Preventing Maternal Deaths Act of 2018

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1318) to support States in their work to save and sustain the health of mothers during pregnancy, childbirth, and in the postpartum period, to eliminate disparities in maternal health outcomes for pregnancy-related and pregnancy-associated deaths, to identify solutions to improve health care quality and health outcomes for mothers, and for other purposes, 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 insert extraneous materials in the Record on the bill.

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

Mr. Speaker, I rise today in support of H.R. 1318, the Preventing Maternal Deaths Act. I am glad that we are finally calling up this bill for a vote, as it is a truly important bill that will impact the lives of pregnant women and new mothers across this country. The media's attention to the issue of maternal morbidity and mortality has shed light on serious problems within our healthcare system in terms of pre- and postpartum care and complications in the delivery room.

I thank Representative Jaime Herrera Beutler and Representative Diana DeGette for their leadership on this critical legislation. Ms. Herrera Beutler testified before the Energy and Commerce Committee's Subcommittee on Health this September in support of her bill, which she and her staff have been working on daily to get across the finish line. She and I have shared a goal to improve maternal outcomes, and I am grateful that we had an opportunity to continue to push this priority forward together.

I also thank the committee staff, which has been working through the language with the various stakeholders over the course of the past year. Their work has been imperative in getting this bill to the floor.

Having spent nearly three decades as an OB/GYN, I believe it should be a national goal to eliminate all preventable maternal deaths. A single one is too many.

The alarming trend in our country's rate of maternal mortality first came to my attention in September 2016 when I was reading in my professional journal called The Green Journal, the journal of Obstetrics & Gynecology. The original research found that the maternal mortality rate had increased in 48 States and Washington, D.C., from 2000 to 2014 while the international trend was moving in the opposite direction. Since reading that article, I have spoken with providers, hospital administrators, State task forces, and public health experts. The more I dove into this troubling issue, the more I realized how little we understand about how our data is lacking.

The Health Subcommittee has held both a member briefing and a hearing on the issue of maternal mortality. Our hearing this past September had a varied panel of witnesses, including Charles Johnson, who lost his wife, Kira, following the birth of their second child in 2016. Mr. Johnson's wife was a healthy and energetic woman, yet he now has to explain to his two sons why their mother is never coming home.

The Johnson family is not alone in living through such tragedy. However, if we pass this bill today and send it to the President's desk, we will be taking a step in the right direction toward preventing future maternal deaths.

This is a problem that we cannot address without accurate data. According to the Centers for Disease Control and Prevention, the United States' maternal mortality rate was 7.2 deaths per 100,000 live births in 1999 and increased to 18 deaths per 100,000 live births in 2014. These are statistics that deserve our full attention.

Representative Jaime Herrera Beutler's bill will address the complex issue of maternal mortality by enabling States to form maternal mortality review committees to evaluate, improve, and standardize their maternity death data. Once we fully understand the problem, there will be an opportunity to use the data to implement best practices.

Texas is an excellent example of a State that has created and sustained a maternal mortality and morbidity task force. Texas has put time, effort, and funding into reviewing maternal deaths in order to identify trends and causes.

Most of the pregnancy-related and pregnancy-associated deaths--or many, I should say--are preventable, but they are all tragic. We should not be losing women to such a fixable problem, leaving their newborn babies and their families to have to wake up each day to face the unsolved mystery of why the mother did not make it home from the hospital or died shortly thereafter.

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

Mr. Speaker, I yield such time as she may consume to the gentlewoman from Washington (Ms. Herrera Beutler), who is the principal author of the bill.

Mr. Speaker, I yield 2 minutes to the gentleman from Georgia (Mr. Carter), who is a valuable member of the Health Subcommittee.

Mr. Speaker, I yield 2 minutes to the gentlewoman from Colorado (Ms. DeGette).

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

Just in addition to all the other people who have been thanked, I want to acknowledge the work of my personal staff, Mr. Ed Kim and Elizabeth Allen, who have worked so hard on this bill, as well as Dr. Kristen Shatynski on the Energy and Commerce Subcommittee on Health staff, who really helped push this along and made sure that we got here today in a successful manner.

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

Mr. Speaker, I move to suspend the rules and pass the bill (S. 3029) to revise and extend the Prematurity Research Expansion and Education for Mothers who deliver Infants Early Act (PREEMIE Act).

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and insert extraneous materials in the Record on the bill.

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

Mr. Speaker, I rise in support of S. 3029, the PREEMIE Reauthorization Act of 2018. This bill passed the Senate with robust bipartisan support, and I expect it will do the same in this Chamber.

This bill reauthorizes a program that is vital to the health and well-being of premature babies and their mothers. It is fitting that we have called this legislation to the floor following Prematurity Awareness Month, which took place the month of November.

While we are taking up the Senate bill, which was led by the Health, Education, Labor, and Pensions Committee, Chairman Lamar Alexander and Senator Michael Bennet, I would like to thank our House champions of this legislation, Representative Anna Eshoo and Representative Leonard Lance. I am pleased that we were able to rally bicameral, bipartisan support around improving the health of premature infants.

Preterm and low birth weight, combined, make up the second leading cause of infant death following birth defects. This legislation will increase research relating to preterm labor and delivery and the care, treatment, and outcomes of preterm and low birthweight infants.

Preemies and low birthweight infants are at risk for various health challenges and disabilities, and we still have much to learn about factors relating to prematurity. This bill allows for continued collection of maternal-infant clinical and biomedical information in conjunction with the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System. Such data collection and surveillance will allow the CDC, and national, State, and local health officials to have a better picture of what prematurity, including its causes and impacts, looks like in our country.

This legislation also requires the Advisory Committee on Maternal and Infant Health to publicly publish and submit to Congress a report on its activities and recommendations. That advisory committee has been tasked with

developing strategies to address gaps in Federal research, programs, and education efforts related to the prevention of severe maternal morbidity, maternal mortality, infant mortality, and other adverse birth outcomes. This ties nicely into H.R. 1318, the Preventing Maternal Deaths Act, which will also be on the floor of this House this afternoon.

Additionally, this legislation establishes an interagency working group, directing the Secretary of the Department of Health and Human Services to collaborate with other departments to improve coordination of programs and activities to prevent preterm birth, infant mortality, and related adverse birth outcomes. The working group is required to submit a report to the House Committee on Energy and Commerce and the Senate Health, Education, Labor, and Pensions Committee.

Mr. Speaker, I urge my colleagues to support S. 3029, and I reserve the balance of my time.

Mr. Speaker, I yield 2 minutes to the gentleman from New Jersey (Mr. Lance), one of the authors of this legislation.

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

Mr. Speaker, I would just like to take a second and thank Representative Davis for his kind remarks, and I reserve the balance of my time.

Mr. Speaker, I urge all of my colleagues to support S. 3029, and I yield back the balance of my time.

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

Mr. Speaker, I thank Chairman Burgess for his tireless commitment on this issue. It is not just the gentleman's career, but it has been something that the gentleman has fought for here in Congress as well, and I am very grateful to be standing here today. I also want to thank my co-conspirator, Diana DeGette, for her work on this bipartisan legislation that has more than 180 cosponsors.

So why is this bill important to you, Mr. Speaker, or to those who are listening? Well, you either are a mom or you have got a mom. This bill impacts you.

I stand in strong support of the Preventing Maternal Deaths Act, a bill to save mothers' lives and prevent more parents, husbands, grandparents, and children from the profound loss of their mother.

Today in the 21st century United States of America, the U.S. is ranked fourth globally for maternal mortality. Many are shocked to learn that the

U.S. not only has the worst maternal mortality rate in the entire developed world, but that these rates are on the rise. Seriously, Mr. Speaker, we are worse than Iran.

Every year, between 700 and 900 maternal deaths occur in the United States, and I have seen tears brought to the eyes of many a colleague when they learn that more than 60 percent of these deaths could have been prevented, according to the CDC. It is difficult to imagine the grief felt by these families when a life is cut short and they learn that it could have been prevented.

As a mom, as an American, and as a lawmaker, we must do better. Combating maternal mortality must become a national priority, which is why I urge my colleagues to support this bill. The Preventing Maternal Deaths Act represents the biggest step taken by Congress to date on this issue. It would enable States to establish and strengthen maternal mortality review committees, which bring together experts in public health, in maternal health, and in infant health to investigate each and every pregnancy-related death to understand what went wrong and how to save future mothers' lives.

Currently, the available data is woefully inadequate, which hinders our ability to understand why moms are dying and why certain women are more at risk. Right now, African American women are three to four times more likely to die from pregnancy-related causes, and women living in rural areas are also facing higher risk. This bill will not only improve data collection, but it will empower States to participate in national information sharing, increase collaboration, and develop best practices.

In closing, Mr. Speaker, I would like to dedicate this bill to the mothers whom we have lost, moms like Kira Johnson who lost her life just hours after giving birth to a healthy baby boy.

I will never forget hearing from Kira's husband, Charles, who has been a tireless advocate on this issue. He is a single father of two boys and now lives by the motto: ``Wake up, make mommy proud, repeat.''

Stories like Kira's have struck at the hearts of many of us and have compelled us to action today. Today, we honor the lives of these moms and the loved ones who remember them.

Mr. Speaker, I urge my colleagues to vote ``yes'' on the Preventing Maternal Deaths Act.

Mr. Speaker, I thank the gentleman from Texas for yielding.

I also want to commend the Subcommittee on Health and the Committee on Energy and Commerce for its outstanding work under the leadership of Dr. Burgess.

Mr. Speaker, I am going to speak about sickle cell, a bill that has been worked on and passed. Of course, sickle cell disease is an inherited blood disorder characterized by affected red blood cells that mutate into the shape of a crescent or sickle. And as such, these cells are unable to pass through small blood vessels. It is a recessive- genetic condition that occurs when a

child inherits two sickle cell genes, or traits, from each parent.

The consequences and complications of this disease are extreme. The Sickle Cell Disease Association of America, whom we have worked with for many years on this legislation, have studied and reported that common complications with this disease include early childhood death from infection; stroke in young children and adults; lung problems similar to pneumonia; chronic damage to organs, including the kidney, leading to kidney failure; damage to the lungs, causing pulmonary hypertension; and severe, painful episodes. In fact, pain episode are a hallmark of sickle cell disease.

Mr. Speaker, I am pleased that we are at this juncture in passing S. 2465, a bill designed to help improve, treat, prevent, and conduct research on sickle cell disease and to include other blood diseases for surveillance and data collection.

While this legislation includes other blood diseases, its original intent and its continuing focus is to put major emphasis on sickle cell disease and issues related to it.

Mr. Speaker, I want to thank my colleagues, Representative Michael Burgess, and Representative G.K. Butterfield, Senator Tim Scott, and Senator Cory Booker for their tireless support and efforts to bring this bipartisan and bicameral bill to fruition.

There has been a great deal of back and forth on this bill. Therefore, I want to thank, again, Dr. Burgess, the chief Republican cosponsor and advocate. I want to commend the leadership on the Committee on Energy and Commerce, Chairman Greg Walden and Ranking Member Frank Pallone.

Mr. Speaker, I want to highlight the work of my colleague and friend, Representative G.K. Butterfield, who carried the bill for this legislation in the Committee on Energy and Commerce.

Our staffs did outstanding work, and I commend all of them, especially my Health Subcommittee staffer, Dr. Caleb Gilchrist. I want to acknowledge and thank our advocate organizations, the Sickle Cell Disease Association of America, the American Society of Hematology, and other organizations, hospital providers, families, and those infected with the sickle cell disease.

Mr. Speaker, those who say that Congress does not work and is not working, I tell you, when we pass legislation of this sort, it tells me that America is on the right track and we are, indeed, moving forward to help make our communities as safe and healthy as they can possibly be.

I end by just thanking Dr. Burgess, again, for his outstanding leadership on this issue.

Mr. Speaker, I thank my colleague and my classmate, Mr. Green, for his distinguished service here in the House. He is retiring, and I want to salute him.

I also want to salute my partner in this effort, Mr. Lance from New Jersey. He is going to be missed at the committee and missed in the House. I think he has always been value added to the Congress, and we all wish him well.

Mr. Speaker, I rise in support of this bipartisan legislation. The shorthand for it is the PREEMIE Act. It is legislation that I introduced with Congressman Lance to expand research, education, and the prevention of preterm birth.

Preterm birth, or birth before 37 weeks of pregnancy, is the leading cause of newborn mortality and the second leading cause of infant mortality in our country. In 2016, over 388,000 infants were born too early; and, every year, over 20,000 babies in the United States will die before their first birthday, many of them from complications of preterm birth.

In addition to being the leading cause of newborn death, premature birth can cause a lifetime of health challenges and intellectual disabilities for children who survive.

In addition to the emotional and physical toll of prematurity, there are significant healthcare costs to families, medical systems, and our overall economy. A report by the Institute of Medicine found the cost associated with preterm birth in the United States was $26.2 billion annually--that is a staggering amount of money--or $51,600 per infant born preterm. While employers, private insurers, and individuals bear about half the costs of healthcare for these infants, 40 percent of this amount is paid for by Medicaid.

Moms and babies face higher risks than ever before. After the statistics decreasing for over a decade, which is exactly what we wanted them to do, for the third year in a row now the preterm birth rate in our country has worsened, so the passing of this legislation has come at the right time.

I am proud of the work that we have done on this Reauthorization Act and that it is going to head to the President for his signature, and I am proud to have authored the original PREEMIE Act with Congressman Fred Upton in 2006.

This updated reauthorization builds on the important investments that have been made, and we add to them. I think that is the most important thing to say.

With the incidence of preterm birth increasing across the United States, we need to do everything that we can for the mothers and for the newborns so that we improve the outcomes for them because it is their lives.

The PREEMIE Act did pass the Senate unanimously on September 12, and I have every confidence that the House is going to double the record.

Mr. Speaker, I thank the gentleman for yielding to me and, again, pay tribute to him for his exceptional service here in the House.