[Congressional Record Volume 170, Number 39 (Tuesday, March 5, 2024)]
[House]
[Pages H793-H796]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         PREVENTING MATERNAL DEATHS REAUTHORIZATION ACT OF 2023

  Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 3838) to amend title III of the Public Health Service Act to 
reauthorize Federal support of States in their work to save and sustain 
the health of mothers during pregnancy, childbirth, and the postpartum 
period, to eliminate disparities in maternal health outcomes for 
pregnancy-related and pregnancy-associated deaths, to identify 
solutions to improve healthcare quality and health outcomes for 
mothers, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3838

       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 ``Preventing Maternal Deaths 
     Reauthorization Act of 2023''.

     SEC. 2. SAFE MOTHERHOOD.

       (a) Maternal Mortality Review Committees.--Section 317K(d) 
     of the Public Health Service Act (42 U.S.C. 247b-12(d)) is 
     amended--
       (1) in paragraph (1)(A), by inserting ``(including 
     obstetricians and gynecologists)'' after ``clinical 
     specialties''; and
       (2) in paragraph (3)(A)(i)--
       (A) in subclause (I), by striking ``as applicable'' and 
     inserting ``if available''; and
       (B) in subclause (III), by striking ``, as appropriate'' 
     and inserting ``and coordinating with death certifiers to 
     improve the collection of death record reports and the 
     quality of death records, including by amending cause-of-
     death information on a death certificate, as appropriate''.
       (b) Best Practices Relating to the Prevention of Maternal 
     Mortality.--Section 317K of the Public Health Service Act (42 
     U.S.C. 247b-12) is amended--
       (1) by redesignating subsections (e) and (f) as subsections 
     (f) and (g), respectively; and
       (2) by inserting after subsection (d) the following:
       ``(e) Best Practices Relating to the Prevention of Maternal 
     Mortality.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall, in consultation with the Administrator of the Health 
     Resources and Services Administration, disseminate to 
     hospitals, State professional society groups, and perinatal 
     quality collaboratives, best practices on how to prevent 
     maternal mortality and morbidity that consider and reflect 
     best practices identified through other relevant Federal 
     maternal health programs.
       ``(2) Frequency.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall disseminate the best practices referred to in paragraph 
     (1) not less than once per fiscal year.''.
       (c) Extension.--Subsection (g) of section 317K of the 
     Public Health Service Act (42 U.S.C. 247b-12), as 
     redesignated by subsection (b), is amended by striking 
     ``$58,000,000 for each of fiscal years 2019 through 2023'' 
     and inserting ``$108,000,000 for each of fiscal years 2024 
     through 2028''.

  The SPEAKER pro tempore (Mr. Luttrell). Pursuant to the rule, the 
gentleman from Texas (Mr. Burgess) and the gentlewoman from Washington 
(Ms. Schrier) each will control 20 minutes.
  The Chair recognizes the gentleman from Texas.


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.

[[Page H794]]

  I rise today in support of my legislation, H.R. 3838, the Preventing 
Maternal Deaths Reauthorization Act of 2023.
  During March, we celebrate National Women's History Month and honor 
the strong women in our lives, especially our mothers who make great 
sacrifices to bring life into this world.
  According to the latest United States data, the maternal mortality 
rate rose yet again in 2021 to almost 33 deaths per 100,000 live births 
compared to a rate of 23 per 100,000 in 2020. While we know that over 
80 percent of pregnancy-related deaths are preventable, we also 
understand that even one is too many.
  The Preventing Maternal Deaths Reauthorization Act works to 
understand and reduce maternal mortalities by reauthorizing Federal 
support for State-led Maternal Mortality Review Committees.
  Maternal Mortality Review Committees are multidisciplinary committees 
that review the causes of maternal deaths in their State and make 
recommendations based on their findings to prevent future deaths and 
improve maternal health outcomes during pregnancy, childbirth, and the 
first year afterward.
  H.R. 3838 also requires the Centers for Disease Control and 
Prevention to work in consultation with the Health Resources and 
Services Administration to disseminate best practices for the 
prevention of maternal mortality and morbidity to hospitals and other 
healthcare providers.
  Maternal Mortality Review Committees are vital to understanding the 
drivers of maternal deaths and informing effective interventions. This 
way we will help to ensure that resources are directed where they will 
have the most positive impact.
  Since its initial authorization in 2018, we have already seen the 
work of the Maternal Mortality Review Committees make a significant 
difference and increasing the number of Maternal Mortality Review 
Committees from 32 States to 49 States, the District of Columbia, New 
York City, Philadelphia, and Puerto Rico.
  Through their work, this body was able to discover that over 50 
percent of pregnancy-related deaths happen between 1 week and 1 year 
after delivery, leading to the critical extension of the State plan 
amendment for Medicaid and Children's Health Insurance Program to 12 
months for postpartum coverage.
  The critical importance of this bill is furthered by the news from my 
home State of Texas just last week. Effective March 1 of 2024, Texas 
extended postpartum coverage for the full 12 months for eligible 
Medicaid and Children's Health Insurance Program recipients through the 
Texas Health and Human Services Commission. I thank Governor Greg 
Abbott and the Texas legislature for their continued efforts to protect 
and defend life, especially the lives of new mothers and newborn 
babies.
  Today, I am joined by 740 of my fellow OB/GYNs who are on the Hill 
with the American College of Obstetricians and Gynecologists urging a 
``yes'' vote on this critically important bill.
  I thank my fellow Representatives, Diana DeGette, Buddy Carter, Robin 
Kelly, Kat Cammack, and Kathy Castor for working with me on this 
important legislation.
  Mr. Speaker, I stand in strong support of H.R. 3838. I urge my fellow 
Members to vote for its passage today, and I reserve the balance of my 
time.
  Ms. SCHRIER. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from Colorado (Ms. DeGette).
  Ms. DeGETTE. Mr. Speaker, I thank the gentlewoman for yielding. As 
Dr. Burgess said, we are facing a maternal health crisis in this 
country.
  From 2018 to 2021, the overall maternal mortality rate in the United 
States nearly doubled. We are simply failing American women as they 
become mothers, and we are particularly failing Black Americans, who in 
2021 were nearly three times as likely than White Americans to die 
becoming mothers, irrespective of education or socioeconomic status.
  This is exactly the trend that the former gentlewoman from Washington 
(Ms. Herrera Beutler) and I sought to address when we passed the 
original Preventing Maternal Deaths Act in 2018.
  Through the programs developed by that legislation we now have a much 
greater knowledge of what is causing this crisis and the infrastructure 
we need to build further understanding and drive solutions.
  Data generated by the Maternal Mortality Review Committees have 
provided us with the insight that 80 percent of maternal deaths are 
preventable. This understanding is the first step toward solutions, and 
we have to ensure that we not only don't lose but that we strengthen 
the process we have made in building, understanding, and standardizing 
data so that we have a clear picture across the country of why this is 
happening.
  The Preventing Maternal Deaths Reauthorization Act will continue and 
bolster our support for the Maternal Mortality Review Committees. It 
will also ensure the timely and frequent dissemination of best 
practices to prevent maternal mortality.
  Make no mistake, further action is needed, and this reauthorization 
in itself will not solve the crisis, but that further action depends on 
the critical insights that we can get from this legislation. It is the 
foundation on which the solution stands.
  I am very grateful that my friend, Dr. Burgess, has taken up the 
mantle on this legislation. I also thank my dear friend, Kathy Castor, 
and our ranking member here, Ms. Schrier, for their work on this 
legislation, and I urge a ``yes'' vote on this legislation.
  Mr. BURGESS. Mr. Speaker, I yield 3 minutes to the gentleman from 
Georgia (Mr. Carter).
  Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for 
yielding.
  Before I begin, Mr. Speaker, I want to thank my colleague, the 
sponsor of this bill, Dr. Burgess, for his outstanding work in 
healthcare, especially as a Member of this august body. For many years 
he has served here, and I know he is going to be retiring at the end of 
this year, and we are certainly going to miss his leadership, 
particularly in the healthcare space, and we appreciate him very much.
  Mr. Speaker, I rise today in strong support of H.R. 3838, the 
Preventing Maternal Deaths Reauthorization Act, which I am co-leading 
with Dr. Burgess.
  Maternal mortality is something that I have worked on for many, many 
years as a member of the Georgia State legislature and now as a Member 
of Congress. It baffles me as to why Georgia, my home State, would be 
one of the leading States in the Nation in maternal mortality. I have 
not been able to get my arms around that and understand why that is, 
but it is.
  Our Nation's maternal mortality crisis, which, as I say, severely 
impacts Georgians, is alarming and trending in the wrong direction. In 
fact, in Georgia, the maternal mortality rate has increased to over 30 
deaths per 100,000 live births. For women of color and people living in 
rural communities, those numbers are much higher.
  The United States is trending in the wrong direction, as well, and we 
need to understand why moms are dying, despite us spending $4.4 
trillion on healthcare in 2022.
  As a father, as a grandfather, and a healthcare professional, I 
believe that we can and we must do much better. It is time for this to 
become a national priority, which is why I am proud to be co-leading 
the Preventing Maternal Deaths Act with Dr. Burgess.
  This legislation would ensure continued support for the critically 
important work that the State Maternal Mortality Review Committees have 
done in addressing the maternal mortality crisis.
  State Maternal Mortality Review Committees are crucial to collecting 
data so that each State can form a plan to address maternal health 
issues impacting their community.
  This bipartisan bill is an important step toward ending the maternal 
mortality crisis in the U.S.
  We value women, we value life, and this bipartisan bill prioritizes 
both.
  I thank Dr. Burgess again for working with me on this important 
issue, and I urge my colleagues to support this legislation.
  Ms. SCHRIER. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, the United States faces a significant crisis with one of 
the highest maternal mortality and morbidity rates among developed 
nations.
  According to the most recent data, in 2021, more than 1,200 women 
died as a result of pregnancy or childbirth, continuing an upward trend 
over nearly 20 years.

[[Page H795]]

  Racial disparities in maternal outcomes continue with Black and 
indigenous women dying at three times the rate of White women.
  Additionally, rural areas experience higher rates of maternal 
mortality compared to urban areas, and yet, experts and research using 
the Maternal Mortality Review Committee data indicates that at least 80 
percent of maternal mortalities are preventable.

                              {time}  1600

  H.R. 3838, the Preventing Maternal Deaths Reauthorization Act of 
2023, is bipartisan legislation to reauthorize support for State-based 
Maternal Mortality Review Committees until 2028. These committees play 
a critical role in reviewing pregnancy-related deaths to identify 
causes and make recommendations for the prevention of future 
mortalities in their State. The legislation also requires the Centers 
for Disease Control and Prevention, the CDC, to work with HRSA, the 
Health Resources and Services Administration, to share best practices 
to prevent maternal mortality with hospitals and healthcare providers.
  Enacting this legislation will provide the needed ongoing support of 
Maternal Mortality Review Committees, ultimately enhancing the safety 
of women throughout their pregnancy, delivery, and postpartum 
experiences while reducing racial disparities and outcomes.
  The legislation is supported by over 85 organizations across the 
healthcare spectrum. I am pleased that it is before us today, and I 
encourage all of my colleagues to vote ``yes'' on this important bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
  I do want to point out in this bill, probably one of the most 
important aspects is the collection and dissemination of data by the 
CDC and HRSA, the best practices that occur across the country. There 
is no reason why one hospital should have excellent statistics and 
another hospital have questionable statistics. We should be able to be 
good enough that every hospital has excellent statistics.
  I know this to be true, because where I did my residency at Parkland 
Hospital in Dallas, they have consistently had some of the best 
maternal mortality statistics in the country, and they take care of a 
population that is low income, women of color, underinsured, uninsured, 
the very populations you think would be at greatest risk.
  I know we can do it. I have seen it done, and it is so important to 
me that we collect and disseminate this data.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SCHRIER. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from Florida (Ms. Castor).
  Ms. CASTOR of Florida. Mr. Speaker, I thank Ms. Schrier for yielding 
me time.
  Mr. Speaker, I rise in strong support of the Preventing Maternal 
Deaths Reauthorization Act. It is critical legislation that I am proud 
to co-lead to address the maternal mortality crisis in America, 
unconscionably the worst in the developed world.
  Each of us deserves to live a healthy life. For mothers, for women, 
that includes access to the care they need before, during, and after 
pregnancy. Pregnancy in America right now is too often traumatic or is 
life-threatening, and our maternal health crisis in many places is 
tearing families apart.
  This is particularly true for Black women, who often experience worse 
outcomes due to disparities in access to medical care, the care that 
they need and that they deserve.
  Our bill will help recommit to the health of our neighbors by 
ensuring that more moms can have safe pregnancies by improving health 
outcomes for the patients at the highest risk of maternal mortality and 
morbidity.
  In the Tampa Bay area, I am proud to represent outstanding OB/GYNs 
and providers, clinics like Evara Health or organizations like REACHUP, 
the Healthy Start Coalitions, and more. They have worked tirelessly to 
address our maternal mortality rates and improve the quality of care 
for new and expecting mothers.
  This bill will help them and similar organizations across the 
country, in partnership with the CDC, by building upon the 
comprehensive framework of the Preventing Maternal Deaths 
Reauthorization Act, supporting Maternal Mortality Review Committees, 
and strengthening lifesaving initiatives to improve health outcomes.
  For example, Florida's Maternal Mortality Review Committee has 
successfully created initiatives to reduce deaths associated with 
postpartum bleeding and opioid use disorder.
  We have to do more. I look forward to working with my colleagues to 
address America's maternal mortality crisis through research, 
prevention, and evidence-based practices.
  I thank my partners on the Committee on Energy and Commerce who 
brought this bill to the floor: Congressman Burgess, Congresswoman 
DeGette, Congressman Carter, Congresswoman Kelly for her years of 
advocacy, Congresswoman Schrier, and Congresswoman Cammack, as well. I 
thank them for co-leading this legislation with me. Families are 
counting on us. Please vote ``yes.''
  Ms. SCHRIER. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from Illinois (Ms. Kelly).
  Ms. KELLY of Illinois. Mr. Speaker, I rise today in support of this 
bipartisan effort to address the maternal health crisis.
  One of the most glaring inequities in our country is the disparities 
in maternal health outcomes. In the richest country in the world, the 
United States is falling behind and failing our mothers and babies.
  Over 1,000 women died in 2021 because of complications from 
childbirth. This is up from 861 deaths in 2020 and 754 deaths in 2019. 
What is even worse, as you have heard, is that Black women are nearly 
three times more likely to die from pregnancy-related causes as non-
Hispanic White women, and that depends on where you live. The area I 
represent is six times as likely. Indigenous women are more than twice 
as likely to die from pregnancy-related causes as non-Hispanic White 
women. Again, it depends on where they live. This is just unacceptable.
  I am proud to say that this legislation will bring us closer to a 
future where no mother has to worry that growing her family will cost 
her life. The Preventing Maternal Deaths Reauthorization Act, that I 
co-led with Representatives Burgess, Cammack, Castor, Carter, 
and DeGette, will strengthen and expand Federal support for Maternal 
Mortality Review Committees, or MMRCs. State-fashioned MMRCs are tasked 
with identifying maternal deaths, analyzing the factors that 
contributed to those deaths, and translating those lessons into policy 
changes.

  I am proud to say that a piece of my comprehensive maternal health 
legislation, the MOMMA's Act, is included in this legislation.
  The Preventing Maternal Deaths Reauthorization Act has received 
unanimous, bipartisan support from the Energy and Commerce Committee's 
Subcommittee on Health and the full committee.
  Mr. Speaker, I encourage my colleagues to support this bill and save 
moms' lives.
  Ms. SCHRIER. Mr. Speaker, I yield myself the balance of my time for 
closing.
  I am so pleased this bill is before us today. I encourage all of my 
colleagues to vote ``yes'' on this very important bill that will save 
lives.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, this bill is personally important to me. My grandfather, 
who I never knew, my father's father, was an academic obstetrician at 
McGill Hospital in Montreal from the end of the World War I until his 
death in 1939.
  During that time, maternal mortality was substantially reduced. The 
caregivers of that time, prior to the introduction of antibiotics, made 
great strides in reducing maternal mortality. Some of that was through 
the imposition of preventive medicine. Some of that was because of 
improved anesthesia and blood bank techniques. Of course, with the 
introduction of antibiotics in 1940, the rates came down even 
substantially more. We know it can be done.

[[Page H796]]

  At that time the major drivers of maternal mortality were 
hypertension, hemorrhage, and infection. Now, the major drivers are 
well after delivery, and they fall into the realm of cardiovascular 
disease, suicide, and drug overdose. This expansion of postpartum 
coverage to the first year after delivery was really work that was 
established in our committee. We did the research on that, and we 
provided the guidance that now has been taken up by a great many 
States.
  I look forward to a day when we see these numbers are significantly 
reduced even over where they are now because of the changes that we 
have made as a result of this legislation. It is important work.
  Mr. Speaker, I encourage all of my colleagues to vote ``yes'' on the 
underlying bill, and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Texas (Mr. Burgess) that the House suspend the rules and 
pass the bill, H.R. 3838, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. BURGESS. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

                          ____________________