[Congressional Record (Bound Edition), Volume 163 (2017), Part 7]
[House]
[Pages 9949-9958]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  1230
PROVIDING FOR CONSIDERATION OF H.R. 1215, PROTECTING ACCESS TO CARE ACT 
                                OF 2017

  Mr. BUCK. Mr. Speaker, by direction of the Committee on Rules, I call 
up House Resolution 382 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 382

       Resolved, That at any time after adoption of this 
     resolution the Speaker may, pursuant to clause 2(b) of rule 
     XVIII, declare the House resolved into the Committee of the 
     Whole House on the state of the Union for consideration of 
     the bill (H.R. 1215) to improve patient access to health care 
     services and provide improved medical care by reducing the 
     excessive burden the liability system places on the health 
     care delivery system. The first reading of the bill shall be 
     dispensed with. All points of order against consideration of 
     the bill are waived. General debate shall be confined to the 
     bill and shall not exceed one hour equally divided and 
     controlled by the chair and ranking minority member of the 
     Committee on the Judiciary. After general debate the bill 
     shall be considered for amendment under the five-minute rule. 
     In lieu of the amendment in the nature of a substitute 
     recommended by the Committee on the Judiciary now printed in 
     the bill, it shall be in order to consider as an original 
     bill for the purpose of amendment under the five-minute rule 
     an amendment in the nature of a substitute consisting of the 
     text of Rules Committee Print 115-10. That amendment in the 
     nature of a substitute shall be considered as read. All 
     points of order against that amendment in the nature of a 
     substitute are waived. No amendment to that amendment in the 
     nature of a substitute shall be in order except those printed 
     in the report of the Committee on Rules accompanying this 
     resolution. Each such amendment may be offered only in the 
     order printed in the report, may be offered only by a Member 
     designated in the report, shall be considered as read, shall 
     be debatable for the time specified in the report equally 
     divided and controlled by the proponent and an opponent, 
     shall not be subject to amendment, and shall not be subject 
     to a demand for division of the question in the House or in 
     the Committee of the Whole. All points of order against such 
     amendments are waived. At the conclusion of consideration of 
     the bill for amendment the Committee shall rise and report 
     the bill to the House with such amendments as may have been 
     adopted. Any Member may demand a separate vote in the House 
     on any amendment adopted in the Committee of the Whole to the 
     bill or to the amendment in the nature of a substitute made 
     in order as original text. The previous question shall be 
     considered as ordered on the bill and amendments thereto to 
     final passage without intervening motion except one motion to 
     recommit with or without instructions.

  The SPEAKER pro tempore. The gentleman from Colorado (Mr. Buck) is 
recognized for 1 hour.
  Mr. BUCK. Mr. Speaker, for the purpose of debate only, I yield the 
customary 30 minutes to the gentleman from Colorado (Mr. Polis), my 
friend, pending which I yield myself such time as I may consume. During 
consideration of this resolution, all time yielded is for the purpose 
of debate only.


                             General Leave

  Mr. BUCK. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Colorado?
  There was no objection.
  Mr. BUCK. Mr. Speaker, I rise today in support of the rule and the 
underlying legislation.
  House Resolution 382 will ultimately drive down healthcare costs and 
make care more affordable to millions of Americans across the country.
  In 2017, we have had a conversation in America about how health 
insurance costs have drastically increased in the past 7 years. We need 
to fix our health insurance market, a task that House Members and 
Senators have been working hard on for the past few months, but if we 
are truly going to address out-of-control health insurance costs, we 
need to start looking at the cost of supplying care itself. That is 
where H.R. 1215, the Protecting Access to Care Act of 2017, plays a 
vital role. H.R. 1215 focuses on lowering the cost of care by placing 
checks and balances on the excessive and frivolous lawsuits faced by 
doctors and other healthcare providers.
  A GAO report found that rising litigation awards are responsible for 
skyrocketing medical professional liability premiums. Unfortunately, 
these premium costs are passed on to the patient and, in many cases, 
are passed on to American taxpayers. The reforms in H.R. 1215 will make 
care more affordable for patients and will improve access to care, 
especially for rural America.
  Over time, unending and excessive lawsuits have limited the amount of 
doctors nationwide, particularly in States that have not instituted 
their own reforms. With a string of frivolous lawsuits levied against 
our medical community, many Americans who would become doctors and 
practice in certain parts of the Nation simply decided against it.
  The reforms in H.R. 1215 will especially help rural and underserved 
urban communities, where quality healthcare can be difficult to access. 
Incentivizing medical professionals to serve in communities that might 
otherwise be overlooked should be one goal of our healthcare reform 
efforts.
  I know the healthcare challenges faced by so many in eastern 
Colorado, where access to quality care is sometimes limited. We need 
doctors who are willing to invest in these communities, but we need to 
empower these doctors by freeing them of frivolous and excessive 
lawsuits.
  Beyond just access to care, the growth of frivolous malpractice 
lawsuits has led to a change in the way care is provided. Many 
providers are forced to practice defensive medicine. In doing so, 
doctors order unnecessary, excessive diagnostics not because the 
patient needs them, but because the doctor attempts to avoid a 
frivolous lawsuit. The practice of defensive medicine increases costs 
for the patient without providing any discernible benefit.
  The legislation we are considering is key to increasing the 
affordability of care and the access to care for all Americans.
  This bill is supported by the American Hospital Association and the 
American Academy of Family Physicians. The American Medical Association 
has also voiced their support.
  But let me be clear: The bill before the House today does not limit 
access to justice for legitimately wronged or injured patients. It does 
not hamper a wronged patient from recovering damages for their 
injuries.
  The bill simply imposes a $250,000 cap on noneconomic damages, a 
provision that has worked well in California, where this legislation 
has already been successfully implemented and modeled for decades. But 
there is no cap on economic damages that a patient may incur in a 
malpractice situation, and the bill's cap does not preempt any State 
law that otherwise caps any form

[[Page 9950]]

of damages at amounts either higher or lower than the cap in H.R. 1215.
  The legislation also limits the contingency fees that lawyers can 
charge when bringing a malpractice case on behalf of a client. In other 
words, we don't want to incentivize lawyers to push forward with 
illegitimate cases. We want patients who have been wronged to have 
access to a fair trial, where they walk home with the winnings in their 
own pocket, not their lawyer's.
  H.R. 1215 builds on the successes of medical malpractice reforms in 
States like California and Texas. In these States, similar laws have 
increased access to affordable medical care. They have created an 
environment where doctors can focus on helping patients rather than 
spending time in endless litigation and dealing with threats from the 
trial bar.
  The legislation before us, while creating a uniform national playing 
field, protects State laws by allowing flexible reforms to be used at 
the discretion of States. State courts will still hear medical lawsuits 
as always.
  The reforms at hand today deal with care that was provided or 
subsidized by the Federal Government, including through a tax benefit.
  We must pass this legislation for the American taxpayer. The taxpayer 
doesn't deserve to have their hard-earned dollars simply end up in the 
pockets of trial lawyers due to frivolous lawsuits. That is why H.R. 
1215 is a critically needed reform.
  Unlimited and opportunistic lawsuits help no one except trial 
lawyers. Consequently, our doctors have to increase their costs and 
practice expensive defensive medicine, costing patients and taxpayers. 
And when our physicians are impacted, so are we.
  Trial lawyers too often stand between patients and their doctors. 
With the looming threat of excessive, unending lawsuits, healthcare 
providers have to worry more about the trial lawyer at their door than 
the patient in their office. H.R. 1215 places important limits on these 
lawsuits so that the truly wronged are compensated without enriching 
trial lawyers at the same time.
  I reserve the balance of my time.
  Mr. POLIS. Mr. Speaker, I thank the gentleman for yielding me the 
customary 30 minutes, and I yield myself such time as I may consume.
  Mr. Speaker, I rise in opposition to this rule today, one that 
provides for consideration of the Protecting Access to Care Act. This 
bill would significantly alter how families and patients that are 
injured as a result of medical error are able to hold healthcare 
providers, facilities, or device makers accountable to make sure that 
that same thing doesn't happen to other people.
  This bill decreases patient safety. It undermines the ability of 
people who are wrongfully injured by medical malpractice or faulty 
medical devices to be compensated for their injuries, and it violates 
the 10th Amendment to our Constitution, the rights reserved to the 
States.
  Before I turn to the merits, or lack thereof, of this bill, I want to 
discuss the process under which this bill came to the floor.
  The Judiciary Committee, which has jurisdiction over this bill, had 
zero hearings on this legislation, heard from zero experts, and went 
straight to markup. Despite the overwhelming opposition to this 
legislation, the Judiciary Committee did not want to hear from groups 
like the American Bar Association, Patient Safety America, the National 
Disability Rights Network, or the National Protection Alliance.
  When I see the American Bar Association, who the committee refused to 
hear from--I know my colleague from Colorado is an attorney. I just 
want to inquire of my colleague from Colorado if he is a member of the 
American Bar Association, and I yield to the gentleman.
  Mr. BUCK. Proudly, no.
  Mr. POLIS. Okay. Well, that is the association which many attorneys, 
excepting, of course, my friend from Colorado, are a member of.
  The supporters of this bill point to its consideration in previous 
Congresses for hearings, but we have over 50 new Members who didn't 
hear a word about this bill from any experts before it was rushed to 
the floor.
  We are considering this bill under a very restrictive rule. That 
means there were 24 amendments filed. This rule only allows the House 
to debate and vote on five of them. That means 19 of them, amendments 
offered by Democrats and Republicans, were simply just tossed out in 
the Rules Committee. That is what this rule does.
  If this rule were to pass, it would mean that the efforts of 19 
Members to offer ideas to improve healthcare wouldn't even be allowed 
to be debated or voted upon here on the floor of this House. It is no 
coincidence that eight amendments filed by Democrats, and not one 
Democratic amendment was made in order. Only 5 out of 24 ideas from 
Democrats and Republicans were made in order.
  One amendment filed by my colleague, Representative Jackson Lee, 
would have provided an exception to the bill for any medical-related 
injury to a child, which seems like common sense. At least have a 
debate about it. If people disagree, let them disagree. Let's have a 
vote.
  This rule continues this very closed process, where Democrats and 
Republicans are shut out of participating in the bills that appear 
fully formed without the opportunity for us to represent our districts 
and offer amendments to improve and make these bills better, to reduce 
costs, to improve the quality of care.
  What I wonder, Mr. Speaker, is: Where is the open process promised by 
Speaker Ryan? This Congress hasn't even considered a single piece of 
legislation under an open rule, and we have had many, many bills 
brought to the floor under closed rules and without any committee 
hearings. But, you know, I am beginning to not be surprised so much 
anymore because secretiveness seems to be the standard that Republicans 
are setting in this Congress.
  How the Republicans have handled their healthcare bill from start 
through now is a perfect example of the closed-door, secretive process 
that has become, tragically, the standard operating procedure for this 
Congress.
  The Republican healthcare bill will increase healthcare costs, 
provide less coverage--22 million fewer people will be covered--
increase costs for those who are lucky enough to keep their current 
coverage, and reduce access to healthcare for the American people. It 
puts a burden on small businesses, on the middle class, on rural 
healthcare providers, while handing hundreds of billions of dollars in 
tax breaks to big corporations and special interests.
  TrumpCare is a billionaire's tax cut disguised as a healthcare bill, 
and it will be one of the largest transfers of wealth from the middle 
class and the working families to the top 1 percent of Americans. 
Effectively, it is removing benefits from people in rural counties and 
cities across our country and giving those tax cuts mostly to people in 
New York and Hollywood. That is what Republicans are delivering with 
this bill.
  When the American people were finally given the chance to see the 
Senate's healthcare legislation, the American people overwhelmingly 
rejected it. Only 16 percent of the American people approve of the 
plan. Democrats oppose it; Republicans oppose it; independents oppose 
it.
  The Congressional Budget Office's recent score of the bill says that 
coverage will significantly decrease under this bill and that the costs 
of deductibles for patients will go up. Patients will have to spend 
more out of pocket, those that are lucky enough to even have insurance 
after this cruel bill.
  But there is still time to stop it, and I call upon my colleagues to 
prevent this bill from moving forward.
  The bill that Republicans are trying to ram through Congress is not 
truly meant to make improvements to our healthcare system but to take 
money away from the middle class and working families and put it into 
the pockets of a very few people who benefit from the tax cuts under 
this bill: for people making millions of dollars a year.
  This bill makes it harder for middle-income families and for low-
income

[[Page 9951]]

families to access quality, affordable healthcare, makes it harder for 
individuals who have preexisting conditions or have genetic disorders 
or long-term diseases from accessing lifesaving medical attention, and 
cuts critical healthcare services for disabled children in schools that 
many of our school districts rely on. And they want to do this all with 
a closed process.
  I offered three amendments to improve healthcare in our Education and 
the Workforce Committee. All were defeated on a partisan vote.

                              {time}  1245

  Every Republican voted not to allow those. No Democrat, as far as I 
know--certainly not me--has been invited to present our ideas to 
Republican leadership or President Trump.
  Democrats have lots of ideas to improve the Affordable Care Act. I am 
sure many Republicans do, too. Those ideas are not reflected whatsoever 
in this bill or in the closed process that prohibits Republicans and 
Democrats from even offering our suggestions to improve this bill.
  So, here we are, debating another piece of healthcare legislation 
that did not go through an open process. Democrats were shut out of the 
amendment process completely.
  This bill would make it more difficult for victims of medical 
malpractice to seek or receive compensation for their injuries. It is 
inconsistent with the 10th Amendment, which reserves these rights to 
the States that are not enumerated in the Constitution, and unlike the 
Democrats' approach to medical malpractice reform in the Affordable 
Care Act, which provided funding for pilot programs in the States to 
reduce the risk of medical malpractice liability consistent with the 
10th Amendment. Many constitutional experts--I would add, many 
conservative constitutional experts--believe that this approach is 
unconstitutional because of the 10th Amendment.
  We have learned that this bill does not actually protect access to 
healthcare but, instead, undermines a State-based tort system, making 
it more difficult for patients to be compensated from bad actors.
  Mr. Speaker, I include in the Record a letter signed by over 60 
national and State organizations opposed to H.R. 1215.
                                                    June 12, 2017.
     Re Groups Urge You to Vote NO on H.R. 1215.

     Hon. Paul Ryan,
     Speaker, House of Representatives,
     Washington, DC.
     Hon. Nancy Pelosi,
     Minority Leader, House of Representatives,
     Washington, DC.
       Dear Speaker Ryan and Leader Pelosi: The undersigned 
     consumer, health, labor, legal and public interest groups 
     strongly oppose H.R. 1215: The ``Protecting Access to Care 
     Act of 2017.'' This bill would limit the legal rights of 
     injured patients and families of those killed by negligent 
     health care. The bill's sweeping scope covers not only cases 
     involving medical malpractice, but also cases involving 
     unsafe drugs and nursing home abuse and neglect.
       Even if H.R. 1215 applied only to doctors and hospitals, 
     recent studies clearly establish that its provisions would 
     lead to more deaths and injuries, and increased health care 
     costs due to a ``broad relaxation of care.'' Add to this 
     nursing home and pharmaceutical industry liability 
     limitations, significantly weakening incentives for these 
     industries to act safely, and untold numbers of additional 
     death, injuries and costs are inevitable, and unacceptable.
       The latest statistics show that medical errors, most of 
     which are preventable, are the third leading cause of death 
     in America. This intolerable situation is perhaps all the 
     more shocking because we already know about how to fix much 
     of this problem. Congress should focus on improving patient 
     safety and reducing deaths and injuries, not insulating 
     negligent providers from accountability, harming patients and 
     saddling taxpayers with the cost, as H.R. 1215 would do.
       For example, this bill would establish a permanent across-
     the-board $250,000 ``cap'' on compensation for ``non-economic 
     damages'' in medical malpractice cases. Such caps are unfair 
     and discriminatory. For example, University of Buffalo Law 
     Professor Lucinda Finley has written, ``certain injuries that 
     happen primarily to women are compensated predominantly or 
     almost exclusively through noneconomic loss damages. These 
     injuries include sexual or reproductive harm, pregnancy loss, 
     and sexual assault injuries.'' Also, ``[J]uries consistently 
     award women more in noneconomic loss damages than men . . . 
     [A]ny cap on noneconomic loss damages will deprive women of a 
     much greater proportion and amount of a jury award than men. 
     Noneconomic loss damage caps therefore amount to a form of 
     discrimination against women and contribute to unequal access 
     to justice or fair compensation for women.''
       Other provisions in H.R. 1215 are just as problematic. The 
     proposed federal statute of limitations, more restrictive 
     than a majority of state laws, lacks complete logic from a 
     deficit reduction angle since its only impact would be to cut 
     off meritorious claims, forcing patients to turn to the 
     government for care. The bill would repeal joint and several 
     liability even though the Congressional Budget Office says 
     this could increase, not lower, costs.
       H.R. 1215 would overturn traditional state common law and 
     would be an unprecedented interference with the work of state 
     court judges and juries in civil cases. Its one-way 
     preemption of state law provisions that protect patients 
     (there are some exceptions) makes clear that the intent of 
     this legislation is not to make laws uniform in the 50 
     states. Rather, it is a carefully crafted bill to provide 
     relief and protections for the insurance, medical and drug 
     industries, at the expense of patient safety. We urge you to 
     oppose H.R. 1215: The ``Protecting Access to Care Act of 
     2017.'' Thank you.
           Very sincerely,


                            NATIONAL GROUPS

       AFL-CIO; American Federation of State, County and Municipal 
     Employees (AFSCME); American Federation of Teachers; Aging 
     Life Care Association; Alliance for Justice; Alliance for 
     Retired Americans; American Association for Justice; American 
     Association of Directors of Nursing Services; American 
     Association of Nurse Assessment Coordination; Annie Appleseed 
     Project; Autistic Self Advocacy Network; Brain Injury 
     Association of America; Center for Independence; Center for 
     Justice & Democracy; Center for Medicare Advocacy; 
     Christopher & Dana Reeve Foundation; Communication Workers of 
     America; Consumer Action; Consumer Federation of America; 
     Consumer Watchdog.
       Daily Kos; Families for Better Care; Gerontological 
     Advanced Practice Nurses Association; Hartford Institute for 
     Geriatric Nursing; Homeowners Against Deficient Dwellings; 
     Justice in Aging; Leahslegacy.org; Long Term Care Community 
     Coalition; Mothers Against Medical Error; NALLTCO, National 
     Association of Local Long Term Care Ombudsman; National 
     Association of Consumer Advocates; National Association of 
     Directors of Nursing Administration in Long Term Care; 
     National Center for Health Research (NCHR); National Consumer 
     Voice for Quality Long-Term Care; National Consumers League; 
     National Disability Rights Network; National Education 
     Association.
       National Gerontological Nursing Association; National 
     Medical Malpractice Advocacy Association; National Women's 
     Health Network; Nursing Home Victim Coalition, Inc.; Our 
     Mother's Voice; Patient Safety America; Public Citizen; 
     Public Justice; Public Justice Center; Public Law Center; 
     Quinolone Vigilance Foundation; The Empowered Patient 
     Coalition; The Impact Fund; United Automobile, Aerospace and 
     Agricultural Implement Workers of America International 
     Union; United Spinal Association; Women's Institute for a 
     Secure Retirement (WISER).


                              STATE GROUPS

       Arkansas State Independent Living Council; California 
     Advocates for Nursing Home Reform; Center for Advocacy for 
     the Rights & Interests of the Elderly (PA); Chatham Advisory 
     Committee for Long Term Care Adult Care Homes and Family Care 
     Homes (NC); Citizen Action/Illinois; Connecticut Center for 
     Patient Safety; Disability Rights Center of Kansas; Elder 
     Justice Committee of Metro Justice of Rochester (NY); Friends 
     of Residents in Long Term Care (NC); Greater Boston Legal 
     Services, on behalf of our clients (MA); Idaho Federation of 
     Families for Children's Mental Health; InterHab, Inc. (KS).
       Iowa Statewide Independence Living Council (SILC); Kansas 
     ADAPT; Kansas Advocates for Better Care; LTC Ombudsman 
     Services of San Luis Obispo County (CA); Massachusetts 
     Advocates for Nursing Home Reform; Michigan Long Term Care 
     Ombudsman Program; Montana Independent Living Project, Inc.; 
     NYPIRG; PULSE of Colorado; Residential Facilities Advisory 
     Committee, State of Oregon; Rhode Island Long Term Care 
     Ombudsman Office; Texas Watch; Voices for Quality Care (LTC) 
     (MD & DC); Washington Advocates for Patient Safety; 
     Washington Civil & Disability Advocate; WISE & Health Aging 
     (CA).

  Mr. POLIS. Some of the groups are the Gerontological Advanced 
Practice Nurses Association, Justice in Aging, Long Term Care Community 
Coalition, National Education Association, National Consumers League, 
National Disability Rights Network, Public Citizen, Public Justice, and 
many, many other great organizations.
  I hope my friend from Colorado is a member of at least two or three 
of

[[Page 9952]]

these wonderful organizations. I will furnish the entire list to him.
  This bill preempts State tort law that has been developed over the 
last 200 years and is contrary to the 10th Amendment of our 
Constitution. It imposes an arbitrary cap on the amount of noneconomic 
damages a victim can collect under a Federal law coopting the ability 
of States to do their own medical malpractice laws and hamstringing 
them with regard to the reforms that they can undertake.
  In fact, capping damages also increases taxpayer spending. According 
to a joint study by Northwestern University and the University of 
Illinois, they found that capping economic damages actually increases 
Medicare part B spending.
  I would point out another horrible feature of the cruel Republican 
healthcare bill is that it guts the Medicare trust fund and would lead 
to Medicare becoming insolvent sooner rather than later by draining the 
Medicare trust fund of over $100 billion. That is another aspect of 
this bill.
  No wonder they didn't want us to see it, Mr. Speaker. No wonder they 
kept it in a locked closet from even Republicans who were allegedly 
writing it, like Ken Buck and my friend, Senator Gardner, who was on 
the committee writing it and who later said he hadn't seen it. No 
wonder it was hidden, when you find out it actually leads to Medicare 
insolvency sooner, when you find that it throws 22 million people off 
the insurance that they already have, when you find out it raises rates 
for those who are lucky enough to maintain their insurance, when you 
find it takes money out of our schools, when you find that it risks 
throwing our elderly out of their nursing homes who rely on Medicaid.
  This bill is a symptom of a problem. I am not a doctor; my friend 
from Colorado is not a doctor; but when I ask my doctor what you do 
when there are symptoms, it is treat the underlying cause.
  Let's do that. This bill doesn't do that. This Republican Senate bill 
that throws people off insurance doesn't do that. Let's begin a process 
where we get ideas from Democrats and Republicans to work together to 
reduce costs in healthcare, to expand coverage in healthcare, and to 
improve the quality of healthcare for American families.
  This bill is not focused on protecting patients. It increases the 
risk to patients. It drains Medicare of additional money. This bill 
will not reduce costs to patients. In fact, no healthcare bill being 
debated in Congress right now actually improves patient care or reduces 
costs to patients.
  Those should be two pillars, two goals of healthcare reform: Can we 
reduce costs, and can we improve patient care?
  This bill risks making patient care worse in an unconstitutional way. 
The Senate bill actually will increase costs to patients, increase 
deductibles, make more people lose their insurance, make you pay more 
for insurance you already have if you are one of the people who is 
lucky enough not to lose it under the cruel Republican bill.
  Instead of politicizing and polarizing access to healthcare--
literally a life-and-death issue for American families--let's work 
together to find solutions that reduce costs, increase coverage, and 
improve care. The Senate Republican healthcare bill meets none of those 
three critical criteria that the American people demand in healthcare 
reform: reducing costs, increasing coverage, and improving the quality 
of care for ourselves and for our loved ones.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BUCK. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I know my friend from Colorado did not mean to insult me 
when he referred to me as a lawyer, but I want to make a quick 
distinction.
  I spent 25 years as a prosecutor, not a lawyer. Prosecutors put 
people in prison and make the world safe for all of us; lawyers get 
people out of prison and make the world less safe for all of us. I want 
to make that distinction.
  Mr. POLIS. Will the gentleman yield?
  Mr. BUCK. I yield to the gentleman from Colorado.
  Mr. POLIS. Prosecutors are lawyers as well. So I just wanted to be 
clear that it is not an insult. Being an attorney is a fine profession. 
There are some attorneys on both sides, both defending as well 
prosecuting criminals, but they are both attorneys. I just wanted to 
clarify that.
  Mr. BUCK. Reclaiming my time, do not tell prosecutors that they are 
merely lawyers. To be a prosecutor is a higher standard.
  Mr. Speaker, I yield 5 minutes to the gentleman from Kansas (Mr. 
Marshall).
  Mr. MARSHALL. Mr. Speaker, I thank the gentleman for yielding.
  I am not an attorney either, Mr. Speaker. I am a physician. As a 
matter of fact, I am an obstetrician. I think, of all the professions 
impacted by malpractice issues, perhaps, Mr. Speaker, obstetricians 
have been the most impacted.
  I remember going back as a medical student and trying to figure out 
what type of doctor I wanted to become. My wife and I were blessed 
somewhere in there to have our first child. I remember when that little 
girl was given to me and I heard her cry, it was maybe the greatest 
single moment of my life.
  As a young medical student, I was very impressed and said: That is 
what I want to do. I want to bring babies into the world and have that 
moment when I get to give a baby to a mom and she looks at that baby 
and it is just a very special moment. It is just the most agape love I 
have ever seen, a mom with a perfect heart towards that little baby. I 
wanted to do that.
  So I started telling my professors I wanted to be an obstetrician. 
Every professor I met said: Don't do it. You are going to get sued. 
Malpractice prices are screaming. You are not going to like that job 
anymore. No one wants to go into obstetrics.
  Well, guess what? My professors were right. I did it anyway.
  The average obstetrician gets sued between three and four times in 
their career. Malpractice remains the biggest deterrent of physicians 
choosing to go into obstetrics. The average obstetrician has to spend 2 
to 3 months every year just to pay for their malpractice insurance.
  I am very blessed. Over 20 years ago, Kansas undertook similar tort 
reform as this, and our malpractice costs have stabilized. My 
malpractice insurance was pretty much the same 20 years after we 
enacted the legislation to curb some of these costs.
  I think it will be true for me to say that my friends that are 
obstetricians in other States without malpractice tort reform, their 
premiums are often three times higher than ours in Kansas. We have seen 
this work very, very well in Kansas. The good news is that this 
legislation will not impact any of that work as well.
  I very much am in favor of this malpractice tort reform and how it is 
going to impact healthcare. I predict that this will help lower premium 
costs some 3 to 4 percent when enacted.
  Malpractice is a huge cost of the current cost of healthcare. This is 
a first step of many that Republicans are encouraging or want to 
implement to start lowering those costs of premiums.
  Small Business Association members were here in D.C. just 2 months 
ago. When they walked out of that meeting, I was expecting them to come 
back and tell me their concerns were mostly regulatory concerns, but 
their number one concern was the cost of healthcare premiums.
  This is a small step. If we can lower their healthcare costs 3 to 4 
percent, this is a great, great opportunity for us to help them out.
  Mr. Speaker, I rise to support this bill. I encourage Members on both 
sides of the aisle to support this bill. It should be bipartisan 
support for this legislation that will help drive healthcare costs 
down.
  Mr. POLIS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Virginia (Mr. McEachin).
  Mr. McEACHIN. Mr. Speaker, I thank the gentleman from Colorado for 
yielding.
  Mr. Speaker, I think a couple of points, before I get to the main 
portion of my remarks, that the manager of the bill threw out need to 
be addressed.

[[Page 9953]]

  First of all, my wife is a prosecutor. I like prosecutors, but they 
are lawyers. I was a trial lawyer until December 31 of last year. Guess 
what? We sue drunk drivers. We sue for people who get hurt when it is 
not their own fault. I come from a State where contributory negligence 
is the law. So I appreciate the reverence you hold prosecutors in--I 
do, as well--but we are all lawyers.
  I also want to point out that, while there may be people on the floor 
who are not lawyers, you can't honestly believe this bill gives you 
equal access to justice, and here is why: You have a cap on noneconomic 
damages. So a person who is injured by a doctor and a person who 
receives the exact same injuries from some other tort have two 
different recoveries that they can reach. One is capped; one is not. 
That is not equal justice, in my judgment, under the law.
  In addition, you all are the pro-business party, yet you all want to 
get into how people contract with one another. I would suggest that is 
inconsistent with your pro-business approach.
  Mr. Speaker, what this bill really underlies is a fundamental 
mistrust for our constituents. Think about it. Juries are made up of 
our constituents. What you are really worried about is that your 
constituents are not going to get it right when they are sitting in 
that jury box and making decisions.
  Your constituents are wise enough to send me and 435 of us here to 
the Congress to make decisions about trillion-dollar budgets, yet you 
don't trust them to sit in the jury box and make the very important 
decisions for their fellow citizens when they are injured.
  Mr. Speaker, I want to suggest that this bill clearly violates the 
spirit of the Seventh Amendment, the right to trial by jury, by putting 
these limitations on the jury, by putting limitations on access to 
justice.
  The SPEAKER pro tempore. The gentleman is reminded that Members are 
to direct all remarks to the Chair.
  Mr. BUCK. Mr. Speaker, I reserve the balance of my time.
  Mr. POLIS. Mr. Speaker, I yield myself such time as I may consume.
  I was glad my colleague pointed out that it violates the Seventh 
Amendment. Now we add that to the 10th Amendment. So there are actually 
two Amendments. I am not even an attorney, but I know this violates two 
Amendments to our Constitution. That is pretty impressive for one bill.
  Mr. Speaker, I yield 2 minutes to the gentlewoman from Illinois (Ms. 
Schakowsky).
  Ms. SCHAKOWSKY. Mr. Speaker, I thank the gentleman for yielding.
  Mr. Speaker, I rise in strong opposition to H.R. 1215.
  My Republican colleagues seem to have a fixation with caps. In their 
healthcare bill, they slash Medicaid and, for the first time in its 
history, cap Federal funding. The result: hospital closures, 
reimbursement and staffing cuts, reduced access, and lower quality. 
Now, in this bill, they want to impose another cap, a cap on 
noneconomic damages for injured healthcare consumers.
  So who will be hurt?
  It will be people like the 76-year-old woman whose tailbone had to be 
removed because her bed sores went untreated for 12 days or an 81-year-
old resident who died because her ventilator was dislodged, alarms 
sounded, and no one responded.
  How about the family of a 92-year-old man who died after suffering 
from malnutrition and dehydration and was found with live insects in 
his eyes and mouth?
  How do we put a $250,000 value on those injured?
  Besides, this is a solution looking for a problem. There is no 
medical malpractice lawsuit crisis. Between 2000 and 2015, the number 
of claims dropped more than 40 percent and the amount paid fell 23 
percent.
  But we do face a medical crisis. Nearly half a million Americans die 
every year from preventable medical errors, and many more are 
permanently injured. This bill does nothing to solve that problem. 
Instead, it just takes away the right of the injured consumers.

                              {time}  1300

  And if you believe that average Americans should not be barred from 
the justice system as they seek to hold wrongdoers accountable, then 
you must oppose this bill.
  Mr. BUCK. Mr. Speaker, I just want to make one point.
  I have heard a number of times now that this bill is a solution 
searching for a problem or it does nothing to help our underlying cost.
  The Congressional Budget Office, the very office that my friend 
relies on for the most recent estimate of those that will decide not to 
seek insurance under the Senate healthcare bill, has estimated that 
this bill will save taxpayers $50 billion over 10 years and reduce 
medical malpractice insurance premiums by 25 percent to 30 percent.
  Mr. Speaker, I reserve the balance of my time.
  Mr. POLIS. Mr. Speaker, I yield myself such time as I may consume.
  I would like to inquire of my friend from Colorado whether 
recognizing those savings is in fact a Federal responsibility or a 
State responsibility.
  I yield to the gentleman from Colorado.
  Mr. BUCK. Mr. Speaker, I will remind my friend from Colorado that the 
very $250,000 cap that we are talking about in this bill is the same 
cap that has been adopted by the Colorado State Legislature.
  Mr. POLIS. Mr. Speaker, exactly. What I would further add, then, is 
whose prerogative is it to institute this kind of cap: States like our 
own State of Colorado, which has that cap? Or Washington, D.C. insiders 
behind closed doors?
  I yield to the gentleman from Colorado.
  Mr. BUCK. Mr. Speaker, I would remind my friend again that the States 
that have adopted any cap--it could be $250,000, it could be $500,000, 
it could be $1 million in non-economic damage caps--will not be 
affected by this bill. This bill only affects those States that have no 
caps, and it is Federal money that is being used to pay for these.
  Mr. POLIS. Mr. Speaker, reclaiming my time, this effectively co-ops 
States and forces other States to do the same thing that my colleague's 
and my State of Colorado has already done. It goes beyond that as well. 
Under the 10th Amendment of the Constitution, this should be a power 
reserved for the States.
  Mr. Speaker, I would like to shed light on a serious issue facing 
millions of students nationally and in my home State of Colorado. Every 
day, 50 million students and 3 million teachers face significant health 
and safety threats due to inadequate school facilities. I have heard 
about many in Colorado, school gyms that are closed down because their 
roofs are falling in, staggering statistics that disproportionately 
affect high-poverty schools, particularly urban and rural schools, and 
many schools serving a high percentage of minority students.
  Today we have a chance to address this rampant inequality throughout 
our school districts and to create jobs in the process.
  If we defeat the previous question, I will offer an amendment to the 
rule to bring up Representative Bobby Scott's Rebuild America's Schools 
Act, H.R. 2475, which I am also a proud co-sponsor of. Mr. Scott's 
legislation would invest $100 billion in the physical and digital 
infrastructure needs of our schools, creating nearly 2 million jobs and 
creating the education infrastructure we need for the 21st century.
  Mr. Speaker, I ask unanimous consent to insert the text of my 
amendment in the Record, along with extraneous material, immediately 
prior to the vote on the previous question.
  The SPEAKER pro tempore (Mr. Donovan). Is there objection to the 
request of the gentleman from Colorado?
  There was no objection.
  Mr. POLIS. Mr. Speaker, I yield 4 minutes to the gentleman from 
Virginia (Mr. Scott), the distinguished ranking member of the Education 
and the Workforce Committee, to discuss our proposal.
  Mr. SCOTT of Virginia. Mr. Speaker, I thank the gentleman from 
Colorado (Mr. Polis) for proposing this amendment.

[[Page 9954]]

  The Rebuild America's Schools Act would help ensure that each of our 
Nation's 50 million public school students, taught by 3 million 
teachers, will have access to safe, healthy, and high-quality learning 
facilities and internet access sufficient for digital learning in the 
classroom.
  This bold proposal would create nearly 2 million jobs, improve 
student learning, and revitalize under-resourced communities.
  The Rebuild America's Schools Act is a win for students, families, 
workers, and the economy; and any responsible infrastructure proposal 
put forth by Congress should include a bold investment in our Nation's 
public schools.
  Mr. Speaker, this bill was introduced on the 63rd anniversary of 
Brown v. Board of Education because, despite the promise of Brown, our 
public school facilities remain largely separate and woefully unequal.
  Last year, on the 62nd anniversary of Brown, Ranking Member Conyers 
and I unveiled the findings of a GAO report that found that more 
students are attending schools highly segregated by race and class.
  Now, that most recent GAO report examining the state of our public 
schools' infrastructure saw that low-income and minority students are 
served by poor and inadequate school facilities.
  If we are to fully achieve the promise of Brown, then no child should 
remain in a classroom with a leaking roof or a broken heating system. 
All students should have equitable access to science labs or spaces for 
high-quality career and technical educational programs.
  Mr. Speaker, 12 States do not invest any money in capital 
construction projects in public schools, leaving responsibility of 
ensuring high-quality classrooms up to localities and local property 
taxes, which virtually guarantees inequitable funding between high- and 
low-income districts.
  This bill targets Federal funding for school infrastructure to 
districts and school buildings with the greatest need for improvement 
to their physical and digital infrastructure, which would be an 
important step in fulfilling the promise of Brown.
  All too often, when Congress talks about infrastructure investment, 
we speak only about investments in roads, bridges, and other public 
buildings. Public schools are often left out of the conversation, but 
schools must be part of that conversation on infrastructure.
  The Rebuild America's Schools Act will ensure safe drinking water in 
schools, prevent instructional materials like textbooks from being 
ruined as a result of broken heating and air-conditioning systems, and 
improve air quality that students breathe in the schools. It will bring 
access to digital learning for more than 11 million students in nearly 
20,000 schools who do not already have it. Finally, the bill would mean 
high-quality jobs for nearly 2 million pipefitters, construction 
workers, and other hardworking Americans.
  Mr. Speaker, I urge Members to defeat the previous question so we can 
debate and pass the Rebuild America's Schools Act. We owe it to 
America's students and hardworking families.
  Mr. BUCK. Mr. Speaker, I want to inquire of my friend from Colorado, 
he mentioned when he was introducing the gentleman from Virginia that 
there are schools that are closing because gym roofs are falling in. I 
know a number of very generous individuals that would like to 
contribute.
  Does the gentleman from Colorado (Mr. Polis) have the names of any of 
those schools for us?
  I yield to the gentleman.
  Mr. POLIS. Mr. Speaker, I will be happy to supply those. To be clear, 
the entire school doesn't close, just the gym closes.
  Mr. BUCK. Mr. Speaker, I have no further speakers.
  Mr. POLIS. Mr. Speaker, I do have further speakers.
  Mr. BUCK. Mr. Speaker, I reserve the balance of my time.
  Mr. POLIS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Nevada (Mr. Kihuen).
  Mr. KIHUEN. Mr. Speaker, I rise today in support of the Rebuilding 
America's Schools Act. Every day, students attend schools that put 
their health and safety at risk. The average school building is nearly 
50 years old, and teachers and children struggle to learn in classrooms 
without heat, leaking ceilings, and no working internet.
  Mr. Speaker, our children deserve better. Research shows that poor 
school facility conditions impact teaching and learning, and 
disproportionately plague schools that serve low-income and minority 
students all throughout America. Regardless of their ZIP Code, all 
children should have access to a quality education, and no child should 
have to learn in an unsafe or dilapidated environment.
  The Rebuilding America's Schools Act would provide critically needed 
investments in Las Vegas and rural Nevada to improve our school 
infrastructure, helping teachers teach and children learn.
  President Trump has repeatedly promised to rebuild our Nation's 
infrastructure. Passing the Rebuilding America's Schools Act would be 
the first step in making this happen. We must make an investment in our 
future generation to guarantee their shot at success.
  Mr. Speaker, I urge my colleagues to support this piece of 
legislation.
  Mr. BUCK. Mr. Speaker, I reserve the balance of my time.
  Mr. POLIS. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, when we think about healthcare, we all think about, of 
course, first and foremost, ourselves and our loved ones and our 
families. As Representatives of 750,000 people, we also think about 
constituents that we know, that we have met, for whom healthcare is 
literally a life-and-death situation.
  I think of my friend Debbie and her son Sam. Debbie's son Sam was 
diagnosed with type 1 diabetes when he was 4 years old. He is now 20 or 
21 or so. He was a healthy kid, he ate healthy food, an active young 
child. As Debbie pointed out to me, it is not that anybody chooses an 
illness or a condition, the illness chooses you. Through the luck of 
the draw, her son Sam is afflicted with type 1 diabetes. Like many 
people with autoimmune diseases, it was not poor choices, it was not 
lifestyle decisions that gave him the disease or even increased his 
risk of the disease. He was dealt a bad hand with an autoimmune gene 
that his family didn't even know that they had.
  Because of that, Sam has a costly disease. Thankfully, one that can 
be treated, if not cured, but he has a costly disease for the rest of 
his life. There is no cure, and the cost of insulin and other 
lifesaving technologies is very high.
  Sam has what here in Washington people call a preexisting condition. 
That is what we are talking about. Without insurance, the cost per 
month would go from about $400, which Debbie and her husband are able 
to afford and put together for Sam, to $2,500 a month, which they could 
not possibly afford to do.
  Sam is now 20, and because of the Affordable Care Act, he will be on 
the family's health insurance until he is 26. That is, if the family 
can keep their health insurance. The family worries, like so many 
others, that they might be one of those 22 million families that loses 
coverage under this Republican healthcare bill. It is a lot of 
families.
  It is not going to be any of my colleagues' families. My colleagues 
have a government health insurance plan from serving in the House of 
Representatives. Their congressional staff has access to the exchanges, 
just like we do, to buy insurance. But 22 million people in each and 
every one of our districts, 435 districts in this country, in each and 
every one of our districts, not dozens of people, not hundreds of 
people, but thousands of real people like Deb and Sam, like a story I 
shared earlier of Marcia and Grace, will actually lose their 
healthcare. They will be forced to give up their home, become 
insolvent, go bankrupt, or die. A choice that no American should have 
to face.
  Mr. Speaker, the bill under consideration today is one of many that 
didn't go through regular order. There were no hearings. Closed 
process. They cut out all the Democratic amendments

[[Page 9955]]

that we had to improve the bill. That is how the Republicans have been 
handling healthcare legislation this Congress. That is why this 
approach isn't working. It is why this approach is so unpopular. No 
hearings, shut Members out of the legislative process, bring a bill to 
the floor that was hidden in some closet, written in secret, widely 
unpopular, throwing people off healthcare insurance, raising rates for 
those who are luckily enough to keep their insurance.
  This bill is not aimed at protecting patients. This bill before us 
and the Senate Republican healthcare bill make it more difficult for 
Americans to deal with real-life healthcare issues that were dealt over 
the course of life for ourselves and our families.
  We need a reset, Mr. Speaker. We need to reset and start real 
discussions about improving healthcare.
  How could Democrats or Republicans work together to reduce costs?
  Democrats and Republicans should work together to expand coverage. We 
shouldn't be talking about whether 22 million people lose coverage or 
10 million people lose coverage or 5 million people lose coverage. 
Let's talk about 5 million people gaining coverage, 10 million people 
gaining coverage. Let's reset and frame the discussion about how more 
people can have access to healthcare.
  The problem we are trying to solve is not how can we get less 
Americans to have access to healthcare. That is why this bill is so 
unpopular. If that is the problem Republicans are trying to solve, they 
solved it in this bill. Less Americans will have healthcare. But that 
is not the problem that the American people want us to address in 
Congress.
  More people with healthcare, and people want to save money. They want 
their insurance rates to be lower, their deductibles to be lower. They 
want to save money. There are some low-hanging fruit in terms of costs 
in healthcare, administrative overhead, wasteful and duplicative 
spending, that we can go after together. These are good ideas, whether 
you are a Democrat or a Republican.
  One of the amendments that I proposed was pricing transparency. One 
of the problems in the healthcare marketplace is nobody knows how much 
anybody charges. Different insurers and private payers pay widely 
different amounts for the exact same procedure. Let's at least disclose 
the pricing and have transparency so market mechanisms will work to 
pull down rates by promoting competition.

                              {time}  1315

  By not allowing the market into healthcare, we are creating 
inefficiencies and raising rates. Let's come together on that. Let's 
come together around a lot of good ideas that Democrats and Republicans 
have bills on and have amendments on. But, no, they are not even 
allowed to be debated and not even allowed to be voted on either on 
this bill, in which every Democratic amendment was shut down, or in the 
Republican healthcare bill, in which no process was allowed for 
Democrats to improve the bill.
  We have never even been invited into the secret backroom to figure 
out what was being debated. We didn't even see the bill until it was 
presented fully formed days before it had to be voted on, affecting the 
lives of 22 million Americans, one-eighth of our entire economy, 
without any hearings, without any expert testimony, and only days to 
digest this hundred-page bill.
  So look, let's reset, let's work together to bring down costs, 
expanding coverage and improving quality, and create a work product in 
healthcare reform that we can be proud of as Republicans, as Democrats, 
and as Americans; one in which Debbie and her son, Sam, don't have to 
worry about giving up their home or facing death; or one in which Grace 
and her mother are able to live out their lives without worrying about 
their preexisting condition.
  Mr. Speaker, I call upon my colleagues to reject this closed rule, 
and I yield back the balance of my time.
  Mr. BUCK. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I appreciate my friend's newfound sense of 
bipartisanship. The Affordable Care Act was passed without a single 
Republican vote in the House, without a single Republican vote in the 
Senate, and without any concern of Republican thoughts about how 
healthcare should be run in this country. Now that the Affordable Care 
Act is, in fact, failing; now that we have over 90 counties in America 
that have zero health insurers to choose from in the individual market; 
and now that we see the Affordable Care Act in a death spiral, all of a 
sudden, we are concerned about the bipartisanship and how to fix the 
problem.
  We have heard zero amendments in the past 6 years to the Affordable 
Care Act that would have, in fact, improved the Affordable Care Act 
from the other side of the aisle while they had the President in the 
White House, and now, all of a sudden, we are looking for 
bipartisanship and solutions. We will find that bipartisanship and 
those solutions in the future.
  Mr. Speaker, if we truly want affordable healthcare in this country, 
then we need to address the cost of supplying care. H.R. 1215 strikes 
at the heart of skyrocketing medical care. By limiting frivolous and 
unending lawsuits, doctors can focus less on the courtroom and more on 
the patient in the operating room.
  The reforms made by H.R. 1215 will be especially important for rural 
America and underserved urban America. Doctors will be able to afford 
to live and practice in these communities, providing the attentive and 
responsive care that all Americans deserve, not just Americans who live 
a few miles from a major hospital.
  I encourage my colleagues on both sides of the aisle to support this 
legislation. I know Democrats and Republicans have different policy 
approaches to reforming our healthcare system, but this legislation has 
already been implemented by Democrats in the State of California, where 
it has proven successful. Now we have the chance to apply this approach 
more broadly, in a way that will help millions of Americans. This 
effort has been bipartisan in the past and should be bipartisan today.
  Mr. Speaker, I thank the sponsor of this bill, Representative Steve 
King.
  Mr. Speaker, I urge a ``yes'' vote on the resolution, and I urge a 
``yes'' vote on the underlying bill.
  Ms. JACKSON LEE. Mr. Speaker, I rise in opposition to the rule 
governing debate of H.R. 1215, the ``Protecting Access to Care Act of 
2017'' and the underlying bill.
  I oppose the rule for H.R. 1215, the ``Protecting Access to Care Act 
of 2017'' for the following reasons:
  There were twenty-five amendments proposed by colleagues from both 
sides of the aisle.
  Only five of those amendments were made in order.
  What did all five of those amendments have in common?
  These amendments were all submitted by my Republican counterparts.
  The rule for this bill incorporates none of the amendments offered by 
my Democratic colleagues.
  Mr. Speaker, that exclusion is problematic.
  The amendments not made in order reflect the crippling partisanship 
of the House majority.
  I also oppose the underlying bill on the merits, because it limits 
noneconomic damages to a mere $250,000, which if enacted, would have a 
disproportionately adverse impact on women, the poor, and other 
vulnerable groups.
  When given the opportunity, members refused to incorporate an 
amendment that would increase that cap to reflect the cost of inflation 
and a concern for the humane treatment of those individuals affected by 
medical malpractice.
  H.R. 1215 provides immunity for health care providers who dispense 
defective or dangerous pharmaceuticals or medical devices.
  Finally, I oppose the bill, because it creates an excessively short 
statute of limitations period, makes it harder for victims to obtain 
adequate legal representation, and imposes the risk of loss on victims 
rather than wrongdoers.
  Mr. Speaker, there are numerous examples of people who have suffered 
at the hands of medical providers and whose lives will never be the 
same.
  Consider the case of Olivia, an exceptionally bright high school 
senior from Santa Monica, California, who had gained early acceptance 
to Smith College in Massachusetts.

[[Page 9956]]

  She never made it to Smith College, because after a medical procedure 
was completed and while Olivia was still under anesthesia, a fellow-in-
training pulled the catheter causing Olivia's vital signs to plummet.
  Hospital staff waited more than ten minutes to resuscitate her, but 
it was far too late for Olivia.
  She passed away, and her promising future disappeared.
  This tragedy never should have happened.
  Mr. Speaker, instead of wasting time on this giveaway to special 
interests, we should be improving the Affordable Care Act, and opposing 
any bill that would leave over twenty million Americans uninsured, and 
investigating Russian involvement in our democratic processes.
  For these reasons, I oppose the rule and the underlying bill.
  The material previously referred to by Mr. Polis is as follows:

            An Amendment to H. Res. 382 Offered by Mr. Polis

       At the end of the resolution, add the following new 
     sections:
       Sec. 2. Immediately upon adoption of this resolution the 
     Speaker shall, pursuant to clause 2(b) of rule XVIII, declare 
     the House resolved into the Committee of the Whole House on 
     the state of the Union for consideration of the bill (H.R. 
     2475) to provide for the long-term improvement of public 
     school facilities, and for other purposes. The first reading 
     of the bill shall be dispensed with. All points of order 
     against consideration of the bill are waived. General debate 
     shall be confined to the bill and shall not exceed one hour 
     equally divided and controlled by the chair and ranking 
     minority member of the Committee on Education and the 
     Workforce. After general debate the bill shall be considered 
     for amendment under the five-minute rule. All points of order 
     against provisions in the bill are waived. At the conclusion 
     of consideration of the bill for amendment the Committee 
     shall rise and report the bill to the House with such 
     amendments as may have been adopted. The previous question 
     shall be considered as ordered on the bill and amendments 
     thereto to final passage without intervening motion except 
     one motion to recommit with or without instructions. If the 
     Committee of the Whole rises and reports that it has come to 
     no resolution on the bill, then on the next legislative day 
     the House shall, immediately after the third daily order of 
     business under clause 1 of rule XIV, resolve into the 
     Committee of the Whole for further consideration of the bill.
       Sec. 3. Clause 1(c) of rule XIX shall not apply to the 
     consideration of H.R. 2475.
                                  ____


        The Vote on the Previous Question: What It Really Means

       This vote, the vote on whether to order the previous 
     question on a special rule, is not merely a procedural vote. 
     A vote against ordering the previous question is a vote 
     against the Republican majority agenda and a vote to allow 
     the Democratic minority to offer an alternative plan. It is a 
     vote about what the House should be debating.
       Mr. Clarence Cannon's Precedents of the House of 
     Representatives (VI, 308-311), describes the vote on the 
     previous question on the rule as ``a motion to direct or 
     control the consideration of the subject before the House 
     being made by the Member in charge.'' To defeat the previous 
     question is to give the opposition a chance to decide the 
     subject before the House. Cannon cites the Speaker's ruling 
     of January 13, 1920, to the effect that ``the refusal of the 
     House to sustain the demand for the previous question passes 
     the control of the resolution to the opposition'' in order to 
     offer an amendment. On March 15, 1909, a member of the 
     majority party offered a rule resolution. The House defeated 
     the previous question and a member of the opposition rose to 
     a parliamentary inquiry, asking who was entitled to 
     recognition. Speaker Joseph G. Cannon (R-Illinois) said: 
     ``The previous question having been refused, the gentleman 
     from New York, Mr. Fitzgerald, who had asked the gentleman to 
     yield to him for an amendment, is entitled to the first 
     recognition.''
       The Republican majority may say ``the vote on the previous 
     question is simply a vote on whether to proceed to an 
     immediate vote on adopting the resolution . . . [and] has no 
     substantive legislative or policy implications whatsoever.'' 
     But that is not what they have always said. Listen to the 
     Republican Leadership Manual on the Legislative Process in 
     the United States House of Representatives, (6th edition, 
     page 135). Here's how the Republicans describe the previous 
     question vote in their own manual: ``Although it is generally 
     not possible to amend the rule because the majority Member 
     controlling the time will not yield for the purpose of 
     offering an amendment, the same result may be achieved by 
     voting down the previous question on the rule . . . When the 
     motion for the previous question is defeated, control of the 
     time passes to the Member who led the opposition to ordering 
     the previous question. That Member, because he then controls 
     the time, may offer an amendment to the rule, or yield for 
     the purpose of amendment.''
       In Deschler's Procedure in the U.S. House of 
     Representatives, the subchapter titled ``Amending Special 
     Rules'' states: ``a refusal to order the previous question on 
     such a rule [a special rule reported from the Committee on 
     Rules] opens the resolution to amendment and further 
     debate.'' (Chapter 21, section 21.2) Section 21.3 continues: 
     ``Upon rejection of the motion for the previous question on a 
     resolution reported from the Committee on Rules, control 
     shifts to the Member leading the opposition to the previous 
     question, who may offer a proper amendment or motion and who 
     controls the time for debate thereon.''
       Clearly, the vote on the previous question on a rule does 
     have substantive policy implications. It is one of the only 
     available tools for those who oppose the Republican 
     majority's agenda and allows those with alternative views the 
     opportunity to offer an alternative plan.

  Mr. BUCK. Mr. Speaker, I yield back the balance of my time, and I 
move the previous question on the resolution.
  The SPEAKER pro tempore. The question is on ordering the previous 
question.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. POLIS. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 and clause 9 of rule 
XX, this 15-minute vote on ordering the previous question will be 
followed by 5-minute votes on:
  Adopting the resolution, if ordered; and
  Agreeing to the Speaker's approval of the Journal.
  The vote was taken by electronic device, and there were--yeas 234, 
nays 184, not voting 15, as follows:

                             [Roll No. 325]

                               YEAS--234

     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)
     Brat
     Bridenstine
     Brooks (AL)
     Brooks (IN)
     Buchanan
     Buck
     Bucshon
     Budd
     Burgess
     Byrne
     Calvert
     Carter (GA)
     Carter (TX)
     Chabot
     Chaffetz
     Cheney
     Coffman
     Cole
     Collins (GA)
     Collins (NY)
     Comer
     Comstock
     Conaway
     Cook
     Costello (PA)
     Cramer
     Crawford
     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
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gaetz
     Gallagher
     Garrett
     Gianforte
     Gibbs
     Gohmert
     Goodlatte
     Gosar
     Gowdy
     Graves (GA)
     Graves (LA)
     Graves (MO)
     Griffith
     Grothman
     Guthrie
     Handel
     Harper
     Harris
     Hartzler
     Hensarling
     Herrera Beutler
     Hice, Jody B.
     Higgins (LA)
     Hill
     Holding
     Hollingsworth
     Hudson
     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)
     King (NY)
     Kinzinger
     Knight
     Kustoff (TN)
     Labrador
     LaHood
     LaMalfa
     Lamborn
     Lance
     Latta
     Lewis (MN)
     LoBiondo
     Loudermilk
     Love
     Lucas
     Luetkemeyer
     MacArthur
     Marchant
     Marino
     Marshall
     Massie
     Mast
     McCarthy
     McCaul
     McClintock
     McHenry
     McKinley
     McMorris Rodgers
     McSally
     Meadows
     Meehan
     Messer
     Mitchell
     Moolenaar
     Mooney (WV)
     Mullin
     Murphy (PA)
     Newhouse
     Noem
     Norman
     Nunes
     Olson
     Palazzo
     Palmer
     Paulsen
     Pearce
     Perry
     Pittenger
     Poe (TX)
     Poliquin
     Posey
     Ratcliffe
     Reed
     Reichert
     Rice (SC)
     Roby
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rohrabacher
     Rokita
     Rooney, Francis
     Rooney, Thomas J.
     Ros-Lehtinen
     Roskam
     Ross
     Rothfus
     Rouzer
     Royce (CA)
     Russell
     Rutherford
     Sanford
     Schweikert
     Scott, Austin
     Sensenbrenner
     Sessions
     Shimkus
     Shuster
     Simpson
     Smith (MO)
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Smucker
     Stefanik
     Stewart
     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 (AK)
     Young (IA)
     Zeldin

                               NAYS--184

     Adams
     Aguilar
     Barragan
     Bass
     Beatty
     Bera
     Beyer
     Bishop (GA)
     Blumenauer
     Blunt Rochester
     Bonamici
     Boyle, Brendan F.
     Brady (PA)
     Brown (MD)

[[Page 9957]]


     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
     Costa
     Courtney
     Crist
     Crowley
     Cuellar
     Davis (CA)
     Davis, Danny
     DeFazio
     DeGette
     Delaney
     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)
     Gottheimer
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hanabusa
     Hastings
     Heck
     Higgins (NY)
     Himes
     Hoyer
     Huffman
     Jackson Lee
     Jeffries
     Johnson (GA)
     Johnson, E. B.
     Kaptur
     Keating
     Kelly (IL)
     Kennedy
     Khanna
     Kihuen
     Kildee
     Kilmer
     Kind
     Krishnamoorthi
     Kuster (NH)
     Langevin
     Larsen (WA)
     Larson (CT)
     Lawrence
     Lawson (FL)
     Lee
     Levin
     Lewis (GA)
     Lieu, Ted
     Lipinski
     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
     Nolan
     Norcross
     O'Rourke
     Pallone
     Panetta
     Pascrell
     Payne
     Pelosi
     Perlmutter
     Peters
     Peterson
     Pingree
     Pocan
     Polis
     Price (NC)
     Quigley
     Raskin
     Rice (NY)
     Richmond
     Rosen
     Roybal-Allard
     Ruiz
     Ruppersberger
     Rush
     Ryan (OH)
     Sanchez
     Sarbanes
     Schakowsky
     Schiff
     Schneider
     Schrader
     Scott (VA)
     Scott, David
     Serrano
     Shea-Porter
     Sherman
     Sinema
     Sires
     Slaughter
     Smith (WA)
     Soto
     Speier
     Suozzi
     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)

                             NOT VOTING--15

     Cummings
     DeLauro
     Flores
     Granger
     Jayapal
     Loebsack
     Long
     Napolitano
     Neal
     O'Halleran
     Renacci
     Scalise
     Sewell (AL)
     Stivers
     Yarmuth

                              {time}  1340

  Ms. KUSTER of New Hampshire, Messrs. VELA, and BISHOP of Georgia 
changed their vote from ``yea'' to ``nay.''
  So the previous question was ordered.
  The result of the vote was announced as above recorded.
  Stated against:
  Ms. SEWELL of Alabama. Mr. Speaker, I was unavoidably detained. Had I 
been present, I would have voted ``nay'' on rollcall No. 325.
  Ms. JAYAPAL. Mr. Speaker, I was unavoidably detained. Had I been 
present, I would have voted ``nay'' on rollcall No. 325.
  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.


                             Recorded Vote

  Mr. POLIS. Mr. Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The SPEAKER pro tempore. This is a 5-minute vote.
  The vote was taken by electronic device, and there were--ayes 235, 
noes 186, not voting 12, as follows:

                             [Roll No. 326]

                               AYES--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)
     Brat
     Bridenstine
     Brooks (AL)
     Brooks (IN)
     Buchanan
     Buck
     Bucshon
     Budd
     Burgess
     Byrne
     Calvert
     Carter (GA)
     Carter (TX)
     Chabot
     Chaffetz
     Cheney
     Coffman
     Cole
     Collins (GA)
     Collins (NY)
     Comer
     Comstock
     Conaway
     Cook
     Costello (PA)
     Cramer
     Crawford
     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
     Gianforte
     Gibbs
     Gohmert
     Goodlatte
     Gosar
     Gowdy
     Granger
     Graves (GA)
     Graves (LA)
     Graves (MO)
     Griffith
     Grothman
     Guthrie
     Handel
     Harper
     Harris
     Hartzler
     Hensarling
     Herrera Beutler
     Higgins (LA)
     Hill
     Holding
     Hollingsworth
     Hudson
     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)
     King (NY)
     Kinzinger
     Knight
     Kustoff (TN)
     Labrador
     LaHood
     LaMalfa
     Lamborn
     Lance
     Latta
     Lewis (MN)
     LoBiondo
     Loudermilk
     Love
     Lucas
     Luetkemeyer
     MacArthur
     Marchant
     Marino
     Marshall
     Massie
     Mast
     McCarthy
     McCaul
     McClintock
     McHenry
     McKinley
     McMorris Rodgers
     McSally
     Meadows
     Meehan
     Messer
     Mitchell
     Moolenaar
     Mooney (WV)
     Mullin
     Murphy (PA)
     Newhouse
     Noem
     Norman
     Nunes
     Olson
     Palazzo
     Palmer
     Paulsen
     Pearce
     Perry
     Pittenger
     Poe (TX)
     Poliquin
     Posey
     Ratcliffe
     Reed
     Reichert
     Rice (SC)
     Roby
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rohrabacher
     Rokita
     Rooney, Francis
     Rooney, Thomas J.
     Ros-Lehtinen
     Roskam
     Ross
     Rothfus
     Rouzer
     Royce (CA)
     Russell
     Rutherford
     Sanford
     Schweikert
     Scott, Austin
     Sensenbrenner
     Sessions
     Shimkus
     Shuster
     Simpson
     Smith (MO)
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Smucker
     Stefanik
     Stewart
     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 (AK)
     Young (IA)
     Zeldin

                               NOES--186

     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
     Costa
     Courtney
     Crist
     Crowley
     Cuellar
     Davis (CA)
     Davis, Danny
     DeFazio
     DeGette
     Delaney
     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)
     Gottheimer
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hanabusa
     Hastings
     Heck
     Higgins (NY)
     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)
     Larson (CT)
     Lawrence
     Lawson (FL)
     Lee
     Levin
     Lewis (GA)
     Lieu, Ted
     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
     Nolan
     Norcross
     O'Halleran
     O'Rourke
     Pallone
     Panetta
     Pascrell
     Payne
     Perlmutter
     Peters
     Peterson
     Pingree
     Pocan
     Polis
     Price (NC)
     Quigley
     Raskin
     Rice (NY)
     Richmond
     Rosen
     Roybal-Allard
     Ruiz
     Ruppersberger
     Rush
     Ryan (OH)
     Sanchez
     Sarbanes
     Schakowsky
     Schiff
     Schneider
     Schrader
     Scott (VA)
     Scott, David
     Serrano
     Sewell (AL)
     Shea-Porter
     Sherman
     Sinema
     Sires
     Slaughter
     Smith (WA)
     Soto
     Speier
     Suozzi
     Swalwell (CA)
     Takano
     Thompson (CA)
     Thompson (MS)
     Titus
     Tonko
     Torres
     Tsongas
     Vargas
     Veasey
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters, Maxine
     Watson Coleman
     Welch
     Wilson (FL)
     Yarmuth

                             NOT VOTING--12

     Cummings
     DeLauro
     Hice, Jody B.
     Himes
     Long
     Napolitano
     Neal
     Pelosi
     Renacci
     Scalise
     Stivers
     Vela

                              {time}  1348

  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.


                          PERSONAL EXPLANATION

  Mrs. NAPOLITANO. Mr. Speaker, I was absent during rollcall votes No. 
323, No. 324, No. 325, and No. 326 due to my spouse's health situation 
in California. Had I been present, I would have voted ``yea'' on H.R. 
2547--Veterans Expanded Trucking Opportunities Act of 2017. I would 
have also voted ``yea'' on H.R. 2258--ADVANCE Act. I would have also 
voted ``nay'' on the Motion on Ordering the Previous Question on the 
Rule providing for consideration of H.R. 1215. I would have also voted 
``nay'' on H. Res. 382--Rule providing for consideration of H.R. 1215--
Protecting Access to Care Act of 2017.

[[Page 9958]]



                          ____________________