RESTORING ACCESS TO MEDICATION AND IMPROVING HEALTH SAVINGS ACT OF 2016; Congressional Record Vol. 162, No. 108
(House of Representatives - July 06, 2016)

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[Pages H4325-H4331]
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RESTORING ACCESS TO MEDICATION AND IMPROVING HEALTH SAVINGS ACT OF 2016

  Ms. JENKINS of Kansas. Mr. Speaker, pursuant to House Resolution 793, 
I call up the bill (H.R. 1270) to amend the Internal Revenue Code of 
1986 to repeal the amendments made by the Patient Protection and 
Affordable Care Act which disqualify expenses for over-the-counter 
drugs under health savings accounts and health flexible spending 
arrangements, and ask for its immediate consideration.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Pursuant to House Resolution 793, in lieu of 
the amendment in the nature of a substitute recommended by the 
Committee on Ways and Means, printed in the bill, an amendment in the 
nature of a substitute consisting of the text of Rules Committee Print 
114-60, is adopted, and the bill, as amended, is considered read.
  The text of the bill, as amended, is as follows:

                               H.R. 1270

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Restoring Access to 
     Medication and Improving Health Savings Act of 2016''.

          TITLE I--RESTORING ACCESS TO MEDICATION ACT OF 2016

     SEC. 101. SHORT TITLE.

       This title may be cited as the ``Restoring Access to 
     Medication Act of 2016''.

     SEC. 102. REPEAL OF DISQUALIFICATION OF EXPENSES FOR OVER-
                   THE-COUNTER DRUGS UNDER CERTAIN ACCOUNTS AND 
                   ARRANGEMENTS.

       (a) HSAs.--Section 223(d)(2)(A) of the Internal Revenue 
     Code of 1986 is amended by striking the last sentence.
       (b) Archer MSAs.--Section 220(d)(2)(A) of such Code is 
     amended by striking the last sentence.
       (c) Health Flexible Spending Arrangements and Health 
     Reimbursement Arrangements.--Section 106 of such Code is 
     amended by striking subsection (f).
       (d) Effective Date.--The amendments made by this section 
     shall apply to expenses incurred after December 31, 2016.

               TITLE II--HEALTH CARE SECURITY ACT OF 2016

     SEC. 201. SHORT TITLE.

       This title may be cited as the ``Health Care Security Act 
     of 2016''.

     SEC. 202. ALLOW BOTH SPOUSES TO MAKE CATCH-UP CONTRIBUTIONS 
                   TO THE SAME HEALTH SAVINGS ACCOUNT.

       (a) In General.--Section 223(b)(5) of the Internal Revenue 
     Code of 1986 is amended to read as follows:
       ``(5) Special rule for married individuals with family 
     coverage.--
       ``(A) In general.--In the case of individuals who are 
     married to each other, if both spouses are eligible 
     individuals and either spouse has family coverage under a 
     high deductible health plan as of the first day of any 
     month--
       ``(i) the limitation under paragraph (1) shall be applied 
     by not taking into account any other high deductible health 
     plan coverage of either spouse (and if such spouses both have 
     family coverage under separate high deductible health plans, 
     only one such coverage shall be taken into account),

[[Page H4326]]

       ``(ii) such limitation (after application of clause (i)) 
     shall be reduced by the aggregate amount paid to Archer MSAs 
     of such spouses for the taxable year, and
       ``(iii) such limitation (after application of clauses (i) 
     and (ii)) shall be divided equally between such spouses 
     unless they agree on a different division.
       ``(B) Treatment of additional contribution amounts.--If 
     both spouses referred to in subparagraph (A) have attained 
     age 55 before the close of the taxable year, the limitation 
     referred to in subparagraph (A)(iii) which is subject to 
     division between the spouses shall include the additional 
     contribution amounts determined under paragraph (3) for both 
     spouses. In any other case, any additional contribution 
     amount determined under paragraph (3) shall not be taken into 
     account under subparagraph (A)(iii) and shall not be subject 
     to division between the spouses.''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to taxable years beginning after December 31, 
     2016.

     SEC. 203. SPECIAL RULE FOR CERTAIN MEDICAL EXPENSES INCURRED 
                   BEFORE ESTABLISHMENT OF HEALTH SAVINGS ACCOUNT.

       (a) In General.--Section 223(d)(2) of the Internal Revenue 
     Code of 1986 is amended by adding at the end the following 
     new subparagraph:
       ``(D) Treatment of certain medical expenses incurred before 
     establishment of account.--If a health savings account is 
     established during the 60-day period beginning on the date 
     that coverage of the account beneficiary under a high 
     deductible health plan begins, then, solely for purposes of 
     determining whether an amount paid is used for a qualified 
     medical expense, such account shall be treated as having been 
     established on the date that such coverage begins.''.
       (b) Effective Date.--The amendment made by this section 
     shall apply with respect to coverage beginning after December 
     31, 2016.

     SEC. 204. MAXIMUM CONTRIBUTION LIMIT TO HEALTH SAVINGS 
                   ACCOUNT INCREASED TO AMOUNT OF DEDUCTIBLE AND 
                   OUT-OF-POCKET LIMITATION.

       (a) Self-Only Coverage.--Section 223(b)(2)(A) of the 
     Internal Revenue Code of 1986 is amended by striking 
     ``$2,250'' and inserting ``the amount in effect under 
     subsection (c)(2)(A)(ii)(I)''.
       (b) Family Coverage.--Section 223(b)(2)(B) of such Code is 
     amended by striking ``$4,500'' and inserting ``the amount in 
     effect under subsection (c)(2)(A)(ii)(II)''.
       (c) Conforming Amendments.--Section 223(g)(1) of such Code 
     is amended--
       (1) by striking ``subsections (b)(2) and'' both places it 
     appears and inserting ``subsection'', and
       (2) by striking ``determined by'' in subparagraph (B) 
     thereof and all that follows through `` `calendar year 
     2003'.'' and inserting ``determined by substituting `calendar 
     year 2003' for `calendar year 1992' in subparagraph (B) 
     thereof .''.
       (d) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2016.

   TITLE III--PROTECTING TAXPAYERS BY RECOVERING IMPROPER OBAMACARE 
                        SUBSIDY OVERPAYMENTS ACT

     SEC. 301. SHORT TITLE.

       This title may be cited as the ``Protecting Taxpayers by 
     Recovering Improper Obamacare Subsidy Overpayments Act''.

     SEC. 302. RECOVERY OF IMPROPER OVERPAYMENTS RESULTING FROM 
                   CERTAIN FEDERALLY SUBSIDIZED HEALTH INSURANCE.

       (a) In General.--Section 36B(f)(2)(B)(i) of the Internal 
     Revenue Code of 1986 is amended to read as follows:
       ``(i) In general.--In the case of a taxpayer whose 
     household income is less than 300 percent of the poverty line 
     for the size of the family involved for the taxable year, the 
     amount of the increase under subparagraph (A) shall in no 
     event exceed the applicable dollar amount determined in 
     accordance with the following table (one-half of such amount 
     in the case of a taxpayer whose tax is determined under 
     section 1(c) for the taxable year):


------------------------------------------------------------------------
 ``If the household income (expressed as a  The applicable dollar amount
       percent of poverty line) is:                      is:
------------------------------------------------------------------------
Less than 200%............................  $600
At least 200% but less than 250%..........  $1,500
At least 250% but less than 300%..........  $3,000.''.
------------------------------------------------------------------------

       (b) Effective Date.--The amendment made by this section 
     shall apply to taxable years beginning after December 31, 
     2016.

  The SPEAKER pro tempore. The bill shall be debatable for 1 hour, 
equally divided and controlled by the chair and ranking minority member 
of the Committee on Ways and Means.
  The gentlewoman from Kansas (Ms. Jenkins) and the gentleman from 
Michigan (Mr. Levin) each will control 30 minutes.
  The Chair recognizes the gentlewoman from Kansas.


                             General Leave

  Ms. JENKINS of Kansas. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days in which to revise and extend their 
remarks and include extraneous material on H.R. 1270, currently under 
consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Kansas?
  There was no objection.
  Ms. JENKINS of Kansas. Mr. Speaker, I yield myself such time as I may 
consume.
  I rise today in support of H.R. 1270, the Restoring Access to 
Medication and Improving Health Savings Act. This bill contains 
policies that folks on both sides of the aisle can support and have 
supported in the past.
  With the cost of health care rising, from hospital stays to doctor 
visits and prescription drugs, and the ever-present regulatory burdens 
of the Patient Protection and Affordable Care Act, H.R. 1270 combines 
three measures that put the people back in control of their own 
healthcare spending, gain more access to the over-the-counter 
medications they need, and decrease government spending.
  One of the most head-scratching provisions of ObamaCare requires 
people to get a doctor's prescription if they want to buy over-the-
counter medicines at a pharmacy with their HSA money. This provision is 
just about the polar opposite to what most folks think of when buying 
aspirin or other common medicines at their pharmacy.
  Instead of simply walking in and paying with their HSA card for that 
medicine, they are turned down and told to set up an appointment with 
their doctor just to get a script for that medicine. It does not 
decrease costs for the patient or the government. It actually increases 
the burden people have to get those medications. Now they must make the 
appointment, wait for days or weeks for the visit, and take that 
doctor's time away from sick patients, all to get some allergy 
medicine.
  H.R. 1270 will allow people to use their HSAs to buy over-the-counter 
medications at pharmacies because, when someone needs some allergy 
medicine during this time, they should be able to get that medicine 
whenever they need it.
  With that, H.R. 1270 will allow people to put more into their HSA 
accounts and match the amount of their deductible and out-of-pocket 
costs. It will allow people to contribute $6,550 individually and 
$13,100 for a family, and those amounts will grow with inflation.
  Another provision that makes it harder to use an HSA declares that 
taxpayers may use HSA funds only for qualified medical expenses 
incurred after the establishment of the HSA, which might be some time 
after the establishment of the associated high-deductible health plan, 
or HDHP. The provision would treat HSAs opened within 60 days after 
gaining coverage under an HDHP as having been opened on the same day as 
the HDHP.
  Also, for eligible older, married Americans, this bill allows them to 
contribute catch-up contributions to one shared HSA, simplifying the 
saving process and ultimately enabling them to save more and gain more 
control over their own health care.
  Finally, H.R. 1270 will better protect taxpayer dollars and modify 
existing limits on the amounts to be repaid by those whose advance 
payments exceed the ObamaCare subsidy to which they are entitled. This 
is a bipartisan offset. Twice, Congress has voted to increase the 
amount of improper ObamaCare subsidy overpayments that need to be 
repaid. Increasing the recovery of improper subsidy overpayments was 
first proposed by Senate Democrats in the 2010 Medicare doc fix and 
extenders legislation. Former HHS Secretary Sebelius described this 
offset as making it ``fairer'' for all taxpayers.
  As currently structured, the Democrats' healthcare law fails to 
adequately protect taxpayers from overpayments of the Federal subsidies 
to purchase health insurance, even in the case of fraud. The current 
law limits the amount of money that can be recouped if recipients 
receive a greater subsidy than they are entitled to, even if that means 
keeping thousands of extra dollars in overpayments.
  H.R. 1270 ensures full repayment for those making more than 300 
percent of the Federal poverty level and doubles the current repayment 
cap for those between 250 and 300 percent of the Federal poverty level. 
This is not a tax increase or a way to punish those who receive a pay 
increase; rather, it is a measure to show our constituents that we are 
taking care of their tax dollars by requiring the return of 
overpayments.

[[Page H4327]]

  Mr. Speaker, I reserve the balance of my time.
  Mr. LEVIN. Mr. Speaker, I yield myself such time as I may consume.
  The House was originally scheduled to take up this bill tomorrow--
tomorrow. There was a hole, a hole created by Republicans' refusal to 
consider meaningful legislation to address gun violence in this 
country.
  I was on the steps of the Capitol earlier today hearing the poignant 
stories--at times, virtually unbearable to hear--from victims of gun 
violence, the shattering impact on themselves or their children, and 
what it means in real terms for the lives of their families.
  The bill now before us can be simply described: a tax cut mainly for 
the most wealthy, being paid for by the loss of health coverage for 
130,000 Americans.
  As the White House noted in its Statement of Administration Policy:
  ``The administration strongly opposes House passage of H.R. 1270, 
which would create new and unnecessary tax breaks that 
disproportionately benefit high-income people, increase taxes for low- 
and middle-income people, and do nothing to improve the quality of or 
address the underlying cost of health care.''
  The Republicans have totally failed during the 6 years of healthcare 
reform to present an alternative. Instead, it is repeal or destroy the 
ACA. This is the 64th vote to repeal or undermine the ACA.
  This bill is one of their scattered proposals on health care. 
According to the Joint Tax Committee, of the approximately 1.2 million 
returns in 2013 with an HSA deduction, more than 50 percent are from 
people with incomes ranging from $100,000 to $200,000 to over $1 
million. This bill would double their tax benefit.
  For Republicans, their banner is ``the more income inequality, the 
better.''
  I strongly urge my colleagues to vote ``no.''
  Mr. Speaker, I reserve the balance of my time, and I yield the 
balance of my time to the gentleman from Washington (Mr. McDermott), 
who is the ranking member on the Health Subcommittee, and ask unanimous 
consent that he may control that time.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Michigan?
  There was no objection.
  Ms. JENKINS of Kansas. Mr. Speaker, I yield 3 minutes to the 
gentleman from Louisiana (Mr. Boustany), our leader on the Ways and 
Means Committee and a subcommittee chairman.
  Mr. BOUSTANY. Mr. Speaker, I rise in support of the Restoring Access 
to Medication and Improving Health Savings Act, bipartisan legislation 
to fix yet another provision within ObamaCare that defies all common 
sense.
  I have to commend my colleagues on the House Ways and Means 
Committee, Congresswoman Lynn Jenkins and Congressman Ron Kind, for 
coming together on this bipartisan legislation for the sake of getting 
good policy.
  This legislation repeals an ObamaCare provision that prohibited 
Americans from using their pretax healthcare savings to purchase 
qualified over-the-counter medications. Over-the-counter treatments 
provide the first line of defense for minor ailments and illnesses. As 
a physician, I certainly know this well. Also, as a parent of two 
children, I know this quite well.
  We all know, Mr. Speaker, concern over the rapidly escalating cost of 
health care is shared on a strongly bipartisan basis. On this point, I 
think we all can agree. In that same vein, ensuring Americans have 
access to the most appropriate care at the right time is a critical 
factor in curbing overutilization of healthcare services. In short, not 
every ailment or minor illness necessitates a trip to the doctor or 
emergency room.
  My colleagues across the aisle, the architects of ObamaCare, have 
vastly underestimated the value in savings that over-the-counter 
treatment options provide each year to the U.S. healthcare system.
  Access to over-the-counter treatments is estimated to save the U.S. 
healthcare system and consumers $102 billion, on average, each year in 
avoided clinical and prescription expenditures.
  On average, physicians cite roughly 10 percent of office visits each 
year that could be avoided through appropriate use of over-the-counter 
treatment options.
  In my home State of Louisiana, out-of-pocket expenditures for health 
care over the past 10 years has more than doubled, with the most recent 
annual statewide expenditure for medications, alone, totaling nearly $5 
billion.
  This is the right approach for protecting American families and 
seniors from some of the worst effects of ObamaCare.
  I firmly believe allowing Americans to use their pretax dollars 
toward their out-of-pocket healthcare costs serves as a powerful tool 
to start really bending the healthcare cost curve in America. That is 
why I urge my colleagues to support this very sensible bipartisan 
legislation.
  Mr. McDERMOTT. Mr. Speaker, I yield myself such time as I may 
consume.
  I include in the Record an editorial from The Washington Post called, 
``The Myth of Paul Ryan.''

                [From the Washington Post, July 5, 2016]

                         The Myth of Paul Ryan

                       (By Katrina vanden Heuvel)

       It's also an apt descrtiption of the man Trump supplanted 
     as de facto leader of the party--Romney's running mate in 
     2012, House Speaker Paul D. Ryan (R-Wis.).
       Indeed, years before Trump sold Republican primary voters 
     on the myth of his own great success, Ryan sold a credulous 
     Washington establishment on the notion that he was a serious 
     thinker overflowing with political courage--a policy wonk 
     uniquely willing to tackle tough issues such as entitlement 
     reform. In the past month, however, it has become more 
     obvious than ever that Ryan's reputation is worth about as 
     much as a degree from Trump University. Let's review.
       After a fleeting flirtation with principle, Ryan kicked off 
     June by endorsing Trump for president. Despite his previous 
     indication that Trump would have to change course to earn his 
     support, Ryan's endorsement came without any public 
     concessions or reassurances from Trump It also came after The 
     Post reported in late 2013 that Ryan was embarking on a 
     personal crusade to steer Republicans ``away from the angry, 
     nativist inclinations of the tea party'' and toward a ``more 
     inclusive vision.''
       A few weeks after bowing to Trump, Ryan did take a stand--
     against the historic sit-in on the House floor led by civil 
     rights icon Rep. John Lewis (D-Ga.) to demand a vote on gun 
     legislation. Ryan derided the show of solidarity with victims 
     of gun violence as a ``publicity stunt'' and warned ominously 
     that in the future, ``We will not take this. We will not 
     tolerate this.'' (But Ryan has said the House will vote on a 
     GOP-sponsored gun bill this week.)
       Lastly, there is Ryan's supposed bread and butter: a policy 
     agenda rolled out over the course of the month.
       Ryan put forward a health-care proposal that was hyped as 
     the long-awaited Republican alternative to the Affordable 
     Care Act, but the ``plan'' consisted largely of well-worn 
     talking points instead of actual legislation. In a withering 
     editorial titled ``Paul Ryan's flimsy health plan,'' The 
     Post's editorial board described it as ``less detailed in a 
     variety of crucial ways than previous conservative health 
     reform proposals,'' while adding, ``The outlines that the 
     speaker did provide suggest that it would be hard on the 
     poor, old and sick.''
       He also released a tax reform proposal that, according to 
     the Wall Street Journal, ``isn't detailed enough for a 
     complete nonpartisan congressional analysis to verify the 
     effect on the budget and on households.'' The limited details 
     he did provide, however, do not paint a pretty picture. It's 
     not just that Ryan proposes to slash rates for the rich and 
     corporations. He also wants to create a new loophole for 
     ``pass-through'' income, which is a feature of Trump's 
     proposal and the disastrous plan implemented by Kansas Gov. 
     Sam Brownback
       (R) that has wrecked his state's finances. And perhaps most 
     significantly, given his disavowal of his past ``makers and 
     takers'' rhetoric, Ryan introduced an ``antipoverty'' plan 
     that would severely weaken the safety net for those living in 
     poverty. The plan, according to Politico, is mostly 
     ``repackaged GOP proposals,'' including cuts to unemployment 
     assistance, Head Start and federal Pell Grants. With Ryan's 
     blue-collar home town of Janesville already suffering the 
     consequences of corporate trade deals and other Ryan-backed 
     economic policies that have eviscerated the city's 
     manufacturing base, TalkPoverty editor Greg Kaufmann writes 
     that Ryan's latest proposal demonstrates ``his enduring 
     disconnect from the people struggling in his own district and 
     across America.''
       None of this is new. Ryan has been selling snake oil for 
     years--promising to ``save'' Medicare by privatizing it, 
     boasting that he could balance the budget with tax cuts for 
     the rich and without any cuts to defense spending, pretending 
     to be a pragmatist while embracing the extreme ideological 
     dogmas of Ayn Rand and the religious right. But his unearned 
     standing as a serious and

[[Page H4328]]

     courageous leader in a sea of cynical hacks has persisted 
     nonetheless. Even today, there are those who sympathize with 
     Ryan, suggesting that he is somehow a victim of Trump and 
     right-wing Republicans in Congress when, in fact, his 
     leadership--and failures thereof--helped pave their path to 
     power.
       When he was nominated for vice president in 2012, I wrote 
     that Ryan's vision for the country isn't courageous--it's 
     cruel. While that remains true four years later, it's not 
     only Ryan's policy goals that need to be exposed for what 
     they are.

  Mr. McDERMOTT. Mr. Speaker, June 22 was a historic day in this House. 
You could look at it from two different positions. One was it was the 
day that the Speaker was going to roll out, finally, after 2,000 days, 
his plan for health care in this country.

                              {time}  1500

  Unfortunately for him, in the well of the House, the Democrats 
decided that, maybe, commonsense gun legislation was more important. 
This bill was supposed to come up that day, but, instead, it was put up 
for today, and then it was put up for tomorrow. It is important because 
this is the fundamental underpinning of the undoing of the ACA for this 
country.
  There was a feeling on this floor that it was more important to talk 
about commonsense gun legislation. People were out there, worried about 
it, and we stood around here again and again, bowing our heads, and 
said: ``Gee, we are feeling awful about this,'' and then went on with 
business; so the Democrats sat down and said: ``We are going to do 
something about this.''
  The Speaker is the Speaker, and he is not to be denied, so here comes 
his bill again. He couldn't get it on June 22. We are revisiting this 
bill with the added benefit of some time to have actually looked at 
what the Republican healthcare plan is. The reviews are now in. The 
article I included from The Washington Post calls it a ``flimsy health 
plan,'' ``Paul Ryan's flimsy health plan.'' The American people don't 
understand what he is about to do to them.
  Medicare would be replaced by a voucher system. Medicaid would be cut 
radically. Consumer protections would be rolled back. Women would be 
denied the care they are entitled to. These are the same tired, harmful 
ideas that the Republicans have proposed time and time again. At the 
heart of this proposal is a dramatic shift of costs onto the patients. 
That means the wealthy will win and that the poor and the middle class 
will lose.
  H.R. 1270, which is knocking gun legislation off the agenda, is the 
first place they will begin the process of putting the Ryan plan into 
action. It is the first of a dozen bills that are required if they are 
serious about destroying the ACA and replacing it with their vision of 
health care for America. Like the rest of the Republican health 
debacle, H.R. 1270 is a harmful, poorly thought-out policy. This bill 
has three main parts, each of which will have damaging impacts on the 
Tax Code and on the healthcare system.
  The first is to expand the HSAs, the health savings accounts. Health 
savings accounts are used by fewer than 1 percent of Americans--0.7 
percent of Americans use HSAs. If you are above $1 million, 6 percent 
use them. These are mechanisms for the rich to save money around 
healthcare costs. Few middle and working class Americans have the 
incomes necessary to even contribute to HSAs.
  The second thing it does is to repeal an important Affordable Care 
Act tax revenue provision and to put more money, tax free, in the hands 
of drug manufacturers--$20 billion for HSAs and $5 billion for the drug 
manufacturers in this country, as if they weren't making enough. We 
can't even have a meaningful hearing in the Ways and Means Committee on 
the costs of pharmaceuticals for Americans in the Medicare program.
  Of course, now that we have given away $25 billion, we have got to 
have a pay-for. Where will we get that pay-for?
  There is something in the ACA called the true-up process. Now, if you 
are somebody with an income of up to 200 percent of poverty and you are 
working and you get a subsidy from the government because you need it 
to afford to buy your healthcare plan, if something changes in your 
life during that year, there has to be a so-called true-up process. 
That is, you received too much in benefits, so you have to pay it back 
to the Federal Government.
  Now, when $175,000 people like us write a bill of a grand here, a 
grand there, it is not really a big deal; but when you are making 
$40,000 or $30,000 for a family of four or $50,000 for a family of 
four, $1,000 is a big deal.
  This was a provision in the Affordable Care Act that said, if you 
have to pay the government back, you have to pay some proportion, not 
all of it, because we know it would be a real hit at the end of the 
year to suddenly get a bill from the IRS for $1,000. It was a way to 
keep people able to buy health insurance. The CBO says 130,000 fewer 
Americans will have coverage because of this provision. That is how you 
pay for giving $20 billion to the top and $5 billion to the 
pharmaceutical manufacturers, and that is why some of us are going to 
oppose this bill.
  My belief is that, if you are serious about dealing with health care, 
you are going to have to write it down. Mr. Ryan put a beautiful 
talking point list out with not a single word of legislation. He will 
not write down what he really intends to do. You have to kind of intuit 
it and have to have spent your life thinking about this stuff to 
understand all of the intricacies of what he is up to.
  The really upsetting thing is that we ought to be dealing with gun 
legislation here. The American people are entitled to have us vote on 
gun legislation.
  I reserve the balance of my time.
  Ms. JENKINS of Kansas. Mr. Speaker, I yield 3 minutes to the 
gentleman from Minnesota (Mr. Paulsen), a member of the Ways and Means 
Committee and an author of one portion of this bill.
  Mr. PAULSEN. I thank the gentlewoman for yielding.
  Mr. Speaker, I thank Representative Jenkins for her leadership and 
advocacy on behalf of consumers' choice in health care, and that is 
exactly what this bipartisan bill does and is all about. It is giving 
everyone the flexibility and the ability to make healthcare choices 
that are best for them and for their families, because no matter what 
your views are about the President's new healthcare law, you have to 
acknowledge that healthcare costs continue to go up for families, for 
small businesses, and for individuals alike. It is a pocketbook issue. 
Families want to have more tools and more flexibility to lower their 
costs and to set aside money to help pay for health care.
  Today, more and more people--nearly 20 million Americans--are using 
these health savings accounts to help save for health care. These are 
accounts that are used by regular, middle-income folks. In fact, the 
Joint Committee on Taxation just released brand new information, while 
we were gone on the Fourth of July recess, that points out that almost 
80 percent of people who are using these HSA accounts are middle-income 
and low-income. Half of the folks had incomes between $75,000 and 
$200,000, and 27 percent of the folks had incomes below $75,000. This 
is because the HSA is a very important tool that gives families 
certainty to help lower their healthcare bills. It allows them to shop 
around for the best quality care at the lowest price just like anything 
else they want to buy.
  Mr. Speaker, HSAs are growing in popularity. We know that. It is time 
to improve these accounts now to make them easier for all consumers to 
use. In Minnesota, 800,000 consumers and Minnesotans are eligible and 
are part of these HSA healthcare plans.
  This bill contains more commonsense reforms to help patients. It does 
include restoring the ability of patients to use their own healthcare 
dollars in health savings accounts and in flexible spending accounts to 
purchase over-the-counter medications without their having to get 
doctors' prescriptions first. There is no reason for patients to have 
to make unnecessary doctors' visits just so they can use their own 
money to buy allergy medication or cold medicine like Advil 
or Claritin.

  In addition, this bill does include provisions, which I authored, to 
make it easier for spouses to contribute and to consolidate their 
accounts as they near retirement. It also allows for them to pay for 
their health care as they open their HSA accounts, and it allows them 
to set aside enough money to cover all

[[Page H4329]]

of their deductible and out-of-pocket costs.
  Mr. Speaker, this bill is good policy. It is bipartisan, and it is 
fiscally responsible. Most importantly, it helps families save and pay 
for their health care.
  Mr. McDERMOTT. Mr. Speaker, I yield 3 minutes to the gentleman from 
Illinois (Mr. Danny K. Davis).
  Mr. DANNY K. DAVIS of Illinois. Mr. Speaker, I would much rather be 
discussing a bill that would get automatic and semiautomatic weapons 
out of our lives. Nevertheless, I strongly oppose H.R. 1270. This bill 
gives advantage to the most secure in our country at the expense of the 
vulnerable. If you really look at it, it is kind of Robin Hood health 
care in reverse.
  According to the Joint Committee on Taxation, health savings accounts 
vastly benefit high-income earners. Fewer than 0.5 percent of taxpayers 
with incomes under $50,000 contribute to HSAs, yet 6.3 percent of 
taxpayers who earn over $500,000 contribute to these accounts. This is 
not surprising because it is high-income earners who can set aside 
thousands of dollars in HSAs. The median income in my congressional 
district is $51,311. The vast majority of my constituents will not 
benefit from this bill, but they will be harmed by it.
  To pay for the $24 million boon to the upper income, this bill hikes 
up the healthcare costs of low- and middle-income Americans. When low- 
and middle-income families receive financial help to make their ACA 
health insurance more affordable, the ACA wisely protects them from 
excessive penalties if they incorrectly predict their annual incomes. 
Shockingly, H.R. 1270 removes these important consumer protections from 
thousands of low- and middle-income families in order to pay for the 
tax breaks for the wealthy.
  In addition to increasing costs for struggling families, the bill 
would result in approximately 130,000 fewer individuals who are covered 
by health insurance. HSA expansion is not a substitute for 
comprehensive healthcare reform. HSA expansion does not lower 
healthcare costs nor improves the quality of healthcare services.
  Rather than raising the minimum wage, creating jobs, or growing the 
economy, the Republican leadership simply advances HSA expansion to 
bolster the wealth of the most privileged at the expense of the 
vulnerable. I urge my colleagues to reject this bill and vote ``no.''
  Ms. JENKINS of Kansas. Mr. Speaker, I yield 2 minutes to the 
gentleman from Texas (Mr. Brady), the esteemed chairman of our House 
Ways and Means Committee.
  Mr. BRADY of Texas. Mr. Speaker, I rise in support of H.R. 1270, the 
Restoring Access to Medication Act of 2016, led and authored by 
Congresswoman Lynn Jenkins.
  House Republicans recognize the Affordable Care Act is really making 
life harder for so many families and job creators. That is why we have 
released a detailed plan to repeal this controversial law and have put 
in place healthcare solutions that are focused on what the American 
people need, not what Washington needs. This bill by Congresswoman 
Jenkins helps build upon and advance that important effort. The 
legislation is a testament to regular legislative order. It contains 
three policies that have been approved in advance by the Ways and Means 
Committee.
  First, H.R. 1270 eliminates a nonsensical ObamaCare regulation that 
puts Washington between patients and the medications they need.
  Under ObamaCare, Americans are limited. They can only use their 
personal medical savings accounts to buy prescription drugs only. It 
doesn't matter if there is an over-the-counter alternative that works 
just as well and costs half as much. No. ObamaCare says you cannot use 
your own health savings to pay for it without an expensive 
prescription. This bill cuts this Federal red tape so Americans, in a 
commonsense way, have the freedom to use their own health savings or 
flexible spending accounts to buy the medication that best suits them 
regardless of what side of the counter it comes from.
  Second, the bill makes commonsense improvements to how you contribute 
to and spend from your health savings accounts.
  These improvements, first introduced by Representative Paulsen and 
Dr. Burgess, allow Americans to save more, to coordinate their savings 
with their spouses, and to have better access to their savings.
  Finally, the measure acts to protect taxpayer dollars by making sure 
that those who aren't eligible to get subsidies pay them back. It makes 
common sense. If you are not eligible, you should pay them back. Some 
patients do under the current law.
  Twice, Republicans and Democrats have come together to make the 
ObamaCare subsidy repayment fairer. I am hopeful that we can continue 
that sense of bipartisan cooperation today. I congratulate 
Congresswoman Jenkins. Her bill will help people in America save. I 
urge its support.

                              {time}  1515

  Mr. McDERMOTT. Mr. Speaker, I reserve the balance of my time.
  Ms. JENKINS of Kansas. Mr. Speaker, I yield 1 minute to the gentleman 
from North Carolina (Mr. Holding), a member of the Ways and Means 
Committee.
  Mr. HOLDING. Mr. Speaker, thank you for the opportunity to speak on 
this important bill. I would also like to thank my colleagues on the 
Ways and Means Committee, particularly Ms. Jenkins, for collaborating 
to put this package together.
  The bill before us is built on two important principles: patient-
centered health care and good governance.
  This bill will expand consumer-driven healthcare accounts. For 
families and individuals, this means expanding their ability to set 
aside hard-earned money tax free and giving them the ability to spend 
their money on the benefits most useful to them.
  This bill will allow Americans to use the money they have set aside 
for health care on over-the-counter medication regardless if they go to 
their doctor beforehand.
  Just as important, Mr. Speaker, this bill will put a stop to the 
Federal Government continuing to overpay for ObamaCare subsidies, 
thereby protecting taxpayer dollars.
  I support these principles, and I urge my colleagues to support the 
bill.
  Mr. McDERMOTT. Mr. Speaker, I reserve the balance of my time.
  Ms. JENKINS of Kansas. Mr. Speaker, I yield 2 minutes to the 
gentleman from Georgia (Mr. Carter).
  Mr. CARTER of Georgia. Mr. Speaker, I rise today in support of H.R. 
1270, because Americans should have every opportunity to use how they 
see fit their health savings accounts or health flexible spending 
arrangements.
  When ObamaCare was passed into law, one of the many things it limited 
was what health savings accounts could be used for. Under ObamaCare, 
health savings accounts or flexible spending accounts can only be used 
for prescription medications and insulin. In other words, if you have a 
headache, you cannot use the money you have saved for medication 
services. You would need to either get a prescription for your headache 
or pay for an over-the-counter drug out of pocket.
  I believe one aspect to any successful marketplace is allowing 
consumers to use their income and resources as they see fit to manage 
their health. Limitations and control by the government on how 
Americans can interact with retail businesses is never good, especially 
in health care. That is why H.R. 1270 is so important.
  H.R. 1270 removes the ObamaCare limitation on medication payments for 
health savings accounts and health flexible spending arrangements so 
Americans can use their accounts for both over-the-counter medications 
as well as prescription medications.
  We must continue to remove the governmental barriers that limit 
consumer action and choice. We must work to ensure that every American 
has choices to make so the U.S. healthcare system remains consumer 
driven.
  I encourage my colleagues to support this legislation.
  Mr. McDERMOTT. Mr. Speaker, I yield myself such time as I may 
consume.
  I include into the Record a letter from the Executive Office of the 
President, a Statement of Administration Policy dated 21 June of 2016 
on this bill where the President says, in the last line:
  ``If the President were presented with H.R. 1270, he would veto the 
bill.''

[[Page H4330]]

  


                   Statement of Administration Policy


    H.R. 1270--The Restoring Access to Medication Act of 2015--Rep. 
                    Jenkins, R-KS, and 39 cosponsors

       The Administration strongly opposes House passage of H.R. 
     1270, which would create new and unnecessary tax breaks that 
     disproportionately benefit high-income people, increase taxes 
     for low- and middle-income people, and do nothing to improve 
     the quality of or address the underlying cost of health care.
       The Affordable Care Act is working and is fully integrated 
     into an improved American health care system. Discrimination 
     based on pre-existing conditions is a thing of the past. 
     Thanks to the Affordable Care Act, 20 million more Americans 
     have health insurance. And under the Affordable Care Act, we 
     have seen the slowest growth in health care prices in 50 
     years, benefiting all Americans.
       H.R. 1270 would repeal the Affordable Care Act's provisions 
     that limit the use of flexible savings accounts for over-the-
     counter drugs--provisions that help fund the law's coverage 
     improvements and expansions. The bill also would provide 
     additional tax breaks that disproportionately benefit those 
     with higher income by expanding tax-preferred health savings 
     accounts. These changes would do little to reduce health care 
     costs or improve quality. To fund these new high-income tax 
     breaks, H.R. 1270 would increase taxes paid by low- and 
     middle-income families by removing the law's limit on 
     repayment of premium tax credits available through the Health 
     Insurance Marketplaces.
       Rather than refighting old political battles by once again 
     voting to repeal parts of the Affordable Care Act, Members of 
     Congress should be working together to grow the economy, 
     strengthen middle-class families, and create new jobs.
       If the President were presented with H.R. 1270, he would 
     veto the bill.

  Mr. McDERMOTT. Mr. Speaker, it is very clear that this is, as Mr. 
Levin said, the 64th or 65th--I have lost count--effort to undermine 
the Affordable Care Act and to begin the process of sliding Americans 
away from Medicare and Medicaid and privatize the whole business and 
leave the American people in the loving hands of the insurance 
industry. We understand.
  Newt Gingrich said, when he became Speaker, that his number one goal 
was to get rid of Medicare; and the Republican Party has been doing 
that since 1994. I have been here the whole time and watched it over 
and over and over again. We have beaten it back, we have beaten it 
back, and we have beaten it back.
  The fact is that the American people are entitled to security in 
their health care. In every other industrialized country in the world, 
people do not worry about being bankrupted by their illness or an 
injury or whatever might happen to them.
  Health care is not something that you have very much control over. In 
fact, this idea that you can shop your health care; that somehow, as 
you are driving down the road and suddenly your heart has problems, you 
can stop and say, ``Well, let me get a phone book here and find the 
cheapest cardiologist to go to or the cheapest cardiac surgeon,'' that 
kind of shopping doesn't go on. We are not buying iceboxes here. We are 
designing a system where we are trying to help everybody.
  The Republican plan is simply pulling people away from that and 
forcing them into their own individual box. You take care of yourself. 
I have no responsibility for you whatsoever.
  That is the end of a civilized society when we stop caring about 
people in the society who have the most trouble dealing with the 
problems they face, not because they are weak or stupid.
  These people who are getting these benefits, buying their healthcare 
plan, are using that money because they don't have enough to do it on 
their own. Something changes in their life. One of their kids gets 
married. Suddenly they are no longer a deduction. So they have suddenly 
got to be in the true-up process, and we are going to take their money 
away from them because their kid got married.
  Now, my view is that everything about this bill is not in the best 
interest of the American people. Not only are they entitled to health 
security, they ought to have some security, and that means that we 
ought to have a process where everybody who wants to buy a gun ought to 
have to go through a background check.
  I was going home on the plane last week after what went on here, and 
a guy came down the aisle about the size of the man in the chair and 
said to me: ``I am a gun collector, and I got 25 guns and they are all 
registered, and they should be. And I am a Republican.''
  This country understands the commonsense nature of the legislation 
that we should be considering today here. Instead, we get the 
beginnings of eroding the healthcare system. The Speaker is inexorably 
working toward it, and we will just have to keep fighting.
  I yield back the balance of my time.
  Ms. JENKINS OF Kansas. Mr. Speaker, as I said in my opening 
statement, this bill deserves bipartisan support.
  It seems that the main objection from my Democratic colleagues 
relates to the ObamaCare subsidy overpayments, and our desire to get 
back some of the money that our constituents have received either 
fraudulently or not under this law is just a commonsense approach.
  This is not a tax on poor Americans nor is it a Robin Hood-style 
break for rich Americans. Rather, it is a bipartisan offset that many 
of my friends on the other side of the aisle have voted for not once, 
but twice. It is a chance to fulfill our obligation to be good stewards 
of the dollars that hardworking Americans have paid in taxes.
  We must pass H.R. 1270 to protect taxpayers, reduce the deficit by 
more than $2 billion, and show that we can agree to change some bad 
provisions in ObamaCare that drive up costs, decrease access, and 
unwisely spend taxpayer dollars.
  I yield back the balance of my time.
  The SPEAKER pro tempore. All time for debate has expired.
  Pursuant to House Resolution 793, the previous question is ordered on 
the bill, as amended.
  The question is on the engrossment and third reading of the bill.
  The bill was ordered to be engrossed and read a third time, and was 
read the third time.
  The SPEAKER pro tempore. The question is on the passage of the bill.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Ms. JENKINS of Kansas. Mr. Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, this 15-
minute vote on the passage of the bill will be followed by 5-minute 
votes on:
  Ordering the previous question on House Resolution 803;
  Adoption of House Resolution 803, if ordered;
  The motion to suspend the rules and pass S. 1252; and
  The motion to suspend the rules and pass H.R. 2646.
  The vote was taken by electronic device, and there were--yeas 243, 
nays 164, not voting 26, as follows:

                             [Roll No. 351]

                               YEAS--243

     Abraham
     Aderholt
     Allen
     Amash
     Amodei
     Ashford
     Babin
     Barletta
     Barr
     Barton
     Benishek
     Bera
     Bilirakis
     Bishop (MI)
     Bishop (UT)
     Black
     Blackburn
     Blum
     Boustany
     Brady (TX)
     Brat
     Bridenstine
     Brooks (AL)
     Brooks (IN)
     Buck
     Bucshon
     Burgess
     Byrne
     Calvert
     Carney
     Carter (GA)
     Carter (TX)
     Chabot
     Chaffetz
     Clawson (FL)
     Coffman
     Cole
     Collins (GA)
     Collins (NY)
     Comstock
     Conaway
     Cook
     Costa
     Costello (PA)
     Crawford
     Crenshaw
     Cuellar
     Curbelo (FL)
     Davidson
     Davis, Rodney
     Dent
     DesJarlais
     Diaz-Balart
     Dold
     Donovan
     Duffy
     Duncan (SC)
     Duncan (TN)
     Emmer (MN)
     Farenthold
     Fincher
     Fitzpatrick
     Fleischmann
     Fleming
     Flores
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Garrett
     Gibbs
     Gibson
     Gohmert
     Goodlatte
     Gosar
     Gowdy
     Granger
     Graves (GA)
     Graves (LA)
     Graves (MO)
     Griffith
     Grothman
     Guinta
     Guthrie
     Hanna
     Hardy
     Harper
     Hartzler
     Heck (NV)
     Hensarling
     Herrera Beutler
     Hice, Jody B.
     Hill
     Holding
     Hudson
     Huelskamp
     Huizenga (MI)
     Hultgren
     Hunter
     Hurd (TX)
     Hurt (VA)
     Issa
     Jenkins (KS)
     Jenkins (WV)
     Johnson (OH)
     Johnson, Sam
     Jolly
     Jones
     Jordan
     Joyce
     Kelly (MS)
     Kelly (PA)
     Kind
     King (IA)
     King (NY)
     Kinzinger (IL)
     Kline
     Knight
     Labrador
     LaHood
     Lamborn
     Lance
     Latta
     Lipinski
     LoBiondo
     Long
     Loudermilk
     Love
     Lucas
     Luetkemeyer
     Lummis
     MacArthur
     Marchant
     Marino
     Massie
     McCarthy
     McCaul
     McClintock
     McHenry
     McKinley
     McMorris Rodgers
     McSally
     Meadows
     Meehan
     Messer
     Mica
     Miller (FL)
     Miller (MI)
     Moolenaar
     Mooney (WV)
     Mullin
     Mulvaney
     Murphy (PA)
     Neugebauer
     Newhouse
     Noem
     Nunes
     Olson
     Palazzo
     Palmer
     Paulsen
     Pearce
     Perry
     Peters
     Peterson
     Pittenger
     Pitts
     Poe (TX)
     Poliquin
     Pompeo
     Posey
     Price, Tom
     Ratcliffe
     Reed
     Reichert
     Renacci
     Ribble
     Rice (SC)

[[Page H4331]]


     Rigell
     Roby
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rohrabacher
     Rokita
     Rooney (FL)
     Ros-Lehtinen
     Roskam
     Ross
     Rothfus
     Rouzer
     Royce
     Russell
     Salmon
     Sanford
     Scalise
     Schweikert
     Sensenbrenner
     Sessions
     Shimkus
     Shuster
     Simpson
     Sinema
     Smith (MO)
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Stefanik
     Stewart
     Stivers
     Stutzman
     Thompson (PA)
     Thornberry
     Tiberi
     Tipton
     Trott
     Turner
     Upton
     Valadao
     Wagner
     Walberg
     Walden
     Walker
     Walorski
     Walters, Mimi
     Weber (TX)
     Webster (FL)
     Wenstrup
     Westerman
     Whitfield
     Williams
     Wilson (SC)
     Wittman
     Womack
     Woodall
     Yoder
     Yoho
     Young (AK)
     Young (IA)
     Young (IN)
     Zeldin
     Zinke

                               NAYS--164

     Adams
     Aguilar
     Beatty
     Becerra
     Beyer
     Bishop (GA)
     Blumenauer
     Bonamici
     Boyle, Brendan F.
     Brady (PA)
     Brown (FL)
     Brownley (CA)
     Bustos
     Butterfield
     Capps
     Capuano
     Cardenas
     Carson (IN)
     Cartwright
     Castor (FL)
     Castro (TX)
     Chu, Judy
     Cicilline
     Clark (MA)
     Clarke (NY)
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly
     Conyers
     Cooper
     Courtney
     Crowley
     Cummings
     Davis (CA)
     Davis, Danny
     DeFazio
     DeGette
     DeLauro
     DelBene
     DeSaulnier
     Deutch
     Dingell
     Doggett
     Doyle, Michael F.
     Duckworth
     Edwards
     Ellison
     Engel
     Eshoo
     Esty
     Foster
     Frankel (FL)
     Fudge
     Gabbard
     Gallego
     Garamendi
     Graham
     Grayson
     Green, Al
     Green, Gene
     Gutierrez
     Hahn
     Heck (WA)
     Higgins
     Himes
     Hinojosa
     Honda
     Hoyer
     Huffman
     Israel
     Jackson Lee
     Jeffries
     Johnson (GA)
     Johnson, E. B.
     Kaptur
     Keating
     Kelly (IL)
     Kennedy
     Kildee
     Kilmer
     Kirkpatrick
     Kuster
     Langevin
     Larsen (WA)
     Larson (CT)
     Lawrence
     Lee
     Levin
     Lieu, Ted
     Loebsack
     Lofgren
     Lowenthal
     Lowey
     Lujan Grisham (NM)
     Lujan, Ben Ray (NM)
     Lynch
     Maloney, Carolyn
     Maloney, Sean
     Matsui
     McCollum
     McDermott
     McGovern
     McNerney
     Meng
     Moore
     Moulton
     Murphy (FL)
     Napolitano
     Neal
     Nolan
     Norcross
     O'Rourke
     Pallone
     Pascrell
     Payne
     Pelosi
     Perlmutter
     Pingree
     Pocan
     Polis
     Price (NC)
     Quigley
     Rangel
     Richmond
     Roybal-Allard
     Ruiz
     Ruppersberger
     Rush
     Ryan (OH)
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schiff
     Schrader
     Scott (VA)
     Scott, David
     Serrano
     Sewell (AL)
     Sherman
     Sires
     Slaughter
     Smith (WA)
     Swalwell (CA)
     Takano
     Thompson (CA)
     Thompson (MS)
     Titus
     Tonko
     Torres
     Tsongas
     Van Hollen
     Vargas
     Veasey
     Vela
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters, Maxine
     Watson Coleman
     Yarmuth

                             NOT VOTING--26

     Bass
     Bost
     Buchanan
     Cramer
     Culberson
     Delaney
     Denham
     DeSantis
     Ellmers (NC)
     Farr
     Grijalva
     Harris
     Hastings
     Katko
     LaMalfa
     Lewis
     Meeks
     Nadler
     Nugent
     Rice (NY)
     Scott, Austin
     Speier
     Takai
     Welch
     Westmoreland
     Wilson (FL)

                              {time}  1543

  Mses. EDWARDS and CLARK of Massachusetts changed their vote from 
``yea'' to ``nay.''
  Mr. ASHFORD changed his vote from ``nay'' to ``yea.''
  So the bill was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.
  Stated for:
  Mr. DENHAM. Mr. Speaker, I was inadvertently detained on rollcall 
vote 351 regarding H.R. 1270, the Restoring Access to Medication Act of 
2015. Had I been present to vote, I would have voted ``yes.''
  Stated against:
  Mr. WELCH. Mr. Speaker, I was unable to vote on rollcall 351. I would 
have voted ``nay'' on rollcall 351 had I been there.

                          ____________________