Hospital Inpatient Services Modernization Act

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

Mr. Speaker, I am really happy to see the chairman of the Ways and Means Committee, and I am certainly happy to support this 5-year extension of the hospital at home program, which, of course, includes a critical study to ensure additional information about the program. I am also happy to hear about the success of this program as people experience it.

Mr. Speaker, the provisions, as the chairman of the Ways and Means Committee has pointed out, get extended every single year. Sometimes they get extended in short increments. Sometimes they move as a kind of tax package. As a matter of fact, this was just extended in the continuing resolution that we just passed and in previous funding bills before that. I am so delighted to be here this evening to see that my Republican colleagues are in the mood to extend current law.

I will offer them the opportunity to maybe extend the Affordable Care Act to the 24 million Americans who are facing unprecedented enormous health insurance premium hikes since we are extending healthcare stuff today.

In my own State of Wisconsin, Mr. Speaker, 279,000 people receive credits to help make insurance coverage affordable. In my State, for a 60-year-old couple not yet eligible for Medicare, earning $85,000 a year, they will see their premiums increase by $23,281 a year. A family of four earning $133,000 a year would see their premiums increase by $14,000 next year.

Families are going to be asked to pay 20, 30, 40 percent of their income for health insurance premiums, and the majority just wants to ignore it. My constituents and your constituents, Mr. Speaker, Americans from coast to coast are going to be staring down these massive amounts of medical debt, massive insurance premiums, or the inability to access healthcare. If they are unable to afford it, they will just drop it.

We have to act. It is December 1. We have to act.

I am reminded, Mr. Speaker, of how fast the Ways and Means Committee and the majority moved to give tax breaks to the wealthy, but when it comes to regular families, we just don't seem to have the time. We could be doing that here on the floor now. This is a marvelous bill we are passing today, but I would much rather be securing the time for that purpose.

Those hikes in healthcare premiums are not isolated, Mr. Speaker. They come on the heels of the One Big Beautiful Bill Act that slashed more than 10 million Americans out of healthcare through the Medicaid program, cut over a trillion dollars in Medicare, and a half-trillion dollar liability in the Medicare fund. Hospitals will close, patients will suffer, and millions of American families will become uninsured all because the majority is refusing to act.

Mr. Speaker, the majority was more than happy to make a whole host of tax breaks permanent for the billionaire business class, but not for these entrepreneurs and families who are facing these tremendous hikes in their premiums. This is part of a Republican economy, I think. Help the billionaires. It will all trickle down. We are going to heap the costs onto middle-class families from every angle. Rising numbers of Americans are falling behind on their utility bills. There is a recent uptick in mortgage delinquencies and a rise in serious delinquency rates for the first time in years. Consumer bankruptcies are on the rise, up 15 percent since last year.

What are we doing? We just passed a $4.3 trillion tax break overwhelmingly for the wealthy.

What else did the majority do, Mr. Speaker?

They found $40 billion for certain people in Argentina, but no healthcare for American families. They found $300 million for a new gilded ballroom where the East Wing of the White House used to be. The ballroom keeps getting bigger and bigger, so I can't describe the dimensions of it, but it is going to have a marble bathroom in it and a fancy new patio, but no healthcare for families.

We have higher electric prices, grocery prices, and housing prices. Half the people in my State who are renting are paying more than a third of their income for housing.

These prices are going through the roof. American families, unless they are billionaires, are struggling to stay afloat in this economy. While President Trump and his family use the White House to haul in billions of dollars to line their own pockets, people will not be able to access healthcare.

Mr. Speaker, while I support this bill, I object to how the majority and the President are making life worse every single day for most Americans.

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

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

I congratulate Mr. Buchanan and Mr. Evans on bringing forth this bill. I certainly agree with them that people do better at home in many instances and ought to have this as an option.

I look forward to the study that is involved in this iteration of the bill that will inform us about ways to improve the bill.

As we look at healthcare as a whole, it is one of those sort of broken markets that we have. We have 60 percent

of folks who get healthcare through their employer or government or labor unions. We have another group of people who are disabled who get healthcare. We have another group of people who are elderly, thank God they get Medicare, but then there is the rest of us out there.

In a broken system of healthcare, we have got to be concerned about those people. We have talked a lot about children with cancer. What if you are 27 and you have cancer, and you are not getting healthcare through an employer? You don't have one of them good government jobs. You are not elected to anything. What do you do?

While we are passing legislation, I hope that before we adjourn, we will not ignore the thousand-pound elephant in the room, and that is the Republican Party standing in the way of doing it.

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

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 4313) to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities, and to require an additional study and report on such flexibilities, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and submit extraneous material on this bill under consideration.

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

Mr. Speaker, I rise in support of the Hospital Inpatient Services Modernization Act introduced by the Committee on Ways and Means Health Subcommittee chairman, Mr. Buchanan, and Congressman Dwight Evans.

I think one of the healthcare-related conversations that frustrates a lot of us around here is the typical year-end healthcare policy extender mess.

The legislation in front of us takes the successful hospital at home program and removes it from that chaos by providing it with a renewed 5-year authorization so more Americans can receive care in the comfort and convenience of their own home.

Hospital at home has become embedded in the fabric of our healthcare system. More than 400 hospitals in nearly 40 States have participated in the program, which has built a track record of improved patient outcomes.

In Health Subcommittee Chairman Buchanan's home State of Florida

alone, there are 23 hospitals participating in this program. Hospital care provided at home cuts mortality rates, reduces the risk of falls and infections, and lowers recovery times. It also can save costs versus expensive in-person hospital visits. It is no wonder that 99 percent of patients said they were satisfied with the program.

At a Ways and Means Committee hearing, we heard the incredible story of a hospital at home patient from North Carolina named Roy who was diagnosed with sepsis and initially treated in a hospital. There, he was disturbed by beeping sounds, uncomfortable in the hospital gown, and alone with no one able to visit him. His recovery was much better at home.

He was able to sleep in his own bed and visit with friends and family. He also continued to receive the same level of care he would have otherwise received at the hospital. His recovery at home was rapid, complete, and without any infections.

Mr. Speaker, I represent one of the most rural districts in America. The long drives to a hospital faced by people living in small towns in remote areas can make seeking care prohibitive. Hospital at home shrinks the physical distance stopping rural patients from getting care. Hospital at home has been a proven success for getting more Americans the healthcare that they need.

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

Mr. Speaker, I yield such time as he may consume to the gentleman from Florida (Mr. Buchanan).

Mr. Speaker, I yield such time as he may consume to the gentleman from Pennsylvania (Mr. Smucker).

Mr. Speaker, I urge my colleagues to approve this legislation, and I yield back the balance of my time.

Mr. Speaker, I also rise in support of H.R. 4429, the Developing and Empowering our Aspiring Leaders Act, or DEAL Act, which is a critical bill to support innovation, entrepreneurship, and capital formation.

The venture capital industry provides vital funding for early-stage startups at points in their life cycle when they are generally deemed to be too risky for traditional bank financing or for raising money on the public market. This basically means that if we are going to have a growing and innovative economy, then we have to have a healthy venture capital sector.

Historically, venture capital earns investor returns and frees up more capital to recycle in other companies by selling their mature portfolio companies to strategic investors or taking them public on public markets.

For a variety of reasons, including public company reporting obligations, economic uncertainty, and the rise of private equity, U.S. companies today are staying private much longer, which has reduced the opportunities for venture capital firms to recycle their investment dollars.

Some venture capital firms have sought to create new liquidity options through secondary acquisitions and investments in other VC funds. This is what Congresswoman Wagner was referring to, but that option right now is constrained by provisions in the Dodd-Frank Act of 2010 that limit venture capital funds' ability to invest in these so- called fund of funds to only 20 percent of their commitments.

That rule was very well-intentioned when passed, and the intent was to ensure that VC firms remained focused on direct investments in early-stage startups. However, it was crafted for a very different financial market than we have today.

I would also note that that constraint is irrelevant to the larger, more well-known VC funds who have the resources to shoulder the compliance burdens associated with registering with the SEC as registered investment advisers. They can already do this, but they are the big ones. They are the ones based in San Francisco and New York. That option isn't available for these emerging regional fund managers located in the middle of the country. Many of those funds increasingly depend on that fund-of-funds model.

What the DEAL Act does is just provides greater flexibility to those smaller VC funds while still ensuring that investors are protected and that fund managers continue to prioritize direct funding in small businesses. It does this by revising the existing rules to raise the cap from 20 percent in fund of funds up to 49 percent but still requiring that the majority of their investments are directly in portfolio companies.

In other words, the DEAL Act supports growth in the startup economy and ensures that capital reaches the communities and innovators who need it most.

I thank my fellow Midwesterner and friend, Congresswoman Wagner, for her leadership on this. I am proud to lead this important legislation, and I urge all my colleagues to support it.

Mr. Speaker, I thank my friend from Ohio for yielding.

Mr. Speaker, I am proud to sponsor H.R. 4429, the Developing and Empowering our Aspiring Leaders, or DEAL, Act.

This bill, which passed with almost unanimous support out of the Financial Services Committee, seeks to ensure the United States remains the most entrepreneurial country in the world, where the next great companies are founded and funded.

It is often said that small businesses are the engine of the American economy, and that is an absolute truth. Small businesses make up 99 percent of U.S. employers, and they are the driving force behind the creation of a majority of new jobs.

The entrepreneurs leading these companies are building something new, taking real risks, and driving growth in communities across the Nation, but too often, they can't get a fair shot at investment.

Right now, our capital markets suffer from an extreme geographic imbalance. The data is stark. Nearly 70 percent of venture capital flows to three States, Mr. Speaker: California, New York, and Massachusetts.

This leaves entire regions of the country struggling to access funding. It leaves communities in the Midwest and the South without the capital they need to build and scale businesses. Access to capital is not just a coastal issue. It is a national economic necessity.

This capital divide is why the DEAL Act is so critically important. This bill is a targeted, forward-looking effort to modernize outdated rules and channel investment to where it is needed most.

The DEAL Act fundamentally strengthens the ability of capital to reach more founders and more communities. It achieves this by allowing larger venture funds to invest directly in smaller, regional funds, a fund-of-funds investment.

This mechanism is a game changer, Mr. Speaker. It means more funding for startups, more opportunities for businesses that might otherwise be overlooked, and more innovation happening everywhere, not just in a handful of elite ZIP Codes.

Newer, regional venture funds are often best positioned to back the entrepreneurs who are building businesses on Main Street. The DEAL Act ensures that these funds can expand that important work, giving them the flexibility to partner with larger institutions to reach a wider base of early-stage companies.

H.R. 4429 ensures our policies are helping capital move efficiently and effectively, empowering those taking risks to build something new, and helping good ideas grow into great companies.

I thank Chairman Hill for his support, and also I thank Congressman Casten for joining me and co-leading this commonsense and bipartisan piece of legislation.

Mr. Speaker, I thank my colleague Mr. Davidson for his broad work in the capital market space and for leading us here on the floor today.

I rise to urge my colleagues to support the Expanding WKSI Eligibility Act. I thank my co-leads, Mr. Fields, as well as Chairman Hill and Ranking Member Waters, for their support.

We have far too many regulations in the United States, and this bill is about rightsizing our regulations in support of investments and jobs.

This commonsense bill will help more well-run companies responsibly raise money in the public markets. It rightsizes regulatory burdens and frees up more resources for companies to invest in American jobs and American innovation.

The well-known seasoned issuer--also known as WKSI--status was first implemented around 20 years ago. It allows qualified public companies in good standing to use automatic shelf registration. This reduces the cost and complexity of a public offering and allows companies to be more responsive to market conditions.

The WKSI construct has a track record of success in expanding access to public markets while protecting investors.

According to Joel Trotter, one of the authors of the JOBS Act, ``Decades of successful experience show that the well-known seasoned issuer category is long overdue for expansion.''

I couldn't agree more, and this bill does exactly that. It lowers the size threshold for WKSI qualification while maintaining all the existing good governance requirements.

In other words, more small and midsized American public companies will be able to benefit from the privileges that already exist for larger businesses with similar compliance records.

The Expanding WKSI Eligibility Act also includes a helpful reporting requirement for the Securities and Exchange Commission. This report will provide Congress and the public with a better understanding of how many previously ineligible companies are trying to regain their WKSI status. Doing so will gain the insight needed to make future legislative adjustments.

The Expanding WKSI Eligibility Act is a tailored, regulatory improvement

that will support small and midsized businesses, job creators, and investments.

Mr. Speaker, I ask my colleagues to support this legislation.