[Congressional Record (Bound Edition), Volume 163 (2017), Part 5]
[House]
[Pages 6183-6194]
[From the U.S. Government Publishing Office, www.gpo.gov]




              FURTHER CONTINUING APPROPRIATIONS ACT, 2017

  Mr. SESSIONS. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 289 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 289

       Resolved, That upon adoption of this resolution it shall be 
     in order to consider in the House the joint resolution (H.J. 
     Res. 99) making further continuing appropriations for fiscal 
     year 2017, and for other purposes. All points of order 
     against consideration of the joint resolution are waived. The 
     joint resolution shall be considered as read. All points of 
     order against provisions in the joint resolution are waived. 
     The previous question shall be considered as ordered on the 
     joint resolution and on any amendment thereto to final 
     passage without intervening motion except: (1) one hour of 
     debate equally divided and controlled by the chair and 
     ranking minority member of the Committee on Appropriations; 
     and (2) one motion to recommit.

  The SPEAKER pro tempore (Mr. POE of Texas). The gentleman from Texas 
is recognized for 1 hour.
  Mr. SESSIONS. Mr. Speaker, for the purpose of debate only, I yield 
the customary 30 minutes to the gentleman from Massachusetts (Mr. 
McGovern), my friend, the ranking member of the committee, pending 
which I yield myself such time as I may consume.


                             General Leave

  Mr. SESSIONS. Mr. Speaker, I ask unanimous consent that all members 
have 5 legislative days to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. SESSIONS. Mr. Speaker, I rise today in support of the rule. It is 
a fair rule that enables this body to continue working in a bipartisan 
fashion to get our work done for the American people. Essentially, it 
is to fund the government for one more week as final preparations are 
made and as the Appropriations Committee finalizes its work. It enables 
us to continue to serve our constituents. It enables the American 
people to have confidence not only in what we are doing, but to provide 
the necessary resources so that this Nation can continue to protect 
itself also.
  I also rise in support of the underlying legislation that is in this 
rule. This short-term CR, while being far from ideal, is exactly what 
we need to do so that we can allow our colleagues in the House, as well 
as the Appropriations Committee and this body, to move forth a bill 
that will find its way to the United States Senate and to the 
President's desk.
  For months now, our colleagues on the Appropriations Committee, under 
the great work of our brand-new chairman, Chairman Frelinghuysen from 
New Jersey, have been working towards funding a government agreement 
while they are trying to reach a long-term bridge.
  Yesterday at the Rules Committee, the young chairman, along with the 
ranking member, Mrs. Lowey from New York, came and spoke to the Rules 
Committee not only with great confidence about the work that they are 
doing, but with great confidence about how they worked well together. 
It was once again another opportunity for Members of Congress in the 
performance of their duties to have confidence not only in their 
working relationship, but in the product that they would wish to move 
forward.
  The Rules Committee was quite blunt to them that, while we were 
pleased to see them, we wanted to see them get their work done a week 
from now. I think the American people feel the same way. I think they 
are willing to take the time to do it right, but it is now time to feel 
a little bit of pressure towards completing the work that needs to be 
done.
  Mr. Speaker, today we are going to have one of the most distinguished 
members of the Rules Committee who will speak with us. He shares a role 
not only as vice chairman of our committee, but he also has an 
opportunity to sit on the Appropriations Committee; a person 
responsible as a cardinal for a massive part of not only the Federal 
Government spending, but the authority and responsibility for the 
Federal Government to deliver in so many areas in support of the 
American people.
  I will be introducing the gentleman from Oklahoma (Mr. Cole) in just 
a few minutes, who will also provide detail and information not only in 
support of the great work that is being done, but why we are doing that 
for the American people.
  Mr. Speaker, I am confident that my colleagues on the Appropriations 
Committee are going to continue their work. We are asking this body 
today to consider this rule to move forth legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. McGOVERN. Mr. Speaker, I thank the gentleman from Texas (Mr. 
Sessions), my good friend, the chairman of the Rules Committee for 
yielding me the customary 30 minutes, and I yield myself such time as I 
may consume.
  Mr. Speaker, I want to begin with some good news for my colleagues 
here in the House and for the American people, and that is my 
Republican colleagues have decided to pull their abysmal repeal and 
replace bill with regard to the Affordable Care Act from consideration 
this week. We can all breathe a sigh of relief. The American people 
dodged another Republican bullet here.
  Their bill, as my colleagues all know, would have caused 24 million 
Americans to lose their health care. It would have cut Medicaid by over 
$800 billion, and then they would have given a trillion-dollar tax 
break to the richest people in the country. It would have compromised 
Medicare. It would have basically denied Americans essential health 
protections that they currently are guaranteed in their health 
insurance; things like emergency room care, maternity care, mental 
health care. I can go on and on.
  Then with their latest addition to their abysmal bill, they would 
have even allowed insurance companies to once again discriminate 
against Americans with preexisting conditions; something that they said 
that they wanted to protect, yet their adjustments to their abysmal 
healthcare bill would have allowed Americans with preexisting 
conditions to be discriminated against.
  I mean, when we talk about essential health benefits, I want to 
stress the word ``essential.'' They are important, yet they are going 
down a road that I think is disastrous for millions of American people.
  Let us begin by being thankful that we are not going to do great harm 
to our country this week. Now, there is always next week--we have to 
worry about that--but at least this week they had the common sense to 
pull this terrible healthcare bill that they have been working on for 
so long. Let's hope that we never ever see the bill. I think it is 
important for people to understand what is at stake. There is an

[[Page 6184]]

awful lot at stake for tens of millions of Americans here today all 
across the country.
  Mr. Speaker, that brings us to today. Let us be clear about why we 
are here again with yet another continuing resolution, the 29th--yes, 
you heard that right, the 29th--continuing resolution since Republicans 
have taken control of the House.
  Republicans have nobody to blame for this mess but themselves. They 
control the White House, they control the Senate, and, unfortunately, 
they control this House. They were even the ones who set this 
artificial deadline of April 28 in the first place. That was after 
Republicans gave themselves a 2-month extension and then a 5-month 
extension.
  Mr. Speaker, this should have all been sorted out last fall, but for 
7 months Republicans have played games and delayed and bickered amongst 
themselves about government funding and health care and other 
priorities.
  What do they have to show for it?
  Nothing.
  Now, maybe the delay was caused by this obsession from the Republican 
Conference with repealing the Affordable Care Act and ripping health 
care away from 24 million Americans. Maybe Republicans have been too 
busy trying to defund Planned Parenthood, trying to undo important 
consumer protections put in place by Democrats, trying to tear down 
commonsense rules to protect public safety and the environment.
  Perhaps if Republicans had been responsibly working with Democratic 
leaders during the past 7 months, we could have already funded our 
government and we could be getting to work on other things that our 
constituents sent us here to do, like creating jobs and repairing our 
crumbling infrastructure.
  We could have avoided events that have transpired during the past 48 
hours: an emergency Rules Committee meeting, another Republican martial 
law rule, and threats of a Saturday session.
  Mr. Speaker, to put it bluntly, this is about Republican dysfunction 
and incompetence, plain and simple. If Congress could be sued by the 
American people for malpractice, we would be in big trouble. This is 
indefensible. I am sure people who are watching these proceedings are 
scratching their heads saying: What the hell is going on in the 
people's House?
  For the life of me, I cannot understand why we are constantly at the 
edge of a cliff. This Republican leadership jumps from one manufactured 
crisis to the next, and has proven ineffective at carrying out even its 
most basic responsibilities, like keeping the government's lights on 
and funding programs that help our constituents.
  But don't take it from me. Listen to what some of my Republican 
colleagues are saying about the priorities of their own leadership. 
Representative Rooney, a Republican from Florida, said:
  ``I have been in this job 8 years, and I am wracking my brain to 
think of one thing our party has done that has been something positive, 
that has been something other than stopping something else from 
happening.''
  Representative Mario Diaz Balart from Florida commented:
  ``It is pretty evident that we don't have the votes among Republicans 
to, in essence, do anything that is real.''
  Mr. Speaker, when you have members of your own party making these 
kinds of statements, you really have to question the capacity of the 
Speaker and his leadership team to govern effectively.
  Mr. Speaker, I very much regret that we are here today to consider 
another short-term CR. One week--that is all this bill does, keeps the 
government running for one additional week. Our constituents expect and 
deserve better from their elected officials.
  Mr. Speaker, I reserve the balance of my time.
  Mr. SESSIONS. Mr. Speaker, I appreciate the gentleman, my friend from 
Massachusetts, for his words of wisdom about the direction we ought to 
be going. That is what we are going to do; we are going to continue 
moving.
  I find in my job, as I perform my duties, that I have a chance to 
really interact with a lot of people in government. Over Christmas, I 
had a chance to visit our troops around the world and look at them and 
give them the confidence that what we do in Washington will allow them 
to keep working for freedom and to represent us.
  Dr. Francis Collins at the National Institutes of Health, an 
enormously brilliant man who helped with the genome project, who keeps 
NIH up and working; and at the National Eye Institute, Dr. Paul 
Sieving; and so many others who do count on us getting it right, 
whether it be the United States military, whether it is our border 
patrol, whether it is our health and human services, but the person who 
knows these characteristics of what it takes to get agreements is also 
on the Rules Committee. He is a valuable member of our Rules Committee. 
He is the gentleman from Oklahoma (Mr. Cole).
  Mr. Speaker, I yield 10 minutes to the gentleman from Oklahoma (Mr. 
Cole), vice chairman of the Labor, Health and Human Services, 
Education, and Related Agencies Subcommittee.
  Mr. COLE. Mr. Speaker, I thank the chairman, my good friend, for 
yielding me the time and for those incredibly gracious and generous 
remarks.
  Mr. Speaker, I certainly rise to support the rule and the underlying 
legislation. By the very nature of Rules debates, everything seems to 
be partisan because it seems to be sort of shirts and skins as it is on 
the rules. The reality is the legislation we are talking about has 
actually been requested by both parties. We had both the chairman and 
the ranking member in there requesting because they are working 
together in a bipartisan way to produce a major piece of legislation 
that will direct spending for the United States government in the range 
of about $1 trillion between now and September 30.
  The important thing to note is that it is a very bipartisan 
negotiation between two very skillful legislators, Chairman 
Frelinghuysen and Ranking Member Nita Lowey. When they bring that 
legislation to the floor, as they will next week, it is going to have 
some pretty important and pretty major things on it.
  We are not only going to adequately fund our military, we are going 
to increase that. We are going to give the President some things he has 
asked for in terms of supplemental money for defense to upgrade and 
improve our military.

                              {time}  0930

  We are going to give him some additional things for border security 
as well that, again, both parties have agreed on. I think we all want 
secure borders. We know there is always some debate about exactly how 
or what we should do, but, in this case, we have a bipartisan 
agreement.
  We will actually give a very substantial increase to the National 
Institutes of Health, which, as the gentleman from Texas (Mr. Sessions) 
mentioned, great work is done on behalf of the American people in that 
institution. Frankly, it has been Republicans that first doubled that 
back in the late 1990s and early 2000s and now have reignited the 
biomedical research engine by putting additional resources in there. It 
is something our friends support, but actually it was Republicans who 
took the initiative to achieve.
  We will see some really important increases in some education 
programs that give some of our less advantaged citizens opportunities 
to go: TRIO, GEAR UP. Both prepare individuals for higher education and 
then have a chance to exploit the opportunity when it comes.
  So that bill will have a lot of good things in it that will be 
bipartisan. My good friend from Massachusetts (Mr. McGovern) 
mentioned--and I think appropriately so--that there is a certain amount 
of dysfunction in the appropriations process. Where we probably 
disagree is--I have got to tell you, it is not new. Since we passed the 
Budget Control Act over 40 years ago in 1974, budgets and 
appropriations have been completed on time exactly four times. It 
didn't matter who was in charge. So maybe we ought to go back and look 
at

[[Page 6185]]

that defective process that was set in motion by our friends back when 
they controlled both Chambers in overwhelming numbers and rethink how 
we do this.
  I do agree with the gentleman from Massachusetts (Mr. McGovern) that 
it is important to focus on first things first. And while tax reform is 
a very important goal that, I think, this Congress will achieve and 
while health care is a very important goal, which I certainly hope this 
Conference achieves and I think we are working toward, there is no 
question the most important thing we do around here is fund the 
government every day. We make sure that our military has what it needs 
to protect us and that our border control officials have what they need 
to make sure they are secure, that we do things like look for cures for 
Alzheimer's and cancer at the NIH. To me, that always is the most 
important thing it has to do.
  So, in this bill and in the bill that will follow next week, we are 
actually doing what we should do. We are putting first things first. 
Let's make sure these basics are done for the American people, and then 
let's get about the important business of changing their Tax Code and 
making sure that they have the best health care in the world.
  In my view, Congress could have--and to my friend's point--could have 
and should have done this months ago. It is important to note that the 
Appropriations Committee had reported out all 12 of the bills that fund 
the day-to-day operation of the budget. Five of them actually moved 
across the floor. We did run into problems in the United States Senate 
where there was a lot of obstruction, but the Appropriations Committee 
did its job. We just have to now, as a Congress, do our job and make 
sure those bills get to the floor in a timely manner, and that we do 
the right thing so that they pass.
  The Appropriations Committee can only prepare them. They don't get to 
schedule them on the floor. They don't get to move them across the 
floor. That has to be done with all sides working together for the good 
of the American people.
  Again, it is worth noting that we can do this process. Two years in a 
row, we have done all 12 bills. So I would hope in the future, as we 
make these decisions--and my friend is right, a decision was made in 
November or December. It is not one I agreed with--to wait and say 
let's let the new administration have some input on this. Now, there is 
certainly nothing wrong with that.
  The new administration wants to come in, and there is a vehicle 
called a supplemental, where, if they want to tweak the budget, they 
can do that and they can bring it to the floor, and that is what we 
should have done. But we shouldn't ask them to write the budget for the 
very year in which they show up. They simply don't have their people in 
place. They are not ready to do that. They have got to get their 
Cabinet appointed. So I would hope, in the future, we remember that and 
do first things first.
  Still, it is never too late to do the right thing, as my mom used to 
say. And the right thing to do today is to pass this rule, pass this 
bill, give our friends, the appropriators, the time that they need to 
negotiate a final bill. I am confident we will do that; I am confident 
we will do it on a bipartisan basis, Mr. Speaker; and I am confident we 
will be back here with a bill the American people can be proud of 
because that will have been negotiated in good faith, it will be 
bipartisan, and it will give us the stability that we need from now 
until September 30.
  Mr. SESSIONS. Mr. Speaker, also I want to recognize the gentleman 
from Oklahoma (Mr. Cole) for another birthday today. The gentleman from 
Oklahoma was very silent last night at the Rules Committee. He didn't 
let us know, so we didn't say anything. But today is his birthday, and 
I congratulate him for that.
  I reserve the balance of my time.
  Mr. McGOVERN. Mr. Speaker, I yield myself such time as I may consume.
  I have a number of the day for my colleagues. I feel like I am on 
Sesame Street. This is the 29th closed rule this year. This is the 29th 
CR of this Republican majority. And the government is about to shut 
down when the calendar flips after midnight, and it is the 29th. So 29 
must be the number of the day.
  I want to wish the gentleman from Oklahoma (Mr. Cole) a happy 
birthday. Maybe he is 29, so it all kind of fits together.
  I would just say to my colleagues, as an indication of how 
dysfunctional this place is: How do you get 29 closed rules in 4 
months? How do we run a place in such a closed manner?
  This is supposed to be a deliberative body. We are supposed to be 
debating issues. People are supposed to have a give-and-take on matters 
of importance. We have had 29 closed rules in the first 4 months of 
this year. It is unprecedented.
  As I have been saying time and time again, when you have a lousy 
process, you usually end up with lousy legislation. I think that is the 
case with regard to the repeal and replace of the Affordable Care Act.
  Here we are at the last minute trying to keep the government open for 
a week so we could have more time to keep it open for the rest of the 
year. I mean, this is not the way this place should be run.
  Mr. Speaker, I yield 4 minutes to the gentlewoman from Florida (Ms. 
Castor), a former member of the Rules Committee.
  Ms. CASTOR of Florida. Mr. Speaker, the American people deserve 
better. The majority is not serving the interest of the families we 
represent back home. They are not focused on lifting the economic 
prospects of our small businesses and hardworking families. They are 
not focused on lifting wages.
  Instead, we are debating what could be the smallest little extension 
of government funding ever: 1 week. Are you kidding me? We have just 
come back this week from a 2-week recess. You would think that the 
majority party would have had the wherewithal to be able to fund the 
government as required through the end of the fiscal year, which is 
only September 30. This was leftover business from last year. How 
small. How unfocused. What a letdown for the people we represent.
  Has the majority party brought a bill to the floor of the House that 
we can debate on jobs, on lifting Americans that work hard every day? 
No.
  Has the majority party brought a bill to debate where we could talk 
about how we fix roads and bridges and connect communities and address 
congestion across the country and create jobs that way? No.
  The majority party, after the very serious military strike on Syria, 
could have brought a debate about an authorization of the use of 
military force where the Congress has been derelict for years in having 
the debate about a country that has been at war for 16 years. That is 
very important. People expect us to address the difficult issues, but 
they haven't brought that debate.
  Across the country this week, a lot of seniors in high school are 
deciding where they are going to attend college or university. We could 
be having a debate on how we help those families and students afford 
the cost of a college education or address the student loan crisis. 
But, no, that debate hasn't been brought
  There is going to be a big march in Washington again this weekend on 
the changing climate. We could discuss and debate the cost of the 
changing climate, extreme weather events. Boy, my folks back home in 
the State of Florida are having to look at increased insurance costs, 
property insurance costs, infrastructure costs because of the changing 
climate, but that debate hasn't been had.
  Instead the Congress has been consumed with a healthcare bill that 
rips coverage away from families, harms Medicare, raises cost on 
everyone, and they were stuck in a debate this week about ending the 
guaranteed protection that families now have if they have a preexisting 
condition. Remember, under the Affordable Care Act, you can no longer 
be discriminated against if you have a preexisting condition like 
cancer or diabetes. They were consumed with: Well, how do we end that 
and send that back to the States to do that? Thank goodness that bill 
hasn't been brought to the floor.

[[Page 6186]]

  Instead, here is an extension of running the government. Again, how 
small. Maybe it does match what is happening in the White House. With 
the flip-flopping, unfocused President, this Republican majority is 
having real trouble governing the country.
  I understand the President is consumed with an investigation of 
associates from his campaign over collusion with the Russians. He is 
consumed with conflicts of interest and how he doesn't want to be 
transparent, whether it is his tax returns or the emoluments under the 
Constitution.
  The American people deserve better, and that is what brought me to 
the floor today. I didn't have to come and talk about the rule that is 
on the floor.
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Mr. McGOVERN. I yield an additional 1 minute to the gentlewoman from 
Florida.
  Ms. CASTOR of Florida. Mr. Speaker, I didn't have to come to the 
floor to oppose a rule and this 1-week appropriations bill. But I am so 
frustrated, just like families and businesses are across this country, 
that this Congress still refuses to have the debates, have the 
discussion on the issues that really impact our families back home. 
They deserve better than this dysfunctional Republican majority. Why 
don't we stand up for them for a change?
  The Democrats are willing to have those debates. Let's debate and 
discuss jobs. Let's debate and discuss how kids can afford the cost of 
a college education. Let's discuss how we lift our public schools. 
Let's discuss rebuilding America and creating jobs through modern 
infrastructure investments. Let's have these debates.
  Let's not take up the time of the American people on a silly 1-week 
extension of funding government so we can do this again next week, 
where we have to debate and take up all the time on how we fund the 
government until September 30. American families deserve better.
  Mr. SESSIONS. Mr. Speaker, last night at the Rules Committee, we had 
a debate where we focused our attention not only on the legislation, 
but also on the need to get this done.
  I appreciate the gentlewoman from Florida (Ms. Castor), the gentleman 
from Oklahoma (Mr. Cole), and the gentleman from Massachusetts (Mr. 
McGovern) and their attention to the ideas that they have. They do have 
ideas, and they do have decisions that would help make this process 
even better. We are here today for the right reasons.
  I would advise the gentleman from Massachusetts (Mr. McGovern) that I 
do not have any further speakers, and I reserve the balance of my time 
pending his close.
  Mr. McGOVERN. Mr. Speaker, I yield myself the balance of my time to 
close.
  Mr. Speaker, I think it is clear that there is a lot of frustration 
on our side because of what is obviously a dysfunctional House. The 
fact that we are here again at the last minute trying to just keep the 
government running really is unfortunate. It is sad because it is not 
like we didn't know about this date. We have known about it for a long 
time.
  My Republicans friends set this date. They have had months and months 
to figure out a way to keep the government running. They, again, are in 
control of the House. They are in control of the Senate. They are in 
control of the White House. Once again, we have a manufactured crisis 
where we are right at the edge of a cliff, and the best we could do 
today is kick the can down the road for a week and we will have this 
little debate again next week.
  Perhaps if the leadership of this House actually focused on the 
people's business instead of on legislation that is about messaging or 
press releases, perhaps if they focused on the people's business rather 
than trying to undermine basic healthcare protections for people, we 
wouldn't have these crises all the time.
  I said at the beginning of my remarks that we can breathe a sigh of 
relief today because my friends on the Republican side are not bringing 
up their abysmal repeal and replace of the Affordable Care Act bill.

                              {time}  0945

  They have been changing it and changing it, and there was some rumor, 
President Trump was saying that they would probably bring a bill up to 
pass it in his first 100 days because somehow it is more important to 
do something in 100 days than it is to get it right. But, nonetheless, 
they added another provision which they claim makes it more palatable 
to their Members. But I want my colleagues to understand that what they 
have done is made a bad bill worse.
  The American College of Physicians sent us a letter to all Members, 
Democrats and Republicans, and I will just read one sentence from it. 
``This amendment'' that my Republican friends added to their healthcare 
bill ``would make the harmful AHCA even worse by creating new coverage 
barriers for patients with preexisting conditions and weakening 
requirements that insurers cover essential benefits.''
  I include in the Record the letter from the American College of 
Physicians.

                               American College of Physicians,

                                                   April 24, 2017.
     Hon. Paul Ryan,
     Speaker, House of Representatives,
     Washington, DC.
     Hon. Mitch McConnell,
     Majority Leader, U.S. Senate,
     Washington, DC.
     Hon. Nancy Pelosi,
     Minority Leader, House of Representatives,
     Washington, DC.
     Hon. Charles Schumer,
     Minority Leader, U.S. Senate,
     Washington, DC.
       Dear Speaker Ryan, Minority Leader Pelosi, Majority Leader 
     McConnell, and Minority Leader Schumer: On behalf of the 
     American College of Physicians (ACP), I am writing to urge 
     Congress to move away from the harmful changes to patient 
     care that would occur if the American Health Care Act (AHCA) 
     were to become law, and to instead work for bipartisan 
     solutions to improve the Affordable Care Act (ACA) rather 
     than repealing and replacing it. We believe that the AHCA, 
     which would repeal and replace the most important coverage 
     and consumer protections created by the ACA, is so 
     fundamentally flawed that it cannot be made acceptable. We 
     understand that the leadership in the House of 
     Representatives continues to explore ways to bring a modified 
     version of the AHCA to a vote, based on a draft amendment 
     reportedly being developed by Representatives MacArthur and 
     Meadows, a summary of which was made available to the public 
     through news organizations. This amendment would make the 
     harmful AHCA even worse by creating new coverage barriers for 
     patients with pre-existing conditions and weakening 
     requirements that insurers cover essential benefits.
       The American College of Physicians is the largest medical 
     specialty organization and the second-largest physician group 
     in the United States. ACP members include 148,000 internal 
     medicine physicians (internists), related subspecialists, and 
     medical students. Internal medicine physicians are 
     specialists who apply scientific knowledge and clinical 
     expertise to the diagnosis, treatment, and compassionate care 
     of adults across the spectrum from health to complex illness.
       The draft MacArthur-Meadows amendment would create what is 
     known as the ``Limited Waiver Option'' that would allow 
     states to eliminate or severely weaken vital ACA Title I 
     consumer protections--specifically, community rating and 
     essential health benefits (EHBs)--returning the country to 
     the pre-ACA days when persons with pre-existing 
     ``declinable'' medical conditions in most states were priced 
     out of the market and the insurance products available in the 
     individual market did not cover medically necessary services.
       Specifically;
       The MacArthur-Meadows amendment would create an option for 
     states to obtain Limited Waivers from certain federal 
     standards that would gut existing law consumer protections. 
     Based on a summary of the draft amendment, states could seek 
     Limited Waivers for:
       Essential Health Benefits (EHBs)
       Community-rating rules, except for the following 
     categories, which are not waivable: Gender or Age (except for 
     reductions of the 5:1 age ratio previously established) or 
     Health Status (unless the state has established a high-risk 
     pool or is participating in a federal high-risk pool)
       To obtain the waiver, states would only need to ``attest 
     that the purpose of their requested waiver is to reduce 
     premium costs,

[[Page 6187]]

     increase the number of persons with healthcare coverage, or 
     advance another benefit to the public interest in the state, 
     including the guarantee of coverage for persons with 
     preexisting medical conditions. The Secretary shall approve 
     applications within 90 days of determining that an 
     application is complete.'' [Emphasis added in italics].
       In other words, as long as a state attested that there was 
     a ``benefit to the public,'' insurers would be once again 
     allowed to charge more to people with pre-existing 
     conditions, or decline to cover needed benefits like 
     physician and hospital visits, maternity care and 
     contraception, mental health and substance use disorder 
     treatments, preventive services, and prescription drugs.
       This would take us back to the days when people had to fill 
     out intrusive insurance company applications to document 
     their previous health history, even before being advised what 
     the premium would be based on their individual health risk. 
     Unlike community rating, which bases premiums based on the 
     expected costs associated with all persons in the insurance 
     pool (adjusted only by age, tobacco use, and family size), 
     the Limited Waiver would again allow insurers in states that 
     obtain a waiver to again charge people exorbitant and 
     unaffordable premiums for their pre-existing conditions.
       Before the ACA, insurance plans sold in the individual 
     insurance market in all but five states typically maintained 
     lists of so-called ``declinable'' medical conditions--
     including asthma, diabetes, arthritis, obesity, stroke, or 
     pregnancy, or having been diagnosed with cancer in the past 
     10 years. Even if a revised bill would not explicitly repeal 
     the current law's guaranteed-issue requirement--which 
     requires insurers to offer coverage to persons with pre-
     existing conditions like these--guaranteed issue without 
     community rating allows insurers to charge as much as they 
     believe a patient's treatment will cost. The result would be 
     that many patients with pre-existing conditions would be 
     offered coverage that costs them thousands of dollars more 
     for the care that they need, and in the case of patients with 
     expensive conditions like cancer, even hundreds of thousands 
     more.
       An amendment to the AHCA reported out of the Rules 
     Committee on April 6th to establish a ``Federal Invisible 
     Risk Sharing Program,'' which would create a fund that states 
     could use to reimburse insurers for some of the costs 
     associated with insuring sicker patients, would not offset 
     the harm done to patients with pre-existing conditions by 
     allowing the Limited Waiver of community rating and essential 
     benefit protections. The pre-ACA experience with high-risk 
     pools was that many had long waiting lists, and offered 
     inadequate coverage with high deductibles and insufficient 
     benefits. Unless a national high-risk pool is supported with 
     a massive infusion of funding it will not be sufficient to 
     cover the millions of people with pre-existing conditions 
     that would be denied or charged more for coverage under the 
     AHCA. One paper estimates that a national high-risk pool 
     would cost $178.1 billion a year, roughly $176.4 billion more 
     than the annual funding provided to the Invisible Risk 
     Sharing Program. Also, shifting people out of the existing 
     health insurance marketplace to a high-risk pool would 
     undermine the assurance that enrollees could keep their 
     existing coverage.
       The Limited Waiver Option will also allow states to seek 
     waivers from the essential health benefits required of all 
     plans sold in the individual insurance market, with the 
     result that millions of patients will be at risk of losing 
     coverage for essential services like maternity care, cancer 
     screening tests and treatments, prescription drugs, 
     preventive services, mental health and substance use disorder 
     treatments, and even physician visits, prescription drugs and 
     hospitalizations.
       Prior to passage of the ACA, 62% of individual market 
     enrollees did not have coverage of maternity services, 34% 
     did not have substance-use disorder-services, 18% did not 
     have mental-health services and 9% did not have coverage for 
     prescription drugs. A recent independent analysis found that 
     the AHCA's repeal of current law required benefits would 
     result in patients on average paying $1,952 more for cancer 
     drugs; $1,807 for drugs for heart disease; $1,127 for drugs 
     to treat lung diseases; $1,607 for drugs to treat mental 
     illnesses; $4,940 for inpatient admission for mental health; 
     $4,555 for inpatient admission for substance use treatment; 
     and $8,501 for maternity care. Such increased costs would 
     make it practically impossible for many patients to avail 
     themselves of the care they need. The result will be delays 
     in getting treatment until their illnesses present at a more 
     advanced, less treatable, and more expensive stage, or not 
     keeping up with life-saving medications prescribed by their 
     physicians.
       Allowing states to eliminate the EHB will threaten our 
     nation's fight against the opioid epidemic. A study concluded 
     that with repeal of the ACA, ``approximately 1,253,000 people 
     with serious mental disorders and about 2.8 million Americans 
     with a substance use disorder, of whom about 222,000 have an 
     opioid disorder, would lose some or all of their insurance 
     coverage.'' Finally, allowing states to drop important 
     benefits like maternity, substance use disorder treatment, 
     and preventive services will do little to reduce premiums. A 
     report by Milliman found that the main drivers of premium 
     costs were ambulatory patient services, hospitalization, and 
     prescription drugs. These are crucial services that form the 
     core of any health insurance plan.
       To be clear: while some younger and healthier persons might 
     be offered lower premiums in states that obtained a ``Limited 
     Waiver'' of community-rating and essential health benefits, 
     it would be at the expense of making coverage unaffordable 
     for those who need it most, older and sicker persons, and 
     result in skimpy ``bare-bones'' insurance for many others 
     that does not cover the medical care they would need if and 
     when they get sick.
       Finally, even without the Limited Waiver Amendment, ACP 
     continues to believe that the AHCA has numerous other 
     provisions and policies that that will do great harm to 
     patients including:
       The phase-out of the higher federal match in states that 
     have opted to expand Medicaid and the ban on non-expansion 
     states being able to access the higher federal contribution 
     if they choose to expand Medicaid;
       Converting the shared federal-state financing structure for 
     Medicaid to one that would cap the federal contribution per 
     enrollee;
       Providing states with a Medicaid block grant financing 
     option;
       Eliminating EHBs for Medicaid expansion enrollees;
       Imposing work or job search requirements on certain 
     Medicaid enrollees;
       Regressive age-based tax credits, combined with changes 
     that will allow insurers to charge older people much higher 
     premiums than allowed under current law;
       Continuous coverage requirements for patients with pre-
     existing conditions;
       Legislative or regulatory restrictions that would deny or 
     result in discrimination in the awarding of federal grant 
     funds and/or Medicaid and Children's Health Insurance Program 
     funding to women's health clinics that are qualified under 
     existing federal law for the provision of evidence-based 
     services including, but not limited to, provision of 
     contraception, preventive health screenings, sexually 
     transmitted infection testing and treatment, vaccines, 
     counseling, rehabilitation, and referrals, and;
       Elimination of the Prevention and Public Health Fund, which 
     provides billions in dollars to the enters for Disease 
     Control and Prevention to prevent and control the spread of 
     infectious diseases.
       The College strongly believes in the first, do no harm 
     principle. Therefore, we continue to urge that Congress move 
     away from the fundamentally flawed and harmful policies that 
     would result from the American Health Care Act and from the 
     changes under consideration--including the proposed ``Limited 
     Waiver'' amendment--that would make the bill even worse for 
     patients. We urge Congress to instead start over and seek 
     agreement on bipartisan ways to improve and build on the ACA. 
     The College welcomes the opportunity to share our ideas for 
     bipartisan solutions that would help make health care better, 
     more accessible, and more affordable for patients rather than 
     imposing great harm on them as the AHCA would do.
           Sincerely,
                                              Jack Ende, MD, MACP,
                                                        President.

  Mr. McGOVERN. Mr. Speaker, we have a press release from the American 
Hospital Association. Their line here is: ``Our top concern is what 
this change could mean for older and sicker patients, including those 
with preexisting conditions such as cancer patients and those with 
chronic conditions'' could suffer. ``This amendment proposed this week 
would dramatically worsen the bill.''
  I include in the Record the American Hospital Association press 
release.

        [From the American Hospital Association--April 27, 2017]

               Statement on the American Health Care Act

  (By Rick Pollack, President and CEO, American Hospital Association)

       The latest version of the AHCA continues to put health 
     coverage in jeopardy for many Americans. Our top concern is 
     what this change could mean for older and sicker patients, 
     including those with pre-existing conditions, such as cancer 
     patients and those with chronic conditions. For these 
     reasons, along with our previously stated concerns about the 
     AHCA, we cannot support the bill. However, we urge Congress 
     to continue to work with stakeholders on a solution that 
     provides meaningful coverage.
       The amendment proposed this week would dramatically worsen 
     the bill. The changes included put consumer protections at 
     greater risk by allowing states to waive the essential health 
     benefit standards, which could leave patients without access 
     to critical health services and increase out-of-pocket 
     spending. This could allow plans to set premium prices based 
     on individual risk for some consumers, which could 
     significantly raise costs for those with pre-existing 
     conditions.

[[Page 6188]]

       Additionally, the Congressional Budget Office has not yet 
     scored the amendment. However, CBO previously projected that 
     the AHCA would result in 24 million fewer people covered in 
     2026. It is unlikely this amendment would improve these 
     coverage estimates.
       As the backbone of America's health safety-net, hospitals 
     and health systems must protect access to care for those who 
     need it and ensure that the most vulnerable patients are not 
     left behind. The AHCA continues to fall far short of that 
     goal.

  Mr. McGOVERN. Mr. Speaker, the AARP issued yet another statement 
saying: ``This harmful legislation still puts an age tax on older 
Americans and puts vulnerable populations at risk through a series of 
backdoor deals that attempts to shift responsibility to States.''
  I include in the Record the statement from the AARP.

            AARP Maintains Opposition to Amended Health Bill


  Age Tax, Weakening Medicare, Backdoor Cuts to Preexisting Condition 
                Population Would Harm American Families

       Washington, DC.--AARP Executive Vice President Nancy 
     LeaMond released the following statement today in response to 
     the amended House bill that would create an ``Age Tax,'' 
     increase premiums, eliminate protections for pre-existing 
     conditions, cut the life of Medicare, and give sweetheart 
     deals to big drug and insurance companies. In a letter sent 
     to all 435 members of the U.S. House of Representatives, AARP 
     restated its strong opposition to the bill and urged each 
     Representative to vote `No' on the proposed legislation. AARP 
     believes this legislation will have a significant harmful 
     impact on the health of millions of older Americans ages 50 
     to 64, as well as other vulnerable groups, including poor 
     seniors and disabled children and adults:
       ``This harmful legislation still puts an Age Tax on older 
     Americans and puts vulnerable populations at risk through a 
     series of backdoor deals that attempts to shift 
     responsibility to states. Older Americans need affordable 
     health care services and prescriptions. This legislation 
     still goes in the opposite direction, increasing insurance 
     premiums for older Americans and not doing anything to lower 
     drug costs.
       ``AARP continues to oppose legislation that would impose an 
     Age Tax, eliminate protections for preexisting conditions, 
     weaken Medicare, erode seniors' ability to live independently 
     because of billions of dollars in Medicaid cuts, and give 
     sweetheart deals to drug and insurance companies while doing 
     nothing to lower the cost of health care or prescription 
     drugs.
       ``We intend to let all 38 million of our members know 
     exactly how their Representative votes on this bill in 
     newsletters, in our publications, on social media and in 
     other formats. Our members care deeply about their health 
     care and have told us repeatedly that they want to know where 
     their elected officials stand.''
       Past statements and releases about this bill can be found 
     here, here, here, and here. Public policy fact sheets about 
     the Age Tax and other harmful policies can be found here. 
     AARP's full letter to the House of Representatives can be 
     found below:

                                                   April 26, 2017.
       Dear Representative: AARP, with its nearly 38 million 
     members in all 50 States and the District of Columbia, Puerto 
     Rico, and U.S. Virgin Islands, is a nonpartisan, nonprofit, 
     nationwide organization that helps people turn their goals 
     and dreams into real possibilities, strengthens communities 
     and fights for the issues that matter most to consumers and 
     families such as healthcare, employment and income security, 
     retirement planning, affordable utilities and protection from 
     financial abuse.
       We write to again share our opposition to the pending 
     American Health Care Act (AHCA) and urge you to vote NO. 
     Throughout consideration of the AHCA, we have been expressing 
     serious concerns about the impact that this legislation will 
     have on older Americans. The Congressional Budget Office 
     (CBO)'s last estimate further demonstrates the harmful impact 
     of this bill on older Americans and some of our most 
     vulnerable. Specifically, we are concerned that the American 
     Health Care Act will weaken the fiscal sustainability of 
     Medicare; dramatically increase premium and out-of-pocket 
     costs for 50-64 year olds purchasing coverage on the 
     individual insurance market; substantially increase the 
     number of Americans without insurance; and put at risk 
     millions of children and adults with disabilities and poor 
     seniors who depend on the Medicaid program to access long-
     term services and supports and other benefits. In addition, 
     changes under consideration that would allow states to waive 
     important consumer protections--such as allowing insurance 
     companies to once again charge Americans with pre-existing 
     conditions more because they've had cancer, diabetes or heart 
     disease--would make this bad bill even worse.
       Our members and others 50 years of age and older care 
     deeply about health care and want to know where their elected 
     leaders stand. Recognizing the importance of the upcoming 
     vote on the American Health Care Act, AARP intends to inform 
     our members, and others over age 50, how their elected 
     officials voted. We'll communicate the results of the vote in 
     our widely-circulated publications, in email alerts, in our 
     online channels, and through the media. Again, we urge all 
     Representatives to vote NO on the American Health Care Act in 
     its current form.


                                Medicare

       Our members and older Americans believe that Medicare must 
     be protected and strengthened for today's seniors and future 
     generations. We strongly oppose any changes to current law 
     that could result in cuts to benefits, increased costs, or 
     reduced coverage for older Americans. According to the 2016 
     Medicare Trustees report, the Medicare Part A Trust Fund is 
     solvent until 2028 (11 years longer than pre-Affordable Care 
     Act (ACA)), due in large part to changes made in the ACA. We 
     have serious concerns that the American Health Care Act 
     repeals provisions in current law that have strengthened 
     Medicare's fiscal outlook, specifically, the repeal of the 
     additional 0.9 percent payroll tax on higher-income workers. 
     Repealing this provision would remove $117.3 billion from the 
     Hospital Insurance trust fund over the next ten years, would 
     hasten the insolvency of Medicare by up to four years, and 
     diminish Medicare's ability to pay for services in the 
     future.


                           Prescription Drugs

       Older Americans use prescription drugs more than any other 
     segment of the U.S. population, typically on a chronic basis. 
     We are pleased that the bill maintains the Medicare Part D 
     coverage gap (``donut hole'') protections created under the 
     ACA. Since the enactment of the law, more than 11.8 million 
     Medicare beneficiaries who have fallen into the coverage gap 
     have saved over $26.8 billion on the improved coverage for 
     prescription drug costs due to closure of the donut hole. We 
     do have strong concerns that the fee on manufacturers and 
     importers of branded prescription drugs, which currently is 
     projected to add $24.8 billion to the Medicare Part B trust 
     fund between 2017 and 2026, will be repealed by the American 
     Health Care Act. Rather than repeal this fee for Medicare, 
     AARP believes Congress must do more to reduce the burden of 
     high prescription drug costs on consumers and taxpayers, and 
     we would be willing to work with you on bipartisan solutions.


                  Individual Private Insurance Market

       About 6.1 million Americans age 50-64 currently purchase 
     insurance in the non-group market, and nearly 3.2 million are 
     currently eligible to receive subsidies for health insurance 
     coverage through either the federal health benefits exchange 
     or a state-based exchange (exchange). We have seen a 
     significant reduction in the number of uninsured since 
     passage of the ACA, with the number of 50-64 year old 
     Americans who are uninsured dropping by half. We are deeply 
     concerned that the AHCA would be a significant step backwards 
     and result in millions of older Americans who cannot afford 
     their health care, including many simply losing their health 
     care.
       Based on CBO estimates, approximately 14 million Americans 
     will lose coverage next year, while a total of 24 million 
     Americans would lose coverage over the next 10 years. This is 
     especially troubling given that in the CBO and Joint 
     Committee on Taxation's (JCT) assessment ``the non-group 
     (individual) market would probably be stable in most areas . 
     . . under current law.''
       Affordability of both premiums and cost-sharing is critical 
     to older Americans and their ability to obtain and access 
     health care. A typical 50-64 year old seeking coverage 
     through an exchange has a median annual income of under 
     $25,000 and already pays significant out-of-pocket costs for 
     health care. We have serious concerns--reinforced by the CBO 
     estimate--that the bill under consideration will dramatically 
     increase health care costs for 50-64 year olds who purchase 
     health care through an exchange due both to the changes in 
     age rating from 3:1 (already a compromise that requires 
     uninsured older Americans to pay three times more than 
     younger individuals) to 5:1 and reductions in current tax 
     credits for older Americans. CBO concluded that the bill will 
     substantially raise premiums for older people and force many 
     into lower quality plans.
       Age rating plus reduced tax credits equal an unaffordable 
     age tax. Our previous estimates on the age-rating change 
     showed that premiums for current coverage could increase by 
     up to $3,200 for a 64 year old, while reducing premiums by 
     only about $700 for a younger enrollee. Significant premium 
     increases for older consumers will make insurance less 
     affordable, will not address their expressed concern about 
     rising premiums, and only encourage a small increase in the 
     enrollment numbers for younger persons.
       In addition to increasing premiums from the age rating 
     change, the bill reduced the tax credits available for older 
     Americans to help purchase insurance. We estimate that the 
     bill's changes to current law's tax credits alone could 
     increase premium costs for a 55-year old earning $25,000 by 
     more than $2,300 a year. For a 64-year old earning $25,000, 
     that

[[Page 6189]]

     increased premium rises to more than $4,400 a year, and more 
     than $5,800 for a 64-year old earning $15,000.
       Overall, both the bill's tax credit changes and 5:1 age 
     rating would result in skyrocketing cost increases for older 
     Americans. In their analysis, CBO found that a 64 year old 
     earning $26,500 a year would see their premiums increase by 
     $12,900--758 percent--from $1,700 to $14,600 a year. In 
     addition, older workers could also face higher out-of-pocket 
     costs because the bill eliminates cost-sharing subsidies 
     which help lower-income Americans with their co-pays and 
     deductibles. It cannot be overstated how much this bill would 
     erase recent gains in health care coverage and affordability 
     for 50-64 year olds, leading to large spikes in the number of 
     uninsured and financial hardship for millions of older 
     Americans.
       Current law prohibits insurance companies from 
     discriminating against individuals due to a preexisting 
     condition. We are extremely concerned that the bill may now 
     repeal pre-existing condition protections and would once 
     again allow insurance companies to charge Americans more due 
     to a pre-existing condition. We estimate that 40 percent of 
     50- to 64-year-olds (or about 25 million people in this age 
     group) have a deniable pre-existing condition and risk losing 
     access to affordable coverage. We strongly oppose any 
     weakening of the law's pre-existing condition protections 
     which benefit millions of Americans.


              Medicaid and Long-Term Services and Supports

       AARP opposes the provisions of the American Health Care Act 
     that create a per capita cap financing structure in the 
     Medicaid program. We are concerned that these provisions 
     could endanger the health, safety, and care of millions of 
     individuals who depend on the essential services provided 
     through Medicaid. CBO found that the bill would cut Medicaid 
     funding by $880 billion over 2017-2026. By 2026, CBO expects 
     Medicaid spending to be about 25 percent less than what it 
     projects under current law. Medicaid is a vital safety net 
     and intergenerational lifeline for millions of individuals, 
     including over 17.4 million low-income seniors and children 
     and adults with disabilities who rely on the program for 
     critical health care and long-term services and supports 
     (LTSS, i.e., assistance with daily activities such as eating, 
     bathing, dressing, managing medications, and transportation). 
     Older adults and people with disabilities now account for 
     over sixty percent of Medicaid spending, and cuts of this 
     magnitude will result in loss of benefits and services for 
     this vulnerable population.
       Of these 17.4 million individuals: 6.9 million are ages 65 
     and older (which equals more than 1 in every 7 elderly 
     Medicare beneficiaries); 10.5 million are children and adults 
     living with disabilities; and about 10.8 million are so poor 
     or have a disability that they qualify for both Medicare and 
     Medicaid (dual eligibles). Dual eligibles account for almost 
     33 percent of Medicaid spending. While they comprise a 
     relatively small percentage of enrollees, they account for a 
     disproportionate share of total Medicare and Medicaid 
     spending.
       Individuals with disabilities of all ages and older adults 
     rely on critical Medicaid services, including home and 
     community-based services (HCBS) for assistance with daily 
     activities such as eating, bathing, dressing, and home 
     modifications; nursing home care; and other benefits such as 
     hearing aids and eyeglasses. People with disabilities of all 
     ages also rely on Medicaid for access to comprehensive acute 
     health care services. For working adults, Medicaid can help 
     them continue to work; for children, it allows them to stay 
     with their families and receive the help they need at home or 
     in their community. Individuals may have low incomes, face 
     high medical costs, or have already spent through their 
     resources paying out-of-pocket for LTSS, and need these 
     critical services. For these individuals, Medicaid is a 
     program of last resort.
       In providing a fixed amount of federal funding per person, 
     this approach to financing would likely result in 
     overwhelming cost shifts to states, state taxpayers, and 
     families unable to shoulder the costs of care without 
     sufficient federal support. This would result in cuts to 
     program eligibility, services, or both--ultimately harming 
     some of our nation's most vulnerable citizens. In terms of 
     seniors, we have serious concerns about setting caps at a 
     time when per-beneficiary spending for poor seniors is likely 
     to increase in future years. By 2026, when Boomers start to 
     turn age 80 and older, they will likely need much higher 
     levels of service--including HCBS and nursing home--moving 
     them into the highest cost group of all seniors. As this 
     group continues to age, their level of need will increase as 
     well as their overall costs. We are also concerned that caps 
     will not accurately reflect the cost of care for individuals 
     in each state, including for children and adults with 
     disabilities and seniors, especially those living with the 
     most severe disabling conditions. CBO estimates that Medicaid 
     spending on a per-enrollee basis would grow at a faster rate 
     than the consumer price index for medical care services (CPI-
     M)--3.7 percent for CPI-M versus an average annual growth 
     rate of 4.4 percent for Medicaid over the 2017-2026 period. 
     Over time, the difference in the growth rate under the per 
     capita cap (CPI-M) and the actual cost of care would further 
     shift costs to states, which could result in even greater 
     potential harm to some of the most vulnerable individuals.
       AARP is also opposed to the repeal of the six percent 
     enhanced federal Medicaid match for states that take up the 
     Community First Choice (CFC) Option. CFC provides states with 
     a financial incentive to offer HCBS to help older adults and 
     people with disabilities live in their homes and communities 
     where they want to be. About 90 percent of older adults want 
     to remain in their own homes and communities for as long as 
     possible. HCBS are also cost effective. On average, in 
     Medicaid, the cost of HCBS per person is one-third the cost 
     of institutional care. Taking away the enhanced match could 
     disrupt services for older adults and people with 
     disabilities in the states that are already providing 
     services under CFC and would result in a loss of about $12 
     billion for HCBS over ten years.
       AARP also has concerns with the removal of the state option 
     in Medicaid to increase the home equity limit above the 
     federal minimum. This provision would take away flexibility 
     for states to adjust a Medicaid eligibility criterion based 
     on the specific circumstances of each state and its residents 
     beyond a federal minimum standard. AARP continues to support 
     critical consumer protections included in current law, 
     including guaranteed issue, prohibitions on preexisting 
     condition exclusions, bans on annual and lifetime coverage 
     limits and allowing families to keep children on their 
     policies until the age of 26. Also, AARP continues to support 
     restoring the 7.5 percent threshold for the medical expense 
     deduction which will directly help older Americans struggling 
     to pay for health care, particularly the high cost of nursing 
     homes and other long-term services and supports.
       We look forward to working with you to ensure that we 
     maintain a strong health care system that ensures robust 
     insurance market protections, controls costs, improves 
     quality, and provides affordable coverage to all Americans.
           Sincerely,

                                             Nancy A. LeaMond,

                                      Executive Vice President and
                            Chief Advocacy and Engagement Officer.

  Mr. McGOVERN. Mr. Speaker, the American Medical Association sent 
letters to Speaker Ryan and Minority Leader Pelosi saying that ``We are 
deeply concerned that the AHCA would result in millions of Americans 
losing their current health insurance coverage. Nothing in the'' so-
called ``MacArthur amendment remedies the shortcomings of the 
underlying bill.''
  And then they say that, basically, this addition that the Republicans 
added to the healthcare bill ``could effectively make coverage 
completely unaffordable for people with preexisting conditions.''
  I include in the Record the letter from the American Medical 
Association.

                                 American Medical Association,

                                      Chicago, IL, April 27, 2017.
     Hon. Paul Ryan,
     Speaker, House of Representatives,
     Washington, DC.
     Hon. Nancy Pelosi,
     Democratic Leader, House of Representatives,
     Washington, DC.
       Dear Speaker Ryan and Leader Pelosi: After reviewing the 
     MacArthur Amendment to H.R. 1628, the American Health Care 
     Act (AHCA), the American Medical Association (AMA) remains 
     opposed to passage of this legislation. As we have previously 
     stated, we are deeply concerned that the AHCA would result in 
     millions of Americans losing their current health insurance 
     coverage. Nothing in the MacArthur amendment remedies the 
     shortcomings of the underlying bill. The amendment does not 
     offer a clear long-term framework for stabilizing and 
     strengthening the individual health insurance market to 
     ensure that low and moderate income patients are able to 
     secure affordable and adequate coverage, nor does it ensure 
     that Medicaid and other critical safety net programs are 
     maintained and adequately funded.
       The MacArthur Amendment would allow states to apply for 
     waivers from critical consumer protections provided in the 
     Affordable Care Act (ACA), including the age rating ratio of 
     3 to 1, the requirements that health insurers must cover 
     certain essential health benefits, and the ban on health 
     status underwriting. The current ban on health status 
     underwriting protects individuals from being discriminated 
     against by virtue of their medical conditions. Prior to the 
     passage of the ACA, such individuals were routinely denied 
     coverage and/or priced out of affordable coverage. We are 
     particularly concerned about allowing states to waive this 
     requirement because it will likely lead to patients losing 
     their coverage. Although the MacArthur Amendment states that 
     the ban on preexisting conditions remains intact, this 
     assurance may be illusory as health status underwriting could 
     effectively make coverage completely unaffordable to people 
     with preexisting conditions. There is also no certainty that 
     the requirement for states to

[[Page 6190]]

     have some kind of reinsurance or high-risk pool mechanism to 
     help such individuals will be sufficient to provide for 
     affordable health insurance or prevent discrimination against 
     individuals with certain high-cost medical conditions.
       We continue to strongly urge Congress to engage in a 
     bipartisan, bicameral dialogue with stakeholders to work on 
     policies that enhance coverage, choice, and affordability.
           Sincerely,
                                              James L. Madara, MD.

  Mr. McGOVERN. Mr. Speaker, I find all this particularly puzzling 
because my friends have said over and over and over and over again that 
they agree with Democrats when it comes to protecting people with 
preexisting conditions. They said that they do not want insurance 
companies to have the ability to discriminate against people with 
preexisting conditions. And yet what they have done is they have 
created a repeal-and-replacement bill that does just that and then goes 
after essential benefits.
  Again, we have been talking about essential benefits over and over 
and over again. And again, I want to remind my colleagues what the word 
``essential'' means. Go to the dictionary. Look up the word 
``essential.'' It says, absolutely necessary, extremely important. That 
is the definition of essential. And so when we talk about essential 
health benefits, that is what we are talking about.
  I have one additional speaker. I was going to close, but I would ask 
indulgence.
  Mr. Speaker, I yield 2 minutes to the gentlewoman from Texas (Ms. 
Jackson Lee).
  Ms. JACKSON LEE. Mr. Speaker, as the gentleman from Massachusetts was 
speaking, I rushed to the floor because he was making such eloquent and 
important statements, and I wanted to make sure to join him on 
recognizing that, though we are pushing the can down the road, we know 
what the mindset of the administration is in terms of funding this 
country. As a member of the Budget Committee, we received the skinny 
budget, and, to my dismay, it was a budget that harmed and hurt and 
undermined the governance of this Nation.
  I think it is important to match the Affordable Care Act with the 
outside needs of living and thriving in this Nation. So my Houston 
Housing Authority has now stopped vouchers for families in Section 8 
housing for fear of not having the money. They had breaking news 2 days 
ago telling those families, don't show up because we have no money to 
house you--similar to no money and no room at the inn.
  The zeroing out of the community development dollars, which ends our 
opportunities for parks and sidewalks and housing and fixing those 
hurricane roofs of senior citizens who are living in devastation from 
Hurricane Ike.
  It is not realizing the importance of the National Endowment for the 
Arts or recognizing the EPA and clean air and clean water for those of 
us who live near the Gulf or near the border.
  It is not recognizing that you are not the President of the 10 
percent that may approve of what you are doing, but you are the 
President of the United States of America.
  And then, for those who work in health care, in a meeting I just had 
with the National Institutes of Health, $6 billion cut. Do you realize 
that one of the institutes sends 88 percent of their moneys out for 
grants so that researchers, young scientists who live here in the 
United States, can thrive and provide new kinds of research?
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Mr. McGOVERN. I yield the gentlewoman from Texas an additional 1 
minute.
  Ms. JACKSON LEE. There are 27 institutes in the National Institutes 
of Health. One of them happens to deal with diabetes. The number one is 
cancer. And for those of us who have experienced it, and for African-
American women and others who have the triple negative trait, breast 
cancer, the research of the NIH is crucial.
  Or Dr. Fauci's National Institute of Allergy and Infectious Diseases. 
Dr. Peter Hotez, in Houston, head of Baylor Infectious Diseases, 
understands Ebola and Zika. We need these resources. What an outrage to 
cut, in the skinny budget, $6 billion.
  So we may push this to another 7 days, but I can tell you that we are 
pushing the hearts and minds of Americans. We are creating a disaster.
  And I can't appreciate the fact that law enforcement will be losing 
funding. The Department of Justice and the Civil Rights Division, in 
spite of who is leading that Department, it is a Department for the 
vulnerable.
  So I thank the gentleman for providing me with this time, but I 
wanted to make sure that we added this long litany of those who will be 
negatively impacted and that America is not about that. America is 
about serving all of the people of the United States.
  Mr. McGOVERN. Mr. Speaker, I yield myself such time as I may consume.
  I thank the gentlewoman for her remarks. I thank the chairman of the 
Rules Committee for his indulgence.
  I would just close by saying I think it is sad that we are here at 
the last minute trying to kick the can down the road to keep the 
government running again for 1 additional week. This could have been 
avoided and, again, it could have been avoided if, instead of trying to 
take away people's health insurance, instead of trying to take away 
people's essential health benefits, instead of trying to cut Medicaid 
by $800 billion and taking that money and giving a tax break of close 
to $1 trillion to the richest people in the country, that we actually 
focused on our job, which is keeping this government running.
  But my colleagues on the Republican side are in charge. We are where 
we are. We have to keep the government running.
  Having said all of that, I yield back the balance of my time.
  Mr. SESSIONS. Mr. Speaker, I yield myself such time as I may consume.
  I want to thank the gentleman from Massachusetts. I want to thank the 
gentlewoman from Florida and the gentlewoman from Texas for their 
comments about trying to focus us on the activities that perhaps they 
would want or not want.
  Mr. Speaker, today we are here because Chairman Frelinghuysen and 
Ranking Member Lowey came to the Rules Committee yesterday and asked us 
to please consider the offer that they were laying on the table, and 
that is to fund the government for 1 more week, with an assurance that 
they needed 1 more week to complete their work.
  You heard the gentleman, the Honorable Tom Cole, distinguished 
gentleman from not only Oklahoma, but a gentleman from the 
Appropriations Committee, reinforce how important the work is.
  We have heard from our colleagues on the Democratic side how 
important the NIH is, Francis Collins, the work that he does there; the 
United States Military; Secretary of Defense Mattis; the men and women 
that protect us; those people that are in Homeland Security. That is 
what we are going to do, so that is what we are going to focus on, and 
that is just the way it is.
  So, Mr. Speaker, I would urge all my colleagues to support this rule 
and the underlying legislation.
  I yield back the balance of my time, and I move the previous question 
on the resolution.
  The previous question was ordered.
  The SPEAKER pro tempore. The question is on the resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. SESSIONS. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The vote was taken by electronic device, and there were--yeas 235, 
nays 178, not voting 17, as follows:

                             [Roll No. 235]

                               YEAS--235

     Abraham
     Aderholt
     Allen
     Amash
     Amodei
     Arrington
     Babin
     Bacon
     Banks (IN)
     Barletta
     Barr
     Barton
     Bergman
     Biggs
     Bilirakis
     Bishop (MI)
     Bishop (UT)
     Black
     Blackburn
     Blum
     Bost
     Brady (TX)
     Bridenstine
     Brooks (AL)
     Brooks (IN)
     Buck
     Bucshon
     Budd
     Burgess
     Byrne
     Calvert
     Carter (GA)
     Carter (TX)
     Chabot
     Cheney
     Coffman
     Cole
     Collins (GA)
     Collins (NY)
     Comer
     Comstock
     Conaway
     Cook
     Costa
     Costello (PA)
     Cramer
     Crawford
     Crist

[[Page 6191]]


     Culberson
     Curbelo (FL)
     Davidson
     Davis, Rodney
     Denham
     Dent
     DeSantis
     DesJarlais
     Diaz-Balart
     Donovan
     Duffy
     Duncan (SC)
     Duncan (TN)
     Dunn
     Emmer
     Estes (KS)
     Farenthold
     Faso
     Ferguson
     Fitzpatrick
     Fleischmann
     Flores
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gaetz
     Gallagher
     Garrett
     Gibbs
     Gohmert
     Goodlatte
     Gosar
     Gottheimer
     Gowdy
     Granger
     Graves (GA)
     Graves (LA)
     Graves (MO)
     Griffith
     Grothman
     Guthrie
     Harper
     Harris
     Hartzler
     Hensarling
     Herrera Beutler
     Hice, Jody B.
     Higgins (LA)
     Hill
     Holding
     Hollingsworth
     Huizenga
     Hultgren
     Hunter
     Hurd
     Issa
     Jenkins (KS)
     Jenkins (WV)
     Johnson (LA)
     Johnson (OH)
     Johnson, Sam
     Jones
     Jordan
     Joyce (OH)
     Katko
     Kelly (MS)
     Kelly (PA)
     King (IA)
     Kinzinger
     Knight
     Kustoff (TN)
     LaHood
     LaMalfa
     Lamborn
     Lance
     Latta
     Lawson (FL)
     Lewis (MN)
     LoBiondo
     Long
     Loudermilk
     Love
     Lucas
     Luetkemeyer
     MacArthur
     Marshall
     Massie
     Mast
     McCarthy
     McCaul
     McClintock
     McHenry
     McKinley
     McMorris Rodgers
     McSally
     Meadows
     Meehan
     Messer
     Mitchell
     Moolenaar
     Mooney (WV)
     Mullin
     Murphy (PA)
     Noem
     Nunes
     O'Halleran
     Palazzo
     Palmer
     Paulsen
     Pearce
     Perry
     Peters
     Pittenger
     Poe (TX)
     Poliquin
     Posey
     Ratcliffe
     Reed
     Reichert
     Renacci
     Rice (SC)
     Roby
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rohrabacher
     Rokita
     Rooney, Francis
     Rooney, Thomas J.
     Ros-Lehtinen
     Rosen
     Roskam
     Ross
     Rothfus
     Royce (CA)
     Russell
     Rutherford
     Sanford
     Scalise
     Schneider
     Schweikert
     Scott, Austin
     Sensenbrenner
     Sessions
     Shimkus
     Shuster
     Simpson
     Sinema
     Smith (MO)
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Smucker
     Stefanik
     Stewart
     Stivers
     Suozzi
     Taylor
     Tenney
     Thompson (PA)
     Thornberry
     Tiberi
     Tipton
     Trott
     Turner
     Upton
     Valadao
     Wagner
     Walberg
     Walden
     Walker
     Walorski
     Walters, Mimi
     Weber (TX)
     Webster (FL)
     Wenstrup
     Westerman
     Williams
     Wilson (SC)
     Wittman
     Womack
     Woodall
     Yoder
     Yoho
     Young (IA)
     Zeldin

                               NAYS--178

     Adams
     Aguilar
     Barragan
     Bass
     Beatty
     Bera
     Beyer
     Bishop (GA)
     Blumenauer
     Blunt Rochester
     Bonamici
     Boyle, Brendan F.
     Brady (PA)
     Brown (MD)
     Brownley (CA)
     Bustos
     Butterfield
     Capuano
     Carbajal
     Cardenas
     Carson (IN)
     Cartwright
     Castor (FL)
     Castro (TX)
     Chu, Judy
     Cicilline
     Clark (MA)
     Clarke (NY)
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly
     Conyers
     Cooper
     Correa
     Courtney
     Crowley
     Cuellar
     Cummings
     Davis (CA)
     Davis, Danny
     DeFazio
     DeGette
     Delaney
     DeLauro
     DelBene
     Demings
     DeSaulnier
     Deutch
     Dingell
     Doggett
     Doyle, Michael F.
     Ellison
     Engel
     Eshoo
     Espaillat
     Esty (CT)
     Evans
     Foster
     Frankel (FL)
     Fudge
     Gabbard
     Gallego
     Garamendi
     Gonzalez (TX)
     Green, Al
     Green, Gene
     Gutierrez
     Hanabusa
     Hastings
     Heck
     Higgins (NY)
     Himes
     Hoyer
     Huffman
     Jackson Lee
     Jayapal
     Jeffries
     Johnson (GA)
     Johnson, E. B.
     Kaptur
     Keating
     Kelly (IL)
     Kennedy
     Khanna
     Kihuen
     Kildee
     Kilmer
     Kind
     Krishnamoorthi
     Kuster (NH)
     Langevin
     Larsen (WA)
     Lawrence
     Lee
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren
     Lowenthal
     Lowey
     Lujan Grisham, M.
     Lujan, Ben Ray
     Lynch
     Maloney, Carolyn B.
     Maloney, Sean
     Matsui
     McCollum
     McEachin
     McGovern
     McNerney
     Meeks
     Meng
     Moore
     Moulton
     Murphy (FL)
     Nadler
     Napolitano
     Neal
     Nolan
     Norcross
     O'Rourke
     Pallone
     Panetta
     Pascrell
     Payne
     Pelosi
     Perlmutter
     Peterson
     Pingree
     Pocan
     Polis
     Price (NC)
     Quigley
     Raskin
     Rice (NY)
     Richmond
     Roybal-Allard
     Ruiz
     Ruppersberger
     Rush
     Ryan (OH)
     Sarbanes
     Schakowsky
     Schiff
     Schrader
     Scott (VA)
     Scott, David
     Serrano
     Sewell (AL)
     Shea-Porter
     Sherman
     Sires
     Smith (WA)
     Soto
     Speier
     Swalwell (CA)
     Takano
     Thompson (CA)
     Thompson (MS)
     Titus
     Tonko
     Torres
     Tsongas
     Vargas
     Veasey
     Vela
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters, Maxine
     Watson Coleman
     Welch
     Wilson (FL)
     Yarmuth

                             NOT VOTING--17

     Brat
     Buchanan
     Chaffetz
     Grijalva
     Hudson
     King (NY)
     Labrador
     Larson (CT)
     Lieu, Ted
     Marchant
     Marino
     Newhouse
     Olson
     Rouzer
     Sanchez
     Slaughter
     Young (AK)

                              {time}  1021

  Mr. LEVIN changed his vote from ``yea'' to ``nay.''
  Mr. KATKO and Ms. ROSEN changed their vote from ``nay'' to ``yea.''
  So the resolution was agreed to.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.
  Mr. FRELINGHUYSEN. Mr. Speaker, pursuant to House Resolution 289, I 
call up the joint resolution (H.J. Res. 99) making further continuing 
appropriations for fiscal year 2017, and for other purposes, and ask 
for its immediate consideration.
  The Clerk read the title of the joint resolution.
  The SPEAKER pro tempore. Pursuant to House Resolution 289, the joint 
resolution is considered read.
  The text of the joint resolution is as follows:

                              H.J. Res. 99

       Resolved by the Senate and House of Representatives of the 
     United States of America in Congress assembled, That the 
     Continuing Appropriations Act, 2017 (division C of Public Law 
     114-223) is further amended by--
       (1) striking the date specified in section 106(3) and 
     inserting ``May 5, 2017''; and
       (2) inserting after section 201 the following new section:
       ``Sec. 202. (a) This section may be cited as the `Further 
     Continued Health Benefits for Miners Act'.
       ``(b) Section 402(h)(2)(C)(ii) of the Surface Mining 
     Control and Reclamation Act of 1977 (30 U.S.C. 
     1232(h)(2)(C)(ii)) is amended--
       ``(1) in subclause (II), by striking `April 30, 2017' and 
     inserting `May 5, 2017';
       ``(2) in subclause (II)(aa), by striking `the Continued 
     Health Benefits for Miners Act' and inserting `the Further 
     Continued Health Benefits for Miners Act'; and
       ``(3) by adding at the end the following: `For purposes of 
     subclause (II)(aa), a beneficiary enrolled in the Plan as of 
     the date of the enactment of the Further Continued Health 
     Benefits for Miners Act shall be deemed to have been eligible 
     to receive health benefits under the Plan on January 1, 
     2017.'.
       ``(c) The provisions of section 167(d) of Public Law 114-
     223 (as added by Public Law 114-254) shall apply to this 
     section.''.

  The SPEAKER pro tempore. The gentleman from New Jersey (Mr. 
Frelinghuysen) and the gentlewoman from New York (Mrs. Lowey) each will 
control 30 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. FRELINGHUYSEN. 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 on H.J. Res. 99.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. FRELINGHUYSEN. Mr. Speaker, I yield myself such time as I may 
consume.
  I rise today to present H.J. Res. 99, a short-term continuing 
resolution that will keep our government open for an additional week 
while work is completed on a full-year funding package.
  First, I would like to thank Ranking Member Lowey for her efforts on 
this bill and, more broadly, on her valuable participation in the 
appropriations process over many years.
  Our current continuing resolution expires today at midnight. Working 
together with the Senate, our leadership, and the White House, we are 
on track to have a full-year, fiscal year 2017 appropriations 
legislation completed soon, but we need a little more time to process 
it and prepare it for the floor.
  This resolution will ensure that the government stays open for 
another week, until May 5, 2017, to give Congress additional time. It 
extends current funding levels for essential government operations that 
the American people rely on, including, most importantly, our national 
defense.
  It continues all policy and funding provisions in the currently 
enacted continuing resolution. In addition, it includes an extension of 
the December CR provision for healthcare benefits for retired coal 
miners and their dependents for the length of the continuing 
resolution.
  Congress must pass this legislation today to keep the government open 
and operating as we wrap up our full-year fiscal year 2017 work. It is 
our constitutional duty and responsibility.
  A continuing resolution is never anyone's first choice for funding 
the government; however, this is our best path forward. This CR is very 
short term, very limited in scope, and will help us

[[Page 6192]]

complete our important work of funding the government for the rest of 
fiscal year 2017.
  Mr. Speaker, I urge my colleagues to support the legislation, and I 
reserve the balance of my time.
  Mrs. LOWEY. Mr. Speaker, I yield myself such time as I may consume.
  At the outset, I want to thank Chairman Frelinghuysen. It has been a 
pleasure for me to work with him. I am cautiously optimistic that we 
will complete this process. Although overdue, we will get our work 
done.
  This is the third continuing resolution during fiscal year 2017. We 
should be voting today on a bipartisan omnibus appropriations act, not 
another stopgap bill to keep the government running. After all, we are 
7 months into the fiscal year.
  Federal departments and agencies have been operating on outdated 
funding levels and policies for more than half of the year. This is 
unacceptable, and it cannot continue. Assuming we get to a solution 
that lasts the remainder of the fiscal year, I do hope Chairman 
Frelinghuysen will help avoid this outcome in the future.
  The continuing resolution we are considering today is a simple date 
change to continue government funding through next Friday and to extend 
health insurance for miners through the same day.
  The backdrop of this continuing resolution is ongoing negotiations on 
an omnibus appropriations act. Democrats continue to work in good faith 
to develop a bipartisan omnibus that provides sufficient funding for 
critical priorities and rejects divisive poison pill riders. For many 
months, Democrats have been clear that we will not help pass an omnibus 
that fails to meet these basic standards, and that remains the case.
  As if this process weren't difficult enough, it occurs as the 
majority is seeking to strip health insurance from 20 million Americans 
and repeal protections against insurance company discrimination for 
millions more. Meanwhile, President Trump continues to tweet false and 
damaging comments about the omnibus negotiations.
  It is my hope that these games will end so that we can come together 
to support investments that create jobs, improve infrastructure, 
provide a quality education for every student, and invest in technology 
and biomedical research that will benefit hardworking Americans.
  To achieve this, we must make progress on eliminating poison pill 
riders and advancing shared priorities in an omnibus appropriations 
act. Next week, we must not consider a fourth continuing resolution, 
but instead have a positive, bipartisan bill after this unnecessarily 
lengthy process.
  Mr. Speaker, I reserve the balance of my time.

                              {time}  1030

  Mr. FRELINGHUYSEN. Mr. Speaker, I reserve the balance of my time.
  Mrs. LOWEY. Mr. Speaker, I yield 4 minutes to the gentleman from 
Maryland (Mr. Hoyer), the Democratic whip.
  Mr. HOYER. Mr. Speaker, I am so pleased to be here in the House. I am 
not pleased that we are considering a continuing resolution. To that 
extent, I presume that I share the opinion of the chairman of the 
committee, Mr. Frelinghuysen. I presume, as she has just articulated, 
that I share the opinion of the ranking member from New York.
  Mr. Speaker, we are now 7 months into fiscal year 2017. We have 5 
months remaining, and the majority party has been unable to fund 
government for the balance of the fiscal year. They have over 218 votes 
in this body, and they have over 50 votes in the Senate. Now, you need 
60 votes in the Senate, so it is more complicated. I understand that. 
But they now have a Republican President.
  As we did for the 2016 budget, which we passed in December of 2015 to 
the balance for September 30, 2016--I know all those dates run 
together--it was my desire and my advice, Mr. Speaker, that we do the 
same thing last December: pass an omnibus, take all the bills that the 
Committee on Appropriations has spent literally hundreds of hours 
hearing and making decisions on, make the compromises necessary in a 
democratic body so that 218 votes would be available.
  Now, the American public, if they have been watching closely, will 
see that not a single major appropriation bill has passed this House 
without Democratic help, so that everybody in this body knows that 
whatever is done in a major fiscal bill has to be done in a bipartisan 
way. The good news for this House is Mr. Frelinghuysen understands that 
well, based upon his experience and his observations, and, in my view, 
is willing to work together. I know that that also applies to the 
gentlewoman from New York (Mrs. Lowey).
  I had the opportunity to be on the Committee on Appropriations for 23 
years. I am still a member of that committee on leave because I am a 
whip at this point in time. I am going to vote for this continuing 
resolution, but I want to put my colleagues and the American people on 
notice, Mr. Speaker, that I will not vote for another one. I said to 
the press a month ago that I would vote for a continuing resolution 
today only if we had an agreement and the continuing resolution was for 
the purpose of allowing sufficient time to memorialize that agreement; 
in other words, put it down on paper and pass it through the House and 
the Senate. We are, unfortunately, not in that position today.
  It is my understanding from Mrs. Lowey, with whom I talked this 
morning, that there are still significant items that are not resolved. 
Mr. Speaker, I talked to the Speaker, Mr. Ryan, and to the majority 
leader standing right there on the floor just hours ago yesterday. It 
is my understanding that the Speaker's intention is that we have a bill 
filed Monday night so, in the Speaker's words, we can give 72 hours to 
review that bill and then pass it on Thursday.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mrs. LOWEY. Mr. Speaker, I yield an additional 2 minutes to the 
gentleman from Maryland.
  Mr. HOYER. Mr. Speaker, I hope that the Speaker's intention is 
carried out, which will require, over the next 72 hours, hard work by 
Members and by staff and a willingness to understand that each side has 
some things it must have and each side has some things it cannot do. 
That is the nature of the legislative process.
  If we exercise the responsibility that our constituents hoped that we 
would exercise when they sent us to this body, surely we can do that. I 
want to tell my friend, the chairman, for whom I have great respect--I 
hope that doesn't hurt him too much on his side of the aisle--that I 
want you to be able to say that Mr. Hoyer said he was going to urge his 
colleagues not to vote for another CR, and that, therefore, unless you 
have 218 votes on your side for whatever the product that you produce, 
that if we are going to fund government, as we surely should do, that 
we come to an agreement.
  Mr. Speaker, as a member of the Committee on Appropriations for 23 
years, I was very proud, it was the most bipartisan committee in the 
Congress, and we understood our responsibility that the appropriation 
bills are the one bill that must pass if we are to continue to serve 
our public and keep America strong and vibrant and economically growing 
jobs. This is a serious matter. Continuing to kick the can down the 
road ought to be an unacceptable alternative.
  The SPEAKER pro tempore. The time of the gentleman has again expired.
  Mrs. LOWEY. Mr. Speaker, I yield an additional 2 minutes to the 
gentleman from Maryland.
  Mr. HOYER. Mr. Speaker, I urge every one of my colleagues--there are 
not a lot of people on the floor, Mr. Speaker, but I hope they are 
watching on television--to understand that the basic responsibility 
that we have of ensuring the functioning of the government of the 
people of the United States is one that we ought to perform in a 
responsible, effective, and timely fashion.
  Mr. Chairman, I will work with you, and I will work with Mrs. Lowey 
over

[[Page 6193]]

the next few days to ensure that next week we have a product that can 
pass this House because it has bipartisan support and is in the best 
interests of our country.
  Mrs. LOWEY. Mr. Speaker, I yield back the balance of my time.
  Mr. FRELINGHUYSEN. Mr. Speaker, I yield back the balance of my time.
  Ms. JACKSON LEE. Mr. Speaker, I rise to speak about H.J. Res. 99, 
``Making Further Continuing Appropriations for Fiscal Year 2017.''
  This resolution is an imperfect vehicle for appropriations for FY 
2017, because it does not fully fund the government for the entire 
fiscal year and it keeps in place sequestration.
  H.J. Res. 99 goes against sound fiscal practice by including the 
budget gimmickry known as sequestration, a fiscal bludgeon that makes 
across the board cuts in funding for the valuable services depended 
upon by American children, seniors, workers, veterans, students, and 
small businesses.
  Mr. Speaker, the Continuing Resolution before us extends current 
Fiscal Year 2017 government funding by seven days, through May 5, 2017, 
at its current rate, which means a continuation of the across-the-board 
cut of .19% for all accounts, defense and non-defense, contained in the 
expiring continuing resolution that was approved December 8, 2016.
  Mr. Speaker, I am disappointed that we have again been placed in the 
position of having to fund the government through the device of a 
continuing resolution rather than through the normal appropriations 
process of considering and voting on the twelve separate spending bills 
reported by the Committee on Appropriations.
  H.J. Res. 99 is far from perfect, but it is a modest and positive 
step since it ensures that funding for appropriated entitlements will 
continue at a rate maintaining program levels under current law and, 
for a week at least, prevents congressional Republicans from shutting 
down the government again and manufacturing a crisis that only harms 
our economy, destroys jobs, and weakens our middle class.
  The government shutdown of 2013, which was manufactured by the 
Republican majority lasted 16 days and cost taxpayers $24 billion.
  The enormous harm and disruption of the lives of federal employees 
and the people they serve, however, was irreparable.
  As I stated, Mr. Speaker, this Continuing Resolution is not perfect 
and it only funds the government until May 5, 2017.
  As veteran and seasoned Members of Congress, we have been in this 
challenging position before.
  But working together--in a spirit of goodwill, bipartisanship, and 
realism, I believe we can reach a long-term agreement that will avert a 
shutdown of government operations and the disruption a shutdown causes 
to the lives of millions of Americans who depend upon federal programs 
to do their jobs, educate their kids, care for their parents, and 
contribute to their communities.
  Our constituents look to the Congress and the President to make 
responsible choices and decisions to keep the nation safe, the economy 
prosperous, and to make necessary and prudent investments in education, 
healthcare and research, transportation and infrastructure, economic 
development, science, the arts and humanities, and the environment.
  This is, after all, just another way of saying that the American 
people expect their leaders in Washington be guided by the 
Constitution's Preamble and pursue policies and provide the resources 
that will:
  ``establish justice, ensure domestic tranquility, provide for the 
common defense, promote the general welfare, and secure the blessings 
of liberty.''
  The funding priorities that have been floated by the Trump 
Administration fail this essential test of leadership because they are 
irresponsible, impracticable, unrealistic, and, in many respects, 
insensitive or indifferent to the deleterious impact they will have on 
the lives of real people living in the real world.
  They do not command majority support in the Congress or of the 
public.
  To win such support, I believe that it is essential that any 
subsequent continuing resolution or omnibus appropriations bill 
achieves the following goals and objectives:
  ``To establish justice'' and ``To promote the general welfare'':
  1. Full funding for the U.S. Department of Justice Civil Rights 
Division and the Department of Education Office of Civil Rights so that 
they have funds needed to enforce laws protecting civil rights, voting 
rights, and prosecuting hate crimes.
  2. Fully funds community development block grants and low income 
housing programs in urban and rural communities.
  3. Fully funds the Legal Services Corporation so that working and 
low-income persons who lack an army of lobbyists to represent them in 
Washington will at least have the assistance of counsel to defend their 
legal rights in courts of law.
  4. Fully funds programs providing food assistance to housebound 
seniors, such as Meals on Wheels.
  5. Fully funds programs that provide students from low and moderate-
income families access to affordable higher education and provides 
students with special needs the support needed to receive the free 
appropriate public education (FAPE) in the least restrictive 
environment (LRE) guaranteed by the Individuals with Disabilities 
Education Act (IDEA Act).
  6. Fully funds before and after school programs and other student 
enrichment programs that help students succeed.
  7. Fully funds programs that make federal housing safer through 
energy efficient heating and cooling systems.
  8. Preserves tax credit programs that help revitalize low income 
communities.
  9. Fully funds the Environmental Protection Agency and Department of 
Energy programs developing the next generation of clean energy and 
transportation technologies.
  ``Provide for the common defense'':
  1. Provides robust funding for the Department of State and USAID to 
advance national security interests in places like Iraq and Afghanistan 
and to end violent conflicts in trouble spots which could threaten the 
security interests of the United States.
  2. Provides adequate funding for United Nations peacekeeping missions 
throughout the world and distribution of food aid to people in 
developing and famine stricken countries, such as South Sudan, Somalia, 
Yemen, and Nigeria.
  ``To ensure domestic tranquility'':
  1. Fully funds cost-sharing reduction subsidies, or CSRs, to 
compensate insurers for reducing deductibles and out-of-pocket maximums 
for low-income customers on the Affordable Care Act exchanges.
  2. Protects the adequacy, solvency, and integrity of the Medicare and 
Medicaid programs, which provide health sustaining support for 70 
million Americans.
  3. Fully funds the National Institutes of Health research programs so 
that patient access to lifesaving treatments is not delayed.
  4. Does not convert funding for the Centers for Disease Control and 
Prevention into block grants which would hinder the nation's ability to 
respond swiftly and effectively to public health crises like Ebola, 
Zika, and HIV/AIDS.
  Mr. Speaker, I believe that if all members of the House and Senate 
work together, we can reach agreement on an appropriate budget 
framework that invests in the American people, preserves our national 
security, and keeps faith with the values that have served our nation 
well and made the United States the leading nation on earth.
  The SPEAKER pro tempore. All time for debate has expired.
  Pursuant to House Resolution 289, the previous question is ordered.
  The question is on the engrossment and third reading of the joint 
resolution.
  The joint resolution was ordered to be engrossed and read a third 
time, and was read the third time.
  The SPEAKER pro tempore. The question is on the passage of the joint 
resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. FRELINGHUYSEN. 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, this 15-
minute vote on passage of the joint resolution will be followed by a 5-
minute vote on agreeing to the Speaker's approval of the Journal, if 
ordered.
  The vote was taken by electronic device, and there were--yeas 382, 
nays 30, not voting 18, as follows:

                             [Roll No. 236]

                               YEAS--382

     Abraham
     Adams
     Aderholt
     Aguilar
     Allen
     Amodei
     Arrington
     Babin
     Bacon
     Banks (IN)
     Barletta
     Barr
     Barragan
     Barton
     Bass
     Beatty
     Bera
     Bergman
     Beyer
     Biggs
     Bilirakis
     Bishop (GA)
     Bishop (MI)
     Bishop (UT)
     Black
     Blackburn
     Blum
     Blumenauer
     Blunt Rochester
     Bonamici
     Brady (PA)
     Brady (TX)
     Brooks (AL)
     Brooks (IN)
     Brown (MD)
     Brownley (CA)
     Buck
     Bucshon
     Budd
     Burgess
     Bustos
     Butterfield
     Byrne
     Calvert
     Capuano
     Carbajal
     Carson (IN)
     Carter (GA)
     Carter (TX)
     Cartwright
     Castro (TX)
     Chabot
     Cheney
     Chu, Judy

[[Page 6194]]


     Cicilline
     Clark (MA)
     Clay
     Cleaver
     Clyburn
     Coffman
     Cohen
     Cole
     Collins (GA)
     Collins (NY)
     Comer
     Comstock
     Conaway
     Connolly
     Conyers
     Cook
     Cooper
     Correa
     Costa
     Costello (PA)
     Courtney
     Cramer
     Crawford
     Crist
     Crowley
     Cuellar
     Culberson
     Cummings
     Curbelo (FL)
     Davidson
     Davis (CA)
     Davis, Danny
     Davis, Rodney
     Delaney
     DeLauro
     DelBene
     Demings
     Denham
     Dent
     DeSantis
     DeSaulnier
     Deutch
     Diaz-Balart
     Dingell
     Doggett
     Donovan
     Doyle, Michael F.
     Duffy
     Duncan (SC)
     Duncan (TN)
     Dunn
     Ellison
     Emmer
     Engel
     Eshoo
     Espaillat
     Estes (KS)
     Esty (CT)
     Evans
     Farenthold
     Faso
     Ferguson
     Fitzpatrick
     Fleischmann
     Fortenberry
     Foster
     Foxx
     Frankel (FL)
     Franks (AZ)
     Frelinghuysen
     Fudge
     Gabbard
     Gallagher
     Gallego
     Garamendi
     Gibbs
     Gohmert
     Gonzalez (TX)
     Goodlatte
     Gosar
     Gottheimer
     Gowdy
     Granger
     Graves (GA)
     Graves (LA)
     Graves (MO)
     Green, Al
     Green, Gene
     Griffith
     Grijalva
     Grothman
     Guthrie
     Hanabusa
     Harper
     Harris
     Hartzler
     Hastings
     Heck
     Hensarling
     Herrera Beutler
     Hice, Jody B.
     Higgins (LA)
     Higgins (NY)
     Hill
     Himes
     Holding
     Hoyer
     Huffman
     Huizenga
     Hultgren
     Hunter
     Hurd
     Issa
     Jackson Lee
     Jayapal
     Jeffries
     Jenkins (KS)
     Jenkins (WV)
     Johnson (GA)
     Johnson (OH)
     Johnson, E. B.
     Jordan
     Joyce (OH)
     Kaptur
     Katko
     Keating
     Kelly (IL)
     Kelly (MS)
     Kelly (PA)
     Kennedy
     Khanna
     Kihuen
     Kildee
     Kilmer
     Kind
     Kinzinger
     Knight
     Krishnamoorthi
     Kuster (NH)
     Kustoff (TN)
     LaHood
     LaMalfa
     Lamborn
     Lance
     Langevin
     Larsen (WA)
     Latta
     Lawrence
     Lawson (FL)
     Levin
     Lewis (MN)
     Lipinski
     LoBiondo
     Loebsack
     Lofgren
     Long
     Loudermilk
     Love
     Lowenthal
     Lowey
     Lucas
     Luetkemeyer
     Lujan, Ben Ray
     Lynch
     MacArthur
     Maloney, Carolyn B.
     Maloney, Sean
     Marchant
     Marshall
     Mast
     Matsui
     McCarthy
     McCaul
     McClintock
     McCollum
     McEachin
     McGovern
     McHenry
     McKinley
     McMorris Rodgers
     McNerney
     McSally
     Meadows
     Meehan
     Meeks
     Meng
     Messer
     Mitchell
     Moolenaar
     Moore
     Moulton
     Murphy (FL)
     Murphy (PA)
     Nadler
     Napolitano
     Neal
     Noem
     Nolan
     Norcross
     Nunes
     O'Halleran
     O'Rourke
     Palazzo
     Pallone
     Palmer
     Panetta
     Pascrell
     Paulsen
     Payne
     Pelosi
     Perlmutter
     Perry
     Peters
     Peterson
     Pingree
     Pittenger
     Pocan
     Poe (TX)
     Poliquin
     Polis
     Posey
     Price (NC)
     Quigley
     Raskin
     Reed
     Reichert
     Rice (NY)
     Rice (SC)
     Richmond
     Roby
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rohrabacher
     Rokita
     Rooney, Francis
     Rooney, Thomas J.
     Ros-Lehtinen
     Rosen
     Roskam
     Ross
     Rothfus
     Roybal-Allard
     Royce (CA)
     Ruiz
     Ruppersberger
     Russell
     Rutherford
     Ryan (OH)
     Sanford
     Sarbanes
     Scalise
     Schakowsky
     Schiff
     Schneider
     Schrader
     Schweikert
     Scott (VA)
     Scott, Austin
     Scott, David
     Serrano
     Sessions
     Sewell (AL)
     Shea-Porter
     Sherman
     Shimkus
     Shuster
     Simpson
     Sinema
     Sires
     Smith (MO)
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Smith (WA)
     Smucker
     Soto
     Speier
     Stefanik
     Stewart
     Stivers
     Suozzi
     Swalwell (CA)
     Takano
     Taylor
     Tenney
     Thompson (CA)
     Thompson (MS)
     Thompson (PA)
     Thornberry
     Tiberi
     Tipton
     Titus
     Tonko
     Torres
     Trott
     Tsongas
     Turner
     Upton
     Valadao
     Vargas
     Veasey
     Visclosky
     Wagner
     Walberg
     Walden
     Walker
     Walorski
     Walters, Mimi
     Walz
     Wasserman Schultz
     Waters, Maxine
     Weber (TX)
     Webster (FL)
     Welch
     Wenstrup
     Westerman
     Williams
     Wilson (FL)
     Wilson (SC)
     Womack
     Woodall
     Yarmuth
     Yoder
     Yoho
     Young (AK)
     Young (IA)
     Zeldin

                                NAYS--30

     Amash
     Boyle, Brendan F.
     Bridenstine
     Cardenas
     Castor (FL)
     Clarke (NY)
     DeFazio
     DeGette
     DesJarlais
     Gaetz
     Garrett
     Gutierrez
     Hollingsworth
     Johnson, Sam
     Jones
     King (IA)
     Lee
     Lewis (GA)
     Lujan Grisham, Michelle
     Massie
     Mooney (WV)
     Pearce
     Ratcliffe
     Renacci
     Rush
     Sensenbrenner
     Vela
     Velazquez
     Watson Coleman
     Wittman

                             NOT VOTING--18

     Bost
     Brat
     Buchanan
     Chaffetz
     Flores
     Hudson
     Johnson (LA)
     King (NY)
     Labrador
     Larson (CT)
     Lieu, Ted
     Marino
     Mullin
     Newhouse
     Olson
     Rouzer
     Sanchez
     Slaughter

                              {time}  1129

  Ms. CLARKE of New York and Mr. GUTIERREZ changed their vote from 
``yea'' to ``nay.''
  Messrs. BUDD, COOPER, and AL GREEN of Texas changed their vote from 
``nay'' to ``yea.''
  So the joint resolution was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.
  Stated for:
  Mr. BOST. Mr. Speaker, I was unavoidably detained. Had I been 
present, I would have voted ``yea'' on rollcall No. 236.
  Mr. JOHNSON of Louisiana. Mr. Speaker, I was unavoidably detained. 
Had I been present, I would have voted ``yea'' on rollcall No. 236.
  Mr. FLORES. Mr. Speaker, I was at the White House for a signing 
ceremony. Had I been present, I would have voted ``yea'' on rollcall 
No. 236.
  Mr. MULLIN. Mr. Speaker, I was at the White House for a signing 
ceremony. Had I been present, I would have voted ``yea'' on rollcall 
No. 236.


                          PERSONAL EXPLANATION

  Mr. HUDSON. Mr. Speaker, I was unavoidably detained. Had I been 
present, I would have voted ``yea'' on rollcall No. 235 and ``yea'' on 
rollcall No. 236.


                          personal explanation

  Mr. BRAT. Mr. Speaker, I was unavoidably detained. Had I been 
present, I would have voted ``yea'' on rollcall No. 235 and ``yea'' on 
rollcall No. 236.


                          personal explanation

  Mr. ROUZER. Mr. Speaker, I was unavoidably detained at the White 
House. Had I been present, I would have voted ``yea'' on rollcall No. 
235 and ``yea'' on rollcall No. 236.


                          personal explanation

  Ms. SLAUGHTER. Mr. Speaker, I was unavoidably detained and missed 
rollcall vote Nos. 235 and 236. Had I been present, I would have voted 
``aye'' on vote 236. I would have voted ``nay'' on vote 235.


                          personal explanation

  Mr. MARINO. Mr. Speaker, I was unable to attend votes on April 28, 
2017, due to a family medical issue. Had I been present, I would have 
voted as follows:
  ``Yea'' for rollcall vote 235.
  ``Yea'' for rollcall vote 236.

                          ____________________