Madam Speaker, by direction of the Committee on Rules, I call up House Resolution 357 and ask for its immediate consideration. Madam Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Texas (Mr.…
Madam Speaker, by direction of the Committee on Rules, I call up House Resolution 357 and ask for its immediate consideration.
Madam Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Texas (Mr. Burgess), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only.
General Leave
Madam Speaker, I ask unanimous consent that all Members be given 5 legislative days to revise and extend their remarks.
Madam Speaker, on Tuesday, the Rules Committee met and reported a rule, House Resolution 357, providing for consideration of H.R. 986, the Protecting Americans with Preexisting Conditions Act, under a structured rule.
The rule makes in order 12 amendments. The rule provides 1 hour of debate equally divided and controlled by the chair and the ranking member of the Committee on Energy and Commerce.
The rule also provides for consideration of H.R. 2157, the Supplemental Appropriations Act, under a structured rule. The rule self-executes a manager's amendment and makes in order 10 amendments to
Madam Speaker, I yield 3 minutes to the gentlewoman from Florida (Ms. Castor), a distinguished member of the Energy and Commerce Committee.
Madam Speaker, I yield 3 minutes to the gentlewoman from Texas (Ms. Jackson Lee).
Madam Speaker, I yield 30 seconds to the gentlewoman from Texas (Ms. Jackson Lee).
Madam Speaker, I yield 2 minutes to the gentleman from Mexico (Mr. Lujan), the Assistant Speaker.
Madam Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Doggett), a distinguished member of the Ways and Means Committee.
Madam Speaker, I am delighted to hear a Member of the other party defend the Affordable Care Act by defending 1332, the waivers.
Let me say this: We are not eliminating the waivers. We are simply objecting to the guidance that was issued by the Department of Health and Human Services, arguing, essentially, that it is inconsistent with the congressional intent when the waivers were created.
Madam Speaker, I include in the Record a letter signed by 24 health organizations, including the Cancer Action Network, the American Lung Association, the American Heart Association, the Susan G. Komen Foundation, and others, urging Members to support H.R. 986.
May 8, 2019.
Re Letter of Support from 23 Patient and Consumer Advocacy
Organizations for H.R. 986.
Hon. Ann McLane Kuster,
House of Representatives,
Washington, DC.
Dear Representative Kuster: Our 24 organizations,
representing the interests of the millions of patients and
consumers who live with serious, acute, and chronic
conditions, have worked together for many months to ensure
that patient voices are reflected in the ongoing
Congressional debate regarding the accessibility of health
coverage for all Americans and families. Today, we write in
strong support of your legislation to protect people with
pre-existing conditions who receive coverage in the
individual marketplace. The Protecting Americans with
Preexisting Conditions Act of 2019, H.R. 986, would require
the Administration to rescind its Section 1332 State Relief
and Empowerment Waivers Guidance, released on October 22,
2018 (1332 guidance). We are concerned about the impact that
this guidance could have on the people we represent and
applaud your introduction of this bill.
In March 2017, we identified three overarching principles
to guide and measure any work to further reform and improve
the nation's health insurance system. Our core principles are
that health insurance coverage must be adequate, affordable,
and accessible. Together, our organizations understand what
individuals and families need to prevent disease, manage
health, and cure illness. Our organizations are deeply
concerned about how the new 1332 guidance will affect the
individual marketplace's stability in states that choose to
pursue some of the policies allowed under this guidance,
including those that promote short term plans and other
substandard coverage. We are pleased that this legislation
represents a significant and meaningful step towards
protecting all Americans from coverage that does not cover
what they need to promote their health and well-being.
As you know, the 1332 guidance substantially erodes the
guardrails governing coverage that people with pre-existing
conditions such as cystic fibrosis, lung disease, cancer,
cardiovascular disease, diabetes, rare disorders, pregnant
women, and many others rely on in the individual marketplace.
Of particular concern, the new guidance would allow states to
let individuals use advanced premium tax credits to purchase
non-compliant short-term, limited duration insurance plans--
which could further draw younger, healthier people out of the
risk pool for comprehensive insurance and drive up premiums
for those who need comprehensive coverage. The guidance also
eliminates protections for vulnerable populations, such as
individuals with low incomes and those with chronic and
serious health issues, by removing the requirement to
safeguard those populations under any waiver. We are deeply
concerned by this as these changes fundamentally alter the
nature of the Section 1332 waiver program and jeopardize
adequate, affordable coverage for people with pre-existing
conditions in the individual market. Halting the
implementation of this guidance will protect people with pre-
existing conditions from the repercussions of these market
destabilizing actions.
H.R. 986 represents a significant step towards protecting
patients and consumers. Yet, we also recognize that there is
much more that needs to be done to improve upon our current
system of care, including making coverage more accessible and
affordable. Up until this year, health insurance enrollment
has steadily increased, and, with it, the promise of a more
diverse risk pool and greater protection for people with
serious health care needs. However, the recent
reinterpretation of the guidelines is jeopardizing
enrollment. Shortened enrollment periods, fewer resources for
outreach and education and less funding for consumer
navigators not only creates confusion for consumers but
directly impacts the number of individuals who enroll in
Marketplace coverage. Without Congressional action, these
trends will make it harder for many to access coverage and
will further contribute to the destabilization of insurance
markets and result in higher premiums for many enrollees.
Making high-quality coverage and care more affordable is
also a high priority for the people that we represent.
Passage of legislation that expands access to and the level
of advance premium tax credits, fixes the family glitch,
creates a nationwide reinsurance program, and reduces
systemic health care costs could significantly ease the cost
burden for people of all income levels who rely on the
individual marketplace for coverage. We urge Congress to
support legislation that maintains the quality of coverage
while expanding access and affordability.
Again, thank you for your leadership on this critical issue
for people with pre-existing conditions. We support your
efforts to halt the implementation of the 2018 guidance,
ensuring the guidance from 2015 remains intact and promoting
stability in the individual marketplace. We urge members of
Congress to vote for H.R. 986.
Sincerely,
Hemophilia Federation of America, National Health Council,
Cystic Fibrosis Foundation, Epilepsy Foundation, March of
Dimes, National Coalition for Cancer Survivorship, American
Heart Association, Alpha-1 Foundation, American Liver
Foundation, Susan G. Komen, National Hemophilia Foundation,
WomenHeart: The National Coalition for Women with Heart
Disease.
National Multiple Sclerosis Society, Muscular Dystrophy
Association, Lutheran Services in America, American Lung
Association, National Alliance on Mental Illness, National
Patient Advocate Foundation, Arthritis Foundation, Leukemia &
Lymphoma Society, American Cancer Society Cancer Action
Network, National Organization for Rare Disorders, Pulmonary
Hypertension Association, Cancer Support Community.
Madam Speaker, I yield 2 minutes to the gentlewoman from the District of Columbia (Ms. Norton).
Madam Speaker, I am prepared to close, and I reserve the balance of my time.
Madam Speaker, I continue to reserve the balance of my time.
Madam Speaker, I yield myself such time as I may consume.
I appreciate the comments of the gentleman from Georgia, and I have enjoyed the opportunity of working with him on the Rules Committee.
We are not objecting to what was done in 1996. We are saying to the States that they must cover preexisting conditions as part of a waiver, and they cannot undermine those conditions by imposing annual limits or charging more. The problem with the guidance is that it gives States the opportunity to propose cheap plans that, in essence, undermine preexisting conditions.
Madam Speaker, I reserve the balance of my time.
Madam Speaker, I yield myself the balance of my time.
It was only 10 years ago that people who lacked employer-provided insurance and had preexisting conditions could not find health insurance in many parts of this country, and those who could find health insurance, too often found that their plans were not comprehensive. They might not cover the type of cancer some buyers previously had, or they might have an annual or even a lifetime cap on coverage.
It was 2 years ago that this body passed a bill that stripped those protections, a bill that would make comprehensive health insurance out of reach for many Americans. Thanks to a courageous few, that bill did not become law.
Now that the administration has lost that battle to destroy the Affordable Care Act, they are trying to do it through guidance and through lawsuits.
H.R. 986 prevents the administration from enforcing guidance that would allow States to use taxpayer money to sell subpar health plans on the exchange.
The administration is taking the 1332 waivers, which are designed to allow States flexibility to lower health insurance costs, like through reinsurance, and using it to take away important consumer protections. The 1332 waiver requires high-quality, affordable health insurance while retaining the basic protections of the Affordable Care Act.
As the American Cancer Society notes: This administration guidance tips the scales in favor of insurance products that are inadequate to meet the needs of millions of Americans with preexisting conditions.
Madam Speaker, I also support H.R. 2157, which provides disaster assistance to communities from every nook and corner of this country who are waiting for our help.
When disaster hits this country, we come together and support each other. When tornados, and floods, and hurricanes strike, we help people quickly. It is an embarrassment that a disaster bill has not yet made it to the President's desk in this Congress.
Madam Speaker, I urge a ``yes'' vote on the rule.
The text of the material previously referred to by Mr. Burgess is as follows:
Amendment to House Resolution 357
At the end of the resolution, add the following:
Sec. 3. Immediately upon adoption of this resolution, the
House shall proceed to the consideration in the House of the
resolution (H. Res. 280), protecting the health care of all
Americans, especially those with preexisting conditions. The
resolution shall be considered as read. The previous question
shall be considered as ordered on the resolution to adoption
without intervening motion or demand for division of the
question except one hour of debate equally divided and
controlled by the chair and ranking minority member of the
Committee on Energy and Commerce. Clause 1(c) of rule XIX
shall not apply to the consideration of House Resolution 280.
Madam Speaker, I yield back the balance of my time, and I move the previous question on the resolution.