[Congressional Record Volume 162, Number 146 (Tuesday, September 27, 2016)]
[House]
[Pages H5954-H5961]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 CO-OP CONSUMER PROTECTION ACT OF 2016

  Mr. SMITH of Nebraska. Mr. Speaker, pursuant to House Resolution 893, 
I call up the bill (H.R. 954) to amend the Internal Revenue Code of 
1986 to exempt from the individual mandate certain individuals who had 
coverage under a terminated qualified health plan funded through the 
Consumer Operated and Oriented Plan (CO-OP) program, as amended, and 
ask for its immediate consideration.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Pursuant to House Resolution 893, the 
amendment in the nature of a substitute recommended by the Committee on 
Ways and Means, printed in the bill, is adopted and the bill, as 
amended, is considered read.
  The text of the bill, as amended, is as follows:

                                H.R. 954

       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 ``CO-OP Consumer Protection 
     Act of 2016''.

     SEC. 2. EXEMPTION FROM INDIVIDUAL MANDATE FOR CERTAIN 
                   INDIVIDUALS WHO HAD COVERAGE UNDER A TERMINATED 
                   HEALTH PLAN FUNDED THROUGH THE CONSUMER 
                   OPERATED AND ORIENTED PLAN (CO-OP) PROGRAM.

       (a) In General.--Section 5000A(e) of the Internal Revenue 
     Code of 1986 is amended by adding at the end the following 
     new paragraph:
       ``(6) Certain individuals previously enrolled in health 
     plans funded through the consumer operated and oriented plan 
     (co-op) program.--Any applicable individual for any month 
     if--
       ``(A) such individual was enrolled in minimum essential 
     coverage offered by a qualified nonprofit health insurance 
     issuer (as defined in subsection (c) of section 1322 of the 
     Patient Protection and Affordable Care Act (42 U.S.C. 18042)) 
     receiving funds with respect to such coverage through the 
     Consumer Operated and Oriented Plan program established under 
     such section,
       ``(B) during the calendar year which includes such month, 
     such issuer terminated such coverage in the area in which the 
     individual resides, and
       ``(C) such month ends after the date on which such coverage 
     was so terminated.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply with respect to months beginning after December 
     31, 2013.

  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 gentleman from Nebraska (Mr. Smith) and the gentleman from 
Michigan (Mr. Levin) each will control 30 minutes.
  The Chair recognizes the gentleman from Nebraska.

                              {time}  1530


                             General Leave

  Mr. SMITH of Nebraska. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days within which to revise and extend 
their remarks and include extraneous materials on H.R. 954, currently 
under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Nebraska?

[[Page H5955]]

  There was no objection.
  Mr. SMITH of Nebraska. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise today in support of H.R. 954, the CO-OP Consumer 
Protection Act.
  H.R. 954 is a simple bill rooted in fairness. If you are a consumer 
who complied with the Federal mandate to obtain health insurance 
coverage and your coverage was terminated midyear because the Consumer 
Oriented and Operated Plan, or CO-OP, you bought your plan from 
collapsed, you shouldn't be liable for the individual mandate penalty 
for the remainder of that calendar year.
  I don't need to spend a lot of time on the history of the CO-OP 
program, but just very briefly, more than $2 billion, largely in the 
form of low-interest, startup, and solvency loans, was distributed to 
approved CO-OPs under the ACA.
  Now, 17 of the 23 CO-OPs, which received more than $1.7 billion of 
those dollars, have closed or are in the process of closing, with the 
remaining six also struggling to remain solvent.
  The 17th CO-OP to announce its closure was Health Republic of New 
Jersey, which announced it would be winding down prior to the 2017 plan 
year 2 weeks ago, just days after we marked up this bill in the Ways 
and Means Committee.
  The first CO-OP to close was CoOpportunity Health, which sold plans 
covering 120 Nebraskans and Iowans in 2014 before being taken over by 
the Iowa Department of Insurance late that year.
  While health providers in Nebraska and Iowa were made whole for 
services provided to CoOpportunity planholders through the States' 
guaranty funds, consumers, and the remaining insurers in the two States 
are now paying back the guaranty funds for those costs.
  Similar situations have played out in other States covered by 
collapsed CO-OPs, including States like New York, Oregon, Ohio, and 
Illinois, where planholders lost coverage midyear.
  When CoOpportunity collapsed, I heard from nearly 300 constituents 
with concerns about what this loss of coverage meant to them and their 
finances. The vast majority of these people wanted to have health 
insurance coverage and did buy new coverage, but were concerned a brief 
lapse would still lead to them paying a penalty.
  The other side will tell you this bill is unnecessary because these 
people were provided a special enrollment period and could already 
apply for a hardship exemption. Most Nebraskans took advantage of that 
special enrollment. I still heard from many of them that the likelihood 
of accidentally incurring a tax penalty was at the front of their minds 
during this period of time.
  There are already more than 20 exemptions to the individual mandate 
in the law. Those who lost insurance through no fault of their own 
after doing their best to follow the law and whose unique circumstances 
led them not to seek new coverage for the remainder of the year should 
not be forced to file additional paperwork and rely on the opinion of a 
bureaucrat to ensure they aren't subject to a tax penalty. And they 
certainly shouldn't have to worry about this additional tax, while also 
searching among very limited options for a new insurance plan.
  Mr. Speaker, I acknowledge there is broad disagreement about the 
individual mandate. This bill isn't about that. It is about ensuring a 
small fraction of consumers in a small number of States who did their 
very best to comply with the law don't have to worry about the threat 
of a tax penalty. It is also about ensuring if any remaining CO-OPs are 
terminated midyear in the future that those consumers have one less 
concern than Nebraskans had last year.
  Mr. Speaker, I reserve the balance of my time.
  Mr. LEVIN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, this bill before us today is yet another attempt to 
undermine the Affordable Care Act, plain and simple. In fact, it is now 
the 65th such attempt by Republicans since the ACA was signed into law.
  There is no denying that the ACA has provided quality, affordable 
health coverage to more than 20 million previously uninsured Americans. 
And importantly, individuals can no longer be denied coverage, as they 
could in the past, for preexisting conditions like high blood pressure 
or diabetes.
  And thanks to the ACA, a new survey from the Centers for Disease 
Control and Prevention found that the number of uninsured Americans has 
fallen to just 8.6 percent, the lowest level ever recorded. Let's also 
not forget that over the last few years, healthcare costs have been 
growing at the slowest rate in more than 50 years, according to the 
Council of Economic Advisers. And the ACA improved Medicare's coverage 
for prescription medicines and preventive care for seniors.
  This bill undermines the individual responsibility provision of the 
ACA, which is important in making many of its benefits possible, 
including no one being denied coverage, no preexisting conditions, and 
no gender discrimination.
  There are provisions in the ACA to provide when coverage is 
interrupted in the middle of a policy. In cases of CO-OP closures 
during a policy year, there is the ACA provision of a special 
enrollment period, SEP, to allow individuals to continue to have 
coverage.
  The Department of Health and Human Services indicates that each 
individual affected by a midyear CO-OP closure was contacted at least 
20 times, providing individuals with additional plan choices they could 
enroll in during the special enrollment period. All individuals in 
States with midyear CO-OP closures had additional choices available to 
them.
  And in instances where a purchasing plan needed to be undertaken and 
would be financially difficult, these individuals could also apply for 
a hardship exemption from the individual mandate penalty. HHS has a 
number of avenues for individuals to apply for an exemption for a 
variety of life circumstances where premiums are a financial burden.
  The Joint Committee on Taxation scored this bill using a generic 
model, since there was no available data on the number of individuals 
potentially impacted.
  Every step of the way, every step of the way, Republicans have worked 
to undermine CO-OPs and ensure their failure. Republicans were 
responsible for the severe reductions in the amount of money available 
to the CO-OPs from Federal loans and strict limits to risk corridor 
payments. CO-OPs that misestimated the risk pool should have been 
eligible for risk stabilization payments to help weather the early 
years of an unknown market, but the Republicans made sure those 
stabilizing funds would not be available as part of their effort to 
kill the ACA with a thousand cuts.
  The American Academy of Actuaries noted that weakening the individual 
mandate, as this bill would do, will lead to both higher premium costs 
for patients and higher costs to the Federal Government.
  BlueCross and BlueShield, one of the largest insurers in the Nation, 
agrees that exemptions from the mandate will drive prices higher.
  We know that this bill will not be signed into law. This morning, the 
White House released its Statement of Administration Policy on this 
legislation, stating:
  ``The Administration strongly opposes House passage of H.R. 954. The 
Administration remains committed to providing Americans with 
accessible, quality, and affordable health coverage, including by 
addressing issues that arise when their health insurers stop offering 
coverage during the year. In such circumstances, the Administration has 
offered special enrollment periods, provided consumer outreach, and 
worked with state departments of insurance to ensure consumers have 
smooth transitions to other health plans. Individuals for whom coverage 
is unaffordable or who experience a hardship also may qualify for an 
exemption from the individual-responsibility provision of the law. 
These options are available to all consumers in these circumstances, 
not just those enrolled in coverage through CO-OPs.
  ``H.R. 954 would exempt anyone whose CO-OP ends coverage during the 
year from the individual-responsibility provision. This is unnecessary 
given consumer protections already available. Moreover, it would create 
a bad precedent for using exemptions from the individual-responsibility 
provision to address unrelated concerns about

[[Page H5956]]

the Affordable Care Act. The individual-responsibility provision is a 
necessary part of a system that prohibits discrimination against 
individuals with pre-existing conditions and requires guaranteed 
issuance. The provision helps prevent people from waiting until they 
get sick to buy health insurance or dropping health insurance when they 
believe they do not need it. Weakening the individual responsibility 
provision would increase health insurance premiums and decrease the 
number of Americans with coverage.
  ``The Administration always is willing to work with the Congress on 
fiscally responsible ways to further improve health care affordability 
and the Affordable Care Act. The President's budget offers a number of 
proposals to do so. However, H.R. 954 would be a step in the wrong 
direction, because it would create a precedent that undermines a key 
part of the law and would do nothing to help middle-class families 
obtain affordable health care.
  ``If the President were presented with H.R. 954, he would veto the 
bill.''
  Mr. Speaker, I reserve the balance of my time.

                   Statement of Administration Policy


H.R. 954--CO-OP Consumer Protection Act of 2016--Rep. Smith, R-NE, and 
                            seven cosponsors

       The Administration strongly opposes House passage of H.R. 
     954. The Administration remains committed to providing 
     Americans with accessible, quality, and affordable health 
     coverage, including by addressing issues that arise when 
     their health insurers stop offering coverage during the year. 
     In such circumstances, the Administration has offered special 
     enrollment periods, provided consumer outreach, and worked 
     with state departments of insurance to ensure consumers have 
     smooth transitions to other health plans. Individuals for 
     whom coverage is unaffordable or who experience a hardship 
     also may quality for an exemption from the individual-
     responsibility provision of the law. These options are 
     available to all consumers in these circumstances, not just 
     those enrolled in coverage through CO-OPs.
       H.R. 954 would exempt anyone whose CO-OP ends coverage 
     during the year from the individual-responsibility provision. 
     This is unnecessary given consumer protections already 
     available. Moreover, it would create a bad precedent for 
     using exemptions from the individual-responsibility provision 
     to address unrelated concerns about the Affordable Care Act. 
     The individual-responsibility provision is a necessary part 
     of a system that prohibits discrimination against individuals 
     with pre-existing conditions and requires guaranteed 
     issuance. The provision helps prevent people from waiting 
     until they get sick to buy health insurance or dropping 
     health insurance when they believe they do not need it. 
     Weakening the individual responsibility provision would 
     increase health insurance premiums and decrease the number of 
     Americans with coverage.
       The Administration always is willing to work with the 
     Congress on fiscally responsible ways to further improve 
     health care affordability and the Affordable Care Act. The 
     President's Budget offers a number of proposals to do so. 
     However, H.R. 954 would be a step in the wrong direction, 
     because it would create a precedent that undermines a key 
     part of the law and would do nothing to help middle-class 
     families obtain affordable health care.
       If the President were presented with H.R. 954, he would 
     veto the bill.

  Mr. SMITH of Nebraska. Mr. Speaker, I certainly will reflect briefly 
on the comments of my colleague across the aisle who says that all of 
the problems have been worked out, that all the provisions have been 
met, and that anyone who lost their coverage, through no fault of their 
own, would find an exemption or a consideration from the bureaucracy.
  I just want to say that Americans who have lost their coverage 
certainly deserve certainty that they won't be subject to the penalties 
when they lost their coverage, and not just promises that the Federal 
Government might take into consideration their situation.
  There had been many characterizations of how easy enrollment would be 
some time ago. It hasn't worked out that way.
  Mr. Speaker, I yield 2 minutes to the gentleman from Louisiana (Mr. 
Boustany).
  Mr. BOUSTANY. Mr. Speaker, I thank the gentleman from Nebraska (Mr. 
Smith) for yielding time to me.
  Mr. Speaker since ObamaCare passed, we have seen nothing but major 
problems: higher costs, higher premium costs, higher out-of-pocket 
costs, network disruptions, and coverage disruptions.
  Just 2 years after the implementation of ObamaCare, the Louisiana 
Health Cooperative closed its doors. Actual 2014 enrollment in the CO-
OP was less than half of estimated enrollment: 13,000 midyear in 2014, 
compared to the 28,100 projected. By December 2014, those numbers had 
dropped significantly, the highest percentage loss among all the 
Nation's 23 CO-OPs during that period.
  Over 7,000 Louisianans complied with ACA's individual mandate by 
purchasing health insurance through one of the CO-OPs created under the 
law, but their plan was terminated midyear by the failure of that CO-
OP.
  Now, let's just have some common sense here. This was no fault of the 
good men and women who put their faith and put their hard-earned 
premium dollars into this CO-OP. They enrolled, as required by law. And 
it is just wrong, it is wrong to hold these working families 
financially responsible for the cost of a CO-OP's failure because it 
went under due to factors out of their control.
  Mr. Smith's bill is very narrowly crafted to provide this kind of 
relief. It is a commonsense bill. It helps people who are struggling 
with these costs, many of whom have lost employment and everything 
else.
  That is why I support the CO-OP Consumer Protection Act. This is 
really important legislation that will help Americans across this 
country who have been harmed, harmed by ObamaCare's closing of these 
CO-OPs. It is not their fault. We should provide them with some relief 
under difficult economic conditions.
  I urge my colleagues to support this legislation. It is common sense. 
It is narrowly crafted, and it is the right thing to do. It is the 
moral thing to do.

                              {time}  1545

  Mr. LEVIN. Mr. Speaker, I yield such time as he may consume to the 
gentleman from Washington (Mr. McDermott), the ranking member on the 
Health Subcommittee of the Committee on Ways and Means.
  (Mr. McDERMOTT asked and was given permission to revise and extend 
his remarks.)
  Mr. McDERMOTT. Mr. Speaker, I would like to offer a piece of advice 
to my Republican colleagues. Be careful what you wish for because you 
may get it, because, despite this newfound compassion for consumers, if 
you listen to these crocodile tears flowing out here, you would think 
they really cared. The truth is Republicans wanted the CO-OPs to fail 
from the very start. For years, they have systematically undermined the 
program and made it virtually impossible for CO-OPs across this country 
to succeed.
  Now, let's look exactly at what they did, because that is a pretty 
hard thing I am saying. Back in 2013, under Republican leadership, 
Congress slashed the funding for loans and grants to CO-OPs by nearly 
two-thirds. The President set it at one level and the Republicans said: 
No, we will give you one-third of it. So they cut it from the very 
start. That devastated the program during the early days and denied 
consumers access to dozens of new plan choices in the marketplace.
  But they didn't stop there. They were determined they were going to 
get those CO-OPs. In 2014, the Republicans inserted a rider in the CR/
omnibus bill. This blocked the administration from shifting 
discretionary funding--discretionary funding--into the ACA's risk 
corridor program which they disingenuously--the Republicans--called an 
insurance company bailout. The truth is that this rider was a 
deliberate effort to destabilize CO-OPs which were taking on new 
populations under the ACA. It isn't only the CO-OPs, but it is also the 
small insurers.
  It cut risk corridor payments to one-eighth. The President put in a 
dollar, the Republicans put in 12 cents, and that devastated CO-OPs. It 
created unpredictability, and small insurers have also got their 
problems and are now raising rates. With the deck stacked against them, 
it is no wonder that so many fledgling CO-OPs struggled. They were a 
victim of a partisan political attack that they simply couldn't 
withstand. They didn't have the money.
  Now, my Republican colleagues didn't do this out of ignorance. They 
did it out of malice because they knew the importance of risk 
mitigation. They knew exactly what they were doing. In fact, when they 
wanted to make their own insurance program work--put in a few years 
before called part D of Medicare--the Republicans

[[Page H5957]]

embraced risk management with open arms. In 2003, when President Bush's 
Medicare part D bill incorporated risk management measures, they were 
nearly identical--nearly identical--to the ones in the ACA.
  But unlike the ACA, they funded those measures very generously. In 
fact, as the part D market--the drug market--fully stabilized, many 
experts have been saying that the risk management measures could now be 
scaled back or revised. Yet, once the Republicans give money to 
somebody, they continue to fund it generously, funneling millions--
billions, actually--into part D plan sponsors even if they don't need 
it. They are giving it to the drug companies. But they wouldn't give it 
to the CO-OPs. The drug companies they love, but the CO-OPs they hated, 
so they took it away.
  Now, talk about an insurance company bailout. Of course, the 
Affordable Care Act hasn't received the same treatment. Instead, we are 
prepared today to vote again to undermine the law weakening the 
individual mandate with yet another carve-out. Republicans somehow 
believe you can put together a healthcare system and only take in the 
sick, I guess. You can't have an individual mandate that everybody has 
to be a part of it.
  So this bill raises many questions, but we never even had a hearing 
on it. They didn't want anybody to come in and testify about what this 
bill was going to do or what it might do or what it has done or what it 
will do. They simply rammed it through the Ways and Means Committee. 
One member wanted it, and one member had one story from one place in 
this country and said this is a bill we need.
  We don't actually know how many people might have paid the individual 
mandate because they didn't enroll in coverage following the midyear 
CO-OP collapse, but we do know one thing: this bill will weaken the 
individual mandate.
  It seems like a small change, and I admit it is a small change, but 
if you go down this road--the Chinese say death by 1,000 cuts. This is 
the first cut or the second cut or whichever one you want. They are 
threatening the sustainability of the entire health insurance industry. 
We know this because, in Washington State, we have seen it.
  When you try to provide universal coverage but don't have a mandate, 
the system simply doesn't work. We tried it in Washington State in 
1993. We had an individual mandate and everybody had to have insurance 
and so forth, and then the Republicans in Washington State decided 
let's take out the individual mandate. The result was a disaster. 
Healthy people couldn't get covered, and premiums spiked out of 
control, creating a death spiral that devastated the individual 
insurance market.
  By 1999, not one single insurer in the United States of America was 
selling individual policies in the State of Washington because of 
taking away that individual mandate. This was a catastrophe for 
everyone: doctors, hospitals, insurers, and most importantly for 
consumers like the person that we heard the story about that we all 
feel it is too bad it happened. But they created it. They created the 
facts that made it happen.
  So when my Republican colleagues put forward a bill to weaken the 
mandate under the guise of helping consumers, I have a hard time 
believing it because their record is clear. After more than 60 votes to 
deny Americans health coverage--they tried to repeal ObamaCare over and 
over and over and over and so on--years of systematic sabotage of the 
CO-OPs and today's crocodile tears about the plight of CO-OP consumers, 
it is downright impossible to take them seriously. The Members in this 
body should vote ``no.''
  Mr. SMITH of Nebraska. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I would like the Record to reflect that hearings have 
taken place that have included the subject matter of the CO-OPs. In 
fact, I recall the chief of staff from HHS came before the Ways and 
Means Committee, and we had a rather extended discussion on the CO-OPs, 
CoOpportunity Health, and the numerous others that have failed; but, 
more importantly, it is crucial to establish the record on the risk 
corridor.
  The gentleman from Washington stated that it is Republicans who 
designed this to fail. Number one, Republicans are not responsible for 
the design of any part of this. Interestingly enough, we were told by 
the administration, and, in fact, the administration is on record, that 
the risk corridor program was intended to be operated on a revenue-
neutral basis, that is, risk corridor payments would be offset by 
payments collected by other insurers. Congress simply acted, and I 
would add, on a bipartisan basis to codify that very statement.
  In fact, I include in the Record an April 2014 memo from CMS, from 
Centers for Medicare and Medicaid Services, explaining how risk 
corridor funding would be prorated if receipts were insufficient to 
meet requests.

         Department of Health & Human Services, Centers for 
           Medicare & Medicaid Services,
                                  Washington, DC., April 11, 2014.


                  risk corridors and budget neutrality

       Q1: In the MIS Notice of Benefit and Payment Parameters for 
     2015 final rule (79 FR 13744) and the Exchange and Insurance 
     Market Standards for 2015 and Beyond NPRM (79 FR 15808), HHS 
     indicated that it intends to implement the risk corridors 
     program in a budget neutral manner. What risk corridors 
     payments will HHS make if risk corridors collections for a 
     year are insufficient to fund risk corridors payments for the 
     year, as calculated under the risk corridors formula?
       A1: We anticipate that risk corridors collections will be 
     sufficient to pay for all risk corridors payments. However, 
     if risk corridors collections are insufficient to make risk 
     corridors payments for a year, all risk corridors payments 
     for that year will be reduced pro rata to the extent of any 
     shortfall. Risk corridors collections received for the next 
     year will first be used to pay off the payment reductions 
     issuers experienced in the previous year in a proportional 
     manner, up to the point where issuers are reimbursed in full 
     for the previous year, and will then be used to fund current 
     year payments. If, after obligations for the previous year 
     have been met, the total amount of collections available in 
     the current year is insufficient to make payments in that 
     year, the current year payments will be reduced pro rata to 
     the extent of any shortfall. If any risk corridors funds 
     remain after prior and current year payment obligations have 
     been met, they will be held to offset potential 
     insufficiencies in risk corridors collections in the next 
     year.
       Example 1: For 2014, HHS collects $800 million in risk 
     corridors charges, and QHP issuers seek $600 million risk 
     corridors payments under the risk corridors formula. HHS 
     would make the $600 million in risk corridors payments for 
     2014 and would retain the remaining $200 million for use in 
     2015 and potentially 2016 in case of a shortfall.
       Example 2: For 2015, HHS collects $700 million in risk 
     corridors charges, but QHP issuers seek $1 billion in risk 
     corridors payments under the risk corridors formula. With the 
     $200 million in excess charges collected for 2014, HHS would 
     have a total of $900 million available to make risk corridors 
     payments in 2015. Each QHP issuer would receive a risk 
     corridors payment equal to 90 percent of the calculated 
     amount of the risk corridors payment, leaving an aggregate 
     risk corridors shortfall of $100 million for benefit year 
     2015. This $100 million shortfall would be paid for from risk 
     corridors charges collected for 2016 before any risk 
     corridors payments are made for the 2016 benefit year.
       Q2: What happens if risk corridors collections do not match 
     risk corridors payments in the final year of risk corridors?
       A2: We anticipate that risk corridors collections will be 
     sufficient to pay for all risk corridors payments over the 
     life of the three-year program. However, we will establish in 
     future guidance or rulemaking how we will calculate risk 
     corridors payments if risk corridors collections (plus any 
     excess collections held over from previous years) do not 
     match risk corridors payments as calculated under the risk 
     corridors formula for the final year of the program.
       Q3: If HHS reduces risk corridors payments for a particular 
     year because risk corridors collections are insufficient to 
     make those payments, how should an issuer's medical loss 
     ratio (MLR) calculation account for that reduction?
       A3: Under 45 CFR 153.710(g)(1)(iv), an issuer should 
     reflect in its MLR report the risk corridors payment to be 
     made by HHS as reflected in the notification provided under 
     153.510(d). Because issuers will submit their risk corridors 
     and MLR data simultaneously, issuers will not know the extent 
     of any reduction in risk corridors payments when submitting 
     their MLR calculations. As detailed in 45 CFR 153.710(g)(2), 
     that reduction should be reflected in the next following MLR 
     report. Although it is possible that not accounting for the 
     reduction could affect an issuer's rebate obligations, that 
     effect will be mitigated in the initial year because the MLR 
     ratio is calculated based on three years of data, and will be 
     eliminated by the second year because the reduction will be 
     reflected. We intend to provide more guidance on this 
     reporting in the future.
       Q4: In the 2015 Payment Notice, HHS stated that it might 
     adjust risk corridors parameters up or down in order to 
     ensure budget neutrality. Will there be further adjustments

[[Page H5958]]

     to risk corridors in addition to those indicated in this FAQ?
       A4: HHS believes that the approach outlined in this FAQ is 
     the most equitable and efficient approach to implement risk 
     corridors in a budget neutral manner. However, we may also 
     make adjustments to the program for benefit year 2016 as 
     appropriate.

  Mr. SMITH of Nebraska. Mr. Speaker, I yield 2 minutes to the 
gentleman from Illinois (Mr. Dold).
  Mr. DOLD. Mr. Speaker, I want to thank my good friend from Nebraska 
for yielding some time.
  Mr. Speaker, it is interesting that we talk about crocodile tears. 
There is nothing of the sort on this side of the aisle. Frankly, I find 
it fascinating because, when I talk to some of my colleagues on the 
other side of the aisle, they recognize that there are issues and 
problems with the Affordable Care Act. Premiums have gone through the 
roof, deductibles are sky-high, and families are paying more and more 
each and every day in order to be able to provide health insurance for 
their families.
  People say: I want to help fix, let's try to help fix. This is a very 
narrowly tailored bill, Mr. Speaker.
  Let me tell you what this bill is not. This bill is not something 
that will abolish the individual mandate--far from it, far from 
abolishing the individual mandate.
  Rising healthcare costs and uncertainty are plaguing communities and 
families across our country. In Illinois, the Land of Lincoln CO-OP 
collapsed in July, resulting in 49,000 people across the State losing 
their coverage. Now these families will need to switch plans and risk 
losing access to their doctors or pay a tax penalty at the end of the 
year, which will put affordability of quality care even further out of 
reach.
  Mr. Speaker, here is just one example that I have heard from one of 
my constituents. They were paying nearly $2,500 a month in premiums 
through the Land of Lincoln plan. Their family paid $2,700 in their 
deductible and even put $5,000 toward their out-of-pocket maximum. Now 
they are being forced, because it has gone away, to start back at zero. 
The plan ends on October 1.
  So what this narrowly tailored bill would do, Mr. Speaker, is it 
would basically say, if you can't find a plan, if for some reason you 
don't get the memo back from the bureaucrat that you are not going to 
get a tax bill, it still requires that same family, come January 1, to 
go get insurance. But what we want to do is we want to say to these 
families that, if indeed you have not gotten your insurance in those 2 
months, that you will not be given a tax penalty by the IRS.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. SMITH of Nebraska. Mr. Speaker, I yield the gentleman from 
Illinois an additional 1 minute.
  Mr. DOLD. Here is the bottom line, Mr. Speaker. Families like the one 
that I just mentioned all across Illinois are already losing their 
healthcare coverage. The absolute least we can do is help them get 
through this year by providing relief from a costly tax penalty.
  The insurance that they lost, they lost through no fault of their 
own. They were doing the right things because they want coverage for 
their families. The least that we can do for these next couple of 
months--or should another CO-OP in the future fail midyear--is not give 
them a tax penalty from the IRS.
  Moving forward, I remain focused on working with everyone who is 
willing to roll up their sleeves and do the hard work needed to drive 
down costs, increase access to quality care, and make our healthcare 
system work for everyone.
  Mr. LEVIN. I yield myself 1 minute, Mr. Speaker.
  Mr. Speaker, I just want to say to the gentleman from Illinois that 
the last thing the Republicans have wanted to do is to work with us to 
make ACA work better--the last thing. Instead, they have, time and time 
again, tried to destroy ACA.
  In Illinois, there are nine carriers providing health insurance. If 
there is an interruption, whether it is a CO-OP or another plan, under 
ACA, there is a special period available for people to obtain a 
different insurance--nine different carriers.
  Essentially, what this is is an effort to destroy a provision that is 
so important to making healthcare reform viable. That is my answer to 
the gentleman from Illinois.
  I reserve the balance of my time, Mr. Speaker.
  Mr. SMITH of Nebraska. Mr. Speaker, I yield 1 minute to the gentleman 
from California (Mr. McCarthy), the majority leader.
  Mr. McCARTHY. Mr. Speaker, I thank the gentleman for yielding.
  Before I speak, Mr. Speaker, I want to congratulate the gentleman. He 
has seen a problem, he has listened to his constituents, and he is 
doing something about it--exactly what we expect from our statesmen.
  Mr. Speaker, ObamaCare is collapsing all around us. Insurers are 
backing out, people can't afford the premiums, and even heavily 
subsidized CO-OPs are crashing. More than $2 billion were funneled into 
23 CO-OPs across the country: 16 have gone under or are about to go 
under; the other 7 are just treading water.
  Now, what does that mean? That means people who had insurance, who 
purchased it just as ObamaCare forced them to do, were left in the 
lurch when the CO-OP they got and the insurance failed. Now, that is 
bad enough. This is just another way the promise that all of us were 
told ``if you like your plan, you can keep it'' was broken. So these 
people are left without insurance through no fault of their own, 
insurance they were forced to buy.
  What is the response? What does ObamaCare say? Tax them. Tax them for 
not having insurance.
  Now, I don't know about you, Mr. Speaker, but isn't that a little 
crazy? How can you punish people for not having insurance when the CO-
OP they bought their insurance from goes under? It is bad enough people 
are left without insurance because of the failures of ObamaCare; but 
why should we have the IRS punish them on top of that?

                              {time}  1600

  Frankly, you don't solve problems by kicking people when they are 
down. Representative Adrian Smith's bill would stop this. Government 
shouldn't be in the business of taxing people when they lose their 
insurance, especially when the CO-OP they used failed.
  Nothing less than replacing ObamaCare will stop all of the havoc it 
is causing. In the meantime, we have an obligation to offer relief to 
the people hurt by this law.
  Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.
  Mr. SMITH of Nebraska. Mr. Speaker, I yield 3 minutes to the 
gentlewoman from Tennessee (Mrs. Blackburn), my colleague from the 
Energy and Commerce Committee.
  Mrs. BLACKBURN. Mr. Speaker, I thank the gentleman for yielding and 
for his work on this issue.
  I think we have to go back in history a little bit on this. ObamaCare 
was passed into law, signed into law, in 2010. A part of that law, by 
the way, we had to wait until it passed so we could read it and find 
out what all was in it established this CO-OP program. The way the law 
was written, it allowed CMS to go in and put in place the terms of the 
loans for the CO-OP program.
  Now, our colleague from Washington said it was the fault of Congress. 
I want to remind you that we did not do the loan terms that have been 
so onerous. That was done through the rulemaking process by CMS. The 
way they set this up put the CO-OPs at a disadvantage from the start. 
As a result of this, we are seeing these plan failures. This is a 
mandate that is crumbling under its own weight, the weight of the 
mandate, coupled with the way CMS has handled the terms of these loans.
  Now, the Energy and Commerce Committee, where I serve as vice chair, 
had released a report earlier this month looking at the failures of 
these CO-OPs and the investigation that we have had on this. The report 
reviewed CMS' mismanagement of this program.
  Closures of these CO-OPs have left consumers scrambling for health 
insurance. It gives them fewer options. It provides them with less 
affordable choices. So the Affordable Care Act becomes unaffordable for 
millions of Americans. Eight million of that 20 million had insurance 
from their employer. They were perfectly happy. All of a sudden they 
are thrown into a program, and now the insured goes out of business. 
Fewer choices.

[[Page H5959]]

  Even in my State of Tennessee, our insurance commissioner, Julie 
McPeak, testified before the Energy and Commerce Committee about the 
burdens of CO-OPs and the failures that it has brought about on our 
State regulators and our communities.
  When Tennessee's CO-OP, the Community Health Alliance Mutual 
Insurance Company, failed approximately 27,000 Tennesseans, they were 
all forced to find new plans. Only 6 of the original 23 CO-OPs remain. 
I will tell my colleagues that this is what you call a false hope. It 
did not work. It made the situation worse.
  The SPEAKER pro tempore (Mr. Simpson). The time of the gentlewoman 
has expired.
  Mr. SMITH of Nebraska. Mr. Speaker, I yield the gentlewoman an 
additional 1 minute.
  Mrs. BLACKBURN. A recent HHS-OIG report found that the remaining CO-
OPs are becoming financially insolvent. They are looking as if they, 
too, are going to go the way of the others that have failed. Not only 
does the failure of CO-OPs waste tax dollars, it also leaves 
individuals in the lurch.
  I am pleased that this legislation is coming before us. It implements 
our committee's recommendation by ensuring that individuals who make a 
good faith effort to comply with the individual mandate are not further 
punished as a result of a CO-OP's failure.
  Mr. LEVIN. Mr. Speaker, I yield myself 1 minute.
  As we have outlined--the administration has likewise--there are 
provisions when policies are interrupted, whether it is CO-OPs or 
otherwise, in the law for people to take advantage of, in the law that 
you want to destroy.
  Let me just mention, in terms of Nebraska, there are 45,000 people in 
Nebraska who are not covered by Medicaid because of the failure of the 
government there to access. In Tennessee, there are 180,000 people--
180,000. You talk about hopes. Those are people who had hopes, and the 
government essentially thumbed their nose at those hopes.
  Mr. Speaker, I yield such time as he may consume to the gentleman 
from Oregon (Mr. Blumenauer), a distinguished member of our 
committee. '

  Mr. BLUMENAUER. Mr. Speaker, I thank Mr. Levin. I appreciate his 
courtesy and I appreciate his focus on the challenges inherent with the 
legislation we have before us.
  If people want to understand why we are having problems under the 
Affordable Care Act, this is a great example. Every single major piece 
of legislation, to my knowledge, landmark legislation, has required 
fine tuning and modification. That has generally been the spirit where 
people in both parties move forward to try and deal with occasional 
oversights, areas to improve mistakes, and opportunities to make it 
better.
  What we have seen for 6 years under the Affordable Care Act is that 
there has been an entirely different mind-set. It was to try and make 
it worse. It was to try and undercut it. I think my count is that this 
is the 65th time there has been an attempt to repeal all or part of the 
Affordable Care Act.
  It is pretty stark what this has produced. We have--and it is 
unassailable--the lowest uninsured rate in America right now. In fact, 
some of the 19 States that have refused the expansion of Medicaid under 
the Affordable Care Act, even there has been a reduction because of the 
availability of subsidies to help make it affordable.
  The insurance policies that people have are fundamentally better. You 
can no longer deny coverage for preexisting conditions. I thought at 
the time that Members of Congress should have declared a conflict of 
interest because I think virtually all of us would have been subjected 
to problems getting insurance if they were denied on the basis of 
preexisting conditions.
  What we have seen from the outset is that people refused during the 
legislative process itself to be able to have the give-and-take of a 
conference committee. Because Republicans refused to legislate, it had 
to be adopted under the reconciliation process. And then for 6 
consecutive years, no refinement, no adjustment, just steadily chipping 
away.
  Now, I have a couple of CO-OPs in my district. Those were an 
interesting addition to try and add some additional competition in a 
model that would not be for-profit insurance. They were given, under 
the existing legislation, access to a risk corridor to try and even out 
premiums because we knew it would be impossible with all of the moving 
pieces for people to be able to very precisely determine exactly what 
the rates should be. So there was some give, there was some adjustment, 
for the risk corridors to be able to have additional resources for 
people who hadn't quite gotten it right.
  That was envisioned under the initial act. It was something that 
insurance companies in Oregon thought that Congress would keep its 
word. They planned accordingly. Unfortunately, the junior Senator, the 
gentleman from Florida (Mr. Rubio), in the 2014 omnibus stripped out 
that language. It really didn't get the attention that it deserved at 
the time, and that was a big piece of legislation that was rumbling 
through, pressed for time, and not given the real authoritative give-
and-take and attention that it deserved. But that took away money that 
those people had been promised, that they needed, and were depending 
on.
  So we precipitated a crisis, like we have seen with other areas with 
attacking the Affordable Care Act. We see the 19 States that have 
refused Medicaid expansion under a relatively tortured interpretation 
of the Supreme Court. Nobody that I know of, when we were voting on the 
Affordable Care Act, thought that States would be able to voluntarily 
deny health care to people who were too poor to qualify for the 
subsidies; but, amazingly, 19 States have done that. That is another 
area of instability that has posed problems with insurance markets. 
States that actually did expand have seen less of the upheaval.
  It brings us to today where people are chipping away again in this 
effort with a piece of legislation that is absolutely unnecessary to 
repeal part of the individual mandate. The individual mandate, by the 
way, was put in the Affordable Care Act as part of an effort to forge a 
bipartisan solution. Bear in mind, the mandate that people purchase 
insurance was not a Democratic idea. It was something that was part of 
the Republican alternative to HillaryCare in the early 1990s. But it 
makes sense to have a mandate so that these burdens are shared broadly 
and everybody benefits.
  Well, there is no reason to get rid of the individual mandate. These 
people who are in a failed CO-OP already have--because under current 
law, if you have a plan that closed midyear, you are already allowed a 
special enrollment period to choose new coverage. And if there are any 
individuals for whom coverage is unaffordable or they experience a 
hardship, they may qualify for an existing exemption from the 
individual responsibility provision. So this is already taken care of 
under existing law.
  What it is doing is continuing this effort to chip away, to 
undermine, to repeal. I hope that we get past this notion that we are 
going to continue to make the primary Republican alternative for health 
care just trying to attack something that is working; and if they would 
cooperate, if they would refine, if they would try and solve problems 
rather than creating new ones, we could make it work even better.
  Mr. Speaker, I am voting against this piece of--I don't know what to 
call it. It is not going to be enacted into law. It shouldn't be 
enacted into law. It represents an empty exercise of stalling and 
attacking instead of refining and improving. The American people 
deserve better.
  Mr. SMITH of Nebraska. Mr. Speaker, I reserve the balance of my time.
  Mr. LEVIN. Mr. Speaker, I yield myself the balance of my time.
  In closing, the case has been so carefully and fully laid out. This 
is another effort to cut and destroy. This is now maybe not the 
thousandth cut, but the 65th. Fortunately, none has succeeded, nor will 
this.
  Republicans come here and indicate some care about individuals in 
terms of their health care. And I just say this personally--and all of 
us who care about health care have the same feelings--this country had 
a disgraceful situation: 50 million people going to sleep every night 
without any healthcare coverage.

                              {time}  1615

  Democrats took the initiative, and we now have the lowest percentage 
of

[[Page H5960]]

uninsured in terms of the records of this country. All we get are bills 
from the Republicans--one cut effort after another--and this is the 
latest. Maybe that is a good reason for us to leave here because, 
otherwise, we will see, I am sure, another one.
  The ACA is very clear for people who lose their coverage during a 
coverage period. There is a special provision for them to obtain 
coverage elsewhere, and there is a hardship provision if that is not 
obtainable, if that is not available. We have been waiting to have 
specific examples. They never come.
  As I said to the gentleman--and I say this respectfully--if he really 
cares about the citizens in his State and their health care, he will go 
back to his State and tell the leadership there that it is time to 
expand Medicaid for those people because, in the gentleman's State, 
there are tens of thousands of people who don't have that coverage 
today because of the inaction or the opposition of Republican 
majorities in States and in this Congress.
  That is what this is all about. I urgently suggest for our fellow 
Democrats--and, I would hope, for a few enlightened Republicans--to 
vote ``no.''
  Mr. Speaker, I yield back the balance of my time.
  Mr. SMITH of Nebraska. Mr. Speaker, I yield myself such time as I may 
consume.
  We need a healthcare plan that involves patients and their providers. 
We need a healthcare plan and healthcare coverage--insurance, if you 
will--that is a product that is purchased by millions of Americans on 
its own merit, not because of the heavy hand of the Federal 
Government's imposing fines and penalties even upon those Americans who 
are doing everything they were supposed to be doing so as to be 
responsible citizens in taking care of themselves.
  What is clear from the debate today, Mr. Speaker, is that, in the 
face of the failures of the ACA or ObamaCare, whichever label you might 
wish to attach to it--and there are certainly many failures of the 
plan--the administration and my colleagues across the aisle continue to 
advocate for the individual mandate at all costs, no matter how 
negatively this might impact a law-abiding individual who seeks to do 
the right thing.
  Mr. Speaker, during the markup of this bill in committee, a supporter 
on the committee referred to the law as a ``work in progress.'' I would 
say that that is a generous description of the law. If it is truly a 
work in progress, why would we penalize Americans--through no fault of 
their own for losing coverage--with fines that run hundreds, if not 
thousands, of dollars?
  We are persistently told that our only desire is to take away health 
insurance coverage from Americans and that we have no constructive 
ideas for improving the healthcare system. This bill is one small way 
to improve the healthcare system.
  It is interesting that this bill has been characterized as an effort 
to undermine the ACA. Is that how weak the ACA is in that a small, 
narrowly crafted bill like this would undermine the entire thing? I 
doubt it. This is a small effort to help innocent Americans who have 
lost coverage through no fault of their own. We should not penalize 
them and create a financial hardship additionally for them than they 
have already been experiencing.
  I urge all of my colleagues to join me in providing this small issue 
of fairness.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BRADY of Texas. Mr. Speaker, the news about the Affordable Care 
Act gets worse every day. Premiums are going through the roof, choice 
and access are falling through the floor, and insurers are fleeing 
exchanges throughout the country.
  Just in the past few days, we learned that one of the nation's 
largest insurers is pulling out of Nebraska and three major cities in 
Tennessee.
  On top of this, all but six of the 23 CO-OPs created under the law 
have failed despite billions of dollars in taxpayer-funded loans.
  These CO-OPs were created by the Affordable Care Act as federally-
backed, non-profit health insurance companies. But, like so many parts 
of the law, the CO-OP program was deeply flawed from the start.
  Seventeen of these CO-OPs have collapsed. Hundreds of thousands of 
Americans have had their health coverage disrupted as a result.
  Many more could suffer the same harm if additional CO-OPs fail--a 
real possibility considering that just two weeks ago New Jersey's CO-OP 
announced it will shut down at the end of the year.
  The magnitude of these failures can be hard to grasp--especially for 
Washington bureaucrats who simply see these families as numbers on 
paper.
  For American families who lost their insurance coverage due to a CO-
OP collapse, the impacts could not be more real. And, for many, it 
could feel like the walls are closing in.
  Their health plans have been terminated through no fault of their 
own.
  The number of options for purchasing a new plan is shrinking as more 
insurers leave the ACA exchanges.
  And, if these Americans fail to purchase new coverage, they could be 
forced to pay the individual mandate tax penalty.
  That's just wrong.
  We have a responsibility to protect Americans and their families from 
these harmful impacts of the Affordable Care Act.
  Congressman Adrian Smith's ``CO-OP Consumer Protection Act,'' 
provides the opportunity to do so right now.
  The bill takes action to exempt Americans from the individual mandate 
tax penalty if their plan was terminated mid-year due to the failure of 
an ACA CO-OP.
  Americans were led to believe these CO-OP plans were reliable. They 
depended on them, and now only six remain standing.
  House Republicans have put forward a consensus plan to repeal and 
replace Obamacare. Our plan will bring patient-focused care to the 
American people.
  And, our plan will bring relief to all Americans from the individual 
mandate and its tax penalty.
  As we work to turn this proposal into legislation, it's only right to 
bring relief from this tax penalty to Americans who lost their 
insurance mid-year--or could lose it in the future--due to the failures 
of the CO-OP program.
  I want to thank Congressman Smith for his leadership on this 
important legislation, and I urge all my colleagues to join me in 
supporting its passage.
  The SPEAKER pro tempore. All time for debate has expired.
  Pursuant to House Resolution 893, 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.


                             Recorded Vote

  Mr. LEVIN. Mr. Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The vote was taken by electronic device, and there were--ayes 258, 
noes 165, not voting 8, as follows:

                             [Roll No. 563]

                               AYES--258

     Abraham
     Aderholt
     Allen
     Amash
     Amodei
     Ashford
     Babin
     Barletta
     Barr
     Barton
     Benishek
     Bera
     Bilirakis
     Bishop (MI)
     Bishop (UT)
     Black
     Blackburn
     Blum
     Bost
     Boustany
     Brady (TX)
     Brat
     Bridenstine
     Brooks (AL)
     Brooks (IN)
     Buchanan
     Buck
     Bucshon
     Bustos
     Byrne
     Calvert
     Carter (GA)
     Carter (TX)
     Chabot
     Chaffetz
     Clawson (FL)
     Coffman
     Cole
     Collins (GA)
     Collins (NY)
     Comstock
     Conaway
     Cook
     Cooper
     Costello (PA)
     Cramer
     Crawford
     Crenshaw
     Cuellar
     Culberson
     Curbelo (FL)
     Davidson
     Davis, Rodney
     Denham
     Dent
     DeSantis
     DesJarlais
     Diaz-Balart
     Dold
     Donovan
     Duckworth
     Duffy
     Duncan (SC)
     Duncan (TN)
     Ellmers (NC)
     Emmer (MN)
     Farenthold
     Fincher
     Fitzpatrick
     Fleischmann
     Fleming
     Flores
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gabbard
     Garrett
     Gibbs
     Gibson
     Gohmert
     Goodlatte
     Gosar
     Gowdy
     Graham
     Granger
     Graves (GA)
     Graves (LA)
     Graves (MO)
     Griffith
     Grothman
     Guinta
     Guthrie
     Hanna
     Hardy
     Harper
     Harris
     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
     Katko
     Kelly (MS)
     Kelly (PA)
     King (IA)
     King (NY)
     Kinzinger (IL)
     Kline
     Knight
     Kuster
     Labrador
     LaHood
     LaMalfa
     Lamborn
     Lance
     Larson (CT)
     Latta
     Lipinski
     LoBiondo
     Long
     Loudermilk
     Love
     Lucas
     Luetkemeyer
     Lummis
     Lynch
     MacArthur
     Maloney, Sean
     Marchant
     Marino
     Massie
     McCarthy
     McCaul
     McClintock
     McHenry
     McKinley

[[Page H5961]]


     McMorris Rodgers
     McSally
     Meadows
     Meehan
     Messer
     Mica
     Miller (FL)
     Miller (MI)
     Moolenaar
     Mooney (WV)
     Mullin
     Mulvaney
     Murphy (PA)
     Neugebauer
     Newhouse
     Noem
     Nugent
     Nunes
     Olson
     Palazzo
     Palmer
     Paulsen
     Pearce
     Perry
     Peters
     Peterson
     Pittenger
     Pitts
     Poliquin
     Pompeo
     Posey
     Price, Tom
     Ratcliffe
     Reed
     Reichert
     Renacci
     Ribble
     Rice (SC)
     Rigell
     Roby
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rohrabacher
     Rokita
     Rooney (FL)
     Ros-Lehtinen
     Roskam
     Ross
     Rothfus
     Rouzer
     Royce
     Russell
     Salmon
     Sanford
     Scalise
     Schweikert
     Scott, Austin
     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
     Williams
     Wilson (SC)
     Wittman
     Womack
     Woodall
     Yoder
     Yoho
     Young (AK)
     Young (IA)
     Young (IN)
     Zeldin
     Zinke

                               NOES--165

     Adams
     Aguilar
     Bass
     Beatty
     Becerra
     Beyer
     Bishop (GA)
     Blumenauer
     Bonamici
     Boyle, Brendan F.
     Brady (PA)
     Brown (FL)
     Brownley (CA)
     Capps
     Capuano
     Cardenas
     Carney
     Carson (IN)
     Cartwright
     Castor (FL)
     Castro (TX)
     Chu, Judy
     Cicilline
     Clark (MA)
     Clarke (NY)
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly
     Conyers
     Costa
     Courtney
     Crowley
     Cummings
     Davis (CA)
     Davis, Danny
     DeFazio
     DeGette
     Delaney
     DeLauro
     DelBene
     DeSaulnier
     Deutch
     Dingell
     Doggett
     Doyle, Michael F.
     Edwards
     Ellison
     Engel
     Eshoo
     Esty
     Farr
     Foster
     Frankel (FL)
     Fudge
     Gallego
     Garamendi
     Grayson
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hahn
     Hastings
     Heck (WA)
     Higgins
     Himes
     Honda
     Hoyer
     Huffman
     Israel
     Jackson Lee
     Jeffries
     Johnson (GA)
     Johnson, E. B.
     Kaptur
     Keating
     Kelly (IL)
     Kennedy
     Kildee
     Kilmer
     Kind
     Langevin
     Larsen (WA)
     Lawrence
     Lee
     Levin
     Lewis
     Lieu, Ted
     Loebsack
     Lofgren
     Lowenthal
     Lowey
     Lujan Grisham (NM)
     Lujan, Ben Ray (NM)
     Maloney, Carolyn
     Matsui
     McCollum
     McDermott
     McGovern
     McNerney
     Meeks
     Meng
     Moore
     Moulton
     Murphy (FL)
     Nadler
     Napolitano
     Neal
     Nolan
     Norcross
     O'Rourke
     Pallone
     Pascrell
     Payne
     Pelosi
     Perlmutter
     Pingree
     Pocan
     Polis
     Price (NC)
     Quigley
     Rangel
     Rice (NY)
     Richmond
     Roybal-Allard
     Ruiz
     Ruppersberger
     Ryan (OH)
     Sanchez, Linda T.
     Sarbanes
     Schakowsky
     Schiff
     Schrader
     Scott (VA)
     Scott, David
     Serrano
     Sewell (AL)
     Sherman
     Sires
     Slaughter
     Smith (WA)
     Speier
     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
     Welch
     Wilson (FL)
     Yarmuth

                             NOT VOTING--8

     Burgess
     Butterfield
     Hinojosa
     Kirkpatrick
     Poe (TX)
     Rush
     Sanchez, Loretta
     Westmoreland

                              {time}  1645

  Messrs. CUELLAR, PETERS, and LYNCH changed their vote from ``no'' to 
``aye.''
  So the bill was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________