Providing for consideration of the bill (H.R. 3162) to amend titles XVIII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and CHIP program, and for other purposes.

Madam Speaker, I thank the gentleman from Texas (Mr. Sessions) for yielding me this time to speak against this closed rule that bars every single Member of this House from offering an amendment to change this Democrat bill, a bill, Madam Speaker, which I am compelled to oppose.

This nearly 500-page bill is being rammed through the House with the Rules Committee meeting on this bill at 1 a.m. this morning and with no Members even being allowed to propose fixes or alternatives because we are told it is absolutely imperative that Congress act to provide government-run health care coverage to more Americans.

So I am compelled to ask: If the purpose of this bill is to provide more health care coverage for Americans, then why are the Medicare plans of over 8 million seniors in our country being put at risk by this legislation?

Why are over 150,000 Washingtonian State seniors going to have their Medicare Advantage health coverage put at risk by cuts in this bill?

Why are one in 12 seniors on Medicare in my congressional district facing a potential loss of their current coverage? How do you expand health care to more Americans if you are forcing the elimination of Medicare plans that seniors have chosen?

Madam Speaker, even more troubling to me is a provision in this bill that would force the closure of the Wenatchee Valley Medical Center in my district in Wenatchee, Washington. After reading the bill, this health center wrote a letter to me that states: ``Should section 651,'' of this bill, ``be enacted into law as written, we foresee the likely closure of the Wenatchee Valley Medical Center and our outlying facilities in the next few years.''

July 26, 2007.

Hon. Maria Cantwell,

U.S. Senate,

Washington, DC.

Hon. Doc Hastings,

House of Representatives,

Washington, DC.

Dear Senator Cantwell and Representative Hastings: Late

yesterday, Representatives Dingell, Rangel, Stark and Pallone

released legislation entitled the Children's Health and

Medicare Protection Act of 2007 (CHAMP). Upon review of this

bill, we discovered a provision, Section 651 that would be

devastating to Wenatchee Valley Medical Center. It appears

that this legislation is on a fast-track towards enactment by

the House and possibly by the entire Congress.

We seek your immediate assistance in attempting: to either

modify this provision or have it removed from the bill

entirely.

Should Section 651 be enacted into law as written, we

foresee the likely closure of WVMC and our outlying

facilities in the next few years.

The Wenatchee Valley Medical Center was founded in 1940 in

a rural and remote area of Washington State. The three

founding physicians desired to establish something akin to

the Mayo Clinic model in a medically underserved area.

Through committed work, personal investment, risk taking, and

collaboration over a geographic region that spans more than

12,000 square miles, the Medical Center has adhered to and

largely achieved that model and vision.

The Wenatchee Valley Medical Center is organized as a

hospital system. The system is located in eight different

communities in the north-central area of Washington State.

Those communities are Wenatchee, East Wenatchee, Moses Lake,

Cashmere, Royal City, Omak, Tonasket, and Oroville. The

Medical Center is one of the largest employers in its region

with 1500 employees. Its physicians provide the majority of

the admissions, medical support, and physician staffing for

these community hospitals: Central Washington Hospital

(Wenatchee); Wenatchee Valley Hospital (Wenatchee); Samaritan

Hospital (Moses Lake); Mid-Valley Hospital (Omak); and North

Valley Hospital (Tonasket).

The Wenatchee Valley Medical Center is a 100% physician-

owned and directed hospital system. Each of the 150+

physicians who are ``owners'' of the WVMC own less than 1% of

the Center. The proposed legislation would require us to stop

being what we are and attempt to morph into something

different. We have concluded that selling 60% of our hospital

(to whom?) as required by Section 651, and preventing WVMC

from growing beyond it's current bed size, as also required

by Section 651 is non-sustainable, a death-knell.

We could attempt to cope initially by closing money-losing

sites like Royal City, Tonasket, and Oroville. The closure of

the latter two sites will have the corollary impact of

depriving North Valley Hospital of seventy five percent of

its medical staff, and

would likely result in its closure. We would have to drop

money-losing services like the Medical Hospitalist program

($550,000 loss per year) and Trauma Surgeon on-call program

($850,000 loss per year) at Central Washington Hospital. We

have supported those programs because they save lives, are

cost-effective (for society at large), and are likely a pre-

requisite to induce many physicians in the physician

recruiting climate to any practice setting.

A broad and comprehensive delivery system in a rural region

is an inter-connected and fragile organism. The proposed

legislation fixes a problem that doesn't exist in either

North Central Washington or the Wenatchee Valley Medical

Center, and will unleash a series of decisions that will be

deleterious in the short-run, and likely calamitous over the

next five years. The proposal needs modification, and a

significant increase in flexibility to reflect actual on the

ground actualities in rural delivery systems.

The multi-specialty physician practice that is part of the

Wenatchee Valley Medical Center includes more than 30 medical

and surgical specialties in addition to a large number of

primary care providers. The Medical Center provides the only

services available in the region in the following

specialties:

1. Medical Oncology

2. Radiation Oncology

3. Pulmonary Medicine

4. Medical Hospitalist

5. Surgical Hospitalist

6. Vascular Surgery

7. Neuro-Surgery

8. Cardiology

9. Rheumatology

10. Endocrinology

11. Nephrology

12. Gastroenterology

13. Neurology

14. Urology

15. Dermatology

16. Physiatry

This year, the Wenatchee Valley Medical Center will serve

more than 150,000 unique patients. Ninety four percent of

those people reside in the four rural counties (Chelan,

Douglas, Grant, Okanogan) where the Medical Center is

located. The majority of these patients have long-standing

relationships with the Wenatchee Valley Medical Center, some

of those continuous relationships reach all the way back to

the organization's founding. The four counties in North

Central Washington have a combined population of 240,000. A

comparison of the patients served by the Medical Center to

the region's population indicates that the Medical Center is

a key, and likely indispensable, component of the region's

healthcare infrastructure.

The Wenatchee Valley Medical Center is a collaborator. It

offers training opportunities to medical students and

residents of the University of Washington and other medical

schools; and has many training affiliations with area

community colleges in the allied health professions.

Wenatchee Valley Medical Center specialists outreach more

than 1200 times annually to hospitals and clinics in outlying

communities. Medical Center staff provides 24/7 coverage for

the Emergency Room at North Valley Hospital in Tonasket.

Medical Center staff provide 24/7 medical and surgical

hospitalist coverage for the Trauma Center at Central

Washington Hospital. The Medical Center is making its

Computerized Medical Record available to all practitioners in

the region, and its Patient Profile is being advanced by the

Community Choice PHCO as a potential continuity of care

record for the region.

The Wenatchee Valley Medical Center has a long-standing

tradition of serving all comers, regardless of their ability

to pay. The Medical Center has a needs based Compassionate

Care program that is well publicized and which will provide

more than $3 million in charitable care this year.

The Wenatchee Valley Medical Center is a cost-effective

health care delivery system and is conservative in its

ordering and treatment patterns. The Medical Center has

ongoing focus and initiatives in areas like prescriptions,

medical imaging, hospital and nursing home lengths of stay,

and cardiovascular interventions.

The Medical Center is a Medicaid safety net provider, and

accepts referrals from throughout the state. The Medical

Center ranks among the top 5 Medicaid providers in Washington

State. The region has a high and growing Medicare aged

demographic. The Medical Center provides a variety of

services needed by Medicare patients. The combination of

Medicaid and Medicare represents sixty percent of the

Wenatchee Valley Medical Center's volumes. Most healthcare

financial analysts would maintain that those percentages are

uneconomic and non-sustainable; that the cost-shift is too

great.

As stated earlier, the Wenatchee Valley Medical Center is a

hospital system. It was organized in that fashion in order to

survive as a vital, dynamic contributor to healthcare and its

delivery in North Central Washington. Having the opportunity

to bill as a hospital provides the economic life ring that

enables the Medical Center to compete in national markets for

the physician recruits that our undermanned and health

shortage regional delivery system is desperate for. Any

``profits'' earned by the Medical Center are plowed back into

the delivery system; either to subsidize new services (like

the recent opening of the Royal City Clinic in a community

that was without healthcare for the last 2 years) or to

invest in new services such as Image Guided Radiation Therapy

and a Chemo-therapy Infusion Center in Moses Lake. The

Medical Center is currently in the process of recruiting 29

new and replacement physicians to place throughout our

region. A number of these recruits have been requested by the

hospitals we co-labor with. There is significant working

capital investment required to establish these practices, and

frequently a tremendous facility investment needed to house

these practices. Both of these investments are currently

ongoing; and will be a death-trap if the proposed hospital

self-referral legislation is enacted as currently drafted.

If you or your staff have questions or need additional

information, please do not hesitate to contact our

Administrator, Shaun Koos, Jay Johnson, our Associate

Administrator or Bill Finerfrock our Washington DC

Representative.

Your immediate consideration of this matter is critical to

the continued availability of healthcare in North-Central

Washington State. We look forward to working with you.

Sincerely,

David Weber,

CEO/Chairman, Board of Directors,

Wenatchee Valley Medical Center.

Madam Speaker, the Wenatchee Valley Medical Center was founded in 1940 by three physicians. In the last 67 years, it has grown and now employs 1,500, serves a population of a quarter of a million people in an area the size of Maryland, and treats 150,000 patients a year.

This bill would force its closure because it prohibits any hospital from being more than 40 percent owned by doctors if they are to continue to receive Medicare payments for providing care for seniors. The Wenatchee Valley Medical Center is 100 percent opened by 150 doctors, and I fail to see why this should be made illegal in the United States of America.

At just after 2 a.m. this morning in the Rules Committee, I raised this concern with the two gentlemen representing the Ways and Means Committee and the Energy and Commerce Committee.

When I first asked why the medical center treating 150,000 patients should be forced to close, the initial reaction of Mr. Pallone of New Jersey and Mr. McDermott from Seattle, Washington, was that the medical center and I must be mistaken; we were wrong. They then stated that other hospitals had called them asking about this section as well.

Madam Speaker, something is terribly wrong in the House of Representatives if hospitals across this country are calling committees in a panic to find out if health care legislation is forcing them to shut down.

Subsequently, after some lengthy discussion in the early morning hours, the two Democrat committee representatives eventually acknowledged that I just might be right about what's going to happen in Wenatchee, and they said that's just what they intend to happen under this bill. Let me restate this. This is not an unintended consequence. It is an intentional consequence. My colleague from Seattle said that some people might squeal about what this bill does, but he stated that's what was needed to be done to save money. This bill saves money by putting the medical center out of business?

I sought to fix this provision by offering an amendment to the Rules Committee with Mrs. McMorris Rodgers from Washington whose constituents would also be affected by this bill. Our amendment simply would have removed one requirement of the bill that would force certain hospitals to close if more than 40 percent were owned by physicians. I'm dismayed, Madam Speaker, that on straight party-line vote that amendment was not allowed to be debated on the floor today.

Madam Speaker, I voted to create the SCHIP program, and I believe it must be renewed, but when we are faced with a bill that puts Medicare plans of over 150,000 seniors in Washington at risk and threatens the closure of the Wenatchee Valley Medical Center and all the patients it serves, I can't support this legislation.

I must ask, what else does this bill do that's not being explained? What other undiscovered ways will it reduce citizens' access to health care?

It doesn't have to be this way, Madam Speaker. This House can defeat this closed rule and we can have an opportunity to open the process. And with that, I urge my colleagues to vote against the rule and the underlying bill.

Madam Speaker, I make a point of order against consideration of H. Res. 594 because the first section of the rule waives all points of order against H.R. 3162 and its consideration, except clauses 9 and 10 of rule XXI. This waiver includes points of order under the Unfunded Mandates Reform Act.

Madam Speaker, while the CBO estimate in the report from the Committee on Ways and Means does not identify any unfunded mandates, it's important to note that there are and that there is no such estimate for the amendment self-executed by the closed rule reported in the dead of night by the majority's Rules Committee. We have no way of knowing whether these new provisions, which we did not see before midnight last night, will impose strict new intergovernmental mandates on our State and local governments.

Furthermore, this new language appears to be littered with earmarks for hospital-specific projects. We do not have a list of the Members requesting those projects, and we do not know if the proper certifications have been filed with the authorizing committees.

Therefore, Madam Speaker, it is essential that we stop, take a breather and put off consideration of this hastily drafted legislation, which was totally rewritten in the dead of night, behind closed doors.

I urge my colleagues to vote ``no'' on the question of consideration.

I yield to the gentleman from California.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, the new Democrat majority promised the American people and those Republicans who are now in the minority that this would be an open and transparent new way of doing business by Democrats. We were told back in January and February, oh, the only reason we're doing closed rules is because we've got to do them to get our agenda through quickly, because we're not going to allow anybody to stop that. Six in '06 has to be done.

Well, Madam Speaker, there were no hearings even done on this with the text of the bill that the committee could look at. Last night, 30 minutes before we went into Rules Committee, we had an opportunity to see the language.

On top of the $200 billion Medicare cuts, the Democrats have now slipped in extra hospital funding for powerful Democrat districts. That means where Democrats are they've slipped in these brand new earmarks, right there for them.

We have not had an opportunity to look at the bill, we don't know whether the proper notification has been done, and so what we're saying now today is that what we should do is take a few minutes and sit back and look.

I yield to the gentleman from California.

Madam Speaker, last night in the Rules Committee we had an opportunity to see firsthand what this new Democrat majority is all about. And not one time, not one time, was the word let's make health care better for America, not one time was it about trying to make things better for

doctors and hospitals and patients. It was a slam dunk, hit 'em out of bounds, the doctors, who they claim make all this money, who it's all about the doctors making money.

And I had an opportunity to engage those people who represented the Ways and Means Committee and the Commerce Committee, and I said, hey, during your hearings, that you talk about you having all these hearings, did anyone ever bring up that specialty hospitals are those many times joint ventures with hospitals where they're trying to take care of patients who come for elective surgeries to get them out of hospitals that are full, emergency rooms that are backed up, and then we've got a problem with health because of bacteria in the hospitals. And these hospitals are safer and offer elective surgery to get people in and out that is much cheaper and safer and better.

They acted like it was a foreign concept. They acted like they had never heard about the marketplace before.

I yield to the gentleman from California.

Madam Speaker, we believe that the earmarks which have been presented, which the way this bill has come to the floor, is not properly done. It did not follow regular order. It is without the transparency that the new Democrat majority has touted and talks about every single day. It is without the smell test of ethics to know, straight up, what somebody is going to spend money on, the people's money. And because of that, we are opposing and asking that this bill go back and be properly done to where everyone can understand.

I reserve the balance of my time.

Madam Speaker, I would like to inquire how much time remains.

Madam Speaker, I believe that the case that we are making here today is a smell test, and that is that if the new Democrat majority wants to have closed rules, not have openness with regular order, not present bills before they would be voted on to allow people enough time to see what is in them and to be transparent about what is in the bills and who is getting the money and who is spending the money, you have not passed the smell test. And thus we are asking that you not do what you are doing.

We oppose the Democrat majority.

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

Madam Speaker, on that I demand the yeas and nays.

Madam Speaker, I rise today in strong opposition to yet another closed rule and to the ill-conceived underlying legislation.

While I do not support this bill nor the way it has been brought to the floor without a single legislative markup, I would like to thank the Democratic leadership for one thing: By cramming this bill through the House, they are giving every single Member of this body the opportunity to go on record regarding which vision for the future our Nation's health care system should take.

Madam Speaker, for that, I truly appreciate and respect what the Democrat leadership has done.

The first vision for our future, for them, is to slowly shift as many Americans as possible into a one-size-fits-all government program. You know what it has been called in the past: Socialized medicine.

I congratulate the Democrat leadership, because that vision is ably embodied in the bill today, H.R. 3162. Rather than using this bill as an opportunity to cover children who cannot obtain coverage through Medicaid or the private market, this bill uses children as pawns in their cynical attempt to make millions of Americans completely reliant upon the government for their health care needs. And you know what they say, Madam Speaker: If you think health care is expensive now, wait until it's free.

Democrat advocates of bureaucrat-run, Washington-run health care fails to disclose how they would achieve this vision. Republicans who actually care about covering children created SCHIP so that children who had no insurance coverage through Medicaid or the insurance market could get it without bankrupting the Federal Government or dislocating a healthy marketplace.

H.R. 3162 turns this innovative vision on its head by increasing government spending exponentially, leaving taxpayers holding the bag for these increased costs. This bill has no income limits for eligibility, no annual authorization limit, and allows States to determine who qualifies, despite the fact that the Federal Government is on the hook 100 percent of the time. This is on top of a current system which we know that some States already abuse. Minnesota spends 61 percent of its children's health care insurance on adults, while Wisconsin spends 75 percent of its children's health care money on adults, taking scarce resources away from the intended target, children.

But the real losers under this big government vision are patients. For 100 children who are enrolled in the new SCHIP proposal, 25 to 50 children will leave private insurance, according to the Congressional Budget Office; 77 percent of children at between 200 and 300 percent of the Federal poverty level already had insurance in 2005.

As we all know, being a part of the government-run health care program does not mean better quality. Since most SCHIP programs reimburse at Medicaid rates, many of these new SCHIP enrollees will encounter significant difficulties accessing care. American Medicaid patients, for example, are currently waiting as long to see a specialist or to have surgery as patients in Canada.

If Democrats were serious about ensuring that every American has access to inexpensive and high-quality health care, we would be taking a different vision and a different direction for our health care; one that tackles the system's real underlying problems and revolutionizes and gives incentives to our health care system to provide better results.

All families should have access to tax exemptions up to $15,000 a year for health care, not just those who work for large employers. Congress should spend its time passing a law to give Americans the ability to purchase health insurance across State lines, because health insurance options should not be limited by your zip code.

Congress should be working to ensure that those who can't get insurance on the market have access to coverage through high-risk pools and low-income tax credits.

Madam Speaker, I am not here to oppose the idea of SCHIP. It was a Republican-controlled Congress that created SCHIP. I do support its true mission. But H.R. 3162 is a camouflaged attempt at slowly siphoning Americans away from insurance plans into a big, Washington, D.C. government-run system.

To pay for this flawed, big government vision, this legislation robs seniors by forcing many of them out of their existing Medicare coverage at a time when our Nation is looking for better ways to sustain Medicare's future. Medicare part C is an innovative plan that is working well by bringing choices into Medicare. After these seniors are harmed in the long run, it is the taxpayers who will be stuck with the rest of the bill for this incredible expansion of government and intrusion into our lives in taking away our choices.

Republicans have already proven this would be a positive, innovative vision that can work. Two years ago, Members from both sides of the aisle came together to pass the Dylan Lee James Family Opportunity Act, or FOA. We learned that many children with disabilities fell into a catch-22 circumstance in which their families made too much to qualify for Medicaid but could not afford or access private coverage, so these children often went without coverage. FOA was a commonsense solution which filled a void and provided coverage for these children up to 300 percent of the poverty level.

Madam Speaker, we have two serious issues facing our Nation that we are dealing with right now: Medicare's future, and making our Nation's health insurance system more affordable and accessible for all Americans. By focusing the wrong vision for our future, the bill does nothing to address either problem.

It ignores the fact that our Nation produced the greatest health care advocates in the world, many of which come as a result of a competitive insurance market. The American survival rate for leukemia is 50 percent. The European rate is just right at 35 percent. For prostate cancer, the American survival rate is 81.2 percent. In France, it is 61.7 percent, and in England, it is 44.3 percent.

Rather than trying to emulate the European socialized, outdated approach, we should be working on a vision to give every single American an opportunity to take part in our competitive insurance market.

Madam Speaker, I encourage my colleagues to oppose this closed rule and the underlying legislation to drag America into a one-size-fits-all model of defeatism. Returning the balance of power, once again, to Washington, D.C. to run our health care plan is what the new Democrat majority is all about.

Madam Speaker, I oppose that.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield 4 minutes to the distinguished gentleman from San Dimas, California (Mr. Dreier), the ranking member of the Rules Committee.

Madam Speaker, these debates are great. It gives everybody on both sides, including the Democrats who ran on an agenda of having socialized medicine, Washington, D.C.-run health care, they can come down to the floor of the House and talk about this is their model of a great bill.

We disagree.

Madam Speaker, I yield 5\1/2\ minutes to the gentleman from Pasco, Washington (Mr. Hastings).

Madam Speaker, I yield 2 minutes to the ranking member on Energy and Commerce, the gentleman from Ennis, Texas (Mr. Barton).

(Mr. BARTON of Texas asked and was given permission to revise and extend his remarks and include extraneous material.)

Madam Speaker, if I could inquire upon the time remaining on both sides, please.

Madam Speaker, I yield 1\1/2\ minutes to the gentleman from North Carolina (Mr. Coble).

Madam Speaker, at this time, I ask unanimous consent that, as a result of the large number of Members who are coming down to speak, as a courtesy to these Members, that we would add 10 minutes to each side for debate.

Do not want to talk further on this bill from the new Democrat majority.

Madam Speaker, at this time I yield 1\1/2\ minutes to the gentleman from Brighton, Michigan (Mr. Rogers).

Madam Speaker, I yield 1\1/2\ minutes to the gentleman from New Jersey (Mr. Smith).

Madam Speaker, I yield 1\3/4\ minutes to the gentleman from Indiana (Mr. Buyer).

Will the gentleman yield?

Welcome to the new Democrat-run House of Representatives: No debate added time. No regular order hearings. Closed rules. Welcome.

Madam Speaker, I yield 1\1/2\ minutes to the gentleman from New York (Mr. Fossella).

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

Madam Speaker, it's my understanding the gentlewoman from Florida is indicating she has no additional speakers and that she would choose to close?

Madam Speaker, by direction of the Committee on Rules, I call up House Resolution 594 and ask for its immediate consideration.

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

This point of order is about whether or not to consider this rule and, ultimately, the Children's Health and Medicare Protection Act. We will stand up for our children and the hardworking families in America and fight through these delaying tactics trying to put off having our parents be able to take their kids to the doctor's office. They deserve no less.

We're going to fight through all these procedural delays today, as we did yesterday, because these parents and children's health in America simply will not wait. We must consider this rule, and we will consider and vote and pass the CHAMP Act today.

I have the right to close, but, in the end, I will urge my colleagues to vote ``yes'' to consider the rule.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I understand that I have the right to close, so I will reserve the balance of my time until the gentleman from Texas has yield back his time.

Madam Speaker, I urge my colleagues to reject these dilatory tactics. Health care for America's children cannot be delayed or denied. I urge a ``yes'' vote on the question of consideration.

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

Madam Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Texas (Mr. Sessions). All time yielded during consideration of the rule is for debate only.

I yield myself such time as I may consume.

general leave

I also ask unanimous consent that all Members be given 5 legislative days in which to revise and extend their remarks on House Resolution 594.

Madam Speaker, House Resolution 594 provides for consideration of H.R. 3162, the Children's Health and Medicare Protection Act of 2007.

The rule provides 2 hours of general debate in the House, with 1 hour controlled by the Committee on Ways and Means and 1 hour controlled by the Committee on Energy and Commerce.

The rule waives all points of order against consideration of the bill, except for clauses 9 and 10 of rule XXI.

The rule makes in order the Ways and Means Committee substitute, modified by an amendment printed in the Rules Committee report. That amendment reflects a compromise between the committees of jurisdiction. The rule provides one motion to recommit, with or without instructions.

Madam Speaker, in our great country today, the wealthiest country in the world, parents still struggle to ensure that their children lead healthy lives.

Is there anything more important, after the birth of your child, than visits to the pediatrician and the care of devoted nurses? And as your baby grows, is there anything more fundamental than regular checkups and physicals?

Many dedicated doctors and nurses are on call at all hours when, God forbid, something goes wrong or your child is sick. Fortunately, in America today, many hardworking families have regular and affordable health care through the State Children's Health Insurance Program, what we called SCHIP; and today the Congress will vote to extend and improve children's health insurance for another 5 years.

Regular, accessible and affordable health care puts children on a path to success in life. A healthy child is a healthy student. A healthy child means more productive parents who do not miss work. Healthy students become productive adults. They succeed in life and eventually make America stronger.

Every parent and grandparent in America today understands the importance of our debate and our fight to ensure that children can see a doctor or a nurse and have access to affordable health care.

Despite all that we understand about the importance of healthy kids and early preventative care, health insurance and those all-important visits to the doctor are all too expensive and out of reach for over 11 million children in America.

Uninsured children are five times less likely than insured kids to have a primary care doctor or to have visited a doctor or a dentist in the past 2 years. This lack of access in medical attention harms that child, the family, the community back home and ultimately this great country.

Madam Speaker, I urge my colleagues today to stand up and fight for these families and America's children by passing this rule and supporting the House Children's Health Insurance Reauthorization bill, the Children's Health and Medicare Protection Act, or the CHAMP Act.

I am proud to say that the precursor to SCHIP originated in the 1990s as a novel plan by State leaders in my home State of Florida. These innovators understood the link between healthy kids and success in school. They helped parents with direct information on access to affordable health care for their kids.

President Clinton and the Congress were so impressed by what the State of Florida was doing for children's health care that they took the Florida KidCare blueprint and fashioned a national program. It has enjoyed national success and bipartisan support ever since. Indeed, the overwhelming majority of Governors in this country support the reauthorization of SCHIP.

Madam Speaker, I include for the Record a letter of support from Republican Governor of Florida, Charlie Crist.

State of Florida,

Office of the Governor,

Tallahassee, FL, August 1, 2007.

Hon. Katherine Castor,

Washington, DC.

Dear Congresswoman Castor: Thank you for your continued

leadership on the reauthorization of the State Children's

Health Insurance Program (SCHIP). As you know, renewing this

program is critical to the approximately two million children

and families currently eligible for SCHIP in our State.

As Governor, I too want to ensure that low-income children

have access to quality health insurance, and commend the

Florida Delegation for working so hard over the past several

months to ensure that this important program is reauthorized

before it expires on September 30, 2007.

The proposals of the Senate Finance and House Energy &

Commerce Committees have positive components that I believe

will make this program stronger. However, as Congress

progresses toward a final product, I wanted to bring your

attention to the core principles that I believe are essential

to ensuring SCHIP remains dedicated to its original intent.

Children Should Be the Cornerstone of SCHIP Funding; States

Need the Flexibility to Dispense SCHIP Funding Over Multiple

Years; Federal SCHIP Funding Should Be Based on Projected

Spending and Allow for Population Growth; States Need the

Flexibility and Funding to Conduct Additional Outreach

Activities.

Thank you again for your commitment to the KidCare program

and to Florida's children and families. I look forward to

working together to ensure that the thousands of eligible

children in our state receive the highest quality benefits

through this important healthcare program.

Sincerely,

Charlie Crist,

Governor.

Despite the great success across the country, 11 million children in the United States remain uninsured. Almost 7 million of them are eligible but not enrolled in the State-Federal children's health care program. Two-thirds come from working families in which one or both parents are working but were not offered employer-based health insurance or were unable to afford it. Most of these families are taking home under $40,000 per year. In my home State of Florida alone, over 700,000 children remain uninsured.

A few months ago, I ran into a high school friend of mine, Mia Dorton, and she explained how important the Children's Health Insurance Program had

become to her and her family. You see, Mia's husband lost his job and the family was uninsured for 2 months. Mia said, ``It's awful to have to choose between whether or not to put food on the table or take your child to a doctor.'' Mia said that she and her husband lived in constant fear that one of their children would get sick or injured.

When he got a new job, the health insurance for the family was over $700 a month, so Mia told me that they just couldn't swing it. But when her KidCare application was approved, she said that this revolutionized her life.

So for the many working families in my district that struggle for access to affordable health care and all of these great families across America, this low-cost insurance is the only way to make ends meet.

Access to health care for working families throughout America through this innovative partnership of Federal, State and local communities is a winning proposition. Indeed, for every 29 cents the State provides, Federal SCHIP provides 71 cents. It's the best matching rate in children's health care. This bill will make it easier for parents and kids to get to the doctor's office. It will eliminate that costly, bureaucratic red tape.

Madam Speaker, we will fight through these procedural delays today that have been brought by the other side of the aisle. We will stand on the side of America's children and hard-working parents. The new direction we chart today for healthier children fulfills the promise of America.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, the record of the House reflects that the Energy and Commerce Subcommittee

on Health did have at least seven hearings, full-blown hearings, on the matter at hand today, and the Ways and Means Subcommittee on Health had over 15 hearings, including four to six seminars for all of the Members involved. So to hear from the other side that there was no hearing whatsoever is not, in fact, the case.

At this time, I would like to yield 6 minutes to the gentlewoman from New York (Ms. Slaughter), the distinguished chairwoman of the Committee on Rules and a leading advocate for children and seniors in this country, from a State that is renowned for its progressive health care institutions.

Madam Speaker, I am pleased to yield 1\1/4\ minutes to the gentleman from Wisconsin, a true health care reformer, Dr. Kagen.

Madam Speaker, I'm pleased to yield 1 minute to the gentleman from Texas (Mr. Edwards), who

has been tireless in his efforts in standing up for healthier children in Texas and across America.

Madam Speaker, we will stay up day and night to bring better health care to America's children.

At this time, I'm pleased to yield 1 minute to the gentleman from Maryland (Mr. Cummings).

Madam Speaker, I'm pleased to yield 3 minutes to the gentlewoman from Ohio (Ms. Sutton), a voice of clarity and one of the most outspoken advocates for the children of Ohio and all of America's children.

I object.

Madam Speaker, I include for the Record the endorsement letter of our actions today by the AARP.

Madam Speaker, I ask unanimous consent to submit for the Record a letter received just yesterday from the Catholic Health Association, which states, in part, we believe the most important pro- life thing that Congress can do right now is to ensure that the State Children's Health Insurance Program is reauthorized. Children's lives and the lives of unborn babies depend on a strong SCHIP reauthorization. So we are standing up for these children and for pregnant women.

Madam Speaker, we are not going to divide this country over health care. We are going to bring them together and fight for better health care for our children and our seniors and everyone.

Madam Speaker, I yield 1\1/2\ minutes to the gentleman from Texas, the distinguished member of the Health Subcommittee on the Committee on Ways and Means, Mr. Doggett.

That is correct, Madam Speaker. I will reserve until Mr. Session closes.

Mr. Speaker, pursuant to House Resolution 594, I call up the bill (H.R. 3162) to amend titles XVIII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and the CHIP program, and for other purposes, and ask for its immediate consideration.

Mr. Speaker, I hope that my good friend from California will not object.

Mr. Speaker, I would hope my good friend would not object.

Mr. Speaker, reserving the right to object.

Mr. Speaker, I am going to make the same unanimous consent request, and then I will withdraw it. But first I want to make an observation here for the benefit of all of my colleagues and friends.

This is a very important piece of legislation. I am not going to defend the behavior of any Member here, and I am not going to criticize the behavior of any Member, but I am going to make an observation that I think is important.

This is a very important piece of legislation. Twelve million of our kids are going to have their health insurance increased or not depending on how we conduct ourselves today. I want to have a broad exposition. If you look at the time that we have to give to Members who wish to be heard on this, we are talking about a minute or 30 seconds, hardly enough time for any Member to adequately make a position on something which is important to him and to the kids.

I think that we have a chance to do a great deal of good for our young people. I don't think that it is excessive to say we are going to give enough time so that this matter can be properly discussed, nor do I think there is any benefit in denying our Members the time to do this and denying the Members a chance to be heard.

Now, I am going to withdraw this.

Mr. Speaker, I have asked unanimous consent and I reserved the right to object.

Mr. Speaker, I yield myself 3 minutes.

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

Mr. Speaker, the Children's Health and Medicare Protection Act, the CHAMP Act, is a good piece of legislation. It expands and improves a most successful program, bipartisan in character, created in 1997. That program has cut the rate of uninsured children by a full third. Some States have been able to ensure as many as 60 percent of the children who previously had no health insurance.

This bill is about taking care of our kids. It is about taking care of the future of the country. Today, 6 million of our youngsters get their health care through the program. With this legislation, an additional 5 million previously uninsured children will be able to see doctors, receive immunizations, and get dental and mental health coverage.

The bill requires that children receive priority in coverage. It allows States to cover pregnant women, recognizing that healthy moms make for healthy babies. I am certain my Republican colleagues on Energy and Commerce understood this point, because our clerk read this bill to them. As I am sure all of us there will recall, all some 486 pages were to be read.

The CHAMP Act does not allow one thin dime to be spent on illegal aliens. You will find this prohibition in section 135 of the bill. Nor does it create a government-run health insurance system. Coverage under CHIP and Medicaid are provided primarily through private health insurance. All but two States use some form of managed care for their programs. Nothing here will change that, and the newly covered children will be exactly the same kind of child in the same situation that every one of the children now covered happens to be.

The CHAMP Act also covers and secures Medicare for the future. This past Monday marked the 42nd anniversary of President Johnson signing that wonderful piece of legislation into law. I was there.

The CHAMP Act shores up the Medicare trust fund, improves benefits for seniors, protects their ability to choose their own doctors, and these reforms effectively provide low-income seniors on Medicare with an additional $1,200 in benefits.

The CHAMP Act is an act of fiscal responsibility. Seniors in traditional Medicare will pay approximately three-quarters of a billion dollars in excess premiums to cover the overpayments now being made to HMOs, a great injustice. The things that my Republican colleagues are complaining about are that we stop that evil practice. The CHAMP Act also adds 3 years to the life of the trust fund by stopping these overpayments which are accelerating the insolvency of the Medicare trust fund.

I know that President Bush has pledged to veto counterpart legislation in the Senate that is much more modest in its ambitions.

I include the rest of my speech for the Record and urge my Republican colleagues to read it. It is an excellent speech.

The legislation before us accomplishes two critical goals. It will provide health care to as many as 12 million children. And it will allow our elderly to continue seeing their own doctors.

The CHAMP Act--the Children's Health and Medicare Protection Act-- improves a most successful program created with bipartisan support in 1997. That program has cut the rate of low-income uninsured children by one-third. Some States have been able to insure as many as 60 percent of their children who previously had no health insurance.

Today, six million children get their health care through this program. With this legislation, five million previously uninsured children will be able to see doctors, receive immunizations, get dental care, and other coverage.

This legislation requires that children receive priority in coverage. It allows States to cover pregnant women, recognizing that healthy moms make for healthy babies.

While I am certain that my Republican colleagues on the Committee on Energy and Commerce understand this point--because our wonderful clerk read the bill to them--I will restate it for others listening:

The CHAMP Act does not allow one Federal dime to be spent on illegal aliens. You will find this prohibition in section 135 of the bill.

Nor does the bill create a ``government run'' health care system. Coverage under CHIP and Medicaid are provided primarily through private insurance--all but two States use some form of managed care for their programs. Nothing here would change that. And the newly covered children are exactly the same as those now covered.

The CHAMP Act also secures Medicare for the future. This past Monday marked the 42nd anniversary of President Johnson signing Medicare into law. The CHAMP Act shores up the Medicare trust fund, improves benefits for seniors, and protects their ability to choose their own doctors. These reforms will effectively provide low-income seniors on Medicare with an additional $1,200 in their pockets.

The CHAMP Act is an act of fiscal responsibility. This year, seniors in traditional Medicare will pay nearly three-quarters of a billion dollars in excess premiums to finance overpayments to HMOs. Those overpayments will accelerate the insolvency of the Medicare trust fund. The CHAMP Act adds three years to the life of the Trust Fund.

I am well aware that President Bush has pledged to veto counterpart legislation in the Senate that is much more modest in its ambitions, and I have received my own veto letter from the Secretary of the Department of Health and Human Services. They stand on one side of the debate.

Let's look at who stands on the other side: 12 million children. The American Medical Association. The American Academy of Pediatrics. The National Rural Health Association. The National Council on Aging. The AARP. The Federation of American Hospitals. The March of Dimes. The Children's Defense Fund. The NAACP. The National Governors Association, including the Governors of New York, Michigan, California, Illinois, and Maryland, and the Catholic Health Association--which notes that ``the most important pro-life thing the Congress can do right now is ensure that the State Children's Health Insurance Program is reauthorized.''

A vote against this bill is a vote to deprive six million children of healthcare. A vote against this bill is a vote to continue the plunder of the Medicare Trust Fund by bloated private interests. A vote against this bill is a vote to deny seniors in Medicare additional benefits.

I urge all of my colleagues to stand up for what's right for children, seniors, people with disabilities, and taxpayers: support the speedy passage of the CHAMP Act.

Mr. Speaker, I yield 2 minutes to the gentleman from Michigan (Mr. Stupak).

Mr. Speaker, my good Republican friends will be discussing process, and we want to discuss kids and the future of the country.

For that purpose, I yield 2 minutes to the distinguished chairman of the subcommittee, my friend, Mr. Pallone of New Jersey.

Mr. Speaker, I yield to the distinguished gentleman from Virginia (Mr. Moran) for purposes of a unanimous consent request.

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

Mr. Speaker, I yield 1 minute to the distinguished gentleman from Texas (Mr. Gene Green).

(Mr. GENE GREEN of Texas asked and was given permission to revise and extend his remarks.)

Mr. Speaker, we reserve the balance of our time.

Mr. Speaker, our problem is a simple one, and I say this with respect and affection to my colleague. Our Republican colleagues have chosen to allocate time with two committees on this side and one committee on that side. The end result is that there is one committee on the Republican side which is not using its time. In order to balance out the time use, Mr. Stark and I are reserving our time at this time.

I reserve the balance of my time.

Mr. Speaker, it would appear at this time that many of the difficulties that confront us could be addressed by the appearance of our good friends on the minority side of the Ways and Means.

Mr. Speaker, I yield to the distinguished gentlewoman from California (Ms. Harman) for purposes of a unanimous consent request.

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

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

Mr. Speaker, I thank the chairman. One minute is scarcely enough time to discuss what we need to discuss today. So I would, just like the chairman of the full committee, put my entire statement into the Record.

Mr. Speaker, I want to confine my comments today to issues that surround issues for physician reimbursement. I had two amendments last night in Rules Committee that were not made in order that would have vastly improved physician reimbursement. Instead, we have language in the Democratic underlying bill that provides a small uptick for the next 2 years, then you fall off the cliff, and then you're frozen for the next 10 years. Hardly measures that will encourage people to go into the practice of medicine in the future.

I also want to reference section 651, the whole hospital exemption. Mr. Speaker, I would just point out that in the Rules Committee it was made in order that several hospitals would actually be grandfathered out or carved out of that exemption, and most of these hospitals lie in Democratic districts. I have a letter from 75 constituents, physicians back in my home State of Texas, who strongly object to the whole hospital exemption in this bill, and I will submit that for the Record as well.

The Democratic party is prepared to take its first step toward cradle to grave government involvement in the lives of all Americans. The 40- plus page SCHIP bill that was unveiled to this committee in the wee hours of last Wednesday represents legislative malpractice. We shouldn't be surprised because we've been here before. A handful of Democratic staff, working behind closed doors, without any input from the real world have produced just what we should expect: a bloated and complicated proposal that grows the size of government, diminishes state fiscal accountability and an individual's personal responsibility, and likely erodes the independent practice of medicine.

I doubt anybody in this body, Republican or Democrat, really understands what is in this proposal. We've not had one legislative hearing on this bill and haven't even taken this bill through regular order in the Energy and Commerce Committee. As a member of the Health Subcommittee of that panel, I'm disappointed in that fact because the subcommittee has shown an ability to come together and work out partisan differences. I haven't spoken with Chairman Pallone, but I imagine he shares that sentiment to some degree.

Just recently, Republicans and Democrats came together to report out a bill that improves drug safety and FDA review of new drugs and devices. We worked through our differences and produced superior legislation. But all that bipartisan comity has been thrown out the window. Any rationalization of how we can vote on this bill and report to our constituents that we conducted an in-depth review of this legislation would be farcical at best, especially when we have learned that the Rules Committee plans to report out a completely different measure in the dark and early hours this coming Wednesday.

Kids need a safety net, but the safety net shouldn't apply to those that can and should help themselves. Taking money from taxpayers to give it to families that have the resources to purchase health insurance for their children is irresponsible. And if affordable options don't exist for these families, well forget it, because this bill doesn't lift a finger to reform an insurance market burdened by regulation and lack of choice.

On immigration, this bill all but ensures that states like mine and other border states will be saddled with more cost as it rewards those that illegally enter our country. The debate on illegal immigration is often ruled by emotion but the provisions in this bill relating to immigrant health care are equally suited--this bill makes little to no effort to understand this dynamic and only serves to pour gasoline on an inferno.

On Medicare, this bill misses the mark widely. This bill would make a bad investment in an attempt to fix Medicare physician payment and in doing so, members will find themselves in the position of spending billions more in the future to fix the problem again.

We shouldn't fool ourselves that this is realistic policy making. For those members about to head home and face their constituents at coffees, lunches, and town halls they should be wary of what Speaker Pelosi is force feeding this body.

Baylor Medical Center at Frisco,

Frisco, TX, August 1, 2007.

Hon. Michael C. Burgess, MD,

U.S. Congressman,

Washington, DC.

Dear Congressman Burgess: We are physicians that practice

at Baylor Medical Center at Frisco. Today, we are writing to

express our deep concern about the language in the S-CHIP

bill (CHAMP Act) once again attempting to prohibit physicians

from owning or investing in any hospital. While this

legislation contains many important and generous provisions,

such as the reauthorization of SCHIP and the SGR fix, Section

651 virtually eliminates physician owned hospitals for no

reason other than the enmity of certain competitors.

Much has been written about the negative effect this

ownership has had on our community hospitals where we also

practice. Many of the large hospital systems claim they are

being harmed by physician-owned specialty hospitals in their

communities. Yet none of them has provided any factual data

to support their claim that they are unable to provide

``essential services'' as a result of specialty hospitals. In

fact each of the last 6 years the American Hospital

Association has reported a 6% increase in profits in their

member hospitals. And many of their arguments (e.g.

``specialty hospitals typically do not provide emergency

care'') simply is not accurate.

The benefits of the physician ownership model are so

convincing that a growing number of not-for-profit healthcare

systems, including some of the largest members of the

American Hospital Association, have embraced the concept of

physician ownership.

MedPAC, CMS, and GAO have all studied this issue. Not one

of them has concluded that physician owned hospitals

represent a threat to the community hospitals where they

exist. To the contrary, some have concluded that the overall

increase in quality of care greatly benefits the communities

in which they exist.

We believe that a major part of our success is due to the

fact that individual physicians are partners in the ownership

in the facility. As any business owner, we take pride in our

facility and have worked hard to make sure the quality of

medical care remains high. And frankly, we are much more

aware of the costs and how to better deliver care more cost

effectively. Through disclosure policies our patients are

aware of the physician ownership and our surveys reveal very

high patient satisfaction.

The best way to manage health care costs is to encourage

physicians to become involved in the development of new

models for the delivery of surgical and other health

services. Maintaining the status quo by giving acute care

hospitals protection from market forces will only lead to

higher health care costs for us all.

When voting, please consider carefully the decision you

will be asked to make regarding physician ownership, it will

not only affect your constituents' rights as a patient to

have the most convenient cost effective care, it will affect

the delivery of health care for generations to come.

Sincere regards,

Benton Ellis, MD; James Gill, MD; David Layden, MD; James

Montgomery, MD; Mark Allen, MD; Dawn Bankston, MD; F.

Alan Barber, MD; Richard Bowman, MD; Dale Burleson, MD;

Cameron Carmody, MD; John Schweers, MD; William Cobb,

MD; Stephen Courtney, MD; A. Joe Cribbins, MD; Bruce

Douthit, MD; Dennis Eisenberg, MD; Berry Fleming, MD;

Richard Guyer, MD; Lloyd Haggard, MD; Stephen Hamn, MD;

Andrea Ku, MD; Briant Herzog, MD; Stephen Hochschuler,

MD; James Hudguns, MD; Fawzia Jaffee, MD; Warrett

Kennard, MD; Adam Kouyoumjian, DO; Jimmy Laferney, MD;

Stephen Lieman, MD; Samuel Lifshitz, MD; Earl Lund, MD;

Gary Mashigian, DPM; Mark McQuaid, MD; William

Mitchell, MD; Dr. Keith Matheny; William Montgomery,

MD; John Moore, MD; Mickey Morgan, MD; William Mulchin,

MD; John Peloza, MD; Ralph Rashbaum, MD; Jon Ricks, MD;

Alfred Rodriguez, MD; Vince Rogenes, MD; David Rogers,

MD; Ivan Rovner, MD; Michael Schwartz, MD; James

Smrekar, MD; Robert Taylor, DPM; Ewen Tseng, MD; Gary

Webb, MD; Stanley Whisenant, MD; Michael Wierschem, MD;

Kathryn White, MD; Kathryn Wood, MD; Iddriss Yusufali,

MD; Roger Skiles, MD; Scott Fitzgerald, MD; Leonard

Bays, MD; Donald Mackenzie, MD; Lloyd Haggard, MD;

David Holder, MD; Joe Hughes, MD; David Perkins; Robert

Purnell, MD; Eddie Pybatt, MD; Elaine Allen, MD; Steven

Michelsen, DO.

amendment to h.r. 3162

This amendment would modify Title III of H.R. 3162 that addresses Medicare physician reimbursement. While H.R. 3162 provides temporary relief to address scheduled Medicare physician payment cuts, it does nothing to address the problem in the long-term, and would in fact exacerbate the problem in the long-term. The amendment does the following:

1. Reset to 2007 the base year for application of the Sustainable Growth Rate (SGR), and eliminates the Sustainable Growth Rate in 2010. The practical effect of this on Medicare physician payment would provide physicians with over a 1 percentage increase in 2008 and

2009, and stable and sustainable growth rate in payment from 2010 and into the future.

2. Makes available incentive payments for increased quality reporting and implementation of health information technology.

3. Provides annual reports to physicians on billing patterns under Medicare.

4. Provides an annual report to Medicare beneficiaries on annual Medicare expenditures.

5. Mandates a study on whether quality reporting requirements on health care disparities.

Amendment to H.R. 3162, as Reported [By The Committee on Ways and

Means] Offered By Mr. Burgess of Texas

(CHAMP amendment)

Strike sections 301, 302, 303, 304, and 307, and insert the

following sections (and redesignate sections 305 and 306

accordingly):

I object.