[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.

                          ____________________