[House Report 112-70]
[From the U.S. Government Publishing Office]


112th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 1st Session                                                     112-70

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PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 1213) TO REPEAL MANDATORY 
  FUNDING PROVIDED TO STATES IN THE PATIENT PROTECTION AND AFFORDABLE 
CARE ACT TO ESTABLISH AMERICAN HEALTH BENEFIT EXCHANGES, AND PROVIDING 
 FOR CONSIDERATION OF THE BILL (H.R. 1214) TO REPEAL MANDATORY FUNDING 
              FOR SCHOOL-BASED HEALTH CENTER CONSTRUCTION

                                _______
                                

 May 2, 2011.--Referred to the House Calendar and ordered to be printed

                                _______
                                

                Mr. Reed, from the Committee on Rules, 
                        submitted the following

                              R E P O R T 

                       [To accompany H. Res. 236]

    The Committee on Rules, having had under consideration 
House Resolution 236, by a nonrecord vote, report the same to 
the House with the recommendation that the resolution be 
adopted.

                SUMMARY OF PROVISIONS OF THE RESOLUTION

    The resolution provides for consideration of H.R. 1213, to 
repeal mandatory funding provided to States in the Patient 
Protection and Affordable Care Act to establish American Health 
Benefit Exchanges, under a structured rule. The resolution 
provides one hour of general debate equally divided and 
controlled by the chair and ranking minority member of the 
Committee on Energy and Commerce. The resolution waives all 
points of order against consideration of the bill. The 
resolution provides that the bill shall be considered as read. 
The resolution waives all points of order against provisions in 
the bill. The resolution makes in order only those amendments 
printed in this report. Each such amendment may be offered only 
in the order printed in this report, may be offered only by a 
Member designated in this report, shall be considered as read, 
shall be debatable for the time specified in this 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 
the amendments are waived. The resolution provides one motion 
to recommit with or without instructions.
    The resolution also provides for consideration of H.R. 
1214, to repeal mandatory funding for school-based health 
center construction, under a modified open rule. The resolution 
provides for one hour of general debate equally divided and 
controlled by the chair and ranking minority member of the 
Committee on Energy and Commerce. The resolution waives all 
points of order against consideration of the bill. The 
resolution provides that the bill shall be considered as read. 
The resolution waives all points of order against provisions in 
the bill. The resolution makes in order only those amendments 
that are received for printing in the portion of the 
Congressional Record designated for that purpose in clause 8 of 
rule XVIII in a daily issue dated May 2, 2011, and pro forma 
amendments for the purpose of debate. Each amendment received 
for printing in the Congressional Record may be offered only by 
the Member who caused it to be printed or a designee, and each 
such amendment shall be considered as read if printed. The 
resolution provides one motion to recommit with or without 
instructions.

                         EXPLANATION OF WAIVERS

    Although the resolution waives all points of order against 
consideration of H.R. 1213, the Committee is not aware of any 
points of order against its consideration. The waiver of all 
points of order is prophylactic.
    Although the resolution waives all points of order against 
provisions in H.R. 1213, the Committee is not aware of any 
points of order against provisions in the bill. The waiver 
against provisions in the bill is prophylactic in nature.
    Although the resolution waives all points of order against 
amendments printed in this report, the Committee is not aware 
of any points of order against the amendments and therefore the 
waiver is prophylactic in nature.
    Although the resolution waives all points of order against 
consideration of the H.R. 1214, the Committee is not aware of 
any points of order against its consideration. The waiver of 
all points of order is prophylactic.
    Although the resolution waives all points of order against 
provisions in H.R. 1214, the Committee is not aware of any 
points of order against provisions in the bill. The waiver 
against provisions in the bill is prophylactic in nature.

                            COMMITTEE VOTES

    The results of each record vote on an amendment or motion 
to report, together with the names of those voting for and 
against, are printed below:

Rules Committee record vote No. 86

    Motion by Mr. Hastings of Florida to make in order 
separately and provide the appropriate waivers for each of the 
following amendments to H.R. 1213: Rep. Woolsey (CA), #2, would 
preserve the competitive health insurance exchanges while also 
enacting a public health insurance option, which would compete 
with private plans within the exchanges; Rep. Ellison (MN), #3, 
would require the Secretary of Health and Human Services to 
submit to Congress a report of the impact of H.R. 1213 on the 
uninsured rate in the United States; Rep. Waters (CA), #5, 
would prevent the bill from taking effect if the Secretary of 
Health and Human Services certifies that a significant number 
of uninsured Americans would have difficulty obtaining 
affordable health insurance coverage without being able to 
access a Health Benefit Exchange; Rep. Waters (CA), #6, would 
prevent the bill from taking effect until legislation is 
enacted that repeals the requirement for states to establish 
Health Benefit Exchanges; Rep. Waters (CA), #7, would prevent 
the bill from taking effect if the Governors of five or more 
states each certify that their states may be unable to afford 
to establish a Health Benefit Exchange without any federal 
assistance; Rep. Waters (CA), #9, would require, within 6 
months after enactment, the Secretary of Health and Human 
Services to submit to Congress a report on the extent to which 
uninsured Americans will have difficulty obtaining affordable 
health insurance coverage without being able to access such 
coverage through Health Benefit Exchanges; Rep. Welch (VT), 
#10, would direct the Government Accountability Office to 
conduct a study to determine the extent to which the repeal of 
funding to states for Health Benefit Exchanges will result in a 
decrease of the number of individuals who have access to health 
insurance. Defeated: 3-9

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                Majority Members                      Vote               Minority Members               Vote
----------------------------------------------------------------------------------------------------------------
Mr. Sessions....................................          Nay   Mr. McGovern......................          Yea
Ms. Foxx........................................          Nay   Mr. Hastings of Florida...........          Yea
Mr. Bishop of Utah..............................          Nay   Mr. Polis.........................          Yea
Mr. Woodall.....................................          Nay
Mr. Nugent......................................          Nay
Mr. Scott of South Carolina.....................          Nay
Mr. Webster.....................................          Nay
Mr. Reed........................................          Nay
Mr. Dreier, Chairman............................          Nay
----------------------------------------------------------------------------------------------------------------

Rules Committee record vote No. 87

    Motion by Mr. Hastings of Florida to report an open rule 
for H.R. 1213. Defeated: 3-9

----------------------------------------------------------------------------------------------------------------
                Majority Members                      Vote               Minority Members               Vote
----------------------------------------------------------------------------------------------------------------
Mr. Sessions....................................          Nay   Mr. McGovern......................          Yea
Ms. Foxx........................................          Nay   Mr. Hastings of Florida...........          Yea
Mr. Bishop of Utah..............................          Nay   Mr. Polis.........................          Yea
Mr. Woodall.....................................          Nay
Mr. Nugent......................................          Nay
Mr. Scott of South Carolina.....................          Nay
Mr. Webster.....................................          Nay
Mr. Reed........................................          Nay
Mr. Dreier, Chairman............................          Nay
----------------------------------------------------------------------------------------------------------------

                  SUMMARY OF AMENDMENTS MADE IN ORDER

    1. Jackson Lee (TX): Would require the Secretary of Health 
and Human Services to post notice of rescission of funds and 
the amount rescinded on the public website of the Department of 
Health and Human Services. (10 minutes)
    2. Waters (CA): Would require, within 6 months after 
enactment, the Secretary of Health and Human Services to submit 
to Congress a report on the extent to which states are expected 
to have difficulties establishing Health Benefit Exchanges 
without the federal assistance repealed and rescinded under 
this bill. (10 minutes)
    3. Ellison (MN): Would require the Secretary of Health and 
Human Services to submit to Congress a report on the impact of 
H.R. 1213 on the possible delays and potential enrollment 
reductions to Health Benefit Exchanges. (10 minutes)
    4. Pallone (NJ): Would require GAO to report on benefits of 
funding in setting up state run exchanges that reflect that 
state's marketplace, as opposed to state exchanges established 
and operated by the federal government. (10 minutes)
    5. Welch (VT) AMENDMENT IN THE NATURE OF A SUBSTITUTE: 
Would preserve funding for establishment of Health Benefit 
Exchanges for states that apply for early innovator grants 
before 2012. The funds used shall be subject to availability of 
appropriations up to $1.9 billion. (10 minutes)

                    TEXT OF AMENDMENTS MADE IN ORDER

1. An Amendment To Be Offered by Representative Jackson Lee of Texas or 
                 Her Designee, Debatable for 10 Minutes

  In section 1, add at the end the following:
  (c) Notice of Rescission of Unobligated Funds.--Not later 
than 10 days after the date of the enactment of this Act, the 
Secretary of Health and Human Services shall post on the public 
website of the Department of Health and Human Services a notice 
of--
          (1) the rescission, pursuant to subsection (b), of 
        the unobligated balance of funds made available by 
        section 1311(a) of the Patient Protection and 
        Affordable Care Act (42 U.S.C. 18031(a)); and
          (2) the amount of such funds so rescinded.
                              ----------                              


2. An Amendment To Be Offered by Representative Waters of California or 
                 Her Designee, Debatable for 10 Minutes

  At the end of section 1, add the following new subsection:
  (c) Report.--Not later than 6 months after the date of the 
enactment of this Act, the Secretary of Health and Human 
Services shall submit to Congress a report on the extent to 
which States are expected to have difficulties establishing 
Health Benefit Exchanges without Federal assistance repealed 
and rescinded under subsections (a) and (b).
                              ----------                              


3. An Amendment To Be Offered by Representative Ellison of Minnesota or 
                 His Designee, Debatable for 10 Minutes

  Add at the end of section 1 the following new subsection:
  (c) Report.--Not later than 6 months after the date of the 
enactment of this Act, the Secretary of Health and Human 
Services shall submit to Congress a report that contains the 
results of a study on the possible delays and potential 
enrollment reductions into Health Benefit Exchanges as a result 
of the repeal and rescission of funds under subsections (a) and 
(b).
                              ----------                              


 4. An Amendment To Be Offered by Representative Pallone of New Jersey 
               or His Designee, Debatable for 10 Minutes

  In section 1, add at the end the following:
  (c) GAO Report on Impacts That Funding Would Have on States 
Establishing Exchanges, if Not Repealed and Rescinded.--
          (1) Study.--The Comptroller General of the United 
        States shall conduct a study to determine the impacts 
        that expenditures by States, using the funding made 
        available under subsection (a) of section 1311 of the 
        Patient Protection and Affordable Care Act (42 U.S.C. 
        18031), would have in establishing State-run American 
        Health Benefit Exchanges (as described in subsection 
        (b) of such section) that reflect the marketplace of 
        the specific State (as opposed to State exchanges 
        established and operated by the Federal Government), if 
        such funding were not repealed and rescinded under 
        subsections (a) and (b) of this section. In determining 
        such impacts, the Comptroller General shall at a 
        minimum address--
                  (A) whether employers with over 50 employees 
                are permitted in such Exchanges to purchase 
                insurance over time;
                  (B) what type financing mechanisms will be 
                used to operate such Exchanges;
                  (C) whether such Exchanges will be active 
                negotiators in selecting health plans to obtain 
                the best price and quality for citizens;
                  (D) whether States will operate such 
                Exchanges together with one or more other 
                States; and
                  (E) whether there will be more than one such 
                Exchange (subsidiary exchanges), each serving a 
                geographically distinct area, in some States.
          (2) Report.--Not later than 1 year after the date of 
        the enactment of this Act, the Comptroller General 
        shall submit to the Congress a report setting forth the 
        results and conclusions of the study under paragraph 
        (1).
                              ----------                              


    5. An Amendment in the Nature of a Substitute To Be Offered by 
   Representative Welch of Vermont or His Designee, Debatable for 10 
                                Minutes

  Strike all after the enacting clause and insert the 
following:

SECTION 1. PRESERVING EXCHANGE GRANTS FOR STATES THAT APPLY FOR EARLY 
                    INNOVATOR GRANTS BEFORE 2012, SUBJECT TO 
                    AVAILABILITY OF APPROPRIATIONS.

  (a) In General.--Section 1311(a) of the Patient Protection 
and Affordable Care Act (42 U.S.C. 18031(a)) is amended--
          (1) in paragraph (1)--
                  (A) by striking ``shall be appropriated to 
                the Secretary, out of any moneys in the 
                Treasury not otherwise appropriated'' and 
                inserting ``is authorized to be appropriated'';
                  (B) by inserting ``(not to exceed 
                $1,900,000,000)'' after ``an amount''; and
                  (C) by inserting ``that apply for an early 
                innovator grant (as described in the January 
                20, 2011, Department of Health and Human 
                Services funding opportunity announcement) 
                before December 31, 2011,'' after ``States'';
          (2) in paragraph (2), by striking ``available to each 
        State'' inserting ``available, subject to the amounts 
        made available by an appropriations Act pursuant to 
        paragraph (1), to each State described in paragraph 
        (1)'';
          (3) in paragraph (4)(A), by inserting ``, subject to 
        the amounts made available by an appropriations Act 
        pursuant to such paragraph,'' after ``under paragraph 
        (1)''; and
          (4) in paragraph (5), by striking ``provide technical 
        assistance to States'' and inserting ``, subject to the 
        amounts made available by an appropriations Act 
        pursuant to paragraph (1), provide technical assistance 
        to States described in paragraph (1)''.
  (b) Rescission of Unobligated Funds.--Of the funds 
appropriated under such section 1311(a) before the date of the 
enactment of this Act, the unobligated balance is rescinded.

                                  
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