the speaker pro tempore: on this vote the yeas are 227. the nays are 191. the resolution is a adopted. without objection, the motion to reconsider is laid upon the table.

for what purpose does the gentleman from louisiana seek recognition? >> madam speaker, i ask unanimous consent that the committee on the judiciary be discharged from further consideration of h.r. 962, the born alive abortion survivors protection act, and ask for its immediate consideration in the house. the speaker pro tempore: under guidelines consistently issued by successive speakers, and as recorded in section 956 of the house rules and manual, the chair is constrained not to entertain the written request unless it has been cleared by the bipartisanner floor and committee leadership. if the speaker --

unanimous consent can cannot be entered into i ask -- the speaker pro tempore: the gentleman has not been recognized for debate.

the speaker pro tempore: for what purpose does the gentleman from new jersey seek recognition? >> madam speaker, i ask unanimous consent that mifes -- that all members may have five legislative days to revise and extend their remarks, and add extraneous material on h.r. 986, the protecting americans with e-existing conditions act of 202019. the speaker pro tempore: without objection. mr. pallone: madam speaker, by direction of the committee on rules, i call up h.r. 986 and ask for its immediate consideration.

the speaker pro tempore: pursuant to house resolution 357 and rule 18, the chair declares the house in the committee of the whole house on the state of the union for the consideration of house resolution 986. the chair appoints the gentleman from illinois, mr. garcia, to preside over the committee of the whole.

the chair: the house is in the committee of the whole on the state of the union for the consideration of house 966 which 986 -- h.r. the clerk will report by title. the clerk: a bill to provide that certain guidance related to waivers for state innovation under the patient protection and affordable care act shall have no force or effect. the chair: pursuant to the rule, the bill is considered as read the first time.

general debate shall be confined to the bill and shall not exceed one hour equally divided and controlled by the chair and ranking minority member of the committee on energy and commerce. the gentleman from new jersey, mr. pallone, and the gentleman from oregon, mr. walden, each will control 30 minutes. the chair recognizes the gentleman from new jersey. mr. pallone: thank you, mr. speaker. i yield myself such time as i may consume. the chair: the gentleman will suspend. he committee will be in order. please proceed. mr. pallone: mr. chairman, i rise to speak in favor of h.r. 986, the protecting americans with pre-existing conditions act, introduced by representative kuster from our committee. this legislation should not be

necessary, but unfortunately the trump administration continues to take actions that undermine the health care of millions of americans, including the more than 133 million people woo pre-existing conditions. today we are here because the trump administration's proposed guidance last october that would allow states to expand and prop up short-term junk insurance plans, even providing taxpayer subsidies for those plans. in order to take this action the administration blatantly ignored the plain text of the affordable care act and gutted standards that states must meet in order to test insurance reforms. i believe the administration's action is illegal. sadly, this administration has never let the law get in the way of its goals. these efforts will without a doubt seriously undermine the health coverage of americans with pre-ex-ising conditions. a coalition of 4 national groups, representing millions of americans with pre-existing conditions, including the american cancer society, the

cancer action network, the american heart association, and the american diabetes association wrote a letter in strong support of h.r. 986 stating, and i'm quoting now, the 1332 guidance substantially erodes the guardrails governing coverage of people with pre-existing conditions such as cystic fibrosis, lung decease, diabetes, rare disorders, pregnant women, and many others rely on in the individual marketplace, end of quote. the patient organizations go on to say that these changes fundamentally alter the nature of section 1332 waiver program and jeopardize adequate affordable coverage for people with pre-existing conditions in the individual marketplace. halting the implementation of this guidance will protect people with pre-existing conditions. mr. chairman, by encouraging states to promote and expand short-term insurance plans, the administration's giving insurerser the green light to directly discriminate against

people with pre-existing conditions. it's giving the green light for these plans to charge people with pre-existing conditions more money, and it's giving these plans the green light to refuse to cover any treatment that is related to someone's pre-existing condition. the expansion of these junk plans will also undermine the insurance market, leading to higher premiums for people with pre-existsing conditions who need comprehensive coverage. this is not the way you protect people with pre-existing conditions. the trump administration's guidance also undermines the a.c.a.'s promise of coverage of essential health benefits. the american people should not have to worry about whether their insurance plan covers prescription drugs, paternity, newborn care, mental health, and substance use disorder services. this guidance is also bad news for older americans who could be charged a lot more for their insurance than what is allowed by the a.c.a. in a nutshell, mr. chairman, this guidance is bad news for any american who wants access to quality and affordable health

coverage that is there for them when they need it. junk plans are just that, they are junk. people shouldn't have to read the fine print to see what is and is not covered. that's the hallmark of the affordable care act. that's why we must rescind the guidance. i want to commend my colleague, ms. kuster, for her great work on this important bill. do i want to emphasize that h.r. 986 would not do anything to interfere with existing 1332 reinsurance waivers, which have bipartisan support and began under the obama administration. my republican colleagues continue to intentionally conflate these reinsurance waivers with the trump administration's new 1332 waiver guidance from october of last year. h.r. 986 does not affect these reinsurance waivers. i'm disappointed my republican colleagues continue to make these arguments, but the bad faith is not surprising given their terrible record on protecting people with with with pre-existing conditions. mr. chairman, this bill is necessary because of the ongoing assault by the trump administration on our health

care system. i urge my colleagues to join me in standing up for the people with pre-existing conditions and standing up for people who want access to affordable and quality health care. with that i reserve the balance of my time. the chair: the gentleman reserves. the gentleman from oregon is recognized. mr. walden: thank you, mr. speaker. i yield myself such time as i may consume. the chair: the gentleman is recognized. mr. walden: thank you. i rise today to call out the mischaracterization of h.r. 986. the misleading title of this bill confirms the democratic majority position to score political points instead of governing. they claim their agenda is for the people. well, this bill is for the politics. let me be clear, this bill has nothing to do with protecting americans with pre-existing conditions. this bill has everything to do with eliminating health care options that would be affordable for americans who can't afford health insurance today, and choice force states. section 1332 waivers were first enacted under obamacare to

provide states the opportunity to innovate and provide their residents with affordable health insurance options. the trump administration is simply updated the guidance for these 1332 obamacare waivers to make it easier for states plan to be approved. this guidance does not. i repeat, does not permit the secretary to waiver pre-existing condition protections, period. but don't take my word for it alone. c.m.s. administrator confirmed yesterday in writing, quote, to be clear, the 2018 guidance does nothing to erode the pre-existing condition provisions, which can cannot be waived under section 1332. wrote the administrator, she wrote on to explain, i quote, section 1332 does not permit states to waive public health service act requirements such as guaranteed availability, and

renublet of health insurance. the prohibitions on using health status, and the prohibition on pre-existing condition exclusions. furthermore, section 1332 waiver can not be approved that might otherwise undermine these requirements. this administration stands committed to protecting people with pre-existing conditions, period, quote. . seema verma, she's the administrator. it's not just her. i want to quote from the trump administration's statement of policy. if h.r. 986 were presented to the president, his advisors would recommend he veto it, wrote the trump administration's statement of administrative policy. the president has repeatedly made clear this president will protarrant county, texas people with pre-existing conditions. 2018 guidance -- will protect people with pre-existing conditions. 2018 guidance would not allow the administration to waive the

requirements in place around pre-existing conditions. the title of this legislation gives the misleading impression that it will enhance americans with pre-existing conditions, closed quote. put simply, mr. chair, this cynically titled messaging bill is all about scoring political points and not legislating, which is what we should be doing. you see, if democratic members actually cared about individuals living with pre-existing conditions, they'd govern and lock in these important safeguards. but since democratic leaders chose to put politics first, i offered an amendment to protect patients with pre-existing conditions to actually lock that into law. mr. chairman, this amendment wasn't presented to the house for a vote. in fact, it was never allowed out of the rules committee. that's a shame. because we could be voting on it today. i tried to bring that vote to the floor on numerous occasions, been denied by the democratic majority. my bill is simple. it provides guaranteed issue nd renewability a ban on

benefits exclusions and underwriting and real pre-existing conditions protections. democratic members claim they support. guess what, it's titled the pre-existing conditions protections act. how ironic. except my bill does what the title says. so let's vote on that bill, mr. chair. here's what it comes down to. the status quo is not working for many americans. health care costs are out of control. patients and families are struggling to pay ever-increasing premiums, deductibles, and out-of-pocket costs. there is work we're doing. i just came from a meeting with the president of the united states in the roosevelt room talking about surprise billing. we're actually going to work together, mr. pallone and i and others to draft legislation to prevent that to protect consumers. we could do more here today than what this bill aledges to do. republicans want -- alleges to do. republicans want to help decrease cost, increase access,

protect individuals with pre-existing conditions and make the health care system work better for families, for patients, and actually be affordable. e want states to innovate. and these section 1332 waivers, again, put forward under president obama, known as state innovation waivers, they're actually working, mr. chair. premiums have gone down in seven states by an average of 20%. down 20%. in my home state of oregon, we've been a real innovator for decades in the space of health care coverage and access and trying to get price down. r premiums under this 1332 waiver oregon has has gone down 6%. down 6% thanks to a state innovation waiver. these waivers could work. states want to innovate. they care about their people and want to bring down costs. but instead of allowing more and more states to innovate and lower the health care costs,

unfortunately, democrats are of the mindset that washington knows best, not our states. states can't be trusted, apparently. they want to limit the ability of states to innovate and this type of top-down command leads to policies which the democrats' one-size-fits-all government takeover of health care. a vote in support of their bill is a vote against innovation. against lowering costs. against your constituents, your legislate ureks your governor, your state insurance commissioner, -- your legislature, your governor, your state insurance commissioner. a vote against this bill is a vote for the people. mr. speaker, i ask my colleagues to oppose this partisan gimmick and i reserve the balance of my time. the chair: the gentleman reserves. the gentleman from new jersey is recognized. mr. pallone: mr. chairman, i now yield a minute and a half to the sponsor of the bill,

mississippi kuster from -- ms. kuster from new hampshire. the chair: the gentlelady from new hampshire is recognized for a minute and a half. ms. kuster: thank you, chairman pallone, for your guidance and leadership on the energy and commerce committee as we advance critical legislation this week to stabilize the affordable care act and drive down prescription drug costs for all americans. mr. chairman, i rise today in support of my legislation, h.r. 986, the protecting americans with pre-existing conditions act. as a patient with a pre-existing condition myself, i rise today to stand with over 52 million americans and over 200,000 granite staters who live with pre-existing conditions every single day. and they could have been denied access to health care prior to passage of the affordable care act and many were. while we recognize we need to strengthen and stabilize the a.c.a., we should equally accept a principle that nobody should be denied coverage

because of a pre-existing condition. when you think about it, asthma, allergies, alzheimer's, cancer, diabetes, just go right through the alphabet, having a child, even, any of these are pre-existing conditions. and in my home state of new hampshire, and across this country, opioid and alcohol addiction are pre-existing conditions. every week, and again here today, we heard republicans in the house energy and commerce committee say, oh, of course we want to protect americans with pre-existing conditions. and yet, at every step, this administration is trying to sabotage the consumer protection guardrails that are in the a.c.a. the chair: the gentleman's time has expired. mr. pallone: i yield the gentlelady another 30 seconds. the chair: the gentlelady is recognized for 30 seconds. ms. kuster: including for

fighting in court for the total elimination of the affordable care act with absolutely no replacement. an important piece of the affordable care act section 32 created the state innovateuation waivers -- innovation waivers as long as plans remained affordable, accessible. however, the trump administration recently issued guidance encouraging states to promote junk health plans through this waiver in order to circumvent essential health benefits and protections for pre-existing conditions. i urge my colleagues to vote yes on this bill, and i yield back the balance of my time. the chair: the gentlelady yields. the gentleman from oregon is recognized. mr. walden: thank you, mr. chairman. i'm delighted to yield two minutes to a very important member of our energy and commerce committee, mr. walberg from michigan.

two minutes. the chair: the gentleman is recognized for two minutes. mr. walberg: i thank the lead republican. mr. chairman, i rise today in opposition to h.r. 986. i would give its title name but it's yet another misleading effort that has nothing to do with the title of the bill. house republicans fully support protections, and i make it clear, for patients with pre-existing conditions. i know that my democrat colleagues and friends want to continue using the mantra that works so well politically without facts, truths or reality during the election. we've gone beyond that now. republicans support protections for patients with pre-existing conditions. these patients deserve peace of mind and safeguards from being treated unfarrell. that's always been a pry -- unfairly. that's always been a priority

of ours and it will continue to be, but that's not what the bill before us would do. h.r. 986 can be summed up in three words -- washington knows best. the bill eliminates flexibility at the state level, taking away options for states to innovate and bring down health care premiums. the high and rising cost of health care is a significant concern for patients and families in my district. we need to focus on solutions, not politics. we need to focus on solutions to provide relief from increasing costs, encourage choice and competition, expand access to quality care, and maintain important -- and i make it very clear here again -- important protections for patients with pre-existing conditions. we have the ideas to do that.

we have the amendments that would put that forward and make this bill of something important to people with pre-existing conditions, but that's not being allowed today. and so let's stop playing political games with a bill title and a title like this and instead focus on patient-centered solutions. i thank you and i yield back. the chair: the gentleman's time has expired. the gentleman from new jersey is recognized. mr. pallone: mr. chairman, i yield a minute and a half now to ms. degette, who chairs our oversight and investigations subcommittee. the chair: the gentlelady is recognized for a minute and a half. ms. degette: i thank you for yielding. i rise in strong support of the protecting americans with pre-existing conditions act. frankly, in my colleagues on the other side of the aisle were so firm in their commitment to protecting americans with pre-existing conditions, they would support this bill because all it says is section 1332 will not stop the protections that we have under current law.

the trump administration's guidance that allows states to undermine the pre-existing condition provisions of the a.c.a. is frankly in clear violation of congressional intent. so let's be clear about something. when we say we're going to protect people with pre-existing conditions, we actually mean it, and that's exactly what this legislation does. so i would welcome support from my friends on the other side of the aisle. according to the kaiser family foundation, over 750,000 people, just in my little state of colorado, would be at risk of losing their health care coverage if it wasn't for the protections of the a.c.a. and the administration's repeated attempts to take the protections away from people and deny them their right to obtain health care coverage is actually the difference for many of them between life and death. we are not going to let this happen. this congress is going to make sure that the goals of the a.c.a., to give full health care coverage to every american, including people with

pre-existing conditions, is going to be preserved. we've come too far to turn back the clock now. i'm glad that we have this bill on the floor now. i want to thank my colleague, ms. kuster, for sponsoring it, and i urge every member of this body to support it. i yield back. the chair: the gentlewoman's time has expired. the gentleman from oregon is recognized. mr. walden: thank you, mr. chairman. it's now my privilege to recognize the pharmacist on our committee, the gentleman from georgia, mr. carter, for two minutes. the chair: the gentleman is recognized for two minutes. mr. carter: thank you, mr. speaker. and i thank the gentleman for yielding. mr. speaker, i rise today in opposition to this so-called protecting americans with pre-existing conditions act. mr. speaker, this is a misnomer. it's defined as a wrong or inaccurate name or designation. and that is what the title of this bill is. it is wrong. i join my colleagues on the

republican side in supporting protections for people with pre-existing conditions. in fact, it was one of the first votes in congress that we took this year and was defeated by my colleagues across the aisle. this bill, which is ironically, as i say, misnamed, because it doesn't actually protect pre-existing conditions, would actually roll back state efforts to lower premiums. one thing i hear from my constituents about is the cost of health care coverage and the lack of options available under obamacare. these waivers would allow for new strategies to address high premiums that so many people are facing. in fact, of the states that created their own reinsurance programs, they saw on average an nearly 20% drop in premiums. one state seeing as high as 43.4%. as states continue to grapple with high insurance costs, they have looked up to these innovative waivers for opportunities to bring about new ideas that help people, not

remove options and opportunities. we all know that there's an issue with affordability of insurance in many areas, and it should be known this isn't as though it's just more conservative to states moving forward with these reinsurance programs. states like new jersey, where the chairman is from, minnesota and maryland have seen the benefits of this. that's why i urge my colleagues to give states the flexibility they need to reduce premiums and to vote no on this legislation. thank you, mr. speaker, and i yield back. the chair: the gentleman yields. the gentleman from new jersey is recognized. mr. pallone: mr. chairman, i yield now a minute and a half to the gentlewoman from illinois, who chairs our consumer protections subcommittee. the chair: the gentlelady is recognized for a minute and a half. ms. schakowsky: thank you, mr. speaker. you know, i believe that my colleagues on the other side of the aisle are standing up and saying what they would like to

see and that is to protect people with pre-existing conditions. the problem with what they're telling the american people is that what they are proposing does not protect people with pre-existing conditions. i know when i first came to congress, as a woman, being a woman was a pre-existing condition. there were a lot of things that weren't covered because we're women until we passed the affordable care act. while the republicans are talking about protecting such people, they are supporting a lawsuit right now that once again would undo all of the affordable care act, sweeping out with them protections for pre-existing conditions. . the other key word to listen to is flexibility. they are talking about allowing up to four years of policies hat states could enact that do

not cover the whole panoply of things the affordable care act covers, and could exclude even protection for pre-existing conditions. that is not flexibility. that is taking away benefits for people. people -- you can sign up for one of these, what we call junk policies, and you're perfectly well, and then all of a sudden you have some kind of an illness that, guess what, is not covered, and won't be covered because by then you'll have a pre-existing condition. the legislation democrats have for you today would protect pre-existing conditions, no questions, period. end of story. thank you. the chair: the gentleman from oregon is recognized. mr. walden: thank you, mr. chair. i recognize the gentleman from texas, mr. arrington, for two minutes. to speak on this matter. the chair: the gentleman is recognized for two minutes. mr. arrington: mr. speaker, i

rise to shed light on a very deceptive practice and the reason the american people refer to politics in washington as the swamp. that's giving bills names that not only have nothing to do with the legislation but actually mislead the american people to believe it's something that it's not. this democrat bill being considered today entitled the protection the american people with pre-ex-isting condition act -- pre-ex-ising condition act has nothing to do with people with pre-ex-isting conditions. it prevents policy to allow states to have the freedom and flexibility to provide for their citizens' health care needs and where they have exercised that flexibility we have seen an average of 20% in the reduction of health care costs. there are laws on the books, mr. speaker, passed by democrats and republicans alike, that prevent and punish people and companies who participate in such false advertising. in fact, there is a good reason

the f.t.c. has strong truth in advertising laws and strictly enforces them against misleading and deceptive practices. because it hurts people. it hurts consumers. and in this case it compromises the american people's trust. mr. speaker, the american people are sick and tired of political games. they are tired of politicians and their duplicity. they are tired, mr. speaker, of their elected representatives deceiving them. that's what this is. i encourage my colleagues to not vote for this bill that takes the american people as fools and preys on their fears. i encourage both sides to stand in opposition of this bill. i yield back. the chair: the gentleman yields. the gentleman from new jersey is recognized. mr. pallone: mr. chairman, i yield one minute toe our majority leader, the gentleman from maryland. the chair: the gentleman is recognized for one minute. thank you, mr. speaker. i thank the chairman, mr.

pallone, for the extraordinary leadership he has shown on this issue and so many others and for his being an original drafter and sponsor of the affordable care act. sitting here and i'm listening to speaker after speaker after speaker tell me that this doesn't protect pre-existing conditions. of course it does. but those are people who not only didn't want to protect pre-existing conditions, they wanted to repeal the whole bill. they wanted to kick 20 million people off health insurance. give me a break. your crocodile tears are not, hopefully, deluding anybody. you are against the affordable care act. we get that. and this administration has done everything they can can think of to undermine the affordable care act. and as an adverse effect on the

ability of americans to get health insurance at a price they can afford. mr. speaker, over the past few years congressional republicans and the trump administration have engaged in a dangerous mpaign to repeal, undermine, and dismantle the affordable care act. depending upon how long they have been here, they may well have voted over 60 times to repeal the affordable care act. all of it. pre-existing conditions and everything else. through executive actions and lawsuits they have sabotaged the law and fueled uncertainty in health insurance markets in the process. they have a suit right now which the to effectively repeal entire affordable care act. that the attorney general of the united states and the president of the united states are supporting.

spare me these crocodile tears about how this bill doesn't protect the pre-existing conditions. it does, but you don't care hether it does or not. they want to know, many of the people want to know protections for those with pre-existing conditions won't disappear. the tense of millions of americans -- tens of millions of americans won't be made effectively uninsurable and lose their coverage. there are very few of us in this chamber or the gallery who don't have some sort of pre-existing condition. and we democrats are committed to making sure that that will not preclude people from getting health insurance. in the first days of the congress we took action to do what the trump administration justice department has refused to do. defend the law in court. we are taking that action.

instead, the trump administration is seeking it overturn the entire law, including the ban on denying coverage for those with pre-existing conditions can. the republicans did pass a bill when they were in charge, they sent it over to the senate. they had a big -- i know other people talked about that, a big celebration at the white house and the president embraced the bill. and some 10 days later he said, no. it is a mean bill. the president of the united states. embraced it, 10 days later it is a mean bill. overturning the law means the end of popular provisions like a ban on forcing women to pay more for the same coverage as men. or allowing those under age 26 to be covered under their parents'policy. the administration's lawsuit would also bring back out-of-pocket cost force prevnive -- for preventive care

and screenings. we want to encourage preventive care. why? it saves money and lives. it would also kick 20 million americans off health insurance coverage who were able to get covered because of the affordable care act. last month the house passed a resolution written by colin nor a ad, new member from texas, condemning that lawsuit which would repeal the affordable care act and reiterating the importance of protecting americans' access to quality affordable care. yesterday the house took another step by passing bipartisan bills which mr. pallone brought to the floor to help speed up the process of bringing the cost of generic drugs down and not prescription costs up. today we have a bill to o overturn the trump administration's -- to overturn the trump administration's guidance that sabotages the

affordable care act by allowing substandard plans. are they cheaper? they are. but in the end, they are much more expensive because the coverage is minimal. the effects of such a rule is to drive up prices for those with pre-existing conditions. that wasn't the intent of the affordable care act which aimed to make coverage affordable for all americans. next week we'll continue focusing on health care by considering additional legislation to help americans access quality, affordable coverage. i urge my colleagues on both sides. some of you said you want to protect pre-existing conditions. some of you have said that. if you believed it, then you need to o vote for this bill. you need to do something to protect those with pre-existing conditions. today's vote is your opportunity to do so.

i want to thank representative kuster who was on the floorer with us today for introducing this legislation. again chairman pallone for putting it to the floor. house democrats will continue as we pledge to do in this last campaign and as the people voted for us expecting us to do is to protect the affordable care act, protect their ability to get insurance notwithstanding a pre-existing condition. protect their families, protect them, and make america better. i yield back the balance of my time. the chair: the gentleman yields. the gentleman from oregon is recognized. mr. walden: thank you, mr. chair. a couple comments. my friend from maryland, he is my friend, always quite poignant and eloquent in his remarks, but what we are debating here today is a bill that is misnamed that doesn't do what it says it's going to do. what we do know is 1332 waivers

work, and my state took advantage of that, 1332 waiver. and reduced insurance premiums by 6%. the great state of maryland, i was just looking at some data, mr. chairman, they had about 181,500 in the enrollment year that they used a 1332 waiver. this year, this year in the individual market, their costs for premiums, individual market percent decreased 43.4%. ow -- let me finish. we know overall 19.9% across the country because you were able to take some of this money, put it together, have a reinsurance program. maine's done it. maryland's done it. oregon's done it. these are things that work. the complaint i get my friend from maryland is people at home say, i maybe have access to coverage now but i can't afford the premium. or if i can afford the premium i can't afford to get sick because

the out-of-pocket costs are so high. they are now falling off. later in the debate i'll share data that's been published this week showing people who literally walk away from health care because they can't afford it. that should be our common mission and goal. when it comes to protecting people with pre-existing conditions, i introduced legislation, tried to get a vote on it. every chance i have had. that would lock into law pre-existing condition protections regardless of what this federal lawsuit's outcome is in texas. we should do that. that would be an easy vote. we could all vote for it. democrats won't let us bring it to the floor. with that i yield two minutes to the gentleman from oklahoma. the chair: the gentleman is ecognized for two minutes. >> mr. speaker, let's be honest. we are not here to solve a problem today. we are not here to change anything today. the bill will do nothing to help people with pre-existing conditions. something not many people know about me is my family's history with spina bifida.

i had an older sister about 13 months older than me who died two hours after birth dawes of spina bifida. my other sister who turned 50 has lived her entire life has a survivor spending the first six months of her life enduring many surgeries. my mother knew my sister was going to be born with that very birth defect that took the life of her first child. my sister had her first daughter, christian, born with a devastating spina bifida condition. during the pregnancies, my mother knew about my sister's birth defect and my sister knew of christian's condition. in spite of that knowledge, their lives were not aborted. christian has a son who just turned 10. in spite of being in a wheelchair for her entire life of 30 years, christian has been n awesome mom to daniel. daniel will have an incredible story to tell about his life because his great grandmother and grandmother did not seek abortions to terminate the lives of their, quote less than perfect children. he is alive today and i'm confident he will have an incredible impact on those

around him. these aren't nameless, faceless people we are talking about. this is my sister, my niece, and my family. these pre-existing conditions have had a massive impact on my life anti-lives of my family. these messaging bills are pointless. people need help not our talking points. our goal should be success. we should aim to write legislation that has a shot to become law and will change people's lives for the better. mr. heroin -- mr. hern: the name of h.r. 986 is to interfere with the president's ability to govern. these are real people and real problems that we are ignoring. i believe that life is precious. every life is worth protecting. we have a lot of work to do and it's time to stop talking and act. that is what we were here elected to do here. mr. speaker, the american people are tired of these political games. i yield back the balance of my time. thank you. the chair: the gentleman yields.

the gentleman from new jersey is recognized. mr. pallone: i yield now a minute and a half to the gentlewoman from california, ms. matsui. the chair: the gentleman is recognized for a minute. ms. matsui: thank you development i rise today as a proud co-sponsor of h.r. 986,er the protecting americans with pre-existing conditions act which prohibits the trump administration from promoting the sale of junk insurance plans that do not fully protect americans with pre-existing conditions. . today, we are taking a critical step to reverse the damaging trump administration policy. with the affordable care act we sought to ensure all people were covered in the same area, chargedecharged the same premium as everyone else, regardless of the health status. women cannot be denied coverage or charged more simply because they are women. and more americans now have the freedom to start their own business or pursue work without fear of losing coverage for pre-existing conditions.

coverage, which before the a.c.a., was often tied to employer plans. in california, we've taken a stance against the trump administration's sabotage of the a.c.a. by protecting consumers from the sale of junk plans. not every state can follow our lead. this legislation protects basic fairness and access to health care for all americans, not just those living in states that have sought aggressive reforms, changes, and improvements to the law. we now have a real opportunity to protect and build on the a.c.a.'s success, and i'm immensely pleased to be able to support such efforts on the floor today. thank you and i yield back. the chair: the gentlelady yields. the gentleman from oregon is recognized. mr. walden: thank you, mr. chairman. i'm now honored to recognize the gentleman from kansas, mr. marshall, for two minutes. the chair: the gentleman is recognized for two minutes. mr. marshall: thank you so much. the lengths that my colleagues across the aisle are willing to

go to mislead the public and increase the political divide over health care is shameful and embarrassing. h.r. 986, which i refuse to call by its name, makes a mockery of americans with pre-existing conditions. mr. speaker, i practiced obstetrics for over 25 years, and you know what the most common pre-existing condition is? it's pregnancy. i came to congress to protect people with pre-existing conditions and to help patients. h.r. 986 does just the opposite. h.r. 986 prevents innovation. it drives the cost of health care up and will cause fewer people to have health care. let me be crystal clear about this, mr. speaker. this bill has absolutely nothing to do with people with pre-existing conditions. that's why i'm proud to join congressman walden and shed light on this deceptive bill democrats are pushing. under current law, states do not have the authority to waive

pre-existing conditions using the section 1332 innovation waiver. it's that simple. section 1332 waivers are working, and contrary to the democrats' claims, patients are raving about the 1332 waivers for reinsurance. these waivers gives states flexibility to provide americans with affordable health care options, and in the seven states using these waivers, premiums have gone down by an average of 20%. they went down 20% with maryland achieving 43% premium reduction. so i stand here today to discuss the facts and not the fiction. the 2018 guide from the president is making the process easier, helping states pursue innovation, strategies that will help more people get coverage while delivering coverage people can actually afford and use. most of us, including the president, are working towards a better health care future for all americans where patients and families, not bureaucrats in washington, are in control of their own health care decisions. i ask that my colleagues across

the aisle stop the partisan politics and come together to develop real health care policy solutions. thank you and i yield back. the chair: the gentleman yields. mr. walden: and i reserve. the chair: the gentleman from new jersey is recognized. mr. pallone: thank you, mr. chairman. i yield a minute and a half now to the gentleman from vermont, a member of the committee. the chair: the gentleman is recognized for a minute and a half. mr. welch: i thank the gentleman. mr. chairman, if we want to level with the american people, let's acknowledge something. we have a difference of opinion on health care. when we passed the affordable care act, it provided the first-time protections for people that have a pre-existing condition. every single one of my colleagues on the republican side voted against that. and then spent the next several years, 69 times, voting to get rid of the protections for pre-existing conditions. and then when they were in the majority, the first opportunity they had they passed a bill out of the house to protect -- to

take away the protection for pre-existing conditions. and thank you, senator john mccain, for protecting the american people. every single opportunity to stand up and protect people who are sick, who lost their job but were sick, wanted to get insurance, you voted no. we voted yes. you're talking now about waivers. i like waivers. we benefit from it in vermont. but not this waiver. you pass this waiver, you are going to wave goodbye to the protections we fought long and hard for pre-existing conditions. we fought for your families. we fought for our families. we fought for all american families. what kind of world is it if you're sick you can't get health care? that's what's at stake now. that should never be in debate. and we will not back down. i'm protecting people from pre-existing conditions. we will not back down on assaults on medicare. we will not back down on

assaults in medicaid. mr. speaker, let us pass this bill and continue to protect americans' health care. i yield back. the chair: members are reminded to direct their remarks to the chair. the gentleman from oregon is recognized. mr. walden: thank you, mr. chairman. i appreciate that. i'd just say to my friend, the biggest assault on medicare is the democrats' proposal to do medicare for all. we know it would cost $32 trillion. double personal and corporate income taxes. i met with hospitals today. 40% reduction in their payments. they are not sure how they would survive. they said most would go bankrupt under the democrats' proposal. with that i recognize the gentleman from the ways and means committee, powerful ways and means committee, mr. reed, to speak on this matter for the next two minutes. the chair: the gentleman is recognized for two minutes. mr. reed: thank you, mr. speaker. mr. speaker, i rise today in opposition to the bill before us. but as the father of a type 1

diabetic, who agrees with the basis of the law of the affordable care act that says pre-existing conditions must be protected in every health insurance plan going forward. we should be celebrating together that that reform is now the law of the land, and i would hope my colleagues would take yes for an answer. but what is being proposed today potentially jeopardizes that protection, because what you're proposing today is to take away the abilities of the states to comply with the law of the land, to protect those pre-existing conditions in a way that allows the states to innovate to drive health insurance premiums down, as the law protects those with pre-existing conditions. this is not a political game. you are talking about real americans. you are talking about kids like my is on who is a type 1 diabetic. and if this law, as proposed, becomes the law of the land,

you potentially increase insurance premiums on millions of americans because you take away the innovation ability of the states to deliver the protections of pre-existing condition reform but lower premiums at the same time. so i stand in strong objection to this political effort from my colleagues on the other side of the aisle, and rather than join with olitics, i the majority of americans that say, you know what, enough is enough of politics. get to the real work of the people and lower health care costs for everyone. with that i yield back. the chair: the gentleman yields. mr. walden: could i just inquire how much time we have on each side, please? the chair: the gentleman from oregon has nine minutes remaining. the gentleman from new jersey has 16 1/2 minutes remaining. mr. walden: we'll reserve.

the chair: the gentleman from new jersey is recognized. mr. pallone: thank you, mr. chairman. i yield a minute and a half now to the gentlewoman from new york, the vice chair of the energy and commerce committee. the chair: the gentlelady is recognized for a minute and a half. ms. clarke: thank you. i thank the chairman for yielding time. i thank congresswoman customer -- customer for her leadership. as co-sponsor of h.r. 986, i'm proud to stand with my colleagues in support of the protecting americans with pre-existing conditions act of 2019. health care is a right. in the 21st century, everyone must have the right to the best quality and affordable health care insurance when they need it most. this human right not must only be limited to individuals, but the right to health care must be available to every american who has ever been ill at anytime or is born with a pre-existing condition. no america should be penalized for a medical condition that

started before the individual's health care coverage benefits went into affect. passage of the protecting americans with pre-existing conditions act would rescind the 1332 guidance issued by the trump administration, which weakens coverage and undermines the affordable care act's protections for people with pre-existing conditions. our friends on the other side of the aisle made more than 70 failed attempts to replace and repeal the affordable care act between 2011 and 2017. mr. speaker, we must do the right thing and enact legislation that strengthens the standards of quality health care affordability, comprehensiveness and coverage. i urge my colleagues to vote yes on h.r. 986. thank you and i yield back the balance of my time. the chair: the gentlelady yields. the gentleman from oregon is recognized. mr. walden: thank you, mr. chairman. i'll continue to reserve my time. the chair: the gentleman from new jersey is recognized. mr. pallone: i'd yield, mr. chairman, a minute and a half

now to the gentlewoman from michigan, mrs. dingell. the chair: the gentlewoman is recognized for a minute and a half. mrs. dingell: thank you, mr. speaker. i rise today to speak in support of protecting people with pre-existing conditions. not that long ago, hardworking people, who did everything right, would be denied insurance coverage just because they had diabetes or asthma or they wanted to start a family. we passed the a.c.a. and ended discrimination against people with pre-existing conditions. millions of americans were able to sign up for coverage for the first time in their lives. and millions who already had coverage knew it wouldn't be taken away from them. remember the stories of people's insurance being cancelled as they were being rolled into operating rooms. that was the truth. the a.c.a. has done a lot of

good. could we work to improve it? yes. and our work with any republican or democrat on those efforts, but when this congress and this administration attempt to roll back protections for people with pre-existing conditions, i will always stand against those policies. two years ago, last week, house republicans passed a bill to rescind the whole a.c.a. and take health care away from 20 million americans. because americans spoke up, that bill failed. the administration's recent section 1332 guidance would let states -- i'm proud to co-sponsor representative kuster's bill. health care should be ffordable to every american. the chair: the gentlewoman's time has expired.

the gentleman from oregon is recognized. mr. walden: thank you, mr. chairman. i continue to reserve my time. the chair: the gentleman from new jersey is recognized. i yield now a minute and a half to the gentleman from virginia, mr. beyer. the chair: the gentleman is recognized for one minute and a half. mr. beyer: i rise to speak in support of h.r. 986, the protecting americans with pre-existing conditions act. frankly, mr. chairman, i'm confused. i serve on the ways and means committee and a few weeks ago we had a long, lively hearing on the need to preserve the pre-existing conditions protection created by the a.c.a., and i was impressed that every member of the ways and means committee, democrat and republican, spoke passionately about this protection. everyone. we emerged with a clear bipartisan consensus we would never again condemn americans who suffer from diabetes or cancer or heart disease or epilepsy to have an

unaffordable insurance and perhaps an early death. today, my republican friends they ady to vote -- argue, no, this is not what c.m.s. is trying to do. yet, this is exactly what would happen when short-term insurance plans in the various states are given the opportunity to do so. that's why virtually every organization that protects human health supports this bill and is against the c.m.s. action. states want waivers. states want to innovate, yes. and this bill won't teep -- keep them from innovating or waivers. states did before the affordable care act when there was no prohibition against higher costs for pre-existing conditions or no insurance, so if what they say is indeed true, there's no harm voting yes for this bill. states will innovate as long as they don't violate the pre-existing conditions

provision. mr. chair, i yield back. the chair: the gentleman yields. the gentleman from oregon is recognized. mr. walden: i'll continue to reserve. the chair: the gentleman from new jersey is recognized. mr. pallone: mr. chairman, i yield now a minute and a half to the gentlewoman from texas, ms. jackson lee. the chair: the gentlewoman is recognized for a minute and a half. . ms. jackson lee: i ask unanimous consent to address the house the house for a minute and a half. i thank the chairman very much. for those of us who were here for the affordable care act where dozens of our committees, including the judiciary committee, heard the pain of people whose family members had died because they had no access

to health care and/or they had junk policies. i rise today with the strongest of support for h.r. 986 and thank my good friend for her great leadership and indicate that since the affordable care act, and i know that we are now looking at medicare for all, my view of it is, yes, so we can have access to health care and it is sure that this bill that we now have that is being attacked by the trump administration in the fifth circuit right now because of my attorney germ attacking the affordable care act, texas saw a decrease of the uninsured from 14.8 to 8.8. now this legislation, which is o turn back the trump guidance on the issue of waivers is vital. because we have lower costs for

health insurance because of the ability for people to access and be taken care of with the affordable care act when they have pre-existing conditions, triple negative breast cancer, diabetes all plaguing my wins constituency, insull in-- insulin costs going through the roof. the trump guidance will be compounded and rates will go up and people suffering from pre-existing conditions will not costinglicy that is low and no mental health and will see a reverse of them being able to have coverage for pre-existing conditions. that is the civil rights of health care, pre-existing conditions must be protected. i rise to support h.r. 986 and i demand that the trump administration stop taking away

the constitutional rights in everything and denying their right to good health care. enough is enough. let us support this legislation. i yield back. the chair: the gentleman from oregon is recognized. mr. walden: i'll continue to reserve my time, mr. chair. the chair: the gentleman from new jersey is recognized. mr. pallone: i yield a minute and a half to the gentleman from connecticut, mr. courtney. the chair: the gentleman is recognized for a minute and a half. mr. courtney: thank you, mr. chairman. after two years of the trump administration trying and failing in congress to repeal the affordable care act, they have gone to plan b. plan b is to use the administrative agencies, the department of health and human services and the court system as a way of trying to accomplish what they could not accomplish through the house and senate in the 115th congress. today we are dealing with an order that was issued in october of last year, issuing new guidelines for state waivers for

the affordable care act, repealing the obamacare guardrails. for example, protecting people with pre-existing conditions, the elimination of lifetime caps on health insurance and also the protections that were built in for essential health benefits which defined real health care, not the cheap health care that was sold before the a.c.a. was enacted. an intervening event occurred. we had an election. largest midterm turnout since 1914. a new majority that was elected with plurality 10 million votes larger than a wave election in the past and the number one issue from the voters was health care and protecting their patient rights to affordable and comprehensive benefits. mr. speaker, we are here today debating an issue which the patient proofs have stepped up across the board and represent

people with chronic illnesses and expensive illnesses saying vote for this legislation to overturn the trump order that they are trying to get through that they could not get through the u.s. congress. vote for this bill. the chair: the gentleman from oregon is recognized. mr. walden: i continue to reserve. the chair: the gentleman from new jersey. mr. pallone: may i inkire how much time remains on each side? the chair: both sides have nine minutes remaining. mr. pallone: i yield myself such time as i may consume. the chair: the gentleman is recognized. mr. pallone: mr. chairman, i wanted to mention this issue of rere-insurance and some republicans brought up the fact in the last few years under the obama administration before president trump that certain states, i believe there are eight now, including my own have applied for 1332 waivers because

they wanted to put in place re-insurance programs. i wanted to assure everyone those types of waivers that are granted for re-insurance would continue and this legislation in no way impacts that. keep in mind we are not opposed to 1332 waivers, but pursuant to the affordable care act which i helped draft, those waivers when granted have to maintain affordability, the comprehensiveness of coverage and keep the same number of people insured as under the a.c.a. when my state and others have applied for waivers for re-insurance programs is because the a.c.a. insurance funding was discontinued at some point under the original bill and those states twant to among other things make sure this competitiveness in the marketplace by providing some kind of re-insurance or risk protection so that more insurers come into the marketplace in those states and create more

competition and lower prices. when you ask the federal government for a re-insurance waiver, you are still maintaining affordability, probably makings things more affordable pause of competition. you are maintaining the comprehensiveness of the coverage because you have to provide policies that have all the essential benefits and keeping the same number of people insured. in fact, what you are doing is having more people insured. the difference between that and section 1332 guidance ta the trump administration is now putting forth is that none of those things are guaranteed under the waivers that the trump administration is proposing. they can say you can sell a junk plan that doesn't have essential benefits. o you violate the section 1332 provision. you also end up having fewer people insured because the trump administration says you don't have to have the same number of people covered, all you have to

do is have access and lastly affordability, they'll argue that it's more affordable because a junk plan doesn't cost as much but that is a misnomer because the coverage disappears. i want everyone to understand no way a state that applies to have re-insurance as part of their program and gets the waiver, that is no way impacted by what we are proposing today with ms. cuss tier's bill. it reinforces that the 1332 waivers are seeking to guarantee. that is a very false bit of information that my colleagues on the other side are trying to put out here today. and i wanted to explain that and with that, i reserve the balance of my time. the chair: the gentleman reserves the balance of his time. the gentleman from oregon is recognized. mr. walden: i continue to reserve. the chair: the gentleman from new jersey is recognized. mr. pallone: i yield a minute and a minute to the gentlewoman.

>> i rise today in support of the protecting people with pre-existing conditions act. for me this issue is particularly personal. it is amajor reason why i ended up coming here to congress. and i believe that the sabotage, the attempts at legislating out protections for people with pre-existing conditions is something that is out of touch with the american people. it is particularly personal to me because of my mom. my mom passed away in 2011 from ovarian cancer and when she was diagnosed she did not have health care. she struggled with health care. e had a breast cancer as a 31-year-old young mom. my parents divorced and lost her job and because of that pre-existing condition, she could not afford health

insurance. she went 5 1/2 years without. no checkup and no exam. we got her health insurance. it was $1,000 a month and $10,000 deductible. in 2009 without us knowing, she let it lapse and two mop later walked into an e.r. and was diagnosed with stage four ovarian cancer. my colleagues around the room know when a loved one gets a terminal diagnosis. your life explodes. that same week was the same month we spent filling out the paperwork to declare bankruptcy. no matter if you are republican, democrat or independent, it is essential we support people with pre-existing conditions and i urge my colleagues to do so. the chair: the gentlewoman's time has expired. the gentleman from oregon is

recognized. mr. walden: i reserve. the chair: the gentleman from new jersey is recognized. mr. pallone: thank you, mr. chairman. i would like to yield myself such time as i may consume. still waiting for one of our other speakers. mr. chairman, i also wanted to respond to my colleague, the ranking member who i respect a great deal, but he has several times today as well as in committee and representative at the rules committee talked about this amendment that he has on pre-existing conditions. first of all, the reality is that the a.c.a. guarantees people coverage with pre-existing conditions. the problem here is not that we need to restate that but section 1332 guidance that the trump administration has proposed would undernine it. mr. one's amendment appears to

maintain pre-existing conditions. that's not the issue and he is not getting rid of the conditions. even with his amendment, the trump administration under their guidance would allow insurance companies to not offer basic services such as hospitalization, maternity coverage, mental health and substance abuse disorders. insurance companies would no longer have to over these benefits to people with pre-existing conditions. his bill, mr. walden's amendment does not include prohibitions on annual or lifetime limits which are critical for pre-existing conditions. these limits with were common are a threat to the life of individuals with serious medical conditions. and the walden amendment would allow insurance companies to charge women more than men and

put a significant burden on older americans. we are not interested in these half measures that will leave americans worst off. i don't have as much time as you. and i would like to yield to the ntleman from california, mr. -- >> he >> i rise in support of my amendment. my legislation would simply require the federal government to issue an expert analysis of the impacts of jumping plans on mental health care access. people deserve access to mental health care and we don't know how many people will lose that access. that's exactly what my amendment would tell us. people who are struggling with depression, anxiety, schizophrenia, deserve coverage.

we are talking about real people in our community and should get it and that is true because of the stigma surrounding mental health issues. if you tell your friend that you have cancer, they tell you to get help. if you tell your friends you have depression, they say tough it up or go to the gym. a lot of people self-med indicate. we have to make sure they are covered with real insurance, not junk plans. these plans are a scam. story of a rrorst h junk plan. her daughter went off to school and got cheap university-sponsored insurance. and she had a mental health issue. when she was denied coverage for the treatment she needed even though she paid premiums for years. her family had to pay thousands of dollars out of pocket. they are still paying it off

today, more than 10 years after her mental health episode. that's a common story. only about half of these plans cover mental health care and a hird cover substance abuse disorder. people show signs of mental health problems in their 20's. people who turn 26 have to get off their parents' insurance. they pick the cheapest thing they can find, and if we don't pass this amendment, we will hear similar stories from people who need it the most. that is a scam. that's what my amendment demands. thank you, mr. speaker, and i yield back. . the chair: the gentleman's time has expired. the gentleman from oregon is recognized. mr. walden: mr. chairman, how much time does each side have? the chair: the gentleman from oregon has nine minutes. the gentleman from new jersey as one minute.

mr. walden: does the gentleman have other speakers? no. then i yield myself such time as i may consume. the chair: the gentleman is recognized. mr. walden: thank you, mr. chairman. let me address a few issues. first, my friend from new jersey, and he is my friend, referenced my amendment. it's unfortunate we couldn't debate my amendment because the rules committee wouldn't allow us to bring it to the floor nor a bill i offered that has more than 100 co-sponsors that would make sure that pre-existing condition prist are protected in case -- pre-existing conditions are protected in case the court decision in texas goes against the a.c.a. and wipes out those protections. see, this would be an insurance policy for people with pre-existing conditions in public law. we could do that today. if it has some shortcomings, then let's have a markup on this bill and work that out. i care deeply about pre-existing condition protections. i fought for it as a

legislator. i helped create the high-risk pools in oregon in the late 1980's, early 1990's. i support it every step of the way. let me again quote from the department of health and human services. we wrote them and they wrote back to us. seema verma, the administrator, said in her letter to me, let me be very clear, the 2018 guidance does nothing to erode -- and i am going to use obamacare, the affordable care act, pre-existing conditions, which cannot be waived under section 1332. they can't waive those protections under 1332. section 1332 does not permit states to waive requirements such as guaranteed availability and renewability of health insurance, the prohibition on using health status to vary premiums and prohibition on pre-existing condition exclusions. furthermore, section 1332 waiver cannot be approved that might otherwise undermine these requirements. this administration stands committed to protecting people

with pre-existing conditions. that's the head of c.m.s. it's her agency that approves 1332 waivers. there have been no waivers so far approved under this guidance. and that is her -- that is what she tells us in writing, period, because of the information that's centered around. we know seven states have taken advantage of the prior 1332 process and has yielded more affordable insurance premiums for american citizens. now, i find it curious, my state has been very progressive in these areas. when i was in the state legislature, i helped try expand access to affordable health care. we had to come to washington to get a waiver for the oregon health plan and medicaid, and we looked at all kinds of different ways to get access to affordable health care. i never let up on that. i believe strongly in helping people with pre-existing conditions, like my colleagues on the other side of the aisle, my wife and i had a is on who did not survive because of a

heart condition -- and i had a son who did not survive because of a heart condition and we dealt with these issues from birth leading to his death. i want to help those with pre-existing conditions. what we're arguing about here is health insurance affordability for americans and are there better ways using states as laboratories to bring down cost of care and cost of insurance? because more are paying out of our pocket. there is an interesting story that i'll put in the record for everyone to read. data from the kaiser foundation this week that ran in a publication called axios. i want to share what they found if you get outside the beltway in washington and talk to real people. they evaluated people who had coverage under their employer, in this case, and had a chronic condition of some sort. it's not a small group. about half of americans who have employer coverage, so that's half of 158 million,

report that six in 10 in that group report they are -- they or their family member skipped care or prescription drugs because of the cost or in some cases tried a home remedy. high deductibles make things worse. among those with chronic conditions whose deductibles were $3,000 for an individual or $5,000 for a family, 3/4, mr. chairman, 3/4, 75% report skipping or postponing some type of care, and about half, 49%, say they or a family member had problems affording their premiums, co-pays, deductibles within the past year. what some said was, hey, washington, d.c., give us just a little flexibility here, let us come up with plans that may be more affordable. they did that. under the prior rules, and rates went down on average

19.9%. some states more, some less. now, what happens when people can't afford to use their own insurance? because that's happening with these conducts of these high levels -- deductibles. a substantial share of people reported taking measures such as increasing credit card debt, 28%, using up most of their satisfaction, 26%, extra job, 19%, borrow money from family or friends, 14%. this is what we're trying to argue could be better taking care of. this is the issue that's being ignored by a washington one size fits all. we protect people with pre-existing conditions. 1332 waivers. that law states in effect. we want states have more flexibility to bring down costs. we're working together on some of these drug reforms so we can get drug costs down. i was at the white house today with the president on surprise

billing, and i think we're going to work together on that issue, mr. chairman so that no american consumer who follows the rules gets stuck with a surprise bill. what are you supposed to do, wake up in the middle of the operation and say, hey, everybody in this room still on my plan? if you play by the rules, you shouldn't get stuck unfairly with a surprised bill. my state came up with a way to do that already. other states have other ideas, but we're going to protect consumers there as well. we'll drive down the cost of drugs, and we should continue to go after this issue of high cost of health care. because that's what americans in my 20 town halls, and i don't think anybody in the house has done more, i've done 20 town halls this year and in almost every one of them they're asking how to get the cost down. 1332 waivers gave my state the opportunity to get costs down. and we should not impede that process. we are going to debate a lot about these policies going forward. if there are junk plans, then

let's expose them, and let's pass ms. eshoo's bill that requires more transparency and accountability. count me in on that. there's a lot more we can do to drive down cost. and my legislation, again, democrats refuse to bring up in committee or have on the floor, would make sure, regardless of any lawsuit, people with pre-existing conditions could continue to get covered. so irrespective of the court decisions, they'd get covered. if my bill would be allowed to get voted on in the house, if there are issues, we can work on it. it would pass, become law. this president is firmly committed to protect people with pre-existing conditions. so we should do that. we should also have a hearing on the medicare for all bill that some on the other side are promoting. i've asked for that. i know there was one in the rules committee, but energy and commerce is the committee of jurisdiction for most of that. we've not seen that hearing

yet. i hope in the future we will, because we should know the mpact of wiping out medicare advantage plans, medigap plans. i've been told tricare would go away. all private insurance would go away. and it would be a one-size-fits-all government-run system, and i'm worried about the delay and access to care. i'm worried about the great new innovative drugs and procedures we would lose in america. so mr. speaker, i must oppose this underlying legislation. i remain committed to protecting people with pre-existing conditions, as do my colleagues on the republican side. we ought to focus together, mr. chairman, we ought to focus together as a congress to do the best thing for our constituents, which is bring the greatest leverage possible to reduce unnecessary costs in the health care system in america. with that, mr. chairman, i yield back and ask my colleagues to oppose this bill. the chair: the gentleman yields. the gentleman from new jersey is recognized. mr. pallone: mr. chairman, i

yield myself the remaining time. the chair: the gentleman is recognized. mr. pallone: mr. chairman, the problem is that nothing that my colleague on the republican side says about his amendment and nothing that's in seema verma's letter will help a person with pre-existing conditions. the bottom line is this 1332 guidance that the trump administration put forward allows junk plans to be sold so people with pre-existing conditions will not get the coverage they need. they can be charged more. they're not guaranteed the things like recisions and lifetime limits don't go back into place. and so the problem that we face is, we can't allow people with pre-existing conditions to suffer and not get coverage because they're going to be charged more or because they are not going to get the coverage they need by buying a junk plan. if you really care about that and you want to make sure people with pre-existing conditions really are guaranteed good coverage and can afford their coverage, then you have to vote for this bill,

for ms. kuster's bill. that's all we're saying here. i'm not saying that my colleague on the other side is not well-meaning, but nothing he's said will protect the people with pre-existing conditions with the problems with the trump guidance. i ask my colleagues to support this bill. and mr. chairman, can i now ask unanimous consent to enter into the record a letter from various nonprofit health organizations supporting the bill, there are two of them? and also, i'm placing into the record an exchange of letters between the chairman of the committee on energy and commerce and the chairman of the committee on ways and means on the bill, h.r. 986. the chair: the gentleman's request will be covered under general leave. all time for general debate has expired. pursuant to the rule, the bill shall be considered for amendment under the five-minute

rule and shall be considered as read. no amendment to the bill shall be in order except those printed in part a of house report 116-51. each such amendment may be offered only in the order printed in the report by a member designated in the report, shall be considered as read, shall be debatable for the time specified in the report and equally divided and controlled by the proponent and an opponent, shall not be subject to the amendment, and shall not be subject to a demand for division of the uestion. it is now in order to consider amendment number 1 printed in part a of house report 116-51. for what purpose does the gentleman from rhode island seek recognition?

mr. langevin: thank you, mr. chairman. i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 1 printed in part a of house report you were 51 offered by mr. langevin of rhode island. the chair: pursuant to house resolution 357, the gentleman from rhode island, mr. langevin, and a member opposed, each will control five minutes. the chair recognizes the gentleman from rhode island. mr. langevin: thank you, mr. chairman. i yield myself such time as i may consume. the chair: the gentleman is recognized. mr. langevin: thank you, mr. chairman. americans with disabilities have always had significant barriers to health care. a decade ago an insurer could charge a family an exorbitant amount to cover a child merely because the child had asthma. an insurer could tell an amputee they would cover her medical equipment except -- medical treatment except for the treatment related to her

amputated limb. or an insurer could flat out deny coverage to someone because they had a spinal cord injury. insurers could legally discriminate against individuals with disabilities and face no consequences. that is absolutely outrageous, mr. chairman. then, the congress finally passed the affordable care act and started to bring those barriers down. for the first time, people with pre-existing health conditions, including the one in four americans living with a disability no longer had the ability whether they would be denied comprehensive health insurance. coverage of essential health benefits meant a mother with a traumatic brain injury could obtain rehabilitative services and learn how to walk. a man with parkin son's could access medication to control his tremendousors. a child with a vision impairment could visit an eye doctor to prevent further

vision loss. and this access to health care is vital because when americans with disabilities are healthy, they can stay active with their families, pursue fulfilling careers and engage in their communities. unfortunately, the trump administration is once again working to raise barriers to health coverage instead of working to eliminate them. the administration's october, 2018 guidance encourages states to allow insurers to offer short-term, limited duration plans that do not have to provide coverage of pre-existing conditions or essential health benefits. this means insurers offering these junk plans can discriminate against disabled individuals by charging astronomical prices, excluding necessary treatments from coverage, or denying an individual health insurance altogether. this is outrageous. if you're having deja vu, it's because this is exactly what was happening to americans with disabilities before the passage

of the affordable care act. . the amendment i'm offering today makes clear what people with disabilities have to lose under the administration's guidance. i have spent near two decades in congress channing areas to help my fellow americans understand their great potential. but fundamentally, none of that means -- that matters, if people with disabilities are not healthy, because insurers deny them coverage to treat their conditions. the damage from the administration's guidance would be borne disproportionately by the disabilities community, my community and my amendment makes that clear. whether someone is born with a disability, develops a disability or becomes disabled due to an accident, that disability, i assure happened by

chance, not by choice. even the healthiest 30-year-old today could be in a car accident tonight and wake up with a life -long disability tomorrow. if that 30-year-old had one of these junk plans, much of that cost for that care would fall on his or her own shoulders and would be on their own. i would hope nine years after the passage of the affordable care act, i would no longer have to come here and defend the idea that quality affordable health care is a right and not a privilege. but once again, here we are -- mr. chairman, i support my friend, congresswoman kuster's underlying legislation and i ask my colleagues to support my amendment that make clear the trump guidance the damage it would cause to people with disabilities. with that, i i reserve. the chair: the gentleman reserves the balance of his time. for what purpose does the gentleman from oregon seek

recognition? mr. walden: i rise to claim time in opposition. the chair: the gentleman is recognized for five minutes. mr. walden: thank you, mr. chairman. i would just say that section 1332 does not permit states to people with ce for pre-existing conditions. and i would cite the director where she states that. again, what we are trying to do here is give states more flexibility to bring down the costs of health insurance while following these guidelines as outlined. as i mentioned earlier in the debate, high deductibles are pricing people out of coverage. and by that, i mean, they are walking away from getting the care they need because they can't pay for it or they are driving up their credit card debt, wiping out their savings,

have to take another job and borrowing money from others. what the trump administration is trying to build on what the obama administration created, 1332 waivers that have been successful in many, many states. with that, mr. chairman, i reserve the balance of my time. the chair: the gentleman reserves the balance of his time. the gentleman from rhode island is recognized. mr. langevin: i just want to make reference to the gentleman's comments state that the plans under the obama administration was supposed to be very short in duration for a three-month period while the individual sought more comprehensive, appropriate health coverage according to their need. it wasn't supposed to be a replacement for a good quality affordable health care plan that would cover pre-existing conditions and essential health benefits to identify health

problems early on in someone's -- in a potential lifelong or very serious illness with long-term health consequences that could lead to one losing one's life. it was to be a stop-gap and now they are trying to make that a permanent plan and that's just wrong. with that, mr. chairman, i reserve the balance of my time. the chair: the gentleman's time has expired. the gentleman from oregon is recognized. mr. walden: i yield back the balance of my time. the chair: the gentleman yields back the balance of his time. the question is on the amendment offered by the gentleman from rhode island. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. he amendment is agreed to.

it is now in order to consider amendment number 2 printed in 116-1. f house report for what purpose does the gentleman from maryland seek recognition? mr. brown: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 2 printed in part a of house report 116-51 offered by mr. brown of maryland. the chair: pursuant to house resolution 357, the gentleman from maryland, mr. brown, and a member opposed each will control five minutes. the chair recognizes the gentleman from maryland. mr. brown: i yield myself such time as i may consume. of the support

underlying bill that will preserve protections for hundreds of americans who like me, have a pre-existing condition and i rise in support of my amendment to protect states who are acting to strengthen their insurance marketplaces, lower premiums and expand access to high quality care by preserving their re-insurance programs that they have established. for more than two years, the president in concert with republicans in congress have had every threat in the book to undermine the affordable care act. they tried repealing it and taking it to the courts and want states to gut protections. these attacks jeopardize health asthma, americans like high blood pressure and dites and threaten to bankrupt thousands of families of a loved one who has fallen ill. it is cruel. that's why in the face of this

this to make the affordable care act less effective, we must provide states with every tool in the tool box to keep premiums down while preventing the guideance to gut. states should have the power and flexibility to innovate and find health care solutions that work best for them. the affordable care act always envisioned a critical role for states. they can shape their own medicaid program and take the lead in enforcing patient protections and reviewing rate increases. these waivers took on new importance after president trump and the republican congress failed to repeal obamacare and sought to undermine the affordable care act by eliminating the requirement to obtain health insurance, ending cost-sharing payments for low-income individuals, passing regulations that encourage junk insurance and defunding

advertising and outreach during open enrollment. this sabotage has caused more families to pay hire premiums and fewer people to get the high quality care. states are establishing re-insurance programs and applying to state innovation waivers. and protect snurp insurers from high medical expenses incurred, alaska, minnesota, oregon, maine, wisconsin, new jersey and my own state have received federal approval to accomplish re-insurance programs. these are the very programs my amendment seeks to protect. these programs work and meet the shared goal of making health insurance affordable and accessible including those with pre-existing conditions. they have cut premiums by 20% on average and sabed the federal government by $1 billion. maryland lowered individual

premiums by more than 43%. these lower premiums will entice younger and healthier individuals making health care more affordable. while we have a president in the white house and republicans in congress that have made health care expensive and stripped protections for those who need it most, it is imperative that this congress protect our state partners on the state level to protect health care for all americans. my amendment would protect these innovative insurance programs and encourage more states to adopt them. i reserve the balance of my time. the chair: for what purpose does the gentleman from oregon rise? mr. walden: i would like to claim time in opposition to the gentleman's amendment. the chair: the gentleman is recognized for five minutes. mr. walden: i'm not necessarily opposed to his amendment. but i do think it is important to talk about the issues when it comes to matters of affordable health care. when we talk about giving states

the authority to innovate and to protect their citizens, we are for that. i come from a state that pine neared the oregon health plan. i created a select committee when i was the republican majority leader of the oregon house that we implemented the oregon health plan. and it was very creative about how to hold down health care costs and expand coverage and do all those things. we have worked on a lot of different issues over the years. what we did with the president today is certainly important and that is look at this issue in surprise billing. if you follow all the rules, you go to a hospital that's in your network and let's say provider gets sick in the night and substitute somebody else who doesn't turn out to be in your network and weeks later you get an astronomical bill.

there was a parent down there whose daughter had some sort of surgery and the physician said on the way out, i want you to do a urine test, so she did. left. and period of time later got a bill for $17,000. her dad's a doctor and said, how did this happen. whoever did the test was not in the network of her insurance. she didn't know. whatever surgery she had and the doctor said, hey, by the way, i got you on this drug. $17,000 arrives couple months later. we were with the president today in the roosevelt room and her dad negotiated and couldn't say what level but it wasn't not what the insurer would have paid. you know what the insurer would have paid in network, 100 bucks.

$17,000 bill arrives. this is what is happening to americans who have insurance. and that's why we have to deal with the surprise billing issue. that's why we have to squeeze the juice out of the middle of the health care delivery system. we do these innovations and republicans led the effort on 21st century cures. we met with dr. francis collins, extraordinary leader at n.i.h. longest serving president under n.i.h. and because what we put forward to dramatically increase investment in n.i.h., republicans led that effort and led by fred upton and representative did he get. they are finding cures and dr. collins have identified 6,500

seases, genetic diseases and some of you may have seen on "60 minutes," they think they found cure for sickle cell aneem yeah. and were able to go in with technology and what we have done collaboratively and alter that letter. and have these people now there is no evidence of sickle cell in their blood plate lieutenants. now they have to figure out how to train your body to have your own cells turned on in a little different way and go after these diseases, these are remarkable advances in life-saving medicines and treatments. we, i think, as a country to figure out how to pay for that.

our system is old and doesn't deal with it. the lifesaving cure isn't going to cure a life if they can't afford the medicine. one of our colleagues was talking about mental health service. my district is bigger district than any state east of the mississippi. and we are getting great results for our veterans using telemelt, but our p providers don't get paid for the services they provide. that's something we have to address. one thing after another after another where we should be spending our valuable legislative time solving the problems that real americans run into every day of the week. how do i pay the bill. you tell me i got insurance and i do -- i don't know whose premium under obamacare went down $2,500. i'll talk about this more and i

yield back. . the chair: the gentleman from maryland is recognized. mr. brown: i join the gentleman from oregon for acknowledging the great work that's happening in the state of oregon, in new jersey, in maryland in establishing these reinsurance programs, and it is my amendment that seeks to protect these very strong programs. so i urge my colleagues to support this amendment, and i yield back the balance of my ime. the chair: the gentleman yields back. the question is on the amendment offered by the gentleman from maryland. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. the amendment is agreed to. mr. brown: mr. chair. the chair: the gentleman from maryland is recognized. mr. brown: i request a recorded vote. the chair: pursuant to clause 6

of rule 18, further proceedings on the amendment offered by the gentleman from maryland will be postponed. it's now in order to consider amendment number 3 printed in part a of house report 116-51. for what purpose does the gentlewoman from massachusetts seek recognition? ms. pressley: mr. chair, i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 3 printed in part a of house report 116-51 offered by ms. pressley of massachusetts. the chair: pursuant to house resolution 357, the gentlewoman from massachusetts, ms. pressley, and a member opposed, each will control five minutes. the chair recognizes the gentlewoman from massachusetts. ms. pressley: thank you, mr. chair. i rise today in support of my amendment to h.r. 986, the

protecting americans with pre-existing conditions act. quality affordable health care is a fundamental human right, period. no one should have to face financial ruin while they're fighting for their life. when people are using go fund me pages to pay their medical bills, when parents are burying their children who ration their insulin to pay their student loans, we know that we are in the midst of a moral crisis. and, yet, we must contend with an administration that's determined to roll back these rights and protections. each of us has loved ones whose lives are put in conditional jeopardy when we erode protections for pre-existing conditions. these efforts put lives at risk, and we are here today to fight back. in my district, the massachusetts seventh, half of the residents are living with pre-existing conditions. families are struggling with some of the highest per capita health care costs in the nation, even as they live in the shadow of some of the best health care institutions in the

world. in my district, travel three miles and life expectancy drops 30 years, 3-0. since its implementation, the a.c.a. has provided critical protections for nearly three million residents of massachusetts living with pre-existing conditions. our families, our neighbors, our communities are depending on us to uphold the lifesaving protections for those with pre-existing conditions, and we can do that today by passing h.r. 986. mr. chair, my amendment to h.r. 986 affirms that women's health care isn't optional. option every al plan must offer. we will not go backwards. at a time when life expectancy is declining because of gun violence, opioid use, we can't decline these services. before the a.c.a., mr. chair,

typical insurance plans considered maternity care a luxury benefit, and women consistently paid for more primary care than men. in fact, women who had given birth had a c-section, living with h.i.v. or previous breast cancer diagnosis should be considered to have -- could be considered to have pre-existing conditions and denied coverage. thanks to the a.c.a., many women who were previously uninsured gained health coverage, including vital access to preventative care. this administration's cruel and dangerous guidance would weaken these provisions and allow insurers to sell skimpy plans that could exclude coverage like maternity care and pediatric services. the a.c.a. is our floor, not our ceiling. we must continue to fight for universal health care. we must continue to push for a health care system that meets the needs of the people that we represent, a health care system that sees all people, hears all people, and cares for all people in a way that promotes safety, dignity, and respect.

i urge my colleagues to support this amendment. thank you and i reserve the remainder of my time. the chair: the gentlewoman reserves. for what purpose does the gentleman from oregon seek recognition? mr. walden: mr. chairman, i'll claim the time in opposition although i am not necessarily opposed to the gentlelady's amendment. the chair: without objection. mr. walden: and i'll reserve my time at this time. the chair: the gentleman reserves. the gentlewoman from massachusetts is recognized. ms. pressley: i yield the remainder of my time. the chair: the gentlewoman yields back. the gentleman from oregon is recognized. mr. walden: well, thank you, mr. chairman. and i appreciate the gentlelady's comments and her amendment. we don't intend to oppose her amendment, but i do want to pick up on something she said that's really important. you mentioned opioids. in the last congress when i chaired the energy and commerce committee, i helped lead the bipartisan effort to produce 60 pieces of legislation dealing with the opioid crisis.

to help those who were addicted get the assistance they need and resources into our communities, to help medical advancements to find nonopioid related medical treatments, to stop fentanyl from coming into our country. i didn't get the opportunity, but i hope the president and his team will continue to raise this issue with the chinese leadership when they come, because a lot of this illicit fentanyl is being produced in china and then coming to the united states. dr. burgess was our chair of the subcommittee on health and is now the of top republican. actually, i think went up to the chairman's district in new jersey and viewed one of the international mail processing facilities, or at least it was in new jersey. precise ow its location. we said working with the trump administration's f.d.a. director, we have to do more at these mail processing facilities to stop fentanyl from coming in. by the way, fentanyl is like 100 times more potent than morphine. if you had a salt shaker and

put out 10, 15 grains of salt and ingested that and it were fentanyl, it would kill you. we said, let's put more resources towards stopping illegal fentanyl from coming in the united states. and we're doing that now. we're beefing that up, and it comes in through mexico as well. it's both china and mexico. it is creating pockets of deaths in our community, especially in some of our you shallans where we've seen it gets mixed in with heroin to give you a higher high or whatever, and then you see groups of people that takes this not knowing it's been jacked up by fentanyl and you have a whole group that die. most insidious discussion or instant i heard about was a parent i got to know a little bit whose daughter, he told me, self-medicated occasionally with heroin and she died in college. when they did the autopsy, they figured out she had been given

100% fentanyl. it wasn't a mix with heroin, mr. chairman. and the tragedy of that was he felt that her supplier knew she was an occasional user so had a low tolerance and basically killed her to prove to his other buyers that he had the most potent stuff on the street. and a colleague of ours, mr. katko, who was a prosecutor before he came to the congress, he and i were having a discussion on this matter and he said he actually prosecuted a case just like that. that's how evil this stuff is. and so as we look at the whole pan plea of issues about health care, about mental health services, addiction services, stopping these things from coming in, we can find a lot of common ground. the republicans supported protections for pre-existing conditions before the a.c.a., during the a.c.a., after the a.c.a. we did. same with putting kids on your policies until 26, we agreed with those principles. but as you know, the obamacare

act was crammed through this house and the senate and we weren't even allowed to bring any of the 90-some amendments we offered to the floor. we were completely shut out of that process. it's a horrible process. and it shouldn't be repeated. and i hear a lot about how we voted to repeal it a about a zillion times. if you go -- bazillion times. if you go through it there were democrats that voted with us at the time. president obama signed of the legislation because even he admitted there were problems in the a.c.a. and so going forward, i hope we can address the big problem in america which is high cost insurance, high deductibles but more importantly the high cost of health care itself because it's pretty hard to go home and -- in why things cost the cost the way they are. i talked about telehealth and telemedicine. there is a lot of work we will do together. unfortunately, this is a mislabeled bill today. 1332 laws -- laws governing

1332 waivers prohibit what the majority's concerned about. but i don't have opposition to this amendment, and i yield back. the chair: the gentleman yields back. the question is on the amendment offered by the gentlewoman from massachusetts. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. he amendment is agreed to. it is now in order to consider amendment number 4 printed in 51.t a of house report 116- for what purpose does the gentleman from california seek recognition? mr. harder: mr. speaker, i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 4 printed in part a of house report 116-51 offered by mr. harder of california. the chair: pursuant to house resolution 357, the gentleman

from california, mr. harder, and a member opposed, each will control five minutes. the chair recognizes the gentleman from california. mr. harder: thank you, mr. speaker. i rise in support of my amendment. as i stated in my previous remarks, my amendment would simply require the federal government to issue an expert analysis of the impact of junk plans on mental health access. people deserve access to mental health care, and we need to know how many people will lose that access if these junk plans become used more widely. thank you, mr. chairman. i reserve my time. the chair: the gentleman reserves. mr. walden: mr. chairman. the chair: for what purpose does the gentleman from oregon rise? mr. walden: thank you, mr. chairman. i seek time in opposition to the gentleman's amendment. the chair: the gentleman is recognized. mr. walden: and i'll reserve the balance of my time for the moment. the chair: the gentleman reserves. the gentleman from california is recognized. mr. harder: thank you, mr. chairman. i yield back.

prepared to close my remarks. the chair: the gentleman yields back. the gentleman from oregon is recognized. mr. walden: thank you, mr. chairman. i appreciate that. i appreciate the gentleman's amendment. and, look, we all care deeply about getting mental health services into our community. in fact, under republican leadership on the energy and commerce committee a few years ago, we rewrote america's mental health laws for the first time since john kennedy signed the last bill into law before he was tragically assassinated in texas. and it was a lot of work and it was bipartisan work and not only did we look at those mental health laws that were on the books -- because what happens around here, somebody comes up with a new idea. you put a new program in place. you give an authorization. maybe it gets funded, maybe it doesn't. a year goes back, somebody has a new idea, it gets puts on the books. nobody looks what worked what didn't. our colleague, dr. murphy, at the time who was a mental health -- a psychologist and

terrific leader in this area and really drove this review said, look, we have to help kids with mental illness. we need to help adults. we could, you know, deal with a lot of violence in america if you have people -- it's not everybody with mental illness goes violent. we do know that mental health services help people in every way. and the programs we had, and we had a lot of them, either were funded, weren't funded properly, some worked better than others. so we had this comprehensive review in the energy and commerce committee of these different programs the federal government has. and then we said, going forward, let's measure kind of what you're trying to do with this g.a.o. report in a little different way but measure the efficacy of the programs we do have. let's find out what's working in our communities, and then let's get aid into our communities directly, cut out the middle bureaucracy and get assistance, financial assistance into our communities. and so we passed it.

that's now the law of the land. and i think last year we were able to get money into that, finally, and i hope we can do more going forward. because we know that -- i'm going to be a little sarcastic here. it's an extraordinary finding. your brain and physical body were connected. who knew? we all knew that. i supported the effort to get the same treatment under insurance for mental health as physical health because they are completely connected. going forward, we have to make sure that bond is strengthened, not weakened. we have to get people help for mental health. i'm a big believe for the that. we know it works. it's fascinating to see with the whole gee noem project, they can do a test and figure out which mental health drug will work in your body o