[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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