The House, Thursday, March 21, 2024

Speaker PackardA division has been called. Members take your seats. This is on the amendment. Clarification only. This is a clarification vote on the amendment. If you are in favor, you'll press the green button. If you are opposed, you'll press the red button. Voting stations will be open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. 189 voting Yea, 176 voting Nay, the amendment is adopted. The motion before us now is Ought to Pass as Amended. The Chair recognizes Rep. Raymond.

Rep. Heather Raymond (D - Hills 5)Thank you for your patience, Mister Speaker. Both child and family law and the family court oversight committee heard testimony about parents who routinely ignore and violate parenting plans. This is a problem. Parenting plans aren't just agreements between parents, they are court orders and there should be consequences for repeatedly violating the terms. However, this bill is not the way to address the issue. This body has already passed bills this session and just this morning that give both the courts and parents tools and incentives to enforce compliance. This bill, however, uses a sledgehammer where a scalpel is needed. It treats every family circumstance the same without regard for differences and mandates that judges ignore the best interest of the child in favor of scripted compensatory time. It ignores complex family dynamics that families experience when parent's behaviors don't quite cross the line into serious injuries or abuse. For example, if we have a 13-year-old who presents with a large handprint bruise on the face and says that mom has been drinking a lot and they have been fighting. DCYF gets called. They ask dad to hold the child for the weekend so that DCYF can fully investigate what is going on. Mom admits to drinking. She drinks heavily. She admits to hitting the child because the child is an adolescent and mouths off sometimes. Under New Hampshire law, this is an unfounded report because bruising does not constitute injury with protracted harm or impairment. A 13-year-old is old enough to call for help so being drunk, even habitually, is not enough to make a finding of neglect. Therefore, under the amendment that we just passed, the family court judge would be prohibited from considering the best interest of this child and would be required to award mom compensatory parenting time to make up for the weekend that she lost. DCYF might recommend counseling or parenting assistance, but the way this bill is worded, the judge could not order it. The judge would be required to return to the original parenting plan agreement. I don't believe that parents who act with DCYF to protect their children should be punished because our abuse laws require extreme injury before the state can act. I also believe that judges should have the discretion to consider all of the evidence before making decisions, not just rely on one piece of evidence which is the DCYF report. We have other bills that address the cases where one parent basically kidnaps the child and we have better teeth for those bills, like the one we passed this morning which would allow a judge to incarcerate the parent who did the kidnapping. However, this bill treats all parents the same whether you have kept the child for a weekend because you were worried about their safety or you kept them for two years. I ask that we support the previous bills by pressing the red button on this bill to overturn the OTP so another motion can be made. I ask for a division vote. Thank you.

Rep. Mark Pearson (R - Rock 34)Thank you, Mister Speaker. Mister Speaker, as my role as Chairman of both Children and Family Law Committee and of the Special Committee on the Family Division of the Circuit Court and also in my role as part time chief executive officer of the Kingston Wellness Center which has two physicians and two certified counselors on staff, I've come to learn how many divorced parents seldom or never see their children despite court ordered parenting plans. Often the aggrieved parents then went to the police and unless there were credible allegations of severe abuse of the child, the police referred the complainants back to the courts. In the research done as to what would happen next, I found a significant variety across the country. In some states, very red, very blue and of various shades of purple, there are laws on the books as to what the court may do next to punish those disobeying parenting plans. Some states have felony charges. Others have misdemeanors to force the parenting plan to be honored as the court had originally ordered. However, I also found that in other states there are no consequences to such willful contempt so the perpetrators can continue to harm both the other parent, but especially the child. We need something more on the books here in New Hampshire. It is for that reason that HB 1659 was filed. However, in the Children and Family Law Committee, there was a concern that the bill as originally submitted may have gone a bit too far. For example, if a child had been denied a visit to the other parent on every other Christmas, the remedy would be for each of those Christmases to be made up. In other words, if the parenting plan called for the child to visit one parent every other Christmas and it was denied twice, upon conviction of defiance of the plan, the first parent would now have the child for four consecutive Christmases. A bit much we thought. Also, the bill as originally written would force the perpetrator, upon conviction, to pay a fine of $500 for every day of noncompliance. The amendment lowered this to just one $500 payment for noncompliance. No sledgehammer. Also, the amendment gave more discretion to the judge. Reading over this amendment, yes, more discretion to the judge because as we all know, no two court cases are alike. So, I believe the amendment we just passed made a good bill much better and much more reasonable. Over the years in my professional capacity, I've had witnessed firsthand not only the utter sadness of parents and grandparents who've been denied appropriate visits with their children, but also, I have noted psychological and emotional scars in the children denied appropriate visitation. So, I asked my staff counselors what does DSM-5 say? This is the Diagnostic and Statistical Manual of Mental Disorders 5th Edition published in 2013, which is the taxonomic and diagnostic tool published by the American Psychiatric Association. In their Section V 995.51 we find what is called pathogenic parenting syndrome appearing in children. Sometimes when parents weaponize the child as a way of wreaking vengeance against the other parent too often, this creates an observable level of psychopathology in the child and as such is deemed psychological child abuse. All of this and much more in great clinical and scientific detail confirms what so many of us have observed in some cases where a parenting plan is willfully disregarded. I believe that HB 1659 as amended gives the courts a better enforcement mechanism against the disregarding of court ordered parenting plans. Mister Speaker, I hope my colleagues will push the green button. And while I know this phrase has become somewhat of a clich� here, I think this is true. We need to do this for the children. Thank you, Mister Speaker.

Speaker PackardRep. Sweeney has requested a roll call. Is that sufficiently seconded? It is sufficiently seconded. This will be a roll call vote. Members take your seats. The motion before us is the majority committee report of Ought to Pass as Amended on HB 1659. This is a roll call vote. The Chair recognizes Rep. Long for a parliamentary inquiry. Representative Long: Thank you, Mister Speaker. If I know that custody matters are of best interest of the child and this bill prevents the court from considering it. And if I also believe that there are a lot of people that came that are going through this issue and this bill does not address them because this bill doesn't become effective or does not address anything prior to January, any order prior to January of 2025, then would I press the red button? Thank you, Mister Speaker.

Speaker PackardThe Chair recognizes Rep. Nelson for a parliamentary inquiry.

Rep. Jodi Nelson (R - Rock 13)Thank you, Mister Speaker and good morning. If I know that when parents weaponize the child as a way to get back at the child's other parent, it leaves lasting scars on the child's emotional wellbeing. And if I know that if there are no repercussions for misconduct, the likelihood that the offense will be repeated increases. And if I know that this bill as amended will help the courts enforce the parenting plan, that when adhered to properly, it is in the best interest of the child, then would I not, Mister Speaker, why would I not, Mister Speaker, press the green to pass the bill as amended?

Speaker PackardThe motion before us is the majority committee report of Ought to Pass as Amended on HB 1659. This is a roll call vote. If you are in favor, you'll press the green button. If you are opposed, you'll press the red button. Voting stations are open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. 198 voting Yea, 174 voting Nay, the majority committee report was adopted.

Speaker PackardRep. Cordelli moves Ought to Pass and offers amendment (0973h). We have a debate on the amendment. We have a division on the amendment. Members take your seats. The motion before us is amendment (0973h). Members need to be in their seats. This is a division vote. If you are in favor, you'll press the green button. If you are opposed, you'll press the red button. Voting stations will be open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. 190 voting Yea, 177 voting Nay, the amendment is adopted. We are now on to Ought to Pass as Amended. The Chair recognizes Rep. Simpson.

Rep. Alexis Simpson (D - Rock 33)Thank you, Mister Speaker. I rise in opposition to the OTP/A motion on HB 1205 and I would ask my colleagues supporting this bill to reconsider their position for three key reasons. I have significant concerns. First with student privacy concerning government documents. Second with conflicts with federal law and a potential loss of federal funding for school districts and third, with issues of gender equality. First, HB 1205 as amended requires that every single student athlete from 5th grade, which is typically 10 years old, through 12th grade must provide their birth certificate to be eligible to participate in any sport, any sport. There is no explanation in the bill as to who collects the birth certificate, who verifies it, whether it needs to be stored at the school district for a certain period of time, how often it needs to be shown or if the documentation is destroyed after a period of time. This bill requires private documents to be submitted with no steps to maintain family privacy. According to the bill, if the parents do not feel comfortable bringing in the birth certificate, because after all we are Granite Staters and we care deeply about privacy, the parents who want their child to participate in sports must provide other evidence. But there is no specification in this bill of what other evidence is acceptable. So, a student may need to disrobe in front of a school official to prove who they are so they can participate in sports for fun with their friends. We should all be gravely concerned about the privacy implications and potential violations of this bill. The second significant concern is how HB 1205 conflicts with federal Title IX law. Title IX says that no person shall on the basis of sex be excluded from participation under any education program or activity. HB 1205 explicitly states that girls' sports teams "shall not be open to students of the male sex." But Title IX says students cannot be excluded based on sex from any activity. This means that to comply with Title IX, schools under HB 1205 will not be eligible for federal funding if they offer a girl's team but not a corresponding boy's team. As this bill says that boys cannot play on teams that are designated for girls only. Let's use volleyball as an example. If a school district does not have enough boys to fill a boys volleyball team, but the district offers a girls volleyball team, if HB 1205 were to pass, boys would be excluded based on sex from participating in this activity. Excluding boys from a girl's team, if there is no boy's volleyball team, is a violation of Title IX. To be clear, HB 1205 is in direct violation of Title IX and federal funding to school districts could be withheld. However, this bill does offer a solution to this conflict with federal law. Girls' teams could instead be designated as coed, but we should ask ourselves what could happen if all girls' teams are designated co-ed in order to comply with federal law. It is safe to assume that more cisgender boys would participate which could then limit the opportunities of girls and bump girls off the starting roster. The supporters of this bill claim to care about protecting women, yet in their apparent quest to exclude transgender students from participating, they are directly harming cisgender girls. This isn't about transgender athletes. Passage of this bill would encourage or even require districts to eliminate girls' sports in order to comply with Title IX federal law so they can continue to receive federal funding. This brings me to the third concern, protecting gender equality. Title IX ensures that all students have access to an activity and cannot be excluded based on their sex. Title IX protects student athletes insuring they can participate in the sport at their school if it is offered, even if it's not offered for their specific gender. Title IX is how girls were able to start participating in sports in the first place so they could have protections and access so they would not be excluded by boys only teams. HB 1205 sends New Hampshire back to before Title IX was passed in 1972. We would be responsible for eliminating opportunities for student athletes across the state by passing a law in direct conflict with Title IX. I also want to address a story that's been told in the public hearing and the executive session for this bill. The story is about a field hockey game in which a girl was injured. She was hit in the face by a field hockey ball, and it was a significant injury. This story has been used to blame a transgender girl, but that's not the truth. The student who hit the ball is a cisgender boy. Born a boy. Identifies as a boy. Has no question he is a boy. The student is not transgender. Pointing to that story as a reason to pass this bill is misleading. That story has been misrepresented to target transgender girls. It is not true. Here is the reality. Anyone who has played sports know injuries happen all of the time. My son was a baseball pitcher. In his time as a pitcher, he threw a lot of strikes, stuck out a lot of batters. He also threw a lot of balls, walked batters and like every single pitcher in baseball and softball, he has hit batters. Under no circumstances was he blamed for the injury nor was he ever the subject of intense media scrutiny or the target of harassment or attacks by peers, coaches, parents or the general public. Think back to when you played sports. You must have pulled calf muscles, torn ACLs, jammed fingers or like me, been hit by a baseball and a softball. We should not blame any student athlete for an injury regardless of their gender. We would also never have rules or pass laws that exclude students who are much taller than others from playing basketball because they have an advantage. We wouldn't exclude students who are stronger than others from wrestling because they might pin their opponents in seconds. We wouldn't exclude athletes who have longer wingspans like Michael Phelps from swimming. We wouldn't exclude athletes who've played on private teams since they were little who might have more experience than their peers and are at an advantage. This bill targets a small group of student athletes claiming there is a categorical advantage when there is not, and it comes with significant consequences for all student athletes. And finally, as I know this is a concern for some of my colleagues, there have been zero transgender athletes in the United States to receive an athletic scholarship for college. Zero. Not just in New Hampshire. Not just in New England. In the entire United States. Transgender student athletes are not taking away opportunities from cisgender student athletes. They are participating for all of the same reasons my son played baseball and throws the javelin. They are participating for the same reasons your kids and grandkids play soccer and football and ice hockey, to learn a lot of important life lessons from sports, like leadership, confidence, self respect and what it means to be part of a team. Every student in New Hampshire deserves those opportunities and should not be excluded, harassed or targeted for wanting those same opportunities. I urge this body to vote down the Ought to Pass motion. Thank you.

Rep. Katy Peternel (R - Carr 6)Thank you, Mister Speaker. Ten years ago, my daughter came to me after cross country practice and said mom, there's a transgender on my team. This isn't fair. What can we do? I asked her if she wanted to make a federal case out of it because I was pretty sure that's what it would take and just last week, 16 female athletes filed a federal lawsuit against the National Collegiate Athletic Association for allowing biological men to compete in women's college sports. Why is this bill necessary and other's just like it across the country? Because in 2010, GLSEN, the gay, lesbian and straight education network in conjunction with the women's sports foundation, the National Center for Lesbian Rights and It Take a Team published a report to provide guidance to high school and collegiate athletic programs about implementing policy to allow transgender student athletes fair, respectful and legal access to school sports teams. These policies were adopted by state and collegiate athletic associations before athletes and parents knew what was even happening. The New Hampshire Interscholastic Athletic Association was among the first to adopt the policy creating a situation where the only method of recourse for displaced girls is to file a lawsuit or to quit the team. How is that fair to girls? I am not here to argue whether everyone has a right to access sports teams. We all want equal access to sports. But a girl should not be displaced by a boy on a team designated for girls. In committee, we heard testimony that transgender athletes are trying to be their authentic selves and find the self esteem, camaraderie and fun that women and girls experience on sports teams. We received testimony about girls losing to boys who would have been ranked far lower had they competed as boys and the chance of girls losing scholarships and championships to boys who are competing as girls. Girls and women have been severely injured by boys and men competing as women in their sports. We've even heard testimony from a colleague that it really didn't matter if a transgender athlete competed in girls high jump because it was an obscure sport that few would watch. This is insulting. Scholarship and championship losses are concerning but what about the girls who are cut from teams or on the junior varsity team because they have been displaced from varsity by a biological male. What about the girls whose self esteem and mental health suffers because they can't live out their true authentic selves? These girls work hard to train and practice only to have their dreams crushed. By allowing biological males to compete in women's sports, we are telling our girls and women that they don't matter, that they need to put their own goals and dreams aside for a boy or a man to take their place, that they need to remain silent in the face of injustice. We owe our daughters and granddaughters more than this. Please support Ought to Pass on HB 1205 and Mister Speaker, I request a roll call.

Speaker PackardRep. Peternel has requested a roll call. Is that sufficiently seconded? It is sufficiently seconded. This will be a roll call vote. Members take your seats. The House will be in order. The motion before us is Ought to Pass as Amended on HB 1205. This is going to be a roll call vote. The Chair recognizes Rep. Woodcock for a parliamentary inquiry.

Rep. Stephen Woodcock (D - Carr 1)Thank you, Mister Speaker. If I know that this bill has absolutely nothing to do with the NCAA federal suit. This only applies to New Hampshire students aged 10 to grades 12. If I know that this bill also requires that those same students submit their birth certificate or undergo a personal investigation by school officials to prove what their body actually looks like to participate in any school sport. And if I know that HB 1205 would discriminate against a group of students in direct violation of Title IX, jeopardize school districts from being able to receive federal funds, which on the average is about $165 million a year. Finally, if I know that all of New Hampshire students regardless of gender, race, sexual orientation, sex, religion, economic status deserve the opportunity to learn those important life lessons in sports like leadership, confidence, self respect, what it means to be part of a team, would I now press the red button so that another motion could be offered? Thank you, Mister Speaker.

Speaker PackardThe Chair recognizes Rep. Ladd for a parliamentary inquiry.

Rep. Rick Ladd (R - Graf 5)Thank you very much, Mister Speaker. If I know this bill protects the future of women and girls' sports and will be the demise, if we don't pass it, of Title IX. If I know by permitting biological men who identify as girls to participate in women and girls' sports, creates both unfairness and severe safety issues. And if I know that it is scientifically a fact that on average males are stronger, faster and larger than average females. And lastly, if I also know by continuing to allow males who identify as girls or women to participate in women's athletics, it will lead to the end of girls sports and significantly reverse the gains women have made since the implementation of Title I, would I then press the green button in support of my granddaughter who captained the indoor and outdoor track teams at Orono, my daughter who ran for Texas A&M and my other daughter who was point guard for Elmira College when they won the championship in basketball? Thank you.

Speaker PackardThe motion before us is Ought to Pass as Amended on HB 1205. This is a roll call vote. If you are in favor, you'll press the green button. If you are opposed, you'll press the red button. Voting stations are open for 30 seconds. Have all members present had an opportunity to vote? The House will attend to the state of the vote. 189 voting Yea, 182 voting Nay, the committee report was adopted.

Speaker PackardRep. Damon moves Ought to Pass and offers floor amendment (0936h). The question is on the amendment. All those in favor, say Aye; those opposed, Nay. There will be a division vote for clarification. Only members in the Chamber right now. Members take your seats. This is a division vote on clarification. If you are in favor of the amendment, you'll press the green button. If you are opposed, you'll press the red button. Voting stations will be open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. 181 voting Yea; 191 voting Nay, the amendment fails. For what reason does the member rise?

Rep. Joe Sweeney (R - Rock 25)Mister Speaker, I move to Indefinitely Postpone HR 30.

Speaker PackardThe motion is to Indefinitely Postpone HR 30. It will be a roll call vote. The motion before us is to Indefinitely Postpone HR 30. This is a roll call vote. The House will be in order. The Chair recognizes Rep. Quaratiello for a parliamentary inquiry.

Rep. Arlene Quaratiello (R - Rock 18)Thank you, Mister Speaker. If I know that the science behind climate change is highly disputed, even among scientists and that the sort of agreement suggested by this resolution does not exist. If I believe that this resolution would promote a curriculum that would discredit traditional reliable energy industries that have not actually caused a climate crisis. If I believe that climate anxiety experienced by students today would only be worsened by this sort of crisis mentality to be pushed by the environmental curriculum this resolution proposes, would I now press the green button?

Speaker PackardThe Chair recognizes Rep. Damon for a parliamentary inquiry.

Rep. Hope Damon (D - Sull 8)Thank you, Mister Speaker. If I know that the adverse effects of climate change on the New Hampshire economy are clearly established, are profound and growing, including loss of jobs that are needed to keep our young people here. And if I know that this House Resolution is simply allowing passionate, informed students to work towards factual climate change education, which would reduce their anxiety. And if I know these youth are watching our votes today looking for hope and positive change and deserve to see our democratic processes fully play out and have this discussion this bill deserves, would I now enthusiastically press the red button for a powerful statement against Indefinite Postponement?

Speaker PackardThe motion before us is Indefinite Postponement on HR 30. This is a roll call vote. If you are in favor, you'll press the green button. If you are opposed, you'll press the red button. Voting stations are open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. You have to be in your seat. 191 voting Yea; 183 voting Nay, HR 30 is Indefinitely Postponed.

Deputy Speaker Steven SmithThe question is Ought to Pass with Amendment. The Chair recognizes Rep. Wayne MacDonald to speak for the committee report.

Rep. Wayne MacDonald (R - Rock 16)Thank you, Mister Speaker. Mister Speaker, the Medicaid program, its appropriation, implementation and coverage provisions have been a major topic of conversations in this chamber. As we all well remember, the debate in committees and on this House floor about a seven-year expansion involved a great deal of discussion. Medical coverage for those in need is indeed an important matter and deserves our attention. However, the Medicaid program is about procedures and treatment that are medically necessary, and circumcision is not always such a procedure. The majority respects those who believe in the procedure being performed, whether it be for religious or other reasons. The purpose of this bill is not to ban it altogether. Mister Speaker and colleagues, I ask that you press the green button and support the bipartisan majority recommendation of Ought to Pass as Amended. Thank you, Mister Speaker.

Deputy Speaker Steven SmithRep. Schapiro is recognized to speak against the committee report.

Rep. Joe Schapiro (D - Ches 16)Thank you, Mister Speaker. Of all the things I thought I would never do before I joined the legislature, making a speech about circumcision to 400 of my peers probably tops the list. Nevertheless, here I am asking you to oppose HB 1683, a bill that would end coverage in the Medicaid program for routine circumcision of male infants. Currently, New Hampshire Medicaid reimburses for circumcision at birth as an elective procedure. It is not considered cosmetic because there is ample research showing potential medical benefits such as reduction in penile cancers and reduced rates of HIV transmission. It is also not considered an urgent required procedure. It is elective. It is a choice, a parental choice and I'm here today to ask you not to take that parental choice, that parental prerogative, dare I say that parental right away. Passing this bill would be an intrusion into the freedom of New Hampshire parents to make medical decisions for their families. Using Medicaid as a tool, this bill will legislate the practice of medicine, something we try to avoid in Health, Human Services and Elderly Affairs. One time it might be something you value. Sometimes it's something that your adversary values. The reality is there is no end. That's why we try to keep healthcare decisions between patients and providers. This bill fails that test. Perhaps the most important reason to oppose HB 1683 is the issue of healthcare equity. Passage of this bill will allow wealthy people, or people with private health insurance to make a choice about circumcision unencumbered by financial concerns while low-income Granite Staters, including low-income Muslim and Jewish Granite Staters will have to consider the financial consequences of their decision. Now, I know that some of you will say that the amendment to this bill will allow for broad doctor discretion and ironically that a bill that intends to prohibit reimbursement for routine male infant circumcision will actually allow it if a healthcare provider deems it medically necessary. This, however, is just not the case. The attorney for the Medicaid program at the HHS informs me that, as written, the amendment does not even apply to infants and in no way clarifies what will be covered and what will not be covered. Some testified that parents at a vulnerable moment having just giving birth are unprepared to make a decision about circumcision, that more education is needed, a fair and balanced presentation of the pros and cons of circumcision. I totally agree. Unlike when my kids were born, virtually every parent knows the sex of their child early on in pregnancy. In fact, anti-circumcision activists have been very, very successful in this regard. Rates of male circumcision have dropped dramatically over the past three decades. In wrapping up, I would ask you to put aside any personal feelings you might have about circumcision. Some of you clearly have very strong feelings about it and some, like myself, thought about it for a short period before their children were born. In my case I ended up having two daughters and then didn't give it much thought until now. There is no right or wrong decision about male circumcision. It is a deeply personal decision and should be made with adequate information and with counsel from family, medical providers and clergy, if relevant. Please push the red button to defeat the OTP/A motion so that another motion can be made, and medical freedom can be preserved. Thank you and I would request a division vote.

Deputy Speaker Steven SmithRep. Phillips is recognized to speak in support of the report. Sorry, does the member yield to a question?

Rep. Emily Phillips (R - Rock 7)Thank you, Mister Speaker. The state is spending over $100,000 a year in billing codes paying for medically unnecessary, non therapeutic elective surgeries, namely infant circumcisions. This does not include fees for providers, supplies, facilities and the 11% revision rate where children return for corrective procedures after botched jobs. Across our nation, 18 states have eliminated Medicaid coverage for infant circumcisions. Since 1996, infant circumcisions have not been publicly insured service through Canada or the UK. The decision to drop coverage in these states has always been based on the lack of valid medical indications for the procedure. Routine circumcision is not recommended by any national medical organization in the world. The Centers for Medicare and Medicaid services have defined circumcision performed at parental requests as elective surgery. The United States Congress appropriates Medicaid funds to states only for medically necessary services. Social, cultural, religious and ethnic traditions are the primary factors and not medical ones that parents cite when making the decision to circumcise their newborn sons. The American Academy of Pediatrics and the American Medical Association have declined to recommend it as a routine practice. As a result, the national circumcision rates have now dropped to 55%. This is evidence that this surgery is not an essential component of newborn care when nearly half of today's parents are not choosing circumcision. It can no longer be defended as a standard of care in the United States or New Hampshire. Medicaid funding coverage implies an endorsement of routine circumcision when no such endorsement actually exists in New Hampshire. Why would a young and uninformed parent decline to accept something ordered, offered by a doctor for free? Why would a doctor not recommend it when he is certain to get Medicaid reimbursement for the service? Circumcision is the only surgery performed on children without a diagnosis and it is the most common one performed on them. Circumcision performed at parental request is something other than medicine and it cannot stand up to objective budget scrutiny because it cannot meet Medicaid's criteria of medically necessary. Please vote green.

Deputy Speaker Steven SmithRep. Beauchemin is recognized to speak against the committee report.

Rep. Paige Beauchemin (D - Hills 3)Thank you, Mister Speaker. Thank you, everybody. My name is Paige Beauchemin and I have been a registered women's health and psychiatric nurse for nearly 15 years. I'm a childbirth and newborn care educator and an expert in maternal mental health. I'm also the nurse in the hospital, whether I love it or not, my job is to bring the baby to the doctor to be circumcised. I come to you today with that experience urging you to oppose this bill, even though the amendment passed. First, I'd like to say I truly appreciate my colleague across the aisle. The underlying intent of this bill is right on the money. We desperately need better public health education about the risks of circumcision. In fact, I myself have spent my career educating families so that they can make a truly informed decision about circumcising or not circumcising their babies. My primary concern with this particular bill is that it does not take into account that currently, most parents in New Hampshire specifically, expect to circumcise their son and this bill will suddenly and unexpectedly have that option stripped from them without warning. I worry how an abrupt ban will impact parents and healthcare systems who are unprepared for a change like this. A better option for addressing the prevalence of unnecessary circumcision would be to improve public health education instead of just banning it. As a clinician I am fully aware circumcision is not medically necessary, but unfortunately its not just that cut and dry. Sorry. The facts remain that the topic has been debated for years and even now as we started debating in our own bodies, many healthcare professionals are still unclear about whether or not circumcision is medically necessary or not. The majority of people in New Hampshire either still believe that circumcision is medically necessary or at the very least, and this is from my experience working with them, it's a very deeply invested cultural norm and its important to them and their identity. If many healthcare providers don't even have the accurate information, how are parents supposed to get the correct information? Now we heard the statistic that circumcision is down to about 55%. That's true but that's a national figure. In New Hampshire, 76% of boys get circumcised and in other states it's down to 10-50% based on a really great job of public education. So, it really is, when we are looking at 76%, it's realistic to say that when most parents in New Hampshire go to have their baby, they are assuming that they will circumcise their son and that they will have that option. Now for just a minute, if any of you are parents, think back to the first day you held that newborn baby in your arms. How you might have been scared about what kind of parent you were going to be. How you desperately wanted to do everything you could possibly do to take care of your baby in the best way that you knew how. Anybody who is a parent knows you didn't know how, but you learned. Now, imagine that the nurse told you that the care that you believed your baby needed would not be available to you because of your low income because that is what I'm going to have to say to people in the room with them if we pass this right now. How would that have affected you in that moment, exhausted and just learning how to be a new parent? How would it have it affected your self worth? These are the kinds of moments that stick with people for a lifetime and can have long term impacts on maternal mental. The birth and immediate postpartum experience significantly impacts the risk of postpartum mental health issues and I fear that suddenly banning circumcisions could have detrimental effects on many of our mothers, especially those with Medicaid coverage who are already often at a higher risk for mental health conditions. Some of you might brush off this idea but having interviewed thousands of pregnant and postpartum women about their stories of birth trauma and associated postpartum depression and anxiety, I can assure you this is a sincere concern. It's true, we should absolutely work as a bipartisan body to decrease unnecessary circumcision in the State of New Hampshire but banning it only for the Granite Staters who are low income doesn't even address the problem of misinformation about circumcision and it has a potential to do more harm than good. I suggest that instead we start with a robust public health campaign and work towards bringing those circumcision numbers down organically, like so many other states have done. Let's take the time to explore other options more closely along with healthcare professionals so that we can develop a solution that relies on education and collaboration instead of force. Thank you.

Deputy Speaker Steven SmithRep. Ellen Read is recognized to speak in support of the committee report.

Rep. Ellen Read (D - Rock 10)Thank you, Mister Speaker. This won't be a surprise to anyone I don't think but I am a huge proponent of socialized healthcare, a huge proponent. Circumcision, medically unnecessary circumcision on infant boys is the only elective, cosmetic, medically unnecessary procedure that we spend taxpayer money on. It's also the only cultural and the only religious based procedure that we spend taxpayer money on. I want to be really clear, it's not a religious procedure as it is done in the hospital because in order for it to be a religious procedure, it has to be done at a certain time, like eight days after birth and by a certain clergy person. So that's not what's happening. What's happening is it has become a cultural norm that we do not question, but we are, in effect, the only country that does this routinely by default. Eighty percent of the men of the world are not circumcised and they are doing okay. In fact, it's not just we are the only country, human beings are the only species we claim that it is medically necessary to do this at birth. Other species that are born with foreskin, dogs, cats, horses, you name it, they seem to get along just fine. In fact, it's purely cultural and...

Deputy Speaker Steven SmithThe member will suspend for a minute. Noise level is rising steadily. Let's descend it steadily. Thank you.

Rep. Ellen Read (D - Rock 10)Thank you, Mister Speaker. One in 16,000 uncircumcised men end up needing a circumcision for medical reasons later in life, but 11% of circumcised infants have some form of complication, including the need for revision surgeries. Some of those infants end up being children that have long lasting negative medical impacts from those complications. What it really comes down to is choice and bodily autotomy and we talk a lot about those concepts here. Now I know that a previous speaker just said this is a parental choice, but it's not a parental choice when that child becomes an adult and that choice has been taken away from them because if you choose to circumcise your infant, they don't get to choose to be uncircumcised when they are older. If you don't circumcise then they get to make that choice when they are older. Another thing I want to bring up is the fact that Medicaid does not cover female genital mutilation. Now, here's the thing about that before you say well that's different. Some of it is very, very different. Some forms of female genital mutilation are extremely severe, however, the most common form in the world is analogous exactly to circumcision. It is the removal of the clitoral hood. We do not cover that with taxpayer money. Also, it's illegal to do it at all on a female child in this country. So female infants have protections that not only do we not extend to male infants, we actually pay for those male infants to have healthy tissue removed from healthy babies, healthy tissue removed from healthy babies. The truth of the matter is I'm a strong proponent of socialized medicine so I believe that the money that's being spent removing healthy tissue from healthy babies should be spent on medically necessary treatment for children. Now I appreciate the previous speaker who wanted to make a point about the access for the poor to this procedure, but we would never want to increase access for the removal of the clitoral hood, for example. We wouldn't want to increase access for that. Seventeen states do not use Medicaid funds to cover unnecessary circumcision and the sky is not falling in those states. There is no trauma to parents in those states. There is no discrimination in those states and in fact, the wealthy around the world, as far as men go, tend to be uncircumcised so it's not really an issue of poverty versus money. It's an issue of right and wrong and how we treat newborn baby boys. With that, thank you.

Deputy Speaker Steven SmithThe question is on the majority committee report of Ought to Pass as Amended on HB 1683. Are you ready for the question? I thought so. This will be a division vote. Members take your seats. The question is on the majority committee report of Ought to Pass as Amended on HB 1683. Rep. Schapiro is recognized for a parliamentary inquiry.

Rep. Joe Schapiro (D - Ches 16)Thank you, Mister Speaker. Mister Speaker, if I know that one's vote on this bill should have nothing to do with one's personal feelings about circumcision. And Mister Speaker, if I know this bill will intrude upon and diminish parent's rights to make healthcare decisions for their children. And Mister Speaker, if I know that it is an insult to New Hampshire citizens to believe that citizens will use circumcision merely because it is free and or doctors will do circumcisions to make money off of it. And If I know that in the long run, persuasion is more effective than force, would I then urge you, Mister Speaker, to push the red button to defeat the OTP/A motion so a new motion may be made? Thank you.

Deputy Speaker Steven SmithRep. Phillips is recognized for a parliamentary inquiry

Rep. Emily Phillips (R - Rock 7)Thank you, Mister Speaker. If I know that Medicaid uses finite resources to cover only medically necessary procedures and no public health organization claims circumcision is medically necessary. And if I know that in executive hearings, we learned that private insurance such as Anthem do not cover elective infant circumcisions. And if I know this legislation has strong bipartisan support and passed committee with a 14-6 vote in favor of OTP. And, lastly, Mister Speaker, if I know that foreskin is not a birth defect and nobody wants less penis, would I press the green button?

Deputy Speaker Steven SmithThe House will be in order. I'm just going to wait. I'd like to go home really bad, but I'm just going to wait until the House is in order. The question is on the majority committee report of Ought to Pass as Amended on HB 1683. This is a division vote. If you are in favor, press the green button, opposed, press the red. Voting stations are open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. 178 in the affirmative, 197 in the negative, the motion is defeated. Rep. Schapiro moves Inexpedient to Legislate. For what reason does Rep. Postpone rise?

Deputy Speaker Steven SmithMy bad. Rep. Sweeney moves that HB 1683 be laid on the table. Are you ready for that question? Rep. Phillips requests a roll call. Is that sufficiently seconded? It is. This will be a roll call vote. Members take your seats. The question is whether to lay HB 1683 on the table. Rep. Schapiro is recognized for a parliamentary inquiry.

Rep. Joe Schapiro (D - Ches 16)Thank you, Mister Speaker. If I know that the majority of this body, whatever their personal feelings are about circumcision, believe that people should have the right to make their own decisions for their own families. And if I know, Mister Speaker, that people do not feel that there should be further disparities for low-income Medicaid recipients, would I then push the red button so that the tabling motion will be defeated, and we can make a more proper motion? Thank you.

Deputy Speaker Steven SmithThe question is whether to lay HB 1683 on the table. This is a roll call vote. If you are in favor, press the green button, opposed press the red. Voting stations are open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. 188 in the affirmative, 187 in the negative, HB 1683 is laid on the table. (Speaker Packard in the Chair)