at risk as this legislation does today.

The Republican proposal would cut the Prevention Fund nearly in half and leave a $400 million hole in funding for prevention and health programs within the CDC's budget beginning in 2019. This cut would be devastating to local, State and Federal efforts to protect the Nation's health.

Unlike my Republican counterparts, what they contend, this cut to these programs would not be made up in the annual appropriations process, as evidenced by the proposed cut of $198 million to the CDC in the House Republican fiscal year 2018 appropriations bill, and the decrease of $580 million in CDC funding since 2010 when adjusted for inflation.

Again, you talk about opiates, you talk about children's health programs. These would be drastically cut because of what they are doing today to the Prevention Fund.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from California (Ms. Matsui).

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from California (Mr. McNerney).

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from New York (Ms. Velazquez).

Mr. Speaker, I yield an additional 30 seconds to the gentlewoman from New York.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Massachusetts (Mr. Kennedy), who is a member of our committee.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from Michigan (Mrs. Dingell).

Mr. Speaker, I yield 1 minute to the gentleman from Texas (Mr. Doggett).

Mr. Speaker, I yield 1 minute to the gentlewoman from Michigan (Mrs. Lawrence).

Mr. Speaker, how much time remains on each side?

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

Mr. Speaker, I want to stress again that one of the pay-fors that the Republicans don't talk about much is the fact that they are reducing the grace period from 90 days to 30 days. So if someone misses a payment on their insurance, they currently have 90 days to make up for it. Under this bill, they will only have 30 days.

Now, the CBO estimates that over 500,000 people will lose their health insurance and have to reapply for next year because of this reduction in the grace period. I know my colleague from the other side says: Well, that is too bad because they have the responsibility to pay it.

But the fact of the matter is that a lot of people have a hard time paying their monthly premium, and we should not be passing legislation that ends up with half-a-million people losing their health insurance.

Again, this is a way to sabotage the Affordable Care Act. The Affordable Care Act is trying to make more people covered, and has succeeded in covering 95 percent of the people in this country.

Why in the world would we use a pay-for that cuts back on half-a- million people who would lose their health insurance?

I want to emphasize, Mr. Speaker, we did not have to be here today. We could have done a bipartisan bill without sabotaging the Affordable Care Act. That is what concerns me most, Mr. Speaker. The Republicans tried to repeal the Affordable Care Act. They failed, and now they are trying to repeal it piece by piece.

The pay-fors that are in this legislation are unfair to the American people. The Prevention Fund is used for opiate prevention and used for kids for various programs. Don't cut back on that to pay for these other things.

The grace period--half-a-million Americans are going to lose their insurance because of the cutbacks in the grace period--another effort to sabotage the Affordable Care Act.

Lastly, and probably even most important, again, the Republicans are going against the Medicare program. They are trying to make cuts in the Medicare program and restructure the Medicare program in a way that I believe will hurt the Medicare program, reduce the amount of people in the insurance pool, and ultimately lead to higher costs for middle class and lower-income seniors and the disabled in the Medicare program.

I urge my colleagues: Don't let the Republicans continue to sabotage the Affordable Care Act. We could have done this on a bipartisan basis. Passing this bill today does nothing for the Children's Health Initiative or for community health centers because this bill is going nowhere. It will end up in the Senate. The Senate will not take it up, and we will be waiting around until Christmas to actually find a way to fund these programs and put these programs at risk. Vote ``no.''

Mr. Speaker, I yield back the balance of my time.

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

Mr. Speaker, I rise to speak on House consideration of H.R. 3922, Championing Healthy Kids Act, which would reauthorize the State Children Health Insurance Program (S-CHIP).

As the founder and chair of the Congressional Children's Caucus, I am well aware of the work that went into creating this important program.

I joined with members of the bipartisan Children's Caucus to champion the worthy goals of S-CHIP.

Congress and President Clinton responded to the needs of 10 million children in the United States who lacked health insurance, S-CHIP was created in 1997 to insure children in families with too much income to qualify for Medicaid and too little to afford private insurance.

I voted for the S-CHIP program when it came to the floor for a vote as part of the Balanced Budget Act of 1997.

I worked tirelessly along with other members of the House to make sure the S-CHIP program was created.

I voted to extend the life of the program when Congress reauthorized S-CHIP in 2009 under the Children's Health Insurance Program Reauthorization Act and again when it became part of the Patient Protection and Affordable Care Act of 2010.

The program represented a grand bargain that allowed Democrats and Republicans to agree that healthcare for the nation's children was a laudable and achievable goal.

H.R. 3922, Championing Healthy Kids Act, is not a reauthorization of the S-CHIP program it is political theater at its worse.

The leadership of the House is betraying all that this body has done for 20 years to sustain and improve S-CHIP.

The bill before the House is political theater and not real legislating--a partisan attack against Medicare that has no place in a real bill about healthcare for children.

I am a strong supporter of S-CHIP and would vote for that program any day it is brought to the House Floor.

This imposter S-CHIP bill is not worthy to be considered by this body.

The motion to recommit this bill should be supported so that the offensive offsets could be removed so that the bill can be brought back to the full House for consideration.

After weeks of negotiations to reauthorize the Children's Health Insurance Program (CHIP), Community Health Centers (CHCs) and other important public health programs, which have always been bipartisan priorities, House Republicans have decided to bring a partisan bill to the Floor.

This bill will only further delay the reauthorization of these programs, many of which expired on September 30th.

The bill passed out of the Energy and Commerce Committee at the beginning of October with no Democratic support.

Democrats in Committee instead offered a package that invests in our children and safety net providers, and does not sacrifice the nation's health.

Democrats have made it clear for weeks that the pay-fors in this bill are problematic.

Rather than working toward a bipartisan agreement, Republicans revised their bill to include even steeper cuts to public health programs, in addition to undermining the Affordable Care Act (ACA).

The bill includes woefully inadequate funding for Medicaid programs in Puerto Rico and the U.S. Virgin Islands, which are facing unprecedented demands on their health care systems following the devastation caused by Hurricane Maria.

Puerto Rico Governor Ricardo Rossello last week requested $1.6 billion annually to deal with the state's underfunded Medicaid program that is expected to be further strained by the short- and long-term health implications of the natural disaster.

The approximately $1 billion over two years in Puerto Rico Medicaid funding included in the Republican bill is not only insufficient, but it would also require Puerto Rico and the U.S. Virgin Islands to match those dollars at a time of increased demand and revenue collapse in both territories, exacerbating delays in recovery.

This bill also seeks to cut $6.35 billion to the Prevention and Public Health Fund (PPHF).

The Prevention Fund was created by the ACA to make national investments in prevention and public health, to improve health outcomes, to enhance health care quality, and reduce health care costs.

It has been used to increase awareness of and access to preventive health services, such as cancer screenings, tobacco cessation and childhood vaccines--as well as concentrating on preventing chronic disease to help more Americans stay healthy.

Cutting these funds will have a devastating impact on public health initiatives at the federal, state and local levels.

Republicans are also shortening the grace period for missed premium payments from ninety days to thirty, which would result in up to 688,000 people losing health coverage.

House Republicans are insisting that in order to provide some of our most vulnerable Americans with coverage, it must be paid for by cancelling the health insurance of other Americans after a single payment is missed.

While Republicans are pushing for tax cuts for the wealthy that explode the deficit, when it comes to health coverage for children and low-income Americans, Republicans are insisting that it be paid for at the cost of weakening our health care system and pushing other Americans off health insurance.

States have begun to use emergency funding, cut benefits, and will soon begin sending disenrollment notices to thousands of families if CHIP is not reauthorized.

Republicans' decision to advance a partisan bill rather than a compromise has very real consequences for families across the country.

In 2016, 35,626,329 children in the United States had healthcare coverage under S-CHIP or the Medicaid Child Program.

In 2016, although the state of Texas had 38 percent of our children covered under the S-CHIP program, there were still 9.2 percent children without health insurance coverage.

Paying for this package by weakening health care in America:

Shortening the grace period for missed premium payments will cause up to 688,000 Americans to lose their health coverage.

Cutting $6.35 billion from the Prevention Fund will have a devastating impact on public health initiatives at the federal, state and local levels.

Requiring Medicare means testing of 100 percent for beneficiaries making over $500,000. This provision will take away a benefit American seniors have paid into their entire lives.

These offsets are even more egregious since they are being considered just one week after House Republicans began the process of passing tax cuts for the wealthy that is not offset and will add $1.5 trillion to the deficit.

Instead of reauthorizing these programs, House Republicans wasted time attempting to repeal the ACA.

There are better ways to pay for S-CHIP that do not put the guarantee of Medicare at risk our nation's seniors.

1. Reduce tax expenditures for the top 1 percent of income-earners-- Our current tax code imposes higher tax rates on income earned through hard work while providing preferential treatment to unearned financial gains and allowing billions of dollars of stock profits and other capital gains to pass tax-free to heirs of multi-million-dollar fortunes. Reducing the benefit of these tax expenditures would help rebalance the tax code so that it stops favoring wealth over work. CBO has determined that 17 percent of the benefits of major ``tax expenditures'' go to households in the top one percent of income earners at a cost of more than $1.5 trillion over ten years. We could reduce this benefit to pay for needed national priorities.

2. Cancel the tax break for corporate jets--Repeal tax breaks such as those for corporate jets, which are allowed a faster depreciation

schedule than passenger and freight aircraft. Based on past Joint Committee on Taxation estimates, repealing the tax break on corporate jets alone would raise $3 billion over ten years.

3. Restrict deductions for egregious CEO bonuses when employees don't get a raise--Repeal the exemption to the $1 million limit on compensation for CEOs and other specified corporate employees that a publicly traded corporation can deduct as a business expense, unless their workers are getting paycheck increases that reflect increases in worker productivity and the cost of living. Based on Joint Committee on Taxation estimates, just limiting the deductibility of excessive CEO compensation would raise $12 billion over ten years.

4. Close loopholes in the U.S. international corporate tax system that encourage companies to invert, and ship jobs and profits overseas--Prevent U.S. companies from ``inverting'' and pretending that they are based in other countries purely to reduce their taxes. Enact proposals that would limit the ability of corporations to reap substantial tax benefits by shifting operations, capital, intellectual property, and jobs overseas for tax purposes or to shelter their profits from U.S. taxation in foreign tax havens. Based on estimates of past proposals, over $500 billion over ten years could be raised under such proposals.

5. Close the ``carried interest'' loophole taxing hedge fund managers' compensation at lower capital gains rates--End the loophole which allows certain investment managers at hedge funds and private equity firms to pay capital gains tax rates (up to a maximum of just 20 percent) on income received as compensation for services they provided, rather than ordinary income tax rates up to 39.6 percent that all other working Americans pay on the compensation they receive for their labor. Past estimates show closing this loophole would raise over $19 billion over ten years.

States have begun to use emergency funding, cut benefits, and will soon begin sending disenrollment notices to thousands of families if CHIP is not reauthorized.

It is time for the House Leadership to stop playing politics with health insurance coverage for our nation's most vulnerable children and pass a clean S-CHIP bill.

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.