[House Report 118-349]
[From the U.S. Government Publishing Office]


118th Congress }                                                {  Report
                        HOUSE OF REPRESENTATIVES
 2d Session    }                                                {   118-349

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



 
        SUPPORTING PREGNANT AND PARENTING WOMEN AND FAMILIES ACT

                                _______
                                

January 16, 2024.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

Mr. Smith of Missouri, from the Committee on Ways and Means, submitted 
                             the following

                              R E P O R T

                             together with

                            DISSENTING VIEWS

                        [To accompany H.R. 6918]

    The Committee on Ways and Means, to whom was referred the 
bill (H.R. 6918) to prohibit the Secretary of Health and Human 
Services from restricting funding for pregnancy centers, having 
considered the same, reports favorably thereon with an 
amendment and recommends that the bill as amended do pass.

                                CONTENTS

                                                                   Page
  I. SUMMARY AND BACKGROUND...........................................2
          A. Purpose and Summary.................................     2
          B. Background and Need for Legislation.................     2
          C. Legislative History.................................     4
          D. Designated Hearing..................................     5
 II. EXPLANATION OF THE BILL..........................................5
III. VOTES OF THE COMMITTEE...........................................5
 IV. BUDGET EFFECTS OF THE BILL......................................11
          A. Committee Estimate of Budgetary Effects.............    11
          B. Statement Regarding New Budget Authority and Tax 
              Expenditures Budget Authority......................    11
  V. COST ESTIMATE PREPARED BY THE CONGRESSIONAL BUDGET OFFICE.......11
 VI. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE......11
          A. Committee Oversight Findings and Recommendations....    11
          B. Statement of General Performance Goals and 
              Objectives.........................................    11
          C. Information Relating to Unfunded Mandates...........    11
          D. Congressional Earmarks, Limited Tax Benefits, and 
              Limited Tariff Benefits............................    12
          E. Duplication of Federal Programs.....................    12
VII. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED...........12
          In compliance with clause 3(e) of rule XIII of the 
              Rules of the House of Representatives, changes in 
              existing law made by the bill, as reported, are 
              shown as follows...................................    12
VIII.DISSENTING VIEWS................................................13


    The amendment is as follows:
    Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Supporting Pregnant and Parenting 
Women and Families Act''.

SEC. 2. PROHIBITION ON DISCRIMINATION AGAINST PREGNANCY CENTERS.

  (a) In General.--The Secretary of Health and Human Services may not 
finalize, implement, or enforce, with respect to expenditures for any 
pregnancy center, the modification to section 263.11 of title 45, Code 
of Federal Regulations, as described in the proposed regulation set 
forth beginning on page 67697 of volume 88 of the Federal Register, or 
any substantially similar regulatory action.
  (b) Definition of Pregnancy Center.--In subsection (a), the term 
``pregnancy center'' means any organization, such as a pregnancy 
resource center, pregnancy help center or organization, or pregnancy 
medical center, that--
          (1) supports protecting the life of the mother and the unborn 
        child; and
          (2) offers resources and services to mothers, fathers, and 
        families, including but not limited to relationship counseling, 
        prenatal and pregnancy education, pregnancy testing, diapers, 
        baby clothes, or material supports.

                       I. SUMMARY AND BACKGROUND


                         A. Purpose and Summary

    H.R. 6918, as amended, the ``Supporting Pregnant and 
Parenting Women and Families Act,'' as ordered reported by the 
Committee on Ways and Means on January 11, 2024 prohibits the 
Department of Health of Human Services from finalizing, 
implementing, or enforcing the Notice of Proposed Rulemaking 
titled, ``Strengthening Temporary Assistance for Needy Families 
(TANF) as a Safety Net and Work Program,'' proposed at 88 FR 
67697, or any substantially similar regulation, as it applies 
to expenditures for pregnancy centers. Introduced by Rep. 
Michelle Fischbach (R-MN), Rep. Claudia Tenney (R-NY), and Rep. 
Chris Smith (R-NJ), this bill protects state flexibility to 
provide federal TANF funds to pregnancy centers that support 
protecting the life of the mother and unborn child that offer 
resources and services including counseling, prenatal and 
pregnancy education, pregnancy testing, diapers, baby clothes, 
or other material supports.

                 B. Background and Need for Legislation

    Temporary Assistance for Needy Families (TANF) is a key 
federal program in the fight against poverty. TANF provides 
$16.5 billion in federal funding to states to further four 
statutory purposes:\1\
---------------------------------------------------------------------------
    \1\42 U.S.C. 601.
---------------------------------------------------------------------------
           Provide assistance to needy families so that 
        children can be cared for in their own home or in the 
        home of relatives;
           End the dependence of needy parents on 
        government benefits by promoting job preparation, work, 
        and marriage;
           Prevent and reduce incidence out-of-wedlock 
        pregnancies; and
           Encourage the formation of two-parent 
        families.
    On October 2, 2023, the Department of Health and Human 
Services (HHS) issued a Notice of Proposed Rulemaking (NPRM), 
``Strengthening Temporary Assistance for Needy Families (TANF) 
as a Safety Net and Work Program'' that includes several 
regulatory reforms to TANF, as well as several technical and 
administrative changes.\2\ One of the proposed regulatory 
changes in this rule is to clarify when an expenditure is 
``reasonably calculated to accomplish a TANF purpose'' to 
increase the thresholds for states to prove their non-
assistance spending meets one of TANF's statutory purposes. 
This proposed change to TANF regulations are at Subpart B, 
Section 263.11, which pertain to uses of federal TANF funds 
that are considered to be improper. The proposed rule would 
amend this section of the regulations by adding a new subpart 
(c) to clarify that if an expenditure does not appear to HHS to 
be reasonably calculated to accomplish a purpose of TANF, a 
state must show that a ``reasonable person'' would consider the 
use of funds to be within one or more of the four statutory 
purposes.
---------------------------------------------------------------------------
    \2\RIN 0970-AC99.
---------------------------------------------------------------------------
    In their explanation of this proposed change, HHS singles 
out pregnancy centers and preemptively suggests state spending 
on these organizations would no longer be an allowable TANF 
expenditure. In the preamble of the proposed rule, HHS states:
          ``[P]rograms that only or primarily provide pregnancy 
        counseling to women only after they become pregnant 
        likely do not meet the reasonable person standard 
        because the connection to preventing and reducing out-
        of-wedlock pregnancies is tenuous or non-existent, and 
        therefore do not accomplish purpose three.''\3\
---------------------------------------------------------------------------
    \3\88 FR 67705.
---------------------------------------------------------------------------
    Pregnancy centers are non-profit organizations that have a 
pro-life mission and provide services to pregnant women and 
families including pregnancy testing, testing for sexually 
transmitted diseases, prenatal and pregnancy education, 
ultrasounds, adoption referrals, diapers, baby clothes, 
linkages to housing, and other material supports. Over 2,700 
pregnancy centers across the country aided nearly two million 
people in 2019.\4\ Services and material assistance provided by 
pregnancy centers had an estimated value of over $358 million 
annually. At least five states in 2023 distributed a portion of 
their TANF funding to pregnancy centers, including Indiana, 
Louisiana, Missouri, Ohio, and Pennsylvania.\5\
---------------------------------------------------------------------------
    \4\Charlotte Lozier Institute, ``A Legacy of Life and Love: 
Pregnancy Centers Stand the Test of Time'', October 21, 2020, https://
lozierinstitute.org/wp-content/uploads/2023/01/Pregnancy-Center-Report-
2020_FINAL.pdf.
    \5\Jeanneane Maxon, Charlotte Lozier Institute, ``Fact Sheet: State 
Alternatives to Abortion Funding'', June 28, 2022, updated on October 
13, 2023, https://lozierinstitute.org/fact-sheet-state-alternatives-to-
abortion-funding/.
---------------------------------------------------------------------------
    HHS's proposed rule inaccurately describes pregnancy 
centers as limited to ``only or primarily provid[ing] pregnancy 
counseling to women only after they become pregnant'' and only 
relevant for the ``prevent and reduce incidence out-of-wedlock 
pregnancies'' and TANF purpose.\6\ However, pregnancy centers 
clearly meet other TANF purposes; for example, by providing 
material support and assistance to women in need so children 
can be cared for in their own home and by reducing dependence 
on government assistance. Documented pregnancy centers services 
include parenting classes, training in life skills, sexual risk 
avoidance education, promoting responsible paternity, promoting 
marriage, care coordination, housing and support services 
through maternity homes, assistance with job searching, 
reducing dependence on government and much more.\7\
---------------------------------------------------------------------------
    \6\88 FR 67705.
    \7\Amanda Stirone Mansfield, Charlotte Lozier Institute, 
``Alternatives to Abortion Programs: Support for Mothers and 
Families,'' February 14, 2022, https://lozierinstitute.org/
alternatives-to-abortion-programs-support-for-mothers-and-families.
---------------------------------------------------------------------------
    Furthermore, the changes in the proposed rule are in clear 
violation of Congressional restrictions placed on the 
Department's ability to regulate. When TANF was created with 
bipartisan support and signed into law by President Clinton in 
1996, the overarching goal and stated purpose in statute was 
``to increase the flexibility of States.''\8\ Likewise, the 
Committee report emphasized the importance of state flexibility 
seven times and stated that TANF's purpose is ``to increase 
state flexibility in providing assistance to needy families . . 
.''\9\ To protect this purpose, Congress explicitly limited the 
ability of the Executive branch from issuing regulations for 
the TANF program:
---------------------------------------------------------------------------
    \8\42 U.S.C. 601.
    \9\H.R. Conference Report No 104-15 (1996).
---------------------------------------------------------------------------
    Sec. 417 Limitations on Federal Authority.\10\
---------------------------------------------------------------------------
    \10\42 U.S.C. 617.
---------------------------------------------------------------------------
          No officer or employee of the Federal Government may 
        regulate the conduct of States under this part of 
        enforce any provision of this part, except to the 
        extent expressly provided in this part.
    Pregnancy centers are an important alternative for 
expectant mothers. This bill protects state flexibility to 
provide federal TANF funds to pregnancy centers that support 
protecting the life of the mother and unborn child that offer 
resources and services including but not limited to 
relationship counseling, prenatal and pregnancy education, 
pregnancy testing, diapers, baby clothes, or other material 
supports.

                         C. Legislative History


Background

    H.R. 6918 was introduced on January 9, 2024, and was 
referred to the Committee on Ways and Means.

Committee Hearings

    The Committee has held the following hearing:
    On July 12, 2023, the Committee on Ways and Means 
Subcommittee on Work and Welfare held a hearing titled, ``Where 
is all the Welfare Money Going? Reclaiming TANF Non-Assistance 
Dollars to Lift Americans Out of Poverty,'' to hear from state 
officials and administrators about needed reforms to balance 
accountability and state flexibility in TANF non-assistance 
spending.

Committee Action

    The Committee on Ways and Means marked up H.R. 6918, the 
``Supporting Pregnant and Parenting Women and Families Act'', 
on January 11, 2023, and ordered the bill, as amended, 
favorably reported (with a quorum being present).

                         D. Designated Hearing

    Pursuant to clause 3(c)(6) of rule XIII, the following 
hearing was used to develop and consider: ``Where is all the 
Welfare Money Going? Reclaiming TANF Non-Assistance Dollars to 
Lift Americans Out of Poverty'' hearing held on July 12, 2023.

                      II. EXPLANATION OF THE BILL


                           REASONS FOR CHANGE

    Section 1. The Committee believes the title accurately 
reflects the content of the bill.
    Section 2. The Committee believes that preventing the 
Department of Health and Human Services from finalizing, 
implementing, or enforcing the Notice of Proposed Rulemaking 
titled, ``Strengthening Temporary Assistance for Needy Families 
(TANF) as a Safety Net and Work Program,'' proposed at 88 FR 
67697, or any substantially similar regulation, as it applies 
to expenditures for pregnancy centers is cost-effective, 
protects state flexibility on the use of federal TANF funds in 
accordance with Part A Title IV of the Social Security Act, and 
will benefit the pregnant and parenting women and families 
served by pregnancy centers.

                       EXPLANATION OF PROVISIONS

    Section 1. This section provides the short title, the 
Supporting Pregnant and Parenting Women and Families Act.
    Section 2. This section prohibits the Department of Health 
of Human Services from finalizing, implementing, or enforcing 
the Notice of Proposed Rulemaking titled, ``Strengthening 
Temporary Assistance for Needy Families (TANF) as a Safety Net 
and Work Program,'' proposed at 88 FR 67697, or any 
substantially similar regulation, as it applies to expenditures 
for pregnancy centers. This section defines ``pregnancy 
centers'' to mean organizations that support protecting the 
life of the mother and unborn child that offer resources and 
services including but not limited to relationship counseling, 
prenatal and pregnancy education, pregnancy testing, diapers, 
baby clothes, or other material supports.

                             EFFECTIVE DATE

    The bill would become effective upon enactment.

                      III. VOTES OF THE COMMITTEE

    In compliance with the Rules of the House of 
Representatives, the following statement is made concerning the 
vote of the Committee on Ways and Means during the markup 
consideration of H.R. 6918, the ``Supporting Pregnant and 
Parenting Women and Families Act'' on January 11, 2024.
    The vote on the amendment offered by Ms. DelBene to the 
amendment in the nature of a substitute to H.R. 6918, which 
would prohibit the legislation from going into effect unless 
the Secretary of Health and Human Services finds implementation 
would not result in funds being made available to any 
organization that presents itself as providing unbiased 
reproductive health information or counseling, but that 
covertly intends to discourage pregnant individuals from 
seeking or accessing abortion services was not agreed to by a 
roll call vote of 17 yeas to 23 nays (with a quorum being 
present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
           Representative              Yea     Nay    Present       Representative       Yea     Nay    Present
----------------------------------------------------------------------------------------------------------------
Mr. Smith (MO).....................  ......      X   .........  Mr. Neal.............      X   ......  .........
Mr. Buchanan.......................  ......      X   .........  Mr. Doggett..........      X   ......  .........
Mr. Smith (NE).....................  ......      X   .........  Mr. Thompson.........      X   ......  .........
Mr. Kelly..........................  ......      X   .........  Mr. Larson...........      X   ......  .........
Mr. Schweikert.....................  ......      X   .........  Mr. Blumenauer.......      X   ......  .........
Mr. LaHood.........................  ......      X   .........  Mr. Pascrell.........      X   ......  .........
Dr. Wenstrup.......................  ......      X   .........  Mr. Davis............      X   ......  .........
Mr. Arrington......................  ......      X   .........  Ms. Sanchez..........      X   ......  .........
Dr. Ferguson.......................  ......      X   .........  Mr. Higgins..........      X   ......  .........
Mr. Estes..........................  ......      X   .........  Ms. Sewell...........  ......  ......  .........
Mr. Smucker........................  ......      X   .........  Ms. DelBene..........      X   ......  .........
Mr. Hern...........................  ......      X   .........  Ms. Chu..............      X   ......  .........
Ms. Miller.........................  ......      X   .........  Ms. Moore............      X   ......  .........
Dr. Murphy.........................  ......      X   .........  Mr. Kildee...........      X   ......  .........
Mr. Kustoff........................  ......      X   .........  Mr. Beyer............      X   ......  .........
Mr. Fitzpatrick....................  ......  ......  .........  Mr. Evans............      X   ......  .........
Mr. Steube.........................  ......  ......  .........  Mr. Schneider........      X   ......  .........
Ms. Tenney.........................  ......      X   .........  Mr. Panetta..........      X   ......  .........
Mrs. Fischbach.....................  ......      X   .........
Mr. Moore..........................  ......      X   .........
Mrs. Steel.........................  ......      X   .........
Ms. Van Duyne......................  ......      X   .........
Mr. Feenstra.......................  ......      X   .........
Ms. Malliotakis....................  ......      X   .........
Mr. Carey..........................  ......      X   .........
----------------------------------------------------------------------------------------------------------------

    In compliance with the Rules of the House of 
Representatives, the following statement is made concerning the 
vote of the Committee on Ways and Means during the markup 
consideration of H.R. 6918, the ``Supporting Pregnant and 
Parenting Women and Families Act'' on January 11, 2024.
    The vote on the amendment offered by Ms. Chu to the 
amendment in the nature of a substitute to H.R. 6918, which 
would prohibit the legislation from going into effect unless 
the Secretary of Health and Human Services determines that 
there will be no negative medical or economic effects on women 
seeking abortion care who are directed to crisis pregnancy 
centers was not agreed to by a roll call vote of 17 yeas to 22 
nays (with a quorum being present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
           Representative              Yea     Nay    Present       Representative       Yea     Nay    Present
----------------------------------------------------------------------------------------------------------------
Mr. Smith (MO).....................  ......      X   .........  Mr. Neal.............      X   ......  .........
Mr. Buchanan.......................  ......      X   .........  Mr. Doggett..........      X   ......  .........
Mr. Smith (NE).....................  ......      X   .........  Mr. Thompson.........      X   ......  .........
Mr. Kelly..........................  ......      X   .........  Mr. Larson...........      X   ......  .........
Mr. Schweikert.....................  ......      X   .........  Mr. Blumenauer.......      X   ......  .........
Mr. LaHood.........................  ......      X   .........  Mr. Pascrell.........      X   ......  .........
Dr. Wenstrup.......................  ......      X   .........  Mr. Davis............      X   ......  .........
Mr. Arrington......................  ......      X   .........  Ms. Sanchez..........      X   ......  .........
Dr. Ferguson.......................  ......      X   .........  Mr. Higgins..........      X   ......  .........
Mr. Estes..........................  ......      X   .........  Ms. Sewell...........  ......  ......  .........
Mr. Smucker........................  ......      X   .........  Ms. DelBene..........      X   ......  .........
Mr. Hern...........................  ......      X   .........  Ms. Chu..............      X   ......  .........
Ms. Miller.........................  ......      X   .........  Ms. Moore............      X   ......  .........
Dr. Murphy.........................  ......  ......  .........  Mr. Kildee...........      X   ......  .........
Mr. Kustoff........................  ......      X   .........  Mr. Beyer............      X   ......  .........
Mr. Fitzpatrick....................  ......  ......  .........  Mr. Evans............      X   ......  .........
Mr. Steube.........................  ......  ......  .........  Mr. Schneider........      X   ......  .........
Ms. Tenney.........................  ......      X   .........  Mr. Panetta..........      X   ......  .........
Mrs. Fischbach.....................  ......      X   .........
Mr. Moore..........................  ......      X   .........
Mrs. Steel.........................  ......      X   .........
Ms. Van Duyne......................  ......      X   .........
Mr. Feenstra.......................  ......      X   .........
Ms. Malliotakis....................  ......      X   .........
Mr. Carey..........................  ......      X   .........
----------------------------------------------------------------------------------------------------------------

    In compliance with the Rules of the House of 
Representatives, the following statement is made concerning the 
vote of the Committee on Ways and Means during the markup 
consideration of H.R. 6918, the ``Supporting Pregnant and 
Parenting Women and Families Act'' on January 11, 2024.
    The vote on the amendment offered by Ms. Sanchez to the 
amendment in the nature of a substitute to H.R. 6918, which 
would prohibit the legislation from going into effect unless 
the Secretary of Health and Human Services certifies that no 
Temporary Assistance to Needy Families funds or resources are 
used to make coercive referrals to Crisis Pregnancy Centers 
that provide misleading or deceptive information was not agreed 
to by a roll call vote of 18 yeas to 22 nays (with a quorum 
being present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
           Representative              Yea     Nay    Present       Representative       Yea     Nay    Present
----------------------------------------------------------------------------------------------------------------
Mr. Smith (MO).....................  ......      X   .........  Mr. Neal.............      X   ......  .........
Mr. Buchanan.......................  ......      X   .........  Mr. Doggett..........      X   ......  .........
Mr. Smith (NE).....................  ......      X   .........  Mr. Thompson.........      X   ......  .........
Mr. Kelly..........................  ......      X   .........  Mr. Larson...........      X   ......  .........
Mr. Schweikert.....................  ......      X   .........  Mr. Blumenauer.......      X   ......  .........
Mr. LaHood.........................  ......      X   .........  Mr. Pascrell.........      X   ......  .........
Dr. Wenstrup.......................  ......      X   .........  Mr. Davis............      X   ......  .........
Mr. Arrington......................  ......      X   .........  Ms. Sanchez..........      X   ......  .........
Dr. Ferguson.......................  ......      X   .........  Mr. Higgins..........      X   ......  .........
Mr. Estes..........................  ......      X   .........  Ms. Sewell...........      X   ......  .........
Mr. Smucker........................  ......      X   .........  Ms. DelBene..........      X   ......  .........
Mr. Hern...........................  ......      X   .........  Ms. Chu..............      X   ......  .........
Ms. Miller.........................  ......      X   .........  Ms. Moore............      X   ......  .........
Dr. Murphy.........................  ......  ......  .........  Mr. Kildee...........      X   ......  .........
Mr. Kustoff........................  ......      X   .........  Mr. Beyer............      X   ......  .........
Mr. Fitzpatrick....................  ......  ......  .........  Mr. Evans............      X   ......  .........
Mr. Steube.........................  ......  ......  .........  Mr. Schneider........      X   ......  .........
Ms. Tenney.........................  ......      X   .........  Mr. Panetta..........      X   ......  .........
Mrs. Fischbach.....................  ......      X   .........
Mr. Moore..........................  ......      X   .........
Mrs. Steel.........................  ......      X   .........
Ms. Van Duyne......................  ......      X   .........
Mr. Feenstra.......................  ......      X   .........
Ms. Malliotakis....................  ......      X   .........
Mr. Carey..........................  ......      X   .........
----------------------------------------------------------------------------------------------------------------

    In compliance with the Rules of the House of 
Representatives, the following statement is made concerning the 
vote of the Committee on Ways and Means during the markup 
consideration of H.R. 6918, the ``Supporting Pregnant and 
Parenting Women and Families Act'' on January 11, 2024.
    The vote on the amendment offered by Ms. Moore to the 
amendment in the nature of a substitute to H.R. 6918, which 
would prohibit the legislation from going into effect unless 
the Secretary of Health and Human Services determines that all 
families in the United States with a child under 5 years of 
age, where the family has a gross annual income that is less 
than the poverty line, have guaranteed access to income 
support, housing, and child care was not agreed to by a roll 
call vote of 18 yeas to 23 nays (with a quorum being present). 
The vote was as follows:

----------------------------------------------------------------------------------------------------------------
           Representative              Yea     Nay    Present       Representative       Yea     Nay    Present
----------------------------------------------------------------------------------------------------------------
Mr. Smith (MO).....................  ......      X   .........  Mr. Neal.............      X   ......  .........
Mr. Buchanan.......................  ......      X   .........  Mr. Doggett..........      X   ......  .........
Mr. Smith (NE).....................  ......      X   .........  Mr. Thompson.........      X   ......  .........
Mr. Kelly..........................  ......      X   .........  Mr. Larson...........      X   ......  .........
Mr. Schweikert.....................  ......      X   .........  Mr. Blumenauer.......      X   ......  .........
Mr. LaHood.........................  ......      X   .........  Mr. Pascrell.........      X   ......  .........
Dr. Wenstrup.......................  ......      X   .........  Mr. Davis............      X   ......  .........
Mr. Arrington......................  ......      X   .........  Ms. Sanchez..........      X   ......  .........
Dr. Ferguson.......................  ......      X   .........  Mr. Higgins..........      X   ......  .........
Mr. Estes..........................  ......      X   .........  Ms. Sewell...........      X   ......  .........
Mr. Smucker........................  ......      X   .........  Ms. DelBene..........      X   ......  .........
Mr. Hern...........................  ......      X   .........  Ms. Chu..............      X   ......  .........
Ms. Miller.........................  ......      X   .........  Ms. Moore............      X   ......  .........
Dr. Murphy.........................  ......      X   .........  Mr. Kildee...........      X   ......  .........
Mr. Kustoff........................  ......      X   .........  Mr. Beyer............      X   ......  .........
Mr. Fitzpatrick....................  ......  ......  .........  Mr. Evans............      X   ......  .........
Mr. Steube.........................  ......  ......  .........  Mr. Schneider........      X   ......  .........
Ms. Tenney.........................  ......      X   .........  Mr. Panetta..........      X   ......  .........
Mrs. Fischbach.....................  ......      X   .........
Mr. Moore..........................  ......      X   .........
Mrs. Steel.........................  ......      X   .........
Ms. Van Duyne......................  ......      X   .........
Mr. Feenstra.......................  ......      X   .........
Ms. Malliotakis....................  ......      X   .........
Mr. Carey..........................  ......      X   .........
----------------------------------------------------------------------------------------------------------------

    In compliance with the Rules of the House of 
Representatives, the following statement is made concerning the 
vote of the Committee on Ways and Means during the markup 
consideration of H.R. 6918, the ``Supporting Pregnant and 
Parenting Women and Families Act'' on January 11, 2024.
    The vote on the amendment offered by Mr. Davis to the 
amendment in the nature of a substitute to H.R. 6918, which 
would require that the legislation shall not take effect unless 
the Department of Health and Human Services submits a report to 
Congress on the total amount made available for part A of title 
IV of the Social Security Act provided to anti-abortion centers 
and on the total number of applications for and recipients of 
assistance under State programs funded under such part to refer 
individuals to anti-abortion centers under or by such a program 
was not agreed to by a roll call vote of 17 yeas to 24 nays 
(with a quorum being present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
           Representative              Yea     Nay    Present       Representative       Yea     Nay    Present
----------------------------------------------------------------------------------------------------------------
Mr. Smith (MO).....................  ......      X   .........  Mr. Neal.............      X   ......  .........
Mr. Buchanan.......................  ......      X   .........  Mr. Doggett..........      X   ......  .........
Mr. Smith (NE).....................  ......      X   .........  Mr. Thompson.........      X   ......  .........
Mr. Kelly..........................  ......      X   .........  Mr. Larson...........      X   ......  .........
Mr. Schweikert.....................  ......      X   .........  Mr. Blumenauer.......      X   ......  .........
Mr. LaHood.........................  ......      X   .........  Mr. Pascrell.........      X   ......  .........
Dr. Wenstrup.......................  ......      X   .........  Mr. Davis............      X   ......  .........
Mr. Arrington......................  ......      X   .........  Ms. Sanchez..........      X   ......  .........
Dr. Ferguson.......................  ......      X   .........  Mr. Higgins..........      X   ......  .........
Mr. Estes..........................  ......      X   .........  Ms. Sewell...........  ......  ......  .........
Mr. Smucker........................  ......      X   .........  Ms. DelBene..........      X   ......  .........
Mr. Hern...........................  ......      X   .........  Ms. Chu..............      X   ......  .........
Ms. Miller.........................  ......      X   .........  Ms. Moore............      X   ......  .........
Dr. Murphy.........................  ......      X   .........  Mr. Kildee...........      X   ......  .........
Mr. Kustoff........................  ......      X   .........  Mr. Beyer............      X   ......  .........
Mr. Fitzpatrick....................  ......  ......  .........  Mr. Evans............      X   ......  .........
Mr. Steube.........................  ......      X   .........  Mr. Schneider........      X   ......  .........
Ms. Tenney.........................  ......      X   .........  Mr. Panetta..........      X   ......  .........
Mrs. Fischbach.....................  ......      X   .........
Mr. Moore..........................  ......      X   .........
Mrs. Steel.........................  ......      X   .........
Ms. Van Duyne......................  ......      X   .........
Mr. Feenstra.......................  ......      X   .........
Ms. Malliotakis....................  ......      X   .........
Mr. Carey..........................  ......      X   .........
----------------------------------------------------------------------------------------------------------------

    In compliance with the Rules of the House of 
Representatives, the following statement is made concerning the 
vote of the Committee on Ways and Means during the markup 
consideration of H.R. 6918, the ``Supporting Pregnant and 
Parenting Women and Families Act'' on January 11, 2024.
    The vote on the amendment offered by Ms. DelBene to the 
amendment in the nature of a substitute to H.R. 6918, which 
would prohibit the legislation from going into effect unless 
the Secretary of Health and Human Services finds there are no 
pregnancy center that provide misleading or deceptive 
information or puts at risk the health of women was not agreed 
to by a roll call vote of 18 yeas to 21 nays (with a quorum 
being present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
           Representative              Yea     Nay    Present       Representative       Yea     Nay    Present
----------------------------------------------------------------------------------------------------------------
Mr. Smith (MO).....................  ......      X   .........  Mr. Neal.............      X   ......  .........
Mr. Buchanan.......................  ......      X   .........  Mr. Doggett..........      X   ......  .........
Mr. Smith (NE).....................  ......      X   .........  Mr. Thompson.........      X   ......  .........
Mr. Kelly..........................  ......      X   .........  Mr. Larson...........      X   ......  .........
Mr. Schweikert.....................  ......      X   .........  Mr. Blumenauer.......      X   ......  .........
Mr. LaHood.........................  ......      X   .........  Mr. Pascrell.........      X   ......  .........
Dr. Wenstrup.......................  ......      X   .........  Mr. Davis............      X   ......  .........
Mr. Arrington......................  ......  ......  .........  Ms. Sanchez..........      X   ......  .........
Dr. Ferguson.......................  ......      X   .........  Mr. Higgins..........      X   ......  .........
Mr. Estes..........................  ......      X   .........  Ms. Sewell...........      X   ......  .........
Mr. Smucker........................  ......      X   .........  Ms. DelBene..........      X   ......  .........
Mr. Hern...........................  ......      X   .........  Ms. Chu..............      X   ......  .........
Ms. Miller.........................  ......      X   .........  Ms. Moore............      X   ......  .........
Dr. Murphy.........................  ......  ......  .........  Mr. Kildee...........      X   ......  .........
Mr. Kustoff........................  ......      X   .........  Mr. Beyer............      X   ......  .........
Mr. Fitzpatrick....................  ......  ......  .........  Mr. Evans............      X   ......  .........
Mr. Steube.........................  ......      X   .........  Mr. Schneider........      X   ......  .........
Ms. Tenney.........................  ......      X   .........  Mr. Panetta..........      X   ......  .........
Mrs. Fischbach.....................  ......      X   .........
Mr. Moore..........................  ......  ......  .........
Mrs. Steel.........................  ......      X   .........
Ms. Van Duyne......................  ......      X   .........
Mr. Feenstra.......................  ......      X   .........
Ms. Malliotakis....................  ......      X   .........
Mr. Carey..........................  ......      X   .........
----------------------------------------------------------------------------------------------------------------

    In compliance with the Rules of the House of 
Representatives, the following statement is made concerning the 
vote of the Committee on Ways and Means during the markup 
consideration of H.R. 6918, the ``Supporting Pregnant and 
Parenting Women and Families Act,'' on January 11, 2024.
    The vote on the amendment offered by Ms. Sewell to the 
amendment in the nature of a substitute to H.R. 6918, which 
would prohibit the legislation from going into effect unless 
the Secretary of Health and Human Services finds that all 
states have in effect laws that provide affordable access to 
healthcare for all women of reproductive age was not agreed to 
by a roll call vote of 18 yeas to 21 nays (with a quorum being 
present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
           Representative              Yea     Nay    Present       Representative       Yea     Nay    Present
----------------------------------------------------------------------------------------------------------------
Mr. Smith (MO).....................  ......      X   .........  Mr. Neal.............      X   ......  .........
Mr. Buchanan.......................  ......      X   .........  Mr. Doggett..........      X   ......  .........
Mr. Smith (NE).....................  ......      X   .........  Mr. Thompson.........      X   ......  .........
Mr. Kelly..........................  ......      X   .........  Mr. Larson...........      X   ......  .........
Mr. Schweikert.....................  ......      X   .........  Mr. Blumenauer.......      X   ......  .........
Mr. LaHood.........................  ......      X   .........  Mr. Pascrell.........      X   ......  .........
Dr. Wenstrup.......................  ......      X   .........  Mr. Davis............      X   ......  .........
Mr. Arrington......................  ......  ......  .........  Ms. Sanchez..........      X   ......  .........
Dr. Ferguson.......................  ......      X   .........  Mr. Higgins..........      X   ......  .........
Mr. Estes..........................  ......      X   .........  Ms. Sewell...........      X   ......  .........
Mr. Smucker........................  ......      X   .........  Ms. DelBene..........      X   ......  .........
Mr. Hern...........................  ......      X   .........  Ms. Chu..............      X   ......  .........
Ms. Miller.........................  ......      X   .........  Ms. Moore............      X   ......  .........
Dr. Murphy.........................  ......  ......  .........  Mr. Kildee...........      X   ......  .........
Mr. Kustoff........................  ......      X   .........  Mr. Beyer............      X   ......  .........
Mr. Fitzpatrick....................  ......  ......  .........  Mr. Evans............      X   ......  .........
Mr. Steube.........................  ......      X   .........  Mr. Schneider........      X   ......  .........
Ms. Tenney.........................  ......      X   .........  Mr. Panetta..........      X   ......  .........
Mrs. Fischbach.....................  ......      X   .........
Mr. Moore..........................  ......  ......  .........
Mrs. Steel.........................  ......      X   .........
Ms. Van Duyne......................  ......      X   .........
Mr. Feenstra.......................  ......      X   .........
Ms. Malliotakis....................  ......      X   .........
Mr. Carey..........................  ......      X   .........
----------------------------------------------------------------------------------------------------------------

    In compliance with the Rules of the House of 
Representatives, the following statement is made concerning the 
vote of the Committee on Ways and Means during the markup 
consideration of H.R. 6918, the ``Supporting Pregnant and 
Parenting Women and Families Act,'' on January 11, 2024.
    H.R. 6918 was ordered favorably reported to the House of 
Representatives as amended by a roll call vote of 24 yeas to 18 
nays (with a quorum being present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
           Representative              Yea     Nay    Present       Representative       Yea     Nay    Present
----------------------------------------------------------------------------------------------------------------
Mr. Smith (MO).....................      X   ......  .........  Mr. Neal.............  ......      X   .........
Mr. Buchanan.......................      X   ......  .........  Mr. Doggett..........  ......      X   .........
Mr. Smith (NE).....................      X   ......  .........  Mr. Thompson.........  ......      X   .........
Mr. Kelly..........................      X   ......  .........  Mr. Larson...........  ......      X   .........
Mr. Schweikert.....................      X   ......  .........  Mr. Blumenauer.......  ......      X   .........
Mr. LaHood.........................      X   ......  .........  Mr. Pascrell.........  ......      X   .........
Dr. Wenstrup.......................      X   ......  .........  Mr. Davis............  ......      X   .........
Mr. Arrington......................      X   ......  .........  Ms. Sanchez..........  ......      X   .........
Dr. Ferguson.......................      X   ......  .........  Mr. Higgins..........  ......      X   .........
Mr. Estes..........................      X   ......  .........  Ms. Sewell...........  ......      X   .........
Mr. Smucker........................      X   ......  .........  Ms. DelBene..........  ......      X   .........
Mr. Hern...........................      X   ......  .........  Ms. Chu..............  ......      X   .........
Ms. Miller.........................      X   ......  .........  Ms. Moore............  ......      X   .........
Dr. Murphy.........................  ......  ......  .........  Mr. Kildee...........  ......      X   .........
Mr. Kustoff........................      X   ......  .........  Mr. Beyer............  ......      X   .........
Mr. Fitzpatrick....................      X   ......  .........  Mr. Evans............  ......      X   .........
Mr. Steube.........................      X   ......  .........  Mr. Schneider........  ......      X   .........
Ms. Tenney.........................      X   ......  .........  Mr. Panetta..........  ......      X   .........
Mrs. Fischbach.....................      X   ......  .........
Mr. Moore..........................      X   ......  .........
Mrs. Steel.........................      X   ......  .........
Ms. Van Duyne......................      X   ......  .........
Mr. Feenstra.......................      X   ......  .........
Ms. Malliotakis....................      X   ......  .........
Mr. Carey..........................      X   ......  .........
----------------------------------------------------------------------------------------------------------------

                     IV. BUDGET EFFECTS OF THE BILL


               A. Committee Estimate of Budgetary Effects

    With respect to clause 3(d) of rule XIII of the Rules of 
the House of Representatives, a cost estimate provided by the 
congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974 was not made available to the 
Committee in time for the filing of this report.

B. Statement Regarding New Budget Authority and Tax Expenditures Budget 
                               Authority

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee states that the 
bill involves no new or increased budget authority. The 
Committee states further that the bill involves no new or 
increased tax expenditures.

      V. COST ESTIMATE PREPARED BY THE CONGRESSIONAL BUDGET OFFICE

    With respect to the requirements of clause 3(c)(2) of rule 
XIII of the Rules of the House of Representatives and section 
308(a) of the Congressional Budget Act of 1974 and with respect 
to requirements of clause (3)(c)(3) of rule XIII of the Rules 
of the House of Representatives and section 402 of the 
Congressional Budget Act of 1974, the Committee has requested 
but not received a cost estimate for this bill from the 
Director of Congressional Budget Office. The Chairman of the 
Committee shall cause such estimate and statement to be printed 
in the Congressional Record upon its receipt by the Committee.

     VI. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE


          A. Committee Oversight Findings and Recommendations

    With respect to clause 3(c)(1) of rule XIII of the Rules of 
the House of Representatives, the Committee made findings and 
recommendations that are reflected in this report.

        B. Statement of General Performance Goals and Objectives

    With respect to clause 3(c)(4) of rule XIII of the Rules of 
the House of Representatives, the Committee advises that the 
bill does not authorize funding, so no statement of general 
performance goals and objectives is required.

              C. Information Relating to Unfunded Mandates

    This information is provided in accordance with section 423 
of the Unfunded Mandates Reform Act of 1995 (Pub. L. No. 104-
4).
    The Committee has determined that the bill does not contain 
Federal mandates on the private sector. The Committee has 
determined that the bill does not impose a Federal 
intergovernmental mandate on State, local, or tribal 
governments.

  D. Congressional Earmarks, Limited Tax Benefits, and Limited Tariff 
                                Benefits

    With respect to clause 9 of rule XXI of the Rules of the 
House of Representatives, the Committee has carefully reviewed 
the provisions of the bill, and states that the provisions of 
the bill do not contain any congressional earmarks, limited tax 
benefits, or limited tariff benefits within the meaning of the 
rule.

                   E. Duplication of Federal Programs

    In compliance with clause 3(c)(5) of rule XIII of the Rules 
of the House of Representatives, the Committee states that no 
provision of the bill establishes or reauthorizes: (1) a 
program of the Federal Government known to be duplicative of 
another Federal program; (2) a program included in any report 
from the Government Accountability Office to Congress pursuant 
to section 21 of Public Law 111-139; or (3) a program related 
to a program identified in the most recent Catalog of Federal 
Domestic Assistance, published pursuant to the Federal Program 
Information Act (Pub. L. No. 95-220, as amended by Pub. L. No. 
98-169).

       VII. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, the bill doesn't make any changes 
to existing law.

                         VIII. DISSENTING VIEWS

                       Committee on Ways and Means,
                                  House of Representatives,
                                  Washington, DC, January 16, 2024.

  DISSENTING VIEWS ON THE SUPPORTING PREGNANT AND PARENTING WOMEN AND 
                        FAMILIES ACT, H.R. 6918

H.R. 6918 doubles down on Republicans' extreme, unpopular war on women
    Ways and Means Democrats strongly oppose H.R. 6918, which 
would allow states to divert funding intended for poor children 
to anti-abortion propaganda and facilities that provide 
deceptive and inaccurate information, endanger women's health 
with very little oversight, and put women's health in danger. 
This legislation does nothing to strengthen access to maternal 
health care, protect pregnant women, or increase federal 
support for struggling families.
    The partisan bill, introduced by Rep. Fischbach, would 
permanently prevent the Department of Health and Human Services 
(HHS) from regulating state expenditure of Temporary Assistance 
for Needy Families (TANF) funding for so-called ``crisis 
pregnancy centers'' or anti-abortion centers (AACs). Under the 
bill, HHS would not be able to require data reporting, enforce 
statutory requirements, or prevent coercion or harm to low-
income women for TANF-funded AACs.
    AACs masquerade as health care facilities, usually 
providing misleading or inaccurate medical information in order 
to prevent women from seeking abortions. The recent HHS 
regulation this legislation would block notes that AACs target 
women who are already pregnant and therefore cannot reasonably 
meet TANF's purpose of reducing out-of-wedlock childbearing; 
thus, they should only receive funding if they meet other TANF 
purposes, including helping low-income children live with their 
parents, reducing use of government assistance, or promoting 
family formation.\1\ Under the bill, AACs would be exempt from 
the requirement to meet TANF's statutory purposes, but 
pregnancy centers or other TANF-funded entities that did not 
have an explicit anti-abortion mission would be subject to 
regulation.
---------------------------------------------------------------------------
    \1\Strengthening Temporary Assistance for Needy Families As a 
Safety Net and Work Program, 88 Fed. Reg. 67,697, Oct. 2, 2023.
---------------------------------------------------------------------------
    This is just another extremist bill from Republicans, timed 
to satisfy their anti-women base that is marching on Washington 
this week.
Anti-abortion centers provide misleading information and should not 
        receive federal taxpayer dollars
    Everyone deserves access to accurate information when 
making personal decisions. Anti-abortion centers (AACs)--
sometimes referred to as Crisis Pregnancy Centers or CPCs--are 
not legitimate health care providers. They are organizations 
attempting to coerce pregnant people seeking abortions into 
carrying pregnancies to term through shame and misinformation. 
Pregnant people seeking pregnancy related counseling and 
services often find themselves at anti-abortion centers because 
of the deceptive way that these centers advertise themselves as 
legitimate, comprehensive health care providers. This bill 
would go further, allowing states to force low-income women to 
visit AACs in order to receive basic necessities like diapers.
Republicans rejected amendments to protect pregnant women from anti-
        abortion centers' deceptive, dangerous unlicensed medical 
        practices
    During the Committee markup, extremist Republicans voted 
down amendments to prevent funding to organizations that 
deceived women about their purpose and qualifications or 
provided medically inaccurate information. Both amendments were 
rejected on a party line vote, despite recent cases in which 
women who went to so-called ``crisis pregnancy centers'' later 
had to seek emergency medical care because unqualified 
personnel missed ectopic pregnancies and other dangerous 
conditions. Republicans also refused to prevent coercive 
referrals of women who needed emergency financial assistance or 
basic necessities but were made to believe that they could only 
receive it if they gave up their reproductive rights.
Republicans voted against Democratic amendments to support pregnant 
        women and mothers
    Despite the bill's misleading title about ``supporting'' 
pregnant women and families, extremist Republicans rejected 
amendments to ensure that families with poor children under 5 
had food, housing, child care, and access to reproductive 
health care. Republicans also refused to require states to 
provide any data about how any diverted money was spent or 
demonstrate that women's health and economic futures were not 
being harmed.
AACs receive federal tax dollars to pursue an extremist ideological 
        agenda at the expense of low-income mothers and children
    Comprehensive data does not exist, but using publicly 
available information, the watchdog group Equity Forward 
identified at least 10 states that had diverted funds intended 
to help poor children and families to fund anti-abortion 
organizations. Michigan\2\ and Pennsylvania\3\ have terminated 
their contracts, but Arkansas, Indiana, Louisiana, Missouri, 
North Carolina, North Dakota, Ohio, Oklahoma, and Texas are all 
thought to have current contracts providing such 
expenditures.\4\ Eight of the nine states funding anti-abortion 
centers served less than 15 percent of poor families in their 
states, and two (Texas and Arkansas) served less than 5 percent 
of families in need.\5\ In most states, the maximum TANF 
benefit for a single parent with one child is less than $400 a 
month.\6\
---------------------------------------------------------------------------
    \2\Tara Murtha, Women's Law Project, Michigan Governor Defunds PA 
Based ``Crisis Pregnancy Center'' Chain Real Alternatives after 
Allegations of Misuse of Funds (October 1, 2019).
    \3\Ivy DeJesus, Penn Live, Gov. Josh Shapiro Cuts Funding to 
``Crisis'' Pregnancy Centers from State Budget (August 4, 2023).
    \4\Rachel Wormer, Equity Forward, Mapping Deception: A Closer Look 
at How States' Anti-Abortion Center Programs Operate (September 2021).
    \5\Aditi Shrivastava and Gina Azito Thompson, Center on Budget and 
Policy Priorities, TANF Cash Assistance Should Reach Millions More 
Families to Lessen Hardship (February 18, 2022).
    \6\Gene Falk & Patrick A. Landers, Congressional Research Service, 
The Temporary Assistance for Needy Families (TANF) Block Grant: 
Responses to Frequently Asked Questions (February 27, 2023).
---------------------------------------------------------------------------
    We urge our colleagues to join us in opposing H.R. 6918.

            Sincerely,
                                           Richard E. Neal,
                                                    Ranking Member.
        RANKING MEMBER RICHARD E. NEAL COMMITTEE ON WAYS 
            AND MEANS MARKUP OF H.R. 6918, DISSENTING 
            VIEWS, THURSDAY, JANUARY 11, 2024
    Happy New Year, Mr. Chairman, and to all of our Committee 
members. I echo the Chairman's sentiments--you will be missed, 
Congressman Ferguson. I wish you all the best in life's next 
chapter.
    Turning to the legislation at hand, after the least 
productive session of Congress since the Great Depression, I 
had hoped we'd open the new session on a better note, working 
together to help the people we represent. Instead, I am gravely 
disappointed to see that, with today's agenda, the majority has 
all but farmed itself out to be an arm of the Trump re-election 
campaign. Look no further than his comments last night, where 
he bragged about stripping women of their essential rights and 
freedoms. He called the end of Roe v Wade: ``a miracle.''
    Next week, Washington will be the site of the largest anti-
abortion rally in the country, and this legislation is to 
pander to attendees. Rather than listen to women about what 
they and their families need, or take action to address child 
poverty, the Majority has chosen to pursue another political 
talking point. What's worse, with this bill, they are choosing 
to divert money away from needy families to dangerous anti-
abortion centers.
    This isn't about health care or reproductive freedom or 
even their wildly unpopular anti-abortion agenda, it's 
fundamentally about control. Republicans have long been on a 
crusade to control and limit the rights of women.
    Our Committee has work to do, and people depend on us to do 
so. We should be focused on addressing the maternal health 
crisis in this country, which is harming black women most of 
all.
    This committee's mission is to safeguard health care, not 
attack it. After all, abortion care is health care, and it is 
overwhelmingly safe. But when health care is difficult or even 
impossible to access, that's when complications arise, and 
health outcomes worsen. We've seen horror after horror come out 
of Texas since their Republican governor and Supreme Court 
banned proper care.
    Around the country, anti-abortion centers masquerading as 
health care providers are jeopardizing women's health and 
endangering their lives. In Massachusetts, one of these centers 
failed to correctly diagnose a woman's ectopic pregnancy 
because the staff wasn't qualified to be handling medical care. 
This misdiagnosis gravely endangered her life and necessitated 
emergency surgery a month later.
    Furthermore, these centers aren't held to the same privacy 
or care standards as health providers.
    This is not acceptable medical care, and it's horrifying 
that some of these propaganda centers are getting federal 
funding legally designated for serving poor children. This bill 
wants to fund more dangerous propaganda and more undeserving 
facilities of this kind. Women are being put in harm's way, 
their health is on the line, and it is all in the service of 
far-right ideology.
    Beyond that, I'd be remiss if I didn't mention that we are 
only 9 days from another potential Republican government 
shutdown. That's the fourth this Congress! Another damaging, 
but completely avoidable outcome for our economy and America's 
families.
    Republicans are wasting precious time with political stunts 
like this one, which everyone in this room understands has zero 
chance of becoming law.
    If Republicans wanted to pass legislation that lived up to 
the name of this bill, they could start by addressing the 
growing child care shortage caused by cutting off emergency 
child care funding and the enhanced dependent care tax credits 
that Democrats championed during the pandemic.
    Or they could address the historic rise--a doubling--of 
child poverty caused by their refusal to extend the enhanced 
Child Tax Credit.
    Or they could make paid family and medical leave a reality 
and spare struggling families from having to make the 
heartbreaking decision between caring for a loved one and 
losing a needed paycheck.
    If you want to support parents, and support pregnant women, 
let's start by helping them, not misinforming them, 
criminalizing them, and making their lives harder.
    With that, I yield back the balance of my time.

                                           Richard E. Neal,
                                                    Ranking Member.