[Congressional Record Volume 172, Number 118 (Monday, July 20, 2026)]
[House]
[Pages H4651-H4652]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 NIH IMPLEMENTING A MATERNAL HEALTH AND PREGNANCY OUTCOMES VISION FOR 
                              EVERYONE ACT

  Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 6238) to establish the IMPROVE Initiative within the 
National Institutes of Health, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 6238

       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 ``NIH Implementing a Maternal 
     health and PRegnancy Outcomes Vision for Everyone Act'' or 
     the ``NIH IMPROVE Act''.

     SEC. 2. IMPROVE INITIATIVE.

       Part B of title IV of the Public Health Service Act (42 
     U.S.C. 284 et seq.) is amended by adding at the end the 
     following:

     ``SEC. 409K. IMPROVE INITIATIVE.

       ``(a) In General.--The Director of NIH shall continue to 
     carry out a program to improve maternal health outcomes, to 
     be known as the Implementing a Maternal health and PRegnancy 
     Outcomes Vision for Everyone Initiative or the `IMPROVE 
     Initiative' (referred to in this section as the 
     `Initiative').
       ``(b) Objectives.--The Initiative shall--
       ``(1) advance research to--
       ``(A) reduce preventable causes of maternal mortality and 
     severe maternal morbidity;
       ``(B) reduce health disparities related to maternal health 
     outcomes, including such disparities associated with 
     populations with disproportionately high rates of maternal 
     mortality and severe maternal morbidity relative to the 
     national rate; and
       ``(C) improve health for pregnant and postpartum women 
     before, during, and after pregnancy;
       ``(2) use an integrated approach to understand the factors, 
     including biological, behavioral, and other factors, that 
     affect maternal mortality and severe maternal morbidity by 
     building an evidence base for improved outcomes in specific 
     regions of the United States; and
       ``(3) target health disparities associated with maternal 
     mortality and severe maternal morbidity by--
       ``(A) implementing and evaluating community-based 
     interventions for disproportionately affected women; and
       ``(B) identifying risk factors and the underlying 
     biological mechanisms associated with leading causes of 
     maternal mortality and severe maternal morbidity in the 
     United States.
       ``(c) Implementation.--The Director of NIH may award grants 
     or enter into contracts, cooperative agreements, or other 
     transactions to carry out this section.
       ``(d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $63,400,000 for 
     each of fiscal years 2026 through 2030.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Kentucky (Mr. Guthrie) and the gentlewoman from Colorado (Ms. DeGette) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Kentucky.


                             general leave

  Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days to revise and extend their remarks on the 
legislation and include extraneous material on H.R. 6238.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Kentucky?
  There was no objection.
  Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in strong support of H.R. 6238, led by my 
colleagues Representatives Underwood and Fitzpatrick, which authorizes 
the Implementing a Maternal health and PRegnancy Outcomes Vision for 
Everyone Initiative within the National Institutes of Health.
  According to CDC estimates, more than 80 percent of the pregnancy-
related deaths and roughly half of the severe maternal morbidity events 
could be prevented.
  That is why it is so essential for us to advance the IMPROVE 
Initiative, which supports research into identifying and reducing 
preventable causes of maternal death and ways to improve maternal 
health outcomes.
  Mr. Speaker, I encourage my colleagues to support this bill, and I 
reserve the balance of my time.
  Ms. DeGETTE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, shockingly, the U.S. has the highest rate of maternal 
mortality among developed nations in this entire world. What is worse 
is that the mortality rates for women of color are exponentially higher 
than those of the general population. Black women die from pregnancy-
related causes at rates at least three times those of White women, and 
that is irrespective of socioeconomic status or income.
  It is appalling that this statistic has emerged from data collection 
by State maternal mortality review committees. Congress affirmed its 
support for these committees in February by reauthorizing my bill, the 
Preventing Maternal Deaths Act.
  Thanks to this enduring bipartisan commitment, we have identified the 
problem, that 649 women died of maternal causes in the U.S. in 2024. 
Now that we have identified the problem, we need to work together to 
solve it.
  Mr. Speaker, 80 to 84 percent of pregnancy-related deaths are 
preventable. The IMPROVE Initiative at NIH investigates the leading 
cause of these deaths, supports the development of interventions to 
prevent them, and importantly identifies factors that contribute to 
disparities in maternal health. We must not let this critical program 
lapse.
  I thank Representatives Underwood and Fitzpatrick for their undying 
and wonderful leadership on this bill, as well as my friend and 
colleague Robin Kelly, who has been a leader on this issue for more 
than a decade.
  Mr. Speaker, I urge my colleagues to join us in passing the bill 
today because no pregnancy-related death is acceptable in the richest 
nation in the world. I reserve the balance of my time.
  Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.

[[Page H4652]]

  Mr. Speaker, I yield 5 minutes to the gentleman from Pennsylvania 
(Mr. Fitzpatrick), my good friend. He is a member of the Ways and Means 
and Intel Committees and is really passionate about these issues.
  My friend from Colorado has touched on this. It is something that we 
absolutely have to get to the bottom of. I am very thankful for the 
leadership of the gentlewoman from Illinois and the gentleman from 
Pennsylvania.
  Mr. FITZPATRICK. Mr. Speaker, I rise today in strong support of our 
legislation, H.R. 6238, the NIH IMPROVE Act.
  Mr. Speaker, this critical legislation will ensure consistent funding 
for research on maternal care and mortality. So many maternal deaths in 
America are preventable. Addressing that reality demands research that 
is stable, long term, and grounded in measurable outcomes.
  The NIH IMPROVE Act locks in the dedicated funding that NIH's 
maternal health portfolio so desperately needs to track outcomes over 
time, evaluate what works in high-risk settings, and direct resources 
to the communities facing the greatest challenges.
  This bipartisan legislation strengthens a proven NIH initiative and 
ensures that mothers across our Nation will benefit from research that 
saves lives and improves care through the entire pregnancy journey.
  Mr. Speaker, I thank my colleague Representative Underwood for her 
leadership on this critical piece of legislation to ensure that 
improvements to maternal health across our Nation continue and are 
strengthened.
  Mr. Speaker, I urge all of my colleagues to support this legislation, 
H.R. 6238.
  Ms. DeGETTE. Mr. Speaker, I yield 3 minutes to the gentlewoman from 
Illinois (Ms. Underwood), the sponsor of this legislation.
  Ms. UNDERWOOD. Mr. Speaker, I rise today in support of my bill, the 
NIH IMPROVE Act.
  This bipartisan bill, co-led by Congressman Fitzpatrick, will provide 
consistent funding for research on maternal mortality.
  The United States has the highest pregnancy-related death rate of any 
high-income country, and Black women are dying at the highest rate of 
all.
  The crisis is only getting worse. Over the past two decades, maternal 
mortality rates have more than doubled, and disparities have worsened.

                              {time}  1610

  What is both frustrating and promising is that over 80 percent of 
these deaths are preventable.
  That is why in 2019 I worked with NIH to start the IMPROVE 
initiative, which stands for Implementing a Maternal health and 
PRegnancy Outcomes Vision for Everyone. Through IMPROVE, we are making 
smart investments in evidence-based solutions that save moms' lives and 
advance birth equity.
  Over the past 7 years, IMPROVE has invested more than $200 million in 
lifesaving research that will help end our Nation's maternal health 
crisis. These investments have already been made all across the 
country, from Utah to Alabama, Mississippi to Pennsylvania, and to my 
home State of Illinois. It is already allowing more moms to survive and 
thrive, and my bill will ensure that this funding keeps flowing to the 
communities that need it the most.
  The NIH IMPROVE Act is one of the 14 bills that make up the momnibus, 
a comprehensive package of evidence-based, data-driven bills that 
address every driver of maternal mortality, morbidity, and disparities 
in the United States.
  I know all my colleagues agree that no mom should feel fear or 
uncertainty about her pregnancy. So, today, I urge them to pass the NIH 
IMPROVE Act. After that, we are going to keep it going until the entire 
momnibus is signed into law. Together, we can end this crisis and keep 
moms alive.
  Mr. Speaker, I thank Chairman Guthrie and Mr. Pallone for their 
support for this legislation.
  Ms. DeGETTE. Mr. Speaker, I yield back the balance of my time.
  Mr. GUTHRIE. In closing, I urge a ``yes'' vote on this legislation. 
Mr. Speaker, I have no further speakers, and I yield back the balance 
of my time.
  Ms. ADAMS. Mr. Speaker, I rise to speak in favor of the NIH IMPROVE 
Act.
  One of my core beliefs that has led to my work in Congress is that 
health care is our most basic human right. Yet, in our country, we see 
some of the worst disparities in health care access and outcomes. The 
maternal health crisis is no exception.
  Black women are two to three times more likely to die from pregnancy-
related causes than other women. Women living in rural areas are losing 
access to local labor and delivery units, as more rural hospitals close 
their maternity wards.
  This has not only delayed care but has led to worsening outcomes. Our 
country's maternal mortality rate is higher than any other high-income 
country in the world. Over 80 percent of these deaths are preventable. 
We can and must do better.
  We have made substantial progress in understanding and addressing 
this crisis through the NIH IMPROVE Initiative. In early 2019, 
Congresswoman Underwood and I met with then-Director of the National 
Institutes of Health to urge the agency to do more to address the 
maternal health crisis.
  In response, the NIH launched the IMPROVE Initiative later that year, 
which stands for Implementing a Maternal Health and Pregnancy Outcomes 
Vision for Everyone. The IMPROVE Initiative supports research to reduce 
preventable causes of maternal deaths and improve health for women 
before, during, and after pregnancy.
  It includes a special emphasis on health disparities and populations 
that are disproportionately affected, such as racial and ethnic 
minorities, very young women and women of advanced maternal age, women 
living in rural areas, and people with disabilities.
  THE IMPROVE Initiative has funded:
  Maternal Health Research Centers of Excellence--two of which are 
housed at HBCUs;
  Research projects on social determinants of maternal health, the 
impact of community violence on maternal health outcomes, and 
structural racism and discrimination; and
  The development of new home-based and point-of-care diagnostic 
devices for postpartum care.
  Through the federal appropriations process, Congress has quintupled 
funding for the Initiative since it was first launched.
  However, it has not yet been put into statute, which would ensure the 
longevity of the program and maintain consistent funding to address 
maternal mortality.
  The bill would authorize $53.4 million every year for seven years. 
With that funding, the program will continue to investigate disparities 
in maternal health care, and develop ways to improve care and outcomes, 
including in our underserved maternal care deserts.
  For too long, families in our country have faced the devastating 
losses of mothers to pregnancy-related causes. And too often these 
deaths have been completely preventable.
  This is personal to me. My daughter, Jeanelle, almost lost her life 
to this crisis. Her doctor dismissed her pain and concerns, and by the 
time her medical team finally responded, it was almost too late.
  That dismissal and delay in care is a story I hear far too often from 
other mothers, especially Black mothers. Jeanelle is one of the tens of 
thousands of women who've experience ``near misses'' with pregnancy-
related complications. That experience made me think about what it 
means to be a mom.
  Jeanelle is my daughter, a sister, and the mother of two amazing 
chiidren--she's also a dedicated contributor to her community.
  Mothers everywhere, like Jeanelle, are calling on Congress to do 
everything we can to better understand this crisis, so we can fix this 
crisis.
  Dedicated research funding is the way to do that. This bill was 
reported out of the Energy and Commerce Committee with unanimous 
support. It is bipartisan and bicameral.
  Passing the NIH IMPROVE Act today signifies Congress's united 
commitment to all mothers across our country that we can and will do 
better. We will deliver for our moms--because our moms can't wait.
  I urge my colleagues to vote in favor of this bill.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Kentucky (Mr. Guthrie) that the House suspend the rules 
and pass the bill, H.R. 6238, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________