CHOICE Arrangement Act

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

Millions of Americans are finding the security and the peace of mind that comes from having access to a family physician through the Affordable Care Act. If the gentleman has been listening to the American people, he has turned a tin ear to the 16 million Americans that have now enrolled in the marketplaces under the Affordable Care Act.

Republicans, unwilling to accept the success of what they demeaned as ObamaCare, Republicans who failed more than 60 times in this House to repeal ObamaCare, who failed three times in the Supreme Court to undermine ObamaCare, have now embarked on a new strategy, which is to circumvent and undermine the invaluable protections of the Affordable Care Act.

With this bill, Republicans are demanding that every individual who gets stuck in one of these newfangled plans that they have is denied protection from having their insurer exclude preexisting conditions, no assurance of coverage for essential medical care, and no assurance of affordability.

I offered an amendment to correct one part of this defective bill to give Americans statutory protection, so they are not back in the old pre-Affordable Care Act period of losing coverage when they needed it most because they had something the insurance company defined as a preexisting condition, but that was rejected.

At the time, they claimed that was their intent, but when you look at the specific statutory language, there is no doubt that the protection for preexisting conditions and essential conditions is excluded from their legislation.

These so-called Individual Coverage Health Reimbursement Arrangements, ICHRAs, are about as convoluted as the name suggests. They are as my grandson, Canyon, would say, they are icky.

Handing people a voucher and telling them to go shop for coverage follows the same ill-conceived Republican approach to sabotage Medicare, which they continue to promote in their latest budget. Instead of giving Medicare beneficiaries guaranteed coverage, they would give seniors a voucher with declining value and tell them to go find coverage.

Instead of the guaranteed, comprehensive coverage workers now receive, this bill would force so many people to find healthcare in a sea of junk, exposing them to misleading marketing and aggressive brokers. An estimated 2 million workers would be immediately impacted by this sorry bill, and with another provision that is in the bill that directs the Treasury Department to go out and promote access to junk plans, we could expect these numbers of impacted workers to increase.

Inevitably, the result is bare-bones, junk insurance that misleads on coverage, has high out-of-pocket costs, and abandons those with preexisting conditions. The policy's fine print takes away all the bold promises of the marketing. Those who need coverage the most will be unable to afford it or receive minimal junk coverage.

In a Nation that is as rich as America, going broke shouldn't be a side effect of trying to get healthcare, but exposing more people to financial ruin is exactly what this kind of legislative approach will achieve.

This misguided scheme suffers, I think, from a form of preexisting condition itself. It is called amnesia, because they forget the conditions that

existed for so many Americans in this country before the Affordable Care Act became law. Situations like those who contacted me from Texas: Someone who had been a victim of domestic violence declared to have a preexisting condition; an infant born with some preexisting condition denied the coverage that they need; any number of excuses when coverage was needed the most because of preexisting conditions.

That is why I thought it was so important to amend this legislation, and the refusal of my Republican colleagues to clarify that now sends forward loud and clear that that is their objective.

There is even more ick to the ICHRA bill that is being introduced, and that is the opportunity that is created for class discrimination. This bill legalizes that discrimination. My amendment would have prevented that also.

Employees that are out there on the assembly line; those who are in the chicken processing plant, or the meat-packer, or out in the cornfields; they are in the dirtiest, most difficult, and usually the lowest-paid jobs. They can be treated one way under this bill, while the executives sitting off in the office tower are treated another and getting an entirely different kind of coverage because of the way they have written their bill.

Lower-wage workers who would be eligible, in fact, for a better policy under the Affordable Care Act with a no-premium or low-premium policy, would instead be required to search for a policy with more holes than safety net.

Finally, we discover something on which Republicans are pro-choice. I didn't think they were pro-choice on anything, but the genuine choice they provide is to the employer, not to the employee, a choice to divide employees into the haves and the have-nots; providing employer coverage to some and leaving others to fend for themselves.

Predictably, that burden will fall on the low-wage workers and the sick employees that employers don't want to cover. One survey already of employers found that 60 percent of large firms intended to offer ICHRA to only low-wage workers. That is icky.

To prohibit discrimination by employers and junk plans alike, the amendment I offered would have offered protection. This bill, as it stands, does not. It should be rejected.

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

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

The gentleman has repeated his stated intent to provide the protection that his bill denies, and I would refer him, again, to page 3, line 2 of this bill as it was presented in committee, and the failure to refer to section 2791(b)(5) of the Public Health Service Act means that that protection will not be there. It could easily have been added if that were the true intent. It is omitted.

Same page, line 12, the failure to include guarantees against nondiscrimination is not there.

He is concerned about federalizing healthcare. Well, all that I want to do is set a minimum Federal standard that no person in this country will be denied because of a preexisting condition the healthcare that they deserve. That is what the Affordable Care Act was designed to achieve, not only for those in the marketplace, but beyond.

Secondly, I want to ensure that different classes of employees are not treated differently. Let me just describe a little more of what is involved there.

Just as they would allow insurers to discriminate against a newborn with a

heart murmur and call that a preexisting condition, their bill would permit an employer to discriminate against their own employees.

Just to give you a practical example. We have a lot of chicken processing plants down in northeast Texas. If there is a facility out there where the chicken pluckers are chasing the chickens, removing the feathers that are flying, those tough, dirty, hot jobs processing them may be managed by a group in some high-rise in Dallas or Tyler.

Well, this bill, as it is written, will allow those executives to get their group health insurance policy with all the protections against preexisting conditions and being able to see, perhaps, a concierge service for their healthcare. But the folks that are down there chasing the chickens and plucking the chickens, they get an ICHRA. All they get is ick. That is wrong.

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

Mr. Chairman, I continue to reserve the balance of my time.

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

Let me respond to the gentleman from Pennsylvania. He says there is nothing in this bill about preexisting conditions and discrimination, and he is absolutely right. That is the whole failing of this bill. It does not include the protections that are necessary to ensure that no American is discriminated against on the basis of preexisting conditions and that no employer can discriminate among groups of its employees.

He also says this is going to open more opportunities for more people to get health coverage. I would point out that studies have shown that 95 percent of the people who are in these icky plans now once had good group health coverage. My concern is that we will see even more people lose their good group health coverage and be put into an icky plan.

As for the Small Business Flexibility Act, I am for the Treasury and others educating all employers and employees about their rights and opportunities, but I think this part of the overall package is very slanted. Treasury needs to be out there educating employers, some of whom may not know themselves the limitations that these junk plans have and how much they will disserve their employees. We need education of employees on how to understand whether their employer's offer of coverage meets the minimum standard and is truly affordable for the

purposes of being able to otherwise enroll in subsidized marketplace coverage. I think there are limitations on that portion of the bill as well and that it, therefore, should be rejected.

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

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

The chairman of our committee says that there were great gifts to insurance companies. What the Build Back Better bill did was to give individuals additional tax credits. Some Republicans call those tax cuts, but they were credits given to people to be able to afford insurance. As a result of that improvement, many more Americans got the insurance that they need.

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

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

I say to the chairman, he is absolutely correct. I referred to the Build Back Better instead of the American Rescue Plan. It is easy to get confused about them. The American Rescue Plan was, of course, signed into law and has helped so many Americans. However, we always know that whatever the name, Republicans are against all of them, as they were, and voted unanimously against all of the opportunity that they created for millions more Americans to get and keep health insurance and provide themselves security.

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

Mr. Chairman, I yield myself the balance of my time to close.

I focused on one part of this entire package of bills, but together it is truly a thinly veiled attempt to circumvent the Affordable Care Act. Being unable to repeal it, having nothing but nothing care to replace it with is really kind of a death by a thousand cuts, making healthcare less accessible and affordable for so many at-risk workers.

The bills in this package include a codification of the Trump-era rule that allows employers to offer these ICHRA plans to their employees instead of employer-sponsored health plans.

Under this plan, employers may offer a voucher and force their employee to shop for their own coverage.

Under this bill, employers are permitted to pick and choose among their employees and discriminate against some with their vouchers.

This bill also includes an expansion of the association health plans, which my colleague from Virginia will discuss at greater length. That has been a standard tenet of Republicans' assault on the Affordable Care Act. It is a provision that would allow self-employed individuals and small businesses to circumvent the guarantees of the Affordable Care Act and steer consumers into shoddy coverage that does not cover the healthcare they most need when they need it, the essential health benefits.

It also does not offer them protection against preexisting conditions or age or the fact that before the Affordable Care Act was adopted, women were discriminated against at a great rate and often denied the coverage that they needed or it was priced so high they could not afford it.

The bill would also preempt State regulation of association health plans and disrupt risk pools as these plans do not have to follow standard premium-setting rules and risk adjustment. This bill is similar to the Trump administration rule that was struck down in 2019.

If you are beginning to recognize a pattern here, this is all Trump, Trump, Trump because he is still the Pied Piper for the Republican Conference, as we just saw in this disgraceful presentation about our honorable colleague Adam Schiff.

This package also contains a provision to encourage employers to offer self-funded plans, which are not required to comply with ACA protections, again, on preexisting conditions, on essential health benefits, and more. Most employers do not want to take on the risk of offering a self-funded plan. However, by expanding stop-loss coverage, which sets a catastrophic amount the employer will be responsible for, and then covers any other costs that may come up from covering their employees, self-funded plans will be more attractive.

This legislation prevents Federal and State governments from regulating stop-loss coverage and risks more employers opting for self- funded plans that do not protect healthcare consumers.

Finally, without providing any additional resources, this legislative package tells the Treasury Department to educate employers about how great these new icky plans are and their health reimbursement accounts, which would bar workers from more affordable coverage under the marketplace already available.

At the heart of this effort is just the perpetual push by House Republicans to weaken the protections of the Affordable Care Act, which have prevented financial ruin for so many people and assured access to healthcare for so many people.

Under the provisions of this bill, employers can form association health plans to skirt some of the requirements of the ACA like the essential health benefits. State and Federal regulators will be hamstrung in their ability to protect small businesses and workers in self-funded plans.

Utilizing these icky ICHRA plans, employers can also push those with preexisting conditions, women, and older workers into the individual market with vouchers while keeping their younger and healthier employees on employee-sponsored insurance. Therefore, the sick get treated differently.

Those who have disabilities, who have had long-term chronic conditions, could be treated very differently and put at great risk.

I think for all these reasons that this legislation should be soundly rejected. This is an opportunity to defend all that the Affordable Care Act has meant to Americans and offer that opportunity to more people rather than deception that is the hallmark of this bill and following the Trump approach that junk insurance is what would be most available to Americans.

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

Madam Chair, I would say to the gentleman from Michigan, I am sure there are many Republicans who want to assure good healthcare to all people. The problem is with this specific bill.

The one-page amendment that I offered could have guaranteed these ICHRA employees that they would face no discrimination among classes of employees and no barrier of preexisting conditions.

That clarification would have solved this problem, and their failure repeatedly to accept that one-page amendment, with no explanation other than that they wanted to do the same thing, or that it was duplicative, betrays the promise of this bill and suggests that discrimination and denial of coverage based on preexisting conditions is what Americans in these plans will face.

The chairman of the Ways and Means Committee, our colleague from Missouri (Mr. Smith) closed by saying that his goal is to cut red tape. Well, that is a goal that I think all of us can share, but I am afraid that this bill, as written, will only throw more Americans into the red and into medical debt, which is already high despite the protections that we have provided to date.

There are so many families overwhelmed by medical debt, and some who will be denied the opportunity to get the protection they need from their healthcare providers because they simply cannot afford it.

Madam Chair, I would say at the appropriate time I will offer a motion to recommit to this bill and send it back to committee. If the House rules permit it, I would have offered this motion with an appropriate amendment to the bill.

My amendment would ensure that this bill does not take effect unless the Secretary of Health and Human Services certifies that this bill will not result in anyone losing access to coverage of essential health benefits or see their healthcare costs rise, the very objective that the gentleman from Virginia has been discussing.

Madam Chair, I include in the Record the text of this amendment.

Mr. Doggett moves to recommit the bill H.R. 3799 to the Committee on Ways and Means with instructions to report the same back to the House forthwith, with the following amendment:

Add at the end the following new title:

Madam Chair, I hope my colleagues will join us in supporting it, recommitting this, pursuing the objective of better healthcare for all, and protecting all Americans from preexisting condition barriers, and ensuring they are not the subject of discrimination.

Madam Chair, I rise in opposition to the amendment.

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

This amendment has a rather nominal effect in not improving what is a very bad and deceptive bill.

It is appealing to talk about rural areas. I am concerned about those rural areas, about the chicken pluckers, about the meatpackers, about the field workers, and the way they will be discriminated against under this bill.

I will elaborate on that. While this is mainly a Republican caucus that follows the seditious pied piper who was our President, in this case, even under the Trump administration, when they considered this kind of proposal, the Treasury Department, the Labor Department, and the Health and Human Services Department came together and recognized the danger of discriminating against different classes of employees.

Ultimately, unfortunately, the Trump administration did not provide the protection against discrimination, so that people who are working in rural areas under this bill may be discriminated against by their employer as a result of this legislation.

It is the failure to have clear language in this bill to prevent such discrimination against rural workers, in favor of those who are in the office towers managing everything, that is at the heart of our opposition, as well as the refusal to provide protection and guarantees against people being denied as a result of their preexisting conditions.

Rural Americans are more likely to die from heart disease, cancer, stroke, unintentional injury, and respiratory disease. Yet, we would take our sickest workers, our most vulnerable low-income workers, and deny them a comprehensive employer plan with many protections and allow them to be the subject of discrimination.

There has already been too much discrimination against rural areas and rural workers. We ought to prevent it, not make it worse.

There are no guarantees that these people can find any coverage with their ICHRA plan, let alone affordable and quality coverage.

I think rural Americans deserve far better than this amendment to try to put a patch on a very sorry bill that undermines the protections of the Affordable Care Act that has offered great benefit to so many Americans, and I urge everyone to vote ``no.''

Madam Chair, I reserve the balance of my time.

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

Madam Chair, I would say that the only education that would be really helpful on this bill would be to educate both employers and employees about all the shortcomings of this bill.

Educating employers that they ought not to be discriminating against classes of workers and treating the rural, hardworking employees there at lower wages differently where they get an ICHRA policy that denies them preexisting conditions, that denies them the essential benefits under the Affordable Care Act, while the folks in the city in management get treated differently--they get a concierge kind of treatment that is not available to the rural workers. Just educating about this bill, which allows that discrimination, would not accomplish much of anything.

I think what we are going to see with this kind of legislation is more and more workers in rural areas, as well as urban areas, who face discrimination and who face great medical debt because these plans are so weak. They are junk insurance that will deny the benefits that most people need.

Educating about them, if truthful education, if not the kind of deception that is buried in this bill, educating about them will only tell people the limitations and the shortcomings. Otherwise, it will be a kind of education that covers up, as this bill does, the great harm that is being done in denying folks access to a family physician with the protection that is there.

Remember that in moving to these ICHRA plans, we already know that 95 percent of those that are in ICHRA plans today, that have this icky kind of coverage, are people who once had good group health insurance that I would like to see available to more Americans.

Again, I urge my colleagues to definitely vote ``no'' on this amendment and vote ``no'' on this sorry bill and support our motion to recommit.

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

Madam Chair, I demand a recorded vote.

Madam Chair, I rise in opposition to the amendment.

The ACTING Chair. The gentleman from Texas is recognized for 5 minutes.

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

Madam Chair, I don't believe that we have noted yet in the course of this debate the great irony, the fact that this is called the CHOICE Arrangement Act, that we have some pro-choice Republicans here who want to give employers the choice and allow them to discriminate against different classes of their own employees. All of this is happening the same horrible anniversary week of the Supreme Court's wrongful decision to overturn decades of reliance upon Roe v. Wade and to eliminate the right to an abortion with an effect on women's healthcare that is so far-reaching that it is affecting our colleges of medicine across the country and delivery of healthcare to women who may never have been involved in the slightest way with an abortion.

They called this healthcare freedom today. I call it the repression and the interference with the basic healthcare rights of women.

By the terms of their own amendment, patients and doctors should make healthcare decisions, not government bureaucrats or insurance companies. The CHOICE Arrangement Act comes at the same time that they interfere with what happens in our bedrooms and our doctors' offices and, most recently, even in our kitchens.

They would sentence patients under this basic legislation with preexisting conditions to a future of very few choices and no freedom. With no choices for adequate and affordable healthcare, this legislation guarantees one kind of prescription and one kind of prescription only, and that is a prescription for personal bankruptcy and unlimited medical debt from policies that do not provide essential healthcare benefits.

It is really a shame that, in a country as wealthy as ours, we still have millions of citizens who go without health coverage. Over 30 million Americans, in fact, lack coverage, and many in our home State of Texas lack coverage because of the fact that our State legislature and Governor were never willing to provide the guarantee we anticipated with the Affordable Care Act of Medicaid expansion as most States have done.

Patients do not have a choice, do not have freedom when they suffer a heart attack or are diagnosed with a dreaded disease or a broken arm, and they lack insurance coverage that provides them the benefits that they need.

Under this amendment, which is a sense of Congress resolution that really doesn't accomplish much of anything, this bill is not improved. Americans would have so much skin in the game they would get burned just as the Republican dirty fossil fuel plan would burn up our planet.

It is not just the Affordable Care Act that is being targeted today. There is reference to socialized medicine of the kind that Newt Gingrich once attacked in this body when he suggested Medicare should ``wither on the vine.''

Contrary to Republican attacks, we have heard about public insurance programs. Seniors on Medicare value their Medicare as do the 16 million people who signed up for the Affordable Care Act this year.

Madam Chair, I reserve the balance of my time.

Madam Chair, this is the freedom resolution on the week that we have the anniversary of the anti-choice Dobbs decision as part of the CHOICE Arrangement Act.

Well, I am reminded of the lyrics of a famous Janis Joplin song: ``Freedom is just another word for nothing left to lose.'' No choice is left. No freedom is left. This is our future under Republican plans--so much to lose, nothing left tomorrow.

We need to protect more Americans from the dangers of health debt and bankruptcy. We need to ensure broader coverage. There is a huge coverage gap that is leaving perhaps as many as 2 million Texans without coverage because of the failures and ideological objections of our State Republican government.

Those Americans deserve the same protection that 16 million Americans got when they signed up for the Affordable Care Act this year. They have access to a family physician that is so very important. They have access to the essential benefits of the Affordable Care Act, getting access to the kind of care that they need to ensure their family is secure.

I believe that there are many improvements that are necessary in the Affordable Care Act. We were limited in being able to make those improvements when all we had for more than a decade were 60-plus Republican attempts to repeal the Affordable Care Act.

Let us reject this bill and this amendment.

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

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

Mr. Speaker, Republicans are in charge of the House of Representatives. They control the schedule here. They control when bills get brought up for debate. They make the Calendar. We could be debating a bipartisan bill that actually helps get more people on to healthcare or lowers prescription drug costs and makes coverage more affordable, but instead Republicans are bringing to the floor a bill to chip away at the Affordable Care Act. They are siding with billionaire corporations and insurance companies and actually spending money to kick people off of healthcare.

We could be debating bipartisan legislation that makes it easier for regular middle-class Americans to buy a home, but instead, Republicans are bringing to the floor a bill that literally increases mortgage fees charged to middle-income borrowers.

Time and time again, this majority brings to the floor bills that benefit billionaire corporations, insurance companies, the rich and powerful, Big Oil, Big Pharma, all at the expense of everyday people back home who send us here to fight for them.

We could be debating bipartisan legislation that actually addresses our broken immigration system. Instead, Republicans are bringing to the floor a nonbinding resolution that condemns a nonexistent problem so they can go after immigrants once again.

We had a Member in the Rules Committee last night yelling and screaming and ranting and raving about all he thinks is wrong with our immigration system and the border. It was actually kind of scary.

Listen, I get being passionate about this problem. I am not here to argue that our immigration system doesn't need to be fixed. We all know that it could use a comprehensive overhaul, but we don't need to be screaming at each other about this nonbinding press release of a bill that does literally nothing to help deal with our border. My God.

Republicans want to talk about immigration, so let's talk about immigration.

Let's talk about how the Republican solution to the border is building a stupid wall that even they know won't work.

Let's talk about fentanyl. Let's talk about how most of it is trafficked through legal ports of entry in the United States by U.S. citizens, by the way, and let's talk about how President Joe Biden seizes more fentanyl at the border than Donald Trump did. That is just a fact.

Yet, we had a Member last night have a complete meltdown over this issue. Would Republicans rather the Biden administration not seize fentanyl? I don't get it. Make it make sense.

Let's talk about how, since the end of title 42 on May 11, unlawful entries along the southern border have plummeted. As of June 6, Customs and Border Protection had an average of 3,700

encounters between points of entry or unscheduled encounters per day, a decrease of over 70 percent.

Republicans don't want to talk about any of that. Instead, they are going to try to get people all worked up by scapegoating vulnerable migrants who are fleeing awful circumstances in search of safety.

I can't believe I have to say this, but migrants are not political pawns. They come to our country seeking a better life, often fleeing violence and oppression. They are human beings and deserve to be treated with dignity and respect. Yet, Republican Governors have treated migrants like they are garbage, busing them across the country like luggage, with no advance notice or coordination, dumping them outside after they call the press to show up and make a scene. I find it disgusting. I find it racist. I find it disrespectful to all that this country stands for.

This nonbinding press release that they are bringing to the floor isn't a serious attempt to solve a problem. They are dropping migrants off in New York City and then attacking New York City for trying to come up with solutions to the problem. This is absurd.

Then, Republicans claim gyms can't be used to house migrants because they want to ``protect students.'' Give me a break. Migrants have never been housed in a facility with kids. That is just a fact. In the Rules Committee last night, we asked the person who was bringing the bill before the committee to give us examples. She couldn't.

If we want to talk about protecting students, let us talk about protecting students. A thousand kids have died from gun violence this year. Where will the next school shooting be? Parents are terrified their kid will be next. Teachers are terrified that their class will be next. Students are terrified they will be next. Republicans are here regulating gyms instead of guns. What the hell is wrong with these people?

This majority is obsessed with demonizing, demeaning, and targeting people who are coming to the United States in desperate search of a better life. Stop appealing to the worst instincts in people. Stop peddling hate. Stop fueling racism.

Here is a contrast I want people to know about. President Biden and the Democrats are working to expand the middle class, to build a strong economy from the bottom up and the middle out. Democrats are lowering costs for working families, helping cut inflation by more than half since last summer.

Democrats have taken on Big Pharma to reduce prescription drug costs, and Democrats continue to fight special interests to lower healthcare costs while making childcare and housing more affordable for working families.

Democrats are investing in America and have created more than 13 million jobs since President Biden took office. Democrats are bringing supply chains back home, fixing our roads and bridges, and delivering clean water and high-speed internet to more communities.

Democrats are making our communities safer. We are committed to building on the gun safety legislation we passed last year by strengthening background checks and keeping dangerous weapons of war off our streets to protect America's kids.

Democrats know that we don't have to choose between an immigration system that reflects our interests and our values, and we don't demonize and attack people who want to come to this country in search of a better life.

You are seeing on the floor today exactly what Republicans have to offer: nothing, not a thing, no plans, no ideas. They are just interested in helping the rich and powerful and using immigrants as political pawns to drive a wedge between people. It is a rotten, shameful thing to do.

Mr. Speaker, I urge all my colleagues to vote ``no'' on this rule and the underlying bill, and I urge my colleagues on the Republican side to get serious about bringing legislation to the floor that will actually make a difference, that will actually help fix some of the challenges that we face in this country. This is a joke.

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

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

I appreciate the gentleman's tirade just now, but the bottom line is that nothing in this bill that his party is championing as somehow this important piece of legislation does anything to provide any assistance to any of these communities. Not one penny goes to offset any of the costs that might be incurred--nothing, not a thing.

I just don't get it. People come onto this floor and speak in sound bites and do press releases and then bring legislation to the floor that is nonbinding, that means nothing, that does nothing. This is ridiculous.

We need to fix our immigration system. We tried to do that when we were in charge. We had challenges in the Senate trying to overcome the filibuster, but we were trying to fix the system. That is a contrast to what we are doing here now, which is a nonbinding resolution.

By the way, a nonbinding resolution, to anybody who is watching, means it is just somebody's opinion. It doesn't do anything--no money, no assistance, no help to anybody. It is just like: ``I want to tell you what my opinion is.'' Big deal.

Mr. Speaker, I am going to urge that we defeat the previous question, and if we do, I am going to offer an amendment to the rule to provide for consideration of a resolution which states that it is the House's duty to protect and preserve Social Security and Medicare for future generations and reject any cuts to these essential programs.

We know, because we have heard from my friends, that they have their eyes on these programs. We need to get people on record to make sure that they will not vote for any cuts.

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

Mr. Speaker, I yield 3 minutes to the gentleman from Illinois (Mr. Sorensen) to discuss that proposal.

Mr. Speaker, I ask unanimous consent to include in the Record a Washington Post article titled: ``House GOP eyes Social Security, Medicare amid spending battle.''

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

Mr. Speaker, it is simple. To lower the national deficit, House Republicans plan to try to cut Social Security and Medicare. This includes potentially ``raising the Social Security retirement age to 70, targeting younger Americans who have yet to obtain Federal benefits.''

We have a number of Members on the Republican side who talk about privatization all the time. That is their favorite word when it comes to Social Security and Medicare. We want to make sure the American people understand who is on their side and who is trying to undercut things that are very meaningful to them.

Mr. Speaker, I also point out that my Republican colleagues have been in disarray since they took the majority, and they have failed to pass meaningful legislation into law on behalf of the American people. As I said, they control this Chamber, the schedule, the committees, and what they bring to the floor.

At this point in the 117th Congress, that is the previous Congress, Democrats had passed 17 bills into law. At this point in the 116th Congress, under divided government, we passed 21 bills into law.

You want to know how much this majority has passed into law?

Six.

They are failing the American people. They are incapable of bringing legislation to the floor that can garner bipartisan support that has any chance in the Senate.

Mr. Speaker, I ask unanimous consent to include in the Record a comparison of the number of bills passed into law by May 31, which demonstrates how utterly unproductive this Congress has been.

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

Mr. Speaker, I spoke about the unproductiveness of my Republican friends and how they are squandering all opportunities to help the American people since they have been in control but let me just talk to you about some of the stuff that we did when we were in charge of this place.

Let me remind people that because of the Affordable Care Act, which I think almost everybody over there voted ``no'' on, 40 million Americans have health coverage under the ACA. Women have access to preventive health services like breast and cervical cancer screening at no cost to them. Prescription drugs are more affordable for older adults.

Americans with disabilities are protected from discrimination on the basis of medical history or preexisting conditions. Lifetime caps on essential health benefits are gone. They are gone.

Since 2010 when the bill became law, Republicans have been obsessed with tearing it apart. Under Republican majorities, we have voted nearly 70 times to repeal and undermine the law. Nearly 70 times Republicans have tried to dismantle a law that provides healthcare coverage to 20 million people and covers preventive health services.

Today, Republicans are continuing this effort to undermine the ACA. It is maddening where their priorities are. It is maddening. Here is the deal. They know that they can't just repeal it outright because everybody doesn't want them to do that. What they are doing is they are going after it bit by bit by bit, trying to chip away at the edges and trying to kill it through a thousand cuts so that maybe people won't notice, that people won't notice when essential benefits are no longer guaranteed.

Healthcare ought to be a right in this country, and we ought to be building on the ACA, not tearing it apart, not tearing it down, not trying to make it more difficult for people to get the essential services they need, not to try to give people plans that don't provide the coverage for whatever may occur to them and their families.

Mr. Speaker, I think it is important to understand--again, the good news here is that all the bills they are bringing to the floor today have no chance in hell of going anywhere in the Senate because they are just over the top and extreme.

Make no mistake about what is happening here. They have a target on healthcare. They have a target on Social Security. They have a target on Medicare. Rather than trying to fix our immigration laws, what are they doing?

They are trying to tear this country apart. They are trying to demonize immigrants. They have no solutions, just a nonbinding resolution that does nothing. It basically addresses a fake problem that was totally ginned up by FOX News. That is where their priorities are. Certainly, we can spend our time doing more productive things.

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

Mr. Speaker, I remind the gentleman that fentanyl is coming across the southern border because U.S. citizens are bringing it

across through ports of entry. Don't trust me on this. You can look to the conservative think tank CATO that will reinforce what I just said.

By the way, this bill that you are bringing here does nothing to solve the problem. It is a waste of time. There are no more resources; nothing to combat it. It is just a press release. What a joke that we are here debating something like this when we could be debating something that might make a real difference.

Mr. Speaker, I yield 3 minutes to the gentlewoman from New Mexico (Ms. Leger Fernandez), a distinguished member of the Rules Committee.

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

Mr. Speaker, I have to say, what I am a little surprised about today is that nobody has raised the deficit or the debt because the Republicans were obsessed with that when they basically threatened to ruin this economy by not allowing us to move forward to increase the debt ceiling.

We had to have all these cuts from programs that help poor people. Throwing people off of programs like SNAP, the food benefit, that is what they did. I now understand why we are not talking about the deficit or debt today because of the bills that they are bringing to the floor.

One of the bills that we are talking about right now, the CHOICE Arrangement Act, cuts more than $348 million. That is what the CBO says.

Mr. Speaker, I ask unanimous consent to include in the Record the CBO score.

Mr. Speaker, that is just the beginning. House Republicans spent half a billion dollars on their H.R. 1 bill that would gut environmental protections and take tax credits away from people who want to upgrade their homes. Half a billion dollars was added to the deficit.

Mr. Speaker, $6 billion was added to the deficit on their deeply flawed H.R. 2, a bill attacking immigrants and essentially ending asylum as we know it.

Get this, $114 billion--billion with a b--was added through their H.R. 23 to protect the wealthy from paying their fair share of taxes. That was their very first bill on the House floor in this Congress, their top priority adding $114 billion to the deficit.

Over $505 million was added through the Republicans' bill last week to enhance access to firearm stabilizing braces.

Republicans are on a spending spree, all on the backs of real people--not the rich, not billionaire corporations, not by reallocating funding from the bloated Pentagon budget. Maybe some of you saw the ``60 Minutes'' piece a few weeks ago about the cost overruns, where former Pentagon officials said that they are spending hundreds of thousands of dollars on a switch that costs a couple hundred dollars.

We can't find a penny, yet they want to increase the Pentagon budget with no questions asked.

They can't touch any of the tax cuts for any of the billionaires or multimillionaires of big corporations. We can't do that, and we all know why. Google where they all spend their money on political campaigns. However, they spend all this money, and they want to balance the budget on the backs of regular, everyday people, and, in particular, the most vulnerable in our country.

Last night everybody was complaining about the CBO score--the CBO score. I guess I understand why my colleagues across the aisle would not want to support the hardworking, nonpartisan people at CBO. Maybe it is because they keep giving them bad news. Maybe it is because they keep saying to my friends that they are spending and spending and spending and it is adding enormously to our deficit and our debt.

Mr. Speaker, I raise this issue because my Republican friends like to come to the floor and talk about the deficit. Today they are not. I think it is because we had this conversation in the Rules Committee last night. I want people to know that they are driving up the deficit and the debt, and then when they want to talk about fiscal responsibility, where do they go?

They go to the middle class, and they go to the people who are poor. That is where their priorities are. So there is a big difference here.

Mr. Speaker, if the gentleman has no other speakers, I am prepared to close, and I reserve the balance of my time.

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

Mr. Speaker, I am surprised my friend has no further speakers. I thought because these bills were so important and unbelievably essential that there would be lots of speakers on the other side.

Mr. Speaker, we all know how valuable our time is here. We only have 13 scheduled legislative weeks until the end of the year--13 weeks that could be used to improve the lives of everyday Americans.

So how have Republicans in the House decided to use this week?

Are we working to make our communities safer or our educational system better?

No. We are not. Republicans would rather demonize immigrants and peddle hate than regulate guns or invest in schools.

They are in control. They can bring what they want to the floor. Don't take my word for it, Mr. Speaker. Look at what they are bringing to the floor.

Are we here to help regular Americans purchase their first home?

No. We are voting on a bill today that will make it easier for those well-off to get even further ahead while making it more difficult on middle-class home buyers.

Mr. Speaker, you can't make this stuff up, but that is what this bill does.

Are we passing legislation that will continue to expand people's access to affordable healthcare?

No. Republicans want to chip away at popular policy that provides quality coverage to millions.

There are very real issues that regular people in this country face every day, and I wish House Republicans could wise up and address them.

This is such a colossal waste of time. One of the bills is nonbinding, but the other bills aren't going anywhere. This is a waste of time. Rather than working across the aisle trying to find common ground, they continue to bring these messaging bills. These are bills that demonize immigrants and that continue to chip away at the Affordable Care Act. These are bills that continue to screw people in the middle class, and they continue to bring these bills to the floor.

I don't know who their base is, but apparently it is popular amongst their base.

This is not about legislating. It is not about making law, and it is not about improving the lives of anybody in this country.

So, Mr. Speaker, I urge a strong ``no'' vote on the underlying legislation and a ``no'' vote on this rule, and I yield back the balance of my time.

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

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

Madam Chair, the proposals in H.R. 3799 are yet another recycled, futile attempt to sabotage the Affordable Care Act and actually make it harder for workers and families to find affordable, high-quality health insurance.

This legislative package includes two bills that were marked up by the Committee on Education and the Workforce.

The first is the Association Health Plans Act. This act undermines a core promise of the ACA, access to affordable healthcare for all. This faulty legislation may provide lower costs for some enrollees, but it would do so by skimping on benefits and increasing costs for everybody else.

Specifically, the bill would allow association health plans to cherry-pick low-risk, young individuals for a pool separate from the ACA marketplace. You may hear my colleagues on the other side of the aisle tout the bill's nominal protections against discrimination based on preexisting conditions, but they omit the details regarding the other large loopholes that leave consumers vulnerable in this bill, such as charging higher risk groups more so that the plan will not be attractive to them and charging low-risk groups less so that they will be the ones that come in.

In fact, this legislation explicitly authorizes AHPs to set premiums based on the ``specific risk profile'' of employer members, enabling them to charge higher premiums to groups based on their age, gender, and other factors. AHPs could also exclude certain categories of coverage, such as maternity care, mental health, or substance abuse disorder, to dissuade certain groups or individuals from enrolling. Under the bill, association health plans could also evade essential health benefits and other consumer protections under State and Federal law.

It is a bad idea because of simple arithmetic. If healthy, low-risk individuals can leave the Affordable Care Act marketplace risk pool and join a separate association and pay lower rates on average, those that did not get into these plans will, on average, pay higher premiums.

Let's be clear. Only low-cost groups will be in these plans because if you are a high-risk group, the cost will be too much and will not be attractive. If they are high-risk groups with preexisting conditions, older groups, and whatnot, they will not be able to form groups that charge less than the ACA marketplace, and nobody will want to join.

Under the ACA, everybody pays an average. If you have a preexisting condition or do not have a preexisting condition, everybody pays the same, and everybody gets insurance at an affordable cost.

Everybody enjoys all the essential benefits under the ACA. Association plans, for example, do not have to provide coverage for essential benefits like maternity benefits. All the costs of maternity care will be borne by fewer and fewer people.

The average cost of insurance for those not in the plans will slowly grow as the number of association plans grows.

Various versions of this legislation have been pushed by Republicans for decades, but all iterations suffer from the same fundamental flaw, they shift costs to the most vulnerable. That is why more than 30 leading consumer and patient groups have expressed serious concerns with this harmful legislation.

The other bill marked up in the Education and the Workforce Committee was the Self-Insurance Protection Act, legislation that further erodes the ACA by exempting stop-loss insurance from key consumer protections.

The bill would prevent the Secretaries of Health and Human Services, Labor, and the Treasury from regulating stop-loss insurance coverage. Even more troubling, the bill makes it virtually impossible for States to protect consumers from abusive practices by invalidating State laws that regulate stop-loss.

Stop-loss insurance usually covers costs above a catastrophic level, over a million dollars or something like that. They can be written to cover everything over a thousand dollars when they become essentially regular insurance except that they are not regulated. There are no solvency regulations, no benefit regulations, no nothing.

We can all agree that small businesses and self-insured people deserve access to affordable healthcare, and that is what you get under the Affordable Care Act. We should also agree that people deserve basic consumer protections to ensure that they have insurance with quality, solvency, an agency to call if something goes wrong, and coverage for essential benefits. That is why we passed the Affordable Care Act in the first place. It is also why, when Democrats were in charge in the last Congress, we passed the American Rescue Plan and the Inflation Reduction Act to make coverage even more affordable.

The question before us is: Do we want to make sure that every individual can continue to find affordable and quality healthcare coverage, or do we want to pass H.R. 3799 and create roadblocks for Americans seeking care?

Madam Chair, I would hope that we would oppose this bill, and I reserve the balance of my time.

Madam Chair, I yield such time as he may consume to the gentleman from Texas (Mr. Doggett), the ranking member of the Health Subcommittee of the Ways and Means Committee.

Madam Chair, I would inquire as to how much time is remaining.

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

Madam Chair, the gentleman from Michigan talked about the motive of employers. I think the employers want to give good coverage. The problem with this bill is it enables one company to find loopholes to get a good deal for that company even if it results in higher costs for everybody else. That is the problem with this legislation.

Madam Chair, I include in the Record a letter of opposition written by the AFL-CIO.

Among other things, the letter states that this bill undermines comprehensive coverage and subjects workers to financial risk.

Madam Chair, I include in the Record a broad post written by the Center on Budget and Policy Priorities.

Among other things, the post states that the bill will undermine consumer protections, segment insurance markets, and impose new burdens on individuals to navigate an already complex system.

[From the Center on Budget and Policy Priorities, June 20, 2023]

Health Bills Headed for a Vote in the House Undermine Consumer

Protections and Market Rules

(By Sarah Lueck)

The House is moving toward a vote on legislation that would

weaken Affordable Care Act (ACA) consumer protections and

private market rules. Proponents of these changes claim they

will increase choices and reduce red tape for employers, but

a closer look shows the problems they would create. The

legislation would:

Expand association health plans (AHPs). The legislation

would allow AHPs, a type of health plan that trade

associations, professional groups, and other organizations

may offer their members, to cover self-employed individuals

and small businesses as if they were large employers. This

would exempt them from ACA standards that otherwise apply to

health plans in the individual and small group markets.

Similar to a Trump-era rule a court struck down in 2019, the

bill would segment insurance risk pools: some individuals who

are younger and healthier, or small businesses whose

employees have that profile, could get plans with lower

premiums because they would be priced separately from ACA-

compliant coverage and would not have to meet ACA standards,

such as a requirement to cover a set of essential health

benefits. As a result, other individuals and small businesses

remaining in ACA-regulated markets would see higher premiums.

Expand Individual Coverage Health Reimbursement

Arrangements (ICHRAs). The legislation would codify

provisions similar to a Trump-era rule currently in place

that allows employers to forgo offering a regular group

health insurance plan and instead offer an HRA (a tax-

favored, employer-funded account) that workers could use to

buy their own individual insurance coverage. Increasing such

arrangements could raise ACA marketplace premiums; they are

likely to attract sicker-than-average firms that can spend

less to fund an ICHRA than they must pay for a group health

plan. And firms may find strategies to shift sicker workers

to HRAs, even with guardrails in the legislation meant to

prevent this.

Plus, these arrangements require employees to do

considerable work compared with signing up for an employer

plan--they must apply for and select a plan, set up premium

payments, and understand what expenses the ICHRA covers.

Also, workers offered an ICHRA could be confused about

whether the offer renders them ineligible for a marketplace

premium tax credit--that is, whether it constitutes an

``affordable'' employer offer that precludes credit

eligibility. And while employers must give workers a notice

of HRA rules, they needn't personalize them to tell

individual workers whether their plan is affordable. These

complications for employees could drive down coverage.

Increase self-insured employer plans. Another provision

would encourage more small employers with healthier workers

to self-insure (meaning that the employer bears the financial

risk), rather than offering a fully insured health plan (for

which an insurer bears the risk). Specifically, the bill

would protect a complex self-insurance arrangement known as

level funding from tighter regulation. Similar to AHPs, this

scheme allows small firms with healthier workers to provide

plans that avoid ACA small-group market premium and benefit

standards without being a large employer or taking on the

risk of self-insurance. This provision would make level

funding an even more common way for smaller firms to avoid

having to offer plans that meet ACA market rules--this would

raise premiums for small businesses that remain in the fully

insured, small-group market if small firms with younger and

healthier workers move to self-insure.

House committees recently approved other health bills that

raise concerns. The Ways and Means Committee moved to expand

health savings accounts (HSAs), which overwhelmingly benefit

high income people and exacerbate racial and ethnic

inequities in coverage access and wealth accumulation. HSA

tax benefits currently are only available when someone has a

high-deductible health plan that meets certain federal rules.

But the committee approved a bill that would allow high-

deductible plans to cover telehealth services pre-deductible,

while still qualifying for HSA tax benefits. It is estimated

to cost $5 billion from 2025 through 2033.

Another bill, approved by the House Education and Workforce

Committee, would let employers offer workers stand-alone

telehealth-only plans and exempt the plans from providing ACA

consumer protections or meeting other federal laws that

otherwise apply to employer coverage. The bill would exempt

telehealth plans from, for example, covering mental health

care at parity with other care and providing preventive

services at no cost to enrollees. The plans could also impose

annual and lifetime limits on coverage and sharply limit the

types of conditions they would address.

Additional policy changes are needed to make health

coverage and care more affordable for many people, despite

the ACA's significant benefits for individuals and small

businesses. But the legislation heading to the House floor is

misguided. It would undermine consumer protections, segment

insurance markets, and impose new burdens on individuals to

navigate an already complex system.

Madam Chair, I reserve the balance of my time.

Madam Chair, I am prepared to close, and I yield myself the balance of my time.

Madam Chair, I regret that my Republican colleagues continue to relitigate the Affordable Care Act. However, what we have seen is not new. It is what we have seen time and time again over the last 13 years. They continue using every tool they can to undermine the ACA and limit access to quality healthcare, weaken consumer protections, and increase average costs.

The provisions of this package do nothing to lower overall healthcare costs for workers and their families. In fact, for most consumers, the result of this legislation is that while some may save a little bit, most consumers will end up paying more.

Madam Chair, I strongly urge my colleagues to oppose the bill, and I yield back the balance of my time.

Madam Chair, I thank the gentlewoman for yielding.

Madam Chair, I rise in support of this amendment. Association health plans have a long, well-documented history of cutting costs for themselves by cherry-picking the cheapest people to cover and leaving the more expensive behind. This raises costs for everybody else and causes premiums to go up in the rest of the market. Republicans have been pushing this idea for decades, and experts have consistently found it to be harmful.

The Affordable Care Act made a number of reforms to commercial insurance markets, including a requirement that plans in the individual and small group markets cover essential health benefits such as maternity care and prescription drugs. The ACA also prevented these plans from charging higher rates based on health status and limited the premium amount that older people could be charged compared to younger people. This was a vital protection that ensured that an age tax would not make coverage unaffordable for older individuals.

This legislation has no protection without this amendment. The bill is entirely silent on discriminatory pricing against older people. In fact, by explicitly allowing associations to base premiums on risk factors of each employer within the group, it actually invites them to charge older Americans much more.

This amendment would ensure that older workers are protected by providing in this bill that it would not take effect until the Secretary of Labor certifies that it would not have the impact of raising premiums for older workers.

I thank the gentlewoman from Connecticut for her leadership on the Education and the Workforce Committee.

Madam Chair, I urge my colleagues to support the amendment.

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 524 and ask for its immediate consideration.

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

General Leave

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

Mr. Speaker, last night the Rules Committee met and reported a rule, House Resolution 524, providing for consideration of three measures: H. Res. 461, H.R. 3799, and H.R. 3564.

The rule provides for consideration of H.R. 3564 under a structured rule with 1 hour of debate equally divided and controlled by the chair and ranking minority member of the Committee on Financial Services or their designee.

The rule makes in order four amendments and provides one motion to recommit. The rule additionally provides for consideration of H.R. 3799 under a structured rule with 80 minutes of general debate equally divided and controlled by the chair and ranking minority member of the Committees on Education and the Workforce or their respective designees and Ways and Means or their respective designees. The rule makes in order three amendments and provides one motion to recommit.

Finally, the rule provides for consideration of H. Res. 461 under a closed rule with 1 hour of debate equally divided and controlled and by the chair and ranking minority member of the Committee on Education and the Workforce or their respective designees.

Mr. Speaker, I rise today in support of the rule and in support of the underlying bills.

Today, the Republican majority continues its long process of reversing and repairing the damages inflicted on the American people by the Biden administration and the previous Democrat majority.

Mr. Speaker, included in the rule is H.R. 3799, the Custom Health Option and Individual Care Expense Arrangement Act, or the CHOICE Arrangement Act, introduced by my friend from Oklahoma, Kevin Hern.

This legislation includes commonsense changes to help lower health insurance costs, increase competition in the healthcare market, and ensure access to high-quality, low-cost plans for Americans and small business owners and their employees.

In 2021, almost 55 percent of Americans were covered by employer- based health coverage. Employer-based health coverage is easily the most popular option for Americans to receive health insurance coverage. According to the National Federation of Independent Business, of small employers

that did not offer health insurance coverage to their employees, two- thirds reported that the reason they do not offer the health insurance is because it is simply too expensive.

In 2019, President Trump and his administration published regulations allowing employers to provide their employees with a fixed amount of money each year in tax-preferred individual health coverage reimbursement accounts that an employee could use to buy coverage in the individual market.

Current regulations allow employers to establish individual coverage health reimbursement accounts which employees can use to purchase individual market coverage and pay for their out-of-pocket medical expenses.

The CHOICE Arrangement Act seeks to codify these regulations to provide tax-advantaged funds for employees to buy portable health insurance plans and requires notification to employers of the availability of these tax-advantaged health insurance benefits.

The CHOICE Arrangement Act also includes provisions codifying the right of small businesses to band together and form association health plans to offer pooled health insurance coverage to their employees.

This legislation will give employers maximum flexibility in how they provide coverage options for their employees by providing CHOICE arrangements while also providing expected benefits like dental plans, vision plans, accident, disability benefits, and more.

This legislation will also ensure that stop-loss coverage is not subject to Federal regulation under the Employee Retirement Income and Security Act. These commonsense changes will stop the Biden administration from administratively making healthcare more expensive by regulating stop-loss coverage and ensuring that small businesses can, in fact, remain competitive.

Mr. Speaker, also included in this rule is H. Res. 461. This condemns the practice of retrofitting our children's schools to house illegal immigrants. President Biden and the Democrats' failures at the southern border are so comprehensive, so overwhelming that municipalities are now co-opting the schools where we educate our children because President Biden refuses to secure the southern border.

Because President Biden cannot or will not secure our southern border, Mr. Speaker, our local communities and municipalities are now casualties of President Biden's border crisis.

The American people rightfully demand that President Biden and Democrats in Congress acknowledge this crisis. They demand that they not only acknowledge the crisis, Mr. Speaker, they demand that their Federal Government solve this self-inflicted crisis that is pushing our communities well past the breaking point.

New York City and its mayor, Eric Adams, are the first to cry uncle. Mr. Speaker, 2 months is how long Mayor Adams and New York City lasted, suffering under conditions of a size and scale not even comparable to the conditions that Texans have been enduring these past 2\1/2\ years under an administration that has only now started to pay attention to this humanitarian crisis when it started to affect their constituents.

Over and over again, we have pleaded with the Biden administration to take this crisis seriously, only to be rebuffed time and again. This humanitarian catastrophe can be laid squarely at the feet of the Secretary of Department of Homeland Security, Secretary Mayorkas, and, of course, President Biden who have chosen to do nothing rather than be labeled xenophobes by their progressive colleagues for actually enforcing existing immigration law and securing our southern border.

Mr. Speaker, the temptation for the Biden administration has been to bury their heads in the sand and hope that these waves of illegal immigrants coming across our border will, in fact, magically disappear. They will not, Mr. Speaker, not until President Biden finally gets serious about the border crisis by demanding that the Secretary of Homeland Security do his job and secure our southern border, or maybe find someone else who can do that job.

Finally, Mr. Speaker, the rule provides for consideration of H.R. 3564, the Middle Class Borrower Protection Act of 2023. This bill would repeal the Federal Housing Finance Agency's recalibrated single-family pricing framework to guarantee mortgages which would charge borrowers with higher credit scores larger fees to subsidize borrowers with lower credit scores.

If not for our Republican majority, Mr. Speaker, one out of every two borrowers with higher credit scores would be assessed higher mortgage fees in President Biden's radical equity agenda.

President Biden is telling the American people that if you work hard, if you are responsible with your finances, if you pay your bills on time, you are going to get to subsidize the mortgages of those who did not make the same sacrifices that you did in order to attain a higher credit score. This sends a terrible message to the American people.

Mr. Speaker, I thank Mr. Davidson for bringing us this final piece of legislation that underscores that the Republican majority stands with those middle-class families who have done the right thing and should not be pushed by a radical administration that is obsessed with radical wealth distribution schemes.

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

Mr. Speaker, I yield 3 minutes to the gentleman from New York (Mr. Langworthy), a valuable new member of the Rules Committee.

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

Mr. Speaker, the only entity cutting Social Security or Medicare right now is the White House, the Biden administration. Over the last 2\1/2\ years, cuts to Medicare have totaled probably $40 billion in the part B drugs administered in physician's offices and $300 billion in Medicare Advantage, all done through the Inflation Reduction Act last year. The only people talking about cutting Medicare right now is the administration, and that is really what ought to be stopped.

Right now, that is not the business at hand. What we are discussing today are three important bills that are going to be considered on the floor. I urge my colleagues to vote in favor of the rule and in favor of the underlying bills.

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

Mr. Speaker, I yield myself 2 minutes.

Mr. Speaker, there are hearings going on right now in the Energy and Commerce Committee for the reauthorization of the SUPPORT Act.

The SUPPORT Act passed in 2017-2018 in that Congress. It was a broadly bipartisan bill. It was geared toward dealing with the problems that were occurring in this country because of an opiate crisis.

Largely, the source of these opiates were prescription drugs that were diverted to other uses, and the consequence was people taking a good overdose and in fact dying from prescription drugs that were actually diverted from their intended use.

Five years later, we are in the process of reauthorizing the SUPPORT Act. The SUPPORT Act actually functioned as intended, it did reduce some of those overdose deaths downward until we were hit with the pandemic, and obviously that changed a lot of things.

In that 5-year interval, this disease has changed. It is no longer prescription opiates that are diverted, it is fentanyl. It is fentanyl that is poisoning our young people. It is fentanyl that is pouring in from the southern border.

Look, I get it. You want to say it is only coming in at the ports of entry--that is what you catch. Our Customs and Border Protection are so overwhelmed with the numbers of people who are coming in at the invitation of the President and the Vice President, people are pouring across our border.

Customs and Border Protection cannot do their normal job. They are doing housekeeping chores, taking care of people who are ill, children who are arriving at their doorstep, and they have no choice but to take care of them.

In the meantime, all other areas of the surveillance are non vis because Customs and Border Protection are tied up with this vast increase of humanity that is coming in. The bottom line is as we reauthorize the SUPPORT Act now, we are actually dealing with a different disease because fentanyl poisoning has replaced opiate overdose.

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

Mr. Speaker, may I inquire as to the time remaining.

Mr. Speaker, I have no other speakers, and I reserve the balance of my time.

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

Mr. Speaker, isn't it interesting that thanks to House Republicans and their investigative efforts there was a settlement yesterday where a member of the President's family has agreed to pay his taxes that he hasn't been paying.

So that is a good thing that delivers money to the Treasury.

Oh, yes, about those background checks, it turns out a member of the President's family wasn't adhering to the background checks and the proper handling of a firearm.

So maybe we all learned something in that exchange over the last 24 hours.

I also want to correct a few things on the underlying bills. Association health plans, like all large employer plans, are required to cover preventative healthcare. This requirement includes covering women's preventative health services without cost sharing. In addition, all AHPs are required to cover pregnancy-related conditions and coverage of a minimal hospital stay after childbirth as mandated by the Affordable Care Act.

Title VII of the Civil Rights Act requires the plans to cover pregnancy, childbirth, and related conditions in the same manner as they cover other medical conditions under the association health plan.

The Newborns' and Mothers' Health Protection Act of 1996--that was about 10 years before the ACA--the Health Protection Act of 1996 requires large group association health plans to cover a hospital stay of at least 48 hours for a childbirth and at least 96 hours for a birth by caesarean delivery.

These are all requirements placed on large group employer-sponsored health plans. Expanding AHPs does not change these requirements. What it changes is making that valuable insurance available to more employees.

The CBO score that the gentleman referenced also had within it the notation that 200,000 people would be covered if this bill, the CHOICE Act, is enacted because insurance would not be as expensive for employers to provide and would give them more possibilities.

Here is probably the crux of that matter: 40,000 of these people have no insurance currently. So there will be 40,000 people moved from uninsured to insured by passing the CHOICE Act. I would say that is a good thing, and I think people would be supportive of that.

I do want to stress that it is important to support the rule and the underlying measures. I thank my colleagues for their diligence and hard work in bringing these important pieces of legislation to the floor today. The Republican majority has demonstrated, yet again, that we are putting forward a legislative agenda that works for all Americans and not just the well-connected few.

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

Mr. Speaker, I rise in opposition to H.J. Res. 45, and I yield myself such time as I may consume.

Mr. Speaker, 43 million Americans are eligible for President Biden's student loan relief. That is about 100,000 people, on average, in each of our districts.

Nearly 26 million borrowers in congressional districts all over the country have already applied for relief, including 16 million who had already been approved for relief prior to litigation stopping the process. H.J. Res. 45 seeks to deny these borrowers the relief that they were promised.

To be clear, the people who would be impacted are not the wealthy and well-connected. Mr. Speaker, 90 percent of the relief would go to borrowers earning less than $75,000 a year, and you are not even eligible if you are making more than $125,000. That is in stark contrast to the Trump tax scam where 80 percent of the benefits went to the

top 1 percent and corporations. For the top 1 percent, that is about half a million dollars.

Moreover, my Republican colleagues refuse to acknowledge the serious questions that have been raised about how the resolution would actually be implemented, because under a Congressional Review Act resolution, you don't pick and choose which parts of the rule you are overturning, you have to overturn the whole rule, including the pause in student payments and the deferral of interest.

Now, how do you unpause a payment that you were supposed to make many months ago? What is going to happen to all those interest payments that now have to be added back to those loans?

What happens to the credits that participants in the Public Service Loan Forgiveness program were promised during those months?

Are the firefighters and teachers and police officers and other public servants who may have already had their loans forgiven based on those credits, now back on the hook for additional payments?

The reality is that H.J. Res. 45 would trigger a wave of delinquencies and defaults for most of our vulnerable borrowers. Intentionally or not, this resolution would create chaos for borrowers and their families, as well as loan servicers. The Congressional Research Service has confirmed that this chaos would be triggered by the retroactive application of this rule.

Mr. Speaker, anyone in this country who wants to take advantage of the benefits of a college education should be able to do so, not just the wealthy few. That is the way it used to be.

Just several decades ago, the Pell grant covered 80 percent of the cost of attending a State college. Now it is less than 30 percent, and States are paying a much lower portion of the costs of State colleges than they used to.

This proposal does nothing to help students, so I strongly urge my colleagues to oppose the resolution.

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

Mr. Speaker, I include in the Record a letter from approximately 200 different organizations in opposition to this resolution.

May 8, 2023.

Hon. Chuck Schumer,

Majority Leader, U.S. Senate,

Washington, DC.

Hon. Kevin McCarthy,

Speaker, House of Representatives,

Washington, DC.

Hon. Mitch McConnell,

Minority Leader, U.S. Senate,

Washington, DC.

Hon. Hakeem Jeffries,

Democratic Leader, U.S. House of Representatives,

Washington, DC.

Leader Schumer, Minority Leader McConnell, Speaker

McCarthy, and Minority Leader Jeffries: The undersigned 261

organizations representing millions of students, workers,

people of color, veterans, people with disabilities,

consumers, and people of faith write in strong opposition to

bicameral efforts to use the Congressional Review Act (CRA)

to overturn President Biden's actions to pause student loan

payments and provide student debt relief for low-income and

working-class Americans continuing to recover from the deadly

COVID-19 pandemic and its devastating economic fallout.

In March, policymakers in the House and Senate unveiled a

CRA resolution to retroactively overturn the pause of federal

student loan payments and interest accrual, and President

Biden's debt relief plan. If successful, these CRA efforts

would immediately force tens of millions of borrowers into

abrupt and unplanned repayment with devastating effects,

including adding thousands of dollars of payments and

interest onto their loan balances. It will also force the

Department of Education to unwind loans forgiven under Public

Service Loan Forgiveness for first responders, nurses,

educators, servicemembers, and hundreds of thousands of other

public service workers across the country. These actions are

a clear attack on millions of the most vulnerable workers and

families who are still reeling from the devastating impact of

Mr. Speaker, I yield 2 minutes to the gentlewoman from Florida (Ms. Wilson), the ranking member of the Subcommittee on Higher Education and Workforce Development.

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

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

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

First, I include in the Record letters from the American Federation of Teachers, another letter from multiple unions including the National Education Association, the AFL-CIO and AFSCME, a letter from Minority Vets, a letter from UnidosUS and the National Urban League, a letter from Third Way, a letter from the National Council of Nonprofits, and a letter from 23 various medical organizations, all in opposition to the legislation.

American Federation of Teachers,

May 22, 2023.

House of Representatives,

Washington, DC.

Dear Representative: On behalf of the 1.7 million members

of the American Federation of Teachers, I strongly urge you

to reject H.J. Res. 45/S.J. Res. 22, a joint resolution

providing for congressional disapproval of the Biden

administration actions to support student loan borrowers that

were announced in August of last year.

This resolution would immediately force tens of millions of

borrowers into abrupt and unplanned repayment with

devastating effects, including adding thousands of dollars of

interest onto their loan balances. Proponents of the

resolution want you to believe that it is simply a method to

stop President Joe Biden's student debt cancellation of up to

$20,000 that would benefit 43 million borrowers, but the

implications are more severe. Passage of this resolution

would be particularly destructive for teachers, nurses,

servicemembers and firefighters eligible for Public Service

Loan Forgiveness.

This resolution would force the U.S. Department of

Education to unwind loans forgiven under Public Service Loan

Forgiveness for nurses, educators, servicemembers and

hundreds of thousands of other public service workers across

the country. Retroactively repealing months of the payment

pause initially authorized by the Trump administration would

have far greater implications than thwarting Biden's

cancellation plan. It would force teachers, veterans and

nurses who finally received Public Service Loan Forgiveness

to write a check back to the Department of Education. This

resolution would reinstate the debt of more than 150,000

public service workers. On the heels of the pandemic, forcing

a nurse to pay back debt that was legally forgiven under a

bipartisan law is cruel.

And the harm wouldn't stop there: More than 400,000

borrowers have received PSLF-qualifying payments under the

last payment pause of 2022, but this resolution would claw

back those benefits, setting back firefighters and educators'

eligibility for PSLF for many months.

The COVID-19 pandemic had a devastating impact on American

workers, many of whom were already struggling to make ends

meet.

Those workers' precarity and risk of delinquency on their

debt has severely worsened during the pandemic. Given the

long-term economic impacts of the pandemic, which continue to

drive workers out of public service, a permanent solution,

rather than a temporary deferment, is necessary.

And the law is clear: Student debt cancellation falls

squarely within the statutory authority Congress granted the

secretaIy in the HEROES Act. Cancellation will help ensure

that millions of people are not left in a ``worse position''

as to their loan payments due to the devastating COVID-19

pandemic.

Tens of millions of families are struggling under the yoke

of $1.7 trillion in student debt. They eagerly await the

breathing room that student debt relief would bring, and

those struggling to get by will benefit the most. The extra

consideration in debt cancellation for Pell recipients

focuses like a laser on people in need. Taking away relief

that has already been granted to borrowers--the moratorium on

payments and interest--while the legal challenge wends its

way through the courts, and retroactively making them pay

what they cannot afford, is cruel. These borrowers are

teachers, firefighters, nurses and so many other dedicated

workers. Their current student debt is a far greater burden

than the debt carried by those of us who went to college long

ago. This means they have little or no wealth to start a

family, buy a car or a house, or make other major life

decisions, and it undermines plans they responsibly made

based on the situation at the time.

Congress should be building on the Biden administration

actions, not undermining those actions. Throwing tens of

millions of student loan borrowers into chaos by

retroactively adding interest and missed payments to their

loan balances, while extending their student debt sentence,

would upend lives. That's the wrong decision. Congress must

oppose H.J. Res. 45/S.J. Res. 22.

Sincerely,

Randi Weingarten,

President, American Federation of Teachers.

Mr. Speaker, there are many challenges we have in higher education that demand our attention: the rising cost of college, student debt crisis, the eroded value of the Pell grant, student mental health issues, and the list goes on.

Instead, we are addressing this resolution which will hurt millions of student borrowers and their families; an average of about 100,000 in each of our districts.

Many of our colleagues on the other side have justified the resolution by arguing that we cannot afford the plan, yet ignoring that we were willing to charge taxpayers $1.9 trillion for a tax package a few years ago that overwhelmingly benefited the top 1 percent and corporations. Now they are unwilling to spend much less than that to help students pay for their education.

We should be passing proposals that meaningfully support borrowers and make college more affordable for current and future students. The bottom line is that we have a responsibility to strengthen support for those seeking college degrees. Those who want a degree should be able to access that opportunity.

Mr. Speaker, I urge my colleagues to oppose the proposal, and I yield back the balance of my time.