[Congressional Record Volume 160, Number 40 (Tuesday, March 11, 2014)]
[House]
[Pages H2273-H2276]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                EQUITABLE ACCESS TO CARE AND HEALTH ACT

  Mr. SCHOCK. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1814) to amend section 5000A of the Internal Revenue Code of 
1986 to provide an additional religious exemption from the individual 
health coverage mandate.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1814

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Equitable Access to Care and 
     Health Act'' or the ``EACH Act''.

     SEC. 2. ADDITIONAL RELIGIOUS EXEMPTION TO HEALTH COVERAGE 
                   MANDATE.

       (a) In General.--Paragraph (2) of section 5000A(d) of the 
     Internal Revenue Code of 1986 is amended by adding at the end 
     the following new subparagraph:
       ``(C) Additional religious exemption.--
       ``(i) In general.--Such term shall not include an 
     individual for any month during a taxable year if such 
     individual files a sworn statement, as part of the return of 
     tax for the taxable year, that the individual was not covered 
     under minimum essential coverage at any time during such 
     taxable year and that the individual's sincerely held 
     religious beliefs would cause the individual to object to 
     medical health care that would be covered under such 
     coverage.
       ``(ii) Nullified if receipt of medical health care during 
     taxable year.--Clause (i) shall not apply to an individual 
     for any month during a taxable year if the individual 
     received medical health care during the taxable year.
       ``(iii) Medical health care defined.--For purposes of this 
     subparagraph, the term `medical health care' means voluntary 
     health treatment by or supervised by a medical doctor that 
     would be covered under minimum essential coverage and--

       ``(I) includes voluntary acute care treatment at hospital 
     emergency rooms, walk-in clinics, or similar facilities, and
       ``(II) excludes--

       ``(aa) treatment not administered or supervised by a 
     medical doctor, such as chiropractic treatment, dental care, 
     midwifery, personal care assistance, or optometry,
       ``(bb) physical examinations or treatment where required by 
     law or third parties, such as a prospective employer, and
       ``(cc) vaccinations.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect as if included in the amendments made by 
     section 1501 of the Patient Protection and Affordable Care 
     Act.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Illinois (Mr. Schock) and the gentleman from Michigan (Mr. Levin) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Illinois.


                             General Leave

  Mr. SCHOCK. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
to include extraneous material on the subject of the bill under 
consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Illinois?
  There was no objection.
  Mr. SCHOCK. Mr. Speaker, I yield myself such time as I may consume.
  Just yesterday, a Washington newspaper headline read: ``Worst 
Congress Ever.''
  The thrust of the article was an indictment against Washington 
partisanship for its failure to move significant legislation on behalf 
of the American people. Now, to some degree, I suppose we have all felt 
at times that Congress just isn't making any laws. Of course, there are 
times, however, when Congress must make no law if we are to honor the 
oath we have sworn, which is to support and defend the Constitution of 
the United States. Indeed, ``Congress shall make no law respecting the 
establishment of religion or prohibiting the free exercise thereof.''
  Today, we have the opportunity to work together, across the aisle, to 
reaffirm this founding principle of our democracy. Together, we will 
reinforce the constitutional protection for sincere believers of all 
faiths against the unnecessary entanglement of government with their 
private religious expression. H.R. 1814 slightly expands the religious 
conscience exemption of the Affordable Care Act to include individuals 
with ``sincerely held religious beliefs'' among those eligible for an 
exemption from the individual mandate penalty.
  In order to qualify for the exemption under the EACH Act, an 
individual must affirm on an annual tax return that he or she cannot 
purchase coverage due to a sincerely held religious belief. This term, 
as defined by the U.S. Equal Employment Opportunity Commission and as 
widely recognized by

[[Page H2274]]

the courts, is designed to protect various types of religious 
believers, not just those who belong to a traditional, organized 
religion.
  Today's bill must become law. Among the many problems with the 
Affordable Care Act, the current conscience exemption only protects the 
religious exemptions of a few select faiths. Now, I am fully aware that 
not every organization purporting to defend religious liberty is in 
favor of today's measure. I am, nevertheless, thankful that my good 
friend from the other side of the aisle, Mr. Keating, joined me in this 
effort. His home State of Massachusetts incorporated a similar 
religious liberty exemption in their State law, and it seems to be 
working out just fine. Since the law passed, only 6,500 Bay Staters 
have claimed the conscience exemption.
  This fact serves to reinforce the very principle of religious liberty 
we affirm today. The Constitution does not only protect the religious 
practices and beliefs of majority faith traditions, but, rather, the 
First Amendment protects even the smallest faith group and even the 
single individual against laws that infringe upon their sincerely held 
religious beliefs.
  Yet H.R. 1814 isn't only about constitutional jurisprudence and 
legislative correctness. It is about real people in my district and in 
yours who feel that their free exercise of religion is encumbered under 
the current law. One of them is a constituent of mine named Andrew, who 
lives in Chillicothe, Illinois. Andrew is a sincere believer whose 
religious commitment leads him to pursue only nonmedical health care 
options. According to Andrew, under the current law, he will be 
required to pay a fine once the individual mandate penalty kicks in. 
Regrettably, Andrew's religious beliefs were not considered when the 
present conscience exemption was enacted.
  Today, the EACH Act gives individuals like Andrew the ability to 
practice his religious beliefs without coercive government fining him 
for coverage he does not intend to use nor can he use and remain true 
to his most sincere religious beliefs. We recognize, however, that the 
immense unpopularity of ObamaCare among many Americans might entice 
otherwise law-abiding citizens to claim an exemption under the EACH Act 
in order to escape the law's penalty. In order to ensure that 
individuals do not game the system, this bill includes a strong 
provision that revokes the exemption and requires the individual to pay 
a stiff penalty if he or she seeks medical treatment at any point 
during that year.
  H.R. 1814 walks that fine line between protecting the First Amendment 
for every American and safeguarding taxpayers against potential fraud. 
Congress has long sought to uphold both of these commitments, and, 
today, this bill affords us a bipartisan opportunity to do it once 
again. I urge my colleagues to support this important fix to the 
Affordable Care Act and to pass H.R. 1814.
  With that, Mr. Speaker, I reserve the balance of my time.
  Mr. LEVIN. Mr. Speaker, it is now my pleasure to yield such time as 
he may consume to the gentleman from California (Mr. Waxman), the 
ranking member on the Energy and Commerce Committee.
  Mr. WAXMAN. I thank the gentleman for yielding to me.
  Mr. Speaker, I know that this legislation carries important personal 
significance for some of our colleagues, and I respect that, but I want 
to express some real concerns about the bill because I feel it is 
overly broad. It could seriously undermine the Affordable Care Act and 
would establish a bad precedent for our tax laws.
  The bill states that individuals would not be required to obtain 
health insurance coverage if their ``sincerely held religious beliefs'' 
cause them to object to treatments that would be covered. The bill does 
not narrowly define ``sincerely held religious beliefs'' as those of 
Christian Scientists or other groups who rely on a religious method of 
healing. As a result, the bill would force the IRS to either accept 
virtually all attestations of exemption or to determine which 
Americans' religious beliefs meet that standard. This is impossibly 
difficult to enforce, and, frankly, it is not a role we want the IRS to 
take on.

  If the IRS chose to define ``sincerely held religious beliefs'' 
broadly, H.R. 1814 could allow, essentially, anyone opposed to the 
Affordable Care Act to opt out of coverage. That would lead to an 
increase in the number of uninsured Americans, and it would shift costs 
on to other taxpayers. Even if we assume the IRS could set a standard, 
there are significant problems with the legislation.
  The bill claims that individuals receiving ``voluntary'' medical care 
would lose their exemptions, but the IRS has no way to monitor 
individuals' use of voluntary medical care, making this totally 
unenforceable. Furthermore, individuals receiving ``involuntary'' care, 
such as expensive emergency care, would be allowed to remain exempt 
from the coverage requirement, passing the costs of their care on to 
hospitals and other taxpayers.
  I understand this is a sensitive issue. If religious groups that 
receive Medicare and Social Security benefits do not want to obtain 
health insurance, we need to examine that issue carefully. This bill 
should have been the subject of hearings. It should have been marked up 
in committee. Unfortunately, it was not.
  The Affordable Care Act is about moving our Nation towards universal 
health insurance coverage. That is the right thing for the health of 
our Nation. So I believe we need to tread very carefully when opening 
up new loopholes or exemptions, and we must be very cautious before 
assigning such sensitive duties to the IRS.
  Because of these concerns, I cannot support this legislation at the 
present time and in its present form. I hope our colleagues in the 
Senate will take a careful look at it and make substantial changes 
before considering it further.
  Mr. SCHOCK. Mr. Speaker, I appreciate my friend's comments from 
California. I would just remind the gentleman that this is a near 
carbon copy of language that was implemented in the State of 
Massachusetts. It has had a very minimal effect, and it has impacted 
and has helped a very small number of people. It is why this bill has 
received such bipartisan support and is on the suspension calendar here 
tonight.
  With that, I yield 1 minute to the gentlelady from Tennessee (Mrs. 
Black), my good friend.
  Mrs. BLACK. I thank the gentleman for yielding.
  Mr. Speaker, I rise today to give my strongest support to my friend 
Mr. Schock's legislation, the Equitable Access to Care and Health Act.
  Even some of the President's most ardent supporters now recognize 
that ObamaCare is a fundamentally unfair law, and I am happy to see 
that so many Democrats join us in support of this important bill.
  Instead of having Federal bureaucrats decide who and what groups 
should be allowed religious conscience exemptions from this law's tax 
penalty, individuals, themselves, should be empowered to affirm their 
objections to this law's onerous and controversial mandates. That is 
what this commonsense bill would do, and I urge its swift passage to 
help protect Americans from the Obama administration's war on religious 
liberties.
  Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.
  Mr. SCHOCK. Mr. Speaker, I yield 2 minutes to the gentleman from 
Texas (Mr. Brady), the distinguished gentleman from the Ways and Means 
Committee.
  Mr. BRADY of Texas. Mr. Speaker, I rise today in support of H.R. 
1814, the Equitable Access to Care and Health Act.
  One of our inalienable rights as American citizens is that we have 
the right to proscribe in whatever faith we so choose. With this right 
comes also the freedom from persecution and different treatment under 
the law. This body has long recognized the freedom of religion and has 
worked to ensure individuals of all faiths are treated fairly under the 
law. Even the Affordable Care Act, which imposes the burden of 
mandating the purchase of insurance, includes a religious conscience 
exemption from that individual mandate. However, this exemption is not 
fairly distributed to all Americans.

                              {time}  1645

  While covering many faiths, it doesn't cover all who seek protection. 
What the EACH Act does is to ensure that this exemption equally applies 
to

[[Page H2275]]

every American who wants it. It also protects individuals' First 
Amendment rights from being placed in jeopardy because of a requirement 
to purchase health insurance or pay a penalty.
  This is commonsense fairness legislation that extends a fundamental 
right to all Americans that have religious objections to standard 
medical care. This is a chance for us to right a wrong that I believe 
was just a drafting oversight.
  Of course, we ensure that the government doesn't impose a $1.5 
billion tax on Americans simply because of their religious beliefs.
  I thank my good friend and colleague from Illinois on the Committee 
on Ways and Means (Mr. Schock) for his leadership, as well as the 
gentleman from Massachusetts (Mr. Keating) for introducing this 
bipartisan legislation.
  I urge all my colleagues to support this bill and vote ``yes'' for 
religious freedom.
  Mr. LEVIN. Mr. Speaker, I continue to reserve the balance of my time.
  Mr. SCHOCK. Mr. Speaker, I yield 1 minute to my good friend and 
neighbor from Illinois (Mr. Rodney Davis).
  Mr. RODNEY DAVIS of Illinois. Thank you to the gentleman and my 
colleague from the great State of Illinois for introducing this 
important bill.
  As somebody who has the only Christian Science college in the Nation 
in his district, this is a very important issue for religious freedom 
and religious rights.
  Principia College in Elsah, Illinois, has 550 students. They sent me 
this card. They have much more artistic talent than I do. It says:

       Thank you. We are so grateful for your defense of religious 
     freedom and hope that you will continue to advocate for this 
     bill until it passes.

  This is the voice of those who need this exemption. This is the voice 
of those who need their religious rights protected. This is why I am 
standing here today with my colleague from Illinois to talk about this 
bill and making sure that it passes.
  I would urge all of my colleagues, Republicans and Democrats, to 
respect the students and the faculty that work and attend this college 
in my district. I would hope that they would support this bill with us.
  Mr. LEVIN. Mr. Speaker, in closing, I yield myself the balance of my 
time.
  I respect very much the specific impetus for this bill. 
Unfortunately, though, there have been no hearings on this legislation, 
and it was not marked up in committee.
  I would like to provide information on current law, on the scope of 
this legislation, and its potential consequences on our health care 
system.
  This is why I do not support this bill in its present form.
  First, it is important to note that the Affordable Care Act contains 
a religious exemption incorporating one that has been in the Internal 
Revenue code since 1965. This provision permits an exemption to members 
of religion that join together to provide mutual aid as a community--
for example, the Amish and Mennonite faiths--or participate in a health 
care sharing ministry, which is akin to insurance. These groups do not 
participate in government-funded social services, including Medicare or 
Social Security. This is a longstanding, well-defined, easy to 
implement exemption, and it was carried over to the ACA.
  The ACA's minimum essential coverage requirement was challenged in 
Federal court under the Religious Freedom Restoration Act. The court 
rejected the challenge, concluding that ACA did not impose a 
substantial burden on plaintiffs' religious exercise, despite claims 
that the plaintiffs ``believe in trusting in God to protect them from 
illness or injury'' and did not ``want to be forced to buy health 
insurance coverage.''
  Second, a requirement to purchase minimum health insurance is not a 
burden on one's exercise of their religious beliefs in the medical 
treatment they seek. The ACA does not preclude coverage for spiritual 
healing or prayer treatments. Indeed, the Church of Christ, Scientist 
explains on their Web site that under current law:

       Various U.S. Federal, State, and private health insurance 
     plans provide for the reimbursement of Christian Science 
     nursing care and practitioner treatment.

  Christian Scientists participate in Medicare, and Medicare covers 
some Christian Science services.
  It is the breadth of the language in the bill and the potential 
unintended consequences implementing it on a national basis that 
concerns me.
  The language provides an exemption if a person files a sworn 
statement to the IRS that their ``sincerely held religious beliefs'' 
would cause them to object to the ``medical health care'' that would be 
covered under ACA's minimum essential health care requirement.

  There is no indication as to how the IRS could implement this 
provision and, as a result, the exemption could essentially be 
available to anyone opposed to the ACA. While the bill states that 
individuals receiving ``voluntary'' medical care would lose their 
exemption, the IRS has no way to monitor individuals' use of voluntary 
medical care and to enforce this provision.
  Under the legislation, individuals receiving ``involuntary'' care--
such as emergency care--would be allowed to remain exempt from the 
coverage requirement, passing the cost of such care on to hospitals and 
other taxpayers.
  Because the bill does not define the ``sincerely held religious 
beliefs'' an individual would need to cite to avoid purchasing 
coverage, the IRS would be forced to determine which Americans' beliefs 
met the standard. Yet just 2 weeks ago, the House considered and passed 
H.R. 2531, the Protecting Taxpayers from Intrusive IRS Requests Act, 
that specifically prevented the IRS from asking taxpayers about their 
religious, political, or social beliefs.
  I regret that normal order has not been followed on H.R. 1814 so that 
these concerns could be surfaced and further information on the broad 
and problematic consequences of H.R. 1814 considered.
  For example, today, the American Academy of Pediatrics just expressed 
their concerns about the impact of H.R. 1814 on children. The American 
Civil Liberties Union also opposes the legislation, and the CBO just 
indicated today that the bill would increase the deficit by $1.5 
billion over 10 years and increase the uninsured by about 500,000 each 
year.
  Current religious exemptions in the Tax Code are circumscribed and 
well-defined. This bill would create a broad and difficult to determine 
exemption in the individual responsibility requirement and force the 
IRS to take on an inappropriate role. Congress should take a more 
careful approach to this issue.
  I yield back the balance of my time.
  Mr. SCHOCK. Mr. Speaker, I yield myself the balance of my time.
  I would just remind my good friend from Michigan that had regular 
order been used when ObamaCare was passed, perhaps we would not be 
attempting to try and fix it now that it is law.
  The U.S. Supreme Court upheld ObamaCare in a 5-4 ruling 2 years ago 
this summer. The Justices did so by affirming that Congress, contrary 
to the repeated assurance by my colleagues on the other side of the 
aisle, had effectively created a tax that falls under the enumerated 
powers of article I of the Constitution, and, like a tax, compliance is 
mandatory, and enforcement is the job of the Internal Revenue Service.
  Since the summer of 2012, we have learned some things about the IRS 
that raise concerns about the agency's ability to do its job fairly. 
Likewise, we have watched the Obama administration usurp congressional 
authority and refuse to enforce the law that bears the President's 
name.
  Among the many ``executive fixes'' that seem to flow from the 
administration with increasing frequency, none have touched upon one of 
the most serious problems with ObamaCare, namely, current law will 
either force millions of Americans to violate their sincerely held 
religious beliefs or punish them for exercising those beliefs.
  We are not likely to agree today--or any day--on the underlying law. 
ObamaCare is as controversial now--and perhaps even more so--than when 
it was passed, but we can agree on this:

       Congress shall make no law respecting the establishment of 
     religion or prohibiting the free exercise thereof.

  Less than a mile from this Chamber, on the bank of the tidal basin, 
are inscribed in marble these words:

       Almighty God hath created the mind free. All attempts to 
     influence it by temporal

[[Page H2276]]

     punishments or burdens are a departure from the plan of the 
     Holy author of our religion. No man shall suffer on account 
     of his religious opinions or belief, but all men shall be 
     free to possess and maintain their opinions in matters of 
     religion.

  Those words, written by Thomas Jefferson, the first Democrat to be 
called ``Mr. President,'' capture the very essence of today's bill. It 
is our duty--even our oath that we take before God--to protect the 
religious freedoms of every American. ObamaCare does not do that. 
Today's bipartisan measure is a small but necessary step if Congress is 
to honor the great tradition of religious liberty enshrined in our 
founding documents and extended to succeeding generations of Americans 
by law.
  Mr. Speaker, I urge passage of H.R. 1814, and I yield back the 
balance of my time.
  Mr. KEATING. Mr. Speaker, I rise in support of the EACH Act on behalf 
of my constituents in Massachusetts that are seeking to continue to 
take advantage of the religious conscience exemption to the individual 
mandate that is currently provided to them under the 2006 Massachusetts 
health reform law.
   Since the individual mandate went into effect in Massachusetts, 
Donna Smiley, a Christian Scientist from Centerville, has taken 
advantage of the religious exemption provided in the law that prevents 
her from being penalized for her religious beliefs. Each year on her 
state tax return, the form has included a section for her to attest 
that because of her sincerely held religious beliefs she has chosen not 
to purchase medical health insurance.
   With the passage of the Affordable Care Act, Donna would no longer 
be able to take advantage of the Massachusetts religious conscience 
exemption and would be penalized by the federal government for not 
having insurance. The EACH Act, modeled after the process that has been 
in place in Massachusetts for the past seven years, would ensure that a 
fair solution is reached so that Donna and other Americans are not 
penalized for their religious beliefs next year.
   The legislation would modestly expand the religious conscience 
exemption in the Affordable Care Act to certain individuals who have 
sincere religious beliefs against medical insurance and related medical 
care. As we saw in Massachusetts, which served as the model for the 
Affordable Care Act as well as the EACH Act, it is clear that a similar 
exemption in no way adversely affected the risk pool or generated a 
rise in abuse or fraud. According to the most recent report from 
Massachusetts' health insurance exchange, approximately 0.1% of the 
population or 6,500 residents apply annually for a religious exemption.
   Allowing for this narrow exemption to the Affordable Care Act is the 
fair and equitable path forward to ensure religious diversity.
   I believe there is a bipartisan coalition of support for this 
measure.
   I urge my colleagues to support this legislation.
  Mr. SMITH of Texas. Mr. Speaker, I support the Equitable Access to 
Care and Health (EACH) Act. This bill provides a modest expansion of 
the religious conscience exemption in the Affordable Care Act (ACA).
  This bipartisan legislation has 218 cosponsors. The ACA currently 
provides for a religious conscience exemption; however, the exemption 
gives preference to only a few faiths. This exemption should be 
expanded to accommodate other religions whose ``sincerely-held 
religious beliefs'' would cause them not to purchase insurance.
  I urge my colleagues on both sides of the aisle to support this 
important piece of legislation.
  The SPEAKER pro tempore (Mr. Duncan of Tennessee). The question is on 
the motion offered by the gentleman from Illinois (Mr. Schock) that the 
House suspend the rules and pass the bill, H.R. 1814.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

                          ____________________