Access to Medicare Imaging Act of 2006

Mr. Speaker, pursuant to House Resolution 1099, I call up from the Speaker's table the bill (H.R. 6111) to amend the Internal Revenue Code of 1986 to provide that the Tax Court may review claims for equitable innocent spouse relief and to suspend the running on the period of limitations while such claims are pending, with a Senate amendment thereto, and ask for its immediate consideration in the House.

Mr. Speaker, pursuant to House Resolution 1099, I offer a motion.

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

Mr. Speaker, to make sure that Members understand what we are doing, and, quite frankly, why we are doing it today rather than yesterday, is that we are considering H.R. 6111. H.R. 6111 is a bill that passed the House on suspension by voice vote on December 5. It then passed the Senate by unanimous consent with an amendment yesterday, December 7.

We are doing this as the House of Representatives to assist the Senate under its rules to facilitate the handling of the amendment we are now discussing, and we are doing this because given the Senate rules, they

would require a 2-day layover, two cloture votes and a number of other procedures. By doing this this way, we will save them a day and a cloture vote. Once again, the courtesy and kindness of the House is assisting the Senate in accomplishing the work of the Congress.

So, if you will please understand, the gentleman from New York and I will lead a discussion on the amendment to H.R. 6111. In fact, the amendment is as though the entire text of H.R. 4608, the Tax Relief and Health Care Act of 2006, is before us. In addition to that, there are several other provisions that accompany the Tax and Health Care Relief Act.

So, notwithstanding the merits of H.R. 6111, the discussion will be on the so-called tax extenders bill; the energy extenders bill; Medicare, the so-called doctors fix; the health care provisions; certain wilderness designations; some tariff procedures and other items which will in fact be the subject of the debate we are about to be engaged in.

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

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

Perhaps again it is necessary to underscore the fact that the procedure we are going through is not the choice of the House. The current minority leader, to be the majority leader, and I know I am violating the rules when I say the gentleman from Nevada, personally called and asked that we engage in this procedure to assist the Senate. I do hope the gentleman from New York, when he assumes his majority rule, will see fit to accommodate even Members of the other party in making sure that the people's work is done in the most reasonable fashion possible.

So, yes, it seems a little bit complicated, but it is in large part because both the Democratic and the Republican leadership of the Senate asked for our assistance in doing it this way.

Mr. Speaker, it is my pleasure to yield 2 minutes to the gentleman from Arizona (Mr. Hayworth), a distinguished member of the Ways and Means Committee.

(Mr. HAYWORTH asked and was given permission to revise and extend his remarks.)

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

Mr. Speaker, so that people again understand the process, notwithstanding the fact we are dealing with what amounts to a tax bill, because of the unusual procedure of using H.R. 6111 as a vehicle, asked for by the bipartisan leadership of the Senate and provided by us as a courtesy, there would be no motion to recommit available to the minority. This is a substantive amendment which is functioning as a substitute for the motion to recommit.

It has been indicated to me directly by that bipartisan leadership and those individuals I mentioned that if what was to be a motion to recommit and which will now be a substantive amendment passes, in their opinion, this bill will not be able to move through the Senate.

It may surprise the gentleman from Massachusetts to know that I agree with virtually everything he said and would like to add additional items in terms of the OCS provision. In fact, an Outer Continental Shelf measure passed the House. The measure that is currently carried in this amendment is totally isomorphic, exactly the same as the Outer Continental Shelf legislation that passed the Senate, that the Senator from New York, Mrs. Clinton, that the Senator from Nevada, Mr. Reid, and others supported 71-25. Need I say, this is an additional courtesy that the House is providing.

If, in fact, Mr. Markey's amendment passes, everything we will be talking about for the rest of the time on this amendment will be moot.

Mr. Speaker, it is now my pleasure to yield 2 minutes to the gentleman from Illinois (Mr. Weller), an extremely valued member of the Ways and Means Committee.

Mr. Speaker, I appreciate people and their passion getting a bit carried away.

This bill was signed into law by the last Democratic President, Mr. Clinton. It was on your watch. To stand in the well and tell us what is in the amendment that is going to be offered in a short time, after being criticized that they have only had 2 days on the content of our amendment, is absolutely unbelievable.

We made this amendment in order because you didn't have the right to the motion to recommit. The Rules Committee out of courtesy asked you, could we have a copy of your amendment? You told the Rules Committee ``No, you couldn't have a copy of the amendment.''

Mr. Markey earlier described your amendment as having more than one item. Mr. Hinchey talked about it being OCS. Mr. Markey said it was OCS and it was AMT and it may be something else.

What amazes me is that they can stand there with a straight face and criticize us because they only got the copy, the absolute legislative language, 2 days ago on our bill, and they have the audacity to go to the well and describe their amendment and what it is when they won't even give us a copy of it. Now, this is a preview of the coming majority in terms of their saying one thing and doing another. Buckle your seat belts. The piety and the arguments about how correct they are and how unfair it is was just said. This was done by this Congress, it was signed by President Clinton, and we have no idea what is in your amendment because you didn't even offer the courtesy of giving us the language of your amendment notwithstanding the fact that we gave you the privilege of offering an amendment. Now, that is what this is about. Okay?

Mr. Speaker, I yield 2 minutes to the gentleman from California (Mr. Herger), a member of the committee.

Mr. Speaker, I yield myself 5 seconds.

Mr. Speaker, this is the third Member on the other side of the aisle who spoke passionately about an amendment that apparently they have had time to write, circulate and read. We have not been presented with that amendment. Obviously, with some fervor, I indicated that I didn't think that probably was the fair thing to do. They now know how the majority feels, having given them the right to offer an amendment. My assumption is that continued refusal to provide us with a copy of the amendment is willful.

Mr. Speaker, will the gentleman yield?

That was 2 days ago. What are you doing for me lately?

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

Mr. Speaker, I want to thank my friend from Massachusetts for providing the majority with the amendment.

Frankly, I was rather baffled why my friend from New York would yield half their time to the gentleman from Massachusetts since he has time under his own amendment. Having now seen the amendment, I find it interesting that it is an 11-page amendment, a portion of a page is on research credits, a portion of a page is on the alternative minimum tax. The Outer Continental Shelf portion of the 11-page bill, which has been the sole focus of my friends on the other side of the aisle, is six lines. Not six pages, six lines.

What in the world is in the rest of the 11-page bill: Eight pages address putting back into this, over the objections of the Democratic leader on the Senate side, the New York railroad bond provision. I now understand why Mr. Markey got his 15 minutes.

Mr. Speaker, it is my pleasure to yield 2 minutes to the gentlewoman from Connecticut (Mrs. Johnson), the chairman of the Health Subcommittee.

Mr. Speaker, will the gentleman yield on my time?

Mr. Speaker, I thank the gentleman because I do appreciate the remarks that he just made. And we probably had not planned on highlighting it, but as the gentleman from Louisiana well knows, another portion of the changes that we are making in this package is to take what was known as the Katrina GO Zone, a benefit, and, after the time has passed, focus the money on those counties that still remain devastated by a high percentage of destruction. Rather than simply having money go where it may not be necessary, a portion of this bill focuses the money where it is absolutely necessary. And as the gentleman from Louisiana well knows, there are still major areas of his State and other States that can easily be defined as devastated.

Mr. Speaker, it is my pleasure now to yield 2 minutes to a valued member of the Ways and Means Committee, the gentleman from Texas (Mr. Brady).

Mr. Speaker, at this time I will place a letter in the Record which is a clarification sought by the gentleman from Georgia (Mr. Price) to me.

Congress of the United States,

Washington, DC, December 8, 2006.

Representative J. Dennis Hastert,

Speaker, House of Representatives,

Washington, DC.

Dear Mr. Speaker: We would like to clarify the intent of

certain provisions in Tax Relief and Health Care Act of 2006,

Mr. Speaker, at this time the Chair would recognize the gentlewoman from Florida (Ms. Ginny Brown-Waite) for 2 minutes.

Mr. Speaker, the Chair appreciates the vigor of the gentleman from Ohio on 6 lines out of an 11-page amendment.

The Chair now recognizes the gentleman from Pennsylvania (Mr. Peterson) for 1\1/2\ minutes.

Mr. Speaker, would you indicate the time remaining for each manager?

And would the Speaker indicate who has the right to close?

Mr. Speaker, the chairman reserves the time.

I would tell the gentleman that I have the chairman of the Energy and Commerce Committee and the chairman of the Ways and Means Committee.

Is the gentleman indicating that the gentleman from New York is the last speaker under his time control?

I thank the gentleman.

Does the gentleman from Massachusetts indicate that he is the last speaker under his time? I thank the gentleman.

The Chair now recognizes the gentleman from Texas, the chairman of the Energy and Commerce Committee, Mr. Barton, for 2 minutes.

Mr. Speaker, I want to refocus our Members. We are not on the Markey amendment. The Markey amendment will be presented following the conclusion of the discussion on the underlying bill.

Mr. Speaker, the Nonpartisan Joint Committee on Taxation has made available to the public a technical explanation of the bill. This technical explanation expresses the committee's understanding and legislative intent behind this important legislation.

Mr. Speaker, the nonpartisan Joint Committee on Taxation has made available to the public a technical explanation of the bill. This technical explanation expresses the Committee's understanding and legislative intent behind this important legislation.

Mr. Speaker, in keeping with the spirit of H. Res. 1000, which the House passed this year to reform the legislative process, I note that the Joint Committee on Taxation has identified 2 provisions of H.R. 6408, introduced yesterday, as ``earmarks'' under the terms of that resolution. These provisions also appear in the amendment to H.R. 6111 which the House will consider today. A copy of the Joint Committee on Taxation's opinion letter is available for Members to review if they wish.

The identified provisions are Title I's Section 414. Modification of special arbitrage rule for certain funds made permanent, and Section 211 of Division C, Certain related persons and successors in interest relieved of liability if premiums prepaid. Section 414 was requested by Congressman Kevin Brady (R-TX). Section 211 is part of a comprehensive mining reform proposal requested by Senators Rick Santorum (R-PA) and Max Baucus (D-MT).

H.R. 6408's Division B--Medicare and Other Health Provisions, contains an earmark. Section 111, Clarification of hospice satellite designation, was requested by Senator Reid (D-NV). The amendment also contains this provision.

In addition, Division C, Title I, Gulf of Mexico Energy Security requested by Congressman Bobby Jindal (R-LA) and Title III, White Pine County Conservation, Recreation and Development requested by Senator Harry

Reid (D-NV) have been identified as containing probable earmarks.

December 8, 2006.

Hon. William M. Thomas,

Chairman, Committee on Ways and Means, 1102 Longworth House

Office Building, Washington, DC.

Dear Chairman Thomas: House Resolution 1000 provides that

the staff of the Joint Committee on Taxation identify any tax

earmark in a bill carrying a tax measure reported by the Ways

and Means Committee or in a conference report to accompany a

bill carrying a tax measure. You requested that we review the

language of H.R. 6408, the ``Tax Relief and Health Care Act

of 2006'' as introduced in the House of Representatives on

December 7, 2006, and the House Amendment to the Senate

amendment to H.R. 6111 (``An Act to amend the Internal

Revenue Code of 1986 to provide that the Tax Court may review

claims for equitable innocent spouse relief and to suspend

the running on the period of limitations while such claims

are pending'') scheduled for consideration by the House on

December 8, 2006, to identify any provisions which would

satisfy the tax earmark standard of House Resolution 1000, if

applicable.

In response to your request, the staff of the Joint

Committee on Taxation has identified two provisions in each

piece of legislation that would qualify as tax earmarks under

House Resolution 1000, were they included in a bill reported

by the Ways and Means Committee or contained in a conference

report. The two provisions, which are the same in both bills,

are: (1) the provision to make permanent the modification of

special arbitrage rules for the Texas Permanent University

Fund (sec. 414 of Division A of each bill); and (2) the

provision of the Surface Mining Control and Reclamation Act

Amendments of 2006 allowing release of joint and several

liability in the case of prepayment of liabilities to the

Combined Benefit Fund, section 9711 individual employer plan,

or 1992 UMWA benefit plan and modifying of the definition of

successor in interest (sec. 211 of Division C of each bill).

Sincerely,

Thomas A. Barthold,

Acting Chief of Staff.

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and to include extraneous material on the subject of the bill under consideration.

Mr. Speaker, I want to thank my friend from New York for the kind comments that he made. I would like to reference his statement about the other side. For those of you who may not have understood what he meant, the other side is not the other side of Jordan. It is the other side of the Capitol. Oftentimes in dealing with the other side of the Capitol, it feels like you have crossed over the other side of Jordan in trying to make sure various things happen.

There are a number of items, and I guess at some point, your entire presentation oftentimes in dealing with Congress was woulda, coulda, shoulda. And that is fine to debate woulda, coulda, shoulda, which is basically process.

We have reached a point where, through great difficulty, the House and Senate have agreed on a number of important measures to extend benefits and to at least keep open the opportunity to do additional items.

We happened to reach agreement at the very end of the session. The point I want to underscore is, we have reached agreement. The question will be on whether we decide to support that agreement or not support the agreement. I do appreciate all the time consumed in complaining about how we got there.

I have counseled my friends on this side that when they become the minority, I will provide them with all the yellow pages and the copies of the other side while they have been in the minority about the ``woulda coulda shoulda.'' Right now, it is about substance, it is about doing something, and we will have the vote on this measure following the debate on the Markey amendment.

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

Mr. Speaker, reserving the right to object, I believe perhaps we ought to proceed in the reading of the amendment.

Mr. Speaker, I rise in opposition to the amendment.

I do think it is important to note there are a number of items in the bill, not just the Outer Continental Shelf. As was indicated by the gentleman from Massachusetts and indicated by the gentleman from New York, there is an alternative minimum tax provision in this amendment. One of the things that the Democratic leadership has said, since prior to the election is, that if they were elected, if they were chosen, if they were going to be dealing with items that cost money, they were going to submit themselves to the so-called PAYGO rules. PAYGO rules are exactly what it sounds like: you pay as you go.

I find it ironic that there is this great pressure to move this amendment now before they do come into the majority, because the alternative minimum tax provisions of this amendment have no PAYGO requirement.

What, in fact, they have is spend without covering the costs, and so I understand the urgency to get this done right now so that they don't have to follow the commitment that they have made.

Boy, is that typical. In terms of the railroad bonds, I will repeat, in a personal conversation with the Democratic leader of the Senate, he asked me to make sure, not withstanding previous support and structure that we were dealing with, in this extremely fragile measure, being carried in an unusual way to make sure that we can send it to the President, notwithstanding whether you believe the railroad bond provision has merit or doesn't have merit, it cannot be added at this time or you will lose the measure. I personally will put my trust in the judgment of the Democratic leader of the Senate.

Finally, on OCS. As I said to the gentleman from Massachusetts, in another time, in another place, in another circumstance for largely the same reason that I mentioned, we have to correct this. I appreciate it has been going on for 10 years. We do understand it was signed into law by President Clinton. I guess my question to you is, if it has been going on for 10 years, and you take over this place in less than a month, and you have 100-day priority structure, 100-hour structure, excuse me, were you not able to find room on the 100-hour structure to do this? It sounds to me, based upon the strength and the merit of your arguments, this would be number 1, 2 or 3 on the 100 hours.

Because in that same conversation that I had with the Democratic leader in the Senate, he said, Bill, please, we cannot have this added to the measure. It will split the Senate. We are very fragile, trying to hold ourselves together, notwithstanding the merits of this. Please, don't put it on this measure.

Time, place, manner, it is 10 years overdue. Can we make it 10 years and 20 days overdue so that you don't destroy all of the stuff that is in this bill so that we can get this done and then we turn the floor over to you in the first 100 hours? I am sure this would be number 1, 2 or 3 based upon the outrage that I think you justifiably present on this particular issue.

For all those reasons, unwillingness to follow their own rules they say they are going to follow on PAYGO for an alternative minimum tax, the fact that we looked at the railroad bonds, there was a bipartisan bicameral agreement, it was too sensitive at this time, and the fact that OCS will blow up everything else in this bill, I will ask my colleagues to vote ``no'' on this amendment so we can vote ``yes'' on everything else.

Mr. Speaker, I rise in support of H.R. 6111, the Tax Relief and Health Care Act of 2006. I do so for three reasons. First, the bill extends and modifies certain key tax relief provisions through 2007, which provide much needed relief to working and middle-class taxpayers.

Second, I believe that among the most urgent challenges confronting the Nation, none is more important than lessening, and ultimately ending, America's dependence on foreign energy sources. H.R. 6111 advances this goal in a small but appreciable way by permitting oil and gas production in an 8.3-million acre area of the Gulf of Mexico, with 37.5 percent of the lease income allocated to the Gulf Coast States closest to the drilling area, excluding the Florida gulf coast.

Third, the bill blocks the scheduled 5 percent cut in Medicare payments to doctors, and provides for a 1.5 percent increase in such payments next July for physicians who submit data relating to certain quality of care standards.

I. Extension of Tax Relief for Working and Middle Class

Mr. Speaker, H.R. 6111 extends through 2007 several tax provisions under current law, including provisions that expired at the end of 2005 and some that are set to expire at the end of this year. Many of these provisions are targeted to middle- and working-class taxpayers. I strongly support this portion of the bill. I would like to discuss several of the more important middle class tax relief provisions.

State and Local Sales Tax Deduction

H.R. 6111 extends by 2 years the provision allowing taxpayers the option of deducting general sales taxes paid. This provision is of particular benefit to taxpayers living in States that do not impose a State income tax. Taxpayers have long been permitted to claim an itemized deduction for certain State and local taxes, including personal income tax, real property taxes and personal property taxes, but they have not been to deduct general sales taxes since 1986. The 2004 corporate tax bill allowed taxpayers, in 2004 and 2005 only, to claim instead an itemized deduction for State and local sales taxes, either by accumulating receipts and deducting the total amount or using tables produced by the Internal Revenue Service. In States without State income tax, this provision provided a new deduction for individuals.

Higher Education Expenses Deduction

Similarly, the bill renews and extends through 2007 the ``above-the- line'' deduction that taxpayers may claim for higher education expenses: An ``above-the-line'' deduction is a deduction that may be claimed by a taxpayer even if he or she does not itemize his or her deductions. Under the provision of law that would be extended, taxpayers can deduct up to $4,000 of such expenses if their adjusted gross income does not exceed $65,000 for a single return or $130,000 for a joint return, and up to $2,000 if their income does not exceed $80,000 for a single return or $160,000 for a joint return. In this increasingly globalized economy, a college education is becoming a necessity. We must do all we can to ensure that access to higher education remains affordable to the working and middle class. That is why I support strongly the renewal and extension of the deductibility of higher education expenses.

Teacher Classroom Deduction

Mr. Speaker, H.R. 6111 also extends through 2007 a provision that expired at the end of 2005, under which teachers may claim an ``above- the-line'' deduction up to $250 of the expenses for certain supplies that they purchase for their elementary or secondary classrooms with their own money.

Mr. Speaker, my daughter taught in elementary schools and I know how devoted she and her colleagues were to providing their students with the most enriching educational experience possible. It is not uncommon for them to dip into their personal funds to buy supplies and materials to supplement those provided by the schools. Teachers go this extra mile because they love what they do; everyone knows it is not because they are overpaid. I approve the teacher classroom deduction included in the bill. I hope we will be able to increase the amount of this deduction in the future.

II. Energy Independence and Security

It is imperative that America achieves energy independence in the 21st century. We must end our addiction to foreign sources of oil, most of which are found in regions of the world which are unstable and in some cases, opposed to our interests. Accordingly, there is no issue more integral to our economic and national security than energy independence.

Although I must admit that I do have reservations about certain aspects of this bill and the process with which this bill has arrived on the House floor, I nevertheless support it as a step in the right direction of America achieving energy independence. I think many of us in the House would agree that the issues central to this bill, the future of energy exploration off of our gulf coastlines, deserves more time for deliberation, debate, and a process for amendment. Some of these provisions which were incorporated into H.R. 4671 include my amendments which supported minority-serving universities and minority- owned businesses.

These very important provisions were designed to ensure that sectors of our Nation and economy which are often overlooked, namely, minority- serving institutions and minority-owned businesses, were given an opportunity to benefit from and compete for the opportunities afforded in this bill.

Nevertheless, I still support H.R. 6111 because it is a step in the right direction, a step towards energy independence, and a step away from being eternally beholden to foreign sources of oil. Additionally, I believe the energy aspects of the bill lay the foundation for the development of a new model for reclaiming wetlands; will help the Gulf Coast States affected by Hurricanes Katrina and Rita to recover from the disaster and prosper in the future; provide thousands of good- paying jobs for the middle class; and serve as a blueprint for general revenue sharing in the 21st century.

In this connection, I would like to emphasize that the revenue sharing formula in the bill ensures that 37.5 percent of the revenue from

new areas of production and new leases go towards gulf producing States. Furthermore, 20 percent of the revenue allocated to gulf producing States must be allocated to the State's coastal subdivisions to be used for the purposes of: coastal protection, conservation, coastal restoration, hurricane protection, protecting coastal wetlands, and mitigating damage to fish and wildlife. In addition, 12.5 percent of the revenue will be allocated to the Land and Water Conservation Fund, which ensures that the environmental impact of offshore drilling will be monitored, managed, and regulated to ensure that our coasts are protected.

Energy is the lifeblood of every economy, especially ours. Producing more of it leads to more good jobs, cheaper goods, lower fuel prices, and greater economic and national security. However, the U.S. is more than 60 percent dependent on foreign sources of energy, twice as dependent today as we were just 30 years ago. Although energy is the lifeblood of America's economic security, this growing and dangerous dependence has resulted in the loss of hundreds of thousands of good American jobs, skyrocketing consumer prices, and vulnerabilities in our national security.

Energy imports now make up one-third of America's trade deficit. Through this bill, America could improve the supply-demand imbalance, lower consumer prices, and increase jobs by producing more of its own energy resources. With my district of Houston being the energy capital of the world, I support the efforts that this bill makes to recognize State stakeholders and incorporate their interests in revenue sharing.

According to the U.S. Minerals Management Service, MMS, America's deep seas on the Outer Continental Shelf, OCS, contain 420 trillion cubic feet of natural gas--the U.S. consumes 23 TCF per year--and 86 billion barrels of oil--the U.S. imports 4.5 billion per year. Even with all these energy resources, the U.S. sends more than $300 billion--and countless American jobs--overseas every year for energy we can create at home.

In some cases, the U.S. is facing much-higher energy prices than other countries. Natural gas, for example, is as much as ten times more expensive in the United States than it is in foreign nations. This fact alone has led to the loss of hundreds of thousands of high-paying American jobs, as natural gas-dependent factories are forced to close their doors and move overseas in search of more affordable energy. The outsourcing of American jobs is an issue of central importance to me and my constituents, and I believe this bill is a step in the right direction of bringing jobs back to hard-working Americans.

iii. h.r. 6111 blocks medicare cuts in physician payments

Finally, Mr. Speaker, I support the bill because it blocks the 5 percent cut in payments to physicians who treat Medicare patients which otherwise would go into effect on January 1, 2007. Over the next 9 years, Medicare's trustees are projecting a total of 40 percent in Medicare payment cuts to physicians. If the January 1 cut is imposed, the average physician payment rate, accounting for increases in the cost of running a practice, will be less in 2007 than it was in 2001.

The Medicare sustainable growth rate, SGR, formula, used in establishing payment rates under the physician fee schedule under the Medicare program, resulted in significant payment cuts to physicians and health care professionals in 2002. These cuts were for doctors only, not for hospitals or other medical facilities.

The Medicare SGR formula would have resulted in payment cuts to physicians and health care professionals in 2003, 2004, 2005, and 2006 had Congress not intervened.

According to the Medicare Payment Advisory Commission, MedPAC, and the board of trustees of the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, the Medicare SGR formula will result in substantial payment cuts to physicians and health care professionals through at least 2015.

MedPAC is very well respected and a recognized authority on Medicare and healthcare issues. It does not support the impending payment cuts and is concerned that such consecutive annual payment cuts would threaten access to physician services over time, particularly primary care servIces.

MedPAC has raised concerns over current payment policies that may discourage medical students and residents from becoming primary care physicians because many Medicare beneficiaries rely on primary care providers for important health care management.

According to a 2006 American Medical Association, survey, if payment cuts to physicians under the Medicare program go into effect: half of physicians plan to decrease the number of new Medicare patients they accept; half of physicians plan to defer the purchase of information technology; 1 in 3 physicians who treat patients living in rural communities will discontinue rural outreach services; and almost half-- 43 percent--of physicians will decrease the number of new TRICARE patients they accept.

The annual actions by Congress that have overridden the Medicare SGR formula have only resulted in instability and unpredictability for physicians, health care professionals, seniors, and individuals with disabilities. It does not solve the long-term systemic problem of rising costs.

Stable, positive updates under the Medicare physician fee schedule that accurately reflect medical practice cost increases are vital for encouraging and economically supporting physicians' ability to make the significant financial investment required for health information technology and participation in quality improvement programs.

A stable payment system for physicians is critical to preserve Medicare beneficiaries' access to high-quality health care.

We cannot in good conscience establish barriers for doctors and health care professionals to surmount in order to continue to provide access to high-quality Medicare services for all Medicare beneficiaries. Congress must halt the impending January 1 cuts and develop an alternative payment system that accurately reflects the costs of providing care to Medicare beneficiaries.

The biggest single flaw is that this payment schedule rubric recently announced by CMS has no connection to the actual cost of providing patient care. Starving doctor's practices will not decrease healthcare prices, or change unethical behavior. It will drive doctors out of business who are desperately needed to provide care to our elderly.

In conclusion, I urge my colleagues to support H.R. 6111 because it takes three steps in the right direction: (1) It provides much needed tax relief to working and middle class taxpayers; (2) It reduces the Nation's dependence on foreign energy supplies and ensures that Gulf Coast States share in the revenue from new areas of production while protecting our environment; and (3) It blocks draconian cuts by Medicare in payments to physicians. I urge all members to support the bill.

Mr. Speaker, I thank the gentleman for yielding and would amplify just for a moment on his point. You can't get your amendment set until you know what the underlying bill is. And with all the moving parts in the underlying bill, that simply was not possible.

But I believe that this election was about restoring more of a bipartisan tone to the functions of this Chamber. And in that context, I want to tell the departing chairman I wish him well as his service in this body comes to a conclusion. I wish all my Ways and Means colleagues, Republicans and Democrats alike, a very happy holiday season.

There are several portions of this bill that are important, and I applaud those who constructed this legislation for including these components. I am not speaking about the amendment which will be brought; that will be dealt with by other speakers. But there is a lot of good in this bill, and I don't want it lost in the discussion here.

I chair, along with Greg Walden, a bipartisan group, the Rural Health Care Coalition. We have advanced legislation to try to improve the unfairness of the Medicare system relative to rural hospitals. I am pleased that the bill includes provisions, including a continuation of the geographic classification issue, section 508, that was in the Medicare Modernization Act and addresses reasonable cost payment for lab tests in small rural hospitals and a number of other provisions found their way into this bill. They are important to us, and I speak in favor of them.

I also believe that it was absolutely essential we address this physician payment issue in this legislation. It should be underscored, I suppose, that this is just a very stop-gap fix and more will need to be done. There is some very important features in here on renewable energy as well. The plus-up of the clean renewable energy bonds with an additional $400 million to fund renewable energy projects, extremely important. A 1-year continuation of the wind production tax credit is, no question, going to allow more wind farms to be brought online, bringing this renewable energy source, clean renewable energy source, more into our power mix. And the extension of the ethanol tariff is also important, something to keep in mind as we consider it this afternoon.

Mr. Speaker, I rise in support of H.R. 6111, the Tax Relief and Health Care Act of 2006 as it provides for much needed relief for those physicians, hospitals and laboratories who serve North Dakota's 103,000 Medicare patients.

As you know, the Medicare Modernization Act made long overdue corrections to significant flaws in Medicare payment schemes that have made a tremendous difference to the hospitals, doctors and other providers in my State and throughout the rural America. Several of these provisions, which help to level the playing and simply keep hospitals and doctors offices open, have or are about to expire. However, access to health care services in rural areas continues to be in jeopardy due to physician shortages, low patient volume and geographic isolation. In my own State of North Dakota, over two-thirds of our counties are designated as Physician Scarcity Areas.

That is why Representative Greg Walden, myself and over 50 other bipartisan members of the Rural Health Care Coalition introduced H.R. 6030, the Health Care Access and Rural Equity Act, otherwise known as H-CARE. This commonsense legislation significantly improves health care quality and access in North Dakota and rural America while also increasing the viability of rural providers.

I am pleased to see that a number of the provisions Representative Walden and I authored for H-CARE are included in today's bill. From extending the Medicare Modernization Act, MMA, floor on the Medicare work geographic adjustment for physician services to continuing to provide reasonable cost payment for lab tests in small rural hospitals, H.R. 6111 helps to maintain important corrections in our current Medicare payment system. In addition, this bill extends a critical provision of the MMA that created greater wage parity between hospitals in my State of North Dakota.

These MMA rural health provisions have already made a tremendous difference in our State. For example, one hospital was able to use the funding to recruit four new physicians. Other hospitals used the funding to invest in capital infrastructure including much needed and costly ultrasound equipment and electronic health record systems. In addition, these hospitals were able to increase salaries anywhere from 4 to 8 percent.

While H.R. 6111 extends many critical rural health care provisions from the MMA and brings temporary relief for our Nations physician's, our work is not done. I think we would all agree that the physician payment system under Medicare is a flawed system that penalizes efficient care and rewards excessive care. I look forward to working with my colleagues in the 110th Congress in a bipartisan manner to improve our Medicare physician payment system and further advance the remaining components of H-CARE in order to improve access to quality, affordable health care in North Dakota and rural America.

This bill also contains important provisions for our growing renewable energy industry. Included in H.R. 6111, the Tax Relief and Health Care Act of 2006, are an extension and expansion of the Clean Renewable Energy Bond program, a 1-year extension of the Wind Production Tax Credit and over a year extension of the ethanol tariff that protects American ethanol producers from subsidized foreign ethanol.

Through this continued investment in renewable energy we not only build a sustainable industry for our State but we are helping make America more energy independent and more secure.

Clean Renewable Energy Bonds, which I helped develop as part of the 2005 Energy Bill, can now be offered for an additional year and have been authorized to release an additional $400 million of clean energy bonds. In North Dakota we have already seen the effects that Clean Renewable Energy Bonds can have. The city of Fargo will be using Clean Renewable Energy Bonds to finance a wind tower and a methane gas facility that will be used to reduce the city's energy costs. Great River Energy will also be using these energy bonds to finance the construction of a coal drying facility which will not only increase the efficiency of North Dakota lignite coal but also reduce emissions.

Clean Renewable Energy Bonds work by allowing a Federal tax credit to holders of bonds issued by public utilities and cooperatives to finance clean energy projects. Not-for-profit utilities can sell clean energy bonds to stakeholders, but instead of the utility or cooperative paying out interest to the bondholder, the Federal Government would give the bondholder a tax credit. These bonds provide what amounts to interest free loans for co-ops and public power systems to finance renewable energy projects.

This bill also extends the wind production tax credit to 2009. In 2015, wind energy generation is expected to reach 63 gigawatts with the tax credit in place compared to an estimated 9.3 gigawatts without. This represents a 650 percent increase in wind generation.

However, without stabilizing the tax credit, companies like DMI Industries in West Fargo and LM Glassfiber in Grand Forks are in constant limbo. DMI manufactures wind turbine towers and had furloughed over 100 employees in late 2003 after the expiration of the wind production tax credit. LM Glassfiber, which manufactures wind turbine blades, had previously idled all production due to the delay in extending the wind tax credit and was forced to furlough 60 to 70 employees.

Mr. Speaker, I ask unanimous consent to yield 15 minutes to the gentleman from Massachusetts (Mr. Markey), who is in opposition to the bill before us.

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

I concur, Mr. Speaker, with the observations of the chairman as to the content of this bill. Naturally, this is the last day of the 109th Congress, and I do hope that the new majority would at least learn how not to legislate. Most of the Members have no clue as to what is in this bill. This is a late hour. There is certainly far more good in it than bad.

I wish we had seen fit to have been able to get the New York Liberty Bond 9/11 relief converted to a transportation infrastructure, which was stripped from this bill that passed the House before.

There are other things in this bill, and I assume those people who are asking for time will be discussing them.

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

Mr. Speaker, I am privileged to yield 2 minutes to the gentleman from Michigan (Mr. Levin), a senior respected member of the Ways and Means Committee.

(Mr. LEVIN asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I am going to be very careful in the words that I select because I am not certain that the House physician's office is still open, and I just don't want to get overstressed over a parliamentary problem that we are having here. But it is very difficult to understand how the outgoing chairman could be so frustrated that the amendment is coming at this late hour, because we cannot really get an amendment together until we know what we are amending, and I assume that we didn't know that until sometime early this morning at a meeting that took place at a room which I don't know where it exists. So I think that this amendment that we do have deals with an issue that we never expected to be included in the extended bills. And under the parliamentary procedures that we have in this august House and this institution, Members, even if they are in the minority, have an opportunity at any time to raise it before the House. And we hope that we can extend this courtesy for the years that we have to come.

I would like to yield 2 minutes to the distinguished gentleman Mr. Pomeroy from the sovereign State of North Dakota.

You may not have received the amendment, but you have received the best wishes from the Democrats on your 65th birthday, and we wish you well.

I yield to the gentleman from California.

We are saying good-bye.

Mr. Speaker, I would like to yield 2 minutes to an outstanding Member who has served this Congress and served the Ways and Means Committee with distinction. And as he goes to raise the level of intellect in the other body, I yield to him on this bill.

Mr. Speaker, I yield 2 minutes to the gentleman from California (Mr. Becerra), an outstanding member of the committee.

Mr. Speaker, I would like to yield 1\1/2\ minutes to the gentleman from Louisiana (Mr. Melancon).

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

I would just ask the chairman whether he is going to be the last speaker, then I can just use whatever time I have.

Well, I reserve. I would just like to be able to close on my side.

Yes.

Mr. Speaker, as we close this debate, I agree it will be a different Congress, and I will sincerely miss the spirited debate from the distinguished gentleman from California who has served the committee and served the Congress and served this country so well. And I am just bothered that he is disturbed about the lateness of the amendment which comes to the floor, but, of course, you cannot amend anything until you get it, and this just came to the floor this morning.

Many of the issues and extenders in this bill are long overdue, and I certainly encourage people to support the bill. But the bill would be strengthened if indeed it excluded the provision that has been debated and will come up in the amendment as relates to the gulf opportunity zone property.

In addition to that, most of us would agree that if there is one provision in the Tax Code, a burden that Republicans, conservatives, Democrats, Republicans, can agree to that should be removed is the alternative minimum tax. Nobody ever intended for these 23 million people to be shoved into a tax bracket that they didn't deserve. And since it is not included in the extenders, for reasons which I don't know, it would seem to me that people would have an opportunity, in this amendment offered by the distinguished gentleman from Massachusetts, to do that and, at the same time, strip from the provision the offending provisions as relates to the Gulf States.

And lastly, those of you that were kind enough to support the city and State of New York during the trying 9/11 experience would know that at one time we had passed a provision that would allow us, under the New York liberty bond provisions, to provide a tax credit for the transportation infrastructure. I want to thank the chairman for trying so hard to see that that provision would be included in this bill. But, because of reasons and problems that we have had on the other side, that provision is omitted. However, it will be included in the amendment, and I am convinced that the base bill, coupled with the amendment, would be a better piece of legislation.

I know we have other issues on the floor, and this is not the time to say farewell to the chairman, but as it relates to at least this part of our debate, Mr. Speaker, I will yield back the balance of my time.

Mr. Speaker, I just want to share with the chairman that I recognize his concern that he got the amendment too late. I am surprised that he is opposing it, because I know that the content of the amendment, even though the procedure may not have been exactly as he would like, were things that he had previously supported. So it would seem to me that those of us who support the base bill, the amendment is only offered to improve upon that, even though it just excludes only one provision which is in this, which the gentleman from Massachusetts has spoken eloquently on, and I think even there the chairman would agree that it might be a better bill if that was excluded.

I do hope, as I am voting for the bill, that we might have a chance for those who are here and those who are listening to recognize that 23 million taxpayers are being held hostage by the alternative minimum tax. We have had ample opportunity to correct that, but coming from a Congress that most of us are against the tax increases, it just seems to me would be inconsistent with the past rhetoric, having the opportunity to remove this tax increase, which is certainly what it would be if we don't extend the relief from the alternative minimum tax for all of these people who never were intended to pay this tax.

So I think it would be a good time to show the bipartisanship in being for this substantial tax cut, or at least to prevent a tax increase, if we supported this amendment, at the same time to support the spirit of the reason in which this great Congress came to the assistance--

I have completed. I yield back to the gentleman from Massachusetts.

I am just saying that we in New York thank you for the generosity that you have, and we just hope that it is not taken back by refusing to support this amendment, where we can receive the tax credit for our transportation.

Mr. Speaker, I yield myself 3 minutes.

Mr. Speaker, this bill contains a provision which really is unrelated completely to the tax extenders. There are indeed tax credits and other things, very good; but what they have decided to do is attach a rider to this bill, and that rider is a special sweetheart deal that changes the entire formula for the collection of royalties, that is, taxes, for the American people for oil and gas which is drilled for on public lands.

Because of this change in formula, $170 billion is going to be transferred from the pockets of the American taxpayer of 46 States and sent to four States. In the course of the debate this afternoon within the hour, we will be considering an amendment, an amendment which will say that if any oil companies want to drill for the oil in the gulf that is going to be permitted under this new bill, that these companies must renegotiate the old leases which they received back in the 1990s, which, believe it or not, makes it possible for them to escape paying royalties on oil and gas drilled for on public lands in the United States. Even if the price of oil goes to $40, $50, $60, $70, $80 a barrel, oil companies do not pay any more royalties.

Well, what our amendment will say is that they must renegotiate. The oil and gas industry must renegotiate with the Federal Government to return those windfall profits on the old leases before they are going to be allowed to drill for these new leases in the Gulf of Mexico. In that way, the taxpayers will reclaim $20 to $30 billion of revenues that can be used for health care, for education, to pay for the war in Iraq, to balance the Federal budget.

So I just want all the Members to know that that is the nature of the amendment which is going to come up within the hour. It is fair. If the oil companies are going to receive such a boon out of this bill, if the gulf States are going to receive such a boon out of this bill, as much as I object to it, the least that we should be able to say is that we reclaim those revenues, and as a bonus, Mr. Rangel has inserted into the amendment, which I will be making, a provision which extends the AMT protection for 20 million Americans so their taxes do not go up next year, 2007.

So with two things, you reclaim 20 to $30 billion from oil companies and you protect all taxpayers from an increase in the AMT.

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

I yield 3\1/2\ minutes to the gentleman from New York (Mr. Hinchey).

Mr. Speaker, I yield 2 minutes to the gentlewoman from New York (Mrs. Maloney).

Mr. Speaker, I yield 2 minutes to the gentlewoman from California (Mrs. Capps).

(Mrs. CAPPS asked and was given permission to revise and extend her remarks.)

Mr. Speaker, I yield 1 minute to the gentlewoman from California (Ms. Waters).

(Ms. WATERS asked and was given permission to revise and extend her remarks.)

Mr. Speaker, I yield 2 minutes to the gentleman from Ohio (Mr. Kucinich).

Mr. Speaker, I only have one speaker remaining.

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

The amendment which we are about to consider does not prohibit drilling in any of this new land. The amendment we are about to debate does not prohibit drilling in any of the new land which is authorized to be drilled in. What the amendment says is this: is that the oil and gas companies that received leases over the last 10 years where they pay no royalties whatsoever, and that has been determined, as a result, deprived the American taxpayer of between 20 and $60 billion worth of royalties, which they are entitled to as taxpayers, will be renegotiated by the oil companies that want to drill in this new land in the Gulf of Mexico. That is all it does. So anyone who is listening to this, this amendment will not prohibit drilling here. All it says is that where these massive, tens of billions of dollars of windfall profits are falling into the pockets of oil and gas companies under these oil leases, that these oil and gas companies do not have the privilege of coming into these new leases. However, any other oil company, any other gas company, they can go right into this Gulf of Mexico area and drill.

So for Mr. Peterson, or anyone else, it has nothing to do with it. The question for you, Mr. Peterson, the question for the other Members is: Do you want to recollect these other royalties? Or if the price of oil goes to 30, 40, 50, 60, 70, $80 a barrel, do you want the oil and gas industry to pay any royalties at all? Because right now, they don't. So if you want all the revenues to go to them, nothing to go to the taxpayer, then, fine. Vote against the Markey amendment. But if you want to open up the lands in the gulf, let the oil industry come in, but to make sure that they pay on their old leases a fair share of the dues to live in this country, because it is a massive part of the revenues that we use to fund our defense, then you vote ``yes'' on the Markey amendment.

Mr. Speaker, I offer an amendment.

Mr. Speaker, I yield myself 1 minute.

Mr. Speaker, again, the Markey amendment does nothing about drilling in the new areas that are opened up in this bill. What the amendment says is that on all of those leases in the 1990s that had no royalty payments required at all, that finally if these oil and gas companies want to move into this new oil and gas gold rush in the Gulf of Mexico, they have to renegotiate those old contracts, those windfall profits, that 20 to $60 billion that could be used for the defense of our country, to reduce the deficit or for any other purposes.

This is a very simple amendment, and what it does is it mirrors what we voted on in May of this year when 252 Members of the House voted to force these oil and gas companies to finally play their role in contributing to the balancing of the budget. Otherwise, the oil companies are going to continue to just tip the American taxpayer upside down.

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

Mr. Speaker, I yield 2 minutes to the gentleman from New York (Mr. Rangel).

Mr. Speaker, how much time do I have remaining?

I apologize to the gentleman. I only have 1 minute to give to the gentleman from New York (Mr. Hinchey) at this time.

I am now advised that the gentleman from New York (Mr. Hinchey) wants to yield his minute to the gentleman from New York (Mr. Rangel).

Mr. Speaker, I yield myself the remainder of the time and that is again to make the point that this amendment is central to the reclaiming of the $60 billion which the oil and gas industry has escaped in paying for drilling on the public lands of the United States. This is like Teapot Dome in the 1920s. They don't pay royalties. They have escaped payment for the use of the oil and gas for the American people.

This isn't their oil and gas; it is ours. This amendment just says that if they want to drill in the Gulf of Mexico in this new land, they have got to renegotiate these old contracts where they don't pay any royalties at all. At $40, $50, $60, $70, $80 a barrel the American taxpayer is paying at the pump, they don't get any tax relief when they use American oil and gas from the American public lands.

Vote ``aye'' for the Markey-Hinchey amendment. It is the key to ensuring that this bill has a fiscally sound core at its heart.

Mr. Speaker, I demand a recorded vote.