(Senate - June 24, 2019)

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[Pages S4458-S4459]
From the Congressional Record Online through the Government Publishing Office []


      By Mr. THUNE (for himself and Mr. Carper):
  S. 1948. A bill to amend the Internal Revenue Code of 1986 to permit 
high deductible health plans to provide chronic disease prevention 
services to plan enrollees prior to satisfying their plan deductible; 
to the Committee on Finance.
  Mr. THUNE. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1948

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


       (a) Short Title.--This Act may be cited as the ``Chronic 
     Disease Management Act of 2019''.
       (b) Findings.--Congress finds the following:
       (1) A small number of chronic diseases account for the 
     majority of health care spending in the United States.
       (2) The Office of the Assistant Secretary for Health of the 
     Department of Health and Human Services used a deliberative 
     process involving the Multiple Chronic Conditions working 
     group subject matter experts in clinical medicine, 
     epidemiology, and public

[[Page S4459]]

     health to develop a list of 20 chronic conditions that are 
     prevalent and potentially amenable to public health or 
     clinical interventions, or a combination of both.
       (3) Limited and targeted interventions for many chronic 
     diseases prevent the need for additional, more costly 
     therapies associated with untreated or unmanaged chronic 
     diseases that lead to adverse effects on quality of life for 
       (4) These types of chronic care preventive services should 
     be encouraged to maximize the effectiveness and positive 
     outcomes of the care provided under high deductible health 
       (5) Section 223(c)(2)(C) of the Internal Revenue Code of 
     1986 explicitly grants the Secretary of the Treasury 
     flexibility in defining the scope of preventive care for 
     purposes of the preventive care safe harbor. As of the date 
     of introduction of this Act, the Secretary of the Treasury 
     has refrained from exercising existing authority under such 
     section to expand the preventive care safe harbor to include 
     chronic disease prevention.
       (6) In the absence of an expansion of the preventive care 
     safe harbor by the Secretary of the Treasury, the Chronic 
     Disease Management Act of 2019 would expressly permit high-
     deductible health plans to provide chronic disease prevention 
     and treatment, subject to certain limitations, prior to a 
     plan enrollee having met their plan deductible.
       (7) Allowing health savings account-eligible high-
     deductible health plans to cover chronic disease prevention 
     and treatment on a pre-deductible basis promotes the concept 
     of Value-Based Insurance Design, which is an effective tool 
     to improve the quality and reduce the cost of care for 
     Americans with chronic diseases, with improved outcomes via 
     increased medication adherence, reduced complications, and 
     decreased emergency department visits.


       (a) In General.--Section 223(c)(2) of the Internal Revenue 
     Code of 1986 is amended by redesignating subparagraph (D) as 
     subparagraph (E) and by inserting after subparagraph (C) the 
     following new subparagraph:
       ``(D) Safe harbor for absence of deductible for care 
     related to chronic conditions.--A plan shall not fail to be 
     treated as a high deductible health plan by reason of failing 
     to have a deductible for care related to the treatment of any 
     chronic condition, as determined by the Assistant Secretary 
     for Health of the Department of Health and Human Services.''.
       (b) Effective Date.--The amendments made by this section 
     shall apply to coverage for months beginning after the date 
     of the enactment of this Act.
      By Ms. COLLINS (for herself and Ms. Smith):
  S. 1949. A bill to amend the Richard B. Russell National School Lunch 
Act to require the Secretary of Agriculture to make loan guarantees and 
grants to finance certain improvements to school lunch facilities, to 
train school food service personnel, and for other purposes; to the 
Committee on Agriculture, Nutrition, and Forestry.
  Ms. COLLINS. Mr. President, I am pleased to join my colleague from 
Minnesota, Senator Smith, in introducing the School Food Modernization 
Act to assist schools in updating outdated kitchen equipment, allowing 
them to provide healthier meals to students.
  School meals play a vital role in the lives of our young people. More 
than 95,000 schools participate in the National School Lunch program, 
serving upwards of 30 million children each day. Many children consume 
up to half their daily caloric intake at school, and some get their 
most nutritious meal of the day at school instead of at home. Because 
school meals are a significant source of daily nutrition for so many, 
we must consistently aim to improve the program to best serve students.
  Schools built decades ago often lack the equipment and infrastructure 
necessary to do more than reheat and serve one or two meal options each 
day. In 2014, it was estimated that Maine schools alone would need 
$58.8 million for equipment infrastructure upgrades needed to serve 
healthy meals to all of our students. I am pleased that the Agriculture 
Appropriations Subcommittee has consistently recognized this need, and 
in Fiscal Year 2019 appropriated $30 million for School Equipment 
Assistance Grants. Through this funding, Maine will be able to 
competitively award $85,470 to school districts in need of updated 
  Nutrition directors at Mount View High School in Thorndike, Maine, 
used USDA Equipment Assistance funding to purchase a blast chiller to 
accommodate increased quantities of fruits and vegetables. Thanks to 
this equipment, the school is now able to quickly and safely preserve 
the food's freshness while reducing spoilage. Other schools have 
acquired hot holding cabinets, mobile food carts, and even combination 
ovens, which prepare foods faster and maintain more vitamin and 
nutrient content compared with many other cooking methods. Our 
legislation would codify and improve this successful grant program to 
better meet the growing need nationwide.
  The School Food Modernization Act seeks to help school food service 
personnel offer a wide variety of nutritious and appealing meals to all 
students. First, the bill would provide targeted grant assistance to 
supply the seed funding needed to upgrade kitchen infrastructure or to 
purchase high-quality equipment. Second, it would establish a loan 
guarantee assistance program within USDA to help schools acquire new 
equipment. Finally, to aid school food services personnel in running 
successful, healthy programs, the legislation would authorize USDA to 
provide support on a competitive basis to highly qualified third-party 
trainers to develop and administer training and technical assistance, 
including online programs.
  I appreciate that some provisions of this legislation were 
incorporated into previous versions of the Children Nutrition 
Reauthorization legislation approved by the Senate Agriculture 
Committee. I encourage our colleagues to continue to support school 
kitchen equipment needs as the reauthorization process continues.
  Mr. President, if our school children are going to be able to learn 
and succeed, they need their minds and bodies to be fully nourished. 
This bill would help us achieve that goal.