H1854 CONGRESSIONAL RECORD — HOUSE March 21, 2010

Whitfield Wittman Young (AK) Green, Gene Marchant Roskam ANNOUNCEMENT BY THE SPEAKER PRO TEMPORE Wilson (SC) Wolf Young (FL) Griffith Markey (CO) Ross The SPEAKER pro tempore (Ms. ED- Grijalva Markey (MA) Rothman (NJ) ANNOUNCEMENT BY THE SPEAKER PRO TEMPORE Guthrie Marshall Roybal-Allard WARDS of Maryland) (during the vote). The SPEAKER pro tempore (during Gutierrez Matheson Royce Two minutes remain in the vote. Hall (NY) Matsui Ruppersberger the vote). There are 2 minutes remain- b 1841 ing in this vote. Hall (TX) McCarthy (CA) Rush Halvorson McCarthy (NY) Ryan (OH) So (two-thirds being in the affirma- Hare McCaul Ryan (WI) b 1829 Harman McClintock Salazar tive) the rules were suspended and the So the resolution was agreed to. Harper McCollum Sa´ nchez, Linda resolution, as amended, was agreed to. The result of the vote was announced Hastings (FL) McCotter T. The result of the vote was announced Hastings (WA) McDermott Sanchez, Loretta as above recorded. as above recorded. Heinrich McGovern Sarbanes The title of the resolution was A motion to reconsider was laid on Heller McHenry Scalise the table. Hensarling McIntyre Schakowsky amended so as to read: ‘‘Expressing the Herger McKeon Schauer sense of the House of Representatives f Herseth Sandlin McMahon Schiff regarding the meritorious service per- Higgins McMorris Schmidt formed by aviators in the United RECOGNIZING MILITARY AVI- Hill Rodgers Schock ATORS WHO ESCAPED CAPTURE Himes McNerney Schrader States Armed Forces who, as a result Hinchey Meek (FL) Schwartz of hostile action, mechanical failures, The SPEAKER pro tempore. The un- Hinojosa Meeks (NY) Scott (GA) or other problems, were forced to evade finished business is the vote on the mo- Hirono Melancon Scott (VA) or escape enemy capture, were cap- tion to suspend the rules and agree to Hodes Mica Sensenbrenner Hoekstra Michaud Serrano tured but subsequently escaped, or the resolution, H. Res. 925, as amended, Holden Miller (FL) Sessions were compelled to endure arduous con- on which the yeas and nays were or- Holt Miller (MI) Sestak finement, retaliation, and even death dered. Honda Miller (NC) Shadegg as a result of their efforts to evade cap- The Clerk read the title of the resolu- Hoyer Miller, Gary Shea-Porter Hunter Miller, George Sherman ture or escape.’’. tion. Inglis Minnick Shimkus A motion to reconsider was laid on The SPEAKER pro tempore. The Inslee Mitchell Shuler the table. question is on the motion offered by Israel Mollohan Shuster f the gentlewoman from Guam (Ms. Issa Moore (KS) Simpson Jackson (IL) Moore (WI) Sires SENATE AMENDMENTS TO H.R. BORDALLO) that the House suspend the Jackson Lee Moran (KS) Skelton rules and agree to the resolution, H. (TX) Moran (VA) Slaughter 3590, SERVICE MEMBERS HOME Res. 925, as amended. Jenkins Murphy (CT) Smith (NE) OWNERSHIP TAX ACT OF 2009, This will be a 5-minute vote. Johnson (GA) Murphy (NY) Smith (NJ) AND H.R. 4872, HEALTH CARE Johnson (IL) Murphy, Patrick Smith (WA) AND EDUCATION RECONCILI- The vote was taken by electronic de- Johnson, E. B. Murphy, Tim Snyder vice, and there were—yeas 426, nays 0, Johnson, Sam Myrick Souder ATION ACT OF 2010 not voting 4, as follows: Jones Nadler (NY) Space The SPEAKER pro tempore. Pursu- Jordan (OH) Napolitano Speier [Roll No. 164] Kagen Neal (MA) Spratt ant to House Resolution 1203, it is now YEAS—426 Kanjorski Neugebauer Stark in order to debate the topics addressed Ackerman Burgess DeFazio Kaptur Nunes Stearns by the Senate amendments to the bill Aderholt Burton (IN) DeGette Kennedy Nye Stupak (H.R. 3590) to amend the Internal Rev- Adler (NJ) Butterfield Delahunt Kildee Oberstar Sullivan enue Code of 1986 to modify the first- Akin Buyer DeLauro Kilroy Obey Sutton Alexander Calvert Dent Kind Olson Tanner time homebuyers credit in the case of Altmire Camp Diaz-Balart, L. King (IA) Olver Taylor members of the Armed Forces and cer- Andrews Campbell Diaz-Balart, M. King (NY) Ortiz Teague tain other Federal employees, and for Arcuri Cantor Dicks Kingston Owens Terry other purposes, and the topics ad- Austria Cao Dingell Kirk Pallone Thompson (CA) Baca Capito Doggett Kirkpatrick (AZ) Pascrell Thompson (MS) dressed by the bill (H.R. 4872) to pro- Bachmann Capps Donnelly (IN) Kissell Pastor (AZ) Thompson (PA) vide for reconciliation pursuant to sec- Bachus Capuano Doyle Klein (FL) Paul Thornberry tion 202 of the concurrent resolution on Baird Cardoza Dreier Kline (MN) Paulsen Tiahrt Baldwin Carnahan Driehaus Kosmas Payne Tiberi the budget for fiscal year 2010. Barrett (SC) Carney Duncan Kratovil Pence Tierney The gentleman from Maryland (Mr. Barrow Carson (IN) Edwards (MD) Kucinich Perlmutter Titus HOYER) and the gentleman from Ohio Bartlett Carter Edwards (TX) Lamborn Perriello Tonko (Mr. BOEHNER), or their designees, each Barton (TX) Cassidy Ehlers Lance Peters Towns Bean Castle Ellison Langevin Peterson Tsongas will control 60 minutes. Becerra Castor (FL) Ellsworth Larsen (WA) Petri Turner The Chair recognizes the gentleman Berkley Chaffetz Emerson Larson (CT) Pingree (ME) Upton from California (Mr. WAXMAN) for 15 Berman Chandler Engel Latham Pitts Van Hollen minutes as a designee of the majority Berry Childers Eshoo LaTourette Platts Vela´ zquez Biggert Chu Etheridge Latta Poe (TX) Visclosky leader. Bilbray Clarke Fallin Lee (CA) Polis (CO) Walden GENERAL LEAVE Bilirakis Clay Farr Lee (NY) Pomeroy Walz Bishop (GA) Cleaver Fattah Levin Posey Wamp Mr. WAXMAN. I would like to ask Bishop (NY) Clyburn Filner Lewis (CA) Price (GA) Wasserman unanimous consent that all Members Bishop (UT) Coble Flake Lewis (GA) Price (NC) Schultz have 5 days in which to revise and ex- Blackburn Coffman (CO) Fleming Linder Putnam Waters tend their remarks and insert extra- Blumenauer Cohen Forbes Lipinski Quigley Watson Blunt Cole Fortenberry LoBiondo Radanovich Watt neous material in the RECORD. Boccieri Conaway Foster Loebsack Rahall Waxman The SPEAKER pro tempore. Is there Bonner Connolly (VA) Frank (MA) Lofgren, Zoe Rangel Weiner objection to the request of the gen- Bono Mack Conyers Franks (AZ) Lowey Rehberg Welch tleman from California? Boozman Cooper Frelinghuysen Lucas Reichert Westmoreland Boren Costa Fudge Luetkemeyer Reyes Whitfield There was no objection. Boswell Costello Gallegly Luja´ n Richardson Wilson (OH) Mr. WAXMAN. Madam Speaker, I Boucher Courtney Garamendi Lummis Rodriguez Wilson (SC) yield 1 minute to the majority leader Boustany Crenshaw Garrett (NJ) Lungren, Daniel Roe (TN) Wittman of the House of Representatives, the Boyd Crowley Gerlach E. Rogers (AL) Wolf Brady (PA) Cuellar Giffords Lynch Rogers (KY) Woolsey gentleman from Maryland (Mr. HOYER). Brady (TX) Culberson Gingrey (GA) Mack Rogers (MI) Wu Mr. HOYER. I thank my friend for Braley (IA) Cummings Gohmert Maffei Rohrabacher Yarmuth Bright Dahlkemper Gonzalez yielding. Maloney Rooney Young (AK) Today is March 21, 2010. On March 21, Broun (GA) Davis (AL) Goodlatte Manzullo Ros-Lehtinen Young (FL) Brown (SC) Davis (CA) Gordon (TN) 1965, Martin Luther King, Jr., led a Brown, Corrine Davis (IL) Granger NOT VOTING—4 march across the Edmund Pettus Brown-Waite, Davis (KY) Graves Ginny Davis (TN) Grayson Boehner Kilpatrick (MI) Bridge. It was a march across that Buchanan Deal (GA) Green, Al Foxx Smith (TX) bridge for the vote in this democracy.

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00036 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1855 It was a march towards a greater free- were far fewer Americans who did not who are struggling to make sure that dom for many Americans. It was a have health insurance and where their children are healthy and well and march for a better quality of life for health care was less costly. Richard safe. But it would be a defeat for them many Americans. Indeed, it was a Nixon was right in 1974 on this issue. and for our country, for a healthy march across the Edmund Pettus Let us in 2010, in a bipartisan way, per- America is a stronger America. Bridge for freedom and a better realiza- haps not a bipartisan vote, but recog- They saw the same thing in 1993, my tion of the promise of our democracy. nizing that this has been a bipartisan Republican colleagues, when to a per- Today, March 21, 2010, we will cross objective, a bipartisan vision, for those son, as I believe will happen tonight, another bridge. It is not a physical Republican Presidents and Democratic unfortunately, in 1993, to a person they bridge, but it is a bridge that too many Presidents whom I have not quoted but did the same thing. My Republican Americans find that they cannot cross; whom, as all of you know, were equally friends voted without a single excep- a river that separates them from the committed to that vision and that ob- tion against the 1993 economic reform security of having available the best jective, affordable health care for all, plan of the Clinton administration. health care that is available in the for all Americans. It was embraced by Congressman BOEHNER asked, ‘‘Who world available to them. both parties’ nominees in the last cam- does this spending stimulate except We are here to conclude a day of de- paign, Senator Obama and Senator maybe the liberal faculty at Harvard or bate, which concludes months of de- MCCAIN. Berkeley?’’ bate, in a national conversation that But what a campaign of fear this bill Congressman Kasich said, ‘‘If it was began more than a century ago. has faced this last year. Its critics call to work, then I’d have to become a Democrat. ‘‘ b 1845 it, without justification, and we will hear it tonight, a ‘‘government take- It did work, and he didn’t change. It But this much is beyond debate. over.’’ That’s not true, but if you be- was a partisan vote, Mr. Speaker, a American health care is on an lieve it’s true, perhaps you think we partisan vote that helped create 22.7 unsustainable course. By the end of ought to repeal veterans health care, million new jobs, contrary to what so this debate, another family will have which is clearly government-run health many of my Republican friends said fallen into bankruptcy because some- care. Perhaps we ought to repeal Medi- that bill would do, and a record budget one had the bad fortune simply to be care, government participated but pri- surplus of $5.6 trillion, contrary to the sick. More families will have joined vate sector providers. Perhaps you be- assertion of Mr. Armey that it would them in paying more and more for less lieve Medicare should be repealed. I create deep debt. and less health coverage. More busi- don’t think you do; I hope you don’t. That bill passed through a gauntlet nesses will have weighted bankruptcy It is more control, however, for of slurs, hyperbole, and untruths, and against cutting their workers’ care and whom? For consumers, and less for in- so did Medicare, which Republicans their workers will have lost. surance companies. It is the end of dis- called ‘‘brazen socialism,’’ and so did We have before us a bill to change an crimination against Americans with Social Security, which a Republican unsustainable course. That is our preexisting conditions, and the end of Congressman called the ‘‘lash of the choice this evening. It is a historic medical bankruptcy and caps on bene- dictator.’’ choice. It’s a choice that all of us vol- fits. It is coverage you can rely on I don’t know whether there are any unteered to be put in the position to whether you lose your job or become Republicans in this body tonight that make. It is a choice that we will be your own boss, coverage that reaches believe that Social Security is the lash honored to make this evening. We 95 percent of all Americans. Its critics of the dictator. I hope not. stood in this Chamber tonight with call it tyranny. There is none. Those slurs were false in 1935, they JOHN DINGELL, JOHN DINGELL, who It is a free, competitive, transparent were false in 1965, and, ladies and gen- stood at that rostrum with the gavel marketplace where individuals and tlemen of this House, they are false in that the Speaker will use tonight to small businesses can pool together to 2010. Ladies and gentlemen of this gavel through Medicare, that ensured buy private insurance at low rates. It House, this bill, this bill will stand in that millions and millions and millions is lower cost for the middle class and the same company, for the misguided of seniors would not be crushed by pov- an end to the prescription drug dough- outrage of its opposition and for its erty and put into bankruptcy by the nut hole that has faced too many lasting accomplishment of the Amer- cost of health care. struggling seniors. Its critics mock ican people. Indeed, they will have been given the this as ‘‘out-of-control government.’’ In closing, Mr. Speaker, I want to opportunity for a longer, better quality In truth, it is the biggest definite-re- honor some of the ‘‘little punk staff- of life in America when JOHN DINGELL duction bill any of us will have an op- ers’’ who gave so much to help us bring brought that gavel down on that desk portunity to vote on in this Congress this bill to the floor. I say to my and noted the passage of Medicare in and, indeed, in other Congresses as friends on the other side of the aisle 1965. well. Indeed, it’s the deepest definite who did so much to bring your pre- For more than 3,000 district events, reduction since the Clinton budget of scription drug bill to the floor, they more than 100 hearings, and almost 2 the 1990s that ushered in a budget sur- need to be honored. They need to be years of public debate, health insur- plus and historic prosperity. thanked. They need to be respected for ance reform has stood up to the scru- According to the nonpartisan CBO, the work they do for this House, for tiny, to criticism, indeed, to false- this bill is $143 billion in savings in the each of us but, more importantly, for hoods. But this purpose is older than first decade and more than $1 trillion America. that. Before we were born, the task of of savings in the second decade. We can From the Legislative Counsel’s Of- bringing affordable health care to add to those deficit savings real cost fice, Ed Grossman, Jessica Shapiro, every American was on our Nation’s controls that bring down the price of Megan Renfrew, Warren Burke, Larry agenda, waiting for this day. At the be- the world’s most expensive health care. Johnston, Henry Christrup, Wade ginning of this decade in 2002, George Take those into account, says leading Ballou and Scott Probst. W. Bush said, ‘‘All Americans should be health care economist David Cutler, I also want to honor, Mr. Speaker, able to choose a health care plan that and America saves an additional $600 the tireless staffs of the House Com- meets their needs at affordable prices.’’ billion in the first 10 years and even mittees on Ways and Means, Energy George Bush was right. more in the second 10 years. and Commerce, Education and Labor, In 1976, Gerald Ford spoke of ‘‘our ef- Yet there are some who hope for the Rules, and the Budget, as well as the fort to upgrade and perpetuate our bill’s defeat. They would see that, I staff of the CBO, Doug Elmendorf, total health care system so no indi- think, as the defeat of one party. One Holly Harvey, Phil Ellis, Kate Massey, vidual in this country will lack help Senator made that observation and Pete Fontaine and the whole CBO whenever or wherever he needs it.’’ said this might be the President’s Wa- health care team, along with Tom Gerald Ford was right. terloo. If this bill fails, the Waterloo Barthold, and everyone of the staff on And Richard Nixon said this, ‘‘Let us will be that of the people who are with- the Joint Committee on Taxation, who act now.’’ That was in 1974, when there out health care insurance, the people contributed to their estimates.

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00037 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1856 CONGRESSIONAL RECORD — HOUSE March 21, 2010 Finally, two remarkable staffers in Health Subcommittee, Mr. DEAL, for 1 are poised to provide access to quality my office have made health reform the minute. health insurance for all. cause of their lives and just about Mr. DEAL of Georgia. I thank the Today is a historic moment. every one of their waking hours for the gentleman for yielding. We will take decisive votes to provide qual- past year, Liz Murray and Ed Lorenzen. Madam Speaker, it has been said that ity, affordable health care to all Americans. Thank you very much. the problem with socialism is that you This is a goal that Presidents of both parties Mr. Speaker, one of my staffers, my eventually run out of other people’s have sought for a hundred years. deputy chief of staff, has a 4-year-old money. We must act. The status quo is daughter. She is a beautiful young girl, Despite billions of dollars in new unsustainable. she is a smart young girl. Her name is taxes, despite billions of dollars in cuts This bill provides all Americans the security Colette. A few days ago a neighbor to Medicare, and despite deceptive ac- of knowing they will always be able to afford asked Colette where her mom was, and counting practices to hide the true cost health care for themselves and their families. I am told that she answered, She’s at of this bill, it appears that we have run The bedrock foundation of this legislation is work making sure everyone can go see out of what money is here in Wash- that it builds on what works today, and re- the doctor. Thanks, Mom. Thanks to ington, because we are seeking to im- forms what doesn’t. all the moms throughout America who, pose unprecedented and unconstitu- If you like your doctor and your current plan, when we pass this bill, will have a tional mandates on our States. you keep them. greater sense of security for their kids, Tonight, as I cast what might be the But we fundamentally reform the insurance for their families, for themselves. last votes of my congressional career, I company practices that are failing our families: Americans with pre-existing conditions can I know this bill is complicated, but am pleased to say that as I pursue my no longer be denied coverage. it’s also very simple. Illness and infir- full-time activity to become the gov- ernor of the great State of Georgia, We abolish lifetime limits on coverage. mity are universal, and we are stronger And your health coverage can no longer be that I will cast my vote in opposition against them together than we are rescinded by your insurance company if you alone. Our bodies may fail us; our to this bill. If this bill becomes law and I am suc- get sick. neighbors don’t have to. In that shared We strengthen Medicare. cessful in my undertakings, I will de- strength is our Nation’s strength, and Seniors who hit the donut hole will get some vote my efforts to making sure that in this bill is a prosperous and more immediate help: a $250 rebate this year, and the people of my State are not sub- just future. a 50 percent discount on their brand-name jected to the unconstitutional indi- Unfortunately, much of this debate drugs next year. has been divisive, much of it has been vidual mandate and that my State is And the donut hole will be completely elimi- irrelevant. We have seen angry people not subject to the unconstitutional nated within a decade. at the doorstep of the Capitol. Every mandate to expand our Medicaid rolls. We provide coverage to 32 million unin- President in this last century has said I know that I am not alone. Yesterday, sured Americans—not just those without insur- this is necessary for a great Nation to 38 States indicated that they would ance today but many who would otherwise be do. join in suing to challenge the constitu- expected to lose their coverage in the coming My colleagues, how proud we must tionality of this statute. years. all be that our neighbors have elected I urge my colleagues to join me on a We eliminate waste, fraud, and abuse and us to come here in this, the people’s ‘‘no’’ vote. reduce the deficit by over a trillion dollars. House, to do this good work this night. Mr. WAXMAN. Madam Speaker, I And we eliminate the special deal for Ne- yield myself 2 minutes. b 1900 braska, providing all states equitable treatment Today is a historic moment. We will under Medicaid. The SPEAKER pro tempore. The gen- take decisive votes to provide quality The American people will see immediate tleman from Texas (Mr. BARTON) is rec- affordable health care for all Ameri- benefits on enactment. ognized for 10 minutes as a designee of cans. This is a goal that Presidents of Starting this year: Your children can stay on the minority leader. both parties have sought for 100 years. your policy through age 26. Mr. BARTON of Texas. Madam We must act. The status quo is Preventive care under Medicare is free. Speaker, I yield to the gentleman from unsustainable. And children with pre-existing conditions Alabama for a unanimous consent re- This bill provides all Americans the cannot be denied coverage. quest. security of knowing they will always Today we vote to make a profound dif- (Mr. ROGERS of Alabama asked and be able to afford health care for them- ference for the better for the American people. was given permission to revise and ex- selves and their families. Under the leadership of the President and tend his remarks.) The bedrock foundation of the legis- our Speaker, we are poised to provide access Mr. ROGERS of Alabama. Madam lation is that it builds on what works to quality health insurance for all Americans. Speaker, I rise in opposition to this today and reforms what doesn’t, but we I now want to turn to some specific provi- flawed health care bill. fundamentally reform the insurance sions in the Senate bill, H.R. 3950. Mr. BARTON of Texas. Madam company practices that are failing our SECTION 2304. CLARIFICATION OF DEFINITION OF MEDICAL Speaker, I yield to the gentleman from families. ASSISTANCE North Carolina for a unanimous con- Americans with preexisting condi- Section 2304 of H.R. 3590 as passed by the sent request. tions can no longer be denied coverage. Senate clarifies the definition of medical as- (Mr. COBLE asked and was given per- We abolish lifetime limits on coverage. sistance. This clarification is identical to that in mission to revise and extend his re- And we ban the practice of rescission section 1781(e) of H.R. 3962 as passed by marks.) by insurance companies when people the House and in section 1781(e) of H.R. Mr. COBLE. Madam Speaker, I rise in get sick. 3200 as reported by the Committee on Energy opposition to this flawed health care We strengthen Medicare. Seniors who and Commerce. The purpose of this clarifica- bill. hit the donut hole for their drug cov- tion is set forth in H. Rept. 111–299, Part 1, Mr. BARTON of Texas. Madam erage will get immediate help, a $250 at pp. 649–650. Speaker, I yield to the gentleman from rebate this year, a 50 percent discount SECTION 3301. MEDICARE COVERAGE GAP DISCOUNT Minnesota for a unanimous consent re- on their brand name drugs next year, PROGRAM quest. and the donut hole will be completely I, on behalf of myself and Chairman LEVIN, (Mr. PAULSEN asked and was given eliminated within the decade. We pro- express our intent regarding this section. Sec- permission to revise and extend his re- vide coverage to 32 million uninsured tion 3301 of this legislation provides for 50 marks.) Americans. We eliminate waste, fraud, percent discounts for brand name drugs in the Mr. PAULSEN. Madam Speaker, I and abuse. The American people will Part D donut hole. It requires that manufactur- rise in opposition to this flawed health see immediate benefits. ers enter into an agreement to provide such care bill. Today we vote to make a profound discounts as a condition of participation in the Mr. BARTON of Texas. Madam difference for the betterment of the Part D program. Speaker, I yield to the gentleman from American people. Under the leadership This section adds to the Social Security Act Georgia, the ranking member of the of the President and our Speaker, we new Section 1860D–43(c)(1), which provides a

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00038 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1857 limited exemption from the requirement to pro- cluding payment reductions for indirect med- esses favored nursing home operators over vide a discount if the Secretary makes a de- ical education under 1886(d)(5)(B), graduate resident welfare. termination that the availability of the drug is medical education under 1886(h), dispropor- In order to avoid these problems, the intent essential to the health of beneficiaries under tionate share hospital payments under of this section is that independent informal dis- this part. This intent of this exemption, if it is 1886(d)(5)(F), and capital payments, as well pute resolution processes should be con- used at all, is that it be used only in extraor- as incentives for adoption and maintenance of ducted by an independent state agency or en- dinary circumstances, and that it be of limited meaningful use of certified electronic health tity with healthcare experience, or by the state duration. For example, if a new drug manufac- record technology under 1886(n). As part of survey agency, so long as no entity or indi- turer without an agreement already in place the effort to make improvements to the Sen- vidual who conducts independent informal dis- receives a new drug application approval after ate-passed bill, Members of the House and pute resolution has a conflict of interest. The the period in which annual agreements are Senate, along with the administration, were Secretary’s implementing regulations may ad- supposed to be signed by the Secretary, the working on a number of improvements to the dress the type and duration of the inde- Secretary could find that the drug is essential IPAB policy. Unfortunately, the Senate parlia- pendent informal dispute resolution processes. to beneficiaries’ health and provide a short- mentarian indicated that we could not modify as determined by the Secretary. As under cur- term exemption until an agreement with the IPAB in reconciliation. Since we were not able rent law, facilities may challenge only the fac- manufacturer is in place. Any exemptions pro- to make any changes to the IPAB as part of tual basis of the deficiency; and states and the vided under this section are intended to be the reconciliation bill, I look forward to working Secretary retain the right to reject independent temporary in nature. on these improvements in the future. informal dispute resolution processes rec- Moreover, nothing in this section requires SECTION 3512 ommendations, any person shall have the the Secretary to make a finding that a given I have spoken with several Members, in- right to attend and participate in the con- drug is essential to beneficiaries’ health, or cluding Congressman CUELLAR of Texas, that ference. provides a right of action for any individual or have expressed concerns about whether the I reserve the balance of my time. organization to force the Secretary to make language of these bills may be interpreted or Mr. BARTON of Texas. Madam such a finding. construed as creating a new cause of action Speaker, I yield to the gentleman from This provision also contains civil monetary or claim or would modify or impair existing Michigan (Mr. UPTON) for 1 minute. penalties for manufacturers that fail to provide state medical malpractice laws. Mr. UPTON. Madam Speaker, folks applicable beneficiary discounts. The civil It is not and never has been the intent of are scared. They are really scared. monetary penalties specified in this provision this legislation to create any new causes of Debt is at a historic level, spending is are not the sole penalties that can be applied action or claims premised on the development out of control, the Nation’s AAA credit to manufacturers that violate requirements of of guidelines or other standards. rating is in jeopardy, and here we are. this section or other provisions of law. For ex- Section 10201(j) of H.R. 3590, which was We are going to spend $1 trillion over ample, relevant CMPs that apply to Medicare part of a manager’s amendment adopted on the next 10 years for just 6 years of fraud or misleading statements and False the Senate floor and added Section 3512 to benefits. Only in Washington can folks Claims Act penalties can also be applied to Subtitle F of title III of the Act, calls for the stand here and claim spending $1 tril- manufacturers that fail to provide required dis- Comptroller General to conduct a study of lion will actually cut the deficit. counts. whether the development, recognition or im- And how did we get here? Well, we Another provision of this section states that plementation of any guideline or other stand- are going to start by raiding $523 bil- the Secretary ‘‘shall not receive or distribute ards under a list of enumerated sections of the lion from the Medicare checks of older any funds of a manufacturer under this pro- Senate bill would result in a new cause of ac- Americans. Shameful. gram’’. This provision refers only to manufac- tion or claim. Whatever happened to tort reform? turer funds, not to other funds or information. Any guideline or standard created under the Not here. The lawyers are going to con- Section 1860D–43 contains no restriction on above enumerated sections should not be tinue to get richer suing doctors and the ability of the Secretary, CMS, or the In- construed as creating any such new actions or hospitals, and older Americans will see spector General to obtain (from any manufac- claims, nor should the request for a study be their benefits evaporate. Where are our turer, PDP or MA–PD plan, or other entity) construed to infer otherwise. This legislation priorities? any data or information necessary for the pur- should not be interpreted or construed as cre- Yesterday I introduced an amend- poses of program compliance and integrity or ating any inference or implication that any ment that would delay the bill until we audit purposes, or otherwise necessary to such guideline or other standard does create can guarantee Medicare’s solvency for identify and eliminate waste, fraud, or abuse any new cause of action or claim. at least the next 30 years, but it was under this section. It is also not and never has been the legis- denied. I guess they would rather spend SECTION 3403. INDEPENDENT MEDICARE ADVISORY lative intent of this legislation to modify, impair money that we don’t have rather than BOARD or supersede any State medical liability law uphold our commitment to seniors. I wish to clarify certain aspects of legislative governing legal standards or procedures used Debt continues to soar beyond belief. intent regarding the Independent Payment Ad- in medical malpractice cases, and this legisla- Today, every man and woman will visory Board (IPAB), which is a new executive tion does not have the authority to prohibit the spend $46,000 on the debt. Let’s do bet- branch body created in the Senate passed states from implementing such laws. ter. We can. health reform bill and charged with con- SECTION 6111. CIVIL MONEY PENALTIES Mr. WAXMAN. Madam Speaker, I am straining Medicare spending. Section The legislation we will pass today contains proud at this time to yield 2 minutes to 1899A(c)(2)(A)(iii) of the Social Security Act, nursing home reforms that will make it easier the gentleman from Michigan (Mr. DIN- as added by Section 3403 of PPACA, states to identify owners responsible for inadequate GELL), the distinguished dean of the that in the case of IPAB proposals submitted care, improve enforcement, and improve nurs- House, who has championed the cause prior to December 31, 2018, IPAB shall not in- ing home quality nationwide. These improve- of health care in all of the time he has clude any recommendations that would reduce ments represent a significant step forward. been in the Congress. And before that, payment rates for providers that receive an Nearly identical provisions were included in his father called upon the Congress to additional market basket cut on top of the pro- health care reform legislation that passed in adopt this legislation as well. ductivity adjustment. The rationale for this pro- the Energy and Commerce Committee, and in (Mr. DINGELL asked and was given vision is that these providers are already fac- HR 3200 as passed by the House. permission to revise and extend his re- ing extra downward adjustments in their pay- Section 6111 of the legislation makes col- marks.) ments and thus should not be subject to ‘‘dou- lection of civil monetary penalties more timely Mr. DINGELL. Madam Speaker, I ble jeopardy’’ by also being subject to IPAB by allowing funds to be escrowed after an thank my colleague, Mr. WAXMAN, for recommendations which will further reduce independent informal dispute resolution proc- his leadership and for his gracious com- spending. In creating this exclusion, it is the ess until other appeals are concluded. ments. And I want to thank and praise intent of Congress to exclude all payment re- A November 2009 GAO report found that our Speaker, our majority leader, and ductions applicable to providers captured by understatement of deficiencies may result from the leader in the Senate for the great this language in all the relevant years. There- ‘‘unbalanced’’ independent dispute resolution leadership that they have given us in fore, in the case of inpatient hospitals, the pro- processes currently used. Over 40 percent of this great undertaking. vision excludes from IPAB recommendations surveyors in four states told GAO that their Today is a day that is going to rank payment reductions applicable to hospitals in- states’ independent dispute resolution proc- with the day we passed the civil rights

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00039 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1858 CONGRESSIONAL RECORD — HOUSE March 21, 2010 bill in 1964. Today we are doing some- Mr. BARTON of Texas. Madam government and the health care system thing that ranks with what we did on Speaker, I yield for a unanimous con- significant money even beyond the Social Security or Medicare. This is sent request to a member of the com- CBO projections. the day on which we can all be proud if mittee from the Keystone State of Madam Speaker, passage of this bill we vote for that legislation. Pennsylvania, Dr. MURPHY. will lead to a healthier and a stronger Facts are an intransigent hard thing. Mr. TIM MURPHY of Pennsylvania. America, and I urge my colleagues to And let’s look at this from the stand- Madam Speaker, I rise in opposition to vote ‘‘yes.’’ point of the facts of what it does. this flawed health care bill. Mr. BARTON of Texas. Madam Thirty-two more million Americans Mr. BARTON of Texas. Madam Speaker, I yield 1 minute to the gen- are going to have health care. They Speaker, I yield for 1 minute to the tleman from the bluegrass State of don’t now. America, which has health gentleman from Florida (Mr. STEARNS). Kentucky (Mr. WHITFIELD). care of the best character in the world, (Mr. STEARNS asked and was given Mr. WHITFIELD. Yesterday I read an does not make it available to 32 mil- permission to revise and extend his re- article by Speaker PELOSI in which she lion people because they can’t afford it, marks.) said the health care bill they proposed and Americans every day are losing Mr. STEARNS. Madam Speaker, this would strengthen Medicare, reduce their health care. Eighteen thousand incredibly expensive $1 trillion health deficits, and bring the predatory prac- Americans every year die for want of care bill will hurt many individuals tices of health insurance companies health care, and 44,000 Americans also that currently have insurance. The bill under control. go bankrupt because of it. will hurt veterans because it does not How can you strengthen Medicare What does this bill do? It gives Amer- accept TRICARE as a qualified medical when you take $500 billion out of it, out icans the same health care that we plan. It will hurt seniors by cutting of nursing homes, out of hospitals, and here in the Congress have. It preserves Medicare advantage to fund these new out of Medicare advantage? their choice, and it sees that if those government programs. Mr. STUPAK, no How do you claim you reduce the def- Americans want to change, they can do lawyer, will argue that an Executive icit by $138 billion when you include so. order is law. So the Senate bill starts the taxes for 10 years and the expendi- It also fixes the insurance company. us on a path of government-sanctioned tures for only 6 years? And as the President has said, this bill abortion-on-demand paid for by tax- And how do you say you are going to is the patient’s bill of rights on payers. The U.S. has a $1.5 trillion def- control the insurance companies, and steroids. And as my colleagues who icit, and now we are adding $1.2 trillion act like you are throwing them in the worked on this bill when we passed it over 10 years. briar patch, when in fact they support years ago will remember, that that is The President pledged no family this bill? They went to the White legislation which protects the rights of making under $250,000 would face tax House and helped write this bill. Why? citizens and ratepayers. increases, yet there are 12 new tax in- Because this bill requires small busi- And the reason that the insurance creases violating that pledge, and 46 nesses and individuals to buy health in- companies are so up in arms about it, percent of families making less than surance, and, if not, they will be sub- and they are the ones that are opposing $66,000 will be forced to pay the indi- ject to civil penalties. this bill, is because it is going to take vidual mandate. Health reform may be necessary, but care of their patients and because it is The bill will expand the IRS by 17,000 this bill is the wrong bill. going to take care of their customers. auditors to enforce these new taxes. It Mr. WAXMAN. Madam Speaker, I What is it going to do? No more pre- will hurt businesses, create health care yield 1 minute to the gentleman from existing conditions. And, they can’t rationing, and move the United States Massachusetts (Mr. MARKEY), a very cancel your policy while you are on the of America to further fiscal instability. important member of our committee. gurney riding into the operating room Mr. WAXMAN. Madam Speaker, I am Mr. MARKEY of Massachusetts. On because you are sick. pleased to yield at this time to the health care, the Democratic party is I want to commend my colleagues for chairman of the Health Subcommittee, the ‘‘party of hope’’ and the Repub- this. who has played such an instrumental licans are the ‘‘party of nope.’’ Madam Speaker, I have much humility, joy, role in the legislation, the gentleman The Democratic health care bill low- and pride in supporting H.R. 3590 and H.R. from New Jersey (Mr. PALLONE) for 1 ers prescription drug costs for seniors, 4872. minute. expands coverage to 32 million more Madam Speaker, all the arguments, for and Mr. PALLONE. Madam Speaker, I am Americans, reduces the deficit by $143 against, have been made. There have been amazed when I hear my colleagues on billion over the next 10 years, and gives endless hours of debate in committees, on the the other side of the aisle. They seem middle class families tax credits to floor of this House, and in meetings through- to ignore the fact that our health care help pay for health coverage. out the country. system is in crisis. Millions of Ameri- What do the Republicans say to this We have heard innumerable stories that in- cans are going without health insur- plan? They say ‘‘nope.’’ Nope to low- spire us to act, and unfortunately stories that ance. Rising health care costs are ering prescription drug prices, nope to have caused us to question whether the civility bankrupting so many American fami- expanding coverage, nope to health in- of our discourse has reached irreversible lows. lies. surance tax breaks. As the historic vote draws near, I urge my Now, Democrats today have proposed GOP used to stand for Grand Old colleagues to act on behalf of the American a bill that will lower health care costs, Party. Now, it stands for grandstand, people. give almost all Americans quality oppose, and postpone. They grandstand Let us this day stand boldly to do what is health care coverage the same as Mem- with phony claims about nonexistent right for the health and well-being of the our bers of Congress—and I am going to re- government takeovers, they oppose constituents, what is essential for the viability peat that—the same as Members of any real reform, and then they want to of American business, and what is necessary Congress, and put an end to insurance postpone fixing a broken health care for our government. company abuses. system. GOP: Grandstand, oppose, and Let us resolve to do what generations be- When we pass this bill, 32 million postpone. fore us determined needed to done to address more Americans are going to be able to Today we have a choice between one of the greatest needs in the history of our see a doctor on a regular basis. Amer- change and more of the same, between people. ica’s seniors are going to be able to get ‘‘hope’’ and ‘‘nope.’’ Ted Kennedy is When we do this, history will smile upon us. more help to afford their prescription looking down and smiling today. Vote And generations to come will say on this day, drugs, which will keep them healthy ‘‘aye’’ for JOHN DINGELL, for Ted Ken- this President and this Congress performed and out of the hospital. nedy, and for all of those Americans something worthy to be remembered. The bottom line is that Americans that need health care in our country. For the sake of the American people, and in will be healthier, fewer people will get ANNOUNCEMENT BY THE SPEAKER PRO TEMPORE honor of my late father, I support the legisla- seriously ill and incur outrageous med- The SPEAKER pro tempore. The tion before us and urge my colleagues to do ical bills for hospital and nursing home Member from Massachusetts should the same. care. And, healthier people save the heed the gavel.

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00040 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1859 b 1915 More than a century has passed since We left there blessed, inspired and claiming Mr. BARTON of Texas. Madam Teddy Roosevelt first called for health care re- the victory we are about to have today for the Speaker, I yield 1 minute to the gen- form. Nineteen presidents later, we stand on American people. tleman from Arizona (Mr. SHADEGG). the threshold of history as we prepare to vote As our Chair BARBARA LEE reminded us (Mr. SHADEGG asked and was given on this historic legislation. The American peo- from the Book of Esther, we are all here, permission to revise and extend his re- ple have been waiting for this. The American called to service, for ‘‘for such a time as this.’’ marks.) people deserve this, and the status quo is no And we are called to do what is right and best Mr. SHADEGG. Madam Speaker, longer affordable or acceptable. for the American people and for our country! never before in the history of our Na- To those who say we can’t afford health We must pass H.R. 4872. tion has such a massive change in pol- care reform in the current economy, I say we With the passage of H.R. 4872, The Patient icy been made on a purely partisan can’t afford not to. We spend more on health Protection and Affordable Care Act, we begin basis and in the face of such over- care than any other country in the world and to guarantee that health care will be a right to whelming opposition. Tragically, this the costs are crippling to our economy. If we all and not a privilege for a few. bill will destroy freedom and do incred- do nothing, in 2015 health care spending will It has been a long road getting here, not ible damage to the very fabric of our jump by 34 percent. By 2020, health care pre- just this past year but the past hundred years society. miums will double and in 2010 alone, we’re and thanks is due to Chairman Emeritus JOHN This bill is a bailout for the insur- projected to spend more than $2.6 trillion on DINGELL, Speaker NANCY PELOSI, Majority ance companies. They get the indi- health care. Leader STENY HOYER, Majority Whip JAMES vidual mandate that they wanted all A vote for this legislation is to stand on the CLYBURN and Chairmen RANGEL, WAXMAN, along—a mandate that is un-American right side of history. I feel privileged to serve MILLER and LARSON for their steadfast leader- and unconstitutional. Mark my words: in Congress and to participate in this historic ship, and commitment to making healthcare The massive expansion of Medicaid in effort. We stand on the shoulders of those accessible, affordable and secure for all Amer- this bill will bankrupt our States. Pre- who toiled for decades, including Senator Ed- icans across this country. miums for average Americans will go ward Kennedy, to bring us to this moment. And we could not have arrived to this day up, taxes will go up, the deficit will go ANNOUNCEMENT BY THE SPEAKER PRO TEMPORE without the leadership, commitment and deter- up, and the debt will go up. This bill is The SPEAKER pro tempore. Mem- mination of our President, Barack Obama. the epitome of Washington politicians We would have all wished for the perfect bill bers are reminded to please heed the telling the American people, We know many of us envisioned when we started on gavel. better how to run your lives than you this path. This is not it, but without question Mr. BARTON of Texas. Madam do. this bill will vastly improve the dysfunctional Speaker, I yield 1 minute to the gentle- We owe the American people much system we now struggle to be well in, and lay woman from California (Mrs. BONO better than this. We owe them real the foundation for the further work needed to MACK). health care reform. We owe them the achieve those things that are still needed but Mrs. BONO MACK. Madam Speaker, I kind of reforms that will bring down could not be included today. their premiums. We owe them across- rise in very strong opposition to this I want to especially thank all of our Demo- State-line purchases. We owe them flawed bill that imposes new taxes, in- cratic leaders for ensuring that the people of health care pooling so that the sick creases costs to consumers, and adds to the Territories were not left out and my Demo- and the ill and those with preexisting our already massive deficit. This bill cratic colleagues—especially the Congres- conditions can get their health care and the outrageous abuse of process sional Black Caucus and our TriCaucus part- paid for. and all the backroom deals needed to ners for their support and encouragement. We owe America better than this. secure passage is simply the wrong ap- They are all—including Senate Leader Mr. WAXMAN. Madam Speaker, I’m proach. REID—to be thanked and applauded for an- honored at this time to yield 1 minute My father was a teaching physician swering our call for prevention, nondiscrimina- to a senior member of our committee, at USC-LA County Medical Center. He tion, equity and diversity in the bill’s provisions the gentlewoman from California (Ms. would have been appalled that a mas- and for going beyond insurance reforms to in- ESHOO). sive new bureaucracy will now be mak- Ms. ESHOO. Madam Speaker, I feel clude measures specifically to eliminate health ing the health care decisions for his pa- disparities for African Americans, all people of so privileged to be part of a Congress tients. In my district, thousands of that is on the threshold of making his- color, the poor, those living in rural areas and seniors will lose their preferred Medi- the Territories and our LGBT community. tory. Since Teddy Roosevelt and all care Advantage coverage that serves Presidents forward, we have struggled This is not only a historic day for our coun- them so well and has saved lives. try, it is a great day. in our country to provide something This bill is little more than a shell for our people that has eluded them. As Today we begin to end the ‘‘shocking and game that shifts costs, picks winners inhumane’’ injustice in healthcare that the Rev. the Catholic sisters said as they urged and losers, and does nothing to achieve us to vote for this legislation, they Dr. Martin Luther King, Jr. spoke of. Today we real reform. The American people have continue the march to the full greatness that is called it ‘‘life affirming.’’ resoundingly rejected this dangerous I think the step that we take this our Nation’s destiny! approach. True reform should be ac- evening will perfect the union in our I am proud to have been given the oppor- complished with bipartisan coopera- country. Why? Because the human tunity by the people of the Virgin Islands and tion, not strong-arm tactics. The only body holds the soul. And when we help our House leadership to be a part of this proc- thing that is truly bipartisan tonight to cure, when we help to heal, when we ess, and though I am not able to cast a vote is opposition to this deeply flawed bill. recognize the dignity of every single on this landmark legislation I support it fully, We can and must do better. I urge my American, that they have first-class proudly and unreservedly. colleagues to join me in voting ‘‘no.’’ citizenship and that they should indeed When the vote is called, let’s do it! The vic- have health care coverage. Mr. WAXMAN. Madam Speaker, I tory has already been claimed for us and for This is a landmark piece of legisla- yield for a unanimous consent request the people of the United States—all of us. tion. I feel privileged that my constitu- to the gentlelady from the Virgin Is- To God be the glory! ents have sent me here to cast a vote lands (Mrs. CHRISTENSEN), who’s played Mr. WAXMAN. Madam Speaker, I for it, and I urge everyone to do so. a very active role in this legislation. yield 1 minute to the gentleman who’s Madam Speaker, I rise in support of the (Mrs. CHRISTENSEN asked and was played a very influential role in this landmark comprehensive health care reform given permission to revise and extend legislation, the gentleman from Michi- that is before us. her remarks.) gan (Mr. STUPAK). For the first time in history, Congress will Ms. CHRISTENSEN. Madam Speaker, Mr. STUPAK. I wish to engage the pass legislation to finally insure all Americans. I rise in strong support of the Patient chairman in a colloquy, if I may. This legislation will reduce the deficit by $143 Protection and Affordable Care Act. Throughout the debate in the House, billion over 10 years and $1.2 trillion over 20; Madam Speaker, this morning the Congres- Members on both sides of the abortion eliminate discriminatory insurance practices, sional Black Caucus attended church together issue have maintained that current law and open the insurance market to millions of at the Mount Zion Baptist Church in Arlington, should apply. Current law with respect Americans who have been priced out. VA. to abortion services includes the Hyde

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00041 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1860 CONGRESSIONAL RECORD — HOUSE March 21, 2010 amendment. The Hyde amendment and he was running for election, criticized the gentleman from Oklahoma (Mr. other similar statutes to it have been the Bush administration’s excessive SULLIVAN). the law of the land on Federal funding use of Executive orders. Congress’ job Mr. SULLIVAN. I’d like to thank of abortion since 1977 and apply to all is to pass legislation. The President Congressman BARTON for yielding me other health care programs—including can veto it or sign it. Executive orders time. SCHIP, Medicare, Medicaid, Indian are not part of his power. The Presi- Higher premiums, higher taxes, and Health Service, Veterans Health Care, dent also said, I’m not comfortable cutting Medicare is not health care re- military health care programs, and the with doing something this significant form. Republicans care about health Federal Employees Health Benefits through Executive orders, relating to care, but we don’t care for this bill. Un- Program. trying terrorists in military commis- fortunately, the White House and con- The intent behind both this legisla- sions. gressional Democrats are still insisting tion and the Executive order the Presi- Now, finally, it is basic law, as reiter- on their massive 2,700-page bill that in- dent will sign is to ensure that, as is ated by the Supreme Court as late as cludes higher premiums, $500 billion in provided for in the Hyde amendment, 2006 in the case of Hamdan v. Rumsfeld, higher taxes, and $500 billion in cuts to that health care reform will maintain a that an Executive order cannot trump senior Medicare. ban on the use of Federal funds for or change existing law. The Executive My son, who’s here this week, abortion services except in the in- order that is being talked about now is Tommy Sullivan, even can consider stances of rape, incest, and a piece of paper. It will have no force that that’s not reform. endangerment of the life of the mother. and no effect. If one is concerned about Mr. WAXMAN. Madam Speaker, I’m Mr. WAXMAN. If the gentleman will preventing the exchanges that are es- pleased to yield, at this time, 1 minute yield to me, that is correct. I agree tablished under the Senate bill that we to someone who’s been a very active with the gentleman from Michigan will be voting on in a few hours, then member of the Health Subcommittee that the intent behind both the legisla- the only thing that one can do is vote and the vice chairman of the full com- tion and the Executive order is to against that Senate bill to preserve the mittee, the gentlewoman from Colo- maintain a ban on Federal funds being Hyde amendment from being expanded rado (Ms. DEGETTE). used for abortion services, as is pro- to programs that are created under the Ms. DEGETTE. Madam Speaker, vided in the Hyde amendment. Senate bill. when you build a house, you have to The SPEAKER pro tempore. The I’m sorry, but the gentleman from first put down a foundation. Today, we time of the gentleman has expired. Michigan and the gentleman from Cali- are laying a foundation for a health Mr. WAXMAN. I yield the gentleman fornia have misstated the law. It is care system that will provide every 30 additional seconds. pretty clear. And even the President American with access to high quality Mr. STUPAK. I thank the chairman. said it during the campaign, and the health care; a foundation that will im- I’m seeking the chairman’s commit- gentlewoman from Florida (Ms. mediately ban insurance companies ment that our conversations on this WASSERMAN SCHULTZ) said it on TV from dropping people from coverage issue, the abortion issue, will continue. earlier today. when they get sick, people like my Mr. WAXMAN. I know that this is an Mr. WAXMAN. Madam Speaker, I childhood friend who lost his insurance issue of great concern to the gentleman yield 1 minute to an important member when he got prostate cancer and later from Michigan and many other mem- of our committee who’s played a very died too young; a foundation that will, bers of the Energy and Commerce Com- important role in this legislation, par- beginning this year, give tax credits to mittee. You have my commitment to ticularly as it relates to his State and small businesses so they can offer af- work with you and other Members in other areas as well, the gentleman fordable coverage to their employees; a the future. from New York (Mr. ENGEL). foundation that will now give parents PARLIAMENTARY INQUIRY Mr. ENGEL. I thank the chairman of young adults the ability to keep Mr. BARTON of Texas. Madam for yielding to me. their kids on their policies while they Speaker, I have a parliamentary in- Madam Speaker, I’m proud to be a start their careers; a foundation that quiry. Member of Congress, but never as will finally give adults with pre- The SPEAKER pro tempore. The gen- proud as I am tonight. Tonight we’re existing conditions the ability to buy tleman will state his inquiry. finally going to pass comprehensive affordable insurance. And starting Mr. BARTON of Texas. It has been health care for the American people. right away, insurance companies can- agreed to, I am told, by the Parliamen- My friends on the Republican side of not exclude children, like my own tarian and others, that if I yield to Mr. the aisle keep saying the bill is flawed. young daughter, Francesca, who have SENSENBRENNER 2 minutes right now, it The only flaw was when they con- chronic conditions such as diabetes or will come out of Leader BOEHNER’s trolled Congress and had the President asthma, from coverage. time. of the United States, not once did they Madam Speaker, this bill is just a The SPEAKER pro tempore. The try pass health care, not even incre- foundation. We need to build on it, but Chair has been so advised of the minor- mentally, as they say we should do it’s a strong foundation. ity leader’s designation of that time. now. Mr. BARTON of Texas. I’d like to Mr. BARTON of Texas. I yield 2 min- No longer, when we get sick, will the yield 1 minute to one of our best pro- utes to the gentleman from Wisconsin insurance companies say, Sorry, we life leaders in the House of Representa- (Mr. SENSENBRENNER). can’t cover you. No longer, if you lose tives, the gentleman from Pennsyl- Mr. SENSENBRENNER. I have lis- your job or change your job, can you vania (Mr. PITTS). tened to this colloquy and, frankly, it not keep your health insurance. You Mr. PITTS. This bill violates the con- doesn’t state the law. The proposed Ex- will be able to keep it. If have you a science of the American people. It vio- ecutive order, which I have a copy of, preexisting condition, you won’t be lates the principle that we should not specifically states that nobody can able to be denied it. If you’re 26 years spend more than we have. This bill is force the Executive order in any court. old, you can stay on your parents’ poli- not reform. It just makes our existing So the Executive order is merely a cies. There’s no annual cap or lifetime entitlement crisis even worse. This bill piece of paper that certainly will not cap. We help seniors by closing the violates the belief held by more than 70 have any effect of law. doughnut hole in Medicaid. We save percent of Americans that money col- Earlier today, the gentlewoman from money. It’s CBO scored. lected by the government should not be Florida (Ms. WASSERMAN SCHULTZ) was Everybody wins with this bill, but es- used to pay for abortion or abortion quoted on Fox News saying, Well, it pecially the American people. I’m coverage, but that’s what this bill does. can’t be changed by Executive order proud that we’re passing comprehen- Regardless of the colloquy, an Execu- because an Executive order can’t sive health care. The current system is tive order is not a statute. It doesn’t change the law. She was right on in not sustainable financially, and what trump a statute. The government will that respect. An Executive order can’t we’re doing means that everybody end up directly paying for abortions at change the law. wins. community health centers. Taxpayer But even on a policy question, Presi- Mr. BARTON of Texas. Madam subsidies will, for the first time in dec- dent Obama, at a campaign rally when Speaker, I would yield 30 seconds to ades, subsidize insurance coverage that

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00042 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1861 includes abortion. The bill and the ac- cuts in service to seniors. It does raise where to be found in either H.R. 3590 or H.R. companying Executive order turns over taxes on many small businesses, in- 4872. the protection of the unborn to the cluding new mandates on businesses Another ‘‘new math’’ trick being used by the most pro-abortion President in our his- and actually increases premiums as Democrats is to tell the American people that tory. much as 13 percent. the Medicare Part D drug benefit ‘‘donut hole’’ This extreme legislation is being In committee, I introduced an will be closed. Yes, the ‘‘donut hole’’ is par- forced on an unwilling Nation. It is the amendment that gives people access to tially closed by this legislation, but not closed most pro-abortion bill and the largest exactly the same care that we have as entirely until the year 2020 which is after the expansion of abortion in our history. Members of Congress, but Mr. MARKEY scoring period used by the CBO. Again, this No Member who votes for it will ever and almost all the Democrats voted ‘‘new math’’ is being used as a gimmick to be able to claim again that they have against it. All Republicans voted for make it appear that this bill will reduce the always stood on the side of the unborn. that. Last, the clear language of this deficit. But it will not. This bill costs more than I’m sad to say this. This is a career-de- bill allows abortion, and I encourage Democrats claim. fining vote. There will be no living it all Members to vote against it. Last year, one of my Democratic colleagues down. Madam Speaker, I rise today in opposition stated, ‘‘The fact of the matter is that some in I urge my colleagues to vote ‘‘no’’ on to this unprecedented legislation that will affect the Republican party don’t want these prob- this terrible bill. one-sixth of our economy, saddle our children lems fixed because they’re already doing just and grandchildren with trillions of dollars of fine. They’ve got choice, they’ve got the fed- b 1930 debt, and lead to a government takeover of eral plan, that’s what I have. Well in the Mr. WAXMAN. I yield 1 minute to America’s health care system. Democratic party we’re saying something else, my colleague from California (Mrs. As a member of one of the House Commit- we want the American people to get at least CAPPS), who is a very active and influ- tees with jurisdiction over health care, I have as good as my friends in the Republican party ential member of the Health Sub- had a front row seat to watch a legislative have. We want at least the benefits that we committee. process that has had one over-riding theme— have here in Congress—choice, affordability, Mrs. CAPPS. I thank the chairman. no reform idea, bill, or amendment on health lower cost and lower taxes for all Americans.’’ Madam Speaker, we’ve been trying to offered by a Republican or even a moderate I wholeheartedly agree with Congressman reform health care in this country for Democrat was given any consideration. From WEINER that Americans should have access to decades, and I’ve been blessed to par- the start this has been a process that is best the same plans as their Members. Last year I ticipate both as a health care provider described as, ‘‘our way or the highway.’’ offered two amendments to Speaker PELOSI’s and now as a Member of Congress. This bill will result in rising health care costs bill. The first was my alternative plan called Passing this bill is not only the right and premiums. The Congressional Budget Of- Simple Universal Healthcare, SUH, which cre- thing to do; it is truly a matter of life fice, CBO, reported in December that if the ates a new health insurance program similar and death for the millions of Ameri- Senate bill was passed, average premiums to the Federal Employee Health Benefits Plan cans who today lack health insurance per policy would rise by 10 to 13 percent in now available to the President, Vice President, coverage, and it is critical for all who 2016, resulting in annual premiums of $5,500 Members of Congress and all federal govern- suffer from diseases that could have for single policies and $13,100 for families. ment employees. The plan allows the unin- been completely preventible or dealt According to the Congressional Budget Of- sured and small businesses access to more with earlier had they had access to fice, CBO, the health care bill carries a price affordable insurance with options, portability screenings. tag of $940 billion over 10 years. Most rev- and no mandates. The other amendment I of- One thing, our bill will now guar- enue raisers come from new taxes on small fered would require that the President, Vice antee no more copays for preventive business, individuals, and medical goods. Fur- President, and Members of Congress enroll in screenings for diseases like cervical thermore, the health care bill includes signifi- PELOSI’s public plan. Both amendments were cancer or heart disease. As a public cant payment changes for Medicare Advan- prevented from a floor vote by Speaker health nurse with decades of experi- tage and $500 billion in cuts to both Medicare PELOSI’s rules. ence, I know this is one of the most im- and Medicaid. A number of arbitrary cuts are Yesterday, I attempted to offer the Simple portant steps we can take to improve made to skilled nursing facilities, hospice, Universal Healthcare plan as an amendment the health of American families, and I home health, Medicaid DSH payments, and in the Rules Committee, however Speaker stress this point because it’s one that’s popular Medicare Advantage plans. Specifi- PELOSI ordered the nine Democrats on the not brought up all that often. cally, the bill reduces Medicare Advantage Committee to kill all Republican amendments I underscore the importance of uni- payment benchmarks over the next 7 years, and therefore my bill did not survive. versal access to preventive care be- resulting in reduced access for millions of Madam Speaker, there are some in this cause this measure will improve the beneficiaries currently on Medicare Advantage chamber who may consider this a momentous lives of millions of families and save us plans. The ‘‘savings’’ Democrats purport are day. And that it will be if the House of Rep- all billions in avoidable health care truly cuts to services that our seniors need. I resentatives votes to spend trillions of dollars costs. I know my constituents are don’t think we can afford this plan and it will, and forwards the bill to future generations. going to appreciate these important in time, hurt both our economy and bene- While we ramp up spending, we have not provisions which will improve health ficiaries. dealt with the exploding costs of Social Secu- care in the United States. It’s one of The scoring used by CBO and our Demo- rity, Medicare or Medicaid. We are on a path the many reasons I urge my colleagues crat colleagues can best be described as of fiscal recklessness that threatens the future to vote ‘‘yes’’ on this bill. ‘‘new math.’’ For example, a 10-year fix for economic growth of America. So for me, this Mr. BARTON of Texas. Can I inquire Medicare reimbursement to physicians will is a sad day, one that could have been avoid- as to the time remaining on each side cost $208 billion, yet that is not counted in the ed had the House worked together on a bipar- for the Energy and Commerce Commit- CBO score. But a separate deal has been tisan basis to provide the American people tee’s control. struck with the doctors to do that later this greater access to health care that we can af- The SPEAKER pro tempore. The gen- year. So by my math, the real cost of health ford. tleman from Texas controls 21⁄2 min- care reform is closer to $1.3 trillion, not $940 I urge my colleagues to vote ‘‘no.’’ utes, and the gentleman from Cali- billion. Mr. WAXMAN. Madam Speaker, I am fornia controls 3 minutes. A recent New York Times article highlighted pleased to yield 1 minute to the gen- Mr. BARTON of Texas. I yield 45 sec- a growing trend of physicians dropping Med- tleman from Pennsylvania (Mr. onds to the gentleman from Nebraska, icaid patients because of low payments—and DOYLE), who has played a very signifi- the Cornhusker State, Mr. TERRY. the Democrats’ solution to our health care cri- cant role in bringing us all together Mr. TERRY. We all want all people sis is to expand Medicaid eligibility to an addi- and I think has a great deal of respon- to have access to affordable health tional 16 million more individuals over the next sibility for getting this bill to the care, but this trillion-dollar tragedy is 10 years? In a letter to Congress following the point where it is today. just bad medicine. Medical costs are Health Care Summit, President Obama ac- Mr. DOYLE. Madam Speaker, my of- high, but this bill does absolutely noth- knowledged the need to increase Medicaid re- fice got a call today from Mary Anne ing to help reduce costs. It does take imbursement to ensure future services and Ferguson, 91 years old from Point $500 billion from Medicare, resulting in yet, those anticipated additional costs are no- Breeze in Pittsburgh. She asked me to

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00043 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1862 CONGRESSIONAL RECORD — HOUSE March 21, 2010 vote for health reform because she deception? The lying, the stealing, the ANNOUNCEMENT BY THE SPEAKER PRO TEMPORE wants everyone to get the coverage she cheating? I have never seen such be- The SPEAKER pro tempore. The has. She remembers before Medicare havior in my entire time in politics. ‘‘If Chair will remind all persons in the when half of our seniors worried about you like your health care, you can gallery that they are here as guests of getting sick because they had no keep it.’’ Not true, if you read the bill. the House and that any manifestation health insurance. Ten years of taxes, 6 years of services, of approval or disapproval of pro- Today, millions of working Ameri- if you read the bill. They steal money ceedings or other audible conversation cans fear getting sick because they from the Social Security trust fund is in violation of the rules of the don’t have health coverage. One of and cut $500 billion from Medicare. House. those was Bill Koehler from Garfield in And not only that, Madam Speaker, Mr. WAXMAN. Madam Speaker, for Pittsburgh. His sister Kitty says that but this pits one American against an- the purpose of a unanimous consent re- Bill was a loving and generous man to other in the cost of health care for the quest, I yield to the gentleman from his friends, family, and those in need. first time in our history. If you’re a the State of Washington (Mr. INSLEE), When he lost his job, he lost his cov- Florida senior citizen, you get to keep a member of our committee. erage. His new job as a pizza delivery your Medicare Advantage. If you’re (Mr. INSLEE asked and was given driver earned too much to qualify for from the other 49 States, you do not. permission to revise and extend his re- Medicaid, and private insurance wasn’t And there is dirty deal after dirty deal marks.) going to cover his preexisting heart after dirty deal in the bill that this Mr. INSLEE. Madam Speaker, I rise condition—the very reason why he House will vote on. It is a disgrace. It’s in strong support for this American needed health insurance. He died last wrong. America deserves better. health care bill. year from a heart attack while driving Mr. WAXMAN. Madam Speaker, I The SPEAKER pro tempore. The gen- home. yield 1 minute to the gentlewoman tleman will be charged. So when I’m called to vote tonight, I from Illinois, JAN SCHAKOWSKY, a mem- Mr. WAXMAN. Madam Speaker, for will stand on the side of Mary Anne ber of our committee and the Health the purpose of a unanimous consent re- Ferguson and Bill Koehler and the tens Subcommittee. quest, I yield to the gentleman from of millions of Americans who need us Ms. SCHAKOWSKY. Tonight I want Texas (Mr. EDWARDS). to pass this bill. ‘‘Yes’’ to health re- to express my profound thanks to the (Mr. EDWARDS of Texas asked and form. ‘‘Yes’’ to Bill Koehler. people of Illinois’ Ninth Congressional was given permission to revise and ex- Mr. BARTON of Texas. I would like District, the place where I was born tend his remarks.) Mr. EDWARDS of Texas. Madam to yield for a unanimous consent re- and lived nearly all my life, for the OGERS Speaker, I rise in opposition to this quest to Mr. R of Kentucky. privilege of being here tonight to cast (Mr. ROGERS of Kentucky asked and bill. my vote for this historic health care was given permission to revise and ex- measure. My life’s work has been to an- Madam Speaker, Americans need and de- tend his remarks.) serve health care reform. Without it, the qual- Mr. ROGERS of Kentucky. Madam swer what is at bottom a moral ques- tion: Will the United States of America ity of our health care system will go down and Speaker, I rise in opposition to this costs will continue to go up. The present trend flawed health bill. continue to allow our people to lose their lives, their homes and their fun- of fast rising health care costs and increasing Mr. BARTON of Texas. Madam numbers of uninsured is unsustainable. If left Speaker, I would like to yield for a damental sense of security, or finally decide that a proud and wealthy coun- unchecked, these problems will bankrupt more unanimous consent request to the gen- businesses, hard-working families, hospitals, tlewoman from Tennessee (Mrs. try like ours has an ethical obligation to provide access to health care for ev- and, ultimately, state and federal budgets. BLACKBURN), a member of the com- This is why I had wanted to vote for health erybody? Is it even credible to think mittee. care reform, and this bill has a number of that a country as rich as ours in so (Mrs. BLACKBURN asked and was positive provisions in it that I support, such as many ways can’t afford to do this? given permission to revise and extend providing tax cuts for small employers offering I am so proud that today this House, her remarks.) health insurance, creating a private health in- under the leadership of perhaps the Mrs. BLACKBURN. Madam Speaker, surance exchange, helping seniors with their most effective Speaker in U.S. history, I rise in opposition to this flawed bill. prescription drug costs and preventing dis- Mr. BARTON of Texas. Madam NANCY PELOSI, will say to all those par- crimination against people with pre-existing Speaker, I would like to yield for a ents agonizing over a sick child who is conditions. unanimous consent request to the gen- now excluded from insurance coverage However, I cannot vote for this bill, because tleman from the Peach State of Geor- because of a preexisting condition, at a time of unprecedented federal deficits, we gia, Dr. GINGREY. Sleep well. Our courageous and vision- simply cannot afford all of its new spending. I (Mr. GINGREY of Georgia asked and ary President Barack Obama, when he believe it would have been better to have was given permission to revise and ex- signs this law, that problem will end. passed a less expensive bill and less expan- tend his remarks.) This is a great day for America. Mr. GINGREY of Georgia. Madam sive bill, one that could have united, not di- The SPEAKER pro tempore. The vided, our Nation. In the long run, for health Speaker, I rise in the strongest opposi- time of the gentlewoman has expired. tion to this flawed health care bill. care reform to work, it must have the support The gentlewoman from Illinois is re- and confidence of the American people. The SPEAKER pro tempore. The gen- minded to please heed the gavel. tleman will be charged. I realize it is easier to criticize than to write Mr. BARTON of Texas. How much Mr. BARTON of Texas. Madam comprehensive health care reform legislation. time do I have remaining, please, Speaker, I would like to yield for a I also realize that some of the criticisms Madam Speaker? unanimous consent request to the gen- lobbed at this bill are without merit, such as tleman from the Pelican State, Mr. The SPEAKER pro tempore. The gen- the false suggestion that it contains death tleman has 55 seconds remaining. SCALISE, another member of the com- panels. Nevertheless, I believe we could have mittee. Mr. BARTON of Texas. I am going to passed a less complicated, more affordable (Mr. SCALISE asked and was given yield to the gentleman from Texas, Dr. bill this year that would have garnered wide- permission to revise and extend his re- BURGESS, 15 of those precious 55 sec- spread support across our country. marks.) onds. Over the past year I have listened to thou- Mr. SCALISE. Madam Speaker, I rise Mr. BURGESS. I thank the gen- sands of constituents from all walks of life against this health care bill. tleman for yielding. You know, it’s across our district on the issue of health care Mr. BARTON of Texas. And, finally, really a shame we have this health care reform. What I have heard is that people gen- Madam Speaker, I yield 45 seconds to bill in front of us. We have provisions erally like the quality of their present health another member of the committee, the now for 17,000 new IRS agents but not care and don’t want big government or big in- distinguished Mr. MIKE ROGERS from one dollar for a new nurse or a new surance companies to stand between them the great State of Michigan. doctor. You know what, you’ll have ac- and their doctors. They also believe we must Mr. ROGERS of Michigan. Madam cess, all right, but you may be getting do something to make health care more af- Speaker, if this bill is so great, why the your prenatal care from Turbo Tax. fordable for families and businesses. I agree.

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00044 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1863 Above all else, what I heard from my con- rise today because of the 539,000 con- work. He was laid off, uninsured, and stituents is that they have to tighten their belts stituents who will see their coverage when he started to get sick again, he in this difficult economy, and they want the improve because of the work we’ve had to turn to emergency rooms for federal government to do a far better job of liv- done. care. ing within its means. There is great wisdom in Madam Speaker, I rise with pride and The SPEAKER pro tempore. The that observation, and I believe we have a hope in the promise of this health care time of the gentleman from Michigan moral obligation to not drown our children and reform bill. There is no doubt that has expired. our economic future in a sea of national debt. powerful interests have strenuously op- Mr. LEVIN. I yield myself 15 addi- Unlike the Medicare prescription drug bill posed reform, and they’ve often re- tional seconds. that was passed in 2003 without being paid sorted to tactics that could make no b 1945 for, I support the principle that health care re- one proud. But nothing can sully the form should be paid for. I hope the Congres- pride I feel today in taking this critical Mr. LEVIN. I yield myself 15 addi- sional Budget Office is right when it says this step to provide health coverage for all tional seconds. bill will reduce the deficit, but, frankly, I am Americans. I’ve worked my entire ca- Republicans have turned their back skeptical that anyone can predict with absolute reer to achieve health care for all. on the problems. Some of them have certainty the cost of such a complex, far- Today we stand on the floor of the peo- taken to saying health care reform reaching bill over a period of 10 to 20 years. ple’s House ready to pass the bill. makes us a different Nation; quite the That is why I had urged that this bill include The SPEAKER pro tempore. The gen- opposite. Today, in the tradition of a fiscally responsible trigger mechanism in it tleman from Texas has 40 seconds re- America, we will pass health care re- that would cut spending if actual costs exceed maining. form, and it will make our beloved projections, if cost savings are not fully real- Mr. BARTON of Texas. I yield myself America a still better Nation. ized or if projected new revenues are overesti- the balance of my time. The SPEAKER pro tempore. The gen- mated. The President mentioned such a trig- (Mr. BARTON of Texas asked and tleman from Michigan (Mr. CAMP) is ger in his address to Congress last year, and was given permission to revise and ex- recognized for 10 minutes as a designee a trigger was included in some parts of the tend his remarks.) of the minority leader. bill. However, I am disappointed that my com- Mr. BARTON of Texas. Madam Mr. CAMP. Madam Speaker, I yield mon sense proposal for a trigger covering all Speaker, this bill will not last. It is myself 1 minute. of the bill’s costs and revenues was not in- based on a fatal assumption that one The American people have spoken. cluded. Today, most Americans simply do not party acting unilaterally can dictate They do not want the tentacles of the believe this bill will reduce the deficit and the entire will of the American people Federal Government reaching into health care costs. I hope they are wrong, but on one-sixth of the economy. That will their lives and controlling their per- I fear that they are right. not happen. It reignites the abortion sonal health care decisions. Yet that is A less expensive bill, with a fiscally respon- debate. It is fatally flawed in its as- exactly what will happen under the sible trigger in it, would have also reduced the sumptions in terms of balancing the Democrats’ health care bill. Federal need for the additional taxes and Medicare re- budget and deficit reduction, and it bureaucrats will be making your ductions included in this bill. Once the new will take away coverage from millions health care choices for you and your revenues and Medicare savings have been of people if it gets as far as 2014 and family, and the IRS will be enforcing used to pay for the new spending in this bill, you kick in the option that puts all them. it will be that much harder to find ways to re- these mandates on employers. The American people know that you duce the massive federal deficits our Nation is Please vote ‘‘no.’’ Let’s go back, can’t reduce health care costs by facing for the foreseeable future. start over. Let’s start from scratch and spending a trillion dollars or raising If left unchecked I believe huge federal defi- do a bill that everybody can support. taxes by more than half a trillion dol- cits will harm our economic growth and our Vote ‘‘no’’ on this bill. lars. The American people know that children’s future. Increasing interest payments The SPEAKER pro tempore. The gen- you cannot cut Medicare by over half a on our $12.7 trillion national debt will lead to tleman from Michigan (Mr. LEVIN) is trillion dollars without hurting sen- higher taxes and crowd out vital education, recognized for 15 minutes as a designee iors. And the American people know health care, infrastructure, national defense of the majority leader. that you can’t create an entirely new and job training programs that are so impor- Mr. LEVIN. Madam Speaker, I yield government entitlement program with- tant for hard-working families and our country. myself 1 minute. out exploding the deficit. They are Reining in massive federal deficits will re- (Mr. LEVIN asked and was given per- right, and the nonpartisan Congres- quire tough choices, the same kind of choices mission to revise and extend his re- sional Budget Office has confirmed it. families and businesses have to make every marks.) Simply put, the Democrats’ bill will day. Given this year’s deficit will be approxi- Mr. LEVIN. We come to the floor for not only ruin our health care system, mately 1.3 trillion dollars, I simply believe we thousands of votes each year, but no but the tax increases will ruin our cannot afford all of the new spending in this single vote comes with so many per- economy and kill jobs. bill. sonal stories within our families and I urge my colleagues to listen to the If this bill becomes law, my hope is that my own. In our districts, people have American people and kill the bill. Congress will protect its positive provisions but spoken out about the need for real re- I reserve the balance of my time. reduce its scope and costs to get our country form. Mr. LEVIN. Madam Speaker, it is back on track toward a balanced budget that The millions and millions that have now my real privilege to yield 1 minute can ensure economic opportunity for future health insurance now worry about los- to the distinguished gentleman from generations of Americans. ing it. The average premium for em- New York (Mr. RANGEL) who has given The SPEAKER pro tempore. The gen- ployer-based insurance has more than decades and decades of service to this tleman has 55 seconds remaining. doubled in the last 10 years. And I Congress, to New York, and to the peo- Mr. WAXMAN. Madam Speaker, I heard from a woman that had worked ple of America. yield the balance of my time to the for a large company, started her own (Mr. RANGEL asked and was given gentlewoman from Wisconsin (Ms. franchise, and she writes, ‘‘I exhausted permission to revise and extend his re- BALDWIN). my COBRA, then joined a group health marks.) Ms. BALDWIN. Madam Speaker, plan. Several years ago, I had open Mr. RANGEL. Thank you, Mr. Chair- what this all boils down to is, Whose heart surgery. The group disbanded. No man. side are you on? Madam Speaker, I rise insurance company would touch me Madam Speaker, my colleagues, one today on behalf of the 13,500 people in with a 10-foot pole. I am uninsured and of the lowest points in my political ca- my district who will finally have ac- was just diagnosed with my second epi- reer was when I asked for a leave of ab- cess to health insurance because of this sode of breast cancer, with no insur- sence from the chairmanship of the measure. I rise for the 1,000 families in ance.’’ Ways and Means Committee. I had south central Wisconsin who will be I heard from a young man diagnosed thought at that time with my feeling protected from medical bankruptcy with leukemia at the age of 17. His dis- about how important it would be for this year because of this effort. And I ease went into remission. He started to the entire Nation to have access to

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00045 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1864 CONGRESSIONAL RECORD — HOUSE March 21, 2010 quality health care that I did not want Mr. SAM JOHNSON of Texas. Madam Folks, this isn’t the future, this is to do anything or be anywhere to dis- Speaker, today’s vote defines what Massachusetts today. Higher costs, tract from our leadership, NANCY kind of America we want to live in. I slower care, and rationing. That is why PELOSI, our leader STENY HOYER or JIM for one know exactly what that is; it is Massachusetts said ‘‘no’’ to Obama CLYBURN, but most important, the the America I fought and sacrificed for, care. America is saying ‘‘no’’ too be- great Members who worked so hard and all the freedoms we hold dear. cause bigger government doesn’t mean with me and our dedicated staff to get Freedom from a $2.6 trillion Wash- better health care. out the first bill on this very impor- ington takeover of health care; free- Mr. LEVIN. Mr. Speaker, I yield to tant subject. dom from skyrocketing taxes; freedom the gentleman from New York for a When people ask how do you feel and from bureaucrats coming between you unanimous consent request. how are you today, I can report that and your doctor; freedom from Medi- (Mr. MAFFEI asked and was given this has been one of the most historic care cuts to seniors; freedom from ex- permission to revise and extend his re- moments of my life, to be privileged to ploding debt; freedom from the govern- marks.) serve in this great body and to be a ment forcing you to buy health insur- Mr. MAFFEI. Mr. Speaker, I submit part of this legislation that I know ance. the remarks for the RECORD that I de- that, no matter how long anybody has I ask my colleagues, what kind of livered at the American Cancer Society been in this great legislative body, peo- legacy do you want to leave for your in East Syracuse on Tuesday of this ple will ask, Which side have you been children and grandchildren? Will you week in support of this historic health on? And thank God I am on the right cave to the demands of Speaker care reform bill. side. PELOSI, or will you listen to the pleas I have heard from thousands of constituents Mr. CAMP. Madam Speaker, I yield of the hardworking American people about the current health care reform debate. 45 seconds to the gentleman from Cali- who elected you. Join me in this fight I’ve tried to listen to everything they’ve had to fornia (Mr. HERGER), a distinguished for freedom, vote ‘‘no.’’ say—for and against health care reform. Their member of the Ways and Means Com- Mr. LEVIN. Madam Speaker, it is advice and their pleas and their stories and mittee. now my privilege to yield 1 minute to their criticisms have helped guide my advo- Mr. HERGER. Madam Speaker, the the very distinguished gentleman from cacy on behalf of changes and improvements American people have spoken again Massachusetts (Mr. NEAL). to proposals before Congress and my decision and again. They do not want to spend Mr. NEAL of Massachusetts. Madam on the compromise legislation before Con- Speaker, this is a most significant day. nearly $1 trillion on a new government gress. health care program paid for by raising Health insurance reform has been com- Now that the President’s changes will be in- taxes, and raiding the Medicare trust ing for a long time, and we are finally corporated into the final legislation, I will sup- fund. They don’t want to force every- here. With passage of this bill, Amer- port this historic health care reform effort. one to buy government-approved ican families are going to take back I am voting in favor of this legislation not be- health insurance or subsidize health control of their health care. cause I think it is perfect, but because I This bill bars insurance companies plans that cover abortion. And they strongly believe it is in the best interests of my from discriminating based on pre- don’t want a 2,400-page bill riddled with constituents—that it will make a positive dif- existing conditions. It caps out-of- backroom deals. ference in the lives of families, businesses, Madam Speaker, Americans are pocket expenses. Half the bankruptcies and hospitals in central and western New watching and know what is at stake. in America are due to health-related York. Let’s reject this destructive legisla- matters. This bill allows individuals First, I’m voting for this because we need to tion. and small businesses to purchase af- do something to control rising health care Mr. LEVIN. Madam Speaker, in fordable insurance from competitive costs that keep taking a bigger and bigger bite terms of seniority and in recognition of marketplaces. It contains cost controls all of his years of service, I would like that will save the taxpayer $138 billion out of the household budgets of upstate New to note that the gentleman from Cali- over the next 10 years. And for parents York. Skyrocketing health care costs aren’t just crippling the U.S. economy—they’re fornia (Mr. STARK) is going to be sub- that are watching tonight, your de- emptying our pocketbooks. My entire life is mitting a statement to the RECORD. pendents can stay on your insurance And I am now pleased, it is a special until they are 26 years old. filled with stories about how people—regular privilege, to yield 1 minute to the very Nobody has defended Social Security middle-class people—can’t afford the health distinguished gentleman from Georgia, and Medicare the way I have in this in- care they need. How insurance companies Mr. JOHN LEWIS. stitution. And I must tell you tonight, have denied needed care. How kids grad- Mr. LEWIS of Georgia. Madam I can’t believe anybody who is wit- uating from college can’t find affordable cov- Speaker, this may be the most impor- nessing this debate would believe for 1 erage. How people with life threatening condi- tant vote that we cast as members of minute that our Republican friends tions need to hold bake sales and bowl-a- this body. We have a moral obligation have been better in history on Medi- thons to pay health bills. Families go bankrupt today, tonight to make health care a care than we have been. It is in our not because they were irresponsible but be- right and not a privilege. DNA. This is a defining moment. The cause they trusted their insurance plans. More There are those who have told us to exclusionary and discriminatory tac- than 72 million adults currently have medical start over. There are those who have tics that exist in our current system debt or problems paying their bills even told us to wait. They have told us to be tonight become history as well. though most of them have insurance. It has to patient. We cannot wait. We cannot be Mr. CAMP. Mr. Speaker, I yield 45 end—and I honestly believe if we don’t take patient. The American people need seconds to the gentleman from Texas action now it never will. health care, and they need it now. On (Mr. BRADY), a distinguished member Second, I’m voting for this because if we this day at this hour, stand with the of the Ways and Means Committee. don’t fix health care, businesses that are American people and not with the big Mr. BRADY of Texas. The govern- struggling to compete in a global economy will insurance companies. On this day at ment promised you health care. When fall further and further behind. this moment in this Chamber, answer forced to buy the government-approved As premiums nearly double, employees in the call of history, answer the spirit of plan or face the tax man, you complied. small firms will see offers of health insurance history and pass health care. Give the But the cost didn’t go down, it went up; options almost cut in half. It is predicted the American people a victory. Give health it’s the highest ever. It takes now 3 41 percent of firms offering insurance in 2010 care a chance. months to see a doctor. And when you will drop to 23 percent in 2020. Not because Mr. CAMP. Madam Speaker, I yield need care, the government plan denies they are bad employers but because they can- 45 seconds to a true American hero, the it four times more often than your in- not afford it. distinguished member of the Ways and surance company. Now the government Every industrialized nation has figured out a Means Committee, the gentleman from is short on money. They started ration- way to get people affordable coverage—the Texas (Mr. SAM JOHNSON). ing care, cutting hospital payments, United States can, too. (Mr. SAM JOHNSON of Texas asked withdrawing coverage from some fami- And finally, I’m voting for this bill because and was given permission to revise and lies, and it has just been 3 years since the county, state, and country are going broke extend his remarks.) it all began. due to health care costs. Sure, we could limp

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00046 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1865 along another few years but if we do, it will three dollars in the U.S. economy—twice as saves money and the further out you go, the only be harder to control those long-term much as it does today. The President’s plan more it saves. But it also saves something costs. gets these costs under control by imple- more precious—it will save lives. I know many people in my district will be en- menting nearly every idea suggested including Mr. LEVIN. Mr. Speaker, it is now couraged that we are finally moving forward, Republican ideas on medical malpractice and my real privilege to yield 1 minute to that we are finally taking action on an issue increasing ability to buy insurance across state the distinguished gentleman from that affects us all. lines. It also over time implements real cuts in Texas (Mr. DOGGETT). I know others will be unhappy. Many of my government spending on health care including Mr. DOGGETT. So very fearful of constituents have strong concerns about this eliminating some of the waste and subsidies. being held accountable, the giant in- legislation. In fact, I share some of those very I believe that many of these cost savers will surance monopolies have spent mil- same concerns. I worked very hard to improve work. I know that doing nothing will bankrupt lions spewing out anger and spreading this bill. I led the fight to hold down the tax on our country and our families and our small fear of reform. We have not seen such medical devices. I advocated for businesses businesses. outlandish, outrageous arguments with less than 25 employees to get subsidies I know the Republicans in Washington have raised since the same forces failed to for health insurance and for a reduced burden said that they want to make health care the block President Lyndon Johnson from on other businesses. I fought successfully to central issue in the elections this coming No- securing approval of Medicare. raise the threshold on any benefit surcharge vember. Thousands and thousands of dollars For Republicans, our bill is too long so that it won’t affect middle-class people in have already been spent on ads running or it is too short. It is too thick or it my district. against me here in central New York. Some of is too thin. It is never just right be- This is not a perfect bill. But it is an impor- these ads have been proven to be false. cause their true answer to health in- tant legislation that we need to pass to move Far from convincing me to oppose the surance reform is ‘‘never, never, this country forward. health care reform, they have strengthened never.’’ Our determined efforts should There are several criticisms of the proposal my resolve. Because when people who have not be derided as a four-letter word, that do come up certainly across the country that much money feel so strongly that they run but you can certainly sum up our and even here in my district that I feel com- attack ads on you, chances are that what many, many pages with four words: pelled to address. you’re doing is in the best interest of tax- you’ve got health care. First, many argue that this is a government payers and ordinary families. With this reform, every insured take-over of health care. That is simply not So what’s in this proposal? American gets valuable consumer pro- true. In fact, except for Medicare, Medicaid, People who have been denied coverage be- tections, and every uninsured Amer- the VA and other already existing programs, cause of a pre-existing condition will finally ican can become insured. Thirty-two Americans would be covered by private insur- have access to affordable coverage. Insurers million Americans will be protected ance plans. A public option which I support is will no longer be able to drop your coverage from the risk of bankruptcy from not even included in this plan. There are some when you get sick and are in the middle of health care. additional regulations that give more rights to treatment. The bill restrains soaring insurance patients such as not allowing health plans to Never again will you lose access to insur- premiums and reduces Federal deficits. deny coverage due to preexisting conditions. ance if you get laid off or switch jobs. The SPEAKER pro tempore. The But these are widely supported and necessary Small businesses and employers getting time of the gentleman has expired. changes. To assert that these new patient crushed by soaring health care costs will see Mr. DOGGETT. My time has expired, rights are some sort of government take-over lower costs. but many Americans will not, as a re- is absurd. Never again will you be subject to annual or sult of this bill. Second, some will say that large majorities lifetime limits on what insurance companies ANNOUNCEMENT BY THE SPEAKER PRO TEMPORE of the American public are against the Presi- will pay, protecting millions of Americans from The SPEAKER pro tempore (Mr. dent’s plan. The Post-Standard printed an AP the threat of medical bankruptcy. SERRANO). The Chair will remind all poll this last weekend that did show slightly Insurers will be required to offer free pre- Members to heed the gavel. more respondents nationwide opposed rather ventive care, lowering your out-of-pocket ex- Mr. CAMP. Mr. Speaker, I yield 45 than supported the health care reform plans— penses and helping ensure that diseases or seconds to the distinguished gentleman by two percentage points—43 to 41. But for conditions can be caught early on. from Georgia, Dr. LINDER. many it’s not that the plan went too far but Seniors who fall into the Medicare Part D Mr. LINDER. Mr. Speaker, I feel rude that it did not change enough. In fact, fully donut hole will see lower prescription drug trying to inject some fact into this ka- 82% of the respondents to that same poll costs as immediate steps are taken to close buki theater, but I am going to try: 85 wanted to change the health system a mod- the donut hole. Employers who cover their percent of America is insured; 95 per- erate amount or more. Only 17 percent said it early retirees will receive temporary funds to cent of those people are happy with should be changed a little or not at all. help offset the cost of expensive claims for re- their insurance. The other 15 percent So this idea that Americans don’t want tirees’ health benefits—lowering premiums and uninsured, they consume 70 percent on change is simply wrong. In this region, it is protecting coverage for early retirees. average as much insurance as those particularly misguided. While it is true that my Insurers are prohibited from charging who are insured. They are cared for. office has received many calls objecting to the women more than men for health insurance or The lady in Cleveland who has been re- health care debate, a vast majority of them discriminating on the basis of domestic vio- ferred to ad nauseam is being cared for have been from out-of-state—a purposeful and lence as a pre-existing condition. Required at the Cleveland Clinic. well-funded attempt to jam our lines so that maternity services as part of the essential So what are we to do about those 15 my constituents cannot get through. And yet benefits package in the exchange. percent? Why not take over 16 percent thousands did and while it is clear there are Young adults will now be able to stay on of the economy. A $2.5 trillion program diverse opinions and that my constituents are their parents’ insurance much longer, through that will destroy health care for the 85 more divided on this than any other major their 26th birthday. percent who are happy, to find health question we’ve faced so far, it is also clear And finally, health reform will guarantee ac- care for the 15 percent who are not in- from our office communications and our re- cess to quality, affordable health insurance for sured. This has never been about search that a majority of my constituents want 31 million Americans who don’t have coverage health care. This is about government. me to work as hard as I can to improve health today, also eliminating the annual hidden tax Mr. LEVIN. Mr. Speaker, I yield 1 care proposal and support the changes we of $1,100 that American families pay to cover minute to the very distinguished gen- need. And I will do just that. the cost of the uninsured. While the official tleman from California (Mr. THOMP- Third, that the President’s proposed health insurance exchanges are being cre- SON). changes will increase costs to businesses and ated, a temporary insurance pool will be avail- Mr. THOMPSON of California. Mr. taxpayers. But I ask compared to what? The able for individuals with pre-existing conditions Speaker, I have worked for access to current trajectory is already bankrupting busi- or chronic illnesses. quality, affordable health care from nesses, states, counties, cities, and right here These benefits are all vitally important. But day one of my very first campaign, and in central New York leading to higher and perhaps in the end it comes down to this: every day since. higher property taxes. Under the current sys- those opposed to health care reform are con- Today, with passage of this bill, we tem, health care will consume one of every cerned that it will cost them more. This bill will be closer to that important goal

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00047 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1866 CONGRESSIONAL RECORD — HOUSE March 21, 2010 than ever before. When the President side, not on the side of the powerful doctors and hospitals that will drive costs signs this bill into law, insurance com- special interests who’ve spent millions through he roof or necessitate rationing panies won’t be able to drop your cov- to kill this bill. Cutting through all of whether it takes the form of denying some erage if you get sick. Kids won’t be de- the deception, misrepresentation, and treatments or making people wait longer for care. nied coverage because of preexisting lies, I stand with the people. The federal government already runs two conditions. Young adults will be able I urge you to do what’s right and of the biggest medical programs in the coun- to stay on their parents’ policy until vote ‘‘yes.’’ try, Medicare and Medicaid, and both are they are 26. Small business owners will Mr. CAMP. Mr. Speaker, I yield 45 headed for insolvency. Consider that the be eligible for a tax credit. Seniors will seconds to a distinguished member of health-care overhaul calls for putting half of see the Medicare doughnut hole start the Ways and Means Committee, the the 31 million uninsured onto state Medicaid to close, and preventive care will be gentleman from Ohio (Mr. TIBERI). rolls at a time when Medicaid already is Mr. TIBERI. Mr. Speaker, I am for driving state budgets into the red. covered without copay. If almost half of Ohio’s congressional dele- The bill is paid for and will reduce health care reform, but not this gation is undecided, the American people are our debt. In my district, 63,000 unin- version. This is a bad bill. It does noth- not. Recent opinion surveys find that half or sured residents will have access to cov- ing to address the cost of health care. more of Americans oppose the proposed over- erage, and it will save my district $70 This bill increases taxes on individuals haul. The number favoring the plan rarely million in uncompensated care costs. and employers. It cuts Medicare and tops 40 percent. No proposal to make over a This bill is a great start toward health adds debt to future generations. sixth of the U.S. economy and to radically care reform and will help millions of But don’t take my word for it, Mr. alter the health-care prospects of all Ameri- Speaker. My hometown newspaper, The cans should be rammed through in the face Americans afford quality health care. of such opposition. Columbus Dispatch, has published b 2000 three editorials this last week against SHORT TAKES Mr. CAMP. Mr. Speaker, I yield 45 the bill suggesting, and I quote, ‘‘It is Congressional Democrats celebrated on seconds to a distinguished member of incredible that a sixth of the U.S. econ- Friday after finally unveiling a Congres- the Ways and Means Committee, the omy and the health of every American sional Budget Office estimate of the cost of gentleman from California (Mr. could be subjected to massive govern- the latest version of their proposed health- NUNES). ment intervention based on such fiscal care overhaul: $940 billion over the first dec- Mr. NUNES. Mr. Speaker, this debate dishonesty and secrecy.’’ ade, with a deficit-reducing surplus of $138 is not about the uninsured; it’s about Mr. Speaker, this bill does nothing to billion. socialized medicine. Today we are However, as with previous CBO estimates, reform our health care system. It adds the key is in the rules and assumptions Con- turning back the clock. For most of people to a broken system. gress required the bean-counters to follow in the 20th century, people fled the ghosts [From Editorials] preparing the estimate. of communist dictators, and now you ADD IT UP And, as before, the rules are gamed to low- ball the costs with assumptions that are dis- are bringing the ghosts back into this ON HEALTH-CARE VOTE, LAWMAKERS SHOULD honest, such as the one that says that the Chamber. With passage of this bill, PAY HEED TO THE PEOPLE overhaul will be financed in part by squeez- they will haunt Americans for genera- The Obama administration and Democratic tions. ing hundreds of billions of dollars in savings leaders in Congress are pushing Democratic from Medicare. Your multitrillion dollar health care members of the House to pass the Senate Everybody in Washington knows that is bill continues the Soviets’ failed Soviet health-care overhaul in the next week or two never going to happen, and that this alone— socialistic experiment. It gives the and to trust the Senate to agree to changes never mind the other gimmicks in the esti- Federal Government absolute control in follow-up bills that will make the plan mate—pushes the plan into deficit. over health care in America. more amenable to House Democrats. The estimate is dishonest, as is the This complicated approach is a parliamen- My friends, that is what this debate planned parliamentary dodge the House is tary maneuver intended to deny Senate Re- likely to use to pass the overhaul without re- is really about. Today, Democrats in publicans the opportunity to kill the bill this House will finally lay the corner- quiring members to directly cast a vote for with a filibuster. the Senate bill that forms the core of the stone of their socialist utopia on the Of the 11 Democratic members of Ohio’s plan. backs of the American people. congressional delegation, one is opposed and Meanwhile, President Barack Obama and Say ‘‘no’’ to socialism. Say ‘‘no’’ to eight say they are undecided about how his aides deny that he is telling balky Demo- totalitarianism. Say ‘‘no’’ to this bill. they’ll vote. Among Ohio’s nine Republican cratic House members that they must vote Mr. LEVIN. It is now my privilege to members of Congress, there is no ambiva- for the measure to save his presidency. But lence. All nine plan to oppose it. Obama’s cancellation of his trip to Asia, yield 1 minute to the Chair of our cau- President Barack Obama is pressing hard cus, the very distinguished gentleman which was to begin on Sunday, speaks vol- for the overhaul because it is his signature umes about what he thinks this vote means from Connecticut (Mr. LARSON). issue. He is more than a year into his admin- to his presidency. Mr. LARSON of Connecticut. I thank istration and has been handed setback after The administration also denies that Obama the chairman, and it’s my honor to setback, despite the fact that the White has cut any special deals in dozens of private yield my time to someone who’s always House, House and Senate are in Democratic meetings with individual House members understood whose side he’s on in this hands. The economy is stalled, unemploy- over the past week. But neither is the White debate, the gentleman from Michigan, ment remains at punishing levels and voters House divulging many details about these are angry at the lack of improvement. Not closed meetings. MARK SCHAUER. only that, but they are alarmed about the se- Mr. SCHAUER. Mr. Speaker, today I It is incredible that a sixth of the U.S. rious amounts of debt the government has economy and the health of every American stand for the people of Michigan who run up in less-than-stimulating stimulus ef- could be subjected to massive government lost their insurance when they lost forts. The ‘‘blame Bush’’ strategy that intervention based on such fiscal dishonesty their jobs—they’ve been dropped and Obama has employed to date is now a dead and secrecy. denied coverage by insurance compa- horse, unresponsive to further lashing. In nies for preexisting conditions or be- short, Obama is desperate for a win. To better render justice, courts should cause they got sick—and are going Ohio’s Democrats must decide whether move at a deliberate speed. But justice de- they were elected to give the American peo- broke because of their medical bills. layed is justice denied. ple the best health-care bill possible, or So, understandably, Ohio Attorney General I stand for the elderly in my district whether they were elected to save a presi- Richard Cordray is urging the Ohio Supreme who fall into the doughnut hole and dent from a political morass. Court to move quickly in settling a dispute must choose between food and medi- The answer should be easy: they should that will decide whether the state can re- cine, and I stand for small businesses vote for the American people. That means claim $260 million in tobacco-settlement who plead for help to put an end to saying no to the health-care overhaul plans money. double-digit premium increases that now before Congress. The plans so are have The money, originally slated for anti-to- make them choose between jobs and been sold under false pretenses using ac- bacco programs, became the center of a legal counting gimmicks that lowball the costs. battle almost two years ago, when the gov- health care. All of these things will end They contain no serious mechanisms for con- ernor and lawmakers sought to divert it for with the passage of this bill. trolling the escalation in health-care costs. use in an economic-stimulus plan. The question of the day is: Whose And extending health insurance to 31 million Officials of the Tobacco Use Prevention side are you on? I’m on the people’s more Americans would place demands on Foundation tried to thwart the governor by

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00048 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1867 transferring the money to the American Leg- circumstances under which they exercise the same way. I believe our country, by acy Foundation in Washington, D.C. The that coverage are going to change signifi- working together, can ensure that all governor and lawmakers retaliated appro- cantly. Expanding to vastly the pool of peo- Americans have access to quality, af- priately by abolishing the Tobacco Use Pre- ple with health insurance is going to mean fordable, and secure health care, re- vention Foundation and ever since have been sacrifices in affordability and access for ev- fighting in court for the money to be re- eryone. gardless if they’re young or old, wheth- turned to the state. Half of the 31 million are to be enrolled in er they’re rich or poor, and even Cordray quite properly argues that as the state Medicaid programs, at a time when whether they have a preexisting condi- next biennial budget looms, with huge short- Medicaid has become the Pac-Man of state tion. And we can do this in a fiscally falls anticipated, state and local officials budgets, swallowing billions in state reve- responsible manner by paying for this need to know whether Ohio will be able to nues each year at a accelerating rate. Mean- bill and finding savings that will re- count on the tobacco money. Even if the an- while, many doctors already refuse to take duce the deficit in future years. swer is no, at least the decision will end the on additional Medicaid patients, so where That national achievement can begin uncertainty and allow budget planning to will the millions of new Medicaid enrollees proceed. find care? today, this evening, with our vote. I Under the proposal, medical costs, health- encourage my colleagues to support [From the Columbus Dispatch] care premiums, annual federal deficits and this health care reform for all Ameri- SAY NO the national debt would increase—the direct cans. opposite of the president’s promise that it HEALTH-CARE OVERHAUL WON’T REDUCE COSTS, The SPEAKER pro tempore. The would provide Americans with affordable WILL DRIVE UP U.S. DEBT Chair will note that the gentleman health care that improves the government’s Democratic lawmakers in the House are from Michigan (Mr. CAMP) has 41⁄2 min- bottom line. utes remaining and the gentleman under tremendous pressure to approve within The Senate bill that the House is being 3 days a massive overhaul of health care. If asked to approve also contains all the back- from Michigan (Mr. LEVIN) has 6 ⁄4 min- these members succumb to the pressure from room political payoffs to favored lawmakers utes remaining. President Barack Obama and Democratic that so enraged the nation when the measure Mr. CAMP. Mr. Speaker, I reserve the leaders, they will be approving a major inter- was passed by the Senate, such as the balance of my time. vention into a sixth of the U.S. economy—a ‘‘Cornhusker kickback,’’ negotiated by Ne- Mr. LEVIN. It is now my privilege to move driven by the president’s need for a po- braska Democratic Sen. Ben Nelson, which yield 1 minute to our vice Chair and litical victory, not by sound policy that would have the federal government pick up the distinguished gentleman from Cali- serves the interests, wallets and health of the increased costs of Medicaid expansion in the American people. fornia, XAVIER BECERRA. his state, while leaving Ohio and other states Mr. BECERRA. Mr. Speaker, today is Approval of the proposed plan would guar- to squeeze more revenue out of state tax- antee that Americans pay more to get less payers. a day of history. Today we will accom- health care. Care ultimately will be reduced, Obama has proposed to eliminate the Ne- plish what 100 years of Congresses either by raising its cost, by limiting the braska giveaway and have the federal gov- could not. We will pass health care re- amount and kind of care available or by ernment provide more but not all the money form, not just for some, but for all making people wait longer. states will need to cope with large Medicaid Finally, the cost of the new government Americans. rolls. But even if the Nelson bribe ultimately Today is also another day in Amer- spending for health care will add to the an- is nixed, news reports say that more special nual federal deficits and increase the na- ica. That means that 123 Americans deals were being cut this week to induce will die today because they do not have tional debt, which already surpasses $12 tril- House members to vote yes. lion. Labor unions also have been promised a health insurance. Another 8,000 will Though the president claims that the over- massive perk: Their members would be ex- lose their health insurance today, and haul will reduce the ever-mounting cost of empt from the bill’s tax on high-end ‘‘Cad- our health care system will cost all of medical care and reduce the federal deficit illac’’ health-care plans until 2018, saving us $6.8 billion this day and every day if over 10 years, his numbers are based on ac- unionized employees $60 billion during that counting tricks, including gaming of revenue we do not change, if we are content period. Meanwhile, nonunion workers will be with doing nothing. and spending estimates and double-counting stiffed for an estimated $90 billion in new of various federal revenues. John F. Kennedy once said, ‘‘Change taxes. is the law of life, and those who look The vaunted Congressional Budget Office Equally unsavory is the so-called ‘‘Slaugh- figures that Obama points to in claiming ter solution,’’ a parliamentary trick by only to the past or present are certain savings are bogus. The CBO is a by-the-books which House members could approve the to miss the future.’’ I’ve heard it said outfit, but it prepares its estimates based on Senate plan without casting a direct vote for another way: The only human institu- the parameters and assumptions laid down it. If, as the president says, the American tion which rejects progress is the ceme- by Congress. If the parameters are dishonest, people are clamoring for his health-care tery. then the resulting estimate will be, too. In overhaul, why should Democratic lawmakers Today this House, the people’s House, its scoring of the Senate health-care bill, for fear voting for it? example, the CBO was required to base its es- is full of life. We will make history, but The answer is that lawmakers know that our sights are toward the future. To timate on 10 years of tax revenues generated the majority of the American people are not under the plan, but balance that against clamoring for this particular overhaul, as every hardworking, taxpaying Amer- only six years of spending mandated by the one opinion survey after another shows. ican, we say today, We hear you. We plan. No surprise then, that the estimate Americans want health-care reform, but not see it in your eyes. You want control of shows the cost coming in at less than $1 tril- the sort that congressional leaders and the your health care. You want to decide lion over its first decade, with a modest sur- president hope to force down their throats in who your doctor is. You want to choose plus. The real question is what the program the next day or two. would cost over a period of 10 years when your health plan. We will deliver today taxation and spending are fully under way. Mr. LEVIN. It is now my real privi- to all of America. That number is $2.3 trillion, by one estimate. lege to yield to another member, an en- Mr. CAMP. Mr. Speaker, at this time The plan proposes to pay for itself, in part, ergetic member of our committee, the I yield 45 seconds to a distinguished with $500 billion to be cut from Medicare, but gentleman from Wisconsin (Mr. KIND). member of the Ways and Means Com- Medicare already is headed for insolvency, so (Mr. KIND asked and was given per- mittee, the gentlewoman from Florida money taken from it simply increases Medi- mission to revise and extend his re- (Ms. BROWN-WAITE). care’s $38 trillion unfunded liability. marks.) Ms. GINNY BROWN-WAITE of Flor- In December, the chief actuary for the fed- eral Centers for Medicare and Medicaid Serv- Mr. KIND. Mr. Speaker, I will never ida. Mr. Speaker, the Democrats on the ices reported that the Senate plan does noth- forget the pride I felt as a 6-year-old other side of the aisle believe that the ing to curb increases in costs and actually kid in Wisconsin watching Neil Arm- American citizens can no longer be would make those costs higher than they strong and Buzz Aldrin walk on the trusted to manage their own health would be without the overhaul. moon. It was a deep and abiding belief care in the best way that they see fit. Adding 31 million people to health-insur- that I live in a country that’s capable You must now do things in their social- ance rolls, as the bill seeks to do, will in- of accomplishing anything once we put ist way or face the wrath of the IRS. crease the lines waiting to see a doctor or to our mind to it. That belief is being Unfortunately, the size of the Fed- enter a hospital for treatment. This massive increase in demand also will drive up the tested throughout America today. eral Government isn’t the only thing cost of care. The president has promised that People are wondering if we’re still ca- that’s going to grow as a result of this those content with their current insurance pable of doing great things. I believe bill. So will your insurance premiums, coverage won’t have to change it, but the we can, and I want my two boys to feel because the cost of insurance will

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00049 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1868 CONGRESSIONAL RECORD — HOUSE March 21, 2010 grow. That’s right. The bill increases prompt them to oppose the pending legisla- fere with the care that our service members premiums for every American who has tion. While there is legitimate debate as to receive under TRICARE. However, we com- insurance. Our national debt will grow. whether or not the pending health care mit to look into this issue further to ensure Your taxes will grow. measures should become law, VVA does not that no unintended consequences may arise appreciate spreading rumors that are not ac- and to take any legislative action that may The only thing that won’t grow are curate by any political partisan from any be necessary. the benefits that the seniors who are in point of the political spectrum.’’ continued HR 3590, as drafted, does not specifically the Medicare Advantage plan have. Rowan. mention that TRICARE coverage meets the They will be losing their doctors be- ‘‘Last summer there was a similar inci- individual responsibility requirement, but cause doctors are refusing to take dent, also involving partisans in the health such coverage would satisfy the require- Medicare patients and will once this care reform debate that VVA soundly con- ments of this bill. To affirm that this is the bill becomes law. demned. We said then: ‘‘It is our hope that case, the U.S. House of Representatives Mr. Speaker, this bill cuts Medicare, sane minds reject fear-mongering, and that unanimously passed HR 4887, the TRICARE veterans recognize these scare tactics for Affirmation Act, which provides assurances raids Social Security, and we need to what they are,’’ Rowan said. Rowan con- to the American people that care provided to reject this bill. cluded by saying ‘‘VVA has always worked those in the military and their families, as Mr. LEVIN. I now yield 1 minute to hard for justice for veterans of all genera- well as military retirees under age 65 and the gentleman from New Jersey (Mr. tions, and their families. We have always, their families, would indeed meet the re- PASCRELL). and will continue to, work with public offi- quirement for coverage. Mr. PASCRELL. Mr. Speaker, many cials representing all political parties and The members of our nation’s military sac- things are said across the aisle in the points of view. Issues affecting veterans and rifice much to defend us all. We commit to heat of a debate, and if it hasn’t been their families are not, should not, and must these dedicated service members and their said yet, maybe the reason is it has not become partisan footballs to bat around. families as well as our veterans that we will VVA decries any effort, by anyone, that protect the quality healthcare they receive. been said by everybody. would do just that.’’ Sincerely, I believe that the ranking member is BOB FILNER, an honorable person. I believe my DEPARTMENT OF VETERANS AFFAIRS, Chairman, Committee chairman is. * * * Even the President March 21, 2010. on Veterans’ Affairs. of the Vietnam Veterans of America STATEMENT FROM VA SECRETARY ERIC K. IKE SKELTON, said this is shameless. SHINSEKI Chairman, Committee on Armed Services. * * * It’s not right. Tell the truth As Secretary of Veterans Affairs, I accept- SANDER LEVIN, and then let the chips fall where it ed the solemn responsibility to uphold our Chairman, Committee may. It is utterly * * * to suggest, Mr. sacred trust with our nation’s Veterans. on Ways and Means. Fears that Veterans health care and Chairman, that we are seeking to deny GEORGE MILLER, TRICARE will be undermined by the health any soldier the health care they de- Chairman, Committee reform legislation are unfounded. I am con- serve and the benefits that nearly all on Education and fident that the legislation being voted on Republicans and Democrats have spent Labor. today will provide the protections afforded HENRY WAXMAN, our careers in Congress working to pro- our nation’s Veterans and the health care Chairman, Committee tect and prove. they have earned through their service. The on Energy and Com- Mr. DAVIS of Kentucky. Mr. Speak- President and I stand firm in our commit- merce er, I ask the gentleman’s words be ment to those who serve and have served in taken down for the false statements our armed forces. We pledge to continue to ANNOUNCEMENT BY THE SPEAKER PRO TEMPORE that he made about this conference to provide the men an women in uniform and The SPEAKER pro tempore. The me as an Army veteran among others our Veterans the high quality health care Chair reminds all Members that any they have earned. statements should be directed through in the Chamber. President Obama has strongly supported The SPEAKER pro tempore. The gen- the Chair and not to others in the sec- Veterans and their needs, specifically health ond person. tleman from New Jersey will be seated. care needs, on every major issue for these The Clerk will report the words. past 14 months—advance appropriations, new PARLIAMENTARY INQUIRY Mr. PASCRELL. Mr. Speaker, I ask GI Bill implementation, new Agent Orange Mr. TIAHRT. Parliamentary inquiry, unanimous consent to remove any presumptions for three additional diseases, Mr. Speaker, word or words that were taken as of- new Gulf War Illness presumptions for nine The SPEAKER pro tempore. The gen- fensive. additional diseases, and a 16% budget in- tleman from Kansas will state his par- The SPEAKER pro tempore. Is there crease in 2010 for the Department of Vet- liamentary inquiry. objection to the request of the gen- erans Affairs, that is the largest in over 30 years, and which has been followed by a 2011 Mr. TIAHRT. Is it true that in the tleman from New Jersey? VA budget request that increases that record course of comfortable debate that we Mr. DAVIS of Kentucky. I accept the budget by an additional 7.6%. not question another Member’s mo- gentleman’s apology. To give our Veterans further assurance tives? The SPEAKER pro tempore. Without that health reform legislation will not affect The SPEAKER pro tempore. The objection, the words will be stricken. their health care systems, the Chairmen of Chair will affirm that Members must There was no objection. five House committees, including Veterans maintain proper standards of decorum. Mr. PASCRELL. Don’t push me. Affairs Chairman Bob Filner and Armed Mr. TIAHRT. Is it against the House I include the following material for Services Chairman Ike Skelton, have just issued a joint letter reaffirming that the rules to question another Member’s the RECORD: health reform legislation as written would motives? VIETNAM VETERANS OF AMERICA, protect those receiving care through all The SPEAKER pro tempore. A Mem- March 21, 2010. TRICARE and Department of Veterans Af- ber’s remarks should avoid personal- VIETNAM VETERANS OF AMERICA APPLAUDS fairs programs. ities toward other Members. PASSAGE OF SKELTON BILL ENSURING PRO- Mr. TIAHRT. I thank the Speaker. TECTION OF TRICARE, VA HEALTH CARE, CONGRESS OF THE UNITED STATES, Mr. CAMP. Mr. Speaker, I yield 45 AND CHAMPUS; DECRIES ‘‘SCARE TACTICS’’ Washington, DC, March 21, 2010. seconds to a distinguished member of WASHINGTON, DC.—‘‘We thank and applaud Hon. LOUISE SLAUGHTER, passage of H.R. 4887 yesterday in the House Committee on Rules, The Capitol, Washington, the Ways and Means Committee, an of Representatives, by a vote of 403–0. Pas- DC. Army Ranger, Mr. DAVIS of Kentucky. sage of this bill ensures that health care pro- DEAR CHAIRWOMAN SLAUGHTER: The House Mr. DAVIS of Kentucky. My heart is grams for veterans, active duty military, re- Democratic leadership asked our committees heavy with grief tonight at this turn- tired military, and their families/survivors to review HR 3590 and HR 4872 to assess the ing point for our Nation, Mr. Speaker. will not be affected negatively by the pend- impact of the bills on the health care pro- This vote will define the America we ing health care reform legislation.’’ said vided by the Department of Defense and the will have in the future: massive tax John Rowan, National President of Vietnam Department of Veterans Affairs. Our reviews burdens, rationed care, and intrusive Veterans of America (VVA). of HR 3590 and HR 4872 lead us to believe that ‘‘It is unfortunate that some continue to the intent of the bills was never to under- bureaucracy. raise what is now is even more clearly a false mine or change the Department of Defense Democrats are thwarting the will of alarm that is apparently meant to frighten and Department of Veterans Affairs oper- the American people, taking them on a veterans and their families in order to ation of their health care programs or inter- headlong rush toward socialism. This is

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00050 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1869 based on a false premise that every freedom to choose their own health Folks like a woman from Raleigh, who fears need a person could have on Earth can care. she will suffer the same fate as her sister who be met by government. Almost like Mr. LEVIN. I yield for the purpose died from asthma because she could not get worshipers, they carry the heart of our for a unanimous consent request to the insurance coverage. Constitution, bought in blood, and sac- gentleman from North Carolina (Mr. Folks like a man from Louisburg, who can- rifice it on the altar of political expedi- ETHERIDGE). not start a new business because he needs ency. It raises taxes, violates your pri- (Mr. ETHERIDGE asked and was the insurance his current employer provides. vacy, is policed by the IRS, intrudes on given permission to revise and extend His mother pleaded with me that they are not free choice, and hurts seniors. his remarks.) looking for a handout; just a fair playing field. I stand firm in my opposition to this Mr. ETHERIDGE. Mr. Speaker, I rise Folks like a woman from Rocky Mount, who exercise in idolatrous statism, a true on behalf of a young man by the name notes that the working poor, self-employed, tyranny that is the largest legislative of Will Privitt who tonight will be able part-time workers and others on the margins transfer of power to the executive to get insurance for the first time. He need relief. She called on me to not let the in- branch in the history of this Republic. was born with a preexisting condition. surance companies win this time. Vote ‘‘no’’ on this bill. Start over Mr. Speaker, I rise today in support of These are the real people that convinced with real reforms that Americans health reform. I have said all along that there me that voting for these bills is the right thing want. are several goals that our efforts must meet to to do. A lot of folks are afraid, both of the cur- Mr. LEVIN. It is now my pleasure to improve security and stability for North Caro- rent system and of potential changes. Thou- yield 45 seconds to the very distin- linians. We need to reform health insurance to sands of families without insurance, and indi- guished gentleman from New York (Mr. reduce costs for people who have insurance viduals with pre-existing conditions, are an ill- CROWLEY). and those who have been priced out of the ness away from financial ruin. Reform needs Mr. CROWLEY. Mr. Speaker, I rise in market. We need to increase consumer to provide them security. support of the Patient Protection and choices and make sure that insurance compa- Mr. Speaker, as we continue to address Affordable Health Care Act, a historic nies do not deny coverage because of pre- America’s financial situation, health reform is measure that will put families first existing conditions or technicalities. We need absolutely necessary to get our economy when it comes to accessing health care to shore up Medicare to improve security for growing again. This bill will reduce the stran- coverage. seniors, reducing costs for medications and glehold that insurance costs have on our small American families need this bill now eliminating copayments. We need to make in- businesses and eliminate the threat of bank- more than ever. In the past decade, the surance affordable for businesses, so that ruptcy due to medical costs that hangs over cost for health care for American fami- they are not faced with the choice of providing so many North Carolina families. It will lies has skyrocketed. If we do nothing, coverage for their employees or making pay- strengthen our rural communities, supporting it’s only going to get worse. If we do roll. Finally, we must put discipline back in the the training of doctors and providing incentives nothing, in 10 years small businesses budget and bring down the budget deficit. I for them to work in underserved areas. And will shell out $29,000 in medical costs rise in support of H.R. 4872, the Health Care the bill is fully paid for, so that not only will it per employee. If we do nothing, the and Education Affordability Reconciliation Act bring down costs for individuals and busi- costs of an employer-sponsored health of 2010 and H.R. 3590, the Patient Protection nesses, but for the taxpayer and future gen- insurance plan will increase 84 percent and Affordable Care Act because together erations. by 2016. And if we do nothing, the they meet these goals. Mr. Speaker, making sure every American American economy will break under The working families of the Second District has access to affordable health insurance and the weight of mounting debt. need solutions, not more fear, neither the real high-quality health care is one of the most im- Americans may very well be tired of fears of rising cost nor the false fears spread portant challenges of our time. If we can afford the endless media coverage regarding by special interests. We cannot continue to to provide health care to Iraqi citizens, as we this debate. But they know as we do allow the current system to kill jobs and bust have over the past decade, we can afford a that we have a serious problem in our the budgets of our families and our Nation. fiscally responsible reform that puts health health care system that must be fixed. After reading the legislation carefully, I have care in reach for all Americans. The health re- We on this side of the aisle are ready to concluded that it will save lives and save form debate is about saving money and sav- deal with it. money. This is the best chance we have to re- ing lives. At its core, health reform is all about Simply put, health care reform is duce sky-rocketing health care costs for North ensuring that American families and busi- good medicine for America and good Carolina families. nesses have more choices, benefit from more medicine for American businesses. North Carolinians know that the current sys- competition, and have greater control over The SPEAKER pro tempore. The tem is broken and that we need common- their own health care, while bringing down time of the gentleman has expired. sense reform. For me, the effort to fix our costs for individuals, our families and busi- ANNOUNCEMENT BY THE SPEAKER PRO TEMPORE health care system has always been about nesses, and for the Nation. The SPEAKER pro tempore. The people not about politics. Our effort is about These bills are fiscally responsible and will Chair will remind both sides to heed North Carolina families. We need reform for improve the health and health care of people the gavel. folks who are struggling with unbearable across my district, North Carolina, and the Mr. CAMP. Mr. Speaker, at this time health care costs, rapidly rising premiums, bu- country. I am pleased to be able to vote in I yield 45 seconds to a distinguished reaucratic meddling, and arbitrary denials of favor of this historic legislation. member of the Ways and Means Com- coverage and a system that is driving our Na- The SPEAKER pro tempore. The gen- mittee, the gentleman from Wash- tion deeper and deeper into debt. tleman from Michigan will be charged ington (Mr. REICHERT). Throughout this process, I have heard from time. Mr. REICHERT. Mr. Speaker, the thousands of folks from the main streets and Mr. LEVIN. I yield to the gentleman American people have spoken loud and country roads of North Carolina who are cry- from Pennsylvania (Mr. FATTAH) for a clear. They don’t want a government ing out for help. At numerous town hall meet- unanimous consent request. takeover of health care. The Demo- ings in North Carolina and over the telephone, (Mr. FATTAH asked and was given crats’ latest plan is still a government as well as in other opportunities, I have spo- permission to revise and extend his re- takeover. Billions of dollars in new ken directly to North Carolinians. I read thou- marks.) taxes on small businesses, over a tril- sands of messages that come in by phone, Mr. FATTAH. I rise in support of the lion dollars in new spending, and it email, fax, or letter every day. The vast major- health care reform bill in honor of a hurts our seniors and special-needs ity say that change is needed. friend of mine, Linda Taylor, who died population by taxing hearing aids, When North Carolina families are hurting, because of the lack of insurance in a pacemakers, wheelchairs. doing nothing really isn’t an option for me. I breast cancer illness that she faced. We’ve heard, ‘‘If you like it, you can have heard from thousands of my North Caro- The SPEAKER pro tempore. The gen- keep it.’’ Not according to this Presi- lina neighbors who are suffering under the tleman from Michigan will be charged dent, who said recently, ‘‘I think some current system. time consumed. of the provisions that got snuck in Folks like a nurse from Sanford, North Caro- Mr. LEVIN. I yield 45 seconds—I wish might have violated that pledge.’’ lina, who says that insurance industry bureau- I could yield more—to our distin- We need to start over, and today I crats are keeping her from providing her pa- guished colleague from Maryland (Mr. stand with Americans who want the tients the care they need. VAN HOLLEN).

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00051 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1870 CONGRESSIONAL RECORD — HOUSE March 21, 2010 Mr. VAN HOLLEN. Mr. Speaker, they mination of a long process. In the late 1950s I saw the beginnings of the AIDS epidemic in called it ‘‘a dangerous device invented and early ’60s, when I was going to medical 1987. in Nazi Germany’’ and a ‘‘method of school in Chicago, Canada’s Tommy Douglas One day my brother called me when I was imposing Stalinism.’’ Those were the was beginning a national health care plan in in Africa and told me there was a seat open statements made by the opponents of the province of Saskatchewan. As I came to in Congress. He suggested that I return to the Medicare, Medicare that now provides the end of my medical training, doctors began U.S. to run for the seat and work on getting health coverage to 45 million Ameri- to strike in Canada because they didn’t want universal health care. The dream was not cans. to practice medicine under any system that dead, it has just been dormant. So I returned, This legislation will ensure that 32 was not totally free enterprise in nature. But ran for Congress and was elected in 1988. I million more Americans have access to as a new physician at the time, it seemed to made the decision to get on the Ways and affordable health care and that no me that the benefits of extending health cov- Means Committee because I thought that was American is held hostage to the abu- erage to everyone in Canada far outweighed where I could be most effective in getting a sive practices of the insurance indus- the benefits of a free enterprise system. Be- national plan established. I was appointed to try. tween 1963 and 1970, while I got my training the committee in 1991 and began working with As in 1965, we have the rhetoric of in adult and child psychiatry and served 2 95 other members who were dedicated to a mass distortions. This morning, Repub- years in the United States Navy, I had the op- single player plan. In 1993 President and Mrs. lican Leader BOEHNER even said this portunity to observe the American healthcare Clinton came to Washington to enact a na- bill means Armageddon. The day after ‘‘nonsystem’’ firsthand. Every day, I watched tional health plan, but we were unsuccessful. this legislation is signed by President as people fell through the cracks. When I en- The years between 1994 and 2006 were a Obama, Americans will see the world is tered politics in the Washington state legisla- painful period as we watched Republicans try not coming to an end, that there are no ture, I knew that it was my obligation to do all to dismantle the only national health care pro- death panels. They will begin to see a that I could to bring about a national system gram we have, Medicare. We breathed a great system that works for them, not the that would provide coverage for everyone. And sigh of relief at the 2008 election of President insurance industry who is spending during my campaign for governor in 1972, I Barack Obama, who stated that he wanted to millions of dollars to kill the bill. made my first speech declaring my support for enact a national health plan. The President Mr. CAMP. At this time, Mr. Speak- a single-payer system similar to Canada. Each was determined not to repeat the errors of the er, I yield 45 seconds to a distinguished year that I served in the state legislature, I Clinton administration, and the process of writ- member of the Ways and Means Com- faced the institutional resistance to the cre- ing the bill has been long and tortuous. Over mittee, Dr. BOUSTANY of Louisiana. ation of a more orderly system. Yet people the course of many months, we’ve watched Mr. BOUSTANY. Mr. Speaker, we all complained they couldn’t get care. Hospitals this bill wind through three committees in the have compassion for families strug- complained about uncompensated care. Peo- House and two committees in the Senate, gling, those who have lost jobs, those ple complained about cost shifting of the ex- which brought us to where we are today. who lack access to health care. We all penses of the uninsured onto the policies paid I still believe that a single-payer model is want to do what’s right for our coun- for by the insured. the most effective to achieve both cost control try. We all want to solve these prob- In the early 1980s, I began trying to estab- and universal coverage. But 40 years of expe- lems. But as I look at this massive, lish an uncompensated care fund that would rience prevent me from being ideological complex and partisan bill, I see pre- be paid into by all hospitals and the receipts about the solution to the problems of universal miums continuing to rise for families would be given to those hospitals that took coverage. Rather than establishing a single- and abject failure to control health care of those in the community who had no payer system, Congress has designed a less care costs for families and businesses. health insurance. But hospitals resisted. I did desirable model that would more tightly regu- I see huge tax increases coupled with a study to find out how many people in the late private insurance companies much in the irresponsible cuts to Medicare services, state of Washington either were not covered same way that we do with utility companies. all to expand new coverage entitle- by a government program or didn’t have insur- Members of Congress have opted for a model ments where physician access will ance through their employment. that provides for insurance regulation at the worsen, continuing to burden our Unsurprisingly, we found that it was a huge national level, rather than the state level as it strapped emergency rooms. number. So in 1983, I began the process of is today. It has much in common with the Mr. Speaker, frankly, I see a sequel trying to do in Washington State what Tommy French system which provides universal cov- to the modern Greek fiscal tragedy un- Douglas had done a few hundred miles away erage to the French people at half the cost of folding before us with a potential for in the province of Saskatchewan. what we spend here in the United States. default. We have a duty to reform As I tried to get universal coverage in the Their system provides a quality of care that is health care, but an obligation to get it state of Washington, I ran into numerous ob- considered the best in the world according to right. stacles. The medical establishment was more the World Health Organization. Mr. LEVIN. I now yield 45 seconds to interested in capital investments than they I know that this bill is far from perfect and a very senior member of our com- were in ensuring that medical coverage was will require continued efforts to adjust and im- mittee, Mr. MCDERMOTT of Wash- available to everyone in Washington. Large prove it in the years to come. But today we ington. businesses were reluctant to accept any re- began. As the Chinese adage says, ‘‘every (Mr. MCDERMOTT asked and was sponsibility beyond what they were already journey of 1,000 miles begins with a single given permission to revise and extend doing for their employees. Any mandate was step.’’ Today we have taken that step. his remarks.) out of the question because under a technical Mr. CAMP. Mr. Speaker, I yield 45 Mr. MCDERMOTT. Mr. Speaker, loophole, big employers are exempt from seconds to a distinguished member of there are times in history that action many regulations that deal with insurance. So the Ways and Means Committee, the is demanded. In 1935, we needed Social instead, I ended up authoring the Washington gentleman from Nevada (Mr. HELLER). Security and unemployment insurance. State Basic Health Plan, which is a subsidized Mr. HELLER. I thank the gentleman The Democrats answered. In 1965, we health insurance program to help lower-in- for yielding. needed health care for senior citizens. come families afford coverage. But I wasn’t Thousands of Nevadans have been The Democrats answered. In 2010, the able to get universal coverage. surveyed and an overwhelming number country needs health care reform, and This experience taught me that it was going oppose the government takeover of the Democrats will answer tonight. to be incredibly difficult to create a health care health care. Yet two-thirds of Nevada’s It was never in doubt. Business want- plan in one state that could be replicated delegation will defy their constituents ed a change, the medical profession across the country as had been done in Can- and vote with their leadership instead. wanted a change, and labor wanted a ada. I wrote the plan originally when the gov- This $2.6 trillion legislation will raise change. And the Republicans brought ernor of the state of Washington was a Re- Nevada taxes, kill Nevada jobs, remove an economic collapse to make it clear publican, so it didn’t get anywhere until Demo- Nevada seniors from Medicare, and sad- to everybody that we all are in danger crat Booth Gardner was elected governor of dle the State of Nevada with budget- if we don’t change the health care sys- Washington in 1984. The process was so frus- busting mandates. I urge my colleagues tem in this country. trating and the final legislation so modest that from Nevada to speak for Nevada—not For me and many of my colleagues, passing I decided I’d go back to medicine. I went to their Beltway benefactors—when cast- a national health care reform bill is the cul- work for the State Department in Africa, where ing their vote today.

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00052 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1871 Mr. LEVIN. I now yield 45 seconds to 32 million additional Americans the The impact on the New York State Medicaid the gentleman from Oregon, a member right to health insurance coverage. It budget went from a projected increased cost of the committee, Mr. BLUMENAUER. would be wrong to keep people cooped of over $700 million to increased aid of $1.3 Mr. BLUMENAUER. Today’s victory up in institutions when they could live billion in just the first year. That’s a ‘‘swing’’ of for health care reform and coverage for at home. It would be wrong to keep over $2 billion. 32 million Americans is not just the senior citizens struggling to try and Finally, these reforms will do more for wom- culmination of 15 months of hard work pay for their prescriptions. en’s health despite the restrictive language on in this Congress. It represents the his- Let’s do the right thing. Let’s vote reproductive health services contained within toric accomplishments sought by for this legislation. Give 32 million the Senate bill—than any other legislation in Presidents and Members of Congress people the right to have insurance cov- my career. dating back to Teddy Roosevelt. That erage. Let’s do the right thing. I am grateful for the opportunity to be a part the accomplishment was achieved in Mr. Speaker, when I was growing up my of this momentous reform and urge my col- the midst of difficult economic times, a parents taught us that right was right if nobody leagues to remember that today we will make toxic political environment without was right and that wrong is wrong is every- a lasting difference in people’s lives. Today we any bipartisan support, makes it all body is wrong. It would be wrong to deny 32 change the overall health of our Nation. the more remarkable. million people health insurance coverage. It Mr. LEVIN. I yield to the gentleman Passage tonight will start making a would be wrong to deny millions of people from Minnesota for a unanimous con- difference for our families this year with pre-existing conditions the right to have sent request. and, most important, the bill is fully insurance coverage. (Mr. ELLISON asked and was given paid for. We’re reforming Medicare, we It would be wrong to keep filling up the permission to revise and extend his re- improve the quality of health care in emergency rooms of hospitals because people marks.) this country and reduce the deficit. To- don’t have regular doctors. It would be wrong Mr. ELLISON. I rise in support of night’s victory starts America on the to keep senior citizens struggling to pay for universal health care. road to better health and economic se- their prescriptions. It would be wrong to keep Mr. Speaker, there was a time in our coun- curity. people with disabilities cooped up in institu- try’s past that the enactment of a comprehen- Mr. CAMP. Mr. Speaker, before I tions when they could live at home. It would sive civil rights law was deemed merely a yield, I would like to remind the Chair be wrong to deny people health coverage be- dream. that Medicare and Social Security cause they have lost their jobs. It would be There was a time in our country’s past that passed with large bipartisan majori- wrong to deny health coverage to people who enactment of Social Security to guarantee the ties. work in small businesses. retirement security of our seniors was deemed With that, I yield 45 seconds to the It is right to provide coverage to as many merely a dream. distinguished member of the Ways and people as we can. It is right to reduce the def- There was a time in our country’s past that Means Committee, the gentleman from icit and save as much money as we can. It is enactment of the Medicare law to guarantee Illinois (Mr. ROSKAM). right to save lives. It is right to do the right the health care for our nation’s senior was Mr. ROSKAM. I thank the gentleman thing. It is right to vote to pass this bill and deemed merely a dream. for yielding. provide health coverage for 32 million addi- We now take all three—civil rights, retire- Mr. Speaker, just because it’s his- tional Americans. ment security for our seniors and health secu- toric doesn’t mean it’s good. I think It is right to do the right thing. rity—for granted in our society. we’ve got to be reminded of that. I Mr. LEVIN. I now yield to the gentle- They are all assumed as a given and as a think back to history for something lady from New York for a unanimous right in our society. that actually was good, and that was consent request. Well, Mr. Speaker, I believe when we leave when Alexander Hamilton said regard- (Mrs. MALONEY asked and was given this chamber tonight after passing this health ing our Constitution, ‘‘Here, sir, the permission to revise and extend her re- care bill, we will forget how hard it was to people govern.’’ marks.) pass this bill. And in another generation, our We would be wise to listen to the Mrs. MALONEY. I thank the gen- grandchildren will also assume that universal American people. The American people tleman for yielding and for his leader- health care is a right and a given in any mod- have said ‘‘no’’ to the ABCs of ship. ern society. PelosiCare. They have said ‘‘no’’ to the I rise in support of the health care Mr. Speaker, tonight marks the beginning of arrogance of this bill. They have said bill. the dream of universal health care becoming ‘‘no’’ to the budget-busting nature of Mr. Speaker, this is an historic vote. With a reality in our society. this bill. And they have said ‘‘no’’ to passage of these health care reforms, 32 mil- It is an important beginning— the crippling of the economy of this lion people without insurance will get it—in- When 40,500 uninsured Fifth District resi- bill. cluding almost 2.5 million uninsured in New dents will have access health care coverage In Illinois, a manufacturer called York State. to health insurance. Caterpillar said that next year alone it It will end discrimination for preexisting con- When 9,700 Fifth District residents with pre- will cost the company a hundred mil- ditions, make progress on cutting high medical existing conditions can no longer be denied lion dollars. What does that do to a costs, and reduce the deficit by over $1 trillion coverage. State that is left roughshod by over- over the next two decades. When 57,000 Fifth District young adults can promises and underdelivering on a This package of reforms that will make a obtain coverage on their parents’ insurance stimulus that failed? real difference in the lives of Americans, over plans. The SPEAKER pro tempore. The their entire lives: When insurance coverage for 358,000 Fifth Chair will note that the time of the If you’re 21 and just graduating college, District residents is improved—and when the gentleman from Michigan (Mr. CAMP) you’ll now be included on your parents’ cov- cost of uncompensated care for hospitals and has expired. The gentleman from erage until your 26th birthday. other health care providers is reduced by $101 Michigan (Mr. LEVIN) has 11⁄2 minutes If you’re self-employed in your thirties or for- million—that is positive change. remaining. ties, you’ll be able to shop for more affordable And when thirty-two million more Americans Mr. LEVIN. I now yield 45 seconds to coverage on exchanges set up by states or have health insurance it is a good beginning. the distinguished gentleman from Illi- the Federal Government. At the same time, when $1.3 trillion in deficit nois (Mr. DAVIS). If you’re 56 and have taken early retirement, spending (accumulated over the past eight (Mr. DAVIS of Illinois asked and was you can continue to be covered under your years) is reduced, it is a good start. given permission to revise and extend employer’s plan until you sign up for Medicare. I look forward to enthusiastically casting my his remarks.) And if you’re a senior with Medicare Part D ‘‘yes’’ vote tonight for this historic legislation. Mr. DAVIS of Illinois. Mr. Speaker, Drug Coverage, the so-called ‘‘donut hole’’ Mr. LEVIN. I yield to the gentlelady as I was growing up, our parents al- has been closed. from California for a unanimous con- ways taught us that right was right if The Senate version penalized states like sent request. nobody was right and that wrong was New York which were already doing more (Ms. RICHARDSON asked and was wrong if everybody was wrong. Well, I than most to provide care to the needy. And given permission to revise and extend can tell you it would be wrong to deny that’s one of the things this House is fixing. her remarks.)

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00053 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1872 CONGRESSIONAL RECORD — HOUSE March 21, 2010 Ms. RICHARDSON. I rise in support the underlying bill. There isn’t. We which is, Why can’t the American peo- of this health care reform legislation. have heard that this is going to add to ple have access to the same type of b 2030 the deficit and the debt of the country. benefit that Members of Congress Don’t listen to what the Democrats have? Mr. LEVIN. I now yield the balance say. Don’t listen to what the Repub- It’s a good question. Some of the of my time, 45 seconds, to the very dis- licans say. Listen to what the non- most hysterical voices in opposition tinguished gentlewoman from Florida partisan Congressional Budget Office have access to a purchasing exchange (Ms. WASSERMAN SCHULTZ). says, which is this: the bill will save through the Federal employee benefits Ms. WASSERMAN SCHULTZ. Mr. $138 billion off the deficit in the first 10 plan that has comprehensive benefits, Speaker, I rise today to cast my vote years and $1.2 trillion off the deficit in choice, no rescissions, no lifetime caps. to end abusive insurance company the next 10 years. And this bill is going to give the Amer- practices that put doctors and patients Finally, we hear the bill will kill ican people exactly what Members of in control of their health care. jobs. When the Clinton economic plan Congress have. And in case there is any And when I do, I will cast it for the was on this floor, a gentleman named question about that, section 1312 will small business owner in my district Dick Armey, a leader of the anti-move- make sure that starting in 2014, Mem- whose health insurance premiums shot ment on this bill, said it would be ‘‘a bers of Congress have to use exactly up more than 100 percent last year sim- recipe for disaster.’’ He was wrong. the same purchasing exchange that the ply because one employee got sick. I That bill created 23 million new jobs American people will have to use. will cast it for the 135,000 people in my and we should vote—— No more haves and have-nots. No district who don’t have health care The SPEAKER pro tempore. The more tax-paying Americans who don’t coverage. On a personal note, I will time of the gentleman has expired. have health insurance, underwriting cast it for the 2.5 million breast cancer Mr. GEORGE MILLER of California. the health benefits of Members of Con- survivors like me, who have a pre- I yield the gentleman 15 additional sec- gress who would deny them access to existing condition that make it next to onds. quality, affordable health care. It is impossible to obtain health insurance. Mr. ANDREWS. Finally, I heard one time to answer that question tonight Finally, I’ll cast it for all of the of our colleagues say this bill will cre- in the affirmative by passing this legis- moms in America with beautiful chil- ate a socialist utopia. No, Mr. Speaker, lation. dren like mine, but who don’t have the it won’t. It will create a decent society Mr. KLINE of Minnesota. Mr. Speak- security of health insurance and who that every man, woman, and child in er, I am pleased to yield 2 minutes to die inside every time their child gets this society and this country so richly the gentleman from Georgia, the rank- sick. Our current system is broken. It’s deserves. Vote ‘‘yes’’ on this bill. ing member of the Health, Employ- un-American. The nightmare ends to- The SPEAKER pro tempore. The gen- ment, Labor, and Pensions Sub- night. committee, Dr. PRICE. tleman from Minnesota (Mr. KLINE) is The SPEAKER pro tempore. All time Mr. PRICE of Georgia. Mr. Speaker, recognized for 8 minutes as a designee has expired. health care decisions that we make for of the minority leader. The gentleman from California (Mr. ourselves and for our families are some Mr. KLINE of Minnesota. Mr. Speak- GEORGE MILLER) is recognized for 15 of the most important and personal in er, I yield myself 11⁄2 minutes. minutes as a designee of the majority our lives. As a physician, early in my I came to Congress 7 years ago to do leader. career of caring for tens of thousands my part to make this country better. Mr. GEORGE MILLER of California. of patients, I recognized that there Every vote I cast and every policy I Mr. Speaker, I yield 2 minutes to the were more folks in Washington who af- help shape must be judged by whether gentleman from New Jersey (Mr. AN- fected what I could do for and with my it achieves what my constituents sent DREWS), a member of the committee. patients than anybody I ever met in me here to accomplish. As each Mem- (Mr. ANDREWS asked and was given residency or in medical school and that permission to revise and extend his re- ber of this, the people’s House, prepares that was wrong. marks.) to vote ‘‘yea’’ or ‘‘nay’’ tonight, we Health care, taking care of people, is Mr. ANDREWS. I thank my chair- should all take a moment to remind a moral endeavor and should be man for yielding. ourselves of why we are here. grounded in principle. And if the prin- Mr. Speaker, the ladies and gentle- Our job is to ensure American em- ciples that we hold dear for health care men of the House should respect our ployers have the tools and the freedom are applied to this debate and to this constituents who are against the bill, they need to sustain jobs and create bill, the picture is not pretty: accessi- who are for the bill, and those who are jobs. Instead, this bill will destroy jobs bility, being able to receive care; af- undecided; but we should respect them at a time when we need them the most. fordability, being able to afford care; enough to give them an accurate Our job is to ensure freedom, security quality, receiving the best care avail- record of what’s in the bill, and I think and prosperity for future generations. able; responsiveness, having a system it’s time for some accuracy. Instead, this bill will be paid for by our that works for patients; and innova- We have heard repeatedly tonight children and our grandchildren and our tion, being certain that we have the that there are cuts to Medicare in this great grandchildren. Our job is to legis- newest and the best treatments and bill. There is not one cut to not one late openly with integrity and fairness. choices, patients being able to choose beneficiary anywhere in this bill. Medi- Instead, this bill is full of back-room their physicians and how and where care benefits expand for prescription deals negotiated behind closed doors. they are treated. drugs and expand for preventive care. This bill is not what the American All of these are harmed by this bill. We heard someone say that the bill in- people want. They are imploring us to All of these principles are violated. creases premiums for Americans. start over with reforms that will bring None of these principles are improved Section 1001 of the reconciliation bill down health care costs while pre- by the further intervention of the Fed- says that for a family making $45,000 a serving the relationship between pa- eral Government. year, if you look at their premiums, tients and their doctors. This is our So you see, Mr. Speaker, mostly this their copays and their deductibles, last chance to stand up for the people is bad for patients, for all Americans. which is what real people have to do, who sent us here and display the cour- The trust that is necessary between the bill saves them $7,000 a year. We age to prove that we can do better. caregiver and care receiver, between have heard that the special interest I reserve the balance of my time. patients and their doctors, to believe provisions, that I think are an abomi- Mr. GEORGE MILLER of California. that your health is not being under- nation, are in the bill. They are not. If I yield 1 minute to the gentleman from mined by the system will be perma- you read section 1201 of the reconcili- Connecticut (Mr. COURTNEY), a member nently eroded, permanently damaged; ation bill, it says goodbye to the so- of the committee. and it is that trust that is the founda- called Cornhusker kickback and other Mr. COURTNEY. Mr. Speaker, to- tion of the morality of health care. special interest provisions. night we are going to answer a ques- So this is a sad day, yes, because We heard that there is taxpayer fund- tion which the tea party on the right there are so many wonderful and posi- ing for abortions. Read section 10,104 of to reformers on the left ask constantly, tive and patient-centered solutions

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00054 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1873 that we could have enacted. You see, just to the north of me in Indiana, Gov- Mrs. BIGGERT. Mr. Speaker, I rise we trust patients and families. They ernor Mitch Daniels said a half a mil- today deeply troubled, not just by this trust government. lion more Hoosiers will be on Medicaid, bill, but by the historic opportunity As a physician, I know that when pa- costing the State taxpayers billions of this body has squandered. We had so tients and their families and their doc- dollars. long to get this right, so many chances tors are not allowed to decide what It’s going to cost my State, accord- to take a step back and listen, really they receive, we lose more than our ing to the Heritage Foundation, $303 listen, to what the American people health care system. We lose our moral- million from 2014 to 2019. So that’s were asking us. ity. We lose our freedom. what our next budget session-mates Instead, true leadership was cast The positive vote, the patient-cen- will be budgeting for 2014. So the State aside in favor of backroom deals, par- tered vote, the bipartisan vote on this legislators tonight who are hoping the tisan games, and legislative gimmicks. bill is a ‘‘no.’’ economy will turn around, maybe there The best intentions on both sides of the Mr. GEORGE MILLER of California. will be a light at the end of the tunnel, aisle never had a chance to turn good I yield 1 minute to the gentlewoman are now having to deal with the $303 ideas into great policy, and we were from California (Ms. WOOLSEY), a mem- million freight train that’s the light at left with a bill that is so poorly crafted ber of the committee. the end of that tunnel. that we are voting to overhaul it the Ms. WOOLSEY. Mr. Speaker, the But on top of that, this proposed bill same day it is going to the President. whole Nation desperately needs health also takes student loan money to fi- But the American people still have a care reform, but no group of Americans nance this bill. The government has choice. It is not between this partisan needs it more than women who face taken over the student loan business; bill and nothing. We can work together discrimination and insult at the hand they have lower interest rates. Instead to deliver the commonsense reforms of the broken status quo every single of lowering the rate our students are that the American people want. Mr. Speaker, I know many colleagues day. We all know that the current sys- going to be paying back on our inter- est, we are going to take part of that have been struggling with this vote. I tem allows insurance companies to urge them to vote ‘‘no’’ and work with deny coverage based on preexisting money and fund this bill on the backs of our students. us to pass reforms we can all be proud conditions. of, that we can all vote for. But I wonder how many of my col- Mr. Speaker, it’s unfair to put these burdens on our States and on our stu- Mr. Speaker, I vote ‘‘no.’’ leagues realize that essentially being a Mr. GEORGE MILLER of California. dents. woman is a preexisting condition. I yield 1 minute to the gentlewoman Mr. GEORGE MILLER of California. Pregnancy, for example, or C-sections, from California (Ms. SHEA-PORTER). can be deemed preexisting conditions. I yield 1 minute to the gentleman from Ms. SHEA-PORTER. Tonight I vote Most unbelievable of all, insurance Arizona (Mr. GRIJALVA), a member of for the middle class. companies can legally turn their backs the committee. I have heard the desperation of par- on women who suffered injuries due to Mr. GRIJALVA. Mr. Speaker, today I ents whose kids were kicked off their domestic violence because that, too, rise in full support of the legislation to plan before they even had a job. This can be defined as a preexisting condi- reform health care before us. It is, in- bill allows 30 percent of young Ameri- tion. We should all be ashamed of a deed, a historic opportunity for the cans currently without coverage to system that puts healthy insurance American people to begin the necessary stay on their parents’ plans until age company profits ahead of healthy process of fixing a failing and broken 26. American women. health care system that is costly and I have listened as New Hampshire This weekend, today, tonight, we will denies basic health care to many, to 48 small business owners told me they make history by passing a health care million Americans in this country. were embarrassed they could no longer It is also a tremendous building bill that will correct these injustices, insure faithful employees. This bill is block for the care of people in this and no longer will female be considered their remedy. country in the future and to begin to a preexisting condition. I heard those who lost homes because Mr. KLINE of Minnesota. Mr. Speak- rein in the greed of private insurance they got sick or hurt, lost their insur- er, at this time it is my pleasure to companies that continue to raise pre- ance, and then could not pay medical yield 2 minutes to the gentleman from miums at the expense of the American bills. I listened as hospitals discussed Kentucky, the ranking member of the people. This legislation has very good the uninsured’s costs to New Hamp- Higher Education, Lifelong Learning, aspects in it. One of them is, finally, shire taxpayers. Here is the cure. and Competitiveness subcommittee, after 10 years of neglect by a Repub- For the late Donald Long of Ray- lican majority and administration, In- Mr. GUTHRIE. mond, who told me he paid $500 for pre- Mr. GUTHRIE. Mr. Speaker, I have dian health care is part of this legisla- scriptions every 3 months because of always liked to describe the process I tion, and this health care brings nec- the doughnut hole, thank you. I heard have seen in the last few weeks of try- essary and increased resources to In- you and all seniors. I heard Sandra Gagnon of Man- ing to put a bill together like putting dian Country. We begin to deal with health dispari- chester, who has a chronically ill a puzzle together, but forcing pieces to- ties in this legislation, which we have daughter. Now, no more preexisting ex- gether and trying to make them fit. not done in the past. I am proud to sup- clusions. And in the end, the puzzle doesn’t have port this legislation. It is not just a For the families in New Hampshire a complete picture. And one of the step forward; it is a historic leap into and across America, I vote ‘‘yes’’ for pieces they are trying to make fit to bringing to the American people a nec- you. keep this under $1 trillion, is what the essary reality, which is health care. Mr. KLINE of Minnesota. Mr. Speak- score is; but what we are not men- The SPEAKER pro tempore. The er, I yield myself the balance of my tioning is the incredible unfunded man- time of the gentleman has expired. time. date that we were placing on our The SPEAKER pro tempore. The gen- States. b 2045 tleman is recognized for 2 minutes. Just a couple of years ago I was a Mr. KLINE of Minnesota. Mr. Speak- Mr. KLINE of Minnesota. Mr. Speak- State senator. And tonight, State sen- er, could I inquire as to the time? er, earlier this month President Obama ators in Kentucky, my former col- The SPEAKER pro tempore. The gen- said, ‘‘Everything there is to say about leagues, are meeting together to try to tleman from California has 93⁄4 minutes health care has been said, and just close a billion-dollar budget gap. And remaining. The gentleman from Min- about everyone has said it.’’ what does this bill do? This bill puts a nesota has 3 minutes remaining. Perhaps he is right. Perhaps every- $30 billion unfunded mandate by CBO Mr. KLINE of Minnesota. Mr. Speak- one in Washington has said all there is estimates onto our States. er, then at this time I am pleased to to say. The lines have been drawn, and To the south of Kentucky, Phil yield 1 minute to the gentlewoman the number of undecided votes is dwin- Bredesen, a very respected Democratic from Illinois, a senior member of the dling. But perhaps it is time for Wash- Governor of Tennessee, says this is the Education and Labor Committee, Mrs. ington to stop talking and start listen- mother of all unfunded mandates. And BIGGERT. ing.

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00055 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1874 CONGRESSIONAL RECORD — HOUSE March 21, 2010 I am listening to the calls coming Texas (Mr. HINOJOSA), the Chair of the Mr. GEORGE MILLER of California. into my office, 13–1 against this legisla- Higher Ed Subcommittee. Mr. Speaker, I yield for the purposes of tion. I am listening to residents of Min- Mr. HINOJOSA. Mr. Speaker, I rise a unanimous consent request to the nesota’s Second Congressional District, today in full support of this reconcili- gentlewoman from the District of Co- who told me during a town hall last ation legislation, to say that we have lumbia (Ms. NORTON). week 72 percent of them are opposed to an extraordinary opportunity today to (Ms. NORTON asked and was given this bill. I am listening to small busi- improve the quality of life for millions permission to revise and extend her re- ness owners in my State and around of Americans, for the 32 million chil- marks.) this Nation who are paralyzed by the dren and families who are uninsured, Ms. NORTON. For the tax-paying fear of new mandates, job-killing taxes, and for students and workers who residents of the District of Columbia, I crushing Federal deficits, and more dream of pursuing higher education rise in strong support of the health government control. and acquiring the skills needed to ac- care reform bill before us today. I am listening to the thousands of cess 21st century jobs. Mr. Speaker, if I could cast a vote on behalf citizens who traveled to our Nation’s As subcommittee chair for Higher of the residents of the District of Columbia, on capital this weekend to tell us in no Education, I am proud to say that final passage of the health care bill before us uncertain terms they want us to kill today Congress will invest billions of today, I would cast a critical ‘‘aye.’’ Unfortu- the bill. I am listening, and what I am dollars to increase accessibility and af- nately, however, the D.C. Voting Rights Act, hearing is the American people shout- fordability in higher education for our like most bills this year, is in line behind health ing ‘‘stop.’’ Nation’s students and workers. This care reform. Fortunately for me, however, the They want us to start over. They landmark legislation provides $36 bil- most important point of contribution to a bill is want health care reform we can afford. lion in Pell Grant scholarships over 10 usually not when the work is done, and all that They want reform that will bring down years. It provides $2 billion of moneys needs to be done is to register your vote for costs without sacrificing quality or for our Nation’s community colleges, the majority. The most critical point in this leg- personal freedom. Mr. Speaker, they and $2.55 billion for our minority-serv- islation was when it was being crafted. I be- want us to say ‘‘no’’ to this bill today ing institutions of higher learning, in- lieve that the many hours I have put into the so we can come back and do better to- cluding HSIs and HBCUs. By moving to health care bill to ensure that it served D.C. morrow. the Federal Government’s direct loan residents have been more than worth it. For There is no question that there are program, we will put the best interests example, beyond the many benefits for all Members in this body, Republicans and of students first and make college Americans in the bill, D.C. will be relieved of Democrats, who are ready to go to loans more reliable and affordable for the $50 million it has generously used to fund work on a much improved bill. students and families. its D.C. Health Alliance for people who do not The die has not yet been cast. It is Mr. GEORGE MILLER of California. qualify for Medicaid, but cannot afford health not too late. I urge my colleagues: Lis- I yield 1 minute to the gentleman from insurance, a cost seldom picked up by other ten to the American people. Vote ‘‘no.’’ Massachusetts (Mr. TIERNEY), a mem- states. Mr. Speaker, this bill specifically benefits my Vote ‘‘no.’’ ber of the committee. Mr. TIERNEY. Mr. Speaker, today is I yield back the balance of my time. constituents in many ways, particularly the fol- an opportunity for this body to stand Mr. GEORGE MILLER of California. lowing: up for middle class families and small For the 62 percent of D.C. residents who al- I recognize the gentlewoman from Ne- businesses. ready have private health insurance, but are vada (Ms. TITUS), a member of the com- Today, by passing this bill, no family facing soaring insurance costs and could be mittee, for 1 minute. will have to worry that their 20-some- dropped at the whim of an insurance com- Ms. TITUS. For over 1 year, I have thing-year-old child will have a serious pany, the bill will reign in insurance costs by listened to the voices of District 3 and condition and not be covered or ever be restricting administrative expenses, profits, heard heartbreaking stories of children refused coverage in their lifetime due and overhead; prohibit insurance companies denied coverage because of a pre- to a preexisting condition. Insurance from denying coverage based on pre-existing existing condition, small business own- companies will no longer be able to conditions; prohibit annual and lifetime benefit ers who can’t afford to insure their em- limit coverage annually or over a life- caps; and prohibit insurance companies from ployees, and single moms who have lost time just when serious conditions re- dropping coverage when a person becomes their jobs and their insurance. They quire care. They won’t be able to re- sick. are the reasons I am voting for reform. scind coverage in the middle of cancer For the 134,000 uninsured families and In District 3 alone, reform will im- or diabetes care, and they will have to 17,300 small businesses, the bill will provide prove coverage for more than 600,000 spend a reasonable portion of premium tax credits to buy affordable insurance at people. It will strengthen Medicare for dollars on actual health services. group rates through the new health insurance 120,000 seniors and close the prescrip- We will be able to see our seniors af- exchanges that will be established, or for indi- tion drug doughnut hole. It will create fording both their groceries and their viduals with incomes below 133 percent of the health care tax breaks for over 200,000 prescription medicines because we will poverty line, through expansion of Medicaid. families and 17,000 small businesses, close the so-called doughnut hole in For the 75,000 seniors receiving Medicare, and lets 72,000 young adults stay on their current coverage, and we will ex- the bill will add free preventative and wellness their parents’ policy. tend the life of Medicare for 9 years care, improve primary, coordinated, and nurs- Insurance companies and others op- even as we improve its coverage. ing home care, and provide a $250 rebate this posed to reform have spent over $1.3 Small business employers and em- year and 50 percent discounts on brand name million in southern Nevada, but I won’t ployees will be better able to afford drugs beginning next year to the 3,300 seniors be intimidated. Today, as I have al- health care and will pay less in admin- who have fallen through the donut hole and ways done, I am standing up for what I istrative costs while having the choices are forced to pay the full cost of prescription believe is in the best interest of my large companies and Federal employees drugs, while closing the hole within 10 years. constituents. As has been said, it is the have now. For 67,000 young adults in the District, the price of leadership to do the thing you All this, Mr. Speaker, and we will be bill will allow them to stay on their parents’ believe has to be done at the time it making the largest pay-down on the plan until age 26 and allow them to purchase must be done. Now is the time to get it Federal deficit in quite some time, re- affordable policies until age 30. done and pass health care reform. ducing our debt by over $1 trillion in For the 5,600 D.C. individuals with pre-exist- The SPEAKER pro tempore (Mr. PAS- the next two decades. ing conditions, the bill will ensure they are not TOR of Arizona). The gentleman from No bill is perfect, but this bill is an denied affordable coverage. Wisconsin (Mr. RYAN) is recognized for enormous improvement of the status Families who purchase insurance through 10 minutes as a designee of the minor- quo. the health insurance exchange or are insured ity leader. ANNOUNCEMENT BY THE SPEAKER PRO TEMPORE by small businesses will no longer face bank- Mr. RYAN of Wisconsin. I reserve the The SPEAKER pro tempore. The ruptcy due to health care costs not covered by balance of my time. Speaker would remind Members to insurance, because the bill will cap out-of- Mr. GEORGE MILLER of California. heed the gavel at the expiration of pocket costs at $6,200 for individuals and I yield 1 minute to the gentleman from their time. $12,400 for families.

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00056 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1875 For District of Columbia health care pro- Two years ago, during a telephone townhall dents. This bill will close the ‘‘donut hole’’ for viders, the bill will provide up to $54.6 million with my constituents, one of my neighbors in 94,000 seniors, and extend the life of Medi- for 42 D.C. community health centers, and will Burbank told me that her young daughter had care. Further, we act tonight in a fiscally re- reduce the burden on uncompensated care by become ill. Our children played together in sponsible manner, reducing the deficit by over $69 million at the District’s hospitals and other preschool, and they lived just a few doors $1.3 trillion during the next two decades. health care facilities. down. When her daughter became sick, they Tonight, we make it illegal to deny health I am particularly pleased about the benefits were able to get her the health care she need- coverage to the 15,000 constituents in my dis- that will be available to my constituents as ed through a program called Healthy Families. trict with pre-existing conditions. We ensure soon as the bill is signed. For individuals, She was now, thankfully, all better. that the costs of health care won’t threaten there will be coverage for early retirees, 55– But now, my constituent told me, she herself their family’s finances, that their doctor is paid 64; coverage for young adults up to age 26 on was ill. She and her husband were both self- for making them well and not ordering unnec- parents’ policies; preventative care for those employed and could not afford health insur- essary tests, and that their health care pre- receiving Medicare and for others, now under ance, and she was scared to death to get her miums are spent on actual care, not paying for private plans; first steps to close the donut illness treated at the emergency room. Her paperwork and red tape. hole, coverage for residents with pre-existing question to me that night was: ‘‘Is there any I have two young children, and I cannot conditions; and tax credits for small business hope for families like mine?’’ imagine the dread that a parent must feel who employees. For many of my constituents, the The answer tonight is ‘‘yes.’’ There is now has a sick child for whom they cannot provide elimination of abuses will be the most impor- hope for millions of self-employed Americans care. That is an agony no parent should ever tant parts of the bill, including no more can- who cannot afford health care, and millions know. Not here. Not in America. I have had cellation of policies when residents get sick; more who are small business people strug- one steady guide through my years in Con- no discrimination against children with pre- gling to provide health care for themselves gress, and it is my two children. When they existing conditions; no lifetime coverage limits; and their employees. And there is hope for are old enough to know of my work in Con- no annual limits on new plans; and requiring millions of others who have pre-existing condi- gress, I want them to be proud of what their 80 percent of premiums for individuals and tions and cannot obtain health insurance. And father did when he had a chance to serve this small groups, and 85 percent of large plan for millions of seniors who have fallen through great Nation. And I believe they will be proud premiums, to be spent on the insured. Other the donut hole in their prescription drug cov- of me for casting my vote to provide health critical provisions that will benefit many D.C. erage. Because tonight’s bill will address the care for millions who do not have it, just as I residents are the funds to double the number needs of each and every one of these Ameri- am proud of the generation who went before of patients the city’s 42 community health cen- cans who are struggling to afford the coverage and provided health care for millions of sen- ters can accommodate, and funding for train- they have, or find health insurance when they iors when they had the courage to pass Medi- ing more primary care doctors. are without. care. The SPEAKER pro tempore. The gen- Our health insurance system is intrinsically I strongly believe that access to affordable, tleman will be charged time. linked to our Nation’s and California’s eco- quality, stable health care is the key to a pro- Mr. GEORGE MILLER of California. nomic recovery. There are now more than 30 ductive work force, small business innovation, Mr. Speaker, I yield for the purposes of million American citizens who do not have and the economic as well as health security of a unanimous consent request to the health insurance coverage, and every day, our families and Nation, and I’m proud to vote gentlewoman from California (Ms. ZOE 14,000 Americans lose their coverage. In fact, for this bill. LOFGREN). Californians are more likely to be uninsured Mr. GEORGE MILLER of California. (Ms. ZOE LOFGREN of California than most Americans—over 7 million Califor- Mr. Speaker, I yield for the purposes of asked and was given permission to re- nians are uninsured this year. a unanimous consent request to the vise and extend her remarks.) Millions of Americans now receive their care gentlewoman from California (Mrs. Ms. ZOE LOFGREN of California. Mr. at the emergency room, and millions more DAVIS). Speaker, I rise in support of the bill. must make the difficult choice of whether to Mrs. DAVIS of California. Mr. Speak- I’m proud to stand on the floor of the House pay their medical bills or pay their mortgage er, I rise in support of health care re- of Representatives today to cast my yes vote because they cannot afford to do both; two- form—finally. for this historic bill. I vote yes for the nearly thirds of all bankruptcies and half of all fore- When people are asked why they chose 50,000 currently uninsured residents of the closures are a result of a health care crisis in their profession, so many say it’s because 16th California Congressional District who will the family. they wanted to make a difference. now be eligible for health insurance. I vote yes This recession has highlighted wide and We have the unique opportunity and honor for the 6,000 seniors in my district who will no growing gaps in our health care system. Fami- to do just that. Passing healthcare reform will impact our longer be subject to the donut hole in Medi- lies lose their insurance coverage when a par- constituents in almost all aspects of their lives. care Part D. I vote yes for the 55,000 young ent in the household becomes unemployed, Good health is one of the most important adults in the 16th District who will now be able and too many parents without employment are things a person can have—there is truth in the to extend their coverage under their parent’s falling through those widening cracks—unable saying that it is more valuable than all the existing insurance. I vote yes for the roughly to afford COBRA, ineligible for public cov- riches in the world. 15,000 small businesses in the 16th District erage, and precluded by high premiums and/ The bill we’re passing isn’t just about reduc- who will be able to extend coverage to their or pre-existing conditions from obtaining pri- ing sky-rocketing premiums or putting patients employees because of the tax credits in this vate insurance. ahead of insurance companies—it’s about the bill. I vote yes for the 800 families in the 16th Collectively, as a Nation, we spend almost total outlay for families when it comes to pro- District who every year are forced to file for twice as much per person on health care as viding for both basic and high risk care. bankruptcy due to medical bills. I vote yes be- any other country, or about 17 percent of our Having affordable and certain health insur- cause this legislation will reduce the deficit by gross domestic product, and this number is ance translates not only to better health care $130 billion over the next 10 years and by growing every year far faster than inflation. but to better financial security so people can some $1.3 trillion over the second decade. Tonight, I’m voting to pass legislation that save money and use it for the betterment of Simply put, I vote yes because it is the right will substantially reform the health insurance their families. thing to do and because my constituents over- industry and practices, extend quality cov- It means Americans can take the job they whelmingly demand it. erage to millions of Americans, and hold down want, not just the job with healthcare. Mr. GEORGE MILLER of California. national, public, and private health care costs. And it means they can strike out on their Mr. Speaker, I yield for the purposes of This bill will help provide stable coverage that own and start the new businesses that spur a unanimous consent request to the cannot be taken away and won’t be lost when our economy. gentleman from California (Mr. you change jobs, and will provide additional We are making a difference as we do this SCHIFF). insurance choices in an invigorated and com- for the American people. (Mr. SCHIFF asked and was given petitive marketplace. I truly appreciate my constituents whether permission to revise and extend his re- In my district alone, this bill will provide tax they are for or against this measure, and I marks.) credits and financial assistance to over thank all of them for sharing their stories with Mr. SCHIFF. Mr. Speaker, I rise in 135,000 families and 15,000 small business me. support of this historic health care re- owners in order to help them afford coverage, Mr. RYAN of Wisconsin. Mr. Speaker, form legislation. and extend coverage to 80,000 uninsured resi- I yield 2 minutes to the vice ranking

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00057 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1876 CONGRESSIONAL RECORD — HOUSE March 21, 2010 member of the Budget Committee, the threatens to bankrupt the Federal Gov- vate product—government approved— gentleman from Texas (Mr. ernment and every other level of gov- as a price of U.S. citizenship. This HENSARLING). ernment, and it is a system that is al- moves far beyond regulating economic Mr. HENSARLING. Mr. Speaker, the ready bankrupting businesses, families activity into the realm of regulating vote we take tonight very well may un- and individuals. inactivity. alterably change the role of govern- Those who stand in the way of reform If we allow that Congress has this au- ment in a society whose most cher- are protecting this system. To do noth- thority under the Constitution, then ished birthright is that of personal ing is to ensure a future of ever esca- there is no limit whatsoever of Wash- freedom. lating rates, slashed benefits, and, ington’s ability to micromanage our There are so many reasons to oppose most tragically, illness and disease lives. In the future, if Congress feels this legislation. Taxpayer-funded abor- that go untreated. our car industry needs a boost again, tions, the sleazy backroom deals that The bill before us is not perfect, but they can require us all, once again, to brought us the Cornhusker kickback, it does enable us to begin to take ac- purchase a car from GM. That is not the Louisiana purchase, the pharma- tion on the most pressing issues that exactly what our Founding Fathers ceutical payoff, one-half trillion dol- affect the hardworking families we rep- had in mind. lars in tax increases on an economy resent. Thirty-seven States have already where millions have lost their jobs and In my district alone, 24,000 uninsured filed legislation to challenge this bill. can still find no gainful employment. individuals will get coverage, 97,000 Two States have already passed laws As a member of the House Budget families will receive tax credits to de- threatening lawsuits if this bill passes Committee, let me give you one more: fray the cost of coverage, 20,000 busi- tonight. One State lawmaker has We can’t afford it. Our government nesses will receive tax credits to pro- pointed out that that’s two-thirds of can’t even pay for the promises it has vide their employees with coverage, the States of this great country, made current generations, much less and 49,000 young adults will be able to enough States to change the Constitu- future generations. remain on their parents’ policies. tion. In addition, there’s another reason it After giving us the largest deficits in On behalf of these people and the mil- should be rejected. It’s because it puts American history, after proposing to lions like them, let’s pass this bill to- us hopelessly in debt. Democrats assert triple the national debt in the next 10 night. that their bill would reduce the deficit years, Democrats today want to add Mr. GEORGE MILLER of California. over the next 10 years, and more there- $2.6 trillion of new spending to the Fed- I yield 1 minute to the gentlewoman after. Utter nonsense. As the ranking eral budget, costing every household from Wisconsin (Ms. MOORE). member has repeatedly pointed out, $22,000. That is more money to borrow Ms. MOORE of Wisconsin. As a mem- there are budget gimmicks in here and from the Chinese, more bills to send to ber of the Budget Committee, I have double counting galore. Your very own our children and grandchildren. Mr. had the opportunity to hear the most actuaries from the HHS, what do they Speaker, you cannot improve the specious, inaccurate, contradictory, say about that? They say that the bill health care of a Nation by bankrupting and downright laughable arguments is ‘‘unrealistic.’’ Furthermore, it would its children. against health insurance reform. ‘‘jeopardize access to care’’ for seniors I have seen the Democrats’ Congres- Take, for example, the argument sional Budget Office letter about cost. citizens. that we need to start over because the So, then, what can we count on after Garbage in, garbage out. When you put Congressional Budget Office score had this massive program passes and we facts in, you get facts out. My Congres- been done 17 months earlier and now have $2.5 trillion in additional spending sional Budget Office letter says the was old and stale. And, oh, by the way, at an 8 percent growth rate? Think program will add to the deficit. the debate has dragged on for 17 about it. We can’t even pay our own But even more than cost, this is real- months. Yet, the minority simulta- debts today. Please, don’t add another ly a debate about who will control the neously complains that somehow we unconstitutional, economic burden to health care resources of this Nation are hurrying and ramming the bill this and future generations. and who will control the health care through. Vote down this bill. decisions of our families. If we pass Once the CBO score was recalculated Mr. GEORGE MILLER of California. this bill, we will wake up one day only demonstrating phenomenal deficit re- I yield to the gentleman from Texas to find that when our loved ones be- duction, the complaint became that (Mr. GENE GREEN) for the purpose of a come ill, they will wait weeks, perhaps the CBO is playing number tricks. Of unanimous consent request. months, to see a mediocre doctor of the course, the minority trusts CBO when (Mr. GENE GREEN of Texas asked government’s choosing, only to be told the scores work for them. and was given permission to revise and by that same doctor that he cannot The minority’s plan is to allow insur- extend his remarks.) help because his treatment must be ance premiums to rise unregulated by Mr. GENE GREEN of Texas. Mr. limited by the government protocol. government intervention, let a family Speaker, I rise in support of H.R. 3590 In America, we must never confuse of four’s premiums double every dec- and also H.R. 4872. the social safety net with the slippery ade, and end Medicare as we know it. Mr. Speaker, I rise in strong support of H.R. slope to socialism. b 2100 3590, the Patient Protection and Affordable When it comes to the health care of Care Act and H.R. 4872, the Reconciliation my family, when it comes to the health If the health insurance reform debate Act of 2010. care of my country, I reject the hubris wasn’t so serious, these arguments We are in desperate need of health care re- and arrogance of government social en- would be laughable. form in the 29th District in Texas. We have gineering, and I embrace the afford- Mr. RYAN of Wisconsin. At this one of the highest number of uninsured indi- ability and portability that comes by time, Mr. Speaker, I’d like to yield 2 viduals in our country where nearly 43 percent preserving the liberties of the Amer- minutes to gentleman from New Jersey of the residents are uninsured. If enacted, ican people. (Mr. GARRETT). H.R. 3590 and H.R. 4872 would provide insur- Mr. GEORGE MILLER of California. Mr. GARRETT of New Jersey. Mr. ance coverage to 95 percent of all Americans I yield 1 minute to the gentleman from Speaker, I rise in strong opposition to and for 223,500 currently uninsured residents New York (Mr. BISHOP), a member of this bill for two very important rea- in the 29th district. the committee. sons. First, I believe that this bill fun- It will also improve the employer based cov- Mr. BISHOP of New York. Mr. Speak- damentally violates the U.S. Constitu- erage for 217,000 residents in my district. er, over the course of this long and pas- tion and it will be found unconstitu- Also, approximately 177,000 families and sionate debate, amidst the angry and tional once it gets its way through the 14.600 small businesses will receive tax cred- at times even hateful rhetoric, amidst courts. its and other assistance to help them afford the misinformation of scare tactics, While Congress is given the power health insurance coverage under these bills. there exists one simple truth, and that under the Constitution to regulate The legislation before us today will give all truth is that the current system is interstate activity, never before have individuals the ability to access quality afford- unsustainable. It is a system that we had to be required to purchase a pri- able health insurance, and approximately

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00058 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1877 34,500 residents in our district will no longer Mr. Speaker, today, history was made. Indeed, this bill is about freedom. be denied coverage for preexisting conditions Today was for Sharon, from St. Louis, Every American will now have the free- and their coverage cannot be capped or whose husband has Parkinson’s Disease, and dom from control of insurance compa- dropped when they get sick. whose medication costs quadruple every May, nies and their record profits and will The legislation before us today also ensures when he falls into the donut hole. have the freedom to access the care no more co-pays for preventive care, no more Today was for Mary, whose has lived in fear they need, when they need it. Our sen- yearly caps on what the insurance company of losing her coverage because she knows her iors will have the freedom to enjoy will cover, and provides premium subsidies for son will be refused coverage because of his Medicare for years to come, and they those who need them. preexisting condition. will have the freedom from worrying We will also improve Medicare benefits for Today was for Michelle, who can’t afford about the cost of their prescription 56,000 seniors in our district by closing the health coverage for the employees in her drugs. Part D donut hole over time and immediately small bookstore. The bottom line for me, Mr. Speaker, provide seniors who are in the donut hole with Today was for Stacy, whose grandmother is whether the people in the capital re- a $250 credit in 2010. died because she didn’t have access to pre- gion of New York will be better off The legislation also improves seniors’ bene- ventative care, leaving her family devastated with these reforms, and my answer is fits under Medicare by providing free preven- and her grandfather broke from medical debt. yes. Absolutely, yes. tive and wellness care, improving primary and An American President once said, ‘‘There Mr. GEORGE MILLER of California. coordinated care, and enhancing nursing has long been a need to assure every Amer- Mr. Speaker, I yield to the gentle- home care. The bill also strengthens the Medi- ican financial access to high quality health woman from Texas (Ms. JACKSON LEE) care Trust Fund, extending its solvency from care. As medical costs go up, that need grows for the purpose of a unanimous consent 2017 to 2026. more pressing. Now, for the first time, we request. H.R. 3590 and H.R. 4872 will rein in rising have not just the need but the will to get this (Ms. JACKSON LEE of Texas asked health costs for American families and small job done.’’ and was given permission to revise and businesses—introducing competition that will That President was Richard Nixon in 1974. extend her remarks.) drive premiums down, capping out-of-pocket Indeed, the effort to make sure quality, af- Ms. JACKSON LEE of Texas. In the spending. fordable health care is available to all Ameri- name of my mother, Ivalita Jackson, I According to the Congressional Budget Of- cans dates back nearly 100 years, when affirmatively support this bill for all of fice, CBO, this legislation is fully paid for by Teddy Roosevelt called for reform, a call America. eliminating waste, fraud, abuse, and excessive Mr. Speaker, I have the great honor and echoed by Democratic and Republican Presi- profits for private insurers. Nationwide, these privilege to rise in strong support of H.R. dents alike—Eisenhower, Kennedy, Nixon— health reform bills will reduce the deficit by 4872, ‘‘The Health Care & Education Afford- and even Missouri’s own Harry S. Truman. over $130 billion over the next 10 years and ability Act of 2010,’’ a bill that will make health Today, we have finally fulfilled this century- by about $1.2 trillion over the second decade. care affordable for the middle class, provide old mission. Texas will also benefit from the legislation security for seniors, and guarantee access to No longer will older Americans face financial before us today. The Texas Department of health insurance coverage for the uninsured— ruin because they can’t afford to purchase life- Health and Human Services, TDHHS, re- while responsibly reducing the federal deficit saving medicine. leased estimates that H.R. 3590 and H.R. over the next decade and beyond. I would like No longer will parents fear that their children 4872 will cost the State $24 billion over the to thank President Obama and the leadership will be denied coverage because they have a next 10 years—this is inaccurate. in the House and Senate for guiding us preexisting condition. These estimates are incorrect because they through this journey. do not include the federal expansion and 100 No longer will small businesses be forced to Mr. Speaker, when I stand here today and percent contribution of Medicaid payments choose between health care or hiring addi- reflect upon what we are about to embark until 2018. Right now Texas accounts for 7 tional employees. upon, I cannot help but think of some of the percent of Medicaid spending nationally. If And no longer will people die, in the wealthi- last words that the Great Senator Edward those levels stay the same after the State- est country in the world, simply because they Kennedy shared in his letter to President based exchanges are set up, the cost to the cannot afford care. Obama. The Senator said, ‘‘And so because That all ends today, with the passage of this State of Texas would be $1.4 billion and not of your (Obama’s) vision and resolve, I came bill to stop the insurance companies from de- $24 billion. Additionally, the bill will reduce the to believe that soon, very soon, affordable nying care to people who are sick and rein in expenses related to uncompensated care in health coverage will be available to all, in an rising costs to make health care more afford- our State by $15 million annually. America where the state of a family’s health Currently, there are 5.9 million uninsured in- able for families and small businesses, giving will never again depend on the amount of a dividuals in Texas. Under H.R. 3590 and H.R. everyone access to the kind of health care family’s wealth. And while I will not see the 4872 nearly all of those individuals will have choices available to Members of Congress. victory, I was able to look forward and know health insurance and most of it will be funded It’s about time. We have a healthier Amer- that we will—yes, we will—fulfill the promise of at federal expense—not at the expense of ica. A healthier America means a stronger, health care in America as a right and not a Texas. In fact, given the size of the State it is more productive, more competitive America. privilege. Well, Senator, your life’s work shall Mr. GEORGE MILLER of California. entirely possible that Texas will receive the today be proven to not be in vain. Mr. Speaker, I yield 1 minute to the largest amount of federal investment of any Though it has been a long journey to get to gentleman from New York (Mr. TONKO). other State and create many new jobs in the this place and many have suggested that we Mr. TONKO. Today we answer the health care sector. need to start over and wait until some other The time for health reform has come. Health clarion call from the American people time in the future to address the health care insurance premiums are growing three times to fix our Nation’s broken health care crisis. In the words of the great civil rights faster than wages and last year, more than system. Today is the day we deliver on leader, Dr. Martin Luther King, Jr., that ‘‘we half of Americans postponed medical care or that promise with a vote as historic as have also come to this hollowed spot to re- skipped their medications because they the creation of Social Security and mind America of the fierce urgency of now.’’ couldn’t afford it. Medicare. We cannot wait. We will not wait any longer to I urge my colleagues to vote in favor of the Today I will cast my vote in favor of provide the citizens of this great Nation access legislation today not only for my constituents, putting the control back into the to affordable, quality health care. but for all Americans. hands of American families and small Today when we pass this bill, it will be a Mr. GEORGE MILLER of California. businesses and their doctors. No longer historic day not only for tens of millions of un- I yield for the purpose of a unanimous will insurance companies be able to insured Americans, but also for our great Na- consent request to the gentleman from hold people hostage by raising rates tion. As Speaker PELOSI has reiterated, we as Missouri (Mr. CARNAHAN). and abuse sick people by dropping and Members of Congress, are ‘‘humbled to stand (Mr. CARNAHAN asked and was denying coverage. Small businesses here at a time when we can associate our- given permission to revise and extend will no longer see their premiums sky- selves with the work of those who passed So- his remarks.) rocket and will not have to make the cial Security, those who passed Medicare, and Mr. CARNAHAN. Mr. Speaker, I rise painful decision to stop offering health now we will pass health care reform.’’ in support of this important health insurance to their employees because Many parallels exist between that time in care package for America. the costs have climbed too high. history and today. Throughout this journey, we

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00059 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1878 CONGRESSIONAL RECORD — HOUSE March 21, 2010 have listened to a parade of Republicans warn Strengthen consumer protections and rein in brand-name and generic drugs to close the that this bill will bring the downfall of American insurance company abuses. donut hole by 2020; society, of the American way of life. This, how- Give millions of Americans the same types Providing new, free annual wellness visits, ever, is not the first time that the Republicans of private insurance choices that members of and eliminates out-of-pocket copayments for have been on the wrong side of history. In an Congress will have—through a new competi- preventive benefits under Medicare, such as interview in 1975, David L. Kopelman, who tive health insurance market that keeps costs cancer and diabetes screenings; played a prominent role in the early adminis- down. Providing better chronic care, with doctors tration of the Medicare Program, remarked Hold insurance companies accountable to collaborating to provide patient-centered care that his colleagues were often criticized by Re- keep premiums down and prevent denials of for the 80 percent of older Americans who publicans. ‘‘Communist,’’ he recalled, ‘‘was the care and coverage, including for pre-existing have at least one chronic medical condition designation all too liberally applied to anyone conditions. like high blood pressure or diabetes; with a progressive idea. Well, after all, when Improve Medicare benefits with lower pre- Improving Medicare payments for primary we went around making contact with employ- scription drug costs for those in the ‘‘donut care which will protect access to these vital ers in those early years that was the designa- hole’’; it also provides better chronic care, free services; tion not delicately applied by many, if not most preventive care, and nearly a decade more of Reduces overpayments to private Medicare of them, to the social security program. It must solvency for Medicare. Advantage plans. Medicare currently overpays be some communist scheme foisted on the As President Obama says, ‘‘we must act private plans by an average of 14 percent. American people.’’ Alf Landon, the Republican now’’ and put American families and small This legislation reins in those overpayments to candidate for President in 1936, even cam- businesses, not health insurance companies, ensure a fair payment system that rewards paigned on the fact that not a dollar in social in control of their own health care. This bill will quality; security benefits would ever be paid. do exactly that. Many of my colleagues on the Encouraging reimbursing health care pro- Mr. Speaker, unfortunately, such ad other side of the aisle claim that we are pass- viders on the basis of value, not volume. The hominem attacks are as prevalent as ever. ing a bill that nobody really knows what is in bill includes a number of proposals to move The Republicans want you to believe that our it. Well, Mr. Speaker, let me just take a minute away from the ‘‘a la carte’’ Medicare fee-for- country is descending into an abyss of social- to list a few things that are in the bill. service system toward paying for quality and ism, but nothing could be further from the The bill provides quality, affordable health value while reducing costs for America’s sen- truth. Today, I am proud to support a bill that care for all Americans that: a iors. is distinctly American. We the people, Thomas Bars insurance companies from discrimi- The bill prevents chronic disease and im- Jefferson wrote in the Declaration of Inde- nating based on pre-existing conditions, health proves public health that promotes preventive pendence are endowed ‘‘with certain status, and gender. health care at all ages and improves public unalienable Rights that among these are Life, Provides Americans with better coverage health activities that help Americans live Liberty and the pursuit of Happiness.—That to and the information they need to make in- healthy lives and retrain the growth of health secure these rights, Governments are insti- formed decisions about their health insurance. care costs over time. The legislation elimi- tuted among Men, deriving their just powers Creates health insurance exchanges—com- nates cost-sharing for recommended preven- from the consent of the governed . . .’’ I be- petitive marketplaces where individuals and tive care, provides individuals with the infor- lieve that it is no coincidence that life is listed small business can buy affordable health care mation they need to make healthy decisions, first—for without it, the Founders realized, no coverage in a manner similar to that of big improves education on disease prevention and other rights can be realized. Over many years, businesses today. public health, and invests in a national preven- the millions of Americans who could not ac- Offers premium tax credits and cost-sharing tion and public health strategy. cess medical services were denied their right assistance to low and middle income Ameri- The bill improves health care workforce by to life—a life with access to quality and afford- cans, providing families and small businesses making key investments in training doctors able health care. with the largest tax cut for health care in his- and nurses and other health care providers. Let me set the record straight, this bill is tory. Currently, 65 million Americans live in commu- good for the American people and will go a Insures access to immediate relief for unin- nities where they cannot easily access a pri- long way to ensuring access to quality and af- sured Americans with pre-existing conditions mary care provider. An additional 16,500 prac- fordable care to those millions of Americans on the brink of medical bankruptcy. titioners are required to meet their needs. The who for far too long have been left out of the Creates a reinsurance program in support of legislation addresses shortages in primary health care equation. This health insurance re- employers who offer retirees age 55–64 health care and other areas of practice by making form legislation (the Senate bill as improved coverage. necessary investments in our Nation’s health by the Reconciliation Bill) that the House is Invests substantially in community health care workforce. Specifically, it will invest in considering today will not only ensure that centers to expand access to health care in scholarship and loan repayment programs Americans have access to quality, affordable communities where it is needed most. through the National Health Service Corps to health care, but will also significantly reduce Empowers the Department of Health and expand the health care workforce. The bill long term health care costs. The non-partisan Human Services and state insurance commis- also includes incentives for primary care prac- Congressional Budget Office (CBO) has deter- sioners to conduct annual reviews of new titioners and for providers to practice in under- mined that it will provide coverage to 32 mil- plans demanding unjustified, egregious pre- served areas. lion more people, or more than 95% percent mium increases. The bill provides for transparency and pro- of Americans, while lowering health care costs Expands eligibility for Medicaid to include all gram integrity by providing consumers with in- over the long term. This historic legislation will non-elderly Americans with income below 133 formation about physician ownership of hos- reduce the deficit by $138 billion over the next percent of the Federal Poverty Level (FPL). pitals and medical equipment companies, as ten years, with $1.2 trillion in additional deficit Replaces the so-called ‘‘Cornhusker’’ deal well as nursing home ownership and other reduction in the following 10 years with fair assistance for all states to help cover characteristics. The bill also includes provi- In the words of the great President John F. the costs of these new Medicaid populations. sions that will crack down on fraud, waste, Kennedy, ‘‘the voters selected us, in short, be- Maintains current funding levels for the Chil- and abuse in Medicare, Medicaid, SCHIP and cause they had confidence in our judgment dren’s Health Insurance Program (CHIP) for private insurance. It establishes a private, non- and our ability to exercise that judgment from an additional two years, through fiscal year profit entity to identify priorities in patient-cen- a position where we could determine what 2015. tered outcomes research that will provide doc- were their own best interest, as a part of the Increases payments to primary care doctors tors with information on how to best treat pa- nation’s interest.’’ in Medicaid. tients and end wasteful overspending. Mr. Speaker, while my colleagues on the The bill improves medicare by: This bill also improves access to innovative other side of the aisle claim that this bill will Adding at least nine years to the solvency of medical therapies and establishes a regulatory harm Americans, nothing could be further from the Medicare Hospital Insurance trust fund; pathway for FDA approval of biosimilar the truth. This bill will: Filling the Medicare prescription drug donut versions of previously licensed biological prod- Make health insurance affordable for middle hole. In 2010, Medicare beneficiaries who go ucts. class and small businesses—including the into the donut hole will receive a $250 rebate. The bill also provides community living as- largest middle class tax cuts for health care in After that they will receive a pharmaceutical sistance services and support that makes history—reducing premiums and out-of-pocket manufacturers’ 50 percent discount on brand- long-term support and services more afford- costs. name drugs, increasing to a 75% discount on able for millions of Americans by providing a

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00060 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1879 lifetime cash benefit that will help people with healthcare, we are actually talking about the Passage of this bill will be a critical first step severe disabilities remain in their homes and right to life—a life that includes access to in helping to reduce such health disparities. communities. CLASS is a voluntary, self-fund- quality health care. This bill will: ed, insurance program provided through the The bill contributes to reducing health dis- 1. Lower costs for minority families and pre- workplace. For those whose employers partici- parities. Minority communities are particularly ventive care for better health. Racial and eth- pate, affordable premiums will be paid through vulnerable to being left uninsured and under- nic minorities are often less likely to receive payroll deductions. Participation by workers is insured. In our current system, most people do preventive care. Vietnamese women, for ex- entirely voluntary. The Congressional Budget not choose to be uninsured but, instead, are ample, are half as likely to receive a pap Office confirms that the program, which has priced out of insurance. These people cannot, smear, and twice as likely to die from cervical been revised from earlier versions, is actuari- as free market proponents often argue, ‘‘Pull cancer as are Whites. Obesity rates are also ally sound. themselves up by their bootstraps.’’ Instead, high among certain minority groups. By ensur- The bill provides revenue provisions that: they and their families are too often cyclically ing all Americans have access to preventive Reduce the deficit in the next ten years and and systemically trapped in their economic sit- care and by investing in public health, health beyond. The bill is fully paid for with revenue uation. As a result, minority communities suf- insurance reform will work to create a system provisions that focus on paying for reform fer grave health disparities that would other- that prevents illness and disease instead of within the health care system. wise be limited but for lack of access to afford- just treating it when it’s too late and costs Tighten current health tax incentives, collect able and quality care. more. industry fees, institute modest excise taxes, According to a 2003 National Health Dis- 2. Provide greater choices and more afford- and slightly increase the Medicare Hospital In- parities Report released by the Agency for Re- able choices and competition. African Ameri- surance (HI) tax for individuals who earn more search Quality and Care: cans, Hispanics, and Asians are all more likely than $200,000 and couples who earn more Minorities are more likely to be diagnosed to need a referral in order to see a specialist than $250,000. The taxable base of the HI tax with late-stage breast cancer and colorectal and they are less likely to get coverage for is also broadened by including net investment cancer compared with whites. seeing a doctor outside of the insurance net- Patients of lower socioeconomic position are income. The HI tax increases will not only help work. Health insurance reform will create a less likely to receive recommended diabetic fund health care reform, but, when combined health insurance exchange so you can com- services and more likely to be hospitalized for with other provisions in the bill, will also ex- pare prices and health plans and decide which tend the solvency of the Medicare Trust Fund diabetes and its complications. When hospitalized for acute myocardial in- quality affordable option is right for you and by at least nine years to 2026. farction, Hispanics are less likely to receive your family. It will include a competitive public Include a fee on insurance companies that optimal care. option that increases choices and holds pri- sell high cost health insurance plans. The fee Many racial and ethnic minorities and per- vate insurers accountable. is designed to generate smarter, more cost-ef- sons of lower socioeconomic position are 3. Allow for quality, affordable health care fective health coverage choices. The reconcili- more likely to die from HIV. Minorities also ac- for minorities and eliminates discrimination in ation bill delays this new fee until 2018 so that count for a disproportionate share of new obtaining health insurance. Health insurance plans have time to implement reform and AIDS cases. reform will prevent any insurance company begin to save from its efficiencies. The use of physical restraints in nursing from denying coverage based on a person’s Change health care tax incentives by in- homes is higher among Hispanics and Asian/ medical history, including genetic discrimina- creasing penalties on nonqualified distributions Pacific Islanders compared with non-Hispanic tion which can disproportionately hurt minority from HSAs, capping FSA contributions, and whites. populations. standardizing the definition of qualified medical Blacks and poorer patients have higher 4. Make health care accessible to everyone. expenses. The industry fees and excise taxes rates of avoidable hospital admissions (i.e., African Americans, Hispanics, and Native reflect responsible contributions from health hospitalizations for health conditions that, in Americans are roughly twice as likely to be care stakeholders who will benefit from the ex- the presence of comprehensive primary care, uninsured as the rest of the population. By panded coverage of millions of additional rarely require hospitalization). providing health insurance choices to all Americans under health care reform. The bill This historic bill is particularly important for Americans and providing premium assistance also assesses a small excise tax on indoor minorities and women—who have gone with- to make it affordable, health insurance reform tanning services. out health care coverage for too long. In 2007, will significantly reduce disparities in accessing In total, the revenue provisions in the bill only 49 percent of African-Americans in com- high-quality health care. represent a balanced, responsible package of parison to 66 percent of non-Hispanic whites 5. Control chronic disease. Nearly half of Af- proposals that bend the health care cost curve used employer-sponsored health insurance, rican Americans suffer from a chronic disease, by putting downward pressure on health according to the Department of Health and compared with 40 percent of the general pop- spending, close unintended tax loopholes, and Human Services. During the same year, 19.5 ulation. Chronic illness is growing in other mi- promote tax compliance. percent of African-Americans in comparison to nority communities as well. Health insurance Mr. Speaker, who among us can say with 10.4 percent of non-Hispanic whites were un- reform includes a number of programs to pre- sincerity that the quality of one’s life, which insured. vent and control chronic disease, including in- certainly includes one’s health, is not heavily Hispanics have the highest uninsured rates centives to provide medical homes and chron- dependent upon the access to quality, afford- of any racial or ethnic group within the United ic disease management pilots in Medicare. able health care. According to the National States. In 2004, the Centers for Disease Con- 6. Promote primary care. By providing Academy of Sciences, Institute of Medicine, trol and Prevention reported that private insur- health insurance choices through a health in- there is a ‘‘consistent and statistically signifi- ance coverage among Hispanic subgroups surance exchange and investing in the primary cant relationship between health insurance varied as follows: 39.1 percent of Mexicans, care workforce (including scholarships and coverage and health outcomes for adults. 47.3 percent of Puerto Ricans, 57.9 percent of grants to increase diversity in health profes- These factors, in turn, improve the likelihood Cubans, and 45.1 percent of other Hispanic sions), health reform will make sure that all of disease screening and early detection, the and Latino groups. Americans have access to a primary care doc- management of chronic illness, and the treat- Health care reform also is critical to ensure tor so they stay healthier, longer. It will also ment of acute conditions . . . .’’ Recently, a that women have access to affordable health strengthen the system of safety-net hospitals study published in the American Journal of care coverage. An estimated 64 million and community health centers to ensure high- Public Health by researchers at Harvard Uni- women do not have adequate health insur- quality, accessible care. versity Medical School concluded that nearly ance coverage. About 1.7 million women have Health reform legislation will require any 45,000 excess deaths of Americans can be lost their health insurance coverage since the health care program to report on race, eth- linked each year to lack of health insurance. beginning of the economic downturn. Nearly nicity, gender, and socioeconomic status in According to the U.S. Census Bureau, 27 two-thirds lost coverage because of their order to better understand health disparities, million Americans live without health insur- spouse’s job loss. And nearly 39 percent of all and devote funding to addressing these ance, and an additional 1.1 million part-time low-income women lack health insurance cov- issues. workers lost their health insurance in 2008. erage. Women also are more likely to deplete The uninsured in Texas. The people of my Implementing this legislation will instantly im- their savings accounts paying medical bills home state of Texas, in particular, with 6 mil- prove the life expectancy of millions of Ameri- than men because they are more likely to be lion uninsured persons, and 26 percent unin- cans of all ages. It is impossible to put a price poor. This bill gives women access to the sured in my district, the 18th Congressional on that. When we talk about the right to health care that they need and deserve. District, have been hit especially hard when it

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00061 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1880 CONGRESSIONAL RECORD — HOUSE March 21, 2010 comes to lack of access to quality, affordable increase; in the Houston area, it was more and allows them to expand. My second care. than 50 percent. During this ten year period, amendment is extremely critical for minority And just what causes such a massive loss the number of hospital emergency depart- communities and high poverty. This amend- of health care coverage? Job layoffs are par- ments dropped by more than 12 percent na- ment would prevent physician safety-net hos- tially to blame especially in the face of the tionally. pitals from closing and preserves critical care economic downturn. Yet, we know that the un- Emergency rooms in Houston hospitals are access for impoverished communities and the insured problems existed way before the dev- routinely overcrowded and overused as disabled. astating recession. Many Americans continue throngs flock seeking care for ailments that My third amendment, supported by Physi- to be forced from their health care plans due may range from a heart attack or gunshot cian Hospital Association of America, would to decisions by insurance companies to put wound to an ear infection or toothache. Ambu- effectively prevent the closure of 230 existing profits over people. Policy cancellations rather lances pile up outside emergency rooms be- hospitals, save $2.9 billion in total payroll, than paying for expensive yet necessary med- fore unloading their patients. It’s reported that $608 million in federal taxes, $3.5 billion in ical treatment is just one of the many tech- a wait of an hour or two to move a patient trade payables, and preserves 62,000 full- and niques used by large insurance companies to from the ambulance to the ER is common in part-time jobs by striking all language that pro- rack up huge profits annually. Houston. David Persse, the Houston Fire De- hibits grandfathered facilities from expanding. According to the latest figures analyzing the partment’s medical director, confided with a During the ongoing healthcare debate, dis- profits of health insurance companies, 10 of reporter recently that the record wait to unload cussions about physician ownership of hos- the country’s largest publicly traded health in- an ambulance at Houston area hospital is six pitals have ignored the positive impact these surance companies enjoyed a rise in profits of hours. facilities have had on minority communities 428 percent, from 2000 to 2007. From filings Ben Taub, the Houston area’s pre-eminent and minority physicians. Physician-owned gen- with the U.S. Securities and Exchange Com- trauma care facility, has seen the brunt of the eral acute care hospitals, who have unprece- mission, it was revealed that in 2007, these in- problem. In a recent USA Today article, one dented amounts of minority owners, have al- surance companies alone generated $12.9 bil- Ben Taub nurse reported arriving to work one lowed Hispanic, Black, and Asian Americans lion in profit. That same year, the chief execu- morning to find ER patients waiting to be seen to enter into the field of hospital ownership. tive officers at these companies collected who arrived the day before, over 24 hours ear- The largest physician-owned hospital, Doctors combined total compensation packages of lier. ER overcrowding is so bad in the Houston Hospital at Renaissance, is over 50 percent $118.6 million—an average of $11.9 million area, that patients have called 911 from one minority owned. To help my colleagues understand what is each. That is 468 times more than what an ER to get to another, according one report. at stake, I would like to highlight some of average American worker made that year. When we pass this bill tonight, these Ameri- Since 2007, there has been a 10 percent in- these success stories: cans who have been flocking to emergency In Houston, St. Joseph’s Hospital, a full- crease in the uninsured rate in Texas alone. rooms for primary care will have another op- service general acute care center, is the only Today, 6,240,000 Texans are without even tion—affordable and accessible health care. hospital that serves one of the most income- basic health insurance. And this broken health The benefits to the 18th congressional dis- challenged and African-American sections of insurance system has cost the Texas econ- trict: In my district, the health care bill will: the city. Within the last few years, a for-profit omy dearly. This year, Texas lost $30 billion in Improve coverage for 279,000 residents with corporation abandoned this hospital and the productivity as a result of its millions of unin- health insurance. surrounding community. Physician ownership sured residents. Give tax credits and other assistance to up provided an avenue for it to stay open and Those in our state who are blessed to have to 186,000 families and 14,600 small busi- prevent a critical loss for the neighborhood. insurance coverage have in some ways been nesses to help them afford coverage. In South Texas, out-of-state corporations losers as well. Specifically, the average Texan Improve Medicare for 70,000 beneficiaries, forced over 700,000 Texans to travel more family pays insurance premiums of over $1000 including closing the doughnut hole. than 250 miles to receive life-saving medical a month. This figure is set to nearly double to Extend coverage to 180,500 uninsured resi- procedures. Decisions not to offer needed $1920.75 per month by 2019, that is, unless dents. services by out-of-state healthcare conglom- we succeed in passing health care reform leg- Guarantee that 27,600 residents with pre- erates and the lack of public or county hos- islation. Today, when we pass this bill, the existing conditions can obtain coverage. pitals, left patients with two options: go without people of Texas and all over this nation be- Protect 500 families from bankruptcy due to or to transfer to another facility up to 350 come winners. unaffordable health care costs. miles away. Income-challenged families who We know that many of our colleagues in this Allow 62,000 young adults to obtain cov- could not afford the travel were placed in great body do not want to reform the health care erage on their parents’ insurance plans. peril. Physician ownership enabled a group of system and are on the side of the big insur- Provide millions of dollars in new funding for local doctors to open a new hospital with ad- ance companies. We choose to stand on the 20 community health centers. vanced medical capabilities that reduced the side of the Americans who need our help. Reduce the cost of uncompensated care for need for travel to seek care. Doctors Hospital President Franklin D. Roosevelt said it best hospitals and other health care providers by at Renaissance, a 506-bed premiere general when he said, ‘‘the test of our progress is not $27 million annually. acute care center, now provides some of the whether we add more to the abundance of As we reach this great milestone today, I best care in the Nation and consistently has those who have much; it is whether we pro- am still reminded of the unfinished work that been recognized by Thompson Reuters as a vide enough for those who have little.’’ is left to do. We must ensure that physician- Top 100 Hospital in the Nation. While the state-wide numbers are shocking, owned hospitals are allowed to maintain oper- In the Chinatown section of Los Angeles, on the local level, the health care figures are ations that allow them to serve the most vul- California, the Pacific Alliance Medical Center even worse. The 18th Congressional District nerable and underserved communities. I am (PAMC), a 142-bed full-service hospital, has and the rest of Houston, account for 1.1 mil- committed to working with the Speaker’s office been the community’s main hospital for 140 lion of the state’s uninsured residents. Nation- and Senatorial leadership now that we are tak- years. This facility was purchased by a group ally, more than 15 percent are uninsured. In ing the first step in stemming the rising tide of of physicians 20 years ago after the existing Texas it’s nearly 24 percent. Here in Harris the many uninsured. The protection of physi- hospital board planned to close and demolish County, it’s 30 percent, according to state fig- cian-owned hospitals is an issue of national in- the facility. Physician ownership once again ures, the highest rate among the nation’s top terest. We have a lot of work to do as we provided an avenue for the hospital to stay 10 metropolitan areas. move toward the Senate and to the con- open and serve an at-risk community. So how do the million plus Houston resi- ference. I was gratified to meet with the I will continue to work on behalf of these dents without insurance company get health Speaker to discuss the continued protection of Americans and to to save physician-owned care—emergency rooms of course. Emer- the very viable physician-owned hospitals and hospitals that are currently treating patients or gency rooms have become the health care believe that we have a real opportunity to ad- under significant development, to ensure that providers of last resort for well over 100 mil- dress this issue in the very near future. Americans can continue to receive healthcare lion Americans annually. Over a 10 year pe- I offered three amendments that would have at the local hospitals they have come to de- riod from 1994 to 2004, ER visits on a national gone a long way to save physician-owned pend upon. Physician-owned hospitals take level saw an 18 percent jump, according to hospitals. My first amendment would have pre- care of patients covered by Medicare and the Centers for Disease Control and Preven- served physician-owned facilities that have a Medicaid, as well as patients who are unin- tion. The Texas Hospital Association reports greater percentage of Medicaid inpatient ad- sured or cannot pay for their care. They also that ERs in the state experienced a 33 percent missions than the state average in operation provide emergency departments access for

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00062 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1881 their communities. At a time when we are con- right to add a single operating room or proce- Luther King, Jr., I urge us to remember that cerned about the shortage of hospital beds in dure room to meet its community’s need. Dur- ‘‘in the process of gaining [life, liberty, and the the face of epidemics like the swine flu, my ing the moratorium on physician-owned hos- pursuit of life], we must not be guilty of wrong- amendment to this landmark bill will make pitals some years ago, Baylor wanted to add ful deeds. Let us not seek to satisfy our thirst sure no hospital is forced to shut its doors or a badly needed OB/GYN service at its Frisco, for freedom by drinking from the cup of bitter- turn away Medicare or Medicaid patients. The Texas, hospital. This service is a money-losing ness and hatred. We must forever conduct our benefits that will come from our efforts to pro- service, but there was no such service within struggle on the high plane of dignity and dis- tect physician-owned hospitals are far reach- many miles for those people—Baylor fulfilled cipline . . . we must rise to the majestic ing and will prevent any further losses to local the need. It was prohibited from adding this heights of meeting physical force with soul economies. Not only do physician hospitals service simply because the hospital had physi- force. deliver high-quality medical care to the pa- cians holding a minority of the ownership of Mr. Speaker, I urge my colleagues and I to tients they serve, they also provide much the hospital. After the moratorium was lifted, stand strong, support this bill on behalf of all needed jobs, pay taxes, and generate signifi- the service was added and is currently work- Americans. cant economic activity for local businesses ing at its capacity. Mr. GEORGE MILLER of California. and communities. Existing physician-owned Mr. Speaker, can we imagine witnessing an I yield myself the balance of my time. hospitals employ approximately 51,700 individ- impact, of no patient beds, 6- to 8-hour waiting (Mr. GEORGE MILLER of California uals, have over 27,000 physicians on staff, times, to extend even to 10-hour waiting asked and was given permission to re- pay approximately $2,421,579,312 in payroll times, turning emergency patients away at the vise and extend his remarks.) Mr. GEORGE MILLER of California. taxes and $512,889,516 in other federal taxes, door? Can we imagine the dramatic case, Mr. Speaker, I rise in support of this and have approximately $1.9 billion in trade when patients are not able to have access to truly historic and great legislation payables. Hospitals currently under develop- quality care? This is true of the most serious that addresses two of America’s great- ment would employ approximately 21,700 trauma, of the most serious medical cases. est troubles: the crushing cost and high more individuals. With approximately 50 physi- Physician-owned hospitals serve in many obstacles of obtaining both quality cian-owned hospitals, Texas leads the Nation cases at least 40 percent of the city’s popu- health care and a quality college edu- in the number of physician-owned hospitals. lation. I don’t just mean the city’s population. cation. Our Nation has suffered from We are discussing a population that is be- The Texas economy could lose more than our longstanding failure to make tween 500,000, which is the indigenous popu- $2.3 billion and more than 22,000 jobs. health care and college accessible to In my district, the 18th Congressional Dis- lation, and the population of 1.5 million that’s all American people. Americans have trict of Houston, Texas, St. Joseph Medical in the city every day. waited a long time for health insurance Center is a general acute-care hospital that When a hospital downsizes in a particular city, it extends beyond the boundaries of that reform, nearly a hundred years. treats all patients. In fact, its 40 percent Med- Today, Congress and President city, and in doing so, with this hospital being icaid patient population is double the average Obama will deliver on a central prom- downsized, it’s impacting all of the hospitals, hospital’s patient population in the entire State ise, a dream deferred, and on a crucial not only in the city, but those hospitals in of Texas and is one of the highest in the demand. Because of this legislation, for country. St. Joseph’s was operated by the Sis- nearby jurisdictions. We’re seeing the epi- the first time in America’s history, ters of Charity for many years until it was center of a catastrophic event, and unless we never again will Americans have to scheduled to be closed because the order realize the importance of this one medical fa- worry about losing their health insur- could no longer support it. The hospital was cility, but look at it not from the perspective ance if they change or lose their job. offered to for-profit and not-for-profit hospital that it serves this city, but we have to realize The insurance companies will not be systems but no one would accept responsi- that it serves the world. It serves the Nation. able to jack up premiums or deny cov- bility for operating St. Joseph’s. A plan was At the very least, it serves the Nation; at the erage because of preexisting condi- developed to convert the hospital into con- very most, it most serves the world. So when tions. They will not be able to drop dominiums. I refused to allow that to happen. you start looking at it from those perspectives, people’s coverage when they get sick— It was only at that point that the physicians then it becomes more than just a problem of when they need it the most. Our re- who had practiced there for many years came Houston, Texas, but a problem of this Nation. forms will improve the lives of every together to buy the hospital to save it from And it should be addressed in that manner. single American, those with insurance closing. If we do not work closely together to look today and those without. St. Joseph’s takes care of patients covered deeper at this issue, we will face a number of We’re also pairing this historic by Medicare and Medicaid, as well as patients medical facility closures that is a disservice to health reform with another oppor- who are uninsured or cannot pay for their the American people. So, we see that there tunity that cannot be missed, the care. The emergency departments of many seems to be a phasing-back or cutback in all chance to make the single largest in- physician-owned ‘‘specialty hospitals’’ have of the major services, but the most important vestment in college affordability ever, been criticized for not having a true emer- of those services, which directly affect the at no cost to the taxpayers. We’re gency department. St. Joseph’s has a depart- health and well-being of the citizens, or again, going to take $61 billion of wasteful ment which is open 24 hours per day, 7 days those 1.5 million people who visit and work in subsidies that have gone to the banks per week, providing an access point for pa- the city every day. So, we hear the same thing and student lenders and instead recycle tients in need of emergency services. In fact, time and time again, even though individuals that money on behalf of students, their St. Joseph’s admissions through the emer- are saying that the patient caseload can be families who are trying to pay for edu- gency department are double the State aver- handled by the surrounding hospitals. You cation, to make that education more age; need but step into any emergency room on affordable and pay down the deficit of St. Luke’s hospital in Houston, which is any day, at any time, and just see the impact this country. church-owned, has three new facilities under of this one hospital being downsized. The im- We now face a very simple choice. We development; the nonprofit religious mission pact will reach out throughout the city of Hous- can side with America’s families and has the controlling interest. One full-service ton. make health insurance and college hospital has one phase already operating, but Mr. Speaker, through all the debate, name- more affordable and accessible while would be under the growth restrictions; the calling, threats, and fear-mongering, we will creating millions of jobs and reducing hospital cannot be completed if the new re- once again be on the right side of history and the deficit, or we can side with the in- strictions apply. The hospital brought approxi- put the American people first. In the midst of surance companies and the banks. It’s mately 300 new jobs to the community; and it all, some of my colleagues have been called a very simple choice. One is to stand Baylor Health Care System, based in Dal- derogatory names, including racial epitjets; with the families and the students of las, has found that their partnership with phy- have been spat on and have been threatened this country, to stand with our future, sicians has increased measurable quality, in- that there will be blood in the streets. But to modernize our education system, to creased patient satisfaction, and decreased there is something that I must say to my fellow make it more affordable, and to mod- the cost in the delivery of their excellent care. Americans as we stand on the threshold of the ernize and make more affordable our This joint venture model has produced a heart door that opens up to access to quality and af- health care system. hospital that has the lowest readmission rate fordable care and, in turn, a better quality of I suggest all my colleagues should in the entire United States. And yet this bill life for all Americans. Heeding one of this stand with American families in this would deny Baylor Health Care System the country’s greatest leaders in history, Dr, Martin country.

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00063 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1882 CONGRESSIONAL RECORD — HOUSE March 21, 2010 Mr. Speaker, I rise in support of this truly lishes exchanges that will negotiate with insur- The term ‘‘rehabilitative and habilitative de- historic legislation that addresses two of Amer- ers to offer health coverage to individuals in a vices’’ includes durable medical equipment, ica’s greatest troubles—the crushing costs and given area or state. These government-spon- prosthetics, orthotics, and related supplies. It high obstacles of obtaining both quality health sored exchanges will establish a level playing is my understanding that the Patient Protec- care and a college education. field market place that will make health bene- tion and Affordable Care Act requires the Sec- Our Nation and its economy have suffered fits fairer to all parties. retary of Health and Human Services to de- from our longstanding failure to make health Insurers will get organized access to large velop, through regulation, standard definitions care and college accessible and affordable to pools of individuals who are required to pur- of many terms for purposes of comparing ben- all of the American people. chase insurance with lower income individuals efit categories from one private health plan to Americans have waited a long time for receiving federal subsidies to afford essential another. It is my expectation ‘‘prosthetics, health insurance reform—nearly 100 years. benefits. Employers will be relieved of their orthotics, and related supplies’’ will be defined Today, Congress and President Obama will current burdens of designing and negotiating separately from ‘‘durable medical equipment.’’ deliver on a central promise, on a dream de- for health benefits under this new health sys- I also expect that durable medical equipment ferred, on a crucial demand. tem. Employers will simply facilitate the enroll- will not be limited to ‘‘in-home’’ use only. Because of this legislation, for the first time ment and payroll deduction of their employees Pursuant to employer requests, this bill codi- in America’s history, never again will Ameri- in exchange health plans with no other re- fies the use of wellness programs. Wellness cans have to worry about losing their health sponsibilities. Employers may select a plan programs are proving to be an emerging area insurance if they change or lose their job. level to which any employer contribution will of health care reform that holds both great Insurance companies will not be able to jack be limited, but employees are free to choose promise and potential for abuse. The Depart- up premiums or deny coverage because of a plans in that or a more favorable level. ments of HHS and Labor will need to issue pre-existing condition. The health plans offered through the ex- regulations to assure that employer wellness They will not be able to drop people’s cov- change are state licensed (with the exception programs meet established standards of med- erage when they get sick—and need it most. of the national plans) and are not ERISA ical treatment and patient protection. It is my There is no other plan on the table today plans. States have full authority to protect their understanding from discussions with my col- that offers Americans these vital assurances. residents and enrolled individuals have state leagues in both the House and Senate that Our reforms will improve the lives of every law rights and consumer protections. There is the design and implementation of voluntary single American—those with insurance today no federal preemption of any state law that wellness programs, including the issuance of and those without it. does not prevent the application of any of the policies and procedures and the adoption of They will improve our economy by reducing rights and responsibilities included in Title I of practices and methods of administration, shall the deficit, creating up to 4 million jobs over this bill. not have the purpose or effect of mandating the next decade, and unshackling innovative Small employers that choose to offer health participation in such programs or punishing, business decisions from crippling health insur- coverage may be eligible for tax credits and denying, limiting or curtailing any rights, privi- ance costs. cannot offer health benefits that discriminate in leges, and protections under the Americans Our legislation offers families and employ- favor of highly compensated employees. For with Disabilities Act, the Genetic Information ees of small businesses access to choices of employers who use employee payroll and Nondiscrimination Act, the Health Insurance similar organizations (i.e. Professional Em- affordable health plans; security and control Portability and Accountability Act, the Family ployee Organizations), I expect that the U.S. over their health care; vital federal and state and Medical Leave Act, and Title VII of the Department of Treasury will issue rules to consumer protections; accountability for insur- Civil Rights Act of 1964. ance companies; and coverage for 32 million make clear the circumstances by which the In order to ensure existing civil rights and Americans who don’t have insurance today. small employer may take the tax credit and privacy protections, regulations related to This legislation also intends to lessen and satisfy the prohibition against discrimination. wellness programs promulgated by the Sec- The bill contains an individual mandate to eventually eliminate the loopholes and incon- retary of Health and Human Services should either obtain health insurance or pay a pen- sistencies in our current system. More specifi- include standards and criteria developed and alty. This provision is grounded in Congress’s cally, it seeks to begin the creation of a joint certified by the Attorney General, the Sec- taxing power but is also necessary and prop- national and state health care system. Cur- retary of Labor, and the Equal Employment er—indeed, a critical linchpin—to the overall rently, we have a fragmented and unfair set of effort to reform the health care market and Opportunity Commission. I expect that nothing rules. bring associated costs under control through- in the Patient Protection and Affordable Care If you are poor you may or may not be cov- out interstate commerce. For example, without Act shall limit the independent authority of the ered by Medicaid and your benefits will vary this requirement, some reforms may create Attorney General, the Secretary of Labor, and depending on the state you live in. the opportunity for moral hazards, such as the the Equal Employment Opportunity Commis- If you are employed, you may or may not be prohibition on pre-existing conditions. sion to issue regulations, interpretations, and offered benefits by your employer and those Without an individual mandate, individuals guidance regarding the applicability of the benefits vary from employer to employer. As could wait to purchase health insurance until Americans with Disabilities Act, the Genetic In- providers continue to increase costs year after they are sick—thereby driving up insurance formation Nondiscrimination Act, the Health In- year, insurers, employers and states have costs and undermining the bill’s efforts to bring surance Portability and Accountability Act, the been unable to effectively negotiate and re- health care costs and costs to the broader Family and Medical Leave Act, and Title VII of sponded by cutting benefits and increasing economy under control. This requirement the Civil Rights Act of 1964 to the design and costs for individuals and families. spreads risk to ensure lower costs for every- implementation of wellness programs. I urge This bill will help change this unsustainable one, prevents adverse selection, helps end the Department of Labor and other agencies and unfair dynamic. Under this legislation, overpayment by the government and other to monitor and ensure that health plans prop- every American will have an obligation and an consumers for the uninsured, and makes erly comply with the standards established by opportunity to enjoy meaningful health bene- health care reform overall sustainable. this Act. I also urge the Congress to continue fits. The Secretary of Health and Human Serv- I also would like to address a few other im- to review and revisit this developing area of ices will establish an essential benefits pack- portant provisions in the bill: health care. age that will provide a basic but comprehen- I am pleased that the essential benefits in The Senate bill includes provisions that sive set of benefits for all Americans. Although the Patient Protection and Affordable Care Act would provide for a ‘‘level playing field’’ be- existing employer plans are not required to include rehabilitative and habilitative services tween private health insurance issuers and a provide this level of benefits, it is our hope and devices, as these benefits are of par- competing Consumer Operated and Oriented that employers will meet or exceed this stand- ticular importance to people with disabilities Plan (‘‘CO-OP’’), a community health insur- ard. However, the bill does end a wide series and chronic conditions. ance option, or a nationwide qualified health of abuses that all health plans, including em- The term ‘‘rehabilitative and habilitative plan. These provisions would prevent unfair ployer provided plans, must comply with. services’’ includes items and services used to competition within a state where these plans These include an end to all pre-existing con- restore functional capacity, minimize limita- compete. dition exclusions, limits on waiting periods for tions on physical and cognitive functions, and For example, if a CO–OP is established in coverage, and elimination of annual and life- maintain or prevent deterioration of func- New York State, it would have to be subject time caps on benefits. tioning. Such services also include training of to all the same federal and state laws enumer- In order to make health care more afford- individuals with mental and physical disabilities ated in these level playing field provisions as able for workers and employers, the bill estab- to enhance functional development. private health insurance issuers in New York

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00064 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1883 State are. Or, for example, if a CO–OP were reforms in the federal student loan programs Colleges and Universities, Hispanic-Serving established in Florida and was exempted from designed to provide a stronger, more reliable, Institutions, Tribal Colleges, Alaska and Ha- a state law relating to licensure, private health and more efficient student loan system. The waiian Native, Predominantly Black Institu- insurance issuers in Florida would also have legislation directs $10 billion of the savings tions, institutions serving Asian American and to be exempted from the same state law. generated under this legislation to paying Pacific Islanders, and institutions serving Na- The bill we are passing contains protections down the country’s deficit. tive Americans, first made under the College for employees who are retaliated against for The education provisions of this legislation Cost Reduction and Access Act of 2007, rec- reporting violations involving health insurance will convert all new federal student loans to ognizing the critical role these institutions play regulation and the operation of exchanges, the Direct Loan program starting in July 2010, in serving the nation’s emerging majority pop- and provides recourse for workers who are saving $61 billion over the next 10 years. ulations. fired or otherwise discriminated against be- These changes will also upgrade the customer Concerning the servicing contracts with eli- cause they participate in the exchange and service borrowers receive when repaying their gible not-for-profit servicers, this legislation the employee receives a tax credit or a sub- loans and promote jobs. The legislation will recognizes that not-for-profit servicers play a sidy to purchase health insurance through an maintain jobs by maintaining a robust role for unique and valuable role in helping students in exchange. Under this legislation such employ- the private sector, allowing lenders and non- their states succeed in postsecondary edu- ees can bring a complaint to and receive as- profits to get contracts with the Department of cation and that students should continue to sistance from the Department of Labor. Education to service Direct Loans. benefit from the assistance provided by not- Section 2951 of H.R. 3590 makes an These education provisions will convert all for-profit servicers, including customer service, amendment to section 511 of Title V of the new federal student loans to the Direct Loan financial counseling, and college access and Social Security Act to require states to con- program starting in July 2010, saving $61 bil- success programs. duct statewide needs assessment and to co- lion over the next 10 years. These changes In addition, by including more high-quality ordinate such assessment with other appro- will also upgrade the customer service bor- servicers in the contracting process, competi- priate assessments, and cross-references sec- rowers receive when repaying their loans and tion will be increased thereby delivering better tion 640(g)(1)(C) of the Head Start Act. This promote jobs. The legislation will maintain jobs quality for student borrowers. Under the bill, should not be interpreted to provide states by maintaining a robust role for the private not-for-profit servicers will be allocated a min- with any new authority over Head Start grant- sector, allowing lenders and non-profits to get imum of 100,000 borrower loan accounts. With ees or entities applying for Head Start funds. contracts with the Department of Education to sufficient loan volume and competitive serv- Now, we’re pairing these truly historic health service Direct Loans. icing rates, eligible not-for-profit servicers can insurance reforms with another opportunity The legislation significantly increases the individually or collectively generate sufficient that cannot be missed: The chance to make federal Pell Grant award; the cornerstone of revenue to continue the valuable services they the single largest investment in college afford- need-based federal student assistance since provide to borrowers. Because of the signifi- ability ever—and at no cost to taxpayers. its creation in 1972. Investments in this pro- cant increase in loan volume as all federal We are going to take tens of billions of dol- gram are essential to ensuring educational ac- loans are moved to the Direct Loan program, lars that for decades has gone to banks in the cess and making college more affordable for additional servicing capacity will be needed student loan program and instead give that students and families. Both the House and and is provided for through the contracts pro- money to students and to pay down the def- Senate authorizing and appropriating commit- vision. I encourage the Secretary to implement icit. tees have made significant investments in in- these provisions so that many local not-for- For decades, banks have enjoyed a sweet- creasing the maximum Pell Grant award in the profit servicers will continue to play a role in heart deal: They receive taxpayer money to past few years—32 percent since 2006. The the student loan program. make virtually risk-free loans to students. investments in this legislation build on these As more students become increasingly de- As we speak, the federal government is now commitments by indexing the maximum Pell pendent on loans, the Department of Edu- funding 88 percent of all federal student loan Grant award to the Consumer Price Index be- cation must increasingly focus on the assist- volume. ginning in the 2013–2014 academic year, to ance, information, and repayment tools that It has proven to be a more stable lender for reach an estimated maximum of $5,975 in the assist students in successful loan repayment. students through shaky financial markets and 2017–2018 academic year. When evaluating the resources and services a more cost-effective lender for taxpayers. The legislation invests additional resources available to student borrowers and schools Ending these subsidies is not a radical idea. in the College Access Challenge Grant pro- under the Direct Loan program, I encourage President Clinton first identified these sub- gram created under the College Cost Reduc- the Secretary to use existing contracting au- sidies as wasteful in the 1990s. thority to contract, when appropriate, with President Bush eyed them in three of his tion and Access Act of 2007 to assist states state-designated guaranty agencies for the de- budgets. working in partnership with institutions of high- livery of services that increase student loan re- And President Obama has correctly pro- er education, non-profit philanthropic organiza- payment and decrease default. Such agencies posed ending this boondoggle once and for all tions, and other organizations with experience shall include those non-profit subsidiaries of by originating all loans through the federal di- in college access, to ensure that students guaranty agencies that were established, pur- rect lending program—saving taxpayers $61 have access to high-quality, affordable higher suant to State law, on or before January 1, billion over 10 years. education. And that’s what our legislation accom- It is the intent of Congress that states re- 1998. Community colleges serve an instrumental plishes. ceiving grants under the College Access Chal- Our reforms are good for students, tax- lenge Grant program should partner with enti- role in both our educational and workforce payers and American jobs. ties, including guaranty agencies (including systems, providing post-secondary education We will help low and middle-income stu- their non-profit subsidiaries), to provide finan- and job training, particularly to individuals and dents pay for college and invest in the support cial literacy, delinquency and default aversion families hardest hit by difficult economic times. they need to graduate. activities, and other loan counseling activities This includes workers eligible for training We will be more responsible with taxpayer for borrowers. under the Trade Adjustment Assistance pro- dollars by using $10 billion of these savings While this legislation seeks to ensure in- gram for communities and for individuals who for deficit reduction. creased access and success for all students, are, or may become eligible for unemployment And we will end the practice of banks ship- we intend for the Secretary to work with states compensation. To ensure that these institu- ping lending jobs offshore. to address the unique access issues faced by tions have access to the resources they need This bill makes unprecedented investments underserved communities, including: low-in- to develop and improve educational and ca- to expand high-quality educational opportuni- come individuals, individuals with disabilities, reer training programs designed to meet the ties to all Americans. It invests in the Pell homeless and foster care youth, disconnected needs of these communities, the legislation di- Grant scholarship award, strengthens Histori- youth, nontraditional students, members of rects the Secretary of Labor to award Commu- cally Black Colleges and Universities and mi- groups that are traditionally underrepresented nity College Career Training Grants especially nority serving institutions, and provides more in higher education, individuals with limited to struggling 2-year public community col- resources to states for college access and English proficiency, veterans (including those leges, (as defined in Section 101 of the Higher completion efforts through the College Access just returning from active duty), and dislocated Education Act of 1965). As the legislation en- Challenge Grant program. workers. sures that all States benefit from these re- Further, these investments are paid for with- The legislation also includes a continuation sources with the inclusion of a state minimum, out increasing our nation’s deficit, through key of funding for investments in Historically Black I also encourage that the Secretary strive to

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00065 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1884 CONGRESSIONAL RECORD — HOUSE March 21, 2010 ensure a diverse geographical representation TRICARE out of the Department of De- The philosophy advanced on this of community colleges in both urban and rural fense. floor by this majority today is so pa- areas. Americans are fed up with govern- ternalistic and so arrogant. It’s conde- I’d like to thank RUBE´N HINOJOSA, our higher ment takeovers of business, like the scending, and it tramples upon the education subcommittee chair, TIM BISHOP, auto industry that closed dealerships principles that have made America so and all of our committee members for their and threw Americans out of work. This exceptional. tireless work on student loan reform. health care bill includes a government My friends, we are fast approaching a Along with all the members of our com- takeover of the student loan business, tipping point where more Americans mittee, I’d like to especially thank ROB AN- throwing 31,000 more Americans out of depend upon the Federal Government DREWS, our health subcommittee chair, for his work. than upon themselves for their liveli- backbreaking work over the last year on We Republicans implored the major- hoods, a point where we, the American health reform. ity for a bipartisan health care reform people, trade in our commitment and And I would like to thank the many mem- bill. The majority party responded our concern for individual liberties in bers of my staff for their long hours and tre- with special deals cut behind closed exchange for government benefits and mendous work over the last year on these two doors to garner votes for its most re- dependences. pieces of reform: Mark Zuckerman, Danny luctant members. More to the point, Mr. Speaker, we Weiss, Alex Nock, Michele Varnhagen, Jody America deserves better than this. have seen this movie before, and we Calemine, Denise Forte, Ruth Friedman, America is better than this. Let’s lis- know how it ends. The European-style Megan O’Reilly, Julie Radocchia, Jeff Appel, ten to America. Kill this bill. Start social welfare state promoted by this Ajita Talwalker, Celine McNicholas, Meredith over with health care we can afford. legislation is not sustainable. This is Regine, Lillian Pace, Kara Marchione, Helen Create jobs and save our economy. not who we are and it is not who we Pacjic, Rachel Racusen, Aaron Albright, Me- Mr. RYAN of Wisconsin. Mr. Speaker, should become. lissa Salmanowitz, Andra Belknap, Betsy at this time I’d like to yield myself the As we march toward this tipping Kittredge, Mike Kruger, Amy Peake and remainder of our Budget Committee point of dependency, we are also accel- Courtney Rochelle. time. erating toward a debt crisis; a debt cri- Their commitment and expertise has been Mr. Speaker, there’s a lot wrong with sis that is the result of the politicians invaluable. this bill. We know the problems with of the past making promises we simply We almost didn’t get here today. You know its costs. We know it doesn’t really re- cannot afford to keep. De´ja` vu all over that. duce the deficit. We know premiums again. It’s unconscionable what we are Opponents of health care reform have said are going to go up. The CBO has given leaving the next generation. anything and done everything to distort the us all this information and it’s clear This moment may mark a temporary facts, delay the process, and try to put off that we have a bill that is chock full of conclusion of the health care debate, what Americans have asked for and needed gimmicks and hidden mandates. I’m but its place in history has not yet for generations. They have tried to sow fear not going to get into all of that again, been decided. If this passes, the request into the American people. but what I want to ask is this: Why has to reclaim the American idea is not They cannot win on the merits. And they will this decision become so personal to our over. The fight to reapply our founding continue to lie and distort the facts going for- constituents? Why are so many people principles is not finished. It is just a ward. But we have made it to the final step in swarming the Capitol today? Why have steeper hill to climb, and it is a climb this process—despite all that noise. we received a hundred thousand calls that we will make. And now we face a simple choice. an hour from around the country? It’s On this issue, more than any other We can side with America’s families and because health care affects every one issue we have ever seen here, the Amer- college students and make health insurance of us. And yet, here we are, debating ican people are engaged. From our and college more affordable and accessible— whether the government should have a town hall meetings to SCOTT BROWN’s while creating millions of jobs and reducing bigger role in making those personal victory in Massachusetts, you have the deficit. decisions. made your voices heard and some of us Or, we can side with insurance companies So make no mistake about it. We are are listening to you. and banks. not just here to pass a health care bill. My colleagues, let’s bring down this That’s it. We are being asked to make a choice bill and bring back the ideas that made That’s the choice. about the future path of this country. this country great. I’m siding with the American people. The speakers to my left are correct: Mr. SPRATT. Mr. Speaker, I first I urge each of my colleagues to join me. this is history. Today marks a major recognize the gentleman from Cali- The SPEAKER pro tempore. The gen- turning point in American history. fornia (Mr. BACA) for a unanimous con- tleman from South Carolina (Mr. This is really not a debate about sent request. SPRATT) is recognized for 15 minutes as prices, coverage, or choosing doctors. (Mr. BACA asked and was given per- a designee of the majority leader. This is ultimately about what kind of mission to revise and extend his re- Mr. SPRATT. I reserve the balance of country we are going to be in the 21st marks.) my time. century. Mr. RYAN of Wisconsin. Mr. Speaker, America is not just a nationality. It’s b 2115 I’d like to yield 2 minutes to the gen- not just a massive land from Hawaii to Mr. BACA. Mr. Speaker, I rise in tlewoman from Wyoming (Mrs. Maine, from Wisconsin to Florida. strong support of this legislation. LUMMIS). America is an idea. It’s the most pro- Mr. SPRATT. I yield to Mr. ISRAEL of Mrs. LUMMIS. The world is begging human idea ever designed by mankind. New York to make a unanimous con- America to get its financial house in Our Founders got it right when they sent statement. order. This Congress responds by dou- wrote in the Declaration of Independ- (Mr. ISRAEL asked and was given bling the debt in 5 years and tripling it ence that our rights come from nature permission to revise and extend his re- in 10. and nature’s God—not from govern- marks.) Americans are begging for jobs, ca- ment. Mr. ISRAEL. Mr. Speaker, I rise in reers, and stability. This Congress re- Should we now subscribe to an ide- support of this bill. sponds by hiring 17,000 people at the ology where government creates rights, Mr. Speaker, I rise in support of this bill for IRS to enforce on Americans govern- is solely responsible for delivering one fundamental reason. It is simply the right ment-approved health insurance. these artificial rights, and then sys- thing to do. Not for my Party, not for the Presi- Small business entrepreneurs beg tematically rations these rights? dent, not for the Speaker, not for me. But for Congress to empower them to create Do we believe that the goal of gov- the people I represent. The middle class and jobs. Congress responds with 20 new ernment is to promote equal oppor- working families; the backbones of our econ- taxes in this health care bill, amount- tunity for all Americans to make the omy—small businesses—challenged by rising ing to half a trillion dollars. most of their lives, or do we now be- health costs. Our military families beg us to leave lieve the government’s role is to equal- Few debates have been as long and as TRICARE alone. This bill transfers ize the results of people’s lives? passionate as this one. Since last August I

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00066 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1885 have heard the strong voices on both sides of bill is fully funded and will actually reduce fed- these bills on the deficit: a reduction of this issue. I have listened to the angry chants eral deficits by $143 billion in the first 10 years $143 billion over the next 10 years and of opponents of the bill at Town Hall meetings. and over a trillion dollars in the next 10. a reduction of $1.2 trillion over the fol- I have read the mail from people who insist This bill is an urgent reversal from 8 years lowing years. We have kept the prom- this is a march towards socialism, that it is a of ignoring the crisis. Between 2000 and 2008, ise we made at the outset by keeping dangerous experiment, that it involves govern- health insurance premiums doubled, insurance health care reform deficit-neutral, and ment death panels who will deny senior citi- company profits quadrupled, and an additional that’s one more reason to vote for this zens the life-saving health care they need. I 6 million Americans became uninsured. As a bill. have watched protesters march outside my result, the leading cause of personal bank- I reserve the balance of my time. district office on Long Island. I have seen the ruptcy today is unpaid medical bills. Without The SPEAKER pro tempore. The gen- repugnant signs here in Washington com- action, these trends will grow worse. tleman from Michigan (Mr. CAMP) is paring health care to the Holocaust. These are the middle class families and recognized for 20 minutes as a designee I have seen and heard it all. But I have also businesses that have always expanded our of the minority leader. heard others. They are the average Long Is- economy. But rising health costs and insecu- Mr. CAMP. Mr. Speaker, at this time landers—not rich, not poor, but usually some- rity have undermined the middle class. This I yield 31⁄2 minutes to the distinguished where in between—who live in quiet despera- bill will provide them with the basic security gentleman from Indiana (Mr. PENCE), tion and concern. they need to do what they’ve always done: our conference chairman. The small business owner on Long Island build our economy. (Mr. PENCE asked and was given per- who told me he just received a 22 percent in- This vote is no different than the 1965 vote mission to revise and extend his re- crease in health insurance premiums and ago- for Medicare. Back then, when one quarter of marks.) nizes at the prospect of either scaling back the American seniors were living in poverty and Mr. PENCE. This is truly a remark- care he provides his workers or scaling back wracked with unpayable medical bills, there able moment in the life of this Nation. the workers he pays. Under this bill, his busi- were loud voices that said, ‘‘do nothing’’ and Some say we’re making history. I say ness will receive a tax credit to help him pro- ‘‘start over’’ and ‘‘vote no.’’ Public opinion was we’re breaking history. We’re breaking vide insurance to his workers. And he will be skeptical then. Had I been in Congress in with our finest traditions—limited gov- able to shop for competitive rates and services 1965, and the choice was voting for Medicare ernment, personal responsibility and in a new market-driven ‘‘Health Insurance Ex- and risking my seat, or voting against Medi- the consent of the governed. The first change.’’ care and saving my seat, I would have voted principle of public service in a free so- The woman who thought health care worked for Medicare. It became the backbone of eco- ciety is humility. The arrogance we’ve pretty well for her, until her daughter was diag- nomic security for our senior citizens and witnessed in this institution is breath- nosed with breast cancer. She’s been forced helped build a middle class with economic se- taking. Only in Washington, D.C., to deal with high medical costs to care for her curity. This is no different. No less necessary. could you say you’re going to spend $1 daughter. But, under this bill, she will not have No less historic. trillion and save the taxpayers money. to worry about an insurance company that re- Mr. SPRATT. Mr. Speaker, I yield to Only in Washington, D.C., could you fuses to pay for her chemotherapy. the gentlewoman from Ohio for a unan- exchange the pro-life protections en- The middle class family with two kids just imous consent request. shrined in the law for 30 years for a out of college who are having trouble finding (Ms. SUTTON asked and was given piece of paper, signed by the most pro- a job that provides health insurance. Under permission to revise and extend her re- abortion President in American his- this bill, those young adults can get coverage marks.) tory. on their parents’ plans until they turn 26. Ms. SUTTON. I rise in support of this Despite overwhelming public opposi- The retired plumber on the block where I historic legislation. tion today, this administration and live. One day he came to my house. I thought Mr. SPRATT. Mr. Speaker, I yield this Congress is poised to ignore the he wanted to debate this bill with me. Instead, myself 2 minutes. majority of the American people. Let he said: ‘‘I wish you would pass this now. Congress cleared the way for health me say, Mr. Speaker, this is not the Don’t these people know that if they lose their care reform in the budget resolution. President’s House. This is not the jobs they lose their health care?’’ And just yesterday, Mr. Speaker, a small And when we did, we stipulated that Democrats’ House. This is the people’s business owner called me with concerns and reform had to be deficit-neutral. We House, and the American people don’t plentiful questions about the legislation we will can now say that the House, Senate want a government takeover of health vote on today. After I explained it, he said: and President have all abided by this care. Now I know they don’t like us to ‘‘There’s been too much confusion about this principle. The bill put before us has call it that. But when you mandate bill. I wish it had been explained.’’ been scored by the Congressional Budg- every American to have government- He is right. This bill has changed in over a et Office. In this case, CBO found that approved insurance, whether they want year of debate. Sometimes in an effort to ac- the 10-year cost of all the covered it or need it or not, when you create a cept bipartisan recommendations. Sometimes changes in the bill put before us government-run plan, paid for with job- to reduce its cost. While one side has had the amount to $788 billion. But the bill be- killing tax increases, and you provide responsibility to improve the bill, the other side fore us also includes reductions, sav- public funding for abortion, that’s a has taken the opportunity to brand it with ings, and new revenues which total $931 government takeover of health care, mischaracterizations. But now the ink is dry, billion. and the American people know it. Mr. Speaker. And the dry ink of this bill rep- When the $931 billion is netted The American people want to face resents the best hope to protect the middle against the $788 billion, the result is a our challenges in health care with class and working families I represent. The net savings, which reduced on-budget more freedom, not more government. small business owner in East Northport who deficits over the next 10 years by $143 And this really is about freedom. The now has a level playing field when shopping billion. That’s CBO’s estimate of the more I think about this debate, the for insurance. The family in Sayville who can first 10 years under these reforms, a re- more I think about what Ronald now keep a child insured until the age of duction in the deficit of $143 billion. Reagan said in 1964. He said then and twenty-six. The senior in Deer Park whose What about the next 10 years? CBO es- now, It’s about whether we abandon drug costs will be covered. The accountant in timates that these two bills together the American Revolution and confess Huntington who lost his job but will be able to will save around .5 percent of GDP over that a little intellectual elite in a far shop for affordable health care. the second 10 years. Now that may distant capital can plan our lives bet- This bill will improve coverage for 485,000 sound minimal, but during that period ter than we can plan them ourselves. of my constituents with coverage through their of time, GDP cumulatively is $272 tril- You know, today we gathered in the employer, give tax credits to as many as lion, so .5 percent of that easily equals old House Chamber for a time of wor- 81,000 families and 21,000 small businesses more than $1.2 trillion. ship and prayer. Members of Congress to make health care affordable in my district, You will hear numbers of all sorts in have been doing that for about 200 and extend coverage to 29,000 uninsured resi- this debate, but remember these be- years. It’s a Chamber filled with stat- dents of the towns I represent. cause they come from a disinterested ues of great Americans: Sam Houston, This bill will reduce our debt. Yesterday, the source with a well-proven record. This Lew Wallace, Robert Fulton, William Congressional Budget Office certified that the is what CBO estimates as the effects of Jennings Bryan, soldiers, heroes and

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00067 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1886 CONGRESSIONAL RECORD — HOUSE March 21, 2010 heroines of freedoms past. As I sat gentleman from California (Mr. tleman who had just called in earlier to there, I thought of that Bible verse MCCARTHY). say that he did not support our efforts that said, ‘‘We are surrounded by such Mr. MCCARTHY of California. Mr. to reform the health care system be- a great cloud of witnesses.’’ Standing Speaker, this is the people’s House, and cause he liked the insurance he had. here tonight, I believe we are as well. we were sent here to represent people The caller shared her experiences of And I mean, not just those that are throughout America. Some are actu- having been dropped from coverage by looking in tonight from here and ally in the gallery, some have been an insurance company she thought she around the country, but those who marching around this building, some liked just as she started her second have gone before. Men and women who are sitting at home watching on TV. Or treatment for breast cancer. She said did freedom’s work in their time who they’re in their car driving back from to the gentleman that maybe he liked persevered, who made this the greatest church, and many of them have been the insurance he had because he had Nation on Earth possible. calling this Congress. And they’ve been never tried to use it. Now it’s our turn. We can reform asking one thing, Why does Wash- With these reforms, dropping people health care without putting our coun- ington refuse to listen? They see what from coverage when they are diagnosed try on a pathway towards socialized many on this side of the aisle see, the with catastrophic illnesses will no medicine. We can reform health care arrogance of Washington. We are here longer be allowed, and denying insur- by giving the American people more to represent our constituents, which is ance to children with diabetes and choices, not more government. So I say why we are asking, Why are we voting other preexisting conditions will end to my Democratic colleagues, stand on a health care bill today that empow- immediately. These reforms will allow with those who have gone before and ers government instead of the people? children to remain on their parents’ in- made the hard choices to defend free- Survey after survey demonstrates surance policies until their 26th birth- dom in their time. Stand with us. the great unpopularity of today’s bill. day. This bill will immediately begin Stand for freedom, and the American Not only the substance of it, but the closing the doughnut hole for prescrip- people will stand with you. trickery, the deals and the shortcuts tion medications for seniors and elimi- Mr. SPRATT. Mr. Speaker, I yield for that led us to where we are today. But nating burdensome copays or a unanimous consent request to Ms. this bill is being pushed through be- deductibles for their preventive care. FUDGE of Ohio. cause the majority in this Congress re- Despite deafening protests from the (Ms. FUDGE asked and was given fused to listen to the people. The other side, the nonpartisan Congres- permission to revise and extend her re- Speaker has even said that she believes sional Budget Office says that the re- marks.) that we have to pass this bill so people forms included in this bill will reduce Ms. FUDGE. Mr. Speaker, I rise in can find out what’s in it. The logic here our deficit by $143 billion in the first 10 support of this health care legislation. is, Washington knows better than the years and $1.2 trillion in the second 10 Mr. Speaker, I rise today to vote for my con- people. years. This bill will also create jobs, stituents. Ohioans want health care reform All this at a time when Washington 400,000 good-paying jobs, reliable jobs and they want it now. They told me: ‘‘ Now is is borrowing 43 cents out of every dol- for every year and for small businesses. the time to stand for change. Now is the mo- lar it spends, adding to our national Small businesses will get a tax break ment to fight for quality care.’’ debt, mortgaging our children’s future. on their health care premiums that I’m voting for Vera—a former nurse who lost And this $2.4 trillion bill will steal even will free up money for them to hire her insurance after a divorce, despite a life- more money from our children’s fu- 80,000 more employees. time of caring for others. She has over ninety tures at a time when this administra- Mr. Speaker, we have debated this thousand dollars in medical debt, as a result tion and Congress are poised to run up issue for several generations. The time of her 3 strokes. the debt more than any other adminis- has come to act. This is the Civil I’m voting for ‘‘Mary’s’’ mom, who faced trations combined. It doesn’t have to Rights Act of the 21st century, and to- cancer without health coverage. ‘‘Mary’s’’ mom be this way. We could have easily found night we will take a significant step to died in her daughter’s arms in pain and with- a positive bipartisan agreement on move our country forward. out medication because she had no insurance. commonsense health care reforms that Mr. CAMP. Mr. Speaker, at this time I’m voting for the father in my District, who reduce the costs, increase competition just for the purpose of a unanimous is forced to choose between maintaining his and increase access, all without raising consent request, I yield to the gen- child’s health insurance or meeting his month- the debt. Today is a legacy vote for tleman from Pennsylvania. ly bills. He shouldn’t have to choose between Members of this people’s House, and I (Mr. DENT asked and was given per- treating his son’s sickle cell disease and put- urge my colleagues to start over and mission to revise and extend his re- ting food on the table. craft the bill to solve the problem. marks.) As a pastor said this morning: Mr. SPRATT. Mr. Speaker, I yield to Mr. DENT. Mr. Speaker, I rise in op- I’m voting like unborn children depend on the gentleman from North Carolina position to this flawed health care bill. me. (Mr. WATT) for a unanimous consent re- Undeniably, health care reform is needed. I’m voting like a single mom in East Cleve- quest. Families and businesses are struggling to land depends on me. (Mr. WATT asked and was given per- keep up with rising insurance premiums. I’m voting like seniors in Warrensville mission to revise and extend his re- Thousands of constituents in my district do not Heights depend on me. marks.) have access to affordable insurance because I’m voting like foster youth are waiting on Mr. WATT. Mr. Speaker, I rise in of skyrocketing costs. An increasing number of me. support of the 32 millions Americans Americans are impacted by policies that pre- I’m voting for the person in Euclid who died who will get insurance under this bill. clude individuals with pre-existing conditions too soon. ANNOUNCEMENT BY THE SPEAKER PRO TEMPORE from securing insurance. Patients are frus- I’m voting like I don’t have health care insur- The SPEAKER pro tempore. Under trated with the difficulty of navigating the ance myself. clause 7 of rule XVII, Members may not health care system and insurance bureauc- I’m voting for justice and equality. refer to the occupants of the gallery. racy. We have all experienced our doctors I’m voting for health care reform, so that I Mr. SPRATT. I now take pleasure in practicing defensive medicine—ordering un- can hold my head high, look my neighbors in yielding 3 minutes to my colleague necessary tests and procedures in an effort to the eye and tell them: ‘‘I voted for you, and from South Carolina (Mr. CLYBURN), ward off frivolous lawsuits. Poor reimburse- you, and you.’’ the majority whip. ment rates mean that doctors cannot afford to Mr. SPRATT. Mr. Speaker, could I Mr. CLYBURN. I thank the gen- place an emphasis on prevention and inquire as to the remaining time? tleman for yielding me the time. Mr. wellness. The SPEAKER pro tempore. The gen- Speaker, we have come to a defining The consequences of reform are profound tleman from South Carolina has 131⁄2 moment in our Nation’s history. To- for families, our economy and the future of our minutes, and the gentleman from night I am thinking about the woman country. Reform policies will have a direct im- Michigan has 161⁄2 minutes. who called in to a talk radio program pact on the lives of all Americans and the Mr. CAMP. Mr. Speaker, at this time that I appeared on last August. She budgets of every household. These changes I yield 2 minutes to the distinguished called in to take issue with the gen- will affect one-sixth of our economy. Done

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00068 Fmt 4636 Sfmt 9920 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1887 right, we will lift burdens that are holding em- ulations will lead to lower wages, lost jobs and that everyone acknowledges is actually ployers back from growing and revitalizing our decreased investment. Employers with more going to increase premiums. economy. Done wrong, jobs will be lost and than 50 employees who do not provide health At a time that we have a $3.8 trillion 10 percent unemployment will become the insurance coverage that is deemed ‘‘accept- budget, 40 percent of which is deficit norm rather than the exception. Health care able’’ by federal standards will be saddled with spending and is being put on the credit expenditures make up an increasing percent- a tax of up to $2,000 per employee. The bill card, this is the wrong time to pass a age of state and federal spending. Addressing will levy a tax of as much as 2.5 percent of new massive government spending pro- health care costs is vital to the long-term eco- household income on Americans who do not gram. And at a time when Americans nomic health of the United States. comply with the individual mandate, which re- are losing trust in Congress, it is the I support reform. I have advocated for delib- quires all Americans to maintain acceptable wrong time to strike backroom deals erate policies that will reduce the cost and in- coverage. Many investors will face a new tax and pass a bill over the will of the peo- crease the quality of health care, provide all of 3.8 percent on capital gains, dividends, in- ple. Americans with the opportunity to obtain af- terest, rents, royalties and other investment in- Everybody in this body acknowledges fordable health insurance, give patients more come. This tax coupled with scheduled rate in- the need for real health care reform. control over their health care decisions, and creases will lead to a top rate of 23.8 percent But this health care reform will make promote innovations and wellness initiatives for capital gains and 43.4 percent for divi- things worse, not better, for the people that lead to cures. dends. we serve. We should not let the hunger I oppose the bill before us today because it We will feel the impact close to home. A 2.3 to do something—anything—trick us will increase health care costs for Americans percent medical device tax will increase the into passing a bill that will cripple free and bend the curve of health care spending in cost of medical devices—everything from enterprise and permanently diminish the wrong direction; it will create a new trillion tongue depressors to wheelchairs—and dis- the freedom of the American indi- dollar entitlement program that the bill does courage the development of critical new med- vidual. not realistically address how we will afford; ical innovations. Specifically, this tax will im- Today I’m reminded of a quote by and it will impede economic growth, particu- pact businesses in our district imperiling jobs; President Ford: ‘‘A government that is larly in our district. curtailing advanced research and innovation; big enough to give you everything you Above all else, health care reform must ad- reducing purchasing from Pennsylvania ven- want is a government big enough to dress the escalating health care costs that are dors; and hampering investment in capital take it all away.’’ This is a time for crippling American families and overall, slow equipment. The ripple effect on our economy courage and clear thinking. I urge my our nation’s healthcare spending. This bill and on working families will be far greater friends on the other side of the aisle to does not accomplish those critical objectives. than the sum of the tax. And ultimately, pa- join in standing with the American According to an analysis by the Congressional tients will see increased costs as a result. people and vote against this bill. Budget Office (CBO), premiums will increase Just yesterday, I offered two amendments to by 10 to 13 percent for families who are pur- the Rules Committee that would have reduced b 2130 chasing health insurance in the individual mar- the negative impacts of H.R. 3590. The first ket. This amounts to more than $2,000 a year amendment would have inserted common- Mr. SPRATT. Mr. Speaker, I yield 2 for a family. In addition, the CBO indicates sense medical liability reforms. Specifically, minutes to the gentlewoman from that H.R. 3590, which will be the law of the the amendment would enact nationwide re- Pennsylvania (Ms. SCHWARTZ). land if we pass it today, will increase the fed- forms aimed at ending the costly practice of Ms. SCHWARTZ. Mr. Speaker, health eral budgetary commitment to health care by defensive medicine and encourage states to care reform represents the largest def- more than $200 billion over the next decade. adopt effective alternative medical liability laws icit-reduction measure in nearly a gen- If the reconciliation package (H.R. 4872) is that will reduce the number of health care law- eration while controlling the rising also signed into law, the combined budgetary suits that are litigated and the average amount cost of health care for families and impact on health care spending will be $390 of time taken to resolve lawsuits, and reduce businesses, and improving access to billion. American families can’t afford that in- the cost of malpractice insurance. The provi- and quality of coverage for 95 percent crease and neither can our country. sions would save our country billions of dollars of Americans. Moreover, this bill creates an unsustainable and reduce national health care spending. The This plan strengthens coverage and new entitlement program at the expense of second amendment would have struck the ill- health care for all Americans, includ- seniors who will be impacted by more than advised medical device tax that a company in ing provisions that I have fought hard half a trillion dollars in Medicare cuts and all my district has dubbed the ‘‘death tax’’ be- for: prohibiting insurance companies Americans who will pay higher health care cause it will increase their tax burden by 77 from excluding coverage for pre- costs and more than half a trillion dollars in in- percent, raising their effective tax rate to over existing conditions for children and creased taxes, fees and penalties. The bill 73 percent. This is an innovation tax that will adults; prohibiting insurers from drop- uses ten years of taxes and Medicare cuts in mean less investment in research and devel- ping coverage when you get sick, or order to pay for six years of programs. Over- opment that leads to medical innovations. Un- placing annual or lifetime limits on all, in the first 10 years of full implementation fortunately the leadership of the House would benefits; insuring that all insurance (2014 to 2023), the health care package will not allow these important amendments to be policies use plain, easy-to-understand result in more than $2.6 trillion in spending. Al- debated on the House floor today. language so that consumers know what though the CBO estimated the overall deficit I regret very much where we are today and they are buying and can honestly com- reduction will be $124 billion over 10 years, in wish that bipartisan efforts to address the pare their choices; allowing young its analysis the CBO cautioned that its long- shortcomings of our system—access and af- adults up to the age of 26 to stay on term deficit projections ‘‘reflect an assumption fordability—while building on our strengths— their parents’ policies; offering tax that the key provisions of the reconciliation choice, quality and innovation had prevailed. credits to small businesses so they can proposal and H.R. 3590 are enacted and re- Mr. CAMP. At this time, Mr. Speak- afford to provide insurance coverage main unchanged throughout the next two dec- er, I yield 2 minutes to the distin- for their employees; eliminating copay- ades, which is often not the case for major guished gentlewoman from Washington ments for preventive care for seniors; legislation. For example, the sustainable (Mrs. MCMORRIS RODGERS). closing the Medicare prescription drug growth rate mechanism governing Medicare’s Mrs. MCMORRIS RODGERS. Mr. coverage known as the doughnut hole, payments to physicians has frequently been Speaker, I know that some of my col- making sure that we close that dough- modified to avoid reductions in those pay- leagues on the other side of the aisle nut hole; promoting the important edu- ments, and legislation to do so again is cur- are still undecided, and I sincerely urge cation and research missions of our Na- rently under consideration by the Congress.’’ you to vote ‘‘no.’’ This is the wrong bill tion’s teaching hospitals and academic House Leadership has already said it will at the wrong time. At a time when 15 medical centers which train the next consider a bill to address the physician pay- million Americans are out of work, generation of doctors and nurses; fo- ment issue. Just that policy alone will cost this is the wrong time to hit small cusing on primary care by better en- $200 billion, which is not reflected in the CBO businesses with more taxes and more suring Americans, particularly those score. requirements. At a time when pre- with chronic diseases, have access to Finally, this bill will have an immediate im- miums are surging for working fami- ongoing primary care; investing in pact on economic growth. New taxes and reg- lies is the wrong time to pass a bill American innovation and technologies

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00069 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1888 CONGRESSIONAL RECORD — HOUSE March 21, 2010 by creating new incentives for the de- drape this legislation across citizens, (Mr. SMITH of Nebraska asked and velopment of new cures and treat- ignoring their pleas against it. And was given permission to revise and ex- ments; and incentivizing collaboration America will again shake its head in tend his remarks.) among health providers through new disbelief and ask how Washington can Mr. SMITH of Nebraska. Mr. Speak- payment reforms that promote high turn a deaf ear and be so disconnected er, I rise in opposition to this flawed quality, efficient delivery of care. from the American people. health care bill. These provisions, and others, in If we stand here in obedience to our Mr. CAMP. Mr. Speaker, at this time health reform ensure new consumer purpose, the Congress will be an effec- I yield 3 minutes to the distinguished rights and protections for those with tive representation of the people of the gentleman from Tennessee, Dr. ROE. insurance. It contains costs for fami- United States. We should stop this un- (Mr. ROE of Tennessee asked and was lies, businesses and for our Nation. And fortunate endeavor, take a step back given permission to revise and extend it extends affordable, meaningful cov- and listen, listen to the heartbeat of his remarks.) erage to 32 million Americans. Health America, the beat that yearns for true Mr. ROE of Tennessee. Mr. Speaker, care reform is vital to the health of health care reform, the beat that asks today we debate and vote on the most Americans and the health of our econ- for bipartisan government committed important piece of social legislation in omy. The status quo is unacceptable to solving America’s problems, the decades, a massive expansion of gov- and unsustainable. I urge a ‘‘yes’’ vote. beat that asks that we put America’s ernment unparalleled in our Nation’s Mr. CAMP. Mr. Speaker, for the pur- families first. America deserves this. history, with the potential to bankrupt poses of a unanimous consent request, America deserves to be heard. future generations by lowering the I yield to the gentleman from Cali- Mr. SPRATT. Mr. Speaker, I yield 2 standard of living for our children and fornia (Mr. MCKEON). minutes to the gentleman from Florida grandchildren. (Mr. MCKEON asked and was given (Mr. BOYD). For the past 30 years, I haven’t been permission to revise and extend his re- (Mr. BOYD asked and was given per- a politician, but a physician, treating marks.) mission to revise and extend remarks.) patients and delivering babies in rural Mr. BOYD. Mr. Speaker, I thank my Mr. MCKEON. Mr. Speaker, I rise in east Tennessee. And I can say without opposition to this flawed health bill. friend, Mr. SPRATT from South Caro- hesitation that we have in this country Mr. CAMP. Mr. Speaker, I yield 3 lina. the highest quality of health care in Mr. Speaker, ladies and gentlemen, I minutes to the distinguished gentle- the world. But I will also say that this heard a wise man once say that you woman from West Virginia (Mrs. care is too expensive for an increasing never saw a great country with an CAPITO). number of people. uneducated and unhealthy population. Mrs. CAPITO. Mr. Speaker, for a mo- Health care should not be a partisan We are headed there. Sixty-seven thou- ment let’s think of this bill as a blan- issue. I have never operated on a Re- sand uninsured in the congressional ket, a blanket of health care legisla- publican or a Democrat cancer in my district that I represent will be helped tion that may be draped across Amer- life. We have heard about how this is by this bill. We all know the statistics ica and its population in the coming going to save money and reduce the about the spiraling cost of insurance years. Unfortunately, this blanket is budget deficit. Seventeen years ago in and the ever-increasing percentage of woven not from all hands working to- Tennessee we tried a plan called uninsureds within our own districts gether, but is the handiwork of strong- TennCare. It was an idea where dif- and across this Nation. We all agree ferent companies were going to com- arm, political deal-making, and, per- this is an unsustainable path. I have pete and we were going to cut costs. haps most disheartening, a resistance heard you say it many times. So I ask What happened in that? Just 10 budget to listen to the American people. you, How high do these numbers have Its cloth has been cut behind closed years later, our costs had tripled and to go before we act? door, and its color is tinged by partisan Earlier I heard the gentlelady from we had to cut the rolls in Tennessee be- hands. It is too short in some areas, Washington State say it is the wrong cause the State was literally going and too long in others, woven to cover time. For 22 years in my legislative bankrupt. And this year for the first the winners and to leave out the losers. service, as I have been trying to find time, we have had to limit patients’ Once this blanket of legislation is laid solutions, I have heard it is the wrong visits to 8 doctor visits per year, and out, those that huddle beneath it will time. I know many of you have been this plan will only pay $10,000, I don’t find that it does not provide the real trying to find those solutions, too, care what the cost of the care is, and health care reform they need for their from time to time; solutions for those those costs are shifted to private insur- families. In fact, it will become a wall high costs, the spiraling high costs, the ers. Also the physicians are not taking of government between them and their ever-increasing number of uninsureds TennCare because it pays them less doctor. on an annual basis, solutions that than 60 percent of their costs of actu- Its huge holes will not protect the would do it in a fiscally responsible ally providing the care. That approach, cold wind of job loss, new taxes, gov- way and use the good parts of our pri- which is pretty much the same ap- ernment bureaucracy, and increased vate-sector delivery system. Ladies and proach we are voting on here today, health care costs. And though we hear gentlemen, this bill does all four of failed, and I know because I am a phy- of coming patches in the future, in all those things. sician who worked in that system. likelihood they will be made of the Mr. Speaker, if we fail to act now, Mr. Speaker, I have one question for same flimsy fabric of broken promises. the path we are on will create a society every Member of this body: If we have All of America will feel the weight of of haves and have-nots based solely on seen how this Big Government scheme this uncomfortable burden. The real one’s ability to purchase health insur- doesn’t work, why would you vote for cost of the $2.6 trillion bill will only in- ance. it again? Well, the States know. They crease in the future. States like mine, I know this bill isn’t perfect. There are already well ahead of the Federal West Virginia, will feel the weight in are some things in it that I don’t like; Government. Thirty-seven States, in- huge budget shortfalls caused by mil- but seldom are bills perfect the first cluding Tennessee, are now proposing lions of dollars in unfunded mandates. time around. The other side has legislation to opt out if the ObamaCare States must balance their budgets and brought us no viable alternatives. So plan should pass. will be forced to absorb the massive in- then I ask you, ladies and gentlemen, if So the States get it because they crease in Medicaid spending demanded not this, then what? If not now, then can’t afford it. The seniors get it be- by this bill. when? cause they understand $500 billion will But, the full burden will be paid by Mr. Speaker, I urge my colleagues to be cut from this program. And let me those who enjoyed this beautiful spring vote ‘‘yes’’ for the health of our people tell you, in the next 10 years we are day, playing outside in backyards and the strength of our economy. going to add 35 million people to the across America. Little do they know as Mr. CAMP. For the purposes of a Medicare rolls in this country when the they play that we are on the cusp of unanimous consent request, Mr. Speak- baby boomers hit. Three things will burdening them with generational er, I yield to the gentleman from Ne- happen when that occurs: you will de- debt. The Speaker and her team will braska (Mr. SMITH). crease access; you will decrease quality

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00070 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE March 21, 2010 CONGRESSIONAL RECORD — HOUSE H1889 because you can’t see your doctor; and tory. Building on the promise that was begun pansion. The legislation will also provide ac- costs will go up. So seniors get it. with the passage of Medicare in 1965, we take cess to health insurance exchanges and sub- The doctors get it. They are going to an historic step today toward acknowledging sidies to help low- and moderate-income fami- work harder and get paid less. Also, health care as a universal right for everyone. lies. Additionally, the bill expands Community there is no meaningful tort reform, and The people of America have suffered far too Health Centers which have been a corner- without that, you cannot reduce the long from a health care system that is stone of primary care services in communities cost of care. The American people get unaffordable, discriminates on the basis of of color, and expands coverage for preventive this. The people of Tennessee don’t gender, disability, and pre-existing conditions, care which has been disproportionately inac- want this plan. The people of the and frequently denies coverage for lifesaving cessible to minorities. United States don’t want this plan; but services and treatments. While we pay more Finally, I will be voting for this bill today for the politicians who vote for it are not than any other country in the world for health the women and mothers in this country who listening. care, we die younger with the highest rate of have long managed the health care of their I choose to listen to the American preventable deaths among 19 industrialized children, their spouses, and the elderly in their people and vote ‘‘no,’’ and urge my col- nations. Obviously this status quo is families. This legislation will mandate cov- leagues to do the same. unsustainable and the time for change is now. erage for maternity care, so all women will be Mr. SPRATT. Mr. Speaker, for the The bill we are voting on today reflects able to give their babies the healthiest start in purposes of a unanimous consent re- many long months of discussion and com- life. quest, I yield to the gentleman from promise. Clearly it is not perfect, and many of By preventing insurance companies from New York (Mr. MEEKS). us would have preferred to see the bill go dropping coverage for extended illness or de- (Mr. MEEKS of New York asked and much further towards granting universal ac- nying coverage for pre-existing conditions, it was given permission to revise and ex- cess to health care for every man, woman and will give moms the peace of mind knowing tend his remarks.) child in this country. But with an issue that im- that their children and spouses will have the Mr. MEEKS of New York. Mr. Speak- pacts so many stakeholders, and involves so health coverage they need if they become ill er, I rise in support of this historic leg- many competing interests, it is doubtful that or suffer from a genetic condition or disability. islation. any single legislative effort could ever satisfy As their young adult children start out in life Mr. Speaker, I rise in support of Affordable everyone and address all the problems we they can protect them by keeping them on Care for America. face in our current system. their family insurance policy until their 26th I am proud to stand with my colleagues in So while this bill falls short of what many of birthday the U.S. House of Representatives in support us had hoped would be included in a final bill, And who among us will not be more secure of this critical legislation to ensure that each I believe it is critical that we move forward knowing that our parents will be protected and every American has access to affordable, today in response to a crippled health care from the Medicare Part D donut hole which quality healthcare. This bill will put Americans system that has been failing our country. With has made life saving medications so and small businesses back in charge of their the passage of this bill we will improve the unaffordable for those that need them most? health care choices and make coverage af- quality and affordability of health services, Mr. Speaker, I thank you for your courage, fordable for everyone. Premium tax credits prioritize prevention and the reduction of tenacity and leadership throughout this year of and cost-sharing assistance will be offered to health disparities, and take the necessary al- deliberation on Health Care Reform. We owe low- and middle-income Americans, which will beit difficult steps to rein in the escalating you, the Majority Leader, and the Leadership be the largest tax cut for health care in the costs of health care in this country. team of this House a debt of gratitude for history of this nation. I will be voting for this bill today for the peo- bringing this House to this historic day. I am My constituents in the Sixth Congressional ple in my 34th Congressional District of Cali- proud to cast my vote for the passage of the District and across the country will be provided fornia. Over 23 percent of my constituents live Senate Amendments to H.R. 3590—the Pa- the opportunity to make informed decisions below the federal poverty level, and 40 per- tient Protection and Affordable Care Act. about their health insurance and purchase the cent of them are uninsured. In 2008, over Mr. SPRATT. Mr. Speaker, I yield 2 plan of their choice. 1100 of my constituents faced health care-re- minutes to the gentleman from Vir- It is extremely important that every hard lated bankruptcies caused primarily by health ginia (Mr. SCOTT). working American receives affordable high care costs that were not covered by their in- Mr. SCOTT of Virginia. Mr. Speaker, quality healthcare. This critical legislation will surance. This bill will extend coverage to America has been debating health care extend coverage to 95 percent of all Ameri- 185,000 of my constituents, and will guarantee for over 100 years, and during this de- cans when passed. For the Sixth Congres- that 28,500 residents with pre-existing condi- bate we have heard complaints and sional District this means that 54,000 residents tions can obtain coverage while protecting blame and misrepresentations, slogans, who currently do not have health insurance those who do have insurance from bankruptcy even name-calling. But today, we fi- will receive coverage. due to unaffordable health care costs. nally get to discuss the bills. By passing this historical legislation we will I will be voting for this bill today for the The bills will provide affordable be able to provide the people of the United small businesses in my District. With its pas- health care insurance to over 30 mil- States the proper healthcare they deserve. No sage, over 16,000 small businesses in my dis- lion Americans who are uninsured American should be denied the right to better trict that have 100 employees or less will be today, including those with preexisting and affordable health care coverage. No able to join the health insurance exchange, conditions. These bills will provide se- American should be discriminated against by benefiting from group rates and a greater curity for those who have insurance be- insurance companies based on pre-existing choice of insurers. H.R. 3590 will also help cause 14,000 Americans will no longer conditions, health status and gender. No make small businesses more competitive by lose their insurance every day, and American should be forced into medical bank- providing tax credits that will make it more af- others will no longer have to watch the ruptcy because their Medicare access was ter- fordable for them to offer health insurance to cost of their insurance skyrocket every minated. I urge my colleagues in the House of their employees. In my district approximately year. Representatives to vote ‘‘yes’’ so no American 15,000 small businesses would qualify for Insurance companies will no longer is told ‘‘no’’ again. these credits. be able to cancel policies or stop mak- Mr. SPRATT. Mr. Speaker, for the As chair of the Congressional Hispanic Cau- ing payments in the middle of an ill- purposes of a unanimous consent re- cus Health Task Force, I will be voting for this ness. No longer will those with health quest, I yield to the gentlewoman from bill today for Hispanic communities all across care have to make copayments for pre- California (Ms. ROYBAL-ALLARD). the country. It is of great concern to me that ventive services, or go bankrupt, be- (Ms. ROYBAL-ALLARD asked and this segment of the population continues to cause the bills provide affordable lim- was given permission to revise and ex- face the highest uninsured rate of any racial or its on copays and deductibles. tend her remarks.) ethnic group within the United States. In fact, And because the legislation will pro- Ms. ROYBAL-ALLARD. I rise in a recent report found that 42 percent of His- vide affordable insurance to virtually strong support of this bill. panic adults lacked health insurance com- all Americans, families with insurance Mr. Speaker, I rise in support of the Senate pared to the national average of 16 percent. will not have to pay an extra thousand Amendments to H.R. 3590—the Patient Pro- This legislation will provide access to afford- dollars a year to offset health care tection and Affordable Care Act. This legisla- able health care to the millions of uninsured costs for those who show up at hos- tion represents a milestone in our Nation’s his- Latinos in this country through Medicaid ex- pitals without insurance.

VerDate Mar 15 2010 02:40 Jun 20, 2010 Jkt 089060 PO 00000 Frm 00071 Fmt 4636 Sfmt 0634 E:\RECORD10\RECFILES\H21MR0.REC H21MR0 mmaher on DSKD5P82C1PROD with CONG-REC-ONLINE H1890 CONGRESSIONAL RECORD — HOUSE March 21, 2010 Seniors will no longer fall into the That’s what is in the bill, and it is we proudly voted in favor of health doughnut hole. more than paid for. The CBO projects care for all. Our youth will be able to stay on significant savings for the first 10 Mr. CAMP. Mr. Speaker, for the pur- their family policies until they are 26. years, and huge savings for the next 10 poses of a unanimous consent request, And small businesses will see signifi- years. I yield to the gentleman from Colorado cant savings in health insurance costs (Mr. LAMBORN). because they will purchase insurance Mr. Speaker, future generations will (Mr. LAMBORN asked and was given with the same price advantages as look back at the votes we cast today, permission to revise and extend his re- large businesses. And many small busi- just as today we look back at the votes marks.) nesses will receive temporary tax cred- on Social Security and Medicare. Mr. LAMBORN. Mr. Speaker, I rise in its. Those future generations will see that opposition to this flawed health bill.

N O T I C E Incomplete record of House proceedings. Except for concluding business which follows, today’s House proceedings will be continued in Book II.

EXECUTIVE COMMUNICATIONS, mitting the Department’s final rule — Air- rorist attacks, natural disasters, or public ETC. worthiness Directives; PIAGGIO AERO IN- health emergencies; to the Committee on DUSTRIES S.p.A. Model P-180 Airplanes Transportation and Infrastructure, and in Under clause 2 of rule XXIV, execu- [Docket No.: FAA-2009-1081; Directorate addition to the Committees on Homeland Se- tive communications were taken from Identifier 2009-CE-058-AD; Amendment 39- curity, and Energy and Commerce, for a pe- the Speaker’s table and referred as fol- 16187; AD 2010-03-04] (RIN: 2120-AA64) received riod to be subsequently determined by the lows: March 4, 2010, pursuant to 5 U.S.C. Speaker, in each case for consideration of 6713. A letter from the Secretary, Depart- 801(a)(1)(A); to the Committee on Transpor- such provisions as fall within the jurisdic- ment of Commerce, transmitting a report in tation and Infrastructure. tion of the committee concerned. accordance with the provisions of Section 6720. A letter from the Paralegal Spe- By Mr. OBEY: 1512 of the Strom Thurmond National De- cialist, Department of Transportation, trans- H.R. 4899. A bill making emergency supple- fense Authorization Act for Fiscal Year 1999; mitting the Department’s final rule — Air- mental appropriations for disaster relief and to the Committee on Foreign Affairs. worthiness Directives; Bell Helicopter Tex- summer jobs for the fiscal year ending Sep- 6714. A letter from the Chief, Branch of tron, Inc. Model 205B and 212 Helicopters tember 30, 2010, and for other purposes; to Permits and Regulations, Division of Migra- [Docket No.: FAA-2010-0065; Directorate the Committee on Appropriations, and in ad- tory Bird Management, Department of the Identifier 2009-SW-01- AD; Amendment 39- dition to the Committee on the Budget, for a Interior, transmitting the Department’s 16186; AD 2010-03-03] (RIN: 2120-AA64) received period to be subsequently determined by the final rule — Migratory Bird Permits; Control March 4, 2010, pursuant to 5 U.S.C. Speaker, in each case for consideration of of Muscovy Ducks, Revisions to the Water- 801(a)(1)(A); to the Committee on Transpor- such provisions as fall within the jurisdic- fowl Permit Exceptions and Waterfowl Sale tation and Infrastructure. tion of the committee concerned. and Disposal Permits Regulations [Docket 6721. A letter from the Paralegal Spe- Number: FWS-R9-MB-2007-0017] (RIN: 1018- cialist, Department of Transportation, trans- f AV34) received March 4, 2010, pursuant to 5 mitting the Department’s final rule — Air- U.S.C. 801(a)(1)(A); to the Committee on Nat- worthiness Directives; The Boeing Company ADDITIONAL SPONSORS ural Resources. Model 747-200C and -200F Series Airplanes 6715. A letter from the Chief, Branch of [Docket No.: FAA-2009-0608; Directorate Under clause 7 of rule XII, sponsors Permits and Regulations, Division of Migra- Identifier 2008-NM-215-AD; Amendment 39- were added to public bills and resolu- tory Bird Management, Department of the 16188; AD 2010-03-05] (RIN: 2120-AA64) received tions as follows: Interior, transmitting the Department’s March 4, 2010, pursuant to 5 U.S.C. H.R. 949: Mr. MICHAUD. final rule — Migratory Bird Permits; Control 801(a)(1)(A); to the Committee on Transpor- of Purple Swamphens [Docket Number: FWS- H.R. 959: Mr. ELLSWORTH. tation and Infrastructure. R9-MB-2007-0018] (RIN: 1018-AV33) received 6722. A letter from the Assistant Chief H.R. 1017: Ms. CORRINE BROWN of Florida. March 4, 2010, pursuant to 5 U.S.C. Counsel for Hazardous Materials Safety, De- H.R. 1822: Mr. DEAL of Georgia. 801(a)(1)(A); to the Committee on Natural partment of Transportation, transmitting H.R. 1879: Mr. TIM MURPHY of Pennsyl- Resources. the Department’s final rule — Hazardous Ma- vania. 6716. A letter from the Chief, Branch of H.R. 2067: Mr. ARCURI. Permits and Regulations, Division of Migra- terial; Miscellaneous Packaging Amend- ments [Docket No.: PHMSA-06-25736 (HM- H.R. 2254: Mr. BERRY, Mr. BISHOP of Geor- tory Bird Management, Department of the gia, and Mr. ENGEL. Interior, transmitting the Department’s 231)] (RIN: 2137-AD89) received March 4, 2010, pursuant to 5 U.S.C. 801(a)(1)(A); to the Com- H.R. 2360: Mr. MATHESON. final rule — Migratory Bird Permits; States H.R. 3217: Mr. BILBRAY. Delegated Falconry Permitting Authority mittee on Transportation and Infrastruc- ture. H.R. 3365: Mr. TONKO. [FWS-R9-MB-2009-0071; 91200-1231-9BPP] (RIN: H.R. 4404: Mr. SESTAK and Mr. ETHERIDGE. 1018-AW98) received March 4, 2010, pursuant f H.R. 4405: Ms. FUDGE, Mr. RUSH, and Mr. to 5 U.S.C. 801(a)(1)(A); to the Committee on PUBLIC BILLS AND RESOLUTIONS BLUMENAUER. Natural Resources. H.R. 4684: Mr. HODES. 6717. A letter from the Paralegal Spe- Under clause 2 of rule XII, public H.R. 4710: Mr. KAGEN. cialist, Department of Transportation, trans- bills and resolutions of the following H.R. 4874: Ms. RICHARDSON. mitting the Department’s final rule — Modi- titles were introduced and severally re- H.R. 4894: Mr. KLINE of Minnesota, Mr. fication of Class E Airspace; Grand Junction, ferred, as follows: WAMP, and Mr. TIAHRT. CO [Docket No.: FAA-2009-0941; Airspace H.J. Res. 76: Mr. TANNER. Docket No. 09-ANM-17] received March 4, By Ms. RICHARDSON: H. Res. 1116: Mr. LEWIS of Georgia, Mr. 2010, pursuant to 5 U.S.C. 801(a)(1)(A); to the H.R. 4897. A bill to amend the Internal Rev- HODES, Ms. CORRINE BROWN of Florida, Mr. Committee on Transportation and Infra- enue Code of 1986 to allow a deduction for in- LEVIN, and Mr. FILNER. structure. terest paid on indebtedness incurred in con- 6718. A letter from the Assistant Chief nection with the purchase of a new auto- H. Res. 1199: Mr. CONAWAY. Counsel for General Law, Department of mobile or light truck; to the Committee on Transportation, transmitting the Depart- Ways and Means. f ment’s final rule — Pipeline Safety: Admin- By Ms. RICHARDSON (for herself, Ms. istrative Procedures, Address Updates, and NORTON, Ms. JACKSON LEE of Texas, DISCHARGE PETITIONS Ms. CLARKE, and Ms. KILROY): Technical Amendments [Docket No.: Under clause 2 of rule XV, the fol- PHMSA-2007-0033] (RIN: 2137-AE29) received H.R. 4898. A bill to authorize the Secretary March 4, 2010, pursuant to 5 U.S.C. of Homeland Security to establish a com- lowing discharge petition was filed: 801(a)(1)(A); to the Committee on Transpor- petitive program to make emergency pre- Petition 10, March 15, 2010, by Mr. WAL- tation and Infrastructure. paredness planning and implementation TER B. JONES on H.R. 775, was signed by the 6719. A letter from the Paralegal Spe- grants to local educational districts/agencies following Members: Joe Wilson and Adam H. cialist, Department of Transportation, trans- located in areas under a high threat of ter- Putnam.

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