[Congressional Record Volume 170, Number 39 (Tuesday, March 5, 2024)] [House] [Pages H793-H796] From the Congressional Record Online through the Government Publishing Office [www.gpo.gov] PREVENTING MATERNAL DEATHS REAUTHORIZATION ACT OF 2023 Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 3838) to amend title III of the Public Health Service Act to reauthorize Federal support of States in their work to save and sustain the health of mothers during pregnancy, childbirth, and the postpartum period, to eliminate disparities in maternal health outcomes for pregnancy-related and pregnancy-associated deaths, to identify solutions to improve healthcare quality and health outcomes for mothers, and for other purposes, as amended. The Clerk read the title of the bill. The text of the bill is as follows: H.R. 3838 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 ``Preventing Maternal Deaths Reauthorization Act of 2023''. SEC. 2. SAFE MOTHERHOOD. (a) Maternal Mortality Review Committees.--Section 317K(d) of the Public Health Service Act (42 U.S.C. 247b-12(d)) is amended-- (1) in paragraph (1)(A), by inserting ``(including obstetricians and gynecologists)'' after ``clinical specialties''; and (2) in paragraph (3)(A)(i)-- (A) in subclause (I), by striking ``as applicable'' and inserting ``if available''; and (B) in subclause (III), by striking ``, as appropriate'' and inserting ``and coordinating with death certifiers to improve the collection of death record reports and the quality of death records, including by amending cause-of- death information on a death certificate, as appropriate''. (b) Best Practices Relating to the Prevention of Maternal Mortality.--Section 317K of the Public Health Service Act (42 U.S.C. 247b-12) is amended-- (1) by redesignating subsections (e) and (f) as subsections (f) and (g), respectively; and (2) by inserting after subsection (d) the following: ``(e) Best Practices Relating to the Prevention of Maternal Mortality.-- ``(1) In general.--The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall, in consultation with the Administrator of the Health Resources and Services Administration, disseminate to hospitals, State professional society groups, and perinatal quality collaboratives, best practices on how to prevent maternal mortality and morbidity that consider and reflect best practices identified through other relevant Federal maternal health programs. ``(2) Frequency.--The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall disseminate the best practices referred to in paragraph (1) not less than once per fiscal year.''. (c) Extension.--Subsection (g) of section 317K of the Public Health Service Act (42 U.S.C. 247b-12), as redesignated by subsection (b), is amended by striking ``$58,000,000 for each of fiscal years 2019 through 2023'' and inserting ``$108,000,000 for each of fiscal years 2024 through 2028''. The SPEAKER pro tempore (Mr. Luttrell). Pursuant to the rule, the gentleman from Texas (Mr. Burgess) and the gentlewoman from Washington (Ms. Schrier) each will control 20 minutes. The Chair recognizes the gentleman from Texas. General Leave Mr. BURGESS. 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 in the Record on the bill. The SPEAKER pro tempore. Is there objection to the request of the gentleman from Texas? There was no objection. Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume. [[Page H794]] I rise today in support of my legislation, H.R. 3838, the Preventing Maternal Deaths Reauthorization Act of 2023. During March, we celebrate National Women's History Month and honor the strong women in our lives, especially our mothers who make great sacrifices to bring life into this world. According to the latest United States data, the maternal mortality rate rose yet again in 2021 to almost 33 deaths per 100,000 live births compared to a rate of 23 per 100,000 in 2020. While we know that over 80 percent of pregnancy-related deaths are preventable, we also understand that even one is too many. The Preventing Maternal Deaths Reauthorization Act works to understand and reduce maternal mortalities by reauthorizing Federal support for State-led Maternal Mortality Review Committees. Maternal Mortality Review Committees are multidisciplinary committees that review the causes of maternal deaths in their State and make recommendations based on their findings to prevent future deaths and improve maternal health outcomes during pregnancy, childbirth, and the first year afterward. H.R. 3838 also requires the Centers for Disease Control and Prevention to work in consultation with the Health Resources and Services Administration to disseminate best practices for the prevention of maternal mortality and morbidity to hospitals and other healthcare providers. Maternal Mortality Review Committees are vital to understanding the drivers of maternal deaths and informing effective interventions. This way we will help to ensure that resources are directed where they will have the most positive impact. Since its initial authorization in 2018, we have already seen the work of the Maternal Mortality Review Committees make a significant difference and increasing the number of Maternal Mortality Review Committees from 32 States to 49 States, the District of Columbia, New York City, Philadelphia, and Puerto Rico. Through their work, this body was able to discover that over 50 percent of pregnancy-related deaths happen between 1 week and 1 year after delivery, leading to the critical extension of the State plan amendment for Medicaid and Children's Health Insurance Program to 12 months for postpartum coverage. The critical importance of this bill is furthered by the news from my home State of Texas just last week. Effective March 1 of 2024, Texas extended postpartum coverage for the full 12 months for eligible Medicaid and Children's Health Insurance Program recipients through the Texas Health and Human Services Commission. I thank Governor Greg Abbott and the Texas legislature for their continued efforts to protect and defend life, especially the lives of new mothers and newborn babies. Today, I am joined by 740 of my fellow OB/GYNs who are on the Hill with the American College of Obstetricians and Gynecologists urging a ``yes'' vote on this critically important bill. I thank my fellow Representatives, Diana DeGette, Buddy Carter, Robin Kelly, Kat Cammack, and Kathy Castor for working with me on this important legislation. Mr. Speaker, I stand in strong support of H.R. 3838. I urge my fellow Members to vote for its passage today, and I reserve the balance of my time. Ms. SCHRIER. Mr. Speaker, I yield such time as she may consume to the gentlewoman from Colorado (Ms. DeGette). Ms. DeGETTE. Mr. Speaker, I thank the gentlewoman for yielding. As Dr. Burgess said, we are facing a maternal health crisis in this country. From 2018 to 2021, the overall maternal mortality rate in the United States nearly doubled. We are simply failing American women as they become mothers, and we are particularly failing Black Americans, who in 2021 were nearly three times as likely than White Americans to die becoming mothers, irrespective of education or socioeconomic status. This is exactly the trend that the former gentlewoman from Washington (Ms. Herrera Beutler) and I sought to address when we passed the original Preventing Maternal Deaths Act in 2018. Through the programs developed by that legislation we now have a much greater knowledge of what is causing this crisis and the infrastructure we need to build further understanding and drive solutions. Data generated by the Maternal Mortality Review Committees have provided us with the insight that 80 percent of maternal deaths are preventable. This understanding is the first step toward solutions, and we have to ensure that we not only don't lose but that we strengthen the process we have made in building, understanding, and standardizing data so that we have a clear picture across the country of why this is happening. The Preventing Maternal Deaths Reauthorization Act will continue and bolster our support for the Maternal Mortality Review Committees. It will also ensure the timely and frequent dissemination of best practices to prevent maternal mortality. Make no mistake, further action is needed, and this reauthorization in itself will not solve the crisis, but that further action depends on the critical insights that we can get from this legislation. It is the foundation on which the solution stands. I am very grateful that my friend, Dr. Burgess, has taken up the mantle on this legislation. I also thank my dear friend, Kathy Castor, and our ranking member here, Ms. Schrier, for their work on this legislation, and I urge a ``yes'' vote on this legislation. Mr. BURGESS. Mr. Speaker, I yield 3 minutes to the gentleman from Georgia (Mr. Carter). Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for yielding. Before I begin, Mr. Speaker, I want to thank my colleague, the sponsor of this bill, Dr. Burgess, for his outstanding work in healthcare, especially as a Member of this august body. For many years he has served here, and I know he is going to be retiring at the end of this year, and we are certainly going to miss his leadership, particularly in the healthcare space, and we appreciate him very much. Mr. Speaker, I rise today in strong support of H.R. 3838, the Preventing Maternal Deaths Reauthorization Act, which I am co-leading with Dr. Burgess. Maternal mortality is something that I have worked on for many, many years as a member of the Georgia State legislature and now as a Member of Congress. It baffles me as to why Georgia, my home State, would be one of the leading States in the Nation in maternal mortality. I have not been able to get my arms around that and understand why that is, but it is. Our Nation's maternal mortality crisis, which, as I say, severely impacts Georgians, is alarming and trending in the wrong direction. In fact, in Georgia, the maternal mortality rate has increased to over 30 deaths per 100,000 live births. For women of color and people living in rural communities, those numbers are much higher. The United States is trending in the wrong direction, as well, and we need to understand why moms are dying, despite us spending $4.4 trillion on healthcare in 2022. As a father, as a grandfather, and a healthcare professional, I believe that we can and we must do much better. It is time for this to become a national priority, which is why I am proud to be co-leading the Preventing Maternal Deaths Act with Dr. Burgess. This legislation would ensure continued support for the critically important work that the State Maternal Mortality Review Committees have done in addressing the maternal mortality crisis. State Maternal Mortality Review Committees are crucial to collecting data so that each State can form a plan to address maternal health issues impacting their community. This bipartisan bill is an important step toward ending the maternal mortality crisis in the U.S. We value women, we value life, and this bipartisan bill prioritizes both. I thank Dr. Burgess again for working with me on this important issue, and I urge my colleagues to support this legislation. Ms. SCHRIER. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, the United States faces a significant crisis with one of the highest maternal mortality and morbidity rates among developed nations. According to the most recent data, in 2021, more than 1,200 women died as a result of pregnancy or childbirth, continuing an upward trend over nearly 20 years. [[Page H795]] Racial disparities in maternal outcomes continue with Black and indigenous women dying at three times the rate of White women. Additionally, rural areas experience higher rates of maternal mortality compared to urban areas, and yet, experts and research using the Maternal Mortality Review Committee data indicates that at least 80 percent of maternal mortalities are preventable. {time} 1600 H.R. 3838, the Preventing Maternal Deaths Reauthorization Act of 2023, is bipartisan legislation to reauthorize support for State-based Maternal Mortality Review Committees until 2028. These committees play a critical role in reviewing pregnancy-related deaths to identify causes and make recommendations for the prevention of future mortalities in their State. The legislation also requires the Centers for Disease Control and Prevention, the CDC, to work with HRSA, the Health Resources and Services Administration, to share best practices to prevent maternal mortality with hospitals and healthcare providers. Enacting this legislation will provide the needed ongoing support of Maternal Mortality Review Committees, ultimately enhancing the safety of women throughout their pregnancy, delivery, and postpartum experiences while reducing racial disparities and outcomes. The legislation is supported by over 85 organizations across the healthcare spectrum. I am pleased that it is before us today, and I encourage all of my colleagues to vote ``yes'' on this important bill. Mr. Speaker, I reserve the balance of my time. Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume. I do want to point out in this bill, probably one of the most important aspects is the collection and dissemination of data by the CDC and HRSA, the best practices that occur across the country. There is no reason why one hospital should have excellent statistics and another hospital have questionable statistics. We should be able to be good enough that every hospital has excellent statistics. I know this to be true, because where I did my residency at Parkland Hospital in Dallas, they have consistently had some of the best maternal mortality statistics in the country, and they take care of a population that is low income, women of color, underinsured, uninsured, the very populations you think would be at greatest risk. I know we can do it. I have seen it done, and it is so important to me that we collect and disseminate this data. Mr. Speaker, I reserve the balance of my time. Ms. SCHRIER. Mr. Speaker, I yield such time as she may consume to the gentlewoman from Florida (Ms. Castor). Ms. CASTOR of Florida. Mr. Speaker, I thank Ms. Schrier for yielding me time. Mr. Speaker, I rise in strong support of the Preventing Maternal Deaths Reauthorization Act. It is critical legislation that I am proud to co-lead to address the maternal mortality crisis in America, unconscionably the worst in the developed world. Each of us deserves to live a healthy life. For mothers, for women, that includes access to the care they need before, during, and after pregnancy. Pregnancy in America right now is too often traumatic or is life-threatening, and our maternal health crisis in many places is tearing families apart. This is particularly true for Black women, who often experience worse outcomes due to disparities in access to medical care, the care that they need and that they deserve. Our bill will help recommit to the health of our neighbors by ensuring that more moms can have safe pregnancies by improving health outcomes for the patients at the highest risk of maternal mortality and morbidity. In the Tampa Bay area, I am proud to represent outstanding OB/GYNs and providers, clinics like Evara Health or organizations like REACHUP, the Healthy Start Coalitions, and more. They have worked tirelessly to address our maternal mortality rates and improve the quality of care for new and expecting mothers. This bill will help them and similar organizations across the country, in partnership with the CDC, by building upon the comprehensive framework of the Preventing Maternal Deaths Reauthorization Act, supporting Maternal Mortality Review Committees, and strengthening lifesaving initiatives to improve health outcomes. For example, Florida's Maternal Mortality Review Committee has successfully created initiatives to reduce deaths associated with postpartum bleeding and opioid use disorder. We have to do more. I look forward to working with my colleagues to address America's maternal mortality crisis through research, prevention, and evidence-based practices. I thank my partners on the Committee on Energy and Commerce who brought this bill to the floor: Congressman Burgess, Congresswoman DeGette, Congressman Carter, Congresswoman Kelly for her years of advocacy, Congresswoman Schrier, and Congresswoman Cammack, as well. I thank them for co-leading this legislation with me. Families are counting on us. Please vote ``yes.'' Ms. SCHRIER. Mr. Speaker, I yield such time as she may consume to the gentlewoman from Illinois (Ms. Kelly). Ms. KELLY of Illinois. Mr. Speaker, I rise today in support of this bipartisan effort to address the maternal health crisis. One of the most glaring inequities in our country is the disparities in maternal health outcomes. In the richest country in the world, the United States is falling behind and failing our mothers and babies. Over 1,000 women died in 2021 because of complications from childbirth. This is up from 861 deaths in 2020 and 754 deaths in 2019. What is even worse, as you have heard, is that Black women are nearly three times more likely to die from pregnancy-related causes as non- Hispanic White women, and that depends on where you live. The area I represent is six times as likely. Indigenous women are more than twice as likely to die from pregnancy-related causes as non-Hispanic White women. Again, it depends on where they live. This is just unacceptable. I am proud to say that this legislation will bring us closer to a future where no mother has to worry that growing her family will cost her life. The Preventing Maternal Deaths Reauthorization Act, that I co-led with Representatives Burgess, Cammack, Castor, Carter, and DeGette, will strengthen and expand Federal support for Maternal Mortality Review Committees, or MMRCs. State-fashioned MMRCs are tasked with identifying maternal deaths, analyzing the factors that contributed to those deaths, and translating those lessons into policy changes. I am proud to say that a piece of my comprehensive maternal health legislation, the MOMMA's Act, is included in this legislation. The Preventing Maternal Deaths Reauthorization Act has received unanimous, bipartisan support from the Energy and Commerce Committee's Subcommittee on Health and the full committee. Mr. Speaker, I encourage my colleagues to support this bill and save moms' lives. Ms. SCHRIER. Mr. Speaker, I yield myself the balance of my time for closing. I am so pleased this bill is before us today. I encourage all of my colleagues to vote ``yes'' on this very important bill that will save lives. Mr. Speaker, I yield back the balance of my time. Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time. Mr. Speaker, this bill is personally important to me. My grandfather, who I never knew, my father's father, was an academic obstetrician at McGill Hospital in Montreal from the end of the World War I until his death in 1939. During that time, maternal mortality was substantially reduced. The caregivers of that time, prior to the introduction of antibiotics, made great strides in reducing maternal mortality. Some of that was through the imposition of preventive medicine. Some of that was because of improved anesthesia and blood bank techniques. Of course, with the introduction of antibiotics in 1940, the rates came down even substantially more. We know it can be done. [[Page H796]] At that time the major drivers of maternal mortality were hypertension, hemorrhage, and infection. Now, the major drivers are well after delivery, and they fall into the realm of cardiovascular disease, suicide, and drug overdose. This expansion of postpartum coverage to the first year after delivery was really work that was established in our committee. We did the research on that, and we provided the guidance that now has been taken up by a great many States. I look forward to a day when we see these numbers are significantly reduced even over where they are now because of the changes that we have made as a result of this legislation. It is important work. Mr. Speaker, I encourage all of my colleagues to vote ``yes'' on the underlying bill, and I yield back the balance of my time. The SPEAKER pro tempore. The question is on the motion offered by the gentleman from Texas (Mr. Burgess) that the House suspend the rules and pass the bill, H.R. 3838, as amended. The question was taken. The SPEAKER pro tempore. In the opinion of the Chair, two-thirds being in the affirmative, the ayes have it. Mr. BURGESS. 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, further proceedings on this motion will be postponed. ____________________