Protecting the health care of all Americans, especially those with preexisting conditions.

Madam Speaker, by direction of the Committee on Rules, I call up House Resolution 274 and ask for its immediate consideration.

Madam Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Texas (Mr. Burgess), 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

Madam Speaker, I ask unanimous consent that all Members be given 5 legislative days to revise and extend their remarks.

Madam Speaker, on Monday, the Rules Committee met and reported a rule, House Resolution 274. It provides for the consideration under closed rules for S.J. Res. 7, with 1 hour of debate equally divided and controlled by the chair and ranking minority member of the Committee on Foreign Affairs, and for the consideration of H. Res. 271, with 1 hour of debate equally divided and controlled by the chair and ranking minority member of Committee on Energy and Commerce. It also provides suspension authority for Thursday, April 4.

Madam Speaker, before I begin, I want to recognize that today marks the 230th anniversary of the Rules Committee being formally constituted for the first time.

Now, the Ways and Means Committee--which my Massachusetts friend and colleague, Richie Neal, chairs--likes to point out that they are the oldest standing committee in the House. While that is true, I would like to remind my friends that the Rules Committee is the oldest committee in the House, being first created on this day in 1789 as a select committee. So it is especially appropriate that we are on the floor today to do some important work before us.

For the record, Madam Speaker, the Ways and Means Committee can celebrate their 230th anniversary on July 24.

Now that I have cleared that up, the first measure included in this rule is S.J. Res. 7, and we are taking action on this because Yemen is in crisis. In a country of roughly 28 million people, an estimated 22 million of them are in need of humanitarian assistance.

That is 75 percent of the population facing famine, disease, and displacement. Half the country is at risk of starvation.

The famine and disease facing children is particularly sobering. Save the Children estimates that as many as 85,000 children under the age of 5 have died because of hunger and disease since 2015.

All told, this is one of the world's worst humanitarian crises, the site of the fastest growing cholera epidemic ever recorded and the biggest food emergency on the planet.

Yet, it wasn't caused by some natural disaster. It is entirely man- made, the result of a Saudi-led military conflict. Seemingly every day, bombs fall on weddings, hospitals, buses, and homes, as civilian neighborhoods are regularly targeted.

This is not some abstract war happening half a world away. In fact, the United States is intimately involved in this conflict. We have supported the Saudi reign of terror by providing logistics, intelligence, ground support, and midair fueling of bombers. Virtually all the bombs that fall on Yemen say ``Made in the United States of America.''

Make no mistake, Madam Speaker, the United States is involved in a war in Yemen today. But if our constituents look through the Congressional Record, they wouldn't find a vote authorizing it. That is because this body abdicated its responsibility to declare war when it began 4 years ago.

Now, we took one of our most sacred responsibilities and handed it to the executive branch. It is not the first time we have done it, but it is becoming a habit around here. We first let the Bush administration decide the contours of our involvement abroad, and that continues through the Trump administration today.

If that wasn't outrageous enough, past Republican Congresses used every legislative trick in the book to block Members from even debating our role there. On two separate occasions, they went so far as to strip War Powers Resolutions related to Yemen of their privilege. It was unprecedented.

But when it comes to Saudi Arabia, this administration and my Republican friends were all too content to look the other way when they murdered a Washington Post journalist. They lured him into a consulate in Turkey, they murdered him, and then they used a bone saw to dismember him. We know, based on our intelligence reports, that the highest level of the Saudi Government was involved in that terrible human rights atrocity, and the Trump administration did nothing. They rationalized it. They justified it. They basically turned a blind eye.

When it comes to human rights, this administration has abdicated its moral authority. That should be of concern to everybody in this Chamber, whether you are Democrat or Republican, because if the United States stands for anything, we need to stand out loud and foursquare for human rights. If the President of the United States and his administration don't want to do it, then we should.

No Congress should be complicit in abdicating our Article I constitutional responsibility. Thankfully, this Democratic Congress is doing the opposite. We are reasserting our power, and we are taking a stand when it comes to human rights.

Thanks especially to the dedication of Speaker Pelosi, Chairman Engel, Congressman Ro Khanna, Congresswoman Jayapal, Congressman Pocan, and the entire Congressional Progressive Caucus, we are considering a bipartisan measure that makes clear it is time for the United States' involvement in Yemen to end. No more excuses.

This is virtually identical to the resolution we passed in February. The difference this time is that this is the first opportunity that this House has had to send something on the war in Yemen right to the President's desk.

So I urge all of my colleagues: seize this opportunity. We have a constitutional responsibility and we have a moral obligation to get this done.

Don't let any legislative maneuvers deter us from ending our Nation's complicity in this humanitarian catastrophe. Let's pass this resolution free of changes that would prevent it from going right to the President.

Let me make that more clear: if we change a single word, we will derail this resolution.

Now, the second measure included in this rule is H. Res. 271, in response to a war of a different kind: the Republican war on healthcare. The Trump Justice Department recently moved in Federal Court not only to strike down preexisting condition coverage under the Affordable Care Act, but to overturn this law completely.

If the President succeeds in Texas v. U.S., the protections for preexisting conditions will be gone. The Medicaid expansion will be nullified. Insurance premiums will skyrocket. I could go on and on and on and on.

Striking down the Affordable Care Act would be a tragedy felt by every single American. We would return to the days when our health insurance marketplace was like the Wild West, when insurers were free to decline or limit coverage because someone had acne, or received an organ transplant, or even because they were a victim of domestic violence. That is how messed up our system was, and that is the system that this President and many of my colleagues want to return to.

Now, for the life of me, I cannot understand what President Trump and his allies in Congress have against Americans getting healthcare. For nearly a decade now, they have worked endlessly to sabotage the Affordable Care Act through Congress, the courts, and administrative actions. Apparently, they are not happy that 20 million people have gained healthcare coverage because of this law, or that 130 million Americans with preexisting conditions can get care. We should be celebrating these advancements. But, instead, some on the other side won't be satisfied until the Affordable Care Act is repealed completely.

Now, this Democratic majority has taken a different course. On the very first day of this Congress, we brought the full weight of the House of Representatives to bear in this lawsuit. As a result, the House Counsel has already intervened in this case to protect the healthcare Americans depend on.

Now, this resolution is our chance to speak with one voice against the administration's attempts to abolish the ACA. I have seen my friends on the other side issue sternly worded press releases and strongly worded letters to the administration. But now it is time to back up words with votes, and then I hope they will work with us moving forward as this majority takes action to reverse the administration's healthcare sabotage and strengthen healthcare for every single American.

Madam Speaker, I believe that healthcare ought to be a fundamental right for every single person in this country. It is unconscionable to me that rather than working with us to strengthen the Affordable Care Act and rather than working with us to expand healthcare protections, my Republican friends have chosen instead to wipe it out. I don't know how anybody could think like that. I don't know what motivates the President of the United States and some on the other side of the aisle to move in that direction.

Now we are told by the President that even though he doesn't have a plan to replace this, if he succeeds in nulling and voiding the Affordable Care Act, he said: Well, we will provide you one in the year 2021.

So, Madam Speaker, the man who has spent all of his time trying to rip protections away from people with preexisting conditions, the person who wants to not allow you to keep your kids on their insurance until they are 26, the leader of our country who doesn't believe in capping insurance when it comes to people with lifetime illnesses, the person who doesn't want to lower the cost of prescription drugs--I could go on and on and on and on--says: I want to repeal it, I want it gone, I want the courts to null and void it; and then just trust me, and then we will come up with some magical plan, some secret plan, after the election.

I don't think the American people are going to fall for that kind of nonsense, and they shouldn't because healthcare is not a Democratic issue or a Republican issue. It is a moral issue. It is not even an issue, it is a value that all of us should share.

So I urge my colleagues on both sides of the aisle to support us in sending a message loud and clear to the administration that we have had enough of their attempts to sabotage the healthcare bill, we have had enough of their trying to take health insurance away from the American people, and that we are going to stand here and make it very clear that we do believe that everybody is entitled to good healthcare in this country.

Madam Speaker, I reserve the balance of my time.

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

Madam Speaker, I have to give the Republicans credit for one thing. They are consistent on the issue of healthcare, in trying to avoid talking about the issue at hand.

We are not talking about universal healthcare, although I support universal healthcare. We are not talking about Medicare for All, although I personally support Medicare for All. We are not talking about the Canadian system or the German system or any other system.

We are talking about preventing this President and his Republican allies from null and voiding the Affordable Care Act, thereby taking away healthcare protections for every single American. We are talking about preventing the President from throwing

tens of millions of people off health insurance. We are talking about protecting the over 100 million people in this country who have preexisting conditions. That is what we are talking about.

I loved it when the gentleman from Texas said that the first vote that the Republicans asked for in this Congress was a procedural motion to protect people with preexisting conditions. Does the gentleman not know that people with preexisting conditions already have protections under the Affordable Care Act?

I mean, it sounds to me--and it seemed to me at the time--that that Republican procedural vote was about covering your rear and not about serious legislating, about trying to get the American people to believe that we really do care about healthcare and we really do care about protecting people with preexisting conditions, even though we all know here that that is just not the case.

When I hear the gentleman say that the Republicans care deeply about people's healthcare and want to make sure that everybody gets coverage, it is just not true. The reason I say that so emphatically is because I have been around here for the last few years, and I have watched the dozens of votes that the Republicans have brought up, one after another after another after another after another, to repeal healthcare protections for people in this country without proposing an alternative.

Now, the President is saying: Trust us.

Madam Speaker, I include in the Record a Politico article that just appeared that is entitled ``Trump punts health care until after 2020.''

[From POLITICO, April 1, 2019]

Trump Punts Health Care Until After 2020

(By Quint Forgey and John Bresnahan)

just last week the president had seemed to go all in on a new effort to

wipe out obamacare

President Donald Trump signaled Monday that congressional

Republicans would wait until after the 2020 elections to vote

on a GOP replacement for Obamacare--putting off a presumably

savage legislative battle on a hot-button campaign issue

until after his re-election bid.

``Everybody agrees that ObamaCare doesn't work. Premiums &

deductibles are far too high--Really bad HealthCare! Even the

Dems want to replace it, but with Medicare for all, which

would cause 180 million Americans to lose their beloved

private health insurance,'' the president tweeted.

``The Republicans . . . are developing a really great

HealthCare Plan with far lower premiums (cost) & deductibles

than ObamaCare,'' Trump continued. ``In other words it will

be far less expensive & much more usable than ObamaCare. Vote

will be taken right after the Election when Republicans hold

the Senate & win . . . back the House.''

Trump claimed that the as-yet-unseen Republican proposal

``will be truly great HealthCare that will work for

America,'' writing online that ``Republicans will always

support Pre-Existing Conditions.''

The unexpected string of tweets added drama to a week that

has seen Obamacare return to the fore as a policy issue.

The president's pledge comes days after his Justice

Department endorsed a federal court ruling to eliminate the

Affordable Care Act in its entirety, moving to invalidate the

landmark health care law despite objections within Trump's

orbit from Health and Human Services Secretary Alex Azar and

Attorney General William Barr. The ruling by District Judge

Reed O'Connor had suggested that the Obamacare statute, which

has passed muster with the Supreme Court, was actually wholly

unconstitutional.

The president appeared on Capitol Hill the next day, saying

that the Republican Party ``will soon be known as the party

of health care.''

Trump's call to again put Obamacare repeal on the table for

Hill Republicans was seen as a potential disaster-in-the

making by GOP leaders, who knew their incumbents and

candidates were badly hurt by it last November. And it was an

invitation to Speaker Nancy Pelosi (D-Calif.) to pound home

the issue once more, as she plans to do with a House vote

this week condemning the administration's decision not to

defend Obamacare in court.

Trump's efforts to eradicate Obamacare have also endangered

some of the administration's health initiatives, such as

lowering prices for prescription drugs and combating opioid

abuse and HIV.

In public and private, Republican leaders made clear that

they didn't want anything to do with the president's most

recent maneuver. They begged Trump to back down and made

their displeasure known to other administration officials, as

well.

GOP lawmakers even took the position that if Trump wanted

to lay out his own health care proposal, then they would be

willing to look at it. But Senate Republicans--facing a tough

electoral fight to maintain their majority in 2020--have

refused to sign on to a new administration drive before

seeing the specifics, giving them room to disavow any Trump

proposal if it hinders their own political outlook.

``I look forward to seeing what the president is proposing

and what he can work out with the speaker,'' Senate Majority

Leader Mitch McConnell (R-Ky.) said in a brief interview

Thursday, adding: ``I am focusing on stopping the Democrats'

`Medicare for None' scheme.''

McConnell is up for re-election this cycle, as are

vulnerable GOP incumbents including Cory Gardner of Colorado

and Susan Collins of Maine, who said she doesn't want the

Justice Department to push to strike down Obamacare.

The Affordable Care Act has been a thorn in the side of

Republicans since it was enacted in 2010. After the GOP took

back the House in the midterm elections that year, GOP

lawmakers repeatedly passed legislation designed to repeal

Obamacare.

Once Trump was elected president on a promise of different

and better health care options, Republicans seemed on the

path to finally scrapping the law, only to see a 2017

``skinny repeal'' effort fail unexpectedly in the Senate.

That attempt collapsed when Arizona Sen. John McCain--upset

with the irregular way the legislation was being handled--

stunned his colleagues by voting against it.

The President says: Repeal everything, and then we will share our secret plan after the election.

Give me a break. The bottom line is that the American people want us to be on their side, not on the side of big health insurance corporations, not on the side of big drug companies. They want us to be on their side.

It wasn't too long ago when people would be provided insurance that didn't cover anything. It was junk insurance. There are people on the Republican side and people in this White House who are eager to get back to those bad old days.

Stop trying to take away people's healthcare. Stop trying to get in bed with corporate interests that basically are fighting every attempt to make sure that people have access to good, quality care in this country.

By the way, if they repealed the Affordable Care Act, that repeals essential benefits protections, which guarantee that every insurance company has to provide you coverage when you get sick. That wasn't always the case.

This is a ridiculous fight that we are having here. I cannot believe, after the midterm elections, after it was made crystal clear by the American people to the Republicans that they wanted no part of their effort to take away healthcare in this country, that here we are doing it all again.

Now, maybe they didn't intend it this way. The President wasn't on message and came out for repealing the Affordable Care Act outright, and now they have to kind of scramble to try to, again, cover their rears. That is what is happening here.

It is really disillusioning, I think, for people who are observing these proceedings that we are back again fighting over whether or not people are entitled to good healthcare, whether people are entitled to protections under our healthcare laws.

I think this is a ridiculous fight for the Republicans to be waging. But if they want to fight it, they own it. I think they will see, in 2020, that the American people are having none of it.

Madam Speaker, on the war in Yemen, we cannot wait. The starving children in Yemen cannot wait on this President or on my Republican colleagues to do the right thing.

Just to highlight how bad the war is, here are a few statistics. I noticed the gentleman from Texas barely talked about how horrific the situation is in Yemen, but let me give you a few statistics.

Madam Speaker, 130 children under 5 die each day from hunger and disease as a result of this war. The number of cholera cases in Yemen is 1 million. You heard that right. This is the largest cholera outbreak in recent history. Finally, 3-year-olds in Yemen have lived through 18,000 air raids already.

As I mentioned in my opening statement, the bombs that are dropping on civilian populations say ``Made in the United States of America.'' All of us should be outraged by that, and not only by the Saudi Government's behavior in Yemen, but the Saudi Government's behavior in general.

Yet, what is the response by this administration and their Republican allies? Send Saudi Arabia more weapons.

Sell them more weapons. Turn a blind eye to what is going on in Yemen. Let's make believe that the murder of Washington Post journalist Jamal Khashoggi never happened.

Again, we need to stand firmly on the side of human rights.

Madam Speaker, I reserve the balance of my time.

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

Let me just say you have got to love the Republicans. I mean, they have been in charge of this House for 8 years previously. They were in charge of the entire government the previous 2 years. They had the House, the Senate, and the White House. They didn't even need a supermajority in the United States Senate to be able to get whatever they wanted through, and they couldn't do it.

So the bottom line is this: You had your chance. The American people rejected your attempt to take away healthcare from millions of people. The American people believe people with preexisting conditions ought not to be discriminated against by insurance companies, and so they are having none of what you are selling here.

So you can make excuses all you want, but, unfortunately for the country, you were in charge of the House, the Senate, and the White House for the previous 2 years.

Madam Speaker, I am happy to yield 4 minutes to the gentleman from California (Mr. Khanna), who has been a leader on the issue of Yemen, and I commend him for his efforts.

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

I have great respect for the gentleman from Texas, the former chair of the Ways and Means Committee. But I just want to remind my colleagues again that my Republican friends have been in charge of this institution for 8 years. They were in charge for 2 years of the House, the Senate, and the Presidency, and they showed us what they were about.

The gentleman says that they are not going to let the courts take away protections for people with preexisting conditions. Well, my Republican friends tried to do that on dozens of occasions. They brought legislation to the floor that would have ripped protections away from people with preexisting conditions. That is their record. It is there for anybody to see.

Now they are saying: ``Oh, we are now for protecting people with preexisting conditions''? Their whole existence in the majority has been about taking protections away from people. Give me a break. I mean, people know what is going on here.

I appreciate the resolution that the gentleman wants to offer to say we all should work together. Look, I am happy to work with my Republican friends to find ways to improve protections for people.

But I want to remind them, when they were in the majority, they didn't want anything to do with us because we wanted to protect people's healthcare. We wanted to protect people with preexisting conditions. We wanted to make sure that parents could keep their kids on their insurance until they were 26. We wanted to lower the cost of prescription drugs. We wanted to put a cap on people with chronic illnesses so that they wouldn't go bankrupt. We wanted to make sure that insurance companies had to offer you real protections. We had essential benefit protections there.

So we are happy to build on that. What we are not happy to do is to work with them to take these things away, and that is what their leadership has been all about for 8 years in the House. And then when they controlled the House, the Senate, and the White House, that is what they tried to do.

Thankfully, some thoughtful Republicans in the Senate didn't go along with it, so they didn't get their way. And now they are trying to use the courts to try to undermine what this body has done.

Madam Speaker, let me inquire of the gentleman from Texas how many more speakers he has.

Okay. Then I will reserve the balance of my time.

We were expecting one more speaker, but she didn't show up. If the gentleman is ready to close, I am ready to close.

I reserve the balance of my time.

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

Madam Speaker, I just find it a little bit interesting that for the last couple of days, my Republican friends have been assailing us for introducing a sense of Congress resolution, and here we have a sense of Congress resolution from them.

I guess you can't make this stuff up.

But in any event, look, I will say to my colleagues, you don't need to defeat the previous question to make clear that you believe that people with preexisting conditions should be protected, because this sense of Congress wouldn't do that.

We have a law that does that now, a law that, unfortunately, my Republican friends have been trying to repeal for years.

So if Members want to protect people with preexisting conditions, then they ought to support us on our sense of Congress resolution.

So, Madam Speaker, when it comes down to it, both of these resolutions that we are offering today are about what this Congress is willing to tolerate, whether we are willing to tolerate our Nation's involvement in the Saudi-led war in Yemen, despite never having authorized it in the first place. Do we really want our Nation to be partners with a regime that murders journalists like Jamal Khashoggi?

President Trump has said of Saudi Arabia: ``They have been a great ally.'' Well, I disagree.

And I hope that this Congress will now speak with one voice that we will not look the other way when it comes to the murder of a U.S. reporter, that we will not look the other way when it comes to the murder of innocent people in Yemen, bombing school buses, bombing weddings, bombing funerals.

Enough. We have to say enough. We are no longer okay with the U.S. and Yemen going on unchecked for another year.

This is about whether this Congress is going to tolerate the administration trying to rip away millions of people's healthcare as well. I know I am not--and many of my colleagues aren't either--willing to tolerate that.

This morning, I joined with many Members of Congress in the House and Senate, including Leader Pelosi and Senator Schumer. We marched from the House and the Senate to the Supreme Court to call on this administration to stop its assault on Americans' healthcare.

Abolishing the Affordable Care Act may be just a talking point to the President, but this law is literally a matter of life and death for people. Millions and millions of Americans could lose their insurance coverage. Premiums and out-of-pocket costs could skyrocket, and lifesaving healthcare could once again be out of reach.

The President and his allies claim to support protections for preexisting conditions, they claim that the Republican Party is the party of healthcare, but their actions say otherwise.

When this House voted on the first day of this Congress to allow us to intervene in Texas v. U.S., more than 190 Republicans sided with the President on his brutal assault on Americans' healthcare.

The majority is not going to stand for it.

Enough is enough. Enough with the unauthorized wars abroad, enough with the assault on people's healthcare.

Madam Speaker, I urge a ``yes'' vote on the previous question, this rule, and the underlying resolutions.

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

Madam Speaker, I thank the gentlewoman for yielding me the customary 30 minutes, and I yield myself as much time as I may consume.

Madam Speaker, today, we are considering a bill that appropriates a little over $17 billion for disasters affecting all parts of the United States.

As Members of Congress, we are elected to serve the people, and part of that duty is providing emergency aid when disaster strikes. I am supportive of disaster relief, and we certainly could have provided this crucial aid months ago. At this time, our communities are still in need.

This is the third time that the House will consider a relief bill to address the same set of disasters.

On 20 December 2018, the House of Representatives passed a continuing

resolution to fund the government through February 8 that also included almost $8 billion of disaster relief funding, but this bill did not become law.

On January 16, 2019, the House passed a supplemental appropriations package that would have provided a little over $12 billion in aid. But at the last minute, during Rules Committee debate, Democrats added a short-term, full-government continuing resolution through a manager's amendment that did not include President Trump's request for border security funding. As a result, the government remained closed without providing a resolution to the problem.

It has now been 4 months since the House last considered providing disaster aid, long enough that additional disasters have struck our country, necessitating an increased number.

The bill before us seeks to provide relief funding for Hurricanes Michael and Florence, as well as continued support for Hurricanes Harvey, Irma, and Maria. The wildfires in California will be included in this supplemental, as well as the severe storms and flooding in multiple States, including Texas; the Alaska earthquake; Typhoons Yutu and Mangkhut in the Northern Mariana Islands and Guam; Tropical Storm Gita in American Samoa; volcanic eruptions in Hawaii; and devastating floods across the Midwest.

This third iteration of disaster relief legislation is similar to a bill passed by the House in January of this year, with an additional $500 million for the Department of Agriculture's Emergency Conservation Program to rehabilitate damaged farmland; $1.5 billion for the Army Corps of Engineers for projects and flood mitigation; and $1 billion for the Community Development Block Grant Disaster Recovery account for rebuilding houses, businesses, and public infrastructure. The bill also includes $600 million for disaster nutrition benefits in Puerto Rico as that island recovers from Hurricane Maria.

The President has expressed concern about Puerto Rico's management of the billions of disaster aid the island has already received. Senate Republicans are negotiating with the White House on a compromise, but Democrats have decided to continue pushing this legislation forward without engaging the other two parties that would be required in order for the bill to become law.

This bill also includes language prohibiting any funds from being used for the construction of a border wall. The crisis on our southern border is not a natural disaster; it is a humanitarian and security disaster, one that we can stop and take steps to prevent in the future. But the Democrats refuse to accept that our Customs and Border Protection and Immigration and Customs Enforcement officers are overwhelmed, that our Office of Refugee Resettlement facilities are near capacity, and that our immigration judges are facing years of backlogged cases.

This is a disaster that we can do something about now. Rather than negotiate in good faith, Democrats have chosen once again to bring up a bill that will not pass the Senate.

I am disappointed that these controversial provisions are included in the bill. It does beg the question: When are we going to get back to the business of legislating?

As an aside, I would note that the House adjourned yesterday at 2 o'clock in the afternoon, plenty of time to continue working on some of these problems. For whatever reason, we decided not to do that.

The second bill under consideration, H.R. 986, is supposed to protect Americans with preexisting conditions. It has a very catchy title. Despite that catchy title, the bill does nothing to enhance preexisting condition protections under the Affordable Care Act.

The first vote that Republicans called this Congress was a motion to require legislation protecting individuals with preexisting conditions. Rather surprisingly, the Democrats voted against that previous question, blocking the motion.

In 2017, as part of the proposed replacement for the Affordable Care Act, Republicans included legislation that would have preserved access for those with preexisting conditions. Again, this was not supported by House Democrats.

H.R. 986 eliminates healthcare choices for States by infringing upon the authority that was given to the Department of Health and Human Services under the Affordable Care Act. Section 1332 of the Affordable Care Act established the Waiver for State Innovation. This allowed States to waive certain ACA regulations in order to provide flexible coverage through new State healthcare programs.

The Secretary of the Department of Health and Human Services was required to promulgate regulations for the granting of these waivers, maintaining that new State health programs stay within the guardrails provided by law.

My constituents of north Texas are consistently concerned about not having access to affordable healthcare. I take meeting after meeting with families who say they are suffering from the high cost of healthcare and prescription drugs, deductibles, and copays. Texans are struggling to afford their health insurance, and I am sure we are not the only ones experiencing these premiums and deductibles.

What good is health insurance if you are afraid to use it because you cannot afford your deductibles and copays? This is an issue that I would like to see us tackle, yet we are here today discussing a bill with a very misleading title that would take flexibility away from States.

During the Rules Committee hearing on Tuesday, we discussed innovative strategies for providing high-quality and affordable health insurance, expanding consumer choice, and some of the positive results for States that have implemented these waivers. In no way did we discuss removing ACA protections for people with preexisting conditions. In fact, I pointed out that the Centers for Medicare and Medicaid Services' Administrator Seema Verma stated in her remarks at the CMS National Forum on State Relief and Empowerment Waivers that ``a waiver cannot be approved that might otherwise undermine these protections.''

Yet Democrats have titled this bill ``Protecting Americans with Preexisting Conditions Act of 2019.'' This is clearly an attempt to coerce Members of Congress into voting for a bill that actually scales back the guidance recently issued for the application of State innovation waivers.

Energy and Commerce Committee Ranking Member Greg Walden offered an amendment to more appropriately title the bill ``This Bill Has Nothing to do with Protecting Americans with Preexisting Conditions Act.'' I hope this amendment will alert Members to the partisan wordplay of the Democrats when we should be focusing on improving the health insurance marketplace.

Taking flexibility away from States is one step closer to a single- payer, government-run healthcare system. This single-payer, government- run healthcare system would only further deteriorate our Nation's healthcare.

The Affordable Care Act was one step in that direction. While it is clear that the Affordable Care Act has proven to be nothing like affordable for Americans, section 1332 waivers would have allowed States the flexibility to employ innovation that works for their citizens.

To date, eight States--Alaska, Hawaii, Maine, Maryland, Minnesota, New Jersey, Oregon, and Wisconsin--have approved State innovation waivers, and seven have created their own reinsurance programs. Premiums in these States--and this is important--premiums in these seven States were almost 20 percent lower, on average, in the first year of enactment. Maryland saw the greatest percent change, with the average individual market premium coming down by more than 40 percent, 43.4 percent, to be precise.

Again, section 1332 of the Affordable Care Act explicitly gives the Department of Health and Human Services the authority to provide guidance surrounding these innovation waivers. As more States submit applications, the administration has learned more about what hurdles States must traverse in order to obtain these waivers.

One limit to a State's ability to apply for an innovation waiver is that the State must have already enacted a State law establishing authority to pursue and implement the waiver. For a State like Texas, where the State legislature meets only every 2 years, this can be a substantial barrier.

The recent Trump administration guidance provides clarity, stating that,

in certain circumstances, existing State legislation coupled with a duly enacted State regulation or executive order could satisfy this requirement.

This guidance, the 1332 guidance, removes some hurdles while maintaining the integrity of the coverage guardrails established by law. Those statutory requirements maintain that coverage must be as comprehensive as coverage would have been absent the waiver, provide cost-sharing to protect against excessive out-of-pocket spending, cover a comparable number of residents, and not increase the Federal deficit.

I would like to reiterate that this is a misleading bill title and that H.R. 986 will restrict healthcare choices for States.

Once again, we are using the valuable time on the floor of the United States House of Representatives to debate something that will not solve the issues of affordability in our Nation's healthcare system and really has no chance of becoming law. It is unfair to patients who are not going to the doctor because, on top of their monthly premiums, their deductible is so high that they cannot afford the visit.

We need a comprehensive solution to address the high patient out-of- pocket costs in our system. This bill moves us in the wrong direction. It will inhibit innovation and much-needed flexibility in our State insurance markets.

As a physician, I cannot support such a piece of legislation, so I will urge opposition to the rule.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, just a point of clarification. While our last vote was just after 2 p.m. yesterday, the House actually adjourned a little after 3 p.m. I did want to make that correction.

Madam Speaker, I yield 2 minutes to the gentleman from Pennsylvania (Mr. Meuser).

Madam Speaker, I yield myself 30 seconds to respond before I yield to the gentleman from Iowa.

Madam Speaker, last Congress passed the first comprehensive, stand- alone sickle cell bill for as long as I can remember. There was a partial reauthorization in 2004, signed by President Bush, that was part of a tax bill.

But Danny Davis' bill passed through our committee, passed through the Senate, and passed on the floor of the House in the previous Congress last year; and as a consequence, for the first time in four decades, new sickle cell therapies are coming through the National Institutes of Health.

Madam Speaker, I yield 1 minute to the gentleman from Iowa (Mr. King).

Madam Speaker, I yield myself 2 minutes for the purposes of a response.

First of all, I am grateful that the Texas Department of Insurance does provide that disclosure and transparency. That is a good thing. In fact, Chairwoman Eshoo, the chairwoman of the Health Subcommittee, when we were hearing bills on limited-duration plans, actually had a bill that would require such disclosure. For whatever reason, it was pulled from the markup that we had that day. I was perfectly prepared to support it, but, again, for whatever reason, the chairman of the committee pulled the bill and we did not get to have that debate or markup.

I also need to point out that our discussion today is not on limited- duration plans. I rather expect that there will be an opportunity to debate limited-duration plans. It may come up as early as next week, and I look forward to that debate. But it is also important to point out that these plans in Texas were permitted under the previous administration for the duration of 1 year.

So, again, the State commissioner of insurance is exactly right. He put those caveats up there so people can know what they are purchasing. I do believe

that is important. I think that is an important aspect of the job of the Texas Commission of Insurance. I wish other State commissioners of insurance would behave in a similar fashion.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield myself 2 minutes.

Madam Speaker, I want everyone to be clear here. This bill today is actually repealing part of the Affordable Care Act.

Look, I didn't vote for the Affordable Healthcare Act. I argued against it, passionately--articulately, I might add--but what does the Affordable Care Act say?

Well, it describes the object of today's legislation, the so-called section 1332 waiver.

Section 1332 is a section of the Affordable Care Act. And section 1332 is titled ``Waiver for State Innovation. In general, a state may apply to the secretary for the waiver of all or any requirements described.''

And this is interesting. ``With respect to health insurance coverage within that State for plan years beginning on or after January 1, 2017.''

The way the law was written, none of these waivers were given during the years that President Obama was President.

They only became eligible--the Secretary only became able to provide these waivers January 1, 2017, which was the last 3 weeks of President Obama's administration.

So when people say, the comparison between the waivers given in the Obama years and the waivers given in the Trump years are vastly different, well, it is true because no waivers were available prior to January 1, 2017.

Look, the Secretary of Health and Human Services has heard the angst that people have trying to deal with the high premiums--premiums, $600, $700, $800 a month for an individual, a deductible of $6,000 to $7,000, and the coinsurance, which runs the bills up so that their annual out- of-pocket costs may be somewhere between $10,000 and $20,000.

Many people point out to me, they spend more for health insurance-- not using anything, but just for the insurance--than they spend for their mortgage payment--not their mortgage insurance, but their mortgage payment.

But, please, let's do remember, 1332 is part of current law.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield myself 2 minutes for purpose of a response.

Look, it is not the Trump Administration that is taking money out of the Affordable Care Act and putting it to other purposes. It is clearly written into the law.

And, again, I didn't vote for this law. I voted against it. I argued against it, but the taking of advanced premium tax credits, cost- sharing reductions and small business tax credits under Section 36(b) of the Internal Revenue Code of 1986 under subpart (1)--blah, blah, blah--an alternative means by which the aggregate amount of such credits or reductions that would have been paid on behalf of participants in the exchanges established under this title had the State not received such a waiver, that amount shall be paid to the State for the purposes of implementing the State plan under the waiver.

So it is really pretty clear in the existing language of law. It is not the Trump Administration deviating funds, it was congressional intent. It was passed by this House of Representatives.

Again, I didn't vote for it. I wouldn't have defended it at the time. I didn't think it was a good idea then, probably not the greatest idea now. But the Secretary has this tool to use and he is responding to requests from people's constituents, do something about the high cost of my insurance, the high costs that I am required to spend in order to protect myself against the health catastrophe.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield 3 minutes to the gentleman from Alabama (Mr. Rogers).

Madam Speaker, I do have one additional speaker.

Madam Speaker, I yield 3 minutes to the gentleman from Georgia (Mr. Woodall), who is a valuable member of the Rules Committee, and gave us a stirring history lesson on the ERISA plans and how the protection from preexisting conditions actually goes back to 1996.

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

Madam Speaker, if we defeat the previous question, I will offer an amendment to the rule to move a resolution that reinforces the Republican's long-held views that every American should have preexisting condition protections.

On the opening day of the 116th Congress, House Republicans brought a measure to the floor that called on lawmakers to legislate on locking in protections for patients with preexisting conditions. Unfortunately, in a fit of partisanship, House Democrats blocked that effort. If Democrats were serious, they would not object to making a statement on behalf of the House of Representatives that we want to work together with the administration to protect patients with preexisting conditions.

Our position is simple and clear. Republicans stand ready to protect those with preexisting conditions in a manner that will withstand judicial scrutiny, and I hope our Democratic colleagues will join us in that effort.

Madam Speaker, if the previous question is defeated, House Republicans will move to immediately consider a resolution that maintains that no American should have their health insurance taken away or lose protections for preexisting conditions due to the Democrats in Congress enacting an unconstitutional law.

It would instruct Congress and the Trump administration to ask the Supreme Court for a stay in the Texas v. United States decision, should the Affordable Care Act be found unconstitutional.

It would instruct Congress to develop bipartisan legislation that guarantees that no American citizen can be denied health insurance coverage or charged more due to a previous illness or health status.

It includes commonsense consumer protections, provides more choice and affordable coverage than the Affordable Care Act, lowers prescription drug prices for patients, strengthens Medicare for current and future beneficiaries, and rejects the Democrats' radical one-size- fits-all, government-run, Soviet-style, top-down healthcare scheme that would only outlaw the employer-based coverage of more than 180 million Americans.

Madam Speaker, I suspect our Democratic colleagues will vote against considering this resolution, so I must ask: Why are Democrats opposed to making a statement that the goal of the House of Representatives of the United States is to work together to protect coverage for patients with preexisting conditions? If that is not the goal, then what might it be?

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

Madam Speaker, again, I would reiterate that neither bill under consideration today has a chance of becoming law.

While I support funding for disaster relief, the Democrats chose not to negotiate with the Senate and included controversial positions.

As a result, we would likely be considering a disaster relief bill yet another time, and our hard-hit communities will continue to struggle without relief.

Once again, despite the title of H.R. 986, this bill will have no impact on protections for preexisting conditions for Americans with those conditions. It will simply overturn a regulation--overturns part of ObamaCare--it overturns a regulation that allows States to innovate in the Affordable Care Act marketplace, and that provides flexibility and consumer choice to healthcare consumers.

House Republicans continue to support preexisting conditions protections and have offered solutions to give patients this assurance. Republicans stand ready to work with Democrats in a bipartisan manner to pass these protections into law and also provide desperately needed disaster relief.

I look forward to when we can all gather around the negotiating table. I urge a ``no'' vote on the previous question, a ``no'' vote on the underlying measures, and I yield back the balance of my time.

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

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

Madam Speaker, we are here again considering one nonbinding resolution and a second resolution that will never become law. Both of these prevent us from focusing on the real business of Congress, which is to legislate.

The first, H. Res. 271, is a resolution condemning the Trump administration's recent position in the case of Texas v. United States.

So let's revisit that for a minute. Republicans are supportive of protecting access to health insurance for individuals with preexisting conditions. This resolution today will not advance the development of any policies to improve healthcare for the American people. There are options that the Democrats could have brought to the floor to lower healthcare costs and increase access to care; such legislation would indeed be worthy of our time. But, instead, we are debating expressions that basically amount to political posturing.

The first vote the Republicans called this year was a motion to require legislation protecting individuals with preexisting conditions. Surprisingly, the Democrats voted against that previous question. In 2017, as part of the proposed replacement for the Affordable Care Act, Republicans included legislation that would have preserved access for those with preexisting conditions.

Speaker Pelosi has already intervened on behalf of the House in Texas v. United States. While the Department of Justice has weighed in, the department is not litigating the case. As with every other legal case, this will play out in the courts. If Congress must act following the final legal decision, certainly we stand ready to do so. In fact, if the Democrats wanted to void this case, they know their options. They could repeal the individual mandate or they could reinstitute the tax on the individual mandate or they could provide a severability clause that was somehow left out when the Affordable Care Act was passed the first time. But we have seen them do none of those options.

The legal process will take time, and no Americans will lose access to their healthcare while the legal process is being heard. Unlike the case of Texas v. United States--which we know will not affect coverage because the judge in that case has issued a stay--individuals covered by what are known as association health plans may actually lose their coverage due to uncertainty in the legal outcome of that case. For last week, a Federal judge in the case of the State of New York, et al. v. Department of Labor, last week a Federal judge ruled that the Department of Labor's final rule on association health plans was not legal.

Association health plans provide employers who otherwise might struggle to provide health insurance for their employees to access the group market through an association, based either on geography or a line of business. The Washington Post recently reported that there are initial signs that association health plans are ``offering generous benefits and premiums lower than found in the ObamaCare marketplaces.''

Association health plans have provided additional choices for Americans seeking innovative healthcare options, but these choices may soon disappear as a result of the lawsuit State of New York, et al. v. the Department of Labor.

The Democrats are using the case of Texas v. United States to delay explaining their real ideas. Their real idea is a one-size-fits-all healthcare. The so-called Medicare for All would be a terrifying reality for our Nation. The Democrats' Soviet style, government-

run, single-payer healthcare bill would not provide access to quality healthcare for Americans. Instead, it would lead to a massive tax increase, eliminate private insurance, and bankrupt the already dwindling Medicare trust fund.

Constituents in my district back in Texas are struggling to afford their health insurance under the Affordable Care Act, and I am certain that we are not the only ones suffering from high premiums and very high deductibles.

Madam Speaker, what good is health insurance if you are afraid to use it because you can't afford your deductible?

This is an issue that I would actually like to see us tackle. But I am confident that a government-run, single-payer system would only further deteriorate our Nation's healthcare.

As the son of a physician who chose to leave Canada because of their system of socialized medicine, I worry that the central state control of healthcare would further damage the doctor-patient relationship. As a physician, I do not believe that the government should hinder a doctor's ability to act in the best interest of his or her patient. I wish the concept of government dictating a physician's practice and decisions was unthinkable, but I find myself here today having to deconstruct the idea of further government control of healthcare.

The House Democratic proposal would implement a global budget, and once that has been set, hospitals and institutions would be required to stick to that for all outpatient and inpatient treatment.

What happens if the budget runs out?

Are the patients simply told: Sorry, we ran out of money, you may try again next year?

Today we should be focusing on the parts of the health insurance market that are working for Americans. For example, 71 percent of Americans are satisfied with their employer-sponsored health insurance. This provides robust protections for individuals with preexisting conditions under ERISA law--a 1970 law, not the 2010 Affordable Care Act. Quite simply, the success of employer-sponsored insurance is not worth wiping out for single-payer healthcare.

Since President Trump took office--and this is important--since the President took office, the number of Americans in employer-sponsored health coverage has increased.

How much has that increased?

I can't precisely tell you because our Congressional Budget folks have not seen fit to give us new coverage numbers.

But since the President took office, how many people are employed that were previously unemployed?

The number is somewhere between 3 and 6 million, and a significant number of those individuals have employer-sponsored health insurance who had no insurance before.

The coverage numbers under President Trump, if the story is ever told, have gone up. Today, there is a greater percentage of Americans in employer-sponsored health coverage than at any time since the year 2000. That is why it is astonishing that House Democrats would want to abolish that insurance option entirely.

Instead of building on the success of our existing health insurance framework, Democrats' radical single-payer, government-run policy would simply tear it down. It would eliminate employer-sponsored health insurance, eliminate all private insurance, eliminate Medicaid, and eliminate CHIP.

Existing Medicare beneficiaries would not be exempt from harm, as the policy would raid the Medicare trust fund, which is already slated to go bankrupt in 2026.

Our Nation's seniors count on the existence of Medicare for their retirement healthcare needs. They have paid into it their entire working lives. How are we supposed to inform them that not only do the Democrats want to endanger their access to Medicare services, but, unbelievably, they will want to increase their taxes also?

There is no question that this policy could be catastrophic for America's patients today and for generations to come.

At least now there is some degree of honesty. Remember, a previous administration said, if you like your doctor, you can keep your doctor. Now at least there is some degree of honesty.

You can't keep your doctor. You can't keep your insurance. You can't keep your personal liberty. You get nothing. Effectively, it would end all the parts of our healthcare system that are, in fact, working for the American people.

Quite simply, single-payer healthcare would be another attempt at a one-size-fits-all approach to healthcare. We know this: Americans are all different. A universal healthcare plan will not meet the varying needs of each and every one of us as individuals. Single-payer is not one-size-fits-all. It is really one-size-fits-no-one.

Again, to restate the obvious: Since the beginning of this Congress, we have heard it. Through the last Congress, we heard it. Republicans support protections for individuals with preexisting conditions.

Instead of spending our time here today worrying about the judicial branch, we could focus on our job as members of the legislative branch. We should be actively working to better our healthcare system, not spending time taking votes that will fail to accomplish any real objective.

Madam Speaker, the second resolution included in this rule directs the removal of the United States Armed Forces from hostilities in the Republic of Yemen that have not been authorized by Congress.

We considered this resolution once before. At that time, Republicans successfully passed a motion to recommit that declared the House's opposition to anti-Semitism. However, this version of the bill does not include that important provision, and we are again debating legislation that is, in fact, based on a false premise.

The resolution is fundamentally flawed. United States forces are not engaged in hostilities between the Saudi-led coalition and the Iranian- backed Houthi forces in Yemen. Previously, the United States was providing midair refueling to Saudi Arabia but ceased this assistance in November 2018. The United States continues to provide limited intelligence-sharing and limited logistics support, which does not amount to engagement in hostilities.

The Trump administration is focused on countering al-Qaida in the Arabian Peninsula and the Islamic State, mitigating the humanitarian crisis in Yemen and assisting our allies.

The United States does not command, coordinate, accompany, nor participate in counter-Houthi operations or any hostilities other than those directed at al-Qaida and the Islamic State.

I might, here, just add: Those activities against the Islamic State have been significantly successful over the last 2 years.

This resolution sets a dangerous precedent. America has a security agreement with Saudi Arabia, just as we do with 117 other countries, including our NATO allies Canada, Australia, South Korea, and Israel. If this resolution were to become law, it could set a precedent that could prevent us from assisting allies and prevent us from meeting our treaty obligations. Rather than condemning a type of assistance that is no longer being provided by the United States, we should be finding ways to aid the millions of Yemenis at risk of starving to death.

Limiting how our forces can engage in the region will only further exacerbate this conflict and not help bring it to a conclusion.

Madam Speaker, I urge opposition to the rule, and I reserve the balance of my time.

Madam Speaker, I yield myself 3 minutes.

Madam Speaker, here is one of the uncomfortable truths of the Affordable Care Act: Under the law, every Member of Congress was supposed to be covered under the Affordable Care Act. Obviously, the pay and benefits of a Member in Congress exceed the subsidy limits, so these would be unsubsidized healthcare.gov policies. But then-Speaker of the House John Boehner, then-Leader of the United States Senate Harry Reid, and President Obama himself all intervened. They were fearful that Members of Congress might leave.

There might be a brain drain in Congress--if such a thing was, in fact, possible--if Members of Congress were required to put their health insurance under the Affordable Care Act, so they created an exception for Members of Congress, and Members of Congress only. They are the only people in the United States who can do this. There is a tax-free subsidy that a Member of Congress can walk into the D.C. exchange and get their coverage in the D.C. exchange.

I rejected that option because: Number one, I didn't think it was right. Number two, I didn't think it was legal. I thought it was going to be taken away from us. Apparently, no one else shared my concern because it still exists.

It does make me wonder why we would not offer a health reimbursement account, and I have brought this up several times in committee, where that same tax-free subsidy could be available to any American to walk into a health insurance plan of their choosing. Why not give the people of the country what Members of the Congress so generously bestowed upon themselves?

I didn't take the option to go into the D.C. exchange. I didn't take the option of the tax-free subsidy that went along with it. I bought an unsubsidized health insurance plan in healthcare.gov, signed up for it October 1, 2012. Many of you may remember that. We were in the process of shutting the government down at the time. It was in all the papers.

I started that process October 1, 2012. The check cleared the middle of January 2013. I went that entire time not knowing if I would have health insurance in healthcare.gov the next year because I couldn't get an answer to any questions.

You couldn't call the people at healthcare.gov. You would try, and you would be put on hold. You would stay on hold for a long period of time. You would eventually get to talk to a person. You would get cut off. You would have to start all over at the beginning. It was a miserable process.

The point is, Members of Congress should have gone through that. We should have had to deal with what we pushed off on the American people, at least those people in the individual market.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield 4 minutes to the gentleman from Texas (Mr. Brady), the Republican leader of the second oldest committee in the United States Congress, the Committee on Ways and Means.

I have as many as I need.

It will be me.

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

Madam Speaker, if we defeat the previous question, I will offer an amendment to the rule to move a resolution that reinforces our long- held views that every American should have preexisting condition protections.

On the opening day of the 116th Congress, House Republicans brought a measure to the floor that called on lawmakers to legislate on locking in protections for patients with preexisting conditions. Unfortunately, in a fit of partisanship, the Democrats blocked this effort.

If the Democrats were serious, they would take up legislation immediately to protect patients with preexisting conditions. Instead, Democrats are trying to score political points.

Our position is simple and clear: Republicans stand ready to protect those with preexisting conditions in a manner that will withstand judicial scrutiny. This is why, if the previous question is defeated, House Republicans will move a resolution that:

Maintains that no American should have their health insurance taken away or lose protections for preexisting conditions due to the Democrats in Congress enacting an unconstitutional law;

Instructs Congress and the Trump administration to immediately ask the Court for a stay in this decision;

Guarantees that no American citizen can be denied health insurance or coverage or charged more due to previous illness or health status;

Includes commonsense consumer protections;

Provides more choice and affordable coverage than the Affordable Care Act;

Lowers prescription drug prices for patients;

Strengthens Medicare for current and future beneficiaries; and

Rejects the Democrats' radical, one-size-fits-all, government-run healthcare that would outlaw the employer-based coverage of more than 150 million Americans.

Finally, it is important to note that Texas v. the United States, the case that is working its way through the courts, did not immediately end ObamaCare and will not affect insurance coverage or premiums for calendar year 2019. Several legal steps remain before the courts reach a final conclusion.

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

Madam Speaker, if the gentleman is agreeable, I am prepared to close.

So, in closing, while Republicans stand ready to legislate, we are again considering unnecessary resolutions. The first seeks to condemn the position of the Department of Justice in Texas v. the United States, the case in which the Department of Justice is not a party.

As I have stated several times, Republicans support protecting coverage

for preexisting conditions. I would hope we could work together to find a way to make health insurance affordable for all Americans rather than considering a divisive messaging resolution.

The resolution to remove the United States Armed Forces from hostilities in Yemen is not only unnecessary, but may prevent future assistance for our allies.

The brave men and women who are assisting Saudi Arabia in the fight against al-Qaida and the Islamic State are working to find solutions to the humanitarian crisis that is unfolding in Yemen, a mission for which we should be unified in our support.

Madam Speaker, with that, I urge a ``no'' vote on the previous question, and a ``no'' on the underlying measures.

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

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

Madam Speaker, I thank the gentlewoman from Florida for yielding, and I thank her for her leadership.

Madam Speaker, the American people will insist that this legislation passes. My Republican friends, since my time in helping to pass the Affordable Care Act, have never offered a plan to ensure that America's wonderful citizens have good healthcare and that those with preexisting conditions, such as many of us, including myself and many of my constituents in Houston, Texas, are able to access healthcare.

Let me be clear on what this legislation does, as I thank Representative Kuster for her leadership.

H.R. 986, of which I am strongly in support of, is a saving grace. What it does is it stops the Trump administration in their tracks from watering down an opportunity of flexibility, section 1332.

Here is what is going to happen if we do not pass this legislation:

We will stop the coverage of preexisting conditions, period;

There will be no protections;

You will see a rise in costs in healthcare;

Short-term plans will be thrown to the people and other plans that will destabilize the risk pool;

It will limit access to comprehensive coverage because the Trump guidance says: Just give access and don't worry about if the plan even allows you to be admitted into a hospital;

And finally, it will reduce benefits like maternity coverage, mental healthcare, and coverage of prescription drugs.

Is that what Americans want?

Every day, in my district, I am seeing people desperate for healthcare. There has been not one proposal coming here.

I rise as well to support the supplemental appropriations, because I have been to Puerto Rico and the U.S. Virgin Islands. We need these resources.

But I have also seen the devastation of victims impacted by Hurricane Michael in Alabama, Florida, and Georgia; the damage in Nebraska, Missouri, South Dakota, Iowa, Kansas, and now in Houston, 10 inches of rain and flooding and more rain coming. I know that people who were impacted by Hurricane Harvey are still suffering.

This particular legislation, appropriations, is important. It is important, in particular, to ensure that we add more funding and that we shore up the infrastructure.

I submitted amendments that covered the idea of improving FEMA so that it would stay longer and it would have oversight to know whether it is helping people; to increase energy services so that we don't black out so that people are suffering; and to make sure we have the right kind of water.

There are many other elements to the appropriations bill which I hope to debate at a later time, but this rule should be supported.

Let me additionally go back to the H.R. 986 legislation and indicate that preexisting diseases cover things like sickle cell, which 1 in 13 African American babies are born with; triple negative breast cancer, which is the most deadly and causes immediate or short-term life to White women, Black women, Asian Pacific Islander, American Indian, and Alaska Native women; diabetes; and HIV/AIDS.

This is why H.R. 986 is important, Madam Speaker, and why the appropriations bill is important.

Madam Speaker, I rise in strong and unequivocal support for the rule governing debate on H.R. 986, the ``Protecting Americans With Pre- Existing Conditions Act of 2019'' as well as the underlying legislation and ask all Members to join me in supporting these legislative initiatives that combat the Trump Administration's ongoing efforts to take away health care from more than 100 million Americans and to make health care dramatically less affordable for those fortunate enough to be insured.

Another reason I strongly support this rule is that it makes in order H.R. 2157, the ``Supplemental Appropriations Act of 2019,'' which provides much needed and long overdue relief to Americans in Puerto Rico and the U.S. Virgin Islands still suffering from the ravages of Hurricanes Maria and Irma, as well as relief to victims of Hurricane Michael which struck Alabama, Florida, and Georgia in October 2018 and to the victims of the Midwestern floods that have caused so much damage in Nebraska, Missouri, South Dakota, Iowa, and Kansas.

H.R. 986, rescinds this damaging, dangerous guidance immediately, and reinforces the ACA's vital protections for people with pre-existing conditions.

It also prevents the Secretaries of HHS and Treasury from promulgating any substantially similar guidance or rule in the future.

Section 1332 of the State Innovation Waivers included in the ACA has a clear statutory directive that states must maintain the level of benefits, affordability, and coverage provided to state residents by the ACA.

This Administration's 2018 Guidance allows states to simply demonstrate that a comparable number of residents will have access to comprehensive and affordable coverage, regardless of whether they actually enroll in that coverage, thereby allowing the Secretaries of HHS and Treasury to approve waivers that do not provide coverage that is as affordable or as comprehensive as under the ACA.

The ``Protecting Americans with Pre-Existing Conditions Act'' is a vital legislative measure that emphasizes the importance of not limiting coverage for individuals with pre-existing conditions or imposing lifetime limits on access to care.

Predatory practices such as this will prove to be devastating to communities across the nation, many of which, who will be affected are disproportionately communities of color.

The people receiving the life-sustaining medical protections under this provision will be cast aside and left with no way to cover the exorbitant healthcare costs that would otherwise be covered in through the Affordable Care Act.

Relenting on this protection will put a great number of my constituents and various communities across the nation at terrible risk.

Specifically, in the 18th Congressional District many of my constituents are disproportionally affected by several pre-existing conditions such as:

Sickle Cell Disease (SCD) affects approximately 100,000 Americans and occurs among about 1 out of every 365 Black or African-American births.

SCD occurs among about 1 out of every 16,300 Hispanic-American births.

And 1 in 13 Black or African-American babies is born with sickle cell trait (SCT).

During 2005, medical expenditures for children with SCD averaged $11,702 for children with Medicaid coverage and $14,772 for children with employer-sponsored insurance.

About 40 percent of both groups had at least one hospital stay.

The most common cancer in women, no matter your race or ethnicity.

The most common cause of death from cancer among Hispanic women.

The second most common cause of death from cancer among white, Black, Asian/Pacific Islander, and American Indian/Alaska Native women.

Diabetes is at an all-time high in the U.S. and continues to increase exponentially every year.

The CDC's Division of Diabetes Translation states that over 30 million Americans are living with Diabetes, over a quarter undiagnosed.

This trend continues in the state of Texas, where Diabetes is the 6th leading cause of death.

Nearly 12 percent of Texas is living with diagnosed Diabetes.

According to a collaboration report between the nonprofit Texas Health Institute, the State Demographer's Office and Methodist Healthcare Ministries of South Texas, one in three adult Texans are either diagnosed with diabetes, have diabetes but have not yet been diagnosed, or are at high risk for developing the disease within a decade.

Approximately 1.1 million people in the U.S. are living with HIV today.

About 15 percent of them (1 in 7) are unaware they are infected.

The Center for Disease Control (CDC) estimates that the decline in HIV infections has plateaued because effective HIV prevention and treatment are not adequately reaching those who could most benefit from them.

These gaps remain particularly troublesome in rural areas and in the South and among disproportionately affected populations like blacks/ African Americans and Hispanics/Latinos.

The overall prevalence of CKD in the general population is approximately 14 percent.

High blood pressure and diabetes are the main causes of CKD.

Almost half of individuals with CKD also have diabetes and/or self- reported cardiovascular disease (CVD).

More than 661,000 Americans have kidney failure. Of these, 468,000 individuals are on dialysis, and roughly 193,000 live with a functioning kidney transplant.

Kidney disease often has no symptoms in its early stages and can go undetected until it is very advanced.

For this reason, kidney disease is often referred to as a ``silent disease.''

What is also concerning is the overwhelming number of constituents plagued by these diseases, are people of color, African American, Latino, and Native American.

H.R. 986 stopped the Trump Administration in its tracks from taking away health care from vulnerable Americans.

Madam Speaker, the Trump administration cannot be trusted to act in the best interests of the American people that is why I offered two amendments to H.R. 986, which would extend the prohibitions of the bill to (1) ban lifetime limits with respect to persons with preexisting conditions and (2) prevent the Secretaries from taking any action that would reduce the affordability of comprehensive coverage for children under 26 with pre-existing conditions who are covered under their parents' policies.

I will soon be introducing legislation that will achieve these important objectives and protect vulnerable Americans from an uncaring Administration that is unceasing in its efforts to take away health care from vulnerable Americans.

Madam Speaker, H.R. 2157, the ``Supplemental Appropriations Act of 2019,'' provides much needed and long overdue relief to Americans in Puerto Rico and the U.S. Virgin Islands still suffering from the ravages of Hurricanes Maria and Irma, as well as relief to victims of Hurricane Michael which struck Alabama, Florida, and Georgia in October 2018 and to the victims of the Midwestern floods.

I support this legislation and offered an amendment that would have provided additional funding for electricity delivery and necessary expenses related to the consequences of Hurricanes Harvey, Maria, Irma, and Super Typhoon Yutu including technical assistance related to electric grids.

As the representative of the Eighteenth Congressional District of Texas, which was ground zero for Hurricane Harvey, I regularly hear from constituents expressing their concern with ineffective and inadequate FEMA mechanisms put in place to help rectify the damage caused by natural disasters.

That is why I also offered an amendment to H.R. 2157 that would prohibit funds in the bill from being used to prevent the FEMA Administrator from monitoring the response given to disaster victims in order to ensure quality control or becoming aware of complaints regarding the response given to disaster victims and having in place a mechanism to address such complaints.

A third Jackson Lee amendment to H.R. 2157 would have provided a minimum of $1 million for wastewater and drinking water treatment works and facilities impacted by Hurricanes Harvey, Irma, and Maria.

Hurricane Sandy inflicted more than $70 billion in damages in 2012, and Matthew cost

the U.S. about $10.3 billion in 2016. With Harvey, an estimated 13 million people were affected, nearly 135,000 homes damaged or destroyed in the historic flooding, and up to a million cars were wrecked.

Hurricane Harvey ranks as the second-most costly hurricane to hit the U.S. mainland since 1900, causing more than $125 billion in damage.

Our residents need more money than for single-family home repairs, whether it is disaster recovery or general housing dollars and I will continue to stride on behalf of the neighborhoods and on behalf of hard-working homeowners who deserve these funds, so they can continue on with their lives and return to their homes.

Victims of natural disasters are entitled to know who to contact when issues related to FEMA arise and to be assured that their questions are answered, and complaints addressed.

Allocating funding for measures such as Electricity Delivery for necessary expenses related to the consequences of Hurricanes Harvey, Maria, Irma, and Super Typhoon Yutu, is vital to negate the effects of these catastrophic events from significantly worsening.

Hospitals, first-responders, and a number of other vital institutions that help our communities recover from the after-effects of natural disasters need access to electricity.

Moreover, with the severity of natural disasters and the ranging of their locations we must be proactive in our preparation for recovery.

Alternatively, water is the most essential recourse known to man.

A human can go for more than three weeks without food--Mahatma Gandhi survived 21 days of complete starvation--but water is a different story.

At least 60 percent of the adult body is made of it and every living cell in the body needs it to keep functioning.

Under extreme conditions an adult can lose 1 to 1.5 liters of sweat per hour and if that lost water is not replaced, the total volume of body fluid can fall quickly and, most dangerously, blood volume may drop.

We do not have the luxury of not preparing for hurricanes, floods, earthquakes, mudslides, tornados or other natural disasters.

With these events it is not a question of if, but when.

For these reasons, I urge my colleagues to support the rule and the underlying legislation.

Madam Speaker, I happen to live and be in the area of the Texas Children's Hospital. I have obviously supported the legislation of Danny Davis.

The point is that people with preexisting conditions, including sickle cell, will not have access to healthcare under the Trump guidance.

I am standing here not about the research, which is certainly beneficial, but about the fact that I am standing for those with sickle cell, which is a preexisting condition, to not be blocked from having good healthcare. That is why I rise to support H.R. 986, in order to ensure access to healthcare and not stopping preexisting conditions from being covered.

Madam Speaker, by direction of the Committee on Rules, I call up House Resolution 357 and ask for its immediate consideration.

Madam Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Texas (Mr. Burgess), 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

Madam Speaker, I ask unanimous consent that all Members be given 5 legislative days to revise and extend their remarks.

Madam Speaker, on Tuesday, the Rules Committee met and reported a rule, House Resolution 357, providing for consideration of H.R. 986, the Protecting Americans with Preexisting Conditions Act, under a structured rule.

The rule makes in order 12 amendments. The rule provides 1 hour of debate equally divided and controlled by the chair and the ranking member of the Committee on Energy and Commerce.

The rule also provides for consideration of H.R. 2157, the Supplemental Appropriations Act, under a structured rule. The rule self-executes a manager's amendment and makes in order 10 amendments to

Madam Speaker, I yield 3 minutes to the gentlewoman from Florida (Ms. Castor), a distinguished member of the Energy and Commerce Committee.

Madam Speaker, I yield 3 minutes to the gentlewoman from Texas (Ms. Jackson Lee).

Madam Speaker, I yield 30 seconds to the gentlewoman from Texas (Ms. Jackson Lee).

Madam Speaker, I yield 2 minutes to the gentleman from Mexico (Mr. Lujan), the Assistant Speaker.

Madam Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Doggett), a distinguished member of the Ways and Means Committee.

Madam Speaker, I am delighted to hear a Member of the other party defend the Affordable Care Act by defending 1332, the waivers.

Let me say this: We are not eliminating the waivers. We are simply objecting to the guidance that was issued by the Department of Health and Human Services, arguing, essentially, that it is inconsistent with the congressional intent when the waivers were created.

Madam Speaker, I include in the Record a letter signed by 24 health organizations, including the Cancer Action Network, the American Lung Association, the American Heart Association, the Susan G. Komen Foundation, and others, urging Members to support H.R. 986.

May 8, 2019.

Re Letter of Support from 23 Patient and Consumer Advocacy

Organizations for H.R. 986.

Hon. Ann McLane Kuster,

House of Representatives,

Washington, DC.

Dear Representative Kuster: Our 24 organizations,

representing the interests of the millions of patients and

consumers who live with serious, acute, and chronic

conditions, have worked together for many months to ensure

that patient voices are reflected in the ongoing

Congressional debate regarding the accessibility of health

coverage for all Americans and families. Today, we write in

strong support of your legislation to protect people with

pre-existing conditions who receive coverage in the

individual marketplace. The Protecting Americans with

Preexisting Conditions Act of 2019, H.R. 986, would require

the Administration to rescind its Section 1332 State Relief

and Empowerment Waivers Guidance, released on October 22,

2018 (1332 guidance). We are concerned about the impact that

this guidance could have on the people we represent and

applaud your introduction of this bill.

In March 2017, we identified three overarching principles

to guide and measure any work to further reform and improve

the nation's health insurance system. Our core principles are

that health insurance coverage must be adequate, affordable,

and accessible. Together, our organizations understand what

individuals and families need to prevent disease, manage

health, and cure illness. Our organizations are deeply

concerned about how the new 1332 guidance will affect the

individual marketplace's stability in states that choose to

pursue some of the policies allowed under this guidance,

including those that promote short term plans and other

substandard coverage. We are pleased that this legislation

represents a significant and meaningful step towards

protecting all Americans from coverage that does not cover

what they need to promote their health and well-being.

As you know, the 1332 guidance substantially erodes the

guardrails governing coverage that people with pre-existing

conditions such as cystic fibrosis, lung disease, cancer,

cardiovascular disease, diabetes, rare disorders, pregnant

women, and many others rely on in the individual marketplace.

Of particular concern, the new guidance would allow states to

let individuals use advanced premium tax credits to purchase

non-compliant short-term, limited duration insurance plans--

which could further draw younger, healthier people out of the

risk pool for comprehensive insurance and drive up premiums

for those who need comprehensive coverage. The guidance also

eliminates protections for vulnerable populations, such as

individuals with low incomes and those with chronic and

serious health issues, by removing the requirement to

safeguard those populations under any waiver. We are deeply

concerned by this as these changes fundamentally alter the

nature of the Section 1332 waiver program and jeopardize

adequate, affordable coverage for people with pre-existing

conditions in the individual market. Halting the

implementation of this guidance will protect people with pre-

existing conditions from the repercussions of these market

destabilizing actions.

H.R. 986 represents a significant step towards protecting

patients and consumers. Yet, we also recognize that there is

much more that needs to be done to improve upon our current

system of care, including making coverage more accessible and

affordable. Up until this year, health insurance enrollment

has steadily increased, and, with it, the promise of a more

diverse risk pool and greater protection for people with

serious health care needs. However, the recent

reinterpretation of the guidelines is jeopardizing

enrollment. Shortened enrollment periods, fewer resources for

outreach and education and less funding for consumer

navigators not only creates confusion for consumers but

directly impacts the number of individuals who enroll in

Marketplace coverage. Without Congressional action, these

trends will make it harder for many to access coverage and

will further contribute to the destabilization of insurance

markets and result in higher premiums for many enrollees.

Making high-quality coverage and care more affordable is

also a high priority for the people that we represent.

Passage of legislation that expands access to and the level

of advance premium tax credits, fixes the family glitch,

creates a nationwide reinsurance program, and reduces

systemic health care costs could significantly ease the cost

burden for people of all income levels who rely on the

individual marketplace for coverage. We urge Congress to

support legislation that maintains the quality of coverage

while expanding access and affordability.

Again, thank you for your leadership on this critical issue

for people with pre-existing conditions. We support your

efforts to halt the implementation of the 2018 guidance,

ensuring the guidance from 2015 remains intact and promoting

stability in the individual marketplace. We urge members of

Congress to vote for H.R. 986.

Sincerely,

Hemophilia Federation of America, National Health Council,

Cystic Fibrosis Foundation, Epilepsy Foundation, March of

Dimes, National Coalition for Cancer Survivorship, American

Heart Association, Alpha-1 Foundation, American Liver

Foundation, Susan G. Komen, National Hemophilia Foundation,

WomenHeart: The National Coalition for Women with Heart

Disease.

National Multiple Sclerosis Society, Muscular Dystrophy

Association, Lutheran Services in America, American Lung

Association, National Alliance on Mental Illness, National

Patient Advocate Foundation, Arthritis Foundation, Leukemia &

Lymphoma Society, American Cancer Society Cancer Action

Network, National Organization for Rare Disorders, Pulmonary

Hypertension Association, Cancer Support Community.

Madam Speaker, I yield 2 minutes to the gentlewoman from the District of Columbia (Ms. Norton).

Madam Speaker, I am prepared to close, and I reserve the balance of my time.

Madam Speaker, I continue to reserve the balance of my time.

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

I appreciate the comments of the gentleman from Georgia, and I have enjoyed the opportunity of working with him on the Rules Committee.

We are not objecting to what was done in 1996. We are saying to the States that they must cover preexisting conditions as part of a waiver, and they cannot undermine those conditions by imposing annual limits or charging more. The problem with the guidance is that it gives States the opportunity to propose cheap plans that, in essence, undermine preexisting conditions.

Madam Speaker, I reserve the balance of my time.

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

It was only 10 years ago that people who lacked employer-provided insurance and had preexisting conditions could not find health insurance in many parts of this country, and those who could find health insurance, too often found that their plans were not comprehensive. They might not cover the type of cancer some buyers previously had, or they might have an annual or even a lifetime cap on coverage.

It was 2 years ago that this body passed a bill that stripped those protections, a bill that would make comprehensive health insurance out of reach for many Americans. Thanks to a courageous few, that bill did not become law.

Now that the administration has lost that battle to destroy the Affordable Care Act, they are trying to do it through guidance and through lawsuits.

H.R. 986 prevents the administration from enforcing guidance that would allow States to use taxpayer money to sell subpar health plans on the exchange.

The administration is taking the 1332 waivers, which are designed to allow States flexibility to lower health insurance costs, like through reinsurance, and using it to take away important consumer protections. The 1332 waiver requires high-quality, affordable health insurance while retaining the basic protections of the Affordable Care Act.

As the American Cancer Society notes: This administration guidance tips the scales in favor of insurance products that are inadequate to meet the needs of millions of Americans with preexisting conditions.

Madam Speaker, I also support H.R. 2157, which provides disaster assistance to communities from every nook and corner of this country who are waiting for our help.

When disaster hits this country, we come together and support each other. When tornados, and floods, and hurricanes strike, we help people quickly. It is an embarrassment that a disaster bill has not yet made it to the President's desk in this Congress.

Madam Speaker, I urge a ``yes'' vote on the rule.

The text of the material previously referred to by Mr. Burgess is as follows:

Amendment to House Resolution 357

At the end of the resolution, add the following:

Sec. 3. Immediately upon adoption of this resolution, the

House shall proceed to the consideration in the House of the

resolution (H. Res. 280), protecting the health care of all

Americans, especially those with preexisting conditions. The

resolution shall be considered as read. The previous question

shall be considered as ordered on the resolution to adoption

without intervening motion or demand for division of the

question except one hour of debate equally divided and

controlled by the chair and ranking minority member of the

Committee on Energy and Commerce. Clause 1(c) of rule XIX

shall not apply to the consideration of House Resolution 280.

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