Michael Burgess

Mr. BURGESS

Mr. BURGESS. Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 1011 and ask for its immediate consideration.

Mr. BURGESS. Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Florida (Mr. Hastings), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only. General Leave

Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks.

Mr. BURGESS. Mr. Speaker, House Resolution 1011 provides for the consideration of two bills aimed at removing some of the most burdensome aspects of the Affordable Care Act, and, as a result, moving toward lowering healthcare costs for the millions of Americans who are confronted daily with rising premiums, rising deductibles, and rising drug prices. With each bill, we take one step closer to ultimately eliminating the Affordable Care Act's government-run approach to healthcare and return to a market-driven solution that puts patients first. The first bill in today's rule, H.R. 184, the Protect Medical Innovation Act of 2017, would repeal the excise tax on medical devices imposed on American companies by the previously mentioned Affordable Care Act. The second bill in today's rule, H.R. 6311, the Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018, expands the availability and the use of health savings accounts to allow individuals and their families to save their own money and budget for the healthcare needs they have that otherwise would not be part of their budget. Today's resolution provides for a closed rule for H.R. 184, the Protect Medical Innovation Act of 2017. This is the standard practice for a tax-related measure on the House floor. The rule provides for 1 hour of debate, equally divided and controlled by the chair and the ranking minority member on the Committee on Ways and Means. The rule does provide the minority with the customary motion to recommit with or without instructions. The second part of today's resolution provides for a closed rule for H.R. 6311, the Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018. The rule provides for 1 hour of debate equally divided and controlled by the chair and the ranking minority member of the Committee on Ways and Means. The customary motion to recommit with or without instructions is provided to the minority. This week, Republicans in the House continue our efforts to increase more healthcare options while driving down premiums in the individual market. According to the Office of the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services, premiums on the exchange are 105 percent higher, on average, in calendar year 2017, compared to premiums in the individual market in calendar year 2013, which was the last year before the Affordable Care Act took effect. It is important that we continue to address the negative impact that the Affordable Care Act has had on the individual market and to help Americans across the country be more in charge of their healthcare purchases. Thus far, the Republican Congress has been successful in nullifying the individual mandate, repealing the Independent Payment Advisory Board, and delaying many of the harmful taxes on American businesses and American consumers. I am also encouraged by the actions of the administration in permitting more low-cost limited duration insurance plans and allowing access to association health plans for more small businesses. These are choices that are provided to the American people so that they, the American people, can be in the driver's seat, not the other way around with the ACA's government-approved one-size-fits-all healthcare model. With that in mind, two bills we are considering this week seek to expand and improve health savings accounts. Under the current rule, H.R. 6311, the Increasing Access to Lower Premium Plan and Expanding Health Savings Accounts Act of 2018, will enhance the benefit of tax- preferred health accounts so that individuals can better plan and save for their healthcare needs, and, also, these individuals will see lower premiums on their healthcare plans. For the last several Congresses, I have argued to improve the utility of health savings accounts, and so I am pleased to see that these important policies are being advanced through the House this week. In addition to offering health insurance, many employers often arrange to reimburse their employees and their dependants some of their medical expenses that are not covered by health insurance. Health flexible spending accounts and health reimbursement arrangements are two of the more common arrangements offered by employers. I have heard the frustration of employees, many of whom are my constituents in north Texas, over forfeiting the remaining amounts in their flexible spending account at the end of each plan year. We can all agree that the healthcare needs and purchases vary from year to year, where one year a person may have more medical expenses than the next or the other way around. One of the provisions in H.R. 6311 eliminates the arbitrary ``use it or lose it'' rule and allows flexible spending account balances to be carried over to the next plan year within a reasonable annual flexible spending account contribution limit. Another provision allows working seniors that are covered under an HSA-eligible high deductible health plan and enrolled in Medicare part A to continue to contribute to their health savings account. Just because someone becomes eligible for Medicare because of age, they should not be prohibited from continuing to contribute to a health savings account. Under current law, there are annual health savings account contribution limits. In 2018, the limit for an individual was $3,450. For families, that amount was $6,900. While these limits are updated annually for inflation, they are significantly less than the combined limit on annual out-of-pocket deductible expenses. H.R. 6311 would allow individuals to increase their contributions to equal to the combined annual limit on the out-of-pocket and deductible expenses under their HSA-qualified insurance plan. That would be $6,550 for an individual and $13,300 for a family this year. The Affordable Care Act limits the option of individuals enrolled in bronze and so-called copper, or catastrophic, plans to make HSA contributions. Also, only those under 30 or those that qualify for a hardship exemption are actually able to purchase the so-called copper health plan. That is a 50 percent actuarial value health plan. So, today, I am pleased that a bill that I introduced with Representative Roskam, H.R. 6314, the Health Savings Act of 2018, to expand the eligibility and the access to health savings accounts by allowing plans categorized as catastrophic and bronze plans in the individual and small group markets to qualify for HSA contributions. That is included in this bill. Lastly, I appreciate working with the Ways and Means Health Subcommittee Chairman Peter Roskam on H.R. 6311. One of the key provisions of the bill is to provide an off-ramp from ObamaCare's rising premiums and limited choices by allowing the premium tax credit to be used for qualified plans offered outside of the law's exchanges and healthcare.gov. In addition, it expands access to the lowest premium plans available, so-called copper or catastrophic plans, for all individuals purchasing coverage in the individual market and allows the premium tax credit to be used to offset the cost of such plans. I recognize not everyone will choose to have a health savings account, but they should have the option because HSAs represent a powerful tool to lower prices and improve access to quality care for everyone, and those are goals that we can all share. Now, it is well documented that many of the provisions contained within the Affordable Care Act have negative consequences on patients, both in access to care and in affordability. One of the provisions that has been universally criticized is that, on a large, bipartisan nature, its repeal was called for almost immediately after the passage of the Affordable Care Act. This is the tax on medical device manufacturers, or more commonly referred to as the medical device tax. It seems illogical that within a piece of legislation that was purported to make medical care available, more accessible to all Americans, the Federal Government would want to tax the very providers of medical innovation that create devices to improve the delivery of healthcare, but, nevertheless, that is exactly what happened when ObamaCare passed in 2010, and it was done as a means to pay for the astronomical price tag that accompanied the Affordable Care Act. This tax burden is unfair, and it actually increases costs that consumers pay at their doctors' offices. The tax has also been cited by dozens of medical device manufacturers who have or are considering moving their operations overseas so that they can continue to innovate without the heavy burden of this tax stifling their growth. This tax slows the creation of new techniques and devices, which will make the delivery of medicine more efficient, and it puts at risk the jobs that were created by the creation of such devices. For anyone who thinks that we are merely talking about the largest and most expensive pieces of technology found within a hospital-- basically, your MRI, CAT scans, and some surgical equipment--let's be clear that this tax covers every piece of medical equipment, from those large machines to the smallest of items, including syringes used to deliver lifesaving antibiotics and vaccines. It continues to negatively impact a number of constituents in my district and, I am certain, in districts around the country, and it does continue to create a burden on a number of companies. The medical device tax has led to the elimination of thousands of good-paying jobs, and repealing it would be the first step to bringing those jobs back and stem the loss of future jobs within this vital industry that is helping to mitigate rising costs of healthcare due to the burdensome provisions within the Affordable Care Act. This is a tax on business, a tax on consumers, and a tax on innovation. To date, 33,000 jobs have been lost in the medical device industry since the passage of the Affordable Care Act, and it is projected that over 130,000 additional jobs are on the chopping block. Why would anyone be surprised about this? Excise taxes--and that is what this is, an excise tax--are meant to lead to a reduction in the consumption of the goods being taxed. We place an excise tax on cigarettes. We want to discourage people from smoking. We make it burdensome to afford a smoking habit. Did we really intend, with the passage of the Affordable Care Act by congressional Democrats in 2010, to make it more burdensome to use more efficient medical devices? H.R. 184 has bipartisan, bicameral support, with currently 277 cosponsors. Republican leadership in the House has heard this request and heard the calls from many Members within this body and is moving this bill in a responsible way to put Americans back to work and lower healthcare costs for all. Mr. Speaker, I urge my colleagues to support today's rule and the underlying bill, and I reserve the balance of my time.

Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume. The gentleman is quite correct in identifying the other body as sometimes an obstacle to good public policy, for it was 1 year ago that the other body blocked a health care reform that this body had passed the previous May. But, Mr. Speaker, I want to draw the House's attention to an article in today's Wall Street Journal. The title of the article is ``TrumpCare beats ObamaCare.'' And I just want to quote a little bit from this article. To set the stage, in December, with the repeal of the individual mandate, and quoting here: ``But while many people didn't realize it at the time, it turns out that Mr. Trump has been helping to improve an important source of insurance coverage since virtually the moment he took office.'' Continuing to quote here: ``By prioritizing economic growth and reducing the tax and regulatory burdens on U.S. business, Mr. Trump has helped create an economy with more job openings than ever before. As if by magic, the invisible hand of a freer marketplace is now generating new benefits as employers compete to fill all those open positions.'' Continuing to quote here: ``For the first time in six years, the share of U.S. workers offered health insurance through their employer has risen, a sign a tighter labor market is prompting businesses to offer more generous benefits.'' So, Mr. Speaker, I simply submit that the activities of the Trump administration have, indeed, improved the healthcare landscape in this country. That is something we should acknowledge and embrace. I reserve the balance of my time.

Mr. BURGESS. Mr. Speaker, I am prepared to close as well.

Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time. The gentleman from Florida is making a point about open rules, and I do feel obligated to point out in the 111th Congress--that was the Congress that was the first 2 years of President Obama's administration--in the 111th Congress, under Speaker Pelosi, the majority had zero open rules. That is zero open rules in the 2 years in which we saw the passage of the Affordable Care Act, the passage of Dodd-Frank; the House-passed Waxman/Markey, which was a cap-and-trade global warming bill, so significant pieces of legislation passed the floor of this House, all under closed rules. But, Mr. Speaker, today's rule brings forward two pieces of legislation that will have a meaningful impact on Americans' healthcare costs, including the premiums and the prices they pay for medicines. H.R. 184, the Protect Medical Innovation Act of 2017, which will repeal the Affordable Care Act's ill-conceived medical device tax, and H.R. 6311, the Increasing Access to Lower Premium Plans and Expanding Health Savings Account Act of 2018, which will provide greater freedom for Americans to use their own money to pay for medical expenses out of their health savings accounts, both of these build on the House's work over the past 2 years to make healthcare a more patient-centered market. Mr. Speaker, I certainly want to thank Representatives Paulsen and Roskam for their work on these measures. I urge my colleagues to support today's rule and move the debate forward on this legislation.

Mr. BURGESS. Mr. Speaker, I yield back the balance of my time, and I move the previous question on the resolution.

Mr. BURGESS

Mr. BURGESS. Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 1012 and ask for its immediate consideration.

Mr. BURGESS. Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentlewoman from California (Mrs. Torres), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only. General Leave

Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks.

Mr. BURGESS. Mr. Speaker, House Resolution 1012 provides for the consideration of an important bill to return control of healthcare spending and budgeting back where it belongs: with the patient. H.R. 6199, the Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018, would amend the Internal Revenue Code of 1986 to include certain over-the-counter medical products as qualified medical expenses for the purposes of spending one's own dollars within a health savings account. Today's resolution provides for a rule to allow H.R. 6199, the Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018, the standard practice for a tax-related measure on the House floor. The rule provides for 1 hour of debate equally divided and controlled between the chair and the ranking minority member of the Committee on Ways and Means. The rule does, however, provide the minority with the customary motion to recommit with or without instructions. Also included in the resolution before us today are the standard provisions allowing the House of Representatives to continue to operate while Members are home, working with their constituents during the August district work period. Mr. Speaker, I rise today to speak in support of the rule on H.R. 6199, the Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018. This rule includes the work of various Members of Congress on the important issue of modernizing health savings accounts. While this legislation did not move through the Health Subcommittee of the Energy and Commerce Committee, my fellow members on the other Health Subcommittee, that of the Ways and Means Committee, have done quality work in moving this package. Each bill was reported favorably out of the Ways and Means Committee. Mr. Speaker, I have long been a supporter of increasing flexibility within our healthcare system, especially through the use of health savings accounts. Health savings accounts allow patients to feel more involved and to have more control over their healthcare spending. As someone who has personally had a health savings account in the past, I believe it to be a powerful tool but that qualified expenses have been limited for too long. This package will give more power to consumers by allowing them to use their hard-earned savings that they put into their health savings accounts on an expanded number of healthcare goods and services. The first bill in this package, Promoting High-Value Healthcare Through Flexibility for High-Deductible Health Plans Act, introduced by Chairman Roskam, allows for first-dollar coverage flexibility for high- deductible health plans. Many individuals, especially in the post- Affordable Care Act world, have chosen to purchase high-deductible health plans. While this is a reasonable choice for many consumers, there are some who are faced with high out-of-pocket costs. H.R. 6199 allows health plans to provide coverage for up to $250 per year for individuals or $500 per year for families before they meet their deductible. The goal of this provision is to incentivize services that could reduce future healthcare costs, such as primary care visits and telehealth services. Additionally, under current law, individuals are unable to contribute to an HSA if they participate in a direct primary care service arrangement. Representative Erik Paulsen's Primary Care Enhancement Act, which is included in this rule, enables patients to be able to participate in a direct primary care service arrangement and remain qualified to contribute to a health savings account. It also includes direct primary care service arrangement fees as medical expenses. Some individuals are fortunate enough to receive certain healthcare services at or nearby their workplace through their employer. Representative Mike Kelly's bipartisan Health Savings Account Improvement Act of 2018, which is included in this package, addresses this issue. While it is convenient and helpful to have access to such services, these individuals should not be barred from having a health savings account. This package creates a special rule that individuals can receive free or discounted services offered by their employers onsite or at retail medical clinics. These services may include physical exams, immunizations, nonprescription drugs, treatment of employment- related injuries, drug testing if required as a condition of employment, hearing or vision screenings, or other services that are not considered significant benefits in the nature of medical care. Mr. Speaker, the post-Affordable Care Act world is riddled with flaws, but one of the biggest problems is its failure to promote consumer-driven healthcare. Expanding the use of health savings accounts could go a long way to reverse this trend. Health savings accounts give consumers incentives to manage their own healthcare costs by coupling a tax-favored savings account used to pay medical expenses with a high-deductible health plan that meets certain requirements for deductibles and out-of-pocket expense limits. The funds in a health savings account are owned by the individual and may be rolled over from year to year. Health savings accounts are not a novel idea. They have been around since 2004, but current health savings account policy is extraordinarily restrictive, making it harder for consumers to take advantage of it. I have spent several years in developing extensive reforms to increase the potential for health savings accounts for consumers, and H.R. 6199 includes meaningful improvements that we can, in fact, get across the finish line now to help families now. One of these improvements is the ability for spouses to contribute to a health savings account under certain circumstances even if their spouse has a flexible spending account. Under current law, one spouse can reimburse expenses for their spouses' and other dependents' medical expenses; therefore, the other spouse is considered to be ineligible for an HSA. This provision enables the spouse without the flexible spending account to reimburse for medical expenses, with certain restrictions. This is critical, as it gives individuals increased flexibility to save for their own healthcare expenses that a shared flexible spending account for the whole family may not provide. Additionally, this bill allows for individuals to terminate or convert their flexible spending account and health reimbursement accounts into a health savings account under certain circumstances. Employers would be able to allow their employees to convert their flexible spending account and health reimbursement account balances into health savings account funds if they enroll in a high-deductible health plan with an HSA. This is critical in empowering patients and allowing them the flexibility to change health plans without losing their savings. There is a dollar limitation of $2,650 for conversions for individuals, $5,300 for families, and the funds transferred into the HSA would count toward the enrollee's HSA contribution for that taxable year. H.R. 6199, the bill introduced by Representative Lynn Jenkins from Kansas, makes commonsense, patient-centered reforms to help defray costs for individuals. Over-the-counter medications, allergy and cold medicines, antibiotic ointment, and pain relievers are historically ineligible expenditures for HSA and other tax-favored healthcare accounts. The ACA created a requirement in Federal law that forced account holders to go to their doctor to obtain a prescription for over-the-counter medications before purchasing them with their health savings account or flexible spending account. Individuals who fail to jump through these hoops and purchase over-the-counter medications without a prescription, in fact, face a tax penalty for making a nonqualified distribution. This policy drives unnecessary utilization of doctor services, decreases access to over-the-counter medications, and discourages people from taking control of saving for their healthcare needs. H.R. 6199 repeals this harmful provision, puts consumers back in the driver's seat, and allows them efficient access to appropriate medications. Lastly, this legislation permits individuals to invest their hard- earned health savings account dollars into their physical fitness and well-being. In many ways, income is a hurdle for individuals and families who would like to participate in a physical activity, whether they would like to pay for a membership at a fitness facility or pay for their children to join a youth sports league. This legislation opens the door for paying for such activities with health savings account dollars. Known originally as a standalone bill, the Personal Health Investment Today Act, introduced by Representative Jason Smith, allows qualified sports and fitness expenses to count as qualified medical expenses. These particular expenses are capped at $500 a year for individuals and $1,000 on a joint return. Passage of this provision will assist individuals and families across the Nation in investing in their physical fitness, which can lead them to healthier lives and stave off conditions such as diabetes and obesity. These bills are an important example of the work we are doing right now to advance Member-driven solutions that will improve healthcare for all Americans. Deductibles, out-of-pocket limitations have been steadily growing. Congress should be taking steps to make it easier for Americans to save, not restricting their options. The rule and the underlying bills included in this package strengthen consumer power and increase flexibility for patients in paying for their medical expenses. I appreciate all of the work that the Members have put into the provisions of this bill. I urge my colleagues to support today's rule and the underlying legislation, and I reserve the balance of my time.

Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, once again, I want to draw attention to an opinion article in today's Wall Street Journal. The title of the article is ``TrumpCare Beats ObamaCare,'' July 23, 2018, penned by James Freeman. ``By prioritizing economic growth and reducing the tax and regulatory burdens on U.S. business, Mr. Trump has helped to create an economy with more job openings than ever before. As if by magic, the invisible hand of a freer marketplace is now generating new benefits as employers compete to fill all those open positions.'' ``For the first time in 6 years, the share of U.S. workers offered health insurance through their employer has risen, a sign a tighter labor market is prompting businesses to offer more generous benefits. . . .'' ``The Trump plan is repairing at least some of the damage caused by ObamaCare. Notes the Journal: ``Among all private-sector workers offered medical benefits, 72 percent opted to take them,'' which is up from the 17 percent in 2010 when it began to decline. Again, Mr. Speaker, this is to point out that this is all occurring without a new government program. This is because of the strength of the economy. This is what happens when you put the focus on creating good jobs for American workers. This is the benefit that results. I reserve the balance of my time, Mr. Speaker.

Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I was serving in the United States House of Representatives when the congressional Democrats passed the Affordable Care Act. I was serving in the House of Representatives when the implementation of ObamaCare happened at the end of calendar year 2013. I have got to tell you something. The President told me I had a junk insurance plan. I was covered by a health savings account in those years. Then-President Obama told me I had a junk insurance plan and that I was going to get something better. I have got to tell you something. I didn't get something better. I went through healthcare.gov. I bought an unsubsidized ObamaCare policy, the bronze plan. I am like any other consumer. I bought on price. What is the cheapest thing I could afford? That was the bronze plan. The premium was unbelievable. It was three times what I had paid for a premium before for my so-called junk insurance which I had had for years, which had covered every medical contingency that had occurred in my family's life for a number of years. But now I have to buy this policy that the premium was unbelievably high. But that wasn't the worst part, Mr. Speaker. The worst part was the deductible. Now, look, I had a health savings account. I bought one as soon as the old medical savings accounts were allowed with the passage of the Kennedy-Kassebaum bill in, I think it was, July of 1996. The rules got written the next year. People were allowed to buy medical savings accounts. I bought one. I converted to a health savings account in 2004. I thought I knew what a high deductible was. That was the whole purpose, after all, of having that medical savings account and, now, health savings account. You have a higher deductible so your premiums are going to be a little bit lower. My premium certainly wasn't lower, but that deductible was something unlike anything I had ever seen. I went from a $3,500 deductible in my old health savings account with what then-President Obama said was a junk insurance policy. I went from a $3,500 premium to a $6,800 premium for just an individual. This is not a family policy, just for an individual. Now, let me tell you something, Mr. Speaker. Someone wakes up at 3 in the morning with a kidney stone, the worst pain they have ever had in their life. They go to the emergency room basically to get a shot of morphine and an appointment with a urologist the next day and hopefully pass the darn thing. That exercise can cost in excess of $4,000. If you have a $6,800 deductible, guess what. That is all on you. Your coverage is meaningless at that point. And at the same time, you are having to pay a very expensive premium for coverage that is not there when you need it. I am not an expert on this, Mr. Speaker, but I would call that junk insurance. That is what then-President Obama and the Congressional Democrats brought us with the passage of the so-called Affordable Care Act. I would far rather go back to those days before. Most people don't understand why it is they have less coverage now and it costs them more money. Yeah, they heard the argument, if you like your doctor, you can keep your doctor; if you like your coverage, you can keep your coverage. They recognize that perhaps that was political hyperbole. But what they do not understand is: Why am I having to pay so much more now to get so much less? Mr. Speaker, I submit that the ability for individuals to buy health savings accounts is not junk insurance. That is coverage that people can use. That is help for right now. Mr. Speaker, I reserve the balance of my time.

Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time. First off, Mr. Speaker, let me reference an article from the Investor's Business Daily from April 10 of this year. I am quoting Investor's Business Daily: ``When the Congressional Budget Office released its updated budget forecast, everyone focused on the deficit number. But buried in the report was the Congressional Budget Office's tacit admission that it vastly overestimated the cost of the Trump tax cuts because it didn't account for the strong economic growth they would generate. ``Among the many details in the report, the one reporters focused on was the Congressional Budget Office's forecast that the Federal deficit would top $1 trillion in 2020. . . .'' Most of the news accounts blame the tax cuts. I am continuing to quote here: ``But there's more to the story that the media overlooked. ``First, the CBO revised its economic forecast sharply upward this year and next. ``Last June, the CBO said GDP growth for 2018 would be just 2 percent. Now it figures growth will be 3.3 percent''--this was last April, Mr. Speaker; I suspect it is probably going to be higher at the end of this quarter--``a significant upward revision. It also boosted its forecast for 2019 from a meager 1.5 percent to a respectable 2.4 percent.'' Mr. Speaker, the tax cuts are working to boost economic growth. Obviously, the story is far from completed, but the revenue generated by that increased growth is more than enough to offset the tax cuts that were passed by this body last December. Mr. Speaker, today's rule allows the House to take another step in fixing the problems created by the Affordable Care Act and returning control of healthcare spending back to patients, where it belongs. H.R. 6199, the Restoring Access to Medication Act of 2018, will allow those Americans with health savings accounts to use those accounts to pay for over-the-counter medications, the practice which existed up until the Democrats took away that ability in the Affordable Care Act. This is the right thing to do. I want to thank Representative Jenkins for her leadership on this legislation and the Members who contributed to the package that is before us today. I urge my colleagues to support today's rule and support the underlying bills.

Mr. BURGESS. Mr. Speaker, I yield back the balance of my time, and I move the previous question on the resolution.

Mr. BURGESS

Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 3728) to amend title VII of the Public Health Service Act to reauthorize certain programs relating to the health professions workforce, and for other purposes, as amended.

Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous material into the Record on the bill.

Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, as the author of the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness Act of 2018, I rise in strong support of this bill. H.R. 3728 moved with strong bipartisan support through regular order in the full Energy and Commerce Committee and the subcommittee, which I chair. This legislation reauthorizes the title VII health professions workforce program for fiscal years 2019 through 2023. Title VII programs have expired but have continued to receive appropriations. In fact, in fiscal year 2018, the appropriations levels for the program actually increased. Reauthorizing these physician workforce programs will provide much-needed stability for those who depend upon this funding. Title VII of the Public Health Service Act includes various programs that are vital to building and maintaining a well-educated, well- trained physician workforce. The EMPOWER Act reauthorizes funding for the Area Health Education Centers at more than $38 million a year. These centers are critical in providing both medical education and healthcare services to medically underserved areas. The bill also reauthorizes programs that incentivize diversity in the physician workforce, including the Centers of Excellence Program, which this bill authorizes at a level of $23 million per year. This particular program provides grants to medical schools that have a disproportionate number of minority students for the purpose of expanding the schools' capacity or to improve curriculum. Primary care is an important aspect of our Nation's healthcare system and how many Americans receive the majority of their healthcare services. H.R. 3728 reauthorizes funding for our Primary Care Training and Enhancement Program at more than $48 million per year. This program provides grants to hospitals and health professional schools to develop and operate supplemental primary care training programs. Lastly, this bill aims to strengthen our workforce that cares for the geriatric population. The bill makes strides toward modernizing the Geriatrics Workforce Enhancement Program and the Geriatric Academic Career Award. With an aging population, our workforce needs to be adequately trained in handling the unique needs of our seniors. These two programs enable physicians and other providers to achieve that training. Lastly, I want to thank Representatives Schakowsky and Bucshon and their staffs and the majority and minority staffs on the Energy and Commerce Committee for their work on this legislation. Reauthorizing title VII programs is long overdue, especially in a time where our existing physician workforce is struggling to keep up with the demands for healthcare services. I urge strong support of the legislation, and I reserve the balance of my time.

Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time. Mr. Speaker, I would just point out that reauthorizing these title VII programs is long overdue. The House of Representatives in the last Congress, the 114th Congress, did provide the reauthorization. It never made it through the other body, unfortunately. It is time to do that work now, and that is what this bill, today, purports to do. Mr. Speaker, this is an important bill. It is long overdue. I urge all Members to support the bill, and I yield back the balance of my time.

Mr. BURGESS

Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5385) to amend the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs, and for other purposes, as amended.

Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous material in the Record on the bill.

Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, today we are considering H.R. 5385, the Dr. Benjy Frances Brooks Children's Hospital Graduate Medical Education Support Reauthorization Act of 2018. This bill, which was submitted by Representative Gene Green and myself, reauthorizes the Children's Hospital Graduate Medical Education programs at $325 million per year for the fiscal years 2019 through 2023. This is an increase of $10 million above the enacted fiscal year 2018 level. This bill recently moved through regular order in the Energy and Commerce Committee and its Subcommittee on Health. Congress created the Children's Hospital Graduate Medical Education program in 1999 as part of the Healthcare Research and Quality Act, which authorized funding to directly support medical residency training at children's hospitals for 2 years. Prior to the establishment of Children's Hospital Graduate Medical Education, children's hospitals received minimal graduate medical education funding because Medicare is the primary funding source of graduate medical education programs, and children's hospitals have few Medicare patients. Since the establishment of this program, Children's Hospital Graduate Medical Education funding has provided critical support to our pediatric workforce, which still is struggling to keep up with the demands for their services. The Children's Hospital Graduate Medical Education program is especially crucial in training pediatric subspecialists. Children's hospitals have a unique patient population with medical conditions from which pediatric medical residents can learn and develop critical skills. The experience gained from such a residency helps to prepare and train physicians for the complex reality of pediatric medicine that they will face in the future of their medical careers. I can say as an OB/GYN who did his residency at Parkland Hospital in Dallas, residency programs play a vital role in shaping our Nation's physician workforce. Our pediatric workforce is no exception. According to the Children's Hospital Association, almost half of children's hospitals reported vacancies for child and adolescent psychiatry, in addition to developmental pediatrics. The Children's Hospital Association also reports that pediatric specialists in emergency medicine, physical medicine, rehabilitation, endocrinology, rheumatology, hospitalists, pain management/palliative care, and adolescent medicine are frequently reported as experiencing vacancies longer than 12 months. The workforce shortage is something that I am concerned about, and that is why passing this legislation is an integral part of maintaining and sustaining our workforce. In 2016, Children's Hospital Graduate Medical Education funding helped to support over 7,000 residents at 58 hospitals across the country. Mr. Green and I agreed to name this bill after Dr. Benjy Frances Brooks, who was born and raised in my district in north Texas, in Lewisville, Texas. Dr. Brooks went on to become the first female pediatric surgeon in the State and to establish pediatric surgery as a separate division at the University of Texas Medical School at Houston. It is an honor to move this bill in Dr. Brooks' name. Our children deserve the best care available to them, and ensuring that we have an adequately prepared workforce is the first step in providing quality healthcare to children. Passing H.R. 5385 is vital to the maintenance and growth of this workforce and to the health of our Nation's children. I urge support of this legislation, and I reserve the balance of my time.

Mr. BURGESS. Mr. Speaker, I yield as much time as he may consume to the gentleman from Oregon (Mr. Walden), chairman of the full committee.

Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time. I only want to point out that 2018 is the 100-year anniversary of the birth of Dr. Benjy Brooks, so it seemed an appropriate time to recognize her contributions to the fields of pediatric surgery and medicine in general. Again, she was born in the town in which I practiced medicine for a number of years. I first encountered her at the University of Texas Medical School at Houston when I was a medical student back there in the 1970s. Surely, hers is a legacy of which all Texans can be proud. Mr. Speaker, I yield back the balance of my time.