State Health Care Premium Reduction Act

Floor Speech

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Mr. WALDEN. Madam Speaker, I yield myself such time as I may consume.

Madam Speaker, our constituents are looking for us to put aside partisan politics. They want us not to play political games, and they want us to find common ground to address the unprecedented deadly challenges caused by COVID-19.

We need to work together to lower prescription drug prices. We need to work together to aid States in stabilizing health markets damaged by the ACA. We need to work together to lower out-of-pocket costs for patients, including capping seniors' drug costs under Medicare, encourage participation of private health insurance, and we really need to fund our community health centers. We need to increase the options available through the market and end surprise medical billing. We could do all of that. We could do it together, and it could become law.

Unfortunately, instead, here we are wasting time on a partisan bill that has zero chance of becoming law. This is no way to govern at any time, but especially in a pandemic.

At a time when we are asking our Nation's innovators to find new cures and treatments to address COVID-19 at record speed and with record investment, Democrats want to enact a socialist drug pricing scheme that could devastate this country's innovation in the middle of a global pandemic. Frankly, it is unconscionable.

This legislation before us today provides $100 billion in bailouts for insurance companies at a time when insurers are not paying for elective procedures due to COVID. Now, we all want to make premiums more affordable, but all signs are insurers do not need a bailout right now.

Wouldn't that money be better spent, Madam Speaker, on funding our Nation's community health centers, giving them certainty, rather than letting their funding run out in just a matter of months? They are on the front lines of this fight in our communities. They are on the front lines of the fight on testing and treating patients in rural and underserved communities. Shouldn't we fund them, give them stability and certainty?

And speaking of monies poorly spent, today Democrats are proposing we spend $400 million to prop up ObamaCare's enrollment. This includes $100 million for the failed and discredited Navigator Program; $100 million for outreach and marketing, only for ACA-compliant plans, not any of the more affordable alternatives; and $200 million for States to boost enrollment, with no strings attached--no transparency, no accountability.

This law has been on the books for 10 years, and we must spend nearly half a billion dollars to make it look like it is working?

In this bill, Democrats want to force States to expand Medicaid, allowing expansion States to get 100 percent of Federal Medicaid payments, while punishing, in the middle of a pandemic, taking money away from, nonexpansion States, taking it away from their Medicaid. That is what this bill does. If they don't expand, the Federal Government's heavy hand comes in and takes money back out of Medicaid. It is vindictive, and it is probably unconstitutional.

You know, the Supreme Court, Madam Speaker, said expansion is the States' decision. This legislation violates that. We need to work together with the States as partners, not treat them like subordinates.

Now, in the last Congress, I advocated for multiple policies that would help States stabilize health markets damaged by the ACA. But, unfortunately, House Democrats repeatedly blocked our ideas.

We all want patients to have access to high-quality and affordable health coverage, but this measure doubles down on policies that have already failed.

One thing is clear: We need to make our healthcare system work better for all Americans. That is why our goal should be to advance solutions to protect patients, to stabilize healthcare markets, to encourage greater flexibility for States, and to promote policies to help Americans get and keep coverage.

Madam Speaker, I have great respect for the chairman. We have worked together on a number of different issues in the Congress with great success at the Energy and Commerce Committee. Unfortunately, our bipartisan work to lower drug prices was derailed by the Speaker in December when she decided to force politics over real progress.

I recently read an article about a man suffering from ALS who has dedicated his life to finding a cure. And like Americans with ALS, there are millions of Americans suffering from other life-threatening or debilitating diseases, like cancer or sickle cell anemia. They are hoping, and their families are hoping, that one day there will be a cure.

Now, it is not debatable the bill before us today will reduce the number of new treatments in the future, new medicines, new lifesaving medicines, perhaps. The Council of Economic Advisers found there could be more than 100 fewer treatments, fewer medicines, that would never be invented, never be discovered, if this legislation we are going to vote on becomes law--100 fewer.

We can lower drug prices while preserving the hope those praying for a cure have. There is common ground to be had here, and I have offered many times to work on bipartisan legislation to lower drug costs without limiting--perhaps, even ending--innovation.

H.R. 19 is a bill comprised entirely of bipartisan policies. That is our Republican alternative. But it is not just a Republican alternative. Everything in there is bipartisan. And already, seven of the provisions we put in months ago have been signed into law, proving that it is, indeed, a bipartisan package.

Instead of pursuing proven bipartisan solutions, unfortunately, Democrats again are forcing partisan politics on this House and this country, fewer options for patients at a time when we need more treatments and more cures than most.

This bill is a perfect illustration why Americans are so cynical about Washington. The American people deserve better.

Madam Speaker, I urge a ``no'' vote, and I reserve the balance of my time.

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Mr. WALDEN. Madam Speaker, I yield 3 minutes to the gentleman from Texas (Mr. Burgess), the ranking member and former chairman of the Health Subcommittee on the Energy and Commerce Committee.

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Mr. WALDEN. Madam Speaker, I would just point out that as we sit here today, Oklahoma, under a Republican Governor, has chosen to expand Medicaid coverage. That is how it should work, not a penalizing system.

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Mr. WALDEN. Madam Speaker, I yield 2 minutes to the gentleman from Indiana (Mr. Bucshon), a member of the Energy and Commerce Committee.
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Mr. WALDEN. Madam Speaker, one of the greatest tragedies for Therese's family, and that of all other families in America, is what the Congressional Budget Office tells us this bill will do, and that is, 38 fewer cures. 38. What if one of those was a cure for COPD?

Madam Speaker, I yield 2 minutes to the gentleman from Georgia (Mr. Carter), our pharmacist on the committee.
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Mr. WALDEN. Madam Speaker, may I inquire as to how much time each side has remaining?

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Mr. WALDEN. Madam Speaker, I yield 4 minutes to the gentleman from Arkansas (Mr. Westerman).

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Mr. WALDEN. Madam Speaker, may I inquire as to the amount of time remaining and if my friend has any other speakers. We do not, on our side.

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Mr. WALDEN. Madam Speaker, I believe neither of us has any more speakers. I yield myself such time as I may consume to close.

Madam Speaker, we have had a good debate here on the floor. Unfortunately, it is not a debate over a bipartisan piece of legislation. It is a debate over a partisan bill that will never become law. The President's office has issued a recommendation that he would veto this bill, should it ever get out of the Senate and to his desk.

Beyond that, let's talk about what impact this will have in this pandemic.

We have heard a lot about drugs. We know from the Congressional Budget Office that this legislation will reverse the gains and innovation made in the bipartisan 21st Century Cures Act, that it would result in fewer new drug products developed and coming to market. In fact, the Congressional Budget Office estimates that up to 38 fewer medicines would be developed to cure diseases.

My friend from Massachusetts talked about Therese on the doorstep in Lowell, Massachusetts, with COPD. What a tragedy it would be if one of those 38 medicines under development happened to cure COPD.

Maybe it is a cure for COVID-19. Maybe it is a cure for ALS or Alzheimer's or some form of cancer, like the ovarian cancer that claimed my mother.

What we do know is it puts a dagger in the heart of innovation. In fact, those scientists we are all turning to right now, Madam Speaker, these brilliant young men and women in laboratories all across America, especially those out in California at California Life Sciences Association, said this legislation, H.R. 3, part of which is incorporated in this bill, could lead to as much as a 58 percent reduction in revenue, which would significantly reduce investment in partnerships, licensing agreements, and emerging companies, and, therefore, lead to an 88 percent reduction in new medicines developed by small U.S. biotech companies. That number was an 88 percent reduction.

Further, they expect it to eliminate 80,000 high-paying biotech and R&D jobs nationwide. Why would you do that now? Why would you knowingly enact a provision in legislation that would cut 80,000 American high- tech and R&D jobs in the healthcare field, where we are pleading for a cure. We are, dare I say, praying for a cure or a treatment not only for COVID but for these other diseases. The legislation before us today would do that.

We have heard a lot about international price controls this legislation would put in place, government price setting. Now, let's talk about what that means.

For example, when looking at a sample of 270 new medicines launched in the United States from 2011 to 2018, of those available in the United States under our formula, 67 percent are available in Germany, 64 percent in the U.K., 48 percent in Japan, 53 percent in France, about 52 percent in Canada, 41 percent in Australia.

Even in countries where treatment may have been launched, patients often have to wait months, sometimes years, before they get access to that treatment. Compared to the United States, in Australia, it takes an average of 19 months longer for medicines to become available to patients.

By the way, this is the scheme that this legislation wants to put into the United States.

Compared to the U.S., in Canada, it takes an average of 14 months longer for medicines to become available to patients.

More than a year is a long time to wait if you know there is a medicine that could help you with some disease and that medicine has just been developed, and you can get it in America tomorrow and wait 14 months in Canada. In the U.K., it could be 11 months longer.

It doesn't have to be that way. We have H.R. 19. We introduced it at the beginning of this debate some time ago. I think there were seven different provisions that have already become law. Everything in that legislation is bipartisan.

Look, there are going to be differences of opinion among really good people that I work with on a regular basis, and we just disagree on policy. But wouldn't it make more sense to take the things upon which we do agree on policy and move those forward into law while we debate the things where we have a disagreement and work to try and find common ground? But that is not what is happening today.

The navigator program, the bill dumps $100 million more into the exchange user fee program, into the failed navigator program. Let's talk about that a minute.

Navigators enroll less than 1 percent of total enrollees, according to one report. In fact, one awardee of the navigator program had an enrollment goal of 2,000. It kind of missed their goal, Madam Speaker. They enrolled one person.

They eventually enrolled a total of 67 for $2,300 per enrollee. And in the private sector, they do that for about $2.40, not $2,300.

The top 10 navigators signed up just 317 people in 2017. We are going to pump far more money into that. This legislation would do that. We have heard about some of that.

The subsidies in here for some of the wealthiest Americans--kind of ironic that the Democrats would be doing this in their legislation, but they removed the subsidy cap that diverts taxpayer dollars for some of the highest earners in the country.

There is a blank check for insurance companies. I have talked about the loss of cures, up to 38 in the next 20 years. Remember, the 10- and 20-year pipelines here, there are some estimates that there could be hundreds of new drugs.

When I think about the farmer in Minnesota we heard about with $20,000 in premiums per year and $12,000 copayments, that is what America got from the ``Affordable Care Act.'' That is what ObamaCare delivered. It didn't do anything to go after the costs of healthcare.

The Trump administration, conversely, has done a lot to go after the cost of healthcare. I have been with the President when he announced initiatives to make hospitals disclose their costs so Americans could shop and we could get competition. We had no more left the Roosevelt Room and returned to the Oval Office when the Secretary of Health and Human Services announced the American Hospital Association already filed suit to stop that transparency in disclosure.

By the way, the administration just won a judgment in court that they can proceed to get that disclosure so consumers can know what things cost and make informed decisions.

We worked together across the aisle when I was chairman of the Energy and Commerce Committee on really powerful legislation to address the opioid crisis in America. We put enormous amounts of money into our community health centers. We fully funded, for a decade, the Children's Health Insurance Program, and we did all of that in a very, very bipartisan way.

We, in the last few years, under the Republican majorities, rewrote America's mental health laws. We all know there is more to be done to get mental health services into our communities, but we have put an unprecedented amount of support into mental health services.

Meanwhile, our community health centers, under the Democrats, continue to get an every-couple-of-month infusion of money, which is enormously frustrating for them. I know when I was chairman, it made national headlines that there were some levels of delay in fully funding our community health centers, and we ended up getting them a 2- year, fully funded, at the highest level ever, funding guarantee.

Their money runs out in November. Why are we doing that? Why aren't we taking that up?

The President led the effort on surprise medical billing so that, even if you have insurance and you end up like a woman in Colorado who, a few years back, gave birth to her second son. That child, born in a hospital, covered by her insurance, doctors covered by her insurance, had a medical issue after birth and had to go to the neonatal intensive care unit--just down the hall, by the way. It turned out that that hospital had contracted out that neonatal intensive care unit, and it turns out it wasn't in her insurance at all. Now, how in the heck does a consumer know that?

We have bipartisan surprise billing legislation. It passed out of the Energy and Commerce Committee a year ago and has yet to come to the floor of the House under the Democrats. So, meanwhile, consumers are getting stuck with surprise bills when they are playing by the rules. It continues and it shouldn't. Hopefully, we can get that legislation to the President's desk. He is ready to sign it.

Meanwhile, we have made record investments at NIH, and we reauthorized the user fee agreement so that FDA, the Food and Drug Administration, our innovators, can bring their drugs and new medical devices to market faster than any time and still safe. We did that under Republican legislation and signed by President Trump.

President Trump invoked the Defense Production Act when we didn't have enough ventilators or masks or gowns to order companies to make swabs, to make ventilators and move forward and continued that investment.

And that was in a bipartisan way, by the way, with the CARES Act. We can do bipartisan work. We are just not doing it today.

The choice to do partisan or bipartisan work is always made by the majority. When I was chairman I could move anything I wanted, generally speaking, at any time, but I chose to try and make the bulk of our work--nearly all of our work--bipartisan because I actually wanted it to become law.

The drug bill Democrats passed earlier this year that takes away access to new medicines and put 88,000 jobs in the high-tech world of innovation in medicine, that bill is going nowhere. This bill is going nowhere. The police reform bill is going nowhere.

What a tragedy. What a lot of opportunity. Because there are many, many of us on this side of the aisle, as the Speaker knows, who stand ready to work in a bipartisan way to get good policy and to solve problems for the American people.

Madam Speaker, it is unfortunate we find ourselves here today when Americans expect so much more out of this institution. I hope people will show up and we can actually do our work and actually do it in a way that will bring a positive view on this House and on our ability to solve these enormous problems that the American people are facing, whether they are suffering from COPD or simply higher insurance premiums and deductibles.

What good is your insurance plan if you can't afford to use it, or when you think you followed all of the rules to use it and then find out they contracted out the emergency room and nobody covers the costs there?

So let's defeat this now. Let's go to a room where we can work these things out, we can find common ground here that won't put a dagger in the heart of innovative jobs in America, that won't slow innovation in medicine and medical devices, lifesaving medicines, but that will bring better healthcare for Americans.

Finally, on the issue of preexisting conditions, the President has been very clear he supports protecting people with preexisting conditions, as do I, going back to when I was in the State legislature in Oregon. We made efforts to do that.

I have had legislation since the opening day of this Congress to make sure, regardless of how the lawsuit comes out, that we protect people with preexisting conditions. The Democrats won't let us bring this bill to the floor.

So, Madam Speaker, I urge a ``no'' vote on this legislation, and I yield back the balance of my time.

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Mr. WALDEN. Madam Speaker, I have a motion to recommit at the desk.

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Mr. WALDEN. Madam Speaker, in its current form, I am.

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Mr. WALDEN. Madam Speaker, this motion should be adopted. It would prevent the bill from upending the very progress we are all counting on for our innovators to develop new vaccines and therapies to confront this killer coronavirus.

You see, it simply states the legislation cannot take effect unless the Secretary of Health and Human Serves certifies that no provision will adversely impact the research, the development, or the approval of any drug intended to treat or prevent COVID-19.

Now, Democrats, with a straight face, come to the floor today to move a bill that would do grave damage to medical innovation. The Congressional Budget Office has told us that on many occasions. Upwards of 30 to 100 drugs, depending upon the source, could never make it into the pipeline. Will that be a cure for COVID or a cure for ALS or a cure for cancer? We don't know, and neither do the Democrats bringing it. But we do know the independent analyses show we will not see a lot of new medicines.

So let's make sure one of those new medicines is not the cure to COVID or a treatment to save lives for people who are on ventilators. That is what our motion to recommit says: Before you move forward with a known innovation killer, let's at least exclude treatments and cures for COVID-19.

Communities are being ravaged, we all know these stories. We all share them with each other about incredible damage done to lungs, organs, and lives as a result of COVID-19. In the wake of this public health crisis, medical innovators have worked at an unprecedented speed to develop safe and effective products so we can safely begin to open our country back up and eventually return to normal lives.

We have seen public-private partnerships to a degree never seen before. Private companies are joining forces with competitors, government agencies, and nonprofits, and they have taken on substantial financial risk in order to bring safe and effective vaccines and treatment to patients as quickly as possible.

But now Democrats, with passage of this bill, want to gut innovation in America.

California Life Sciences tells us the provisions of this bill that were included in H.R. 3 can result in 88,000 innovation tech jobs, R&D jobs going away from America to somewhere else. That is the price of this bill. We know House Democrats voted to impose these dangerous price controls with passage of H.R. 3.

We also know that one of the side benefits, shall we say, of adopting socialized medicine is you don't get access to new medicines when they do become available in as timely a manner as you do here. Compared to the U.S., in Australia, it takes an average of 19 months longer for medicines to become available to patients; for Canada, it is up to 14 months longer; United Kingdom, 11 months longer for those cures for cancer, those new medicines on the market, revolutionary sort of new innovations we all want.

So all we are asking for here is, before your bill becomes law--and, by the way, the administration said they will recommend a veto--before it moves through the path, let's at least make sure that an unintended but dangerous consequence of this bill does not take effect, and that is let's make sure that it will not inhibit research and innovation for a treatment or cure to COVID-19. That is what our motion asks for.

Madam Speaker, I urge a ``yes'' vote on the motion to recommit.

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

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

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