[House Report 113-46]
[From the U.S. Government Publishing Office]


113th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 1st Session                                                     113-46

======================================================================

 
PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 1549) TO AMEND PUBLIC LAW 
  111-148 TO TRANSFER FISCAL YEAR 2013 THROUGH FISCAL YEAR 2016 FUNDS 
 FROM THE PREVENTION AND PUBLIC HEALTH FUND TO CARRY OUT THE TEMPORARY 
     HIGH RISK HEALTH INSURANCE POOL PROGRAM FOR INDIVIDUALS WITH 
 PREEXISTING CONDITIONS, AND TO EXTEND ACCESS TO SUCH PROGRAM TO SUCH 
INDIVIDUALS WHO HAVE HAD CREDITABLE COVERAGE DURING THE 6 MONTHS PRIOR 
            TO APPLICATION FOR COVERAGE THROUGH SUCH PROGRAM

                                _______
                                

   April 23, 2013.--Referred to the House Calendar and ordered to be 
                                printed

                                _______
                                

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

                              R E P O R T

                       [To accompany H. Res. 175]

    The Committee on Rules, having had under consideration 
House Resolution 175, by a record vote of 9 to 2, 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. 1549, the 
Helping Sick Americans Now Act, 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 makes in order as original text for the purpose of 
amendment an amendment in the nature of a substitute consisting 
of the text of Rules Committee Print 113-8 and provides that it 
shall be considered as read. The resolution waives all points 
of order against the amendment in the nature of a substitute. 
The resolution makes in order only those further 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. The resolution waives all 
points of order against the amendments printed in this report. 
The resolution provides one motion to recommit with or without 
instructions.

                         EXPLANATION OF WAIVERS

    The waiver of all points of order against consideration of 
the bill includes a waiver of 302(f) of the Congressional 
Budget Act, prohibiting consideration of legislation providing 
new budget authority in excess of a committee's 302(a) 
allocation of such authority and section 311(a) of the 
Congressional Budget Act of 1974, prohibiting the consideration 
of a measure which would cause the total level of new budget 
authority or outlays in the most recent budget resolution to be 
exceeded.
    The waiver of all points of order against the amendment in 
the nature of a substitute made in order as original text 
includes a waiver of clause 4 of rule XXI, which prohibits 
reporting a bill or joint resolution carrying an appropriation 
from a committee not having jurisdiction to report an 
appropriation.
    Although the resolution waives all points of order against 
the amendments printed in this report, the Committee is not 
aware of any points of order. The waiver 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. 23

    Motion by Ms. Slaughter to report an open rule. Defeated: 
2-9.

----------------------------------------------------------------------------------------------------------------
                Majority Members                      Vote               Minority Members               Vote
----------------------------------------------------------------------------------------------------------------
Ms. Foxx........................................          Nay   Ms. Slaughter.....................          Yea
Mr. Bishop of Utah..............................          Nay   Mr. McGovern......................          Yea
Mr. Cole........................................          Nay   Mr. Hastings of Florida...........
Mr. Woodall.....................................          Nay   Mr. Polis.........................
Mr. Nugent......................................          Nay
Mr. Webster.....................................          Nay
Ms. Ros-Lehtinen................................          Nay
Mr. Burgess.....................................          Nay
Mr. Sessions, Chairman..........................          Nay
----------------------------------------------------------------------------------------------------------------

Rules Committee record vote No. 24

    Motion by Mr. McGovern to make in order and provide the 
appropriate waivers for amendment #1 offered by Rep. Pallone 
Jr. (NJ), which makes the same changes to the PCIP program that 
the underlying bill does, but is paid for through a 4 cent per 
pack increase in the tax on cigarettes; amendment #2 offered by 
Rep. Pallone Jr. (NJ), which makes the same changes to the PCIP 
program that the underlying bill does, but is paid for by 
continuing the solvency of the Oil Spill Liability Trust Fund 
by increasing the per-barrel amount that oil companies are 
required to pay into the fund by four cents; amendment #3 
offered by Rep. Schakowsky (IL), which extends funding for 
reopening enrollment under the Preexisting Condition Insurance 
Program (PCIP) through the modification of class life for 
corporate jets; amendment #4 offered by Rep. Capps (CA), which 
removes the public health and prevention trust fund as a pay-
for and instead pays for the bill by ending the section 199 
domestic manufacturing deduction for oil and gas production; 
amendment #5, offered Rep. Green (TX), which makes the same 
changes to the PCIP program that the underlying bill does, but 
is paid for by requiring a minimum term and a remainder 
interest greater than zero for new Grantor Retained Annuity 
Trusts (GRATs); and amendment #10 offered by Rep. Horsford 
(NV), which seeks to protect funds in the Prevention and Public 
Health Fund that are to be used for reducing health disparities 
in minority populations. Defeated: 2-9.

----------------------------------------------------------------------------------------------------------------
                Majority Members                      Vote               Minority Members               Vote
----------------------------------------------------------------------------------------------------------------
Ms. Foxx........................................          Nay   Ms. Slaughter.....................          Yea
Mr. Bishop of Utah..............................          Nay   Mr. McGovern......................          Yea
Mr. Cole........................................          Nay   Mr. Hastings of Florida...........
Mr. Woodall.....................................          Nay   Mr. Polis.........................
Mr. Nugent......................................          Nay
Mr. Webster.....................................          Nay
Ms. Ros-Lehtinen................................          Nay
Mr. Burgess.....................................          Nay
Mr. Sessions, Chairman..........................          Nay
----------------------------------------------------------------------------------------------------------------

Rules Committee record vote No. 25

    Motion by Ms. Foxx to report the rule. Adopted: 9-2.

----------------------------------------------------------------------------------------------------------------
                Majority Members                      Vote               Minority Members               Vote
----------------------------------------------------------------------------------------------------------------
Ms. Foxx........................................          Yea   Ms. Slaughter.....................          Nay
Mr. Bishop of Utah..............................          Yea   Mr. McGovern......................          Nay
Mr. Cole........................................          Yea   Mr. Hastings of Florida...........
Mr. Woodall.....................................          Yea   Mr. Polis.........................
Mr. Nugent......................................          Yea
Mr. Webster.....................................          Yea
Ms. Ros-Lehtinen................................          Yea
Mr. Burgess.....................................          Yea
Mr. Sessions, Chairman..........................          Yea
----------------------------------------------------------------------------------------------------------------

                  SUMMARY OF AMENDMENTS MADE IN ORDER

    1. Pitts (PA), Upton (MI): Terminates the prevention fund 
after FY 2016 and authorizes a state-based high-risk pool 
program. (10 minutes)
    2. Brownley, Julia (CA): Requires that within 90 days of 
enactment of H.R. 1549, the Secretary of Health and Human 
Services shall prepare a report to Congress detailing the exact 
amount of money to be transferred out of the Prevention and 
Public Health Fund, and how that transfer will impact the 
access of uninsured and underinsured children, adolescents, and 
adults to immunization programs, Alzheimer's disease education 
and prevention programs, and the Baby Friendly Hospital 
Initiative and maternal care programs. (10 minutes)

                    TEXT OF AMENDMENTS MADE IN ORDER

 1. An Amendment To Be Offered by Representative Pitts of Pennsylvania 
               or His Designee, Debatable for 10 Minutes

  Page 3, after line 2, insert the following:

SEC. 5. TERMINATING FUNDING FOR PREVENTION AND PUBLIC HEALTH FUND AFTER 
                    FISCAL YEAR 2016.

  Section 4002(b) of Public Law 111-148 (42 U.S.C. 300u-11(b)), 
as amended by section 3205 of the Middle Class Tax Relief and 
Job Creation Act of 2012, is further amended--
          (1) in paragraph (1), by inserting ``and'' after the 
        semicolon;
          (2) in paragraph (2)--
                  (A) by striking ``2017'' and inserting 
                ``2016''; and
                  (B) by striking the semicolon and inserting a 
                period; and
          (3) by striking each of paragraphs (3) through (5).

SEC. 6. ESCAPE VALVE FROM THE TRAINWRECK.

  (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall award 
block grants to States to provide for the development of 
innovative models that ensure affordable health insurance 
coverage for Americans with pre-existing health conditions.
  (b) Use of Funds.--A State shall use amounts received under a 
grant under this section for innovative State high-risk pool 
programs that meet the requirements of subsection (c) and that 
ensure the provision of affordable health insurance coverage 
for eligible individuals described in subsection (d) with pre-
existing health conditions. Such funds may be used for the 
development, start-up, and funding of new State high-risk pools 
satisfying such requirements and for the enhancement of funding 
for existing State high-risk pools satisfying such 
requirements.
  (c) Requirements for High Risk Pool.--For purposes of this 
section, the requirements described in this subsection, for a 
State high-risk pool are each of the following requirements:
          (1) The pool provides at least two health insurance 
        coverage options, one of which being a high deductible 
        health plan coupled with a health savings account.
          (2) The pool is funded with a stable funding source.
          (3) The pool does not have any waiting lists so that 
        all eligible individuals described in subsection (d) 
        who are seeking coverage through the pool are allowed 
        to receive coverage through the pool.
          (4) The pool allows for coverage of individuals who, 
        but for the 24-month disability waiting period under 
        section 226(b) of the Social Security Act (42 U.S.C. 
        426(b)), would be eligible for Medicare under title 
        XVIII of such Act during such waiting period.
          (5) The premium rate charged for health insurance 
        coverage offered to eligible individuals through the 
        pool does not exceed the rate that is 150 percent of 
        the average premium rate for applicable standard risk 
        populations in the State.
  (d) Eligible Individuals.--For purposes of this section, an 
eligible individual described in this subsection, with respect 
to a State high risk pool funded by a grant under this section, 
is an individual who--
          (1) is a resident of such State; and
          (2) complies with any other requirements established 
        by the State for participation in such pool.
  (e) Amount of Grant.--The amount of a grant to a State under 
this section shall be determined by the Secretary based on a 
review of State applications and requests.
  (f) Limitation on Abortion Funding.--No funds authorized by 
this section may be used to pay for any abortion or to cover 
any part of the costs of any health plans that includes 
coverage of abortion, except--
          (1) if the pregnancy is the result of an act of rape 
        or incest; or
          (2) in the case where a pregnant woman suffers from a 
        physical disorder, physical injury, or physical illness 
        that would, as certified by a physician, place the 
        woman in danger of death unless an abortion is 
        performed, including a life-endangering physical 
        condition caused by or arising from the pregnancy 
        itself.
  (g) Pre-existing Condition Defined.--For purposes of this 
section, the term ``pre-existing condition'' means, with 
respect to an individual, a medical or other condition of the 
individual that exists prior to the date on which such 
individual attempts to enroll in health insurance coverage, 
whether or not any medical advice, diagnosis, care, or 
treatment was recommended or received for such condition before 
such date.
  (h) Authorization of Appropriations.--There is authorized to 
be appropriated to carry out this section for fiscal year 2014, 
$5,000,000,000, to be made available to States for calendar 
year 2014.
                              ----------                              


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

  Page 3, after line 2, add the following:

SEC. 5. REPORT ON IMPACT OF TRANSFERRING FUNDS FROM PREVENTION AND 
                    PUBLIC HEALTH FUND.

  Not later than 90 days after the date of the enactment of 
this Act, the Secretary of Health and Human Services shall 
submit to Congress a report on--
          (1) the total amount of funds that are transferred 
        from the Prevention and Public Health Fund under 
        section 4002(c) of Public Law 111-148 pursuant to the 
        amendment made by section 2 of this Act; and
          (2) the impact such transfer would have on access 
        to--
                  (A) immunizations for uninsured and 
                underinsured children, adolescents, and adults;
                  (B) Alzheimer's disease education and 
                prevention programs; and
                  (C) the Baby Friendly Hospitals Initiative 
                and maternal care programs.

                                  
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