[Congressional Record Volume 169, Number 20 (Tuesday, January 31, 2023)]
[House]
[Pages H539-H551]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
FREEDOM FOR HEALTH CARE WORKERS ACT
Mr. BUCSHON. Mr. Speaker, pursuant to House Resolution 75, I call up
the bill (H.R. 497) to eliminate the COVID-19 vaccine mandate on health
care providers furnishing items and services under certain Federal
health care programs, and ask for its immediate consideration in the
House.
The Clerk read the title of the bill.
The SPEAKER pro tempore. Pursuant to House Resolution 75, the bill is
considered read.
The text of the bill is as follows:
H.R. 497
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 ``Freedom for Health Care
Workers Act''.
SEC. 2. ELIMINATING THE COVID-19 VACCINE MANDATE ON HEALTH
CARE PROVIDERS FURNISHING ITEMS AND SERVICES
UNDER CERTAIN FEDERAL HEALTH CARE PROGRAMS.
The Secretary of Health and Human Services may not
implement, enforce, or otherwise give effect to the rule
entitled ``Medicare and Medicaid Programs; Omnibus COVID-19
Health Care Staff Vaccination'' published by the Department
of Health and Human Services on November 5, 2021 (86 Fed.
Reg. 61555) and may not promulgate any substantially similar
rule.
The SPEAKER pro tempore. The bill shall be debatable for 1 hour
equally divided and controlled by the chair and ranking minority member
of the Committee on Energy and Commerce or their respective designees.
The gentleman from Indiana (Mr. Bucshon) and the gentleman from New
Jersey (Mr. Pallone) each will control 30 minutes.
The Chair recognizes the gentleman from Indiana (Mr. Bucshon).
General Leave
Mr. BUCSHON. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days to revise and extend their remarks on the
legislation and to insert extraneous material on H.R. 497.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Indiana?
There was no objection.
Mr. BUCSHON. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of H.R. 497, the Freedom for
Health Care Workers Act, introduced by my Energy and Commerce Committee
colleague Representative Duncan.
I want to start by making one thing clear: I believe in the safety
and effectiveness of vaccines. I am a physician. I am pro-vaccine. At
the same time, I am conservative, and I believe in individual choice.
It is my firm conviction that, whenever possible, the Federal
Government should leave decisionmaking to State or local authorities.
Additionally, my background in medicine has informed my belief that
medical decisions are extremely personal and should be made by
individuals in consultation with their doctors.
So, at the end of 2021, when the Centers for Medicare and Medicaid
Services announced a decision to mandate that healthcare workers
receive a COVID-19 vaccine to remain employed, I opposed the decision.
I believed this move by the Biden administration to be unnecessary,
inappropriate, and a net harm to our healthcare system as a whole.
That is why my colleague Vern Buchanan and I led a letter with 113
other Members outlining our opposition to the mandate and our concerns.
Mr. Speaker, I include in the Record that letter in opposition to the
mandate.
Congres of the United States,
House of Representatives,
Washington, DC, December 6, 2021.
Hon. Chiquita Brooks-LaSure,
Administrator, Centers for Medicare & Medicaid Services,
Baltimore, MD.
Dear Administrator Brooks-LaSure: The COVID-19 pandemic has
taken a significant toll on the American public both
physically and emotionally for almost two years. In that
time, though, multiple vaccines have become widely available
for those wishing to
[[Page H540]]
be vaccinated. According to the Mayo Clinic, nearly 60
percent of the United States population over the age of 12 is
fully vaccinated, including over 83 percent of the Medicare-
aged population.
Thankfully, the United States has seen an overall decrease
in new COVID-19 infections, hospitalizations and deaths since
vaccines became readily available, and while we are not yet
out of the woods, many are saying the end of the pandemic is
in sight. Former Food and Drug Administration Commissioner
Scott Gottlieb, M.D. recently stated the pandemic ``may well
be over'' by January 4, which is the deadline the Centers for
Medicare and Medicaid Services (CMS) set for complying with
either its vaccination mandate or enforcing the continued use
of masks and weekly testing.
At a time when we are facing a growing health care
workforce shortage--including a projected physician shortage
of more than 100,000 by 2034--implementing a federal vaccine
mandate will only serve to exacerbate the problem. By your
own admission, ``[t]hese requirements will apply to
approximately 76,000 providers and cover over 17 million
health care workers across the country.'' It is difficult, if
not impossible, to reconcile the rationale for implementing a
mandate like this at the tail end of the pandemic while we,
as a nation, are struggling to staff hospitals, physician
offices and other ancillary providers.
We fully support your agency's goal of ``[e]nsuring patient
safety and protection,'' but if seniors are unable to access
care because their provider no longer participates in the
Medicare program, this rule will undermine its stated goal.
By subjecting providers to egregious federal overreach, our
nation's most vulnerable populations will be at risk and
America's seniors will bear the brunt of any provider loss
due to non-compliance with this heavy-handed and
constitutionally dubious vaccine mandate. Americans are
quitting their jobs at a record pace, and this new federal
mandate will only make matters worse and keep more Americans
out of the workforce.
There are over 54 million Medicare-aged Americans, and it
is our duty as Members of Congress representing those seniors
to ensure they maintain access to their preferred health care
provider. This is especially true when that means opposing an
administrative agency's actions that will lead to fewer
options for our constituents; longer wait times; and the
inevitability of adverse health outcomes due to fewer
available providers.
We strongly urge you to abandon implementing this onerous
new rule and instead heed current statistics that show
seniors are vaccinated at a higher rate than the rest of the
population of vaccinated Americans while also uniquely
vulnerable to disruptions in the health care system and
consider the potentially negative consequences this mandate
will have on the size and strength of our health care
workforce. To truly ensure patient safety and protection, we
must preserve Americans' access to their preferred providers
rather than impose a new one-size-fits-all federal mandate on
our nation's health care providers at a time when they can
least afford it.
Sincerely,
Vern Buchanan, Elise Stefanik, Jeff Duncan, Jodey V.
Arrington, Mike Kelly, Larry Bucshon, M.D., Jim Banks, Brett
Guthrie, Jackie Walorski, David B. McKinley, P.E., Gus M.
Bilirakis, Bill Johnson, Debbie Lesko, Dan Crenshaw, Bill
Posey, Bob Gibbs, Ralph Norman, John Joyce, M.D., Markwayne
Mullin, Earl L. ``Buddy'' Carter, Michael Waltz, Doug
Lamborn, Randy Feenstra, Neal P. Dunn, M.D., Brian Mast,
Robert E. Latta.
Guy Reschenthaler, Kelly Armstrong, William Timmons,
Gregory F. Murphy, M.D., Mike Johnson, Beth Van Duyne, Darin
LaHood, Warren Davidson, Brian Babin, D.D.S., Brad R.
Wenstrup, D.P.M., Glen Grothman, John H. Rutherford, Adrian
Smith, Fred Keller, Jack Bergman, Michelle Steel, Kevin Hern,
Dan Newhouse, Michael Cloud, Troy Balderson, A. Drew
Ferguson, IV, D.M.D., John Moolenaar, Tim Burchett, C. Scott
Franklin, Barry Moore, Tom McClintock, Eric A. ``Rick''
Crawford, Ronny L. Jackson, M.D., Jody Hice, Diana
Harshbarger, Parm.D., Jason Smith, Tom Rice.
Tom Reed, Carlos Gimenez, Pete Sessions, Greg Pence, Ben
Cline, Glenn ``GT'' Thompson, Mariannette J. Miller-Meeks,
M.D., Claudia Tenney, Mike Rogers, Ron Estes, Ted Budd, Andy
Harris, M.D., David Kustoff, Steve Chabot, Michael Guest, W.
Gregory Steube, Randy K. Weber, Majorie Taylor Green, Lance
Gooden, Pat Fallon, Michael C. Burgess, M.D., Kat Cammack,
Andy Biggs, Carol D. Miller, Andrew S. Clyde, Devin Nunes,
Stephanie Bice, Tracey Mann, Daniel Webster, Mary Miller,
Darrell Issa, Rodney Davis.
Lisa McClain, Richard Hudson, Ann Wagner, Mario Diaz-
Balart, Lloyd Smucker, Jeff Fortenberry, Dan Bishop, Jim
Baird, John Rose, Louie Gohmert, David Schweikert, Rick W.
Allen, Bill Huizenga, Bryon Donalds, Bruce Westerman, Andrew
R. Garbarino, Nancy Mace, Vicky Hartzler, Steven M. Palazzo,
Jake LaTurner, Chuck Fleischmann, Tom Emmer, Austin Scott,
Trey Hollingsworth, Mike Bost.
Mr. BUCSHON. The move was unprecedented. CMS does not impose such a
mandate for any other vaccine. Furthermore, the vaccine, while
effective at preventing severe disease and death, is not shown to
totally prevent transmission of the virus.
It was difficult, if not impossible, to reconcile the rationale for
implementing a mandate like this at the tail end of the pandemic while
we as a Nation are struggling to staff hospitals, physician offices,
and other ancillary providers.
Our Nation's healthcare system was already facing a growing
healthcare workforce shortage, including a projected physician shortage
of more than 100,000 by 2034. I was worried--and, indeed, we saw it
play out--that implementing a Federal vaccine mandate would only serve
to exacerbate the problem.
For example, in my home State, Indiana University lost 125 employees
as a direct result of the vaccine requirement, and that is just one
small example. Thousands of individuals across the country either
resigned or were let go due to this mandate.
Now, over a year later, despite several lawsuits rising through the
courts questioning the validity of this exact rule, the Biden
administration continues to enforce this mandate.
Today's bill does what the Biden administration will not. It ends the
onerous mandate imposed by a Federal Government agency on the American
people. It provides important autonomy to healthcare workers and
critical relief to hospitals and other facilities that continue to face
staff shortages.
My Democratic colleagues will say that this mandate was worth it,
that repealing it will hurt healthcare workers or patients they serve.
I haven't seen any data to suggest that.
What we do know is that 95 percent of Americans have either been
vaccinated or had COVID-19. We know the vaccine no longer totally
prevents transmission of COVID-19.
CMS' vaccine mandate won't end with the public health emergency on
May 11 or sooner if the previous bill that we just debated goes into
law. It will go on indefinitely unless the administration rescinds it
or Congress takes action.
Given that the administration threatened to veto this legislation, it
doesn't seem like they plan to reverse course, so Congress must step
in.
We are not taking away anyone's ability to get vaccinated. Healthcare
workers can and should protect themselves, including getting vaccinated
if they choose. Nor are we taking away the ability of individual health
systems to make decisions about what vaccinations they may require.
{time} 1515
For instance, many healthcare systems have required employees to get
a flu shot for many years. The Federal Government simply shouldn't
demand they do so.
Federal bureaucrats in Washington, D.C., do not know the needs of
Hoosiers in my district or many Americans across the country and must
not be allowed to make medical decisions on their behalf.
Mr. Speaker, for all of these reasons, I urge my colleagues to
support H.R. 497 here today, and I reserve the balance of my time.
Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in strong opposition to H.R. 497, a bill I
consider reckless that endangers the health and well-being of
Americans. With this legislation, House Republicans are putting
politics over science. The legislation would eliminate the COVID-19
vaccine requirement for healthcare workers. It ignores the fact that
vaccination of healthcare workers saves lives and protects the most
vulnerable.
The bill has had no hearings, no markups, no opportunity to examine
its impact on our healthcare system. It is what we call regular order.
But I am not saying that it should have had hearings or markups in
committee just for regular order. I believe that if Republicans had
taken the time to solicit input on this bill, they would have heard
from healthcare leaders that H.R. 497 will jeopardize the health and
safety of providers, patients, and their families. That is why we have
committee hearings. That is why we have committee markups, to hear and
get input from our constituents.
COVID-19 vaccines are safe and effective, and they have been
essential to saving lives, rebuilding our economy, and protecting the
health of our communities. More than 668 million
[[Page H541]]
COVID-19 vaccine doses have been administered here in the United
States, which has resulted in 120 million fewer COVID-19 infections,
18.5 million fewer hospitalizations, and 3.2 million lives saved.
These vaccines are especially vital to protecting the most vulnerable
in our community, including seniors, people with disabilities, and
people living in nursing homes. The public health data clearly shows
that increased vaccination in nursing homes has prevented additional
hospitalizations and saved lives. New deaths among nursing home
residents decreased by 83 percent once vaccination efforts began.
We also know that vaccination of healthcare providers has protected
our healthcare workforce and saved lives by ensuring that patients can
receive safe, essential, and timely care. Prior to the availability of
COVID-19 vaccines, healthcare providers were at higher risk of becoming
infected with COVID-19, endangering themselves and their families while
leaving patients without access to care when they needed it most. That
is why more than 50 healthcare organizations representing doctors,
nurses, and hospitals, agree that requiring COVID-19 vaccination of
healthcare workers saves lives and improves health outcomes.
My colleague from Indiana mentioned the U.S. Supreme Court. They
actually upheld the vaccine mandate for healthcare workers.
Mr. Speaker, vaccines mandates are also not new. Healthcare workers
are often required to receive vaccinations for a variety of infectious
diseases. Many States have requirements that healthcare workers be
vaccinated against communicable diseases like hepatitis, flu, and
measles, mumps, or rubella.
Why wouldn't we want the same requirements to prevent the continued
spread of COVID-19, especially amongst our most vulnerable?
Again, in response to my colleague from Indiana, the healthcare
workforce has grown since the vaccine requirement, with more healthcare
providers and staff employed, for example, on December 10, 2022, than
prior to when the COVID-19 vaccine requirement went into effect. As of
December 2022, employment in the healthcare sector was 1.2 percent
higher than the previous peak of February 2020.
Data shows requiring COVID-19 vaccination of healthcare workers did
not contribute to worsening of staffing shortages in nursing homes.
Nursing homes who were experiencing staffing shortages prior to COVID-
19 had staffing levels remain stable after the COVID-19 vaccine
requirement went into effect.
But I have to say, I was most disappointed yesterday. Yesterday, I
was at the Rules Committee, last evening, where some of my Republican
colleagues chose to ignore the broad-based scientific and medical
consensus that the COVID-19 vaccine is safe and effective at reducing
deaths and hospitalizations. Instead, some of my Republican colleagues
chose to spend their time entertaining fringe theories about vaccine
side effects and propagating vaccine myths, despite the fact that
millions of Americans have received the COVID-19 vaccine safely and
with no effect on their health.
It is just truly disappointing to me that this is what we have come
to in the United States Congress. The last thing that I want on either
side of this aisle is for any of us to make statements on this floor--
and I know you are not saying that, my colleague from Indiana--but I am
just so afraid that so much of this rhetoric, particularly last night
in the Rules Committee, is giving the impression to the public that
they shouldn't take the vaccine. If you listened to the Rules Committee
last night and the Republican comments, you would have assumed that;
you would suggest that. I think it is very dangerous. People should be
taking the vaccine.
Finally, this legislation, I want to say, is also a distraction from
Republicans' true agenda on healthcare, which they are continuing to
work on behind closed doors, and that is to cut healthcare and
retirement for millions of Americans. Republicans have repeatedly
pledged that they will refuse to raise the debt limit unless they can
cut Social Security, Medicare, Medicaid, and other vital programs. They
are so determined to cut Americans' healthcare that they are willing to
recklessly risk defaulting on the national debt and wreaking havoc on
the economy in order to do so.
If successful, their actions will result in millions of Americans
losing benefits and lifesaving protections, including seniors, children
with complex medical needs, people with disabilities, and pregnant and
postpartum women. This is unconscionable.
I want to underscore that Democrats will not fall for this
manufactured crisis, and we will not, under any circumstances, agree to
cut these vital programs.
I hope I am wrong. I hope I won't see the other side moving toward
these types of cuts. They are unacceptable to us.
I would just say, Democrats are committed to putting families first.
We will continue to follow the science to fight COVID-19. We will build
on the success of the most productive Democratic Congress in modern
history and fight to ensure that Americans have access to affordable
and quality healthcare, further lower healthcare, and prescription drug
costs, and support our healthcare workforce.
This legislation is dangerous, and I strongly urge my colleagues to
oppose it.
Mr. Speaker, I reserve the balance of my time.
Mr. BUCSHON. Mr. Speaker, I just want to remind everyone that I am a
physician, and I support vaccination. I just don't support the Federal
Government mandating it. If local facilities want to mandate
vaccination, that is up to them. I just don't believe the Federal
Government at CMS should do it. Also, in recent history, the only ones
who have cut Medicare are the administration and the Democrats, not
Republicans.
Mr. Speaker, I yield 2 minutes to the gentleman from South Carolina
(Mr. Duncan), the primary sponsor of the bill.
Mr. DUNCAN. Mr. Speaker, I rise in support of my legislation to end
Joe Biden's COVID-19 vaccine mandate for our Nation's healthcare
workers.
We have had a lot of debate and conversation, and we have learned a
lot about COVID since 2020. I am proud to continue our work from last
Congress to end this mandate, and I will not stop leading the charge
until this requirement is lifted.
No American should be forced to choose between receiving a COVID shot
or losing their livelihood. But CMS uses the purse strings of forced
policies on healthcare systems. I have serious concerns regarding the
practicality, efficacy, and morality of a vaccine mandate for
healthcare providers.
The CMS mandate is one of the strictest mandates the Biden
administration has implemented. With few permissible exceptions for
healthcare workers, this mandate has only created resentment and
distrust toward the government and loss of jobs, nursing jobs, CNA
jobs, often replaced with traveling nurses being paid a higher rate, a
higher cost for the taxpayers and the hospitals.
Joe Biden's draconian vaccine mandate is unscientific, un-American,
and is deeply damaging to healthcare workers as we already face a
nationwide shortage.
CMS's one-size-fits-all vaccine mandate exacerbates the ongoing
staffing shortage by limiting the ability of healthcare providers to
make important accommodations and set standards for their employees
based on their staffing needs.
No American should stand for this type of authoritarianism that is a
detriment to our healthcare system.
Last night, the Biden administration threatened to veto this
legislation. The administration went on and on about protecting
individuals from COVID-19, but there was no mention that the COVID-19
vaccine prevents transmission. That is because the CDC has confirmed
that the shot does not prevent transmission.
Let's follow the science here and allow individuals to make choices
for themselves.
I encourage my colleagues to support my legislation, the Freedom for
Health Care Workers Act, and give medical freedom back to our Nation's
healthcare workers and let them get back to work.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Illinois (Ms. Schakowsky), who is the
[[Page H542]]
Ranking Member of our Subcommittee on Innovation, Data, and Commerce.
Ms. SCHAKOWSKY. Mr. Speaker, I thank the gentleman for yielding to
me.
The Freedom for Health Care Workers Act. Really? Freedom? Freedom
from what?
We know that vaccine mandates are absolutely not new, and healthcare
workers are often required to get vaccinated against infectious
diseases, for various diseases. During the pandemic, the COVID-19
vaccine allowed our heroic nurses and healthcare workers to save lives
and protect the most vulnerable, including senior citizens.
But, you know, we are not done with it yet. People are still getting
sick and dying. If you have a loved one in a nursing home, if you know
people, people you care about, that are immunocompromised, if you have
a child who is in fragile health, don't you want to make sure that when
you seek care, that the nurse that is going to be serving them, that
the healthcare provider, is going to be safe and not bring that
disease, not bring COVID to them?
I think this is really a serious mistake that we are making. This is
not about freedom. This is about healthcare. Doctors, nurses,
hospitals, and the American Medical Society believe that requiring
COVID-19 vaccines for healthcare workers saves lives.
Let's do that. Let's save lives. Vote ``no'' on this legislation.
Mr. BUCSHON. Mr. Speaker, I just want to remind everyone that CMS
doesn't mandate any other vaccine, and this also doesn't preclude local
hospital systems, local governments, or State governments from
mandating a vaccine.
Mr. Speaker, I yield 2 minutes to the gentleman from Kentucky (Mr.
Guthrie), the chairman of the Energy and Commerce Subcommittee on
Health.
Mr. GUTHRIE. Mr. Speaker, I rise today in support of H.R. 497,
introduced by my good friend from South Carolina, Mr. Duncan.
I strongly support this legislation, which would immediately repeal
the Biden administration's vaccine mandates for all healthcare workers
working in Centers for Medicare and Medicaid Services-regulated
facilities.
CMS officials decided in November of 2021 to tell doctors, nurses,
chefs, physical therapists, and anyone else working in the facility
that sees Medicare and Medicaid patients that they needed to be
vaccinated against COVID-19 or lose their job.
This unprecedented, one-size-fits-all mandate came at a time in which
healthcare workforce shortages are still challenging healthcare
providers all over. This is the only such vaccine mandate in effect by
CMS.
This overreaching decision requires affected facilities to be 100
percent compliant or risk significant civil monetary penalties, losing
payment on new patients, or even the ability to bill Medicare or
Medicaid at all. More consequentially, this misguided policy was issued
at a time in which the United States is facing perhaps the worst
healthcare workforce shortages in history. In the long-term care
industry alone, there are 210,000 fewer jobs now than at the beginning
of the pandemic in March of 2020.
We have all read about and heard directly from constituents about the
impact this policy had in someone's employment status. The forced
choice between getting the jab or losing your job has undoubtedly
contributed to an already depleted healthcare workforce nationally and
will continue to threaten patient access to high-quality care.
Mr. Speaker, I oppose this mandate, and I encourage my colleagues to
support this legislation.
Mr. PALLONE. Mr. Speaker, I yield 3 minutes to the gentlewoman from
Florida (Ms. Castor), who is the ranking member of our Subcommittee on
Oversight and Investigations.
Ms. CASTOR of Florida. Mr. Speaker, I rise in strong opposition to
H.R. 497, which would actually endanger the lives of frontline
healthcare workers, patients, and their families.
We have been fighting the COVID-19 pandemic now for nearly 3 years.
Sadly, we have lost over 1 million Americans to this horrendous
coronavirus.
Thankfully, we have turned the corner, in large part by making safe,
effective, and rigorously tested vaccinations available to all
Americans. These lifesaving vaccines help save lives. They help prevent
unnecessary hospitalizations and severe illness, as well.
Perhaps nowhere is vaccination more important than for our healthcare
heroes who care for our neighbors every day. Vaccination is a vital
tool to protect them and to help end the pandemic.
{time} 1530
Don't take it from me. Listen to the American Medical Association and
the American Academy of Family Physicians who support the vaccination
for healthcare workers.
They say that halting vaccination for healthcare professionals would
severely and irreparably harm patients and undermine the patient-public
interest.
They say the science is clear: No arguments against the need for
vaccination are medically valid. Vaccines are our way out of the
pandemic. No other measure has been shown to reduce hospitalizations,
severe disease, and death to the degree that vaccination does. We must
continue to let science lead the way.
Mr. Speaker, I urge my Republican colleagues not to confuse
Americans, or worse, endanger their lives. Vote ``no'' on this reckless
bill.
Mr. BUCSHON. Mr. Speaker, I support vaccination of healthcare
workers. I just don't think that CMS should be mandating it nationally.
Mr. Speaker, I yield 2 minutes to the gentleman from Georgia (Mr.
Carter), a pharmacist.
Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for
yielding.
Mr. Speaker, I rise to speak in favor of H.R. 497, the Freedom for
Health Care Workers Act. When President Biden, Mr. Speaker, admitted
that there is no Federal solution to COVID-19, he admitted that these
vaccine mandates are not about public health. They are about control.
Nowhere in America, especially in Georgia's First Congressional
District, should workers have to choose between a vaccine and their
job.
As a pharmacist, I trust patients to work with medical professionals
and their families to make the vaccine decision that works best for
them and their health.
Listen, Mr. Speaker, I chose to participate in the trials, in the
vaccine trials. I volunteered to do that because I trust the process.
But that was my decision, and no one else's, as it should be.
A decision to receive a vaccine is a personal one and should only be
done in consultation with a trusted healthcare professional. This
mandate has also exacerbated our healthcare worker shortages and could
cost patients' lives instead of saving them.
We need policies that empower workers to work, businessowners to
innovate, and patients to foster relationships with their healthcare
professionals, not one-size-fits-all mandates that are nothing short of
government overreach in its most tyrannical form.
Mr. Speaker, I thank Representative Duncan and Chairman Rodgers for
working together on this legislation, and I encourage my colleagues to
support this bill.
Mr. PALLONE. Mr. Speaker, I yield 3 minutes to the gentleman from
California (Mr. Robert Garcia).
Mr. ROBERT GARCIA of California. Mr. Speaker, I want to thank Ranking
Member Pallone for yielding his time and for his leadership in this
legislative body.
Mr. Speaker, I rise today to discuss the so-called Freedom for Health
Care Workers Act. This legislation is an attack on public health and
will endanger the lives of medical personnel and patients. Why should
we remove vaccine protections for nurses and medical workers in our
hospital and clinical settings?
This bill is not supported by our public health officials and
certainly not supported by our nurses on the ground. Why would we
endanger vulnerable populations? This is cruel and irrational.
Over 1 million people have died in this country due to the pandemic,
many of them nurses and healthcare workers. One of them was my mother,
Gaby Elena O'Donnell.
My mom was my rock. She was a kind, loving, and strong immigrant
woman who dedicated her life to serving her country and community. She
served our country as a frontline healthcare worker. My mom also
[[Page H543]]
taught me what real patriotism is, it is serving your neighbors through
service and giving back to your country.
She was on the front lines of this pandemic helping as many people as
possible. In the summer of 2020, my mom lost her life to COVID-19.
This vaccine could have saved my mom's life, but it was not yet
available. I made a promise to my mom and to my community to fight for
legislation that would protect them and keep them from the pandemic and
keep them healthy.
No other family should have to go through what mine did and millions
of others had to go through in this country. We know, due to science,
that the vaccine saves lives, and our medical workers should be able to
go to work knowing that their lives won't be endangered due to the
service they are giving to our country. Vaccinating hospital and
healthcare workers is a basic form of protection that they all deserve.
Mr. Speaker, for this reason, I urge my colleagues to vote ``no'' on
the Freedom for Health Care Workers Act.
Mr. BUCSHON. Mr. Speaker, no one is endangered by this legislation.
As I have said before, it doesn't prevent healthcare facilities from
requiring a COVID vaccine for their employees.
Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr.
Pfluger).
Mr. PFLUGER. Mr. Speaker, I thank my colleague for yielding. Mr.
Speaker, I rise today in strong support of H.R. 497, Freedom for Health
Care Workers Act. I would also like to offer my condolences to my
colleague on the other side of the aisle for the loss of his mother. I
think that, you know, in a stark contrast of what CMS is doing to
mandate this, which is the only vaccine that is mandated, what we
should be doing is investigating the origins of COVID, the billions of
dollars that have been spent, the countless lives that have been lost.
I am proud to serve on Energy and Commerce, to be the only rural
Texan serving on that committee. Growing up in rural Texas, it gave me
a strong appreciation for healthcare, for workers just like my
colleague's mother, the heroes that were on the front line during
the pandemic and those that have served as doctors and nurses in Texas,
quite literally, saving lives every single day.
We are facing a massive shortage of healthcare workers throughout our
Nation, and, unfortunately, this crisis is amplified in rural America.
Rural healthcare workers and providers are among the most negatively
impacted by the President's tyrannical COVID vaccine mandate, which
remains in effect for Medicare and Medicaid-certified providers.
The Biden administration should not be forcing American workers to
take the vaccine or face the possibility of losing their job. Instead,
they should be listening to the reasons that so many people in my
district, throughout the State of Texas, and throughout the country,
quite frankly, may not want to take it. That choice should not have to
be made. Unfortunately, the overreach never ends.
Republicans are standing up today to free our healthcare heroes from
this unconstitutional mandate. I am proud to join Representative Jeff
Duncan on this legislation, and I urge my colleagues to support this
bill.
Mr. PALLONE. Mr. Speaker, I yield 3 minutes to the gentlewoman from
Texas (Ms. Jackson Lee).
Ms. JACKSON LEE. Mr. Speaker, this is another moment that I am on the
floor of the House, and I thank the ranking member of the Committee on
Energy and Commerce who has been so dutiful throughout the years that
we suffered, somewhat lonely and somewhat confused, about COVID-19.
We never experienced this trauma. It certainly brings me to a deep
sense of loss to hear a Member speak about the loss of his mother.
These are personal matters for many of us, some having lost dear
friends, but nothing can equate to losing a beloved loved one.
So when we stand on the floor, we speak with a sense of compassion
and concern. I think it is certainly fine for there to be individual--I
turn the card. I flip the coin--individual examples of individuals
seeking not to be vaccinated. They can find medical facilities that
would allow them to work there.
It is no doubt that the actions of the Biden administration saved
lives. There is no doubt that, on our side of this issue, 50 healthcare
organizations, professional societies, and others, believe that
vaccinations helped healthcare workers save their own lives and save
the lives of others.
It is well-known that prior to the widespread availability of the
COVID-19 vaccine, healthcare workers in the United States were more
than three times more likely to die. I have seen it myself. In my
community, the Texas Medical Center, all of the beds in every medical
facility within the reach of my district and others had people in
hallways, in emergency rooms, individuals who couldn't see their loved
ones take their last breaths; individuals who flew in from other
jurisdictions, other States, desperate to get the care they thought was
here in Houston, Texas because, yes, we did have the ability to save
lives with the medical technology that we were using.
Many States have requirements that healthcare workers be vaccinated
against many things: hepatitis, flu, measles, mumps, or rubella. Why
are we trying to stand against COVID-19 in this long litany of
infectious diseases? COVID-19 vaccines have resulted in 120 million
fewer cases and 18.5 million less hospitalizations and saved $1.15
trillion.
So if we just talked about the numbers, that in and of itself would
say that this legislation is wrongheaded, but it is also important to
recognize that the Mental Health America, 76 percent of the respondents
were worried about bringing COVID home to their children.
These are healthcare professionals. We know of some of them who died,
unfortunately, because they got COVID, and they didn't even see their
families because of this whole issue of separating people who had
COVID. Half of the respondents worried about bringing COVID to their
partners or an older family member.
Many U.S. physicians found that the portion of the day spent treating
COVID-19 patients was associated with higher PTSD scores, depression,
and anxiety. This was not a fun time, but it was the commitment of
medical professionals and those who wanted to be saved to use the
vaccines and use all precautions.
The SPEAKER pro tempore (Mr. Ellzey). The time of the gentlewoman has
expired.
Mr. PALLONE. Mr. Speaker, I yield an additional 1 minute to the
gentlewoman from Texas.
Ms. JACKSON LEE. Mr. Speaker, these medical professionals in the
early stages were suffering from higher PTSD scores, depression, and
anxiety. Many healthcare workers at the beginning of the pandemic saw
workers get sick and die from COVID almost right in front of them, and
this contributed to their increased stress and anxiety.
We did push them to the limit when we didn't have massive testing or
massive vaccines, I hate to say it, in the past administration.
According to the University of Chicago, it was found that an increase
in staff vaccination rates resulted in fewer COVID cases among staff
and patients.
My final words, Mr. Speaker, is, yeah, this is a free country.
Laissez-faire, do as you will, but this mandate for medical workers
saved their lives, saved patients' lives, and saved families' lives. I
don't understand why we are going down this route where soon it will
happen in good time, but since I remember 6 million dead around the
world as the number that is gleaming and 1.11 million in the United
States, this legislation is not going in the right direction. I ask for
opposition to the underlying legislation.
Mr. BUCSHON. Mr. Speaker, CMS mandates one vaccine, COVID-19. They
don't mandate any other vaccines. That doesn't mean healthcare workers
don't get the COVID-19 vaccine.
Mr. Speaker, I yield 3 minutes to the gentlewoman from Washington
(Mrs. Rodgers), the chairwoman of the Energy and Commerce Committee.
Mrs. RODGERS of Washington. Mr. Speaker, I appreciate the leadership
of Dr. Bucshon and thank him for yielding me the time.
Mr. Speaker, I rise in strong support of this legislation.
Representative Duncan's bill, H.R. 497, the Freedom for Health Care
Workers Act, and I join in offering my heartfelt condolences to the
gentleman from California, Representative Garcia, who lost his mom
[[Page H544]]
early on in this pandemic, early on in 2020.
I also want to note that in November of 2021, long after the date it
became available, the vaccines did not prevent the transmission of
COVID-19.
{time} 1545
We have known since November 2021 that the vaccines do not prevent
transmission of COVID-19, yet the Biden administration released their
interim final regulation requiring this vaccination for all Medicare
and Medicaid providers.
This bill is long overdue to repeal what is an egregious mandate and
to return the decisionmaking to our healthcare workers, as well as
providing relief to our healthcare facilities that are struggling to
hire frontline healthcare workers today.
Because of this mandate, facilities all across this country are being
forced to require all of their employees, including support staff such
as cooks and cleaners, to get the COVID-19 vaccination regardless of
whether they even had the infection prior, or they face civil monetary
penalties, a denial of payment for new patients, or termination of
their entire Medicare or Medicaid provider agreement.
Healthcare workers have been forced to choose between violating their
own personally held beliefs and their healthcare decisions informed by
their doctors' medical advice or potentially lose their job and
livelihood, be forced to move from their communities, and struggle to
pay their bills during record-high inflation.
This mandate did not build trust in the vaccine. It has only further
eroded Americans' trust in our public health officials and
institutions. The CDC and other institutions have acknowledged that the
vaccines do not prevent transmission of the COVID-19 virus, which
reinforces that this is just an authoritarian mandate and that it does
not protect vulnerable patients.
This is not about science. In Washington State, the Washington State
Hospital Association estimates that 2 percent of the workforce has been
lost because of this healthcare vaccine mandate. That may not sound
like a lot, but at a time when we have unprecedented shortages, we need
every nurse and every doctor available to be able to be hired and help
meet the needs of patients. This is a burden on an already struggling
system.
There is no reason that this administration should continue this
policy, but since they haven't taken action, Congress must step in
again as we did when we removed the mandate for our troops last year.
I am hopeful that some of our Democrat colleagues will recognize the
toll of this mandate on this already stressed workforce and join us in
supporting this legislation. Let's return critical healthcare decisions
to doctors and their patients. It is time to close this chapter on the
pandemic and the mandates and start looking ahead.
Mr. Speaker, I urge my colleagues to support this legislation.
Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I want to correct certain things that are being said on
the other side of the aisle.
First of all, the fact of the matter is that the healthcare workforce
has grown since the vaccine requirement. There are more healthcare
workers now than there were before.
The other thing I keep hearing from my colleagues on the other side
of the aisle is that the COVID-19 vaccines do not help prevent
infection from the disease. That is factually incorrect. Although
breakthrough infections do occur, especially with more transmissible
variants of the disease, COVID-19 vaccines still help in preventing
infection and reduce transmission.
In fact, according to a study released just this month, it is
confirmed that vaccinated individuals were likely to be less infectious
than unvaccinated individuals, and the likelihood of transmission fell
by 11 percent for each dose of the vaccine.
Moreover, we know that vaccination and continued upkeep with boosters
continues to protect the public from infection. According to CDC, the
most recent COVID-19 boosters cut the likelihood of infection by more
than one-half in those who have gotten them.
As I hope none of us will dispute, even when there is breakthrough
infection, vaccines are safe, effective, and dramatically reduce the
length of illness. That matters for healthcare workers because we still
have thousands of people hospitalized every day with COVID-19, cancer,
and other grave illnesses, and without COVID-19 vaccines, we would have
fewer people there to take care of them.
COVID-19 vaccines reduce infections, and they save lives. We can't
let disinformation dictate our policy choices in this debate. We have
to refer to the science.
Mr. Speaker, I reserve the balance of my time.
Mr. BUCSHON. Mr. Speaker, viral diseases like measles have been
around for centuries. COVID-19 likely will also be persistent.
So, when do my Democratic colleagues propose that this Federal
mandate end? I propose that we pass this legislation and end it.
Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman from Florida
(Mrs. Cammack).
Mrs. CAMMACK. Mr. Speaker, I rise in strong support of H.R. 497, the
Freedom for Health Care Workers Act. This bill would repeal the Federal
CMS mandate imposed on healthcare workers nationwide.
On December 4, 2020, then-President-elect Joe Biden was asked
pointblank if he would mandate COVID-19 vaccines for Americans. His
answer? ``No, I don't think it should be mandatory. I wouldn't demand
it be mandatory.''
Well, as we came to find out and have since learned, you can't take
him at his word. By September 2021, the President's tone and position
on vaccine mandates did a complete 180. He said that he was getting
impatient and ``frustrated'' with unvaccinated Americans. He went so
far as to call it ``a pandemic of the unvaccinated.''
Mr. President, I hate to break it to you, but the American people do
not exist to please you or any President for that matter. We don't
simply comply because you are ``frustrated.'' Yet, it was his
impatience that led to this vaccine mandate.
I don't know about you, but I am not sure where in the Constitution
the government's powers over one's personal health decisions can be
found, but apparently, those signs that we see so often, particularly
outside the Supreme Court Chamber in bold letters screaming, ``My Body,
My Choice,'' are only applicable when it is a certain political agenda.
What we do know is that the Biden administration's authoritarian
COVID-19 vaccine mandate on our dedicated medical professionals is an
absolute abuse of power. It is an attack on the personal freedoms of
our frontline workers, and it has certainly unnecessarily exacerbated
the healthcare workforce shortage.
This bears repeating: We are not anti-vaccine. We are anti-mandate.
If you want the vaccine, great. Take it. If you don't, then don't. It
shouldn't be mandated.
As many of you in this Chamber know, my husband serves our local
community as a firefighter paramedic. At the height of COVID, as he was
showing up--not staying home--and continually responding to 911 calls
of folks who were getting sick, not once did a patient ask if he was
vaccinated. Not once did they demand that the firefighters who showed
up be vaccinated.
When they did answer the call, they went with honor and diligence,
and they continued to do their job. Not once did they ask if that
patient was vaccinated. Not once did fellow firefighters ask my husband
if he was vaccinated.
Likewise, as the hospitals filled up, doctors, nurses, medics, and
EMTs were working double and triple overtime, taking care of the sick,
comforting people who had been left to take their last breath alone as
families were left outside. They never once demanded a vaccinated
doctor, never once asked for a vaccinated nurse. They were doing their
jobs taking care of them because that is what they do. These are the
frontline workers, and it is time we stand up for them.
Today, in every congressional district in America, hospitals are
struggling with staffing shortages. We can address these shortages by
looking to the thousands of healthcare workers who were fired or left
their job because of this mandate.
[[Page H545]]
Let's stand up to the Big Government, one-size-fits-all power grab.
It is wrong. It ends today.
Mr. Speaker, I urge my colleagues to support this legislation.
The SPEAKER pro tempore. Members are reminded to direct their remarks
to the Chair.
Mr. PALLONE. Mr. Speaker, I yield 5 minutes to the gentlewoman from
California (Ms. Jacobs).
Ms. JACOBS. Mr. Speaker, I thank Ranking Member Pallone for his
leadership on this issue and for yielding me time.
Vaccinating healthcare workers against COVID-19 is a simple and
effective way to save lives. It helped protect our healthcare workers
and the most vulnerable from serious illness, hospitalization, and
death. It has prevented our healthcare workforce shortage from getting
worse by keeping our workers healthy and able to continue their
essential work.
H.R. 497 is nonsense and would expose patients to unnecessary risk,
all because Republicans are trying to score political points.
That is why my motion to recommit would strike this bill and insert
the Women's Health Protection Act, legislation that would actually keep
the American people safe and healthy.
Since the Supreme Court overturned the constitutional right to
abortion access, 24 States have banned abortion or are likely to do so.
Without Roe, Americans are now facing a confusing patchwork of State
laws dictating who can make decisions about their healthcare and when.
Without Roe, State governments are forcing pregnancy on people.
Maternal and infant healthcare outcomes are worsening. It is harder for
people to access medications to treat arthritis, cancer, lupus, and
more, all because they are also used for medical abortion.
This is deeply personal for me. As a 33-year-old woman, reproductive
healthcare is my healthcare, as it is for millions of Americans. I want
the freedom to be able to make the best choices for my body and my
life, and so do other Americans.
That is why Congress needs to pass the Women's Health Protection Act
to guarantee a pregnant person's right to access an abortion and a
provider's ability to deliver these services, regardless of State laws.
Whether we admit it or not, we all know that conversations about
reproductive healthcare in the House Chamber aren't reflective of
America. In real America, whether you are living in a red State or a
blue State or a purple State, the average American wants the freedom
and the ability to make their own healthcare decisions, including if,
when, and how to have a family.
We saw that clearly reflected in the midterms, with Americans
mobilizing to defend abortion rights in places as disparate as
California, Vermont, Michigan, Montana, and Kentucky.
The American people want the Women's Health Protection Act, and the
House should pass it again today.
Mr. Speaker, I ask unanimous consent to insert the text of the
amendment in the Record immediately prior to the vote on the motion to
recommit.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from California?
There was no objection.
Mr. BUCSHON. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Iowa (Mrs. Miller-Meeks), who is a physician.
Mrs. MILLER-MEEKS. Mr. Speaker, I thank Dr. Bucshon for yielding me
time.
Mr. Speaker, before I acknowledge my support for the Freedom for
Health Care Workers Act, H.R. 497, I want to respond that as a
physician, as a mother, as a working woman my entire life, and as a
former director of public health, let me just say unequivocally that
the care of ectopic pregnancy is not an abortion. That is a lie. That
is a misconstruction. I want to put that to rest right now.
Now, on to H.R. 497. This overdue legislation repeals the Biden
administration's invasive vaccine mandate for America's healthcare
workers who have borne a significant brunt of the COVID-19 pandemic.
As I have listened to this discourse, I thought we were back in 2020.
It was deja vu all over again when we just started to have vaccines. We
are not at the beginning of a pandemic. We are 2 years, almost 3 years,
into a pandemic.
Even before this pandemic, rural areas in southeastern Iowa, such as
in my district, were already struggling with maintaining healthcare
staffing levels. Existing challenges were exacerbated by the pandemic,
which were then compounded by the vaccine mandates.
Healthcare workers, if you will remember, Mr. Speaker, were lauded
for over a year for going to work every single day. I was part of that,
administering vaccines in all 24 counties in my district. They were
lauded for going to work, putting themselves and their families at risk
for a novel coronavirus of which we knew very little.
Yet, even though they put themselves and their families at risk, we
are going to insult them by telling them, despite a plethora of
research and data that infection-acquired immunity can be even superior
to the vaccine, that we are going to demand that they be vaccinated
even though they worked over a year with no vaccine available, putting
themselves at risk.
We also have further data after the delta variant that the COVID-19
vaccine does not prevent transmission. Yes, there is rebound illness.
Yes, it does reduce maybe illness and death, but it doesn't prevent
transmission.
As a physician, I understand the importance and the meaning of the
doctor-patient relationship.
The SPEAKER pro tempore. The time of the gentlewoman has expired.
Mr. BUCSHON. Mr. Speaker, I yield an additional 15 seconds to the
gentlewoman from Iowa.
Mrs. MILLER-MEEKS. Healthcare workers have a variety of knowledge and
information available about the vaccine, and like any other individual,
they should be able to make healthcare decisions for themselves with
the guidance of their physicians. This vaccine mandate is almost
malpractice.
Mr. Speaker, I am proud to support this repeal through this
legislation.
Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
Again, I know that the previous speaker is a physician, and I respect
her, but I have to continue to point out that this idea that vaccines
don't help prevent infection from the disease is factually incorrect.
I mentioned before various studies, and I include in the Record a
study by Berkeley Lovelace, Jr., that shows that the vaccine does cut
the infection risk.
[From NBC News, Jan. 25, 2023]
Updated Covid Boosters Cut the Infection Risk From XBB.1.5 Subvariant
by Nearly Half, CDC Finds
(By Berkeley Lovelace Jr.)
The updated Covid boosters reduce the risk of Covid
infection from the predominant omicron subvariant by nearly
half, according to early data published Wednesday by the
Centers for Disease Control and Prevention.
In adults up to age 49, the latest boosters from Pfizer-
BioNTech and Moderna were 48% effective against symptomatic
infection from the XBB.1.5 subvariant, the new report said.
As of Jan. 21, that subvariant accounted for about 1 in 2 new
cases in the U.S.
Protection was lower in older groups: The boosters were 40%
effective in adults ages 50 to 64 and 43% effective in people
65 and older.
The findings are ``quite reassuring,'' Dr. Brendan Jackson,
the head of the CDC's Covid response, said on a call with
reporters Wednesday. ``These updated vaccines are protecting
people against the latest Covid-19 variants.''
The Covid boosters were modified in the summer to target
the BA.4 and BA.5 omicron subvariants, in addition to the
original strain of the coronavirus first identified in Wuhan,
China, in 2019.
BA.5 was the dominant variant in the U.S. in the fall, but
now accounts for only 2% of new cases.
As of last Wednesday, only about 15% of people in the U.S.
had received an updated booster, according to CDC data.
``With this data, we see there is a benefit that might
convince some people to sign up and get a bivalent booster,''
said Dr. Peter Hotez, the co-director of the Center for
Vaccine Development at Texas Children's Hospital and the dean
of the National School of Tropical Medicine at the Baylor
College of Medicine in Houston.
The CDC report is based on test results from more than
29,100 adults with Covid symptoms who were tested at
pharmacies nationwide from Dec. 1 through Jan. 13.
People who were vaccinated but had not received the updated
booster were compared to those who got the updated booster in
the previous two to three months. Those who hadn't received
the updated booster had their last vaccine dose about 13
months ago, Ruth Link-Gelles, who heads the CDC's vaccine
effectiveness program, said on the call.
The protection provided by the booster is on par with
what's typically seen with the flu vaccine. Flu vaccine
effectiveness varies
[[Page H546]]
from season to season, but the shots reduce the risk of the
flu by 40% to 60%, according to the CDC.
Dr. Greg Poland, the director of the Mayo Clinic Vaccine
Research Group in Rochester, Minnesota, cautioned that the
CDC's estimate on the updated boosters may be an
overestimate.
People who got the updated boosters are probably ``much
more likely to wear masks indoors or restrain their travel or
not go to indoor restaurants,'' he said.
He also pointed out that the CDC data doesn't capture
people who were vaccinated with the updated booster but were
asymptomatic, or people who were sick enough that they went
to the hospital.
Hotez said that while the CDC's findings appear promising,
he'd like to see data on how well the boosters perform
against symptomatic infections after five or six months.
He said he'd also like to see more data on how well the
updated boosters work against hospitalization.
Jackson, of the CDC, said on the call that the agency is
releasing data later Wednesday that found the updated
boosters reduced the risk of death from Covid by nearly
thirteenfold, compared to people who are unvaccinated.
The data, he said, also found that people who got the
updated booster had more than twofold lower rates of death
from Covid compared to vaccinated people who did not get it.
The CDC's report comes a day before a meeting of the Food
and Drug Administration's advisory committee that will
discuss simplifying the Covid vaccination schedule.
In a document posted online Monday, the FDA proposed using
the bivalent formula in all Covid vaccines moving forward,
not just for booster shots.
Mr. PALLONE. Mr. Speaker, I include in the Record an article from the
University of California San Francisco regarding COVID-19 vaccines
reducing transmission.
[From the University of California San Francisco, Jan. 2, 2023]
Covid-19 Vaccines, Prior Infection Reduce Transmission of Omicron
(By Laura Kurtzman)
Vaccination and boosting, especially when recent, helped to
limit the spread of COVID-19 in California prisons during the
first Omicron wave, according to an analysis by researchers
at UC San Francisco that examined transmission between people
living in the same cell.
The study demonstrates the benefits of vaccination and
boosting, even in settings where many people are still
getting infected, in reducing transmission. And it shows the
cumulative effects from boosting and the additional
protection that vaccination gives to those who were
previously infected. The likelihood of transmission fell by
11% for each additional dose.
vaccines reduce risk of serious illness from omicron infection
In dense populations such as prisons, vaccines were shown
to significantly reduce the risk of hospitalization and death
from Omicron infections.
Of over 20,000 confirmed Omicron infections in California
prisons, there were 31 hospitalizations and no deaths
attributed to COVID-19 infection.
Vaccinated residents with breakthrough infections were
significantly less likely to transmit them: 28% versus 36%
for those who were unvaccinated.
``A lot of the benefits of vaccines to reduce
infectiousness were from people who had received boosters and
people who had been recently vaccinated,'' said Nathan Lo,
M.D., Ph.D, a faculty research fellow in the Division of HIV,
Infectious Diseases and Global Medicine at UCSF and the
senior author of the study, published Jan. 2, 2022, in Nature
Medicine. ``Our findings are particularly relevant to
improving health for the incarcerated population.''
The researchers analyzed deidentified data collected by the
California Department of Corrections and Rehabilitation
(CDCR). This included COVID-19 test results, vaccine status
and housing locations for 111,687 residents, 97% of whom were
male, between Dec. 15, 2021, and May 20, 2022.
Breakthrough infections were common, despite the residents'
relatively high vaccination rate of 81% with the primary
vaccine series. But the rate of serious illness was low. In
just over five months, there were 22,334 confirmed SARS-CoV-2
Omicron infections, 31 hospitalizations and no COVID-19
deaths.
Vaccinated residents with breakthrough infections were
significantly less likely to transmit them: 28% versus 36%
for those who were unvaccinated. But the likelihood of
transmission grew by 6% for every five weeks that passed
since someone's last vaccine shot.
Natural immunity from a prior infection also had a
protective effect, and the risk of transmitting the virus was
23% for someone with a reinfection compared to 33% for
someone who had never been infected:
``A lot of the benefits of vaccines to reduce
infectiousness were from people who had received boosters and
people who had been recently vaccinated.''--Nathan Lo, M.D.,
Ph.D
Those with hybrid immunity, from both infection and
vaccination, were 40% less likely to transmit the virus. Half
of that protection came from the immunity that one acquires
from fighting an infection and the other half came from being
vaccinated.
The researchers said they were gratified to see that
vaccination confers addition protection even for those who
had already been infected, but they were surprised by how
much the infection continued to spread, despite the
residents' relatively high vaccination rates.
``Regardless of the benefits you see in vaccination and
prior infection, there is still a high amount of transmission
in this study,'' said Sophia Tan, a researcher in Lo's lab
and the study's first author. ``We hope these findings can
support ongoing efforts to protect this vulnerable
population.''
This includes making efforts to keep residents current with
boosters and increasing the vaccination rate of the prison
staff, only 73 percent of whom had received the primary
series at the time of the study.
The general rate of boosting could also be improved
significantly. At the time of the study, just 59% of
residents and 41% of staff had received all the doses
recommended by the U.S. Centers for Disease Control and
Prevention (CDC), based on their age and health status.
``Within the two months following vaccination, people are
the least infectious, which indicates that boosters and large
timed vaccination campaigns may have a role to reduce
transmission in surges,'' Lo said. ``New ideas are needed
since the risk of infection in this vulnerable population
remains so great.''
Mr. PALLONE. Mr. Speaker, I reserve the balance of my time.
Mr. BUCSHON. Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman
from Georgia (Ms. Greene).
Ms. GREENE of Georgia. Mr. Speaker, I rise in support of the Freedom
for Health Care Workers Act.
I would like to take a minute to reflect on what one of my colleagues
was talking about across the aisle, and that is about having the
ability to choose when it comes to abortion. Yet, here are mandates
that have been forced on our healthcare workers since the vaccines have
been introduced through the Democrats and through the Biden
administration, and it has been devastating for our healthcare
industry.
It is pretty hypocritical to talk about abortion rights for
healthcare workers in the workplace when they are completely against
the ability of healthcare workers, who I would call the experts--
doctors, nurses, and people who work in the healthcare field. They have
the right to choose when it comes to the vaccines.
{time} 1600
Mandates are tyrannical and they need to end. The COVID pandemic is
over, and I am glad Republicans are making sure that we declare that
this week on the House floor.
I would also point out that we have a severe shortage of healthcare
workers, many of whom were heroes who worked on the front lines saving
lives throughout this pandemic who have said they don't want a vaccine,
they do not want to take it, and they want to trust their own natural
immunity. We need to give these healthcare workers the right to choose
their natural immunity and not be forced to take a jab or a vaccine
that they know they do not need and they do not want.
We believe in freedom here in the Republican Conference. We believe
in freedom for Americans. We believe in freedom for the healthcare
workers of this country.
Mr. PALLONE. Mr. Speaker, I continue to reserve the balance of my
time because I believe the other side has more speakers.
Mr. BUCSHON. Mr. Speaker, I yield 1 minute to the gentleman from
Missouri (Mr. Alford).
Mr. ALFORD. Mr. Speaker, I rise today in support of H.R. 497, the
Freedom for Health Care Workers Act.
Mr. Speaker, this is not about political points. This is about
freedom. Our workers in the healthcare industry fight every day on the
front line for us. These precious workers should never have been placed
in this position to choose between a forced medical procedure and
losing their employment.
Today, we are going to vote on this bill. I will tell you the story
of Melissa Thomas from my district. Melissa lives in Cass County,
Missouri. She is a nurse who has served her community for more than 40
years. When CMS, a government bureaucracy, implemented the vaccine
mandate, Melissa was presented with three different outrageous choices:
to fight for her job, to comply with the mandate, or be forced out of
the medical field entirely.
Ultimately, Melissa fought. She was granted an exemption, but
Melissa's story does not hold true for thousands
[[Page H547]]
of frontline workers, workers who were forced out of their jobs, where
they worked for years to protect us.
Today, I urge my colleagues to pass this bill to end this mandate, to
take a stand. This is a stand for freedom.
Mr. PALLONE. Mr. Speaker, I yield myself 1 minute.
Mr. Speaker, one of the things that hasn't come up, and it didn't
come up in Rules last night as well, we have exemptions for this
mandate for people who have serious religious convictions or medical
reasons to grant an exemption. No one has mentioned that, but I think
it is important that that exists.
The mandate exists, but at the same time, if people have serious
religious reservations or they have medical conditions that would
result in having an exemption, those do exist. I think everyone should
understand that.
Mr. Speaker, I reserve the balance of my time.
Mr. BUCSHON. Mr. Speaker, I yield 1 minute to the gentlewoman from
Texas (Ms. Van Duyne).
Ms. VAN DUYNE. Mr. Speaker, I rise today in strong support of H.R.
497, the Freedom for Health Care Workers Act.
The people of north Texas have expressed their opposition to
President Biden's authoritarian COVID-19 vaccine mandate for a variety
of reasons.
Today, I would like to highlight the concerns that I have heard from
firefighters and EMTs back home. The Biden administration's COVID-19
vaccine mandate is not only an overreach of government power, it has
also become a public safety threat.
Since the vaccine mandate took effect, fire and EMT departments in
north Texas have struggled to fully staff their departments.
This administration claims the vaccine requirement is in place to
ensure patients have access to safe and essential care, but what about
the people who experience a medical emergency, dial 911, and must wait
longer for care due to staffing shortages?
Our local firefighters, paramedics, and EMTs provide lifesaving care.
A fast response time can quite literally make the difference between
life and death. It is already difficult to recruit and retain people to
work in these stressful roles. The Federal Government shouldn't make it
any harder.
The healthcare system is being overburdened by this unnecessary
mandate, which has only worsened the EMS staffing shortage.
Mr. Speaker, I was proud to cosponsor this bill. I urge my colleagues
to join me in voting for H.R. 497 today.
The SPEAKER pro tempore. Members are reminded to refrain from
engaging in personalities toward the President.
Mr. PALLONE. Mr. Speaker, if the gentleman has additional speakers, I
continue to reserve the balance of my time.
Mr. BUCSHON. Mr. Speaker, I yield 1 minute to the gentleman from
North Carolina (Mr. Murphy), who is a physician.
Mr. MURPHY. Mr. Speaker, I speak on this bill from personal
experience because I am probably the only Member in the Chamber who
actually fell under this mandate because I am still actively
practicing, and I am still on staff at an active medical center.
I have practiced at this one institution for 30 years. I don't know
how many calls I got from nurses, people on the floor taking care of
COVID patients, pleading with me to not be forced to take this vaccine.
Let me just say, if there were any individuals who knew what they
were talking about, it was these nurses. They were actually taking care
of COVID patients. I have been very pro-vaccine, very pro-vaccine, but
I have said since day one that this is not a decision that should be
made between a government and a citizen, but rather one made between a
doctor and a patient. It is a medication. There are risks and benefits
that go with this.
Sadly enough, we lost a lot of our nurses, way too many, because
they chose not to get this. They were young, of fertility age, and they
were fearful.
I am just going to speak to my colleague's comments about exemptions.
Yes, there were exemptions, but they were minute, and I won't speak
about one institution in specific, but nationwide they were oftentimes
ignored. Thirty-year-olds who desired not to get this vaccine based
upon fears about fertility don't have preexisting medical conditions.
I think this is the right thing. I am pro-vaccine, but I do not
believe in the avenue of forced vaccination. I ask my colleagues to
support H.R. 497.
Mr. BUCSHON. Mr. Speaker, may I inquire as to how much time remains
on each side?
The SPEAKER pro tempore. The gentleman from Indiana has 4\1/2\
minutes remaining. The gentleman from New Jersey has 7 minutes
remaining.
Mr. BUCSHON. Mr. Speaker, I reserve the balance of my time.
Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
I stress again that for people who have serious religious
reservations, for people who have medical conditions, they can get
exemptions from the mandate.
In addition to that, I know that the previous gentleman on the
Republican side talked about risks and side effects. The FDA and CDC
have been transparent that there are rare side effects that may happen
to some individuals when they take the vaccines, but they and
independent health experts all agree that the benefits of being
vaccinated far outweigh the risks of any side effects.
Arguments from the other side of the aisle insinuating an inflated
risk of side effects also ignore the risks associated with contracting
COVID-19 as an unvaccinated individual. COVID-19 is a dangerous disease
that has killed over a million of our fellow Americans, and the
vaccines are safe and effective. They are strongly protective against
severe illness and death.
Mr. Speaker, I am very concerned that some Members use their
opportunity to speak on the floor--and I am not saying that the people
who spoke here have, but last night I certainly heard it in the Rules
Committee--to fan the flames of misinformation when describing the
risks of side effects when the risks of being unvaccinated are so
grave.
I just think that this is dangerous and opposed by virtually every
public health and medical organization. They are saying that they
recommend the vaccine. Again, there may be some rare side effects.
There may be some people that, you know, would seek to have exemptions.
Let's try to understand that this is often a difficult situation, but
the bottom line is that vaccines have saved millions of lives, and we
can't give the impression that that is not the case.
Mr. Speaker, I reserve the balance of my time.
Mr. BUCSHON. Mr. Speaker, I yield myself 2 minutes.
Mr. Speaker, I say again that I am a physician. I was a practicing
physician for 15 years before I came into Congress. I am pro-vaccine. I
believe that the COVID-19 vaccine saves lives and prevents serious
illness. I have been vaccinated myself and boosted. My family has taken
the vaccines.
That is not what this is about, Mr. Speaker. What this is about is a
Federal mandate to force medical decisions on individual American
citizens.
Again, it also doesn't stop local hospitals, like my hospitals in
Evansville, Indiana, from requiring the COVID-19 vaccine for their
employees. I think we have a disconnect here about what this
legislation is actually about. It is actually about Federal control at
CMS. Again, CMS has only mandated one vaccine, and that is the COVID-19
vaccine.
Mr. Speaker, I agree with my colleagues on the other side of the
aisle that vaccines save lives, but I also think it should be a
personal choice, and that is what this is about. We need to get past
this because, as I mentioned earlier, other viral diseases like the
measles have been around literally for centuries--centuries--so when
does a Federal vaccine mandate for COVID-19 end?
When do we come to an end point, say, okay, the risk is so low that
we are not going to mandate from CMS that you get a medical treatment
that you may not want or you lose your job?
Now, again, I reiterate, if your local hospital or medical facility
says, look, this is part of our employment requirement, okay, that is
up to them, but not the Federal Government.
Mr. Speaker, I yield 1 minute to the gentleman from Georgia (Mr.
Allen).
Mr. ALLEN. Mr. Speaker, the pandemic is over. The President said so
himself. So why, then, are our friends on the other side of the aisle
fighting
[[Page H548]]
to keep in place an authoritarian mandate on our healthcare workers?
When the Centers for Medicare and Medicaid Services issued its
vaccine mandate in 2021, the emergency situation with respect to the
delta variant was cited as its justification. The problem isn't just
that the delta variant has come and gone, it is that we have an
administration that has made a habit out of violating Americans' basic
freedoms.
Our frontline workers were the heroes of the pandemic, but this
vaccine mandate robbed those very workers of the right to make medical
decisions for themselves.
All of the President's vaccine mandates are wrong. They have been
wrong from the start. Today, House Republicans will begin to set things
straight by prohibiting this administration from enforcing COVID
vaccine mandates on our healthcare providers.
During a time of workforce shortages, especially among healthcare
staff, no American should be forced to choose between the jab and the
job.
The SPEAKER pro tempore. Members are reminded to refrain from
engaging in personalities toward the President.
Mr. BUCSHON. Mr. Speaker, I am prepared to close, and I reserve the
balance of my time.
Mr. PALLONE. Mr. Speaker, I yield myself the balance of my time to
close.
Mr. Speaker, I am just so concerned that we are seeing another
example here on the floor today of what I call Republican extremism.
Republicans are keeping up their commitment to extremism, in my
opinion, by attempting to eliminate the COVID-19 vaccine requirement
for healthcare workers.
Mr. Speaker, this is really dangerous legislation that is going to
strain our healthcare system, exacerbate existing staffing shortages,
and further limit American families' access to healthcare.
With H.R. 497, the Republicans are really putting politics over
science. Democrats are committed to putting families first, where we
can continue to follow the science to fight COVID-19. We are going to
build on the success. We had a lot of success in the previous Congress
in so many things to make sure that Americans have access to affordable
and quality healthcare, to further lower healthcare costs and
prescription drug costs, and to support our healthcare workforce.
Everything that we do here should be designed to not only prevent
infection but prepare for future types of pandemics. I am just so
concerned because I listened last night at Rules and here on the floor,
and I just think that the impression is being given somehow that maybe
people shouldn't take vaccines or that there are risks to vaccines
that, in my opinion, are being stated that are way out of proportion or
that somehow there is significant evidence out there that it doesn't
matter if you get vaccinated or not because that is not going to cause
more infection.
The bottom line is that this mandate was put in place for healthcare
workers because the agencies involved that studied the science at the
Federal level believed that it was going to be a good thing for the
healthcare workers themselves, that they wouldn't get ill and die, that
it would help in preventing the spread of COVID-19, and that it would
give people a sense of security knowing that the people that are
helping them when they are sick have also been vaccinated.
{time} 1615
I just don't understand why all of a sudden now the Republicans say:
Well, that is not really accurate. Let all the healthcare workers do
whatever they want.
It makes no sense. I just think it is politically motivated, if you
will, because they have certain people, I guess, their base voters, who
are anti-vaccination. But you can't be anti-vaccination if you look at
the science and what has been done with these vaccinations that saved
so many lives, to make it so that now the situation with COVID-19 is
much better than it has been in the last few years, which is why the
President is saying that he can lift the healthcare emergency.
We have made a lot of progress. We have made a lot of progress
because we have based our actions on science. To suggest today that we
should eliminate this mandate, I think is very dangerous.
Mr. Speaker, I strongly urge my colleagues to oppose it, and I yield
back the balance of my time.
Mr. BUCSHON. Mr. Speaker, I reiterate again that as a physician, I
support vaccination for healthcare workers if they choose to do so or
if their local medical facility says it is a requirement for them to be
employed at that facility. I just don't support the Federal Government
mandating it nationwide because they don't mandate any other vaccine,
and they never have that I am aware of.
So there are all kinds of other things in medicine that I wish people
would do:
I wish people would get screened for colon cancer.
I wish people would get their mammograms.
I wish people would get their pap smears.
I wish people would get their prostates checked.
The reality is it is a free country. We are not going to mandate all
of those things, are we?
We could, I guess.
This is just another medical treatment that people should have the
freedom to choose. The Federal Government shouldn't be mandating it.
Again, I can't be more clear, and other doctors that have spoken
today have said, ``we believe in vaccinations.'' In fact, we did public
service announcements supporting it. We just don't believe that CMS
should be mandating this for healthcare workers, and that this mandate
should end.
Mr. Speaker, I urge all of my colleagues to support H.R. 497, and I
yield back the balance of my time.
The SPEAKER pro tempore. All time for debate has expired.
Pursuant to House Resolution 75, the previous question is ordered on
the bill.
The question is on the engrossment and third reading of the bill.
The bill was ordered to be engrossed and read a third time, and was
read the third time.
Motion to Recommit
Ms. JACOBS. Mr. Speaker, I have a motion to recommit at the desk.
The SPEAKER pro tempore. The Clerk will report the motion to
recommit.
The Clerk read as follows:
Ms. Jacobs moves to recommit the bill H.R. 497 to the
Committee on Energy and Commerce.
The material previously referred to by Ms. Jacobs is as follows:
Ms. Jacobs moves to recommit the bill H.R. 497 to the
Committee on Energy and Commerce with instructions to report
the same back to the House forthwith, with the following
amendment:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Women's Health Protection
Act of 2023''.
SEC. 2. FINDINGS AND PURPOSE.
(a) Findings.--Congress finds the following:
(1) Abortion services are essential to health care and
access to those services is central to people's ability to
participate equally in the economic and social life of the
United States. Abortion access allows people who are pregnant
to make their own decisions about their pregnancies, their
families, and their lives.
(2) Since 1973, the Supreme Court repeatedly has recognized
the constitutional right to terminate a pregnancy before
fetal viability, and to terminate a pregnancy after fetal
viability where it is necessary, in the good-faith medical
judgment of the treating health care professional, for the
preservation of the life or health of the person who is
pregnant.
(3) Nonetheless, access to abortion services has been
obstructed across the United States in various ways,
including blockades of health care facilities and associated
violence, prohibitions of, and restrictions on, insurance
coverage; parental involvement laws (notification and
consent); restrictions that shame and stigmatize people
seeking abortion services; and medically unnecessary
regulations that neither confer any health benefit nor
further the safety of abortion services, but which harm
people by delaying, complicating access to, and reducing the
availability of, abortion services.
(4) Reproductive justice requires every individual to have
the right to make their own decisions about having children
regardless of their circumstances and without interference
and discrimination. Reproductive Justice is a human right
that can and will be achieved when all people, regardless of
actual or perceived race, color, national origin, immigration
status, sex (including gender
[[Page H549]]
identity, sex stereotyping, or sexual orientation), age, or
disability status have the economic, social, and political
power and resources to define and make decisions about their
bodies, health, sexuality, families, and communities in all
areas of their lives, with dignity and self-determination.
(5) Reproductive justice seeks to address restrictions on
reproductive health, including abortion, that perpetuate
systems of oppression, lack of bodily autonomy, white
supremacy, and anti-Black racism. This violent legacy has
manifested in policies including enslavement, rape, and
experimentation on Black women; forced sterilizations;
medical experimentation on low-income women's reproductive
systems; and the forcible removal of Indigenous children.
Access to equitable reproductive health care, including
abortion services, has always been deficient in the United
States for Black, Indigenous, and other People of Color
(BIPOC) and their families.
(6) The legacy of restrictions on reproductive health,
rights, and justice is not a dated vestige of a dark history.
Presently, the harms of abortion-specific restrictions fall
especially heavily on people with low incomes, BIPOC,
immigrants, young people, people with disabilities, and those
living in rural and other medically underserved areas.
Abortion-specific restrictions are even more compounded by
the ongoing criminalization of people who are pregnant,
including those who are incarcerated, living with HIV, or
with substance-use disorders. These communities already
experience health disparities due to social, political, and
environmental inequities, and restrictions on abortion
services exacerbate these harms. Removing medically
unjustified restrictions on abortion services would
constitute one important step on the path toward realizing
Reproductive Justice by ensuring that the full range of
reproductive health care is accessible to all who need it.
(7) Abortion-specific restrictions are a tool of gender
oppression, as they target health care services that are used
primarily by women. These paternalistic restrictions rely on
and reinforce harmful stereotypes about gender roles, women's
decision-making, and women's need for protection instead of
support, undermining their ability to control their own lives
and well-being. These restrictions harm the basic autonomy,
dignity, and equality of women, and their ability to
participate in the social and economic life of the Nation.
(8) The terms ``woman'' and ``women'' are used in this bill
to reflect the identity of the majority of people targeted
and affected by restrictions on abortion services, and to
address squarely the targeted restrictions on abortion, which
are rooted in misogyny. However, access to abortion services
is critical to the health of every person capable of becoming
pregnant. This Act is intended to protect all people with the
capacity for pregnancy--cisgender women, transgender men,
non-binary individuals, those who identify with a different
gender, and others--who are unjustly harmed by restrictions
on abortion services.
(9) Since 2011, States and local governments have passed
nearly 500 restrictions singling out health care providers
who offer abortion services, interfering with their ability
to provide those services and the patients' ability to obtain
those services.
(10) Many State and local governments have imposed
restrictions on the provision of abortion services that are
neither evidence-based nor generally applicable to the
medical profession or to other medically comparable
outpatient gynecological procedures, such as endometrial
ablations, dilation and curettage for reasons other than
abortion, hysteroscopies, loop electrosurgical excision
procedures, or other analogous non-gynecological procedures
performed in similar outpatient settings including vasectomy,
sigmoidoscopy, and colonoscopy.
(11) Abortion is essential health care and one of the
safest medical procedures in the United States. An
independent, comprehensive review of the state of science on
the safety and quality of abortion services, published by the
National Academies of Sciences, Engineering, and Medicine in
2018, found that abortion in the United States is safe and
effective and that the biggest threats to the quality of
abortion services in the United States are State regulations
that create barriers to care. These abortion-specific
restrictions conflict with medical standards and are not
supported by the recommendations and guidelines issued by
leading reproductive health care professional organizations
including the American College of Obstetricians and
Gynecologists, the Society of Family Planning, the National
Abortion Federation, the World Health Organization, and
others.
(12) Many abortion-specific restrictions do not confer any
health or safety benefits on the patient. Instead, these
restrictions have the purpose and effect of unduly burdening
people's personal and private medical decisions to end their
pregnancies by making access to abortion services more
difficult, invasive, and costly, often forcing people to
travel significant distances and make multiple unnecessary
visits to the provider, and in some cases, foreclosing the
option altogether. For example, a 2018 report from the
University of California San Francisco's Advancing New
Standards in Reproductive Health research group found that in
27 cities across the United States, people have to travel
more than 100 miles in any direction to reach an abortion
provider.
(13) An overwhelming majority of abortions in the United
States are provided in clinics, not hospitals, but the large
majority of counties throughout the United States have no
clinics that provide abortion.
(14) These restrictions additionally harm people's health
by reducing access not only to abortion services but also to
other essential health care services offered by many of the
providers targeted by the restrictions, including--
(A) screenings and preventive services, including
contraceptive services;
(B) testing and treatment for sexually transmitted
infections;
(C) LGBTQ health services; and
(D) referrals for primary care, intimate partner violence
prevention, prenatal care and adoption services.
(15) The cumulative effect of these numerous restrictions
has been to severely limit the availability of abortion
services in some areas, creating a patchwork system where
access to abortion services is more available in some States
than in others. A 2019 report from the Government
Accountability Office examining State Medicaid compliance
with abortion coverage requirements analyzed seven key
challenges (identified both by health care providers and
research literature) and their effect on abortion access, and
found that access to abortion services varied across the
States and even within a State.
(16) International human rights law recognizes that access
to abortion is intrinsically linked to the rights to life,
health, equality and non-discrimination, privacy, and freedom
from ill-treatment. United Nations (UN) human rights treaty
monitoring bodies have found that legal abortion services,
like other reproductive health care services, must be
available, accessible, affordable, acceptable, and of good
quality. UN human rights treaty bodies have likewise
condemned medically unnecessary barriers to abortion
services, including mandatory waiting periods, biased
counseling requirements, and third-party authorization
requirements.
(17) Core human rights treaties ratified by the United
States protect access to abortion. For example, in 2018, the
UN Human Rights Committee, which oversees implementation of
the ICCPR, made clear that the right to life, enshrined in
Article 6 of the ICCPR, at a minimum requires governments to
provide safe, legal, and effective access to abortion where a
person's life and health is at risk, or when carrying a
pregnancy to term would cause substantial pain or suffering.
The Committee stated that governments must not impose
restrictions on abortion which subject women and girls to
physical or mental pain or suffering, discriminate against
them, arbitrarily interfere with their privacy, or place them
at risk of undertaking unsafe abortions. Furthermore, the
Committee stated that governments should remove existing
barriers that deny effective access to safe and legal
abortion, refrain from introducing new barriers to abortion,
and prevent the stigmatization of those seeking abortion.
(18) UN independent human rights experts have expressed
particular concern about barriers to abortion services in the
United States. For example, at the conclusion of his 2017
visit to the United States, the UN Special Rapporteur on
extreme poverty and human rights noted concern that low-
income women face legal and practical obstacles to exercising
their constitutional right to access abortion services,
trapping many women in cycles of poverty. Similarly, in May
2020, the UN Working Group on discrimination against women
and girls, along with other human rights experts, expressed
concern that some states had manipulated the COVID-19 crisis
to restrict access to abortion, which the experts recognized
as ``the latest example illustrating a pattern of
restrictions and retrogressions in access to legal abortion
care across the country'' and reminded U.S. authorities that
abortion care constitutes essential health care that must
remain available during and after the pandemic. They noted
that barriers to abortion access exacerbate systemic
inequalities and cause particular harm to marginalized
communities, including low-income people, people of color,
immigrants, people with disabilities, and LGBTQ people.
(19) Abortion-specific restrictions affect the cost and
availability of abortion services, and the settings in which
abortion services are delivered. People travel across State
lines and otherwise engage in interstate commerce to access
this essential medical care, and more would be forced to do
so absent this Act. Likewise, health care providers travel
across State lines and otherwise engage in interstate
commerce in order to provide abortion services to patients,
and more would be forced to do so absent this Act.
(20) Health care providers engage in a form of economic and
commercial activity when they provide abortion services, and
there is an interstate market for abortion services.
(21) Abortion restrictions substantially affect interstate
commerce in numerous ways. For example, to provide abortion
services, health care providers engage in interstate commerce
to purchase medicine, medical equipment, and other necessary
goods and services. To provide and assist others in providing
abortion services, health care providers engage in interstate
commerce to obtain and provide training. To provide abortion
services, health care providers employ and obtain commercial
services from doctors, nurses, and other personnel who engage
[[Page H550]]
in interstate commerce and travel across State lines.
(22) It is difficult and time and resource-consuming for
clinics to challenge State laws that burden or impede
abortion services. Litigation that blocks one abortion
restriction may not prevent a State from adopting other
similarly burdensome abortion restrictions or using different
methods to burden or impede abortion services. There is a
history and pattern of States passing successive and
different laws that unduly burden abortion services.
(23) When a health care provider ceases providing abortion
services as a result of burdensome and medically unnecessary
regulations, it is often difficult or impossible for that
health care provider to recommence providing those abortion
services, and difficult or impossible for other health care
providers to provide abortion services that restore or
replace the ceased abortion services.
(24) Health care providers are subject to license laws in
various jurisdictions, which are not affected by this Act
except as provided in this Act.
(25) Congress has the authority to enact this Act to
protect abortion services pursuant to--
(A) its powers under the commerce clause of section 8 of
article I of the Constitution of the United States;
(B) its powers under section 5 of the Fourteenth Amendment
to the Constitution of the United States to enforce the
provisions of section 1 of the Fourteenth Amendment; and
(C) its powers under the necessary and proper clause of
section 8 of Article I of the Constitution of the United
States.
(26) Congress has used its authority in the past to protect
access to abortion services and health care providers'
ability to provide abortion services. In the early 1990s,
protests and blockades at health care facilities where
abortion services were provided, and associated violence,
increased dramatically and reached crisis level, requiring
Congressional action. Congress passed the Freedom of Access
to Clinic Entrances Act (Public Law 103-259; 108 Stat. 694)
to address that situation and protect physical access to
abortion services.
(27) Congressional action is necessary to put an end to
harmful restrictions, to federally protect access to abortion
services for everyone regardless of where they live, and to
protect the ability of health care providers to provide these
services in a safe and accessible manner.
(b) Purpose.--It is the purpose of this Act--
(1) to permit health care providers to provide abortion
services without limitations or requirements that single out
the provision of abortion services for restrictions that are
more burdensome than those restrictions imposed on medically
comparable procedures, do not significantly advance
reproductive health or the safety of abortion services, and
make abortion services more difficult to access;
(2) to promote access to abortion services and women's
ability to participate equally in the economic and social
life of the United States; and
(3) to invoke Congressional authority, including the powers
of Congress under the commerce clause of section 8 of article
I of the Constitution of the United States, its powers under
section 5 of the Fourteenth Amendment to the Constitution of
the United States to enforce the provisions of section 1 of
the Fourteenth Amendment, and its powers under the necessary
and proper clause of section 8 of article I of the
Constitution of the United States.
SEC. 3. DEFINITIONS.
In this Act:
(1) Abortion services.--The term ``abortion services''
means an abortion and any medical or non-medical services
related to and provided in conjunction with an abortion
(whether or not provided at the same time or on the same day
as the abortion).
(2) Government.--The term ``government'' includes each
branch, department, agency, instrumentality, and official of
the United States or a State.
(3) Health care provider.--The term ``health care
provider'' means any entity or individual (including any
physician, certified nurse-midwife, nurse practitioner, and
physician assistant) that--
(A) is engaged or seeks to engage in the delivery of health
care services, including abortion services, and
(B) if required by law or regulation to be licensed or
certified to engage in the delivery of such services--
(i) is so licensed or certified, or
(ii) would be so licensed or certified but for their past,
present, or potential provision of abortion services
permitted by section 4.
(4) Medically comparable procedure.--The term ``medically
comparable procedures'' means medical procedures that are
similar in terms of health and safety risks to the patient,
complexity, or the clinical setting that is indicated.
(5) Pregnancy.--The term ``pregnancy'' refers to the period
of the human reproductive process beginning with the
implantation of a fertilized egg.
(6) State.--The term ``State'' includes the District of
Columbia, the Commonwealth of Puerto Rico, and each territory
and possession of the United States, and any subdivision of
any of the foregoing, including any unit of local government,
such as a county, city, town, village, or other general
purpose political subdivision of a State.
(7) Viability.--The term ``viability'' means the point in a
pregnancy at which, in the good-faith medical judgment of the
treating health care provider, based on the particular facts
of the case before the health care provider, there is a
reasonable likelihood of sustained fetal survival outside the
uterus with or without artificial support.
SEC. 4. PERMITTED SERVICES.
(a) General Rule.--A health care provider has a statutory
right under this Act to provide abortion services, and may
provide abortion services, and that provider's patient has a
corresponding right to receive such services, without any of
the following limitations or requirements:
(1) A requirement that a health care provider perform
specific tests or medical procedures in connection with the
provision of abortion services, unless generally required for
the provision of medically comparable procedures.
(2) A requirement that the same health care provider who
provides abortion services also perform specified tests,
services, or procedures prior to or subsequent to the
abortion.
(3) A requirement that a health care provider offer or
provide the patient seeking abortion services medically
inaccurate information in advance of or during abortion
services.
(4) A limitation on a health care provider's ability to
prescribe or dispense drugs based on current evidence-based
regimens or the provider's good-faith medical judgment, other
than a limitation generally applicable to the medical
profession.
(5) A limitation on a health care provider's ability to
provide abortion services via telemedicine, other than a
limitation generally applicable to the provision of medical
services via telemedicine.
(6) A requirement or limitation concerning the physical
plant, equipment, staffing, or hospital transfer arrangements
of facilities where abortion services are provided, or the
credentials or hospital privileges or status of personnel at
such facilities, that is not imposed on facilities or the
personnel of facilities where medically comparable procedures
are performed.
(7) A requirement that, prior to obtaining an abortion, a
patient make one or more medically unnecessary in-person
visits to the provider of abortion services or to any
individual or entity that does not provide abortion services.
(8) A prohibition on abortion at any point or points in
time prior to fetal viability, including a prohibition or
restriction on a particular abortion procedure.
(9) A prohibition on abortion after fetal viability when,
in the good-faith medical judgment of the treating health
care provider, continuation of the pregnancy would pose a
risk to the pregnant patient's life or health.
(10) A limitation on a health care provider's ability to
provide immediate abortion services when that health care
provider believes, based on the good-faith medical judgment
of the provider, that delay would pose a risk to the
patient's health.
(11) A requirement that a patient seeking abortion services
at any point or points in time prior to fetal viability
disclose the patient's reason or reasons for seeking abortion
services, or a limitation on the provision or obtaining of
abortion services at any point or points in time prior to
fetal viability based on any actual, perceived, or potential
reason or reasons of the patient for obtaining abortion
services, regardless of whether the limitation is based on a
health care provider's degree of actual or constructive
knowledge of such reason or reasons.
(b) Other Limitations or Requirements.--The statutory right
specified in subsection (a) shall not be limited or otherwise
infringed through, in addition to the limitations and
requirements specified in paragraphs (1) through (11) of
subsection (a), any limitation or requirement that--
(1) is the same as or similar to one or more of the
limitations or requirements described in subsection (a); or
(2) both--
(A) expressly, effectively, implicitly, or as implemented
singles out the provision of abortion services, health care
providers who provide abortion services, or facilities in
which abortion services are provided; and
(B) impedes access to abortion services.
(c) Factors For Consideration.--Factors a court may
consider in determining whether a limitation or requirement
impedes access to abortion services for purposes of
subsection (b)(2)(B) include the following:
(1) Whether the limitation or requirement, in a provider's
good-faith medical judgment, interferes with a health care
provider's ability to provide care and render services, or
poses a risk to the patient's health or safety.
(2) Whether the limitation or requirement is reasonably
likely to delay or deter some patients in accessing abortion
services.
(3) Whether the limitation or requirement is reasonably
likely to directly or indirectly increase the cost of
providing abortion services or the cost for obtaining
abortion services (including costs associated with travel,
childcare, or time off work).
(4) Whether the limitation or requirement is reasonably
likely to have the effect of necessitating a trip to the
offices of a health care provider that would not otherwise be
required.
(5) Whether the limitation or requirement is reasonably
likely to result in a decrease in the availability of
abortion services in a given State or geographic region.
[[Page H551]]
(6) Whether the limitation or requirement imposes penalties
that are not imposed on other health care providers for
comparable conduct or failure to act, or that are more severe
than penalties imposed on other health care providers for
comparable conduct or failure to act.
(7) The cumulative impact of the limitation or requirement
combined with other new or existing limitations or
requirements.
(d) Exception.--To defend against a claim that a limitation
or requirement violates a health care provider's or patient's
statutory rights under subsection (b), a party must
establish, by clear and convincing evidence, that--
(1) the limitation or requirement significantly advances
the safety of abortion services or the health of patients;
and
(2) the safety of abortion services or the health of
patients cannot be advanced by a less restrictive alternative
measure or action.
SEC. 5. APPLICABILITY AND PREEMPTION.
(a) In General.--
(1) Except as stated under subsection (b), this Act
supersedes and applies to the law of the Federal Government
and each State government, and the implementation of such
law, whether statutory, common law, or otherwise, and whether
adopted before or after the date of enactment of this Act,
and neither the Federal Government nor any State government
shall administer, implement, or enforce any law, rule,
regulation, standard, or other provision having the force and
effect of law that conflicts with any provision of this Act,
notwithstanding any other provision of Federal law, including
the Religious Freedom Restoration Act of 1993 (42 U.S.C.
2000bb et seq.).
(2) Federal statutory law adopted after the date of the
enactment of this Act is subject to this Act unless such law
explicitly excludes such application by reference to this
Act.
(b) Limitations.--The provisions of this Act shall not
supersede or apply to--
(1) laws regulating physical access to clinic entrances;
(2) insurance or medical assistance coverage of abortion
services;
(3) the procedure described in section 1531(b)(1) of title
18, United States Code; or
(4) generally applicable State contract law.
(c) Defense.--In any cause of action against an individual
or entity who is subject to a limitation or requirement that
violates this Act, in addition to the remedies specified in
section 8, this Act shall also apply to, and may be raised as
a defense by, such an individual or entity.
SEC. 6. EFFECTIVE DATE.
This Act shall take effect immediately upon the date of
enactment of this Act. This Act shall apply to all
restrictions on the provision of, or access to, abortion
services whether the restrictions are enacted or imposed
prior to or after the date of enactment of this Act, except
as otherwise provided in this Act.
SEC. 7. RULES OF CONSTRUCTION.
(a) In General.--In interpreting the provisions of this
Act, a court shall liberally construe such provisions to
effectuate the purposes of the Act.
(b) Rule of Construction.--Nothing in this Act shall be
construed to authorize any government to interfere with a
person's ability to terminate a pregnancy, to diminish or in
any way negatively affect a person's constitutional right to
terminate a pregnancy, or to displace any other remedy for
violations of the constitutional right to terminate a
pregnancy.
(c) Other Individuals Considered as Government Officials.--
Any person who, by operation of a provision of Federal or
State law, is permitted to implement or enforce a limitation
or requirement that violates section 4 of this Act shall be
considered a government official for purposes of this Act.
SEC. 8. ENFORCEMENT.
(a) Attorney General.--The Attorney General may commence a
civil action on behalf of the United States against any State
that violates, or against any government official (including
a person described in section 7(c)) that implements or
enforces a limitation or requirement that violates, section
4. The court shall hold unlawful and set aside the limitation
or requirement if it is in violation of this Act.
(b) Private Right of Action.--
(1) In general.--Any individual or entity, including any
health care provider or patient, adversely affected by an
alleged violation of this Act, may commence a civil action
against any State that violates, or against any government
official (including a person described in section 7(c)) that
implements or enforces a limitation or requirement that
violates, section 4. The court shall hold unlawful and set
aside the limitation or requirement if it is in violation of
this Act.
(2) Health care provider.--A health care provider may
commence an action for relief on its own behalf, on behalf of
the provider's staff, and on behalf of the provider's
patients who are or may be adversely affected by an alleged
violation of this Act.
(c) Equitable Relief.--In any action under this section,
the court may award appropriate equitable relief, including
temporary, preliminary, or permanent injunctive relief.
(d) Costs.--In any action under this section, the court
shall award costs of litigation, as well as reasonable
attorney's fees, to any prevailing plaintiff. A plaintiff
shall not be liable to a defendant for costs or attorney's
fees in any non-frivolous action under this section.
(e) Jurisdiction.--The district courts of the United States
shall have jurisdiction over proceedings under this Act and
shall exercise the same without regard to whether the party
aggrieved shall have exhausted any administrative or other
remedies that may be provided for by law.
(f) Abrogation of State Immunity.--Neither a State that
enforces or maintains, nor a government official (including a
person described in section 7(c)) who is permitted to
implement or enforce any limitation or requirement that
violates section 4 shall be immune under the Tenth Amendment
to the Constitution of the United States, the Eleventh
Amendment to the Constitution of the United States, or any
other source of law, from an action in a Federal or State
court of competent jurisdiction challenging that limitation
or requirement.
SEC. 9. SEVERABILITY.
If any provision of this Act, or the application of such
provision to any person, entity, government, or circumstance,
is held to be unconstitutional, the remainder of this Act, or
the application of such provision to all other persons,
entities, governments, or circumstances, shall not be
affected thereby.
The SPEAKER pro tempore. Pursuant to clause 2(b) of rule XIX, the
previous question is ordered on the motion to recommit.
The question is on the motion to recommit.
The question was taken; and the Speaker pro tempore announced that
the noes appeared to have it.
Mr. PALLONE. 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 question are postponed.
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