[Congressional Record Volume 165, Number 77 (Thursday, May 9, 2019)]
[House]
[Pages H3510-H3519]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]





  PROVIDING FOR CONSIDERATION OF H.R. 986, PROTECTING AMERICANS WITH 
PREEXISTING CONDITIONS ACT OF 2019, AND PROVIDING FOR CONSIDERATION OF 
            H.R. 2157, SUPPLEMENTAL APPROPRIATIONS ACT, 2019

  Ms. SHALALA. Madam Speaker, by direction of the Committee on Rules, I 
call up House Resolution 357 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 357

       Resolved, That at any time after adoption of this 
     resolution the Speaker may, pursuant to clause 2(b) of rule 
     XVIII, declare the House resolved into the Committee of the 
     Whole House on the state of the Union for consideration of 
     the bill (H.R. 986) to provide that certain guidance related 
     to waivers for State innovation under the Patient Protection 
     and Affordable Care Act shall have no force or effect. The 
     first reading of the bill shall be dispensed with. All points 
     of order against consideration of the bill are waived. 
     General debate shall be confined to the bill and shall not 
     exceed one hour equally divided and controlled by the chair 
     and ranking minority member of the Committee on Energy and 
     Commerce. After general debate the bill shall be considered 
     for amendment under the five-minute rule. The bill shall be 
     considered as read. All points of order against provisions in 
     the bill are waived. No amendment to the bill shall be in 
     order except those printed in part A of the report of the 
     Committee on Rules accompanying this resolution. Each such 
     amendment may be offered only in the order printed in the 
     report, may be offered only by a Member designated in the 
     report, shall be considered as read, shall be debatable for 
     the time specified in the report equally divided and 
     controlled by the proponent and an opponent, shall not be 
     subject to amendment, and shall not be subject to a demand 
     for division of the question in the House or in the Committee 
     of the Whole. All points of order against such amendments are 
     waived. At the conclusion of consideration of the bill for 
     amendment the Committee shall rise and report the bill to the 
     House with such amendments as may have been adopted. The 
     previous question shall be considered as ordered on the bill 
     and amendments thereto to final passage without intervening 
     motion except one motion to recommit with or without 
     instructions.
       Sec. 2.  At any time after adoption of this resolution the 
     Speaker may, pursuant to clause 2(b) of rule XVIII, declare 
     the House resolved into the Committee of the Whole House on 
     the state of the Union for consideration of the bill (H.R. 
     2157) making supplemental appropriations for the fiscal year 
     ending September 30, 2019, and for other purposes. The first 
     reading of the bill shall be dispensed with. All points of 
     order against consideration of the bill are waived. General 
     debate shall be confined to the bill and shall not exceed one 
     hour equally divided and controlled by the chair and ranking 
     minority member of the Committee on Appropriations. After 
     general debate the bill shall be considered for amendment 
     under the five-minute rule. An amendment in the nature of a 
     substitute consisting of the text of Rules Committee Print 
     116-12, modified by the amendment printed in part B of the 
     report of the Committee on Rules accompanying this 
     resolution, shall be considered as adopted in the House and 
     in the Committee of the Whole. The bill, as amended, shall be 
     considered as the original bill for the purpose of further 
     amendment under the five-minute rule and shall be considered 
     as read. All points of order against provisions in the bill, 
     as amended, are waived. Clause 2(e) of rule XXI shall not 
     apply during consideration of the bill. No further amendment 
     to the bill, as amended, shall be in order except those 
     printed in part C of the report of the Committee on Rules. 
     Each such further amendment may be offered only in the order 
     printed in the report, may be offered only by a Member 
     designated in the report, shall be considered as read, shall 
     be debatable for the time specified in the report equally 
     divided and controlled by the proponent and an opponent, 
     shall not be subject to amendment, and shall not be subject 
     to a demand for division of the question in the House or in 
     the Committee of the Whole. All points of order against such 
     further amendments are waived. At the conclusion of 
     consideration of the bill for amendment the Committee shall 
     rise and report the bill, as amended, to the House with such 
     further amendments as may have been adopted. The previous 
     question shall be considered as ordered on the bill, as 
     amended, and any further amendment thereto to final passage 
     without intervening motion except one motion to recommit with 
     or without instructions.

  The SPEAKER pro tempore. The gentlewoman from Florida is recognized 
for 1 hour.
  Ms. SHALALA. Madam Speaker, for the purpose of debate only, I yield 
the customary 30 minutes to the gentleman from Texas (Mr. Burgess), 
pending which I yield myself such time as I may consume. During 
consideration of this resolution, all time yielded is for the purpose 
of debate only.


                             General Leave

  Ms. SHALALA. Madam Speaker, I ask unanimous consent that all Members 
be given 5 legislative days to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Florida?
  There was no objection.
  Ms. SHALALA. Madam Speaker, on Tuesday, the Rules Committee met and 
reported a rule, House Resolution 357, providing for consideration of 
H.R. 986, the Protecting Americans with Preexisting Conditions Act, 
under a structured rule.
  The rule makes in order 12 amendments. The rule provides 1 hour of 
debate equally divided and controlled by the chair and the ranking 
member of the Committee on Energy and Commerce.
  The rule also provides for consideration of H.R. 2157, the 
Supplemental Appropriations Act, under a structured rule. The rule 
self-executes a manager's amendment and makes in order 10 amendments to 
H.R. 2157.
  Finally, the rule provides 1 hour of debate equally divided and 
controlled by the chair and ranking member of the Committee on 
Appropriations.
  Madam Speaker, I rise today in support of the two bills in this rule, 
H.R. 986, the Protecting Americans with Preexisting Conditions Act of 
2019, and H.R. 2157, the Supplemental Appropriations Act.
  H.R. 986 will ensure that the patient protections and benefits of the 
Affordable Care Act are protected. It will prevent this administration 
from doing administratively what they failed to do legislatively, make 
health insurance inaccessible for the, at least, 52 million Americans 
who live with preexisting conditions.
  The administration is trying to coax States, through misuse of the 
1332 innovation waivers, to make available plans that don't cover all 
of the essential health benefits that the ACA requires, or don't cover 
preexisting conditions, possibly with tax credits. This is consumer 
fraud. It is a misuse of taxpayer money.
  The administration would make it possible for plans to deny coverage 
or charge higher premiums based on health status. Under their guidance, 
plans could have lifetime or annual limits. They would be able to 
charge higher rates to older people than the ACA allows and are not 
required is cover essential health benefits.
  It will hurt consumers who think they are buying comprehensive health 
insurance and then find out that their plan doesn't cover whatever 
health crisis they may be facing.
  The guidance from the administration is a back door to destroying the 
Affordable Care Act. H.R. 986 makes sure that that will not happen.

                              {time}  1230

  I also rise to support H.R. 2157. The disaster supplemental will 
provide $17.2 billion in disaster relief to communities across America, 
including my own State of Florida.
  The House passed a similar bill in January, which the Senate failed 
to take up. Since January, there have been floods in the Midwest and 
tornadoes in Alabama, and we have included additional money to fund 
those disasters.
  No American should wait for assistance while Congress squabbles. 
Seven months have passed since Hurricane Michael devastated the 
panhandle in Florida, including completely leveling Tyndall Air Force 
Base. It is time to pass both of these bills.
  Madam Speaker, I reserve the balance of my time.
  Mr. BURGESS. Madam Speaker, I thank the gentlewoman for yielding me 
the customary 30 minutes, and I yield myself as much time as I may 
consume.
  Madam Speaker, today, we are considering a bill that appropriates a 
little over $17 billion for disasters affecting all parts of the United 
States.
  As Members of Congress, we are elected to serve the people, and part 
of that duty is providing emergency aid when disaster strikes. I am 
supportive of disaster relief, and we certainly could have provided 
this crucial aid months ago. At this time, our communities are still in 
need.
  This is the third time that the House will consider a relief bill to 
address the same set of disasters.
  On 20 December 2018, the House of Representatives passed a continuing

[[Page H3511]]

resolution to fund the government through February 8 that also included 
almost $8 billion of disaster relief funding, but this bill did not 
become law.
  On January 16, 2019, the House passed a supplemental appropriations 
package that would have provided a little over $12 billion in aid. But 
at the last minute, during Rules Committee debate, Democrats added a 
short-term, full-government continuing resolution through a manager's 
amendment that did not include President Trump's request for border 
security funding. As a result, the government remained closed without 
providing a resolution to the problem.
  It has now been 4 months since the House last considered providing 
disaster aid, long enough that additional disasters have struck our 
country, necessitating an increased number.
  The bill before us seeks to provide relief funding for Hurricanes 
Michael and Florence, as well as continued support for Hurricanes 
Harvey, Irma, and Maria. The wildfires in California will be included 
in this supplemental, as well as the severe storms and flooding in 
multiple States, including Texas; the Alaska earthquake; Typhoons Yutu 
and Mangkhut in the Northern Mariana Islands and Guam; Tropical Storm 
Gita in American Samoa; volcanic eruptions in Hawaii; and devastating 
floods across the Midwest.
  This third iteration of disaster relief legislation is similar to a 
bill passed by the House in January of this year, with an additional 
$500 million for the Department of Agriculture's Emergency Conservation 
Program to rehabilitate damaged farmland; $1.5 billion for the Army 
Corps of Engineers for projects and flood mitigation; and $1 billion 
for the Community Development Block Grant Disaster Recovery account for 
rebuilding houses, businesses, and public infrastructure. The bill also 
includes $600 million for disaster nutrition benefits in Puerto Rico as 
that island recovers from Hurricane Maria.
  The President has expressed concern about Puerto Rico's management of 
the billions of disaster aid the island has already received. Senate 
Republicans are negotiating with the White House on a compromise, but 
Democrats have decided to continue pushing this legislation forward 
without engaging the other two parties that would be required in order 
for the bill to become law.
  This bill also includes language prohibiting any funds from being 
used for the construction of a border wall. The crisis on our southern 
border is not a natural disaster; it is a humanitarian and security 
disaster, one that we can stop and take steps to prevent in the future. 
But the Democrats refuse to accept that our Customs and Border 
Protection and Immigration and Customs Enforcement officers are 
overwhelmed, that our Office of Refugee Resettlement facilities are 
near capacity, and that our immigration judges are facing years of 
backlogged cases.
  This is a disaster that we can do something about now. Rather than 
negotiate in good faith, Democrats have chosen once again to bring up a 
bill that will not pass the Senate.
  I am disappointed that these controversial provisions are included in 
the bill. It does beg the question: When are we going to get back to 
the business of legislating?
  As an aside, I would note that the House adjourned yesterday at 2 
o'clock in the afternoon, plenty of time to continue working on some of 
these problems. For whatever reason, we decided not to do that.
  The second bill under consideration, H.R. 986, is supposed to protect 
Americans with preexisting conditions. It has a very catchy title. 
Despite that catchy title, the bill does nothing to enhance preexisting 
condition protections under the Affordable Care Act.
  The first vote that Republicans called this Congress was a motion to 
require legislation protecting individuals with preexisting conditions. 
Rather surprisingly, the Democrats voted against that previous 
question, blocking the motion.
  In 2017, as part of the proposed replacement for the Affordable Care 
Act, Republicans included legislation that would have preserved access 
for those with preexisting conditions. Again, this was not supported by 
House Democrats.
  H.R. 986 eliminates healthcare choices for States by infringing upon 
the authority that was given to the Department of Health and Human 
Services under the Affordable Care Act. Section 1332 of the Affordable 
Care Act established the Waiver for State Innovation. This allowed 
States to waive certain ACA regulations in order to provide flexible 
coverage through new State healthcare programs.

  The Secretary of the Department of Health and Human Services was 
required to promulgate regulations for the granting of these waivers, 
maintaining that new State health programs stay within the guardrails 
provided by law.
  My constituents of north Texas are consistently concerned about not 
having access to affordable healthcare. I take meeting after meeting 
with families who say they are suffering from the high cost of 
healthcare and prescription drugs, deductibles, and copays. Texans are 
struggling to afford their health insurance, and I am sure we are not 
the only ones experiencing these premiums and deductibles.
  What good is health insurance if you are afraid to use it because you 
cannot afford your deductibles and copays? This is an issue that I 
would like to see us tackle, yet we are here today discussing a bill 
with a very misleading title that would take flexibility away from 
States.
  During the Rules Committee hearing on Tuesday, we discussed 
innovative strategies for providing high-quality and affordable health 
insurance, expanding consumer choice, and some of the positive results 
for States that have implemented these waivers. In no way did we 
discuss removing ACA protections for people with preexisting 
conditions. In fact, I pointed out that the Centers for Medicare and 
Medicaid Services' Administrator Seema Verma stated in her remarks at 
the CMS National Forum on State Relief and Empowerment Waivers that ``a 
waiver cannot be approved that might otherwise undermine these 
protections.''
  Yet Democrats have titled this bill ``Protecting Americans with 
Preexisting Conditions Act of 2019.'' This is clearly an attempt to 
coerce Members of Congress into voting for a bill that actually scales 
back the guidance recently issued for the application of State 
innovation waivers.
  Energy and Commerce Committee Ranking Member Greg Walden offered an 
amendment to more appropriately title the bill ``This Bill Has Nothing 
to do with Protecting Americans with Preexisting Conditions Act.'' I 
hope this amendment will alert Members to the partisan wordplay of the 
Democrats when we should be focusing on improving the health insurance 
marketplace.
  Taking flexibility away from States is one step closer to a single-
payer, government-run healthcare system. This single-payer, government-
run healthcare system would only further deteriorate our Nation's 
healthcare.
  The Affordable Care Act was one step in that direction. While it is 
clear that the Affordable Care Act has proven to be nothing like 
affordable for Americans, section 1332 waivers would have allowed 
States the flexibility to employ innovation that works for their 
citizens.
  To date, eight States--Alaska, Hawaii, Maine, Maryland, Minnesota, 
New Jersey, Oregon, and Wisconsin--have approved State innovation 
waivers, and seven have created their own reinsurance programs. 
Premiums in these States--and this is important--premiums in these 
seven States were almost 20 percent lower, on average, in the first 
year of enactment. Maryland saw the greatest percent change, with the 
average individual market premium coming down by more than 40 percent, 
43.4 percent, to be precise.
  Again, section 1332 of the Affordable Care Act explicitly gives the 
Department of Health and Human Services the authority to provide 
guidance surrounding these innovation waivers. As more States submit 
applications, the administration has learned more about what hurdles 
States must traverse in order to obtain these waivers.
  One limit to a State's ability to apply for an innovation waiver is 
that the State must have already enacted a State law establishing 
authority to pursue and implement the waiver. For a State like Texas, 
where the State legislature meets only every 2 years, this can be a 
substantial barrier.
  The recent Trump administration guidance provides clarity, stating 
that,

[[Page H3512]]

in certain circumstances, existing State legislation coupled with a 
duly enacted State regulation or executive order could satisfy this 
requirement.
  This guidance, the 1332 guidance, removes some hurdles while 
maintaining the integrity of the coverage guardrails established by 
law. Those statutory requirements maintain that coverage must be as 
comprehensive as coverage would have been absent the waiver, provide 
cost-sharing to protect against excessive out-of-pocket spending, cover 
a comparable number of residents, and not increase the Federal deficit.
  I would like to reiterate that this is a misleading bill title and 
that H.R. 986 will restrict healthcare choices for States.
  Once again, we are using the valuable time on the floor of the United 
States House of Representatives to debate something that will not solve 
the issues of affordability in our Nation's healthcare system and 
really has no chance of becoming law. It is unfair to patients who are 
not going to the doctor because, on top of their monthly premiums, 
their deductible is so high that they cannot afford the visit.
  We need a comprehensive solution to address the high patient out-of-
pocket costs in our system. This bill moves us in the wrong direction. 
It will inhibit innovation and much-needed flexibility in our State 
insurance markets.
  As a physician, I cannot support such a piece of legislation, so I 
will urge opposition to the rule.
  Madam Speaker, I reserve the balance of my time.
  Ms. SHALALA. Madam Speaker, I yield 3 minutes to the gentlewoman from 
Florida (Ms. Castor), a distinguished member of the Energy and Commerce 
Committee.
  Ms. CASTOR of Florida. Madam Speaker, I thank my colleague and friend 
from Florida for yielding the time.
  Madam Speaker, I rise today in support of the rule and the two very 
important bills the House of Representatives will consider.
  The first is H.R. 986 by my colleague, Representative Kuster from New 
Hampshire, that will work to protect our neighbors who have preexisting 
health conditions, like cancer or heart disease.
  Unfortunately, the Trump administration is trying to weaken those 
protections. They are doing so in the courts and through Congress. So 
it is very important that the House of Representatives pass into law 
protections for our neighbors with preexisting conditions.
  In fact, the name of the bill is ``Protecting Americans with 
Preexisting Conditions Act.'' Passing this bill will help keep 
healthcare accessible and affordable for all Americans.
  The second bill is also very important, H.R. 2157. It provides about 
$17 billion in disaster relief to Americans who need it, who have 
suffered through horrendous natural disasters.
  It was October 10, 2018, when Florida took a direct hit from 
Hurricane Michael. It was one of the most powerful storms to make 
landfall in the United States. It slammed into the panhandle and caused 
tremendous damage and destruction.
  To help meet disaster needs, the House of Representatives, the 
Democratic-led House, one of the first bills we passed was a disaster 
relief package on January 16, 2019. It passed by a wide margin with a 
bipartisan vote. Unfortunately, it ran into opposition from the Senate 
and the White House.
  Madam Speaker, I urge my colleagues now to come back together in a 
bipartisan way and use this bill to break the logjam in the Senate and 
keep the focus on our fellow Americans who need disaster assistance.
  Disaster relief used to be bipartisan. We need to return to those 
days and pass it in a timely manner.

                              {time}  1245

  Mr. BURGESS. Madam Speaker, just a point of clarification. While our 
last vote was just after 2 p.m. yesterday, the House actually adjourned 
a little after 3 p.m. I did want to make that correction.
  Madam Speaker, I yield 2 minutes to the gentleman from Pennsylvania 
(Mr. Meuser).
  Mr. MEUSER. Madam Speaker, I rise today to speak against H.R. 986.
  I think everyone in this Chamber can agree that individuals with 
preexisting conditions should be protected and that the American people 
should have access to affordable and quality healthcare. This bill 
falls short of achieving, or even making progress towards, these 
important goals.
  This bill showcases a fundamental misunderstanding of section 1332 
waivers, which allow States to pursue more creative and innovative 
strategies to provide their residents with access to high-quality 
health insurance. This bill actually rolls back the ability of States 
to innovate lower costs and expand coverage options for patients and 
families.
  Additionally, this bill is disingenuous in suggesting that it is 
protecting individuals with preexisting conditions when section 1332 
waivers already require States to do so. Rather than calling this the 
``Protecting Americans with Preexisting Conditions Act,'' this bill 
would be more appropriately named the ``Don't Let States Innovate 
Act.''
  Not surprisingly, this bill also neglects to address the grievous 
shortcomings of ObamaCare.
  In my district, not a day goes by that I don't hear from constituents 
about the untenable costs of ObamaCare. It is no secret that ObamaCare 
has led to skyrocketing premiums and deductibles, offering anything but 
affordable care to the American people. However, the data clearly shows 
that States using section 1332 waivers to create their own reinsurance 
programs saw premiums drop by an average of nearly 20 percent.
  We must make our country's healthcare system work better by 
supporting choice, access, and affordability. This bill forces our 
country on a pathway towards one size fits all, Big Government-centered 
healthcare. And this Democrat vision of a top-down healthcare system is 
one that I absolutely cannot support.
  Madam Speaker, I urge my colleagues to vote ``no'' on the rule and 
the underlying bill.
  Ms. SHALALA. Madam Speaker, I yield 3 minutes to the gentlewoman from 
Texas (Ms. Jackson Lee).
  Ms. JACKSON LEE. Madam Speaker, I thank the gentlewoman from Florida 
for yielding, and I thank her for her leadership.
  Madam Speaker, the American people will insist that this legislation 
passes. My Republican friends, since my time in helping to pass the 
Affordable Care Act, have never offered a plan to ensure that America's 
wonderful citizens have good healthcare and that those with preexisting 
conditions, such as many of us, including myself and many of my 
constituents in Houston, Texas, are able to access healthcare.
  Let me be clear on what this legislation does, as I thank 
Representative Kuster for her leadership.
  H.R. 986, of which I am strongly in support of, is a saving grace. 
What it does is it stops the Trump administration in their tracks from 
watering down an opportunity of flexibility, section 1332.
  Here is what is going to happen if we do not pass this legislation:
  We will stop the coverage of preexisting conditions, period;
  There will be no protections;
  You will see a rise in costs in healthcare;
  Short-term plans will be thrown to the people and other plans that 
will destabilize the risk pool;
  It will limit access to comprehensive coverage because the Trump 
guidance says: Just give access and don't worry about if the plan even 
allows you to be admitted into a hospital;
  And finally, it will reduce benefits like maternity coverage, mental 
healthcare, and coverage of prescription drugs.
  Is that what Americans want?
  Every day, in my district, I am seeing people desperate for 
healthcare. There has been not one proposal coming here.
  I rise as well to support the supplemental appropriations, because I 
have been to Puerto Rico and the U.S. Virgin Islands. We need these 
resources.
  But I have also seen the devastation of victims impacted by Hurricane 
Michael in Alabama, Florida, and Georgia; the damage in Nebraska, 
Missouri, South Dakota, Iowa, Kansas, and now in Houston, 10 inches of 
rain and flooding and more rain coming. I know that people who were 
impacted by Hurricane Harvey are still suffering.

[[Page H3513]]

  This particular legislation, appropriations, is important. It is 
important, in particular, to ensure that we add more funding and that 
we shore up the infrastructure.
  I submitted amendments that covered the idea of improving FEMA so 
that it would stay longer and it would have oversight to know whether 
it is helping people; to increase energy services so that we don't 
black out so that people are suffering; and to make sure we have the 
right kind of water.
  There are many other elements to the appropriations bill which I hope 
to debate at a later time, but this rule should be supported.
  Let me additionally go back to the H.R. 986 legislation and indicate 
that preexisting diseases cover things like sickle cell, which 1 in 13 
African American babies are born with; triple negative breast cancer, 
which is the most deadly and causes immediate or short-term life to 
White women, Black women, Asian Pacific Islander, American Indian, and 
Alaska Native women; diabetes; and HIV/AIDS.
  This is why H.R. 986 is important, Madam Speaker, and why the 
appropriations bill is important.
  Madam Speaker, I rise in strong and unequivocal support for the rule 
governing debate on H.R. 986, the ``Protecting Americans With Pre-
Existing Conditions Act of 2019'' as well as the underlying legislation 
and ask all Members to join me in supporting these legislative 
initiatives that combat the Trump Administration's ongoing efforts to 
take away health care from more than 100 million Americans and to make 
health care dramatically less affordable for those fortunate enough to 
be insured.
  Another reason I strongly support this rule is that it makes in order 
H.R. 2157, the ``Supplemental Appropriations Act of 2019,'' which 
provides much needed and long overdue relief to Americans in Puerto 
Rico and the U.S. Virgin Islands still suffering from the ravages of 
Hurricanes Maria and Irma, as well as relief to victims of Hurricane 
Michael which struck Alabama, Florida, and Georgia in October 2018 and 
to the victims of the Midwestern floods that have caused so much damage 
in Nebraska, Missouri, South Dakota, Iowa, and Kansas.
  H.R. 986, rescinds this damaging, dangerous guidance immediately, and 
reinforces the ACA's vital protections for people with pre-existing 
conditions.
  It also prevents the Secretaries of HHS and Treasury from 
promulgating any substantially similar guidance or rule in the future.
  Section 1332 of the State Innovation Waivers included in the ACA has 
a clear statutory directive that states must maintain the level of 
benefits, affordability, and coverage provided to state residents by 
the ACA.
  This Administration's 2018 Guidance allows states to simply 
demonstrate that a comparable number of residents will have access to 
comprehensive and affordable coverage, regardless of whether they 
actually enroll in that coverage, thereby allowing the Secretaries of 
HHS and Treasury to approve waivers that do not provide coverage that 
is as affordable or as comprehensive as under the ACA.
  The ``Protecting Americans with Pre-Existing Conditions Act'' is a 
vital legislative measure that emphasizes the importance of not 
limiting coverage for individuals with pre-existing conditions or 
imposing lifetime limits on access to care.
  Predatory practices such as this will prove to be devastating to 
communities across the nation, many of which, who will be affected are 
disproportionately communities of color.
  The people receiving the life-sustaining medical protections under 
this provision will be cast aside and left with no way to cover the 
exorbitant healthcare costs that would otherwise be covered in through 
the Affordable Care Act.
  Relenting on this protection will put a great number of my 
constituents and various communities across the nation at terrible 
risk.
  Specifically, in the 18th Congressional District many of my 
constituents are disproportionally affected by several pre-existing 
conditions such as:
  Sickle Cell Disease (SCD) affects approximately 100,000 Americans and 
occurs among about 1 out of every 365 Black or African-American births.
  SCD occurs among about 1 out of every 16,300 Hispanic-American 
births.
  And 1 in 13 Black or African-American babies is born with sickle cell 
trait (SCT).
  During 2005, medical expenditures for children with SCD averaged 
$11,702 for children with Medicaid coverage and $14,772 for children 
with employer-sponsored insurance.
  About 40 percent of both groups had at least one hospital stay.
  The most common cancer in women, no matter your race or ethnicity.
  The most common cause of death from cancer among Hispanic women.
  The second most common cause of death from cancer among white, Black, 
Asian/Pacific Islander, and American Indian/Alaska Native women.
  Diabetes is at an all-time high in the U.S. and continues to increase 
exponentially every year.
  The CDC's Division of Diabetes Translation states that over 30 
million Americans are living with Diabetes, over a quarter undiagnosed.
  This trend continues in the state of Texas, where Diabetes is the 6th 
leading cause of death.
  Nearly 12 percent of Texas is living with diagnosed Diabetes.
  According to a collaboration report between the nonprofit Texas 
Health Institute, the State Demographer's Office and Methodist 
Healthcare Ministries of South Texas, one in three adult Texans are 
either diagnosed with diabetes, have diabetes but have not yet been 
diagnosed, or are at high risk for developing the disease within a 
decade.
  Approximately 1.1 million people in the U.S. are living with HIV 
today.
  About 15 percent of them (1 in 7) are unaware they are infected.
  The Center for Disease Control (CDC) estimates that the decline in 
HIV infections has plateaued because effective HIV prevention and 
treatment are not adequately reaching those who could most benefit from 
them.
  These gaps remain particularly troublesome in rural areas and in the 
South and among disproportionately affected populations like blacks/
African Americans and Hispanics/Latinos.
  The overall prevalence of CKD in the general population is 
approximately 14 percent.
  High blood pressure and diabetes are the main causes of CKD.
  Almost half of individuals with CKD also have diabetes and/or self-
reported cardiovascular disease (CVD).
  More than 661,000 Americans have kidney failure. Of these, 468,000 
individuals are on dialysis, and roughly 193,000 live with a 
functioning kidney transplant.
  Kidney disease often has no symptoms in its early stages and can go 
undetected until it is very advanced.
  For this reason, kidney disease is often referred to as a ``silent 
disease.''
  What is also concerning is the overwhelming number of constituents 
plagued by these diseases, are people of color, African American, 
Latino, and Native American.
  H.R. 986 stopped the Trump Administration in its tracks from taking 
away health care from vulnerable Americans.
  Madam Speaker, the Trump administration cannot be trusted to act in 
the best interests of the American people that is why I offered two 
amendments to H.R. 986, which would extend the prohibitions of the bill 
to (1) ban lifetime limits with respect to persons with preexisting 
conditions and (2) prevent the Secretaries from taking any action that 
would reduce the affordability of comprehensive coverage for children 
under 26 with pre-existing conditions who are covered under their 
parents' policies.
  I will soon be introducing legislation that will achieve these 
important objectives and protect vulnerable Americans from an uncaring 
Administration that is unceasing in its efforts to take away health 
care from vulnerable Americans.
  Madam Speaker, H.R. 2157, the ``Supplemental Appropriations Act of 
2019,'' provides much needed and long overdue relief to Americans in 
Puerto Rico and the U.S. Virgin Islands still suffering from the 
ravages of Hurricanes Maria and Irma, as well as relief to victims of 
Hurricane Michael which struck Alabama, Florida, and Georgia in October 
2018 and to the victims of the Midwestern floods.
  I support this legislation and offered an amendment that would have 
provided additional funding for electricity delivery and necessary 
expenses related to the consequences of Hurricanes Harvey, Maria, Irma, 
and Super Typhoon Yutu including technical assistance related to 
electric grids.
  As the representative of the Eighteenth Congressional District of 
Texas, which was ground zero for Hurricane Harvey, I regularly hear 
from constituents expressing their concern with ineffective and 
inadequate FEMA mechanisms put in place to help rectify the damage 
caused by natural disasters.
  That is why I also offered an amendment to H.R. 2157 that would 
prohibit funds in the bill from being used to prevent the FEMA 
Administrator from monitoring the response given to disaster victims in 
order to ensure quality control or becoming aware of complaints 
regarding the response given to disaster victims and having in place a 
mechanism to address such complaints.
  A third Jackson Lee amendment to H.R. 2157 would have provided a 
minimum of $1 million for wastewater and drinking water treatment works 
and facilities impacted by Hurricanes Harvey, Irma, and Maria.
  Hurricane Sandy inflicted more than $70 billion in damages in 2012, 
and Matthew cost

[[Page H3514]]

the U.S. about $10.3 billion in 2016. With Harvey, an estimated 13 
million people were affected, nearly 135,000 homes damaged or destroyed 
in the historic flooding, and up to a million cars were wrecked.
  Hurricane Harvey ranks as the second-most costly hurricane to hit the 
U.S. mainland since 1900, causing more than $125 billion in damage.
  Our residents need more money than for single-family home repairs, 
whether it is disaster recovery or general housing dollars and I will 
continue to stride on behalf of the neighborhoods and on behalf of 
hard-working homeowners who deserve these funds, so they can continue 
on with their lives and return to their homes.
  Victims of natural disasters are entitled to know who to contact when 
issues related to FEMA arise and to be assured that their questions are 
answered, and complaints addressed.
  Allocating funding for measures such as Electricity Delivery for 
necessary expenses related to the consequences of Hurricanes Harvey, 
Maria, Irma, and Super Typhoon Yutu, is vital to negate the effects of 
these catastrophic events from significantly worsening.
  Hospitals, first-responders, and a number of other vital institutions 
that help our communities recover from the after-effects of natural 
disasters need access to electricity.
  Moreover, with the severity of natural disasters and the ranging of 
their locations we must be proactive in our preparation for recovery.
  Alternatively, water is the most essential recourse known to man.
  A human can go for more than three weeks without food--Mahatma Gandhi 
survived 21 days of complete starvation--but water is a different 
story.
  At least 60 percent of the adult body is made of it and every living 
cell in the body needs it to keep functioning.
  Under extreme conditions an adult can lose 1 to 1.5 liters of sweat 
per hour and if that lost water is not replaced, the total volume of 
body fluid can fall quickly and, most dangerously, blood volume may 
drop.
  We do not have the luxury of not preparing for hurricanes, floods, 
earthquakes, mudslides, tornados or other natural disasters.
  With these events it is not a question of if, but when.
  For these reasons, I urge my colleagues to support the rule and the 
underlying legislation.
  Mr. BURGESS. Madam Speaker, I yield myself 30 seconds to respond 
before I yield to the gentleman from Iowa.
  Madam Speaker, last Congress passed the first comprehensive, stand-
alone sickle cell bill for as long as I can remember. There was a 
partial reauthorization in 2004, signed by President Bush, that was 
part of a tax bill.
  But   Danny Davis' bill passed through our committee, passed through 
the Senate, and passed on the floor of the House in the previous 
Congress last year; and as a consequence, for the first time in four 
decades, new sickle cell therapies are coming through the National 
Institutes of Health.
  Madam Speaker, I yield 1 minute to the gentleman from Iowa (Mr. 
King).
  Mr. KING of Iowa. Madam Speaker, I appreciate the gentleman from 
Texas yielding to me.
  Madam Speaker, I came to the floor to highlight the disasters that we 
have in the Midwest.
  I recall back in 2011 when the Missouri River was 11 miles wide at 
its widest and 5 to 6 miles wide most everywhere else, all the way 
through Iowa and down across Missouri. It was a secret flood because 
you couldn't drive there. You had to fly over to see it.
  We have some of these similar circumstances this spring, although it 
has gotten a little more of the press. We had more water come down 
below Gavins Point than ever before. It wiped out a lot of ag land on 
the Iowa side and more so, even, on the Nebraska side.
  We have critical infrastructure that has got to be reconstructed. We 
have got to protect some of these communities that have been nearly 
wiped out. This Corps of Engineers, in particular, has 41 breaches on 
the levees just on the Iowa side of the river.
  I urge that we get to a conclusion and adoption of a final package on 
this disaster relief.
  But I would point out, Madam Speaker, that this message from the 
White House said that Congress should not use natural disasters as a 
pretext to engage in unnecessary spending outside the agreed upon 
discretionary spending caps.
  I am hopeful that this gets worked out between the House and the 
Senate. We need the relief, and we need it very soon.
  Ms. SHALALA. Madam Speaker, I yield 30 seconds to the gentlewoman 
from Texas (Ms. Jackson Lee).
  Ms. JACKSON LEE. Madam Speaker, I happen to live and be in the area 
of the Texas Children's Hospital. I have obviously supported the 
legislation of   Danny Davis.
  The point is that people with preexisting conditions, including 
sickle cell, will not have access to healthcare under the Trump 
guidance.
  I am standing here not about the research, which is certainly 
beneficial, but about the fact that I am standing for those with sickle 
cell, which is a preexisting condition, to not be blocked from having 
good healthcare. That is why I rise to support H.R. 986, in order to 
ensure access to healthcare and not stopping preexisting conditions 
from being covered.
  Ms. SHALALA. Madam Speaker, I yield 2 minutes to the gentleman from 
Mexico (Mr. Lujan), the Assistant Speaker.
  Mr. LUJAN. Madam Speaker, I rise today to support the rule because, 
for the past 2 years, the Trump administration has relentlessly 
sabotaged the Affordable Care Act and attacked my constituents' access 
to care.
  My Republican colleagues use a lot of smoke and mirrors to talk about 
these plans, so today I want to read straight from the Texas Department 
of Insurance website, texas.gov. This page is titled: ``What You Need 
to Know About Short-Term Health Insurance.''
  Right there, the Texas Department of Insurance says: ``Know what the 
plan covers. It is important to ask what's covered and what's not. For 
example, short-term plans might not cover emergency care, maternity 
care, prescriptions, or certain other services. They might not cover 
care for accidents or health issues.''
  Listen closely to this: ``These plans also do not have to cover 
preexisting conditions. If a company sells you a plan, it may deny a 
claim if it determines you had a related condition in the past.''
  There it is in black and white on the Texas Department of Insurance 
website. These Trump junk plans discriminate against people with 
preexisting conditions.
  Let me continue, because it gets better, to the third point, ``Other 
costs.'' Here the State of Texas specifies that ``short-term health 
plans often have lower premiums, but other costs may be higher.''
  Let me translate. These Trump junk plans might be cheaper for us up 
front, but you will pay more money for less coverage on the back end.
  That is why, today, I stand proudly with my Democratic colleagues for 
standing up to the Trump administration's harmful policies and for 
acting to protect healthcare for the 50 percent of Americans who have a 
preexisting health condition.
  The Trump administration's destructive policies will force the 
American people to pay more money for less coverage. If you don't 
believe me, just go to the website yourself. This is unacceptable.
  Madam Speaker, I urge my colleagues to vote ``yes'' on the rule and 
``yes'' on Ann Kuster's bill, H.R. 986.
  Mr. BURGESS. Madam Speaker, I yield myself 2 minutes for the purposes 
of a response.
  First of all, I am grateful that the Texas Department of Insurance 
does provide that disclosure and transparency. That is a good thing. In 
fact, Chairwoman Eshoo, the chairwoman of the Health Subcommittee, when 
we were hearing bills on limited-duration plans, actually had a bill 
that would require such disclosure. For whatever reason, it was pulled 
from the markup that we had that day. I was perfectly prepared to 
support it, but, again, for whatever reason, the chairman of the 
committee pulled the bill and we did not get to have that debate or 
markup.
  I also need to point out that our discussion today is not on limited-
duration plans. I rather expect that there will be an opportunity to 
debate limited-duration plans. It may come up as early as next week, 
and I look forward to that debate. But it is also important to point 
out that these plans in Texas were permitted under the previous 
administration for the duration of 1 year.
  So, again, the State commissioner of insurance is exactly right. He 
put those caveats up there so people can know what they are purchasing. 
I do believe

[[Page H3515]]

that is important. I think that is an important aspect of the job of 
the Texas Commission of Insurance. I wish other State commissioners of 
insurance would behave in a similar fashion.
  Madam Speaker, I reserve the balance of my time.
  Ms. SHALALA. Madam Speaker, I yield 2 minutes to the gentleman from 
Texas (Mr. Doggett), a distinguished member of the Ways and Means 
Committee.

                              {time}  1300

  Mr. DOGGETT. Madam Speaker, after so many failed attempts to repeal 
our access to healthcare, Trump and his Republican cohorts are finding 
new ways to take away coverage from millions of Americans who suffer 
with preexisting conditions.
  Now, Republicans have hijacked the mechanism that was designed to 
promote State healthcare innovation to subvert that very innovation.
  What they call ``innovation'' is finding new ways to destroy 
protections for preexisting conditions and to promote junk insurance 
plans that cover--well, they cover what you don't need most.
  If you really need it, if it is for your medical condition, they are 
unlikely to cover it.
  How outrageous.
  A waiver of Federal regulations designed to encourage innovation that 
just waves goodbye to the safeguards that an estimated 40 percent of 
Texans with preexisting conditions really need.
  So, while Trump continues to hide his tax returns, he cannot hide the 
fact that he is sabotaging the healthcare protections for millions of 
Americans.
  After bankrupting his own businesses and leaving creditors at a loss 
for decades, Trump would bankrupt families with serious medical needs.
  And it is almost a joke that he tells us he's got a great plan to 
solve all of our healthcare needs--he said it again at the White House 
this morning--but he is going to wait until after the next election to 
show us what his secret plan is, which sounds a lot like the failed 
plan that he advocated in the last election.
  Let's just pass this bill and tear down the wall that Trump and his 
cohorts want to build between too many Americans and their doctors.
  Mr. BURGESS. Madam Speaker, I yield myself 2 minutes.
  Madam Speaker, I want everyone to be clear here. This bill today is 
actually repealing part of the Affordable Care Act.
  Look, I didn't vote for the Affordable Healthcare Act. I argued 
against it, passionately--articulately, I might add--but what does the 
Affordable Care Act say?
  Well, it describes the object of today's legislation, the so-called 
section 1332 waiver.
  Section 1332 is a section of the Affordable Care Act. And section 
1332 is titled ``Waiver for State Innovation. In general, a state may 
apply to the secretary for the waiver of all or any requirements 
described.''
  And this is interesting. ``With respect to health insurance coverage 
within that State for plan years beginning on or after January 1, 
2017.''
  The way the law was written, none of these waivers were given during 
the years that President Obama was President.
  They only became eligible--the Secretary only became able to provide 
these waivers January 1, 2017, which was the last 3 weeks of President 
Obama's administration.
  So when people say, the comparison between the waivers given in the 
Obama years and the waivers given in the Trump years are vastly 
different, well, it is true because no waivers were available prior to 
January 1, 2017.
  Look, the Secretary of Health and Human Services has heard the angst 
that people have trying to deal with the high premiums--premiums, $600, 
$700, $800 a month for an individual, a deductible of $6,000 to $7,000, 
and the coinsurance, which runs the bills up so that their annual out-
of-pocket costs may be somewhere between $10,000 and $20,000.
  Many people point out to me, they spend more for health insurance--
not using anything, but just for the insurance--than they spend for 
their mortgage payment--not their mortgage insurance, but their 
mortgage payment.
  But, please, let's do remember, 1332 is part of current law.
  Madam Speaker, I reserve the balance of my time.
  Ms. SHALALA. Madam Speaker, I am delighted to hear a Member of the 
other party defend the Affordable Care Act by defending 1332, the 
waivers.
  Let me say this: We are not eliminating the waivers. We are simply 
objecting to the guidance that was issued by the Department of Health 
and Human Services, arguing, essentially, that it is inconsistent with 
the congressional intent when the waivers were created.
  Madam Speaker, I include in the Record a letter signed by 24 health 
organizations, including the Cancer Action Network, the American Lung 
Association, the American Heart Association, the Susan G. Komen 
Foundation, and others, urging Members to support H.R. 986.

                                                      May 8, 2019.
     Re Letter of Support from 23 Patient and Consumer Advocacy 
         Organizations for H.R. 986.

     Hon. Ann McLane Kuster,
     House of Representatives,
     Washington, DC.
       Dear Representative Kuster: Our 24 organizations, 
     representing the interests of the millions of patients and 
     consumers who live with serious, acute, and chronic 
     conditions, have worked together for many months to ensure 
     that patient voices are reflected in the ongoing 
     Congressional debate regarding the accessibility of health 
     coverage for all Americans and families. Today, we write in 
     strong support of your legislation to protect people with 
     pre-existing conditions who receive coverage in the 
     individual marketplace. The Protecting Americans with 
     Preexisting Conditions Act of 2019, H.R. 986, would require 
     the Administration to rescind its Section 1332 State Relief 
     and Empowerment Waivers Guidance, released on October 22, 
     2018 (1332 guidance). We are concerned about the impact that 
     this guidance could have on the people we represent and 
     applaud your introduction of this bill.
       In March 2017, we identified three overarching principles 
     to guide and measure any work to further reform and improve 
     the nation's health insurance system. Our core principles are 
     that health insurance coverage must be adequate, affordable, 
     and accessible. Together, our organizations understand what 
     individuals and families need to prevent disease, manage 
     health, and cure illness. Our organizations are deeply 
     concerned about how the new 1332 guidance will affect the 
     individual marketplace's stability in states that choose to 
     pursue some of the policies allowed under this guidance, 
     including those that promote short term plans and other 
     substandard coverage. We are pleased that this legislation 
     represents a significant and meaningful step towards 
     protecting all Americans from coverage that does not cover 
     what they need to promote their health and well-being.
       As you know, the 1332 guidance substantially erodes the 
     guardrails governing coverage that people with pre-existing 
     conditions such as cystic fibrosis, lung disease, cancer, 
     cardiovascular disease, diabetes, rare disorders, pregnant 
     women, and many others rely on in the individual marketplace. 
     Of particular concern, the new guidance would allow states to 
     let individuals use advanced premium tax credits to purchase 
     non-compliant short-term, limited duration insurance plans--
     which could further draw younger, healthier people out of the 
     risk pool for comprehensive insurance and drive up premiums 
     for those who need comprehensive coverage. The guidance also 
     eliminates protections for vulnerable populations, such as 
     individuals with low incomes and those with chronic and 
     serious health issues, by removing the requirement to 
     safeguard those populations under any waiver. We are deeply 
     concerned by this as these changes fundamentally alter the 
     nature of the Section 1332 waiver program and jeopardize 
     adequate, affordable coverage for people with pre-existing 
     conditions in the individual market. Halting the 
     implementation of this guidance will protect people with pre-
     existing conditions from the repercussions of these market 
     destabilizing actions.
       H.R. 986 represents a significant step towards protecting 
     patients and consumers. Yet, we also recognize that there is 
     much more that needs to be done to improve upon our current 
     system of care, including making coverage more accessible and 
     affordable. Up until this year, health insurance enrollment 
     has steadily increased, and, with it, the promise of a more 
     diverse risk pool and greater protection for people with 
     serious health care needs. However, the recent 
     reinterpretation of the guidelines is jeopardizing 
     enrollment. Shortened enrollment periods, fewer resources for 
     outreach and education and less funding for consumer 
     navigators not only creates confusion for consumers but 
     directly impacts the number of individuals who enroll in 
     Marketplace coverage. Without Congressional action, these 
     trends will make it harder for many to access coverage and 
     will further contribute to the destabilization of insurance 
     markets and result in higher premiums for many enrollees.
       Making high-quality coverage and care more affordable is 
     also a high priority for the people that we represent. 
     Passage of legislation that expands access to and the level

[[Page H3516]]

     of advance premium tax credits, fixes the family glitch, 
     creates a nationwide reinsurance program, and reduces 
     systemic health care costs could significantly ease the cost 
     burden for people of all income levels who rely on the 
     individual marketplace for coverage. We urge Congress to 
     support legislation that maintains the quality of coverage 
     while expanding access and affordability.
       Again, thank you for your leadership on this critical issue 
     for people with pre-existing conditions. We support your 
     efforts to halt the implementation of the 2018 guidance, 
     ensuring the guidance from 2015 remains intact and promoting 
     stability in the individual marketplace. We urge members of 
     Congress to vote for H.R. 986.
           Sincerely,
       Hemophilia Federation of America, National Health Council, 
     Cystic Fibrosis Foundation, Epilepsy Foundation, March of 
     Dimes, National Coalition for Cancer Survivorship, American 
     Heart Association, Alpha-1 Foundation, American Liver 
     Foundation, Susan G. Komen, National Hemophilia Foundation, 
     WomenHeart: The National Coalition for Women with Heart 
     Disease.
       National Multiple Sclerosis Society, Muscular Dystrophy 
     Association, Lutheran Services in America, American Lung 
     Association, National Alliance on Mental Illness, National 
     Patient Advocate Foundation, Arthritis Foundation, Leukemia & 
     Lymphoma Society, American Cancer Society Cancer Action 
     Network, National Organization for Rare Disorders, Pulmonary 
     Hypertension Association, Cancer Support Community.

  Ms. SHALALA. Madam Speaker, I yield 2 minutes to the gentlewoman from 
the District of Columbia (Ms. Norton).
  Ms. NORTON. Madam Speaker, I thank my good friend for yielding.
  Madam Speaker, the administration's guidance permitting junk plans to 
replace the Affordable Healthcare Act has fooled no one, and certainly 
not the millions with preexisting conditions and those who now enjoy 
essential health benefits.
  The administration's true intent is clear from its support, in court 
now, as I speak, of a case to repeal the ACA in its entirety, including 
preexisting conditions.
  Republicans, historically, have initially opposed virtually every 
form of coverage for the American people, including Social Security, 
but they have never succeeded in withdrawing or reducing benefits then 
in use. They will not succeed this time.
  In my own District of Columbia, 106,000 residents with preexisting 
conditions would lose or risk losing or being denied or charged 
significantly more for health coverage.
  The District, on its own, has succeeded in overcoming Republican 
attempts to weaken the ACA and now has reached virtually universal 
coverage, in spite of a specific attempt to block the city's successful 
efforts.
  The administration's junk coverage is particularly untenable in 
allowing Federal subsidies of junk plans.
  Republicans failed to overturn the ACA when they controlled 
majorities in both the House and the Senate. Plans that the 
administration has put forward to dismember the Act will not succeed 
either. Because of how insurance works, junk plans put all insured at 
risk of paying more for insurance.
  Today, we intend to expose and defeat the administration's dangerous 
substitution for the Affordable Healthcare Act.
  Mr. BURGESS. Madam Speaker, I yield myself 2 minutes for purpose of a 
response.
  Look, it is not the Trump Administration that is taking money out of 
the Affordable Care Act and putting it to other purposes. It is clearly 
written into the law.
  And, again, I didn't vote for this law. I voted against it. I argued 
against it, but the taking of advanced premium tax credits, cost-
sharing reductions and small business tax credits under Section 36(b) 
of the Internal Revenue Code of 1986 under subpart (1)--blah, blah, 
blah--an alternative means by which the aggregate amount of such 
credits or reductions that would have been paid on behalf of 
participants in the exchanges established under this title had the 
State not received such a waiver, that amount shall be paid to the 
State for the purposes of implementing the State plan under the waiver.
  So it is really pretty clear in the existing language of law. It is 
not the Trump Administration deviating funds, it was congressional 
intent. It was passed by this House of Representatives.
  Again, I didn't vote for it. I wouldn't have defended it at the time. 
I didn't think it was a good idea then, probably not the greatest idea 
now. But the Secretary has this tool to use and he is responding to 
requests from people's constituents, do something about the high cost 
of my insurance, the high costs that I am required to spend in order to 
protect myself against the health catastrophe.
  Madam Speaker, I reserve the balance of my time.
  Ms. SHALALA. Madam Speaker, I am prepared to close, and I reserve the 
balance of my time.
  Mr. BURGESS. Madam Speaker, I yield 3 minutes to the gentleman from 
Alabama (Mr. Rogers).
  Mr. ROGERS of Alabama. Madam Speaker, I thank my friend from Texas 
for yielding.
  Madam Speaker, I rise in strong opposition to this rule. This rule 
demonstrates, once again, that the Democrat majority refuses to 
acknowledge, accept, or address the very real crisis at our southern 
border.
  Numbers came out yesterday illustrating the magnitude of the crisis. 
CBP detained more than 109,000 migrants along the southwest border last 
month alone--a 591 percent increase compared with April of 2017.
  In just the last 7 months, more than 1 percent of the total 
population of Honduras and Guatemala have migrated to the United 
States.
  In total, over a half a million migrants have crossed our border 
since October of last year, approximately the population of Tucson, 
Arizona.
  Smugglers and cartels continue to preach that now is the time to come 
to the U.S. These criminal organizations run an international smuggling 
organization filled with misery and abuse.
  CBP has already rescued more than 2,000 migrants this fiscal year, 
pulling families out of the Rio Grande River and saving children who 
smugglers have abandoned.
  Migrants that survive the smugglers often arrive in poor health, 
physically exhausted, and in need of urgent medical care.
  The men and women of CBP are doing the best they can to respond to 
this humanitarian crisis, but they have run out of space to safely 
house and process unprecedented numbers of family units seeking entry 
into the United States.
  Health and Human Services is on the urge of running out of funds to 
shelter vulnerable, unaccompanied children that are crossing our 
borders at levels 50 percent higher than just last year.
  Last week, the President sent Congress an urgent request for 
supplemental appropriations to address this humanitarian crisis.
  Ranking Member Collins and I filed an amendment to the supplemental, 
which would have provided $4.5 billion requested by the President.
  It would have replenished critical funds needed to feed and shelter 
migrant families and unaccompanied children, provide urgent medical 
care and transportation services, and pay the growing cost of overtime 
for the men and women of DHS working on the front lines of this crisis.
  Unfortunately, the majority refused to make our amendment in order, 
and in doing so they, again, refused to take action to address this 
crisis.
  They stunningly refused to support the men and women of DHS, and most 
remarkably, they refused to provide the needed assistance to thousands 
of vulnerable migrants arriving at our border on a daily basis.
  The majority's political dysfunction is disgraceful. I urge them to 
work with the President and Republicans in Congress to immediately 
resolve this humanitarian crisis.
  Madam Speaker, I urge all Members to oppose this rule.
  Ms. SHALALA. Madam Speaker, I continue to reserve the balance of my 
time.
  Mr. BURGESS. Madam Speaker, I do have one additional speaker.
  Madam Speaker, I yield 3 minutes to the gentleman from Georgia (Mr. 
Woodall), who is a valuable member of the Rules Committee, and gave us 
a stirring history lesson on the ERISA plans and how the protection 
from preexisting conditions actually goes back to 1996.
  Mr. WOODALL. Madam Speaker, I hope what I am getting ready to say, it 
turns out to be redundant, that we are going to hear it in the closings 
of both the gentlewoman from Florida and the gentleman from Texas.

[[Page H3517]]

  We talk about this preexisting conditions' bill today as if it is 
going to help with preexisting conditions. As we have discussed 
already, it is not.
  But the preexisting conditions issue is a very real issue. It is a 
very real issue for families all across the country, and it has been 
for a long time.
  And undeniably, elections were won and lost this past cycle over a 
preexisting conditions issue based on the misinformation around it.
  I don't know how we are advantaged as a community by continuing to 
perpetuate the misinformation. When we first tackled preexisting 
conditions in a serious way, we did it together in this institution.

  I know, because it was a gentleman from my State, Madam Speaker, 
Speaker Newt Gingrich, who was sitting in that chair at the time.
  It was 1996. Bill Clinton was sitting in the White House. Newt 
Gingrich was sitting here leading the United States House, and we came 
together, Republicans and Democrats, we passed the Health Insurance 
Affordability and Accountability Act that abolished preexisting 
condition worries for every single family with an ERISA-based plan. 
Those are the plans that the Federal Government controls.
  So what I mean, Madam Speaker, is that for every single plan the 
Federal Government had dominion over, we eliminated preexisting 
conditions.
  Medicare, no preexisting conditions.
  Medicaid, no preexisting conditions.
  ERISA plans, no preexisting conditions.
  Collectively, that is about 250 million Americans.
  What we didn't do was go into the area where the Federal Government 
had no dominion, which were State-regulated plans, and we said States 
should have the ability to regulate their own plans.
  Now President Obama said, no, States had been moving too slow to help 
their constituency.
  He ran on the platform of taking those plans away from State control; 
he won that debate. The Affordable Care Act implemented those 
conditions. And the bill today says, if states have an idea about how 
to protect families from preexisting conditions that is better than the 
one in the Affordable Care Act, we don't want to hear it.

                              {time}  1315

  There is one solution for preexisting conditions and it is the one 
that President Obama has implemented, no other. I think that is wrong.
  Dr. Burgess knows more about medicine than I will ever hope to know. 
He knows more about serving patients than I will ever hope to know.
  Ms. Shalala, as Secretary of Health and Human Services, knows more 
about healthcare than I will ever hope to know. I trust these folks to 
find solutions differently in Florida, and differently in Texas than we 
do in Georgia.
  This bill does one thing and one thing only. It continues the debate 
from 1996, not about whether to help people with preexisting 
conditions, but about whether States have anything to add to the 
discussion. I am certain the State of Georgia does. I believe the State 
of Florida does. I know the State of Texas does.
  If we defeat this rule and defeat this bill, it will allow those very 
best ideas to come out and not ideas about how to keep people down, 
Madam Speaker, but ideas about how to lift families up.
  We have come together on those issues before, Madam Speaker, and we 
can do it again.
  Ms. SHALALA. Madam Speaker, I yield myself such time as I may 
consume.
  I appreciate the comments of the gentleman from Georgia, and I have 
enjoyed the opportunity of working with him on the Rules Committee.
  We are not objecting to what was done in 1996. We are saying to the 
States that they must cover preexisting conditions as part of a waiver, 
and they cannot undermine those conditions by imposing annual limits or 
charging more. The problem with the guidance is that it gives States 
the opportunity to propose cheap plans that, in essence, undermine 
preexisting conditions.
  Madam Speaker, I reserve the balance of my time.
  Mr. BURGESS. Madam Speaker, I yield myself the balance of my time.
  Madam Speaker, if we defeat the previous question, I will offer an 
amendment to the rule to move a resolution that reinforces the 
Republican's long-held views that every American should have 
preexisting condition protections.
  On the opening day of the 116th Congress, House Republicans brought a 
measure to the floor that called on lawmakers to legislate on locking 
in protections for patients with preexisting conditions. Unfortunately, 
in a fit of partisanship, House Democrats blocked that effort. If 
Democrats were serious, they would not object to making a statement on 
behalf of the House of Representatives that we want to work together 
with the administration to protect patients with preexisting 
conditions.
  Our position is simple and clear. Republicans stand ready to protect 
those with preexisting conditions in a manner that will withstand 
judicial scrutiny, and I hope our Democratic colleagues will join us in 
that effort.
  Madam Speaker, if the previous question is defeated, House 
Republicans will move to immediately consider a resolution that 
maintains that no American should have their health insurance taken 
away or lose protections for preexisting conditions due to the 
Democrats in Congress enacting an unconstitutional law.
  It would instruct Congress and the Trump administration to ask the 
Supreme Court for a stay in the Texas v. United States decision, should 
the Affordable Care Act be found unconstitutional.
  It would instruct Congress to develop bipartisan legislation that 
guarantees that no American citizen can be denied health insurance 
coverage or charged more due to a previous illness or health status.
  It includes commonsense consumer protections, provides more choice 
and affordable coverage than the Affordable Care Act, lowers 
prescription drug prices for patients, strengthens Medicare for current 
and future beneficiaries, and rejects the Democrats' radical one-size-
fits-all, government-run, Soviet-style, top-down healthcare scheme that 
would only outlaw the employer-based coverage of more than 180 million 
Americans.
  Madam Speaker, I suspect our Democratic colleagues will vote against 
considering this resolution, so I must ask: Why are Democrats opposed 
to making a statement that the goal of the House of Representatives of 
the United States is to work together to protect coverage for patients 
with preexisting conditions? If that is not the goal, then what might 
it be?
  Madam Speaker, I ask unanimous consent to insert the text of this 
amendment into the Record, along with extraneous material, immediately 
prior to the vote on the previous question.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Madam Speaker, again, I would reiterate that neither 
bill under consideration today has a chance of becoming law.
  While I support funding for disaster relief, the Democrats chose not 
to negotiate with the Senate and included controversial positions.
  As a result, we would likely be considering a disaster relief bill 
yet another time, and our hard-hit communities will continue to 
struggle without relief.
  Once again, despite the title of H.R. 986, this bill will have no 
impact on protections for preexisting conditions for Americans with 
those conditions. It will simply overturn a regulation--overturns part 
of ObamaCare--it overturns a regulation that allows States to innovate 
in the Affordable Care Act marketplace, and that provides flexibility 
and consumer choice to healthcare consumers.
  House Republicans continue to support preexisting conditions 
protections and have offered solutions to give patients this assurance. 
Republicans stand ready to work with Democrats in a bipartisan manner 
to pass these protections into law and also provide desperately needed 
disaster relief.
  I look forward to when we can all gather around the negotiating 
table. I urge a ``no'' vote on the previous question, a ``no'' vote on 
the underlying measures, and I yield back the balance of my time.

[[Page H3518]]

  

  Ms. SHALALA. Madam Speaker, I yield myself the balance of my time.
  It was only 10 years ago that people who lacked employer-provided 
insurance and had preexisting conditions could not find health 
insurance in many parts of this country, and those who could find 
health insurance, too often found that their plans were not 
comprehensive. They might not cover the type of cancer some buyers 
previously had, or they might have an annual or even a lifetime cap on 
coverage.
  It was 2 years ago that this body passed a bill that stripped those 
protections, a bill that would make comprehensive health insurance out 
of reach for many Americans. Thanks to a courageous few, that bill did 
not become law.
  Now that the administration has lost that battle to destroy the 
Affordable Care Act, they are trying to do it through guidance and 
through lawsuits.
  H.R. 986 prevents the administration from enforcing guidance that 
would allow States to use taxpayer money to sell subpar health plans on 
the exchange.
  The administration is taking the 1332 waivers, which are designed to 
allow States flexibility to lower health insurance costs, like through 
reinsurance, and using it to take away important consumer protections. 
The 1332 waiver requires high-quality, affordable health insurance 
while retaining the basic protections of the Affordable Care Act.
  As the American Cancer Society notes: This administration guidance 
tips the scales in favor of insurance products that are inadequate to 
meet the needs of millions of Americans with preexisting conditions.
  Madam Speaker, I also support H.R. 2157, which provides disaster 
assistance to communities from every nook and corner of this country 
who are waiting for our help.
  When disaster hits this country, we come together and support each 
other. When tornados, and floods, and hurricanes strike, we help people 
quickly. It is an embarrassment that a disaster bill has not yet made 
it to the President's desk in this Congress.
  Madam Speaker, I urge a ``yes'' vote on the rule.
  The text of the material previously referred to by Mr. Burgess is as 
follows:

                   Amendment to House Resolution 357

       At the end of the resolution, add the following:
       Sec. 3. Immediately upon adoption of this resolution, the 
     House shall proceed to the consideration in the House of the 
     resolution (H. Res. 280), protecting the health care of all 
     Americans, especially those with preexisting conditions. The 
     resolution shall be considered as read. The previous question 
     shall be considered as ordered on the resolution to adoption 
     without intervening motion or demand for division of the 
     question except one hour of debate equally divided and 
     controlled by the chair and ranking minority member of the 
     Committee on Energy and Commerce. Clause 1(c) of rule XIX 
     shall not apply to the consideration of House Resolution 280.

  Ms. SHALALA. Madam Speaker, I yield back the balance of my time, and 
I move the previous question on the resolution.
  The SPEAKER pro tempore. The question is on ordering the previous 
question.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. BURGESS. Madam Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 9 of rule XX, the Chair 
will reduce to 5 minutes the minimum time for any electronic vote on 
the question of adoption of the resolution.
  The vote was taken by electronic device, and there were--yeas 227, 
nays 190, answered ``present'' 1, not voting 13, as follows:

                             [Roll No. 189]

                               YEAS--227

     Adams
     Aguilar
     Allred
     Axne
     Barragan
     Beatty
     Bera
     Beyer
     Bishop (GA)
     Blumenauer
     Blunt Rochester
     Bonamici
     Boyle, Brendan F.
     Brindisi
     Brown (MD)
     Brownley (CA)
     Bustos
     Butterfield
     Carbajal
     Carson (IN)
     Cartwright
     Case
     Casten (IL)
     Castor (FL)
     Castro (TX)
     Chu, Judy
     Cicilline
     Cisneros
     Clark (MA)
     Clarke (NY)
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly
     Cooper
     Correa
     Costa
     Courtney
     Cox (CA)
     Craig
     Crist
     Crow
     Cuellar
     Cunningham
     Davids (KS)
     Davis (CA)
     Davis, Danny K.
     Dean
     DeFazio
     DeGette
     DeLauro
     DelBene
     Delgado
     Demings
     DeSaulnier
     Deutch
     Dingell
     Doggett
     Doyle, Michael F.
     Engel
     Escobar
     Eshoo
     Espaillat
     Evans
     Finkenauer
     Fletcher
     Foster
     Frankel
     Fudge
     Gabbard
     Gallego
     Garamendi
     Garcia (IL)
     Garcia (TX)
     Golden
     Gomez
     Gonzalez (TX)
     Gottheimer
     Green (TX)
     Grijalva
     Haaland
     Harder (CA)
     Hastings
     Hayes
     Heck
     Higgins (NY)
     Hill (CA)
     Himes
     Horn, Kendra S.
     Horsford
     Houlahan
     Hoyer
     Huffman
     Jackson Lee
     Jayapal
     Jeffries
     Johnson (GA)
     Johnson (TX)
     Kaptur
     Keating
     Kelly (IL)
     Kennedy
     Khanna
     Kildee
     Kilmer
     Kim
     Kind
     Kirkpatrick
     Krishnamoorthi
     Kuster (NH)
     Lamb
     Langevin
     Larsen (WA)
     Larson (CT)
     Lawrence
     Lawson (FL)
     Lee (CA)
     Lee (NV)
     Levin (CA)
     Levin (MI)
     Lewis
     Lieu, Ted
     Lipinski
     Loebsack
     Lofgren
     Lowenthal
     Lowey
     Lujan
     Luria
     Lynch
     Malinowski
     Maloney, Carolyn B.
     Maloney, Sean
     Matsui
     McAdams
     McBath
     McCollum
     McEachin
     McGovern
     McNerney
     Meeks
     Meng
     Moore
     Morelle
     Moulton
     Mucarsel-Powell
     Murphy
     Nadler
     Napolitano
     Neal
     Neguse
     Norcross
     O'Halleran
     Ocasio-Cortez
     Omar
     Pallone
     Panetta
     Pappas
     Pascrell
     Payne
     Perlmutter
     Peters
     Peterson
     Phillips
     Pingree
     Pocan
     Porter
     Pressley
     Price (NC)
     Quigley
     Raskin
     Rice (NY)
     Rose (NY)
     Rouda
     Roybal-Allard
     Ruiz
     Ruppersberger
     Rush
     Ryan
     Sanchez
     Sarbanes
     Scanlon
     Schiff
     Schneider
     Schrader
     Schrier
     Scott (VA)
     Scott, David
     Serrano
     Sewell (AL)
     Shalala
     Sherman
     Sherrill
     Sires
     Slotkin
     Smith (WA)
     Soto
     Spanberger
     Speier
     Stanton
     Stevens
     Suozzi
     Takano
     Thompson (CA)
     Thompson (MS)
     Titus
     Tlaib
     Tonko
     Torres (CA)
     Torres Small (NM)
     Trahan
     Trone
     Underwood
     Van Drew
     Vargas
     Veasey
     Vela
     Velazquez
     Wasserman Schultz
     Waters
     Watson Coleman
     Welch
     Wexton
     Wild
     Wilson (FL)
     Yarmuth

                               NAYS--190

     Abraham
     Aderholt
     Allen
     Amash
     Amodei
     Armstrong
     Arrington
     Babin
     Bacon
     Baird
     Balderson
     Banks
     Barr
     Bergman
     Biggs
     Bilirakis
     Bost
     Brady
     Brooks (AL)
     Brooks (IN)
     Buchanan
     Buck
     Bucshon
     Budd
     Burchett
     Burgess
     Byrne
     Calvert
     Carter (GA)
     Carter (TX)
     Chabot
     Cheney
     Cline
     Cloud
     Cole
     Collins (GA)
     Collins (NY)
     Comer
     Conaway
     Cook
     Crawford
     Crenshaw
     Curtis
     Davidson (OH)
     Davis, Rodney
     DesJarlais
     Diaz-Balart
     Duffy
     Duncan
     Dunn
     Estes
     Ferguson
     Fitzpatrick
     Fleischmann
     Flores
     Fortenberry
     Foxx (NC)
     Fulcher
     Gaetz
     Gallagher
     Gianforte
     Gibbs
     Gohmert
     Gonzalez (OH)
     Gooden
     Gosar
     Granger
     Graves (GA)
     Graves (LA)
     Graves (MO)
     Green (TN)
     Griffith
     Grothman
     Guest
     Guthrie
     Hagedorn
     Harris
     Hartzler
     Hern, Kevin
     Herrera Beutler
     Hice (GA)
     Higgins (LA)
     Hill (AR)
     Holding
     Hollingsworth
     Hudson
     Huizenga
     Hunter
     Hurd (TX)
     Johnson (LA)
     Johnson (OH)
     Johnson (SD)
     Jordan
     Joyce (OH)
     Joyce (PA)
     Katko
     Kelly (MS)
     Kelly (PA)
     King (IA)
     King (NY)
     Kinzinger
     Kustoff (TN)
     LaHood
     LaMalfa
     Lamborn
     Latta
     Lesko
     Long
     Loudermilk
     Lucas
     Luetkemeyer
     Marchant
     Marshall
     Massie
     Mast
     McCarthy
     McCaul
     McClintock
     McHenry
     McKinley
     Meadows
     Meuser
     Miller
     Mitchell
     Moolenaar
     Mooney (WV)
     Mullin
     Newhouse
     Norman
     Nunes
     Palazzo
     Palmer
     Pence
     Perry
     Posey
     Ratcliffe
     Reed
     Reschenthaler
     Rice (SC)
     Riggleman
     Roby
     Rodgers (WA)
     Roe, David P.
     Rogers (AL)
     Rogers (KY)
     Rose, John W.
     Rouzer
     Rutherford
     Scalise
     Schweikert
     Scott, Austin
     Sensenbrenner
     Shimkus
     Simpson
     Smith (MO)
     Smith (NE)
     Smith (NJ)
     Smucker
     Spano
     Stauber
     Stefanik
     Steil
     Steube
     Stewart
     Stivers
     Taylor
     Thompson (PA)
     Thornberry
     Timmons
     Tipton
     Turner
     Upton
     Wagner
     Walberg
     Walden
     Walorski
     Waltz
     Watkins
     Weber (TX)
     Webster (FL)
     Westerman
     Williams
     Wilson (SC)
     Wittman
     Womack
     Woodall
     Wright
     Yoho
     Young
     Zeldin

                        ANSWERED ``PRESENT''--1

       
     Roy
       

                             NOT VOTING--13

     Bass
     Bishop (UT)
     Cardenas
     Cummings
     Emmer
     Olson
     Richmond
     Rooney (FL)
     Schakowsky
     Swalwell (CA)
     Visclosky
     Walker
     Wenstrup

                              {time}  1352

  Messrs. AMASH, ADERHOLT, KINZINGER, BUDD, BILIRAKIS, STIVERS, and 
KATKO changed their vote from ``yea'' to ``nay.''
  Ms. SEWELL of Alabama changed her vote from ``nay'' to ``yea.''

[[Page H3519]]

  So the previous question was ordered.
  The result of the vote was announced as above recorded.
  The SPEAKER pro tempore. The question is on the resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. BURGESS. Madam Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. This is a 5-minute vote.
  The vote was taken by electronic device, and there were--yeas 227, 
nays 191, not voting 13, as follows:

                             [Roll No. 190]

                               YEAS--227

     Adams
     Aguilar
     Allred
     Axne
     Barragan
     Beatty
     Bera
     Beyer
     Bishop (GA)
     Blumenauer
     Blunt Rochester
     Bonamici
     Boyle, Brendan F.
     Brindisi
     Brown (MD)
     Brownley (CA)
     Bustos
     Butterfield
     Carbajal
     Carson (IN)
     Cartwright
     Case
     Casten (IL)
     Castor (FL)
     Castro (TX)
     Chu, Judy
     Cicilline
     Cisneros
     Clark (MA)
     Clarke (NY)
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly
     Cooper
     Correa
     Costa
     Courtney
     Cox (CA)
     Craig
     Crist
     Crow
     Cuellar
     Cunningham
     Davids (KS)
     Davis (CA)
     Davis, Danny K.
     Dean
     DeFazio
     DeGette
     DeLauro
     DelBene
     Delgado
     Demings
     DeSaulnier
     Deutch
     Dingell
     Doggett
     Doyle, Michael F.
     Engel
     Escobar
     Eshoo
     Espaillat
     Evans
     Finkenauer
     Fletcher
     Foster
     Frankel
     Fudge
     Gabbard
     Gallego
     Garamendi
     Garcia (IL)
     Garcia (TX)
     Golden
     Gomez
     Gonzalez (TX)
     Gottheimer
     Green (TX)
     Grijalva
     Haaland
     Harder (CA)
     Hastings
     Hayes
     Heck
     Higgins (NY)
     Hill (CA)
     Himes
     Horn, Kendra S.
     Horsford
     Houlahan
     Hoyer
     Huffman
     Jackson Lee
     Jayapal
     Jeffries
     Johnson (GA)
     Johnson (TX)
     Kaptur
     Keating
     Kelly (IL)
     Kennedy
     Khanna
     Kildee
     Kilmer
     Kim
     Kind
     Kirkpatrick
     Krishnamoorthi
     Kuster (NH)
     Lamb
     Langevin
     Larsen (WA)
     Larson (CT)
     Lawrence
     Lawson (FL)
     Lee (CA)
     Lee (NV)
     Levin (CA)
     Levin (MI)
     Lewis
     Lieu, Ted
     Lipinski
     Loebsack
     Lofgren
     Lowenthal
     Lowey
     Lujan
     Luria
     Lynch
     Malinowski
     Maloney, Carolyn B.
     Maloney, Sean
     Matsui
     McAdams
     McBath
     McCollum
     McEachin
     McGovern
     McNerney
     Meeks
     Meng
     Moore
     Morelle
     Moulton
     Mucarsel-Powell
     Murphy
     Nadler
     Napolitano
     Neal
     Neguse
     Norcross
     O'Halleran
     Ocasio-Cortez
     Omar
     Pallone
     Panetta
     Pappas
     Pascrell
     Payne
     Perlmutter
     Peters
     Peterson
     Phillips
     Pingree
     Pocan
     Porter
     Pressley
     Price (NC)
     Quigley
     Raskin
     Rice (NY)
     Rose (NY)
     Rouda
     Roybal-Allard
     Ruiz
     Ruppersberger
     Rush
     Ryan
     Sanchez
     Sarbanes
     Scanlon
     Schakowsky
     Schiff
     Schneider
     Schrader
     Schrier
     Scott (VA)
     Scott, David
     Sewell (AL)
     Shalala
     Sherman
     Sherrill
     Sires
     Slotkin
     Smith (WA)
     Soto
     Spanberger
     Speier
     Stanton
     Stevens
     Suozzi
     Takano
     Thompson (CA)
     Thompson (MS)
     Titus
     Tlaib
     Tonko
     Torres (CA)
     Torres Small (NM)
     Trahan
     Trone
     Underwood
     Van Drew
     Vargas
     Veasey
     Vela
     Velazquez
     Wasserman Schultz
     Waters
     Watson Coleman
     Welch
     Wexton
     Wild
     Wilson (FL)
     Yarmuth

                               NAYS--191

     Abraham
     Aderholt
     Allen
     Amash
     Amodei
     Armstrong
     Arrington
     Babin
     Bacon
     Baird
     Balderson
     Banks
     Barr
     Bergman
     Biggs
     Bilirakis
     Bost
     Brady
     Brooks (AL)
     Brooks (IN)
     Buchanan
     Buck
     Bucshon
     Budd
     Burchett
     Burgess
     Byrne
     Calvert
     Carter (GA)
     Carter (TX)
     Chabot
     Cheney
     Cline
     Cloud
     Cole
     Collins (GA)
     Collins (NY)
     Comer
     Conaway
     Cook
     Crawford
     Crenshaw
     Curtis
     Davidson (OH)
     Davis, Rodney
     DesJarlais
     Diaz-Balart
     Duffy
     Duncan
     Dunn
     Estes
     Ferguson
     Fitzpatrick
     Fleischmann
     Flores
     Fortenberry
     Foxx (NC)
     Fulcher
     Gaetz
     Gallagher
     Gianforte
     Gibbs
     Gohmert
     Gonzalez (OH)
     Gooden
     Gosar
     Granger
     Graves (GA)
     Graves (LA)
     Graves (MO)
     Green (TN)
     Griffith
     Grothman
     Guest
     Guthrie
     Hagedorn
     Harris
     Hartzler
     Hern, Kevin
     Herrera Beutler
     Hice (GA)
     Higgins (LA)
     Hill (AR)
     Holding
     Hollingsworth
     Hudson
     Huizenga
     Hunter
     Hurd (TX)
     Johnson (LA)
     Johnson (OH)
     Johnson (SD)
     Jordan
     Joyce (OH)
     Joyce (PA)
     Katko
     Kelly (MS)
     Kelly (PA)
     King (IA)
     King (NY)
     Kinzinger
     Kustoff (TN)
     LaHood
     LaMalfa
     Lamborn
     Latta
     Lesko
     Long
     Loudermilk
     Lucas
     Luetkemeyer
     Marchant
     Marshall
     Massie
     Mast
     McCarthy
     McCaul
     McClintock
     McHenry
     McKinley
     Meadows
     Meuser
     Miller
     Mitchell
     Moolenaar
     Mooney (WV)
     Mullin
     Newhouse
     Norman
     Nunes
     Palazzo
     Palmer
     Pence
     Perry
     Posey
     Ratcliffe
     Reed
     Reschenthaler
     Rice (SC)
     Riggleman
     Roby
     Rodgers (WA)
     Roe, David P.
     Rogers (AL)
     Rogers (KY)
     Rose, John W.
     Rouzer
     Roy
     Rutherford
     Scalise
     Schweikert
     Scott, Austin
     Sensenbrenner
     Shimkus
     Simpson
     Smith (MO)
     Smith (NE)
     Smith (NJ)
     Smucker
     Spano
     Stauber
     Stefanik
     Steil
     Steube
     Stewart
     Stivers
     Taylor
     Thompson (PA)
     Thornberry
     Timmons
     Tipton
     Turner
     Upton
     Wagner
     Walberg
     Walden
     Walorski
     Waltz
     Watkins
     Weber (TX)
     Webster (FL)
     Westerman
     Williams
     Wilson (SC)
     Wittman
     Womack
     Woodall
     Wright
     Yoho
     Young
     Zeldin

                             NOT VOTING--13

     Bass
     Bishop (UT)
     Cardenas
     Cummings
     Emmer
     Olson
     Richmond
     Rooney (FL)
     Serrano
     Swalwell (CA)
     Visclosky
     Walker
     Wenstrup

                              {time}  1401

  So the resolution was agreed to.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________