[Congressional Record Volume 164, Number 195 (Tuesday, December 11, 2018)]
[House]
[Pages H10054-H10057]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PREMATURITY RESEARCH EXPANSION AND EDUCATION FOR MOTHERS WHO DELIVER
INFANTS EARLY REAUTHORIZATION ACT OF 2018
Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the
bill (S. 3029) to revise and extend the Prematurity Research Expansion
and Education for Mothers who deliver Infants Early Act (PREEMIE Act).
The Clerk read the title of the bill.
The text of the bill is as follows:
S. 3029
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 ``Prematurity Research
Expansion and Education for Mothers who deliver Infants Early
Reauthorization Act of 2018'' or the ``PREEMIE
Reauthorization Act of 2018''.
SEC. 2. RESEARCH RELATING TO PRETERM LABOR AND DELIVERY AND
THE CARE, TREATMENT, AND OUTCOMES OF PRETERM
AND LOW BIRTHWEIGHT INFANTS.
Section 2 of the Prematurity Research Expansion and
Education for Mothers who deliver Infants Early Act (42
U.S.C. 247b-4f) is amended--
(1) in subsection (b)--
(A) in paragraph (1)(A), by striking ``clinical,
biological, social, environmental, genetic, and behavioral
factors relating'' and inserting ``factors relating to
prematurity, such as clinical, biological, social,
environmental, genetic, and behavioral factors, and other
determinants that contribute to health disparities and are
related''; and
(B) in paragraph (2), by striking `` concerning the
progress and any results of studies conducted under paragraph
(1)'' and inserting ``regarding activities and studies
conducted under paragraph (1), including any applicable
analyses of preterm birth. Such report shall be posted on the
Internet website of the Department of Health and Human
Services.'';
(2) by striking subsection (c) and inserting the following:
``(c) Pregnancy Risk Assessment Monitoring Survey.--The
Secretary of Health and Human Services, acting through the
Director of the Centers for Disease Control and Prevention,
shall--
``(1) continue systems for the collection of maternal-
infant clinical and biomedical information, including
electronic health records, electronic databases, and
biobanks, to link with the Pregnancy Risk Assessment
Monitoring System (PRAMS) and other epidemiological studies
of prematurity in order to track, to the extent practicable,
all pregnancy outcomes and prevent preterm birth; and
[[Page H10055]]
``(2) provide technical assistance, as appropriate, to
support States in improving the collection of information
pursuant to this subsection.''; and
(3) in subsection (e), by striking ``except for subsection
(c), $1,880,000 for each of fiscal years 2014 through 2018''
and inserting ``$2,000,000 for each of fiscal years 2019
through 2023''.
SEC. 3. PUBLIC AND HEALTH CARE PROVIDER EDUCATION AND SUPPORT
SERVICES.
Section 399Q of the Public Health Service Act (42 U.S.C.
280g-5) is amended--
(1) in subsection (a)--
(A) by striking ``conduct demonstration projects'' and
inserting ``conduct activities, which may include
demonstration projects''; and
(B) by striking ``for babies born preterm'' and inserting
``mothers of infants born preterm, and infants born preterm,
as appropriate''; and
(2) in subsection (b)--
(A) in the matter preceding paragraph (1), by striking
``under the demonstration project'';
(B) in paragraph (1)--
(i) in the matter preceding subparagraph (A), by striking
``programs to test and evaluate various strategies to
provide'' and inserting ``programs, including those to test
and evaluate strategies, which, in collaboration with States,
localities, tribes, and community organizations, support the
provision of'';
(ii) by redesignating subparagraphs (B) through (F) as
subparagraphs (C) through (G), respectively;
(iii) by inserting after subparagraph (A), the following:
``(B) evidence-based strategies to prevent preterm birth
and associated outcomes;'';
(iv) in subparagraph (C), as so redesignated, by inserting
``, and the risks of non-medically indicated deliveries
before full term'' before the semicolon;
(v) in subparagraph (D), as so redesignated--
(I) in clause (ii), by inserting ``intake'' before the
semicolon;
(II) in clause (iii), by striking ``and'' at the end;
(III) by redesignating clause (iv) as clause (vii); and
(IV) by inserting after clause (iii), the following:
``(iv) screening for and treatment of substance use
disorders;
``(v) screening for and treatment of maternal depression;
``(vi) maternal immunization; and'';
(vi) in subparagraph (E), as so redesignated, by adding
``and'' after the semicolon;
(vii) in subparagraph (F), as so redesignated, by striking
``; and'' and inserting a period; and
(viii) by striking subparagraph (G), as so redesignated;
and
(C) in paragraph (2), by inserting ``, as well as
prevention of a future preterm birth'' before the semicolon.
SEC. 4. ADVISORY COMMITTEE ON MATERNAL AND INFANT HEALTH.
Section 104(b) of the PREEMIE Reauthorization Act (42
U.S.C. 247b-4f note) is amended--
(1) in paragraph (2)--
(A) in the matter preceding subparagraph (A), by striking
``and recommendations to the Secretary concerning the
following activities'' and inserting ``, recommendations, or
information to the Secretary as may be necessary to improve
activities and programs to reduce severe maternal morbidity,
maternal mortality, infant mortality, and preterm birth,
which may include recommendations, advice, or information
related to the following'';
(B) in subparagraph (A), by striking ``and improving the
health status of pregnant women and infants'' and inserting
``, preterm birth, and improving the health status of
pregnant women and infants, and information on cost-
effectiveness and outcomes of such programs'';
(C) in subparagraph (C), by striking ``Implementation of
the'' and inserting ``The''; and
(D) by striking subparagraph (D) and inserting the
following:
``(D) Implementation of Healthy People objectives related
to maternal and infant health.
``(E) Strategies to reduce racial, ethnic, geographic, and
other health disparities in birth outcomes, including by
increasing awareness of Federal programs related to
appropriate access to, or information regarding, prenatal
care to address risk factors for preterm labor and delivery.
``(F) Strategies, including the implementation of such
strategies, to address gaps in Federal research, programs,
and education efforts related to the prevention of severe
maternal morbidity, maternal mortality, infant mortality, and
other adverse birth outcomes.'';
(2) by striking paragraph (3) and redesignating paragraph
(4) as paragraph (3); and
(3) by adding at the end the following:
``(4) Biennial report.--Not later than 1 year after the
date of enactment of the PREEMIE Reauthorization Act of 2018,
and every 2 years thereafter, the Advisory Committee shall--
``(A) publish a report summarizing activities and
recommendations of the Advisory Committee since the
publication of the previous report;
``(B) submit such report to the Secretary and the
appropriate Committees of Congress; and
``(C) post such report on the Internet website of the
Department of Health and Human Services.''.
SEC. 5. INTERAGENCY WORKING GROUP.
(a) In General.--The Secretary of Health and Human
Services, in collaboration with other departments, as
appropriate, may establish an interagency working group in
order to improve coordination of programs and activities to
prevent preterm birth, infant mortality, and related adverse
birth outcomes.
(b) Duties.--The working group established under subsection
(a) shall--
(1) identify gaps, unnecessary duplication, and
opportunities for improved coordination in Federal programs
and activities related to preterm birth and infant mortality;
(2) assess the extent to which the goals and metrics of
relevant programs and activities within the Department of
Health and Human Services, and, as applicable, those in other
departments, are aligned; and
(3) assess the extent to which such programs are
coordinated across agencies within such Department; and
(4) make specific recommendations, as applicable, to reduce
or minimize gaps and unnecessary duplication, and improve
coordination of goals, programs, and activities across
agencies within such Department.
(c) Report.--Not later than 1 year after the date on which
the working group is established under subsection (a), the
Secretary of Health and Human Services shall submit to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House
of Representatives a report summarizing the findings of the
working group under subsection (b) and the specific
recommendations to improve Federal programs at the Department
of Health and Human Services under subsection (b)(4).
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Texas (Mr. Burgess) and the gentleman from Texas (Mr. Gene Green) each
will control 20 minutes.
The Chair recognizes the gentleman from Texas (Mr. Burgess).
General Leave
Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days in which to revise and extend their remarks and
insert extraneous materials in the Record on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of S. 3029, the PREEMIE
Reauthorization Act of 2018. This bill passed the Senate with robust
bipartisan support, and I expect it will do the same in this Chamber.
This bill reauthorizes a program that is vital to the health and
well-being of premature babies and their mothers. It is fitting that we
have called this legislation to the floor following Prematurity
Awareness Month, which took place the month of November.
While we are taking up the Senate bill, which was led by the Health,
Education, Labor, and Pensions Committee, Chairman Lamar Alexander and
Senator Michael Bennet, I would like to thank our House champions of
this legislation, Representative Anna Eshoo and Representative Leonard
Lance. I am pleased that we were able to rally bicameral, bipartisan
support around improving the health of premature infants.
Preterm and low birth weight, combined, make up the second leading
cause of infant death following birth defects. This legislation will
increase research relating to preterm labor and delivery and the care,
treatment, and outcomes of preterm and low birthweight infants.
Preemies and low birthweight infants are at risk for various health
challenges and disabilities, and we still have much to learn about
factors relating to prematurity. This bill allows for continued
collection of maternal-infant clinical and biomedical information in
conjunction with the Centers for Disease Control and Prevention's
Pregnancy Risk Assessment Monitoring System. Such data collection and
surveillance will allow the CDC, and national, State, and local health
officials to have a better picture of what prematurity, including its
causes and impacts, looks like in our country.
This legislation also requires the Advisory Committee on Maternal and
Infant Health to publicly publish and submit to Congress a report on
its activities and recommendations. That advisory committee has been
tasked with
[[Page H10056]]
developing strategies to address gaps in Federal research, programs,
and education efforts related to the prevention of severe maternal
morbidity, maternal mortality, infant mortality, and other adverse
birth outcomes. This ties nicely into H.R. 1318, the Preventing
Maternal Deaths Act, which will also be on the floor of this House this
afternoon.
Additionally, this legislation establishes an interagency working
group, directing the Secretary of the Department of Health and Human
Services to collaborate with other departments to improve coordination
of programs and activities to prevent preterm birth, infant mortality,
and related adverse birth outcomes. The working group is required to
submit a report to the House Committee on Energy and Commerce and the
Senate Health, Education, Labor, and Pensions Committee.
Mr. Speaker, I urge my colleagues to support S. 3029, and I reserve
the balance of my time.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I
may consume.
Mr. Speaker, I rise in support of S. 3029, the Prematurity Research
Expansion and Education for Mothers Who Deliver Infants Early, or
PREEMIE, Reauthorization Act of 2018.
Over the past 3 years, the preterm birth rate in the United States
worsened, placing more mothers and babies at risk. Such preterm births
are the largest contributors to infant death in the United States and,
for those infants who survive, a major cause of long-term health
problems throughout their lives.
While this preterm rate in the U.S. is 9.93 percent, mothers and
infants in Texas are at even greater risk. In fact, in 2017, the most
recent year for which data is available, 10.6 percent of live births
were born preterm. The percentage is even greater for African American
mothers and infants at 13.6 percent, a rate that is 39 percent higher
than the rate among all women in Texas.
This legislation would help combat those negative trends by
continuing support for federally supported activities that prevent
premature births, such as research and programs at the Centers for
Disease Control and Prevention, as well as activities that promote
healthy pregnancies and preventing preterm birth at the Health
Resources and Services Administration.
This reauthorization legislation also requires such efforts to
address the determinants that contribute to the health disparities in
preterm birth.
I thank Representative Eshoo and Representative Lance for their
leadership on this issue.
I encourage my colleagues to support S. 6085 to extend and expand
Federal efforts to prevent and address preterm birth.
Mr. Speaker, I reserve the balance of my time.
Mr. BURGESS. Mr. Speaker, I yield 2 minutes to the gentleman from New
Jersey (Mr. Lance), one of the authors of this legislation.
Mr. LANCE. Mr. Speaker, I thank the chairman for his leadership on
this issue.
Mr. Speaker, I rise today in very strong support of the PREEMIE
Reauthorization Act. My partner in this effort over several years has
been the distinguished Congresswoman from California, Anna Eshoo.
There may be no greater calling than to help infants thrive in the
early days of their lives. Working together and getting this
legislation signed into law is a matter of essential importance. This
is good and important work and the kind of positive difference Federal
efforts can make in the lives of many.
We have a tremendous partner in the March of Dimes. For many
families, the March of Dimes and its network and advocates across the
country are beacons of light at dark moments. I thank the March of
Dimes and their supporters for being the great defenders and fighters
for mothers and for their infants.
This legislation will keep up the momentum to help pregnant women. We
need to reauthorize the Centers for Disease Control and Prevention's
research and data collection efforts and improve the Health Resources
and Services Administration. Doctors and the public need to have the
best information and care options available, and this bill does that.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield such time as she may
consume to the gentlewoman from California (Ms. Eshoo), the cosponsor
of this bill and a member of the Energy and Commerce Committee and the
Health Subcommittee.
Ms. ESHOO. Mr. Speaker, I thank my colleague and my classmate, Mr.
Green, for his distinguished service here in the House. He is retiring,
and I want to salute him.
I also want to salute my partner in this effort, Mr. Lance from New
Jersey. He is going to be missed at the committee and missed in the
House. I think he has always been value added to the Congress, and we
all wish him well.
Mr. Speaker, I rise in support of this bipartisan legislation. The
shorthand for it is the PREEMIE Act. It is legislation that I
introduced with Congressman Lance to expand research, education, and
the prevention of preterm birth.
Preterm birth, or birth before 37 weeks of pregnancy, is the leading
cause of newborn mortality and the second leading cause of infant
mortality in our country. In 2016, over 388,000 infants were born too
early; and, every year, over 20,000 babies in the United States will
die before their first birthday, many of them from complications of
preterm birth.
In addition to being the leading cause of newborn death, premature
birth can cause a lifetime of health challenges and intellectual
disabilities for children who survive.
In addition to the emotional and physical toll of prematurity, there
are significant healthcare costs to families, medical systems, and our
overall economy. A report by the Institute of Medicine found the cost
associated with preterm birth in the United States was $26.2 billion
annually--that is a staggering amount of money--or $51,600 per infant
born preterm. While employers, private insurers, and individuals bear
about half the costs of healthcare for these infants, 40 percent of
this amount is paid for by Medicaid.
Moms and babies face higher risks than ever before. After the
statistics decreasing for over a decade, which is exactly what we
wanted them to do, for the third year in a row now the preterm birth
rate in our country has worsened, so the passing of this legislation
has come at the right time.
I am proud of the work that we have done on this Reauthorization Act
and that it is going to head to the President for his signature, and I
am proud to have authored the original PREEMIE Act with Congressman
Fred Upton in 2006.
This updated reauthorization builds on the important investments that
have been made, and we add to them. I think that is the most important
thing to say.
With the incidence of preterm birth increasing across the United
States, we need to do everything that we can for the mothers and for
the newborns so that we improve the outcomes for them because it is
their lives.
The PREEMIE Act did pass the Senate unanimously on September 12, and
I have every confidence that the House is going to double the record.
Mr. Speaker, I thank the gentleman for yielding to me and, again, pay
tribute to him for his exceptional service here in the House.
Mr. BURGESS. Mr. Speaker, I have no additional speakers, and I
reserve the balance of my time.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield such time as he may
consume to the gentleman from Illinois (Mr. Danny K. Davis).
Mr. DANNY K. DAVIS of Illinois. Mr. Speaker, I thank the gentleman
from Texas for yielding.
I also want to commend the Subcommittee on Health and the Committee
on Energy and Commerce for its outstanding work under the leadership of
Dr. Burgess.
{time} 1345
Mr. Speaker, I am going to speak about sickle cell, a bill that has
been worked on and passed. Of course, sickle cell disease is an
inherited blood disorder characterized by affected red blood cells that
mutate into the shape of a crescent or sickle. And as such, these cells
are unable to pass through small blood vessels. It is a recessive-
genetic condition that occurs when a
[[Page H10057]]
child inherits two sickle cell genes, or traits, from each parent.
The consequences and complications of this disease are extreme. The
Sickle Cell Disease Association of America, whom we have worked with
for many years on this legislation, have studied and reported that
common complications with this disease include early childhood death
from infection; stroke in young children and adults; lung problems
similar to pneumonia; chronic damage to organs, including the kidney,
leading to kidney failure; damage to the lungs, causing pulmonary
hypertension; and severe, painful episodes. In fact, pain episode are a
hallmark of sickle cell disease.
Mr. Speaker, I am pleased that we are at this juncture in passing S.
2465, a bill designed to help improve, treat, prevent, and conduct
research on sickle cell disease and to include other blood diseases for
surveillance and data collection.
While this legislation includes other blood diseases, its original
intent and its continuing focus is to put major emphasis on sickle cell
disease and issues related to it.
Mr. Speaker, I want to thank my colleagues, Representative Michael
Burgess, and Representative G.K. Butterfield, Senator Tim Scott, and
Senator Cory Booker for their tireless support and efforts to bring
this bipartisan and bicameral bill to fruition.
There has been a great deal of back and forth on this bill.
Therefore, I want to thank, again, Dr. Burgess, the chief Republican
cosponsor and advocate. I want to commend the leadership on the
Committee on Energy and Commerce, Chairman Greg Walden and Ranking
Member Frank Pallone.
Mr. Speaker, I want to highlight the work of my colleague and friend,
Representative G.K. Butterfield, who carried the bill for this
legislation in the Committee on Energy and Commerce.
Our staffs did outstanding work, and I commend all of them,
especially my Health Subcommittee staffer, Dr. Caleb Gilchrist. I want
to acknowledge and thank our advocate organizations, the Sickle Cell
Disease Association of America, the American Society of Hematology, and
other organizations, hospital providers, families, and those infected
with the sickle cell disease.
Mr. Speaker, those who say that Congress does not work and is not
working, I tell you, when we pass legislation of this sort, it tells me
that America is on the right track and we are, indeed, moving forward
to help make our communities as safe and healthy as they can possibly
be.
I end by just thanking Dr. Burgess, again, for his outstanding
leadership on this issue.
Mr. BURGESS. Mr. Speaker, I would just like to take a second and
thank Representative Davis for his kind remarks, and I reserve the
balance of my time.
Mr. GENE GREEN of Texas. Mr. Speaker, we have no further speakers on
this bill, and I yield back the balance of my time
Mr. BURGESS. Mr. Speaker, I urge all of my colleagues to support S.
3029, and I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Texas (Mr. Burgess) that the House suspend the rules and
pass the bill, S. 3029.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. BURGESS. 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, further
proceedings on this motion will be postponed.
____________________