Donna Shalala

Ms. SHALALA

Ms. SHALALA. Madam Speaker, I yield 30 seconds to the gentlewoman from Texas (Ms. Jackson Lee).

Ms. SHALALA. Madam Speaker, I yield 2 minutes to the gentleman from Mexico (Mr. Lujan), the Assistant Speaker.

Ms. SHALALA. Madam Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Doggett), a distinguished member of the Ways and Means Committee.

Ms. SHALALA. Madam Speaker, I am delighted to hear a Member of the other party defend the Affordable Care Act by defending 1332, the waivers. Let me say this: We are not eliminating the waivers. We are simply objecting to the guidance that was issued by the Department of Health and Human Services, arguing, essentially, that it is inconsistent with the congressional intent when the waivers were created. Madam Speaker, I include in the Record a letter signed by 24 health organizations, including the Cancer Action Network, the American Lung Association, the American Heart Association, the Susan G. Komen Foundation, and others, urging Members to support H.R. 986. May 8, 2019. Re Letter of Support from 23 Patient and Consumer Advocacy Organizations for H.R. 986. Hon. Ann McLane Kuster, House of Representatives, Washington, DC. Dear Representative Kuster: Our 24 organizations, representing the interests of the millions of patients and consumers who live with serious, acute, and chronic conditions, have worked together for many months to ensure that patient voices are reflected in the ongoing Congressional debate regarding the accessibility of health coverage for all Americans and families. Today, we write in strong support of your legislation to protect people with pre-existing conditions who receive coverage in the individual marketplace. The Protecting Americans with Preexisting Conditions Act of 2019, H.R. 986, would require the Administration to rescind its Section 1332 State Relief and Empowerment Waivers Guidance, released on October 22, 2018 (1332 guidance). We are concerned about the impact that this guidance could have on the people we represent and applaud your introduction of this bill. In March 2017, we identified three overarching principles to guide and measure any work to further reform and improve the nation's health insurance system. Our core principles are that health insurance coverage must be adequate, affordable, and accessible. Together, our organizations understand what individuals and families need to prevent disease, manage health, and cure illness. Our organizations are deeply concerned about how the new 1332 guidance will affect the individual marketplace's stability in states that choose to pursue some of the policies allowed under this guidance, including those that promote short term plans and other substandard coverage. We are pleased that this legislation represents a significant and meaningful step towards protecting all Americans from coverage that does not cover what they need to promote their health and well-being. As you know, the 1332 guidance substantially erodes the guardrails governing coverage that people with pre-existing conditions such as cystic fibrosis, lung disease, cancer, cardiovascular disease, diabetes, rare disorders, pregnant women, and many others rely on in the individual marketplace. Of particular concern, the new guidance would allow states to let individuals use advanced premium tax credits to purchase non-compliant short-term, limited duration insurance plans-- which could further draw younger, healthier people out of the risk pool for comprehensive insurance and drive up premiums for those who need comprehensive coverage. The guidance also eliminates protections for vulnerable populations, such as individuals with low incomes and those with chronic and serious health issues, by removing the requirement to safeguard those populations under any waiver. We are deeply concerned by this as these changes fundamentally alter the nature of the Section 1332 waiver program and jeopardize adequate, affordable coverage for people with pre-existing conditions in the individual market. Halting the implementation of this guidance will protect people with pre- existing conditions from the repercussions of these market destabilizing actions. H.R. 986 represents a significant step towards protecting patients and consumers. Yet, we also recognize that there is much more that needs to be done to improve upon our current system of care, including making coverage more accessible and affordable. Up until this year, health insurance enrollment has steadily increased, and, with it, the promise of a more diverse risk pool and greater protection for people with serious health care needs. However, the recent reinterpretation of the guidelines is jeopardizing enrollment. Shortened enrollment periods, fewer resources for outreach and education and less funding for consumer navigators not only creates confusion for consumers but directly impacts the number of individuals who enroll in Marketplace coverage. Without Congressional action, these trends will make it harder for many to access coverage and will further contribute to the destabilization of insurance markets and result in higher premiums for many enrollees. Making high-quality coverage and care more affordable is also a high priority for the people that we represent. Passage of legislation that expands access to and the level of advance premium tax credits, fixes the family glitch, creates a nationwide reinsurance program, and reduces systemic health care costs could significantly ease the cost burden for people of all income levels who rely on the individual marketplace for coverage. We urge Congress to support legislation that maintains the quality of coverage while expanding access and affordability. Again, thank you for your leadership on this critical issue for people with pre-existing conditions. We support your efforts to halt the implementation of the 2018 guidance, ensuring the guidance from 2015 remains intact and promoting stability in the individual marketplace. We urge members of Congress to vote for H.R. 986. Sincerely, Hemophilia Federation of America, National Health Council, Cystic Fibrosis Foundation, Epilepsy Foundation, March of Dimes, National Coalition for Cancer Survivorship, American Heart Association, Alpha-1 Foundation, American Liver Foundation, Susan G. Komen, National Hemophilia Foundation, WomenHeart: The National Coalition for Women with Heart Disease. National Multiple Sclerosis Society, Muscular Dystrophy Association, Lutheran Services in America, American Lung Association, National Alliance on Mental Illness, National Patient Advocate Foundation, Arthritis Foundation, Leukemia & Lymphoma Society, American Cancer Society Cancer Action Network, National Organization for Rare Disorders, Pulmonary Hypertension Association, Cancer Support Community.

Ms. SHALALA. Madam Speaker, I yield 2 minutes to the gentlewoman from the District of Columbia (Ms. Norton).

Ms. SHALALA. Madam Speaker, I am prepared to close, and I reserve the balance of my time.

Ms. SHALALA. Madam Speaker, I continue to reserve the balance of my time.

Ms. SHALALA. Madam Speaker, I yield myself such time as I may consume. I appreciate the comments of the gentleman from Georgia, and I have enjoyed the opportunity of working with him on the Rules Committee. We are not objecting to what was done in 1996. We are saying to the States that they must cover preexisting conditions as part of a waiver, and they cannot undermine those conditions by imposing annual limits or charging more. The problem with the guidance is that it gives States the opportunity to propose cheap plans that, in essence, undermine preexisting conditions. Madam Speaker, I reserve the balance of my time.

Ms. SHALALA. Madam Speaker, I yield myself the balance of my time. It was only 10 years ago that people who lacked employer-provided insurance and had preexisting conditions could not find health insurance in many parts of this country, and those who could find health insurance, too often found that their plans were not comprehensive. They might not cover the type of cancer some buyers previously had, or they might have an annual or even a lifetime cap on coverage. It was 2 years ago that this body passed a bill that stripped those protections, a bill that would make comprehensive health insurance out of reach for many Americans. Thanks to a courageous few, that bill did not become law. Now that the administration has lost that battle to destroy the Affordable Care Act, they are trying to do it through guidance and through lawsuits. H.R. 986 prevents the administration from enforcing guidance that would allow States to use taxpayer money to sell subpar health plans on the exchange. The administration is taking the 1332 waivers, which are designed to allow States flexibility to lower health insurance costs, like through reinsurance, and using it to take away important consumer protections. The 1332 waiver requires high-quality, affordable health insurance while retaining the basic protections of the Affordable Care Act. As the American Cancer Society notes: This administration guidance tips the scales in favor of insurance products that are inadequate to meet the needs of millions of Americans with preexisting conditions. Madam Speaker, I also support H.R. 2157, which provides disaster assistance to communities from every nook and corner of this country who are waiting for our help. When disaster hits this country, we come together and support each other. When tornados, and floods, and hurricanes strike, we help people quickly. It is an embarrassment that a disaster bill has not yet made it to the President's desk in this Congress. Madam Speaker, I urge a ``yes'' vote on the rule. The text of the material previously referred to by Mr. Burgess is as follows: Amendment to House Resolution 357 At the end of the resolution, add the following: Sec. 3. Immediately upon adoption of this resolution, the House shall proceed to the consideration in the House of the resolution (H. Res. 280), protecting the health care of all Americans, especially those with preexisting conditions. The resolution shall be considered as read. The previous question shall be considered as ordered on the resolution to adoption without intervening motion or demand for division of the question except one hour of debate equally divided and controlled by the chair and ranking minority member of the Committee on Energy and Commerce. Clause 1(c) of rule XIX shall not apply to the consideration of House Resolution 280.

Ms. SHALALA. Madam Speaker, I yield back the balance of my time, and I move the previous question on the resolution.

Ms. SHALALA

Ms. SHALALA. Mr. Chairman, I have an amendment at the desk.

Ms. SHALALA. Mr. Chairman, since 1950, the sea level in south Florida has risen 8 inches and it is only speeding up. By 2030, the sea level in south Florida is projected to rise up to 12 inches, and by the end of the century, perhaps 80 inches. If we continue to do nothing on climate change, my community, and, in fact, my district, will disappear. We have a moral obligation to mitigate and adapt immediately, as we are already seeing the effects of climate change and sea level rise. That is why I was so heartened when the international community came together to sign the Paris Agreement, and that is why I was so devastated when this administration announced the United States' withdrawal. The Paris Agreement strengthens the international response to climate change adaptation, mitigation, and capacity building. It is our best, collective effort to combat climate change. The withdrawal from the Paris Agreement and the failure to act on climate is a mistake with global implications and catastrophic consequences for my south Florida community. I am proud to support H.R. 9 because it rejects the decision to withdraw from Paris and requires the President to develop a plan to meet the United States' commitment under the agreement. My amendment strengthens the bill because it makes clear that addressing climate change means addressing its effects that are ravaging our coastal communities, sea level rise, saltwater intrusion, and flooding. My region's drinking water is seriously threatened as the sea rises and the saltwater reaches further inland and gets dangerously close to our fragile aquifer. In south Florida, it no longer takes a strong hurricane to flood our streets. They now flood just from a particularly high tide, such as the king tides. In fact, tidal flooding has become three times as common in south Florida in just the past 19 years, causing so-called sunny-day flooding. We simply cannot wait. Coastal communities around the world, including my south Florida community, are counting on us. I urge support for this amendment. Mr. Chair, I yield such time as he may consume to the gentleman from New Jersey (Mr. Pallone).

Ms. SHALALA. Mr. Chair, I reserve the balance of my time.

Ms. SHALALA. Mr. Chairman, I have completed my statement. This is absolutely critical to my south Florida community. I yield back the balance of my time.

Ms. SHALALA

Ms. SHALALA. Madam Speaker, I rise today in celebration of Miami-Dade Parks' 90 years of service to our community. South Florida is blessed with abundant green spaces and outdoor attractions. From the luscious Chapman Field Park to the historic Deering Estate to the countless dog parks nestled in quiet neighborhoods, residents of Miami-Dade are fortunate to have access to such spectacular natural areas. As the third-largest county park system in the United States, Miami- Dade Parks is a staple of our community. Founded in 1929 and now covering 270 parks and over 13 thousand acres of land, Miami-Dade Parks has spent 90 years providing all of South Florida with opportunities to explore our natural heritage and enjoy the outdoors. In addition to leading environmental restoration efforts and cultural programs, Miami- Dade Parks offers summer camps and fitness programs for children, adults, seniors, and people with disabilities. Miami-Dade Parks brings our community together by helping all of us enjoy the beauty of South Florida's natural wonders together. We are better friends to the environment and to each other thanks to the incredible work of this department. I hope my fellow Miami-Dade residents join me in celebrating Miami-Dade Parks by renewing our dedication to protecting our shared natural spaces.

Ms. SHALALA

Ms. SHALALA. Madam Speaker, I rise today in recognition of two groups of Miami high school students who were among the winners of C-SPAN's 2019 StudentCam documentary filmmaking competition. The StudentCam competition tasked middle and high schoolers with creating a documentary that addressed the question ``What Does it Mean to Be American?'' Dahlia Harris, Neena Deosaran, and Ceci Richardson, students at South Miami Middle School, won third prize for their documentary What is Your Limit, which addressed the issue of gun violence. The Immigrant Dream, by Bianca Vucetich, Javier Pujols, and Aimet Ruiz of iPrep Academy in Miami earned an honorable mention. What is Your Limit centers on its title's question: what is our limit before we act to counter the epidemic of gun violence in our country? They focus on the young students whose lives are torn apart by school shootings, who fear for their safety sitting in classrooms. These young directors have more insight into what needs to be done to stop gun violence than many adults. This documentary holds us all to account for what we need to do if we do not want America to be defined by our gun violence. The Immigrant Dream is both a stunning indictment of the anti- immigrant rhetoric and policies in the United States in recent years as well as a celebration of all that immigrants have brought to our country. Watching their work celebrate the diversity of the United States, I am filled with pride in remembrance of my own grandparents' journey to this country from Lebanon. These young directors remind us there is more that unites us than divides us. Dahlia Harris, Neena Deosaran, Ceci Richardson, Bianca Vucetich, Javier Pujols, and Aimet Ruiz exemplify the incredible talent, intellect of South Florida. I am pleased to celebrate their achievements as documentarians and look forward to seeing all achieve in the future.

Ms. SHALALA

Ms. SHALALA. Madam Speaker, I rise today in recognition of the 100 Ladies of Deering, a philanthropic women's organization dedicated to preserving the Deering Estate, a pillar of South Florida history. As Women's History Month comes to an end, I am proud to honor the 100 Ladies of Deering for carrying on the long tradition of Miami women working tirelessly on behalf of our community. Listed on the National Register of Historic Places, the Deering Estate is the 1920's era Miami home of Charles Deering, an industrialist, preservationist, and environmentalist. The work of the 100 Ladies of Deering is vital to the preservation the Estate, and more broadly, to keeping our South Florida community connected to our shared history. The 100 Ladies of Deering are deeply involved in the maintenance of the Deering Estate, including the Stone House, Richmond Cottage, outbuildings, grounds, and natural areas. Today, visitors can explore these sites as they would have appeared when Charles Deering occupied the Estate in the 1920's. The 100 Ladies of Deering provide resources and assistance for the 444-acre Estate's historic furnishings. They preserve original objects in their original settings, recreate the scenes of daily life on the Estate, and create a period setting for original objects. As anyone who has visited can attest, the furnishings evoke a powerful experience of time and space while providing witness to past events and personalities. The 100 Ladies of Deering exemplify extraordinary dedication to the South Florida community. I am pleased to celebrate their achievements as community leaders, philanthropists, and Miami women.

Ms. SHALALA

Ms. SHALALA. Madam Speaker, I rise today in recognition of Ed, Carol, and Trae Williamson. The Williamsons are pillars of the South Florida community and have been named Citizens of the Year by the Biscayne Bay Kiwanis Club, one of my District's most active community service organizations. The Biscayne Bay Kiwanis Club serves disadvantaged children in Miami through partnerships with more than a dozen local schools. In addition, the Club has awarded over $200,000 in college scholarships over the past seven years. This year marks the first time the Biscayne Bay Kiwanis Club has selected an entire family for the Citizen of the Year Award. Ed, Carol, and Trae have made tremendous contributions to our community, both through Ed's business, the Williamson Automative Group, and through their involvement with numerous community organizations in Miami, including the Orange Bowl Committee, the Greater Miami Chamber of Commerce, the Beacon Council, the Dade Foundation, the United Way of Dade County, the Rotary Club of South Florida, and the Miami Business Forum. The Williamsons are also generous supporters of the University of Miami, where Trae is currently a PhD candidate and adjunct professor in management. The Williamson family exemplifies extraordinary dedication to the South Florida community. I am pleased to celebrate their achievements as community leaders.

Ms. SHALALA

Ms. SHALALA. Mr. Speaker, this evening, Congress will vote on a bill I introduced, H.R. 920, the Venezuela Arms Restriction Act. This bipartisan bill prohibits the export of defense articles and crime control materials from the United States to the security forces of Venezuela. The United States should have no business selling these tools for oppression to the Maduro regime, as it punishes and kills those who are peacefully protesting and demanding a return to democracy. Since Maduro usurped power in January, we have seen headline after headline: ``Maduro's Forces Kill, Injure Protestors as Standoff Over Aid in Venezuela Escalates''; ``Four Dead, Hundreds Detained After Venezuela Blackout''; and ``Venezuela Security Forces Kill, Punish Anti-Maduro Protestors.'' A few weeks ago, I traveled to the Venezuela-Colombia border, where I heard heartbreaking stories of friends and family members dying of starvation and treatable diseases, all while a brutal dictator does everything possible to prevent aid from being delivered. I met with refugees at hospitals in Colombia and heard their harrowing stories of being on the verge of death due to a lack of medical care. There were a number of high-risk pregnancies as a result. This is a humanitarian crisis that has bled through Venezuela's borders, and it continues to grow. This is personal for us in south Florida, where thousands of Venezuelans who have fled the crisis now call home. We will continue to push for TPS, because our response to this crisis must include supporting our friends and neighbors in south Florida and around the country. Today, in addition to the Venezuela Arms Restriction Act, we will vote on bills introduced by my south Florida colleagues to support the people of Venezuela as they demand free and fair elections. We will vote on bills to provide humanitarian aid directly to the Venezuelan people and a bill targeting Russian influence in Venezuela and its impact on the United States. Today, Congress will not stand idly by as this humanitarian crisis rages on. With the passage of the Venezuela Arms Restriction Act, we will move one step closer to fulfilling our obligations to ensure that no weapons originating in the United States are used to silence dissent through intimidation, repression, and execution. Congress, today, will affirm its commitment to the women and men of Venezuela who are fighting for democracy and a brighter future.

Ms. SHALALA

Ms. SHALALA. Madam Speaker, today, I would like to speak about my dear friend, Congresswoman Louise Slaughter. Louise was larger than life, a force of nature, and a trailblazer for women. She was an embodiment of her district's long history in the women's rights movement, going back to Susan B. Anthony and Frederick Douglass. She would have been so proud to see the record number of women elected to Congress this year. She would have been an extraordinary mentor. She was the best retail politician I have ever known. I have never served in this body with Louise, but, as a Cabinet member, I knew her well and joined her in her district eight times and had numerous phone calls over the years. She held degrees in microbiology and public health. Her knowledge of health policy and her political smarts helped her shepherd critical legislation. Thanks to Louise, we have the Affordable Care Act, the Violence Against Women Act, and the Genetic Information Nondiscrimination Act, just to name a few. She was the first chairwoman of the Rules Committee. I am proud to now serve on this committee. It is Louise's spirit that keeps all of us going through long Rules Committee meetings. We should all aspire to be the person she was, to tirelessly serve our constituents, the Constitution, and this country.

Ms. SHALALA

Ms. SHALALA. Madam Speaker, last weekend, I traveled to the Colombia- Venezuela border to see firsthand the catastrophic humanitarian and public health crisis caused by the criminal Maduro regime. I met with refugees at a hospital in Colombia and heard their harrowing stories of being on the verge of death due to malnutrition, treatable diseases, and a lack of medical care for high-risk pregnancies. People with HIV cannot access antiretroviral drugs, as the government supplies dwindle and the Maduro regime continues to reject humanitarian aid. And now this crisis is spreading. I met with Colombian officials who are doing everything they can to support 1.5 million refugees crossing the border. They can't do it alone. We must increase aid to countries like Colombia for public health. Madam Speaker, our response to the crisis must include supporting the Venezuelan community that has already contributed to the richness of south Florida and the United States. Thousands of Venezuelans claiming political asylum in this country are stuck in limbo because of unnecessary delays in the adjudication of their claims. Granting TPS is necessary and humane for those Venezuelans now here.

Ms. SHALALA

Ms. SHALALA. Mr. Chairman, I have an amendment at the desk.

Ms. SHALALA. Mr. Chairman, last year, we learned that of the 59 EPA hires, roughly a third worked as registered lobbyists or lawyers for fossil fuel producers, chemical manufacturers, or other corporate clients. Several of these EPA hires have gotten waivers, allowing them to participate in actions involving their former clients. This directly impacts my district. In my district, climate change and sea level rise aren't debated. These are not partisan issues because, for Miami, climate change is life or death. There are no climate deniers in south Florida. This is a real-life example of why these ethics waivers matter, and they matter to my constituents. I am very pleased that H.R. 1 mandates that the executive branch promptly disclose waivers of executive branch ethics rules to the Office of Government Ethics. My amendment will maximize transparency by highlighting who is now captured by the upgraded ethics waiver regime. We need to know who is now getting these waivers, why they are getting it, and what are the implications. We need to know the impact so that we can simply uphold our constitutional duty as Members of Congress and hold this administration accountable and hold future administrations accountable. Whether it impacts climate change policy, foreign policy, health policy, or any other issue, the American people deserve to know who is working behind closed doors in their government. Mr. Chair, I urge a ``yes'' vote, and I reserve the balance of my time.

Ms. SHALALA. Mr. Chair, I do not believe that this is an undue burden on the Office of Government Ethics. It is simply a request for us to apply the new waiver to see what the explanations are for the number of ethics waivers that have already been given. It is simply a transparency issue, and it is perfectly appropriate for Congress to request this information. Mr. Chair, I reserve the balance of my time.

Ms. SHALALA. Mr. Chairman, I yield back the balance of my time.