[Congressional Record (Bound Edition), Volume 158 (2012), Part 13]
[House]
[Pages 17772-17777]
[From the U.S. Government Publishing Office, www.gpo.gov]




 PREMATURITY RESEARCH EXPANSION AND EDUCATION FOR MOTHERS WHO DELIVER 
                   INFANTS EARLY REAUTHORIZATION ACT

  Mr. PITTS. Mr. Speaker, I move to suspend the rules and pass the bill 
(S. 1440) to reduce preterm labor and delivery and the risk of 
pregnancy-related deaths and complications due to pregnancy, and to 
reduce infant mortality caused by prematurity, as amended.
  The Clerk read the title of the bill.
  The text of the amendments is as follows:

       Amendments:
       Strike out all after the enacting clause and insert:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Prematurity Research 
     Expansion and Education for Mothers who deliver Infants Early 
     Reauthorization Act'' or the ``PREEMIE Reauthorization Act''.

     SEC. 2. TABLE OF CONTENTS.

       The table of contents of this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.

 TITLE I--PREMATURITY RESEARCH EXPANSION AND EDUCATION FOR MOTHERS WHO 
                         DELIVER INFANTS EARLY

Sec. 101. Research and activities at the Centers for Disease Control 
              and Prevention.
Sec. 102. Activities at the Health Resources and Services 
              Administration.
Sec. 103. Other activities.

[[Page 17773]]

             TITLE II--NATIONAL PEDIATRIC RESEARCH NETWORK

Sec. 201. National Pediatric Research Network.

       TITLE III--CHILDREN'S HOSPITAL GME SUPPORT REAUTHORIZATION

Sec. 301. Program of payments to children's hospitals that operate 
              graduate medical education programs.

 TITLE I--PREMATURITY RESEARCH EXPANSION AND EDUCATION FOR MOTHERS WHO 
                         DELIVER INFANTS EARLY

     SEC. 101. RESEARCH AND ACTIVITIES AT THE CENTERS FOR DISEASE 
                   CONTROL AND PREVENTION.

       (a) Epidemiological Studies.--Section 3 of the Prematurity 
     Research Expansion and Education for Mothers who deliver 
     Infants Early Act (42 U.S.C. 247b-4f) is amended by striking 
     subsection (b) and inserting the following:
       ``(b) Studies and Activities on Preterm Birth.--
       ``(1) In general.--The Secretary of Health and Human 
     Services, acting through the Director of the Centers for 
     Disease Control and Prevention, may, subject to the 
     availability of appropriations--
       ``(A) conduct epidemiological studies on the clinical, 
     biological, social, environmental, genetic, and behavioral 
     factors relating to prematurity, as appropriate;
       ``(B) conduct activities to improve national data to 
     facilitate tracking the burden of preterm birth; and
       ``(C) continue efforts to prevent preterm birth, including 
     late preterm birth, through the identification of 
     opportunities for prevention and the assessment of the impact 
     of such efforts.
       ``(2) Report.--Not later than 2 years after the date of 
     enactment of the PREEMIE Reauthorization Act, and every 2 
     years thereafter, the Secretary of Health and Human Services, 
     acting through the Director of the Centers for Disease 
     Control and Prevention, shall submit to the appropriate 
     committees of Congress reports concerning the progress and 
     any results of studies conducted under paragraph (1).''.
       (b) Reauthorization.--Section 3(e) of the Prematurity 
     Research Expansion and Education for Mothers who deliver 
     Infants Early Act (42 U.S.C. 247b-4f(e)) is amended by 
     striking ``2011'' and inserting ``2017''.

     SEC. 102. ACTIVITIES AT THE HEALTH RESOURCES AND SERVICES 
                   ADMINISTRATION.

       (a) Telemedicine and High-risk Pregnancies.--Section 
     330I(i)(1)(B) of the Public Health Service Act (42 U.S.C. 
     254c-14(i)(1)(B)) is amended by striking ``or case management 
     services'' and inserting ``case management services, or 
     prenatal care for high-risk pregnancies'';
       (b) Public and Health Care Provider Education.--Section 
     399Q of the Public Health Service Act (42 U.S.C. 280g-5) is 
     amended--
       (1) in subsection (b)--
       (A) in paragraph (1), by striking subparagraphs (A) through 
     (F) and inserting the following:
       ``(A) the core risk factors for preterm labor and delivery;
       ``(B) medically indicated deliveries before full term;
       ``(C) the importance of preconception and prenatal care, 
     including--
       ``(i) smoking cessation;
       ``(ii) weight maintenance and good nutrition, including 
     folic acid;
       ``(iii) the screening for and the treatment of infections; 
     and
       ``(iv) stress management;
       ``(D) treatments and outcomes for premature infants, 
     including late preterm infants;
       ``(E) the informational needs of families during the stay 
     of an infant in a neonatal intensive care unit; and
       ``(F) utilization of evidence-based strategies to prevent 
     birth injuries;''; and
       (B) by striking paragraph (2) and inserting the following:
       ``(2) programs to increase the availability, awareness, and 
     use of pregnancy and post-term information services that 
     provide evidence-based, clinical information through 
     counselors, community outreach efforts, electronic or 
     telephonic communication, or other appropriate means 
     regarding causes associated with prematurity, birth defects, 
     or health risks to a post-term infant;''; and
       (2) in subsection (c), by striking ``2011'' and inserting 
     ``2017''.

     SEC. 103. OTHER ACTIVITIES.

       (a) Interagency Coordinating Council on Prematurity and Low 
     Birthweight.--The Prematurity Research Expansion and 
     Education for Mothers who deliver Infants Early Act is 
     amended by striking section 5 (42 U.S.C. 247b-4g).
       (b) Advisory Committee on Infant Mortality.--
       (1) Establishment.--The Secretary of Health and Human 
     Services (referred to in this section as the ``Secretary'') 
     may establish an advisory committee known as the ``Advisory 
     Committee on Infant Mortality'' (referred to in this section 
     as the ``Advisory Committee'').
       (2) Duties.--The Advisory Committee shall provide advice 
     and recommendations to the Secretary concerning the following 
     activities:
       (A) Programs of the Department of Health and Human Services 
     that are directed at reducing infant mortality and improving 
     the health status of pregnant women and infants.
       (B) Strategies to coordinate the various Federal programs 
     and activities with State, local, and private programs and 
     efforts that address factors that affect infant mortality.
       (C) Implementation of the Healthy Start program under 
     section 330H of the Public Health Service Act (42 U.S.C. 
     254c-8) and Healthy People 2020 infant mortality objectives.
       (D) Strategies to reduce preterm birth rates through 
     research, programs, and education.
       (3) Plan for hhs preterm birth activities.--Not later than 
     1 year after the date of enactment of this section, the 
     Advisory Committee (or an existing advisory committee 
     designated by the Secretary) shall develop a plan for 
     conducting and supporting research, education, and programs 
     on preterm birth through the Department of Health and Human 
     Services and shall periodically review and revise the plan, 
     as appropriate. The plan shall--
       (A) examine research and educational activities that 
     receive Federal funding in order to enable the plan to 
     provide informed recommendations to reduce preterm birth and 
     address racial and ethnic disparities in preterm birth rates;
       (B) identify research gaps and opportunities to implement 
     evidence-based strategies to reduce preterm birth rates among 
     the programs and activities of the Department of Health and 
     Human Services regarding preterm birth, including 
     opportunities to minimize duplication; and
       (C) reflect input from a broad range of scientists, 
     patients, and advocacy groups, as appropriate.
       (4) Membership.--The Secretary shall ensure that the 
     membership of the Advisory Committee includes the following:
       (A) Representatives provided for in the original charter of 
     the Advisory Committee.
       (B) A representative of the National Center for Health 
     Statistics.
       (c) Patient Safety Studies and Report.--
       (1) In general.--The Secretary shall designate an 
     appropriate agency within the Department of Health and Human 
     Services to coordinate existing studies on hospital 
     readmissions of preterm infants.
       (2) Report to secretary and congress.--Not later than 1 
     year after the date of the enactment of this Act, the agency 
     designated under paragraph (1) shall submit to the Secretary 
     and to Congress a report containing the findings and 
     recommendations resulting from the studies coordinated under 
     such paragraph, including recommendations for hospital 
     discharge and followup procedures designed to reduce rates of 
     preventable hospital readmissions for preterm infants.

             TITLE II--NATIONAL PEDIATRIC RESEARCH NETWORK

     SEC. 201. NATIONAL PEDIATRIC RESEARCH NETWORK.

       Section 409D of the Public Health Service Act (42 U.S.C. 
     284h; relating to the Pediatric Research Initiative) is 
     amended--
       (1) by redesignating subsection (d) as subsection (f); and
       (2) by inserting after subsection (c) the following:
       ``(d) National Pediatric Research Network.--
       ``(1) Network.--In carrying out the Initiative, the 
     Director of NIH, in consultation with the Director of the 
     Eunice Kennedy Shriver National Institute of Child Health and 
     Human Development and in collaboration with other appropriate 
     national research institutes and national centers that carry 
     out activities involving pediatric research, may provide for 
     the establishment of a National Pediatric Research Network 
     consisting of the pediatric research consortia receiving 
     awards under paragraph (2).
       ``(2) Pediatric research consortia.--
       ``(A) In general.--The Director of NIH may award funding, 
     including through grants, contracts, or other mechanisms, to 
     public or private nonprofit entities--
       ``(i) for establishing or strengthening pediatric research 
     consortia; and
       ``(ii) for providing support for such consortia, including 
     with respect to--

       ``(I) basic, clinical, behavioral, or translational 
     research to meet unmet pediatric research needs; and
       ``(II) training researchers in pediatric research 
     techniques in order to address unmet pediatric research 
     needs.

       ``(B) Research.--The Director of NIH may ensure that--
       ``(i) each consortium receiving an award under subparagraph 
     (A) conducts or supports at least one category of research 
     described in subparagraph (A)(ii)(I) and collectively such 
     consortia conduct or support all such categories of research; 
     and
       ``(ii) one or more such consortia provide training 
     described in subparagraph (A)(ii)(II).
       ``(C) Number of consortia.--
       ``(i) In general.--The Director of NIH may make awards 
     under this paragraph for not more than 8 pediatric research 
     consortia, with a minimum of one pediatric research 
     consortium that prioritizes collaboration with institutions 
     serving rural areas.
       ``(ii) Exception.--Notwithstanding clause (i), the Director 
     of NIH may make awards under this paragraph for more than 8 
     pediatric research consortia based on a finding of need by 
     the Director. Before making any award pursuant to the 
     preceding sentence, the Director of NIH shall give written 
     notice to the Congress of the Director's intent to make the 
     award and shall include in the notice an explanation of the 
     Director's finding of need.
       ``(D) Organization of consortium.--Each consortium 
     receiving an award under subparagraph (A) shall--
       ``(i) be formed from a collaboration of cooperating 
     institutions;
       ``(ii) be coordinated by a lead institution;
       ``(iii) agree to disseminate scientific findings rapidly 
     and efficiently; and

[[Page 17774]]

       ``(iv) meet such requirements as may be prescribed by the 
     Director of NIH.
       ``(E) Supplement, not supplant.--Any support received by a 
     consortium under subparagraph (A) shall be used to 
     supplement, and not supplant, other public or private support 
     for activities authorized to be supported under this 
     paragraph.
       ``(F) Duration of consortium support.--Support of a 
     consortium under subparagraph (A) may be for a period of not 
     to exceed 5 years. Such period may be extended at the 
     discretion of the Director of NIH.
       ``(3) Coordination of consortia activities.--The Director 
     of NIH shall--
       ``(A) as appropriate, provide for the coordination of 
     activities (including the exchange of information and regular 
     communication) among the consortia established pursuant to 
     paragraph (2); and
       ``(B) as appropriate, require the periodic preparation and 
     submission to the Director of reports on the activities of 
     each such consortium.
       ``(4) Assistance with registries.--Each consortium 
     receiving an award under paragraph (2)(A) shall provide 
     assistance to the Centers for Disease Control and Prevention 
     in the establishment or expansion of patient registries and 
     other surveillance systems as appropriate and upon request by 
     the Director of the Centers.
       ``(e) Research on Pediatric Rare Diseases or Conditions.--
     In making awards under subsection (d)(2) for pediatric 
     research consortia, the Director of NIH shall ensure that an 
     appropriate number of such awards are awarded to such 
     consortia that agree to--
       ``(1) focus primarily on pediatric rare diseases or 
     conditions (including any such diseases or conditions that 
     are genetic disorders or are related to birth defects); and
       ``(2) conduct or coordinate one or more multisite clinical 
     trials of therapies for, or approaches to, the prevention, 
     diagnosis, or treatment of one or more pediatric rare 
     diseases or conditions.''.

       TITLE III--CHILDREN'S HOSPITAL GME SUPPORT REAUTHORIZATION

     SEC. 301. PROGRAM OF PAYMENTS TO CHILDREN'S HOSPITALS THAT 
                   OPERATE GRADUATE MEDICAL EDUCATION PROGRAMS.

       (a) In General.--Section 340E of the Public Health Service 
     Act (42 U.S.C. 256e) is amended--
       (1) in subsection (a), by striking ``through 2005 and each 
     of fiscal years 2007 through 2011'' and inserting ``through 
     2005, each of fiscal years 2007 through 2011, and each of 
     fiscal years 2013 through 2017'';
       (2) in subsection (f)(1)(A)(iv), by inserting ``and each of 
     fiscal years 2013 through 2017'' after ``2011''; and
       (3) in subsection (f)(2)(D), by inserting ``and each of 
     fiscal years 2013 through 2017'' after ``2011''.
       (b) Report to Congress.--Section 340E(b)(3)(D) of the 
     Public Health Service Act (42 U.S.C. 256e(b)(3)(D)) is 
     amended by striking ``Not later than the end of fiscal year 
     2011'' and inserting ``Not later than the end of fiscal year 
     2016''.
       Amend the title so as to read: ``An Act to reduce preterm 
     labor and delivery and the risk of pregnancy-related deaths 
     and complications due to pregnancy; to reduce infant 
     mortality caused by prematurity; to provide for a National 
     Pediatric Research Network, including with respect to 
     pediatric rare diseases or conditions; and to reauthorize 
     support for graduate medical education programs in children's 
     hospitals.''.

  The SPEAKER pro tempore (Mr. Westmoreland). Pursuant to the rule, the 
gentleman from Pennsylvania (Mr. Pitts) and the gentleman from New 
Jersey (Mr. Pallone) each will control 20 minutes.
  The Chair recognizes the gentleman from Pennsylvania.


                             General Leave

  Mr. PITTS. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous materials into the Record on S. 1440.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Pennsylvania?
  There was no objection.
  Mr. PITTS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, S. 1440, the Prematurity Research Expansion and 
Education for Mothers who deliver Infants Early Reauthorization, or the 
``PREEMIE'' Reauthorization Act, would take important steps to protect 
and improve children's health. The bill includes three important 
programs: the PREEMIE Reauthorization Act, the National Pediatric 
Research Network, and the Children's Hospitals Graduate Medical 
Education Reauthorization.
  The PREEMIE Reauthorization Act addresses one of the leading causes 
of neonatal death and a major cause of childhood disabilities: preterm 
birth. Since its passage in 2006, the PREEMIE Act has sponsored 
important research that has led to improved prevention and care of 
children born too early. Reauthorization will mean the continuation of 
the program that will lead to even better outcomes for children.
  The National Pediatric Research Network is a proven way to support 
pediatric research by coordinating multicentered research activities, 
including those in rural areas. By working in teams, innovative 
research improves especially for diseases that are rare or affect a 
small population of children. Most of the approximately 7,000 rare 
diseases are pediatric and often genetic, and doctors do not have 
sufficient therapies to treat them. This bill will help alleviate that 
problem.
  The Children's Hospital Graduate Medical Education Reauthorization 
would enable the Department of Health and Human Services to provide 
funding to freestanding children's hospitals to support the training of 
pediatricians and other residents. Prior to the enactment of CHGME, the 
number of residents in children's hospitals had declined by 13 percent. 
Now the program has enabled children's hospitals to increase their 
training programs by 35 percent.
  In my home State of Pennsylvania, three premier children's hospitals, 
Children's Hospital of Pittsburgh, St. Christopher's Hospital for 
Children, and Children's Hospital of Philadelphia receive CHGME funds 
that support and ensure world-renowned health care for children.
  CHGME is a significant achievement in pediatric health care in 
Pennsylvania and across the country. Despite these gains, shortages 
still exist, and the future of the pediatric workforce relies on the 
continuation of CHGME.
  I commend the leadership on both sides of the aisle and in the 
committee for their leadership on this. These programs enjoy bipartisan 
support, and I urge my colleagues to support S. 1440.
  I reserve the balance of my time.
  Mr. PALLONE. Madam Speaker, I yield myself such time as I may 
consume.
  I am pleased to rise in support of S. 1440, as amended. The 
legislation before us extends two existing programs and creates one new 
initiative, all activities that impact children's health.
  The first title of the legislation reauthorizes the Prematurity 
Research Expansion and Education for Mothers who deliver Infants Early, 
or PREEMIE, Act through fiscal year 2017. The PREEMIE Act was signed 
into law in 2006, and I was proud to be a cosponsor of the original 
House legislation.
  S. 1440, as amended, calls for further studies on factors related to 
prematurity, improved data on the national burden of preterm birth, 
continued preterm birth prevention efforts, and strengthened public and 
health provider education on risk factors for preterm delivery and 
treatments and outcomes for preterm infants. The legislation also 
codifies an advisory committee to the Secretary of Health and Human 
Services on infant mortality and directs the Secretary to coordinate 
existing quality studies on hospital readmissions and preterm infants.
  Since the enactment of the PREEMIE Act, we've seen the preterm birth 
rate decline to its present level of just under 12 percent, the lowest 
rate we've seen since the late nineties. The good news is there's been 
progress in better understanding the causes of premature births and 
promoting interventions that work. On the other hand, however, we still 
don't know the causes of premature birth in up to 40 percent of cases. 
And then there's the cost to the health care system of premature 
births--more than $26 billion each year--not to mention the increased 
risks of serious disability and death for newborns and the tremendous 
toll prematurity takes on their families. And that's precisely why the 
goals of the PREEMIE Act remain just as salient as they were 6 years 
ago.
  The second title is similar to the House-passed National Pediatric 
Research Network Act of 2012 and allows the National Institutes of 
Health to establish a national pediatric research network comprised of 
up to eight pediatric research consortia, or groups of collaborating 
institutions. The consortia will conduct basic clinical, behavioral, 
and translational research on pediatric diseases and conditions.

[[Page 17775]]

  Among the eight consortia, the NIH Director will ensure that an 
appropriate number of awards go to consortia that focus primarily on 
pediatric rare diseases, such as spinal muscular atrophy or birth 
defects such as Down syndrome. There are many rare pediatric diseases, 
and in some of these diseases, the children are incredibly fragile. If 
we can allow for research to occur across the country, not just one 
single location, research can be done at a larger level because 
children could then participate without having to travel.
  Additionally, we all know too well that, traditionally, pediatric 
research has been underfunded. That can make it hard to train and 
develop the research talent needed to address these devastating 
illnesses. The consortia can therefore be the training grounds for 
future researchers, helping to fill the pediatric pipeline.
  Finally, the third title, Madam Speaker, of the amendment to S. 1440 
reauthorizes the Children's Hospitals Graduate Medical Education, or 
CHGME, program through fiscal year 2017. The legislation maintains the 
current authorization level and will support the work of 56 children's 
hospitals training over 5,000 pediatric residents in 30 States.
  The CHGME program was first established in 1999, following declines 
in pediatric training programs that threatened the stability of the 
pediatric workforce.

                              {time}  1310

  Like any parent knows, it's important to have a trusted health 
provider to turn to when your child is sick or hurt. In Congress, on a 
bipartisan basis, we recognize that if we didn't create and fund 
programs to train pediatricians, there wouldn't be anyone left to care 
for our kids.
  Since its inception, the CHGME program has been a success story, 
supporting children's hospitals and their work to train future 
generations of our pediatric workforce, including pediatric 
subspecialists in very short supply. Representing only 1 percent of all 
hospitals, the small number of children's hospitals that participate in 
the program train approximately 40 percent of all pediatricians and 
nearly half of all pediatric specialists. That's why continuing this 
critical program will have a major impact on access to primary care and 
specialty care for kids.
  Reauthorizing this program, Madam Speaker, was one of my top health 
priorities of the year, and I want to thank Chairman Joe Pitts, the 
chairman of our Health Subcommittee, for working with me on this bill. 
Together with his help and leadership, we were able to move this bill 
through our committee and to the House floor last year. I'm hopeful 
that reauthorization of the CHGME program will finally make it to the 
President's desk as part of S. 1440.
  I just want to take a moment to commend Chairman Upton, Chairman 
Pitts, and Ranking Member Waxman for their leadership on this 
legislation. I have to recognize and thank the House sponsor of the 
PREEMIE Act and the National Pediatric Research Network Act, and those 
Energy and Commerce members: Congresswoman Eshoo, Congressman Lance, 
Congresswoman Capps, and Congresswoman McMorris Rodgers. They were 
really dedicated to these important issues.
  Madam Speaker, I reserve the balance of my time.
  Mr. PITTS. Madam Speaker, I yield 2 minutes to the gentleman from 
Georgia, one of the leaders on this issue, Dr. Phil Gingrey.
  Mr. GINGREY of Georgia. Madam Speaker, I thank the chairman for 
yielding.
  The gentleman from New Jersey just gave attributions to so many 
members, both Republicans and Democrats, from the Energy and Commerce 
Committee that worked so long and hard on this legislation back 
originally in 2006 and now in the reauthorization of S. 1440, the 
PREEMIE Act.
  There are a lot of statistics that some people may not be aware of. 
One is the fact that about two-thirds of all infant deaths in the first 
year of life are among the preterm infants. In 2008, 12.3 percent of 
all live births, over 500,000 babies, were born preterm.
  Madam Speaker, let me put it a little bit in context. Prematurity or 
preterm birth is by definition a birth earlier than 37 weeks. Those 
children are usually not the problem. They're not the ones that end up 
with permanent disabilities. But there is a subset of prematurity, 
maybe sometimes referred to as ``immaturity,'' children that are born 
as early as 20 weeks, all the way up to 37 weeks. Those children are 
the ones that very often, if they survive, are left with permanent 
long-term disabilities. We see a lot of folks on the Hill coming down 
the halls of our office buildings, and sometimes they're in 
wheelchairs, sometimes they're visually impaired, sometimes they're 
hearing impaired, but so many of those adults and children that we see 
on Capitol Hill were born prematurely. So a piece of legislation like 
this is hugely important.
  I'll end my remarks by just making it a little personal. My wife, 
Billie, and I, Madam Speaker, have 13 grandchildren, and the oldest 
will be 15 years old in about 3 weeks. And they were born at 26 weeks--
they each weighed 1 pound and 12 ounces. Thank God they are virtually 
unimpaired today and in the eighth grade and doing well. It tugs at 
your heartstrings. This is something that is hugely important.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. PITTS. I yield an additional 30 seconds to the gentleman from 
Georgia.
  Mr. GINGREY of Georgia. The graduate medical education piece is very 
important because these children's hospitals, they see so many of these 
young kids. In fact, 50 percent or more of their patient population are 
Medicaid, and they need this funding for continuing medical education 
for pediatric residents.
  I will just conclude with that and say how proud I am to be 
supportive of such a great piece of legislation.
  Mr. PALLONE. Madam Speaker, I would like to now yield such time as 
she may consume to the sponsor of the House PREEMIE Act, the 
gentlewoman from California (Ms. Eshoo).
  Ms. ESHOO. I thank the gentleman.
  Madam Speaker, I'm very proud to rise in support of the PREEMIE Act 
legislation that I introduced with Congressman Leonard Lance. He's been 
a terrific partner not only on this legislation but on other pieces of 
legislation that we've moved through the Energy and Commerce Committee, 
and I salute him.
  This bill will expand research, education, and prevention of preterm 
birth. As the mother of two children, I know how precious the earliest 
part of life is, and it's our responsibility to do everything we can to 
make sure that our little ones begin their lives with more than a 
fighting chance.
  Each year, as was stated, half a million babies are born prematurely 
in our country, and preterm birth is the leading cause of newborn 
mortality and the second-leading cause of infant mortality. Babies born 
even a few weeks too early can require weeks to months of 
hospitalization after birth, and premature birth can sometimes lead to 
developmental delays and disability later in life.
  In addition to the emotional and physical toll of prematurity, there 
are significant health care costs to families, to our medical systems, 
and our economy. A 2006 report by the Institute of Medicine found the 
cost associated with preterm birth in the United States was $26.2 
billion annually, or $51,600 per infant born preterm. These are 
staggering amounts of dollars. While employers, private insurers, and 
individuals bear about half of the cost of health care for these 
infants, 40 percent is paid for by Medicaid. So it's in the best 
interest of healthy babies, hopeful families, and the budget of our 
country to decrease preterm births.
  The good news is our investment in preventing prematurity is paying 
off. In 2006, I introduced and Congress passed the first ever 
comprehensive PREEMIE Act, and prematurity rates have declined since 
then. This is very good news. The better news is that today we're 
reauthorizing this law, which will build upon the momentum

[[Page 17776]]

of the original law and provide us with new tools and knowledge to 
improve the lives and health of America's mothers and children.
  The PREEMIE Act has been packaged with other important pediatric 
health bills. I thank the chairman of the subcommittee, Mr. Pitts, the 
chairman of our full committee, Mr. Upton, the ranking member of the 
full committee, as well as Mr. Pallone, and all of our colleagues.
  You know very well, Madam Speaker, that we come to this place to do 
good things for our country that will strengthen our Nation. How proud 
I am that we are living up to that in presenting this bill here today.
  In closing, I would also like to thank Erin Katzelnick-Wise of my 
staff, who has worked on this bill as if it were the most important 
thing she could do in her life, understanding that it is one of the 
most important things she could do in her life for children in our 
country; to the American Academy of Pediatricians, who have been so 
magnificent in instructing all of us in our work on this legislation; 
and a particular shout-out to Dr. Phil Pizzo, the dean of the Stanford 
School of Medicine, a pediatrician himself who at one time worked with 
great distinction at the National Institutes of Health.

                              {time}  1320

  Mr. PITTS. Madam Speaker, I yield 2\1/2\ minutes to the chairman of 
the full committee, the gentleman from Michigan (Mr. Upton).
  Mr. UPTON. I, too, want to commend the Republicans and Democrats, who 
worked very, very hard to get this legislation to the floor and, 
hopefully, to the President's desk as soon as possible. I particularly 
commend Chairman Pitts and Ranking Member Pallone, Leonard Lance, Anna 
Eshoo, Lois Capps, and the staffs, really, on both sides. I made a 
commitment to all of these Members early on that we would work very 
diligently to get this legislation here, and we are finally here.
  Madam Speaker, this bill, S. 1440, known as the PREEMIE 
Reauthorization Act, is designed to strengthen health care for kids, 
particularly for vulnerable kids. Not only does the bill reauthorize 
the PREEMIE Act, but it also includes the reauthorization of the 
Children's Hospital Graduate Medical Education program, and it 
authorizes the National Pediatric Research Network.
  The original PREEMIE Act that I sponsored brought attention to the 
problems related to preterm birth, and since its passage, the preterm 
birth rate has declined. Good news. Yet, despite that improvement, 
according to the CDC, still a half a million babies are born 
prematurely every year in this country. That's one out of eight. We can 
and we must do better. This reauthorization will continue to strengthen 
the ongoing effort to track, prevent, and treat prematurity, ensuring 
that every child has a healthy start and a better chance at a healthy 
and a productive future.
  Madam Speaker, the National Pediatric Research Network brings us a 
step closer in providing more help to children with unmet health needs, 
particularly to those with rare pediatric and genetic diseases. I've 
met a number of times with a family in my district, the Kennedys, whose 
wonderful little daughters--Brielle and Brooke, who are affectionately 
known in our office as ``Sleeping Beauty'' and ``Cinderella''--have a 
rare disease called spinal muscular atrophy. It's often difficult to 
conduct research into these diseases due to the very small number of 
kids with that disease, but today, we are working to provide families 
like the Kennedys and so many others with greater hope for a cure or an 
advancement in the treatment.
  This bill will help establish pediatric research networks and the 
consortia that are effective in overcoming gaps in research. Networks 
and consortia will be comprised of leading institutions that will act 
as partners to consolidate and coordinate those research efforts.
  The SPEAKER pro tempore (Mrs. Emerson). The time of the gentleman has 
expired.
  Mr. PITTS. I yield the gentleman an additional 30 seconds.
  Mr. UPTON. With the passage of the Children's Hospital Graduate 
Medical Education in 1999, freestanding children's hospitals began 
receiving funds to support their pediatric medical residency programs. 
As a result, the number of pediatricians in the U.S. has grown 
steadily. Today, over 40 percent of the pediatricians and pediatric 
specialists are trained in the 57 freestanding children's hospitals 
that receive this funding. A proven track record. We need to get it 
done.
  Again, I congratulate the Members on the floor today for getting this 
bill, hopefully, to the President's desk before the year is out.
  Mr. PALLONE. I yield such time as she may consume to the Democratic 
sponsor of the House National Pediatric Research Network Act of 2012, 
which is the second title of the legislation before us, the gentlewoman 
from California (Mrs. Capps).
  Mrs. CAPPS. I do want to acknowledge the gentlelady in the chair as 
my partner in the Capps-Emerson lectures and as my neighbor and a real 
friend.
  Madam Speaker, I rise in strong support of the PREEMIE 
Reauthorization Act. This is an important bill to improve the health 
outcomes of pregnant women and their babies, and it shows our Nation's 
commitment to addressing the costly and emotionally troubling incidence 
of preterm birth. While this is enough reason for me to support this 
legislation, I would like to highlight two additional sections of the 
bill that will improve the health and well-being not only of newborns 
but of our children as they grow.
  First, it includes the reauthorization of the Children's Hospital 
Graduate Medical Education program. This is a critical investment in 
both the health of our kids and in the health of our economy by 
bringing new, talented individuals into the health care workforce.
  From my years as a school nurse, I know the difficulty that children 
experience, especially those with special health care needs, when they 
look for a pediatric specialist. Over the years, we have seen how CHGME 
programs have made a measurable impact in alleviating that burden, 
allowing these children and their families to focus on healing. I am 
proud to be an original cosponsor of this legislation and will continue 
to champion it in the House.
  While we must ensure that the providers are available for our kids, 
we are still far behind on too many important diagnostics, cures, and 
treatments for many of our ailing children. That is why this bill also 
includes the National Pediatric Research Network Act, which is a bill 
that I coauthored with my colleague, Representative Cathy McMorris 
Rodgers.
  This legislation will help strengthen and coordinate our Nation's 
research on pediatric diseases. It will disseminate research findings 
quickly so that all children may benefit, especially those who have 
rare diseases; and it will expand the geographic scope of research, 
giving sick kids easier access to research programs and to clinical 
trials. Moreover, this bill places an added emphasis on researching 
children's rare diseases, like spinal muscular atrophy, as my colleague 
Mr. Upton has noted, and on developing new treatments to fight them.
  The low prevalence of these diseases makes them particularly hard to 
research, and yet these diseases have such a marked impact on the lives 
of far too many families and communities, like the Strong family of 
Santa Barbara. My constituents Bill and Victoria Strong have worked 
tirelessly on behalf of their daughter, Gwendolyn, and all children 
with spinal muscular atrophy and other rare diseases. The work they've 
done to help raise the profile of pediatric rare disease research is 
going to help families all across the Nation. I thank them.
  I also thank the leadership of the Energy and Commerce Committee--
Chairman Upton, Ranking Member Waxman, Chairman Pitts, and Ranking 
Member Pallone--for their dedication to this bill. I thank the staff, 
especially Ruth Katz, for working across the aisle and across the 
Capitol to bring a strong bill now to the floor.

[[Page 17777]]

  I urge my colleagues to support this bipartisan bill. I urge its 
swift passage in the Senate so that we can improve the health and well-
being of all infants and all children.
  Mr. PITTS. Madam Speaker, I yield 2 minutes to the gentleman from New 
Jersey (Mr. Lance), a leader on this issue.
  Mr. LANCE. It is wonderful to see you in the chair, and I 
congratulate you on your magnificent service to the people of Missouri 
and the Nation.
  I rise in strong support of S. 1440, to reauthorize the 2006 PREEMIE 
Act and to provide important continued research, education, and 
intervention in the national effort to reduce preterm births.
  Madam Speaker, our Nation's premature birth rate is one of the 
highest in the world, and it is the leading cause of newborn death in 
the United States. Infants born just a few weeks too soon can face 
serious health challenges and are at risk for lifelong health and 
learning disabilities. In addition to its human toll, premature birth 
costs our economy billions of dollars per year; and while the medical 
community has made great strides in identifying the risk factors 
associated with premature births, far too many premature births today 
have no known causes.
  That is why the Members of the House and Senate have worked in a 
bipartisan and bicameral fashion to reauthorize the 2006 PREEMIE Act so 
that we may continue to spur innovative solutions that will ultimately 
lead not just to healthier babies but to lower annual health care 
costs.
  I thank Chairman Upton and Chairman Pitts and Ranking Member Waxman 
and Ranking Member Pallone for their steadfast leadership on this issue 
as well as to thank Senators Lamar Alexander and Michael Bennet. Once 
again, I commend Congresswoman Anna Eshoo of California for working on 
an important issue to the health and well-being of the American people.
  While many complain about the partisan nature of Congress, we have 
worked in a cooperative fashion on this and other issues, as has the 
entire Energy and Commerce Committee. It is in that bipartisan spirit 
that I ask all of my colleagues to join with us in the support of the 
PREEMIE Reauthorization Act so that we as a Nation will be able to 
continue our focus on premature birth research and prevention.
  Mr. PALLONE. I have no additional speakers, Madam Speaker, so I would 
simply ask that we support this legislation and pass it on a bipartisan 
basis.
  I yield back the balance of my time.

                              {time}  1330

  Mr. PITTS. Madam Speaker, I have no further speakers. I urge support 
for this bipartisan legislation.
  I yield back the balance of my time.
  Mr. WAXMAN. Madam Speaker, I rise in support of S. 1440, as amended, 
and urge my colleagues to support the bill as well.
  As amended, S. 1440 is comprised of the authorization or re-
authorization of three different programs, all related to children's 
health. Together, these provisions constitute a bipartisan effort to 
help ensure that our kids--and their health care needs--are 
appropriately and adequately addressed.
  Title One of the bill would reauthorize and improve the Prematurity 
Research Expansion and Education for Mothers Who Deliver Infants 
Early--or PREEMIE--Act. Established in 2006, the PREEMIE Act expands 
federal research related to preterm labor and delivery, and the care 
and treatment, and outcomes of preterm and low birth weight infants. It 
also supports education programs for health professionals and the 
public on prematurity. Title One is designed to enhance these 
activities and represents a renewed commitment to our nation's efforts 
to reduce premature birth, the leading killer of newborns.
  Title Two of S. 1440 would allow the National Institutes of Health to 
establish a national pediatric research network dedicated to finding 
treatments and cures for pediatric diseases and conditions--especially 
those that are rare. In addition to the research itself, Title Two 
places special emphasis on professional training for future pediatric 
researchers. These and other related components of Title Two are 
intended to build on the strong body of pediatric research that NIH 
already conducts and supports. I would encourage NIH to take full 
advantage of this opportunity.
  Finally, Title Three of the bill would reauthorize the children's 
hospital graduate medical education--or CHGME--program. This program 
provides ongoing and consistent financial support to hospitals such as 
Children's Hospital of Los Angeles for the training of doctors who want 
to specialize in pediatrics. Over the years, the CHGME program has been 
enormously successful in reversing the significant decline in the 
number of pediatrician trainees across the country. Indeed, today, 
children's hospitals nationwide that are supported by the program train 
40% of all pediatricians and 43% of all pediatric specialists.
  As I have noted, this package of programs is a bi-partisan initiative 
that reflects the work of several members of the Energy and Commerce 
Committee. I especially want to note Congresswoman Eshoo, the 
Democratic sponsor of the original PREEMIE Reauthorization Act; 
Congresswoman Capps, the Democratic sponsor of the original National 
Pediatric Research Network Act; and Congressman Pallone, the Democratic 
sponsor of the original Children's Hospital GME Support Reauthorization 
Act. All of them and all of us--on both sides of the aisle--have much 
to be proud of in supporting S. 1440, as amended.
  I urge my colleagues to vote for S. 1440, as amended.
  Mrs. McMORRIS RODGERS. Madam Speaker, as a mother, I am reminded on a 
daily basis of the importance of the health of our Nation's children.
  For that reason, I am proud to support the Prematurity Research 
Expansion and Education for Mothers who deliver Infants Early (PREEMIE) 
Act. This important legislation authorizes research to prevent preterm 
births and it requires the Secretary of HHS to coordinate our Nation's 
efforts to achieve this goal.
  This legislation also amends the Public Health Service Act to extend 
and reauthorize appropriations for Children's Hospital Graduate Medical 
Education. This is the source of training of most of our Nation's 
pediatricians.
  The PREEMIE act also includes legislation introduced by 
Representative Capps and myself, the National Pediatric Research 
Network Act which will build upon our Nation's commitment to pediatric 
medical research. That commitment has led to the prevention and 
treatment of terrible conditions such as polio, meningitis, childhood 
leukemia, and congenital heart disease.
  Research networks have a proven track record in their ability to 
ensure collaboration and sharing of resources which, in turn, have led 
to medical discoveries that have improved lives. This legislation will 
authorize NIH to establish up to 8 pediatric research networks 
throughout the nation. Each network will be selected by NIH through a 
competitive review process. These networks will allow multiple 
institutions to work together in a ``hub and spoke'' fashion in order 
to encourage collaboration and resource sharing.
  These pediatric networks will improve health outcomes for children 
who have conditions such as spinal muscular atrophy, Down syndrome, and 
Fragile X. This will be accomplished by encouraging teamwork among 
researchers, patients, and NIH.
  Today, I am proud to vote for measures to improve the health of our 
Nation's children.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Pennsylvania (Mr. Pitts) that the House suspend the 
rules and pass the bill, S. 1440, 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.

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