2:28 PM EDT

Devin Nunes, R-CA 22nd

Mr. NUNES. Mr. Speaker, pursuant to House Resolution 555, I call up the bill (H.R. 4414) to clarify the treatment under the Patient Protection and Affordable Care Act of health plans in which expatriates are the primary enrollees, and for other purposes, and ask for its immediate consideration.

The Clerk read the title of the bill.

2:29 PM EDT

Devin Nunes, R-CA 22nd

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

Mr. Speaker, the bill before the House today comes down to one simple question: Will we allow American companies to offer expatriate plans or will we force the offshoring of these plans? Will we support employment in America or stimulate employment overseas?

Mr. Carney and I have worked carefully and in good faith on a bipartisan basis to craft a bill that is limited in scope while at the same time remaining true to our commitment to save American jobs.

There have been a few changes to the bill since a bipartisan majority of the House supported it a few weeks ago. We clarified that an expatriate plan must be a comprehensive health care health plan and not a mini-med or other substandard plan.

[Time: 14:30]

We tightened the definition of an expatriate. The bill says that an expatriate must be abroad for at least 6 months. This is a much tougher standard, and it will guard against potential abuse.

The bill now also requires an expatriate plan to offer reimbursements in more than two currencies. Plans meet this requirement today, but the addition of this provision protects against the possible abuse of the expatriate exemption in the future.

Finally, Mr. Speaker, the bill now makes explicit that the expatriate plans must continue to comply with relevant laws enacted prior to ACA, specifically ERISA and the Public Health Service Act.

Mr. Speaker, this bill is a good bill. It is a bipartisan bill, and I urge the support of the House.

I reserve the balance of my time.

2:29 PM EDT

Devin Nunes, R-CA 22nd

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

Mr. Speaker, the bill before the House today comes down to one simple question: Will we allow American companies to offer expatriate plans or will we force the offshoring of these plans? Will we support employment in America or stimulate employment overseas?

Mr. Carney and I have worked carefully and in good faith on a bipartisan basis to craft a bill that is limited in scope while at the same time remaining true to our commitment to save American jobs.

There have been a few changes to the bill since a bipartisan majority of the House supported it a few weeks ago. We clarified that an expatriate plan must be a comprehensive health care health plan and not a mini-med or other substandard plan.

[Time: 14:30]

We tightened the definition of an expatriate. The bill says that an expatriate must be abroad for at least 6 months. This is a much tougher standard, and it will guard against potential abuse.

The bill now also requires an expatriate plan to offer reimbursements in more than two currencies. Plans meet this requirement today, but the addition of this provision protects against the possible abuse of the expatriate exemption in the future.

Finally, Mr. Speaker, the bill now makes explicit that the expatriate plans must continue to comply with relevant laws enacted prior to ACA, specifically ERISA and the Public Health Service Act.

Mr. Speaker, this bill is a good bill. It is a bipartisan bill, and I urge the support of the House.

I reserve the balance of my time.

2:31 PM EDT

Sander Levin, D-MI 12th

Mr. LEVIN. Mr. Speaker, I yield myself such time as I shall consume.

There is no doubt about where Democrats stand. We have taken the lead to make sure there is no offshoring, and there has been a good faith effort here, up to a point. Surely, that has been true of Mr. Carney in all of his efforts, working with Mr. Nunes.

But the problem is that there remain some serious shortcomings in this bill, and unfortunately, we cannot try to remedy it through an amendment, so the notion there is an open process here isn't correct.

The definition of expatriate has been tightened. I think there remain some issues, at least one regarding it; but the major problem relates to the language and how it would impact, potentially, health insurance for an estimated 13 million legal permanent residents and others who are lawfully present foreign workers in the U.S.

Let me just give you examples of where the standards remain weak. For example, under this legislation, expat plans would have dispensation to be weaker than other employer plans in this country.

They could, for example, impose cost sharing on preventive benefits. They could impose annual and lifetime limits on coverage. They could impose unduly long waiting periods.

Indeed, the only ACA provision that would clearly remain in effect would be that they would have to offer coverage to young adults under 26.

So the bottom line is, unfortunately, that the legislation, in its present form, could substantially undermine health security for foreign workers, as well as American dependents who remain in this country.

Also, what it does is provide unprecedented special treatment for these plans in terms of exempting them from financing mechanisms.

Let me say further, as we found out from the Joint Tax Committee and CBO, they confirm this bill would cause some employers who would offer ACA-compliant plans under present law to offer less generous expatriate plans that are no longer subject to the ACA. This is the reason the administration issued, I think just today, a Statement of Administration Policy, and they say they do not support H.R. 4414.

The ACA gives people, it continues, greater control over their health care; and what they say is that this is not true sufficiently in this case.

It says, because of the ACA, Americans who have previously been denied coverage due to a preexisting medical condition now have access to coverage, and that may well not continue.

So the administration concludes it remains willing to work with Congress to improve H.R. 4414 to address those issues and to maintain basic consumer protections for all workers. There are straightforward changes to the legislation, which we have shared with the Congress, that would satisfy these goals, and the Congress should pursue a solution.

Unfortunately, because of this rule, we cannot propose an amendment which would essentially implement these proposals from the administration that they have shared with the Congress. That is why I, unfortunately, have no choice but to suggest a ``no'' vote on the floor of this House.

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

2:31 PM EDT

Sander Levin, D-MI 12th

Mr. LEVIN. Mr. Speaker, I yield myself such time as I shall consume.

There is no doubt about where Democrats stand. We have taken the lead to make sure there is no offshoring, and there has been a good faith effort here, up to a point. Surely, that has been true of Mr. Carney in all of his efforts, working with Mr. Nunes.

But the problem is that there remain some serious shortcomings in this bill, and unfortunately, we cannot try to remedy it through an amendment, so the notion there is an open process here isn't correct.

The definition of expatriate has been tightened. I think there remain some issues, at least one regarding it; but the major problem relates to the language and how it would impact, potentially, health insurance for an estimated 13 million legal permanent residents and others who are lawfully present foreign workers in the U.S.

Let me just give you examples of where the standards remain weak. For example, under this legislation, expat plans would have dispensation to be weaker than other employer plans in this country.

They could, for example, impose cost sharing on preventive benefits. They could impose annual and lifetime limits on coverage. They could impose unduly long waiting periods.

Indeed, the only ACA provision that would clearly remain in effect would be that they would have to offer coverage to young adults under 26.

So the bottom line is, unfortunately, that the legislation, in its present form, could substantially undermine health security for foreign workers, as well as American dependents who remain in this country.

Also, what it does is provide unprecedented special treatment for these plans in terms of exempting them from financing mechanisms.

Let me say further, as we found out from the Joint Tax Committee and CBO, they confirm this bill would cause some employers who would offer ACA-compliant plans under present law to offer less generous expatriate plans that are no longer subject to the ACA. This is the reason the administration issued, I think just today, a Statement of Administration Policy, and they say they do not support H.R. 4414.

The ACA gives people, it continues, greater control over their health care; and what they say is that this is not true sufficiently in this case.

It says, because of the ACA, Americans who have previously been denied coverage due to a preexisting medical condition now have access to coverage, and that may well not continue.

So the administration concludes it remains willing to work with Congress to improve H.R. 4414 to address those issues and to maintain basic consumer protections for all workers. There are straightforward changes to the legislation, which we have shared with the Congress, that would satisfy these goals, and the Congress should pursue a solution.

Unfortunately, because of this rule, we cannot propose an amendment which would essentially implement these proposals from the administration that they have shared with the Congress. That is why I, unfortunately, have no choice but to suggest a ``no'' vote on the floor of this House.

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

2:31 PM EDT

Sander Levin, D-MI 12th

Mr. LEVIN. Mr. Speaker, I yield myself such time as I shall consume.

There is no doubt about where Democrats stand. We have taken the lead to make sure there is no offshoring, and there has been a good faith effort here, up to a point. Surely, that has been true of Mr. Carney in all of his efforts, working with Mr. Nunes.

But the problem is that there remain some serious shortcomings in this bill, and unfortunately, we cannot try to remedy it through an amendment, so the notion there is an open process here isn't correct.

The definition of expatriate has been tightened. I think there remain some issues, at least one regarding it; but the major problem relates to the language and how it would impact, potentially, health insurance for an estimated 13 million legal permanent residents and others who are lawfully present foreign workers in the U.S.

Let me just give you examples of where the standards remain weak. For example, under this legislation, expat plans would have dispensation to be weaker than other employer plans in this country.

They could, for example, impose cost sharing on preventive benefits. They could impose annual and lifetime limits on coverage. They could impose unduly long waiting periods.

Indeed, the only ACA provision that would clearly remain in effect would be that they would have to offer coverage to young adults under 26.

So the bottom line is, unfortunately, that the legislation, in its present form, could substantially undermine health security for foreign workers, as well as American dependents who remain in this country.

Also, what it does is provide unprecedented special treatment for these plans in terms of exempting them from financing mechanisms.

Let me say further, as we found out from the Joint Tax Committee and CBO, they confirm this bill would cause some employers who would offer ACA-compliant plans under present law to offer less generous expatriate plans that are no longer subject to the ACA. This is the reason the administration issued, I think just today, a Statement of Administration Policy, and they say they do not support H.R. 4414.

The ACA gives people, it continues, greater control over their health care; and what they say is that this is not true sufficiently in this case.

It says, because of the ACA, Americans who have previously been denied coverage due to a preexisting medical condition now have access to coverage, and that may well not continue.

So the administration concludes it remains willing to work with Congress to improve H.R. 4414 to address those issues and to maintain basic consumer protections for all workers. There are straightforward changes to the legislation, which we have shared with the Congress, that would satisfy these goals, and the Congress should pursue a solution.

Unfortunately, because of this rule, we cannot propose an amendment which would essentially implement these proposals from the administration that they have shared with the Congress. That is why I, unfortunately, have no choice but to suggest a ``no'' vote on the floor of this House.

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

2:36 PM EDT

Jim Renacci, R-OH 16th

Mr. RENACCI. Mr. Speaker, I rise today in support of H.R. 4414, the Expatriate Health Coverage Clarification Act, a bill introduced by my good friend, John Carney.

When Mr. Carney and I first came to Congress, we looked around in search of others who, like us, were interested in finding common ground. Mr. Carney and I now meet regularly for breakfast with a group of Members from both sides of the aisle.

We come together to discuss commonsense ways to solve our Nation's problems that Members on both sides of the aisle can get behind. The bill that is on the floor today is an example of this type of commonsense approach to making policy.

The purpose of the bill is to fix a problem created by the President's health care law. If we don't fix it, 1,200 jobs will be lost across the country.

Mr. Carney and I may not agree on everything. In fact, the President's health care law is one thing we disagree on; but we do agree this specific provision is another example of one of the law's unintended consequences.

This bill before us today will keep America competitive and save American jobs. I encourage my colleagues on both sides of the aisle to support this important legislation.

2:37 PM EDT

John Carney, D-DE

Mr. CARNEY. Mr. Speaker, last week, when I was back home in my district in Delaware getting a workout at the YMCA in my hometown of Wilmington, a man came up to me as I was on the exercise bike and said: Excuse me, do you mind if I interrupt?

I said: Of course not, I work for you. He said: I wanted to see if you know about the status of H.R. 4414 because I write expatriate health insurance plans [Page: H3268]

for Cigna, and I don't want to lose my job.

Losing even one job like this in my State keeps me up at night. The prospect of losing 500 jobs is a punch to the gut. That is how many jobs we will lose in my home State of Delaware if we don't pass this bill on the floor today.

I am a strong supporter of the Affordable Care Act, so are a lot of people in my State; but no law is perfect, and in a law as important, as complicated, and as technical as the Affordable Care Act, there are bound to be a few things that needed to be fixed.

The ACA was unintentionally written in a way that subjects U.S. expatriate health insurance plans to all the provisions of the ACA, which places a unique burden on these types of plans.

Expatriate health insurance plans offer a high-end, robust coverage to people working outside their home country, giving them access to a global network of health care providers. Individuals on the plan could be foreign employees working here in America, Americans working abroad, or, say, a German working in France.

Expatriate plans ensure that these employees have worldwide access to quality health care while working outside their home country.

Several U.S. health insurance companies--Cigna, MetLife, Aetna, and United Health--offer expatriate health insurance plans. These insurance companies compete with foreign insurance companies that also sell the same kind of plan. The issue is these foreign plans don't have to comply with the ACA.

Forcing U.S. expatriate insurance plans to comply with the ACA thereby gives their foreign competitors a distinct advantage. As a result, to stay competitive, a U.S. expatriate insurer will move their business overseas, taking the jobs with them; and that is why I am here on the floor today.

The good news is that we have bipartisan legislation here today that will level the playing field. In fact, the administration has already provided temporary relief for expatriate plans from nearly every Affordable Care Act provision that has gone into effect so far. The problem is this relief is only partial and only temporary. The administration can't make this relief without this legislative fix.

Our legislation ensures that American expatriate insurance carriers are on a level playing field with their foreign competitors, so that American jobs stay here in America.

Many of you know that this is our second go-round at this legislation. Over the past few weeks, we have worked painstakingly to improve our bill, and we have.

We are confident that our original version of the bill wouldn't have negatively impacted green card holders or create loopholes in the ACA, but we have worked hard over the past few weeks to address the concerns we heard.

We heard concerns the bill would let insurance companies create low-quality plans. Our bill now requires expat plans to meet the same value standard as any other employer-based plan under the ACA, and if the plan doesn't meet that standard, the expat can use subsidies to buy coverage on the exchange, just like any other American.

We heard concerns that the definition of an expat was too broad, that it could be taken advantage of. We changed that definition, tightened it up, and it is identical to the HHS regulations today.

We now make explicit that expat plans must follow all ERISA and Public Health Service Act requirements that were in place before the ACA.

We have been working on this issue for 3 years. The crafting of this bill has been a more collaborative bipartisan process than I think this Chamber has seen in quite a while, and I want to thank my friends and colleagues on both sides of the aisle for that effort.

This bill isn't perfect. The Affordable Care Act wasn't perfect. No bill is perfect, but if there was ever a case where the perfect was being made the enemy of the good, we are hearing it from my colleagues today.

2:37 PM EDT

John Carney, D-DE

Mr. CARNEY. Mr. Speaker, last week, when I was back home in my district in Delaware getting a workout at the YMCA in my hometown of Wilmington, a man came up to me as I was on the exercise bike and said: Excuse me, do you mind if I interrupt?

I said: Of course not, I work for you. He said: I wanted to see if you know about the status of H.R. 4414 because I write expatriate health insurance plans [Page: H3268]

for Cigna, and I don't want to lose my job.

Losing even one job like this in my State keeps me up at night. The prospect of losing 500 jobs is a punch to the gut. That is how many jobs we will lose in my home State of Delaware if we don't pass this bill on the floor today.

I am a strong supporter of the Affordable Care Act, so are a lot of people in my State; but no law is perfect, and in a law as important, as complicated, and as technical as the Affordable Care Act, there are bound to be a few things that needed to be fixed.

The ACA was unintentionally written in a way that subjects U.S. expatriate health insurance plans to all the provisions of the ACA, which places a unique burden on these types of plans.

Expatriate health insurance plans offer a high-end, robust coverage to people working outside their home country, giving them access to a global network of health care providers. Individuals on the plan could be foreign employees working here in America, Americans working abroad, or, say, a German working in France.

Expatriate plans ensure that these employees have worldwide access to quality health care while working outside their home country.

Several U.S. health insurance companies--Cigna, MetLife, Aetna, and United Health--offer expatriate health insurance plans. These insurance companies compete with foreign insurance companies that also sell the same kind of plan. The issue is these foreign plans don't have to comply with the ACA.

Forcing U.S. expatriate insurance plans to comply with the ACA thereby gives their foreign competitors a distinct advantage. As a result, to stay competitive, a U.S. expatriate insurer will move their business overseas, taking the jobs with them; and that is why I am here on the floor today.

The good news is that we have bipartisan legislation here today that will level the playing field. In fact, the administration has already provided temporary relief for expatriate plans from nearly every Affordable Care Act provision that has gone into effect so far. The problem is this relief is only partial and only temporary. The administration can't make this relief without this legislative fix.

Our legislation ensures that American expatriate insurance carriers are on a level playing field with their foreign competitors, so that American jobs stay here in America.

Many of you know that this is our second go-round at this legislation. Over the past few weeks, we have worked painstakingly to improve our bill, and we have.

We are confident that our original version of the bill wouldn't have negatively impacted green card holders or create loopholes in the ACA, but we have worked hard over the past few weeks to address the concerns we heard.

We heard concerns the bill would let insurance companies create low-quality plans. Our bill now requires expat plans to meet the same value standard as any other employer-based plan under the ACA, and if the plan doesn't meet that standard, the expat can use subsidies to buy coverage on the exchange, just like any other American.

We heard concerns that the definition of an expat was too broad, that it could be taken advantage of. We changed that definition, tightened it up, and it is identical to the HHS regulations today.

We now make explicit that expat plans must follow all ERISA and Public Health Service Act requirements that were in place before the ACA.

We have been working on this issue for 3 years. The crafting of this bill has been a more collaborative bipartisan process than I think this Chamber has seen in quite a while, and I want to thank my friends and colleagues on both sides of the aisle for that effort.

This bill isn't perfect. The Affordable Care Act wasn't perfect. No bill is perfect, but if there was ever a case where the perfect was being made the enemy of the good, we are hearing it from my colleagues today.

2:41 PM EDT

John Carney, D-DE

Mr. CARNEY. So if we don't pass this legislation today, people who have expatriate plans and the companies that offer them will continue to do so. The question is whether they will do so here in the United States and keeping those workers here or whether they will move those operations overseas.

I understand, as well as anyone, that the ACA is a political weapon in a larger political war on both sides of the aisle. All I am asking today is that we take actions so that 500 hard-working Americans in my district don't become collateral damage in that partisan political fight. Let's call a temporary truce in that battle today to protect those jobs.

Finally, I want to thank my colleague, Congressman Nunes, and the Ways and Means staff on both sides of the aisle for their hard work on this issue, and I want to thank leadership on both sides of the aisle for recognizing this is a very serious problem that needs fixing.

I ask my colleagues on both sides of the aisle to support us and vote ``yes'' on this legislation today. Vote ``yes'' on H.R. 4414.

2:42 PM EDT

John Carney, D-DE

Mr. CARNEY. So if we don't pass this legislation today, people who have expatriate plans and the companies that offer them will continue to do so. The question is whether they will do so here in the United States and keeping those workers here or whether they will move those operations overseas.

I understand, as well as anyone, that the ACA is a political weapon in a larger political war on both sides of the aisle. All I am asking today is that we take actions so that 500 hard-working Americans in my district don't become collateral damage in that partisan political fight. Let's call a temporary truce in that battle today to protect those jobs.

Finally, I want to thank my colleague, Congressman Nunes, and the Ways and Means staff on both sides of the aisle for their hard work on this issue, and I want to thank leadership on both sides of the aisle for recognizing this is a very serious problem that needs fixing.

I ask my colleagues on both sides of the aisle to support us and vote ``yes'' on this legislation today. Vote ``yes'' on H.R. 4414.

2:43 PM EDT

Charlie Dent, R-PA 15th

Mr. DENT. Mr. Speaker, I rise today in strong support of H.R. 4414, the Expatriate Health Care Coverage Clarification Act.

I do want to point out that the American people do expect us to work together in a responsible manner to solve real problems, and that is what this bill we are talking about today does.

I certainly want to thank my colleagues, Representative Carney of Delaware and Representative Nunes of California, for taking the initiative to craft this really important piece of legislation.

I also know it is really difficult to look at any bill dealing with the health care law without considering the broader context of the law. However, it is also difficult to look at the state of our economy today and be nonchalant about the fact that 1,200 of our fellow Americans stand to lose their jobs if we don't act and pass this legislation.

Many of those folks live in the State of Delaware. Many of them live in the State of Pennsylvania, just over the Delaware State line. So our constituents are hearing about it, just like the story you heard from Mr. Carney and he is stopped by his constituents. We are hearing about this at home.

So that is really what this bill introduced by Mr. Carney and Mr. Nunes does. It saves jobs, it is that simple, and it does so without jeopardizing anybody's health care.

No one is going to be affected by this in a negative way. The bill on the floor today simply allows American companies to continue selling insurance to people who live and work overseas, many of our neighbors and friends. That happens to them.

[Time: 14:45]

If we don't pass this bill, the business will go to foreign insurance companies who will be selling these plans and possibly getting many of these jobs. Why would we want to do that? More importantly, why would we even allow that?

So this bill represents a very narrow change to the law and saves jobs. This bill simply amends the law. It does not end the law. This is not a partisan bill. This bill is a vote to keep jobs here in America and Pennsylvania and Delaware and California and other places and would take sensible steps to fix a law that we all know needs to be fixed.

Again, I know it is difficult, but we need to focus on the trees here and look past the forest, so to speak, on this bill. We need to take action and save jobs for American workers. And most important of all, we need to demonstrate to the American people that we can work together to solve very specific problems that need to be fixed. That is what we are doing. That is why everybody, whether you are a Republican or a Democrat, should stand up and enthusiastically support this bill that will not

harm anyone's health care and will save American jobs.

2:43 PM EDT

Charlie Dent, R-PA 15th

Mr. DENT. Mr. Speaker, I rise today in strong support of H.R. 4414, the Expatriate Health Care Coverage Clarification Act.

I do want to point out that the American people do expect us to work together in a responsible manner to solve real problems, and that is what this bill we are talking about today does.

I certainly want to thank my colleagues, Representative Carney of Delaware and Representative Nunes of California, for taking the initiative to craft this really important piece of legislation.

I also know it is really difficult to look at any bill dealing with the health care law without considering the broader context of the law. However, it is also difficult to look at the state of our economy today and be nonchalant about the fact that 1,200 of our fellow Americans stand to lose their jobs if we don't act and pass this legislation.

Many of those folks live in the State of Delaware. Many of them live in the State of Pennsylvania, just over the Delaware State line. So our constituents are hearing about it, just like the story you heard from Mr. Carney and he is stopped by his constituents. We are hearing about this at home.

So that is really what this bill introduced by Mr. Carney and Mr. Nunes does. It saves jobs, it is that simple, and it does so without jeopardizing anybody's health care.

No one is going to be affected by this in a negative way. The bill on the floor today simply allows American companies to continue selling insurance to people who live and work overseas, many of our neighbors and friends. That happens to them.

[Time: 14:45]

If we don't pass this bill, the business will go to foreign insurance companies who will be selling these plans and possibly getting many of these jobs. Why would we want to do that? More importantly, why would we even allow that?

So this bill represents a very narrow change to the law and saves jobs. This bill simply amends the law. It does not end the law. This is not a partisan bill. This bill is a vote to keep jobs here in America and Pennsylvania and Delaware and California and other places and would take sensible steps to fix a law that we all know needs to be fixed.

Again, I know it is difficult, but we need to focus on the trees here and look past the forest, so to speak, on this bill. We need to take action and save jobs for American workers. And most important of all, we need to demonstrate to the American people that we can work together to solve very specific problems that need to be fixed. That is what we are doing. That is why everybody, whether you are a Republican or a Democrat, should stand up and enthusiastically support this bill that will not

harm anyone's health care and will save American jobs.

2:45 PM EDT

Henry Waxman, D-CA 33rd

Mr. WAXMAN. I thank the gentleman for yielding to me.

Mr. Speaker, my colleagues, this is a bill that could have been worked out. This is a bill that could have accomplished the purpose that I know that our colleague from Delaware wants to see put into place, and I applaud him [Page: H3269]

for working hard to improve the bill under very difficult circumstances.

In trying to allow the American insurance companies to sell policies to expats, we could craft a bill that is narrow, but we are not getting cooperation to get to that point. The reason we are not getting cooperation is we are told we must pass a bill right away. Well, we were told that 2 weeks ago when we had the bill under suspension, and we couldn't consider any amendments under suspension. Now we have the bill under a rule. Oh, and the rule provides for no amendments either.

There is a bill to be crafted, but this bill before us does not accomplish the goal in a way that really doesn't hurt some people's insurance coverage.

There are still two major problems with the legislation before us today. First, it does not have enough safeguards to guarantee that these expatriate plans are high quality, and the second issue is the bill creates problems for millions of other people who are legal permanent residents here in the United States and others working in this country who are currently protected by the Affordable Care Act.

On the first issue, the insurers tell us that their expatriate plans are going to be extremely generous. They say they cover people in dozens of countries around the world and they have comprehensive benefits, but we don't see any language to verify that claim. Supporters of the bill claim to guarantee the plans are as high quality as the insurers say they are. But it is one thing to say that their plans will be of high quality; it is another thing to actually require them to offer comprehensive

benefits. As President Reagan used to say, ``Trust, but verify.''

The second issue has nothing to do with the expatriate plans and the companies that are threatening to shut down their operations here in the United States. It has to do with millions of other people who are legal permanent residents and workers on visas who currently benefit from the ACA's protections. But this bill creates a loophole that could allow these people to be sold plans here in the United States that do not meet ACA standards. That is why a lot of people looking at this legislation

are saying--such as major labor unions, immigration advocacy organizations--that this bill is not one they can support, and they urge that we vote against it.

So I think we can fix both of those issues. We should have fixed both of those issues before this bill was brought up on the House floor. But as it stands, we don't know if the Senate can pass any bill, and I don't believe the President can sign this bill.

My colleague from Delaware and my other colleagues have already helped make important improvements for the bill. Changing the definition of an expatriate to someone who is outside of the country for 6 months is an important step. We should continue to make progress.

There have been productive negotiations on the legislation in recent days. We need to reach an agreement, and we should bring that compromise to the House floor; but without that compromise, I don't feel I can vote for the bill as it presently stands. There are these two glaring problems that need to be fixed; and without it, we will not know if those expatriate plans really are the high quality they claim to be, and we will not know if legal residents of the United States will be able to get

the kind of high-quality plan that everybody else in the United States will have.

So I urge a ``no'' vote and suggest that we get back to the negotiating table.

2:46 PM EDT

Henry Waxman, D-CA 33rd

Mr. WAXMAN. I thank the gentleman for yielding to me.

Mr. Speaker, my colleagues, this is a bill that could have been worked out. This is a bill that could have accomplished the purpose that I know that our colleague from Delaware wants to see put into place, and I applaud him [Page: H3269]

for working hard to improve the bill under very difficult circumstances.

In trying to allow the American insurance companies to sell policies to expats, we could craft a bill that is narrow, but we are not getting cooperation to get to that point. The reason we are not getting cooperation is we are told we must pass a bill right away. Well, we were told that 2 weeks ago when we had the bill under suspension, and we couldn't consider any amendments under suspension. Now we have the bill under a rule. Oh, and the rule provides for no amendments either.

There is a bill to be crafted, but this bill before us does not accomplish the goal in a way that really doesn't hurt some people's insurance coverage.

There are still two major problems with the legislation before us today. First, it does not have enough safeguards to guarantee that these expatriate plans are high quality, and the second issue is the bill creates problems for millions of other people who are legal permanent residents here in the United States and others working in this country who are currently protected by the Affordable Care Act.

On the first issue, the insurers tell us that their expatriate plans are going to be extremely generous. They say they cover people in dozens of countries around the world and they have comprehensive benefits, but we don't see any language to verify that claim. Supporters of the bill claim to guarantee the plans are as high quality as the insurers say they are. But it is one thing to say that their plans will be of high quality; it is another thing to actually require them to offer comprehensive

benefits. As President Reagan used to say, ``Trust, but verify.''

The second issue has nothing to do with the expatriate plans and the companies that are threatening to shut down their operations here in the United States. It has to do with millions of other people who are legal permanent residents and workers on visas who currently benefit from the ACA's protections. But this bill creates a loophole that could allow these people to be sold plans here in the United States that do not meet ACA standards. That is why a lot of people looking at this legislation

are saying--such as major labor unions, immigration advocacy organizations--that this bill is not one they can support, and they urge that we vote against it.

So I think we can fix both of those issues. We should have fixed both of those issues before this bill was brought up on the House floor. But as it stands, we don't know if the Senate can pass any bill, and I don't believe the President can sign this bill.

My colleague from Delaware and my other colleagues have already helped make important improvements for the bill. Changing the definition of an expatriate to someone who is outside of the country for 6 months is an important step. We should continue to make progress.

There have been productive negotiations on the legislation in recent days. We need to reach an agreement, and we should bring that compromise to the House floor; but without that compromise, I don't feel I can vote for the bill as it presently stands. There are these two glaring problems that need to be fixed; and without it, we will not know if those expatriate plans really are the high quality they claim to be, and we will not know if legal residents of the United States will be able to get

the kind of high-quality plan that everybody else in the United States will have.

So I urge a ``no'' vote and suggest that we get back to the negotiating table.

2:50 PM EDT

Devin Nunes, R-CA 22nd

Mr. NUNES. Mr. Speaker, I yield myself 14 seconds.

Mr. Speaker, we have waited for 4 years. For 4 years, we have been trying to fix this problem. Four years, time is up. We have got to pass this bill and send it to the Senate so that it can be signed into law.

I will continue to reserve the balance of my time.

2:50 PM EDT

Devin Nunes, R-CA 22nd

Mr. NUNES. Mr. Speaker, I yield myself 14 seconds.

Mr. Speaker, we have waited for 4 years. For 4 years, we have been trying to fix this problem. Four years, time is up. We have got to pass this bill and send it to the Senate so that it can be signed into law.

I will continue to reserve the balance of my time.

2:51 PM EDT

Peter Welch, D-VT

Mr. WELCH. Mr. Speaker, I support this bill.

There are really two issues at stake. One is preserving the integrity of the ACA, the Obama health care bill. There is huge division in this Congress as to whether that bill should have been passed. It was passed. But there is unity of purpose now that where there is an identified problem, we should fix it rather than just having the ideological battle about whether the law should have been passed in the first place. That is actually progress because, as my friend from Pennsylvania said, there

is a legitimate expectation on the part of the people we represent to solve concrete, discrete problems when, in the solving of them, we are going to keep 1,200 people working. And that is the real goal of this.

Is there a way where both sides--those who agree with the health care bill and those who disagree with it--can come together with a narrow fix that allows 1,200 people--500 in Delaware and 700 in other parts of the country--to keep doing their work? And, of course, we can.

There is a second question that has come up, and that is whether this bill right now goes as far as it needs to go. Is this crafted as well as it needs to be crafted? And that is debatable. The points that the gentleman from California (Mr. Waxman) made were heartfelt, but there has been real progress because there has been engagement.

You have had Mr. Carney and Mr. Nunes working very closely with colleagues on both of their sides to deal with practical issues that have come up. You have had the White House meeting with Cigna, and both sides understood. Cigna understood that the White House had

had some legitimate concerns as proponents of the ACA; the White House understood that Cigna had real and legitimate concerns about their business and their jobs.

So the progress is reflected in this bill. There is now a debate about whether that is enough progress. So we have to make a decision: Do we wait and try to keep negotiating here or do we move it on to the Senate?

In my view, we move it on to the Senate, partly because, as Mr. Nunes said, we have been grappling with this for 3 to 4 years. Second, we have got ACA supporters--and this gives me comfort--on the Senate side, Senator Carper and Senator Coons from Delaware, who are committed to making certain that the fix doesn't compromise the health care bill. That is important to folks like me who voted for the ACA.

So this is a practical step that we can take, working together in order to save jobs without compromising the underlying legislation.

2:51 PM EDT

Peter Welch, D-VT

Mr. WELCH. Mr. Speaker, I support this bill.

There are really two issues at stake. One is preserving the integrity of the ACA, the Obama health care bill. There is huge division in this Congress as to whether that bill should have been passed. It was passed. But there is unity of purpose now that where there is an identified problem, we should fix it rather than just having the ideological battle about whether the law should have been passed in the first place. That is actually progress because, as my friend from Pennsylvania said, there

is a legitimate expectation on the part of the people we represent to solve concrete, discrete problems when, in the solving of them, we are going to keep 1,200 people working. And that is the real goal of this.

Is there a way where both sides--those who agree with the health care bill and those who disagree with it--can come together with a narrow fix that allows 1,200 people--500 in Delaware and 700 in other parts of the country--to keep doing their work? And, of course, we can.

There is a second question that has come up, and that is whether this bill right now goes as far as it needs to go. Is this crafted as well as it needs to be crafted? And that is debatable. The points that the gentleman from California (Mr. Waxman) made were heartfelt, but there has been real progress because there has been engagement.

You have had Mr. Carney and Mr. Nunes working very closely with colleagues on both of their sides to deal with practical issues that have come up. You have had the White House meeting with Cigna, and both sides understood. Cigna understood that the White House had

had some legitimate concerns as proponents of the ACA; the White House understood that Cigna had real and legitimate concerns about their business and their jobs.

So the progress is reflected in this bill. There is now a debate about whether that is enough progress. So we have to make a decision: Do we wait and try to keep negotiating here or do we move it on to the Senate?

In my view, we move it on to the Senate, partly because, as Mr. Nunes said, we have been grappling with this for 3 to 4 years. Second, we have got ACA supporters--and this gives me comfort--on the Senate side, Senator Carper and Senator Coons from Delaware, who are committed to making certain that the fix doesn't compromise the health care bill. That is important to folks like me who voted for the ACA.

So this is a practical step that we can take, working together in order to save jobs without compromising the underlying legislation.

2:53 PM EDT

Devin Nunes, R-CA 22nd

Mr. NUNES. Mr. Speaker, I yield myself 21 seconds.

Mr. Speaker, I would like to submit for the Record three letters: one from the Council for Affordable Health Coverage in support of our bill, the other from the National Association of Health Underwriters in support of our bill, and the last one from the Business Roundtable in support of our bill.

COUNCIL FOR AFFORDABLE

HEALTH COVERAGE,

April 29, 2014.

Hon. JOHN CARNEY,

Longworth House Office Building,

Washington, DC.

Hon. DEVIN NUNES,

Longworth House Office Building,

Washington, DC.

DEAR CONGRESSMEN CARNEY AND NUNES: We write to endorse H.R. 4414, the Expatriate Health Coverage Clarification Act of 2014. We strongly support this modification of the Affordable Care Act (ACA) because it will prevent Americans workers abroad and American companies providing health coverage internationally from being disadvantaged compared to their foreign counterparts.

Employers are not alone in their concerns about the application of the ACA to expatriates. The Department of Labor in a Frequently Asked Questions document stated, ``The Departments recognize that expatriate health plans may face special challenges in complying with certain provisions of the Affordable Care Act. In particular, challenges in reconciling and coordinating the multiple regulatory regimes that apply to expatriate health plans might make it impossible or impracticable to comply with

all the relevant rules at least in the near term.'' The Center Consumer Information and Insurance Oversight (CCIIO) concurred with the Department of Labor by posting the same document on their website.

It is clear that the ACA never envisioned the impact of the law on expatriate plans. For example, CCIIO and the Department of Labor used the following example to illustrate the impracticality of applying the ACA to expatriate plans. ``For example, independent review organizations may not exist abroad, and it may be difficult for certain preventive services to be provided, or even be identified as preventive, when such services are provided outside the United States by clinical providers that

use different code sets [Page: H3270]

and medical terminology to identify services.''

Because of the challenges and impracticalities associated with this aspect of the Affordable Care Act, we urge you to quickly pass this legislation to protect American workers abroad and American insurers selling insurance on the international market.

Sincerely,

Communicating for America;

Council for Affordable Health Coverage;

National Association of Health Underwriters;

National Retail Federation;

Retail Industry Leaders Association;

Small Business & Entrepreneurship Council; and

U.S Chamber of Commerce.--

NATIONAL ASSOCIATION OF

HEALTH UNDERWRITERS,

Washington, DC, April 28, 2014.

Congressman JOHN CARNEY,

Longworth House Office Building,

Washington, DC.

DEAR CONGRESSMAN CARNEY: On behalf of the National Association of Health Underwriters (NAHU), representing 100,000 licensed agents and brokers who are engaged in the sale and service of health insurance and other ancillary products and serving employers and consumers around the country, I want to commend you on your efforts to pass the Expatriate Health Coverage Clarification Act as amended.

NAHU members work to help millions of employers of all sizes finance administer and utilize their group health benefit plans on a daily basis. Expatriate health insurance plans offer high-end, robust coverage to executives and others working outside their home country, giving them access to a global network of health care providers.

U.S. insurance companies compete with foreign insurance companies that also sell expatriate health insurance plans, but these foreign carriers are not required to comply with the Affordable Care Act (ACA). This imbalance gives foreign competitors an unfair advantage. The bill narrowly clarifies that the Affordable Care Act does not apply to expatriate health insurance plans.

Since the legislation's original introduction, it has been amended and now requires an expatriate plan to meet minimum value requirements as defined under the ACA (60 percent actuarial value). This is the same standard all other employer-provided plans must meet in order to comply with the laws employer shared responsibility provisions. Should an expatriate plan offered under this bill fail to meet minimum value requirements, an employee would be eligible to seek coverage on the exchange and

could be eligible for income-based subsidies.

Further, the amended bill tightens the definition of an expatriate. It says that an expatriate must be abroad for at least six months. The previous version of the bill said that an expatriate only had to be abroad for three months, or travel outside the country 15 times in a year. This bill requires a much tougher standard that will guard against potential abuse. Finally, the amended bill explicitly states that expatriate plans must continue to comply with relevant laws enacted prior to the ACA--specifically

the Employee Retirement Income Security Act and the Public Health Service Act.

We appreciate your leadership on this important issue for businesses and their employees so that the law can help all Americans get quality health insurance. We look forward to working with you and your colleagues in enacting this bipartisan legislation this year.

Best regards,

Janet Trautwein,

Executive Vice President and CEO.

--

BUSINESS ROUNDTABLE,

Washington, DC, April 28, 2014.

Hon. HARRY REID,

Majority Leader, U.S. Senate,

Washington, DC.

Hon. MITCH MCCONNELL,

Minority Leader, U.S. Senate,

Washington, DC.

Hon. JOHN BOEHNER,

Speaker, House of Representatives,

Washington, DC.

Hon. NANCY PELOSI,

Minority Leader, House of Representatives,

Washington, DC.

DEAR LEADERS: The Business Roundtable encourages you to support legislation that does not apply Affordable Care Act (ACA) requirements upon employer-sponsored health care coverage for those employees and their families who work outside of the United States. Business Roundtable is an association of chief executive officers of leading U.S. companies with $7.4 trillion in annual revenues and more than 16 million employees.

Business Roundtable companies provide health coverage to over 40 million Americans around the globe. We consider our employees to be among our strongest competitive assets and are committed to a benefits strategy that enhances their health, well-being, and sense of security wherever they may be. We have also advocated for reforms that will improve quality and make health care more affordable and more efficient.

As companies expand operations internationally, we face challenges in a global competitive environment, one of which is the application of ACA requirements to our globally mobile employees and their families. As currently interpreted, the complex and prescriptive requirements of the ACA apply to U.S.-based expatriate plans, which means U.S.-based international plans must comply with the domestic law's requirements in all parts of the world and for all employees outside the United States covered

on those plans, regardless of their citizenship and work location. Many of these requirements are difficult to implement in other countries and may not be relevant in other locations.

For example, the Summary of Benefit Coverage notification uses terminology and data that is specifically tailored to types of benefits, costs, and care offered in the United States. This form is not relevant to those who live outside the country. There are numerous examples of these types of requirements in the law that are unique to our health care system and should not be applied to benefits offered to employees who are residing outside of the United States.

Expatriate health care benefits are highly valued by our employees and ensure they can continue to benefit from an American health care option. This, in turn, assures the competitiveness of U.S. jobs in the global market. For these reasons, we urge Congress to pass narrow, common sense relief that provides certainty and clarity for multinational corporations and their ability to continue providing comprehensive health benefits for those employees outside the United States.

Sincerely,

Gary Loveman,

Chairman, Chief Executive Officer and President, Caesars Entertainment Corporation; Chair, Health and Retirement Committee, Business Roundtable.

2:53 PM EDT

Devin Nunes, R-CA 22nd

Mr. NUNES. Mr. Speaker, I yield myself 21 seconds.

Mr. Speaker, I would like to submit for the Record three letters: one from the Council for Affordable Health Coverage in support of our bill, the other from the National Association of Health Underwriters in support of our bill, and the last one from the Business Roundtable in support of our bill.

COUNCIL FOR AFFORDABLE

HEALTH COVERAGE,

April 29, 2014.

Hon. JOHN CARNEY,

Longworth House Office Building,

Washington, DC.

Hon. DEVIN NUNES,

Longworth House Office Building,

Washington, DC.

DEAR CONGRESSMEN CARNEY AND NUNES: We write to endorse H.R. 4414, the Expatriate Health Coverage Clarification Act of 2014. We strongly support this modification of the Affordable Care Act (ACA) because it will prevent Americans workers abroad and American companies providing health coverage internationally from being disadvantaged compared to their foreign counterparts.

Employers are not alone in their concerns about the application of the ACA to expatriates. The Department of Labor in a Frequently Asked Questions document stated, ``The Departments recognize that expatriate health plans may face special challenges in complying with certain provisions of the Affordable Care Act. In particular, challenges in reconciling and coordinating the multiple regulatory regimes that apply to expatriate health plans might make it impossible or impracticable to comply with

all the relevant rules at least in the near term.'' The Center Consumer Information and Insurance Oversight (CCIIO) concurred with the Department of Labor by posting the same document on their website.

It is clear that the ACA never envisioned the impact of the law on expatriate plans. For example, CCIIO and the Department of Labor used the following example to illustrate the impracticality of applying the ACA to expatriate plans. ``For example, independent review organizations may not exist abroad, and it may be difficult for certain preventive services to be provided, or even be identified as preventive, when such services are provided outside the United States by clinical providers that

use different code sets [Page: H3270]

and medical terminology to identify services.''

Because of the challenges and impracticalities associated with this aspect of the Affordable Care Act, we urge you to quickly pass this legislation to protect American workers abroad and American insurers selling insurance on the international market.

Sincerely,

Communicating for America;

Council for Affordable Health Coverage;

National Association of Health Underwriters;

National Retail Federation;

Retail Industry Leaders Association;

Small Business & Entrepreneurship Council; and

U.S Chamber of Commerce.--

NATIONAL ASSOCIATION OF

HEALTH UNDERWRITERS,

Washington, DC, April 28, 2014.

Congressman JOHN CARNEY,

Longworth House Office Building,

Washington, DC.

DEAR CONGRESSMAN CARNEY: On behalf of the National Association of Health Underwriters (NAHU), representing 100,000 licensed agents and brokers who are engaged in the sale and service of health insurance and other ancillary products and serving employers and consumers around the country, I want to commend you on your efforts to pass the Expatriate Health Coverage Clarification Act as amended.

NAHU members work to help millions of employers of all sizes finance administer and utilize their group health benefit plans on a daily basis. Expatriate health insurance plans offer high-end, robust coverage to executives and others working outside their home country, giving them access to a global network of health care providers.

U.S. insurance companies compete with foreign insurance companies that also sell expatriate health insurance plans, but these foreign carriers are not required to comply with the Affordable Care Act (ACA). This imbalance gives foreign competitors an unfair advantage. The bill narrowly clarifies that the Affordable Care Act does not apply to expatriate health insurance plans.

Since the legislation's original introduction, it has been amended and now requires an expatriate plan to meet minimum value requirements as defined under the ACA (60 percent actuarial value). This is the same standard all other employer-provided plans must meet in order to comply with the laws employer shared responsibility provisions. Should an expatriate plan offered under this bill fail to meet minimum value requirements, an employee would be eligible to seek coverage on the exchange and

could be eligible for income-based subsidies.

Further, the amended bill tightens the definition of an expatriate. It says that an expatriate must be abroad for at least six months. The previous version of the bill said that an expatriate only had to be abroad for three months, or travel outside the country 15 times in a year. This bill requires a much tougher standard that will guard against potential abuse. Finally, the amended bill explicitly states that expatriate plans must continue to comply with relevant laws enacted prior to the ACA--specifically

the Employee Retirement Income Security Act and the Public Health Service Act.

We appreciate your leadership on this important issue for businesses and their employees so that the law can help all Americans get quality health insurance. We look forward to working with you and your colleagues in enacting this bipartisan legislation this year.

Best regards,

Janet Trautwein,

Executive Vice President and CEO.

--

BUSINESS ROUNDTABLE,

Washington, DC, April 28, 2014.

Hon. HARRY REID,

Majority Leader, U.S. Senate,

Washington, DC.

Hon. MITCH MCCONNELL,

Minority Leader, U.S. Senate,

Washington, DC.

Hon. JOHN BOEHNER,

Speaker, House of Representatives,

Washington, DC.

Hon. NANCY PELOSI,

Minority Leader, House of Representatives,

Washington, DC.

DEAR LEADERS: The Business Roundtable encourages you to support legislation that does not apply Affordable Care Act (ACA) requirements upon employer-sponsored health care coverage for those employees and their families who work outside of the United States. Business Roundtable is an association of chief executive officers of leading U.S. companies with $7.4 trillion in annual revenues and more than 16 million employees.

Business Roundtable companies provide health coverage to over 40 million Americans around the globe. We consider our employees to be among our strongest competitive assets and are committed to a benefits strategy that enhances their health, well-being, and sense of security wherever they may be. We have also advocated for reforms that will improve quality and make health care more affordable and more efficient.

As companies expand operations internationally, we face challenges in a global competitive environment, one of which is the application of ACA requirements to our globally mobile employees and their families. As currently interpreted, the complex and prescriptive requirements of the ACA apply to U.S.-based expatriate plans, which means U.S.-based international plans must comply with the domestic law's requirements in all parts of the world and for all employees outside the United States covered

on those plans, regardless of their citizenship and work location. Many of these requirements are difficult to implement in other countries and may not be relevant in other locations.

For example, the Summary of Benefit Coverage notification uses terminology and data that is specifically tailored to types of benefits, costs, and care offered in the United States. This form is not relevant to those who live outside the country. There are numerous examples of these types of requirements in the law that are unique to our health care system and should not be applied to benefits offered to employees who are residing outside of the United States.

Expatriate health care benefits are highly valued by our employees and ensure they can continue to benefit from an American health care option. This, in turn, assures the competitiveness of U.S. jobs in the global market. For these reasons, we urge Congress to pass narrow, common sense relief that provides certainty and clarity for multinational corporations and their ability to continue providing comprehensive health benefits for those employees outside the United States.

Sincerely,

Gary Loveman,

Chairman, Chief Executive Officer and President, Caesars Entertainment Corporation; Chair, Health and Retirement Committee, Business Roundtable.

2:54 PM EDT

Xavier Becerra, D-CA 34th

Mr. BECERRA. I thank the gentleman for yielding me the time.

Mr. Speaker, let me say in advance that I appreciate the work that has been done by any number of Members with regard to this legislation. Many people have engaged in a good faith effort to try to find an acceptable solution that resolves issues which are legitimate and have raised a concern for a lot of us with regard to how we move forward with the Affordable Care Act and make sure that not only Americans are covered, but that our companies can continue to offer insurance coverage for those

Americans that are not only affordable but have high quality.

And many of us have recognized that in the case of Americans who are out of the country for more time than they are in the country in a year, that we may have to make some exceptions for them so that the company that is offering them health insurance can offer a policy that is competitive. We don't want to price out our American companies that offer health insurance coverage simply because they are trying to meet domestic care standards for health care that are required as a result of the Affordable

Care Act but that may not work as well abroad.

So you take a look at the name of this bill, the Expatriate Health Coverage Clarification Act of 2014. You think, okay, that is what we are trying to do. We are trying to help expatriates, Americans who work abroad more time than they are here at home. But when you take a close look at the bill, that is not what it does.

We are told by the Congressional Research Service that there are probably about 285,000 Americans who have expatriate health care coverage. This bill wouldn't impact just those 285,000 Americans. This bill impacts millions because it impacts U.S. citizens who are here in the country, not abroad for more than half of the time, and it could have an impact on every single legal immigrant who is in this country.

So I think all of us agree. We want to make sure that the Affordable Care Act and its patient protections work, and if we could tweak things to make it work better, we should. But this is not a bill for expatriates. This is a bill that goes way beyond.

So let's not fool ourselves. We have to take care of trying to deal with the narrow exception that we are looking at for expatriates, not create a giant loophole by which we can now remove the protection against discrimination for preexisting conditions that right now all Americans and legal immigrants can now know that they have.

We want to make sure that all of those people who now have protection from the plans that don't provide coverage after a certain amount of money, where all of a sudden, boom, you go bankrupt because you didn't know that your insurance company would only [Page: H3271]

cover $50,000 of your health care costs, that protection might be gone. What we don't want is to create a giant loophole in trying to help a narrow band of Americans and companies that offer these Americans

health insurance coverage.

The White House has said there is a fix here. And I know the White House has been trying to work with the proponents of this bill to come up with a fix. But as they said the last time this was up, this needs work, and it should not come up for a vote.

But what are they saying now? The administration issued this today:

The administration does not support House passage of H.R. 4414 in its current form because it would reduce consumer protections and create even more loopholes in the Tax Code.

There is a fix, but this is not it because it goes way beyond. And what we also have to do is recognize that there are other things involved.

This bill will cost the American taxpayers money. How much? We are told by the Congressional Budget Office and Joint Tax Committee, $1.4 billion. Is it paid for? Are the $1.4 billion that we would take away from--or have to take from other taxpayers covered so that we won't have to have other Americans pay for this? No. This bill is unpaid for.

And so for any number of reasons, we should sit down and get this resolved the right way because the White House says there is a fix. Those of us who oppose this bill say there is a fix. But to create more loopholes which allow American citizens and immigrants who are lawfully here, working hard, to all of a sudden be deprived of their protections----

2:54 PM EDT

Xavier Becerra, D-CA 34th

Mr. BECERRA. I thank the gentleman for yielding me the time.

Mr. Speaker, let me say in advance that I appreciate the work that has been done by any number of Members with regard to this legislation. Many people have engaged in a good faith effort to try to find an acceptable solution that resolves issues which are legitimate and have raised a concern for a lot of us with regard to how we move forward with the Affordable Care Act and make sure that not only Americans are covered, but that our companies can continue to offer insurance coverage for those

Americans that are not only affordable but have high quality.

And many of us have recognized that in the case of Americans who are out of the country for more time than they are in the country in a year, that we may have to make some exceptions for them so that the company that is offering them health insurance can offer a policy that is competitive. We don't want to price out our American companies that offer health insurance coverage simply because they are trying to meet domestic care standards for health care that are required as a result of the Affordable

Care Act but that may not work as well abroad.

So you take a look at the name of this bill, the Expatriate Health Coverage Clarification Act of 2014. You think, okay, that is what we are trying to do. We are trying to help expatriates, Americans who work abroad more time than they are here at home. But when you take a close look at the bill, that is not what it does.

We are told by the Congressional Research Service that there are probably about 285,000 Americans who have expatriate health care coverage. This bill wouldn't impact just those 285,000 Americans. This bill impacts millions because it impacts U.S. citizens who are here in the country, not abroad for more than half of the time, and it could have an impact on every single legal immigrant who is in this country.

So I think all of us agree. We want to make sure that the Affordable Care Act and its patient protections work, and if we could tweak things to make it work better, we should. But this is not a bill for expatriates. This is a bill that goes way beyond.

So let's not fool ourselves. We have to take care of trying to deal with the narrow exception that we are looking at for expatriates, not create a giant loophole by which we can now remove the protection against discrimination for preexisting conditions that right now all Americans and legal immigrants can now know that they have.

We want to make sure that all of those people who now have protection from the plans that don't provide coverage after a certain amount of money, where all of a sudden, boom, you go bankrupt because you didn't know that your insurance company would only [Page: H3271]

cover $50,000 of your health care costs, that protection might be gone. What we don't want is to create a giant loophole in trying to help a narrow band of Americans and companies that offer these Americans

health insurance coverage.

The White House has said there is a fix here. And I know the White House has been trying to work with the proponents of this bill to come up with a fix. But as they said the last time this was up, this needs work, and it should not come up for a vote.

But what are they saying now? The administration issued this today:

The administration does not support House passage of H.R. 4414 in its current form because it would reduce consumer protections and create even more loopholes in the Tax Code.

There is a fix, but this is not it because it goes way beyond. And what we also have to do is recognize that there are other things involved.

This bill will cost the American taxpayers money. How much? We are told by the Congressional Budget Office and Joint Tax Committee, $1.4 billion. Is it paid for? Are the $1.4 billion that we would take away from--or have to take from other taxpayers covered so that we won't have to have other Americans pay for this? No. This bill is unpaid for.

And so for any number of reasons, we should sit down and get this resolved the right way because the White House says there is a fix. Those of us who oppose this bill say there is a fix. But to create more loopholes which allow American citizens and immigrants who are lawfully here, working hard, to all of a sudden be deprived of their protections----

2:58 PM EDT

Xavier Becerra, D-CA 34th

Mr. BECERRA. To deprive American citizens who don't know about this, to deprive those immigrants who came to this country legally and are working in this country and today have the same protections to make sure they are not discriminated against for a preexisting condition, who also have a chance to get offered a plan that has those protections against that fine print we used to see in the health policies, to all of a sudden tell them that they are going to be denied that because we were trying

to fix a problem for Americans who work abroad for more than a half a year, that is not what we should be doing.

There is a fix. This should not cost the taxpayers more money. And I believe we could do this pretty quickly because it is a narrow issue.

If we really want to help expats, take out the language in the bill that talks about legal immigrants who are in the country. It talks about workers who come to this country to work under worker visa categories, like in the high-tech field or in agriculture. We can do this very simply. And I just appeal to my colleagues and friends on both sides of the aisle: Let's not open up bigger loopholes that cost the taxpayers money simply to try to fix a narrow version of this that we know we can do.

So with that, I hope that sanity will prevail before this goes too far.

[Time: 15:00]

2:58 PM EDT

Xavier Becerra, D-CA 34th

Mr. BECERRA. To deprive American citizens who don't know about this, to deprive those immigrants who came to this country legally and are working in this country and today have the same protections to make sure they are not discriminated against for a preexisting condition, who also have a chance to get offered a plan that has those protections against that fine print we used to see in the health policies, to all of a sudden tell them that they are going to be denied that because we were trying

to fix a problem for Americans who work abroad for more than a half a year, that is not what we should be doing.

There is a fix. This should not cost the taxpayers more money. And I believe we could do this pretty quickly because it is a narrow issue.

If we really want to help expats, take out the language in the bill that talks about legal immigrants who are in the country. It talks about workers who come to this country to work under worker visa categories, like in the high-tech field or in agriculture. We can do this very simply. And I just appeal to my colleagues and friends on both sides of the aisle: Let's not open up bigger loopholes that cost the taxpayers money simply to try to fix a narrow version of this that we know we can do.

So with that, I hope that sanity will prevail before this goes too far.

[Time: 15:00]

2:59 PM EDT

Devin Nunes, R-CA 22nd

Mr. NUNES. Mr. Speaker, before I yield to my friend from Pennsylvania again, I just want to say that as someone who used to work in the fields, I would much prefer an expatriate plan over ObamaCare.

At this time, I will yield 2 minutes to the gentleman from Pennsylvania (Mr. Dent).

2:59 PM EDT

Devin Nunes, R-CA 22nd

Mr. NUNES. Mr. Speaker, before I yield to my friend from Pennsylvania again, I just want to say that as someone who used to work in the fields, I would much prefer an expatriate plan over ObamaCare.

At this time, I will yield 2 minutes to the gentleman from Pennsylvania (Mr. Dent).

3:00 PM EDT

Charlie Dent, R-PA 15th

Mr. DENT. Mr. Speaker, just in response to some of the comments I heard from my colleagues from California, I think it is pretty clear, the Joint Committee on Taxation, JCT, has been quoted here, but under this bill, the Joint Committee on Taxation confirms that all plans are ACA compliant. The JCT also confirms that more U.S. employers--American employers--will offer employer-sponsored insurance as a result of this bill.

Further, the Joint Committee on Taxation confirms that the impacts of this legislation are under 1 million people, closer to 300,000 at best. That is what we are talking about here.

Let's be very clear. The Nunes amendment that was offered to this bill actually does help solve many of the problems I believe that have been raised here in the last few minutes. Mr. Waxman from California also raised his concerns. But I must say that if we don't move on this bill, we are not going to have to worry about any of this, because Americans working overseas as expats will be buying insurance from German insurance companies or British or some other European concern. These Americans

may be working in places like Ghana, Ethiopia, or Poland. Frankly, the ACA, the health care law, really has no standing in those countries.

So, please, this is a very targeted piece of legislation. These Americans will have good, quality health care as they are working overseas in countries that really don't recognize the health care law. So it is a commonsense proposal. The JCT, the Joint Committee on Taxation, confirms that this is going to affect fewer than 300,000 people. We know that all these plans are ACA compliant, and we know that more U.S. employers are going to offer employer-sponsored health insurance as a result of passing

this bill.

I say vote for the bill, do the right thing, get the bill to the Senate and ultimately to the President's desk.

3:00 PM EDT

Charlie Dent, R-PA 15th

Mr. DENT. Mr. Speaker, just in response to some of the comments I heard from my colleagues from California, I think it is pretty clear, the Joint Committee on Taxation, JCT, has been quoted here, but under this bill, the Joint Committee on Taxation confirms that all plans are ACA compliant. The JCT also confirms that more U.S. employers--American employers--will offer employer-sponsored insurance as a result of this bill.

Further, the Joint Committee on Taxation confirms that the impacts of this legislation are under 1 million people, closer to 300,000 at best. That is what we are talking about here.

Let's be very clear. The Nunes amendment that was offered to this bill actually does help solve many of the problems I believe that have been raised here in the last few minutes. Mr. Waxman from California also raised his concerns. But I must say that if we don't move on this bill, we are not going to have to worry about any of this, because Americans working overseas as expats will be buying insurance from German insurance companies or British or some other European concern. These Americans

may be working in places like Ghana, Ethiopia, or Poland. Frankly, the ACA, the health care law, really has no standing in those countries.

So, please, this is a very targeted piece of legislation. These Americans will have good, quality health care as they are working overseas in countries that really don't recognize the health care law. So it is a commonsense proposal. The JCT, the Joint Committee on Taxation, confirms that this is going to affect fewer than 300,000 people. We know that all these plans are ACA compliant, and we know that more U.S. employers are going to offer employer-sponsored health insurance as a result of passing

this bill.

I say vote for the bill, do the right thing, get the bill to the Senate and ultimately to the President's desk.

3:02 PM EDT

Jim Costa, D-CA 16th

Mr. COSTA. Mr. Speaker, I thank the ranking member, Mr. Levin, for the 2 minutes.

I rise today to speak in favor of H.R. 4414, the Expatriate Health Coverage Clarification Act. I am a cosponsor of this bill because I think it provides a targeted fix to the unintended consequences of the Affordable Care Act. It is too bad, though, that we cannot work together in fixing other flaws in the ACA instead of trying to repeal it over 50 times over the last 2 years.

I think, though, this bill will save American jobs, including many in the San Joaquin Valley. There have been some concerns that this bill would negatively impact green card holders and other immigrants to our country. I think this bill does provide safeguards to ensure that that will not happen.

An expat plan, by its nature, offers robust benefits across the globe. No one should be concerned that this bill will somehow erode coverage or quality for non-Americans living here in the U.S. or for Americans living abroad, for that matter.

With more than 1,000 jobs at stake, passing this bill will signal to the American people that, yes, on occasion Congress can work together and that we do care about more than business as usual.

I am pleased to join my colleagues, Mr. Carney and Mr. Nunes, in standing up for this effort to protect some American jobs. But let's remind ourselves that it is a work in progress and the author knows that this legislation, I suspect, would not be signed into law in its current form. But it is a work in progress. We move it along, we work with the Senate and get the concerns addressed the administration has raised. That is what it takes working together on a bipartisan basis

to get legislation done.

I urge my colleagues to vote ``yes'' on the bill when it comes up for a vote today.

3:02 PM EDT

Jim Costa, D-CA 16th

Mr. COSTA. Mr. Speaker, I thank the ranking member, Mr. Levin, for the 2 minutes.

I rise today to speak in favor of H.R. 4414, the Expatriate Health Coverage Clarification Act. I am a cosponsor of this bill because I think it provides a targeted fix to the unintended consequences of the Affordable Care Act. It is too bad, though, that we cannot work together in fixing other flaws in the ACA instead of trying to repeal it over 50 times over the last 2 years.

I think, though, this bill will save American jobs, including many in the San Joaquin Valley. There have been some concerns that this bill would negatively impact green card holders and other immigrants to our country. I think this bill does provide safeguards to ensure that that will not happen.

An expat plan, by its nature, offers robust benefits across the globe. No one should be concerned that this bill will somehow erode coverage or quality for non-Americans living here in the U.S. or for Americans living abroad, for that matter.

With more than 1,000 jobs at stake, passing this bill will signal to the American people that, yes, on occasion Congress can work together and that we do care about more than business as usual.

I am pleased to join my colleagues, Mr. Carney and Mr. Nunes, in standing up for this effort to protect some American jobs. But let's remind ourselves that it is a work in progress and the author knows that this legislation, I suspect, would not be signed into law in its current form. But it is a work in progress. We move it along, we work with the Senate and get the concerns addressed the administration has raised. That is what it takes working together on a bipartisan basis

to get legislation done.

I urge my colleagues to vote ``yes'' on the bill when it comes up for a vote today.

3:05 PM EDT

Ron Kind, D-WI 3rd

Mr. KIND. Mr. Speaker, I thank my friend and colleague for yielding me this time.

Mr. Speaker, I rise in support of this legislation before us today not because I believe it is a perfect answer to a problem that needs to be fixed but in order to make sure that the process moves forward. I want to commend my colleagues who have worked tirelessly over the ensuing weeks to try to address the concerns--legitimate concerns, I view--of some of the shortcomings of the legislation before us, Mr. Nunes and my good friend, Mr. Carney from Delaware.

This is, I think, emblematic of how we should be addressing reform within the health care system, having the wisdom as a body to recognize what is working with health care reform and what isn't working and then try to deal with that with fixes and needed adjustments along the way.

This was an unintended consequence affecting expat health insurance plans. In my view, there are competitiveness issues from those insurance plans offering expat coverage compared to what other foreign plans are offering, but also the ability of people to be able to work and live effectively abroad.

Even the administration has admitted in their Statement of Administration Policy that there is a problem that needs to be addressed. They have identified certain shortcomings of this legislation, from consumer protections to issues affecting the Tax Code, but I am sure that as we move forward today, hopefully with bipartisan support, the Senate will have an opportunity to address many of these concerns, and we will have to continue to work with the administration with the legitimate concerns

that they continue to raise.

Again, this is, I think, an approach that we should be taking as a nation right now, having the wisdom to understand what is working and also dealing with the unintended consequences of health care reform, which affects one-fifth of the entire U.S. economy. You are not going to change that overnight. If you try, you are going to introduce shocks to the system that aren't going to work for people.

I think this is an honest approach done in a bipartisan fashion with a lot of listening on both sides and a lot of vetting of issues that I think are legitimately being raised right now in order to address one of those small, unintended consequences of the health care reform.

I think, clearly, everyone recognizes more work needs to go into this legislative package in order to allay some of the concerns. The Senate, again, will have an opportunity to address and will continue to engage the administration in order to address some of the concerns that they are raising, as well. But this is a good, I think, first honest approach in order to find that solution so we don't see the detrimental job impact occurring right here in the United [Page: H3273]

States

and that we do allow affordable and quality health care coverage for those workers overseas.

Again, I commend my friends, Mr. Carney and Mr. Nunes, for the outreach and the work that they have put into this legislation. I encourage my colleagues to support this legislation as it moves forward.

3:05 PM EDT

Ron Kind, D-WI 3rd

Mr. KIND. Mr. Speaker, I thank my friend and colleague for yielding me this time.

Mr. Speaker, I rise in support of this legislation before us today not because I believe it is a perfect answer to a problem that needs to be fixed but in order to make sure that the process moves forward. I want to commend my colleagues who have worked tirelessly over the ensuing weeks to try to address the concerns--legitimate concerns, I view--of some of the shortcomings of the legislation before us, Mr. Nunes and my good friend, Mr. Carney from Delaware.

This is, I think, emblematic of how we should be addressing reform within the health care system, having the wisdom as a body to recognize what is working with health care reform and what isn't working and then try to deal with that with fixes and needed adjustments along the way.

This was an unintended consequence affecting expat health insurance plans. In my view, there are competitiveness issues from those insurance plans offering expat coverage compared to what other foreign plans are offering, but also the ability of people to be able to work and live effectively abroad.

Even the administration has admitted in their Statement of Administration Policy that there is a problem that needs to be addressed. They have identified certain shortcomings of this legislation, from consumer protections to issues affecting the Tax Code, but I am sure that as we move forward today, hopefully with bipartisan support, the Senate will have an opportunity to address many of these concerns, and we will have to continue to work with the administration with the legitimate concerns

that they continue to raise.

Again, this is, I think, an approach that we should be taking as a nation right now, having the wisdom to understand what is working and also dealing with the unintended consequences of health care reform, which affects one-fifth of the entire U.S. economy. You are not going to change that overnight. If you try, you are going to introduce shocks to the system that aren't going to work for people.

I think this is an honest approach done in a bipartisan fashion with a lot of listening on both sides and a lot of vetting of issues that I think are legitimately being raised right now in order to address one of those small, unintended consequences of the health care reform.

I think, clearly, everyone recognizes more work needs to go into this legislative package in order to allay some of the concerns. The Senate, again, will have an opportunity to address and will continue to engage the administration in order to address some of the concerns that they are raising, as well. But this is a good, I think, first honest approach in order to find that solution so we don't see the detrimental job impact occurring right here in the United [Page: H3273]

States

and that we do allow affordable and quality health care coverage for those workers overseas.

Again, I commend my friends, Mr. Carney and Mr. Nunes, for the outreach and the work that they have put into this legislation. I encourage my colleagues to support this legislation as it moves forward.

3:09 PM EDT

Sander Levin, D-MI 12th

Mr. LEVIN. So let me close, and I yield myself such time as I may consume.

I think it is regrettable that we are here in this predicament when we don't need to be. I think we do need to fix the expat issue, but not by unfixing health care reform for millions of people. This is more than about 300,000 people. We are talking about the health care protections and provisions applicable to 13 million people in this country who are here legally.

It has been said, and I very much respect this, it has taken 3 years to try to fix this problem, and Mr. Carney and others have truly been working, and Mr. Nunes, and there have been bipartisan discussions.

But here is the problem: If we are really going to continue effectively to work together when there is an outstanding issue, when there has been this aura of good faith, the majority should have let the minority place on the floor an amendment to the bill and let us debate it.

In fact, it only works against bipartisanship in this kind of circumstance to say it is essentially a closed rule. What is there to fear? The only thing to fear is that we would have discussion that [Page: H3274]

might make this a still more bipartisan bill. So instead of getting a likely minority of members on the Democratic side, we would have, I think, an overwhelming majority on both sides determined to keep jobs here, but not at a price of undoing necessary protections

in terms of the health of millions and millions of Americans.

So that is where we are here and essentially so for so many of us placed in a situation where we say we must do better, we shouldn't simply leave it to the other body, we have the abilities within this House with true bipartisanship to continue working, and after 3 years, it might take another week or 2, that would be worth it in terms of trying to restore the reality of bipartisanship that really works.

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

3:09 PM EDT

Sander Levin, D-MI 12th

Mr. LEVIN. So let me close, and I yield myself such time as I may consume.

I think it is regrettable that we are here in this predicament when we don't need to be. I think we do need to fix the expat issue, but not by unfixing health care reform for millions of people. This is more than about 300,000 people. We are talking about the health care protections and provisions applicable to 13 million people in this country who are here legally.

It has been said, and I very much respect this, it has taken 3 years to try to fix this problem, and Mr. Carney and others have truly been working, and Mr. Nunes, and there have been bipartisan discussions.

But here is the problem: If we are really going to continue effectively to work together when there is an outstanding issue, when there has been this aura of good faith, the majority should have let the minority place on the floor an amendment to the bill and let us debate it.

In fact, it only works against bipartisanship in this kind of circumstance to say it is essentially a closed rule. What is there to fear? The only thing to fear is that we would have discussion that [Page: H3274]

might make this a still more bipartisan bill. So instead of getting a likely minority of members on the Democratic side, we would have, I think, an overwhelming majority on both sides determined to keep jobs here, but not at a price of undoing necessary protections

in terms of the health of millions and millions of Americans.

So that is where we are here and essentially so for so many of us placed in a situation where we say we must do better, we shouldn't simply leave it to the other body, we have the abilities within this House with true bipartisanship to continue working, and after 3 years, it might take another week or 2, that would be worth it in terms of trying to restore the reality of bipartisanship that really works.

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

3:12 PM EDT

Devin Nunes, R-CA 22nd

Mr. NUNES. Mr. Speaker, I will close, and I yield myself such time as I may consume.

The need for this bill wasn't conceived by opponents of the Affordable Care Act or ObamaCare. The Obama administration and the army of regulators acknowledged there is a problem and have come to the Congress to fix it. Treasury, HHS, and Labor have all accepted the fact that expat plans should not be regulated the same way domestic plans are regulated.

After 4 years of examining this issue, as I said earlier, the administration issued limited and temporary regulatory relief for expat plans. This bill is necessary because despite the administration's limited and temporary fixes, thousands of jobs are on the chopping block. American businesses can't compete based on the promise of limited and temporary relief.

Mr. Speaker, I want to also remind my colleagues that Mr. Carney and I have worked on this for many years, and we have worked not only in a bipartisan way in the House of Representatives, we have also worked with our Senate counterparts where we have bipartisan support in the United States Senate.

So, the Obama administration has said they have concerns, but we don't know what the concerns are and they did not issue a veto threat. So I think that more level heads will prevail. This bill will pass today. It will go to the Senate, it will pass, and I would urge, then, President Obama to sign it into law so that we can save these jobs.

With that, Mr. Speaker, I yield back the balance of my time.

3:12 PM EDT

Devin Nunes, R-CA 22nd

Mr. NUNES. Mr. Speaker, I will close, and I yield myself such time as I may consume.

The need for this bill wasn't conceived by opponents of the Affordable Care Act or ObamaCare. The Obama administration and the army of regulators acknowledged there is a problem and have come to the Congress to fix it. Treasury, HHS, and Labor have all accepted the fact that expat plans should not be regulated the same way domestic plans are regulated.

After 4 years of examining this issue, as I said earlier, the administration issued limited and temporary regulatory relief for expat plans. This bill is necessary because despite the administration's limited and temporary fixes, thousands of jobs are on the chopping block. American businesses can't compete based on the promise of limited and temporary relief.

Mr. Speaker, I want to also remind my colleagues that Mr. Carney and I have worked on this for many years, and we have worked not only in a bipartisan way in the House of Representatives, we have also worked with our Senate counterparts where we have bipartisan support in the United States Senate.

So, the Obama administration has said they have concerns, but we don't know what the concerns are and they did not issue a veto threat. So I think that more level heads will prevail. This bill will pass today. It will go to the Senate, it will pass, and I would urge, then, President Obama to sign it into law so that we can save these jobs.

With that, Mr. Speaker, I yield back the balance of my time.