Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2020
Floor Speech
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Ms. DeLAURO. Mr. Chair, I rise to speak about the fiscal year 2020 appropriations bill for the Labor, Health and Human Services, Education, and Related Agencies.
To start, let me recognize the ranking member, Tom Cole, for his work on this bill. We have worked closely together over the years inasmuch as we have developed a mutual respect for one another. While we may have differences of opinions, we have the same values about the scope of these programs and whom they ought to be benefiting.
I want to say thank you to the ranking member of the full committee, Congresswoman Granger. I believe we have put together very strong and serious resources in the Labor-H bill.
I want to say a particular thank you to the chair of the full committee, Congresswoman Nita Lowey, for making the Labor-H bill a high priority.
The Labor-HHS-Education bill supports some of the Nation's most critical programs. They touch individuals and families throughout their lifespan, from Early Head Start to the Social Security Administration.
For 2020, the subcommittee is providing a total of $189.9 billion in discretionary funding. It is an increase of nearly $12 billion over last year's enacted levels.
Our mission has been to advance a positive agenda, to look at issues where programs have been starved, and to reflect the oversight we have been conducting. I believe we have done so.
To arrive at these figures, we hosted 12 hearings on the budget, predatory for-profit colleges, Federal student loan servicing, the unaccompanied children program, wage theft, and the administration's cost-increasing changes to the Affordable Care Act.
We collected nearly 15,000 requests from Members, and we fulfilled, in part or in whole, more than 90 percent of them.
With this input, we produced what I believe to be historic investments in working people, in students, in parents, in children, in families, and in our future.
We make a historic $4 billion increase over last year for early childhood programs: $2.4 billion for the childcare and development block grant, equal to 300,000 new slots for childcare; $1.5 billion for Head Start; and $100 million for preschool development grants.
We also increased funding for K-12 education by $3.4 billion, $1 billion more for title I, and $1 billion more for IDEA, State grants for special education. In post-secondary education, we make an additional investment of $928 million. We increase the maximum Pell grant award by $150.
In health, we make a net increase of $2 billion in the National Institutes of Health, enabling a 5 percent increase for all institutes and centers. We also increased the Centers for Disease Control and Prevention's budget by $938 million.
We held the first appropriations hearing on gun violence prevention research in 20 years. Experts told us that the CDC and the NIH can do and must do this research, so we provide $50 million for gun violence prevention research.
We are investing in women's health. That includes a $114 million increase for Title X. Title X provides annually more than 4 million low-income women and men with contraception counseling services and health screenings. These investments transform lives.
We know this President is highly invested in continuing what we call a tax on women's health. We know the power of the White House and that the President will reject a repeal of the Hyde amendment. That is why this bill maintains current law with regard to the Hyde amendment.
The Hyde amendment is a discriminatory policy that makes access to basic reproductive healthcare contingent on your income. That is simply wrong, and I oppose it, as do others. We will continue the long fight, and we will win that fight in the near term to ensure that women of color, low-income women, and all women are on equal footing with regard to reproductive rights.
Finally, we invest in working people whose pay does not keep up with their rising costs. They struggle to deal with healthcare, prescription drugs, and childcare.
We invest an additional $1.2 billion to help working people find good-paying jobs and to protect and empower them in the workplace. That includes $69 million more for at least 500 new investigators at the Wage and Hour Division to combat wage theft and to help working people receive their full pay.
I am also proud of the new initiatives we are introducing. We provide $150 million for community colleges and other 4-year institutions to train working people for in-demand industries. For too long, working people and middle-class families have been shortchanged, and we are moving ambitiously to make sure that we provide every individual with a better chance at a better life.
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Ms. DeLAURO. We are moving ambitiously to make sure that we provide every individual with a better chance at a better life because we believe that that is our obligation as Members of Congress.
Once again, I want to say thank you to the ranking member, Mr. Cole; to the chair, Mrs. Lowey; to the ranking member of the full committee, Ms. Granger; and to all the subcommittee members who worked so hard in putting this effort together.
And a thank you to the staff who have worked so hard: for the majority, Brad Allen, Jared Bass, Jennifer Cama, Robin Juliano, Jaclyn Kilroy, Laurie Mignone, Stephen Steigleder, and Philip Tizzani; and for the minority, Susan Ross and Kathryn Salmon.
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Ms. DeLAURO. Mr. Chairman, the gentleman and I have had these conversations, and I appreciate being able to speak with him.
Mr. Chairman, I thank the gentleman from North Carolina (Mr. Hudson) for bringing attention to this critical issue. I proudly support increased access to Head Start for all children, which is why this bill provides an increase of $1.5 billion for this important program.
Mr. Chairman, let me commit to working with the gentleman and the agency to get to the bottom of this issue that has impacted the children in his district and prevented access to high-quality early childhood education.
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Ms. DeLAURO. Mr. Chair, I strongly oppose my colleague's amendment that would allow the Department of Health and Human Services to use funding in this bill to implement the Trump-Pence refusal of care rule.
Personal beliefs should never determine the type of healthcare an individual receives. However, the administration's rule would completely undermine patient protections by allowing hospitals, doctors, nurses, and other individuals and institutions to deny a patient standard medical care based on personal beliefs, not based on what is best for the patient.
Current law already provides protections for hospitals and healthcare workers to refuse to perform abortions, but the administration's rule would expand Federal law to allow certain individuals and entities to refuse care for any reason at all. That is why we added a provision to the Labor-HHS-Education bill to block this unacceptable rule.
Let's be clear: Freedom of religion is important. It is already protected by the First Amendment. However, this freedom does not give anyone the right to impose their religious beliefs on others, to hurt others, or to discriminate.
This rule has never been about religious liberty. It has been about discriminating, shaming, and denying individuals the healthcare they need.
Under this rule, we know women will be denied access to standard medical care. We know hospitals have refused to treat or refer an individual who needs an abortion.
Under this rule, we know a transgender individual can be denied medical care. For women in rural communities, small towns, or in an emergency situation, the hospital or pharmacy that says ``no'' means these women will not get the care they need.
In this bill, we have made investments to right these wrongs, yet this rule would completely undermine those efforts instead of addressing real areas of concern.
The Trump-Pence administration is completely obsessed with allowing institutions and providers the license to put their religious doctrine before an individual's health.
As stewards of taxpayer dollars, we cannot allow these dollars to be used to deny medical care because of religious beliefs, nor can we allow an individual to impose their religious beliefs on another individual. That could lead to tremendous harm, including deaths.
Mr. Chair, I strongly oppose this amendment, and I reserve the balance of my time.
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Researchers on the campuses of the National Institutes of Health conduct groundbreaking, lifesaving research on diseases and disorders that affect individuals and families across the Nation. These researchers need state-of-the-art facilities and equipment to conduct this research, which is why I was proud to provide an increase in funding for NIH facility maintenance and construction in fiscal year 2019 in the appropriations bill.
This year's bill maintains that level of support and allows NIH to make progress in reducing its backlog of facilities projects. I share the gentleman's concern about this issue. I look forward to working with him in the future to address NIH's facility construction and maintenance needs.
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Ms. DeLAURO. Mr. Chair, this bill includes a provision prohibiting the implementation of the administration's damaging new rule for the Title X Family Planning program. It is often referred to as the domestic gag rule. The administration's domestic gag rule is an ideological assault on family planning services.
The Title X Family Planning program is the only Federal program that provides quality, affordable, comprehensive, preventive, and reproductive healthcare services in every single State. Title X clinics serve more than 4 million women and men each year at 4,000 health clinics across every State.
Over two-thirds of the patients who seek care at Title X clinics are in a household that is at or below the poverty level. Many of these patients are uninsured or underinsured.
To be clear, the Title X program does not provide funding for abortions, despite what the others may be saying. However, the proposed rule would make clinics that use non-Federal funding to provide abortions or even referrals for abortions ineligible for funding.
The proposed rule also eliminates the requirement that grantees provide nondirective pregnancy options counseling. That means grantees can simply refuse to offer complete and accurate information to patients.
The rule also allows grantees to refuse to give referrals to patients or even give misleading information to patients when they request a referral.
When patients can no longer rely on their healthcare provider to share full and accurate information with them or to refer them to other care when necessary or when they request it, then the provider-patient relationship has been broken.
We need to trust women. We need to respect women to make choices that are best for themselves and for their families, and we must support providers to offer medically accurate information to patients.
This bill's provision to block the domestic gag rule is critical to maintaining support for healthcare providers offering evidence-based preventive and reproductive healthcare across the country.
Mr. Chair, I urge my colleagues to oppose this amendment, and I reserve the balance of my time.
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Ms. DeLAURO. Mr. Chair, let me just repeat: Over two-thirds of the patients who seek care at Title X clinics are in a household that is at or below the poverty level. Many of these patients are uninsured and underinsured.
We are looking at the opportunity for healthcare screenings in 4,000 clinics around this country, which is what we want to do. That is not happening because of some ideological assault on family planning, again, someone's personal beliefs being foisted on millions of people around the country. That is not the job we came here to do.
Our job is to be able to have people get the kinds of services that they need, to be told where they can go to get those services, to make the referrals on healthcare that they need. This is not one's own personal view of what someone else's healthcare needs are.
Fundamentally, at the root of all of this is a distrust and a lack of respect for the decisions that women make on behalf of themselves and their families.
Let's trust women. They know what is good for themselves and their families, not 435 people who sit in this body who have their own personal religious beliefs.
Mr. Chair, I yield back the balance of my time.
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Ms. DeLAURO. Mr. Chair, I thank my friend for yielding. She is a loyal champion for her constituents, for the children who benefit from the high-quality early childhood education and services that Head Start offers, and for the business owners in her district.
We want to hold these facilities to high standards. The recompete process needs to be sensitive to the needs of the communities that rely on these services.
I promise to work closely with Representative Waters and ACF to conduct the proper oversight that this issue deserves.
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Ms. DeLAURO. I support this amendment, Mr. Chairman. I know the gentleman is a longtime supporter of increased funding for the CDC's Lyme disease program. I commend him for his continued efforts to address this issue, and I thank him for appearing before this subcommittee on Member Day to talk about the importance of this issue.
I have a particular interest in this effort as well as the Lyme disease was discovered in Lyme, Connecticut, so I know all about the illness.
The underlying bill does include a $1 million increase. It is a total funding level of $13 million for the CDC to intensify efforts to develop better diagnostics and to bolster critical prevention and surveillance networks, which are critically important as Lyme disease is being reported in every single State. This amendment would increase the program by an additional $1 million. And I do know from reviewing the amendments that are coming up in the next several hours that there, in fact, is another Lyme disease amendment.
So, Mr. Chairman, I urge my colleagues to vote ``yes'' on this amendment, and I yield back the balance of my time.
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Ms. DeLAURO. Mr. Chairman, I rise in support of this amendment. This is about protecting existing beryllium standards established by the Occupational Safety and Health Administration for construction and maritime workers.
Any effort to weaken or revoke the 2017 rule limiting exposure to beryllium would reflect the first time that OSHA has proposed to weaken a standard protecting workers against a known human carcinogen. It leaves construction and shipyard workers vulnerable to life-threatening beryllium-related diseases and increases their risk of developing lung cancer.
I appreciate that the amendment is drawing attention to the importance of strengthening--not weakening--worker health and safety standards. This is about saving people's lives.
Mr. Chairman, how can you be opposed and support bureaucracy versus saving people's lives?
I am so happy to support this amendment.
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Ms. DeLAURO. Mr. Chair, I rise in support of this amendment, which rejects the administration's plan to terminate the joint partnership between the Department of Agriculture and the Department of Labor that governs the operation of the Job Corps Civilian Conservation Centers.
The Trump administration wants to turn its back on disconnected and vulnerable youth, especially those who depend on Job Corps programs in rural communities. These centers give disadvantaged young people valuable, on-the-job experience and training, putting them on a path to a good job while learning about how to conserve and protect our natural resources.
As a matter of fact, of the top-performing 15 centers, 6 were Civilian Conservation Centers.
Mr. Chair, I urge my colleagues to vote in favor of this bipartisan amendment.
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Ms. DeLAURO. Mr. Chairman, I rise in support of this amendment.
African American adults are almost twice as likely to suffer from diabetes as White adults and are also more likely to suffer from serious complications, such as limb amputations.
I agree with the gentlewoman that increasing the representation of African Americans among biomedical researchers, as well as participants in clinical trials, is essential to addressing disparities in health outcomes for African Americans suffering from this disease.
I would tell the gentlewoman that I was part of a bipartisan effort in the early nineties where we changed the rules of the NIH, including minorities and women in clinical trials, but it would appear that we have more to do. And we have increased funding for research centers in minority institutions by $11 million to support the next generation of researchers and enhance the research infrastructure in minority-serving institutions.
I thank the gentlewoman for offering this amendment. I urge my colleagues to vote ``yes,'' and I look forward to working with her to see if we can turn this around.
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Ms. DeLAURO. Mr. Chairman, I rise in support of this amendment.
The TRIO programs provide student support services to students in helping them to pursue and to complete a college education. These students may be the first in their families to attend college or face other challenges. The student support services provided under the TRIO programs include tutoring, academic advice, financial aid counseling, college preparation, and so much more.
To help our most vulnerable youth access and succeed in college, the Labor-HHS bill increases funding for TRIO by $100 million, for a total of $1.16 billion. And I can tell you, there is bipartisan support for this effort because I know that Ranking Member Cole is a strong supporter of the TRIO program. He recognizes its ability to help youngsters be able to realize their dreams and their aspirations.
So I appreciate that the amendment is highlighting the importance of providing services to encourage individuals from disadvantaged backgrounds to enter, to complete college, and postgraduate education, and I am happy to support it.
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Ms. DeLAURO. Mr. Chair, I rise in support of this amendment.
The National Institute for Occupational Safety and Health, NIOSH, is leading the effort to track the link between the workplace exposures of firefighters and cancer. This registry will provide something that is a more complete, broader representation of our firefighters in our country compared to previous studies.
The underlying bill that we are considering includes an increase of $600,000 to the National Firefighter Registry, and this amendment would provide an additional increase of $900,000.
Mr. Chair, I thank the gentleman for offering this amendment to highlight the importance of the health of our firefighters, first responders who never say no. They were going up in the building on 9/11 while others were coming down in order to be able to survive, and so many lost their lives on that day.
Mr. Chair, I urge my colleagues to vote ``yes.''
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Ms. DeLAURO. Mr. Chair, I thank my colleague for yielding, and I rise in support of this amendment.
Sickle cell disease is a major public health concern. It affects an estimated 100,000 Americans, with a disproportionate effect on African Americans.
People living with sickle cell disease experience significant pain and life-threatening complications.
The Centers for Disease Control and Prevention is working to better identify affected individuals, to understand their health outcomes, and to evaluate strategies to prevent complications and factors that affect individuals living with sickle cell disease.
We may be close to a cure for sickle cell disease because of gene editing, making it all the more important for us to work with people who live day after day with sickle cell.
Mr. Chair, I commend the gentleman for raising attention about this important program, and I urge my colleagues to support this amendment.
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I share the gentleman's concerns about the potential health impacts of red tide and harmful algal blooms and recognize the opportunity for NIH research to contribute to the body of knowledge on this topic.
I would note that the underlying bill under consideration today provides an additional $1 million for the Centers for Disease Control and Prevention to expand its efforts related to surveillance and reporting of health concerns related to harmful algal blooms.
Madam Chair, I thank the gentleman for his amendment and urge my colleagues to vote ``yes,'' and I yield back the balance of my time.
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Ms. DeLAURO. Madam Chair, I thank the gentleman for yielding, and I strongly support my friend's amendment to increase the Administration for Community Living's lifespan respite care program.
There are over 43 million family caregivers in this country providing the vast majority of our Nation's long-term services and support. National, State, and local surveys have shown respite care to be among the most frequently requested services by family caregivers.
In kitchen-cabinet meetings I hosted in my home State of Connecticut, I had constituents asking me about how respite care relief could be available to them.
The committee included additional resources for respite care in several places in the bill. We provided a $21 million increase for the national family caregivers program. We included a $4 million demonstration project through the Alzheimer's disease program to provide direct respite services to these caregivers and to demonstrate the benefits these services can provide.
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Ms. DeLAURO. We included a modest increase for the lifespan respite care program, but this program really is unique in that it is the only Federal effort that addresses respite care issues for families regardless of age or disability. An additional $4.5 million will go a long way for this small but mighty program.
I appreciate my friend taking the time to highlight it, and I thank him for all of his service.
Madam Chair, I urge my colleagues to support the amendment.
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Ms. DeLAURO. Madam Chair, I rise in support of Congressman Foster's amendment, a bipartisan amendment to allow for the creation of a unique health identifier.
We must do all we can to bring down the skyrocketing costs of healthcare. A universal and interoperable patient identifier could do so by reducing avoidable administrative errors.
Inaccurate patient information costs patients $2,000 per inpatient stay and $800 per ER visit, according to a 2018 survey by Black Book Market Research.
We could improve patient matching, reduce avoidable errors, and bring down costs if we stop tying the hands of the Department of Health and Human Services with regard to universal identifiers. As Pew Trusts reported in 2018, ``The ban has limited government actions to collaborate with the private sector on solutions.''
Let us reduce skyrocketing healthcare costs by reducing avoidable medical administrative errors. I urge my colleagues to support the amendment.
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Ms. DeLAURO. Madam Chair, I rise in support of this amendment.
As noted in the report accompanying the underlying bill that we are considering, relapse following opioid detoxification is a contributing factor to the overdose crisis.
Medication-assisted treatment provides a whole-patient approach to the treatment of substance use disorders, especially opioids. In combination with counseling and behavioral therapies, FDA-approved medications are used to treat substance misuse to prevent relapse and to sustain recovery.
This amendment calls for the prioritization of funding for medication-assisted treatment at the Substance Abuse and Mental Health Services Administration. As part of our commitment to support people to enter into treatment, to be in sustained recovery, medication-assisted treatment is an effective option.
Madam Chair, I urge my colleagues to support this amendment.
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Ms. DeLAURO. Madam Chair, I thank the gentleman for yielding.
Madam Chair, I rise in support of this amendment. The underlying bill that we are considering includes a $5 million increase to HHS' Biomedical Advanced Research and Development Authority, BARDA.
This organization has the significant responsibility to help counter biological threats and other challenges to domestic and global health security and safety, while fostering scientific progress.
This amendment would provide an additional $1 million specifically for biosecurity research and development, further supporting efforts to accelerate the development of emerging technologies and products vital to our national security.
Research and development investments help our Nation to be prepared for a wide range of chemical, biological, radiological, and nuclear threats; pandemic influenza; and emerging infectious diseases.
Madam Chair, I urge my colleagues to vote ``yes'' on this amendment.
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Ms. DeLAURO. Madam Chair, I rise in support of this amendment. As noted in the report accompanying the underlying bill that we are considering, the current measles outbreak that has cases confirmed in 28 States, including in my State of Connecticut and in my colleague's State of California, highlights the importance of immunizations.
Vaccines are one of the greatest success stories in public health. They are the most effective way to protect the public from highly infectious and potentially deadly diseases.
This amendment highlights efforts conducted by the Department of Health and Human Services to understand the reasons that people do not vaccinate themselves and their children, as well as to combat misinformation about vaccines. What we need is, through research, to dispel that misinformation which is, in fact, today, right now, putting the lives of our children and families at risk.
Vaccines are safe; they are effective; and I urge my colleagues to support this lifesaving amendment.
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Ms. DeLAURO. Madam Chair, I rise in support of this, in fact, bipartisan amendment.
Drug overdose deaths continue to increase in the United States. Nearly 70 percent of these deaths involve an opioid. It is staggering that, on average, 130 Americans die every day from an opioid overdose.
This amendment provides $10 million for a new program at the Substance Abuse and Mental Health Services Administration, SAMHSA, to develop best practices for emergency treatment and the coordination and continuation of care for overdose patients.
By providing overdose reversal medications, we can save lives. By providing overdose reversal medication, we can, I will repeat it, save lives.
We have no higher calling in this institution than to save lives. Those who have experienced a nonfatal drug overdose can benefit from evidence-based, long-term treatment to prevent relapse and future overdoses.
I urge my colleagues to support this bipartisan amendment, and I yield back the balance of my time.
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Ms. DeLAURO. Madam Chair, I thank the gentleman for yielding to me. I rise to support the gentleman's amendment.
There is no doubt that the child welfare system is overwhelmed by the opioid epidemic. This additional funding would build upon existing data efforts and provide child welfare caseworkers with evidence-based data that can better inform how children are cared for if they are in the system because of parental substance abuse.
Think about the tragedy of these youngsters. Please, let us not let these children fall through the cracks such that we don't provide them with the kinds of services that they need.
Madam Chair, we have both sides of the aisle recognizing the ongoing opioid crisis, and I think this effort to help these innocent bystanders to the crisis is an important one. I urge my colleagues to support the amendment.
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This amendment calls for funding of a new program at the Substance Abuse and Mental Health Services Administration. In fact, it would establish its Regional Centers of Excellence in Substance Use Disorder Education.
In 2017, approximately 19 million adults had a substance use disorder. This program would improve the training of health professionals in substance use disorder prevention, treatment, and recovery so that more people can get treatment and we can reduce the number of those who do need treatment. Part of this is to be able to educate and train folks to be able to deal with the scale and the scope of this public health emergency, which is what I call it, across the Nation.
Madam Chair, I urge my colleagues to support this amendment, and I yield back the balance of my time.
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Ms. DeLAURO. Madam Chair, I rise in support of this amendment.
I would note, as my colleague, Congresswoman Moore, noted, the underlying bill under consideration today includes $2 million for a new dedicated effort on sudden unexpected infant death and sudden unexplained death in childhood at the CDC. Despite the decline in the rate of sudden unexpected infant death in the past two decades, significant racial and ethnic differences continue. CDC is working to better understand the circumstances that may increase risks, so that public awareness and provider education can be improved to reduce these risks.
I strongly support the Congresswoman's efforts to prevent these tragic deaths of very young children and the profound suffering of their families.
I just say to my colleagues, those who are here and who are not here, think about the power of the institution that we serve in and what it can do in so many of these areas to profoundly change people's lives, to save people's lives, and to give people comfort to know that we have not forgotten them, and that while they have experienced a tragedy, we will work to see that others will not have to face a tragedy and saving the lives of children.
Madam Chair, I urge my colleagues to vote ``yes'' on this amendment.
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Ms. DeLAURO. Madam Chair, I rise in support of this amendment.
Intimate partner violence is a serious, preventable public health problem that affects millions of Americans. This amendment would increase funding for CDC's efforts to work in communities to implement proven prevention strategies, including programs that mobilize boys and men to be allies in sexual violence prevention, and coalitions with local governments, community partners, and police to increase safe spaces in neighborhood parks.
The negative consequences associated with intimate partner violence underscore the importance of stopping it before it occurs. I commend the amendment sponsors for raising attention to this important program.
Madam Chair, I urge my colleagues to vote ``yes'' on this amendment.
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Ms. DeLAURO. Madam Chair, I thank the gentlewoman for yielding.
Madam Chair, I rise to support the Developmental Disabilities Projects of National Significance program, which is why this bill rejects the administration's proposal to virtually eliminate funding for it--why?--and instead provides a $1 million increase over the fiscal year 2019 level.
These grants fund innovative projects that create opportunities for those with developmental disabilities. They promote quality of opportunity and inclusion of persons with disabilities in all aspects of community life, which benefits our society as a whole.
I thank the gentlewoman from California (Ms. Matsui), my friend, for highlighting this particular grant initiative for schools that serve young adults on the autism spectrum by helping them develop practical life skills that will help them transition to work and independence.
We need innovative programs like this one that create and enhance opportunities for individuals with developmental disabilities to contribute to, to participate in, to feel their value, to know that we recognize their value and give them respect and independence and self- confidence in who they are. This means that they can participate in all facets of community life.
Madam Chair, I urge my colleagues to support this amendment.
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Ms. DeLAURO. Madam Chair, I rise in support of this amendment. I appreciate my colleague offering this amendment. I am a strong supporter of recovery support services, and I recognize their essential role in the recovery of individuals with substance use disorders.
In my district in Connecticut, I have met with my own constituents who credit their recoveries and often their lives to recovery coaches.
I met with constituents who were substance-use abusers, but also with the providers, and they all said to me very specifically that one of the difficulties is that someone can get treatment, and then they go back out onto the street, but they have no one to be in touch with as a support system in order to be able to continue on a road to recovery. They slip back, and they are then once again on the street.
What you are talking about is increasing the funding for building communities of recovery so that people don't feel that they are alone and that there is nowhere to go, but to take up an unhealthy lifestyle once again.
This bill will expand access to critical and lifesaving services, including recovery support from drug or alcohol addiction, primary care, housing services, and employment services. Maybe we could put together some number, a 211 number, that a person can call, and they can be referred on employment, and housing, and the kinds of services that people need when they find themselves in this situation.
So I commend my colleague on this amendment, and I urge my colleagues to support the amendment.
I yield back the balance of my time.
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Ms. DeLAURO. Madam Chair, I rise in support of this amendment. Suicide is devastating communities across our country as evidenced by more than 47,000 deaths in 2017. It makes me proud that what we put together in the underlying bill that we consider tonight includes $20 million of new funding for suicide prevention efforts at the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration.
This amendment would increase funding for efforts to prevent suicide among our youth at the places that many of them can be found: colleges and universities, and youth-serving organizations. Through training and activities aimed at identifying youth at risk for suicide, screenings and the connection to appropriate services are preventing suicide and suicide attempts.
We shouldn't be dealing with this after the fact. But what we ought to be doing is trying to provide the kinds of counseling and have people who are trained to recognize the telltale signs of a youngster who is in difficulty and who needs help.
As the underlying bill that we consider shows, we strongly support suicide prevention efforts, and I commend the gentleman for offering this amendment. I urge my colleagues to support this amendment.
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Ms. DeLAURO. Madam Chair, I rise in strong support of Congresswoman Castor's amendment that, in fact, blocks the Trump administration's rule to promote junk health insurance plans. Plain and simple, that is what they are.
This is just another attempt by the administration to sabotage the Affordable Care Act. Their policies have increased the costs of healthcare. The level of uninsured in this Nation has gone up, and they want to bring us back to a time when those folks with a preexisting condition could no longer get healthcare coverage.
There are some who say that today, for the first time in their lives, they have gotten that coverage, and otherwise, they would have died. Maybe that doesn't cut it with some folks here.
Short-term plans do not have to cover the ACA's essential health benefits. They frequently do not include maternity services, prescription drugs, mental healthcare, or substance use disorder treatment. Short-term plans can deny coverage to or charge higher prices for people with preexisting conditions.
As I said a moment ago, remember those days when even being a woman was a preexisting condition. If a child had asthma, Madam Chair, it was a preexisting condition, and they couldn't get any help.
They often will not cover medical services associated with preexisting conditions. We reiterate: They are junk plans.
Every American deserves affordable, high-quality health coverage, which is why we need to block these junk plans that provide the opposite.
Madam Chair, I urge my colleagues to support this amendment.
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Ms. DeLAURO. Madam Chair, I rise in opposition, and I strongly oppose my colleague's amendment that would strike $100 million from CMS program management. This is funding that has been designated to support the Affordable Care Act navigator program as well as outreach, enrollment, and advertising during the ACA open enrollment period, just further attempts to sabotage the act.
Because of the Affordable Care Act, more than 20 million people gained health insurance, many for the first time in their lives. The uninsured rate declined from a high of 18 percent before the Affordable Care Act to a low of less than 11 percent. For families, it meant that insurance companies could no longer discriminate against people because of their medical history and being a woman was no longer a preexisting condition.
The ACA was not perfect, but it was a significant achievement. Unfortunately, the Trump administration has tried to sabotage the Affordable Care Act since the day the President took office. It was not successful, I might add, at least legislatively not successful. But they have come around to the appropriations process to continue the sabotage.
HHS shortened open enrollment, cut the annual budget for outreach and advertising by 90 percent, and cut funding by 80 percent for ACA navigators.
Who are the navigators? They are the people who provide in-person assistance to a consumer who may need help in finding a health plan.
We held a hearing in February to highlight the administration's efforts to undermine the Affordable Care Act. One of our expert witnesses estimated that HHS' cuts to outreach, advertising, and enrollment activities resulted in more than 1 million fewer enrollments in 2017 and a similar shortfall in 2018.
The Labor, HHS, Education appropriations bill sends a clear message to the administration: Stop undermining healthcare for millions of Americans. Members of Congress have healthcare. They shouldn't be undermining other Americans' healthcare. Stop allowing insurance companies to discriminate again with junk insurance plans. Stop attacking the mechanisms that we put in place to hold down costs for American families.
Our bill specifically designates $100 million from ACA user fees to support ACA navigators as well as outreach, enrollment, and advertising during the ACA open enrollment period. These funds will help millions of American families navigate the complicated maze of health insurance to find a health plan that works for them. It strengthens the Affordable Care Act individual market by bringing healthier individuals into the risk pool, thereby reducing premiums for everyone.
The gentleman's amendment seeks to eliminate those funds, which will make it harder for Americans to enroll in high-quality health insurance.
Madam Chair, I strongly oppose the amendment, and I reserve the balance of my time.
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Ms. DeLAURO. Madam Chair, let me just repeat a statistic. Because of the Affordable Care Act, more than 20 million people gained health insurance, many for the first time in their lives, and the uninsured rate declined from a high of 18 percent before the Affordable Care Act to a low of less than 11 percent.
Now, keep in mind, from the outset of the Trump administration, the effort was to repeal and replace the Affordable Care Act. I don't know the umpteen times that my colleagues on the other side of the aisle tried to repeal the Affordable Care Act.
They could never find a way to replace it. Ultimately, they failed legislatively to repeal and replace the Affordable Care Act.
So, what have they done subsequently? They move through the appropriations bills, and they cut back. They work to do away with the cost-sharing subsidies for the insurance companies, which drives the cost up.
They say ``no'' to the navigators to help people go through the system and understand insurance. I will bet everyone in this institution has somebody who explains an insurance policy to them.
So, therefore, I will just finish this and say: Let's defeat this amendment because it is just one more attempt to sabotage the Affordable Care Act.
Madam Chair, I yield back the balance of my time.
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Ms. DeLAURO. Madam Chair, this amendment would open up scarce Federal dollars to untested and unproven, nonregistered apprenticeship programs.
In fiscal year 2016, the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies established funding for the Apprenticeship Grant Program, which has been expanding work-based learning programs in in-demand industries through registered apprenticeships, a proven strategy for meeting the needs of our Nation's workforce and industry, simultaneously.
The registered apprenticeship model has been rapidly expanding over the past several years. It has grown from 56 percent since 2013--from 375,000 to 585,000--in diverse careers like software development, nursing assistants, and insurance agents. According to the Department of Labor, more than 3,000 new apprenticeship programs were established in fiscal year 2018 alone.
To further this important work, the underlying bill provides an unprecedented $250 million investment in registered apprenticeship programs, a $90 million increase over last year. Yet, instead of supporting and investing in a tried-and-true program, this amendment would roll back worker protections and quality assurances, wasting millions of Federal dollars on an entirely duplicative system called IRAPs, industry-recognized apprenticeship programs.
The administration claims critics of registered apprenticeships lament the registration process, calling it onerous, but I have spoken with some of the industry groups represented on the President's task force, and, frankly, I hear a different story. They like the registered model.
During a panel discussion I held on apprenticeships, Bridget Gainer, vice president of Aon, commented on the ease of registration, saying: ``It was not an overwhelmingly or overly onerous process.''
A former staffer at the Department of Labor and Education, who is now with New America, wrote an excellent piece in Inside Higher Ed on the risks of the Trump administration's plans to deregulate apprenticeships.
She said: ``Rather than focus its efforts on growing our small but high-performing system of registered apprenticeships, the administration has opted for building an entirely new system of industry-recognized apprenticeship programs, or IRAPs.''
These IRAPs have little or no accountability, much like the predatory for-profit colleges.
The Inside Higher Education piece makes that point: ``The administration is copying the system used to ensure quality in the lowest performing and most fraud-ridden sector of higher education--a system that has repeatedly failed to protect students and taxpayers-- for its new approach to apprenticeship . . . and once Federal dollars are on the line, the risks--and the scale of potential harm--increase exponentially.''
We should be focusing Federal dollars on expanding the existing system that is working for employers and for apprentices alike and not on a confusing duplicate system.
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Ms. DeLAURO. Madam Chair, my Republican colleagues talk about the need for fiscal restraint, government waste, the problem of duplication. In fact, many will oppose the underlying bill, claiming fiscal responsibility, but now they are offering an amendment that is the antithesis of fiscal restraint.
Let's be clear. The IRAPs are duplicative. They promote government waste. This amendment would open up Federal resources to support a program that does not exist.
There are no IRAPs. The Department of Labor has yet to produce any binding definition of what these programs are or what they will do. It is easy to make promises when you do not have to deliver.
Registered apprenticeship programs do and currently are delivering. That is why, in a bipartisan fashion, Congress has increased funding year after year in a tested, proven model.
If the gentleman and my Republican colleagues want to support workforce development, they can vote in favor of the underlying bill. It provides $3 billion to States for job training to adults, youth, and dislocated workers. I have a feeling that they will not because, like the Trump administration's proposed IRAPs, they support workforce development in name only.
Madam Chair, I urge my colleagues to vote ``no'' on this amendment.
We have many supporters of this effort: North American Building Trade Unions, United Association of Plumbers and Pipefitters, AFL-CIO, International Union of Operating Engineers, National Electrical Contractors Association, New America, International Union of Painters and Allied Trades, and Laborers' International Union of North America.
Vote ``no'' on this amendment.
Madam Chair, I yield back the balance of my time.
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Ms. DeLAURO. Madam Chair, I rise in support of this amendment.
I would note the underlying bill under consideration tonight includes a 10 percent increase, $5 million for rape prevention and education activities at the Centers for Disease Control and Prevention.
As the increase in our bill highlights, I am a strong supporter of this program. We must stop sexual violence before it begins. This amendment would add an additional increase of $5.57 million.
I commend my colleagues for bringing further attention to this scourge that still exists in our society today and puts women at grave risk. It is an important program so that we can look at, address, and prevent sexual violence.
I urge my colleagues to vote ``yes'' on this amendment.
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Ms. DeLAURO. Mr. Chairman, I thank the gentleman for his commitment, his concern, and his dedication.
I rise in support of my colleague's amendment.
The death of any child is devastating. The fact that children have died while in the custody of the Federal Government and we don't know the circumstances of why, or sometimes even when, they have died is almost beyond comprehension to me.
We have an oversight role. It is our responsibility to make sure that children are safe and protected while they are in the custody of Health and Human Services. If you take a look at the mission statement of Health and Human Services, it says to place a child in a safe environment and do it as expeditiously as possible.
It is also our responsibility to ensure that HHS is fully transparent and they ``appropriately respond to the death of an unaccompanied alien child in the care and custody of ORR.''
What my colleague, Mr. Castro, wants to do is to make sure that the Department of Health and Human Services follows its own written policy. It is as simple as that. HHS' own policy, section 3.3.16 states: ``ORR and its care providers must immediately report the death to appropriate Federal, State, and local authorities. ORR must also notify the child or youth's parent, legal guardian, or next-of-kin; attorney; and applicable consulate of the death.''
My God, if we can't do that, who are we? Where are our values? Shame on us if we are not protecting these children and reporting when something is wrong or when they have died.
Mr. Chairman, this is a commonsense amendment. I strongly support it. I thank the gentleman for offering it.
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