Greg Walden

Mr. WALDEN

Mr. WALDEN. Madam Speaker, Congress has already passed and President Trump has already signed into law a ban on tobacco product sales, including vaping product sales to children under the age of 21. We did that. It is now law. Those are banned. The Food and Drug Administration is aggressively going after companies that still try to target kids and has the authority to stop them--and will. But we all care deeply about the health of our children. Taking care to protect the health and welfare of children is a common cause. We know that the younger the child, the more vulnerable and defenseless they are, the more these children need our help. That is why we are offering a final amendment to the bill that literally would save the lives of the youngest children, the babies. I would hope we could agree to end the ghastly practice of letting children die without medical help when they are born alive after an abortion. Providing, literally, lifesaving medical care to these babies is something on which we should all find common ground and support. It is the right thing to do. It is the right thing to do for the children. These are not fetuses that are born. These are tiny little babies that are struggling to live. Madam Speaker, I yield to the gentlewoman from Missouri (Mrs. Wagner), author of the Born-Alive Abortion Survivors Protection Act, a mother and a grandmother herself, who always puts the lives of children first.

Mr. WALDEN. Madam Speaker, I yield back the balance of my time.

Mr. WALDEN. Madam Speaker, on that I demand the yeas and nays.

Mr. WALDEN. Madam Speaker, on that I demand the yeas and nays.

Mr. WALDEN

Mr. WALDEN. Madam Speaker, I yield myself such time as I may consume. Madam Speaker, my colleague from the Energy and Commerce Committee and I do disagree on this bill. Every Member in this Chamber is concerned, and rightfully so, about the rise in youth tobacco use. We all know this: Smoking is harmful, and we must do what we can to prevent use by children and adolescents. This is a goal that we share as Republicans and Democrats and with President Trump, which is why we have worked together to address the increase in youth tobacco use by making it illegal for anybody under the age of 21 to buy these products. We have done that together. We have passed that. It is now law. The use of traditional tobacco products by children has actually declined over the last decade. In fact, the surge in tobacco use in recent years has been caused by one thing, and that is the emerging popularity of e-cigarettes, vaping. The use of e-cigarettes increased from 3.6 million youth users in 2018 to 5.4 million last year. That increase is truly alarming. But that is not what this bill addresses. We addressed youth vaping when we raised the age to 21 to be able to buy these tobacco products. Most children were acquiring e-cigarettes through social sourcing. So, what does that mean? This occurs in high schools where kids who are over 18 at that time would acquire the products and then resell them to kids who were under 18. That is what was going on. By moving the legal age to 21, we have closed that loophole. We unanimously passed legislation requiring online retailers to verify age at the time of sale and delivery. That bill is still awaiting the Senate's action, but I think it demonstrates that we did come together in a bipartisan way to address this problem. Now the legislation before us goes much further than most of us can support, because what it does is make legal products for adults illegal. Now, I am not a smoker, I am not a chewer, I don't do any of that stuff, but I know a lot of people who do. And they use these products as adults, and these flavored products will be banned under this law. So if you do chew, if you do smoke, if you use these menthol cigarettes or menthol chew or something, and you are an adult, this legal product today will be illegal if this bill were to become law. Now, meanwhile, the majority Democrats have refused to address another issue that is a big problem in my communities and my schools. Marijuana-based products can still be flavored, and they are not covered by this legislation. Now, they will say, oh, that is illegal in America anyway. Well, we all know states like Oregon and others that have passed these rules, nobody is enforcing the law against marijuana, it is Federal. But what we do have is literally products named CannaKids grape flavor. Another one over here CannaKids. This is what is happening. They are using these products mixed with acetate vitamin E oil to cut it with cannabis products, THC products, and they are vaping those. That is left out of this legislation. So you can't go to the store and get your snuff and chew that or whatever you do with it if it is menthol, but you can still go to the pot store and get this. That makes no sense to me. Madam Speaker, I reserve the balance of my time

Mr. WALDEN. Madam Speaker, I yield myself such time as I may consume. Madam Speaker, I commend my colleague for her comments and putting this letter into the Record. She is absolutely right, according to the ACLU, the National Association of Social Workers, the Law Enforcement Action Partnership. They say in this letter: ``Any ban on menthol cigarettes will disproportionately affect people of color.'' They go on to talk about how other criminal laws will be affected under this act, including those that could lead, their concern, to the sort of stop and frisk that occurred in New York in the Eric Garner case that they cite in this letter. Madam Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Flores).

Mr. WALDEN. Madam Speaker, I yield 2\1/2\ minutes to the gentleman from North Carolina (Mr. Hudson), a distinguished member of the Energy and Commerce Committee.

Mr. WALDEN. Madam Speaker, I yield myself such time as I may consume. I want to point out again that if you want to do something about kids, if you want to do something about lung disease, then we need to do something about marijuana and the oils it gets mixed with that this bill does not address. These are literally named CannaKids--CannaKids, flavors. What does this one say? Liquid Black Cherry, DOPE. They voted that down when we tried to put this in the bill to ban it. If you are going to ban something, let's ban something kids are using. But, no, we let the marijuana products go forward. Madam Speaker, I yield 2 minutes to the gentleman from Georgia (Mr. Allen).

Mr. WALDEN. Madam Speaker, I would inquire how much time is remaining on each side.

Mr. WALDEN. Madam Speaker, I yield myself such time as I may consume. Madam Speaker, I just want to point out the administration, in their opposition to this legislation, reminds us that, in January of 2020, the administration issued guidance to prioritize enforcement against the unauthorized marketing of certain vaping products to youth. The FDA is conducting regular surveillance and, when appropriate, taking enforcement measures against websites, social media, and other publications that advertise regulated tobacco products. And the Speaker knows, the President signed into law the ban against these products being sold to anyone 21 and under. So we agree that it is about the children. We believe Congress has acted in this measure. This bill is about adults. Madam Speaker, I yield 1\1/2\ minutes to the gentlewoman from North Carolina (Ms. Foxx), the top Republican on the Education and Labor Committee.

Mr. WALDEN. Madam Speaker, I yield 2 minutes to the gentleman from North Carolina (Mr. Bishop).

Mr. WALDEN. Madam Speaker, may I inquire as to the time available on both sides.

Mr. WALDEN. Madam Speaker, I yield 2 minutes to the gentleman from Kentucky (Mr. Comer).

Mr. WALDEN. Madam Speaker, I reserve the balance of my time.

Mr. WALDEN. I continue to reserve the balance of my time, Madam Speaker.

Mr. WALDEN

Mr. WALDEN. Madam Speaker, on February 14, Oregon celebrates her 161st birthday. As a lifelong Oregonian whose ancestors came there by wagon train in 1845, I may be a little biased, but I can confidently say there is no place like Oregon. She boasts of so many unparalleled wonders and sights from the mighty, powerful Columbia River and the winds of the Columbia River Gorge to the majestic Painted Hills to the rugged landscape of the Umatilla National Forest, the clear, deep blue waters of Crater Lake, the deepest lake in North America. Then think about the great Cascade Mountains or Steens Mountain or the Wallowas or the Blues, and then all the way down to the depths of Hells Canyon. The late great Republican Governor Tom McCall said it best. He said, ``Oregon is an inspiration. Whether you come to it, or are born to it, you become entranced by our State's beauty, the opportunity she affords, and the independent spirit of her citizens.'' Madam Speaker, I wish a happy birthday to Oregon. She truly does fly with her own wings.

Mr. WALDEN

Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in opposition to this resolution. We wouldn't be having what is going to be a spirited debate today over the facts if the Energy and Commerce Committee had bothered to have a hearing on the underlying issue. I have asked the chairman, my friend, Mr. Pallone, to do exactly that. He cited a source, Kaiser Family Foundation, saying pregnant women are going to be involved in all of this. The head of CMS and their lawyers say: Not true. Not the case at all. So here we have a disputed fact on the floor being hammered out here without the benefit of due process and regular order. There has been no regular order, no hearing, no opportunity to bring in these very qualified people, and do what we do best in this Congress, which is listen to the experts, take the testimony, make up our minds, and have debates. No. The administration put out their letter, their guidance, saying here is how States can innovate. Our State of Oregon spent a lot on innovation in this space. We were both in the State legislature at times, and we sought waivers as a State so we could innovate, create the Oregon Health Plan, and do all of these things. Forty States have waivers. Most of our States have waivers so they can innovate; so they can bring better healthcare to the working poor; and find cost savings they can plow back into better services and more services, which is what this underlying proposal allows. Let me talk about a couple of things: One, there is no mandate here. This is not, as my friend describes, some evil-empire approach where the Trump administration is forcing something on States. That is factually not the case. This is States seeking an option to innovate and provide better healthcare at lower costs to the people they are trying to serve. They would have to meet rigorous standards, including all of the essential health benefits required under ObamaCare. That is a requirement here. They can't walk away from that. This applies to able-bodied adults, not to children, not to people with disabilities, on down that list of mandatory populations. This does not affect the mandatory. This is only the expansion population in the States that expanded Medicaid. They are going to argue differently because I heard it in the Rules Committee. I can tell you directly from CMS, that is not the case. That is not their intent. That is not what they have suggested. That is not in their proposal. If we are going to have this difference of opinion, I go back to the underlying issue here. Why in the devil did we not take an hour or two to do regular order and have the Subcommittee on Health, chaired by my dear friend from California, Ms. Eshoo, who could have done a great job having a hearing? She can be rigorous on the administration. We could have hashed this out there. But no. This isn't even a resolution of disapproval that stops what the administration is proposing. This is the partisan equivalent of a press release. It is a sense of Congress saying: We don't like this. So when we are done with that, then what happens? Nothing. This is a partisan, political, pathetic debate that serves no real legislative purpose. Done. If you want to argue legislation, the grownup work we do so well at Energy and Commerce, then let's have a legislative hearing. Let's bring in the Kaiser Family Foundation that was just cited and hold them accountable under oath to show us where what they claim is fact. We can dispute whether something is legal or not. Let's have the lawyers there to give us guidance. But that is not what we are doing. On Monday afternoon, this language got posted. We went to the Rules Committee. We asked for an opportunity to have an alternative, a motion to recommit on this issue. We were denied that. We had no opportunity to dig into the facts and the figures. We do know one thing: Our States are great laboratories for innovation. They really are. California has waivers. Oregon has waivers. A lot of States have waivers. We had it back in the day when, I think, Project Independence was a waiver from Medicaid because we thought we could do it better and be a laboratory. This administration believes in that. States can, those closest to the people can create even better programs to take care of those they serve. This is a Federal-State partnership. Mr. Speaker, I object to this resolution. Mr. Speaker, I rise in opposition to House Resolution 826; a resolution hastily put together that opposes the Administration's Healthy Opportunity demonstration initiative in Medicaid. The Centers for Medicare and Medicaid Services introduced a voluntary proposal to allow states to file for an 1115 Waiver called the Healthy Adult Opportunity Initiative. This is an option; let me emphasize, an option, for states for certain able-bodied adults-only. This optional Healthy Adult Opportunity Initiative does not apply to children, seniors, or those with disabilities--just able-bodied adults. It is a prepackaged set of flexibilities, most of which are already used by states in running their programs. There are many provisions in this proposal that we can all get behind: lowering drug costs, increasing transparency, and greater access to health care. These proposals build on bipartisan legislation we've worked on in the past. Administrator Verma released a 56-page letter for the demonstration initiative on January 30th. Industry groups were already voicing opposition to the initiative only an hour later--pretty quick to read it and write an opposition to it if you ask me. House members were faster than that. The day before the plan was released, 36 House members sent a letter to Secretary Azar and Administrator Verma opposing the initiative. How can you oppose something you haven't even seen? The resolution says that the goal of the Waiver Opportunity is to deprive Medicaid beneficiaries of health services. But on Page 7, CMS points out that any state electing to participate in this demonstration initiative will be expected, at a minimum, to provide coverage of items and services in the categories of the ACA's Essential Health Benefits (EHBs), benefits such as (1) ambulatory patient services; (2) emergency services; (3) hospitalization; (4) maternity and newborn care; (5) mental health and substance use disorder services, including behavioral health treatment; (6) prescription drugs; (7) rehabilitative and habilitative services and devices; (8) laboratory services; (9) preventive and wellness services and chronic disease management; and (10) pediatric services, including oral and vision care, which generally are not applicable for the populations that would be covered under any state that participates in the Waiver Opportunity. The resolution also asserts the initiative would roll back access standards. But on Page 4, CMS expressly states that those who participate in the demonstration will be monitored to ensure health outcomes are achieved. This resolution is just another case of Democrats putting partisan political rhetoric in the way of facts and meaningful health reform. The Healthy Adult Opportunity--if states choose to participate in it--will not give states the ability to cap beneficiary enrollment or cut benefits. CMS is putting an expenditure cap on the waiver should a state choose to take this option, but expenditure caps are fairly common in health programs. For example, the Children's Health Insurance Program (CHIP) and many section 1115 Medicaid demonstrations (of which more than 40 states currently participate voluntarily) already operate under a funding ceiling. I want to point out that while total federal funding will be capped, the waiver does not change the need for states to submit claims reflecting actual expenditures to obtain federal matching funds for the Medicaid program and to maintain health outcomes as under current law. Again, states will not be allowed to cap enrollment and qualify for the statutory enhanced federal match rate for this expansion population. Finally, to the extent a State achieves savings and demonstrate no declines in access or quality, CMS will share back a portion of the federal savings for reinvestment into Medicaid. Perhaps, this sort of shared responsibility and incentives could help the people the Medicaid program is intended to serve. Now, to be clear, I agree this is a major proposal, one that needs to be examined carefully. To that end, let's have a committee hearing at Energy and Commerce, the Committee with jurisdiction over Medicaid, where we can hear from stakeholders as well as the Administration and walk through the facts of the Waiver Opportunity. Instead of a hurried disapproval resolution that bypassed the Committee process, let's do the work at the Committee level to examine this proposal carefully. When I was Chairman of the Energy and Commerce Committee, we were committed to a process of regular order, allowing for enough time to have meaningful debate and examination of the issues that came before our committee. House Democrats said they are just as committed to regular order, yet time and time again, we come to the House floor to debate bills or resolution with no committee process and always for partisan political theatre. Instead of this resolution, we should be voting to end surprise billing. We should be debating how to avoid the Part D catastrophic cliff Obamacare created. We should be considering bipartisan legislation to lower drug prices. This is another episode of House Democrats putting politics over progress. Mr. Speaker, I reserve the balance of my time.

Mr. WALDEN. Mr. Speaker, I yield 2 minutes to the gentleman from Ohio (Mr. Latta).

Mr. WALDEN. Mr. Speaker, I have to just respond in that none of that is what is in this resolution because this resolution has no force of law. This resolution is not healthcare policy; it is a press statement. It does nothing to deal with any of the issues my dear friend has just raised, other than make a statement. Do you want to legislate? Then legislate. Let's go have a hearing. Let's go have a markup. Let's go work on these issues together. Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Burgess). The good doctor is the former chairman of the Health Subcommittee.

Mr. WALDEN. Mr. Speaker, once again, I just point out the State Governor would have to seek a waiver and get approval to maintain all the essential benefits of the Affordable Care Act in everything they do. This only applies in States that took the expansion, not others. States are the great laboratories that innovate and deliver healthcare better for the working poor. Mr. Speaker, I yield 2 minutes to the gentlewoman from Washington (Mrs. Rodgers).

Mr. WALDEN. Mr. Speaker, could I inquire as to how much time each side has remaining.

Mr. WALDEN. Mr. Speaker, I yield 2 minutes to the gentleman from Michigan (Mr. Mitchell).

Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume. I just point out that, again, this is a State option. Nobody is mandating anything on any State. States can come to the Federal Government, as they willfully do, and say: We have a better idea to take care of the working poor. We think we can achieve some savings that we understand. If we do, we will be plowed back into more benefits and services in some large measure to improve and expand Medicaid in our State. Mr. Speaker, our States have done that. As you know, others are. This is an option. It is not a mandate. Finally, the resolution on the floor today has no legal effect on any of this. It is a press release called a resolution. It never even goes to the Senate. It will never go to the President. It will never become a law. It is just a press statement. Mr. Speaker, so for all the comments about stopping this and stopping that, you do that with legislation. That is why we have said you ought to have a hearing in the committee of jurisdiction. If you want to mark up a bill, let's go do that. Let's have witnesses. Let's do what we do best around here. But we are not doing this. Mr. Speaker, I yield 2 minutes to the gentleman from Georgia (Mr. Carter), Congress' pharmacist.

Mr. WALDEN. Mr. Speaker, I yield 2 minutes to the gentleman from Kentucky (Mr. Guthrie).

Mr. WALDEN. Mr. Speaker, I reserve the balance of my time.