[Congressional Record Volume 163, Number 33 (Friday, February 24, 2017)]
[Extensions of Remarks]
[Pages E227-E228]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 PROVIDING FOR CONGRESSIONAL DISAPPROVAL OF FINAL RULE BY SECRETARY OF 
                       HEALTH AND HUMAN SERVICES

                                 ______
                                 

                               speech of

                            HON. DIANE BLACK

                              of tennessee

                    in the house of representatives

                      Thursday, February 16, 2017

  Mrs. BLACK. Madam Speaker, I include in the Record 3 letters, one 
from myself and Senator Joni Ernst, a letter from the Family Research 
Council, and one from 25 outside organizations, which support H.J. Res. 
43.

                                Congress of the United States,

                               Washington, DC, September 23, 2016.
     Hon. Sylvia Mathews Burwell,
     Secretary, U.S. Department of Health and Human Services, 
         Washington, DC.
       Dear Secretary Burwell: We write to express our strong 
     opposition to the Department of Health and Human Services 
     (HHS) September 7, 2016, notice of proposed rulemaking titled 
     ``Compliance with Title X Requirements by Project Recipients 
     in Selecting Subrecipients.'' Although we appreciate the 
     Department's intent to follow proper regulatory procedure 
     pursuant to the Administrative Procedure Act, HHS's purpose 
     for engaging in the rulemaking appears on its face to be an 
     attempt to subvert the will of elected representatives.
       Moreover, apart from the Department's impetus for the 
     notice of proposed rulemaking, we also question whether the 
     Department's stated rationale adequately supports its 
     conclusion that providers with a reproductive health focus 
     are more ``effective'' than other health providers that offer 
     comprehensive care for women and men. Nowhere in the proposed 
     notice of rulemaking does HHS clearly define what it means to 
     provide Title X services in an ``effective'' manner. It does 
     appear to assert that a number of factors--such as the range 
     of contraceptive methods on-site, the number of clients in 
     need of publicly funded family planning services served, and 
     the availability of preconception care--distinguish providers 
     with a reproductive health focus as more ``effective'' and 
     ``high quality'' than other types of providers. However, that 
     list of factors falls far short of all of the attributes and 
     recommendations included in the Centers for Disease Control 
     and Office of Population Affairs report entitled ``Providing 
     Quality Family Planning Services: Recommendations of CDC and 
     the U.S. Office of Population Affairs.''
       To further complicate the argument about quality and 
     effectiveness, the data cited in the notice of proposed 
     rulemaking is not adequate for determining patient outcomes. 
     The Department relies heavily on utilization and demographic 
     statistics, but appears to lack hard data regarding actual 
     patient outcomes and need, as the Department does not require 
     grantees to track patients or verify their income. As you 
     know, the issue of inadequate data has previously been raised 
     by the Institute of Medicine (IOM), after the HHS Office of 
     Family Planning in 2007 asked IOM to provide a critical 
     review of the Title X Family Planning Program. In addition to 
     finding ``no clear, evidence-based process for establishing 
     or revising program priorities and guidelines,'' IOM stated 
     the following in its May 2009 Report Brief:
       ``The committee concludes that the program does not collect 
     all the data needed to monitor and evaluate its impact. 
     Therefore, the committee proposes a comprehensive framework 
     to evaluate the program and assess how well clinics meet the 
     family planning needs of the program's clients. The committee 
     concludes that additional data will be needed in the areas of 
     client needs, structure, process, and outcomes in order to 
     assess the program's overall progress.''
       We welcome evidence that this recommendation has been fully 
     adopted, but are unaware of any clear evidence confirming 
     that to be the case. If HHS cannot clearly define an 
     ``effective'' or ``high quality'' provider, it is unclear to 
     us how state and local project grantees are supposed to do so 
     in order to comply with this proposed rule. It is also 
     therefore unclear how HHS will be able to accurately 
     determine in every case whether state or local project 
     recipients--who are generally closer to and more familiar 
     with subrecipients and the patient base in their geographical 
     region--have considered inappropriate criteria in evaluating 
     subrecipients. Rarely do the American people benefit when the 
     federal government attempts to substitute its judgment for 
     that of state or local governments--particularly when the 
     criteria used to inform that judgment are unclear, and that 
     judgment is not supported by coherent and impartial facts.
       Finally, if HHS is going to assert the authority to adapt 
     its rules in order to address changing circumstances, we 
     implore HHS to consider the recent general shift in health 
     care policy toward comprehensive care. As HHS states on its 
     website, in addition to assisting individuals and couples in 
     planning and spacing births, part of the mission of Title X 
     is to contribute to ``improved health for women and 
     infants.'' HHS's suggestion that subrecipients like federally 
     qualified health centers--which provide greater preventive 
     and primary health care services than providers with a 
     reproductive health focus--are per se less ``effective'' than 
     providers with a reproductive health focus does not comport 
     with that stated mission.
       We urge HHS to reconsider this overreaching and ill-
     supported rule. We will continue to closely monitor this 
     proposed rulemaking, and intend to submit this letter as a 
     formal comment. We look forward to a detailed response from 
     your Department.
           Sincerely,
     Joni K. Ernst,
       United States Senator.
     Diane Black,
       United States Congressman.
                                  ____
                                  
         


                                      Family Research Council,

                               Washington, DC, February 14, 2017.-
     House of Representatives,
     Washington, DC.
       Dear Representative: On behalf of Family Research Council 
     and the families we represent, I urge you to vote Yes on Rep. 
     Diane

[[Page E228]]

     Black's (R-TN) H.J. Res. 43, a joint resolution of 
     disapproval under the Congressional Review Act to overturn 
     former President Obama's HHS final rule on Title X family 
     planning funds (81 FR 91852, December 19, 2016). This rule 
     blocks states from restricting Title X family planning funds 
     to abortion providers like Planned Parenthood, effectively 
     creating a backdoor handout for the abortion industry. 
     Congress can and must act to overturn this harmful rule, 
     which lacks any statutory basis. FRC will score in favor of 
     this resolution.
       This rule prohibits Title X primary grant recipients, 
     including states and some private entities, from 
     ``prohibit[ing] an entity from participating for reasons 
     other than its ability to provide Title X services.'' The 
     stated intent of this rule is to coerce numerous states to 
     give family planning funds to abortion providers like Planned 
     Parenthood. This harms states which have chosen to prioritize 
     these family planning funds to health clinics and community 
     health centers that seamlessly offer a full range of 
     healthcare services, including family planning, but which do 
     not participate in abortion. In addition, the rule disrupts 
     the current health care arrangements of tens of thousands of 
     women who obtain services that are uniquely provided to them 
     by current Title X-funded comprehensive health care clinics 
     in those states.
       The Title X statute of the Public Health Service Act itself 
     requires that no funds may be used for ``programs where 
     abortion is a method of family planning,'' but nowhere does 
     the law say that states cannot exclude certain providers, let 
     alone abortion providers. Furthermore, states realize that 
     money is fungible. When Planned Parenthood or other abortion 
     providers receive Title X grant funding, it frees up 
     resources for them to spend more on abortion, their main 
     source of non-governmental income.
       States should be free to allocate Title X funds in a way 
     that clearly keeps family planning and abortion separate by 
     not funding abortion providers like Planned Parenthood, which 
     use abortion, the killing of an innocent unborn human being, 
     as a form of ``family planning.'' Obama's HHS rule on Title X 
     is an executive overreach and a handout to the abortion 
     industry that is simply without basis in the law.
       Again, on behalf of FRC, I urge you to vote for Rep. Diane 
     Black's H.J. Res. 43, a Congressional resolution of 
     disapproval to overturn this harmful rule. FRC will score in 
     favor of this resolution.
           Sincerely,
                                                David Christensen,
     Vice President for Government Affairs.
                                  ____

                                                February 15, 2017.
       Dear Member of Congress: On behalf of the millions of 
     members of our national and state-based pro-life and pro-
     family organizations listed below, we urge you support 
     application of the Congressional Review Act to eliminate 
     former President Obama's 11th-hour rule preventing states 
     from eliminating Title X funding from Planned Parenthood and 
     other abortion providers.
       During the 114th Congress, efforts to defund America's 
     abortion giant were spurred by undercover videos which show 
     that Planned Parenthood has been engaged in unethical and 
     possibly illegal practices connected to the trafficking of 
     unborn children's organs for profit. The videos detail 
     Planned Parenthood's willingness to manipulate abortion 
     methods--at times, in ways that raise questions about whether 
     the ban on partial-birth abortion has been violated--to more 
     easily obtain intact hearts, lungs, brains, and other organs 
     to be sold to tissue brokers.
       Because of Congressional efforts to defund Planned 
     Parenthood and President Donald Trump's campaign commitment 
     to defend the nation's largest abortion provider, President 
     Obama finalized an 11th-hour rule forcing states to award 
     Title X funds to Planned Parenthood and other abortion 
     providers.
       Like other efforts to defund Planned Parenthood, the 
     Congressional Review Act eliminating President Obama's 11th-
     hour rule would allow states to continue using their legal 
     authority to award Title X funds to family planning clinics 
     that do not engage in abortion or trafficking of baby body 
     parts.
       We urge the 115th Congress to act swiftly to undo the 
     bureaucratic protectionism that President Obama put in place 
     to grant America's largest abortion provider permanent and 
     privileged access to our taxpayer dollars.
           For Life,
         Marjorie Dannenfelser, President, Susan B. Anthony List; 
           Paul Weber, President & CEO, Family Policy Alliance; 
           Tom McClusky, Vice President, March for Life Action; 
           Frank Cannon, President, American Principles Project; 
           Clarke Forsythe, Acting President & Senior Counsel, 
           Americans United for Life Action; Penny Nance, CEO & 
           President, Concerned Women for America; Kristan 
           Hawkins, President, Students for Life; Lauren Muzyka, 
           Executive Director, Sidewalk Advocates for Life; 
           Melissa Ortiz, Able Americans; Eric Teetsel, President, 
           Family Policy Alliance of Kansas; Troy Newman, 
           President, Operation Rescue; Brian Fisher, Human 
           Coalition, President & Co-Founder.
         Maria McFadden Maffucci, Editor, Human Life Review; Matt 
           Lockett, Executive Director, Bound4LIFE International; 
           Roland C. Warren, President and CEO, Care Net; Judie 
           Brown, President, American Life League; Jim Sedlak, 
           Founder, STOPP International; Steven Ertelt, Editor, 
           LifeNews.com; Joe Ortwerth, Executive Director, 
           Missouri Family Policy Council; Denise Leipold, 
           Executive Director, Right to Life of Northeast Ohio; 
           Tami L. Fitzgerald, Executive Director, NC Values 
           Coalition; Jeanette Burdell, Executive Director, St 
           Joseph County Right To Life; Nicole Theis, President, 
           Delaware Family Policy Council; John Helmberger, Chief 
           Executive Officer, Minnesota Family Council; Chris 
           Slattery, Director, Expectant Mother Care-EMC FrontLine 
           Pregnancy Centers.

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