Floor Statements

Mr. Speaker, a quick history lesson:

CHIP, 1996, a bipartisan offering; a Democratic President, Bill Clinton; a Republican Speaker of the House, Newt Gingrich; as part of welfare reform, we are going to move people from welfare to work.

But what do we do about the children?

If those parents are moved into employment, they are going to lose their Medicaid. Their children will be lost at sea. So CHIP was created. CHIP was created as a block grant program, maximum flexibility to the States. It was authorized for 10 years.

Then when the Affordable Care Act passed, CHIP was authorized for 10 years; funded for 5 years, but authorized for 10 years. We are finishing up that tenth year of authorization with this bill. I actually wanted only a 2-year bill as we started. I compromised. Committee Democrats wanted a 5-year bill. Senate Democrats, Senate Republicans wanted a 5-year bill. We gave you a 5-year bill.

We funded community health centers. We delayed the DSH cuts that were part of the Affordable Care Act that our hospitals back home were saying we can't manage.

Remember, everyone was supposed to be able to lay down in the Elysian Fields of ObamaCare, except they are not, so our hospitals are tasked with taking care of uninsured and underinsured patients. We need to delay those DSH cuts.

But here is the thing that really strikes me. We passed a 5-year bill through this House. Two dozen Democrats voted for it. And then the Congressional Budget Office, between then and the end of the year, said: With the repeal of the individual mandate, it just got a lot less expensive; and, in fact, if you will broaden it out to a 6-year window, you will return money to the Federal Treasury.

What that tells me is that ObamaCare is so bad and makes everything so expensive and the States can do it cheaper.

Okay. The CBO put it on sale, and we should buy. And we brought it back to you on the floor, and the 2 dozen of you who said, ``We liked it before when it cost more,'' said you didn't like it when it actually returned money to the Treasury.

I don't know how we can intuit what you will take. We gave you a good bill. It was part of a 3- or 4-week continuing resolution. It is not that hard. Let's pass it. Let's do the right thing for America's children, our military, and Federal workers across this country.

Mr. Speaker, I rise today to recognize the exemplary work of Mr. James Gandy and congratulate him on his retirement. Mr. Gandy has served as the President of the Frisco Economic Development Corporation (FEDC) for 22 years, and in that time, has witnessed firsthand the economic boom that transformed Frisco from a small farm town to the economic hub it is today.

During his tenure, the FEDC facilitated more than 345 projects with an economic impact of $31.1 billion to the Dallas-Fort Worth Metropolitan area. As a result of his work, more than 27,000 direct on- site jobs have been created, amounting to one fifth of the jobs in Frisco today. Mr. Gandy played a key role in bringing the Stonebriar Centre Mall and globally recognized brands--including the Dallas Cowboys--to this once-small town. As a direct result of the completion of these projects, Frisco is the proud host to more than 6 million visitors per year.

Mr. Gandy's record of achievement does not stop there. This Frisco community leader was integral to forging public-private partnerships to create sports and entertainment venues, including the Ford Center at the Star, the Dr. Pepper Ballpark and Arena, the Toyota Stadium, and the Frisco Superdome.

As a result of his hard work, Mr. Gandy has received attention not only at the local level, but also from around our state. Under his leadership, the FEDC was awarded the 2017 Economic Development Leadership/Innovation award from the North Texas Chapter of CoreNet Global. The Dallas Business Journal, in the year 2012 and 2015, ranked the FEDC as number one among North Texas economic development agencies, and the FEDC was recognized as high performing in both 2013 and 2016 by Atlas Advertising.

He is truly an exemplary North Texas leader. Before serving on the FEDC, Mr. Gandy served on the Jackson County Chamber of Commerce as the Director of Economic Development for the City of Seguin, and as the President of the San Marcos Chamber of Commerce.

It is clear that Mr. Gandy has worked tirelessly to bolster the Frisco economy. Under his leadership at FEDC, the City of Frisco has seen an increase of the tax base of 38 times what it was when he took office. On behalf of the citizens and businesses of Frisco, I want to thank James Gandy for the unparalleled impact he has made on the city and wish him a very happy retirement.

Mr. Speaker, I rise today to recognize the exemplary work of Fire Chief Mike Duncan in his service to the City of Roanoke, Texas as we mark his retirement. During his sixteen years as Fire Chief in Roanoke, he has been a committed leader in his community.

Chief Duncan was a seasoned fire fighter when he joined the Roanoke Fire Department as chief in 2001. He first began his firefighting career in 1974 with the City of North Richland Hills Fire Department. Since that time, he has served his community tirelessly in a variety of leadership roles.

Throughout his years of service, Chief Duncan earned certifications as a Master Firefighter, Advanced Fire Inspector, a Fire Service Instructor II and as the Department Head for the Fire Department. He is a leading member of the Denton County Fire Chiefs Association where he served as Treasurer for 11 years, the Tarrant County Fire Chiefs Association where he served as President in 2004, the International Association of Fire Chiefs, the National Fire Protection Association, the North East Fire Department Association and the International Code Conference.

Chief Duncan has devoted 43 years to protecting his neighbors. For more than four decades, he has put strangers' safety above his own, and we are indebted to him. I am deeply grateful for his service to the City of Roanoke and North Texas, and I wish Chief Duncan and his family the best in his retirement.

Mr. Speaker, I thank the gentleman for yielding, and I thank him for his work as the chairman of the Appropriations Subcommittee that deals with funding public health as well as medical research.

I heard some comments about extension of the funding for the Children's Health Insurance Program at the beginning of the debate, and I wanted to

come to the floor and remind people that the Energy and Commerce Committee did do its work as far as continuing the funding for the Children's Health Insurance Program. It completed its work. We delayed a little bit at the request of committee Democrats, we delayed a little bit at the request of the ranking member of the full committee, but we did deliver a product the first part of October.

That product passed the floor of this House late October, early November. It passed with, of course, almost every Republican vote and over two dozen Democratic votes. It was, indeed, a bipartisan effort.

It funded the Children's Health Insurance Program for 5 years, which was the Democratic request; the funding levels were requested by the Democrats; and it was offset in a responsible way.

That bill is pending over in the United States Senate, and I, frankly, do not understand why the Senate minority leader will not release that bill for a vote by his Senators because it is, after all, Democratic Senators who represent States around this country that are going to suffer as a consequence of not passing this bill.

Mr. Speaker, I thank the gentleman for yielding.

Mr. Speaker, late in June of 2012, like many Americans, I anxiously awaited a ruling by the Supreme Court of the United States while they were considering the constitutionality of the individual mandate. Of course, we were

told during the run-up to that law, the Affordable Care Act law, that the individual mandate was not a tax; it was, in fact, just a requirement that everyone should buy the insurance.

It seemed unreasonable under the Commerce Clause that that requirement, in fact, would be constitutional. Then, at the end of June, the Supreme Court made the ruling. I was probably right that it was unconstitutional under the Commerce Clause. But with some creative work, the Supreme Court said: It is a tax, and the Congress has the absolute power to tax; so, of course, it can stay in the law, and the law stands.

So here we are today, considering tax reform for the first time in 31 years. And since the Supreme Court told us the individual mandate is indeed a tax, it is appropriate, it is right that the individual mandate be part of the discussion today.

The House bill, when we passed it, did not include anything on the individual mandate; but the Senate, in their wisdom, sent it back to us with the individual mandate repealed.

Now, make no mistake about it, the House has repealed the individual mandate any number of times over the last several years. The Senate has not. So the Senate has repealed the individual mandate for the first time.

I say: Let's meet them where they are, let's pass this bill, let's repeal the individual mandate, and get on with making America great again.

Mr. Speaker, I thank the chairman for yielding.

Mr. Speaker, I must confess, today I was astonished to read an article in one of the online magazines that House Democratic leadership had asked their Members to vote against this stopgap funding bill because of the stalemate over the funding of the State Children's Health Insurance Program. We just heard the chairman of the Energy and Commerce Committee detail the work that has already been done on this bill.

Let me assure this Congress, there are probably people in here saying: What do you mean? We voted on this bill. We voted this bill out of the House weeks ago. It was offset. Everything that the Senate asked for, they were delivered: the 5-year timeframe, the funding levels the Senate asked for. They got everything they wanted.

Yes, it was offset in a responsible fashion, but now we are told House Democratic leadership says vote ``no'' on this continuing resolution because we don't like the stopgap funding for the State Children's Health Insurance Program.

What in the devil do they want to happen? We did our work. We did our work. We had our legislative hearings on this bill in the summertime. We did delay things, unfortunately, 1 day. There was a shooting at a House baseball game--you may remember that--that caused us some delay, but we came back 2 weeks later. We got our work done.

We had a responsible bill. It was reflective of everything that was requested by the Senate. It was offset, as was requested by a number of Members of this body, and it has languished over in the Senate since the early part of October. It is time for the Senate to take up and pass that bill so we don't have to have this continued discussion.

This continuing resolution is important because it stops a problem that some of our States are going to face. It was completely unnecessary. The other body could fix it, and they should.

Mr. Speaker, I rise today to pay tribute to Uwe Reinhardt, a leading health economist whose work has shaped health care policy. Professor Reinhardt passed away this week at the age of 80, leaving behind a legacy of scholarship and dedication.

Professor Reinhardt was a longtime member of Princeton University. He started in 1967 as an assistant professor before rising through the ranks to become the James Madison professor of political economy and professor of economics and public affairs at the Woodrow Wilson School.

Throughout his career, Professor Reinhardt became known as a leading expert in health economics. He served on the governing council of the Institute of Medicine and on the Physician Payment Review Commission, and won countless awards for his work.

Born in Germany in 1937, Professor Reinhardt later moved to Canada. He earned his bachelor of commerce degree from the University of Saskatchewan in 1964, and his Ph.D. in economics from Yale University.

While I did not always agree with Professor Reinhardt, I always found him to be agreeable, and I always learned something from each encounter with him. He will be missed.

Mr. Speaker, I want to share with you a letter that was received in the Rules Committee last night.

It is a letter actually addressed to Chairman Kevin Brady of the Ways and Means Committee. It is from the Joint Committee on Taxation. It is a long letter. I will not read all of it. Some of it is difficult to understand, but let me pick out the important points.

In each case, the taxpayers' total income tax liability is lower. Here is their concluding paragraph:

In its totality, the combined effect of the tax rate and

the income threshold and amendments made by the bill, along

with the increase in the standard deduction, would not, in

and of themselves, result in an increase in the amount of tax

imposed on virtually any filer as a result of these changes.

Translation: no one's taxes go up; not 36 million; not 3,600; not 36. According to the Joint Committee on Taxation, that number is zero, Mr. Speaker.

Mr. Speaker, I thank the chairman of the Rules Committee for yielding.

Today, the House of Representatives is considering tax reform for the first time since 1986.

In the last 31 years, the world has changed a lot and it is time that we bring the Tax Code into the 21st century. This needed tax reform will put our country on a path to long-term economic stability and help hardworking families around the country get ahead.

The Tax Cuts and Jobs Act will help American families in important ways. First, it focuses on Americans in the middle of the earning scale by doubling the standard deduction and creating a new family flexibility credit for nondependents. Taxpayers will be able to deduct even more from their taxable income, reducing the need for tedious itemization.

In addition, the bill repeals the alternative minimum tax. This tax was never intended to be as broad as it has become, but because it was not indexed for inflation when it was introduced, many of us find ourselves having to calculate our taxes twice to see if we are ensnared by the alternative minimum tax. It is time for this one to go away.

With decreased taxation, American families have more money in their pockets, resulting in greater contributions to the economy.

The bill also alleviates some of the cost of raising children by expanding the child tax credit. It preserves the adoption tax credit so parents can continue to receive additional tax relief as they open their hearts and their homes to an adopted child.

This bill reduces the number of tax brackets from seven to four, with rates of zero, 12, 25 and 35 percent for most taxpayers. It does preserve the 39.6 percent rate of the previous administration for the highest earners. These reforms will help simplify the Tax Code and make it more competitive for hardworking American families.

I am grateful the Ways and Means Committee kept the step-up in basis, despite repealing the estate tax by 2024. The step-up in basis is an important component of estate planning when people are planning for future generations. This will allow people who may experience a tragedy to continue ownership of family property without bearing excessive penalties.

Mr. Speaker, I am a supporter of the flat tax. I have introduced H.R. 1040 in every term that I have been in office, but I recognize this bill makes a lot of needed reforms and repeals some credits while maintaining those important to American taxpayers.

Donors will still be able to make tax-exempt charitable contributions, employers will still be able to contribute to 401(k) retirement savings accounts, new homeowners will be able to deduct the interest expense on up to $500,000 of a mortgage, and no changes are made as to Social Security.

I was actually hoping we could lower Social Security taxes. We couldn't. But we certainly do not increase Social Security taxes, despite what some of the fake news says.

Students will continue receiving a credit through the consolidated American opportunity tax credit.

Simply put, this bill will promote growth at middle-income levels, create a more favorable business environment, and continue important tax credits.

Mr. Speaker, I include in the Record the following letter from Thomas Barthold to Chairman Kevin Brody:

Congress of the United States,

Joint Committee on Taxation,

Washington, DC, November 14 2017.

Hon. Kevin Brady,

House of Representatives,

Washington, DC.

Dear Chairman Brady: You asked me to comment on the changes

made by H.R. 1 as ordered reported by the House Committee on

Ways and Means in the context of Clause 5(b) of Rule XXI of

the House of Representatives.

Clause 5(b) of Rule XXI sets special passage requirements

for measures that amend subsections (a), (b), (c), (d), or

(e) of section 1 or section 11(b) or 55(b) of the Internal

Revenue Code in a manner that imposes a new percentage rate

of tax and thereby increases the amount of tax imposed by

such section. H.R. 1 amends the relevant sections by

eliminating the 10-percent bracket, which is obviated as a

marginal rate as a result of the increase in the standard

deduction provided in section 63(c) and makes general changes

to the income thresholds at which the varying tax rate

brackets apply and eliminating several other tax rates of

present law. These changes combined with the increased value

of the child tax credit (in section 24) result in virtually

every taxpayer who formerly would have been in the 10-percent

tax bracket having a lower tax liability under the changes

that would be effectuated by H.R. 1 than they would under

present law.

Similarly, H.R. 1 eliminates the present-law 33-percent

marginal tax bracket. As a result there are some taxpayers

who would claim the standard deduction and had his or her

last dollar of income taxed in the 33-percent tax bracket

under present law but under H.R. 1 after claiming the

increased the standard deduction would have their last dollar

of income taxed in the 35-percent tax bracket. However, in

each such case the taxpayer's total income tax liability is

lower under H.R. 1 than under present law. For taxpayers who

eschew the standard deduction under present law there is

substantially greater variability in resulting tax

liabilities. With the elimination of some deductions that

taxpayers may elect to itemize under present law, it is not

possible to say in all cases that these taxpayers have lower

total income tax liability under H.R. 1 than under present

law. However, by comparison to the case of a taxpayer

claiming the standard deduction, the variability of these

results is clearly a consequence of the changes to the tax

base effectuated by H.R. 1 rather than a consequence solely

of the elimination of the present-law 33-percent bracket.

Because the House rule does not contemplate changes to the

Internal Revenue Code as a whole and the interactions such

changes have on tax liability, H.R. 1 requires a waiver of

the rule's provisions. In its totality, the combined effect

of the tax rate and income threshold amendments made by the

bill, along with the increase in the standard deduction,

would not, in and of themselves, result in an increase in the

amount of tax imposed on virtually any filer as a result of

these changes.

I hope this discussion is helpful. Please contact me with

any questions.

Sincerely,

Thomas A. Barthold.

Mr. Speaker, I rise today to honor the memory of former Shady Shores Mayor Olive Stephens. Mayor Stephens, who passed away on October 30 at the age of 101, was known for her commitment to her family, her neighbors, and the Shady Shores community. She was a dedicated public servant who helped Shady Shores grow from a small weekend fishing and camping spot to an incorporated city with a population of more than 2,800.

An East Texas native, Mayor Stephens and her late husband moved to Shady Shores in 1956 and opened a general store. In 1963, Olive Stephens began her public service career when she volunteered to serve on the Town Council. After 10 years as a council member, she ran for higher office, and in 1973 won a successful bid to serve as the first elected mayor of Shady Shores. Mayor Stephens served her community in this capacity for almost 40 years until she retired from full time public service at the age of 94.

A pioneer of local Texas politics, Olive Stephens left a legacy of lifelong commitment to public service. We will miss her leadership and passion for her Shady Shores community and all of Texas.

Mr. Speaker, I rise today to recognize Bob Williams and the non-profit animal rescue and counseling center he founded as Ranch Hands Rescue in Argyle, Texas.

Founded in 2008, Ranch Hands Rescue came to life as an outcome of a year-long recovery from a debilitating stroke Bob had suffered. With his background as a Motorola executive and a challenging recovery process, Bob was inspired with the recognition of the need for rescuing animals that would otherwise be euthanized. Rescuing the worst-of-the worst farm animal abuse and neglect cases, Ranch Hands Rescue was initially envisioned as a place that would provide a loving, caring and safe sanctuary to the animals that cannot be adopted due to special care needs.

Through his own experience with the rescued animals, Bob realized the therapeutic impact they could also have on mental health. In 2010 he started the Ranch Hands Rescue Equine and Animal Assisted Couseling (EEAC) program. Through the work of animal partners and Licensed Professional Counselors, Ranch Hands Rescue provides hope and healing for children, women, veterans and others suffering from painful mental health symptoms brought on by sexual assault, physical abuse, domestic violence, and other traumatic life experiences. In relating with the trauma experienced by the rescued animals at Ranch Hands Rescue, clients of the non-profit from across the entire Dallas/Ft Worth metroplex benefit from the unique trauma-informed animal assisted psychotherapy provided by highly-trained Licensed Professional Counselors.

Thanks to the commitment and ongoing passion for rescuing abused and neglected farm animals that would otherwise be considered ``throw aways,'' Ranch Hands Rescue is ``animals helping people and people helping animals'' to provide a special sanctuary for healing in the heart of Texas 26th Congressional District.

Mr. Speaker, I thank the gentleman for yielding the time, for the recognition.

Let me just say, I want to thank members of the Health Subcommittee, both sides of the dais, who have worked hard on this legislation, and it is unfortunate that it was not brought to the floor of the House in the month of September.

From a subcommittee perspective, we were ready. We had our legislative hearings in June. We were delayed one time when the whole House recessed after the shooting of the Members at the baseball practice, but we rescheduled for 2 weeks later, and we had a successful hearing. We had a good hearing; a lot of facts were laid out. We came up with commonsense legislation that was offset in a responsible way. The offsets are not draconian.

We have before us a bill today that will, in fact, fund some of the Nation's most important public health programs. It does fund the State Children's Health Insurance for 5 years, one of the longest extensions for this program since its inception in 1996. It will ensure that children and families who rely on this program will continue to receive the access they need. It also includes, in a fiscally responsible way, to delay the harmful ObamaCare-mandated cuts to safety net hospitals, who also provide care to underserved patients.

Now, think about that for a minute. We are accused of undermining ObamaCare, but here is a cut that ObamaCare mandates to your safety net hospitals across the country--not just in Texas, but across the country--and we are replacing that today in a fiscally responsible way.

It provides funding for community health centers, an important key part of healthcare in communities across the country. It will help the Americans who rely on these vital health services.

Not only does the bill provide assistance for underserved populations, but it does so without adding to the national debt. The Committee for a Responsible Federal Budget called this a responsible health package, noting that the $18 billion cost is fully offset, with savings beyond the 10-year budget window.

Other groups have also been supportive: Texas Hospital Association, Texas Health Resources--for me back home--Children's Hospital, and a number of healthcare organizations.

We have data from MACPAC, whose job it is to advise Congress on Medicaid and CHIP policy; and MACPAC has advised us that, under current law, there are no new Federal funds for State Children's Health Insurance for fiscal year 2018 and beyond. Unless Congress acts to renew funding, all States will experience a shortfall in CHIP funds for 2018, which means, if someone is contemplating a ``no'' vote on this bill, if you are contemplating a ``no'' vote, you do need to be aware that if you live in the States of Arizona and Minnesota, you ran out of money in October of 2017; North Carolina, same situation. Oregon runs out next month. Vermont runs out next month. You need to think about your ``no'' vote before you apply it.

Every single U.S. territory, with the exception of Puerto Rico, ran out of money in the month of October.

So those are a few facts that people do need to bear in mind, if they vote ``no'' on this bill, what the actual implications of that are.

Yesterday, during debate on the rule, I heard a lot of discussion about taking money out of the Prevention Fund. It doesn't take money out of the Prevention Fund, but it does provide discretion for some prevention and public health dollars. It takes it away from the executive branch and redirects these dollars to proven public health programs that enjoy broad bipartisan support in Congress, like community health centers.

So we are fulfilling our Article I responsibility. We shouldn't just be giving everything to the administration to decide how to spend money, whether it be a Democratic or Republican administration. This is the right thing to do.

I am proud of the work done by our subcommittee. I think our subcommittee staff has performed admirably on both sides of the dais.

Mr. Speaker, I urge a ``yes'' vote on the bill. It is time to act, as our chairman has said.

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 600 and ask for its immediate consideration.

Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentlewoman from New York (Ms. Slaughter), 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, House Resolution 600 provides for the consideration of a bipartisan bill reported by the House Ways and Means Committee and the Energy and Commerce Committee.

The rule provides for 1 hour of debate equally divided and controlled by the chairs and ranking members of the Committee on Energy and Commerce and the Committee on Ways and Means.

The rule adopts the amendment in the nature of a substitute recommended by the Committee on Ways and Means.

Further, the rule waives all points of order and makes in order no further amendments to the legislation. However, the minority is afforded the customary motion to recommit.

Mr. Speaker, on behalf of millions of seniors in my home State of Texas and all across the United States, I am grateful that the House is considering H.R. 849, the Protecting Seniors' Access to Medicare Act of 2017.

This bill has been championed by my good friend from Tennessee, Dr. Phil Roe, in this Congress and in previous

Congresses. It accomplishes a very simple task: To repeal the unpopular Independent Payment Advisory Board created under the Affordable Care Act.

This repeal has strong bipartisan support in both the Energy and Commerce Committee, on which I serve, and in this entire body.

As of today, there are 270 Republican and Democratic cosponsors to the bill who all agree that the creation of this board was a very bad idea.

More than 800 organizations representing every State support this bill. If I may add, this includes seniors, patient advocacy groups, physician groups, and other healthcare provider organizations.

This board is charged with broad, sweeping powers to reduce Medicare spending when Medicare spending exceeds an arbitrary target.

The board is a panel composed of 15 members appointed by the President, confirmed by the Senate for up to two consecutive 6-year terms. Fewer than half of the Independent Payment Advisory Board members can be healthcare providers, and no one--and this is an important point--on the board may receive outside income. So that means by its very definition that this board is comprised of people who cannot be practicing physicians.

The other members will come from the ranks of think tanks, unions, and academia.

For a panel with so much authority over Medicare spending, there could be little to no clinical expertise amongst the board members.

Is this what Americans really want?

Now, here is some good news. The board has yet to be formed. Hooray for that. According to the 2017 Annual Report on the Boards of Medicare Trustees from the Centers for Medicare and Medicaid Services' Office of the Actuary, the Independent Payment Advisory Board may not be formed until at least 2021, based on the current Medicare spending rate projections.

Well, that is good news to seniors and their doctors and their families, but these projections are just numbers and they can change. In fact, last year the projection was very different, that the Independent Payment Advisory Board would be triggered this year rather than the delay.

The concern of many of us here in the House and hundreds of stakeholders I have heard from is that under the law, the Independent Payment Advisory Board's proposals are required to be implemented by the Secretary of Health and Human Services unless Congress acts by creating its own proposal to achieve the exact same savings or by preventing the automatic implementation process as defined by law.

So what is that process?

The law mandates immediate introduction of legislation

encompassing the Independent Payment Advisory Board proposed

bills in Congress--

Stop and think about that for a minute. That is not a bill introduced by a Member of Congress. That is a bill introduced by an outside board. That is a bill introduced by the administration. Let me recapitulate.

The law mandates immediate introduction of legislation

encompassing the Independent Payment Advisory Board proposed

bills in Congress and establishes strict deadlines for

committee and Senate floor consideration, and places limits

on the appropriations process.

While Congress is permitted to modify the type of cuts to

Medicare, it must achieve identical savings amounts to

Medicare spending as contained in the board's plan. The law

bars Congress from changing the Independent Payment Advisory

Board fiscal targets in any other legislation it considers,

and it creates procedures whereby a super majority vote is

required in the Senate to waive this requirement.

If the Independent Payment Advisory Board fails to report

recommendations or never becomes operational, the Secretary

of the Department of Health and Human Services is given the

power to implement the cuts unilaterally.

Well, you might think that, then, of course this would be under judicial or administrative review, but the Independent Payment Advisory Board is exempt from administrative or judicial review.

No matter what your views are on the Affordable Care Act, we should all agree that giving this much power to a panel of unelected and unaccountable officials or a Cabinet Secretary, whoever he or she may be in any administration, giving away this much power is simply bad policy. The House shouldn't be for that.

This process is extremely complicated, and maybe that was the intent of the people who wrote the provision creating this board under the Affordable Care Act.

I also fundamentally believe that the Independent Payment Advisory Board infringes on the separation of powers by shifting authority from the legislative to the executive branch. Not only does the creation of this board significantly limit Congress' authority, it eliminates needed transparency from hearings and debate. It eliminates any meaningful opportunity for stakeholder input.

I believe leaving Medicare payment decisions in the hands of those who are unelected and unaccountable, with little congressional oversight, will actually harm seniors' access to quality healthcare.

Congress has played an integral role in shaping policies that best reflect the needs of our districts and our States, and our constituents demand that. That is the reason they sent us here.

Lastly, as a physician, I treasure the doctor-patient relationship. I believe we must do more to honor this relationship and prevent the Federal Government from further eroding this precious commodity.

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

Mr. Speaker, I yield 5 minutes to the gentleman from Tennessee (Mr. Roe), the chief sponsor of the bill.

Mr. Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Dunn), who is also a physician.

Mr. Speaker, I yield myself 1\1/2\ minutes.

Mr. Speaker, I did want to delineate the membership of this board, as is outlined in the Affordable Care Act. The board will be appointed by the President with the advice and consent of the Senate, with the advice and consent of the Secretary or the Administrator of the Centers for Medicare and Medicaid Services, and the Administrator of the Health Resources and Services Administration. All of those individuals will serve as ex officio nonvoting members. But here are the qualifications for the actual board:

``The appointed membership of the board shall include individuals with national recognition for their expertise in health finance and economics, in actuarial science, health facility management, health plans, and integrated delivery systems, and reimbursement of healthcare facilities. . . .''

Missing from that picture, of course, are the people who actually provide the care to people who are involved in that doctor-patient relationship. Almost as an afterthought, here at the end of that paragraph, ``allopathic and osteopathic physicians.''

The other aspect is that no member of the board can receive outside income. That may be a good idea, but that guarantees there will not be a practicing physician on that board. I think that is a significant oversight.

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

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

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

I recall things a little differently. I recall the lie of the year being, if you like your doctor, you can keep your doctor, but I guess that is a debate for another day.

Mr. Speaker, today's rule provides for consideration of an important piece of legislation to protect seniors' access to healthcare from the ill-advised Medicare Independent Payment Advisory Board created by the Obama administration within the Affordable Care Act.

I thank the authors, Chairman Brady and Dr. Roe, and the 270 House cosponsors of H.R. 849 for their thoughtful and bipartisan legislation, and I urge my colleagues to support the rule providing for consideration of this underlying bill, and then support the bill.

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

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 601 and ask for its immediate consideration.

Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentlewoman from New York (Ms. Slaughter), 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 in which to revise and extend their remarks.

Mr. Speaker, House Resolution 601 provides for the consideration of a critical bill to provide health insurance and healthcare to millions of underprivileged children. This package, which includes two separate bills: H.R. 3922, the Community Health And Medical Professional Improves Our Nation, CHAMPION, Act of 2017; and H.R. 3921, the Healthy Kids Act. This was reported out of the Committee on Energy and Commerce after lengthy deliberation and negotiation and a lengthy markup.

The rule provides for 1 hour of debate, equally divided and controlled by the chair and the ranking member of the Committee on Energy and Commerce.

The rule adopts an amendment from the chairman of the Energy and Commerce Committee, modified by a second amendment by the same author, combining the two bills into the package on the floor today.

Further, the rule waives all points of order and makes in order no further amendments to the legislation. However, the minority is afforded the customary motion to recommit.

The congressionally appropriated stream of funding for the Children's Health Insurance Program expired at the end of September. Funding for other important public health programs, such as community health centers, the National Health Service Corps, and Teaching Health Center Graduate Medical Education, also expired at the end of September.

While every State that receives Federal funding through these programs continues to have adequate dollars to maintain health insurance for every enrolled child, several States are beginning to exhaust their unspent 2017 funds and redistributed funds from the Center for Medicare and Medicaid Services. With November now upon us, waiting any longer will only put more

pressure on those States to begin sending notifications to children and families that they are losing their coverage for those programs; so it is important that we reauthorize funding for the Children's Health Insurance Program and other programs now.

H.R. 3922, the CHAMPIONING HEALTHY KIDS Act, will achieve that important task. It is essential to our efforts to ensuring that these programs continue to meet the healthcare needs of children and families who have come to rely upon them.

Today, more than 8 million low-income children across our country depend on the Children's Health Insurance Program for many of their healthcare services. These include routine doctor visits, immunizations, prescription medicines, and dental care. Through flexible, capped allotments to the States, the program has been able to successfully support these children, while providing States with opportunities to tailor their respective programs as best meet the needs of their respective populations.

The CHAMPIONING HEALTHY KIDS Act would extend CHIP for another 5 years, which is the longest extension since its inception in 1996. An extension through fiscal year 2022 will provide financial stability for every State's CHIP program and certainty for those children and their families who are covered. Additionally, ensuring coverage for CHIP- eligible children will make them less likely to have to enroll in Medicaid or ObamaCare.

This bill also contains and maintains a provision under the Affordable Care Act that provided 23 percent increased matching for 2 years; then that draws down to an increase of 11.5 percent matching in the third year; and then, finally, provides funding at pre-ACA levels for the final 2 years.

These funding levels will provide the States enough time to plan their budgets before returning to the regular CHIP matching rates, thereby restoring the fiscally responsible Federal-State Medicaid partnership.

While reauthorizing CHIP funding is the primary focal point of this legislation, the CHAMPIONING HEALTHY KIDS Act also includes other important provisions relating to our Nation's healthcare. The bill provides a 2-year extension of funding for Federally Qualified Health Centers, community health centers.

One in thirteen individuals nationwide relies upon a community health center to receive healthcare services. The Community Health Center Fund plays an important role in supplementing the services that Federally Qualified Health Centers are able to deliver to underserved communities by providing care to all Americans, regardless of income or ability to pay.

Funding for the Teaching Health Center Graduate Medical Education program is also extended for another 2 years.

The legislation includes a 2-year extension of other important health programs, including funding for the National Health Service Corps, Family-to-Family Health Information Centers, the Youth Empowerment Program, the Personal Responsibility Education Program, the Special Diabetes Program for Type 1 Diabetes, and the Special Diabetes Program for American Indians.

In addition to the important funding streams addressed in this bill, the Committee on Energy and Commerce incorporated a way to help our Nation's territories in a time of need following recent natural disasters. The bill includes more than $1 billion for the Medicaid programs in both Puerto Rico and the U.S. Virgin Islands. This funding should assist our territories in providing care for their populations who have faced substantial devastation from Hurricanes Irma and Maria.

The Medicare funding issue is unique to Puerto Rico and the United States citizens living in the territories. This was a problem that predated the hurricanes, but it was exacerbated by the devastation that the storm brought to the islands. Without a legislative fix from Congress, this will be an ongoing and festering problem until it is properly addressed, and the bill before us today begins to do just that.

Additionally, the bill delays the $5 billion in cuts to many of the hospitals across the country from the Affordable Care Act-mandated Medicaid disproportionate share hospital reductions for fiscal years 2018 and 2019. I am sure that many of my colleagues have heard from hospitals in their districts whose ability to remain operational and to continue to provide care could be jeopardized by these payment cuts.

These cuts are offset in future years, adding an additional $6 billion in reductions in fiscal year 2021, 2022, and 2023. This delays but does not fix a problem that ObamaCare created for safety net hospitals. It is one which we will have to revisit, but it delays the cuts that have already been affected by current law and protects these safety net hospitals which provide care to the neediest citizens in our country.

Not only does the CHAMPIONING HEALTHY KIDS Act reauthorize funding for essential health programs, the bill is fully offset. It will not add to the national debt. The Committee for a Responsible Federal Budget called this a ``responsible health package,'' noting that the $18 billion cost of the bill is fully offset with savings beyond the 10-year budget window.

One of the ways that costs are offset was to alter the qualified health plan grace period so that it would align with State law grace period requirements. This involved changing, in the Affordable Care Act, the grace period for subsidized individuals from 90 days to 30 days unless a State specifically allows otherwise.

It also redirected $6.4 million from the Prevention and Public Health Fund to help pay for the legislation. This fund is required by law to receive $2.5 billion in annual appropriations which must be used for prevention, wellness, and public health initiatives administered by the Department of Health and Human Services. If Congress--let me say it again--if Congress does not direct these funds toward specific efforts, the Secretary of Health and Human Services has the authority to spend the funds however he or she deems fit.

While we are redirecting these taxpayer dollars, the overarching purpose of the funding is still to improve the health and wellness of Americans through existing mechanisms, and community health centers will do just that.

We allow for certain wealthy Medicare beneficiaries with individual incomes of over $500,000 to pay increased premiums in order to offset some of the cost of authorizing these programs. These beneficiaries will be subject to higher premiums, thereby increasing their overall cost, but still their cost will be lower than if they purchased insurance on the exchange.

The CHAMPIONING HEALTHY KIDS Act is a fiscally responsible way to fund some of our Nation's most important public health programs. The bill would ensure continued access to care for children and individuals who rely on the programs for vital healthcare services.

Mr. Speaker, this is a good bill. Mr. Speaker, these offsets are reasonable. For these reasons, I encourage my colleagues to support today's rule and support the underlying bill, and I reserve the balance of my time.

Mr. Speaker, I yield myself 30 seconds in response before yielding to the chairman of the Rules Committee.

It pains me to hear people talk about the 33-day delay in getting SCHIP funding resubmitted. I just want to assure the House of Representatives that Republicans on the Subcommittee of Health in the Energy and Commerce Committee have been ready to go with this legislation. We did our legislative hearings early in the summer, as the gentleman will recall because he was there, and we were ready for our markup in the month of September.

Why was it delayed? Let me reference an article from CQ News, October 23, 2017: ``Democrats do not want a children's health insurance bill to come to the floor this week for a vote, said Frank Pallone, Jr., ranking member of the House Energy and Commerce Committee at a district event. . . .''

`` `The idea is to not have the bill come to the floor this week,' said Pallone. . . .''

I include in the Record a copy of the CQ News article.

[From CQ News, Oct. 23, 2017]

House Democrats Push To Delay Children's Health Vote

(By Sandhya Raman)

Democrats do not want a children's health insurance program

bill to come to the floor this week for a vote, said Frank

Pallone Jr., ranking member of the House Energy and Commerce

Committee at a district event broadcast on Facebook Live on

Monday.

``The idea is to not have the bill come to the floor this

week,'' said Pallone, emphasizing that Democrats still want

to find a bipartisan compromise and will not accept the

changes to Medicare or Medicaid that Republicans want to use

to fund the coverage. He later added, ``This is supposed to

come up Thursday. Hopefully, it won't.''

Pallone suggested that the process could be lengthy if the

House passes a partisan bill and the Senate does not act

quickly to pass their bipartisan measure. The two likely

would have to be reconciled through conference negotiations.

``We're going to just delay this for months, and the end

result could be we don't deal with this until the end of the

year,'' said Pallone, speaking at a community health center.

Democrats disagree with the offsets in House bills to

reauthorize CHIP (HR 3921) and community health centers and

other safety net programs (HR 3922). The CHIP bill's offsets

include increasing premiums for Medicare recipients with

income over $500,000 a year and limiting Medicaid benefits

for lottery winners. In addition, Democrats take issue with

an offset that would bill other insurance before Medicaid for

recipients who use more than one form of coverage.

The offsets for the community health centers include

changes to undermine the 2010 health care law (PL 111-148, PL

111-152) including cutting almost $6.4 billion from the

Prevention and Public Health Fund over 10 years. Republicans

also would allow states to create their own grace periods for

individuals on the exchanges to pay their premiums or use a

default one-month grace period. The current grace period is

three months.

``If you miss it and you don't pay it, you can't get your

insurance. You've got to re-enroll for the next year,''

Pallone said about the grace period.

``The problem is that they haven't been willing to give

much on taking this money from the Affordable Care Act or

Medicare, but why do they even have to come out of health

care at all? Why can't we use another vehicle to pay for

it?'' said Pallone, adding, ``Part of that could be cut back

significantly.''

Democrats also object to the way Puerto Rico's Medicaid

funding in the CHIP bill would be addressed.

``They're still requiring a state match from Puerto Rico,''

said Pallone. ``The bill funds a little bit, but it's totally

worthless if Puerto Rico has to come up with the match.''

The island does not have money to contribute, Democrats

say.

Earlier this month, Committee Chairman Greg Walden of

Oregon asked his Democratic colleagues to suggest offsets

that may be more amenable than those currently in the bill

that the committee passed. Last week, Walden said in a

statement that he had not received any Democratic offers.

Democrats contend they have put suggestions on the table.

One idea would require drug companies to help seniors

better afford their prescriptions by closing a funding gap,

known as the ``doughnut hole,'' in Medicare coverage.

Currently, seniors have to pick up more costs after a certain

spending threshold until they hit another limit when Medicare

resumes paying for coverage.

``We've been making offers back. One of the things we said

is make the drug companies pay for the doughnut hole. We

still have a doughnut hole for Medicare Part D. So if they

pay for the cost of that, that could be used as a payfor,''

said Pallone.

``This bill that may go to the floor next week is going

nowhere,'' said Pallone, stating that it would ``be a totally

partisan vote.''

Federal funding for CHIP expired Sept. 30. The Centers for

Medicare and Medicaid Services has redistributed unused CHIP

funds to nine states and territories including Arizona,

California, Minnesota, Washington, American Samoa, Guam,

Northern Mariana Islands, U.S. Virgin Islands and Oregon. The

funds come from unused CHIP allotments from previous years

and are used to help states that are running low on their

current year funds.

Mr. Speaker, I yield 5 minutes to the gentleman from Texas (Mr. Sessions).

Mr. Speaker, I yield myself 30 seconds for the purpose of a response before I yield to the gentleman from Georgia.

Mr. Speaker, if we are going to tell stories, then ``once upon a time'' should be part of our opening.

This bill merely takes some of the discretion for the Prevention and Public Health Fund away from the administration and returns it to Congress where it is supposed to be in the first place, so we take discretion over some of the Prevention and Public Health Fund dollars away from the executive branch and redirect these dollars to proven public health programs that enjoy broad, bipartisan support in Congress like the community health centers. Every Democrat voted for the Cures for the 21st Century, and it did exactly the same thing.

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

Mr. Speaker, I am pleased to yield 3 minutes to the gentleman from Alabama (Mr. Byrne), who is a fellow member of the House Rules Committee.

Madam Speaker, I yield myself 30 seconds.

First off, the gentleman may not remember that we had a legislative hearing in June on this very bill. It was delayed from June 14. The gentleman may recall there was an unfortunate circumstance of a shooting at a congressional baseball practice. In fact, a member of our committee, Majority Whip Steve Scalise, was in surgery, and most felt we couldn't go through with the hearing that day, but we had it 2 weeks later as soon as we could get the hearing time. So it was done well in advance of the expiration of the funding.

Furthermore, as far as the substitute goes, the minority is afforded the customary motion to recommit. I look forward to the gentleman introducing a substitute at that time.

Madam Speaker, I yield 2 minutes to the gentlewoman from Tennessee (Mrs. Blackburn).

Madam Speaker, I yield an additional 30 seconds to the gentlewoman from Tennessee.

Madam Speaker, may I inquire as to how much time is remaining?

Madam Speaker, I yield myself 2 minutes.

Madam Speaker, I want to address the issue of the Prevention and Public Health Fund.

The bill before us does redirect $8.9 billion for the Prevention and Public Health Fund to support critically important public health programs that expand access to care and improve health outcomes.

The Prevention Fund was established in the Affordable Care Act as mandatory funding for prevention and public health programs to improve health and help restrain the rate of growth in private and public sector healthcare costs.

According to statute, billions of dollars in advanced appropriations are to be used for the broad purpose of supporting programs authorized by the Public Health Service Act for prevention, wellness, and public health activities. However, prevention, wellness, and public health activities are allowable, but no Prevention Fund-specific or generally applicable definitions of these terms are to be found in the Public Health Service Act, the Affordable Care Act, or anywhere else in Federal law.

The Affordable Care Act was not accompanied by committee reports in either Chamber. The Department of Health and Human Services has not published regulations, guidance, or other information to clarify the Department's views about the types of activities that are within the scope of the Prevention Fund.

Annual mandatory appropriations, the Prevention Fund, continue in perpetuity. If Congress does not explicitly allocate the funding, then the Secretary of HHS has the authority to spend these dollars without congressional oversight.

This bill takes discretion over some of the--some, not all--some of the Prevention Fund dollars. It takes it away from the executive branch and redirects these dollars to proven public health programs that enjoy broad bipartisan support in Congress like community health centers, a program that employs 190,000 people and served over 24 million patients in 2015.

This has been supported in the past in other legislation, most recently in the Cures initiative, where Democrats and Republicans supported the redirecting of funding for the Prevention Fund for the specific purpose of preserving public health.

Madam Speaker, I reserve the balance of my time.

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

I do want to address one of the things that has come up in the discussion, and that is the issue of the language in the underlying bill that supports the citizens, the American citizens in Puerto Rico.

There was a problem in Puerto Rico with their Medicare system, the way people were not automatically enrolled as they were in every other State and territory. There was a problem under the Affordable Care Act where they faced a Medicaid funding cliff.

These problems existed prior to the two hurricanes that hit the island, and a request was made to Chairman Walden and me, on behalf of the people of Puerto Rico, to fix these problems prior to the storms coming ashore, and that is what we fixed in the language of this bill.

I might remind this body that, when Hurricane Katrina came ashore around Labor Day of 2005, a similar problem was encountered. Ultimately, the State's share of that FMAP payment was made. It was made with funds from the Deficit Reduction Act, which were allocated on September 30, 2006, over a year later.

The fact is that there are going to be funds available to Puerto Rico to help offset their part, their match of their State's share of the Federal match, but it will likely come through the money that is appropriated for disaster relief. But we are fixing their underlying problem that existed before the hurricanes. If we don't fix it, it continues to be a problem year in and year out, and the American citizens of Puerto Rico are poorly served by that.

So this body is taking that up today, and I am proud of the fact that our subcommittee and our full committee recognize that and provided that relief.

Madam Speaker, I want to enter into the Record a letter from Texas Health Resources, Mr. Barclay Berdan. I want to quote from this letter: ``We . . . appreciate your leadership on delaying cuts to Medicaid DSH, which took effect on October 1, 2017.''

``Thankfully, H.R. 3922 would eliminate the scheduled Medicaid DSH reductions in fiscal years 2018 and 2019, thus allowing a critical source of funding to continue for safety net hospitals.''

Texas Health Resources,

November 1, 2017.

Hon. Michael Burgess,

House of Representatives,

Washington, DC.

Dear Representative Burgess: As one of the nation's largest

faith-based, nonprofit health care systems, Texas Health

Resources (Texas Health) provides more than 350 points of

access throughout North Texas, including 29 hospitals (acute-

care, short-stay, behavioral health, rehabilitation and

transitional care) and more than 100 outpatient facilities,

satellite emergency rooms, surgery centers, behavioral health

facilities, fitness centers and imaging centers. The system

also includes a large physician group, home health,

preventive and well-being services as well as more than 250

clinics and physician offices to provide the full continuum

of care for all stages of life. I am writing to thank you for

your leadership on the Championing Healthy Kids Act of 2017

(H.R. 3922) to extend funding for the Children's Health

Insurance Program (CHIP). We strongly support a five-year

extension of CHIP funding, along with the elimination of

reductions in fiscal years (FY) 2018 and 2019 to the Medicaid

disproportionate share hospital (DSH) payments.

Texas Health has supported CHIP since its inception, and

the program currently covers 8.9 million children with family

incomes above Medicaid eligibility limits who lack access to

affordable private coverage. The nation's uninsured rate for

children is a record low of 5 percent due in part to Medicaid

and CHIP coverage. While CHIP is authorized by Congress to

operate until October 1, 2019, legislative action is needed

to continue funding beyond FY 2017. Failure to extend CHIP

funding could result in coverage losses for millions of

children and increased financial pressure for states that may

lead to reductions in eligibility and benefits This

legislation safeguards the program by providing for a five-

year extension of funding.

We also certainly appreciate your leadership on delaying

cuts to Medicaid DSH, which took effect on October 1, 2017.

As you know, Medicaid DSH payments support Texas Health's

hospitals in serving north Texas' most vulnerable

individuals--the poor, the elderly, and the disabled.

Congress reduced Medicaid DSH payments in the Affordable Care

Act, reasoning that hospitals would care for fewer uninsured

patients as health coverage expanded. However, the projected

increase in coverage has not been fully realized, and

Congress subsequently delayed the start of the cuts that were

scheduled to begin in FY 2014. As a result, Texas hospitals

will sustain a $148 million cut in vital payments in federal

fiscal year 2018. The cumulative loss for Texas hospitals for

2018 through 2024 is $3.2 billion. Thankfully, H.R. 3922

would eliminate the scheduled Medicaid DSH reductions in

Fiscal Years 2018 and 2019, thus allowing a critical source

of funding to continue for safety net hospitals.

Thank you for your steadfast leadership on addressing these

important programs by supporting H.R. 3922. As Congress moves

forward on these important issues, we appreciate your

continued willingness to work with us to extend funding for

CHIP, eliminate reductions to Medicaid DSH payments, and

safeguard programs critical to hospitals. If we can provide

you or your staff with additional information, please do not

hesitate to contact.

Sincerely,

Barclay Berdan,

FACHE, Chief Executive Officer,

Texas Health Resources.

Madam Speaker, I also have a letter from the Children's Hospital Association, which renews the call for bipartisan CHIP extension: ``Children's hospitals thank Congress for its long-term bipartisan commitment to CHIP and for the children it serves. We look forward to working with lawmakers to maintain a strong CHIP program and strengthen healthcare for children in the future.''

Children's Hospitals Renew Call for Bipartisan CHIP Extension

Children's hospitals urge Congress to protect children and

families by passing a bipartisan five-year extension of the

Children's Health Insurance Program (CHIP) as soon as

possible.

We are pleased that members of the House Energy and

Commerce Committee have developed bipartisan CHIP policies

that reflect the needs of children, including a five-year

extension of the program that provides for robust CHIP

funding, and continue important beneficiary protections such

as the Maintenance of Effort provision, funding for

the Pediatric Quality Measures Program, express lane

eligibility, and outreach and enrollment grants. These

policies are also included in the bipartisan Senate proposal

on CHIP, and we thank the committees of jurisdiction in both

chambers for including these crucial policies.

If CHIP funding is not extended soon, CHIP-enrolled

children may become underinsured or uninsured altogether.

CHIP is an important bipartisan health coverage program for

over 6 million low-income children. CHIP builds off of a

strong Medicaid program by providing age-appropriate and

affordable coverage for children who fall above Medicaid

eligibility levels, but lack access to other health coverage

options.

Concerning reports indicate that states are taking steps to

limit programs in order to address the looming funding

shortfall, despite receiving federal redistribution funds. We

urge Congress to act now and avoid potentially disastrous

consequences caused by further delay by enacting a strong,

bipartisan five-year extension of CHIP.

Children's hospitals thank Congress for its long-term

bipartisan commitment to CHIP and the children it serves. We

look forward to working with lawmakers to maintain a strong

CHIP program and strengthen health care for children into the

future.

Finally, Madam Speaker, I will tell you I am perplexed. I, frankly, do not understand why there is reticence to providing an offset for funding of children's health insurance by income relating to part B premiums for people who earn over $500,000 a year, seniors who earn over $500,000 a year, or a couple who earns over $875,000 a year. This was language that was included in President Obama's budget, so don't tell me it is not bipartisan, because it was bipartisan.

Now, Madam Speaker, today's rule provides for the consideration of an important piece of legislation to maintain the important funding streams for millions of underprivileged children depending on the program.

I want to thank Chairman Walden for his efforts to continually work with the minority on the Energy and Commerce Committee, repeatedly providing the requested extensions by the ranking member in order to continue discussions on the legislation.

The package reflects hours of work to create legislation that will benefit millions of America's children so that they can lead healthier lives. I urge my colleagues to support today's rule and the underlying legislation, the CHAMPIONING HEALTHY KIDS Act

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

Mr. Speaker, today I rise in support of S. 920, the National Clinical Care Commission Act, sponsored by Senator Shaheen.

This legislation has been around for a while. It has been championed in the House by our good friend and fellow Texan, Representative Pete Olson, as H.R. 309. This bill has strong bipartisan support. It passed this House unanimously earlier this year.

Diabetes and other endocrine disorders have been a great cost burden on Medicare and, in fact, our Nation's healthcare system in general. Thirty million Americans have diabetes, 84 million Americans have prediabetes, and three out of four Americans on Medicare have diabetes or prediabetes. And $1 out of every $3 Medicare spends is spent on diabetes.

This bill will establish a clinical care commission to evaluate and recommend solutions for better coordination and use of Federal programs aimed at improving care for people with diabetes and other related endocrine disorders. This commission will be tasked with identifying gaps where new approaches are needed, eliminating duplication across Federal agencies, and leveraging the Federal resources and tools available to enhance the quality of patient care.

I am confident their work will improve the lives of tens of millions of Americans living with diabetes and with other endocrine disorders while beginning the process of reducing the staggering impact of these diseases.

Mr. Speaker, I certainly want to thank and commend our colleague, Representative Pete Olson, for spearheading this important initiative. I want to thank him for bringing it to the floor of the House as many times as he has. This has been a lengthy process, but today, with the passage of this bill, we are voting on final passage, and this bill will be sent to the President's desk for signature. Mr. Speaker, Mr. Olson's long and arduous journey now will be completed with the passage of this bill, and we should all look forward to that.