Floor Statements

Mr. Speaker, pursuant to House Resolution 949, I call up the bill (H.R. 6082) to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records, and ask for its immediate consideration in the House.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and insert extraneous material on H.R. 6082.

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

Mr. Speaker, over the course of the past several months, the Energy and Commerce's Subcommittee on Health held four legislative hearings on bills to address the opioid epidemic and reported 57 bills to the full committee. Of those 57 bills, only one received its own discrete hearing. That bill was H.R. 6082, the Overdose Prevention and Patient Safety Act, introduced by Representatives Mullin and Blumenauer.

As a physician, I believe it is vital that doctors have all of the appropriate information to determine the proper course of treatment for a patient, ensuring patient safety and privacy, as required by Federal regulation known as HIPAA. The Overdose Prevention and Patient Safety Act maintains the original intent of the 1970s statute behind 42 CFR part 2 by protecting patients and improving care coordination.

In fact, the bill increases protections for those seeking treatment by more severely penalizing those who illegally share patient data than under the current statute. Current part 2 law does not protect individuals from discrimination based on their treatment records and, to this date, there have been no criminal actions undertaken to enforce part 2.

This bill has a wide range of support from national and State organizations. Since the bill was introduced, the Energy and Commerce Committee has heard from over 100 organizations in its support.

Arguably, the most notable support for this legislation comes from the Substance Abuse and Mental Health Services Administration in the Department of Health and Human Services. Dr. Elinore McCance-Katz, the Assistant Secretary for Mental Health and Substance Use, wrote to Mr. Mullin in March, stating that SAMHSA ``is encouraged to see Congress examine the benefits of aligning part 2 with HIPAA. Patient privacy is, of course, critical but so too is patient access to safe, effective, and coordinated treatment.''

I agree with Dr. McCance-Katz that in order to ensure patient safety, physicians must have secure access to patient records, including substance use disorder information. When this information is not provided to healthcare professionals, they may end up prescribing medications that have dangerous drug interactions or may lead a patient who is in recovery to be inappropriately prescribed an opioid and fall back into addiction.

One particular complication driven by 42 CFR part 2 directly impacts the care for pregnant women and their infants. For women who are pregnant, part 2 does not allow redisclosure of substance use disorder medical documentation to the women's OB/GYN doctor, primary care physician, or health home without their written consent. This leads to fragmented care, which opens up the mother and her baby to potential harm.

Centerstone, one of the Nation's largest not-for-profit healthcare organizations, notes that ``mothers who continue to use during pregnancy and who do not wish to sign secondary releases to allow their care providers to treat them comprehensively put their unborn children at risk for addiction.''

Centerstone watches these women and their infants suffer right before their eyes, but, because of part 2, Centerstone cannot share the information to ensure that the mother and baby are getting proper care.

As an OB/GYN physician myself, I cannot imagine having this information withheld. Such a situation would leave me with the inability to treat the whole patient and ensure that the mother is healthy and her baby is not on a path for addiction.

In another situation, a patient was referred to a treatment center following an emergency room visit for an overdose. The patient was not able to give written consent to his providers due to acute intoxication. Due to a lack of written consent and 42 CFR part 2, the treatment facility could not communicate to the ER and learn about the patient's condition or confirm that the patient had, indeed, enrolled in a drug treatment center, further delaying critical care coordination.

There is clear evidence that part 2 is a massive roadblock to providing safe, quality, and coordinated care to individuals suffering from substance use disorder.

The issue of the stigma associated with substance use disorder has been a constant in all of the discussions that we have had, both in our offices and in our hearings. In April, we heard from numerous individuals who were parents of children who died from opioid overdoses. Some noted that their children were afraid to seek help from their families or from healthcare professionals because they were embarrassed or they felt stigmatized.

We should enable physicians to fully care for these patients suffering from substance use disorder as if they had any other disease. The Overdose Prevention and Patient Safety Act will do just that.

The first step in addressing a problem is admitting that it exists. I would like to pose a question to those who are arguing against this legislation:

If we continue to silo the substance use disorder treatment information of a select group of patients rather than integrating it into our medical records and comprehensive care models, how can we ensure that these patients are, in fact, receiving quality care? How can we really treat substance use disorder like all other complex health conditions?

H.R. 6082 ensures adequate patient data protection in accordance with Federal law, with HIPAA. There are provisions in the language that ensure that the data may only be used for purposes of treatment, payment, or healthcare operations. Substance use disorder data cannot be used in criminal, civil, or administrative investigations, actions, or proceedings without patient consent or a court order.

Additionally, the legislation explicitly prohibits discrimination against an individual on the basis of their patient needs. Currently, part 2 includes no antidiscrimination protections and no protections for individuals if there is a data breach or improper disclosure.

Think about that for a minute, Mr. Speaker. This was a 1970s-era law. There were not data breaches back in the 1970s. 42 CFR part 2 was never intended to protect a patient in the instance of a data breach.

Should any entity or individual share patient data under H.R. 6082, they, in fact, will be severely penalized.

There is a reason why SAMHSA and most of the healthcare stakeholder community is asking for this change. Clearly, there is an issue here that must be addressed. This opioid crisis is devastating our country. Passing the Overdose Prevention and Patient Safety Act will enable greater coordination among healthcare providers in providing quality, effective care for individuals across the country who are battling substance use disorder.

My thanks to Mr. Mullin on the Energy and Commerce Committee and to Mr. Blumenauer for introducing this legislation that is of utmost importance.

I urge strong support for the bill, and I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to the gentleman from Oklahoma (Mr. Mullin), the principal sponsor of the bill and a valuable member of the Energy and Commerce Committee.

Mr. Speaker, I yield 5 minutes to the gentleman from Oregon (Mr. Walden), the chairman of the full committee.

Mr. Speaker, I yield myself 2 minutes for the purpose of response before I yield to Dr. Bucshon.

Mr. Speaker, the tragic story that was just related to us really only reinforces the need to change the statute behind 42 CFR part 2. There are some important facts missing from the description of the situation that occurred.

It appears evident that at least one or both of the parties involved, the judge, and/or the methadone maintenance program, violated existing regulations under both part 2 and HIPAA.

Under part 2, patient records may only be disclosed without patient consent if the disclosure is authorized by an appropriate order of a court of competent jurisdiction. There must be a showing of good cause in which the court must weigh the public interest and need for disclosure against the injury to the patient, the physician-patient relationship, and treatment services. Further, the court must impose appropriate safeguards against unauthorized disclosure.

It is not clear from the description provided in the letter how the judge found out about the patient's participation in a methadone maintenance program. If the information to the judge was provided without an appropriate court order, then the methadone maintenance program likely violated the requirements under part 2 to safeguard the patient's records from such disclosure. If the information was provided as a result of a court order, then it is possible that the judge violated his or her ethical obligations to appropriately weigh the need for the information and safeguard the information once received.

Under HIPAA, there is still an obligation for the parties seeking information to confirm that reasonable efforts have been made to ensure that the individual has been given notice of the request for personal health information and the opportunity to object or that reasonable efforts have been made to secure a qualified protective order. Compliance with either of these requirements appears to have been lacking in the situation described in the letter.

All of this suggests that part 2 currently is insufficient to protect patients in these situations. The legislation before us today does not decrease the protections against the use of the records in criminal proceedings that already exist under part 2, but HIPAA makes the protections stronger.

I yield 3 minutes to the gentleman from Indiana (Mr. Bucshon), a valuable member of our committee and our subcommittee that has heard the testimony on this legislation.

Mr. Speaker, I yield 3 minutes to the gentleman from Illinois (Mr. Shimkus), a valuable member of the Energy and Commerce Committee.

(Mr. SHIMKUS asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I yield an additional 30 seconds to the gentleman from Illinois.

Mr. Speaker, I yield myself 3 minutes.

Mr. Speaker, I would like to point out that there are over 100 groups in support of the Partnership to Amend 42 CFR part 2. A letter from that partnership says, in part:

We are pleased that the bill aligns part 2 with HIPAA's

consent requirements for the purposes of treatment, payment

and operations, which will allow for the appropriate sharing

of substance use disorder records, among covered entities, to

ensure persons with opioid use disorder and other substance

use disorders receive the integrated care that they need.

Additionally, as we do not want patients with substance use

disorders to be made vulnerable as a result of seeking

treatment for addiction, this legislation strengthens

protections and limits the number of institutions that have

access to their records.

I am not going to read all of the names on the list, but some of the notable ones are the National Alliance on Mental Illness, Mental Health America, Hazelden Betty Ford Foundation, National Governors Association, Healthcare Leadership Council, American Hospital Association, American Society of Addiction Medicine, Centerstone, New Jersey Hospitals, and National Association of Addiction Treatment Providers.

Mr. Speaker, I include in the Record the entire list of all of the groups in favor of the Partnership to Amend 42 CFR.

Partnership To Amend 42 CFR Part 2--A Coalition of Over 40 Health Care Stakeholders Committed To Aligning 42 CFR Part 2 (Part 2) With HIPAA To Allow Appropriate Access to Patient Information That Is Essential for

Providing Whole-Person Care

June 15, 2018.

Hon. Markwayne Mullin,

House of Representatives,

Washington, DC.

Hon. Earl Blumenauer,

House of Representatives,

Washington, DC.

Dear Representatives Mullin and Blumenauer: The undersigned

members of the Partnership to Amend 42 CFR Part 2

(Partnership) and additional stakeholder organizations

applaud your leadership on the issue of substance use

disorder privacy records. We strongly support the Overdose

Prevention and Patient Safety (OPPS) Act, H.R. 6082, which

will align 42 CFR Part 2 (Part 2) with the Health Insurance

Portability and Accountability Act (HIPAA) for the purposes

of health care treatment, payment, and operations (TPO). The

Partnership is pleased that the OPPS Act was voted out of the

Committee on Energy and Commerce with a bipartisan vote.

The Partnership is a coalition of more than 40

organizations representing stakeholders across the health

care spectrum committed to aligning Part 2 with HIPAA to

allow appropriate access to patient information that is

essential for providing whole-person care.

We are pleased that the bill aligns Part 2 with HIPAA's

consent requirements for the purposes of TPO, which will

allow for the appropriate sharing of substance use disorder

records, among covered entities, to ensure persons with

opioid use disorder and other substance use disorders receive

the integrated care they need. Additionally, as we do not

want patients with substance use disorders to be made

vulnerable as a result of seeking treatment for addiction,

this legislation strengthens protections and limits the

number of institutions that have access to patient records.

Thank you both for your leadership on this issue and we

look forward to working with you on helping to address the

opioid crisis by passing this important bipartisan

legislation on the floor of the U.S. House of

Representatives.

Sincerely,

Partnership to Amend 42 CFR Part 2 Members

Academy of Managed Care Pharmacy; American Association on

Health and Disability; American Health Information Management

Association; American Hospital Association; American

Psychiatric Association; American Society of Addiction

Medicine; American Society of Anesthesiologists; America's

Essential Hospitals; America's Health Insurance Plans; AMGA;

Association for Ambulatory Behavioral Healthcare; Association

for Behavioral Health and Wellness; Association for Community

Affiliated Plans; BlueCross BlueShield Association; Catholic

Health Association of the U.S.; Centerstone; Confidentiality

Coalition; Employee Assistance Professionals Association;

Global Alliance for Behavioral Health and Social Justice;

Hazelden Betty Ford Foundation.

Health IT Now; Healthcare Leadership Council; The Joint

Commission; InfoMC; Medicaid Health Plans of America; Mental

Health America; National Alliance on Mental Illness; National

Association for Behavioral Healthcare; National Association

of ACOs; National Association of Counties (NACo); National

Association of State Mental Health Program Directors

(NASMHPD); Netsmart; OCHIN; Otsuka; Pharmaceutical Care

Management Association; Premier Healthcare Alliance.

Additional Stakeholder Organizations

ACO Health Partners; Aetna; AMITA Health; Anthem, Inc.;

Ascension Health; Avera Health; Banner Health; Baptist

Healthcare System; Beacon Health Options; Bon Secours Health

System, Inc.; CareSource; Catholic Health Initiatives;

Centene Corporation; Change Healthcare; Cigna; College of

Healthcare Information Management Executives (CHIME).

Excellus BlueCross BlueShield; Franciscan Sisters of

Christian Charity Sponsored Ministries, Inc.; Greater New

York Hospital Association; Henry Ford Health System; Howe

Home Designers; Johns Hopkins Medicine; Kern Health

Systems; Leidos; Lycoming County; Magellan Health;

Marshfield Clinic Health System; Mental Health America of

Indiana; Mosaic Life Care; NAMI; NAMI DC; NAMI Delaware.

NAMI Greene County Tennessee; NAMI Helena; NAMI of Howard

County, MD; NAMI Jefferson County, Washington; NAMI Kaufman

County; NAMI Kershaw County; NAMI Lewistown; NAMI Lexington;

NAMI of the Pee Dee (South Carolina); NAMI Piedmont Tri-

County; NAMI Sarasota County; NAMI South Suburbs of Chicago;

NAMI Sussex, Inc.; NAMI Temple Area; NAMI Utah; NAMI Valley

of the Sun.

National Alliance on Mental Illness (NAMI) Texas; National

Association of Addiction Treatment Providers; New Directions

Behavioral Health; OPEN MINDS; Optum; PerformCare; Providence

St. Joseph Health; SCAN Health Plan; SSM Health; Texas Health

Resources; The Center for Health Affairs/Northeast Ohio

Hospital Opioid Consortium; The MetroHealth System; Trinity

Health; University of Tennessee Medical Center; Valley Health

System; Vizient; Wayne Meriwether.

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

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

Mr. Speaker, by continuing to segregate substance use disorder records means that we are willing to allow some patients to receive care that is potentially lower quality at a higher cost.

Treating patient substance use disorder in isolation from their medical and mental health conditions--which predominated care in the 1970s--is not the standard for good practice today. There is now overwhelming evidence that patients' substance use disorders cannot be treated in isolation from other healthcare conditions. In the 1970s when part 2 was written, this was not widely accepted, and treatment for addiction was largely separate from treatment for other illnesses.

Mr. Speaker, further, I would say that the problem here is we need to treat addiction just like any other medical illness and improve our outreach to patients who meet the criteria for treatment. Maintaining a decades old, ineffective confidentiality law simply is not going to do that.

I urge my colleagues to support the bill. It is a good bill supported by Mr. Mullin and Mr. Blumenauer.

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

Mr. Speaker, I reserve a point of order against the motion.

Mr. Speaker, I withdraw my point of order.

Mr. Speaker, I claim the time in opposition to the motion.

Mr. Speaker, I urge a ``no'' vote on the motion to recommit as it will destroy the intent of the bill.

Eliminating the sharing of records for the purposes of treatment, payment, and healthcare operations completely negates the entire purpose of this initiative.

Aligning 42 CFR part 2 with HIPAA for purposes of treatment, payment, and healthcare operations is the entire purpose of the legislation.

Opponents of this bill have offered no evidence or findings to back up their claim that HIPAA is inadequate to protect sensitive data contained in substance use disorder treatment records.

HIPAA is currently functioning well in protecting sensitive patient information in a number of areas.

Real integration of behavioral health and primary care simply cannot happen until we align 42 CFR part 2 with HIPAA.

The opposition of H.R. 6082 is not based on protecting privacy. It is based on very specific distrust of the healthcare community to properly provide care to people with substance use disorder--the very people whom we are asking to help us with this.

Yet, the ranking member is strongly in favor of numerous bills that seek to expand access to evidence-based medication-assisted treatment, telehealth and integration with mainstream medicine--the very things that demand alignment with HIPAA. So the thinking, Mr. Speaker, to be kind, is incongruous.

Prohibiting the sharing of addiction medical records for treatment, payment, and healthcare operations makes it impossible to prescribe the latest substance use treatment medications safely.

Like most pharmaceuticals, buprenorphine and methadone have drug interactions and interact with other medicines. Adverse events from drug interactions can lead to emergency hospital visits, serious injuries, or death.

We must amend part 2 so we can safely prescribe medication-assisted treatment for patients. Put simply, standard clinical practices like medication reconciliation are not feasible under the current Federal law. For that reason, I urge my colleagues to vote ``no'' on the motion to recommit. Vote ``yes'' on the underlying motion.

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

Mr. Chair, I want to thank Mrs. Walters for introducing this legislation.

Throughout this committee's and subcommittee's work on opioids, the IMD exclusion has been consistently identified by many stakeholders in conversations not only in my office but with the subcommittee as a barrier to care for Medicaid patients who need inpatient treatment.

In the face of an epidemic that is taking the lives of 115 Americans on average every day, I believe this policy strikes the right balance. The IMD CARE Act targets limited resources to remove a barrier to care by allowing States to repeal the IMD exclusion for 5 years for Medicaid beneficiaries between the ages of 21 and 64 who have an opioid use disorder. This approach will provide States the flexibility to increase access to institutional care for those who truly need it.

While getting a waiver from CMS for the IMD exclusion is a good option for many States, less than half the States have applied for a waiver. We are losing too many of our friends and neighbors each day to this crisis to ask States to go through what can be a lengthy and uncertain process to secure a waiver.

The IMD CARE Act allows States to act now to ensure their patients who are suffering now from a terrible disease can get the care that they need and get it now.

I ask my fellow Members to join me in support of Mrs. Walters' bill.

Mr. Speaker, I yield myself 2 minutes.

Mr. Speaker, we heard about this issue in both the Health Subcommittee that I chair as well as the Oversight and Investigations Subcommittee on Energy and Commerce chaired by Mr. Gregg Harper.

We had a roundtable of family members who had lost family due to the opioid crisis. They spoke very eloquently about this issue. Two in particular stand out, Gail Smith and Lisa Daniels, both mothers who had lost sons to the opioid crisis. Both sons had been brokered into recovery homes that really didn't have their best interests at heart and ultimately succumbed to their disease of addiction.

This is significantly important legislation. I obviously encourage all of my colleagues to be supportive.

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

Mr. Speaker, I yield such time as she may consume to the gentlewoman from California (Mrs. Mimi Walters), a valuable member of the Energy and Commerce Committee and cosponsor of the bill before us.

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

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5002) to expand the unique research initiatives authority of the National Institutes of Health.

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, today I rise to express my support for H.R. 5002, the Advancing Cutting Edge Research Act.

This important bill gives the National Institutes of Health a critical tool to help combat the opiate crisis by giving the National Institutes of Health director more flexibility to conduct innovative research and to spur urgently needed research on new, nonaddictive pain medications.

By providing these authorities, the National Institutes of Health will be able to more easily partner with innovative companies with cutting-edge technology to address the opiate crisis and other public health threats.

I do want to thank colleagues from Michigan, Representatives Dingell and former Chairman Fred Upton, for leading this important initiative.

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

Mr. Speaker, I yield such time as he may consume to the gentleman from Michigan (Mr. Upton), the principal author on the bill.

Mr. Speaker, I yield myself 1 minute.

Mr. Speaker, I want to wholeheartedly agree with the comments we just heard from the gentlewoman from Michigan. It is imperative that we guard against the pendulum swinging too far in either direction.

One of the very first hearings I attended as the newest member of the Energy and Commerce Subcommittee on Health in 2005 was a hearing on why doctors do not prescribe adequate pain relief for their patients who are in pain.

Now we fast-forward today, to the significant number of drug overdose deaths, many of those attributed to opiates that this country has seen in the past several years, and, clearly, it is important that the committee do something. It is important that in doing something, we do not further damage those people who are stable and depending upon a pain medication regimen that works for them. But going forward, we need to find, if we can, a way out of this predicament in the future for future patients.

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

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

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 923 and ask for its immediate consideration.

Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentlewoman from California (Mrs. Torres), 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 have 5 legislative days to revise and extend their remarks.

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

House Resolution 923 provides for the consideration of two important bills related to Federal spending of taxpayer dollars.

The first, H.R. 5895, the combined appropriations bill, containing three individual fiscal year 2019 Energy and Water, Legislative Branch, and Military Construction and Veterans Affairs bills, provides the annual funding for these Federal departments.

The second bill, H.R. 3, the Spending Cuts to Expired and Unnecessary Programs Act, is a critical bill to honor the House Republicans' commitment to eliminating wasteful Federal spending.

The resolution before us this afternoon provides for a structured rule for H.R. 5895. Yesterday, the House passed the first rule pertaining to this bill, providing for 1 hour of general debate on the measure. Today's rule makes in order 40 amendments offered by both Democrats and Republicans.

House Resolution 923 also provides a closed rule for H.R. 3, the rescissions package, but does execute Leader McCarthy's amendment which incorporates President Trump's revised and updated spending proposal.

One hour of debate time for H.R. 3 is provided, divided and controlled equally by the majority leader and the minority leader or their respective designees.

Finally, the rule provides the minority the customary motion to recommit on both pieces of legislation under consideration.

H.R. 5895, the Energy and Water, Legislative Branch, and Military Construction and Veterans Affairs Appropriations Act of 2019, funds a net total of $144 billion in base discretionary spending, $33 billion for defense, and $112 billion for nondefense purposes. The totals reflect the amount specified in the Bipartisan Budget Act of 2018.

Division A of the appropriations package funds the Energy and Water Development and Related Agencies Appropriations Act at nearly $45 billion,

providing for national security and energy and water infrastructure investments.

The bill would increase Federal investments in nuclear security by $600 million above fiscal year 2018, then totaling more than $15 billion.

As President Trump has repeatedly stated, our Nation must modernize its aging nuclear forces. They are the centerpiece of our deterrent strategy, and we cannot allow them to degrade to a point where they become functionally useless.

To prevent this outcome, nuclear weapons activities, especially Navy nuclear reactors, all continue to receive funding. Congress must not leave the United States unprepared while our adversaries continue to advance their own nuclear weapons programs.

Division A also improves the security of our energy infrastructure. Most Americans take for granted the ability to easily access electricity, but that convenience is tenuous. The electric grid is massive, it is complex, and it is vulnerable to cyber and physical attacks. These threats have become increasingly likely as more operations go online or are connected to a network which is not secure.

This bill appropriates $117 million to ensure that our energy infrastructure operators have the resources they need to develop these defenses.

Additionally, the bill supports the completion of the Yucca Mountain nuclear waste repository, helping to ease the risk and burden of storing nuclear waste in temporary storage sites across the country.

In 2007, the Energy Independence and Security Act gave the Department of Energy authority to regulate incandescent light bulbs through the law's excessive energy efficiency standards, effectively killing free market competition.

Therefore, I submitted an amendment that would prohibit the use of Federal funds to carry out these onerous enforcement standards. This amendment has been included in the Energy and Water Development appropriations bill every fiscal year since 2011, and I look forward to continued consumer choice in this market.

Division A includes the United States Army Corps of Engineers. In Texas' 26th Congressional District that I represent, the Army Corps has been instrumental in ensuring the thorough maintenance, repair, and safety of Lake Lewisville Dam, which sustained damage due to heavy rains in the north Texas area in 2015.

This is just one example of the important work the Army Corps performs throughout the United States, and the bill increases funding of the agency to more than $7 billion for fiscal year 2019.

The bill also repeals the massive overreach of Federal authority known as the waters of the United States rule, promulgated by the Environmental Protection Agency and the United States Army Corps of Engineers. This rule changed the definition of navigable waters subject to Federal regulation under the Clean Water Act, placing significant costs on property owners.

Last, the bill prohibits the use of nuclear nonproliferation projects in Russia without certain notifications from the Secretary of Energy.

Division B appropriates $3.8 billion for the legislative branch. This encompasses the House of Representatives and joint operations with the Senate.

The House of Representatives is funded at $1.2 billion, which is $25 million below the President's budget request. Funding also supports Capitol security and police forces, services for visitors, and Capitol operations and maintenance.

The Capitol Police are funded at $456 million, an increase of $30 million above fiscal year 2018. Last year, we learned just how vital the Capitol Police are when they responded to and stopped a shooter who opened fire at a congressional baseball game practice.

The bravery and skill demonstrated by those agents are what allows Members of Congress, our staff, our support personnel, and visitors to go to work or visit the Capitol complex every day without fear. They deserve our full support.

The Office of Compliance is appropriated over $5 million for employee and Member workplace rights training. This funding will also support a dispute resolution process that is fair and accessible for all.

The bill also includes almost $580 million for the Government Accountability Office so that it may continue its vital work of oversight and reporting on how Federal programs are using taxpayer dollars.

Two important things that the bill does not fund are a cost-of-living increase for Members of Congress and allowances for former Speakers of the House.

Division C of the appropriations package provides over $96 billion in discretionary funding for Military Construction and Veterans Affairs, an increase of more than $4 billion over fiscal year 2018.

Nearly all of the increase in funding goes toward supporting the efforts and the services of the Department of Veterans Affairs. Robust funding for Veterans Affairs will ensure that those who have served our country have access to quality services.

This bill includes a total of $194 billion in discretionary and mandatory funding for Veterans Affairs, which is $9 billion more than fiscal year 2018.

Importantly, this bill provides more than $71 billion for Veterans Affairs medical care and more than $1 billion in funding for the Department of Veterans Affairs to deploy a new electronic health records system that aligns with the Department of Defense.

Mr. Speaker, this is something that we have been promised since 2006. This will allow our veterans an easier transition into the Veterans Affairs system than they experience today.

The bill also includes funding for reducing the disability claims backlog so that veterans will receive more timely compensation.

Yesterday, the VA MISSION Act was signed into law. American veterans deserve the best possible care, and this bill gives the Department of Veterans Affairs the resources to work towards providing that care for the 7 million patients who are expected to receive Veterans Affairs treatment in fiscal year 2019.

Additionally, this bill funds construction, operation, and maintenance of housing for our troops and medical and education facilities at over $10 billion.

This is the first step toward funding the government and its essential programs for fiscal year 2019. This year, Congress will do its job to ensure smart, efficient, and appropriate use of taxpayer dollars.

H.R. 3, the second bill contained in today's rule, is the rescissions package to cut stagnant and unused prior-year Federal funding.

President Trump submitted and recently revised a proposal to rescind approximately $14.5 billion of budget authority, affecting 15 Federal departments and agencies. These include unobligated balances from the Department of Energy's Advanced Technology Vehicles Manufacturing Loan Program and the Innovative Technology Loan Guarantee Program; the Department of Housing and Urban Development's capital fund; the Department of Justice's Assets Forfeiture Fund; the Department of State's Complex Crisis Fund; and unnecessary funding for the Millennium Challenge Corporation, among other things.

President Trump recently revised his request to withdraw the proposed rescission of emergency Ebola funds as well as supplemental appropriations for Superstorm Sandy recovery and to decrease proposed rescissions to Housing and Urban Development's capital fund and Treasury's capital management fund.

Two provisions related to the Children's Health Insurance Program should be noted.

The first rescinds over $5 billion that was included in the Medicare Access and CHIP Reauthorization Act of 2015 that supplements the fiscal year 2017 allotments to States. This was in addition to the annual Children's Health Insurance Program appropriation to reimburse States for Children's Health Insurance Program expenses. The remaining funds are no longer needed.

The second provision rescinds almost $2 billion made available to the Children's Health Insurance Program contingency fund, which is used to provide payments to States that have funding shortfalls. The Centers for Medicare and Medicaid Services currently does

not expect any State to need a payment from the contingency fund during the current fiscal year.

It is important that the American people understand that these Children's Health Insurance Program rescissions will have no impact on the current Children's Health Insurance Program.

Early this year, Republicans passed and signed into law the longest and most generous extension to the Children's Health Insurance Program in its 20-year history. When House Democrats were presented this opportunity, they voted against it not once but twice.

Mr. Speaker, when Federal funds are no longer needed in an agency or have not been obligated, Congress should do the right thing and use these taxpayer dollars to reduce the deficit.

I support passage of the rule to allow debate on these important priorities. I urge Members to support today's rule and both underlying bills.

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

Mr. Speaker, I yield myself 30 seconds.

Mr. Speaker, February 9 of this year, the House of Representatives passed the most generous extension of the Children's Health Insurance Program since its inception in 1996. The gentlewoman from California voted against that extension.

Mr. Speaker, I yield 3 minutes to the gentleman from Ohio (Mr. Gibbs), a valuable member of the Transportation and Infrastructure Committee and the Committee on Agriculture.

Mr. Speaker, I yield myself 30 seconds.

Mr. Speaker, I would like to point out that as of June 7 of this year, Republicans in the 115th Congress have provided consideration for over 1,200 amendments on the House floor.

Mr. Speaker, during the entirety of the 111th Congress, when Speaker Pelosi was Speaker, the Democrats allowed less than 1,000 amendments to be considered on the floor. Their majority blocked nearly 3,000 amendments that year in Congress.

Mr. Speaker, I yield myself an additional 30 seconds.

I would like to recognize that on February 9 of this year, the most generous extension of the Children's Health Insurance Program--for 10 years' time--was passed by the House and eventually signed into law. The gentleman from Massachusetts fought against that.

Mr. Speaker, I yield 3 minutes to the gentleman from California (Mr. Knight).

Mr. Speaker, I yield myself 2 minutes.

Mr. Speaker, I certainly appreciate the gentleman's service to our country. I would point out that I worked as a physician in a VA facility in the 1970s, and I am well aware of the good work that the doctors and nurses in VA facilities provide.

I would like to point out that, in the Statement of Administration Policy, the administration expected the MISSION Act to be in place by the beginning of fiscal year 2018. Do remember that this was one of the promises that then-candidate Trump promised to the Nation, that he would make the funding of the veterans programs a priority, and I believe he has done that.

Continuing to quote from the administration: ``The delay in enacting the MISSION Act's new community care program increases the requirements to continue the VA's current traditional community care program by an additional $1.6 billion in fiscal year 2019.''

Here is the important point: ``The administration looks forward to working with Congress to secure this funding within the existing nondefense discretionary cap.''

I think it is fair to say there is more to come.

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

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

Mr. Speaker, I yield myself 1 minute.

Mr. Speaker, I will point out that one of the things that the Military Construction and VA appropriation does fund is the improvements to the VA Electronic Health Record. This is something that has been sought by this Congress and previous administrations going back to 2006. I am happy to say that in this appropriations bill it is being taken care of.

Three administrations is too long for that to happen. I am grateful for the focus that the administration put on this problem, and I am grateful that they have finally gotten it solved.

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

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

Mr. Speaker, as of June 7, 2018, Republicans in the 115th Congress have provided for consideration of over 1,200 amendments on the House floor. Over 570 of those amendments have been proposed by Democrats, 480 proposed by Republicans, and 190 were bipartisan. That is 46 percent Democratic amendments, 39 percent Republican amendments, and 16 percent were bipartisan.

By contrast, during the entire 111th Congress, that was the last Congress where Speaker Pelosi was the Speaker of the House, Democrats were in the majority. During the entire 111th Congress, Speaker Pelosi allowed less than 1,000 amendments to be considered on the House floor, and, in fact, the Democratic majority blocked 3,000 amendments, with roughly 2,400 during, actually, the first session, the first year of that Congress.

These numbers include measures where the summaries of amendments submitted are publicly available, but at that time, due to the lack of the majority's transparency, the number is likely much higher that were blocked.

Now, look, Chairman Sessions of the Rules Committee has made it a point

to ensure that every single Member has the opportunity to submit their amendments and come to the Committee on Rules and share their thoughts and concerns. And as the gentlewoman knows well, there is no clock in the Rules Committee. Any Member can come and spend as much time with us as they wish.

Mr. Speaker, today's rule provides for the consideration of two important pieces of legislation: H.R. 5895, the Energy and Water, Legislative Branch, and Military Construction and Veterans Affairs Appropriations Act of 2019, and H.R. 3, the Spending Cuts to Expired and Unnecessary Programs Act. Both are responsible measures that take seriously our responsibility to be vigilant stewards of the Federal taxpayers' dollars.

I want to thank the President for his leadership in eliminating unused and unnecessary funding from past years, a responsible approach that until this President has been underutilized. I urge my colleagues today to support the rules and the two underlying pieces of legislation.

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

Mr. Speaker, I rise today to honor the public service of Mr. Gary Shafferman, Principal of Edward S. Marcus High School in Flower Mound, Texas and congratulate him on his retirement after a successful thirty-five year career in education. Upon retirement, his dedication and leadership will be greatly missed by his Lewisville ISD colleagues, as well as the students and parents he served so well at Marcus High School.

Mr. Shafferman received his bachelor's and master's degrees in education from the University of North Texas. He began his career in education as a science teacher and coach in Grand Prairie ISD. Prior to spending ten years as principal at Marcus High School, he served at schools across North Texas as a coach, teacher, counselor, assistant principal, and principal. Throughout his career, Mr. Shafferman has fostered close working relationships amongst community leaders, parents, and staff, and he has encouraged his students to pursue excellence and achieve their greatest potential.

Please join me in recognizing Mr. Gary Shafferman, Principal of Marcus High School, for his commitment to the teaching profession, his sincere dedication to the education and well-being of his students, and his many years of exemplary public service. It is a privilege to represent the students, families, teachers, and staff of Lewisville ISD in the U.S. House of Representatives.

Mr. Speaker, I rise today to recognize Heroes Park in Providence Village, Texas. Heroes Park, which will be dedicated on Memorial Day of this year, seeks to honor the selfless acts of men and women in uniform, first responders, and other unsung heroes. Today I would like to thank the Providence Village Hope Foundation for its work to establish this park and support our community's men and women in uniform.

Each Memorial Day, we remember the brave members of our Armed Services who put their service to our nation first. While Heroes Park is a physical tribute to them, our gratitude and respect extends far beyond the confines of its land.

I am grateful to join Providence Village Mayor Michael Jordan and Providence Village Hope Foundation Founders Eric and Karen Mattson to dedicate this beautiful park, and pay tribute to North Texas service members past and present.

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 905 and ask for its immediate consideration.

Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Florida (Mr. Hastings), 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 to revise and extend their remarks.

Mr. Speaker, House Resolution 905 provides for the consideration of three important bills aimed at protecting our country, reducing regulatory burdens in the financial sector, and allowing patients who have nowhere else to turn with another option to potentially save their lives.

These three bills, taken together, show House Republicans' commitment to putting Americans' interests first.

Today's rule provides for a structured rule to begin consideration of H.R. 5515, the National Defense Authorization Act for Fiscal Year 2019. The resolution grants 1 hour of debate equally divided between the chair and ranking member of the House Committee on Armed Services.

In addition, as the first of two likely rules on the fiscal year 2019 NDAA, the rule provides for the consideration of 103 amendments to the defense bill.

Along with the Defense Authorization Act, the resolution today provides for a rule for House consideration of S. 2155, the Economic Growth, Regulatory Relief, and Consumer Protection Act, the Senate- passed bipartisan bill to reduce the regulatory burdens imposed on community and local banks by the Dodd-Frank financial regulatory legislation.

The legislation went through rigorous debate in the House and the Senate, and it mirrors in many ways the House-passed CHOICE Act, passed by the House in the summer of 2017 under the stewardship of Financial Services Chair Jeb Hensarling.

Moreover, the resolution before us provides for a rule to allow the House to consider the unanimously passed Senate bill, S. 204, the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017.

This legislation, highlighted by the President during his last State of the Union address, has been a top priority of the President for the Congress, allowing terminally ill patients a last chance at survival using a carefully crafted FDA process.

H.R. 5515, the National Defense Authorization Act for Fiscal Year 2019, would authorize appropriations for military activities of the Department of Defense and for military construction, as well as prescribe military personnel strengths for the next fiscal year.

This critical piece of legislation, one of the most important bills that any Congress will consider in any year, provides the resources and the direction necessary for our men and women in uniform to do what they do best: protect and serve our country throughout the world.

As will be discussed by many Members of this body over this week, this bill touches on all aspects of military policy, from the Middle East to the Korean Peninsula to the Arctic waters.

Among the hundreds of amendments the Rules Committee is likely to make in order on this legislation, I am pleased that, once again, my amendment, offered with Ms. Lee, Mr. Lance, Mr. DeFazio, Mr. Jones, Mr. Welch, Mr. Lewis, and Ms. Schakowsky, will again be made in order. This continues to push the Department of Defense to finally complete a full audit of its finances, as required by law.

S. 2155, the Economic Growth, Regulatory Relief, and Consumer Protection Act, corrects some of the more egregious provisions in the Dodd-Frank financial regulatory legislation.

The bill focuses on regulatory relief on smaller financial institutions--namely, community banks and credit unions--so they can more readily meet the needs of their local communities without burdensome Federal regulations stifling their economic growth. This places the focus of the financial institutions back on their customers instead of completing paperwork and answering to agencies in Washington, D.C.

Finally, Mr. Speaker, our final bill in today's rule, S. 204, will look familiar to many people here today, as we are again considering legislation that would bring hope to terminally ill patients across our country.

A similar bill, H.R. 5247, passed this House in March. Minority Leader Chuck Schumer and Senate Democrats have refused to act on H.R. 5247, the revised version of the Right to Try legislation, which passed the House 2 months ago on a strong bipartisan vote.

As this body had heard earlier this year, Right to Try was the one piece of legislation that President Trump came and stood in the well of this House and specifically promised to the American people in his State of the Union address.

Today, I will say again what I said in March when we first took up Right to Try: I stand with the President and I stand with the thousands of Americans with terminal diseases and their families and their friends in getting this important policy to the President's desk.

Mr. Speaker, when we pass this bill today, it doesn't go back to the Senate. It has already been passed by the Senate. It goes immediately down to the White House for a signature and becomes law.

Here is an interesting fact. In the last couple of months since the House passed its Right to Try bill, even more States have joined this strong grassroots movement. Now, 40 States, including my home State of Texas, have passed and signed a version of Right to Try into law.

In nine other States, a version of Right to Try has already been introduced, including the State of New York, which is the home State of the minority leader of the United States Senate.

Last year, the Energy and Commerce Health Subcommittee held a hearing on access to investigational drugs where S. 204 was discussed. At that time, the Commissioner of the Food and Drug Administration, Dr. Scott Gottlieb, and other advocacy groups expressed concerns on the various Right to Try bills introduced in the Senate and the House.

So, when the President asked the Congress to act, the House responded by holding multistakeholder discussions with patient groups, medical research advocates, and the administration in order to improve the original Right to Try bill. I want to commend Chairman Walden for leading these negotiations.

I am also proud of the revised Right to Try legislation that the Energy and Commerce Committee produced because the policies were sound, and I believe it was a positive step forward in granting access to new treatments while allowing additional input from the Food and Drug Administration.

Unfortunately, the minority party on the other side of the Capitol, Senate Democrats, said ``no, thank you'' to the revised House bill. While I am not surprised by their decision, I think the American people, particularly patients

with terminal diseases and their loved ones, would not be satisfied with a ``no, thank you'' nonaction by Congress on such an important issue.

Today, the House is ready to act for the American people and will be considering S. 204, the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017.

This passed the Senate unanimously last August. This bill will offer terminally ill patients a chance at life. After it passes this House, it will be signed into law.

Our Nation has achieved unprecedented innovation and scientific breakthroughs recently and over the course of the last decade. American patients have widespread access to innovative treatments, thanks to researchers and our academic institutions and those working in the pharmaceutical and medical device industries.

Despite these achievements, we continue to hear from patients with serious, life-threatening conditions, including my constituents from north Texas, who remain frustrated with what they see as regulatory barriers from trying new therapies when everything else has failed them.

As a physician, I understand that access to investigational drugs and therapies is a deeply personal priority for those seeking treatment for loved ones diagnosed with very difficult diseases.

This crossroads where our Nation seems to be--when a potentially lifesaving treatment, while not approved, both exists but remains unavailable--is an important debate that we are having for these Americans. To them, it is not only a matter of life or death but another chance to spend more time with their children, grandchildren, parents, and other family members.

Some of the opponents of Right to Try point to the Food and Drug Administration's current expanded access program, which is aimed at helping patients who do not qualify for clinical trials gain access to therapies that the agency has yet to approve.

While this program makes a good faith effort to help patients, we can do more by passing Right to Try and creating an alternative pathway for these patients to access eligible investigational drugs.

Additionally, we know that many individuals may not qualify for a clinical trial if they do not meet strict patient inclusion criteria, which may include factors such as age, gender, type and stage of their disease, previous treatment history, and other medical conditions.

There are also many patients for whom participation in a clinical trial is not feasible, especially those who live in rural areas far from the clinical trial sites.

Most, if not all, of the patients with a terminal medical condition fall into one of these categories. This legislation that we are doing today allows these patients to participate in an alternative pathway, opening another door to investigational drugs that does not exist today.

While there are a few differences between S. 204 and the House-passed Right to Try legislation, the underlying policies between the two bills are very similar.

For example, only certain investigational drugs are considered eligible under both bills. In order to qualify, the drug must have completed a phase one clinical trial; have an active application at the Food and Drug Administration; be under active development or production by a manufacturer; and not have been approved, licensed, or cleared for sale under current law.

Also, both bills require reporting of serious adverse events, having written informed consent to the treating physician, and notifying the agency when a sponsor provides an investigational drug.

Lastly, Commissioner Gottlieb at the Food and Drug Administration recently expressed support for the Senate-passed Right to Try bill being considered today and said that his agency could ensure an appropriate level of patient safety through guidance and rulemaking.

In other words, while the Food and Drug Administration may have some additional work, the key point is the agency can achieve the proper balance of ensuring patient safety and granting access to new investigational drugs.

I think the Commissioner would agree that we would have preferred the revised House Right to Try legislation, but doing nothing is currently not an option. Hundreds of thousands of Americans with terminal illnesses and their families are looking for us to act. I support restoring hope for these patients and giving them a fighting chance at life.

Mr. Speaker, I urge Members of this esteemed body to support today's rule and all three underlying bills, and I reserve the balance of my time.

Madam Speaker, I yield 2 minutes to the gentleman from Michigan (Mr. Bergman), a member of the Financial Services Committee.

Madam Speaker, I yield 1 minute to the gentleman from Indiana (Mr. Messer).

Madam Speaker, I yield myself 30 seconds for purposes of rebuttal before I yield to the gentleman from North Carolina (Mr. Budd).

As a point of situational awareness, as of last week, in this Congress, over 1,000 amendments have been heard on the House floor: 47 percent Democratic, 41 percent Republican, 15 percent bipartisan.

For a point of reference, the last term that Nancy Pelosi was Speaker of the House, the 111th Congress, less than 1,000 amendments for the entire Congress. We passed that milestone prior to last week. We will continue to hear amendments on the floor.

Madam Speaker, I yield 1 minute to the gentleman from North Carolina (Mr. Budd).

Madam Speaker, I yield 1 minute to the gentleman from Georgia (Mr. Loudermilk).

Madam Speaker, I yield 1 minute to the gentleman from Ohio (Mr. Davidson).

Madam Speaker, I yield 1 minute to the gentleman from Tennessee (Mr. Kustoff).

Mr. Speaker, I yield an additional 30 seconds to the gentleman.

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

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

Mr. Speaker, I yield myself 1\1/2\ minutes for the purposes of a response.

I would, of course, lead with the observation that those who do not remember their history are doomed to repeat it. I don't remember precisely who said it, but I think it bears repeating today.

In the 111th Congress, Speaker Pelosi and the Democrats allowed less than a thousand amendments to be considered on the floor.

Of the bills that were considered at that time, the Dodd-Frank bill was one of those bills. The amendments that were blocked by the Democrats in the 111th Congress were precisely the type of amendments that we are now considering today in the bill to alleviate some of the obstructions, some of the gridlock that has occurred with our credit unions and smaller banks--things that people have been asking us for repeatedly for the last 5 to 7 years.

Mr. Speaker, the number of amendments that were blocked in the 111th Congress was significant. We have a chance today to undo some of that process, and I believe we ought to take that opportunity. As of 1\1/2\ weeks ago, over a thousand amendments had been made in order in this Congress.

The Committee on Rules is run differently today than it was in the 111th Congress. It used to be that you had to submit 45 copies of an amendment and you had a time limit by which you had to submit those amendments. You can submit amendments late now.

Mr. Speaker, I yield an additional 30 seconds to myself.

Chairman Sessions has been very accommodating in allowing us to bring amendments to the Committee on Rules late.

There is no clock in the Committee on Rules, as the gentleman well knows. You can talk as long as you want in the Committee on Rules about your amendments, and you can offer whatever amendments you prefer.

The process is not ideal, but it is important that we move forward with these important reforms that people have been asking us for years. And, today, that day is at hand, and those reforms will be delivered.

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

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

Mr. Speaker, seeing no more speakers on my side, I am prepared to close.

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

Mr. Speaker, I again want to reiterate, the Rules Committee has spent hours listening and considering Member testimony. We have welcomed over 225 Members to testify during this Congress, and roughly 493 times have made over 1,000 amendments in order, including 474 from Democrats, 383 from Republicans, and over 150 which were bipartisan amendments.

The rule today is important, three important pieces of legislation.

The National Defense Authorization Act. Our number one priority when we are elected to this body is the defense

of our Nation, and we are authorizing that expenditure today.

The bill to reform the financial services institutions is one that has been requested by small banks and credit unions for years, and this body is today prepared to deliver.

Then finally, the Right to Try Act. The President stood in the State of the Union message and said that it was not correct that people had to go to other countries in order to get the medicines that they needed to prolong their lives. He wanted that to end, and today we are taking the step to end that.

Mr. Speaker, I urge my colleagues to support today's rule and the three underlying pieces of legislation

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

Mr. Speaker, I was unavoidably detained. Had I been present, I would have voted ``yea'' on rollcall No. 210.

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

Mr. Speaker, I move to suspend the rules and pass the bill

(S. 292) to maximize discovery, and accelerate development and availability, of promising childhood cancer treatments, and for other purposes.

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 into the Record on the bill.

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

Mr. Speaker, today, we are here to debate the Childhood Cancer Survivorship, Treatment, Access, and Research Act, also known as the Childhood Cancer STAR Act.

Each of us knows someone who has suffered from cancer, whether it is a family member, friend, patient, or loved one. It is especially heart- wrenching to watch children go through a cancer diagnosis and cancer treatment.

The bill we are considering today is for our children, the future of our Nation. I would like to acknowledge and thank my fellow Texan, Congressman Michael McCaul, for leading our work to deliver hope to America's youngest cancer patients.

Congress has done remarkable work to pass legislation such as the 21st Century Cures Act, which provided Americans with great hope that increased investment in biomedical research would lead to treatment and even cures for our most devastating diseases.

The 21st Century Cures Act authorized over $4.5 billion in new funding for the National Institutes of Health, including nearly $2 billion for the Cancer Moonshot.

The Childhood Cancer STAR Act builds upon the mission of 21st Century Cures but focuses on empowering the National Institutes of Health and the Centers for Disease Control and Prevention to increase the amount of research and surveillance for cancer in children, adolescents, and young adults.

Groundbreaking discoveries rely on robust and reliable investment in research, and this requires robust and reliable dollars for research.

This bill authorizes $30 million a year through fiscal year 2023 for the National Childhood Cancer Registry, which will provide grant funding for the purpose of collecting information to better understand the epidemiology of cancer in children, adolescents, and young adults.

The bill also authorizes the National Cancer Institute at the National Institutes of Health to make awards that will support childhood cancer biorepositories, giving physicians and researchers tools to better understand these diseases.

Mr. Speaker, it is vital that physicians and their teams can provide comprehensive and coordinated care for pediatric cancer patients. The bill allows the Secretary of the Department of Health and Human Services to make grants to establish pilot programs to develop, study, or evaluate model systems to improve the quality and the efficiency of care for childhood cancer survivors.

It also provides for greater efficiency and coordination of care for those survivors as they transition into adulthood and for the Secretary to work with experts to identify best practices.

Similarly, this bill gives the National Institutes of Health Director the authority to make grants to programs that conduct or support research relating to pediatric cancer survivors.

As I have said, this legislation is for our children. It is for the families that are building our Nation's future. If we can ensure that these young patients receive treatment and cures for childhood cancer, they may grow up to become biomedical researchers who will find the next generation of cures; they may write the next great American classic; they may become prima ballerinas, Olympic athletes, or all of the above.

This legislation is for kids like Sadie. Sadie was diagnosed with ALL, acute lymphoblastic leukemia, on February 25, 2015. She was just 7 years old at the time. This young north Texan fought through infections, blood transfusions, and rare side effects. She missed out on second grade and she missed out on third grade as she underwent weekly chemotherapy sessions.

Today, it is my great joy to share that Sadie beat the odds and Sadie survived leukemia. She received her last chemotherapy treatment May 26, 2017. Now, at 10 years old, Sadie is able to live the life of a normal kid.

I would like to thank Sadie and her family for their willingness to share their story and for their advocacy in support of this important legislation.

Mr. Speaker, I met Sadie in my office last spring, and I was inspired by her story. She started a nonprofit, the Sadie Keller Foundation, to raise money to help other kids who are facing cancer. Her mission is pretty simple. It is to put a smile on the faces of children fighting cancer all over the country and to remind them to keep fighting.

So, today, I urge Members of Congress to support this important bipartisan legislation. In sending this bill to the President's desk, we will help Sadie achieve her mission of putting a smile on the faces of children fighting cancer. We will provide families across this country with hope for a better tomorrow.

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

Mr. Speaker, I yield as much time as he may consume to the gentleman from Oregon (Mr. Walden), the chairman of the full committee.

Mr. Speaker, I yield 2 minutes to the gentleman from New Jersey (Mr. Lance), vice chairman of one of our subcommittees.

Mr. Speaker, I yield 5 minutes to the gentleman from Texas (Mr. McCaul), chairman of the House Committee on Homeland Security, fellow Texan, and the principal author of the bill that we have before us today.

Mr. Speaker, I yield 2 minutes to the gentleman from Tennessee (Mr. Roe).

Mr. Speaker, I, too, want to express my strong support for S. 292, the Childhood Cancer Survivorship, Treatment, Access, and Research Act of 2018, Childhood Cancer STAR Act.

And, once again, I want to thank my colleague, the gentleman from Texas (Mr. McCaul), for spearheading this effort.

I urge all my colleagues to support the legislation.

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

Mr. Speaker, pursuant to House Resolution 905, I call up the bill (S. 204) to authorize the use of unapproved medical products by patients diagnosed with a terminal illness in accordance with State law, and for other purposes, and ask for its immediate consideration in the House.

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

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

Mr. Speaker, here in the people's House, we reflect the will of the American people. When the Right to Try Act is law in 40 States, it may no longer just be a grassroots movement. It is a call to action from Americans from coast to coast--many of the over 1 million Americans who die from a terminal illness every year--to return choice and control over treatment options to where it is most effective: with the patient, with the doctor.

Today, the House is taking up the Right to Try Act for the third time. But the reason we are here again debating this issue is because of the Senate Democrats' refusal to take up the revised right-to-try legislation that passed this House by a bipartisan vote 2 months ago.

That revised bill, H.R. 5247, was more narrowly crafted than this version of S. 204.

This version, the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017, is before us today. S. 204 was authored by Senator Ron Johnson of Wisconsin and passed by unanimous consent in the Senate last August.

I think it is important, so let me take a moment to lay out the efforts by the Energy and Commerce Committee since that time.

First, the Energy and Commerce Health Subcommittee, which I chair, held a hearing last October to consider right-to-try bills, including this bill, S. 204, where Members heard from Dr. Scott Gottlieb, the Commissioner of the Food and Drug Administration, from patients and other groups that either support or oppose the concept of right to try.

For several months, our committee engaged in conversations with patients, advocates, the administration, particularly the Food and Drug Administration, and stakeholders on all sides of this complex topic.

Our aim was to open the door to innovative, experimental drugs for terminally ill patients without necessarily compromising the vital work and mission of the Food and Drug Administration. The product of that aim was H.R. 5247, the revised House right-to-try bill.

Sadly, Senate Democrats said ``thanks, but no thanks'' to the House bill. Frankly, I am perplexed by their decision, because not a single Senate Democrat expressed any reservation when S. 204 passed their Chamber by unanimous consent last August.

So House Republicans will show the American people that we hear you. We will act to deliver on a promise made by the President in this House before the joint session of the House and Senate during the State of the Union address. He told us that we would pass the right-to-try legislation. Well, today, we are doing just that.

You know, this was kind of a bold statement by the President, to stand up in the State of the Union and say that he wanted to sign this bill into law. So I am proud to boldly stand with him and stand with the American people.

Mr. Speaker, we live in the greatest Nation in the world. An unprecedented amount of innovation and scientific breakthrough is the norm. We have innovative treatments at our fingertips because of the valuable contributions of researchers in academia and the private sector.

Despite these achievements, I still hear from patients with serious, life-threatening conditions, including constituents from north Texas, who remain frustrated with the current regulatory processes that prevent them from trying or experimenting with new therapies when everything else has failed them.

As a physician, I understand that access to investigational drugs and therapies is a deeply personal priority for those seeking treatment for their loved ones with serious terminal conditions.

To my friends on the other side of the dais in the committee and the aisle here in the House, I have a simple question: Why do you not want to allow these patients to exercise their right to fight for their future?

Mr. Speaker, I am proud to support H.R. 5247, the House right-to-try bill that currently remains in the Senate.

However, the right-to-try legislation before the House today is the Senate bill, S. 204, so I am pleased that we are considering this right-to-try bill so that terminally ill patients have a chance, maybe a second chance, at life.

These patients are our constituents. They could be someone we know. Let us take this opportunity to improve access to experimental treatments for them and give them renewed hope.

S. 204 establishes an alternative pathway for terminally ill patients to access certain investigational drugs that have successfully completed a phase one clinical trial and have an active application at the Food and Drug Administration. They also must be under active development or production by the manufacturer.

It is important to note that, for these patients, they have exhausted all FDA-approved treatment options and are unable to participate in a clinical trial involving these investigational drugs.

The bill we will be voting out soon is about patients. It is about having more

time with their loved ones. In the words of Vice President Mike Pence, ``It's about restoring hope and giving patients with life-threatening diseases a fighting chance.''

With hundreds of thousands of Americans with a terminal illness and their families looking for us to act, I urge Members of this House, the people's House, to support restoring hope and giving them a fighting chance at life.

I urge a vote in support of S. 204. Let us send this groundbreaking legislation to the President's desk for his signature, and let it become the law of the land.

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

Mr. Speaker, I yield 5 minutes to the gentleman from Oregon (Mr. Walden), the chairman of the full committee.

Mr. Speaker, I am pleased to yield 3 minutes to the gentleman from Texas (Mr. Barton), the vice chairman of the full committee and chairman emeritus of the Energy and Commerce Committee.

(Mr. BARTON asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I yield an additional 30 seconds to the gentleman from Texas.

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

Mr. Speaker, I yield 2 minutes to the gentleman from Arizona (Mr. Biggs).

Mr. Speaker, I yield an additional 30 seconds to the gentleman from Arizona.

Mr. Speaker, I yield 2 minutes to the gentleman from Pennsylvania (Mr. Fitzpatrick), another principal author of the bill.

Mr. Speaker, I yield an additional 30 seconds to the gentleman from Pennsylvania.

Mr. Speaker, I yield myself 1 minute.

Mr. Speaker, I want to read from the Statement of Administration Policy that was put out by the Executive Office of the President.

The last paragraph:

Since the late 1980s, the Food and Drug Administration has facilitated access to investigational drugs, devices, and biological products for the treatment of seriously ill patients. Families in these situations have sometimes found this process challenging, and the Food and Drug Administration is constantly striving to make improvements to its expanded access program. Some patients and their families, however, still have challenges accessing investigational treatments. The administration believes that the treatment decisions for those facing terminal illnesses are best made by the patients with the support and the guidance of their treating physicians. This legislation will advance those principles.

Mr. Speaker, that is from the Statement of Administration Policy, and I reserve the balance of my time.

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

Mr. Speaker, on January 30 of this year, the President of the United States came to this House and addressed a joint session of the House and Senate in the State of the Union address, and he said, right from that podium, ``People who are terminally ill should not have to go from country to country to seek a cure. I want to give them a chance right here at home. It is time for Congress to give these wonderful Americans the right to try.''

Mr. Speaker, I couldn't say it any better than the President has already put it. The Right to Try Act is before us. It is a good bill. The House needs to support it, and it will go to the President for his signature.

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

Mr. Speaker, I claim the time in opposition to the motion.

Mr. Speaker, while the motion to recommit may be well intentioned, it has a practical effect of killing this bill because the Senate has rejected House attempts to refine the Senate bill that was passed by unanimous consent last August. So if you want to provide that right to try for patients, this is the vehicle.

Now, interestingly enough, the Food and Drug Administration Administrator, this morning, Dr. Gottlieb, put out a statement. He said that he is: ``. . . ready to implement it in a way that achieves Congress' intent to promote access and protect patients; and build on FDA's longstanding commitment to these important goals.''

Mr. Speaker, I urge people to vote against the motion to recommit and vote for the underlying bill. Let's give patients that expanded access, and I yield back the balance of my time.

Mr. Speaker, I rise today to recognize the Greater Denton Arts Council as it celebrates its 50th Anniversary as the home for Denton's artists and community organizations.

The Greater Denton Arts Council traces its roots back to 1967, when the Denton Chamber of Commerce formed a Fine Arts and Cultural Affairs Committee to demonstrate its support of the arts. In 1969, this committee became an independent entity and renamed itself the Greater Denton Arts Council (GDAC), becoming the umbrella organization for area arts, cultural and educational entities.

To address the need for a permanent arts facility in Denton, an ad hoc committee began planning in 1973 to reach that goal. A lease was finally negotiated by the GDAC in 1981 to convert several existing industrial buildings located at the southwest corner of East Hickory St. and South Bell Ave. Renovations began in 1984 to convert the warehouse located at the southwest corner of the intersection into what would become the Center for the Visual Arts (CVA). The CVA opened to the public with its first art exhibition in the Meadows Gallery. In 2014, the CVA was subsequently renamed the Patterson-Appleton Arts Center.

The GDAC also renovated the Campus Theatre building in the 1990s, converting the 1,200 seat movie house into a 300 seat live theatre and performance venue. In doing so, the GDAC preserved the unique late-deco design features of the structure and established a suitable local venue to support performing organizations.

In the decades since its inception, GDAC venues have provided local Denton County audiences with high-quality permanent and temporary exhibitions for local and national artists. Additionally, the GDAC has served as an umbrella organization for collaborative efforts with area universities, the Denton Independent School District and the City of Denton, including programs such as the ``Get Started with the Arts'' program to introduce Denton elementary students to classical music, visual arts, professional theater, ballet and opera.

GDAC has been an integral part of the annual Congressional Art Contest since 2003, serving as host of the annual High School Art Contest for the 26th District of Texas. Each year the GDAC has staged the exhibition and hosted the recognition reception for hundreds of North Texas students, their parents, and teachers following this professionally-judged contest.

As the GDAC meets for the presentation of the Community Arts Recognition Award (CARA) to this year's recipients, I extend my deepest appreciation on behalf of the constituents of the 26th District of Texas. The commitments of those recognized this year, along with the past and future honorees, are well-deserved for their role in support of educational and cultural mission of GDAC and the artistic and cultural presence that makes Denton, Texas such a unique place to call home.

Mr. Speaker, I rise today to recognize Deborah Leliaert, Vice President for University Relations and Planning, as she retires from her position at the University of North Texas.

Ms. Leliaert joined UNT in 1992 as director of news while attending UNT's Toulouse Graduate School. In 1996, she advanced to associate vice president for marketing and communication and UNT System associate vice chancellor for communications and marketing. She held this title until 2001 when the UNT System Board of Regents approved the creation of associate vice president for university relations. Ms. Leliaert was promoted into this new role to oversee the university's communications and marketing as well as visitor and public relations. She continued in this capacity as associate vice chancellor for communications and marketing for the UNT System.

In a career spanning more than a quarter century of UNT's history, Ms. Leliaert witnessed a tremendous period of growth, challenge, and celebration, serving six presidents and three chancellors as the institution's chief internal and external spokesperson through much of this time. This window of UNT's history included its acceptance as a full member of the Association of Public and Land-grant Universities; countless new programs and building projects; new campuses; recognition of UNT as an emerging research institution and the development of ground-breaking relationships for the University through research efforts and public partnerships such as exists with UNT's current relationship with the Dallas Cowboys.

Managing much of the marketing and communications involved in supporting UNT's brand management and institutional reputation, Ms. Leliaert also supported UNT's ambitious student recruitment and retention objectives for a campus that has grown by almost 20 percent in only the second half of her tenure with UNT. Her efforts to bolster UNT in the media intersected with the rapid rise of social media and modern transformation of the media landscape.

Ms. Leliaert's talents, particularly her eloquence and skill to respond in times of crisis, will be sorely missed by the UNT community. As a proud UNT alumnus, I thank her for her contributions as a long- serving member of UNT's staff, and I wish her much happiness as she commences her retirement after a significant and successful career.

Mr. Speaker, I rise today to recognize Denton County, Texas and members of the Denton County Chambers of Commerce leadership delegation who have traveled here to Washington, D.C. These local officials and business leaders understand that policy made in Washington impacts our local communities at home.

During this productive visit, the group is meeting with members of leadership here in Congress, Department of Housing and Urban Development Secretary Ben Carson, as well as Senator Ted Cruz and Representatives from Texas and across the country. Additionally, these leaders are meeting with members of the U.S. Chamber of Congress and other national business leaders. They also have had the opportunity to visit the White House and the Federal Bureau of Investigations Headquarters.

Mr. Speaker, I include in the Record the following names of the Denton County delegation:

Rachel Bagley, Barry Bonds, Kevin Bryant, Fred Busche, Kevin Cruser, Andrew Eads, Lori Fickling, Barbara Fleming, Monica Glenn, Ken Heerman, Gary Henderson, Donna Hernandez, Kelly Heslep.

Cindi Howard, Dan Irvin, Roy Jackson, Dan Jaworski, Brandon Jones, James Kunke, Sunny Lindsey, Mike Lombardo, Jana Onstead, Nate Prevost, Ryan Schroer, Lori Walker, Neal Walker, Charlotte Wilcox.

Mr. Chairman, I have an amendment at the desk, and I rise to speak in support of the amendment.

Mr. Chairman, today, I offer an amendment to prevent a person from operating an unmanned aircraft or an unmanned aircraft system in the national airspace if that aircraft is equipped or armed with a dangerous weapon, unless that equipment is authorized by the Administrator of the Federal Aviation Administration. I have introduced this important language as the No Armed Drones Act since the 112th Congress.

In 2015, an 18-year-old in Connecticut built a multirotor drone mounted with a .45-caliber semiautomatic handgun capable of firing live ammunition while flying. This individual demonstrated how easy it was for a private citizen to create and operate an armed drone in his YouTube video entitled ``Flying Gun.''

Police did not arrest this person, saying that no violation of law had occurred. According to the then-chief of police in Clinton, Connecticut, where the drone video was made, this appeared to be a case of technology surpassing current legislation.

In response to this and other drone incidents, government agencies are developing counter-drone technology to redirect rogue drones. Police say their greatest fear, with the increase in the use of recreational drones, is their weaponization. In addition, North Dakota has allowed law enforcement to fly drones armed with ``less than lethal'' weapons since 2015, something many in law enforcement say they are not comfortable doing.

The use of drones for regular business operations is increasing, and that is a good thing. Farmers use drones to inspect their crops, security companies use drones to conduct surveillance over guarded properties, home repair companies use drones to assess damage on structures, and drones are even beginning to be used for home delivery services. While these abilities may prove convenient to our daily lives, we must not let the civilian applications of drone technology advance to weaponization.

Outside of the United States, terrorist groups in the Middle East have used small drones as weapons. There is real concern that homegrown extremists in the United States could do the same thing. It is imperative that we take steps to protect the public before death by armed drone becomes a headline.

There is no statute in the United States Code that affirmatively states that an unmanned aircraft system may not be used in the national airspace as a weapon. This amendment today protects the public from drones that have been weaponized, both lethal and nonlethal, by private citizens by preventing a person from flying an armed drone in the national airspace without FAA authorization. A person who violates this requirement may be fined a civil penalty of up to $25,000 per violation under the statute.

I offer this language as an amendment to the FAA Reauthorization Act of 2018 in order to align current legislation with available technology. It is time we take a preemptive, rather than a reactive, step to protect all Americans.

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

Mr. Chairman, I urge adoption of the amendment, and I yield back the balance of my time.