[Congressional Record Volume 162, Number 108 (Wednesday, July 6, 2016)]
[House]
[Pages H4325-H4331]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
RESTORING ACCESS TO MEDICATION AND IMPROVING HEALTH SAVINGS ACT OF 2016
Ms. JENKINS of Kansas. Mr. Speaker, pursuant to House Resolution 793,
I call up the bill (H.R. 1270) to amend the Internal Revenue Code of
1986 to repeal the amendments made by the Patient Protection and
Affordable Care Act which disqualify expenses for over-the-counter
drugs under health savings accounts and health flexible spending
arrangements, and ask for its immediate consideration.
The Clerk read the title of the bill.
The SPEAKER pro tempore. Pursuant to House Resolution 793, in lieu of
the amendment in the nature of a substitute recommended by the
Committee on Ways and Means, printed in the bill, an amendment in the
nature of a substitute consisting of the text of Rules Committee Print
114-60, is adopted, and the bill, as amended, is considered read.
The text of the bill, as amended, is as follows:
H.R. 1270
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 ``Restoring Access to
Medication and Improving Health Savings Act of 2016''.
TITLE I--RESTORING ACCESS TO MEDICATION ACT OF 2016
SEC. 101. SHORT TITLE.
This title may be cited as the ``Restoring Access to
Medication Act of 2016''.
SEC. 102. REPEAL OF DISQUALIFICATION OF EXPENSES FOR OVER-
THE-COUNTER DRUGS UNDER CERTAIN ACCOUNTS AND
ARRANGEMENTS.
(a) HSAs.--Section 223(d)(2)(A) of the Internal Revenue
Code of 1986 is amended by striking the last sentence.
(b) Archer MSAs.--Section 220(d)(2)(A) of such Code is
amended by striking the last sentence.
(c) Health Flexible Spending Arrangements and Health
Reimbursement Arrangements.--Section 106 of such Code is
amended by striking subsection (f).
(d) Effective Date.--The amendments made by this section
shall apply to expenses incurred after December 31, 2016.
TITLE II--HEALTH CARE SECURITY ACT OF 2016
SEC. 201. SHORT TITLE.
This title may be cited as the ``Health Care Security Act
of 2016''.
SEC. 202. ALLOW BOTH SPOUSES TO MAKE CATCH-UP CONTRIBUTIONS
TO THE SAME HEALTH SAVINGS ACCOUNT.
(a) In General.--Section 223(b)(5) of the Internal Revenue
Code of 1986 is amended to read as follows:
``(5) Special rule for married individuals with family
coverage.--
``(A) In general.--In the case of individuals who are
married to each other, if both spouses are eligible
individuals and either spouse has family coverage under a
high deductible health plan as of the first day of any
month--
``(i) the limitation under paragraph (1) shall be applied
by not taking into account any other high deductible health
plan coverage of either spouse (and if such spouses both have
family coverage under separate high deductible health plans,
only one such coverage shall be taken into account),
[[Page H4326]]
``(ii) such limitation (after application of clause (i))
shall be reduced by the aggregate amount paid to Archer MSAs
of such spouses for the taxable year, and
``(iii) such limitation (after application of clauses (i)
and (ii)) shall be divided equally between such spouses
unless they agree on a different division.
``(B) Treatment of additional contribution amounts.--If
both spouses referred to in subparagraph (A) have attained
age 55 before the close of the taxable year, the limitation
referred to in subparagraph (A)(iii) which is subject to
division between the spouses shall include the additional
contribution amounts determined under paragraph (3) for both
spouses. In any other case, any additional contribution
amount determined under paragraph (3) shall not be taken into
account under subparagraph (A)(iii) and shall not be subject
to division between the spouses.''.
(b) Effective Date.--The amendment made by this section
shall apply to taxable years beginning after December 31,
2016.
SEC. 203. SPECIAL RULE FOR CERTAIN MEDICAL EXPENSES INCURRED
BEFORE ESTABLISHMENT OF HEALTH SAVINGS ACCOUNT.
(a) In General.--Section 223(d)(2) of the Internal Revenue
Code of 1986 is amended by adding at the end the following
new subparagraph:
``(D) Treatment of certain medical expenses incurred before
establishment of account.--If a health savings account is
established during the 60-day period beginning on the date
that coverage of the account beneficiary under a high
deductible health plan begins, then, solely for purposes of
determining whether an amount paid is used for a qualified
medical expense, such account shall be treated as having been
established on the date that such coverage begins.''.
(b) Effective Date.--The amendment made by this section
shall apply with respect to coverage beginning after December
31, 2016.
SEC. 204. MAXIMUM CONTRIBUTION LIMIT TO HEALTH SAVINGS
ACCOUNT INCREASED TO AMOUNT OF DEDUCTIBLE AND
OUT-OF-POCKET LIMITATION.
(a) Self-Only Coverage.--Section 223(b)(2)(A) of the
Internal Revenue Code of 1986 is amended by striking
``$2,250'' and inserting ``the amount in effect under
subsection (c)(2)(A)(ii)(I)''.
(b) Family Coverage.--Section 223(b)(2)(B) of such Code is
amended by striking ``$4,500'' and inserting ``the amount in
effect under subsection (c)(2)(A)(ii)(II)''.
(c) Conforming Amendments.--Section 223(g)(1) of such Code
is amended--
(1) by striking ``subsections (b)(2) and'' both places it
appears and inserting ``subsection'', and
(2) by striking ``determined by'' in subparagraph (B)
thereof and all that follows through `` `calendar year
2003'.'' and inserting ``determined by substituting `calendar
year 2003' for `calendar year 1992' in subparagraph (B)
thereof .''.
(d) Effective Date.--The amendments made by this section
shall apply to taxable years beginning after December 31,
2016.
TITLE III--PROTECTING TAXPAYERS BY RECOVERING IMPROPER OBAMACARE
SUBSIDY OVERPAYMENTS ACT
SEC. 301. SHORT TITLE.
This title may be cited as the ``Protecting Taxpayers by
Recovering Improper Obamacare Subsidy Overpayments Act''.
SEC. 302. RECOVERY OF IMPROPER OVERPAYMENTS RESULTING FROM
CERTAIN FEDERALLY SUBSIDIZED HEALTH INSURANCE.
(a) In General.--Section 36B(f)(2)(B)(i) of the Internal
Revenue Code of 1986 is amended to read as follows:
``(i) In general.--In the case of a taxpayer whose
household income is less than 300 percent of the poverty line
for the size of the family involved for the taxable year, the
amount of the increase under subparagraph (A) shall in no
event exceed the applicable dollar amount determined in
accordance with the following table (one-half of such amount
in the case of a taxpayer whose tax is determined under
section 1(c) for the taxable year):
------------------------------------------------------------------------
``If the household income (expressed as a The applicable dollar amount
percent of poverty line) is: is:
------------------------------------------------------------------------
Less than 200%............................ $600
At least 200% but less than 250%.......... $1,500
At least 250% but less than 300%.......... $3,000.''.
------------------------------------------------------------------------
(b) Effective Date.--The amendment made by this section
shall apply to taxable years beginning after December 31,
2016.
The SPEAKER pro tempore. The bill shall be debatable for 1 hour,
equally divided and controlled by the chair and ranking minority member
of the Committee on Ways and Means.
The gentlewoman from Kansas (Ms. Jenkins) and the gentleman from
Michigan (Mr. Levin) each will control 30 minutes.
The Chair recognizes the gentlewoman from Kansas.
General Leave
Ms. JENKINS of Kansas. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days in which to revise and extend their
remarks and include extraneous material on H.R. 1270, currently under
consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from Kansas?
There was no objection.
Ms. JENKINS of Kansas. Mr. Speaker, I yield myself such time as I may
consume.
I rise today in support of H.R. 1270, the Restoring Access to
Medication and Improving Health Savings Act. This bill contains
policies that folks on both sides of the aisle can support and have
supported in the past.
With the cost of health care rising, from hospital stays to doctor
visits and prescription drugs, and the ever-present regulatory burdens
of the Patient Protection and Affordable Care Act, H.R. 1270 combines
three measures that put the people back in control of their own
healthcare spending, gain more access to the over-the-counter
medications they need, and decrease government spending.
One of the most head-scratching provisions of ObamaCare requires
people to get a doctor's prescription if they want to buy over-the-
counter medicines at a pharmacy with their HSA money. This provision is
just about the polar opposite to what most folks think of when buying
aspirin or other common medicines at their pharmacy.
Instead of simply walking in and paying with their HSA card for that
medicine, they are turned down and told to set up an appointment with
their doctor just to get a script for that medicine. It does not
decrease costs for the patient or the government. It actually increases
the burden people have to get those medications. Now they must make the
appointment, wait for days or weeks for the visit, and take that
doctor's time away from sick patients, all to get some allergy
medicine.
H.R. 1270 will allow people to use their HSAs to buy over-the-counter
medications at pharmacies because, when someone needs some allergy
medicine during this time, they should be able to get that medicine
whenever they need it.
With that, H.R. 1270 will allow people to put more into their HSA
accounts and match the amount of their deductible and out-of-pocket
costs. It will allow people to contribute $6,550 individually and
$13,100 for a family, and those amounts will grow with inflation.
Another provision that makes it harder to use an HSA declares that
taxpayers may use HSA funds only for qualified medical expenses
incurred after the establishment of the HSA, which might be some time
after the establishment of the associated high-deductible health plan,
or HDHP. The provision would treat HSAs opened within 60 days after
gaining coverage under an HDHP as having been opened on the same day as
the HDHP.
Also, for eligible older, married Americans, this bill allows them to
contribute catch-up contributions to one shared HSA, simplifying the
saving process and ultimately enabling them to save more and gain more
control over their own health care.
Finally, H.R. 1270 will better protect taxpayer dollars and modify
existing limits on the amounts to be repaid by those whose advance
payments exceed the ObamaCare subsidy to which they are entitled. This
is a bipartisan offset. Twice, Congress has voted to increase the
amount of improper ObamaCare subsidy overpayments that need to be
repaid. Increasing the recovery of improper subsidy overpayments was
first proposed by Senate Democrats in the 2010 Medicare doc fix and
extenders legislation. Former HHS Secretary Sebelius described this
offset as making it ``fairer'' for all taxpayers.
As currently structured, the Democrats' healthcare law fails to
adequately protect taxpayers from overpayments of the Federal subsidies
to purchase health insurance, even in the case of fraud. The current
law limits the amount of money that can be recouped if recipients
receive a greater subsidy than they are entitled to, even if that means
keeping thousands of extra dollars in overpayments.
H.R. 1270 ensures full repayment for those making more than 300
percent of the Federal poverty level and doubles the current repayment
cap for those between 250 and 300 percent of the Federal poverty level.
This is not a tax increase or a way to punish those who receive a pay
increase; rather, it is a measure to show our constituents that we are
taking care of their tax dollars by requiring the return of
overpayments.
[[Page H4327]]
Mr. Speaker, I reserve the balance of my time.
Mr. LEVIN. Mr. Speaker, I yield myself such time as I may consume.
The House was originally scheduled to take up this bill tomorrow--
tomorrow. There was a hole, a hole created by Republicans' refusal to
consider meaningful legislation to address gun violence in this
country.
I was on the steps of the Capitol earlier today hearing the poignant
stories--at times, virtually unbearable to hear--from victims of gun
violence, the shattering impact on themselves or their children, and
what it means in real terms for the lives of their families.
The bill now before us can be simply described: a tax cut mainly for
the most wealthy, being paid for by the loss of health coverage for
130,000 Americans.
As the White House noted in its Statement of Administration Policy:
``The administration strongly opposes House passage of H.R. 1270,
which would create new and unnecessary tax breaks that
disproportionately benefit high-income people, increase taxes for low-
and middle-income people, and do nothing to improve the quality of or
address the underlying cost of health care.''
The Republicans have totally failed during the 6 years of healthcare
reform to present an alternative. Instead, it is repeal or destroy the
ACA. This is the 64th vote to repeal or undermine the ACA.
This bill is one of their scattered proposals on health care.
According to the Joint Tax Committee, of the approximately 1.2 million
returns in 2013 with an HSA deduction, more than 50 percent are from
people with incomes ranging from $100,000 to $200,000 to over $1
million. This bill would double their tax benefit.
For Republicans, their banner is ``the more income inequality, the
better.''
I strongly urge my colleagues to vote ``no.''
Mr. Speaker, I reserve the balance of my time, and I yield the
balance of my time to the gentleman from Washington (Mr. McDermott),
who is the ranking member on the Health Subcommittee, and ask unanimous
consent that he may control that time.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Michigan?
There was no objection.
Ms. JENKINS of Kansas. Mr. Speaker, I yield 3 minutes to the
gentleman from Louisiana (Mr. Boustany), our leader on the Ways and
Means Committee and a subcommittee chairman.
Mr. BOUSTANY. Mr. Speaker, I rise in support of the Restoring Access
to Medication and Improving Health Savings Act, bipartisan legislation
to fix yet another provision within ObamaCare that defies all common
sense.
I have to commend my colleagues on the House Ways and Means
Committee, Congresswoman Lynn Jenkins and Congressman Ron Kind, for
coming together on this bipartisan legislation for the sake of getting
good policy.
This legislation repeals an ObamaCare provision that prohibited
Americans from using their pretax healthcare savings to purchase
qualified over-the-counter medications. Over-the-counter treatments
provide the first line of defense for minor ailments and illnesses. As
a physician, I certainly know this well. Also, as a parent of two
children, I know this quite well.
We all know, Mr. Speaker, concern over the rapidly escalating cost of
health care is shared on a strongly bipartisan basis. On this point, I
think we all can agree. In that same vein, ensuring Americans have
access to the most appropriate care at the right time is a critical
factor in curbing overutilization of healthcare services. In short, not
every ailment or minor illness necessitates a trip to the doctor or
emergency room.
My colleagues across the aisle, the architects of ObamaCare, have
vastly underestimated the value in savings that over-the-counter
treatment options provide each year to the U.S. healthcare system.
Access to over-the-counter treatments is estimated to save the U.S.
healthcare system and consumers $102 billion, on average, each year in
avoided clinical and prescription expenditures.
On average, physicians cite roughly 10 percent of office visits each
year that could be avoided through appropriate use of over-the-counter
treatment options.
In my home State of Louisiana, out-of-pocket expenditures for health
care over the past 10 years has more than doubled, with the most recent
annual statewide expenditure for medications, alone, totaling nearly $5
billion.
This is the right approach for protecting American families and
seniors from some of the worst effects of ObamaCare.
I firmly believe allowing Americans to use their pretax dollars
toward their out-of-pocket healthcare costs serves as a powerful tool
to start really bending the healthcare cost curve in America. That is
why I urge my colleagues to support this very sensible bipartisan
legislation.
Mr. McDERMOTT. Mr. Speaker, I yield myself such time as I may
consume.
I include in the Record an editorial from The Washington Post called,
``The Myth of Paul Ryan.''
[From the Washington Post, July 5, 2016]
The Myth of Paul Ryan
(By Katrina vanden Heuvel)
It's also an apt descrtiption of the man Trump supplanted
as de facto leader of the party--Romney's running mate in
2012, House Speaker Paul D. Ryan (R-Wis.).
Indeed, years before Trump sold Republican primary voters
on the myth of his own great success, Ryan sold a credulous
Washington establishment on the notion that he was a serious
thinker overflowing with political courage--a policy wonk
uniquely willing to tackle tough issues such as entitlement
reform. In the past month, however, it has become more
obvious than ever that Ryan's reputation is worth about as
much as a degree from Trump University. Let's review.
After a fleeting flirtation with principle, Ryan kicked off
June by endorsing Trump for president. Despite his previous
indication that Trump would have to change course to earn his
support, Ryan's endorsement came without any public
concessions or reassurances from Trump It also came after The
Post reported in late 2013 that Ryan was embarking on a
personal crusade to steer Republicans ``away from the angry,
nativist inclinations of the tea party'' and toward a ``more
inclusive vision.''
A few weeks after bowing to Trump, Ryan did take a stand--
against the historic sit-in on the House floor led by civil
rights icon Rep. John Lewis (D-Ga.) to demand a vote on gun
legislation. Ryan derided the show of solidarity with victims
of gun violence as a ``publicity stunt'' and warned ominously
that in the future, ``We will not take this. We will not
tolerate this.'' (But Ryan has said the House will vote on a
GOP-sponsored gun bill this week.)
Lastly, there is Ryan's supposed bread and butter: a policy
agenda rolled out over the course of the month.
Ryan put forward a health-care proposal that was hyped as
the long-awaited Republican alternative to the Affordable
Care Act, but the ``plan'' consisted largely of well-worn
talking points instead of actual legislation. In a withering
editorial titled ``Paul Ryan's flimsy health plan,'' The
Post's editorial board described it as ``less detailed in a
variety of crucial ways than previous conservative health
reform proposals,'' while adding, ``The outlines that the
speaker did provide suggest that it would be hard on the
poor, old and sick.''
He also released a tax reform proposal that, according to
the Wall Street Journal, ``isn't detailed enough for a
complete nonpartisan congressional analysis to verify the
effect on the budget and on households.'' The limited details
he did provide, however, do not paint a pretty picture. It's
not just that Ryan proposes to slash rates for the rich and
corporations. He also wants to create a new loophole for
``pass-through'' income, which is a feature of Trump's
proposal and the disastrous plan implemented by Kansas Gov.
Sam Brownback
(R) that has wrecked his state's finances. And perhaps most
significantly, given his disavowal of his past ``makers and
takers'' rhetoric, Ryan introduced an ``antipoverty'' plan
that would severely weaken the safety net for those living in
poverty. The plan, according to Politico, is mostly
``repackaged GOP proposals,'' including cuts to unemployment
assistance, Head Start and federal Pell Grants. With Ryan's
blue-collar home town of Janesville already suffering the
consequences of corporate trade deals and other Ryan-backed
economic policies that have eviscerated the city's
manufacturing base, TalkPoverty editor Greg Kaufmann writes
that Ryan's latest proposal demonstrates ``his enduring
disconnect from the people struggling in his own district and
across America.''
None of this is new. Ryan has been selling snake oil for
years--promising to ``save'' Medicare by privatizing it,
boasting that he could balance the budget with tax cuts for
the rich and without any cuts to defense spending, pretending
to be a pragmatist while embracing the extreme ideological
dogmas of Ayn Rand and the religious right. But his unearned
standing as a serious and
[[Page H4328]]
courageous leader in a sea of cynical hacks has persisted
nonetheless. Even today, there are those who sympathize with
Ryan, suggesting that he is somehow a victim of Trump and
right-wing Republicans in Congress when, in fact, his
leadership--and failures thereof--helped pave their path to
power.
When he was nominated for vice president in 2012, I wrote
that Ryan's vision for the country isn't courageous--it's
cruel. While that remains true four years later, it's not
only Ryan's policy goals that need to be exposed for what
they are.
Mr. McDERMOTT. Mr. Speaker, June 22 was a historic day in this House.
You could look at it from two different positions. One was it was the
day that the Speaker was going to roll out, finally, after 2,000 days,
his plan for health care in this country.
{time} 1500
Unfortunately for him, in the well of the House, the Democrats
decided that, maybe, commonsense gun legislation was more important.
This bill was supposed to come up that day, but, instead, it was put up
for today, and then it was put up for tomorrow. It is important because
this is the fundamental underpinning of the undoing of the ACA for this
country.
There was a feeling on this floor that it was more important to talk
about commonsense gun legislation. People were out there, worried about
it, and we stood around here again and again, bowing our heads, and
said: ``Gee, we are feeling awful about this,'' and then went on with
business; so the Democrats sat down and said: ``We are going to do
something about this.''
The Speaker is the Speaker, and he is not to be denied, so here comes
his bill again. He couldn't get it on June 22. We are revisiting this
bill with the added benefit of some time to have actually looked at
what the Republican healthcare plan is. The reviews are now in. The
article I included from The Washington Post calls it a ``flimsy health
plan,'' ``Paul Ryan's flimsy health plan.'' The American people don't
understand what he is about to do to them.
Medicare would be replaced by a voucher system. Medicaid would be cut
radically. Consumer protections would be rolled back. Women would be
denied the care they are entitled to. These are the same tired, harmful
ideas that the Republicans have proposed time and time again. At the
heart of this proposal is a dramatic shift of costs onto the patients.
That means the wealthy will win and that the poor and the middle class
will lose.
H.R. 1270, which is knocking gun legislation off the agenda, is the
first place they will begin the process of putting the Ryan plan into
action. It is the first of a dozen bills that are required if they are
serious about destroying the ACA and replacing it with their vision of
health care for America. Like the rest of the Republican health
debacle, H.R. 1270 is a harmful, poorly thought-out policy. This bill
has three main parts, each of which will have damaging impacts on the
Tax Code and on the healthcare system.
The first is to expand the HSAs, the health savings accounts. Health
savings accounts are used by fewer than 1 percent of Americans--0.7
percent of Americans use HSAs. If you are above $1 million, 6 percent
use them. These are mechanisms for the rich to save money around
healthcare costs. Few middle and working class Americans have the
incomes necessary to even contribute to HSAs.
The second thing it does is to repeal an important Affordable Care
Act tax revenue provision and to put more money, tax free, in the hands
of drug manufacturers--$20 billion for HSAs and $5 billion for the drug
manufacturers in this country, as if they weren't making enough. We
can't even have a meaningful hearing in the Ways and Means Committee on
the costs of pharmaceuticals for Americans in the Medicare program.
Of course, now that we have given away $25 billion, we have got to
have a pay-for. Where will we get that pay-for?
There is something in the ACA called the true-up process. Now, if you
are somebody with an income of up to 200 percent of poverty and you are
working and you get a subsidy from the government because you need it
to afford to buy your healthcare plan, if something changes in your
life during that year, there has to be a so-called true-up process.
That is, you received too much in benefits, so you have to pay it back
to the Federal Government.
Now, when $175,000 people like us write a bill of a grand here, a
grand there, it is not really a big deal; but when you are making
$40,000 or $30,000 for a family of four or $50,000 for a family of
four, $1,000 is a big deal.
This was a provision in the Affordable Care Act that said, if you
have to pay the government back, you have to pay some proportion, not
all of it, because we know it would be a real hit at the end of the
year to suddenly get a bill from the IRS for $1,000. It was a way to
keep people able to buy health insurance. The CBO says 130,000 fewer
Americans will have coverage because of this provision. That is how you
pay for giving $20 billion to the top and $5 billion to the
pharmaceutical manufacturers, and that is why some of us are going to
oppose this bill.
My belief is that, if you are serious about dealing with health care,
you are going to have to write it down. Mr. Ryan put a beautiful
talking point list out with not a single word of legislation. He will
not write down what he really intends to do. You have to kind of intuit
it and have to have spent your life thinking about this stuff to
understand all of the intricacies of what he is up to.
The really upsetting thing is that we ought to be dealing with gun
legislation here. The American people are entitled to have us vote on
gun legislation.
I reserve the balance of my time.
Ms. JENKINS of Kansas. Mr. Speaker, I yield 3 minutes to the
gentleman from Minnesota (Mr. Paulsen), a member of the Ways and Means
Committee and an author of one portion of this bill.
Mr. PAULSEN. I thank the gentlewoman for yielding.
Mr. Speaker, I thank Representative Jenkins for her leadership and
advocacy on behalf of consumers' choice in health care, and that is
exactly what this bipartisan bill does and is all about. It is giving
everyone the flexibility and the ability to make healthcare choices
that are best for them and for their families, because no matter what
your views are about the President's new healthcare law, you have to
acknowledge that healthcare costs continue to go up for families, for
small businesses, and for individuals alike. It is a pocketbook issue.
Families want to have more tools and more flexibility to lower their
costs and to set aside money to help pay for health care.
Today, more and more people--nearly 20 million Americans--are using
these health savings accounts to help save for health care. These are
accounts that are used by regular, middle-income folks. In fact, the
Joint Committee on Taxation just released brand new information, while
we were gone on the Fourth of July recess, that points out that almost
80 percent of people who are using these HSA accounts are middle-income
and low-income. Half of the folks had incomes between $75,000 and
$200,000, and 27 percent of the folks had incomes below $75,000. This
is because the HSA is a very important tool that gives families
certainty to help lower their healthcare bills. It allows them to shop
around for the best quality care at the lowest price just like anything
else they want to buy.
Mr. Speaker, HSAs are growing in popularity. We know that. It is time
to improve these accounts now to make them easier for all consumers to
use. In Minnesota, 800,000 consumers and Minnesotans are eligible and
are part of these HSA healthcare plans.
This bill contains more commonsense reforms to help patients. It does
include restoring the ability of patients to use their own healthcare
dollars in health savings accounts and in flexible spending accounts to
purchase over-the-counter medications without their having to get
doctors' prescriptions first. There is no reason for patients to have
to make unnecessary doctors' visits just so they can use their own
money to buy allergy medication or cold medicine like Advil
or Claritin.
In addition, this bill does include provisions, which I authored, to
make it easier for spouses to contribute and to consolidate their
accounts as they near retirement. It also allows for them to pay for
their health care as they open their HSA accounts, and it allows them
to set aside enough money to cover all
[[Page H4329]]
of their deductible and out-of-pocket costs.
Mr. Speaker, this bill is good policy. It is bipartisan, and it is
fiscally responsible. Most importantly, it helps families save and pay
for their health care.
Mr. McDERMOTT. Mr. Speaker, I yield 3 minutes to the gentleman from
Illinois (Mr. Danny K. Davis).
Mr. DANNY K. DAVIS of Illinois. Mr. Speaker, I would much rather be
discussing a bill that would get automatic and semiautomatic weapons
out of our lives. Nevertheless, I strongly oppose H.R. 1270. This bill
gives advantage to the most secure in our country at the expense of the
vulnerable. If you really look at it, it is kind of Robin Hood health
care in reverse.
According to the Joint Committee on Taxation, health savings accounts
vastly benefit high-income earners. Fewer than 0.5 percent of taxpayers
with incomes under $50,000 contribute to HSAs, yet 6.3 percent of
taxpayers who earn over $500,000 contribute to these accounts. This is
not surprising because it is high-income earners who can set aside
thousands of dollars in HSAs. The median income in my congressional
district is $51,311. The vast majority of my constituents will not
benefit from this bill, but they will be harmed by it.
To pay for the $24 million boon to the upper income, this bill hikes
up the healthcare costs of low- and middle-income Americans. When low-
and middle-income families receive financial help to make their ACA
health insurance more affordable, the ACA wisely protects them from
excessive penalties if they incorrectly predict their annual incomes.
Shockingly, H.R. 1270 removes these important consumer protections from
thousands of low- and middle-income families in order to pay for the
tax breaks for the wealthy.
In addition to increasing costs for struggling families, the bill
would result in approximately 130,000 fewer individuals who are covered
by health insurance. HSA expansion is not a substitute for
comprehensive healthcare reform. HSA expansion does not lower
healthcare costs nor improves the quality of healthcare services.
Rather than raising the minimum wage, creating jobs, or growing the
economy, the Republican leadership simply advances HSA expansion to
bolster the wealth of the most privileged at the expense of the
vulnerable. I urge my colleagues to reject this bill and vote ``no.''
Ms. JENKINS of Kansas. Mr. Speaker, I yield 2 minutes to the
gentleman from Texas (Mr. Brady), the esteemed chairman of our House
Ways and Means Committee.
Mr. BRADY of Texas. Mr. Speaker, I rise in support of H.R. 1270, the
Restoring Access to Medication Act of 2016, led and authored by
Congresswoman Lynn Jenkins.
House Republicans recognize the Affordable Care Act is really making
life harder for so many families and job creators. That is why we have
released a detailed plan to repeal this controversial law and have put
in place healthcare solutions that are focused on what the American
people need, not what Washington needs. This bill by Congresswoman
Jenkins helps build upon and advance that important effort. The
legislation is a testament to regular legislative order. It contains
three policies that have been approved in advance by the Ways and Means
Committee.
First, H.R. 1270 eliminates a nonsensical ObamaCare regulation that
puts Washington between patients and the medications they need.
Under ObamaCare, Americans are limited. They can only use their
personal medical savings accounts to buy prescription drugs only. It
doesn't matter if there is an over-the-counter alternative that works
just as well and costs half as much. No. ObamaCare says you cannot use
your own health savings to pay for it without an expensive
prescription. This bill cuts this Federal red tape so Americans, in a
commonsense way, have the freedom to use their own health savings or
flexible spending accounts to buy the medication that best suits them
regardless of what side of the counter it comes from.
Second, the bill makes commonsense improvements to how you contribute
to and spend from your health savings accounts.
These improvements, first introduced by Representative Paulsen and
Dr. Burgess, allow Americans to save more, to coordinate their savings
with their spouses, and to have better access to their savings.
Finally, the measure acts to protect taxpayer dollars by making sure
that those who aren't eligible to get subsidies pay them back. It makes
common sense. If you are not eligible, you should pay them back. Some
patients do under the current law.
Twice, Republicans and Democrats have come together to make the
ObamaCare subsidy repayment fairer. I am hopeful that we can continue
that sense of bipartisan cooperation today. I congratulate
Congresswoman Jenkins. Her bill will help people in America save. I
urge its support.
{time} 1515
Mr. McDERMOTT. Mr. Speaker, I reserve the balance of my time.
Ms. JENKINS of Kansas. Mr. Speaker, I yield 1 minute to the gentleman
from North Carolina (Mr. Holding), a member of the Ways and Means
Committee.
Mr. HOLDING. Mr. Speaker, thank you for the opportunity to speak on
this important bill. I would also like to thank my colleagues on the
Ways and Means Committee, particularly Ms. Jenkins, for collaborating
to put this package together.
The bill before us is built on two important principles: patient-
centered health care and good governance.
This bill will expand consumer-driven healthcare accounts. For
families and individuals, this means expanding their ability to set
aside hard-earned money tax free and giving them the ability to spend
their money on the benefits most useful to them.
This bill will allow Americans to use the money they have set aside
for health care on over-the-counter medication regardless if they go to
their doctor beforehand.
Just as important, Mr. Speaker, this bill will put a stop to the
Federal Government continuing to overpay for ObamaCare subsidies,
thereby protecting taxpayer dollars.
I support these principles, and I urge my colleagues to support the
bill.
Mr. McDERMOTT. Mr. Speaker, I reserve the balance of my time.
Ms. JENKINS of Kansas. Mr. Speaker, I yield 2 minutes to the
gentleman from Georgia (Mr. Carter).
Mr. CARTER of Georgia. Mr. Speaker, I rise today in support of H.R.
1270, because Americans should have every opportunity to use how they
see fit their health savings accounts or health flexible spending
arrangements.
When ObamaCare was passed into law, one of the many things it limited
was what health savings accounts could be used for. Under ObamaCare,
health savings accounts or flexible spending accounts can only be used
for prescription medications and insulin. In other words, if you have a
headache, you cannot use the money you have saved for medication
services. You would need to either get a prescription for your headache
or pay for an over-the-counter drug out of pocket.
I believe one aspect to any successful marketplace is allowing
consumers to use their income and resources as they see fit to manage
their health. Limitations and control by the government on how
Americans can interact with retail businesses is never good, especially
in health care. That is why H.R. 1270 is so important.
H.R. 1270 removes the ObamaCare limitation on medication payments for
health savings accounts and health flexible spending arrangements so
Americans can use their accounts for both over-the-counter medications
as well as prescription medications.
We must continue to remove the governmental barriers that limit
consumer action and choice. We must work to ensure that every American
has choices to make so the U.S. healthcare system remains consumer
driven.
I encourage my colleagues to support this legislation.
Mr. McDERMOTT. Mr. Speaker, I yield myself such time as I may
consume.
I include into the Record a letter from the Executive Office of the
President, a Statement of Administration Policy dated 21 June of 2016
on this bill where the President says, in the last line:
``If the President were presented with H.R. 1270, he would veto the
bill.''
[[Page H4330]]
Statement of Administration Policy
H.R. 1270--The Restoring Access to Medication Act of 2015--Rep.
Jenkins, R-KS, and 39 cosponsors
The Administration strongly opposes House passage of H.R.
1270, which would create new and unnecessary tax breaks that
disproportionately benefit high-income people, increase taxes
for low- and middle-income people, and do nothing to improve
the quality of or address the underlying cost of health care.
The Affordable Care Act is working and is fully integrated
into an improved American health care system. Discrimination
based on pre-existing conditions is a thing of the past.
Thanks to the Affordable Care Act, 20 million more Americans
have health insurance. And under the Affordable Care Act, we
have seen the slowest growth in health care prices in 50
years, benefiting all Americans.
H.R. 1270 would repeal the Affordable Care Act's provisions
that limit the use of flexible savings accounts for over-the-
counter drugs--provisions that help fund the law's coverage
improvements and expansions. The bill also would provide
additional tax breaks that disproportionately benefit those
with higher income by expanding tax-preferred health savings
accounts. These changes would do little to reduce health care
costs or improve quality. To fund these new high-income tax
breaks, H.R. 1270 would increase taxes paid by low- and
middle-income families by removing the law's limit on
repayment of premium tax credits available through the Health
Insurance Marketplaces.
Rather than refighting old political battles by once again
voting to repeal parts of the Affordable Care Act, Members of
Congress should be working together to grow the economy,
strengthen middle-class families, and create new jobs.
If the President were presented with H.R. 1270, he would
veto the bill.
Mr. McDERMOTT. Mr. Speaker, it is very clear that this is, as Mr.
Levin said, the 64th or 65th--I have lost count--effort to undermine
the Affordable Care Act and to begin the process of sliding Americans
away from Medicare and Medicaid and privatize the whole business and
leave the American people in the loving hands of the insurance
industry. We understand.
Newt Gingrich said, when he became Speaker, that his number one goal
was to get rid of Medicare; and the Republican Party has been doing
that since 1994. I have been here the whole time and watched it over
and over and over again. We have beaten it back, we have beaten it
back, and we have beaten it back.
The fact is that the American people are entitled to security in
their health care. In every other industrialized country in the world,
people do not worry about being bankrupted by their illness or an
injury or whatever might happen to them.
Health care is not something that you have very much control over. In
fact, this idea that you can shop your health care; that somehow, as
you are driving down the road and suddenly your heart has problems, you
can stop and say, ``Well, let me get a phone book here and find the
cheapest cardiologist to go to or the cheapest cardiac surgeon,'' that
kind of shopping doesn't go on. We are not buying iceboxes here. We are
designing a system where we are trying to help everybody.
The Republican plan is simply pulling people away from that and
forcing them into their own individual box. You take care of yourself.
I have no responsibility for you whatsoever.
That is the end of a civilized society when we stop caring about
people in the society who have the most trouble dealing with the
problems they face, not because they are weak or stupid.
These people who are getting these benefits, buying their healthcare
plan, are using that money because they don't have enough to do it on
their own. Something changes in their life. One of their kids gets
married. Suddenly they are no longer a deduction. So they have suddenly
got to be in the true-up process, and we are going to take their money
away from them because their kid got married.
Now, my view is that everything about this bill is not in the best
interest of the American people. Not only are they entitled to health
security, they ought to have some security, and that means that we
ought to have a process where everybody who wants to buy a gun ought to
have to go through a background check.
I was going home on the plane last week after what went on here, and
a guy came down the aisle about the size of the man in the chair and
said to me: ``I am a gun collector, and I got 25 guns and they are all
registered, and they should be. And I am a Republican.''
This country understands the commonsense nature of the legislation
that we should be considering today here. Instead, we get the
beginnings of eroding the healthcare system. The Speaker is inexorably
working toward it, and we will just have to keep fighting.
I yield back the balance of my time.
Ms. JENKINS OF Kansas. Mr. Speaker, as I said in my opening
statement, this bill deserves bipartisan support.
It seems that the main objection from my Democratic colleagues
relates to the ObamaCare subsidy overpayments, and our desire to get
back some of the money that our constituents have received either
fraudulently or not under this law is just a commonsense approach.
This is not a tax on poor Americans nor is it a Robin Hood-style
break for rich Americans. Rather, it is a bipartisan offset that many
of my friends on the other side of the aisle have voted for not once,
but twice. It is a chance to fulfill our obligation to be good stewards
of the dollars that hardworking Americans have paid in taxes.
We must pass H.R. 1270 to protect taxpayers, reduce the deficit by
more than $2 billion, and show that we can agree to change some bad
provisions in ObamaCare that drive up costs, decrease access, and
unwisely spend taxpayer dollars.
I yield back the balance of my time.
The SPEAKER pro tempore. All time for debate has expired.
Pursuant to House Resolution 793, the previous question is ordered on
the bill, as amended.
The question is on the engrossment and third reading of the bill.
The bill was ordered to be engrossed and read a third time, and was
read the third time.
The SPEAKER pro tempore. The question is on the passage of the bill.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Ms. JENKINS of Kansas. Mr. Speaker, on that I demand the yeas and
nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, this 15-
minute vote on the passage of the bill will be followed by 5-minute
votes on:
Ordering the previous question on House Resolution 803;
Adoption of House Resolution 803, if ordered;
The motion to suspend the rules and pass S. 1252; and
The motion to suspend the rules and pass H.R. 2646.
The vote was taken by electronic device, and there were--yeas 243,
nays 164, not voting 26, as follows:
[Roll No. 351]
YEAS--243
Abraham
Aderholt
Allen
Amash
Amodei
Ashford
Babin
Barletta
Barr
Barton
Benishek
Bera
Bilirakis
Bishop (MI)
Bishop (UT)
Black
Blackburn
Blum
Boustany
Brady (TX)
Brat
Bridenstine
Brooks (AL)
Brooks (IN)
Buck
Bucshon
Burgess
Byrne
Calvert
Carney
Carter (GA)
Carter (TX)
Chabot
Chaffetz
Clawson (FL)
Coffman
Cole
Collins (GA)
Collins (NY)
Comstock
Conaway
Cook
Costa
Costello (PA)
Crawford
Crenshaw
Cuellar
Curbelo (FL)
Davidson
Davis, Rodney
Dent
DesJarlais
Diaz-Balart
Dold
Donovan
Duffy
Duncan (SC)
Duncan (TN)
Emmer (MN)
Farenthold
Fincher
Fitzpatrick
Fleischmann
Fleming
Flores
Forbes
Fortenberry
Foxx
Franks (AZ)
Frelinghuysen
Garrett
Gibbs
Gibson
Gohmert
Goodlatte
Gosar
Gowdy
Granger
Graves (GA)
Graves (LA)
Graves (MO)
Griffith
Grothman
Guinta
Guthrie
Hanna
Hardy
Harper
Hartzler
Heck (NV)
Hensarling
Herrera Beutler
Hice, Jody B.
Hill
Holding
Hudson
Huelskamp
Huizenga (MI)
Hultgren
Hunter
Hurd (TX)
Hurt (VA)
Issa
Jenkins (KS)
Jenkins (WV)
Johnson (OH)
Johnson, Sam
Jolly
Jones
Jordan
Joyce
Kelly (MS)
Kelly (PA)
Kind
King (IA)
King (NY)
Kinzinger (IL)
Kline
Knight
Labrador
LaHood
Lamborn
Lance
Latta
Lipinski
LoBiondo
Long
Loudermilk
Love
Lucas
Luetkemeyer
Lummis
MacArthur
Marchant
Marino
Massie
McCarthy
McCaul
McClintock
McHenry
McKinley
McMorris Rodgers
McSally
Meadows
Meehan
Messer
Mica
Miller (FL)
Miller (MI)
Moolenaar
Mooney (WV)
Mullin
Mulvaney
Murphy (PA)
Neugebauer
Newhouse
Noem
Nunes
Olson
Palazzo
Palmer
Paulsen
Pearce
Perry
Peters
Peterson
Pittenger
Pitts
Poe (TX)
Poliquin
Pompeo
Posey
Price, Tom
Ratcliffe
Reed
Reichert
Renacci
Ribble
Rice (SC)
[[Page H4331]]
Rigell
Roby
Roe (TN)
Rogers (AL)
Rogers (KY)
Rohrabacher
Rokita
Rooney (FL)
Ros-Lehtinen
Roskam
Ross
Rothfus
Rouzer
Royce
Russell
Salmon
Sanford
Scalise
Schweikert
Sensenbrenner
Sessions
Shimkus
Shuster
Simpson
Sinema
Smith (MO)
Smith (NE)
Smith (NJ)
Smith (TX)
Stefanik
Stewart
Stivers
Stutzman
Thompson (PA)
Thornberry
Tiberi
Tipton
Trott
Turner
Upton
Valadao
Wagner
Walberg
Walden
Walker
Walorski
Walters, Mimi
Weber (TX)
Webster (FL)
Wenstrup
Westerman
Whitfield
Williams
Wilson (SC)
Wittman
Womack
Woodall
Yoder
Yoho
Young (AK)
Young (IA)
Young (IN)
Zeldin
Zinke
NAYS--164
Adams
Aguilar
Beatty
Becerra
Beyer
Bishop (GA)
Blumenauer
Bonamici
Boyle, Brendan F.
Brady (PA)
Brown (FL)
Brownley (CA)
Bustos
Butterfield
Capps
Capuano
Cardenas
Carson (IN)
Cartwright
Castor (FL)
Castro (TX)
Chu, Judy
Cicilline
Clark (MA)
Clarke (NY)
Clay
Cleaver
Clyburn
Cohen
Connolly
Conyers
Cooper
Courtney
Crowley
Cummings
Davis (CA)
Davis, Danny
DeFazio
DeGette
DeLauro
DelBene
DeSaulnier
Deutch
Dingell
Doggett
Doyle, Michael F.
Duckworth
Edwards
Ellison
Engel
Eshoo
Esty
Foster
Frankel (FL)
Fudge
Gabbard
Gallego
Garamendi
Graham
Grayson
Green, Al
Green, Gene
Gutierrez
Hahn
Heck (WA)
Higgins
Himes
Hinojosa
Honda
Hoyer
Huffman
Israel
Jackson Lee
Jeffries
Johnson (GA)
Johnson, E. B.
Kaptur
Keating
Kelly (IL)
Kennedy
Kildee
Kilmer
Kirkpatrick
Kuster
Langevin
Larsen (WA)
Larson (CT)
Lawrence
Lee
Levin
Lieu, Ted
Loebsack
Lofgren
Lowenthal
Lowey
Lujan Grisham (NM)
Lujan, Ben Ray (NM)
Lynch
Maloney, Carolyn
Maloney, Sean
Matsui
McCollum
McDermott
McGovern
McNerney
Meng
Moore
Moulton
Murphy (FL)
Napolitano
Neal
Nolan
Norcross
O'Rourke
Pallone
Pascrell
Payne
Pelosi
Perlmutter
Pingree
Pocan
Polis
Price (NC)
Quigley
Rangel
Richmond
Roybal-Allard
Ruiz
Ruppersberger
Rush
Ryan (OH)
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Schakowsky
Schiff
Schrader
Scott (VA)
Scott, David
Serrano
Sewell (AL)
Sherman
Sires
Slaughter
Smith (WA)
Swalwell (CA)
Takano
Thompson (CA)
Thompson (MS)
Titus
Tonko
Torres
Tsongas
Van Hollen
Vargas
Veasey
Vela
Velazquez
Visclosky
Walz
Wasserman Schultz
Waters, Maxine
Watson Coleman
Yarmuth
NOT VOTING--26
Bass
Bost
Buchanan
Cramer
Culberson
Delaney
Denham
DeSantis
Ellmers (NC)
Farr
Grijalva
Harris
Hastings
Katko
LaMalfa
Lewis
Meeks
Nadler
Nugent
Rice (NY)
Scott, Austin
Speier
Takai
Welch
Westmoreland
Wilson (FL)
{time} 1543
Mses. EDWARDS and CLARK of Massachusetts changed their vote from
``yea'' to ``nay.''
Mr. ASHFORD changed his vote from ``nay'' to ``yea.''
So the bill was passed.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.
Stated for:
Mr. DENHAM. Mr. Speaker, I was inadvertently detained on rollcall
vote 351 regarding H.R. 1270, the Restoring Access to Medication Act of
2015. Had I been present to vote, I would have voted ``yes.''
Stated against:
Mr. WELCH. Mr. Speaker, I was unable to vote on rollcall 351. I would
have voted ``nay'' on rollcall 351 had I been there.
____________________