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House Roll Call: 415     Vote Date: Sep 28th, 2018

Issue:  H. Res. 1099, Providing for the concurrence by the House in the Senate amendment to H.R. 6, with an amendment. H.R. 6: Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act.  Question: On Motion to Suspend the Rules and Agree (2/3 vote required).

Result:  Agreed to in House, 393 to 8, 27 not voting.  Agreed in Senate (Vote 221, 10-3-18).  Became Public Law 115-271 (signed by the President, 10-24-18).  GOP and Democrats scored.

Freedom First Society: H.R. 6 is a package of more than 50 bills addressing the nation’s “opioid crisis.” (See House Roll Call 288, 6-28-18).  Unfortunately, almost all of these bills comfortably ignore the source of the nation’s deadly epidemic — drug cartels taking advantage of a porous southern border and an increasingly responsive culture. Instead, of forcing the federal government to exercise its constitutional responsibility to enforce our borders, H.R. 6 would throw more money at the resulting addiction problem with more unconstitutional intervention in the medical marketplace.

We have assigned (good vote) to the Nays and (bad vote) to the Yeas. (P = voted present; ? = not voting; blank = not listed on roll call.)

CRS Summary of H. Res. 1099
Shown Here:
Introduced in House (09/28/2018)

Sets forth the rule for consideration of the Senate amendment to H.R. 6 (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act).

H.R. 6 Bill Summary:
Although at the time of this posting, H.R. 6 has become public law, the Congressional Research Service has not updated its summary from the version passed by the House in Roll Call 288 (6-28-18).

Since then, the Senate took up the measure and passed an amended version (Senate Vote 210, 9-17-18).  Next, the House considered the Senate amendment with this Roll Call 415 (H. Res. 1099) and added its amendment.  The Senate accepted the House amendment with Senate Vote 221 (10-3-18).  Both of these actions added new programs and provisions to the original House passed bill.   For example during the Senate “debate” leading up to its initial September 17th vote, Senator Lamar Alexander (R-Tenn.) stated:

“We have a sense of bipartisan urgency about  finishing our work in the Senate and combining our efforts with the House. Their bill is a good bill. I think combining it with ours will  help make it stronger, and we will get our bill to the President.”

In an October 24, 2018 news release following the President’s signing of the amended H.R. 6 into law, Senator Alexander listed the following ten key provisions of the legislation:

  1. STOP Act—to stop illegal drugs, including fentanyl, at the border [FFS: i.e., shipments via the U.S. Mail]
  2. New non-addictive painkillers, research and fast-track
  3. Blister packs for opioids, such as a 3 or 7 day supply
  4. Extends support for Medicaid patients seeking treatment from 15 to 30 days, covering all substance use disorders
  5. TREAT Act—permanently allows more medical professionals to treat people in recovery to prevent relapse and overdoses
  6. Prevent “doctor-shopping” by improving state prescription drug monitoring programs
  7. More behavioral and mental health providers
  8. Support for comprehensive opioid recovery centers
  9. Help for babies born in opioid withdrawal and for mothers with opioid use disorders
  10. More early intervention with vulnerable children who have experienced trauma

Freedom First Society Analysis: In our earlier analysis of the House action (Roll Call 288, 6-22-2018), we accused Congress of ignoring the root causes of the deadly epidemic while proposing to treat its symptoms with an unconstitutional expansion of government.  As for the root causes, we place the blame on Establishment elites and a complicit Congress marching to their tune.

The Establishment has an open borders agenda which explains why Congress has refused to enforce our borders thus allowing the easy inflow of illegal drugs.  Even more fundamentally, the Establishment has attacked the underpinnings of a free society — traditional morality and religion.  No wonder that many, finding little purpose in life, choose the escape of the opium den.  As we see below, America is also suffering from a “Meth” crisis, so the subversion of America’s cultural underpinnings must not be ignored.

Unfortunately, the Congressional floor debates over H.R. 6 are glaring in their refusal to address the fundamental question:  Why is America afflicted with these crises?

The following remarks are from the House debates on 9-28-18 regarding H. Res. 1099 (this Roll Call, 415) [Emphasis added]:

Rep.  Greg Walden (R-Oregon): “Mr. Speaker, this legislation is a product of months of bipartisan,  bicameral work, eight House committees involved, I think probably every  Member of this House, five Senate committees, dozen and dozens of  Members of Congress.”

Rep.  Frank Pallone (D-New Jersey): “Mr. Speaker, the legislation also expands access to coverage…. This bill requires State Medicaid programs to  cover all forms of medication-assisted treatment, which plays a  critical and lifesaving role in treating opioid use disorder…..

“In closing, Mr. Speaker, these are all policies that have the  potential to make a real impact on this epidemic, but our work here is  not complete. An epidemic of this size will take a long-term commitment  to improving health insurance coverage, treatment, access, and  affordability.   This bill is an important step, but I want to stress that we have to  do a lot more. The opioid crisis continues to get worse. A lot more  needs to be done to provide treatment and expand the treatment infrastructure. More resources are needed to support the families and  communities impacted by this crisis. So what we are doing today is clearly helpful, but it is not enough.”

[Freedom First SocietyRep. Pallone is right. It’s not enough.  Because Congress is ignoring the root causes of the epidemic and, in particular, its role in creating the “poison,” while boasting over its work in addressing the crisis with more unconstitutional intervention in the medical marketplace.

Most in Congress no longer accept that the federal government is authorized to perform relatively few functions, as spelled out in the Constitution. Instead, they realize they can get reelected simply by championing popular causes.  It works, since the public is regularly given the image that we have a national government responsible for anything that needs doing.  Yet with its excesses, Congress creates the poison and the power-grabbing antidote in the same laboratory.]

Rep. Richard Neal (D-Mass.): “The bill includes a number of Democratic priorities to expand treatment optionsfor our neighbors, family members, and friends  suffering from opioid use disorders. It includes my bill, with Member Pallone, that would require Medicare to cover opioid treatment programs so that our Nation’s seniors might have more outpatient options for treatment….

“While the bill before us is a step in the right direction, this  epidemic is not going to turn around overnight. It needs a thoughtful,  long-term, sustainable approach that requires significant Federal investments. H.R. 6 represents the initial step in addressing this  crisis, but it cannot be the end. Part of that long-term approach must  include protecting and strengthening Medicaid and the Affordable Care Act….

“I encourage all of us here in this Chamber today and in Congress to continue to work together to develop policy solutions for members of our community who are suffering from this terrible epidemic.”

Rep. Elijah Cummings (D-Maryland): “Mr. Speaker, I rise in support of provisions in this package  reauthorizing and reforming the Office of National Drug Control Policy [ONDCP] to improve coordination of our national response to the drug crisis.   At my request, the bill creates a demand reduction coordinator position, parallel to the existing interdiction coordinator, to  strengthen demand reduction initiatives, including efforts to expand treatment.   Among other critical reforms, this legislation also requires ONDCP to report whether drug control program agency budgets are adequate to achieve the goals of the National Drug Control Strategy.

“So while the provisions of H.R. 6 are important, without significantly expanding access to treatment and wraparound services through long-term, sustained funding, we continue to nibble at the  edges of our national crisis, and the crisis will continue to worsen.”

Rep. Robert Latta (R-Ohio): “I am pleased that my bill, the INFO Act, is part of the fight against  the opioid crisis. The INFO Act is essential to ensuring we are  providing behavioral health professionals, advocates, physicians, and  families with the tools, resources, and funding information they need  to prevent, identify, and treat addiction.”

Rep. Gene Green (D-Texas): “I am proud to see our committee and both Chambers of  Congress come together and support the package before us today that  includes the Comprehensive Opioid Recovery Centers Act that I  introduced, along with my friend Representative Brett Guthrie from Kentucky, earlier this year.   This legislation would fund designated treatment centers where  Americans suffering from opioid abuse can receive comprehensive patient-centered care. The bill would allow designated treatment centers to provide wraparound services, including mental health,  counseling, recovery housing, and job training and placement to support reintegration into the workforce.”

Rep. Leonard Lance (R-New Jersey): “I am especially pleased that a bill that I sponsored related to infectious diseases is included in the final package.”

Rep. Ben Ray Lujan (D-New Mexico): “Mr. Speaker, I rise today in support  of H.R. 6, the SUPPORT for Patients and Communities Act.   This is an important step forward in the fight against the Nation’s  opioid epidemic. However, this Congress must acknowledge that this is not the end.  Healthcare is a right, not a privilege. There is much more work to do to ensure that families get the help that they deserve….

“In addition, this bill will create pathways to behavioral  healthcare jobs in communities like New Mexico.   Still, Congress must do more.  As we have heard from Representative  Cummings, this is going to take much more money, investment, and  comprehensive legislation.”

Rep. Maxine Waters (D-Calif.): “While I appreciate the work that has been done on many components of this bill, I still have some important concerns. As the Ranking Member  of the House Committee on Financial Services, which has jurisdiction  over housing programs, I am concerned that this bill falls short when  it comes to providing housing for people with substance use disorders.  The bill includes a provision that creates a new grant program to  provide temporary housing assistance to help people with substance use  disorders, but this new funding will only be available in half of the  states. This will leave the other half of the states continuing to struggle with the challenges of helping people with substance use  disorders who are in need of housing.

“Furthermore, this bill does nothing to address the overly punitive and unfair policies governing  our federal housing programs that create unnecessary barriers to housing for people who have criminal backgrounds related to substance use disorders.”

[Freedom First Society:  Is that a euphemism for “drug pushers” or those engaged in crime to finance their drug habits?]

The following remarks are from the Senate debates on 9-17-18 [Emphasis added]:

Senator John Boozman (R-Arkansas): “This comprehensive package covers a wide range of avenues to attack this problem and get individuals the help and support they need to recover. This includes prevention, treatment, additional law enforcement tools, and expanding research into non-addictive pain treatments.   I appreciate the leadership of my colleagues on the HELP, Finance,  Judiciary, and Commerce Committees to advance this important  legislation that is necessary to address the ever-growing opioid crisis.   The legislation expands a grant program to train our first responders administering naloxone, the drug that can be used to block the effects of opioids and prevent deaths from an overdose….

“Not only does this legislation help those already impacted by the  crisis, it also aims to stop even more dangerous drugs, like fentanyl,  from getting into the country in the first place by improving detection  of prohibited drugs being illegally imported through the mail.   These provisions are just a small piece of the puzzle. Together, with other measures in this bill, we can make a real difference and change the conversations we have around opioid abuse and addiction to focus not on the lives taken but on the lives which are being saved. The comprehensive response to the crisis shows how committed we are as a nation to combating opioid addiction.

Senator Edward Markey (D-Mass.): “This bill contains a number of proposals that will help families and  communities struggling day in and day out to respond to the opioid  overdose crisis. One of those proposals is my bipartisan Opioids Milestones Act, a bill I authored with Senator Lisa Murkowski and Senator Maggie Hassan to create a scorecard for our Nation’s response to the opioid crisis.   The Milestones Act will require the Federal Government to both set  tangible benchmarks for how we are addressing the opioid crisis in our country and measure progress on key objectives every single year. When  people are sick, they get a treatment plan. The United States of America needs a nationwide treatment plan for fighting the opioid crisis, and that is what this provision will create for our country.  Those objectives include reducing overdose deaths, expanding treatment availability, increasing the number of individuals in sustained  recovery, and decreasing emergency room visits for overdoses….

“With more than 220 counties across the United States at risk of a  hepatitis C or HIV outbreak related to the opioid crisis, we cannot  afford to wait any longer to arm our States with the tools needed to tackle the public health consequences of this epidemic….

“If we are going to reduce the supply of heroin, fentanyl, and illicit prescription opioids, then we have to reduce the demand through treatment. That must include increasing access to effective medication-assisted treatment, or MAT….

[Freedom First Society: Is treatment really how you reduce the demand?  Senator Markey’s treatment solution merely targets the demand that has been already created and tries to divert it.]

Senator Markey continues:  “The bill we vote on today cannot be the end of our efforts to help solve the opioid overdose crisis. The opioid crisis knows no  boundaries, and neither should our efforts to combat it.”

[Freedom First Society:  What a prescription for unlimited government!  Collectivism run amok!]

Senator Angus King (Ind.-Maine): “Mr. President, the discussion today is about the opioid  crisis, one of the most serious public health crisesI have seen in my  adult life, certainly in the State of Maine. It is an enormous problem  across the country, particularly in rural areas. In my State, we are losing more than one person a day to an overdose death. That is an epidemic by anybody’s definition.”

Senator Margaret Wood Hassan (D-New Hampshire): “I rise as the Senate considers bipartisan legislation that marks a  critical step forward in the fight against the fentanyl, heroin, and  opioid crisis.  In New Hampshire, and all across our Nation, entire communities are being ravaged by this epidemic. In order to turn the tide, we need to combat the challenges communities are experiencing from all angles; we need to collaborate across traditional boundaries; we need to take a truly all-hands-on-deck approach because the magnitude of this crisis demands it….

“This is a good start, but it is and must be only a start.”

Senator Steve Daines (R-Montana): “While we must focus on combating the opioid crisis, we must also continue to address a related but separate epidemic that is wreaking  havoc in Montana and in many other States; that is, the methamphetamine epidemic.   In Montana, meth is destroying families and communities and disproportionately impacting our Tribes. In fact, we have seen a 415-percent increase in meth cases from 2011 to 2017, and a 375-percent increase in meth-related deaths in that same timeframe.”

Rebuilding a Congress accountable to an informed electorate, a Congress that respects the limits of the Constitution, will require organized action from responsible, concerned citizens.  Please consider the program of Freedom First Society.