Providing for Consideration of H.R. Lower Health Care Premiums for All Americans Act; Providing for Consideration of H.R. Do No Harm in Medicaid Act; Providing for Consideration of H.R. Protect Children's Innocence Act; and Relating to Consideration of H.R. Standardizing Permitting and Expediting Economic Development Act

Floor Speech

Mr. Speaker, the Rules Committee met last night and reported out a rule providing for consideration of three measures: H.R. 6703, Lower Healthcare Premiums for All Americans Act; H.R. 498, Do No Harm in Medicaid Act; and H.R. 3492, Protect Children's Innocence Act.

Mr. Speaker, House Resolution 953 provides for consideration of H.R. 6703, the Lower Healthcare Premiums for All Americans Act, under a closed rule. The rule provides 1 hour of general debate, equally divided among and controlled by the respective chairs and ranking minority members of the Committees on Education and the Workforce, Energy and Commerce, and Ways and Means, or their respective designees, and one motion to recommit.

The rule also provides for consideration of H.R. 498, the Do No Harm in Medicaid Act, under a closed rule with 1 hour of general debate, equally divided and controlled by the chair and ranking minority member of the Committee on Energy and Commerce, or their respective designees, and provides one motion to recommit.

The rule further provides for consideration of H.R. 3492, the Protect Children's Innocence Act, under a structured rule with 1 hour of general debate, equally divided and controlled by the chair and ranking minority member of the Committee on the Judiciary, or their respective designees, and provides each one a motion to recommit.

Finally, the rule provides that, during consideration of H.R. 4776, pursuant to House Resolution 951, the further amendment specified in section 5 of this resolution shall be considered as adopted.

Mr. Speaker, this rule deals with several important bills that will lower healthcare costs for Americans and protect children. One of the bills, H.R. 3492, the Protect Children's Innocence Act, is led by the gentlewoman from Georgia (Ms. Greene).

This bill prohibits genital and bodily mutilation and chemical castration for a minor, which generally is anyone under the age of 18 years, while also preserving the exception for this care if there is a legitimate medical need for certain procedures.

Another bill we are considering in this rule is H.R. 498, the Do No Harm in Medicaid Act, led by the gentleman from Texas (Mr. Crenshaw).

This is a simple bill that prohibits Federal medical dollars to pay for gender transition procedures for individuals under the age of 18. The bill also includes protections for individuals if some of those treatments are medically necessary.

These are important bills to ensure that Federal taxpayer dollars are not going toward a minor's gender transition surgery if it is not medically necessary. These bills also put guardrails in place so that minors cannot make permanent life-altering decisions before they are 18 years of age.

Finally, we are considering H.R. 6703, the Lower Healthcare Premiums for All Americans Act, led by the gentlewoman from Iowa (Mrs. Miller- Meeks).

This bill lowers premiums for Americans, creates more insurance options, brings greater transparency, and cuts red tape.

Unlike our Democrat friends' plan, our Republican plan actually lowers premiums by double digits, roughly 11 percent, according to the data.

All the Democrats want to do is throw billions more dollars toward insurance companies. Instead of attempting to lower the premiums of the individuals who are on the insurance plan that the Democrats created, which should be called the unaffordable care act, the Democrats have cried wolf that Republicans are responsible for premiums being unaffordable, but let's get the facts straight.

Every single Democrat voted in support of the so-called Affordable Care Act. They claimed that people's premiums would be lowered; patients would have more choice; and if you like your doctor, you can keep him or her. However, just the opposite has happened. Their so- called Affordable Care Act has caused premiums to skyrocket. Due to this, the Democrats are too afraid to own up to the fact that their health plan has failed to actually lower premiums.

Instead, they have said to themselves: Hey, instead of acknowledging our failure, let's just blame the Republicans for that failure.

Mr. Speaker, I distinctly remember a hearing before the Committee on Energy and Commerce, shortly after I was elected, where most of the witnesses said that the so-called Affordable Care Act was going to make insurance premiums go up for Americans.

Mr. Speaker, that was over a decade ago, but the Democrats on the committee insisted that the witnesses were wrong and that Republicans were merely trying to scare the American people.

Mr. Speaker, unfortunately for the American people, the witnesses were right. The so-called Affordable Care Act has, in fact, negatively impacted the price of health insurance in America. This plan, the so- called Affordable Care Act, is a major reason that your insurance premiums have gone up and have done so repeatedly.

When not blaming Republicans for the failures of this so-called Affordable Care Act, do you know what the Democrats' solution is? Folks watching this debate at home won't be surprised to know it. Democrats want to throw billions of additional dollars to healthcare insurance companies in an attempt to distract the American people from their own policy failures.

I don't know if you all have been following the news closely, but the insurance companies that the Democrats want to give an additional $85 billion to with their 3-year clean extension of the temporary COVID enhanced premium tax credits have not been knocking on the doors, Mr. Speaker, of the United States bankruptcy courts seeking protection or aid. In fact, they have been making record profits--record profits. (930)

Further, we know these temporary COVID-enhanced premium tax credits have been riddled with waste, fraud, and abuse.

The independent Government Accountability Office recently came out with a preliminary report that showed one Social Security number was used to receive over 125 different insurance policies in 2023 alone. That is fraud.

There is also a huge amount of waste. Mr. Speaker, my estimate, based on data that I have seen, is that roughly 20 percent of enrollees in the temporary COVID-enhanced premium tax credits don't really exist. They are shadow enrollees.

Let me explain. In most healthcare insurance plans, they generally have about 15 percent of the enrollees who make no claims in a given year. In the arena of the temporary COVID-enhanced premium tax credits, that number for those particular policies that have no claims is closer to 35 percent. There is no reasonable explanation, Mr. Speaker, other than those extra 20 percent of people not making claims don't really exist. Now, I call this waste and not fraud, and that is because I actually believe the insurance companies don't know which enrollees are shadow enrollees.

How does this happen? It is a glitch in the way the bill was written originally. People move around. If an individual signed up for a program in north Florida to receive the enhanced premium tax credit and then moved to south Georgia, or even to another city in Florida, and signed up again, thinking, ``Well, I have moved, so I probably need a different plan,'' the consumer has a right to believe that somebody at their new plan or new company will notify the old carrier that they have switched policies.

The way the program was designed by our friends on the other side of the aisle, that never happens, and because an individual is automatically reenrolled each year, this can go on for years. Thus, over time, it builds up to that 20 percent of shadow enrollees.

We cannot, in good conscience, in defense of the American taxpayers' money, just cleanly extend these temporary COVID-enhanced premium tax credits without addressing the realities behind the waste, the fraud, and the abuse that is occurring in this program.

I also find it interesting that the Democrats voted twice to extend these temporary enhanced premium tax credits but specifically did not make these premium tax credits permanent. They didn't do it. They had many opportunities to make these permanent if they wanted to do that as much as they say today, but they didn't. They had many opportunities to make these permanent if the enhanced premium tax credits were as imperative to make the system work as they will claim here on the floor today, and have been for several weeks, but they didn't do it.

Whose fault is that? Logic would tell us it is the Democrats' fault, but when it comes to healthcare, the Democrats are never willing to admit their policies failed. What do they do? Blame Republicans.

In the Inflation Reduction Act, Mr. Speaker, the Democrats prioritized giving out around $1 trillion to Green New Deal initiatives instead of making their temporary premium tax credit program permanent.

The fact is, even they couldn't find the votes when they had control of both Houses and the White House to make the enhanced premium tax credits permanent. Now, they are demanding Republicans do what they could not do and clean up their mess, which was an add-on to the so- called Affordable Care Act.

I can't make that make sense, and, Mr. Speaker, I bet you can't either.

What are they asking for now? You guessed it: another temporary extension that fails to address the underlying causes of the skyrocketing costs; doesn't deal with the waste, fraud, and abuse; and worsens healthcare access caused by their so-called Affordable Care Act. Instead, they just want to blame Republicans, use it as a political issue, and give more money to insurance companies making enormous profits.

What the Republicans have drafted is a plan to address health issues across the board for our people and for our Nation. This bill brings more transparency on the pharmacy benefit manager middlemen, better known as PBMs, for employers. For too long, PBMs have gotten away with operating in a black box and causing drug prices to rise. We are bringing transparency into the commercial market for PBMs under this bill.

The bill also expands access to association health plans, which allow small businesses and self-employed workers to band together and purchase health insurance. One of the biggest complaints we hear from businesses, especially small businesses, is the rising costs of premiums that they have.

In fact, Mr. Speaker, Virginia tried to create these plans, and CMS told them they couldn't do it, that they would penalize them. The Virginia Association of Realtors--let's see if I got the name right--in an article from 2023, the leader said that they would create a plan for 7,000 association members who were uninsured because they don't make enough money to afford the Federal marketplace coverage--that would be the so-called Affordable Care Act--or to qualify for subsidies in the small group and individual plans.

These small businesses don't have the bargaining power that larger businesses do to help lower their premiums. Allowing these small businesses to join together and have more bargaining power will help lower their health insurance costs.

Another part of the plan codifies a 2019 Trump administration rule that allows employers to give tax-advantaged dollars to their employees, who can then use those dollars to purchase health insurance and for other medical costs. When businesses are planning their financial future, unpredictable health insurance costs and rising premiums make it almost financially unviable in some cases. Allowing businesses to have this option brings them more certainty and will give power to their employees to choose a plan that is best for them.

Another flexibility we grant under this bill is by exempting stop- loss insurance from the definition of health insurance coverage. Stop- loss coverage is a type of coverage an employer can purchase to protect themselves from unexpected catastrophic health claims if that employer has chosen to self-insure their employees' healthcare. This allows an employer to limit the financial risk imposed on them if an employee, or a few of them, have unusually high medical claims that exceed the budgeted amount. Some States have attempted to restrict or prohibit these plans, which makes a self-insured option less attractive.

This bill clarifies that this type of coverage is exempted from the definition of health insurance coverage, which means that these States would be limited in how they can regulate stop-loss coverage while still having to follow the regulations of ERISA.

On top of all of this, I would reiterate that the bill lowers premiums of individuals who are enrolled in the so-called Affordable Care Act plans by roughly 11 percent. It does this by appropriating dollars for cost-sharing reductions. This will stop the practice of silver loading by putting dollars toward lowering beneficiaries' out- of-pocket costs, which in turn lowers premiums for Americans who are on the so-called Affordable Care Act, again, by roughly 11 percent.

Today, Mr. Speaker, you will hear my friends and colleagues on the other side, the Democrats, tell you this plan is not meaningful and that the only way to help individuals is to throw more money at big insurance. Throwing more money at the insurance companies, Mr. Speaker, is not the answer.

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Mr. GRIFFITH. Greene).

It gets curiouser and curiouser.

The gentleman from Massachusetts referenced that our protocol is to have sunsets, but when my colleagues on the other side of the aisle had the opportunity to make permanent the premium enhanced tax credits, we didn't control the floor. They controlled the floor.

They don't have that protocol, as I understand it. They don't have that protocol that they put sunsets on things. They could have and did make other programs in the Green New Deal permanent. They could have made it permanent; they chose not to. They had the Senate, the House, and the Presidency.

It is not House Republican protocol that stopped them. It was a lack of votes or will. If the program is so imperative today, why wasn't it imperative for them 3 years ago?

I submit this is a paper tiger and that there is no substance in their arguments or, if some substance, just a small amount.

Mr. Speaker, they had the chance. They had the power, and they didn't use it to do what they want us to do today to fix their problems with their so-called Affordable Care Act.
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Mr. GRIFFITH. Foxx) who is the chairwoman of the Rules Committee.

Mr. Speaker, my colleagues on the other side continually say that we haven't done anything. We just received a message from the Senate on a Republican bill that does something. Now, they may not like it, but I find it fascinating. These debates are always so interesting, Mr. Speaker.

They say we haven't put forward anything at some points, and at other points in their debate, they claim that this bill is terrible, that it does nothing.

Let me remind you, Mr. Speaker, that a part of this bill revives a Democratic plan that was supposed to be short term called cost-sharing reductions. It is fascinating because during the first Trump administration, in May 2017, my Democratic colleagues--and I know some of them weren't here yet--but 196 of them, including the gentleman from Massachusetts, signed a letter asking--because it was not codified-- President Trump to use his executive power to continue the cost-sharing reduction plan.

Mr. Speaker, I would love to hear from my colleagues why cost-sharing reduction by them was considered to be so important to be continued to help 7 million hardworking Americans and their families, more than half--I am reading from their letter--of all marketplace enrollees for 2017 afford their out-of-pocket healthcare costs. That is what cost- sharing reduction does.

Today, they claim, as a part of our bill, it is nothing. It is worthless. It is not worth the paper it is written on, but in 2017, 196 of them, including the gentleman from Massachusetts, asked the President of the United States to continue the program.

Today, we are answering that call, saying we will answer that and put it in our bill, but because it is now proposed as part of a Republican bill, my colleagues, for some reason, don't remember their position in 2017 and call it trash.

Could it be mere political posturing for November elections? I submit it is.
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Mr. GRIFFITH. Mr. Speaker, I am prepared to close, and I reserve the balance of my time.

Mr. Speaker, the gentleman is absolutely correct on this one point. If what they want is socialized medicine, yes, I am against it and so are most of the Republicans in this House. We are not for socialized medicine.

When I was a student, I remember being in Edinburgh in 1979. Mr. Finch across the hall with socialized medicine had to wait 10 months to get surgery for a blockage in his heart.

When I came home, I discovered that in the United States it would have been 3 days before he would have had that surgery. He died a couple of years later because socialized medicine warehouses people until they have time to get to them. That is not what our system does nor should it.

Further, I would say that the Democrats come here today, and it is their healthcare system. They created it. When they created the Affordable Care Act, there were no Republican votes. When they extended it or changed it a little bit and eventually renewed it again in the Inflation Reduction Act, there were no Republican votes for that.

Today, they want to blame Republicans for their policy failures. The American people will eventually see through that. I know they have done a great job of convincing the American people that is the case, but it isn't true.

They talk about the fact that, as costs are going up and they want this new plan to throw $85 billion at the insurance companies, 85 percent has to be spent on healthcare. That is true.

Mr. Speaker, 15 percent of $500 that the insurance companies get to put in their pockets is a whole lot less than 15 percent of $2,000. If we throw more money at the insurance companies, the big insurance executives get more money to put in their pockets. They are smiling like Cheshire cats as the costs go up and they pocket larger profits.

Perhaps my Democratic colleagues don't want to admit it or don't realize that they are the front men for big insurance, but that is what they are. They are the front men for big insurance. Instead of facing reality, their answer is to blame the Republicans and throw more taxpayer money at the big insurance companies.

Mr. Speaker, giving the insurance companies more money will not solve our healthcare problems.

The material previously referred to by Mr. McGovern is as follows:

An Amendment to H. Res. 953 Offered By Mr. McGovern of Massachusetts

At the end of the resolution, add the following:

Sec. 6. Immediately upon adoption of this resolution, the House shall proceed to the consideration in the House of the bill (H.R. 6074) to amend the Internal Revenue Code of 1986 to extend the enhancement of the health care premium tax credit. All points of order against consideration of the bill are waived. The bill shall be considered as read. All points of order against provisions in the bill are waived. The previous question shall be considered as ordered on the bill and on any amendment thereto to final passage without intervening motion except: (1) one hour of debate equally divided and controlled by the chair and ranking minority member of the Committee on Ways and Means or their respective designees; and (2) one motion to recommit.

Sec. 7. Clause 1(c) of the rule XIX shall not apply to the consideration of H.R. 6074.
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